Objective This study was to investigate the lymph node metastasis pattern in thoracic esophageal squamous cell carcinoma (ESCC),and analyze the risk factors to provide reference for the delineation of radiotherapy target.Methods A total of 319 patients with thoracic ESCC who underwent surgical treatment at the second hospital of Dalian medical university were analyzed retrospectively.The lymph nodes around esophageal were divided into 20 groups according to the mapping scheme of the American Thoracic Society (ATS) modified by Casson et al.Analyzed the pattern of lymph node metastasis and its relationship with tumor location,tumor length,depth of invasion,pathological grade,and vessel invasion.Results The lymph node metastatic rate was 48.90％ (156/319),while the metastatic ratio of lymph node (LMR) was 15.70％ (562/3 581).The lymph node metastatic rates had gradually increasing trend with tumor sites descending (upper ESCC 35.48％,middle ESCC 47.06％ and lower ESCC 56.43％),but no statistically significance (P ＞ 0.05) was observed.In the whole 20 groups,the higher node metastasis stations of upper thoracic ESCC LMR were 1,2,4,5,7,9 (x2 =27.38,P ＜ 0.05),while the middle thoracic ESCC LMR were 2,4,5,7,8M (x2 =57.77,P ＜ 0.05),and the lower thoracic ESCC LMR were 4,5,7,8L,16,17,20 (x2 =28.88,P ＜ 0.05),with statistically significance.So the main lymph node metastasis stations were paraesophageal nodes,tracheobronchial nodes,paratracheal nodes,aroticopumonary nodes,left gastric nodes,subcarinalnodes and celiac nodes.The univariate analysis revealed that lymph node metastasis was correlated with the tumor length,depth of invasion,pathological grade,and presence of vascular invasion (x2 =6.82,26.04,36.26,4.56respectivcly,P ＜ 0.05).The muhi-variate regression analysis showed that tumor length and depth of tumor invasion were independent risk factors for lymph node metastasis (OR =2.212,2.123,P ＜ 0.05).Conclusions The factors influencing lymph node metastasis in thoracic ESCC include tumor length,depth of invasion,pathological grade,and presence of vascular invasion,which should be carefully considered during the target delineation of radiotherapy for esophageal carcinoma.

Objective: To explore the relationship between the changes of plasma levels of resistin with the contemporary body weigh changes in the same population. Methods: The community based epidemiological surveys were carried out in the same population in Shijingshan district of Beijing at the year of 2005 and year of 2010. A total of 943 subjects with the entire information of cardiovascular related risk factors were enrolled including 316 male with the mean age of (58.2 ± 8.5) years and 627 female with the mean age of (59.3 ± 7.5) years. Plasma levels of resistin in both year of 2005 and year of 2010 in all subjects were recorded, and the subjects were divided into 4 groups based on the quartile levels of resistin. Group①, the subjects with plasma level of resistin ≤ (-0.66) mmol/L,n=239, Group②, resistin level (from -0.67 to 0.25) mmol/L,n=233, Group③, resistin level (0.26-1.24) mmol/L, n=235 and Group④, resistin level ≥1.25 mmol/L,n=236. Pearson correlation study with uni- and multi- regression analysis were conducted to investigate the relationship between the changes of plasma levels of resistin with the contemporary body weight changes in the same population.Results: The uni-variate analysis showed that in female subjects, plasma levels of resistin were obviously related to the percentage (%) of body weight changes (correlation coefifcient: 0.1173), body weight index (kg/m2) changes (0.1521), the% of body weight index changes (0.1412), the waist circumference (cm) changes (0.1228) and the % of waist circumference changes (0.1057) respectively, allP<0.05; while the above changes in male subjects were not signiifcant, allP>0.05. Multi-regression analysis indicated that with adjusted baseline variables, in female subjects, the plasma levels of resistin were obviously related to body weight (kg) changes and the % of body weight changes (regression coefifcient: 0.0261 and 0.2916), body weight index (kg/m2) changes and % of body weight index changes (0.2157 and 0.3072), the waist circumference (cm) changes and the% of waist circumference changes (0.0532 and 0.2738) respectively, allP<0.05; while the above changes in male subjects were not signiifcant, allP>0.05. Conclusion: The changes of plasma levels of resistin are signiifcantly related to contemporary body weight changes in female subjects, but not in male subjects.

Objective To study the short-term efficacy of computed tomography (CT)-guided iodine-125(125I) radioactive seed implantation in the treatment of hypoxic tumors.Methods Twenty-two patients treated with 125I radioactive seed implantation in our department from 2014 to 2016 were divided into hypovascular tumor group (hypoxic group,n =12) and hypervascular tumor group (non-hypoxic group,n=10) based on the hemodynamics of solid tumor evaluated by color Doppler ultrasound.The enhanced CT images were loaded to the three-dimensional particle implantation planning system for preoperative planning.After 125I radioactive seed implantation,the D90 for target volume was verified to be 106-128 cGy.Treatment outcomes were evaluated according to the World Health Organization criteria at 1-3 months after surgery.Results In all the patients,the overall response rate was 82％ at 3 months after surgery.There were no significant differences in response (complete response + partial response) rates at 1,2,or 3 months after surgery between the hypoxic group and the non-hypoxic group (P=0.840,0.696,0.840).Conclusions In the treatment of solid malignant tumor,125I radioactive seed implantation can overcome the resistance of hypoxic tumor to radiotherapy in vitro and achieve satisfactory short-term efficacy.