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1.
Article in Chinese | WPRIM | ID: wpr-1027558

ABSTRACT

Objective:To investigate the magnetic resonance imaging (MRI) characteristics and pathological imaging findings of primary hepatic angiosarcoma (PHA).Methods:A retrospective analysis was conducted on the clinical, pathological and MRI data of 15 cases of PHA confirmed by pathology at the Affiliated Zhongshan Hospital of Fudan University from October 2011 to August 2022, including 9 males and 6 females, aged (57.4±11.5) years old. The MRI data included the number, location, size, morphology, signal intensity on non-contrast MRI, enhancement features, and apparent diffusion coefficient (ADC) values of the lesions were collected.Results:Among the 15 cases, 4 presented as dominant masses, 10 as multiple nodules, and 1 as diffuse small nodule type. Among the 15 patients, 11(73.3%) had multiple lesions, all involving the left and right lobes of the liver. The size of the lesion varies from punctate to 13.5 cm. A total of 24 lumpy lesions and 53 nodular lesions were analyzed. Among the 24 lumpy lesions, 14 were irregular. Among the 53 nodular lesions, 28 were quasi circular and 25 were irregular. Compared to nodular lesions, the signal of lumpy lesions is uneven, with varying degrees of necrotic areas visible in 100% (24/24) and bleeding in 91.7% (22/24) of the cases. The arterial phase enhancement of 24 lumpy lesions was mainly characterized by central cord, grid like enhancement with or without peripheral points, lines, and incomplete ring enhancement (66.7%, 16/24). The arterial phase of 53 nodular lesions mainly showed circular and overall enhancement (64.2%, 34/53), while during the portal vein, continuous circular enhancement, centripetal or grid filling and complete enhancement were observed. After removing some small lesions or artifact interference, 55 lesions were measured, and the ADC value of the lesions was (1.57±0.54)×10 -3 mm 2/s, the ADC of adjacent liver parenchyma in the same layer was (1.36±0.30)×10 -3 mm 2/s, the difference between the two was statistically significant ( P=0.012). Conclusions:The MRI manifestations of PHA patients have certain characteristics, especially the discovery of vascular perforation and malformation within the lesion. Combined with clinical and laboratory examinations, it is helpful for the diagnosis of the disease.

2.
Article in Chinese | WPRIM | ID: wpr-993259

ABSTRACT

Objective:To study the magnetic resonance imaging (MRI) features of primary hepatic diffuse large B-cell lymphoma (PDLBCLL) with the aim to improve the diagnosis of this disease.Methods:The clinical data of 15 patients with PDLBCLL confirmed by biopsy or surgical resection specimens at Zhongshan Hospital of Fudan University and Yiwu Central Hospital from May 2015 to August 2021 were retrospectively analyzed. There were 8 males and 7 females, aged (58.3±12.0) years old. Thirteen patients underwent conventional Gd-DTPA enhanced MR examinations, and 2 patients underwent hepatobiliary specific contrast agent (Gd-EOB-DTPA) enhanced MR examinations. Image analysis included the number, location, size, shape, signal intensity and enhancement features of the lesions. Apparent diffusion coefficient (ADC) values of lesions and surrounding liver parenchyma were measured on the ADC map, and paired sample t-test was used to compare the differences between the two groups. Results:In 15 patients, 10 patients had a single, 4 had multiple lesions. In 1 patient, there was diffuse, mild enhancement in the arterial phase, slow decrease in the early portal venous, late portal venous and equilibrium phases, and ring low signal signals were detected in the hepatobiliary specific phase. The average ADC value of the 15 patients was (0.826±0.379)×10 -3 mm 2/s, and the average ADC value of the adjacent liver parenchyma was (1.311±0.236)×10 -3 mm 2/s. The difference was significant ( P<0.05). Uniform signals were detected in lesions in 3 patients, in the scar tissues of 2 patients, moderate enhancement scan lesions were improved in 10 patients, mild aggrandizement in 5 patients, lesions showing a " floating vessels" sign in 6 patients, lesions showing a typical " target" appearance in 7 patients, abnormal perfusion around the lesion in 7 patients, and compression of bile ducts with perifocal bile duct dilatation in 2 patients. Conclusion:The MRI findings of PDLBCLL showed certain characteristics. The lesion boundary was clear and the signal was uneven. Contrast-enhanced scans showed a lack of blood supply, most of which were accompanied by necrosis, and the " vessel floating sign" and " target sign" were characteristic.

3.
Article in Chinese | WPRIM | ID: wpr-755111

ABSTRACT

Objective To study the clinical features of hepatic pseudolymphoma.Methods A retrospective study was conducted on 19 patients with hepatic pseudolymphoma who were diagnosed and treated at Zhongshan Hospital in Shanghai from June 2013 to December 2017.Eighteen patients were females and one was a male.The mean age was (55±9) years,range 36 to 68 years.This study mainly analyzed the imaging features,treatment and postoperative results.Results All patients were diagnosed accidentally,and 78.9% patients did not exhibit any evidence of hepatic B viral infection.A monofocal lesion was found in 14 patients and multifocal lesions in 5 patients.Surgical treatment was performed in all the patients.The lesion size was (1.1±0.4) cm (range 0.5~2.4 cm).Ultrasound revealed hypo-or slightly hypo-echogenicity.On MRI,diffusion weighted imaging showed slight hyperintensity or hyperintensity,all lesions manifested as homogeneous and slightly hyperintensity on T2WI and hypointensity on T1WI.Dynamic enhancement pattern,wash in and wash out,degressive and persistent enhancement were observed in 16(55.2%),12(41.4%),and 1 (3.4%) patients,respectively.More than 70% of lesions were diagnosed as malignant tumors on preoperative imaging.During a follow-up of 6 ~ 44 months (median:19 months),no patient developed metastasis or recurrence.Conclusions Hepatic pseudolymphoma commonly occurred in women with a small sized lesion.Due to the lack of specific clinical manifestations and imaging findings,preoperative diagnosis was difficult.Surgical resection is still the most optimal treatment.The patients usually have favorable prognosis.

4.
Chinese Journal of Ultrasonography ; (12): 1042-1047, 2018.
Article in Chinese | WPRIM | ID: wpr-734217

ABSTRACT

Objective To investigate the imaging features of dysplastic nodules with a focus of hepatocellular carcinoma ( DN-HCC ) on contrast-enhanced ultrasound ( CEUS ) and to improve the diagnostic accuracy . Methods The clinical data of 60 patients and CEUS imaging of 62 hepatic nodules [DN-HCCs , n =54 ;dysplastic nodules (DN) , n =8] pathologically proved were reviewed retrospectively . According to Contrast Enhanced Ultrasound Liver Imaging Reporting and Data System (CEUS LI-RADS) , the lesions were categorized . Results Significantly different CEUS patterns between DN-HCCs and DNs were observed ( P < 0 .05) . During the arterial phase ,54 DN-HCC lesions showed various enhancement patterns [ hypervascular ,59 .3% ( 32/54 ) ;nodule-in-nodule ,9 .3% ( 5/54 ) ;isovascular ,13 .0% ( 7/54 ) and hypovascular ,18 .5% (10/54)] . Of the 54 DN-HCC lesions ,44 .4% (24/54) showed washout during the late phase .Of the 8 DN lesions ,62 .5% (5/8) showed iso-enhancement during the arterial phase ,25% (2/8) showed hypo-enhancement ,and 12 .5% (1/8) showed hyper-enhancement . No DN lesion showed washout during the late phase .According to CEUS LI-RADS (LR) algorithm ,27 .8% (15/54) DN-HCCs were LR-5 ,46 .3% (25/54) DN-HCCs were LR-4 ,25 .9% (14/54) DN-HCCs and 100% (8/8) DNs were LR-3 . Regarding hyper-enhancement ( including local hyper-enhancement ) during the arterial phase or hypo-enhancement (including local hypo-enhancement) during the late phase as the diagnostic standard of DN-HCC , the diagnostic sensitivity , specificity and accuracy value were 83 .3% , 87 .5% and 83 .9% , respectively . Conclusions The imaging features of hyper-enhancement during the arterial phase or hypo-enhancement during the late phase on CEUS are useful to diagnose DN-HCCs .

5.
Article in Chinese | WPRIM | ID: wpr-734378

ABSTRACT

Objective To investigate the risk factors of intrahepatic recurrence after resection for Barcelona Clinic Liver Cancer (BCLC) stage 0 hepatocellular carcinoma (HCC).Methods 58 patients with pathologically confirmed BCLC stage 0 HCC treated with liver resection at the Zhongshan Hospital,Fudan University from January to December 2011 were included in this study.The male/female ratio was 50/8.The age ranged from 31 to 72 years.The clinical,pathological and MR imaging features of these patients were analyzed.The recurrence-free survival rates between patients with HCC ≤ 1.5 cm (n=27) and > 1.5 cm (n=31) were compared.The risk factors of intrahepatic recurrence for HCCs were compared using the Cox regression analysis.Results Intrahepatic recurrence was identified in 25 patients,and the median recurrence time was 33 months.The 3-and 5-year cumulative recurrence-free survival rates were 73.0% (95%CI:60.7%~85.3%) and 52.3% (95%CI:37.2%~67.4%).No significant differences were found in the recurrence-free survival rates between tumors ≤ 1.5 cm and > 1.5 cm (P>0.05).Multivariate analyses demonstrated that serum alpha-fetoprotein level >20 g/L (HR 3.773,95%CI:1.628~8.745;P<0.05) and irregular tumor shape (HR 4.584,95%CI:1.485~ 14.155;P<0.05) were independent risk factors of intrahepatic recurrence.Conclusions Elevated serum alpha-fetoprotein level and irregular tumor shape were associated with an increased risk of intrahepatic recurrence for BCLC stage 0 HCC patients after resection.They could be used as early prognostic indicators in clinical practice.

6.
Chinese Journal of Epidemiology ; (12): 810-815, 2018.
Article in Chinese | WPRIM | ID: wpr-736583

ABSTRACT

Objective To explore the effect of BMI and waist circumference on diabetes of adults.Methods After excluding participants with heart disease,stroke,cancer and diabetes at baseline study,53 916 people aged 30-79 in the China Kadoorie Biobank (CKB) study from Tongxiang city of Zhejiang province were recruited.Cox regression model was used to estimate the hazards ratios (HR) for the associations of baseline BMI and waist circumference with incident diabetes.Results Among 391 512 person-years of the follow-up program between 2004 and 2013 (median 7.26 years),a total of 944 men and 1 643 women were diagnosed as having diabetes.Compared to those with normal weight,after adjusting for known or potential factors,HR of both overweight and obesity in men for incident diabetes appeared as 2.72 (95%CI:2.47-2.99) and 6.27 (95%CI:5.33-7.36),respectively.The corresponding figures in women were 2.19 (95%CI:2.04-2.36)and 3.78 (95%CI:3.36-4.26).Compared to those with normal waist circumference,after adjusting for known or potential factors,HR of Ⅰ grade and Ⅱ grade in men for diabetes were 2.56 (95% CI:2.22-2.95) and 4.66 (95%CI:4.14-5.24),respectively.The corresponding figures in women were 1.99 (95%CI:1.80-2.21) and 3.16 (95%CI:2.90-3.44),respectively.Conclusions Overweight,obesity and central obesity were all associated with the increased incident of diabetes.Strategies on diabetes prevention should include not only losing weight,but reducing waist circumference as well.

7.
Chinese Journal of Epidemiology ; (12): 1200-1205, 2018.
Article in Chinese | WPRIM | ID: wpr-736655

ABSTRACT

Objective To prospectively explore the association between tea drinking and incidence of stroke of adults of Zhejiang province.Methods After excluding participants with heart disease,stroke,cancer and diabetes at baseline study,53 916 participants aged 30-79 years in the China Kadoorie Biobank (CKB) study from Tongxiang were included for final analysis.Cox regression model was used to estimate the hazard ratio (HR) for the association of tea drinking with incident stroke.Results The main type of drinking tea was black tea (79.78%),followed by green tea (20.08%).Of the 53 916 participants,the proportion of participants who drank tea at least once per week was 31.27%.The corresponding proportions for men and women were 60.24% and 10.30%,respectively.Among 391 512 person-years of the follow-up program (median 7.26 years),a total of 1 487 men and 1 769 women were diagnosed with stroke.After adjusting for socio-demographic status,lifestyle,BMI,waist circumference,and systolic blood pressure,HR for incident stroke decreased with the increase of daily average tea consumption amount (P=0.000 6).Compared with participants who did not drink tea weekly,the HRs for incident stroke in those consuming tea 0.1-,3.0-and ≥5.0 g/d were 0.93 (95% CI:0.85-1.00),0.88 (95% CI:0.77-0.99) and 0.79 (95% CI:0.69-0.89),respectively.The HRs for incident stroke in smokers and non-smokers who consumed tea ≥5.0 g/d were 0.71 (95%CI:0.59-0.86) and 0.97 (95%CI:0.77-1.21),respectively,compared with current smokers and non-smokers who did not drink tea weekly (P=0.040 0).The corresponding HRs for alcohol drinkers and non-drinkers were 0.96 (95%CI:0.76-1.22) and 0.70 (95%CI:0.58-0.84),respectively (P=0.040 0).The corresponding HRs for central obese persons and non-central obese persons were 0.60 (95% C1:0.44-0.81) and 0.86 (95% CI:0.73-1.01),respectively (P=0.040 0).Conclusion Tea drinking had an effect on reducing the possibility of incident stroke,especially among those who were current smokers,non-alcohol drinkers and central obese.

8.
Chinese Journal of Epidemiology ; (12): 810-815, 2018.
Article in Chinese | WPRIM | ID: wpr-738051

ABSTRACT

Objective: To explore the effect of BMI and waist circumference on diabetes of adults. Methods: After excluding participants with heart disease, stroke, cancer and diabetes at baseline study, 53 916 people aged 30-79 in the China Kadoorie Biobank (CKB) study from Tongxiang city of Zhejiang province were recruited. Cox regression model was used to estimate the hazards ratios (HR) for the associations of baseline BMI and waist circumference with incident diabetes. Results: Among 391 512 person-years of the follow-up program between 2004 and 2013 (median 7.26 years), a total of 944 men and 1 643 women were diagnosed as having diabetes. Compared to those with normal weight, after adjusting for known or potential factors, HR of both overweight and obesity in men for incident diabetes appeared as 2.72 (95%CI: 2.47-2.99) and 6.27 (95%CI: 5.33-7.36), respectively. The corresponding figures in women were 2.19 (95%CI: 2.04-2.36) and 3.78 (95%CI: 3.36-4.26). Compared to those with normal waist circumference, after adjusting for known or potential factors, HR of Ⅰgrade andⅡgrade in men for diabetes were 2.56 (95%CI: 2.22-2.95) and 4.66 (95%CI: 4.14-5.24), respectively. The corresponding figures in women were 1.99 (95%CI: 1.80-2.21) and 3.16 (95%CI: 2.90-3.44), respectively. Conclusions: Overweight, obesity and central obesity were all associated with the increased incident of diabetes. Strategies on diabetes prevention should include not only losing weight, but reducing waist circumference as well.


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Body Mass Index , China/epidemiology , Diabetes Mellitus/ethnology , Incidence , Obesity/epidemiology , Obesity, Abdominal/epidemiology , Overweight/epidemiology , Proportional Hazards Models , Prospective Studies , Risk Factors , Waist Circumference
9.
Chinese Journal of Epidemiology ; (12): 1200-1205, 2018.
Article in Chinese | WPRIM | ID: wpr-738123

ABSTRACT

Objective: To prospectively explore the association between tea drinking and incidence of stroke of adults of Zhejiang province. Methods: After excluding participants with heart disease, stroke, cancer and diabetes at baseline study, 53 916 participants aged 30-79 years in the China Kadoorie Biobank (CKB) study from Tongxiang were included for final analysis. Cox regression model was used to estimate the hazard ratio (HR) for the association of tea drinking with incident stroke. Results: The main type of drinking tea was black tea (79.78%), followed by green tea (20.08%). Of the 53 916 participants, the proportion of participants who drank tea at least once per week was 31.27%. The corresponding proportions for men and women were 60.24% and 10.30%, respectively. Among 391 512 person-years of the follow-up program (median 7.26 years), a total of 1 487 men and 1 769 women were diagnosed with stroke. After adjusting for socio-demographic status, lifestyle, BMI, waist circumference, and systolic blood pressure, HR for incident stroke decreased with the increase of daily average tea consumption amount (P=0.000 6). Compared with participants who did not drink tea weekly, the HRs for incident stroke in those consuming tea 0.1-, 3.0- and ≥5.0 g/d were 0.93 (95%CI: 0.85-1.00), 0.88 (95%CI: 0.77-0.99) and 0.79 (95%CI: 0.69-0.89), respectively. The HRs for incident stroke in smokers and non-smokers who consumed tea ≥5.0 g/d were 0.71 (95%CI: 0.59-0.86) and 0.97 (95%CI: 0.77-1.21), respectively, compared with current smokers and non-smokers who did not drink tea weekly (P=0.040 0). The corresponding HRs for alcohol drinkers and non-drinkers were 0.96 (95%CI: 0.76-1.22) and 0.70 (95%CI: 0.58-0.84), respectively (P=0.040 0). The corresponding HRs for central obese persons and non-central obese persons were 0.60 (95%CI: 0.44-0.81) and 0.86 (95%CI: 0.73-1.01), respectively (P=0.040 0). Conclusion: Tea drinking had an effect on reducing the possibility of incident stroke, especially among those who were current smokers, non-alcohol drinkers and central obese.


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , China/epidemiology , Prospective Studies , Risk Assessment/methods , Risk Factors , Stroke/ethnology , Tea/adverse effects
10.
Article in Chinese | WPRIM | ID: wpr-492796

ABSTRACT

Objective To establish a simple, efficient and low-cost method for the detection of Salmonella typhimurium carrying SSeC gene. Methods In this study, a nano-biosensor ( FAM-P/GO) was successfully established based on the noncovalent assembly of carboxy-fluorescein ( FAM)-labeled probe and graphene oxide ( GO) . The target gene at different concentrations and SSeC gene-harbored bacterium sam-ples were detected by the FAM-P/GO nano-biosensor to evaluate its sensitivity. The specificity of the estab-lished nano-biosensor was evaluated by using DNAs with mismatched base pairs and single-stranded DNAs ( ssDNAs) extracted from various species. Results The established strategy for SSeC gene detection showed a good linear range of 0. 05-1. 0 μmol/L (R2=0. 992 1) with a lower limit of 0. 05 μmol/L. Moreover, the lower detection limit for target bacterium samples was 103 CFU/ml and the fluorescence intensity increased linearly with the concentration from 103 CFU/ml to 108 CFU/ml. The signal-to-noise ( S/N) of the experi-mental group was much greater than that of the control group, which indicated that the establish method was highly specific. Conclusion The FAM-P/GO nano-biosensor was successfully established in this study, which provided a new and possible way for the rapid detection of Salmonella typhimurium harboring SSeC gene.

11.
China Pharmacist ; (12): 1369-1373, 2016.
Article in Chinese | WPRIM | ID: wpr-495163

ABSTRACT

Flavonoids are the secondary metabolites of plants , which are found in many plants .Flavonoids have extensive phar-macological actions , such as anti-inflammation, anti-tumor, anti-bacteria and anti-virus, scavenging free radicals , osteoporosis preven-tion and cardiovascular protection .Based on the analysis of relative literatures published at home and abroad in recent years , the mech-anisms of anti-inflammatory effects of flavonoids were reviewed , including arachidonic acid metabolism pathway , cytokine and its recep-tor, cell second messenger, active oxygen, nitrogen monoxide, platelet activating factor and its receptor , nuclear factor, intercellular adhesion molecule and so on .The review aimed to provide theoretical basis for the further development and research .

12.
Article in Chinese | WPRIM | ID: wpr-497625

ABSTRACT

Objective To explore and analyze the related factors of nosocomial infection in patients after total laparoscopic hysterectomy.Methods A total of 231 patients undergoing total laparoscopic hysterectomy were enrolled in this study and their data were retrospectively analyzed.The related factors such as uterus size,operation duration,intraoperative blood loss,type of disease,drainage tube,hospital duration before surgery,and history of pelvic surgery were analyzed.Results Among the 231 cases undergoing total laparoscopic hysterectomy,23 cases had infection and the infection rate was 9.96%.Univariate analysis showed uterus size,operation duration,intraoperative blood loss,hospital duration before surgery,and history of pelvic surgery had influence on postoperative infection and the difference had statistical significance (P<0.05),while the difference of age and drainage tube had no statistical significance on postoperative infection (P>0.05).Conclusion The incidence of infection after laparoscopic hysterectomy is related to uterus size,operation duration,intaoperative blood loss,hospital duration before surgery,and history of pelvic surgery.

13.
Chinese Journal of Epidemiology ; (12): 1210-1215, 2015.
Article in Chinese | WPRIM | ID: wpr-248678

ABSTRACT

<p><b>OBJECTIVE</b>To explore the association between sleep duration and stroke in adults.</p><p><b>METHODS</b>Baseline data of 57 704 subjects who were aged 30-79 years and enrolled into China Kadoorie Biobank (CKB) study from Tongxiang county, Zhejiang province were analyzed. Multiple logistic regression analysis was conducted to investigate the putative association between sleep duration and stroke after adjusting for potential confounders.</p><p><b>RESULTS</b>The mean age of the subjects was (53.15 ± 10.20) years in males and (51.72 ± .69) years in females, respectively. There were 14.43% of males and 15.30% of females reporting sleep durations ≤ 6 hours per day and 5.39% of males and 5.95% of females reporting long duration of sleep (≥ 10 hours per day). The prevalence of stroke was 0.92% in males compared with 0.44% in females. The prevalence of stroke showed a U-shaped distribution with sleep duration. Compared with 7 hours sleep duration per day, long sleep duration (≥ 10 hours per day) was associated with stroke. The odds ratios (OR) were 2.11 (95%CI: 1.32-3.37) for males and 2.13 (95%CI: 1.24-3.65) for females after adjusting for age, socioeconomic status, health behaviors and health status. No statistical significant association was found between short sleep duration and stroke. Meanwhile, frequent sleep snoring was found to be associated with stroke in females (OR=1.63, 95% CI: 1.11-2.40).</p><p><b>CONCLUSION</b>Longer sleep duration was found to be associated with higher risk of stroke in both males and females. Frequent sleep snoring would increase the risk of stroke in females.</p>


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , China , Epidemiology , Odds Ratio , Prevalence , Risk Factors , Sleep , Snoring , Stroke , Epidemiology , Time Factors
14.
Chinese Journal of Radiology ; (12): 520-524, 2015.
Article in Chinese | WPRIM | ID: wpr-477883

ABSTRACT

Objective To investigate the value of susceptibility?weighted imaging (SWI) for characterization of small hepatocellular carcinoma (sHCC) in cirrhotic livers. Methods Two hundred seventy?two patients suspiciousof HCC underwent conventional MR imaging and susceptibility?weighted imaging (SWI). Two hundred and five patients were excluded due to either size larger than 3.0 cm, no cirrhosis or HCC. Finally, a total of 84 hepatocellular nodules in 67 patients were included in this prospective study. There were 22 DNs in 12 cases, 8 DNs with HCC foci in 7 cases, and 54 overt HCCs in 48 cases. Two abdominal radiologists independently evaluated signal intensity and enhancing pattern using conventional MRI set and conventional MRI combining with SWI set. A five?point scale was performed to evaluate diagnostic confidence of HCC. Kappa analysis was performed to assess interobserver agreement of the two sets by two readers.The diagnostic performance and confidence level were compared for each image set,ROC was used to evaluate the diagnostic efficiency.Results Good interobserver agreement was identified with a Kappa value of 0.923 for conventional MRI set and 0.865 for conventional MRI combining with SWI set, respectively. The diagnostic sensitivity, specificity, accuracy, and area under the alternative?free response ROC (Az) were 80.6% and 80.6%, 81.8% and 77.3%, 81.0% and 79.8%, 0.804 and 0.782 using conventional MRI set, and 93.5%and 85.5%, 90.9%and 86.4%, 92.9%and 85.7%, 0.898 and 0.859 using conventional MRI combining with SWI set for reader 1 and reader 2, respectively.The diagnostic confidence level of conventional MRI combining with SWI set for diagnosis of HCC with less than 2 cm in size(n=36) was significantly higher than that of conventional MRI (reader 1, 3.86±0.47 vs 3.40±0.91;reader 2, 3.85±0.57 vs 3.41±0.92;t values were 3.733 and 2.468, P were 0.001 and 0.018).Conclusion SWI can provide additional valuable information and improve diagnostic performance for characterization of sHCC in cirrhotic livers.

15.
Chinese Journal of Pathology ; (12): 301-306, 2014.
Article in Chinese | WPRIM | ID: wpr-292304

ABSTRACT

<p><b>OBJECTIVE</b>To study the clinical features, pathologic findings and prognosis of patients with dysplastic nodules of liver (DN) and early hepatocellular carcinomas (eHCC).</p><p><b>METHODS</b>One hundred and forty-five archival cases previously diagnosed as DN or eHCC or well-differentiated HCC during the period from 2000 to 2009 were retrieved and reevaluated with the new diagnostic criteria by two experienced pathologists, according to International Consensus Group for Hepatocellular Neoplasia (ICGHN) 2008. Immunohistochemical study (EnVision method) for CD34, HSP70, glutamine synthetase, glypican 3 and Ki-67 was carried out. The original diagnosis and diagnosis after review were compared and correlated with the survival data of the patients, with statistical analysis.</p><p><b>RESULTS</b>With the new criteria, 16 cases were diagnosed as low-grade DN, 50 cases as high-grade DN, 72 cases as DN with microinvasion, 7 cases as advanced HCC. Slide review showed no diagnostic discrepancy in 112 cases (77.2%). Amongst the 33 (22.8%) underdiagnosed cases, there were 7 cases of advanced HCC initially diagnosed as DN or DN with microinvasion and 26 cases of eHCC initially diagnosed as high-grade DN. Kaplan-Meier analysis showed that the diagnosis of high-grade DN or early HCC carried no statistically significant difference in overall survival (P = 0.778, 0.677) or disease-free survival (P = 0.949, 0.700) in all patients and in patients with no history of HCC. The co-existence of advanced HCC in patients with DN or eHCC significantly correlated with overall survival (P = 0.004) but not with disease-free survival (P = 0.079).</p><p><b>CONCLUSIONS</b>The new diagnostic criteria by ICGHN 2008 are useful in delineating high-grade DN and eHCC. The overall survival and disease-free survival of patients with eHCC or high-grade DN undergoing hepatectomy show no statistically significant difference. Patients with DN or eHCC have better prognosis than patients with advanced HCC, though there is still a high risk of tumor recurrence.</p>


Subject(s)
Female , Humans , Male , Middle Aged , Antigens, CD34 , Metabolism , Carcinoma, Hepatocellular , Metabolism , Pathology , General Surgery , Cell Transformation, Neoplastic , Disease-Free Survival , Follow-Up Studies , HSP70 Heat-Shock Proteins , Metabolism , Hepatectomy , Kaplan-Meier Estimate , Ki-67 Antigen , Metabolism , Liver Cirrhosis , Metabolism , Pathology , General Surgery , Liver Neoplasms , Metabolism , Pathology , General Surgery , Survival Rate
16.
Chinese Journal of Radiology ; (12): 288-293, 2014.
Article in Chinese | WPRIM | ID: wpr-447745

ABSTRACT

Objective To compare the MR features of small hepatocellular carcinoma (sHCC) and small intrahepatic mass-forming cholangiocarcinoma (sIMCC) (≤ 3 cm) and improve the accuracy in diagnosis.Methods Imaging studies of 318 patients with 351 sHCCs and 42 patients with 47 sIMCCs were retrospectively reviewed.Signal intensity on T2WI and on each phase of dynamic enhanced imaging,enhancement patterns,and accompanying findings of the two groups were compared by qualitative and quantitative studies.The qualitative imaging features of tumors were compared by the x2 test and the Fisher exact test,and the statistically significant variables obtained from univariate analysis were used to conduct multivariate stepwise logistic regression analysis.Enhancement pattern between sHCCs with elevated AFP and normal AFP were assessed by thex2 test.Results Multivariate analysis indicated that signal features of enhancement pattern and the accompanying findings of tumor capsule and hepatic capsule retraction were key predictors in differentiating sHCC from sIMCC:Wash-out pattern (276/351) with enhanced tumor capsule (275/351) highly indicated sHCC,while progressive enhancement pattern (27/47) with hepatic capsule retraction (8/47) indicated the diagnosis of sIMCC (P < 0.01).Compared with sHCC with normal AFP,atypical patterns as progressive (n =4) and stable enhancement (n =32) were more commonIy seen in lesions with elevated AFP,dynamic enhancement pattern was different between the two subgroups (x2 =8.241,P < 0.05).Conclusions Enhancement patterns and the accompanying tumor capsule and hepatic capsule retraction were the most important predictors in differentiating sHCC from sIMCC.In addition,enhancement pattern was relatively more typical in sHCCs with normal AFP which provided valuable information in diagnosis for clinicians.

17.
Article in Chinese | WPRIM | ID: wpr-440239

ABSTRACT

Microglia can be activated immediately after acute cerebral ischemia and play a role of double-edged sword of nerve repair and neurotoxicity.Studies in recent years have suggested that this dual role of microglia can be achieved by a Toll-like receptor 2 (TLR2) signal transduction pathway.Therefore,reasonable regulation of TLR2 expression of microglia may improve the therapeutic effect of cerebral ischemia to a certain extent.This article reviews the mechanisms of TLR2 in cerebral ischemia and the possible interventions.

18.
Chinese Journal of Radiology ; (12): 1014-1018, 2013.
Article in Chinese | WPRIM | ID: wpr-442686

ABSTRACT

Objective To investigate imaging characteristics of multistep hepatocarcinogenesis in cirrhotic livers on susceptibility-weighted imaging (SWI).Methods Seventy-three patients with 83 nodules in cirrhotic livers underwent hepatic MR imaging with SWI.Two radiologists reviewed MR images by consensus.Imaging characteristics of dysplastic nodules (DN),DN with malignant foci and hepatocellular carcinoma (HCC) were evaluated.Prussian blue staining was performed for semiquantification of hepatic iron content and above cirrhosis-associated nodules.Results Positive iron staining of background liver parenchyma was found in 69 of 73 patients and 4 HCC patients showed iron-negative staining of background liver parenchyma.Nine DNs appeared as hypointensity or isointensity with pathologically confirmed similar (n =7) or slightly decreased (n =2) iron deposition compared with background liver parenchyma.SWI detected 14 of 15 DNs with malignant foci.Seven patients appeared as homogeneous hyperintensity and 1 patient appeared as heterogeneous hyperintensity due to intratumoral hemorrhages.The remaining 6 patients demonstrated as nodule-in-nodule appearance with iron deposition in all background nodules,iron deposition with grade 1 in one internal HCC foci,and iron-free in 5 internal HCC foci.The remaining 50 patients with hepatic iron deposition had 55 HCC lesions.Three HCC lesions had iron deposition with grade 1 to 2 and the remaining 52 HCC lesions were pathologically iron-resistant.HCC appeared as hyperintensity compared with siderotic surrounding liver parenchyma.However,HCCs with diameter larger than 3 cm usually demonstrated heterogeneous hyperintensity due to intratumoral hemorrhage.Conclusions SWI could accurately demonstrate dynamic iron depletion on multistep hepatocarcinogenesis in cirrhotic livers.On SWI images,DNs appear as hypointensity due to siderosis and malignant nodules appear as hyperintensity due to iron depletion.

19.
Article in Chinese | WPRIM | ID: wpr-425082

ABSTRACT

Objective To study the clinicopathological features of primary and metastatic hepatic neuroendocrine carcinoma.Methods The records of 35 patients with primary hepatic neuroendocrine carcinoma and 35 patients with metastatic hepatic neuroendocrine carcinoma were retrospectively reviewed.These patients served as the primary group(priNET,n=35)and the metastasis group (metNET,n=35),respectively.Results There were significant differences between the two groups of patients in gender,site,size and number of tumor(P<0.05).Although there was no significant difference between the two groups in the distribution of the tumors in the two lobes of liver (P>0.05),priNET had more tumors localized to one lobe of liver while metNET had more tumors involving both lobes of liver(P<0.05).Conclusions Gender,size,site and number of tumor may play an important role in the differentiation of primary or metastatic hepatic neuroendocrine tumor.

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Article in Chinese | WPRIM | ID: wpr-427573

ABSTRACT

Objective To varify contrast-enhanced ultrasound (CEUS) quantitative analysis plaque enhancement is able to assess the intraplaque neovascularization.Methods The abdominal aortas were examined with CEUS in 9 atherosclerosis rabbits established by feeding high-fat diet.Sonographic examinations were performed with ultrasound instruments equipped with low mechanical index contrast imaging software.Contrast agent SonoVue was used with a dose of 0.2 ml,The enhanced intensity (EI) with the plaque and the ratio of EI within the plaque to that in the lumen of the carotid artery was calculated with QLab software,Each aorta specimen was stained with F8 (von willebrand factor) for mierovessel.The quantitative parameters EI and ratio were compared with the immunohistochemical study results.Results The mean value of EI and ratio were (3.91 ± 0.87)dB and 0.30 ± 0.06,respectively.Five specimens showed positive F8 staining and 4 showed negative.EI and ratio were significantly greater in positive group than in negative group [(4.47 ± 0.60) dB vs (3.22 ± 0.62) dB,0.34 ± 0.05 vs 0.25 ± 0.05].CEUS quantitative parameters EI ( r =0.779,P =0.013) and ratio ( r =0.693,P =0.019) were correlated to microvessels marked with F8,respectively.Conclusions It is histologically validated that CEUS quantifies the neovascularization in atherosclerosis plaques.CEUS provides a window for plaque risk stratification.

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