The MRI and clinical features of acinic cell carcinoma of the parotid gland / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To analyze the MR imaging findins of acinic cell carcinoma(ACC) in parotid gland and develop the diagnosis of this disease.@*METHOD@#The MR imaging fearures of 11 patients with pathologically proved ACC were retrospectively analyzed. MR imagings were analyzed in relation to the follow:amount, location, size, shape, margin, pseudocapsule, MR signal intensity and enhanced pattern and the cervical lymphadenopathy. The clinical analysis on patients included age, sex, and follow-up.@*RESULT@#There were 11 patients, 7 lesions was located in the right parotid gland and 4 lesions was located in the left parotid gland; the average maximum diameter was (2.66±0.99)cm; 7 lesions showed lobulated,and 4 lesions showed round; 8 lesions had no pseudocapsules and 3 lesions had incomplete pseudocapsule. All lesions showed homogeneous or heterogeneous isointense and slight hyperintense on T1 WI and T2WI. On post contrast images, the tumor parenchyma ingredients showed remarkable enhancement in all lesions.@*CONCLUSION@#The MR imaging of ACC in the parotid gland don't have specific features, but when the tumor of the parotid gland showed no pseudocapsule (or showed incomplete pseudocapsule), lobulate, small cysitc and remarkable enhancement, it may indicate ACC, and the correct diagnosis depends on clinical pathology.

High-risk HPV genotyping for cervical intraepithelial neoplasia grade 2 or worse:A comparison of single types and type combinations / 中国癌症杂志

Background and purpose:Risk of invasive cervical carcinoma (ICC) and its precancerous lesions following high risk human papillomavirus (hrHPV) infection may vary according to HPV types and geographic regions. Analyzing HPV-type distribution in cervical samples from local women aged 30 years and older, this study aimed to identify HPV types with higher risk of developing CIN2+, and to compare diagnostic performance for CIN2+using these types and type combinations. Methods:Cervical samples with histology follow-up from patients of a tertiary cancer center in Shanghai were collected for HPV genotyping by PCR-RDB. The risk associations of HPV types with CIN2+were estimated by logistic regression analysis, and ROC curves were plotted for diagnostic performance evaluation. Results:A total number of 413 specimens were obtained, including 38 CIN1, 184 CIN2/3, 126 ICC patients and 65 negative control people. The 4 most common HPV types in CIN2+were HPV16, 58, 33 and 18, in descending order. And only HPV16 (P<0.000 1), 58 (P=0.002), 33 (P=0.015) were signiifcantly associated with CIN2+lesions. Besides, the area under the ROC curve of the HPV16/18/33/58 test scored statistically higher than the HPV16/18 test did (P=0.006 6). Conclusion:A combined test of HPV16/18/33/58 may offer better performance for detecting CIN2+lesions in our geographic region.

Assessment of HER2 gene amplification in breast cancer: a comparison of dual-color in-situ hybridization and fluorescence in-situ hybridization / 中华病理学杂志

<p><b>OBJECTIVE</b>To compare dual-color in-situ hybridization (DISH) with fluorescence in situ hybridization(FISH) in evaluating the human HER2 gene status in invasive breast cancer.</p><p><b>METHODS</b>HER2 gene status in 110 cases of breast invasive ductal carcinomas with a 2+ score on immunohistochemistry (IHC) was investigated by FISH and DISH. The 2007 and 2013 ASCO (American Society of Clinical Oncology)/CAP (College of American Pathologists) HER2 guideline were used respectively to evaluate the agreement between these two techniques.</p><p><b>RESULTS</b>(1) Using the 2007 ASCO/CAP guideline, the overall concordance between FISH and DISH was 97.3% (107/110). Fifty of 51 samples with amplification by FISH were also detected by DISH and the remaining one sample was equivocal.Eight of 10 equivocal samples by FISH were equivocal by DISH and the remaining two samples were negative. Forty-nine samples with no amplification by FISH were all negative by DISH. The concordance was 98.0%, 8/10 and 100.0% respectively for the FISH positive, equivocal and negative groups. (2) Using the 2013 ASCO/CAP guideline, the overall concordance between FISH and DISH was 90.0% (99/110). Fifty-three of 55 samples with amplification by FISH were also detected by DISH and the remaining two were equivocal and negative respectively. Two of 12 equivocal samples by FISH were equivocal by DISH and the remaining ten samples were negative in 7 cases and equivocal in 3 cases. Forty-three samples with no amplification by FISH were all negative by DISH. The concordance was 96.4%, 3/12 and 100.0% respectively for the FISH positive, equivocal and negative groups. Pearson correlation analysis indicated that the HER2 status detected by FISH and DISH were significantly correlated with each other (R=0.584, P<0.01).</p><p><b>CONCLUSIONS</b>There is a high concordance between DISH and FISH for assessing the HER2 gene status in invasive breast cancer. DISH is a new option for assessing HER2 gene status of breast cancer in clinical practice. The clinical significance of the discordance between DISH and FISH in equivocal cases warrants further study.</p>

MR diffusion weighted imaging in the differential diagnosis of cystic lesions of the pancreas / 中华胰腺病杂志

Objective To evaluate the value of diffusion-weighted imaging (DWI) in the differential diagnosis of cystic pancreatic lesions.Methods Thirty-four cystic pancreatic lesions confirmed clinically or pathologically were collected,including 11 case of non-neoplastic pseudocyst,5 cases of simple cyst,6 cases of serous cystadenoma,10 cases of mucinous cystadenoma and 2 cases of mucinous cystadenocarcinoma.All the patients underwent routine serial MR and echo-planar DW imaging examination of the pancreas with b values of 0 and 600 s/mm2.The appearances of signal intensity of DWI with all cysts were recorded.ADC maps were reconstructed,and the ratio of the cysts and cyst-to-pancreas ADC (ADCR) were calculated.The receiver operating characteristic (ROC) curves were constructed to evaluate the diagnostic value of ADC and ADCR.Results Among all the 16 non-neoplastic cysts,2 cysts were slightly hyperintense in DWI,and 14 cysts were isointense.Among all the 18 neoplastic cysts,17 cysts appeared slightly hyperintense or hyperintense in DWI,and 1 cyst was isointense.The difference between the two groups was statistically significant (P ＜ 0.001).The ADC values of non-neoplastic and neoplastic cysts were (3.30 ± 0.30) × 10-3,(2.74 ± 0.34) × 10-3 mm2/s ; and the ADCR values of non-neoplastic and neoplastic cysts were 1.85 ± 0.20,1.31 ± 0.21,the difference between the two groups was statistically significant (P ＜ 0.001).The areas under the ROC curves of ADC and ADCR diagnosing neoplastic cysts were 0.94 ± 0.04,0.98 ± 0.02,respectively.An ADC of 3.105 × 10-3 mm2/s showed 81.3％ sensitivity and 94.4％ specificity for predicting neoplastic cysts.An ADCR of 1.525 showed 100％ sensitivity and 88.9％ specificity for predicting neoplastic cysts.Conclusions Diffusion-weighted imaging is of importance in the diagnosis and differential diagnosis of pancreatic cysts,and can be applied as a complementary tool for routine MRI.

The Application of MR Diffusion-weighted Imaging in Discriminating Benign and Malignant Vertebral Fractures / 实用放射学杂志

Objective To investigate the value in distinguishing benign and malignant vertebral fractures with MR diffusion-weighted imaging(DWI).Methods 31 patients with 58 vertebral fractures were underwent routine MRI scanning and echo-planar DWI(EPI/DWI).The materials were divided into benign group(n=32,20 cases),malignant group(n=18,8cases),tuberculosis group(n=8,3cases) and normal vertebral body group(n=31). Signal intensities on DWI were compared and apparent diffusion coeffient(ADC) values of normal and abnormal vertebral bodies were calculated. ADC values among the benign,malignant,tuberculosis vertebral bodies and normal ones were quantitatively analyzed and compared.Results The ADC values of benign,malingnant,tuberculosis and normal vertebral bodies were (1.44?0.41)?10 -3 mm2/s,(0.94?0.17)?10 -3 mm2/s,(0.98?0.13)?10 -3 mm2/s and(0.42?0.16)?10 -3 mm2/s ,respectively. The ADC values of the three abnormal groups were higher than normal group ( all P0.05). The sensitivity and specificity of ADC for the diagnosis of malignant lesion were 72.2% and 90.6% if the upper bound of 95% confidence interval was set as a differential level.Conclusion DWI provides an important supplement to the routine MRI in the differentiation of benign with malignant vertebral fractures.