Early stage nasopharyngeal carcinoma: radiotherapy dose and time factors in tumor control

OBJECTIVE: To evaluate radiotherapy dose and length of treatment in the control of early stage nasopharyngeal carcinoma (NPC) treated with a combination of external radiotherapy and brachytherapy, MATERIALS & METHODS: We reviewed the records of 133 patients with early stage nasopharyngeal carcinoma (stage I or II, AJC/UICC staging system) who received definitive radiotherapy in Chang Gung Memorial Hospital from 1979 to 1991. The median follow-up time was 7.1 years with a minimum of 2 years. All patients were treated with megavoltage external radiotherapy to the nasopharynx area (63-72 Gy) followed by high dose rate intracavitary brachytherapy (5-16.5 Gy in one to three fractions, spaced 1-2 weeks apart). The median total dose and time of irradiation was 75 Gy (69.8-81.4 Gy) and 11.6 weeks (7.8-20 weeks) respectively. Survival analysis was used to examine the effect of several variables on prognosis. RESULTS: The 5-year rates were 86.4% for local control, 84.7% for disease free survival, 88.5% for actuarial survival and 84.2% for overall survival. The treatment group (combination of time and dose of irradiation) was the most important prognostic factor according to Cox's proportional hazard model. Patients receiving radiation at a total dose of < or = 75 Gy completed in < 12 weeks showed the best prognosis. CONCLUSION: Treatment time and total treatment dose are both important factors in treating early stage NPC. Decreasing the total radiation time to < 12 weeks and not exceeding a radiation dose of 75 Gy gave the best results.      

Direct uterine sampling with the Tao brush sampler using a liquid‐based preparation method for the detection of endometrial cancer and atypical hyperplasia

BACKGROUND.

Endometrial cytology sampling devices for direct uterine sampling have been shown in previous studies to be a reliable and relatively painless method for detecting endometrial lesions. The purpose of the current study was to determine the performance characteristics of endometrial cytology for the detection of malignancy and atypical hyperplasia using liquid‐based cytology specimens collected with the Tao brush sampler.

METHODS.

Brushings of the endometrial cavity were obtained from 139 hysterectomy specimens before routine histopathologic evaluation. Cytology specimens were fixed in PreservCyt and processed using ThinPrep technology. Cytology diagnoses were classified as nondiagnostic, negative, atypical, or positive for malignancy. Histopathologic findings were used as the gold standard for determining the performance characteristics of cytology.

RESULTS.

Histopathologic results from the 139 patients included 81 (58%) endometrial cancers, 7 (5%) complex hyperplasias with atypia, 2 (1%) complex hyperplasias without atypia, and 49 (35%) patients with benign histology. The number of specimens diagnosed cytologically as positive, atypical, negative, or nondiagnostic was 60 (43%), 40 (29%), 37 (27%), and 2 (1%) specimens, respectively. The overall sensitivity and specificity of cytology for detecting endometrial cancer and atypical hyperplasia were 95% and 66% when atypical cytology specimens were considered positive.

CONCLUSIONS.

The results of the current study indicate that direct endometrial sampling by liquid‐based endometrial cytology collected with the Tao brush sampler produces specimens that contain cellular material that may be identified as endometrial cancer or atypical hyperplasia. Both atypical and positive cytology diagnoses are indicators for triage to more specific methods of diagnosis. Cancer (Cancer Cytopathol) 2008. © 2008 American Cancer Society     

爆裂性骨折所致眼球内陷的CT研究

目的:研究眼眶爆裂性骨折后,眼球内陷与眼眶容积扩大的关系并对眼球内陷进行早期预报。方法:28例单侧眼眶爆裂性骨折后1～350 d患者,分别测量双侧眼球位置和骨性眼眶容积值,计算患侧眼球内陷值(E)和骨性眼眶容积扩大值(V),应用pearson积矩法研究E、V相关性并建立直线回归方程。结果:28例患侧E、V呈正相关(r=0.88,P<0.001);15例≤24 d的患者直线回归方程为E=0.85 V-1.74(r=0.86,P<0.001),13例>24 d的患者直线回归方程为E=0.86 V-0.60(r=0.9,P<0.001)。结论:眼球内陷值与眼眶容积扩大值高度相关;1 mL眼眶容积的扩大,可引起大约0.9mm(0.85～0.86 mm)的眼球内陷。与伤后>24 d的相比,≤24 d的眼球有明显的抗拒内陷的趋势,>24 d之后,这种趋势逐渐消失,随之发生眼球内陷。     

肺癌CT伪彩成像肿瘤红色色彩程度与Ki-67蛋白表达关系初步研究

[摘要] 目的 探讨肺癌16层螺旋CT伪彩成像肿瘤红色色彩程度与其Ki-67蛋白表达的关系。方法 25例肺癌行16层螺旋CT增强扫描及肿瘤病灶VR伪彩成像,对每个肿瘤病灶进行免疫组化Ki-67蛋白表达检测。用肿瘤VR伪彩成像红色色彩程度代表肿瘤强化状况,分析肺癌病灶VR伪彩成像红色色彩程度与肿瘤Ki-67蛋白表达关系。结果 VR伪彩成像重度红色色彩肺癌5例,中度红色色彩肺癌8例,轻度红色色彩肺癌9例,无红色色彩肺癌3例。13例重、中度红色色彩肺癌强化增加CT值为26.32±9.17Hu,肿瘤Ki-67蛋白表达阳性率为69.23%。12例轻及无红色色彩肺癌强化增加CT值为10.87±4.257Hu,肿瘤Ki-67蛋白表达阳性率为33.33%。重、中度色彩组与轻或无色彩组肺癌Ki-67蛋白表达比较差异有显著性。结论 肺癌CT伪彩成像红色色彩程度与肿瘤Ki-67蛋白表达有一定相关性,可初步反映其Ki－67表达状况。