1.Clinical diagnosis and treatment and prognosis of appendiceal neoplasms
Qi LIU ; Zhanfei SHE ; Huaiming WANG ; Lu MA ; Rui LU ; Bo WU
Chinese Journal of General Surgery 2020;35(4):296-299
Objective:To analyze the pathogenesis and clinical characteristics of appendiceal neoplasms and its prognosis.Methods:In recent 14 years, 94 appendiceal neoplasms were found among 6 334 patients undergoing appendectomy in a single center of Ordos Central Hospital.The initial symptoms, clinical features, auxiliary examinations, pathology, surgical methods, and clinical outcomes of 94 patients diagnosed with appendix tumors were recorded.Results:Appendiceal neoplasms accounted for 1.48% for all undergoing appendectomy. Among these 94 cases, 49 cases were female and 45 cases were male. The median age was 59.5 years. 80 cases were followed up with a follow-up rate of 85.1%, and the follow-up period was 2-175 months.The 5-year overall survival rate was 91.9% and the 10-year overall survival rate was 88.9%.The results of univariate analysis of prognosis showed that the prognosis of patients with WBC count>10.0×10 9/L (χ 2 =8.884, P=0.003) and lymph node metastasis(χ 2 =17.216, P=0.001) was relatively poor. The prognosis of appendiceal adenocarcinoma is relatively poor compared with mucinous tumors(χ 2=13.857 , P=0.001 ). Conclusions:The incidence of appendiceal neoplasms is very low; Chronic lower right abdominal pain accounted for a large proportion of the manifestations; Classification of appendiceal neoplasms, leukocyte count and lymph node metastasis predict the prognosis of patients with appendiceal neoplasms.
2.Survival analysis of proximal gastrectomy in patients with advanced upper gastric cancer
Zhanfei LU ; Hao WANG ; Xin YIN ; Junpeng WU ; Jiaqi ZHANG ; Yingwei XUE
Chinese Journal of General Surgery 2023;38(4):253-257
Objective:To compare the prognosis difference between proximal gastrectomy (PG) and total gastrectomy (TG) in patients with advanced upper gastric cancer.Methods:This study included patients of upper gastric cancer admitted from Jan 2011 to Dec 2016 undergoing radical resection at Harbin Medical University Cancer Hospital. Patients were divided into TG group (178 cases) and PG group (185 cases).Results:Comapared to PG group , more TG patients were with tumor diameter >4 cm, Borrmann type Ⅲ and postoperative stage Ⅲ ( χ2=9.687, P=0.002; χ2=24.897, P=0.001; χ2=6.257 P=0.044).The 5-year overall survival (OS) of the PG group and the TG group were 64.3% (95% CI: 45.1%-50.5%) and 60.6% (95% CI: 41.3%-47.6%) ( P=0.297).After propensity score matching, the OS between the two groups was not statistically significant ( P=0.876).Subgroup analysis of chemotherapy showed that the difference in survival between TG group and PG group was not statistically significant ( P=0.309). Conclusion:There was no difference in survival between PG and TG in patients with advanced upper gastric cancer.
3.Prognostic value of lymphocyte subsets in gastric cancer with different tumor infiltration patterns
Hao WANG ; Xin YIN ; Xibo WANG ; Zhanfei LU ; Jiaqi ZHANG ; Junpeng WU ; Yimin WANG ; Yingwei XUE
Chinese Journal of General Surgery 2023;38(4):280-286
Objective:To probe into the potential prognostic value of lymphocyte subsets in gastric cancer.Methods:This study included patients who underwent radical gastrectomy for gastric cancer from Aug 2014 to Dec 2016. The immunological differences was analyzed in different infiltration patterns. The overall survival of patients was analyzed by Kaplan-Meier method and Log-rank test. COX regression was performed to assess independent prognostic factors of the patients, and finally constructed nomogram.Results:The median number of peripheral CD4 and CD19 cells in infiltration pattern c was 750 (94-2 504) cells/μl and 186 (17-820) cells/μl; the median number of peripheral CD4 and CD19 cells in infiltration pattern a was 802 (203-2 071) cells/μl and 213 (5-948) cells/μl, the number of peripheral CD4,CD19 cells in infiltration pattern c was lower than that in infiltration pattern a, with statistically significant differences (CD4: Z=-3.061, P=0.002; CD19: Z=-2.016 , P=0.044). CD19 lymphocytes ( P=0.023) were associated with infiltration pattern a, CD8 lymphocytes ( P=0.027) were associated with infiltration pattern b, and CD4 lymphocytes ( P=0.026) were independent risk factors associated with the prognosis of infiltration pattern c. A nomogram can be constructed to evaluate the prognosis of patients. Conclusion:There are differences in the number of peripheral lymphocyte subsets in patients with different INF types. A nomogram can be constructed from lymphocyte subsets and clinicopathological features to assess patient prognosis.