BACKGROUNDTo study the correlation between CT/MRI features and surgical and pathological findings of cancerous invasion of the main pulmonary artery (CIMPA) in lung cancer and to evaluate the role of CT and MRI in making surgical plan.

METHODSCT findings in 15 cases and MRI findings in 13 cases were observed and blindly compared with surgical and pathological findings in this prospective study of 23 cases of central type lung cancer.

RESULTSThe CT and MRI features showed as follows: the wall thickening sign in 73.7% of CT and 84.6% of MRI; lumen narrowing sign in 55.3% of CT and 69.2% of MRI; peri-vascular fat sign in 100.0% of both CT and MRI. Two types of CIMPA were visualized: contacted type (10 cases in CT and 7 cases in MRI) and encased type (5 cases in CT and 6 cases in MRI). Surgically, contacted type was found in 10 cases who all underwent lobectomy with sleeve-angioplasty. Encased type was found in 13 cases, among whom unresectable in 2, pneumonectomy in 7, and lobectomy with angioplasty in 4. Of the 21 resected specimen, the cancerous infiltration was demonstrated 100.0% (21/21) in adventitia, 66.7% (14/21) in media and 4.8% (1/21) in intima. There was no significant difference in the deepness of the cancer infiltration between the two types (P>0.05). Acute or chronic inflammatory infiltration which enhanced the thickening of the wall were shown on all specimens. CT and MRI findings were well corresponding to surgical and pathological appearance (Kappa value = 0.61 in CT and 0.84 in MRI).

CONCLUSIONSIn our study of CIMPA, CT and MRI features characterized by wall thickening and lumen narrowing without occlusion are closely correlated with pathological findings that cancerous invasion prominently limited adventitia and media with remarkable proliferation of connective tissue, and classifying two types is valuable in making surgical plan.

OBJECTIVETo investigate the expression of fragile histidine triad (FHIT) gene protein, FHIT and the possible relationship between FHIT expression and clinicopathological indices in colorectal carcinoma.

METHODSDetecting FHIT protein expression in 60 cases of formalin-fixed, paraffin-embedded colorectal carcinoma by citrate-microwave-SP immunohistochemical method, and analyzing its relationship to histological grade, Dukes' stage and 5-year survival rate.

RESULTS55% of the carcinomas showed a marked loss or absence of FHIT expression compared with their matched normal mucosa. Carcinomas with reduced expression of FHIT correlated with their histological grade, Dukes' stage (P < 0.05) and 5-year survival rate. The distribution of decreased expression of FHIT was 7/16 in grade I carcinoma, 14/30 in grade II, 12/14 in grade III, respectively. The correlation between decreased expression of FHIT and Dukes' staging was 5/11 in stage A, 12/28 in stage B, and 16/21 in stage C. The difference between stage A, B with no lymph nodes metastases and the stage C with lymph nodes metastases was of significance (P < 0.05). The follow-up data of 39 cases showed that in the 5-year survival group, 13/25 were of the low FHIT expression carcinomas, while in 5-year deceased group 12/14 were of the low FHIT expression carcinomas (P < 0.05).

CONCLUSIONSThe reduced expression of FHIT may be associated with decreasing differentiation, metastasis and 5-year survival rate in colorectal carcinoma. It is suggested that decreased FHIT expression plays an important role in the development and progression of the tumor, and thus may become a new prognostic marker in colorectal carcinoma.

Acid Anhydride Hydrolases ; Colorectal Neoplasms ; metabolism ; pathology ; Humans ; Immunohistochemistry ; Lymphatic Metastasis ; Neoplasm Proteins ; biosynthesis ; Neoplasm Staging ; Survival Analysis

Based on the management by objectives and developmental performance appraisal,Shanghai Tenth People's Hospital explored the performance appraisal scheme for attending,including disease-specific complexity,disease-specific difficulty,clinical risk-taking and comprehensive quality.Assessment and feedback work was imple-mented by the medical management department,which format a set of independent budget of the physician perfor-mance assessment system.It introduced incentive measures to encourage attending to treat difficult and critical cases,provided high quality medical services,and eventually enhance hospital management effectiveness to attending.

Based on the management by objectives and developmental performance appraisal,Shanghai Tenth People's Hospital explored the performance appraisal scheme for attending,including disease-specific complexity,disease-specific difficulty,clinical risk-taking and comprehensive quality.Assessment and feedback work was imple-mented by the medical management department,which format a set of independent budget of the physician perfor-mance assessment system.It introduced incentive measures to encourage attending to treat difficult and critical cases,provided high quality medical services,and eventually enhance hospital management effectiveness to attending.

Based on the management by objectives and developmental performance appraisal,Shanghai Tenth People's Hospital explored the performance appraisal scheme for attending,including disease-specific complexity,disease-specific difficulty,clinical risk-taking and comprehensive quality.Assessment and feedback work was imple-mented by the medical management department,which format a set of independent budget of the physician perfor-mance assessment system.It introduced incentive measures to encourage attending to treat difficult and critical cases,provided high quality medical services,and eventually enhance hospital management effectiveness to attending.

Based on the management by objectives and developmental performance appraisal,Shanghai Tenth People's Hospital explored the performance appraisal scheme for attending,including disease-specific complexity,disease-specific difficulty,clinical risk-taking and comprehensive quality.Assessment and feedback work was imple-mented by the medical management department,which format a set of independent budget of the physician perfor-mance assessment system.It introduced incentive measures to encourage attending to treat difficult and critical cases,provided high quality medical services,and eventually enhance hospital management effectiveness to attending.

Based on the management by objectives and developmental performance appraisal,Shanghai Tenth People's Hospital explored the performance appraisal scheme for attending,including disease-specific complexity,disease-specific difficulty,clinical risk-taking and comprehensive quality.Assessment and feedback work was imple-mented by the medical management department,which format a set of independent budget of the physician perfor-mance assessment system.It introduced incentive measures to encourage attending to treat difficult and critical cases,provided high quality medical services,and eventually enhance hospital management effectiveness to attending.

Based on the management by objectives and developmental performance appraisal,Shanghai Tenth People's Hospital explored the performance appraisal scheme for attending,including disease-specific complexity,disease-specific difficulty,clinical risk-taking and comprehensive quality.Assessment and feedback work was imple-mented by the medical management department,which format a set of independent budget of the physician perfor-mance assessment system.It introduced incentive measures to encourage attending to treat difficult and critical cases,provided high quality medical services,and eventually enhance hospital management effectiveness to attending.

Based on the management by objectives and developmental performance appraisal,Shanghai Tenth People's Hospital explored the performance appraisal scheme for attending,including disease-specific complexity,disease-specific difficulty,clinical risk-taking and comprehensive quality.Assessment and feedback work was imple-mented by the medical management department,which format a set of independent budget of the physician perfor-mance assessment system.It introduced incentive measures to encourage attending to treat difficult and critical cases,provided high quality medical services,and eventually enhance hospital management effectiveness to attending.

Based on the management by objectives and developmental performance appraisal,Shanghai Tenth People's Hospital explored the performance appraisal scheme for attending,including disease-specific complexity,disease-specific difficulty,clinical risk-taking and comprehensive quality.Assessment and feedback work was imple-mented by the medical management department,which format a set of independent budget of the physician perfor-mance assessment system.It introduced incentive measures to encourage attending to treat difficult and critical cases,provided high quality medical services,and eventually enhance hospital management effectiveness to attending.