1.Related factors of N2 lymph node metastasis in non-small cell lung cancer and selection of lymph node dissection
Lei CAI ; Jingxiao LIANG ; Qian CHEN ; Xun YANG ; Youhua JIANG
Journal of Chinese Physician 2019;21(2):232-234,238
Objective To analyze the related factors of lymph node metastasis in N2 group of patients with non-small cell lung cancer,and found its meaning for lymph node dissection.Methods A retrospective analysis was made on 110 patients with non-small cell lung cancer from July 2014 to May 2016 in our thoracic surgery department.Potential related factors were collected,single factor analysis and variate analysis were carried out to find the relationship between N2 lymph node metastasis and potential related factors.Results Univariate analysis showed that the longest diameter of the tumor > 2 cm (P =0.016),lymph node imaging (P =0.021),pleural involvement (P =0.002) were related factors of lymph node metastasis in N2 group,and these three factors were independent related factors of lymph node metastasis in N2 group.Conclusions The longest diameter of the tumor,lymph node imaging and pleural involvement are related factors of N2 lymph node metastasis.Systematic lymph node dissection is strongly recommended for patients with three related factors at the same time.
2.Effects of body mass index, appendicular skeletal muscle mass index and serum lipid levels on the risk of tumor progression in patients with high-risk renal clear cell carcinoma
Danping ZHENG ; Yancai LIANG ; Zhiyuan ZHANG ; Jian CUI ; Jingxiao HAO ; Xiangyun LU ; Juan WANG ; Na GUO ; Kang YU
Chinese Journal of Clinical Nutrition 2022;30(4):199-205
Objective:To evaluate the potential effects of serum lipid levels, appendicular skeletal muscle mass index (ASMI) and body mass index (BMI), together with its dynamic changes, on tumor progression in renal clear cell carcinoma patients, so as to inform body weight management.Methods:This prospective cohort study included a total of 100 patients with high-risk clear cell renal cell carcinoma. Serum lipid levels were detected, ASMI and BMI were measured using bioelectrical impedance analysis and the dynamic changes of BMI were tracked. The effects of BMI, ASMI and serum lipid levels on tumor progression within 2 years were explored.Results:Patients with normal BMI and low ASMI had 5.248 (95% CI: 1.946 to 14.153, P = 0.001) times higher risk of tumor progression than those who were overweight or obese. For every 0.1-unit increase in pre-operative HDL-C, the risk of tumor progression decreased by 0.771 (95% CI: 0.631 to 0.942, P = 0.011) times. Patients who experienced more than 5% decrease in BMI compared with baseline had 5.165 (95% CI: 1.735 to 15.370, P = 0.003) times the progression risk of patients whose BMI changed within ±5% from baseline. Conclusions:The advantage of obese clear cell carcinoma patients over normal-weight patients in tumor progression-free survival may be influenced by ASMI, pre-onset involuntary weight loss and lipid levels. Therefore, patient weight management should not merely focus on absolute BMI but tailor to individual characteristics, including cancer stage, body composition and metabolic status.