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Objective:To investigate the association between the parameters of thin-section computed tomography and the invasion and histological subtypes of subsolid nodules measuring 1-2 centimeters in diameter as lung adenocarcinoma.Methods:We retrospectively reviewed the cases with subsolid nodules measuring 1-2 centimeters on thin-section computed tomography and histologically confirmed as lung adenocarcinoma.Results:A total of 135 patients were enrolled in this study, including 23 with pure ground glass nodules and 112 with part-solid ground glass nodule. We observed significant differences of nodule size, solid component size, consolidation-to-tumor ratio, nodule attenuation and attenuation ratio( P<0.0001). The receiver operating curve indicated certain predictive value of solid component size, nodule attenuation and attenuation ratio: AUC were 0.838(0.756-0.919)、0.823(0.729-0.917) and 0.820(0.726-0.914), respectively. Of the invasive adenocarcinoma, those with solid or micropapillary components merely showed a significance in solid component size( P=0.024). Conclusion:The parameters of thin-section computed tomography of 1-2 centimeters subsolid nodules showed significant differences in varied invasiveness of lung adenocarcinoma, and these could have certain predictive value.
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@#Objective To investigate the association between the baseline 18F-FDG PET/CT SUVmax and histological subtypes of ≤2 cm early peripheral lung adenocarcinoma (cN0). Methods We retrospectively reviewed the clinical data of consecutive patients who received baseline 18F-FDG PET/CT and underwent anatomic lung resection for ≤2 cm early peripheral lung adenocarcinoma from 2011 to 2014 in our institute. Results A total of 195 patients were enrolled in this study, including 86 males and 109 females, with an average age of 59.96±9.19 years. Twenty-two patients were pathologically confirmed with lymph node metastasis. One hundred and fifty-seven patients were in the subtype group 1, which included lepidic, acinar, and papillary predominant tumors. Thirty-eight patients were in the subtype group 2, which included solid and micropapillary predominant tumors. The 5-year survival rate was 79.0% and 58.0% in the subtype group 1 and subtype group 2, respectively (P=0.006). The median SUVmax was 2.00 (0.30-13.10) and 4.15 (1.20-17.90) in the subtype group 1 and subtype group 2, respectively (P=0.000). Logistic regression suggested that baseline SUVmax≥2.5 was an independent risk factor for the subtype group 2 (OR=6.635, 95%CI 2.510-17.545, P=0.000). The receiver operating characteristic curve suggested that the continuous SUVmax had an moderate predictive value for subtypes (area under the curve was 0.792, 95%CI 0.717-0.866). Conclusion Baseline 18F-FDG PET/CT SUVmax has certain predictive value for histological subtypes of ≤2 cm early peripheral lung adenocarcinoma.
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Objective To explore the application value of modified self-traction Overlap method in intrathoracic esophagogastrostomy of Ivor Lewis surgery.Methods The retrospective and descriptive study was conducted.The clinical data of 12 patients with lower esophageal carcinoma who underwent Ivor Lewis surgery in the Zhongshan Hospital of Fudan University from January to May 2018 were collected.There were 9 males and 3 females,aged from 50 to 73 years,with a median age of 61 years.Modified self-traction Overlap method was used for intrathoracic esophagogastrostomy during the surgery.The esophagus was pulled down with the ligature as traction and rotated clockwise by 45 degrees to perform side-to-side esophagogastric anastomosis.The common opening was closed by a laparoscopic linear cutting suturing device to form an esophagogastric Overlap triangle anastomosis,and finally the esophagus was disconnected.Observation indicators:(1) intraoperative and postoperative situations;(2) follow-up situations.Follow-up using outpatient examination and telephone interview was performed to detect survival situation and tumor recurrence and metastasis up to January 2019.Measurement data were described as M (range).Results (1) Intraoperative and postoperative situations:all the 12 patients underwent successful Ivor Lewis surgery,without conversion to open surgery.The operation time,time of tubular gastroesophageal anastomosis,volume of intraoperative blood loss,time to initial anal exsufflation and time for initial fluid diet intake were 145 minutes (range,125-189 minutes),20 minutes (range,16-35 minutes),98 mL (range,78-135 mL),4 days (range,3-5 days),6 days (range,5-7 days),respectively.All the patients had no complication.Patients underwent upper gastrointestinal iodine hydrography at 5 days after surgery,confirming no anastomotic leakage or stenosis.Patients recovered well and were discharged postoperatively.The duration of postoperative hospital stay was 8 days (range,7-11 days).(2) Follow-up situations:12 patients were followed up for 8.0-12.0 months,with a median time of 10.6 months.Patients survived well,with no tumor recurrence or metastasis.Condusion Modified self-traction Overlap method in thoracic esophagogastrostomy of Ivor Lewis surgery is safe and feasible for lower esophageal carcinoma,with easy operating
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With the development of molecular biology,liquid biopsy has been the hot spot in the research of tumor precision therapy.Liquid biopsy technology has been found having high value in areas such as diagnosis,treatment and evaluation of tumor.Compared with traditional tissue biopsy,liquid biopsy technology is not only less invasive and can be performed repeatedly at various times to monitor tumor in real time,but it also has a distinct advantage in reflecting the heterogeneity of tumor.This review introduced circulating tumor cell (CTC) and circulating tumor DNA (ctDNA) which was the most studied in liquid biopsy,mainly focusing on the detection technology and application in esophageal cancer.