Background: We performed this meta-analysis to assess the effectiveness and safety of axillary dissection in old women. Methods: The Cochrane Library, PubMed, EMBASE and Chinese Biomedical Literature Database were searched and all randomized controlled trials of axillary dissection in old women (at least 60 years old) were considered. Meta-analyses were completed using RevMan5.1. Results: Three eligible randomized controlled trials (RCTs) including 5,337 patients were considered. There was weak evidence in favour of axillary dissection (AD) in old women. The meta-analysis showed that the overall survival (OS) after 1, 3, 5 and 7 years and the disease free survival (DFS) after 1, 3 and 5 year were not statistically significantly different between AD and no AD groups. However, there was a difference in the 7 year DFS. Conclusions: Axillary dissection did not provide survival benefit to the old women with breast cancer analysed. Therefore, axillary dissection is not well-indicated in old women with breast cancer.
Objective. To evaluate the diagnostic value of the nanometer carbon suspension tracer staining technique in sentinel lymph node biopsy of breast cancer is the objective of this study. Methods. The PubMed, Embase, Cochrane Library (Central), and Web of Science (SCI Expanded), and Chinese databases (CNKI, VIP, Wan Fang, and CBM) were systematically searched for studies on the diagnostic value of nanocarbon suspension in sentinel lymph node biopsy of breast cancer. Two reviewers independently assessed the methodological quality of each study using the QUADAS-2 tool. The extracted valid data were calculated using Meta-Disc1.4 software and tested for heterogeneity. STATA14.0 software was selected for sensitivity analysis of the included studies, and publication bias was assessed using Deeks’ forest plot asymmetry test. Results. A total of 10 studies were obtained. The pooled data were as follows: sensitivity, 0.92 (0.88~0.95); specificity, 0.99 (0.98~1.00); positive likelihood ratio, 69.24 (30.34~158.02); negative likelihood ratio, 0.09 (0.06~0.13); and the combined diagnostic odds ratio, 747.40 (285.77~1954.76), AUC = 0.9881 . Nanocarbon suspension tracers have an accuracy rate of 98.81% in the diagnosis of sentinel lymph nodes in breast cancer. Conclusion. Tracer staining technology based on nanocarbon suspension can accurately assess the status of lymph nodes in sentinel lymph node biopsy of breast cancer and has good stability and operability, which is worthy of clinical promotion.
We reviewed clinical and radiographic data on 73 patients evaluated for possible Marfan syndrome (MFS) at the National Institutes of Health for the purpose of comparing the 1987 Berlin and 1996 Gent diagnostic criteria. All patients had a physical examination, all had echocardiograms or known aortic root dilatation, 64 (88%) had ophthalmologic exams or known ectopia lentis, and 35 (48%) have had MRI scans to screen for dural ectasia. Thirty-one had a first degree relative who had been diagnosed with MFS, and we directly confirmed this diagnosis in 22 cases. Forty-eight patients met diagnostic criteria under the Berlin criteria and 39 under the Gent criteria {kappa correlation coefficient K=0.75). No patient who met diagnostic criteria under the Gent criteria failed to meet the Berlin criteria. Of patients diagnosed under the Berlin criteria, all had skeletal features of MFS, 40 (83%) had aortic root dilatation, 19 of 27 examined (70%) had dural ectasia, 27 (56%) had an affected first degree relative, and 12 of 44 examined (27%) had ectopia lentis. Determination of dural ectasia established the diagnosis for 9 patients under the Gent criteria but had no effect on diagnoses made under the Berlin criteria (K=0.53 comparing Berlin to Gent without dural ectasia data). In summary, approximately 20 percent of patients diagnosed with Marfan syndrome using the Berlin criteria do not meet the Gent diagnostic standard. Long term follow-up or molecular diagnostic data are necessary to establish the relative sensitivity and specificity of these diagnostic tools.
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