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901.
902.
903.

Introduction

Prophylactic cranial irradiation (PCI) improves survival for small-cell lung cancer (SCLC). Evidence for PCI in limited-stage SCLC largely derives from studies requiring only chest x-ray (CXR) to determine remission status. We analyzed thoracic chemoradiation therapy (TCRT) outcomes according to imaging modality to determine which patients benefitted most from PCI.

Patients and Methods

All limited-stage SCLC patients who received TCRT as well as PCI at our institution were reviewed. Imaging between TCRT end and PCI start was characterized as complete (CR), partial (PR), or other response.

Results

Thirty-eight consecutive patients were assessed for TCRT response before PCI with CXR (n = 21), chest computed tomography (CT; n = 27), and/or positron emission tomography (PET)/CT (n = 11). CR was identified on 71% of CXRs, 41% of CT scans, and 18% of PET/CT scans. Median survival was 28.3 months for the entire cohort and did not differ for patients who had CXR alone versus CT and/or PET/CT for restaging (P = .78) or those with PR using any modality versus CR using all modalities (22.6 months vs. 45.5 months; P = .22). CT CR patients had numerical but not statistically significant improved 2-year (P = .18) and 3-year (P = .13) survival compared with CT PR.

Conclusion

CXR remains an appropriate modality to assess TCRT response before PCI in limited-stage SCLC. Advanced imaging did not inform the decision to offer PCI in this study. Because of similar excellent survival profiles independent of imaging modality and TCRT response, this analysis suggests limited-stage SCLC patients with PR using any modality should not be denied PCI, akin to standards for extensive-stage SCLC.  相似文献   
904.

Background

E-cadherin and vimentin are regarded as major conventional canonical markers of the epithelial–mesenchymal transition. It is commonly assumed that E-cadherin is uniformly lost during the process of epithelial–mesenchymal transition. Breast tumor cells typically invade as a cohesive multicellular unit in a process called collective invasion. The aim of this study was to reveal the clinical importance of the expression pattern of E-cadherin and vimentin in breast cancer.

Methods

E-cadherin and vimentin protein expression was evaluated by immunohistochemistry in 176 invasive breast cancer samples. Among these, E-cadherin and vimentin expression were evaluated in the set of primary site and metastatic lymph nodes in 65 cases. In addition, E-cadherin and vimentin expression were analyzed by confocal laser scanning microscopy to see E-cadherin and vimentin localization in the breast cancer cells.

Results

Both at the primary site and metastatic lymph nodes, both E-cadherin– and vimentin-positive tumors had the worst disease-free and overall survival among all cases. In addition, E-cadherin and vimentin protein is colocalized within the same tumor cells in a human breast cancer specimen.

Conclusion

Our present data suggest the existence of an aggressive subpopulation in the primary tumor nest of breast cancer.  相似文献   
905.
Partial segmental thrombosis of the corpus cavernosum is an unusual clinical condition of unknown origin that mainly affects young males, whose characteristic presentation is the appearance of unexplained perineal pain associated with a palpable perineal mass. This entity consists of thrombosis in the perineal portion of the corpus cavernosum, usually unilateral and it is associated with underlying malignant pathologies and predisposing factors such as microtrauma. After the adequate adherence to conservative treatment, the appearance of complications such as erectile dysfunction is very uncommon.  相似文献   
906.

Objective

To develop criteria for safe and oncologically satisfying liver resection in case of early hepatocellular carcinoma with a 5-year overall survival (OS) similar to liver transplantation.

Summary background data

Liver resection (LR) and liver transplantation (LT) are potentially curative treatment options for hepatocellular carcinoma. Generally, LT achieves better OS. Due to organ shortage, however not all patients can receive a LT.

Methods

To decide which patients to resect and which to transplant we have developed biological resection criteria (BRC) as a compound out of mGPS (modified Glascow Prognostic Scale) and the Kings-Score (for HCV cirrhosis). These are based on routine clinical values that reflect both liver function and tumor biology/immunology.

Results

276 patients were analyzed. Patients undergoing LR within BRC (inBRC) had a significantly better overall (73.6% vs. 35.4%, (p?<?0.001)) and disease-free survival (54.7% vs. 17.2%, (p?<?0.001)) as compared to patients outside the BRC (outBRC). The predictive value of BRC was independent of tumor burden. In a subgroup analysis outBRC patients had significantly worse outcome after major resection. In LT patients BRC had no predictive value.

Conclusions

BRC may be a valuable tool to predict survival after LR for HCC. Patients resected inBRC may achieve comparable survival as LT. LR in outBRC patients are unlikely to be curative. All outBRC patients should be monitored closely for salvage LT.  相似文献   
907.
目的 :探讨应用梨状窝粘膜修复喉部分切除术后粘膜缺损及恢复喉功能的效果。方法 :对 198例患者施行此术式 ,其中喉水平部分切除术 87例、喉垂直部分或扩大喉垂直部分切除术 6 5例、喉水平加垂直部分切除术 4 6例。同时进行随访观察。结果 :喉水平部分切除术者拔管率为 10 0 % ;术后发音、呼吸、吞咽功能恢复好 ;5年生存率为 84 .7%。喉垂直部分或扩大喉垂直部分切除术拔管率为 87.7% ;5年生存率 86 .2 % ;术后吞咽、呼吸功能恢复好 ,但有声音嘶哑。喉水平加垂直部分切除术后初期进食呛咳较重 ,训练适应时间较长 ,拔管率为82 .6 % ;5年生存率为 78.3% ;术后声音嘶哑 ,部分患者喉狭窄导致拔管困难。结论 :本方法操作简单 ,取材方便 ,手术时间较短 ,成活率高 ,术后喉功能保留好 ,患者的 5年生存率高。  相似文献   
908.
在总结现有各种软测量技术的基础上,指出统计分析方法中的部分最小二乘法和神经网络方法中的径向基函数网络,是经实际应用证明有效的方法。提出了一种将PLS和RBFN结合的方法,并将PLS,RBFN,PLS-RBFN3种算法分别用于加氢裂化分馏塔航煤点软测量模型的建立,其泛化结果表明基于PL-SRBFN算法建立的软测量模型具有更好的预测精度。  相似文献   
909.
为探讨不同配方胃肠外营养支持对肝部分切除术后肝再生的影响及其机理,将大鼠随机分为4组, A 组正常切肝后用强化支链氨基酸胃肠外营养(强化 B C A A T P N)治疗; B组正常肝切除后用标准胃肠外营养(标准 T P N)治疗; C、 D组制成肝硬化模型后切肝和营养支持分别同 A、 B组;术后第三天处死动物测定肝再生情况。结果:肝 D N A 合成率和有丝分裂率在 A、 B组分别显著高于 C、 D组;肝再生率、 D N A 合成率及有丝分裂率在 A、 C组分别显著高于 B、 D组。以上提示:切肝后在相同胃肠外营养支持下硬化肝再生较正常肝差;在强化 B C A A T P N 支持下正常肝和硬化肝的再生均优于标准 T P N 支持  相似文献   
910.
目的:为降低后腹腔镜入路的腹侧肾部分切除术手术难度,减少手术风险,总结归纳并发展后腹腔镜入路肾部分切除术的肾蒂旋转法及相关技术。方法:总结归纳并发展一整套针对腹侧肾门区肾肿瘤的肾蒂旋转法操作技术,包括肾蒂旋转、双层缝合、早期开放动脉等。该技术有助于实施后腹腔入路的肾部分切除术,手术效果的评价由手术时间、热缺血时间、术中出血量、手术切缘、术后肾功能、手术并发症等组成。本研究回顾性分析中南大学湘雅医院28例腹侧肾肿瘤患者资料,其中15例为较复杂的肾门区肿瘤。结果:平均肿瘤大小为(3.8±0.5) cm,平均R.E.N.A.L评分为8(范围7~9)。手术中平均热缺血时间(23.8±4.7) min,缝合时间(26.2±6.5) min,估计失血量(139.1±54.0) mL,手术时间(124.1±12.1) min,中位住院天数为4 d。7例患者出现Clavien Dindo Ⅰ~Ⅱ级并发症,所有患者病理检查均示切缘阴性,中位随访7个月无局部复发或远处转移。结论:对于腹侧肾肿瘤,尤其是位于肾门区的肾肿瘤,利用肾蒂旋转法行后腹腔镜下肾部分切除术是安全有效的;短时间随访结果较乐观,但需长时间随访。  相似文献   
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