The principal breast cancer treatment approach has long been surgical removal of the primary breast lesions and regional lymph nodes,particularly the axillary lymph nodes.However,the advent of minimally invasive diagn...The principal breast cancer treatment approach has long been surgical removal of the primary breast lesions and regional lymph nodes,particularly the axillary lymph nodes.However,the advent of minimally invasive diagnostic techniques,such as sentinel lymph node biopsy(SLNB),has markedly diminished the extent of surgery required for regional lymph nodes.展开更多
BACKGROUND The National Comprehensive Cancer Network guidelines recommend adjuvant chemotherapy(ACT)for patients with stage II colon cancer who have undergone curative surgery when fewer than 12 lymph nodes(LNs)are re...BACKGROUND The National Comprehensive Cancer Network guidelines recommend adjuvant chemotherapy(ACT)for patients with stage II colon cancer who have undergone curative surgery when fewer than 12 lymph nodes(LNs)are retrieved.This study seeks to further examine the requirement for ACT in individuals who had 12 or more LNs harvested.AIM To investigate if stage II colon cancer patients with 12 or more LNs retrieved benefit from ACT.METHODS This retrospective cohort study included individuals diagnosed with stage II colon cancer who underwent surgery between 2008 and 2017 from the Surveillance,Epidemiology,and End Results(SEER)registry and a Chinese multicenter database.All patients had at least 12 LNs retrieved.The key endpoint was overall survival(OS).Cox regression analysis was performed to assess independent OS predictors.Propensity score matching controlled for confounders,and Kaplan-Meier analysis evaluated the impact of ACT on survival.RESULTS A total of 32742 patients with stage II colon cancer from the SEER cohort and 3153 patients from the Chinese cohort were included.The average number of LNs retrieved was 20.0(15.0,26.0)in the SEER cohort and 18.0(15.0,22.0)in the Chinese cohort.No-ACT remained an independent risk factor in both cohorts(hazard ratio=1.589,95%confidence interval:1.485-1.700 and hazard ratio=1.865,95%confidence interval:1.465-2.375,respectively).In the SEER cohort,patients in the ACT group consistently demonstrated better 5-year OS rates both before and after propensity score matching(79.4%vs 66.1%and 79.4%vs 69.4%,both P<0.0001).Similarly,these findings were further validated in the Chinese cohort(91.2%vs 82.1%and 90.0%vs 82.8%,both P<0.0001).ACT improved prognosis even in T3 and grade 1/2 patients.CONCLUSION This research,based on two large population-based cohorts,demonstrates that stage II colon cancer patients with 12 or more LNs retrieved can still benefit from ACT.展开更多
Accurately identifying key nodes is essential for evaluating network robustness and controlling information propagation in complex network analysis. However, current research methods face limitations in applicability ...Accurately identifying key nodes is essential for evaluating network robustness and controlling information propagation in complex network analysis. However, current research methods face limitations in applicability and accuracy. To address these challenges, this study introduces the K-GCN model, which integrates neighborhood k-shell distribution analysis with Graph Convolutional Network(GCN) technology to enhance key node identification in complex networks. The K-GCN model first leverages neighborhood k-shell distributions to calculate entropy values for each node, effectively quantifying node importance within the network. These entropy values are then used as key features within the GCN, which subsequently formulates intelligent strategies to maximize network connectivity disruption by removing a minimal set of nodes, thereby impacting the overall network architecture. Through iterative interactions with the environment, the GCN continuously refines its strategies, achieving precise identification of key nodes in the network. Unlike traditional methods, the K-GCN model not only captures local node features but also integrates the network structure and complex interrelations between neighboring nodes, significantly improving the accuracy and efficiency of key node identification.Experimental validation in multiple real-world network scenarios demonstrates that the K-GCN model outperforms existing methods.展开更多
Background:Metastasis to the infraclavicular and supraclavicular lymph nodes(ISLNs)is an important factor that predicts poor survival in patients with breast cancer;however,pathological nodal staging does not traditio...Background:Metastasis to the infraclavicular and supraclavicular lymph nodes(ISLNs)is an important factor that predicts poor survival in patients with breast cancer;however,pathological nodal staging does not traditionally include ISLNs because of their non-routine surgical dissection.This study aimed to evaluate the prognostic impact of ISLN metastasis and propose a refined nodal staging system tailored for patients undergoing neoadjuvant chemotherapy(NAC).Methods:We retrospectively reviewed 1,072 patients with breast cancer with or without ISLN metastasis who received NAC at two institutions(Fujian cohort and Hebei cohort)from 2010 to 2022.We conducted detailed survival analysis to evaluate the diagnostic consistency and prognostic significance of ISLNs.Results:There were no survival differences among patients with ISLN involvement across different assay method-ologies and patient cohorts.Among 887 patients in the Fujian cohort,238 patients(26.8%)with positive ISLNs had significantly inferior 3-year progression-free survival(PFS,75.9%vs.90.4%,P<0.001)and overall survival(OS,90.6%vs.95.9%,P<0.001).After adjusting for potential confounders,ISLN involvement persisted as an independent predictor of both PFS and OS.We propose a refined axillary classification that combines pathologi-cal axillary staging post-NAC with ISLN involvement,revealing 3-year PFS rates of 95.3%,87.6%,73.4%,and 64.5%for the respective four groups defined by this refined classification combining axillary stage and ISLN status.Conclusions:Involvement of the ISLNs was associated with a worse prognosis,underscoring their prognostic value.This finding highlights the potential of ISLN status to influence decisions regarding adjuvant treatment in patients with breast cancer.展开更多
BACKGROUND The log odds of positive lymph nodes(LODDS)are correlated with survival outcomes in gastric cancer(GC)patients.However,the prognostic value across different tumor differentiation levels remains unclear.AIM ...BACKGROUND The log odds of positive lymph nodes(LODDS)are correlated with survival outcomes in gastric cancer(GC)patients.However,the prognostic value across different tumor differentiation levels remains unclear.AIM To evaluate the independent prognostic value of LODDS and the stratified predictive efficacy in GC patients with different histologic differentiations.METHODS We conducted a retrospective analysis of 2103 GC patients who underwent radical gastrectomy at Zhejiang Cancer Hospital.The prognostic value of LODDS was compared with that of other lymph node-based metrics,including the pathologic N stage,number of positive lymph nodes,number of total lymph nodes,and lymph node ratio,stratified by tumor differentiation.RESULTS LODDS was identified as an independent prognostic factor for overall survival in moderately to poorly differentiated GC patients.LODDS demonstrated superior predictive accuracy over other lymph node metrics.A nomogram incorporating LODDS,age,carbohydrate antigen(CA)125,carcinoembryonic antigen,and tumor differentiation showed good predictive accuracy(C-index=0.703).A higher LODDS was significantly associated with an increased risk of recurrence or metastasis,poorly differentiated tumors,advanced cancer,mucinous gastric adenocarcinoma,nerve invasion,and vascular tumor thrombus.Additionally,LODDS was positively correlated with the tumor markers CA19-9,CA72-4,CA125,and CA242(all P<0.05).CONCLUSION LODDS is an independent prognostic indicator for patients with moderately and poorly differentiated GC,and its predictive performance is superior to that of other models.展开更多
Hypergraphs,which encapsulate interactions of higher-order beyond mere pairwise connections,are essential for representing polyadic relationships within complex systems.Consequently,an increasing number of researchers...Hypergraphs,which encapsulate interactions of higher-order beyond mere pairwise connections,are essential for representing polyadic relationships within complex systems.Consequently,an increasing number of researchers are focusing on the centrality problem in hypergraphs.Specifically,researchers are tackling the challenge of utilizing higher-order structures to effectively define centrality metrics.This paper presents a novel approach,LGK,derived from the K-shell decomposition method,which incorporates both global and local perspectives.Empirical evaluations indicate that the LGK method provides several advantages,including reduced time complexity and improved accuracy in identifying critical nodes in hypergraphs.展开更多
Identifying critical nodes is a pivotal research topic in network science,yet the efficient and accurate detection of highly influential nodes remains a challenge.Existing centrality measures predominantly rely on loc...Identifying critical nodes is a pivotal research topic in network science,yet the efficient and accurate detection of highly influential nodes remains a challenge.Existing centrality measures predominantly rely on local or global topological structures,often overlooking indirect connections and their interaction strengths.This leads to imprecise assessments of node importance,limiting practical applications.To address this,we propose a novel node centrality measure,termed six-degree gravity centrality(SDGC),grounded in the six degrees of separation theory,for the precise identification of influential nodes in networks.Specifically,we introduce a set of node influence parameters—node mass,dynamic interaction distance,and attraction coefficient—to enhance the gravity model.Node mass is calculated by integrating K-shell and closeness centrality measures.The dynamic interaction distance,informed by the six-degrees of separation theory,is determined through path searches within six hops between node pairs.The attraction coefficient is derived from the difference in K-shell values between nodes.By integrating these parameters,we develop an improved gravity model to quantify node influence.Experiments conducted on nine real-world networks demonstrate that SDGC significantly outperforms nine existing classical and state-of-the-art methods in identifying the influential nodes.展开更多
This study examines the development of painting techniques of Chinese ink wash landscape paintings,pays attention to its unique brush and ink language and features of the representation of elements,and deeply analyzes...This study examines the development of painting techniques of Chinese ink wash landscape paintings,pays attention to its unique brush and ink language and features of the representation of elements,and deeply analyzes the artistic characteristics of digital ink wash texture materials.The research focuses on key aspects such as the ink brushstrokes with the combination of emptiness and reality,the profound and serene ink wash space,and the extremely ingenious position layout.It proposes a construction path of digital ink wash texture materials based on the Blender material node system.This method makes use of the flexibility of the Blender material node system to successfully simulate highly realistic digital ink wash textures.It can not only construct static ink wash textures but also realize the dynamic transformation of static ink wash works through animation nodes and procedural control,thereby enhancing the artistic expression of digital ink wash works.The proposal and implementation of this method expand the application scope of the Blender material node system,help deeply explore the potential of digital ink wash art,and open up a brand new research path for constructing digital ink wash textures.展开更多
Hypergraphs can accurately capture complex higher-order relationships,but it is challenging to identify their important nodes.In this paper,an improved PageRank(ImPageRank)algorithm is designed to identify important n...Hypergraphs can accurately capture complex higher-order relationships,but it is challenging to identify their important nodes.In this paper,an improved PageRank(ImPageRank)algorithm is designed to identify important nodes in a directed hypergraph.The algorithm introduces the Jaccard similarity of directed hypergraphs.By comparing the numbers of common neighbors between nodes with the total number of their neighbors,the Jaccard similarity measure takes into account the similarity between nodes that are not directly connected,and can reflect the potential correlation between nodes.An improved susceptible–infected(SI)model in directed hypergraph is proposed,which considers nonlinear propagation mode and more realistic propagation mechanism.In addition,some important node evaluation methods are transferred from undirected hypergraphs and applied to directed hypergraphs.Finally,the ImPageRank algorithm is used to evaluate the performance of the SI model,network robustness and monotonicity.Simulations of real networks demonstrate the excellent performance of the proposed algorithm and provide a powerful framework for identifying important nodes in directed hypergraphs.展开更多
BACKGROUND Internal mammary(IM)lymphadenopathies in breast cancer indicate a worse prognosis than axillary metastases,yet they are rarely assessed.Accurate staging is essential for treatment planning.Robotic biopsy of...BACKGROUND Internal mammary(IM)lymphadenopathies in breast cancer indicate a worse prognosis than axillary metastases,yet they are rarely assessed.Accurate staging is essential for treatment planning.Robotic biopsy offers a promising alternative to video-assisted thoracic surgery for precise histological sampling.This article outlines a systematic robot-assisted dissection approach to enhance staging accuracy and optimize breast cancer management.CASE SUMMARY At our institution,robotic lymphadenectomy of the IM chain was performed in 5 patients between July 2020 and December 2024.Patients were positioned in a 30°semi-supine position with a roll under the shoulder to elevate the chest.The camera port was inserted in the fifth intercostal space along the mid-axillary line,allowing a 0°,12 mm robotic camera to inspect the chest cavity;CO_(2) insufflation(8 L/minute,8-10 mmHg)facilitated lung collapse and pneumo-mediastinum formation for improved dissection.Under direct vision,two additional operative ports were placed:One in the third intercostal space(anterior axillary line)and another in the fifth intercostal space(3-4 cm lateral to the parasternal line).The mean operative time was 118 minutes,with a median hospital stay of two days.No major complications occurred.Histology confirmed breast carcinoma metas tases in three patients,while two had benign disease.CONCLUSION Robotic biopsy of IM lymph nodes is safe,feasible,and provides key information on breast cancer management,with very rare contraindications.展开更多
BACKGROUND The number of tumor deposits(TDs)does not play a part in the current tumor node metastasis staging.Negative lymph node(NLN)status is associated with the prognosis of colorectal cancer(CRC),but its clear rol...BACKGROUND The number of tumor deposits(TDs)does not play a part in the current tumor node metastasis staging.Negative lymph node(NLN)status is associated with the prognosis of colorectal cancer(CRC),but its clear role in N1c stage remains to be defined.AIM To evaluate the combination of TDs and NLNs as potential prognostic indicators in N1c CRC.METHODS We retrospectively identified 107 consecutive patients who had N1c CRC radically resected at China-Japan Friendship Hospital.The combination of TDs and NLNs was calculated by the formula NLNTD=NLN/(TD+1).Cutoff values of NLNs and NLNTD were determined using the R package“survminer”.Disease-free survival(DFS),overall survival(OS)and cancer-specific survival(CSS)were determined using the Kaplan-Meier method to assess the impact of NLNTD on prognosis.Results were compared using the log-rank test.RESULTS The median follow-up time was 63.17(45.33-81.37)months for DFS,with 33.64%(36/107)of patients experiencing recurrence during follow-up.Five-year DFS was 66.0%(57.3%-76.0%).There was no significant difference in prognosis between patients with>12 and≤12 NLNs(P=0.058)for DFS.Similar results were seen according to the number of TDs.The definition of NLNTD=NLN/(TD+1)with a cutoff value of 6 divided patients into two groups with different DFS(P=0.005).Five-year DFS for patients with NLNTD>6 was 73.5%(63.6%-85.0%),compared with 50.0%(35.7%-70.0%)for those with NLNTD≤6.These two groups had different prognosis without perineural invasion(P=0.012)or lymphovascular invasion(P=0.002)even neither(P=0.053).Similar results were seen for OS and CSS.CONCLUSION NLNTD could serve as important prognostic factor for outcomes in N1c CRC patients.These patients could be stratified for prognosis through NLNTD and the high-risk should be given more attention during treatment.展开更多
BACKGROUND Colorectal cancer is a malignancy with a high risk of lymph node metastasis and poor prognosis,and thus requires an accurate diagnosis.AIM To assess the diagnostic value of combined magnetic resonance T2-we...BACKGROUND Colorectal cancer is a malignancy with a high risk of lymph node metastasis and poor prognosis,and thus requires an accurate diagnosis.AIM To assess the diagnostic value of combined magnetic resonance T2-weighted imaging(T2WI)and diffusion-weighted imaging(DWI)in colorectal cancer.METHODS We included 120 patients with suspected colorectal cancer who underwent magnetic resonance imaging.Surgical pathology was used as the gold standard for comparison.Combined T2WI and DWI showed higher diagnostic efficacy than either of the two methods used individually.RESULTS The combined method achieved 94.74%sensitivity,95.45%specificity,95.00%accuracy,94.74%positive predictive value,and 95.45%negative predictive value in qualitative diagnosis.It showed 94.44%sensitivity,95.00%specificity,94.74%accuracy,94.44%positive predictive value,and 95.00%negative predictive value in clinical staging.Finally,it showed 94.74%sensitivity,94.59%specificity,94.74%accuracy,94.74%positive predictive value,and 94.59%negative predictive value in diagnosing lymph node metastasis.These results were highly consistent with that of the gold standard.CONCLUSION This study combined T2WI and DWI for accurate diagnosis of colorectal cancer,aiding clinical staging and lymph node metastasis assessment.This approach is promising for clinical application.展开更多
This paper focuses on applying the barycentric Lagrange interpolation collocation method(BLICM)for solving 2D time-fractional diffusion-wave equation(TFDWE).In order to obtain the discrete format of the equation,we co...This paper focuses on applying the barycentric Lagrange interpolation collocation method(BLICM)for solving 2D time-fractional diffusion-wave equation(TFDWE).In order to obtain the discrete format of the equation,we construct the multivariate barycentric Lagrange interpolation approximation function and process the integral terms by using the Gauss-Legendre quadrature formula.We provide a detailed error analysis of the discrete format on the second kind of Chebyshev nodes.The efficacy of the proposed method is substantiated by some numerical experiments.The results of these experiments demonstrate that our method can obtain high-precision numerical solutions for fractional partial differential equations.Additionally,the method's capability to achieve high precision with a reduced number of nodes is confirmed.展开更多
Rack-level loop thermosyphons have been widely adopted as a solution to data centers’growing energy demands.While numerous studies have highlighted the heat transfer performance and energy-saving benefits of this sys...Rack-level loop thermosyphons have been widely adopted as a solution to data centers’growing energy demands.While numerous studies have highlighted the heat transfer performance and energy-saving benefits of this system,its economic feasibility,water usage effectiveness(WUE),and carbon usage effectiveness(CUE)remain underexplored.This study introduces a comprehensive evaluation index designed to assess the applicability of the rack-level loop thermosyphon system across various computing hub nodes.The air wet bulb temperature Ta,w was identified as the most significant factor influencing the variability in the combination of PUE,CUE,and WUE values.The results indicate that the rack-level loop thermosyphon system achieves the highest score in Lanzhou(94.485)and the lowest in Beijing(89.261)based on the comprehensive evaluation index.The overall ranking of cities according to the comprehensive evaluation score is as follows:Gansu hub(Lanzhou)>Inner Mongolia hub(Hohhot)>Ningxia hub(Yinchuan)>Yangtze River Delta hub(Shanghai)>Chengdu Chongqing hub(Chongqing)>Guangdong-Hong Kong-Macao Greater Bay Area hub(Guangzhou)>Guizhou hub(Guiyang)>Beijing-Tianjin-Hebei hub(Beijing).Furthermore,Hohhot,Lanzhou,and Yinchuan consistently rank among the top three cities for comprehensive scores across all load rates,while Guiyang(at a 25%load rate),Guangzhou(at a 50%load rate),and Beijing(at 75%and 100%load rates)exhibited the lowest comprehensive scores.展开更多
Major consideration dimensions for the physical layer design of wireless sensor network （WSN） nodes is analyzed by comparing different wireless communication approaches, diverse mature standards, important radio fre...Major consideration dimensions for the physical layer design of wireless sensor network （WSN） nodes is analyzed by comparing different wireless communication approaches, diverse mature standards, important radio frequency （RF） parameters and various microcontroller unit （MCU） solutions. An implementation of the WSN node is presented with experimental results and a novel ＂one processor working at two frequencies＂ energy saving strategy. The lifetime estimation issue is analyzed with consideration to the periodical listen required by common WSN media access control （MAC） algorithms. It can be concluded that the startup time of the RF which determines the best sleep time ratio and the shortest backoff slot time of MAC, the RF frequency and modulation methods which determinate the RX and TX current, and the overall energy consumption of the dual frequency MCU SOC （ system on chip） are the most essential factors for the WSN node physical layer design.展开更多
Based on the theory of complex network and gray system, the sugesstion that there exist two types of gray nodes in complex networks, Gray Node I and Gray Node II, is concluded. The first one refers to the existent unk...Based on the theory of complex network and gray system, the sugesstion that there exist two types of gray nodes in complex networks, Gray Node I and Gray Node II, is concluded. The first one refers to the existent unknown gray nodes, and the second the evolution gray nodes. The relevant definitions are also given. Further- more, grayness degree in complex networks is described and divided into two forms--the relative grayness degree （RGD） and the absolute grayness degree （AGD）, which are proved respectively.展开更多
BACKGROUND The accurate prediction of lymph node metastasis(LNM)is crucial for managing locally advanced(T3/T4)colorectal cancer(CRC).However,both traditional histopathology and standard slide-level deep learning ofte...BACKGROUND The accurate prediction of lymph node metastasis(LNM)is crucial for managing locally advanced(T3/T4)colorectal cancer(CRC).However,both traditional histopathology and standard slide-level deep learning often fail to capture the sparse and diagnostically critical features of metastatic potential.AIM To develop and validate a case-level multiple-instance learning(MIL)framework mimicking a pathologist's comprehensive review and improve T3/T4 CRC LNM prediction.METHODS The whole-slide images of 130 patients with T3/T4 CRC were retrospectively collected.A case-level MIL framework utilising the CONCH v1.5 and UNI2-h deep learning models was trained on features from all haematoxylin and eosinstained primary tumour slides for each patient.These pathological features were subsequently integrated with clinical data,and model performance was evaluated using the area under the curve(AUC).RESULTS The case-level framework demonstrated superior LNM prediction over slide-level training,with the CONCH v1.5 model achieving a mean AUC(±SD)of 0.899±0.033 vs 0.814±0.083,respectively.Integrating pathology features with clinical data further enhanced performance,yielding a top model with a mean AUC of 0.904±0.047,in sharp contrast to a clinical-only model(mean AUC 0.584±0.084).Crucially,a pathologist’s review confirmed that the model-identified high-attention regions correspond to known high-risk histopathological features.CONCLUSION A case-level MIL framework provides a superior approach for predicting LNM in advanced CRC.This method shows promise for risk stratification and therapy decisions,requiring further validation.展开更多
BACKGROUND Early screening,preoperative staging,and diagnosis of lymph node metastasis are crucial for improving the prognosis of gastric cancer(GC).AIM To evaluate the diagnostic value of combined multidetector compu...BACKGROUND Early screening,preoperative staging,and diagnosis of lymph node metastasis are crucial for improving the prognosis of gastric cancer(GC).AIM To evaluate the diagnostic value of combined multidetector computed tomography(MDCT)and gastrointestinal endoscopy for GC screening,preoperative staging,and lymph node metastasis detection,thereby providing a reference for clinical diagnosis and treatment.METHODS In this retrospective study clinical and imaging data of 134 patients with suspected GC who were admitted between January 2023 and October 2024 were initially reviewed.According to the inclusion and exclusion criteria,102 patients were finally enrolled in the analysis.All enrolled patients had undergone both MDCT and gastrointestinal endoscopy examinations prior to surgical intervention.Preoperative clinical staging and lymph node metastasis findings were compared with pathological results.RESULTS The combined use of MDCT and gastrointestinal endoscopy demonstrated a sensitivity of 98.53%,specificity of 97.06%,accuracy of 98.04%,positive predictive value of 98.53%,and negative predictive value of 97.06%for diagnosing GC.These factors were all significantly higher than those of MDCT or endoscopy alone(P<0.05).The accuracy rates of the combined approach for detecting clinical T and N stages were 97.06%and 92.65%,respectively,outperforming MDCT alone(86.76% and 79.41%)and endoscopy alone(85.29% and 70.59%)(P<0.05).Among 68 patients with confirmed GC,50(73.53%)were pathologically diagnosed with lymph node metastasis.The accuracy for detecting lymph node metastasis was 66.00%with endoscopy,76.00%with MDCT,and 92.00% with the combined approach,all with statistically significant differences(P<0.05).CONCLUSION The combined application of MDCT and gastrointestinal endoscopy enhanced diagnostic accuracy for GC,provided greater consistency in preoperative staging,and improved the detection of lymph node metastasis,thereby demonstrating significant clinical utility.展开更多
AIM:To evaluate the ability of endoscopic ultrasound(EUS) elastography to distinguish benign from malignant pancreatic masses and lymph nodes.METHODS:A multicenter study was conducted and included 222 patients who und...AIM:To evaluate the ability of endoscopic ultrasound(EUS) elastography to distinguish benign from malignant pancreatic masses and lymph nodes.METHODS:A multicenter study was conducted and included 222 patients who underwent EUS examination with assessment of a pancreatic mass(n=121) or lymph node(n=101).The classification as benign or malignant,based on the real time elastography pattern,was compared with the classif ication based on the B-mode EUS images and with the fi nal diagnosis obtained by EUS-guided fi ne needle aspiration(EUS-FNA) and/or by surgical pathology.An interobserver study was performed.RESULTS:The sensitivity and specificity of EUS elastography to differentiate benign from malignant pancreatic lesions are 92.3% and 80.0%,respectively,compared to 92.3% and 68.9%,respectively,for the conventional B-mode images.The sensitivity and specificity of EUS elastography to differentiate benign from malignant lymph nodes was 91.8% and 82.5%,respectively,compared to 78.6% and 50.0%,respectively,for the B-mode images.The kappa coefficient was 0.785 for the pancreatic masses and 0.657 for the lymph nodes.CONCLUSION:EUS elastography is superior compared to conventional B-mode imaging and appears to be able to distinguish benign from malignant pancreatic masses and lymph nodes with a high sensitivity,specificity and accuracy.It might be reserved as a second line examination to help characterise pancreatic masses after negative EUS-FNA and might increase the yield of EUS-FNA for lymph nodes.展开更多
基金supported by grants from the National Natural Science Foundation of China(Grant Nos.81672638 and W2421095)National Natural Science Foundation of Shandong Province(Grant No.ZR2024LMB011)Collaborative Academic Innovation Project of Shandong Cancer Hospital(Grant No.GF003)。
文摘The principal breast cancer treatment approach has long been surgical removal of the primary breast lesions and regional lymph nodes,particularly the axillary lymph nodes.However,the advent of minimally invasive diagnostic techniques,such as sentinel lymph node biopsy(SLNB),has markedly diminished the extent of surgery required for regional lymph nodes.
基金Supported by Shanxi Special Projects of the Central Government Guiding Local Science and Technology Development of China,No.YDZJSX2021B016Shanxi Cancer Hospital Doctoral Master’s Guide and Companion Flying Fund,No.SD2023010.
文摘BACKGROUND The National Comprehensive Cancer Network guidelines recommend adjuvant chemotherapy(ACT)for patients with stage II colon cancer who have undergone curative surgery when fewer than 12 lymph nodes(LNs)are retrieved.This study seeks to further examine the requirement for ACT in individuals who had 12 or more LNs harvested.AIM To investigate if stage II colon cancer patients with 12 or more LNs retrieved benefit from ACT.METHODS This retrospective cohort study included individuals diagnosed with stage II colon cancer who underwent surgery between 2008 and 2017 from the Surveillance,Epidemiology,and End Results(SEER)registry and a Chinese multicenter database.All patients had at least 12 LNs retrieved.The key endpoint was overall survival(OS).Cox regression analysis was performed to assess independent OS predictors.Propensity score matching controlled for confounders,and Kaplan-Meier analysis evaluated the impact of ACT on survival.RESULTS A total of 32742 patients with stage II colon cancer from the SEER cohort and 3153 patients from the Chinese cohort were included.The average number of LNs retrieved was 20.0(15.0,26.0)in the SEER cohort and 18.0(15.0,22.0)in the Chinese cohort.No-ACT remained an independent risk factor in both cohorts(hazard ratio=1.589,95%confidence interval:1.485-1.700 and hazard ratio=1.865,95%confidence interval:1.465-2.375,respectively).In the SEER cohort,patients in the ACT group consistently demonstrated better 5-year OS rates both before and after propensity score matching(79.4%vs 66.1%and 79.4%vs 69.4%,both P<0.0001).Similarly,these findings were further validated in the Chinese cohort(91.2%vs 82.1%and 90.0%vs 82.8%,both P<0.0001).ACT improved prognosis even in T3 and grade 1/2 patients.CONCLUSION This research,based on two large population-based cohorts,demonstrates that stage II colon cancer patients with 12 or more LNs retrieved can still benefit from ACT.
基金Supported by the National Natural Science Foundation of China(Grant No.12031002)。
文摘Accurately identifying key nodes is essential for evaluating network robustness and controlling information propagation in complex network analysis. However, current research methods face limitations in applicability and accuracy. To address these challenges, this study introduces the K-GCN model, which integrates neighborhood k-shell distribution analysis with Graph Convolutional Network(GCN) technology to enhance key node identification in complex networks. The K-GCN model first leverages neighborhood k-shell distributions to calculate entropy values for each node, effectively quantifying node importance within the network. These entropy values are then used as key features within the GCN, which subsequently formulates intelligent strategies to maximize network connectivity disruption by removing a minimal set of nodes, thereby impacting the overall network architecture. Through iterative interactions with the environment, the GCN continuously refines its strategies, achieving precise identification of key nodes in the network. Unlike traditional methods, the K-GCN model not only captures local node features but also integrates the network structure and complex interrelations between neighboring nodes, significantly improving the accuracy and efficiency of key node identification.Experimental validation in multiple real-world network scenarios demonstrates that the K-GCN model outperforms existing methods.
基金supported by the Fujian Key Laboratory of Intelligent Imaging and Precision Radiotherapy for Tumors(Fujian Medical University)and Clinical Research Center for Radiology and Radiotherapy of Fujian Province(Digestive,Hematological and Breast Malignancies).
文摘Background:Metastasis to the infraclavicular and supraclavicular lymph nodes(ISLNs)is an important factor that predicts poor survival in patients with breast cancer;however,pathological nodal staging does not traditionally include ISLNs because of their non-routine surgical dissection.This study aimed to evaluate the prognostic impact of ISLN metastasis and propose a refined nodal staging system tailored for patients undergoing neoadjuvant chemotherapy(NAC).Methods:We retrospectively reviewed 1,072 patients with breast cancer with or without ISLN metastasis who received NAC at two institutions(Fujian cohort and Hebei cohort)from 2010 to 2022.We conducted detailed survival analysis to evaluate the diagnostic consistency and prognostic significance of ISLNs.Results:There were no survival differences among patients with ISLN involvement across different assay method-ologies and patient cohorts.Among 887 patients in the Fujian cohort,238 patients(26.8%)with positive ISLNs had significantly inferior 3-year progression-free survival(PFS,75.9%vs.90.4%,P<0.001)and overall survival(OS,90.6%vs.95.9%,P<0.001).After adjusting for potential confounders,ISLN involvement persisted as an independent predictor of both PFS and OS.We propose a refined axillary classification that combines pathologi-cal axillary staging post-NAC with ISLN involvement,revealing 3-year PFS rates of 95.3%,87.6%,73.4%,and 64.5%for the respective four groups defined by this refined classification combining axillary stage and ISLN status.Conclusions:Involvement of the ISLNs was associated with a worse prognosis,underscoring their prognostic value.This finding highlights the potential of ISLN status to influence decisions regarding adjuvant treatment in patients with breast cancer.
基金Supported by the National Natural Science Foundation of China,No.82473195 and No.32370797the Natural Science Foundation of Zhejiang Province,No.LTGY23H160018+3 种基金the Zhejiang Medical and Health Science and Technology Program,No.2024KY789 and No.2023KY615the National Research Center for Translational Medicine at Shanghai Program,No.NRCTM(SH)-2025-07the Beijing Science and Technology Innovation Medical Development Foundation,No.KC2023-JX-0270-07the Key Laboratory of Prevention,Diagnosis and Therapy of Upper Gastrointestinal Cancer of Zhejiang Province,No.2022E10021.
文摘BACKGROUND The log odds of positive lymph nodes(LODDS)are correlated with survival outcomes in gastric cancer(GC)patients.However,the prognostic value across different tumor differentiation levels remains unclear.AIM To evaluate the independent prognostic value of LODDS and the stratified predictive efficacy in GC patients with different histologic differentiations.METHODS We conducted a retrospective analysis of 2103 GC patients who underwent radical gastrectomy at Zhejiang Cancer Hospital.The prognostic value of LODDS was compared with that of other lymph node-based metrics,including the pathologic N stage,number of positive lymph nodes,number of total lymph nodes,and lymph node ratio,stratified by tumor differentiation.RESULTS LODDS was identified as an independent prognostic factor for overall survival in moderately to poorly differentiated GC patients.LODDS demonstrated superior predictive accuracy over other lymph node metrics.A nomogram incorporating LODDS,age,carbohydrate antigen(CA)125,carcinoembryonic antigen,and tumor differentiation showed good predictive accuracy(C-index=0.703).A higher LODDS was significantly associated with an increased risk of recurrence or metastasis,poorly differentiated tumors,advanced cancer,mucinous gastric adenocarcinoma,nerve invasion,and vascular tumor thrombus.Additionally,LODDS was positively correlated with the tumor markers CA19-9,CA72-4,CA125,and CA242(all P<0.05).CONCLUSION LODDS is an independent prognostic indicator for patients with moderately and poorly differentiated GC,and its predictive performance is superior to that of other models.
文摘Hypergraphs,which encapsulate interactions of higher-order beyond mere pairwise connections,are essential for representing polyadic relationships within complex systems.Consequently,an increasing number of researchers are focusing on the centrality problem in hypergraphs.Specifically,researchers are tackling the challenge of utilizing higher-order structures to effectively define centrality metrics.This paper presents a novel approach,LGK,derived from the K-shell decomposition method,which incorporates both global and local perspectives.Empirical evaluations indicate that the LGK method provides several advantages,including reduced time complexity and improved accuracy in identifying critical nodes in hypergraphs.
基金supported by the National Natural Science Foundation of China(Grant No.62173065)the Natural Science Foundation of Beijing(Grant No.4242040)+1 种基金the Intelligent Policing and National Security Risk Management Laboratory Open Topics for the year 2025(Grant No.ZHKFYB2503)the Intelligent Policing and National Security Risk Management Laboratory Open Topics for the year 2024(Grant No.ZHKFZD2401).
文摘Identifying critical nodes is a pivotal research topic in network science,yet the efficient and accurate detection of highly influential nodes remains a challenge.Existing centrality measures predominantly rely on local or global topological structures,often overlooking indirect connections and their interaction strengths.This leads to imprecise assessments of node importance,limiting practical applications.To address this,we propose a novel node centrality measure,termed six-degree gravity centrality(SDGC),grounded in the six degrees of separation theory,for the precise identification of influential nodes in networks.Specifically,we introduce a set of node influence parameters—node mass,dynamic interaction distance,and attraction coefficient—to enhance the gravity model.Node mass is calculated by integrating K-shell and closeness centrality measures.The dynamic interaction distance,informed by the six-degrees of separation theory,is determined through path searches within six hops between node pairs.The attraction coefficient is derived from the difference in K-shell values between nodes.By integrating these parameters,we develop an improved gravity model to quantify node influence.Experiments conducted on nine real-world networks demonstrate that SDGC significantly outperforms nine existing classical and state-of-the-art methods in identifying the influential nodes.
基金Research results of the General Scientific Research Project of Zhejiang Education Department in 2024,“Research on the Digitalization of Song Yun Ink Painting-Taking the Ten Scenes of West Lake as an Example”(Project No.:Y202455200).
文摘This study examines the development of painting techniques of Chinese ink wash landscape paintings,pays attention to its unique brush and ink language and features of the representation of elements,and deeply analyzes the artistic characteristics of digital ink wash texture materials.The research focuses on key aspects such as the ink brushstrokes with the combination of emptiness and reality,the profound and serene ink wash space,and the extremely ingenious position layout.It proposes a construction path of digital ink wash texture materials based on the Blender material node system.This method makes use of the flexibility of the Blender material node system to successfully simulate highly realistic digital ink wash textures.It can not only construct static ink wash textures but also realize the dynamic transformation of static ink wash works through animation nodes and procedural control,thereby enhancing the artistic expression of digital ink wash works.The proposal and implementation of this method expand the application scope of the Blender material node system,help deeply explore the potential of digital ink wash art,and open up a brand new research path for constructing digital ink wash textures.
基金Project supported by the National Natural Science Foundation of China(Grant No.62166010)the Guangxi Natural Science Foundation(Grant No.2023GXNSFAA026087).
文摘Hypergraphs can accurately capture complex higher-order relationships,but it is challenging to identify their important nodes.In this paper,an improved PageRank(ImPageRank)algorithm is designed to identify important nodes in a directed hypergraph.The algorithm introduces the Jaccard similarity of directed hypergraphs.By comparing the numbers of common neighbors between nodes with the total number of their neighbors,the Jaccard similarity measure takes into account the similarity between nodes that are not directly connected,and can reflect the potential correlation between nodes.An improved susceptible–infected(SI)model in directed hypergraph is proposed,which considers nonlinear propagation mode and more realistic propagation mechanism.In addition,some important node evaluation methods are transferred from undirected hypergraphs and applied to directed hypergraphs.Finally,the ImPageRank algorithm is used to evaluate the performance of the SI model,network robustness and monotonicity.Simulations of real networks demonstrate the excellent performance of the proposed algorithm and provide a powerful framework for identifying important nodes in directed hypergraphs.
文摘BACKGROUND Internal mammary(IM)lymphadenopathies in breast cancer indicate a worse prognosis than axillary metastases,yet they are rarely assessed.Accurate staging is essential for treatment planning.Robotic biopsy offers a promising alternative to video-assisted thoracic surgery for precise histological sampling.This article outlines a systematic robot-assisted dissection approach to enhance staging accuracy and optimize breast cancer management.CASE SUMMARY At our institution,robotic lymphadenectomy of the IM chain was performed in 5 patients between July 2020 and December 2024.Patients were positioned in a 30°semi-supine position with a roll under the shoulder to elevate the chest.The camera port was inserted in the fifth intercostal space along the mid-axillary line,allowing a 0°,12 mm robotic camera to inspect the chest cavity;CO_(2) insufflation(8 L/minute,8-10 mmHg)facilitated lung collapse and pneumo-mediastinum formation for improved dissection.Under direct vision,two additional operative ports were placed:One in the third intercostal space(anterior axillary line)and another in the fifth intercostal space(3-4 cm lateral to the parasternal line).The mean operative time was 118 minutes,with a median hospital stay of two days.No major complications occurred.Histology confirmed breast carcinoma metas tases in three patients,while two had benign disease.CONCLUSION Robotic biopsy of IM lymph nodes is safe,feasible,and provides key information on breast cancer management,with very rare contraindications.
基金Supported by the National High Level Hospital Clinical Research Funding,No.2023-NHLHCRF-BQ-32 and No.2023-NHLHCRFYYPPLC-ZR-13National Key Research and Development Program of China,No.2024YFE0198300Beijing Municipal Natural Science Foundation,No.7222316.
文摘BACKGROUND The number of tumor deposits(TDs)does not play a part in the current tumor node metastasis staging.Negative lymph node(NLN)status is associated with the prognosis of colorectal cancer(CRC),but its clear role in N1c stage remains to be defined.AIM To evaluate the combination of TDs and NLNs as potential prognostic indicators in N1c CRC.METHODS We retrospectively identified 107 consecutive patients who had N1c CRC radically resected at China-Japan Friendship Hospital.The combination of TDs and NLNs was calculated by the formula NLNTD=NLN/(TD+1).Cutoff values of NLNs and NLNTD were determined using the R package“survminer”.Disease-free survival(DFS),overall survival(OS)and cancer-specific survival(CSS)were determined using the Kaplan-Meier method to assess the impact of NLNTD on prognosis.Results were compared using the log-rank test.RESULTS The median follow-up time was 63.17(45.33-81.37)months for DFS,with 33.64%(36/107)of patients experiencing recurrence during follow-up.Five-year DFS was 66.0%(57.3%-76.0%).There was no significant difference in prognosis between patients with>12 and≤12 NLNs(P=0.058)for DFS.Similar results were seen according to the number of TDs.The definition of NLNTD=NLN/(TD+1)with a cutoff value of 6 divided patients into two groups with different DFS(P=0.005).Five-year DFS for patients with NLNTD>6 was 73.5%(63.6%-85.0%),compared with 50.0%(35.7%-70.0%)for those with NLNTD≤6.These two groups had different prognosis without perineural invasion(P=0.012)or lymphovascular invasion(P=0.002)even neither(P=0.053).Similar results were seen for OS and CSS.CONCLUSION NLNTD could serve as important prognostic factor for outcomes in N1c CRC patients.These patients could be stratified for prognosis through NLNTD and the high-risk should be given more attention during treatment.
文摘BACKGROUND Colorectal cancer is a malignancy with a high risk of lymph node metastasis and poor prognosis,and thus requires an accurate diagnosis.AIM To assess the diagnostic value of combined magnetic resonance T2-weighted imaging(T2WI)and diffusion-weighted imaging(DWI)in colorectal cancer.METHODS We included 120 patients with suspected colorectal cancer who underwent magnetic resonance imaging.Surgical pathology was used as the gold standard for comparison.Combined T2WI and DWI showed higher diagnostic efficacy than either of the two methods used individually.RESULTS The combined method achieved 94.74%sensitivity,95.45%specificity,95.00%accuracy,94.74%positive predictive value,and 95.45%negative predictive value in qualitative diagnosis.It showed 94.44%sensitivity,95.00%specificity,94.74%accuracy,94.44%positive predictive value,and 95.00%negative predictive value in clinical staging.Finally,it showed 94.74%sensitivity,94.59%specificity,94.74%accuracy,94.74%positive predictive value,and 94.59%negative predictive value in diagnosing lymph node metastasis.These results were highly consistent with that of the gold standard.CONCLUSION This study combined T2WI and DWI for accurate diagnosis of colorectal cancer,aiding clinical staging and lymph node metastasis assessment.This approach is promising for clinical application.
基金Supported by the Scientific Research Foundation for Talents Introduced of Guizhou University of Finance and Economics(Grant No.2023YJ16)the Institute of Complexity Science,Henan University of Technology(Grant No.CSKFJJ-2025-33)the International Science and Technology Cooperation Project of Henan Province(Grant No.252102520007).
文摘This paper focuses on applying the barycentric Lagrange interpolation collocation method(BLICM)for solving 2D time-fractional diffusion-wave equation(TFDWE).In order to obtain the discrete format of the equation,we construct the multivariate barycentric Lagrange interpolation approximation function and process the integral terms by using the Gauss-Legendre quadrature formula.We provide a detailed error analysis of the discrete format on the second kind of Chebyshev nodes.The efficacy of the proposed method is substantiated by some numerical experiments.The results of these experiments demonstrate that our method can obtain high-precision numerical solutions for fractional partial differential equations.Additionally,the method's capability to achieve high precision with a reduced number of nodes is confirmed.
基金supported by the Natural Science Foundation of Hunan Province,China(Grant Nos.2023JJ50178 and 2023JJ50194)the Excellent Youth Project of Hunan Provincial Department of Education(Grant No.23B0542).
文摘Rack-level loop thermosyphons have been widely adopted as a solution to data centers’growing energy demands.While numerous studies have highlighted the heat transfer performance and energy-saving benefits of this system,its economic feasibility,water usage effectiveness(WUE),and carbon usage effectiveness(CUE)remain underexplored.This study introduces a comprehensive evaluation index designed to assess the applicability of the rack-level loop thermosyphon system across various computing hub nodes.The air wet bulb temperature Ta,w was identified as the most significant factor influencing the variability in the combination of PUE,CUE,and WUE values.The results indicate that the rack-level loop thermosyphon system achieves the highest score in Lanzhou(94.485)and the lowest in Beijing(89.261)based on the comprehensive evaluation index.The overall ranking of cities according to the comprehensive evaluation score is as follows:Gansu hub(Lanzhou)>Inner Mongolia hub(Hohhot)>Ningxia hub(Yinchuan)>Yangtze River Delta hub(Shanghai)>Chengdu Chongqing hub(Chongqing)>Guangdong-Hong Kong-Macao Greater Bay Area hub(Guangzhou)>Guizhou hub(Guiyang)>Beijing-Tianjin-Hebei hub(Beijing).Furthermore,Hohhot,Lanzhou,and Yinchuan consistently rank among the top three cities for comprehensive scores across all load rates,while Guiyang(at a 25%load rate),Guangzhou(at a 50%load rate),and Beijing(at 75%and 100%load rates)exhibited the lowest comprehensive scores.
基金The National High Technology Research and Deve-lopment Program of China (863Program) (No.2003AA143040).
文摘Major consideration dimensions for the physical layer design of wireless sensor network （WSN） nodes is analyzed by comparing different wireless communication approaches, diverse mature standards, important radio frequency （RF） parameters and various microcontroller unit （MCU） solutions. An implementation of the WSN node is presented with experimental results and a novel ＂one processor working at two frequencies＂ energy saving strategy. The lifetime estimation issue is analyzed with consideration to the periodical listen required by common WSN media access control （MAC） algorithms. It can be concluded that the startup time of the RF which determines the best sleep time ratio and the shortest backoff slot time of MAC, the RF frequency and modulation methods which determinate the RX and TX current, and the overall energy consumption of the dual frequency MCU SOC （ system on chip） are the most essential factors for the WSN node physical layer design.
基金Supported by the National Natural Science Foundation of China(71110307023)~~
文摘Based on the theory of complex network and gray system, the sugesstion that there exist two types of gray nodes in complex networks, Gray Node I and Gray Node II, is concluded. The first one refers to the existent unknown gray nodes, and the second the evolution gray nodes. The relevant definitions are also given. Further- more, grayness degree in complex networks is described and divided into two forms--the relative grayness degree （RGD） and the absolute grayness degree （AGD）, which are proved respectively.
基金Supported by Chongqing Medical Scientific Research Project(Joint Project of Chongqing Health Commission and Science and Technology Bureau),No.2023MSXM060.
文摘BACKGROUND The accurate prediction of lymph node metastasis(LNM)is crucial for managing locally advanced(T3/T4)colorectal cancer(CRC).However,both traditional histopathology and standard slide-level deep learning often fail to capture the sparse and diagnostically critical features of metastatic potential.AIM To develop and validate a case-level multiple-instance learning(MIL)framework mimicking a pathologist's comprehensive review and improve T3/T4 CRC LNM prediction.METHODS The whole-slide images of 130 patients with T3/T4 CRC were retrospectively collected.A case-level MIL framework utilising the CONCH v1.5 and UNI2-h deep learning models was trained on features from all haematoxylin and eosinstained primary tumour slides for each patient.These pathological features were subsequently integrated with clinical data,and model performance was evaluated using the area under the curve(AUC).RESULTS The case-level framework demonstrated superior LNM prediction over slide-level training,with the CONCH v1.5 model achieving a mean AUC(±SD)of 0.899±0.033 vs 0.814±0.083,respectively.Integrating pathology features with clinical data further enhanced performance,yielding a top model with a mean AUC of 0.904±0.047,in sharp contrast to a clinical-only model(mean AUC 0.584±0.084).Crucially,a pathologist’s review confirmed that the model-identified high-attention regions correspond to known high-risk histopathological features.CONCLUSION A case-level MIL framework provides a superior approach for predicting LNM in advanced CRC.This method shows promise for risk stratification and therapy decisions,requiring further validation.
文摘BACKGROUND Early screening,preoperative staging,and diagnosis of lymph node metastasis are crucial for improving the prognosis of gastric cancer(GC).AIM To evaluate the diagnostic value of combined multidetector computed tomography(MDCT)and gastrointestinal endoscopy for GC screening,preoperative staging,and lymph node metastasis detection,thereby providing a reference for clinical diagnosis and treatment.METHODS In this retrospective study clinical and imaging data of 134 patients with suspected GC who were admitted between January 2023 and October 2024 were initially reviewed.According to the inclusion and exclusion criteria,102 patients were finally enrolled in the analysis.All enrolled patients had undergone both MDCT and gastrointestinal endoscopy examinations prior to surgical intervention.Preoperative clinical staging and lymph node metastasis findings were compared with pathological results.RESULTS The combined use of MDCT and gastrointestinal endoscopy demonstrated a sensitivity of 98.53%,specificity of 97.06%,accuracy of 98.04%,positive predictive value of 98.53%,and negative predictive value of 97.06%for diagnosing GC.These factors were all significantly higher than those of MDCT or endoscopy alone(P<0.05).The accuracy rates of the combined approach for detecting clinical T and N stages were 97.06%and 92.65%,respectively,outperforming MDCT alone(86.76% and 79.41%)and endoscopy alone(85.29% and 70.59%)(P<0.05).Among 68 patients with confirmed GC,50(73.53%)were pathologically diagnosed with lymph node metastasis.The accuracy for detecting lymph node metastasis was 66.00%with endoscopy,76.00%with MDCT,and 92.00% with the combined approach,all with statistically significant differences(P<0.05).CONCLUSION The combined application of MDCT and gastrointestinal endoscopy enhanced diagnostic accuracy for GC,provided greater consistency in preoperative staging,and improved the detection of lymph node metastasis,thereby demonstrating significant clinical utility.
文摘AIM:To evaluate the ability of endoscopic ultrasound(EUS) elastography to distinguish benign from malignant pancreatic masses and lymph nodes.METHODS:A multicenter study was conducted and included 222 patients who underwent EUS examination with assessment of a pancreatic mass(n=121) or lymph node(n=101).The classification as benign or malignant,based on the real time elastography pattern,was compared with the classif ication based on the B-mode EUS images and with the fi nal diagnosis obtained by EUS-guided fi ne needle aspiration(EUS-FNA) and/or by surgical pathology.An interobserver study was performed.RESULTS:The sensitivity and specificity of EUS elastography to differentiate benign from malignant pancreatic lesions are 92.3% and 80.0%,respectively,compared to 92.3% and 68.9%,respectively,for the conventional B-mode images.The sensitivity and specificity of EUS elastography to differentiate benign from malignant lymph nodes was 91.8% and 82.5%,respectively,compared to 78.6% and 50.0%,respectively,for the B-mode images.The kappa coefficient was 0.785 for the pancreatic masses and 0.657 for the lymph nodes.CONCLUSION:EUS elastography is superior compared to conventional B-mode imaging and appears to be able to distinguish benign from malignant pancreatic masses and lymph nodes with a high sensitivity,specificity and accuracy.It might be reserved as a second line examination to help characterise pancreatic masses after negative EUS-FNA and might increase the yield of EUS-FNA for lymph nodes.
