Rare case of mantle cell lymphoma of the lacrimal sac

ABSTRACT Mantle cell lymphoma of the ocular and periorbital regions is extremely rare but should be considered in the differential diagnosis of lesions affecting the periorbital tissues. In this study, we present a rare case of mantle cell lymphoma of the lacrimal sac in a 65-year-old male presenting with a mass in the lacrimal sac region and epiphora. After clinical examinations and imaging studies, the mucocele was misdiagnosed. Considering the unexpected findings during external dacryocystorhinostomy, a frozen biopsy was performed, which confirmed the diagnosis of lymphoma.

Estadio, perfil biológico y tendencias de incidencia y mortalidad de cáncer de mama en Uruguay: análisis por franjas etarias / Stage, biological profile and trends in the incidence and mortality of breast cancer in Uruguay: analysis by age groups / Estágio, perfil biológico e tendências da incidência e mortalidade por cáncer de mama no Uruguai: análise por faixa etária

Introducción: el cáncer de mama es el tumor maligno más frecuente y la primera causa de muerte por cáncer en mujeres en Uruguay y en el mundo. La evidencia epidemiológica sugiere que el cáncer de mama en diferentes grupos de edades se comportaría como patologías distintas. El objetivo de este trabajo es caracterizar el cáncer de mama en Uruguay para diferentes estratos de edades. Material y método: se analizaron las tendencias temporales de la incidencia de cáncer de mama en mujeres en Uruguay en el período 2002-2019, y de la mortalidad por esta causa en 1990-2020. Para el quinquenio 2015-2019, se analiza además la distribución de estadios al diagnóstico y de perfiles biológicos (luminales, triple negativos y HER2 positivos). Se analizan tres segmentos de edades: mujeres de 20 a 44 años, de 45 a 69 y de 70 y más años. Resultados: las tasas de incidencia para el conjunto de edades se presentaron estables en el período 2002-2019, mientras que la mortalidad presenta una tendencia decreciente en el período 1990-2020. En las mujeres menores de 45 años se encuentra un aumento en la incidencia, con mortalidad que decrece hasta el 2010, seguido de una estabilización de las tasas; en las mujeres de 45 a 69 años la incidencia se mantiene estable y la mortalidad decrece; en las mayores de 70 años, la incidencia decrece mientras la mortalidad se mantiene estable. Más del 70% de los casos se diagnostican en estadios I y II. Los tumores luminales (receptores hormonales positivos, HER2 negativos) son el subtipo más frecuente para todos los grupos, la proporción de tumores con estas características aumenta con la edad, mientras decrece la proporción de HER2 positivo y triple negativo. Conclusión: en las mujeres uruguayas el cáncer de mama presenta características diferenciales para las tres franjas de edades analizadas.

Introduction: Breast cancer is the most common malignant tumor and the leading cause of cancer death in women in Uruguay and worldwide. Epidemiological evidence suggests that breast cancer in different age groups behaves as distinct pathologies. The objective of this work is to characterize breast cancer in Uruguay for different age groups. Method: Temporal trends in the incidence of breast cancer in women in Uruguay are analyzed for the period 2002-2019, along with mortality trends for this cause from 1990 to 2020. For the five-year period 2015-2019, the distribution of stages at diagnosis and biological profiles (Luminal, Triple-negative, and Her2 positive) is also analyzed. Three age segments are analyzed: women aged 20 to 44 years, 45 to 69 years, and 70 years and older. Results: The incidence rates for all age groups remained stable during the period 2002-2019, while mortality showed a decreasing trend in the period 1990-2020. In women under 45, there is an increase in incidence, with mortality decreasing until 2010, followed by a stabilization of rates; in women aged 45 to 69, incidence remains stable and mortality decreases; in those over 70, incidence decreases while mortality remains stable. More than 70% of cases are diagnosed at stages I and II. Luminal tumors (hormone receptor positive, Her2 negative) are the most frequent subtype for all age groups. The proportion of tumors with these characteristics increases with age, while the proportion of Her2 positive and triple-negative tumors decreases. Conclusions: In Uruguayan women, breast cancer presents differential characteristics for the three age groups analyzed.

Introdução: O câncer de mama é o tumor maligno mais comum e a principal causa de morte por câncer em mulheres no Uruguai e no mundo. Evidências epidemiológicas sugerem que o câncer de mama se comportaria como patologias distintas em diferentes faixas etárias. O objetivo deste trabalho é caracterizar o câncer de mama no Uruguai para diferentes faixas etárias. Materiais e Métodos: São analisadas as tendências temporais da incidência de câncer de mama em mulheres no Uruguai no período 2002-2019 e a mortalidade por esta causa no período 1990-2020. Para o quinquénio 2015-2019 são também analisadas a distribuição dos estádios ao diagnóstico e os perfis biológicos (Luminal, Triplo negativo e Her2 positivo). São analisados três segmentos etários: mulheres dos 20 aos 44 anos, dos 45 aos 69 anos e dos 70 anos ou mais. Resultados: As taxas de incidência para todas as idades permaneceram estáveis no período 2002-2019 enquanto a mortalidade apresentou tendência decrescente no período 1990-2020. Nas mulheres com menos de 45 anos verifica-se um aumento da incidência, com uma redução da mortalidade até 2010, seguida de uma estabilização das taxas; nas mulheres de 45 a 69 anos, a incidência permanece estável e a mortalidade diminui; nas pessoas com mais de 70 anos, a incidência diminui enquanto a mortalidade permanece estável. Mais de 70% dos casos são diagnosticados nos estágios I e II. Os tumores luminais (receptor hormonal positivo, Her2 negativo) são o subtipo mais comum para todos os grupos sem do que a proporção de tumores com essas características aumenta com a idade, enquanto a proporção de (Her2 positivo e triplo negativo) diminui. Conclusão: Nas mulheres uruguaias, o câncer de mama apresenta características diferenciadas para as três faixas etárias analisadas.

Caracterización histológica del melanoma cutáneo en reportes de patología en la ciudad de Cali, 2016-2021 / Histological characterization of cutaneous melanoma in pathology reports in the city of Cali, 2016-2021

Introducción. El melanoma es la proliferación maligna de melanocitos asociado a un comportamiento agresivo. El objetivo de este estudio fue determinar las variables histológicas del melanoma cutáneo. Métodos. Estudio observacional retrospectivo, transversal descriptivo, realizado con reportes de patologías de pacientes con diagnóstico de melanoma cutáneo en un laboratorio de patología en Cali, Colombia, entre 2016-2021. Se incluyeron las variables edad, sexo, localización, subtipo, espesor de Breslow, ulceración, márgenes, mitosis, invasión linfovascular, neurotrofismo, regresión tumoral, nivel de Clark e infiltración tumoral por linfocitos. Resultados. Se obtuvieron 106 reportes y fueron excluidos 54 por duplicación. Se incluyeron 52 registros, la media de edad fue de 61 años, con una mayor frecuencia de mujeres (55,8 %). De los 33 casos donde se especificó el subtipo histológico, el más frecuente fue el de extensión superficial (66,6 %), seguido del acral lentiginoso (18,1 %) y nodular con (15,2 %). La localización más frecuente fue en extremidades (61,5 %). El espesor de Breslow más común fue IV (34,6 %) y el nivel de Clark más frecuente fue IV (34,6 %). La ulceración estuvo en el 40,4 %. El subtipo nodular fue el de presentación más agresiva, donde el 100 % presentaron espesor de Breslow IV. Conclusiones. El subtipo de melanoma más común en nuestra población fue el de extensión superficial; el segundo en frecuencia fue el subtipo acral lentiginoso, que se localizó siempre en extremidades. Más del 50 % de los melanomas tenían espesor de Breslow mayor o igual a III, lo que impacta en el pronóstico.

Background. Melanoma is the malignant proliferation of melanocytes associated with aggressive behavior. The objective of this study was to determine the histological variables of cutaneous melanoma. Methods. Observational, cross-sectional, descriptive, retrospective study carried out with reports of pathologies with a diagnosis of cutaneous melanoma in a pathology laboratory in Cali between 2016-2021. The variables were age, sex, location, subtype, Breslow thickness, ulceration, margins, mitosis, lymphovascular invasion, neurotropism, tumoral regression, Clark level and tumor infiltration by lymphocytes. Results. One hundred and six reports were obtained and 54 were excluded due to duplication. A descriptive analysis was made on the 52 records that were included, the mean age was 61 years, with a higher frequency in women with 55.8%. Of the 33 cases where the histological subtype was specified, the most frequent was superficial extension with 66.6%, followed by acral lentiginous with 18.1% and nodular with 15.2%. The most frequent location was in the extremities (61.5%); the most common Breslow was IV (34.6%), and the most frequent Clark was IV (34.6%). Ulceration was in 40.4%. The nodular subtype was the most aggressive presentation where 100% presented Breslow IV. Conclusions. The most common subtype of melanoma was that of superficial extension. In our population, the second most frequent was the acral lentiginous subtype, which was always located on the extremities. More than 50% of the melanomas had Breslow greater than or equal to III, which affects the prognosis.

División ganglionar posquirúrgica y su efecto en el recuento ganglionar y la estadificación en pacientes con cáncer gástrico / Postoperative lymph node division and its effect on lymph node count and staging in patients with gastric cancer

Introducción. La gastrectomía y disección ganglionar es el estándar de manejo para los pacientes con cáncer gástrico. Factores como la identificación de ganglios por el patólogo, pueden tener un impacto negativo en la estadificación y el tratamiento. El objetivo de este estudio fue comparar el recuento ganglionar de un espécimen quirúrgico después de una gastrectomía completa (grupo A) y de un espécimen con un fraccionamiento por grupos ganglionares (grupo B). Métodos. Estudio de una base de datos retrospectiva de pacientes sometidos a gastrectomía D2 en el Servicio de Cirugía gastrointestinal de la Liga Contra el Cáncer seccional Risaralda, Pereira, Colombia. Se comparó el recuento ganglionar en especímenes quirúrgicos con y sin división ganglionar por regiones anatómicas previo a su envío a patología. Resultados. De los 94 pacientes intervenidos, 65 pertenecían al grupo A y 29 pacientes al grupo B. El promedio de ganglios fue de 24,4±8,6 y 32,4±14,4 respectivamente (p=0,004). El porcentaje de pacientes con más de 15 y de 25 ganglios fue menor en el grupo A que en el grupo B (27 vs 57, p=0,432 y 19 vs 24, p=0,014). El promedio de pacientes con una relación ganglionar menor 0,2 fue mayor en el grupo B (72,4 % vs 55,4 %, p=0,119). Conclusiones. Los resultados de nuestro estudio mostraron que una división por grupos ganglionares previo a la valoración del espécimen por el servicio de patología incrementa el recuento ganglionar y permite establecer de manera certera el pronóstico de los pacientes, teniendo un impacto positivo en su estadificación, para evitar el sobretratamiento

Introduction. A gastrectomy and lymph node dissection is the standard of management for patients with gastric cancer. Factors such as the identification of nodes by the pathologist can have a negative impact on staging and treatment. The objective of this study was to compare the lymph node count of a surgical specimen after a complete gastrectomy (group A) and of a specimen with lymph node by groups (group B). Methods. Study of a retrospective database of patients undergoing D2 gastrectomy in the Risaralda section of the Liga Contra el Cancer Gastrointestinal surgical service, Pereira, Colombia. The lymph node count was compared in surgical specimens with and without lymph node division by anatomical regions, prior to sending them to pathology. Results. Of the 94 patients who underwent surgery, 65 were from group A and 29 patients were from group B. The average number of nodes was 24.4±8.6 and 32.4±14.4, respectively (p=0.004). The percentage of patients with more than 15 and 25 nodes was lower in group A than in group B (27 vs 57, p=0.432 and 19 vs 24, p=0.014). The average number of patients with a nodal ratio less than 0.2 was higher in group B (72.4% vs 55.4%, p=0.119). Conclusions. The results of our study showed that a division by lymph node groups prior to the evaluation of the specimen by the pathology service increases the lymph node count and allows the prognosis of patients to be accurately established, having a positive impact on their staging, to avoid overtreatment.

Utilidad diagnóstica de citopatología para diagnóstico de nódulos tiroideos malignos en un hospital peruano / Diagnostic utility of cytopathology for the diagnosis of malignant thyroid nodules in a Peruvian hospital

RESUMEN Objetivos: determinar el rendimiento diagnóstico de la biopsia por punción aspiración con aguja fina (PAAF) para el diagnóstico de nódulos tiroideos malignos. Materiales y métodos: estudio retrospectivo que evaluó las PAAF de tiroides realizadas en el Hospital Nacional Guillermo Almenara Irigoyen en Lima, Perú, durante un período de tres años. Se categorizó el diagnóstico citopatológico de las biopsias usando el sistema de Bethesda, se consideró las categorías V y VI como malignas y la categoría II como benigna. Se obtuvo solo una biopsia por paciente y se consideró el resultado con la categoría de Bethesda más alta. Todos los pacientes fueron sometidos a tiroidectomía y los resultados histopatológicos se categorizaron como malignos o benignos. Resultados: se incluyó a 173 pacientes con resultados citopatológicos de Bethesda II al VI. El diagnóstico citológico mostró que el 47,4% de los pacientes tenían Bethesda VI. El 59,5% de los nódulos tiroideos fueron malignos en la histopatología, siendo el carcinoma papilar el tipo más frecuente. El rendimiento diagnóstico de la PAAF fue alta cuando considera Bethesda V y VI como malignos, con una sensibilidad 91,92%, especificidad 71,67%, valor predictivo positivo 84,26%, valor predictivo negativo 84,31% y precisión de 84,28%, razón de verosimilitud positiva 3,39; pero mejoró significativamente cuando se consideró solo Bethesda VI como maligno, con sensibilidad del 90,7%, especificidad del 89,58%, precisión 90,3% y razón de verosimilitud positiva 8,71. Conclusiones : la PAAF tiene buen rendimiento. Este estudio demostró ser de gran utilidad en nuestro centro de salud para detectar errores y promover mejoras, así también como modelo para próximas investigaciones en diferentes establecimientos de salud.

ABSTRACT Objectives: To determine the diagnostic performance of fine needle aspiration biopsy (FNAB) for diagnosing malignant thyroid nodules. Methods: This is a retrospective study that assessed thyroid FNABs in Guillermo Almenara-Irigoyen National Hospital in Lima, Peru, during a three-year period. Cytopathologic diagnosis of biopsies was categorized using the Bethesda System, considering categories V and VI as malignant, and category II as benign. A single biopsy per patient was obtained, and results with the highest value in the Bethesda System were considered. All patients underwent thyroidectomy and histopathological results were characterized as malignant or benign. Results: One hundred and seventy-three patients were included in the study. Their cytopathology results were Bethesda II to VI. Cytological diagnosis showed that 47.4% of all patients were Bethesda VI. Nearly sixty percent (59.5%) of thyroid nodules were malignant in histopathology, and papillary carcinoma was the most frequent neoplasm. Diagnostic performance of FNAB was high when considering Bethesda V and VI as malignant, with 91.92% sensitivity, 71.67% specificity, 84.26 positive predictive value, 84.31% negative predictive value, and 84.28% precision. Positive verisimilitude rate was 3.39; but this significantly improved when only Bethesda VI was considered as malignant, with 90.7% sensitivity, 89.58% specificity, 90.3% precision, and 8.71 positive verisimilitude rate. Conclusion: FNAB showed good performance. This study proved to be quite useful in our healthcare facility for detecting errors and promote improvement, as well as a model for future research in different healthcare instances.

Correlation between preoperative plasma fibrin degradation products level and clinicopathological features in patients with non-small cell lung cancer / 肿瘤研究与临床

Objective:To investigate the relationship between preoperative plasma fibrin degradation products (FDP) level and clinicopathological features of patients with completely resected non-small cell lung cancer (NSCLC).Methods:A retrospective case series study was performed. The clinical data of 521 patients who were pathologically diagnosed with NSCLC in Beijing Friendship Hospital Affiliated to Capital Medical University from January 2016 to December 2017 were retrospectively analyzed. Among 521 cases, 406 cases were postoperatively pathologically confirmed as non-lymph node and non-distant metastasis (non-metastasis group) and 115 cases were postoperatively pathologically confirmed as lymph node or distant metastasis (metastasis group). The preoperative FDP level and clinicopathological characteristics as well as the clinicopathological characteristics of NSCLC patients with different FDP levels were compared between the two groups. The correlation between preoperative FDP level and TNM staging was analyzed by using Spearman correlation analysis.Results:Among 521 NSCLC patients, 266 cases were female, 255 cases were male; the age [ M( Q1, Q3)] was 59 years (54 years, 65 years); 441 cases were adenocarcinoma and 70 cases were squamous cell carcinoma. The preoperative median FDP level was 2.78 mg/L (2.35 mg/L, 3.13 mg/L) and 2.99 mg/L (2.56 mg/L, 4.16 mg/L), respectively of NSCLC patients in non-metastasis group and metastasis group, and the difference was statistically significant ( Z = 6.13, P < 0.001). The preoperative FDP level was 2.56 mg/L (2.35 mg/L, 3.20 mg/L) and 2.99 mg/L (2.56 mg/L, 3.20 mg/L), respectively in the early-stage NSCLC (stage Ⅰ-Ⅱ) and advanced NSCLC (stage Ⅲ-Ⅳ) patients, and the difference was statistically significant ( Z = 8.42, P < 0.001). Spearman correlation analysis showed that preoperative FDP level was positively correlated with tumor diameter ( r = 0.287, P < 0.001). There was a positive correlation between preoperative FDP level and the number of metastatic lymph nodes in 115 patients with lymph node metastasis ( r = 0.679, P < 0.001). According to the preoperative median FDP (2.78 mg/L), all patients were divided into FDP ≤2.78 mg/L group and FDP >2.78 mg/L, and there were statistically significant differences in age, metastasis, tumor staging, tumor diameter, the metastatic number of lymph node and histological types of NSCLC patients in both groups (all P < 0.05). Conclusions:The increase of preoperative plasma FDP level may be related to the tumor metastasis and clinical stage of NSCLC patients

The value of ultrasonography combined with serum thyroglobulin levels in preoperative N staging and therapeutic effect evaluation in patients with thyroid cancer / 中国基层医药

Objective:To investigate the clinical value of ultrasonography combined with serum thyroglobulin (Tg) levels in preoperative N staging and therapeutic effect evaluation in patients with thyroid cancer.Methods:A retrospective analysis was conducted on the clinical data of 125 patients with thyroid cancer who underwent total thyroidectomy at The 903 Hospital of PLA Joint Logistics Support Force between January 2016 and December 2021. Based on the pathological results, the patients were divided into stages N0, N1a, and N1b. Consistency testing was performed to assess the consistency between ultrasonographic and pathological findings. The serological markers were compared between stage N0 and stage N1. A multivariate logistic regression analysis was conducted to investigate the correlation between antithyroid peroxidase antibodies (TPOAb) and Tg and lymph node metastasis. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of serum Tg, ultrasonography, and the combination of serum Tg with ultrasonography for lymph node metastasis.Results:Among the 125 patients, 51 cases were diagnosed with stage N1, including 36 cases of stage N1a and 15 cases of stage N1b. The pathological examination confirmed stage N0 in 74 cases. Ultrasonography results showed stage N0 in 96 cases, stage N1a in 7 cases, and stage N1b in 22 cases. The preoperative N staging of thyroid cancer patients by ultrasonography was moderately consistent with the pathological staging ( Kappa = 0.44, P < 0.001). Serum free triiodothyronine and Tg levels were higher in stage N1 compared with stage N0 ( P < 0.001), while serum TPOAb levels were lower in stage N1 than in stage N0 ( P = 0.017). Multivariate logistic regression analysis was performed with lymph node metastasis as the dependent variable and the factors FT3, TPOAb, and Tg levels as independent variables. The analysis revealed that Tg was associated with lymph node metastasis ( OR = 1.02, P < 0.001). The ROC curve analysis showed that the area under the ROC curve for serum Tg level and ultrasonography for the diagnosis of lymph node metastasis were 0.67 and 0.65, respectively, which were significantly lower than the area under the curve (0.76) for the combined detection ( P < 0.001). Conclusion:The combined utilization of ultrasonography and serum Tg levels in the preoperative staging of thyroid cancer patients holds distinct clinical relevance. Notably, this combined approach offers a more precise diagnosis of lymph node metastasis compared with ultrasonography alone. Consequently, when making clinical judgments regarding preoperative lymph node metastasis, it is advisable to consider the results of both ultrasonography and serum Tg testing to facilitate surgical planning and evaluate surgical outcomes.

CT radiomics combined with clinical and CT features for predicting TNM stage of thymic epithelial tumor / 中国介入影像与治疗学

Objective To explore the value of CT radiomics combined with clinical data and CT features for predicting TNM stage of thymic epithelial tumor(TET).Methods Data of 216 single TET patients confirmed by surgical pathology were retrospectively analyzed.Totally 151 cases with TNM stage Ⅰ TET were divided into early group,while 27 with TNM stage Ⅲ and 38 with TNM stage Ⅳ TET were divided into late group(n=65).Univariate analysis was used to analyze clinical data and chest CT manifestations.Based on non-contrast-enhanced CT(NECT)and contrast-enhanced CT(CECT),the best radiomics features were extracted and screened to establish radiomics models(RMNECT,RMCECT)for predicting TNM stage of TET.RMNECT-clinic,RMCECT-clinic,RMNECT-clinic-CT and RMCECT-clinic-CT were constructed based on combination of clinical and CT features being significantly different between groups,respectively.The patients were divided into training set(n=151)and validation set(n=65)at the ratio of 7∶3.The above models were trained in the training set using repeated 5-fold cross validation method,and their efficacy were verified in the validation set.Results Significant differences of clinical symptoms and CT manifestations including fat infiltration around the lesion,mediastinal lymph node enlargement and pleural effusion were found between groups(all P＜0.05).Based on NECT and CECT,2 and 9 best radiomics features were selected to construct the corresponding models.In validation set,the area under the curve(AUC)of RMNECT-clinic-CT for predicting TNM stage of TET(0.864)was higher than that of RMNECT and RMNECT-clinic(AUC=0.634,0.721,Z=3.081,2.937,P=0.002,0.003),while AUC of RMCECT-clinic-CT(0.920)was also higher than that of RMCECT and RMCECT-clinic(AUC=0.689,0.751,Z=2.698,2.390,P=0.007,0.017).Conclusion CT radiomics combined with clinical data and CT features could effectively predict TNM stage of TET.

Proposal for the applicability of modified Breslow (measured from the basal membrane) as a predictor of survival and sentinel lymph node outcome in patients with cutaneous melanoma

Abstract Background Cutaneous melanoma is a neoplasm with a high mortality rate and risk of metastases to distant organs. The Breslow micrometric measurement is considered the most important factor for evaluating prognosis and management, measured from the granular layer to the deepest portion of the neoplasm. Despite its widespread use, the Breslow thickness measurement has some inaccuracies, such as not considering variations in the thickness of the epidermis in different body locations or when there is ulceration. Objective To evaluate the applicability of a modified Breslow measurement, measured from the basal membrane instead of from the granular layer, in an attempt to predict sentinel lymph node examination outcome and survival of patients with melanoma. Methods A retrospective and cross-sectional analysis was carried out based on the evaluation of slides stained with hematoxylin & eosin from 275 cases of melanoma that underwent sentinel lymph node biopsy from 2008 to 2021 at a reference center in Brazil. Results Analysis of the Cox model to evaluate the impact of the Breslow measurement and the modified Breslow measurement on survival showed that both methods are statistically significant. Logistic regression revealed a significant association between both measurements and the presence of metastasis in sentinel lymph nodes. Conclusion Measuring melanoma depth from the basal membrane (modified Breslow measurement) is capable of predicting survival time and sentinel lymph node outcome, as well as the conventional Breslow measurement.

EBUS-TBNA in mediastinal staging of non-small cell lung cancer: comparison with pathological staging

ABSTRACT Objective: Although EBUS-TBNA combined with EUS-FNA or EUS-B-FNA stands as the primary approach for mediastinal staging in lung cancer, guidelines recommend mediastinoscopy confirmation if a lymph node identified on chest CT or showing increased PET scan uptake yields negativity on these techniques. This study aimed to assess the staging precision of EBUS/EUS. Methods: We conducted a retrospective study comparing the clinical staging of non-small cell lung cancer patients undergoing EBUS/EUS with their post-surgery pathological staging. We analyzed the influence of histology, location, tumor size, and the time lapse between EBUS and surgery. Patients with N0/N1 staging on EBUS/EUS, undergoing surgery, and with at least one station approached in both procedures were selected. Post-surgery, patients were categorized into N0/N1 and N2 groups. Results: Among the included patients (n = 47), pathological upstaging to N2 occurred in 6 (12.8%). Of these, 4 (66.7%) had a single N2 station, and 2 (33.3%) had multiple N2 stations. The adenopathy most frequently associated with upstaging was station 7. None of the analyzed variables demonstrated a statistically significant difference in the occurrence of upstaging. PET scan indicated increased uptake in only one of these adenopathies, and only one was visualized on chest CT. Conclusions: Upstaging proved independent of the studied variables, and only 2 patients with negative EBUS/EUS would warrant referral for mediastinoscopy. Exploring other noninvasive methods with even greater sensitivity for detecting micrometastatic lymph node disease is crucial.

Etapa al diagnóstico de cáncer de próstata en un hospital institucional. Revisión y comparación de datos nacionales e internacionales / Stage at diagnosis of prostate cancer in an institutional hospital. Review and comparison of national and international data

INTRODUCCIÓN: El cáncer prostático (CaP) es una patología de alta prevalencia e incidencia mundial. El tamizaje ha perseguido el diagnóstico precoz de esta enfermedad para otorgar tratamientos oportunos. Nosotros buscamos caracterizar los pacientes de un hospital local respecto al diagnóstico y etapificación, y comparar estos resultados con datos previamente reportados. MATERIAL Y MÉTODO: Análisis retrospectivo de pacientes diagnosticados con CaP en un hospital institucional. Se recolectaron variables clínicas al momento del diagnóstico, los métodos de etapificación, el estadío según TNM y grado histológico. RESULTADOS: Se incluyeron 129 pacientes en el análisis. La mediana de APE (ng/mL) al diagnóstico fue de 7,29. El grado histológico fue clasificado como ISUP 1 en 37,5%. Se realizó una resonancia magnética multiparamétrica de próstata (RMmp) en el 42,19% de los pacientes, siendo clasificados como PIRADS 4 en mayor proporción (21,09%). La etapificación con PET-CT PSMA se utilizó principalmente en el grupo de alto riesgo y ante dudas frente a etapificación con medios convencionales. Se prefirió la Tomografía computada (TC) contrastada y la cintigrafía ósea en los otros grupos. 6,25% fue catalogado N1 y 9,37% M1. CONCLUSIÓN: La etapa al diagnóstico de nuestra serie es algo mayor a lo reportado por países desarrollados, pero considerablemente menor a lo publicado por otros países de Latinoamérica e inclusive de otros hospitales de nuestro país. Pareciera ser de gran relevancia nacional contar con protocolos claros de tamizaje y acceso a APE con el fin de disminuir los casos diagnosticados en etapas avanzadas.

INTRODUCTION: Prostate cancer (PCa) is a disease with a high prevalence and incidence worldwide. Screening has pursued the early diagnosis of this disease to provide early treatment. We sought to characterize patients from a local hospital with respect to diagnosis and staging and to compare these results with previously reported data. METHODS: We conducted a retrospective analysis of patients diagnosed with PCa at an institutional hospital. Clinical variables were collected at the time of diagnosis, staging methods, TNM stage, and histological grade. RESULTS: 129 patients were included in the analysis. The median PSA (ng/mL) at diagnosis was 7.29. The histological grade was classified as ISUP 1 in 37.5%. An MRI was performed in 42.19% of the patients, being classified mostly as PIRADS 4 (21.09%). PET-CT PSMA staging was used mainly in the high-risk group, preferring contrast-enhanced CT and bone scintigraphy in the other groups. 6.25% were classified as N1 and 9.37% as M1. CONCLUSION: The stage at diagnosis in our series is somewhat higher than that reported by developed countries but considerably lower than that published by other Latin American countries and even from other hospitals in our country. It is of great national relevance to have clear protocols for screening and access to PSA to reduce the cases diagnosed in advanced stages.

Situación actual de la laparoscopía de estadificación en pacientes con cáncer gástrico en Colombia: ¿Cómo lo estamos haciendo?

Introducción. La laparoscopía de estadificación permite identificar con gran precisión el compromiso locorregional avanzado y metastásico a peritoneo en los pacientes con cáncer gástrico. Las guías internacionales aún difieren en las indicaciones para incluir este procedimiento como parte del proceso de estadificación. Métodos. Se diseñó una encuesta dirigida a cirujanos residentes en Colombia, sobre el uso de la laparoscopía de estadificación en los pacientes con cáncer gástrico. Se analizaron los resultados y con base en la evidencia disponible se proponen algunas pautas en las indicaciones y técnica del procedimiento. Resultados. Respondieron la encuesta 74 cirujanos; el 43,8 % considera que el objetivo de la laparoscopía de estadificación es descartar la carcinomatosis peritoneal. El 54,1 % realiza el procedimiento en estadios tempranos, sin embargo, el 48,6 % considera realizarla solo en pacientes con sospecha de carcinomatosis por imágenes. Las áreas evaluadas con mayor frecuencia por los cirujanos (más del 85 %) son la superficie hepática, las cúpulas diafragmáticas, los recesos parietocólicos y la pelvis. Las zonas evaluadas en menor frecuencia son la válvula ileocecal (40,5 %) y el ligamento de Treitz (39 %). El 33 % de los cirujanos no toma rutinariamente citología peritoneal. Conclusión. Este trabajo muestra la tendencia de los cirujanos en el uso de la laparoscopía de estadificación en pacientes con cáncer gástrico. A pesar de encontrar resultados muy positivos en relación con las indicaciones y técnica del procedimiento, es necesario analizar la evidencia disponible para su uso según cada escenario y mejorar la sistematización del procedimiento.

Introduction. In patients with gastric cancer, staging laparoscopy allows advanced locoregional and metastatic involvement to the peritoneum to be identified with high accuracy. International guidelines still differ indications to include this procedure as part of the staging process. Methods. A survey was designed for surgeons practicing in Colombia on the use of staging laparoscopy in gastric cancer patients. The results were analyzed and based on the available evidence some guidelines on the indications and technique of the procedure were proposed. Results. 74 surgeons responded to the survey and 39.7% consider that staging laparoscopy is a reliable tool to define resectability. 43.8% of surgeons consider that the objective of staging laparoscopy is to rule out peritoneal carcinomatosis and 54.1% perform the procedure in early stages; however, 48.6% consider performing it only in patients with suspected carcinomatosis by imaging. The areas evaluated by most surgeons (>85%) were the hepatic surface, diaphragmatic domes, parietocolic recesses and pelvis. The least frequently evaluated areas were the ileocecal valve (40.5%) and the ligament of Treitz (39%). Peritoneal cytology is not routinely taken by 33% of surgeons. Conclusions. This study provides insight into surgeons' trends in the use of staging laparoscopy in gastric cancer patients. Despite finding very positive results in relation to the indications and technique of the procedure for many surgeons, it is necessary to analyze the available evidence for the use of staging laparoscopy according to each scenario of gastric cancer patients, and a better systematization of the procedure is necessary.

Analysis of clinical characteristics of multiple myeloma patients combined with kidney injury and risk factors for kidney injury / 白血病·淋巴瘤

Objective:To investigate the clinical characteristics of patients with multiple myeloma (MM) combined with kidney injury and the risk factors associated with the occurrence of kidney injury.Methods:The clinical data of 96 newly treated MM patients in Heze Municipal Hospital from January 2017 to June 2021 were retrospectively analyzed, and the patients were divided into the kidney injury group (33 cases) and the non-kidney injury group (63 cases) based on whether the blood creatinine was >177 μmol/L at the time of diagnosis. The general data and laboratory results of the two groups were compared. The risk factors for kidney injury in MM patients were analyzed by logistic regression method, and the receiver operating characteristic (ROC) curve was drawn to assess the predictive value of each risk factor for the occurrence of kidney injury in MM patients.Results:Compared with the non-kidney injury group, hemoglobin was lower in the kidney injury group, and white blood cell count, blood uric acid, urea nitrogen, β 2-microglobulin (β 2-MG), cystatin C, the proportion of patients with light chain type, and the proportion of patients with international staging system (ISS) stage Ⅲ were higher in the kidney injury group, and the differences were statistically significant (all P < 0.05). Thirty-four patients underwent fluorescence in situ hybridization (FISH) test, and 22 cases (64.7%) had abnormal results. In the non-kidney injury group, genetic testing were performed in 26 cases, and the results were abnormal in 14 cases, including 11 cases (42.3%) of IgH rearrangement, 4 cases (15.4%) of RB1 deletion, 4 cases (15.4%) of 1q21 amplification, and 1 case (3.8%) of P53 deletion; in the kidney injury group, 8 cases underwent genetic testing, and all results were abnormal, including 6 cases (75.0%) of IgH rearrangement, 5 cases (40.0%) of RB1 deletion, and 2 cases (25.0%) of 1q21 amplification. The rate of RB1 mutation in the kidney injury group was higher than that in the non-kidney injury group, and the difference was statistically significant ( χ2 = 4.43, P = 0.035). Logistic regression analysis showed that elevated blood uric acid ( OR = 1.009, 95% CI 1.002-1.016, P = 0.015) and ISS stage Ⅲ ( OR = 16.401, 95% CI 1.174-229.164, P = 0.038), elevated white blood cell count ( OR = 1.833, 95% CI 1.020-3.294, P = 0.043), elevated β 2-MG ( OR = 1.320, 95% CI 1.009-1.728, P = 0.043), and decreased hemoglobin ( OR = 0.900, 95% CI 0.832-0.922, P = 0.008) were independent risk factors for the development of kidney injury in MM patients. According to the area under the ROC curve (AUC), blood uric acid (AUC = 0.775, 95% CI 0.675-0.875, P < 0.001), white blood cell count (AUC = 0.696, 95% CI 0.583-0.809, P = 0.002), β 2-MG (AUC = 0.822, 95% CI 0.732-0.911, P < 0.001), hemoglobin (AUC = 0.755, 95% CI 0.652-0.857, P < 0.001), and ISS stage Ⅲ (AUC = 0.763, 95% CI 0.669-0.856, P < 0.001) had predictive value for kidney injury in MM. Conclusions:MM patients have a high incidence of combined kidney injury, and active monitoring and control of risk factors may improve the outcome and prognosis of patients.

Expression and clinical significance of CREB3L1 in gastric cancer / 国际外科学杂志

Objective:To investigate the expression and clinical significance of cAMP response element-binding protein 3-like 1 (CREB3L1) in gastric cancer.Methods:A total of 97 patients who received surgical resection of gastric cancer in Lanzhou University Second Hospital from Jan. 2019 to Dec. 2020 were selected as the study subjects. Immunohistochemistry was used to detect the expression level of CREB3L1 in gastric cancer tissues and matched paracancer tissues. Real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) was used to detect the expression level of CREB3L1 in gastric cancer and adjacent tissues. Statistical methods were used to analyze the relationship between the expression level of CREB3L1 in gastric cancer tissues and the degree of differentiation of tumor cells, tumor size, depth of invasion, TNM staging and other clinicopathological data, and Logistic regression analysis was used to study the risk factors of gastric cancer. To explore the clinical significance of CREB3L1 expression level in gastric cancer.Results:Immunohistochemical results showed that CREB3L1 protein was mainly expressed in the nucleus. The positive rate in gastric cancer tissues was 17.5% (17 cases), which was lower than that in normal adjacent tissues 84.5% (82 cases), and the difference was statistically significant ( χ2=87.15, P<0.001). qRT-PCR was used to detect the expression of CREB3L1 in gastric cancer and adjacent tissues. The results showed that the expression level of CREB3L1 was significantly higher in adjacent tissues than in cancer cells. The results were statistically significant ( P<0.05). The positive expression rate of CREB3L1 was decreased in the cancer tissues of gastric cancer patients, and its expression level was correlated with the degree of tumor differentiation, tumor size, invasion depth and TNM stage ( P<0.05), but not with Lauren classification and tumor location ( P>0.05). Logistic regression analysis showed that the positive expression level of CREB3L1 was correlated with the degree of tumor differentiation in gastric cancer patients ( P<0.05). Conclusion:The expression of CREB3L1 is decreased in gastric cancer, which is related to the degree of tumor differentiation, tumor size, invasion depth and TNM stage, which is of great value in early and accurate diagnosis of benign and malignant gastric cancer.

Diagnostic value of dynamic contrast enhanced MRI quantitative parameters for preoperative staging of gastric cancer and its relationship with prognostic factors / 中国医师进修杂志

Objective:To investigate the diagnostic value of dynamic contrast enhanced MRI (DCE-MRI) quantitative parameters for preoperative staging of gastric cancer and its relationship with prognostic factors.Methods:The clinical data of 98 patients with gastric cancer from March 2021 to March 2022 in Guangyuan First People′s Hospital were retrospectively analyzed. All patients underwent DCE-MRI examination, MRI features were observed, and the DCE-MRI quantitative parameters were recorded, including the transport constant (K trans), volume fraction (V e) and rate constant (K ep). The expression levels of human epidermal growth factor receptor 2 (HER2) and epidermal growth factor receptor (EGFR) in gastric cancer tissue were detected by immunohistochemistry methods. The correlation between DCE-MRI quantitative parameters and T stage, HER2, EGFR of gastric cancer was analyzed by Spearman method; the receiver operating characteristic (ROC) curve was used to evaluate the diagnosis value of DCE-MRI quantitative parameters in T staging of gastric cancer. Results:Among 98 patients with gastric cancer, T 1 to T 2 staging was in 50 cases, T 3 to T 4 staging was in 48 cases; HER2 positive expression in gastric cancer tissue was in 35 cases, negative expression was in 63 cases; EGFR positive expression in gastric cancer tissue was in 43 cases, negative expression was in 55 cases. The K trans and V e in patients with T 3 to T 4 staging were significantly higher than those in patients with T 1 to T 2 staging: (0.25 ± 0.04) min -1 vs. (0.19 ± 0.03) min -1 and 0.45 ± 0.11 vs. 0.39 ± 0.09, and there were statistical differences ( P<0.01); there was no statistical difference in K ep between the two ( P>0.05). The K trans and V e in patients with HER2 positive expression were significantly higher than those in patients with HER2 negative expression: (0.27 ± 0.06) min -1 vs. (0.19 ± 0.03) min -1 and 0.49 ± 0.13 vs. 0.38 ± 0.08, and there were statistical differences ( P<0.01); there was no statistical difference in K ep between the two ( P>0.05). The K trans and V e in patients with EGFR positive expression were significantly higher than those in patients with EGFR negative expression: (0.28 ± 0.07) min -1 vs. (0.17 ± 0.04) min -1 and 0.50 ± 0.14 vs. 0.36 ± 0.08, and there were statistical differences ( P<0.01); there was no statistical difference in K ep between the two ( P>0.05). Spearman analysis result showed that the K trans was positively correlated with gastric cancer T stage, and the expression of HER2, EGFR in gastric cancer tissue ( r = 0.539, 0.612 and 0.640; P<0.01), the V e was positively correlated with gastric cancer T stage, and the expression of HER2, EGFR in gastric cancer tissue ( r = 0.462, 0.551 and 0.583; P<0.01), while there was no correlated between K ep and gastric cancer T stage and the expression of HER2, EGFR in gastric cancer tissue ( P>0.05). ROC curve analysis result showed that the area under the curve of K trans combined with V e in diagnosis the T 3 to T 4 staging of gastric cancer was 0.929, with a specificity of 81.25% and a specificity of 92.00%. Conclusions:The DCE-MRI quantitative parameters K trans and V e have certain value in the diagnosis of gastric cancer T staging, and they are closely related to the expression of prognostic factors HER2 and EGFR.

Changes in serum miRNA-21 and miRNA-4534 levels in patients with lung adenocarcinoma and their effects on pathological characteristics and prognosis / 中国基层医药

Objective:To investigate the changes in serum miRNA-21 and miRNA-4534 levels in patients with lung adenocarcinoma and their relationships with pathological characteristics and prognosis.Methods:A total of 148 patients with lung adenocarcinoma who received treatment in the First People's Hospital of Huzhou from January 2018 to January 2019 were included in the observation group. An additional 100 healthy controls who concurrently received physical examinations were included in the control group. The relative expression of serum miRNA-21 and miRNA-4534 was measured using real-time fluorescence quantitative PCR. The relative expression of serum miRNA-21 and miRNA-4534 was compared between the two groups. The relative expression of serum miRNA-21 and miRNA-4534 was compared between patients with different pathological characteristics. Total survival time was compared between patients with high and low miRAN-21 expression and between patients with high and low miRNA-4534 expression.Results:The relative expression of miRNA-21 and miRNA-4534 in the observation group was 3.27 ± 0.87 and 6.74 ± 1.56, respectively, which was significantly higher than 1.00 ± 0.01 and 1.02 ± 0.02 in the control group ( t = 20.07, 36.64, both P < 0.05). There was no significant difference in the relative expression of miRNA-21 and miRNA-4534 between different genders, ages, body mass index values, tumor regions, and tumor diameters (all P > 0.05). The relative expression of serum miRNA-21 in patients with stage Ⅲ-Ⅳ lung adenocarcinoma was 4.45 ± 1.05, which was significantly higher than 1.92 ± 0.53 in patients with stage Ⅰ-Ⅱ lung adenocarcinoma. The relative expression of serum miRNA-21 in patients with lymph node metastasis was higher than that in patients without lymph node metastasis (4.97 ± 1.28 vs. 1.34 ± 0.60, t = 17.53, 23.48, both P < 0.05). The relative expression of miRNA-4534 in patients with stage Ⅲ-Ⅳ lung adenocarcinoma was higher than that in patients with stage Ⅰ-Ⅱ lung adenocarcinoma (8.97 ± 1.85 vs. 4.48 ± 1.09, t = 17.17, P < 0.05). The relative expression of miRNA-4534 in patients with lymph node metastasis was higher than that in patients without lymph node metastasis (9.65 ± 1.35 vs. 3.78 ± 0.91, t = 30.59, P < 0.05). The total survival time in patients with high miRNA-21 expression was shorter than that in patients with low miRNA-21 expression [(18.37 ± 4.35) months vs. (29.93 ± 3.24) months, t = 18.45, P < 0.05]. The total survival time in patients with high miRNA-4534 expression was shorter than that in patients with low miRNA-4534 expression [(17.56 ± 4.21) months vs. (30.43 ± 3.63) months, t = 19.97, P < 0.05)]. Conclusion:Patients with lung adenocarcinoma have high expression of miRNA-21 and miRNA-4534 in the serum, which is closely related to the tumor-node-metastasis stage, lymph node metastasis, and prognosis.

Effect of 18F-FDG combined with 18F-PSMA-1007 PET/CT on TNM staging and clinical treatment decision of prostate cancer / 中华核医学与分子影像杂志

Objective:To investigate the effect of 18F-FDG combined with 18F-prostate specific membrane antigen (PSMA)-1007 PET/CT on TNM staging and clinical treatment decision of patients with prostate cancer. Methods:Clinical data and PET/CT images of 31 patients (age (69.9±9.2) years) with prostate cancer who underwent PET/CT imaging with 18F-FDG and 18F-PSMA-1007 (dual-tracer imaging) in the Second Xiangya Hospital of Central South University from June 2020 to March 2022 were retrospectively analyzed. Paired χ2 test was used to compare the diagnostic efficacy of 18F-FDG, 18F-PSMA-1007 and combined imaging for diagnosing primary prostate cancer, regional lymph node metastases and distant metastases, and to analyze the influence of combined imaging on clinical treatment decision. Results:There were 282 metastatic sites in 31 patients, including 46 regional lymph node metastases in 13 patients and 236 distant metastases in 15 patients. The detection rates of 18F-PSMA-1007 PET/CT and combined imaging for primary lesions were higher than the detection rate of 18F-FDG PET/CT (100%(31/31), 100%(31/31) vs 64.5%(20/31); χ2=13.37, P<0.001). Based on analysis of patients, the detection rates of 18F-PSMA-1007 PET/CT and combined imaging for regional lymph node metastases were higher than the detection rate of 18F-FDG PET/CT (12/13, 12/13 vs 6/13; χ2=4.51, P=0.034), and the 3 detection rates for distant metastases were also significantly different (15/15, 15/15 vs 10/15; χ2=6.00, P=0.042). Based on analysis of lesions, the detection rates of 18F-PSMA-1007 PET/CT and combined imaging for regional lymph node metastases were higher than the detection rate of 18F-FDG PET/CT (95.7%(44/46), 97.8%(45/46) and 45.7%(21/46); χ2 values: 25.37-49.56, all P<0.001). The detection rate of combined imaging for distant metastases was higher than that of 18F-FDG or 18F-PSMA-1007 PET/CT alone (96.2%(227/236) vs 68.6%(162/236), 58.9%(139/236)); and the detection rate of 18F-FDG PET/CT was higher than that of 18F-PSMA-1007 PET/CT ( χ2 values: 4.85-94.22, all P<0.05). Clinical treatment decisions in 10 patients (32.3%, 10/31) were changed based on the results of combined imaging. Conclusion:For prostate cancer with suspected distant metastases, 18F-FDG and 18F-PSMA-1007 dual-tracer PET/CT imaging can improve staging and guide clinical treatment decisions.

A multicenter study of R-ISS staging combined with frailty biomarkers to predict the prognosis and early death in newly diagnosed elderly multiple myeloma patients / 中华老年医学杂志

Objective:To improve the prognosis stratification, especially early mortality(EM), of elderly patients with newly diagnosed multiple myeloma(NDMM).Methods:In this retrospective study, univariate and multivariate Cox regression analysis were conducted to identify the independent prognostic factors associated with overall survival(OS)and the chi-square test and multivariate Logistic analysis were used to identify the prognostic factors associated with EM in 223 elderly patients(age≥65 years)with NDMM from three centers in the country.Results:Increased NT-pro-BNP(≥300 pg/ml), ECOG-PS≥2 and stage Ⅲ R-ISS were identified as three independent adverse prognostic factors of OS.The rates of EM3, EM6, EM12 and EM24 were 12.1%, 20.1%, 32.2% and 60%, respectively.The most common cause for EM6(particularly EM3)was disease-related complications resulting from ineligibility for treatment due to poor physical performance, severe organ dysfunction or treatment discontinuation due to treatment intolerance, while the most common cause for EM12(particularly EM24)was disease progression or relapse mainly as a result of inadequate treatment.R-ISS staging failed to predict EM, while decreased eGFR, ECOG-PS≥2, and increased NT-pro-BNP were able to estimate the risk of EM, with increased NT-pro-BNP as a common independent factor for EM12( P=0.03)and EM24( P=0.015). Conclusions:R-ISS staging, which primarily reflects MM biology, cannot predict EM.However, factors such as NT-pro-BNP, eGFR and ECOG-PS associated with frailty and impairment of organ functions can be used to estimate the risk of EM, among which NT-pro-BNP may be the most important independent factor for EM.Therefore, incorporation of these frailty-related biomarkers into R-ISS staging may be able to more precisely estimate the prognosis and particularly early death of elderly patients with NDMM.

Biplane transrectal ultrasound combining superb microvascular imaging in evaluating preoperative T staging of mid-low rectal cancer / 中华普通外科杂志

Objective:To explore the application value of biplane transrectal ultrasound (TRUS) combining superb microvascular imaging (SMI) in evaluating preoperative T stage of mid-low rectal cancer.Methods:From Jan 2021 to Apr 2022, 90 patients with middle and low rectal cancer undergoing surgical treatment in Da Ping Hospital, Army Medical Center of PLA were equally divided into trial group and control group . Patients in the control group received TRUS combining with color Doppler blood flow imaging (CDFI) mode, patients in the trial group received additional SMI . Preoperative ultrasound T staging was performed. Artery blood flow resistance index (RI), pulsation index (PI), peak systolic velocity (PSV), and end diastolic velocity (EDV) of tumors were measured and recorded. Receiver operating characteristics curves were drawn to evaluate the diagnostic efficacy.Results:The accuracy rate of the control group was 67% (30/45), and the consistence with the pathological stage (Kappa=0.510, P<0.05) was lower than that of 84% (38/45) and (Kappa=0.779, P<0.001) of the trial group ( χ2=3.850, P<0.05). Among different T stages, the difference of RI and PI were significant ( F=5.619, P=0.002; F=25.500, P<0.001), the difference of PSV was not significant ( F=1.464, P=0.231), and the difference of EDV was weakly correlated ( F=2.723, P=0.05). The ROC curves showed that the area under curve of RI, PI, EDV, and PSV was 0.573, 0.517, 0.527 and 0.501, respectively. With the diagnostic sensitivity rate for T1 to T4 as 70.4%, 58.8%, 93.3%, 68.8%, while the diagnostic specificity rate was 87.3%, 90.4%, 96.8%, 93.2%. Conclusion:Biplane TRUS combining SMI can improve the accuracy in preoperative ultrasound T staging of mid-low rectal cancer.

Progress in the application of transrectal ultrasound in preoperative evaluation of anal preservation in low and middle rectal cancer surgery / 中国医师杂志

Rectal cancer is one of the most common malignant tumors in the digestive system, and mid to low rectal cancer has attracted great attention due to its unique anatomy, examination, and treatment. Accurate diagnosis and appropriate treatment are key to improving the prognosis of rectal cancer patients. One of the long-standing technical challenges in colorectal surgery is how to make a more accurate evaluation of the surgical plan for rectal cancer before surgery. Transrectal intracavitary ultrasound can provide some effective objective basis for the selection of surgical plans for middle and low rectal cancer. This article reviews the application value and progress of preoperative evaluation of preoperative staging and anal preservation of middle and low rectal cancer using transrectal intracavitary ultrasound.