Recently, the D'Amico classification system is widely used for the risk stratification of prostate cancer (PCa) , although no consensus has been reached for the definition of high-risk PCa. This system defines high-risk PCa as a prostate-specific antigen (PSA) level > 20 ng/ml, a Gleason score of 8-10, or a clinical stage ≥ T2c. Because high-risk PCa is prone to recurrence and metastasis after treatment, a proper initial therapy plays a crucial role. Currently, radical prostatectomy and radiation therapy are considered to be two most important options for the initial treatment of high-risk PCa although it remains controversial which is better.
Humans ; Male ; Neoplasm Grading ; Neoplasm Recurrence, Local ; Prostate-Specific Antigen ; blood ; Prostatectomy ; methods ; Prostatic Neoplasms ; blood ; pathology ; radiotherapy ; surgery ; Risk

OBJECTIVETo investigate the causes of misdiagnosis and the surgical treatment of primary hyperparathyroidism (PHPT).

METHODSThe clinical data of 26 patients with PHPT from July 2008 to January 2013 in The Affiliated Hospital of Chengde Medical College and The Fourth Hospital of Hebei Medical University were retrospectively analyzed, including preoperative diagnosis and operative method. The level of serum calciumion and serum parathyroid hormone (PTH), Ultrasonography, CT, (99)mTc-methoxy isobutylis onitrile ((99)mTc-MIBI) were used in the diagnosis before operation. All patients accepted surgical treatment after the level of serum calciumion decreased to normal.

RESULTSThe level of PTH was examined 10 min after resection, which declined more than 50%. After pathological examination, 23 cases were diagnosed as parathyroid adenoma, 2 cases were parathyroid hyperplasia, and 1 case was parathyroid carcinoma. The level of serum calciumion and serum parathyroid hormone were returned to the normal level after operation. All patients recovered with no postoperative complication.Followed up lasted from 6 months to 5 years, no case recurred.Sixteen cases with symptoms experienced significant improvement in signs, including 10 cases with clinical symptoms completely disappeared.

CONCLUSIONSThe test of serum calciumion and serum PTH, Ultrasonography, CT, (99)mTc-MIBI are helpful to reduce the misdiagnose rate of primary hyperparathyroidism before operation. The examination of serum parathyroid hormone in operation is helpful to reduce the operation range and time.

Adenoma ; diagnosis ; Humans ; Hyperparathyroidism, Primary ; Neoplasm Recurrence, Local ; Parathyroid Hormone ; blood ; Parathyroid Neoplasms ; surgery

Objective To dynamically observe the early change of thyroglobulin(Tg) levels after (131)I therapy in differentiated thyroid cancer(DTC) patients. Methods The study enrolled 22 post-total-thyroidectomy DTC patients and they were stratified as low to intermediate recurrence according to the 2009 American Thyroid Association Guidelines. The clinical data including pre-ablation stimulated Tg (ps-Tg),corresponding thyroid stimulating hormone(TSH),anti-thyroglobulin (TgAb) values,and the afterwards parameters were dynamically measured each week in the first month after (131)I therapy. Values collected at the first time were defined as Tg 0 and TSH0,while Tg1 and TSH1 were collected at the first week after (131)I therapy respectively. Then the variation trend curves of Tg were drawn,and factors influencing the variation of Tg were analyzed. Two groups were divided according to Tg levels:G1 (Tg≤0.1 ng/ml,n=9) and G2(Tg>0.1 ng/ml,n=13). Results The rates of negative Tg were 4.5%,18.0%,27.0%,36.0%,and 41.0%,respectively,exactly before (131)I therapy and the 1(st),2(nd),3(rd),and 4(th) week after the therapy. One-way analysis of variance showed that the two groups statistically differed in age (F=3.182,P=0.04) and remnant thyroid (U=4.849,P=0.026). Multivariate logistic regression analysis showed that early negative Tg was related to remnant thyroid tissue (OR:2.132;95%Cl:1.418- 6.532,P=0.009). Conclusions Negative Tg can be achieved in nearly half of DTC patients by the end of first month after (131)I therapy. The negative conversion is closely related with the volume of remnant thyroid tissue.
Autoantibodies ; blood ; Humans ; Iodine Radioisotopes ; therapeutic use ; Neoplasm Recurrence, Local ; Thyroglobulin ; blood ; Thyroid Neoplasms ; radiotherapy ; Thyroidectomy ; Thyrotropin ; blood

OBJECTIVETo investigate the clinical significance of plasma vascular endothelial growth factor (p-VEGF) levels in gastrointestinal stromal tumor (GIST) patients.

METHODSThe p-VEGF levels in 61 primary GIST patients, 18 patients with recurrence or metastasis, and 28 healthy blood donators (as control) were measured by enzyme-linked immunosorbent assay. Paired p-VEGF levels of pre- and post-treatment were obtained from 44 patients. One patient received 22 consecutive detections during the follow up.

RESULTSPrimary and recurrent GIST patients had higher p-VEGF levels than healthy controls [(145.31+/-45.58) ng/L, (145.72+/-52.73) ng/L vs (89.86+/-18.30) ng/L] (P<0.01). And there were no significant differences between primary patients and patients with recurrence or metastasis (P>0.05). Significant difference were found in the p-VEGF levels between pre- and post-treatment patients (P<0.01). Post-treatment p-VEGF levels decreased markedly both in 26 primary and 11 recurrent patients [(101.81+/-27.63) ng/L and (112.45+/-38.58) ng/L]. As for the patient with 22 consecutive detections during the follow up, p-VEGF levels the period of were higher before surgery and after recurrence, and lower two months after surgery and during Glivec therapy.

CONCLUSIONSThe p-VEGF level of GIST patients is significantly higher than that of healthy people, which will decrease markedly after effective management. Monitoring the p-VEGF level in GIST patients will be helpful to evaluate the therapeutic efficacy and predict the recurrence or metastasis.

Case-Control Studies ; Female ; Gastrointestinal Stromal Tumors ; blood ; pathology ; Humans ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Vascular Endothelial Growth Factor A ; blood

OBJECTIVETo investigate the relation between changes in serum vascular endothelial growth factor (VEGF) level after transcatheter arterial chemoembolization (TACE) and hepatocellular carcinoma (HCC) progression, especially in relation to metastasis.

METHODSSerum VEGF expression level, measured by quatitative sandwich enzyme-linked immunosorbent assay (ELISA, R&D system), was measured before, 3 days and 4 weeks after TACE in 30 patients with HCC. The development of metastasis was evaluated at the end of the third month after TACE.

RESULTS1. The serum VEGF level in 30 patients was 154.47 +/- 90.17 pg/ml, 2. Post-TACE total serum VEGF level increased as compared with their basal level in 30 patients (P < 0.05) and serum VEGF level had a tendency to increase in patients with heterogeneous uptake of iodized oil and portal vein thrombosis. During the follow-up of 1 - 2 years, metastatic foci were found in 74% (20) patients with SVEGF increase, while none of the patients showing SVEGF decrease developed metastasis.

CONCLUSIONSerum VEGF expression increase is associated with the development of metastasis in hepatocellular carcinoma after TACE.

Carcinoma, Hepatocellular ; blood ; pathology ; therapy ; Chemoembolization, Therapeutic ; Female ; Humans ; Liver Neoplasms ; blood ; pathology ; therapy ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Vascular Endothelial Growth Factor A ; blood

OBJECTIVETo compare the outcomes of hand-assisted laparoscopic liver surgery (HALS) and pure laparoscopic liver surgery (PLS).

METHODSThe clinical data were analyzed for 64 patients undergoing major hepatectomy with HALH (23 cases) and PLS (41 cases) between January, 2010 and December, 2012.

RESULTSThe general data of the two groups were comparable. Compared with PLS, HALS was associated with a significantly shorter operative time (240 vs 191 min), less intraoperative blood loss (430 vs 220 ml, P<0.05), and a lower cost (P<0.05). There was no significant difference between the two groups in postoperative hospital stay, complication rates or recurrence rate of hepatocellular carcinoma.

CONCLUSIONHALS is safe for major liver resection with such advantages over PLS as causing less trauma and a lower cost.

Blood Loss, Surgical ; Carcinoma, Hepatocellular ; surgery ; Hepatectomy ; methods ; Humans ; Laparoscopy ; methods ; Length of Stay ; Liver Neoplasms ; surgery ; Neoplasm Recurrence, Local

Objective To analyze the predictive factor of surgical efficacy in male patients with prolactinoma. Method The clinical data of 184 male patients with prolactinoma who had undergone surgery were retrospectively analyzed.Results Before the surgery,the serum prolactin level from 150 to 204 952 ng/ml,the tumors sized 6 to 70 mm. Macroadenoma was seen in 152 cases (82.6%) and suprasellar adenoma with visual deficitsin 75 cases (40.7%). Complete resection was achieved in 149 patients. After surgical therapy,postoperative immediate prolactin level declined in 182 patients (98.4%);57 patients (31.0%)achieved initial remission,while the disease recurred in 26 patients (45.6%).Larger tumor had significantly lower rate of complete resection (P<0.05). The recurrence rate was significantly higher in the group with higher Ki-67 index (P<0.001). The recurrence rate was significantly lower in patients with intrasellar adenoma (P<0.001).No significant relationship was found between preoperative prolactin level and complete resection (P=0.306). Conclusions Tumor size can predictthe degree of surgical resection. The prognostic factors include tumor size,preoperative growth pattern of prolactinoma,and Ki-67 index.
Humans ; Male ; Neoplasm Recurrence, Local ; Pituitary Neoplasms ; pathology ; surgery ; Postoperative Period ; Prolactin ; blood ; Prolactinoma ; pathology ; surgery ; Retrospective Studies

OBJECTIVE: lo discuss the inmtluence of different thyroidectomy on perioperative blood calcium concentration. METHOD: Total number of patients was 240. These patients of thyroid tumors were recruited. Clinical and follow-up datum were retrospective analyzed. RESULT: Patients were divided into four groups by different operative methods. Group one was patients taken one-side thyroidectomy, group two taken one-side lymph node dissection plus, group three taken two-sides thyroidectomy,and group four taken one or two sides lymph node dissection plus. Group two was easier to become hypocalcemia and their calcium concentration decreased more remarkably, compared with group one. Patients taken two-sides thyroidectomy had the familiar outcome. CONCLUSION Patients taken lymph node dissection were easier to become hypocalcemia, compared with patients only taken thyroidectomy.
Calcium ; blood ; Humans ; Hypocalcemia ; etiology ; Lymph Node Excision ; Neoplasm Recurrence, Local ; Retrospective Studies ; Thyroid Neoplasms ; Thyroidectomy ; adverse effects

OBJECTIVETo investigate the plasma Big endothelin-1 levels in patients with gastric carcinoma before and after radical gastrectomy, and explore its clinical significance.

METHODSOne hundred and six patients with gastric carcinoma and 20 controls were enrolled. The Big ET-1 plasma levels were examined by enzyme-linked immuno absorbent assay before and on the 1st, 3rd, and 10th day after curative surgery, and then were tested every 3 months in the patients with advanced gastric cancer.

RESULTSAll patients, except those with stage I gastric cancer, had significantly higher mean plasma Big ET-1 levels compared with normal controls (P=0.000). Higher plasma Big ET-1 levels were associated with lymph node metastasis (P=0.020) and serosal infiltration (P=0.035). The plasma Big Endothelin-1 levels were markedly increased on the first post-operative day (1st POD) in all patients,but decreased on the 3rd POD with no significant difference compared to the preoperative levels. On the 10th POD, the patients with stage I and II gastric cancer showed marked reduction in plasma Big ET-1 levels (P=0.010 and P=0.000, respectively), whereas no significant difference was observed in stage III and IV patients. During the follow-up, the plasma Big ET-1 levels just before recurrence in stage II patients were significantly higher compared with the levels on the 10th POD (P=0.011).

CONCLUSIONSPlasma Big ET-1 might be a reliable marker to determine the severity of gastric carcinoma. Monitoring plasma Big ET-1 levels after curative resection in stage II gastric cancer patients is valuable to predict recurrence.

Adult ; Aged ; Case-Control Studies ; Endothelin-1 ; blood ; Female ; Follow-Up Studies ; Gastrectomy ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; pathology ; Neoplasm Staging ; Stomach Neoplasms ; blood ; pathology ; surgery

OBJECTIVETo assess the value of detecting peripheral blood circulating tumor cells (CTCs) in the diagnosis and treatment of hepatocellular carcinoma (HCC).

METHODSA total of 296 patients diagnosed with HCC admitted in our department from July 2013 to January 2015 were analyzed, with 39 patients with benign liver disease serving as the control group. The distribution of CTCs in the peripheral blood of HCC patients were detected by CanPatrol(TM) CTCs, and its relationship with the clinical features and prognosis of the patients were analyzed.

RESULTSs CTCs were detected in 64.5% (191/296) of the HCC patients but in none of the control group (P<0.05). Positive CTCs in peripheral blood of HCC patients were significantly correlated with serum AFP level, tumor number, TNM stage, BCLC stage, portal vein tumor thrombus and metastasis (P<0.05). In 127 HCC patients receiving radical surgery, the patients positive for CTCs showed significantly shorter relapse-free survival time (P<0.05).

CONCLUSIONPositive CTCs in the peripheral blood may indicate a poor prognosis in HCC patients. CTCs may serve as a indicator for monitoring the prognosis of HCC.

Carcinoma, Hepatocellular ; blood ; diagnosis ; Case-Control Studies ; Humans ; Liver Neoplasms ; blood ; diagnosis ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Neoplastic Cells, Circulating ; Portal Vein ; pathology ; Prognosis