1.The combination of sephedex and docetaxel used in intervention for clinical treatment of primary liver cancer
Jingxian LI ; Yanping JIANG ; Jiaping WANG ; Li GUO ; Li ZHU ; Rui LIU ; Ruimin ZHAO ; Yuyun TONG ; Yuanxi JIAN
Journal of Practical Radiology 2017;33(5):739-741,753
Objective To study the clinical efficacy of the combination of sephedex and docetaxel used in transcatheter arterial chemoembolization (TACE) for clinical treatment of primary liver cancer.Methods 120 patients with primary liver cancer in our hospital were divided into the experimental group and the control group randomly and equally, the 60 cases in experimental group were treated with sephedex suspensoid (Sephedex, G-50, 300-500 μm) and docetaxel-iodized oil, while other 60 cases in control group were treated with docetaxel-iodized oil suspension liquid.Results The success rate of surgical intubation in the two groups was 100%.After an average follow-up of 12 months, the postoperative tumor diameter of the experimental group was reduced by (4.4±1.4) cm, while that of the control group was (1.8±1.0) cm;The overall response rate was 70% in the experimental group in contrast to 30% in the control group;the alpha fetal protein (AFP) value was decreased by (33.2±15.2) μg/L in the experimental group and (10.4±9.8) μg/L in the control group.Conclusion The combination of sephedex, docetaxel suspensoid and iodized oil shows great potential in TACE treatment of primary liver cancer, from which the treatment effect can be improved significantly.
2.Aromatase inhibitors and TAM in the treatment of post-menopausal Luminal B breast cancer patients
Jinghong ZHANG ; Yan LIU ; Xiaomeng HAO ; Rui HUI ; Fenglin ZANG ; Peng LIU ; Yuanxi ZHU ; Yi YANG ; Jin ZHANG
Chinese Journal of General Surgery 2010;25(6):449-452
Objective To evaluate a therapeutic strategy using aromatase inhibitors and TAM in postmenopausal Luminal B breast cancer patients. Methods The clinical data of 733 primary breast cancer cases receiving postoperative endocrine thempy from July 2002 to Mar 2005 in Tianjin Cancer Hospital were retrospectively analyzed.Diagnosis was confirmed by pathology in all the cases.All patients were post-menopausal and ER-positive.501 patients were given tamoxifen(TAM 2.5 mg qd,po),232 patients were given aromatase inhibitors(Letrozole 10 mg bid,po).The follow-up time ranged from 36 to 90 months.Median follow-up time was 46 months.Results The disease-free-survival(DFS)rate of Luminal B breast cancer patients in aromatase inhibitors(AIS)group was higherthan that in TAM group(90.6% vs.88.6%,P=0.038).In TAM group,subgroup analysis showed 3-year DFS of node-positive with HER2(+)is lower than that of node-positive with Her-2-negative(88.2% vs.90.4%,P=0.037);3-year DFS of ER+/PR+ group in HER2(+) patients was higher than that of ER+/PR-group(90.8% vs.89.5%.P=0.032).In AIs group,in spite of the axillary lymph node status,there was no significant difference of 3-year DFS between HER2(+)patients and HER2(-)ones(P>0.05).3-year DFS of ER+/PR+with HER2(+) patients was higher than that of ER+/PR-ones with HER2(+)(91.9% vs.90.5%,P=0.029).Hot flush,vaginal bleeding and thromboembolics in AIS group is less frequent,but muscle pain and bone fracture is more common than that in TAM group(P<0.05).Conclusion Compared to TAM, AIs is more effective and safer with postmenopausal Luminal B patients,and the effect is independent on node stams.
3.MRI manifestations and analysis of misdiagnosis of extrapleural solitary fibrous tumor
Li ZHU ; Xinxiang ZHAO ; Yingchun LI ; Yuanxi JIAN ; Daobing ZENG
Journal of Practical Radiology 2018;34(1):27-30
Objective To explore MRI manifestations of extrapleural solitary fibrous tumor(SFT)and to analyze the reasons of misdiagnosis.Methods MRI data of 9 cases with extrapleural SFT proved by pathology were analyzed retrospectively.Lesions location, size,shape,intensity,degrees and patterns of enhancement were assessed,and the imaging features and causes of misdiagnosis were also analyzed.Results Among 9 lesions,1 was located in the right cerebellopontine angle region,2 were in subdural-extramedullary region,4 were in the abdominal cavity and 2 were in the pelvic cavity.7 cases were misdiagnosed before operation including 1 as meningioma, 2 as schwannoma,2 as mesenchymal stem cell tumor,1 as pancreatic carcinoma and 1 as Castleman disease.8 lesions were isointense and 1 was mixed iso-or slightly hyperintense on T1WI.3 lesions were isointense,4 were mixed iso-or slightly hyperintense and 2 were mixed slightly hyperintense,iso-or hypointense on T2WI.3 lesions showed significant homogeneous enhancement after the administration of contrast agent,1 lesion showed varying degrees of enhancement and the enhancement was more remarkable in isointense area on T2WI than peripheral hyperintense area.4 lesions showed heterogeneous peripherial enhancement in the early phase,progressive filling in the late phase and finally remarkable homogeneous enhancement.1 lesion showed predominant peripheral striped enhancement in the early phase,and progressive filling and mildly inhomogeneous enhancement with patchy unenhanced area in the center of the lesion in the late phase.Conclusion The MRI features of extrapleural SFT have certain characteristics.It needs to be carefully diagnosed to improve the diagnostic accuracy.
4.MRI manifestations of abdominal leiomyosarcoma and literature review
Li ZHU ; Yuanxi JIAN ; Xinxiang ZHAO
Journal of Practical Radiology 2018;34(5):702-705
Objective To investigate the MRI characteristics of abdominal leiomyosarcoma and literature review.Methods Preoperative MRI data of 9 cases with leiomyosarcoma proved by pathology were analyzed retrospectively.The size,shape,signal intensity and enhancement type of the lesion were analyzed and some related literatures were reviewed in order to summarize its imaging features.Results In the 9 cases,1 was located in the liver,5 cases in the abdominal retroperitoneul space and other 3 case in the pelvic retroperitoneul space.Before operation,6 cases had wrong diagnosis,including 1 case misdiagnosed as hepatocellular carcinoma with intrahepatic metastases,3 cases as ganglioneuroma and 2 cases as uterine myoma.On plain MRI,5 cases showed iso-/slightly hypo-mixed signal and 4 cases showed hypointensity on T1 WI.Five cases showed iso-/slightly hyper-mixed signal and 4 cases showed iso-/slightly hyper/ hyper-mixed signal on T2WI.On diffusion weighted images (DWI),5 cases showed significant diffusion restriction and 4 cases showed moderate diffusion restriction.On contrast-enhanced MRI,3 cases showed obvious peripheral inhomogeneous enhancement,the enhancement degree in portal vein phase was more obvious than that in arterial phase and was sustained in delayed phase.The lesions showed progressive enhancement and the enhancement was higher in peripheral than central areas.Six cases demonstrated obviously inhomogeneous enhancement in arterial phase,no obvious washout was observed in portal vein phase and delayed phase,and non-enhanced area was still observed in late delayed phase.One lesion in the liver had the sign of pseudocapsule.Conclusion Abdominal leiomyosarcoma has certain characteristic MRI manifestations.Leiomyosarcoma should be considered in the differential diagnosis list,when the lesion is large,with cystic degeneration,necrosis,moderate to significant diffusion restriction on DWI and obvious peripheral enhancement.