BACKGROUND Endoscopy has rapidly developed in recent years and has enabled further investigation into the origin and features of intestinal tumors.The small size and concealed position of these tumors make it difficul...BACKGROUND Endoscopy has rapidly developed in recent years and has enabled further investigation into the origin and features of intestinal tumors.The small size and concealed position of these tumors make it difficult to distinguish them from nonneoplastic polyps and carcinoma in adenoma(CIA).The invasive depth and metastatic potential determine the operation regimen,which in turn affects the overall survival and distant prognosis.The previous studies have confirmed the malignant features and clinicopathological features of de novo colorectal cancer(CRC).AIM To provide assistance for diagnosis and treatment,but the lack of a summary of endoscopic features and assessment of risk factors that differ from the CIA prompted us to conduct this retrospective study.METHODS In total,167 patients with small-sized CRCs diagnosed by endoscopy were reviewed.The patients diagnosed as advanced CRCs and other malignant cancers or chronic diseases that could affect distant outcomes were excluded.After screening,63 cases were excluded,including 33 de novo and 30 CIA cases.Patient information,including their follow-up information,was obtained from an electronic His-system.The characteristics between two group and risk factors for invasion depth were analyzed with SPSS 25.0 software.RESULTS Nearly half of the de novo CRCs were smaller than 1 cm(n=16,48.5%)and the majority were located in the distal colon(n=26,78.8%).The IIc type was the most common macroscopic type of de novo CRC.In a Pearson analysis,the differential degree,Sano,JNET,and Kudo types,surrounding mucosa,and chicken skin mucosa(CSM)were correlated with the invasion depth(P<0.001).CSM was a significant risk factor for deep invasion and disturbed judgment of endoscopic ultrasound.A high degree of tumor budding and tumor-infiltrating lymphocytes are accompanied by malignancy.Finally,de novo CRCs have worse outcomes than CIA CRCs.CONCLUSION This is the first comprehensive study to analyze the features of de novo CRCs to distinguish them from nonneoplastic polyps.It is also the first study paying attention to CSM invasive depth measurement.This study emphasizes the high metastatic potential of de novo CRCs and highlights the need for more research on this tumor type.展开更多
BACKGROUND: The clinical manifestations of Wernicke encephalopathy(WE) are atypical and short of effective auxiliary examination means. The effects of magnetic resonance imaging (MRI) in the diagnosis of WE have been ...BACKGROUND: The clinical manifestations of Wernicke encephalopathy(WE) are atypical and short of effective auxiliary examination means. The effects of magnetic resonance imaging (MRI) in the diagnosis of WE have been reported successively. But its imageological detection needs to be further investigated. OBJECTIVE: To analyze the characteristics of clinical manifestations, skull MRI examination and pathological results in patients with WE. DESIGN: Retrospective analysis. SETTING: The General Hospital of Chinese PLA. PARTICIPANTS: Ten patients of WE admitted to the Department of Neurology, General Hospital of Chinese PLA were recruited. Among them, five patients were diagnosed pathologically after death. Their pathological changes accorded with the pathological characteristics of WE. The other 5 patients were diagnosed clinically before death. Their pathological changes accorded with clinical and imageological manifestations and had definite reaction to the treatment of thiamine. Ten patients, 7 males and 3 females, were aged (47±13) years ranging from 33 to 73 years. Their disease courses averaged 6 weeks ranging from 3 to 10 weeks. They all were non-alcoholics. Four patients developed WE after acute pancreatitis, two patients after the recurrence of gastric cancer, two patients after cholecystectomy, one patient after hepatitis medicamentosa, one patient after Alzheimer disease. Informed consents were obtained from all the patients and their relatives. METHODS: After admission, clinical manifestations of patients were observed and recorded. Five patients underwent skull MRI examination and their detected results were recorded. Five dead patients underwent autopsy and brain pathological examinations. Neuropathological examination involved cerebrum, cerebellum and brain stem. MAIN OUTCOME MEASURES: Clinical manifestations, MRI examination results, pathological analysis results and prognosis of all the patients. RESULTS: Ten patients with WE were involved in the final analysis. ①Nine patients presented various degrees of mental and conscious disturbance. Six patients initially presented vertigo, nausea, and vomiting. Five patients showed opthalmoplegia. Three patients presented hypotension (BP < 120/60 mm Hg, 1 mm Hg= 0.133 kPa). Two patients showed ataxia. One patient showed severe polyneuropathy. Both lower extremities were more severe. EMG showed axonal degeneration. ②Five patients accepted skull MRI examination. Three patients showed typical high signals in periaqueductal regions and circumference of third and fourth ventriculus in T2 -weighted and flair-weighted images, two of them showed high signals in fornixes in T2 -weighted and flair-weighted images, and one of them showed high signals in optic chiasma, both mammillary bodies, and subcortical white matter. No abnormality was found in the other two patients. Two patients who accepted the supplements of thiamine showed obviously improvements in the second MRI examination. ③Macroscopically, the border between gray and white matters was clear in the coronal section of cerebrum. Congestions, edema and multiple petechial hemorrhages were found in periaqueductal regions, circumference of third and fourth ventriculus, and both mammillary bodies. Microscopically, various degrees of necrosis of parenchymal structures, loss of nerve cells and ischemic changes were found. Myelinated fibers were more affected than neurons. There were focal capillary proliferation and multiple petechial hemorrhages. Prominent astrocytic proliferations were found in gelatinous fiber staining. And demyelinations were found in myelin staining. These pathological findings were all in accord with the diagnostic criteria of WE. ④In the diagnosis before death, 4 of 5 patients who were supplemented with thiamine had obvious improvement 2 weeks later and 1 of them abandoned therapy due to progressive aggravation of jaundice caused by recurrence of stomach cancer. The other 5 patients who were not diagnosed definitely before death and not supplemented with thiamine died. Final diagnosis was performed in autopsy examination. CONCLUSION: The clinical manifestations of this group of WE patients are atypical. MRI and pathological examination results are corresponding, and both have the characteristic manifestations of WE.展开更多
Objective: The aim of this study was to determine whether the presence of IL-18 polymorphisms -137 G/C and -607 A/C was associated with grade, clinical stage, and survival in patients with prostate cancer. Methods: Th...Objective: The aim of this study was to determine whether the presence of IL-18 polymorphisms -137 G/C and -607 A/C was associated with grade, clinical stage, and survival in patients with prostate cancer. Methods: The study cohort included 126 patients with prostate cancer. Control group consisted of 125 samples from Chinese population. Genomic DNA was extracted from EDTA-anticoagulated peripheral blood leukocytes by the salting-out method. The genotyping of the two IL-18 polymorphisms was performed using predesigned TaqMan SNP Genotyping Assays. Results: The studied IL-18 gene polymorphisms did not influence susceptibility to prostate cancer in the analyzed group of patients (IL-18-607, P = 0.342; IL-18-137 P = 0.715) but may contribute to disease onset and aggressiveness. IL-18-607 CC genotype was significantly associated with higher tumor grade (P = 0.025) and stage (P = 0.001). IL-18-137 GG genotype was correlated with higher tumor grade (P = 0.018) and stage (P = 0.007). The Cox proportional hazard model showed that tuumor grade and stage grouping were independent prognostic factors but IL-18 polymorphism was not. Polymorphism variants in the IL-18 gene (IL-18-607 and IL-18-137) may be associated with a worse prognosis for prostate cancer. Conclusion: High levels of IL-18 production may play a major role in the growth, invasion and metastasis of prostate cancer.展开更多
Objective:To investigate clinic pathological peculiarities and evaluate the prognosis of metaplastic breast carcinoma.Methods:Patients with metaplastic breast carcinoma at the First Affiliated Hospital of Zhejiang Uni...Objective:To investigate clinic pathological peculiarities and evaluate the prognosis of metaplastic breast carcinoma.Methods:Patients with metaplastic breast carcinoma at the First Affiliated Hospital of Zhejiang University and Guangxing Hospital Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine from 2008 to 2013 were retrospectively selected.Results:A total of 73 female patients were reviewed,including 41 cases of purely epithelial type and 32 cases of mixed epithelial and mesenchymal type.Median tumor size was 4.6cm.Forty-three patients(58.8%)presented with lymph node metastasis,84.9%of cases were in advanced TNM stage,and 60.2%of cases were overexpressed by Ki-67.At a median follow-up of 59 months,median overall survival and disease-free survival were 59.7 and 43.9 months,respectively.Five-year overall survival rate was 45.2%and disease-free survival rate was 30.1%,and 76.7%of patients had recurrence or metastasis.Univariate analysis showed that tumor size,lymph node,and radiotherapy were associated with overall survival and disease-free survival(P<0.05),while Ki-67 over-expression was correlated with overall survival(P<0.05).With multivariate analysis,tumor size,lymph node,and radiotherapy affected prognosis(P<0.05);however,pathological typing was not an independent prognostic factor(P>0.05).Conclusion:Metaplastic breast carcinoma is a rare malignant tumor with large tumor,high lymph node metastasis rate,staging relatively late,high local recurrence and distant metastasis rate.The treatment follows the principle of comprehensive treatment based on surgery,but the prognosis is poor.Tumor size,lymph node,and radiotherapy treatment affect the prognosis.Overexpression of Ki-67 can be used as a potential diagnostic,therapeutic and prognostic indicator for metaplastic breast cancer.展开更多
基金Natural Science Foundation of Liaoning Province,China,No.2022-YGJC-71
文摘BACKGROUND Endoscopy has rapidly developed in recent years and has enabled further investigation into the origin and features of intestinal tumors.The small size and concealed position of these tumors make it difficult to distinguish them from nonneoplastic polyps and carcinoma in adenoma(CIA).The invasive depth and metastatic potential determine the operation regimen,which in turn affects the overall survival and distant prognosis.The previous studies have confirmed the malignant features and clinicopathological features of de novo colorectal cancer(CRC).AIM To provide assistance for diagnosis and treatment,but the lack of a summary of endoscopic features and assessment of risk factors that differ from the CIA prompted us to conduct this retrospective study.METHODS In total,167 patients with small-sized CRCs diagnosed by endoscopy were reviewed.The patients diagnosed as advanced CRCs and other malignant cancers or chronic diseases that could affect distant outcomes were excluded.After screening,63 cases were excluded,including 33 de novo and 30 CIA cases.Patient information,including their follow-up information,was obtained from an electronic His-system.The characteristics between two group and risk factors for invasion depth were analyzed with SPSS 25.0 software.RESULTS Nearly half of the de novo CRCs were smaller than 1 cm(n=16,48.5%)and the majority were located in the distal colon(n=26,78.8%).The IIc type was the most common macroscopic type of de novo CRC.In a Pearson analysis,the differential degree,Sano,JNET,and Kudo types,surrounding mucosa,and chicken skin mucosa(CSM)were correlated with the invasion depth(P<0.001).CSM was a significant risk factor for deep invasion and disturbed judgment of endoscopic ultrasound.A high degree of tumor budding and tumor-infiltrating lymphocytes are accompanied by malignancy.Finally,de novo CRCs have worse outcomes than CIA CRCs.CONCLUSION This is the first comprehensive study to analyze the features of de novo CRCs to distinguish them from nonneoplastic polyps.It is also the first study paying attention to CSM invasive depth measurement.This study emphasizes the high metastatic potential of de novo CRCs and highlights the need for more research on this tumor type.
文摘BACKGROUND: The clinical manifestations of Wernicke encephalopathy(WE) are atypical and short of effective auxiliary examination means. The effects of magnetic resonance imaging (MRI) in the diagnosis of WE have been reported successively. But its imageological detection needs to be further investigated. OBJECTIVE: To analyze the characteristics of clinical manifestations, skull MRI examination and pathological results in patients with WE. DESIGN: Retrospective analysis. SETTING: The General Hospital of Chinese PLA. PARTICIPANTS: Ten patients of WE admitted to the Department of Neurology, General Hospital of Chinese PLA were recruited. Among them, five patients were diagnosed pathologically after death. Their pathological changes accorded with the pathological characteristics of WE. The other 5 patients were diagnosed clinically before death. Their pathological changes accorded with clinical and imageological manifestations and had definite reaction to the treatment of thiamine. Ten patients, 7 males and 3 females, were aged (47±13) years ranging from 33 to 73 years. Their disease courses averaged 6 weeks ranging from 3 to 10 weeks. They all were non-alcoholics. Four patients developed WE after acute pancreatitis, two patients after the recurrence of gastric cancer, two patients after cholecystectomy, one patient after hepatitis medicamentosa, one patient after Alzheimer disease. Informed consents were obtained from all the patients and their relatives. METHODS: After admission, clinical manifestations of patients were observed and recorded. Five patients underwent skull MRI examination and their detected results were recorded. Five dead patients underwent autopsy and brain pathological examinations. Neuropathological examination involved cerebrum, cerebellum and brain stem. MAIN OUTCOME MEASURES: Clinical manifestations, MRI examination results, pathological analysis results and prognosis of all the patients. RESULTS: Ten patients with WE were involved in the final analysis. ①Nine patients presented various degrees of mental and conscious disturbance. Six patients initially presented vertigo, nausea, and vomiting. Five patients showed opthalmoplegia. Three patients presented hypotension (BP < 120/60 mm Hg, 1 mm Hg= 0.133 kPa). Two patients showed ataxia. One patient showed severe polyneuropathy. Both lower extremities were more severe. EMG showed axonal degeneration. ②Five patients accepted skull MRI examination. Three patients showed typical high signals in periaqueductal regions and circumference of third and fourth ventriculus in T2 -weighted and flair-weighted images, two of them showed high signals in fornixes in T2 -weighted and flair-weighted images, and one of them showed high signals in optic chiasma, both mammillary bodies, and subcortical white matter. No abnormality was found in the other two patients. Two patients who accepted the supplements of thiamine showed obviously improvements in the second MRI examination. ③Macroscopically, the border between gray and white matters was clear in the coronal section of cerebrum. Congestions, edema and multiple petechial hemorrhages were found in periaqueductal regions, circumference of third and fourth ventriculus, and both mammillary bodies. Microscopically, various degrees of necrosis of parenchymal structures, loss of nerve cells and ischemic changes were found. Myelinated fibers were more affected than neurons. There were focal capillary proliferation and multiple petechial hemorrhages. Prominent astrocytic proliferations were found in gelatinous fiber staining. And demyelinations were found in myelin staining. These pathological findings were all in accord with the diagnostic criteria of WE. ④In the diagnosis before death, 4 of 5 patients who were supplemented with thiamine had obvious improvement 2 weeks later and 1 of them abandoned therapy due to progressive aggravation of jaundice caused by recurrence of stomach cancer. The other 5 patients who were not diagnosed definitely before death and not supplemented with thiamine died. Final diagnosis was performed in autopsy examination. CONCLUSION: The clinical manifestations of this group of WE patients are atypical. MRI and pathological examination results are corresponding, and both have the characteristic manifestations of WE.
文摘Objective: The aim of this study was to determine whether the presence of IL-18 polymorphisms -137 G/C and -607 A/C was associated with grade, clinical stage, and survival in patients with prostate cancer. Methods: The study cohort included 126 patients with prostate cancer. Control group consisted of 125 samples from Chinese population. Genomic DNA was extracted from EDTA-anticoagulated peripheral blood leukocytes by the salting-out method. The genotyping of the two IL-18 polymorphisms was performed using predesigned TaqMan SNP Genotyping Assays. Results: The studied IL-18 gene polymorphisms did not influence susceptibility to prostate cancer in the analyzed group of patients (IL-18-607, P = 0.342; IL-18-137 P = 0.715) but may contribute to disease onset and aggressiveness. IL-18-607 CC genotype was significantly associated with higher tumor grade (P = 0.025) and stage (P = 0.001). IL-18-137 GG genotype was correlated with higher tumor grade (P = 0.018) and stage (P = 0.007). The Cox proportional hazard model showed that tuumor grade and stage grouping were independent prognostic factors but IL-18 polymorphism was not. Polymorphism variants in the IL-18 gene (IL-18-607 and IL-18-137) may be associated with a worse prognosis for prostate cancer. Conclusion: High levels of IL-18 production may play a major role in the growth, invasion and metastasis of prostate cancer.
基金This study was supported by the Scientific Research Projects of Hainan Provincial Health Department(Gant No:18A20007,13A210331).
文摘Objective:To investigate clinic pathological peculiarities and evaluate the prognosis of metaplastic breast carcinoma.Methods:Patients with metaplastic breast carcinoma at the First Affiliated Hospital of Zhejiang University and Guangxing Hospital Affiliated Hospital of Zhejiang University of Traditional Chinese Medicine from 2008 to 2013 were retrospectively selected.Results:A total of 73 female patients were reviewed,including 41 cases of purely epithelial type and 32 cases of mixed epithelial and mesenchymal type.Median tumor size was 4.6cm.Forty-three patients(58.8%)presented with lymph node metastasis,84.9%of cases were in advanced TNM stage,and 60.2%of cases were overexpressed by Ki-67.At a median follow-up of 59 months,median overall survival and disease-free survival were 59.7 and 43.9 months,respectively.Five-year overall survival rate was 45.2%and disease-free survival rate was 30.1%,and 76.7%of patients had recurrence or metastasis.Univariate analysis showed that tumor size,lymph node,and radiotherapy were associated with overall survival and disease-free survival(P<0.05),while Ki-67 over-expression was correlated with overall survival(P<0.05).With multivariate analysis,tumor size,lymph node,and radiotherapy affected prognosis(P<0.05);however,pathological typing was not an independent prognostic factor(P>0.05).Conclusion:Metaplastic breast carcinoma is a rare malignant tumor with large tumor,high lymph node metastasis rate,staging relatively late,high local recurrence and distant metastasis rate.The treatment follows the principle of comprehensive treatment based on surgery,but the prognosis is poor.Tumor size,lymph node,and radiotherapy treatment affect the prognosis.Overexpression of Ki-67 can be used as a potential diagnostic,therapeutic and prognostic indicator for metaplastic breast cancer.
