AIM: To explore the impact of tumor size on outcomes in patients with advanced gastric cancer in the lower third of the stomach. METHODS: We retrospectively analyzed the clinical records of 430 patients with advanced ...AIM: To explore the impact of tumor size on outcomes in patients with advanced gastric cancer in the lower third of the stomach. METHODS: We retrospectively analyzed the clinical records of 430 patients with advanced gastric cancer in the lower third of the stomach who underwent distal subtotal gastrectomy and D2 lymphadenectomy in our hospital from January 1998 to June 2004. Receiver-operating characteristic (ROC) curve analysis was used to determine the appropriate cutoff value for tumor size, which was measured as maximum tumor diameter. Based on this cutoff value, patients were divided into two groups: those with large-sized tumors (LSTs) and those with small-sized tumors (SSTs). The correlations between other clinicopathologic factors and tumor size were investigated, and the 5-year overall survival (OS) rate was compared between the two groups. Potential prognostic factors were evaluated by univariate KaplanMeier survival analysis and multivariate Cox's propor-tional hazard model analysis. The 5-year OS rates in the two groups were compared according to pT stage and pN stage. RESULTS: The 5-year OS rate in the 430 patients with advanced gastric cancer in the lower third of the stomach was 53.7%. The mean ± SD tumor size was 4.9 ± 1.9 cm, and the median tumor size was 5.0 cm. ROC analysis indicated that the sensitivity and specificity results for the appropriate tumor size cutoff value of 4.8 cm were 80.0% and 68.2%, respectively (AUC=0.795, 95%CI: 0.751-0.839, P=0.000). Using this cutoff value, 222 patients (51.6%) had LSTs (tumor size ≥ 4.8 cm) and 208 (48.4%) had SSTs (tumor size<4.8 cm). Tumor size was significantly correlated with histological type (P=0.039), Borrmann type (P=0.000), depth of tumor invasion (P=0.000), lymph node metastasis (P=0.000), tumor-nodes metastasis stage (P=0.000), mean number of metastatic lymph nodes (P=0.000) and metastatic lymph node ratio (P=0.000). Patients with LSTs had a significantly lower 5-year OS rate than those with SSTs (37.1% vs 63.3%, P=0.000). Univariate analysis showed that depth of tumor invasion (c 2=69.581, P=0.000), lymph node metastasis (c 2=138.815, P=0.000), tumor size (c 2=78.184, P=0.000) and metastatic lymph node ratio (c 2=139.034, P=0.000) were significantly associated with 5-year OS rate. Multivariate analysis revealed that depth of tumor invasion (P=0.000), lymph node metastasis (P=0.019) and tumor size (P=0.000) were independent prognostic factors. Gastric cancers were divided into 12 subgroups: pT2N0; pT2N1; pT2N2; pT2N3; pT3N0; pT3N1; pT3N2; pT3N3; pT4aN0; pT4aN1; pT4aN2; and pT4aN3. In patients with pT2-3N3 stage tumors and patients with pT4a stage tumors, 5-year OS rates were significantly lower for LSTs than for SSTs (P<0.05 each), but there were no significant differences in the 5-year OS rates in LST and SST patients with pT23N0-2 stage tumors (P > 0.05). CONCLUSION: Using a tumor size cutoff value of 4.8cm, tumor size is a prognostic factor in patients with pN3 stage or pT4a stage advanced gastric cancer located in the lower third of the stomach.展开更多
The Neoproterozoic and Lower Paleozoic along the profile of Yuanguping in western Hunan Province, China underwent anchimetamorphism. The illite crystallinity (IC) of the <2 μm fractions ranges from 0.23-0.34°...The Neoproterozoic and Lower Paleozoic along the profile of Yuanguping in western Hunan Province, China underwent anchimetamorphism. The illite crystallinity (IC) of the <2 μm fractions ranges from 0.23-0.34°△2θfor the Neoproterozoic to 0.23-0.35°△A2θ for the Lower Paleozoic (calibrated with the Kisch IC set, Kisch, 1991). This indicates that the metamorphic grade of the Neoproterozoic and Lower Paleozoic is the anchizone. The peak metamorphic temperature is estimated to be 290-210℃. This result does not agree with the greenschist or subgreenschist facies of the Banxi Group, nor with the lower-greenschist facies or sedimentary cover of the Sinian to Lower Paleozoic, as most previous researchers thought. The illite (K-mica) b0 values range from 0.9074 to 0.8963 (nm) for the Neoproterozoic and the Lower Paleozoic. Based on cumulative frequency curves of the illite (K-mica) b0, the peak metamorphic pressure of the Banxi Group was derived to be of a type that is slightly higher than that of the N. New Hampshire low-intermediate pressure type. Most illites occur as the 2M1 polytype and some in the Neoproterozoic as a mixture of the 2M1+1M types. The distributions of coherent scanning domains (CSDs) of illites along the profile, measured with the XRD method, display a lognormal model and spread out with decreasing Kubler Index of IC. It indicates that illites underwent an Ostwald ripening. The post-anchimetamorphic structural movement not only results in a series of faults but also induces the lattice strain in minerals along the faults and hence impacts the illite crystallinity and causes diagenetic samples to occur within the anchizone. Compared with the cases in eastern and central Hunan Province, the Neoproterozoic and Lower Paleozoic rocks in the west underwent a lower-temperature anchimetamorphism with a pressure lower than that in the east and higher than that in the center of Hunan Province.展开更多
In the East Asian monsoon region, eolian deposits widely distributed in the middle-lower reaches of the Yantgze River are among the best materials available for studies on Quaternary climate change in the subtropical ...In the East Asian monsoon region, eolian deposits widely distributed in the middle-lower reaches of the Yantgze River are among the best materials available for studies on Quaternary climate change in the subtropical zone of Southern China. Typical eolian deposits in this region include upper Xiashu Loess （XL） and underlying Vermiculated Red Soil （VRS） layers. In this paper, chronological and paleoclimatic studies are conducted on an eolian deposit sequence near Jiujiang （J J） city in northern Jiangxi province. A magnetostratigraphic study, combined with optically stimulated luminescence （OSL） dating, is conducted on the JJ section and provides further evidence that eolian deposits in the middle-lower reaches of the Yangtze River have been formed since the late Early Pleistocene, and that the boundary age between the XL and VRS layers is about 300-400 kaBP. In grain-size records of the JJ section, the median grain-size and content of the 〉30μn size fraction increase sharply after 300-400 kaBP, representing an East Asian winter monsoon intensification event. Further pollen analysis reveals differing pollen assemblages before and after 300-400 kaBP： there is an evident increase in plants adapted to grow in a warm humid environment after 300-400 kaBP, implying an increase in precipitation caused by intensification of the East Asian summer monsoon. Global ice volume and uplift of the Tibet Plateau （TP） are regarded as crucial factors influencing variations of the East Asian monsoon on a long-term scale. The deep-sea JlSO record, which reflects variations in global ice volume, shows no obvious change after 300-400 kaBP. Moreover, the influence of global ice volume changes on the East Asian summer and winter monsoons is inverse; the global ice volume increase （decrease） implies a strengthened （weakened） winter monsoon and weakened （strengthened） summer monsoon. We therefore interpret the coupled intensifications of the East Asian summer and winter monsoons at about 300-400 kaBP to the uplift of the TP in the Middle Pleistocene. This climate event is also documented in eolian deposits from the southern margin of the Chinese Loess Plateau （CLP） and from the desert-loess transitional belt. However, it is not recorded in the loess-paleosol sequences from the central part of the CLP, thereby indicating differing climate responses to TP uplift in different regions, which requires further study.展开更多
文摘AIM: To explore the impact of tumor size on outcomes in patients with advanced gastric cancer in the lower third of the stomach. METHODS: We retrospectively analyzed the clinical records of 430 patients with advanced gastric cancer in the lower third of the stomach who underwent distal subtotal gastrectomy and D2 lymphadenectomy in our hospital from January 1998 to June 2004. Receiver-operating characteristic (ROC) curve analysis was used to determine the appropriate cutoff value for tumor size, which was measured as maximum tumor diameter. Based on this cutoff value, patients were divided into two groups: those with large-sized tumors (LSTs) and those with small-sized tumors (SSTs). The correlations between other clinicopathologic factors and tumor size were investigated, and the 5-year overall survival (OS) rate was compared between the two groups. Potential prognostic factors were evaluated by univariate KaplanMeier survival analysis and multivariate Cox's propor-tional hazard model analysis. The 5-year OS rates in the two groups were compared according to pT stage and pN stage. RESULTS: The 5-year OS rate in the 430 patients with advanced gastric cancer in the lower third of the stomach was 53.7%. The mean ± SD tumor size was 4.9 ± 1.9 cm, and the median tumor size was 5.0 cm. ROC analysis indicated that the sensitivity and specificity results for the appropriate tumor size cutoff value of 4.8 cm were 80.0% and 68.2%, respectively (AUC=0.795, 95%CI: 0.751-0.839, P=0.000). Using this cutoff value, 222 patients (51.6%) had LSTs (tumor size ≥ 4.8 cm) and 208 (48.4%) had SSTs (tumor size<4.8 cm). Tumor size was significantly correlated with histological type (P=0.039), Borrmann type (P=0.000), depth of tumor invasion (P=0.000), lymph node metastasis (P=0.000), tumor-nodes metastasis stage (P=0.000), mean number of metastatic lymph nodes (P=0.000) and metastatic lymph node ratio (P=0.000). Patients with LSTs had a significantly lower 5-year OS rate than those with SSTs (37.1% vs 63.3%, P=0.000). Univariate analysis showed that depth of tumor invasion (c 2=69.581, P=0.000), lymph node metastasis (c 2=138.815, P=0.000), tumor size (c 2=78.184, P=0.000) and metastatic lymph node ratio (c 2=139.034, P=0.000) were significantly associated with 5-year OS rate. Multivariate analysis revealed that depth of tumor invasion (P=0.000), lymph node metastasis (P=0.019) and tumor size (P=0.000) were independent prognostic factors. Gastric cancers were divided into 12 subgroups: pT2N0; pT2N1; pT2N2; pT2N3; pT3N0; pT3N1; pT3N2; pT3N3; pT4aN0; pT4aN1; pT4aN2; and pT4aN3. In patients with pT2-3N3 stage tumors and patients with pT4a stage tumors, 5-year OS rates were significantly lower for LSTs than for SSTs (P<0.05 each), but there were no significant differences in the 5-year OS rates in LST and SST patients with pT23N0-2 stage tumors (P > 0.05). CONCLUSION: Using a tumor size cutoff value of 4.8cm, tumor size is a prognostic factor in patients with pN3 stage or pT4a stage advanced gastric cancer located in the lower third of the stomach.
基金supported by the National Nature Science Foundation of China(Grant No.40272022).
文摘The Neoproterozoic and Lower Paleozoic along the profile of Yuanguping in western Hunan Province, China underwent anchimetamorphism. The illite crystallinity (IC) of the <2 μm fractions ranges from 0.23-0.34°△2θfor the Neoproterozoic to 0.23-0.35°△A2θ for the Lower Paleozoic (calibrated with the Kisch IC set, Kisch, 1991). This indicates that the metamorphic grade of the Neoproterozoic and Lower Paleozoic is the anchizone. The peak metamorphic temperature is estimated to be 290-210℃. This result does not agree with the greenschist or subgreenschist facies of the Banxi Group, nor with the lower-greenschist facies or sedimentary cover of the Sinian to Lower Paleozoic, as most previous researchers thought. The illite (K-mica) b0 values range from 0.9074 to 0.8963 (nm) for the Neoproterozoic and the Lower Paleozoic. Based on cumulative frequency curves of the illite (K-mica) b0, the peak metamorphic pressure of the Banxi Group was derived to be of a type that is slightly higher than that of the N. New Hampshire low-intermediate pressure type. Most illites occur as the 2M1 polytype and some in the Neoproterozoic as a mixture of the 2M1+1M types. The distributions of coherent scanning domains (CSDs) of illites along the profile, measured with the XRD method, display a lognormal model and spread out with decreasing Kubler Index of IC. It indicates that illites underwent an Ostwald ripening. The post-anchimetamorphic structural movement not only results in a series of faults but also induces the lattice strain in minerals along the faults and hence impacts the illite crystallinity and causes diagenetic samples to occur within the anchizone. Compared with the cases in eastern and central Hunan Province, the Neoproterozoic and Lower Paleozoic rocks in the west underwent a lower-temperature anchimetamorphism with a pressure lower than that in the east and higher than that in the center of Hunan Province.
基金supported by the National Department Public Benefit Research Foundation of China(grant no. 201211077)the Mineral Resources Investigation and Appraisal Project of the Ministry of Land and Resources (grant no.12120114001501)the Fundamental Research Funds for the Central Universities(grant no. 53200859557)
文摘In the East Asian monsoon region, eolian deposits widely distributed in the middle-lower reaches of the Yantgze River are among the best materials available for studies on Quaternary climate change in the subtropical zone of Southern China. Typical eolian deposits in this region include upper Xiashu Loess （XL） and underlying Vermiculated Red Soil （VRS） layers. In this paper, chronological and paleoclimatic studies are conducted on an eolian deposit sequence near Jiujiang （J J） city in northern Jiangxi province. A magnetostratigraphic study, combined with optically stimulated luminescence （OSL） dating, is conducted on the JJ section and provides further evidence that eolian deposits in the middle-lower reaches of the Yangtze River have been formed since the late Early Pleistocene, and that the boundary age between the XL and VRS layers is about 300-400 kaBP. In grain-size records of the JJ section, the median grain-size and content of the 〉30μn size fraction increase sharply after 300-400 kaBP, representing an East Asian winter monsoon intensification event. Further pollen analysis reveals differing pollen assemblages before and after 300-400 kaBP： there is an evident increase in plants adapted to grow in a warm humid environment after 300-400 kaBP, implying an increase in precipitation caused by intensification of the East Asian summer monsoon. Global ice volume and uplift of the Tibet Plateau （TP） are regarded as crucial factors influencing variations of the East Asian monsoon on a long-term scale. The deep-sea JlSO record, which reflects variations in global ice volume, shows no obvious change after 300-400 kaBP. Moreover, the influence of global ice volume changes on the East Asian summer and winter monsoons is inverse; the global ice volume increase （decrease） implies a strengthened （weakened） winter monsoon and weakened （strengthened） summer monsoon. We therefore interpret the coupled intensifications of the East Asian summer and winter monsoons at about 300-400 kaBP to the uplift of the TP in the Middle Pleistocene. This climate event is also documented in eolian deposits from the southern margin of the Chinese Loess Plateau （CLP） and from the desert-loess transitional belt. However, it is not recorded in the loess-paleosol sequences from the central part of the CLP, thereby indicating differing climate responses to TP uplift in different regions, which requires further study.
