Objective To investigate the accuracy of preoperative high-resolution magnetic resonance imaging (MRI) scans to predict tumor stage, lymph node stage, and circumferential resection margin (CRM) involvement. Methods Between September 2006 and May 2009, 42 patients with histologically proven rectal cancer by the colonoscopic biopsy in Peking Union Medical College Hospital were staged preoperatively using MRI. All of the patients underwent total mesorectum excision (TME) operation within 1 week after MRI examination. The specimens were reported according to the 2002 TNM staging system for primary colorectal cancer of the American Joint Committee on Cancer (AJCC). Concordance between radiologic staging of tumor, local lymph node, and CRM involvement and pathologic reporting was assessed by means of the Kappa statistic.Results For all of 42 patients, MRI correctly staged the tumor in 36 patients, understaged in 3 patients and overstaged in 3 patients. Statistically, there was a better correlation between pathologic and radiologic tumor staging (Kappa=0.731, P=0.000). MRI correctly staged lymph node status in 31 patients, understaged in 5 patients and overstaged in 6 patients. Statistically, there was a common correlation between pathologic and radiologic lymph node staging (Kappa=0.410, P=0.009). MRI correctly reported the status of the CRM in 40 patients. Statistically, there was the best correlation between pathologic and radiologic reporting of CRM involvement (Kappa=0.829, P=0.000). Conclusion Preoperative highresolution MRI scans has a good concordance with pathologic tumor stage but common with pathologic lymph node stage. Preoperative highresolution MRI can provide reliable information about CRM and thus help to choose which patient could benefit from the preoperative neoadjuvant therapy.
In this report, 1175 cases of resected gastric cancer were staged, followed up and statistincally calculated by using the international unifying new TNM staging system for gastric cancer. The prognostic value of the TNM staging system was also tested with relevant statistics. The results showed that:(1)the 5-year survival rates of Ⅰa、Ⅰb、Ⅱ、Ⅲa、Ⅲb and Ⅳ were 100%,84%,65%,43%,25% and 13% respectively; (2)The 5-year survival rates of the subgroups withing same stage were quite; (3)the analysys of correlation and regression between the new staging and the prognosis provided that correlation coefficient r equals to -0.990(Ｐ＜0.005), and regression coefficient b equals to -0.1345(Ｐ＜0.005). These results indicate that there is statistical identity beween the new TNM staging for gastric cancer and the prognosis, and certify the rationality for the new staging in application and its accuracy to reflect the prognosis.
ObjectiveTo detect the expression of Prox1 (prospero-related homeobox 1) gene in primary hepatocellular carcinoma (HCC), and to analyze the correlation of Prox1 gene expression with pathological grade and clinical stage of HCC. MethodsThe expressions of Prox1 gene in carcinoma tissues and adjacent cancerous tissues in HCC as well as normal liver tissues were detected by semi-quantitative RT-PCR, then the correlation of Prox1 gene expression with HCC pathological grade and clinical stage were analyzed. ResultsThe expression of Prox1 gene in carcinoma tissues (0.243±0.102) and adjacent cancerous liver tissues (0.537±0.235) was significantly lower than that in normal liver tissue (0.812±0.372), respectively （ Plt;0.01 or Plt;0.05）. Furthermore, the expression of Prox1 gene in carcinoma tissues was significantly lower than that adjacent cancerous liver tissues (Plt;0.05). The expressions of Prox1 gene in different pathological grade (F=97.950, Plt;0.001) and clinical stage were significantly different (F=228.300, Plt;0.001), and when compared with each other, the differences of pathological grade and clinical stage were also significant (Plt;0.001 or Plt;0.01). The expressions of Prox1 gene in HCC carcinoma tissue were negatively correlated with pathological grade (r=-0.930, Plt;0.01) and clinical stage (r=-0.980, Plt;0.01) of HCC. ConclusionsExpression of Prox1 gene may be related to the initiation and development of HCC, however, that whether Prox1 gene functions as tumor suppressor in HCC needs further investigation.
Objective To analyze the relationship between age and prognosis of colorectal patients in the database from colorectal cancer (DACCA). Methods The DACCA version selected for this data analysis was updated on January 5, 2022. The data items analyzed included age, sex, tumor site, tumor pathological nature, obstruction, pathological TNM (pTNM) stage, positive lymph node ratio, survival status and survival time. According to China’s age segmentation standard, the included data were grouped into younger group (<35 years old), middle-aged group (35–59 years old) and elderly group (>59 years old). Overall survival (OS) and disease specific survival (DFS) were analyzed in three age group, and OS and DSS in three age group were analyzed in pTNM stage stratification. Results Three thousand six hundred and twenty-five rows of data were obtained from DACCA database according to the screening conditions. The survival analysis results of different age groups show that: The middle-aged group had better OS compared with the elderly group at 1-year (97.4% vs. 96.0%, P=0.037), 3-year (90.9% vs. 88.0%, P=0.030) and 5-year (81.7% vs. 75.7%, P=0.002). Also, the middle-age group had better 5-year DSS (82.2% vs. 77.7%, P=0.020). There was no statistical difference in survival between the younger group and the elderly group (P>0.05). The survival analysis results of different age groups in each pTNM stage show that: ① The middle-aged group had better medium-term and long-term OS than the elderly group. In the pTNM Ⅰ stage, the 3- and 5-year OS in the middle-aged group were better than those in the elderly group (100% vs. 93.4%, P=0.004; 100% vs. 91.4%, P=0.005). In the pTNM Ⅱ stage, the 5- and 10-year OS in the middle-aged group were better than those in the elderly group (96.5% vs. 91.3%, P=0.018; 88.2% vs. 54.3%, P<0.001). In pTNM Ⅲ stage, 10-year OS in the middle-aged group was better than that in the elderly group (36.5% vs. 36.0%, P<0.001). In pTNM Ⅳ stage, the 5- and 10- year of OS in the middle-aged group were better than those in the elderly group (67.7% vs. 58.4%, P=0.016; 19.1% vs. 7.2%, P=0.049). ② The middle-aged group had better medium-term and long-term DSS than the elderly group. In the pTNM Ⅰ stage, the 3- and 5- year DSS in the middle-aged group wrer better compared to the elderly group (100% vs. 96.9%, P=0.047; 100% vs. 94.9%, P=0.049). In the pTNM Ⅱ stage, the 10-year DSS in the middle-aged group outperformed that in the elderly group (88.2% vs. 61.9%, P=0.002). In the pTNM Ⅳ stage, the 5- and 10-year DSS in the middle-aged group were better than the elderly group (68.3% vs. 59.1%, P=0.020; 20.9% vs. 7.7%, P=0.040). ③ Except pTNM I stage, there was no significant difference in survival of other pTNM stages between young group and old group (P>0.05). In the pTNM Ⅰ stage, 3- and 5- year OS were better in the younger group compared with the elderly group (100% vs. 93.4%, P=0.004; 100% vs. 91.4%, P=0.005), and better 3- and 5- year DSS in the younger group (100% vs. 96.9%, P=0.047; 100% vs. 94.9%, P=0.049). Conclusions The age of colorectal cancer patients may have an impact on long-term survival. Middle-aged patients have better prognosis compared with elderly patients, and the younger group patients have better prognosis in pTNM stage Ⅰ only.
The International Association for the Study of Lung Cancer (IASLC) recently introduced the ninth edition of the TNM classification for lung cancer. This milestone is supported by a comprehensive database comprising 124 581 lung cancer patients from 75 centers across 25 nations between 2011 and 2019. Following the exclusion of incomplete data, the analysis focused on 87 043 patients. These insights guided the modifications in the ninth edition of the TNM classification for lung cancer. The updated classification now includes a higher representation of Asian patients, particularly showing significant growth among Chinese patients. This revised classification will offer more pertinent benchmarks for the diagnosis and prognostic assessment of lung cancer. This article delves into the database updates, stage adjustments, and rationale behind the IASLC ninth edition of the TNM classification for lung cancer.
【Abstract】Objective To evaluate the value of pTNM classification in predicting the prognosis of hepatic cell carcinoma after liver transplantation. Methods Fifty-nine HCC cases undergoing liver transplantation between April 1993 and January 2003 were retrospectively reviewed. Fiftynine cases were staged by using the pTNM classification. Results The 1-year survival rates were 66.67%, 66.67%, 40.91% and 31.75% for Ⅰ，Ⅱ，Ⅲa and Ⅳa stages，2-year survival rates were 66.67%, 66.67%, 21.29% and 31.75%, the difference was not statistically significant. Conclusion The pTNM classification is not good enough to predict the prognosis of hepatic cell carcinoma after liver transplantation.
ObjectiveTo quantitate expression of microRNA-21 (miRNA-21) in gastric cancer of different tumor stages and discuss its clinical value. Method The relative expressions of miRNA-21 were quantitated in the cancer tissues, corresponding normal gastric tissues adjacent to gastric cancer, and serums of 50 gastric cancer patients received opera-tion and confirmed gastric cancer by pathology and the serums of nongastric cancer patients in Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine and its Chongming Branch from January 2015 to January 2016 by real time quantitative PCR.
ResultsThe relative expression level of miRNA-21 in the gastric cancer tissues was significantly higher than that in the normal gastric tissues adjacent to gastric cancer. Among the TNM stageⅠ, Ⅱ, Ⅲ of gastric cancer patients, the relative expression levels of miRNA-21 in the cancer tissues were 2.17 (1.48-2.90), 4.08 (2.30-4.86), 8.64 (5.82-18.20), respectively and the differences among these three stages were statistically significant (P<0.05). The relative expression level of the serum miRNA-21 in the gastric cancer patients was significantly higher than that in the nongastric cancer patients, which in the serums for stageⅠ, Ⅱ, and Ⅲpatients were 31.00 (24.60-37.15), 39.10 (28.90-39.80), 44.15 (38.95-56.68), respectively and the differences among three stages were statistically significant (P<0.05). The relative expression level of miRNA-21 in the serums and cancer tissues had a positive correlation (r=0.86, P<0.05).
ConclusionMiRNA-21 appears to have a potential association with TNM stage of gastric cancer, which cautiously suggests that it might be a potential indicator for prediction of preoperative TNM stage of gastric cancer.
ObjectiveTo explore the evaluation value of preoperative multislice spiral computed tomography angiography (MSCTA) for normative radical gastrectomy. MethodsThe anatomic distributions of celiac trunk and its three branches and their tributaries (common hepatic artery, right hepatic artery, left hepatic artery, splenic artery, and left gastric artery) of 86 patients with gastric cancer were comprehended by preoperative MSCTA, which were verified during the surgery. Simultaneously preoperative TNM staging was evaluated by MSCTA, which compared with postoperative pathological results. ResultsThe accuracy rate of preoperative MSCTA evaluating the distribution of celiac trunk and its three branches and their tributaries was 100%. Abnormal hepatic arteries were found in 22 cases by MSCTA, the mutation rate was 25.58%. Abnormal right hepatic arteries were found in 11 cases (12.79%), abnormal left hepatic arteries in 7 cases (8.14%), both abnormal right and left hepatic arteries in 1 case (1.16%), and abnormal common hepatic arteries in 3 cases (3.49%). Straight splenic arteries were found in 24 cases (27.91%), slightly curved splenic arteries in 44 cases (51.16%), and significantly curved splenic arteries in 18 cases (20.93%). Compared with postoperative pathological results, the accuracy rates of preoperative MSCTA evaluating gastric cancer T, N, and M staging were 75.58%（65/86）, 74.42%(64/86), and 91.86%(79/86), respectively. ConclusionsPreoperative MSCTA is an objective way to assess the distributions of celiac artery trunk and related tributaries of patients with gastric cancer. Also, it is an accurate method to evaluate the preoperative TNM stage of gastric cancer, which can help to make an individual operative plan and avoid the intraoperative injury of the artery.
