Objective To study the characteristics of microscopic spread of esophageal squamous-cell carcinoma (ESCC) and the influence of clinicopathological features on it to help define the clinical target volume (CTV) margin in radiotherapy.Methods Sixty-four surgical specimens of ESCC were observed for longitudinal microscopic spread per centimeter both proximally and distally from the tumor.The shrinkage ratio of each specimen was calculated and used for tissue incision.Results The further the distance beyond the tumor, the lower the incidence there was of microscopic spread.Positive rates of microscopic spread in group 3 cm of proximal and distal were 4.8% and 6.9%, respectively, and in group 4 cm were both 3.6%.Tumors longer than 5 cm in length,with poorer differentiation, lymph nodes metastasis and more aggressive phase had higher positive rates (79.3% vs 45.7%,77.4% vs 45.5%,76.0% vs 51.2%,70.5% vs 40.0%,χ2=7.52,6.86,3.91,5.36;P=0.006,0.009,0.042,0.021).Differentiation and tumor length were main factors contributing to microscopic spread (χ2=0.19,4.82;P=0.020,0.017).Conclusions To cover 95% of the microscopic spread,a margin of 3.0 cm proximal and 4.0 cm distal beyond gross tumor volume is needed and as to 90%, a margin of 3.0 cm both proximal and distal is needed.Moreover, the influence of pathological features should be taken into account.

Objective To investigate the diagnostic value of serum anti-Müllerian hormone combined with sex hormones for polycystic ovary syndrome ( PCOS).Methods The serum levels of anti-Müllerian hormone ( AMH), testosterone ( T), luteinizing hormone ( LH), follicle-stimulating hormone (FSH) and the estradiol ( E2) were measured by electrochemiluminescence method in 82 patients with PCOS and 60 controls. The sensitivities, specificities and the areas under the receiver operating characteristic curves ( ROC-AUC) of the indicators and their combination for diagnosis of PCOS were compared by chi-square test and Z test separately.The correlations of serum AMH levels with age and sex hormones levels were analyzed separately by Spearman correlation analysis .Results The levels of serum AMH, T, LH and LH/FSH ratio in patients with PCOS were obviously higher than those in controls (62.19 pmol/L vs 27.63 pmol/L, 1.39 nmol/L vs 0.88 nmol/L, 12.72 IU/L vs 6.44 IU/L, 2.17 vs 1.17, U＝592.00, 1 096.00, 1 233.50, 1 134.00, all P＜0.01).The sensitivity of AMH (80.5%, 66/82) for diagnosis of PCOS was higher than that of LH (62.2%, 51/82) and LH/FSH ratio (54.9%, 45/82, χ2＝5.6, 13.79, all P＜0.05), but no significant difference was found when comparing with T (72%, 59/82, χ2＝1.71, P＞0.05 ) .The sensitivity of AMH ( 80.5%, 66/82 ) increased when combined with T (89.0%, 73/82), LH (87.8%, 72/82) and T+LH (95.10%, 78/82, χ2＝5.14, 4.17, 10.08, all P＜0.05), but no significant change by the combination of AMH +LH/FSH (85.4%, 70/82, χ2＝2.25, P＞0.05) .The specificity of AMH (80%, 48/60) for diagnosis of PCOS was no significant difference compared with that of T (71.7%, 43/60), LH (85%, 51/60), and LH/FSH ratio (91.7%, 55/60) (χ2＝3.20, 0.36, 2.77, all P＞0.05) .Also no increase when combined with T (71.7%, 43/60), LH (73.3%, 44/60), LH/FSH (75%, 45/60) and T +LH (66.7%, 40/60, χ2＝3.20, 2.25, 1.33, 3.38, all P＞0.05).The ROC-AUC of multiple indicators for diagnosis of PCOS were compared , AMH (0.880) was higher than T, LH and LH/FSH ratio (0.778, 0.760, 0.778, Z＝2.12, 2.46, 2.12, all P＜0.05), but no significant differences were found comparing with AMH and the combination of AMH +T, AMH+LH, AMH+LH/FSH and AMH+T+LH (0.892, 0.897, 0.898, 0.902, Z＝0.31, 0.45, 0.48, 0.59, all P＞0.05).Serum AMH levels were positively correlated with T , LH levels and LH/FSH ratio (r＝0.258, 0.241, 0.290, all P＜0.05), but not correlated with age in PCOS group (r＝-0.178, P＞0.05).In the control group, AMH levels had no correlations with T, LH levels and LH/FSH ratio (r＝0.025, 0.104, 0.111, P＞0.05), while negatively correlated with age (r＝-0.307, P＜0.05).The cutoff value of AMH for diagnosis of PCOS decreased with age .Conclusions The sensitivity of AMH for diagnosis of PCOS was higher than that of LH and LH /FSH ratio, and the sensitivity could be further improved by the combination with T or /and LH without reducing the specificity .Age-stratified cut-off values of AMH were better for accurate diagnosis of PCOS.