1.Characteristics of lymph node metastasis and surgical treatment of gastric stump cancer
Xiang HU ; Dayu TIAN ; Liang CAO
Chinese Journal of Digestive Surgery 2010;9(3):203-206
Objective To explore the characteristics of lymph node metastasis in gastric stump cancer and the efficacy of surgical treatment. Methods The clinical data of 42 patients with gastric stump cancer (test group) and 56 patients with primary cancer in the upper stomach (control group) who were admitted to The First Affiliated Hospital of Dalian Medical University from January 1994 to January 2008 were retrospectively analyzed. All data were analyzed by t test and chi-square test. The survival of the patients and lymph node metastasis rate were analyzed using the Kaplan-Meier method and Log-rank test, respectively. Results The metastasis rates of lymph nodes 1-3 of the test group and control group were similar (43%-61%), with no significant difference between the 2 groups (χ2 = 0.752, 0. 833, 0. 678, P > 0. 05). The metastasis rates of lymph nodes 7-9 of the test group and control group were 22% , 18% , 25% and 46% , 25% , 30% , respectively, and this was signifi-cantly different between the 2 groups (χ2 = 2. 168, 3. 263, 5. 761, P < 0. 05). The metastasis rates of lymph nodes 10-14 were 47% , 36% , 31% , 20% and 25% in the test group, which were significantly higher than 33% , 34% , 19% , 6% and zero in the control group, respectively (χ2 =3.225, 1.883, 3.945, 4.137, 6.823, P <0.05). The metastasis rate of lymph node no. 16 was zero in the test group and 23% in the control group. The metastasis rate of jejunal mesenteric lymph nodes was 27% in the test group and zero in the control group. The accumulative 5-year survival rate of patients was 38% in the test group and 48% in the control group, and this was significantly different (χ2 =4. 165, P<0.05). The overall 5-year survival rate of patients with radical resection was not significantly different between degree A (54%) and B (57%) (χ2 = 0. 622, P > 0. 05). Conclusions Gastric stump cancer has a unique pattern in lymph node metastasis. Surgical resection is effective in improving the prognosis of patients with gastric stump cancer.
2.Clinical analysis of early gastric cancer in 338 cases
Dayu TIAN ; Songhai ZHANG ; Xiang HU
Chinese Journal of Postgraduates of Medicine 2011;34(2):21-24
Objective To find out the relationship between lymph node metastasis and clinical pathological specificity, the prognostic factors for the purpose of improving survival of early gastric cancer (EGC) and quality of life. Methods The clinical data of the 338 EGC patients from July 1999 to June 2009 was analyzed retrospectively, includirg the possible relationship of lymph node metastasis, the size of tumor,types of histopathology,depth of infiltration. Using Kaplan-Meier method to process suvival rate,immunohistochemistry method to detect the micrometastasis. Results Lymphnode metastasis was relative to the size of tumor, depth of infiltration (P < 0.05 or < 0.01). Total 5-year survival rate was 92.1%, intramucosa 5-year survival rate 97.1%, submucosa 5-year survival rate was 85.7% in 63 followed up patients, the survival rate of EGC was related with depth of infiltration and size of tumor (P = 0.043,0.004). Conclusion By precisely estimating depth of infiltration, the size of tumor and correct estimating the state of lymph node metastasis, choosing right 5-year surgical protocol can improve EGC survival rate and prognosis.
3.Pylorus-preserving gastrectomy for early gastric cancer
Xiang HU ; Liang CAO ; Yi YU ; Dayu TIAN
Chinese Journal of General Surgery 2011;26(4):316-319
Objective To discuss the effect of pylorus-preserving gastrectomy for early gastric cancer(EGC). Methods Between August 1995 and December 2005, 52 cases of EGC underwent pyloruspreserving gastrectomy(PPG) and 159 cases of EGC underwent distal gastrectomy(DG), Clinicopathlogic data and follow-up results of the two groups were analyzed retrospectively, and gastric emptying and gallbladder function of 15 cases PPG and 17 cases DG were compared at the same time.Results Compared with DG group, patients in PPG group maintain the body weight, gastric emptying and gallbladder function. There was no significant difference between PPG group (92. 3% ) and DG group (93.1% ) in overall 5-year survival rate ( P = 0. 881 ). The 5-year survival rate of the the PPG group with lymph node dissection was D1 100%, D1+α 92. 3%, D1+β 88.9%, D2 87. 5% respectively.Conclusions For early gastric cancer, the pylorus-preserving gastrectomy is effective for maintaining the postoperative function with similar long term survival as that of distal gastrectomy.
4.The outcome and prognosis of surgical treatment for gastric carcinoma in the elderly
Zhenglin WANG ; Xiang HU ; Pin LIANG ; Dayu TIAN
Chinese Journal of General Surgery 1997;0(04):-
Objective To analyze the clinicopathologic features,effect of surgical treatment and prognosis of elderly patients with gastric cancer.Methods The records of 84 elderly patients(aged 80 years or above) with gastric cancer who underwent operation in our hospital from 2000-2008 were analyzed retrospectively.Results Ten patients had early gastric cancer(1a,8 cases,1b,2cases),stage II 12 cases,stage III 45 cases(53.6%) and stage IV 17 cases.Among them,81% patients had one or more co-morbidities.Cardiovascular disease was present in 43 cases(51.2%).Resection rate was 85.7%(72/84).Radical resection rate was 60.7%(51/84).Limited nodal dissection(
5.Measurement of microvessel density in laryngeal carcinoma and its clinical significance
Liqiang ZHANG ; Xinyong LUAN ; Xinliang PAN ; Xiaodong TIAN ; Fenglei XU ; Dayu LIU ; Dapeng LEI
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2001;(3):115-117
Objective:To determine the microvessel density (MVD) in laryngeal carcinoma and its clinical significance.Method:Thirty-eight tumor specimens were selected from laryngeal cancer patients from January,1994 to March,1996.Histological sections of the tumors were stained immunohistochemically for factor Ⅷ.Using light microscopy,we counted microvessels per 400×field in the most active areas of tumor angiogenesis.Result:①The tumor blood vessels,composed of only one layer of endothelium were mainly distrbuted heterogenously in the interstitial tissue of laryngeal carcinoma with irregular lumen,poorly developed structure.②The MVD in the cancer tissues were statistically higher than that in peritumoral tissues (P<0.01).③The MVD in the cancer tissues in group of patients with metastasis to cervical lymphonodes were statistically higher than in group without metastasis (P<0.01),the MVD in the cancer tissues in group of advanced cases (Ⅲ,Ⅳ stages) were statistically higher than that in group of early cases (Ⅰ,Ⅱ stages,P<0.01).④There was no statistically difference in MVD in the cancer tissue between supraglottic and glottic laryngeal carcinoma patients (P>0.05).⑤There was no statistically difference in MVD in the cancer tissue among the G1,G2 and G3 group (P>0.05).Conclusion:The laryngeal cancer blood vessels have some characteristics that don′t appear in normal vessels.It is suggested that tumor angiogenesis can promote tumor growth and metastasis and MVD may be a new prognostic indicator of laryngeal carcinoma.