BACKGROUND Microvascular invasion(MVI)is a critical prognostic factor for postoperative hepatocellular carcinoma recurrence,but the reliability of its current pathological diagnosis remains uncertain.AIM To evaluate t...BACKGROUND Microvascular invasion(MVI)is a critical prognostic factor for postoperative hepatocellular carcinoma recurrence,but the reliability of its current pathological diagnosis remains uncertain.AIM To evaluate the accuracy of current 7-point sampling methods and propose an optimal pathological protocol using whole-mount slide imaging(WSI)for better MVI detection.METHODS We utilized 40 New Zealand white rabbits to establish VX2 liver tumor models.The entire tumor-containing liver lobe was subsequently obtained,following which five different sampling protocols(A-E)were employed to evaluate the detection rate,accuracy,quantity,and distribution of MVI,with the aim of identifying the optimal sampling method.RESULTS VX2 liver tumor models were successfully established in 37 rabbits,with an incidence of MVI of 81.1%(30/37).The detection rates[27%(10/37),43%(16/37),62%(23/37),68%(25/37),and 93%(14/15)]and quantity(15,36,107,125,and 395)of MVI increased significantly from protocols A to E.The distribution of MVI showed fewer MVIs farther away from the tumor,but the percentage of MVI detected quantity gradually increased from 6.7%to 48.3%in the distant nonneoplastic liver tissue from protocols A to E.Protocol C was identified as the optimal sampling method by comparing them in sequence.The sampling protocol of three consecutive interval WSIs at the tumor center(WSI3)was further screened to determine the optimal number of WSIs.Protocol A(7-point sampling method)exhibited only 46%accuracy and a high false-negative rate of 67%.Notably,the WSI3 protocol improved the accuracy to 78%and decreased the false-negative rate to 27%.CONCLUSION The current 7-point sampling method has a high false-negative rate in MVI detection.In contrast,the WSI3 protocol provides a practical and effective approach to improve MVI diagnostic accuracy,which is crucial for hepatocellular carcinoma diagnosis and treatment planning.展开更多
目的:探究纳米炭在单孔腹腔镜经肛全直肠系膜切除术治疗低位直肠癌中的应用效果。方法:行单孔腹腔镜经肛全直肠系膜切除术患者96例,随机分为观察组(术前给予纳米炭混悬注射液)与对照组,每组48例。术后记录清扫的淋巴结数目,检测其中的...目的:探究纳米炭在单孔腹腔镜经肛全直肠系膜切除术治疗低位直肠癌中的应用效果。方法:行单孔腹腔镜经肛全直肠系膜切除术患者96例,随机分为观察组(术前给予纳米炭混悬注射液)与对照组,每组48例。术后记录清扫的淋巴结数目,检测其中的黑染淋巴结数目,并行病理检测明确各淋巴结发生转移情况。结果:观察组检获淋巴结平均数目(18.46±3.52 vs 10.63±1.95)明显多于对照组(P<0.05)。观察组检出淋巴结发生转移率(12.19%)高于对照组(9.41%)(P>0.05)。黑染类淋巴结发生转移率(88/611,14.40%)明显高于未黑染(20/275,6.18%)与对照组(48/510,9.41%)(χ^(2)=9.007、6.495,P=0.003、0.011)。结论:术前应用纳米活性炭混悬注射液,能够提高行单孔腹腔镜经肛全直肠系膜切除术患者淋巴结检获数目以及转移淋巴结检出率,可确保病理分期的准确性,在直肠癌临床治疗方面具有指导意义。展开更多
基金Supported by the National Natural Science Foundation of China,No.82072038 and No.82371975.
文摘BACKGROUND Microvascular invasion(MVI)is a critical prognostic factor for postoperative hepatocellular carcinoma recurrence,but the reliability of its current pathological diagnosis remains uncertain.AIM To evaluate the accuracy of current 7-point sampling methods and propose an optimal pathological protocol using whole-mount slide imaging(WSI)for better MVI detection.METHODS We utilized 40 New Zealand white rabbits to establish VX2 liver tumor models.The entire tumor-containing liver lobe was subsequently obtained,following which five different sampling protocols(A-E)were employed to evaluate the detection rate,accuracy,quantity,and distribution of MVI,with the aim of identifying the optimal sampling method.RESULTS VX2 liver tumor models were successfully established in 37 rabbits,with an incidence of MVI of 81.1%(30/37).The detection rates[27%(10/37),43%(16/37),62%(23/37),68%(25/37),and 93%(14/15)]and quantity(15,36,107,125,and 395)of MVI increased significantly from protocols A to E.The distribution of MVI showed fewer MVIs farther away from the tumor,but the percentage of MVI detected quantity gradually increased from 6.7%to 48.3%in the distant nonneoplastic liver tissue from protocols A to E.Protocol C was identified as the optimal sampling method by comparing them in sequence.The sampling protocol of three consecutive interval WSIs at the tumor center(WSI3)was further screened to determine the optimal number of WSIs.Protocol A(7-point sampling method)exhibited only 46%accuracy and a high false-negative rate of 67%.Notably,the WSI3 protocol improved the accuracy to 78%and decreased the false-negative rate to 27%.CONCLUSION The current 7-point sampling method has a high false-negative rate in MVI detection.In contrast,the WSI3 protocol provides a practical and effective approach to improve MVI diagnostic accuracy,which is crucial for hepatocellular carcinoma diagnosis and treatment planning.
文摘目的:探究纳米炭在单孔腹腔镜经肛全直肠系膜切除术治疗低位直肠癌中的应用效果。方法:行单孔腹腔镜经肛全直肠系膜切除术患者96例,随机分为观察组(术前给予纳米炭混悬注射液)与对照组,每组48例。术后记录清扫的淋巴结数目,检测其中的黑染淋巴结数目,并行病理检测明确各淋巴结发生转移情况。结果:观察组检获淋巴结平均数目(18.46±3.52 vs 10.63±1.95)明显多于对照组(P<0.05)。观察组检出淋巴结发生转移率(12.19%)高于对照组(9.41%)(P>0.05)。黑染类淋巴结发生转移率(88/611,14.40%)明显高于未黑染(20/275,6.18%)与对照组(48/510,9.41%)(χ^(2)=9.007、6.495,P=0.003、0.011)。结论:术前应用纳米活性炭混悬注射液,能够提高行单孔腹腔镜经肛全直肠系膜切除术患者淋巴结检获数目以及转移淋巴结检出率,可确保病理分期的准确性,在直肠癌临床治疗方面具有指导意义。
