2022 Vol. 46, No. 11
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2022, 46(11): 649-654.
doi: 10.3760/cma.j.cn121381-202112008-00240
Abstract:
Objective To investigate the correlation of multi-parametric magnetic resonance imaging (mpMRI) features and clinical factors with the risk of biochemical recurrence (BCR) after radical prostatectomy. Methods A retrospective analysis was performed on the imaging data and clinical data of 152 male patients who were aged 44–82 (69.0±7.2) years and underwent mpMRI before radical prostatectomy in the Affiliated Hospital of Qingdao University from September 2013 to October 2020. Magnetic resonance imaging (MRI) features were analyzed according to the Prostate Imaging Report and Data System (PI-RADS), which mainly included PI-RADS score, prostate volume, maximum tumor diameter, tumor site, involvement of capsule and seminal vesicle, and mpMRI clinical T staging. mpMRI images were scored using the latest prostate PI-RADS V2.1. The occurrence of BCR was used as the end point of follow-up. X-tile statistical software was used to determine the optimal critical value of continuous variables. Univariate and multivariate analyses were performed using log-rank test and Cox proportional risk regression model to analyze the independent risk factors of BCR after radical prostatectomy. Results The median follow-up was 13 months, and BCR rate was 27% (41/152). The results of univariate analysis showed that body mass index (BMI), preoperative prostate specific antigen (PSA) levels and prostate specific antiqen density (PSAD) levels, biopsy and postoperative pathologica Gleason score, PI-RADS score, tumor site, maximum diameter of tumor lesion, MRI involvement of the capsule, pathological capsule invasion, seminal vesicle invasion, and mpMRI clinical T stage were the risk factors for BCR (χ2=4.224–23.531, all P<0.05). The results of multivariate analysis showed that BMI, preoperative PSA levels, and MRI involvement of the capsule were independent risk factors for BCR after radical prostatectomy (HR=3.238, 2.675, 3.175; 95%CI: 1.437–7.293, 1.046–6.841, 1.061–9.502; all P<0.05). Conclusion Low BMI, high PSA level, and MRI involvement of the capsule were closely associated with BCR after radical prostatectomy.
2022, 46(11): 655-660.
doi: 10.3760/cma.j.cn121381-202110019-00229
Abstract:
Objective To investigate the CT imaging characteristics of congenital mesoblastic nephroma (CMN) and compare them with ultrasound and histopathological features to explore the histopathological basis of CMN. Methods Clinical and imaging data of 10 children with CMN confirmed by histopathology in the First Affiliated Hospital, Sun Yat-sen University from January 2008 to July 2017 were retrospectively analyzed. The cohort included 8 males and 2 females, aged from 1 month to 7 years ((12.6±26.1) months). Two cases of cellular CMN, 6 cases of typical CMN, and 2 cases of mixed CMN mainly with typical components (>80%) were evaluated. The characteristics of plain and contrast-enhanced CT scans of the children with CMN were summarized, and the CT characteristics of typical CMN and mixed CMN mainly with typical components (>80%) were compared with ultrasound and histopathological features. Results CT imaging characteristics of typical CMN and mixed CMN mainly with typical components (>80%) were as follows: mostly round solid (3/8) or cystic solid (5/8) masses with poorly defined boundaries (8/8); uneven density of the solid part of the tumor (7/8); and uneven enhancement (8/8). Compared with cellular CMN, intratumoral renal pelvis (8/8) and bilateral sign (7/8) after enhanced scan were the special imaging features. Histopathological results showed that the bilateral sign in the CT imaging characteristics corresponded to the hypoechoic ring signal in ultrasound images, which is a special imaging sign caused by the dilated blood sinus around the tumor. Conclusion Bilateral sign and intratumoral renal pelvis were the CT imaging characteristics of typical CMN and mixed CMN mainly with typical components.
2022, 46(11): 661-668.
doi: 10.3760/cma.j.cn121381-202110008-00235
Abstract:
Objective To investigate the high resolution CT (HRCT) imaging features of pulmonary ground-glass nodules (GGN) and their correlation with immunohistochemical (IHC) examination indexes and evaluate their clinical value. Methods The clinical data of 144 patients with pulmonary GGN diagnosed by surgery and histopathological examination in Shunde Hospital of Southern Medical University (the First People's Hospital of Shunde) from January 2019 to May 2020 were retrospectively analyzed, including 46 males and 98 females, aged 28–80 (51.9±11.9) years old. All patients underwent surgery and IHC. Based on the new classification of lung tumor tissue by the World Health Organization in 2021, 144 patients with pulmonary GGN were divided into three groups: pre-invasive lesion (PI), microinvasive adenocarcinoma (MIA), and invasive adenocarcinoma (IA). The differences in HRCT imaging features of the three groups of pulmonary GGN patients and their correlation with IHC examination indexes were compared. The image features were compared between groups by analysis of variance or χ2 test. Univariate and multivariate Logistic regression models were used to analyze the influencing factors and establish a prediction model. In addition, the receiver operator characteristic curves were drawn to obtain the best diagnostic cut-off value. χ2 test was used to analyze the correlation between HRCT image features and the expression level of IHC examination indexes. Results Results of univariate Logistic regression analysis showed that the GGN diameter, lobulation, spiculation, pleural traction sign, tumor-lung boundary, microvascular perforation sign and air bronchial sign were significantly different among the three groups (F=8.952–82.901, all P<0.05). Meanwhile, the results of multivariate Logistic regression analysis showed that the GGN diameter was an independent risk factor for the evaluation of pulmonary GGN infiltration. It tended to PI when the GGN diameter was <6 mm, MIA when the GGN diameter was 6 mm≤GGN diameter≤10 mm, and IA when the GGN diameter was >10 mm. Results of IHC showed that vascular endothelial growth factor (VEGF), p53, and proliferating cell nuclear antigen (Ki-67) had high predictive values in predicting the degree of pulmonary GGN infiltration, with area under curves of 0.829, 0.773, and 0.760, respectively. Moreover, results of correlation analysis showed that patients with GGN diameter of >10 mm, lobulation, spiculation, and pleural traction sign as well as tumor-lung boundary were correlated with the expression of VEGF, p53, Ki-67 (χ2=13.582–41.351, all P<0.05). Microvascular perforation sign was correlated with the high expression level of Ki-67, and the low expression level of VEGF and p53 (χ2=15.111, 15.644, 16.121; all P<0.05）. Conclusions GGN diameter was an independent risk factor for the evaluation of pulmonary GGN infiltration and has good diagnostic efficacy. The HRCT imaging features of the pulmonary GGN were correlated with the expression levels of Ki-67, p53, and VEGF. The comprehensive analysis of HRCT imaging features and IHC examination indexes of pulmonary GGN can evaluate the histopathological classification, proliferative activity, and infiltration of tumor cells, as well as provide valuable references for clinical management and selection of appropriate treatment for patients with pulmonary GGN.
2022, 46(11): 669-678.
doi: 10.3760/cma.j.cn121381-202111009-00237
Abstract:
Objective To systematically evaluate the efficacy and safety of 131I+glucocorticoid (GC) in the treatment of Graves' ophthalmopathy (GO). Methods PubMed, Embase, Cochrane Library, China National Knowledge Internet, and Wanfang data Knowledge Service Platform were searched for relevant studies on the use of 131I+GC treatment GO. The search time was from database establishment to July 20, 2021. They selected the literature and extracted the data according to the inclusion and exclusion criteria. Meta-analysis was performed with Stata 15.0 software to compare the efficacy of 131I+GC and 131I for treating Graves' hyperthyroidism (GH) complicated with GO in different periods, as well as to analyze the effects of intravenous injection and oral GC administration on the treatment of GO and its complications. The heterogeneity of an article was evaluated using P values of χ2 test and I2. The progression of GO was expressed by relative risk (RR). The publication bias and sensitivity of the included literature were analyzed by the Egger and clipping methods, and the therapeutic efficacy of the two methods was analyzed by the Z test. Results Finally, a total of 22 articles were included, among which 15 were randomized controlled trials and 7 were cohort studies. The curative effect of 131I+GC was better than that of 131I in patients with GH complicated with GO, and the difference was statistically significant (Z=3.18, RR=0.37, 95%CI: 0.20–0.68, P=0.004). A standard dose of GC (0.3–0.5 mg/kg) can better prevent the progression of GO than a low-dose one (0.2–0.3 mg/kg). Different ways of drug use had little effect on the progress of GO prevention. Conclusions 131I+GC treatment was effective in preventing the progression of GH complicated with GO, especially in active GO patients. A standard dose of GC can better control the progression of GO than a low-dose one, but at the same time produces more complications. Intravenous injection and oral administration of GC had the same effect on patients with GO after 131I treatment.
2022, 46(11): 679-684.
doi: 10.3760/cma.j.cn121381-202204031-00236
Abstract:
Primary central nervous system lymphoma (PCNSL) is relative rare and highly aggressive extranodal non-Hodgkin's lymphoma, accounting for 4%−6% of all extranodal lymphomas and 4% of primary central nervous system tumors. In recent years, a rising incidence has been recognized. The diagnosis of PCNSL mainly depends on stereotactic biopsy histopathological examination and surgical pathology. However, these procedures have high risks and multiple complications. Therefore, it is especially necessary to find a reliable non-invasive imaging method to evaluate PCNSL accurately. CT, MRI, PET/CT and PET/MRI are used to evaluate PCNSL currently. This review focuses on the research progress of neuroimaging in PCNSL.
Primary central nervous system lymphoma (PCNSL) is relative rare and highly aggressive extranodal non-Hodgkin's lymphoma, accounting for 4%−6% of all extranodal lymphomas and 4% of primary central nervous system tumors. In recent years, a rising incidence has been recognized. The diagnosis of PCNSL mainly depends on stereotactic biopsy histopathological examination and surgical pathology. However, these procedures have high risks and multiple complications. Therefore, it is especially necessary to find a reliable non-invasive imaging method to evaluate PCNSL accurately. CT, MRI, PET/CT and PET/MRI are used to evaluate PCNSL currently. This review focuses on the research progress of neuroimaging in PCNSL.
2022, 46(11): 685-691.
doi: 10.3760/cma.j.cn121381-202202003-00239
Abstract:
Ischaemia with non-obstructive coronaries arteries(INOCA) has a high morbidity. The atypical and diverse presentation of patients with chest pain, and its multiple endotypes have led to a high risk of being overlooked by patients themselves and clinicians. The pathogenesis of INOCA includes epicardial coronary artery spasm (CAS) and coronary microvascular dysfunction (CMD). Therefore, various diagnostic methods basically revolve around CAS and CMD. By diagnosing and analyzing its pathogenetic factors, the authors can ultimately achieve targeted treatment for patients with INOCA and improve their symptoms, quality of life and prognosis. This paper reviews the current status and research progress of diagnoses for INOCA to improve the clinician's knowledge of INOCA and in-depth understanding of INOCA related imaging diagnostic means.
Ischaemia with non-obstructive coronaries arteries(INOCA) has a high morbidity. The atypical and diverse presentation of patients with chest pain, and its multiple endotypes have led to a high risk of being overlooked by patients themselves and clinicians. The pathogenesis of INOCA includes epicardial coronary artery spasm (CAS) and coronary microvascular dysfunction (CMD). Therefore, various diagnostic methods basically revolve around CAS and CMD. By diagnosing and analyzing its pathogenetic factors, the authors can ultimately achieve targeted treatment for patients with INOCA and improve their symptoms, quality of life and prognosis. This paper reviews the current status and research progress of diagnoses for INOCA to improve the clinician's knowledge of INOCA and in-depth understanding of INOCA related imaging diagnostic means.
2022, 46(11): 692-696.
doi: 10.3760/cma.j.cn121381-202202004-00241
Abstract:
In recent years, the detection rate of differentiated thyroid cancer (DTC) has increased significantly due to the wide application of high-resolution ultrasonography and fine needle aspiration biopsy. Cervical lymph nodes metastases (CLNM) is the most common type of postoperative persistent/recurrent disease in DTC patients, and its diagnosis and treatment involve multiple disciplines. At present, the most common diagnostic method and the "gold standard" is cervical ultrasound and histopathological examination respectively. The main treatment is operation. In addition, some alternative treatments such as 131I therapy, ultrasound-guided ablation and follow-up observation have gradually been proposed and applied in clinical practice. The authors review the diagnosis and treatment of postoperative persistent/recurrent CLNM in DTC patients.
In recent years, the detection rate of differentiated thyroid cancer (DTC) has increased significantly due to the wide application of high-resolution ultrasonography and fine needle aspiration biopsy. Cervical lymph nodes metastases (CLNM) is the most common type of postoperative persistent/recurrent disease in DTC patients, and its diagnosis and treatment involve multiple disciplines. At present, the most common diagnostic method and the "gold standard" is cervical ultrasound and histopathological examination respectively. The main treatment is operation. In addition, some alternative treatments such as 131I therapy, ultrasound-guided ablation and follow-up observation have gradually been proposed and applied in clinical practice. The authors review the diagnosis and treatment of postoperative persistent/recurrent CLNM in DTC patients.
2022, 46(11): 697-703.
doi: 10.3760/cma.j.cn121381-202112007-00233
Abstract:
Caenorhabditis elegans (C.elegans for short) has been widely used in researches on ionizing radiation as a classic model organism. Similar to vertebrates, the injury induced by radiation mainly include DNA damage, increase of reactive oxygen species level, accelerated aging, and the injury in reproductive system. As a model of ionizing radiation, C.elegans have made many breakthroughs in the field of radiation damage. The accelerated aging induced by ionizing radiation is controlled by multiple factors, like the incorrect expression of proteins and altered lipid metabolism. Ionizing radiation induces apoptosis, cell cycle arrest, and DNA damage in germ cells. C.elegans, as a well-established model of ionizing radiation, has significant implications for the study of radiation effects in higher organisms. The research progress in ionizing radiation damage using C.elegans as a model is reviewed in this paper.
Caenorhabditis elegans (C.elegans for short) has been widely used in researches on ionizing radiation as a classic model organism. Similar to vertebrates, the injury induced by radiation mainly include DNA damage, increase of reactive oxygen species level, accelerated aging, and the injury in reproductive system. As a model of ionizing radiation, C.elegans have made many breakthroughs in the field of radiation damage. The accelerated aging induced by ionizing radiation is controlled by multiple factors, like the incorrect expression of proteins and altered lipid metabolism. Ionizing radiation induces apoptosis, cell cycle arrest, and DNA damage in germ cells. C.elegans, as a well-established model of ionizing radiation, has significant implications for the study of radiation effects in higher organisms. The research progress in ionizing radiation damage using C.elegans as a model is reviewed in this paper.
2022, 46(11): 704-712.
doi: 10.3760/cma.j.cn121381-202205015-00234
Abstract:
Since the 1960s, our country has carried out radioactive monitoring of food and water sources. So far, due to two major nuclear power plant accidents, especially the radionuclides produced in the Fukushima nuclear accident in Japan in 2011, which have spread in the ocean, atmosphere and land and accumulated in the food chain, the hazard degree of radionuclides to human health needs to be quantitatively assessed. Therefore, the measurement of the level of radioactivity in food is crucial. This article outlined the commonly used measurement methods for radionuclides in food, and analyzed the specific measurement techniques and standards for the main contributing nuclides in the Fukushima nuclear accident that caused public health hazards. The aim was to provide theoretical support for further improving the technology and standards for measuring radionuclides in food, to provide data support for emergency management and recovery strategies of nuclear radiation, and to provide practical protection for public health finally.
Since the 1960s, our country has carried out radioactive monitoring of food and water sources. So far, due to two major nuclear power plant accidents, especially the radionuclides produced in the Fukushima nuclear accident in Japan in 2011, which have spread in the ocean, atmosphere and land and accumulated in the food chain, the hazard degree of radionuclides to human health needs to be quantitatively assessed. Therefore, the measurement of the level of radioactivity in food is crucial. This article outlined the commonly used measurement methods for radionuclides in food, and analyzed the specific measurement techniques and standards for the main contributing nuclides in the Fukushima nuclear accident that caused public health hazards. The aim was to provide theoretical support for further improving the technology and standards for measuring radionuclides in food, to provide data support for emergency management and recovery strategies of nuclear radiation, and to provide practical protection for public health finally.
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