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1.
目的探讨高荧光细胞(HFC)和血清腹水白蛋白梯度(SAAG)诊断恶性腹水的价值。方法选取202例出现腹水的患者,依据脱落细胞学检查结果分为恶性腹水组(36例)和良性腹水组(166例),分析HFC和SAAG在良、恶性腹水组中的分布差异。采用受试者工作特征(ROC)曲线评价各项指标单项及联合检测诊断恶性腹水的效能。结果恶性腹水组高荧光细胞绝对值(HF#)和高荧光细胞百分比(HF%)均显著高于良性腹水组(P=0.0000、P=0.0001),SAAG水平显著低于良性腹水组(P=0.0000)。HF#、HF%和SAAG诊断恶性腹水的曲线下面积分别为0.797、0.704、0.770。单项指标分析时,HF#和SAAG的敏感性、特异性、准确性分别为83.3%、66.9%、69.8%和88.9%、62.0%、66.8%,HF#和SAAG串联检测的敏感性、特异性、准确性分别为77.8%、80.1%、79.7%,HF#和SAAG并联检测的敏感性、特异性、准确性分别为94.4%、48.8%、56.9%。结论HF和SAAG联合检测诊断恶性腹水的敏感性有所下降,但特异性和准确性均明显升高,更有利于恶性腹水的诊断。  相似文献   
2.
SOX4是SOX家族C组亚科的成员,它可能通过赋予癌细胞生存、迁移和侵袭能力来促进肿瘤发生发展。目前已有多种证据支持SOX4是一种重要的癌基因的观点。SOX4在多种恶性肿瘤中过表达,包括消化系统肿瘤,而消化系统肿瘤是发展中国家癌症患者死亡的最常见原因。近年来,SOX4引起恶性转化的分子机制及其与消化系统肿瘤的关系成为研究的焦点和前沿领域。本文就SOX4在消化系统肿瘤中的研究现状进行综述。  相似文献   
3.
《Pancreatology》2022,22(1):123-129
Background/Objectives: Although the presence of lymph node metastasis (LNM) defines malignant potential, preoperative prediction of LNM has not been established for non-functional pancreatic neuroendocrine neoplasm (NF-PNEN). We sought to develop a prediction system using only preoperatively available factors that would stratify the risk of LNM for NF-PNEN.MethodsWe retrospectively reviewed patients who underwent R0/1 resection of NF-PNEN at Kyoto University (2007–2019) and the University of California, San Francisco (2010–2019). Risk stratification of LNM was developed using preoperative factors by the logistic regression analysis. Long-term outcomes were compared across the risk groups.ResultsA total of 131 patients were included in this study. Lymph nodes were pathologically examined in 116 patients, 23 (20%) of whom had LNM. Radiological tumor size [1.5–3.5 cm (odds ratio: 13.5, 95% confidence interval: 1.77–398) and >3.5 cm (72.4, 9.06–2257) against ≤1.5 cm], <50% cystic component (8.46 × 10^6, 1.68 × 10^106-), and dilatation of main pancreatic duct ≥5 mm (31.2, 3.94–702) were independently associated with LNM. When patients were classified as the low-risk (43 patients), intermediate-risk (44 patients), and high-risk groups (29 patients), proportions of LNM differed significantly across the groups (0%, 14%, and 59%, respectively). Recurrence-free survival (RFS) of the low- and intermediate-risk groups were significantly better than that of the high-risk group (5-year RFS rates of 92.2%, 85.4%, and 47.1%, respectively).ConclusionsThe prediction system using preoperative radiological factors stratifies the risk of LNM for NF-PNEN. This stratification helps to predict malignant potential and determine the surgical procedure and necessity of regional lymphadenectomy.  相似文献   
4.
ObjectiveWe encountered a case of high-grade serous carcinoma (HGSC) of the ovary which recurred as carcinosarcoma of the sigmoid colon. Tumor cells of both the primary carcinoma and the secondary carcinosarcoma were negative for estrogen receptor (ER), WT-1, and PAX8. It is well known that most ovarian carcinomas arising from the Müllerian duct are immunoreactive for these biologic parameters. To our knowledge, this is the first case report that provides the results of immunohistochemical analysis of WT-1 and PAX8 for a primary carcinoma and recurrent carcinosarcoma.Case reportA 61-year-old woman had an advanced right ovarian HGSC. After a primary debulking surgery (hysterectomy, bilateral salpingo-oophorectomy and omentectomy) and adjuvant chemotherapy, complete remission was achieved. However, four and a half years later, a tumor arising beside the sigmoid colon was detected. A tumorectomy was performed through combined partial resection of the ileum and sigmoid colon. Microscopically, the tumor was diagnosed as carcinosarcoma of the sigmoid colon, which had originated from HGSC of the ovary. Interestingly, the malignant cells of the primary carcinoma and epithelial components of the recurrent carcinosarcoma were negative for ER, WT-1, and PAX8. These immunohistochemical features were unusual. Three cycles of chemotherapy with the previously used regimen and three additional cycles of doxorubicin and ifosfamide combination chemotherapy were administered. Currently, 3 years after the final chemotherapy was administered, the patient remains healthy.ConclusionHGSC of the ovary can recur as carcinosarcoma. Tumor cells of the primary HGSC without ER, WT-1, and PAX8 expression may have dedifferentiated and recurred as carcinosarcoma.  相似文献   
5.
ObjectivesTo review the evidence pertaining to the association between cow’s milk protein allergy and recurrent acute otitis media and otitis media with effusion.MethodsThe CENTRAL, Web of Science, EMBASE, MEDLINE, LILACS databases, and gray literature were searched.ResultsFour studies were included, identifying the prevalence rates: 0.2% of delayed speech due to chronic otitis media with effusion in 382 children with cow’s milk protein allergy, 10.7% of cow’s milk protein allergy in 242 children who underwent ENT procedures, 40% of cow’s milk protein allergy in 25 children with recurrent otitis media with effusion and higher tendency to otitis media in children with cow’s milk protein allergy of 186 children (1.5 + 0.6 vs. 0.4 + 0.1; p < 0.1).ConclusionConsidering the characteristics and methodological variations of the identified studies, it is not possible to state that there is reliable evidence of an association between cow’s milk protein allergy and otitis media.  相似文献   
6.
BackgroundIn order to avoid excessive treatment of thyroid nodules in the clinic, it is necessary to find a simple and practical analysis method to comprehensively and accurately reflect benign or malignant thyroid nodules. This study aimed to construct and validate a comprehensive and reliable network-based predictive model using a variety of imaging and laboratory criteria for thyroid nodules to stratify the risk of malignancy prior to surgery.MethodsWe retrospectively analyzed data from patients who underwent surgical treatment for thyroid nodules at the Thyroid and Breast Diagnosis and Treatment Center of Weifang Hospital of Traditional Chinese Medicine between January 2018 and December 2020. Binary logical regression analysis was performed to predict whether nodules were malignant or benign. The developmental dataset included 457 patients (January 2018–December 2020). The validation set included separate data points (n = 225, January 2018–December 2020).ResultsIn this study, criteria that showed significant predictive value for malignant nodules included TI-RADS: 4b (p = 0.065); Bethesda IV, Bethesda V, Bethesda VI (P < 0.0001); BRAFV600E mutation (P < 0.0001); Calcitonin>5 pg/ml (p = 0.0037); and FNA-Tg>30 ng/ml (p = 0.0003). A 10-grade risk scoring system was developed. The risk of malignancy risk ranged from 2.06% to 100% and was positively associated with increasing risk grade. The areas under the receiver-operating characteristic curve of the development and validation sets were 0.972 and 0.946, respectively.ConclusionA simple, comprehensive and reliable web-based predictive model was designed using a variety of imaging and laboratory criteria to stratify thyroid nodules by probability of malignancy.  相似文献   
7.
腹膜癌是指在腹膜上发生和(或)发展的一类恶性肿瘤,包括原发性腹膜癌和继发性腹膜癌。既往认为腹膜癌是一种终末期疾病,无特殊治疗,患者生存期短,预后差。随着对腹膜癌认识的转变,肿瘤学界将其视为一种可治性区域癌转移,开创了以肿瘤细胞减灭术加腹腔热灌注化疗为核心的综合治疗技术体系,并以此建立了专业化腹膜癌诊疗中心,显著延长了患者生存,部分患者甚至能达到临床治愈。然而在中国,目前规范化腹膜癌诊疗中心少,但腹膜癌患者数量庞大,大部分患者得不到规范化治疗,导致生存和预后并不理想。本文旨在根据我国国家癌症中心发布的癌症新发病例统计数据,结合腹膜癌的临床预后资料,按照临床流行病学的研究方法,估算我国所需腹膜癌诊疗中心数,为推广我国腹膜癌规范化诊疗技术体系提供数据支撑,促进腹膜肿瘤学科发展。  相似文献   
8.
目的探讨浆膜腔积液细胞蜡块在免疫细胞化学和分子病理技术中的应用价值。方法1191例浆膜腔积液均制作细胞蜡块,细胞蜡块切片中发现非典型细胞、可疑恶性肿瘤细胞或典型恶性肿瘤细胞的,将进一步进行免疫细胞化学染色鉴别细胞良恶性、识别病变细胞的组织来源,必要时行分子病理检测,指导临床靶向治疗。结果1191例浆膜腔积液中,检出恶性肿瘤356例,肿瘤原发灶来源以肺癌为主,占56.18%(200/356);病理类型以腺癌为主,占86.80%(309/356)。细胞蜡块切片诊断为Ⅰ级者710例,Ⅱ级者131例,Ⅲ级者210例,Ⅳ级者140例,特异度为91.01%,敏感度为96.89%。细胞蜡块免疫组化检测诊断为Ⅰ级者125例,Ⅱ级及Ⅲ级者均为0,Ⅳ级者356例,其敏感度及特异度均为100%。细胞蜡块免疫组化检测总准确率为100%(481/481),高于细胞蜡块切片的总准确率95.13%(1133/1191),两者相比差异有统计学意义(χ2=7.81,P<0.05)。46例肺腺癌及15例乳腺癌行分子病理检测,肺腺癌EGFR基因突变阳性率为32.6%(15/46),ALK基因重排阳性率为10.8%(5/46),乳腺癌HER?2基因扩增阳性率为40%(6/15)。结论细胞蜡块是鉴别浆膜腔积液的良恶性、判断肿瘤细胞组织来源及病理类型的有效载体,同时亦可作为分子病理检材,对后续精准治疗具有重要的临床应用价值。  相似文献   
9.
目的分析恶性肿瘤免疫治疗相关性低血糖反应3例的治疗失误原因、防范措施及规范疗法。方法对2018年1月—2021年1月恶性肿瘤患者应用免疫治疗后出现低血糖反应3例的临床资料进行回顾性分析。结果3例恶性肿瘤分别应用程序性细胞死亡蛋白-1抑制剂过程中或治疗后出现心悸、大汗淋漓等症状,查血糖水平降低,补充高浓度葡萄糖后好转,但症状反复。排除其他常见成人低血糖病因后,均确诊为免疫治疗相关性低血糖反应。3例应用糖皮质激素治疗后,均未再出现低血糖反应。结论低血糖反应是恶性肿瘤免疫治疗后较为罕见的不良反应,临床医生需加强对该病的认识,明确病因,及时应用糖皮质激素治疗。  相似文献   
10.
Objectives: Oral Submucous Fibrosis (OSMF) is potentially malignant disorder known to transform into oral cancer. The aim of this study is to determine the degree and pattern of expression of aberrant Ki67 in OSMF, oral squamous cell carcinoma (OSCC) and in normal oral mucosa  patients (NOM). The objective is to correlate between Ki67 expression and degree of dysplasia in OSMF patents and also Ki67 expression with clinical and histological grading of OSMF and OSCC patient. Materials and Methods: A prospective cross-sectional study was conducted with purposive sampling technique from Jan 2017 to April 2020.The study groups consist of 35 OSMF cases, 10 cases of each OSCC and NOM. The samples were immunohistochemically analyzed for expression Ki67 antigen using chi-square test (P < 0.05). Results: The expression of Ki67 was significantly higher in OSMF than that of NOM samples, but less than that of OSCC samples. Present study showed correlation between expression of Ki67 with clinical staging and histological grading both in OSMF and OSCC patients. Conclusion: The study demonstrated a high incidence of Ki67 over expression in, OSMF and OSCC. Hence, Ki-67 can be widely used as a proliferation marker to measure growth fraction of cells in OSMF and also for determining the severity of epithelial dysplasia.  相似文献   
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