Clinical analysis of stage Ⅰ and Ⅱ cervical carcinoma in elderly women

Objective To explore the characteristics, related risk factors and prognosis of cervical carcinoma in elderly women. Methods 163 cases with stage Ⅰ-Ⅱ cervical carcinoma according to International Federation of Gynecology and Obstetrics (FIGO) criteria underwent radical hysterectomy and pelvic lymph dissection from January 1997 to December 2006. They were divided into aged group, adult group and young group. The clinical pathological data, prognosis and recurrence were retrospectively analyzed. Results The prevalence rate of stage Ⅱ cervical carcinoma was 78.7% (37/47) in aged group, 61.7 % (58/94) in adult group and 59.1% (13/22) in young group. The prevalence difference was statically significant. The prevalence rate of non-squamous cell carcinoma was 8. 5 % (4/47) in aged group, which was higher than that in adult group [5.3%(5/94)]and lower than that in young group [18. 2% (4/22)] (P<0.05). In aged group, pathological grading were 78.7% (37/47) of middle differentiation and 4. 3% (2/47) of low differentiation(P<0. 01). The rate of lymph node metastasis was 8. 51% (4/47)in aged women, 27.7 % (26/94) in adult women and 40.90% (9/22) in young women (P<0. 01). The recurrence rate was similar among the three groups. The death rate was 85.7% in overall recurrent cases, (12/14)in aged group, 73.1% (19/26)in adult group and 50.0% (4/8)in young group, and there was no significant difference (P=0. 193). Conclusions Cervical carcinoma in elderly women has a later clinical stage, higher prevalence of non-squamous cell carcinoma, more middle differentiation tumour tissues and fewer lymphatic metastasis, which can provide evidence for clinical diagnosis and treatment.     

Clinical analysis of stage Ⅰ and Ⅱ cervical carcinoma in elderly women

Objective To explore the characteristics, related risk factors and prognosis of cervical carcinoma in elderly women. Methods 163 cases with stage Ⅰ-Ⅱ cervical carcinoma according to International Federation of Gynecology and Obstetrics (FIGO) criteria underwent radical hysterectomy and pelvic lymph dissection from January 1997 to December 2006. They were divided into aged group, adult group and young group. The clinical pathological data, prognosis and recurrence were retrospectively analyzed. Results The prevalence rate of stage Ⅱ cervical carcinoma was 78.7% (37/47) in aged group, 61.7 % (58/94) in adult group and 59.1% (13/22) in young group. The prevalence difference was statically significant. The prevalence rate of non-squamous cell carcinoma was 8. 5 % (4/47) in aged group, which was higher than that in adult group [5.3%(5/94)]and lower than that in young group [18. 2% (4/22)] (P<0.05). In aged group, pathological grading were 78.7% (37/47) of middle differentiation and 4. 3% (2/47) of low differentiation(P<0. 01). The rate of lymph node metastasis was 8. 51% (4/47)in aged women, 27.7 % (26/94) in adult women and 40.90% (9/22) in young women (P<0. 01). The recurrence rate was similar among the three groups. The death rate was 85.7% in overall recurrent cases, (12/14)in aged group, 73.1% (19/26)in adult group and 50.0% (4/8)in young group, and there was no significant difference (P=0. 193). Conclusions Cervical carcinoma in elderly women has a later clinical stage, higher prevalence of non-squamous cell carcinoma, more middle differentiation tumour tissues and fewer lymphatic metastasis, which can provide evidence for clinical diagnosis and treatment.     

Clinical analysis of stage Ⅰ and Ⅱ cervical carcinoma in elderly women

Objective To explore the characteristics, related risk factors and prognosis of cervical carcinoma in elderly women. Methods 163 cases with stage Ⅰ-Ⅱ cervical carcinoma according to International Federation of Gynecology and Obstetrics (FIGO) criteria underwent radical hysterectomy and pelvic lymph dissection from January 1997 to December 2006. They were divided into aged group, adult group and young group. The clinical pathological data, prognosis and recurrence were retrospectively analyzed. Results The prevalence rate of stage Ⅱ cervical carcinoma was 78.7% (37/47) in aged group, 61.7 % (58/94) in adult group and 59.1% (13/22) in young group. The prevalence difference was statically significant. The prevalence rate of non-squamous cell carcinoma was 8. 5 % (4/47) in aged group, which was higher than that in adult group [5.3%(5/94)]and lower than that in young group [18. 2% (4/22)] (P<0.05). In aged group, pathological grading were 78.7% (37/47) of middle differentiation and 4. 3% (2/47) of low differentiation(P<0. 01). The rate of lymph node metastasis was 8. 51% (4/47)in aged women, 27.7 % (26/94) in adult women and 40.90% (9/22) in young women (P<0. 01). The recurrence rate was similar among the three groups. The death rate was 85.7% in overall recurrent cases, (12/14)in aged group, 73.1% (19/26)in adult group and 50.0% (4/8)in young group, and there was no significant difference (P=0. 193). Conclusions Cervical carcinoma in elderly women has a later clinical stage, higher prevalence of non-squamous cell carcinoma, more middle differentiation tumour tissues and fewer lymphatic metastasis, which can provide evidence for clinical diagnosis and treatment.     

Clinical analysis of stage Ⅰ and Ⅱ cervical carcinoma in elderly women

Objective To explore the characteristics, related risk factors and prognosis of cervical carcinoma in elderly women. Methods 163 cases with stage Ⅰ-Ⅱ cervical carcinoma according to International Federation of Gynecology and Obstetrics (FIGO) criteria underwent radical hysterectomy and pelvic lymph dissection from January 1997 to December 2006. They were divided into aged group, adult group and young group. The clinical pathological data, prognosis and recurrence were retrospectively analyzed. Results The prevalence rate of stage Ⅱ cervical carcinoma was 78.7% (37/47) in aged group, 61.7 % (58/94) in adult group and 59.1% (13/22) in young group. The prevalence difference was statically significant. The prevalence rate of non-squamous cell carcinoma was 8. 5 % (4/47) in aged group, which was higher than that in adult group [5.3%(5/94)]and lower than that in young group [18. 2% (4/22)] (P<0.05). In aged group, pathological grading were 78.7% (37/47) of middle differentiation and 4. 3% (2/47) of low differentiation(P<0. 01). The rate of lymph node metastasis was 8. 51% (4/47)in aged women, 27.7 % (26/94) in adult women and 40.90% (9/22) in young women (P<0. 01). The recurrence rate was similar among the three groups. The death rate was 85.7% in overall recurrent cases, (12/14)in aged group, 73.1% (19/26)in adult group and 50.0% (4/8)in young group, and there was no significant difference (P=0. 193). Conclusions Cervical carcinoma in elderly women has a later clinical stage, higher prevalence of non-squamous cell carcinoma, more middle differentiation tumour tissues and fewer lymphatic metastasis, which can provide evidence for clinical diagnosis and treatment.     

Clinical analysis of stage Ⅰ and Ⅱ cervical carcinoma in elderly women

Objective To explore the characteristics, related risk factors and prognosis of cervical carcinoma in elderly women. Methods 163 cases with stage Ⅰ-Ⅱ cervical carcinoma according to International Federation of Gynecology and Obstetrics (FIGO) criteria underwent radical hysterectomy and pelvic lymph dissection from January 1997 to December 2006. They were divided into aged group, adult group and young group. The clinical pathological data, prognosis and recurrence were retrospectively analyzed. Results The prevalence rate of stage Ⅱ cervical carcinoma was 78.7% (37/47) in aged group, 61.7 % (58/94) in adult group and 59.1% (13/22) in young group. The prevalence difference was statically significant. The prevalence rate of non-squamous cell carcinoma was 8. 5 % (4/47) in aged group, which was higher than that in adult group [5.3%(5/94)]and lower than that in young group [18. 2% (4/22)] (P<0.05). In aged group, pathological grading were 78.7% (37/47) of middle differentiation and 4. 3% (2/47) of low differentiation(P<0. 01). The rate of lymph node metastasis was 8. 51% (4/47)in aged women, 27.7 % (26/94) in adult women and 40.90% (9/22) in young women (P<0. 01). The recurrence rate was similar among the three groups. The death rate was 85.7% in overall recurrent cases, (12/14)in aged group, 73.1% (19/26)in adult group and 50.0% (4/8)in young group, and there was no significant difference (P=0. 193). Conclusions Cervical carcinoma in elderly women has a later clinical stage, higher prevalence of non-squamous cell carcinoma, more middle differentiation tumour tissues and fewer lymphatic metastasis, which can provide evidence for clinical diagnosis and treatment.     

Clinical analysis of stage Ⅰ and Ⅱ cervical carcinoma in elderly women

Objective To explore the characteristics, related risk factors and prognosis of cervical carcinoma in elderly women. Methods 163 cases with stage Ⅰ-Ⅱ cervical carcinoma according to International Federation of Gynecology and Obstetrics (FIGO) criteria underwent radical hysterectomy and pelvic lymph dissection from January 1997 to December 2006. They were divided into aged group, adult group and young group. The clinical pathological data, prognosis and recurrence were retrospectively analyzed. Results The prevalence rate of stage Ⅱ cervical carcinoma was 78.7% (37/47) in aged group, 61.7 % (58/94) in adult group and 59.1% (13/22) in young group. The prevalence difference was statically significant. The prevalence rate of non-squamous cell carcinoma was 8. 5 % (4/47) in aged group, which was higher than that in adult group [5.3%(5/94)]and lower than that in young group [18. 2% (4/22)] (P<0.05). In aged group, pathological grading were 78.7% (37/47) of middle differentiation and 4. 3% (2/47) of low differentiation(P<0. 01). The rate of lymph node metastasis was 8. 51% (4/47)in aged women, 27.7 % (26/94) in adult women and 40.90% (9/22) in young women (P<0. 01). The recurrence rate was similar among the three groups. The death rate was 85.7% in overall recurrent cases, (12/14)in aged group, 73.1% (19/26)in adult group and 50.0% (4/8)in young group, and there was no significant difference (P=0. 193). Conclusions Cervical carcinoma in elderly women has a later clinical stage, higher prevalence of non-squamous cell carcinoma, more middle differentiation tumour tissues and fewer lymphatic metastasis, which can provide evidence for clinical diagnosis and treatment.     

Clinical analysis of stage Ⅰ and Ⅱ cervical carcinoma in elderly women

Objective To explore the characteristics, related risk factors and prognosis of cervical carcinoma in elderly women. Methods 163 cases with stage Ⅰ-Ⅱ cervical carcinoma according to International Federation of Gynecology and Obstetrics (FIGO) criteria underwent radical hysterectomy and pelvic lymph dissection from January 1997 to December 2006. They were divided into aged group, adult group and young group. The clinical pathological data, prognosis and recurrence were retrospectively analyzed. Results The prevalence rate of stage Ⅱ cervical carcinoma was 78.7% (37/47) in aged group, 61.7 % (58/94) in adult group and 59.1% (13/22) in young group. The prevalence difference was statically significant. The prevalence rate of non-squamous cell carcinoma was 8. 5 % (4/47) in aged group, which was higher than that in adult group [5.3%(5/94)]and lower than that in young group [18. 2% (4/22)] (P<0.05). In aged group, pathological grading were 78.7% (37/47) of middle differentiation and 4. 3% (2/47) of low differentiation(P<0. 01). The rate of lymph node metastasis was 8. 51% (4/47)in aged women, 27.7 % (26/94) in adult women and 40.90% (9/22) in young women (P<0. 01). The recurrence rate was similar among the three groups. The death rate was 85.7% in overall recurrent cases, (12/14)in aged group, 73.1% (19/26)in adult group and 50.0% (4/8)in young group, and there was no significant difference (P=0. 193). Conclusions Cervical carcinoma in elderly women has a later clinical stage, higher prevalence of non-squamous cell carcinoma, more middle differentiation tumour tissues and fewer lymphatic metastasis, which can provide evidence for clinical diagnosis and treatment.     

Clinical analysis of stage Ⅰ and Ⅱ cervical carcinoma in elderly women

Objective To explore the characteristics, related risk factors and prognosis of cervical carcinoma in elderly women. Methods 163 cases with stage Ⅰ-Ⅱ cervical carcinoma according to International Federation of Gynecology and Obstetrics (FIGO) criteria underwent radical hysterectomy and pelvic lymph dissection from January 1997 to December 2006. They were divided into aged group, adult group and young group. The clinical pathological data, prognosis and recurrence were retrospectively analyzed. Results The prevalence rate of stage Ⅱ cervical carcinoma was 78.7% (37/47) in aged group, 61.7 % (58/94) in adult group and 59.1% (13/22) in young group. The prevalence difference was statically significant. The prevalence rate of non-squamous cell carcinoma was 8. 5 % (4/47) in aged group, which was higher than that in adult group [5.3%(5/94)]and lower than that in young group [18. 2% (4/22)] (P<0.05). In aged group, pathological grading were 78.7% (37/47) of middle differentiation and 4. 3% (2/47) of low differentiation(P<0. 01). The rate of lymph node metastasis was 8. 51% (4/47)in aged women, 27.7 % (26/94) in adult women and 40.90% (9/22) in young women (P<0. 01). The recurrence rate was similar among the three groups. The death rate was 85.7% in overall recurrent cases, (12/14)in aged group, 73.1% (19/26)in adult group and 50.0% (4/8)in young group, and there was no significant difference (P=0. 193). Conclusions Cervical carcinoma in elderly women has a later clinical stage, higher prevalence of non-squamous cell carcinoma, more middle differentiation tumour tissues and fewer lymphatic metastasis, which can provide evidence for clinical diagnosis and treatment.     

Clinical analysis of stage Ⅰ and Ⅱ cervical carcinoma in elderly women

Objective To explore the characteristics, related risk factors and prognosis of cervical carcinoma in elderly women. Methods 163 cases with stage Ⅰ-Ⅱ cervical carcinoma according to International Federation of Gynecology and Obstetrics (FIGO) criteria underwent radical hysterectomy and pelvic lymph dissection from January 1997 to December 2006. They were divided into aged group, adult group and young group. The clinical pathological data, prognosis and recurrence were retrospectively analyzed. Results The prevalence rate of stage Ⅱ cervical carcinoma was 78.7% (37/47) in aged group, 61.7 % (58/94) in adult group and 59.1% (13/22) in young group. The prevalence difference was statically significant. The prevalence rate of non-squamous cell carcinoma was 8. 5 % (4/47) in aged group, which was higher than that in adult group [5.3%(5/94)]and lower than that in young group [18. 2% (4/22)] (P<0.05). In aged group, pathological grading were 78.7% (37/47) of middle differentiation and 4. 3% (2/47) of low differentiation(P<0. 01). The rate of lymph node metastasis was 8. 51% (4/47)in aged women, 27.7 % (26/94) in adult women and 40.90% (9/22) in young women (P<0. 01). The recurrence rate was similar among the three groups. The death rate was 85.7% in overall recurrent cases, (12/14)in aged group, 73.1% (19/26)in adult group and 50.0% (4/8)in young group, and there was no significant difference (P=0. 193). Conclusions Cervical carcinoma in elderly women has a later clinical stage, higher prevalence of non-squamous cell carcinoma, more middle differentiation tumour tissues and fewer lymphatic metastasis, which can provide evidence for clinical diagnosis and treatment.     

Hepatocellular carcinoma in extremely elderly patients： An analysis of clinical characteristics, prognosis- and patient survival

AIM:To identify the clinical and prognostic features ofpatients with hepatocellular carcinoma (HCC) aged 80years or more.METHODS:A total of 1310 patients with HCC wereincluded in this study.Ninety-one patients aged 80 yearsor more at the time of diagnosis of HCC were defined asthe extremely elderly group.Two hundred and thirty-fourpatients aged≥50 years but less than 60 years wereregarded as the non-elderly group.RESULTS:The sex ratio (male to female) wassignificantly lower in the extremely elderly group (0.90:1)than in the non-elderly group (3.9:1,P<0.001).The positive rate for HBsAg was significantly lower in theextremely elderly group and the proportion of patientsnegative for HBsAg and HCVAb obviously increased inthe extremely elderly group (P<0.001).There wereno significant differences in the following parameters:diameter and number of tumors,Child-Pugh grading,tumor staging,presence of portal thrombosis or ascites,and positive rate for HCVAb.Extremely elderly patientsdid not often receive surgical treatment (P<0.001) andthey were more likely to receive conservative treatment(P<0.01).There were no significant differences insurvival curves based on the Kaplan-Meier methods incomparison with the overall patients between the twogroups.However,the survival curves were significantlyworse in the extremely elderly patients with stage Ⅰ/Ⅱ,stage Ⅰ/Ⅱ and Child-Pugh grade A cirrhosis in comparisonwith the non-elderly group.The causes of death did notdiffer among the patients,and most cases died of liver-related diseases even in the extremely elderly patients.CONCLUSION:In the patients with good liver functionsand good performance status,aggressive treatment forHCC might improve the survival rate,even in extremelyelderly patients.     

Morphological analysis of lymph vessels and capillaries in gastric carcinoma

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Clinical and experimental study of oxaliplatin in treating human gastric carcinoma

AIM:To evaluate the therapeutic effectiveness of oxaliplatinon human gastric carcinoma and to explore its mechanisms.METHODS:Twenty-two cases of stage IV gastric carcinomareceived 4-6(mean 4.6)cycles of first line combinedchemotherapy with oxaliplatin(oxaliplatin 85 mg/m~2,iv,gtt,1 h,d 1;leukovorin 200 mg/m~2,iv,gtt,1 h,d 1 and d 2;5-FU 300 mg/m~2,iv,d 1 and d 2,5-FU,continuous iv,gtt,48 h;1 cycle/2 wk).Response rate,progression-free survival(PFS),total survival time,toxic side effects were evaluated.The inhibitory effect of oxaliplatin on human gastric cell lineSGC-7901 was detected and IC_(50) was calculated by MTT.Transmission electron microscopy,flow cytometry andTUNEL were performed to evaluate the apoptosis of cellline induced by the drug.The expression of Caspase-3m-RNA was detected by RT-PCR.AC-DEVD-CHO,aCaspase-3 specific inhibitor,was used to elucidate the roleof activated Caspase-3 in the process of apoptosis inducedby oxaliplatin.RESULTS:Total response(complete and partial)occurredin 9(40.9%) patients.Mean PFS was 4.2 mo and meantotal survival time was 7.2 mo.Cumulative neurotoxicity(all grade Ⅰ-Ⅱ),vomiting and diarrhea,myelosuppressionappeared in 93.5%,20%,32.9% patients,respectively.IC_(50) was calculated to be 0.71 mg/L by MTT assay.A maximalinhibitory rate reached 85.3%.Apoptosis index was elevatedafter incubated with 1 mmol/L oxaliplatin for 30 min,butwithout statistic significance(P>0.05).However it couldbe detected at a much higher degree both by flowcytometryand by TUNEL with a statistical significance(68.47±7.92%and 8.23±2.67%,respectively,P<0.05)after incubated with1 mmol/L oxaliplatin for 2 d.By means of RT-PCR,we detectedan enhancement of Caspase-3 m-RNA expression inducedby oxaliplatin which was also in positive correlation withthe apoptotic level.AC-DEVD-CHO,a Caspase-3 specificinhibitor,could significantly inhibit and delay apoptosisinduced by oxaliplatin.CONCLUSION:Oxaliplatin is effective and well-toleratedin patients with advanced gastric carcinoma.Oxaliplatincould significantly inhibit the growth of human gastric cell lineSGC-7901.The induction of Caspase-3 m-RNA expression,activation of Caspase-3 and promotion of apoptosis maybe some of the therapeutic mechanisms of oxaliplatin ongastric carcinoma.Annexin-V-fluorescein labeling flowcytometry is much more sensitive than TUNEL in detecting early stage apoptosis.     

Clinical significance of serum IGF-Ⅰ, IGF-Ⅱ and IGFBP-3 in liver cirrhosis

AIM: To investigate the relationship between insulin-like growth factor-Ⅰ, -Ⅱ (IGF-Ⅰ and IGF-Ⅱ), IGF-binding protein 3(IGFBP-3) and Child-Pugh score in patients with liver cirrhosis,and to search for potential clinical markers of liver function.METHODS: Forty-four patients with advanced liver cirrhosis of viral origin were divided into 3 groups according to severity of cirrhosis (Child-Pugh score) and 38 healthy subjects served as controls. Serum levels of IGF-Ⅰ, IGF-Ⅱ and IGFBP-3 were measured by immunoradiometric assay.RESULTS: Serum IGF-Ⅰ, IGF-Ⅱ and IGFBP-3 levels were significantly lower in patients with cirrhosis than in controls,and serum concentrations of IGF-Ⅰ, IGF-Ⅱ and IGFBP-3 were associated with the severity of liver dysfunction, and dropped sharply during the progression of liver failure. Among these 3 parameters, serum IGF-Ⅱ was the most sensitive and effective indicator for liver dysfunction. Concentrations of IGF-Ⅰ &lt;30 ng/mL, IGF-Ⅱ &lt;200 ng/mL and IGFBP-3 &lt;6 ng/mL implied a negative prognosis for patients with liver cirrhosis.CONCLUSION: Serum IGF-Ⅰ, IGF-Ⅱ and IGFBP-3 may provide a new dimension in the assessment of liver dysfunction.Combined detection of serum IGF-Ⅰ, IGF-Ⅱ and IGFBP-3 with Child-Pugh score is more effective in predicting prognosis than Child-Pugh score alone.     

Histological mixed-type as an independent prognostic factor in stageⅠgastric carcinoma

AIM: To evaluate the clinicopathological features of mixed-type gastric cancer and their influence on prognosis of mixed-type stageⅠgastric cancer.METHODS: We analyzed 446 patients who underwent curative gastrectomy for stageⅠgastric cancer between 1999 and 2009. The patients were divided into two groups: those with differentiated or undifferentiated cancer(non-mixed-type, n = 333) and those with a mixture of differentiated and undifferentiated cancers(mixed-type, n = 113).RESULTS: The overall prevalence of mixed-type gastric cancer was 25.3%(113/446). Compared with patients with non-mixed-type gastric cancer, those with mixedtype gastric cancer tended to be older at onset(P = 0.1252) and have a higher incidence of lymph node metastasis(P = 0.1476). They also had significantly larger tumors(P 0.0001), more aggressive lymphatic invasion(P = 0.0011), and deeper tumor invasion(P 0.0001). In addition, they exhibited significantly worse overall survival rates than did patients with non-mixedtype gastric cancer(P = 0.0026). Furthermore, mixedtype gastric cancer was independently associated with a worse outcome in multivariate analysis [P = 0.0300, hazard ratio = 11.4(1.265-102.7)].CONCLUSION: Histological mixed-type of gastric cancer contributes to malignant outcomes and highlight its usefulness as a prognostic indicator in stageⅠgastric cancer.     

Prognosis and feasibility of en-bloc vascular resection in stage Ⅱ pancreatic adenocarcinoma

AIM:To establish the prognosis and feasibility of en-bloc vascular resection of stage pancreatic adenocarcinoma of the head and uncinate process.METHODS:We retrospectively analyzed 87 patients with stage pancreatic adenocarcinoma,who were subjected to pancreaticoduodenectomy (PD) and pylo-rus-preserving PD (PPPD) between 1996 and 2006 in Chang Gung Memorial Hospital,Taiwan. Twelve and 75 patients underwent PD/PPPD with and without resection of portal vein/superior mesenteric vein (PV/SMV),respectively.RESUL...     

Evaluation of ¹⁸F-FDG PET/CT in early-stage cervical carcinoma

IntroductionThe purpose is to evaluate ¹⁸F-fluorodeoxy glucose-positron emission tomography (PET)/computed tomography (CT) for the detection of cervical carcinoma of the International Federation of Gynecology and Obstetrics stages Ib and IIa.MethodsTwenty-two patients with cervical carcinoma were included in this study. Eleven of them were at the International Federation of Gynecology and Obstetrics stage Ib, and the remaining patients were at stage IIa. All the patients underwent ¹⁸F-fluorodeoxy glucose-PET/CT scan, and in 15 patients, additional delayed imaging of pelvis was performed. The PET/CT findings were compared with histopathologic and follow-up results.ResultsOf the 22 patients, 20 had cervical cancer with abnormal uptake that were detected directly using PET/CT without additional information from delayed imaging of pelvis; the other 2 patients showed lesions with no abnormal uptake. The use of delayed imaging of the pelvis with PET/CT corrected 1 false-negative case. Thus, the accuracy of PET/CT for early-stage cervical carcinoma was 95.45% (21/22). The uptake of early-stage cervical carcinoma showed no statistical significance between the group of stage Ib and the group of stage IIa (P > 0.05). The false-negative rate and negative predictive value of PET/CT imaging in predicting pelvic nodal involvement were 6.25% (1/16) and 93.75%, respectively.ConclusionsPET/CT showed a high accuracy for the diagnosis of early-stage cervical cancer and a high-negative predictive value for predicting the pelvic nodal status in early-stage cervical cancer.     

Clinical significance of immunohistochemica study of P53 protein in colorectal carcinoma

AIMS To determine the clinical significance of P53 protein ex-pression in colorectal carcinoma.METHODS The expression of P53 protein in 92 colorectal car-cinomas was examined using the monoclonal antibody PAb 1801.Correlation between P53 protein expression and prognosis in col-orectal carcinoma was analyzed using log-rank test.RESULTS The frequency of P53 protein expression was 57.61%,corresponding with Dukes' staging.Analysis of survivordata demonstrated that the survival rate of colorectal carcinomawith positive P53 protein group was lower than that of negativeP53 protein group.CONCLUSIONS We conclude that the expression of P53 pro-tein is correlated with poor prognosis in colorectal carcinoma.     

Comparison of nifedipine GITS and hydrochlorothiazide in the management of elderly patients with stage I–III diastolic hypertension

A randomized, double blind, parallel study was performed to compare the effects of nifedipine gastrointestinal therapeutic system (GITS) to hydrochlorothiazide (HCTZ) in the management of the elderly hypertensive. Eighteen patients, mean age 65 ± 5 years, with Stage I–III diastolic hypertension (sitting diastolic BP between 90 and 115 mm Hg) were included in each treatment group. Following a 2 to 8 week placebo washout phase, patients received either nifedipine GITS or HCTZ and were titrated over 5 weeks to achieve a goal diastolic blood pressure less than 90 mm Hg.Patients were then continued on medication during an 8 week maintenance phase. Treatment effect on systolic and diastolic blood pressure was assessed. Serum electrolytes, lipids, blood urea nitrogen, and creatinine were measured before and after treatment. Posttreatment changes in renal and cardiovascular function, as well as left ventricular mass were evaluated.The results showed significant reductions in systolic and diastolic blood pressure with both drugs; no treatment difference was found, although goal blood pressure was achieved more rapidly with nifedipine GITS (28 v 34 days, P < .05). BUN was significantly increased only after diuretic therapy (P < .01) and serum potassium fell to a greater degree with HCTZ (0.3 mEq/L v 0.1 mEq/L) than with nifedipine GITS. No statistically significant changes in left ventricular mass, ejection fraction, glomerular filtration rate, or renal blood flow were seen after therapy with either drug. However, the time to peak LV diastolic filling rate decreased with nifedipine GITS (197 to 164 msec) and increased with HCTZ (172 to 198 msec). This treatment difference approached statistical significance (P = .07). Adverse side effects of treatment were reported by 50% of nifedipine GITS patients and 28% of patients treated with HCTZ. This treatment difference was not statistically significant.We conclude that both nifedipine GITS and HCTZ monotherapy provide significant blood pressure reduction in older hypertensives with Stage I–III diastolic hypertension. Both drugs are well tolerated with no significant adverse effect on renal or cardiovascular function after short term therapy.     

Achievements and challenges in PCI of elderly patients

The very elderly patient population ( > 80 years) represents a rapidly increasing segment of our demographics, a consequence of the longer life expectancy and aging of the 'baby boom' generation. Coronary artery disease remains a major cause of mortality and morbidity among octogenarians with an estimated 30% of them having symptomatic heart disease and 50% eventually dying from it.