Background： D2 lymphadenectomy has been increasingly regarded as standard surgical procedure for advanced gastric cancer （GC）, while the necessity of No.14v lymph node （14v） dissection for distal GC is still cont...Background： D2 lymphadenectomy has been increasingly regarded as standard surgical procedure for advanced gastric cancer （GC）, while the necessity of No.14v lymph node （14v） dissection for distal GC is still controversial. Methods： A total of 920 distal GC patients receiving at least a D2 lymph node dissection in Department of Gastric Cancer, Tianjin Medical University Cancer Institute and Hospital were enrolled in this study, of whom, 243 patients also had the 14v dissected. Other 677 patients without 14v dissection were used for comparison. Results： Forty-five （18.5%） patients had 14v metastasis. There was no significant difference in 3-year overall survival （OS） rate between patients with and without 14v dissection. Following stratified analysis, in TNM stages I, II, IIIa and IV, 14v dissection did not affect 3-year OS; in contrast, patients with 14v dissection had a significant higher 3-year OS than those without in TNM stages IIIb and IIIc. In multivariate analysis, 14v dissection was found to be an independent prognostic factor for GC patients with TNM stage IIIb/IIIc disease [hazard ratio （HR）, 1.568; 95% confidence interval （CI）： 1.186-2.072; P=0.002]. GC patients with 14v dissection had a significant lower locoregional, especially lymph node, recurrence rate than those without 14v dissection （11.7 % vs. 21.1%, P=0.035）. Conclusions： Adding 14v to D2 lymphadenectomy may be associated with improved 3-year OS for distal GC staged TNM IIIb/IIIc.展开更多
Objective: Lymphovascular infiltration(LVI) is frequently detected in gastric cancer(GC) specimens. Studies have revealed that GC patients with LVI have a poorer prognosis than those without LVI.Methods: In total, 1,0...Objective: Lymphovascular infiltration(LVI) is frequently detected in gastric cancer(GC) specimens. Studies have revealed that GC patients with LVI have a poorer prognosis than those without LVI.Methods: In total, 1,007 patients with curatively resected GC at Department of Gastric Cancer, Tianjin Medical University Cancer Institute and Hospital were retrospectively enrolled. The patients were categorized into two groups based on the LVI status: a positive group(PG;presence of LVI) and a negative group(NG;absence of LVI). The clinicopathological factors corrected with LVI and prognostic variables were analyzed. Additionally, a pathological lymphovascular-node(lvN) classification system was proposed to evaluate the superiority of its prognostic prediction of GC patients compared with that of the eighth edition of the N staging system.Results: Two hundred twenty-four patients(22.2%) had LVI. The depth of invasion and lymph node metastasis were independently associated with the presence of LVI. GC patients with LVI demonstrated a significantly lower overall survival(OS) rate than those without LVI(42.8% vs. 68.9%, respectively;P<0.001). In multivariate analysis,LVI was identified as an independent prognostic factor for GC patients(hazard ratio: 1.370;95% confidence interval: 1.094-1.717;P=0.006). Using strata analysis, significant prognostic differences between the groups were only observed in patients at stage I-IIIa or N0-2. The lvN classification was found to be more appropriate to predict the OS of GC patients after curative surgery than the pN staging system. The-2 log-likelihood of lvN classification(4,746.922) was smaller than the value of pN(4,765.196), and the difference was statistically significant(χ^2=18.434, P<0.001).Conclusions: The presence of LVI influences the OS of GC patients at stage Ⅰ-Ⅲ a or N0-2. LVI should be incorporated into the pN staging system to enhance the accuracy of the prognostic prediction of GC patients.展开更多
Objective： Elevated plasma D-dimer has been reported to be associated with advanced tumor stage and poor survival in several types of malignancies. The purpose of this study was to assess the potential impact of preo...Objective： Elevated plasma D-dimer has been reported to be associated with advanced tumor stage and poor survival in several types of malignancies. The purpose of this study was to assess the potential impact of preoperative plasma D-dimer level（PDL） on overall survival（OS） of gastric cancer（GC） patients undergoing curative surgery by applying propensity score analysis.Methods： A total of 1,025 curatively resected GC patients in Tianjin Medical University Cancer Institute ＆Hospital were enrolled. Patients were categorized into two groups based on preoperative PDL： the elevated group（EG） and the normal group（NG）. To overcome bias due to the different distribution of covariates for the two groups, a one-to-one match was applied using propensity score analysis, after matching, prognostic factors were analyzed.Results： In analysis for the whole study series, patients in the EG were more likely to have a larger proportion of tumor size ≥5 cm（67.5% vs. 55.8%, P=0.006）, elder mean age（64.0±10.8 years vs. 60.5±11.6 years, P〈0.001） and advanced tumor（T）, node（N）, and TNM stage. Patients with elevated PDL demonstrated a significantly lower 5-year OS than those with normal PDL（27.0% vs. 42.6%, P〈0.001）, however, the PDL was not an independent prognostic factor for OS in multivariate analysis [hazard ratio： 1.13, 95% confidence interval（95% CI）： 0.92–1.39,P=0.236]. After matching, 163 patients in the EG and 163 patients in the NG had the same characteristics. The 5-year OS rate for patients in the EG was 27.0% compared with 25.8% for those in the NG（P=0.809, log-rank）.Conclusions： The poor prognosis of GC patients with elevated preoperative PDL was due to the advanced tumor stage and elder age rather than the elevated D-dimer itself.展开更多
This paper presents a 26-Gb/s CMOS optical receiver that is fabricated in 65-nm technology. It consists of a tripleinductive transimpedance amplifier(TIA), direct current(DC) offset cancellation circuits, 3-stage gm-T...This paper presents a 26-Gb/s CMOS optical receiver that is fabricated in 65-nm technology. It consists of a tripleinductive transimpedance amplifier(TIA), direct current(DC) offset cancellation circuits, 3-stage gm-TIA variable-gain amplifiers(VGA), and a reference-less clock and data recovery(CDR) circuit with built-in equalization technique. The TIA/VGA frontend measurement results demonstrate 72-dB? transimpedance gain, 20.4-GHz-3-dB bandwidth, and 12-dB DC gain tuning range. The measurements of the VGA’s resistive networks also demonstrate its efficient capability of overcoming the voltage and temperature variations. The CDR adopts a full-rate topology with 12-dB imbedded equalization tuning range. Optical measurements of this chipset achieve a 10-12 BER at 26 Gb/s for a 2;-1 PRBS input with a-7.3-dBm input sensitivity. The measurement results with a 10-dB @ 13 GHz attenuator also demonstrate the effectiveness of the gain tuning capability and the built-in equalization. The entire system consumes 140 mW from a 1/1.2-V supply.展开更多
Objective： Though D2 lymphadenectomy has been increasingly regarded as standard surgical procedure for advanced gastric cancer （GC）, the modified D2 （D 1＋7, 8a and 9） lymphadenectomy may be more suitable than D2...Objective： Though D2 lymphadenectomy has been increasingly regarded as standard surgical procedure for advanced gastric cancer （GC）, the modified D2 （D 1＋7, 8a and 9） lymphadenectomy may be more suitable than D2 dissection for T2 stage GC. The purpose of this study is to elucidate whether the surgical outcome of modified D2 lymphadenectomy was comparable to that of standard D2 dissection in T2 stage GC patients. Methods： A retrospective cohort study with 77 cases and 77 controls matched for baseline characteristics was conducted. Patients were categorized into two groups according to the extent of lymphadenectomy： the modified D2 group （roD2） and the standard D2 group （D2）. Surgical outcome and recurrence date were compared between the two groups. Results： The 5-year overall survival （OS） rate was 71.4% for patients accepted mD2 lymphadenectomy and 70.1% for those accepted standard D2, respectively, and the difference was not statistically significant. Multivariate survival analysis revealed that curability, tumor size, TNM stage and postoperative complications were independently prognostic factors for T2 stage GC patients. Patients in the mD2 group tended to have less intraoperative blood loss （P=0.001） and shorter operation time （P〈0.001） than those in the D2 group. While there were no significant differences in recurrence rate and types, especially lymph node recurrence, between the two groups. Conclusions： The surgical outcome of mD2 lymphadenectomy was equal to that of standard D2, and the use of mD2 instead of standard D2 can be a better option for T2 stage GC.展开更多
文摘Background： D2 lymphadenectomy has been increasingly regarded as standard surgical procedure for advanced gastric cancer （GC）, while the necessity of No.14v lymph node （14v） dissection for distal GC is still controversial. Methods： A total of 920 distal GC patients receiving at least a D2 lymph node dissection in Department of Gastric Cancer, Tianjin Medical University Cancer Institute and Hospital were enrolled in this study, of whom, 243 patients also had the 14v dissected. Other 677 patients without 14v dissection were used for comparison. Results： Forty-five （18.5%） patients had 14v metastasis. There was no significant difference in 3-year overall survival （OS） rate between patients with and without 14v dissection. Following stratified analysis, in TNM stages I, II, IIIa and IV, 14v dissection did not affect 3-year OS; in contrast, patients with 14v dissection had a significant higher 3-year OS than those without in TNM stages IIIb and IIIc. In multivariate analysis, 14v dissection was found to be an independent prognostic factor for GC patients with TNM stage IIIb/IIIc disease [hazard ratio （HR）, 1.568; 95% confidence interval （CI）： 1.186-2.072; P=0.002]. GC patients with 14v dissection had a significant lower locoregional, especially lymph node, recurrence rate than those without 14v dissection （11.7 % vs. 21.1%, P=0.035）. Conclusions： Adding 14v to D2 lymphadenectomy may be associated with improved 3-year OS for distal GC staged TNM IIIb/IIIc.
基金supported in part by grants from the Program of National Natural Science Foundation of China (No. 81572372)National Key Research and Development Program of Major Chronic Non-infectious Disease Prevention and Control Research (No. 2016YFC1303202)+2 种基金National Key Research and Development Program “Precision Medicine Research” Program (No. 2017 YFC0908300)Application Foundation and Advanced Technology Program of Tianjin Municipal Science and Technology Commission (No. 15JCYBJC24800)Scientific Research Project of Tianjin Municipal Education Commission (No. 2018KJ015)
文摘Objective: Lymphovascular infiltration(LVI) is frequently detected in gastric cancer(GC) specimens. Studies have revealed that GC patients with LVI have a poorer prognosis than those without LVI.Methods: In total, 1,007 patients with curatively resected GC at Department of Gastric Cancer, Tianjin Medical University Cancer Institute and Hospital were retrospectively enrolled. The patients were categorized into two groups based on the LVI status: a positive group(PG;presence of LVI) and a negative group(NG;absence of LVI). The clinicopathological factors corrected with LVI and prognostic variables were analyzed. Additionally, a pathological lymphovascular-node(lvN) classification system was proposed to evaluate the superiority of its prognostic prediction of GC patients compared with that of the eighth edition of the N staging system.Results: Two hundred twenty-four patients(22.2%) had LVI. The depth of invasion and lymph node metastasis were independently associated with the presence of LVI. GC patients with LVI demonstrated a significantly lower overall survival(OS) rate than those without LVI(42.8% vs. 68.9%, respectively;P<0.001). In multivariate analysis,LVI was identified as an independent prognostic factor for GC patients(hazard ratio: 1.370;95% confidence interval: 1.094-1.717;P=0.006). Using strata analysis, significant prognostic differences between the groups were only observed in patients at stage I-IIIa or N0-2. The lvN classification was found to be more appropriate to predict the OS of GC patients after curative surgery than the pN staging system. The-2 log-likelihood of lvN classification(4,746.922) was smaller than the value of pN(4,765.196), and the difference was statistically significant(χ^2=18.434, P<0.001).Conclusions: The presence of LVI influences the OS of GC patients at stage Ⅰ-Ⅲ a or N0-2. LVI should be incorporated into the pN staging system to enhance the accuracy of the prognostic prediction of GC patients.
文摘Objective： Elevated plasma D-dimer has been reported to be associated with advanced tumor stage and poor survival in several types of malignancies. The purpose of this study was to assess the potential impact of preoperative plasma D-dimer level（PDL） on overall survival（OS） of gastric cancer（GC） patients undergoing curative surgery by applying propensity score analysis.Methods： A total of 1,025 curatively resected GC patients in Tianjin Medical University Cancer Institute ＆Hospital were enrolled. Patients were categorized into two groups based on preoperative PDL： the elevated group（EG） and the normal group（NG）. To overcome bias due to the different distribution of covariates for the two groups, a one-to-one match was applied using propensity score analysis, after matching, prognostic factors were analyzed.Results： In analysis for the whole study series, patients in the EG were more likely to have a larger proportion of tumor size ≥5 cm（67.5% vs. 55.8%, P=0.006）, elder mean age（64.0±10.8 years vs. 60.5±11.6 years, P〈0.001） and advanced tumor（T）, node（N）, and TNM stage. Patients with elevated PDL demonstrated a significantly lower 5-year OS than those with normal PDL（27.0% vs. 42.6%, P〈0.001）, however, the PDL was not an independent prognostic factor for OS in multivariate analysis [hazard ratio： 1.13, 95% confidence interval（95% CI）： 0.92–1.39,P=0.236]. After matching, 163 patients in the EG and 163 patients in the NG had the same characteristics. The 5-year OS rate for patients in the EG was 27.0% compared with 25.8% for those in the NG（P=0.809, log-rank）.Conclusions： The poor prognosis of GC patients with elevated preoperative PDL was due to the advanced tumor stage and elder age rather than the elevated D-dimer itself.
基金supported in part by Research and Development Program in Key Areas of Guangdong Province under Grant 2019B010116002in part by the National Natural Science Foundation of China under Grant 62074074in part by the Science and Technology Plan of Shenzhen under Grants JCYJ20190809142017428 and JCYJ20200109141225025。
文摘This paper presents a 26-Gb/s CMOS optical receiver that is fabricated in 65-nm technology. It consists of a tripleinductive transimpedance amplifier(TIA), direct current(DC) offset cancellation circuits, 3-stage gm-TIA variable-gain amplifiers(VGA), and a reference-less clock and data recovery(CDR) circuit with built-in equalization technique. The TIA/VGA frontend measurement results demonstrate 72-dB? transimpedance gain, 20.4-GHz-3-dB bandwidth, and 12-dB DC gain tuning range. The measurements of the VGA’s resistive networks also demonstrate its efficient capability of overcoming the voltage and temperature variations. The CDR adopts a full-rate topology with 12-dB imbedded equalization tuning range. Optical measurements of this chipset achieve a 10-12 BER at 26 Gb/s for a 2;-1 PRBS input with a-7.3-dBm input sensitivity. The measurement results with a 10-dB @ 13 GHz attenuator also demonstrate the effectiveness of the gain tuning capability and the built-in equalization. The entire system consumes 140 mW from a 1/1.2-V supply.
文摘Objective： Though D2 lymphadenectomy has been increasingly regarded as standard surgical procedure for advanced gastric cancer （GC）, the modified D2 （D 1＋7, 8a and 9） lymphadenectomy may be more suitable than D2 dissection for T2 stage GC. The purpose of this study is to elucidate whether the surgical outcome of modified D2 lymphadenectomy was comparable to that of standard D2 dissection in T2 stage GC patients. Methods： A retrospective cohort study with 77 cases and 77 controls matched for baseline characteristics was conducted. Patients were categorized into two groups according to the extent of lymphadenectomy： the modified D2 group （roD2） and the standard D2 group （D2）. Surgical outcome and recurrence date were compared between the two groups. Results： The 5-year overall survival （OS） rate was 71.4% for patients accepted mD2 lymphadenectomy and 70.1% for those accepted standard D2, respectively, and the difference was not statistically significant. Multivariate survival analysis revealed that curability, tumor size, TNM stage and postoperative complications were independently prognostic factors for T2 stage GC patients. Patients in the mD2 group tended to have less intraoperative blood loss （P=0.001） and shorter operation time （P〈0.001） than those in the D2 group. While there were no significant differences in recurrence rate and types, especially lymph node recurrence, between the two groups. Conclusions： The surgical outcome of mD2 lymphadenectomy was equal to that of standard D2, and the use of mD2 instead of standard D2 can be a better option for T2 stage GC.
