Background: Sentinel lymph node (SLN) biopsy remains a cornerstone in the management of breast cancer, as it provides an accurate staging of the disease while minimizing the morbidity associated with complete axillary...Background: Sentinel lymph node (SLN) biopsy remains a cornerstone in the management of breast cancer, as it provides an accurate staging of the disease while minimizing the morbidity associated with complete axillary lymph node dissection. Advances in SLN detection have been very important in refining surgical techniques and improving patient outcomes. The purpose of the present study is to compare the effectiveness of radiocolloids, blue dyes, and fluorescent tracers in detecting the sentinel lymph node in breast cancer. Materials and Methods: Specifically, we analyzed the detection rate, accuracy, and safety profile of the techniques to outline the most reliable and clinically available. A comprehensive review was conducted, searching key databases, including PubMed, Scopus, and Web of Science, for studies published between 2010 and 2024. The review focused on studies that compared the performance of radiocolloids, blue dyes, and fluorescent tracers in the detection of sentinel lymph nodes in breast cancer patients. A total of 54 studies were included based on specific inclusion criteria. Results: Radiocolloids showed high detection rates in studies. Blue dyes have comparable results, but a small percentage of allergic reactions has been observed. Fluorescent tracers such as indocyanine green have improved visualization and accuracy, but their use requires specialized equipment and expertise. Combining radiocolloids with blue dyes or fluorescent tracers has improved detection rates in several studies. Cost and accessibility challenges have also been pointed out, particularly in low-resource settings. Conclusions: Radiocolloids have attained the status of gold standard in the detection of SLNs in breast cancer for their reliability and accuracy. While combined use with other tracers, like blue dyes or fluorescent agents, enhances overall detection performance, making it more holistic. As expected, further innovation and effort are required to improve accessibility and optimize the technique of sentinel lymph node biopsy worldwide.展开更多
BACKGROUND Lymph node status is a critical prognostic factor in gastric cancer(GC),but stage migration may occur in pathological lymph nodes(pN)staging.To address this,alternative staging systems such as the positive ...BACKGROUND Lymph node status is a critical prognostic factor in gastric cancer(GC),but stage migration may occur in pathological lymph nodes(pN)staging.To address this,alternative staging systems such as the positive lymph node ratio(LNR)and log odds of positive lymph nodes(LODDS)were introduced.AIM To assess the prognostic accuracy and stratification efficacy of three nodal staging systems in GC.METHODS A systematic review identified 12 studies,from which hazard ratios(HRs)for overall survival(OS)were summarized.Sensitivity analyses,subgroup analyses,publication bias assessments,and quality evaluations were conducted.To enhance comparability,data from studies with identical cutoff values for pN,LNR,and LODDS were pooled.Homogeneous stratification was then applied to generate Kaplan-Meier(KM)survival curves,assessing the stratification efficacy of three staging systems.RESULTS The HRs and 95%confidence intervals for pN,LNR,and LODDS were 2.16(1.72-2.73),2.05(1.65-2.55),and 3.15(2.15-4.37),respectively,confirming all three as independent prognostic risk factors for OS.Comparative analysis of HRs demonstrated that LODDS had superior prognostic predictive power over LNR and pN.KM curves for pN(N0,N1,N2,N3a,N3b),LNR(0.1/0.2/0.5),and LODDS(-1.5/-1.0/-0.5/0)revealed significant differences(P<0.001)among all prognostic stratifications.Mean differences and standard deviations in 60-month relative survival were 27.93%±0.29%,41.70%±0.30%,and 26.60%±0.28%for pN,LNR,and LODDS,respectively.CONCLUSION All three staging systems are independent prognostic factors for OS.LODDS demonstrated the highest specificity,making it especially useful for predicting outcomes,while pN was the most effective in homogeneous stratification,offering better patient differentiation.These findings highlight the complementary roles of LODDS and pN in enhancing prognostic accuracy and stratification.展开更多
BACKGROUND One of the main characteristics of oral squamous cell carcinoma(OSCC)is that it metastasizes to cervical lymph nodes frequently with a high degree of local invasiveness.A primary feature of malignant tumors...BACKGROUND One of the main characteristics of oral squamous cell carcinoma(OSCC)is that it metastasizes to cervical lymph nodes frequently with a high degree of local invasiveness.A primary feature of malignant tumors is their penetration of neighboring tissues,such as lymphatic and blood arteries,due to the tumor cells'capacity to break down the extracellular matrix(ECM).Matrix metalloproteinases(MMPs)constitute a family of proteolytic enzymes that facilitate tissue remodeling and the degradation of the ECM.MMP-9 and MMP-13 belong to the group of extracellular matrix degrading enzymes and their expression has been studied in OSCC because of their specific functions.MMP-13,a collagenase family member,is thought to play an essential role in the MMP activation cascade by breaking down the fibrillar collagens,whereas MMP-9 is thought to accelerate the growth of tumors.Elevated MMP-13 expression has been associated with tumor behavior and patient prognosis in a number of malignant cases.AIM To assess the immunohistochemical expression of MMP-9 and MMP-13 in OSCC.METHODS A total of 40 cases with histologically confirmed OSCC by incisional biopsy were included in this cross-sectional retrospective study.The protocols for both MMP-9 and MMP-13 immunohistochemical staining were performed according to the manufacturer’s recommendations along with the normal gingival epithelium as a positive control.All the observations were recorded and Pearson’sχ²test with Fisher exact test was used for statistical analysis.RESULTS Our study showed no significant correlation between MMP-9 and MMP-13 staining intensity and tumor size.The majority of the patients were in advanced TNM stages(III and IV),and showed intense expression of MMP-9 and MMP-13.CONCLUSION The present study suggests that both MMP-9 and MMP-13 play an important and independent role in OSCC progression and invasiveness.Intense expression of MMP-9 and MMP-13,irrespective of histological grade of OSCC,correlates well with TNM stage.Consequently,it is evident that MMP-9 and MMP-13 are important for the invasiveness and progression of tumors.The findings may facilitate the development of new approaches for evaluating lymph node metastases and interventional therapy techniques,hence enhancing the prognosis of patients diagnosed with OSCC.展开更多
Identifying key nodes in complex networks is crucial for understanding and controlling their dynamics. Traditional centrality measures often fall short in capturing the multifaceted roles of nodes within these network...Identifying key nodes in complex networks is crucial for understanding and controlling their dynamics. Traditional centrality measures often fall short in capturing the multifaceted roles of nodes within these networks. The Page Rank algorithm, widely recognized for ranking web pages, offers a more nuanced approach by considering the importance of connected nodes. However, existing methods generally overlook the geometric properties of networks, which can provide additional insights into their structure and functionality. In this paper, we propose a novel method named Curv-Page Rank(C-PR), which integrates network curvature and Page Rank to identify influential nodes in complex networks. By leveraging the geometric insights provided by curvature alongside structural properties, C-PR offers a more comprehensive measure of a node's influence. Our approach is particularly effective in networks with community structures, where it excels at pinpointing bridge nodes critical for maintaining connectivity and facilitating information flow. We validate the effectiveness of C-PR through extensive experiments. The results demonstrate that C-PR outperforms traditional centrality-based and Page Rank methods in identifying critical nodes. Our findings offer fresh insights into the structural importance of nodes across diverse network configurations, highlighting the potential of incorporating geometric properties into network analysis.展开更多
Objective:The neglect of occult lymph nodes metastasis(OLNM)is one of the pivotal causes of early non-small cell lung cancer(NSCLC)recurrence after local treatments such as stereotactic body radiotherapy(SBRT)or surge...Objective:The neglect of occult lymph nodes metastasis(OLNM)is one of the pivotal causes of early non-small cell lung cancer(NSCLC)recurrence after local treatments such as stereotactic body radiotherapy(SBRT)or surgery.This study aimed to develop and validate a computed tomography(CT)-based radiomics and deep learning(DL)fusion model for predicting non-invasive OLNM.Methods:Patients with radiologically node-negative lung adenocarcinoma from two centers were retrospectively analyzed.We developed clinical,radiomics,and radiomics-clinical models using logistic regression.A DL model was established using a three-dimensional squeeze-and-excitation residual network-34(3D SE-ResNet34)and a fusion model was created by integrating seleted clinical,radiomics features and DL features.Model performance was assessed using the area under the curve(AUC)of the receiver operating characteristic(ROC)curve,calibration curves,and decision curve analysis(DCA).Five predictive models were compared;SHapley Additive exPlanations(SHAP)and Gradient-weighted Class Activation Mapping(Grad-CAM)were employed for visualization and interpretation.Results:Overall,358 patients were included:186 in the training cohort,48 in the internal validation cohort,and 124 in the external testing cohort.The DL fusion model incorporating 3D SE-Resnet34 achieved the highest AUC of 0.947 in the training dataset,with strong performance in internal and external cohorts(AUCs of 0.903 and 0.907,respectively),outperforming single-modal DL models,clinical models,radiomics models,and radiomicsclinical combined models(DeLong test:P<0.05).DCA confirmed its clinical utility,and calibration curves demonstrated excellent agreement between predicted and observed OLNM probabilities.Features interpretation highlighted the importance of textural characteristics and the surrounding tumor regions in stratifying OLNM risk.Conclusions:The DL fusion model reliably and accurately predicts OLNM in early-stage lung adenocarcinoma,offering a non-invasive tool to refine staging and guide personalized treatment decisions.These results may aid clinicians in optimizing surgical and radiotherapy strategies.展开更多
BACKGROUND Gastric schwannoma(GS)is often misdiagnosed as gastrointestinal stromal tumors due to the high incidence of the latter.However,these two types differ significantly in pathology and biological behavior.AIM T...BACKGROUND Gastric schwannoma(GS)is often misdiagnosed as gastrointestinal stromal tumors due to the high incidence of the latter.However,these two types differ significantly in pathology and biological behavior.AIM To evaluate the computed tomography characteristics of GS and provide insights into its accurate diagnosis.METHODS Twenty-three cases of GS confirmed between January 2011 and December 2023 were assessed clinically and radiologically.Imaging characteristics,including tumor location,size,contour,ulceration,growth pattern,enhancement degree and pattern,cystic change,calcification,and perigastric lymph nodes(PLNs),were reviewed by two experienced radiologists.RESULTS Our sample included 18 females and 5 males,with a median age of 54.7 years.A total of 39.1%of cases were asymptomatic.GSs appeared as oval and well-defined submucosal tumors,with exophytic(43.5%)or mixed(endoluminal+exophytic;43.5%)growth patterns.The tumors were primarily located in the gastric body(78.3%).Ulcerations were observed in 8 cases(34.5%),and PLNs were observed in 15 cases(65%).The average degree of enhancement was 48.3 Hounsfield units.Twenty cases(87%)showed peak enhancement in the delayed phase.Most GSs were homogeneous,while cystic change(13.0%)and calcification(17.4%)were rare.CONCLUSION GS predominantly showed gradual homogenous enhancement with peak enhancement in the delayed phase.PLNs around GS are helpful in differentiating GS from other gastric submucosal tumors.展开更多
Background With the development of the Internet,the topology optimization of wireless sensor networks has received increasing attention.However,traditional optimization methods often overlook the energy imbalance caus...Background With the development of the Internet,the topology optimization of wireless sensor networks has received increasing attention.However,traditional optimization methods often overlook the energy imbalance caused by node loads,which affects network performance.Methods To improve the overall performance and efficiency of wireless sensor networks,a new method for optimizing the wireless sensor network topology based on K-means clustering and firefly algorithms is proposed.The K-means clustering algorithm partitions nodes by minimizing the within-cluster variance,while the firefly algorithm is an optimization algorithm based on swarm intelligence that simulates the flashing interaction between fireflies to guide the search process.The proposed method first introduces the K-means clustering algorithm to cluster nodes and then introduces a firefly algorithm to dynamically adjust the nodes.Results The results showed that the average clustering accuracies in the Wine and Iris data sets were 86.59%and 94.55%,respectively,demonstrating good clustering performance.When calculating the node mortality rate and network load balancing standard deviation,the proposed algorithm showed dead nodes at approximately 50 iterations,with an average load balancing standard deviation of 1.7×10^(4),proving its contribution to extending the network lifespan.Conclusions This demonstrates the superiority of the proposed algorithm in significantly improving the energy efficiency and load balancing of wireless sensor networks to extend the network lifespan.The research results indicate that wireless sensor networks have theoretical and practical significance in fields such as monitoring,healthcare,and agriculture.展开更多
BACKGROUND Tissue hardness is closely related to disease pathophysiology.Shear-wave ela-stography(SWE)is a simple and noninvasive ultrasound technique that has been used to evaluate the presence of lymph node metastas...BACKGROUND Tissue hardness is closely related to disease pathophysiology.Shear-wave ela-stography(SWE)is a simple and noninvasive ultrasound technique that has been used to evaluate the presence of lymph node metastases and differentiate between benign and malignant tumors.AIM To investigate SWE usefulness in measuring lymph node hardness to predict metastasis presence or absence in surgically removed lymph nodes.METHODS This observational study obtained data from patients who underwent surgery for esophageal or gastric cancer at Nippon Medical School Hospital.The hardness of the surgically removed lymph nodes was measured using SWE.The lymph nodes with hardness values≥2.2 m/s were considered clinically positive for metastasis,whereas those with lower hardness values were considered clinically negative.The lymph nodes subsequently underwent pathological examination to determine the presence of metastasis,and the SWE results and pathological assessments were compared.RESULTS A total of 1077 lymph nodes were evaluated;18 and 15 cases of esophageal and gastric cancer were identified,respectively.The optimal cutoff value for lymph node size was calculated to be 5.1 mm,and the area under the curve value was 0.74(95%confidence interval:0.69-0.84).When limited to a lymph node larger than the cut off value,the SWE sensitivity and specificity for metastasis identification were 0.76 and 0.82,respectively.CONCLUSION SWE was useful in detecting lymph node metastases in the upper gastrointestinal tract.展开更多
Most papillary thyroid carcinoma(PTC) patients have a good prognosis. However, lymph node metastasis(LNM), the most common manifestation of disease progression, is frequently associated with a poor prognosis.Neverthel...Most papillary thyroid carcinoma(PTC) patients have a good prognosis. However, lymph node metastasis(LNM), the most common manifestation of disease progression, is frequently associated with a poor prognosis.Nevertheless, few studies have focused on the underlying mechanisms of LNM. In the current study, we aimed to investigate the potential role of exosomal circRNAs that contribute to LNM in PTC. We identified 9 000 differentially expressed exosomal circRNAs in PTC patients with LNM, including 684 upregulated and 2 193 downregulated circRNAs. Functional enrichment analysis revealed that these differentially expressed circRNAs were primarily involved in a variety of molecular and signaling pathways correlated with PTC progression and LNM. Through bioinformatics analysis, we identified 14 circRNA-miRNA-mRNA networks related to LNM-associated signaling pathways in PTC. Moreover, both circTACC2-miR-7-EGFR and circBIRC6-miR-24-3p-BCL2L11 axes were verified for their potential involvement in PTC with LNM. Additionally, we identified four upregulated circRNA-related hub genes and eight hub genes correlated with downregulated circRNAs, some of which were validated as being potentially involved in LNM in PTC. Collectively, our findings provide a novel framework for an in-depth investigation of the function of dysregulated exosomal circRNAs and their potential as biomarkers in PTC patients with LNM.展开更多
BACKGROUND Accumulating studies indicated that maintain nuclei homeostasis was deemed to the protective factors for the occurrence of cancer.Thus,high-mobility group box 1(HMGB1)might influence the risk and poorer pro...BACKGROUND Accumulating studies indicated that maintain nuclei homeostasis was deemed to the protective factors for the occurrence of cancer.Thus,high-mobility group box 1(HMGB1)might influence the risk and poorer prognoses of colorectal cancer(CRC).AIM This study was designed to investigate whether HMGB1 polymorphisms influence the risk and lymph node metastasis(LNM)of CRC.METHODS Firstly,we designed an investigation with 1003 CRC patients and 1303 cancer-free controls to observe whether HMGB1 rs1412125 T>C and rs1045411 C>T SNPs could influence the risk of cancer.Subsequently,we carried out a correlation-analysis to assess whether these SNPs could alter the risk of LNM.RESULTS The current investigation suggested a relationship of HMGB1 rs1412125 SNP with the increased susceptibility of CRC.In a subgroup analysis,our findings suggested that this SNP could enhance an occurrence of CRC in≥61 years,non-drinker and body mass index<24 kg/m2 subgroups.However,we found that there was null association between HMGB1 rs1412125 SNP and LNM,even in different CRC region.These observations were confirmed by calculating the power value(more than 0.8).The association of HMGB1 rs1045411 C>T SNP with CRC risk and LNM was not found in any compare.CONCLUSION This study highlights a possible association between HMGB1 rs1412125 polymorphism and the increased risk of CRC.In the future,more studies should be conducted to explore HMGB1 rs1412125 polymorphism in relation to CRC development.展开更多
BACKGROUND Gastric mixed-adenoneuroendocrine carcinoma(G-MANEC)is a subtype of gastric cancer.Building upon prior research findings,we propose that tumours containing both neuroendocrine carcinoma(NEC)and adenocarcino...BACKGROUND Gastric mixed-adenoneuroendocrine carcinoma(G-MANEC)is a subtype of gastric cancer.Building upon prior research findings,we propose that tumours containing both neuroendocrine carcinoma(NEC)and adenocarcinoma(AC)components,with each component ranging from 1%to 99%of the tumour,be classified as a distinct entity.We hereby term this adenoneuroendocrine mixed gastric cancer(G-ANEC).Research on lymph node(LN)involvement in GMANEC has focused mainly on metastasis status,with limited studies on metastatic composition.AIM To investigate the LN metastasis patterns of G-ANEC,the clinicopathological features associated with these metastasis patterns,and to explore adjuvant chemotherapy regimens for G-ANEC.METHODS We analyzed 68 G-ANEC cases treated with radical surgery and confirmed LN metastasis at Peking University Cancer Hospital between August 2012 and June 2022.Utilizingχ2 tests in IBM statistical product and service solutions statistics and R software.RESULTS We identified three distinct LN metastasis patterns in G-ANEC that were significantly associated with the NEC proportion,tumour invasion depth,Lauren classification,and tumour location(P values:0.008,0.015,0.01,and 0.004,respectively).When the SOX/XELOX regimen was applied for adjuvant chemotherapy,patients with LN metastasis comprising only AC exhibited better overall survival(OS)(94.25±11.07 months vs 54.36±11.36 months)than did those with NEC.When LN metastasis components contained NEC,there was a trend towards improved OS(64±10.77 months vs 54.35±11.36 months)and disease-free survival(71.28±9.92 months vs 66.28±11.93 months)in patients treated with the etoposide and cisplatin compared to those receiving the SOX/XELOX regimen.CONCLUSION We found a significant correlation between the NEC percentage,tumour invasion depth,Lauren classification,and tumour location and LN metastasis patterns in G-ANEC.For G-ANEC,a lower proportion of NEC or AC in the primary lesion does not preclude the possibility of these components metastasizing to the LNs.Different adjuvant chemotherapy regimens should be administered on the basis of the varying components of LN metastasis in patients with G-ANEC.展开更多
Emerging two-dimensional(2D)semiconductors are among the most promising materials for ultra-scaled transistors due to their intrinsic atomic-level thickness.As the stacking process advances,the complexity and cost of ...Emerging two-dimensional(2D)semiconductors are among the most promising materials for ultra-scaled transistors due to their intrinsic atomic-level thickness.As the stacking process advances,the complexity and cost of nanosheet field-effect transistors(NSFETs)and complementary FET(CFET)continue to rise.The 1 nm technology node is going to be based on Si-CFET process according to international roadmap for devices and systems(IRDS)(2022,https://irds.ieee.org/),but not publicly confirmed,indicating that more possibilities still exist.The miniaturization advantage of 2D semiconductors motivates us to explore their potential for reducing process costs while matching the performance of next-generation nodes in terms of area,power consumption and speed.In this study,a comprehensive framework is built.A set of MoS2 NSFETs were designed and fabricated to extract the key parameters and performances.And then for benchmarking,the sizes of 2D-NSFET are scaled to a extent that both of the Si-CFET and 2D-NSFET have the same average device footprint.Under these conditions,the frequency of ultra-scaled 2D-NSFET is found to improve by 36%at a fixed power consumption.This work verifies the feasibility of replacing silicon-based CFETs of 1 nm node with 2D-NSFETs and proposes a 2D technology solution for 1 nm nodes,i.e.,“2D eq 1 nm”nodes.At the same time,thanks to the lower characteristic length of 2D semiconductors,the miniaturized 2D-NSFET achieves a 28%frequency increase at a fixed power consumption.Further,developing a standard cell library,these devices obtain a similar trend in 16-bit RISC-V CPUs.This work quantifies and highlights the advantages of 2D semiconductors in advanced nodes,offering new possibilities for the application of 2D semiconductors in high-speed and low-power integrated circuits.展开更多
Gastric cancer(GC)represents a significant global health burden due to its high morbidity and mortality.Specific behaviors of GC sub-types,distinct dissem-ination patterns,and associated risk-factors remain poorly und...Gastric cancer(GC)represents a significant global health burden due to its high morbidity and mortality.Specific behaviors of GC sub-types,distinct dissem-ination patterns,and associated risk-factors remain poorly understood.This editorial highlights several key prognostic factors,including pathological staging and vascular invasion,that impact GC.It examines a recent study’s investigation of differential metastatic lymph nodes distribution and survival in upper and lower GC sub-types,focusing on histological characterization,pathophysiology,usage of neoadjuvant chemotherapy,and additional predictive determinants.We assess the statistical robustness and clinical applicability of the findings,un-derscoring the importance of treating GC as a heterogeneous disease and em-phasizing how tailored surgical approaches informed by lymph node distribution can optimize tumor detection while minimizing unnecessary interventions.The study’s large cohort,multi-center design,and strict inclusion criteria strengthen its validity in guiding surgical planning and risk-stratification.However,inte-grating genetic and molecular data is critical for refining models and broadening applicability.Additionally,recurrence-metrics and infection-related factors,such as Helicobacter pylori and Epstein-Barr virus,absent in the original study,remain vital for directing future research.By bridging metastatic patterns with pros-pective methodologies and inclusion of diverse populations,this editorial pro-vides a framework for advancing early detection and personalized GC care.展开更多
BACKGROUND Lymph node metastasis is a specific type of metastasis in hepatic alveolar echinococcosis(AE).Currently,there is a scarcity of describing the clinical characteristics and lymph node metastasis rules of pati...BACKGROUND Lymph node metastasis is a specific type of metastasis in hepatic alveolar echinococcosis(AE).Currently,there is a scarcity of describing the clinical characteristics and lymph node metastasis rules of patients with hepatic AE combined with lymph node metastasis and its mechanism and management are still controversial.Radical hepatectomy combined with regional lymph node dissection is a better treatment.AIM To analyse the clinical features of hepatic AE combined with lymph node metastasis to explore its treatment and efficacy.METHODS A total of 623 patients with hepatic AE admitted to the First Affiliated Hospital of Xinjiang Medical University from 1 January 2012 to 1 January 2022 were retrospectively analysed.Fifty-five patients with combined lymph node metastasis were analysed for their clinical data,diagnosis and treatment methods,follow-up efficacy,and characteristics of lymph node metastasis.Finally,we comparatively analysed the lymph node metastasis rates at different sites.Categorical variables are expressed as frequencies and percentages,and the analysis of difference was performed using theχ2 test.The Bonferroni method was used for pairwise comparisons when statistical differences existed between multiple categorical variables.RESULTS A lymph node metastasis rate of 8.8%(55/623)was reported in patients with hepatic AE,with a female predilection(69.1%)and a statistically significant sex difference(χ2=8.018,P=0.005).Of the 55 patients with lymph node metastasis,72.7%had a parasite lesion,neighbouring organ invasion,and metastasis stage of P3N1M0 and above,of which 67.3%,78.2%,and 34.5%of hepatic AE lesions invaded the bile ducts,blood vessels,and distant metastases,respectively.Detection rates of lymph node metastasis of 16.4%,21.7%,and 34.2%were reported for a preoperative abdominal ultrasound,magnetic resonance imaging,and computed tomography examinations.All patients were intraoperatively suspected with enlarged lymph nodes and underwent radical hepatectomy combined with regional lymph node dissection.After surgery,a routine pathological examination was conducted on the resected lymph nodes.A total of 106 positive lymph nodes were detected in six groups at various sites,including 51 single-group metastasis cases and four multi-group metastasis cases.When the metastasis rates at different sites were statistically analysed,we observed that the metastasis rate in the para-hepatoduodenal ligament lymph nodes was significantly higher than that of the other sites(χ^(2)=128.089,P=0.000<0.05).No statistical difference was observed in the metastasis rate between the five other groups.Clavien-Dindo grade IIIa complication occurred in 14 cases,which improved after administering symptomatic treatment.Additionally,lymph node dissection-related complications were not observed.Recurrence after 2 years was observed in one patient.CONCLUSION Lymph node metastasis is a rare form of metastasis in hepatic AE,which is more frequent in women.Parahepatoduodenal ligament lymph nodes are commonly observed.Radical hepatectomy combined with regional lymph node dissection is a safe,effective,and feasible treatment for liver AE combined with lymph node metastasis.展开更多
BACKGROUND The effect of the number of lymph node dissections(LNDs)during radical resection for colorectal cancer(CRC)on overall survival(OS)remains controver-sial.AIM To investigate the association between the number...BACKGROUND The effect of the number of lymph node dissections(LNDs)during radical resection for colorectal cancer(CRC)on overall survival(OS)remains controver-sial.AIM To investigate the association between the number of LNDs and OS in patients with tumor node metastasis(TNM)stage Ⅰ–Ⅱ CRC undergoing radical resection.METHODS Patients who underwent radical resection for CRC at a single-center hospital between January 2011 and December 2021 were retrospectively analyzed.Cox regression analyses were performed to identify the independent predictors of OS at different T stages.RESULTS A total of 2850 patients who underwent laparoscopic radical resection for CRC were enrolled.At stage T1,age[P<0.01,hazard ratio(HR)=1.075,95%confidence interval(CI):1.019-1.134]and tumour size(P=0.021,HR=3.635,95%CI:1.210-10.917)were independent risk factors for OS.At stage T2,age(P<0.01,HR=1.064,95%CI:1.032-1.098)and overall complications(P=0.012,HR=2.297,95%CI:1.200-4.397)were independent risk factors for OS.At stage T3,only age(P<0.01,HR=1.047,95%CI:1.027-1.066)was an independent risk factor for OS.At stage T4,age(P<0.01,HR=1.057,95%CI:1.039-1.075)and body mass index(P=0.034,HR=0.941,95%CI:0.890-0.995)were independent risk factors for OS.However,there was no association between LNDs and OS in stages Ⅰ and Ⅱ.CONCLUSION The number of LDNs did not affect the survival of patients with TNM stages Ⅰ and Ⅱ CRC.Therefore,insufficient LNDs should not be a cause for alarm during the surgery.展开更多
In a post-disaster environment characterized by frequent interruptions in communication links,traditional wireless communication networks are ineffective.Although the“store-carry-forward”mechanism characteristic of ...In a post-disaster environment characterized by frequent interruptions in communication links,traditional wireless communication networks are ineffective.Although the“store-carry-forward”mechanism characteristic of Delay Tolerant Networks(DTNs)can transmit data from Internet of things devices to more reliable base stations or data centres,it also suffers from inefficient data transmission and excessive transmission delays.To address these challenges,we propose an intelligent routing strategy based on node sociability for post-disaster emergency network scenarios.First,we introduce an intelligent routing strategy based on node intimacy,which selects more suitable relay nodes and assigns the corresponding number of message copies based on comprehensive utility values.Second,we present an intelligent routing strategy based on geographical location of nodes to forward message replicas secondarily based on transmission utility values.Finally,experiments demonstrate the effectiveness of our proposed algorithm in terms of message delivery rate,network cost ratio and average transmission delay.展开更多
文摘Background: Sentinel lymph node (SLN) biopsy remains a cornerstone in the management of breast cancer, as it provides an accurate staging of the disease while minimizing the morbidity associated with complete axillary lymph node dissection. Advances in SLN detection have been very important in refining surgical techniques and improving patient outcomes. The purpose of the present study is to compare the effectiveness of radiocolloids, blue dyes, and fluorescent tracers in detecting the sentinel lymph node in breast cancer. Materials and Methods: Specifically, we analyzed the detection rate, accuracy, and safety profile of the techniques to outline the most reliable and clinically available. A comprehensive review was conducted, searching key databases, including PubMed, Scopus, and Web of Science, for studies published between 2010 and 2024. The review focused on studies that compared the performance of radiocolloids, blue dyes, and fluorescent tracers in the detection of sentinel lymph nodes in breast cancer patients. A total of 54 studies were included based on specific inclusion criteria. Results: Radiocolloids showed high detection rates in studies. Blue dyes have comparable results, but a small percentage of allergic reactions has been observed. Fluorescent tracers such as indocyanine green have improved visualization and accuracy, but their use requires specialized equipment and expertise. Combining radiocolloids with blue dyes or fluorescent tracers has improved detection rates in several studies. Cost and accessibility challenges have also been pointed out, particularly in low-resource settings. Conclusions: Radiocolloids have attained the status of gold standard in the detection of SLNs in breast cancer for their reliability and accuracy. While combined use with other tracers, like blue dyes or fluorescent agents, enhances overall detection performance, making it more holistic. As expected, further innovation and effort are required to improve accessibility and optimize the technique of sentinel lymph node biopsy worldwide.
基金the Clinical Medical Team Introduction Program of Suzhou,No.SZYJTD201804.
文摘BACKGROUND Lymph node status is a critical prognostic factor in gastric cancer(GC),but stage migration may occur in pathological lymph nodes(pN)staging.To address this,alternative staging systems such as the positive lymph node ratio(LNR)and log odds of positive lymph nodes(LODDS)were introduced.AIM To assess the prognostic accuracy and stratification efficacy of three nodal staging systems in GC.METHODS A systematic review identified 12 studies,from which hazard ratios(HRs)for overall survival(OS)were summarized.Sensitivity analyses,subgroup analyses,publication bias assessments,and quality evaluations were conducted.To enhance comparability,data from studies with identical cutoff values for pN,LNR,and LODDS were pooled.Homogeneous stratification was then applied to generate Kaplan-Meier(KM)survival curves,assessing the stratification efficacy of three staging systems.RESULTS The HRs and 95%confidence intervals for pN,LNR,and LODDS were 2.16(1.72-2.73),2.05(1.65-2.55),and 3.15(2.15-4.37),respectively,confirming all three as independent prognostic risk factors for OS.Comparative analysis of HRs demonstrated that LODDS had superior prognostic predictive power over LNR and pN.KM curves for pN(N0,N1,N2,N3a,N3b),LNR(0.1/0.2/0.5),and LODDS(-1.5/-1.0/-0.5/0)revealed significant differences(P<0.001)among all prognostic stratifications.Mean differences and standard deviations in 60-month relative survival were 27.93%±0.29%,41.70%±0.30%,and 26.60%±0.28%for pN,LNR,and LODDS,respectively.CONCLUSION All three staging systems are independent prognostic factors for OS.LODDS demonstrated the highest specificity,making it especially useful for predicting outcomes,while pN was the most effective in homogeneous stratification,offering better patient differentiation.These findings highlight the complementary roles of LODDS and pN in enhancing prognostic accuracy and stratification.
文摘BACKGROUND One of the main characteristics of oral squamous cell carcinoma(OSCC)is that it metastasizes to cervical lymph nodes frequently with a high degree of local invasiveness.A primary feature of malignant tumors is their penetration of neighboring tissues,such as lymphatic and blood arteries,due to the tumor cells'capacity to break down the extracellular matrix(ECM).Matrix metalloproteinases(MMPs)constitute a family of proteolytic enzymes that facilitate tissue remodeling and the degradation of the ECM.MMP-9 and MMP-13 belong to the group of extracellular matrix degrading enzymes and their expression has been studied in OSCC because of their specific functions.MMP-13,a collagenase family member,is thought to play an essential role in the MMP activation cascade by breaking down the fibrillar collagens,whereas MMP-9 is thought to accelerate the growth of tumors.Elevated MMP-13 expression has been associated with tumor behavior and patient prognosis in a number of malignant cases.AIM To assess the immunohistochemical expression of MMP-9 and MMP-13 in OSCC.METHODS A total of 40 cases with histologically confirmed OSCC by incisional biopsy were included in this cross-sectional retrospective study.The protocols for both MMP-9 and MMP-13 immunohistochemical staining were performed according to the manufacturer’s recommendations along with the normal gingival epithelium as a positive control.All the observations were recorded and Pearson’sχ²test with Fisher exact test was used for statistical analysis.RESULTS Our study showed no significant correlation between MMP-9 and MMP-13 staining intensity and tumor size.The majority of the patients were in advanced TNM stages(III and IV),and showed intense expression of MMP-9 and MMP-13.CONCLUSION The present study suggests that both MMP-9 and MMP-13 play an important and independent role in OSCC progression and invasiveness.Intense expression of MMP-9 and MMP-13,irrespective of histological grade of OSCC,correlates well with TNM stage.Consequently,it is evident that MMP-9 and MMP-13 are important for the invasiveness and progression of tumors.The findings may facilitate the development of new approaches for evaluating lymph node metastases and interventional therapy techniques,hence enhancing the prognosis of patients diagnosed with OSCC.
基金Project partially supported by the National Natural Science Foundation of China (Grant Nos. 61672298 and 62373197)the Major Project of Philosophy and Social Science Research in Colleges and Universities in Jiangsu Province,China (Grant No. 2018SJZDI142)the Postgraduate Research & Practice Innovation Program of Jiangsu Province,China (Grant No. KYCX23 1045)。
文摘Identifying key nodes in complex networks is crucial for understanding and controlling their dynamics. Traditional centrality measures often fall short in capturing the multifaceted roles of nodes within these networks. The Page Rank algorithm, widely recognized for ranking web pages, offers a more nuanced approach by considering the importance of connected nodes. However, existing methods generally overlook the geometric properties of networks, which can provide additional insights into their structure and functionality. In this paper, we propose a novel method named Curv-Page Rank(C-PR), which integrates network curvature and Page Rank to identify influential nodes in complex networks. By leveraging the geometric insights provided by curvature alongside structural properties, C-PR offers a more comprehensive measure of a node's influence. Our approach is particularly effective in networks with community structures, where it excels at pinpointing bridge nodes critical for maintaining connectivity and facilitating information flow. We validate the effectiveness of C-PR through extensive experiments. The results demonstrate that C-PR outperforms traditional centrality-based and Page Rank methods in identifying critical nodes. Our findings offer fresh insights into the structural importance of nodes across diverse network configurations, highlighting the potential of incorporating geometric properties into network analysis.
基金supported by the National Natural Science Foundation of China(No.82272845)the Natural Science Foundation of Shandong(No.ZR2023ZD26).
文摘Objective:The neglect of occult lymph nodes metastasis(OLNM)is one of the pivotal causes of early non-small cell lung cancer(NSCLC)recurrence after local treatments such as stereotactic body radiotherapy(SBRT)or surgery.This study aimed to develop and validate a computed tomography(CT)-based radiomics and deep learning(DL)fusion model for predicting non-invasive OLNM.Methods:Patients with radiologically node-negative lung adenocarcinoma from two centers were retrospectively analyzed.We developed clinical,radiomics,and radiomics-clinical models using logistic regression.A DL model was established using a three-dimensional squeeze-and-excitation residual network-34(3D SE-ResNet34)and a fusion model was created by integrating seleted clinical,radiomics features and DL features.Model performance was assessed using the area under the curve(AUC)of the receiver operating characteristic(ROC)curve,calibration curves,and decision curve analysis(DCA).Five predictive models were compared;SHapley Additive exPlanations(SHAP)and Gradient-weighted Class Activation Mapping(Grad-CAM)were employed for visualization and interpretation.Results:Overall,358 patients were included:186 in the training cohort,48 in the internal validation cohort,and 124 in the external testing cohort.The DL fusion model incorporating 3D SE-Resnet34 achieved the highest AUC of 0.947 in the training dataset,with strong performance in internal and external cohorts(AUCs of 0.903 and 0.907,respectively),outperforming single-modal DL models,clinical models,radiomics models,and radiomicsclinical combined models(DeLong test:P<0.05).DCA confirmed its clinical utility,and calibration curves demonstrated excellent agreement between predicted and observed OLNM probabilities.Features interpretation highlighted the importance of textural characteristics and the surrounding tumor regions in stratifying OLNM risk.Conclusions:The DL fusion model reliably and accurately predicts OLNM in early-stage lung adenocarcinoma,offering a non-invasive tool to refine staging and guide personalized treatment decisions.These results may aid clinicians in optimizing surgical and radiotherapy strategies.
基金Supported by the National Natural Science Foundation of China,No.82101985.
文摘BACKGROUND Gastric schwannoma(GS)is often misdiagnosed as gastrointestinal stromal tumors due to the high incidence of the latter.However,these two types differ significantly in pathology and biological behavior.AIM To evaluate the computed tomography characteristics of GS and provide insights into its accurate diagnosis.METHODS Twenty-three cases of GS confirmed between January 2011 and December 2023 were assessed clinically and radiologically.Imaging characteristics,including tumor location,size,contour,ulceration,growth pattern,enhancement degree and pattern,cystic change,calcification,and perigastric lymph nodes(PLNs),were reviewed by two experienced radiologists.RESULTS Our sample included 18 females and 5 males,with a median age of 54.7 years.A total of 39.1%of cases were asymptomatic.GSs appeared as oval and well-defined submucosal tumors,with exophytic(43.5%)or mixed(endoluminal+exophytic;43.5%)growth patterns.The tumors were primarily located in the gastric body(78.3%).Ulcerations were observed in 8 cases(34.5%),and PLNs were observed in 15 cases(65%).The average degree of enhancement was 48.3 Hounsfield units.Twenty cases(87%)showed peak enhancement in the delayed phase.Most GSs were homogeneous,while cystic change(13.0%)and calcification(17.4%)were rare.CONCLUSION GS predominantly showed gradual homogenous enhancement with peak enhancement in the delayed phase.PLNs around GS are helpful in differentiating GS from other gastric submucosal tumors.
基金Supported by 2021 Zhanjiang University of Science and Technology"Brand Enhancement Plan"Project:Network Series Course Teaching Team(PPJH202102JXTD)2022 Zhanjiang University of Science and Technology"Brand Enhancement Plan"Project:Network Engineering(PPJHKCSZ-2022301)+1 种基金2023 Zhanjiang Science and Technology Bureau Project:Design and Simulation of Zhanjiang Mangrove Wetland Monitoring Network System(2023B01017)2022 Zhanjiang University of Science and Technology Quality Engineering Project:Audiovisual Language Teaching and Research Office(ZLGC202203).
文摘Background With the development of the Internet,the topology optimization of wireless sensor networks has received increasing attention.However,traditional optimization methods often overlook the energy imbalance caused by node loads,which affects network performance.Methods To improve the overall performance and efficiency of wireless sensor networks,a new method for optimizing the wireless sensor network topology based on K-means clustering and firefly algorithms is proposed.The K-means clustering algorithm partitions nodes by minimizing the within-cluster variance,while the firefly algorithm is an optimization algorithm based on swarm intelligence that simulates the flashing interaction between fireflies to guide the search process.The proposed method first introduces the K-means clustering algorithm to cluster nodes and then introduces a firefly algorithm to dynamically adjust the nodes.Results The results showed that the average clustering accuracies in the Wine and Iris data sets were 86.59%and 94.55%,respectively,demonstrating good clustering performance.When calculating the node mortality rate and network load balancing standard deviation,the proposed algorithm showed dead nodes at approximately 50 iterations,with an average load balancing standard deviation of 1.7×10^(4),proving its contribution to extending the network lifespan.Conclusions This demonstrates the superiority of the proposed algorithm in significantly improving the energy efficiency and load balancing of wireless sensor networks to extend the network lifespan.The research results indicate that wireless sensor networks have theoretical and practical significance in fields such as monitoring,healthcare,and agriculture.
基金This study was approved by the Ethics Committee of Nippon Medical School Hospital(No.B-2022-582).
文摘BACKGROUND Tissue hardness is closely related to disease pathophysiology.Shear-wave ela-stography(SWE)is a simple and noninvasive ultrasound technique that has been used to evaluate the presence of lymph node metastases and differentiate between benign and malignant tumors.AIM To investigate SWE usefulness in measuring lymph node hardness to predict metastasis presence or absence in surgically removed lymph nodes.METHODS This observational study obtained data from patients who underwent surgery for esophageal or gastric cancer at Nippon Medical School Hospital.The hardness of the surgically removed lymph nodes was measured using SWE.The lymph nodes with hardness values≥2.2 m/s were considered clinically positive for metastasis,whereas those with lower hardness values were considered clinically negative.The lymph nodes subsequently underwent pathological examination to determine the presence of metastasis,and the SWE results and pathological assessments were compared.RESULTS A total of 1077 lymph nodes were evaluated;18 and 15 cases of esophageal and gastric cancer were identified,respectively.The optimal cutoff value for lymph node size was calculated to be 5.1 mm,and the area under the curve value was 0.74(95%confidence interval:0.69-0.84).When limited to a lymph node larger than the cut off value,the SWE sensitivity and specificity for metastasis identification were 0.76 and 0.82,respectively.CONCLUSION SWE was useful in detecting lymph node metastases in the upper gastrointestinal tract.
基金National Natural Science Foundation of China (Grant No. 81800698)Jiangsu Provincial Medical Key Discipline Cultivation Unit (Grant No. JSDW202241)+1 种基金Research Project of Jiangsu Commission of Health (Grant No. H2023053)Zhenjiang Science and the Technology Planning Project (Grant Nos. SH2023006and SH2023008)。
文摘Most papillary thyroid carcinoma(PTC) patients have a good prognosis. However, lymph node metastasis(LNM), the most common manifestation of disease progression, is frequently associated with a poor prognosis.Nevertheless, few studies have focused on the underlying mechanisms of LNM. In the current study, we aimed to investigate the potential role of exosomal circRNAs that contribute to LNM in PTC. We identified 9 000 differentially expressed exosomal circRNAs in PTC patients with LNM, including 684 upregulated and 2 193 downregulated circRNAs. Functional enrichment analysis revealed that these differentially expressed circRNAs were primarily involved in a variety of molecular and signaling pathways correlated with PTC progression and LNM. Through bioinformatics analysis, we identified 14 circRNA-miRNA-mRNA networks related to LNM-associated signaling pathways in PTC. Moreover, both circTACC2-miR-7-EGFR and circBIRC6-miR-24-3p-BCL2L11 axes were verified for their potential involvement in PTC with LNM. Additionally, we identified four upregulated circRNA-related hub genes and eight hub genes correlated with downregulated circRNAs, some of which were validated as being potentially involved in LNM in PTC. Collectively, our findings provide a novel framework for an in-depth investigation of the function of dysregulated exosomal circRNAs and their potential as biomarkers in PTC patients with LNM.
基金Supported by the Major Project of Changzhou Science and Technology Bureau,No.CJ20220255.
文摘BACKGROUND Accumulating studies indicated that maintain nuclei homeostasis was deemed to the protective factors for the occurrence of cancer.Thus,high-mobility group box 1(HMGB1)might influence the risk and poorer prognoses of colorectal cancer(CRC).AIM This study was designed to investigate whether HMGB1 polymorphisms influence the risk and lymph node metastasis(LNM)of CRC.METHODS Firstly,we designed an investigation with 1003 CRC patients and 1303 cancer-free controls to observe whether HMGB1 rs1412125 T>C and rs1045411 C>T SNPs could influence the risk of cancer.Subsequently,we carried out a correlation-analysis to assess whether these SNPs could alter the risk of LNM.RESULTS The current investigation suggested a relationship of HMGB1 rs1412125 SNP with the increased susceptibility of CRC.In a subgroup analysis,our findings suggested that this SNP could enhance an occurrence of CRC in≥61 years,non-drinker and body mass index<24 kg/m2 subgroups.However,we found that there was null association between HMGB1 rs1412125 SNP and LNM,even in different CRC region.These observations were confirmed by calculating the power value(more than 0.8).The association of HMGB1 rs1045411 C>T SNP with CRC risk and LNM was not found in any compare.CONCLUSION This study highlights a possible association between HMGB1 rs1412125 polymorphism and the increased risk of CRC.In the future,more studies should be conducted to explore HMGB1 rs1412125 polymorphism in relation to CRC development.
基金Supported by the National Key Research and Development Program of China,No.2023YFF1204702the National Natural Science Foundation of China,No.82173151+2 种基金Capital’s Funds for Health Improvement and Research,No.CFH 2022-4-1025Beijing Hospitals Authority Clinical Medicine Development of Special Funding,No.XMLX202119Science Foundation of Peking University Cancer Hospital,No.PY202329.
文摘BACKGROUND Gastric mixed-adenoneuroendocrine carcinoma(G-MANEC)is a subtype of gastric cancer.Building upon prior research findings,we propose that tumours containing both neuroendocrine carcinoma(NEC)and adenocarcinoma(AC)components,with each component ranging from 1%to 99%of the tumour,be classified as a distinct entity.We hereby term this adenoneuroendocrine mixed gastric cancer(G-ANEC).Research on lymph node(LN)involvement in GMANEC has focused mainly on metastasis status,with limited studies on metastatic composition.AIM To investigate the LN metastasis patterns of G-ANEC,the clinicopathological features associated with these metastasis patterns,and to explore adjuvant chemotherapy regimens for G-ANEC.METHODS We analyzed 68 G-ANEC cases treated with radical surgery and confirmed LN metastasis at Peking University Cancer Hospital between August 2012 and June 2022.Utilizingχ2 tests in IBM statistical product and service solutions statistics and R software.RESULTS We identified three distinct LN metastasis patterns in G-ANEC that were significantly associated with the NEC proportion,tumour invasion depth,Lauren classification,and tumour location(P values:0.008,0.015,0.01,and 0.004,respectively).When the SOX/XELOX regimen was applied for adjuvant chemotherapy,patients with LN metastasis comprising only AC exhibited better overall survival(OS)(94.25±11.07 months vs 54.36±11.36 months)than did those with NEC.When LN metastasis components contained NEC,there was a trend towards improved OS(64±10.77 months vs 54.35±11.36 months)and disease-free survival(71.28±9.92 months vs 66.28±11.93 months)in patients treated with the etoposide and cisplatin compared to those receiving the SOX/XELOX regimen.CONCLUSION We found a significant correlation between the NEC percentage,tumour invasion depth,Lauren classification,and tumour location and LN metastasis patterns in G-ANEC.For G-ANEC,a lower proportion of NEC or AC in the primary lesion does not preclude the possibility of these components metastasizing to the LNs.Different adjuvant chemotherapy regimens should be administered on the basis of the varying components of LN metastasis in patients with G-ANEC.
基金supported in part by STI 2030-Major Projects under Grant 2022ZD0209200in part by Beijing Natural Science Foundation-Xiaomi Innovation Joint Fund(L233009)+4 种基金in part by National Natural Science Foundation of China under Grant No.62374099in part by the Tsinghua-Toyota Joint Research Fundin part by the Daikin Tsinghua Union Programin part by Independent Research Program of School of Integrated Circuits,Tsinghua UniversityThis work was also sponsored by CIE-Tencent Robotics X Rhino-Bird Focused Research Program.
文摘Emerging two-dimensional(2D)semiconductors are among the most promising materials for ultra-scaled transistors due to their intrinsic atomic-level thickness.As the stacking process advances,the complexity and cost of nanosheet field-effect transistors(NSFETs)and complementary FET(CFET)continue to rise.The 1 nm technology node is going to be based on Si-CFET process according to international roadmap for devices and systems(IRDS)(2022,https://irds.ieee.org/),but not publicly confirmed,indicating that more possibilities still exist.The miniaturization advantage of 2D semiconductors motivates us to explore their potential for reducing process costs while matching the performance of next-generation nodes in terms of area,power consumption and speed.In this study,a comprehensive framework is built.A set of MoS2 NSFETs were designed and fabricated to extract the key parameters and performances.And then for benchmarking,the sizes of 2D-NSFET are scaled to a extent that both of the Si-CFET and 2D-NSFET have the same average device footprint.Under these conditions,the frequency of ultra-scaled 2D-NSFET is found to improve by 36%at a fixed power consumption.This work verifies the feasibility of replacing silicon-based CFETs of 1 nm node with 2D-NSFETs and proposes a 2D technology solution for 1 nm nodes,i.e.,“2D eq 1 nm”nodes.At the same time,thanks to the lower characteristic length of 2D semiconductors,the miniaturized 2D-NSFET achieves a 28%frequency increase at a fixed power consumption.Further,developing a standard cell library,these devices obtain a similar trend in 16-bit RISC-V CPUs.This work quantifies and highlights the advantages of 2D semiconductors in advanced nodes,offering new possibilities for the application of 2D semiconductors in high-speed and low-power integrated circuits.
文摘Gastric cancer(GC)represents a significant global health burden due to its high morbidity and mortality.Specific behaviors of GC sub-types,distinct dissem-ination patterns,and associated risk-factors remain poorly understood.This editorial highlights several key prognostic factors,including pathological staging and vascular invasion,that impact GC.It examines a recent study’s investigation of differential metastatic lymph nodes distribution and survival in upper and lower GC sub-types,focusing on histological characterization,pathophysiology,usage of neoadjuvant chemotherapy,and additional predictive determinants.We assess the statistical robustness and clinical applicability of the findings,un-derscoring the importance of treating GC as a heterogeneous disease and em-phasizing how tailored surgical approaches informed by lymph node distribution can optimize tumor detection while minimizing unnecessary interventions.The study’s large cohort,multi-center design,and strict inclusion criteria strengthen its validity in guiding surgical planning and risk-stratification.However,inte-grating genetic and molecular data is critical for refining models and broadening applicability.Additionally,recurrence-metrics and infection-related factors,such as Helicobacter pylori and Epstein-Barr virus,absent in the original study,remain vital for directing future research.By bridging metastatic patterns with pros-pective methodologies and inclusion of diverse populations,this editorial pro-vides a framework for advancing early detection and personalized GC care.
基金Supported by Natural Science Foundation of Xinjiang Uygur Autonomous Region,China,No.2022D01D17.
文摘BACKGROUND Lymph node metastasis is a specific type of metastasis in hepatic alveolar echinococcosis(AE).Currently,there is a scarcity of describing the clinical characteristics and lymph node metastasis rules of patients with hepatic AE combined with lymph node metastasis and its mechanism and management are still controversial.Radical hepatectomy combined with regional lymph node dissection is a better treatment.AIM To analyse the clinical features of hepatic AE combined with lymph node metastasis to explore its treatment and efficacy.METHODS A total of 623 patients with hepatic AE admitted to the First Affiliated Hospital of Xinjiang Medical University from 1 January 2012 to 1 January 2022 were retrospectively analysed.Fifty-five patients with combined lymph node metastasis were analysed for their clinical data,diagnosis and treatment methods,follow-up efficacy,and characteristics of lymph node metastasis.Finally,we comparatively analysed the lymph node metastasis rates at different sites.Categorical variables are expressed as frequencies and percentages,and the analysis of difference was performed using theχ2 test.The Bonferroni method was used for pairwise comparisons when statistical differences existed between multiple categorical variables.RESULTS A lymph node metastasis rate of 8.8%(55/623)was reported in patients with hepatic AE,with a female predilection(69.1%)and a statistically significant sex difference(χ2=8.018,P=0.005).Of the 55 patients with lymph node metastasis,72.7%had a parasite lesion,neighbouring organ invasion,and metastasis stage of P3N1M0 and above,of which 67.3%,78.2%,and 34.5%of hepatic AE lesions invaded the bile ducts,blood vessels,and distant metastases,respectively.Detection rates of lymph node metastasis of 16.4%,21.7%,and 34.2%were reported for a preoperative abdominal ultrasound,magnetic resonance imaging,and computed tomography examinations.All patients were intraoperatively suspected with enlarged lymph nodes and underwent radical hepatectomy combined with regional lymph node dissection.After surgery,a routine pathological examination was conducted on the resected lymph nodes.A total of 106 positive lymph nodes were detected in six groups at various sites,including 51 single-group metastasis cases and four multi-group metastasis cases.When the metastasis rates at different sites were statistically analysed,we observed that the metastasis rate in the para-hepatoduodenal ligament lymph nodes was significantly higher than that of the other sites(χ^(2)=128.089,P=0.000<0.05).No statistical difference was observed in the metastasis rate between the five other groups.Clavien-Dindo grade IIIa complication occurred in 14 cases,which improved after administering symptomatic treatment.Additionally,lymph node dissection-related complications were not observed.Recurrence after 2 years was observed in one patient.CONCLUSION Lymph node metastasis is a rare form of metastasis in hepatic AE,which is more frequent in women.Parahepatoduodenal ligament lymph nodes are commonly observed.Radical hepatectomy combined with regional lymph node dissection is a safe,effective,and feasible treatment for liver AE combined with lymph node metastasis.
基金Chongqing Medical University Future Medical Youth Innovation Team Development Support Program,No.03030299QCW0007.
文摘BACKGROUND The effect of the number of lymph node dissections(LNDs)during radical resection for colorectal cancer(CRC)on overall survival(OS)remains controver-sial.AIM To investigate the association between the number of LNDs and OS in patients with tumor node metastasis(TNM)stage Ⅰ–Ⅱ CRC undergoing radical resection.METHODS Patients who underwent radical resection for CRC at a single-center hospital between January 2011 and December 2021 were retrospectively analyzed.Cox regression analyses were performed to identify the independent predictors of OS at different T stages.RESULTS A total of 2850 patients who underwent laparoscopic radical resection for CRC were enrolled.At stage T1,age[P<0.01,hazard ratio(HR)=1.075,95%confidence interval(CI):1.019-1.134]and tumour size(P=0.021,HR=3.635,95%CI:1.210-10.917)were independent risk factors for OS.At stage T2,age(P<0.01,HR=1.064,95%CI:1.032-1.098)and overall complications(P=0.012,HR=2.297,95%CI:1.200-4.397)were independent risk factors for OS.At stage T3,only age(P<0.01,HR=1.047,95%CI:1.027-1.066)was an independent risk factor for OS.At stage T4,age(P<0.01,HR=1.057,95%CI:1.039-1.075)and body mass index(P=0.034,HR=0.941,95%CI:0.890-0.995)were independent risk factors for OS.However,there was no association between LNDs and OS in stages Ⅰ and Ⅱ.CONCLUSION The number of LDNs did not affect the survival of patients with TNM stages Ⅰ and Ⅱ CRC.Therefore,insufficient LNDs should not be a cause for alarm during the surgery.
基金funded by the Researchers Supporting Project Number RSPD2024R681,King Saud University,Riyadh,Saudi Arabia.
文摘In a post-disaster environment characterized by frequent interruptions in communication links,traditional wireless communication networks are ineffective.Although the“store-carry-forward”mechanism characteristic of Delay Tolerant Networks(DTNs)can transmit data from Internet of things devices to more reliable base stations or data centres,it also suffers from inefficient data transmission and excessive transmission delays.To address these challenges,we propose an intelligent routing strategy based on node sociability for post-disaster emergency network scenarios.First,we introduce an intelligent routing strategy based on node intimacy,which selects more suitable relay nodes and assigns the corresponding number of message copies based on comprehensive utility values.Second,we present an intelligent routing strategy based on geographical location of nodes to forward message replicas secondarily based on transmission utility values.Finally,experiments demonstrate the effectiveness of our proposed algorithm in terms of message delivery rate,network cost ratio and average transmission delay.
