The authors present a clinical analysis of 96 patients with pituitary adenoma who underwent surgical treatment. These patients were analyzed in terms of preoperative clinical manifestations, size and extension of tumor, therapeutic modalities and changes of neurological and hormonal symptoms. There were marked improvements of neurological and hormonal sympotms, especially of vision and diabetes insipidus, immediately after operation. Transsphenoidal approach was a safe and effective operative method to achieve rapid decompression. Radiation therapy played a important role as a adjuvant therapeutic method to eradicate postoperative residual tumors.
Decompression ; Diabetes Insipidus ; Diagnosis* ; Humans ; Neoplasm, Residual ; Pituitary Neoplasms*

Warthin's tumor is the second most common benign tumor of the parotid gland. Malignancy arising from Warthin's tumor is extremely rare, and only 29 cases have been reported. Diagnosis can be made prior to the surgery, but in many cases, the disease is detected through postoperative pathology report or by recurrence of the mass lesion. We report a case of polymorphous low grade adenocarcinoma arising from Warthin's tumor diagnosed by the excision of a parotid mass and treated by an additional surgery of superficial parotidectomy. The postoperative pathology report revealed no residual cancer cells and the patient is free of disease for 8 months since the operation.
Adenocarcinoma* ; Adenolymphoma ; Diagnosis ; Humans ; Neoplasm, Residual ; Parotid Gland ; Pathology ; Recurrence

Possible lymph node metastasis (LNM) and residual cancer are major concerns in endoscopic submucosal dissection (ESD) for early gastric cancer. To reduce the risk of LNM and cancer recurrence, the proper indications for ESD should be considered. Histology, size, depth of invasion, and presence of ulceration should be thoroughly evaluated before proceeding with ESD. However, with incomplete information, discrepancies often arise between the pathological diagnosis based on the forceps biopsy and that based on the totally resected specimen. In addition, the presence of lymphovascular involvement and histological homogeneity can be clarified only after ESD. If the pathological diagnosis changes after ESD, we should reevaluate the curativeness and reformulate the goal of treatment. Additional surgery is a reasonable strategy for non-curative ESD, but a patient's other health conditions should also be considered. It is simple to read pathological reports before and after ESD, but it can be a complicated art to interpret the report and formulate an optimal approach. In this review, various considerations regarding the pathological diagnosis will be discussed.
Biopsy ; Diagnosis ; Lymph Nodes ; Neoplasm Metastasis ; Neoplasm, Residual ; Pathology ; Recurrence ; Stomach Neoplasms* ; Surgical Instruments ; Ulcer

Ovarian cancer is the most lethal of the gynecologic cancers worldwide because most patients present with advanced stage disease at the time of diagnosis. Although multiple therapeutic modalities are employed in the management of ovarian cancer, and despite advances in chemotherapeutic and biologic agents, primary surgery followed by adjuvant chemotherapy remains the cornerstone treatment of this disease. Adequate, comprehensive surgical staging in women with early stage ovarian cancer has been shown to improve oncologic outcomes. Complete surgical cytoreduction leaving no gross residual disease is known to be the only physician-driven prognostic factor for patients with advanced disease. This review describes the rationale and surgical steps for full surgical staging for women with early ovarian cancer, and outlines the cytoreductive surgical procedures required to achieve optimal cytoreduction in patients with advanced ovarian cancer. In addition, the impact of radical surgery (as part of maximal tumor debulking) on the amount of residual tumor and on survival rates will be discussed.
Biological Factors ; Chemotherapy, Adjuvant ; Diagnosis ; Female ; Humans ; Neoplasm Staging ; Neoplasm, Residual ; Ovarian Neoplasms* ; Survival Rate

MRD detection in children leukemia has a potential importance to predict clinical outcome and to modify treatment protocols of the diseases. Although some patients with leukemia have achieved complete remission according to the clinical and morphological criteria, there are still very low numbers of malignant cells that can not be discriminated by morphology and remained in bone marrow, which is called minimal residual disease (MRD) and is the main reason leading to relapse. MRD detection has an important significance for designing treatment protocols. Several methods of MRD detection have been developed. These include conventional cytogenetics, fluorescence in situ hybridization (FISH), flow-cytometric immunophenotyping (FCM), Southern blot and polymerase chain reaction (PCR) techniques, etc. Each of these techniques has its advantages and disadvantages, so not all of them are suitable for clinical MRD detection because of several inherent disadvantages, such as limited sensitivity, time-consuming, high cost, or requiring high-quality DNA or RNA. For example, the sensitivities of conventional cytogenetics, FISH, FCM and Southern blot approaches for MRD monitoring are 10(-1) - 10(-2), 10(-2), 10(-3) - 10(-4) and 10(-1), respectively. Relatively, PCR can reach a good sensitivity of 10(-4) - 10(-6), and show more advantages, such as fast, specific, simple and low-cost, as well as minimal amounts of DNA or RNA for detection, etc., so PCR has its specific features for MRD detection. In this review, the progress on the detection technique for screening leukemia specific marker by muitiplex PCR and FQ-PCR in recent years are summarized.
Child ; Humans ; Leukemia ; diagnosis ; genetics ; Neoplasm, Residual ; diagnosis ; genetics ; Polymerase Chain Reaction ; methods ; Sensitivity and Specificity

In recent years, with the advent of new chemotherapeutic agents, the treatment of acute leukemia has made a great progress and its complete remission rate is up to 50%-80% in patients. However, some patients still relapse in 3 to 5 years after diagnosis. It is believed that the main cause is related to the minimal residual disease (MRD). At present, multiparametric flow cytometry (MFC) with high sensitivity and accurate quantity is one of the effective methods for detecting MRD. Leukemia cells and normal cells are differentiated by analyzing different immunophenotypes. The monitoring of MRD by MFC can help to assess efficacy of treatment, guide treatment selection and predict recurrence of the disease. This article reviewed advantages, challenges, clinical significance and prospect of MFC in detecting MRD.
Acute Disease ; Flow Cytometry ; methods ; Humans ; Leukemia ; diagnosis ; Neoplasm, Residual ; diagnosis

OBJECTIVE: To establish 10-color fluorescent antibody combination panels for the detection of minimal residual disease (MRD) of acute myeloid leukemia (AML) in our laboratory and discuss the value of clinical application. METHODS: According to the antigen expression characteristics of leukemia cells of incipient AML patients, MRD in bone marrow were detected by multiparameter flow cytometry, and the test results were compared with both bone marrow cell morphology and PCR results, then 10-color fluorescent antibody combination panels in our lab for MRD detection was determined. RESULTS: The immunophenotypic characteristics of 392 incipient patients with AML in the First Affiliated Hospital of Zhengzhou University were analyzed, among them 357 (91.07%) cases showed abnormal immunophenotypes, which mainly included cross-lineage expression, cross-stage expression, deficiency of antigen expression or abnormal antigen intensity and other abnormal expression. The 10-color fluorescent antibody combination panels established according to abnormal immunophenotypic characteristics of leukemia cells were applied for detecting MRD in 156 patients with AML, the positive rate (43.6%) was higher than 26.8% of morphology, and the results were highly consistent with PCR detection results (96.49%), moreover, the recurrence rate of MRD positive patients (86.96%) was significantly higher than 5.75% of MRD negative patients. Therefore, this method could truly reflect the load of leukemia cells and prompt change of disease condition. CONCLUSION Multiparameter flow cytometry can detect various abnormal immunophenotypes of AML. The 10-color fluorescent antibody combination panels in our lab based on the characteristics of antigens expression in leukemia cells can well detect MRD of leukemia cells, so as to predict relapse and provide basis for clinical treatment.
Bone Marrow ; Flow Cytometry/methods* ; Humans ; Immunophenotyping ; Leukemia, Myeloid, Acute/diagnosis* ; Neoplasm, Residual/diagnosis*

Thyrotropin(TSH)-secreting pituitary adenoma is a rare disorder causing hyperthyroidism, which is one of the syndrome of inappropriate secretion of TSH. It is characterized by high serum T4, T3 as well as elevated serum TSH. Generally serum free alpha-subunit concentration is also increased and alpha- subunit/TSH molar ratio is more than 1. This alpha- subunit/TSH molar ratio is a clue of diagnosis as well as a useful marker of therapeutic response. We experienced a case of 29-years old man with hyperthyroidism due to TSH-secreting pituitary adenoma. He was underwent 1.5cm sized pituitary tumor removal via transsphenoidal approach in our neurosurgery department. In immunohistochemical stain monotonous tumor cells showed strong positive reaction to antihuman TSH antibody and equivocal reaction to ACTH antibody. After operation, goiter size was progressively decreased and also serum T4, T3 and TSH were decreased in nearly normal range. However, he showed elevated serum T4, T3 and TSH after 1 month due to residual tumor. So he received radiation therapy thereafter. In this case the alpha-subunit and alpha-subunit/TSH molar ratio were not increased. So we report a case of TSH-secreting pituitary macroadenoma which had low alpha-subunit/TSH molar ratio with a literature review.
Adrenocorticotropic Hormone ; Adult ; Diagnosis ; Goiter ; Humans ; Hyperthyroidism ; Molar* ; Neoplasm, Residual ; Neurosurgery ; Pituitary Neoplasms* ; Reference Values ; Thyrotropin*

Endoscopic resection of gastric subepithelial tumors (SETs) has several advantages over biopsy techniques, such as superior diagnostic yield and definite diagnosis. Removal of gastric SETs and histopathologic confirmation should be considered whenever gastric SETs are highly suspected to have malignant potential such as gastrointestinal stromal tumor (GIST) or neuroendocrine tumor. According to our clinical experience, we suggest that endoscopic resection of gastric SETs is feasible for GISTs less than 3.0 cm without positive endoscopic ultrasonography findings or for hypoechoic SETs less than 3.0 cm. However, serious complications such as macroperforation may occur during endoscopic resection, and this procedure is highly dependent on endoscopists' skills. We recently reported the long-term clinical outcomes of endoscopic resection of gastric GIST, which showed a relatively low recurrence rate (2.2%) during long-term follow-up (46.0±28.5 months) despite the low R0 resection rate (25.0%). We suggest that endoscopic surveillance might be possible without additional surgical resection in completely resected GISTs without residual tumor confirmed to be lower risk, even if they show an R1 resection margin.
Biopsy ; Diagnosis ; Endoscopy ; Endosonography ; Follow-Up Studies ; Gastrointestinal Stromal Tumors* ; Neoplasm, Residual ; Neuroendocrine Tumors ; Recurrence

PURPOSE: To determine the value of mammography compared to clinical examination in evaluating residual cancer of locally advanced breast carcinoma treated with neoadjuvant chemotherapy. MATERIALS AND METHODS: Among 67 patients with locally advanced breast carcinoma who were treated with neoadjuvant chemotherapy, 18 patients (age:35-67, mean:48) had taken the mammography before and after neoadjuvant chemotherapy. Those 18 sets of mammography were analyzed retrospectively and compared with the result of clinical examination on the basis of histologic diagnosis. RESULTS: On histologic examinations, 16 of 18 patients (88%) had residual cancer, one of them was diagnosed to have no residual cancer in mammography. On mammographic findings, 16 patients were determined to have residual cancer, and one of them was found not to have residual cancer on histologic examination. Clinically, there were 4 patients showed complete response, 11 patients with partial, and 3 with no response. 3 of 4 patients with complete clinical response were found to have residual cancer in histologic examination. In posttreatment mammographic findings, 11 patients were noted to have measurable mass, 8 patients had microcalcifications. All 11 patients with measurable mass in mammography had residual cancer (positive predictive value:100%). However, 5 of 7 patents who showed no measurable mass in mammography had residual cancer. 7 of 8 patients showing microcalcifications in mammography revealed to have residual cancer (positive predictable value: 88%). Sensitivity of mammography in predicting residual cancer was greater than that of clinical examination (94% vs 81%), even when microscopic residual cancer was considered as a complete response (92% vs 77%). Specificity of mammography were same as those of clinical examination (50% vs 50%, 20 % vs 20%). CONCLUSION: Mammography is more accurate and offers more information than clincal examination in evaluating residual cancer of locally advanced breast carcinoma after neoadjuvant chemotherapy. However, prediction of residual cancer with mammography is not accurate enough to replace histologic examination.
Breast Neoplasms* ; Breast* ; Diagnosis ; Drug Therapy* ; Humans ; Mammography* ; Neoplasm, Residual* ; Retrospective Studies ; Sensitivity and Specificity