OBJECTIVE:To explore the relationship between colorectal polyps and pulmonary nodules from the perspective of the lung and the large intestine being internally and externally connected,aiming to provide a theoretical ...OBJECTIVE:To explore the relationship between colorectal polyps and pulmonary nodules from the perspective of the lung and the large intestine being internally and externally connected,aiming to provide a theoretical basis for clinical diagnosis and treatment.METHODS:We retrospectively analyzed the data of patients who underwent electronic colonoscopy and were found to have colorectal polyps at the Gastrointestinal Endoscopy Center of Dongfang Hospital,Beijing University of Chinese Medicine,from January 1,2017,to December 31,2023.We also reviewed their lung CT results and used statistical software to analyze the recurrence,location,size,and pathology of colorectal polyps in relation to the presence,number,and size of pulmonary nodules.RESULTS:Both colorectal polyps and pulmonary nodules are more common in elderly males.Patients with recurrent colorectal polyps are more likely to have pulmonary nodules,which tend to be located in the left colon and are more likely to be adenomatous in nature;those without pulmonary nodules show no clear pattern in polyp distribution,with a tendency towards inflammatory and hyperplastic pathology;the data from this study suggests that the proportion of lung nodules larger than 0.5 cm in the recurrent group is higher than in the non-recurrent group,and the proportion of colorectal polyps larger than 1 cm in the recurrent group is also higher than in the non-recurrent group.CONCLUSION:There is a certain connection between the pathogenesis and treatment of colorectal polyps and pulmonary nodules.Cold,phlegm,dampness,blood stasis,and toxic coagulation are common pathogenic factors of the two diseases.Patients with larger colorectal polyps should be advised to undergo regular colonoscopy.Patients with recurrent polyps or those with left colon necrosis or cancer indicated by colonoscopy should be advised to complete lung related examinations to rule out the possibility of pulmonary nodules.展开更多
Objective:To investigate the application of experience-based and Magnetic Resonance Imaging(MRI)radiomics in differentiating benign and malignant pulmonary nodules and masses.Methods:Sixty patients with pulmonary nodu...Objective:To investigate the application of experience-based and Magnetic Resonance Imaging(MRI)radiomics in differentiating benign and malignant pulmonary nodules and masses.Methods:Sixty patients with pulmonary nodules or masses admitted from April 2024 to April 2025 were selected as study subjects.Surgical pathology was used as the gold standard to explore the differential diagnostic value of experience-based and MRI radiomics.Results:Twenty one MRI radiomic features were selected for screening,with 14 features removed and 7 remaining for normality testing.Using surgical pathology as the gold standard,among the 60 patients,36 were benign and 24 were malignant,with detection rates of 60.00%and 40.00%,respectively.The detection rates of lobulation,vascular convergence sign,and GGO components in benign pulmonary nodules/masses were lower than those in malignant ones(P<0.05).The radiomics formula was Radscore=Intercept+Weight(Feature)×Feature,with the calculated formula being Radscore=0.16-0.32×Sphericity+0.11×Mass.The AUC of the UTE Rad-score model was 0.672,which was lower than the AUC of the UTE nomogram(0.789)and the combined model(0.832)(P<0.05).Conclusion:Experience-based and MRI radiomics can play a significant role in differentiating benign and malignant pulmonary nodules and masses,with the combined model demonstrating more prominent diagnostic value.展开更多
Pulmonary nodules represent an early manifestation of lung cancer.However,pulmonary nodules only constitute a small portion of the overall image,posing challenges for physicians in image interpretation and potentially...Pulmonary nodules represent an early manifestation of lung cancer.However,pulmonary nodules only constitute a small portion of the overall image,posing challenges for physicians in image interpretation and potentially leading to false positives or missed detections.To solve these problems,the YOLOv8 network is enhanced by adding deformable convolution and atrous spatial pyramid pooling(ASPP),along with the integration of a coordinate attention(CA)mechanism.This allows the network to focus on small targets while expanding the receptive field without losing resolution.At the same time,context information on the target is gathered and feature expression is enhanced by attention modules in different directions.It effectively improves the positioning accuracy and achieves good results on the LUNA16 dataset.Compared with other detection algorithms,it improves the accuracy of pulmonary nodule detection to a certain extent.展开更多
Accurate classification of pulmonary nodules is critical for early diagnosis of lung cancer. However, non-invasive and accurate diagnosis of benign and malignant pulmonary nodules faces great challenges. In this study...Accurate classification of pulmonary nodules is critical for early diagnosis of lung cancer. However, non-invasive and accurate diagnosis of benign and malignant pulmonary nodules faces great challenges. In this study, we develop a nano zero-valent iron(nZVI)-assisted laser desorption/ionization mass spectrometry(LDI MS) platform, which enables ultra-high-throughput acquisition of abundant metabolic fingerprint information of serum in negative ion mode. We further recruit a large-scale multicenter prospective cohort and collect 1099 serum samples from participants with benign and malignant nodules. The accurate machine learning models are built and validated based on n ZVI-assisted LDI MS metabolomics to achieve efficient classification of benign and malignant nodules. Using our established stacking ensemble learning model, the AUC of the ROC curve for benign and malignant lung nodule classification can be as high as 0.9, and the sensitivity can reach 85.5%, which is significantly better than existing clinical models. This work provides an integrated workflow from detection technology to diagnostic models for biomarkerbased pulmonary nodule diagnosis, which would be widely used in rapid and large-scale screening of pulmonary nodules.展开更多
Objective:To explore the application value of artificial intelligence-assisted diagnostic systems in the computed tomography(CT)diagnosis of pulmonary nodules.Methods:A total of 80 patients with pulmonary nodules,trea...Objective:To explore the application value of artificial intelligence-assisted diagnostic systems in the computed tomography(CT)diagnosis of pulmonary nodules.Methods:A total of 80 patients with pulmonary nodules,treated from June 2023 to May 2024,were included.All patients underwent pathological examination and CT scans,with pathological results serving as the gold standard.The diagnostic performance of CT alone and CT combined with the artificial intelligence-assisted diagnostic system was analyzed,and differences in CT imaging features and evaluation results of benign and malignant pulmonary nodules were compared.Results:The sensitivity,specificity,and accuracy of CT combined with the artificial intelligence-assisted diagnostic system were significantly higher than those of CT alone(P<0.05).Moreover,the false-positive and false-negative rates were significantly lower for the combined approach compared to CT alone(P<0.05).Conclusion:The artificial intelligence-assisted diagnostic system effectively identifies malignant features in pulmonary nodules,providing valuable clinical reference data and enhancing diagnostic accuracy and efficiency.展开更多
BACKGROUND Small pulmonary nodules are tissue shadows and thoracoscopic segmentectomy in China is still at the exploratory stage with limited application.AIM To evaluate the efficacy of thoracoscopic anatomical segmen...BACKGROUND Small pulmonary nodules are tissue shadows and thoracoscopic segmentectomy in China is still at the exploratory stage with limited application.AIM To evaluate the efficacy of thoracoscopic anatomical segmentectomy for small pulmonary nodules.METHODS Medical records of 86 patients with small pulmonary nodules treated at our hospital between August 2016 and October 2019 were retrospectively analyzed;40 cases who underwent thoracoscopic lobectomy were set as a reference group,and 46 cases who underwent thoracoscopic anatomical segmentectomy were set as an observation group.Preoperative and postoperative parameters were measured in both groups,including the percentage of forced expiratory volume in the first second(FEV1%),the percentage of forced vital capacity(FVC%),and the FEV1/FVC ratio(FEV1/FVC).Patients with positive pathological diagnosis received tests for neuron-specific enolase,carbohydrate antigen 125(CA125),CA19-9,and squamous cell carcinoma antigen.Intraoperative bleeding volume,drainage volume,the number of dissected lymph nodes,drainage time,hospital stay,treatment cost,postoperative complications,and postoperative pain condition were compared between the two groups.RESULTS No significant difference was observed in the results of four serum tumor marker(CA125,CA19-9,squamous cell carcinoma antigen,and neuron-specific enolase),the number of dissected lymph nodes,treatment cost,or preoperative pulmonary ventilation index between the two groups.Intraoperative bleeding volume,drainage volume,drainage time,hospital stay,and visual analogue scale score were significantly lower in the observation group(P<0.05).The results of FEV1%,FVC%,and FEV1/FVC were significantly higher in the observation group(P<0.05).CONCLUSION The efficacy of thoracoscopic anatomical segmentectomy and lobectomy for small pulmonary nodules shows no significant difference in terms of lesion removal,but anatomical segmentectomy is less invasive with fewer postoperative complications and less influence on lung function.展开更多
Objective： To explore the role of the texture features of images in the diagnosis of solitary pulmonary nodules （SPNs） in different sizes. Materials and methods： A total of 379 patients with pathologically confirm...Objective： To explore the role of the texture features of images in the diagnosis of solitary pulmonary nodules （SPNs） in different sizes. Materials and methods： A total of 379 patients with pathologically confirmed SPNs were enrolled in this study. They were divided into three groups based on the SPN sizes： ≤10, 11-20, and 〉20 mm. Their texture features were segmented and extracted. The differences in the image features between benign and malignant SPNs were compared. The SPNs in these three groups were determined and analyzed with the texture features of images. Results： These 379 SPNs were successfully segmented using the 2D Otsu threshold method and the self-adaptive threshold segmentation method. The texture features of these SPNs were obtained using the method of grey level co-occurrence matrix （GLCM）. Of these 379 patients, 120 had benign SPNs and 259 had malignant SPNs. The entropy, contrast, energy, homogeneity, and correlation were 3.5597±0.6470, 0.5384±0.2561, 0.1921±0.1256, 0.8281±0.0604, and 0.8748±0.0740 in the benign SPNs and 3.8007±0.6235, 0.6088±0.2961, 0.1673±0.1070, 0.7980±0.0555, and 0.8550±0.0869 in the malignant SPNs （all P〈0.05）. The sensitivity, specificity, and accuracy of the texture features of images were 83.3%, 90.0%, and 86.8%, respectively, for SPNs sized 〈10 mm, and were 86.6%, 88.2%, and 87.1%, respectively, for SPNs sized 11-20 mm and 94.7%, 91.8%, and 93.9%, respectively, for SPNs sized 〉20 mm. Conclusions： The entropy and contrast of malignant pulmonary nodules have been demonstrated to be higher in comparison to those of benign pulmonary nodules, while the energy, homogeneity correlation of malignant pulmonary nodules are lower than those of benign pulmonary nodules. The texture features of images can reflect the tissue features and have high sensitivity, specificity, and accuracy in differentiating SPNs. The sensitivity and accuracy increase for larger SPNs.展开更多
Objective： To evaluate the correlation between the quantifiable parameters of blood flow pattern derived with dynamic CT in malignant solitary pulmonary nodules and tumor size. Methods： Sixty-eight patients with mal...Objective： To evaluate the correlation between the quantifiable parameters of blood flow pattern derived with dynamic CT in malignant solitary pulmonary nodules and tumor size. Methods： Sixty-eight patients with malignant solitary pulmonary nodules （SPNs） （diameter 〈4 cm） underwent multi-location dynamic contrast material-enhanced （nonionic contrast material was administrated via the antecubitai vein at a rate of 4mL/s by using an autoinjector, 4×5 mm or 4×2.5 mm scanning mode with stable table were performed）. Precontrast and postcontrast attenuation on every scan was recorded. Blood flow （BF）, peak, height （PHSPN）, ratio of peak height of the SPN to that of the aorta （SPN-to-A ratio） and mean transit time （MTT） were calculated. The correlation between the quantifiable parameters of blood flow pattern derived with dynamic CT in malignant solitary pulmonary nodules and tumor size were assessed by means of linear regression analysis. Results： No significant correlations were found between the tumor size and each of the peak height （PHSPN） （35.79±10.76 Hu）, ratio of peak height of the SPN to that of the aorta （SPN-to-A ratio）, （14.27%±4.37） and blood flow （BF） （30.18 mL/min/100 g±9.58） （r=0.180, P=0.142〉0.05; r=0.205, P=0.093〉0.05; r=0.008, P=0.947〉0.05）. Conclusion： No significant correlations were found between the tumor size and each of the quantifiable parameters of blood flow pattern derived with dynamic CT in malignant solitary pulmonary nodules.展开更多
Objective: Pulmonary nodules(PNs) are one of the imaging manifestations of early lung cancer screening,which should receive more attention. Traditional Chinese medicine believes that voice changes occur in patients wi...Objective: Pulmonary nodules(PNs) are one of the imaging manifestations of early lung cancer screening,which should receive more attention. Traditional Chinese medicine believes that voice changes occur in patients with pulmonary diseases. The purpose of this study is to explore the differences in phonetic characteristics between patients with PNs and able-bodied persons.Methods: This study explores the phonetic characteristics of patients with PNs in order to provide a simpler and cheaper method for PN screening. It is a case-control study to explore the differences in phonetic characteristics between individuals with and without PNs. This study performed non-parametric statistics on acoustic parameters of vocalizations, collected from January 2017 to March 2018 in Shanghai,China, from these two groups;it explores the differences in third and fourth acoustic parameters between patients with PNs and a normal control group. At the same time, computed tomography(CT) scans,course of disease, combined disease and other risk factors of the patients were collected in the form of questionnaire. According to the grouping of risk factors, the phonetic characteristics of the patients with PNs were analyzed.Results: This study was comprised of 200 patients with PNs, as confirmed by CT, and 86 healthy people that served as a control group. Among patients with PNs, 43% had ground glass opacity, 32% had nodules with a diameter ≥ 8 mm, 19% had a history of smoking and 31% had hyperlipidemia. Compared with the normal group, there were statistically significant differences in pitch, intensity and shimmer in patients with PNs. Among patients with PNs, patients with diameters ≥ 8 mm had a significantly higher third formant. There was a significant difference in intensity, fourth formant and harmonics-to-noise ratio(HNR)between smoking and non-smoking patients. Compared with non-hyperlipidemia patients, the pitch, jitter and shimmer of patients with PNs and hyperlipidemia were higher and the HNR was lower;these differences were statistically significant.Conclusion: This measurable changes in vocalizations can be in patients with PNs. Patients with PNs had lower and weaker voices. The size of PNs had an effect on the phonetic formant. Smoking may contribute to damage to the voice and formant changes. Voice damage is more pronounced in individuals who have PNs accompanied by hyperlipidemia.展开更多
Objective： To evaluate the efficacy of dynamic multi-slice spiral computed tomography （MSCT） for providing quantitative information about blood flow patterns of solitary pulmonary nodules （SPNs）. Methods： Sevent...Objective： To evaluate the efficacy of dynamic multi-slice spiral computed tomography （MSCT） for providing quantitative information about blood flow patterns of solitary pulmonary nodules （SPNs）. Methods： Seventy-eight patients with SPNs （diameter 〈 4 cm; 68 malignant; 10 active inflammatory） were underwent multi-location dynamic contrast material-enhanced serial CT （nonionic contrast material was administrated via the antecubital vein at a rate of 4 mLJs by using an autoinjector, 4 × 5 mm or 4 × 2.5 mm transverse scanning mode with stable table were performed）. Sixteen series CT scans （16 scans each for the first and second series and one scan each for the rest series） were obtained during 9 min scanning period. Precontrast and postcontrast attenuation on every scan was recorded. Perfusion, peak height and ratio of peak height of the SPN to that of the aorta were calculated. Perfusion was calculated from the maximum gradient of the time-attenuation curve and the peak height of the aorta. Results： No statistically significant difference in the peak height was found between malignant （35.79 ± 10.76 Hu） and active inflammatory （39.76 ± 4.59 Hu） （t = 1.148, P = 0.255 〉 0.05）. SPN-to-aorta ratio （14.27% ± 4.37） and perfusion value （30.18 mL/min/100 g ± 9.58） in malignant SPNs were significantly lower than those of active inflammatory （18.51% ± 2.71, 63.44 mL/min/100 g ± 43.87） （t = 2.978, P = 0.004 〈 0.05; t = 5.590, P 〈 0.0001）. Conclusion： The quantitative information about blood flow patterns of malignant and active inflammatory SPNs is different. SPN-to-aorta ratio and perfusion value are helpful in differentiating malignant nodules from active inflammatory.展开更多
Objective To evaluate the efficacy of contrast enhanced dynamic MRI in differentiating solitary pulmonary nodules（SPNs）. Methods Eighty-three patients with SPNs undertaken contrast enhanced dynamic MRI. Time-signal ...Objective To evaluate the efficacy of contrast enhanced dynamic MRI in differentiating solitary pulmonary nodules（SPNs）. Methods Eighty-three patients with SPNs undertaken contrast enhanced dynamic MRI. Time-signal intensity curve （T-SI Curve） was made. Peak height （PH） , steepest slope （SS）, maximum enhancement （ Emax ） and the enhancement rates of signal intensity were recorded at the frst （ E1 ）, second （ E2 ）, third （ E3 ） , fourth （ E4 ） , fifth （E5）, and sixth （ E6 ） minute after injection. Results Malignant nodules and inflammatory nodules enhanced significantly higher than benign nodules, and malignant nodules and inflammatory nodules showed obviously higher PH, SS, Emax, El-E6 values than benign nodules （ P 〈 0. 01 ）. There were no sig- nificant differences in PH, SS, Emax, E1-E6 values between malignant nodules and inflammatory nodules （P 〉 0. 05）. Conclusion Contrast enhanced dynamic MR imaging can provide SPNs＇ hemodynamic information and is helpful in differentiating SPNs.展开更多
Objective:To compare the clinical effect of complete thoracoscopic segmentectomy and pulmonary lobectomy for pulmonary nodules.Methods:In this study,176 patients with pulmonary nodules were treated in Changshu Hospita...Objective:To compare the clinical effect of complete thoracoscopic segmentectomy and pulmonary lobectomy for pulmonary nodules.Methods:In this study,176 patients with pulmonary nodules were treated in Changshu Hospital Affiliated to Nanjing University of Chinese Medicine from January 2019 to June 2021;according to the type of surgery,the patients were divided into group A(complete thoracoscopic segmentectomy)and group B(complete thoracoscopic pulmonary lobectomy),and the clinical effects were analyzed.Results:The intraoperative blood loss,postoperative drainage volume,postoperative hospitalization days,and lung function of patients in group A were significantly better than those in group B(P<0.05),while there was no significant difference in the number of dissected lymph nodes.Conclusion:The clinical effect of complete thoracoscopic segmentectomy for patients with small pulmonary nodules is more significant;it does not only ensure lymph node dissection,but also improve surgical-related indicators and treatment safety as well as speed up the recovery of pulmonary function.Its clinical application value is worthy of key analysis by medical institutions.展开更多
Objective:The heightened prevalence of pulmonary nodules(PN)has escalated its significance as a public health concern.While the precise identification of high-risk PN carriers for malignancy remains an ongoing challen...Objective:The heightened prevalence of pulmonary nodules(PN)has escalated its significance as a public health concern.While the precise identification of high-risk PN carriers for malignancy remains an ongoing challenge,genetic variants hold potentials as determinants of disease susceptibility that can aid in diagnosis.Yet,current understanding of the genetic loci associated with malignant PN(MPN)risk is limited.Methods:A frequency-matched case-control study was performed,comprising 247 MPN cases and 412 benign NP(BNP)controls.We genotyped 11 established susceptibility loci for lung cancer in a Chinese cohort.Loci associated with MPN risk were utilized to compute a polygenic risk score(PRS).This PRS was subsequently incorporated into the diagnostic evaluation of MPNs,with emphasis on serum tumor biomarkers.Results:Loci rs10429489G>A,rs17038564A>G,and rs12265047A>G were identified as being associated with an increased risk of MPNs.The PRS,formulated from the cumulative risk effects of these loci,correlated with the malignant risk of PNs in a dose-dependent fashion.A high PRS was found to amplify the MPN risk by 156%in comparison to a low PRS[odds ratio(OR)=2.56,95%confidence interval(95%CI),1.40−4.67].Notably,the PRS was observed to enhance the diagnostic accuracy of serum carcinoembryonic antigen(CEA)in distinguishing MPNs from BPNs,with diagnostic values rising from 0.716 to 0.861 across low-to high-PRS categories.Further bioinformatics investigations pinpointed rs10429489G>A as an expression quantitative trait locus.Conclusions:Loci rs10429489G>A,rs17038564A>G,and rs12265047A>G contribute to MPN risk and augment the diagnostic precision for MPNs based on serum CEA concentrations.展开更多
AIM: To analyze the cost-effectiveness of the diagnosis of solitary pulmonary nodule(SPN) in China. METHODS: Decision analysis models were constructed to assess the cost-effectiveness of four strategies for the manage...AIM: To analyze the cost-effectiveness of the diagnosis of solitary pulmonary nodule(SPN) in China. METHODS: Decision analysis models were constructed to assess the cost-effectiveness of four strategies for the management of SPN: computed tomography(CT) alone, CT plus CT-guided automated cutting needle biopsy(ACNB), CT plus positron emission tomography/computed tomography(PET/CT), CT plus diffusionweighted magnetic resonance imaging(DWI) plus PET/CT. RESULTS: The prevalence of lung cancer among SPN discovered in the clinical setting was approximately 50%. The CT plus ACNB strategy had higher diagnostic accuracies(87% vs 81%), with a cost saving of $1945 RMB per patient, and reducing unnecessary thoracotomy by 16.5%; this was associated with a 4.5% missed diagnosis rate. CT plus DWI plus PET/CT strategy also had higher accuracies(95% vs 81%), with a cost saving of $590 RMB per patient, and reducing unneces-sary thoracotomy by 13.5%; this was accompanied by 0.3% missed diagnosis rate. CT plus PET strategy is cost effective at a prevalence rate of 0-34%, but there was a larger prevalence range of lung cancer for CT plus ACNB strategy(from 0 to 0.6) and CT plus DWI plus PET/CT strategy(from 0 to 0.64). CONCLUSION: CT plus DWI plus PET/CT strategy was cost-effective, and had a higher accuracy accompanied by a lower missed diagnosis rate than CT plus ACNB strategy.展开更多
BACKGROUND Primary hyperparathyroidism is typically caused by a single parathyroid adenoma.Ectopic parathyroid adenomas occur as well,with cases involving various sites,including the mediastinum,presenting in varying ...BACKGROUND Primary hyperparathyroidism is typically caused by a single parathyroid adenoma.Ectopic parathyroid adenomas occur as well,with cases involving various sites,including the mediastinum,presenting in varying frequencies.Secondary hyperparathyroidism develops in the context of chronic kidney disease,primarily due to vitamin D deficiency,hypocalcemia,and hyperphosphatemia.It is frequently diagnosed in patients undergoing dialysis.This article presents a rare case of hyperparathyroidism involving multiple hyperplastic parathyroid glands with pulmonary seeding in a 50-year-old female patient undergoing hemodialysis(HD).CASE SUMMARY The patient had a history of parathyroidectomy 10 years prior but developed recurrent hyperparathyroidism with symptoms of pruritus and cough with sputum during a period of routine dialysis.Radiographic imaging revealed multiple nodules in both lungs,with the largest measuring approximately 1.35 cm.Surgical histopathology confirmed the presence of hyperplastic parathyroid glands within the pulmonary tissue.After tumor resection surgery via videoassisted thoracic surgery with wedge resection,the patient was discharged in stable condition and in follow-up her symptoms showed improvement.CONCLUSION This article describes hyperparathyroidism presenting as pulmonary nodules in a patient undergoing postparathyroidectomy HD,highlighting diagnostic challenges and a positive outcome from tumor resection surgery.展开更多
BACKGROUND Incidental pulmonary nodules are an increasingly common finding on computed tomography(CT)scans of the thorax due to the exponential rise in CT examin-ations in everyday practice.The majority of incidental ...BACKGROUND Incidental pulmonary nodules are an increasingly common finding on computed tomography(CT)scans of the thorax due to the exponential rise in CT examin-ations in everyday practice.The majority of incidental pulmonary nodules are benign and correctly identifying the small number of malignant nodules is cha-llenging.Ultra-low-dose CT(ULDCT)has been shown to be effective in diagnosis of respiratory pathology in comparison with traditional standard dose techniques.Our hypothesis was that ULDCT chest combined with model-based iterative reconstruction(MBIR)is comparable to standard dose CT(SDCT)chest in the analysis of pulmonary nodules with significant reduction in radiation dose.AIM To prospectively compare ULDCT chest combined with MBIR with SDCT chest in the analysis of solid pulmonary nodules.METHODS A prospective cohort study was conducted on adult patients(n=30)attending a respiratory medicine outpatient clinic in a tertiary referral university hospital for surveillance of previously detected indeterminate pulmonary nodules on SDCT chest.This study involved the acquisition of a reference SDCT chest followed immediately by an ULDCT chest.Nodule identification,nodule characterisation,nodule measurement,objective and subjective image quality and radiation dose were compared between ULDCT with MBIR and SDCT chest.RESULTS One hundred solid nodules were detected on ULDCT chest and 98 on SDCT chest.There was no significant difference in the characteristics of correctly identified nodules when comparing SDCT chest to ULDCT chest protocols.Signal-to-noise ratio was significantly increased in the ULDCT chest in all areas except in the paraspinal muscle at the maximum cardiac diameter level(P<0.001).The mean subjective image quality score for overall diagnostic acceptability was 8.9/10.The mean dose length product,computed tomography volume dose index and effective dose for the ULDCT chest protocol were 5.592 mGy.cm,0.16 mGy and 0.08 mSv respectively.These were significantly less than the SDCT chest protocol(P<0.001)and represent a radiation dose reduction of 97.6%.CONCLUSION ULDCT chest combined with MBIR is non-inferior to SDCT chest in the analysis of previously identified solid pulmonary nodules and facilitates a large reduction in radiation dose.展开更多
Background: As the population age structure gradually ages, more and more elderly people were found to have pulmonary nodules during physical examinations. Most elderly people had underlying diseases such as heart, lu...Background: As the population age structure gradually ages, more and more elderly people were found to have pulmonary nodules during physical examinations. Most elderly people had underlying diseases such as heart, lung, brain and blood vessels and cannot tolerate surgery. Computed tomography (CT)-guided percutaneous core needle biopsy (CNB) was the first choice for pathological diagnosis and subsequent targeted drugs, immune drugs or ablation treatment. CT-guided percutaneous CNB requires clinicians with rich CNB experience to ensure high CNB accuracy, but it was easy to cause complications such as pneumothorax and hemorrhage. Three-dimensional (3D) printing coplanar template (PCT) combined with CT-guided percutaneous pulmonary CNB biopsy has been used in clinical practice, but there was no prospective, randomized controlled study. Methods: Elderly patients with lung nodules admitted to the Department of Oncology of our hospital from January 2019 to January 2023 were selected. A total of 225 elderly patients were screened, and 30 patients were included after screening. They were randomly divided into experimental group (Group A: 30 cases) and control group (Group B: 30 cases). Group A was given 3D-PCT combined with CT-guided percutaneous pulmonary CNB biopsy, Group B underwent CT-guided percutaneous pulmonary CNB. The primary outcome measure of this study was the accuracy of diagnostic CNB, and the secondary outcome measures were CNB time, number of CNB needles, number of pathological tissues and complications. Results: The diagnostic accuracy of group A and group B was 96.67% and 76.67%, respectively (P = 0.026). There were statistical differences between group A and group B in average CNB time (P = 0.001), number of CNB (1 vs more than 1, P = 0.029), and pathological tissue obtained by CNB (3 vs 1, P = 0.040). There was no statistical difference in the incidence of pneumothorax and hemorrhage between the two groups (P > 0.05). Conclusions: 3D-PCT combined with CT-guided percutaneous CNB can improve the puncture accuracy of elderly patients, shorten the puncture time, reduce the number of punctures, and increase the amount of puncture pathological tissue, without increasing pneumothorax and hemorrhage complications. We look forward to verifying this in a phase III randomized controlled clinical study. .展开更多
This paper reviewed the literature on medication rule of pulmonary nodules in recent years. It is found that contemporary doctors pay more attention to regulating Qi, clearing heat and detoxifying, eliminating phlegm,...This paper reviewed the literature on medication rule of pulmonary nodules in recent years. It is found that contemporary doctors pay more attention to regulating Qi, clearing heat and detoxifying, eliminating phlegm, dissolving phlegm and dissipating masses. They use mild drugs, cold and warm treatments in parallel, combining the tastes of pungent, bitterness, and sweetness at the same time. The treatment focuses on the five viscera with emphasis on the lung meridian while also considering the spleen and stomach functions as well as soothing liver stagnation. This information aims to provide some reference for clinical treatment of pulmonary nodules.展开更多
Objective: to analyze the clinical significance of low-dose thin-layer CT scanning in the treatment of small pulmonary nodules. Methods: the clinical data of 78 patients with micronodular pulmonary nodules admitted to...Objective: to analyze the clinical significance of low-dose thin-layer CT scanning in the treatment of small pulmonary nodules. Methods: the clinical data of 78 patients with micronodular pulmonary nodules admitted to our hospital from August 2019 to August 2020 were retrospectively analyzed. The two treatments were compared and the radiation dose was scanned simultaneously. Results: Compared the detection rate of nodules in the process of low-dose thin-layer CT scanning with the way of conventional low-dose CT scanning, the difference between the two was not statistically significant (P > 0.05). The current weight CT dose index (CTDlw) and the product of dose length (DLP) of low-dose thin-slice CT scan are much lower than those of conventional dose CT scan, and the difference between the two is statistically significant (P <0.05). Conclusion: the low-dose thin-layer CT scanning technology has very ideal diagnostic value for the diagnosis of small pulmonary nodules, and can very effectively reduce the scanning radiation dose.展开更多
Objective: to study the diagnostic value of solitary pulmonary nodules on dynamic enhancement of CT scan. Methods: the clinical data of 100 patients with solitary pulmonary nodules in our hospital from January 2018 to...Objective: to study the diagnostic value of solitary pulmonary nodules on dynamic enhancement of CT scan. Methods: the clinical data of 100 patients with solitary pulmonary nodules in our hospital from January 2018 to December 2020 were analyzed retrospectively. All patients underwent dynamic enhancement of CT scanning, and the results of pathological examination and CT scanning were compared and analyzed. Results: in the comparison between dynamic enhancement of CT scan and pathological examination, 95.83% were the diagnostic coincidence rate of malignant pulmonary nodules and 93.33% were benign pulmonary nodules. The coincidence rate of benign and malignant pulmonary nodules before and after enhanced scan was significantly lower than that after enhanced scan (P < 0.05);There was significant difference in CT value between benign and malignant pulmonary nodules (P < 0.05). Conclusion: in the differential diagnosis and diagnosis of solitary pulmonary nodules by dynamic contrast-enhanced CT scanning, it is worthy of clinical application and has high application value.展开更多
基金Beijing Natural Science Foundation:Research on the Mechanism of Chaiqi Decoction in Improving Vascular Endothelial Injury in Metabolic Syndrome by Regulating Pyroptosis via miR-21(No.7212181)。
文摘OBJECTIVE:To explore the relationship between colorectal polyps and pulmonary nodules from the perspective of the lung and the large intestine being internally and externally connected,aiming to provide a theoretical basis for clinical diagnosis and treatment.METHODS:We retrospectively analyzed the data of patients who underwent electronic colonoscopy and were found to have colorectal polyps at the Gastrointestinal Endoscopy Center of Dongfang Hospital,Beijing University of Chinese Medicine,from January 1,2017,to December 31,2023.We also reviewed their lung CT results and used statistical software to analyze the recurrence,location,size,and pathology of colorectal polyps in relation to the presence,number,and size of pulmonary nodules.RESULTS:Both colorectal polyps and pulmonary nodules are more common in elderly males.Patients with recurrent colorectal polyps are more likely to have pulmonary nodules,which tend to be located in the left colon and are more likely to be adenomatous in nature;those without pulmonary nodules show no clear pattern in polyp distribution,with a tendency towards inflammatory and hyperplastic pathology;the data from this study suggests that the proportion of lung nodules larger than 0.5 cm in the recurrent group is higher than in the non-recurrent group,and the proportion of colorectal polyps larger than 1 cm in the recurrent group is also higher than in the non-recurrent group.CONCLUSION:There is a certain connection between the pathogenesis and treatment of colorectal polyps and pulmonary nodules.Cold,phlegm,dampness,blood stasis,and toxic coagulation are common pathogenic factors of the two diseases.Patients with larger colorectal polyps should be advised to undergo regular colonoscopy.Patients with recurrent polyps or those with left colon necrosis or cancer indicated by colonoscopy should be advised to complete lung related examinations to rule out the possibility of pulmonary nodules.
文摘Objective:To investigate the application of experience-based and Magnetic Resonance Imaging(MRI)radiomics in differentiating benign and malignant pulmonary nodules and masses.Methods:Sixty patients with pulmonary nodules or masses admitted from April 2024 to April 2025 were selected as study subjects.Surgical pathology was used as the gold standard to explore the differential diagnostic value of experience-based and MRI radiomics.Results:Twenty one MRI radiomic features were selected for screening,with 14 features removed and 7 remaining for normality testing.Using surgical pathology as the gold standard,among the 60 patients,36 were benign and 24 were malignant,with detection rates of 60.00%and 40.00%,respectively.The detection rates of lobulation,vascular convergence sign,and GGO components in benign pulmonary nodules/masses were lower than those in malignant ones(P<0.05).The radiomics formula was Radscore=Intercept+Weight(Feature)×Feature,with the calculated formula being Radscore=0.16-0.32×Sphericity+0.11×Mass.The AUC of the UTE Rad-score model was 0.672,which was lower than the AUC of the UTE nomogram(0.789)and the combined model(0.832)(P<0.05).Conclusion:Experience-based and MRI radiomics can play a significant role in differentiating benign and malignant pulmonary nodules and masses,with the combined model demonstrating more prominent diagnostic value.
文摘Pulmonary nodules represent an early manifestation of lung cancer.However,pulmonary nodules only constitute a small portion of the overall image,posing challenges for physicians in image interpretation and potentially leading to false positives or missed detections.To solve these problems,the YOLOv8 network is enhanced by adding deformable convolution and atrous spatial pyramid pooling(ASPP),along with the integration of a coordinate attention(CA)mechanism.This allows the network to focus on small targets while expanding the receptive field without losing resolution.At the same time,context information on the target is gathered and feature expression is enhanced by attention modules in different directions.It effectively improves the positioning accuracy and achieves good results on the LUNA16 dataset.Compared with other detection algorithms,it improves the accuracy of pulmonary nodule detection to a certain extent.
基金financially supported by the Fundamental Research Funds for the Central Universities (No. WHU 2042024kf0009)National Key Research and Development Program of China (No. 2021YFC2700700)the National Natural Science Foundation of China (Nos. 22074111, 22004093)。
文摘Accurate classification of pulmonary nodules is critical for early diagnosis of lung cancer. However, non-invasive and accurate diagnosis of benign and malignant pulmonary nodules faces great challenges. In this study, we develop a nano zero-valent iron(nZVI)-assisted laser desorption/ionization mass spectrometry(LDI MS) platform, which enables ultra-high-throughput acquisition of abundant metabolic fingerprint information of serum in negative ion mode. We further recruit a large-scale multicenter prospective cohort and collect 1099 serum samples from participants with benign and malignant nodules. The accurate machine learning models are built and validated based on n ZVI-assisted LDI MS metabolomics to achieve efficient classification of benign and malignant nodules. Using our established stacking ensemble learning model, the AUC of the ROC curve for benign and malignant lung nodule classification can be as high as 0.9, and the sensitivity can reach 85.5%, which is significantly better than existing clinical models. This work provides an integrated workflow from detection technology to diagnostic models for biomarkerbased pulmonary nodule diagnosis, which would be widely used in rapid and large-scale screening of pulmonary nodules.
基金supported by Chengdu University of Traditional Chinese Medicine“Xinglin Scholars”Subject Talent Scientific Research Enhancement Plan(No.YYZX2022056).
文摘Objective:To explore the application value of artificial intelligence-assisted diagnostic systems in the computed tomography(CT)diagnosis of pulmonary nodules.Methods:A total of 80 patients with pulmonary nodules,treated from June 2023 to May 2024,were included.All patients underwent pathological examination and CT scans,with pathological results serving as the gold standard.The diagnostic performance of CT alone and CT combined with the artificial intelligence-assisted diagnostic system was analyzed,and differences in CT imaging features and evaluation results of benign and malignant pulmonary nodules were compared.Results:The sensitivity,specificity,and accuracy of CT combined with the artificial intelligence-assisted diagnostic system were significantly higher than those of CT alone(P<0.05).Moreover,the false-positive and false-negative rates were significantly lower for the combined approach compared to CT alone(P<0.05).Conclusion:The artificial intelligence-assisted diagnostic system effectively identifies malignant features in pulmonary nodules,providing valuable clinical reference data and enhancing diagnostic accuracy and efficiency.
文摘BACKGROUND Small pulmonary nodules are tissue shadows and thoracoscopic segmentectomy in China is still at the exploratory stage with limited application.AIM To evaluate the efficacy of thoracoscopic anatomical segmentectomy for small pulmonary nodules.METHODS Medical records of 86 patients with small pulmonary nodules treated at our hospital between August 2016 and October 2019 were retrospectively analyzed;40 cases who underwent thoracoscopic lobectomy were set as a reference group,and 46 cases who underwent thoracoscopic anatomical segmentectomy were set as an observation group.Preoperative and postoperative parameters were measured in both groups,including the percentage of forced expiratory volume in the first second(FEV1%),the percentage of forced vital capacity(FVC%),and the FEV1/FVC ratio(FEV1/FVC).Patients with positive pathological diagnosis received tests for neuron-specific enolase,carbohydrate antigen 125(CA125),CA19-9,and squamous cell carcinoma antigen.Intraoperative bleeding volume,drainage volume,the number of dissected lymph nodes,drainage time,hospital stay,treatment cost,postoperative complications,and postoperative pain condition were compared between the two groups.RESULTS No significant difference was observed in the results of four serum tumor marker(CA125,CA19-9,squamous cell carcinoma antigen,and neuron-specific enolase),the number of dissected lymph nodes,treatment cost,or preoperative pulmonary ventilation index between the two groups.Intraoperative bleeding volume,drainage volume,drainage time,hospital stay,and visual analogue scale score were significantly lower in the observation group(P<0.05).The results of FEV1%,FVC%,and FEV1/FVC were significantly higher in the observation group(P<0.05).CONCLUSION The efficacy of thoracoscopic anatomical segmentectomy and lobectomy for small pulmonary nodules shows no significant difference in terms of lesion removal,but anatomical segmentectomy is less invasive with fewer postoperative complications and less influence on lung function.
基金supported by National Natural Science Fund project [81202284]Guangdong Provincial Natural Science Fund project [S2011040004735]+2 种基金Project for Outstanding Young Innovative Talents in Colleges and Universities of Guangdong Province [LYM11106]Special Research Fund for Basic Scientific Research Projects in Central Universities [21612305, 21612101]Guangzhou Municipal Science and Technology Fund project [2014J4100119]
文摘Objective： To explore the role of the texture features of images in the diagnosis of solitary pulmonary nodules （SPNs） in different sizes. Materials and methods： A total of 379 patients with pathologically confirmed SPNs were enrolled in this study. They were divided into three groups based on the SPN sizes： ≤10, 11-20, and 〉20 mm. Their texture features were segmented and extracted. The differences in the image features between benign and malignant SPNs were compared. The SPNs in these three groups were determined and analyzed with the texture features of images. Results： These 379 SPNs were successfully segmented using the 2D Otsu threshold method and the self-adaptive threshold segmentation method. The texture features of these SPNs were obtained using the method of grey level co-occurrence matrix （GLCM）. Of these 379 patients, 120 had benign SPNs and 259 had malignant SPNs. The entropy, contrast, energy, homogeneity, and correlation were 3.5597±0.6470, 0.5384±0.2561, 0.1921±0.1256, 0.8281±0.0604, and 0.8748±0.0740 in the benign SPNs and 3.8007±0.6235, 0.6088±0.2961, 0.1673±0.1070, 0.7980±0.0555, and 0.8550±0.0869 in the malignant SPNs （all P〈0.05）. The sensitivity, specificity, and accuracy of the texture features of images were 83.3%, 90.0%, and 86.8%, respectively, for SPNs sized 〈10 mm, and were 86.6%, 88.2%, and 87.1%, respectively, for SPNs sized 11-20 mm and 94.7%, 91.8%, and 93.9%, respectively, for SPNs sized 〉20 mm. Conclusions： The entropy and contrast of malignant pulmonary nodules have been demonstrated to be higher in comparison to those of benign pulmonary nodules, while the energy, homogeneity correlation of malignant pulmonary nodules are lower than those of benign pulmonary nodules. The texture features of images can reflect the tissue features and have high sensitivity, specificity, and accuracy in differentiating SPNs. The sensitivity and accuracy increase for larger SPNs.
文摘Objective： To evaluate the correlation between the quantifiable parameters of blood flow pattern derived with dynamic CT in malignant solitary pulmonary nodules and tumor size. Methods： Sixty-eight patients with malignant solitary pulmonary nodules （SPNs） （diameter 〈4 cm） underwent multi-location dynamic contrast material-enhanced （nonionic contrast material was administrated via the antecubitai vein at a rate of 4mL/s by using an autoinjector, 4×5 mm or 4×2.5 mm scanning mode with stable table were performed）. Precontrast and postcontrast attenuation on every scan was recorded. Blood flow （BF）, peak, height （PHSPN）, ratio of peak height of the SPN to that of the aorta （SPN-to-A ratio） and mean transit time （MTT） were calculated. The correlation between the quantifiable parameters of blood flow pattern derived with dynamic CT in malignant solitary pulmonary nodules and tumor size were assessed by means of linear regression analysis. Results： No significant correlations were found between the tumor size and each of the peak height （PHSPN） （35.79±10.76 Hu）, ratio of peak height of the SPN to that of the aorta （SPN-to-A ratio）, （14.27%±4.37） and blood flow （BF） （30.18 mL/min/100 g±9.58） （r=0.180, P=0.142〉0.05; r=0.205, P=0.093〉0.05; r=0.008, P=0.947〉0.05）. Conclusion： No significant correlations were found between the tumor size and each of the quantifiable parameters of blood flow pattern derived with dynamic CT in malignant solitary pulmonary nodules.
基金supported by the TCM Diagnosis Key Discipline of Administration of TCM of ChinaKey Laboratory of Health Identification and Assessment in Shanghai (No. 13DZ2261000)+1 种基金TCM Diagnosis Leading Academic Discipline Project of State Administration of TCM of ChinaSpecial Fund of Technical Standards by Science and Technology Commission of Shanghai (No.14DZ0500400)。
文摘Objective: Pulmonary nodules(PNs) are one of the imaging manifestations of early lung cancer screening,which should receive more attention. Traditional Chinese medicine believes that voice changes occur in patients with pulmonary diseases. The purpose of this study is to explore the differences in phonetic characteristics between patients with PNs and able-bodied persons.Methods: This study explores the phonetic characteristics of patients with PNs in order to provide a simpler and cheaper method for PN screening. It is a case-control study to explore the differences in phonetic characteristics between individuals with and without PNs. This study performed non-parametric statistics on acoustic parameters of vocalizations, collected from January 2017 to March 2018 in Shanghai,China, from these two groups;it explores the differences in third and fourth acoustic parameters between patients with PNs and a normal control group. At the same time, computed tomography(CT) scans,course of disease, combined disease and other risk factors of the patients were collected in the form of questionnaire. According to the grouping of risk factors, the phonetic characteristics of the patients with PNs were analyzed.Results: This study was comprised of 200 patients with PNs, as confirmed by CT, and 86 healthy people that served as a control group. Among patients with PNs, 43% had ground glass opacity, 32% had nodules with a diameter ≥ 8 mm, 19% had a history of smoking and 31% had hyperlipidemia. Compared with the normal group, there were statistically significant differences in pitch, intensity and shimmer in patients with PNs. Among patients with PNs, patients with diameters ≥ 8 mm had a significantly higher third formant. There was a significant difference in intensity, fourth formant and harmonics-to-noise ratio(HNR)between smoking and non-smoking patients. Compared with non-hyperlipidemia patients, the pitch, jitter and shimmer of patients with PNs and hyperlipidemia were higher and the HNR was lower;these differences were statistically significant.Conclusion: This measurable changes in vocalizations can be in patients with PNs. Patients with PNs had lower and weaker voices. The size of PNs had an effect on the phonetic formant. Smoking may contribute to damage to the voice and formant changes. Voice damage is more pronounced in individuals who have PNs accompanied by hyperlipidemia.
文摘Objective： To evaluate the efficacy of dynamic multi-slice spiral computed tomography （MSCT） for providing quantitative information about blood flow patterns of solitary pulmonary nodules （SPNs）. Methods： Seventy-eight patients with SPNs （diameter 〈 4 cm; 68 malignant; 10 active inflammatory） were underwent multi-location dynamic contrast material-enhanced serial CT （nonionic contrast material was administrated via the antecubital vein at a rate of 4 mLJs by using an autoinjector, 4 × 5 mm or 4 × 2.5 mm transverse scanning mode with stable table were performed）. Sixteen series CT scans （16 scans each for the first and second series and one scan each for the rest series） were obtained during 9 min scanning period. Precontrast and postcontrast attenuation on every scan was recorded. Perfusion, peak height and ratio of peak height of the SPN to that of the aorta were calculated. Perfusion was calculated from the maximum gradient of the time-attenuation curve and the peak height of the aorta. Results： No statistically significant difference in the peak height was found between malignant （35.79 ± 10.76 Hu） and active inflammatory （39.76 ± 4.59 Hu） （t = 1.148, P = 0.255 〉 0.05）. SPN-to-aorta ratio （14.27% ± 4.37） and perfusion value （30.18 mL/min/100 g ± 9.58） in malignant SPNs were significantly lower than those of active inflammatory （18.51% ± 2.71, 63.44 mL/min/100 g ± 43.87） （t = 2.978, P = 0.004 〈 0.05; t = 5.590, P 〈 0.0001）. Conclusion： The quantitative information about blood flow patterns of malignant and active inflammatory SPNs is different. SPN-to-aorta ratio and perfusion value are helpful in differentiating malignant nodules from active inflammatory.
文摘Objective To evaluate the efficacy of contrast enhanced dynamic MRI in differentiating solitary pulmonary nodules（SPNs）. Methods Eighty-three patients with SPNs undertaken contrast enhanced dynamic MRI. Time-signal intensity curve （T-SI Curve） was made. Peak height （PH） , steepest slope （SS）, maximum enhancement （ Emax ） and the enhancement rates of signal intensity were recorded at the frst （ E1 ）, second （ E2 ）, third （ E3 ） , fourth （ E4 ） , fifth （E5）, and sixth （ E6 ） minute after injection. Results Malignant nodules and inflammatory nodules enhanced significantly higher than benign nodules, and malignant nodules and inflammatory nodules showed obviously higher PH, SS, Emax, El-E6 values than benign nodules （ P 〈 0. 01 ）. There were no sig- nificant differences in PH, SS, Emax, E1-E6 values between malignant nodules and inflammatory nodules （P 〉 0. 05）. Conclusion Contrast enhanced dynamic MR imaging can provide SPNs＇ hemodynamic information and is helpful in differentiating SPNs.
文摘Objective:To compare the clinical effect of complete thoracoscopic segmentectomy and pulmonary lobectomy for pulmonary nodules.Methods:In this study,176 patients with pulmonary nodules were treated in Changshu Hospital Affiliated to Nanjing University of Chinese Medicine from January 2019 to June 2021;according to the type of surgery,the patients were divided into group A(complete thoracoscopic segmentectomy)and group B(complete thoracoscopic pulmonary lobectomy),and the clinical effects were analyzed.Results:The intraoperative blood loss,postoperative drainage volume,postoperative hospitalization days,and lung function of patients in group A were significantly better than those in group B(P<0.05),while there was no significant difference in the number of dissected lymph nodes.Conclusion:The clinical effect of complete thoracoscopic segmentectomy for patients with small pulmonary nodules is more significant;it does not only ensure lymph node dissection,but also improve surgical-related indicators and treatment safety as well as speed up the recovery of pulmonary function.Its clinical application value is worthy of key analysis by medical institutions.
基金supported by the National Natural Science Foundation of China(No.82073628,81871876 and 82173609).
文摘Objective:The heightened prevalence of pulmonary nodules(PN)has escalated its significance as a public health concern.While the precise identification of high-risk PN carriers for malignancy remains an ongoing challenge,genetic variants hold potentials as determinants of disease susceptibility that can aid in diagnosis.Yet,current understanding of the genetic loci associated with malignant PN(MPN)risk is limited.Methods:A frequency-matched case-control study was performed,comprising 247 MPN cases and 412 benign NP(BNP)controls.We genotyped 11 established susceptibility loci for lung cancer in a Chinese cohort.Loci associated with MPN risk were utilized to compute a polygenic risk score(PRS).This PRS was subsequently incorporated into the diagnostic evaluation of MPNs,with emphasis on serum tumor biomarkers.Results:Loci rs10429489G>A,rs17038564A>G,and rs12265047A>G were identified as being associated with an increased risk of MPNs.The PRS,formulated from the cumulative risk effects of these loci,correlated with the malignant risk of PNs in a dose-dependent fashion.A high PRS was found to amplify the MPN risk by 156%in comparison to a low PRS[odds ratio(OR)=2.56,95%confidence interval(95%CI),1.40−4.67].Notably,the PRS was observed to enhance the diagnostic accuracy of serum carcinoembryonic antigen(CEA)in distinguishing MPNs from BPNs,with diagnostic values rising from 0.716 to 0.861 across low-to high-PRS categories.Further bioinformatics investigations pinpointed rs10429489G>A as an expression quantitative trait locus.Conclusions:Loci rs10429489G>A,rs17038564A>G,and rs12265047A>G contribute to MPN risk and augment the diagnostic precision for MPNs based on serum CEA concentrations.
文摘AIM: To analyze the cost-effectiveness of the diagnosis of solitary pulmonary nodule(SPN) in China. METHODS: Decision analysis models were constructed to assess the cost-effectiveness of four strategies for the management of SPN: computed tomography(CT) alone, CT plus CT-guided automated cutting needle biopsy(ACNB), CT plus positron emission tomography/computed tomography(PET/CT), CT plus diffusionweighted magnetic resonance imaging(DWI) plus PET/CT. RESULTS: The prevalence of lung cancer among SPN discovered in the clinical setting was approximately 50%. The CT plus ACNB strategy had higher diagnostic accuracies(87% vs 81%), with a cost saving of $1945 RMB per patient, and reducing unnecessary thoracotomy by 16.5%; this was associated with a 4.5% missed diagnosis rate. CT plus DWI plus PET/CT strategy also had higher accuracies(95% vs 81%), with a cost saving of $590 RMB per patient, and reducing unneces-sary thoracotomy by 13.5%; this was accompanied by 0.3% missed diagnosis rate. CT plus PET strategy is cost effective at a prevalence rate of 0-34%, but there was a larger prevalence range of lung cancer for CT plus ACNB strategy(from 0 to 0.6) and CT plus DWI plus PET/CT strategy(from 0 to 0.64). CONCLUSION: CT plus DWI plus PET/CT strategy was cost-effective, and had a higher accuracy accompanied by a lower missed diagnosis rate than CT plus ACNB strategy.
文摘BACKGROUND Primary hyperparathyroidism is typically caused by a single parathyroid adenoma.Ectopic parathyroid adenomas occur as well,with cases involving various sites,including the mediastinum,presenting in varying frequencies.Secondary hyperparathyroidism develops in the context of chronic kidney disease,primarily due to vitamin D deficiency,hypocalcemia,and hyperphosphatemia.It is frequently diagnosed in patients undergoing dialysis.This article presents a rare case of hyperparathyroidism involving multiple hyperplastic parathyroid glands with pulmonary seeding in a 50-year-old female patient undergoing hemodialysis(HD).CASE SUMMARY The patient had a history of parathyroidectomy 10 years prior but developed recurrent hyperparathyroidism with symptoms of pruritus and cough with sputum during a period of routine dialysis.Radiographic imaging revealed multiple nodules in both lungs,with the largest measuring approximately 1.35 cm.Surgical histopathology confirmed the presence of hyperplastic parathyroid glands within the pulmonary tissue.After tumor resection surgery via videoassisted thoracic surgery with wedge resection,the patient was discharged in stable condition and in follow-up her symptoms showed improvement.CONCLUSION This article describes hyperparathyroidism presenting as pulmonary nodules in a patient undergoing postparathyroidectomy HD,highlighting diagnostic challenges and a positive outcome from tumor resection surgery.
文摘BACKGROUND Incidental pulmonary nodules are an increasingly common finding on computed tomography(CT)scans of the thorax due to the exponential rise in CT examin-ations in everyday practice.The majority of incidental pulmonary nodules are benign and correctly identifying the small number of malignant nodules is cha-llenging.Ultra-low-dose CT(ULDCT)has been shown to be effective in diagnosis of respiratory pathology in comparison with traditional standard dose techniques.Our hypothesis was that ULDCT chest combined with model-based iterative reconstruction(MBIR)is comparable to standard dose CT(SDCT)chest in the analysis of pulmonary nodules with significant reduction in radiation dose.AIM To prospectively compare ULDCT chest combined with MBIR with SDCT chest in the analysis of solid pulmonary nodules.METHODS A prospective cohort study was conducted on adult patients(n=30)attending a respiratory medicine outpatient clinic in a tertiary referral university hospital for surveillance of previously detected indeterminate pulmonary nodules on SDCT chest.This study involved the acquisition of a reference SDCT chest followed immediately by an ULDCT chest.Nodule identification,nodule characterisation,nodule measurement,objective and subjective image quality and radiation dose were compared between ULDCT with MBIR and SDCT chest.RESULTS One hundred solid nodules were detected on ULDCT chest and 98 on SDCT chest.There was no significant difference in the characteristics of correctly identified nodules when comparing SDCT chest to ULDCT chest protocols.Signal-to-noise ratio was significantly increased in the ULDCT chest in all areas except in the paraspinal muscle at the maximum cardiac diameter level(P<0.001).The mean subjective image quality score for overall diagnostic acceptability was 8.9/10.The mean dose length product,computed tomography volume dose index and effective dose for the ULDCT chest protocol were 5.592 mGy.cm,0.16 mGy and 0.08 mSv respectively.These were significantly less than the SDCT chest protocol(P<0.001)and represent a radiation dose reduction of 97.6%.CONCLUSION ULDCT chest combined with MBIR is non-inferior to SDCT chest in the analysis of previously identified solid pulmonary nodules and facilitates a large reduction in radiation dose.
文摘Background: As the population age structure gradually ages, more and more elderly people were found to have pulmonary nodules during physical examinations. Most elderly people had underlying diseases such as heart, lung, brain and blood vessels and cannot tolerate surgery. Computed tomography (CT)-guided percutaneous core needle biopsy (CNB) was the first choice for pathological diagnosis and subsequent targeted drugs, immune drugs or ablation treatment. CT-guided percutaneous CNB requires clinicians with rich CNB experience to ensure high CNB accuracy, but it was easy to cause complications such as pneumothorax and hemorrhage. Three-dimensional (3D) printing coplanar template (PCT) combined with CT-guided percutaneous pulmonary CNB biopsy has been used in clinical practice, but there was no prospective, randomized controlled study. Methods: Elderly patients with lung nodules admitted to the Department of Oncology of our hospital from January 2019 to January 2023 were selected. A total of 225 elderly patients were screened, and 30 patients were included after screening. They were randomly divided into experimental group (Group A: 30 cases) and control group (Group B: 30 cases). Group A was given 3D-PCT combined with CT-guided percutaneous pulmonary CNB biopsy, Group B underwent CT-guided percutaneous pulmonary CNB. The primary outcome measure of this study was the accuracy of diagnostic CNB, and the secondary outcome measures were CNB time, number of CNB needles, number of pathological tissues and complications. Results: The diagnostic accuracy of group A and group B was 96.67% and 76.67%, respectively (P = 0.026). There were statistical differences between group A and group B in average CNB time (P = 0.001), number of CNB (1 vs more than 1, P = 0.029), and pathological tissue obtained by CNB (3 vs 1, P = 0.040). There was no statistical difference in the incidence of pneumothorax and hemorrhage between the two groups (P > 0.05). Conclusions: 3D-PCT combined with CT-guided percutaneous CNB can improve the puncture accuracy of elderly patients, shorten the puncture time, reduce the number of punctures, and increase the amount of puncture pathological tissue, without increasing pneumothorax and hemorrhage complications. We look forward to verifying this in a phase III randomized controlled clinical study. .
文摘This paper reviewed the literature on medication rule of pulmonary nodules in recent years. It is found that contemporary doctors pay more attention to regulating Qi, clearing heat and detoxifying, eliminating phlegm, dissolving phlegm and dissipating masses. They use mild drugs, cold and warm treatments in parallel, combining the tastes of pungent, bitterness, and sweetness at the same time. The treatment focuses on the five viscera with emphasis on the lung meridian while also considering the spleen and stomach functions as well as soothing liver stagnation. This information aims to provide some reference for clinical treatment of pulmonary nodules.
文摘Objective: to analyze the clinical significance of low-dose thin-layer CT scanning in the treatment of small pulmonary nodules. Methods: the clinical data of 78 patients with micronodular pulmonary nodules admitted to our hospital from August 2019 to August 2020 were retrospectively analyzed. The two treatments were compared and the radiation dose was scanned simultaneously. Results: Compared the detection rate of nodules in the process of low-dose thin-layer CT scanning with the way of conventional low-dose CT scanning, the difference between the two was not statistically significant (P > 0.05). The current weight CT dose index (CTDlw) and the product of dose length (DLP) of low-dose thin-slice CT scan are much lower than those of conventional dose CT scan, and the difference between the two is statistically significant (P <0.05). Conclusion: the low-dose thin-layer CT scanning technology has very ideal diagnostic value for the diagnosis of small pulmonary nodules, and can very effectively reduce the scanning radiation dose.
文摘Objective: to study the diagnostic value of solitary pulmonary nodules on dynamic enhancement of CT scan. Methods: the clinical data of 100 patients with solitary pulmonary nodules in our hospital from January 2018 to December 2020 were analyzed retrospectively. All patients underwent dynamic enhancement of CT scanning, and the results of pathological examination and CT scanning were compared and analyzed. Results: in the comparison between dynamic enhancement of CT scan and pathological examination, 95.83% were the diagnostic coincidence rate of malignant pulmonary nodules and 93.33% were benign pulmonary nodules. The coincidence rate of benign and malignant pulmonary nodules before and after enhanced scan was significantly lower than that after enhanced scan (P < 0.05);There was significant difference in CT value between benign and malignant pulmonary nodules (P < 0.05). Conclusion: in the differential diagnosis and diagnosis of solitary pulmonary nodules by dynamic contrast-enhanced CT scanning, it is worthy of clinical application and has high application value.
