Objective To explore the safety of Yttrium-90 resin microsphere selective internal radiation therapy (⁹⁰Y-SIRT) on malignant liver tumors. Methods A retrospective analysis was conducted on 64 patients with malignant liver tumors who underwent ⁹⁰Y-SIRT from February 2023 to November 2024 at Weifang People’s Hospital. The clinical characteristics of the patients and the occurrence of adverse reactions after treatment were analyzed to assess the safety of ⁹⁰Y-SIRT. Results Among the 64 patients, there were 52 males (81.25%) and 12 females (18.75%); the average age was (56.29±11.08) years. Seven patients (10.94%) had tumors with maximum diameter of less than 5 cm, 38 patients (59.38%) had tumors with maximum diameter of 5-10 cm, and 19 patients (29.68%) had tumors with maximum diameter of greater than 10 cm. There were 47 cases (73.44%) of solitary lesions and 17 cases (26.56%) of multiple lesions; 53 cases (82.81%) were primary liver cancers and 11 cases (17.19%) were metastatic liver cancers. Of the 64 patients, 63 successfully completed the Technetium-99m macroaggregated albumin (^99mTc-MAA) perfusion test and received the ⁹⁰Y-SIRT; one patient received ⁹⁰Y-SIRT after the second ^99mTc-MAA perfusion test due to a work error. The most common adverse reactions included grade 1 alanine aminotransferase (ALT) elevation in 26 cases (40.62%) and grade 2 in 2 cases (9.37%), grade 1 aspartate aminotransferase (AST) elevation in 27 cases (42.18%) and grade 2 in 7 cases (10.93%); grade 1 nausea in 17 cases (26.56%) and grade 2 in 6 cases (9.37%); grade 1 abdominal pain in 12 cases (18.75%), grade 2 in 5 cases (7.81%), and grade 3 in 1 case (1.56%); grade 1 vomiting in 11 cases (17.18%), grade 2 in 5 cases (7.81%), and grade 3 in 1 case (1.56%). Conclusion The adverse reactions of ⁹⁰Y-SIRT for treating malignant liver tumors are mild, indicating good safety.

Objective To study the value of postmortem imaging on the diagnosis of intestinal perforation.Method Postmortem imaging(PMCT and PMCTA)data of 2 intestinal perforation deaths(and 4 controlled cases)were reviewed retrospectively.Diagnosing capacities of intestinal perforation by postmortem imaging method were further investigated.Results PMCT is sensitive in detecting the free air and liquid induced by intestinal perforation.PMCT can sometimes detect the gravity-dependent purulent secretions in the abdominopelvic cavity.PMCTA can visualize the extravasation of contrast agent from the perforation,which can be used to locate the accurate perforation region.Conclusion Postmortem imaging method(PMCT and PMCTA)is an important tool for the diagnosis of intestinal perforation,which can not only be used as a forensic diagnosis method,but is also useful to locate the perforation site before an forensic autopsy.

Objective:The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China.Methods:This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems.Results:According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%).Conclusion:Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.

Objective:To investigate the value of CT enhancement degree in diagnosing cervical lymph node metastasis of papillary thyroid carcinoma (PTC) .Methods:CT data of 535 neck lymph nodes with pathological diagnosis in 251 cases were retrospectively analyzed. The ratio and difference between the density of CT enhancement and plain scan were calculated. Mann-Whitney test was used to analyze the distribution of ratio and difference in lymph node metastasis group and non-metastasis group. The optimal thresholds of ratio and difference in the two groups were obtained by receiver operating characteristic (ROC) curve analysis.Results:535 cervical lymph nodes including 271 in metastatic group and 264 in non-metastatic group. The ratios of two groups were 2.30 (2.04, 2.76) and 1.66 (1.51, 1.81) ( Z=-16.94, P<0.05) respectively, and the differences were 58 (49, 76) Hu and 31 (22, 36) Hu ( Z=-18.045, P<0.05) respectively. When the ROC area under curve of ratio and difference between the two groups were 0.923 and 0.951 respectively, the optimal thresholds were 1.93 and 39.5Hu respectively. The sensitivity and specificity of diagnosing lymph node metastasis were 84.9% and 87.1%、91.5% and 86.0%respectively.The sensitivity and specificity of combination of the two diagnosing lymph node metastasis were 82.3% and 91.7%. Conclusions:The ratio of enhancement and plain scan density ≥1.93 and the difference ≥39.5Hu have a high diagnostic efficiency for cervical lymph node metastasis of PTC. The specificity of the two is similar, but the latter has higher sensitivity. The combination of the two can significantly improve the specificity, thereby reducing unnecessary surgical trauma.

Objective:To study the proportion and clinicopathological characteristics of gastric adenocarcinoma with enteroblastic differentiation (GAED) in gastric cancers showing an elevated serum alpha fetoprotein(AFP).Methods:A total of 724 resected gastric adenocarcinomas were collected from 2008 to 2018 at the 904 Hospital of Joint Service Support Force, and cases with pre-operative serum AFP >10 μg/L were screened. From the cases with elevated serum AFP, GAED cases were further evaluated based on morphology. Then the clincopathological features and immunohistochemical phenotypes of GAED were reviewed. In addition, the amplification of HER2 gene was detected with fluorescence in situ hybridization(FISH). When overall survival (OS) and progression-free survival (PFS) of GAED were analyzed, 289 cases ordinary gastric adenocarcinoma with normal serum AFP were employed as a control. Results:The percentage of GAED was 44% (11/25) in gastric cancers with elevated serum AFP. GAED was histologically tubular or papillary with clear cytoplasm, and some GAED cases showed cystadenoid structure similar to embryo sac (5 cases), homogeneous eosinophilic granules (4 cases) and intragland ulareosinophilic material (6 cases). All 11 GAED cases had lymph node metastasis. Liver metastasis and vascular thrombus were observed in 2 cases and 5 cases respectively. GAED was immunohistochemically positive for CDX2 (11/11), CD10 (8/11) and MUC2(3/11), which were intestinal epithelium differentiation markers. Meanwhile, primitive markers SALL4 (8/11), GPC3 (7/11) and AFP (5/11) were also expressed in GAED, and HER2 gene amplification was found in 3 cases (3/11) of GAED. Lastly, the PFS of GAED were significantly shorter than that of the control group ( P=0.02), while OS was not statistically different between these two groups ( P=0.99). Conclusions:Patients with GAED usually have a higher rate of elevated serum AFP in gastric adenocarcinoma, and the cancer exhibites features of both intestinal and primitive differentiation. As GAED is highly invasive, the prognosis of GAED may be poor. For GAED, the diagnosis of well-differentiated or moderately-differentiated adenocarcinoma should be avoided, because this diagnosis leads to underestimated malignant potential.

Objective: To investigate the relationship between the expression of leptin protein and clinicopathological features and prognosis of gastric cancer. Methods: The cancer tissue specimens of 112 patients diagnosed with gastric cancer in Shaanxi Provincial Cancer Hospital from January 2009 to December 2012 were collected. Random number table method was used to select 50 cases of paracancerous normal mucosa tissues as the controls. The expression of leptin protein was detected by using immunohistochemistry. And the relationship between the expression of lepin protein and the clinicopathological features and prognosis was analyzed. Results: The positive rate of leptin protein in gastric cancer tissues was higher than that in paracancerous normal gastric mucosa tissues, and the difference was statistically significant [68.8% (77/112) vs. 34.0% (17/50), χ² = 17.139, P < 0.01]. The expression of leptin protein was associated with tumor vessel invasion, invasion depth and TNM stage (all P < 0.05). The expression of leptin protein was positively correlated with tumor invasion depth and TNM stage (r = 0.265, P = 0.005; r = 0.318, P = 0.001). The 5-year total survival rates of patients with positive and negative expression of leptin protein were 65.2% and 78.4%, respectively, and the difference was statistically significant (χ ² = 9.526, P = 0.002). The 5-year total survival rates of patients who received neoadjuvant chemotherapy or not were 71.7% and 67.6%, respectively, and the difference was not statistically significant (χ ² = 2.321, P = 0.128). In patients with positive expression of leptin protein, 5-year total survival rates of patients who received neoadjuvant chemotherapy or not were 47.4% and 74.2%, respectively (χ ² = 6.336, P = 0.012). In patients with negative expression of leptin protein, 5-year total survival rates of patients who received neoadjuvant chemotherapy or not were 92.3% and 18.2%, respectively (χ ² = 14.237, P < 0.01). Cox multivariate regression analysis showed that leptin protein expression, lymph node metastasis, pathological grading, vessel invasion and TNM stage were independent prognostic factors for patients with gastric cancer (all P < 0.05). Conclusion Leptin protein is highly expressed in gastric cancer tissues, and it can be used as a marker for judging the prognosis and chemotherapy effect of gastric cancer patients.

Objective To investigate the relationship between vascular endothelial growth factor C (VEGF-C) and lymphatic vessel density (LVD) with clinicopathological features of the patients in stage Ⅱ colorectal cancer.Methods Fifty-seven tissues in stage Ⅱ colorectal cancer and 57 normal mucosal tissues in Shaanxi Provincial Cancer Hospital from January 2005 to December 2010 were collected.The expression of VEGF-C and LVD were detected by using immunohistochemical method.The relationship between VEGF-C and LVD with the clinicopathological features of colorectal cancer was analyzed.Results The expression of VEGF-C and LVD in cancer tissues was higher than that in normal tissues (6.80±1.24 vs.2.07±0.17,t =3.773,P =0.000;3.19±0.53 vs.1.84±0.26,t =2.276,P =0.025).There were statistical differences between VEGF-C and LVD in different tumor diameter (4.00±0.54 vs.11.26±2.89,t =-3.049,P =0.004;1.89±0.37 vs.5.27±1.12,t =-3.376,P =0.001) and relapse or metastasis (4.74±1.31 vs.10.62 ±2.39,t =-2.158,P =0.039;1.86±0.45 vs.5.65±1.06,t =-3.778,P =0.000).LVD in VEGF-C positive group was higher than that in VEGF-C negative group (4.16±0.64 vs.0.21±0.11,t =3.503,P =0.001).The expression of VEGF-C was positively correlated with LVD (r =0.892,P =0.000).Conclusions The expression of VEGF-C in stage Ⅱ colorectal cancer is correlated with LVD,as well as tumor size and relapse or metastasis.VEGF-C and LVD could also play important roles in the occurrence,development and metastasis in stage Ⅱ colorectal cancer.

Objective To investigate the expressions and significances of phosphatase and tension homologous genes (PTEN) and human telomerase reverse transcriptase (hTERT) in esophageal cancer.Methods 84 specimens of esophageal cancer underwent surgical resection from December 2010 to December 2012 were collected,at the same time,30 cases of para cancerous tissues and 30 normal esophageal mucosa tissues were taken as control.Streptavidin peroxidase (SP) immune-histochemical method was used to detect the expressions of PTEN and hTERT in the esophageal tissue specimens,according to the clinical data,the relationships between PTEN,hTERT in the esophageal cancer tissues with clinical pathological features and prognosis was analyzed.Results (1) The positive expression rate of PTEN in esophageal cancer tissue was significantly lower than that in para cancerous tissue (x2 =5.077,P =0.024) and normal mucosa tissue (x2 =22.810,P =0.000);the positive expression rate of PTEN in para cancer tissues was significantly lower than that in normal mucosa (x2 =5.104,P =0.024).(2) The positive expression rate of hTERT in esophageal cancer tissues was significantly higher than that in para cancerous tissue (x2 =19.724,P =0.000) and normal mucosa tissue (x2 =46.392,P =0.000);The positive expression rate of hTERT in para cancerous tissues was significantly higher than that in normal mucosa (x2 =4.565,P =0.033).(3) The expression intensities of PTEN and hTERT in esophageal cancer tissues were related to the degree of tumor invasion,clinical stage,lymph node metastasis and degree of differentiation (P ＜ 0.05).(4) At the end of the follow-up,the median survival period of all patients was 22 months,the cumulative survival rates of 1,3,and 5 years after operation were 65.48％,38.10％ and 28.57％ respectively.The cumulative survival rates of 1,3,and 5 years after operation in patients with low expression of PTEN and patients with high expression of PTEN were 60.00％ and 84.21％,30.77％ and 63.16％,23.08％ and 47.37％,respectively.The survival rate of patients with high expression of PTEN was significantly higher than that of patients with low expression of PTEN (x2 =5.073,P =0.024).The cumulative survival rates of 1,3,and 5 years after operation in patients with low expression of hTERT and patients with high expression of hTERT were 76.47％ and 58.00％,50.00％ and 30.00％,38.24％ and 22.00％,respectively.The survival rate of patients with high expression of hTERT was significantly lower than that of patients with low expression of hTERT (x2 =4.174,P =0.041).Conclusions The expression of PTEN was low in esophageal cancer tissues and high in hTERT,which could be used as a predictor of clinical prognosis in patients with esophageal cancer.

Objective To investigate diagnostic value of CT signs in papillary thyroid carcinoma (PTC) by comparing CT signs of PTC with different sizes.Methods CT signs of 406 PTC from 396 patients confirmed by histology were analyzed retrospectively.Based on the largest tumor diameter,PTC were divided into 1.1-2.0 cm group,2.1-3.0 cm group and＞3.0 cm group.Distribution of irregular shape,cookie bite sign,enhanced narrow/ fuzzy and microcalcification in each group was analyzed.Results There were 318 pieces in 1.1-2.0 cm group,60 pieces in 2.1-3.0 cm group and 28 pieces in ＞3.0 cm group,respectively.The rate of irregular shape was 89.6％(285/318),75.0％(45/60) and 64.3％(18/28) in each group,the rate of cookie bite sign was 83.6％(266/318),71.7％(43/60) and 64.3％ (18/28),and enhanced narrow/fuzzy was 84％(267/318),78.3％ (47/60) and 67.9％ (19/28) in each group,and microcalcification was 35.5％ (113/318),40.0％ (24/60) and 59.3％ (16/27) in each group.The rate of irregular shape (x2=20.092,P=0.000)and cookie bite sign (x2=9.695,P=0.008)had statistical difference among the three groups,while the rate of enhanced narrow/fuzzy(x2=5.175,P=0.075)and microcalcification (x2=5.277,P=0.071) had no statistical difference among each group.Furthermore,irregular shape and cookie bite sign were compared between groups.Rate of irregular shape in 1.1-2.0 cm group and 2.1-3.0 cm (x2=9.746,P=0.002)group,1.1-2.0 cm group and ＞ 3.0 cm group (x2=15.180,P=0.000) was statistically different.Rate of cookie bite sign in 1.1-2.0 cm group and ＞3.0 cm(x2=6.560,P=-0.010)was statistically different.There was no statistical difference between other groups.Conclusions Although irregular shape,cookie bite sign,enhanced narrow/fuzzy and microcalcification are important CT signs in diagnosing PTC,distribution of different signs varies with tumor sizes.Correct identification of these differences will help to improve the accuracy of preoperative diagnosis,and reduce occurrence of misdiagnosis.

Objective To study the relationship between expression of leptin and clinical pathogenesis and prognosis of stage Ⅱ colorectal cancer.Methods The clinical data of 102 patients with colorectal cancer admitted to Shaanxi Provincial Tumor Hospital between January 2005 and December 2010 was collected and statistically analyzed.The expression of leptin in postoperative colorectal cancer tissues and 40 normal colorectal tissues was detected by P-V immunohistochemical technique.Results The expression of leptin in cancer tissues were obviously higher than that in normal tissues [59.8 ％ (61/102) vs.17.5 ％ (7/40),x 2 =20.605,P =0.000].There was no association between leptin expression level and gender,age,tumor location,pathological grading,pathological types,tumor size,invasion depth and body mass index (all P ＜ 0.05).Cox multivariate regression analysis showed that leptin expression (P =0.041) and adjuvant chemotherapy (P =0.008) were independent factors affecting OS in patients with stage Ⅱ colorectal cancer.The patients with positive expression of leptin could not benefit from the adjuvant chemotherapy (P =0.259),and patients without leptin expression had improved survival when treated by adjuvant chemotherapy (P =0.021).Conclusion The expression of leptin in stage Ⅱ colorectal cancer tissues is obviously higher than that in normal tissues.Leptin is associated with chemotherapy resistance and therapy-independent prognosis.