Objective To evaluate the diagnostic value of vascular endothelial growth factor (VEGF)-D detection for the diagnosis of lymphangioleiomyomatosis (LAM) by Meta-analysis. Methods Literatures published before August 2017 were retrieved from PubMed, Embase, China Biology Medicine database, China National Knowledge Internet, Wangfang, and VIP database to retrieve the study about VEGF-D detection for LAM. The studies were screened according to the inclusive and exclusive criteria, the data were extracted, the quality was assessed and the Meta-analysis was performed with related statistical software. Results Six primary studies were included and 521 patients met the inclusion criterion. The Meta-analysis showed the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of 0.75 [95% confidence interval (CI) (0.70, 0.79)], 0.95 [95%CI (0.91, 0.98)], 16.20 [95%CI (8.70, 30.19)], 0.20 [95%CI (0.10, 0.40)] and 89.49 [95%CI (38.46, 208.22)], respectively. The area under the curve was 0.953 9. Conclusions VEGF-D detection showes a good diagnostic value for LAM. A positive result is more clinical meaningful compared with a negative result, helping for the confirmation of the disease.
Abstract: Objective To explore the outcomes of videoassistedthoracoscopic surgery (VATS) in the treatment of esophageal leiomyoma. Me thods [WTBZ] We reviewed and analyzed the clinical data of 87 patients with esophageal leiomyoma treated with VATS in Changhai Hospital of Second Military Medical University between June 2002 and January 2009. [WTHZ]Results [WTBZ]Videoassisted thoracoscopic leiomyoma enucleations was performed in 80 patients, whilea conversion to minithoracotomy was required in 7 others. All procedures werecompleted smoothly and the postoperative recovery was uneventful, without mortality or severe complications. The patients were drinking liquids from postoperative day 1 and were eating a normal diet from day 3. All patients were pathologically diagnosed with leiomyoma after operation. Followups of 6 months to 6.5 years (mean: 3.8 years) found no recurrence. [WTHZ] Conclusion [WTBZ]Videoassisted thoracoscopic enucleation can be the first choice for esophageal leiomyomas derived from lamina propria. Patients with esophageal leiomyomas of diameter gt;1.0 cm should be treated with VATS .
Pulmonary lymphangioleiomyomatosis (PLAM) is a rare chronic multi-system neoplastic disease that occurs in women of childbearing age. It lacks specific clinical manifestations and requires reliable biomarkers to achieve precise management. In recent years, with the emergence of emerging biomarkers, the detection rate of PLAM has been significantly improved, which can better monitor disease progression and provide timely feedback on the efficacy. These emerging biomarkers mainly include vascular endothelial growth factor-D, vitamin D-binding protein, CT score and prostaglandins. This article will focus on the current research results, and summarize the research progress of emerging biomarkers in PLAM diagnosis, prognosis evaluation, and disease monitoring, aiming to provide new ideas for the research and treatment of PLAM.
【摘要】 目的 探讨子宫颈巨大平滑肌瘤在其诊断及治疗上的特殊性。 方法 对2007年10月-2010年3月收治的11例子宫颈巨大平滑肌瘤患者的临床资料进行分析，对其发病率，诊断和手术治疗进行评价。 结果 11例子宫颈巨大平滑肌瘤中黏膜下2例，腹膜后9例。术前9例出现误诊，其中误诊为盆腔包块5例，子宫体肌瘤3例，子宫肉瘤1例。6例行经腹子宫全切加双附件切除，2例行经腹子宫切除术，1例行经腹肌瘤挖除术，1例行经阴道肌瘤摘除术，1例行经腹肌瘤挖出加宫颈残端切除术。 结论 子宫颈巨大平滑肌瘤由于其位置的特殊性，尤其是凸向腹膜后的肌瘤，由于盆腔器官被挤压，使盆腔解剖结构发生改变，术前易被误诊。且手术过程中易出现损伤及出血，因此术前估计充分，术中仔细认清各器官解剖关系，可有效地减少术中损伤和控制出血。【Abstract】 Objective To investigate the particularity of diagnosis and treatment for giant uterine cervical leiomyoma. Methods We analyzed the clinical data of 11 patients with giant uterine cervical leiomyoma who were admitted in our hospital from October 2007 to March 2010. The incidence, diagnosis and surgical treatment of the disease were evaluated. Results Of the 11 cases, nine were retroperitoneal leiomyoma and two were submucous leiomyoma. There were nine misdiagnosed cases before operation, including five diagnosed as pelvic mass, one as uterine sarcoma and three as uterine corpus leiomyoma. Six patients underwent abdominal hysterectomy and bilateral salpingo-oophorectomy; two underwent abdominal hysterectomy; one underwent abdominal myomectomy; one underwent transvaginal myomectomy; and one underwent abdominal myomectomy with excision of cervical stump. Conclusion The giant uterine cervical leiomyoma is easily misdiagnosed preoperatively due to its special anatomic site. A good example is the retroperitoneal leiomyoma in which the pelvic anatomic structure is changed because of the extrusion of the tumor on other pelvic organs. Furthermore, injuries and bleeding often happen during the operation. Consequently, sufficient preoperative assessment and clearly identifying regional anatomical relations can effectively reduce the damage and bleeding during the operation.