Lymph node metastasis in early gastric cancer with submucosal invasion:Feasibility of minimally invasive surgery

AIM:To explore the feasibility of pertorming minimally invasive surgery(MIS)on subsets of submucosal gastric cancers that are unlikely to have regional lymph node metastasis. METHODS:A total of 105 patients underwent radical gastrectomy with lymph node dissection for submucosal gastric cancer at our hospital from January 1995 to December 1995.Besides investigating many clinicopathological features such as tumor size,gross appearance,and differentiation, we measured the depth of invasion into submucosa minutely and analyzed the clinicopathologic features of these patients regarding lymph node metastasis. RESULTS:The rate of lymph node metastasis in cases where the depth of invasion was<500 μm,500-2 000 μm,or >2 000 μm was 9%(2/23),19%(7136),and 33%(15/46), respectively(P<0.05).In univariate analysis,no significant correlation was found between lymph node metastasis and clinicopathological characteristics such as age,sex,tumor location,gross appearance,tumor differentiation,Lauren's classification,and lymphatic invasion.In multivariate analysis, tumor size(>4 cm vs≤2 cm,odds ratio=4.80, P=0.04)and depth of invasion(>2 000 μm vs ≤500 μm, odds ratio=6.81,P=0.02)were significantly correlated with lymph node metastasis.Combining the depth and size in cases where the depth of invasion was less than 500 μm, we found that lymph node metastasis occurred where the tumor size was greater than 4 cm.In cases where the tumor size was less than 2 cm,lymph node metastasis was found only where the depth of tumor invasion was more than 2 000 μm. CONCLUSION:MIS can be applied to submucosal gastric cancer that is less than 2 cm in size and 500 μm in depth.

Detection of D2-40 monoclonal antibody-labeled lymphatic vessel invasion in esophageal squamous cell carcinoma and its clinicopathologic significance

Objective： This study aims to investigate the clinicopathologic significance of lymphatic vessel invasion （LVI） labeled by D2-40 monoclonal antibody in esophageal squamous cell carcinoma （ESCC）. Methods： Immunohistochemical assay was used to detect the expression of D2-40 and LVI in 107 ESCC patients. Then, the correlation between the clinicopathologic feature and the overall survival time of the patients was analyzed. Results： The lymph node metastasis rates were 70% and 21% in the LVI-positive and LVI-negative groups, respectively. The nodal metastasis rate was higher in the LVI-positive group than in the LVI-negative group. Multivariate regression analysis showed that LVI was related to nodal metastasis （P〈0.001）. The median survival time of the patients was 26 and 43 months in the LVI-positive and LVI-negative groups, respectively. Mthough univariate regression analysis showed significant difference between the two groups （P=0.014）, multivariate regression analysis revealed that LVI was not an independent prognostic factor for overall survival in the ESCC patients （P=0.062）. Lymphatic node metastasis （P=0.031）, clinical stage （P=0.019）, and residual tumor （P=0.026） were the independent prognostic factors. Conclusion： LVI labeled by D2-40 monoclonal antibody is a risk factor predictive of lymph node metastasis in ESCC patients.

2023版子宫内膜癌FIGO分期更新对病理诊断内容的影响

子宫内膜癌是女性生殖系统最常见的恶性肿瘤,近年来子宫内膜癌诊疗中备受关注的热点问题,如淋巴脉管间隙浸润的定量评价、前哨淋巴结超分期和子宫内膜癌分子分型等,已经逐渐用于临床实践。目前,子宫内膜癌相关的新进展已被写入2023版国际妇产科联盟(International Federation of Gynecology and Obstetrics,FIGO)子宫内膜癌分期修订版本,并在临床推广应用。规范的病理诊断是评估子宫内膜癌患者预后和指导辅助治疗的重要依据,介绍2023版FIGO子宫内膜癌分期更新对病理诊断内容的影响,旨在帮助提高病理医生子宫内膜癌病理诊断的规范化及标准化水平,辅助临床医生更准确地理解和应用新分期。

Assessment of vascular invasion in gastric cancer: A comparative study

AIM: To evaluate and compare detection of lymphatic and blood vessel invasion (LVI and BVI) by hematox-ylin-eosin (HE) and immunohistochemistry (IHC) in gastric cancer specimens, and to correlate with lymph node status. METHODS: IHC using D2-40 (a lymphatic endothelial marker) and CD34 (a pan-endothelial marker) was performed to study LVI and BVI in surgical specimens froma consecutive series of 95 primary gastric cancer cases. The results of the IHC study were compared with the detection by HE using McNemar test and kappa index. The morphologic features of the tumors and the presence of LVI and BVI were related to the presence of lymph node metastasis. A χ2 test was performed to obtain associations between LVI and BVI and other prognostic factors for gastric cancer. RESULTS: The detection rate of LVI was considerably higher than that of BVI. The IHC study identified eight false-positive cases and 13 false-negative cases for LVI, and 24 false-positive cases and 10 false-negative cases for BVI. The average Kappa value determined was moderate for LVI (k=0.50) and low for BVI (k=0.20). Both LVI and BVI were statistically associated with the presence of lymph node metastasis (HE: P=0.001, P=0.013, and IHC: P=0.001, P=0.019). The mor-phologic features associated with LVI were location of the tumor in the distal third of the stomach (P=0.039), Borrmann's macroscopic type (P=0.001), organ inva-sion (P=0.03) and the depth of tumor invasion (P=0.001). The presence of BVI was related only to the depth of tumor invasion (P=0.003). CONCLUSION: The immunohistochemical identification of lymphatic and blood vessels is useful for increasing the accuracy of the diagnosis of vessel invasion and for predicting lymph node metastasis.

肝门部胆管癌淋巴结转移和神经丛浸润特点及清扫要点

肝门部胆管癌是胆道中最常见的恶性肿瘤,根治性手术是患者可能获得长期生存的唯一手段。本文简述了肝门部胆管癌发生淋巴结转移、神经丛侵犯的特点,回顾了国内外目前对淋巴结清扫、神经丛廓清的观点。分析表明,国内外观点普遍认可区域淋巴结清扫、神经丛廓清,但对淋巴结的扩大清扫尚存争议。

炎症指标预测宫颈癌淋巴结转移的列线图风险模型建立与验证

目的:基于炎症指标预测宫颈癌淋巴结转移风险并构建列线图预测模型。方法:回顾性纳入2017年1月-2022年12月来本院初诊并行手术治疗的219例宫颈癌患者临床资料,根据淋巴结转移情况分为两组,收集比较两组临床资料,通过logistic回归分析宫颈癌淋巴结转移的影响因素,应用R软件构建预测宫颈癌淋巴结转移的列线图模型并验证其准确性。结果:淋巴结转移组血清中性粒细胞(NE)、单核细胞(MO)计数,全身免疫炎症指数(SII)和Ki67的表达均高于非转移组,雌激素受体(ER)表达低于非转移组,淋巴血管间隙侵犯(LVSI)与宫颈癌淋巴结转移有关(均P<0.05)。通过logistic回归分析发现,SII和LVSI是宫颈癌淋巴结转移的独立危险因素(P<0.05)。构建列线图预测模型,经检验预测概率与实际观测值具有良好的一致性,Hosmer-Lemeshow P=0.276。受试者工作特征曲线分析,SII联合LVSI可显著提高宫颈癌淋巴结转移的诊断效率(AUC=0.823,P<0.001)。结论:构建术前基于炎症指标预测宫颈癌淋巴结转移的列线图模型预测准确性良好,可为临床制定宫颈癌诊疗方案提供参考。

MRI测量和评估口腔黏膜鳞状细胞癌临床分期指标的准确性分析

目的:研究磁共振成像(MRI)测量和评估口腔黏膜鳞状细胞癌(oral squamous cell carcinoma,OSCC)临床分期指标的准确性。方法:纳入2020年2月—2022年9月就诊于中国科学技术大学附属第一医院的OSCC患者71例,记录MRI测量的肿瘤最大直径(maximum tumor diameter,MTD)、浸润深度(depth of invasive,DOI)以及最大值截面,按相应截面制作病理切片,测量病理MTD和DOI值并进行统计分析,将MRI图像评估的患者颈淋巴结状态与术后病理证实的淋巴结状态进行比较,分析术前MRI测量和评估临床分期的准确性。采用SPSS 26.0软件包对数据进行统计学分析。结果:MRI Gd-T1WI序列测量的DOI平均较病理结果高出2.54 mm(95%CI:3.56~1.53,P<0.05),相关系数r为0.984;T2WI序列测量的DOI平均较病理结果高出3.09 mm(95%CI:4.88~1.29,P<0.05),相关性系数r为0.953。Bland-Altman散点图显示,Gd-T1WI序列的测量结果与病理DOI值一致性更高。临床测量的MTD较病理结果高出0.85 cm(95%CI:0.78~0.91,P<0.05),相关性系数r为0.958;MRI测量的MTD较病理结果高出0.21 cm(95%CI:0.10~0.32,P<0.05),相关性系数r为0.878。MRI测量肿瘤的MTD值较临床目测的结果误差显著降低。通过MRI术前评估患者颈淋巴结状态,真阳性率为69.6%,真阴性率为89.6%。结论:MRI在测量OSCC患者临床分期指标DOI和MTD的准确性较高,可作为评估患者临床分期的一种可靠的参考方法。

Relations of proliferative activities of gastric carcinoma cells to lymphatic involvement, venous invasion and prognosis

Background This study was to evaluate bivariate bromodeoxyuridine(BrdUrd)/DNA flow cytometric analysis in detection of gastric carcinoma and to study the relations of cellular BrdUrd labeling indices (LI), G_2/M-phase fraction(G_2/MPF) and DNA ploidy pattern to lymphatic involvement, venous invasion and prognosis.Methods Fresh tumor samples from 60 patients with gastric carcinoma were analyzed by bivariate BrdUrd/DNA flow cytometry. The results were correlated with lymphatic vessel invasion, lymphatic node metastasis, the number of matastatic lymphatic nodes, and venous invasion. Propidium iodide (PI) was used as a fluorescent probe for total cellular DNA, and a monoclonal antibody against BrdUrd was used as a probe for BrdUrd incorporated into DNA. Fluorescent-labeled goat anti-mouse antibody was used as a second antibody. S-phase fractions were measured by in vitro BrdUrd labeling, and DNA ploidy and G_2/MPF were also measured. Comparison of survival was performed with the log-rank test, the Chi-square test for qualitative data, and Student’s t test for quantu data. Results BrdUrd LI and G_2/MPF values were significantly higher in tumors with lymphatic vessel invasion than in those without invasion respectively (P<0.01); the patients who had tumors with lymphatic vessel invasion showed a significantly poor prognosis (P<0.01). Both BrdUrd LI and G_2/MPF values were significantly higher in tumors with lymphatic node metastasis than in those without metastasis (P<0.01). A statistical significant difference was noted in the 5-year survival rates between the patients with lymph node metastasis and those without metastasis. Compared with diploid carcinoma, the incidence of lymph node metastasis was significantly higher in aneuploid carcinoma (P<0.05), and the patients with aneuploid carcinoma showed a significantly poor prognosis (P<0.05). BrdUrd LI was significantly higher in patients with more than 5 metastatic lymph nodes than those with 1-4 metastatic lymph nodes (P<0.05) and those without metastasis (P<0.01). G_2/MPF values in those patients either with more than 5 metastatic lymph nodes or 1-4 metastatic lymph nodes were higher than those without metastasis (P<0.01 and P<0.05). A statistical significance was seen in the 5-year survival rates among the patients with no metastatic lymph node, 1-4 metastatic nodes and more than 5 metastatic nodes (P<0.01). G_2/MPF values were significantly higher in patients with venous invasion than in those without invasion (P<0.01).Conclusions Positive correlations exist between cellular BrdUrd LI, G_2/MPF with lymphatic involvement and prognosis, and DNA aneuploid with lymphatic involvement and prognosis. The same was true between G_2/MPF value and venous invasion in gastric carcinoma.

CXCR4在VEGF-C介导的胃癌淋巴道转移中的作用

目的探索趋化因子受体CXCR4和VEGF-C与胃癌淋巴道转移的关系,为研究干预胃癌淋巴转移的新方法提供理论依据。方法采用RT-PCR方法检测86例胃癌组织中趋化因子受体CXCR4 mRNA的表达及VEGF-C mRNA的表达,探索其与胃癌淋巴结转移的关系;Boyden趋化小室法检测CXCR4不同表达状态胃癌细胞的趋化活性和趋化抑制性。结果86例胃癌组织均有不同程度的CXCR4 mRNA和VEGF-C mRNA的表达。53例CXCR4 mRNA呈高表达,表达率为61.63%,VEGF-C mRNA高表达率为56.98%(49/86);VEGF-C mRNA高表达组中的CXCR4 mRNA的表达率也较高;CXCR4 mRNA的表达与胃癌淋巴结转移呈正相关(P<0.05);CXCR4的配体SDF-l对胃癌细胞的平均趋化率为81%,经抗CXCR4单克隆抗体处理后癌细胞的平均趋化率下降至30%,CXCR4被特异性抗体封闭前后的癌细胞趋化活性有显著性差异(P<0.05)。结论胃癌CXCR4的表达和VEGF-C的表达与胃癌淋巴结转移呈正相关;CXCR4的功能状态影响胃癌细胞的迁移活性。通过干预趋化因子受体CXCR4和VEGF-C的活性可能成为阻断胃癌淋巴转移的新靶点。

胃癌阴性淋巴结的微转移检测的临床意义

目的 探讨胃癌淋巴结微转移与临床病理参数的关系及其临床意义。方法 采用免疫组织化学方法 ,用细胞角蛋白CK19,细胞角蛋白CK 2 0及CD 44v6检测 5 3例常规病理检查无淋巴结转移的胃癌周围淋巴结 5 0 9枚。结果 5 3例胃癌患者中 2 1例有淋巴结微转移 (3 9.6% )。微转移与浸润深度有关 ;深层组织的微转移阳性率高于浅层 (P <0 .0 5 ) ,PT3,PT4 患者阳性率明显高于PT1 ,PT2 患者。低分化癌微转移阳性率明显高于高分化癌 (P <0 .0 5 )。结论 对常规检查淋巴结为阴性的胃癌 ,微转移检测可能对准确地确定临床分期、指导治疗。

前哨淋巴结检测对胃癌淋巴结转移的预测价值

目的探讨前哨淋巴结(SLN)在不同部位和不同浸润深度胃癌中定位检测对淋巴结转移的预测价值。方法使用亚甲蓝多点注射对90例胃癌患者行前哨淋巴结术中标识活检,5-10分钟内,在胃周可找到蓝染淋巴结,即SLN,将其送病理切片,随后行D2或D2以上手术。胃标本及其余胃周淋巴结行常规病理检查。结果 90例中88例检出SLN,检出率97.8%。88例SLN中,SLN预测胃周淋巴结转移的敏感性86.2%(50/58),准确性90.9%(80/88),特异性100.0%(30/30),假阴性率13.8%(8/58)。同时,SLN预测胃周淋巴结转移的敏感性和准确率随胃癌浸润深度的增加呈降低趋势,随胃癌部位按L区、M区、U区的顺序而呈降低趋势。结论亚甲蓝多点注射是一个操作方便、结果可靠的检测胃癌前哨淋巴结淋巴结的方法,早期胃癌SLN的敏感性、准确率较高。L、M区胃癌SLN的敏感性、准确率较U区更高。

p^（53）过表达与胃癌患者淋巴结转移的关系

应用Ｓ－Ｐ免疫组化方法，研究ｐ^（５３）在８８例原发性胃癌患者的表达变化与肿瘤细胞增殖和浸润深度及淋巴结转移的关系。发现ｐ^（５３）阳性染色率为４８．９％，ｐ^（５３）阳性染色与肿瘤浸润深度及癌细胞增殖活性呈正相关，ｐ^（５３）阳性肿瘤的淋巴结转移率（９３％）明显高于ｐ^（５３）阴性的肿瘤（６０％，Ｐ＜０．０５）。提示ｐ^（５３）过表达在胃癌淋巴结转移和肿瘤浸润及增殖中起重要作用。

RNAi抑制Layilin表达对肺腺癌A549细胞体外侵袭和荷瘤鼠体内淋巴转移的影响

背景与目的:透明质酸参与了多种肿瘤细胞的侵袭行为,Layilin是一种新发现的特异性透明质酸受体。本研究在发现Layilin表达于人肺腺癌A549细胞株的前期工作基础上,观察用RNA干扰(RNA interference,RNAi)技术抑制Layilin表达后,对人肺腺癌A549细胞体外侵袭和体内淋巴道转移的影响。方法:构建能表达针对Layilin的小干扰RNA(small interfering RNA,siRNA)的RNAi质粒(Layilin siRNA plasmid)和表达不针对任何已知mRNA的siRNA的阴性对照RNAi质粒(control siRNA plasmid),分别转染A549细胞,新霉素抗性筛选得到Layilin表达受抑制的A549-siLayilin细胞和Layilin表达未受影响的A549-siControl细胞。针对非转染(A549-nontransfec-tion)、A549-siLayilin、A549-siControl 3组细胞,分别采用RT-Real time PCR和Western blot技术检测Layilin表达,用Boyden小室实验检测细胞体外侵袭能力,用爪垫皮下种植淋巴结转移模型检测淋巴转移能力。结果:与A549-non-transfection组和A549-siControl组相比,A549-siLayilin组细胞Layilin表达减少,体外侵袭能力降低,体内淋巴转移率下降。结论:通过RNAi抑制Layilin表达后,能有效抑制透明质酸所诱导的A549细胞体外侵袭和裸鼠移植瘤淋巴转移。本研究为通过RNAi手段抑制Layilin表达,进而抑制肺腺癌淋巴转移提供了有益的思路。

c-erbB-2、VEGF和组织蛋白酶D在胃癌中的表达及其相关性

目的 :探讨癌基因c erbB 2、血管内皮生长因子 (VEGF)和组织蛋白酶D(Cath D)在胃癌中的表达及其与胃癌生物学行为的关系。方法 :采用免疫组织化学 (S P)法 ,检测了 10 2例胃癌手术标本中c erbB 2、VEGF及Cath D的表达 ,同时观察了网状纤维分布与c erbB 2、Cath D之间的关系 ,并将检测结果与跟踪随访资料进行了综合分析。结果 :10 2例胃癌组织中c erbB 2表达阳性率为 38 2 4 % (39/ 10 2 ) ,与胃癌浸润深度 (P <0 0 5 )、淋巴结转移 (P <0 0 5 )密切相关 ;VEGF表达阳性率为 5 0 %(5 1/ 10 2 ) ,与胃癌浸润深度 (P <0 0 1)、生长方式 (P <0 0 1)、淋巴结转移 (P <0 0 1)密切相关 ;Cath D表达阳性率为81 37% (83/ 10 2 ) ,与胃癌浸润深度 (P <0 0 5 )、生长方式 (P <0 0 5 )、淋巴结转移 (P <0 0 5 )及脉管内有无癌栓 (P <0 0 5 )有关。对生存期分析显示 :Cath D、VEGF、c erbB 2阳性患者预后差 ,5年生存率低于阴性表达患者。结论 :c erbB 2、VEGF及Cath D与胃癌的生长、浸润、转移、预后有密切关系 。

乳腺浸润性导管癌中SATB1和BRMS1的表达及与淋巴转移的相关性

目的探讨核基质结合区结合蛋白-1(SATB1)及乳腺癌转移抑制基因1(BRMS1)在乳腺浸润性导管癌(IDC)原发灶、腋窝淋巴结转移灶中的表达,分析SATB1与临床病理参数的关系及两者表达的相关性。方法采用免疫组化SP法及qRT-PCR检测51例乳腺IDC组织、17例对应腋窝淋巴结转移灶组织、32例配对癌旁乳腺组织中SATB1、BRMS1蛋白及mRNA的表达情况。结果在原发灶组织、腋窝淋巴结转移灶组织SATB1阳性表达率分别是76.47%、82.35%,均高于癌旁组织的28.12%(P<0.05);BRMS1蛋白的表达率分别是25.49%、23.53%,均低于于癌旁组织的87.50%(P<0.05);在原发灶组织、腋窝淋巴结转移灶组织SATB1 mRNA表达量分别是癌旁组织的3.88、6.06倍;BRMS1 mRNA表达量分别是癌旁组织的0.36、0.35倍,差异均有统计学意义(P<0.05);SATB1蛋白及mRNA、BRMS1 mRNA在腋窝淋巴结有转移的乳癌原发灶中的表达与腋窝淋巴结无转移乳癌原发灶间存在明显差异(P<0.05);在原发灶和淋巴结转移灶中的表达差异无统计学意义(P>0.05)。SATB1蛋白和mRNA表达与腋窝淋巴结转移数目、临床分期有关(P<0.05),与患者的年龄、肿瘤大小、肿瘤病理学分级、雌激素受体、孕激素受体、人表皮生长因子受体2、增殖细胞核抗原(Ki-67)及绝经状态无关(P>0.05)。相关分析结果显示在原发灶组织、腋窝淋巴结转移组织中SATB1、BRMS1蛋白及mRNA表达均无相关性(P>0.05)。结论 SATB1、BRMS1异常表达与IDC发生、发展、淋巴转移有密切关系,SATB1有望成为评估乳腺IDC淋巴结转移潜能的分子标记物。

COX-2、u-PA和TSP-1在胃癌及周围淋巴结中的表达及意义

目的:研究COX-2、u-PA和TSP-1在胃癌及周围淋巴结中的表达状况,探讨它们在胃癌浸润和淋巴结转移中的作用和意义。方法:用组织芯片技术和免疫组化法检测COX-2、u-PA和TSP-1的表达。结果:COX-2、u-PA和TSP-1在胃癌组阳性表达率分别为67.7%、78.1%和78.6%,均显著高于对照组(40.0%、6.7%和40.0%,P<0.05)。COX-2表达与浸润深度有关(P<0.05)。u-PA表达与浸润深度和淋巴结转移均有关(P<0.05)。TSP-1表达与浸润深度和淋巴结转移均无关(P>0.05)。COX-2、u-PA和TSP-1在转移淋巴结和对应癌组织间的表达差异无显著性(P>0.05)。COX-2和u-PA、TSP-1的表达呈正相关,u-PA和TSP-1的表达无相关关系。结论:胃癌中COX-2、u-PA和TSP-1高表达;COX-2表达与胃癌的浸润深度有关,u-PA表达与浸润深度和淋巴结转移有关。

微创食管癌术后淋巴结转移情况对预后的影响研究

目的探讨食管癌患者胸、腹腔淋巴结的转移规律及其对生存预后的影响。方法选取经微创食管癌切除术(minimally invasive esophagectomy,MIE)治疗的食管鳞癌患者103例,按照日本食管肿瘤研究会(Japan Esophageal Cancer Research Association,JEOG)淋巴结分区的标准进行淋巴结清扫,统计淋巴结的转移情况,分析淋巴结转移情况对3年总生存率的影响。结果胸上段食管癌主要向左、右喉返神经旁淋巴结转移。胸中段食管癌呈现双向淋巴结转移。胸下段食管癌主要向胃左动脉旁和肝总动脉旁淋巴结转移。食管癌患者3年总生存率在病变长度、分化程度、浸润深度、肿瘤位置和淋巴结转移方面比较,差异均具有统计学意义(均P<0.05)。结论淋巴结转移是影响胸段食管癌患者术后效果的重要影响因素,结合病变位置情况,重点清扫相应部位的淋巴结,并可依据病变长度、分化程度、浸润深度、肿瘤位置及淋巴结转移判定远期预后。

237例宫颈腺癌及腺鳞癌患者临床特征及预后分析

目的:探讨宫颈腺癌和宫颈腺鳞癌患者的临床特征和预后差异。方法:回顾性分析2007年9月至2016年9月因ⅠB1～ⅡA期宫颈腺癌(201例)或宫颈腺鳞癌(36例)在山东大学齐鲁医院手术治疗患者的临床资料。比较两组的临床特征,并采用Kaplan-Meier生存曲线对两种组织学类型宫颈癌的预后进行评价。结果:宫颈腺鳞癌组淋巴血管浸润比例较宫颈腺癌组高(P <0. 01),而在年龄、FIGO分期、肿瘤直径、间质浸润深度、宫旁浸润、淋巴结转移和危险分级方面两组差异均无统计学意义(均P>0. 05)。宫颈腺癌组和宫颈腺鳞癌组患者5年总存活率分别为79. 4%和78. 3%,5年无复发存活率分别为77. 4%和73. 0%,组间差异均无统计学意义(均P> 0. 05)。术后接受同步放射治疗和化疗的患者中,5年总存活率分别为71. 0%和61. 4%,5年无复发存活率分别为68. 8%和61. 1%,组间差异均无统计学意义(均P> 0. 05)。结论:宫颈腺鳞癌较宫颈腺癌更易发生淋巴血管浸润,但两者的预后相似。

外周血血小板计数与食管癌临床病理相关性研究

目的:研究外周血血小板与食管癌的关系。方法:比较415例食管癌患者及325例对照人群血小板水平,并分析血小板水平与食管癌患者临床病理参数之间的关系。结果:食管癌患者外周血血小板水平(286±88)×109/L显著高于正常人群(204±114)×109/L;食管癌患者血小板增多的比例为23.6%,高于对照组(P<0.05)。食管癌患者血小板与肿瘤浸润深度、淋巴结转移有关(P<0.05)。结论:血小板升高可能与食管癌的发展有关。

分化型甲状腺癌高细胞亚型的临床特征分析

目的总结少见病理亚型的分化型甲状腺癌的临床特征。方法回顾性分析首都医科大学附属北京同仁医院头颈外科2014年1月~2019年1月接受治疗的44例少见病理亚型的分化型甲状腺癌患者,其中高细胞亚型、弥漫硬化型、侵袭性滤泡癌为侵袭组;巨滤泡亚型、嗜酸细胞亚型、滤泡亚型为非侵袭组。结果侵袭组中主要为高细胞亚型,多灶病变为50%(9/18),颈转移率为72.2%(13/18),非侵袭组中多灶病变为15.4%(4/26),颈转移率为7.7%(2/26),两组间差异比较有统计学意义。侵袭组就诊时易侵犯喉返神经、食管和喉气管。结论甲状腺癌高细胞亚型有多灶性的倾向,淋巴结转移率更高,易侵犯喉返神经和周围结构;随着肿瘤大小的增加,颈转移率也相应升高。