A preliminary study of radiomics in predicting WHO/ISUP grading of clear cell renal cell carcinoma based on unenhanced CT texture analysis / 中华放射学杂志

Objective:To investigate the value of radiomics based on unenhanced CT texture analysis in predicting the WHO/International Society of Urological Pathology (ISUP) grading of clear cell renal cell carcinoma (ccRCC).Methods:Postoperative pathology-confirmed ccRCC subjects ( n=90) who received CT scanning and had a definite pathological grading in Cancer Hospital of the University of Chinese Academy of Sciences were collected retrospectively from December 2016 to May 2019. The cases were randomly divided into training group ( n=63) and test group ( n=27) as a ratio of 7∶3. All cases were classified into low grade (grades Ⅰ and Ⅱ, n=57) and high grade (grades Ⅲ and Ⅳ, n=37) according to the new pathological grading (WHO/ISUP grading, version 2016) of renal carcinoma. 3D-ROI segmentation was performed on unenhanced CT images and 93 texture features were extracted. The least absolute shrinkage and selection operator (LASSO) regression was used to reduct dimension of texture parameters and then the radiomics score (Rad-score) was established. The logistic regression was used to develop the prediction model with the pathological grading as the gold standard. The ROC curve and calibration curve were used to evaluate the predictive performance of the model, and the area under the curve (AUC), accuracy, sensitivity and specificity were calculated. The Hosmer-Lemeshow test was used to evaluate calibration degree of the model. Results:The 10 non-zero coefficient texture features were screened out through dimension reduction steps. The Rad-score was formed according to the linear combination of these ten features and corresponding coefficients, and then the prediction model was developed. The AUC of the model in training group was 0.933 (95%CI 0.862-1.000), the sensitivity was 92.3%, the specificity was 89.2%, and the model accuracy was 90.5%. The calibration curve showed the good calibration ( P=0.257). The AUC value in test group was 0.875 (95%CI 0.734-1.000), the sensitivity, specificity and accuracy were 72.7%, 87.5% and 81.5%. The calibration curve showed the good calibration ( P=0.125). Conclusion:The radiomics prediction model based on unenhanced CT texture analysis have application potential for the evaluation of WHO/ISUP grading of ccRCC.

Clinical study of the cerebral collateral venous circulation scale based on individualized delayed rotational phlebography / 中华放射学杂志

Objective:To investigate the correlation between venous collateral circulation and clinical data such as symptoms, parenchymal injury, and prognosis in patients with cerebral venous thrombosis(CVT).Methods:The clinical and imaging data of patients with CVT diagnosed in the department of Neurosurgery of the Third Affiliated Hospital of Southern Medical University from December 2011 to August 2018 were retrospectively analyzed. A total of 32 patients with CVT were included, 19 males and 13 females, aged from 20 to 60 (39±12) years. All patients underwent cerebral angiography, individualized delayed rotational phlebography. According to the number and diameter of collateral circulation and the phenomenon of flow delay of contrast medium, the collateral venous circulation scale (CVCS) was developed and divided into 3 levels. The clinical data (risk factors, course of disease, clinical symptoms), imaging data (parenchymal injury, thrombus site), treatment (endovascular treatment, decompressive craniectomy) and prognosis of all patients were recorded. The differences in clinical data, imaging appearances, parenchymal injury, and prognosis between patients with different CVCS were compared, and the correlation between variables with statistically significant differences and CVCS was compared using the Gamma method or Spearman correlation analysis.Results:Among the 32 patients with CVT, 9 were CVCS 0, 13 were CVCS 1 and 10 were CVCS 2. Among them, there were 19 cases of neurological deficit and 17 cases of brain parenchymal injury. There were significant differences in course of disease, neurological deficit, focal dyskinesia, language dysfunction, consciousness disorder, isolated headache, deep vein thrombosis, cortical vein thrombosis and prognosis across different CVCS ( P<0.05). Correlation analysis showed that CVCS was positively correlated with course of disease and isolated headache ( r=0.724, 0.637, P<0.001), and negatively correlated with neurological deficit symptoms, focal dyskinesia, disturbance of consciousness, brain parenchymal injury and deep vein thrombosis ( r=-0.797, -0.451, -0.782, -0.697, -0.427, P<0.05). The results of 90 days follow-up showed that there were 18 cases with mRS 0, 6 cases with mRS 1, 2 cases with mRS 2-4, and 1 case with mRS 5-6 points. There was a negative correlation between CVCs grading and mRS score at 90 days ( r=-0.732, P<0.001). Conclusion:Lower cerebral venous collateral circulation grade is associated with higher incidence of brain parenchymal injury, neurological deficit symptoms, and worse clinical prognosis.

Efficacy and safety of Gemcitabine combined with cisplatin in the treatment of bladder cancer / 中国生化药物杂志

Objective To evaluate the clinical efficacy and safety of gemcitabine combined with cisplatin in the treatment of bladder cancer.MethodsFrom October 2012 to August 2015, 92 patients with bladder cancer were enrolled in our hospital.Patients were divided into observation group and control group by random number table method.On the basis of routine nutrition support and symptomatic treatment, cisplatin was administered by intravenous infusion of cisplatin 70mg/m2 in the first 3d in control group.On the 1d and 8d, gemcitabine 1000mg/m2 was intravenously infused in observation group and 21 days treatment was taken continuous for 2 courses.Curative effect, IL-17, IL-18, transforming growth factor-β (TGF-β), vascular endothelial growth factor (VEGF) and urinary TGF-β1 levels and adverse reactions of two groups were comparatively studied.ResultsThe total effective rate in the control group (63.05%) was significantly lower than that in the observation group (76.09%) (P<0.05).After treatment, the levels of serum IL-17, IL-18, TGF-β1 and VEGF in the two groups were significantly decreased and with significant difference between two groups (P<0.05).The levels of urinary TGF-β1 were significantly increased and with significant difference between two groups (P<0.05).The incidence of adverse reactions in the control and observation groups was 15.22% and 6.52%, respectively.There was no significant difference between the two groups.ConclusionGemcitabine combined with cisplatin has a significant clinical efficacy and safety in the treatment of bladder cancer.

Multidisciplinary diagnosis and treatment of advanced thyroid carcinoma invading common carotid artery / 中华内分泌外科杂志

Objective To investigate the application of carotid artery resection and reconstruction in surgical management of thyroid carcinoma with carotid artery involvement.Methods We conducted a retrospective cohort study involving 10 patients whose common carotid arteries were invaded by thyroid carcinoma.All patients underwent tumor en bloc resection and carotid arteries reconstruction.Patients were evaluated by muhidisciplinary team and surgeries were cooperated by general surgeons,orthopedists and vascular surgeons.The perioperative complications and surgical outcomes were also recorded and analyzed.Results No patient had complications of central nervous system.One patient suffered Horner syndrome and one presented hoarseness postoperative.Two patients had wound infection,two patients presented carcinoma recurrence and two patients presented distant metastasis during the follow-up.Conclusion En bloc resection of tumor and carotid artery reconstruction is a feasible modality in treatment of thyroid carcinoma with carotid artery invasion.

Preoperative serum thyroglobulin in prediction of follicular thyroid tumors / 中华内分泌外科杂志

Objective To analyze whether preoperative serum thyroglobulin (Tg) can be the indicator for predicting malignancy in follicular thyroid tumors (FTC).Methods A retrospective analysis was done for 125 patients with FTC who had been diagnosed by pathology in our hospital.The patients were grouped into benign group and malignant group.Sex,age,tumor size and preoperative serum Tg concentration were analyzed.Results There were 62 patients in benign group (23 male and 39 female).The mean age was 49 years old,ranging from 19 to 78 years,and the mean diameter of tumors was (3.4±1.374) cm,ranging from 0.1 to 5.5 cm.There were 63 patients in malignant group (13 male and 50 female).The mean age was 46 years old,ranging from 15 to 79 years,and the mean diameter of tumors was (3.14±1.143) cm,ranging from 0.3 to 7 cm.The mean preoperative serum Tg concentration was (299.73± 495.02) ng/ml in malignant group and(48.20 ±43.68)ng/ml in the benign group.Through comparing the two groups,we found age and tumors diameter had no statistical difference between the two groups (P＞0.05),while sex and Tg had statistical difference (P＜0.05).When the cutoff of Tg was 100 ng/ml,the sensitivity and specificity for the diagnosis of malignancy was 48.7％ and 90％ respectively.Conclusions Tg can be used as auxiliary diagnosis index of thyroid FTC.High preoperative Tg levels should be highly suspected the possibility of FTC.

Partial cystectomy in treatment of localized muscle invasive bladder cancer / 中华泌尿外科杂志

Objective To evaluate the efficacy of partial cystectomy in treatment of localized muscle invasive bladder cancer.Methods From 1999 to 2005,data from 71 patients with muscle invasive bladder cancer(MIBC) were reviewed.There were 47 patients underwent partial cystectomy (PC) and 24 underwent total cystectomy (TC).The overall survival and disease-free survival in patients with MIBC with PC or TC were compared.All patients had pathologic T2-T3.Matched Kaplan-Meier survival analyses compared the effect of PC vs.TC on overall survival and disease-free survival.Univariate (log rank) and multivariate (Cox' proportional hazard model) analyses were used to test the statistical significance of several potential prognostic factors for survival rate.Results In the entire cohort,the overall survival rate and disease-free survival rate estimated at 5 years were 57％ and 50％ for PC patients,53％ and 46％ for TC patients,respectively (P＞0.05).On univariate analysis,T stage (include vessel tumor embolus) and whether the tumor was pedunculated were the significant predictors of tumor recurrence.Age,gender,tumor quantity,tumor size and histology category were not associated with prognosis.Cox proportional hazard regression model confirmed that the independent prognosis factors of tumor was T stage (EXP(B)=1.64,P＜0.05).Conclusions PC might not undermine cancer control in appropriately selected patients with MIBC.