Lymph node metastasis informs prognosis and is a key factor in deciding further management, particularly adjuvant chemotherapy. It is core to all contemporary staging systems, including the widely used tumor node meta...Lymph node metastasis informs prognosis and is a key factor in deciding further management, particularly adjuvant chemotherapy. It is core to all contemporary staging systems, including the widely used tumor node metastasis staging system. Patients with nodenegative disease have 5-year survival rates of 70%-80%, implying a significant minority of patients with occult lymph node metastases will succumb to disease recurrence. Enhanced staging techniques may help to identify this subset of patients, who might benefit from further treatment. Obtaining adequate numbers of lymph nodes is essential for accurate staging. Lymph node yields are affected by numerous factors, many inherent to the patient and the tumour, but others related to surgical and histopathological practice. Good lymph node recovery relies on close collaboration between surgeon and pathologist. The optimal extent of surgical resection remains a subject of debate. Extended lymphadenectomy, extra-mesenteric lymph node dissection, high arterial ligation and complete mesocolic excision are amongst the surgical techniques with plausible oncological bases, but which are not supported by the highest levels of evidence. With further development and refinement, intra-operative lymphatic mapping and sentinel lymph node biopsy may provide a guide to the optimum extent of lymphadenectomy, but in its present form, it is beset by false negatives, skip lesions and failures to identify a sentinel node. Once resected, histopathological assessment of the surgical specimen can be improved by thorough dissection techniques, step-sectioning of tissue blocks and immunohistochemistry. More recently, molecular methods have been employed. In this review, we consider the numerous factors that affect lymph node yields, including the impact of the surgical and histopathological techniques. Potential future strategies, including the use of evolving technologies, are also discussed.展开更多
The dynamic process of wound healing has various phases,and the knowledge of which is essential for identification of the pathology involved in a chronic intractable wound.Various instruments for the assessment of wou...The dynamic process of wound healing has various phases,and the knowledge of which is essential for identification of the pathology involved in a chronic intractable wound.Various instruments for the assessment of wound healing have been described,primarily for clinical assessment of the wound.However,very few instruments are currently available for histological grading of the wound.The aim of this article is to review all available literature from 1993 to 2014 on the objective histological scoring of the state of wound healing.This review article emphasizes the importance of histological grading of wounds based on the different parameters from each phase of wound healing and the need for an ideal grading system in order to help assessment of wound status.The parameter chosen in an experimental model should be defined by the scientific question,the underlying hypothesis and the pathogenesis of the disease.展开更多
文摘Lymph node metastasis informs prognosis and is a key factor in deciding further management, particularly adjuvant chemotherapy. It is core to all contemporary staging systems, including the widely used tumor node metastasis staging system. Patients with nodenegative disease have 5-year survival rates of 70%-80%, implying a significant minority of patients with occult lymph node metastases will succumb to disease recurrence. Enhanced staging techniques may help to identify this subset of patients, who might benefit from further treatment. Obtaining adequate numbers of lymph nodes is essential for accurate staging. Lymph node yields are affected by numerous factors, many inherent to the patient and the tumour, but others related to surgical and histopathological practice. Good lymph node recovery relies on close collaboration between surgeon and pathologist. The optimal extent of surgical resection remains a subject of debate. Extended lymphadenectomy, extra-mesenteric lymph node dissection, high arterial ligation and complete mesocolic excision are amongst the surgical techniques with plausible oncological bases, but which are not supported by the highest levels of evidence. With further development and refinement, intra-operative lymphatic mapping and sentinel lymph node biopsy may provide a guide to the optimum extent of lymphadenectomy, but in its present form, it is beset by false negatives, skip lesions and failures to identify a sentinel node. Once resected, histopathological assessment of the surgical specimen can be improved by thorough dissection techniques, step-sectioning of tissue blocks and immunohistochemistry. More recently, molecular methods have been employed. In this review, we consider the numerous factors that affect lymph node yields, including the impact of the surgical and histopathological techniques. Potential future strategies, including the use of evolving technologies, are also discussed.
文摘The dynamic process of wound healing has various phases,and the knowledge of which is essential for identification of the pathology involved in a chronic intractable wound.Various instruments for the assessment of wound healing have been described,primarily for clinical assessment of the wound.However,very few instruments are currently available for histological grading of the wound.The aim of this article is to review all available literature from 1993 to 2014 on the objective histological scoring of the state of wound healing.This review article emphasizes the importance of histological grading of wounds based on the different parameters from each phase of wound healing and the need for an ideal grading system in order to help assessment of wound status.The parameter chosen in an experimental model should be defined by the scientific question,the underlying hypothesis and the pathogenesis of the disease.
