ObjectiveDistal pancreatectomy with splenectomy may be required for optimal cytoreductive surgery in patients with epithelial ovarian cancer (EOC) metastasized to splenic hilum. This study evaluates the morbidity and treatment outcomes of the uncommon procedure in the management of advanced or recurrent EOC.MethodsThis study recruited 18 patients who underwent distal pancreatectomy with splenectomy during cytoreductive surgery of EOC. Their clinicopathological characteristics and follow-up data were retrospectively analyzed.ResultsAll tumors were confirmed as high-grade serous carcinomas. The median diameter of metastatic tumors located in splenic hilum was 3.5 cm (range, 1 to 10 cm). Optimal cytoreduction was achieved in all patients. Eight patients (44.4%) suffered from postoperative complications. The morbidity associated with distal pancreatectomy and splenectomy included pancreatic leakage (22.2%), encapsulated effusion in the left upper quadrant (11.1%), intra-abdominal infection (11.1%), pleural effusion with or without pulmonary atelectasis (11.1%), intestinal obstruction (5.6%), pneumonia (5.6%), postoperative hemorrhage (5.6%), and pancreatic pseudocyst (5.6%). There was no perioperative mortality. The majority of complications were treated successfully with conservative management. During the median follow-up duration of 25 months, nine patients experienced recurrence, and three patients died of the disease. The 2-year progression-free survival and overall survival were 40.2% and 84.8%, respectively.ConclusionThe inclusion of distal pancreatectomy with splenectomy as part of cytoreduction for the management of ovarian cancer was associated with high morbidity; however, the majority of complications could be managed with conservative therapy.
This study investigated the phenotype and function of natural killer T (NKT) cells infiltrating cervical cancer tissues, in an attempt to understand the regulation of NKT cells by cervical cancer cells. Forty-two patients with cervical cancer were included. Flow cytometry was used to analyze the percentage of NKT cells in tumour tissues and its correlation with clinical staging and lymphatic metastasis. The expression of surface receptor and effector molecules on infiltrating NKT cells was determined. The changes of the phenotype, subtype and cytotoxicity of NKT cells were investigated. The regulation of NKT cells by cervical cancer cells was investigated by coculture with HeLa or SiHa cells. The effect of TGF-b1 on NKT activity regulated by cervical cancer cells was studied. The results showed that the infiltration of NKT cells in cervical cancer tissues was significantly higher than that in tumour-adjacent tissues, and the degree of infiltration was negatively correlated with the progression of the disease. The activity and killing effect of infiltrating NKT were inhibited in cervical cancer tissues, leading to increase of CD4 þ NKT cells and decrease of CD8 À CD4 À NKT cells. The activity of NKT cells was down-regulated by co-culture with cervical cancer cells, but subtypes of NKT cells were not altered. Cervical cancer cells inhibited the function of NKT cells by secreting TGF-b1. The study demonstrates that the infiltration of NKT cells in cervical cancer tissues is increased significantly and negatively correlated with tumour progression.
Background. Associations between iodine intake and thyroid nodules (TNs) were not consistent. We aimed to illustrate the relationship between urinary iodine concentration (UIC) and TNs. Methods. A total of 12,698 participants were enrolled in analysis. All of the participants filled out questionnaires and underwent physical examinations, laboratory tests, and thyroid ultrasonography. UIC, serum thyrotropin (TSH), thyroid peroxidase antibodies (TPOAb), and thyroglobulin antibodies (TgAb) were measured in the central laboratory. Results. The prevalence of TNs was 16.00%, and the median UIC was 206.1 μg/L. TNs and UIC were negatively related when UIC was less than 527 μg/L (
adjusted
OR
=
0.87
; 95% CI, 0.80, 0.94), and the relationship between UIC and TNs was not statistically significant when UIC was greater than 527 μg/L (
adjusted
OR
=
1.25
; 95% CI, 0.98, 1.60). In women, UIC was negatively associated with risk for TNs (adjusted OR 0.95; 95% CI, 0.91, 0.99). Conclusion. The relationship between TNs and UIC differed between men and women. The risk of TNs decreased with the elevation of UIC in men when UIC was lower than 527 μg/L, while UIC and the presence of TNs were negatively correlated in women. In the future, cohort studies or other studies that can explain causality must be conducted to explore the relationship between iodine status and TNs.
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