Pancreatic cancer is recognized as one of the leading causes of cancer mortality,representing the second most common source of cancer-related deaths within the gastrointestinal domain.Surgical resection is currently t...Pancreatic cancer is recognized as one of the leading causes of cancer mortality,representing the second most common source of cancer-related deaths within the gastrointestinal domain.Surgical resection is currently the only definitive treatment;however,the subtle emergence of symptoms often leads to a diagnosis at an advanced stage,with merely 10%-15%of patients being eligible for surgical intervention.The primary obstacle to achieving a potential radical resection is the presence of distant metastatic disease or invasion of adjacent major vascular structures.This review aims to highlight the critical role of endoscopic ultrasound in the diagnosis and staging of pancreatic tumors.We systematically searched PubMed,MEDLINE and Web of Science by using‘pancreatic cancer’and‘endoscopic ultrasonography’as keywords.Relevant studies were reviewed and analyzed.Endoscopic ultrasonography(EUS)is efficient in the diagnosis and staging of pancreatic cancer,past studies reported the accuracy of EUS is 63%to 94%for T-staging and 44%to 82%for N-staging but there are still limitations that need to be comprehensively applied with other diagnostic methods to evaluation of distant metastasis for surgical resectability.Our review aims to reveal the value for the staging of pancreatic cancer.展开更多
BACKGROUND Rectal cancer requires accurate preoperative assessment of T stage and differentiation grade for treatment planning.Traditional imaging and serum markers have limitations in diagnostic accuracy.AIM To evalu...BACKGROUND Rectal cancer requires accurate preoperative assessment of T stage and differentiation grade for treatment planning.Traditional imaging and serum markers have limitations in diagnostic accuracy.AIM To evaluate the predictive value of dynamic contrast-enhanced-magnetic resonance imaging(DCE-MRI)parameters and serum biomarkers[carbohydrate antigen(CA)19-9,CA125]for determining T stage and differentiation grade in rectal cancer.METHODS We conducted a retrospective review of clinical data from 126 patients who were pathologically diagnosed with rectal cancer between January 2021 to June 2024.Each patient underwent DCE-MRI scans and serum tests for CA19-9 and CA125.Receiver operating characteristic curves were utilized to assess the diagnostic value of DCE-MRI parameters,including volume transfer constant(Ktrans),rate constant(Kep),and volume fraction of extravascular extracellular space(Ve),as well as serum biomarkers for staging and grading rectal cancer.The DeLong test algorithm was employed to evaluate differences in diagnostic performance among the various indicators.RESULTS There were statistically higher levels of Ktrans,Ve,CA19-9,and CA125 serum concentrations of patients with advanced T stages and on poorly differentiated tumors than that in patients with low stages and moderate to high differentiation(P<0.05).Combined use of Ktrans and Ve for T stage diagnosis showed an area under the curve(AUC)of 0.892[95%confidence interval(CI):0.832-0.952],which increased to 0.923(95%CI:0.865-0.981)when combined with serum biomarkers.For grades differentiation,the combined DCE-MRI parameters had an AUC of 0.883(95%CI:0.821-0.945),which rose to 0.912(95%CI:0.855-0.969)when combined with serum markers.According to the Delong test,the combined diagnostic method performed better than a single diagnostic method(P<0.05).CONCLUSION The combined application of DCE-MRI functional parameters and serum tumor markers can significantly improve the diagnostic accuracy of T staging and differentiation degree of rectal cancer,providing a new approach to improve the preoperative assessment system of rectal cancer.This combined diagnostic model has important clinical application value,but further validation is needed through large-scale multicenter studies.展开更多
AIM The purpose of this study was to evaluate the diagnostic value of trefoil factor family 3(TFF3) for the early detection of colorectal cancer(CC). METHODS Serum TFF3 and carcino-embryonic antigen(CEA) were detected...AIM The purpose of this study was to evaluate the diagnostic value of trefoil factor family 3(TFF3) for the early detection of colorectal cancer(CC). METHODS Serum TFF3 and carcino-embryonic antigen(CEA) were detected in 527 individuals, including 115 healthy control(HC), 198 colorectal adenoma(CA), and 214 CC individuals in the training group. RESULTS Serum TFF3 showed no significant correlation with age, gender, or tumor location but showed significant correlation with the tumor stage. Serum TFF3 in the CC group was significantly higher than in the HC or CA group. The AUC values of TFF3 for discriminating between HC and CC and between CA and CC were 0.930(0.903, 0.958) and 0.834(0.796, 0.873). A multivariate model combining TFF3 and CEA was built. Compared to TFF3 or CEA alone, the multivariate model showed significant improvement(P < 0.001). For discriminating between HC and CC, HC and early stage CC, HC and advanced stage CC, CA and CC, CA and early stage CC, and CA and advanced stage CC in the training group, the sensitivities were 92.99%, 91.46%, 93.18%, 73.83%, 76.83%, and 81.82%, and the specificities were 91.30%, 91.30%, 93.91%, 88.38%, 77.27%, and 88.38%, respectively. After validation, the sensitivities were 89.39%, 85.71%, 90.79%, 72.73%, 71.43%, and 78.95%, and the specificities were 87.85%, 87.85%, 2.52%, 87.85%, 80.77%, and 87.50%, respectively. CONCLUSION The multivariate diagnostic model that included TFF3 and CEA showed significant improvement over the conventional biomarker CEA and might provide a potential method for the early detection of CC.展开更多
BACKGROUND Numerous studies have demonstrated that human epididymis protein 4(HE4)is overexpressed in various malignant tissues including ovarian,endometrial,lung,breast,pancreatic,and gastric cancers.However,no study...BACKGROUND Numerous studies have demonstrated that human epididymis protein 4(HE4)is overexpressed in various malignant tissues including ovarian,endometrial,lung,breast,pancreatic,and gastric cancers.However,no study has examined the diagnostic impact of HE4 in patient with esophageal squamous cell carcinoma(ESCC)until now.AIM To analyze the value of four serum tumor markers for the diagnosis of ESCC,and examine the associations of serum levels of HE4 with ESCC patients’clinicopathological characteristics.METHODS The case group consisted of 80 ESCC patients,which were compared to a control group of 56 patients with benign esophageal disease.Serum levels of HE4,carcinoma embryonic antigen(CEA),alpha fetal protein,and carbohydrate antigen 19-9(CA19-9)were detected by ELISA.The associations of serum HE4 levels with ESCC patients’clinicopathological characteristics such as gender,tumor location,and pathological stage were also examined after operation.RESULTS The result of ELISA showed that serum HE4 level was significantly higher in the patients with ESCC than in the controls,and the staining intensity was inversely correlated with the pathological T and N stages.Serum HE4 levels had a sensitivity of 66.2%and specificity of 78.6%when the cutoff value was set at 3.9 ng/mL.Moreover,the combined HE4 and CA19-9 increased the sensitivity to 83.33%,and interestingly,the combination of HE4 with CEA led to the most powerful sensitivity of 87.5%.Furthermore,A positive correlation was observed between HE4 serum levels and pathological T and N stages(P=0.0002 and 0.0017,respectively),but there was no correlation between HE4 serum levels and ESCC patient gender(P=0.4395)or tumor location(P=0.6777).CONCLUSION The results of this study suggest that detection of serum HE4 levels may be useful in auxiliary diagnosis and evaluation of the progression of ESCC.展开更多
BACKGROUND Pleural effusions occur for various reasons,and their diagnosis remains challenging despite the availability of different diagnostic modalities.Medical thoracoscopy(MT)can be used for both diagnostic and th...BACKGROUND Pleural effusions occur for various reasons,and their diagnosis remains challenging despite the availability of different diagnostic modalities.Medical thoracoscopy(MT)can be used for both diagnostic and therapeutic purposes,especially in patients with undiagnosed pleural effusion.AIM To assess the diagnostic efficacy and safety of MT in patients with pleural effusion of different causes.METHODS Between January 1,2012 and April 30,2021,patients with pleural effusion underwent MT in the Department of Respiratory Medicine,The Second Affiliated Hospital of Xi’an Jiaotong University(Shaanxi,China).According to the discharge diagnosis,patients were divided into malignant pleural effusion(MPE),tuberculous pleural effusion(TBPE),and inflammatory pleural effusion(IPE)groups.General information,and tuberculosis-and effusion-related indices of the three groups were analyzed.The diagnostic yield,diagnostic accuracy,performance under thoracoscopy,and complications of patients were compared among the three groups.Then,the significant predictive factors for diagnosis between the MPE and TBPE groups were analyzed.RESULTS Of the 106 patients enrolled in this 10-year study,67 were male and 39 female,with mean age of 57.1±14.184 years.Among the 74 thoracoscopy-confirmed patients,41(38.7%)had MPE,21 had(19.8%)TBPE,and 32(30.2%)were undiagnosed.Overall diagnostic yield of MT was 69.8%(MPE:75.9%,TBPE:48.8%,and IPE:75.0%,with diagnostic accuracies of 100%,87.5%,and 75.0%,respectively).Under thoracoscopy,single or multiple pleural nodules were observed in 81.1%and pleural adhesions in 34.0%with pleural effusions.The most common complication was chest pain(41.5%),followed by chest tightness(11.3%)and fever(10.4%).Multivariate logistic regression analyses showed effusion appearance[odds ratio(OR):0.001,95%CI:0.000-0.204;P=0.010]and carcinoembryonic antigen(OR:0.243,95%CI:0.081-0.728;P=0.011)as significant for differentiating MPE and TBPE,with area under the receiver operating characteristic curve of 0.977(95%CI:0.953-1.000;P<0.001).CONCLUSION MT is an effective,safe,and minimally invasive procedure with high diagnostic yield for pleural effusion of different causes.展开更多
ObjectiveTo investigate the diagnostic value of 18F-fluorodeoxyglucose positron emission tomography （18F-FDG PET） in the as-sessment of myocardial viability in patients with known coronary artery disease （CAD） whe...ObjectiveTo investigate the diagnostic value of 18F-fluorodeoxyglucose positron emission tomography （18F-FDG PET） in the as-sessment of myocardial viability in patients with known coronary artery disease （CAD） when compared to99mTc single photon emission computed tomography （SPECT） and echocardiography, with invasive coronary angiography as the gold standard.MethodsThirty patients with diagnosed CAD met the selection criteria, with 10 of them （9 men, mean age 59.5 ± 10.5 years） undergoing all of these imaging proce-dures consisting of SPECT and PET, echocardiography and invasive angiography. Diagnostic sensitivity of these less invasive modalities for detection of myocardial viability was compared to invasive coronary angiography. Inter- and intra-observer agreement was assessed for di-agnostic performance of SPECT and PET.ResultsOf all patients with proven CAD, 50% had triple vessel disease. Diagnostic sensitivity of SPECT, PET and echocardiography was 90%, 100% and 80% at patient-based assessment, respectively. Excellent agreement was achieved between inter-observer and intra-observer agreement of the diagnostic value of SPECT and PET in myocardial viability （k= 0.9）. Conclusion18F-FDG PET has high diagnostic value in the assessment of myocardial viability in patients with known CAD when com-pared to SPECT and echocardiography. Further studies based on a large cohort with incorporation of18F-FDG PET into patient management are warranted.展开更多
Objective To explore the correlation between macrophages and interleukin-10(IL-10 in the peripheral blood of breast cancer(BC)patients and the diagnostic value of joint detection.Methods BC patients(n=50)and healthy c...Objective To explore the correlation between macrophages and interleukin-10(IL-10 in the peripheral blood of breast cancer(BC)patients and the diagnostic value of joint detection.Methods BC patients(n=50)and healthy controls(n=40)were prospectively recruited.The percentage of circulating cluster of differentiation 14(CD 14)macrophage cells was analyzed by flow cytometry,and an enzyme-linked immunosorbent assay(ELISA)was used to detect IL-10 expression levels.Receiver operating characteristic(ROC)curves were used to verify the diagnostic value of the models based on the expression of CD14 macrophage cell populations and IL-10.In addition,the association between model expression and clinicopathological characteristics was investigated.Another 30 patients with BC and 30 with benign breast disease were selected to validate the IL-10 and CD14 macrophage joint detection model using the same method.Results CD14 macrophage and IL-10 expression levels in BC patients were higher than those in healthy controls(P<0.05).The ROC curve showed that the area under the curve(AUC)of CD14+macrophages combined with IL-10 was 0.830,the sensitivity was 72.0%,and the specificity was 87.5%.Its diagnostic efficiency was better than all other single and joint detections.Correlation analysis of clinicopathological features showed that IL-10 and CD14+macrophage joint detection was significantly correlated with tumor size,tumor-node-metastasis(TNM)stage,and lymph node,estrogen receptor(ER),and Ki-67 expression(P<0.05).The validation analysis results were consistent with the test results.Conclusion Peripheral blood macrophages can be an independent diagnostic marker for BC.Joint detection of CD14-macrophages and IL-10 suggests poor prognosis,which has unlimited potential to guide BC development and provides a new theory for studying tumor-associated macrophages in BC.展开更多
[Objectives]To explore the relationship between neutrophil percentage to albumin ratio(NPAR),monocyte to high density lipoprotein ratio(MHR),fasting blood glucose(GLU)and CAD+T2DM and its diagnostic value.[Methods]A t...[Objectives]To explore the relationship between neutrophil percentage to albumin ratio(NPAR),monocyte to high density lipoprotein ratio(MHR),fasting blood glucose(GLU)and CAD+T2DM and its diagnostic value.[Methods]A total of 3937 patients who underwent coronary angiography in the Affiliated Hospital of Chengde Medical University from January 2016 to December 2018 were collected.The patients with Gensini score>0 and diabetes were selected as the experimental group(CAD+T2DM,n=756),and the patients with Gensini score=0 and without diabetes were taken as the control group(n=388),with a total of 1144 cases.The patient's medical record number,sex,age,contact number,biochemical test results,cardiac color ultrasound,coronary artery imaging and other data were recorded.NPAR,MHR,and GLU were calculated.A binary Logistic regression model was established combined with the receiver operating characteristic(ROC)curve.The predictive value of single index and joint test for CAD+T2DM was analyzed.[Results]The serum levels of NPAR,MHR and GLU in CAD+T2DM were significantly higher than those in the control group.Binary Logistic regression analysis showed that serum NPAR,MHR and GLU were risk factors for CAD+T2DM(P<0.05).The final prediction model is P=1/[1+e-(-3.722+0.014×NPAR+0.51×MHR+0.461×GLU)].ROC curve showed that the area under the curve of serum NPAR,MHR and GLU was 0.739,0.628 and 0.852,respectively,and the prediction probability of combined detection was 0.882,which was significantly higher than that of single index.[Conclusions]There was a close correlation between serum NPAR,MHR,GLU and CAD+T2DM in patients with coronary heart disease.The combined application of these indexes can significantly improve the predictive value of CAD+T2DM.展开更多
BACKGROUND Acute gastrointestinal injury(AGI)is common in intensive care unit(ICU)and worsens the prognosis of critically ill patients.The four-point grading system proposed by the European Society of Intensive Care M...BACKGROUND Acute gastrointestinal injury(AGI)is common in intensive care unit(ICU)and worsens the prognosis of critically ill patients.The four-point grading system proposed by the European Society of Intensive Care Medicine is subjective and lacks specificity.Therefore,a more objective method is required to evaluate and determine the grade of gastrointestinal dysfunction in this patient population.Digital continuous monitoring of bowel sounds and some biomarkers can change in gastrointestinal injuries.We aimed to develop a model of AGI using continuous monitoring of bowel sounds and biomarkers.AIM To develop a model to discriminate AGI by monitoring bowel sounds and biomarker indicators.METHODS We conducted a prospective observational study with 75 patients in an ICU of a tertiary-care hospital to create a diagnostic model for AGI.We recorded their bowel sounds,assessed AGI grading,collected clinical data,and measured biomarkers.We evaluated the model using misjudgment probability and leave-one-out cross-validation.RESULTS Mean bowel sound rate and citrulline level are independent risk factors for AGI.Gastrin was identified as a risk factor for the severity of AGI.Other factors that correlated with AGI include mean bowel sound rate,amplitude,interval time,Sequential Organ Failure Assessment score,Acute Physiology and Chronic Health Evaluation II score,platelet count,total protein level,blood gas potential of hydrogen(pH),and bicarbonate(HCO3-)level.Two discriminant models were constructed with a misclassification probability of<0.1.Leave-one-out cross-validation correctly classified 69.8%of the cases.CONCLUSION Our AGI diagnostic model represents a potentially effective approach for clinical AGI grading and holds promise as an objective diagnostic standard for AGI.展开更多
BACKGROUND Despite significant advancements in the medical treatment of primary hepato-cellular carcinoma(PHC)in recent years,enhancing therapeutic effects and im-proving prognosis remain substantial challenges worldw...BACKGROUND Despite significant advancements in the medical treatment of primary hepato-cellular carcinoma(PHC)in recent years,enhancing therapeutic effects and im-proving prognosis remain substantial challenges worldwide.AIM To investigate the expression levels of serum vascular endothelial growth factor(VEGF)and interleukin(IL)-17 in patients with PHC and evaluate their diagnostic value while exploring their relationship with patients’clinical characteristics.METHODS The study included 50 patients with confirmed PHC who visited Wuhan Han-yang Hospital from January 2021 to January 2022,and 50 healthy individuals from the same period served as the control group.Serum VEGF and IL-17 levels in both groups were measured by Enzyme-Linked Immunosorbent Assay,and their diagnostic value was assessed using receiver operating characteristic(ROC)curves.Pearson correlation analysis was performed to examine the relationship between serum VEGF and IL-17 levels.Pathological data of the PHC patients were analyzed to determine the relationship between serum VEGF and IL-17 levels and pathological characteristics.RESULTS Serum VEGF and IL-17 levels were significantly higher in the study group com-pared to the control group(P<0.05).No significant association was observed between serum VEGF and IL-17 levels and gender,age,combined cirrhosis,tumor diameter,or degree of differentiation(P>0.05).However,there was a significant relationship between clinical TNM stage,tumor metastasis,and serum VEGF and IL-17 levels(P<0.05).Correlation analysis revealed a positive correlation between serum VEGF and IL-17(P<0.05).ROC analysis demonstrated that both serum VEGF and IL-17 had good diagnostic efficacy for PHC.CONCLUSION Serum VEGF and IL-17 levels were significantly higher in PHC patients compared to healthy individuals.Their levels were closely related to pathological features such as tumor metastasis and clinical TNM stage,and there was a significant positive correlation between VEGF and IL-17.These biomarkers may serve as valuable reference in-dicators for the early diagnosis and treatment guidance of PHC.展开更多
BACKGROUND Colorectal cancer(CRC)is a highly malignant cancer with a high incidence and mortality in China.It is urgent to find a diagnostic marker with higher sensitivity and specificity than the traditional approach...BACKGROUND Colorectal cancer(CRC)is a highly malignant cancer with a high incidence and mortality in China.It is urgent to find a diagnostic marker with higher sensitivity and specificity than the traditional approaches for CRC diagnosis.AIM To provide new ideas for the diagnosis of CRC based on serum proteomics.METHODS Specimens from 83 healthy people,62 colon polyp(CRP)patients,and 101 CRC patients were analyzed by matrix-assisted laser desorption/ionization time-offlight mass spectrometry.The diagnostic value of the profiles of differentially expressed proteins was then analyzed.RESULTS Compared with the healthy control group,CRC patients had elevated expression of 5 proteins and reduced expression of 14 proteins.The area under the curve(AUC)for a differentially expressed protein with a mass-to-charge ratio of 2022.34 was the largest;the AUC was 0.843,which was higher than the AUC of 0.717 observed with carcinoembryonic antigen(CEA),and the sensitivity and specificity of this identified marker were 75.3%and 79.5%,respectively.After cross-validation,the accuracy of diagnosis using levels of this differentially expressed protein was 82.37%.Compared with the CRP group,the expression of 3 proteins in the serum of CRC patients was elevated and 11 proteins were expressed at reduced levels.Proteins possessing mass-to-charge ratio values of 2899.38 and 877.3 were selected to establish a classification tree model.The results showed that the accuracy of CRC diagnosis was 89.5%,the accuracy of CRP diagnosis was 81.6%,and the overall accuracy of this approach was 86.3%.The overall sensitivity and specificity of diagnosis using the proteomics approach were 81.8%and 66.75%,respectively.The sensitivities and specificities of diagnoses based on CEA and carbohydrate antigen 19-9 expression were 55.6%and 91.3%and 65.4%and 65.2%,respectively.CONCLUSION We demonstrated that serum proteomics may be helpful for the detection of CRC,and it may assist clinical practice for CRC diagnosis.展开更多
Serum pancreatic tissue carcinoma antigen (PCA) was measured by ELISA in 396 patients with pancreatic carcinoma (PC) and other diseases diagnosed by clinical examination, histopathology and operation. Serum PCA more t...Serum pancreatic tissue carcinoma antigen (PCA) was measured by ELISA in 396 patients with pancreatic carcinoma (PC) and other diseases diagnosed by clinical examination, histopathology and operation. Serum PCA more than 300 U/ml was considered as diagnostic value for PC and 30-299 U/ml as probable index for PC. The sensitivity of PCA for PC was 78.2% (43/55), and the specifity 94.6%. The positive rate of PCA in other diseases were 0-13.3%. Combining the determination of PCA with B-mode ultrasonic scanning (BU). CT and/or ERCP (endos-copic retrograde cholangiopancreatography) may increase the diagnostic rate of PC to 89-91%, and with the "cocktail" of CA19-9, CEA (carcino-embryonic antigen) and RNase-C, PC be diagnosed in 88.9%. Therefore, it is suggest that PCA si a promising tumor market of PC with high sensitivity and relative specificity.展开更多
Objective:To study is to evaluate the diagnostic value of the expression of thymidine kinase 1(TK1)in lung cancer through literature review and meta-analysis.Methods:Firstly,we searched Pubmed,Embase,Cochrane,Web of S...Objective:To study is to evaluate the diagnostic value of the expression of thymidine kinase 1(TK1)in lung cancer through literature review and meta-analysis.Methods:Firstly,we searched Pubmed,Embase,Cochrane,Web of Science,CBM,CNKI,Wanfang and other databases up to June 2022.Then two researchers separately selected the clinical study on diagnosis of lung cancer by the expression of the TK1 and treatment and obtained the full text of the literature.Then we evaluated the systematic quality and bias risk of the included literatures by using Revman 5.3 software,and the consistency among the covariables in meta analysis.Finally,the Sensitivity(Sen),the Specificity(Spe)and other indicators were analyzed by using Stata16.0 software.Results:The study included 37 literatures,including 3218 lung cancer cases and 2976 control cases.The meta-analysis showed that the Ser and Spe of the expression of the TK1 in the diagnosis of lung cancer were 0.63(95%CI:0.57,0.68)and 0.88(95%CI:0.84,0.91),while positive likelihood ratio(PLR)was 5.34(95%CI:4.02,7.1)and negative likelihood ratio(NLR)was 0.42(95%CI:0.37,0.48),diagnostic odd sratio(DOR)was 12.69(95%CI:8.91,18.08),and the area under the ROC curve(AUC)was 0.82(95%CI:0.79,0.85).When TK1,CEA and CYFRA21-1 were used as combined diagnostic indexes of lung cancer,Sen was 0.82(95%CI:0.76,0.86),Spe 0.78(95%CI:0.46,0.94),PLR 3.69(95%CI:1.28,10.66),NLR 0.24(95%CI:0.18,0.31),DOR 15.59(95%CI:4.56,53.36),AUC 0.84(95%CI:0.80,0.87).The Youden index of combined diagnosis was 0.60,which was higher than that of TK1 alone.Conclusion:TK1 alone as a diagnostic index of lung cancer has low Sen,but its Sep is higher.So it has a certain diagnostic value.TK1 combined with CEA and CYFRA21-1 has higher Sen in the diagnosis of lung cancer,and the diagnostic value is better.展开更多
Objective:To compare and analyze the clinical diagnostic value of multi-slice spiral CT and enhanced MRI for primary liver cancer(PLC),and to summarize the imaging findings.Methods:The research subjects in this articl...Objective:To compare and analyze the clinical diagnostic value of multi-slice spiral CT and enhanced MRI for primary liver cancer(PLC),and to summarize the imaging findings.Methods:The research subjects in this article were 50 patients with PLC who were admitted to our hospital from 2017 April to 2018 September.After the patients were admitted,they were examined by multi-slice spiral CT and enhanced MRI scanning,and the pathological diagnosis results were followed up.Relevant information was reviewed and analyzed.Results:The detection rate of multi-slice spiral CT was higher than that of MRI in the portal venous phase lesion detection.The difference was statistically significant(P<0.05).The detection rate of lesions in the arterial phase and delayed phase was not statistically significant(P>0.05);the diagnostic accuracy of multi-slice spiral CT was 85.96%,and the diagnostic accuracy of enhanced MRI scanning was 91.11%,which was not statistically significant(P>0.05).MRI scans showed the capsules of primary liver cancer better than CT,but the difference was not statistically significant(P>0.05).Conclusion:In conclusion,both multi-slice spiral CT and enhanced MRI can be used for the effective diagnosis of primary liver cancer intrahepatic lesions.The diagnostic value of the two is equivalent,but enhanced MRI has a slightly higher diagnostic accuracy and can be used as the preferred method.展开更多
Objective: to analyze the diagnostic value of thyroid CT plain scan + enhanced scan in patients with this study disease. Methods: the clinical data of 194 patients with study diseases from March 2019 to March 2020 wer...Objective: to analyze the diagnostic value of thyroid CT plain scan + enhanced scan in patients with this study disease. Methods: the clinical data of 194 patients with study diseases from March 2019 to March 2020 were analyzed retrospectively, of which 122 patients were benign, a total of 158;There were 36 patients with malignant tumors, a total of 44. They were divided into regular type (SCC) and irregular type (non SCC) according to calcification. The degree and distribution of calcification were analyzed. At the same time, the satisfaction of patients with examination services was counted. Results: among 122 benign patients, there were 46 patients with regular calcification and 76 patients with irregular calcification. Among the 36 malignant patients, 4 cases were regular and 32 cases were irregular. There were significant differences between regular and irregular types in benign and malignant nodules (P < 0.05);The distribution of benign and malignant nodules in irregular type is quite different from that around calcification after CT scanning, which is comparable (P < 0.05). After 194 patients received the examination, 98 patients were very satisfied with the examination service, 94 patients were relatively satisfied with the examination service, and 2 patients were dissatisfied with the examination service. The satisfaction with the examination service was 98.97%. Conclusion: plain and enhanced CT has certain differential diagnostic significance in the diagnosis of coarse calcification of thyroid nodules, and delayed enhanced CT has higher diagnostic value.展开更多
Objective:To explore the diagnostic value of conventional ultrasonography combined with contrast-enhanced ultrasonography in thyroid nodules.Methods:From June 2021 to July 2022,163 patients with thyroid nodules enroll...Objective:To explore the diagnostic value of conventional ultrasonography combined with contrast-enhanced ultrasonography in thyroid nodules.Methods:From June 2021 to July 2022,163 patients with thyroid nodules enrolled in our hospital were selected as research subjects.After pathological diagnosis,24 cases were malignant thyroid nodules,and 139 cases were benign thyroid nodules.The diagnosis rate of malignant and benign thyroid nodules was observed and analyzed,with 95%CI.Results:Among them,the malignant and benign detection rates of routine ultrasound were 88.63%and 75.00%,respectively,and the malignant and benign detection rates of contrast-enhanced ultrasound were 81.82%and 81.25%,respectively.The malignant and benign detection rates of conventional ultrasound combined with contrast-enhanced ultrasound were 93.18%and 87.50%,respectively,and the 95%CI was greater than 0.7.Conclusion:Conventional ultrasound combined with contrast-enhanced ultrasound can help improve the diagnostic accuracy of benign and malignant thyroid nodules and reduce the misdiagnosis rate.展开更多
Objective: To analyze and study the diagnostic value of multi-slice spiral CT and magnetic resonance imaging in patients with occult fractures. Methods: Forty patients from our hospital with occult fractures were sele...Objective: To analyze and study the diagnostic value of multi-slice spiral CT and magnetic resonance imaging in patients with occult fractures. Methods: Forty patients from our hospital with occult fractures were selected as the observation group for MRI diagnosis, and 40 patients as the control group for ct diagnosis. The positive detection rates of patients in the two groups were compared. Results The diagnostic effect of MRI technique was superior to that of CT technique (P < 0.05), and the positive detection rate of patients in the control group was lower than that of patients in the observation group. Conclusion The value of MRI three-dimensional reconstruction in patients with occult fractures is higher than that of multi-slice spiral CT technology, the fracture data of patients detected are more accurate, and the effect of its application value is more significant in the case of occult complex fractures, which is worthy of promotion in all hospitals.展开更多
Objective: this study aims to explore a new clinical multiparameter diagnostic formula for lower limb atherosclerotic stenosis / occlusion based on the retrospective data of 429 patients at Peking University Hospital....Objective: this study aims to explore a new clinical multiparameter diagnostic formula for lower limb atherosclerotic stenosis / occlusion based on the retrospective data of 429 patients at Peking University Hospital. Methods: this study is a retrospective study. A number of patients with color Doppler ultrasound from November 2013 to October 2021 and improved the test and measurement of common risk factors for atherosclerosis in the same period. A total of 429 cases were selected as the study data. According to the color Doppler ultrasound results, it was divided into the "normal / plaque group" and the "stenosis / occlusion group", including 300 cases in the "normal / plaque group" and 129 cases in the stenosis / occlusion group. Variables included in the diagnostic model screening in this study included age, sex, BMI, ApoA1, ApoB, HbA1c, Hcy, SUA, T C, L DL-C, H DL-C, TG, and blood pressure. Diagnostic models were constructed using logistic regression for variable screening using backward methods. Diagnostic efficacy was evaluated using ROC curves for both single measures and the final diagnostic formula. Results: after a variable screening, The final diagnostic formula is as follows: 0.07 Age (year) + Gender (male value of 0);Female value of-1.38) + HDL-C (normal value of 0;Low side to take a value of 0.79;High value-0.71) + ApoA1 (normal value 0;Low side to take the value of-0.75;High value-0.04) + HbA1c (normal value 0;High value 0.54) + SUA (normal value 0;High value-1.19) + B P (normal value 0;Normal high value value-0.67;Hypertension values were taken at 0.11) -5.17. The optimal threshold of this diagnostic formula is-0.852, specificity of 0.713, sensitivity of 0.760, and the area under the ROC curve is 0.79, which is greater than the area under the R OC curve of any single index in the diagnostic formula. It is a new index of more diagnostic value than other single risk factor indicators in the formula. Conclusion: the diagnosis of lower limb atherosclerotic stenosis / occlusion is of good clinical utility, and the first attempt to use the integration of atherosclerosis risk factors for multiple parameters, and then derive a new diagnostic index, providing a new idea and method for the prevention and treatment of atherosclerosis.展开更多
文摘Pancreatic cancer is recognized as one of the leading causes of cancer mortality,representing the second most common source of cancer-related deaths within the gastrointestinal domain.Surgical resection is currently the only definitive treatment;however,the subtle emergence of symptoms often leads to a diagnosis at an advanced stage,with merely 10%-15%of patients being eligible for surgical intervention.The primary obstacle to achieving a potential radical resection is the presence of distant metastatic disease or invasion of adjacent major vascular structures.This review aims to highlight the critical role of endoscopic ultrasound in the diagnosis and staging of pancreatic tumors.We systematically searched PubMed,MEDLINE and Web of Science by using‘pancreatic cancer’and‘endoscopic ultrasonography’as keywords.Relevant studies were reviewed and analyzed.Endoscopic ultrasonography(EUS)is efficient in the diagnosis and staging of pancreatic cancer,past studies reported the accuracy of EUS is 63%to 94%for T-staging and 44%to 82%for N-staging but there are still limitations that need to be comprehensively applied with other diagnostic methods to evaluation of distant metastasis for surgical resectability.Our review aims to reveal the value for the staging of pancreatic cancer.
文摘BACKGROUND Rectal cancer requires accurate preoperative assessment of T stage and differentiation grade for treatment planning.Traditional imaging and serum markers have limitations in diagnostic accuracy.AIM To evaluate the predictive value of dynamic contrast-enhanced-magnetic resonance imaging(DCE-MRI)parameters and serum biomarkers[carbohydrate antigen(CA)19-9,CA125]for determining T stage and differentiation grade in rectal cancer.METHODS We conducted a retrospective review of clinical data from 126 patients who were pathologically diagnosed with rectal cancer between January 2021 to June 2024.Each patient underwent DCE-MRI scans and serum tests for CA19-9 and CA125.Receiver operating characteristic curves were utilized to assess the diagnostic value of DCE-MRI parameters,including volume transfer constant(Ktrans),rate constant(Kep),and volume fraction of extravascular extracellular space(Ve),as well as serum biomarkers for staging and grading rectal cancer.The DeLong test algorithm was employed to evaluate differences in diagnostic performance among the various indicators.RESULTS There were statistically higher levels of Ktrans,Ve,CA19-9,and CA125 serum concentrations of patients with advanced T stages and on poorly differentiated tumors than that in patients with low stages and moderate to high differentiation(P<0.05).Combined use of Ktrans and Ve for T stage diagnosis showed an area under the curve(AUC)of 0.892[95%confidence interval(CI):0.832-0.952],which increased to 0.923(95%CI:0.865-0.981)when combined with serum biomarkers.For grades differentiation,the combined DCE-MRI parameters had an AUC of 0.883(95%CI:0.821-0.945),which rose to 0.912(95%CI:0.855-0.969)when combined with serum markers.According to the Delong test,the combined diagnostic method performed better than a single diagnostic method(P<0.05).CONCLUSION The combined application of DCE-MRI functional parameters and serum tumor markers can significantly improve the diagnostic accuracy of T staging and differentiation degree of rectal cancer,providing a new approach to improve the preoperative assessment system of rectal cancer.This combined diagnostic model has important clinical application value,but further validation is needed through large-scale multicenter studies.
基金Supported by The Capital Health Development Special Scientific Research Projects,No.2014-2-2154National Natural Science Foundation of China,No.81471761 and No.81501568
文摘AIM The purpose of this study was to evaluate the diagnostic value of trefoil factor family 3(TFF3) for the early detection of colorectal cancer(CC). METHODS Serum TFF3 and carcino-embryonic antigen(CEA) were detected in 527 individuals, including 115 healthy control(HC), 198 colorectal adenoma(CA), and 214 CC individuals in the training group. RESULTS Serum TFF3 showed no significant correlation with age, gender, or tumor location but showed significant correlation with the tumor stage. Serum TFF3 in the CC group was significantly higher than in the HC or CA group. The AUC values of TFF3 for discriminating between HC and CC and between CA and CC were 0.930(0.903, 0.958) and 0.834(0.796, 0.873). A multivariate model combining TFF3 and CEA was built. Compared to TFF3 or CEA alone, the multivariate model showed significant improvement(P < 0.001). For discriminating between HC and CC, HC and early stage CC, HC and advanced stage CC, CA and CC, CA and early stage CC, and CA and advanced stage CC in the training group, the sensitivities were 92.99%, 91.46%, 93.18%, 73.83%, 76.83%, and 81.82%, and the specificities were 91.30%, 91.30%, 93.91%, 88.38%, 77.27%, and 88.38%, respectively. After validation, the sensitivities were 89.39%, 85.71%, 90.79%, 72.73%, 71.43%, and 78.95%, and the specificities were 87.85%, 87.85%, 2.52%, 87.85%, 80.77%, and 87.50%, respectively. CONCLUSION The multivariate diagnostic model that included TFF3 and CEA showed significant improvement over the conventional biomarker CEA and might provide a potential method for the early detection of CC.
基金National Natural Science Foundation of China,No.81602023.
文摘BACKGROUND Numerous studies have demonstrated that human epididymis protein 4(HE4)is overexpressed in various malignant tissues including ovarian,endometrial,lung,breast,pancreatic,and gastric cancers.However,no study has examined the diagnostic impact of HE4 in patient with esophageal squamous cell carcinoma(ESCC)until now.AIM To analyze the value of four serum tumor markers for the diagnosis of ESCC,and examine the associations of serum levels of HE4 with ESCC patients’clinicopathological characteristics.METHODS The case group consisted of 80 ESCC patients,which were compared to a control group of 56 patients with benign esophageal disease.Serum levels of HE4,carcinoma embryonic antigen(CEA),alpha fetal protein,and carbohydrate antigen 19-9(CA19-9)were detected by ELISA.The associations of serum HE4 levels with ESCC patients’clinicopathological characteristics such as gender,tumor location,and pathological stage were also examined after operation.RESULTS The result of ELISA showed that serum HE4 level was significantly higher in the patients with ESCC than in the controls,and the staining intensity was inversely correlated with the pathological T and N stages.Serum HE4 levels had a sensitivity of 66.2%and specificity of 78.6%when the cutoff value was set at 3.9 ng/mL.Moreover,the combined HE4 and CA19-9 increased the sensitivity to 83.33%,and interestingly,the combination of HE4 with CEA led to the most powerful sensitivity of 87.5%.Furthermore,A positive correlation was observed between HE4 serum levels and pathological T and N stages(P=0.0002 and 0.0017,respectively),but there was no correlation between HE4 serum levels and ESCC patient gender(P=0.4395)or tumor location(P=0.6777).CONCLUSION The results of this study suggest that detection of serum HE4 levels may be useful in auxiliary diagnosis and evaluation of the progression of ESCC.
基金Supported by Shaanxi Science and Technology Research Plan Program,Shaanxi,China,No. 2020SF-106
文摘BACKGROUND Pleural effusions occur for various reasons,and their diagnosis remains challenging despite the availability of different diagnostic modalities.Medical thoracoscopy(MT)can be used for both diagnostic and therapeutic purposes,especially in patients with undiagnosed pleural effusion.AIM To assess the diagnostic efficacy and safety of MT in patients with pleural effusion of different causes.METHODS Between January 1,2012 and April 30,2021,patients with pleural effusion underwent MT in the Department of Respiratory Medicine,The Second Affiliated Hospital of Xi’an Jiaotong University(Shaanxi,China).According to the discharge diagnosis,patients were divided into malignant pleural effusion(MPE),tuberculous pleural effusion(TBPE),and inflammatory pleural effusion(IPE)groups.General information,and tuberculosis-and effusion-related indices of the three groups were analyzed.The diagnostic yield,diagnostic accuracy,performance under thoracoscopy,and complications of patients were compared among the three groups.Then,the significant predictive factors for diagnosis between the MPE and TBPE groups were analyzed.RESULTS Of the 106 patients enrolled in this 10-year study,67 were male and 39 female,with mean age of 57.1±14.184 years.Among the 74 thoracoscopy-confirmed patients,41(38.7%)had MPE,21 had(19.8%)TBPE,and 32(30.2%)were undiagnosed.Overall diagnostic yield of MT was 69.8%(MPE:75.9%,TBPE:48.8%,and IPE:75.0%,with diagnostic accuracies of 100%,87.5%,and 75.0%,respectively).Under thoracoscopy,single or multiple pleural nodules were observed in 81.1%and pleural adhesions in 34.0%with pleural effusions.The most common complication was chest pain(41.5%),followed by chest tightness(11.3%)and fever(10.4%).Multivariate logistic regression analyses showed effusion appearance[odds ratio(OR):0.001,95%CI:0.000-0.204;P=0.010]and carcinoembryonic antigen(OR:0.243,95%CI:0.081-0.728;P=0.011)as significant for differentiating MPE and TBPE,with area under the receiver operating characteristic curve of 0.977(95%CI:0.953-1.000;P<0.001).CONCLUSION MT is an effective,safe,and minimally invasive procedure with high diagnostic yield for pleural effusion of different causes.
文摘ObjectiveTo investigate the diagnostic value of 18F-fluorodeoxyglucose positron emission tomography （18F-FDG PET） in the as-sessment of myocardial viability in patients with known coronary artery disease （CAD） when compared to99mTc single photon emission computed tomography （SPECT） and echocardiography, with invasive coronary angiography as the gold standard.MethodsThirty patients with diagnosed CAD met the selection criteria, with 10 of them （9 men, mean age 59.5 ± 10.5 years） undergoing all of these imaging proce-dures consisting of SPECT and PET, echocardiography and invasive angiography. Diagnostic sensitivity of these less invasive modalities for detection of myocardial viability was compared to invasive coronary angiography. Inter- and intra-observer agreement was assessed for di-agnostic performance of SPECT and PET.ResultsOf all patients with proven CAD, 50% had triple vessel disease. Diagnostic sensitivity of SPECT, PET and echocardiography was 90%, 100% and 80% at patient-based assessment, respectively. Excellent agreement was achieved between inter-observer and intra-observer agreement of the diagnostic value of SPECT and PET in myocardial viability （k= 0.9）. Conclusion18F-FDG PET has high diagnostic value in the assessment of myocardial viability in patients with known CAD when com-pared to SPECT and echocardiography. Further studies based on a large cohort with incorporation of18F-FDG PET into patient management are warranted.
基金Supported by grants from the National Natural Science Foundation of China(No.82104952,No.82004240)Special project for clinical research of health industry of Shanghai Municipal Health Commission(No.202140172)+1 种基金Special project of medical innovation research of Shanghai Science and Technology Commission(No.21Y11923600)the Shanghai Office of Traditional Chinese Medicine Development(No.ZY2018-2020-RCPY-2009).
文摘Objective To explore the correlation between macrophages and interleukin-10(IL-10 in the peripheral blood of breast cancer(BC)patients and the diagnostic value of joint detection.Methods BC patients(n=50)and healthy controls(n=40)were prospectively recruited.The percentage of circulating cluster of differentiation 14(CD 14)macrophage cells was analyzed by flow cytometry,and an enzyme-linked immunosorbent assay(ELISA)was used to detect IL-10 expression levels.Receiver operating characteristic(ROC)curves were used to verify the diagnostic value of the models based on the expression of CD14 macrophage cell populations and IL-10.In addition,the association between model expression and clinicopathological characteristics was investigated.Another 30 patients with BC and 30 with benign breast disease were selected to validate the IL-10 and CD14 macrophage joint detection model using the same method.Results CD14 macrophage and IL-10 expression levels in BC patients were higher than those in healthy controls(P<0.05).The ROC curve showed that the area under the curve(AUC)of CD14+macrophages combined with IL-10 was 0.830,the sensitivity was 72.0%,and the specificity was 87.5%.Its diagnostic efficiency was better than all other single and joint detections.Correlation analysis of clinicopathological features showed that IL-10 and CD14+macrophage joint detection was significantly correlated with tumor size,tumor-node-metastasis(TNM)stage,and lymph node,estrogen receptor(ER),and Ki-67 expression(P<0.05).The validation analysis results were consistent with the test results.Conclusion Peripheral blood macrophages can be an independent diagnostic marker for BC.Joint detection of CD14-macrophages and IL-10 suggests poor prognosis,which has unlimited potential to guide BC development and provides a new theory for studying tumor-associated macrophages in BC.
基金Key Medical Science Research Project of Hebei Health and Family Planning Commission(20181153).
文摘[Objectives]To explore the relationship between neutrophil percentage to albumin ratio(NPAR),monocyte to high density lipoprotein ratio(MHR),fasting blood glucose(GLU)and CAD+T2DM and its diagnostic value.[Methods]A total of 3937 patients who underwent coronary angiography in the Affiliated Hospital of Chengde Medical University from January 2016 to December 2018 were collected.The patients with Gensini score>0 and diabetes were selected as the experimental group(CAD+T2DM,n=756),and the patients with Gensini score=0 and without diabetes were taken as the control group(n=388),with a total of 1144 cases.The patient's medical record number,sex,age,contact number,biochemical test results,cardiac color ultrasound,coronary artery imaging and other data were recorded.NPAR,MHR,and GLU were calculated.A binary Logistic regression model was established combined with the receiver operating characteristic(ROC)curve.The predictive value of single index and joint test for CAD+T2DM was analyzed.[Results]The serum levels of NPAR,MHR and GLU in CAD+T2DM were significantly higher than those in the control group.Binary Logistic regression analysis showed that serum NPAR,MHR and GLU were risk factors for CAD+T2DM(P<0.05).The final prediction model is P=1/[1+e-(-3.722+0.014×NPAR+0.51×MHR+0.461×GLU)].ROC curve showed that the area under the curve of serum NPAR,MHR and GLU was 0.739,0.628 and 0.852,respectively,and the prediction probability of combined detection was 0.882,which was significantly higher than that of single index.[Conclusions]There was a close correlation between serum NPAR,MHR,GLU and CAD+T2DM in patients with coronary heart disease.The combined application of these indexes can significantly improve the predictive value of CAD+T2DM.
基金Supported by The Clinical Research Center of the First Affiliated Hospital of Xi'an Jiaotong University,No.XJTU1AF2021CRF-018.
文摘BACKGROUND Acute gastrointestinal injury(AGI)is common in intensive care unit(ICU)and worsens the prognosis of critically ill patients.The four-point grading system proposed by the European Society of Intensive Care Medicine is subjective and lacks specificity.Therefore,a more objective method is required to evaluate and determine the grade of gastrointestinal dysfunction in this patient population.Digital continuous monitoring of bowel sounds and some biomarkers can change in gastrointestinal injuries.We aimed to develop a model of AGI using continuous monitoring of bowel sounds and biomarkers.AIM To develop a model to discriminate AGI by monitoring bowel sounds and biomarker indicators.METHODS We conducted a prospective observational study with 75 patients in an ICU of a tertiary-care hospital to create a diagnostic model for AGI.We recorded their bowel sounds,assessed AGI grading,collected clinical data,and measured biomarkers.We evaluated the model using misjudgment probability and leave-one-out cross-validation.RESULTS Mean bowel sound rate and citrulline level are independent risk factors for AGI.Gastrin was identified as a risk factor for the severity of AGI.Other factors that correlated with AGI include mean bowel sound rate,amplitude,interval time,Sequential Organ Failure Assessment score,Acute Physiology and Chronic Health Evaluation II score,platelet count,total protein level,blood gas potential of hydrogen(pH),and bicarbonate(HCO3-)level.Two discriminant models were constructed with a misclassification probability of<0.1.Leave-one-out cross-validation correctly classified 69.8%of the cases.CONCLUSION Our AGI diagnostic model represents a potentially effective approach for clinical AGI grading and holds promise as an objective diagnostic standard for AGI.
文摘BACKGROUND Despite significant advancements in the medical treatment of primary hepato-cellular carcinoma(PHC)in recent years,enhancing therapeutic effects and im-proving prognosis remain substantial challenges worldwide.AIM To investigate the expression levels of serum vascular endothelial growth factor(VEGF)and interleukin(IL)-17 in patients with PHC and evaluate their diagnostic value while exploring their relationship with patients’clinical characteristics.METHODS The study included 50 patients with confirmed PHC who visited Wuhan Han-yang Hospital from January 2021 to January 2022,and 50 healthy individuals from the same period served as the control group.Serum VEGF and IL-17 levels in both groups were measured by Enzyme-Linked Immunosorbent Assay,and their diagnostic value was assessed using receiver operating characteristic(ROC)curves.Pearson correlation analysis was performed to examine the relationship between serum VEGF and IL-17 levels.Pathological data of the PHC patients were analyzed to determine the relationship between serum VEGF and IL-17 levels and pathological characteristics.RESULTS Serum VEGF and IL-17 levels were significantly higher in the study group com-pared to the control group(P<0.05).No significant association was observed between serum VEGF and IL-17 levels and gender,age,combined cirrhosis,tumor diameter,or degree of differentiation(P>0.05).However,there was a significant relationship between clinical TNM stage,tumor metastasis,and serum VEGF and IL-17 levels(P<0.05).Correlation analysis revealed a positive correlation between serum VEGF and IL-17(P<0.05).ROC analysis demonstrated that both serum VEGF and IL-17 had good diagnostic efficacy for PHC.CONCLUSION Serum VEGF and IL-17 levels were significantly higher in PHC patients compared to healthy individuals.Their levels were closely related to pathological features such as tumor metastasis and clinical TNM stage,and there was a significant positive correlation between VEGF and IL-17.These biomarkers may serve as valuable reference in-dicators for the early diagnosis and treatment guidance of PHC.
基金Supported by National Key Research and Development Program of China,No.2020YFC2002700CAMS Initiative for Innovative Medicine,No.2016-I2M-1-007National Natural Science Foundation of China,No.81972010,and No.81500003.
文摘BACKGROUND Colorectal cancer(CRC)is a highly malignant cancer with a high incidence and mortality in China.It is urgent to find a diagnostic marker with higher sensitivity and specificity than the traditional approaches for CRC diagnosis.AIM To provide new ideas for the diagnosis of CRC based on serum proteomics.METHODS Specimens from 83 healthy people,62 colon polyp(CRP)patients,and 101 CRC patients were analyzed by matrix-assisted laser desorption/ionization time-offlight mass spectrometry.The diagnostic value of the profiles of differentially expressed proteins was then analyzed.RESULTS Compared with the healthy control group,CRC patients had elevated expression of 5 proteins and reduced expression of 14 proteins.The area under the curve(AUC)for a differentially expressed protein with a mass-to-charge ratio of 2022.34 was the largest;the AUC was 0.843,which was higher than the AUC of 0.717 observed with carcinoembryonic antigen(CEA),and the sensitivity and specificity of this identified marker were 75.3%and 79.5%,respectively.After cross-validation,the accuracy of diagnosis using levels of this differentially expressed protein was 82.37%.Compared with the CRP group,the expression of 3 proteins in the serum of CRC patients was elevated and 11 proteins were expressed at reduced levels.Proteins possessing mass-to-charge ratio values of 2899.38 and 877.3 were selected to establish a classification tree model.The results showed that the accuracy of CRC diagnosis was 89.5%,the accuracy of CRP diagnosis was 81.6%,and the overall accuracy of this approach was 86.3%.The overall sensitivity and specificity of diagnosis using the proteomics approach were 81.8%and 66.75%,respectively.The sensitivities and specificities of diagnoses based on CEA and carbohydrate antigen 19-9 expression were 55.6%and 91.3%and 65.4%and 65.2%,respectively.CONCLUSION We demonstrated that serum proteomics may be helpful for the detection of CRC,and it may assist clinical practice for CRC diagnosis.
文摘Serum pancreatic tissue carcinoma antigen (PCA) was measured by ELISA in 396 patients with pancreatic carcinoma (PC) and other diseases diagnosed by clinical examination, histopathology and operation. Serum PCA more than 300 U/ml was considered as diagnostic value for PC and 30-299 U/ml as probable index for PC. The sensitivity of PCA for PC was 78.2% (43/55), and the specifity 94.6%. The positive rate of PCA in other diseases were 0-13.3%. Combining the determination of PCA with B-mode ultrasonic scanning (BU). CT and/or ERCP (endos-copic retrograde cholangiopancreatography) may increase the diagnostic rate of PC to 89-91%, and with the "cocktail" of CA19-9, CEA (carcino-embryonic antigen) and RNase-C, PC be diagnosed in 88.9%. Therefore, it is suggest that PCA si a promising tumor market of PC with high sensitivity and relative specificity.
基金This study was supported by Key Projects in Hainan Province(ZDYF2019139)。
文摘Objective:To study is to evaluate the diagnostic value of the expression of thymidine kinase 1(TK1)in lung cancer through literature review and meta-analysis.Methods:Firstly,we searched Pubmed,Embase,Cochrane,Web of Science,CBM,CNKI,Wanfang and other databases up to June 2022.Then two researchers separately selected the clinical study on diagnosis of lung cancer by the expression of the TK1 and treatment and obtained the full text of the literature.Then we evaluated the systematic quality and bias risk of the included literatures by using Revman 5.3 software,and the consistency among the covariables in meta analysis.Finally,the Sensitivity(Sen),the Specificity(Spe)and other indicators were analyzed by using Stata16.0 software.Results:The study included 37 literatures,including 3218 lung cancer cases and 2976 control cases.The meta-analysis showed that the Ser and Spe of the expression of the TK1 in the diagnosis of lung cancer were 0.63(95%CI:0.57,0.68)and 0.88(95%CI:0.84,0.91),while positive likelihood ratio(PLR)was 5.34(95%CI:4.02,7.1)and negative likelihood ratio(NLR)was 0.42(95%CI:0.37,0.48),diagnostic odd sratio(DOR)was 12.69(95%CI:8.91,18.08),and the area under the ROC curve(AUC)was 0.82(95%CI:0.79,0.85).When TK1,CEA and CYFRA21-1 were used as combined diagnostic indexes of lung cancer,Sen was 0.82(95%CI:0.76,0.86),Spe 0.78(95%CI:0.46,0.94),PLR 3.69(95%CI:1.28,10.66),NLR 0.24(95%CI:0.18,0.31),DOR 15.59(95%CI:4.56,53.36),AUC 0.84(95%CI:0.80,0.87).The Youden index of combined diagnosis was 0.60,which was higher than that of TK1 alone.Conclusion:TK1 alone as a diagnostic index of lung cancer has low Sen,but its Sep is higher.So it has a certain diagnostic value.TK1 combined with CEA and CYFRA21-1 has higher Sen in the diagnosis of lung cancer,and the diagnostic value is better.
文摘Objective:To compare and analyze the clinical diagnostic value of multi-slice spiral CT and enhanced MRI for primary liver cancer(PLC),and to summarize the imaging findings.Methods:The research subjects in this article were 50 patients with PLC who were admitted to our hospital from 2017 April to 2018 September.After the patients were admitted,they were examined by multi-slice spiral CT and enhanced MRI scanning,and the pathological diagnosis results were followed up.Relevant information was reviewed and analyzed.Results:The detection rate of multi-slice spiral CT was higher than that of MRI in the portal venous phase lesion detection.The difference was statistically significant(P<0.05).The detection rate of lesions in the arterial phase and delayed phase was not statistically significant(P>0.05);the diagnostic accuracy of multi-slice spiral CT was 85.96%,and the diagnostic accuracy of enhanced MRI scanning was 91.11%,which was not statistically significant(P>0.05).MRI scans showed the capsules of primary liver cancer better than CT,but the difference was not statistically significant(P>0.05).Conclusion:In conclusion,both multi-slice spiral CT and enhanced MRI can be used for the effective diagnosis of primary liver cancer intrahepatic lesions.The diagnostic value of the two is equivalent,but enhanced MRI has a slightly higher diagnostic accuracy and can be used as the preferred method.
文摘Objective: to analyze the diagnostic value of thyroid CT plain scan + enhanced scan in patients with this study disease. Methods: the clinical data of 194 patients with study diseases from March 2019 to March 2020 were analyzed retrospectively, of which 122 patients were benign, a total of 158;There were 36 patients with malignant tumors, a total of 44. They were divided into regular type (SCC) and irregular type (non SCC) according to calcification. The degree and distribution of calcification were analyzed. At the same time, the satisfaction of patients with examination services was counted. Results: among 122 benign patients, there were 46 patients with regular calcification and 76 patients with irregular calcification. Among the 36 malignant patients, 4 cases were regular and 32 cases were irregular. There were significant differences between regular and irregular types in benign and malignant nodules (P < 0.05);The distribution of benign and malignant nodules in irregular type is quite different from that around calcification after CT scanning, which is comparable (P < 0.05). After 194 patients received the examination, 98 patients were very satisfied with the examination service, 94 patients were relatively satisfied with the examination service, and 2 patients were dissatisfied with the examination service. The satisfaction with the examination service was 98.97%. Conclusion: plain and enhanced CT has certain differential diagnostic significance in the diagnosis of coarse calcification of thyroid nodules, and delayed enhanced CT has higher diagnostic value.
文摘Objective:To explore the diagnostic value of conventional ultrasonography combined with contrast-enhanced ultrasonography in thyroid nodules.Methods:From June 2021 to July 2022,163 patients with thyroid nodules enrolled in our hospital were selected as research subjects.After pathological diagnosis,24 cases were malignant thyroid nodules,and 139 cases were benign thyroid nodules.The diagnosis rate of malignant and benign thyroid nodules was observed and analyzed,with 95%CI.Results:Among them,the malignant and benign detection rates of routine ultrasound were 88.63%and 75.00%,respectively,and the malignant and benign detection rates of contrast-enhanced ultrasound were 81.82%and 81.25%,respectively.The malignant and benign detection rates of conventional ultrasound combined with contrast-enhanced ultrasound were 93.18%and 87.50%,respectively,and the 95%CI was greater than 0.7.Conclusion:Conventional ultrasound combined with contrast-enhanced ultrasound can help improve the diagnostic accuracy of benign and malignant thyroid nodules and reduce the misdiagnosis rate.
文摘Objective: To analyze and study the diagnostic value of multi-slice spiral CT and magnetic resonance imaging in patients with occult fractures. Methods: Forty patients from our hospital with occult fractures were selected as the observation group for MRI diagnosis, and 40 patients as the control group for ct diagnosis. The positive detection rates of patients in the two groups were compared. Results The diagnostic effect of MRI technique was superior to that of CT technique (P < 0.05), and the positive detection rate of patients in the control group was lower than that of patients in the observation group. Conclusion The value of MRI three-dimensional reconstruction in patients with occult fractures is higher than that of multi-slice spiral CT technology, the fracture data of patients detected are more accurate, and the effect of its application value is more significant in the case of occult complex fractures, which is worthy of promotion in all hospitals.
文摘Objective: this study aims to explore a new clinical multiparameter diagnostic formula for lower limb atherosclerotic stenosis / occlusion based on the retrospective data of 429 patients at Peking University Hospital. Methods: this study is a retrospective study. A number of patients with color Doppler ultrasound from November 2013 to October 2021 and improved the test and measurement of common risk factors for atherosclerosis in the same period. A total of 429 cases were selected as the study data. According to the color Doppler ultrasound results, it was divided into the "normal / plaque group" and the "stenosis / occlusion group", including 300 cases in the "normal / plaque group" and 129 cases in the stenosis / occlusion group. Variables included in the diagnostic model screening in this study included age, sex, BMI, ApoA1, ApoB, HbA1c, Hcy, SUA, T C, L DL-C, H DL-C, TG, and blood pressure. Diagnostic models were constructed using logistic regression for variable screening using backward methods. Diagnostic efficacy was evaluated using ROC curves for both single measures and the final diagnostic formula. Results: after a variable screening, The final diagnostic formula is as follows: 0.07 Age (year) + Gender (male value of 0);Female value of-1.38) + HDL-C (normal value of 0;Low side to take a value of 0.79;High value-0.71) + ApoA1 (normal value 0;Low side to take the value of-0.75;High value-0.04) + HbA1c (normal value 0;High value 0.54) + SUA (normal value 0;High value-1.19) + B P (normal value 0;Normal high value value-0.67;Hypertension values were taken at 0.11) -5.17. The optimal threshold of this diagnostic formula is-0.852, specificity of 0.713, sensitivity of 0.760, and the area under the ROC curve is 0.79, which is greater than the area under the R OC curve of any single index in the diagnostic formula. It is a new index of more diagnostic value than other single risk factor indicators in the formula. Conclusion: the diagnosis of lower limb atherosclerotic stenosis / occlusion is of good clinical utility, and the first attempt to use the integration of atherosclerosis risk factors for multiple parameters, and then derive a new diagnostic index, providing a new idea and method for the prevention and treatment of atherosclerosis.
