Objective To study the pathological types,expression of mismatch repair protein,human epidermal growth factor receptor 2(HER2),and Pan-TRK,and Epstein-Barr virus(EBV)infection in patients with colorectal cancer resected in Tibet. Methods A total of 79 patients with colorectal cancer resected in Tibet Autonomous Region People's Hospital from December 2013 to July 2021 were enrolled in this study.The clinical and pathological data of the patients were collected.The expression of mismatch repair protein,HER2,and Pan-TRK was detected by immunohistochemical(IHC)staining,and detection of HER2 gene by fluorescence in situ hybridization(FISH)in the patients with HER2 IHC results of 2+ or above.EBV was detected by in situ hybridization with EBV-encoded small RNA. Results A total of 79 colorectal cancer patients were included in this study,with the male-to-female ratio of 1.26:1 and the mean age of(57.06±12.74)years(24-83 years).Among them,4 patients received preoperative neoadjuvant therapy.Colonic cancer and rectal cancer occurred in 57(57/79,72.15%,including 31 and 26 in the right colon and left colon,respectively)and 22(22/79,27.85%)patients,respectively.The maximum diameter of tumor varied within the range of 1-20 cm,with the mean of(6.61±3.33)cm.Among the 79 colorectal cancer patients,75(75/79,94.94%)patients showed adenocarcinoma.Lymph node metastasis occurred in 12(12/21,57.14%)out of the 21 patients with severe tumor budding,13(13/23,56.52%)out of the 23 patients with moderate tumor budding,and 2(2/31,6.45%)out of the 31 patients with mild tumor budding,respectively.The lymph node metastasis rate showed differences between the patients with severe/moderate tumor budding and the patients with mild tumor budding(all P<0.001).The IHC staining showed that mismatch repair protein was negative in 10(10/65,15.38%)patients,including 5 patients with both MSH2 and MSH6 negative,4 patients with both MLH1 and PMS2 negative,and 1 patient with MSH6 negative.Pan-TRK was negative in 65 patients.The IHC results of HER2 showed 0 or 1+ in 60 patients and 2+ in 5 patients.FISH showed no positive signal in the 5 patients with HER2 IHC results of 2+.The detection with EBV-encoded small RNA showed positive result in 1(1/65,1.54%)patient. Conclusions Non-specific adenocarcinoma of the right colon is the most common in the patients with colorectal cancer resected in Tibet,and 15% of the patients showed mismatch repair protein defects.EBV-associated colorectal carcer is rare,Pan-TRK expression and HER2 gene amplification are seldom.The colorectal cancer patients with moderate and severe tumor budding are more likely to have lymph node metastasis.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Adenocarcinoma ; Biomarkers, Tumor/genetics* ; Colorectal Neoplasms/pathology* ; DNA Mismatch Repair ; DNA-Binding Proteins/genetics* ; Epstein-Barr Virus Infections/diagnosis* ; Herpesvirus 4, Human/metabolism* ; In Situ Hybridization, Fluorescence ; Lymphatic Metastasis ; Tibet ; Young Adult ; Aged, 80 and over

OBJECTIVES: Laryngeal squamous cell carcinoma (LSCC) is a common malignant tumor of head and neck. Screening of target genes for malignant tumor therapy is one of the focuses of cancer research, with proto-oncogene and tumor suppressor gene as the breakthrough. It has become an urgent need to find the target gene related to the treatment and prognosis of LSCC.This study aims to explore the role of Lin28B and C-myc in LSCC by detecting the expressions of these two proteins and analyze the correlation between the expression of Lin28B and C-myc and clinicopathological features and prognosis of LSCC. METHODS: We detected the expression of Lin28B and C-myc proteins in 102 specimens of LSCC and 90 specimens of adjacent tissues by immunochemistry, and analyzed the correlation between Lin28B and C-myc protein expressions in LSCC as well as the correlation between the expressions of the two proteins and the clinicopathological features of LSCC. At the same time, the Kaplan-Meier method was used to analyze the relation between Lin28B and C-myc protein levels with the postoperative survival rate of LSCC patients. RESULTS: The protein levels of Lin28B and C-myc in the LSCC tissnes were significantly higher than those in the adjacent tissues (both P<0.05),and there was a positive correlation between the expression of Lin28B and C-myc in LSCC (r＝0.476, P<0.05). The expression of Lin28B protein was closely related to age, lymph node metastasis, clinical stage, tumor size, and pathological differentiation of LSCC patients (all P<0.05). while the expression of C-myc protein was closely related to lymph node metastasis, clinical stage, tumor size, and pathological differentiation of LSCC patients (all P<0.05). A relevant survival analysis showed that in patients with higher level of Lin28B (P＝0.001) or C-myc protein (P<0.001), the postoperative survival rate was relatively low. CONCLUSIONS Lin28B and C-myc proteins are highly expressed in LSCC with a positive correlation. Furthermore, they are closely related to lymph node metastasis, clinical stage, tumor size, pathological differentiation and prognosis, suggesting that both Lin28B and C-myc might be involved in the occurrence and development of LSCC.
Humans ; Squamous Cell Carcinoma of Head and Neck ; Proto-Oncogene Proteins c-myc/metabolism* ; Laryngeal Neoplasms/diagnosis* ; Carcinoma, Squamous Cell/genetics* ; Lymphatic Metastasis ; Prognosis ; Head and Neck Neoplasms ; Biomarkers, Tumor/metabolism* ; RNA-Binding Proteins/genetics*

Objective: To establish a survival prediction model based on the independent prognostic factors of long-term prognosis after laparoscopic liver resection(LLR) for intrahepatic cholangiocarcinoma(ICC). Methods: The clinical and pathological data of 351 consecutive patients with ICC who received radical LLR in 13 Chinese medical centers from August 2010 to May 2021 were collected retrospectively. There were 190 males and 161 females,aged(M(IQR)) 61(14)years(range:23 to 93 years). The total cohort was randomly divided into a training dataset(264 cases) and a validation dataset(87 cases). The patients were followed up by outpatient service or telephone,and the deadline for follow-up was October 2021. Based on the training dataset,the multivariate Cox proportional hazards regression model was used to screen the independent influencing factors of long-term prognosis to construct a Nomogram model. The Nomogram model's discrimination,calibration,and clinical benefit were evaluated through internal and external validation,and an assessment of the overall value of two groups was made through the use of a receiver operating characteristic(ROC) curve. Results: There was no significant difference in clinical and pathological characteristics and long-term survival results between the training and validation datasets(all P>0.05). The multivariate Cox analysis showed that CA19-9,CA125,conversion to laparotomy during laparoscopic surgery,and lymph node metastasis were independent prognostic factors for ICC patients after LLR(all P<0.05). The survival Nomogram was established based on the independent prognostic factors obtained from the above screening. The ROC curve showed that the area under the curve of 1, 3 and 5-year overall survival rates of patients in the training dataset were 0.794(95%CI:0.721 to 0.867),0.728(95%CI:0.618 to 0.839) and 0.799(95%CI:0.670 to 0.928),and those in the validation dataset were 0.787(95%CI:0.660 to 0.915),0.831(95%CI:0.678 to 0.983) and 0.810(95%CI:0.639 to 0.982). Internal and external validation proved that the model exhibited a certain discrimination,calibration,and clinical applicability. Conclusion: The survival Nomogram model based on the independent influencing factors of long-term prognosis after LLR for ICC(including CA19-9,CA125,conversion to laparotomy during laparoscopic surgery,and lymph node metastasis) exhibites a certain differentiation,calibration,and clinical practicability.
Bile Duct Neoplasms/surgery* ; Bile Ducts, Intrahepatic/pathology* ; CA-19-9 Antigen ; Cholangiocarcinoma/diagnosis* ; Female ; Humans ; Laparoscopy ; Lymphatic Metastasis ; Male ; Nomograms ; Prognosis ; Retrospective Studies

OBJECTIVE: To observe the expression of HELQ and RAD51C in normal endometrial and endometrial stromal sarcoma (ESS) and analyze their correlation with the clinical features of the patients. METHODS: The expressions of HELQ and RAD51C proteins were detected by immunohistochemical staining in normal endometrial tissues (14 cases) and tumor tissues from patients with ESS (37 cases) treated in Hunan Provincial Cancer Hospital from January, 2013 to December, 2016. The correlations of the expressions of the two proteins with the patients'age, FIGO staging, tissue type, tumor size, and lymph node metastasis were analyzed. RESULTS: Immunohistochemical staining showed that the expressions of HELQ and RAD51C were both decreased in ESS patients compared with the normal group, and there was a positive correlation between HELQ and RAD51C expression ( < 0.05). HELQ expression in ESS was correlated with the tumor size and type. The expressions of HELQ and RAD51C were not correlated with the patients' age, FIGO stage and status of lymph node metastasis ( > 0.05). CONCLUSIONS Homologous recombination- directed DNA repair involving HELQ and RAD51C may participate in the occurrence and progression of ESS.
DNA Helicases ; genetics ; DNA-Binding Proteins ; genetics ; Endometrial Neoplasms ; diagnosis ; physiopathology ; Endometrium ; physiopathology ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Lymphatic Metastasis ; physiopathology ; Sarcoma, Endometrial Stromal ; physiopathology

To analyze the potential associations of ultrasound-guided fine-needle aspiration(FNA),BRAF gene mutation detection,and the combination of these two techniques with the clinicopathological features of papillary thyroid cancer(PTC). Methods Patients with PTC confirmed by surgery from April 2016 to July 2017 were included in this study.The relationship between clinicopathological features and BRAF mutation,FNA results,and the combination of them were explored. Results The sensitivity of FNA was 86.3%(227/263)and the mutation rate of BRAF was 85.9%(226/263)in 263 patients with PTC.The mutation rate of papillary thyroid microcarcinoma(PTMC)was 91.1%(153/168)and that of non-PTMC was 76.8%(73/95).A total of 225 patients underwent lymph node dissection.The lymph node metastasis rate was 35.6%(80/225),and it was 23.8%(34/143)in PTMC,56.1%(46/82)in non-PTMC;in addition,9.9%(26/263)of PTC patients had extracapsular invasion.BRAF mutation rate was higher in patients with the following features:aged over 45 years(=0.043);the tumor was FNA diagnosed as malignant or suspected malignant(=0.011);the tumor had a maximum diameter of ≤1 cm(=0.001);and the primary tumor was in stage T(=0.039);however,there was no significant difference in BRAF mutation rate among patients with different sex,capsule invasion,or lymph node metastasis.The diagnostic sensitivity of FNA was not statistically different under different clinical and pathological characteristics.The clinicopathologic features of FNA and BRAF double-positive patients were not significantly different from those of other patients. Conclusion FNA-confirmed malignancy,BRAF gene mutation,and their double-positive results are not correlated with the invasive pathological features of PTC,and thus their roles in guiding an extended operation(or not)are limited.
Biopsy, Fine-Needle ; Humans ; Lymphatic Metastasis ; Mutation ; Proto-Oncogene Proteins B-raf ; genetics ; Thyroid Cancer, Papillary ; diagnosis ; genetics ; Thyroid Neoplasms ; diagnosis ; genetics

Lateral lymph node metastasis represents a major cause of local pelvic recurrence after curative resection for mid-low rectal cancer. Considerable controversies over issues remain among eastern and western countries, with respect to the diagnosis of lateral lymph node metastasis, the multidisciplinary management regime, indication for lateral pelvic lymph node dissection, and the prognosis of surgical dissection. The purpose of this expert consensus is to improve the understanding of this condition among Chinese specialists, and to help standardizing the diagnosis and therapeutic strategies for lateral lymph node metastasis. Each statement and recommendation in this consensus were generated based on suggestions from at least three experts, agreed by a majority of experts from the Chinese expert panel. The evaluation criteria by U.S. Preventive Services Task Force was adopted for the grading of recommendations. In respect to the aforementioned controversies, the present consensus produced 21 statements on diagnosis and treatment for lateral lymph node metastasis. The pending issues in this consensus need further high-quality clinical practice and research.
China ; Consensus ; Humans ; Lymph Node Excision ; Lymph Nodes ; pathology ; surgery ; Lymphatic Metastasis ; Neoplasm Recurrence, Local ; pathology ; Prognosis ; Rectal Neoplasms ; diagnosis ; pathology ; surgery

The presence of lymph node metastasis of thyroid papillary carcinoma usually occurs in the internal jugular and paratracheal space on the side of the lesion. For this reason, metastasis to the retropharyngeal lymph nodes from papillary thyroid carcinoma is rare. We currently experienced two cases of retropharyngeal lymph node metastasis of thyroid papillary carcinoma. Both patients had a history of total thyroidectomy and ipsilateral neck dissection and had undergone retropharyngeal lymph node dissection via transoral approach after the diagnosis of retropharyngeal node metastasis. We suggest that the metastatic retropharyngeal lymph nodes can be successfully removed through transoral apparoach. The diagnosis of this rare lymph node metastasis requires sufficient imaging studies such as MRI, CT or PET-CT as well as appropriate history taking and physical examination.
Carcinoma, Papillary ; Diagnosis ; Follow-Up Studies ; Humans ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Metastasis ; Magnetic Resonance Imaging ; Neck Dissection ; Neck ; Neoplasm Metastasis ; Physical Examination ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy

OBJECTIVE: To investigate the prognostic value of metabolic tumor volume (MTV) and total lesion glycolysis (TLG), measured by preoperative ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT), in risk stratification of patients with endometrial carcinoma (EC). METHODS: The patients with pathological diagnosis of EC who underwent preoperative ¹⁸F-FDG PET/CT imaging were retrospectively selected for analysis of the prognostic values of PET parameters in risk classification and lymph node metastases (LNMs). Receiver-operating-characteristic analysis was used to analyze the correlation of PET parameters cutoff values with deep myometrial invasion (MI), lymphovascular space involvement and LNM for prognostic values in risk stratification. RESULTS: The sensitivity, specificity, positive predictive value, negative predictive value and accuracy for detection of LNM are 83.3%, 99.7%, 90.9%, 99.5% and 99.2%, respectively. The MTV and TLG of primary lesion of EC in the patients with LNM are notably higher than those in patients without LNM, p<0.010. The MTV and TLG of the EC primary lesions in high-risk patients are significantly higher than those in low-risk patients (p<0.010), but the maximum standardized uptake value (SUVmax) is not. The MTV and TLG of primary lesions were superior to SUVmax for predicting of deep MI, LNM and high-risk of EC (p<0.005). CONCLUSION: MTV and TLG of primary lesions are more valuable in predicting risk stratification of EC patients. Preoperative ¹⁸F-FDG PET/CT imaging is useful in predicting the LNM of EC and may help guide pelvic lymphadenectomy to avoid unnecessary pelvic lymphadenectomy in EC patients with low-risk stratification.
Classification ; Diagnosis ; Electrons ; Endometrial Neoplasms ; Female ; Glycolysis ; Humans ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Metastasis ; Metabolism ; Neoplasm Metastasis ; Positron-Emission Tomography and Computed Tomography ; Retrospective Studies ; Risk Assessment ; Sensitivity and Specificity ; Tumor Burden

PURPOSE: There is still a clinical need to easily evaluate the metastatic status of lymph nodes during breast cancer surgery. We hypothesized that ex vivo shear-wave elastography (SWE) would predict precisely the presence of metastasis in the excised lymph nodes. METHODS: A total of 63 patients who underwent breast cancer surgery were prospectively enrolled in this study from May 2014 to April 2015. The excised axillary lymph nodes were examined using ex vivo SWE. Metastatic status was confirmed based on the final histopathological diagnosis of the permanent section. Lymph node characteristics and elasticity values measured by ex vivo SWE were assessed for possible association with nodal metastasis. RESULTS: A total of 274 lymph nodes, harvested from 63 patients, were examined using ex vivo SWE. The data obtained from 228 of these nodes from 55 patients were included in the analysis. Results showed that 187 lymph nodes (82.0%) were nonmetastatic and 41 lymph nodes (18.0%) were metastatic. There was significant difference between metastatic and nonmetastatic nodes with respect to the mean (45.4 kPa and 17.7 kPa, p<0.001) and maximum (55.3 kPa and 23.2 kPa, p<0.001) stiffness. The elasticity ratio was higher in the metastatic nodes (4.36 and 1.57, p<0.001). Metastatic nodes were significantly larger than nonmetastatic nodes (mean size, 10.5 mm and 7.5 mm, p<0.001). The size of metastatic nodes and nodal stiffness were correlated (correlation coefficient of mean stiffness, r=0.553). The area under curve of mean stiffness, maximum stiffness, and elasticity ratio were 0.794, 0.802, and 0.831, respectively. CONCLUSION: Ex vivo SWE may be a feasible method to predict axillary lymph node metastasis intraoperatively in patients undergoing breast cancer surgery.
Area Under Curve ; Axilla ; Breast Neoplasms* ; Breast* ; Diagnosis ; Elasticity ; Elasticity Imaging Techniques* ; Humans ; Lymph Nodes* ; Lymphatic Metastasis ; Methods ; Neoplasm Metastasis* ; Prospective Studies

Objective To explored the risk factors of lymph node metastasis in papillary thyroid microcarcinoma (PTMC) by analyzing the data from the Surveillance,Epidemiology and End Results (SEER) database.Methods The data of 31 017 patients with PTMC in the SEER database from 2002 to 2012 were retrospectively analyzed. Logistic and Cox regression analyses were used to explore the associations of the factors and the risk of lymph node metastasis in PTMC.Results Multivariate analysis revealed that male (OR=0.673,95%CI=0.605-0.748,P=0.001),age<55 years (OR=0.683,95%CI =0.623-0.749,P=0.001),tumor size >5 mm(OR=1.172,95%CI=1.153-1.191,P=0.001),follicular variant (OR=0.641,95%CI =0.574-0.716,P=0.001),and multifocal (OR=1.662,95%CI=1.516-1.821,P=0.001) and external thyroid extension (ETE) (capsular invasion OR=1.232,95%CI=1.183-1.543,P=0.001;minor invasion OR=2.119,95%CI=1.377-3.263,P=0.001;and gross invasion OR=2.546,95%CI=2.218-2.921,P=0.001) were significantly associated with central lymph node metastasis (CLNM). Multivariate analysis revealed that tumor size >5 mm(OR=1.112,95%CI =1.091-1.133,P=0.001),male (OR=0.36,95%CI=0.322-0.401,P=0.001),age<55 years (OR=0.503,95%CI=0.453-0.559,P=0.001),follicular variant (OR=0.625,95%CI =0.549-0.711,P=0.001),multifocal (OR=2.265,95%CI =2.039-2.517,P=0.001),ETE (capsular invasion OR=2.105,95%CI=1.681-2.637,P=0.001;minor invasion OR=4.601,95%CI=3.994-5.300,P=0.001;and gross invasion OR=7.093,95%CI=4.910-10.246,P=0.001),and distant metastasis (OR=11.948,95%CI=7.523-18.975,P=0.001) were significantly associated with lateral lymph node metastasis.Conclusions Male,young age(<55 years),large tumor(>5 mm),follicular variant-PTMC,ETE,and multifocality are the risk factors for cervical lymph node metastasis. Distant metastasis is associated with lateral lymph node metastasis. For patients at high risk of PTMC,prophylactic neck lymph node dissection is recommended.
Carcinoma, Papillary ; pathology ; Female ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; diagnosis ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; SEER Program ; Thyroid Neoplasms ; pathology