BACKGROUND The treatment technology of liver cancer is progressing.In addition to traditional surgical resection,combined therapies of immunotherapy based on immune checkpoint inhibitors,chemotherapy,and transcatheter...BACKGROUND The treatment technology of liver cancer is progressing.In addition to traditional surgical resection,combined therapies of immunotherapy based on immune checkpoint inhibitors,chemotherapy,and transcatheter arterial chemoembolization for hepatocellular carcinoma are more and more widely used.Accurate preoperative diagnosis of liver cancer will provide important information for comprehensive treatment and prognosis evaluation of liver cancer.Sonazoidcontrast-enhanced ultrasound is not only helpful for the qualitative diagnosis of liver lesions,but also has great potential in the diagnosis of histological differentiation of liver cancer.AIM To assess the differentiation of hepatocellular carcinoma(HCC)by utilizing the parameters and imaging features of Sonazoid-contrast-enhanced ultrasound(CEUS).METHODS A retrospective analysis was conducted on the CEUS data of 239 lesions through case-control study.These patients received Sonazoid-CEUS within one week before surgery and were confirmed as HCC by postoperative pathology.Within the cases,patients were further categorized into well-differentiated and poorlydifferentiated group.Time-intensity curves of the region of interest in both arterial and Kupffer phases were generated,allowing for the acquisition of quantitative parameters to assess the diagnostic efficacy in distinguishing lesions between these two groups and determining an appropriate cut-off value.RESULTS Univariate analysis showed that the absolute value of enhancement intensity(EIAV),intensity ratio(IR)and intensity difference(ID)in Kupffer phase were statistically different between the groups with different degree(P=0.015,P=0.000,P=0.000).The sensitivity and specificity were 40.2%,82.4%,80.4% and 78.1%,86.9% and 74.5%,respectively,for differentiating HCC lesions with EIAV≥56.384 dB,IR≥1.215 and ID≥9.184 dB.The area under the receiver operating characteristic curve were 0.590,0.877,0.815.There was no significant difference in the parameters of arterial phase,including peak time,initial growth time,rise time and the absolute value of peak intensity of lesions between the two groups(P>0.05).Multivariate analysis showed that the level of alphafetoprotein(AFP)and IR were risk factors for poor differentiation(P=0.001).CONCLUSION Among the parameters of Sonazoid-CEUS,IR in Kupffer phase exhibits superior diagnostic efficacy with high sensitivity and specificity in the diagnose of pathological differentiation of HCC.Combined with preoperative AFP level,a more accurate diagnosis will be obtained.Compared with portal vein phase,Kupffer phase showed the ability to identify HCC lesions more sensitive.These findings hold significant guiding implications and reference value for clinical practice.展开更多
Objective To explore the value of contrast-enhanced ultrasound(CEUS)for predicting differentiation degree of hepatocellular carcinoma(HCC).Methods Totally 86 HCC patients confirmed by postoperative pathology were retr...Objective To explore the value of contrast-enhanced ultrasound(CEUS)for predicting differentiation degree of hepatocellular carcinoma(HCC).Methods Totally 86 HCC patients confirmed by postoperative pathology were retrospectively enrolled and divided into poorly differentiated,moderately differentiated and highly differentiated groups according to postoperative Edmondson-Steiner grading.Preoperative CEUS parameters were compared among groups,and binary logistic regression was used to analyze CEUS-related independent predictors of HCC with different differentiation.The receiver operating characteristic curves of parameters being significant different among groups were drawn,the areas under the curve(AUC)were calculated,and the efficacy for predicting HCC with different differentiation degree was evaluated.Results There were 29 cases in poorly differentiated group,37 in moderately differentiated group and 20 cases in highly differentiated group.The arrival time of contrast agent in poorly differentiated group was earlier than that in moderately and high differentiated groups(both P<0.05),while in moderately differentiated group was not significantly different with that in highly differentiated group(P>0.05).The washout grade were significantly different between each 2 groups(all P<0.05).The arrival time of contrast agent and washout grade were independent predictors of highly or poorly differentiated,moderately or poorly differentiated,moderate-highly or poorly differentiated HCC,and washout grade also was independent predictor of highly or moderately differentiated HCC(all P<0.05).The AUC of the arrival time of contrast agent for predicting highly or moderately differentiated,highly or poorly differentiated,moderately or poorly differentiated,moderate-highly or poorly differentiated HCC was 0.615,0.787,0.690 and 0.724,respectively,while of washout grade was 0.801,0.927,0.795 and 0.841,respectively.Conclusion CEUS could be used to effectively predict differentiation degree of HCC.展开更多
BACKGROUND The expression level of Ki-67 and the degree of differentiation in pancreatic cancer determine tumor aggressiveness and patient prognosis,which holds significant implications for clinical decision-making.A ...BACKGROUND The expression level of Ki-67 and the degree of differentiation in pancreatic cancer determine tumor aggressiveness and patient prognosis,which holds significant implications for clinical decision-making.A major challenge in preoperative pancreatic ductal adenocarcinoma management is predicting tumor malignancy.Contrast-enhanced ultrasound(CEUS),a dynamic imaging technique based on blood pool visualization,can reveal lesion vasculature and provide quantitative perfusion data reflecting angiogenesis.By tracking contrast agent kinetics,CEUS offers non-invasive insights into tumor vascularization,helping assess malig-nancy potential.AIM To investigate the correlation between Ki-67 and pancreatic cancer differentiation using CEUS quantitative parameters and evaluated their diagnostic accuracy.METHODS This retrospective study analyzed pancreatic cancer patients who underwent CEUS and pathological confirmation.Pathological differentiation,clinical data,and quantitative CEUS parameters[maximum intensity(IMAX),rise time(RT),rise slope 50%(Rs50),rise slope 10%-90%(Rs1090),etc.]were collected.Based on Ki-67 expression(<50%vs≥50%),patients were divided into low-and high-expression groups.The study evaluated correlations between Ki-67 expression,differentiation degree,and CEUS quantitative parameters to assess tumor aggressiveness.RESULTS Among 54 patients(25 high Ki-67,29 low Ki-67),significant differences(P<0.05)were observed in Rs50,IMAX,wash-out area under the curve(WoutAUC),wash-in and out area under curve,and Rs1090 between high and low Ki-67 groups.High-expression patients showed elevated Rs50,IMAX,WoutAUC,and area under the curve(AUC),while RT and falling slope 50%(Fs50)were lower.Rs1090 demonstrated the highest diagnostic accuracy(AUC=0.863,sensitivity=0.92,specificity=0.759).Fs50 was effective in low Ki-67 detection(AUC=0.838).No correlation was found between enhancement patterns and Ki-67 or differentiation.CONCLUSION CEUS parameters(Rs50,IMAX,WoutAUC,Rs1090)strongly correlate with Ki-67,aiding non-invasive pancreatic cancer assessment.Rs1090/IMAX predict high Ki-67;Fs50 identifies low Ki-67,supporting CEUS for tumor aggressiveness evaluation.展开更多
AIMS To study the relationship between the modern clinical and pathohistological classification and TCM Syndrome-Typing of chronic ulcerative colitis (CUC). METHODS Totally 452 patients with CUC were clas- sified acco...AIMS To study the relationship between the modern clinical and pathohistological classification and TCM Syndrome-Typing of chronic ulcerative colitis (CUC). METHODS Totally 452 patients with CUC were clas- sified according to the standards of TCM Syndrome- Typing set up in the Conference of the Combination of the Chinese-Western Medicine on Digestive Diseases in Linfen. The relevant changes between both classifica- tions were analyzed and compared through the colonofiberscopic and pathohistological examination. RESULTS The type of retention of damp-heat in inte- rior is more commonly seen in the patients with initial onset of disease (P<0.01). There is no significant difference among other TCM Syndrome-Typing groups in patients with chronic persistent and recurrent disease (P>0.05). The congestion,edema,reduction of goblet cells and the infiltration of neutrophils are patho- logically common to all TCM Syndrome-Typing groups. Mucosal ulcer is dominant in damp-heat syndrome while crypt ulcer is dominant in the types of spleen-stomach asthenia and spleen-kidney Yang deficiency (P< 0.01). CONCLUSIONS There appears a certain relation- ship between the TCM syndrome typing and pathohis- tological changes of the colonal mucosa of CUC.展开更多
文摘BACKGROUND The treatment technology of liver cancer is progressing.In addition to traditional surgical resection,combined therapies of immunotherapy based on immune checkpoint inhibitors,chemotherapy,and transcatheter arterial chemoembolization for hepatocellular carcinoma are more and more widely used.Accurate preoperative diagnosis of liver cancer will provide important information for comprehensive treatment and prognosis evaluation of liver cancer.Sonazoidcontrast-enhanced ultrasound is not only helpful for the qualitative diagnosis of liver lesions,but also has great potential in the diagnosis of histological differentiation of liver cancer.AIM To assess the differentiation of hepatocellular carcinoma(HCC)by utilizing the parameters and imaging features of Sonazoid-contrast-enhanced ultrasound(CEUS).METHODS A retrospective analysis was conducted on the CEUS data of 239 lesions through case-control study.These patients received Sonazoid-CEUS within one week before surgery and were confirmed as HCC by postoperative pathology.Within the cases,patients were further categorized into well-differentiated and poorlydifferentiated group.Time-intensity curves of the region of interest in both arterial and Kupffer phases were generated,allowing for the acquisition of quantitative parameters to assess the diagnostic efficacy in distinguishing lesions between these two groups and determining an appropriate cut-off value.RESULTS Univariate analysis showed that the absolute value of enhancement intensity(EIAV),intensity ratio(IR)and intensity difference(ID)in Kupffer phase were statistically different between the groups with different degree(P=0.015,P=0.000,P=0.000).The sensitivity and specificity were 40.2%,82.4%,80.4% and 78.1%,86.9% and 74.5%,respectively,for differentiating HCC lesions with EIAV≥56.384 dB,IR≥1.215 and ID≥9.184 dB.The area under the receiver operating characteristic curve were 0.590,0.877,0.815.There was no significant difference in the parameters of arterial phase,including peak time,initial growth time,rise time and the absolute value of peak intensity of lesions between the two groups(P>0.05).Multivariate analysis showed that the level of alphafetoprotein(AFP)and IR were risk factors for poor differentiation(P=0.001).CONCLUSION Among the parameters of Sonazoid-CEUS,IR in Kupffer phase exhibits superior diagnostic efficacy with high sensitivity and specificity in the diagnose of pathological differentiation of HCC.Combined with preoperative AFP level,a more accurate diagnosis will be obtained.Compared with portal vein phase,Kupffer phase showed the ability to identify HCC lesions more sensitive.These findings hold significant guiding implications and reference value for clinical practice.
文摘Objective To explore the value of contrast-enhanced ultrasound(CEUS)for predicting differentiation degree of hepatocellular carcinoma(HCC).Methods Totally 86 HCC patients confirmed by postoperative pathology were retrospectively enrolled and divided into poorly differentiated,moderately differentiated and highly differentiated groups according to postoperative Edmondson-Steiner grading.Preoperative CEUS parameters were compared among groups,and binary logistic regression was used to analyze CEUS-related independent predictors of HCC with different differentiation.The receiver operating characteristic curves of parameters being significant different among groups were drawn,the areas under the curve(AUC)were calculated,and the efficacy for predicting HCC with different differentiation degree was evaluated.Results There were 29 cases in poorly differentiated group,37 in moderately differentiated group and 20 cases in highly differentiated group.The arrival time of contrast agent in poorly differentiated group was earlier than that in moderately and high differentiated groups(both P<0.05),while in moderately differentiated group was not significantly different with that in highly differentiated group(P>0.05).The washout grade were significantly different between each 2 groups(all P<0.05).The arrival time of contrast agent and washout grade were independent predictors of highly or poorly differentiated,moderately or poorly differentiated,moderate-highly or poorly differentiated HCC,and washout grade also was independent predictor of highly or moderately differentiated HCC(all P<0.05).The AUC of the arrival time of contrast agent for predicting highly or moderately differentiated,highly or poorly differentiated,moderately or poorly differentiated,moderate-highly or poorly differentiated HCC was 0.615,0.787,0.690 and 0.724,respectively,while of washout grade was 0.801,0.927,0.795 and 0.841,respectively.Conclusion CEUS could be used to effectively predict differentiation degree of HCC.
基金Supported by the Liaoning Province Science and Technology Plan Joint Program,No.2024JH2/102600310.
文摘BACKGROUND The expression level of Ki-67 and the degree of differentiation in pancreatic cancer determine tumor aggressiveness and patient prognosis,which holds significant implications for clinical decision-making.A major challenge in preoperative pancreatic ductal adenocarcinoma management is predicting tumor malignancy.Contrast-enhanced ultrasound(CEUS),a dynamic imaging technique based on blood pool visualization,can reveal lesion vasculature and provide quantitative perfusion data reflecting angiogenesis.By tracking contrast agent kinetics,CEUS offers non-invasive insights into tumor vascularization,helping assess malig-nancy potential.AIM To investigate the correlation between Ki-67 and pancreatic cancer differentiation using CEUS quantitative parameters and evaluated their diagnostic accuracy.METHODS This retrospective study analyzed pancreatic cancer patients who underwent CEUS and pathological confirmation.Pathological differentiation,clinical data,and quantitative CEUS parameters[maximum intensity(IMAX),rise time(RT),rise slope 50%(Rs50),rise slope 10%-90%(Rs1090),etc.]were collected.Based on Ki-67 expression(<50%vs≥50%),patients were divided into low-and high-expression groups.The study evaluated correlations between Ki-67 expression,differentiation degree,and CEUS quantitative parameters to assess tumor aggressiveness.RESULTS Among 54 patients(25 high Ki-67,29 low Ki-67),significant differences(P<0.05)were observed in Rs50,IMAX,wash-out area under the curve(WoutAUC),wash-in and out area under curve,and Rs1090 between high and low Ki-67 groups.High-expression patients showed elevated Rs50,IMAX,WoutAUC,and area under the curve(AUC),while RT and falling slope 50%(Fs50)were lower.Rs1090 demonstrated the highest diagnostic accuracy(AUC=0.863,sensitivity=0.92,specificity=0.759).Fs50 was effective in low Ki-67 detection(AUC=0.838).No correlation was found between enhancement patterns and Ki-67 or differentiation.CONCLUSION CEUS parameters(Rs50,IMAX,WoutAUC,Rs1090)strongly correlate with Ki-67,aiding non-invasive pancreatic cancer assessment.Rs1090/IMAX predict high Ki-67;Fs50 identifies low Ki-67,supporting CEUS for tumor aggressiveness evaluation.
文摘AIMS To study the relationship between the modern clinical and pathohistological classification and TCM Syndrome-Typing of chronic ulcerative colitis (CUC). METHODS Totally 452 patients with CUC were clas- sified according to the standards of TCM Syndrome- Typing set up in the Conference of the Combination of the Chinese-Western Medicine on Digestive Diseases in Linfen. The relevant changes between both classifica- tions were analyzed and compared through the colonofiberscopic and pathohistological examination. RESULTS The type of retention of damp-heat in inte- rior is more commonly seen in the patients with initial onset of disease (P<0.01). There is no significant difference among other TCM Syndrome-Typing groups in patients with chronic persistent and recurrent disease (P>0.05). The congestion,edema,reduction of goblet cells and the infiltration of neutrophils are patho- logically common to all TCM Syndrome-Typing groups. Mucosal ulcer is dominant in damp-heat syndrome while crypt ulcer is dominant in the types of spleen-stomach asthenia and spleen-kidney Yang deficiency (P< 0.01). CONCLUSIONS There appears a certain relation- ship between the TCM syndrome typing and pathohis- tological changes of the colonal mucosa of CUC.
