Correlation of prothrombin time with clinicopathological features and prognosis of patients with osteosarcoma北大核心CSCD

Objective: To investigate the correlation of prothrombin time (PT) with clinicopathological features and prognosis of the patients with osteosarcoma. Methods: The activated partial thromboplastin time (APTT), PT, fibrinogen (FIB) and D-dimer in peripheral blood of 111 patients with osteosarcoma and 35 concurrent healthy volunteers (as the control) from May 2011 to May 2018 were tested. The correlation of PT with clinicopathological features and prognosis of the patients with osteosarcoma was analyzed. Results: The median survival time of 111 patients with osteosarcoma was 25 months, and the one-and two-year survival rates were 76.6% and 51.4%, respectively. The levels of D-dimer and FIB in the patients with osteosarcoma were higher than those in the control group (both P < 0.01), and the PT was shorter than that in the control group (P < 0.01), while the APTT was not statistical different between these two groups (P > 0.05). The PT was longer in the patients with osteosarcoma younger than 20 years old (P = 0.002), while PT had no correlation with gender, tumor size, clinical stage, tumor location and metastatic status (all P> 0.05). The overall survival time of the patients with osteosarcoma in PT ≥ 10.4 s group was shorter than that in PT < 10.4 s group (P = 0.024), the progression-free survival time of the patients with osteosarcoma had no significant difference between these two groups (P= 0.594). The overall survival time and progression-free survival time of the patients with osteosarcoma in metastasis group were shorter than those in non-metastasis group (both P< 0.001). The overall survival time (P= 0.004) and progression-free survival time (P= 0.013) of the patients with osteosarcoma in stage I / II group were longer than those in stage EI/IV group. The clinical stage, PT and metastasis status were related with the prognosis of patients with osteosarcoma (all P< 0.05). The PT and metastasis status were independent predictive factors for the prognosis of patients with osteosarcoma (both P < 0.05). Conclusion: The changes of PT may provide a reference for monitoring the condition and prognosis of patients with osteosarcoma. © 2019 by TUMOR. All rights reserved.     

鼻咽癌组织中EGFR和nm23基因表达与预后关系研究

Objective To evaluate the prognostic value of the expression of epidermal growth factor receptor (EGFR) and nm23 in patients with nasopharyngeal carcinoma (NPC). Methods From 2003 to 2006, 127 NPC patients who had undergone biopsy before radiotherapy were reviewed retrospectively. All patients received intensity-modulated radiotherapy using 6 MV X-rays combined with platinum-based chemotherapy. Immunohistochemistry SP method was adopted to detect the expression of EGFR and nm23 in NPC biopsy specimens . The relationship between the expression of EGFR and nm23 and survival was analyzed. Results The positive rate of EGFR and nm23 were 80.3% and 47. 2% respectively. The nm23expression was correlated with distant metastasis (χ2=7.03, P = 0. 008 ). The 5-year estimated local control, over-all survival (OS) and disease-free survival (DFS) were 58.3% ,53.5% and 46. 5%. Patients with negative expression of EGFR had a significantly better 5-year OS, DFS (χ2=8.23, P=0.004;χ2=5.25,P=0.022) than those with positive expression. Patients with positive expression of nm23 had a significantly higher 5-year OS (χ2=15.68, P = 0. 000) and DFS (χ2=14. 85, P = 0. 000) than those with negative expression. The clinical stage, EGFR and nm23 expression were independent prognostic factors shown by Cox proportional hazard model (χ2=23.03, 18.33, 39.92, P= 0.000, 0.000, 0.000).Conclusions The EFGR and nm23 expression were correlated with the prognosis in NPC patients.     

Prognostic role of lymph node metastasis in early gastric cancer

Objective： To clarify the relationship between clinicopathological features and lymph node metastasis and to propose the potential indications of lymph node metastasis for prognosis in early gaswic cancer （EGC） patients. Methods： We retrospectively observed 226 EGC patients with lymph node resection, and analyzed the associations between lymph node metastasis and clinicopathological parameters using the chi-square test in univariate analysis and logistic regression analysis in multivariate analysis. Overall survival analysis was determined using the Kaplan-Meier and log-rank test. We conducted multivariate prognosis analysis using the Cox proportional hazards model. Results： Of all the EGC patients, 7.5% （17/226） were histologically shown to have lymph node metastasis. The differentiation, lymphovascular invasion and depth of invasion were independent risk factors for lymph node metastasis in EGC. The 5- and 10-year survival rates were significantly lower in patients with lymph node metastasis than in those without and the patients also had shorter progress-free survival time. Lymph node metastasis and tumor size were independent prognostic factors for EGC. The status of the lymph nodes was a significant factor in predicting recurrence or metastasis after surgery. Conclusions： The undifferentiated carcinoma and lymphovascular and/or submucosal invasion were associated with a higher incidence of lymph node metastasis in EGC patients, whom need to perform subsequent D2 lymphadenectomy or laparoscopic lymph node dissection and more rigorous follow-up or additional chemotherapy/radiation after D2 gastrectomy for poor prognosis and high recurrence/metastasis rate.     

Meta-analysis:prognostic value of survivin in patients with pancreatic cancer

Objective： The aim of the study was to conduct a systematic review of the literature evaluating survivin expres- sion in pancreatic carcinoma as a prognostic indicator. Methods： The relevant literatures were searched using PubMed, EMBASE, and Chinese Biomedicine Databases. A meta-analysis of the association between survivin expression and overall survival in patients with pancreatic cancer was performed. Studies were pooled and summary hazard ratios （HRs） were calculated. Subgroup analysis according to the location of survivin expression was also performed. Results： Seven eligible studies with a total of 448 patients were included in this study. Combined HR suggested that survivin expression had an unfavorable impact on survival of pancreatic cancer patients （HR = 1.65, 95% CI： 1.02-2.68）. When stratified according to the location of survivin expression, the combined HR showed that expression in the cytoplasm was significantly associated with poor prog- nosis of pancreatic cancer patients （HR = 2.09, 95% CI： 1.29-3.40）. In contrast, survivin expression in the nucleus was not significantly associated with poor prognosis （HR = 0.83, 95% CI： 0.24-2.81）, and the heterogeneity was highly significant （I2 = 87.2%, P = 0.005）. Conclusien： Survivin expression was associated with a poor prognosis in patients with pancreatic cancer. Cytoplasmic expression of survivin may be a prognostic factor for pancreatic cancer patients. Based on the current obtained data, there was no evidence that survivin expression in the nucleus had a significant impact on patients＇ overall survival.     

复发卵巢上皮性癌的治疗与预后分析

Objective To discuss the prognostic factors of recurrent ovarian epithelial carcinoma and to analyze the curative effect of post-relapse treatment.Methods The clinical records of 293 patients with ovarian epithelial carcinoma were reviewed retrospectively.There were 199 recurrent cases during the following up.Results All the 199 patients received chemotherapy.And 173 patients only received chemotherapy.16 patients received surgery and chemotherapy and the other 10 patients received radiotherapy and chemotherapy.158 patients received platinum-based chemotherapy again and 41 patients received chemotherapy without platinum.The response rate of all the patients was 43.7%(87/199),the response rate of only chemotherapy was 39.9%(69/173),the response rate of surgery and chemotherapy was 75.0%(12/16),and the response rate of radiotherapy and chemotherapy was 60.0%(6/10).The patients were divided into four groups according to the progression free interval(PFI).The response rates in groups that PFI ≤6 months,7-12 months,13-24 months and ＞24 months were 5.1%,47.2%,82.1% and 96.0%,respectively.The median survival time in the 16 patients received second cyto-reductive surgery was 41 months.Multivariate analysis revealed that PFI was significantly correlated with prognosis of recurrent ovarian epithelial carcinoma(OR =0.589,P =0.021).Conclusion PFI is an individual prognostic factor for survival of recurrent ovarian epithelial carcinoma.PFI is significantly associated with the response rate of chemotherapy.Optimal secondary cytoreductive surgery may improve the overall survival of recurrent patients.The response rate of paclitaxel plus platinum chemotherapy in platinum-sensitive patients is higher than that of other platinum-based chemotherapy.     

Influence of the Number of Lymph Nodes Examined on the Prognosis of Patients with Dukes'''' B and C Colorectal Carcinoma

OBJECTIVE To analyze the influence of the number of lymph nodes examined on the prognosis of Dukes' B and C colorectal cancer patients.METHODS The relationship between the clinicopathologic features of 373 patients with Dukes' B and C colorectal cancer and number of the lymph nodes examined was retrospectively analyzed.The effect of the different number of nodes examined on the prognosis of the patients was appraised RESULTS The overall mean number of retrieved lymph nodes of the 373 patients with Dukes' B and C colorectal cancer was 13.71±9.38.The site and size of the tumor as well as the depth of tumor infiltration were the major reasons which influenced the number of lymph nodes retrieved.The mean number of lymph nodes examined in the colon-cancer patients was 17.51± 12.79,which was significantly more than the 11.09±6.17(P = 0.000)exam-ined in the rectal-cancer patients.The 5-year survival rate of the patients with Dukes' B large intestinal carcinoma,with fewer lymph nodes retrieved(0 to 10),was only 60.4%,while those with more lymph node retrieved(≥10)had a 5-year survival of 77.5%.So there was a significant difference between the two groups.However the number of lymph nodes examined had no effect on prognosis of the patients with Dukes' C large intestinal carcinoma.Separate analysis of the colon and rectal cancers indicated that to improve the 5-year survival rate,the number of retrieved nodes in cases with rectal cancer should be at least 9,and with colon cancer cases at least 13.CONCLUSION In order to guarantee an accuracy of tumor staging for developing a possible postoperative treatment,at least 9 lymph nodes in rec-tal cancer patients or 13 in colon cancer patients should be harvested.     

凋亡抑制蛋白Survivin和血管内皮生长因子高表达是喉鳞状细胞癌生存预后的独立预测因子

Objective: To study the relationship between Survivin and VEGF proteins in a subgroup of patients with squa-mous carcinoma of larynx. Methods: 108 cases of squamous carcinoma of larynx with clinical data were collected and expressions of Survivin and VEGF in peripheral blood were investigated by enzyme-linked immunosorbent assay (ELISA). Results: Expressions of Survivin and VEGF were significantly associated with T stage, N stage and metastasis of squamous carcinoma of larynx. The patients with Survivin or VEGF over-expressions presented lower survival rate, respectively, as compared to those of low-expression (P < 0.05). The survival rate in squamous carcinoma of larynx patients with Survivin and VEGF dual over-expressions was significantly lower than that of patients with dual low-expression (P < 0.05). Multivariate analysis indicated that both Survivin and VEGF over-expressions in squamous carcinoma of larynx peripheral blood samples were strong independent factors of poor prognosis in squamous carcinoma of larynx patients. Conclusion: Survivin and VEGF over-expressions are independent prognostic factors for the patients with squamous carcinoma of larynx. These results also suggest that peripheral blood Survivin and VEGF expressions are valuable prognostic markers for prognosis prediction in squamous carcinoma of larynx patients.     

Male Breast Cancer: 10-Year Experience at Mansoura University Hospital in Egypt

Objective Male breast cancer(MBC) is a rare disease representing less than 1%of all malignancies.The objective of the study is to report clinicopathological characteristics,treatment patterns,and outcomes of MBC in Mansoura University Hospital,Egypt. Methods This retrospective study focused on male breast cancer patients during 10 years(2000-2009).The studied variables were data regarding general characteristics of patients,treatment modalities and survival. Results The series included 37 patients(0.8%of all breast cancer).The median age was 57.7 years(range:26-86 years).The main clinical complaint was a mass beneath the areola in 94.5%of the cases.Most patients had a locally advanced disease.94.5%of tumors were invasive duct carcinomas.The treatment was essentially surgery in 91.8%,followed by adjuvant radiotherapy(in 89.2%), hormonal therapy(in 56.7%) and chemotherapy(in 91.8%).Follow-up period ranged from 6-115 months.Local recurrence occurred in 4 cases and metastasis in 11 cases.The 2-year and 5-year overall survival(OS) rates were 81.6%and 60.5%,respectively.The 2-year and 5-year disease-free survival(DFS) rates were 68.4%,and 52.6%,respectively.OS was not significantly affected by any of the studied parameters.Factors influencing DFS were:T stage(P=0.05),positive lymph nodes(P=0.043),metastasis(P=0.004),and chemotherapy (P=0.046). Conclusions MBC is a rare disease and often diagnosed at a locally advanced stage.The management of male and female breast carcinoma is identical.Future research for better understanding of this disease is needed to improve the management and prognosis of male breast cancer patients.     

腋淋巴结阴性乳腺癌血管生成与预后相关性研究

】 ObjectiveTo determine the relation of microvessel density (MVD) and the expression of vascular endothelial growth factor (VEGF) with the prognosis of axillary-node-negative breast carcinoma (ANNBC) for searching for new prognostic factors. MethodsEighty specimens resected from patients with ANNBC were investigated by staining with a monoclonal antibody against FVⅢ-RA and polyclonal antibody against VEGF. Correlations between the expression of VEGF,MVD and several of clinicopathologic factors were studied. ResultsThe mean of MVD was 35.99± 20.27 in all patients.The positive rate of VEGF was 36.25％ . Both of them were not correlated with the clinicopathological factors. MVD was significantly higher in VEGF-positive tumors or relapsed or metastatic group than in VEGF-negative tumors or disease-free survival group. Moreover, patients with higher MVD or VEGF positive tumors had lower disease-free survival (DFS) or overall survival (OS) than those with lower MVD or VEGF-negative tumors. When those (45 cases) without adjuvant therapies after surgery were analyzed, the results were the same.But OS of them (35 cases) with adjuvant therapies had no significiant difference between high and low MVD group,and between VEGF positive and negative group. DFS was the same among VEGF positive and negative group. Multivariate analysis indicated that MVD,the expression of VEGF and tumor size were independent prognostic factors in patients with ANNBC. ConclusionsMVD,the expression of VEGF may be good prognostic indicators for patients with ANNBC and adjuvant therapies after surgery or antiangiogenic therapy may be useful to improve the prognosis of patients with high MVD or VEGF-positive tumors.     

Impact of serum vascular endothelial growth factor on prognosis in patients with unresectable hepatocellular carcinoma after transarterial chemoembolization

Objective:To investigate the expression level of serum vascular endothelial growth factor(VEGF) in patients with unresectable hepatocellular carcinoma(HCC) and its relationship with the clinicopathological characteristics,and to assess the impact of serum VEGF as a predictive factor for HCC prognosis during transarterial chemoembolization(TACE) treatments.Methods:Serum VEGF levels were measured using enzyme-linked immunosorbent assay(ELISA) in 60 random patients who underwent TACE or transarterial infusion(TAI) for unresectable HCC between May and September 2008 and 12 healthy volunteers were also involved in this study to serve as control.All patients’ clinicopathological features were retrospectively analyzed.Serum VEGF levels were correlated with clinicopathological features of the HCC patients.The patients’ survival rates were analyzed with Kaplan-Meier survival curves and compared by the log-rank test.The prognostic significance of serum VEGF levels and factors related to survival rate were evaluated by univariate and multivariate analysis.Results:The median serum VEGF level in the HCC patients was 285 pg/ml(range 14 1,207 pg/ml),significantly higher than that of healthy controls(P=0.021).The serum VEGF levels were significantly correlated with platelet counts(r=0.396,P=0.002) but not other clinicopathological features.Patients with serum VEGF level >285 pg/ml had worse overall survival compared with those with serum VEGF level <285 pg/ml(P=0.002).By multivariate analysis,the serum VEGF level was a significant prognostic factor.Conclusion: High serum VEGF levels may predict poor prognosis of HCC after TACE. This study highlights the importance of tumor biomarker as a prognostic predictor in TACE therapy for HCC, which has an intrinsic problem of unavailability of histopathological prognostic features.     

Prognostic Factors for Patients with FIGO Stage-IB Cervical Squamous Cell Carcinoma：Does the Tumor Size（≤4 cm or〉4 cm）Really Matter？

OBJECTIVE To investigate the factors that can accurately predict the prognosis for patients with FIGO stage-IB cervical squamous cell carcinoma treated with radical surgery. METHODS A retrospective analysis of clinical data from 174 cases of FIGO Stage-IB cervical squamous cell carcinoma treated in our institute was conducted. RESULTS The 5-year overal disease-free survival of the patients was 79.4%and the recurrence rate was 16.7%.Seventy-five percent of the 60 patients with a tumor>4 cm and 28.1%of the 114 patients with a tumor≤4 cm received preoperative radiotherapy,resuting in a significant difference be- tween the two groups(P<0.001).The 5-year disease-free survival rate for the groups with a tumor≤4 cm without and with preoperative radiotherapy, and with a tumor>4 cm without and with preoperative radiation therapy were 80.5%,85.2%,69.3%and 77.1%,respectively.There was no significant dif- ference between any of the groups(P>0.05).A univariate analysis showed that pelvic node metastasis,a positive parametrial surgical margin and post- operative adjuvant therapy were al significantly correlated with the 5-year disease-free survivals(P<0.05).Multivariate analysis revealed that pelvic node metastasis(P=0.004)and a positive parametrial surgical margin(P= 0.040)were independent factors that influenced the prognosis.The 5-year disease-free survivals for the cases with a tumor≤4 cm and>4 cm were 57.4%and 44.7%respectively in the high-risk group(patients with pelvic lymphatic metastasis and/or positive parametrial surgical margin)(P=0.575) and the recurrence ratio was 7/18 and 6/14 for the cases of the two tumor sizes in the same risk group.There was no significant difference between the two groups(P=0.821).The 5-year disease-free survivals for the cases with a tumor≤4 cm and>4 cm were 86.5%and 82.9%respectively in the low-risk group(patients without pelvic lymph-node metastasis and/or positive para- metrial surgical margin),respectively(P>0.05)and the recurrence ratio was 9/95 and 7/47 for the cases of the two tumor sizes in the same risk group. There was no significant difference between the two groups(P>0.05). CONCLUSIONS For FIGO Stage-IB cervical squamous cel carcinoma patients with radical surgery as the major means of treatment,the features of pelvic lymph-node metastasis and a positive parametrial surgical margin are independent factors that influence the prognosis.The tumor size can not be used as a criterion for predicting the prognosis.     

Synchronous primary cancers of the endometrium and ovary： review of 43 cases

Objective:To investigate the clinicsl and pathological characteristics.treatment methods,and prognosis of synchronous primary cancer of the endometrium and ovary.Methods:The clinical data of 43 patients with synchronous primary cancer of endometrium and ovary were retrospectively reviewed.The survival was calculated by Kaplan-Meier method and compared using the log-rank test.Results:The median age of the patients at diagnosis was 49 years(range.28-73 years).The most common symptoms were abnormal vaginal bleeding(69.8%)and abdominal or pelvic pain(44.2%).Pelvic masses were found in 39.5%of the patients and enlarged corpus in 27.9%at physic examination.while pelvic masses were found in 67.4%of the 43 patients(29 cases)and thickening or abnormal endometrium in 23.3%(10 cases)during ultrasound exami-nation.Of 25 patients examined by CT/MRI.pelvic masses were found in 13 cases and enlarged uterus in 11 cases.All 15 patients who underwent endometriaI biopsies were proven to have endometrioid carcinomas.Serum CA125 level was found to be elevated in 22 of the 34 examined cases(64.7%)with median value 500 U/mL(range,39-3439 U/mL).FIGO stages of endometrial carcinomas:ⅠA 18 cases,ⅠB 20 cases.ⅠC 2 cases,and ⅡA 3 cases;Stages of ovarian cardnomas:ⅠA 19 case,ⅠB 4 cases,ⅠC 7 cases.Ⅱ 4 cases,and ⅢC 9cases.Twenty-four patients(55.8%)were in stage Ⅰ both endometrial and ovar-ian carcinomas.Thirty-one patients underwent total hysterectomy plus bilateral salpingo-oophorectomy with omentectomy and appendectomy,meanwhile,12 patients had pelvic lymph nedes dissection.Thirty-eight of the 43 patients(88.4%)had a pathologically proven endometrial adenocarcinomas.The predominant ovarian histologies were endometrioid or mixed tumors with endometrioid components(30/43,69.8%).Postoperatively,26 patients(60.5%)received adjuvant chemotherapy alone.12 had chemotherapy plus radiotherapy,only one patients had radiation alone and the remaining 4 cases received no adiuvant treatment.The 3-year and 5-year survival rates of the group were 87.4%and 71.1%respectively.The 3-year and 5-year survival rates of patients with endometriold carcinoma at both endometrial and ovarian were higher than that of those with non-endometriold or mixed histologic subtypes(93.8%,82% vs 79.7%.69%).The 3-year and 5-year survival rates of patients with earty stages disease were better than those of other patients(93.3%,93.3% vs 69.7%,36.7%).Recurrence developed in 15 patients(34.9%).It was showed by univariate analysis that lower CA125 level,early FIGO stage,and adjuvant chemotherapy plus radiotherapy significantly and positively affected the 5-year survival rate.while only eady FIGO stage and chemotherapy plus radiotherapy were revealed by multivariate analysis as independent prognostic factors.Conclusion:Syn- chronous primary cancers of the endometrium and ovary were different from either the primary endometrial or ovarian cancer,while usually it can be detected in early stage with a good prognosis.The impact of the CA125 level on prognosis needs to be further studied.Surgery treatment alone may be enough for early stage patients.Chemotherapy plus radiotherapy may benecessary for advanced patients.     

The recurrence and survival of oral squamous cell carcinoma: a report of 275 cases

Oral squamous cell carcinoma （OSCC） is a common malignant tumor of the head and neck, and recurrence is an important prognostic factor in patients with OSCC. We explored the factors associated with recurrence of OSCC and analyzed the survival of patients after recurrence. Clinicopathologic and follow-up data of 275 patients with OSCC treated by surgery in the Cancer Institute and Hospital of Tianjin Medical University between 2002 and 2006 were analyzed. Recurrence factors were analyzed with Chi- square or Fisher＇s exact test and multivariate analysis. The prognosis of patients after recurrence was analyzed with the Kaplan-Meier method and log-rank test. The recurrence rate was 32.7%. The recurrence time ranged from 2 to 96 months, with a median of 14 months. Univariate analysis showed that T stage, degree of differentiation, pN stage, flap application, resection margin, and lymphovascular invasion were factors of recurrence （P 〈 0.05）. Multivariate analysis showed that T stage, degree of differentiation, and pN stage were independent factors of recurrence （P 〈 0.001）. The differences in gender, age, tumor site, region of lymph node metastasis, and perineural invasion between the recurrence and non-recurrence groups were not significant （P 〉 0.05）. Kaplan-Meier and log-rank tests showed that the 2- and 5-year survival rates were significantly lower in the recurrence group than in non-recurrence group （67.6% vs. 88.0%, 31.8% vs. 79.9%, P 〈 0.001）. Therefore, to improve prognosis, we recommend extended local excision, flap, radical neck dissection, and adjuvant chemoradiotherapy for patients more likely to undergo recurrence.     

Ovarian metastasis in patient with endometrial carcinoma

Objective： To study the clinical pathological characteristics of ovarian metastasis of endometrial carcinoma and the factors affecting prognosis. Methods： Retrospective analysis was made to the clinical pathological outcome of endometrial carcinoma patients receiving surgical treatment in our hospital from January 1990 to December 2002. Results： Among the 191 cases of endometrial carcinoma patients, 17 cases （8.9%） had ovarian metastasis and young patients were more likely to have ovarian metastasis. The multiple factor analysis showed that the independent risk factors of ovarian metastasis in endometrial carcinoma included the depth of myometrial invasion, lymph node metastasis and pathological types. Conclusion： Ovarian metastasis in patients with endometrial carcinoma is associated with poor prognosis, the depth of myometrial invasion, lymph node metastasis and histologic types are independent risk factors affecting the prognosis. For young patients at early stage of the disease, it should be prudent as to whether to retain the ovary.     

Influence of the Number of Lymph Nodes Examined on the Prognosis of Patients with Dukes＇ B and C Colorectal Carcinoma

OBJECTIVE To analyze the influence of the number of lymph nodes examined on the prognosis of Dukes＇ B and C colorectal cancer patients. METHODS The relationship between the clinicopathologic features of 373 patients with Dukes＇ B and C colorectal cancer and number of the lymph nodes examined was retrospectively analyzed. The effect of the different number of nodes examined on the prognosis of the patients was appraised RESULTS The overall mean number of retrieved lymph nodes of the 373 patients with Dukes＇ B and C colorectal cancer was 13.71±9.38. The site and size of the tumor as well as the depth of tumor infiltration were the major reasons which influenced the number of lymph nodes retrieved. The mean number of lymph nodes examined in the colon-cancer patients was 17.51± 12.79, which was significantly more than the 11.09±6.17 （P = 0.000） examined in the rectal-cancer patients. The 5-year survival rate of the patients with Dukes＇ B large intestinal carcinoma, with fewer lymph nodes retrieved （0 to 10）, was only 60.4%, while those with more lymph node retrieved （≥10） had a 5-year survival of 77.5%. So there was a significant difference between the two groups. However the number of lymph nodes examined had no effect on prognosis of the patients with Dukes＇ C large intestinal carcinoma. Separate analysis of the colon and rectal cancers indicated that to improve the 5-year survival rate, the number of retrieved nodes in cases with rectal cancer should be at least 9, and with colon cancer cases at least 13. CONCLUSION In order to guarantee an accuracy of tumor staging for developing a possible postoperative treatment, at least 9 lymph nodes in rectal cancer patients or 13 in colon cancer patients should be harvested.     

Rational Operation for Primary Gastric Carcinoma with Liver Metastasis

OBJECTIVE To investigate the prognosis of advanced gastric carcinoma patients with liver metastasis, and provide a foundation for rational operations. METHODS The operations and prognosis of 102 primary gastric carcinoma patients with liver metastasis were studied retrospectively. RESULTS In gastric carcinoma patients with H1 metastasis who underwent a resection operation, the 6-month, 1- and 2-year post-operative survival rates were 61%, 42% and 7%. There was a statistically significant difference in survival between resected and non-resected patients （P=0.000） in gastric carcinoma cases with H2 metastasis, resection operations resulted in 54%, 16% and 8% respective survival rates, with no significant difference compared to patients not receiving a resection （P=0.132）. Gastric carcinoma patients with H3 metastasis who received a resection operation showed 25%, 13% and 0% respective survivals with no significantly better prognosis compared to the non-resected cases （P=0.135）. There was no statistically significant difference in survival between the cases with or without peritoneal metastasis （P=0.152）. CONCLUSION A resection operation provides a better prognosis for gastric carcinoma patients with H1 metastasis independent of peritoneal metastasis, but resection has no benefit for gastric carcinoma cases with H2 or H3 metastasis. Peritoneal metastases are not the significant influencing factor for the prognosis of gastric cancer with liver metastasis.     

TREATMENT OF LOCAL RECURRENCE OF NASOPHARYN-GEAL CARCINOMA WITH REIRRADIATION

From 1975 to 1987, 112 patients with loco-regional recurrence of nasopharyngeal carcinoma (N P C) were treated again with radiation at our hospital. All cases were proven histologically by biopsy. Of these patients, 92 had their recurrence in the nasopharynx only, 13 had additional involvement of the base of the skull, and 7 had tumor recurrences simultaneously in the nasopharynx as well as the cervical lymph nodes. Radiotherapy adopted in this series was 60Co external irradiation (X R Te) and/ or betatron in 96 patients, X R Te plus intracavitary 60Co irradiation (X R Ti) in 12 patients and X R Ti alone in the other 4 patients. The 1-, 3-, and 5-year survival rates were 86.3%, 45.8% and 30.2% respectively after the start of recurrence retreatment. The 63 patients who survived for 5 years or more were analyzed. The prognosis of the patient was related to the histological type, clinical stage, modality of treatment, and disease interval to recurrence and site of recurrence. No serious complications occur     

Prognostic factors of ampulla of vater carcinoma after radical surgery

OBJECTIVE Ampullary carcinoma is a rare disease with better prognosis than other periampullary neoplasms. This study investigated the association between clinicopathologic factors and prognosis after radical resection of ampulla of Vater carcinoma.
METHODS Clinical data from 105 patients who underwent radical pancreaticoduodenectomy from January 1990 to December 2005 were retrospectively analyzed by the Kaplan-Meier method, log-rank test, and the Cox proportional hazard model.
RESULTS The in-hospital mortality rate was 8.6%, the lymph node metastasis rate was 37.1%, and the five-year survival rate was 42.8%. Pancreatic involvement （P = 0.027）, tumor diameter （P = 0.008）, T stage （P = 0.003）, TNM stage （P 〈 0.001）, and number of metastatic lymph nodes （P 〈 0.001） were associated with prognosis when the univariate analysis was used. Multivariate analysis showed that the number of lymph node metastases （P 〈 0.001; OR： 1.923; CI： 1.367-2.705） and tumor diameter （P = 0.03; OR： 1.432; CI： 1.035-1.981） were the independent prognostic factors.
CONCLUSION The number of metastatic lymph nodes and tumor diameter are important pathologic factors predicting prognosis of ampulla of Vater carcinoma after radical resection, and lymph node dissection during the radical surgery effectively improves the survival rate.     

原发性乳腺癌患者治疗前血清TPS水平与预后之间的关系(英文)

Objective: The aim of this study was to explore the correlation of pretreatment serum tissue polypeptide specific antigen (TPS) with prognosis in primary breast cancer. Methods: A total of 361 patients with grades I-III breast cancer had been followed up from January 2001 to February 2011. Serumal TPS level was measured by enzyme-linked immunosorbent assays (ELISA). Univariate and multivariate analyses were used to investigate associations between pretreatment TPS level and clinicopathological parameters and patient outcomes. Results: First, at the univariate analysis, the expression of TPS was related with some clinicopathological traditional prognostic factors such as tumor size (P = 0.030), histologic grade (P = 0.001) and lymph node status (P = 0.008). Second, overall survival were significantly shorter among patients with elevated pretreatment serum TPS (P = 0.038). However, finally, multivariate Cox regression indicated that the level of pretreatment serum TPS was not an independent prognostic parameter for overall survival in primarily breast cancer patients (P > 0.05). Conclusion: The expression of pretreatment serum TPS is closely correlated with clinicopathology parameters and overall survival of patients with primarily breast cancer, but its level has no independent prognostic value.