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With the expansion of aging population, Alzheimer′s disease (AD) is increasingly imposing a substantial burden on the society. Because of irreversible neuronal death in the brain, effective control of AD relies on early diagnosis for timely therapeutic intervention, and this requires efficient laboratory tests and molecular imaging. Current laboratory tests for AD includes measurements of Aβ peptides, Tau, and a number of other recently discovered molecules in the cerebrospinal fluid and the peripheral blood. PET-based imaging of glucose metabolism, amyloid Aβ, Tau neurofibrillary tangles, TSPO protein, and neuronal receptors, has also proven to be useful in clinical finding of AD. This review will focus on the progress in studies of these biomarkers and methodologies for ADdiagnosis.
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Objective To observe MSCT features of partially or completely low enhancement of pancreas neuroendocrine tumors (PNENs).Methods The clinical data and MSCT features before pancreatectomy in 44 patients with confirmed PNENs were retrospectively reviewed.The MSCT findings were evaluated including tumor size, location, margin, density, intratumoral structure, bile duct and pancreatic ductal dilation and distant metastasis.Tumors were classified into complete enhancement type, partially or completely low enhancement type for further comparative analysis based on MSCT enhancement during pancreatic stage.Results A total of 56 PNENs in 44 patients were found, and there were 31 partially or completely low enhanced PNENs and 25 completely enhanced PNENs.The former were larger than the latter [mean tumor size, (3.3±2.2)cm vs (1.4±0.9) cm], and irregular shape and cystic components within tumors were more often observed (all P<0.05).There were no significant differences between the two types of PNENs in terms of gender, the presence of functional tumor, tumor location, clear tumor margin, intratumoral calcification, bile and pancreatic duct dilation and metastasis.76.0%(19/25) of completely enhanced PNENs reached peak enhancement in arterial phase, and 71.0%(22/31) of low enhancement PNENs reached peak in pancreatic phase.Enhanced intratumoral blood vessels in the arterial phase were more frequent in low enhancement PNENs, and the difference was statistically significant (P<0.05).There were significant differences on pathological grade between the two types of PNENs (G1=21,G2=4,G3=0 vs G1=18,G2=5, G3=8), and the difference was statistically significant (P<0.05).Conclusions Compared with complete enhancement PNENs, partially or completely low enhancement PNENs had bigger size, irregular shape, and cystic component.Intratumoral blood vessels in the arterial phase were observed, peak enhancement arrived later and the pathological grade was higher.
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Objective To establish a predictive model and to find the preoperative predictors for the nature of lesion in the setting of chronic pancreatitis. Methods The 121 patients from 7 tertiary medical centers in Shanghai from July 1998 to April 2007 with focal mass lesions in the setting of chronic pancreatitis were selected as the study population. The final diagnosis had to be confirmed histologically by surgical specimens (n =97) or by follow-up (n = 24). A case control study was conducted; the patients were divided into pancreatic cancer group and chronic pancreatitis group. The age, sex, past history, initial clinical presentations, lab results and imaging exams were collected by reviewing the medical records of these patients. χ~2 test and t test was used for univariate analysis, then the factors with P≤0. 25 were selected for further multivariate analysis, and multivariate logistic regression model was used to estimate odds ratio and 95% CI. Results Of 121 , 21 patients had a final diagnosis of pancreatic cancer and other 90 patients had a final diagnosis of chronic pancreatitis. Abdominal tenderness, direct bilirubin, CA19-9 and CEA were independent predictors of cancer in patients with focal mass lesions. Their odds ratios (95% CI) were 5. 691 (1.468, 22.070) , 1.011 (1.001 , 1.021) , 1.003 (1.001, 1.005) , 101.9 (0.988, 1.051) , respectively. Their P values were 0. 012, 0. 030, 0.003 and 0. 23 , respectively. Conclusions The logistic regression model may accurately predict the nature of lesion in the setting of chronic pancreatitis and may have certain clinical implication.