We read with great interest the investigation of Kang et al related the applications of the multiparametric magnetic resonance imaging-based predictive model for assessing chemotherapy efficacy in colorectal cancer pa...We read with great interest the investigation of Kang et al related the applications of the multiparametric magnetic resonance imaging-based predictive model for assessing chemotherapy efficacy in colorectal cancer patients with gene mutations.The authors focused on decision-making based on the integration of tumor differentiation,signal intensity ratio,margin distance,and magnetic resonance imaging-detected lymph node metastasis.Indeed,these multiparameter predictive models could also be used for diagnosis as an alternative to invasive tissue examination methods.However,progress in this field enables us to shift the paradigm to radiology biopsies,particularly given the nonlinear effects of various radiation sources.展开更多
We read with great interest Deng et al.’s study 1 comparing sextant(6-core)and 12-core systematic biopsy in theMRI-targeted era,which valuably challenges the“more cores=higher accuracy”dogma by proposing a precisio...We read with great interest Deng et al.’s study 1 comparing sextant(6-core)and 12-core systematic biopsy in theMRI-targeted era,which valuably challenges the“more cores=higher accuracy”dogma by proposing a precision sampling strategy based on prostate cancer’s spatial distribution,aligning with personalized diagnosis trends.展开更多
Pediatric cancers are particularly significant due to their uncommon occurrence in children,driven by a variety of underlying factors.Because of their distinct molecular and genetic makeup,which makes early detection ...Pediatric cancers are particularly significant due to their uncommon occurrence in children,driven by a variety of underlying factors.Because of their distinct molecular and genetic makeup,which makes early detection challenging,they are linked to problems.Diagnostic methods like imaging and tissue biopsy are only effective when the tumor has reached a size that can be identified.The liquid biopsy technique,the least intrusive and most convenient diagnostic method,is the subject of this review.It focuses on the significance of single cell analysis in examining uncommon cancer types.The many biomarkers found in bodily fluids and the cancer types they are linked to in children have been assessed,as has the potential route towards early detection and cancer recurrence forecasting.Combining the single cell liquid biopsy with the newest technologies,such as computational and multi-omics approaches,which have improved the efficiency of processing massive and unique genetic data,appears promising.This article discusses on a number of case reports for uncommon pediatric malignancies,such as Neuroblastoma,Medulloblastoma,Wilms Tumor,Rhabdomyosarcoma,Ewing Sarcoma,and Retinoblastoma,as well as their liquid biopsy profiles.Furthermore,the findings raise ethical questions regarding the therapeutic application of the technology as well as possible difficulties related to clinical translation.The likelihood that this single cell liquid biopsy will be clinically validated and eventually used as a routine diagnostic tool for uncommon pediatric cancers will rise with the realistic approach to sensitivity monitoring,specificity upgrading,and optimization.展开更多
Objective:To investigate the long-term prognosis and postoperative cosmetic outcomes of breast-conserving surgery combined with sentinel lymph node biopsy in patients with early-stage breast cancer,providing a referen...Objective:To investigate the long-term prognosis and postoperative cosmetic outcomes of breast-conserving surgery combined with sentinel lymph node biopsy in patients with early-stage breast cancer,providing a reference for the selection of clinical treatment plans.Methods:A retrospective analysis was conducted on the clinical data of 68 patients with early-stage breast cancer admitted from January 2022 to December 2025.Based on the surgical approach,patients were divided into an observation group(breast-conserving surgery+sentinel lymph node biopsy)and a control group(other surgical methods such as modified radical mastectomy/total mastectomy).Clinical and pathological characteristics,incidence of postoperative complications,follow-up prognosis,and satisfaction with cosmetic outcomes were compared between the two groups.Results:Among the 68 patients,41 were in the observation group and 27 in the control group.The average age of patients in the observation group was(54.32±8.15)years,while that in the control group was(62.45±9.76)years.The average tumor size in the observation group was(1.86±0.72)cm,compared to(3.21±1.45)cm in the control group.The incidence of postoperative complications in the observation group was 9.76%,significantly lower than that in the control group at 33.33%(P<0.05).The 6-month disease-free survival rate was 95.12%in the observation group and 88.89%in the control group,with no statistically significant difference between the two groups(P>0.05).The excellent and good rate of cosmetic outcomes in the observation group was 87.80%,significantly higher than that in the control group at 29.63%(P<0.05).Conclusion:Breast-conserving surgery combined with sentinel lymph node biopsy for early-stage breast cancer can achieve long-term prognostic outcomes comparable to those of traditional radical surgery,with the advantages of fewer postoperative complications and superior cosmetic results.This approach is worthy of clinical promotion and application,particularly for early-stage breast cancer patients who have a demand for preserving breast morphology.展开更多
Objectives:Cancer treatment relies heavily on accurate diagnosis and effective monitoring of the disease.These processes often involve invasive procedures,such as colonoscopy,to detect malignant tissues,followed by mo...Objectives:Cancer treatment relies heavily on accurate diagnosis and effective monitoring of the disease.These processes often involve invasive procedures,such as colonoscopy,to detect malignant tissues,followed by molecular analyses to determine relevant biomarkers.This study aimed to evaluate the clinical performance of droplet digital PCR(ddPCR)for detecting Kirsten Rat Sarcoma Viral Proto-Oncogene(KRAS),Neuroblastoma RAS Viral Oncogene Homolog(NRAS),and B-Raf Murine Sarcoma Viral Oncogene Homolog B(BRAF)mutations in circulating tumor DNA(ctDNA)from colorectal cancer patients using liquid biopsy.Methods:ctDNA was isolated from colorectal cancer(CRC)patients(n=110)and analyzed for KRAS,BRAF,and NRAS mutations.The ctDNA obtained through liquid biopsy was analyzed using ddPCR,and the findings were compared with sequencing data from tumor DNA archived in formalin-fixed paraffin-embedded(FFPE)blocks.Results:For KRAS mutations,ddPCR achieved a sensitivity of 72.0%and a specificity of 71.4%.However,when pooling all target mutations(KRAS,NRAS and BRAF),the overall sensitivity and specificity were lower,at 48.3%and 51.1%,respectively.Conclusion:The results of this study indicate that the ddPCR analysis of ctDNA may provide complementary information for the molecular diagnosis of CRC patients.展开更多
The inability to access brain tissue has greatly hindered our ability to study and care for individuals suffering from psychiatric and neurological conditions.Critics have questioned efforts to develop peripheral bloo...The inability to access brain tissue has greatly hindered our ability to study and care for individuals suffering from psychiatric and neurological conditions.Critics have questioned efforts to develop peripheral blood biomarkers in neurological and psychiatric disorders based on the assertion that disease pathology is limited to the brain.The discovery that all tissues,including the brain,release extracellular vesicles(Raposo and Stoorvogel,2013)and cell free DNAs(Chan et al.,2013)into various body fluids has provided a potential way to measure activity from inaccessible tissues like the central nervous system(CNS)and has given rise to the term“liquid biopsy.”The development of liquid biopsies that can diagnose and predict the course of psychiatric and neurological disorders would be transformative.The ability to predict episodic events such as mania,depression,and risk for suicide would be particularly useful for psychiatric care as it would enable the development of interventions that prevent mortality and improve outcomes.Additionally,biomarkers that are informative about drug response and aid in treatment decisions would be a significant advance in psychiatric care as it would prevent patients from having to endure multiple courses of ineffective treatments and side effects.展开更多
AIM: To assess the diagnostic yield and safety of adeep and large biopsy technique under the guidance of endoscopic ultrasound(EUS) for diagnosis of gastric infiltrating tumors with negative malignant endoscopy biopsi...AIM: To assess the diagnostic yield and safety of adeep and large biopsy technique under the guidance of endoscopic ultrasound(EUS) for diagnosis of gastric infiltrating tumors with negative malignant endoscopy biopsies.METHODS: From January 2009 to March 2014, 36 patients in whom gastric infiltrating tumors had been diagnosed by EUS received negative results for malignancy after endoscopic biopsies. The deep and large biopsy technique combined bite-on-bite technique with or without endoscopic mucosal resection(EMR) to obtain submucosal tissue from lesions. EUS was used to select the appropriate biopsy sites. If the lesion protruded into the cavity, EMR was performed for removal of the overlying mucosa and then bite-onbite technique was conducted in the resected area to obtain submucosal tissue. If the lesion appeared to be flat or was difficult to lift by injection, the bite-on-bite technique was directly used.RESULTS: Twenty-eight of the 36 patients were treated by EMR followed by bite-on-bite technique, while 8 patients only underwent bite-on-bite technique. Histological results showed 23 of the 36 lesions were poorly differentiated adenocarcinomas, 2 diffuse large B cell lymphomas, 4 mucosa-associated lymphoid tissue-type lymphomas, and 7 undiagnosed. The deep and large biopsy technique provided a definitive and conclusive diagnosis in 29(80.6%) of the 36 patients. The 12 gastric linitis plastica and 6 lymphoma patients received chemotherapy and avoided surgery. Minor oozing of blood in 2 mucosal resection wounds was managed by argon plasma coagulation and in 5 cases after deep biopsies by epinephrine(0.001%). Neither severe hemorrhage nor perforation occurred in any patient.CONCLUSION: The deep and large biopsy technique is superior to ordinary endoscopic biopsy for achieving an accurate diagnosis of gastric infiltrating tumors.This procedure guided by EUS is an effective and safe diagnostic method for gastric infiltrating tumors in which endoscopic biopsy results were negative for malignancy.展开更多
Introduction: Percutaneous renal biopsy (PRB) is the gold standard for the diagnosis of most renal diseases. It is a safe and effective modality for the collection of renal tissue. However, many safety measures are no...Introduction: Percutaneous renal biopsy (PRB) is the gold standard for the diagnosis of most renal diseases. It is a safe and effective modality for the collection of renal tissue. However, many safety measures are not based on sufficient evidence and therefore vary considerably from a center to another. The aim of this work is to determine the rate of bleeding complications, to identify the risk factors for these complications, and to clarify the post renal biopsy prognosis. Materials and Methods: We performed a single-center retrospective observational study in the nephrology department at the University Hospital of Fez, including all patients who underwent percutaneous renal biopsy on native kidney between January 2018 and December 2019. Results: Overall, 157 biopsies were performed. Deglobulization was present in 20.4% (40) of patients, the mean age of patients was 41.57 ± 16.11 years [16.78]. The sex ratio M/F: 1.22. Diabetes mellitus was present in four cases (11.1%), arterial hypertension was present in four cases (11.1%). On clinical examination, systolic hypertension was found in 45.7%, diastolic hypertension in 45%, antihypertensive therapy was initiated in all patients with hypertension before. Hyperuremia was present in 29 patients (80.6%), renal failure was present in 77.8%. Anemia was present in 55.6%, thrombocytopenia in six cases (16.7%). Radiologically, the size of the kidneys was reduced in 5 patients (17.2%), differentiation was limited in 5 patients (17.2%). Major complications occurred in 3.8% (6/157). These six patients had a lumbar pain and required blood transfusions. A radiological embolization procedure was indicated in only one patient. Minor complications were seen in 21.6% (34/157). The diagnoses that were retained in patients with deglobulization were: Lupus in 34.71%, pauci-immune vasculitis in 13.79%, membranous glomerulonephritis in 10.34%, focal and segmental hyalinosis in 10.34%, membrano-proliferative glomerulonephritis in 10.34%. In univariate and multivariate analysis, the major risk factors for deglobulization found in our patients were: hyperuremia 80.6% (p: 0.017), acute renal failure 77.8% (p: 0.04), acute hemodialysis 24.7% (p: 0.02), hyperphosphatemia 63.6% (0.04). Conclusion: Renal biopsies are an overall safe procedure with rare major complications. Post-renal biopsy deglobulization is common. Routine post-biopsy ultrasound may not be necessary. Renal biopsies can be performed safely if risk factors are controlled, such as renal failure, hyperuremia, hyperphosphatemia, hemodialysis patients and a diagnosis of lupus nephropathy.展开更多
Objective： Diagnosis of patients with negative prostate biopsy and persistent suspicion of prostate cancer re- mains a serious problem. In this study, we investigated the application of optimizing prostate biopsy for...Objective： Diagnosis of patients with negative prostate biopsy and persistent suspicion of prostate cancer re- mains a serious problem. In this study, we investigated the application of optimizing prostate biopsy for patients who need repeat prostate biopsy. Methods： In this prospective, non-randomized phase-I clinical trial, the prostate cancer detection rate of initial detection scheme was compared with optimizing prostate biopsy scheme. The number of punctures of initial detection scheme was the same as that of optimizing prostate biopsy scheme. The puncture direction of optimizing prostate biopsy was a 45~ angle to the sagittal plane from front, middle, and back. The two cores from each lateral lobe were horizontally inwardly inclined 45~. Results： A total of 45 patients with initial negative biopsy for cancer were received the optimizing prostate biopsy scheme. The cancer detection rate was 17.8% （8/45）, and prostate intraepithelial neoplasm （PIN） was 6.7% （3/45）. The pa- tients receiving repeat transrectal prostate biopsies were pathologically diagnosed as lower Gleason grade prostate cancers. Conclusion： The cancer detection rate of repeat biopsy prostate cancer is lower than that of initial biopsy. Our study showed that the optimizing prostate biopsy is important to improve the detection rate of repeat transrecta~ prostate biopsies patients.展开更多
BACKGROUND Persistent suspicion of prostate cancer(PCa)due to a rising prostate-specific antigen(PSA)level after repeated negative biopsies is a serious challenge in clinical practice.AIM To determine the role of Hira...BACKGROUND Persistent suspicion of prostate cancer(PCa)due to a rising prostate-specific antigen(PSA)level after repeated negative biopsies is a serious challenge in clinical practice.AIM To determine the role of Hiraoka’s transurethral detachment of the prostate(TUDP)combined with biopsy of the peripheral zone during the same session in patients with repeated negative biopsies in the diagnosis of PCa.METHODS We retrospectively evaluated the records of 10 patients who were eligible for inclusion in our hospital between December 2012 and August 2017.Patient demographics,a family history of PCa,the number of biopsies,prostate volume,pathological examination,and perioperative PSA level were obtained.RESULTS Two of 10 patients were pathologically diagnosed with PCa after surgery;the Gleason scores were 4+4 and 4+3,respectively.Both patients subsequently underwent laparoscopic radical prostatectomy.The median PSA levels preoperatively,and 3 mo and 1 year postoperatively in the other eight patients who were diagnosed with benign prostate hyperplasia after surgery were 19.10 ng/mL,1.10 ng/mL,and 1.15 ng/mL,respectively.The adjusted P values of the 3-mo and 1-year post-operative PSA level vs pre-operative PSA level were 0.003 and 0.026,respectively.None of the patients had increased PSA levels or PCa detected after a median 35 mo of follow-up.CONCLUSION TUDP combined with peripheral zone biopsy may improve the detection rate of PCa in patients with repeated negative biopsies.The PSA level declined rapidly in patients who had negative pathological examinations after TUDP,which remained stable 1 year after surgery.展开更多
The introduction of wireless capsule endoscopy has brought a revolutionary change in the diagnostic procedures for gastrointestinal disorders.Biopsy,an essential procedure for disease diagnosis,has been integrated int...The introduction of wireless capsule endoscopy has brought a revolutionary change in the diagnostic procedures for gastrointestinal disorders.Biopsy,an essential procedure for disease diagnosis,has been integrated into robotic capsule endoscopy to augment diagnostic capabilities.In this study,we propose a magnetically driven biopsy robot based on a Kresling origami.Considering the bistable properties of Krelsing origami and the elasticity of the creases,a foldable structure of the robot with constant force characteristics is designed.The folding motion of the structure is used to deploy the needle into the target tissue.The robot is capable of performing rolling motion under the control of an external magnetic drive system,and a fine needle biopsy technique is used to collect deep tissue samples.We also conduct in vitro rolling experiments and sampling experiments on apple tissues and pork tissues,which verify the performance of the robot.展开更多
BACKGROUND Early detection of esophageal squamous neoplasms(ESN)is essential for improving patient prognosis.Optical diagnosis of ESN remains challenging.Probebased confocal laser endomicroscopy(pCLE)enables accurate ...BACKGROUND Early detection of esophageal squamous neoplasms(ESN)is essential for improving patient prognosis.Optical diagnosis of ESN remains challenging.Probebased confocal laser endomicroscopy(pCLE)enables accurate in vivo histological observation and optical biopsy of ESN.However,interpretation of pCLE images requires histopathological expertise and extensive training.Artificial intelligence(AI)has been widely applied in digestive endoscopy;however,AI for pCLE diagnosis of ESN has not been reported.AIM To develop a pCLE computer-aided diagnostic system for ESN and assess its diagnostic performance and assistant efficiency for nonexpert endoscopists.METHODS The intelligent confocal laser endomicroscopy(iCLE)system consists of image recognition(based on inception-ResNet V2),video diagnosis,and quality judgment modules.This system was developed using pCLE images and videos and evaluated through image and prospective video recognition tests.Patients between June 2020 and January 2023 were prospectively enrolled.Expert and nonexpert endoscopists and the iCLE independently performed diagnoses for pCLE videos,with histopathology as the gold standard.Thereafter,the non-expert endoscopists performed a second assessment with iCLE assistance.RESULTS A total of 25056 images from 2803 patients were selected for iCLE training and validation.Another 2442 images from 226 patients were used for testing.iCLE achieved a high accuracy of 98.3%,sensitivity of 95.3%and specificity of 98.8%for diagnosing ESN images.A total of 2581 patients underwent upper gastrointestinal pCLE examination and were prospectively screened;54 patients with suspected ESN were enrolled.Overall,187 videos from 67 lesions were assessed by iCLE,three nonexpert and three expert endoscopists.iCLE achieved a high accuracy,sensitivity and specificity of 90.9%,92.0%,and 90.2%,respectively.Compared to experts,iCLE showed significantly higher sensitivity(92.0%vs 80.4%;P<0.001)and negative predictive value(94.4%vs 87.7%;P=0.003).With iCLE assistance,nonexpert endoscopists showed significant improvements in accuracy(from 83.6%to 88.6%)and sensitivity(from 76.0%to 89.8%).CONCLUSION iCLE system demonstrated high diagnostic performance for ESN.It can assist nonexpert endoscopists in improving the diagnostic efficiency of pCLE for ESN and has the potential for reducing unnecessary biopsies.展开更多
Wireless capsule endoscopy(WCE)has the potential to fully replace conventional wired counterparts for its low invasiveness.Recent studies have attempted to expand the functions of capsules toward this goal.However,lim...Wireless capsule endoscopy(WCE)has the potential to fully replace conventional wired counterparts for its low invasiveness.Recent studies have attempted to expand the functions of capsules toward this goal.However,limitations in space and energy supply have resulted in the inability to perform multiple diagnostic and treatment tasks using a single capsule.In this study,we developed a dual-functional capsule robot(DFCR)for drug delivery and tissue biopsy based on magnetic torsion spring technology.The delivery module was shown to rotate the push rod with a thrust of 894 mN to release approximately 0.3 mL of semisolid drug.The biopsy module used a built-in blade to cut tissue with a shear stress of 22.87 MPa,producing a sample of approximately 1.8 mm3.Additionally,a five-degree-of-freedom permanent magnet drive system was developed.By adjusting the strength of the unidirectional magnetic field generated by an external magnet,the capsule can be wirelessly controlled to sequentially trigger the two functions.Ex vivo tests on porcine stomachs confirmed the feasibility of the prototype capsule(12 mm in diameter and 45 mm in length)in active movement,medication,and tissue biopsy.The newly developed DFCR further expands the clinical application prospects of WCE robots in minimally invasive surgery.展开更多
BACKGROUND Percutaneous liver biopsies,including coaxial needle biopsy(CNB),are the pre-ferred method for tissue sampling to diagnose or characterize an array of hepatic conditions.Despite the advent of intraprocedura...BACKGROUND Percutaneous liver biopsies,including coaxial needle biopsy(CNB),are the pre-ferred method for tissue sampling to diagnose or characterize an array of hepatic conditions.Despite the advent of intraprocedural image guidance,and various“plugging”techniques,bleeding remains a frequent and potentially highly mor-bid complication,particularly in patients with bleeding risks.Thus,post-biopsy bleeding risk leads to extended patient monitoring,and in significant cases,ad-ditional imaging,intervention,and even surgery.Very rarely,death has resulted.CASE SUMMARY We report a series of five image-guided liver biopsy cases undertaken due to a variety of clinical conditions followed by the use of a new electrocautery hemo-stasis device called SinglePass Kronos.Indications for the CNB included non-alcoholic steatohepatitis,hepatocellular carcinoma and cirrhosis,abnormal liver function tests with positive autoimmune serologies,abnormal imaging findings,and jaundice.All biopsy procedures were successful with no complications th-rough 30 days following CNB.Post-procedure ultrasound confirmed the absence of bleeding in all five cases.CONCLUSION Hemostasis of CNB tracts using SinglePass Kronos was obtained in all cases.Ad-ditional study of this device is warranted.展开更多
The choice of biopsy method is critical in diagnosing prostate cancer(PCa).This retrospective cohort study compared systematic biopsy(SB)or cognitive fusion-targeted biopsy combined with SB(CB)in detecting PCa and cli...The choice of biopsy method is critical in diagnosing prostate cancer(PCa).This retrospective cohort study compared systematic biopsy(SB)or cognitive fusion-targeted biopsy combined with SB(CB)in detecting PCa and clinically significant prostate cancer(csPCa).Data from 2572 men who underwent either SB or CB in Fudan University Shanghai Cancer Center(Shanghai,China)between January 2019 and December 2023 were analyzed.Propensity score matching(PSM)was used to balance baseline characteristics,and detection rates were compared before and after PSM.Subgroup analyses based on prostate-specific antigen(PSA)levels and Prostate Imaging-Reporting and Data System(PI-RADS)scores were performed.Primary and secondary outcomes were the detection rates of PCa and csPCa,respectively.Of 2572 men,1778 were included in the PSM analysis.Before PSM,CB had higher detection rates for both PCa(62.9%vs 52.4%,odds ratio[OR]:1.54,P<0.001)and csPCa(54.9%vs 43.3%,OR:1.60,P<0.001)compared to SB.After PSM,CB remained superior in detecting PCa(63.1%vs 47.9%,OR:1.86,P<0.001)and csPCa(55.0%vs 38.2%,OR:1.98,P<0.001).In patients with PSA 4–12 ng ml−1(>4 ng ml-1 and≤12 ng ml-1,which is also applicable to the following text),CB detected more PCa(59.8%vs 40.7%,OR:2.17,P<0.001)and csPCa(48.1%vs 27.7%,OR:2.42,P<0.001).CB also showed superior csPCa detection in those with PI-RADS 3 lesions(32.1%vs 18.0%,OR:2.15,P=0.038).Overall,CB significantly improves PCa and csPCa detection,especially in patients with PSA 4–12 ng ml−1 or PI-RADS 3 lesions.展开更多
Background:Transrectal(TR)and transperineal(TP)biopsies are commonly used methods for diagnosing prostate cancer.However,their comparative effectiveness in conjunction with machine learning(ML)techniques remains under...Background:Transrectal(TR)and transperineal(TP)biopsies are commonly used methods for diagnosing prostate cancer.However,their comparative effectiveness in conjunction with machine learning(ML)techniques remains underexplored.This study aimed to evaluate the predictive accuracy of ML algorithms in detecting prostate cancer using data derived from TR and TP biopsies.Methods:The clinical records of patients who underwent prostate biopsy at King Saud University Medical City and King Faisal Specialist Hospital and Research Centerin Riyadh,Saudi Arabia,between 2018 and 2025 were analyzed.Data were used to train and testMLmodels,including eXtreme Gradient Boosting(XGBoost),Decision Tree,Random Forest,and Extra Trees.Results:The two datasets are comparable.The models demonstrated exceptional performance,achieving accuracies of up to 96.49%and 95.56%on TP and TR biopsy datasets,respectively.The area under the curve(AUC)values were also high,reaching 0.9988 for TP and 0.9903 for TR biopsy predictions.Conclusion:These findings highlight the potential of MLto enhance the diagnostic accuracy of prostate cancer detection irrespective of the biopsy method.However,TP biopsy data showed marginally higher accuracy,possibly because of the lower risk of contamination.While ML holds great promise for transforming prostate cancer care,further research is needed to address limitations.Collaboration between clinicians,data scientists,and researchers is crucial to ensure the clinical relevance and interpretability of ML models.展开更多
Trophectoderm(TE)biopsy has become the preferred approach in preimplantation genetic testing,providing clear advantages over polar body and cleavage-stage biopsy.However,the optimal timing and methodology for blastocy...Trophectoderm(TE)biopsy has become the preferred approach in preimplantation genetic testing,providing clear advantages over polar body and cleavage-stage biopsy.However,the optimal timing and methodology for blastocyst biopsy remain subjects of ongoing debate.McArthur et al in 2005 were the first to demonstrate the safety of TE biopsy at the hatching blastocyst stage with laser-assisted opening in the zona pellucida(ZP)on Day 3,reporting 100%survival of 1050 biopsied blastocysts,all of which re-expanded,with an implantation rate of 41%[1].Nearly a decade later,Capalbo et al in 2014 introduced a modified strategy,performing biopsy on fully expanded blastocysts by creating a laser-assisted ZP opening and immediately aspirating TE cells on Day 5.展开更多
BACKGROUND To evaluate the diagnostic utility of endobronchial ultrasound(EBUS)-guided mediastinal lymph node fenestration biopsy in atypical sarcoidosis using fine biopsy forceps[i.e.,EBUS-transbronchial forceps biop...BACKGROUND To evaluate the diagnostic utility of endobronchial ultrasound(EBUS)-guided mediastinal lymph node fenestration biopsy in atypical sarcoidosis using fine biopsy forceps[i.e.,EBUS-transbronchial forceps biopsy(TBFB)].CASE SUMMARY In this case series,two atypical sarcoidosis cases admitted in 2024 were retrospectively analyzed,both of whom lacked classical clinical manifestations.After chest computed tomography/positron emission tomography-computed tomography imaging and serum angiotensin-converting enzyme testing,EBUStransbronchial needle aspiration was performed using a 21-G needle.Subsequently,tissue sampling was performed at the enlarged puncture site by means of a 1.2-mm fine biopsy forceps.At the same time,bronchoalveolar lavage fluid lymphocyte subset analysis was conducted.CONCLUSION Both cases demonstrated non-caseating granulomatous inflammation on histopathology,elevated serum angiotensin-converting enzyme levels,and markedly increased CD4/CD8 ratios in bronchoalveolar lavage fluid.Case 1 was observed after confirmation of stage II sarcoidosis,whereas case 2 required glucocorticoid therapy due to the involvement of multiple systems.EBUS-TBFB can be used to make a definitive pathological diagnosis.For radiologically atypical sarcoidosis,EBUS-TBFB improves diagnostic accuracy by obtaining larger histological samples,thereby addressing the limitations of transbronchial needle aspiration cytology.This approach significantly improves differential diagnostic efficacy and holds substantial clinical relevance for broader adoption.展开更多
BACKGROUND Liver biopsy is an important diagnostic tool to investigate patients with suspected liver disease.The efficacy and safety of endoscopic ultrasound-guided liver biopsy(EUS-LB)as a method for liver tissue acq...BACKGROUND Liver biopsy is an important diagnostic tool to investigate patients with suspected liver disease.The efficacy and safety of endoscopic ultrasound-guided liver biopsy(EUS-LB)as a method for liver tissue acquisition remain uncertain.AIM To study the diagnostic yield and safety of EUS-LB in patients with suspected parenchymal liver disease.METHODS This is a retrospective observational cohort study of patients undergoing EUS-LB in 2 tertiary-care centers in Kuwait in the period between January 2022-June 2025.The primary outcome was sample adequacy,while secondary outcomes included histological quality of the specimen and adverse events.Predictors of increased diagnostic adequacy and specimen quality were explored.RESULTS A total of 50 patients[mean age 43.9(15.5)years,40%males]were included.The left liver lobe was targeted for biopsy in most patients(96%),and 19-gauge fine needle aspiration(FNA)was used in most cases(52%).The median number of passes performed was 3(range 2-5),and the heparin-wet suction technique was used in 40%of patients.The overall diagnostic adequacy of EUS-LB was 86%,with no significant difference between 19-gauge FNA and 19-gauge fine needle biopsy(FNB)needles.Fulfillment of the European Association for the Study of Liver(EASL)and the American Association for the Study of Liver Diseases criteria was achieved in 54%and 34%,respectively,with a significantly higher number of patients fulfilling these criteria when FNB needle was used compared to FNA needle(83.3%vs 26.9%,P<0.0001)and(62.5%vs 7.7%,P<0.0001),respectively.Only 1 patient(2.0%)developed adverse post-procedure events,namely bleeding requiring transfusion.Multivariate regression analysis did not identify any factor that increased diagnostic adequacy;however,the use of FNB needles and wet heparin suction methods were associated with significantly increased odds of fulfilling EASL criteria,while performing more than 2 passes reduced the quality of the specimen.CONCLUSION EUS-LB is an effective and safe method for obtaining liver biopsy in patients with suspected parenchymal liver disease.EUS-LB demonstrated a favorable safety profile in our cohort,although larger prospective studies are required to validate bleeding risk.The use of 19-gauge FNB needles,wet-heparin suction technique,and performing≤2 passes is associated with improved quality of the specimen obtained without increasing the risk of adverse events.展开更多
To the Editor:With the popularity of liver transplantation(LT)and the inspiration for long-time survival,issues related to evaluating the liver allograft have increased in recent years[1-3].Although there has been ren...To the Editor:With the popularity of liver transplantation(LT)and the inspiration for long-time survival,issues related to evaluating the liver allograft have increased in recent years[1-3].Although there has been renewed interest in non-invasive methods to evaluate diffuse liver disease,liver biopsy is still the golden standard in clinical practice,particularly for liver transplant recipients(LTRs).The liver biopsy has always been performed in LTRs as a part of standard procedure in cases whose liver function was normal,named as protocol liver biopsy,or to identify histological abnormalities for abnormal liver function and provide guidance for the adjustment of immunosuppressive regimen[4,5].Percutaneous liver biopsy(PLB)has been frequently conducted in LTRs;however,the clinical implementation of protocol liver biopsy by PLB in LTRs is challenging due to their suboptimal compliance,particularly in China[6].Besides,the PLB procedure has been associated with discomfort and potentially life-threatening complications in the general population,as reported in the literature[7,8].展开更多
基金Supported by Russian Science Foundation,No.24-64-00028.
文摘We read with great interest the investigation of Kang et al related the applications of the multiparametric magnetic resonance imaging-based predictive model for assessing chemotherapy efficacy in colorectal cancer patients with gene mutations.The authors focused on decision-making based on the integration of tumor differentiation,signal intensity ratio,margin distance,and magnetic resonance imaging-detected lymph node metastasis.Indeed,these multiparameter predictive models could also be used for diagnosis as an alternative to invasive tissue examination methods.However,progress in this field enables us to shift the paradigm to radiology biopsies,particularly given the nonlinear effects of various radiation sources.
文摘We read with great interest Deng et al.’s study 1 comparing sextant(6-core)and 12-core systematic biopsy in theMRI-targeted era,which valuably challenges the“more cores=higher accuracy”dogma by proposing a precision sampling strategy based on prostate cancer’s spatial distribution,aligning with personalized diagnosis trends.
文摘Pediatric cancers are particularly significant due to their uncommon occurrence in children,driven by a variety of underlying factors.Because of their distinct molecular and genetic makeup,which makes early detection challenging,they are linked to problems.Diagnostic methods like imaging and tissue biopsy are only effective when the tumor has reached a size that can be identified.The liquid biopsy technique,the least intrusive and most convenient diagnostic method,is the subject of this review.It focuses on the significance of single cell analysis in examining uncommon cancer types.The many biomarkers found in bodily fluids and the cancer types they are linked to in children have been assessed,as has the potential route towards early detection and cancer recurrence forecasting.Combining the single cell liquid biopsy with the newest technologies,such as computational and multi-omics approaches,which have improved the efficiency of processing massive and unique genetic data,appears promising.This article discusses on a number of case reports for uncommon pediatric malignancies,such as Neuroblastoma,Medulloblastoma,Wilms Tumor,Rhabdomyosarcoma,Ewing Sarcoma,and Retinoblastoma,as well as their liquid biopsy profiles.Furthermore,the findings raise ethical questions regarding the therapeutic application of the technology as well as possible difficulties related to clinical translation.The likelihood that this single cell liquid biopsy will be clinically validated and eventually used as a routine diagnostic tool for uncommon pediatric cancers will rise with the realistic approach to sensitivity monitoring,specificity upgrading,and optimization.
文摘Objective:To investigate the long-term prognosis and postoperative cosmetic outcomes of breast-conserving surgery combined with sentinel lymph node biopsy in patients with early-stage breast cancer,providing a reference for the selection of clinical treatment plans.Methods:A retrospective analysis was conducted on the clinical data of 68 patients with early-stage breast cancer admitted from January 2022 to December 2025.Based on the surgical approach,patients were divided into an observation group(breast-conserving surgery+sentinel lymph node biopsy)and a control group(other surgical methods such as modified radical mastectomy/total mastectomy).Clinical and pathological characteristics,incidence of postoperative complications,follow-up prognosis,and satisfaction with cosmetic outcomes were compared between the two groups.Results:Among the 68 patients,41 were in the observation group and 27 in the control group.The average age of patients in the observation group was(54.32±8.15)years,while that in the control group was(62.45±9.76)years.The average tumor size in the observation group was(1.86±0.72)cm,compared to(3.21±1.45)cm in the control group.The incidence of postoperative complications in the observation group was 9.76%,significantly lower than that in the control group at 33.33%(P<0.05).The 6-month disease-free survival rate was 95.12%in the observation group and 88.89%in the control group,with no statistically significant difference between the two groups(P>0.05).The excellent and good rate of cosmetic outcomes in the observation group was 87.80%,significantly higher than that in the control group at 29.63%(P<0.05).Conclusion:Breast-conserving surgery combined with sentinel lymph node biopsy for early-stage breast cancer can achieve long-term prognostic outcomes comparable to those of traditional radical surgery,with the advantages of fewer postoperative complications and superior cosmetic results.This approach is worthy of clinical promotion and application,particularly for early-stage breast cancer patients who have a demand for preserving breast morphology.
基金funded by the Ministry of Health of the Czech Republic—conceptual development of research organization(MMCI,00209805)Czech Science Foundation(No.25-15990S)+1 种基金the project 7D241003 EUREKA EUROSTARS35897,project SALVAGE(P JAC,reg.No.CZ.02.01.01/00/22_008/0004644)—funded by the European Unionby the State Budget of the Czech Republic,and by the LRI project BBMRI.cz(Nos.LM2023033 and CZ.02.1.01/0.0/0.0/16_013/0001674.).
文摘Objectives:Cancer treatment relies heavily on accurate diagnosis and effective monitoring of the disease.These processes often involve invasive procedures,such as colonoscopy,to detect malignant tissues,followed by molecular analyses to determine relevant biomarkers.This study aimed to evaluate the clinical performance of droplet digital PCR(ddPCR)for detecting Kirsten Rat Sarcoma Viral Proto-Oncogene(KRAS),Neuroblastoma RAS Viral Oncogene Homolog(NRAS),and B-Raf Murine Sarcoma Viral Oncogene Homolog B(BRAF)mutations in circulating tumor DNA(ctDNA)from colorectal cancer patients using liquid biopsy.Methods:ctDNA was isolated from colorectal cancer(CRC)patients(n=110)and analyzed for KRAS,BRAF,and NRAS mutations.The ctDNA obtained through liquid biopsy was analyzed using ddPCR,and the findings were compared with sequencing data from tumor DNA archived in formalin-fixed paraffin-embedded(FFPE)blocks.Results:For KRAS mutations,ddPCR achieved a sensitivity of 72.0%and a specificity of 71.4%.However,when pooling all target mutations(KRAS,NRAS and BRAF),the overall sensitivity and specificity were lower,at 48.3%and 51.1%,respectively.Conclusion:The results of this study indicate that the ddPCR analysis of ctDNA may provide complementary information for the molecular diagnosis of CRC patients.
基金supported by Department of Defense grant HT9425-24-1-0030 a grant from the Stanley Medical Research Institute(to SS).
文摘The inability to access brain tissue has greatly hindered our ability to study and care for individuals suffering from psychiatric and neurological conditions.Critics have questioned efforts to develop peripheral blood biomarkers in neurological and psychiatric disorders based on the assertion that disease pathology is limited to the brain.The discovery that all tissues,including the brain,release extracellular vesicles(Raposo and Stoorvogel,2013)and cell free DNAs(Chan et al.,2013)into various body fluids has provided a potential way to measure activity from inaccessible tissues like the central nervous system(CNS)and has given rise to the term“liquid biopsy.”The development of liquid biopsies that can diagnose and predict the course of psychiatric and neurological disorders would be transformative.The ability to predict episodic events such as mania,depression,and risk for suicide would be particularly useful for psychiatric care as it would enable the development of interventions that prevent mortality and improve outcomes.Additionally,biomarkers that are informative about drug response and aid in treatment decisions would be a significant advance in psychiatric care as it would prevent patients from having to endure multiple courses of ineffective treatments and side effects.
文摘AIM: To assess the diagnostic yield and safety of adeep and large biopsy technique under the guidance of endoscopic ultrasound(EUS) for diagnosis of gastric infiltrating tumors with negative malignant endoscopy biopsies.METHODS: From January 2009 to March 2014, 36 patients in whom gastric infiltrating tumors had been diagnosed by EUS received negative results for malignancy after endoscopic biopsies. The deep and large biopsy technique combined bite-on-bite technique with or without endoscopic mucosal resection(EMR) to obtain submucosal tissue from lesions. EUS was used to select the appropriate biopsy sites. If the lesion protruded into the cavity, EMR was performed for removal of the overlying mucosa and then bite-onbite technique was conducted in the resected area to obtain submucosal tissue. If the lesion appeared to be flat or was difficult to lift by injection, the bite-on-bite technique was directly used.RESULTS: Twenty-eight of the 36 patients were treated by EMR followed by bite-on-bite technique, while 8 patients only underwent bite-on-bite technique. Histological results showed 23 of the 36 lesions were poorly differentiated adenocarcinomas, 2 diffuse large B cell lymphomas, 4 mucosa-associated lymphoid tissue-type lymphomas, and 7 undiagnosed. The deep and large biopsy technique provided a definitive and conclusive diagnosis in 29(80.6%) of the 36 patients. The 12 gastric linitis plastica and 6 lymphoma patients received chemotherapy and avoided surgery. Minor oozing of blood in 2 mucosal resection wounds was managed by argon plasma coagulation and in 5 cases after deep biopsies by epinephrine(0.001%). Neither severe hemorrhage nor perforation occurred in any patient.CONCLUSION: The deep and large biopsy technique is superior to ordinary endoscopic biopsy for achieving an accurate diagnosis of gastric infiltrating tumors.This procedure guided by EUS is an effective and safe diagnostic method for gastric infiltrating tumors in which endoscopic biopsy results were negative for malignancy.
文摘Introduction: Percutaneous renal biopsy (PRB) is the gold standard for the diagnosis of most renal diseases. It is a safe and effective modality for the collection of renal tissue. However, many safety measures are not based on sufficient evidence and therefore vary considerably from a center to another. The aim of this work is to determine the rate of bleeding complications, to identify the risk factors for these complications, and to clarify the post renal biopsy prognosis. Materials and Methods: We performed a single-center retrospective observational study in the nephrology department at the University Hospital of Fez, including all patients who underwent percutaneous renal biopsy on native kidney between January 2018 and December 2019. Results: Overall, 157 biopsies were performed. Deglobulization was present in 20.4% (40) of patients, the mean age of patients was 41.57 ± 16.11 years [16.78]. The sex ratio M/F: 1.22. Diabetes mellitus was present in four cases (11.1%), arterial hypertension was present in four cases (11.1%). On clinical examination, systolic hypertension was found in 45.7%, diastolic hypertension in 45%, antihypertensive therapy was initiated in all patients with hypertension before. Hyperuremia was present in 29 patients (80.6%), renal failure was present in 77.8%. Anemia was present in 55.6%, thrombocytopenia in six cases (16.7%). Radiologically, the size of the kidneys was reduced in 5 patients (17.2%), differentiation was limited in 5 patients (17.2%). Major complications occurred in 3.8% (6/157). These six patients had a lumbar pain and required blood transfusions. A radiological embolization procedure was indicated in only one patient. Minor complications were seen in 21.6% (34/157). The diagnoses that were retained in patients with deglobulization were: Lupus in 34.71%, pauci-immune vasculitis in 13.79%, membranous glomerulonephritis in 10.34%, focal and segmental hyalinosis in 10.34%, membrano-proliferative glomerulonephritis in 10.34%. In univariate and multivariate analysis, the major risk factors for deglobulization found in our patients were: hyperuremia 80.6% (p: 0.017), acute renal failure 77.8% (p: 0.04), acute hemodialysis 24.7% (p: 0.02), hyperphosphatemia 63.6% (0.04). Conclusion: Renal biopsies are an overall safe procedure with rare major complications. Post-renal biopsy deglobulization is common. Routine post-biopsy ultrasound may not be necessary. Renal biopsies can be performed safely if risk factors are controlled, such as renal failure, hyperuremia, hyperphosphatemia, hemodialysis patients and a diagnosis of lupus nephropathy.
基金Supported by grants from the Pudong New Area Medical Health System Outstanding Young Talent Training Plan(No.PWRq2013-17)Zhoupu Hospital of Pudong New District(No.ZP-XM-2012B-22)
文摘Objective： Diagnosis of patients with negative prostate biopsy and persistent suspicion of prostate cancer re- mains a serious problem. In this study, we investigated the application of optimizing prostate biopsy for patients who need repeat prostate biopsy. Methods： In this prospective, non-randomized phase-I clinical trial, the prostate cancer detection rate of initial detection scheme was compared with optimizing prostate biopsy scheme. The number of punctures of initial detection scheme was the same as that of optimizing prostate biopsy scheme. The puncture direction of optimizing prostate biopsy was a 45~ angle to the sagittal plane from front, middle, and back. The two cores from each lateral lobe were horizontally inwardly inclined 45~. Results： A total of 45 patients with initial negative biopsy for cancer were received the optimizing prostate biopsy scheme. The cancer detection rate was 17.8% （8/45）, and prostate intraepithelial neoplasm （PIN） was 6.7% （3/45）. The pa- tients receiving repeat transrectal prostate biopsies were pathologically diagnosed as lower Gleason grade prostate cancers. Conclusion： The cancer detection rate of repeat biopsy prostate cancer is lower than that of initial biopsy. Our study showed that the optimizing prostate biopsy is important to improve the detection rate of repeat transrecta~ prostate biopsies patients.
基金Supported by Shengjing Hospital Science and Technology Program,No.MC05.
文摘BACKGROUND Persistent suspicion of prostate cancer(PCa)due to a rising prostate-specific antigen(PSA)level after repeated negative biopsies is a serious challenge in clinical practice.AIM To determine the role of Hiraoka’s transurethral detachment of the prostate(TUDP)combined with biopsy of the peripheral zone during the same session in patients with repeated negative biopsies in the diagnosis of PCa.METHODS We retrospectively evaluated the records of 10 patients who were eligible for inclusion in our hospital between December 2012 and August 2017.Patient demographics,a family history of PCa,the number of biopsies,prostate volume,pathological examination,and perioperative PSA level were obtained.RESULTS Two of 10 patients were pathologically diagnosed with PCa after surgery;the Gleason scores were 4+4 and 4+3,respectively.Both patients subsequently underwent laparoscopic radical prostatectomy.The median PSA levels preoperatively,and 3 mo and 1 year postoperatively in the other eight patients who were diagnosed with benign prostate hyperplasia after surgery were 19.10 ng/mL,1.10 ng/mL,and 1.15 ng/mL,respectively.The adjusted P values of the 3-mo and 1-year post-operative PSA level vs pre-operative PSA level were 0.003 and 0.026,respectively.None of the patients had increased PSA levels or PCa detected after a median 35 mo of follow-up.CONCLUSION TUDP combined with peripheral zone biopsy may improve the detection rate of PCa in patients with repeated negative biopsies.The PSA level declined rapidly in patients who had negative pathological examinations after TUDP,which remained stable 1 year after surgery.
基金supported by the National Natural Science Foundation of China(Grant Nos.51805047 and 52175003)the Outstanding Youth Program of Hunan Education Department(Grant No.23B0335)the Natural Science Foundation of Hunan Province(Grant Nos.2023JJ30021 and 2023JJ50077).
文摘The introduction of wireless capsule endoscopy has brought a revolutionary change in the diagnostic procedures for gastrointestinal disorders.Biopsy,an essential procedure for disease diagnosis,has been integrated into robotic capsule endoscopy to augment diagnostic capabilities.In this study,we propose a magnetically driven biopsy robot based on a Kresling origami.Considering the bistable properties of Krelsing origami and the elasticity of the creases,a foldable structure of the robot with constant force characteristics is designed.The folding motion of the structure is used to deploy the needle into the target tissue.The robot is capable of performing rolling motion under the control of an external magnetic drive system,and a fine needle biopsy technique is used to collect deep tissue samples.We also conduct in vitro rolling experiments and sampling experiments on apple tissues and pork tissues,which verify the performance of the robot.
基金Supported by the National Key Research and Development Program of China,No.2023YFC2413800the Taishan Scholars Program of Shandong Province,No.tsqn202306344the National Natural Science Foundation of China,No.82270580 and No.82070552.
文摘BACKGROUND Early detection of esophageal squamous neoplasms(ESN)is essential for improving patient prognosis.Optical diagnosis of ESN remains challenging.Probebased confocal laser endomicroscopy(pCLE)enables accurate in vivo histological observation and optical biopsy of ESN.However,interpretation of pCLE images requires histopathological expertise and extensive training.Artificial intelligence(AI)has been widely applied in digestive endoscopy;however,AI for pCLE diagnosis of ESN has not been reported.AIM To develop a pCLE computer-aided diagnostic system for ESN and assess its diagnostic performance and assistant efficiency for nonexpert endoscopists.METHODS The intelligent confocal laser endomicroscopy(iCLE)system consists of image recognition(based on inception-ResNet V2),video diagnosis,and quality judgment modules.This system was developed using pCLE images and videos and evaluated through image and prospective video recognition tests.Patients between June 2020 and January 2023 were prospectively enrolled.Expert and nonexpert endoscopists and the iCLE independently performed diagnoses for pCLE videos,with histopathology as the gold standard.Thereafter,the non-expert endoscopists performed a second assessment with iCLE assistance.RESULTS A total of 25056 images from 2803 patients were selected for iCLE training and validation.Another 2442 images from 226 patients were used for testing.iCLE achieved a high accuracy of 98.3%,sensitivity of 95.3%and specificity of 98.8%for diagnosing ESN images.A total of 2581 patients underwent upper gastrointestinal pCLE examination and were prospectively screened;54 patients with suspected ESN were enrolled.Overall,187 videos from 67 lesions were assessed by iCLE,three nonexpert and three expert endoscopists.iCLE achieved a high accuracy,sensitivity and specificity of 90.9%,92.0%,and 90.2%,respectively.Compared to experts,iCLE showed significantly higher sensitivity(92.0%vs 80.4%;P<0.001)and negative predictive value(94.4%vs 87.7%;P=0.003).With iCLE assistance,nonexpert endoscopists showed significant improvements in accuracy(from 83.6%to 88.6%)and sensitivity(from 76.0%to 89.8%).CONCLUSION iCLE system demonstrated high diagnostic performance for ESN.It can assist nonexpert endoscopists in improving the diagnostic efficiency of pCLE for ESN and has the potential for reducing unnecessary biopsies.
基金supported by the National Natural Science Foundation of China(No.52105072)Zhejiang Provincial Natural Science Foundation of China(No.LZ24E050004)+2 种基金Jiangsu Provincial Outstanding Youth Program(No.BK20230072)a grant from Suzhou Industrial Foresight and Key Core Technology Project(No.SYC2022044)grants from Jiangsu Qinglan Project and Jiangsu 333 High-level Talents.
文摘Wireless capsule endoscopy(WCE)has the potential to fully replace conventional wired counterparts for its low invasiveness.Recent studies have attempted to expand the functions of capsules toward this goal.However,limitations in space and energy supply have resulted in the inability to perform multiple diagnostic and treatment tasks using a single capsule.In this study,we developed a dual-functional capsule robot(DFCR)for drug delivery and tissue biopsy based on magnetic torsion spring technology.The delivery module was shown to rotate the push rod with a thrust of 894 mN to release approximately 0.3 mL of semisolid drug.The biopsy module used a built-in blade to cut tissue with a shear stress of 22.87 MPa,producing a sample of approximately 1.8 mm3.Additionally,a five-degree-of-freedom permanent magnet drive system was developed.By adjusting the strength of the unidirectional magnetic field generated by an external magnet,the capsule can be wirelessly controlled to sequentially trigger the two functions.Ex vivo tests on porcine stomachs confirmed the feasibility of the prototype capsule(12 mm in diameter and 45 mm in length)in active movement,medication,and tissue biopsy.The newly developed DFCR further expands the clinical application prospects of WCE robots in minimally invasive surgery.
文摘BACKGROUND Percutaneous liver biopsies,including coaxial needle biopsy(CNB),are the pre-ferred method for tissue sampling to diagnose or characterize an array of hepatic conditions.Despite the advent of intraprocedural image guidance,and various“plugging”techniques,bleeding remains a frequent and potentially highly mor-bid complication,particularly in patients with bleeding risks.Thus,post-biopsy bleeding risk leads to extended patient monitoring,and in significant cases,ad-ditional imaging,intervention,and even surgery.Very rarely,death has resulted.CASE SUMMARY We report a series of five image-guided liver biopsy cases undertaken due to a variety of clinical conditions followed by the use of a new electrocautery hemo-stasis device called SinglePass Kronos.Indications for the CNB included non-alcoholic steatohepatitis,hepatocellular carcinoma and cirrhosis,abnormal liver function tests with positive autoimmune serologies,abnormal imaging findings,and jaundice.All biopsy procedures were successful with no complications th-rough 30 days following CNB.Post-procedure ultrasound confirmed the absence of bleeding in all five cases.CONCLUSION Hemostasis of CNB tracts using SinglePass Kronos was obtained in all cases.Ad-ditional study of this device is warranted.
基金supported financially by the National Nature Science Foundation of China(No.82373355,No.82172703,No.82303856,and No.82473505)the Discipline Leader Project of Shanghai Municipal Health Commission(No.2022XD013)the AoXiang Project of Shanghai Anti-Cancer Association(No.SACA-AX202302).
文摘The choice of biopsy method is critical in diagnosing prostate cancer(PCa).This retrospective cohort study compared systematic biopsy(SB)or cognitive fusion-targeted biopsy combined with SB(CB)in detecting PCa and clinically significant prostate cancer(csPCa).Data from 2572 men who underwent either SB or CB in Fudan University Shanghai Cancer Center(Shanghai,China)between January 2019 and December 2023 were analyzed.Propensity score matching(PSM)was used to balance baseline characteristics,and detection rates were compared before and after PSM.Subgroup analyses based on prostate-specific antigen(PSA)levels and Prostate Imaging-Reporting and Data System(PI-RADS)scores were performed.Primary and secondary outcomes were the detection rates of PCa and csPCa,respectively.Of 2572 men,1778 were included in the PSM analysis.Before PSM,CB had higher detection rates for both PCa(62.9%vs 52.4%,odds ratio[OR]:1.54,P<0.001)and csPCa(54.9%vs 43.3%,OR:1.60,P<0.001)compared to SB.After PSM,CB remained superior in detecting PCa(63.1%vs 47.9%,OR:1.86,P<0.001)and csPCa(55.0%vs 38.2%,OR:1.98,P<0.001).In patients with PSA 4–12 ng ml−1(>4 ng ml-1 and≤12 ng ml-1,which is also applicable to the following text),CB detected more PCa(59.8%vs 40.7%,OR:2.17,P<0.001)and csPCa(48.1%vs 27.7%,OR:2.42,P<0.001).CB also showed superior csPCa detection in those with PI-RADS 3 lesions(32.1%vs 18.0%,OR:2.15,P=0.038).Overall,CB significantly improves PCa and csPCa detection,especially in patients with PSA 4–12 ng ml−1 or PI-RADS 3 lesions.
文摘Background:Transrectal(TR)and transperineal(TP)biopsies are commonly used methods for diagnosing prostate cancer.However,their comparative effectiveness in conjunction with machine learning(ML)techniques remains underexplored.This study aimed to evaluate the predictive accuracy of ML algorithms in detecting prostate cancer using data derived from TR and TP biopsies.Methods:The clinical records of patients who underwent prostate biopsy at King Saud University Medical City and King Faisal Specialist Hospital and Research Centerin Riyadh,Saudi Arabia,between 2018 and 2025 were analyzed.Data were used to train and testMLmodels,including eXtreme Gradient Boosting(XGBoost),Decision Tree,Random Forest,and Extra Trees.Results:The two datasets are comparable.The models demonstrated exceptional performance,achieving accuracies of up to 96.49%and 95.56%on TP and TR biopsy datasets,respectively.The area under the curve(AUC)values were also high,reaching 0.9988 for TP and 0.9903 for TR biopsy predictions.Conclusion:These findings highlight the potential of MLto enhance the diagnostic accuracy of prostate cancer detection irrespective of the biopsy method.However,TP biopsy data showed marginally higher accuracy,possibly because of the lower risk of contamination.While ML holds great promise for transforming prostate cancer care,further research is needed to address limitations.Collaboration between clinicians,data scientists,and researchers is crucial to ensure the clinical relevance and interpretability of ML models.
文摘Trophectoderm(TE)biopsy has become the preferred approach in preimplantation genetic testing,providing clear advantages over polar body and cleavage-stage biopsy.However,the optimal timing and methodology for blastocyst biopsy remain subjects of ongoing debate.McArthur et al in 2005 were the first to demonstrate the safety of TE biopsy at the hatching blastocyst stage with laser-assisted opening in the zona pellucida(ZP)on Day 3,reporting 100%survival of 1050 biopsied blastocysts,all of which re-expanded,with an implantation rate of 41%[1].Nearly a decade later,Capalbo et al in 2014 introduced a modified strategy,performing biopsy on fully expanded blastocysts by creating a laser-assisted ZP opening and immediately aspirating TE cells on Day 5.
基金Supported by the National Natural Science Foundation of China,No.82170103Natural Science Foundation of Fujian Province,No.2024J011325+1 种基金Young People Training Project from Fujian Province Health Bureau,No.2020GGB057 and No.2023QNB008Xiamen Medical and Health Guidance Project,No.3502Z20224ZD1060,No.3502Z20214ZD1043,and No.3502Z20224ZD1058.
文摘BACKGROUND To evaluate the diagnostic utility of endobronchial ultrasound(EBUS)-guided mediastinal lymph node fenestration biopsy in atypical sarcoidosis using fine biopsy forceps[i.e.,EBUS-transbronchial forceps biopsy(TBFB)].CASE SUMMARY In this case series,two atypical sarcoidosis cases admitted in 2024 were retrospectively analyzed,both of whom lacked classical clinical manifestations.After chest computed tomography/positron emission tomography-computed tomography imaging and serum angiotensin-converting enzyme testing,EBUStransbronchial needle aspiration was performed using a 21-G needle.Subsequently,tissue sampling was performed at the enlarged puncture site by means of a 1.2-mm fine biopsy forceps.At the same time,bronchoalveolar lavage fluid lymphocyte subset analysis was conducted.CONCLUSION Both cases demonstrated non-caseating granulomatous inflammation on histopathology,elevated serum angiotensin-converting enzyme levels,and markedly increased CD4/CD8 ratios in bronchoalveolar lavage fluid.Case 1 was observed after confirmation of stage II sarcoidosis,whereas case 2 required glucocorticoid therapy due to the involvement of multiple systems.EBUS-TBFB can be used to make a definitive pathological diagnosis.For radiologically atypical sarcoidosis,EBUS-TBFB improves diagnostic accuracy by obtaining larger histological samples,thereby addressing the limitations of transbronchial needle aspiration cytology.This approach significantly improves differential diagnostic efficacy and holds substantial clinical relevance for broader adoption.
文摘BACKGROUND Liver biopsy is an important diagnostic tool to investigate patients with suspected liver disease.The efficacy and safety of endoscopic ultrasound-guided liver biopsy(EUS-LB)as a method for liver tissue acquisition remain uncertain.AIM To study the diagnostic yield and safety of EUS-LB in patients with suspected parenchymal liver disease.METHODS This is a retrospective observational cohort study of patients undergoing EUS-LB in 2 tertiary-care centers in Kuwait in the period between January 2022-June 2025.The primary outcome was sample adequacy,while secondary outcomes included histological quality of the specimen and adverse events.Predictors of increased diagnostic adequacy and specimen quality were explored.RESULTS A total of 50 patients[mean age 43.9(15.5)years,40%males]were included.The left liver lobe was targeted for biopsy in most patients(96%),and 19-gauge fine needle aspiration(FNA)was used in most cases(52%).The median number of passes performed was 3(range 2-5),and the heparin-wet suction technique was used in 40%of patients.The overall diagnostic adequacy of EUS-LB was 86%,with no significant difference between 19-gauge FNA and 19-gauge fine needle biopsy(FNB)needles.Fulfillment of the European Association for the Study of Liver(EASL)and the American Association for the Study of Liver Diseases criteria was achieved in 54%and 34%,respectively,with a significantly higher number of patients fulfilling these criteria when FNB needle was used compared to FNA needle(83.3%vs 26.9%,P<0.0001)and(62.5%vs 7.7%,P<0.0001),respectively.Only 1 patient(2.0%)developed adverse post-procedure events,namely bleeding requiring transfusion.Multivariate regression analysis did not identify any factor that increased diagnostic adequacy;however,the use of FNB needles and wet heparin suction methods were associated with significantly increased odds of fulfilling EASL criteria,while performing more than 2 passes reduced the quality of the specimen.CONCLUSION EUS-LB is an effective and safe method for obtaining liver biopsy in patients with suspected parenchymal liver disease.EUS-LB demonstrated a favorable safety profile in our cohort,although larger prospective studies are required to validate bleeding risk.The use of 19-gauge FNB needles,wet-heparin suction technique,and performing≤2 passes is associated with improved quality of the specimen obtained without increasing the risk of adverse events.
基金supported by a grant from 2021 Shandong Provincial Social Science Popularization and Application Research Project (2021-SKZC-18)。
文摘To the Editor:With the popularity of liver transplantation(LT)and the inspiration for long-time survival,issues related to evaluating the liver allograft have increased in recent years[1-3].Although there has been renewed interest in non-invasive methods to evaluate diffuse liver disease,liver biopsy is still the golden standard in clinical practice,particularly for liver transplant recipients(LTRs).The liver biopsy has always been performed in LTRs as a part of standard procedure in cases whose liver function was normal,named as protocol liver biopsy,or to identify histological abnormalities for abnormal liver function and provide guidance for the adjustment of immunosuppressive regimen[4,5].Percutaneous liver biopsy(PLB)has been frequently conducted in LTRs;however,the clinical implementation of protocol liver biopsy by PLB in LTRs is challenging due to their suboptimal compliance,particularly in China[6].Besides,the PLB procedure has been associated with discomfort and potentially life-threatening complications in the general population,as reported in the literature[7,8].
