ABSTRACT
Background and Objectives: - Carcinoma Breast is most common malignancy in females in USA and second among cases deaths in females (after lung cancer). There is considerable geographic , ethnic and racial variability in Breast cancer in evidence with about 5 fold variation throughout the world. Triple negative breast cancer is a heterogonous disease diagnosed by Immune Histo Chemistry (IHC).Triple Negative Breast cancer is characterized by tumor that do not express ER or PR and HER2neu . Proto typical Triple Negative Brest cancer is aggressive in nature and associate with poor prognosis. The Objectives of this study is to analyse the clinical and Pathological features of Triple Negative Breast Cancer and compare the result with similar studies in literature. Fifty Methods:- cases Triple negative Breast Cancer were included in this study. Clinical and pathological features and treatment were noted. Incidence Result:- of Triple Negative Breast Cancer was 35%. The median age of presentation was 45yrs. There were 4% males Triple negative Breast cancer cases out of female patients, most of patients were Pre (or) Perimenopausal(65%). 4% patients had family history of malignantly. Most common stage of presentation was stage III (46%). In Stage IV, Lung and bone metastasis was common. Ten Patients received Neoadjuvant chemo therapy (NACJ) and disease progressed in 4% while on Neoadjuvant chemotherapy, Even though 45 patients had surgery only 34 were eligible to received Adjuvant Radiotherapy. Total of 18% Patients had either progressive disease while on treatment (8%) (or) recurrence 10%. Eighteen percent patients died due to the disease. 33% patients on follow up. There were more Invasive Duct Cell carcinoma (IDCC) cases with medullary differentiations (or) Purse medullary Carcinomas (12%). No deaths Occur in the medullary variants TNBC. Majority of the tumor were high grade margins were negative in most of the cases. Incidence of Tri Inclusion:- ple negative breast cases was higher than western literature but comparable to Indian Studies. The age of Presentation was about 10 years younger than western data. Triple Negative Breast cancer was more common in young, pre (or) perimenopausal women. Small number of patients had family history, majority were state II (or) III. There was high number of progressive disease, recurrence and death while on the study (or) within less than 1 yr of treatment. Triple Negative Breast cancer is very aggressive disease with relatively better prognosis in the medullary variant Triple Negative Breast Cancer.
ABSTRACT
Objective To investigate the value of tumor volume to uterine volume ratio(N/U)combined with tumor apparent diffusion coefficient(ADC)in predicting the pathological grade of endometrial carcinoma(EC).Methods Data of 107 patients with EC admitted from July 2020 to January 2023 were retrospectively ana-lyzed.All patients underwent preoperative magnetic resonance imaging(MRI),and pathological diagnosis was used as the gold standard.Patients with low differentiation were included in the high grade group,and patients with medium and high differentiation were included in the low grade group.The factors affecting the pathological grading of EC patients were analyzed,and the value of MRI index in predicting the pathological grading of EC patients was analyzed.Results The pathological examination showed that there were 24 high-grade patients and 83 low-grade patients..Logistic multivariate regression analysis showed that N/U,ADC,rADC internal obturator muscle were factors affecting the pathological grade of EC patients(P<0.05).ROC curve results showed that the sensitivity of N/U,ADC,rADC internus obturator muscle and their combination to predict the pathological grading of EC patients were 70.83%,75.00%,79.17%,83.33%,the specificity were 71.08%,79.52%,78.31%,85.54%,and the AUC were 0.734,0.756,0.741 and 0.891.Conclusion The combination of N/U,ADC,rADC and obturator internal muscle was effective in predicting the preoperative pathological grading of EC patients.
ABSTRACT
Objective To explore the expression of programmed cell death protein 5 in cervical cancer and its relationship with lymph node metastasis.Methods 98 cases of cervical cancer patients admitted to our hospital were selected as the observation group,and 98 cases of cervical benign lesions were selected as the control group.The expression levels of PDCD5 in serum and lesion tissues of the two groups were compared to analyze the relationship between PDCD5 and pathological features of cervical cancer,and the diagnostic value of PDCD5 in lymph node metastasis of patients with cervical cancer was analyzed by ROC curve.Results The expression levels of PDCD5 in serum and lesion tissue of observation group were lower than those of control group(P<0.05).With the increase of clinical stage and pathological grade of cervical cancer,the expression of PDCD5 in serum and lesion tissue was significantly decreased(P<0.05).Among the 98 patients with cervical cancer,32 had lymph node metastasis.The expression levels of PDCD5 in serum and lesion tissue of lymph node metastasis group were lower than those of non-lymph node metastasis group(P<0.05).ROC curve results showed that the AUCs of PDCD5 in serum and lesion tissue to predict lymph node metastasis of cervical cancer patients were 0.810 and 0.850,respectively,with no statistical significance(P>0.05).Conclusion The Programmed cell death protein 5 is closely related to the pathological features of patients with cervical cancer,and it has a good predictive effect on lymph node metastasis,which is worthy of further study and application.
ABSTRACT
Objective@#To investigate the value of clinical data and qualitative and quantitative computed tomography (CT) in predicting the pathological grade of thymoma．@*Methods@#The clinical data and CT images of 81 patients with confirmed pathological diagnoses of thymoma were retrospectively analyzed．The patients were divided into low-risk and high-risk groups according to the pathological results，and the clinical features and qualitative and quantitative CT findings were compared between the groups．The efficacy of different parameters in predicting the pathological thymoma grade was evaluated by logistic univariate and multivariate regression analyses and receiver operating characteristic (ROC) curves. @*Results@#Sixty-two tumors were classified as low-risk thymoma and 19 as high-risk thymoma. The efficacies of both the maximum CT values on enhancement and maximum degree of enhancement for risk prediction were statistically significant (P＜0. 001)．Logistic regression analysis showed that both the maximum CT values on enhancement (OR = 0. 88，95% CI : 0. 83 － 0．94) and maximum degree of enhancement (OR = 0. 92，95% CI :0. 88－0. 97) were independent predictors of thymoma risk (P＜0. 001)．The area under the ROC curve (AUC) of the maximum CT values on enhancement was 0. 884，with a sensitivity of 68. 4% and a specificity of 96. 8% ; the AUC of the maximum degree of enhancement was 0. 833，with a sensitivity of 89. 5% and a specificity of 72. 6% . @*Conclusion@#Quantitative parameters based on enhanced CT are helpful for the preoperative prediction of thymoma risk stratification．The predictive efficacy of the maximum CT values on enhancement is superior to that of the maximum degree of enhancement.
ABSTRACT
Objective:To explore the value of spectral CT in the preoperative evaluation of solid lung adenocarcinoma with different pathological grades based on the 2011 and 2020 version of the pathological grading system.Methods:A total of 76 cases of solid lung adenocarcinoma confirmed by surgery in Renji Hospital, School of Medicine, Shanghai Jiao Tong University, from January 2019 to September 2021 were analyzed retrospectively. All cases were divided into groups according to the grading system for invasive adenocarcinoma proposed by the International Association for the Study of Lung Cancer (IASLC) in 2011 and 2020 (G low group included G1 and G2 adenocarcinoma, G high group included G3 adenocarcinoma). The tumors with stage Ⅰ and Ⅱ were non-advanced and the tumors with stage Ⅲ and Ⅳ were advanced. The clinical manifestations (gender, age, smoking history and stage), routine CT parameters (tumor size, morphological characteristics, plain CT value and enhancement degree) and spectral parameters [iodine concentration, effective atomic number, enhanced monochromatic CT attenuation values of 40-200 keV (CT 40 keV-CT 200 keV), and the slope of spectral curve (k value)] were compared between G low group and G high group using independent sample t-test or Mann-Whitney U test. And the efficacy of each parameter for indicating G high adenocarcinoma was analyzed using receiver operating characteristic curve analysis and area under the curve (AUC), and the Z test was used to compare the AUC. Results:Seventy-six cases were included (59 cases of G low group and 17 cases of G high group in 2011 version; 46 cases of G low group and 30 cases of G high group in 2020 version). Among the 76 cases, 62 cases were non-advanced stage (50 cases of G low group and 12 cases of G high group in 2011 version; 37 cases of G low group and 25 cases of G high group in 2020 version) and 14 cases were advanced stage (9 cases of G low group and 5 cases in G high group in both 2011 and 2020 version). Among the non-advanced adenocarcinomas, the CT parameters of enhancement degree, k value and CT 40 keV-CT 60 keV in arterial phase and enhancement degree, k value and CT 40 keV-CT 70 keV in venous phase of G high group in 2011 grading system were significantly lower than those of G low group ( P<0.05), while other parameters were similar between G low and G high group in 2011 grading system ( P>0.05); and the CT parameters of CT 60 keV in arterial phase and CT 50 keV-CT 70 keV in venous phase of G high group in 2020 grading system were significantly lower than those of G low group ( P<0.05). Among the advanced adenocarcinomas, all of the clinical and CT parameters were similar between G low and G high group in both 2020 and 2011 grading systems ( P>0.05). For the non-advanced adenocarcinomas, there was medium to good efficacy of the CT parameters of enhancement degree, k value and CT 40 keV-CT 60 keV in arterial phase and enhancement degree, k value and CT 40 keV-CT 70 keV in venous phase for diagnosing 2011 grading system G high adenocarcinoma (AUC=0.700-0.853), with CT 50 keV in venous phase as the best; while the diagnosis efficacy of CT parameters of CT 60 keV in arterial phase and CT 50 keV-CT 70 keV in venous phase was poor for 2020 grading system G high adenocarcinoma (AUC=0.652-0.688), with CT 60 keV in venous phase as the best. After combining smoking history and CT 60 keV in venous phase, the diagnosis efficacy for 2020 grading system G high adenocarcinoma was slightly improved (AUC=0.772), but the difference had no significance ( Z=0.93, P=0.176). Conclusion:The spectral parameters are useful for distinguishing the pathological grades of solid lung adenocarcinoma. And the detecting efficacy for G high adenocarcinoma of IASLC 2011 version is slightly better than that of 2020 version.
ABSTRACT
Objective:To investigate the value of imaging features of contrast-enhanced computed tomography (CT) of pancreatic neuroendocrine neoplasm (panNEN) in predicting preoperative pathological grade.Methods:From February 2009 to August 2020, at Zhongshan Hospital affiliated to Fudan University, the CT data of 136 patients with panNEN diagnosed by surgery and pathology were retrospectively analyzed. According to World Health Organization classification of digestive tumors (5th edition, 2019), panNEN was classified into G1, G2, G3 neuroendocrine tumor (NET) and neuroendocrine carcinoma (NEC). The differences in CT values and correlative parameters of solid part of lesions with different pathological grades were compared. The receiver operator characteristic curve was drawn and the area under the curve (AUC) was calculated to evaluate the CT value and related parameters in the differential diagnosis of panNEN of different pathological grades. The Kruskal-Wallis test and chi-square test were used for statistical analysis.Results:A total of 142 tumor lesions were detected in 136 panNEN patients, of which the numbers of G1, G2, G3 NET and NEC were 58, 73, 7 and 4, respectively. Along with the increase of pathological grade, the degree of CT enhancement in the solid part of panNEN lesions gradually decreased. The CT value, CT value difference and relative density of arterial phase and venous phase of patients with G2 NET were all lower than those of patients with G1 NET (Arterial phase: 105 HU, 46 to 251 HU vs. 126 HU, 57 to 195 HU; 62 HU, 6 to 212 HU vs. 81 HU, 23 to 166 HU; 1.1, 0.4 to 2.5 vs. 1.4, 0.7 to 2.0. Venous phase: 90 HU, 49 to 159 HU vs. 107 HU, 63 to 162 HU; 49 HU, 9 to 134 HU vs. 62 HU, 24 to 128 HU; 1.1, 0.5 to 2.0 vs. 1.4, 0.9 to 2.0), and the differences were statistically significant ( Harterial phase=2.880, 2.607 and 3.482, Hvenous phase=3.426, 3.323 and 3.891, all P<0.05). The CT value difference, the percentage of lesion enhancement, the index of lesion enhancement in arterial phase, and the CT value difference and the index of lesion enhancement in venous phase of patients with G3 NET were all lower than those of patients with G2 NET (31 HU, 27 to 52 HU vs. 62 HU, 6 to 212 HU; 67%, 59% to 153% vs. 151%, 15% to 705%; 0.6 HU, 0.5 to 0.9 HU vs. 1.3 HU, 0.1 to 5.8 HU; 40 HU, 36 to 52 HU vs. 49 HU, 9 to 134 HU; 0.9, 0.7 to 1.6 vs. 1.5, 0.2 to 5.4), and the differences were statistically significant ( H=2.634, 2.801, 3.267, 2.264 and 2.882, all P<0.05). The relative density index of arterial phase and venous phase to identify G1 and G2 NET received maximum AUC value of 0.679 (95% confidence interval ( CI) 0.587 to 0.771, P<0.01) and 0.701 (95% CI 0.609 to 0.793, P<0.01), respectively. The index of lesion enhancement in arterial phase and venous phase to identify G2 and G3 NET received maximum AUC value of 0.875 (95% CI 0.793 to 0.956, P=0.001) and 0.828 (95% CI 0.700 to 0.956, P=0.004), respectively. Conclusion:The enhanced CT parameters of panNEN can be used to predict the pathological grade before operation.
ABSTRACT
Objective@#To investigate the relationship between the apparent diffusion coefficient (ADC) histogram parameters based on the whole tumor and the pathological grade and lymph node metastasis (LNM) of PCa.@*METHODS@#This retrospective study included 82 cases of PCa confirmed pathologically and subjected to MRI preoperatively. We obtained a series of ADC histogram parameters, such as ADCmean, ADCmedian, ADC25%, ADC75%, entropy, and histogram width, by processing the ADC images via the Firevoxel Post-Processing and the SPSS24 software. We compared the parameters between the high-risk and low- or moderate-risk groups as well as between the LNM-positive and LNM-negative groups of the patients, and analyzed the diagnostic performance of the parameters with statistically significant differences.@*RESULTS@#The high-risk group, compared with the low- or moderate-risk one, showed a significantly lower ADCmean (［590 ± 120］ vs ［837 ± 142］ ×10－6 mm2/s, P < 0.01), ADCmedian (［560 ± 117］ vs ［804 ± 139］ ×10－6 mm2/s, P < 0.01), ADC25% (［446.5 ± 98］ vs ［717 ± 118］ ×10－6 mm2/, P < 0.01) and ADC75% (［667 ± 132］ vs ［931 ± 167］ ×10－6 mm2/s, P < 0.01). The ADCmean manifested the highest diagnostic performance, with an AUC of 0.907, a sensitivity of 0.933 and a specificity of 0.796. No statistically significant difference was found between the high-risk and the low- or moderate-risk one in entropy (3.58 ± 0.39 vs 3.63 ± 0.42, P = 0.238) or the histogram width (［540 ± 73］ vs ［520 ± 65］ ×10－6 mm2/s, P = 0.086). Both entropy and the histogram width were remarkably higher in the LNM-positive than in the LNM-negative group (3.95 ± 0.41 vs 3.12 ± 0.45, P < 0.01; ［578 ± 59］ vs ［455 ± 68］ ×10－6 mm2/s, P < 0.01), and the former had an even higher diagnostic performance, with an AUC of 0.836, a sensitivity of 0.887 and a specificity of 0.781. There were no statistically significant differences between the LNM-positive and LNM-negative groups in the ADCmean (［768 ± 135］ vs ［790±128］ ×10－6 mm2/s, P = 0.402), ADCmedian (［759 ± 110］ vs ［775 ± 121］ ×10－6 mm2/s, P = 0.225), ADC25% (［643 ± 91］ vs ［657 ± 89］ ×10－6 mm2/s, P = 0.654) or ADC75% (［895 ± 127］ vs ［872 ± 129］ ×10－6 mm2/s, P = 0.926).@*CONCLUSIONS@#ADC histogram parameters are related to pathological grade and LNM of PCa, and the analysis of the ADC histogram based on the whole tumor has an important value for preoperative evaluation and prognostic estimation of the malignancy.
Subject(s)
Humans , Male , Diffusion Magnetic Resonance Imaging , Lymphatic Metastasis , Prognosis , Prostatic Neoplasms/pathology , Retrospective StudiesABSTRACT
The pathological grading diagnosis of pancreatic neuroendocrine neoplasms is the basis of clinical treatment and prognosis.The general principle guiding the classification of NEN has been evoluted several times.From the size of tumor,to the proliferation index as a key factor,and subsequently proposed distuishing between well-differentiated neuroendocrine tumors and poorly differentiated neuroendocrine carcinomas.Firstly,neuroendocrine tumors and neuroendocrine carcinomas were classified according to their morphology.Then,according to mitotic image and Ki67 proliferation index,the former was classified into G1,G2 and G3 grades.
ABSTRACT
Objective To observe the utility value of MR intravoxel incoherent motion (IVIM) in histological grading and muscle invasion of bladder urothelial carcinoma.Methods According to postoperative histologic grade and T staging,60 patients with bladder urothelial carcinoma confirmed by surgery and pathology were divided into low grade (LG) group and high grade (HG) group,as well as muscle-noninvasive bladder cancer (NMIBC) or muscle-invasive bladder cancer (MIBC) group.MR IVIM parameters (apparent diffusion coefficient standard [ADCst],true diffusion coefficient [D],pseudodiffusion coefficient [D*] and perfusion fraction [f]) were compared with independent-samples t tests.A binary Logistic regression model was established to evaluate the predicted probability of combined IVIM parameters.ROC curves of IVIM parameters and their combination's predicted probability were drawn,and the diagnostic efficiency was evaluated.Results ADCst,D and f values of HG group were significantly lower than those of LG group (all P＜0.05).Area under ROC curve (AUCs) for ADCst,D and f value to differentiate HG from LG were 0.88,0.86 and 0.72,respectively (all P＜0.01),and AUCs for predicted probability of combined ADCst and D,combined ADCst and f and combined D and f were 0.91,0.90 and 0.88,respectively (all P＜0.0001).ADCst,D and f values of M1BC group were significantly lower than those of NMIBC group (all P＜0.0001).AUCs for ADCst,D and f value to differentiate MIBC from NMIBC were 0.91,0.85 and 0.88,respectively (all P＜0.0001),and all AUCs for predicted probability of combined ADCst and D,combined ADCst and f and combined D and f were both 0.93 (all P＜0.000 1).Conclusion Lower ADCst,D and f values may indicate greater possibility of high grade and muscle invasion of bladder urothelial carcinoma.Combination of IVIM parameters can improve diagnostic efficacy.
ABSTRACT
Objective:To evaluate the staging and grading valut of Ki-67,TP53,Cyclin D1,HER-2 in non-muscle invasive bladder cancer (NMIBC).Methods:Retrospective analysis was performed on the clinicopathologic characteristics of 184 Ta,T1 stage NMIBC patients who underwent transurethral resection of the bladder(TURBT)at the Tianjin Medical University Cancer Institute and Hospital from January 2015 to December 2016.The expression of Ki-67,TP53,Cyclin D1 and HER-2 was evaluated by immunohistochemical assay.Then,the association between immunohistochemical indicators expression,staging and grading of NMIBC were assessed by univariate analysis.The independent factors of staging and grading in NMIBC were assessed by multivariate Logistic analysis,and their sensitivity and specificity were compared. Results:Univariate analysis showed a positively correlation between tumor size and T1 and G3 of NMIBC(P<0.05).The high expression of Ki-67 and HER-2 was positively correlated with tumor staging and grading(P<0.05)in T1,G3 NMIBC tissues.The high expression of CyclinD1 was negatively correlated with tumor staging and grading(P<0.05)in Ta stage tissues.Logistic multivariate analysis showed that high expression of Ki-67 and low expression of Cyclin D1 were independent predictors of T1 in NMIBC.High expression of Ki-67,high expression of HER-2 and low expression of Cyclin D1 were independent predictors of G3 in NMIBC.The Ki-67 expression had high sensitivity and specificity for predicting tumor staging and grading in NMIBC.The sensitivity were 81.40%(48/59)and 76.80%(96/125),and the specificity were 76.83%(63/82)and 86.30%(88/102),respectively.Conclusions:Detection of Ki-67 expression could predict staging and grading in NMIBC,and provide the basis for appropriate treatment.
ABSTRACT
Objective To investigate the value of renal CT volumetric texture analysis with machine learning radiomics in assessment of pathological grade of clear cell renal cell carcinoma(ccRCC). Methods Thirty-four biopsy-confirmed ccRCC subjects who had four-phase CT scanning (NC:non-contrast, CM: Corticomedullary, N: Nephrographic, E: Excretory) were collected retrospectively from June 2013 to October 2017 for the study.Non-rigid registration was performed on multi-phase CT images in reference to CM-phase.Each lesion was segmented on CM-phase CT images using our in-house volumetric image analysis platform,"3DQI".A set of fifty-nine volumetric textures,including histogram,gradient,gray level co-occurrence matrix(GLCM),run-length(RL),moments,and shape,was calculated for each segment lesion in each phase as parameters for the training/testing of Random Forest (RF) classifier. Four groups according to pathological Fuhrman grade on a scaleⅠtoⅣ,these tumors were then divided into low(Ⅰ+Ⅱ) and high grade ( Ⅲ + Ⅳ) groups. Feature selection was performed by Boruta algorithm. A 10-fold cross-validation method was applied to validate the RF performance by receiver operating characteristic (ROC) curves analysis to determine the diagnostic accuracy of the model. Results Subjects were divided into four groups by Fuhrman grade on a scaleⅠtoⅣ:3 cases gradeⅠ,19 cases gradeⅡ,8 cases gradeⅢand 4 cases gradeⅣ.In CM-phase,kurtosis and long-run-emphasis(RLE)were selected the most important textures for ccRCC staging among 59 features. The area under curve (AUC) of ROC was 0.88 (79% sensitivity and 82% specificity)by using kurtosis and RLE textures.The mean values of kurtosis and RLE were(-20.00±22.00)×10-2and(3.00±0.40)×10-2for low group,whereas(31.00±32.00)×10-2and(5.00± 0.02)×10-2for high group.Within the mean±SD range of statistics,radiomics can distinguish between low and high grade tumors.In multi-phase analysis,three most important features were selected among 236(59× 4) textures: kurtosis (CM-phase), GLCM homogeneity I (HOMO 1) (E-phase), and GLCM homogeneity 2 (HOMO2)(E-phase).The mean values of HOMO 1(E-phase)and HOMO 2(E-phase)were(19.00±0.03)× 10-2and(11.00±0.02)×10-2for low group,whereas(22.00±0.03)×10-2and(14.00±0.02)×10-2for high group. The AUC was 0.92(93% sensitivity and 87% specificity)by using these three textures. Conclusion This study has demonstrated that renal CT volumetric texture analysis with machine learning radiomics could preoperative accurately perform cancer staging for ccRCC.
ABSTRACT
Objective To describe the MSCT manifestations of different pathological grading of gastroenteropancreatic neuroendocrine neoplasm(GEP-NEN)and to improve the understanding of CT characteristics of this disease.Methods MSCT images and pathological results of 38 GEP-NEN proved by surgical pathology were analyzed retrospectively in our hospital.All of the tumors were graded as G1 to G3.Measured respectively the CT value of the same location of each tumor in the noncontrast enhanced phase, arterial and venous phase.And divided them into mild,moderate and obvious.Statistically analyzed the number of tumors with different degree of enhancement.Results In arterial and venous phase of G1 group,the number of mild enhancement was respectively 3 and 0 case, the number of moderate enhancement was respectively 6 and 8 cases,and the number of obvious enhancement was respectively 7 and 8 cases.In arterial and venous phase of G2 group,the number of mild enhancement was respectively 2 and 0 case,the number of moderate enhancement was respectively 4 and 6 cases,and the number of obvious enhancement was respectively 4 and 4 cases.In arterial and venous phase of G3 group,the number of mild enhancement was respectively 9 and 4 cases,the number of moderate enhancement was respectively 3 and 8 cases,and the number of obvious enhancement was respectively 0 and 0 case.Kruskal-Wallis rank sum test was performed for the number of tumor enhancement,the result was P<0.05.Conclusion MSCT multi-phase enhancement is valuable in judging the pathological grade of GEP-NEN.Arterial phase usually shows moderate to obvious enhancement in G1 group.The enhancement of tumors with higher grade shows a trend of decrease in arterial phase,while shows mild to moderate enhancement in venous phase.
ABSTRACT
Objective To analyze the correlation between ultrasonographic features and pathological grade of clear cell renal carcinoma(CCRCC). Methods We retrospectively analyzed the conventional ultrasound and contrast enhanced ultrasound in 150 cases of CCRCC from November 2013 to February 2017 which were confirmed by pathology in Institute of Nephrology of Nanjing Gener-al Hospital .Pathological grade was classified into Ⅰ , Ⅱ, Ⅲ,Ⅳ, with 122 cases of low grade CCRCC (grade Ⅰ and grade Ⅱ) and 28 cases of high grade CCRCC ( grade Ⅲ and grade Ⅳ ) .Their correlations with the features of conventional ultrasound and contrast en-hanced ultrasound were analyzed . Results The maximum diameter of the tumor ( low grade:40.00 ±16.11, high grade:56.43 ± 23.30), the minimum diameter of the tumor(low grade:34.73±14.02,high grade:45.79±16.17), rate of pseudocapsule displaying [low grade:presence52(74%),absence70(26%);high grade:presence4(14%),absence24(86%)], and the enhanced uniformity [low grade:uniformity 19(16%),Cystic change 95(78%),necrosis 8(6%);high grade:uniformity 5(18%),Cystic change 1(4%), necrosis 22( 78%) ] were related to the pathological grade .Binary logistic regression analysis showed that the main factors related to the pathological grade were the rate of pseudocapsule displaying (OR:4.348,95%CI: 1.252-15.096)and the enhanced uniformity (OR:11.425,95%CI:4.326-29.229) Conclusion The characteristics of CCRCC conventional ultrasound and contrast-enhanced ultra-sound were related to the pathological grade , and the main factors were the rate of pseudocapsule displaying and enhanced uniformity .
ABSTRACT
Objective To analyze the correlation between ultrasonographic features and pathological grade of clear cell renal carcinoma(CCRCC). Methods We retrospectively analyzed the conventional ultrasound and contrast enhanced ultrasound in 150 cases of CCRCC from November 2013 to February 2017 which were confirmed by pathology in Institute of Nephrology of Nanjing Gener-al Hospital .Pathological grade was classified into Ⅰ , Ⅱ, Ⅲ,Ⅳ, with 122 cases of low grade CCRCC (grade Ⅰ and grade Ⅱ) and 28 cases of high grade CCRCC ( grade Ⅲ and grade Ⅳ ) .Their correlations with the features of conventional ultrasound and contrast en-hanced ultrasound were analyzed . Results The maximum diameter of the tumor ( low grade:40.00 ±16.11, high grade:56.43 ± 23.30), the minimum diameter of the tumor(low grade:34.73±14.02,high grade:45.79±16.17), rate of pseudocapsule displaying [low grade:presence52(74%),absence70(26%);high grade:presence4(14%),absence24(86%)], and the enhanced uniformity [low grade:uniformity 19(16%),Cystic change 95(78%),necrosis 8(6%);high grade:uniformity 5(18%),Cystic change 1(4%), necrosis 22( 78%) ] were related to the pathological grade .Binary logistic regression analysis showed that the main factors related to the pathological grade were the rate of pseudocapsule displaying (OR:4.348,95%CI: 1.252-15.096)and the enhanced uniformity (OR:11.425,95%CI:4.326-29.229) Conclusion The characteristics of CCRCC conventional ultrasound and contrast-enhanced ultra-sound were related to the pathological grade , and the main factors were the rate of pseudocapsule displaying and enhanced uniformity .
ABSTRACT
AIM: To detect the expression of ALEX 1 in the breast cancer tissues in order to verify whether ALEX1 has correlation with clinical pathological features in breast cancer .METHODS:Real-time PCR and immmunohis-tochemistry were applied to detect the expression of ALEX 1 at mRNA and protein levels in the breast tissues .The statistical analysis were performed for determining the correlation with the level of ALEX 1 and the clinical pathological features in breast cancer .RESULTS:The protein levels of ALEX1 in the breast cancer tissues were lower than that in the non-breast cancer tissues (P<0.01).The expression of ALEX1 had correlations with pathological grade , clinical stage, molecular type (P<0.05) but had no correlation with the patients ’ age, tumor size and tumor types in breast cancer .Furthermore, the result of real-time PCR showed that mRNA expression of ALEX 1 was also significantly reduced in the breast cancer tis-sues (P<0.01).CONCLUSION:The expression of ALEX1 in the breast cancer tissues is lower than that in non-breast cancer tissues .The pathological grade and clinical stage in breast cancer are negatively correlated with the expression of ALEX1.
ABSTRACT
Objective To study appliction value of quantitative dynamic contrast enhanced MRI(T1-DCE MRI)in preoperative grading of brain glioma.Methods 80 patients who were pathologically confirmed with a tumor grade (WHO grade Ⅰ 20 cases, grade Ⅱ 20 cases,grade Ⅲ 20 cases and grade Ⅳ 20 cases).All patients were examined with MR enhancements and T1-DCE MRI. The original perfusions imaging datas were analyzed using the GE Omni Kinetic software,which produced the transfer constant (Ktrans )map,the rate constant (Kep )map and fractional volume (Ve )map.Choose ROI and get values of Ktrans ,Kep and Ve .Pearson correlation was carried out to analyze the correlation between values of Ktrans ,Kep ,Ve of different grades of gliomas and pathology classifications.The Ktrans ,Kep and Ve values of the different grade gliomas were statistically analyzed using an ANOVA .Receiver operator characteristics (ROC)curve was used to analyze sensitivity and specificity of permeability parameters.Results The Ktrans ,Kep and Ve values of each levels has a strong correlation with pathological grading (r=0.95 1,0.804,0.766).There was obviously statistically significant difference between different grade groups(P < 0.01 )by Ktrans .Kep values have statistically difference between different grades except grade Ⅱ and Ⅲ.Ve values were different between different grades except grade I andⅡand grade Ⅲ and IV.Accord-ing to ROC curve,Ktrans seemed to be a better parameter for evaluating the tumor grade with the highest sensitivity and specificity. With the cutoff thresholds of Ktrans of 0.1 60,0.420 and 0.935,different grades of glioma can be differentiated with sensitivities of 90%,95%,95% and specificities of 95%,95%,85% respectively.Conclusion Quantitative analysis of microcirculation perfusion status of different grade gliomas by Ktrans values obtained from T1-DCE MRI can assessment the degree of the destruction of the blood brain barrier and evaluate the grade of gliomas more accurately before operation.
ABSTRACT
Objective To explore the correlation of peritumoral brain edema( PTBE)size,histologi-cal grades and the expression rate of Ki-67 in gliomas. Methods The data and specimens about 74 cases of gliomas in People's Hospital of Xinjiang Uygur Autonomous Region during 2010-2013 were collected. All cases were confirmed by surgery and pathology. According to preoperative MRI,PTBE was graded. Immunohisto-chemical discriminate the expression of Ki-67. HE coloration distinguish the histological grades. Results In this study,90. 54%(67/74)patients occured PTBE,the incidence of PTBE inⅠ,Ⅱ,Ⅲ,Ⅳlevel of groups were 100%(3/3),78. 95%(15/19),83. 33%(15/18),100%(34/34). Ki-67 expression was positive in 75. 68%(56/74)patients,and the rates were 0,36. 84%(7/19),94. 44%(17/18),94. 12%(32/34) in Ⅰ,Ⅱ,Ⅲ,Ⅳ level of groups. The expression rate of Ki-67 was 57. 14%(4/7),60. 00%(6/10),and 80. 70%(46/57)in normal group,Ⅰ-level groups of PTBE,Ⅱ-level groups of PTBE. The result of Kruskal-Wallis H showed that the PTBE from different grades was statistically significant(H=11. 304,P=0. 010). The expression rate of Ki-67 in different grade gliomas was statistically significant(H=38. 530,P﹤0. 05), The difference of expression Ki-67 in gliomas of different PTBE was statistically significant( H=6. 478,P=0. 039). The result of Spearman rank correlation analysis showed that the PTBE level increased with the histo-logical grade up in gliomas(r=0. 385,P=0. 001). The expression rate of Ki-67 increased with the histologi-cal grade up in gliomas(r=0. 692,P﹤0. 05),and the expression rate of Ki-67 increased with the degree of PTBE up in glomas( r =0. 256,P =0. 028 ). Conclusion Accorrding to the PTBE size,the histological grades and proliferation ability of glioma can be judged pre-operation. Ki-67 can be used as the indicator of pro-liferation activity of tumor,and also be used as the important basis of histological grades.
ABSTRACT
PURPOSE: The aim of this study was to investigate the prognosis of papillary thyroid carcinoma (PTC) patients according to different pathologic grades of lymphocytic thyroiditis (LT). MATERIALS AND METHODS: This study included 144 PTC patients who underwent total thyroidectomy with radioactive iodine remnant ablation therapy. Pathologic grades of LT were separated at two points, chronic lymphocytic thyroiditis (CLT) and Hashimoto thyroiditis (HT). Patients were divided into two groupings according to the presence of the diseases (Grouping 1; patients with CLT or HT and without CLT or HT, Grouping 2; patients with HT and without HT). The groupings were compared according to recurrence, clinicopathologic and ultrasound (US) characteristics, and disease free survival. RESULTS: Of 144 patients, 41 had CLT and 19 had HT. There were 10 patients (6.9%) with tumor recurrence. In both groupings, the presence of calcification was more frequently associated with patients with LT (p=0.041 and 0.047, respectively). In Grouping 2, the mean age at diagnosis was older in patients without HT compared to patients with HT (p=0.032). On multivariate analysis, the presence of LT was not an independent predictor of recurrence in both groupings. For both groupings, pathologic tumor size and taller than wide shape on US were independent predictors of recurrence. The presence of LT in PTC patients did not affect recurrence. CONCLUSION: There was no relationship between PTC prognosis and different grades of LT. Pathologic tumor size and taller than wide shape on ultrasound were independent predictors of PTC recurrence regardless of concurrent LT.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Carcinoma/pathology , Carcinoma, Papillary/pathology , Hashimoto Disease/pathology , Retrospective Studies , Thyroid Neoplasms/pathologyABSTRACT
PURPOSE: The aim of this study was to investigate the prognosis of papillary thyroid carcinoma (PTC) patients according to different pathologic grades of lymphocytic thyroiditis (LT). MATERIALS AND METHODS: This study included 144 PTC patients who underwent total thyroidectomy with radioactive iodine remnant ablation therapy. Pathologic grades of LT were separated at two points, chronic lymphocytic thyroiditis (CLT) and Hashimoto thyroiditis (HT). Patients were divided into two groupings according to the presence of the diseases (Grouping 1; patients with CLT or HT and without CLT or HT, Grouping 2; patients with HT and without HT). The groupings were compared according to recurrence, clinicopathologic and ultrasound (US) characteristics, and disease free survival. RESULTS: Of 144 patients, 41 had CLT and 19 had HT. There were 10 patients (6.9%) with tumor recurrence. In both groupings, the presence of calcification was more frequently associated with patients with LT (p=0.041 and 0.047, respectively). In Grouping 2, the mean age at diagnosis was older in patients without HT compared to patients with HT (p=0.032). On multivariate analysis, the presence of LT was not an independent predictor of recurrence in both groupings. For both groupings, pathologic tumor size and taller than wide shape on US were independent predictors of recurrence. The presence of LT in PTC patients did not affect recurrence. CONCLUSION: There was no relationship between PTC prognosis and different grades of LT. Pathologic tumor size and taller than wide shape on ultrasound were independent predictors of PTC recurrence regardless of concurrent LT.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Carcinoma/pathology , Carcinoma, Papillary/pathology , Hashimoto Disease/pathology , Retrospective Studies , Thyroid Neoplasms/pathologyABSTRACT
Objective To investigate the relationship between D-dimer levels and the clinical stage and pathological grade of patients with ovarian cancer.Methods The clinical data of 66 patients with ovarian cancer whose D-dimer had been monitored before surgery were retrospectively analyzed.The relationship between D-dimer levels and the clinical stage,pathological grade was evaluated.Results D-dimer levels before surgery were uncorrelated with the patient's age (r =0.1324,P ＞ 0.05 ).There was significant difference in D-dimer levels between FIGO Ⅰ + Ⅱ patients and FIGO Ⅲ + Ⅳ patients [(377.89 ± 183.85) mg/L vs.(858.03 ± 138.29) mg/L] (t =11.602,P＜0.01).There was significant difference in D-dimer levels between high-moderately differentiated patients and poorly differentiated patients [(463.39 ±246.85) mg/L vs.(784.64 ±265.69) mg/L](t =4.983,P＜0.01).Conclusions D-dimer levels are related with the clinical stage and pathological grade of patients with ovarian cancer.It can predict the harmful biological behaviour of ovarian cancer.