Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 14.083
Filtrar
1.
BMJ ; 368: l6670, 2020 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-31911452

RESUMO

Thyroid nodules are extremely common and can be detected by sensitive imaging in more than 60% of the general population. They are often identified in patients without symptoms who are undergoing evaluation for other medical complaints. Indiscriminate evaluation of thyroid nodules with thyroid biopsy could cause a harmful epidemic of diagnoses of thyroid cancer, but inadequate selection of thyroid nodules for biopsy can lead to missed diagnoses of clinically relevant thyroid cancer. Recent clinical guidelines advocate a more conservative approach in the evaluation of thyroid nodules based on risk assessment for thyroid cancer, as determined by clinical and ultrasound features to guide the need for biopsy. Moreover, newer evidence suggests that for patients with indeterminate thyroid biopsy results, a combined assessment including the initial ultrasound risk stratification or other ancillary testing (molecular markers, second opinion on thyroid cytology) can further clarify the risk of thyroid cancer and the management strategies. This review summarizes the clinical importance of adequate evaluation of thyroid nodules, focuses on the clinical evidence for diagnostic tests that can clarify the risk of thyroid cancer, and highlights the importance of considering the patient's values and preferences when deciding on management strategies in the setting of uncertainty about the risk of thyroid cancer.


Assuntos
Neoplasias/diagnóstico , Medição de Risco/métodos , Neoplasias da Glândula Tireoide/diagnóstico , Nódulo da Glândula Tireoide , Biópsia/métodos , Testes de Química Clínica , Diagnóstico Diferencial , Humanos , Achados Incidentais , Nódulo da Glândula Tireoide/diagnóstico por imagem , Nódulo da Glândula Tireoide/patologia
2.
Mymensingh Med J ; 29(1): 48-54, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31915335

RESUMO

One-fourth of all women suffer from breast disease in their lifetime. World Health Organization estimated that over 508,000 women died in 2011 due to breast cancer worldwide.For several years, fine needle aspiration cytology (FNAC) was the most practiced method for the pathological diagnosis of breast lump specially differentiation of benign from malignant. The advent of core needle or True-Cut biopsy (TCB) in the new millennium has resulted in many surgeons switching to TCB since it provides a sufficient amount of tissue for pathologists to make an accurate histological diagnosis.During the study period, patients present with clinically palpable breast lump admitted in different surgicalunits of MMCH, among them 100 patients selected purposively. Then a prospective comparative study was carried out in the Department of Surgery, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from September 2017 to February 2018. Out of a total of 100 patients, who presented with suspicious breast lump, as clinically diagnosed 68 patients had benign breast lump and 32 patients had malignant breast lump. FNAC confirmed the diagnosis of breast carcinoma in 27 patients with sensitivity 89.65% and specificity 66.66%. True-cut biopsy confirmed the diagnosis of breast carcinoma in 29 patients with sensitivity 96.66% and specificity 100%. It also gave the definitive histological type and grade which correlated with the final histopathology report in 29 out of the 30 patientsTCB also provides adequate tissue for the evaluation of molecular markers which have extreme therapeutic value.


Assuntos
Biópsia por Agulha/métodos , Biópsia/métodos , Doenças Mamárias/patologia , Neoplasias da Mama/patologia , Mama/patologia , Carcinoma/patologia , Adulto , Bangladesh/epidemiologia , Biópsia por Agulha Fina , Neoplasias da Mama/epidemiologia , Carcinoma/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Sensibilidade e Especificidade
3.
J Zoo Wildl Med ; 50(4): 997-999, 2020 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-31926535

RESUMO

A single incision laparoscopic system (SILS) was used to remove the falciform ligament of an adult male cheetah (Acinonyx jubatus) during routine diagnostic liver biopsy. Adipose tissue isolated from the falciform ligament was used to establish a mesenchymal stem cell culture. The use of a SILS port for liver biopsy and falciform ligament collection allowed for a large amount of fat to be collected from a small surgical incision and rapid postoperative recovery. This case expands the use of the single incision laparoscopy surgical technique beyond reproductive sterilization procedures in large cats.


Assuntos
Acinonyx/cirurgia , Laparoscopia/veterinária , Ligamentos/cirurgia , Tecido Adiposo/citologia , Animais , Biópsia/instrumentação , Biópsia/métodos , Biópsia/veterinária , Fígado/patologia , Masculino , Células-Tronco Mesenquimais
4.
World Neurosurg ; 133: e513-e521, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31550541

RESUMO

OBJECTIVE: Owing to technical development of specific fluorophore filters, the neurosurgical application of sodium fluorescein (SF) has regained value in brain tumor surgery. The aim of this study was to determine the usefulness of SF during nerve biopsies. METHODS: This single-center study included 5 cases of nerve biopsies performed under microscope-based fluorescence with SF performed between March 2016 and February 2017. SF was applied intravenously (1 mg/kg body weight). After microsurgical dissection of the involved nerve segment, fluorescence-guided fascicular biopsy was performed. Selection of target fascicles was at the surgeon's discretion and took into account nerve stimulation for preservation of motor function and fluorescence intensity. Correlation to histopathologic examination was examined. Video analysis of intraoperative images comparing target fascicles with intense fluorescent response to adjacent fascicles of the same nerve segment was performed using ImageJ. RESULTS: All patients had motor or sensory deficits. Magnetic resonance imaging findings were similar, depicting long segments of gadolinium enhancement (minimum 11.7 cm). Each biopsy sample was positive resulting in diverse histopathologic results. Digital image analysis revealed a statistically significant difference of the complementary color green (P = 0.0473). CONCLUSIONS: Magnetic resonance imaging is the gold standard in diagnostic work-up of peripheral nerve disorders. Longitudinal nerve thickening with positive contrast enhancement is an unspecific magnetic resonance imaging finding. Various pathologies, such as tumors and inflammatory lesions, may cause this morphologic phenomenon. Nerve biopsies may be needed for diagnostic work-up. Intraoperative SF may help to depict the most affected fascicles and identify target fascicles for biopsy and increase diagnostic certainty of nerve biopsies.


Assuntos
Biópsia/métodos , Meios de Contraste , Fluoresceína , Procedimentos Neurocirúrgicos/métodos , Doenças do Sistema Nervoso Periférico/diagnóstico , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
5.
J Craniomaxillofac Surg ; 47(12): 1963-1967, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31810845

RESUMO

INTRODUCTION: Neck dissection is an essential component of oral cancer therapy. Based on a standardised approach to cervical lymph node management, we seek to define the relevance of neck dissection extension in cN + cases. MATERIAL AND METHODS: A retrospective analysis from January 2009 to February 2017 identified 84 patients with oral squamous cell carcinoma with a cN + neck or histologically proven lymph node involvement in intraoperative frozen sectioning and who received modified radical neck dissection according to the presented neck dissection algorithm. RESULTS: Overall 11 patients showed lymph node metastasis level IV or V, whereas 19 developed disease recurrence, of which 5 cases were neck recurrences. A total of 30 patients died within the time of observance (overall survival of n = 54). None of those patients with pN + status in levels IV and V reached a 5-year survival. DISCUSSION: With a look to the possibility of a 5-year survival in patients with a N+ status in level IV and V, the justification for a radical approach to the neck appears questionable. However, modified radical neck dissection appears to be a suitable for a high-risk oral cancer subgroup. A randomised controlled trial is needed to define guidelines for the neck dissection extent in c/pN + cases.


Assuntos
Carcinoma de Células Escamosas/cirurgia , Secções Congeladas , Neoplasias Bucais/cirurgia , Esvaziamento Cervical/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Biópsia/métodos , Carcinoma de Células Escamosas/patologia , Feminino , Humanos , Linfonodos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/patologia , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Estudos Retrospectivos
6.
Medicine (Baltimore) ; 98(51): e18505, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31861036

RESUMO

Targeted biopsy with multiparametric magnetic resonance imaging and hypoechoic lesions on transrectal ultrasound has been implemented to increase prostate cancer detection rate.We compared the detection abilities of systematic prostate biopsy, hypoechoic lesion-targeted biopsy (HL-TBx), and cognitive magnetic resonance imaging-targeted biopsy (MRI-TBx) in patients with suspected prostate cancer. Between September 2014 and August 2016, 193 patients with a prostate-specific antigen level of 3 to 10 ng/mL underwent HL-TBx or MRI-TBx. In patients who refused magnetic resonance imaging examination before prostate biopsy, HL-TBx was performed. We compared cancer detection rates and pathologic outcomes between systematic prostate biopsy and HL-TBx or MRI-TBx.The cancer detection rates for HL-TBx and MRI-TBx were 40.8% and 43.8%, respectively, without a significant difference (P = .683). Of the 81 patients diagnosed with prostate cancer, most patients (77 patients, 95.1%) were diagnosed with prostate cancer by systematic prostate biopsy. The detection ability for prostate cancer was significantly better for systematic prostate biopsy than for HL-TBx or MRI-TBx (P < .001).The detection abilities for clinically significant prostate cancer similar between HL-TBx and systematic prostate biopsy. Systematic prostate biopsy alone should be recommended for detection prostate cancer in patients with a prostate-specific antigen ≤10 ng/mL.


Assuntos
Próstata/patologia , Neoplasias da Próstata/diagnóstico , Idoso , Biópsia/métodos , Imagem de Difusão por Ressonância Magnética , Humanos , Masculino , Pessoa de Meia-Idade , Próstata/diagnóstico por imagem , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/sangue , Estudos Retrospectivos
7.
Anticancer Res ; 39(11): 6359-6363, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31704868

RESUMO

BACKGROUND/AIM: To analyze whether demographic and facility type characteristics cause inequality in the type of biopsy performed in patients with cutaneous melanoma. PATIENTS AND METHODS: The skin cancer National Cancer Database was assessed. Men and women of all ages with cutaneous melanoma in situ and malignant melanoma at any stage of the disease were included. Patients were selected who underwent one of the following biopsy types: excisional, punch, shave, or incisional. Bivariate and multivariate analyses were performed. RESULTS: We found that the likelihood of undergoing an excisional biopsy decreased in patients who were: Hispanic [odds ratio (OR)=0.63, confidence interval (CI)=0.55-0.71], non-White (OR=0.66, CI=0.58-0.76), older than 80 years (OR=0.77, CI=0.72-0.87), or in Comprehensive Community Cancer Programs (OR=0.33, CI=0.31-0.36), Community Cancer Programs (OR=0.52, CI=0.50-0.54) and Integrated Network Cancer Programs (OR=0.58, CI=0.55-0.61). CONCLUSION: Our study results demonstrate disparities in biopsy type in the treatment of melanoma.


Assuntos
Biópsia/métodos , Disparidades em Assistência à Saúde , Melanoma/patologia , Neoplasias Cutâneas/patologia , Padrão de Cuidado , Fatores Etários , Biópsia/normas , Grupos de Populações Continentais , Grupos Étnicos , Feminino , Disparidades em Assistência à Saúde/etnologia , Hispano-Americanos , Humanos , Cobertura do Seguro/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Análise de Regressão , Características de Residência , Fatores Sexuais , Fatores Socioeconômicos
10.
Medicine (Baltimore) ; 98(48): e18161, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31770261

RESUMO

RATIONALE: Epithelioid hemangioma (EH) of bone is an intermediate vascular tumor that can be locally aggressive. The optimum management of multifocal EH of bone is not well delineated. We described our experience treating one patient with multifocal EH of bone in an effort to document the effect of bisphosphonates in bone EH. PATIENT CONCERNS: In this report, a 53-year old male patient presented with back pain which was initially been diagnosed of multiple bone metastatic carcinoma by 18F-FDG PET/CT scan and bone scintigraphy. DIAGNOSIS: CT-guided bone biopsy of ilium indicated that puncture tissue had irregular hyperplasia of thick and thin-walled blood vessels, immunohistochemistry revealed positive staining for CD31 and CD34, negative for CAMTA-1, PCK and EMA, which confirmed the diagnosis of multiple EH. INTERVENTIONS: The patient was treated with 4 times of intravenous Zometa (zoledronate, 4 mg each time) with average three-month interval. Bone metabolic markers including serum bone specific alkaline phosphatase (BALP) and type I collagen cross-linked C-terminal telopeptide (CTX) levels were closely monitored before and after use of bisphosphonates each time. OUTCOME: BALP and CTX were significantly lowered following intravenous Zometa and the back pain improved with integrated therapy including bone graft fusion internal fixation surgery and vertebroplasty. CONCLUSIONS: EH of multiple bones responded favorably to intravenous Zometa with improvement of bone metabolic markers. After 1 year on follow-up, the patient was doing well with no significant pain. We suggest that bisphosphonates should be considered in the treatment of multifocal osteolytic EH of bone.


Assuntos
Neoplasias Ósseas , Osso e Ossos , Hemangioendotelioma Epitelioide , Imuno-Histoquímica/métodos , Metástase Neoplásica/diagnóstico , Procedimentos Ortopédicos/métodos , Ácido Zoledrônico/administração & dosagem , Biópsia/métodos , Conservadores da Densidade Óssea/administração & dosagem , Neoplasias Ósseas/diagnóstico , Neoplasias Ósseas/metabolismo , Neoplasias Ósseas/patologia , Neoplasias Ósseas/terapia , Remodelação Óssea/efeitos dos fármacos , Osso e Ossos/diagnóstico por imagem , Osso e Ossos/metabolismo , Osso e Ossos/patologia , Terapia Combinada , Diagnóstico Diferencial , Difosfonatos/administração & dosagem , Monitoramento de Medicamentos/métodos , Hemangioendotelioma Epitelioide/diagnóstico , Hemangioendotelioma Epitelioide/metabolismo , Hemangioendotelioma Epitelioide/patologia , Hemangioendotelioma Epitelioide/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
11.
Medicine (Baltimore) ; 98(48): e18179, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31770270

RESUMO

RATIONALE: Immunoglobulin G4-related disease (IgG4-RD) is regarded as an immune-mediated systemic fibroinflammatory disease. Several studies have linked IgG4-RD to infections such as tuberculosis and actinomycosis. However, the coexistence of IgG4-RD and non-tuberculous mycobacterium (NTM) in a single pulmonary nodule has not been reported yet. PATIENT CONCERNS: A 76-year-old male patient presented with cough and sputum. A solitary pulmonary nodule suspicious of lung cancer was found on chest CT. DIAGNOSIS: Through video-assisted thoracoscopic biopsy, a diagnosis of co-existing NTM and IgG4-RD in a single nodule was made. INTERVENTIONS: Antibiotic treatment was applied for pneumonia developed after surgery. The patient was also supported by extracorporeal membrane oxygenation and mechanical ventilation since his pneumonia was refractory to medical treatment. OUTCOMES: The patient expired on the 60th postoperative day due to multiple organ failure. LESSONS: IgG4-RD can occur singularly or accompanied by other diseases. We report a solitary pulmonary nodule caused by NTM and concurrent IgG4-RD, suggesting a possible association between these 2 entities. Immunologic relations between IgG4-RD and accompanying infection should be further investigated.


Assuntos
Doença Relacionada a Imunoglobulina G4 , Infecções por Micobactéria não Tuberculosa , Micobactérias não Tuberculosas/isolamento & purificação , Pneumonia , Complicações Pós-Operatórias/tratamento farmacológico , Nódulo Pulmonar Solitário , Cirurgia Torácica Vídeoassistida/métodos , Idoso , Antibacterianos/administração & dosagem , Biópsia/métodos , Oxigenação por Membrana Extracorpórea/métodos , Evolução Fatal , Humanos , Doença Relacionada a Imunoglobulina G4/complicações , Doença Relacionada a Imunoglobulina G4/diagnóstico , Doença Relacionada a Imunoglobulina G4/fisiopatologia , Pulmão/diagnóstico por imagem , Pulmão/patologia , Masculino , Insuficiência de Múltiplos Órgãos/etiologia , Infecções por Micobactéria não Tuberculosa/complicações , Infecções por Micobactéria não Tuberculosa/diagnóstico , Infecções por Micobactéria não Tuberculosa/patologia , Infecções por Micobactéria não Tuberculosa/terapia , Pneumonia/tratamento farmacológico , Pneumonia/etiologia , Nódulo Pulmonar Solitário/complicações , Nódulo Pulmonar Solitário/microbiologia , Nódulo Pulmonar Solitário/patologia , Nódulo Pulmonar Solitário/cirurgia , Tomografia Computadorizada por Raios X/métodos
12.
Medicine (Baltimore) ; 98(43): e17633, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31651879

RESUMO

PURPOSE: To investigate potential preoperative predictors of urethral or apical positive surgical margin (PSM) and the value of apical prostate biopsy in predicting urethral/apical margin status after radical prostatectomy (RP). METHODS: A total of 531 patients who underwent RP during 2010 to 2017 at West China Hospital were enrolled in this retrospective study. Preoperative and postoperative factors including age, BMI, PSA, clinical T stage and biopsy Gleason score were analyzed. Univariate analysis and logistic regression were used to find out the potential predictive factors for PSM. Two logistic regression models were built to evaluate the role of apical prostate biopsy in predicting urethral/apical margin status. RESULTS: The overall PSM rate was about 30.1% (160/531) and 97 of them were reported urethral/apical PSM. The incidence of urethral or apical PSM in patients with positive cores in the apical prostate was higher than those without (23.0% vs 9.9%, P < .001). We further found that the multivariable model with positive apical prostate biopsy could significantly increase the predictive value of urethral or apical PSM status (AUC: 0.744 vs 0.783, P = .016). Our analysis also showed that neo-adjuvant hormone therapy was an independent protective factor for urethral or apical PSM in patients with positive apical prostate biopsy, but not all patients. CONCLUSION: This study revealed the necessity of apical prostate biopsy to predict the risk of apical or urethral PSM. In clinical practice, neo-adjuvant hormone therapy should be given when patients with positive apical prostate biopsy to reduce the presence of PSM, especially patients with high/very high risk prostate cancer.


Assuntos
Biópsia/métodos , Margens de Excisão , Prostatectomia , Neoplasias da Próstata/patologia , Neoplasias da Próstata/cirurgia , Uretra/patologia , Idoso , China , Humanos , Masculino , Gradação de Tumores , Invasividade Neoplásica , Estadiamento de Neoplasias , Valor Preditivo dos Testes , Estudos Retrospectivos
13.
BMC Infect Dis ; 19(1): 909, 2019 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-31664931

RESUMO

BACKGROUND: Disseminated nontuberculous mycobacteria (NTM) infections occur mostly in immunocompromised patients. Therefore, it is difficult to diagnose disseminated NTM infections in patients without history of immunocompromised diseases or using immunosuppressant. Patients with anti-interferon-γ (IFN-γ) autoantibodies are vulnerable to intracellular infections, such as disseminated NTM. Currently, there is no widely used and efficient technique for the detection of anti-IFN-γ autoantibodies. Herein, we report a case of an apparently healthy patient with disseminated Mycobacterium avium complex (MAC) infection who tested positive for anti-IFN-γ autoantibodies. CASE PRESENTATION: A 64-year-old non-immunocompromised and apparently healthy Asian male presented to the emergency department with complaints of progressive chest pain for about 6 months and weight loss. A bulging tumour was found in the anterior chest wall. Chest computed tomography showed a lung mass over the right lower lobe and an osteolytic lesion with a soft tissue component at the sternum. Sonography-guided biopsies for the osteolytic lesion and sputum culture confirmed the presence of disseminated MAC infection. In addition, positive test result of anti-IFN-γ autoantibodies was noted. The patient was prescribed antibiotics. The lesions over the right lower lobe and sternum attenuated following the antibiotic treatment. CONCLUSION: Detection of anti-IFN-γ autoantibodies is important among previously healthy people with disseminated NTM infection. Presence of anti-IFN-γ autoantibodies may suggest a high risk of severe intracellular infection, such as disseminated NTM infection.


Assuntos
Autoanticorpos/análise , Interferon gama/imunologia , Neoplasias Pulmonares/diagnóstico , Infecções por Micobactéria não Tuberculosa/diagnóstico por imagem , Complexo Mycobacterium avium , Tuberculose Pulmonar/diagnóstico por imagem , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Biópsia/métodos , Diagnóstico Diferencial , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Infecções por Micobactéria não Tuberculosa/tratamento farmacológico , Infecções por Micobactéria não Tuberculosa/microbiologia , Infecções por Micobactéria não Tuberculosa/patologia , Infecção por Mycobacterium avium-intracellulare/tratamento farmacológico , Escarro/microbiologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Tuberculose Pulmonar/tratamento farmacológico , Tuberculose Pulmonar/microbiologia , Tuberculose Pulmonar/patologia
14.
Adv Clin Exp Med ; 28(11): 1513-1517, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31596556

RESUMO

BACKGROUND: The main purpose of a biopsy is microscopic examination and diagnosis. Keeping the margins of specimens safe and readable is always fundamental to detecting marginal infiltrations or malignant transformation. Numerous options and tools have been introduced for biopsy procedures. Lasers are one of these options that provide many enhancements to clinical and surgical biopsy procedures in comparison to scalpels. OBJECTIVES: The aim of the present study is to quantify the thermal artefacts in histological specimens obtained using a CO2 laser from different oral mucosal lesions and to evaluate if the resulting thermal effect hinders the histological examination. This aim is accomplished through quantitatively and qualitatively assessing the thermal effect in both the epithelium and connective tissue. MATERIAL AND METHODS: A super-pulsed CO2 laser (10,600 nm) was used to obtain 10 excision biopsy samples. The parameters were a power of 4.2 W in focused mode and a frequency of 80 Hz in super-pulse mode. The histological analysis was performed with an optical microscope. Computerized imaging software was utilized to quantitatively evaluate the thermal effect in both the epithelium and connective tissue expressed in microns. RESULTS: The thermal effect of the CO2 laser was limited to the surgical resection margins in all the specimens and did not hinder the histological analysis. Thermal artefacts were observed in 3 specimens. The range of thermal effects in the epithelial tissue was between 184 µm and 2,292 µm, while in the connective tissue it was between 133 µm and 2,958 µm. CONCLUSIONS: The resulting thermal effects of using a CO2 laser did not hamper the histological evaluation. Utilizing a laser in biopsy procedures should be tailored. Not only should laser parameters and safety margins be taken into consideration but also the working time, clinical accessibility, and the nature and water content of the tissue.


Assuntos
Biópsia/métodos , Terapia a Laser , Lasers de Gás , Humanos
15.
J Low Genit Tract Dis ; 23(4): 241-247, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31592970

RESUMO

OBJECTIVE: The aim of the study was to assess whether lower proportions of cervical intraepithelial neoplasia 2+ diagnosed by random biopsy are from lower cut points defining an abnormal colposcopic impression or obtaining only one random biopsy when colposcopic impression is normal. METHODS: We compared colposcopy experiences within Shanxi Province Cervical Cancer Screening Study (SPOCCS) (n = 1,383) and Shenzhen Cervical Cancer Screening Trial (SHENCCAST) (n = 631), which had instructive differences in the cut point defining an abnormal colposcopic impression. RESULTS: The proportion of CIN 2+ diagnosed by random biopsy in SPOCCS (35.0%, 141/403) was higher than SHENCCAST (18.4%, 35/190, p < .001). Quadrant-specific receiver operating characteristic curves for diagnosis of CIN 2+ by colposcopic impression in SPOCCS and SHENCCAST were similar; a lower cut point for an abnormal colposcopic impression in SHENCCAST resulted in lower proportion of CIN 2+ diagnosed by random biopsy. Normal colposcopic impression was found in 85.1% (120/141) of cases of CIN 2+ diagnosed by random biopsy in SPOCCS and in 57.1% (20/35) of such cases in SHENCCAST. Of CIN 2+ diagnosed by random cervical biopsy with normal colposcopic impression, one cervical quadrant was involved with CIN 2+ in 66.7% (80/120) of colposcopies in SPOCCS and 80% (16/20) of colposcopies in SHENCCAST. CONCLUSIONS: Colposcopy series with higher proportions of CIN 2+ diagnosed by random biopsy likely have more stringent cut points defining an abnormal colposcopic impression and have more random biopsies when the colposcopic impression is normal. At colposcopy, we advise multiple biopsies of all acetowhite epithelium or multiple random biopsies to increase the sensitivity of colposcopy.


Assuntos
Biópsia/métodos , Neoplasia Intraepitelial Cervical/diagnóstico , Colposcopia/métodos , Neoplasias do Colo do Útero/diagnóstico , Adulto , Colo do Útero/patologia , China , Feminino , Humanos , Sensibilidade e Especificidade
16.
Anticancer Res ; 39(10): 5683-5688, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31570467

RESUMO

BACKGROUND/AIM: This study aimed to compare the efficacies of cryobiopsy and forceps biopsy for peripheral lung cancer detection. PATIENTS AND METHODS: A retrospective review of peripheral lung cancer cases between December 2017 and April 2019 was conducted. Forceps biopsy was performed followed by cryobiopsy using a guide sheath (GS). Diagnostic yields were compared between cryobiopsy and forceps biopsy. RESULTS: A total of 53 lung cancer lesions were evaluated. The diagnostic yields of forceps biopsy and cryobiopsy were 86.8% and 81.1%, respectively. Univariate and multivariate analyses indicated that cryobiopsy with a GS was significantly associated with increased diagnostic yield (odds ratio(OR)=11.6; p=0.044). Among the four patients who tested positive on cryobiopsy and negative on forceps biopsy, one had diffused pulmonary metastases and the others showed intratumoural air bronchograms. CONCLUSION: Cryobiopsy using a GS can significantly increase diagnostic yield and help identify lesions with intratumoural air bronchograms and external wall lesions.


Assuntos
Biópsia/métodos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/patologia , Pulmão/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Broncoscopia/métodos , Criocirurgia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Instrumentos Cirúrgicos
17.
Anticancer Res ; 39(10): 5733-5739, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31570475

RESUMO

BACKGROUND/AIM: To analyze patterns of care and overall survival for elderly patients with malignant brain tumors. MATERIALS AND METHODS: The database from the National Health Insurance Service was searched January 2008-December 2016. A total of 1,607 patients aged 65-year-old or more with malignant brain tumors who underwent surgery or biopsy were extracted. Treatment performed in 180 days after surgery was divided into no treatment (N=522), radiotherapy (RT) (N=351), chemotherapy (N=69), and chemotherapy plus RT (N=665). Survival was recorded at 3, 6, 9, 12, 18, and 24 months after surgery. RESULTS: Patients were divided into groups by age: 65-69, 70-74, 75-79, and ≥80 years. Chemotherapy plus RT was most commonly used in all age groups except those aged 80 years and more. Treatment modality after surgery or biopsy was significantly prognostic (p<0.001) in univariate analysis. CONCLUSION: Adjuvant treatment can be recommended for elderly patients with malignant brain tumors based on data from the National Health Insurance Service.


Assuntos
Neoplasias Encefálicas/terapia , Idoso , Idoso de 80 Anos ou mais , Biópsia/métodos , Neoplasias Encefálicas/tratamento farmacológico , Neoplasias Encefálicas/patologia , Neoplasias Encefálicas/cirurgia , Quimioterapia Adjuvante/métodos , Bases de Dados Factuais , Feminino , Humanos , Masculino , Programas Nacionais de Saúde , Prognóstico , Radioterapia Adjuvante/métodos , República da Coreia
18.
Anticancer Res ; 39(10): 5767-5772, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31570480

RESUMO

BACKGROUND/AIM: To investigate the impact of inguinal lymph node dissection (ILND) following neoadjuvant chemoradiotherapy (NACRT) for rectal cancer patients with ILN metastasis. PATIENTS AND METHODS: Forty-three patients with rectal cancer underwent NACRT followed by curative surgery between January 2005 and December 2016. Seven patients underwent ILND after NACRT for clinically-positive ILN metastasis (ILND (+) group), while the remaining 36 did not receive ILND for clinically negative ILN metastasis (ILND (-) group). Their outcomes were retrospectively analyzed. RESULTS: Only one patient in the ILND (+) group had a local recurrence at six years after surgery. The 5-year recurrence-free survival was 100% and 65.4% in the ILND (+) and ILND (-) groups, respectively (p=0.09), and the 5-year overall survival was 100% and 83.2%, respectively (p=0.32). CONCLUSION: ILND following NACRT seems effective for rectal cancer patients with ILN metastasis.


Assuntos
Canal Inguinal/patologia , Linfonodos/efeitos dos fármacos , Linfonodos/patologia , Metástase Linfática/patologia , Neoplasias Retais/tratamento farmacológico , Neoplasias Retais/radioterapia , Adulto , Idoso , Biópsia/métodos , Quimiorradioterapia/métodos , Intervalo Livre de Doença , Feminino , Humanos , Excisão de Linfonodo/métodos , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante/métodos , Recidiva Local de Neoplasia/tratamento farmacológico , Recidiva Local de Neoplasia/patologia , Neoplasias Retais/patologia , Estudos Retrospectivos
19.
Medicine (Baltimore) ; 98(37): e17104, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31517842

RESUMO

Esophageal cancer is a common human malignant tumor with high mortality. Glandular epithelial markers, such as CAM5.2, can be expressed in esophageal squamous cell carcinoma (ESCC), but the clinical significance of these cells in ESCC remains elusive.Immunohistochemical analysis of CAM5.2 was performed on 604 ESCC specimens using tissue microarray. Our study design and study population used retrospective cohorts based on the hospital information system and pathological information management system which included medical information, date of admission, procedures undergone, registration, examinations, and medication.In total, positive staining of CAM5.2 was 145 of 604 (24%). Statistical analysis showed that the expression of CAM5.2 had no relationship with sex, age, tumor differentiation, tumor size, tumor-node-metastasis (TNM) classification, and lymph node metastasis, but it was significantly associated with poor prognosis of overall survival (P = .0041) and disease-free survival (P = .0048) in ESCC patients.Herein, we report for the first time that the high expression of the CAM 5.2 is an independent predictor of poor prognosis in patients with ESCC.


Assuntos
Biomarcadores/análise , Neoplasias Esofágicas/classificação , Carcinoma de Células Escamosas do Esôfago/complicações , Queratinas/análise , Queratinas/genética , Adulto , Idoso , Biópsia/métodos , Biópsia/estatística & dados numéricos , China , Estudos de Coortes , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/patologia , Carcinoma de Células Escamosas do Esôfago/diagnóstico , Carcinoma de Células Escamosas do Esôfago/patologia , Feminino , Humanos , Imuno-Histoquímica/métodos , Imuno-Histoquímica/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Transcriptoma
20.
Eur J Radiol ; 120: 108660, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31546123

RESUMO

PURPOSE: To compare the correlation of transition zone prostate-specific antigen density (TZPSAD) versus whole gland (WG) density (PSAD) with Gleason score. METHODS: In this single-center, retrospective cohort study, men undergoing MRI of the prostate in 2015 and 2016 who had a transperineal template saturation biopsy within 6 months of MRI were included (n = 178; median age 64 y, interquartile range [IQR] 58-68 y; PSA 6.6 ng/ml, 4.6-9.7 ng/ml). The WG and TZ were segmented voxel-wise on T2-weighted transverse planes. The volumes and corresponding PSA-densities were calculated. Correlations with the Gleason score were assessed with Spearman's rho. Optimal thresholds of the PSA densities were computed using the Youden Index of the receiver-operating-characteristics curve. A p-value of ≤ 0.05 was considered statistically significant. RESULTS: Median WG volume was 45 ml (IQR: 33.9-58.7 ml, range: 17.2-165.3 ml), median volume of the TZ was 27.3 ml (IQR: 19.2-39.3 ml, range: 9.0-141.1 ml). Both PSA density values, PSAD and TZPSAD, correlated significantly with the Gleason score: The PSAD (rho = 0.39) showed significantly weaker correlation than the TZPSAD (rho = 0.44, p = 0.05). ROC analysis revealed an ideal cut-off of 0.15 ng/ml2 for PSAD (95%-CI: 0.09-0.16 ng/ml2) and 0.22 ng/ml2 for the TZPSAD (0.15-0.32 ng/ml2) for discrimination between Gleason 3 + 4 and 4 + 3. CONCLUSION: The TZPSAD exhibited a stronger correlation with cancer dedifferentiation than PSAD and may thus be a better surrogate marker for cancer aggressiveness than PSAD. Moreover, the TZPSAD threshold of 0.22 ng/ml2 may help in risk stratification of men with suspected PCa.


Assuntos
Antígeno Prostático Específico/metabolismo , Neoplasias da Próstata/patologia , Idoso , Biomarcadores Tumorais/metabolismo , Biópsia/métodos , Estudos de Coortes , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Curva ROC , Estudos Retrospectivos , Medição de Risco
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA