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Objective To investigate the risk factors for pathological upstaging of clinical T2N0M0 esophageal carcinoma by analyzing the clinicopathological data. Methods We collected 149 patients with clinical T2N0M0 esophageal squamous carcinoma who underwent minimally invasive esophagectomy with two-field lymph node dissection. Univariate and multivariate Logistic regression analyses were performed to identify the factors related to pathologic upstaging. Results There were 59 (39.6%) cases of pathologic T2N0M0; 23(15.4%) cases were downstaged; 67(45%) cases were upstaged; 42(28.2%) cases were pathological T upstaged; and 45(30.2%) cases had lymph node metastasis. Both T upstaging and lymph node metastasis occurred in 12.8% patients. Univariate analysis showed that tumor length, depth of infiltration, differentiation degree and pathological morphology were related to T upstaging and the influencing factors of lymph node metastasis were tumor length and depth of infiltration (P < 0.05). Multivariate analysis revealed that tumor length, depth of infiltration and differentiation degree were risk factors for T upstaging and the factors influencing lymph node metastasis were tumor length, degree of differentiation and lesion location (P < 0.05). Conclusion Clinical staging of T2N0M0 esophageal cancer remains inaccurate. Tumor length, depth of infiltration and differentiation degree are risk factors for T upstaging. The factors influencing lymph node metastasis are tumor length, degree of differentiation and lesion location.

Background18F-Flutemetamol (18F-FMM) PET/CT imaging has been widely applied to the diagnosis of mild cognitive impairment and Alzheimer's disease.PurposeThis study aims to explore the distributions of 18F-FMM in different brain regions of mild cognitive impairment (MCI) and Alzheimer's disease (AD) patients and the factors that may affect the combination of 18F-FMM, evaluating the use of 18F-FMM PET/CT imaging in the diagnosis of MCI and AD patients.MethodsFrom July 2020 to April 2021, 24 subjects with MCI (12 males, 12 females, aged of (70.54±9.27) years old), 25 subjects with AD (11 males, 14 females, aged (70.56±7.30) years old) and 9 subjects as normal controls (NC, 2 males, 7 females, aged (57.67±9.00) years old) were recruited from Shanghai. The 18F-FMM PET/CT brain imaging of all subjects were qualitatively and semi-quantitatively analyzed by visual evaluation and standardized uptake value ratio (SUVR), respectively. Student's t-test, one-way analysis of variance and rank sum test were used for the comparison of quantitative variables. Pearson's chi-squared test and Fisher's exact test were used for the comparison of qualitative variables. The diagnostic efficiency was obtained by ROC curve. Multiple linear regression analysis was used to analyze the factors that might affect the combination of 18F-FMM.ResultsThe positive rate of visual assessment was significantly different in NC, MCI and AD groups (χ2=26.85, p < 0.001), and significant differences existed statistically in SUVR of all brain regions among the three groups (H value: 11.54~19.34, F value: 7.43, 11.48, all p < 0.01). The mean values of SUVR in the whole brain of the three groups were statistically different (Z value: -3.87, -2.79, -2.45, all p < 0.016 7). Compared with MCI group, the positive rate in occipital lobe, temporal lobe, parietal lobe and posterior cingulate gyrus was statistically significant (χ2=7.53~10.89, all p < 0.01). With respect to NC, SUVR of all brain regions was lower than that in AD, while SUVR of temporal lobe, frontal lobe and precuneu were lower than that in MCI. Meanwhile, SUVR of occipital lobe, temporal lobe, frontal lobe and parietal lobe in MCI were lower than that in AD. Receiver operating characteristic (ROC) curves showed that the SUVR value of temporal lobe and the mean value of SUVR in the whole brain had the ability to distinguish NC, MCI and AD in sequence. Multiple linear regression analysis showed that cognitive level was significantly negatively correlated with 18F-FMM SUVR in different brain regions.Conclusion18F-FMM PET/CT brain imaging could reflect the cognitive level of middle-aged and elderly people intuitively and has clear diagnostic value for MCI and AD.

Objective: To describe clinical and genetic feature in a Chinese family with familial idiopathic basal ganglia calcification 3 (IBGC-3) caused by a novel mutation in the SLC20A2 gene., Methods: Clinical data was collected from a family with familial IBGC-3. All of the family members underwent cerebral CT. Potential mutation of the SLC20A2 gene were screened in the proband, 5 symptomatic patients, 5 asymptomatic family members, and 100 healthy Chinese controls. Exon 8 of the SLC20A2 gene was cloned into plasmid and sequenced., Results: There were 6 symptomatic patients (3 males and 3 females) in an autosomal dominant pedigree. The patients manifested as juvenile-onset paroxysmal kinesigenic dyskinesia, in addition to pyramidal signs in proband. 5 patients alive had calcification in bilateral basal ganglia and subcortical areas. One asymptomatic member also had calcification in the brain; and 2 cases of asymptomatic young members had bilateral globus pallidus calcification. A novel c.1086delC mutation in SLC20A2 gene has been identified in proband and 7 family members with intracranial calcification. The deletion mutation was not found in 2 family members without intracranial calcification and healthy controls members. There is no clear relationship between clinical symptoms and the severity of calcification in cerebral CT., Conclusion: Familial idiopathic basal ganglia calcification caused by the SLC20A2 gene mutation can manifest as juvenile onset paroxysmal kinesigenic dyskinesia. Further study should be done to validate the unrelated relationships between the severity of calcification in IBGC 3 cranial CT and clinical symptoms.

Background: To investigate the expression features of the heterogeneous nuclear ribonucleoprotein A2/B1 (hnRNP A2/B1) in non-small cell lung cancer and its clinical significance., Methods: hnRNP A2/B1 expression of cancer tissues, paracancerous lung tissues, resected bronchial stump epithelium tissues was detected in 58 non-small cell lung cancer patients and pulmonary tissues in 30 patients with benigh pulmonary lesions as control by immunohistochemistry methods., Results: The positive expressive rate of hnRNP A2/B1 in lung cancer tissue (63.79%) was significantly higher than those in paracancerous lung tissue (43.10%) and benign pulmonary lesion tissues (20.00%) (P=0.000), and the positive rate in paracancerous lung tissue was also significantly higher than that in benign pulmonary lesion tissues (P < 0.05). The positive rate of hnRNP A2/B1 in the hyperplastic and dysplastic epithelium (40.00%) of resected bronchial stump was remarkably higher than that in normal bronchial epithelium (15.15%) in lung cancer patients (P=0.032). The positive rate of hnRNP A2/B1 in poor differentiated lung cancer (78.13%) was remarkably higher than that in moderate and well differentiated lung cancer (46.15%) (P < 0.05). The positive rate of hnRNP A2/B1 in lung cancer with lymph node metastasis (75.00%) was significantly higher than that without lymph node metastasis (50.00%) (P < 0.05). The positive rate of hnRNP A2/B1 in stage III+IV disease (78.57%) was significantly higher than that in stage I+II disease (50.00%) (P < 0.05). The positive rate of hnRNP A2/B1 in T3+T4 cancer (77.42%) was significantly higher than that in T1+T2 cancer (48.15%) (P < 0.05). The positive rate of hnRNP A2/B1 expression in lung cancer tissues was not related to histological classification of the cancer (P > 0.05)., Conclusions: The overexpression of hnRNP A2/B1 in cancer tissues may play an important role in the oncogenesis, development and metastasis of lung cancer. Detection of hnRNP A2/B1 expression may be helpful to diagnose lung cancer and to predict prognosis of the patients with lung cancer.