ObjectiveTo investigate the clinical value of DNA ploidy analysis system in the diagnosis of benignancy or malignancy with bronchial brushing or bronchoalveolar lavage fluid. MethodsWe studied 96 bronchial brush tablets or bronchoalveolar lavage fluid specimens confirmed pathologically between June 2012 and June 2013, in which there were 49 cases of benignancy and 47 malignancies. Bronchial brush pieces were acquired by clinicians when they performed bronchoscopy for the patients. Each bronchoalveolar lavage fluid specimen was made into two slides, of which one was stained by HE method for cytology analysis, and the other was stained with Feulgen method for DNA ploidy analysis through automatic imaging cytometer. ResultsThe specificity, sensitivity and accuracy of the routine cytological investigation were respectively 85.7%, 78.7% and 77.1%, while the three indexes for DNA ploidy analysis were 100.0%, 91.5% and 95.8%, respectively. ConclusionDNA ploidy analysis can improve the bronchial brushing or bronchoalveolar lavage fluid positive rate, and compared with cytological investigation, it is more specific and more sensitive with a high clinical value.
ObjectiveTo review and summarize the clinical data and survival information of patients with cholangiocarcinoma treated by surgery, and to explore the clinical and pathological features of cholangiocarcinoma, and the relationship between intraoperative and postoperative characteristics and prognosis. MethodsWe retrospectively analyzed the clinical data of 678 cholangiocarcinoma patients after operation in the PLA General Hospital from January 2004 to December 2010, including the follow-up results of 397 cases. Only 293 patients with surgical resection of cholangiocarcinoma and non-surgical reasons for death were analyzed using Cox proportional hazards model. All indicators were analyzed by univariate and multivariate analysis. ResultsThe median follow-up time was 55.9 months. As of the end of follow-up, there were 158 cases of recurrence (53.9%) and 223 cases of death (76.1%). The median overall survival time was 21.2 months, and 1-year, 3-year and 5-year survival rates were 71.7%, 38.2% and 10.6%, respectively. Tumor differentiation, TNM stage, surgical margin, intraoperative blood transfusion, tumor location, alkaline phosphatase levels in blood and recurrence were independent risk factors for overall survival time. ConclusionLow degree of tumor differentiation, advanced TNM stage, cancer invasion on the surgical margin, intraoperative blood transfusion, tumor located outside the liver, alkaline phosphatase levels in blood higher than normal, and cholangiocarcinoma tumor recurrence are risk factors for overall survival rate in patients with cholangiocarcinoma.