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Objective To evaluate the value of T2WI scores for diagnosis and differential diagnosis of transition zone prostate cancer(PCa).Methods T2WI of 43 cases of transition zone PCa and 91 cases of benign prostatic hyperplasia(BPH) were analyzed retrospectively.Transition zone T2WI signs were divided into the main signs and the secondary signs, which were given different scores and were evaluated separately by receiver operating characteristic (ROC) curve for their diagnostic value.Results In a total of 11 scores sections (-1-10), as the increase of scores, the sensitivity of transition zone PCa was decreased while the specificity and positive predictive value were both increased.According to the ROC curve, when the critical value of scores≥4.5, the sensitivity, specificity, negative predictive value, and the accuracy were 81%,73.3%,90.9%,70.4% respectively.When the scores ≥8.5,the specificity and positive predictive value were both 100%.When the scores ≥0.5 and ≥1.5,the negative predictive value were 100%.Conclusion T2WI scores can quantitatively analyze the transition zone PCa,which has an important value to improve the clinical diagnosis and guide treatment.
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Objective To investigate the diagnostic value of multiparametric MRI in early prostate cancer(PCa) based on PI-RADS version 2.Methods 27 surgically-proved early PCa patients were collected in this retrospective study.T2WI,DWI and DCE were evaluated by two blinded radiologists.By 12 sub-region classification method the possibility of the presence of cancer at each sub-region was scored according to the PI-RADS V2.The receiver operating characteristic (ROC) curve was used to analyze the diagnosic efficacy of the following 4 protocols:T2WI alone(protocol 1),T2WI+DWI(protocol 2),T2WI+DCE(protocol 3),T2WI+DWI+DCE(protocol 4).The sensitivity,specificity and accuracy for each protocol were calculated.The average scores of cancerous sub-regions and non-cancerous sub-regions were calculated and the independent sample t test was used to compare the four protocols.Results 324 sub-regions were analyzed in 27 early PCa patients and then divided into 119 cancerous sub-regions and 205 non-cancerous sub-regions,including 64 peripheral zone cancerous sub-regions and transition zone cancerous sub-regions.In protocol 1-4, the average scores of cancerous sub-regions in orderwere 3.13±1.19,3.27±1.15,3.28±1.23, 3.33±1.16,respectively.Non-cancerous sub-regions's scores in order were 1.98±0.90,1.91±0.91, 2.03±0.99,1.94±0.96 respectively and there were significant differences among each protocol (P0.05).In four protocols, the sensitivity in order were 45.40%, 56.30%, 59.70%, 61.34%, while the specificity in order were 95.10%, 96.10%, 89.80%, 96.60%, and the accuracy in order were 76.85%, 81.48%, 78.70%, 83.65%.Conclusion Multiparametric MRI can improve the diagnostic accuracy for the detection of early PCa, and T2WI+DWI+DCE is with the highest value.The PI-RADS V2 system is a better semi quantitative method for evaluation of early PCa.
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Objective To evaluate the diagnostic capabilities of T2 WI features in peripheral zone prostate cancer.Methods The characteristics of T2 WI in 56 cases of peripheral zone prostate cancer,75 cases of benign prostatic hyperplasia and 7 cases of prostatitis confirmed by pathology were analyzed retrospectively.Eight indexes were initially screened byχ2 test,then indexes with significant difference were entered into multivariate Logistic regression analysis.Results The indexes showing statistical differences between prostate cancer and benign prostatic disorders were as following:lesion shape,signal intensity,signal uniformity,boundary of peripheral zone and transition zone,the volume of peripheral zone and prostatic capsule on T2 WI (P0.05).By multivariate Logistic analysis,the statistically significant difference were found in lesion shape, the volume of peripheral zone,prostatic capsule and boundary of peripheral zone and transition zone.Conclusion The lesion shape, volume of peripheral zone and prostatic capsule on T2 WI are independent risk factors for peripheral zone prostate cancer.
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Objective To investigate the histogenesis,clinicopathological features and biological behavior of goblet cell carcinoid (GCC) of the appendix. Methods 3 cases of GCC of the appendix were studied by light microscopy and immunohistochemistry. Results 3 cases all occured in men. Microscopically: the tumor was composed of goblet cells containing mucin-filled with basal round to crescentic nuclei without atypia.These tumor cells were arranged in single forms,nests or acinus with no central lumen. 1 case was composed of simple goblet cells and typical carcinoid cells were seen in other 2 cases arranged in trabeculae and tubule.There was transition between goblet cells with tubelar and crypt epithelium.Immunohistochemical staining revealed that goblet cells were positively reacted with CgA, Syn, CEA, CK and p53 in 1 case. Conclusions Goblet cell carcinoid of the appendix arise from a pluripotent cell with divergent neuroendocrine and mucinous differentiation .It is a subtype of carcinoids of the appendix.The diagnosis mainly bases on its morphologic changes and immunohistochemical findings. The unpredictable behavior of this tumor is probably related to its component and the degree of infiltration.
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Objective To study the clinicopathological and immunophenotypical features of gastrointestinal stromal tumor (GIST). Methods A SP Immunohistochemical method was selected to detect the 71 cases of GIST for a panel of antibodies CD117, CD34, Vim, Act, S-100. Results The patient's ages ranged from 21 years to 86 years (mean 55 years) including 34 male and 37 female. Most cases were diagnosed by bellyache and alimentary tract bleeding. Tumor size varied from 0.3 cm to 23 cm (mean 5.8 cm). GIST were composed of spindle cells and (or) epithelioid cells. Various sized eosinophilic globules were observed between the tumor cells and were designated as skeinoid fibers. The positive rate by immunohistochemical methods for CD117 and CD34 were 94.4 % and 73.2 % respectively. Conclusion GIST predominantly occurred in middle aged or older patients over 40 years. The histological characters are similar to smooth muscle tumor and schwannoma. CD117 and CD34 are more specific and sensitive markers. GIST may have been derived from interstitial cell of cajal or show differentiation toward interstitial cell of Cajal.