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The aim of this study is to compare the efficacy and safety of percutaneous radiofrequency ablation (RFA) under general anesthesia or local anesthesia plus intraoperative analgesia in the treatment of hepatocellular carcinoma (HCC) at unusual regions.
From July 2012 to October 2019, 83 consecutive patients with 107 HCC lesions were treated with interventional radiology therapy. The lesions were located at some unusual regions such as diaphragmatic surface, hepatic hilum, hepatic subcapsular region, tissues near inferior vena cava, and tissues near the colon. General anesthesia was applied in 57 cases (general anesthesia group) and local anesthesia plus intraoperative analgesia was used in 26 cases (local anesthesia group). All patients were treated with transcatheter arterial chemoembolization, followed immediately by RFA. The rate of tumor inactivation, time used for placing RF needles to the scheduled sites, pain score, and complications were analyzed.
All continuous variables were tested for the normgeneral anesthesia group and four cases of pneumothorax and three cases of slight hepatic subcapsular hemorrhage in the local anesthesia group, and the difference was not statistically significant between the two groups (P = 0.715).
For HCC located at unusual regions, general anesthesia is superior to local anesthesia plus intraoperative analgesia in percutaneous RFA in reducing the difficulty of the procedure and improving the safety of RFA.
For HCC located at unusual regions, general anesthesia is superior to local anesthesia plus intraoperative analgesia in percutaneous RFA in reducing the difficulty of the procedure and improving the safety of RFA.
The objectives of this study were to prospectively compare individualized dietary counseling with or without oral nutritional supplements (ONSs) in nasopharyngeal carcinoma (NPC) patients undergoing concurrent chemoradiotherapy (CCRT) in a Phase II, randomized trial.
Between June 2014 and August 2016, Stage II-IVb NPC patients were randomly enrolled. The primary endpoint was change in body weight between during CCRT, and the secondary endpoints were change in body mass index (BMI) and fat-free mass index (FFMI).
Fifty-two patients were randomized; 19 patients in the control group and 23 in the ONS group were eligible for analysis. Weight, BMI, and body composition parameters significantly decreased from baseline to week 6. FFMI was significantly better in patients with ONS intake >2/3 planed than the control group (P = 0.028). Weight and BMI maintenance was slightly better in patients with total intake >2/3 planed (P = 0.170 and P= 0.229, respectively). The mean Patient-Generated Subjective Global Assessment score was also better in the ONS group at the end of CCRT (P = 0.053).
ONSs with individualized dietary counseling may be beneficial in patients with enough intake, and further prospective studies with large groups of patients are warranted.
ONSs with individualized dietary counseling may be beneficial in patients with enough intake, and further prospective studies with large groups of patients are warranted.
Pancreatic cancer portal hypertension (PCPH) is a rare cause of gastrointestinal bleeding. This study retrospectively assessed gastrointestinal bleeding risk factors in 57 PCPH patients diagnosed via multidetector computed tomography (MDCT).
The data of patients with pancreatic cancer from January 2008 to January 2018 at Qingdao Municipal Hospital were reviewed. PCPH patients were screened with MDCT and followed up. MDCT findings (e.g., the location of the venous obstruction, type of variceal veins pathway, and splenomegaly) were recorded. Variceal hemorrhage was recorded. The MDCT findings and clinical data of the PCPH patients were used in this analysis to explore the risk factors of variceal hemorrhage using binary logistic regression and multivariate logistic regression model.
Fifty-seven of the 182 patients were diagnosed with PCPH. A total of 7 draining routes and 11 types of varices were found. Of these patients, eight experienced variceal hemorrhage. Univariate analysis showed that splenomegaly (odds ratio [OR] = 10.364, P = 0.003) was significantly associated with an increased risk of variceal hemorrhage. Multivariate analysis showed that splenomegaly (OR = 66.491, 95% confidence interval 2.790-1584.643, P = 0.009) was an independent influencing factor for variceal hemorrhage in PCPH patients.
Patients with pancreatic cancer have high morbidity of PCPH. The splenomegaly is more prone to hemorrhage. Splenomegaly was an independent risk factor of variceal hemorrhage. MDCT can provide insight into the stenosis and occlusion of the portal vein system and the drainage routes of variceal veins and is one of the best ways to diagnose PCPH.
Patients with pancreatic cancer have high morbidity of PCPH. The splenomegaly is more prone to hemorrhage. Splenomegaly was an independent risk factor of variceal hemorrhage. MDCT can provide insight into the stenosis and occlusion of the portal vein system and the drainage routes of variceal veins and is one of the best ways to diagnose PCPH.
Mucinous adenocarcinoma (MA) is a distinct histotype of rectal cancer, possibly having prognostic differences with adenocarcinoma (AD). We investigated the prognostic significance of mucinous histology in patients with Stage II rectal cancer.
Eligible patients were retrieved from the Surveillance, Epidemiology, and End Results database from 2004 to 2017, and the survival difference between AD and MA patients in the overall and subgroup populations (divided by age) was compared. Multivariate Cox proportional hazard regression analysis was performed to assess whether the mucinous histotype was an independent prognostic factor.
A total of 10, 910 patients with Stage II rectal cancer were enrolled and divided into a young group (≤55 years, n = 3248) and an old group (>55 years, n = 7662). Patients with MA exhibited a lower cancer-specific survival rate than those with common AD in the overall population and the young group, but not in the old group. The analysis revealed that the mucinous histotype was an independent prognostic factor in the young group, but not in the old group. Moreover, after excluding patients with risk factors (including poorly differentiated or undifferentiated tumor grade, T4 stage, <12 lymph nodes examined, and elevated preoperative carcinoembryonic antigen level), prognosis of the mucinous histotype was poorer in the young group than that in the old group.
The mucinous histotype was an independent prognostic factor in young patients with Stage II rectal cancer. The presence of mucinous histology reflected poor prognosis, especially in the low-risk young population.
The mucinous histotype was an independent prognostic factor in young patients with Stage II rectal cancer. Selleckchem PRT4165 The presence of mucinous histology reflected poor prognosis, especially in the low-risk young population.
The objective of this study is to further clarify the correlation between colorectal cancer (CRC) and human papillomavirus (HPV) through literature search and meta-analysis, which is conducive to the formulation of further prevention programs.
Searching Web of Science, PubMed, MEDLINE, Scopus, and CENTRAL for studies investigating the relationship between CRC and HPV. All analyses were performed through Revman (version 5.3, the Cochrane Collaboration, Oxford, UK). Data from selected studies were extracted into two by two tables. Moreover, all included studies were weighted and summarized.
Eighteen studies were included. The expression of HPV in CRC tissues was obviously higher than that in nonmalignant tissues (odds ratio [OR] = 5.56, 95% confidence interval [CI] = 3.18-9.72, Z = 6.02, P < 0.00001). The expression of HPV in CRC tissues and adenoma tissues showed no significant abnormalities (OR = 1.74, 95% CI = 0.92-3.29, Z = 1.70, P = 0.09). The expression of HPV in CRC tissues was obviously higher than that in normal tissues (OR = 7.23, 95% CI = 3.89-13.42, Z = 6.27, P < 0.00001).
HPV infection in CRC tissues was obviously higher than that in nonmalignant tumor tissues and normal colon tissues, but there were no statistically significant abnormalities between CRC tissues and adenoma tissues.
HPV infection in CRC tissues was obviously higher than that in nonmalignant tumor tissues and normal colon tissues, but there were no statistically significant abnormalities between CRC tissues and adenoma tissues.
The objective of this study was to evaluate whether whole-uterine magnetic resonance imaging (MRI) radiomic features can predict myometrial invasion (MI) depth in endometrial cancer (EC).
The preoperative 3.0 T magnetic resonance examinations of EC patients were retrospectively reviewed. Whole-uterus segmentation was performed, and features were extracted based on sagittal T2-weighted imaging (T2WI) and axial diffusion-weighted imaging (DWI). The logistic regression (LR) classifier algorithm was used to establish the radiomic model, which was verified by ten times five-fold cross-validation. The areas under the receiver operating characteristic (ROC) curves (AUCs) were assessed by the DeLong test to compare differences among the models based on different sequences. The LR model was compared with the subjective diagnosis results by the Chi-square test.
Of the 163 EC patients included, 44 had deep myometrial invasion (DMI). The feature consistency of the whole uterus was higher than that of the lesion (P < 0.05). The sagittal T2WI, axial DWI, and combined models had AUCs of 0.76, 0.80, and 0.85 in the validation set, respectively. The DeLong test showed that there were no significant differences in AUCs among the models (P > 0.05). The single-sequence LR models had lower specificity and accuracy than the corresponding subjective diagnostic results (P < 0.05), while the sensitivity was higher (P > 0.05). The combined model included 24 radiomic features, and the accuracy, sensitivity, and specificity were 0.83, 0.77, and 0.85 for DMI, respectively. There was no significant difference compared with subjective diagnosis (P > 0.05).
Whole-uterine MRI radiomic features based on sagittal T2WI and axial DWI show potential in predicting MI in EC.
Whole-uterine MRI radiomic features based on sagittal T2WI and axial DWI show potential in predicting MI in EC.
To investigate the diagnostic value of lung-specific X protein (LUNX) messenger ribonucleic acid (mRNA) expression in peripheral blood of patients with nonsmall cell lung cancer (NSCLC) in micrometastasis.
Peripheral blood samples of 112 patients with NSCLC were collected, and the expression of LUNX, cytokeratin 19 (CK19), and carcinoembryonic antigen (CEA) mRNA was measured by reverse transcription-polymerase chain reaction (RT-PCR).
The expression of LUNX, CK19, and CEA mRNA was increased in peripheral blood of patients with NSCLC compared with that of patients with benign lung disease (P < 0.05), and the sensitivity of LUNX mRNA was higher than that of CK19 and CEA mRNA (P < 0.05). LUNX-positive expression was also associated with lymph node metastasis, tumor-node-metastasis (TNM) staging, and reduced 5-year survival rate of patients in our cohort (P < 0.05). Further, the 5-year survival improved for those LUNX-positive patients who became LUNX negative following adjuvant chemotherapy compared to those who remain LUNX positive (P < 0.
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