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@#Objective To evaluate the effectiveness of the artificial intelligence-assisted diagnosis and treatment system in distinguishing benign and malignant lung nodules and the infiltration degree. Methods Clinical data of 87 patients with pulmonary nodules admitted to the First Affiliated Hospital of Xiamen University from January 2019 to August 2020 were retrospectively analyzed, including 33 males aged 55.1±10.4 years, and 54 females aged 54.5±14.1 years. A total of 90 nodules were included, which were divided into a malignant tumor group (n=80) and a benign lesion group (n=10), and the malignant tumor group was subdivided into an invasive adenocarcinoma group (n=60) and a non-invasive adenocarcinoma group (n=20). The malignant probability and doubling time of each group were compared and its ability to predict the benign and malignant nodules and the invasion degree was analyzed. Results Between the malignant tumor group and the benign lesion group, the malignant probability was significantly different, and the malignant probability could better distinguish malignant nodules and benign lesions (87.2%±9.1% vs. 28.8%±29.0%, P=0.000). The area under the curve (AUC) was 0.949. The maximum diameter of nodules in the benign lesion group was significantly longer than that in the malignant tumor group (1.270±0.481 cm vs. 0.990±0.361 cm, P=0.026); the doubling time of benign lesions was significantly longer than that of malignant nodules (1 083.600±258.180 d vs. 527.025±173.176 d, P=0.000), and the AUC was 0.975. The maximum diameter of the nodule in the invasive adenocarcinoma group was longer than that of the non-invasive adenocarcinoma group (1.350±0.355 cm vs. 0.863±0.271 cm, P=0.000), and there was no statistical difference in the probability of malignancy between the invasive adenocarcinoma group and the non-invasive adenocarcinoma group (89.7%±5.7% vs. 86.4%±9.9%, P=0.082). The AUC was 0.630. The doubling time of the invasive adenocarcinoma group was significantly shorter than that of the non-invasive adenocarcinoma group (392.200±138.050 d vs. 571.967±160.633 d, P=0.000), and the AUC was 0.829. Conclusion The malignant probability and doubling time of lung nodules calculated by the artificial intelligence-assisted diagnosis and treatment system can be used in the assessment of the preoperative benign and malignant lung nodules and the infiltration degree.
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BACKGROUND@#It has been known that the volume doubling time (VDT) of different lung nodule types is different. At present, there is still a lack of studies about the volume doubling time of lung cancer with different pathological types. The purpose of the study is to explore the factors influencing the progression of the early-stage adenocarcinoma, and provide some reference for the follow-up strategy of lung nodules by retrospective analysis of the image data of 143 early-stage adenocarcinoma.@*METHODS@#143 cases of the early adenocarcinoma were classified according to the 2015 World Health Organization Classification of Lung Tumors and the Eighth edition of the tumor-node-metastasis (TNM) classification of lung cancer. The volume doubling time was calculated with reference to the revised Schwartz formula.@*RESULTS@#Among the 143 cases of the early adenocarcinoma, 50 cases (34.97%) were in progression. By multivarIate analysis, there were several factors associated with the progression of the early adenocarcinoma: the follow-up time, the dimension of nodule, the pathological type, the nodule type and the pathological stage. The VDT of lepidic predominant adenocarcinoma (LPA) is (594±272) d. The VDT of the invasive adenocarcinoma with lepidic part, but not predominant, is (520±285) d. The VDT of the invasive adenocarcinoma without lepidic part is (371±183) d.@*CONCLUSIONS@#About 35% of the early adenocarcinoma is in progress. Whether with the lepidic component is a positive factor to the speed of tumor progression.
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Female , Humans , Male , Middle Aged , Disease Progression , Lung Neoplasms , Diagnostic Imaging , Pathology , Retrospective Studies , Tomography, X-Ray ComputedABSTRACT
Objective To investigate the imaging features of the elderly patients with GGN and to guide the follow-up.Methods Thirty-four cases of elderly patients with pulmonary GGN were enrolled in this study, including 14 cases of adenocarcinoma in situ(AIS)and 20 cases of invasive adenocarcinoma(IAC).The clinical characteristics of these patients were analyzed and compared.The CT imaging features of burr sign, lobulated sign,pleural retraction sign,vacuole sign and solid component were analyzed by two doctors via blind method.The average diameter,volume,mass,volume doubling time(VDT)and mass doubling time(MDT)of GGN were measured and calculated by software layer by layer overlay model.Results There were no statistically significant differences between the group AIS and group IAC in age,gender,smoking history(P>0.05);The burr sign,lobulated sign,vacuole sign,pleural retraction sign and the average diameter had no significant difference(P>0.05).There were statistically significant difference between the group AIS and group IAC in the solid component incidence(14.3%,65%,P=0.003),volume((714.4+261.8)mm3,(927.2 ±259.7)mm3,t= 2.344,P= 0.025),mass((376.4 ± 144.0)mg,(586.8 ± 182.0)mg,t= 3.600,P=0.001),volume doubling time((1511.1± 1098.2)d,(654.1± 229.0)d,t=-2.876,P=0.012),quality doubling time((1427.4±989.3)d,(540.4±190.7)d,t=-3.312,P=0.005).Conclusion The signs of solid components,volume,mass,VDT,MDT can be used as an important basis for identification of AIS and GGN in the elderly patients.The treatment of the elderly patients with GGN should be based on the basic diseases,life expectancy,surgical risk and imaging features of the elderly patients,so as to give more appropriate treatment strategies for the elderly patients.
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Objective To investigate the imaging features of the elderly patients with GGN and to guide the follow-up.Methods Thirty-four cases of elderly patients with pulmonary GGN were enrolled in this study, including 14 cases of adenocarcinoma in situ(AIS)and 20 cases of invasive adenocarcinoma(IAC).The clinical characteristics of these patients were analyzed and compared.The CT imaging features of burr sign, lobulated sign,pleural retraction sign,vacuole sign and solid component were analyzed by two doctors via blind method.The average diameter,volume,mass,volume doubling time(VDT)and mass doubling time(MDT)of GGN were measured and calculated by software layer by layer overlay model.Results There were no statistically significant differences between the group AIS and group IAC in age,gender,smoking history(P>0.05);The burr sign,lobulated sign,vacuole sign,pleural retraction sign and the average diameter had no significant difference(P>0.05).There were statistically significant difference between the group AIS and group IAC in the solid component incidence(14.3%,65%,P=0.003),volume((714.4+261.8)mm3,(927.2 ±259.7)mm3,t= 2.344,P= 0.025),mass((376.4 ± 144.0)mg,(586.8 ± 182.0)mg,t= 3.600,P=0.001),volume doubling time((1511.1± 1098.2)d,(654.1± 229.0)d,t=-2.876,P=0.012),quality doubling time((1427.4±989.3)d,(540.4±190.7)d,t=-3.312,P=0.005).Conclusion The signs of solid components,volume,mass,VDT,MDT can be used as an important basis for identification of AIS and GGN in the elderly patients.The treatment of the elderly patients with GGN should be based on the basic diseases,life expectancy,surgical risk and imaging features of the elderly patients,so as to give more appropriate treatment strategies for the elderly patients.
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Objective To evaluate volume doubling time (VDT) and net mass doubling time of tumor (nMDT) of pulmonary pure ground glass nodules (PGGN) of different pathological types and to investigate whether VDT and nMDT can help to differentiate invasive pulmonary adenocarcinomas from minimally invasive adenocarcinomas and preinvasive lesions.Methods Fifty-one pathologically confirmed pGGNs in 46 patients were retrospectively evaluated,in whom at least two HRCT scans were obtained preoperatively (median scan times,3 times;range,2-6 times) with 1-month or longer follow-up interval (median follow-up interval,251 days;range,30-1 552 days).According to the rechecked results of the postoperative pathological section,51 pGGNs were divided into two groups:group A,invasive adenocarcinoma (IAC),30 pGGNs (58.8％);group B,21 pGGNs (41.2％),including 8 minimally invasive adenocarcinoma (MIA),7 adenocarcinomas in situ (AIS) and 6 atypical adenomatous hyperplasia (AAH).The volume,cumulative percentage of volume growth and VDTs of pGGNs were automatically acquired by Lung VCAR (advantage windows 4.6,GE HealthCare).Subsequently,the mass,cumulative percentage of mass growth and nMDTs of pGGNs were calculated.The count data and measurement data between two groups were compared using Fisher exact probability and Mann-Whitney U test,respectively.A pairwise comparision were performed by using Wilcoxon signed-rank test.Subsequently,the receiver operating characteristic (ROC) curve was used to determine the optimal cut-off values of VDT and nMDT for the differential diagnosis of IAC and MIA/AIS/AAH,and calculated the area under the curve (AUC).Results The median VDT and nMDT of 51 pGGNs were 1 854.11 days (range,165.22—+∞ days) and 1 138.45 days (range,95.92—+ ∞ days),respectively.The median nMDT was shorter than the median VDT,and the difference was significant (Z=-2.444,P=-0.O15).The median VDTs of IAC and MIA/AIS/AAH were 847.07 days (165.22—+∞ days) and 4 460.09 days (691.14—+∞ days),respectively.The median nMDTs of IAC,MIA/AIS/AAH were 769.93 days (95.92—+∞ days) and 3814.77 days (611.56—+∞ days),respectively.The median VDT and nMDT of IAC were significantly shorter than those of MIA/AIS/AAH (Z=-3.443,-3.860,P＜ 0.01,respectively).Differentiating IAC from MIA/AIS/AAH,the optimal cutoff value of VDT was 2095.86 days (sensitivity,71.4％;specificity,80.0％),the optimal cutoff value of nMDT was 1 169.77 days (sensitivity,81.0％;specificity,76.7％).Conclusions In pulmonary pGGNs,IAC showed significantly shorter VDT and nMDT than MIA/AIS/AAH.When VDT is shorter than 2 095.86 days or nMDT is shorter than 1 169.77 days,IAC is suggested.
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Objective To measure volume of breast cancer , calculate tumor volume doubling time (TVDT), and analyze the correlated factors affecting TVDT using three-dimensional ultrasound (3D-US). Methods We applied 3D-US to measure the volume of breast cancer of BI-RADS-US 4A classified by conventional ultrasound. The breast cancer case scanned by 3D-US at least twice (the interval is 3 months at least) without any medical intervention were included in the study. We calculated TVDT according to the formula, and analyzed the affecting factors of TVDT using multiple linear regression. Results Sixty-nine cases were enrolled in the study. The TVDT of breast cancer were from 66 to 521 days , in an average of 185 ± 126 days and the median time of 164 days. We found that: ① there were no statistics significances in TVDT between different breast cancer pattern , smoothing border lines , speculated sign , hyperechoic halo , microcalcification and different rear echo (P > 0.05). ② TVDT of different age groups, lymph node metastasis, pathological grade and NPI score were significantly different (P 0.05). ③ TVDT of patients with different expression of ER, PR and Ki-67, molecular typing showed statistically difference (P 0.05). ④ multi-factor analysis showed that the NPI score, lymph node metastasis, Ki-67 and molecular typing of breast cancer were relative factors in TVDT (P < 0.05). Conclusions The NPI score , lymph node metastasis , Ki-67 and molecular typing significantly correlate with TVDT of breast cancer. Triple-negative breast cancer in molecular typing has the fastest growth rate.
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Objective To detect the doubling time of airway smooth muscle cells of human and rat by the xCELLigence in-strument,a real time cellular analyzer.Methods The airway smooth muscle cells were separated by collagenase-pancreatin digestion from the rat airway.Then,added to the different holes of E-plate of xCELLigence instrument with the planting destiny of 3 000 cells/well.and so were the human airway smooth muscle cells.The E-plate was then placed on the xCELLi-gence instrument to monitor cell proliferation for 100 hours to calculate the doubling time by using the RTCA Software Package 2.0 software.Results The doubling time of human airway smooth muscle cell calculated by the real time cellular analyzer was 23.96±0.47 h,which was consistent with the data provided by the reference.The doubling time of rat airway smooth muscle cell was 18.62±0.15 h,and the computational process was simple,time-saving and also effective.Conclusion The xCELLigence instrument can be used to calculate doubling time of airway smooth muscle cells of human and rat, which provides experimental methods and reference data for the basic respiratory disease research.
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PURPOSE: To investigate the relationship between rising patterns of prostate-specific antigen (PSA) before chemotherapy and PSA flare during the early phase of chemotherapy in patients with castration-resistant prostate cancer (CRPC). MATERIALS AND METHODS: This study included 55 patients with CRPC who received chemotherapy and in whom pre-treatment or post-treatment PSA levels could be serially obtained. The baseline parameters included age, performance, Gleason score, PSA level, and disease extent. PSA doubling time was calculated using the different intervals: the conventional interval from the second hormone manipulation following the nadir until anti-androgen withdrawal (PSADT1), the interval from the initial rise after anti-androgen withdrawal to the start of chemotherapy (PSADT2), and the interval from the nadir until the start of chemotherapy (PSADT3). The PSA growth patterns were analyzed using the ratio of PSADT2 to PSADT1. RESULTS: There were two growth patterns of PSA doubling time: 22 patients (40.0%) had a steady pattern with a more prolonged PSADT2 than PSADT1, while 33 (60.0%) had an accelerating pattern with a shorter PSADT2 than PSADT1. During three cycles of chemotherapy, PSA flare occurred in 11 patients (20.0%); of these patients, 3 were among 33 (9.1%) patients with an accelerating PSA growth pattern and 8 were among 22 patients (36.4%) with a steady PSA growth pattern (p=0.019). Multivariate analysis showed that only PSA growth pattern was an independent predictor of PSA flare (p=0.034). CONCLUSION: An exponential rise in PSA during anti-androgen withdrawal is a significant predictor for PSA flare during chemotherapy in CRPC patients.
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Aged , Aged, 80 and over , Humans , Male , Middle Aged , Androgen Antagonists , Antineoplastic Agents/therapeutic use , Follow-Up Studies , Karnofsky Performance Status , Neoplasm Grading , Predictive Value of Tests , Prostate-Specific Antigen/blood , Prostatic Neoplasms, Castration-Resistant/blood , Taxoids/therapeutic use , Biomarkers, Tumor/bloodABSTRACT
Objective To study the value of PSADT in predicting the prognosis and the possibility of disease progression for patients with prostate cancer after MAB therapy.Methods Based on the retrospective review of the history and the follow-up of 159 prostate cancer patients,who received MAB therapy in our department from January 1994 to December 2010,PSADT values were calculated and survival analysis was performed.The ages at diagnosis ranged from 54 to 90 years with a median of 74 years.The pretreatment PSA value ranged from 2.6 to 275.0 μg/L with a median of 46.8 μg/L.The patients of Gleason score ≤6,7 and ≥8 constituted 27.7％,42.1％ and 25.2％,respectively.Only 26.4％ of the patients were staged as T1N0M0-T2N0M0 and the others had locally advanced disease or metastasis.A multivariate analysis with a Cox's proportional hazard model was used and the disease progression rates in different PSADT groups were also compared.Chi-square test and Log-rank test were applied in statistic analysis.Results The 159 patients received follow-up with a median period of 28 months (6-126 m).The median PSADT of these 159 patients was 5.7 months (0.5-21.0 m).The 3-year and 5-year survival for the 71 patients,whose PSADT were not less than 6 months,were 89.4％ and 47.6％ respectively,compared with 49.8％ and 30.6％ for the other 88 patients whose PSADT were less than 6 months.The survivals were significantly different between the two groups (P ＜ 0.01).It was confirmed by a further multivariate analysis with a Cox' s proportional hazard model that PSADT was one of the predictive factors of the prognosis of these prostate cancer patients with a hazard ratio of 2.6 (P ＜ 0.01).Moreover,disease progression were found in 19.7％ of the PSADT≥6 m group during the follow-up compared with 63.6％ in the PSADT ＜6 m group.The disease progression rates were also significantly different (P ＜ 0.0 l).Conclusions PSADT can be used to predict the prognosis of patients with prostate cancer after the MAB therapy.The survival for the patients,whose PSADT are not less than 6 months,is higher than those whose PSADT less than 6 months.Meanwhile,PSADT can predict the possibility of disease progression after MAB treatment.
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The prognosis of lung cancer is very poor. Patients with lung cancer have usually no symptom in early stage or some mild cough, sputum. When patient feel weight loss or dyspnea, majority of patients with lung cancer are advanced stage and inoperable. The growth rate of lung cancer is different according to cell type of tumor and related to prognosis. Generally, tumor. doubling time (TDT) of lung cancer has been known that small cell lung cancer is about 65 days, squamous cell carcinoma is about 90 days, and adenocarcinoma is about 185 days. There has been rarely reported of lung cancer with very fast or very slow growth. The prognosis of a slow growing lung cancer is relatively good but rapidly growing cancer is not. We report a very rare case that surgicallytreated early stage non-small cell lung cancer (adenocarcinoma) with 4-year- TDT without invasion or distant metastasis
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Humans , Adenocarcinoma , Carcinoma, Non-Small-Cell Lung , Carcinoma, Squamous Cell , Cough , Dyspnea , Lung Neoplasms , Lung , Neoplasm Metastasis , Prognosis , Small Cell Lung Carcinoma , Sputum , Weight LossABSTRACT
BACKGROUND: The purpose of this study was to evaluate the cost-effectiveness of screening tests (AFP and US) for early detection of primary hepatocellular carcinoma (HCC) and its optimal screening interval in Korean hepatitis B virus carriers. METHODS: Data relating to tumor incidence, efficacy of screening tests, tumour growth times and various cost for detecting HCC were obtained from reviews of Korean literature. Decision analysis technique was used to calculate the efficacy of these screening tests and screening interval. RESULTS: When the doubling time of HCC was 6 months, the most cost-effective screening interval of each AFP and US was 6 months, respectively. The optimal screening intervals of AFP and US were 3 and 5 months for each, respectively, and 7 months for both when a detection rate of 80% was expected. These results were significantly altered when the different tumour growth times reported in other literatures were applied. CONCLUSION: If the doubling time of HCC was 6 months, the optimal screening interval was 7 months on using both tests. Because the tumour doubling time alters the optimal screening interval, further evaluation on the doubling time of Korean hepatoma is needed.
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Carcinoma, Hepatocellular , Decision Support Techniques , Hepatitis B virus , Hepatitis B , Hepatitis , Incidence , Mass ScreeningABSTRACT
2 months had higher effective rate.PSAV and nPSA could not predict the effect of chemotherapy.
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The average interval from first operation to recurrence is about 4 years and the reported shortest interval of malignant meningioma is about 6 months. The authors reported a case of rapidly regrowing benign meningioma, located on the outer 1/3 of the right sphenoid wing. The patient was free of recurrence only at 4 months after the first surgery in spite of macroscopic complete removal of the tumor. Factors associated with recurrence of meningioma are also discussed.