高分辨薄层直肠核磁共振新序列（3.0T RESOLVE-DWI）在直肠癌临床分期中的价值评估

目的探讨高分辨薄层直肠MRI新序列（3.0T RESOLVE-DWI）在直肠癌术前临床分期中的准确性。 方法回顾性分析四川大学华西医院75例行术前高分辨薄层直肠MRI新序列扫描的直肠癌根治性切除术的病例,分析MRI影像中肿瘤浸润深度（T）,并测量肿瘤及周围淋巴结（N）的表观弥散系数（ADC）值。以术后病检结果为金标准,分析MRI评估T分期的准确性,ADC值与肿瘤T、N分期及分化程度的相关性。 结果MRI从T1到T4期的诊断准确性在未行新辅助治疗的患者中分别为0%、38.1%、72%、14.3%（κ=0.200）,在行新辅助治疗的患者中分别为50%、33%、75%、0%（κ=0.270）。肿瘤ADC值与T分期（F=0.074,P=0.929;F=0.737,P=0.496）、肿瘤分化程度（F=1.889,P=0.783;F=4.385,P=0.627）在两组均无显著相关性。在未行新辅助治疗的患者中,淋巴结ADC值在术后病理淋巴结阳性组高于淋巴结阴性组（F=0.073,P=0.012）,而在新辅助治疗组差异无统计学意义（F=0.035,P=0.793）。 结论直肠癌高分辨薄层MRI新序列对T3期直肠癌的诊断准确率高,整体准确率较低;新序列ADC值对于直肠癌N分期的评估具有一定价值,还需进一步研究验证。     

前列腺癌相关脑梗死的发病特点

目的 探讨前列腺癌相关脑梗死的发病特点。方法 收集2003年1月-2015年12月在广西医科大学第一附属院住院治疗的前列腺癌合并脑梗死患者的临床表现、实验室及器械检查等资料。结果 本研究共筛查前列腺癌患者2 584例,其中符合前列腺癌合并脑梗死的患者共有34例(1.31%),平均年龄(61.60±6.28)岁。入选的患者中无脑卒中危险因素21例(61.76%)。血液学检查发现D-二聚体水平升高22例(64.71%),总前列腺特异性抗原(Total prostate specific antigen,T-PSA)水平异常升高(>100 ng/mL )19例(55.88%),头颅MRI显示脑内单一梗死灶8例(23.52%),出现累及多个动脉供血区的2个或2个以上梗死灶26例(76.47%),脑梗死发生30 d多数患者预后不良,其中4例(11.77%)死亡。结论 前列腺癌相关脑梗死的患者以缺少常见的脑卒中危险因素、血清D-二聚体水平升高以及T-PSA异常升高、一次发病出现累及多血管分布区的多发性梗死灶以及预后不良等为特点,其发生机制可能与患者血液的凝固性升高有关。     

增生硬化性IgA肾病伴贫血患者的临床病理特征及预后研究

目的　分析增生硬化性IgA肾病（IgAN）伴贫血患者的临床病理特征及预后。方法　选取2012年1月—2016年6月在郑州大学第一附属医院行肾脏穿刺活检诊断为增生硬化性IgAN的患者261例为研究对象。按照贫血的诊断标准,将患者分为贫血组（100例）和非贫血组（161例）。收集患者一般资料、实验室检查结果、肾组织病理检查指标,以肾活检日期为起点,随访至2017-06-01。采用Kaplan-Meier法绘制生存曲线,进行Log-rank检验;采用多因素Cox比例风险模型分析贫血对增生硬化性IgAN患者预后的影响。结果　贫血组患者估算肾小球滤过率（eGFR）、清蛋白、血钙低于非贫血组,尿素、血肌酐、血磷、24 h尿蛋白定量、肾小球总硬化比例、肾小管萎缩/间质纤维化≥25%发生率高于非贫血组（P<0.05）。中位随访时间为11（6,21）个月,两组患者生存曲线比较,贫血组患者肾脏累积生存率低于非贫血组（χ2=30.307,P<0.001）。CKD3期不同贫血程度患者肾脏累积生存率比较,差异有统计学意义（χ2=22.066,P<0.001）。多因素Cox比例风险模型分析显示,贫血〔HR=2.864,95%CI（1.611,5.093）〕、24 h尿蛋白定量〔HR=1.164,95%CI（1.065,1.272）〕、肾小球总硬化比例〔HR=3.858,95%CI（1.120,13.290）〕、肾小管萎缩/间质纤维化〔HR=1.902,95%CI（1.070,3.383）〕是增生硬化性IgAN进展至终末期肾脏病（ESRD）的危险因素（P<0.05）。结论　增生硬化性IgAN伴贫血患者的临床病理表现相对较严重,肾脏累积生存率较低,且贫血是增生硬化性IgAN病情进展的独立危险因素。     

隐源性非硬化性门脉高压症患者临床和肝组织病理学表现

正特发性非硬化性门脉高压症(Idiopathoc noncirrhotic portal hypertension,INCPH)是近来提出的名词,代替门脉性肝硬化、隐源性门脉高压、不完全间隔性硬化或再生性结节性增生(NRH)等,用来描述由于未知原因引起肝窦前性门脉高压,其特征是门脉高压(食管静脉曲张,非恶性腹水,侧枝循环),脾肿大,门静脉和肝静脉通畅,而没有临床和     

Primary isolated intracranial Rosai–Dorfman disease: Report of a rare case and review of the literature

Background

Intracranial involvement is an uncommon manifestation of Rosai–Dorfman disease (RDD) and had been rarely reported. In this study, we explore clinical characteristics, imageology manifestations and pathological features of primary intracranial RDD so as to improve the understanding for this disease.

La 8.ª edición de la clasificación AJCC-TNM: nuevas aportaciones a la estadificación del cáncer de la unión esofagogástrica

The new 8th edition of the TNM classification system for esophageal and cardia or esophagogastric junction cancer provides important innovations in the TNM stages. Two classifications are presented, updated by stages, clinical (cTNM) and pathological (pTNM) methods, together with another pathological classification applicable to cases receiving neoadjuvant treatment (ypTNM). There is a notable increase in complexity compared to previous versions, but it is still early to determine whether the current modifications will result in a clear improvement in the prognostic discrimination of survival among the patient groups (which is their main objective), although the initial expectations are favorable.     

Ghost cell odontogenic carcinoma of the jaws: Report of two cases and a literature review

BACKGROUND Ghost cell odontogenic carcinoma(GCOC) is a rare malignant odontogenic epithelial tumor with features of benign calcifying odontogenic cysts. Herein, we report two new cases of GCOC and systematically review the previous literature.CASE SUMMARY In case 1, a 46-year-old man complained of painless swelling of the right maxilla for 3 years, with a 1-mo history of hemorrhinia in the right nasal cavity. In case 2,a 72-year-old man was referred to our hospital with a chief complaint of painful swelling of the right mandible. Initially, the preliminary diagnoses were ameloblastomas. Thus, the two patients underwent resection of the tumor under general anesthesia. Finally, immunohistochemical examination confirmed the diagnosis of GCOC. The patient in case 1 was followed for 2 years, with no evidence of recurrence. However, the patient in case 2 was lost to follow-up.CONCLUSION GCOC is a rare malignant odontogenic epithelial tumor with high recurrence.Local extensive resection is necessary for the definitive treatment of GCOC.