Background:Pancreatic signet ring cell carcinoma(SRCC)is an exceedingly rare histological subtype of pancreatic cancer.Previous studies have focused on the trends of incidence and independent predictors of pancreatic ...Background:Pancreatic signet ring cell carcinoma(SRCC)is an exceedingly rare histological subtype of pancreatic cancer.Previous studies have focused on the trends of incidence and independent predictors of pancreatic SRCC.Our objectives of the study were to analyze the prognostic value of the lymph node ratio(LNR)and to explore the minimal number of lymph nodes examined to accurately evaluate the N stage in resected pancreatic SRCC.Method:We analyzed 120 patients diagnosed from January 1,1990,to December 31,2016,constituted the study cohort from the Surveillance,Epidemiology,and End Results(SEER)registry.We calculated the overall survival(OS)of these patients by using a Kaplan–Meier analysis.The Kaplan–Meier analysis was used to analyze the influence of various factors on the prognosis of patients in the univariate analysis.The multivariate Cox analysis were applied to find independent prognostic factors of patients with pancreatic SRCC.Receiver-operating characteristic curve(ROC)analysis to investigate the discriminatory ability of the total number of lymph nodes examined(TNLE)relative to whether lymph node metastasis was present.Results:The median number of lymph nodes examined among 120 patients with resected pancreatic SRCC was 14(interquartile range:6.25–20.0).According to the univariate analysis of OS,age,grade,chemotherapy,LNR,and TNLE were significantly different(P<.05).We demonstrated the prognostic benefit of chemotherapy in resected pancreatic SRCC,whereas radiotherapy was not associated with improved survival.The multivariate survival analysis showed that LNR and grade were independent prognostic indicators after pancreatic SRCC resection for OS.TNLE≥8 showed the highest discriminatory power for evaluating lymph node metastasis(Area under curve(AUC):0.656,95%confidence interval:0.564–0.741,Youden index:0.2533,sensitivity:78.67%,specificity:46.67%,P=.003).Conclusion:Our study indicated that the LNR was a valuable independent prognostic factor for resected pancreatic SRCC.Regional lymphadenectomy of at least 8 lymph nodes was necessary to accurately stage patients.An adequate number of lymph nodes examined are necessary for clinicians to accurately predict the significance of the LNR in resected pancreatic SRCC.展开更多
目的:本实验旨在研究大鼠眶下孔注射高渗盐水阿霉素后,三叉神经功能和三叉神经节细胞病理形态的变化。方法:48只SD大鼠,随机分为A、B两组,每组24只,每组又分四个时间点:1周组,2周组,1月组,3月组取材,每时间点6只大鼠。将A、B组分别给予1...目的:本实验旨在研究大鼠眶下孔注射高渗盐水阿霉素后,三叉神经功能和三叉神经节细胞病理形态的变化。方法:48只SD大鼠,随机分为A、B两组,每组24只,每组又分四个时间点:1周组,2周组,1月组,3月组取材,每时间点6只大鼠。将A、B组分别给予10%NaCl和1%阿霉素的混合溶液10μl眶下孔注射,生理盐水10μl眶下孔注射(B组)每组给药后于1周、2周、1月及3月时测试各组剩余大鼠的触须垫感觉功能,后处死取三叉神经节标本,制作H E染色切片,分别观察神经节细胞的形态学变化,用等距随机抽样法记录节细胞总数及异常节细胞率。结果:各组动物感觉功能测试,A、B组同时间点有统计学差异(P<0.01),眶下孔内神经周围注射高渗盐水阿霉素溶液后A 1-A 4组节细胞总数呈递减趋势(同组各时间点分别比较,P<0.01),显著低于B组同时间点(P<0.01),而与B组各时间点相比,无统计学差异(P>0.05);异常节细胞率A 1-A 4组呈递增趋势(A组各时间点相比(P<0.01),显著高于B组同时间点(P<0.01)。结论:大鼠眶下孔内神经周围注射高渗盐水阿霉素后,阿霉素可在高渗盐水的作用下被神经纤维大量吸收并进一步逆行运输到三叉神经节,随着时间的延续引起三叉神经节细胞的渐进性退变。展开更多
文摘Background:Pancreatic signet ring cell carcinoma(SRCC)is an exceedingly rare histological subtype of pancreatic cancer.Previous studies have focused on the trends of incidence and independent predictors of pancreatic SRCC.Our objectives of the study were to analyze the prognostic value of the lymph node ratio(LNR)and to explore the minimal number of lymph nodes examined to accurately evaluate the N stage in resected pancreatic SRCC.Method:We analyzed 120 patients diagnosed from January 1,1990,to December 31,2016,constituted the study cohort from the Surveillance,Epidemiology,and End Results(SEER)registry.We calculated the overall survival(OS)of these patients by using a Kaplan–Meier analysis.The Kaplan–Meier analysis was used to analyze the influence of various factors on the prognosis of patients in the univariate analysis.The multivariate Cox analysis were applied to find independent prognostic factors of patients with pancreatic SRCC.Receiver-operating characteristic curve(ROC)analysis to investigate the discriminatory ability of the total number of lymph nodes examined(TNLE)relative to whether lymph node metastasis was present.Results:The median number of lymph nodes examined among 120 patients with resected pancreatic SRCC was 14(interquartile range:6.25–20.0).According to the univariate analysis of OS,age,grade,chemotherapy,LNR,and TNLE were significantly different(P<.05).We demonstrated the prognostic benefit of chemotherapy in resected pancreatic SRCC,whereas radiotherapy was not associated with improved survival.The multivariate survival analysis showed that LNR and grade were independent prognostic indicators after pancreatic SRCC resection for OS.TNLE≥8 showed the highest discriminatory power for evaluating lymph node metastasis(Area under curve(AUC):0.656,95%confidence interval:0.564–0.741,Youden index:0.2533,sensitivity:78.67%,specificity:46.67%,P=.003).Conclusion:Our study indicated that the LNR was a valuable independent prognostic factor for resected pancreatic SRCC.Regional lymphadenectomy of at least 8 lymph nodes was necessary to accurately stage patients.An adequate number of lymph nodes examined are necessary for clinicians to accurately predict the significance of the LNR in resected pancreatic SRCC.
文摘目的:本实验旨在研究大鼠眶下孔注射高渗盐水阿霉素后,三叉神经功能和三叉神经节细胞病理形态的变化。方法:48只SD大鼠,随机分为A、B两组,每组24只,每组又分四个时间点:1周组,2周组,1月组,3月组取材,每时间点6只大鼠。将A、B组分别给予10%NaCl和1%阿霉素的混合溶液10μl眶下孔注射,生理盐水10μl眶下孔注射(B组)每组给药后于1周、2周、1月及3月时测试各组剩余大鼠的触须垫感觉功能,后处死取三叉神经节标本,制作H E染色切片,分别观察神经节细胞的形态学变化,用等距随机抽样法记录节细胞总数及异常节细胞率。结果:各组动物感觉功能测试,A、B组同时间点有统计学差异(P<0.01),眶下孔内神经周围注射高渗盐水阿霉素溶液后A 1-A 4组节细胞总数呈递减趋势(同组各时间点分别比较,P<0.01),显著低于B组同时间点(P<0.01),而与B组各时间点相比,无统计学差异(P>0.05);异常节细胞率A 1-A 4组呈递增趋势(A组各时间点相比(P<0.01),显著高于B组同时间点(P<0.01)。结论:大鼠眶下孔内神经周围注射高渗盐水阿霉素后,阿霉素可在高渗盐水的作用下被神经纤维大量吸收并进一步逆行运输到三叉神经节,随着时间的延续引起三叉神经节细胞的渐进性退变。
