Objective To investigate the clinicopathological characteristics and factors influencing the prognosis of rectal carcinoid. Methods Clinical data of 31 cases with rectal careinoid, which identified diagnosis through operation and pathologic examination from January 2003 to March 2010 were retrospectively reviewed. Primary tumors were classified by size （≤1.0 cm， 1.0-2.0 cm， and ＞2.0 cm）and muscularis invasion respectively, compared therapeutic effect of different groups. Results Median age of 31 cases was 49 years (22-83 years). Median follow-up time was 36 months (15-86 months), follow-up rate was 80.6% （25 /31）. During the follow-up period, there were no cases with recurrence among the 15 patients with tumor size≤l.0 cm, 1 case recurred in the 7 patients with turmor size between 1.0 cm to 2.0 cm, and 2 cases died from postoperative liver metastasis among the 3 patients with tumor size＞2.0 cm.There were relations between the tumor size, invasion depth, and metastasis （P＜0.05）. Metastasis and invasion depth of tumor were possibility increment to follow the aggrandizement of the diameter of rectal carcinoid. Conclusion The diameter of rectal carcinoid and muscularis invasion may be important factors affecting survival, which may be an important basis for the choice of operative mode.
Objective To investigate the clinical application and complicationof the lyophilized small-segment allogeneic bone used in repairing bone defectscaused by benign bone tumor and tumor-like lesions after resection and curettage. Methods From December 1999 to December 2005, 230 patients (156 males, 74 females; age, 5-56years, averaged 32.8 years), who had bone defects caused by benign bone tumors and tumor-like lesions after surgical resection and curettage, were treated by the lyophilized small-segment allogeneic bones. The cavities left by the tumor curettage ranged in size from 1.0 cm×0.8 cm to 10.0 cm×2.0 cm, andthe bone defects were about 1.0 to 3.5 cm in diameter after the localized resection of the bones. According to the bone defect degrees, the autogenous nonvascular iliac bone and the bone allograft (0.5-30.0 g) were implanted, followed by the drainage for 2-3 days and the use of antibiotics to prevent infection. The postoperative systemic and local reactions were observed, and the regular X-ray examinations were performed to observe the bone union. ResultsThere was no significant difference in the allergic reactions, such as postoperative temperature, drained amount, and body swelling, between this kind of transplantation and the autogenous bonetransplantation. The wounds in 196 patients were healed by the first intension.The wounds in 34 patients had extravasate. Among them, the wound was healed by changing dressing in 30cases; the wound had delayed healing in 4, including 3 whose wounds were healedby changing dressing for 3-4 weeks,and 1 whose wound was healed by taking out the implants. The follow-up for 6-60 months (average, 38 months) revealed that all the patients had the allograft unions of the bones within 6-18 months after the transplantation, and only 6patients had recurrence of the tumor (3.0%). Evaluated by the Mankin,Komender and WANG Zhiqiang’s standards, 196 (85.22%) patients were satisfied with their outcomes while the other 34 (14.78%) patients were not satisfied. Conclusion The lyophilized small-segment allogeneic bone has a good compatibility and osteogenesis, when it is used in repairing bone defects caused by benign bone tumor and tumor-like lesions after resection and curettage. So, this kind of bone is a good, convenient and safe material for the bone transplantation. The important factors affecting the allograft union are as follows: the mechanical stability in the recipient region, local blood supply, and management of the bone cavity left by resection and curettage of the bone tumor.
Objective To understand the development, research status, advantages and disadvantages of patient-derived organoid (PDO) and patient-derived tumor xenograft (PDX), and to summarize their applications in pancreatic cancer, so as to provide new ideas for the selection of early modeling of pancreatic cancer. Method The recent studies on PDO and PDX of pancreatic cancer at home and abroad were reviewed. Results The PDO and PDX models had a wide range of applications in preclinical research of tumor, especially played an important role in the basic research of present pancreatic cancer patients with poor clinical treatment effects, such as the pathogenesis research of pancreatic cancer, developing new targets and new drugs, testing preclinical drug toxicity and effectiveness. Conclusion PDO and PDX, as classical tumor research model, have broad clinical application prospects in the research of pancreatic cancer.
【Abstract】Objective To study the significance of expression of p27 in thyroid follicular tumors. Methods The tumor samples were obtained from 53 thyroid follicular tumors, and 10 normal thyroid tissues were used as a control group. p27 was detected by the immunohistochemical staining S-P method. Results The normal thyroid group had the highest expression of p27.There were significant differences in the expression of p27 between thyroid follicular adenomas (FA) and follicular carcinomas (FTC), FA had much higher expression of p27 than FTC did. There were no significant differences in the p27 staining indexes between minimally and widely invasive FTC nor between metastized and non-metastized FTC. Logistic regression showed that p27 were effective in distinguishing FA from FTC(P=0.0048). Conclusion It appears that p27 may be necessary for the malignant transformation of the thyroid follicular epithelium, which might relate to a decrease in p27. p27 detection may be helpful in distinguishing FA from FTC.
Objective To summarize the advances of total femur replacement in recent years. Methods The literature related to total femur replacement was reviewed, and the indications, techniques, prosthesis design, complications, rehabilitation, and function were summarized. Results The indication of total femur replacement is a wide involvement of the femur, skip lesions and a huge bone defect in revision. Watson-Jone is the main incision in the proximal, and then the full length of the thigh to the patella. Vascular and nerve bundle, abduction muscles are well protected, and combined or costumed prosthesis are replaced. The prosthesis design progresses, showing a diversified prostheses. Complication is frequent and varied. Rehabilitation in early stage is physical therapy, weight training is evolutionary. The main function evaluation system is Musculoskeletal Tumor Society (MSTS) score. Conclusion Total femur replacement is effective in limb salvage. Large sample size and long-term follow-up study should be carried out to unify indications and functional exercise standards and reduce postoperative complications.
Objective To investigate the clinical implication on expression of HLA class I in breast cancer tissures.Methods The expression of HLA class I in 271 patients with breast cancer that underwent radical operation was examinedby using immunohistochemically， and the correlation between the expression of HLA class I and clinicalpathological characteristics and prognosis of breast cancer was analyzed. Results The b positive expression of HLA class I in breast cancer tissures was observed in 92 patients （33.9%）， the expressions of HLA class I in 179 patients （66.1%）were downregulation. The expression of HLA class I expression in breast cancer tissures was significantly associated with the axillary lymph node metastasis， TNM stage （P＜0.05）， other lymph node metastasis， and vascular invasion （P＜0.05）. The disease free survival rate of patients with positive expression of HLA class I was higher than that expression downregulation of HLA class I （P＜0.05）. Conclusion The examination of HLA class I expression is useful for the prediction of tumor progression and recurrent risk of breast cancer via the antitumor immune system.
ObjectiveTo investigate the short-term effectiveness of allogeneic bone transplantation for pelvic reconstruction of large skeletal defects after tumor resection. MethodsBetween January 2008 and November 2009, 9 patients with pelvic tumor were treated, and the clinical data were retrospectively analyzed. There were 1 male and 8 females with an average age of 36.1 years (range, 18-44 years). There were 5 cases of giant cell tumor of bone, 2 cases of chondrosarcoma, 1 case of malignant giant cell tumor of bone, and 1 case of Ewing sarcoma. According to the Enneking system for staging musculoskeletal tumors, the lesion involved ilium (region I) in 4 cases, acetabulum (region II) in 6 cases, pubis and ischium (region III) in 3 cases, and sacrum (region IV) in 1 case. The average disease duration was 6.8 months (range, 1-36 months). After accurate resection of the tumor, allograft ilium with or without acetabulum was used in 6 cases and 2 cases respectively, and allogenous bone plate in 1 case for pelvic reconstruction; total hip arthroplasty was performed in 6 cases; sacrum screw was used in 1 case. ResultsInfection of incision and abdominal distention occurred in 1 case, and was cured after debridement; primary healing of incision was obtained in the other cases, without infection, lower limb deep venous thrombosis, or dislocation. The average follow-up was 11.8 months (range, 8-15 months). The X-ray films showed breakage of plate in 1 case at 8 months after operation and partial bone resorption in 2 cases; good position of the prosthesis, plate, and transplanted bone was observed in the other cases. No local recurrence was found. At last follow-up, the average musculoskeletal tumor score (MSTS) was 23 (range, 18-29). ConclusionAllogeneic bone transplantation for pelvic reconstruction of large skeletal defects after tumor resection can achieve satisfactory short-term surgical and functional effectiveness.
Objective To introduce the experience and comprehensionto reconstruct nasal defect after tumor excision. Methods FromApril 1996 to April 2006, based on the aesthetic subunit principle and according to the size, shape, location of nasal defect and the conditions of surrounding skin, homologous local flap was selected to cover the nasal defect in 428 cases which nasal tumors were removed. Among 428 cases, there were 273 men and 155 women, with a median age of 52 years (12-78 years); including 146 cases of basal cell carcinoma, 83 cases of squamous cell carcinoma, 54 cases of epidermal cyst, and 145 cases of pigmented naevus.The clinical stage of malignant tumor was 0-Ⅰstage, the course of disease was 1 week to 3 months. The locations were nasal tip in 51 cases, nasal ala in 102 cases, dorsum of nose in 138 cases, and nasal side in 137 cases, across 2 nasal subunits in 83 cases. The area of thedefect ranged between 0.6 cm×0.6 cm and 3.0 cm×4.0 cm. The origin of flaps was frontonasal flap in 58 cases, bilobed flap in 67 cases, reforming rhomboid flap in 152 cases, nasolabial flap in 118 cses, forehead falp in 33 cases. The secondary defect of donor site was directly sutured. Results Among 428 cases, 423 cases acquired complete recovery; 3 cases which had epiderm necrosis over the far end of the flap achieved healing by the first intention and 2 cases which had suffered low-grade infection of incision achieved healing by the second intention after regional change dressings.The nasal defect was successfully repaired in all patients,and the all flaps survived. A total of 385 patients were available forfollow-up of 1 to 60 months, no tumor recurrence occurred, and the repaired tissue were good match with surrounding tissue, good nasal contour was obtained, the cosmetic results were satisfactory. Conclusion Based on the nasal aesthetic subunit principle, the local flap can reconstruct the nasal above medial defect, and a good color, contour and texture match with the surrounding skin can be obtained, the cosmetic results are satisfactory.
ObjectiveTo investigate the relationship between vascular endothelial growth factor receptor-3 (VEGFR-3) and clinical pathology of gastric carcinoma(GC).MethodsThe expression of VEGFR-3 in 80 GCs and 20 gastric benign tissues (GBT) was detected by immunohistochemistry(SP), by which the density of lymphatic vessels (DLV) was calculated. ResultsThe DLV in GC was （5.800 0±2.318 9）/×200, in GBT （2.380 0±0.462 9）/×200(P=0.000); in GC with lymph node metastasis （6.948 3±1.583 1）/×200, without lymph node metastasis （2.772 7±0.428 9）/×200 （P=0.000）. In poorly differentiated type group, DLV was （7.681 8±0.982 9）/×200, higher than that in moderately and highly differentiated type group 〔(3.500 0±1.028 2）/×200, P=0.000〕. DLV in pTNM Ⅰ+Ⅱ was （4.291 7±1.688 0）/×200, in Ⅲ+Ⅳ （8.062 5±0.759 4）/×200 （P=0.000）.ConclusionDLV shows positive relations with pTNM stage, differentiation and lymph node metastasis of GC.
Objective To explore the independent risk factors for tumor invasiveness of ground-glass nodules and establish a tumor invasiveness prediction model. Methods A retrospective analysis was performed in 389 patients with ground-glass nodules admitted to the Department of Thoracic Surgery in the First Hospital of Lanzhou University from June 2018 to May 2021 with definite pathological findings, including clinical data, imaging features and tumor markers. A total of 242 patients were included in the study according to inclusion criteria, including 107 males and 135 females, with an average age of 57.98±9.57 years. CT data of included patients were imported into the artificial intelligence system in DICOM format. The artificial intelligence system recognized, automatically calculated and output the characteristics of pulmonary nodules, such as standard diameter, solid component size, volume, average CT value, maximum CT value, minimum CT value, central CT value, and whether there were lobulation, burr sign, pleural depression and blood vessel passing. The patients were divided into two groups: a preinvasive lesions group (atypical adenomatoid hyperplasia/adenocarcinoma in situ) and an invasive lesions group (minimally invasive adenocarcinoma/invasive adenocarcinoma). Univariate and multivariate analyses were used to screen the independent risk factors for tumor invasiveness of ground-glass nodules and then a prediction model was established. The receiver operating characteristic (ROC) curve was drawn, and the critical value was calculated. The sensitivity and specificity were obtained according to the Yorden index. Results Univariate and multivariate analyses showed that central CT value, Cyfra21-1, solid component size, nodular nature and burr of the nodules were independent risk factors for the diagnosis of tumor invasiveness of ground-glass nodules. The optimum critical value of the above indicators between preinvasive lesions and invasive lesions were –309.00 Hu, 3.23 ng/mL, 8.65 mm, respectively. The prediction model formula for tumor invasiveness probability was logit (P)=0.982–(3.369×nodular nature)+(0.921×solid component size)+(0.002×central CT value)+(0.526×Cyfra21-1)–(0.0953×burr). The areas under the curve obtained by plotting the ROC curve using the regression probabilities of regression model was 0.908. The accuracy rate was 91.3%. Conclusion The logistic regression model established in this study can well predict the tumor invasiveness of ground-glass nodules by CT and tumor markers with high predictive value.