Association between neutrophil-to-lymphocyte ratio and differentiated thyroid cancer: a meta-analysis.

The association between neutrophil-to-lymphocyte ratio (NLR) and differentiated thyroid cancer (DTC) is undecided. To rectify this question, we conducted a systematic meta-analysis based on 7 prospective cohort studies published between 2013 and 2015, comprising 7349 patients. Six of these cohorts included pretreatment (baseline) NLR data for patients with thyroid nodules. The meta-analysis of these 6 cohorts showed that the NLR of patients with DTC (4617 cases) was statistically similar to patients with benign nodules only (1666 cases), with a mean difference (MD) of 0.19 (95% CI: -0.09 to 0.46; I2 = 93%; P < 0.001). No significant difference in NLR was found between patients with DTC and patients with benign nodules. Two studies addressed an association between NLR and papillary thyroid carcinoma in patients stratified by age <45 and ≥45 years (496 and 891 cases, respectively); the pooled MD was 0.09 (95% CI: -0.37 to 0.55; I2 = 92.2%, P < 0.001). An elevated NLR seems not a reliable indicator of progressing DTC in patients with goiters, and there was no difference in NLR between patients aged <45 years and those aged ≥45 years. Well-designed and large-scale investigations are warranted to understand the value of NLR in the prognosis of DTC.

[Biological relativity of imaging of CT perfusion for pancreases to pancreatic cancer].

OBJECTIVE: To explore the relationships between perfusion values of pancreatic cancers and the microvessel density of tumors (MVD) and vessel endothelial growth factor (VEGF), and the clinical value of multiple-slice spiral CT perfusion imaging in diagnosing pancreatic cancers. METHODS: Forty-two people with normal pancreas and eighteen patients with pancreatic cancers underwent multiple-slice spiral CT perfusion examinations. The time-density curve (TDC) of the region of interest (ROI) was drawn with the software equipped in the spiral CT. The CT perfusion parameters of the ROI peak reinforcement values were calculated, including blood flow (BF), blood volume (BV), time to start (TTS), time to peak (TTP), permeability, and mean of the patlak blood volume (pBV). Twenty patients (11 with pancreatic cancers and 9 with chronic pancreatitis) were chosen for CD34 and VGEF antibody immunohistochemistry staining on the same layers of pancreatic tissues as the CT perfusion targeted. The associations between the imaging of CT perfusion and MVD and VFGF were examined. RESULTS: The patients with pancreatic cancers had lower BF, VB, and pBV, and higher permeability than the normal controls (P<0.01). No differences appeared between the two groups in time to start and time to peak (P>0.05). The difference in average MVD of the 9 patients with chronic pancreatitis (13.8 +/- 9.6), and the 11 patients with pancreatic cancers (30.5 +/- 14.8) was statistically significant. Eight patients with pancreatic cancers showed strong positive VEGF and three showed weak positive VEGF. Only one patient with chronic pancreatitis showed strong positive VEGF while eight showed weak positive VEGF. The difference in positive rate of VEGF between the two groups of patients was statistically significant (P<0.01). The MVD in patients with pancreatic cancers (median 40.2) was correlated with BF (median 26.9), TTS (median 14.8), and TTP (median 145.3) (r=0.42, 0.63, and 0.45, respectively). The expression of VGEF (median 4.3) was negatively correlated with BV (r=-0.39). CONCLUSION: Imaging of CT perfusion has certain clinical value for diagnosing pancreatic cancers. The imaging of CT perfusion reflects the MVD and VEFG in the tumor tissues.

[CT and MR imaging differences between intrahepatic cholangiocarcinoma and hepatocellular carcinoma with invasions to billary tracts].

OBJECTIVE: To identify the CT and MR imaging differences between intrahepatic cholangiocarcinoma (ICC) and hepatocellular carcinoma (HCC) with invasions to biliary tracts. METHODS: Eighteen patients with ICC and 32 HCC patients with invasions to biliary tracts confirmed by postoperative pathological diagnosis were enrolled in the study. All of the patients underwent CT or MR examinations. The image features about the tumor and the biliary tracts were analyzed retrospectively. RESULTS: The imaging features of ICC were: faint rim-like enhancement and no enhancement of the masses. The ICC invasions to biliary tracts were shown as severe dilation of biliary tracts, coarse-to-fine or separation of dilated tracts, thickened and enhanced walls, dilation of biliary tract encased in the mass. The HCCs showed quick fill-in and wash-out of the contrast media in the mass. The imaging features of HCC with invasions to biliary tracts were: mild dilated tracts, compressed and extruded tracts, thickening of the wall of dilated tracts and enhancement of the walls. The location of the dilated tracts were mostly alongside of the tumors. The chi square tests revealed significant differences between ICC and HCC in the above features (P<0.05). CONCLUSION: CT or MR imaging may help differentiate ICC and HCC with invasions to biliary tracts.