Objective To study the incidence of PTEN, p53 and Ki-67 expression in astrocytoma and show the relationship between PTEN, p53 expression and the proliferation activity. Methods The surgical specimens from 68 brain astrocytoma patients were analysed to detect PTEN, p53 and Ki-67 expression with immunohistochemical method. Results The incidence of PTEN, p53 and Ki-67 expression was 54.4 %,45.6 % and 48.5 % respectively in astrocytoma. With the grade of astrocytoma increasing the levels of PTEN protein decreased, on the other hand the levels of p53, Ki-67 increased. There was a negative correlation between PTEN expression and grade of astrocytoma while there was a positive correlation between p53, Ki-67 expression and grade of astrocytoma by using the Spearman Correlation test to analyse the data. The incidence of Ki-67 positive expression was 24.3 % in 37 cases exhibiting PTEN positive staining, whereas the incidence of Ki-67 positive expression was 77.4 % in 31 cases exhibiting PTEN negative staining. In statistics, there was an inverse correlation between PTEN and Ki-67 expression. Conclusion There is an inverse correlation between histopathological grades of astrocytoma and PTEN expression. A positive correlation is found between p53, Ki-67 expression and histopathological grades of astrocytoma. PTEN can inhibit tumor cell proliferation in astrocytoma.

Background and purpose: With the development of the means of preoperative diagnosis and treatment of breast cancer, ifne needle puncture no longer seems to be popular with the clinical use. The safety and effectiveness of fine needle aspiration as preoperative diagnosis of breast cancer are controversial. This study was aimed to investigate the application of fine needle aspiration (FNA) of breast cancer and association between FNA and recurrence and metastasis for 30 years in our hospital. Methods:A total number of 1 260 patients with breast cancer treated in Peking Union Medical College Hospital from 1975 to 2006 were reviewed in two groups for clinical characters, recurrence, and survival rate. The two groups were FNA and non-FNA. Results:The positive rate of FNA was 61.4%and the highest rate was inⅣstage (100%). StageⅡandⅢwere the major ones in FNA group (45.2%). The local recurrence (7.0%vs 6.4%), recurrence and metastasis (13.2%vs 14.0%), 5-year (82.0%vs 81.0%) and 10-year disease free survival rates (51.0%vs 64.0%) have no signiifcant difference between FNA and non-FNA groups. Conclusion:FNA is still one of the most important methods for preoperative investigation of breast cancer. Background and purpose: With the development of the means of preoperative diagnosis and treatment of breast cancer, ifne needle puncture no longer seems to be popular with the clinical use. The safety and effectiveness of fine needle aspiration as preoperative diagnosis of breast cancer are controversial. This study was aimed to investigate the application of fine needle aspiration (FNA) of breast cancer and association between FNA and recurrence and metastasis for 30 years in our hospital. Methods:A total number of 1 260 patients with breast cancer treated in Peking Union Medical College Hospital from 1975 to 2006 were reviewed in two groups for clinical characters, recurrence, and survival rate. The two groups were FNA and non-FNA. Results:The positive rate of FNA was 61.4%and the highest rate was inⅣstage (100%). StageⅡandⅢwere the major ones in FNA group (45.2%). The local recurrence (7.0%vs 6.4%), recurrence and metastasis (13.2%vs 14.0%), 5-year (82.0%vs 81.0%) and 10-year disease free survival rates (51.0%vs 64.0%) have no signiifcant difference between FNA and non-FNA groups. Conclusion:FNA is still one of the most important methods for preoperative investigation of breast cancer.

@@

Objective:To summarize the experiences of the surgical treatment of tumors in the posterior part of the third ventricle and pineal region. Methods: Twenty-seven patients with tumors in this region treated microsurgically from 1990 to 2000 were analyzed. The surgical indications, approaches, and operative key points were discussed. The prognostic factors were also analyzed. Results:Tumors were removed totally in 11 patients, removed subtotally in 7 and removed partially in 5. Biopsy and ventriculo-peritoneal shunt was performed in 4 patients. Of 17 patients in follow-up, 13 patients survived longer than 5 years. Conclusions: Most tumors in the posterior part of the third ventricle and pineal region can be surgically removed.Sufficient specimen obtained in the operation can confirm pathologic property of the tumor,guiding next chemotherapy and radiotherapy.

Adult ; Female ; Homocysteine ; blood ; Humans ; Liver Cirrhosis ; blood ; pathology ; Liver Neoplasms ; blood ; pathology ; Male ; Middle Aged

OBJECTIVETo investigate the clinical characteristics and prognosis of patients with different subtypes of breast cancer: basaloid, HER-2 and luminal types, and try to find the evidence of individualized treatment for the patients.

METHODS1280 histologically and immunohistochemically proven patients with resectable breast cancer were treated, and the clinical data including characteristics, relapse and survival of the patients with different subtypes of breast cancer were analyzed retrospectively.

RESULTSOf the 1280 breast cancer patients, basaloid, HER-2 and luminal types accounted for 20.9%, 23.2% and 55.9%, respectively. Basaloid type was more likely to be found in younger patients frequently with a family history of breast cancer. HER-2 type usually had a tumor of larger size with more advanced stage disease and more metastatic lymph nodes. Luminal type was likely to occur in aged patients with an earlier stage disease. The recurrence rates in basaloid, HER-2 and luminal types were 25.0%, 27.9% and 11.7%, respectively. Patients with basaloid or HER-2 type were found to have a significantly higher recurrence rate than the patients with luminal type breast cancer (P < 0.001), but no significant difference was observed between the basaloid and HER-2 types. However, patients with basaloid type breast cancer were more likely to develop lung metastasis than HER-2 type (13.4% vs. 7.1%, P = 0.017). Up to December 2006, the 5-year disease-free survival (DFS) rates for patients with basaloid, HER-2 and luminal types were 72.2%, 68.2% and 86.2% (P < 0.001), respectively. The overall 5-yr survival (OS) rates of the three groups were 88.6%, 83.8% and 95.8% (P < 0.001) , respectively. Of the patients with luminal type breast cancer, HER2-negative patients had a higher DFS (86.2% vs 57.0%, P < 0.001) and OS (95.8% vs 87.7%, P = 0.0001) compared with those with HER2-positive. The results of Multivariate Cox Regression showed that tumor size and lymph node state were the most important factors influencing the prognosis.

CONCLUSIONEach subtype of breast cancer has somewhat its own specific clinical features in terms of recurrence pattern and prognosis, therefore, individualized treatment regimen may be required.

Adult ; Aged ; Breast Neoplasms ; classification ; metabolism ; pathology ; therapy ; Chemotherapy, Adjuvant ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms ; secondary ; Lymphatic Metastasis ; Mastectomy ; methods ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Proportional Hazards Models ; Radiotherapy, Adjuvant ; Receptor, ErbB-2 ; metabolism ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism ; Retrospective Studies ; Survival Rate ; Young Adult

OBJECTIVETo investigate the therapeutic effect, long term survival and side effect on NSCLC patients treated with nadaplatin combined with paclitaxol and cisplatin combined with paclitaxol.

METHODSNSCLC patients with stage IIIB or IV were randomized into two groups in this prospective clinical study. TN group: nadaplatin 30 mg/m2 dl-3, paclitaxol 175 mg/m2 dl, repeated every 4 weeks. TP group: DDP 30 mg/m2 dl-3, paclitaxol 175 mg/m2 dl, repeated every 4 weeks.

RESULTSSixty patients were enrolled and 57 were evaluable with 30 in TN group and 27 in TP group. The overall response rate were 43.3% vs. 48.1% (P = 0.716), and the disease control rate were 86.7% vs. 88.8% in TN and TP group (P = 0.799), respectively. The median survival time was 14.3 vs. 13.0 months, and the 1- and 2-year survival rate was 62.5% vs. 59.1%, 0% vs. 5.8% in TN and TP group (P = 0.839), respectively. The rates of neutropenia and thrombocytopenia were similar in TN and TP groups whereas more patients in TP group than in TN group suffered from anemia (38.5% vs. 17.5%, P = 0.001), nausea and vomiting (82.6% vs. 35.6%, P = 0.000), fatigue (35.9% vs. 14.1%, P = 0.000) and peripheral neurotoxicity (50.0% vs. 21.9%, calculated by case, P = 0.023).

CONCLUSIONNadaplatin combined with paclitaxol is an effective treatment regimen for NSCLC patients. When compared with similar regimen with cisplatin, the response rate and survival were similar; however, nadaplatin regimen shows some superiority as regards some treatment side effect.

Adult ; Aged ; Anemia ; chemically induced ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; pathology ; Cisplatin ; administration & dosage ; adverse effects ; Female ; Humans ; Lung Neoplasms ; drug therapy ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Neutropenia ; chemically induced ; Organoplatinum Compounds ; administration & dosage ; adverse effects ; Paclitaxel ; administration & dosage ; adverse effects ; Prospective Studies ; Remission Induction ; Survival Analysis ; Thrombocytopenia ; chemically induced ; Treatment Outcome

Objective To explore rationale and clinical application of simplified modified radical thyroideetomy for differentiated thyroid carcinoma.Methods From Jan.2007 to Jun.2010,349 cases of differentiated thyroid carcinoma received simplified operative procedure based on standard modified radical thyroidectomy.The simplified procedure took a low small collar incision(about 10-12 cm).In separating upper and lower skin flaps,subcutaneous tissues covering posterior triangle of neck and posterior edge of sternoeleidomastoid muscle were spared to protect sensory nerves.Subtotal thyroidectomy Was performed to resect the affected lobe,isthmus,and the majority of opposite lobe without considering the size of primary tumor or whether metastasis to the neck lymph nodes happened.Soft tissues of the mainly metastatic areas(Ⅱ a、Ⅲ、Ⅳ、Ⅴb)were cleared.The accessory nerve was not exposed routinely to avoid stimulation.Lymph nodes metastasis in different areas was recorded respectively.Complications in different operative modes were compared.Results Compared with standard modified radical thyroidectomy,the simplified mode had shorter scar-and no limit of neck mobility.Because of muscles and nerves pemervation,movement dysfunction and abnormal sensation of neck and shoulder decreased obviously.The operation duration was shortened.Cervical lymph node status Was evaluated,which provided basis for prognosis judgment and comprehensive treatment.Conclusions The simplified modified radical procedure has the benefit of decreased trauma while maintains the similar recurrence rate compared to modified radical thyroidectomy.It improvs the life quality of patients.This procedure fits the principle of functional radical neck dissection better.

OBJECTIVE: To analyze the oncological outcomes, functional outcomes in patients undergoing supracricoid partial laryngectomy (SCPL). Provide clinical experience for application of SCPL. METHOD: A retrospective analysis of the 115 cases with laryngeal carcinoma accepted SCPL in our department from Jan 1996 to Dec 2004. Use the Kaplan-Meier method to analyze the patients'survival rate. Evaluate the value of reserve larynx function. RESULT: The 5-years survival rates and the decannulation rate was 80.8%, 99.1% respectively; and the average decannulation time was 22.25 days. The mean time of removal of gastric tube was 9.57 days. The function of CHEP was superior to CHP. The vocal function of 115 cases were all achieved in general communication. CONCLUSION SCPL get better oncological and functional outcomes and allows the preservation of the basic function of the larynx. It's a safe, effective technique and deserved to generalization.
Adult ; Aged ; Carcinoma, Squamous Cell ; mortality ; pathology ; surgery ; Cricoid Cartilage ; surgery ; Female ; Humans ; Laryngeal Neoplasms ; mortality ; pathology ; surgery ; Laryngectomy ; methods ; Male ; Middle Aged ; Retrospective Studies ; Survival Rate ; Treatment Outcome

Objective:To explore the effects of hematoma removal by neuroendoscopy or craniotomy on thalamic hemorrhage.Methods:Eighty-three patients with thalamic hemorrhage, admitted to our hospital from September 2016 to March 2019, were chosen in our study; 44 patients accepted hematoma removal by neuroendoscopy and 39 patients accepted hematoma removal by craniotomy under microscope. These patients were divided into severe type ( n=55) and mild type ( n=28) according to Glasgow coma scale scores at admission. The efficacy and safety of the two procedures were compared. Patients were followed up until one year after onset, and their recovery was assessed by Glasgow outcome scale (GOS). Results:As compared with those in the craniotomy group, patients in the neuroendoscopy group had significantly small volume of intraoperative blood loss ([284.90±31.74] mL vs. [45.70±6.94] mL), significantly shorter hospital stays ([18.40±2.75] d vs. [14.70±2.13] d), and statistically lower incidence of epilepsy (15.4% vs. 2.3%, P<0.05). In critical survived patients, the GOS scores in the endoscopic group were 4.99±0.48 until one year after onset, which were significantly higher than those in the craniotomy group (2.64±0.41, P<0.05). Conclusion:As compared with hematoma removal by craniotomy, that by neuroendoscopy has the advantages of minimal invasion, good visual field, and high efficiency in the treatment of thalamic hemorrhage.