ObjectiveTo analyze the pathological manifestations and imaging characteristics of bronchiolar adenoma (BA).MethodsThe clinical data of 11 patients with BA who received surgeries in our hospital from January 2019 to September 2020 were retrospectively analyzed, including 5 males and 6 females aged 40-73 (62.40±10.50) years. The intraoperative rapid freezing pathological diagnosis, postoperative pathological classification, cell growth pattern, nuclear proliferation index Ki-67 and other immunohistochemical staining combined with preoperative chest CT imaging characteristics were analyzed.ResultsThe average preoperative observation time was 381.10±278.28 d. The maximum diameter of imaging lesions was 5-27 (10.27±6.34) mm. Eight (72.7%) patients presented with irregular morphology of heterogeneous ground-glass lesions, and 3 (27.3%) patients presented with pure ground-glass lesions. There were 10 (90.9%) patients with vascular signs, 8 (72.7%) patients with vacuolar signs, 1 (9.1%) patient with bronchus sign, 3 (27.3%) patients with pleural traction and 9 (81.8%) patients with burr/lobular sign. The surgical methods included sub-lobectomy in 10 patients and lobectomy in 1 patient. Five (45.5%) patients were reported BA by intraoperative frozen pathology. The postoperative pathological classification included 8 patients with distal-type and 3 patients with proximal-type, and the maximum diameter of the lesions was 4-20 (8.18±5.06) mm. Eight (72.7%) patients showed characteristic bilayer cell structure under microscope, and 10 (90.9%) patients showed thyroid transcription factor 1 expression in pathological tissues. The expression of NapsinA in intracavity cells was found in 9 (81.8%) patients. The Ki-67 index of the lesion tissue was 1%-5% (3.22%±1.72%).ConclusionThe pathological features and imaging findings of BA confirm the premise that BA is a neoplastic lesion. However, to identify BA as a benign or inert tumor needs more clinical data and evidence of molecular pathological studies.
ObjectiveTo analyze differences in postoperative pathological stage characteristics of colorectal cancer (CRC) patients with different marital status in Database from Colorectal Cancer (DACCA). MethodsAccording to the established screening conditions, the patients were collected from the updated version of DACCA on January 23, 2023, and then assigned into three categories according to marital status: married, unmarried, widowed or divorced patients. The differences in postoperative pathological staging, peripheral nerve involvement, pathological tumor regression grade (TRG), cancer nodules, and high-risk factors among the CRC patients with different marital statuses were analyzed. ResultsA total of 6 947 data matching the screening criteria were collected, including 113 unmarried patients (1.6%), 6 315 married patients (90.9%), and 519 divorced or widowed patients (7.5%). The analysis results showed that the pathological TNM staging (Ⅰ–Ⅳ staging: H=19.030, P<0.001;Ⅰ+Ⅱ and Ⅲ+Ⅳ staging: χ2=19.124, P<0.001), pathological T staging (H=7.147, P=0.028), and high-risk factors grading (H=10.246, P=0.006) had statistical differences. The trend presented that the proportions of the patients with earlier pathological TNM staging and T staging (Ⅰor T1 staging) in the married patients were the highest among the 3 marital statuses patients, and the proportions of the later staging (Ⅳ or T4 staging) were the lowest in the married patients. The same trend was found in the high-risk factors grading. However, there were no statistical differences in other pathological features such as peripheral nerve involvement, pathological TRG, and cancer nodules among the CRC patients with 3 marital statuses (P>0.05). ConclusionsThrough data analysis in DACCA, it is found that CRC patients with different marital statuses exhibit certain differences in postoperative pathological stage characteristics, especially in terms of pathological TNM staging, pathological T staging, and high-risk factor grading. However, this conclusion needs to be objectively regarded. From a statistical perspective, the samples size of patients with 3 marital statuses in this study is different. In the future, further analysis can be conducted by balancing the samples size on this basis. From a clinical perspective, there may be more influencing factors, so objective analysis should be conducted after eliminating interference factors one by one.
Objective To explore the diagnosis and treatment strategies for elderly patients with ground-glass opacity (GGO) by reviewing the clinical data such as imaging features, surgical methods, postoperative pathological results and average hospital stay. MethodsThe imaging features and postoperative pathological findings of the elderly patients with pulmonary GGO in our hospital from January 2017 to December 2019 were retrospectively analyzed. The patients were divided into an elderly patient group and a non-elderly patient group based on their age. Results Finally 575 patients were included in the study. There were 281 elderly patients, including 83 males and 198 females, with an average age of 67.0±5.3 years. There were 294 non-elderly patients, including 88 males and 206 females, with an average age of 49.1±7.3 years. Compared with the non-elderly patients, elderly GGO patients showed the following distinct clinical features: the lesions were observed for a long time (P<0.001), the GGO margin was not smooth (P<0.001), the pleural signs (P<0.05) and bronchial signs (P<0.05) were obvious, there were more patients of type Ⅱ to Ⅳ GGO (P<0.001), more patients of lobectomy (P<0.05), and more patients of postoperative pathological reports of infiltrating lesions (P<0.05). There was no statistical difference in the average length of stay between the two groups (P>0.05). Multivariate logistic regression analysis showed that GGO diameter and GGO type were the main factors affecting the operation. Observation time, GGO diameter and GGO type were the main influencing factors for postoperative pathological infiltrative lesions. The cut-off value of GGO diameter in predicting infiltrating lesions was 10.5 mm in the elderly group. Conclusion The size and type of GGO are important factors in predicting invasive lesions and selecting surgical methods. Elderly patients with radiographic manifestations of type Ⅱ to Ⅳ GGO lesions with a diameter greater than 10.5 mm should be closely followed.