1.Short-term clinical effect of endoscopic photodynamic therapy on esophageal squamous cell carcinoma and precancerous lesion
Xionghuai HUA ; Wei ZHANG ; Ruixiang ZHANG ; Jun ZHANG ; Haixia CAO ; Yongkui YU ; Haomiao LI ; Yin LI
Chinese Journal of Digestive Endoscopy 2017;34(1):38-42
Objective To evaluate the short?term efficacy and safety of endoscopic photodynamic therapy ( PDT ) for esophageal squamous cell carcinoma ( ESCC ) and precancerous lesion. Methods Retrospective analysis was performed on 30 patients with early ESCC or precancerous lesions who received PDT between September 2013 and April 2015 in Endoscopy Center, Henan Tumor Hospital,and its indications were summarized. The main outcomes including histological complete response rate ( CR ) , recurrence rate and adverse events after treatment of one year were analyzed. Results Three patients with middle grade dysplasia( MGD) , 18 with high grade dysplasia( HGD) and 4 with squamous cell carcinoma in situ, all negative lymph node metastasis, received PDT. CRs were 72?0%(18/25) and 88?0%(22/25)after one PDT session in 3 months and 12 months, respectively. One?year follow?up showed 3 recurrences ( 12?0%) ,4 ( 16?0%) severe strictures, and no perforation. Five patients with advanced squamous cell carcinoma received palliative PDT. Partial remission rate was 60?0%( 3/5) after one PDT session in 3 months, and 40?0% ( 2/5) after 12 months. Two died of tumor metastasis, one died of gastrointestinal bleeding one year after PDT. No perforation occurred. Conclusion Endoscopic photodynamic therapy for esophageal squamous cell carcinoma and precancerous lesions is safe and feasible, with remarkable short?term effect. As for the patients with advanced squamous cell carcinoma, it is equally safe and effective in the short term.
2.Clinical Application of Endobronchial Ultrasound-guided Transbronchial Needle Aspiration Biopsy for the Diagnosis of Superior Vena Cava Obstruction Syndrome
HUA XIONGHUAI ; ZHANG WEI ; FENG HUIMIN ; WEI XIUFENG ; QIAO SIJIE ; LI YIN
Chinese Journal of Lung Cancer 2013;(9):482-486
Background and objective Mediastinal lymphoma or right upper lung cancer is a common cause of superior vena cava obstruction syndrome (SVCOS). Endobronchial ultrasound-guided needle aspiration (EBUS-TBNA) biopsy is applied for the diagnosis of mediastinal mass disease. hTe aim of this study is to explore the safety and feasibility of EBUS-TBNA biopsy under general anesthesia for the clinical diagnosis of SVCOS. Methods Twenty-ifve cases of SVCOS re-ceived EBUS-TBNA under general anesthesia between June 2012 and June 2013. hTe group consisted of 16 male and 9 female patients aged 33 years to 76 years, with a median age of 62.5. Results Twenty-four cases were conifrmed to be of malignant pathology, and one case failed to yield a clear pathological diagnosis. No patient experienced any complications related to the operation, such as heavy bleeding and pneumothorax. Conclusion For patients presenting with SVCOS, EBUS-TBNA under general anesthesia is a safe and reliable inspection method of high diagnostic yield. hTis method can be used for routine exami-nation when other means cannot obtain clear pathological diagnosis.
3.An aortic arch anomaly protruding into the esophagus misdiagnosed as leiomyoma of the esophagus.
Xionghuai HUA ; Wei ZHANG ; Yin LI
Chinese Medical Journal 2014;127(15):2879-2879
Aorta, Thoracic
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abnormalities
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Esophageal Neoplasms
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diagnosis
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Humans
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Leiomyoma
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diagnosis
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Male
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Middle Aged
4.Accuracy and influence factors of preoperative clinical staging for T2 esophageal cancer by endoscopic ultrasound
ZHANG Jun ; CAO Haixia ; ZHANG Wei ; HUA Xionghuai ; MA Haibo ; LI Yin
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2017;24(10):760-763
Objective To evaluate the accuracy and investigate the influence factors of preoperative T staging by endoscopic ultrasonography (EUS) in patients with postoperative pathological stage of T2 esophageal carcinoma (EC). Methods A total of 206 patients with EC underwent EUS and curative operation in Henan Tumor Hospital from March 2015 to January 2016 were enrolled, among whom 81 patients were identified with pathological stage of T2 EC followed by esophageal resection without induction therapy. There were 59 males and 22 females, with a mean age of 63.9 years and meadian age of 63.0 years. We reviewed the medical records of the 81 patients and compared EUS findings with histopathologic results according to clinicopathologic factors. Results The overall accuracy of EUS for evaluating staging of T2 EC was 61.7% (50/81), while 38.3% (31/81) were overstaged by EUS. Accuracy differed between the accurate staging group and over staging group (P=0.023). There was no significant difference in sex, age, tumor location and shape, histologic type, tumor differentiation or lymph node metastasis between two groups. Conclusion EUS is highly overstaged in the diagnosis of postoperative pathological stage of T2 EC. Higher postoperative pathological TNM stage appears to be a factor of EUS overstaging in patients with postoperative pathological stage of T2 EC.