Construction of machine learning models based on transrectal ultrasound combined with contrast-enhanced ultrasound to predict preoperative regional lymph node metastasis of rectal cancer.

Purpose: Constructing a machine learning model based on transrectal ultrasound (TRUS) combined with contrast-enhanced ultrasound (CEUS) to predict preoperative regional lymph node metastasis (RLNM) of rectal cancer and provide new references for decision-making. Materials and methods: 233 patients with rectal cancer were enrolled and underwent TRUS and CEUS prior to surgery. Clinicopathological and ultrasound data were collected to analyze the correlation of RLNM status, clinical features and ultrasound parameters. A 75% training set and 25% test set were utilized to construct seven machine learning algorithms. The DeLong test was used to assess the model's diagnostic performance, then chose the best one to predict RLNM of rectal cancer. Results: The diagnostic performance was most dependent on the following: MMT difference (36), length (30), location (29), AUC ratio (27), and PI ratio (24). The prediction accuracy, sensitivity, specificity, precision, and F1 score range of KNN, Bayes, MLP, LR, SVM, RF, and LightGBM were (0.553-0.857), (0.000-0.935), (0.600-1.000), (0.557-0.952), and (0.617-0.852), respectively. The LightGBM model exhibited the optimal accuracy (0.857) and F1 score (0.852). The AUC for machine learning analytics were (0.517-0.941, 95% CI: 0.380-0.986). The LightGBM model exhibited the highest AUC (0.941, 95% CI: 0.843-0.986), though no statistic significant showed in comparison with the SVM, LR, RF, and MLP models (P > 0.05), it was significantly higher than that of the KNN and Bayes models (P < 0.05). Conclusion: The LightGBM machine learning model based on TRUS combined with CEUS may help predict RLNM prior to surgery and provide new references for clinical treatment in rectal cancer.

Assessment of the effects of transforming growth factor beta1 (TGF-ß1)-Smad2/3 on fibrosis in rat myofascial trigger points using point shear wave elastography.

Background & Aims: Myofascial trigger points (MTrPs) are highly sensitive irritated points within a tense belt of skeletal muscle, and are the main cause of muscle pain and dysfunction. MTrPs can also cause paraesthesia and autonomic nervous dysfunction. Furthermore, long-term and chronic MTrPs can cause muscle atrophy and even disability, seriously affecting the quality of life and mental health of patients, and increasing the social and economic burden. However, to date, there have been few studies on fibrogenesis and changes in MTrPs. Therefore, this study investigated whether transforming growth factor beta1 (TGF-ß1)-Smad2/3 participates in the formation of MTrPs and how it affects fibrosis using point shear wave elastography. Methods: Forty Sprague‒Dawley rats were randomly divided into the MTrPs group and the control group. Blunt injury combined with eccentric exercise was used to establish an MTrPs model. Electromyography (EMG), haematoxylin and eosin (H&E) staining and transmission electron microscopy (TEM) were used to verify the model. The collagen volume fraction was measured by Masson staining, the protein expression of TGF-ß1 and p-Smad2/3 was measured by Western blotting (WB) and immunohistochemistry (IHC), and the shear wave velocity (SWV) was measured by point shear wave elastography. Results: EMG, H&E and TEM examination indicated that the modelling was successful. The collagen volume fraction and the protein expression of TGF-ß1 and p-Smad2/3 were higher in the MTrPs group than in the control group. The SWV of the MTrPs group was also higher than that of the control group. These differences suggest that MTrPs may exhibit fibrosis. The correlations between the collagen volume fraction and SWV and between the collagen volume fraction and TGF-ß1 were positive. Conclusion: Fibrotic conditions may be involved in the formation of MTrPs. Ultrasound point shear wave elastography and assessment of TGF-ß1 and p-Smad2/3 expression can reflect the degree of MTrPs fibrosis to some extent. Further exploration of the important role of TGF-ß1 and Smad2/3 in the pathogenesis of MTrPs will be of great significance for clinical treatment.

Evaluation and clinical significance of cyclin-dependent kinase5 expression in cervical lesions: a clinical research study in Guangxi, China.

BACKGROUND: Studies have been reported that cyclin-dependent kinase5 (CDK5) was associated with the development of several cancers. However, the relationship between CDK5 level and clinicopathological factors is still poorly understood in cervical diseases. The aim of the current study was to investigate the expression of CDK5 and its clinical significance in variant cervical lesions. METHODS: Immunohistochemistry (IHC) was used to detect CDK5 expression in 54 cases of chronic cervicitis, 42 cases of condyloma acuminate (CA), 38 cases of carcinoma in situ, and 360 cases of cervical cancers [adenocarcinoma, n = 63; squamous cell carcinoma (SCC), n = 263; adenosquamous carcinoma, n = 34]. The clinicopathological characteristics in relation to CDK5 were examined by Pearson's Chi-square test. RESULTS: The positive rates of CDK5 were 27.8, 31.0, 50, 54.0, 58.8, and 62.7 % in chronic cervicitis, CA, carcinoma in situ, adenocarcinoma, adenosquamous carcinoma and SCC, respectively. Statistically analysis showed that CDK5 expression in cervical cancer tissues was higher than non-cervical cancer tissues (inflammation and CA) (P < 0.001). The overexpression of CDK5 was significantly correlated with lymph node metastasis (r = 0.317; P < 0.001), histological type (r = 0.198; P < 0.001), FIGO stage (r = 0.358; P < 0.001), TNM stage (r = 0.329; P < 0.001) and pathological grade (r = 0.259; P < 0.001) in cervical lesions evaluated by Pearson's Chi-square test. Furthermore, the positive relationships were found between CDK5 and lymph node metastasis (P < 0.001), FIGO stage (P < 0.001), TNM stage (P < 0.001) and pathological grade (P < 0.001) in SCC. CDK5 was positively interrelated to TNM stage (P = 0.017) in adenosquamous carcinoma. CONCLUSIONS: CDK5 may play a vital role in the development of cervical cancer, which may be a marker for the diagnosis, therapy and prognosis of cervical cancer.

The prognostic role of Ki-67/MIB-1 in cervical cancer: a systematic review with meta-analysis.

BACKGROUND: A significant relationship has been reported in which Ki-67/MIB-1 expression is correlated with survival in cervical cancer patients. However, the prognostic value of Ki-67/MIB-1 in cervical cancer is still not well understood. MATERIAL AND METHOD: A meta-analysis was carried out to explore the prognostic value of Ki-67/MIB-1 on overall survival (OS) and/or disease-free survival (DFS) in cervical cancer. The databases of PubMed, ISI Web of Science, EMBASE, Cochrane Central Register of Controlled Trials, ScienceDirect, and Wiley Online Library were used to identify relevant literature. RESULTS: We included 18 studies covering 1344 patients in the meta-analysis. The effect of Ki-67/MIB-1 on OS for pooled random effects HR estimate was 1.63 (95% confidence intervals (CI) 1.09-2.45; P<0.05). Subgroup analysis by ethnicity suggested that high expression of Ki-67/MIB-1 had association with Asians (1.84, 95% CI 1.04-3.23), but not with Africans (HR=1.53, 95% CI 0.34-6.86) or Europeans (HR=1.29, 95% CI 0.74-2.23). Furthermore, subgroup analysis of diverse treatments revealed no difference in surgery (HR=1.97, 95% CI 0.78-4.99) and radiation therapy (RT) (HR=1.56, 95% CI 0.93-2.63). The pooled HR for DFS was 1.26 (95% CI 0.58-2.73; P>0.05) and the subgroup analysis indicated Ki-67/MIB1 was associated with DFS (HR=3.67, 95% CI 2.65-5.09) in Asians. In the treatment subgroup analysis, no direct value was found among surgery (HR=1.13, 95% CI 0.10-13.53) and RT (HR=1.26, 95% CI 0.71-2.24). CONCLUSIONS: Our meta-analysis concludes that Ki-67/MIB-1 had a prognostic value for OS in cervical cancer patients. To further evaluate the prognostic role of Ki-67/MIB-1 on DFS, studies with larger numbers of patients are needed to validate our findings.

Allergic conditions reduce the risk of glioma: a meta-analysis based on 128,936 subjects.

Many studies have investigated the association between the allergic conditions and the risk of glioma. However, the evidence is inadequate to draw robust conclusions because most studies were generally small and conducted in heterogeneous populations. To shed light on these inconclusive findings, we conducted a meta-analysis of studies relating the allergic conditions to the risk of glioma. We identified the relevant studies by searching ISI Web of Science, PubMed, EMBASE, Chinese National Knowledge Infrastructure (CNKI) databases, and Wanfang database by October 2013. We included studies that reported odds ratio (OR) or hazard ratio (HR) with its 95% confidence interval (CI) for the association between the allergic condition and the risk of glioma. Eighteen independent publications, with 9,986 glioma cases and 118,950 controls, were included. Our results showed that allergic condition was reversely associated with the risk of glioma (OR = 0.78, 95% CI 0.73-0.83, P < 0.001). The results of our meta-analysis indicated that allergic conditions significantly reduce the risk of glioma.