The results of 2389 patients exmained by colonofiverscope in past nine years are reported. Polyps were found in 561 cases, including 1256 polyps in the large intestine and 82 polyps in the terminal ileum. All 1299 polyps were removed with biopsy forceps. Pathology demonstrated that there were 406 adenomas, including 89 atypical hyperplasia and 23 cases with malignant change and 932 non-canerous polyps with 102 atypical hyperplasia. Since adenoma is seen to be a precancerous change, the polypectomy by colonofiberscope , ecpecially atypical hyperplastic polyps may decrease morbidity of large intestinal cancer. Cancer associated with adenoma may be as high as 51.28%, so the recrudescence of polyps may possibly be found even afer the cancer removal. These data showed that an early discovery of small malignant adenoma is key to improve efficiency.
ObjectiveTo systematically evaluate the efficacy and safety of computer-aided detection (CADe) and conventional colonoscopy in identifying colorectal adenomas and polyps. MethodsThe PubMed, Embase, Cochrane Library, Web of Science, WanFang Data, VIP, and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) comparing the effectiveness and safety of CADe assisted colonoscopy and conventional colonoscopy in detecting colorectal tumors from 2014 to April 2023. Two reviewers independently screened the literature, extracted data, and evaluated the risk of bias of the included literature. Meta-analysis was performed by RevMan 5.3 software. ResultsA total of 9 RCTs were included, with a total of 6 393 patients. Compared with conventional colonoscopy, the CADe system significantly improved the adenoma detection rate (ADR) (RR=1.22, 95%CI 1.10 to 1.35, P<0.01) and polyp detection rate (PDR) (RR=1.19, 95%CI 1.04 to 1.36, P=0.01). It also reduced the missed diagnosis rate (AMR) of adenomas (RR=0.48, 95%CI 0.34 to 0.67, P<0.01) and the missed diagnosis rate (PMR) of polyps (RR=0.39, 95%CI 0.25 to 0.59, P<0.01). The PDR of proximal polyps significantly increased, while the PDR of ≤5 mm polyps slightly increased, but the PDR of >10mm and pedunculated polyps significantly decreased. The AMR of the cecum, transverse colon, descending colon, and sigmoid colon was significantly reduced. There was no statistically significant difference in the withdrawal time between the two groups. Conclusion The CADe system can increase the detection rate of adenomas and polyps, and reduce the missed diagnosis rate. The detection rate of polyps is related to their location, size, and shape, while the missed diagnosis rate of adenomas is related to their location.
【Abstract】ObjectiveTo review recent studies on Muir-Torre syndrome (MTS) and to improve the knowledge about MTS.MethodsThe literatures in recent years on clinic and gene research of MTS were reviewed.ResultsMTS was is a rare autosomal-dominant disorder characterized by the predisposition to both sebaceous tumors (or multiple keratoacanthomas) and internal malignancies. Gastrointestinal cancers were the most common kind of internal malignancies in MTS patients(61%)，followed by genitourinary cancers(22%). In most cases(56%)，sebaceous tumors appeared after the emergence of internal maliganancy. Both hereditary nonpolyposis colorectal cancer(HNPCC) and MTS were caused by germline mutations in the DNA mismatch repair genes. MTS patients exhibit significantly more mutations in the hMSH2 than in the hMLH1. In these cases , both internal and skin tumors showed the characteristic of high microsatellite instability(MSI).ConclusionThe presence of sebaceous tumors(or multiple keratoacanthomas) necessitates the search for internal malignancies. It is mandatory that patients with MTS, as patients with HNPCC, should be regularly followed up to search new malignancies. Evaluation and monitoring of the family members of patients are also necessary. The patients and their families should be counseled for genetic test. Sequencing the hMSH2 gene should be the prior selection of further examinations when clinical manifestations, history and laboratory tests suggest MTS.
目的：评价宫腔声学造影(SHG)对子宫内膜息肉的诊断价值。方法：对临床拟诊宫内膜息肉的76例患者进行TVS、SHG及宫腔镜手术病理检查，并对结果进行分析。结果：以手术病理结果作为诊断金标准，内膜息肉48例，黏膜下肌瘤9例，内膜增生10例，宫腔内机化血凝块3例，正常内膜6例。SHG对子宫内膜息肉诊断的准确性为93.4%，敏感性为93.7%，特异性为92.8%。TVS对子宫内膜息肉诊断的准确性为59.2%，敏感性为81.2%，特异性为21.4%。两种方法对内膜息肉的诊断准确率比较有显著差异(χ2=5.45，P=0.019)。结论：宫腔声学造影准确率高，是诊断子宫内膜息肉的可靠方法。
Out of 4500 patients with gastro-intesinal disorders coming to our department from January 1970 to May 1994,31 of them were fund to be suffering from gastric adenomotous polyps(GAP).The detective rat of GAP was 0.7% with two malignant adenomatous polyps detected and 13 percent of GAP cases complicated with adenocarcinoma of the stomach(4/31).The size of the polyps is closely relevant to the malignant change.Twelve patients underwent surgical therapy and 19 gastrocopic polypectomy.On follow up.2 cases of recurrence were detected in both surgical and endoscopic removal proups.
Gallbladder polypoid lesion (GPL) is a common gallbladder disease, mainly including tumor lesions such as gallbladder cancer and gallbladder adenoma and non-tumor lesions such as cholesterol polyps and gallbladder adenomyomatosis. Contrast-enhanced ultrasound (CEUS) can improve the diagnostic accuracy of GPL. This paper reviews the application progress of CEUS in the diagnosis of gallbladder cancer, gallbladder adenoma, gallbladder cholesterol polyps and gallbladder adenomyosis, and the limitations of CEUS in the diagnosis of GPL.
目的 提高对幼年性息肉致小肠套叠的诊治水平。方法 按检索策略，检索PubMed、中国生物医学文献数据库（CBM）、中文科技期刊全文数据库（CSJD）、中国期刊全文数据库（CJFD）及CNKI数字图书馆的相关文献，并结合笔者所在医院于2011年收治的1例幼年性息肉致小肠套叠病例资料，对该病进行一系统的描述。结果 共检出相关文献65篇，按纳入及排除标准，最后纳入6篇文献。共7例患者，临床表现为腹痛、呕吐5例，便血2例，贫血3例；经超声检查诊断4例；全组均行小肠切除肠吻合术，其中1例为腹腔镜辅助手术；有1例患者共实施了3次手术，最后死于恶液质，其余患者恢复较好。结论 幼年性息肉致小肠套叠为临床罕见疾病，超声检查仍为首选诊断方法；提高医师对该病的认识，术中彻底探查肠道，必要时术中行快速冰冻切片病理学检查，有望减少息肉遗留，改善患者的预后。
Early diagnosis and treatment of colorectal polyps are crucial for preventing colorectal cancer. This paper proposes a lightweight convolutional neural network for the automatic detection and auxiliary diagnosis of colorectal polyps. Initially, a 53-layer convolutional backbone network is used, incorporating a spatial pyramid pooling module to achieve feature extraction with different receptive field sizes. Subsequently, a feature pyramid network is employed to perform cross-scale fusion of feature maps from the backbone network. A spatial attention module is utilized to enhance the perception of polyp image boundaries and details. Further, a positional pattern attention module is used to automatically mine and integrate key features across different levels of feature maps, achieving rapid, efficient, and accurate automatic detection of colorectal polyps. The proposed model is evaluated on a clinical dataset, achieving an accuracy of 0.9982, recall of 0.9988, F1 score of 0.9984, and mean average precision (mAP) of 0.9953 at an intersection over union (IOU) threshold of 0.5, with a frame rate of 74 frames per second and a parameter count of 9.08 M. Compared to existing mainstream methods, the proposed method is lightweight, has low operating configuration requirements, high detection speed, and high accuracy, making it a feasible technical method and important tool for the early detection and diagnosis of colorectal cancer.