Objective To explore the safety of minimally invasive esophagectomy (MIE) with three-field lymphadenectomy (3-FL) for esophageal squamous cell carcinoma (ESCC) by comparing the short-term outcomes between the 3-FL and the two-field lymphadenectomy (2-FL) in MIE. Methods The clinical data of patients with ESCC who underwent minimally invasive McKeown esophagectomy in our hospital from July 2015 to March 2022 were collected retrospectively. Patients were divided into a 3-FL group and a 2-FL group according to lymph node dissection method. And the clinical outcomes and postoperative complications were compared between the two groups. Results A total of 257 patients with ESCC were included in this study. There were 211 males and 46 females with an average age of 62.2±8.1 years. There were 109 patients in the 3-FL group and 148 patients in the 2-FL group. The operation time of the 3-FL group was about 20 minutes longer than that of the 2-FL group (P<0.001). There was no statistical difference between the two groups in the intraoperatve blood loss (P=0.376). More lymph nodes (P<0.001) and also more positive lymph nodes (P=0.003) were obtained in the 3-FL group than in the 2-FL group, and there was a statistical difference in the pathological N stage between the two groups (P<0.001). But there was no statistical difference in the incidence of anastomotic leak (P=0.667), chyle leak (P=0.421), recurrent laryngeal nerve injury (P=0.081), pulmonary complications (P=0.601), pneumonia (P=0.061), cardiac complications (P=0.383), overall complications (P=0.147) or Clavien-Dindo grading (P=0.152) between the two groups. Conclusion MIE 3-FL can improve the efficiency of lymph node dissection and the accuracy of tumor lymph node staging, but it does not increase the postoperative complications, which is worthy of clinical application.

Objective To investigate the changes and clinical significance of CYFRA 21-1,CEA and CA199 in patients with esophageal cancer.Methods patients with esophageal cancer (esophageal cancer group) and 90 healthy subjects (control group) were enrolled in this study.Serum levels of CYFRA 21-1,CEA,and CA 199 were measured in two groups.Patients with esophageal cancer were subdivided according to TNM stage,differentiation,and lymph node metastasis condition,and the diagnostic value was calculated.Results The serum levels of CYFRA 21-1,CEA and CA 199 in patients with esophageal cancer were significantly higher than that in the control group (P ＜ 0.05).The levels of above indicators in esophageal cancer patients with poorly differentiation,lymphatic metastasis in Ⅲ and Ⅳ stages were significantly higher than those in Ⅰ,Ⅱ phase of TNM staging,high and mild differentiation,and without lymph node metastasis (P ＜ 0.05).The sensitivity and specificity,missed diagnosis rate,misdiagnosis rate of combined detection of CYFRA 21-1,CEA,CA 199 levels for esophageal cancer were 80.00％,94.44％,20.00％,5.56％,respectively.Conclusion The levels of CYFRA 21-1,CEA,CA 199 in patients with esophageal cancer serum are significantly increased,and the combination detection of above three indicators has significant diagnosis value.

Objective To investigate the changes and clinical significance of CYFRA 21-1,CEA and CA199 in patients with esophageal cancer.Methods patients with esophageal cancer (esophageal cancer group) and 90 healthy subjects (control group) were enrolled in this study.Serum levels of CYFRA 21-1,CEA,and CA 199 were measured in two groups.Patients with esophageal cancer were subdivided according to TNM stage,differentiation,and lymph node metastasis condition,and the diagnostic value was calculated.Results The serum levels of CYFRA 21-1,CEA and CA 199 in patients with esophageal cancer were significantly higher than that in the control group (P ＜ 0.05).The levels of above indicators in esophageal cancer patients with poorly differentiation,lymphatic metastasis in Ⅲ and Ⅳ stages were significantly higher than those in Ⅰ,Ⅱ phase of TNM staging,high and mild differentiation,and without lymph node metastasis (P ＜ 0.05).The sensitivity and specificity,missed diagnosis rate,misdiagnosis rate of combined detection of CYFRA 21-1,CEA,CA 199 levels for esophageal cancer were 80.00％,94.44％,20.00％,5.56％,respectively.Conclusion The levels of CYFRA 21-1,CEA,CA 199 in patients with esophageal cancer serum are significantly increased,and the combination detection of above three indicators has significant diagnosis value.

Objective To observe the influences of different anesthesia methods or adjuvant chemotherapy on hemorheological parameters in patients with cervical cancer.Methods Sixty pa-tients with cervical cancer were equally randomized into two groups.Patients in group A received three courses of chemotherapy preoperatively while those in group B did not.The patients of group A and B were divided respectively into two subgroups,combined epidural general anesthesia group (groups A1 and B1),general anesthesia group (group A2 and B2).Blood samples were taken for the hemorheological measurement at 5 min before induction of anesthesia,60 min after induction of anes-thesia and at the end of surgery.Results Red cell deformability index (EDI)was significantly lower in group A than that in group B;Erythrocyte rigidity index (ERI)and blood viscosity were higher in group A compared with those in group B (P <0.05).In groups A1 and B1,EDI,plasmic viscosity packed ERI,and ERI were all lower than those before anesthesia induction (P < 0.01 );while in groups A2 and B2 Hct decreased.Conclusion The patients of cervical cancer after chemotherapy showed some hemorheological changes characterized by a lowered EDI.Combined general and epidural anesthesia can significantly improve the above parameters.

Objective To compare the efficiency of 18F-FDG PET/CT and contrast enhanced ultrasound (CEUS) in detection of HCC recurrence after surgery or radiofrequency ablation (RFA).Methods Twenty-seven HCC patients (22 males,5 females; average age:47 years) were included in this study,of which 15 patients underwent surgery and 12 patients underwent RFA therapy.18F-FDG PET/CT and CEUS were performed within 2 weeks in all patients to detect recurrence.Final diagnosis was made by pathology or clinical follow-up (＞6 months),and the sensitivity,specificity and accuracy of 18F-FDG PET/CT and CEUS were calculated and compared.McNemar test was used for data analysis.Results Twenty-five patients were diagnosed with HCC recurrence,including 11 cases with extrahepatic metastases.Another 2 patients had extrahepatic metastases without HCC recurrences.The sensitivity,specificity and accuracy in detection of liver lesion with 18F-FDG PET/CT were 92.0％ (23/25),2/2 and 92.6％ (25/27),respectively.While with CEUS,the corresponding values were 60.0％ (15/25),2/2 and 63.0％ (17/27),respectively.In CEUS positive group,the sensitivity and accuracy were 100％(15/15) for both methods.In CEUS negative group,the sensitivity,specificity and accuracy of 18 F-FDG PET/CT in detection of liver lesion were 8/10,2/2 and 83.3％(10/12),respectively.The sensitivity and accuracy of 18F-FDG PET/CT were significantly higher than those of CEUS (0,16.7％(2/12) ; x2 =5.373,5.250,both P＜0.05).Moreover,the sensitivity of 18 F-FDG PET/CT in detecting extrahepatic metastasis was 100％ (13/13).Conclusions 18 F-FDG PET/CT is more sensitive and accurate than CEUS (especially in CEUS negative cases) in detecting recurrence of HCC after surgery or RFA.18F-FDG PET/CT also could be useful for detection of extrahepatic metastasis.

Background and objective It is unclear how could endostatin effect tumor lymphangiogenesis? hTe aim of this study is to explore inhibitory effect of recombinant human endostatin injection (endostar) on lymphangiogenesis in non-small cell lung cancer (NSCLC) tissue and its effect on circulating tumor cells (CTC) in peripheral blood. Methods Tu-mor-bearing model nude mice were divided into eight groups randomly (n=7), including control group, cisplatin group, several concentration endostar groups and endostar plus cisplatin groups. Continuous administration of Endostar for two weeks, ob-served one week atfer the end of administration. Using HE staining and immunohistochemical staining to diagnose the tumor tissue and suspect metastasis lymph nodes, detected vascular endothelial growth factor (VEGF)-C, VEGF-D, VEGF receptor (VEGFR)-3 expression level and microlymphatic vessel density (MLVD) of tumor tissue. Enrichment of circulating tumor cells in peripheral blood used immunomagnetic negative selection strategy, used immunolfuorescence staining to diagnose and count CTCs. Results Microlymphatic vessel density and the positive expression rate of VEGF-C, VEGF-D, VEGFR-3 in three endostar groups and three endostar plus cisplatin groups were signiifcantly less than those in control group and cisplatin group. Microlymphatic vessel density and the positive expression rate of VEGF-C, VEGF-D, VEGFR-3 in endostar plus cisplatin group and endostar group with high endostar concentration were signiifcantly less than those with low endostar concentration;hTere was a signiifcant positive correlation between microlymphatic vessel density and the positive expression rate of VEGF-C, VEGF-D, VEGFR-3. hTe number of circulating tumor cells in endostar plus cisplatin groups were signiifcantly less than that of endostar or cisplatin alone. Conclusion Endostar could inhibit tumor lymphangiogenesis and reduce tumor cells into the bloodstream through the lymphatic. Inhibitory effect concerned with drug concentrationwith a dose-dependant.

Objective To investigate the usefulness of 13N-NH3 PET in detecting brain lesions which show hypometabolism on 18F-FDG PET.Methods 13N-NH3 PET imaging was performed for a prospective study in 18 patients with brain lesions that showed hypometabolism compared with normal brain tissue on 18F-FDG PET scans.Fourteen patients underwent 18 F-FDG PET imaging for initial diagnosis and 4 patients for detection of astrocytoma recurrence (13 males,5 females,age 20-68 (42.4 ± 12.6) years).Ten gliomas,1 metastatic tumor,1 dysembryoplastic neuroepithelial tumor (DNT) and 6 non-neoplastic lesions (including 3 cases of radiation necrosis,2 cases of encephalitic foci,and 1 case of ischemic lesion)were verified by histopathological examination (n =13) or clinical follow-up (n =5).The tumor-to-contralateral brain tissue ratios (T/C) were calculated by the ROI method.The diagnostic efficacy of 13N-NH3 PET was evaluated.Paired t test and two-sample t test were performed to analyze the differences of T/C between different groups.Results Seven (5 astrocytomas and 2 glioblastomas) of 12 brain tumors (sensitivity:58％,7/12) showed increased 13N-NH3 uptake (higher uptake than the contralateral brain tissue),while 3 low-grade gliomas,1 metastatic tumor,and 1 DNT showed decreased 13N-NH3 uptake (no uptake or lower uptake than the contralateral brain tissue).The uptake ratio of 13N-NH3 was significantly higher than that of 18 F-FDG (1.24 ± 0.66 vs 0.67 ± 0.24,t =-3.740,P ＜ 0.05) in the tumors.All six non-neoplastic lesions showed decreased 13N-NH3 uptake (specificity:6/6).The T/C ratios of 18F-FDG and 13N-NH3 in the non-neoplastic lesions were 0.68 ±0.15 and 0.70 ±0.19,respectively,and there was no significant difference between them (t =-0.246,P ＞ 0.05).The T/C ratio of 13N-NH3 in the tumors was significantly higher than that in the non-neoplastic lesions (1.24 ± 0.53 vs 0.70 ± 0.19,t =2.624,P ＜ 0.05).Conclusion 13N-NH3 PET imaging may be helpful to detect and differentiate brain tumors with hypometabolism as detected by 18 F-FDG PET imaging from non-neoplastic lesions with high specificity,especially for cerebral astrocytomas,but the sensitivity is relatively limited.

OBJECTIVE: To investigate the effect of laryngoscopic surgery combined with nasal endoscopic system for the treatment of vocal cords benign lesions. METHOD: Fifty-two patients admitted to our department with vocal cords benign lesions (including vocal polyps, vocal nodules, vocal cord cyst) underwent laryngoscopic surgery combined with nasal endoscopic system. RESULT: All patients were treated successfully once and for all without any significant postoperative complication. CONCLUSION The laryngoscopic surgery combined with nasal endoscopic system is a safe, minimally invasive and simple method for the treatment of benign lesions of vocal cords.
Adult ; Aged ; Female ; Humans ; Laryngeal Diseases ; surgery ; Laryngoscopy ; methods ; Male ; Middle Aged ; Vocal Cords ; pathology

OBJECTIVETo assess the clinical value of (18)F-FDG PET/CT and contrast-enhanced computed tomography (CECT) in detecting residual tumor or tumor recurrence and metastasis in patients with hepatocellular carcinoma (HCC) who show an elevated serum alpha-fetoprotein (AFP) level after surgical intervention.

METHODSThe data of (18)F-FDG PET/CT and CECT, which were performed at an interval within 2 weeks, were reviewed in 54 HCC patients showing elevated AFP levels after surgical interventions of the tumor. The patients were followed up for at least 6 months and the imaging findings were confirmed by pathological examination, follow-up imaging examination, or serum AFP level monitoring.

RESULTSForty-five patients were found to have focal intrahepatic HCC recurrence after surgical interventions, and 9 patients were free of HCC recurrence. Twenty-three patients developed extrahepatic metastasis, among whom 19 also had intrahepatic tumor recurrence and 4 had extrahepatic metastasis only. The sensitivity, specificity, and accuracy of (18)F-FDG PET/CT in the detection of HCC recurrence were 88.9% (40/45), 77.8% (7/9), and 87.0% (47/54), respectively, as compared with those of 57.8% (26/45), 100% (9/9), and 64.8% (35/54) by CECT detection.

CONCLUSIONCompared with CECT, (18)F-PET/CT shows a high sensitivity and accuracy in detecting postoperative tumor residual or recurrence in the liver, and can also be an effective modality for detecting extrahepatic lesions in HCC patients.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular ; diagnostic imaging ; therapy ; Female ; Fluorodeoxyglucose F18 ; Humans ; Liver Neoplasms ; diagnostic imaging ; therapy ; Male ; Middle Aged ; Multimodal Imaging ; Neoplasm Metastasis ; diagnosis ; diagnostic imaging ; Neoplasm Recurrence, Local ; diagnostic imaging ; Positron-Emission Tomography ; Retrospective Studies ; Tomography, X-Ray Computed ; alpha-Fetoproteins ; metabolism