目的通过改良脂肪清除技术的应用,对直肠癌标本淋巴结转移情况进行准确分析,为直肠全系膜切除术提供临床病理学依据。方法研究组选2003—2005年的中低位直肠癌33例,对照组选取50名中低位直肠癌病例。研究组术后直肠标本通过改良脂肪清...目的通过改良脂肪清除技术的应用,对直肠癌标本淋巴结转移情况进行准确分析,为直肠全系膜切除术提供临床病理学依据。方法研究组选2003—2005年的中低位直肠癌33例,对照组选取50名中低位直肠癌病例。研究组术后直肠标本通过改良脂肪清除技术处理后记录检出淋巴结数量、直径和转移情况。对照组标本采用常规方法检测。结果研究组33例共检出淋巴结1035枚,其中淋巴结直径≥5 mm 529枚,＜5 mm 506枚,平均淋巴结检出数目为31．36枚/人。20例发现存在淋巴结转移,共检出132枚淋巴结有肿瘤转移,其中淋巴结直径≥5 mm 75枚,＜5 mm 57枚。研究组淋巴结总检出数以及转移淋巴结检出数较对照组明显增多,特别是直径＜5 mm淋巴结检出数目明显增加。结论改良脂肪清除技术使直肠癌全系膜切除术后标本淋巴结检出数目明显增加。常规病理检测评价为T3N0(但淋巴结检出总数＜12枚)的病例,应用改良脂肪清除技术处理标本,可获得更多的淋巴结检出数量,有助于获得更为准确的病理评价、指导术后辅助治疗。展开更多
Background:Most Chinese patients with type 2 diabetes mellitus(T2DM)have mild obesity and central obesity.Central obesity is combined with insulin resistance.The aim of this study was to assess the effect of abdominal...Background:Most Chinese patients with type 2 diabetes mellitus(T2DM)have mild obesity and central obesity.Central obesity is combined with insulin resistance.The aim of this study was to assess the effect of abdominal adipose tissue on insulin-sensitivity improvement after Roux-en-Y gastric bypass(RYGB)in Chinese diabetic patients with mild and central obesity.Methods:Seventeen T2DM patients with a mean body mass index of 30.3 kg/m^(2) were scheduled for laparoscopic RYGB.A hyperinsulinemic-euglycemic clamp and dual-energy X-ray absorptiometry were performed prior to surgery and 3 months after RYGB.The primary end points were the correlations between insulin sensitivity and abdominal adipose tissue,including visceral adipose tissue(VAT)and subcutaneous adipose tissue(SAT),before and 3 months after RYGB.Results:Indices of peripheral insulin sensitivity,including glucose-disposal rate(M value)and glucose infusion rate,were significantly increased after RYGB.Body-fat mass,VAT and SAT were significantly reduced after RYGB.The pre-operative M value was significantly correlated with VAT mass(r=–0.57,P=0.02),but not correlated with SAT mass.M value changes after RYGB were highly correlated with changes in VAT mass(r=–0.59,P=0.01),percentage of VAT mass(r=–0.66,P<0.01),VAT area(r=–0.56,P=0.02)and percentage of VAT area(r=–0.57,P=0.02).Conclusions:A significant correlation was observed between increased peripheral insulin sensitivity and decreased VAT following RYGB in Chinese patients with mild and central obesity.VAT and SAT were significantly decreased with improved insulin sensitivity after RYGB.VAT mass may be considered as an indication for gastric bypass during patient selection.展开更多
文摘目的通过改良脂肪清除技术的应用,对直肠癌标本淋巴结转移情况进行准确分析,为直肠全系膜切除术提供临床病理学依据。方法研究组选2003—2005年的中低位直肠癌33例,对照组选取50名中低位直肠癌病例。研究组术后直肠标本通过改良脂肪清除技术处理后记录检出淋巴结数量、直径和转移情况。对照组标本采用常规方法检测。结果研究组33例共检出淋巴结1035枚,其中淋巴结直径≥5 mm 529枚,＜5 mm 506枚,平均淋巴结检出数目为31．36枚/人。20例发现存在淋巴结转移,共检出132枚淋巴结有肿瘤转移,其中淋巴结直径≥5 mm 75枚,＜5 mm 57枚。研究组淋巴结总检出数以及转移淋巴结检出数较对照组明显增多,特别是直径＜5 mm淋巴结检出数目明显增加。结论改良脂肪清除技术使直肠癌全系膜切除术后标本淋巴结检出数目明显增加。常规病理检测评价为T3N0(但淋巴结检出总数＜12枚)的病例,应用改良脂肪清除技术处理标本,可获得更多的淋巴结检出数量,有助于获得更为准确的病理评价、指导术后辅助治疗。
基金supported by the New Xiangya Talent Projects of Third Xiangya Hospital of Central South University(grant number JY201628).
文摘Background:Most Chinese patients with type 2 diabetes mellitus(T2DM)have mild obesity and central obesity.Central obesity is combined with insulin resistance.The aim of this study was to assess the effect of abdominal adipose tissue on insulin-sensitivity improvement after Roux-en-Y gastric bypass(RYGB)in Chinese diabetic patients with mild and central obesity.Methods:Seventeen T2DM patients with a mean body mass index of 30.3 kg/m^(2) were scheduled for laparoscopic RYGB.A hyperinsulinemic-euglycemic clamp and dual-energy X-ray absorptiometry were performed prior to surgery and 3 months after RYGB.The primary end points were the correlations between insulin sensitivity and abdominal adipose tissue,including visceral adipose tissue(VAT)and subcutaneous adipose tissue(SAT),before and 3 months after RYGB.Results:Indices of peripheral insulin sensitivity,including glucose-disposal rate(M value)and glucose infusion rate,were significantly increased after RYGB.Body-fat mass,VAT and SAT were significantly reduced after RYGB.The pre-operative M value was significantly correlated with VAT mass(r=–0.57,P=0.02),but not correlated with SAT mass.M value changes after RYGB were highly correlated with changes in VAT mass(r=–0.59,P=0.01),percentage of VAT mass(r=–0.66,P<0.01),VAT area(r=–0.56,P=0.02)and percentage of VAT area(r=–0.57,P=0.02).Conclusions:A significant correlation was observed between increased peripheral insulin sensitivity and decreased VAT following RYGB in Chinese patients with mild and central obesity.VAT and SAT were significantly decreased with improved insulin sensitivity after RYGB.VAT mass may be considered as an indication for gastric bypass during patient selection.
