1.Assessment of lymph node metastasis in gastric cancer: status quo, recent advances and new perspectives.
Min TU ; Zhen-shu ZHU ; Lin-sen SHI ; Xi-qun JIANG ; Hao WANG ; Wen-xian GUAN
Chinese Journal of Gastrointestinal Surgery 2012;15(2):197-200
The precondition of accurate gastric cancer surgery is precise assessment of lymph node metastasis. To date, no imaging modality achieves both high sensitivity and high specificity in detecting lymph node metastasis in gastric cancer. Intraoperative sentinel node tracing and biopsy are the most popular method to identify the localization of tumor cell, but is limited to early gastric cancer. Nano-composite materials, designed for tumor imaging and tracing, show us a newly emerging domain for tumor detection in gastric cancer. The function of these nano-composite materials to detect lymph node metastasis in gastric cancer relies on the effective backflow of lymph system. However, the lymph vessels can be obstructed by tumor cells in advanced gastric cancer, which may restrain the application of these nanoparticles. Therefore, more methods to detect lymph node metastasis in gastric cancer should be explored. This review summarizes the characteristic of the targeted nanosphere. Based on the reported studies, a novel idea is conceived that targeted multifunctional nanosphere may be a potential method to achieve precise assessment of lymph node metastasis in gastric cancer.
Humans
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Lymph Nodes
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pathology
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Lymphatic Metastasis
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pathology
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Stomach Neoplasms
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pathology
2.Evaluation of lymphatic emboli in gastric cancer by D2-40/CKpan dual immunostain and its significance.
Baoyan ZHANG ; Jing YUAN ; Xianghong LI ; Youyong LYU
Chinese Journal of Gastrointestinal Surgery 2014;17(2):145-149
OBJECTIVETo investigate the evaluation of lymphatic emboli by D2-40/CKpan dual immunostain and its prognostic significance in advanced primary gastric adenocarcinoma.
METHODSTissue samples of 108 cases of advanced gastric adenocarcinoma with radical gastrectomy were collected from Chinese PLA General Hospital in 2001. Lymphatic emboli were evaluated by D2-40/CKpan dual immunostain on consecutive sections, and compared with routine HE staining. The correlation of lymphatic emboli with lymph node metastasis and overall survival was analyzed by Pearson Chi-squared test and univariate survival analysis, respectively.
RESULTSLymphatic emboli were detected in 73/108 (67.6%) cases by D2-40/CKpan staining, compared to 57/108 (52.8%) by HE staining. There was significant difference (P=0.007). Lymphatic emboli on HE staining revealed false negative in 24/108 cases and false positive in 8/108 cases. A significant correlation was found between lymphatic emboli and lymph node metastasis on HE staining (P=0.024), while it was not found on D2-40/CKpan staining (P=0.422). The overall survival rate was significantly different between lymphatic emboli positive and negative cases on HE staining (P=0.043). The overall survival rate was lower in lymphatic emboli positive cases on HE staining. Lymphatic emboli evaluated on D2-40/CKpan staining had no prognostic value (P=0.402).
CONCLUSIOND2-40/Ckpan dual immunostaining is more sensitive for lymphatic emboli in gastric adenocarcinoma but may not predict lymph node metastasis and survival, while HE staining may.
Gastrectomy ; Humans ; Lymphatic Metastasis ; Lymphatic Vessels ; pathology ; Prognosis ; Stomach Neoplasms ; pathology
3.The rule of lymphatic formation in rabbit VX2 supraglottic carcinoma model with lymph node metastasis.
Pin ZHANG ; Wenyue JI ; Xiangbo ZHANG
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2012;26(3):125-128
OBJECTIVE:
Establishment of transplanted model of VX2 supraglottic carcinoma in rabbits and investigation the rule of lymphatic vessels formation.
METHOD:
After establishment of VX2 tumor-bearing rabbits, the carcinoma tissues were transplanted into the operculum laryngis submucosa in sixty New-Zealand white rabbits to establish transplanted tumor model. Vascular endothelial growth factor-3 (VEGFR-3) label staining was performed to observe lymphatic vessels. Number density, volume density of lymphatics periphery region of carcinoma, normal region and centre region were measured using computer image analysis system.
RESULT:
There was no lymphatic vessels in carcinomatous centre region,but the lymphatic vessels number density, volume density in periphery region was much more than normal region. Their cavities were dilated. The discrepancy had statistical significance (P<0.01).
CONCLUSION
The rule of lymphatic formation in rabbit VX2 supraglottic carcinoma model mimesis rule of lymphatic formation anthropo- supraglottic carcinoma. Lymphatic multiplication and dilation at periphery region of carcinoma is associated with lymph node metastasis. Evaluation of it at periphery region of carcinoma may be useful in predicting lymph node metastasis in patients with supraglottic carcinoma. This conclusion provides theoretical basis for utility of the anti-tumor medicines which inhibit lymphatic formation in animal model.
Animals
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Cell Line, Tumor
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Humans
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Laryngeal Neoplasms
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pathology
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Lymphatic Metastasis
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Lymphatic Vessels
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pathology
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Neoplasm Transplantation
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Rabbits
4.Lymph node metastasis in early gastric cancer.
Rong CHEN ; Qingsheng HE ; Jianxin CUI ; Shibo BIAN ; Lin CHEN ;
Chinese Medical Journal 2014;127(3):560-567
OBJECTIVETo discuss the clinicopathological factors for lymph node metastasis (LNM) in early gastric cancer (EGC), including age, gender, location, size, macroscopic type, depth of invasion, histological type, and lymphatic invasion, and the regulation of LNM in EGC.
DATA SOURCESThe data used in this review were mainly from PubMed articles published in English. The search terms were "early gastric cancer" and "lymph node metastasis".
STUDY SELECTIONArticles were selected if they reported the clinicopathological factors and regulation of LNM in EGC.
RESULTSThe prognosis of EGC is better than advanced gastric cancer, with over 90% 5-year survival rate. The main risk factors for LNM in EGC are tumor size, macroscopic type, depth of invasion, histological type, ulceration, and lymphatic invasion.
CONCLUSIONSLNM in EGC is a critical factor for assessment of prognosis and determination of therapeutic strategy. Endoscopic mucosal resection or endoscopic submucosal dissection should be considered when patients have low risk of LNM.
Female ; Humans ; Lymphatic Metastasis ; Male ; Stomach Neoplasms ; complications ; pathology ; surgery
5.A case report of childhood histocytic sarcoma.
Ying-Xia LI ; Hua-Jie WU ; Jing-Jing ZHANG ; Kai-Li PAN ; Pu YU ; Xin FU ; Zhe WANG
Chinese Journal of Contemporary Pediatrics 2010;12(5):405-406
6.Association of tumor budding with clinicopathological characteristics and prognosis in T2 rectal cancer.
Jian-xiang HE ; Hao WANG ; Chuan-gang FU ; Rong-gui MENG ; Lian-jie LIU ; Wei ZHANG ; En-da YU
Chinese Journal of Gastrointestinal Surgery 2012;15(4):363-366
OBJECTIVETo demonstrate the association of tumor budding with clinicopathological features and prognosis in T2 rectal cancer.
METHODSClinicopathological data of 123 patients who underwent potentially curative resection for T2 rectal carcinoma between 2001 and 2005 at the Changhai Hospital were collected. All pathology slides were stained with hematoxylin and eosin for microscopic examinations. The maximum value of tumor buds(MV) and average value of tumor buds(AV) were calculated, which were classified as low value (≤5), median value (5 < bud value < 10), and high value (≥10).
RESULTSUnivariate analysis and multivariate analysis revealed that MV(P=0.000), AV(P=0.001), and lymphatic invasion (P=0.006) were independent predictors for lymph node metastasis in T2 rectal cancer. Neural invasion and poorly differentiation were significantly associated with MV(P<0.05). Neural invasion, vascular invasion and poorly differentiation were were significantly associated to AV (P<0.01). Disease-free survival (DFS) of patients with low AV, median AV and high AV was 110.5 months, 95.8 months, and 60.0 months respectively. There were significance differences in DFS of low AV with median and high AV(P<0.05). DFS of patients with low MV, median MV and high MV was 115.1 months, 98.5 months, and 86.0 months respectively. There were significance differences in DFS between low and high AV, and median and high MV(P<0.01 and P<0.05), while no significant difference existed between low and median MV.
CONCLUSIONTumor budding is a useful marker to indicate high invasiveness of rectal cancer and a valuable prognostic predictor.
Female ; Humans ; Lymphatic Metastasis ; Male ; Prognosis ; Rectal Neoplasms ; pathology ; surgery
7.Nomogram-Based Prediction of Risk of Cervical Lymph Node Metastasis in Differentiated Thyroid Carcinoma.
Yan TIAN ; Xue-Hua XI ; Jiao-Jiao MA ; Jia-Jia TANG ; Hui-Lin LI ; Qi ZHU ; Bo ZHANG
Acta Academiae Medicinae Sinicae 2023;45(3):355-360
Objective To establish a nomogram for predicting the risk of cervical lymph node metastasis in differentiated thyroid carcinoma (DTC). Methods The patients with complete clinical data of DTC and cervical lymph node ultrasound and diagnosed based on pathological evidence from January 2019 to December 2021 were assigned into a training group (n=444) and a validation group (n=125).Lasso regression was performed to screen the data with differences between groups,and multivariate Logistic regression to establish a prediction model with the factors screened out by Lasso regression.C-index and calibration chart were employed to evaluate the prediction performance of the established model. Results The predictive factors for establishing the model were lymph node short diameter≥0.5 cm,long-to-short-axis ratio<2,disappearance of lymph node hilum,cystic transformation,hyperechogenicity,calcification,and abnormal blood flow (all P<0.001).The established model demonstrated a good discriminative ability,with the C index of 0.938 (95%CI=0.926-0.961) in the training group. Conclusion The nomogram established based on the ultrasound image features of cervical lymph nodes in DTC can accurately predict the risk of cervical lymph node metastasis in DTC.
Humans
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Nomograms
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Lymphatic Metastasis
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Lymph Nodes/pathology*
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Neck/pathology*
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Thyroid Neoplasms/pathology*
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Adenocarcinoma/pathology*
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Retrospective Studies
9.New knowledge in pathology of colorectal cancer.
Chinese Journal of Surgery 2009;47(13):975-977
10.Papillary Thyroid Microcarcinomas Are Different from Latent Papillary Thyroid Carcinomas at Autopsy.
Yong Sang LEE ; Hyunsun LIM ; Hang Seok CHANG ; Cheong Soo PARK
Journal of Korean Medical Science 2014;29(5):676-679
The aim of this study was to review the literature of latent papillary thyroid carcinomas (PTCs) discovered at autopsy and describe the available pathologic and demographic differences from a group of papillary thyroid microcarcinomas (PTMCs) the reported in a previous publication. We searched the PubMed for published articles describing latent thyroid carcinomas detected at autopsy. Meta-analysis was performed to identify differences between the clinicopathologic features of PTMCs analyzed previously in our institution (Group I) and those of latent PTCs described in autopsy studies (Group II). We identified 1,355 patients with PTMC (Group I) and 989 with latent PTCs (Group II). Mean patient age was 47.3 yr in Group I and 64.5 yr in Group II. The male:female ratio was 1:10.9 in Group I and 1:1 in Group II. Most PTMCs (67.6%) were larger than 0.5 cm in size, whereas most latent PTCs were <1-3 mm in diameter. The rates of multifocality were 24.7% in Group I and 30.5% in Group II, and the rates of cervical lymph node metastasis were 33.4% in Group I and 10.0% in Group II. Currently available data indicated that clinically evident PTMCs differ from latent PTCs detected at autopsy. Therefore, these two entities should be regarded as different.
Autopsy
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Carcinoma/*pathology
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Carcinoma, Papillary/*pathology
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Female
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Humans
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Lymphatic Metastasis
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Male
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Middle Aged
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Thyroid Neoplasms/*pathology