RESUMO
OBJECTIVES: The application of video-assisted thoracoscopic surgery (VATS) for relatively large mediastinal tumours (≥5.0 cm) has been a subject of debate, and few studies have investigated the subxiphoid approach VATS in different tumour size categories. The study aims to compare the efficacy of the subxiphoid approach VATS for achieving curative outcomes based on tumour size categories (<3.0, 3.0-4.9 and 5.0-10.0 cm). METHODS: A total of 165 patients with anterior mediastinal tumours who underwent surgery at our hospital between January 2018 and July 2022 were consecutively enrolled, categorized according to tumour size-group A (<3.0 cm): 58, group B (3.0-4.9 cm): 70 and group C (5.0-10.0 cm): 37. Clinical baseline data, intraoperative and postoperative outcomes, and postoperative complications were analysed. RESULTS: The study revealed significant differences in operation time among the 3 groups (group A: 103.4 ± 36.1, group B: 106.4 ± 35.2, group C: 127.4 ± 44.8; P < 0.05) as well as in the volume of drainage (group A: 273.3 ± 162.0, group B: 411.9 ± 342.6, group C: 509.7 ± 543.7; P < 0.05). However, no differences were seen in blood loss, drainage duration, postoperative hospital stay and duration of postoperative oral analgesics. Additionally, the incidence of postoperative complications did not exhibit significant differences across these groups. CONCLUSIONS: Subxiphoid approach VATS is considered a feasible and safe surgical method for large-sized anterior mediastinal tumours (5.0-10.0 cm) with no invasion to the surrounding tissues and organs.
RESUMO
OBJECTIVE: To investigate the possible relationship between liver-specific insulin-like growth factor I (IGF-1) and the pathogenesis of breast cancer. METHODS: Fifty non-IGF-1 deficient (LID) mice were randomly divided into 2 equal groups: Group I, fed with dimethyl-benzanthracene (DMBA) for 8 weeks to cause mammary cancer, and Group III, fed with DMBA and ginsenoside Rg for 28 d; and 50 LID mice were randomly divided into 2 equal groups too Group II, fed with DMBA for 8 weeks, and Group IV, fed with DMBA and ginsenoside Rg for 28 d. The mice were killed after the cessation of DMBA use. The serum IGF-1 expression was detected with method Six Gene chips were used to detect the gene expression in the breast cancer tissues. RESULTS: The breast cancer rates were 66.67% in Group I and 33.33% in Group II, 36.00% in Group III, and 12.00% in Group IV. The tumor size was (0.79 +/- 0.20) cm in Group I, (0.37 +/- 0.08) cm in Group III , (0.32 +/- 0.08) cm in Group II, and (0.15 +/- 0.05) cm Group IV. The IGF-1 level of Group II was (41.33 +/- 7.52) ng/ml, 1/4 as high as that of Group I [(166.51 +/- 12.32) ng/ml], and the IGF-1 level of Group IV was (33.48 +/- 6.73) ng/ml, 1/4 as high as that of Group III [(155.84 +/- 11.34) ng/ml]. Compared with those of the control mice, the breast cancers of the LID mice had longer latency, lower incidence, and slower growth rate. The differential gene expression in different serum IGF-1 levels involved binding, metabolism, apoptosis, cell cycle, signal transduction, immune response, transcription regulation and interpretation regulation and so on. Among these genes, Col11, Egln3, Glycam1, Irf6, Lgals7, Perp, Rag1, and Rbm35a genes were closely related to the incidence of breast cancer. CONCLUSION: IGF-1 plays a role as a risk factor in the onset and development of breast cancer by affecting the expression of many differentially expressed genes.
