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ABSTRACT: BACKGROUND: The 7th edition of the American Joint Committee on Cancer (AJCC) cancer staging manual incorporates tumor grade and location for staging pT2-3N0M0 esophageal squamous cell carcinoma. Patients with pT3N0M0, classified as stage IIa according to the 6th edition of the AJCC cancer staging manual, can now be classified as stage Ib, IIa, or IIb. We aimed to discuss whether these changes affect survival and determine other potential prognostic factors. METHODS: We retrospectively analyzed 302 patients with postoperative pathologic stage T3N0M0 who underwent esophagectomy between 1990 and 2005 at Sun Yat-sen University Cancer Center. We performed univariate and multivariate analyses to identify prognostic factors for survival and used the Kaplan-Meier method to compare survival difference in each prognostic factor, including tumor grade and location. RESULTS: The 5-year overall survival rate was 46 %, with a median survival of 1,244.5 days. Gender, age, alcohol consumption, forced expiratory volume in 1 s (FEV1), and number of removed lymph nodes were independent prognostic factors in both univariate and multivariate analyses. Smoking was also a prognostic factor in survival analysis by the Kaplan-Meier method. However, histologic tumor grade and location had no significant influence on patient survival. CONCLUSIONS: Age, gender, alcohol consumption, FEV1, number of removed lymph nodes, and cigarette smoking are independent prognostic factors in patients with pT3N0M0 esophageal squamous cell carcinoma. However, tumor grade and location may not be as strong predictors in these patients as indicated in the 7th edition of the AJCC cancer staging manual.
Annals of Surgical Oncology 09/2012; · 4.17 Impact Factor
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Yongbin Lin,
Xiaodong Su,
Hongyu Su,
Peng Lin,
Hao Long,
Lanjun Zhang, Jianhua Fu,
Tiehua Rong,
Zihui Tan,
Yuqi Meng,
Guowei Ma
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ABSTRACT: Smoking is well known as a risk factor for esophageal cancer, but controversial as a prognostic factor. Moreover, evidence is scarce that a dose-response relationship exists. We conducted a retrospective study on the effect and dose-response relationship of prediagnostic smoking on the postoperative disease-specific survival of patients with lymph node-negative esophageal squamous cell carcinoma (ESCC). We enrolled 643 patients with lymph node-negative ESCC who had undergone esophagectomy between 1990 and 2005 at the Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China. The patients' demographic, pathological, preoperative and cancer outcome data were obtained from medical records. These data were reviewed and analyzed using life table, Kaplan-Meier analysis and multivariate Cox regression. A significant reduction in 3- and 5-year survival rates was observed in smokers with lymph node-negative ESCC compared with those in non-smokers. The 3- and 5-year survival rates were 54% and 46% for smokers, and 67% and 64% for non-drinkers, respectively (P < 0.05). Multivariate Cox analysis revealed that smoking was an independent prognostic factor (P = 0.008, hazard ratio = 1.404). Both log-rank test (P = 0.065) and multivariate analysis (P = 0.091) showed no significant difference between the survival rates of light and heavy smokers. Prediagnostic smoking is an independent prognostic factor for patients with lymph node-negative ESCC, but the dose-response relationship needs further investigation.
Cancer Science 08/2012; · 3.33 Impact Factor
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European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 06/2012; 42(4):759-60. · 2.40 Impact Factor
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ABSTRACT: OBJECTIVES; The demographic and clinicopathologic factors associated with 5-year survivors have not been well documented in oesophageal squamous cell carcinoma (OSCC). We evaluated factors predictive of actual 5-year survival in the present research.
We analysed 1241 patients underwent oesophagectomy for invasive OSCC retrospectively. The demographic and clinicopathologic characteristics were compared between patients who were alive >5 years after oesophagectomy and patients who died within 5 years of oesophagectomy.
Univariate analysis showed significant differences between the two groups regarding 11 different factors. Further analysis by logistic regression showed that eight factors were identified as independent predictors of actual 5-year survival.
The independent positive predictors for actual 5-year survival are younger patients, female gender, absence of weight loss, R0 resection, lower pathological T stage, lower pathological N stage, higher histologic grade and more resected lymph nodes.
European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 12/2011; 41(3):e7-11. · 2.40 Impact Factor
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ABSTRACT: Subcarinal node metastasis is common in patients with esophageal cancer. Some scholars have suggested that subcarinal nodes might not need to be sampled or dissected in patients with superficial squamous cell carcinoma of the thoracic esophagus. This research investigated the frequency of subcarinal node metastasis in patients with esophageal squamous cell carcinoma, identified the factors correlated to subcarinal node metastasis, and evaluated the clinical relevance of subcarinal node metastasis in thoracic esophageal squamous cell carcinoma.
We retrospectively analyzed the clinical data of 1,812 consecutive patients with thoracic esophageal squamous cell carcinoma who underwent esophagectomy in the Cancer Center of Sun Yat-sen University. The surgical procedures included the left transthoracic procedure, Ivor-Lewis approach, and the cervical-thoracoabdominal procedure.
The frequency of subcarinal node metastasis was 10.0%. The univariate and multivariate analysis showed that longer tumor length, higher pathologic T stage, lower histologic grade, and positive lymph node metastases of other groups were associated with a higher frequency of subcarinal node metastasis (all p<0.05). Patients with solitary subcarinal node metastasis had a significantly lower 5-year cumulative survival rate than those with solitary paraesophageal node metastasis (25.3% vs 39.6%, p<0.05).
Longer tumor length, higher pathologic T stage, lower histologic grade, and positive lymph node metastases of other groups are associated with a higher frequency of subcarinal node metastasis. Subcarinal node metastasis indicates worse prognosis of patients with thoracic esophageal squamous cell carcinoma compared with paraesophageal node metastasis.
The Annals of thoracic surgery 12/2011; 93(2):423-7. · 3.74 Impact Factor
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ABSTRACT: The use of metal stents for malignant esophageal strictures for palliation is well accepted. However, utilization of metal stents for benign esophageal diseases has been controversial. Given the availability of removable, fully covered, self-expandable metal stents (RFCSEMSs), this study was undertaken to evaluate the effectiveness and safety of RFCSEMSs in patients with refractory benign esophagogastric anastomotic strictures. Twenty-four patients with RFCSEMSs were enrolled in this study. All patients had undergone endoscopic Savary-Gilliard bougie dilatation five times or more but there was no significant improvement in symptoms. For all 24 patients, the symptom of dysphagia was alleviated significantly while the stent was in place and for a short time after stent removal, and dysphagia scores decreased from 3-4 to 0-1. After 12 months of follow-up, 18 patients were free from dysphagia but the other 6 patients still suffered obvious dysphagia. RFCSEMSs are still not perfect and can induce some complications. The treatment failure rate of restenting was remarkably high after the first failure. Given that effective methods for treating refractory stricture have not been found, RFCSEMSs could be considered for treating refractory benign esophagogastric anastomotic stricture.
Dysphagia 08/2011; 27(2):260-4. · 1.39 Impact Factor
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ABSTRACT: Esophageal squamous cell carcinoma (ESCC) is a highly malignant disease that is generally not responding to chemotherapy. It is particularly predominant in China. Although ESCC is significantly associated with cigarette smoking, the relationship between its molecular pathogenesis and responsiveness to chemotherapy and cigarette smoke remains elusive. This study reported the constitutive activation of aryl hydrocarbon receptor (AhR), leading to ABCG2 upregulation and the multidrug resistance (MDR) phenotype, in ESCC cell lines with acquired cisplatin resistance. Reporter gene assay, chromatin immunoprecipitation analysis and specific gene knockdown confirmed that the enhanced AhR binding to a xenobiotic response element (XRE) within the ABCG2 promoter is responsible for ABCG2 overexpression. A HSP90 inhibitor (17-AAG) and two AhR antagonists (kaempferol and salicylamide) were shown to inhibit ABCG2 upregulation, thereby reversing the ABCG2-mediated MDR. Our data therefore advocate the use of these inhibitors as novel chemosensitizers for the treatment of esophageal cancer.
Molecular Carcinogenesis 06/2011; 51(6):449-64. · 3.16 Impact Factor
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ABSTRACT: High cyclooxygenase 2 (COX-2) expression has been reported to be clinically associated with reduced cisplatin-based therapy efficacy in esophageal cancer. However, the benefit of including COX-2-selective inhibitors in therapeutic regimens remains uncertain. Thus, we sought to determine the effects of COX inhibitors on the cytotoxicity of cisplatin and to further explore the mechanism involved in human esophageal squamous cell carcinoma cells. Among the four tested COX inhibitors [celecoxib, 4-[5-(4-chlorophenyl)-3-(trifluoromethyl)-1H-pyrazol-1-yl]benzenesulfonamide (SC-236), nimesulide, and indomethacin], all of which substantially suppressed prostaglandin E(2) production to a similar extent; only the COX-2-selective inhibitors celecoxib and SC-236 antagonized cisplatin-induced cytotoxicity and apoptosis in both cisplatin-resistant cells and their wild-type counterparts. Knockdown of COX-2 by small interference RNA failed to mimic the antagonizing effects of celecoxib and SC-236, implying that their action is COX-2-independent. Further mechanistic analysis revealed that the antagonizing effect of celecoxib and SC-236 on cytotoxic action of cisplatin was associated with decreased whole-cell cisplatin accumulation and DNA platination. Reduced influx, accompanied by the reduction of protein level of copper transporter 1, accounts for decreased intracellular cisplatin accumulation. In addition, combined treatment did not elicit greater antitumor activity than cisplatin or celecoxib monotherapy in vivo in an esophageal cancer xenograft model. Collectively, these data demonstrate that celecoxib antagonizes the cytotoxicity of cisplatin by decreasing intracellular cisplatin and DNA platination. The combination treatment also shows no beneficial effect compared with cisplatin or celecoxib monotherapy in vivo. Therefore, current clinical trials with celecoxib in combination with cisplatin should be approached with caution.
Molecular pharmacology 03/2011; 79(3):608-17. · 4.53 Impact Factor
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ABSTRACT: Lung cancer is the leading cause of cancer deaths worldwide. Recent advance in targeted therapy for lung cancer patients with epidermal growth factor receptor (EGFR) mutations has demonstrated a promising development toward personalized therapy for lung cancer patients. The development of lung cancer is a complex process, involving a series of genetic and epigenetic changes. Tobacco smoke is the predominant etiologic risk factor for lung cancer. However, some lung cancers, especially adenocarcinomas, arise in patients who have never smoked, suggesting the importance of host genetic/epigenetic susceptibility in the occurrence and development of lung cancer. Understanding of these genetic and epigenetic changes will further aid in the biomarker-driven personalized therapy for lung cancer patients. In this review, we summarize the genetic and epigenetic alterations observed in lung cancers, including chromosomal loss of heterozygosity, tumor-suppressor gene mutation, gene methylation, histone modification, and microRNA expression changes. Clinical and preclinical studies have implied specific genetic/epigenetic changes for clinical application in lung cancer patients. However, more efforts are required in validation of the identified molecular markers in lung cancer patients for early detections, assessment for treatment response, and survival predictions.
Modern Pathology 03/2011; 24(7):932-43. · 4.79 Impact Factor
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ABSTRACT: This study aims to evaluate the clinical utility of automated breast volume scanner (ABVS) against handheld ultrasound in detecting and diagnosing breast lesions.
Eighty-one patients were subjected to both automated breast volume scanner and handheld ultrasound examination in the supine position. The number of lesions detected and the average scanning time (both device-specific and user-specific) for each device were compared. The diagnostic accuracy, sensitivity and specificity were calculated for each method. The maximum diameters of the lesions based on handheld ultrasound and ABVS were compared with the final pathological sizes.
Of the 81 patients, both automated breast volume scanner and handheld ultrasound detected 95 breast lesions. Compared with the pathological diagnosis in 35 lesions, both ABVS and handheld ultrasound exhibited high sensitivity (both 100%) and high specificity (95.0%, and 85.0%, respectively). In addition, ABVS had a higher diagnostic accuracy (97.1%) than handheld ultrasound (91.4%) for breast neoplasms. More importantly, ABVS was capable of displaying the retraction phenomenon in coronal plane. All the invasive ductal carcinomas (12 lesions) presented the retraction phenomenon. In contrast, intraductal carcinomas (3 lesions) and benign lesions did not display such features. Thus, retraction phenomenon had a high specificity (100.0%) and high sensitivity (80.0%) in detecting breast cancer while it also had high accuracy (91.4%) in determining malignant from benign lesions. There was no significant difference in maximum diameters of pathology, 2D and ABVS (p>0.05), however the correlation coefficient revealed that ABVS had better correlation with pathology (r=0.616) than 2D (r=0.468). The user scanning time for the ABVS demonstrated no difference between two examiners (11.7 ± 1.3 min and 12.1 ± 1.4 min; p>0.05). However, device-specific scanning time was longer for ABVS than handheld ultrasound (11.9 ± 1.4 min vs. 6.8 ± 1.1 min, respectively; p<0.01).
Automated breast volume scanner provides advantages of high diagnostic accuracy, better lesion size prediction, operator-independence and visualization of the whole breast. It is a promising modality in breast imaging.
European journal of radiology 03/2011; 81(5):873-8. · 2.65 Impact Factor
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ABSTRACT: Bronchopulmonary carcinoid (BPC) account for less than 2% of all primary lung malignant tumors, but few related studies were reported. The aim of this study is to analyze this rare disease's clinicopathological characteristics.
The clinical data of 28 patients with BPC in Cancer Center of Sun Yat-sen University, from January 1994 to June 2009, were enrolled into retrospective analysis. First, the corresponding paraffin blocks reexamined, slice up and stained, multiple pathologists re-consulted, and its subsets (typical carcinoid, TC; atypical carcinoid, AC) defined. Second, the clinical characteristics and immunohistochemical markers and its relationship with prognosis were analyzed.
First, the 5-year survival for overall and TC, AC was 56% and 70%, 41% respectively in 28 cases. The markers CD99, Bcl-2 and Ki-67 expression correlated significantly with the BPC subsets (P = 0.017, P = 0.043, and P = 0.033 respectively). Further univariate analysis revealed that advanced TNM staging (P = 0.037), lymph node metastasis (P = 0.001) and Ki-67 nucleolus's positive expression (P = 0.009) are poor prognostic factors. Second, the overall, TC, AC 5-year survival rate was 73%, 83%, 57% respectively in 20 cases underwent the radically surgical resection. Further univariate analysis revealed that AC subset (P = 0.013), lymph node metastasis (P = 0.004) and Ki-67 nucleolus's positive expression (P = 0.006), advanced TNM staging (P = 0.047) are poor prognostic factors in this 20 cases. Third, as univariate analysis, local recurrence and metastasis (n = 4) correlate significantly with Ki-67 nucleolus's and Bcl-2 positive expression (P = 0.027, 0.045, respectively).
The prognosis of BPC was better than other types of primary lung cancer. Ki-67, Bcl-2 high expression and advanced TNM staging are the poor recurrence and prognostic factors of BPC. The radical surgery remains the treatment of choice for resectable candidates in BPC as NSCLC.
Zhongguo fei ai za zhi = Chinese journal of lung cancer 06/2010; 13(6):591-7.
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ABSTRACT: Inhibitor of differentiation 1 (Id1) plays a role in cellular differentiation, proliferation, angiogenesis and tumor invasion. In current study, we investigated the expression of Id1 protein in 189 specimens of stage III ESCC by immunohistochemistry. The correlation between Id1 expression and clinicopathological parameters in terms of gender, age, tumor location, differentiation, pathological T stage and pathological N stage was also explored. Immunohistochemical staining showed that Id1 was expressed in all cases (100%). According to ROC curve, we selected 6.33 as the cutoff score. There were 95 cases in high expression group (> 6.33) and 94 cases in low expression group (⩽ 6.33) respectively. The Id1 expression was associated negatively with differentiation, and positively with pathological N stage (P< 0.05, bothly); No significant correlation was observed between Id1 expression and gender, age, tumor location or pathological T stage (P> 0.05). As shown by the Kaplan-Meier curve, the overall survival rate of high expression group was significantly lower than that of low expression group (P< 0.001). The expression of Id1 protein has a close relationship with differentiation degree, pathological N stage and survival in ESCC patients. Id1 could be considered as a prognostic predictor for stage III ESCC patients.
Cancer biomarkers: section A of Disease markers 01/2010; 8(2):67-72. · 1.08 Impact Factor
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Chunyu Zhang,
Li Fu, Jianhua Fu,
Liang Hu,
Hong Yang,
Tie-Hua Rong,
Yan Li,
Haibo Liu,
Song-Bin Fu,
Yi-Xin Zeng,
Xin-Yuan Guan
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ABSTRACT: Tumor fibroblasts (TF) have been suggested to play an essential role in the complex process of tumor-stroma interactions and tumorigenesis. The aim of the present study was to investigate the specific role of TF in the esophageal cancer microenvironment.
An Affymetrix expression microarray was used to compare gene expression profiles between six pairs of TFs and normal fibroblasts from esophageal squamous cell carcinoma (ESCC). Differentially expressed genes were identified, and a subset was evaluated by quantitative real-time PCR and immunohistochemistry.
About 43% (126 of 292) of known deregulated genes in TFs were associated with cell proliferation, extracellular matrix remodeling, and immune response. Up-regulation of fibroblast growth factor receptor 2 (FGFR2), which showed the most significant change, was detected in all six tested TFs compared with their paired normal fibroblasts. A further study found that FGFR2-positive fibroblasts were only observed inside the tumor tissues and not in tumor-surrounding stromal tissues, suggesting that FGFR2 could be used as a TF-specific marker in ESCC. Moreover, the conditioned medium from TFs was found to be able to promote ESCC tumor cell growth, migration, and invasion in vitro.
Our study provides new candidate genes for the esophageal cancer microenvironment. Based on our results, we hypothesize that FGFR2(+)-TFs might provide cancer cells with a suitable microenvironment via secretion of proteins that could promote cancer development and progression through stimulation of cancer cell proliferation, induction of angiogenesis, inhibition of cell adhesion, enhancement of cell mobility, and promotion of the epithelial-mesenchymal transition.
Clinical Cancer Research 07/2009; 15(12):4017-27. · 7.74 Impact Factor
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ABSTRACT: ObjectiveTo evaluate the efficacy of adjuvant chemotherapy in patients with esophageal carcinoma undergoing radical surgery by meta-analysis.
MethodsCBMDisc, CNKI, Pubmed databases were searched from January 1995 to June 2005. Randomized trials on comparison surgery plus
adjuvant chemotherapy (S + C) and surgery alone for patients with localized carcinoma of esophagus were selected. RevMan 4.2
software was used for meta-analysis.
Results7 studies were included in the meta-analysis. A total of 401 patients underwent radical surgery plus chemotherapy and 463
underwent surgery alone. Compared with surgery alone, the patients underwent S + C were significantly superior in the 3-year
survival rate: the combined relative risk (RRs) of death was 0.83, 95% confidence interval (CI) was 0.71 to 0.95, P = 0.009.
ConclusionBased on the review, adjuvant chemotherapy has a benefit on the 3-year survival rate in the patients with esophageal carcinoma.
The Chinese-German Journal of Clinical Oncology 05/2007; 6(3):P241-P244.
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Guowei Ma,
Xu Zhang,
Junye Wang,
Qiuliang Wu,
Hao Long,
Peng Lin, Jianhua Fu,
Richard Malthaner,
Meiqing Zhao,
Lanjun Zhang,
Zhesheng Wen,
Tiehua Rong
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ABSTRACT: OBJECTIVE It has been shown that application of molecular biological techniques to surgical margins of some cancers could predict risk
of local recurrence. However, the optimal length of surgical resection with tumor-free surgical margins for esophageal squamous
cell carcinoma (ESCC) is unknown. This study was conducted to evaluate the optimal length of surgical resection for ESCC with
molecularly tumor-free surgical margins marked by p53 and Ki67.
METHODS Surgical specimens from 70 patients with ESCC were collected for study. The lengths of the upper margin, tumor, and lower
margin of every specimen were measured during the operation. Each specimen was divided into three large pathologic sections,
stained with H&E and immunohistochemically for p53 and Ki67, and examined microscopically. The lengths of the upper and lower
resection ends were measured for p53 and Ki67 positive expression. The actual surgical lengths were calculated by the principle
of rational shrinkage.
RESULTS All surgical margins were histologically tumor-free, while the positive rates of p53 and Ki67 were 66% and 54%. The positive
rates of p53 and Ki67 in the upper resection end were 17% and 20%. The mean lengths of the upper resection end showing p53
and Ki67 positive expression were 1.08±1.12 cm and 1.64±1.01 cm, and the maximum lengths were 3.73 cm and 3.26 cm. The positive
rates of p53 and Ki67 in the lower resection end were 20% and 23%. The mean lengths of the lower resection end of p53 and
Ki67 with positive expression were 1.11±1.15 cm and 1.34±0.94 cm, and the maximum lengths were 3.73 cm and 3.61 cm.
CONCLUSION The optimal length of surgical resection with molecularly tumor-free surgical margins of ESCC is not more than 5 cm.
Chinese Journal of Clinical Oncology 09/2006; 3(5):315-321.
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Mingtian Yang,
Tiehua Rong,
Zhifan Huang,
Changuang Zeng,
Hao Long, Jianhua Fu,
Peng Lin,
Xin Wang,
Siyu Wang,
Xi Wang,
Jun Tang
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ABSTRACT: ObjectiveIn Europe and America breast cancer commonly occurs in women of middle and old age, with a median age of about 57 years. Modified
radical mastectomy now called standard radical mastectomy, has taken the place of traditional radical mastectomy. Patients
with breast cancer at an early stage commonly receive BCT (breast conservative therapy). The TNM stage (especially the lymph
node status) affects the prognosis, and adjuvant therapy can improve survival. In China, only a few reports have been published
studying large numbers of breast cancer patients. This study was designed to analyze the clinical features, surgical pattern
and treatment outcome of resectable breast cancer, as well as to explore the prognostic factors and the effect of adjuvant
therapy, with a goal to improve the level of diagnosis and treatment.
MethodsRecords of the 6,263 patients with resectable breast cancer who had been admitted into our hospital from June 1964 to June
2003 were analyzed retrospectively.
ResultsOf the 6,263 cases, 98.8% were female. Breast cancer occurred most frequently in patients of ages 40∼49 years (41.0%), especially
in patients 45∼49 years old (25.2%). A breast lump, which occurred in 96.2% of the patients, was the main clinical manifestation.
The overall 5- and 10-year survival rates were 75.16% and 40.44%. Of the patients in TNM stages 0-I, II, and III, the 5-year
survival rates were 96.8%, 73.7% and 46.4% respectively and the 10-year survival rates were 78.7%, 64.6% and 33.5% respectively.
The 5-, and 10-year survival rates were higher in the lymph node negative group than in the lymph node positive group (80.3%
vs. 55.6%, and 59.2% vs. 31.9%,P<0.01). Since the 1980s there was no significant difference in survival rates of patients who received a radical mastectomy
compared to a modified radical mastectomy(P>0.05). Of the 73 patients who underwent breast conservative therapy, no local recurrence or metastasis occurred during a
maximal follow-up of 17 years. Of the patients in stage T2-T4, the 5-, and 10-year survival rates were significantly higher
in the group treated with adjuvant chemotherapy compared to the non -chemotherapy group (78.2% vs. 60.1%, and 48.9% vs. 30.7%,P<0.01).
ConclusionAccording to our data, breast cancer most frequently occurred in patients of ages 45∼49 years. The TNM stage (especially the
lymph node status) relates to breast cancer prognosis. The prognosis was worse in patients with positive lymph nodes compared
to the patients with negative lymph nodes. The efficacy of a modified radical mastectomy is equal to that of a radical mastectomy,
and breast conservative therapy can be applied to patients in an early stage. Adjuvant chemotherapy and endocrine therapy
can improve the survival of resectable breast cancer patients.
Chinese Journal of Clinical Oncology 01/2005; 2(5):761-766.
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Xin Wang,
Gang Ma,
Tiehua Rong,
Zhifan Huang,
Mingtian Yang,
Canguang Zeng,
Peng Lin,
Hao Long, Jianhua Fu,
Siyu Wang,
Xuening Yang
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ABSTRACT: To identify predictors of survival following pneumonectomy for non-small cell lung cancer (NSCLC) and provide evidence for the revision of patient selection criteria.
81 cases of pneumonectomy for NSCLC from January 1990 to May 1996 at our hospital were reviewed retrospectively. There were 65 men (80.2%) and 16 women (19.8%), with a mean age 53.4 +/- 9.4 years (range 20 - 68 years). Predominant histological types included squamous cell carcinoma (54.3%), adenocarcinoma (24.7%), and squamoadenocarcinoma (17.3%). After follow-up for more than 5 years, data were examined using the chi-square test, Kaplan-Meier method, and Cox-mantel test. The possible factors affecting survival were tested with univariate and multivariate analysis.
The 5-year survival of N(0), N(1) and N(2) disease of NSCLC following pneumonectomy was (20.8 +/- 9.9)%, (15.4 +/- 10.0)% and (4.0 +/- 2.8)%, respectively. There was no perioperative death. The operative complications morbidity was 22.2%. Factors adversely affecting survival with univariate analysis included age over 60 years for right pneumonectomy, cardiopulmonary complications, adenocarcinoma, peripheral location, tumor greatest dimension more than 10 cm, chest wall involvement and N(2) disease. Factors adversely affecting survival with multivariate analysis included cardiopulmonary complications, greatest tumor dimension more than 10 cm, chest wall involvement and N(2) disease.
Pneumonectomy provides survival benefit with a high operative complications morbidity. Old age (>/= 60 years) for right pneumonectomy, cardiopulmonary complications, adenocarcinoma, and N(2) disease may be negative prognostic factors of long-term survival. Patient selection should be based on cardiopulmonary evaluation and the stage of disease.
Zhonghua wai ke za zhi [Chinese journal of surgery] 09/2002; 40(8):567-70.
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ABSTRACT: To evaluate the value of mediastinoscopy in diagnosing unknown mediastinal disease and staging of lung cancers.
From October 2000 to August 2001, 41 patients were examined by cervical mediastinoscopy with or without anterior mediastinotomy for diagnostic and staging purposes. Of these 41 patients, 12 were for diagnosis of unknown mediastinal disease, 3 for diagnosis and staging of pulmonary nodule or mass clinically suspected to be malignancy and 26 for the staging of lung cancer.
Ten of 12 patients with unknown mediastinal disease were diagnosed pathologically as thymoma in 1, metastatic lesion from lung cancer in 1, metastatic thyroid carcinoma in 1, lymph node hyperplasia in 1, teratoma in 1, sarcoidosis in 1, inflammatory pseudotumor in 1 and tuberculosis in 3, giving a diagnostic rate of 83.3%. Of three patients with suspected malignancy, one was diagnosed as tuberculosis by cervical mediastinoscopy and the other two as lymphoma and pulmonary inflammatory pseudotumor by thoracoscopy and thoracotomy. The sensitivity and specificity of mediastinoscopy for the staging of mediastinal nodes in 26 lung cancers were 87.5% and 100%. Only one wound infection but no other major complication was found.
Mediastinoscopy is a safe procedure which can accurately provide information on diagnosis and staging.
Zhonghua zhong liu za zhi [Chinese journal of oncology] 02/2002; 24(1):74-6.
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ABSTRACT: An exploratory study of the microtopological dimensions and shape features of yeast RNA polymerase II (y-poly II) on freshly cleaved mica was made in phosphate aqueous buffer solution at room temperature following previous work by Hansma and others. The molecules were imaged by stabilization on freshly cleaved mica at a limiting resolution of 10 Å and scanned using dynamical atomic force microscopy with a 10 nm multi-wall carbon nanotube in the resonance frequency modulation mode. They indicated microtopological shape and dimensional features similar to those predicted by electron density plots derived from the X-ray crystallographic model. It is concluded that this is considered primarily a feasibility study with definitive conclusions subject to more detailed systematic measurements of the 3D microtopology. These measurements appear to establish validity of the noncontact atomic force microscopy (nc-AFM) approach into defining the primary microtopology and biochemical functionality of RNA polymerase II. Further nc-AFM studies at higher resolution using dynamical nc-AFM will be required to clearly define the detailed 3D microtopology of RNA polymerase II in anaerobic aqueous environments for both static and dynamic conditions.
Applied Surface Science.
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ABSTRACT: An atomic force microscopy (AFM) study of the shape, orientation and surface topology of RNA polymerase II supported on silanized freshly cleaved mica was made. The overall aim is to define the molecular topology of RNA polymerase II in appropriate fluids to help clarify the relationship of conformational features to biofunctionality. A Nanoscope III atomic force microscope was used in the tapping mode with oxide-sharpened (8–10 nm) Si3N4 probes in aqueous zinc chloride buffer. The main structural features observed by AFM were compared to those derived from electron-density plots based on X-ray crystallographic studies. The conformational features included a bilobal silhouette with an inverted umbrella-shaped crater connected to a reaction site. These studies provide a starting point for constructing a 3D-AFM profiling analysis of proteins such as RNA polymerase complexes.
Applied Surface Science 210:105-111. · 2.10 Impact Factor
