Search

Clinical Significance of Serum VEGF-C Level and C-erbB-2 Protein Expression in Patients with Breast Cancer

Objective To investigate clinical significance of serum VEGF-C level and C-erbB-2 protein expression in patients with breast cancer. Methods Sixty-two female patients with breast invasive ductal cancer and breast benign lesion were respectively selected. Serum VEGF-C level was detected by enzyme-linked immunosorbent assay (ELISA) before operation and at one month after operation, and C-erbB-2 protein expression in tissues of breast cancer was detected by immunohistochemistry. Then, the relationship between serum VEGF-C level and clinicopathologic characteristics and C-erbB-2 protein expressions wereas analyzed. Results The serum VEGF-C level before operation in breast cancer patients〔(279.65±17.34) pg/ml〕 was significantly higher than that in breast benign lesions patients 〔(167.26±12.15) pg/ml〕, P＜0.01. In breast cancer patients, the serum VEGF-C level before operation was higher than that at one month after operation 〔(209.45±15.23) pg/ml〕, P＜0.01. The serum VEGF level was related to tumor stage (P＜0.05) but not to patient age, tumor size, menopause status , lymph node metastasis or not and ER and PR expression (Pgt;0.05). The positive expression rate of C-erbB-2 protein in breast cancer patients (54.84%, 34/62) was significantly higher than that in breast benign lesion patients (11.29%, 7/62), P＜0.01. Moreover, the positive expression rate of C-erbB-2 protein in breast cancer patients with axilla lymph node metastasis (69.44%) was significantly higher than that without axilla lymph node metastases (34.62%), P＜0.05. The serum VEGF level increased with increasing expression intensity of C-erbB-2 protein and there was positive correlation between them (r=0.813，P＜0.05). Conclusions The serum VEGF-C level in breast cancer may be conducted as an assisted marker to differential diagnosis of breast tumor. C-erbB-2 is related to lymph node metastasis of breast cancer patients. There is synergistic effect between VEGF-C and C-erbB-2 in the lymph node metastasis way of breast cancer.

老年肝脏未分化胚胎性肉瘤伴囊内出血1例报道

Multislice CT Differential Diagnosis Between Thymoma andMalignant Lymphoma In The Anterior Mediastinum

摘要:目的:研究胸腺瘤与前纵隔(血管前间隙)淋巴瘤的MSCT表现,提高对二者的诊断与鉴别诊断能力。方法:回顾性分析经手术病理证实的30例胸腺瘤与18例血管前间隙淋巴瘤MSCT表现,着重观察肿瘤的密度、形态及其与周围结构的关系。结果:30例胸腺瘤中,24例良性胸腺瘤与邻近大血管分界清晰,肿块表现 “D”字或反“D”字状,平扫CT值16~59 Hu,增强CT值20~110 Hu;6例侵袭性胸腺瘤边界不清,呈分叶状、不规则形,密度不均,平扫CT值23~42 Hu,增强CT值23~60 Hu。18例淋巴瘤中,单发于前上纵隔者6例,其余12例呈多结节、肿块状,侵入血管间隙生长,致大血管受压,增强扫描呈轻度强化,常伴有其它部位淋巴结增大。结论:MSCT能清晰显示胸腺瘤与前纵隔淋巴瘤的影像学表现特征,并能有效提高对二者的鉴别诊断。Abstract: Objective: To diagnosis and differentiate thymoma and malignant lymphoma in the anterior mediastinum on the basis of multislice CT (MSCT) imaging features. Methods:We retrospectively reviewed 30 cases with thymoma and 18 cases with malignant lymphoma proven by surgery and pathology.More attention was put on the density, morphology and relation with the surrounding structures of the tumors. Results: The CT manifestations of 30 cases of thymoma were shown as: For 24 cases of benign thymoma, the boundaries were clear, the shapes were “D” signs or contra“D” signs, CT attenuation value were 1659Hu and 20110Hu on unenhanced and contrastenhanced scanning. For 6 cases of malignant thymoma, the boundaries were unclear, the shapes were lobulated or irregular, the density was heterogeneous, CT attenuation value were 2342Hu and 2360Hu on unenhanced and contrastenhanced scanning. For 18 cases of malignant lymphoma, 6 cases were located at anterior mediastinum, 12 cases were nodes or multiple mass, enveloped the neighboring vessel structures, mildly enhanced on contrastenhanced scanning, and associated with enlargement of lymph nodes in other place. Conclusion: MSCT can display the imaging features of thymoma and anterior mediastinal lymphoma, and effectively differentiate thymoma and mediastinal lymphoma.

Gallbladder Abnormal Changes Caused by Liver Parenchymal Diseases Versus Inflammatory Cholecystitis: Differential Diagnosis by MultiDetector Row Spiral CT

【Abstract】ObjectiveBy using multidetector row spiral CT (MDCT) to investigate the CT imaging findings of gallbladder abnormalities caused by hepatic parenchymal diseases and those of inflammatory cholecystitis. MethodsCT and clinical data of 80 patients with gallbladder abnormalities were retrospectively reviewed. Fifty patients were in hepatic disease group, including 20 chronic hepatitis, 25 liver cirrhosis, and 5 cirrhosis with hepatocellular carcinoma. Thirty patients were in inflammatory group, including 19 chronic cholecystitis, 6 acute cholecystitis, 3 cholecystitis with acute pancreatitis, 1 gangrenous cholecystitis, and 1 xanthogranulomatous cholecystitis. All patients underwent MDCT plain scan and contrastenhanced dualphase scanning of upper abdomen. ResultsIn hepatic disease group, 48 cases had evenly thickened gallbladder wall (96%) with mean thickness of (3.67±0.49) mm; 38 cases had clear gallbladder outlines (76%); 38 cases had gallbladder wall enhancement of various degree (76%); 14 cases had gallbladder bed edema and localized nondependant pericholecystic fluid collection (28%). In inflammatory cholecystitis group, 28 cases had obscuring gallbladder outlines (93%) ; 26 cases had gallbladder wall evenly thickened (87%), 4 cases showed unevenly thicked wall (13%), the mean thickness being (4.54±1.14) mm; 30 cases had inhomogenous enhancement of the gallbladder wall (100%); 9 cases had highattenuation bile (30%); 4 cases had dependant pericholecystic fluid collection (13%); 5 cases had transient enhancement of adjacent hepatic bed in arterial phase (17%); microabscess and gas in the gallbladder wall was observed in 1 case respectively. ConclusionMDCT can offer imaging findings useful for differentiating abnormal gallbladder changes caused by hepatic parenchymal diseases from those due to inflammatory cholecystitis.

可疑肾上腺内异位甲状腺1例报道并文献复习

目的总结肾上腺内异位甲状腺的影像学表现、病理特征、临床诊断、鉴别诊断以及治疗方法和预后。方法回顾性分析2023年3月广东医科大学附属医院收治的1例可疑肾上腺内异位甲状腺的临床表现、病理特征、治疗及预后情况，并结合国内外相关文献报道的26例肾上腺内异位甲状腺的病例资料进行分析。结果本例66岁女性患者，术前检查提示左侧肾上腺占位（考虑嗜铬细胞瘤）并行手术完整切除，术后根据病理学检查和免疫组织化学检查最终考虑诊断为肾上腺内异位甲状腺并腺瘤样增生，术后随访6个月未见复发。复习国内外文献报道的26例肾上腺内异位甲状腺患者资料，亚洲中老年女性多见（22例），左侧多发（17例），大部分（19例）由体检发现，通常表现为无痛性囊性肿块，大体呈类圆形，镜下可见甲状腺样组织，并见甲状腺样滤泡，滤泡腔内见嗜酸性胶质样物，部分区域可见滤泡与肾上腺皮质混杂，通常无肾上腺髓质成分，囊壁被覆扁平上皮细胞或甲状腺滤泡样细胞、可见核重叠，偶见核沟和包涵体，类似甲状腺乳头状癌细胞核，但未见砂粒体。免疫组织化学表现为PCK、EMA、TTF-1、Tg、Vimentin阳性，提示甲状腺分化，BRAFV600E、KRAS基因突变阴性。治疗以完整切除肿瘤为主，预后良好。结论肾上腺内异位甲状腺罕见，确切发生机制有待研究，临床术前不易辨识，应与肾上腺肿瘤、转移性甲状腺滤泡癌、乳头状癌等鉴别，免疫组织化学染色及基因检测有助于明确诊断，治疗以完整切除肿瘤为主，预后良好。

Ultrasonography in the Diagnosis of Benign and Malignant Breast Masses

目的:探讨乳腺良恶性肿块二维超声图像和彩色多普勒血流状况,提高乳腺肿块的超声诊断符合率。方法:回顾性分析105例乳腺肿块的二维及彩色多普勒超声图像特点。结果:本组恶性肿块37例,超声诊断和疑诊恶性肿块32例,符合率为865%(32/37);良性肿块68例,超声诊断良性肿块58例,符合率为853%(58/68)。乳腺良恶性肿块在形态、 边界、 包膜、 内部回声、 后方回声、 沙粒样钙化、血流形态分布,血流动力学等方面具有明显差异。结论:二维及彩色多普勒超声对良恶性乳腺肿块有较高鉴别诊断价值。

Construction of differential diagnosis model of viral pneumonia and bacterial pneumonia based on lung ultrasonography characteristics

Objective To construct the differential diagnosis model of viral pneumonia and bacterial pneumonia based on lung ultrasonography (LUS) characteristics. Methods A total of 248 patients with pneumonia who completed LUS in our hospital from January 2021 to March 2024 were retrospectively included, and were divided into a viral group (140 cases) and a bacterial group (108 cases) according to the final etiological diagnosis. Predictors in differential diagnosis between viral pneumonia and bacterial pneumonia were analyzed by univariate and multivariate methods. The differential diagnosis model of viral pneumonia and bacterial pneumonia and the prediction efficiency were evaluated. Results Univariate and multivariate logistic analysis showed that the presence or absence of lung consolidation, pleural effusion, B-line range of both lungs and pulmonary ultrasound score were independent predictors of the differential diagnosis of viral pneumonia and bacterial pneumonia (P<0.05). Using the logistic regression model of lung consolidation, pleural effusion, bilateral B-line range, and pulmonary ultrasound score, including the P-values of three variables (lung consolidation, pleural effusion, and bilateral B-line range), and the P-values of four variables (lung consolidation, pleural effusion, bilateral B-line range, and pulmonary ultrasound score), the receiver operating characteristic curve was used to predict the diagnosis of patient. The areas under the curve were 0.863, 0.612, 0.669, 0.684, 0.904, and 0.920, respectively. Conclusion Lung consolidation, pleural effusion, B-line range of both lungs and pulmonary ultrasound score detected by LUS have good diagnostic efficacy in the differential diagnosis of viral pneumonia and bacterial pneumonia, suggesting that LUS technology may be used in the differential diagnosis of viral pneumonia and bacterial pneumonia.

The Diagnostic Value of Serum Cardiac Troponin Ⅰ in Acute Heart Failure

目的:明确肌钙蛋白Ⅰ(cTnI)在心源性呼吸困难的鉴别诊断中有无应用价值。方法:比较急性心衰与急性肺源性呼吸困难时cTnI的变化情况,并观察一定的cTnI临界值辅助诊断心衰的敏感性和特异性。结果:总共156例患者,最后确诊为急性心衰的患者69例,而肺源性呼吸困难患者87例。急性心衰组的平均cTnI值为076±085ng/dL,而肺源性呼吸困难组为025±032ng/dL,两组间有显著性差异(Plt;0001)。根据ROC曲线计算肌钙蛋白Ⅰ的临界值(截点值)为042ng/dL,其鉴别心衰的敏感度为7153%,特异度为9036%,准确度为8014%。结论:检测肌钙蛋白Ⅰ水平并与其它临床信息相结合,有助于快速准确地诊断充血性心力衰竭。

MDT discussion of a case of primary diffuse large B cell lymphoma of liver

ObjectiveTo investigate the clinical manifestations, imaging manifestations, etiology, histological origin, pathological characteristics, diagnosis and differential diagnosis, selection of treatment methods, and prognosis of primary diffuse large B cell lymphoma of livers (PDLBCLL), so as to improve understanding and reasonable diagnosis and treatment of this kind of disease.MethodThe clinicopathologic data of a case of PDLBCLL diagnosed in the West China Hospital of Sichuan University in June 2019 were analyzed retrospectively.ResultsIt was very difficult to diagnose PDLBCLL preoperatively and to distinguish PDLBCLL from primary liver cancer and other liver space occupying lesions. It was also easy to ignore the possibility of invasion of liver by lymphopoietic tissue tumor, which was often diagnosed by postoperative pathological diagnosis or puncture biopsy, and after the elimination of hematological diseases by various examinations. This patient was admitted to the hospital as a space occupying in right liver. Preoperative imaging examination considered that may be a tumor. After MDT discussion, considering that the nature of the tumor should be confirmed by surgical resection, and then go to the Department of Oncology. Irregular right hemihepatectomy + cholecystectomy + hilar lymphadenectomy + diaphragmatic repair was performed after MDT discussion. The diagnosis of PDLBCLL was confirmed by postoperative pathological examination. The operation duration was about 230 min, and the intraoperative blood loss was about 200 mL. The patient recovered well without complications and was discharged on the 10th day after operation. The patient was followed up for 9 months. The liver and kidney function, electrolytes and abdominal Doppler ultrasound examination were regularly reviewed every month. No obvious abnormality was found in these results.ConclusionsAt present, there is no unified treatment principle, most of them will undergo surgery, chemotherapy, radiotherapy or combined treatment. Due to its unknown etiology and unclear mechanism, clinicians can only implement individualized treatment according to the characteristics of patients’ conditions.

Value of Acoustic Radiation Force Impulse Imaging in The Differential Diagnosis Between Benign and Malignant Thyroid Nodules

Objective To explore the value of virtual touch tissue quantification(VTQ) of acoustic radiation force impulse (ARFI) in the differential diagnosis between benign and malignant thyroid nodules. Methods The ultrasound (US), elastography imaging(EI), and VTQ of ARFI were performed to determine the characteristics and features of 63 thyroid nodules. The pathological diagnosis was the gold standard. According to the receiver operating characteristic curve (ROC) of US, EI, and VTQ, the critical points and diagnostic values of US, EI, and VTQ in diag-nosis of malignant thyroid nodules were achieved. Results Of the 63 nodules, 45 were benign and 18 were malignant. The area under curves of US, EI, and shear wave velocity(SWV) were 0.837(95% CI:0.712-0.962), 0.863(95% CI:0.751-0.974), and 0.900 (95% CI:0.810-0.990) respectively, and all the 3 kinds of technique had diagnostic value(P=0.001), but there were no significant difference among the 3 kinds of technique on the area under curve(P > 0.05). According to the receiver operating characteristic(ROC) curve, the critical point of US in distinguishing benign nodules with malignant nodules was 3 conventional ultrasonography, which displayed a sensitivity of 83.3%, a specificity of 86.7%, and a accuracy of 85.7%. The critical point of EI grades in distinguishing benign nodules with malignant nodules was gradeⅣ, which displayed a sensitivity of 94.1%, a specificity of 82.6%, and a accuracy of 87.3%. The critical value of SWV in distinguishing benign nodules with malignant nodules was 3.39 m/s, which displayed a sensiti-vity of 88.9%, a specificity of 91.1%, and a accuracy of 90.5%. Conclusion US, EI, and VTQ techniques all have diagnostic values in the differential diagnosis between benign and malignant thyroid nodules, and we should make combination with all of the 3 kinds of technique when performing differential diagnosis.