The value of the improved percutaneous and intravenous contrast-enhanced ultrasound diagnostic classification in sentinel lymph nodes of breast cancer.

Background: Metastatic burden of sentinel lymph node (SLN) in breast cancer patient is the basis for the decision to choose SLN biopsy or axillary lymph node dissection (ALND). However, the diagnostic performance of the previous percutaneous contrast-enhanced ultrasound (P-CEUS) and intravenous contrast-enhanced ultrasound (IV-CEUS) pattern were not satisfied. This study aimed to establish new classification based on structural characteristics for P-CEUS and IV-CEUS of SLN in breast cancer and evaluate the diagnostic efficacy. Methods: This retrospective study included consecutive breast cancer patients who had not received neoadjuvant therapy in the First Affiliated Hospital of Sun Yat-sen University between June 2019 and December 2021. Conventional ultrasound, P-CEUS and IV-CEUS were performed. The new classification methods for P-CEUS and IV-CEUS of SLN were established based on structural characteristics of SLN. Pathology was considered as the gold standard, the diagnostic efficacy of P-CEUS, IV-CEUS and combined contrast-enhanced ultrasound in SLNs was analyzed. Results: The detection rate of SLN by P-CEUS in 368 patients was 95.42%. The P-CEUS pattern of SLNs was divided into six types. The IV-CEUS sequence was divided into three types. The IV-CEUS mode was divided into four types. Among the 438 SLNs detected by P-CEUS, 105 (23.97%) were malignant and 333 (76.03%) were benign. Among the previously classified P-CEUS, P-CEUS, IV-CEUS and combined contrast-enhanced ultrasound, the latter had the highest diagnostic efficacy (P<0.05), with sensitivity, specificity, positive predictive value, negative predictive value, accuracy and area under curve (AUC) of 81.90% (86/105), 97.30% (324/333), 90.53% (86/95), 94.46% (324/343), 93.61% (410/438) and 0.896 (0.864-0.923), respectively. Conclusions: The new classification of the P-CEUS and IV-CEUS features of SLNs was performed based on structural characteristics of lymph nodes. Compared with the previously classified P-CEUS, the new classification method has higher diagnostic performance. The combination of new classified P-CEUS and IV-CEUS is helpful to further improve the diagnostic performance of SLNs.

Human papillomavirus and cervical cancer in the microbial world: exploring the vaginal microecology.

The vaginal microbiota plays a crucial role in female reproductive health and is considered a biomarker for predicting disease outcomes and personalized testing. However, its relationship with human papillomavirus (HPV) infection and cervical cancer is not yet clear. Therefore, this article provides a review of the association between the vaginal microbiota, HPV infection, and cervical cancer. We discuss the composition of the vaginal microbiota, its dysbiosis, and its relationship with HPV infection, as well as potential mechanisms in the development of cervical cancer. In addition, we assess the feasibility of treatment strategies such as probiotics and vaginal microbiota transplantation to modulate the vaginal microbiota for the prevention and treatment of diseases related to HPV infection and cervical cancer. In the future, extensive replication studies are still needed to gain a deeper understanding of the complex relationship between the vaginal microbiota, HPV infection, and cervical cancer, and to clarify the role of the vaginal microbiota as a potential biomarker for predicting disease outcomes, thus providing a theoretical basis for personalized testing.

Relationship between Cervicovaginal Microecological Changes and HPV16/18 Infection and Cervical Cancer in Women of Childbearing Age.

OBJECTIVE: The current study aimed to investigate the correlation between HPV16/18 infection and the microecological characteristics of the female reproductive tract and cervical lesions and to explore the risk factors associated with cervical precancerous lesions (CIN) and cervical cancer (CC). METHODS: A total of 326 women were selected for HPV screening, with 121 testing negative for HPV, 113 infected with HPV16/18, and 92 infected with other types of HPV. Microecological characteristics of the vaginal flora in all subjects were analyzed. Liquid-based thin layer cell (TCT) tests, genitourinary tract infection pathogen (STDs) assessments, HPV typing, and colposcopic pathological biopsies of exfoliated cervical cells were conducted. RESULTS: Among patients with HPV infection, there was a higher detection rate of abnormal microecological indicators such as bacterial vaginosis (BV) and vaginal cleanliness. Additionally, an increased proportion of vaginal microbiota (VM) imbalance was observed. Ureaplasma urealyticum (Uu) infection in the reproductive tract was closely associated with HPV 16/18 infection and showed co-infection. Moreover, patients with BV infection and high expression of HPV mRNA were at a higher risk of persistent HPV16/18 positive infection. BV infection, Uu infection, and HPV16/18 positive infection were identified as risk factors for CIN and CC. Furthermore, BV and Uu infections promoted the development of CIN/CC in patients infected with HPV16/18. CONCLUSIONS: Changes in vaginal microecology are strongly linked to HPV16/18 infection. BV infection, Uu infection, HPV viral load, and HPV16/18 infection are risk factors for CIN/CC. Timely treatment of BV and Uu infections, restoration of a normal vaginal microecological environment, and improvement of HPV16/18 outcomes can delay the occurrence and progression of CIN/CC.

Research advances in the association of drug-induced liver injury with polymorphisms in human leukocyte antigen.

Drug-induced liver injury is an important adverse drug reaction. Due to the lack of specificity in clinical symptoms and pathological features, there are still no reliable diagnostic biomarkers, so drug-induced liver injury is a diagnosis of exclusion. The article reviews the relevant advances in the association between novel human leukocyte antigen gene polymorphisms and drug-induced liver injury in order to identify potential biomarkers and provide a new method for the prediction and diagnosis of drug-induced liver injury. Henceforth, while studying the association between them, it will also need that the large sample and prospective studies to gain supporting evidence to implement translational application, so as to improve the safety and effectiveness of medication and achieve individualized treatment.

Development of LAMP assays for the molecular detection of taeniid infection in canine in Tibetan rural area.

For field-identification of taeniid cestodes in canine animals in Tibetan area, loop-mediated isothermal amplification (LAMP) assays for Echinococcus multilocularis, E. shiquicus, Taenia hydatigena, T. multiceps, T. pisiformis and T. crassiceps were developed and evaluated along with the reported assay for E. granulosus. The LAMP assays showed specific reaction with their corresponding target species DNA with the detection limit of 1 to 10 pg. Moreover, the assays for E. granulosus, E. multilocularis, T. hydatigena and T. multiceps could detect DNA extracted from 3 or more eggs of their corresponding target species. Then, the LAMP assays were applied on samples containing 3 to 35 taeniid eggs obtained from 61 field-collected canine feces in Qinghai, and the result was compared with a reported multiplex PCR and sequence analysis. The LAMP assays and the PCR detected single species DNA of E. granulosus, E. shiquicus, T. hydatigena and T. multiceps in 5, 2, 44 and 2 samples, respectively. In the rest 8 samples, DNA of both E. granulosus and T. hydatigena were detected by the PCR but the LAMP assays detected those DNAs in 2 samples and only T. hydatigena DNA in 6 samples. It was assumed that less than 3 E. granulosus eggs were mixed in the samples although the samples contained 21 to 27 eggs in total. In conclusion, the LAMP assays were less sensitive than the multiplex PCR, but would have adequate sensitivity for field use in Tibetan area.