Artificial intelligence breast ultrasound and handheld ultrasound in the BI-RADS categorization of breast lesions: A pilot head to head comparison study in screening program.

Background: Artificial intelligence breast ultrasound diagnostic system (AIBUS) has been introduced as an alternative approach for handheld ultrasound (HHUS), while their results in BI-RADS categorization has not been compared. Methods: This pilot study was based on a screening program conducted from May 2020 to October 2020 in southeast China. All the participants who received both HHUS and AIBUS were included in the study (N = 344). The ultrasound videos after AIBUS scanning were independently watched by a senior radiologist and a junior radiologist. Agreement rate and weighted Kappa value were used to compare their results in BI-RADS categorization with HHUS. Results: The detection rate of breast nodules by HHUS was 14.83%, while the detection rates were 34.01% for AIBUS videos watched by a senior radiologist and 35.76% when watched by a junior radiologist. After AIBUS scanning, the weighted Kappa value for BI-RADS categorization between videos watched by senior radiologists and HHUS was 0.497 (p < 0.001) with an agreement rate of 78.8%, indicating its potential use in breast cancer screening. However, the Kappa value of AIBUS videos watched by junior radiologist was 0.39, when comparing to HHUS. Conclusion: AIBUS breast scan can obtain relatively clear images and detect more breast nodules. The results of AIBUS scanning watched by senior radiologists are moderately consistent with HHUS and might be used in screening practice, especially in primary health care with limited numbers of radiologists.

[Relationship between serum HBV DNA level and follicular helper T lymphocyte in patients with chronic hepatitis B and its significance].

OBJECTIVE: To explore relationship between HBV DNA level and peripheral blood follicular helper T lymphocyte (Tfh) in patients with chronic hepatitis B (CHB) and its significance. METHODS: HBV DNA levels of 179 cases of CHB patients with positive HBV DNA, positive HBeAg and positive human leukocyte antigen(HLA)-A2 were tested with real time fluorescent quantitative PCR. Tfh and HBV specific CTL were tested with flow cytometry. IL-21 was also tested. 179 cases of CHB patients were divided into group A and group B based on HBV DNA levels, 86 cases in group A, HBV DNA levels were 10(4)-10(5) copies/ml, 93 cases in group B, HBV DNA levels were 10(6)-10(7) copies/ml. Above testing indexes of the two groups were compared. RESULTS: HBV DNA levels of group A were (4.85 +/- 0.37) log10 copies/ml, HBV DNA levels of group B were (6.83 +/- 0.31 ) log10 copies/ml, t = 27.31, P < 0. 001; Tfh of group A was (5.96 +/- 1.59)%, higher than that of group B (3.71 +/- 2.15)%, t = 4.92, P < 0.01; IL-21 of group A was (42.61 +/- 15.11)ng/L, higher than that of group B (14.91 +/- 3.15) ng/L, t = 8.62, P < 0.01; HBV specific CTL of group A was (0.36 +/- 0.08)%, higher than that of group B (0.18 +/- 0.06)%, t = 19.99, P < 0.001. CONCLUSION: Serum HBV DNA level of CHB patients is related to the level of peripheral blood Tfh level: patients with low HBV DNA level have high Tfh level, high IL-21 level and high HBV specific CTL level. Patients with high HBV DNA level have low Tfh level, low IL-21 level and low HBV specific CTL level. The mechanism of baseline HBV DNA level affecting anti-viral therapy may be related to Tfh level.

Serum miR-18a: a potential marker for hepatitis B virus-related hepatocellular carcinoma screening.

BACKGROUND: Alpha-fetoprotein detection is currently mainly used in clinic for diagnosis of primary hepatocellular carcinoma (HCC). However, its sensitivity and specificity are not satisfying. Approximately 60-80 % of patients with HCC have an established background of chronic infection with hepatitis B virus (HBV). AIMS: To investigate the potential of serum microRNAs (miRNAs) as biomarkers for HBV-related HCC. METHODS: This study was divided into two phases: firstly, marker (miR-95, miR-18a, miR-10b, miR125a, and miR-378) detection by real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) in sera from HBV patients with HCC (n = 15) and health subject (n = 15); and, secondly, marker validation by real-time qRT-PCR on HBV patients with HCC (n = 86) or hepatitis or cirrhosis (n = 30), and healthy subject (n = 45). RESULTS: Serum miR-18a was significantly higher in HBV patients with HCC than healthy controls (p < 0.01); serum miR-378 was significantly lower in HBV patients with HCC compared to healthy control (p < 0.05). Receiver operating characteristic (ROC) curve analyses suggested that serum miR-18a had significant diagnostic value for HBV-related HCC. MiR-18a yielded an area under the curve (AUC) of ROC of 0.881 with 86.1 % sensitivity and 75.0 % specificity in discriminating HBV-related HCC from healthy controls, and an AUC of ROC of 0.775 with 77.2 % sensitivity and 70.0 % specificity in discriminating HBV-related HCC from chronic hepatitis or cirrhosis. CONCLUSIONS: Our results suggest that serum miR-18a might serve as a novel and potential noninvasive biomarker for HBV-related HCC screening.

[Difference of HBV DNA levels and HBV genotypes between the patients with primary hepatocellular carcinoma and liver cirrhosis with hepatitis B].

OBJECTIVE: To compare the difference of HBV DNA levels and HBV genotypes between the patients with primary hepatocellular carcinoma (HCC) and liver cirrhosis who infected with hepatitis B virus. METHODS: Total 430 patients with hepatitis B were enrolled and further divided into the HCC group (210 cases) and liver cirrhosis group (HBV LC, 220 cases). The levels of HBV DNA and HBV genotypes were detected in all of the serum samples from the two groups, and the differences in the genotypes and virological markers between HCC patients and HBV LC patients were further analyzed. RESULTS: The positive rates of HBV DNA of HCC patients and HBV LC patients were 84.3% (177/210) and 94. 5% (208/220), respectively. The mean values of serum HBV DNA in HCC patients and HBV-LC patients were (5.06 +/- 1.01) log10 cps/ml and (5.36 +/- 1.13) log10 cps/ml, respectively. The positive rates of HBV DNA and the mean values of serum HBV DNA were higher in HBV-LC patients than those in HCC patients (P < 0.01). Furthermore, the main genotype was C in both groups and the distribution of genotype C and genotype B had no statistical difference. CONCLUSIONS: Mainly presented as a C genotype in both groups, the total levels of serum HBV DNA in HCC patients were lower than those in HBV-LC patients.

[Relationship between viral genotype and specific and nonspecific CTL of patients with cirrhotic hepatitis B and its significance].

OBJECTIVE: To explore relationship between different HBV genotypes and peripheral blood HBV specific and nonspecific CTL of patients with cirrhotic hepatitis B and its significance. METHODS: HBV genotypes were tested in 91 patients with cirrhotic hepatitis B, differences of HBV specific and nonspecific CTL between patients infected with genotype B and C were compared and its significance was explored. RESULTS: In 91 cases of cirrhotic hepatitis B, 55 cases (60.44%) belong to genotype C, 35 cases (38.46%) belong to genotype B, 1 case (1.1%) belongs to mixture genotype B and C. In genotype C, 27 cases (49.09%) had positive (HLA)-A2, HBV specific CTL was 0.18% +/- 0.03%. In genotype B, 18 cases (51.43%) had positive HLA-A2, HBV specific CTL was 0.38% +/- 0.04%, higher than that in genotype C, t = 5.01, P < 0.01. Nonspecific CTL: genotype C (11.87% +/- 1.50%); genotype B (11.90% +/- 1.51%), t = 0.14, P < 0.05. HBV DNA level: genotype C (6.01 +/- 0.81) log10 copy/ml, higher than that in genotype B (5.01 +/- 0.54) log10 copy/ml, t = 5.01, P < 0.01. ALT: genotype C (251.13 +/- 131.11) U/L, higher than that in genotype B (121.25 +/- 63.21) U/L, t = 3.61, P < 0.01. TBil (45.61 +/- 15.11) micromol/L, higher than that in genotype B (28.11 +/- 6.25) micromol/L, t = 3.05, P < 0.01. CONCLUSION: Compared with patients infected with genotype B of cirrhotic hepatitis B, HBV specific CTL of patients infected with genotype C was lower, resulting in higher level of HBV DNA and more severe damage of liver function.