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 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
Alzheimer'sdisease(AD)isaprogressive neurodegenerative disorder characterized by cognitive impairment and distinct neuropathological features,including amyloid-βplaques,neurofibrillary tangles,and reactive astrog...Alzheimer'sdisease(AD)isaprogressive neurodegenerative disorder characterized by cognitive impairment and distinct neuropathological features,including amyloid-βplaques,neurofibrillary tangles,and reactive astrogliosis.Developing effective diagnostic,preventative,and therapeutic strategies for AD necessitates the establishment of animal models that accurately recapitulate the pathophysiological processes of the disease.Existing transgenic mouse models have significantly contributed to understanding AD pathology but often fail to replicate the complexity of human AD.Additionally,these models are limited in their ability to elucidate the interplay among amyloid-βplaques,neurofibrillary tangles,and reactive astrogliosis due to the absence of spatially and temporally specific genetic manipulation.In this study,we introduce a novel AD mouse model(APP/PS1-TauP301L-Adeno mice)designed to rapidly induce pathological symptoms and enhance understanding of AD mechanisms.Neurofibrillary tangles and severe reactive astrogliosis were induced by injecting AAVDJ-EF1a-hTauP301L-EGFP and Adeno-GFAP-GFP viruses into the hippocampi of 5-month-old APP/PS1 mice.Three months post-injection,these mice exhibited pronounced astrogliosis,substantial amyloid-βplaque accumulation,extensiveneurofibrillarytangles,accelerated neuronal loss,elevated astrocytic GABA levels,and significant spatial memory deficits.Notably,these pathological features were less severe in AAVTauP301L-expressing APP/PS1 mice without augmented reactive astrogliosis.These findings indicate an exacerbating role of severe reactive astrogliosis in amyloid-βplaque and neurofibrillary tangle-associated pathology.The APP/PS1-TauP301L-Adeno mouse model provides a valuable tool for advancing therapeutic research aimed at mitigating the progression of AD.展开更多
Alzheimer's disease (AD) is characterized by an imbalance between excitatory and inhibitory brain networks,leading to aberrant homeostatic synaptic plasticity.AD has progressively been recognized as syna ptopathy ...Alzheimer's disease (AD) is characterized by an imbalance between excitatory and inhibitory brain networks,leading to aberrant homeostatic synaptic plasticity.AD has progressively been recognized as syna ptopathy and syna ptic dysfunction has been identified as a key component of its pathogenesis (Schirinzi et al.,2020).Syna ptic dysfunction is believed to precede synapse loss,a primary biological correlate of cognitive decline in AD,inevita bly associated with neuronal death.展开更多
BACKGROUND Pancreatic cancer remains one of the most lethal malignancies worldwide,with a poor prognosis often attributed to late diagnosis.Understanding the correlation between pathological type and imaging features ...BACKGROUND Pancreatic cancer remains one of the most lethal malignancies worldwide,with a poor prognosis often attributed to late diagnosis.Understanding the correlation between pathological type and imaging features is crucial for early detection and appropriate treatment planning.AIM To retrospectively analyze the relationship between different pathological types of pancreatic cancer and their corresponding imaging features.METHODS We retrospectively analyzed the data of 500 patients diagnosed with pancreatic cancer between January 2010 and December 2020 at our institution.Pathological types were determined by histopathological examination of the surgical spe-cimens or biopsy samples.The imaging features were assessed using computed tomography,magnetic resonance imaging,and endoscopic ultrasound.Statistical analyses were performed to identify significant associations between pathological types and specific imaging characteristics.RESULTS There were 320(64%)cases of pancreatic ductal adenocarcinoma,75(15%)of intraductal papillary mucinous neoplasms,50(10%)of neuroendocrine tumors,and 55(11%)of other rare types.Distinct imaging features were identified in each pathological type.Pancreatic ductal adenocarcinoma typically presents as a hypodense mass with poorly defined borders on computed tomography,whereas intraductal papillary mucinous neoplasms present as characteristic cystic lesions with mural nodules.Neuroendocrine tumors often appear as hypervascular lesions in contrast-enhanced imaging.Statistical analysis revealed significant correlations between specific imaging features and pathological types(P<0.001).CONCLUSION This study demonstrated a strong association between the pathological types of pancreatic cancer and imaging features.These findings can enhance the accuracy of noninvasive diagnosis and guide personalized treatment approaches.展开更多
This study aims to explore the unconscious motivations underlying migration in Niger, with an emphasis on understanding the phenomenon of pathological travel. Its aim is to identify the unconscious factors of patholog...This study aims to explore the unconscious motivations underlying migration in Niger, with an emphasis on understanding the phenomenon of pathological travel. Its aim is to identify the unconscious factors of pathological travel among migrants. Pathological travel, as discussed in the scientific literature on psychopathology, is characterised by movements initiated under the influence of delusions, hallucinations or other serious psychiatric disorders. The aim of this research is to contribute to our understanding of how these unconscious factors influence migration decisions. Using a retrospective analysis of five cases, this study examines the psychological and psychiatric dimensions of migration, particularly among patients referred to the psychiatry department of the Niamey National Hospital between 2017 and 2018. The five cases analysed, representing 12% of a cohort of 40 migrant patients, suffered from chronic psychotic disorders, including schizophrenia and chronic hallucinatory psychosis. By means of diagnostic interviews and categorical sorting, three main unconscious motivations were identified: the delusional state with themes of filiation and persecution, the hallucinations that dictated the travel behaviour, and the dissociative states manifested by depersonalisation and derealisation. It also emerges from this analysis that pathological travel often involves prolonged journeys on foot and without purpose. Thus, untreated mental illness plays a significant role in shaping and influencing individual and social behaviour. The results of this study have important implications for public health and migration policy. They highlight the need to integrate health assessments into migration management systems, particularly in regions serving as transit hubs for migrants. The research also highlights the need for culturally sensitive psychiatric interventions to address the interaction between pre-existing mental disorders and migration. This study contributes to a better understanding of the psychological dimensions of migration by highlighting the importance of addressing mental health as an integral part of humanitarian action. The knowledge gained paves the way for future research to explore this understudied aspect of migration on a broader scale.展开更多
The damage map is an important tool for the investigation of the conservation state of a building,especially when the surveyed element is a property with historical preservation interest.Thereby,we consider that the f...The damage map is an important tool for the investigation of the conservation state of a building,especially when the surveyed element is a property with historical preservation interest.Thereby,we consider that the full understanding of the construction techniques is crucial to diagnose anomalies found in the facades of the buildings.It is very important to know the materials used in the construction and the routine of building maintenance.It is also necessary to emphasize the importance of having historical information about interventions and modifications that the building’s structure suffered over the years in order to obtain data and requirements for the complete configuration of the analyzed building.This article results from a master's research in progress and it aims to present the process of the development of a damage map,seeking its implementation in a real case study,the facades of the Carmo’s Church in the city of Olinda.There are three reasons why we chose this church to study.First,this building is inserted in the Historic Centre of the Town of Olinda,which is inscribed on the UNESCO’s World Heritage list since 1982;second it was built in 1588 configuring the oldest church of the Carmelite Order in Brazil and finally the building has been restored and recovered recently in July 2012 and it is observed that,after four years,we observe some pathological manifestations in their facades.展开更多
AIM:To investigate the clinicopathological features of cranial-nasal-orbital communicating lesions and identify key diagnostic indicators for differentiating benign and malignant neoplasms.METHODS:The retrospective co...AIM:To investigate the clinicopathological features of cranial-nasal-orbital communicating lesions and identify key diagnostic indicators for differentiating benign and malignant neoplasms.METHODS:The retrospective cohort study analyzed 74 histologically confirmed cases stratified by anatomical involvement at the Wuhan Union Hospital between January 2010 and December 2020:Group A(orbital-nasal group,n=29),Group B(orbital-cranial group,n=27),and Group C(cranial-nasal-orbital group,n=18).Clinicopathological profiles including symptom presentation,histopathology,and invasion patterns were systematically evaluated.RESULTS:The cohort comprised 49(66.2%)benign and 25(33.8%)malignant lesions.Compared with benign lesions,malignant lesions had a shorter onset time(12mo vs 2.5mo,P=0.004)and resulted in poorer vision(0.6 vs 1.53,P=0.025).Headache was reported in 28.6%of patients with benign lesions,but none in those with malignant lesions(P=0.002).Conjunctival congestion and edema were observed in 32.7%of patients with benign lesions and 60%of patients with malignant lesions(P=0.028).The ethmoid sinus was the most frequently invaded site(35 cases).Malignant lesions showed greater invasion in the nasal cavity(28.0%vs 0,P=0.000)and anterior cranial fossa(40.0%vs 8.2%,P=0.003)than benign lesions.The orbital-cranial group was more likely to invade through osseous foramina compared with the orbitalnasal group(P=0.002).Neurogenic tumors predominated benign cases(34.7%),whereas blood derived(28%)and glandular tumors(28%)were most prevalent in malignant subgroups.The proportion of malignant tumors in multidisciplinary combined surgery was higher than that of benign lesions(61.5%vs 38.5%).CONCLUSION:Malignant cranial-nasal-orbital communicating lesions exhibit distinct clinicopathological signatures characterized by rapid progression,aggressive anterior fossa and nasal region,and severe visual morbidity.展开更多
AIM:To explore the methylation status of MSH6 in retinoblastoma(RB)and its impact on clinicopathological features and diagnosis.METHODS:Differentially expressed genes were identified through bioinformatics screening o...AIM:To explore the methylation status of MSH6 in retinoblastoma(RB)and its impact on clinicopathological features and diagnosis.METHODS:Differentially expressed genes were identified through bioinformatics screening of the GSE24673 and GSE125903 datasets,combined with GeneCards database analysis.A total of 102 RB patients and 62 traumaenucleated controls between January 2018 and December 2023 were enrolled,with their clinicopathological data and retinal tissues collected.The mRNA and methylation levels of MSH6 in retinal tissues were detected using real-time quantitative polymerase chain reaction(PCR)and methylation-specific PCR.Western blot analysis was conducted in one pair of RB and control tissues for preliminary protein-level validation of MSH6 expression.Based on the methylation status of MSH6,RB patients were categorized into two groups:low-methylation and highmethylation.Both univariate and multivariate analyses were conducted to identify independent factors influencing the methylation levels using clinicopathological data.Receiver operating characteristic(ROC)curves were applied to evaluate the diagnostic potential of MSH6 methylation in RB.RESULTS:Bioinformatics analysis of public datasets revealed that MSH6 expression was downregulated across multiple cancers,RB.Consistently,in clinical RB tissues,MSH6 mRNA expression was significantly lower than that in control retinal tissues,whereas the promoter methylation level of MSH6 was markedly higher(both P<0.001),indicating that promoter hypermethylation may contribute to transcriptional silencing of MSH6 in RB.Patients with higher MSH6 methylation levels showed more advanced pathological classification and a higher frequency of metastasis.Multivariate logistic regression confirmed that metastatic status(P=0.008,OR=3.51)and pathological classification(P=0.005,OR=3.7)were independent factors associated with MSH6 methylation.Receiver operating characteristic(ROC)analysis demonstrated that MSH6 methylation could effectively distinguish RB tissues from non-tumorous controls(AUC=0.847,sensitivity=78.43%,specificity=80.65%),suggesting that MSH6 hypermethylation may serve as a potential diagnostic biomarker for RB.CONCLUSION:The methylation level of the MSH6 gene may be a key factor in RB pathogenesis.The methylation status of the MSH6 gene is closely associated with clinicopathological features and shows diagnostic potential.展开更多
BACKGROUND Esophageal cancer is the sixth most common cancer worldwide,with a high mortality rate.Early prognosis of esophageal abnormalities can improve patient survival rates.The progression of esophageal cancer fol...BACKGROUND Esophageal cancer is the sixth most common cancer worldwide,with a high mortality rate.Early prognosis of esophageal abnormalities can improve patient survival rates.The progression of esophageal cancer follows a sequence from esophagitis to non-dysplastic Barrett’s esophagus,dysplastic Barrett’s esophagus,and eventually esophageal adenocarcinoma(EAC).This study explored the application of deep learning technology in the precise diagnosis of pathological classification and staging of EAC to enhance diagnostic accuracy and efficiency.AIM To explore the application of deep learning models,particularly Wave-Vision Transformer(Wave-ViT),in the pathological classification and staging of esophageal cancer to enhance diagnostic accuracy and efficiency.METHODS We applied several deep learning models,including multi-layer perceptron,residual network,transformer,and Wave-ViT,to a dataset of clinically validated esophageal pathology images.The models were trained to identify pathological features and assist in the classification and staging of different stages of esophageal cancer.The models were compared based on accuracy,computational complexity,and efficiency.RESULTS The Wave-ViT model demonstrated the highest accuracy at 88.97%,surpassing the transformer(87.65%),residual network(85.44%),and multi-layer perceptron(81.17%).Additionally,Wave-ViT exhibited low computational complexity with significantly reduced parameter size,making it highly efficient for real-time clinical applications.CONCLUSION Deep learning technology,particularly the Frequency-Domain Transformer model,shows promise in improving the precision of pathological classification and staging of EAC.The application of the Frequency-Domain Transformer model enhances the automation of the diagnostic process and may support early detection and treatment of EAC.Future research may further explore the potential of this model in broader medical image analysis applications,particularly in the field of precision medicine.展开更多
The study by Luo et al published in the World Journal of Gastrointestinal Oncology presents a thorough and scientific methodology.Pancreatic cancer is the most challenging malignancy in the digestive system,exhibiting...The study by Luo et al published in the World Journal of Gastrointestinal Oncology presents a thorough and scientific methodology.Pancreatic cancer is the most challenging malignancy in the digestive system,exhibiting one of the highest mortality rates associated with cancer globally.The delayed onset of symptoms and diagnosis often results in metastasis or local progression of the cancer,thereby constraining treatment options and outcomes.For these patients,prompt tumour identification and treatment strategising are crucial.The present objective of pancreatic cancer research is to examine the correlation between various pathological types and imaging data to facilitate therapeutic decision-making.This study aims to clarify the correlation between diverse pathological markers and imaging in pancreatic cancer patients,with prospective longitudinal studies potentially providing novel insights into the diagnosis and treatment of pancreatic cancer.展开更多
BACKGROUND Colorectal cancer(CRC)is a common malignant tumor in the digestive system,whose main treatment comprises surgical resection,radiotherapy and chemotherapy,and targeted drug therapy.At present,the radical res...BACKGROUND Colorectal cancer(CRC)is a common malignant tumor in the digestive system,whose main treatment comprises surgical resection,radiotherapy and chemotherapy,and targeted drug therapy.At present,the radical resection of CRC is the main way of achieving an early cure.AIM To investigate the logistic regression analysis of bone metastasis after CRC surgery and related influencing factors.METHODS We selected 100 patients who underwent surgery for CRC and were admitted from February 2018 to February 2024,collected the general data of bone metastasis,and collected the pathological characteristics of patients with bone metastasis.Next,we divided them into groups with and without bone metastasis(Bone metastases group,n=44;no bone metastases group,n=56),compared the clinical data of the two groups,and analyzed the risk factors of bone metastasis using logistic regression analysis.RESULTS Among the 100 patients,the mean age was 54.33±8.45 years,and most were male(54.55%).The proportion of patients with lytic bone changes was 43.18%.The most common location of combined bone metastasis was the pelvis,whereas only 5 patients had limb transfer.There was a higher incidence of lung than of pancreatic or liver metastases.Regression analysis showed that the primary location of the cancer was rectal cancer.Lymph node involvement,lung metastasis,and no postoperative chemotherapy were the risk factors for postoperative bone metastasis in patients who underwent surgery for CRC(P<0.05).CONCLUSION Rectal cancer,lymph node involvement,complicated pulmonary metastasis,and no postoperative chemotherapy treatment can help predict high risk of bone metastasis in CRC.展开更多
This letter comments on Wei et al's study applying the Wave-Vision Transformer for oesophageal cancer classification.Highlighting its superior accuracy and efficiency,we discuss its potential clinical impact,limit...This letter comments on Wei et al's study applying the Wave-Vision Transformer for oesophageal cancer classification.Highlighting its superior accuracy and efficiency,we discuss its potential clinical impact,limitations in dataset diversity,and the need for explainable artificial intelligence to enhance adoption in pathology and personalized treatment.展开更多
BACKGROUND Epigenetic involvement of methyltransferase-like factor 14(METTL14)in tumor development has not been clearly defined.AIM To investigate METTL14 expression and its relationship with pathological stage in pat...BACKGROUND Epigenetic involvement of methyltransferase-like factor 14(METTL14)in tumor development has not been clearly defined.AIM To investigate METTL14 expression and its relationship with pathological stage in patients undergoing radical surgery for colorectal cancer(CRC).METHODS This retrospective study included 80 patients with CRC who were admitted to the Third Hospital of Hefei and the Western District of the First Affiliated Hospital of Anhui Medical University between June 2021 and June 2024.These patients were selected for treatment.Lesions and adjacent tissues were collected from these patients,and METTL14 expression was assessed using immunohistochemistry.Expression levels of METTL14 were compared across different tissue samples.Additionally,we evaluated METTL14 expression in patients with varying pa-thological characteristics using statistical methods such asχ2 tests and analysis of variance to identify significant differences.RESULTS The positivity rate of METTL14 in tumor tissues was significantly lower than that in adjacent tissues(30%vs 60%,P<0.05).Conversely,the negative expression rate of METTL14 was higher in tumor tissues compared to adjacent tissues(P<0.05).The positive expression of METTL14 mRNA did not differ by age,sex,tumor tissue classification,tumor diameter,or tumor location(P>0.05).However,the positive expression rate of METTL14 was significantly lower in patients with lymph node metastasis,invasion depth T3+T4,and tumor,node,and metastasis(TNM)stage III/IV compared to those without lymph node metastasis,invasion depth T1+T2,and TNM stage I(P<0.05).Specifically,METTL14 mRNA expression was significantly lower in patients with lymph node metastasis(0.51±0.12 vs 1.23±0.25,P<0.001),invasion depth T3+T4(0.48±0.15 vs 1.18±0.21,P<0.001),and TNM stage III/IV(0.45±0.13 vs 1.20±0.22,P<0.001)compared to those with no lymph node metastasis,invasion depth T1+T2,and TNM stage I,respectively.CONCLUSION In CRC,low positive METTL14 expression is closely correlated with lymph node metastasis,invasion depth T3+T4,and TNM stage,indicating the malignant biological behavior of rectal cancer.展开更多
BACKGROUND Gastric cancer ranks among the leading malignancies worldwide,noted for its high morbidity and mortality,and remains a significant challenge to global public health.AIM To investigate the association betwee...BACKGROUND Gastric cancer ranks among the leading malignancies worldwide,noted for its high morbidity and mortality,and remains a significant challenge to global public health.AIM To investigate the association between the expression of splicing factor 3b subunit 4(SF3B4)and high mobility group box 1(HMGB1)with the clinical characteristics and prognostic outcomes of gastric cancer patients.METHODS A retrospective cohort study was conducted involving 114 individuals diagnosed with gastric cancer and admitted to our institution from January 2020 to December 2021.A comparison group of 90 patients diagnosed with benign gastric disorders during the same period was also included.Expression levels of SF3B4 and HMGB1 were assessed using real-time quantitative polymerase chain reaction.Expression patterns were analyzed in relation to various clinicopathological features.Receiver operating characteristic curves were constructed to evaluate the ability of SF3B4 and HMGB1,alone and in combination,to predict unfavorable one-year outcomes.Multivariate logistic regression was utilized to identify independent predictors of mortality.Kaplan-Meier survival curves were generated to examine survival differences based on SF3B4 and HMGB1 expression levels.RESULTS Both SF3B4 and HMGB1 were markedly upregulated in tumor tissues of gastric cancer patients compared to adjacent normal tissues and to tissues from nonmalignant gastric disease patients(^(a)P<0.05).Higher expression levels of these two genes were significantly associated with aggressive pathological features,including poor differentiation,tumor size>5 cm,deep infiltration(T3-T4),lymph node involvement,and advanced clinical stage(III–IV)(^(a)P<0.05).Receiver operating characteristic analysis revealed that the combined use of SF3B4 and HMGB1 yielded an area under the curve of 0.914,surpassing the predictive performance of either marker alone(SF3B4:0.776;HMGB1:0.757).Multivariate analysis identified SF3B4≥1.45,HMGB1≥0.93,poor differentiation,larger tumor size,deeper invasion,lymph node metastasis,and advanced clinical tumor-node-metastasis staging as independent factors contributing to one-year mortality(^(a)P<0.05).Survival analysis indicated that patients with elevated SF3B4 and HMGB1 levels had a shorter median survival(25.74±5.46 months)compared to those with lower expression levels(33.29±6.71 months,log-rank=10.534,^(a)P<0.05).CONCLUSION Elevated SF3B4 and HMGB1 expression in gastric cancer tissue is significantly associated with tumor aggressiveness,worse prognosis,and reduced survival.These biomarkers may offer clinical value in stratifying patients by risk and in forecasting outcomes.Their combined assessment improves predictive accuracy for poor prognosis and may serve as a more effective tool than individual evaluation.展开更多
Introduction:We examined the pathology and safety outcomes associated with the extent of pelvic lymph node dissection in patients with high-risk prostate cancer undergoing radical prostatectomy.Materials and Methods:W...Introduction:We examined the pathology and safety outcomes associated with the extent of pelvic lymph node dissection in patients with high-risk prostate cancer undergoing radical prostatectomy.Materials and Methods:We retrospectively identified men with prostate cancer who underwent robot-assisted radical prostatectomy with pelvic lymph node dissection between May 2016 and September 2021.Cases were categorized using Current Procedural Terminology(CPT)codes(38571)for extended lymph node dissection and super-extended lymph node dissection(38572).Using logistic regression,we compared the groups on a number of factors,including recurrence.Results:Super-extended lymph node dissection had significantly higher median prostate-specific antigen and National Comprehensive Cancer Network risk classification prior to surgery.Significant differences were observed in the pathologic T stage and pathology grade group.Time on robot was significantly longer for the super-extended group,while estimated blood loss was lower.No differences were observed in length of stay or any complication-related variable.Super-extended had significantly higher node positivity(36.1%vs.7.6%,p<0.001)and recurrence.10.0%of super-extended cases had node positivity in the aortic bifurcation,the common iliac,or the pre-sacral chains that would have been missed with an extended dissection.2.2%of patients had node positivity in these chains only.Conclusions:Super-extended lymph node dissection is safe and feasible for patients with high-risk prostate cancer.Further research is needed to better understand its clinical benefit and to further inform optimal patient selection.展开更多
One in every eight men in the US is diagnosed with prostate cancer,making it the most common cancer in men.Gleason grading is one of the most essential diagnostic and prognostic factors for planning the treatment of p...One in every eight men in the US is diagnosed with prostate cancer,making it the most common cancer in men.Gleason grading is one of the most essential diagnostic and prognostic factors for planning the treatment of prostate cancer patients.Traditionally,urological pathologists perform the grading by scoring the morphological pattern,known as the Gleason pattern,in histopathology images.However,thismanual grading is highly subjective,suffers intra-and inter-pathologist variability and lacks reproducibility.An automated grading system could be more efficient,with no subjectivity and higher accuracy and reproducibility.Automated methods presented previously failed to achieve sufficient accuracy,lacked reproducibility and depended on high-resolution images such as 40×.This paper proposes an automated Gleason grading method,ProGENET,to accurately predict the grade using low-resolution images such as 10×.This method first divides the patient’s histopathology whole slide image(WSI)into patches.Then,it detects artifacts and tissue-less regions and predicts the patch-wise grade using an ensemble network of CNN and transformer models.The proposed method adapted the International Society of Urological Pathology(ISUP)grading system and achieved 90.8%accuracy in classifying the patches into healthy and Gleason grades 1 through 5 using 10×WSI,outperforming the state-of-the-art accuracy by 27%.Finally,the patient’s grade was determined by combining the patch-wise results.The method was also demonstrated for 4−class grading and binary classification of prostate cancer,achieving 93.0%and 99.6%accuracy,respectively.The reproducibility was over 90%.Since the proposedmethod determined the grades with higher accuracy and reproducibility using low-resolution images,it is more reliable and effective than existing methods and can potentially improve subsequent therapy decisions.展开更多
A recent study by Luo et al examined the relationship between the pathological types of pancreatic cancer(PC)and their imaging characteristics.While this study presented an important step toward improving diagnostic a...A recent study by Luo et al examined the relationship between the pathological types of pancreatic cancer(PC)and their imaging characteristics.While this study presented an important step toward improving diagnostic accuracy for PC,we have several concerns regarding its generalizability,cohort selection,imaging variability,statistical methods,and potential confounding factors.We recommended that future research adopt multi-center,prospective designs to improve representation and minimize bias.Additionally,incorporating advanced imaging techniques such as radiomics and artificial intelligence and conducting more comprehensive statistical analyses would be valuable.By implementing these strategies,future studies can yield more reliable and externally validated findings that improve the clinical applicability of imaging-based differentiation of PC.Addressing these methodological issues could significantly advance the field of gastrointestinal oncology and improve patient management and outcomes.展开更多
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.
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.
基金supported by the National Research Foundation of Korea (NRF)funded by the Ministry of Science,ICT&Future Planning (2022R1A2C2006229,2022R1A6A3A01086868)Korea Dementia Research Project through the Korea Dementia Research Center (KDRC)funded by the Ministry of Health&Welfare and Ministry of Science and ICT,Republic of Korea (RS-2024-00345328)KIST Institutional Grant (2E32851)。
文摘Alzheimer'sdisease(AD)isaprogressive neurodegenerative disorder characterized by cognitive impairment and distinct neuropathological features,including amyloid-βplaques,neurofibrillary tangles,and reactive astrogliosis.Developing effective diagnostic,preventative,and therapeutic strategies for AD necessitates the establishment of animal models that accurately recapitulate the pathophysiological processes of the disease.Existing transgenic mouse models have significantly contributed to understanding AD pathology but often fail to replicate the complexity of human AD.Additionally,these models are limited in their ability to elucidate the interplay among amyloid-βplaques,neurofibrillary tangles,and reactive astrogliosis due to the absence of spatially and temporally specific genetic manipulation.In this study,we introduce a novel AD mouse model(APP/PS1-TauP301L-Adeno mice)designed to rapidly induce pathological symptoms and enhance understanding of AD mechanisms.Neurofibrillary tangles and severe reactive astrogliosis were induced by injecting AAVDJ-EF1a-hTauP301L-EGFP and Adeno-GFAP-GFP viruses into the hippocampi of 5-month-old APP/PS1 mice.Three months post-injection,these mice exhibited pronounced astrogliosis,substantial amyloid-βplaque accumulation,extensiveneurofibrillarytangles,accelerated neuronal loss,elevated astrocytic GABA levels,and significant spatial memory deficits.Notably,these pathological features were less severe in AAVTauP301L-expressing APP/PS1 mice without augmented reactive astrogliosis.These findings indicate an exacerbating role of severe reactive astrogliosis in amyloid-βplaque and neurofibrillary tangle-associated pathology.The APP/PS1-TauP301L-Adeno mouse model provides a valuable tool for advancing therapeutic research aimed at mitigating the progression of AD.
文摘Alzheimer's disease (AD) is characterized by an imbalance between excitatory and inhibitory brain networks,leading to aberrant homeostatic synaptic plasticity.AD has progressively been recognized as syna ptopathy and syna ptic dysfunction has been identified as a key component of its pathogenesis (Schirinzi et al.,2020).Syna ptic dysfunction is believed to precede synapse loss,a primary biological correlate of cognitive decline in AD,inevita bly associated with neuronal death.
文摘BACKGROUND Pancreatic cancer remains one of the most lethal malignancies worldwide,with a poor prognosis often attributed to late diagnosis.Understanding the correlation between pathological type and imaging features is crucial for early detection and appropriate treatment planning.AIM To retrospectively analyze the relationship between different pathological types of pancreatic cancer and their corresponding imaging features.METHODS We retrospectively analyzed the data of 500 patients diagnosed with pancreatic cancer between January 2010 and December 2020 at our institution.Pathological types were determined by histopathological examination of the surgical spe-cimens or biopsy samples.The imaging features were assessed using computed tomography,magnetic resonance imaging,and endoscopic ultrasound.Statistical analyses were performed to identify significant associations between pathological types and specific imaging characteristics.RESULTS There were 320(64%)cases of pancreatic ductal adenocarcinoma,75(15%)of intraductal papillary mucinous neoplasms,50(10%)of neuroendocrine tumors,and 55(11%)of other rare types.Distinct imaging features were identified in each pathological type.Pancreatic ductal adenocarcinoma typically presents as a hypodense mass with poorly defined borders on computed tomography,whereas intraductal papillary mucinous neoplasms present as characteristic cystic lesions with mural nodules.Neuroendocrine tumors often appear as hypervascular lesions in contrast-enhanced imaging.Statistical analysis revealed significant correlations between specific imaging features and pathological types(P<0.001).CONCLUSION This study demonstrated a strong association between the pathological types of pancreatic cancer and imaging features.These findings can enhance the accuracy of noninvasive diagnosis and guide personalized treatment approaches.
文摘This study aims to explore the unconscious motivations underlying migration in Niger, with an emphasis on understanding the phenomenon of pathological travel. Its aim is to identify the unconscious factors of pathological travel among migrants. Pathological travel, as discussed in the scientific literature on psychopathology, is characterised by movements initiated under the influence of delusions, hallucinations or other serious psychiatric disorders. The aim of this research is to contribute to our understanding of how these unconscious factors influence migration decisions. Using a retrospective analysis of five cases, this study examines the psychological and psychiatric dimensions of migration, particularly among patients referred to the psychiatry department of the Niamey National Hospital between 2017 and 2018. The five cases analysed, representing 12% of a cohort of 40 migrant patients, suffered from chronic psychotic disorders, including schizophrenia and chronic hallucinatory psychosis. By means of diagnostic interviews and categorical sorting, three main unconscious motivations were identified: the delusional state with themes of filiation and persecution, the hallucinations that dictated the travel behaviour, and the dissociative states manifested by depersonalisation and derealisation. It also emerges from this analysis that pathological travel often involves prolonged journeys on foot and without purpose. Thus, untreated mental illness plays a significant role in shaping and influencing individual and social behaviour. The results of this study have important implications for public health and migration policy. They highlight the need to integrate health assessments into migration management systems, particularly in regions serving as transit hubs for migrants. The research also highlights the need for culturally sensitive psychiatric interventions to address the interaction between pre-existing mental disorders and migration. This study contributes to a better understanding of the psychological dimensions of migration by highlighting the importance of addressing mental health as an integral part of humanitarian action. The knowledge gained paves the way for future research to explore this understudied aspect of migration on a broader scale.
文摘The damage map is an important tool for the investigation of the conservation state of a building,especially when the surveyed element is a property with historical preservation interest.Thereby,we consider that the full understanding of the construction techniques is crucial to diagnose anomalies found in the facades of the buildings.It is very important to know the materials used in the construction and the routine of building maintenance.It is also necessary to emphasize the importance of having historical information about interventions and modifications that the building’s structure suffered over the years in order to obtain data and requirements for the complete configuration of the analyzed building.This article results from a master's research in progress and it aims to present the process of the development of a damage map,seeking its implementation in a real case study,the facades of the Carmo’s Church in the city of Olinda.There are three reasons why we chose this church to study.First,this building is inserted in the Historic Centre of the Town of Olinda,which is inscribed on the UNESCO’s World Heritage list since 1982;second it was built in 1588 configuring the oldest church of the Carmelite Order in Brazil and finally the building has been restored and recovered recently in July 2012 and it is observed that,after four years,we observe some pathological manifestations in their facades.
基金Supported by Natural Science Foundation of Hubei Province(No.2023BCB147,No.2023AFB1026).
文摘AIM:To investigate the clinicopathological features of cranial-nasal-orbital communicating lesions and identify key diagnostic indicators for differentiating benign and malignant neoplasms.METHODS:The retrospective cohort study analyzed 74 histologically confirmed cases stratified by anatomical involvement at the Wuhan Union Hospital between January 2010 and December 2020:Group A(orbital-nasal group,n=29),Group B(orbital-cranial group,n=27),and Group C(cranial-nasal-orbital group,n=18).Clinicopathological profiles including symptom presentation,histopathology,and invasion patterns were systematically evaluated.RESULTS:The cohort comprised 49(66.2%)benign and 25(33.8%)malignant lesions.Compared with benign lesions,malignant lesions had a shorter onset time(12mo vs 2.5mo,P=0.004)and resulted in poorer vision(0.6 vs 1.53,P=0.025).Headache was reported in 28.6%of patients with benign lesions,but none in those with malignant lesions(P=0.002).Conjunctival congestion and edema were observed in 32.7%of patients with benign lesions and 60%of patients with malignant lesions(P=0.028).The ethmoid sinus was the most frequently invaded site(35 cases).Malignant lesions showed greater invasion in the nasal cavity(28.0%vs 0,P=0.000)and anterior cranial fossa(40.0%vs 8.2%,P=0.003)than benign lesions.The orbital-cranial group was more likely to invade through osseous foramina compared with the orbitalnasal group(P=0.002).Neurogenic tumors predominated benign cases(34.7%),whereas blood derived(28%)and glandular tumors(28%)were most prevalent in malignant subgroups.The proportion of malignant tumors in multidisciplinary combined surgery was higher than that of benign lesions(61.5%vs 38.5%).CONCLUSION:Malignant cranial-nasal-orbital communicating lesions exhibit distinct clinicopathological signatures characterized by rapid progression,aggressive anterior fossa and nasal region,and severe visual morbidity.
文摘AIM:To explore the methylation status of MSH6 in retinoblastoma(RB)and its impact on clinicopathological features and diagnosis.METHODS:Differentially expressed genes were identified through bioinformatics screening of the GSE24673 and GSE125903 datasets,combined with GeneCards database analysis.A total of 102 RB patients and 62 traumaenucleated controls between January 2018 and December 2023 were enrolled,with their clinicopathological data and retinal tissues collected.The mRNA and methylation levels of MSH6 in retinal tissues were detected using real-time quantitative polymerase chain reaction(PCR)and methylation-specific PCR.Western blot analysis was conducted in one pair of RB and control tissues for preliminary protein-level validation of MSH6 expression.Based on the methylation status of MSH6,RB patients were categorized into two groups:low-methylation and highmethylation.Both univariate and multivariate analyses were conducted to identify independent factors influencing the methylation levels using clinicopathological data.Receiver operating characteristic(ROC)curves were applied to evaluate the diagnostic potential of MSH6 methylation in RB.RESULTS:Bioinformatics analysis of public datasets revealed that MSH6 expression was downregulated across multiple cancers,RB.Consistently,in clinical RB tissues,MSH6 mRNA expression was significantly lower than that in control retinal tissues,whereas the promoter methylation level of MSH6 was markedly higher(both P<0.001),indicating that promoter hypermethylation may contribute to transcriptional silencing of MSH6 in RB.Patients with higher MSH6 methylation levels showed more advanced pathological classification and a higher frequency of metastasis.Multivariate logistic regression confirmed that metastatic status(P=0.008,OR=3.51)and pathological classification(P=0.005,OR=3.7)were independent factors associated with MSH6 methylation.Receiver operating characteristic(ROC)analysis demonstrated that MSH6 methylation could effectively distinguish RB tissues from non-tumorous controls(AUC=0.847,sensitivity=78.43%,specificity=80.65%),suggesting that MSH6 hypermethylation may serve as a potential diagnostic biomarker for RB.CONCLUSION:The methylation level of the MSH6 gene may be a key factor in RB pathogenesis.The methylation status of the MSH6 gene is closely associated with clinicopathological features and shows diagnostic potential.
文摘BACKGROUND Esophageal cancer is the sixth most common cancer worldwide,with a high mortality rate.Early prognosis of esophageal abnormalities can improve patient survival rates.The progression of esophageal cancer follows a sequence from esophagitis to non-dysplastic Barrett’s esophagus,dysplastic Barrett’s esophagus,and eventually esophageal adenocarcinoma(EAC).This study explored the application of deep learning technology in the precise diagnosis of pathological classification and staging of EAC to enhance diagnostic accuracy and efficiency.AIM To explore the application of deep learning models,particularly Wave-Vision Transformer(Wave-ViT),in the pathological classification and staging of esophageal cancer to enhance diagnostic accuracy and efficiency.METHODS We applied several deep learning models,including multi-layer perceptron,residual network,transformer,and Wave-ViT,to a dataset of clinically validated esophageal pathology images.The models were trained to identify pathological features and assist in the classification and staging of different stages of esophageal cancer.The models were compared based on accuracy,computational complexity,and efficiency.RESULTS The Wave-ViT model demonstrated the highest accuracy at 88.97%,surpassing the transformer(87.65%),residual network(85.44%),and multi-layer perceptron(81.17%).Additionally,Wave-ViT exhibited low computational complexity with significantly reduced parameter size,making it highly efficient for real-time clinical applications.CONCLUSION Deep learning technology,particularly the Frequency-Domain Transformer model,shows promise in improving the precision of pathological classification and staging of EAC.The application of the Frequency-Domain Transformer model enhances the automation of the diagnostic process and may support early detection and treatment of EAC.Future research may further explore the potential of this model in broader medical image analysis applications,particularly in the field of precision medicine.
基金Supported by the National Health Commission’s Key Laboratory of Gastrointestinal Tumor Diagnosis and Treatment for The Year 2022,National Health Commission’s Master’s and Doctoral/Postdoctoral Fund Project,No.NHCDP2022001Gansu Provincial People’s Hospital Doctoral Supervisor Training Project,No.22GSSYA-3.
文摘The study by Luo et al published in the World Journal of Gastrointestinal Oncology presents a thorough and scientific methodology.Pancreatic cancer is the most challenging malignancy in the digestive system,exhibiting one of the highest mortality rates associated with cancer globally.The delayed onset of symptoms and diagnosis often results in metastasis or local progression of the cancer,thereby constraining treatment options and outcomes.For these patients,prompt tumour identification and treatment strategising are crucial.The present objective of pancreatic cancer research is to examine the correlation between various pathological types and imaging data to facilitate therapeutic decision-making.This study aims to clarify the correlation between diverse pathological markers and imaging in pancreatic cancer patients,with prospective longitudinal studies potentially providing novel insights into the diagnosis and treatment of pancreatic cancer.
文摘BACKGROUND Colorectal cancer(CRC)is a common malignant tumor in the digestive system,whose main treatment comprises surgical resection,radiotherapy and chemotherapy,and targeted drug therapy.At present,the radical resection of CRC is the main way of achieving an early cure.AIM To investigate the logistic regression analysis of bone metastasis after CRC surgery and related influencing factors.METHODS We selected 100 patients who underwent surgery for CRC and were admitted from February 2018 to February 2024,collected the general data of bone metastasis,and collected the pathological characteristics of patients with bone metastasis.Next,we divided them into groups with and without bone metastasis(Bone metastases group,n=44;no bone metastases group,n=56),compared the clinical data of the two groups,and analyzed the risk factors of bone metastasis using logistic regression analysis.RESULTS Among the 100 patients,the mean age was 54.33±8.45 years,and most were male(54.55%).The proportion of patients with lytic bone changes was 43.18%.The most common location of combined bone metastasis was the pelvis,whereas only 5 patients had limb transfer.There was a higher incidence of lung than of pancreatic or liver metastases.Regression analysis showed that the primary location of the cancer was rectal cancer.Lymph node involvement,lung metastasis,and no postoperative chemotherapy were the risk factors for postoperative bone metastasis in patients who underwent surgery for CRC(P<0.05).CONCLUSION Rectal cancer,lymph node involvement,complicated pulmonary metastasis,and no postoperative chemotherapy treatment can help predict high risk of bone metastasis in CRC.
文摘This letter comments on Wei et al's study applying the Wave-Vision Transformer for oesophageal cancer classification.Highlighting its superior accuracy and efficiency,we discuss its potential clinical impact,limitations in dataset diversity,and the need for explainable artificial intelligence to enhance adoption in pathology and personalized treatment.
文摘BACKGROUND Epigenetic involvement of methyltransferase-like factor 14(METTL14)in tumor development has not been clearly defined.AIM To investigate METTL14 expression and its relationship with pathological stage in patients undergoing radical surgery for colorectal cancer(CRC).METHODS This retrospective study included 80 patients with CRC who were admitted to the Third Hospital of Hefei and the Western District of the First Affiliated Hospital of Anhui Medical University between June 2021 and June 2024.These patients were selected for treatment.Lesions and adjacent tissues were collected from these patients,and METTL14 expression was assessed using immunohistochemistry.Expression levels of METTL14 were compared across different tissue samples.Additionally,we evaluated METTL14 expression in patients with varying pa-thological characteristics using statistical methods such asχ2 tests and analysis of variance to identify significant differences.RESULTS The positivity rate of METTL14 in tumor tissues was significantly lower than that in adjacent tissues(30%vs 60%,P<0.05).Conversely,the negative expression rate of METTL14 was higher in tumor tissues compared to adjacent tissues(P<0.05).The positive expression of METTL14 mRNA did not differ by age,sex,tumor tissue classification,tumor diameter,or tumor location(P>0.05).However,the positive expression rate of METTL14 was significantly lower in patients with lymph node metastasis,invasion depth T3+T4,and tumor,node,and metastasis(TNM)stage III/IV compared to those without lymph node metastasis,invasion depth T1+T2,and TNM stage I(P<0.05).Specifically,METTL14 mRNA expression was significantly lower in patients with lymph node metastasis(0.51±0.12 vs 1.23±0.25,P<0.001),invasion depth T3+T4(0.48±0.15 vs 1.18±0.21,P<0.001),and TNM stage III/IV(0.45±0.13 vs 1.20±0.22,P<0.001)compared to those with no lymph node metastasis,invasion depth T1+T2,and TNM stage I,respectively.CONCLUSION In CRC,low positive METTL14 expression is closely correlated with lymph node metastasis,invasion depth T3+T4,and TNM stage,indicating the malignant biological behavior of rectal cancer.
文摘BACKGROUND Gastric cancer ranks among the leading malignancies worldwide,noted for its high morbidity and mortality,and remains a significant challenge to global public health.AIM To investigate the association between the expression of splicing factor 3b subunit 4(SF3B4)and high mobility group box 1(HMGB1)with the clinical characteristics and prognostic outcomes of gastric cancer patients.METHODS A retrospective cohort study was conducted involving 114 individuals diagnosed with gastric cancer and admitted to our institution from January 2020 to December 2021.A comparison group of 90 patients diagnosed with benign gastric disorders during the same period was also included.Expression levels of SF3B4 and HMGB1 were assessed using real-time quantitative polymerase chain reaction.Expression patterns were analyzed in relation to various clinicopathological features.Receiver operating characteristic curves were constructed to evaluate the ability of SF3B4 and HMGB1,alone and in combination,to predict unfavorable one-year outcomes.Multivariate logistic regression was utilized to identify independent predictors of mortality.Kaplan-Meier survival curves were generated to examine survival differences based on SF3B4 and HMGB1 expression levels.RESULTS Both SF3B4 and HMGB1 were markedly upregulated in tumor tissues of gastric cancer patients compared to adjacent normal tissues and to tissues from nonmalignant gastric disease patients(^(a)P<0.05).Higher expression levels of these two genes were significantly associated with aggressive pathological features,including poor differentiation,tumor size>5 cm,deep infiltration(T3-T4),lymph node involvement,and advanced clinical stage(III–IV)(^(a)P<0.05).Receiver operating characteristic analysis revealed that the combined use of SF3B4 and HMGB1 yielded an area under the curve of 0.914,surpassing the predictive performance of either marker alone(SF3B4:0.776;HMGB1:0.757).Multivariate analysis identified SF3B4≥1.45,HMGB1≥0.93,poor differentiation,larger tumor size,deeper invasion,lymph node metastasis,and advanced clinical tumor-node-metastasis staging as independent factors contributing to one-year mortality(^(a)P<0.05).Survival analysis indicated that patients with elevated SF3B4 and HMGB1 levels had a shorter median survival(25.74±5.46 months)compared to those with lower expression levels(33.29±6.71 months,log-rank=10.534,^(a)P<0.05).CONCLUSION Elevated SF3B4 and HMGB1 expression in gastric cancer tissue is significantly associated with tumor aggressiveness,worse prognosis,and reduced survival.These biomarkers may offer clinical value in stratifying patients by risk and in forecasting outcomes.Their combined assessment improves predictive accuracy for poor prognosis and may serve as a more effective tool than individual evaluation.
文摘Introduction:We examined the pathology and safety outcomes associated with the extent of pelvic lymph node dissection in patients with high-risk prostate cancer undergoing radical prostatectomy.Materials and Methods:We retrospectively identified men with prostate cancer who underwent robot-assisted radical prostatectomy with pelvic lymph node dissection between May 2016 and September 2021.Cases were categorized using Current Procedural Terminology(CPT)codes(38571)for extended lymph node dissection and super-extended lymph node dissection(38572).Using logistic regression,we compared the groups on a number of factors,including recurrence.Results:Super-extended lymph node dissection had significantly higher median prostate-specific antigen and National Comprehensive Cancer Network risk classification prior to surgery.Significant differences were observed in the pathologic T stage and pathology grade group.Time on robot was significantly longer for the super-extended group,while estimated blood loss was lower.No differences were observed in length of stay or any complication-related variable.Super-extended had significantly higher node positivity(36.1%vs.7.6%,p<0.001)and recurrence.10.0%of super-extended cases had node positivity in the aortic bifurcation,the common iliac,or the pre-sacral chains that would have been missed with an extended dissection.2.2%of patients had node positivity in these chains only.Conclusions:Super-extended lymph node dissection is safe and feasible for patients with high-risk prostate cancer.Further research is needed to better understand its clinical benefit and to further inform optimal patient selection.
基金supported by Princess Nourah bint Abdulrahman University Researchers Supporting Project number(PNURSP2025R104),Princess Nourah bint Abdulrahman University,Riyadh,Saudi Arabia.
文摘One in every eight men in the US is diagnosed with prostate cancer,making it the most common cancer in men.Gleason grading is one of the most essential diagnostic and prognostic factors for planning the treatment of prostate cancer patients.Traditionally,urological pathologists perform the grading by scoring the morphological pattern,known as the Gleason pattern,in histopathology images.However,thismanual grading is highly subjective,suffers intra-and inter-pathologist variability and lacks reproducibility.An automated grading system could be more efficient,with no subjectivity and higher accuracy and reproducibility.Automated methods presented previously failed to achieve sufficient accuracy,lacked reproducibility and depended on high-resolution images such as 40×.This paper proposes an automated Gleason grading method,ProGENET,to accurately predict the grade using low-resolution images such as 10×.This method first divides the patient’s histopathology whole slide image(WSI)into patches.Then,it detects artifacts and tissue-less regions and predicts the patch-wise grade using an ensemble network of CNN and transformer models.The proposed method adapted the International Society of Urological Pathology(ISUP)grading system and achieved 90.8%accuracy in classifying the patches into healthy and Gleason grades 1 through 5 using 10×WSI,outperforming the state-of-the-art accuracy by 27%.Finally,the patient’s grade was determined by combining the patch-wise results.The method was also demonstrated for 4−class grading and binary classification of prostate cancer,achieving 93.0%and 99.6%accuracy,respectively.The reproducibility was over 90%.Since the proposedmethod determined the grades with higher accuracy and reproducibility using low-resolution images,it is more reliable and effective than existing methods and can potentially improve subsequent therapy decisions.
文摘A recent study by Luo et al examined the relationship between the pathological types of pancreatic cancer(PC)and their imaging characteristics.While this study presented an important step toward improving diagnostic accuracy for PC,we have several concerns regarding its generalizability,cohort selection,imaging variability,statistical methods,and potential confounding factors.We recommended that future research adopt multi-center,prospective designs to improve representation and minimize bias.Additionally,incorporating advanced imaging techniques such as radiomics and artificial intelligence and conducting more comprehensive statistical analyses would be valuable.By implementing these strategies,future studies can yield more reliable and externally validated findings that improve the clinical applicability of imaging-based differentiation of PC.Addressing these methodological issues could significantly advance the field of gastrointestinal oncology and improve patient management and outcomes.
