Objective:To characterize placental morphologic features in Moroccan women with adverse outcomes,across different clinical contexts,based on the Amsterdam consensus classification.Methods:A prospective analysis was co...Objective:To characterize placental morphologic features in Moroccan women with adverse outcomes,across different clinical contexts,based on the Amsterdam consensus classification.Methods:A prospective analysis was conducted on placentas with umbilical cords collected fresh between March 1,2024 and July 15,2024 from women with adverse pregnancy outcomes.Clinical data(age,parity,gravidity,complications)were retrieved.Macroscopic parameters(weight,dimensions,cord insertion,membranes,lesions)were assessed,followed by systematic sampling.Tissue was processed by standard histology(formalin fixation,paraffin embedding,hematoxylin and eosin staining),and lesions were classified per Amsterdam criteria.Results:16 placentas from patients with adverse pregnancy outcomes were included.The median maternal age was 30 years.Adverse conditions included placental abruption(50%),intrauterine growth restriction(IUGR,38%),intrauterine fetal death(IUFD,31%),pre-eclampsia/eclampsia(19%),premature rupture of membranes(13%),and oligohydramnios(13%).Several placentas were associated with more than one adverse condition.Histopathology revealed maternal vascular malperfusion lesions in 94%,particularly in pre-eclampsia,IUGR,and IUFD.Fetal vascular malperfusion was found in 88%,mainly in IUGR and IUFD.Inflammatory lesions,dominated by acute maternal and fetal responses stage 3(necrotizing chorioamnionitis and funisitis),were primarily linked to IUFD.Conclusions:Placental examination enhances understanding of the pathophysiology underlying adverse pregnancy outcomes,supports diagnostic confirmation,and guides preventive strategies for recurrence.This study highlights the prevalence of maternal vascular malperfusion in Moroccan women and emphasizes the importance of systematic placental histopathology in obstetric care.展开更多
The respiratory-circulatory system, including organs such as the nose, pharynx, larynx, trachea, bronchi, and heart, is an organic community responsible for ventilation and gas exchange. The integrity of its anatomica...The respiratory-circulatory system, including organs such as the nose, pharynx, larynx, trachea, bronchi, and heart, is an organic community responsible for ventilation and gas exchange. The integrity of its anatomical structure directly affects the evolution of pathological processes, and the analysis of their correlation is a core entry point for clinical disease diagnosis, treatment, and mechanism research. Based on this, this paper mainly explores the correlation between the anatomical and pathological characteristics of the respiratory-circulatory system, aiming to provide anatomical and pathological theoretical support for clinical accurate diagnosis, targeted therapy, and prognosis evaluation.展开更多
Knee osteoarthritis(KOA)is a chronic degenerative disease.Monosodium iodoac-etate(MIA)induction is the most commonly used therapeutic effect evaluation and mechanism of action research model;we observed a lack of stan...Knee osteoarthritis(KOA)is a chronic degenerative disease.Monosodium iodoac-etate(MIA)induction is the most commonly used therapeutic effect evaluation and mechanism of action research model;we observed a lack of standardization and uni-formity in current model building methods,which led us to conduct this study.Background:The aim was to investigate the time-and dose-related changes in the behavioral and pathological characteristics in the MIA-induced KOA model rat.Methods:MIA(40,50,and 60 mg/mL)was injected into the left joint of male Sprague-Dawley rats.After 2 weeks,the changes in the KOA rat model were observed by be-havioral evaluation,imaging-level evaluation,and histological-level evaluation.The changes were also compared after 40-mg/mL MIA injection for 2 and 6 weeks.Results:MIA-induced bone surface defects,osteophyte hyperplasia around the artic-ular rim,increased subchondral bone density,thinning of the sparse trabecular bone,structural disorder,and local clustering were observed.The degree of injury gradually increased with the increase in MIA concentration.After 6 weeks,subchondral bone density and sparse trabecular bone increased in the KOA model.Conclusions:The severity of the model also increased significantly with the changes in dose and time.In dose-dependent experiments,this study revealed that 40 mg/mL was the optimal dose to induce significant pathological changes without causing undue discomfort or death in animals.This dose may induce pathological changes stably and is suitable for long-term observation.展开更多
BACKGROUND Inappropriate selection of patients with early gastric cancer(EGC)for endoscopic submucosal dissection(ESD)may lead to non-curative resection,necessitating additional gastrectomy.Conversely,inappropriate se...BACKGROUND Inappropriate selection of patients with early gastric cancer(EGC)for endoscopic submucosal dissection(ESD)may lead to non-curative resection,necessitating additional gastrectomy.Conversely,inappropriate selection for gastrectomy may result in overtreatment,adversely affecting patients’quality of life.Few have systematically evaluated the concordance between therapeutic indications under current Japanese guidelines and pathological criteria in EGC.To minimize noncurative resection risks while sparing unnecessary surgery for low-risk patients’,we specifically assess the suitability of Japanese guidelines in non-Japanese populations.This work aims to optimize clinical practice by refining endoscopic treatment criteria for adoption beyond Japan.AIM To evaluate EGC clinical decision accuracy by comparing therapeutic indication with postoperative pathological criteria and analyzing factors influencing discrepancies.METHODS A retrospective analysis was conducted on 796 EGC cases diagnosed at Peking University Third Hospital between January 2010 and December 2022.Cases were categorized into three groups:Same-estimated(preoperative therapeutic indication with postoperative pathological criteria matched),underestimated(preoperative ESD indication but postoperative surgical criteria),and overestimated(preoperative surgical indication but postoperative ESD criteria).The rate of discrepancy and associated risk factors were assessed.RESULTS The accuracy rates of preoperative evaluation for ESD and gastrectomy indications were 73.0%(321/430)and 76.0%(278/366),respectively.The overall discrepancy rate was 25.6%(204/796).Multivariate analysis identified tumor location in the upper-third stomach(odds ratio=2.158,95%confidence interval:1.373-3.390,P=0.001)was significantly associated with a higher likelihood of being underestimated and undifferentiated histologic type on preoperative biopsy(odds ratio=2.005,95%confidence interval:1.036-3.879,P=0.039)was more likely to be overestimated.Significant differences were observed in tumor diameter(P<0.001),depth of infiltration(P<0.001),ulcerative findings(P<0.001),and histologic type(P<0.001)between preoperative and postoperative evaluations.CONCLUSION The accuracy of preoperative EGC indications is 74.4%.Upper-third stomach and undifferentiated histology are primary discrepancy predictors.Upper-third tumors are prone to underestimation,while undifferentiated tumors are prone to overestimation.展开更多
Uveal melanoma(UM)is the most common intraocular cancer,with approximately 5.2 individuals per million affected annually in the United States.It represents approximately 3%of the global malignant melanoma cases,accoun...Uveal melanoma(UM)is the most common intraocular cancer,with approximately 5.2 individuals per million affected annually in the United States.It represents approximately 3%of the global malignant melanoma cases,accounting for 80%of the overall noncutaneous melanomas.Clinically,it remains silent in about 30%of the cases;when symptomatic,it generally causes metamorphopsia(painless loss or distortion of vision)and/or photopsia(flashing or flickering of light in the visual field).Discoloration of the iris,astigmatism,glaucoma,and even blindness are other,less common clinical manifestations.Several pathophysiological mechanisms underlie the development of UM.Genetic mutations,involving especially the G protein subunit alpha q(GNAQ),guanine nucleotide-binding protein subunit alpha-11(GNA11),BRCA1 associated deubiquitinase 1(BAP1),splicing factor 3b subunit 1(SF3B1),and eukaryotic translation initiation factor 1A,X-linked(EIF1AX)genes as well as the MAPK/ERK signaling pathway genes,have been largely associated with the development of UM.Chromosomal aberrations,inflammatory and immunological alterations are often concurrent factors for the development and progression of UM.Therapies targeting specific genetic alterations and immunotherapy agents have been recently developed and introduced in clinical practice for the management of advanced-stage UMs.This review aims to present the latest advances in the clinical molecular pathology of UM,along with the resulting targeted,immunological,and other therapies that have been introduced or are currently under investigation.展开更多
Objective To develop a prognostic prediction model for early-stage triple-negative breast cancer(TNBC)using H&E-stained pathological images and to investigate its underlying biological interpretability.Methods A d...Objective To develop a prognostic prediction model for early-stage triple-negative breast cancer(TNBC)using H&E-stained pathological images and to investigate its underlying biological interpretability.Methods A deep learning model was trained on 340 WSIs and externally validated using 81 TCGA cases.Image-derived features extracted through convolutional neural networks were integrated with clinicopathological variables.Model performance was assessed using ROC curve analysis,and interpretability was evaluated by correlating image features with mRNA-seq data and characteristics of the immune microenvironment.Results The model achieved AUCs of 0.86 and 0.75 in the training and validation cohorts,respectively.Analysis using HoVer-Net indicated that lymphocyte abundance was associated with recurrence risk.Texture-related features showed significant correlations with immune cell infiltration and prognostic gene expression profiles.Conclusion This study demonstrates that deep learning can enable accurate prognostic prediction in early-stage TNBC,with interpretable image features that reflect the tumor immune microenvironment and gene expression profiles.展开更多
Objective:Accurate detection of PIK3CA mutations is essential for guiding PI3K-targeted therapies in breast cancer,yet sequencing is not universally accessible,and single-modality prediction models have limited perfor...Objective:Accurate detection of PIK3CA mutations is essential for guiding PI3K-targeted therapies in breast cancer,yet sequencing is not universally accessible,and single-modality prediction models have limited performance.This study developed a multimodal deep learning framework integrating whole-slide imaging(WSI)and structured clinical data to improve mutation prediction.Methods:A total of 1,047 patients from TCGA and 166 patients from 3 external centers were included.The histopathology model used a transformer-based pretrained encoder(H-optimus-0)and a clustering-constrained attention multiple instance learning(CLAM-SB MIL)classifier to generate WSI-level representations.The clinical model incorporated engineered clinical variables and an extreme gradient boosting(XGBoost)model.A decision-level late fusion strategy(Multimodal PIK3CA Model,MPM)combined probabilistic outputs from both branches.Performance was evaluated with the area under the curve(AUC)and secondary metrics.Interpretability was assessed via attention heatmaps and shapley additive explanations(SHAP)analysis.Results:MPM outperformed single-modality models.It achieved an AUC of 0.745 on TCGA and maintained stable performance across external cohorts(0.695,0.690,and 0.680).SHAP analysis identified molecular subtype as the most influential clinical feature,whereas attention maps highlighted mutation-associated morphological regions.Conclusions:The developed multimodal framework effectively integrates complementary morphological and clinical information,and provides a robust and generalizable method for predicting PIK3CA mutation status.Strong multicenter adaptability and biological interpretability support its potential use as a clinical decision-support tool and an accessible alternative to molecular testing.展开更多
Parkinson's disease(PD)is the second most common neurodegenerative disorder.The clinical manifestations of PD include motor symptoms,such as bradykinesia,resting tremor,rigidity,and nonmotor symptoms,which include...Parkinson's disease(PD)is the second most common neurodegenerative disorder.The clinical manifestations of PD include motor symptoms,such as bradykinesia,resting tremor,rigidity,and nonmotor symptoms,which include disturbances in sleep,gastrointestinal function,and olfaction.PD misdiagnosis rates have been reported to reach approximately 30%,partly owing to the heterogeneity of parkinsonism with non-PD pathologies,and the differential diagnosis of PD from neurodegenerative diseases such as multiple systemic atrophy(MSA)and progressive supranuclear palsy poses another unmet need.展开更多
Small intestinal villi are essential for nutrient absorption,and their impairment can lead to malabsorption.Small intestinal villous atrophy(VA)encompasses a heterogeneous group of disorders,including immune-mediated ...Small intestinal villi are essential for nutrient absorption,and their impairment can lead to malabsorption.Small intestinal villous atrophy(VA)encompasses a heterogeneous group of disorders,including immune-mediated conditions(e.g.,celiac disease,autoimmune enteropathy,inborn errors of immunity),lymphoproliferative disorders(e.g.,enteropathy-associated T-cell lymphoma),infectious causes(e.g.,tropical sprue,Whipple’s disease),iatrogenic factors(e.g.,Olmesartanassociated enteropathy,graft-vs-host disease),as well as inflammatory and idiopathic types.These disorders are often rare and challenging to distinguish due to overlapping clinical,serological,endoscopic,and histopathological features.Through a systematic literature search using keywords such as small intestinal VA,malabsorption,and specific enteropathies,this review provides a comprehensive overview of diagnostic clues for VA and malabsorption.We systematically summarize the pathological characteristics of each condition to assist pathologists and clinicians in accurately identifying the underlying etiologies.Current studies still have many limitations and lack broader and deeper investigations into these diseases.Therefore,future research should focus on the development of novel diagnostic tools,predictive models,therapeutic targets,and mechanistic molecular studies to refine both diagnosis and management strategies.展开更多
Alzheimer’s disease(AD)remains an incurable neurodegenerative disorder with devastating societal and personal impacts.Despite decades of intensive research,therapeutic efforts targeting the clinical stages of AD have...Alzheimer’s disease(AD)remains an incurable neurodegenerative disorder with devastating societal and personal impacts.Despite decades of intensive research,therapeutic efforts targeting the clinical stages of AD have largely failed to halt or reverse disease progression.This has prompted a critical shift in focus toward the earlier,preclinical stages of AD,where interventions may hold greater promise for altering the disease trajectory.展开更多
Whole Slide Imaging (WSI) technology, as a revolutionary digital technology in the field of pathology, is gradually changing the traditional clinical pathological diagnosis model. By converting traditional glass patho...Whole Slide Imaging (WSI) technology, as a revolutionary digital technology in the field of pathology, is gradually changing the traditional clinical pathological diagnosis model. By converting traditional glass pathological sections into complete digital images through high-resolution scanning, it provides a new method for pathological diagnosis. Based on this, this paper studies the application of WSI technology in clinical pathological diagnosis, elaborates on its application value, analyzes the current application status, and proposes corresponding application countermeasures, aiming to provide reference for the standardized and popularized development of this technology in clinical pathological diagnosis.展开更多
The purpose of this perspective is to discuss the future development of a potential treatment of glial pathology in Alzheimer's disease(AD) and a new regulatory mechanism, nuclear lipids, which may be involved in ...The purpose of this perspective is to discuss the future development of a potential treatment of glial pathology in Alzheimer's disease(AD) and a new regulatory mechanism, nuclear lipids, which may be involved in the pathogenesis of the disease, based on the work of the authors(Takasugi et al., 2011;Komai et al., 2024).展开更多
Neoadjuvant therapy(NAT)has become the standard treatment for patients with locally advanced breast cancer and stage II-III HER2-positive(HER2+)or triple-negative breast cancer(TNBC)1,2.It is essential to accurately m...Neoadjuvant therapy(NAT)has become the standard treatment for patients with locally advanced breast cancer and stage II-III HER2-positive(HER2+)or triple-negative breast cancer(TNBC)1,2.It is essential to accurately mark the primary breast tumor and positive axillary lymph nodes(ALNs)prior to NAT to ensure precise surgical excision,guide axillary downstaging,and guarantee reliable lesion retrieval for pathologic evaluation3.The false-negative rate of sentinel lymph node biopsy(SLNB)after NAT can be reduced to<10%by applying modalities,such as the identification of≥3 sentinel lymph nodes(SLNs)with dual-mapping techniques or removal of the marked lymph node with target axillary dissection(TAD)according to the ASCO,NCCN,and CBCS guidelines3-5.However,there is a lack of consensus regarding the optimal methods and materials for accurate marking6,7.Conventional techniques include clip placement,guidewire localization,and carbon or ink tattooing,whereas wireless technologies,such as MagseedR,radiofrequency identification tags,SAVI SCOUTR,and radioactive iodine-125(125I)seeds,have also been adopted.Traditional marking techniques have a localization failure rate of approximately 10%.In contrast,the use of 125I seeds(with a radiation dose of 0.1-0.3 mCi)has significantly improved localization accuracy8,9.Nevertheless,owing to radioactive properties,concerns have been raised regarding the potential impact of 125I seed marking on assessing the pathologic complete response(pCR)after NAT10.Moreover,whether the influence of 125I seed marking on pCR could lead to suboptimal adjuvant treatment decisions and potentially compromise long-term oncologic outcomes has not been established.To investigate the potential impact of 125I seed placement on the pCR rate and long-term outcomes in breast cancer patients receiving NAT,we conducted a retrospective cohort study utilizing propensity score matching(PSM).展开更多
Neuromyelitis optica spectrum disorder-related optic neuritis involves various cellular responses to inflammation and degeneration.In most patients,the primary mechanism underlying neuromyelitis optica spectrum disord...Neuromyelitis optica spectrum disorder-related optic neuritis involves various cellular responses to inflammation and degeneration.In most patients,the primary mechanism underlying neuromyelitis optica spectrum disorder-related optic neuritis is the interaction of aquaporin-4 antibodies with the aquaporin-4 protein present on astrocytes within posterior optic nerve.This binding subsequently initiates a cascade of events leading to secondary demyelination of the optic nerve,ultimately culminating in optic nerve degeneration.Earlier studies on this disorder primarily used systemic-induced animal models,which often require prior activation of a systemic immune response.This can result in primary demyelination of the optic nerve,complicating the interpretation of experimental results.Such methodologies hinder the ability to isolate immune responses triggered by specific antibodies.Additionally,the lack of a detailed profile of disease progression over time limits our capacity to identify potential intervention windows.Therefore,constructing a targeted optic neuritis animal model induced by specific antibodies and elucidate the disease progression arecrucial for exploring the mechanisms underlying neuromyelitis optica spectrum disorder-related optic neuritis.In this study,specific antibodies against aquaporin-4 were precisely injected into the retrobulbar optic nerve of mice to induce a targeted inflammatory response in the posterior optic nerve,resulting in a more representative mouse model of neuromyelitis optica spectrum disorder-related optic neuritis than current models.The progression of the disease was then dynamically observed from both histological and functional perspectives over the course of 1 month following the induction of inflammation.By the first week,astrocytes were damaged,as evidenced by the loss of aquaporin-4 and glial fibrillary acidic protein,the activation of microglia,and the upregulation of microglia-related cytokines,including tumor necrosis factor,interleukin-6,interleukin-1β,C-X-C motif ligand 10,and brain-derived neurotrophic factor.Starting from the second week,there were signs of optic nerve demyelination and significant damage to axonal fibers and retinal ganglion cell bodies.Visual-evoked potentials and dark adaptation threshold responses in electroretinogram both indicated dysfunction in the visual pathway and retina,while optical coherence tomography revealed thinning of the retinal nerve fiber layer in live mice.In summary,in this study we conducted a dynamic exploration of the occurrence and progression of neuromyelitis optica spectrum disorder-related optic neuritis triggered by specific antibodies.Our results show pathological changes at various stages and correlate histological and molecular alterations with in vivo structural and functional deterioration.The findings from this study lay an important foundation for further research on neuromyelitis optica spectrum disorder-related optic neuritis.展开更多
Computational pathology,a field at the intersection of computer science and pathology,leverages digital technology to enhance diagnostic accuracy and efficiency.With the digitization of pathology and the development o...Computational pathology,a field at the intersection of computer science and pathology,leverages digital technology to enhance diagnostic accuracy and efficiency.With the digitization of pathology and the development of artificial intelligence,computational pathology has made significant strides in the automatic analysis of pathology images,including pathological structure segmentation,tumor classification,and prognosis analysis.Driven by large-scale datasets and advanced methods,computational pathology is moving toward building foundation models to reach more general applications.Generative methods provide a new perspective on addressing challenges in computational pathology.However,challenges in data security and model reliability,reproducibility,and clinical application remain.This review outlines the evolution of computational pathology from pathology slide digitization to pathology image analysis,consolidates the development of foundation and generative models in computational pathology,and discusses the key challenges that persist.Finally,we introduce some rising techniques for precision pathology.展开更多
As a practicing anatomic pathologist specialized in urologic pathology,a vast difference may be observed between what pathologists designate as neuroendocrine(or small cell)carcinoma of the prostate,and what clinician...As a practicing anatomic pathologist specialized in urologic pathology,a vast difference may be observed between what pathologists designate as neuroendocrine(or small cell)carcinoma of the prostate,and what clinicians or basic scientists define as such.展开更多
Objective:To enhance the reading skills of clinical pathology residents,it is essential to establish a well-structured electronic pathology reading library.Methods:In accordance with the Resident Standardization Train...Objective:To enhance the reading skills of clinical pathology residents,it is essential to establish a well-structured electronic pathology reading library.Methods:In accordance with the Resident Standardization Training Content and Standards(2022 Edition),clinical pathology residents are required to master pathological diagnoses across 11 systems:skin,head and neck,mediastinum and respiratory,digestive,urinary and male reproductive,female reproductive and breast,lymphatic and hematopoietic,bone and soft tissue,cardiovascular,central nervous,and endocrine diseases.Senior pathologists specializing in each subspecialty selected classic pathological slides,which were systematically scanned and compiled into an electronic pathology library.Results:A questionnaire survey was conducted to gather feedback on the electronic pathology reading library.Residents generally found it to be convenient,efficient,and conducive to learning.Conclusion:Training in clinical pathology diagnosis is a core component of standardized resident training.The electronic pathology reading library has been well-received and recognized by resident doctors.However,further efforts are needed to explore diverse teaching methods that align with modern educational approaches,ultimately contributing to the development of highly skilled resident doctors.展开更多
Objective:This study aims to develop a deep multiscale image learning system(DMILS)to differentiate malignant from benign thyroid follicular neoplasms on multiscale whole-slide images(WSIs)of intraoperative frozen pat...Objective:This study aims to develop a deep multiscale image learning system(DMILS)to differentiate malignant from benign thyroid follicular neoplasms on multiscale whole-slide images(WSIs)of intraoperative frozen pathological images.Methods:A total of 1,213 patients were divided into training and validation sets,an internal test set,a pooled external test set,and a pooled prospective test set at three centers.DMILS was constructed using a deep learningbased weakly supervised method based on multiscale WSIs at 10×,20×,and 40×magnifications.The performance of the DMILS was compared with that of a single magnification and validated in two pathologist-unidentified subsets.Results:The DMILS yielded good performance,with areas under the receiver operating characteristic curves(AUCs)of 0.848,0.857,0.810,and 0.787 in the training and validation sets,internal test set,pooled external test set,and pooled prospective test set,respectively.The AUC of the DMILS was higher than that of a single magnification,with 0.788 of 10×,0.824 of 20×,and 0.775 of 40×in the internal test set.Moreover,DMILS yielded satisfactory performance on the two pathologist-unidentified subsets.Furthermore,the most indicative region predicted by DMILS is the follicular epithelium.Conclusions:DMILS has good performance in differentiating thyroid follicular neoplasms on multiscale WSIs of intraoperative frozen pathological images.展开更多
BACKGROUND The heterogeneous group of disorders called peripheral vascular diseases(PVDs)occurs outside the heart and brain tissue to cause ischemia and severe health complications.Diagnosis accuracy is essential in s...BACKGROUND The heterogeneous group of disorders called peripheral vascular diseases(PVDs)occurs outside the heart and brain tissue to cause ischemia and severe health complications.Diagnosis accuracy is essential in starting appropriate patient management at the proper time.Modern medicine considers skin biopsies crucial diagnostic tools that yield histopathological and molecular evidence for examining PVD-related microvascular changes.AIM To evaluate skin biopsy applications in PVD diagnostics through artistic analysis of technical processes and examination of pathological and innovative molecular indicators.METHODS A systematic review of randomized controlled trials and original studies about skin biopsy utility in PVD diagnosis used PubMed,Scopus,and EMBASE search platforms.The reviewed studies met specific entry requirements,while all case reports and review articles remained excluded.RESULTS A total of 22 studies suited the research criteria that were evaluated.Researchers emphasized the value of skin biopsies for identifying inflammatory from non-inflammatory PVDs.At the same time,they detect systemic sclerosis and diabetic vasculopathy abnormalities of micro-vessels and identify endothelial dysfunction through measurements of vascular endothelial growth factor and intercellular adhesion molecule-1 and endothelial nitric oxide synthase markers.Skin biopsies require further improvement because they cause patient discomfort and produce variable diagnostic results that specialists must interpret.CONCLUSION Skin biopsies enable essential diagnostic findings about PVD and improve patient detection.The development of standardized biopsy procedures and molecular diagnosis techniques should be studied to advance PVD diagnoses in clinical practice.展开更多
BACKGROUND The discrepancy between endoscopic biopsy pathology and the overall pathology of gastric low-grade intraepithelial neoplasia(LGIN)presents challenges in developing diagnostic and treatment protocols.AIM To ...BACKGROUND The discrepancy between endoscopic biopsy pathology and the overall pathology of gastric low-grade intraepithelial neoplasia(LGIN)presents challenges in developing diagnostic and treatment protocols.AIM To develop a risk prediction model for the pathological upgrading of gastric LGIN to aid clinical diagnosis and treatment.METHODS We retrospectively analyzed data from patients newly diagnosed with gastric LGIN who underwent complete endoscopic resection within 6 months at the First Medical Center of Chinese People’s Liberation Army General Hospital between January 2008 and December 2023.A risk prediction model for the pathological progression of gastric LGIN was constructed and evaluated for accuracy and clinical applicability.RESULTS A total of 171 patients were included in this study:93 patients with high-grade intraepithelial neoplasia or early gastric cancer and 78 with LGIN.The logistic stepwise regression model demonstrated a sensitivity and specificity of 0.868 and 0.800,respectively,while the least absolute shrinkage and selection operator(LASSO)regression model showed sensitivity and specificity values of 0.842 and 0.840,respectively.The area under the curve(AUC)for the logistic model was 0.896,slightly lower than the AUC of 0.904 for the LASSO model.Internal validation with 30%of the data yielded AUC scores of 0.908 for the logistic model and 0.905 for the LASSO model.The LASSO model provided greater utility in clinical decision-making.CONCLUSION A risk prediction model for the pathological upgrading of gastric LGIN based on white-light and magnifying endoscopic features can accurately and effectively guide clinical diagnosis and treatment.展开更多
文摘Objective:To characterize placental morphologic features in Moroccan women with adverse outcomes,across different clinical contexts,based on the Amsterdam consensus classification.Methods:A prospective analysis was conducted on placentas with umbilical cords collected fresh between March 1,2024 and July 15,2024 from women with adverse pregnancy outcomes.Clinical data(age,parity,gravidity,complications)were retrieved.Macroscopic parameters(weight,dimensions,cord insertion,membranes,lesions)were assessed,followed by systematic sampling.Tissue was processed by standard histology(formalin fixation,paraffin embedding,hematoxylin and eosin staining),and lesions were classified per Amsterdam criteria.Results:16 placentas from patients with adverse pregnancy outcomes were included.The median maternal age was 30 years.Adverse conditions included placental abruption(50%),intrauterine growth restriction(IUGR,38%),intrauterine fetal death(IUFD,31%),pre-eclampsia/eclampsia(19%),premature rupture of membranes(13%),and oligohydramnios(13%).Several placentas were associated with more than one adverse condition.Histopathology revealed maternal vascular malperfusion lesions in 94%,particularly in pre-eclampsia,IUGR,and IUFD.Fetal vascular malperfusion was found in 88%,mainly in IUGR and IUFD.Inflammatory lesions,dominated by acute maternal and fetal responses stage 3(necrotizing chorioamnionitis and funisitis),were primarily linked to IUFD.Conclusions:Placental examination enhances understanding of the pathophysiology underlying adverse pregnancy outcomes,supports diagnostic confirmation,and guides preventive strategies for recurrence.This study highlights the prevalence of maternal vascular malperfusion in Moroccan women and emphasizes the importance of systematic placental histopathology in obstetric care.
文摘The respiratory-circulatory system, including organs such as the nose, pharynx, larynx, trachea, bronchi, and heart, is an organic community responsible for ventilation and gas exchange. The integrity of its anatomical structure directly affects the evolution of pathological processes, and the analysis of their correlation is a core entry point for clinical disease diagnosis, treatment, and mechanism research. Based on this, this paper mainly explores the correlation between the anatomical and pathological characteristics of the respiratory-circulatory system, aiming to provide anatomical and pathological theoretical support for clinical accurate diagnosis, targeted therapy, and prognosis evaluation.
基金Construction Project of High-Level Traditional Chinese Medicine Key Discipline of National Administration of Traditional Chinese Medicine,Grant/Award Number:zyyzdxk-2023022Key Team of Scientific and Technological Innovation Talents of Shanxi Province with Integrated Traditional Chinese and Western Medicine for Preventing and Treating Rheumatological Diseases,Grant/Award Number:202204051002033+4 种基金Traditional Chinese Medicine+Stem Cell Innovation Project,Grant/Award Number:2024KJZY0062023 Shanxi Graduate Research Practice Project,Grant/Award Number:2023KY6762023 Graduate Innovation and Entrepreneurship Project of Shanxi University of Traditional Chinese Medicine,Grant/Award Number:2023CX023 and 2023CX027Science and Technology Innovation Project for University in Shanxi Province,Grant/Award Number:2022L358Key Laboratory of Rheumatological and Immunological Diseases Treated by Integrated Chinese and Western Medicine,Grant/Award Number:zyyyjs2024021。
文摘Knee osteoarthritis(KOA)is a chronic degenerative disease.Monosodium iodoac-etate(MIA)induction is the most commonly used therapeutic effect evaluation and mechanism of action research model;we observed a lack of standardization and uni-formity in current model building methods,which led us to conduct this study.Background:The aim was to investigate the time-and dose-related changes in the behavioral and pathological characteristics in the MIA-induced KOA model rat.Methods:MIA(40,50,and 60 mg/mL)was injected into the left joint of male Sprague-Dawley rats.After 2 weeks,the changes in the KOA rat model were observed by be-havioral evaluation,imaging-level evaluation,and histological-level evaluation.The changes were also compared after 40-mg/mL MIA injection for 2 and 6 weeks.Results:MIA-induced bone surface defects,osteophyte hyperplasia around the artic-ular rim,increased subchondral bone density,thinning of the sparse trabecular bone,structural disorder,and local clustering were observed.The degree of injury gradually increased with the increase in MIA concentration.After 6 weeks,subchondral bone density and sparse trabecular bone increased in the KOA model.Conclusions:The severity of the model also increased significantly with the changes in dose and time.In dose-dependent experiments,this study revealed that 40 mg/mL was the optimal dose to induce significant pathological changes without causing undue discomfort or death in animals.This dose may induce pathological changes stably and is suitable for long-term observation.
基金Supported by China Health&Medical Development Foundation,No.M2021551.
文摘BACKGROUND Inappropriate selection of patients with early gastric cancer(EGC)for endoscopic submucosal dissection(ESD)may lead to non-curative resection,necessitating additional gastrectomy.Conversely,inappropriate selection for gastrectomy may result in overtreatment,adversely affecting patients’quality of life.Few have systematically evaluated the concordance between therapeutic indications under current Japanese guidelines and pathological criteria in EGC.To minimize noncurative resection risks while sparing unnecessary surgery for low-risk patients’,we specifically assess the suitability of Japanese guidelines in non-Japanese populations.This work aims to optimize clinical practice by refining endoscopic treatment criteria for adoption beyond Japan.AIM To evaluate EGC clinical decision accuracy by comparing therapeutic indication with postoperative pathological criteria and analyzing factors influencing discrepancies.METHODS A retrospective analysis was conducted on 796 EGC cases diagnosed at Peking University Third Hospital between January 2010 and December 2022.Cases were categorized into three groups:Same-estimated(preoperative therapeutic indication with postoperative pathological criteria matched),underestimated(preoperative ESD indication but postoperative surgical criteria),and overestimated(preoperative surgical indication but postoperative ESD criteria).The rate of discrepancy and associated risk factors were assessed.RESULTS The accuracy rates of preoperative evaluation for ESD and gastrectomy indications were 73.0%(321/430)and 76.0%(278/366),respectively.The overall discrepancy rate was 25.6%(204/796).Multivariate analysis identified tumor location in the upper-third stomach(odds ratio=2.158,95%confidence interval:1.373-3.390,P=0.001)was significantly associated with a higher likelihood of being underestimated and undifferentiated histologic type on preoperative biopsy(odds ratio=2.005,95%confidence interval:1.036-3.879,P=0.039)was more likely to be overestimated.Significant differences were observed in tumor diameter(P<0.001),depth of infiltration(P<0.001),ulcerative findings(P<0.001),and histologic type(P<0.001)between preoperative and postoperative evaluations.CONCLUSION The accuracy of preoperative EGC indications is 74.4%.Upper-third stomach and undifferentiated histology are primary discrepancy predictors.Upper-third tumors are prone to underestimation,while undifferentiated tumors are prone to overestimation.
文摘Uveal melanoma(UM)is the most common intraocular cancer,with approximately 5.2 individuals per million affected annually in the United States.It represents approximately 3%of the global malignant melanoma cases,accounting for 80%of the overall noncutaneous melanomas.Clinically,it remains silent in about 30%of the cases;when symptomatic,it generally causes metamorphopsia(painless loss or distortion of vision)and/or photopsia(flashing or flickering of light in the visual field).Discoloration of the iris,astigmatism,glaucoma,and even blindness are other,less common clinical manifestations.Several pathophysiological mechanisms underlie the development of UM.Genetic mutations,involving especially the G protein subunit alpha q(GNAQ),guanine nucleotide-binding protein subunit alpha-11(GNA11),BRCA1 associated deubiquitinase 1(BAP1),splicing factor 3b subunit 1(SF3B1),and eukaryotic translation initiation factor 1A,X-linked(EIF1AX)genes as well as the MAPK/ERK signaling pathway genes,have been largely associated with the development of UM.Chromosomal aberrations,inflammatory and immunological alterations are often concurrent factors for the development and progression of UM.Therapies targeting specific genetic alterations and immunotherapy agents have been recently developed and introduced in clinical practice for the management of advanced-stage UMs.This review aims to present the latest advances in the clinical molecular pathology of UM,along with the resulting targeted,immunological,and other therapies that have been introduced or are currently under investigation.
基金Supported by Capital’s Funds for Health Improvement and Research(CFH2024-1-4021)。
文摘Objective To develop a prognostic prediction model for early-stage triple-negative breast cancer(TNBC)using H&E-stained pathological images and to investigate its underlying biological interpretability.Methods A deep learning model was trained on 340 WSIs and externally validated using 81 TCGA cases.Image-derived features extracted through convolutional neural networks were integrated with clinicopathological variables.Model performance was assessed using ROC curve analysis,and interpretability was evaluated by correlating image features with mRNA-seq data and characteristics of the immune microenvironment.Results The model achieved AUCs of 0.86 and 0.75 in the training and validation cohorts,respectively.Analysis using HoVer-Net indicated that lymphocyte abundance was associated with recurrence risk.Texture-related features showed significant correlations with immune cell infiltration and prognostic gene expression profiles.Conclusion This study demonstrates that deep learning can enable accurate prognostic prediction in early-stage TNBC,with interpretable image features that reflect the tumor immune microenvironment and gene expression profiles.
基金financially supported by the Hebei Natural Science Foundation(Grant No.H2024206504)the Medical Science Research Project of Hebei(Grant No.20260484,20260530)the Fundamental Research Funds for the Central Universities(Grant No.20822041J4123).
文摘Objective:Accurate detection of PIK3CA mutations is essential for guiding PI3K-targeted therapies in breast cancer,yet sequencing is not universally accessible,and single-modality prediction models have limited performance.This study developed a multimodal deep learning framework integrating whole-slide imaging(WSI)and structured clinical data to improve mutation prediction.Methods:A total of 1,047 patients from TCGA and 166 patients from 3 external centers were included.The histopathology model used a transformer-based pretrained encoder(H-optimus-0)and a clustering-constrained attention multiple instance learning(CLAM-SB MIL)classifier to generate WSI-level representations.The clinical model incorporated engineered clinical variables and an extreme gradient boosting(XGBoost)model.A decision-level late fusion strategy(Multimodal PIK3CA Model,MPM)combined probabilistic outputs from both branches.Performance was evaluated with the area under the curve(AUC)and secondary metrics.Interpretability was assessed via attention heatmaps and shapley additive explanations(SHAP)analysis.Results:MPM outperformed single-modality models.It achieved an AUC of 0.745 on TCGA and maintained stable performance across external cohorts(0.695,0.690,and 0.680).SHAP analysis identified molecular subtype as the most influential clinical feature,whereas attention maps highlighted mutation-associated morphological regions.Conclusions:The developed multimodal framework effectively integrates complementary morphological and clinical information,and provides a robust and generalizable method for predicting PIK3CA mutation status.Strong multicenter adaptability and biological interpretability support its potential use as a clinical decision-support tool and an accessible alternative to molecular testing.
基金supported by Swiss Center for Applied Human Toxicology(SCAHT AP22-01)(to RN)。
文摘Parkinson's disease(PD)is the second most common neurodegenerative disorder.The clinical manifestations of PD include motor symptoms,such as bradykinesia,resting tremor,rigidity,and nonmotor symptoms,which include disturbances in sleep,gastrointestinal function,and olfaction.PD misdiagnosis rates have been reported to reach approximately 30%,partly owing to the heterogeneity of parkinsonism with non-PD pathologies,and the differential diagnosis of PD from neurodegenerative diseases such as multiple systemic atrophy(MSA)and progressive supranuclear palsy poses another unmet need.
基金Supported by National High-Level Hospital Clinical Research Funding,No.2022-PUMCH-B-022,and No.2022-PUMCH-D-002CAMS Innovation Fund for Medical Sciences,No.CIFMS 2021-1-I2M-003Undergraduate Innovation Program,No.2024dcxm025.
文摘Small intestinal villi are essential for nutrient absorption,and their impairment can lead to malabsorption.Small intestinal villous atrophy(VA)encompasses a heterogeneous group of disorders,including immune-mediated conditions(e.g.,celiac disease,autoimmune enteropathy,inborn errors of immunity),lymphoproliferative disorders(e.g.,enteropathy-associated T-cell lymphoma),infectious causes(e.g.,tropical sprue,Whipple’s disease),iatrogenic factors(e.g.,Olmesartanassociated enteropathy,graft-vs-host disease),as well as inflammatory and idiopathic types.These disorders are often rare and challenging to distinguish due to overlapping clinical,serological,endoscopic,and histopathological features.Through a systematic literature search using keywords such as small intestinal VA,malabsorption,and specific enteropathies,this review provides a comprehensive overview of diagnostic clues for VA and malabsorption.We systematically summarize the pathological characteristics of each condition to assist pathologists and clinicians in accurately identifying the underlying etiologies.Current studies still have many limitations and lack broader and deeper investigations into these diseases.Therefore,future research should focus on the development of novel diagnostic tools,predictive models,therapeutic targets,and mechanistic molecular studies to refine both diagnosis and management strategies.
基金supported by the Canadian Institutes of Health Research Project grant (PJT-169197) to QYsupported by a CGS-M fellowship from the Canadian Institutes of Health Research
文摘Alzheimer’s disease(AD)remains an incurable neurodegenerative disorder with devastating societal and personal impacts.Despite decades of intensive research,therapeutic efforts targeting the clinical stages of AD have largely failed to halt or reverse disease progression.This has prompted a critical shift in focus toward the earlier,preclinical stages of AD,where interventions may hold greater promise for altering the disease trajectory.
文摘Whole Slide Imaging (WSI) technology, as a revolutionary digital technology in the field of pathology, is gradually changing the traditional clinical pathological diagnosis model. By converting traditional glass pathological sections into complete digital images through high-resolution scanning, it provides a new method for pathological diagnosis. Based on this, this paper studies the application of WSI technology in clinical pathological diagnosis, elaborates on its application value, analyzes the current application status, and proposes corresponding application countermeasures, aiming to provide reference for the standardized and popularized development of this technology in clinical pathological diagnosis.
基金supported by a grant from the Japan Foundation for applied enzymology (to NT)the Grant-in-Aid for Scientific Research (C) from the Japan Society for the Promotion of Science (26430059, 17K08272, and 20K07014 to NT)+1 种基金the establishment of university fellowships toward the creation of science technology innovation (JPMJFS2128)a Grant-in-Aid for JSPS Fellows (23KJ1603)(to MK)。
文摘The purpose of this perspective is to discuss the future development of a potential treatment of glial pathology in Alzheimer's disease(AD) and a new regulatory mechanism, nuclear lipids, which may be involved in the pathogenesis of the disease, based on the work of the authors(Takasugi et al., 2011;Komai et al., 2024).
基金supported by grants from the National Natural Science Foundation of China(Grant Nos.82573747,82172873,W2421095,and 82503888)National Science and Technology Major Project(Grant No.2025ZD0543900)+2 种基金Natural Science Foundation of Shandong Province(Grant Nos.ZR2024LMB011 and ZR2024QH058)Taishan Scholars Program of Shandong Province(Grant No.tsqn202211337)Collaborative Academic Innovation Project of Shandong Cancer Hospital(Grant No.GF003).
文摘Neoadjuvant therapy(NAT)has become the standard treatment for patients with locally advanced breast cancer and stage II-III HER2-positive(HER2+)or triple-negative breast cancer(TNBC)1,2.It is essential to accurately mark the primary breast tumor and positive axillary lymph nodes(ALNs)prior to NAT to ensure precise surgical excision,guide axillary downstaging,and guarantee reliable lesion retrieval for pathologic evaluation3.The false-negative rate of sentinel lymph node biopsy(SLNB)after NAT can be reduced to<10%by applying modalities,such as the identification of≥3 sentinel lymph nodes(SLNs)with dual-mapping techniques or removal of the marked lymph node with target axillary dissection(TAD)according to the ASCO,NCCN,and CBCS guidelines3-5.However,there is a lack of consensus regarding the optimal methods and materials for accurate marking6,7.Conventional techniques include clip placement,guidewire localization,and carbon or ink tattooing,whereas wireless technologies,such as MagseedR,radiofrequency identification tags,SAVI SCOUTR,and radioactive iodine-125(125I)seeds,have also been adopted.Traditional marking techniques have a localization failure rate of approximately 10%.In contrast,the use of 125I seeds(with a radiation dose of 0.1-0.3 mCi)has significantly improved localization accuracy8,9.Nevertheless,owing to radioactive properties,concerns have been raised regarding the potential impact of 125I seed marking on assessing the pathologic complete response(pCR)after NAT10.Moreover,whether the influence of 125I seed marking on pCR could lead to suboptimal adjuvant treatment decisions and potentially compromise long-term oncologic outcomes has not been established.To investigate the potential impact of 125I seed placement on the pCR rate and long-term outcomes in breast cancer patients receiving NAT,we conducted a retrospective cohort study utilizing propensity score matching(PSM).
基金The study was partially supported by the General Research Fund(GRF)from the Research Grants Council(RGC)of the Hong Kong Special Administrative Region,China,No.15103522(to ST)the Internal Research Grant from the Hong Kong Polytechnic University 2021-23,No.P0035512(to ST)and P0035375(to HHLC)+1 种基金the Innovation and Technology Commission of the Hong Kong Special Administrative Region(ITC InnoHK CEVR Project)The Hong Kong Polytechnics University Research Center for Sharp Vision,No.P0039595.
文摘Neuromyelitis optica spectrum disorder-related optic neuritis involves various cellular responses to inflammation and degeneration.In most patients,the primary mechanism underlying neuromyelitis optica spectrum disorder-related optic neuritis is the interaction of aquaporin-4 antibodies with the aquaporin-4 protein present on astrocytes within posterior optic nerve.This binding subsequently initiates a cascade of events leading to secondary demyelination of the optic nerve,ultimately culminating in optic nerve degeneration.Earlier studies on this disorder primarily used systemic-induced animal models,which often require prior activation of a systemic immune response.This can result in primary demyelination of the optic nerve,complicating the interpretation of experimental results.Such methodologies hinder the ability to isolate immune responses triggered by specific antibodies.Additionally,the lack of a detailed profile of disease progression over time limits our capacity to identify potential intervention windows.Therefore,constructing a targeted optic neuritis animal model induced by specific antibodies and elucidate the disease progression arecrucial for exploring the mechanisms underlying neuromyelitis optica spectrum disorder-related optic neuritis.In this study,specific antibodies against aquaporin-4 were precisely injected into the retrobulbar optic nerve of mice to induce a targeted inflammatory response in the posterior optic nerve,resulting in a more representative mouse model of neuromyelitis optica spectrum disorder-related optic neuritis than current models.The progression of the disease was then dynamically observed from both histological and functional perspectives over the course of 1 month following the induction of inflammation.By the first week,astrocytes were damaged,as evidenced by the loss of aquaporin-4 and glial fibrillary acidic protein,the activation of microglia,and the upregulation of microglia-related cytokines,including tumor necrosis factor,interleukin-6,interleukin-1β,C-X-C motif ligand 10,and brain-derived neurotrophic factor.Starting from the second week,there were signs of optic nerve demyelination and significant damage to axonal fibers and retinal ganglion cell bodies.Visual-evoked potentials and dark adaptation threshold responses in electroretinogram both indicated dysfunction in the visual pathway and retina,while optical coherence tomography revealed thinning of the retinal nerve fiber layer in live mice.In summary,in this study we conducted a dynamic exploration of the occurrence and progression of neuromyelitis optica spectrum disorder-related optic neuritis triggered by specific antibodies.Our results show pathological changes at various stages and correlate histological and molecular alterations with in vivo structural and functional deterioration.The findings from this study lay an important foundation for further research on neuromyelitis optica spectrum disorder-related optic neuritis.
基金supported in part by the Shenzhen Natural Science Fund(the Stable Support Plan Program 20220810144949003)the Key Technology Development Program of Shenzhen(JSGG20210713091811036)+2 种基金the Key-Area Research and Development Program of Guangdong Province(2021B0101420005)the Shenzhen Key Laboratory Foundation(ZDSYS20200811143757022)the Guangdong Provincial Key Laboratory of Mathematical and Neural Dynamical Systems(2024B1212010004).
文摘Computational pathology,a field at the intersection of computer science and pathology,leverages digital technology to enhance diagnostic accuracy and efficiency.With the digitization of pathology and the development of artificial intelligence,computational pathology has made significant strides in the automatic analysis of pathology images,including pathological structure segmentation,tumor classification,and prognosis analysis.Driven by large-scale datasets and advanced methods,computational pathology is moving toward building foundation models to reach more general applications.Generative methods provide a new perspective on addressing challenges in computational pathology.However,challenges in data security and model reliability,reproducibility,and clinical application remain.This review outlines the evolution of computational pathology from pathology slide digitization to pathology image analysis,consolidates the development of foundation and generative models in computational pathology,and discusses the key challenges that persist.Finally,we introduce some rising techniques for precision pathology.
文摘As a practicing anatomic pathologist specialized in urologic pathology,a vast difference may be observed between what pathologists designate as neuroendocrine(or small cell)carcinoma of the prostate,and what clinicians or basic scientists define as such.
文摘Objective:To enhance the reading skills of clinical pathology residents,it is essential to establish a well-structured electronic pathology reading library.Methods:In accordance with the Resident Standardization Training Content and Standards(2022 Edition),clinical pathology residents are required to master pathological diagnoses across 11 systems:skin,head and neck,mediastinum and respiratory,digestive,urinary and male reproductive,female reproductive and breast,lymphatic and hematopoietic,bone and soft tissue,cardiovascular,central nervous,and endocrine diseases.Senior pathologists specializing in each subspecialty selected classic pathological slides,which were systematically scanned and compiled into an electronic pathology library.Results:A questionnaire survey was conducted to gather feedback on the electronic pathology reading library.Residents generally found it to be convenient,efficient,and conducive to learning.Conclusion:Training in clinical pathology diagnosis is a core component of standardized resident training.The electronic pathology reading library has been well-received and recognized by resident doctors.However,further efforts are needed to explore diverse teaching methods that align with modern educational approaches,ultimately contributing to the development of highly skilled resident doctors.
基金supported by the Taishan Scholar Project(No.ts20190991,tsqn202211378)the Key R&D Project of Shandong Province(No.2022CXPT023)the General Program of National Natural Science Foundation of China(No.82371933)。
文摘Objective:This study aims to develop a deep multiscale image learning system(DMILS)to differentiate malignant from benign thyroid follicular neoplasms on multiscale whole-slide images(WSIs)of intraoperative frozen pathological images.Methods:A total of 1,213 patients were divided into training and validation sets,an internal test set,a pooled external test set,and a pooled prospective test set at three centers.DMILS was constructed using a deep learningbased weakly supervised method based on multiscale WSIs at 10×,20×,and 40×magnifications.The performance of the DMILS was compared with that of a single magnification and validated in two pathologist-unidentified subsets.Results:The DMILS yielded good performance,with areas under the receiver operating characteristic curves(AUCs)of 0.848,0.857,0.810,and 0.787 in the training and validation sets,internal test set,pooled external test set,and pooled prospective test set,respectively.The AUC of the DMILS was higher than that of a single magnification,with 0.788 of 10×,0.824 of 20×,and 0.775 of 40×in the internal test set.Moreover,DMILS yielded satisfactory performance on the two pathologist-unidentified subsets.Furthermore,the most indicative region predicted by DMILS is the follicular epithelium.Conclusions:DMILS has good performance in differentiating thyroid follicular neoplasms on multiscale WSIs of intraoperative frozen pathological images.
文摘BACKGROUND The heterogeneous group of disorders called peripheral vascular diseases(PVDs)occurs outside the heart and brain tissue to cause ischemia and severe health complications.Diagnosis accuracy is essential in starting appropriate patient management at the proper time.Modern medicine considers skin biopsies crucial diagnostic tools that yield histopathological and molecular evidence for examining PVD-related microvascular changes.AIM To evaluate skin biopsy applications in PVD diagnostics through artistic analysis of technical processes and examination of pathological and innovative molecular indicators.METHODS A systematic review of randomized controlled trials and original studies about skin biopsy utility in PVD diagnosis used PubMed,Scopus,and EMBASE search platforms.The reviewed studies met specific entry requirements,while all case reports and review articles remained excluded.RESULTS A total of 22 studies suited the research criteria that were evaluated.Researchers emphasized the value of skin biopsies for identifying inflammatory from non-inflammatory PVDs.At the same time,they detect systemic sclerosis and diabetic vasculopathy abnormalities of micro-vessels and identify endothelial dysfunction through measurements of vascular endothelial growth factor and intercellular adhesion molecule-1 and endothelial nitric oxide synthase markers.Skin biopsies require further improvement because they cause patient discomfort and produce variable diagnostic results that specialists must interpret.CONCLUSION Skin biopsies enable essential diagnostic findings about PVD and improve patient detection.The development of standardized biopsy procedures and molecular diagnosis techniques should be studied to advance PVD diagnoses in clinical practice.
基金Supported by the National Key Research and Development Program of China,No.2022YFC2503600。
文摘BACKGROUND The discrepancy between endoscopic biopsy pathology and the overall pathology of gastric low-grade intraepithelial neoplasia(LGIN)presents challenges in developing diagnostic and treatment protocols.AIM To develop a risk prediction model for the pathological upgrading of gastric LGIN to aid clinical diagnosis and treatment.METHODS We retrospectively analyzed data from patients newly diagnosed with gastric LGIN who underwent complete endoscopic resection within 6 months at the First Medical Center of Chinese People’s Liberation Army General Hospital between January 2008 and December 2023.A risk prediction model for the pathological progression of gastric LGIN was constructed and evaluated for accuracy and clinical applicability.RESULTS A total of 171 patients were included in this study:93 patients with high-grade intraepithelial neoplasia or early gastric cancer and 78 with LGIN.The logistic stepwise regression model demonstrated a sensitivity and specificity of 0.868 and 0.800,respectively,while the least absolute shrinkage and selection operator(LASSO)regression model showed sensitivity and specificity values of 0.842 and 0.840,respectively.The area under the curve(AUC)for the logistic model was 0.896,slightly lower than the AUC of 0.904 for the LASSO model.Internal validation with 30%of the data yielded AUC scores of 0.908 for the logistic model and 0.905 for the LASSO model.The LASSO model provided greater utility in clinical decision-making.CONCLUSION A risk prediction model for the pathological upgrading of gastric LGIN based on white-light and magnifying endoscopic features can accurately and effectively guide clinical diagnosis and treatment.
