ABSTRACT
Objective:To investigate the high-resolution CT features and risk factors of secondary bronchiolitis obliterans (BO) in children with adenovirus pneumonia.Methods:In this study, a case-control study method was adopted, and 44 children with BO secondary to adenovirus pneumonia in Dongguan Children′s Hospital Affiliated to Guangdong Medical University from January 2015 to October 2020 were selected as the observation group, and 45 children with simple adenovirus pneumonia during the same period were selected as the control group. The differences in the chest high-resolution CT imaging characteristics of the two groups of children were compared. The risk factors of secondary BO in children with adenovirus pneumonia were analyzed by single factor and multiple factor logistic regression.Results:In the lung CT examination of children in the observation group, the detection rates of mosaic perfusion sign, bronchial wall thickening, bronchiectasis, lung consolidation and clear lung were significantly higher than those in the control group, and the difference was statistically significant (all P<0.05); Logistic regression model showed that prolonged heat course, high heat peak, mechanical ventilation treatment and prolonged mechanical ventilation time were independent risk factors of secondary BO children with adenovirus pneumonia (all P<0.05). Conclusions:Children with BO secondary to adenovirus pneumonia have typical high-resolution CT features, which is of high practical value for clinical diagnosis. Prolonged heat course, high heat peak, mechanical ventilation treatment and prolonged mechanical ventilation were independent risk factors of secondary BO in children with adenovirus pneumonia.
ABSTRACT
Objective To explore the accuracy of endoscopic ultrasonography (EUS) for evaluating T3 esophageal squamous cell carcinoma (ESCC).Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 733 patients diagnosed with T3 ESCC by preoperative EUS who were admitted to the Sun Yat-sen University Cancer Center from January 2003 to December 2015 were collected.All the patients underwent radical resection of ESCC.The postoperative pathological stage as a gold standard,the accuracy,overstaged and understaged rates of clinical staging by preoperative EUS were assessed.Observation indicators:(1) comparison between clinical T staging evaluated by preoperative EUS and postoperative pathological T staging;(2) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect patients' diseases and postoperative survival up to December 30,2016.Overall survival time was from operation time to death or last effective follow-up.Measurement data with normal distribution were represented as (x)±s.Measurement data with skewed distribution were described as M (range).Count data were represented as cases and percentage.The survival curve was drawn by the Kaplan-Meier method,and survival analysis was done using the Log-rank test.Results (1) Comparison between clinical T staging evaluated by preoperative EUS and postoperative pathological T staging:all the 733 patients were confirmed as T3 ESCC by preoperative EUS.Postoperative pathological diagnosis showed that 9 patients were detected in pT1b,87 in pT2,630 in pT3 and 7 in pT4a.The accuracy,overstaged and understaged rates of preoperative EUS in evaluating T3 ESCC were 85.95％(630/733),13.10％(96/733) and 0.95％(7/733),respectively.N0,N1,N2 and N3 of postoperative pathological N stage were respectively detected in 329,247,110 and 47 patients.Twenty-seven,323 and 383 patients were in stage Ⅰ,Ⅱ and Ⅲ of TNM stage,respectively.The high-,moderate-and lowdifferentiated tumors were respectively detected in 125,403 and 205 patients.(2) Follow-up and survival situations:among 733 patients,639 were followed up for 1.0-153.0 months,with a median time of 29.0 months.The median survival time,1-,3-,5-year overall survival rates were 53.0 months (range,37.7-68.3 months),85.3％,58.1％ and 48.2％ in 733 patients,respectively.The 5-year overall survival rate was 75.2％ in 9 patients with pT1b,63.0％ in 87 patients with pT2,46.3％ in 630 patients with pT3 and 0 in 7 patients with pT4a,respectively,with a statistically significant difference (x2=24.089,P＜0.05).Conclusion There is a higher accuracy of EUS for evaluating T3 ESCC,however,the stage migration should be noted.