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Reappraise role of lymph node status in patterns of recurrence following curative resection of gastric adenocarcinoma

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Chinese Journal of Cancer Research 2021年第3期33卷 331-342页

作者： Yihui Tang Jianxian Lin Junpeng Lin Jiabin Wang Jun Lu Qiyue Chen Longlong Caolj Mi Lin Ruhong Tu Changming Huang Ping Li chaohui zheng Jianwei Xie Department of Gastric Surgery Fujian Medical University Union HospitalFuzhou 350001China Key Laboratory of Ministry of Education of Gastrointestinal Cancer Fujian Medical UniversityFuzhou 350108China

Objective: To examine the association between lymph node status and recurrence patterns in completely resected gastric ***: We retrospectively assessed 1,694 patients who underwent curative gastrectomy from January 2010 to August 2014. Patients stratified according to lymph node status and recurrence patterns among different subgroups were ***: Of all, 517(30.5%) patients developed recurrent disease, and complete data of recurrence could be obtained in 493(95.4%) patients. For p^(N0) patients, the patterns of recurrence were different according to p T stage: locoregional recurrence was most common in patients with p T1-2 disease(57.1%), distant recurrence was most common in patients with p T3 disease(57.1%), and peritoneal recurrence was most common in patients with p T4 a disease(66.7%). For p^(N+) patients, distant metastasis was most common pattern irrespective of p T stage. The site-specific trend of recurrence showed that locoregional recurrence increased within 5 years in patients with p^(N0)-2 disease but plateaued 3 years after surgery in patients with p N3 disease. Time to recurrence was significantly longer for the p^(N0) patients compared with the p^(N+) patients(median: 25 vs. 16 months, P=0.001).Moreover, post-recurrence survival was significantly better for the p^(N0) patients than for the p^(N+) patients(median:12 vs. 6 months, P<0.001), especially in patients with non-peritoneal recurrence, late recurrence, single recurrence,and receipt of potential curative ***: Among clinicopathologic factors, lymph node status is the most important factor associated with recurrence patterns after curative gastrectomy. Lymph node status may be used as an adjunct in clinical decisionmaking about postoperative therapeutic and follow-up strategies.

关键词： Recurrence patterns lymph node status post-recurrence survival recurrence-free survival gastric cancer

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A matched cohort study of laparoscopy-assisted and open total gastrectomy for advanced proximal gastric cancer without serosa invasion

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Chinese Medical Journal 2014年第3期127卷 403-407页

作者： Lin Jianxian Huang Changming zheng chaohui Li Ping Xie Jianwei Wang Jiabin Lu Jun Department of Gastric Surgery Fujian Medical University Union Hospital Fuzhou Fujian 350001 China

Background Little is known about the feasibility and safety of laparoscopy-assisted total gastrectomy （LATG） with extended lymphadenectomy in patients with advanced gastric cancer （AGC）.This study compared the technical feasibility,safety,and oncologic efficacy of LATG with open total gastrectomy （OTG） for AGC without serosa *** From January 2009 to December 2011,235 patients underwent LATG and 153 patients underwent OTG for AGC without serosa ***,gender,and depth of invasion （pT2 and pT3） were matched by propensity scoring,and 116 patients （58 LATG and 58 OTG） were selected for *** clinicopathologic characteristics,postoperative outcomes,and survival were *** There was no significant difference in clinicopathologic characteristics between the two propensity-matched *** number of lymph nodes per patient was 29,and the mean number of retrieved lymph nodes was similar in the LATG and OTG groups （30.8±10.2 vs.29.0±8.3）.Peri-operative characteristics,operation time,number of transfused units per patient,and time to resumption of activities were similar in the two groups; while blood loss,times to first flatus and resumption of soft diet,and post-operative stay were significantly lower in the LATG group （P ＜0.05,respectively）.Rates of post-operative complications （12.1％ vs.15.5％） and postoperative mortality （0％ vs.1.7％）,as well as cumulative survival rates,were *** LATG with D2 lymphadenectomy is a safe and feasible procedure for AGC patients without serosa ***,randomized trials are needed to confirm the efficacy of LATG in this patient population.

关键词： laparoscopic surgery total gastrectomy advanced gastric cancer D2 lymphadenectomy matched cohort study

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Textbook Outcome as a measure of surgical quality assessment and prognosis in gastric neuroendocrine carcinoma:A large multicenter sample analysis

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Chinese Journal of Cancer Research 2021年第4期33卷 433-446页

作者： Qiyue Chen Zhongliang Ning Zhiyu Liu Yanbing Zhou Qingliang He Yantao Tian Hankun Hao Wei Lin Lixin Jiang Gang Zhao Ping Li chaohui zheng Changming Huang on behalf of the Study Group for Gastric Neuroendocrine Tumors Department of Gastric Surgery Fujian Medical University Union HospitalFuzhou 350001China Department of General Surgery Fujian Medical University Union HospitalFuzhou 350001China Key Laboratory of Ministry of Education of Gastrointestinal Cancer Fujian Medical UniversityFuzhou 350004China Fujian Key Laboratory of Tumor Microbiology Fujian Medical UniversityFuzhou 350004China Department of Gastrointestinal Surgery West District of the First Affiliated Hospital of USTCDivision of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefei 230001China Department of Gastrointestinal Surgery Affiliated Hospital of Qingdao UniversityQingdao 266000China Department of Gastrointestinal Surgery the First Affiliated Hospital of Fujian Medical UniversityFuzhou 350005China Department of Pancreatic and Gastric Surgery National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100021China Department of General Surgery Huashan HospitalFudan UniversityShanghai 200040China Department of Gastrointestinal Surgery and Gastrointestinal Surgery Research Institute the Affiliated Hospital of Putian UniversityPutian 351106China Department of Gastrointestinal Surgery Yantai Yuhuangding HospitalYantai 264099China Department of Gastrointestinal Surgery Renji HospitalShanghai Jiaotong UniversityShanghai 200127China 不详

Objective:Quality assurance is crucial for oncological surgical treatment *** rare diseases,singlequality indicators are not *** aim to develop a comprehensive and reproducible measurement,called the"Textbook Outcome"(TO),to assess the quality of surgical treatment and prognosis of gastric neuroendocrine carcinoma(G-NEC)***:Data from patients with primary diagnosed G-NEC included in 24 high-volume Chinese hospitals from October 2005 to September 2018 were *** included receiving a curative resection,≥15 lymph nodes examined,no severe postoperative complications,hospital stay≤21 d,and no hospital readmission≤30 d after *** variation in TO was analyzed using a case mix-adjusted funnel *** factors of survival and risk factors for non-Textbook Outcome(non-TO)were analyzed using Cox and logistic models,***:TO was achieved in 56.6%of 860 G-NEC *** patients had better overall survival(OS),disease-free survival(DFS),and recurrence-free survival(RFS)than non-TO patients(P200 mL blood loss were independent risk factors for non-TO patients(P<0.05).Conclusions:TO is strongly associated with multicenter surgical quality and prognosis for G-NEC *** predicting non-TO are identified,which may help guide strategies to optimize G-NEC outcomes.

关键词： Textbook Outcome gastric neuroendocrine carcinoma surgical quality prognosis risk factor

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谁来鉴定审计失败

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中国审计 2001年第4期 57-58页

作者：郑朝晖福州大学会计系

新修订的中的一个重大突破,是加大对虚假会计信息的惩治力度,但什么是虚假的会计信息?如何去衡量和判断?如何正确运用重要性原则?由谁作裁定?由谁来界定注册会计师的验资报告是否虚假呢?由谁来鉴定会计信息与审计报告的真伪?这已成为亟... 详细信息

新修订的中的一个重大突破,是加大对虚假会计信息的惩治力度,但什么是虚假的会计信息?如何去衡量和判断?如何正确运用重要性原则?由谁作裁定?由谁来界定注册会计师的验资报告是否虚假呢?由谁来鉴定会计信息与审计报告的真伪?这已成为亟待解决的问题.

关键词：注册会计师虚假会计信息审计失败审计报告重要性原则职业谨慎会计师事务所裁定新修订主观过错

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Effect of visceral obesity on outcomes of fluorescence-guided lymphadenectomy during laparoscopic gastrectomy for gastric cancer:Post hoc analysis of a randomized phase 3 trial

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Chinese Journal of Cancer Research 2024年第5期36卷 503-516页

作者： Yihui Tang Zening Huang Xingqi Zhang Ping Li Jianwei Xie Jiabin Wang Qiyue Chen Longlong Cao Mi Lin Ruhong Tu Guangtan Lin Hualong zheng Qing Zhong Juli Lin Zihao Yao Dong Wu chaohui zheng Jianxian Lin Changming Huang Department of Gastric Surgery Fujian Medical University Union HospitalFuzhou 350001China Department of General Surgery Fujian Medical University Union HospitalFuzhou 350001China Fujian Province Minimally Invasive Medical Center Fuzhou 350001China Key Laboratory of Gastrointestinal Cancer(Fujian Medical University) Ministry of EducationFuzhou 350108China

Objective:To explore the impact of visceral fat area(VFA)on the short-and long-term efficacy of indocyanine green(ICG)-guided D2 lymphadenectomy for gastric cancer(GC).Methods:A post hoc analysis was performed in patients who participated in a phase 3 randomized clinical trial of ICG-guided laparoscopic radical gastrectomy *** laparoscopic radical gastrectomy from November 2018 to July *** VFA was calculated based on preoperative computed tomography ***-term efficacy included the quality of lymph node(LN)dissection and surgical outcomes,while long-term efficacy included overall survival(OS)and recurrence-free survival(RFS).Results:This study included 126 patients each in the ICG(high-VFA,n=43)and non-ICG groups(high-VFA,n=38).Compared with the non-ICG group,the ICG group had significantly more retrieved LNs(low-VFA:50.1 vs.43.9,P=0.001;high-VFA:49.6 vs.37.5,P<0.001)and a significantly lower LN noncompliance rate(low-VFA:32.5%vs.50.0%,P=0.020;high-VFA:32.6%vs.73.7%,P<0.001),regardless of the *** ICG group had a shorter postoperative hospital stay and fewer intra-abdominal infections than the ICG group in the high-VFA patients(P=0.025 and P=0.020,respectively)but not in the low-VFA *** of the VFA,the 3-year OS(RFS)was better in the ICG group than in the non-ICG group[low-VFA:83.1%(76.9%)vs.73.9%(67.0%);high-VFA:90.7%(90.7%)vs.73.7%(73.5%);P for interaction=0.474(0.547)].Conclusions:The short-and long-term efficacies of ICG tracing were not influenced by visceral obesity.

关键词： Gastric cancer laparoscopic gastrectomy indocyanine green visceral obesity lymph node dissection survival

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中国移动通信新的业务增长点——移动智能业务

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电信科学 2000年第5期16卷 22-24页

作者：胡怡郑朝晖中国移动通信集团公司北京100053

本文首先讨论了移动智能网的概念、网络结构和特点 ,然后介绍了中国移动通信集团智能业务的开展。

关键词：移动通信智能网虚拟专用网移动智能业务

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基于Siewert分型食管胃结合部腺癌的治疗策略

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中华消化外科杂志 2019年第6期18卷 536-541页

作者：郑朝辉郑华龙陆俊福建医科大学附属协和医院胃外科福州350001

近年来,胃癌发病率在全世界范围逐年下降,但食管胃结合部腺癌(AEG)发病率却呈明显上升趋势,以欧洲、美洲国家尤为明显。AEG预后较差,建立AEG最佳诊断与治疗策略,从而改善患者的远期疗效极其必要。目前,最常用的AEG分型是1987年由德国学... 详细信息

近年来,胃癌发病率在全世界范围逐年下降,但食管胃结合部腺癌(AEG)发病率却呈明显上升趋势,以欧洲、美洲国家尤为明显。AEG预后较差,建立AEG最佳诊断与治疗策略,从而改善患者的远期疗效极其必要。目前,最常用的AEG分型是1987年由德国学者基于食管胃结合部的解剖学特点提出的Siewert分型,其为手术方式的选择提供了重要指导意义。与欧洲、美洲国家比较,亚洲国家AEG以Siewert Ⅱ型或Ⅲ型多见,且主要依照近端胃癌方案治疗。与其他部位胃肿瘤比较,AEG在解剖、生理、病理等方面存在明显差异性和特殊性,且在外科治疗和综合治疗问题上还存在较大争议。

关键词：食管胃结合部腺癌 Siewert分型治疗策略外科手术综合治疗

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腹腔镜胃癌根治术中助手配合的要点和技巧

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中华胃肠外科杂志 2014年第8期17卷 764-767页

作者：郑朝辉黄昌明福建医科大学附属协和医院胃外科福州350001

腹腔镜胃癌根治术要求进行胃周间隙的多方位和多层次解剖分离，其淋巴结清扫范围较广，手术操作复杂，需要良好的团队配合，尤其是助手的牵拉与暴露在手术中起到十分关键的作用。能与主刀默契配合的功能型助手能够使手术时间缩短，术中... 详细信息

腹腔镜胃癌根治术要求进行胃周间隙的多方位和多层次解剖分离，其淋巴结清扫范围较广，手术操作复杂，需要良好的团队配合，尤其是助手的牵拉与暴露在手术中起到十分关键的作用。能与主刀默契配合的功能型助手能够使手术时间缩短，术中出血减少，提高手术质量。助手的成长需要时间和手术例数的积累，除应具备一定开腹胃癌根治术的经验外，还应熟练掌握术中各种腹腔镜器械的使用和操作技巧，保持与主刀一致的手术思路。要想尽快成为腹腔镜胃癌手术优秀而全面的助手，应不断学习及总结以缩短自己的学习曲线。

关键词：腹腔镜手术胃肿瘤助手配合

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高精度腹腔镜显像技术在微创胃癌手术中的精准应用与评价

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中华消化外科杂志 2023年第10期22卷 1173-1179页

作者：郑朝辉钟情张志权吴栋福建医科大学附属协和医院胃外科福州350001

高精度腹腔镜显像技术是近年来新兴的腹腔镜技术平台,其主要包括3D腹腔镜、4K超高清腹腔镜以及吲哚菁绿近红外光成像等技术。在微创胃癌手术中,这些技术能够重建出更真实、更直观的三维立体结构,精准定位肿瘤和胃周淋巴结,从而清晰暴露... 详细信息

高精度腹腔镜显像技术是近年来新兴的腹腔镜技术平台,其主要包括3D腹腔镜、4K超高清腹腔镜以及吲哚菁绿近红外光成像等技术。在微创胃癌手术中,这些技术能够重建出更真实、更直观的三维立体结构,精准定位肿瘤和胃周淋巴结,从而清晰暴露解剖层次,为腹腔镜下胃周血管裸化、淋巴结清扫和消化道重建等手术操作提供便利。笔者结合团队的实践经验和国内外相关文献,深入阐述高精度腹腔镜显像技术在微创胃癌手术中的最新进展,分析该技术在临床应用中的优势及挑战,旨在推动高精度腹腔镜显像技术在微创胃癌手术中的普及应用。

关键词：胃肿瘤腹腔镜胃切除术 3D腹腔镜 4K腹腔镜吲哚菁绿近红外光成像

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基于稀疏处理的波束形成算法改进

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电子科技 2014年第11期27卷 11-13页

作者：郑超辉西安电子科技大学电子工程学院陕西西安710071

自适应抗干扰算法中,在基于LCMV算法的波束形成算法的基础上,文中提出了一种基于稀疏处理的波束形成算法。该算法通过对角度做稀疏处理,在目标与干扰的入射角小范围内作小步长遍历,而在其他角度上做大步长遍历,使方向图在形成过程中运... 详细信息

自适应抗干扰算法中,在基于LCMV算法的波束形成算法的基础上,文中提出了一种基于稀疏处理的波束形成算法。该算法通过对角度做稀疏处理,在目标与干扰的入射角小范围内作小步长遍历,而在其他角度上做大步长遍历,使方向图在形成过程中运算量大幅减少。通过仿真验证了其正确性,在达到抗干扰效果要求的基础上,提高了运算效率。

关键词：自适应调零 LCMV 稀疏处理抗干扰

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