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简介：AIMTodeterminewhetherthenumberofexaminedlymphnodes(LNs)iscorrelatedwiththeoverallsurvivalofgallbladdercarcinoma(GBC)patients.METHODSPatientswerecollectedfromtheSurveillanceEpidemiologyandEndResultsdatabase(2004-2013)andcategorizedbythenumberofLNsintosixgroups:1LN,2LNs,3LNs,4LNs,5LNs,and≥6LNs.SurvivalcurvesforoverallsurvivalwereplottedwithaKaplan-Meieranalysis.Thelog-ranktestwasusedforunivariatecomparisons.RESULTSInacohortof893patients,themediannumberofexaminedLNswastwofortheentirecohort.Thesurvivalforthe1LNgroupwassignificantlypoorerthanthoseofthestageⅠandⅡdiseasegroupsandfortheentirecohort.BydichotomizingthenumberofLNsfrom1to6,wefoundthattheminimumnumberofLNsthatshouldbeexaminedwasfourforstageⅠ,fourorfiveforstageⅡ,andsixforstageⅢAdisease.Therefore,fortheentirecohort,thenumberofexaminedLNsshouldbeatleastsix,whichisexactlyconsistentwiththeAmericanJointCommitteeonCancercriteria.CONCLUSIONTheexaminationofhighernumbersofLNsisassociatedwithimprovedsurvivalafterresectionsurgeryforN0GBC.TheguidelinesforGBCsurgery,whichrecommendthatsixLNsbeexaminedatleast,arestatisticallyvalidandshouldbeappliedinclinicalpracticewidely.

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简介：AbstractBackground:Pathological complete response (pCR) of axillary lymph nodes (ALNs) is frequently achieved in patients with clinically node-positive breast cancer after neoadjuvant chemotherapy (NAC), and ALN status is an important prognostic factor for breast cancer patients. This study aims to develop a new predictive clinical model to assess the ALN pCR rate after NAC.Methods:This was a retrospective series of 467 patients who had biopsy-proven positive ALNs at diagnosis and underwent ALN dissection from 2007 to 2014 at the National Cancer Center/Cancer Hospital of the Chinese Academy of Medical Sciences. We analyzed the clinicopathologic features of the patients and developed a nomogram to predict the probability of ALN pCR. A multivariable logistic regression stepwise model was used to construct a nomogram to predict ALN pCR in node-positive patients. The adjusted area under the receiver operating characteristic curve (AUC) was calculated to quantify the ability to rank patients by risk. Internal validation was performed using the 50/50 hold-out validation method. The nomogram was externally validated with prospective cohorts of 167 patients from 2016 to 2018 at the Cancer Hospital of the Chinese Academy of Medical Sciences and 114 patients from 2018 to 2020 at Beijing Tiantan Hospital.Results:In this retrospective study, 115 (24.6%) patients achieved ALN pCR after NAC. Multivariate analysis showed that clinical tumor stage (Odds ratio [OR]: 0.321, 95% confidence interval [CI]: 0.121-0.856; P = 0.023); primary tumor response (OR: 0.189; 95% CI: 0.123-0.292; P < 0.001), and estrogen receptor status (OR: 0.530, 95% CI: 0.304-0.925; P = 0.025) were independent predictors of ALN pCR. The nomogram was constructed based on the result of multivariate analysis. In the internal validation of performance of nomogram, the AUCs for the training and test sets were 0.719 and 0.753, respectively. The nomogram was validated in external cohorts with AUCs of 0.720, which demonstrated good discriminatory power in these data sets.Conclusion:We developed a nomogram to predict the likelihood of axillary pCR in node-positive breast cancer patients after NAC. The predictive model performed well in multicenter prospective external validation. This practical tool could provide information to surgeons regarding whether to perform additional ALN dissection after NAC.Trial registration:ChiCTR.org.cn, ChiCTR1800014968.

简介：瞄准：检验矩阵metalloproteinase-2(MMP-2)在胃的癌症纸巾并且到的表示与淋巴节点评估它的关系微转移。方法：作者从30学习了850淋巴结resected与淋巴腺切除术经历了胃切除术用的有胃的癌的病人颠倒抄写聚合酶链反应(RT-PCR)试金除了他染色。肿瘤纸巾的MMP-2表示被免疫检测组织化学的技术(EliVision加)。结果：MMP-2表示在21是积极的(70%)在9的盒子和negative(30%)盒子。没有重要关联在象年龄，性，肿瘤地点，肿瘤直径，Lauren分类和淋巴的侵略那样的MMP-2表示和另外的变量之间被发现。相反，MMP-2表示与肿瘤渗入的深度显著地相关(P=0.022)，淋巴节点转移(P=0.030)并且肿瘤区别(P=0.043)。淋巴节点微转移在77被检测(12.5%)14的淋巴节点(46.7%)胃的癌病人。MMP-2表示在12是积极的(85.7%)有淋巴节点的14个病人微转移，并且在9(56.3%)没有淋巴节点的16个病人微转移(P=0.118)。结论：我们的结果证明那MMP-2表情与肿瘤侵略，肿瘤区别和淋巴节点转移有重要关联。MMP-2表示可以是一个重要生物特征和胃的癌的重要预示的参数。我们也断定MMP-2可以参予淋巴节点的发展胃的癌的微转移。进一步的调查被需要得出一个结论。

简介：AIM:Tostudyhowlymphnodemetastasis(LNM)riskisstratifiedinundifferentiated-typeearlygastriccancer(undiff-EGC)dependentoncombinationsofriskfactors.METHODS:Fivehundredandsixty-sevencaseswithundiff-EGCundergoinggastrectomywithlymphadenectomywereexaminedretrospectively.Usingclinicopathologicalfactorsofpatientage,location,size,anendoscopicmacroscopictumorform,ulceration,depth,histology,lymphaticinvolvement(LI)andvenousinvolvement(VI),LNMriskwasexaminedandstratifiedbyconventionalstatisticalanalysisanddatamininganalysis.RESULTS:LNMwaspositivein44of567cases(7.8%).Univariateanalysisrevealed>2cm,protrusion,submucosal(sm),mixedtype,LIandVIassignificantprognosticfactorsand>2cmandLI-positivewereindependentfactorsbymultivariateanalysis.InpreoperativelyevaluablefactorsexcludingLVI,smand>2cmwereindependentfactors.Accordingtothedepthandsize,caseswerecategorizedintothelow-riskgroup[mand≤2cm,0%(LNMincidence)],themoderateriskgroup(mand>2cm,5.6%;andsmand≤2cm,6.0%),andthehigh-riskgroup(smand>2cm,19.3%).Ontheotherhand,LNMoccurredin1.4%inallLI-negativecases,greatlylowerthan28.2%inallLI-positivecases,andLNMincidencewaslowinLInegativecaseseveninthemoderate-andhigh-riskgroups.CONCLUSION:LNM-relatedfactorsinundiff-EGCweredepthandsizepreoperativelywhilethosewereLIandsizepostoperatively.Amongthesefactors,LIwasthemostsignificantlycorrelatedfactor.

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简介：Objective:Toinvestigatethefeaturesofthepreoperativeclinicopathologiccharacteristicsincorrelationwithlymphnodemetastasis.Methods:Thepreoperativeclinicopathologiccharacteristicsandlymphnodemetastasisof265patientswithearlygastriccarcinomawereanalyzedretrospectively.Results:Thethreeclinicopathologiccharacteristics,maximumcancerdiameter>2cmunderendoscope,poordifferentiationandexcavatedtypeweresignificanthighriskindependentpreoperativeclinicopathologiccharacteristics(P<0.05).Thepatientswhohadnoneofthethreepreoperativeclinicopathologiccharacteristicshadnolymphnodemetastasis,while27.27%ofthepatientswhohadallthethreepreoperativeclinicopathologiccharacteristicshadN2lymphnodemetastasis.Conclusion:Thethreepreoperativeclinicopathologiccharacteristics,maximumcancerdiameterunderendoscope,celldifferentiationandgrosstypewereveryusefultoevaluatetheextentoflymphnodemetastasis.

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简介：AbstractBackground:Breast cancer patients with ipsilateral supraclavicular lymph node metastasis (ISLNM) but without distant metastasis are considered to have a poor prognosis. This study aimed to develop a nomogram to predict the overall survival (OS) of breast cancer patients with ISLNM but without distant metastasis.Methods:Medical records of breast cancer patients who received surgical treatment at the Affiliated Cancer Hospital of Zhengzhou University, Jiyuan People’s Hospital and Huaxian People’s Hospital between December 21, 2012 and June 30, 2020 were reviewed retrospectively. Overall, 345 patients with pathologically confirmed ISLNM and without evidence of distant metastasis were identified. They were further randomized 2:1 and divided into training (n = 231) and validation (n = 114) cohorts. A nomogram to predict the probability of OS was constructed based on clinicopathologic variables identified by the univariable and multivariable analyses. The predictive accuracy and discriminative ability were measured by calibration plots, concordance index (C-index), and risk group stratification.Results:Univariable analysis showed that estrogen receptor-positive (ER+), progesterone receptor-positive (PR+), human epidermal growth factor receptor 2-positive (HER2+) with Herceptin treatment, and a low axillary lymph node ratio (ALNR) were prognostic factors for better OS. PR+, HER2+ with Herceptin treatment, and a low ALNR remained independent prognostic factors for better OS on multivariable analysis. These variables were incorporated into a nomogram to predict the 1-, 3-, and 5-year OS of breast cancer patients with ISLNM. The C-indexes of the nomogram were 0.737 (95% confidence interval [CI]: 0.660-0.813) and 0.759 (95% CI: 0.636-0.881) for the training and the validation cohorts, respectively. The calibration plots presented excellent agreement between the nomogram prediction and actual observation for 3 and 5 years, but not 1 year, OS in both the cohorts. The nomogram was also able to stratify patients into different risk groups.Conclusions:In this study, we established and validated a novel nomogram for predicting survival of patients with ISLNM. This nomogram may, to some extent, allow clinicians to more accurately estimate prognosis and to make personalized therapeutic decisions for individual patients with ISLNM.

简介：AbstractObjective:To investigate the risk factors for lateral lymph node metastasis (LLNM) in papillary thyroid carcinoma (PTC).Methods:A retrospective analysis of 209 patients with PTC who underwent primary surgery at the Beijing Friendship Hospital affiliated with Capital Medical University from November 2014 to November 2018 was performed. The patients were divided into the LLNM group and the non-LLNM group. The clinical and pathological characteristics of the patients were analysed. The risk factors for LLNM were analysed by univariate and multivariate analyses.Results:The incidence of LLNM was 13.4% in PTC patients. Univariate analysis showed that the maximum diameter of the primary tumour > 2 cm (P < 0.001), bilateral primary tumour (P= 0.020), extrathyroidal extension (ETE) (P < 0.001), central lymph node metastasis (CLNM) (P < 0.001), and CLNM number ≥ 5 (P < 0.001) were significantly associated with LLNM. Multivariate logistic regression analysis showed that the maximum diameter of the primary tumour > 2 cm, ETE, and CLNM were independent risk factors for LLNM (OR values were 3.880, 5.202, and 4.474, respectively). There were 6 patients with skip lateral cervical lymph node metastasis, accounting for 21% of all LLNM patients.Conclusion:This study revealed several independent risk factors for predicting LLNM in PTC patients, such as the maximum diameter of the primary tumour > 2 cm, ETE and CLNM. Lateral neck dissection may be recommended in PTC patients with those risk factors. Paying attention to the occurrence of skip lateral cervical lymph node metastasis during the clinical diagnosis and treatment processes is necessary.

简介：AbstractBackground:Methylene blue is the most commonly used tracer for sentinel lymph node (SLN) biopsy (SLNB) in China. This study aimed to investigate the feasibility of clinical application of SLNB using methylene blue dye (MBD) for early breast cancer and the prognosis of patients with different SLN and non-SLN statuses.Methods:We retrospectively analyzed the clinicopathological data of patients with early breast cancer treated at the Peking University First Hospital between 2013 and 2018. We calculated the SLN identification rate (IR) in SLNB with MBD and the false-negative rate (FNR), and analyzed the prognosis of patients with different SLN and non-SLN statuses using Kaplan-Meier curves.Results:Between January 2013 and December 2018, 1603 patients with early breast cancer underwent SLNB with MBD. The SLN IR was 95.8% (1536/1603). Two SLNs (median) were detected per patient. There were significant differences in FNR between patients with SLN micrometastasis and macrometastasis (19.0% vs. 4.5%, χ2 = 12.771, P < 0.001). Chi-square test showed that there were significant differences in SLN successful detection rates among patients with different vascular tumor embolism status (96.3% vs. 90.8%, χ2 = 9.013, P = 0.003) and tumor (T) stages (96.6% vs. 94.1%, χ2 = 5.189, P = 0.023). Multivariate analysis showed that vascular tumor embolism was the only independent factor for SLN successful detection (odds ratio: 0.440, 95% confidence interval: 0.224-0.862, P = 0.017). Survival analysis showed a significant difference in disease-free survival (DFS) between patients with non-SLN metastasis and patients without non-SLN metastasis (P = 0.006).Conclusion:Our single-center data show that, as a commonly used tracer in SLNB in China, MBD has an acceptable SLN IR and a low FNR in frozen sections. This finding is consistent with reports of dual tracer-guided SLNB. Positive SLNs with non-SLN metastasis are associated with DFS.

简介：雷文东，张汝刚，阎水忠，王秀琴，牟巨伟，张大为，吴Ｎｍ２３ＧＥＮＥＥＸＰＲＥＳＳＩＯＮＡＮＤＩＴＳＣＯＲＲＥＬＡＴＩＯＮＷＩＴＨＬＹＭＰＨＮＯＤＥＭＥＴＡＳＴＡＳＩＳＩＮＨＵＭＡＮＬＵＮＧＣＡＮＣＥＲ￥ＬｅｉＷｅｎｄｏｎｇ；ＺｈａｎｇＲｏｕｇｉｎｇ；...

简介：Objective:ThepurposesofthisstudyweretoidentifyriskfactorsforcervicallymphnodemetastasisandtoexaminetheassociationbetweenBRAFV600Estatusandclinicalfeaturesinpapillarythyroidmicrocarcinoma(PTMC).Methods:Atotalof1,587patientswithPTMC,treatedinTianjinMedicalUniversityCancerInstituteandHospitalfromJanuary2011toMarch2013,underwentretrospectiveanalysis.Wereviewedandanalyzedfactorsincludingclinicalresults,pathologyrecords,ultrasoundresults,andBRAFV600Estatus.Results:Multivariatelogisticregressionanalysesdemonstratedthatgender(male)[oddsratio(OR)=1.845,P=0.000],age(<45years)(OR=1.606,P=0.000),tumorsize(>6mm)(OR=2.137,P=0.000),bilateralism(OR=2.011,P=0.000)andextrathyroidalextension(OR=1.555,P=0.001)servedasindependentpredictorsofcentrallymphnodemetastasis(CLNM).Moreover,CLNM(OR=29.354,P=0.000)servedasanindependentpredictoroflaterallymphnodemetastasis(LLNM).Amongpatientswithasolitaryprimarytumor,thosewithtumorlocationinthelowerthirdofthethyroidlobeortheisthmusweremorelikelytoexperienceCLNM(P<0.05).UnivariateanalysesindicatedthatCLNM,LLNM,extrathyroidalextension,andmultifocalitywerenotsignificantlyassociatedwithBRAFV600Emutation.Conclusions:ThepresentstudysuggestedthatprophylacticneckdissectionofthecentralcompartmentshouldbeconsideredinpatientswithPTMC,particularlyinmenwithtumorsizegreaterthan6mm,agelessthan45years,extrathyroidalextension,andtumorbilaterality.AmongpatientswithPTMC,BRAFV600Emutationisnotsignificantlyassociatedwithprognosticfactors.ForabetterunderstandingofsurgicalmanagementofPTMCandtheriskfactors,werecommendmulticenterresearchandlong-termfollow-up.

简介：AbstractBackground:Previous studies have revealed that diabetes mellitus (DM) promotes disease progress of gastric cancer (GC). This study aimed to further investigating whether DM advanced lymph nodes (LNs) metastasis in GC.Methods:The clinicopathologic data of GC patients with >15 examined LN (ELN) between October 2004 and December 2019 from a prospectively maintained database were included. The observational outcomes included the number (N3b status) and anatomical distribution (N3 stations) of metastatic LN (MLN).Results:A total of 2142 eligible patients were included in the study between October 2004 and December 2019. N3 stations metastasis (26.8% in DM vs. 19.3% in non-DM, P = 0.026) and N3b status (18.8% in DM vs. 12.8% in non-DM, P = 0.039) were more advanced in the DM group, and multivariate logistic regression analyses confirmed that DM was an independent factor of developing N3 stations metastasis (odds ratio [OR] = 1.771, P= 0.011) and N3b status (OR= 1.752, P= 0.028). Also, multivariate analyses determined DM was independently associated with more MLN (β = 1.424, P = 0.047). The preponderance of N3 stations metastasis (DM vs. non-DM, T1-2: 2.2% vs. 4.9%, T3: 29.0% vs. 20.3%, T4a: 38.9% vs. 25.8%, T4b: 50.0% vs. 36.6%; ELN16-29: 8.6% vs. 10.4%, ELN30-44: 27.9% vs. 20.5%, ELN ≥ 45: 37.7% vs. 25.3%), N3b status (DM vs. non-DM, T1-2: 0% vs. 1.7%, T3: 16.1% vs. 5.1%, T4a: 27.8% vs. 19.1%, T4b: 44.0% vs. 28.0%; ELN16-29: 8.6% vs. 7.9%, ELN30-44: 18.0% vs. 11.8%, ELN ≥ 45: 26.4% vs. 17.3%), and the number of MLN (DM vs. non-DM, T1-2: 0.4 vs. 1.1, T3: 8.6 vs. 5.2, T4a: 9.7 vs. 8.6, T4b: 17.0 vs. 12.8; ELN16-29: 3.6 vs. 4.6, ELN30-44: 5.8 vs. 5.5, ELN ≥ 45: 12.0 vs. 7.7) of DM group increased with the advancement of primary tumor depth stage and raising of ELN.Conclusions:DM was an independent risk factor for promoting LN metastasis. The preponderance of LN involvement in the DM group was aggravated with the advancement of tumor depth.

简介：Objective:Tocreateanomogramtopredicttheincidenceoflymphnodemetastasis(LNM)inearlygastriccancer(EGC)patientsandtoexternallyvalidatethenomogram.Methods:Toconstructthenomogram,weretrospectivelyanalyzedaprimarycohortof272EGCpatients.Univariateanalysisandabinarylogisticregressionwereperformed.AnomogrampredictingtheincidenceofLNMinEGCpatientswascreated.Thediscriminationabilityofthenomogramwasmeasuredusingtheconcordanceindex(c-index),andthenomogramwasalsocalibrated.Then,anotherprospectivecohortof81patientswasanalyzedtovalidatethenomogram.Results:Intheprimarycohort,LNMwaspathologicallyconfirmedin37(13.6%)patients.Inmultivariateanalysis,thepresenceofanulcer,themaximumlesiondiameterobservedviagastroscopy,thethicknessofthelesionobservedviaendoscopicultrasonography,andthepresenceofenlargedlymphnodesoncomputedtomography(CT)wereindependentriskfactorsforLNM.Anomogramwasthencreatedbasedontheregressionmodelwiththec-indexof0.905,andthecalibrationcurveofthenomogramfellapproximatelyontheideal45-degreeline.Thecut-offscoreofthenomogramwas110,andthesensitivity,specificity,positivepredictiveandnegativepredictivevaluesofthenomogramintheprimarycohortwere81.1%,86.0%,47.6%and96.7%,respectively,andintheprospectivevalidationcohortwere75.0%,91.0%,60.0%and95.5%,respectively.Thecalibrationcurveoftheexternalvalidationcohortwasalmostonthe45-degreeline.Conclusions:WedevelopedaneffectivenomogrampredictingtheincidenceofLNMforEGCpatients.

简介：Objective:TheUnionforInternationalCancerControl(UICC)Node(N)classificationisthemostcommonusedstagingmethodfortheprognosisofgastriccancer.Itdemandsadequate,atleast16lymphnodes(LNs)tobedissected;thereforedifferentstagingsystemswereinvented.Methods:BetweenMarch2005andMarch2010,164patientswereevaluatedattheDepartmentofGeneralSurgeryintheKenézyGyulaHospitalandattheDepartmentofGeneral,ThoracicandVascularSurgeryintheKaposiMórHospital.The6th,7thand8thUICCN-stagingsystems,thenumberofexaminedLNs,thenumberofharvestednegativeLNs,themetastaticlymphnoderatio(MLR)andthelogoddsofpositiveLNs(LODDS)weredeterminedtomeasuretheir5-yearsurvivalratesandtocomparethemtoeachother.Results:Theoverall5-yearsurvivalrateforallpatientswas55.5%withamedianoverallsurvivaltimeof102months.Thetumorstage,gender,UICCN-stages,MLRandtheLODDSweresignificantprognosticfactorsforthe5-yearsurvivalwithunivariateanalysis.The6thUICCN-stagedidnotfollowtheadequateriskincomparingN2vs.N0andN3vs.N0withmultivariateinvestigation.ComparisonofperformancesoftheresidualNclassificationsprovedthattheLODDSsystemwasfirstinthepredictionofprognosisduringtheevaluationofallpatientsandincaseswithlessthan16harvestedLNs.TheMLRgavethebestprognosticpredictionwhenadequate(morethanorequalto16)lymphadenectomywasperformed.Conclusions:WesuggesttheapplicationofLODDSsystemroutinelyinwesternpatientsandtheusageofMLRclassificationincaseswithextendedlymphadenectomy.

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简介：为排干肿瘤的淋巴的刺激发现一个可行方法为在诊所的使用作准备的节点(TDLN)房间，TDLN房间的CTL活动由不同刺激导致了(IL-2独自一个，IL-2+自体同源的肿瘤抗原(atAg)，IL-2+GM-CSF+IL-4+atAg)被最大的LDH测量酶版本。机制被形态学和CD83+TDLN房间的察觉的观察探索。由IL-2+GM-CSF+IL-4+atAg的TDLN房间的扩大由独自一个的IL-2或IL-2+atAg比那显著地高(p<0.01)。IL-2+GM-CSF+IL-4+atAg导致的TDLN房间的AntitumorCTL活动比另外的组的那些显著地高。在与IL-2+GM-CSF+IL-4+atAg对待的TDLN人口以内的CD83+房间的数字显著地被提高。由IL-2+GM-CSF+IL-4+atAg刺激TDLN房间的方法比有IL-2或IL-2+atAg的刺激好。IL-2+GM-CSF+IL-4+atAg导致的TDLN房间生产了更树枝状的房间(DC)。在我们的学习，我们建立了T房间和DC一起被刺激的一个系统前vivo，它是容易的进行并且生产有希望的结果。它为改进可能在临床的癌症治疗被使用的TDLN房间antitumor活动提供了一个新方法。