Objective To investigate the effect of different lymph node dissection methods on the prognosis of patients with stage ⅠA spread through air spaces (STAS)-positive lung adenocarcinoma measuring ≤2 cm. Methods The clinical data of 3 148 patients with lung adenocarcinoma who underwent surgery at the Department of Thoracic Surgery, The First Affiliated Hospital of University of Science and Technology of China from 2016 to 2018 were retrospectively analyzed. Patients with stage ⅠA STAS-positive lung adenocarcinoma measuring ≤2 cm were included and divided into two groups based on the extent of lymph node dissection: a systematic lymph node dissection (SLND) group and a limited lymph node dissection (LLND) group. Clinicopathological data between the two groups were compared, and a Cox proportional hazards regression model was used for multivariate survival analysis. Results A total of 209 patients (98 males and 111 females) were included. The mean age was (60.42±10.15) years (ranging from 28 to 83 years). All patients successfully completed the surgery. Univariate analysis revealed that the extent of lymph node dissection, past medical history, and micropapillary histological subtype were influencing factors for prognosis. Multivariate analysis indicated that the extent of lymph node dissection, age, and the micropapillary histological subtype were independent influencing factors for prognosis. Furthermore, among STAS-positive patients, those in the SLND group exhibited a better prognosis compared to those in the LLND group. Conclusion The extent of lymph node dissection is an independent prognostic factor for patients with stage ⅠA STAS-positive lung adenocarcinoma measuring ≤2 cm.Performing SLND may be more beneficial for their long-term prognosis.

Background and objective With further understanding and research into non-small cell lung cancer with tumours ≤2 cm in maximum diameter,segmental lung resection is able to achieve the same long-term prognosis as lobec-tomy.However,there are few studies on the prognostic effect of wedge resection on small volume invasive lung adenocarci-noma with an invasion depth of 0.5 to 1.0 cm.Therefore,this study focuses on the clinical efficacy and prognosis of wedge re-section in patients with small-volume invasive lung adenocarcinoma.Methods A retrospective analysis of the medical records of 208 patients who underwent surgery in the Department of Thoracic Surgery of the Affiliated Provincial Hospital of Anhui Medical University from February 2016 to December 2017 was made,and the postoperative pathological results confirmed small volume invasive lung adenocarcinoma.According to their surgical methods,they were divided into lobectomy group(n=115),segmentectomy group(n=48)and wedge resection group(n=45).Kaplan-Meier survival curve estimation and Cox proportional risk regression model were used to explore the influence of different surgical methods on the prognosis of patients with small volume invasive lung adenocarcinoma.Results The wedge resection group had better perioperative outcomes compared with the segmentectomy group and lobectomy group,with statistically significant differences in intraoperative bleed-ing(P=0.036),postoperative drainage(P＜0.001),operative time(P=0.018),postoperative time with tubes(P=0.001),and postoperative complication rate(P=0.006).There were no significant differences when comparing the three groups in terms of survival rate(lobectomy group vs segmentectomy group,P=0.303;lobectomy group vs wedge resection group,P=0.742;and segmentectomy group vs wedge resection group,P=0.278)and recurrence-free survival rate(lobectomy group vs segmentec-tomy group,P=0.495;lobectomy group vs wedge resection group,P=0.362;segmentectomy group vs wedge resection group,P=0.775).Univariate and multivariate survival analyses showed that consolidation tumor ratio(CTR)was the prognostic factor of overall survival and revurrence-free survival for patients with small-volume invasive lung adenocarcinoma(P＜0.05).Conclusion Wedge resection in patients with small volume invasive lung adenocarcinoma can achieve long-term outcomes similar to segmentectomy and lobectomy.When the CTR≤0.5,wedge resection is preferred in such patients.

Objective:To investigate the clinical feature, diagnosis and treatment of autoimmune pancreatitis(AIP).Methods:Clinical data of 20 AIP patients admitted to the First Affiliated Hospital of University of Science and Technology of China from Jan 2014 to Dec 2019 were retrospectively analyzed.Results:Nineteen patients were diagnosed with type 1 AIP and 1 patient was with type 2 AIP. Fifteen patients were diagnosed by imaging, serology and other organ involvement, and 5 patients were confirmed by postoperative histopathology. Thirteen patients received glucocorticoid therapy. Five patients have not received glucocorticoid therapy after surgery.One patient refused treatment, and 1 patient is currently under clinical observation. Seventeen of the 20 patients were followed up, 11 patients were on glucocorticoid therapy with related clinical symptoms being gradually improved, serum IgG4 decreased and imaging findings improved. Five patients did not relapse after drug withdrawal. Three patients had recurrence of jaundice after drug withdrawal. One patient had recurrence of pancreatic lesions after drug withdrawal. Two patients had recurrence of high serum IgG4 after tapering the doses, these 6 patients were treated with steroid maintenance therapy. One patient died of repeated gastrointestinal bleeding 2 months later, and another 4 surgical patients and 1 patient under clinical observation are in good condition.Conclusions:AIP should be diagnosed in combination with clinical manifestations, serological examination, imaging examination and histopathology, especially focal lesions should be differentiated from pancreatic cancer, so as to avoid missed diagnosis and unnecessary surgical intervention.

Objective: To investigate the expression and clinical significance of sphingosine-1-phosphate transporter 2 (spinster homolog 2, SPNS2) in colorectal cancer. Methods: Colorectal cancer and adjacent normal tissues were collected from 133 patients undergoing colorectal cancer resection in Anhui Provincial Hospital from January 2010 to June 2013. The expression of SPNS2 protein was detected by immunohistochemistry. RT-qPCR was performed on the cancer tissues and adjacent normal tissues of 29 patients with colorectal cancer from February 2018 to June 2018. The relationship between the expression of SPNS2 in cancer tissues and clinicopathological features of colorectal cancer patients was analyzed using χ2test. The relationship between the expression of SPNS2 and prognosis of patients with colorectal cancer was analyzed based on univariate and multivariate analysis. Results: Immunohistochemistry results indicated that the expression of SPNS2 in colorectal cancer tissues was higher than that in adjacent normal tissues (81.20% vs. 22.60%, χ2=69.136, P<0.001). The results of RT-qPCR indicated that the expression of SPNS2 mRNA in colorectal cancer tissues was significantly higher than that in the corresponding adjacent normal tissues (t=3.974, P<0.001). The overexpression of SPNS2 protein was closely related to tumor differentiation, lymph node metastasis (pN), tumor size, and depth of invasion (Tx); this difference was statistically significant (P<0.001). The survival time of patients with negative SPNS2 expression was significantly longer than that of patients with positive expression (χ2=13.080, P<0.001). Univariate and Cox multivariate analyses showed that abnormal expression of SPNS2 affects the overall survival of colorectal cancer patients and is an independent influencing factor for patient prognosis. Conclusions: The positive expression of SPNS2 in colorectal cancer is related to the occurrence and development of colorectal cancer. SPNS2 can be used as a new colorectal tumor marker to evaluate the prognosis of patients, monitor the invasion and metastasis of postoperative tumors, and serve as a new target for diagnosis and treatment.

Purpose To study clinical pathological characteristics,margin status and its influencing factors in different type of facial basal cell carcinoma (BCC).Methods The histopathological features,margin status of the first frozen section and influencing factors was retrospectively analyzed,with review of the relevant literature.The primary outcome variable was the rate of initially positive frozen section margins.Multivariable Logistic regression was used to study histologic subtype,surgical margins,tumor size,location and other factors influence on the rate of initially positive frozen section margins.Results The pathological subtype is the major risk factor,the infiltrative (OR =4.463,95％ CI =1.919-10.380,P ＜0.05) and morpheaform (OR=5.018,95％CI=2.025-16.623,P＜0.05) had higher risk on positive surgical margin compared with the nodular.The rate of initially positive frozen section margins of nodular and superficial BCC at different margins were observed but the difference were not significant (P ＞ 0.05).Conclusion The pathological subtype is the major risk factor.Surgical excision with a 3 mm margin can achieve ideal results for nodular and superficial BCC in facial area.

Objective To summarize the experience of diagnosis and treatment for pancreatic neuroendocrine neoplasms (pNENs).Methods Forty-seven patients with pNENs who were treated at Anhui Province Hospital during January 2002 to December 2013 were retrospectively analyzed.They were followed by telephone or clinic interview,and the deadline date was January 31st,2014.Survival was analyzed with the Kaplan-Meier method,and the prognostic factors for survival were identified.Results Among the47 patients,there were 13 males and 34 females,aged from 16 to 74 years old,with a median age of 45 years,There were 17 cases of non-functioning pNENs,30 cases of functioning pNENs.The detection rate of B ultrasound,CT,MRI was 71.8％ (28/39),92.7％ (38/41),75.6％ (6/8).Forty-six patients underwent radical surgery,and 1 patient underwent palliative surgery.The pathologic type included 41 cases of pancreatic neuroendocrine neoplasms,6 cases of neuroendocrine cancer.There were 22,19,6 cases of grade G1,G2,G3 lesions,respectively.There were 32,11,4 cases of TNM staging Ⅰ,Ⅱ,Ⅲ,respectively.Vascular structure was invaded in 15 cases,and nerve was invaded in 18 cases.Lymph node was examined in 15 cases,and 5 were found to have metastatic lesion.After surgery,pancreatic fistula occurred in 9 patients,ascites in 4 patients,wound infection in 4.The follow-up period ranged from 2 to 144 months.The overall 1,3,5-year survival rates were 94.9％,88.4％,and 84.4％.The 5-year survival rates of patients with grade G1,G2,G3 were 100％,73.3％,60％;and the 5-year survival rates of patients with TNM staging Ⅰ,Ⅱ,Ⅲ were 100％,70.0％,33.3％.It was showed that TNM staging system,WHO classification,lymph node metastasis,vascular and neural invasion were associated with the prognosis.Conclusions CT is the imaging test of choice for pNENs,while surgery is the first choice for treatment.Surgical resection of pNENs results in long-term survival.TNM staging,WHO classification,lymphatic metastasis,vascular and neural invasion are closely related to the prognosis of pNENs.

Objective To determine the expression of brain-derived neurotrophic factor (BDNF) in pancreatic ductal adenocarcinoma and its clinical significance.Methods SP immunohistochemical staining method was used to detect the expression of BDNF in 46 cases of pancreatic ductal adenocarcinoma,38 cases of benign pancreatic diseases and 20 cases of normal pancreatic tissue.Real time PCR and Western blot was used to detect the protein and mRNA expression levels.The relationship between BDNF expression and clinicopathological parameters of pancreatic cancer was determined.Results The positive expression rate of BDNF was 52.2％ (24/46) in pancreatic ductal adenocarcinoma pancreatic ductal adenocarcinoma,7.8％ (3/38) in benign pancreatic diseases,and none of the normal pancreatic tissue was BDNF positive.The BDNF protein expression levels in pancreatic ductal adenocarcinoma,benign pancreatic diseases and normal pancreatic tissue were 0.38± 0.01,0.56± 0.01,0.97± 0.01,respectively,and the BDNF mRNA expression levels were 0.85 ± 0.14,1.67 ± 0.21,3.45 ± 0.67,respectively,and the expression levels in pancreatic ductal adenocarcinoma and benign pancreatic diseases were significantly higher than that in normal pancreatic tissue,while the expression level in pancreatic ductal adenocarcinoma was significantly higher than that in benign pancreatic diseases (P ＜0.05).Positive BDNF expression was correlated with nerve infiltration and lymph node metastasis of pancreatic ductal adenocarcinoma,but it was not related to age,sex,tumor size,location and differentiated degree (P ＞ 0.05).Conclusions BDNF is involved in the development and growth of pancreatic cancer,and it may be related with patient's prognosis.

Objective To explore the key points of diagnosis,treatment and the reasonable surgical methods in 39 cases of pancreas trauma.Methods A retrospective review and analysis the cause and classification of injury,surgical methods of 39 cases of pancreatic trauma in the Department of General Surgery of Affiliated Provinical Hospital of Anhui Medical University during Jan.1990 to Dec.2011.Results In the 39 patients who underwent surgery,38 patients were cured,1 dead duing to craniocerebral injuries,3 patients with complications of pancreatic leakage cured after adequate drainage.Two patients with pancreatic pseudocyst pancreatic pseudocystcyst cured after pancreatic pseudocyst jejunum anastomosis.One patients with traumatic pancreatitis cured after conservative treatment.Conclusions Blunt injury is the most common cause of pancreas trauma.Imaging examination has high value in the early diagnosis of pancreas trauma.The reasonable surgical methods and careful examination during operation can improve the cure rate and reduce the mortality and incidence of complications of pancreatic trauma.If the patient's condition allowed,endoscopy not only contributes to the diagnosis of pancreatic trauma,but is an effective method for treatment of it.

Objective A comparative proteomic method was utilized to analyze serum proteins among pancreatic cancer patients,pancreatic benign tumor group,chronic pancreatitis group and normal control group to discover a new potential specific early diagnostic marker.Methods Comparative analysis on the pancreatic peripheral blood protein profiling from 40 pancreatic cancer patients,10 benign tumor patients,10 chronic pancreatitis patients and 40 cancer-free controls from May 2009 to April 2011 was carried out by 2D differential gel electrophoresis (2D-DIGE) and differentially expressed proteins were identified by matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS).Results Three differentially expressed proteins,Hemopexin (Hpx),Ficolin 3 (FCN3) and Serum amyloid P-component (SAP) was identified.Those proteins were higher expression in pancreatic cancer group compared with benign tumor group,chronic pancreatitis group and normal control group.Each point in pancreatic cancer expression were 1.57,1.99,1.63 times than normal control expression,respectively (P ＜0.05).Conclusions In this study,the identified proteins,Hpx,FCN3 and SAP may be as potential specific early diagnostic markers of pancreatic carcinoma.2D-DIGE and MALDI-TOF-MS technology in screening specific serum tumor markers of pancreatic cancer has a well repeatability and stability.

ObjectiveTo find out the inhibitory effects of CD4 - CD8 - DNT cells on growth of which depresses the pancreatic cancer in vitro and in vivo.Methods The inhibitory effects of DNT cells on the growth of Panc- 1 were studied in vitro by MTT method.Eighteen BALB/c mice were divided into 3 groups randomly.Human pancreatic cancer xenografts were established in 2 groups randomly.The last group was injected the cell suspension which comprises DNT and Panc- 1 cells ( Panc- 1∶ DNT =1∶ 5 ).When the diameter of tumor was about 5 mm,the first 2 group mice were further divided into 2 groups randomly.One was control,treated with distilled water.The other was treated with celebrex (4 mg/d).The size of the tumors was calculated every 2 weeks and tumor growth curve was depicted.At the end of the treatments,the mice were sacrific and the tumors were harvested.The tumor inhibition rate was calculated.Results( 1 ) MTT study showed that DNT cells produced a dose- dependent inhibition of Panc- 1 proliferation in vitro.(2) The growth of transplanted pancreatic cancer was down-regulated by treatment of DNT cells.ConclusionDNT cells can inhibit the growth of pancreatic cancer in vitro and in vivo.