Role of endoscopic ultrasound in the diagnosis of pancreatic cancer

Endoscopic ultrasonography (EUS) with or without fine needle aspiration has become the main technique for evaluating pancreatobiliary disorders and has proved to have a higher diagnostic yield than positron emission tomography, computed tomography (CT) and transabdominal ultrasound for recognising early pancreatic tumors. As a diagnostic modality for pancreatic cancer, EUS has proved rates higher than 90%, especially for lesions less than 2-3 cm in size in which it reaches a sensitivity rate of 99% vs 55% for CT. Besides, EUS has a very high negative predictive value and thus EUS can reliably exclude pancreatic cancer. The complication rate of EUS is as low as 1.1%-3.0%. New technical developments such as elastography and the use of contrast agents have recently been applied to EUS, improving its diagnostic capability. EUS has been found to be superior to the recent multidetector CT for T staging with less risk of overstaying in comparison to both CT and magnetic resonance imaging, so that patients are not being ruled out of a potentially beneficial resection. The accuracy for N staging with EUS is 64%-82%. In unresectable cancers, EUS also plays a therapeutic role by means of treating oncological pain through celiac plexus block, biliary drainage in obstructive jaundice in patients where endoscopic retrograde cholangiopancreatography is not affordable and aiding radiotherapy and chemotherapy.     

Role of video-assisted thoracoscopy in diagnosis of neoplasms in mediastinal organs]

Diagnostic potential of video-assisted thoracoscopy was evaluated in 66 patients (36 males and 30 females) with neoplasms (aged 24-68 yrs). When used in conjunction with biopsy, it confirmed the following diagnoses: lymph proliferative disease (23), mediastinal malignancies (11), sarcoidosis (21), benign mediastinal tumors (7), Castleman's benign lymphoma (2) and mediastinal cyst (2). Clinical diagnosis was substantially changed in 40 (61%) cases as a result of videothoracoscopy application. It has proved precise, fairly safe and conservative; it has a potential in diagnosis of mediastinal tumors.     

Role of conventional radiology in the diagnosis and staging of gastrointestinal tract neoplasms

Preoperative diagnosis and staging of primary gastrointestinal (GI) neoplasms are challenges for both clinicians and radiologists. Barium studies are very sensitive in disclosing primary malignancies, even at an early stage. Radiologic signs depend on the evolutional stage of the disease and its appearance on gross pathology. A neoplasm may be manifested on barium studies by a wide spectrum of findings, including mucosal abnormalities, mass presence, ulcerative lesions, submucosal infiltration, and lumen stenosis. Advanced disease can be accurately diagnosed, whereas early cancer should be differentiated from other neoplastic or inflammatory disorders by meticulous analysis of radiologic findings. The extent of GI involvement and multiplicity of the lesions can be assessed on barium studies. In the staging of GI neoplasms, barium studies are of little value. Skeletal survey by conventional radiographs and chest plain films can reveal distant metastases in a short time and with low cost, although they are not that sensitive to the detection of early or subtle lesions. The exact role of conventional radiology in the imaging workup of GI malignancies depends on local expertise and availability of other diagnostic techniques and modalities.     

超声内镜与多层螺旋CT诊断胰腺神经内分泌肿瘤的价值

目的:探讨超声内镜(EUS)与多层螺旋CT(MSCT)诊断胰腺神经内分泌肿瘤(pNENs)的价值.方法:回顾性分析2012年至2016年43例均行EUS和MSCT检查并经组织病理学确诊为pNENs患者的临床、影像和病理资料,比较EUS和MSCT对pNENs的检出率和敏感性,并分析EUS和MSCT在肿瘤最大径≥2 cm或<2 cm、功能性或无功能性pNENs诊断中是否存在差异.结果:43例经组织病理学确诊的pNENs中,男23例、女20例,年龄(57.2±13.6)岁(28~75岁),肿瘤最大径(2.6±2.1) cm(0.6~7.3 cm),其中19例≥2 cm、24例<2 cm,功能性pNENs 26例、非功能性pNENs 17例.总体而言,EUS和MSCT检出率分别为90.7%(39/43)和69.8%(30/43),差异具有统计学意义(P=0.015);EUS和MSCT敏感性分别为71.8%(28/39)和73.3%(22/30),差异无统计学意义(P=0.887).按肿瘤最大径不同比较:EUS和MSCT对肿瘤最大径≥2 cm pNENs的检出率分别为100%(19/19)和100%(19/19),差异无统计学意义(P=1.000);敏感性分别为73.7%(14/19)和78.9%(15/19),差异无统计学意义(P=0.703).EUS和MSCT对肿瘤最大径<2 cm pNENs的检出率分别为83.3%(20/24)和45.8%(11/24),差异具有统计学意义(P=0.007);敏感性分别为70.0%(14/20)和63.6%(7/11),差异无统计学意义(P=0.717).按肿瘤有无功能比较:EUS和MSCT对功能性pNENs的检出率分别为88.5%(23/26)和53.8%(14/26),差异有统计学意义(P=0.006);敏感性分别为73.9%(17/23)和64.3%(9/14),差异无统计学意义(P=0.534).EUS和MSCT对非功能性pNENs的检出率分别为94.1%(16/17)和94.1%(16/17),差异无统计学意义(P=1.000);敏感性分别为68.8%(11/16)和81.3%(13/16),差异无统计学意义(P=0.414).结论:MSCT对直径≥2 cm 的pNENs检出率和敏感性较好,但对直径<2 cm的pNENs检出率和敏感性较低,有必要联合EUS检查.     

Advances in endoscopic resection of sinonasal neoplasms

Management of sinonasal diseases has undergone significant change with the advent of endoscopic techniques. A wide variety of pathology can now be surgically managed with the use of endoscopes both within and beyond the sinonasal tract. Endoscopic techniques allow for excellent visualization and complete tumor resection with low morbidity. As experience continues to grow, endonasal endoscopic techniques are becoming the surgical procedures of choice for the management of a wide variety of benign neoplasms.     

Role of genealogical studies for the prevention of malignant neoplasms]

Based on clinico-genealogical studies of 219 cancer patients, whose relatives suffered neoplastic processes, it was concluded that a hereditory factor plays a definite role in cancer morbidity. It seems to be rational to single out the relatives of the proband as a high-risk group in malignant tumor morbidity and to keep them under a dispensary control.     

胃癌术前超声内镜评估TNM分期的临床研究

为了评估超声内镜在胃癌术前分期评估中的作用,83例胃癌患者均于术前行超声内镜检查,并将其内镜分期结果与术后病理学检查分期结果比较.超声内镜分期结果与病理学分期结果比较显示,各期准确率分别为T1期88.9%(8/9),T2期91.2%(21/23),T3期81.5%(31/38),T4期92.3%(12/13);淋巴结转移准确率为78.9%.超声内镜检查可有效进行术前分期,有助于制订合理的治疗方案.     

Impact of cytogenetic and molecular cytogenetic studies on hematologic malignancies

Conventional cytogenetic analysis of chromosome abnormalities in hematologic malignancies is hampered by the low mitotic index and poor quality of metaphases. A range of techniques based on fluorescence in situ hybridization (FISH) has greatly enhanced the identification of non-random translocations and deletions, pinpointing regions which contain genes involved in leukemogenesis. One of the main advantages of FISH is its ability to use non-dividing interphase cells as DNA targets, enabling the screening of large numbers of cells and providing access to a variety of cells with different hematopoetic activity. Furthermore, multicolor FISH (SKY, M-FISH and CGH microarrays) combines the screening potential of cytogenetics with the accuracy of molecular genetics, allowing the visualization of the entire human genome in 24 different colors.     

PCR和FISH技术在子宫颈淋巴瘤与淋巴瘤样病变诊断和鉴别诊断中的作用

 目的　探讨PCR和FISH检测技术在原发性子宫颈淋巴瘤与淋巴瘤样病变的诊断与鉴别诊断中的作用。方法　收集3例原发性子宫颈弥漫性大B细胞淋巴瘤（DLBCL）与2例子宫颈淋巴瘤样病变,进行PCR-IgH重排及FISH检测。结果　PCR检测显示3例DLBCL和1例淋巴瘤样病变中出现单克隆性IgH基因重排。间期FISH检测显示3例DLBCL均发生了IgH和bcl-6基因断裂,而2例淋巴瘤样病变均未检测到特定的染色体断裂。结论　PCR-IgH重排并非仅见于子宫颈细胞淋巴瘤。间期FISH检测IgH和bcl-6基因的断裂对于子宫颈B细胞淋巴瘤和淋巴瘤样病变的诊断和鉴别诊断有帮助。     

Peripheral blood cytogenetic studies in myelofibrosis: overall yield and comparison with bone marrow cytogenetic studies

Among 59 consecutive patients with myelofibrosis (MF) in whom peripheral blood (PB) cytogenetic studies were performed, at least two analyzable metaphases (median 20, range 2-31) were obtained in 49 (81%) patients and in all 37 (100%) cases with PB myeloid progenitor cell count of 0.1 x 10(9)L(-1) or above (p=0.02). Twenty-two patients had concomitant PB and bone marrow (BM) cytogenetic studies; 6 showed similarly abnormal findings in both BM and PB. In another 2 cases, results were abnormal in BM but normal in PB; the opposite was seen in 1 case. These results suggest that PB can be considered as an alternative to BM for cytogenetic studies as currently used in MF but additional prospective studies are needed to support change in practice.     

ROLE OF COLPOSCOPY IN THE DIAGNOSIS OF HUMAN PAPI- LLOMAVIRUS INFECTION OF THE UTERINE CERVIX

Among 6706 women screened by cytology, only 9 (0.13%) showed evidence of human pppillomavirus infection (HPVI). In 133 women examined by colposcopy for abnormal cytology or/ and suspected lestions on the cervix, 41.(30. 8%) showed subclinical papillomavirus infection (SPI), while 17. 4% and 5. 3% showed HPVI by histopathology and cytology, respectively. The conformation rate between colposcopy and pathology was 69. 6%. Sixty-nine specimens out of 133 colposcopy piled biopaies were assayed by HPV-DNA dot hybridization with 6B/11, 16, 18 probes to detect the presence of HPV-DNA In the cervical specimens. Thirty-nine (56.5%) gave a positive result. The colposcopic predictive value of positive result for HPVI was 76.7%. The difference between colposcopy (59%) and pathology (20. 5%) is statistically significant (P<0. 01). These results suggest that colposcopy is superior to cytology and hjstopathology for the detection of SPI in the cervix. In colposcopy HPV-DNA positive women, aceto while epithelium was mos     

Athymic rats in preclinical immunodiagnostic studies

The usefulness of nude rat xenograft systems in immunolocalization studies was investigated using the monoclonal antibody 9.2.27 which binds to melanomas and osteosarcomas. Three human tumors, two melanomas (LOX and FEMX-I) and one osteosarcoma (OHSX), were used. They were established as s.c. xenografts in congenitally athymic (rnu/rnu) nude rats. These serially transplantable tumors showed the same morphology, take rate and growth properties in nude rats as in nude mice. Radiolabeled 9.2.27 F(ab')2 fragments injected i.v. into nude rats were concentrated in s.c. LOX and OHSX xenografts, reaching tumor to blood ratios of up to 30 after 3-4 days. However, the injected antibody failed to concentrate in FEMX-I xenografts, in contrast to previous findings in mice. This discrepancy could be attributed neither to significant differences in in vivo distribution of the labeled antibody nor to the presence of blocking factors in the serum of nude rats. In immunoscintigraphic studies clear images of s.c. LOX tumors were obtained, whereas lung colonies were less well visualized. Biodistribution studies showed a low tumor to blood ratio of about 4 in the latter animals, suggesting a tumor site-dependent variation in homing of labeled antibodies. Radiography was found to be superior to immunoscintigraphy in detecting the lung tumors. The present findings demonstrate that results of immunolocalization studies in nude mice cannot readily be extrapolated to other species. For the purpose of preclinical evaluation of new methods in cancer diagnosis and treatment, tumor xenografts in nude rats may represent a valuable complement to nude mouse models.