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Objective:To investigate the clinicopathological characteristics and 18F-fluorodeoxyglucose (FDG) PET/CT imaging features of bronchopulmonary neuroendocrine tumors(BP-NETs) with different pathological subtypes. Methods:From January 2013 to May 2018, 280 patients (196 males, 84 females, median age 58 years) with BP-NETs proved by pathology in Henan Provincial People′s Hospital were retrospectively analyzed. Age, gender, smoking history, the location and size of tumor, Ki-67 positive index, thyroid transcription factor-1 (TTF-1), synaptophysin (Syn), chromogranin-A (CgA), CD56, maximum standardized uptake value (SUV max), lymph node metastasis and distant metastasis were compared among 4 pathological subtypes of BP-NETs, including typical carcinoid (TC), atypical carcinoid (AC), small cell lung carcinoma (SCLC) and large cell neuroendocrine carcinoma (LCNEC). One-way analysis of variance, χ2 test, Fisher exact test and Kruskal-Wallis rank sum test were used for data analysis. Results:There were significant differences in age, smoking history, tumor size and location, Ki-67 positive index, CgA, CD56, TTF-1, SUV max and TNM stage among TC( n=59), AC( n=21), SCLC( n=184) and LCNEC ( n=16) groups ( F values: 2.067, 3.358, H values: 17.749-22.351, all P<0.05). SCLC had the largest tumor size (5.5(3.0, 6.8) cm) and the highest proportion of central type (85.3%, 157/184), and were more prone to lymph node metastasis. LCNEC had the oldest age ((66±16) years), the largest proportion of smoking history (14/16) and peripheral type (12/16). CD56 in SCLC (95.7%, 176/184) and LCNEC(15/16) mostly showed positive expression, while the positive expression rates of CgA and TTF-1 were higher in TC and AC (96.6%(57/59), 93.2%(55/59) and 95.2%(20/21), 90.5%(19/21), respectively). The Ki-67 positive index and SUV max of the four subtypes were significantly different, with the highest in SCLC group and the lowest in TC group. Conclusion:Different pathological subtypes of BP-NETs manifest different clinicopathological features and imaging presentation on 18F-FDG PET/CT, which are useful for understanding their characteristics.
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Objective@#To investigate the regularity and clinical significance of abnormal bone uptake of 99Tcm-methylene bisphosphonate (MDP) in benign and malignant lesions.@*Methods@#A retrospective analysis was performed on 266 patients (132 males, 134 females, age range: 8-85 years) with abnormal uptake of 99Tcm-MDP in extraosseous tissues from September 2015 to March 2018. The final diagnosis of abnormal uptake was made according to the histopathology, laboratory and related imaging examination (CT, MRI, ultrasound, SPECT/CT or PET/CT imaging) results within 2 weeks after 99Tcm-MDP imaging. Regularity of abnormal 99Tcm-MDP uptake was comprehensively analyzed. Differences between benign and malignant groups were compared by χ2 test or Fisher exact test.@*Results@#Abnormal 99Tcm-MDP uptake in extraosseous tissues in 232 patients (87.2%, 232/266) were confirmed as malignant lesions and those in 34 patients (12.8%, 34/266) were benign. There were no significant differences in gender (χ2=0.611, P>0.05), age (P=0.584), and location (P=0.118) between benign and malignant lesions, but the involvement was significantly different (χ2=19.515, P<0.05). There were significant differences between single focus and diffuse foci of single organ, diffuse foci of single organ and multiple foci groups (χ2=8.959, 19.325, both P<0.01).@*Conclusions@#The detection rate of malignancy among foci with abnormal 99Tcm-MDP uptake in extraosseous tissues is high, and the malignancy may relate with the involvement of foci. When extraosseous uptake is found, clinical information and related examination results should be comprehensively analyzed and the malignancy should be taken into account.
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The clinical data of 113 early pregnant (11-14 weeks) women with high risk of placenta accreta undergoing ultrasound examination in Jinhua Maternal and Child Health Hospital from June 2013 to June 2018 were retrospectively analyzed.Among them,there were 21 cases of placenta accreta (implanted group) and 92 cases without placenta accreta (non-implanted group).The diagnostic value of different μltrasound signs for placenta accreta was assessed.The sensitivity of loss of clear zone was 71％(15/21),and the specificity was 87％ (80/92);the sensitivity of placental lacunae and bladder wall interruption was 67％(14/21) and 62％(13/21),and the specificity was 78％(72/92) and 95％(87/92),respectively.The uterovesical hypervascularity has the lowest sensitivity (38％,8/21),but the highest specificity (98％,90/92).When combination of 2 sings was used for diagnosis,the sensitivity of the ultrasound examination was 76％ (16/21) and the specificity was 65％(60/92);when the combination of 3 signs was used,the sensitivity and specificity were 76％ (16/21) and 93％ (86/92),respectively.It is suggested that ultrasound examination in early pregnancy may find all types of placenta implants with good diagnostic accuracy.
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Objective To investigate the regularity and clinical significance of abnormal bone up-take of 99Tcm-methylene bisphosphonate (MDP) in benign and malignant lesions. Methods A retrospec-tive analysis was performed on 266 patients ( 132 males, 134 females, age range:8-85 years) with abnor-mal uptake of 99 Tcm-MDP in extraosseous tissues from September 2015 to March 2018. The final diagnosis of abnormal uptake was made according to the histopathology, laboratory and related imaging examination ( CT, MRI, ultrasound, SPECT/CT or PET/CT imaging) results within 2 weeks after 99 Tcm-MDP imaging. Regularity of abnormal 99 Tcm-MDP uptake was comprehensively analyzed. Differences between benign and malignant groups were compared by χ2 test or Fisher exact test. Results Abnormal 99 Tcm-MDP uptake in extraosseous tissues in 232 patients (87.2％, 232/266) were confirmed as malignant lesions and those in 34 patients (12.8％, 34/266) were benign. There were no significant differences in gender (χ2=0.611, P>0. 05) , age ( P=0.584) , and location ( P=0.118) between benign and malignant lesions, but the involve-ment was significantly different (χ2=19.515, P<0.05). There were significant differences between single focus and diffuse foci of single organ, diffuse foci of single organ and multiple foci groups (χ2=8. 959, 19. 325, both P<0.01) . Conclusions The detection rate of malignancy among foci with abnormal 99 Tcm-MDP uptake in extraosseous tissues is high, and the malignancy may relate with the involvement of foci. When extraosseous uptake is found, clinical information and related examination results should be compre-hensively analyzed and the malignancy should be taken into account.
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Objective To investigate the critical value of TSH-stimulated Tg(sTg) in the diagnosis of metastasis from DTC,and to evaluate the diagnostic value of the ratio of sTg to suppressed Tg (sTg/suppressed Tg).Methods A total of 330 post-operative DTC patients(87 males,243 females,age range:12-70 years)who underwent thyroid remnant ablation from August 2008 to December 2014 were retrospectively reviewed.Their serum TgAb levels were normal.The patients were divided into non-metastasis group (147 cases) and metastasis group(183 cases) according to results of ultrasonography,CT and WBS.The difference of sTg between the two groups were compared by Mann-Whitney rank sum test.ROC curve was used to analyze the relationship between sTg,sTg/suppressed Tg ratio and metastasis,the cutoff value was calculated.Results The sTg was significantly different between the non-metastasis group and metastasis group:1.0 (0.1,2.0) μg/L vs 36.5 (3.9,126.7) μg/L;u=-6.642,P＜0.05.The AUC for ROC curve in metastasis group was 0.85,and the cutoff value was 2.05 μg/L,with the sensitivity 85.2％,specificity 67.3％,and accuracy 82.3％.While sTg＜2.05 μg/L,the AUC of sTg/suppressed Tg ratio was 0.941,and the cutoff value was 4.3,with the sensitivity 93.3％,specificity 88.2％,and accuracy 92.3％.Conclusions The sTg has a specific value for the diagnosis of metastasis from DTC after operation and the cutoff value is 2.05 μg/L in this set of patients.The ratio of sTg/suppressed Tg could be used to correct the sTg and to improve the diagnostic sensitivity.
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Objective To investigate the critical value of TSH-stimulated Tg(sTg) in the diagnosis of metastasis from DTC, and to evaluate the diagnostic value of the ratio of sTg to suppressed Tg (sTg/suppressed Tg).Methods A total of 330 post-operative DTC patients(87 males, 243 females, age range: 12-70 years)who underwent thyroid remnant ablation from August 2008 to December 2014 were retrospectively reviewed.Their serum TgAb levels were normal.The patients were divided into non-metastasis group(147 cases)and metastasis group(183 cases) according to results of ultrasonography, CT and WBS.The difference of sTg between the two groups were compared by Mann-Whitney rank sum test.ROC curve was used to analyze the relationship between sTg, sTg/suppressed Tg ratio and metastasis, the cutoff value was calculated.Results The sTg was significantly different between the non-metastasis group and metastasis group: 1.0 (0.1, 2.0) μg/L vs 36.5 (3.9, 126.7) μg/L;u=-6.642, P<0.05.The AUC for ROC curve in metastasis group was 0.85, and the cutoff value was 2.05 μg/L, with the sensitivity 85.2%, specificity 67.3%, and accuracy 82.3%.While sTg<2.05 μg/L, the AUC of sTg/suppressed Tg ratio was 0.941, and the cutoff value was 4.3, with the sensitivity 93.3%, specificity 88.2%, and accuracy 92.3%.Conclusions The sTg has a specific value for the diagnosis of metastasis from DTC after operation and the cutoff value is 2.05 μg/L in this set of patients.The ratio of sTg/suppressed Tg could be used to correct the sTg and to improve the diagnostic sensitivity.