Contrast-enhanced ultrasound for differentiating benign from malignant focal solid renal lesions in pediatric patients.

The contrast-enhanced ultrasound (CEUS) has been mainly applied to adults to differentiate benign and malignant renal lesions, however, the characteristics of CEUS in pediatric has not been as well studied as in adults. In the present work, the eligible pediatric patients who underwent renal CEUS between March 2016 and February 2023 were retrospectively analyzed. It included 20 lesions (median diameter, 8.4 cm; range, 1.8-18.0 cm) from 20 patients (median age, 28.0 months; range, 3.0-212.0 months; 9 boys) in malignant group and 5 lesions (median diameter, 3.8 cm; range, 1.3-7.5 cm) from 5 patients (median age, 25.0 months; range, 0.7-216.0 months; 2 boys) in benign group. The diagnostic performance was assessed. Nonparametric and Chi-square tests were performed. With hyperenhancement plus wash-out, CEUS showed a sensitivity of 95.0% [95% confidence interval (CI): 75.1%, 99.9%], a specificity of 80.0% (CI: 28.4%, 99.5%), a positive predictive value of 95.0% (CI: 75.1%, 99.9%) and a negative predictive value of 80.0% (CI: 28.4%, 99.5%). It suggested that CEUS is a valuable technique for identifying between malignant and benign renal lesions in children.

Associations of BRAFV600E mutation with the American College of Radiology Thyroid Imaging Reporting and Data System and clinicopathological characteristics in pediatric patients with papillary thyroid carcinoma.

BACKGROUND: Identifying the associations between BRAFV600E mutation, the American College of Radiology Thyroid Imaging Reporting and Data System (TI-RADS) and clinicopathological characteristics could assist in making appropriate treatment strategies for pediatric patients with papillary thyroid carcinoma. OBJECTIVE: To retrospectively assess the associations between BRAFV600E mutation, TI-RADS, and clinicopathological characteristics in pediatric patients with papillary thyroid carcinoma. MATERIALS AND METHODS: Between May 2013 and May 2023, pediatric patients with papillary thyroid carcinoma who underwent thyroidectomy were retrospectively evaluated. Univariate and multivariate logistic regression analyses were performed to determine the associations between BRAFV600E mutation, TI-RADS, and clinicopathological characteristics. The diagnostic performance of TI-RADS to predict BRAFV600E mutation was assessed. RESULTS: The BRAFV600E mutation was found in 59.1% (39/66) of pediatric patients with papillary thyroid carcinoma. Multivariate analyses showed that hypoechoic/very hypoechoic [odds ratio (OR) = 8.48; 95% confidence interval (CI) = 1.48-48.74); P-value = 0.02] and punctate echogenic foci (OR = 24.3; 95% CI = 3.80-155.84; P-value = 0.001) were independent factors associated with BRAFV600E mutation. In addition, BRAFV600E mutation was significantly associated with TI-RADS 5 (OR = 12.61; 95% CI = 1.28-124.49; P-value = 0.03). There were no associations between BRAFV600E mutation and nodule size, composition, shape, margin, cervical lymph node metastasis, or Hashimoto's thyroiditis (P-value > 0.05). Combined with hypoechoic/very hypoechoic and punctate echogenic foci, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 89.7%, 85.2%, 89.7%, 85.2%, and 87.9%, respectively. CONCLUSIONS: Hypoechoic/very hypoechoic, punctate echogenic foci, and TI-RADS 5 are independently associated with BRAFV600E mutation in pediatric patients with papillary thyroid carcinoma.

Modification of size cutoff for biopsy based on the American College of Radiology Thyroid Imaging Reporting and Data System (TI-RADS) for thyroid nodules in patients younger than 19 years.

OBJECTIVES: To modify the size cutoff for biopsy for thyroid nodules in patients < 19 years based on the American College of Radiology Thyroid Imaging Reporting and Data System (TI-RADS) and evaluate the performance of the new criteria in two referral centers. METHODS: Patients < 19 years with cytopathologic or surgical pathology results were retrospectively identified from two centers from May 2005 to August 2022. Patients from one center were classified as the training cohort, and those from the other center were classified as the validation cohort. The diagnostic performance, unnecessary biopsy rates, and missed malignancy rates of the TI-RADS guideline, and the new criteria (≥ 35 mm for TR3 and no threshold for TR5) were compared. RESULTS: A total of 236 nodules from 204 patients in the training cohort and 225 nodules from 190 patients in the validation cohort were analyzed. The area under the receiver operating characteristic curve of the new criteria in identifying thyroid malignant nodules was higher (0.809 vs. 0.681, p < 0.001; 0.819 vs. 0.683, p < 0.001), and the unnecessary biopsy rates (45.0% vs. 56.8%; 42.2% vs. 56.8%) and missed malignancy rates (5.7% vs. 18.6%; 9.2% vs. 21.5%) were lower than that of the TI-RADS guideline in the training cohort and validation cohort, respectively. CONCLUSIONS: The new criteria (≥ 35 mm for TR3 and no threshold for TR5) for biopsy based on the TI-RADS may help improve the diagnostic performance and reduce unnecessary biopsy rates and missed malignancy rates for thyroid nodules in patients < 19 years. CLINICAL RELEVANCE STATEMENT: The study developed and validated the new criteria (≥ 35 mm for TR3 and no threshold for TR5) to indicate FNA based on the ACR TI-RADS of thyroid nodules in patients younger than 19 years. KEY POINTS: •The AUC of the new criteria (≥ 35 mm for TR3 and no threshold for TR5) in identifying thyroid malignant nodules was higher than that of the TI-RADS guideline (0.809 vs. 0.681) in patients < 19 years. •The unnecessary biopsy rates and missed malignancy rates of the new criteria (≥ 35 mm for TR3 and no threshold for TR5) in identifying thyroid malignant nodules were lower than that of the TI-RADS guideline in patients < 19 years (45.0% vs. 56.8% and 5.7% vs. 18.6%, respectively).

Reference intervals for serum progastrin-releasing peptide in healthy Chinese adults with electrochemiluminescence immunoassay.

BACKGROUND: Reliable reference intervals for serum progastrin-releasing peptide (ProGRP) in healthy Chinese adults with electrochemiluminescence immunoassay (ECLIA) are still lacking in the Chinese population. OBJECTIVES: The study aims to establish reference intervals for ProGRP with ECLIA in apparently healthy Chinese adults. METHODS: A total of 384 apparently healthy individuals from six representative geographical regions in China were enrolled: 200 males and 184 females with a mean age of 43.4±12.2 years, and an age range from 21 to 85 years. Serum ProGRP levels were analyzed on Cobas e601 automatic immunoassay analyzer with ECLIA. Reference intervals for serum ProGRP with ECLIA were determined following CLSI C28-A3 guidelines using a nonparametric method. RESULTS: In an apparently healthy Chinese population, the reference intervals for serum ProGRP with ECLIA were ⩽53.92 ng/L for adults aged 21-70 years and ⩽75.69 ng/L for adults aged >70 years, respectively. CONCLUSIONS: The reference values for serum ProGRP with ECLIA in an apparently healthy Chinese population were established according to the CLSI C28-A3 document, providing a reference for the clinical work.

Pretreatment neutrophil-lymphocyte count ratio may associate with gastric cancer presence.

BACKGROUND: Inflammation plays a pivotal role in cancer development and progression. Neutrophil-lymphocyte count ratio (NLR) is an indicator of systemic inflammatory response which is supposedly associated with gastric cancer (GC) development and progression. Since this parameter can be easily obtained from routine blood examination, it will be a great economic relief to gastric patients if we can bring it into clinical application. OBJECTIVE: The current study aims to evaluate the pretreatment NLR in gastric cancer patients through retrospectively reviewing the medical records. METHODS: A total of 327 patients hospitalized on a tertiary care hospital were retrospectively investigated and divided into two groups. Gastric cancer group were composed of patients with newly diagnosed, pathologically confirmed GC and the control group were patients with gastric polyp or benign gastric stromal tumor. The value of NLR in the presence and stage of gastric cancer was investigated in the entire gastric cancer group. RESULTS: Our study showed levels of NLR were significantly higher in gastric cancer cohort (2.17 (1.63-3.09) versus 1.62 (0.85-2.32), p< 0.001). After all the known confounders were excluded, NLR was an independent predicator of GC (OR = 1.446, 95%CI (1.121-1.866), and P= 0.005). Area under ROC curve (AUC) of NLR was 0.694. In addition, the results of Spearman's correlation showed NLR may have a positive correlation with size of tumor, N-stage, distant metastasis, and overall stage (r = 0.256, 0.256, 0.161 and 0.171, resp., all p < 0.05). CONCLUSIONS: The current study demonstrated that pre-treatment NLR may be a useful biomarker in the health care of gastric cancer patients.