1.Influence of microextension on clinical target volume delineation in adenocarcinoma and squamous cell carcinoma among patients with non-small cell lung cancer
Weike ZHANG ; Limei XIE ; Zhongshan WANG ; Dequan PANG
Chinese Journal of Radiation Oncology 2017;26(5):522-526
Objective To better understand the relationship between the maximum tumor diameter and the most distant micrometastases in different types of non-small cell lung cancer (NSCLC) and to provide histological evidence for the delineation of clinical target volume (CTV) from gross tumor volume.Methods We retrospectively studied the pathological specimens from 113 surgically treated NSCLC patients (44 squamous cell carcinoma patients and 69 adenocarcinoma patients) who were admitted to our hospital from 2014 to 2015.The maximum tumor diameter was determined by a combination of gross and microscopic measurements.Micrometastases were microscopically determined.The distances between the tumor edges and micrometastases outside the tumor boundaries were measured by an ocular micrometer followed by a calculation.Quantitative data were analyzed by t test, and qualitative data were analyzed by logistic regression.Results The regression relationship between the maximum tumor diameter and micrometastases was significant in the adenocarcinoma group, but not significant in the squamous cell carcinoma group (P=0.151).The association between the presence or absence of lymph node metastasis and the most distant micrometastasis was significant in the adenocarcinoma group, but not significant in the squamous cell carcinoma group (P=0.597).No association between the degree of tumor differentiation and the most distant micrometastasis was observed in either group (P=0.113).The average measurement of the most distant micrometastases was 2.94 mm in the adenocarcinoma group, with 7.5 mm as the distance to cover 95% of the most distant micrometastases.To reach the same coverage, 4 mm was needed for tumor size smaller than 3 cm, 6 mm for those between 3 cm and 5 cm, and 7.5 mm for those larger than 5 cm.The average measurement of the most distant micrometastases was 2.69 mm in the squamous cell carcinoma group, with 6 mm as the distance to cover 95% of the most distant micrometastases.Conclusions For NSCLC, the most distant micrometastasis of adenocarcinoma is associated with the maximum tumor diameter and presence or absence of lymph node metastasis, and the CTV should thus be adjusted accordingly;no relevance between the most distant micrometastasis and maximum tumor diameter is observed in squamous cell carcinoma;there is no relationship between the most distant micrometastasis and the degree of tumor differentiation in adenocarcinoma and squamous cell carcinoma.
2.Application value of adjustable closed loop in SBS with ostomy in continuity
Qi GAO ; Zhaoping LAN ; Weike XIE ; Qi WANG ; Yongkang PAN ; Chaoxiang LU ; Zhongwen LI ; Lei WANG
Chinese Journal of Primary Medicine and Pharmacy 2020;27(17):2107-2111
Objective:To evaluate the effect and safety of adjustable closed loop(ACL) in the treatment of short bowel syndrome (SBS).Methods:From January 2017 to December 2017, the clinical data of 2 cases with ostomy in continuity after surgery in Children's Hospital Affiliated to Xi'an Jiaotong University were analyzed.The age was 1 and 3 months, both were females, and preservation of intestinal tube length were 65 cm and 60 cm respectively.They were all diagnosed SBS with a lot of stool like water.Self-made ACL was installed to maintain SBS.The blood circulation of stoma, weight, BMI, defecating, abdomen, nutrition status changes, nursing convenience, intestinal infection susceptibility were observed.Results:There was no necrosis in stoma, and the overall condition was improved, and no significant increase in abdominal distension.ACL used in babies with ostomy in continuity could improve the anus stool, weight, nursing convenience.Conclusion:ACL installed in baby with SBS could contribute to intestinal management, and is easy to install.