血清肿瘤标志物和乳腺钼靶在乳腺癌诊断中的应用价值

目的 探讨乳腺钼靶和血清肿瘤标志物在乳腺癌诊断中的应用价值.方法 回顾性分析2013年1月至2014年10月在我院明确诊断的104例乳腺癌患者的临床资料,按照乳腺肿块大小分别统计乳腺钼靶和血清肿瘤标志物CEA、CA153和CA125检测结果,对两种检查方法阳性符合率进行比较,探讨其在乳腺癌诊断中的意义.结果 乳腺肿瘤直径＜2cm组、2～ 5cm组、＞5cm组,钼靶结果阳性率分别为76.7％,87.5％,94.4％;肿瘤标志物联合诊断阳性率分别为33.3％,62.2％,100％.结论 在乳腺癌诊断中,钼靶诊断是乳腺癌诊断的重要方法,其诊断阳性率明显高于血清肿瘤标志物诊断;血清肿瘤标志物在晚期肿瘤中阳性率明显高于早期肿瘤,其在癌症复发监测、肿瘤疗效评价中的有较高价值.     

电化学发光免疫分析技术检测肿瘤标志物在乳腺癌诊断中的应用

目的 探究电化学发光免疫分析技术检测肿瘤标志物在乳腺癌的临床诊断中的应用价值。方法 选取本院2014年1月~2017年1月收治的30例乳腺癌患者和30例乳腺良性肿瘤患者,均采用电化学发光免疫分析技术与超声检查,比较两种诊断方式准确率,以及乳腺癌患者与乳腺良性肿瘤患者CEA和CA15-3指标。结果 与病理结果对照,电化学发光免疫分析技术准确率为93.33%,高于超声诊断的40.00%,差异具有统计学意义（P＜0.05）。乳腺癌患者CEA、CA15-3分别为（27.3±25.0）ng/ml、（49.4±51.1）U/ml,高于乳腺良性肿瘤患者的（10.1±5.1）ng/ml、（11.2±8.0）U/ml,差异具有统计学意义（P＜0.05）。结论 在乳腺癌临床诊断中,电化学发光免疫分析技术检测肿瘤标志物效果显著,还可以根据CEA、CA15-3等水平检测进行辅助诊断。     

Highly scattering optical system identificationvia frequency response analysis of NIR-TRS spectra

Frequency response analysis via pulse testing is often used for the characterization of engineering systems. Near infrared-time resolved spectroscopy (NIR-TRS) is a frequently used technique for the analysis of biological system properties. Since the TRS input is a very sharp photon pulse, a well designed TRS input pulse can produce a multi-frequency response over the useful frequency range for the system identification. This new approach for analyzing NIR-TRS provides new optical system parameters (e.g., magnitude ratio and phase shift at multi-frequencies, system time constant, system order, and steady state gain) that are not available by traditional TRS spectra analysis. In this paper, the basic theory of pulse reduction is introduced for the multi-modulation frequency response of TRS spectra. Homogeneous system response with various absorption and scattering properties were analyzed for the multi-system parameters. In heterogeneous systems, the position of the localized absorber is correlated with the multi-parameters, which can ultimately be used to enhance medical imaging.     

乳腺癌的钼靶X线征象与免疫组化标记物表达的关系

目的 分析乳腺癌的主要X线征象,肿块、局限性致密浸润影与病理检测常用的免疫组化标记物ER,PR,C-erbB-2,nm23之间的关系。方法 收集云南省第一人民医院2016年1月~2019年1月经病理证实107例乳腺癌患者作为研究对象,病灶共108例,所有患者均行钼靶X线摄影。根据X线征象将所有病灶分为肿块组73例及局限性致密影组35例。使用免疫组化技术测定乳腺癌ER,PR,C-erbB-2,nm23的表达水平,比较两组癌灶中基因表达水平。结果 乳腺癌钼靶X线征象表现为局限性致密浸润影组（80.00%）C-erbB-2的表达高于肿块组（56.16%）,差异有统计学意义（P＜0.05）;局限性致密浸润影组（40.00%）nm23高表达者低于肿块组（64.38%）,差异有统计学意义（P＜0.05）;局限性致密浸润影组腋窝淋巴结转移多于肿块组（P＜0.05）;肿块和局限性致密浸润影其ER,PR阳性表达比较,差异均无统计学意义（P＞0.05）。结论 乳腺癌主要X线征象的差异可反映肿瘤细胞基因表达C-erbB-2与nm23水平,针对乳腺癌具体征象分析对于其早期诊断及其预后的初步判断有一定意义。     

<Emphasis Type="Italic">In Vivo</Emphasis> Spectroscopic Characterization of Porcine Biliary Tract Tissues: First Step in the Development of New Biliary Tract Imaging Devices

Background Approximately 400,000 cholecystectomies are performed annually in the United States. The most important complication of the operation is bile duct injury (BDI). Injury prevention relies mostly on an individual surgeon’s skill. As of yet no technology has been introduced that will enable surgeons to visualize the bile ducts while operating. Theoretically, such a device could eliminate BDI. Near infrared (NIR) spectroscopy capitalizes on near infrared light’s ability to penetrate deeply into tissues and spectroscopic capability to discern tissue’s chemical properties. The purpose of this work is to characterize the NIR optical properties of bile containing structures that are needed for later development of a clinically useful probe. Methods NIR Spectroscopy combined with visible light spectroscopy was used to determine the spectroscopic properties of the biliary tree and its adjacent structures. Eight anesthetized pigs were used to obtain reflectance measurements using a fiber probe. Radial Basis functions (RBFs) were used to characterize the reflected light spectra. Parameters describing the RBFs were then used to classify tissues based on their observed spectra using machine automation. Results Biliary tissues, arteries and veins all had unique reflectance spectra. These spectra were characterized by their unique set of RBFs. Conclusion We have developed an optical probe capable of imaging and identifying biliary tract tissues in a porcine model. In this study, we characterized the reflectance properties for bile and blood vessels such that when the probe is applied to the porta hepatis it will enable surgeons to localize important biliary structures prior to any portal dissection, potentially eliminating the risk for inadvertent BDI.     

131I标记重组人表皮生长因子体内抑制乳腺癌生长的实验研究

研究 1 31 I标记重组人表皮生长因子 (1 31 I- Recombinant hum an epiderm al growth factor,1 31 I- rh EGF)对荷人乳腺癌裸鼠肿瘤生长的抑制作用。1 31 I- rh EGF在荷人乳腺癌裸鼠体内的组织分布实验证实 1 31 I- rh EGF的生物活性及乳腺癌组织对 1 31 I- rh EGF的摄取 ,通过给药后荷人乳腺癌裸鼠肿瘤的生长实验观察 1 31 I- rh EGF对肿瘤生长的影响 ,用透射电镜和病理组织学检查分别观察 1 31 I- rh EGF治疗后肿瘤细胞的超微结构变化和组织病理学变化。1 31 I-rh EGF的组织分布显示 ,荷人乳腺癌裸鼠的肿瘤组织对 1 31 I- rh EGF有明显摄取。肿瘤生长观察结果显示 ,静脉注射和瘤体内注射 1 31 I- rh EGF均能明显抑制肿瘤的生长 ,抑瘤率 (82 .0 0 %和 80 .70 % )显著大于 1 31 I(7.4 9% )和 1 31 I- HSA(6 .91% ) (P<0 .0 5 )。透射电镜和病理学观察均显示 ,静脉注射和瘤体内注射 1 31 I- rh EGF均能明显杀伤、杀死肿瘤组织细胞。实验表明 ,1 31 I- rh EGF能抑制裸鼠体内的人乳腺癌细胞生长 ,可望成为受体介导放射性靶向治疗乳腺癌的新药物     

超声、钼靶、MRI及肿瘤标志物联合检测在乳腺癌诊断中的价值研究

目的 探讨乳腺癌在彩色多普勒超声、乳腺钼靶和乳腺MRI上的表现及乳腺癌肿瘤标志物CA15-3的表达水平,比较超声、钼靶和MRI及CA15-3在早期乳腺癌诊断中的应用价值.方法 回顾性分析2014年3月至2016年3月在唐山市人民医院收治的92例乳腺癌患者,比较术前超声、钼靶、MRI、CA15-3及联合检查与术后病理诊断的符合情况.结果 MRI的确诊率明显地高于超声和钼靶,两者间差异有统计学意义(x2=3.761,P＜0.050;x2 =3.513,P＜0.05),钼靶也明显高于超声,两者间差异有统计学意义(x2 =5.312,P＜0.05).CA15-3与MRI差异无统计学意义.超声检查漏诊及误诊率明显高于钼靶、MRI、CA15-3.超声、钼靶和MRI三种影像学检查联合血清CA15-3水平检测正确诊断86例,诊断正确率为93.5％.结论 乳腺癌较容易漏诊,疑难病例定性困难,超声、钼靶、MRI及肿瘤标志物联合检测可以有效提高乳腺癌诊断的灵敏度和正确率,减少漏诊率.     

Characterization of epithelial V-like antigen in human choroid plexus epithelial cells: potential role in CNS immune surveillance

Near-infrared spectroscopy (NIRS) can detect two different kinds of signals from the human brain: the hemodynamic response (slow) and the neuronal response (fast). This paper explores a nonlinear aspect in the tactile-stimulus-evoked neuronal optical response over a NIRS time series (light intensity variation). The existence of the fast optical responses (FORs) over the time series recorded in stimulus sessions is confirmed by event-related averaging. The chaos levels of the NIRS time series recorded both in stimulus and in rest sessions are then identified according to the estimated largest Lyapunov exponent. The obtained results ascertain that stimulus-evoked neuronal optical responses can be detected in the somatosensory cortex using continuous-wave NIRS equipment. Further, the results strongly suggest that the chaos level can be used to recognize the FORs in NIRS time series and, thereby, the state of the pertinent brain activity.     

CEA、CA15-3和CA125对乳腺癌的诊断价值以及影响因素探讨

研究肿瘤标志物CEA、CA15—3和CA125对乳腺癌的诊断价值,并对影响肿瘤标志物阳性率的相关因素进行分析。采用CLIA法测定血清CEA、CA15—3和CA125水平,以CEA〉4．8μg/mL、CA15-3〉25U／mL、CA125〉35U／mL作为诊断阳性标准。乳腺癌组患者59例,乳腺良性组患者69例,对照组65名。结果表明：乳腺癌CEA,CA15—3和CA125水平较对照组和乳腺良性组明显升高（P〈0．05）。CA15-3的灵敏度（42．4％）最高,CA125的特异度（89．6％）最高。采用平行联检法,可提高乳腺癌诊断的灵敏度（67．8％）和阴性预测值（85．0％）。而采用系列联检法,可提高特异度（91．0％）和阳性预测值（58．6％）。与乳腺癌肿瘤标志物阳性率显著相关的因素有：肿瘤分期、皮肤改变、淋巴转移、远处转移和P53（P〈0．05）。     

An Interactive System for Computer-Aided Diagnosis of Breast Masses

Although mammography is the only clinically accepted imaging modality for screening the general population to detect breast cancer, interpreting mammograms is difficult with lower sensitivity and specificity. To provide radiologists “a visual aid” in interpreting mammograms, we developed and tested an interactive system for computer-aided detection and diagnosis (CAD) of mass-like cancers. Using this system, an observer can view CAD-cued mass regions depicted on one image and then query any suspicious regions (either cued or not cued by CAD). CAD scheme automatically segments the suspicious region or accepts manually defined region and computes a set of image features. Using content-based image retrieval (CBIR) algorithm, CAD searches for a set of reference images depicting “abnormalities” similar to the queried region. Based on image retrieval results and a decision algorithm, a classification score is assigned to the queried region. In this study, a reference database with 1,800 malignant mass regions and 1,800 benign and CAD-generated false-positive regions was used. A modified CBIR algorithm with a new function of stretching the attributes in the multi-dimensional space and decision scheme was optimized using a genetic algorithm. Using a leave-one-out testing method to classify suspicious mass regions, we compared the classification performance using two CBIR algorithms with either equally weighted or optimally stretched attributes. Using the modified CBIR algorithm, the area under receiver operating characteristic curve was significantly increased from 0.865 ± 0.006 to 0.897 ± 0.005 (p < 0.001). This study demonstrated the feasibility of developing an interactive CAD system with a large reference database and achieving improved performance.     

Breast cancer, stem cells and sex hormones. Part 3: the impact of the menopause and hormone replacement

Breast stem cells are long-lived cells and so are exposed to carcinogenic influences for much longer than normal differentiated breast ductal cells. It is hypothesized that these stem cells are the major site of carcinogenesis within the breast. Epidemiological studies have suggested that early life events and early first pregnancy profoundly affect breast cancer risk in adult life. It seems likely that these observations may be, at least partially explained, through changes in stem cell number and function. After menopause, despite very low systemic oestradiol levels, intra-breast oestradiol concentrations remain high due to increased biosynthesis of oestrogens in breast fat and stromal tissue. Stem cells are usually tightly regulated within a niche. The malignant process seems to involve changes in not only the cancer stem cell but also its microenvironment. The likely impact of hormone replacement and SERMs on stem cell function is discussed.     

全身骨显像、肿瘤标志物及碱性磷酸酶在乳腺癌患者骨转移中的临床应用

目的 探讨全身骨显像、肿瘤标志物及碱性磷酸酶对乳腺癌骨转移的诊断及疗效评估的临床价值.方法 回顾性分析本院2011年1月至2014年1月100例临床确诊为乳腺癌患者,单光子发射型计算机辅助断层(single-photon emission computed tomography,SPECT)全身骨显像、CT扫描及肿瘤标志物[糖链抗原153(CA15-3)、癌胚抗原(CEA)及碱性磷酸酶(ALP)]检测结果,分析各项检查诊断骨转移的灵敏度、特异度和准确度,其中22例骨转移患者治疗前后均行各项检查,分析治疗前后的变化.结果 100例乳腺癌患者中62例发生骨转移,骨显像诊断骨转移的灵敏度为88.71％,特异度为78.95％,准确度为85.00％;CT诊断骨转移的灵敏度为72.58％,特异度为92.11％,准确度为80.00％.乳腺癌骨转移组血清CA15-3、CEA、ALP水平较未发生骨转移患者组浓度升高,差异有统计学意义(P＜0.05).随着乳腺癌骨转移分级的增高,血清CA15-3、CEA及ALP含量升高,呈正相关(P值均＜0.05,r值分别为0.65、0.40、0.63).治疗有效组骨转移患者血清CA15-3、CEA及ALP水平均下降,差异有统计学意义(均P＜0.05).结论 全身骨显像诊断的乳腺癌骨转移灵敏度、特异度及准确度较高;血清CA15-3、CEA及ALP检测可协助诊断骨转移并评价疗效.     

Reduced prefrontal activation during Tower of London in first-episode schizophrenia: A multi-channel near-infrared spectroscopy study

Cognitive impairments are considered as a core feature of schizophrenia and have been reported in associated with dysfunction of the prefrontal cortex (PFC). The Tower of London (TOL) task is a widely used neuropsychological test to assess the planning ability and the PFC function. In the present study, we examined functional changes in the PFC of 40 first-episode schizophrenia patients and 40 age- and gender-matched healthy controls by means of multi-channel Near-infrared spectroscopy (NIRS) during performance of the TOL task. NIRS is a noninvasive optical method that can measure relative changes in oxygenated ([oxy-Hb]) and deoxygenated ([deoxy-Hb]) hemoglobin in cortical tissue. Compared to the healthy controls, schizophrenia patients exhibited a significant decreased activation in the left PFC and poorer TOL performance. The results confirm the functional deficits of the PFC and impaired planning ability in first-episode schizophrenia patients and suggest that NIRS may be a useful clinical tool for evaluating PFC activation in psychiatric disorders.     

Feature Extraction from a Signature Based on the Turning Angle Function for the Classification of Breast Tumors

Malignant breast tumors and benign masses appear in mammograms with different shape characteristics: the former usually have rough, spiculated, or microlobulated contours, whereas the latter commonly have smooth, round, oval, or macrolobulated contours. Features that characterize shape roughness and complexity can assist in distinguishing between malignant tumors and benign masses. Signatures of contours may be used to analyze their shapes. We propose to use a signature based on the turning angle function of contours of breast masses to derive features that capture the characteristics of shape roughness as described above. We propose methods to derive an index of the presence of convex regions (XR ( TA )), an index of the presence of concave regions (VR ( TA )), an index of convexity (CX ( TA )), and two measures of fractal dimension (FD ( TA ) and FDd ( TA )) from the turning angle function. The methods were tested with a set of 111 contours of 65 benign masses and 46 malignant tumors with different parameters. The best classification accuracies in discriminating between benign masses and malignant tumors, obtained for XR ( TA ), VR ( TA ), CX ( TA ), FD ( TA ), and FDd ( TA ) in terms of the area under the receiver operating characteristics curve, were 0.92, 0.92, 0.93, 0.93, and, 0.92, respectively.     

乳腺癌根治术保留肋间臂神经对患者术后生存质量的影响

目的　对照研究乳腺癌改良根治术腋淋巴结清扫术中对肋间臂神经的保留与否,探讨该术式对患者术后生存质量的影响。 方法 在以往对I期、Il期乳腺癌患者实施乳腺癌根治术Anchincloss术式的基础上进行保留肋间臂神经改良,随机选取了 150例Ⅰ、Ⅱ期女性乳腺癌患者 ,随机均分为保留组和切除组。 结果 保留组的上臂后内侧感觉异常和疼痛等不良主诉的发生率较对照组明显降低,两者比较差异有显著性意义(P<0.01);随访期内两者的局部复发及远处转移率无统计学差异。 结论 I期、Il期乳腺癌患者行改良根治术保留肋间臂神经,减少了患者术后疼痛综合症的发生,提高了患者术后生活质量,临床应用具有可行性,值得推广应用。     

Expression of Biomolecular Markers (Ki-67, PCNA, Bcl-2, BAX, BclX, VEGF) in Breast Tumors

We carried out a retrospective immunohistochemical study of Ki-67, PCNA, Bcl-2, BAX, BclX, and VEGF expression in tumors of two groups of breast cancer patients with favorable and unfavorable course of the disease. Considerably enhanced VEGF expression was detected in tumors of patients with early relapses of breast cancer. High VEGF expression was paralleled by high level of Ki-67 and PCNA expression in tumors. It can be hypothesized that expression of VEGF, Ki-67, and PCNA in primary tumor can be used for predicting the course of breast cancer or detecting the patients at a high risk of early relapses.     

外侧组织瓣转移用于保留乳房的乳癌根治术

目的 探讨乳腺癌根治手术的同时进行乳房成形的术式及其临床意义。方法 自1997年至2002年对20例早期原发乳腺癌进行乳房成形的根治术。结果 20例手术均获成功,切口均甲级愈合,无乳头坏死。其中10例患者术后2年以上随访,均无肿瘤局部复发及转移。与不保留乳房的根治手术相比肿瘤的复发和生存差异无显著性。乳房成形根治术按lino Y美观标准评价,优15例,良5例。结论 随着医学模式的改进,对乳腺癌手术治疗原则已经转为由大到小的趋势,在充分切除原发癌的前提下,尽量采用破坏性较小的术式,重视保留乳房的美学理念。应用外侧软组织瓣(lateral tissue flap,LTF)乳房成形,显示出良好临床效果和使用价值。     

腔内影像学方法评价降脂治疗对冠状动脉粥样硬化斑块影响的研究进展

动脉粥样硬化斑块与动脉粥样硬化性心血管疾病(atherosclerotic cardiovascular diseases,ASCVD)的发生及发展密切相关.借助腔内影像学,如血管内超声(intravascular ultrasound,IVUS)、光学相干成像(optical coherence tomography...     

VEGF-C及VEGFR-3在乳腺癌中的表达

目的探讨乳腺癌中血管内皮生长因子-C(VEGF-C)、血管内皮生长因子受体-3(VEGFR-3)的表达及与淋巴管生成的关系。方法采用免疫组化SP法检测57例乳腺癌组织中VEGF-C及VEGFR-3的表达,并在显微镜下记数VEGFR-3标记的脉管。结果淋巴结转移组VEGF-C的阳性率(90.48%)显著高于无淋巴结转移组(47.22%)(P<0.05);淋巴结转移组VEGFR-3阳性脉管数(7.62±1.18)显著高于无淋巴结转移组(5.27±0.96)(P<0.05);VEGF-C的阳性表达与VEGFR-3阳性脉管数呈正相关,相关系数为r为0.882(P<0.05)。结论 VEGF-C及VEGFR-3与乳腺癌的生长,淋巴管的生长及淋巴结的转移有关。