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Carcinoma ex pleomorphic adenoma of the trachea:A case report 预览
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作者 Heng-Xing Gao Quan Li +3 位作者 Wen-Li Chang Ya-Long Zhang Xiao-Zhi Wang Xue-Xue Zou 《世界临床病例杂志》 2019年第17期2623-2629,共7页
BACKGROUND Carcinoma ex pleomorphic adenoma (CXPA) is defined as a malignant salivary gland tumor arising from a primary or recurrent pleomorphic adenoma.Only three cases of CXPA of the trachea have been reported in t... BACKGROUND Carcinoma ex pleomorphic adenoma (CXPA) is defined as a malignant salivary gland tumor arising from a primary or recurrent pleomorphic adenoma.Only three cases of CXPA of the trachea have been reported in the literature.CASE SUMMARY We report a case of tracheal CXPA in a 55-year-old woman,who presented with a more than 3-mo history of progressive dyspnea.Computed tomography of the neck and thorax revealed an inhomogeneous,broad-based lesion arising from the tracheal wall on the right side.Endoscopy revealed a subglottic neoplasm causing up to 90% luminal stenosis.The tumor was resected using a highfrequency electrosurgical snare combined with argon plasma coagulation.Histopathology and immunohistochemistry revealed that the tumor was a CXPA of the trachea.CONCLUSION We report the fourth case of tracheal CXPA,and present the first instance of resection of CXPA using high-frequency electrosurgical snare and laser ablation.We also discuss the pathogenesis,diagnosis,histopathology,and systemic therapy of this rare disease. 展开更多
关键词 Case report CARCINOMA EX PLEOMORPHIC ADENOMA TRACHEA PLEOMORPHIC ADENOMA
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Effective chemotherapy for submandibular gland carcinoma ex pleomorphic adenoma with lung metastasis after radiotherapy: A case report 预览
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作者 Zhi-Yuan Chen Yu Zhang +2 位作者 Yan Tu Wei Zhao Mei Li 《世界临床病例杂志》 2019年第6期792-797,共6页
BACKGROUND Only a few cases of carcinoma ex pleomorphic adenoma arising in the submandibular gland have ever been reported, all with a poor prognosis. The standard treatment for salivary gland carcinoma ex pleomorphic... BACKGROUND Only a few cases of carcinoma ex pleomorphic adenoma arising in the submandibular gland have ever been reported, all with a poor prognosis. The standard treatment for salivary gland carcinoma ex pleomorphic adenoma is surgical resection combined with postoperative radiotherapy, but the necessity of chemotherapy as well as the most appropriate treatment regimen for patients with distant metastasis after radiotherapy remains controversial. CASE SUMMARY This report presents the case of a 73-year-old woman who suffered submandibular gland carcinoma ex pleomorphic adenoma. She accepted surgery to remove the mass;she was found to have lung metastasis after radiotherapy. Her condition was controlled by chemotherapy with liposomal doxorubicin plus cisplatin. CONCLUSION The positive clinical outcome in the patient reveals that this chemotherapy regimen may be an alternative treatment for such a condition. 展开更多
关键词 Malignant PLEOMORPHIC ADENOMA SALIVARY GLAND TUMORS CHEMOTHERAPY Carcinoma ex PLEOMORPHIC ADENOMA Case report
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Immunohistochemical features of carcinoma ex pleomorphic adenoma and pleomorphic adenoma in the lacrimal gland
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作者 Ping Zhang Li-Juan Tang +3 位作者 Huan-Huan Gao Wen-Xin Zhang Jian-Xian Lin Hua-Sheng Yang 《国际眼科杂志:英文版》 SCIE CAS 2019年第8期1238-1242,共5页
AIM: To investigate C-myc, Ki-67, pan-cytokeratin, and vimentin immunohistochemical features of carcinoma ex pleomorphic adenoma(Ca-ex-PA) and pleomorphic adenoma(PA) in the lacrimal gland in order to find some clues ... AIM: To investigate C-myc, Ki-67, pan-cytokeratin, and vimentin immunohistochemical features of carcinoma ex pleomorphic adenoma(Ca-ex-PA) and pleomorphic adenoma(PA) in the lacrimal gland in order to find some clues in the differential diagnosis between them.METHODS: We reviewed microscopic slides and clinical records of 64 cases of PA and 15 cases of Ca-ex-PA in the lacrimal gland. Immunohistochemical antibodies for C-myc, Ki-67, pan-cytokeratin, and vimentin were employed.RESULTS: Median age of PA was 43.2 y(from 21 to 75). The 35 patients(54.7%) were male and 29 patients(45.3%) were female. For the PAs, the average positivity of C-myc was 4.6%;the average proliferation index of Ki-67 was 3.2%;pan-cytokeratin was positive in ductal cells, and vimentin was positive in myoepithelial cells. Median age of Ca-ex-PA was 54.3 y(from 26 to 76). There were 7 male patients(46.7%) and 8 female patients(53.3%). Among 15 Ca-ex-PAs, there were 6 myoepithelial carcinomas, 4 adenocarcinomas, 3 epithelial-myoepithelial carcinomas, and 2 squamous cell carcinomas. For the Ca-ex-PAs, the average positivity of C-myc was 36.4%;the average proliferation index of Ki-67 was 29.2%;pan-cytokeratin was positive in all cases, and vimentin was positive in myoepithelial carcinomas.CONCLUSION: PA has a lower positivity of C-myc and Ki-67, while Ca-ex-PA had a higher positivity of these two biomarkers. These four biomarkers as a set could provide valuable clues in the differential diagnosis between Ca-exPA and PA. Our results indicate that the activation of C-myc could play an important role in the pathogenesis of Ca-exPA and PA. 展开更多
关键词 carcinoma EX PLEOMORPHIC ADENOMA PLEOMORPHIC ADENOMA C-MYC IMMUNOHISTOCHEMISTRY
Confounders in Adenoma Detection at Initial Screening Colonoscopy: A Factor in the Assessment of Racial Disparities as a Risk for Colon Cancer 预览
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作者 Yakira David Lorenzo Ottaviano +15 位作者 Jihye Park Sadat Iqbal Michelle Likhtshteyn Samir Kumar Helen Lyo Ayanna E. Lewis Brandon E. Lung Jesse T. Frye Li Huang Ellen Li Jie Yang Laura Martello Shivakumar Vignesh Joshua D. Miller Michele Follen Evan B. Grossman 《癌症治疗(英文)》 2019年第4期269-289,共21页
Background and Aims: The incidence and mortality of colorectal cancer is persistently highest in Black/African-Americans in the United States. While access to care, barriers to screening, and poverty might explain the... Background and Aims: The incidence and mortality of colorectal cancer is persistently highest in Black/African-Americans in the United States. While access to care, barriers to screening, and poverty might explain these findings, there in increased interest in examining biological factors that impact the colonic environment. Our group is examining biologic factors that contribute to disparities in development of adenomas prospectively. In preparation for this and to characterize a potential patient population, we conducted a retrospective review of initial screening colonoscopies in a cohort of patients. Methods: A retrospective review was performed on initial average risk screening colonoscopies on patients (age 45 - 75 years) during 2012 at three institutions. Descriptive statistics and multivariable logistic regression models were used to examine the relationship between potential risk factors and the detection of adenomas. Results: Of the 2225 initial screening colonoscopies 1495 (67.2%) were performed on Black/African-Americans and 566 (25.4%) on Caucasians. Multivariable logistic regression revealed that older age, male sex, current smoking and teaching gastroenterologists were associated with higher detection of adenomas and these were less prevalent among Black/African-Americas except for age. Neither race, ethnicity, BMI, diabetes mellitus, HIV nor insurance was associated with adenoma detection. Conclusion: In this sample, there was no association between race and adenoma detection. While this may be due to a lower prevalence of risk factors for adenomas in this sample, our findings were confounded by a lower detection rate by consultant gastroenterologists at one institution. The study allowed us to rectify the problem and characterize patients for future trials. 展开更多
关键词 COLORECTAL Cancer SCREENING ADENOMA Quality
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Functioning gonadotroph adenoma
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作者 Yi Zhao Wei Lian +2 位作者 Bing Xing Ming Feng Wen-Bin Ma 《中华医学杂志:英文版》 SCIE CAS CSCD 2019年第8期1003-1004,共2页
To the Editor:Pituitary gonadotroph adenoma is a type of non-functioning pituitary adenoma of which approximately 35%ecrete biologically active luteinizing hormone(LH)or follicle-stimulating hormone(FSH),and these ade... To the Editor:Pituitary gonadotroph adenoma is a type of non-functioning pituitary adenoma of which approximately 35%ecrete biologically active luteinizing hormone(LH)or follicle-stimulating hormone(FSH),and these adenomas are named functioning gonadotroph adenoma(FGA).We present three cases of FSH-secreting adenomas who were admitted to our hospital between 2014 and 2016.Case 1:A 37-year-old woman was admitted due to menstrual irregularity and galactorrhea for 2 years.The laboratory tests showed a significantly elevated estradiol 2(E2)level,and multiple cyst fusions could be observed by transvaginal ultrasonography.The pituitary magnetic resonance imaging(MRI)revealed an upper-right wing distension and detected a mass with a size of approximately 7.5 mm×10.7 mm in the saddle area,and a pituitarymacroadenoma was considered.The patient underwent a transsphenoidal microsurgical resection of the pituitary adenoma.The pathologic examination showed a positive result for FSH,LH,and SF-1,and a negative result for growth hormone,insulin-like growth factor 1,TPIT,and PIT1. 展开更多
关键词 PITUITARY gonadotroph ADENOMA non-functioning PITUITARY ADENOMA luteinizing hormone(LH) follicle-stimulating hormone(FSH)
Malignant transformation of hepatocellular adenoma in a young female patient after ovulation induction fertility treatment: A case report 预览
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作者 Juan Glinka Rodrigo Sanchez Clariá +7 位作者 Eugenia Fratanoni Juan Spina Eduardo Mullen Victoria Ardiles Oscar Mazza Juan Pekolj Martin de Santibanes Eduardo de Santibanes 《世界胃肠外科杂志:英文版(电子版)》 2019年第4期229-236,共8页
BACKGROUND Hepatocellular adenoma (HCA) is a rare benign liver tumor usually affecting young women with a history of prolonged use of hormonal contraception. Although the majority is asymptomatic, a low proportion may... BACKGROUND Hepatocellular adenoma (HCA) is a rare benign liver tumor usually affecting young women with a history of prolonged use of hormonal contraception. Although the majority is asymptomatic, a low proportion may have significant complications such as bleeding or malignancy. Despite responding to the hormonal stimulus, the desire for pregnancy in patients with small HCA is not contraindicated. However, through this work we demonstrate that intensive hormonal therapies such as those used in the treatment of infertility can trigger serious complications CASE SUMMARY A 33-year-old female with a 10-year history of oral contraceptive use was diagnosed with a hepatic tumor as an incidental finding in an abdominal ultrasound. The patient showed no symptoms and physical examination was unremarkable. Laboratory functional tests were within normal limits and tests for serum tumor markers were negative. An abdominal magnetic resonance imaging (MRI) was performed, showing a 30 mm × 29 mm focal lesion in segment VI of the liver compatible with HCA or Focal Nodular Hyperplasia with atypical behavior. After a total of six years of follow-up, the patient underwent ovulationinduction treatment for infertility. On a following MRI, a suspected malignancy was warned and hence, surgery was decided. The surgical specimen revealed malignant transformation of HCA towards trabecular hepatocarcinoma with dedifferentiated areas. There was non-evidence of tumor recurrence after three years of clinical and imaging follow-up. CONCLUSION HCAs can be malignant regardless its size and low-risk appearance on MRI when an ovultation induction therapy is indicated. 展开更多
关键词 HEPATOCELLULAR ADENOMA MALIGNANT transformation FOCAL liver LESION ADENOMA OVULATION induction Case report
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Effect of Endocuff use on colonoscopy outcomes:A systematic review and meta-analysis 预览
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作者 Konstantinos Triantafyllou Paraskevas Gkolfakis +3 位作者 Georgios Tziatzios Ioannis S Papanikolaou Lorenzo Fuccio Cesare Hassan 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第9期1158-1170,共13页
BACKGROUND Endocuff-a plastic device with flexible projections-mounted on the distal tip of the colonoscope,promises improved colonic mucosa inspection.AIM To elucidate the effect of Endocuff on adenoma detection rate... BACKGROUND Endocuff-a plastic device with flexible projections-mounted on the distal tip of the colonoscope,promises improved colonic mucosa inspection.AIM To elucidate the effect of Endocuff on adenoma detection rate(ADR),advanced ADR(AADR)and mean number of adenomas per colonoscopy(MAC).METHODS Literature searches identified randomized-controlled trials evaluating Endocuffassisted colonoscopy(EAC)vs conventional colonoscopy(CC)in terms of ADR,AADR and MAC.The effect size on study outcomes was calculated using fixed or random effect model,as appropriate,and it is shown as relative risk(RR)[95%confidence interval(CI)]and mean difference(MD)(95%CI).The rate of device removal in EAC arms was also calculated.RESULTS We identified nine studies enrolling 6038 patients.All studies included mixed population(screening,surveillance and diagnostic examinations).Seven and two studies evaluated the first and the second-generation device,respectively.EAC was associated with increased ADR compared to CC[RR(95%CI):1.18(1.05-1.32);Ι^2=71%];EAC benefits more endoscopists with ADR≤35%compared to those with ADR>35%[RR(95%CI):1.37(1.08-1.74);Ι^2=49%vs 1.10(0.99-1.24);Ι^2=71%].In terms of AADR and MAC,no difference was detected between EAC and CC[RR(95%CI):1.03(0.85-1.25);Ι^2=15%and MD(95%CI):0.30(-0.17-0.78);Ι^2=99%].Subgroup analysis did not show any difference between the two device generations regarding all three endpoints.In EAC arms,the device had to be removed in 3%(95%CI:2%-5%)of the cases mainly due to tortuous sigmoid or presence of diverticula along it.CONCLUSION EAC increases ADR compared to CC,especially for endoscopists with lower ADR.On the other hand,no significant effect on AADR and MAC was detected. 展开更多
关键词 ADENOMA DETECTION rate COLONOSCOPY ADENOMA DETECTION Endocuff Endocuff-Vision
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颅内碰撞瘤二例报告 预览
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作者 程轶峰 徐德生 +2 位作者 刘东 任义 尹绍雅 《天津医药》 CAS 北大核心 2019年第1期79-81,115共4页
颅内碰撞瘤临床少见,术前诊断困难,诊断主要依靠术后病理确诊。本文报道的2例颅内碰撞瘤分别位于小脑和鞍区,分别采用后正中入路和翼点入路行开颅手术治疗。其中小脑碰撞瘤肿瘤完整切除,病理结果为转移瘤与脑膜瘤碰撞,术后14个月随访患... 颅内碰撞瘤临床少见,术前诊断困难,诊断主要依靠术后病理确诊。本文报道的2例颅内碰撞瘤分别位于小脑和鞍区,分别采用后正中入路和翼点入路行开颅手术治疗。其中小脑碰撞瘤肿瘤完整切除,病理结果为转移瘤与脑膜瘤碰撞,术后14个月随访患者因全身多发转移多脏器衰竭死亡;鞍区碰撞瘤次全切除,病理结果为脑膜瘤与垂体瘤碰撞,术后左眼睑上抬困难,左眼视力下降,术后3个月随访左眼睑上抬困难症状缓解,术后1年随访未见肿瘤复发。 展开更多
关键词 肿瘤转移 脑膜瘤 腺瘤 病理学 碰撞瘤 垂体腺瘤
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内镜下切除十二指肠球部Brunner大腺瘤:1例报道并文献复习 预览
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作者 曾小辉 曾锻 杨兵 《胃肠病学和肝病学杂志》 CAS 2019年第11期1318-1320,共3页
十二指肠Brunner腺瘤(Brunner gland adenoma,BGA)是十二指肠良性肿瘤的一种罕见疾病,随着消化内镜技术的发展,内镜下切除十二指肠BGA已逐渐替代传统外科手术治疗。最近深圳市龙岗中心医院行内镜下切除十二指肠球部巨大BGA 1例,无出血... 十二指肠Brunner腺瘤(Brunner gland adenoma,BGA)是十二指肠良性肿瘤的一种罕见疾病,随着消化内镜技术的发展,内镜下切除十二指肠BGA已逐渐替代传统外科手术治疗。最近深圳市龙岗中心医院行内镜下切除十二指肠球部巨大BGA 1例,无出血、穿孔等并发症发生。内镜治疗十二指肠BGA是安全、有效的,值得推广。 展开更多
关键词 十二指肠 BRUNNER腺 腺瘤 胃镜 内镜治疗
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Identification of CDK6 and RHOU in Serum Exosome as Biomarkers for the Invasiveness of Non-functioning Pituitary Adenoma 预览
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作者 Shan Yu Xiaoshuang Wang +2 位作者 Kaican Cao Xinjie Bao Jia Yu 《中国医学科学杂志:英文版》 CAS CSCD 2019年第3期168-176,共9页
Objective To explore circulating biomarkers for screening the invasiveness of non-functioning pituitary adenomas(NF-PAs).Methods The exosomal RNAs were extracted from serum of patients with invasive NF-PA(INF-PA)or no... Objective To explore circulating biomarkers for screening the invasiveness of non-functioning pituitary adenomas(NF-PAs).Methods The exosomal RNAs were extracted from serum of patients with invasive NF-PA(INF-PA)or noninvasive NF-PA(NNF-PA).Droplet digital PCR was adapted to detect the mRNA expression of candidate genes related to tumor progression or invasion,such as cyclin dependent kinase 6(CDK6),ras homolog family member U(RHOU),and spire type actin nucleation factor 2(SPIRE2).Student’s t-test was used to analyze the statistical difference in the mRNA expression of candidate genes between the two groups.Receiver operating characteristic(ROC)curve was used to establish a model for predicting the invasiveness of NF-PAs.The accuracy,sensitivity,specificity and precision of the model were then obtained to evaluate the diagnostic performance.Results CDK6(0.2600±0.0912 vs.0.1789±0.0628,t=3.431,P=0.0013)and RHOU mRNA expressions(0.2696±0.1118 vs.0.1788±0.0857,t=2.946,P=0.0052)were upregulated in INF-PAs patients’serum exosomes as compared to NNF-PAs.For CDK6,the area under the ROC curve(AUC)was 0.772(95%CI:0.600-0.943,P=0.005),the accuracy,sensitivity,specificity and precision were 77.27%,83.33%,75.00%and 55.56%to predict the invasiveness of NF-PAs.For RHOU,the AUC was 0.757(95%CI:0.599-0.915,P=0.007),the accuracy,sensitivity,specificity and precision were 72.73%,83.33%,68.75%and 50.00%.In addition,the mRNA levels of CDK6 and RHOU in serum exosomes were significantly positively correlated(r=0.935,P<0.001).After combination of the cut-off scores of the two genes,the accuracy,sensitivity,specificity and precision were 81.82%,83.33%,81.25%and 62.50%.Conclusions CDK6 and RHOU mRNA in serum exosomes can be used as markers for predicting invasiveness of NF-PAs.Combination of the two genes performs better in distinguishing INF-PAs from NNF-PAs.These results indicate CDK6 and RHOU play important roles in the invasiveness of NF-PAs,and the established diagnostic method is valuable for directing the clinical screening 展开更多
关键词 PITUITARY ADENOMA INVASIVENESS EXOSOME DROPLET digital PCR biomarkers RHOU CDK6
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Evaluation and comparison of short chain fatty acids composition in gut diseases 预览
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作者 Elena Niccolai Simone Baldi +9 位作者 Federica Ricci Edda Russo Giulia Nannini Marta Menicatti Giovanni Poli Antonio Taddei Gianluca Bartolucci Antonino Salvatore Calabrò Francesco Claudio Stingo Amedeo Amedei 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第36期5543-5558,共16页
BACKGROUND An altered (dysbiosis) and unhealthy status of the gut microbiota is usually responsible for a reduction of short chain fatty acids (SCFAs) concentration. SCFAs obtained from the carbohydrate fermentation p... BACKGROUND An altered (dysbiosis) and unhealthy status of the gut microbiota is usually responsible for a reduction of short chain fatty acids (SCFAs) concentration. SCFAs obtained from the carbohydrate fermentation processes are crucial in maintaining gut homeostasis and their determination in stool samples could provide a faster, reliable and cheaper method to highlight the presence of an intestinal dysbiosis and a biomarker for various gut diseases. We hypothesize that different intestinal diseases, such as celiac disease (CD), adenomatous polyposis (AP) and colorectal cancer (CRC) could display a particular fecal SCFAs’ signature. AIM To compare the fecal SCFAs’ profiles of CD, AP, CRC patients and healthy controls, using the same analytical method. METHODS In this cross-sectional study, we defined and compared the SCFAs’ concentration in fecal samples of 9 AP, 16 CD, 19 CRC patients and 16 healthy controls (HC). The SCFAs’ analysis were performed using a gas-chromatography coupled with mass spectrometry method. Data analysis was carried out using Wilcoxon ranksum test to assess pairwise differences of SCFAs’ profiles, partial least squaresdiscriminate analysis (PLS-DA) to determine the status membership based on distinct SCFAs’ profiles, and Dirichlet regression to determine factors influencing concentration levels of SCFAs. RESULTS We have not observed any difference in the SCFAs’ amount and composition between CD and healthy control. On the contrary, the total amount of SCFAs was significantly lower in CRC patients compared to HC (P = 0.044) and CD (P = 0.005). Moreover, the SCFAs’ percentage composition was different in CRC and AP compared to HC. In detail, HC displayed higher percentage of acetic acid (P value = 1.3 × 10-6) and a lower amount of butyric (P value = 0.02192), isobutyric (P value = 7.4 × 10-5), isovaleric (P value = 0.00012) and valeric (P value = 0.00014) acids compared to CRC patients. AP showed a lower abundance of acetic acid (P value = 0.00062) and higher percentages 展开更多
关键词 Short chain FATTY ACIDS MICROBIOTA Colorectal cancer ADENOMA CELIAC disease
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白光内镜与放大内镜联合窄带光成像技术对良性病变中肠型胃腺瘤的诊断作用比较
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作者 滕腊梅 章庆伟 +3 位作者 张昕恬 陈锦南 周菁 李晓波 《中华消化内镜杂志》 CSCD 北大核心 2019年第8期558-562,共5页
目的比较常规白光内镜与放大内镜联合窄带光成像技术在良性病变中诊断肠型胃腺瘤的准确性。方法收集2016年1月至2017年12月在上海仁济医院消化内镜中心经白光内镜检查怀疑胃早期肿瘤性病变的连续患者,择期再次行白光内镜及放大内镜联合... 目的比较常规白光内镜与放大内镜联合窄带光成像技术在良性病变中诊断肠型胃腺瘤的准确性。方法收集2016年1月至2017年12月在上海仁济医院消化内镜中心经白光内镜检查怀疑胃早期肿瘤性病变的连续患者,择期再次行白光内镜及放大内镜联合窄带光成像检查,分别记录其内镜诊断结果,并以活检或术后病理诊断为评判标准,除外癌变病灶,比较白光内镜和放大内镜联合窄带光成像内镜在良性病灶中区分肠型胃腺瘤和其他非腺瘤病变的诊断准确性。结果共纳入232例患者(232个病灶),其中肠型胃腺瘤124例,其他非腺瘤性良性病灶(萎缩、溃疡、增生、非肠型胃腺瘤相关低级别上皮内瘤变等)108例,放大内镜联合窄带光成像区分肠型胃腺瘤与非腺瘤性良性病变的灵敏度、阴性预测值、准确率均显著高于白光内镜(分别为92.7%比71.8%,91.6%比73.7%,91.8%比80.6%,P均<0.01),特异度一致(均为90.7%),阳性预测值和白光内镜相比(92.0%比89.9%),差异无统计学意义(P>0.05)。结论放大内镜联合窄带光成像鉴别肠型胃腺瘤与非腺瘤性良性病变的诊断效能显著高于白光内镜。 展开更多
关键词 腺瘤 胃肿瘤 内窥镜检查 胃肠道 窄带光成像
T2WI肿瘤最大层面直方图分析鉴别腮腺多形性腺瘤与恶性肿瘤 预览
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作者 黄荟玉 张勇 +3 位作者 程敬亮 许珂 文萌萌 文宝红 《中国介入影像与治疗学》 北大核心 2019年第8期464-468,共5页
目的探讨T2WI肿瘤最大层面直方图分析鉴别腮腺多形性腺瘤与恶性肿瘤的价值。方法回顾性分析经手术病理证实的41例腮腺多形性腺瘤及23例腮腺恶性肿瘤患者的MRI资料。采用MaZda软件在轴位最大肿瘤层面T2WI中勾画ROI,进行灰度直方图分析,获... 目的探讨T2WI肿瘤最大层面直方图分析鉴别腮腺多形性腺瘤与恶性肿瘤的价值。方法回顾性分析经手术病理证实的41例腮腺多形性腺瘤及23例腮腺恶性肿瘤患者的MRI资料。采用MaZda软件在轴位最大肿瘤层面T2WI中勾画ROI,进行灰度直方图分析,获取9个特征参数(均值、方差、峰度、偏度、第1百分位数、第10百分位数、第50百分位数、第90百分位数及第99百分位数)进行统计分析,比较腮腺多形性腺瘤与恶性肿瘤间直方图特征参数的差异;绘制ROC曲线,评价以直方图特征参数鉴别腮腺多形性腺瘤与恶性肿瘤的效能。结果9个特征参数中,第1百分位数及第10百分位数在腮腺多形性腺瘤与恶性肿瘤间差异有统计学意义(P均<0.05),腮腺多形性腺瘤均高于恶性肿瘤。ROC曲线分析显示,第10百分位数最具鉴别诊断效能,AUC为0.70(P=0.01),最佳临界值为76.00,敏感度为66.70%,特异度为60.00%。第1百分位数的ROC曲线AUC、最佳临界值、敏感度及特异度分别为0.67(P=0.04)、46.50、63.90%及60.00%。结论T2WI肿瘤最大层面直方图分析可作为术前鉴别腮腺多形性腺瘤与恶性肿瘤的重要手段,为临床提供有价值的参考信息。 展开更多
关键词 腮腺肿瘤 腺瘤 多形性 恶性肿瘤 磁共振成像 直方图
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Higher dose of simethicone decreases colonic bubbles and increases prep tolerance and quality of bowel prep: Meta-analysis of randomized controlled trials 预览
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作者 Mohammad F Madhoun Maham Hayat Ijlal Akbar Ali 《世界荟萃分析杂志》 2019年第3期110-119,共10页
BACKGROUND Antifoaming agents, such as simethicone, may facilitate mucosal inspection during colonoscopy. However, conflicting results have been reported with regard to the impact of simethicone on quality of bowel pr... BACKGROUND Antifoaming agents, such as simethicone, may facilitate mucosal inspection during colonoscopy. However, conflicting results have been reported with regard to the impact of simethicone on quality of bowel preparation and adenoma detection rate (ADR). AIM To perform a meta-analysis of trials that have compared simethicone vs placebo during colonoscopy. METHODS A reproducible literature search of multiple medical databases yielded eleven studies (n = 2605) for inclusion. Studies were compared for quality of bowel preparation, bubbles quality, ADR, and tolerability. Two reviewers independently scored the identified studies for methodology and abstracted pertinent data. Pooling was conducted by both fixed-effects and random-effects models. Relative risk (RR) estimates with a 95% confidence interval (CI) were calculated. Heterogeneity was assessed by I-squared index (I2) statistics. RESULTS Patients’ demographic characteristics were comparable in all studies. Of the 2605 patients, 1300 were in the simethicone group, whereas 1305 were in the placebo group. Inadequate bowel preparation was much lower in the simethicone group than in the placebo group [13% vs 24.6%;RR = 0.51 (0.31-0.82);P < 0.0001]. The placebo group was more likely to have significant colonic bubbles than was the simethicone group [35% vs 8%;RR = 1.49 (1.25-1.76);P = 0.0001]. Use of simethicone resulted in a slight, statistically significant increase in ADR compared with the placebo group [26.6% vs 21.6%, RR = 1.07 (1.01-1.13);P = 0.02]. Higher doses of simethicone (> 478 mg) were more likely to result in significant reduction of inadequate bowel preparation, colonic bubbles, and to improve ADR. CONCLUSION Adding simethicone improved the quality of bowel preparation, visualization, tolerability, and, eventually, ADR. 展开更多
关键词 SIMETHICONE Colonoscopy BUBBLES BOWEL preparation ADENOMA detection rate
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CT联合MRI检查对肝脏病变的定性诊断价值分析
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作者 王磊 吴静泽 《中国基层医药》 CAS 2019年第12期1480-1483,共4页
目的探讨CT联合MRI检查对肝脏病变的定性诊断价值.方法选取2015年8月至2018年3月舟山医院收治的肝脏病变患者100例,对患者分别进行CT、MRI以及两者联合检查,比较分析三种不同方式对肝脏疾病的诊断结果.结果通过CT检查检出96处病灶,检出... 目的探讨CT联合MRI检查对肝脏病变的定性诊断价值.方法选取2015年8月至2018年3月舟山医院收治的肝脏病变患者100例,对患者分别进行CT、MRI以及两者联合检查,比较分析三种不同方式对肝脏疾病的诊断结果.结果通过CT检查检出96处病灶,检出率为88.89%;通过MRI检查检出97处病灶,检出率为89.81%;通过CT与MRI两者联合扫描共检出105处病灶,检出率为97.22%两者联合检查检出率和检出病灶数明显高于单一检出率,差异均有统计学意义(X^2=8.25、6.22,均P<0.05),但CT和MRI检出率与病灶数差异均无统计学意义(均P>0.05)。结论通过CT与MRI联合对肝脏病变位置进行检查,对良恶性病灶诊断均有着很好的诊断效果、副作用相对较少、安全系数高,值得在临床诊断中广泛使用。 展开更多
关键词 体层摄影术 X线计算机 磁共振成像 腺瘤 肝细胞 肝细胞 肝脓肿
近焦窄带光成像鉴别诊断增生性息肉及无蒂型锯齿状腺瘤/息肉的价值
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作者 肖子理 项平 +3 位作者 李风 黄任翔 季大年 保志军 《中华消化内镜杂志》 CSCD 北大核心 2019年第8期568-571,共4页
目的评估近焦窄带光成像(near focus narrow-band imaging, NF-NBI)鉴别增生性息肉(hyperplastic polyp, HP)及无蒂型锯齿状腺瘤/息肉(sessile serrated adenoma/polyp, SSA/P)的价值。方法回顾性分析2017年10月至2018年9月于复旦大学... 目的评估近焦窄带光成像(near focus narrow-band imaging, NF-NBI)鉴别增生性息肉(hyperplastic polyp, HP)及无蒂型锯齿状腺瘤/息肉(sessile serrated adenoma/polyp, SSA/P)的价值。方法回顾性分析2017年10月至2018年9月于复旦大学附属华东医院消化内镜中心内镜下切除后病理结果为HP或SSA/P,且数据库内有清晰NF-NBI图像的65例结肠息肉患者的病倒资料。由3名高年资医师分别观察NF-NBI图像,包括扩张的隐窝开口( expanded crypt opening, ECO)及增粗的树枝样血管(thick and branched vessel, TBV),将结果与病理结果进行对比,分析ECO与TBV对于HP及SSA/P鉴别诊断价值。结果65例病变中,病理结果显示SSA/P 44例,HP 21例。ECO鉴别诊断HP与SSA/P的灵敏度、特异度和准确率分别为80. 3%( 106/132). 85. 7%( 54/63 )和82. 1%(160/195);TBV鉴别诊断HP与SSA/P的灵敏度、特异度和准确率分别为38. 6%(51/132).82. 5%(52/63)和52. 8%( 103/195)。ECO联合TBV鉴别诊断HP与SSA/P的灵敏度、特异度和准确率分别为 84. 8%( 112/132)、73. 0%(46/63)和 81.0%( 158/195)。结论 NF-NBI 下 ECO 对于诊断 SSA/P 具有较高灵敏度。ECO与TBV联合诊断,有助于SSA/P与HP的鉴别诊断。 展开更多
关键词 腺瘤 息肉 近焦窄带光成像
Primary hyperparathyroidism in a woman with multiple tumors: A case report 预览
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作者 Can-Can Hui Xue Zhang +1 位作者 Jian-Ran Sun Da-Tong Deng 《世界临床病例杂志》 2019年第19期3132-3137,共6页
BACKGROUND Parathyroid adenoma(PTA)is known as an adenomatous hyperparathyroidism syndrome.At earlier times,the major symptoms of this disease included high blood calcium and low phosphorus.PTA is a benign neuroendocr... BACKGROUND Parathyroid adenoma(PTA)is known as an adenomatous hyperparathyroidism syndrome.At earlier times,the major symptoms of this disease included high blood calcium and low phosphorus.PTA is a benign neuroendocrine neoplasm.We have reviewed the literature and found that it is rare for patients with hyperparathyroidism to have benign tumors with multiple organs at the same time.This report describes a patient with a PTA and four nonfunctional adenomas.CASE SUMMARY We report a case of primary hyperparathyroidism in a 39-year-old woman with multiple organ tumors.The patient was admitted to hospital because of hypercalcemia.Laboratory,imaging,and histological examinations confirmed a left parathyroid neoplasm.Right thyroid adenoma was discovered during hospitalization.She had a medical history of uterine fibroids,right benign mammary gland tumor,and meningioma.The patient recovered after surgical and conservative treatments.CONCLUSION Primary hyperparathyroidism with multiple organ tumors is uncommon,and further studies should be conducted to determine if there is genetic heterogeneity. 展开更多
关键词 Primary HYPERPARATHYROIDISM PARATHYROID NEOPLASM THYROID ADENOMA MENINGIOMA Breast NEOPLASM Case report
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复发性上颌窦多形性腺瘤恶变为肌上皮癌1例
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作者 胡真真 李道明 +1 位作者 金晓朗 王英 《临床耳鼻咽喉头颈外科杂志》 CAS 北大核心 2019年第9期891-893,共3页
1病例报告患者,女,44岁,因左侧鼻塞、面部麻木4月余于2018年6月入院,不伴复视、视力下降、涕中带血、头晕头痛等不适。患者曾于1991年在当地医院行左侧上颌黏膜囊肿切除术,术后病理回示:多形性腺瘤;2001年病情复发,于外院再次行左侧上... 1病例报告患者,女,44岁,因左侧鼻塞、面部麻木4月余于2018年6月入院,不伴复视、视力下降、涕中带血、头晕头痛等不适。患者曾于1991年在当地医院行左侧上颌黏膜囊肿切除术,术后病理回示:多形性腺瘤;2001年病情复发,于外院再次行左侧上颌黏膜囊肿切除术,病理回示:上颌多形性腺瘤。 展开更多
关键词 上颌窦 腺瘤 多形性 肌上皮瘤
Diagnostic and prognostic potential of tissue and circulating long non-coding RNAs in colorectal tumors 预览
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作者 Orsolya Galamb Barbara K Barták +5 位作者 Alexandra Kalmár Zsófia B Nagy Krisztina A Szigeti Zsolt Tulassay Peter Igaz Béla Molnár 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第34期5026-5048,共23页
Long non-coding RNAs(lncRNAs)are members of the non-protein coding RNA family longer than 200 nucleotides.They participate in the regulation of gene and protein expression influencing apoptosis,cell proliferation and ... Long non-coding RNAs(lncRNAs)are members of the non-protein coding RNA family longer than 200 nucleotides.They participate in the regulation of gene and protein expression influencing apoptosis,cell proliferation and immune responses,thereby playing a critical role in the development and progression of various cancers,including colorectal cancer(CRC).As CRC is one of the most frequently diagnosed malignancies worldwide with high mortality,its screening and early detection are crucial,so the identification of disease-specific biomarkers is necessary.LncRNAs are promising candidates as they are involved in carcinogenesis,and certain lncRNAs(e.g.,CCAT1,CRNDE,CRCAL1-4)show altered expression in adenomas,making them potential early diagnostic markers.In addition to being useful as tissue-specific markers,analysis of circulating lncRNAs(e.g.,CCAT1,CCAT2,BLACAT1,CRNDE,NEAT1,UCA1)in peripheral blood offers the possibility to establish minimally invasive,liquid biopsy-based diagnostic tests.This review article aims to describe the origin,structure,and functions of lncRNAs and to discuss their contribution to CRC development.Moreover,our purpose is to summarise lncRNAs showing altered expression levels during tumor formation in both colon tissue and plasma/serum samples and to demonstrate their clinical implications as diagnostic or prognostic biomarkers for CRC. 展开更多
关键词 Long NON-CODING RNA COLORECTAL cancer COLORECTAL adenoma CIRCULATING long NON-CODING RNAs Exosome Biomarker DIAGNOSTIC MARKER PROGNOSTIC MARKER
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多参数MRI对甲状腺腺瘤和甲状腺乳头状癌的鉴别诊断价值
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作者 王娴 胡曙东 +5 位作者 张衡 张国梁 徐绯鞠 钱晓芹 谌业荣 倪恩珍 《临床放射学杂志》 CSCD 北大核心 2019年第3期414-418,共5页
目的探讨多参数磁共振成像表观扩散系数(ADC)和时间信号强度曲线(TIC)在甲状腺腺瘤(TA)和甲状腺乳头状癌(PTC)诊断及鉴别诊断中的价值。方法回顾性分析2016年1月至2017年6月江苏大学附属人民医院收治的88例患者共计132枚病灶的影像学资... 目的探讨多参数磁共振成像表观扩散系数(ADC)和时间信号强度曲线(TIC)在甲状腺腺瘤(TA)和甲状腺乳头状癌(PTC)诊断及鉴别诊断中的价值。方法回顾性分析2016年1月至2017年6月江苏大学附属人民医院收治的88例患者共计132枚病灶的影像学资料,经病理证实TA 53枚和PTC 79枚,依次行磁共振平扫、扩散加权成像(DWI)、动态增强磁共振成像(DCE-MRI),计算多b值时TA、PTC的ADC值,绘制受试者工作特征(ROC)曲线,判定诊断阈值并评价诊断效能,绘制病变的TIC,最后DWI联合DCE-MRI对TA、PTC进行鉴别诊断,与病理对照,研究DWI和DCE-MRI联合应用鉴别诊断TA和PTC的敏感度、特异度、准确度、阳性预测值、阴性预测值。结果 b=500 s/mm2时,DWI诊断PTC的ADC值诊断效果最佳,ROC曲线下面积(AUC)为0.871,诊断阈值取1.538×10-3mm2/s时,诊断PTC的敏感度为83.0%、特异度为78.5%、准确度为81.8%、阳性预测值为78.2%、阴性预测值为84.3%,约登指数为61.5;DCE-MRI中,PTC 62枚为Ⅲ型曲线,TA 40枚为Ⅰ型曲线,差异具有统计学意义(P=0.000),DCE-MRI的TIC曲线诊断PTC的敏感度为78.5%、特异度为75.5%、准确度为77.3%、阳性预测值为82.7%、阴性预测值为70.2%;b=500 s/mm2时,DWI和DCE-MRI联合诊断PTC的敏感度为91.1%、特异度为90.6%、准确度为90.9%、阳性预测值为93.5%、阴性预测值为87.3%;DWI、DCE-MRI、DWI和DCE-MRI联合诊断,三者相比较其敏感性、特异性、准确性、阴性预测值、阳性预测值差异均具有统计学意义(P=0.044、0.010、0.024、0.009、0.006)。结论多参数MRI鉴别诊断TA和PTC较单一DCE-MRI或DWI诊断效能强。 展开更多
关键词 扩散加权成像 动态增强磁共振成像 甲状腺肿瘤 腺瘤 乳头状癌
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