Epidemiological patterns of chronic kidney disease attributed to type 2 diabetes from 1990-2019.

Background: This study investigates the burden of chronic kidney disease attributed to type 2 diabetes (CKD-T2D) across different geographical locations and time periods from 1990 to 2019. A total of 204 countries and regions are included in the analysis, with consideration given to their socio-demographic indexes (SDI). The aim is to examine both spatial and temporal variations in CKD-T2D burden. Methods: This research utilized data from the 2019 Global Burden of Diseases Study to evaluate the age-standardized incidence rates (ASIR), Disability-Adjusted Life Years (DALYs), and Estimated Annual Percentage Change (EAPC) associated with CKD-T2D. Results: Since 1990, there has been a noticeable increase of CKD age-standardized rates due to T2D, with an EAPCs of 0.65 (95% confidence interval [CI]: 0.63 to 0.66) for ASIR and an EAPC of 0.92 (95% CI: 0.8 to 1.05) for age-standardized DALYs rate. Among these regions, Andean Latin America showed a significant increase in CKD-T2D incidence [EAPC: 2.23 (95% CI: 2.11 to 2.34) and North America showed a significant increase in CKD-T2D DALYs [EAPC: 2.73 (95% CI: 2.39 to 3.07)]. The burden was higher in male and increased across all age groups, peaking at 60-79 years. Furthermore, there was a clear correlation between SDI and age-standardized rates, with regions categorized as middle SDI and High SDI experiencing a significant rise in burden. Conclusion: The global burden of CKD-T2D has significantly risen since 1990, especially among males aged 60-79 years and in regions with middle SDI. It is imperative to implement strategic interventions to effectively address this escalating health challenge.

Validated preoperative computed tomography risk estimation for postoperative hepatocellular carcinoma recurrence.

AIM: To develop and validate a risk estimation of tumor recurrence following curative resection of operable hepatocellular carcinoma (HCC). METHODS: Data for 128 patients with operable HCC (according to Barcelona Clinic Liver Cancer imaging criteria) who underwent preoperative computed tomography (CT) evaluation at our hospital from May 1, 2013 through May 30, 2014 were included in this study. Follow-up data were obtained from hospital medical records. Follow-up data through May 30, 2016 were used to retrospectively analyze preoperative multiphasic CT findings, surgical histopathology results, and serum α-fetoprotein and thymidine kinase-1 levels. The χ2 test, independent t-test, and Mann-Whitney U test were used to analyze data. A P-value of < 0.05 was considered statistically significant. RESULTS: During the follow-up period, 38 of 128 patients (29.7%) had a postoperative HCC recurrence. Microvascular invasion (MVI) was associated with HCC recurrence (χ2 = 13.253, P < 0.001). Despite postoperative antiviral therapy and chemotherapy, 22 of 44 patients with MVI experienced recurrence after surgical resection. The presence of MVI was 57.9% sensitive, 75.6% specific and 70.3% accurate in predicting postoperative recurrence. Of 84 tumors without MVI, univariate analysis confirmed that tumor margins, tumor margin grade, and tumor capsule detection on multiphasic CT were associated with HCC recurrence (P < 0.05). Univariate analyses showed no difference between groups with respect to hepatic capsular invasion, Ki-67 proliferation marker value, Edmondson-Steiner grade, largest tumor diameter, necrosis, arterial phase enhanced ratio, portovenous phase enhanced ratio, peritumoral enhancement, or serum α-fetoprotein level. CONCLUSION: Non-smooth tumor margins, incomplete tumor capsules and missing tumor capsules correlated with postoperative HCC recurrence. HCC recurrence following curative resection may be predicted using CT.

Diffusion-weighted MR imaging in prediction of response to neoadjuvant chemotherapy in patients with breast cancer.

This study aims to evaluate the potential of apparent diffusion coefficient (ADC) derived from diffusion-weighted MR imaging for predicting the treatment response to neoadjuvant chemotherapy (NACT) in patients with breast cancer. Magnetic resonance imaging was performed prior to NACT and after two cycles of NACT. The correlation between mean ADCpre values, mean ADCpost values, changes in ADC values and changes in tumor diameters after NACT was examined using Spearman rank correlation. A total of 164 breast cancers were enrolled in this study. Mean ADCpre values of responders ([0.85 ± 0.16] × 10-3 mm2/s) and non-responders ([0.84 ± 0.21] × 10-3 mm2/s) had no significant difference (P = 0.759). While mean ADCpost value of responders was significantly higher than that of non-responders ([1.17 ± 0.37] × 10-3 mm2/s vs. [1.01 ± 0.28] × 10-3 mm2/s; P = 0.002). Both mean ADCpost values (r = 0.288, P = 0.000) and changes in mean ADC values (r = 0.222, P = 0.004) were positively correlated to changes in tumor diameter after NACT, except for mean ADCpre values (r = 0.031, P = 0.695). Our results indicated that mean ADCpost values and changes in ADC values after NACT might be a biological marker for assessing the efficacy of chemotherapy.

GSTT1 and GSTM1 polymorphisms predict treatment outcome for breast cancer: a systematic review and meta-analysis.

Observational studies have reported controversial results on the association between GSTT1 and GSTM1 genotypes and treatment outcome of breast cancer. The purpose of this study is to evaluate the association between GSTT1 and GSTM1 and treatment outcome in breast cancer patients. Eligible studies were searched in PubMed, EMBASE, Cochrane Library, and China National Knowledge Infrastructure databases. A random-effect model or fixed-effect model was used to calculate the overall combined risk estimates. Twenty-one studies with a total of 4990 patients were included in this meta-analysis. The GSTM1 null genotype (odds ratio (OR) = 1.33, 95 % confidence interval (CI) 1.01-1.75, P = 0.046) and GSTT1/GSTM1 double null genotype (OR = 2.22, 95 % CI 1.02-4.84, P = 0.045) were significantly associated with an increased tumor response. A reduced overall survival (hazard ratio (HR) = 0.84, 95 % CI 0.72-0.98, P = 0.024) was observed in GSTM1 null genotype, especially in mixed descent (HR = 0.77, 95 % CI 0.61-0.96, P = 0.018) and large sample size (HR = 0.85, 95 % CI 0.72-0.99, P = 0.033). Evidence of publication bias was observed in GSTM1 genotype rather than in GSTT1 genotype. This meta-analysis suggests that GSTM1 null and GSTT1/GSTM1 double null polymorphisms might be significantly associated with an increased tumor response. However, the GSTM1 null genotype might be significantly associated with a reduced overall survival. Future studies are warranted to confirm these findings.

Diagnostic performance of ADCs in different ROIs for breast lesions.

OBJECTIVE: The purpose of this study was to explore the diagnostic performance of apparent diffusion coefficient (ADC) values for breast lesions by different measuring methods and find out the optimum measuring method. METHODS: ADCW-mean and ADCW-min were obtained by whole-measurement method, while ADCmean and ADCmin were extracted by spot-measurement method. Four ADCs were analyzed by One-way ANOVA and Independent T-test. The diagnostic performances of these four ADCs were calculated by receiver operating characteristics (ROC) curves and the area under the curves (AUC) were compared through Z-test. RESULTS: For the whole-measurement method, there were significant differences between malignant and benign lesions (ADCW-mean=1.014±0.197 for malignant, ADCW-mean=1.650±0.348 for benign, F=37.511, P<0.001; ADCW-min=0.627±0.144 for malignant, ADCW-min=1.245±0.290 for benign, F=41.446, P<0.001), as well as the spot-measurement method (ADCmean=1.010±0.234 for malignant, ADCmean=1.648±0.392 for benign, F=34.580, P<0.001; ADCmin=0.817±0.203 for malignant, ADCmin=1.411±0.357 for benign, F=40.039, P<0.001). The optimal diagnostic threshold of ADCW-mean, ADCW-min, ADCmean, and ADCmin values were 1.223×10(-3) mm(2)/s, 0.897×10(-3) mm(2)/s, 1.315×10(-3) mm(2)/s, and 1.111×10(-3) mm(2)/s, respectively. ROC curves indicated that the AUC for ADCW-min (0.969) was statistically significant higher than the AUC for ADCW-mean (0.940; Z=2.473, p=0.013), ADCmean (0.919; Z=3.691, P=0.000), and ADCmin (0.928; Z=3.634, P=0.000). The AUC for ADCW-mean was also significantly higher than the AUC for ADCmean (Z=2.863, P=0.004). CONCLUSION: The results provided evidence that the most reliable and accurate value in demonstrating the limitation of diffusion may be ADCW-min, and it has the highest diagnostic value in distinguishing breast lesions from malignant to benign.