Objective To investigate the diagnosis and treatment of the liver hydatidosis in nonpastureland. Methods Clinical features of 16 patients with liver hydatidosis were analyzed retrospectively. Results Only 8 of 16 patients possessed the clinical symptoms and 8 patients had had history of inhabitancy in epidemic area. Casoni test and indirect hemagglutination showed a sensitivity of 90% and the correct diagnostic rate of CT was higher than that of B-ultrasound examination. The main effective treatment of the liver hydatidosis was surgical, 15 out of 16 patients received surgical treatment. In this series, the curative effect was good without any death, allergic reaction and implantation. Conclusion The cystic lesion of liver should be considered as liver hydatidosis and Casoni test, indirect hemagglutination, together with CT and B-us examination can be used to comfirm the diagnosis though no clinical symptoms and history of inhabitancy in epidemic area presented. Surgical operation is the main effective treatment for liver hydatidosis.
【Abstract】Objective To study the correlation between focal adhesion kinase (FAK) expression and biological behavior of invasion and metastasis in gastric carcinoma. MethodsThe immunoreactivity of FAK was revealed by immunohistochemical method in gastric carcinoma tissues,canceradjacent tissues, normal gastric mucosa,and 200 regional lymph nodes in 50 collected specimens when radical resection of gastric carcinoma were carried out. ResultsThe percentage of FAK bly positive immunoreactivity were 10.0%（5/50）， 20.0%（10/50） and 78.0%（39/50） in normal gastric mucosa， cancer-adjacent tissues and gastric carcinoma tissues respectively. The b immunoreactivity was obviously higher in gastric carcinoma tissues than that in normal gastric mucosa or canceradjacent tissues (P＜0.01). There were no difference between normal gastric mucosa and canceradjacent tissues (Pgt;0.05). The percentage of bly positive immunoreactivity of FAK were 68.8%（22/32） and 33.3%（6/18） in cases with metastasis and without metastasis of lymph node respectively. The immunoreactivity of FAK in cases with metastasis of lymph node was significantly higher than that without metastasis of lymph node (P＜0.05).The b immunoreactivity of FAK were 87.2%（136/156） and 40.9%(18/44) in withmetastatic lymph node and withoutmetastatic lymph node. The immunoreactivity of FAK in withmetastatic lymph node was significantly higher than that withoutmetastatic lymph node （P＜0.01）. The percentage of FAK bly positive immunoreactivity showed correlation with the cellular differentiation and depth of infiltration of gastric carcinoma. The deeper infiltration and lower differentiation, the ber expression rate was obtained (P＜0.05), which showed no correlation with Borrmann type, location and size of tumor (Pgt;0.05). ConclusionIncreased immunoreactivity of FAK is an important role of invasion and metastasis for gastric carcinoma cells. Detection of FAK expression in cancer tissues can be helpful to understand the carcinogenic biological behavior of gastric carcinoma as well as to make judgment and treatment of prognosis of patients.
【摘要】 目的 探索腹部淋巴结结核在多层螺旋CT（multi-layered screw CT，MSCT）扫描中CT值动态变化规律。 方法 2007年1月—2010年8月，收集经诊断性治疗或诊断性活检确诊的17例患者腹部淋巴结结核，记录肿大淋巴结数量、大小、位置，测量兴趣淋巴结中心、次中心、边缘部平扫及注药后20、60、120、180、360 s的CT值。 结果 共检测出肿大淋巴结269个，主要分布在肝十二指肠韧带、门腔间隙、肝胃韧带、肠系膜根部和腰3平面以上腹主动脉周围，CT值（49.2±13.6） Hu；强化淋巴结215个，选择21个兴趣淋巴结，测得注药20、60、120、180、360 s后强化区CT值分别为（67.7±15.3）、（75.2±14.6）、（76.3±18.7）、（75.6±13.4）、（72.6±17.4） Hu。 结论 腹部淋巴结结核动态CT值表明动脉期明显强化，静脉期及延时扫描强化值维持在动脉期水平呈平台样改变，反映了淋巴结结核慢性感染的病理状态。【Abstract】 Objective To explore the changing rule of dynamic CT values for abdominal lymph node tuberculosis in multi-layered screw CT (MSCT) multiphasic scanning. Methods Between January 2007 and August 2010, 17 cases of abdominal lymph node tuberculosis confirmed by diagnosis treatment or diagnosis biopsy were retrospectively analyzed. The quantity, size and position of the lymph nodes were recorded, and CT plain scanning values of the interested lymph node center, subcenter, and the margin of the node, and the CT values 20, 60, 120, 180 and 360 seconds after drug administration were also measured. Results Enlargement was found in 269 lymph nodes which were mainly distributed in the liver duodenum ligament, the gate cavity gap, the hepatogastric ligament, the mesentery root and the nodes in retroperitoneal space above the third lumbar vertebra. The average CT value was (49.2±13.6) Hu. A total of 215 lymph nodes had strengthened manifestations, and 21 interested lymph nodes were chosen for the study. The average CT values for lymph nodes with strengthened manifestations 20 ,60, 120, 180, and 360 seconds after drug administration were respectively (67.7±15.3), (75.2±14.6), (76.3±18.7), (75.6±13.4), and (72.6±17.4) Hu. Conclusion Dynamic CT value of abdominal lymph node tuberculosis shows a strengthening in the arterial phase, and the values in the the venous phase and the delayed phase maintain at the arterial phase level, and do not change, which indicates a pathological state of chronic infection of the lymph node tuberculosis.
ObjectiveTo investigate the long-term efficacy of laparoscopic cholecystectomy (LC) for gallbladder cancer.MethodThe clinical data of 52 patients with gallbladder cancer only underwent LC from January 1998 to December 2018 in the Peking Union Medical College Hospital were analyzed retrospectively.ResultsFifty-two patients met the inclusion criteria were included, including 23 males and 29 females. The age was (67±12) years. Fifty-two patients were treated with LC because of gallbladder occupying or gallstone. Twenty-three patients were diagnosed as incidental gallbladder cancer after the surgery, while 29 patients were diagnosed as the gallbladder cancer before or during the operation. Eleven patients with T1a lesions received the close follow-up, the other 41 patients refused the radical operation due to the advanced age, severe underlying diseases or their own preferences. Five cases of postoperative complications were observed. All patients were followed-up for (40.2±33.8) months, 21 patients survived and 31 died. The dead patients had an older age, longer hospital stays, and later T stage (P<0.050) as compared with the living patients. The patients with T1a lesions had significantly longer survival time than those with T1b and above (113.5 months versus 39.6 months, P<0.001).ConclusionsLC is a radical operation in T1a lesions. At the same time, it can meet the requirements of postoperative life quality for some special patients due to its safety and low postoperative complication rate.
ObjectiveTo investigate the effect of combined or non-combined liver resection for T2a gallbladder cancer. MethodsAccording to the established inclusion and exclusion criteria, the patients with T2a gallbladder cancer admitted to Peking Union Medical College Hospital from January 2016 to December 2021 were retrospectively collected, then were assigned into combined with liver resection group and non-combined with liver resection group. The general characteristics, perioperative information, and prognosis of the two groups were compared. ResultsA total of 58 patients were enrolled in this study, including 23 males and 35 females; aged (64.8±11.1) years. There were 43 cases in the combined with liver resection group and 15 cases in the non-combined with liver resection group. There were no statistic differences in the demographic data, lifestyle, onset symptoms, preoperative combined diseases, and preoperative tumor markers between the two groups (P>0.05). Compared with the combined with liver resection group, the proportion of patients received bile duct resection was higher (P=0.013) and the operation time was shorter (P=0.045) in the non-combined with liver resection group. There were no statistic differences in the other perioperative informations between the two groups (P>0.05). A total of 12 patients had postoperative complications, including 3 cases of grade Ⅰ, 8 cases of grade Ⅱ, and 1 case of grade Ⅲa by Clavien-Dindo classification. All patients improved after treatment and were discharged smoothly. No patient was readmitted within 30 d after discharge. All 58 patients were followed up with a median follow up time of 29 months. During the follow-up period, there were 47 cases (81.0%) of tumor-free survival, 2 cases (3.4%) of survival with tumor, and 9 cases (15.5%) of death. There were no statistic differences in the overall survival and disease-free survival between the two groups by log-rank test (χ2=3.418, P=0.064; χ2=1.543, P=0.214). ConclusionFromthe results of this study, for T2a gallbladder cancer, liver resection would not result in increased complications or longer hospital stay, but don’t obviously improve prognosis.