[Analysis of multimodal ultrasound in differential diagnosis of salivary gland tumors].

PURPOSE: To explore the differential diagnosis of salivary gland tumors by multimodal ultrasound and to establish a preliminary scoring system by assigning meaningful parameters. METHODS: Seventy-seven tumors from 69 patients with salivary gland tumors were examined by two-dimensional gray-scale ultrasound, color Doppler flow imaging (CDFI), superb microvascular imaging(SMI), real time tissue elastography(RTE) and acoustic radiation force impulse (ARFI). Different scoring schemes were obtained for the assignment and combination of meaningful parameters. The ROC curve of each scheme was drawn, and the one with the largest area under the curve was taken as the best scoring scheme. SPSS 25.0 software package was used for statistical analysis of the data. RESULTS: There were significant differences in tumor shape, boundary, posterior echo, blood flow resistance index, RTE grade and ARFI average value between benign and malignant salivary gland tumors(P<0.05). The scoring scheme 7, which was composed of the above 6 parameters, was the best scoring scheme. When each parameter was assigned a score of 1, the total score was 6, and the area under the curve was 0.944. The sensitivity, specificity and accuracy of distinguishing benign and malignant salivary gland tumors with ≥4 points were 80.0%, 98.4% and 94.8%, respectively. CONCLUSIONS: Application of multimodal ultrasound and establishment of a scoring system can effectively improve the ability of ultrasound in the differential diagnosis of benign and malignant salivary gland tumors.

[Analysis of multimodal ultrasound in differential diagnosis of salivary gland tumors].

PURPOSE: To explore the differential diagnosis of salivary gland tumors by multimodal ultrasound and to establish a preliminary scoring system by assigning meaningful parameters. METHODS: Seventy-seven tumors from 69 patients with salivary gland tumors were examined by two-dimensional gray-scale ultrasound, color Doppler flow imaging (CDFI), superb microvascular imaging(SMI), real time tissue elastography(RTE) and acoustic radiation force impulse (ARFI). Different scoring schemes were obtained for the assignment and combination of meaningful parameters. The ROC curve of each scheme was drawn, and the one with the largest area under the curve was taken as the best scoring scheme. SPSS 25.0 software package was used for statistical analysis of the data. RESULTS: There were significant differences in tumor shape, boundary, posterior echo, blood flow resistance index, RTE grade and ARFI average value between benign and malignant salivary gland tumors(P<0.05). The scoring scheme 7, which was composed of the above 6 parameters, was the best scoring scheme. When each parameter was assigned a score of 1, the total score was 6, and the area under the curve was 0.944. The sensitivity, specificity and accuracy of distinguishing benign and malignant salivary gland tumors with ≥4 points were 80.0%, 98.4% and 94.8%, respectively. CONCLUSIONS: Application of multimodal ultrasound and establishment of a scoring system can effectively improve the ability of ultrasound in the differential diagnosis of benign and malignant salivary gland tumors.

[Application of intraoral ultrasonic imaging in diagnosis and treatment of 18 patients with oral leukoplakia in non-masticatory mucosa].

PURPOSE: To explore the sonographic appearance of leukoplakia in non-masticatory oral mucosa, classifying mucosal leukoplakia according to the characteristics of sonogram, and providing reference for clinical diagnosis and treatment. METHODS: Eighteen patients (24 lesions) were diagnosed as oral leukoplakia at the Department of Oral Mucosal Diseases, Shanghai Ninth People's Hospital. The lesions were located in the tongue, floor of mouth, buccal mucosa and libial mucosa. Before the biopsy was taken, intra-oral path ultrasound was performed at the Department of Ultrasound to observe the lesion's extent, continuity, presence or absence of keratinization, the thickness of each layer in the epithelium, and color doppler flow imaging of the lesions. Quantitative analysis software 'Qontraxt' was used to randomly measure the relative echo intensity of the mucosal surface in leukoplakia areas, and summarize the keratinization type. SPSS 25.0 software package was used for statistical analysis of the data, and paired t test was used for inter-group comparison of the data. RESULTS: Oral leukoplakia sonograms showed that the epithelial layer appeared keratinization, the epithelial was thickened, and the echo was enhanced. The stratum intermedium showed a low echo thickening band, and the echo of partial lesions' surface decreased or the blood flow signal in oral mucosa increased. The hyperechoic band in the leukoplakia area was significantly thickened (P<0.001), and the echo was enhanced, with the tongue and buccal mucosa being the most significant. The hypoechoic band was significantly thicker (P<0.001), with the buccal mucosa and labial mucosa being the most significant. The surface and stratum corneum echo intensity values were determined by Qontraxt quantitative analysis software to determine whether there were keratinization and the keratinization types. The echo intensity values was 43.28±9.33 in non-OLK area, 92.88±3.12 in OLK with orthokeratosis, and 84.75±5.76 in OLK with parakeratosis. CONCLUSIONS: Ultrasound imaging can effectively define mucosal leukoplakia and measure the thickness of each layer in the epithelium. In addition, special adjoint changes such as ulcers, infections and cancerous changes can be detected. Intraoral ultrasonic imaging can provide imaging evidence for clinical diagnosis, treatment planning and post-treatment follow-up and contribute to avoid unnecessary mucosal iatrogenic injury or recurrence of disease after treatment.

[The value of ultrasonic elastography in diagnosis of salivary gland lesions in patients with Sjogren's syndrome].

PURPOSE: The present study was aimed to clinically evaluate transitional treatment of pulpitis during pregnancy. METHODS: Sixty pregnant women with pulpitis were divided into the first, second and third trimester. They were anesthetized locally using STA system combined with psychological intervention during treatment. The teeth were given one-appointment root canal preparation and filled with vitapex pasta. Normal obturation of the root canal was conducted after delivery. The effects of dental treatment, pregnancy outcomes and neonatal health status were observed. Data of the survey were analyzed by SPSS 20.0 software package, including Student's t test and chi-square test. RESULTS: The symptoms of pulpitis were significantly improved 24h after treatment,and the effective rate was 96.7%. The difference of VAS before and after treatment was statistically significant (P<0.05). Patients had no discomfort till the end of pregnancy,and the success rate was 98.3%. No adverse pregnancy outcomes were observed after treatment during different periods of pregnancy. Neonatal health was good. Significant differences were not found in birth gestational age, body weight, malformations, and neonatal complications between three treatment periods (P>0.05). CONCLUSIONS: Transitional treatment of pulpitis during pregnancy is a safe and effective procedure and worthy of wide use clinically.

Egr-1 promotes cell proliferation and invasion by increasing ß-catenin expression in gastric cancer.

BACKGROUND: Abnormal expression of early growth response gene 1 (Egr-1) and ß-catenin may play a crucial role in the development and progression of human cancer. However, little is known about the expression and underlying molecular mechanisms in which Egr-1 and ß-catenin are involved in the development and progression of gastric cancer. AIMS: The purpose of this study was to elucidate the potential relationship between Egr-1 and ß-catenin expression in gastric cancer, which contributes to finding new molecular carcinogenesis as a potential therapeutic target for gastric cancer. METHODS: In a sample of 102 cases of human gastric cancer, the expression of Egr-1 and ß-catenin was detected using immunohistochemistry. Egr-1 gene was transfected into gastric cancer SGC7901 cells and its role in proliferation and cell invasion was detected by MTT assay, flow cytometry, wound-healing and transwell invasion assay. Western blot analysis was used to study the expression of ß-catenin and cyclin D1 proteins. RESULTS: Upregulated Egr-1 and ß-catenin protein expression were strongly correlated with cancer progression and depth of invasion in gastric cancer. ß-catenin, present mainly in cytoplasmic and nucleus of gastric cancer cells, was also positively correlated with Egr-1 expression in gastric cancer. Furthermore, the overexpression of Egr-1 upregulated ß-catenin expression level, promoted cell proliferation, increased cell population in S-phase and enhanced gastric cancer cell migration and invasion in vitro. CONCLUSIONS: Egr-1 might contribute to gastric cancer proliferation and invasion through activation of the ß-catenin signaling pathway.