Objective To evaluate the value of texture features derived from intravoxel incoherent motion(IVIM) parameters for differentiating pancreatic neuroendocrine tumor(pNET) from pancreatic adenocarcinoma(PAC).Methods Eigh...Objective To evaluate the value of texture features derived from intravoxel incoherent motion(IVIM) parameters for differentiating pancreatic neuroendocrine tumor(pNET) from pancreatic adenocarcinoma(PAC).Methods Eighteen patients with pNET and 32 patients with PAC were retrospectively enrolled in this study. All patients underwent diffusion-weighted imaging with 10 b values used(from 0 to 800 s/mm2). Based on IVIM model, perfusion-related parameters including perfusion fraction(f), fast component of diffusion(Dfast) and true diffusion parameter slow component of diffusion(Dslow) were calculated on a voxel-by-voxel basis and reorganized into gray-encoded parametric maps. The mean value of each IVIM parameter and texture features [Angular Second Moment(ASM), Inverse Difference Moment(IDM), Correlation, Contrast and Entropy] values of IVIM parameters were measured. Independent sample t-test or Mann-Whitney U test were performed for the betweengroup comparison of quantitative data. Regression model was established by using binary logistic regression analysis, and receiver operating characteristic(ROC) curve was plotted to evaluate the diagnostic efficiency.Results The mean f value of the pNET group were significantly higher than that of the PAC group(27.0% vs. 19.0%, P = 0.001), while the mean values of Dfast and Dslow showed no significant differences between the two groups. All texture features(ASM, IDM, Correlation, Contrast and Entropy) of each IVIM parameter showed significant differences between the pNET and PAC groups(P = 0.000-0.043). Binary logistic regression analysis showed that texture ASM of Dfast and texture Correlation of Dslow were considered as the specific imaging variables for the differential diagnosis of pNET and PAC. ROC analysis revealed that multiple texture features presented better diagnostic performance than IVIM parameters(AUC 0.849-0.899 vs. 0.526-0.776), and texture ASM of Dfast combined with Correlation of Dslow in the model of logistic regression had largest area under ROC curve for distinguishing pNET from PAC(AUC 0.934, cutoff 0.378, sensitivity 0.889, specificity 0.854). Conclusion Texture analysis of IVIM parameters could be an effective and noninvasive tool to differentiate pNET from PAC.展开更多
THYMIC carcinoma is a rare malignant tumor, but the most common malignant tumor of the ante-rior mediastinum. According to the latest World Health Organization （WHO） classification, primary thymic carcinoma has a va...THYMIC carcinoma is a rare malignant tumor, but the most common malignant tumor of the ante-rior mediastinum. According to the latest World Health Organization （WHO） classification, primary thymic carcinoma has a variety of histological types, mainly including squamous cell, basaloid, mucoepidermoid,lymphoepithelioma-like, sarcomatoid, clear cell and neuro-endocrine carcinomas, and papillary adenocarcinoma.1-4 Thymic mucinous adenocarcinoma was discovered in re-cent years, and only 10 cases were reported. In this paper, we described a case of thymic mucinous adenocarcinoma, the histopathological findings and immunohistochemical results.展开更多
An 88-year-old man presented symptoms and signs of ascending cholangitis and died 20 days after the onset of illness. Postmortem examination revealed a mucinous tumor arising from the head of the pancreas, encasing ...An 88-year-old man presented symptoms and signs of ascending cholangitis and died 20 days after the onset of illness. Postmortem examination revealed a mucinous tumor arising from the head of the pancreas, encasing the common bile duct and invading the liver with multiple hepatic metastasis. The tumor showed a unique and uniform histological apperarance, consisting of signet-ring neoplastic cells floating in mucin pools. The rapid clinical course and widespread hepatic metastasis of this patient suggest that this pure, signet-ring variant of mucinous adenocarcinoma of the pancreas might have a poorer prognosis.展开更多
Objective To quantitatively compare and determine the best pancreatic tumor contrast to noise ratio (CNR) in different dual-energy derived datasets. Methods In this retrospective, single center study, 16 patients (9 m...Objective To quantitatively compare and determine the best pancreatic tumor contrast to noise ratio (CNR) in different dual-energy derived datasets. Methods In this retrospective, single center study, 16 patients (9 male, 7 female, average age 59.4±13.2 years) with pathologically diagnosed pancreatic cancer were enrolled. All patients received an abdominal scan using a dual source CT scanner 7 to 31 days before biopsy or surgery. After injection of iodine contrast agent, arterial and pancreatic parenchyma phase were scanned consequently, using a dual-energy scan mode (100 kVp/230 mAs and Sn 140 kVp/178 mAs) in the pancreatic parenchyma phase. A series of derived dual-energy datasets were evaluated including non-liner blending (non-linear blending width 0-500 HU; blending center -500 to 500 HU), mono-energetic (40-190 keV), 100 kVp and 140 kVp. On each datasets, mean CT values of the pancreatic parenchyma and tumor, as well as standard deviation CT values of subcutaneous fat and psoas muscle were measured. Regions of interest of cutaneous fat and major psoas muscle of 100 kVp and 140 kVp images were calculated. Best CNR of subcutaneous fat (CNR F ) and CNR of the major psoas muscle (CNR M ) of non-liner blending and mono-energetic datasets were calculated with the optimal mono-energetic keV setting and the optimal blending center/width setting for the best CNR. One Way ANOVA test was used for comparison of best CNR between different dual-energy derived datasets. Results The best CNR F (4.48±1.29) was obtained from the non-liner blending datasets at blending center -16.6±103.9 HU and blending width 12.3±10.6 HU. The best CNR F (3.28±0.97) was obtained from the mono-energetic datasets at 73.3±4.3 keV. CNR F in the 100 kVp and 140 kVp were 3.02±0.91 and 1.56±0.56 respectively. Using fat as the noise background, all of these images series showed significant differences (P<0.01) except best CNR F of mono-energetic image sets vs. CNR F of 100 kVp image (P=0.460). Similar results were found using muscle as the noise background (mono-energetic image vs. 100 kVp image: P=0.246; mono-energetic image vs. non-liner blending image: P=0.044; others: P<0.01). Conclusion Compared with mono-energetic datasets and low kVp datasets, non-linear blending image at automatically chosen blending width/window provides better tumor to the pancreas CNR, which might be beneficial for better detection of pancreatic tumors.展开更多
Objective To examine the expression of cell division cycle associated 2(CDCA 2) in pancreatic ductal adenocarcinoma(PDAC) and investigate its role in prognosis of PDAC patients.Methods This retrospective study include...Objective To examine the expression of cell division cycle associated 2(CDCA 2) in pancreatic ductal adenocarcinoma(PDAC) and investigate its role in prognosis of PDAC patients.Methods This retrospective study included 155 PDAC patients who underwent surgical treatment and complete post-operative follow-up.Clinicopathologic data were collected through clinical database.Tissue microarray was constructed and immunohistochemistry was performed to detect CDCA2 expression in the PDAC tumor tissues and adjacent non-tumor tissues.Clinicopathological characteristics between high and low CDCA2 expression were compared.Correlation of CDCA2 expressions with patients' survival was analyzed using Kaplan-Meier method and Cox regression analysis.Results Expression of CDCA2 in PDAC cells was significantly higher than that in adjacent non-tumor tissues(U=4056.5,P<0.001).Univariate analysis showed that CDCA2 expression [hazard ratio(HR)=1.574,95% confidence interval(CI)=1.014-2.443,P=0.043] and node metastasis(HR=1.704,95%CI=1.183-2.454,P=0.004) were significantly associated with prognosis.Cox regression analysis showed CDCA2 expression was not an independent prognostic risk factor(HR=1.418,95%CI=0.897-2.242,P=0.135) for PDCA patients.Stratification survival analysis demonstrated CDCA2 expression as an independent prognostic risk factor in male patients(HR=2.554,95%CI=1.446-4.511,P=0.003) or in non-perineural invasion patients(HR=2.290,95%CI=1.146-4.577,P=0.012).Conclusions CDCA2 is highly expressed in PDAC tumor tissue.Although CDCA2 is not an independent prognostic risk factor for PDAC patients,it might be used to help predict prognosis of male or non-perineural invasion patients of PDAC.展开更多
Objective: To study the effects of transferred wild type p73α gene on the sensitivity to the chemotherapeutic agents and the growth of p53-null H1299 cells of human lung adenocarcinoma. Methods: The pcDNA3-HA-p73α p...Objective: To study the effects of transferred wild type p73α gene on the sensitivity to the chemotherapeutic agents and the growth of p53-null H1299 cells of human lung adenocarcinoma. Methods: The pcDNA3-HA-p73α plasmid was transferred into the cultured p53-null H1299 cells of human lung adenocarcinoma with the mediation of Dosper liposome; The cells resistant to G418 were selected. The expression of p73α gene in the cells was examined with Western blot. MTT assay was used to analyze the response of the transfected cells to cis-dichlorodiamine platinum (cDDP) and adriamycin (ADM). The rate of drug-induced apoptosis of the transfected cells was determined with flow cytometry and DNA fragmentation assay. The changes of the biological behaviors were observed with colony formation assay. Results: The transfected H1299 cells of human lung adenocarcinoma over-expressed p73α protein stably. MTT assay showed that the IC 50 values of cDDP and ADM were reduced by approximately 7 fold and 130 fold respectively in the transfected cells as compared with the untransfected ones. Lower concentration of the chemotherapeutic agents (1.25 μmol/L of cDDP and 0.05 μmol/L of ADM) could be employed to suppress markedly the growth of the transfected H1299 cells. The apoptotic rate induced by cDDP was increased from 10.1% to 38 4% (P<0.01) and that of ADM from 12.1% to 49.3% (P<0.01). The clonogenecity after the administration of chemotherapeutic agents was significantly lower in the transfected H1299 cells than in the parental cells (P<0.01). The sensitive enhancement ratios were 1.8 and 2.6 for cDDP and ADM respectively. Conclusion: The transfection of H1299 cells with wild type p73α gene results in an increase of the sensitivity of the cells to chemotherapeutic agents.展开更多
Objective Many studies have revealed the crucial roles of miRNA in multiple human cancers,including lung adenocarcinoma(LUAD).In this study,we sought to explore new miRNA-mRNA pairs that are associated with LUAD progn...Objective Many studies have revealed the crucial roles of miRNA in multiple human cancers,including lung adenocarcinoma(LUAD).In this study,we sought to explore new miRNA-mRNA pairs that are associated with LUAD prognosis.Methods A novel miRNA-mRNA regulatory network associated with prognosis in LUAD was identified and validated using the bioinformatic tools including OncomiR database,StarBase,miRnet,GEPIA2,UALCAN.Results Twenty key miRNAs were compiled after the analysis of the expression and prognostic value in OncomiR and StarBase.Targeted mRNAs of these key miRNAs were predicted in miRnet,and the resulting mRNAs were also analyzed for their prognostic values and expression patterns in GEPIA2 and UALCAN,respectively.Further expression correlation analysis was performed in StarBase.Subsequently,a new miRNA-mRNA network was built,of which each RNA pair showed negative expression correlation,opposite expression pattern,and prognostic value.Protein-protein interaction network was under construction for the mRNAs,and 19 hub genes were determined.Enrichment analysis showed that“Cell Cycle,Mitotic”was the most significantly enriched term.Then,a miRNA-hub gene sub-network was built.We selected and validated the regulatory relationship of some miRNA-hub pairs,including hsa-miR-1976/RFC2,hsa-let-7c-5p/RFC2,hsa-let-7c-5p/ESPL1,hsa-let-7c-5p/CDC25A,and hsa-miR-101-3p/KIF2C.Moreover,over-expression of hsa-miR-1976 and hsa-let-7c-5p resulted in significant cell cycle arrest.Conclusions Our results determined new prognosis-associated miRNA-mRNA pairs and might shed further light on the mechanism via which miRNA-mRNA network influences prognosis in LUAD.展开更多
Objective To investigate the associations between epidermal growth factor receptor （EGFR） gene mutations and serum tumor markers in advanced lung adenocarcinomas. Methods We investigated the association between EGF...Objective To investigate the associations between epidermal growth factor receptor （EGFR） gene mutations and serum tumor markers in advanced lung adenocarcinomas. Methods We investigated the association between EGFR gene mutations and clinical features, including serum tumor marker levels, in 97 advanced lung adenocarcinomas patients who did not undergo the treatment of EGlaR tyrosine kinase inhibitors. EGFR gene mutation was detected by real-time PCR at exons 18, 19, 20, and 21. Serum tumor marker concentrations were analyzed by chemiluminescence assay kit at the same time. Results EGFR gene mutations were detected in 42 （43%） advanced lung adenocarcinoma patients. Gender （P=0.003）, smoking status （P=0.001）, and abnormal serum status of carcinoembryonic antigen （CEA, P=0.028） were significantly associated with EGFR gene mutation incidence. Multivariate analysis showed the abnormal CEA level in serum was independently associated with the incidence of EGFR gene mutation （P=0.046） with an odds ratio of 2.613 （95% Ch 1.018-6.710）. However, receiver operating characteristic （ROC） curve analysis revealed CEA was not an ideal predictive marker for EGFR gene mutation status in advanced lung adenocarcinoma （the area under the ROC curve was 0.608, P=0.069）. Conclusions EGFR gene mutation status is significantly associated with serum CEA status in advanced lung adenocarcinmoas. However, serum CEA is not an ideal predictor for EGFR mutation.展开更多
Sixty-six patients with advanced adenocarcinoma of the cardia underwent total gastrectomybetween 1978 and 1986.The operative morbidity rate was 7.5% and the hospital mortalityrate (1 month) was 1.5%.The postoperative ...Sixty-six patients with advanced adenocarcinoma of the cardia underwent total gastrectomybetween 1978 and 1986.The operative morbidity rate was 7.5% and the hospital mortalityrate (1 month) was 1.5%.The postoperative 1,3,4,and 5 year survival rates were 69%.50.7%,20% and 13.8% respectively.The quality of life after surgery was improved.Patho-logical type,lymph node metastasis,completeness of resectionand postoperative chemotherapywere the main factors influencing postoperative survival time.Indications for total gastrec-tomy and the advantages of transthoracic total gastrectomy are discussed.展开更多
文摘Objective To evaluate the value of texture features derived from intravoxel incoherent motion(IVIM) parameters for differentiating pancreatic neuroendocrine tumor(pNET) from pancreatic adenocarcinoma(PAC).Methods Eighteen patients with pNET and 32 patients with PAC were retrospectively enrolled in this study. All patients underwent diffusion-weighted imaging with 10 b values used(from 0 to 800 s/mm2). Based on IVIM model, perfusion-related parameters including perfusion fraction(f), fast component of diffusion(Dfast) and true diffusion parameter slow component of diffusion(Dslow) were calculated on a voxel-by-voxel basis and reorganized into gray-encoded parametric maps. The mean value of each IVIM parameter and texture features [Angular Second Moment(ASM), Inverse Difference Moment(IDM), Correlation, Contrast and Entropy] values of IVIM parameters were measured. Independent sample t-test or Mann-Whitney U test were performed for the betweengroup comparison of quantitative data. Regression model was established by using binary logistic regression analysis, and receiver operating characteristic(ROC) curve was plotted to evaluate the diagnostic efficiency.Results The mean f value of the pNET group were significantly higher than that of the PAC group(27.0% vs. 19.0%, P = 0.001), while the mean values of Dfast and Dslow showed no significant differences between the two groups. All texture features(ASM, IDM, Correlation, Contrast and Entropy) of each IVIM parameter showed significant differences between the pNET and PAC groups(P = 0.000-0.043). Binary logistic regression analysis showed that texture ASM of Dfast and texture Correlation of Dslow were considered as the specific imaging variables for the differential diagnosis of pNET and PAC. ROC analysis revealed that multiple texture features presented better diagnostic performance than IVIM parameters(AUC 0.849-0.899 vs. 0.526-0.776), and texture ASM of Dfast combined with Correlation of Dslow in the model of logistic regression had largest area under ROC curve for distinguishing pNET from PAC(AUC 0.934, cutoff 0.378, sensitivity 0.889, specificity 0.854). Conclusion Texture analysis of IVIM parameters could be an effective and noninvasive tool to differentiate pNET from PAC.
文摘THYMIC carcinoma is a rare malignant tumor, but the most common malignant tumor of the ante-rior mediastinum. According to the latest World Health Organization （WHO） classification, primary thymic carcinoma has a variety of histological types, mainly including squamous cell, basaloid, mucoepidermoid,lymphoepithelioma-like, sarcomatoid, clear cell and neuro-endocrine carcinomas, and papillary adenocarcinoma.1-4 Thymic mucinous adenocarcinoma was discovered in re-cent years, and only 10 cases were reported. In this paper, we described a case of thymic mucinous adenocarcinoma, the histopathological findings and immunohistochemical results.
文摘An 88-year-old man presented symptoms and signs of ascending cholangitis and died 20 days after the onset of illness. Postmortem examination revealed a mucinous tumor arising from the head of the pancreas, encasing the common bile duct and invading the liver with multiple hepatic metastasis. The tumor showed a unique and uniform histological apperarance, consisting of signet-ring neoplastic cells floating in mucin pools. The rapid clinical course and widespread hepatic metastasis of this patient suggest that this pure, signet-ring variant of mucinous adenocarcinoma of the pancreas might have a poorer prognosis.
文摘Objective To quantitatively compare and determine the best pancreatic tumor contrast to noise ratio (CNR) in different dual-energy derived datasets. Methods In this retrospective, single center study, 16 patients (9 male, 7 female, average age 59.4±13.2 years) with pathologically diagnosed pancreatic cancer were enrolled. All patients received an abdominal scan using a dual source CT scanner 7 to 31 days before biopsy or surgery. After injection of iodine contrast agent, arterial and pancreatic parenchyma phase were scanned consequently, using a dual-energy scan mode (100 kVp/230 mAs and Sn 140 kVp/178 mAs) in the pancreatic parenchyma phase. A series of derived dual-energy datasets were evaluated including non-liner blending (non-linear blending width 0-500 HU; blending center -500 to 500 HU), mono-energetic (40-190 keV), 100 kVp and 140 kVp. On each datasets, mean CT values of the pancreatic parenchyma and tumor, as well as standard deviation CT values of subcutaneous fat and psoas muscle were measured. Regions of interest of cutaneous fat and major psoas muscle of 100 kVp and 140 kVp images were calculated. Best CNR of subcutaneous fat (CNR F ) and CNR of the major psoas muscle (CNR M ) of non-liner blending and mono-energetic datasets were calculated with the optimal mono-energetic keV setting and the optimal blending center/width setting for the best CNR. One Way ANOVA test was used for comparison of best CNR between different dual-energy derived datasets. Results The best CNR F (4.48±1.29) was obtained from the non-liner blending datasets at blending center -16.6±103.9 HU and blending width 12.3±10.6 HU. The best CNR F (3.28±0.97) was obtained from the mono-energetic datasets at 73.3±4.3 keV. CNR F in the 100 kVp and 140 kVp were 3.02±0.91 and 1.56±0.56 respectively. Using fat as the noise background, all of these images series showed significant differences (P<0.01) except best CNR F of mono-energetic image sets vs. CNR F of 100 kVp image (P=0.460). Similar results were found using muscle as the noise background (mono-energetic image vs. 100 kVp image: P=0.246; mono-energetic image vs. non-liner blending image: P=0.044; others: P<0.01). Conclusion Compared with mono-energetic datasets and low kVp datasets, non-linear blending image at automatically chosen blending width/window provides better tumor to the pancreas CNR, which might be beneficial for better detection of pancreatic tumors.
基金Supported by the National High Technology Research and Development Program of China(863 Program)(2012AA02A212)
文摘Objective To examine the expression of cell division cycle associated 2(CDCA 2) in pancreatic ductal adenocarcinoma(PDAC) and investigate its role in prognosis of PDAC patients.Methods This retrospective study included 155 PDAC patients who underwent surgical treatment and complete post-operative follow-up.Clinicopathologic data were collected through clinical database.Tissue microarray was constructed and immunohistochemistry was performed to detect CDCA2 expression in the PDAC tumor tissues and adjacent non-tumor tissues.Clinicopathological characteristics between high and low CDCA2 expression were compared.Correlation of CDCA2 expressions with patients' survival was analyzed using Kaplan-Meier method and Cox regression analysis.Results Expression of CDCA2 in PDAC cells was significantly higher than that in adjacent non-tumor tissues(U=4056.5,P<0.001).Univariate analysis showed that CDCA2 expression [hazard ratio(HR)=1.574,95% confidence interval(CI)=1.014-2.443,P=0.043] and node metastasis(HR=1.704,95%CI=1.183-2.454,P=0.004) were significantly associated with prognosis.Cox regression analysis showed CDCA2 expression was not an independent prognostic risk factor(HR=1.418,95%CI=0.897-2.242,P=0.135) for PDCA patients.Stratification survival analysis demonstrated CDCA2 expression as an independent prognostic risk factor in male patients(HR=2.554,95%CI=1.446-4.511,P=0.003) or in non-perineural invasion patients(HR=2.290,95%CI=1.146-4.577,P=0.012).Conclusions CDCA2 is highly expressed in PDAC tumor tissue.Although CDCA2 is not an independent prognostic risk factor for PDAC patients,it might be used to help predict prognosis of male or non-perineural invasion patients of PDAC.
文摘Objective: To study the effects of transferred wild type p73α gene on the sensitivity to the chemotherapeutic agents and the growth of p53-null H1299 cells of human lung adenocarcinoma. Methods: The pcDNA3-HA-p73α plasmid was transferred into the cultured p53-null H1299 cells of human lung adenocarcinoma with the mediation of Dosper liposome; The cells resistant to G418 were selected. The expression of p73α gene in the cells was examined with Western blot. MTT assay was used to analyze the response of the transfected cells to cis-dichlorodiamine platinum (cDDP) and adriamycin (ADM). The rate of drug-induced apoptosis of the transfected cells was determined with flow cytometry and DNA fragmentation assay. The changes of the biological behaviors were observed with colony formation assay. Results: The transfected H1299 cells of human lung adenocarcinoma over-expressed p73α protein stably. MTT assay showed that the IC 50 values of cDDP and ADM were reduced by approximately 7 fold and 130 fold respectively in the transfected cells as compared with the untransfected ones. Lower concentration of the chemotherapeutic agents (1.25 μmol/L of cDDP and 0.05 μmol/L of ADM) could be employed to suppress markedly the growth of the transfected H1299 cells. The apoptotic rate induced by cDDP was increased from 10.1% to 38 4% (P<0.01) and that of ADM from 12.1% to 49.3% (P<0.01). The clonogenecity after the administration of chemotherapeutic agents was significantly lower in the transfected H1299 cells than in the parental cells (P<0.01). The sensitive enhancement ratios were 1.8 and 2.6 for cDDP and ADM respectively. Conclusion: The transfection of H1299 cells with wild type p73α gene results in an increase of the sensitivity of the cells to chemotherapeutic agents.
基金supported by the National Natural Sci-ence Foundation of China(81901519)Anhui Provincial Natural Science Foundation(1908085QH380)and the Talent Scientific Research Start-up Foundation of Yijis-han Hospital,Wannan Medical College(YR201901).
文摘Objective Many studies have revealed the crucial roles of miRNA in multiple human cancers,including lung adenocarcinoma(LUAD).In this study,we sought to explore new miRNA-mRNA pairs that are associated with LUAD prognosis.Methods A novel miRNA-mRNA regulatory network associated with prognosis in LUAD was identified and validated using the bioinformatic tools including OncomiR database,StarBase,miRnet,GEPIA2,UALCAN.Results Twenty key miRNAs were compiled after the analysis of the expression and prognostic value in OncomiR and StarBase.Targeted mRNAs of these key miRNAs were predicted in miRnet,and the resulting mRNAs were also analyzed for their prognostic values and expression patterns in GEPIA2 and UALCAN,respectively.Further expression correlation analysis was performed in StarBase.Subsequently,a new miRNA-mRNA network was built,of which each RNA pair showed negative expression correlation,opposite expression pattern,and prognostic value.Protein-protein interaction network was under construction for the mRNAs,and 19 hub genes were determined.Enrichment analysis showed that“Cell Cycle,Mitotic”was the most significantly enriched term.Then,a miRNA-hub gene sub-network was built.We selected and validated the regulatory relationship of some miRNA-hub pairs,including hsa-miR-1976/RFC2,hsa-let-7c-5p/RFC2,hsa-let-7c-5p/ESPL1,hsa-let-7c-5p/CDC25A,and hsa-miR-101-3p/KIF2C.Moreover,over-expression of hsa-miR-1976 and hsa-let-7c-5p resulted in significant cell cycle arrest.Conclusions Our results determined new prognosis-associated miRNA-mRNA pairs and might shed further light on the mechanism via which miRNA-mRNA network influences prognosis in LUAD.
基金Supported by National Natural Science Fund of China(31370920)Public Technology Research Program of Zhejiang Province(2014C33157)Medical and Health Research Project of Zhejiang Province(2014KYA225)
文摘Objective To investigate the associations between epidermal growth factor receptor （EGFR） gene mutations and serum tumor markers in advanced lung adenocarcinomas. Methods We investigated the association between EGFR gene mutations and clinical features, including serum tumor marker levels, in 97 advanced lung adenocarcinomas patients who did not undergo the treatment of EGlaR tyrosine kinase inhibitors. EGFR gene mutation was detected by real-time PCR at exons 18, 19, 20, and 21. Serum tumor marker concentrations were analyzed by chemiluminescence assay kit at the same time. Results EGFR gene mutations were detected in 42 （43%） advanced lung adenocarcinoma patients. Gender （P=0.003）, smoking status （P=0.001）, and abnormal serum status of carcinoembryonic antigen （CEA, P=0.028） were significantly associated with EGFR gene mutation incidence. Multivariate analysis showed the abnormal CEA level in serum was independently associated with the incidence of EGFR gene mutation （P=0.046） with an odds ratio of 2.613 （95% Ch 1.018-6.710）. However, receiver operating characteristic （ROC） curve analysis revealed CEA was not an ideal predictive marker for EGFR gene mutation status in advanced lung adenocarcinoma （the area under the ROC curve was 0.608, P=0.069）. Conclusions EGFR gene mutation status is significantly associated with serum CEA status in advanced lung adenocarcinmoas. However, serum CEA is not an ideal predictor for EGFR mutation.
文摘Sixty-six patients with advanced adenocarcinoma of the cardia underwent total gastrectomybetween 1978 and 1986.The operative morbidity rate was 7.5% and the hospital mortalityrate (1 month) was 1.5%.The postoperative 1,3,4,and 5 year survival rates were 69%.50.7%,20% and 13.8% respectively.The quality of life after surgery was improved.Patho-logical type,lymph node metastasis,completeness of resectionand postoperative chemotherapywere the main factors influencing postoperative survival time.Indications for total gastrec-tomy and the advantages of transthoracic total gastrectomy are discussed.
