AIM To investigate the clinical significance of preoperative systemic immune-inflammation index(SII) in patients with colorectal cancer(CRC). METHODS A retrospective analysis of 1383 cases with CRC was performed follo...AIM To investigate the clinical significance of preoperative systemic immune-inflammation index(SII) in patients with colorectal cancer(CRC). METHODS A retrospective analysis of 1383 cases with CRC was performed following radical surgery. SII was calculated with the formula SII =(P × N)/L, where P, N, and L refer to peripheral platelet, neutrophil, and lymphocyte counts, respectively. The clinicopathological features and follow-up data were evaluated to compare SII with other systemic inflammation-based prognostic indices such as the neutrophil-lymphocyte ratio(NLR) and platelet-lymphocyte ratio(PLR) in patients with CRC.RESULTS The optimal cut-off point for SII was defined as 340. The overall survival(OS) and disease-free survival(DFS) were better in patients with low NLR, PLR, and SII(P < 0.05). The SII was an independent predictor of OS and DFS in multivariate analysis. The area under the receiver-operating characteristics(ROC) curve for SII(0.707) was larger than those for NLR(0.602) and PLR(0.566). In contrast to NLR and PLR, SII could effectively discriminate between the TNM subgroups. CONCLUSION SII is a more powerful tool for predicting survival outcome in patients with CRC. It might assist the identification of high-risk patients among patients with the same TNM stage.展开更多
AIM: To assess the prognostic significance of immunological and nutritional-based indices, including the prognostic nutritional index(PNI), neutrophillymphocyte ratio(NLR), and platelet-lymphocyte ratio in gastric can...AIM: To assess the prognostic significance of immunological and nutritional-based indices, including the prognostic nutritional index(PNI), neutrophillymphocyte ratio(NLR), and platelet-lymphocyte ratio in gastric cancer.METHODS: We retrospectively reviewed 632 gastric cancer patients who underwent gastrectomy between1998 and 2008. Areas under the receiver operating characteristic curve were calculated to compare the predictive ability of the indices, together with estimating the sensitivity, specificity and agreement rate.Univariate and multivariate analyses were performed to identify risk factors for overall survival(OS). Propensity score analysis was performed to adjust variables to control for selection bias.RESULTS: Each index could predict OS in gastric cancer patients in univariate analysis, but only PNI had independent prognostic significance in multivariate analysis before and after adjustment with propensity scoring(hazard ratio, 1.668; 95% confidence interval:1.368-2.035). In subgroup analysis, a low PNI predicted a significantly shorter OS in patients with stage Ⅱ-Ⅲ disease(P = 0.019, P < 0.001), T3-T4 tumors(P <0.001), or lymph node metastasis(P < 0.001). Canton score, a combination of PNI, NLR, and platelet, was a better indicator for OS than PNI, with the largest area under the curve for 12-, 36-, 60-mo OS and overall OS(P = 0.022, P = 0.030, P < 0.001, and P = 0.024,respectively). The maximum sensitivity, specificity, and agreement rate of Canton score for predicting prognosis were 84.6%, 34.9%, and 70.1%, respectively.CONCLUSION: PNI is an independent prognostic factor for OS in gastric cancer. Canton score can be a novel preoperative prognostic index in gastric cancer.展开更多
AIM:To investigate the clinicopathological features of gastric carcinoma in southern China and disease trends changes over the last 18 years.METHODS:We designed a retrospective study in the Department of Gastrointesti...AIM:To investigate the clinicopathological features of gastric carcinoma in southern China and disease trends changes over the last 18 years.METHODS:We designed a retrospective study in the Department of Gastrointestinal Surgery,the first affiliated hospital,Sun Yat-sen University.A total of 2100adult patients with definitely diagnosed,histologically proven gastric carcinomas treated with radical gastrectomy from 1994 to 2013 were examined retrospectively.In all cases patient age,gender,tumor location,Borrmann type,histopathological type and grade,and pTNM stage were identified and recorded.The information was obtained from hospital records.The data were analyzed with Stata12.0 software.RESULTS:In this study,the mean age of patients was 57 years with a range from 19-89 years.A higher incidence was found in patients over 60 years of age.In the study population,67.38%of patients were male and 32.62%were female.Women had a higher disease incidence than men in patients less than 40 years of age(P<0.001).No obvious change of patient age and gender was observed in the last 18 years.The rates of disease by location were the following:antrum(44.57%),followed by fundus/body(24.95%)and cardia/gastroesophageal junction(23.00%).The mean tumor diameter was 5.57 cm,and advanced gross type BorrmannⅢwas most common.Most patients were at advanced stages when first diagnosed,and patients with early stage disease were relatively rare.More early stage patients were detected in recent years,especially after 2000(P<0.001).Gastric carcinoma has different features in young and old patients.The young patients had the following features:more frequently female,tumors in the antrum,larger tumor size,poorly differentiated carcinoma,high rate of metastasis to other sites and advanced stages(P<0.05).CONCLUSION:In southern China,gastric carcinoma was more frequent in old men and young women.Young and old patients should be treated differently for having different features.展开更多
AIM: To explore the relationship between metastasis and vagina vasorum in the progress of gastric carcinoma and to find some facts and references for gastric surgeons. METHODS: One hundred and seven specimens of left ...AIM: To explore the relationship between metastasis and vagina vasorum in the progress of gastric carcinoma and to find some facts and references for gastric surgeons. METHODS: One hundred and seven specimens of left or right gastric arteries (55 left and 52 right) were gathered from 59 patients undergoing radical gastrectomy for gastric carcinoma. All the frozen specimens were cut into 3 μm-thick sections and stained with hematoxylin-eosin (HE) and immunohistochemical method separately. Cytokeratin (CK) and mesothelial cells (MC) were stained with immunohistochemical method. Cancer cells inside vagina vasorum were detected and the structure of artery wall was observed under microscope. RESULTS: Metastatic cancer cells or tubercles were found inside vagina vasorum in some stage Ⅲ or Ⅳ specimens, but not in stageⅠor Ⅱ specimens. Tumor cells in vagina vasorum were CK positive in 26 specimens of 14 tumors. Among them, stage Ⅲ was found in 4 specimens of 2 tumors, and stage Ⅳ in 22 specimens of 12 tumors. None of these specimens was positive for MC. The positive rate of CK increased with TNM staging. Compared with the lower part, tumors in the upper and middle parts of stomach were more likely to metastasize into vagina vasorum. CONCLUSION: Vagina vasorum dissection should be performed during D2 lymphadenectomy for TNM stage Ⅲ or Ⅳ gastric carcinoma.展开更多
基金Sponsored by National Natural Science Foundation of China(51605145)the Experimental Technology Development Fund Project of Henan University of Science and Technology(SY1718003)~~
基金Supported by National Nature Science Foundation of China,No.81672343 and No.81372341Guangdong Province Natural Science Fund of China,No.2014A030310111Guangdong Science and Technology Plan Project of China,No.2013B021800131and No.201604020003
文摘AIM To investigate the clinical significance of preoperative systemic immune-inflammation index(SII) in patients with colorectal cancer(CRC). METHODS A retrospective analysis of 1383 cases with CRC was performed following radical surgery. SII was calculated with the formula SII =(P × N)/L, where P, N, and L refer to peripheral platelet, neutrophil, and lymphocyte counts, respectively. The clinicopathological features and follow-up data were evaluated to compare SII with other systemic inflammation-based prognostic indices such as the neutrophil-lymphocyte ratio(NLR) and platelet-lymphocyte ratio(PLR) in patients with CRC.RESULTS The optimal cut-off point for SII was defined as 340. The overall survival(OS) and disease-free survival(DFS) were better in patients with low NLR, PLR, and SII(P < 0.05). The SII was an independent predictor of OS and DFS in multivariate analysis. The area under the receiver-operating characteristics(ROC) curve for SII(0.707) was larger than those for NLR(0.602) and PLR(0.566). In contrast to NLR and PLR, SII could effectively discriminate between the TNM subgroups. CONCLUSION SII is a more powerful tool for predicting survival outcome in patients with CRC. It might assist the identification of high-risk patients among patients with the same TNM stage.
基金Supported by National Natural Science Foundation of China,Nos.81101865 and 81272637Doctoral Fund of the Ministry of Education of China,No.20110171120064+1 种基金Natural Science Foundation of Guangdong Province,No.S2013020012724Clinical Medicine Research Project 5010 of Sun Yat-sen University,No.2010006
文摘AIM: To assess the prognostic significance of immunological and nutritional-based indices, including the prognostic nutritional index(PNI), neutrophillymphocyte ratio(NLR), and platelet-lymphocyte ratio in gastric cancer.METHODS: We retrospectively reviewed 632 gastric cancer patients who underwent gastrectomy between1998 and 2008. Areas under the receiver operating characteristic curve were calculated to compare the predictive ability of the indices, together with estimating the sensitivity, specificity and agreement rate.Univariate and multivariate analyses were performed to identify risk factors for overall survival(OS). Propensity score analysis was performed to adjust variables to control for selection bias.RESULTS: Each index could predict OS in gastric cancer patients in univariate analysis, but only PNI had independent prognostic significance in multivariate analysis before and after adjustment with propensity scoring(hazard ratio, 1.668; 95% confidence interval:1.368-2.035). In subgroup analysis, a low PNI predicted a significantly shorter OS in patients with stage Ⅱ-Ⅲ disease(P = 0.019, P < 0.001), T3-T4 tumors(P <0.001), or lymph node metastasis(P < 0.001). Canton score, a combination of PNI, NLR, and platelet, was a better indicator for OS than PNI, with the largest area under the curve for 12-, 36-, 60-mo OS and overall OS(P = 0.022, P = 0.030, P < 0.001, and P = 0.024,respectively). The maximum sensitivity, specificity, and agreement rate of Canton score for predicting prognosis were 84.6%, 34.9%, and 70.1%, respectively.CONCLUSION: PNI is an independent prognostic factor for OS in gastric cancer. Canton score can be a novel preoperative prognostic index in gastric cancer.
文摘AIM:To investigate the clinicopathological features of gastric carcinoma in southern China and disease trends changes over the last 18 years.METHODS:We designed a retrospective study in the Department of Gastrointestinal Surgery,the first affiliated hospital,Sun Yat-sen University.A total of 2100adult patients with definitely diagnosed,histologically proven gastric carcinomas treated with radical gastrectomy from 1994 to 2013 were examined retrospectively.In all cases patient age,gender,tumor location,Borrmann type,histopathological type and grade,and pTNM stage were identified and recorded.The information was obtained from hospital records.The data were analyzed with Stata12.0 software.RESULTS:In this study,the mean age of patients was 57 years with a range from 19-89 years.A higher incidence was found in patients over 60 years of age.In the study population,67.38%of patients were male and 32.62%were female.Women had a higher disease incidence than men in patients less than 40 years of age(P<0.001).No obvious change of patient age and gender was observed in the last 18 years.The rates of disease by location were the following:antrum(44.57%),followed by fundus/body(24.95%)and cardia/gastroesophageal junction(23.00%).The mean tumor diameter was 5.57 cm,and advanced gross type BorrmannⅢwas most common.Most patients were at advanced stages when first diagnosed,and patients with early stage disease were relatively rare.More early stage patients were detected in recent years,especially after 2000(P<0.001).Gastric carcinoma has different features in young and old patients.The young patients had the following features:more frequently female,tumors in the antrum,larger tumor size,poorly differentiated carcinoma,high rate of metastasis to other sites and advanced stages(P<0.05).CONCLUSION:In southern China,gastric carcinoma was more frequent in old men and young women.Young and old patients should be treated differently for having different features.
文摘AIM: To explore the relationship between metastasis and vagina vasorum in the progress of gastric carcinoma and to find some facts and references for gastric surgeons. METHODS: One hundred and seven specimens of left or right gastric arteries (55 left and 52 right) were gathered from 59 patients undergoing radical gastrectomy for gastric carcinoma. All the frozen specimens were cut into 3 μm-thick sections and stained with hematoxylin-eosin (HE) and immunohistochemical method separately. Cytokeratin (CK) and mesothelial cells (MC) were stained with immunohistochemical method. Cancer cells inside vagina vasorum were detected and the structure of artery wall was observed under microscope. RESULTS: Metastatic cancer cells or tubercles were found inside vagina vasorum in some stage Ⅲ or Ⅳ specimens, but not in stageⅠor Ⅱ specimens. Tumor cells in vagina vasorum were CK positive in 26 specimens of 14 tumors. Among them, stage Ⅲ was found in 4 specimens of 2 tumors, and stage Ⅳ in 22 specimens of 12 tumors. None of these specimens was positive for MC. The positive rate of CK increased with TNM staging. Compared with the lower part, tumors in the upper and middle parts of stomach were more likely to metastasize into vagina vasorum. CONCLUSION: Vagina vasorum dissection should be performed during D2 lymphadenectomy for TNM stage Ⅲ or Ⅳ gastric carcinoma.
