lncRNA FAS-AS1 served as a diagnostic biomarker of end-stage renal disease and mediated vascular calcification via regulating oxidative stress and inflammation.

PURPOSE: Vascular calcification is a frequently occurring complication of end-stage renal disease (ESRD). This study focused on the significance of long non-coding RNA Fas cell surface death receptor-antisense 1(lncRNA FAS-AS1) in ESRD-related vascular calcification aiming to explore a potential biomarker for the detection. METHODS: The study enrolled 65 healthy individuals, 79 ESRD patients (48 patients with vascular calcification), and 93 early-stage (I-IV) chronic kidney disease (CKD) patients. The expression of FAS-AS1 in serum was evaluated by real-time quantitative polymerase chain reaction (PCR). The diagnostic potential of FAS-AS1 was assessed in discriminating ESRD patients, vascular calcification, and the severity of vascular calcification. In vitro, the vascular smooth muscle cells (VSMCs) were treated with a hyperphosphatemia medium to evaluate the effect of FAS-AS1 on VSMCs calcification. RESULTS: Elevated serum FAS-AS1 was observed in ESRD patients, which could discriminate from healthy individuals and early-stage CKD patients. FAS-AS1 was associated with the development of ESRD and the occurrence of vascular calcification. FAS-AS1 was also upregulated in vascular calcification patients, especially the patients with severe calcification, which showed diagnostic significance in evaluating vascular calcification degrees. Calcified VSMCs showed significantly increased levels of Ca2+, reactive oxygen species (ROS), tumor necrosis factor-α (TNF-α), and interleukin 6 (IL-6), which was attenuated by silencing FAS-AS1. CONCLUSIONS: FAS-AS1 discriminated ERSD patients and was associated with the occurrence of vascular calcification. The knockdown of FAS-AS1 suppressed hyperphosphatemia-induced vascular calcification via alleviating oxidative stress and inflammation.

Risk of second primary cancers in patients with rectal neuroendocrine neoplasms: a surveillance, epidemiology, and end results analysis.

Background: While an elevated risk of second primary cancers (SPCs) has been observed in many other cancers, risk of SPCs has not been quantified in patients with rectal neuroendocrine neoplasms (NENs). Methods: Survivors of primary rectal NENs diagnosed between 2000 and 2018 were identified from the Surveillance, Epidemiology, and End Results (SEER)-18 registries. Relative risk of SPCs was estimated as the standardized incidence ratio (SIR), which was calculated using SEER*Stat software. Results: Between 2000 and 2018, a total of 15836 patients diagnosed with rectal NENs, of whom 1436 (9.1%) received diagnosis of SPCs (SIR: 1.19, 95%CI: 1.13-1.26). The majority of patients were aged 50-69 and had their first cancer diagnosed at the localized stage. Male survivors had a higher propensity for developing SPCs overall, while female survivors exhibited higher risks of specific SPCs. Age at diagnosis of rectal NENs influenced the risk of SPCs, with younger patients having greater risks. A statistically significant increase in the incidence of SPCs was observed among patients aged 30-64 years. Black patients had higher relative risks of certain SPCs, while White patients had a lower risk of subsequent melanoma. Trend analysis revealed that the highest excess burden of SPCs was observed in the years 2000 to 2002. Risk of SPCs remained elevated within the first four years post-diagnosis for survivors of rectal NENs, but diminished thereafter. Conclusion: The study revealed that individuals who survived rectal NENs were at an elevated risk of developing SPCs compared to the general population. Our results hold important implications for the formulation of lifelong surveillance recommendations for cancer survivors.

Evaluation of the prognostic value of lncRNA UCA1 combined with extravascular lung water index and lung ultrasound score in patients with acute lung injury.

INTRODUCTION: Acute lung injury (ALI) is a common and rapidly developing critical inflammatory lung disease in clinic. This study investigated the predictive value of lncRNA UCA1, extravascular lung water index (EVLWI), and lung ultrasound score (LUS) in predicting the overall outcome of patients with ALI. METHODS: Patients with ALI were recruited for detecting the content of UCA1, EVLWI, and LUS. All patients were cataloged into the survival group and death group according to the prognosis. The discrepancy of UCA1, EVLWI, and LUS was compared in the two groups. The prognostic significance of UCA1, EVLWI, LUS, and their combination was estimated by logistic regression and the receiver operating characteristic (ROC) curve. RESULTS: The levels of UCA1, LUS, and EVLWI were elevated in the death group compared with the survival group. The content of UCA1 was positively correlated with LUS scores and EVLWI scores. UCA1, LUS, and EVLWI were independent indicators of predicting the prognosis of patients with ALI. The ROC curve reflected that UCA1, LUS, and EVLWI could forecast the endpoint events of patients with ALI whereas their combined approach had the highest accuracy. CONCLUSION: Highly expressed UCA1 is a biomarker in forecasting the outcome of patients with ALI. It had high accuracy in predicting the endpoint of patients with ALI when combined with LUS and EVLWI.

Combining serum AFP and CEUS LI-RADS for better diagnostic performance in Chinese high-risk patients.

PURPOSE: To evaluate and compare the diagnostic performance of revised contrast-enhanced ultrasound (CEUS) Liver Imaging Reporting and Data System version by combining LR-M category and serum alpha-fetoprotein (AFP) under different cut-off values. MATERIAL AND METHODS: This retrospective study enrolled 152 high-risk patients with 152 histology-proven nodules. For revised LI-RADS, nodules in LR-M with different elevated AFP thresholds have been reclassified as the LR-5 category. The diagnostic performances of original and revised CEUS LI-RADS were evaluated and compared. RESULTS: To compare with the original version, the sensitivity of revised LR-5 (adjusted with AFP value > 200 ng/ml or 400 ng/ml) for the diagnosis of hepatocellular carcinoma (HCC) improved from 52.5 to 69.2% or 65.0%, respectively (both p < 0.001) without compromising specificity (87.5% vs. 71.9% or 78.1%, respectively, both p > 0.05). For the diagnosis of non-HCC malignancy, the specificity of the LR-M after reclassification was improved (69.6% vs. 84.4% or 80.7%, respectively, both p < 0.001) with a non-significant sensitivity reduction (100.0 vs. 70.6% or 82.4%, respectively, both p > 0.05). After modification, the sensitivity of LR-5 also increased to 69.1% or 64.9% (both p < 0.001), while the specificity and PPV did not change (both p > 0.05) for larger nodules (> 20 mm). CONCLUSION: The diagnostic performance of CEUS LI-RADS can be further improved by reclassifying LR-M nodules with elevated AFP thresholds to LR-5.

Application value of conventional ultrasound and real-time shear wave elastography in patients with type 2 diabetic polyneuropathy.

PURPOSE: To explore the application value of conventional ultrasound and real-time shear wave elastography (SWE) to the tibial nerve (TN) and the common peroneal nerve (CPN) in diabetic peripheral neuropathy (DPN). MATERIALS AND METHODS: Thirty-three healthy volunteers, 33 diabetic patients without DPN, and 30 diabetic patients with DPN were enrolled in this study. The anteroposterior diameter (APD), the cross-sectional area (CSA), and the perimeter of the TN and the CPN were measured by conventional ultrasound, and the stiffness of the nerves was measured by SWE. RESULTS: The conventional ultrasound parameters and stiffness of the TN in patients with DPN were significantly larger than those of the other two groups (P < 0.01). The conventional ultrasound parameters of the CPN were significantly higher in patients with DPN than in the other two groups (P < 0.01).The patients with DPN demonstrated a greater stiffness of the CPN compared to the control group (P < 0.05). The comparison of all parameters for the left and right TNs and CPNs among the three groups showed no significant difference. The area under the curve (AUC) of TN stiffness for the diagnosis of DPN was significantly greater than that of conventional ultrasound parameters. CONCLUSION: The conventional ultrasound parameters and the stiffness of the TN and the CPN were significantly higher in patients with DPN. The stiffness of the TN could better diagnose DPN than conventional ultrasound parameters. In short, conventional ultrasound and SWE of nerves are of good application value in the diagnosis of DPN.

Virtual touch tissue imaging and quantification (VTIQ) in the evaluation of breast lesions: The associated factors leading to misdiagnosis.

PURPOSE: To investigate the factors that could cause a misdiagnosis in virtual touch tissue imaging and quantification (VTIQ) when differentiating benign and malignant breast lesions, and to analyze the imaging characteristics of those lesions with incorrect findings. METHODS: The conventional ultrasound (CUS) features and the VTIQ parameters of 153 benign lesions and 99 malignant lesions were retrospectively analyzed and compared with histopathological and/or core-needle biopsy (CNB)-proven results. Independent variables that led to inaccurate VTIQ results were selected by binary logistic regression analysis. RESULTS: The maximum shear wave speed (SWS-max), the mean SWS (SWS-mean), the minimum SWS (SWS-min), the lesion-to-fat SWS ratio (SWS-L/F), and the lesion-to-gland SWS ratio (SWS-L/G) in malignant lesions were significantly higher than those in benign lesions (all P < 0.001). The false-positive rate (FPR) of benign lesions and the false-negative rate (FNR) of malignant lesions were 9.8% and 19.2%, respectively, using an SWS-max cut-off value of 4.46 m/s. Diameter, depth, and posterior acoustic features were independent variables related to false-positive VTIQ findings (P: 0.049, 0.010 and 0.032, respectively). The invasive status and the histologic grade of infiltrating carcinoma were significantly associated with false-negative VTIQ findings (P: 0.026 and 0.015). CONCLUSION: Diameter, depth, posterior acoustic features, invasive status, and histologic grade have a significant influence on the accuracy of VTIQ results, and these characteristics of breast lesions should be taken into account when interpreting the results of VTIQ examinations.

Pre-operative Conventional Ultrasound and Sonoelastography Evaluation for Predicting Axillary Lymph Node Metastasis in Patients with Malignant Breast Lesions.

The objective of our study was to evaluate the association between the sonoelastography features of breast tumor and axillary lymph node metastasis (ALNM) in patients with breast cancer. In a cohort of 106 women with breast cancer, the conventional ultrasound features and elasticity parameters by elasticity imaging and Virtual Touch Tissue Imaging & Quantification (VTIQ) were retrospectively analyzed. Ultrasound and elastography findings were compared with pathologic axillary lymph node status. Receiver operating characteristic curve analysis was used to evaluate diagnostic performance. Pathologically, the overall incidence of ALNM was 39.6% (42/106) in the final analysis. ALNM was significantly more frequent in tumors with elasticity imaging scores >4.5, maximal shear wave velocity values (Smax) >6.42 m/s and mean shear wave velocity values (Smean) >5.66 m/s, respectively. The sensitivity, specificity and accuracy were 78.6%, 54.7% and 64.2% for elasticity imaging score; 85.7%, 54.7% and 67.0% for Smax; and 59.5%, 79.7% and 71.7% for Smean, respectively Elastography features, including elasticity imaging score and VTIQ, can be used to supplement conventional ultrasound to predict ALNM in patients with breast cancers.

Comparison of strain and acoustic radiation force impulse elastography of breast lesions by qualitative evaluation.

OBJECTIVES: To compare the diagnostic performance of conventional strain elastography (CSE) and acoustic radiation force impulse (ARFI) induced SE for qualitative assessment of breast lesions and evaluate the additional value of the two techniques combined with Breast Imaging Reporting and Data System (BI-RADS) respectively for the differentiation of benign and malignant breast lesions. METHODS: In a cohort of 110 women, the conventional ultrasound (US) features and the elasticity scores of CSE and ARFI induced SE were recorded. The diagnostic performances of BI-RADS, elastography and BI-RADS plus elastography were evaluated, including the area under the receiver operating characteristic curve (AUROC), sensitivity, specificity and accuracy. RESULTS: Pathologically, there were forty-eight malignant and sixty-two benign breast lesions in the final analysis. The AUCs for CSE and ARFI induced SE are similar (CSE, 0.807; ARFI induced SE, 0.846; p > 0.05), however, the specificity of the latter method was significantly higher than that of CSE (83.9% vs. 58.1%, p = 0.004) in differentiating breast lesions. The accuracy and specificity of BI-RADS plus ARFI induced SE (84.5%, 80.6%, respectively) were significantly higher than BI-RADS alone (73.6%, 54.8%, respectively) and BI-RADS plus conventional SE (72.7%, 56.5%, respectively), respectively (p < 0.05) without loss of sensitivity. CONCLUSIONS: Our study showed that BI-RADS plus ARFI induced SE had a better diagnostic performance in the diagnosis of breast lesions in comparison with BI-RADS alone or BI-RADS plus CSE.

Differentiation of metastatic cervical lymph nodes with ultrasound elastography by virtual touch tissue imaging: preliminary study.

OBJECTIVES: The purpose of this study was to investigate the clinical usefulness of acoustic radiation force impulse elastography for the differential diagnosis of cervical lymph nodes. METHODS: Virtual touch tissue imaging (Siemens Medical Solutions, Mountain View, CA) was analyzed in 81 patients (mean age, 46.6 years; range, 5-82 years) with 81 lymph nodes (45 metastatic nodes and 36 benign nodes). RESULTS: Most benign lymph nodes were slightly darker or the same in brightness compared with surrounding tissue, whereas most metastatic nodes were obviously darker. The mean area ratio of benign lymph nodes ± SD (1.05 ± 0.15) was statistically lower than the mean area ratio of metastatic lymph nodes (1.39 ± 0.20; P < 0.001). The area ration cutoff level for metastatic lymph nodes was estimated to be 1.16. With the use of a receiver operating characteristic curve with this cutoff value, the area ratio predicted malignancy with sensitivity of 91.1%, specificity of 83.3%, and an area under the curve of 0.925. CONCLUSIONS: Acoustic radiation force impulse imaging is feasible for cervical lymph nodes. The Virtual Touch tissue imaging technique can complement conventional sonography, thereby making it easier to diagnose cervical lymph nodes.