Clinicopathologic features

临床病理特征
  • 文章类型: Journal Article
    背景:在三阴性乳腺癌(TNBC)中,间质瘤浸润淋巴细胞(sTIL)水平升高与治疗结果和预后相关。本研究旨在探讨TNBC的临床病理和超声特征与sTILs水平的关系。
    方法:本研究包括侵袭性TNBC患者手术切除后对sTILs的术后评估。肿瘤形状,margin,定位,回声模式,后部特征,钙化,和血管分布进行回顾性评估。患者分为高sTIL(≥20%)和低sTIL(<20%)水平组。卡方或Fisher精确检验用于评估临床病理和超声特征与sTILs水平的关联。
    结果:171例患者(平均±SD年龄,54.7±10.3年[范围,22-87年])包括低sTIL水平的58.5%(100/171)和高sTIL水平的41.5%(71/171)。高sTILs水平的TNBC肿瘤更有可能是非特殊类型的浸润性癌(p=0.008)。组织学分级较高(p=0.029),较高的Ki-67增殖率(均p<0.05),以及相关DCIS分量的较低频率(p=0.026)。此外,高sTIL水平的TNBC肿瘤更可能是椭圆形或圆形(p=0.001),平行取向(p=0.011),外接或微分叶边缘(p<0.001),复杂的囊性和实性回声模式(p=0.001),后增强(p=0.002),并且不太可能具有异质模式(p=0.001)并且没有后验特征(p=0.002)。
    结论:这项初步研究表明,术前超声特征有助于区分TNBC患者的高sTILs和低sTILs。
    BACKGROUND: Increased level of stromal tumor-infiltrating lymphocytes (sTILs) are associated with therapeutic outcomes and prognosis in triple-negative breast cancer (TNBC). This study aimed to investigate the associations of clinicopathologic and sonographic features with sTILs level in TNBC.
    METHODS: This study included invasive TNBC patients with postoperative evaluation of sTILs after surgical resection. Tumor shape, margin, orientation, echo pattern, posterior features, calcification, and vascularity were retrospectively evaluated. The patients were categorized into high-sTILs (≥ 20%) and low-sTILs (< 20%) level groups. Chi-square or Fisher\'s exact tests were used to assess the association of clinicopathologic and sonographic features with sTILs level.
    RESULTS: The 171 patients (mean ± SD age, 54.7 ± 10.3 years [range, 22‒87 years]) included 58.5% (100/171) with low-sTILs level and 41.5% (71/171) with high-sTILs level. The TNBC tumors with high-sTILs level were more likely to be no special type invasive carcinoma (p = 0.008), higher histologic grade (p = 0.029), higher Ki-67 proliferation rate (all p < 0.05), and lower frequency of associated DCIS component (p = 0.026). In addition, the TNBC tumors with high-sTILs level were more likely to be an oval or round shape (p = 0.001), parallel orientation (p = 0.011), circumscribed or micro-lobulated margins (p < 0.001), complex cystic and solid echo patterns (p = 0.001), posterior enhancement (p = 0.002), and less likely to have a heterogeneous pattern (p = 0.001) and no posterior features (p = 0.002).
    CONCLUSIONS: This preliminary study showed that preoperative sonographic characteristics could be helpful in distinguishing high-sTILs from low-sTILs in TNBC patients.
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  • 文章类型: Journal Article
    背景:采用Meta分析探讨信使核糖核酸(mRNA)表达与乳腺癌临床病理特征的相关性。
    方法:英文数据库,PubMed,WebofScience,Embase,和Cochrane图书馆,等。,是用电脑搜索的.检索的时间范围设置为从数据库建立到2023年12月。搜索词设置为“mRNA”,“乳腺癌”,“病理学”,“临床病理特征”,等。筛选符合纳入和排除标准的文献,并提取数据供Revman5.3分析。
    结果:最后,选择5篇合适的纳入文献,包括969名患者。分析结果发现mRNA表达与BC分级之间存在显着关联(OR=0.11,95%CI=0.04-0.30,Z=4.26,P<0.0001);mRNA表达与BC分期之间存在显着相关性(OR=0.19,95%CI=0.05-0.65,Z=2.65,P=0.008<0.05);在BC患者中,mRNA表达与月经状态之间没有相关性(OR=0.48%CI=0.88,在讨论部分,这项研究,包括10项研究,目的探讨信使核糖核酸与BC临床病理特征的相关性。BC的分期和分级,与肿瘤大小有一定的相关性,与BC患者的月经状况无相关性。
    BACKGROUND: Meta analysis was adopted to investigate the correlation between messenger ribonucleic acid (mRNA) expression and clinicopathological features of breast cancer (BC).
    METHODS: English databases, PubMed, Web of Science, Embase, and The Cochrane Library, etc., were searched using a computer. The time range of retrieval was set to be from the establishment of the database to December 2023. The search terms were set as \"mRNA\", \"Breast cancer\", \"Pathology\", \"Clinicopathological characteristics\", etc. The literatures were screened in line with the inclusion and exclusion criteria, and the data was extracted for analysis by Revman5.3.
    RESULTS: Finally, 5 suitable included literatures were selected, including 969 patients. The analysis results were found to reveal a significant association between mRNA expression and BC grading (OR = 0.11, 95% CI = 0.04-0.30, Z = 4.26, P<0.0001); a significant correlation was observed between mRNA expression and BC staging (OR = 0.19, 95% CI = 0.05-0.65, Z = 2.65, P = 0.008<0.05); no correlation was found between mRNA expression and menstrual status of BC patients (OR = 0.63, 95% CI = 0.22-1.78, Z = 0.88, P = 0.38>0.05); a correlation was identified between mRNA expression and tumor size in BC (OR = 0.48, 95% CI = 0.24-0.99, Z = 2.00, P = 0.05). In the Discussion section, this study, comprising 10 research studies, aimed to explore the correlation between messenger ribonucleic acid and the clinical pathological features of BC. staging and grading of BC, a certain correlation with tumor size, and no correlation with the menstrual status of BC patients.
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  • 文章类型: Journal Article
    背景:本研究的目的是探讨脂质代谢生物标志物与胃癌的相关性。
    方法:1120名胃癌患者和1134名健康体检者参加了这项研究。临床数据和血脂水平,包括总胆固醇(TC),甘油三酯(TG),低密度脂蛋白胆固醇(LDL-C)和高密度脂蛋白胆固醇(HDL-C),被收集。
    结果:胃癌患者血清TG和LDL-C水平高于对照组。HDL-C水平低于对照组(P<0.05)。HDL-C和LDL-C与胃癌风险显著相关。专注于临床病理特征,TG升高在远端胃癌男性患者中更为常见,N0期和早期TNM期。在T早期,TC增加更频繁,N和TNM阶段。HDL-C降低在远端和低分化胃癌中更为常见。LDL-C升高在远端胃癌和早期T期更为常见。
    结论:胃癌患者的血脂水平高于健康对照组。HDL-C和LDL-C异常与胃癌风险相关。然而,随着胃癌的进展,患者摄入量差,肿瘤消耗增加,营养状况持续下降,进展期胃癌患者血清TC和TG水平逐渐降低。
    BACKGROUND: The aim of this study was to explore the correlation between biomarkers of lipid metabolism and gastric cancer.
    METHODS: 1120 gastric cancer patients and 1134 health examiners enrolled in this study. The clinic data and serum lipid level, including Total cholesterol (TC), Triglyceride (TG), Low-density lipoprotein cholesterol (LDL-C) and High-density lipoprotein cholesterol (HDL-C), were collected.
    RESULTS: Serum TG and LDL-C levels in patients with gastric cancer were higher than those in the control group. HDL-C levels were lower than the control group (P < 0.05). HDL-C and LDL-C were significantly correlated with the risk of gastric cancer. Concentrating on clinicopathological features, increased TG was more frequently in male patients with distal gastric cancer, N0 stage and early TNM stage. Increased TC was more frequently in early T, N and TNM stage. Decreased HDL-C was more common in distal location and low-undifferentiated gastric cancer. LDL-C elevation was more common in distal gastric cancer and early T stage.
    CONCLUSIONS: The serum lipid level of gastric cancer patients was higher than healthy controls. HDL-C and LDL-C abnormal correlated with gastric cancer risk. However, as the progresses of gastric cancer, poor patient intake, increased tumor consumption, and continuous declining in nutritional status, the levels of TC and TG gradually decreased in advanced gastric cancer.
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  • 文章类型: Journal Article
    背景:由于胰腺未分化肉瘤样癌(USCP)的罕见性,其临床病程和手术结果仍不明确。本研究旨在描述组织学,临床病理特征,围手术期结局,23例切除的USCP患者的总生存期(OS)。
    方法:我们回顾性描述了组织学,临床病理特征,在单个机构中接受胰腺切除术并最终诊断为USCP的患者的围手术期结果和OS。
    结果:本研究共纳入23例患者。12名患者为男性,诊断时的中位年龄为61.5±13.0岁(范围:35~89岁).USCP患者没有特异性症状和特征性影像学表现。21例获得R0切除。对9例患者进行了En整块切除和肠系膜门静脉轴重建。在这项研究中,没有因围手术期并发症而死亡。对14例患者进行了术中肿瘤引流淋巴结(TDLN)清扫。1-,3、5年生存率为43.5%,在整个研究中分别为4.8%和4.8%,中位生存期为9.0个月.只有1名患者存活超过5年,并且在最后一次随访时仍然活着。远处转移的存在(p=0.004)和经病理证实的肠系膜门静脉轴浸润的存在(p=0.007)与不良OS独立相关。
    结论:USCP是一种罕见的胰腺恶性肿瘤亚组,预后不佳。由于缺乏特定的表现,通过成像诊断USCP非常困难。准确的诊断取决于病理活检,USCP的IHC谱主要表现为上皮和间充质标志物的共表达。很大一部分病人早逝,特别是对于有远处转移和病理证实的肠系膜-门轴侵犯的患者。USCPs根治性切除术后的长期生存仍然很少。
    BACKGROUND: The clinical course and surgical outcomes of undifferentiated sarcomatoid carcinoma of the pancreas (USCP) remain poorly characterized owing to its rarity. This study aimed to describe the histology, clinicopathologic features, perioperative outcomes, and overall survival (OS) of 23 resected USCP patients.
    METHODS: We retrospectively described the histology, clinicopathologic features, perioperative outcomes and OS of patients who underwent pancreatectomy with a final diagnosis of USCP in a single institution.
    RESULTS: A total of 23 patients were included in this study. Twelve patients were male, the median age at diagnosis was 61.5 ± 13.0 years (range: 35-89). Patients with USCP had no specific symptoms and characteristic imaging findings. The R0 resection was achieved in 21 cases. The En bloc resection and reconstruction of mesenteric-portal axis was undertaken in 9 patients. There were no deaths attributed to perioperative complications in this study. The intraoperative tumor-draining lymph nodes (TDLNs) dissection was undergone in 14 patients. The 1-, 3- and 5-year survival rates were 43.5%, 4.8% and 4.8% in the whole study, the median survival was 9.0 months. Only 1 patient had survived more than 5 years and was still alive at last follow-up. The presence of distant metastasis (p = 0.004) and the presence of pathologically confirmed mesenteric-portal axis invasion (p = 0.007) was independently associated with poor OS.
    CONCLUSIONS: USCP was a rare subgroup of pancreatic malignancies with a bleak prognosis. To make a diagnose of USCP by imaging was quite difficult because of the absence of specific manifestations. Accurate diagnosis depended on pathological biopsy, and the IHC profile of USCP was mainly characterized by co-expression of epithelial and mesenchymal markers. A large proportion of patients have an early demise, especially for patients with distant metastasis and pathologically confirmed mesenteric-portal axis invasion. Long-term survival after radical resection of USCPs remains rare.
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  • 文章类型: Review
    背景:脑膜瘤和颅面纤维发育不良(CFD)的共存很少。由于类似的放射学特征,将这种共存性与孤立性肥厚性脑膜瘤区分开来是具有挑战性的,导致了迅速诊断和适当干预的两难选择.
    方法:我们对2003年至2021年在北京天坛医院接受治疗的21例合并脑膜瘤和CFD患者的数据进行了回顾性回顾。我们总结了他们的临床病理特征,并进行了全面的文献综述。此外,我们测试了GNAS基因外显子8和9的特征性致病变异以及与CFD相关的刺激性G蛋白(Gαs)的相应α亚基的表达,以探索这两种疾病之间的潜在相互作用。
    结果:该队列包括4名男性和17名女性(平均年龄,45.14年)。CFD最常见的是蝶骨(n=10),脑膜瘤主要位于颅底(n=12)。对4个CFD病变和14个脑膜瘤进行了手术治疗。在14例切除的脑膜瘤中,有12例实现了辛普森I-II级切除,几乎所有脑膜瘤都被归类为WHOI级(n=13)。平均随访时间56.89个月,2例复发。在7个肿瘤标本中进行了遗传学研究,在8个样本中完成了免疫组织化学,表明尽管未检测到GNAS变体,Gαs蛋白呈不同程度的阳性表达。
    结论:我们介绍了一系列罕见的共同诊断脑膜瘤和CFD,并提供了其临床病理特征的详细描述,治疗策略和预后。尽管尚未建立明确的因果关系,不能排除这两种疾病之间可能的遗传或环境相互作用。对伴随的脑膜瘤和CFD进行及时诊断和适当治疗具有挑战性,因为其放射学表现与具有反应性增生的脑膜瘤相似。脑膜瘤和CFD的共存应采取个性化和多学科的管理策略。
    BACKGROUND: The co-existence of meningioma and craniofacial fibrous dysplasia (CFD) is rare. Due to the similar radiological characteristics, it is challenging to differentiate such co-existence from solitary hyperostotic meningioma resulting in a dilemma of prompt diagnosis and appropriate intervention.
    METHODS: We conducted a retrospective review of the data from 21 patients with concomitant meningioma and CFD who were treated at Beijing Tiantan Hospital from 2003 to 2021. We summarized their clinicopathological features and performed a comprehensive literature review. Additionally, we tested the characteristic pathogenic variants in exon 8 and 9 of GNAS gene and the expression of corresponding α-subunit of the stimulatory G protein (Gαs) related to CFD to explore the potential interactions between these two diseases.
    RESULTS: The cohort comprised 4 men and 17 women (mean age, 45.14 years). CFD most commonly involved the sphenoid bone (n = 10) and meningiomas were predominantly located at the skull base (n = 12). Surgical treatment was performed in 4 CFD lesions and 14 meningiomas. Simpson grade I-II resection was achieved in 12 out of the 14 resected meningiomas and almost all of them were classified as WHO I grade (n = 13). The mean follow-up duration was 56.89 months and recurrence was noticed in 2 cases. Genetic study was conducted in 7 tumor specimens and immunohistochemistry was accomplished in 8 samples showing that though GNAS variant was not detected, Gαs protein were positively expressed in different degrees.
    CONCLUSIONS: We presented an uncommon case series of co-diagnosed meningioma and CFD and provided a detailed description of its clinicopathological features, treatment strategy and prognosis. Although a definite causative relationship had not been established, possible genetic or environmental interplay between these two diseases could not be excluded. It was challenging to initiate prompt diagnosis and appropriate treatment for concomitant meningioma and CFD because of its similar radiological manifestations to meningioma with reactive hyperostosis. Personalized and multi-disciplinary management strategies should be adopted for the co-existence of meningioma and CFD.
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  • 文章类型: Journal Article
    背景:自Z0011试验以来,对腋窝淋巴结状态的评估已从以前仅对淋巴结转移的评估转向对淋巴结负荷程度的评估.我们的目的是应用术前乳腺超声和临床病理特征来预测腋窝淋巴结负荷对早期浸润性乳腺癌的诊断价值。
    方法:将1247个病灶根据腋窝淋巴结状态分为高淋巴结负荷组和有限淋巴结负荷组。使用单因素和多因素分析来预测淋巴结负荷高和有限的两组之间临床病理特征和乳腺超声特征的差异。病理学结果被用作金标准。
    结果:单变量分析显示ki-67,最大直径(MD),病变距离乳头,病变与皮肤的距离,MS,和一些特征性的超声特征(P<0.05)。在多因素分析中,与腋窝高淋巴结负荷相关的乳腺肿瘤的超声特征包括MD(比值比[OR],1.043;P<0.001),形状(或,2.422;P=0.0018),高回声光环(或,2.546;P<0.001),后部特征中的阴影(或,2.155;P=0.007),和腋窝超声检查的可疑淋巴结(OR,1.418;P=0.031)。利用五个危险因素建立预测模型,并且它实现了0.702的受试者工作特征(ROC)曲线下面积(AUC)。
    结论:乳腺超声特征和临床病理特征是早期浸润性乳腺癌高淋巴结负荷的较好预测因素。这种预测有助于制定更有效的治疗计划。
    BACKGROUND: Since the Z0011 trial, the assessment of axillary lymph node status has been redirected from the previous assessment of the occurrence of lymph node metastasis alone to the assessment of the degree of lymph node loading. Our aim was to apply preoperative breast ultrasound and clinicopathological features to predict the diagnostic value of axillary lymph node load in early invasive breast cancer.
    METHODS: The 1247 lesions were divided into a high lymph node burden group and a limited lymph node burden group according to axillary lymph node status. Univariate and multifactorial analyses were used to predict the differences in clinicopathological characteristics and breast ultrasound characteristics between the two groups with high and limited lymph node burden. Pathological findings were used as the gold standard.
    RESULTS: Univariate analysis showed significant differences in ki-67, maximum diameter (MD), lesion distance from the nipple, lesion distance from the skin, MS, and some characteristic ultrasound features (P < 0.05). In multifactorial analysis, the ultrasound features of breast tumors that were associated with a high lymph node burden at the axilla included MD (odds ratio [OR], 1.043; P < 0.001), shape (OR, 2.422; P = 0.0018), hyperechoic halo (OR, 2.546; P < 0.001), shadowing in posterior features (OR, 2.155; P = 0.007), and suspicious lymph nodes on axillary ultrasound (OR, 1.418; P = 0.031). The five risk factors were used to build the predictive model, and it achieved an area under the receiver operating characteristic (ROC) curve (AUC) of 0.702.
    CONCLUSIONS: Breast ultrasound features and clinicopathological features are better predictors of high lymph node burden in early invasive breast cancer, and this prediction helps to develop more effective treatment plans.
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  • 文章类型: Journal Article
    异常翻译调节是癌症发生和发展中的重要现象。真核翻译起始因子4A1(eIF4A1)蛋白是一种ATP依赖性核糖核酸(RNA)解旋酶,这是翻译必不可少的,并具有双向RNA解绕器功能。在这次审查中,我们讨论表达的层次,eIF4A1在不同人类肿瘤中的调控机制和蛋白质功能。eIF4A1通常在上皮-间质转化过程中作为microRNAs或长的非编码RNAs的靶标,与肿瘤细胞的增殖和转移有关。eIF4A1蛋白显示出癌前病变的快速诊断的有希望的生物标志物,组织学表型,临床分期诊断和结果预测,为肿瘤患者的精准医疗和靶向治疗提供了新的策略,相关的小分子抑制剂也被应用于临床,为该基因靶点的开发提供可靠的理论支持和临床依据。
    Abnormal translate regulation is an important phenomenon in cancer initiation and progression. Eukaryotic translation initiation factor 4A1 (eIF4A1) protein is an ATP-dependent Ribonucleic Acid (RNA) helicase, which is essential for translation and has bidirectional RNA unwinders function. In this review, we discuss the levels of expression, regulatory mechanisms and protein functions of eIF4A1 in different human tumors. eIF4A1 is often involved as a target of microRNAs or long non-coding RNAs during the epithelial-mesenchymal transition, associating with the proliferation and metastasis of tumor cells. eIF4A1 protein exhibits the promising biomarker for rapid diagnosis of pre-cancer lesions, histological phenotypes, clinical staging diagnosis and outcome prediction, which provides a novel strategy for precise medical care and target therapy for patients with tumors at the same time, relevant small molecule inhibitors have also been applied in clinical practice, providing reliable theoretical support and clinical basis for the development of this gene target.
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  • 文章类型: Case Reports
    背景:Warthin样乳头状肾细胞癌(WPRCC)在2022年世界卫生组织泌尿和男性生殖系统分类中被描述为乳头状肾细胞癌的一种罕见病理亚型。在此,我们报告了左肾WPRCC病例。
    方法:对一名健康的47岁女性进行体格检查,发现她的左肾有肿块,尺寸为4.5cm×3.5cm×3.5cm。根据临床资料,成像数据,组织学特征,和免疫组织化学结果,病理诊断为左肾WPRCC。
    结论:切除左肾肿块,术后进展顺利。
    BACKGROUND: Warthin-like papillary renal cell carcinoma (WPRCC) has been described as a rare pathological subtype of papillary renal cell carcinoma in the 2022 World Health Organization Classification of the Urinary and Male Reproductive System. Herein we report a case of WPRCC in the left kidney.
    METHODS: Physical examination of a previously healthy 47-year-old woman revealed a lump in her left kidney, 4.5 cm × 3.5 cm × 3.5 cm in size. Based on the clinical information, imaging data, histmorphological features, and immunohistochemistry results, the pathological diagnosis was WPRCC in left kidney.
    CONCLUSIONS: Resection of the mass in the left kidney was performed and her postoperative course was uneventful.
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  • DOI:
    文章类型: English Abstract
    目的:回顾性分析北京大学第三医院2016年1月至2022年12月40岁以下肾肿瘤合并癌栓手术患者的临床资料。并评价其手术效果,探讨其临床病理特征与预后的关系。
    方法:回顾性分析17例青年肾癌栓患者的临床资料,并对其临床病理特征及预后进行总结。根据有无症状对患者进行分组,2017年美国癌症联合委员会(AJCC)临床分期,术后联合辅助治疗。采用Kaplan-Meier法绘制存活曲线,采用Log-rank检验比较不同组间术后生存时间和无进展生存时间的差异。分析临床病理特征与预后的关系。
    结果:17例患者均接受静脉肿瘤栓切除术,其中16例(94.1%)接受根治性肾切除术,1例(5.9%)接受部分肾切除术。12例(70.6%)患者术前出现症状,5例(29.4%)患者术前无症状。共观察到17个肾肿瘤,其中2例(11.8%)为良性,15例(88.2%)为恶性。在恶性肿瘤中,1例患者(6.7%)诊断为透明细胞癌,而其余14例患者(93.3%)被归类为非透明细胞癌。就肿瘤分期而言,8例(53.3%)按AJCC分级分为Ⅲ期,其中7例(46.7%)为Ⅳ期。此外,6例(40%)患者接受了多种辅助治疗,而9例患者(60%)未接受此类治疗。随访2~78个月,中位随访时间为41个月。在此期间,3例患者(20%)逝世亡。术后中位生存时间为39.0(2.3,77.8)个月,无进展生存期为16.4(2.3,77.8)个月。年轻肾肿瘤合并癌栓患者术后生存时间和无进展生存时间差异无统计学意义,根据手术前症状的存在(P=0.307,P=0.302),AJCC临床分期(P=0.340,P=0.492),术后辅助治疗组(P=0.459,P=0.253)。
    结论:年轻肾肿瘤伴癌栓患者的病理类型因症状而更为复杂多样,非透明细胞癌在癌栓恶性肿瘤中的比例较高。有症状和非透明细胞癌可能与不良预后有关。手术联合辅助治疗是年轻肾肿瘤和癌栓患者相对安全有效的治疗方法。
    OBJECTIVE: To retrospectively analyze clinical data of patients under 40 years old who underwent surgical treatment for renal tumors with tumor thrombus from January 2016 to December 2022 at Peking University Third Hospital, and to evaluate the surgical effect and investigate the relationship between clinicopathological characteristics and prognosis.
    METHODS: The clinical data of 17 young patients with renal tumor thrombus were retrospectively analyzed, and the clinicopathological features and prognosis were summarized. The patients were grouped according to the presence or absence of symptoms, 2017 American Joint Committee on Cancer (AJCC) clinical stage, and postoperative combined adjuvant therapy. Kaplan-Meier method was used to plot the survival curve, and Log-rank test was used to compare the differences in postoperative survival time and progression-free survival time between the different groups. The relationship between clinicopathological features and prognosis was analyzed.
    RESULTS: All the 17 patients received venous tumor thrombectomy, including 16 patients (94.1%) who underwent radical nephrectomy and 1 patient (5.9%) who underwent partial nephrectomy. Twelve patients (70.6%) had symptoms and 5 (29.4%) had no symptoms before operation. A total of 17 renal tumors were observed, with 2 patients (11.8%) identified as benign and 15 patients (88.2%) classified as malignant. Among the malignant tumors, 1 patient (6.7%) was diagnosed as clear cell carcinoma, while the remaining 14 patients (93.3%) were categorized as non-clear cell carcinoma. In terms of tumor stage, 8 patients (53.3%) were classified as stage Ⅲ according to the AJCC classification, while 7 patients (46.7%) were categorized as stage Ⅳ. Additionally, 6 patients (40%) received multiple adjuvant therapy, while 9 patients (60%) did not undergo such treatment. The follow-up period ranged from 2 to 78 months, with a median follow-up of 41 months. During this time, 3 patients (20%) died. The median survival time after surgery was 39.0 (2.3, 77.8) months, and the progression-free survival time was 16.4 (2.3, 77.8) months. There was no significant difference in postoperative survival time and progression-free survival time among young patients with renal tumor with tumor thrombus, based on the presence of symptoms before surgery (P=0.307, P=0.302), clinical stage of AJCC (P=0.340, P=0.492), and postoperative adjuvant therapy (P=0.459, P=0.253) group.
    CONCLUSIONS: The pathological types of young patients with renal tumor with tumor thrombus are more complex and varied due to symptoms, and the proportion of non-clear cell carcinoma in malignant tumor with tumor thrombus is higher. Symptomatic and non-clear cell carcinoma may be potentially associated with poor prognosis. Surgical operation combined with adjuvant therapy is a relatively safe and effective treatment for young patients with renal tumor and tumor thrombus.
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  • 文章类型: Journal Article
    本研究的目的是描述在单个机构管理肝上皮样血管内皮瘤(HEHE)的经验。
    我们纳入了51例经组织学证实为HEHE的患者。我们使用Kaplan-Meier方法进行了log-rank(Cox-Mantel)生存分析,以测试不同组患者之间的生存差异。进行单因素Cox回归分析和多因素比例风险回归模型以确定独立的预后因素。
    使用不同的成像模式来诊断HEHE并具有不同的表现。肝切除术(LR),肝移植,全身治疗(ST),我们的研究中使用了监控。LR组和监测组的平均生存率有显著差异(p=0.006),与LR组和ST组一样(p=0.036),以及手术入路(LR和LT)和非手术入路(ST和监测)(p=0.008)。ST组和监测组之间的平均生存率没有显着差异(p=0.851)。LR(p=0.010)和手术方式(p=0.014)是预后的有利预测因子,而大血管侵犯(MaVI)(p=0.037),肺转移(p=0.040),在单因素分析中,监测(p=0.033)是不良预后因素。多因素分析显示LR(p=0.010)和手术入路(p=0.014)与良好的OS独立相关。而监测(p=0.033)与不良OS独立相关。在调整混杂因素后,LR组患者的OS明显优于监测组(p=0.013).然而,LR组与ST组的OS差异无统计学意义(p=0.254),与ST组和监测组一样(p=0.857).
    HEHE的明确诊断取决于组织病理学,由于放射学检查结果与某些肝脏恶性肿瘤相似,因此不可能在没有活检的情况下做出具体诊断。对于不适合手术的患者,不建议使用ST。无论疾病阶段如何,都应保证手术方法。回顾性性质和数据的小范围限制了研究的普遍性,设计一个全球数据库,其中包含有关HEHE患者的所有数据,而与他们的治疗无关,这是强烈推荐的。
    UNASSIGNED: The aim of the present study was to describe the experience at a single institution in the management of hepatic epithelioid hemangioendothelioma (HEHE).
    UNASSIGNED: We included 51 patients with histologically confirmed HEHE. We performed log-rank (Cox-Mantel) survival analyses using Kaplan-Meier methods to test differences in survival between patients in different groups. Univariate Cox regression analyses and multivariate proportional hazards regression model were carried out to identify independent prognostic factors.
    UNASSIGNED: Different imaging modalities were used to diagnose HEHE with various presentations. Liver resection (LR), liver transplantation (LT), systemic treatment (ST), and surveillance had been used in our study. A significant difference was noted between the LR group and the surveillance group with respect to mean survival (p = 0.006), as was in the LR group and the ST group (p = 0.036), and in surgical approach (LR and LT) and nonsurgical approach (ST and surveillance) (p = 0.008). The mean survival between the ST group and the surveillance group was not significantly different (p = 0.851). LR (p = 0.010) and surgical approach (p = 0.014) were favorable predictors of outcome, while macrovascular invasion (MaVI) (p = 0.037), lung metastasis (p = 0.040), and surveillance (p = 0.033) were poor prognostic factors in univariate analysis. Multivariate analysis showed that LR (p = 0.010) and surgical approach (p = 0.014) were independently associated with good OS, while surveillance (p = 0.033) was independently associated with poor OS. After adjusting for confounding factors, patients in the LR group have much better OS than those in the surveillance group (p = 0.013). However, there was no significant difference in OS between the LR group and ST group (p = 0.254), as was in the ST group and the surveillance group (p = 0.857).
    UNASSIGNED: The definitive diagnosis of HEHE was dependent on histopathology, and it was not possible to make a specific diagnosis without biopsy because the radiological findings were similar to those in some hepatic malignancies. ST was not recommended for patients who were not candidates for surgical approaches, and surgical approaches should be warranted regardless of disease stage. The retrospective nature and the small size of the data limited the generalizability of the study, designing a worldwide database that contains all data about patients with HEHE independent of their therapy, which was highly recommended.
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