Objective:To investigate the clinicopathological characteristics and prognostic factors of different histological subtypes of intrahepatic cholangiocarcinoma (ICC).Methods:The retrospective cohort study was conducted. The clincopathological data of 171 patients with ICC who underwent initial curative resection in Peking University People′s Hospital from January 2015 to December 2023 were collected. There were 94 males and 77 females, aged 60(range, 53-68)years. Measurement data with normal distribution were expressed as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were expressed as M(range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi‐square test or Fisher exact probability. The Kaplan‐Meier method was used to draw survival curve and calculate survival rates, and the Log-rank test was used for survival analysis. The COX stepwise regression model was used for univariate and multivariate analyses. Results:(1) Comparison of clinicopathological characteristics of different histological subtypes of ICC. Results of postoperative histopathological examination showed that of the 171 ICC patients, there were 76 cases of large duct type ICC and 95 cases of small duct type ICC. There was a significant difference in cases with concomitant intrahepatic biliary stone between patients with different histological subtypes of ICC ( P<0.05), and there were significant differences in cases with concomitant viral hepatitis, cases with CA19-9 >39 U/mL versus CA19-9 ≤39 U/mL, cases with CA19-9 >1 000 U/mL versus CA19-9 >39-1 000 U/mL, tumor gross morphology, and tumor peri-neural invasion between patients with different histological subtypes of ICC ( χ2=8.906, 18.208, 5.689, 43.886, 6.178, P<0.05). (2) Prognostic analysis of different histological subtypes of ICC. Of the 171 patients, 130 cases were followed up for 22(range, 16-43)months, including 63 cases of large duct type ICC and 67 cases of small duct type ICC. The 5-year overall survival rates of the 63 cases of large duct type ICC and 67 cases of small duct type ICC were 12.60% and 43.70%, respectively, showing a significant difference between them ( χ2=5.799, P<0.05). (3) Analysis of prognostic factors for patients undergoing radical resection of ICC. Results of multivariate analysis showed that tumor perineural invasion and lymph node metastasis were independent risk factors affecting overall survival rates of patients undergoing radical resection of ICC ( hazard ratio=0.447, 0.383, 95% confidence interval as 0.259-0.771, 0.225-0.651, P<0.05). Conclusions:There are differences in both clinicopatholo-gical characteristics and prognosis between patients with large duct type ICC and small duct type ICC. Tumor perineural invasion and lymph node metastasis are independent risk factors affecting overall survival rates of patients undergoing radical resection of ICC.

Objective:To investigate the clinicopathological characteristics and prognostic factors of different histological subtypes of intrahepatic cholangiocarcinoma (ICC).Methods:The retrospective cohort study was conducted. The clincopathological data of 171 patients with ICC who underwent initial curative resection in Peking University People′s Hospital from January 2015 to December 2023 were collected. There were 94 males and 77 females, aged 60(range, 53-68)years. Measurement data with normal distribution were expressed as Mean± SD, and comparison between groups was conducted using the independent sample t test. Measurement data with skewed distribution were expressed as M(range), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi‐square test or Fisher exact probability. The Kaplan‐Meier method was used to draw survival curve and calculate survival rates, and the Log-rank test was used for survival analysis. The COX stepwise regression model was used for univariate and multivariate analyses. Results:(1) Comparison of clinicopathological characteristics of different histological subtypes of ICC. Results of postoperative histopathological examination showed that of the 171 ICC patients, there were 76 cases of large duct type ICC and 95 cases of small duct type ICC. There was a significant difference in cases with concomitant intrahepatic biliary stone between patients with different histological subtypes of ICC ( P<0.05), and there were significant differences in cases with concomitant viral hepatitis, cases with CA19-9 >39 U/mL versus CA19-9 ≤39 U/mL, cases with CA19-9 >1 000 U/mL versus CA19-9 >39-1 000 U/mL, tumor gross morphology, and tumor peri-neural invasion between patients with different histological subtypes of ICC ( χ2=8.906, 18.208, 5.689, 43.886, 6.178, P<0.05). (2) Prognostic analysis of different histological subtypes of ICC. Of the 171 patients, 130 cases were followed up for 22(range, 16-43)months, including 63 cases of large duct type ICC and 67 cases of small duct type ICC. The 5-year overall survival rates of the 63 cases of large duct type ICC and 67 cases of small duct type ICC were 12.60% and 43.70%, respectively, showing a significant difference between them ( χ2=5.799, P<0.05). (3) Analysis of prognostic factors for patients undergoing radical resection of ICC. Results of multivariate analysis showed that tumor perineural invasion and lymph node metastasis were independent risk factors affecting overall survival rates of patients undergoing radical resection of ICC ( hazard ratio=0.447, 0.383, 95% confidence interval as 0.259-0.771, 0.225-0.651, P<0.05). Conclusions:There are differences in both clinicopatholo-gical characteristics and prognosis between patients with large duct type ICC and small duct type ICC. Tumor perineural invasion and lymph node metastasis are independent risk factors affecting overall survival rates of patients undergoing radical resection of ICC.

Objective:To investigate the expression level between AT-Rich Interaction Domain 1A(ARID1A) in intrahepatic cholangiocarcinoma (ICC) and the correlation with tumor microenvironment.Methods:The clinicopathological and survival data of 110 ICC patients undergoing radical hepatectomy in Peking University People's Hospital from Jan 2015 to May 2021 were retrospectively analyzed. Immunohistochemical staining was used to detect the expressions of ARID1A , programmed cell death 1 ligand 1( PD-L1) in tumor tissues , programmed cell death protein 1(PD-1) and cluster of differentiation 8(CD8) in the microenvironment. The relationship between ARID1A expression and PD-L1, PD-1, CD8 protein expression was analyzed.Results:Twenty seven patients did not express ARID1A, absence of ARID1A was associated with high PD-L1, PD-1 and CD8 expression ( P<0.05). Multivariate analysis showed ARID1A expression, preoperative CEA level,preoperative CA19-9 level, lymph node metastasis and tumor number were independent risk factors. Conclusion:Absent expression of ARID1A suggests poor prognosis of ICC patients, high expression of PD-L1,PD-1 and CD8 protein in ICC tumor microenvironment with ARID1A-deficient expression suggests a possible prognosis benefit by using anti-PD-1, anti-PD-L1 and other immunotherapy regimens.

Objective:To investigate the correlation between cervical lymph node metastasis,extra thyroidal extension and other clinicopathologic features and BRAF V600E gene mutation abundance in papillary thyroid carcinoma. Methods:The clinicopathologic data of 123 PTC patients admitted from Jan 2018 to Oct 2020 in Peking University People's Hospital were analyzed retrospectively. All the PTC cases were examined by next generation sequencing technology. BRAF V600E gene mutation abundances were detected and analyzed with different clinicopathologic features, and differences between groups were compared. Results:There were statistical differences compared to control group in BRAF V600E gene mutation abundances in lymph node metastasized group and extra thyroidal extended group(all P<0.05). BRAF V600E gene mutation abundances were positively related with severity of extra thyroidal extension( P<0.05). Conclusion:BRAF V600E gene mutation abundance was related with cervical lymph node metastasis and extra thyroidal extension in PTC patients.

Digestival functional surgery refers to surgical treatment for patients with functional diseases of the digestive tract. With the continuous development of minimally invasive surgery, most of surgical procedures for digestive functional diseases have been conducted by minimal invasive approach. Based on decades of clinical practice, the authors focus on minimally invasive surgeries for a group of digestive functional diseases such as achalasia of cardia, gastroesophageal reflux disease, volvulus of stomach, gastroptosis, dolichocolon, refractory constipation, rectocele and rectal prolapse, and make ageneral summary on current status and prospects of its clinical application combined with literatures.