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Clinically lymph node-positive urothelial bladder cancer treated with upfront radical cystectomy:Diagnostic accuracy of MRI and long-term oncologic outcomes 认领 引用
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作者 Mahmoud Laymon Amr A.Elsawy +5 位作者 Ali Elsorougy Abdelwahab Hashem Ahmed Mosbah Hassan Abol-enein Islam Mansour Ahmed S.El-Hefnawy 《Asian Journal of Urology》 CAS CSCD 2025年第4期520-528,共9页
Objective:This study aimed to evaluate the diagnostic accuracy of MRI in the detection of nodal metastasis in urothelial bladder cancer(UBC)and to assess the long-term oncological outcomes of upfront radical cystectom... Objective:This study aimed to evaluate the diagnostic accuracy of MRI in the detection of nodal metastasis in urothelial bladder cancer(UBC)and to assess the long-term oncological outcomes of upfront radical cystectomy(RC)in patients with clinical lymph node-positive(cN+)muscle-invasive UBC.Methods:A retrospective analysis of 1053 consecutive UBC patients treated with RC between January 1,2004 and January 31,2014 was performed.Radiological,clinical,pathological data and survival outcomes of cN+ patients were collected.Cox regression analyses were used to assess the impact of the radiological,clinical,and pathological variables on survival.Results:A total of 233(22%)patients were diagnosed with cN+ UBC with a mean age of 57.3(standard deviation 8.1)years,of whom 144(62%)were found to have pathologically positive lymph nodes at final pathology.Adjuvant chemotherapy was administered to 58(25%)patients.The sensitivity,specificity,positive predictive value,and negative predictive value of MRI to detect pathological lymph node-positive disease were 51%,88%,62%,and 83%,respectively.The overall accuracy was 79% with a calculated area under the curve of 70%.The median follow-up period was 17.0(interquartile range 8.2e58.7)months.During this period,54(23%)patients developed local recurrence while 56(24%)experienced distant metastasis and the estimated 1-,3-,5-,and 10-year recurrence-free survival for cN+ patients were 78%,56%,51%,and 48%,respectively.On multivariate analysis,advanced pT stage(pT3e4 vs.pT2)was the only independent predictor of recurrence-free survival.Conclusion:Despite its potential in preoperative assessment of muscle-invasive UBC,MRI showed limited sensitivity for detecting node-positive disease.Notably,in patients with MRIdetected cN+ UBC,those who underwent upfront RC demonstrated long-term survival outcomes comparable to those treated with neoadjuvant chemotherapy followed by consolidative cystectomy in previously published studies. 展开更多
关键词 Upfront cystectomy Urothelial cancer Lymph node-positive Clinically positive lymph node Induction chemotherapy Adjuvant chemotherapy Recurrence-free survival
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Benefit of adjuvant chemoradiotherapy in patients with pathologically lymph node-positive and locally advanced gastric cancer 认领 引用
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作者 Shanhui Zhang Fei Zhou +2 位作者 Donghai Liang Hongying Lv Hongsheng Yu 《Oncology and Translational Medicine》 CAS 2020年第2期72-80,共9页
Objective This study aimed to compare the effectiveness of adjuvant chemoradiotherapy(CRT)and adjuvant chemotherapy(ChT)for T3–4/N+gastric cancer(GC)following D2/R0 dissection,and identify the specific subgroups that... Objective This study aimed to compare the effectiveness of adjuvant chemoradiotherapy(CRT)and adjuvant chemotherapy(ChT)for T3–4/N+gastric cancer(GC)following D2/R0 dissection,and identify the specific subgroups that could benefit from adjuvant CRT.Methods All eligible patients were divided into the CRT group and ChT group.We assessed the survival outcomes and patterns of recurrence for each group,and determined the prognostic factors for survival by performing Cox proportional risk regression analyses.Results A total of 192 gastric cancer patients were included in the study.The estimated 3-year and 5-year disease-free survival(DFS)probabilities in the CRT and ChT groups were 52.9%vs.36.7%(P=0.024)and 41.2%vs.31.1%(P=0.148),respectively,and the estimated 3-year and 5-year overall survival(OS)probabilities were 82.4%vs.70.0%(P=0.044)and 52.0%vs.35.6%(P=0.022).Patients in the CRT group had a lower risk of locoregional recurrence than those in the ChT group(20.6%vs.34.4%;P=0.031).The subset analyses revealed that patients with stage N1–2 disease were more likely to benefit from adjuvant CRT than from adjuvant ChT(DFS:53.1%vs.36.4%;P=0.039;OS:53.1%vs.38.6%;P=0.036).Conclusion For locally advanced gastric cancer patients with LN+,adjuvant CRT showed superior survival benefits compared with adjuvant ChT alone.Patients with N1–2 achieved better survival from adjuvant CRT. 展开更多
关键词 locally advanced gastric cancer adjuvant chemoradiotherapy adjuvant radiotherapy lymph node-positive survival and prognosis
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Analysis of factors related to non-sentinel lymph node metastasis in 296 sentinel lymph node-positive Chinese breast cancer patients 认领 引用 被引量：20
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作者 Amina Maimaitiaili Di Wu +3 位作者 Zhenyu Liu Haimeng Liu Xiamusiye Muyiduli Zhimin Fan 《Cancer Biology & Medicine》 SCIE CAS CSCD 2018年第3期282-289,共8页
Objective: Axillary lymph node dissection(ALND) may be unnecessary in 20%–60% of breast cancer patients with sentinel lymph node(NSLN) metastasis. The aim of the present study was to review the medical records of Chi... Objective: Axillary lymph node dissection(ALND) may be unnecessary in 20%–60% of breast cancer patients with sentinel lymph node(NSLN) metastasis. The aim of the present study was to review the medical records of Chinese patients with early-stage breast cancer and positive NSLN metastasis to identify clinicopathological characteristics as risk factors for non-NSLN metastasis.Methods: The medical records of 2008 early-stage breast cancer patients who received intraoperative sentinel lymph node biopsy(SLNB) between 2006 and 2016 were retrospectively reviewed. These patients were clinically and radiologically lymph nodenegative and had no prior history of receiving neoadjuvant chemotherapy or endocrinotherapy. The clinicopathological characteristics of patients with positive NSLN metastasis who underwent ALND were investigated.Results: In the present study, 296 patients with positive NSLN metastases underwent ALND. Positive non-NSLN metastases were confirmed in 95 patients(32.1%). On univariate analysis, ≥ 3 positive NSLN metastases(P <0.01), NSLN macrometastases(P =0.023), and lymphovascular invasion(P = 0.04) were associated with non-NSLN metastasis(P <0.05). In multivariate analysis, the number of positive SLNs was the most significant predictor of non-SLN metastasis. For patients with 0, 1, 2, or 3 associated risk factors, the non-SLN metastatic rates were 11.5%, 22.5%, 35.2%, and 73.1%, respectively.Conclusions: The number of positive NSLNs, NSLN macrometastases, and lymphovascular invasion were correlated with nonSLN metastasis. The number of positive SLNs was an independent predictor for non-NSLN metastasis. When 2 or 3 risk factors were present in one patient, the probability of non-NSLN was higher than that in the American College of Surgeons Oncology Group Z0011 trial(27.3%); thus, avoiding ALND should be considered carefully. 展开更多
关键词 Breast cancer sentinel lymph node metastasis axillary lymph node dissection non-sentinel lymph node metastasis
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Expert consensus on multidisciplinary management of laparoscopic-endoscopic cooperative surgery combined with sentinel lymph node navigation surgery for early gastric cancer(2026 edition) 认领 引用 被引量：4
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作者 Zhi Zheng Yu Zhao +15 位作者 Rui Xu Zimeng Wang Jie Yin Fandong Meng Kuiliang Liu Guangyong Chen Jun Zhang Peng Li Lin Chen Zhongtao Zhang Shutian Zhang National Clinical Research Center for Digestive Diseases National Key Laboratory of Digestive Health Digestive Endoscopy Branch of Chinese Medical Association Gastroenterologist and Hepatologist Branch of Chinese Medical Doctor Association Chinese Gastric Cancer Association of China Anti-Cancer Association 《Chinese Journal of Cancer Research》 SCIE CAS CSCD 2026年第1期1-26,共26页
With the advancement of surgical techniques and enhanced management of early gastric cancer(EGC),minimally invasive function-preserving surgical approaches have emerged as a common goal for patients and clinicians.Lap... With the advancement of surgical techniques and enhanced management of early gastric cancer(EGC),minimally invasive function-preserving surgical approaches have emerged as a common goal for patients and clinicians.Laparoscopic-endoscopic cooperative surgery combined with sentinel lymph node navigation surgery(LECSSNNS)has drawn increasing interest because of its dual benefits of minimal invasiveness and organ function preservation.However,robust evidence-based support for guiding clinical implementation remains limited.To address this gap,we systematically evaluated available studies on the clinical application of LECS-SNNS in EGC and integrated expert insights to formulate 20 recommendations.These included preoperative assessment,surgical techniques,intraoperative endoscopic procedures,pathological evaluation,postoperative care,and follow-up.This consensus aimed to provide comprehensive guidance for the standardized application of LECS-SNNS,thereby advancing precise,minimally invasive,and function-preserving treatment for EGC. 展开更多
关键词 Sentinel lymph node laparoscopic-endoscopic cooperative surgery navigation surgery early gastric cancer multidisciplinary diagnosis and treatment consensus
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Identification of the lymph node metastasis atlas and optimal lymph node dissection strategy in patients with resectable lung invasive mucinous adenocarcinoma:a real-world multicenter study 认领 引用 被引量：3
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作者 Chao Zheng Guo-Chao Zhang +19 位作者 Long Zhang Yu-Zhuo Zhang Jia Jia Shun Xu Wen-Yue Zhao Yang Liu Meng Yue Yue-Ping Liu Shuang-Ping Zhang Yi Shen Qi-Yue Ge Yu-Ning Han Jing Li Hong-Jiang Yan Li-Yan Xue Yu-Shun Gao Feng-Wei Tan Shu-Geng Gao Qi Xue Jie He 《Military Medical Research》 SCIE CAS CSCD 2026年第5期689-705,共17页
Background:Lung invasive mucinous adenocarcinoma(LIMA)is a rare,unique,and heterogeneous subtype of lung cancer whose patterns of lymph node(LN)metastasis are unknown,and a consensus on LN dissection(LND)has not been ... Background:Lung invasive mucinous adenocarcinoma(LIMA)is a rare,unique,and heterogeneous subtype of lung cancer whose patterns of lymph node(LN)metastasis are unknown,and a consensus on LN dissection(LND)has not been reached.This study aimed to evaluate LN metastasis patterns in LIMAs and establish optimal LND strategies.Methods:Data about 19,596 LNs from 1474 LIMA patients collected between January 2010 and December 2021 at 8 lung cancer research centers and tertiary hospitals across China,and data from 5304 LIMA patients between 2004 and 2021 in the SEER database were analysed.Metastasis probabilities were calculated for each LN station to construct a metastasis atlas.Statistical methods,including LOWESS fitting,restricted cubic spline,Kaplan-Meier,and logistic regression analyses,were employed to identify optimal LND strategies.Results:Compared with non-mucinous adenocarcinoma patients,LIMA patients exhibited distinct clinicopathological features and a significantly lower probability of LN metastasis(4.20%vs.7.19%,P0.5)risk patients were 7,14,and 17,respectively.For those with uncertain metastatic risk,dissecting 18 LNs may be the most appropriate and robust strategy.Conclusions:This study systematically revealed the pattern of LIMA-specific LN metastasis and proposed a risk-stratified LND strategy.These recommendations balance the imperatives of accurate staging with the preservation of long-term patient prognosis,offering a practical guideline for surgical decision-making. 展开更多
关键词 Lung invasive mucinous adenocarcinoma(LIMA) Lymph node dissection(LND) Metastasis atlas N-staging Prognosis
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Predicting lymph node metastasis in colorectal cancer using caselevel multiple instance learning 认领 引用 被引量：1
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作者 Ling-Feng Zou Xuan-Bing Wang +4 位作者 Jing-Wen Li Xin Ouyang Yi-Ying Luo Yan Luo Cheng-Long Wang 《World Journal of Gastroenterology》 SCIE CAS 2026年第1期110-125,共16页
BACKGROUND The accurate prediction of lymph node metastasis(LNM)is crucial for managing locally advanced(T3/T4)colorectal cancer(CRC).However,both traditional histopathology and standard slide-level deep learning ofte... BACKGROUND The accurate prediction of lymph node metastasis(LNM)is crucial for managing locally advanced(T3/T4)colorectal cancer(CRC).However,both traditional histopathology and standard slide-level deep learning often fail to capture the sparse and diagnostically critical features of metastatic potential.AIM To develop and validate a case-level multiple-instance learning(MIL)framework mimicking a pathologist's comprehensive review and improve T3/T4 CRC LNM prediction.METHODS The whole-slide images of 130 patients with T3/T4 CRC were retrospectively collected.A case-level MIL framework utilising the CONCH v1.5 and UNI2-h deep learning models was trained on features from all haematoxylin and eosinstained primary tumour slides for each patient.These pathological features were subsequently integrated with clinical data,and model performance was evaluated using the area under the curve(AUC).RESULTS The case-level framework demonstrated superior LNM prediction over slide-level training,with the CONCH v1.5 model achieving a mean AUC(±SD)of 0.899±0.033 vs 0.814±0.083,respectively.Integrating pathology features with clinical data further enhanced performance,yielding a top model with a mean AUC of 0.904±0.047,in sharp contrast to a clinical-only model(mean AUC 0.584±0.084).Crucially,a pathologist’s review confirmed that the model-identified high-attention regions correspond to known high-risk histopathological features.CONCLUSION A case-level MIL framework provides a superior approach for predicting LNM in advanced CRC.This method shows promise for risk stratification and therapy decisions,requiring further validation. 展开更多
关键词 Colorectal cancer Lymph node metastasis Deep learning Multiple instance learning Histopathology
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Which lymph node dissection should be performed in advanced distal gastric cancer?A critical assessment of D2 lymphadenectomy 认领 引用
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作者 Giuseppe Brisinda Maria Michela Chiarello +6 位作者 Filomena Misuriello Maria Cariati Giuseppe Tropeano Edoardo Piras Gaia Altieri Giada Bracalente Valerio Papa 《World Journal of Gastrointestinal Surgery》 SCIE 2026年第3期9-23,共15页
Lymph node invasion stands out as the most critical prognostic factor in gastric cancer.The extent of lymph node dissection required during curative gastric cancer surgery has long been debated.Japanese Gastric Cancer... Lymph node invasion stands out as the most critical prognostic factor in gastric cancer.The extent of lymph node dissection required during curative gastric cancer surgery has long been debated.Japanese Gastric Cancer Association was the first to define a classification system for regional gastric lymph node stations,numbering them from No.1 to No.16.This classification was later used to differentiate between different types of lymph node dissection,such as D1,D2 and D3.However,these definitions were often considered too complex to be universally adopted,resulting in wide variations of recommendations from one country to another and making it difficult to compare published studies.Moreover,the optimal extent of lymph node dissection remains uncertain,as the extensive dissections that where initially recommended are associated with significant morbidity without a clear survival benefit.Though gastrectomy with extended D2 lymphadenectomy is classified as a non-standard gastrectomy,its clinical significance has been evaluated in many studies.D2 plus superior mesenteric vein lymph node(No.14v)dissection is recommended when metastasis to No.6 nodes is suspected in the lower stomach,and D2 plus posterior surface of the pancreatic head(No.13)lymph node dissection may be an option in potentially curative gastrectomy for cancer invading the duodenum.No.14v lymph node dissection has been shown to improve overall survival in patients with distal gastric cancer,primarily in patients with clinical stage Ⅲ/Ⅳ distal gastric cancer.Furthermore,D2 plus lymphadenectomy showed a significantly higher 5-year overall survival rate(55.3%vs 43.9%)and a lower recurrence rate(51.5%vs 69.5%)then D2 standard dissection.The quality of lymphadenectomy may influence prognosis in gastric cancer patients.Both hospital volume and surgeon volume were important factors for the quality of radical gastrectomy.The purpose of this review is to support the extension of lymph node dissection based on the existing literature,including a comprehensive review of current definitions of lymphadenectomy.An outcome analysis is performed to assess the need for lymphadenectomy with removal of lymph nodes not included in the standard D2 lymphadenectomy in patients with distal gastric cancer,especially if the tumor is advanced. 展开更多
关键词 Gastric cancer Lymph node dissection Lymph nodes metastases Guidelines Surgery
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Robot-assisted post-chemotherapy retroperitoneal lymph node dissection for metastatic non-seminomatous germ cell tumors using two distinct surgical approaches:A tertiary care experience 认领 引用
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作者 Xiangdong Li Wilhem M.S.Teixeira +5 位作者 Renjie Ding Shengjie Guo Hui Han Kai Yao Fangjian Zhou Zhuowei Liu 《Asian Journal of Urology》 CAS CSCD 2026年第1期107-115,共9页
Objective:Robot-assisted post-chemotherapy retroperitoneal lymph node dissection(R-PC-RPLND)is increasingly used as an alternative to open surgery for metastatic testicular cancer.This study aimed to summarize the exp... Objective:Robot-assisted post-chemotherapy retroperitoneal lymph node dissection(R-PC-RPLND)is increasingly used as an alternative to open surgery for metastatic testicular cancer.This study aimed to summarize the experience with lateral and supine approaches in R-PC-RPLND for metastatic non-seminomatous germ cell tumors,applied based on different clinical indications.Methods:We conducted a retrospective analysis of 42 consecutive patients who underwent R-PC-RPLND at our tertiary cancer center from May 2016 to July 2023.Patients were categorized based on the surgical approach used:lateral position(28 patients)or supine position(14 patients).Data on perioperative outcomes,complications,and oncological efficacy were assessed and reported using descriptive statistics.Results:The median patient age was 28.0(interquartile range[IQR]:23.5-30.5)years,and the median body mass index was 22.7(IQR:19.9-24.2)kg/m2.The median operative time was 167.5(IQR:135.0-216.0)min,and the median estimated blood loss was 100.0(IQR:50.0-200.0)mL.Vascular injuries occurred in 4.8% of the cases,with no conversions to open surgery required.Postoperative complications were observed in 14% of the patients,all classified as ClavieneDindo grades IeII.Histopathological examination revealed necrosis or fibrosis in 43% of the cases,teratoma in 31%,and viable germ cell tumor in 26%.During a median follow-up of 22.0(IQR:16.0-30.5)months,17% of the patients experienced relapse,with a median time to relapse of 5.0(IQR:4.0-7.0)months.Conclusion:Both lateral and supine approaches for R-PC-RPLND demonstrated favorable surgical and oncological outcomes,with acceptable operative times,minimal blood loss,low complication rates,and effective oncological control.The choice between these approaches should consider patient-specific factors and surgeon expertise,allowing for tailored treatment that optimizes outcomes. 展开更多
关键词 Testicular cancer Robotic surgery Post-chemotherapy retroperitoneal lymph node dissection Surgical approach
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Virtual histology imaging of lymph nodes via dynamic full-field optical coherence tomography and deep learning to differentiate metastasis 认领 引用
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作者 Shuwei Zhang Houpu Yang +8 位作者 Yiyin Zhang Xiaoxian Li Jin Zhao Yuanyuan Zhang Ping Xue Hua Kang Hongchuan Jiang Wenhui Ren Shu Wang 《Cancer Biology & Medicine》 SCIE CAS CSCD 2026年第3期418-429,共12页
Objective:The current pathological diagnosis of lymph node metastasis is time-consuming,labor-intensive,and dependent on sectioning of paraffin blocks.Herein,in a prospective cohort of patients with breast cancer,we v... Objective:The current pathological diagnosis of lymph node metastasis is time-consuming,labor-intensive,and dependent on sectioning of paraffin blocks.Herein,in a prospective cohort of patients with breast cancer,we validated dynamic full-field optical coherence tomography(D-FFOCT),a virtual pathology tool integrating deep learning for nodal metastasis detection,and offering rapid and label-free histologic approximations of fresh tissues.Methods:In a prospective dual-center cohort of 155 patients with breast cancer,747 freshly bisected lymph node slides were obtained via D-FFOCT.Surgeons interpreted each slide with histopathology as the gold standard.A deep learning model was trained on 28,911 patches(corresponding to 590 slides)and tested on 7,736 patches(corresponding to 157 slides).The results were mapped to the slide level for potential intraoperative evaluation.Results:D-FFOCT strongly correlated with hematoxylin and eosin(H&E)-stained histological images.Surgeons achieved 97.10%specificity in nodal diagnosis with D-FFOCT.The performance of the artificial intelligence(AI)model was not inferior to that of human experts and had a sensitivity/specificity of 87.88%/91.94%and an area under the receiver operating characteristic curve of 0.899 at the slide level.The human–AI collaborative system reduced labor requirements by 75%and increased the specificity by 6.5%,to 98.39%.Conclusions:D-FFOCT has excellent potential as a tool for assessing lymph node metastatic status without tissue preparation or consumption.The integration of D-FFOCT with deep learning decreases labor demands and maintains high accuracy,thereby enabling streamlined nodal prediction independent of routine pathology procedures. 展开更多
关键词 Breast cancer dynamic full field optical coherence tomography lymph nodes AI model metastatic status
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Lymph node regression grade as a prognostic marker in rectal cancer after neoadjuvant therapy and radical resection 认领 引用
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作者 Yun-Jie Shi Pan-Pan Duan +5 位作者 Qian-Qian Liu Hong-Yan Ru Ya-Jun Huang Wen Xia Ling Chen Xu Li 《World Journal of Gastroenterology》 SCIE CAS 2026年第15期61-72,共12页
BACKGROUND Neoadjuvant chemoradiotherapy(nCRT)followed by radical resection is the standard for locally advanced rectal cancer(LARC).The tumor regression grade(TRG)of the primary tumor is a known prognostic marker,but... BACKGROUND Neoadjuvant chemoradiotherapy(nCRT)followed by radical resection is the standard for locally advanced rectal cancer(LARC).The tumor regression grade(TRG)of the primary tumor is a known prognostic marker,but its value may be limited by lymph node(LN)status.Assessment of treatment response in LNs is not standardized.AIM To determine the prognostic significance of both primary TRG and a novel LN regression grade(LRG)in patients with LARC after nCRT and surgery.METHODS The study cohort included patients with LARC who received nCRT and subsequent radical resection from January 2022 to March 2025.The impacts of TRG and LRG scores were assessed.RESULTS During the study period,155 patients underwent long-course nCRT followed by radical rectal resection.Overall,51(32.9%)patients developed recurrence,and 34(21.9%)patients died over the follow-up period.The 5-year overall survival(OS)was 66.1%,and the 5-year disease-free survival(DFS)was 59.5%.With all patients taken into consideration,TRG had no significant correlation with OS(P=0.11)and DFS(P=0.18).Conversely,TRG was significantly associated with DFS(P=0.01)in the 92 patients with ypN0.After excluding patients without LN metastasis,LRG was significantly associated with OS(P=0.001)and DFS(P=0.04).Furthermore,LRG was an independent predictor for mortality(hazard ratio=1.533,P=0.0002)and recurrence(hazard ratio=1.278,P=0.01).CONCLUSION Among patients with advanced rectal cancer after nCRT,TRG emerged as a predictive factor solely limited to patients with ypN0.In patients with LN metastasis,LRG could have independent prognostic significance. 展开更多
关键词 Rectal cancer Lymph node regression grade Tumor regression grade Neoadjuvant chemoradiotherapy Prognostic marker
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Deep learning for predicting lymph node metastasis in T1b gastric cancer using histopathology:a retrospective,multicenter study 认领 引用
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作者 Linbin Lu Jun Yu +18 位作者 Yan Zhang Ning Han Xinlin Wang Sitian Dai Ruirong Yao Abudurousuli Reyila Shibo Wang Junya Yan Yan Pan Yuanyuan Lu Mengbin Li Jipeng Li Qingchuan Zhao Kaichun Wu Qingzhi Lan Weiguo Dong Xiong Chen Xianchun Gao Yongzhan Nie 《Medicine Plus》 CAS 2026年第2期34-45,共12页
Background:T1b gastric cancer(T1b-GC)carries a high risk of lymph node metastasis(LNM),which is a key determinant of treatment choice and prognosis.However,assessing LNM risk in T1b-GC remains challenging.This study a... Background:T1b gastric cancer(T1b-GC)carries a high risk of lymph node metastasis(LNM),which is a key determinant of treatment choice and prognosis.However,assessing LNM risk in T1b-GC remains challenging.This study aimed to develop machine learning models that integrate clinical data and postoperative hematoxylin and eosin-stained whole-slide images(HE-WSIs)to predict LNM in T1b-GC.Methods:This retrospective,multicenter cohort study analyzed 1023 patients with T1b-GC who underwent radical gastrectomy with lymphadenectomy.Thirteen machine learning algorithms were evaluated to develop a baseline predictive model using clinical variables.A deep learning system(DL-T1b)was trained and validated to predict LNM from histopathological tumor sections.A nomogram combining the baseline model and DL-T1b score was developed and evaluated.Results:Linear discriminant analysis was the optimal baseline model,achieving an area under the curve(AUC)of 0.771(95%CI:0.747,0.813)based on six factors:sex,tumor size,differentiation grade,Laurén classification,tumor location,and lymphovascular invasion.The DL-T1b model demonstrated superior performance(AUC:0.910;95%CI:0.869,0.945).Incorporating the DL-T1b score with baseline clinical features into a nomogram enhanced its discriminatory performance(AUC:0.964;95%CI:0.949,0.978),achieving 93.2%sensitivity and 85.1%specificity.Spatial heatmaps of HE-WSIs revealed that the proportion of patches with a 100%predicted probability correlated positively with LNM risk.Conclusion:Derived from HE-WSI tumor regions,the DL-T1b score provides a robust and interpretable tool for individualized LNM risk stratification to guide clinical treatment. 展开更多
关键词 Gastric cancer Lymph node metastasis Machine learning Whole slide images Vision transformer
Computed tomography with carcinoembryonic antigen and carbohydrate antigen 19-9 in diagnosing lymph node metastasis of early gastric cancer 认领 引用
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作者 Hong-Zhi Chen Ping Zhang Jun Ma 《World Journal of Gastrointestinal Oncology》 SCIE 2026年第2期112-121,共10页
BACKGROUND Gastric cancer(GC)is the fifth most prevalent and fourth most lethal malignancy globally.China bears a disproportionately high burden,accounting for 44.0%of new cases and 48.6%of deaths worldwide.In early G... BACKGROUND Gastric cancer(GC)is the fifth most prevalent and fourth most lethal malignancy globally.China bears a disproportionately high burden,accounting for 44.0%of new cases and 48.6%of deaths worldwide.In early GC(EGC),the presence of lymph node metastasis(LNM)is a critical prognostic determinant that directly guides therapeutic strategy.While multi-detector computed tomography(CT)and serum biomarkers carcinoembryonic antigen(CEA)/carbohydrate antigen 19-9(CA19-9)are established diagnostic tools,each demonstrates limited efficacy when used independently.This study therefore aims to verify whether a combined diagnostic approach integrating multi-detector CT(MDCT)with serum CEA/CA19-9 can significantly improve the accuracy of LNM detection in EGC patients.AIM To investigate the diagnostic value of CT combined with CEA or CA19-9 for detecting LNM in EGC.METHODS This retrospective study included 120 patients with EGC confirmed by gastroscopic biopsy at our institution(Huai’an Hospital of Huai’an City)between February 2024 and August 2024.Based on postoperative pathological findings,participants were categorized into a LNM group(n=60)and a non-metastasis group(n=60).All patients underwent MDCT scanning and serum CEA and CA19-9 level measurements.The diagnostic efficacy of CT,CEA,and CA19-9 alone and in combination was evaluated using receiver operating characteristic(ROC)curve and Kappa consistency analysis.RESULTS Serum analysis showed significantly elevated CEA and CA19-9 levels and higher positivity rates in the metastasis group(P<0.0001).ROC analysis yielded area under the curves of 0.9443(CEA)and 0.9292(CA19-9),with Kappa values of 0.683 and 0.650,respectively.CT revealed significantly greater short-axis diameter,CT attenuation,blood volume,and permeability in metastatic nodes(P<0.05),whereas blood flow and mean transit time showed no significant differences.CT alone demonstrated 85.00%sensitivity and 95.00%specificity(Kappa=0.800).Combined diagnosis improved sensitivity to 91.67%(CT+CEA)and 90.00%(CT+CA19-9),with specificities of 90.00%and 88.33%,respectively.CONCLUSION The combination of CT with CEA or CA19-9 improves sensitivity for detecting LNM in EGC,supporting personalized treatment planning and demonstrating clinical value. 展开更多
关键词 Computed tomography Carcinoembryonic antigen Carbohydrate antigen 19-9 Gastric cancer Lymph node metastasis
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Pulmonary sclerosing pneumocytoma with lymph node metastasis and high 18FDG uptake in PET/CT:a rare case report and literature review 认领 引用
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作者 Jingfeng XU Yilei ZHAO +1 位作者 Qiuli WU Feng CHEN 《Journal of Zhejiang University-SCIENCE B》 SCIE CAS CSCD 2026年第2期202-206,共5页
Pulmonary sclerosing pneumocytoma(PSP)was first reported by Liebow and Hubbell(1956).It was initially called pulmonary sclerosing hemangioma(PSH)because it was thought to be derived from endothelial cells with rich va... Pulmonary sclerosing pneumocytoma(PSP)was first reported by Liebow and Hubbell(1956).It was initially called pulmonary sclerosing hemangioma(PSH)because it was thought to be derived from endothelial cells with rich vascularity.However,the 2015 World Health Organization Classification of Lung Tumors removed the term"sclerosing hemangioma,1 since these tumors lack vascular origin(Travis et al.2015),and the renamed tumor was considered a rare and benign lung tumor.However,several reports have described PSP with lymph node metastasis(Soo et al.,2017).Thus,PSP is not always benign and has the potential to metastasize. 展开更多
关键词 literature review endothelial cells pulmonary sclerosing pneumocytoma psp lymph node metastasis pulmonary sclerosing pneumocytoma pulmonary sclerosing hemangioma psh F DG uptake PET CT
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Lymphatic–venous anastomosis: Cracking the code of Alzheimer's disease treatment? 认领 引用
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作者 Fan Fan Nannan Zhao Mian Guo 《Neural Regeneration Research》 SCIE CAS CSCD 2026年第6期2367-2368,共2页
Deep cervical lymph-venous anastomosis(LVA)is a surgical procedure initially developed to treat cervical lymphatic obstruction,such as lymphedema,a condition caused by the accumulation of lymphatic fluid due to blocke... Deep cervical lymph-venous anastomosis(LVA)is a surgical procedure initially developed to treat cervical lymphatic obstruction,such as lymphedema,a condition caused by the accumulation of lymphatic fluid due to blocked or damaged lymphatic vessels.In early 2024,Dr.Qingping Xie from Hangzhou Qiushi Hospital,China,and Dr.Wei F.Chen from the Cleveland Clinic,USA,adapted LVA for the treatment of patients with Alzheimer’s disease(AD).As a VIEWPOINT,they presented a video showcasing the post-surgery cognitive recovery of an 84-year-old AD patient(Xie et al.,2024). 展开更多
关键词 alzheimer s disease post surgery cognitive recovery surgical procedure lymphatic venous anastomosis deep cervical lymph venous anastomosis lymphedema lymphatic fluid cervical lymphatic obstructionsuch
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Impact of metastatic lymph node ratio in node-positive colorectal cancer 认领 引用 被引量：10
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作者 Shingo Noura Masayuki Ohue +6 位作者 Shingo Kano Tatsushi Shingai Terumasa Yamada Isao Miyashiro Hiroaki Ohigashi Masahiko Yano Osamu Ishikawa 《World Journal of Gastrointestinal Surgery》 2010年第3期70-77,共8页
Colorectal cancer(CRC) is one of the most common malignant diseases in the world.Presently,the most widely used staging system for CRC is the tumor nodes metastasis classification system,which classifies patients into... Colorectal cancer(CRC) is one of the most common malignant diseases in the world.Presently,the most widely used staging system for CRC is the tumor nodes metastasis classification system,which classifies patients into prognostic groups according to the depth of the primary tumor,presence of regional lymph node(LN) metastases,and evidence of distant metastatic spread.The number of LNs with confirmed metastasis is related to the severity of the disease,but this number depends on the number of LNs retrieved,which varies depending on patient age,tumor grade,surgical extent,and tumor site.Numerous studies and a recent structured review have demonstrated associated improvements in the survival of CRC patients with increasing numbers of LNs retrieved for examination.Hence,the impact of lymph node ratio(LNR),defined as the number of metastatic LNs divided by the number of LNs retrieved,has been investigated in various malignancies,including CRC.In this editorial,we review the literature demonstrating the clinicopathological significance of LNR in CRC pati-ents.Some reports have indicated the advantage of considering the LNR compared to the number of LNs retrieved and/or LN status.When the LNR is taken into consideration for survival analysis,the number of LNs retrieved and/or the LN status is not always found to be a prognostic factor.The cut-off points for LNRs were proposed in numerous studies.However,optimal thresholds for LNRs have not yet received consensus.It is still unclear whether the LNR has more prognostic validity than N stage.For all these reasons,the potential advantages of LNRs in the staging system should be investigated in large prospective data sets. 展开更多
关键词 Lymph node ratio Lymph node Colorectal cancer Prognostic factor Tumor nodes metastasis stage
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The validity of predicting prognosis by the number of lymph node metastases in node-positive colon cancer 认领 引用 被引量：4
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作者 Kiichi Sugimoto Masaya Kawai +11 位作者 Kazuhiro Takehara Yoshihiko Tashiro Shinya Munakata Kiichi Nagayasu Koichiro Niwa Shun Ishiyama Hiromitsu Komiyama Makoto Takahashi Yutaka Kojima Michitoshi Goto Yuichi Tomiki Kazuhiro Sakamoto 《Open Journal of Gastroenterology》 CAS 2013年第4期217-222,共6页
Background: We examined the possibility of predicting prognosis by the number of lymph node metastases. Methods: Two hundred and forty nine patients with lymph node metastases who underwent curative surgery for colon ... Background: We examined the possibility of predicting prognosis by the number of lymph node metastases. Methods: Two hundred and forty nine patients with lymph node metastases who underwent curative surgery for colon cancer were enrolled in this study. We calculated cancer-specific survival according to the number of lymph node metastases. Results: There was a tendency toward better rates of cancer-specific survivals among the patients with 1 LNM, compared with those with 2 LNM (p = 0.07). When comparing cancer-specific survival between the patients with 1, 2-3 and 4 or more lymph node metastases, cancer-specific survival was well stratified (p i.e., the patients with 1, 2 and 3 and 4 or more lymph node metastases. This study was in favor of the TNM classification in which N category is classified by the number of lymph node metastases. 展开更多
关键词 Colon Cancer Lymph Node Metastasis Stage Classification TNM Classification Prognostic Factors
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Unusual recurrence of colon cancer with isolated axillary lymph node metastasis:A case report 认领 引用
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作者 Ali Toffaha Mahmood Al-Dhaheri +5 位作者 Mohammad AL.Zoubi Arwa Abdelrahim Mahir Petkar Ahmed Badr Mohamed Abunada Ayman Ahmed 《Laparoscopic, Endoscopic and Robotic Surgery》 2026年第1期58-61,共4页
The metastatic pattern of colon cancer is typically well characterized,with initial dissemination occurring through regional lymphatics,followed by hematogenous spread.The most frequent sites of metastasis in colorect... The metastatic pattern of colon cancer is typically well characterized,with initial dissemination occurring through regional lymphatics,followed by hematogenous spread.The most frequent sites of metastasis in colorectal cancer(CRC)include regional lymph nodes(50%–70%),liver(35%–50%),lungs(21%),peritoneum(15%),and ovaries(13%).1 Isolated distant lymph node metastasis,particularly in the absence of concurrent systemic disease,is exceedingly rare in CRC.To date,only six cases of isolated axillary lymph node metastasis(ALNM)from colorectal primaries have been documented in the literature.1–6 Even more uncommon is the incidental discovery of malignant cells in anastomotic doughnuts following stoma reversal procedures.Herein,we report a rare case involving both the incidental histopathological detection of tumor cells within doughnuts during stoma closure and the subsequent development of isolated ALNM after curative resection of sigmoid colon carcinoma. 展开更多
关键词 axillary lymph node hematogenous spreadthe axillary lymph node metastasis distant lymph node metastasisparticularly colon cancer regional lymph nodes liver lungs peritoneum colorectal cancer crc include regional lymphaticsfollowed
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PSMA PET/CT-guided pelvic lymph node dissection in patients with unfavorable intermediate-or high-risk prostate cancer 认领 引用
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作者 Eva Donck Sofie Verbeke +4 位作者 Pieter De Visschere Valérie Fonteyne Charles Van Praet Kathia De Man Nicolaas Lumen 《The Canadian Journal of Urology》 SCIE 2026年第1期83-92,共10页
Objectives:PSMA PET/CT(Prostate-Specific MembraneAntigen Positron Emission Tomography/Computed Tomography)offers improved accuracy in detecting lymph node invasion(LNI)in prostate cancer(PC)patients,potentially reduci... Objectives:PSMA PET/CT(Prostate-Specific MembraneAntigen Positron Emission Tomography/Computed Tomography)offers improved accuracy in detecting lymph node invasion(LNI)in prostate cancer(PC)patients,potentially reducing the need for extended pelvic lymph node dissection(ePLND).This study aims to evaluate a patient-tailored care pathway in which ePLND is performed only in patients with unfavorable intermediate-or high-risk PC who are deemed at risk for LNI based on PSMA PET/CT findings.Methods:In this interventional cohort study,81 patients were managed according to the new care pathway.ePLND was omitted in cases of negative PSMA PET/CT findings(N0M0),while those with positive PSMA PET/CT findings(N1M0)underwent ePLND.A comparator group of 81 patients was selected from a prospectively generated database for comparison.Results:The intervention group experienced a 75% reduction in the number of ePLNDs performed compared to the comparator group(p<0.001).ePLND-related complications were significantly lower in the intervention group(p=0.008).No significant difference was observed in 3-year biochemical-recurrence free survival(BRFS)between the two groups(p=0.958).Conclusion:Omitting ePLND in patients with negative PSMA PET/CT findings(N0M0)leads to a substantial reduction in the number of ePLNDs performed,resulting in a decrease in morbidity,without compromising early oncological outcomes. 展开更多
关键词 prostate cancer PSMA PET/CT radical prostatectomy pelvic lymph node dissection lymph node invasion staging
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A systematic review of open versus robotic retroperitoneal lymph node dissection for testicular cancer:Comparative operative and oncological outcomes 认领 引用
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作者 Daniel Peter McNicholas Freddy Kattakayam +2 位作者 Joshua Hemmant Robin Weston Vishwanath Hanchanale 《Laparoscopic, Endoscopic and Robotic Surgery》 2026年第1期1-7,共7页
Objective:Open retroperitoneal lymph node dissection(RPLND)is the gold-standard surgical approach for the management of metastatic testicular cancer,but robotic RPLND is becoming increasingly popular.There is limited ... Objective:Open retroperitoneal lymph node dissection(RPLND)is the gold-standard surgical approach for the management of metastatic testicular cancer,but robotic RPLND is becoming increasingly popular.There is limited research directly comparing open and robotic RPLND.The objective of this systematic review is to identify all the literature with direct comparisons between the open and robotic techniques for RPLND and to compare the two techniques.The primary outcome was peri-operative outcomes,and the secondary outcomes included oncological outcomes and patient demographics.Methods:This systematic review was prospectively registered and was conducted in accordance with the PRISMA statement.The PubMed,Embase and MEDLINE databases were searched for relevant publication from January 2006 to August 2024.Results:Eight studies,totaling 3995 patients,are included in this systematic review,with 3521 patients who underwent open RPLND and 474 who underwent robotic RPLND.For open RPLND,the mean operative duration,blood loss and length of stay were 267.8 min,475 mL and 7.3 d,respectively.For robotic RPLND,the mean operative duration,blood loss and length of stay were 334.5 min,94.6 mL and 3.7 d,respectively.Teratoma was the most common RPLND specimen pathology from both open and robotic surgeries.For open RPLND,the specimens have 13–23 nodes(26–32 mm),whereas the robotic RPLND specimens have 13–28 nodes(18–20 mm).Conclusion:This systematic review suggests that the benefitsof robotic RPLND may be associated with reduced blood loss,shorter hospitalisation and an overall lower risk of minor and major complications while maintaining oncological safety. 展开更多
关键词 Retroperitoneal lymph node dissection Robotic surgery Testicular cancer
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Combined multidetector computed tomography and gastrointestinal endoscopy for gastric cancer screening,preoperative staging,and lymph node metastasis detection 认领 引用
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作者 Le-Ping Ye Yan-Ping Zhang +4 位作者 Gang Chen Yi-Xian Wu Cheng-Long He Dong Wang Qiao Mei 《World Journal of Gastrointestinal Oncology》 SCIE 2026年第1期200-210,共11页
BACKGROUND Early screening,preoperative staging,and diagnosis of lymph node metastasis are crucial for improving the prognosis of gastric cancer(GC).AIM To evaluate the diagnostic value of combined multidetector compu... BACKGROUND Early screening,preoperative staging,and diagnosis of lymph node metastasis are crucial for improving the prognosis of gastric cancer(GC).AIM To evaluate the diagnostic value of combined multidetector computed tomography(MDCT)and gastrointestinal endoscopy for GC screening,preoperative staging,and lymph node metastasis detection,thereby providing a reference for clinical diagnosis and treatment.METHODS In this retrospective study clinical and imaging data of 134 patients with suspected GC who were admitted between January 2023 and October 2024 were initially reviewed.According to the inclusion and exclusion criteria,102 patients were finally enrolled in the analysis.All enrolled patients had undergone both MDCT and gastrointestinal endoscopy examinations prior to surgical intervention.Preoperative clinical staging and lymph node metastasis findings were compared with pathological results.RESULTS The combined use of MDCT and gastrointestinal endoscopy demonstrated a sensitivity of 98.53%,specificity of 97.06%,accuracy of 98.04%,positive predictive value of 98.53%,and negative predictive value of 97.06%for diagnosing GC.These factors were all significantly higher than those of MDCT or endoscopy alone(P<0.05).The accuracy rates of the combined approach for detecting clinical T and N stages were 97.06%and 92.65%,respectively,outperforming MDCT alone(86.76%and 79.41%)and endoscopy alone(85.29%and 70.59%)(P<0.05).Among 68 patients with confirmed GC,50(73.53%)were pathologically diagnosed with lymph node metastasis.The accuracy for detecting lymph node metastasis was 66.00%with endoscopy,76.00%with MDCT,and 92.00%with the combined approach,all with statistically significant differences(P<0.05).CONCLUSION The combined application of MDCT and gastrointestinal endoscopy enhanced diagnostic accuracy for GC,provided greater consistency in preoperative staging,and improved the detection of lymph node metastasis,thereby demonstrating significant clinical utility. 展开更多
关键词 Multidetector computed tomography Gastrointestinal endoscopy Gastric cancer Preoperative staging Lymph node metastasis
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