Lung cancer is the most common cancer worldwide. In the United States, it causes more cancer-related deaths than the next four causes （breast cancer, prostate cancer, colon cancer, and pancreatic cancer） of cancer-r...Lung cancer is the most common cancer worldwide. In the United States, it causes more cancer-related deaths than the next four causes （breast cancer, prostate cancer, colon cancer, and pancreatic cancer） of cancer-related mortality combined （1）. About 30% of people have already progressed to stage III lung cancer and 40% to stage IV at the time they are diagnosed （2）. Although chest X-ray and sputum cytology, when applied in health check-ups, can identify some relatively small tumors, they are not able to lower the overall mortality （3）. More recently,展开更多
AIM To investigate the relationship between histological mixed-type of early gastric cancer(EGC) in the mucosa and submucosa and lymph node metastasis(LNM).METHODS This study included 298 patients who underwent gastre...AIM To investigate the relationship between histological mixed-type of early gastric cancer(EGC) in the mucosa and submucosa and lymph node metastasis(LNM).METHODS This study included 298 patients who underwent gastrectomy for EGC between 2005 and 2012. Enrolled lesions were divided into groups of pure differentiated(pure D), pure undifferentiated(pure U), and mixed-type according to the proportion of the differentiated and undifferentiated components observed under a microscope. We reviewed the clinicopathological features, including age, sex, location, size, gross type, lymphovascular invasion, ulceration, and LNM, among the three groups. furthermore, we evaluated the predictors of LNM in the mucosa-confined EGC.RESULTS Of the 298 patients, 165(55.4%) had mucosa-confined EGC and 133(44.6%) had submucosa-invasive EGC. Only 13(7.9%) cases of mucosa-confined EGC and 30(22.6%) cases of submucosa-invasive EGC were observed to have LNM. The submucosal invasion(OR = 4.58, 95%CI: 1.23-16.97, P = 0.023), pure U type(OR = 4.97, 95%CI: 1.21-20.39, P = 0.026), and mixedtype(OR = 5.84, 95%CI: 1.05-32.61, P = 0.044) were independent risk factors for LNM in EGC. The rate of LNM in mucosa-confined EGC was higher in the mixedtype group(P = 0.012) and pure U group(P = 0.010) than in the pure D group, but no significant difference was found between the mixed-type group and pure U group(P = 0.739). Similarly, the rate of LNM in the submucosa-invasive EGC was higher in the mixedtype(P = 0.012) and pure U group(P = 0.009) than in the pure D group but was not significantly different between the mixed-type and pure U group(P = 0.375). Multivariate logistic analysis showed that only female sex(OR = 5.83, 95%CI: 1.64-20.70, P = 0.028) and presence of lymphovascular invasion(OR = 13.18, 95%CI: 1.39-125.30, P = 0.020) were independent risk factors for LNM in mucosa-confined EGC, while histological type was not an independent risk factor for LNM in mucosa-confined EGC(P = 0.106).CONCLUSION for mucosal EGC, histological mixed-type is not an independent risk factor for LNM and could be managed in the same way as the undifferentiated type.展开更多
In order to reduce power consumption of sensor nodes and extend network survival time in the wireless sensor network （WSN）, sensor nodes are scheduled in an active or dormant mode. A chain-type WSN is fundamental y ...In order to reduce power consumption of sensor nodes and extend network survival time in the wireless sensor network （WSN）, sensor nodes are scheduled in an active or dormant mode. A chain-type WSN is fundamental y different from other types of WSNs, in which the sensor nodes are deployed along elongated geographic areas and form a chain-type network topo-logy structure. This paper investigates the node scheduling prob-lem in the chain-type WSN. Firstly, a node dormant scheduling mode is analyzed theoretical y from geographic coverage, and then three neighboring nodes scheduling criteria are proposed. Sec-ondly, a hybrid coverage scheduling algorithm and dead areas are presented. Final y, node scheduling in mine tunnel WSN with uniform deployment （UD）, non-uniform deployment （NUD） and op-timal distribution point spacing （ODS） is simulated. The results show that the node scheduling with UD and NUD, especial y NUD, can effectively extend the network survival time. Therefore, a strat-egy of adding a few mobile nodes which activate the network in dead areas is proposed, which can further extend the network survival time by balancing the energy consumption of nodes.展开更多
AIM To evaluate the incidence of lymph node metastasis （LNM） and its risk factors in patients with Siewert type Ⅰ and type Ⅱ pT1 adenocarcinomas.METHODS We enrolled 85 patients [69 men, 16 women; median age （ra...AIM To evaluate the incidence of lymph node metastasis （LNM） and its risk factors in patients with Siewert type Ⅰ and type Ⅱ pT1 adenocarcinomas.METHODS We enrolled 85 patients [69 men, 16 women; median age （range）, 67 （38-84） years] who had undergone esophagectomy or proximal gastrectomy for Siewert type Ⅰ and type Ⅱ pT1 adenocarcinomas. Predictive risk factors of LNM included age, sex, location of the tumor center, confirmed Barrett’s esophageal adenocarcinoma, tumor size, macroscopic tumor type, pathology, invasion depth, presence of ulceration, and lymphovascular invasion. Multivariate logistic regression analysis was used to identify factors predicting LNM. We also evaluated the frequencies of LNM for Siewert type Ⅰ and type Ⅱ pT1 adenocarcinomas in meta-data analysis.RESULTSLNMs were found in 11 out of 85 patients （12.9%, 95%CI： 5.8-20.0）. Only 1 of the 15 patients （6.6%, 95%CI： 0.0-19.2） who had a final diagnosis of pT1a adenocarcinoma had a positive LNM, whereas 10 of the 70 patients （14.2%, 95%CI： 6.0-22.4） with a final diagnosis of pT1b adenocarcinoma had positive LNM. Furthermore, only one of the 30 patients （3.3%, 95%CI： 0.0-9.7） with a tumor invasion depth within 500 μm from muscularis mucosae had positive LNM. Poor differentiation and lymphovascular invasion were independently associated with a risk of LNM. In meta-data analysis, 12 of the 355 patients （3.3%, 95%CI： 1.5-5.2） who had a final diagnosis of pT1a adenocarcinoma had a positive LNM, whereas 91 of the 438 patients （20.7%, 95%CI： 16.9-24.5） with a fnal diagnosis of pT1b adenocarcinoma had positive LNM.CONCLUSIONWe consider endoscopic submucosal dissection （ESD） is suitable for patients with Siewert type Ⅰ and type Ⅱ T1a adenocarcinomas. For patients with T1b adenocarcinoma, especially invasion depth is within 500 μm from muscularis mucosae with no other risk factor for LNM, diagnostic ESD could be a treatment option according to the overall status of patients and the presence of comorbidities.展开更多
It has been reported recently that small undifferentiated intramucosal early gastric cancer(EGC) < 20 mm in size without any lymphovascular involvement or ulcerative findings had virtually no risk of lymph-node(LN)...It has been reported recently that small undifferentiated intramucosal early gastric cancer(EGC) < 20 mm in size without any lymphovascular involvement or ulcerative findings had virtually no risk of lymph-node(LN) metastasis.Consequently,the indications for endoscopic resection were expanded to include such undifferentiated EGC lesions.We describe herein a case of a small undifferentiated intramucosal EGC < 20 mm in size without lymphovascular involvement or ulcerative findings that involved lymph-node metastasis.A 57-year-old female underwent pylorus preserving gastrectomy as standard treatment for an undifferentiated EGC 15 mm in size without any ulcerative finding.The surgical specimen revealed a signet-ring cell carcinoma with a moderately to poorly differentiated adenocarcinoma limited to the mucosa that was 15 mm in size with no lymphovascular involvement or ulcerative findings.This case involved LN metastasis,however,and the lesion was diagnosed as pathological stage ⅡA(T1N2M0) according to the Japanese Classification of Gastric Carcinoma.展开更多
The surgical treatment of localized breast cancer has become progressively less aggressive over the years.The management of the axillary lymph nodes has been modified by the introduction of sentinel lymph node biopsy....The surgical treatment of localized breast cancer has become progressively less aggressive over the years.The management of the axillary lymph nodes has been modified by the introduction of sentinel lymph node biopsy. Axillary dissection can be avoided in patients with sentinel lymph node negative biopsies. Based on randomized trials data, it has been proposed that no lymph node dissection should be carried out even in certain patients with sentinel lymph node positive biopsies. This commentary discusses the basis of such recommendations and cautions against a general omission of lymph node dissection in breast cancer patients with positive sentinel lymph node biopsies. Instead, an individualized approach based on axillary tumor burden and biology of the cancer should be considered.展开更多
Based on a node group <img src="Edit_effba4ca-e855-418a-8a72-d70cb1ec3470.png" width="240" height="46" alt="" />, the Newman type rational operator is constructed in the p...Based on a node group <img src="Edit_effba4ca-e855-418a-8a72-d70cb1ec3470.png" width="240" height="46" alt="" />, the Newman type rational operator is constructed in the paper. The convergence rate of approximation to a class of non-smooth functions is discussed, which is <img src="Edit_174e8f70-651b-4abb-a8f3-a16a576536dc.png" width="85" height="50" alt="" /> regarding to X. Moreover, if the operator is constructed based on further subdivision nodes, the convergence rate is <img src="Edit_557b3a01-7f56-41c0-bb67-deab88b9cc63.png" width="85" height="45" alt="" />. The result in this paper is superior to the approximation results based on equidistant nodes, Chebyshev nodes of the first kind and Chebyshev nodes of the second kind.展开更多
BACKGROUND To date, the histopathological parameters predicting the risk of lymph node (LN) metastases and local recurrence, associated mortality and appropriateness of endoscopic or surgical resection in patients wit...BACKGROUND To date, the histopathological parameters predicting the risk of lymph node (LN) metastases and local recurrence, associated mortality and appropriateness of endoscopic or surgical resection in patients with gastric neuroendocrine neoplasms type 1 (GNENs1) have not been fully elucidated. AIM To determine the rate of LN metastases and its impact in survival in patients with GNEN1 in relation to certain clinico-pathological parameters. METHODS The PubMed, EMBASE, Cochrane Library, Web of Science and Scopus databases were searched through January 2019. The quality of the included studies and risk of bias were assessed using the Newcastle-Ottawa Scale (NOS) in accordance with the Cochrane guidelines. A random effects model and pooled odds ratios (OR) with 95%CI were applied for the quantitative meta-analysis. RESULTS We screened 2933 articles. Thirteen studies with 769 unique patients with GNEN1 were included. Overall, the rate of metastasis to locoregional LNs was 3.3%(25/769). The rate of LN metastases with a cut-off size of 10 mm was 15.3% for lesions > 10 mm (vs 0.8% for lesions < 10 mm) with a random-effects OR of 10.5 (95%CI: 1.4 -80.8;heterogeneity: P = 0.126;I2 = 47.5%). Invasion of the muscularis propria was identified as a predictor for LN metastases (OR: 17.2;95%CI: 1.8-161.1;heterogeneity: P = 0.165;I2 = 44.5%), whereas grade was not clearly associated with LN metastases (OR: 2;95%CI: 0.3-11.6;heterogeneity: P = 0.304;I2 = 17.4%). With regard to GNEN1 local recurrence, scarce data were available. The 5-year disease-specific survival for patients with and without LN metastases was 100% in most available studies irrespective of the type of intervention. Surgical resection was linked to a lower risk of recurrence (OR: 0.3;95%CI: 0.1-1.1;heterogeneity: P = 0.173;I2 = 31.9%). The reported complication rates of endoscopic and surgical intervention were 0.6 and 3.8%, respectively. CONCLUSION This meta-analysis confirms that tumor size ≥ 10 mm and invasion of the muscularis propria are linked to a higher risk of LN metastases in patients with GNEN1. Overall, the metastatic propensity of GNEN1 is low with favorable 5- year disease-specific survival rates reported;hence, no clear evidence of the prognostic value of LN positivity is available. Additionally, there is a lack of evidence supporting the prediction of local recurrence in GNEN1, even if surgery was more often a definitive treatment.展开更多
文摘Lung cancer is the most common cancer worldwide. In the United States, it causes more cancer-related deaths than the next four causes （breast cancer, prostate cancer, colon cancer, and pancreatic cancer） of cancer-related mortality combined （1）. About 30% of people have already progressed to stage III lung cancer and 40% to stage IV at the time they are diagnosed （2）. Although chest X-ray and sputum cytology, when applied in health check-ups, can identify some relatively small tumors, they are not able to lower the overall mortality （3）. More recently,
基金Supported by Medical Science and Technology Development Foundation of Nanjing Department of Health,No.201402032
文摘AIM To investigate the relationship between histological mixed-type of early gastric cancer(EGC) in the mucosa and submucosa and lymph node metastasis(LNM).METHODS This study included 298 patients who underwent gastrectomy for EGC between 2005 and 2012. Enrolled lesions were divided into groups of pure differentiated(pure D), pure undifferentiated(pure U), and mixed-type according to the proportion of the differentiated and undifferentiated components observed under a microscope. We reviewed the clinicopathological features, including age, sex, location, size, gross type, lymphovascular invasion, ulceration, and LNM, among the three groups. furthermore, we evaluated the predictors of LNM in the mucosa-confined EGC.RESULTS Of the 298 patients, 165(55.4%) had mucosa-confined EGC and 133(44.6%) had submucosa-invasive EGC. Only 13(7.9%) cases of mucosa-confined EGC and 30(22.6%) cases of submucosa-invasive EGC were observed to have LNM. The submucosal invasion(OR = 4.58, 95%CI: 1.23-16.97, P = 0.023), pure U type(OR = 4.97, 95%CI: 1.21-20.39, P = 0.026), and mixedtype(OR = 5.84, 95%CI: 1.05-32.61, P = 0.044) were independent risk factors for LNM in EGC. The rate of LNM in mucosa-confined EGC was higher in the mixedtype group(P = 0.012) and pure U group(P = 0.010) than in the pure D group, but no significant difference was found between the mixed-type group and pure U group(P = 0.739). Similarly, the rate of LNM in the submucosa-invasive EGC was higher in the mixedtype(P = 0.012) and pure U group(P = 0.009) than in the pure D group but was not significantly different between the mixed-type and pure U group(P = 0.375). Multivariate logistic analysis showed that only female sex(OR = 5.83, 95%CI: 1.64-20.70, P = 0.028) and presence of lymphovascular invasion(OR = 13.18, 95%CI: 1.39-125.30, P = 0.020) were independent risk factors for LNM in mucosa-confined EGC, while histological type was not an independent risk factor for LNM in mucosa-confined EGC(P = 0.106).CONCLUSION for mucosal EGC, histological mixed-type is not an independent risk factor for LNM and could be managed in the same way as the undifferentiated type.
基金supported by the China Doctoral Discipline New Teacher Foundation(200802901507)the Sichuan Province Basic Research Plan Project(2013JY0165)the Cultivating Programme of Excellent Innovation Team of Chengdu University of Technology(KYTD201301)
文摘In order to reduce power consumption of sensor nodes and extend network survival time in the wireless sensor network （WSN）, sensor nodes are scheduled in an active or dormant mode. A chain-type WSN is fundamental y different from other types of WSNs, in which the sensor nodes are deployed along elongated geographic areas and form a chain-type network topo-logy structure. This paper investigates the node scheduling prob-lem in the chain-type WSN. Firstly, a node dormant scheduling mode is analyzed theoretical y from geographic coverage, and then three neighboring nodes scheduling criteria are proposed. Sec-ondly, a hybrid coverage scheduling algorithm and dead areas are presented. Final y, node scheduling in mine tunnel WSN with uniform deployment （UD）, non-uniform deployment （NUD） and op-timal distribution point spacing （ODS） is simulated. The results show that the node scheduling with UD and NUD, especial y NUD, can effectively extend the network survival time. Therefore, a strat-egy of adding a few mobile nodes which activate the network in dead areas is proposed, which can further extend the network survival time by balancing the energy consumption of nodes.
文摘AIM To evaluate the incidence of lymph node metastasis （LNM） and its risk factors in patients with Siewert type Ⅰ and type Ⅱ pT1 adenocarcinomas.METHODS We enrolled 85 patients [69 men, 16 women; median age （range）, 67 （38-84） years] who had undergone esophagectomy or proximal gastrectomy for Siewert type Ⅰ and type Ⅱ pT1 adenocarcinomas. Predictive risk factors of LNM included age, sex, location of the tumor center, confirmed Barrett’s esophageal adenocarcinoma, tumor size, macroscopic tumor type, pathology, invasion depth, presence of ulceration, and lymphovascular invasion. Multivariate logistic regression analysis was used to identify factors predicting LNM. We also evaluated the frequencies of LNM for Siewert type Ⅰ and type Ⅱ pT1 adenocarcinomas in meta-data analysis.RESULTSLNMs were found in 11 out of 85 patients （12.9%, 95%CI： 5.8-20.0）. Only 1 of the 15 patients （6.6%, 95%CI： 0.0-19.2） who had a final diagnosis of pT1a adenocarcinoma had a positive LNM, whereas 10 of the 70 patients （14.2%, 95%CI： 6.0-22.4） with a final diagnosis of pT1b adenocarcinoma had positive LNM. Furthermore, only one of the 30 patients （3.3%, 95%CI： 0.0-9.7） with a tumor invasion depth within 500 μm from muscularis mucosae had positive LNM. Poor differentiation and lymphovascular invasion were independently associated with a risk of LNM. In meta-data analysis, 12 of the 355 patients （3.3%, 95%CI： 1.5-5.2） who had a final diagnosis of pT1a adenocarcinoma had a positive LNM, whereas 91 of the 438 patients （20.7%, 95%CI： 16.9-24.5） with a fnal diagnosis of pT1b adenocarcinoma had positive LNM.CONCLUSIONWe consider endoscopic submucosal dissection （ESD） is suitable for patients with Siewert type Ⅰ and type Ⅱ T1a adenocarcinomas. For patients with T1b adenocarcinoma, especially invasion depth is within 500 μm from muscularis mucosae with no other risk factor for LNM, diagnostic ESD could be a treatment option according to the overall status of patients and the presence of comorbidities.
文摘It has been reported recently that small undifferentiated intramucosal early gastric cancer(EGC) < 20 mm in size without any lymphovascular involvement or ulcerative findings had virtually no risk of lymph-node(LN) metastasis.Consequently,the indications for endoscopic resection were expanded to include such undifferentiated EGC lesions.We describe herein a case of a small undifferentiated intramucosal EGC < 20 mm in size without lymphovascular involvement or ulcerative findings that involved lymph-node metastasis.A 57-year-old female underwent pylorus preserving gastrectomy as standard treatment for an undifferentiated EGC 15 mm in size without any ulcerative finding.The surgical specimen revealed a signet-ring cell carcinoma with a moderately to poorly differentiated adenocarcinoma limited to the mucosa that was 15 mm in size with no lymphovascular involvement or ulcerative findings.This case involved LN metastasis,however,and the lesion was diagnosed as pathological stage ⅡA(T1N2M0) according to the Japanese Classification of Gastric Carcinoma.
文摘The surgical treatment of localized breast cancer has become progressively less aggressive over the years.The management of the axillary lymph nodes has been modified by the introduction of sentinel lymph node biopsy. Axillary dissection can be avoided in patients with sentinel lymph node negative biopsies. Based on randomized trials data, it has been proposed that no lymph node dissection should be carried out even in certain patients with sentinel lymph node positive biopsies. This commentary discusses the basis of such recommendations and cautions against a general omission of lymph node dissection in breast cancer patients with positive sentinel lymph node biopsies. Instead, an individualized approach based on axillary tumor burden and biology of the cancer should be considered.
文摘Based on a node group <img src="Edit_effba4ca-e855-418a-8a72-d70cb1ec3470.png" width="240" height="46" alt="" />, the Newman type rational operator is constructed in the paper. The convergence rate of approximation to a class of non-smooth functions is discussed, which is <img src="Edit_174e8f70-651b-4abb-a8f3-a16a576536dc.png" width="85" height="50" alt="" /> regarding to X. Moreover, if the operator is constructed based on further subdivision nodes, the convergence rate is <img src="Edit_557b3a01-7f56-41c0-bb67-deab88b9cc63.png" width="85" height="45" alt="" />. The result in this paper is superior to the approximation results based on equidistant nodes, Chebyshev nodes of the first kind and Chebyshev nodes of the second kind.
基金Supported by Swedish Society of Medicine Post Doctoral Scholarship,No.SLS-785911the Lennander Scholarship
文摘BACKGROUND To date, the histopathological parameters predicting the risk of lymph node (LN) metastases and local recurrence, associated mortality and appropriateness of endoscopic or surgical resection in patients with gastric neuroendocrine neoplasms type 1 (GNENs1) have not been fully elucidated. AIM To determine the rate of LN metastases and its impact in survival in patients with GNEN1 in relation to certain clinico-pathological parameters. METHODS The PubMed, EMBASE, Cochrane Library, Web of Science and Scopus databases were searched through January 2019. The quality of the included studies and risk of bias were assessed using the Newcastle-Ottawa Scale (NOS) in accordance with the Cochrane guidelines. A random effects model and pooled odds ratios (OR) with 95%CI were applied for the quantitative meta-analysis. RESULTS We screened 2933 articles. Thirteen studies with 769 unique patients with GNEN1 were included. Overall, the rate of metastasis to locoregional LNs was 3.3%(25/769). The rate of LN metastases with a cut-off size of 10 mm was 15.3% for lesions > 10 mm (vs 0.8% for lesions < 10 mm) with a random-effects OR of 10.5 (95%CI: 1.4 -80.8;heterogeneity: P = 0.126;I2 = 47.5%). Invasion of the muscularis propria was identified as a predictor for LN metastases (OR: 17.2;95%CI: 1.8-161.1;heterogeneity: P = 0.165;I2 = 44.5%), whereas grade was not clearly associated with LN metastases (OR: 2;95%CI: 0.3-11.6;heterogeneity: P = 0.304;I2 = 17.4%). With regard to GNEN1 local recurrence, scarce data were available. The 5-year disease-specific survival for patients with and without LN metastases was 100% in most available studies irrespective of the type of intervention. Surgical resection was linked to a lower risk of recurrence (OR: 0.3;95%CI: 0.1-1.1;heterogeneity: P = 0.173;I2 = 31.9%). The reported complication rates of endoscopic and surgical intervention were 0.6 and 3.8%, respectively. CONCLUSION This meta-analysis confirms that tumor size ≥ 10 mm and invasion of the muscularis propria are linked to a higher risk of LN metastases in patients with GNEN1. Overall, the metastatic propensity of GNEN1 is low with favorable 5- year disease-specific survival rates reported;hence, no clear evidence of the prognostic value of LN positivity is available. Additionally, there is a lack of evidence supporting the prediction of local recurrence in GNEN1, even if surgery was more often a definitive treatment.
