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OBJECTIVES: Gastric cancer is a heterogeneous malignancy in terms of stage-wise prognosis. This study aimed at finding any prognostic significance of preoperative carcinoembryonic antigen (CEA) and cancer antigen (CA) 19-9 in resectable gastric cancer. METHODS: A total of 57 patients at Kidwai Memorial Institute of Oncology, Bengaluru, India from January 2022 to March 2023 were included in this observational prospective study. Included patients had a resectable tumor at clinical staging. Patients were divided into two categories (raised and non-raised) based on serum tumor marker (CEA and CA 19-9) levels. Their relationship with clinicopathological features was studied. The association was studied using chi-square test, and p-value <0.05 was considered significant. RESULTS: The mean age of the study group was 55.47 years with male predominance (63.2%, n=36). Raised CEA and CA 19-9 were seen in 15.8% (n=9) and 10.5% (n=6) patients, respectively, while both markers were raised in 5.3% (n=3). Raised CEA was found significantly associated with grade 3 adenocarcinoma stomach (OR 7.825, 95%CI: 1.374-44.562; p= 0.020) and intraoperative finding of inoperability due to occult intra-abdominal disease (p<0.05). CA 19-9 (pre- and post-operative levels) had no statistically significant association (p>0.05) with the grade of adenocarcinoma. CONCLUSION: This study indicates a benefit in estimating CEA for the prediction of prognosis in gastric cancer. CEA levels have been found to predict chances of finding occult intra-abdominal metastasis in gastric cancer.
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Tracheal length and lung anatomy have been rarely studied; however, the anatomy of the lung has been shown to vary significantly. Moreover, the surgery regarding trachea are few, and hence the surgeons do not have extensive experience in the trachea. OBJECTIVE: We aimed to study the variations of the lung anatomy and the relation between tracheal length and body height in the Indian population. MATERIALS AND METHODS: This is an observational study to observe the tracheal length in relation to body height and sex and gross morphological anatomy of the lung in 70 cadavers. The data was collected from the forensic department of Bangalore Medical College and Research Institute (BMCRI), and further analysis was done at Kidwai Memorial Institute of Oncology. RESULTS: Deviation from normal lung morphology was seen in 37.86% of the specimens studied. The tracheal length (average, 9.97 cm) correlated with the body length (average, 147.02 cm) with a Pearson coefficient of 0.806 (p value=0.001) Conclusion: The study of lung fissure morphology guides clinicians in understanding and planning lung disease treatment, especially lobectomy/segmentectomy surgeries. The information of the average length of the trachea with respect to body height in a given ethnicity will help during endotracheal intubation and tracheal surgical planning.
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The concept of reverse axillary mapping originated with the main purpose of reducing lymphedema. In this study, we test the advantage of reverse axillary mapping to delineate the arm-draining lymph nodes and their involvement in various stages of breast carcinoma. In this study, we also attempt to redefine the template for axillary dissection in breast cancer. During the period of September 30, 2020, to August 30, 2021, 46 patients were recruited to undergo a procedure in which isosulfan blue dye was injected into the upper arm and the axilla was explored to isolate the lymph nodes. The lymph nodes were submitted for examination histopathologically. The results conclusively showed that axillary lymph node metastasis was only influenced by the advanced stage of the disease (p=0.014) and the visualization of the lymphatics was independent of the stage, type of surgery, decubitus, or age. The study conclusively shows that attempts to preserve the upper limb-draining nodes in advanced stages would be futile and the preservation of such lymph nodes should be limited to the early stages of breast cancer.
