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1.
胰腺腺鳞癌六例临床分析   总被引:2,自引:1,他引:1  
目的探讨胰腺腺鳞癌的生物学特征及临床治疗方法。方法回顾性分析我院 1995年-2005年间收治的6例胰腺腺鳞癌的临床特点、影像学改变、病理学特征、治疗过程及随访资料并结合文献讨论。结果本组6例胰腺腺鳞癌患者.平均年龄(51.8±10.8)岁。肿瘤位于胰头 4例,胰体尾1例,胰尾1例。行胰头十二指肠切除3例,其中一例因为肿瘤侵犯门静脉行门静脉切除、人造血管重建术。行胰体尾切除、脾切除术1例。1例胰头肿块术中发现肿瘤广泛浸润,行胰腺肿块活检和空肠造瘘术。1例肿瘤已侵犯胃底,行胰体尾、脾脏切除合并部分胃切除。病理检查:瘤体平均5.2 cm×4.1 cm×3.0 cm,肿瘤原发灶和肝转移灶均呈腺癌和鳞癌混杂表现。肿瘤呈浸润生长的特点。4例胰头肿瘤中侵犯十二指肠、胆总管3例,侵犯包绕门静脉1例。肿瘤侵犯神经4例,淋巴结转移3例。随访6例,死亡4例术后生存6-8个月,平均生存6.7个月,均死于肿瘤复发和肝转移。结论胰腺腺鳞癌以腺癌和鳞癌混合为组织学特点,恶性程度高,预后差。  相似文献   

2.
目的:探讨胰腺腺鳞癌诊治经验,以提高对该病的认识和诊治水平。方法:回顾性分析2002年6月—2014年6月期间收治的6例胰腺腺鳞癌患者的临床资料并结合相关文献进行讨论。结果:6例患者中,肿瘤位于胰头部者3例,位于胰体尾部者3例;平均年龄63.3岁;主要症状为腹痛和小便发黄;CA19-9升高5例;CT等影像学检查均提示胰腺占位病变;行胰头十二指肠切除术2例,胰体尾部加脾切除3例;1例术中发现肿瘤侵及胃后壁、十二指肠降部,行姑息性手术治疗;镜下病理检查均可见腺癌和鳞癌成分混杂。术后随访,死亡4例,失访1例,术后生存7~56个月,平均21个月。结论:胰腺腺鳞癌是一种罕见肿瘤,恶性程度高,术前诊断困难,预后差,但手术切除仍是首选治疗手段,通过联合放化疗的综合治疗可能提高疗效。  相似文献   

3.
目的 探讨原发性胃腺鳞癌和胃鳞癌的临床病理特点.方法 回顾性分析12例原发性胃腺鳞癌和胃鳞癌的临床病理资料,对腺鳞癌进行CK17及CK18免疫组化染色.结果 本组原发性胃腺鳞癌和胃鳞癌病例占同期全部外科治疗胃癌病例的0.28%,其中原发性胃腺鳞癌10例,胃鳞癌2例;男10例,女2例;平均年龄65岁.主要临床症状有上腹隐痛或胀痛不适,呕血及黑便.术前胃镜活检确诊率为33%(4/12).肿瘤直径≤5 cm 3例,>5 cm 9例.根治性切除8例,姑息性切除4例.TNM分期Ⅰ期1例,Ⅲ期5例,Ⅳ期6例.本组术后2年内死于肿瘤转移复发10例,其中4例腺鳞癌姑息切除患者存活少于半年,且鳞癌和腺癌所占瘤体成分均在30%以上.术后3年死于其他疾病1例,术后5个月存活1例.结论 原发性胃腺鳞癌和胃鳞癌在临床上少见,具有独特的临床病理特点,腺鳞癌预后较差可能与其兼有腺癌和鳞癌两种恶性生物学行为有关.  相似文献   

4.
目的对比胆囊腺鳞癌患者与胆囊腺癌患者的临床病理特征及分析预后影响因素。方法回顾性分析2018年1月至2022年12月宁波市医疗中心李惠利医院肝胆胰外科接受手术治疗的135例胆囊癌患者临床资料。最终入组122例患者, 其中男性55例, 女性67例, 年龄(68.0±9.8)岁。122例患者依据肿瘤病理类型不同, 分为胆囊腺鳞癌组(n=14)和胆囊腺癌组(n=108)。比较两组患者肿瘤最大径、肿瘤分化程度、肿瘤TNM分期等临床病理特征及预后。采用Kaplan-Meier法计算生存率, 生存率比较采用log-rank检验。进一步采用多因素Cox回归分析术后预后影响因素。结果胆囊腺鳞癌组肿瘤最大径、肝脏侵犯比例、肿瘤低分化比例以及TNM分期Ⅲ~Ⅳ期比例高于胆囊腺癌组, 差异均有统计学意义(均P<0.05)。两组肝切除范围比较, 差异有统计学意义(χ2=9.22, P=0.016)。胆囊腺鳞癌组术后1、2年累积生存率分别为28.6%、9.5%, 低于胆囊腺癌组的78.7%、60.5%, 差异有统计学意义(χ2=27.88, P<0.001)。胆囊腺鳞癌组中接受术后辅助治疗的患者(n=...  相似文献   

5.
目的:探讨前列腺小细胞癌的临床表现、诊断方法、病理特征及治疗方法,以期提高对前列腺小细胞癌的进一步认识。方法:回顾性分析2017年11月至2018年3月收治的2例确诊前列腺小细胞癌的临床及病理资料,并复习相关文献。结果:2例患者均有排尿困难症状,PSA均有升高,前列腺触诊有II°~III°增大,其中1例行前列腺穿刺活检,1例行经尿道前列腺部肿瘤1470激光汽化切除术。术后病理均提示前列腺腺癌伴前列腺小细胞癌,1例患者行EP方案化疗,于确诊20个月后死于全身多器官功能衰竭;1例患者行内分泌治疗,目前带瘤存活。结论:前列腺小细胞癌发病率低,恶性程度高。确诊后平均生存期约7~10个月,目前仍无可靠治疗方案,现基本参照肺小细胞癌的治疗经验,仍以化疗为主,该病预后较差,治疗效果多不满意。  相似文献   

6.
目的:提高对原发性前列腺鳞癌的病因及诊治的认识。方法:回顾性分析1例64岁男性原发性前列腺鳞癌患者临床资料:经病理检查诊断为原发性前列腺鳞癌,行手术治疗后辅以放疗,并复习相关文献,探讨本病的病因、诊治及预后。结果:患者术后随访11个月,仍存活。结论:原发性前列腺鳞癌临床罕见,恶性程度高,肿瘤进展快,预后差;对内分泌治疗无效,早期手术治疗并辅以放化疗效果明显。  相似文献   

7.
目的:总结胆囊原发性腺鳞癌的临床病理特点及诊治经验。方法:回顾性分析1998年―2012年收治的4例胆囊腺鳞癌患者的临床资料。结果:4例患者中,3例行根治性手术,1例行姑息性手术;术后病理结果显示,癌组织中含有腺癌和鳞癌两种成分,CK8/18及CK5/64阳性;4例患者均于术后1年内死亡,中位生存期为180 d,均死于肿瘤复发或转移。结论:胆囊腺鳞癌非常罕见、恶性程度高、临床表现缺乏特异性,发现时分期已较晚;目前尚无有效的治疗方法,手术仍是目前主要的治疗手段,与胆囊腺癌相比总体预后较差。  相似文献   

8.
尽管结肠、直肠肿瘤是西方国家第 2位最常见的恶性肿瘤 ,但绝大多数是腺癌 ,结肠直肠的鳞癌和腺鳞癌很罕见。目前直肠腺癌和肛管鳞癌的治疗已经取得了很大进展 ,但结肠直肠鳞癌和腺鳞癌的临床病理特笥和最恰当的治疗方式仍不明确。本研究目的是阐明这种罕见肿瘤的独特危险因素 (包括人乳头瘤病毒 )、临床病理特征、预后和预后相关因素 ,并讨论辅助治疗的作用。  方法 :回顾分析单中心报告的病例最多的一组 5 2例结肠和齿线 8cm以上的近侧直肠的鳞癌和腺鳞癌 ,其中 44例有足够的组织材料可供研究。单纯性鳞癌 1 1例、混合笥腺鳞癌 3 1例、…  相似文献   

9.
目的探讨男性尿道癌临床特点和诊治措施。方法总结本院2000~2008年诊治的3例男性尿道癌的临床资料,并结合文献讨论。结果男性尿道鳞癌2例,移行细胞癌1例。1例尿道鳞癌行膀胱、前列腺、精囊、阴茎全切和盆腔淋巴结清扫术及回肠膀胱术,术后2年死于心肌梗死。1例尿道鳞癌行膀胱、前列腺、精囊、阴茎全切、耻骨部分切除和盆腔淋巴结清扫术以及回肠膀胱术,存活至今。1例尿道移行细胞癌行姑息性经尿道后尿道肿瘤电切和前列腺部分电切,术后半年患者死于心肺疾病。结论男性尿道癌以手术治疗为主,辅助化疗和放疗,其预后与肿瘤部位、临床分级和病理分级有关。远端尿道癌预后优于球膜部尿道癌。  相似文献   

10.
目的:探讨非浸润性前列腺移行细胞癌(PTCC)的病理以及诊治.方法:结合文献复习,回顾分析6例PTCC的临床资料.6例年龄67~74岁,平均71岁.3例表现为无痛性间歇性血尿和排尿困难,有BPF{史,经系统检查术前诊断为多发性浅表性膀胱癌和BPH,行经尿道膀胱肿瘤电切(TURBT)加经尿道前列腺电切术(TURP);1例尿频尿急血尿,经膀胱镜检查并活检诊断为膀胱原位癌(Tis)G3,行根治性膀胱前列腺切除(Briker术);1例诊断BPH,行TURP;1例有2次膀胱癌手术史.进行性排尿困难,前列腺质硬,诊断为膀胱颈挛缩,行TUR切除膀胱预及前列腺.所有病例术前的临床表现、生化及影像学检查均未提示前列腺肿瘤.结果:3例TURBT加TURP者膀胱病理为移行细胞癌(TCC)P1aG2、P1bG2、P1bG2,前列腺标本中发现前列腺导管内TCC细胞簇未穿透管壁,随访3~5年,其中1例死于脑出血,1例膀胱癌复发再次TURBT;经Briker术者膀胱病理为PisG3,前列腺导管内非侵润性移行细胞癌,随访7年无癌生存;1例TURP后病理发现PTCC,膀胱镜随访,于术后10周发现膀胱多发性TCC G3,拒绝再次手术,1年后死亡;有膀胱癌史者的TUR标本发现TCC已穿透前列腺导管侵犯基质,2月后发现肝脏转移而于术后5月死亡.本组6例PTCC均因术后病理而诊断,占本院同期所有TCC的1.9%.结论:PTCC多与膀胱癌伴发,早期因无特征性临床表现和生化、影象学提示而容易漏诊.病理是目前唯一的诊断途径.危险因素包括:①高级别膀胱TCC;②多发性膀胱TCC;③膀胱Tis.相比前列腺穿刺活检,TUR获取的组织标本阳性率高.根治性膀胱前列腺切除疗效肯定,TURP亦可作为治疗PTCC的有效手段.  相似文献   

11.
Mai KT  Yazdi HM  Farmer J 《The Prostate》2001,47(3):172-182
BACKGROUND: In vitro and experimental studies of mesenchymal-epithelial interaction for the prostatic stroma have demonstrated that the prostatic stroma is capable of inducing the nonprostatic epithelium to acquire many features of prostatic epithelium. We investigated whether this phenomenon could be observed in vivo in human prostatic stroma. MATERIALS AND METHODS Sixty transitional cell carcinoma (TCC) of the urinary bladder: (a) 20 with glandular lumen; (b) 20 without glandular lumen: (c) 10 mixed TCC-adenocarcinoma (ACA); and (d) 10 with synchronous or metachronous TCC of the prostate; and three primary TCC of the prostate were examined and submitted for immunostaining for prostatic acid phosphatase (PAP) and prostatic specific antigen (PSA). RESULTS: There was a spectrum of immunostaining for PSA ranging from negative reactivity in TCC without glandular lumen of the urinary bladder, to focal and weak reactivity in single cells with varying degrees of nonmucinous glandular differentiation and to strong reactivity in groups of cells in primary and synchronous or metachronous TCC in the prostate. The areas of carcinoma geographically closest to the prostate and with the most extensive nonmucinous glandular differentiation displayed the most frequent and strongest immunoreactivity for PSA. The immunoreactivity for PAP was usually stronger than for PSA. Four cases of TCC and mixed TCC-ACA were immunoreactive only for PAP. Furthermore, there was a change in the phenotype of TCC in the urinary bladder as it spread into the prostate. For 10 TCC in the urinary bladder with synchronous or metachronous tumor in the prostate, all TCC in the urinary bladder were negative for PAP and PSA, whereas six TCC in the prostate were focally positive. CONCLUSIONS: The spectrum of immunoreactivity for PAP and PSA and the change in immunoreactivity of TCC of the urinary bladder as it spreads into the prostate are likely induced by the prostatic stroma through the mechanism of mesenchymal-epithelial interaction. Prostate 47:172-182, 2001.  相似文献   

12.
BACKGROUND: Any carcinoma of prostatic origin which is not an acinary adenocarcinoma of the prostate is considered to be an atypical carcinoma. One member of this group of atypical prostatic tumors is the oat-cell carcinoma, or small cell carcinoma (SCC) of the prostate. This variety of carcinoma constitutes the histologic basis of <1% of all prostatic neoplasms. METHODS: Between 1992 and 1997, four patients were diagnosed with SCC of the prostate at our hospital. In 3 of the 4 cases, the histopathological diagnosis was pure SCC, and in the 4th case there was a component of prostatic adenocarcinoma associated with the SCC. At the time of diagnosis, extracapsular extension of the tumor was present in all 4 cases, with T3 or higher stages in all of them (T(3A)N(0)M(1), T(3A)N(0)M(0), T(3B)N(0)M(1), and T(4)N(0)M(0)). Because of the presence of extracapsular extension, radiotherapy and radical surgery were ruled out for all 4 patients. They were all offered systemic chemotherapy with cyclophosphamide (1 g/m(2)), doxorubicin (50 mg/m(2)) and vincristine (1.2 mg/m(2)). This therapeutic protocol was carried out in only 2 cases. RESULTS: Survival was <1 year in the 3 patients with pure SCC, and the patient with a mixed tumor is alive with detectable disease 9 months after diagnosis. CONCLUSIONS: This poor vital prognosis in SCC stresses the need for early diagnosis a timely and appropriate therapeutic intervention in this condition.  相似文献   

13.
BACKGROUND: Histologic sections from an archival collection of a veterinary teaching hospital were examined to determine the likelihood of detection of canine high-grade prostatic intraepithelial neoplasms (HGPIN), as a prelude to use of the canine model of prostatic carcinogenesis for chemopreventive strategies. METHODS: Tissue specimens representing clinically healthy (normal) prostate glands, benign prostatic hyperplasia, and prostatic carcinoma were examined in one tissue plane for histological evidence of HGPIN. RESULTS: No histological evidence of HGPIN was detected in 20 normal prostate glands or 95 prostate glands with benign prostatic hyperplasia. Seven of 20 prostatic carcinomas had synchronous HGPIN. CONCLUSIONS: Histological evidence of HGPIN is unlikely to be detected in the healthy or hyperplastic canine prostate gland with the clinically-procured biopsy. This might diminish the usefulness of canine HGPIN in temporal studies of chemoprevention of prostate cancer. HGPIN was found simultaneously with prostatic carcinoma in more than one-third of the carcinomas examined.  相似文献   

14.
OBJECTIVE: To elucidate the incidence of inducible nitric oxide synthase (iNOS) expression in benign prostatic hyperplasia (BPH), low- and high-grade prostatic intraepithelial neoplasia (PIN) and prostatic carcinoma lesions, and to explore the role of iNOS in prostate tumorigenesis. MATERIALS AND METHODS: Immunoreactivity for iNOS was examined in 20 samples each of BPH, high-grade PIN, low-grade PIN and prostatic carcinoma. RESULTS: Positive iNOS immunostaining was detected in all samples from all patients; iNOS was detected in both basal epithelial cells and secretory cells of the glandular epithelium. High-grade PIN and prostatic carcinoma samples had more intense iNOS immunostaining than low-grade PIN and BPH samples. In all samples, smooth muscle cells showed weak or moderate iNOS immunoreactivity and endothelial cells showed moderate immunostaining. CONCLUSIONS: Nitric oxide generated by iNOS may be involved in prostate tumorigenesis and further studies with immunohistochemical and molecular biology are needed to determine the exact role of iNOS in the pathogenesis of prostatic carcinoma.  相似文献   

15.
BACKGROUND: Transitional cell carcinoma of the prostate in patients with bladder cancer appears to influence the prognosis and affects the decision about therapeutic modality. Therefore, it is important to characterize transitional cell carcinoma associated with bladder cancer. METHODS: From April 1980 to December 1998, 81 male patients underwent total cystoprostatectomies for transitional cell carcinoma of the bladder. The 81 cystoprostatectomy specimens were examined to clarify the characteristics of prostatic involvement by transitional cell carcinoma. The extent, origin, mode of spread and risk factor of prostatic involvement as well as the prognosis were investigated. In 13 of 15 patients with prostatic involvement the prostate was examined by sequential step sections. RESULTS: Prostatic involvement was observed in 15 of 81 patients (18.5%). Prostatic urethral involvement, invasion to prostatic duct/acinus, prostatic stromal invasion and extraprostatic extension and/or seminal vesicle involvement were recognized in 12 (80%), 14 (93.3%), six (40%), and five (33.3%) of the 15 patients, respectively. Twelve of the 15 patients (80%) with prostatic involvement had papillary or non-papillary tumors (i.e. carcinoma in situ) both in the prostatic urethra and prostatic duct. In 10 of these 12 patients (88.3%), there was contiguity between prostatic urethral and ductal tumors. Seven of the 23 patients (30.4%) with carcinoma in situ of the bladder showed prostatic involvement, which increased to 50% in the presence of carcinoma in situ of the trigone or bladder neck. CONCLUSIONS: Eighty per cent of the patients with prostatic involvement showed papillary or non-papillary tumors both in the prostatic urethra and prostatic duct. There was a high level of contiguity between both tumors. Patients with carcinoma in situ of the trigone or bladder neck revealed significantly higher incidence of prostatic involvement.  相似文献   

16.
Specimens from 84 radical cystectomies for bladder carcinoma performed between January 1984 and July 1986 were reviewed to characterize the involvement of the prostate with transitional cell carcinoma. Whole-mount sectioning of the prostate was performed at 4 mm. intervals and processed in the same manner as radical prostatectomy specimens. A total of 36 patients (43 per cent) had transitional cell carcinoma of the prostate: 94 per cent of these had prostatic urethra involvement and 6 per cent had a normal prostatic urethra but transitional cell carcinoma was present in the periurethral structures. In situ prostatic duct or acini, ejaculatory duct and seminal vesicle involvement occurred, respectively, in 67, 8 and 17 per cent of the patients with prostatic involvement. Of the patients with prostatic involvement 39 per cent had stromal invasion (22 per cent focal and 17 per cent diffuse invasion). The incidence of carcinoma in situ of the bladder neck or trigone (59 per cent), previous intravesical chemotherapy (59 per cent) and ureteral carcinoma (79 per cent) was significantly increased in patients with prostatic involvement. In patients with carcinoma in situ of the trigone or bladder neck, or in whom previous intravesical chemotherapy treatments have failed prostatic involvement should be suspected so that this disease can be detected before stromal invasion occurs.  相似文献   

17.
OBJECTIVES: To prospectively evaluate the incidence of transitional cell carcinoma (TCC) in the prostatic urethra and prostate in the cystoprostatectomy specimen, investigate characteristics of bladder tumours in relation to the risk of involvement of the prostatic urethra and prostate and examine the sensitivity of preoperative loop biopsies from the prostatic urethra. MATERIAL AND METHODS: Preoperatively, patients were investigated with cold cup biopsies from the bladder and transurethral loop biopsies from the bladder neck to the verumontanum. The prostate and bladder neck were submitted to sagittal whole-mount pathological analysis. RESULTS: The incidence of TCC in the prostatic urethra and prostate in the cystoprostatectomy specimen was 29% (50/175 patients). Age, previous bacillus Calmette-Guérin treatment, carcinoma in situ (Cis) in the cold cup mapping biopsies and tumour grade were not associated with the risk of TCC in the prostatic urethra/prostate. Cis, multifocal Cis (> or = 2 locations) and tumour location in the trigone were significantly more common in cystectomy specimens with TCC in the prostatic urethra and prostate: 21/50 (42%) vs 32/125 (26%), p=0.045; 20/50 (40%) vs 27/125 (22%), p=0.023; and 20/50 (40%) vs 26/125 (21%), p=0.01, respectively. Preoperative resectional biopsies from the prostatic urethra in the 154 patients analysed identified 31/47 (66%) of patients with TCC in the prostatic urethra/prostate, with a specificity of 89%. The detection of stromal-invasive and non-stromal involvement was similar: 66% and 65%, respectively. CONCLUSIONS: The incidence of TCC in the prostatic urethra and prostate was 29% (50/175) in the cystoprostatectomy specimen. Preoperative biopsies from the prostatic urethra identified 66% of patients with such tumour growth. Our findings suggest that preoperative cold cup mapping biopsies of the bladder for detection of Cis add little extra information with regard to the risk of TCC in the prostatic urethra and prostate.  相似文献   

18.
PURPOSE: Because TRAIL (tumor necrosis factor related apoptosis inducing ligand) selectively kills cancer cells without damaging normal cells, a gene therapy approach using TRAIL is feasible for treating patients with cancer. However, recent publications suggest that significant portions of human tumors appear to be TRAIL resistant. Furthermore, there is some controversy about whether TRAIL receptor composition influences TRAIL sensitivity in cancer cells. Our recent studies suggest that TRAIL receptor composition is the major modulator of TRAIL sensitivity, as demonstrated using prostate, breast and lung cancer cells. We investigated TRAIL and TRAIL receptor expression profiles during prostate carcinogenesis to evaluate their potential as biomarkers and predict the feasibility of a related gene therapy approach. MATERIALS AND METHODS: Paraffin embedded prostate tissues of 44 patients with benign prostatic hyperplasia, 28 with organ confined prostate carcinoma and 26 with advanced prostate carcinoma were analyzed using immunohistochemical staining procedures. RESULTS: Significant levels of TRAIL-R4 decoy receptor expression were detected in patients with benign prostatic hyperplasia, and organ confined and advanced prostate carcinoma. All TRAIL markers tested appear to be valuable markers for separating patients with benign prostatic hyperplasia from patients with organ confined prostate carcinoma or advanced prostate carcinoma. CONCLUSIONS: Due to high TRAIL-R4 expression in all patient groups complementary gene therapy modalities might be needed to bypass potential TRAIL-R4 induced resistance.  相似文献   

19.
Objective: To analysis the chromosome 8 heterozygosity loss in human prostate carcinoma and high grade prostatic intraepithelial neoplasia. Methods: Pure DNA was obtained from prostate neoplasms and normal tissues by tissue microdissection. The chromosome 8 heterozygosity loss was detected by PCR based micro-satellite polymorphism analysis technique using 14 pairs of microsatellite primers in 10 samples of prostate carcinoma and 10 samples of high grade prostatic intraepithelial neoplasia. Results: There were different frequencies of chromosome 8 heterozygosity loss in 10 samples of prostate carcinoma. 8p23.1-p23.2 and p21-p22 were two high frequency heterozygosity loss regions. Chromosome 8 heterozygosity loss was detected in 3 samples of high grade prostatic intraepithelial neoplasia. Conclusion: There were high frequency heterozygosity loss regions on chromosome 8 of prostate carcinoma, located at 8p23.1-p23.2 and p21-p22. The high grade prostatic intraepithelial neoplasia and prostate carcinoma share  相似文献   

20.
Carcinoma of prostatic ducts is a rare clinical feature. We have reviewed 398 histories of patients with histologic diagnosis of prostatic carcinoma and found 10 patients with the ductal variety (2.51%). Four had pure ductal transitional cell carcinoma, 5 had mixed acinar adenocarcinoma plus ductal transitional cell carcinoma, and the last one had mixed acinar and ductal adenocarcinoma. Age, symptoms, physical findings, and imaging diagnoses were similar to those of acinar carcinoma. Rectal examination disclosed hard prostate in 9 patients. The metastatic way depended on the histologic elements present in each patient. Cystoscopy showed a malignant-resembling image in 4 cases. The mean survival (23 months) was lower than that of patients with acinar carcinoma. Early diagnosis and radical surgery still are the only way to increase the expectation of life of patients affected by this pathology.  相似文献   

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