Positive non-sentinel axillary lymph nodes in breast cancer with 1-2 sentinel lymph node metastases.

Recent clinical trials have shown that sentinel lymph node biopsy (SLNB) alone without axillary lymph node dissection (ALND) can offer excellent regional control if there is sentinel lymph nodes (SLN) metastases to 1-2 nodes. This study aimed to explore the predictive factors for non-sentinel lymph node (NSLN) metastasis in breast cancer patients with 1-2 positive SLNs.Patients with breast cancer and 1-2 positive SLN admitted between March 2009 and March 2017 and who underwent ALND after SLN biopsy (SLNB) at Beijing Chaoyang Hospital were analyzed retrospectively. Factors influencing the status of NSLN were studied by univariate and multivariate analysis.Of 1125 patients, 147 patients had SLN metastasis (13.1%) and 119 patients (81.0%) had 1-2 positive SLNs. Among them, 42 patients (35.3%) had NSLN metastasis. The invasive tumor size (P <.001), histological grade (P =.011), lymphovascular invasion (LVI) (P =.006), and over-expression of HER2 (P =.025) significantly correlated with non-SLN metastasis by univariate analysis. LVI (LVI) (P =.007; OR: 4.130; 95% confidence interval [CI]: 1.465-11.641), invasive tumor size (P <.001; OR: 7.176; 95% CI: 2.710-19.002), and HER2 over-expression (P =.006; OR: 5.489; 95% CI: 1.635-18.428) were independently associated with NSLN metastasis by the Logistic regression model. The ROC analysis identified a cut-off point of 26 mm of tumor size (area under the receiver operating characteristic [ROC] curve [AUC] 0.712, CI: 0.614-0.811) was useful for dividing patients with positive SLN (1-2 nodes) into non-SLN-positive and non-SLN-negative groups.For 1-2 positive SLNs of breast cancer, LVI, large invasive tumor size, and HER2 over-expression are independent factors affecting NSLN metastases.

Investigation on nutritional risk assessment and nutritional support status of surgical patients with colorectal cancer.

PURPOSE: To investigate the malnutrition, the incidence of nutritional risk and the application of nutritional support for patients with colorectal cancer, so as to provide a basis for the rational clinical application of nutritional support. METHODS: A total of 264 surgical patients with colorectal cancer treated/followed up from January 2016 to March 2017 in Beijing Chaoyang Hospital were selected. The nutritional risk was assessed using the Nutritional Risk Screening 2002 (NRS2002), and the nutritional risk and application of nutritional support for patients with different gender, age and clinical disease stage were analyzed; the hospitalization duration and postoperative complications were also analyzed and compared. RESULTS: According to NRS2002, malnutrition accounted for 6.06% and nutrition risk accounted for 79.55%. There was no statistically significant difference in the nutritional risk between patients with different gender (p=0.059), the nutritional risk of the elderly patients (≥60 years) was higher than that of the non-elderly patients (<60 years) (p<0.001), and the nutritional risk among patients with different clinical stages had no statistically significant difference (p=0.654). All patients received nutritional support; the parenteral nutrition (PN) support rate was 39.02%, while PN+enteral nutrition (EN) support rate was 60.98%, while there was no patient receiving complete EN support. There was no statistically significant difference in the incidence rates of postoperative complications between patients with and without nutritional risk (p=0.546), but there was a statistically significant difference in the hospitalization duration between patients with and without nutritional risk (p=0.019). CONCLUSION: The incidence rates of malnutrition and nutritional risk are high in patients with colorectal cancer and the incidence of nutritional risk is related to age. The application of NRS2002 in nutritional risk screening for patients with colorectal cancer can provide a reasonable and effective basis for the clinical nutritional support.

Evaluation of clinical significance and risk factors of incidental parathyroidectomy due to thyroidectomy: A single-center retrospective clinical study.

We assessed the clinical significance and risk factors of incidental parathyroidectomy during total thyroidectomy with or without central neck dissection or subtotal thyroidectomy.Retrospective analysis of clinical and pathological features of 548 consecutive thyroidectomy cases was compared by grouping into inadvertent resection (IR, n = 86) with IR of parathyroid glands, non-IR (n = 462) without, and then into postoperative hypoparathyroidism (PH, n = 140) with PH and non-PH (n = 408) without.Two hundred ninety-eight patients had total thyroidectomy and 250 had subtotal thyroidectomy. IR had higher malignant disease (P < .001), total thyroidectomy (P = .016), T3 and T4 classification (P = .005), central neck dissection (P < .001), recurrent laryngeal nerve palsy (P = .003), postoperative transient hypoparathyroidism (P < .001), duration of disease prior to thyroidectomy (P < .001), and weight of excised thyroid tissue (P < .001) than non-IR.Preoperative diagnosis of malignant disease, duration of disease prior to thyroidectomy, and central neck dissection were independent risk factors for incidental parathyroidectomy. Preoperative diagnosis of malignant disease, central neck dissection, duration of disease prior to thyroidectomy, weight of excised thyroid tissue, and incidental parathyroidectomy were correlated with PH.

Correlation between clinicopathology and expression of heat shock protein 70 and glucose-regulated protein 94 in human colonic adenocarcinoma.

AIM: To investigate the correlation between clinicopathology and expression of heat shock protein 70 (HSP70) and glucose-regulated protein 94 (grp94) in human colonic carcinoma. METHODS: The expression of HSP70 and grp94 was studied in 80 human colonic cancers with or without metastasis as well as in their adjacent mucous membrane by way of immunohistochemistry and pathology photograph analysis. RESULTS: The expression of HSP70 and grp94 was significantly higher in cancer than that in adjacent mucous membrane (92.5%, 85.0% vs 56.3%, 42.5%, P<0.01). HSP70 and grp94 expressed higher in moderately- and poorly-differentiated colonic cancers than that in their adjacent tissues (93.7%, 87.5%; 100%, 90% vs 56.3%, 42.5%; P<0.01). Dukes C and D stages of colonic cancers showed higher positive rates than Dukes A and B stage groups (97.1%, 91.2%; 100%, 90.9%; vs 80%, 70%; 78.6%, 71.4%; P<0.05). There were definite differences in HSP70 and grp94 expression between metastasis groups and non-metastasis groups (100% vs 75%, 100% vs 50%, P<0.05). CONCLUSION: The HSP70 and grp94 expression rates in colonic cancer groups are significantly higher than that in their adjacent mucous membrane. The HSP70 and grp94 expression in poorly-differentiated colonic cancers with metastasis is significantly higher than well-differentiated cancers without metastasis. The overexpression of HSP70 and grp94 can be used as diagnostic or prognostic markers for colonic cancer.

[Expression of vascular endothelial growth factor in colorectal cancer and its clinical significance].

OBJECTIVE: To evaluate the relationship between vascular endothelial growth factor (VEGF) and colorectal cancer. METHODS: Samples of cancer and adjacent normal mucosa were taken from 34 patients with colorectal cancer. The percentage and average fluorescence intensity pf VEGF positive cells in these samples were examined by using flow cytometry. RESULTS: The percentage of VEGF positive cells was 57% +/- 29% in cancer tissue and 42% +/- 24% in normal tissue (P < 0.05). The average fluorescence intensity of VEGF positive cells was 24% +/- 11% in cancer tissue and 16% +/- 7% in normal tissue (P < 0.01). The percentage of VEGF positive cells was 30% +/- 22% in cancer of Dukes stage B and 72% +/- 18% in cancer of Dukes stage C (P < 0.01). The average fluorescence intensity was 18% +/- 25% in cancer of Dukes stage B and 27% +/- 12% in cancer of Dukes stage C (P < 0.01). CONCLUSION: VEGF is associated with the development and prognosis of colorectal cancer. Its relation with degree of differentiation of colorectal cancer remains to be studied.