Significance of TERT promoter mutation in differential diagnosis of non-invasive inverted urothelial lesions of bladder / 中华病理学杂志

Objective: To investigate the gene mutation of telomerase reverse transcriptase (TERT) promoter in inverted urothelial lesions of the bladder and its significance in differential diagnosis. Methods: From March 2016 to February 2022, a total of 32 patients with inverted urothelial lesions diagnosed in Department of Pathology at Qingdao Chengyang People's Hospital and 24 patients at the Affiliated Hospital of Qingdao University were collected, including 7 cases of florid glandular cystitis, 13 cases of inverted urothelial papilloma, 8 cases of inverted urothelial neoplasm with low malignant potential, 17 cases of low-grade non-invasive inverted urothelial carcinoma, 5 cases of high-grade non-invasive inverted urothelial carcinoma, and 6 cases of nested subtype of urothelial carcinoma were retrospectively analyzed for their clinical data and histopathological features. TERT promoter mutations were analyzed by Sanger sequencing in all the cases. Results: No mutations in the TERT promoter were found in the florid glandular cystitis and inverted urothelial papilloma. The mutation rates of the TERT promoter in inverted urothelial neoplasm with low malignant potential, low grade non-invasive inverter urothelial carcinoma, high grade non-invasive inverted urothelial carcinoma and nested subtype urothelial carcinoma were 1/8, 8/17, 2/5 and 6/6, respectively. There was no significant difference in the mutation rate of TERT promoter among inverted urothelial neoplasm with low malignant potential, low-grade non-invasive inverted urothelial carcinoma, and high-grade non-invasive inverted urothelial carcinoma (P>0.05). All 6 cases of nested subtype of urothelial carcinoma were found to harbor the mutation, which was significantly different from inverted urothelial neoplasm with low malignant potential and non-invasive inverted urothelial carcinoma (P<0.05). In terms of mutation pattern, 13/17 of TERT promoter mutations were C228T, 4/17 were C250T. Conclusions: The morphology combined with TERT promoter mutation detection is helpful for the differential diagnosis of bladder non-invasive inverted urothelial lesions.

Study on the current status of smoking, intention of tobacco concession and related risk factors among 18-65-year olds patients with chronic diseases in Beijing / 中华流行病学杂志

Objective: To understand the status, attitude and related risk factors on smoking among 18-65 years old patients with hypertension, diabetes, dyslipidemia, chronic obstructive pulmonary disease (COPD) or asthma in Beijing. Methods: Data was gathered from the 2014 Beijing Non-communicable and Chronic Disease Surveillance Program. Multiple classified cluster sampling method was used and 19 815 participants aged 18-65 were sampled from 16 districts in Beijing. Results: Among all the 18 405 participants, male hypertensive patients showed a higher rate on current smoking than the other groups (χ(2)=17.695, P<0.001). Male patients with dyslipidemia had higher current smoking rate than the other groups (χ(2)=39.292, P<0.001). However, female patients with COPD or with asthma showed higher rate on current smoking than the other groups (χ(2)=6.276, P=0.012), (χ(2)=8.245, P=0.004). Among the smokers, hypertensive patients presented lower rate (χ(2)=20.487, P<0.001) on intention of smoking concession, than the other groups. Patients with COPD showed greater intention in quitting smoking (χ(2)=6.085, P=0.048), than the other groups. Male patients with diabetes (χ(2)=9.219, P=0.010) or dyslipidemia (χ(2)=13.513, P=0.001) who had stopped smoking tobacco appeared having higher rates in keeping the current status. Results from logistic regression analyses showed that smoking was the risk factor for hypertension (OR=1.17), dyslipidemia (OR=1.25), COPD (OR=1.78), and asthma (OR=1.57). Conclusions: Patients with certain kinds of chronic diseases showed higher rate of current smoking and lower rate of quitting. Cigarette consumption appeared an important risk factor for patients with hypertension, dyslipidemia, COPD, or asthma in Beijing.

Clinical applications of virtual, non-contrast head images derived from dual-source, dual-energy cerebrovascular computed tomography angiography

Background: This study set out to evaluate the utility of cerebrovascular virtual non-contrast [VNC] scans. Materials and Methods: Conventional non-contrast [CNC] and dual-energy computed tomography angiography [DE-CTA] head scans were conducted on 100 subjects, of which 46 were normal, 15 had parenchymal hematomas of the brain, 13 had ischemic infarction, 22 had tumors, and 4 had calcified lesions. VNC images were extracted from the DE-CTA head scans by post-processing. The true [or conventional] and VNC images were compared in terms of the mean CT attenuation value and signal-to-noise ratio [SNR] of the cerebral parenchyma, the image quality, the lesion detection sensitivity, and the radiation exposure level. Results: The image qualities of the CNC and VNC scans were [4.95 +/- 0.22] points and [3.94 +/- 0.24] points [t = 31.18, P < 0.05], the mean CT values for the CNC and VNC images were [34.6 +/- 2.44] and [28.6 +/- 5.40] HU [t = 10.126, P < 0.05], the SNRs were [9.45 +/- 1.26] and [6.87 +/- 1.77], and the HU for white matter was [t = 11.859, P<0.05], respectively. The effective radiation doses from the DE-CTA head scans and the conventional non-contrast scans were [8.55 +/- 0.57] mSv and [9.41 +/- 1.00] mSv, respectively. No significant difference in the lesion detection sensitivities was observed between the CNC and VNC scans, except for tiny calcified lesions, which could not be identified by a VNC scan. Conclusion: VNC and contrast-enhanced images could be obtained from DE-CTA head scans and could aid in the diagnosis of cerebral lesions. The radiation dose from the VNC scan was less than that from the CNC scan