[Design of an improved percutaneous transhepatic cholangio drainage tube based on MRCP imaging data].

Objective: Quantified MRCP imaging data was used as a reference for design and preparation of a modified percutaneous transhepatic cholangio drainage (PTCD) tube. Methods: 3.0 T upper abdominal MR and MRCP imaging data of 2 300 patients treated from July 2015 to July 2020 at the Department of Radiology of the Affiliated Cancer Hospital of Zhengzhou University were screened and a total of 381 patients diagnosed with biliary duct structures were identified. Causative etiologies among these patients included pancreatic adenocarcinoma (pancreatic head), cholangiocarcinoma, ampullary carcinoma, as well as intrahepatic and/or extrahepatic bile duct dilation. An improved PTCD tube was designed based on MRCP quantification of left and right hepatic and common hepatic duct length. Results: In the setting of biliary obstruction caused by malignancy, the distance of the left hepatic duct from its origin to the point of left and right hepatic duct confluence was 15.9±3.8 mm, while the distance of the right hepatic duct from its origin to the point of left and right hepatic duct confluence was 12.4±3.2 mm; the length of the bile duct from its origin to the point of left and right hepatic duct confluence was 34.0±8.1 mm. The improved PTCD tube design incorporated an altered length of the drainage orifice. Conclusion: MRCP imaging of the biliary tract is effective for measuring biliary tract length in the setting of pathological dilation. Based on our biliary tract measurements, a modified PTCD tube was designed to more effectively meet drainage requirements and manage biliary obstruction caused by Bismuth-Corlette type Ⅱ and Ⅲ malignancies.

[The expression of Plakoglobin in residual cancer after neoadjuvant chemotherapy for breast cancer and its prognostic impact on patients].

Objective: To investigate the relationship between the expression levels of Plakoglobin protein in residual lesions after neoadjuvant chemotherapy (NAC) and the prognosis of breast cancer patients. Methods: Clinical and pathological data from 174 breast cancer patients who underwent surgery after receiving NAC at the Cancer Hospital of Chinese Academy of Medical Sciences from January 2009 to December 2017 were collected. The expression level of Plakoglobin in residual cancer lesions was evaluated by immunohistochemistry. The correlation between Plakoglobin expression level and clinicopathological features was analyzed. Survival analysis was performed using the Kaplan-Meier method, and Cox proportional hazard regression models were used for factor analysis. Results: Among the 174 patients, 140 had low expression of Plakoglobin, and 34 had high expression. The median disease-free survival (DFS) and overall survival (OS) in the Plakoglobin low expression group were 59.46 and 71.68 months, respectively, both of which were higher than those in the high expression group (36.58 and 47.26 months, respectively, both P<0.05). Univariate analysis showed that Plakoglobin expression, pathological N stage, lymphovascular invasion status, histological grade, Ki-67, and molecular subtypes were associated with OS (all P<0.05), while pathological N stage, histological grade, and Ki-67 were associated with DFS (all P<0.05). Multivariate analysis revealed that Plakoglobin expression (HR=2.438, 95% CI: 1.256-4.735, P=0.008) was an independent predictor for OS, and Ki-67 (HR=2.228, 95% CI: 1.316-3.773, P=0.003) was an independent predictor for DFS. Conclusion: In breast cancer patients with residual lesions after NAC, those with low Plakoglobin expression have relatively longer OS and Plakoglobin is an independent prognostic factor for OS.

The diagnostic efficiency of diffusion-weighted imaging in placenta accreta spectrum: a systematic review and meta-analysis.

OBJECTIVE: This study aims to evaluate the diagnostic efficiency of diffusion-weighted imaging (DWI) in patients with placenta accreta spectrum (PAS). MATERIALS AND METHODS: The present study searched on PubMed, Embase, OVID, Cochrane, Scopus and CNKI, Chinese Bio-Medical Literature, VIP, Wanfang, Duxiu, databases for studies related to the diagnostic performance of DWI for PAS from inception to December 2022. The pooled sensitivity, the pooled specificity, positive likelihood ratio (LR+), negative likelihood ratio (LR-), and diagnosis odds ratios (DOR) were calculated by Meta-disc 1.4 and STATA 16.0. RESULTS: A total of 11 studies met the criteria and were included in the meta-analysis. The effect indexes of DWI in combined PAS were as follows. The pooled sensitivity was 0.670 (0.619-0.719). The pooled specificity was 0.720 (0.661-0.773). The pooled LR+ was 2.161 (1.454-3.211). The pooled LR- was 0.413 (0.280-0.609). The pooled AUC was 0.7841, and Q* was 0.7221. The pooled diagnostic ratio DOR was 6.713 (2.981-15.118). Subgroup analysis showed that four studies used T2-weighted imaging (T2WI) + DWI to diagnose PAS, and the pooled AUC was 0.9822. CONCLUSIONS: The results showed that DWI had high sensitivity and specificity in the diagnosis of PAS. Furthermore, T2WI+DWI has higher diagnostic efficacy than DWI alone in the diagnosis of PAS. Therefore, it is necessary to set T2WI+DWI as a routine sequence for PAS, and T2WI+DWI should be a routine method for the daily diagnosis of PAS.