Differentiating gastric cancer and gastric lymphoma using texture analysis (TA) of positron emission tomography (PET) / 中华医学杂志(英文版)

BACKGROUND@#Texture analysis (TA) can quantify intra-tumor heterogeneity using standard medical images. The present study aimed to assess the application of positron emission tomography (PET) TA in the differential diagnosis of gastric cancer and gastric lymphoma.@*METHODS@#The pre-treatment PET images of 79 patients (45 gastric cancer, 34 gastric lymphoma) between January 2013 and February 2018 were retrospectively reviewed. Standard uptake values (SUVs), first-order texture features, and second-order texture features of the grey-level co-occurrence matrix (GLCM) were analyzed. The differences in features among different groups were analyzed by the two-way Mann-Whitney test, and receiver operating characteristic (ROC) analysis was used to estimate the diagnostic efficacy.@*RESULTS@#InertiaGLCM was significantly lower in gastric cancer than that in gastric lymphoma (4975.61 vs. 11,425.30, z = -3.238, P = 0.001), and it was found to be the most discriminating texture feature in differentiating gastric lymphoma and gastric cancer. The area under the curve (AUC) of inertiaGLCM was higher than the AUCs of SUVmax and SUVmean (0.714 vs. 0.649 and 0.666, respectively). SUVmax and SUVmean were significantly lower in low-grade gastric lymphoma than those in high grade gastric lymphoma (3.30 vs. 11.80, 2.40 vs. 7.50, z = -2.792 and -3.007, P = 0.005 and 0.003, respectively). SUVs and first-order grey-level intensity features were not significantly different between low-grade gastric lymphoma and gastric cancer. EntropyGLCM12 was significantly lower in low-grade gastric lymphoma than that in gastric cancer (6.95 vs. 9.14, z = -2.542, P = 0.011) and had an AUC of 0.770 in the ROC analysis of differentiating low-grade gastric lymphoma and gastric cancer.@*CONCLUSIONS@#InertiaGLCM and entropyGLCM were the most discriminating features in differentiating gastric lymphoma from gastric cancer and low-grade gastric lymphoma from gastric cancer, respectively. PET TA can improve the differential diagnosis of gastric neoplasms, especially in tumors with similar degrees of fluorodeoxyglucose uptake.

Health literacy investigation results among residents in Jing′an District of Shanghai in 2018 / 上海预防医学

Objective To investigate the level of health literacy of residents in Jing′an District of Shanghai, providing basis for the intervention programs of health literacy. Methods By using Probability Proportionate to Size Sampling method, 1 760 residents aged 15-69 were surveyed through face-to-face interviews. Results The overall level of adjusted health literacy of Jing′an District was 31.89%.The health literacy level of basic health concepts and knowledge, health lifestyle and behaviors, and health related skills were 46.30%, 27.02%, 43.44%, respectively.The 6 health issues regarding awareness of health literacy from high to low were safety and first aid (65.49%), scientific attitude towards health(60.75%), health information literacy(56.86%), chronic diseases prevention (34.22%), basic medical care(31.10%), and infectious diseases prevention (24.28%).People of 65-69 years old had the lowest health literacy level (χ2=22.03, P < 0.05).Those with collage degree or above had higher health literacy level (χ2=43.54, P < 0.05).In terms of occupation, civil servant had higher health literacy level(χ2=22.78, P < 0.05). Conclusion The level of health literacy in Jing′an District is on a steady rise, however, intensive intervention is needed for residents with lower health literacy.