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101.
Christophe Cassinotto Anthony Dohan Benoît Gallix Eve Simoneau Louis-Martin Boucher Peter Metrakos Tatiana Cabrera Carlos Torres Karl Muchantef David A. Valenti 《Journal of vascular and interventional radiology : JVIR》2017,28(7):963-970
Purpose
To assess frequency of adverse events, efficacy, and clinical outcomes of percutaneous portal vein embolization (PVE) in patients with bilobar colorectal liver metastases undergoing staged hepatectomy with preservation of segment IV ± I only.Materials and Methods
Retrospective analysis was performed of 40 consecutive patients who underwent right PVE after successful left lobectomy between 2005 and 2013. Rates of adverse events, future liver remnant (FLR) > 30% compared with baseline liver volume, clinical success (completion of staged hepatectomy with clearance of liver metastases), and overall survival were analyzed.Results
PVE was performed using polyvinyl alcohol particles (n = 7; 17.5%), particles plus coils (n = 23; 57.5%), and N-butyl cyanoacrylate glue plus ethiodized oil (n = 10; 25%). Technical success was 100%. After PVE, 20% (n = 8) of patients exhibited portal venous thrombosis, ranging from isolated intrahepatic portal branch thrombosis to massive thrombosis of the main portal vein (n = 3) and responsible for periportal cavernoma and portal hypertension in 5 patients. Of patients, 23 (57.5%) had FLR ≥ 30%, and 21 (52.5%) had clinical success. Six patients had significant stenosis or occlusion of the left portal vein or biliary system after original left lobectomy, which was independently associated with FLR < 30% (R2 = 0.24). Clinical success was the only independent variable associated with survival (R2 = 0.25).Conclusions
PVE for staged hepatectomy with preservation of segment IV ± I only is technically feasible, leading to adequate hypertrophy and clinical success rates in these patients with poor oncologic prognosis. Portal venous thrombosis is greater after the procedure than in the setting of standard PVE. 相似文献102.
Karol Polom Daniele Marrelli Valeria Pascale Francesco Ferrara Costantino Voglino Mario Marini Franco Roviello 《European journal of surgical oncology》2017,43(12):2341-2348
Background
Microsatellite instability (MSI) is one of the new groups of molecular divisions of gastric cancer (GC). The aim of this study was to investigate the pattern of lymph node metastasis according to MSI status.Methods
MSI analysis of 361 GC patients with information about lymph node stations was performed using 5 quasimonomorphic mononucleotide repeats. The metastasis rates for each lymphatic station was analyzed, combined with clinicopathologic characteristics. Stations were divided into compartments 1–3 on the basis of Japanese Classification. A median number (interquartile range, IQR) of 33 (18–50) lymph nodes were removed and analyzed.Results
N0 status was observed in 53.7% MSI patients, and in 29.7% microsatellite stable (MSS) (p < 0.001).The median value of involved nodes was 1 in MSI vs. 5 in MSS (p < 0.001). Furthermore, the number of involved node stations was significantly lower in the MSI group (p < 0.001). MSS tumors showed a higher propensity to spread to second and third compartment nodes. In absence of lymphovascular invasion only 3.2% cases demonstrated positive nodes beyond the first compartment. Skip metastases were seen in 6.1% MSS patients and 0% MSI (p = 0.011). No difference in the 10-year cancer related survival among MSI and MSS patients was found, for both those with 1st compartment (p = 0.223) and with 2nd compartment involvement (p = 0.814).Conclusions
MSI GC shows a high rate of N0 stage, a lower number of lymph node metastases, and a less extensive spread to lymph node stations than MSS tumors. These data indicate that tailored lymphadenectomy may be investigated for these patients. 相似文献103.
D. Citterio S. Pusceddu A. Facciorusso J. Coppa M. Milione R. Buzzoni M. Bongini F. deBraud V. Mazzaferro 《European journal of surgical oncology》2017,43(2):380-387
Background
Functional well-differentiated neuroendocrine tumours (NET) with liver metastases represent a therapeutic challenge with few alternative options in guidelines. In these patients, the role of surgical resection of the primary tumour is controversial.Patients and methods
From a regional registry collecting somatostatin analogue (SSA)-treated tumours from 1979 to 2005, a series of 139 patients presenting with symptomatic, liver-metastatic, well-differentiated NET (G1–G2, mitoses: ≤20, Ki-67: ≤20%) was prospectively collected and retrospectively analysed. Surgery on either the primary tumour or liver metastases was chosen: 1) when low perioperative risk was predictable; 2) in presence of an impending risk of obstruction, bleeding, or perforation; or 3) if liver metastases were suitable of curative or subtotal (>90%) tumour removal. Impact of the most relevant clinico-pathological parameters on survival was studied.Results
Median follow-up was 127 months and median survival was 94 months, with 138 vs. 37 months in resected vs. non-resected primary NET (p < 0.001), respectively. In the univariate analysis, prolonged survival was significantly associated with primary tumour resection (p < 0.001), resection of liver metastases (p = 0.002), site of primary (carcinoid vs. pancreatic, p = 0.018), basal chromogranin-A (CgA) <200 ng/mL (p = 0.001), and absence of diarrhea (p = 0.012). Multivariate analysis showed that primary tumour resection was an independent positive prognostic factor (HR = 3.17; 95% CI: 1.77–5.69, p < 0.001), whereas diarrhea, basal CgA ≥200 ng/mL, and high tumour load were independent negative prognostic factors. Also, in 103 patients with non-resectable liver metastases, primary tumour resection was significantly associated with prolonged survival (median 137 vs. 32 months, p < 0.0001).Conclusions
Primary tumour resection may improve survival in functional well-differentiated NET with liver metastases. 相似文献104.
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106.
Cheng Chen Qiang Guo Yang Tang Wendong Qu Jiebin Zuo Xixian Ke Yongxiang Song 《Journal of thoracic disease》2021,13(8):5016
BackgroundBrain metastasis was one of the factors leading to the poor long-term prognosis of patients with lung adenocarcinoma (LUAD).MethodsThe expression levels of immune genes in LUAD and LUAD brain metastases tissues were analyzed in dataset using the GEO2R, and the levels of differential immune genes in normal lung and LUAD tissues were verified. The biological functions and signaling mechanisms of the differential immune genes were explored via Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analysis. Cox regression analysis was used to screen the prognostic factors of LUAD patients, and a risk model was constructed. The role of the model was checked in the development of LUAD via receiver operating characteristic analysis, gene set enrichment analysis, and Cox regression analysis.ResultsDifferentially expressed genes (DEGs) in brain metastasis were involved in the adaptive immune response, B cell differentiation, leukocyte migration, NF-kB signaling pathway, among others. The expression levels of TNFRSF11A, MS4A2, IL11, CAMP, MS4A1, and F2RL1 were independent factors affecting the poor prognosis of LUAD patients via Cox regression analysis and Akaike information criterion. In the constructed risk model, the overall survival of LUAD patients in the high-risk group was poor. The risk model was significantly related to the gender, clinical stage, T stage, lymph node metastasis, and survival status of LUAD patients. In addition, the risk model score was an independent risk factor that affected the poor prognosis of LUAD patients. TNFRSF11A, CAMP, F2RL1, IL11, MS4A1, and MS4A2 of the risk factors had diagnostic significance in LUAD brain metastasis and LUAD. The risk model participated in cytokinetic process, cell cycle, citrate cycle TCA cycle, etc. The risk model score was correlated with the levels of B cells memory, mast cells resting, macrophages M0, mast cells activated, neutrophils, eosinophils, T cells gamma delta, and immune cell markers.ConclusionsThe risk model based on the LUAD brain metastasis immune factors TNFRSF11A, MS4A2, IL11, CAMP, MS4A1, and F2RL1 was related to the diagnosis, poor prognosis, and immune infiltrating cells of LUAD patients, and is expected to provide a reference for the development of treatment strategies for LUAD patients. GSE161116相似文献
107.
Justin Moon 《中国医疗器械信息》2011,17(8):10-13,36
医疗设备必须满足严格的产品质量要求,达到严格的行业标准以便通过各种认证。设备制造企业如果在产品操作系统的选择上谨慎行事,那么就可以在整个认证过程中节省时间和经费并且显著提高产品通过认证的概率。本文介绍了不同的操作系统架构,讲解了为何"微内核结构"更适合医疗设备的特点,以及该架构的操作系统如何能帮助企业满足本行业的特殊需求,通过各种认证。 相似文献
108.
目的 克隆人骨肉瘤细胞U-2OS中抑癌基因pitx1,进行测序,并检测pitx1下游基因p53的表达情况.方法 采用RT-PCR法扩增U-2OS中Pitx1基因,并进行克隆测序;采用定量PCR和western blot方法 检测pitx1下游基因p53的RNA和蛋白水平表达情况.结果 在U-2OS中抑癌基因pitx1发生突变,其下游基因p53的相对表达量显著低于pitx1野生型细胞株HOS.结论 pitx1 属于重要的抑癌基因p53及原癌基因ras的上游调控因子,在pitx1中的突变可能导致了该细胞株的恶变及化疗耐药. 相似文献
109.
110.