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1.
Sci Total Environ ; 915: 169691, 2024 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-38160814

RESUMO

Plenty of the toxic gold cyanide residues are produced by cyanidation process of gold extraction. As a kind of hazardous solid wastes, cyanide residues must be treated to remove cyanide before disposal. In this study, the removal of cyanide in gold cyanide residues by manganese compounds (KMnO4 and MnO2) was investigated. It was found that both KMnO4 and MnO2 could be used as new decyanation reagents for cyanide removal. To make the residue after cyanide removal meet the national standard, it needed KMnO4 1.8 wt% for 60 min reaction or MnO2 1.0 wt% for 30 min reaction with about pH 8.0. The mechanisms of two processes were investigated by X-ray photoelectron spectroscopy (XPS). The results show that KMnO4 concentrates on the reactions with pyrite in the cyanide residue, the products are mainly Fe(II), Fe(III), SO42- and MnO2. KMnO4 added in the slurry could be consumed by pyrite before oxidation of cyanide, resulting in relatively low cyanide remove efficiency and high KMnO4 consumption. On the surface of the residue after MnO2 treatment, there are mainly pyrite, Fe(II), Mn(II), Fe-CN and CN-, showing that the MnO2 process focuses on the removal of cyanide in the cyanide residue. The MnO2 process has the advantages of low reagents consumption, short reaction time and high cyanide removal efficiency, presenting a promise use for cyanide removal of cyanide residues in a range of applications.

2.
Zhongguo Dang Dai Er Ke Za Zhi ; 25(11): 1131-1136, 2023 Nov 15.
Artigo em Chinês | MEDLINE | ID: mdl-37990457

RESUMO

OBJECTIVES: To investigate the expression of interleukin-37 (IL-37), vascular endothelial growth factor A (VEGFA), and transforming growth factor-ß1 (TGF-ß1) in children with primary immune thrombocytopenia (ITP) and their correlation with T cells. METHODS: A retrospective analysis was conducted on 45 children with ITP (ITP group) who were admitted to Handan Central Hospital from January 2020 to April 2022, and 30 healthy children who underwent physical examination during the same period were included as the healthy control group. The mRNA expression levels of IL-37, VEGFA, and TGF-ß1 and the levels of regulatory T cells (Treg) and helper T cells 17 (Th17) were measured before and after treatment, and the correlation between the mRNA expression levels of IL-37, VEGFA, and TGF-ß1 and the levels of Treg, Th17, and Treg/Th17 ratio were analyzed. RESULTS: Compared with the healthy control group, the ITP group had a significantly higher mRNA expression level of IL-37 and a significantly higher level of Th17 before and after treatment, as well as significantly lower mRNA expression levels of VEGFA and TGF-ß1 and significantly lower levels of Treg and Treg/Th17 ratio (P<0.05). After treatment, the ITP group had significant reductions in the mRNA expression level of IL-37 and the level of Th17 and significant increases in the mRNA expression levels of VEGFA and TGF-ß1 and the levels of Treg and Treg/Th17 ratio (P<0.05). Correlation analysis showed that in the ITP group, the mRNA expression levels of IL-37 and TGF-ß1 were negatively correlated with the levels of Treg and Treg/Th17 ratio (P<0.05) and were positively correlated with the level of Th17 (P<0.05) before and after treatment; the mRNA expression level of VEGFA was positively correlated with the levels of Treg and Treg/Th17 ratio (P<0.05) and was negatively correlated with the Th17 level (P<0.05) before and after treatment. CONCLUSIONS: Abnormal expression levels of IL-37, VEGFA, and TGF-ß1 may be observed in children with ITP, which is significantly associated with the imbalance of Treg/Th17 ratio. It is speculated that the cytokines such as IL-37, VEGFA, and TGF-ß1 may be involved in the development and progression of ITP or may become important potential targets for the treatment of children with ITP. Citation:Chinese Journal of Contemporary Pediatrics, 2023, 25(11): 1131-1136.


Assuntos
Púrpura Trombocitopênica Idiopática , Fator de Crescimento Transformador beta1 , Criança , Humanos , Interleucinas , Estudos Retrospectivos , RNA Mensageiro/metabolismo , Linfócitos T Reguladores , Células Th17/metabolismo , Fator de Crescimento Transformador beta1/genética , Fator A de Crescimento do Endotélio Vascular/genética
3.
Arch Environ Contam Toxicol ; 82(2): 227-238, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34490489

RESUMO

Stormwater runoff samples were collected from five different land use sites (gas station, city road, campus, park, and residential) in a precipitation event on May 22nd, 2017, from a small suburban area (5 km × 2 km) of the city of Beijing, China. There were 72 types of semi-volatile organic compounds (SVOCs) found in these runoff samples, including 33 types of monocyclic aromatic hydrocarbons (MAHs), 22 types of polycyclic aromatic hydrocarbons (PAHs), 6 types of phthalate esters (PAEs), 9 types of pesticides and 2 types of polychlorinated biphenyls (PCBs). Especially, 26 types of SVOCs (7 MAHs, 9 PAHs, 5 PAEs, and 5 pesticides) were detected in all water samples. SVOCs concentrations were higher in the samples from gas station and city road, and lower in runoff from campus, park and residential sites. The change in the ratio of anthracene to anthracene plus phenanthrene (ANT/(ANT + PHE)) in this study, reflected the importance of PAH source and land use. Di-2-ethylhexyl phthalate (DEHP) and di-n-butyl phthalate, are two of the phthalate esters 100% detected in the runoff samples. The city road runoff DEHP concentrations recorded the highest values (> 6000 ng/L), however, were still less than those wastewater DEHP pollutants measured in developed countries (e.g. UK, Canada, Finland, etc.). One-way ANOVA analysis in this study, showed that land use could significantly influence 23 SVOCs in the runoff samples, whereas the runoff SVOCs in different precipitation period showed no statistical changes in the five sites, and presented a general temporal trends "high (beginning)-low (middle period)-little raising (ending)". The findings in this study could be used in municipal management of wastewater collection and treatment.


Assuntos
Ácidos Ftálicos , Bifenilos Policlorados , Hidrocarbonetos Policíclicos Aromáticos , Compostos Orgânicos Voláteis , Poluentes Químicos da Água , Pequim , China , Monitoramento Ambiental , Bifenilos Policlorados/análise , Hidrocarbonetos Policíclicos Aromáticos/análise , Poluentes Químicos da Água/análise
4.
Water Res ; 209: 117890, 2021 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-34856430

RESUMO

Traditional methods of cyanides' (CN-) mineralization cannot overcome the contradiction between the high alkalinity required for the inhibition of hydrogen cyanide evolution and the low alkalinity required for the efficient hydrolysis of cyanate (CNO-) intermediates. Thus, in this study, a novel Electro-Fenton system was constructed, in which the free cyanides released from ferricyanide photolysis can be efficiently mineralized by the synergy of •OH and •O2-. The complex bonds in ferricyanide (100 mL, 0.25 mM) were completely broken within 80 min under ultraviolet radiation, releasing free cyanides. Subsequently, in combination with the heterogeneous Electro-Fenton process, •OH and •O2- were simultaneously generated and 92.9% of free cyanides were transformed into NO3- within 120 min. No low-toxic CNO- intermediates were accumulated during the Electro-Fenton process. A new conversion mechanism was proposed that CN- was activated into electron-deficient cyanide radical (•CN) by •OH, and then the •CN intermediates reacted with •O2- via nucleophilic addition to quickly form NO3-, preventing the formation of CNO- and promoting the mineralization of cyanide. Furthermore, this new strategy was used to treat the actual cyanide residue eluent, achieving rapid recovery of irons and efficient mineralization of cyanides. In conclusion, this study proposes a new approach for the mineralization treatment of cyanide-containing wastewater.

5.
J Cell Mol Med ; 2021 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-34060213

RESUMO

Due to the high heterogeneity of lung adenocarcinoma (LUAD), molecular subtype based on gene expression profiles is of great significance for diagnosis and prognosis prediction in patients with LUAD. Invasion-related genes were obtained from the CancerSEA database, and LUAD expression profiles were downloaded from The Cancer Genome Atlas. The ConsensusClusterPlus was used to obtain molecular subtypes based on invasion-related genes. The limma software package was used to identify differentially expressed genes (DEGs). A multi-gene risk model was constructed by Lasso-Cox analysis. A nomogram was also constructed based on risk scores and meaningful clinical features. 3 subtypes (C1, C2 and C3) based on the expression of 97 invasion-related genes were obtained. C3 had the worst prognosis. A total of 669 DEGs were identified among the subtypes. Pathway enrichment analysis results showed that the DEGs were mainly enriched in the cell cycle, DNA replication, the p53 signalling pathway and other tumour-related pathways. A 5-gene signature (KRT6A, MELTF, IRX5, MS4A1 and CRTAC1) was identified by using Lasso-Cox analysis. The training, validation and external independent cohorts proved that the model was robust and had better prediction ability than other lung cancer models. The gene expression results showed that the expression levels of MS4A1 and KRT6A in tumour tissues were higher than in normal tissues, while CRTAC1 expression in tumour tissues was lower than in normal tissues. The 5-gene signature prognostic stratification system based on invasion-related genes could be used to assess prognostic risk in patients with LUAD.

6.
Front Microbiol ; 11: 1773, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32849397

RESUMO

In arsenopyrite bioleaching, the interfacial reaction between mineral and cells is one of the most important factors. The energy of the interface is influenced by the mineralogical and microbiological characteristics. In this paper, the interfacial energy was calculated, and the surface of arsenopyrite during the bioleaching process was characterized by 3D laser microscopy, scanning electron microscopy with energy-dispersive X-ray spectroscopy, and X-ray photoelectron spectroscopy, in order to assess the dissolution and oxidation behavior of arsenopyrite during bioleaching. The results showed that the contact angles of arsenopyrite were 22 ± 2° when covered with biofilms, but the reaction surface of arsenopyrite turned 103 ± 2°. However, the angle was 45-50° when covered by passive layer, which was half as that of arsenopyrite surface. The interfacial energy of arsenopyrite without biofilms increased from 45 to 62 mJ/m2, while it decreased to 5 ± 1 mJ/m2 when covered by biofilms during the leaching process. The surface was separated into fresh surface, oxidized surface, and (corrosion) pits. The interfacial energy was influenced by the fresh and oxidized surfaces. Surface roughness increased from 0.03 ± 0.01 to 5.89 ± 1.97 µm, and dissolution volume increased from 6.31 ± 0.47 × 104 to 2.72 ± 0.49 × 106 µm3. The dissolution kinetics of arsenopyrite followed the model of Kt = lnX, and the dissolution mechanisms were mixed controlled: surface reaction control and diffusion through sulfur layer. On the surface of arsenopyrite crystal, the oxidation steps of each element can be described as: for Fe, Fe(II)-(AsS)→Fe(III)-(AsS)→Fe(III)-OH or Fe(III)-SO; for S, As-S(-1) or Fe-S(-1)→polysulfide S→intermediate S-O→sulfate; and for As, As-1-S→As0→As+1-O→As+3-O→As+5-O.

7.
Extremophiles ; 24(3): 365, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32291524

RESUMO

In the original publication the section heading "Classification of microorganisms" appearing above the sub-section "Air and liquid circulation in the heap" in page four is incorrect. The correct section heading should be read as "Results and discussion".

8.
Extremophiles ; 24(3): 355-364, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32108913

RESUMO

Heap biooxidation method was used to evaluate the availability of Paodaoling gold ore in Anhui province, China. 15,000 tons of gold ores (≤ 10 mm in diameter) were bioxidized under mesophilic conditions. Under the synergistic effect of microbial community, arsenic and sulfur were oxidized by 42% and 38% after 80 days. Relatively, leaching of gold was improved from 36 to 78% after heap biooxidation. The sequencing results showed there were 28 operational taxonomic units identified the microbial community in the heap. The main genera were Acidithiobacillus, Ferroplasma, Acidiferrobacter and Nitrospira. According to stoichiometry, the content of microorganisms with various functions tended to be balanced. The biomass production rate was 10 g/s, the CO2 fixation rate was 18 g/s, and the oxygen consumption rate was 60 g/s. This study provides a good basis for the further design and application of heap biooxidation technology.


Assuntos
Bactérias , Acidithiobacillus , Arsênio , China , Ouro , Oxirredução
9.
Sci Rep ; 9(1): 15040, 2019 10 21.
Artigo em Inglês | MEDLINE | ID: mdl-31636294

RESUMO

The XRF, XRD, polarizing microscopy and SEM-EDS were used to study the alteration mechanism of copper-bearing biotite and the leachable property of copper-bearing minerals in Mulyashy Copper Mine, Zambia. It was found that biotite can be divided into copper-bearing biotite and copper-free biotite. Some copper-bearing biotite existed in the form of monomer, and others aggregated with copper-bearing chlorite, malachite or copper-bearing limonite. The main reason for the occurrence of biotite aggregations was that copper-bearing biotite underwent two kinds of alteration mechanisms as follows: altering into copper-bearing chlorite and malachite, and altering into copper-bearing chlorite and copper-bearing limonite. The order of factors effecting the copper leaching rate of the ores in acid leaching experiments was temperature > sample size > H2SO4 concentration > leaching time > stirring speed. In addition, the copper leaching rate of copper-bearing minerals at different temperatures was in the following order: malachite, chrysocolla and pseudomalachite > copper-bearing chlorite > copper-bearing muscovite > copper-bearing biotite > copper-bearing limonite. The leachable property of biotite is closely related to its special structure.

10.
Environ Pollut ; 239: 554-561, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29684882

RESUMO

Stormwater samples were collected from six different land use sites with three time-intervals during a precipitation event on August 12, 2016, from a community of Beijing, China. A total of 46 species volatile organic compounds (VOCs) were detected in these stormwater samples, including methyl tertiary-butyl ether (MTBE), aromatic hydrocarbons, halogenated aromatics, Halogenated alkanes, and alkenes. The total VOC concentrations varied in the six sites following order: highway junction > city road > gas station > park > campus > residential area, except for MTBE, which was much higher at gas station compared to other land use sites. ANOVA results indicated both land use and precipitation time intervals could significantly affect the VOC concentrations even in the small area. The Beijing atmospheric VOC concentrations were too low to explain the high concentrations in stormwater, suggesting that land surfaces may be the main sources of VOC other than the ambient atmosphere. MTBE and other VOCs correlation analysis indicated that MTBE mostly came from gasoline emissions, spills or vehicle exhausts, whereas the BTEX (benzene, toluene, ethylbenzene, Xylenes) and the halogenated aromatics were transferred from chemical plants through land surfaces accumulating and the wind blowing atmospheric VOCs. Xylenes/ethylbenzene (X/E) ratios variations indicated that stormwater incorporated larger amount of fresh emitted air during the precipitation event than prior to it. Information of these stormwater VOCs in this study could be used in the community pollution reduction strategies.


Assuntos
Poluentes Atmosféricos/análise , Monitoramento Ambiental , Compostos Orgânicos Voláteis/análise , Poluentes Químicos da Água/análise , Alcanos/análise , Atmosfera/análise , Pequim , Benzeno/análise , China , Cidades , Gasolina/análise , Hidrocarbonetos Aromáticos/análise , Tolueno/análise , Emissões de Veículos/análise , Vento , Xilenos/análise
11.
BMC Cancer ; 13: 123, 2013 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-23496812

RESUMO

BACKGROUND: Whether the 7th edition of American Joint Committee on Cancer (AJCC) TNM staging system (AJCC-7) is a successful revision remains debatable. We aimed to compare the predictive capacity of the AJCC-7 for colorectal cancer with the 6th edition of the AJCC TNM staging system (AJCC-6). METHODS: The National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) dataset consisting of 158,483 records was used in this study. We evaluated the predictive capacity of the two editions of the staging system using Harrell's C index and Bayesian Information Criterion (BIC). RESULTS: There was a significant prognostic difference between patients at stage IIB and IIC (P < 0.001). Stage III patients with similar prognoses were adequately sub-grouped in the same stage according to AJCC-7. The Harrell's C index revealed a value of 0.7692 for AJCC-7, which was significantly better than 0.7663 for AJCC-6 (P < 0.001). BIC analysis provided consistent results (P < 0.001). CONCLUSIONS: This study demonstrates that AJCC-7 is superior to the AJCC-6 staging system in predictive capacity.


Assuntos
Neoplasias Colorretais/patologia , Estadiamento de Neoplasias/métodos , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Estimativa de Kaplan-Meier , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Programa de SEER
12.
PLoS One ; 7(7): e42015, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22848691

RESUMO

OBJECTIVE: Over the past decades, many studies have used data mining technology to predict the 5-year survival rate of colorectal cancer, but there have been few reports that compared multiple data mining algorithms to the TNM classification of malignant tumors (TNM) staging system using a dataset in which the training and testing data were from different sources. Here we compared nine data mining algorithms to the TNM staging system for colorectal survival analysis. METHODS: Two different datasets were used: 1) the National Cancer Institute's Surveillance, Epidemiology, and End Results dataset; and 2) the dataset from a single Chinese institution. An optimization and prediction system based on nine data mining algorithms as well as two variable selection methods was implemented. The TNM staging system was based on the 7(th) edition of the American Joint Committee on Cancer TNM staging system. RESULTS: When the training and testing data were from the same sources, all algorithms had slight advantages over the TNM staging system in predictive accuracy. When the data were from different sources, only four algorithms (logistic regression, general regression neural network, bayesian networks, and Naïve Bayes) had slight advantages over the TNM staging system. Also, there was no significant differences among all the algorithms (p>0.05). CONCLUSIONS: The TNM staging system is simple and practical at present, and data mining methods are not accurate enough to replace the TNM staging system for colorectal cancer survival prediction. Furthermore, there were no significant differences in the predictive accuracy of all the algorithms when the data were from different sources. Building a larger dataset that includes more variables may be important for furthering predictive accuracy.


Assuntos
Algoritmos , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/patologia , Mineração de Dados/métodos , Estadiamento de Neoplasias/métodos , Bases de Dados Factuais , Feminino , Seguimentos , Humanos , Masculino , Prognóstico , Curva ROC , Análise de Sobrevida
13.
PLoS One ; 7(4): e35021, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22529970

RESUMO

OBJECTIVE: At present, only the number of metastatic lymph nodes (LNs+) is used for the pN category of AJCC TNM system for colon cancer. Recently, the ratio of metastatic to examined lymph nodes (LNR) has been reported to represent powerful independent predictive capacity in colon cancer. We sought to propose a novel category (nLN) which intergrades LNR and LNs+ into the AJCC staging system for colon cancer. DESIGN: 34476 patients from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) dataset with stage III colon cancer were reviewed. Harrell's C statistic was used to evaluate the predictive capacity. The Cox proportional hazards model was used to construct a novel category. RESULTS: The LNR category had more predictive capacity than the pN category in whole groups of patients (Harrell's C index: 0.6194 vs 0.6113, p = 0.003). Subgroup analysis showed that the LNR category was not better than pN category in predictive capacity if the number of lymph nodes examined was more than 13. We also found that there was significant survival heterogeneity among different pN categories at the same LNR category (P<0.001). The Harrell's C index for our nLN category which intergrades LNR and LNs+ was 0.6228, which was significant higher than that of the pN category (Harrell's C index: 0.6113, P<0.001) or LNR category (Harrell's C index: 0.6194, P = 0.005), respectively. CONCLUSION: To evaluate the prognosis of colon cancer, our nLN category which intergrades LNR with LNs+ is more accurate than the pN category or LNR category, respectively.


Assuntos
Neoplasias do Colo/patologia , Linfonodos/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias do Colo/mortalidade , Feminino , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Programa de SEER
14.
Ann Surg ; 255(2): 208-13, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21527844

RESUMO

OBJECTIVE: To assess the rationality of the seventh edition of TNM staging system on tumor deposits (TDs) and propose a novel subclassification. SUMMARY BACKGROUND DATA: The TDs had been debated for many years. The seventh edition of TNM staging system proposed a "pN1c" concept. However, the value of the modification is still debated. METHODS: A total of 1541 patients with colorectal cancer were reviewed. Overall survival rates were compared between patients without LNM but TD (+), and those who were TD (-). The TDs were stratified into the "any T + any N" category. Two-step multivariate analysis was performed to identify significant prognostic factors. Univariate analysis was used to determine whether a correlation existed between the number of TDs and prognosis. RESULTS: There was a significant prognostic difference between patients without LNM or TDs compared with those with positive TDs. Only in T3N2bM0 there was a significant prognostic difference between LNM (+), TD (+) patients and TD (-) patients. The seventh edition of TNM staging system was substituted by the novel TNM staging system in 2-step multivariate analysis. Only in T3N1cM0 there was a significant prognostic difference between patients with only 1 TD and those with more than 1 TD. CONCLUSION: The seventh edition of TNM staging system on TDs satisfactorily predicts patients' outcome for those without LNM. Patients who categorized as T3N2bM0TD (+) and T4N2bM0TD (-/+) should be reclassified as stage IV. Number of TDs was not an independent prognostic parameter in the TNM staging system.


Assuntos
Adenocarcinoma/patologia , Neoplasias Colorretais/patologia , Estadiamento de Neoplasias/métodos , Adenocarcinoma/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Colorretais/mortalidade , Feminino , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida
15.
PLoS One ; 6(12): e28937, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-22174929

RESUMO

OBJECTIVE: The aim of the current study was to investigate which is the most suitable classification for colorectal cancer, log odds of positive lymph nodes (LODDS) classification or the classifications based on the number of positive lymph nodes (pN) and positive lymph node ratio(LNR) in a Chinese single institutional population. DESIGN: Clinicopathologic and prognostic data of 1297 patients with colorectal cancer were retrospectively studied. The log-rank statistics, Cox's proportional hazards model, the Nagelkerke R(2) index and a Harrell's C statistic were used. RESULTS: Univariate and three-step multivariate analyses identified that LNR was a significant prognostic factor and LNR classification was superior to both the pN and LODDS classifications. Moreover, the results of the Nagelkerke R(2) index (0.130) and a Harrell's C statistic (0.707) of LNR showed that LNR and LODDS classifications were similar and LNR was a little better than the other two classifications. Furthermore, for patients in each LNR classification, prognosis was homologous between those in different pN or LODDS classifications. However, for patients in pN1a, pN1b, LODDS2 and LODDS3 classifications, significant differences in survival were observed among patients in different LNR classifications. CONCLUSIONS: For patients with colorectal cancer, the LNR classification is more suitable than pN and LODDS classifications for prognostic assessment in a Chinese single institutional population.


Assuntos
Neoplasias Colorretais/classificação , Neoplasias Colorretais/patologia , Idoso , Feminino , Humanos , Linfonodos/patologia , Masculino , Pessoa de Meia-Idade , Modelos Biológicos , Análise Multivariada , Estadiamento de Neoplasias , Razão de Chances , Prognóstico , Análise de Sobrevida
16.
Ann Surg Oncol ; 18(9): 2453-60, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21455596

RESUMO

BACKGROUND: Lymph node ratio (LNR) has been reported to represent a powerful independent prognostic value in some malignancies. The significance of LNR in colorectal cancer is still under debate. METHODS: A total of 505 patients with stage III colorectal cancer were reviewed. Using running log-rank statistics, we calculated the best cutoff values for LNRs and proposed a novel rN category: rN1, 0% < LNR ≤ 35%; rN2, 35% < LNR ≤ 69%; and rN3, LNR > 69%. A Spearman's correlation coefficient test was used to assess the correlation between the number of retrieved nodes and the number of metastatic nodes, as well as the number of retrieved nodes and the LNRs. Univariate and two-step multivariate analyses were performed, respectively, to identify the significant prognostic clinicopathologic factors. RESULTS: The 5-year overall survival rate decreased significantly with increasing LNRs: rN(1) = 61% survival rate, rN(2) = 30.3% survival rate, and rN(3) = 11.2% survival rate (P < 0.001). Univariate and two-step multivariate analyses identified the rN category as a significant prognostic factor no matter whether the minimum number of LNs retrieved was met. There was a significant prognostic difference among different rN categories for any pN category, but no apparent prognostic difference was seen between different pN categories in any rN category. Moreover, marked heterogeneity could be seen within III(a-c) substages when survival was compared among rN(1-3) categories but not between pN(1-2) categories. CONCLUSIONS: rN categories have more potential for predicting patient outcomes and are superior to the UICC/AJCC pN categories. We recommend rN categories for prognostic assessment and rN categories should be reported routinely in histopathological reports.


Assuntos
Neoplasias Colorretais/classificação , Neoplasias Colorretais/patologia , Linfonodos/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Taxa de Sobrevida , Adulto Jovem
17.
Ann Surg Oncol ; 18(5): 1389-96, 2011 May.
Artigo em Inglês | MEDLINE | ID: mdl-21107740

RESUMO

BACKGROUND: This study aimed to evaluate the prognostic impact of pT2 subclassification according to the depth of muscularis propria (MP) invasion and to explore the clinicopathologic factors correlated with lymph node metastasis (LNM) and postoperative hematogenous metastasis in pT2 colorectal cancer. METHODS: A total of 317 patients with pT2 colorectal cancer were reviewed. pT2a represents the infiltration of the inner circumferential layer of the MP, and pT2b represents the infiltration of the outer longitudinal layer of the MP. Clinicopathologic factors and overall survival rates were compared in patients with pT2a and pT2b stage cancers. Multivariate analysis was performed to identify the significantly important prognostic factors. Univariate and multivariate analyses were performed, respectively, to identify the significantly important clinicopathologic factors correlated with LNM and postoperative hematogenous metastasis in pT2 colorectal cancer. RESULTS: According to the depth of MP invasion, 107 patients were classified as pT2a and 210 patients were classified as pT2b. Among them, there were 55 patients with LNM, 34 patients with postoperative hematogenous metastasis. There was significant difference in most of clinicopathologic features between patients in the pT2a and pT2b stages. Multivariate analysis identified pN stage (P < .001) and tumor location (P = .036) were independent factors affecting the prognosis. However, no apparent difference was observed between pT2a versus pT2b cancer. Univariate and multivariate analyses uniformly identified lymphovascular invasion (P = .035) and the depth of MP invasion (P = .005) as significantly correlated with LNM. Multivariate analysis found tumor location (P = .021) and the presence or absence of LNM (P < .001) were important factors affecting postoperative hematogenous metastasis. CONCLUSIONS: In pT2 colorectal cancer treated with R0 surgery, there is a high risk of LNM in deep MP invasion versus superficial MP invasion. The pT2 subclassification system had no significant advantage in identifying a different prognosis, except for predicting the LNM before surgery. Rectal cancer and the presence of LNM were high-risk factors resulting in hematogenous metastasis postoperatively.


Assuntos
Neoplasias Colorretais/classificação , Neoplasias Colorretais/patologia , Recidiva Local de Neoplasia/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias Colorretais/cirurgia , Feminino , Seguimentos , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Invasividade Neoplásica , Recidiva Local de Neoplasia/diagnóstico , Estadiamento de Neoplasias , Valor Preditivo dos Testes , Estudos Prospectivos , Medição de Risco , Taxa de Sobrevida
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