Objective:To evaluate the accuracy of mass puncture that is guided by magnetic resonance imaging-ultrasonography (MRI-US) image fusion when diagnosing lymphoma and lymphoma subtype among patients with suspected childhood lymphoma.Methods:A total of 276 suspected childhood lymphoma patients the Affiliated Cancer Hospital of Zhengzhou University from April 2015 to April 2020 were included.According to the methods of guidance before puncture and biopsied, they were classified into two groups.Totally, 86 patients were punctured and biopsied guided by the nuclear magnetic resonance imaging-ultrasonography (MRI-US) image fusion, and they were classified as " fusion group" , while 190 patients guided by the color ultrasound were classified as " control group" . Propensity score matching was applied to reduce the imbalance of covariates between the two groups.Diagnostic rate, lymphoma diagnosis rate, pathological type diagnosis rate, and complication rate were adopted to evaluate the accuracy of different guidance methods before puncture biopsy.Results:A total of 80 patients in each group were matched after propensity score matching, and the distribution of covariates between the two groups was balanced ( P>0.05). The total diagnosis rate, lymphoma diagnosis rate and pathological type diagnosis rate were higher in the fusion group (97.50%, 78.75%, and 96.25%) than those in the control group (86.25%, 63.75%, and 87.50%), and the differences were statistically significant ( χ2=6.872, 4.393, 4.196; P=0.009, 0.036, and 0.041). The complication rate was lower in the fusion group than that in the control group ( χ2=4.444, P=0.035), with 5.00% and 15.00%, respectively. Conclusions:Mass puncture guided by MRI-US image fusion could improve the accuracy when diagnosing lymphoma and lymphoma subtype, and it could also reduce the relevant complication incidence.

Objective To evaluate the clinical effect of lymphatic cysts after surgical operation for gynecologic cancer using method of ultrasound guided percutaneous catheter.Methods Totally 103 gynecologic cancer patients who have already received surgical operation were included in our study,then the ultrasound guided percutaneous catheter drainage operation was provided.The patients were followed up by 3 months,the therapy effect and the complications were observed.Results Among the 103 patients,the drainage-tube was successfully operated in 1 10 lymphatic cysts,and the catheterization related conditions were not observed.The results of 3 months follow up showed that lymphatic cysts disappeared in 105 (95％) patients,and the conditions were completely relieved.3 patients were improved and the conditions were obviously relieved after therapy.2 patients were invalid after therapy,however,the total effect rate was 98％.Conclusion Percutaneous catheter guided by ultrasound was a safe and effect way for therapy of lymphatic cysts after surgical operation for gynecologic cancer,it should be promoted application in clinical.

Objective To explore the clinical features and risk factors influencing the prognosis of childhood non-hodgkin's lymphoma (NHL).Methods Pathologically diagnosed 81 pediatric patients with NHL and treated in our hospital from March 2006 to October 2012 were collected and analyzed.The 5-years overall survival rate and replace-free survival rate were calculated and analyzed by Kaplan-Meier method.The relationship between survival rates and differentfactors were analyzed using chi-square test.Logistic analysis were used to analyze risk factors of prognosis.Results Totally 81 pediatric patients with NHL included 23 cases of lymphoblastic lymphoma,11 cases of mature T/NK-cell tumor,and 47 cases of mature B-cell tumor,Burkitt lymphoma was the most common (35.80％).Swelling of periphery lymph node (43.78％),mediastinal involvement (45.45％) were observed as initial symptom in lymphoblastic lymphoma and mature T/NK-cell tumor,respectively.Among mature B-cell tumor,the main clinical feature of abdominal cavity (41.40％) was observed in 29 cases of Burkitt lymphoma,and abdominal mass (60.00％) was observed as initial symptom in diffuse large cell lymphoma.77 pediatric patients with NHL (4 cases withdrawing treatment) received treatments were found that 90.5％ attained complete remission (CR),5.19％ attained partial remission (PR),2.60％ rapidly relapsed after treatment,and 1.30％ appeared the central nervous system infiltration.76 pediatric patients with NHL were finished the follow up.The 5-years overall survival rate was 67.11％.The 5-years replace-free survival rate was 63.16％.B symptoms,the level of lactate dehydrogenase (LDH),and clinical stages were the influence factors of 5-years overall survival rate and replace-free survival rate (P ＜ 0.05).LDH ≥500 U/L (OR:3.294) and late stage (Ⅳ) were the independent risk factors of prognosis (P ＜ 0.05).Conclusion Clinical features of pediatric patients with NHL were variable.The level of LDH and late stage (Ⅳ) are independent risk factors of prognosis,which can provide some reference in early treatment.

Objective To explore the characteristic performance and value of ultrasonic testing for benign and malignant thyroid tumors of children with thyroid neoplasms.Methods Selected 64 cases of children with thyroid tumors in our hospital from July 2013 to August 2016.The patients were divided into benign group and malignant group depended on pathological results.Color Doppler ultrasonography was used to examine the thyroid gland in all children.Results The diagnostic accuracy of ultrasonography in the diagnosis of benign and malignant thyroid tumors was 95.45％ and 95％,respectively.The color blood flow was the main type of thyroid tumor in the benign group.The color blood flow was the main type of malignant tumor in the malignant group.The peak systolic blood flow velocity (Vmax) and resistance index (IR) in malignant group were significantly higher than those in benign group (P ＜0.05).The malignant group mainly has the characteristics of small calcified lesions,irregular shape,fuzzy edge,and inhomogeneous internal echo.Meanwhile,in the benign group,the thyroid tumors were mainly characterized by non calcified lesions,morphological rules,non blurred edges,and even internal echoes.The highest sensitivity was highest in the diagnosis of malignant thyroid tumors,and the highest specificity was highest in the diagnosis of malignant thyroid tumors.Conclusion Color Doppler ultrasound examination of thyroid tumors in children have a high accurate rate.Benign and malignant thyroid tumor ultrasound image characteristics are significantly different,and have practical value for clinical use.

Objective To evaluation the application and safety of ultrasonography (US)-guided core needle biopsy (CNB) of supraclavicular lymph node for diagnosis and the molecular genetic testing of advanced lung cancer.Methods The clinical data of 178 lung cancer patients who underwent US-guided CNB of supraclavicular lymph node from March 2013 to May 2015 were retrospectively analyzed.Results The accuracy of US-guided CNB of supraclavicular lymph node diagnosing was 96.1%(171/178).The cutoff value of the short-axis dimension of supraclavicular lymph node on US was 9.75 mm, the sensitivity was 88.8%, and the specificity was 88.9%.There were significant differences between positive metastasis group and negative metastasis group in losing or deviating of a central hilar structure, lower echogenicity of cortex and RI (P<0.05).The rate of EGFR mutation positive and ALK positive in lung adenocarcinoma was 36.5% and 2.9% respectively.There was no operation-related complication of US-guided CNB of supraclavicular lymph node.Conclusions US-guided CNB of supraclavicular lymph node is a reliable method for diagnosing metastasis, histologic subtyping, and molecular genetic testing in lung cancer.It may gradually replace invasive lung biopsy.

目前腹横肌平面阻滞技术越来越受到重视［1－2］。加之罗哌卡因作为局麻药物进行切口局部浸润麻醉可有效减轻术后切口疼痛［3－6］。因此，本科室自2014年7月开始，对胃癌患者创新性采用腹横肌平面阻滞并联合罗哌卡因切口局部浸润麻醉，取得了较好的疗效，现报告如下。

目的 探讨颈部不同区域肿大淋巴结穿刺活检病理结果特点.方法 对767例颈部肿大淋巴结行超声引导下穿刺活检,结合颈部超声分区,对不同区域肿大淋巴结的病理结果分析.结果 转移性淋巴结多见于Ⅳ、Ⅴ区,淋巴瘤多见于Ⅱ、Ⅲ、Ⅳ区,反应增生淋巴结多见于Ⅰ、Ⅱ、Ⅲ区.结论 颈部不同区域肿大淋巴结性质不同,对颈部淋巴结进行精确的分区可为临床医生诊断、治疗疾病提供有价值的信息.

Aim:To research the expressions of Pin1 and mammalian target of rapamycin(mTOR)in esophageal squamous cell carcinoma(ESCC) tissue.Methods:Immunohistochemistry SP was used to detect the expressions of Pin1,mTOR in ESCC tissue and adjacent normal tissue.To explore the relationship between the expressions of Pin,mTOR and the clinical pathologic features of ESCC.Results:The positive rates of Pin protein and mTOR protein in ESCC tissue [60.0%(24/40),62.5%(25/40)] were higher than those in adjacent normal tissue [32.5%(13/40),27.5%(11/40)](χ2Pin1=4.762,P=0.027;χ2mTOR=6.036,P=0.014).The expression of Pin1 was related with lymph node metastasis(P0.05),but not with degree of differentiation,age,gender,or TNM staging.The expressions of Pin1 and mTOR protein were positively associated in ESCC tissue(rP=0.389,P=0.008).Conclusion:The expressions of Pin1 and mTOR in ESCC are significantly increased,and Pin1 may interact with mTOR in regulation of the cell cycle,thus plays an important role in the carcinogenesis of ESCC.

目的:通过检测TSLC1、caspase-3蛋白在食管鳞状细胞癌和癌旁正常组织中的表达水平,从而探讨两者在食管鳞状细胞癌发生、发展中的作用。方法:收集45例食管鳞状细胞癌组织标本及其癌旁正常组织标本,应用免疫组化方法对TSLC1、caspase-3蛋白的表达进行测定。结果:在食管鳞状细胞癌组织和癌旁正常组织中TSLC1的表达阳性率分别为37.8%(17/45)和82.2%(37/45),两者相比差异具有统计学意义(P<0.05);caspase-3的阳性表达率分别为44.4%(20/45)和75.6%(34/45),两者相比差异有统计学意义(P<0.05)。TSLC1和caspase-3在食管鳞状细胞癌组织中表达呈正相关(r=0.303,P=0.033)。结论:TSLC1与caspase-3蛋白在食管鳞状细胞癌的发生发展中起重要作用,可能成为食管鳞状细胞癌的分子标记物或食管鳞状细胞癌治疗的新分子靶点。

Aim:To study the expression of phospholipase C epsilon-1 (PLCE1) in lung squamous cell carcinoma tissue and its clinical significance.Methods:The expression of PLCE1 protein in 48 cases of lung squamous cell carcinoma tissues and 48 cases of normal lung tissues was examined by immunohistochemical SP staining.Results:The positive expression rate of PLCE1 in lung carcinoma tissue was 81.3%,higher than that in normal lung tissue (12.5%,χ2=26.561,P0.001).The expression of PLCE1 was related with tumor lymph node metastasis and tumor staging (χ2=6.274,4.255,P0.05),but not with gender,age or tumor differentiation(P0.05).Conclusion: High expression of PLCE1 may be associated with the occurrence and development of lung carcinoma.Detection of PLCE1 has important clinical significance for prediction of lung carcinoma.

Aim:To detect the expressions of hypoxia inducible factor-1α(HIF-1α),chemokine receptor7(CCR7) and vascular endothelial growth factor C(VEGF-C) protein in esophageal squamous cell carcinoma(ESCC) tissue.Methods:Immunohistochemical SP method was used to detect the expressions of HIF-1α,CCR7,and VEGF-C in 45 cases of ESCC and their adjacent normal esophageal mucosa tissue.Results:The positive expression rate of HIF-1α,CCR7,and VEGF-C in ESCC tissue was 55.6%,71.1% and 64.4%,higher than those (11.1%,17.8%,and 35.6%) in adjacent normal esophageal mucosa tissue (χ2=16.409,17.633,and 6.261,P0.05).The expressions of HIF-1α,CCR7,and VEGF-C were related with pathological stage and lymph node metastasis of ESCC(P0.05).The expression of HIF-1α was positively associated with that of CCR7,and that of CCR7 was positively associated with that of VEGF-C (rP=0.303,rP=0.409,P0.05) in ESCC tissue.Conclusion:The increased expressions of HIF-1α,CCR7,and VEGF-C may promote the invasion and lymph node metastasis of ESCC.