Humans ; Female ; Carcinoma, Intraductal, Noninfiltrating/surgery* ; Thoracic Wall/pathology* ; Adenocarcinoma, Papillary ; Breast Neoplasms/surgery* ; Carcinoma, Ductal, Breast/pathology*

Objective:To investigate the risk factors of recurrence after surgical resection of differentiated thyroid carcinoma combined with iodine-131 and TSH（Thyroid stimulating hormone） inhibition therapy. Methods:From January 2015 to April 2020, the clinical data of patients with structural recurrence and without recurrence were retrospectively collected after surgical treatment combined with iodine-131 and TSH inhibition therapy in the First Medical Center of PLA General Hospital. The general conditions of the two groups of patients were analyzed and the measurement data in line with the normal distribution was used for comparison between groups. For measurement data with non-normal distribution, the rank sum test was used for inter-group comparison. The Chi-square test was used for comparison between the counting data groups. Univariate and multivariate regression analyses were used to determine the risk factors associated with relapse. Results:The median follow-up period was 43 months（range 18-81 months） and 100 patients（10.5%） relapsed among the 955 patients. Univariate analysis showed that tumor size, tumor multiple, the number of lymph node metastases>5 in the central region of the neck, and the number of lymph node metastases>5 in the lateral region were significantly correlated with post-treatment recurrence（P<0.001, P=0.018, P<0.001, P<0.001）. Multivariate analysis showed that tumor size（adjusted odds ratio OR: 1.496, 95%CI: 1.226-1.826, P<0.001）, tumor frequency（adjusted odds ratio OR: 1.927, 95%CI: 1.003-3.701, P=0.049）, the number of lymph node metastases in the central neck region>5（adjusted odds ratio OR: 2.630, 95%CI: 1.509-4.584, P=0.001） and the number of lymph node metastases in the lateral neck region>5（adjusted odds ratio OR: 3.074, 95%CI: 1.649-5.730, P=0.001） was associated with tumor recurrence. Conclusion:The study showed that tumor size, tumor multiple, the number of lymph node metastases in the central region of the neck>5 and the number of lymph node metastases in the side of the neck >5 are independent risk factors for recurrence of differentiated thyroid cancer after surgical resection combined with iodine-131 and TSH inhibition therapy.
Humans ; Thyroid Cancer, Papillary/surgery* ; Lymphatic Metastasis/pathology* ; Retrospective Studies ; Neck Dissection ; Thyroidectomy/adverse effects* ; Neoplasm Recurrence, Local/pathology* ; Thyroid Neoplasms/surgery* ; Risk Factors ; Adenocarcinoma ; Thyrotropin ; Lymph Nodes/pathology*

Adenocarcinoma, Follicular ; diagnosis ; diagnostic imaging ; surgery ; Aged ; Female ; Humans ; Hyperparathyroidism, Primary ; diagnosis ; diagnostic imaging ; surgery ; Thyroid Cancer, Papillary ; diagnosis ; diagnostic imaging ; surgery ; Tomography, Emission-Computed, Single-Photon ; Tomography, X-Ray Computed

OBJECTIVE: In this study we utilized the Surveillance, Epidemiology and End-Results (SEER) registry to identify risk factors for lymphatic spread and determine the incidence of pelvic and para-aortic lymph node metastases in patients with uterine papillary serous carcinoma (UPSC) and uterine clear cell carcinoma (UCCC) who underwent complete surgical staging and lymph node dissection. METHODS: Nine hundred seventy-two eligible patients diagnosed between 1998 to 2009 with International Federation of Gynecology and Obstetrics (FIGO) 1988 stage IA-IVA UPSC (n=685) or UCCC (n=287) were identified for analysis. Binomial logistic regression was used to determine risk factors for lymph node metastasis, with the incidence of pelvic and para-aortic lymph node metastases reported for each FIGO primary tumor stage. The Cox proportional hazards regression model was used to determine factors associated with overall survival. RESULTS: FIGO primary tumor stage was the only independent risk factor for lymph node metastasis (p<0.01). The incidence of pelvis-only and para-aortic lymph node involvement according to the FIGO primary tumor stage were as follows: IA (2.3%/3.8%), IB (7.5%/5.2%), IC (22.5%/16.9%), IIA (20.8%/13.2%), IIB (25.7%/14.9%), and III/IV (25.7%/24.3%). Prognostic factors for overall survival included lymph node involvement (hazard ratio [HR], 1.42; 95% confidence interval [CI], 1.09 to 1.85; p<0.01), patient age >60 years (HR, 1.70; 95% CI, 1.21 to 2.41; p<0.01), and advanced FIGO primary tumor stage (p<0.01). Tumor grade, histologic subtype, and patient race did not predict for either lymph node metastasis or overall survival. CONCLUSION: There is a high incidence of both pelvic and para-aortic lymph node metastases for FIGO stages IC and above uterine papillary serous and clear cell carcinomas, suggesting a potential role for lymph node-directed therapy for these patients.
Adenocarcinoma, Clear Cell/epidemiology/pathology/*secondary/surgery ; Adult ; Aged ; Aged, 80 and over ; Aorta, Abdominal ; Cystadenocarcinoma, Papillary/epidemiology/pathology/*secondary/surgery ; Cystadenocarcinoma, Serous/epidemiology/pathology/*secondary/surgery ; Female ; Humans ; Incidence ; Kaplan-Meier Estimate ; Lymph Node Excision ; Lymphatic Metastasis ; Middle Aged ; Neoplasm Grading ; Neoplasm Staging ; Pelvis ; SEER Program ; United States/epidemiology ; Uterine Neoplasms/*epidemiology/pathology/surgery

Patients with nasopharyngeal foreign body sensation for 3 years, and had nasal obstruction in the past six months. electric nasopharyngoscopy: a irregular ellipse shape mass occupied in the nasopharynx, the mass surface is not smooth, with erosion ulcer and filthy secretions, the mass had a root in the back-end of nasal septum, and was adjacent to the bilateral round pillow. Sinus CT showed an irregular soft tissue shadow connected to the nasal septum backend in the nasopharynx, the size is about 2.8 cm X 3.5 cm, CT value is about 43 HU. Pathological examination: papillary adenocarcinoma.
Adenocarcinoma, Papillary ; diagnosis ; surgery ; Endoscopy ; Humans ; Nasal Obstruction ; Nasal Septum ; pathology ; Nasal Surgical Procedures ; Nasopharynx ; Tomography, X-Ray Computed

Intraductal papillary mucinous neoplasm of the bile duct (IPMN-B) and intraductal papillary mucinous neoplasm of the pancreas (IPMN-P) have striking similarities and are recognized as counterparts. However, simultaneous occurrence of IPMN-B and IPMN-P is extremely rare. A 66 year-old female presented with recurrent epigastric pain and fever. During the past 9 years, she had three clinical episodes related to intrahepatic duct stones and IPMN-P in the pancreas head and was managed by medical treatment. Laboratory test results at admission revealed leukocytosis (12,600/mm3) and elevated CA 19-9 level (1,200 U/mL). Imaging study demonstrated liver abscess in the Couinaud's segment 4, IPMN-B in the left lobe, and IPMN-P in the whole pancreas with suspicious malignant change. Liver abscess was drained preoperatively, followed by left lobectomy with bile duct resection and total pancreatectomy with splenectomy. On histologic examination, non-invasive intraductal papillary mucinous carcinoma arising from various degree of dysplastic mucosa of the liver and pancreas could be observed. However, there was no continuity between the hepatic and pancreatic lesions. This finding in our case supports the theory that double primary lesions are more likely explained by a diffuse IPMN leading to synchronous tumors arising from both biliary and pancreatic ducts rather than by a metastatic process. Herein we present a case of simultaneous IPMN of the bile duct and pancreas which was successfully treated by surgical management.
Adenocarcinoma, Mucinous/*diagnosis/pathology/surgery ; Adenocarcinoma, Papillary/*diagnosis/pathology/surgery ; Aged ; Bile Duct Neoplasms/*diagnosis/pathology/surgery ; Bile Ducts, Intrahepatic/pathology ; CA-19-9 Antigen/analysis ; Carcinoma, Pancreatic Ductal/*diagnosis/pathology/surgery ; Female ; Hepatectomy ; Humans ; Leukocytosis/diagnosis ; Pancreatectomy ; Pancreatic Neoplasms/*diagnosis/pathology/surgery ; Tomography, X-Ray Computed

OBJECTIVETo investigate the relationship between aberrant methylation of Syk and Runx3 genes and recurrence and metastasis after resection of gastric cancer.

METHODSApplying methylation-specific polymerase chain reaction technique, promoter methylation of Syk and Runx3 genes in the tumor tissues and adjacent normal tissues of gastric cancer patients were detected to investigate the relationship between methylation status of the promoter region of Syk and Runx3 genes and postoperative recurrence and metastasis.

RESULTSIn the 70 cases of gastric cancer, the frequencies of promoter methylation of Syk and Runx3 genes were 45.7% (32/70) and 55.7% (39/70) in gastric cancer, and 0 (0/70) and 7.1% (5/70), respectively, in the adjacent normal tissues. The rates of promoter methylation of Syk and Runx3 genes in the gastric cancers were significantly higher than that in the adjacent normal tissues (P < 0.001 for all). The promoter methylation of Syk and Runx3 genes was significantly correlated with the degree of tumor differentiation, depth of invasion, lymph node metastasis and pathological staging (P < 0.05 for all). The frequency of postoperative recurrence and metastasis in 32 patients with Syk promoter methylation was 65.6% (21/32) and that in 38 cases with Syk promoter unmethylation was 18.4% (7/38), showing a significant difference between the two subgroups (χ(2) = 16.13, P < 0.001). The rate of postoperative recurrence and metastasis in 39 patients with Runx3 promoter methylation was 61.5% (24/39) and that in 31 patients with Runx3 promoter unmethylation was 12.9% (4/31, P < 0.001).

CONCLUSIONSThe methylation of Syk and Runx3 promoters plays an important role in postoperative recurrence and metastasis of gastric cancer. Combined detection of promoter methylation of Syk and Runx3 genes is helpful for early diagnosis and evaluation of prognosis of gastric cancer.

Adenocarcinoma ; genetics ; pathology ; surgery ; Adenocarcinoma, Mucinous ; genetics ; pathology ; surgery ; Adenocarcinoma, Papillary ; genetics ; pathology ; surgery ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Signet Ring Cell ; genetics ; pathology ; surgery ; Core Binding Factor Alpha 3 Subunit ; genetics ; DNA Methylation ; Female ; Follow-Up Studies ; Gastrectomy ; Humans ; Intracellular Signaling Peptides and Proteins ; genetics ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Promoter Regions, Genetic ; Protein-Tyrosine Kinases ; genetics ; Stomach Neoplasms ; genetics ; pathology ; surgery ; Syk Kinase ; Young Adult

OBJECTIVE: The purpose of this study was to evaluate the patterns of failure, overall survival (OS), disease-free survival (DFS) and factors influencing outcome in endometrial cancer patients who presented with metastatic lymph nodes and were treated with curative intent. METHODS: One hundred and twenty-six patients treated between January 1996 to December 2008 with surgery and adjuvant radiotherapy were identified from our service's prospective database. Radiotherapy consisted of 45 Gy in 1.8 Gy fractions to the whole pelvis. The involved nodal sites were boosted to a total dose of 50.4 to 54 Gy. RESULTS: The 5-year OS rate was 61% and the 5-year DFS rate was 59%. Grade 3 endometrioid, serous, and clear cell histologies and involvement of upper para-aortic nodes had lower OS and DFS. The number of positive nodes did not influence survival. Among the histological groups, serous histology had the worst survival. Among the 54 patients relapsed, only three (6%) failed exclusively in the pelvis and the rest of the 94% failed in extrapelvic nodal or distant sites. Patients with grade 3 endometrioid, serous and clear cell histologies did not influence pelvic failure but had significant extrapelvic failures (p<0.001). CONCLUSION: Majority of node positive endometrial cancer patients fail at extrapelvic sites. The most important factors influencing survival and extrapelvic failure are grade 3 endometrioid, clear cell and serous histologies and involvement of upper para-aortic nodes.
Adenocarcinoma, Clear Cell/pathology/radiotherapy/*secondary/surgery ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Endometrioid/pathology/radiotherapy/*secondary/surgery ; Cystadenocarcinoma, Papillary/pathology/radiotherapy/*secondary/surgery ; Endometrial Neoplasms/pathology/radiotherapy/*surgery ; Female ; Humans ; Lymphatic Metastasis ; Middle Aged ; Neoplasm Staging ; Prognosis ; Prospective Studies ; Radiotherapy, Adjuvant ; Salvage Therapy/methods ; Survival Analysis ; Treatment Failure ; Treatment Outcome

Adenocarcinoma, Follicular ; classification ; diagnosis ; pathology ; Carcinoma, Papillary ; diagnosis ; pathology ; surgery ; Humans ; Lymphatic Metastasis ; Thyroid Neoplasms ; diagnosis ; pathology ; surgery

OBJECTIVETo study the expression, clinicopathologic correlation and prognostic significance of caveolin-1 in lung adenocarcinomas(LAC).

METHODSImmunohistochemical study (EnVision method) for caveolin-1 and TTF-1 was carried out in 185 cases of LAC encountered during the period from 2005 to 2010. The correlation between caveolin-1 expression and various clinicopathologic parameters was analyzed statistically.

RESULTSThe rate of caveolin-1 expression in the 185 cases of LAC was 26.5% (49/185) and significantly lower than that in normal lung tissue (P<0.01). There was also higher rate of caveolin-1 expression in male patients (P=0.004), smokers (P=0.006), tumors larger than 3.5 cm (P=0.048), predominantly solid tumor subtype (P=0.025), high tumor grade (P=0.044), tumors with vascular invasion (P=0.019), lymph node metastasis (P=0.030), recurrence (P=0.021) and high clinical stage (P=0.027). The expression level of caveolin-1 in TTF1-negative cases was significantly higher than that in TTF1-positive cases and caveolin-1 expression also negatively correlated with TTF-1 expression in LAC (r=-0.154, P=0.037). The five-year overall survival rate of patients with caveolin-1 positive tumors was lower than that in caveolin-1 negative group (P<0.01).Univariate analysis indicated the expression level of caveolin-1 and TTF-1 (P<0.01), histologic subtype (P=0.002), tumor grade (P=0.002), tumor size (P=0.009), vascular invasion (P=0.019), lymph node metastasis (P=0.018), recurrence (P=0.032) and clinical stage (P=0.024) correlated with the survival of patients with LAC. COX multivariate analysis revealed that LAC with caveolin-1 positive expression, TTF-1 negative expression and high tumor grade carried a significantly unfavorable prognosis.

CONCLUSIONCaveolin-1 expression correlates with histologic subtype, tumor grade, invasiveness and metastatic potential of LAC. The detection of caveolin-1 in LAC is helpful in predicting prognosis.LAC with caveolin-1 expression carries a poor prognosis.

Adenocarcinoma ; metabolism ; pathology ; surgery ; Adenocarcinoma, Papillary ; metabolism ; pathology ; surgery ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Acinar Cell ; metabolism ; pathology ; surgery ; Caveolin 1 ; metabolism ; DNA-Binding Proteins ; metabolism ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; metabolism ; pathology ; surgery ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Prognosis ; Survival Rate ; Transcription Factors ; Tumor Burden