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Objective: To investigate the risk factors of microvascular invasion (MVI) in China liver cancer staging system stage Ⅰa (CNLC Ⅰa) hepatocellular carcinoma (HCC), and develop a nomogram for predicting MVI based on clinical and radiographic data. Methods: This retrospective study focused on CNLC Ⅰa HCC patients who underwent radical resection at the Cancer Hospital, Chinese Academy of Medical Sciences from January 2016 to December 2020. Patients' clinical characteristics and laboratory test results and pre-surgery gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging results were collected. The clinical and radiographic risk factors for MVI were identified by univariate and multivariate logistic regression analyses and used for the construction of the predictive nomogram. The nomogram model was then internally validated, and its performance was assessed. Results: A total of 104 patients were divided into the MVI-positive group (n=28) and the MVI-negative group (n=76). Multivariate logistic regression analysis at the P<0.1 level identified serum alpha-ferroprotein >7 ng/ml, total bilirubin >21 μmol/L, prothrombin time >12.5 s, non-smooth margin, and incomplete or absent capsule as risk factors of MVI, based on which a nomogram model was built. The model achieved an area under the curve (AUC) value of 0.867 (95% confidence interval, 0.791-0.944) in the internal validation. The sensitivity and specificity of the nomogram model were 0.786 and 0.829, respectively, with the prediction curve nearly overlapping the ideal curve. Based on the Hosmer-Lemeshow test, the predicted and real results were not significantly different (P=0.956). Conclusions: The probability of MVI of CNLC Ⅰa HCC can be objectively predicted by the monogram model that quantifies the clinical and radiographic risk factors. The model can also help clinicians select individualized surgical plans to improve the long-term prognosis of patients.
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Objective: To investigate the risk factors of microvascular invasion (MVI) in China liver cancer staging system stage Ⅰa (CNLC Ⅰa) hepatocellular carcinoma (HCC), and develop a nomogram for predicting MVI based on clinical and radiographic data. Methods: This retrospective study focused on CNLC Ⅰa HCC patients who underwent radical resection at the Cancer Hospital, Chinese Academy of Medical Sciences from January 2016 to December 2020. Patients' clinical characteristics and laboratory test results and pre-surgery gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging results were collected. The clinical and radiographic risk factors for MVI were identified by univariate and multivariate logistic regression analyses and used for the construction of the predictive nomogram. The nomogram model was then internally validated, and its performance was assessed. Results: A total of 104 patients were divided into the MVI-positive group (n=28) and the MVI-negative group (n=76). Multivariate logistic regression analysis at the P<0.1 level identified serum alpha-ferroprotein >7 ng/ml, total bilirubin >21 μmol/L, prothrombin time >12.5 s, non-smooth margin, and incomplete or absent capsule as risk factors of MVI, based on which a nomogram model was built. The model achieved an area under the curve (AUC) value of 0.867 (95% confidence interval, 0.791-0.944) in the internal validation. The sensitivity and specificity of the nomogram model were 0.786 and 0.829, respectively, with the prediction curve nearly overlapping the ideal curve. Based on the Hosmer-Lemeshow test, the predicted and real results were not significantly different (P=0.956). Conclusions: The probability of MVI of CNLC Ⅰa HCC can be objectively predicted by the monogram model that quantifies the clinical and radiographic risk factors. The model can also help clinicians select individualized surgical plans to improve the long-term prognosis of patients.
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Objective To investigate the correlations of diffusion weighted imaging (DWI) with pathological grading,typing and clinical staging of cervical adenocarcinoma. Methods The data of 95 patients with cervical adenocarcinoma from May 2011 to February 2018 in Cancer Hospital Chinese Academy of Medical Sciences were collected for retrospective analysis.Before treatment,conventional MRI and DWI (b=0,800 s/mm2) were performed,and the apparent diffusion coefficient (ADC) value of cervical adenocarcinoma was measured.The ADC values were compared among different pathological grades,types,and clinical stages. Results The mean ADC value was (1.00±0.25)×10-3 mm2/s in the poorly differentiation group,(1.09±0.25)×10-3 mm2/s in the moderately differentiation group,and (1.22±0.20)×10-3 mm2/s in the well differentiation group,which showed significant difference between the poorly and well differentiation groups (P=0.002).The mean ADC values were (1.04±0.24) ×10-3 mm2/s and (1.21±0.26)×10-3 mm2/s in the endocervical adenocarcinoma (usual type) group and mucinous carcinoma group,respectively,which showed significant difference (P=0.005). Conclusions The worse differentiation of cervical adenocarcinoma corresponded to the lower ADC value.The ADC value of mucinous carcinoma was higher than that of endocervical adenocarcinoma (usual type).
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Femelle , Humains , Adénocarcinome/anatomopathologie , Imagerie par résonance magnétique de diffusion/méthodes , Imagerie par résonance magnétique/méthodes , Études rétrospectives , Tumeurs du col de l'utérus/imagerie diagnostiqueRÉSUMÉ
Objective To prepare the 99Tcm-survivin mRNA antisense peptide nucleic acid (PNA)and investigate its value as a gene imaging agent in tumor bearing mice and early diagnosis in tumor.Methods Survivin mRNA antisense PNA and mismatch PNA were synthesized.Four amino acids (Gly- (D)Ala-Gly-Gly) and Aba (4-aminobutyric acid) were linked to the 5' end of PNA.Gly- (D)Ala-Gly-Gly served as a chelating moiety for strong chelation of 99Tcm and Aba acted as a spacer to minimize the steric hindrance.PNAs were labeled with 99Tcm by the ligand-exchange method.The labeling efficiency and radiochemical purity were measured by HPLC and ITLC methods.There were five BALB/c nude mice bearing human lung carcinoma ( A549 ) in each of antisense PNA and mismatch PNA groups.Gene imaging of 99Tcm-survivin mRNA antisense and mismatch PNAs were performed at 1,2 and 4 h post the injection,respectively,and the T/NT ratio was measured by the method of ROI.The statistical comparisons of average values were performed with the two-group t-test for independent sample by SPSS 13.0.Results The product kept stable in vitro.The labeling efficiency of 99Tcm-survivin mRNA antisense PNA was (95.48 ±1.92)% and more than 85% after the incubation for24 h in serum.The radiochemical purity was > 95%.The labeling efficiency of mismatch PNA was similar to the antisense PNA.99Tcm-survivin mRNA antisense PNA was especially uptaken by tumor lesion,and its accumulation reached the top at 4 h post the injection.T/NT ratios at 1,2,and 4 h were 2.70 ± 0.28,3.44 ± 0.35,4.21 ± 0.63,respectively.In the comparison,the T/NT ratio of 99Tcm-survivin mRNA mismatch PNA at 4 h (3.12 ±0.50) was significantly lower (t =2.918,P =0.019).Conclusions 99Tcm-survivin mRNA antisense PNA has high labeling efficiency,good stability and no need of purification.Its characteristic of especial uptake by tumor lesion provides the potential value in early diagnosis of tumor.
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ObjectiveTo investigate the value of 99Tcm labeled survivin mRNA antisense peptide nucleic acid (PNA) as an imaging agent in the specific diagnosis for carcinoma.MethodsSurvivin mRNA antisense PNA was labeled directly with 99Tcm by the ligand-exchange method.Twenty nude mice with lung carcinoma A549 xenografts were randomly divided into 4 groups.Three groups were used for biodistribution study and one group was used for imaging study.Other twenty mice infected by staphylococcus aureus underwent the same procedure.The biodistribution and imaging of 99Tcm-survivin mRNA antisense PNA was studied at 1,2 and 4 h respectively after the intravenous injection in nude mice bearing lung carcinoma A549 xenografts or inflammation models.SPSS 13.0 was used in the study and all data were analyzed by t test.ResultsBiodistribution results showed that the highest radioactivity was found in the liver,and then in the kidney.Four hours after the administration of the imaging agent,the radioactivity ratios of target-tonon target (T/NT,tumor or inflamumatory lesions to the contralateral regions) in tumor model group were significantly higher than those in inflammation model group ( 3.69 ± 1.13 vs 2.03 ± 0.47,t =3.01,P =0.02 ).Tumors were clearly visible in the tumor model groups at 0.5 h and still clearly seen at 4 h after the injection of antisense PNA.On the contrary,inflammatory lesions could not be seen clearly.Conclusion 99Tcm labeled survivin mRNA antisense PNA can be used to distinguish tumor from inflammation and it may provide a new feasible method for specific tumor diagnosis.
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<p><b>OBJECTIVE</b>To evaluate prospectively the efficacy of ultrasonography (US), helical computed tomography (HCT), endoscopic ultrasonography (EUS) and magnetic resonance imaging (MRI) in the assessment of vascular invasion and lymph node metastasis in pancreatic carcinoma.</p><p><b>METHODS</b>Consecutive 68 patients with pancreatic carcinoma were studied. Results of each imaging techniques regarding vascular invasion and lymph node metastasis were compared with the surgical and pathological findings.</p><p><b>RESULTS</b>(1) US findings were confirmed moderately in accordance with surgical and pathological results in the evaluation of inferior cava vein, splenic artery and vein invasion of pancreatic carcinoma. HCT findings of evaluating superior mesenteric vein, portal vein, splenic vein were confirmed greatly in accordance with surgical and pathological results. The results of evaluating superior mesenteric artery, inferior cava vein, splenic artery, common hepatic artery, proper hepatic artery, celiac trunk, abdominal aorta were confirmed moderately in accordance with surgical and pathological results. MRI findings of evaluating superior mesenteric artery and vein, portal artery and vein were moderately in accordance with surgical and pathological results. EUS findings of evaluating splenic vein were confirmed greatly in accordance with surgical and pathological results, and moderately in accordance with surgical and pathological results in the evaluation of superior mesenteric vein. (2) EUS had the highest sensitivity (75.0%), accuracy (87.5%), and negative predictive values (91.7%) in the evaluation of lymph node metastasis. The sensitivity of HCT and MRI were 37.5% and 35.3%, which were significantly lower than that of EUS. The sensitivity of US was 18.7%, which was the lowest of all. In addition, the multivariate logistic regression analysis confirmed that EUS had an independent predictive value (OR: 34.50, 95%CI: 6.54 - 182.09).</p><p><b>CONCLUSION</b>Helical CT should be considered the most precise technique to evaluate vascular invasion. EUS had an independent predictive value with respect to tumor metastasis to regional lymph nodes.</p>
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Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Vaisseaux sanguins , Imagerie diagnostique , Anatomopathologie , Endosonographie , Méthodes , Métastase lymphatique , Imagerie par résonance magnétique , Méthodes , Invasion tumorale , Tumeurs du pancréas , Imagerie diagnostique , Anatomopathologie , Chirurgie générale , Études prospectives , Tomodensitométrie hélicoïdale , Méthodes , Échographie-doppler couleur , MéthodesRÉSUMÉ
<p><b>OBJECTIVE</b>To evaluate prospectively the efficacy and clinical significance of ultrasonography (US), helical computed tomography (HCT), endoscopic ultrasonography (EUS) and magnetic resonance imaging (MRI) in assessing locoregional invasion to the surrounding tissue or organs of primary pancreatic carcinoma.</p><p><b>METHODS</b>Sixty-eight consecutive patients with pancreatic carcinoma underwent US, HCT, EUS and MRI examinations before surgical exploration. All imaging results in terms of tumor size and locoregional invasion were assessed separately by two diagnostic radiologists and compared with the surgical and pathological findings.</p><p><b>RESULTS</b>Among the HCT, US, EUS and MRI examinations, EUS had the highest accuracy in assessing tumor size with a regression coefficient for the maximal and minimal diameter of 1.0250 (P = 0.0426) and 0.9873 (P < 0.0001), respectively. In the assessment of locoregional invasion to the surrounding tissue or organs, EUS also had the highest accuracy (75.8%) and sensitivity (80.0%), but MRI had the highest positive predicting value (97.4%). None of these four imaging techniques was significantly correlated with the surgical findings when analyzed by univariate logistic regression.</p><p><b>CONCLUSION</b>Endoscopic ultrasonography may be the most useful imaging technique in assessing tumor size, but for assessing loco-regional invasion of primary pancreatic carcinoma, combination of more than one imaging techniques may be necessary.</p>
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Adulte , Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Imagerie diagnostique , Méthodes , Endosonographie , Modèles logistiques , Imagerie par résonance magnétique , Invasion tumorale , Anatomopathologie , Tumeurs du pancréas , Imagerie diagnostique , Anatomopathologie , Chirurgie générale , Études prospectives , Scintigraphie , Tomodensitométrie hélicoïdale , Charge tumoraleRÉSUMÉ
Objective To evaluate the significance of multi-slice helical CT with multiplanar reconstruction in laryngeal carcinoma.Methods Thirty-five patients with laryngeal carcinoma were studied by helical CT,MPR were subsequently done.The lesion extent of the axial image findings,MPR findings and the combined image findings were compared with the pathological results respectively.The data were statistically analyzed.Results In the evaluation of the anterior commissure,the axial image findings,MPR findings and the combined image findings were 82.9%,68.6% and 91.4% in accuracy respectively,the results were statistically different(P0.05).The combined images were superior to the axial images and the MPR images in sensitivity,specificity and accuracy of the lesion extent.Conclusion The axial images could show the shape,size,extension of the tumor and the lymphadenopathy,MPR images displayed the shape,size and extension roundly and directly,they were the supplement for the axial images.Axial images combined with MPR could improve the accuracy in the diagnoses of laryngeal carcinoma.