1.Diagnosis and clinical staging of thyroid carcinoma by ultrasound
Xiangqian ZHENG ; Ming GAO ; Yigong LI ; Sheng ZHANG ; Yan ZHANG ; Songyuan GAO ; Yang YU
Chinese Journal of General Surgery 2008;23(5):324-328
Objective To analyze and compare the ultrasound characteristics in different pathologic classifications of thyroid carcinoma.The ultrasound characteristics of thyroid carcinoma were investigated in order to determine the clinical diagnosis and clinical stasing of thyroid carcinoma.Methods In this study,407 cases of thyroid carcinoma were enlisted for ultrasonic typing of thyroid carcinoma according to the ultrasound features.The resuh was used for clinical staging of thyroid carcinoma. Results Combined ultrasound mediated clinical stage has a higher accuracy rate and specificity,its accuracy rate of T stage is 93.9%,for No stage is 86.1%,for N1a stage is 80%,for Nlb stage is 74.9%.Preoporative US detected 51.5% occult metastatic LN.Conclusion Ultrasound has a very important effectiveness for the evaluation.staging,location of thyroid carcinoma and cervical lymph node metastasis.
2.Multifocal papillary thyroid carcinoma
Lin LIN ; Xiangqian ZHENG ; Lei LIU ; Yigong LI ; Yan ZHANG ; Ming GAO
Chinese Journal of General Surgery 2010;25(8):621-623
Objective To investigate the biological characteristics and management of multifocal papillary thyroid carcinoma. Methods Clinical data of 86 patients who underwent thyroidectomy and were pathologically diagnosed as progressive multifocal papillary thyroid carcinoma from 1995 to 1997 in Tianjin Cancer Hospital were retrospectively analyzed. Results There were 86 cases of multifocal papillary thyroid carcinoma, accounting for 23.4% of all papillary thyroid carcinoma of the same period. In the 86 cases of multifocal papillary thyroid carcinoma, there was unilateral in 12 cases and bilateral in 74 cases; cervical lymph node metastasis in 51 cases ( 59. 3% ); combined microcarcinoma of 46 cases ( 53.5% );Hashimoto's thyroiditis was concomitant in 23 cases (26.7%); local invasion was found in 19 cases (22. 1% ); distant metastasis occurred in 1 case ( 1.2% ); 10-year survival rate was 95.3%. American Joint Committee on Cancer ( AJCC ) stage was associated with prognosis significantly ( x2 = 63. 395, P =0.000). Conclusions Multifocal papillary thyroid carcinoma often occurs bilaterally, concomitant microcarcinoma and Hashimoto's thyroiditis is common with a comparatively favorable prognosis. AJCC stage is still the best prognostic factor.
3.The prognostic value of serum HE4 in lung cancer
Yigong ZHANG ; Yan ZHENG ; Long JIANG ; Zerui ZHAO ; Wanli LIU ; Hao LONG
Chinese Journal of Radiological Medicine and Protection 2014;34(6):423-426
Objective The study was designed to investigate the serum levels of HE4 in patients with lung cancer,and explore its prognostic value.Methods Blood samples of 106 healthy adults and 191 patients with lung cancer before treatment were measured by means of ELISA for HE4 levels in different stages and pathological types,for analyzing prognostic effect of HE4.Results The serum levels of HE4 in patients with lung cancer (median level 91.63 pmol/L) were significantly higher than control group (median level 56.42 pmol/L) (U =3 081.00,P < 0.05).AUC of serum HE4 was 0.85,with a cut-off value of 82.70 pmol/L (specificity =95.31%,sensitivity =62.32%).HE4 expression was not statistically related to clinical stage and pathological types of lung cancer.The median overall survival (mOS) was 36.87 months in the HE4-low group and 30.43 months in the HE4-high group (P <0.05),respectively.HE4 level was an independent prognostic factor for overall survival (HR =2.15,95% CI 1.49-3.12,P < 0.05).Conclusions The prognosis of patients with high HE4 expression is poor.Therefore,it might be necessary for patients with high level of HE4 to receive more aggressive adjuvant therapy.
4.Clinico-biological characteristics and prognosis of salivary duct carcinoma in 12 cases
Songfeng WEI ; Xinwei YUN ; Yigong LI ; Yan ZHANG ; Wenyuan CHENG ; Xiangqian ZHENG ; Xiaoyong YANG ; Ming GAO
Chinese Journal of General Surgery 2010;25(7):540-542
Objective To explore the clinico-biological characteristics, treatment and prognosis of salivary duct carcinoma. Methods This study included 12 cases of salivary duct carcinoma treated in our hospital. Clinical data were retrospectively analyzed for patients admitted between April 1995 and October 2006. The clinical characteristics, histological features, imaging, therapy methods and prognosis were analyzed. Results Of 12 salivary duct carcinoma, there were 10 males, 2 females. The age of onset ranged from 53 to 73 year old and the average was 56 year old. Physical examination revealed a firm and unboundary mass accompanied by nerve infiltrating symptom. The histological appearance was characterized by solid cell nests with ductal structures and central comedonecrosis. Extensive resection and radical neck dissection was performed in 11 patients, postoperation radiation done in 10 patients and chemotherapy in 3 patients. One year survival rate was 83. 33% , that of 3 years was 41. 67% , and of 5 years was 25. 00% , the median survival time was 36 months. Conclusion Salivary duct carcinoma is a rare malignant salivary tumor and most patients are men. Regional extensive resection and postoperative radiation or chemotherapy are the mainstay of therapy. Lymph node metastases in level Ⅰ ,Ⅱ , Ⅲ are a common finding in patients with SDC and the prognosis is poor.
5.Acupuncture with regulating menstruation to promote pregnancy for diminished ovarian reverse: a prospective case series study.
Xiaotong LI ; Huanfang XU ; Yigong FANG ; Jie SHANG ; Huisheng YANG ; Xuelin ZHOU ; Minglong ZHANG
Chinese Acupuncture & Moxibustion 2017;37(10):1061-1065
OBJECTIVETo investigate the effect and safety of acupuncture with regulating menstruation to promote pregnancy for diminished ovarian reverse (DOR).
METHODSAccording to prospective case series, 46 patients were observed and finally 40 cases were included. The acupoints were ① Baihui (GV 20), Shenting (GV 24), Guanyuan (CV 4) and bilateral Benshen (GB 13), Huangshu (KI 16), Dahe (KI 12), Luanchao (Extra), Zusanli (ST 36), Sanyinjiao (SP 6), Taixi (KI 3), Taichong (LR 3) and ② bilateral Shenshu (BL 23) and Ciliao (BL 32). The points in the two groups were used alternately. Acupuncture was given for 3 courses, 12 times as a course and 3 times a week. Before and after treatment, and 3 months after treatment, follicle-stimulating hormone (FSH), follicle-stimulating hormone/luteinizing hormone (FSH/LH), estradiol (E), antral follicle count (AFC) and TCM symptom score were observed. The safety was evaluated.
RESULTSCompared with before treatment, the levels of FSH, FSH/LH decreased, and the levels of Eand AFC increased after treatment and at follow-up (all<0.05). And the TCM symptom scores were significantly lower than those before treatment (both<0.05). The rate of pregnancy after treatment was 15% (6/40). There was no infection and organ injury.
CONCLUSIONAcupuncture with regulating menstruation to promote pregnancy can safely improve the ovarian reserve of patients with DOR.