BACKGROUND Despite significant advancements in the medical treatment of primary hepato-cellular carcinoma(PHC)in recent years,enhancing therapeutic effects and im-proving prognosis remain substantial challenges worldw...BACKGROUND Despite significant advancements in the medical treatment of primary hepato-cellular carcinoma(PHC)in recent years,enhancing therapeutic effects and im-proving prognosis remain substantial challenges worldwide.AIM To investigate the expression levels of serum vascular endothelial growth factor(VEGF)and interleukin(IL)-17 in patients with PHC and evaluate their diagnostic value while exploring their relationship with patients’clinical characteristics.METHODS The study included 50 patients with confirmed PHC who visited Wuhan Han-yang Hospital from January 2021 to January 2022,and 50 healthy individuals from the same period served as the control group.Serum VEGF and IL-17 levels in both groups were measured by Enzyme-Linked Immunosorbent Assay,and their diagnostic value was assessed using receiver operating characteristic(ROC)curves.Pearson correlation analysis was performed to examine the relationship between serum VEGF and IL-17 levels.Pathological data of the PHC patients were analyzed to determine the relationship between serum VEGF and IL-17 levels and pathological characteristics.RESULTS Serum VEGF and IL-17 levels were significantly higher in the study group com-pared to the control group(P<0.05).No significant association was observed between serum VEGF and IL-17 levels and gender,age,combined cirrhosis,tumor diameter,or degree of differentiation(P>0.05).However,there was a significant relationship between clinical TNM stage,tumor metastasis,and serum VEGF and IL-17 levels(P<0.05).Correlation analysis revealed a positive correlation between serum VEGF and IL-17(P<0.05).ROC analysis demonstrated that both serum VEGF and IL-17 had good diagnostic efficacy for PHC.CONCLUSION Serum VEGF and IL-17 levels were significantly higher in PHC patients compared to healthy individuals.Their levels were closely related to pathological features such as tumor metastasis and clinical TNM stage,and there was a significant positive correlation between VEGF and IL-17.These biomarkers may serve as valuable reference in-dicators for the early diagnosis and treatment guidance of PHC.展开更多
Objective:To explore the diagnostic value of endoscopic ultrasound(EUS)in the staging of rectal cancer.Methods:Fifty patients with rectal cancer,treated at the Department of Endoscopy,Cancer Hospital Affiliated to Fud...Objective:To explore the diagnostic value of endoscopic ultrasound(EUS)in the staging of rectal cancer.Methods:Fifty patients with rectal cancer,treated at the Department of Endoscopy,Cancer Hospital Affiliated to Fudan University,from March 2023 to June 2024,were selected.All patients underwent EUS and computed tomography(CT)examination within two weeks before surgery.The postoperative pathological staging was used as the standard to compare the accuracy of tumor TN staging using EUS and/or CT.Results:The accuracy rates of T and N staging by abdominal spiral CT were 72.00%and 76.00%,respectively,while those by EUS were 88.00%and 74%,respectively.There was a significant difference in the accuracy of T staging between the two methods(both P<0.05).Conclusion:EUS has high diagnostic value in the staging of rectal cancer,providing important reference information for clinicians,aiding in the development of personalized treatment plans,and assessing patient prognosis.展开更多
Objective:To study is to evaluate the diagnostic value of the expression of thymidine kinase 1(TK1)in lung cancer through literature review and meta-analysis.Methods:Firstly,we searched Pubmed,Embase,Cochrane,Web of S...Objective:To study is to evaluate the diagnostic value of the expression of thymidine kinase 1(TK1)in lung cancer through literature review and meta-analysis.Methods:Firstly,we searched Pubmed,Embase,Cochrane,Web of Science,CBM,CNKI,Wanfang and other databases up to June 2022.Then two researchers separately selected the clinical study on diagnosis of lung cancer by the expression of the TK1 and treatment and obtained the full text of the literature.Then we evaluated the systematic quality and bias risk of the included literatures by using Revman 5.3 software,and the consistency among the covariables in meta analysis.Finally,the Sensitivity(Sen),the Specificity(Spe)and other indicators were analyzed by using Stata16.0 software.Results:The study included 37 literatures,including 3218 lung cancer cases and 2976 control cases.The meta-analysis showed that the Ser and Spe of the expression of the TK1 in the diagnosis of lung cancer were 0.63(95%CI:0.57,0.68)and 0.88(95%CI:0.84,0.91),while positive likelihood ratio(PLR)was 5.34(95%CI:4.02,7.1)and negative likelihood ratio(NLR)was 0.42(95%CI:0.37,0.48),diagnostic odd sratio(DOR)was 12.69(95%CI:8.91,18.08),and the area under the ROC curve(AUC)was 0.82(95%CI:0.79,0.85).When TK1,CEA and CYFRA21-1 were used as combined diagnostic indexes of lung cancer,Sen was 0.82(95%CI:0.76,0.86),Spe 0.78(95%CI:0.46,0.94),PLR 3.69(95%CI:1.28,10.66),NLR 0.24(95%CI:0.18,0.31),DOR 15.59(95%CI:4.56,53.36),AUC 0.84(95%CI:0.80,0.87).The Youden index of combined diagnosis was 0.60,which was higher than that of TK1 alone.Conclusion:TK1 alone as a diagnostic index of lung cancer has low Sen,but its Sep is higher.So it has a certain diagnostic value.TK1 combined with CEA and CYFRA21-1 has higher Sen in the diagnosis of lung cancer,and the diagnostic value is better.展开更多
Objective:To explore the diagnostic value of conventional ultrasonography combined with contrast-enhanced ultrasonography in thyroid nodules.Methods:From June 2021 to July 2022,163 patients with thyroid nodules enroll...Objective:To explore the diagnostic value of conventional ultrasonography combined with contrast-enhanced ultrasonography in thyroid nodules.Methods:From June 2021 to July 2022,163 patients with thyroid nodules enrolled in our hospital were selected as research subjects.After pathological diagnosis,24 cases were malignant thyroid nodules,and 139 cases were benign thyroid nodules.The diagnosis rate of malignant and benign thyroid nodules was observed and analyzed,with 95%CI.Results:Among them,the malignant and benign detection rates of routine ultrasound were 88.63%and 75.00%,respectively,and the malignant and benign detection rates of contrast-enhanced ultrasound were 81.82%and 81.25%,respectively.The malignant and benign detection rates of conventional ultrasound combined with contrast-enhanced ultrasound were 93.18%and 87.50%,respectively,and the 95%CI was greater than 0.7.Conclusion:Conventional ultrasound combined with contrast-enhanced ultrasound can help improve the diagnostic accuracy of benign and malignant thyroid nodules and reduce the misdiagnosis rate.展开更多
AIM The purpose of this study was to evaluate the diagnostic value of trefoil factor family 3(TFF3) for the early detection of colorectal cancer(CC). METHODS Serum TFF3 and carcino-embryonic antigen(CEA) were detected...AIM The purpose of this study was to evaluate the diagnostic value of trefoil factor family 3(TFF3) for the early detection of colorectal cancer(CC). METHODS Serum TFF3 and carcino-embryonic antigen(CEA) were detected in 527 individuals, including 115 healthy control(HC), 198 colorectal adenoma(CA), and 214 CC individuals in the training group. RESULTS Serum TFF3 showed no significant correlation with age, gender, or tumor location but showed significant correlation with the tumor stage. Serum TFF3 in the CC group was significantly higher than in the HC or CA group. The AUC values of TFF3 for discriminating between HC and CC and between CA and CC were 0.930(0.903, 0.958) and 0.834(0.796, 0.873). A multivariate model combining TFF3 and CEA was built. Compared to TFF3 or CEA alone, the multivariate model showed significant improvement(P < 0.001). For discriminating between HC and CC, HC and early stage CC, HC and advanced stage CC, CA and CC, CA and early stage CC, and CA and advanced stage CC in the training group, the sensitivities were 92.99%, 91.46%, 93.18%, 73.83%, 76.83%, and 81.82%, and the specificities were 91.30%, 91.30%, 93.91%, 88.38%, 77.27%, and 88.38%, respectively. After validation, the sensitivities were 89.39%, 85.71%, 90.79%, 72.73%, 71.43%, and 78.95%, and the specificities were 87.85%, 87.85%, 2.52%, 87.85%, 80.77%, and 87.50%, respectively. CONCLUSION The multivariate diagnostic model that included TFF3 and CEA showed significant improvement over the conventional biomarker CEA and might provide a potential method for the early detection of CC.展开更多
BACKGROUND Numerous studies have demonstrated that human epididymis protein 4(HE4)is overexpressed in various malignant tissues including ovarian,endometrial,lung,breast,pancreatic,and gastric cancers.However,no study...BACKGROUND Numerous studies have demonstrated that human epididymis protein 4(HE4)is overexpressed in various malignant tissues including ovarian,endometrial,lung,breast,pancreatic,and gastric cancers.However,no study has examined the diagnostic impact of HE4 in patient with esophageal squamous cell carcinoma(ESCC)until now.AIM To analyze the value of four serum tumor markers for the diagnosis of ESCC,and examine the associations of serum levels of HE4 with ESCC patients’clinicopathological characteristics.METHODS The case group consisted of 80 ESCC patients,which were compared to a control group of 56 patients with benign esophageal disease.Serum levels of HE4,carcinoma embryonic antigen(CEA),alpha fetal protein,and carbohydrate antigen 19-9(CA19-9)were detected by ELISA.The associations of serum HE4 levels with ESCC patients’clinicopathological characteristics such as gender,tumor location,and pathological stage were also examined after operation.RESULTS The result of ELISA showed that serum HE4 level was significantly higher in the patients with ESCC than in the controls,and the staining intensity was inversely correlated with the pathological T and N stages.Serum HE4 levels had a sensitivity of 66.2%and specificity of 78.6%when the cutoff value was set at 3.9 ng/mL.Moreover,the combined HE4 and CA19-9 increased the sensitivity to 83.33%,and interestingly,the combination of HE4 with CEA led to the most powerful sensitivity of 87.5%.Furthermore,A positive correlation was observed between HE4 serum levels and pathological T and N stages(P=0.0002 and 0.0017,respectively),but there was no correlation between HE4 serum levels and ESCC patient gender(P=0.4395)or tumor location(P=0.6777).CONCLUSION The results of this study suggest that detection of serum HE4 levels may be useful in auxiliary diagnosis and evaluation of the progression of ESCC.展开更多
BACKGROUND Pleural effusions occur for various reasons,and their diagnosis remains challenging despite the availability of different diagnostic modalities.Medical thoracoscopy(MT)can be used for both diagnostic and th...BACKGROUND Pleural effusions occur for various reasons,and their diagnosis remains challenging despite the availability of different diagnostic modalities.Medical thoracoscopy(MT)can be used for both diagnostic and therapeutic purposes,especially in patients with undiagnosed pleural effusion.AIM To assess the diagnostic efficacy and safety of MT in patients with pleural effusion of different causes.METHODS Between January 1,2012 and April 30,2021,patients with pleural effusion underwent MT in the Department of Respiratory Medicine,The Second Affiliated Hospital of Xi’an Jiaotong University(Shaanxi,China).According to the discharge diagnosis,patients were divided into malignant pleural effusion(MPE),tuberculous pleural effusion(TBPE),and inflammatory pleural effusion(IPE)groups.General information,and tuberculosis-and effusion-related indices of the three groups were analyzed.The diagnostic yield,diagnostic accuracy,performance under thoracoscopy,and complications of patients were compared among the three groups.Then,the significant predictive factors for diagnosis between the MPE and TBPE groups were analyzed.RESULTS Of the 106 patients enrolled in this 10-year study,67 were male and 39 female,with mean age of 57.1±14.184 years.Among the 74 thoracoscopy-confirmed patients,41(38.7%)had MPE,21 had(19.8%)TBPE,and 32(30.2%)were undiagnosed.Overall diagnostic yield of MT was 69.8%(MPE:75.9%,TBPE:48.8%,and IPE:75.0%,with diagnostic accuracies of 100%,87.5%,and 75.0%,respectively).Under thoracoscopy,single or multiple pleural nodules were observed in 81.1%and pleural adhesions in 34.0%with pleural effusions.The most common complication was chest pain(41.5%),followed by chest tightness(11.3%)and fever(10.4%).Multivariate logistic regression analyses showed effusion appearance[odds ratio(OR):0.001,95%CI:0.000-0.204;P=0.010]and carcinoembryonic antigen(OR:0.243,95%CI:0.081-0.728;P=0.011)as significant for differentiating MPE and TBPE,with area under the receiver operating characteristic curve of 0.977(95%CI:0.953-1.000;P<0.001).CONCLUSION MT is an effective,safe,and minimally invasive procedure with high diagnostic yield for pleural effusion of different causes.展开更多
ObjectiveTo investigate the diagnostic value of 18F-fluorodeoxyglucose positron emission tomography （18F-FDG PET） in the as-sessment of myocardial viability in patients with known coronary artery disease （CAD） whe...ObjectiveTo investigate the diagnostic value of 18F-fluorodeoxyglucose positron emission tomography （18F-FDG PET） in the as-sessment of myocardial viability in patients with known coronary artery disease （CAD） when compared to99mTc single photon emission computed tomography （SPECT） and echocardiography, with invasive coronary angiography as the gold standard.MethodsThirty patients with diagnosed CAD met the selection criteria, with 10 of them （9 men, mean age 59.5 ± 10.5 years） undergoing all of these imaging proce-dures consisting of SPECT and PET, echocardiography and invasive angiography. Diagnostic sensitivity of these less invasive modalities for detection of myocardial viability was compared to invasive coronary angiography. Inter- and intra-observer agreement was assessed for di-agnostic performance of SPECT and PET.ResultsOf all patients with proven CAD, 50% had triple vessel disease. Diagnostic sensitivity of SPECT, PET and echocardiography was 90%, 100% and 80% at patient-based assessment, respectively. Excellent agreement was achieved between inter-observer and intra-observer agreement of the diagnostic value of SPECT and PET in myocardial viability （k= 0.9）. Conclusion18F-FDG PET has high diagnostic value in the assessment of myocardial viability in patients with known CAD when com-pared to SPECT and echocardiography. Further studies based on a large cohort with incorporation of18F-FDG PET into patient management are warranted.展开更多
Objective To explore the correlation between macrophages and interleukin-10(IL-10 in the peripheral blood of breast cancer(BC)patients and the diagnostic value of joint detection.Methods BC patients(n=50)and healthy c...Objective To explore the correlation between macrophages and interleukin-10(IL-10 in the peripheral blood of breast cancer(BC)patients and the diagnostic value of joint detection.Methods BC patients(n=50)and healthy controls(n=40)were prospectively recruited.The percentage of circulating cluster of differentiation 14(CD 14)macrophage cells was analyzed by flow cytometry,and an enzyme-linked immunosorbent assay(ELISA)was used to detect IL-10 expression levels.Receiver operating characteristic(ROC)curves were used to verify the diagnostic value of the models based on the expression of CD14 macrophage cell populations and IL-10.In addition,the association between model expression and clinicopathological characteristics was investigated.Another 30 patients with BC and 30 with benign breast disease were selected to validate the IL-10 and CD14 macrophage joint detection model using the same method.Results CD14 macrophage and IL-10 expression levels in BC patients were higher than those in healthy controls(P<0.05).The ROC curve showed that the area under the curve(AUC)of CD14+macrophages combined with IL-10 was 0.830,the sensitivity was 72.0%,and the specificity was 87.5%.Its diagnostic efficiency was better than all other single and joint detections.Correlation analysis of clinicopathological features showed that IL-10 and CD14+macrophage joint detection was significantly correlated with tumor size,tumor-node-metastasis(TNM)stage,and lymph node,estrogen receptor(ER),and Ki-67 expression(P<0.05).The validation analysis results were consistent with the test results.Conclusion Peripheral blood macrophages can be an independent diagnostic marker for BC.Joint detection of CD14-macrophages and IL-10 suggests poor prognosis,which has unlimited potential to guide BC development and provides a new theory for studying tumor-associated macrophages in BC.展开更多
[Objectives]To explore the relationship between neutrophil percentage to albumin ratio(NPAR),monocyte to high density lipoprotein ratio(MHR),fasting blood glucose(GLU)and CAD+T2DM and its diagnostic value.[Methods]A t...[Objectives]To explore the relationship between neutrophil percentage to albumin ratio(NPAR),monocyte to high density lipoprotein ratio(MHR),fasting blood glucose(GLU)and CAD+T2DM and its diagnostic value.[Methods]A total of 3937 patients who underwent coronary angiography in the Affiliated Hospital of Chengde Medical University from January 2016 to December 2018 were collected.The patients with Gensini score>0 and diabetes were selected as the experimental group(CAD+T2DM,n=756),and the patients with Gensini score=0 and without diabetes were taken as the control group(n=388),with a total of 1144 cases.The patient's medical record number,sex,age,contact number,biochemical test results,cardiac color ultrasound,coronary artery imaging and other data were recorded.NPAR,MHR,and GLU were calculated.A binary Logistic regression model was established combined with the receiver operating characteristic(ROC)curve.The predictive value of single index and joint test for CAD+T2DM was analyzed.[Results]The serum levels of NPAR,MHR and GLU in CAD+T2DM were significantly higher than those in the control group.Binary Logistic regression analysis showed that serum NPAR,MHR and GLU were risk factors for CAD+T2DM(P<0.05).The final prediction model is P=1/[1+e-(-3.722+0.014×NPAR+0.51×MHR+0.461×GLU)].ROC curve showed that the area under the curve of serum NPAR,MHR and GLU was 0.739,0.628 and 0.852,respectively,and the prediction probability of combined detection was 0.882,which was significantly higher than that of single index.[Conclusions]There was a close correlation between serum NPAR,MHR,GLU and CAD+T2DM in patients with coronary heart disease.The combined application of these indexes can significantly improve the predictive value of CAD+T2DM.展开更多
BACKGROUND Colorectal cancer(CRC)is a highly malignant cancer with a high incidence and mortality in China.It is urgent to find a diagnostic marker with higher sensitivity and specificity than the traditional approach...BACKGROUND Colorectal cancer(CRC)is a highly malignant cancer with a high incidence and mortality in China.It is urgent to find a diagnostic marker with higher sensitivity and specificity than the traditional approaches for CRC diagnosis.AIM To provide new ideas for the diagnosis of CRC based on serum proteomics.METHODS Specimens from 83 healthy people,62 colon polyp(CRP)patients,and 101 CRC patients were analyzed by matrix-assisted laser desorption/ionization time-offlight mass spectrometry.The diagnostic value of the profiles of differentially expressed proteins was then analyzed.RESULTS Compared with the healthy control group,CRC patients had elevated expression of 5 proteins and reduced expression of 14 proteins.The area under the curve(AUC)for a differentially expressed protein with a mass-to-charge ratio of 2022.34 was the largest;the AUC was 0.843,which was higher than the AUC of 0.717 observed with carcinoembryonic antigen(CEA),and the sensitivity and specificity of this identified marker were 75.3%and 79.5%,respectively.After cross-validation,the accuracy of diagnosis using levels of this differentially expressed protein was 82.37%.Compared with the CRP group,the expression of 3 proteins in the serum of CRC patients was elevated and 11 proteins were expressed at reduced levels.Proteins possessing mass-to-charge ratio values of 2899.38 and 877.3 were selected to establish a classification tree model.The results showed that the accuracy of CRC diagnosis was 89.5%,the accuracy of CRP diagnosis was 81.6%,and the overall accuracy of this approach was 86.3%.The overall sensitivity and specificity of diagnosis using the proteomics approach were 81.8%and 66.75%,respectively.The sensitivities and specificities of diagnoses based on CEA and carbohydrate antigen 19-9 expression were 55.6%and 91.3%and 65.4%and 65.2%,respectively.CONCLUSION We demonstrated that serum proteomics may be helpful for the detection of CRC,and it may assist clinical practice for CRC diagnosis.展开更多
Serum pancreatic tissue carcinoma antigen (PCA) was measured by ELISA in 396 patients with pancreatic carcinoma (PC) and other diseases diagnosed by clinical examination, histopathology and operation. Serum PCA more t...Serum pancreatic tissue carcinoma antigen (PCA) was measured by ELISA in 396 patients with pancreatic carcinoma (PC) and other diseases diagnosed by clinical examination, histopathology and operation. Serum PCA more than 300 U/ml was considered as diagnostic value for PC and 30-299 U/ml as probable index for PC. The sensitivity of PCA for PC was 78.2% (43/55), and the specifity 94.6%. The positive rate of PCA in other diseases were 0-13.3%. Combining the determination of PCA with B-mode ultrasonic scanning (BU). CT and/or ERCP (endos-copic retrograde cholangiopancreatography) may increase the diagnostic rate of PC to 89-91%, and with the "cocktail" of CA19-9, CEA (carcino-embryonic antigen) and RNase-C, PC be diagnosed in 88.9%. Therefore, it is suggest that PCA si a promising tumor market of PC with high sensitivity and relative specificity.展开更多
Objective:To compare and analyze the clinical diagnostic value of multi-slice spiral CT and enhanced MRI for primary liver cancer(PLC),and to summarize the imaging findings.Methods:The research subjects in this articl...Objective:To compare and analyze the clinical diagnostic value of multi-slice spiral CT and enhanced MRI for primary liver cancer(PLC),and to summarize the imaging findings.Methods:The research subjects in this article were 50 patients with PLC who were admitted to our hospital from 2017 April to 2018 September.After the patients were admitted,they were examined by multi-slice spiral CT and enhanced MRI scanning,and the pathological diagnosis results were followed up.Relevant information was reviewed and analyzed.Results:The detection rate of multi-slice spiral CT was higher than that of MRI in the portal venous phase lesion detection.The difference was statistically significant(P<0.05).The detection rate of lesions in the arterial phase and delayed phase was not statistically significant(P>0.05);the diagnostic accuracy of multi-slice spiral CT was 85.96%,and the diagnostic accuracy of enhanced MRI scanning was 91.11%,which was not statistically significant(P>0.05).MRI scans showed the capsules of primary liver cancer better than CT,but the difference was not statistically significant(P>0.05).Conclusion:In conclusion,both multi-slice spiral CT and enhanced MRI can be used for the effective diagnosis of primary liver cancer intrahepatic lesions.The diagnostic value of the two is equivalent,but enhanced MRI has a slightly higher diagnostic accuracy and can be used as the preferred method.展开更多
Objective To investigate the value of special examination in the diagnosis of thumb syndactyly. Methods Fourteen cases of thumb deformities were detected preoperatively by X-ray plain film, angiography and ultrasound ...Objective To investigate the value of special examination in the diagnosis of thumb syndactyly. Methods Fourteen cases of thumb deformities were detected preoperatively by X-ray plain film, angiography and ultrasound examination. The deformities of bone, hemokinesis of thumbs and its blood supply were analysed. The results were compared with their pathological changes during the operation. The deformity was corrected by operations of bone resection, reconstruction of tendon insertion site and preservation of main arteries. Results There were bone deformities 13 cases, abnormal or absent tendon insertion of the main thumb 14 cases. The nutrient of the deformity thumb was supplied by main trunk artery in 11 cases. Conclusion Angiography and ultrasonic examination play an important role in the diagnosis of thumb syndactyly. It can help determine appropriate surgical procedure so that secondary deformities can be prevented after operation. 3 refs,5 figs.展开更多
To compare the diagnostic value of four signs for superior labrum anterior and posterior (SLAP) lesions of the shoulder.Methods The physical examination was performed randomly on 81 cases with abnormalities of the sho...To compare the diagnostic value of four signs for superior labrum anterior and posterior (SLAP) lesions of the shoulder.Methods The physical examination was performed randomly on 81 cases with abnormalities of the shoulder.There were four tests,including Kibler anterior sliding test,Liu crank test,O’Brien active compression test and Kim biceps load test Ⅱ.The arthroscopic examination were also performed.The result of the arthroscopic examination was considered as a golden standard,so that we could estimate the diagnosis value of the four tests according to the method of evaluation of diagnosis test on clinical epidemiology,their sensitivity,specificity,positive and negative predictive value,accuracy.Results There were 21 cases diagnosed as SLAP lesions by arthroscopy.The diagnosis value of Kim biceps load test Ⅱ was the highest among the four tests,in which 19 of true positive,59 of true negative,1 of false positive,only 2 of false negative cases;while the sensitivity was 90.48%,specificity was 98.33%,positive predictive value was 95.00%,negative predictive value was 96.72%,and accuracy was 96.30%.However the sensitivity,specificity,positive predicitive value,negative predictive vale and accuracy of Kibler anterior sliding test were 76.19%,96.67%,88.89%,92.06%,91.33%;and those of Liu crank test were 85.71%,93.33%,81.82%,94.92%,91.35%;those of O’Brien active compression test were 80.95%,91.66%,77.27%,93.22%,88.89%.Conclusion Kim Biceps load test Ⅱ may be the best for clinical diagnosis of SLAP lesions of the shoulder.9 refs,4 figs,2 tabs.展开更多
BACKGROUND Gastric cancer is a global health concern that poses a significant threat to human well-being.AIM To detecting serum changes in carcinoembryonic antigen(CEA),carbohydrate antigens(CA)724,CA242,and CA19-9 ex...BACKGROUND Gastric cancer is a global health concern that poses a significant threat to human well-being.AIM To detecting serum changes in carcinoembryonic antigen(CEA),carbohydrate antigens(CA)724,CA242,and CA19-9 expression among patients with gastric cancer.METHODS Eighty patients diagnosed with gastric cancer between January 2020 and January 2023 were included in the observation group,while 80 patients with benign gastric diseases were included in the control group.Both groups were tested for tumor markers(CA724,CEA,CA242,and CA19-9].Tumor marker indicators(CA724,CEA,CA242,and CA19-9)were compared between the two groups,assessing positive rates of tumor markers across various stages in the observation group.Additionally,single and combined detection of various tumor markers were examined.RESULTS The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value observed for the combined detection of CA724,CEA,CA242,and CA19-9 were higher than those of CA724,CEA,CA242,and CA19-9 individually.Therefore,the combined detection of CA724,CEA,CA242,and CA19-9 has a high diagnostic accuracy and could reduce the occurrence of missed or misdiagnosed cases,facilitating the early diagnosis and treatment of patients.CONCLUSION CA724,CEA,CA242,and CA19-9 serum levels in gastric cancer patients significantly surpassed those in non-gastric cancer patients(P<0.05).Their combined detection can improve the diagnostic accuracy for gastric cancer,warranting clinical promotion.展开更多
Background A free running asthma screening test is usually used for screening exercise-induced bronchoconstriction.The total serum allergen IgE level can reveal the patient＇s atopy characteristics.Our study is to eva...Background A free running asthma screening test is usually used for screening exercise-induced bronchoconstriction.The total serum allergen IgE level can reveal the patient＇s atopy characteristics.Our study is to evaluate the diagnostic values of the combination of the two tests in asthmatic children and compare this new diagnostic method with the Intemational Study of Asthma and Allergies in Childhood （ISSAC） questionnaires and the bronchial provocation test,which are popular diagnostic tool for pediatric asthma.Methods A total of 773 school children were recruited in this study.The children＇s asthma was diagnosed by means of a combination of the free running asthma screening test and total serum allergen IgE level.The new diagnostic method value was assessed using receiver operating characteristic （ROC） curves and compared with other diagnostic tools such as ISSAC questionnaires and the bronchial provocation test.Results The AUC of this new diagnostic method was higher than 0.9.When the cut-off value of total serum allergen IgE level was ≥47 KU/L,the sensitivity and the specificity were 71.4％ and 85.1％,respectively,which were better than those of either the ISSAC questionnaires or bronchial provocation test.Conclusion The combination of the free running asthma screening test and total serum allergen IgE level may be an effective diagnostic tool for children＇s asthma.展开更多
Background:Since the diagnostic value of aldosterone to renin ratio(ARR)calculated by plasma renin concentration(PRC)or plasma renin activity(PRA)is still inconclusive,we conducted a meta-analysis by systematically re...Background:Since the diagnostic value of aldosterone to renin ratio(ARR)calculated by plasma renin concentration(PRC)or plasma renin activity(PRA)is still inconclusive,we conducted a meta-analysis by systematically reviewing relevant literature to explore the difference in the diagnostic efficacy of ARR calculated by PRC or PRA,so as to provide guidance for clinical diagnosis.Methods:We searched PubMed,Embase,and Cochrane Library from the establishment of the database to March 2021.We included studies that report the true positive,false positive,true negative,and false negative values for the diagnosis of primary aldosteronism,and we excluded duplicate publications,research without full text,incomplete information,or inability to conduct data extraction,animal experiments,reviews,and systematic reviews.STATA 15.1 was used to analyze the data.Results:The pooled results showed that ARR(plasma aldosterone concentration[PAC]/PRC)had a sensitivity of 0.82(95%confidence interval[CI]:0.78-0.86),a specificity of 0.94(95%CI:0.92-0.95),a positive-likelihood ratio(LR)of 12.77(95%CI:7.04-23.73),a negative LR of 0.11(95%CI:0.07-0.17),and symmetric area under the curve(SAUC)of 0.982,respectively.Furthermore,the diagnostic odds ratio(DOR)of ARR(PAC/PRC)was 180.21.Additionally,the pooled results showed that ARR(PAC/PRA)had a sensitivity of 0.91(95%CI:0.86-0.95),a specificity of 0.91(95%CI:0.90-0.93),a positive LR of 7.30(95%CI:2.99-17.99),a negative LR of 0.10(95%CI:0.04-0.26),and SAUC of 0.976,respectively.The DOR of ARR(PAC/PRA)was 155.52.Additionally,we conducted a subgroup analysis for the different thresholds(<35 or≥35)of PAC/PRC.The results showed that the DOR of the cut-off≥35 groups was higher than the cut-off<35 groups(DOR=340.15,95%CI:38.32-3019.66;DOR=116.40,95%CI=23.28-581.92).Conclusions:The research results suggest that the determination of ARR(PAC/PRC)and ARR(PAC/PRA)was all effective screening tools for PA.The diagnostic accuracy and diagnostic value of ARR(PAC/PRC)are higher than ARR(PAC/PRA).In addition,within a certain range,the higher the threshold,the better the diagnostic value.展开更多
文摘BACKGROUND Despite significant advancements in the medical treatment of primary hepato-cellular carcinoma(PHC)in recent years,enhancing therapeutic effects and im-proving prognosis remain substantial challenges worldwide.AIM To investigate the expression levels of serum vascular endothelial growth factor(VEGF)and interleukin(IL)-17 in patients with PHC and evaluate their diagnostic value while exploring their relationship with patients’clinical characteristics.METHODS The study included 50 patients with confirmed PHC who visited Wuhan Han-yang Hospital from January 2021 to January 2022,and 50 healthy individuals from the same period served as the control group.Serum VEGF and IL-17 levels in both groups were measured by Enzyme-Linked Immunosorbent Assay,and their diagnostic value was assessed using receiver operating characteristic(ROC)curves.Pearson correlation analysis was performed to examine the relationship between serum VEGF and IL-17 levels.Pathological data of the PHC patients were analyzed to determine the relationship between serum VEGF and IL-17 levels and pathological characteristics.RESULTS Serum VEGF and IL-17 levels were significantly higher in the study group com-pared to the control group(P<0.05).No significant association was observed between serum VEGF and IL-17 levels and gender,age,combined cirrhosis,tumor diameter,or degree of differentiation(P>0.05).However,there was a significant relationship between clinical TNM stage,tumor metastasis,and serum VEGF and IL-17 levels(P<0.05).Correlation analysis revealed a positive correlation between serum VEGF and IL-17(P<0.05).ROC analysis demonstrated that both serum VEGF and IL-17 had good diagnostic efficacy for PHC.CONCLUSION Serum VEGF and IL-17 levels were significantly higher in PHC patients compared to healthy individuals.Their levels were closely related to pathological features such as tumor metastasis and clinical TNM stage,and there was a significant positive correlation between VEGF and IL-17.These biomarkers may serve as valuable reference in-dicators for the early diagnosis and treatment guidance of PHC.
文摘Objective:To explore the diagnostic value of endoscopic ultrasound(EUS)in the staging of rectal cancer.Methods:Fifty patients with rectal cancer,treated at the Department of Endoscopy,Cancer Hospital Affiliated to Fudan University,from March 2023 to June 2024,were selected.All patients underwent EUS and computed tomography(CT)examination within two weeks before surgery.The postoperative pathological staging was used as the standard to compare the accuracy of tumor TN staging using EUS and/or CT.Results:The accuracy rates of T and N staging by abdominal spiral CT were 72.00%and 76.00%,respectively,while those by EUS were 88.00%and 74%,respectively.There was a significant difference in the accuracy of T staging between the two methods(both P<0.05).Conclusion:EUS has high diagnostic value in the staging of rectal cancer,providing important reference information for clinicians,aiding in the development of personalized treatment plans,and assessing patient prognosis.
基金This study was supported by Key Projects in Hainan Province(ZDYF2019139)。
文摘Objective:To study is to evaluate the diagnostic value of the expression of thymidine kinase 1(TK1)in lung cancer through literature review and meta-analysis.Methods:Firstly,we searched Pubmed,Embase,Cochrane,Web of Science,CBM,CNKI,Wanfang and other databases up to June 2022.Then two researchers separately selected the clinical study on diagnosis of lung cancer by the expression of the TK1 and treatment and obtained the full text of the literature.Then we evaluated the systematic quality and bias risk of the included literatures by using Revman 5.3 software,and the consistency among the covariables in meta analysis.Finally,the Sensitivity(Sen),the Specificity(Spe)and other indicators were analyzed by using Stata16.0 software.Results:The study included 37 literatures,including 3218 lung cancer cases and 2976 control cases.The meta-analysis showed that the Ser and Spe of the expression of the TK1 in the diagnosis of lung cancer were 0.63(95%CI:0.57,0.68)and 0.88(95%CI:0.84,0.91),while positive likelihood ratio(PLR)was 5.34(95%CI:4.02,7.1)and negative likelihood ratio(NLR)was 0.42(95%CI:0.37,0.48),diagnostic odd sratio(DOR)was 12.69(95%CI:8.91,18.08),and the area under the ROC curve(AUC)was 0.82(95%CI:0.79,0.85).When TK1,CEA and CYFRA21-1 were used as combined diagnostic indexes of lung cancer,Sen was 0.82(95%CI:0.76,0.86),Spe 0.78(95%CI:0.46,0.94),PLR 3.69(95%CI:1.28,10.66),NLR 0.24(95%CI:0.18,0.31),DOR 15.59(95%CI:4.56,53.36),AUC 0.84(95%CI:0.80,0.87).The Youden index of combined diagnosis was 0.60,which was higher than that of TK1 alone.Conclusion:TK1 alone as a diagnostic index of lung cancer has low Sen,but its Sep is higher.So it has a certain diagnostic value.TK1 combined with CEA and CYFRA21-1 has higher Sen in the diagnosis of lung cancer,and the diagnostic value is better.
文摘Objective:To explore the diagnostic value of conventional ultrasonography combined with contrast-enhanced ultrasonography in thyroid nodules.Methods:From June 2021 to July 2022,163 patients with thyroid nodules enrolled in our hospital were selected as research subjects.After pathological diagnosis,24 cases were malignant thyroid nodules,and 139 cases were benign thyroid nodules.The diagnosis rate of malignant and benign thyroid nodules was observed and analyzed,with 95%CI.Results:Among them,the malignant and benign detection rates of routine ultrasound were 88.63%and 75.00%,respectively,and the malignant and benign detection rates of contrast-enhanced ultrasound were 81.82%and 81.25%,respectively.The malignant and benign detection rates of conventional ultrasound combined with contrast-enhanced ultrasound were 93.18%and 87.50%,respectively,and the 95%CI was greater than 0.7.Conclusion:Conventional ultrasound combined with contrast-enhanced ultrasound can help improve the diagnostic accuracy of benign and malignant thyroid nodules and reduce the misdiagnosis rate.
基金Supported by The Capital Health Development Special Scientific Research Projects,No.2014-2-2154National Natural Science Foundation of China,No.81471761 and No.81501568
文摘AIM The purpose of this study was to evaluate the diagnostic value of trefoil factor family 3(TFF3) for the early detection of colorectal cancer(CC). METHODS Serum TFF3 and carcino-embryonic antigen(CEA) were detected in 527 individuals, including 115 healthy control(HC), 198 colorectal adenoma(CA), and 214 CC individuals in the training group. RESULTS Serum TFF3 showed no significant correlation with age, gender, or tumor location but showed significant correlation with the tumor stage. Serum TFF3 in the CC group was significantly higher than in the HC or CA group. The AUC values of TFF3 for discriminating between HC and CC and between CA and CC were 0.930(0.903, 0.958) and 0.834(0.796, 0.873). A multivariate model combining TFF3 and CEA was built. Compared to TFF3 or CEA alone, the multivariate model showed significant improvement(P < 0.001). For discriminating between HC and CC, HC and early stage CC, HC and advanced stage CC, CA and CC, CA and early stage CC, and CA and advanced stage CC in the training group, the sensitivities were 92.99%, 91.46%, 93.18%, 73.83%, 76.83%, and 81.82%, and the specificities were 91.30%, 91.30%, 93.91%, 88.38%, 77.27%, and 88.38%, respectively. After validation, the sensitivities were 89.39%, 85.71%, 90.79%, 72.73%, 71.43%, and 78.95%, and the specificities were 87.85%, 87.85%, 2.52%, 87.85%, 80.77%, and 87.50%, respectively. CONCLUSION The multivariate diagnostic model that included TFF3 and CEA showed significant improvement over the conventional biomarker CEA and might provide a potential method for the early detection of CC.
基金National Natural Science Foundation of China,No.81602023.
文摘BACKGROUND Numerous studies have demonstrated that human epididymis protein 4(HE4)is overexpressed in various malignant tissues including ovarian,endometrial,lung,breast,pancreatic,and gastric cancers.However,no study has examined the diagnostic impact of HE4 in patient with esophageal squamous cell carcinoma(ESCC)until now.AIM To analyze the value of four serum tumor markers for the diagnosis of ESCC,and examine the associations of serum levels of HE4 with ESCC patients’clinicopathological characteristics.METHODS The case group consisted of 80 ESCC patients,which were compared to a control group of 56 patients with benign esophageal disease.Serum levels of HE4,carcinoma embryonic antigen(CEA),alpha fetal protein,and carbohydrate antigen 19-9(CA19-9)were detected by ELISA.The associations of serum HE4 levels with ESCC patients’clinicopathological characteristics such as gender,tumor location,and pathological stage were also examined after operation.RESULTS The result of ELISA showed that serum HE4 level was significantly higher in the patients with ESCC than in the controls,and the staining intensity was inversely correlated with the pathological T and N stages.Serum HE4 levels had a sensitivity of 66.2%and specificity of 78.6%when the cutoff value was set at 3.9 ng/mL.Moreover,the combined HE4 and CA19-9 increased the sensitivity to 83.33%,and interestingly,the combination of HE4 with CEA led to the most powerful sensitivity of 87.5%.Furthermore,A positive correlation was observed between HE4 serum levels and pathological T and N stages(P=0.0002 and 0.0017,respectively),but there was no correlation between HE4 serum levels and ESCC patient gender(P=0.4395)or tumor location(P=0.6777).CONCLUSION The results of this study suggest that detection of serum HE4 levels may be useful in auxiliary diagnosis and evaluation of the progression of ESCC.
基金Supported by Shaanxi Science and Technology Research Plan Program,Shaanxi,China,No. 2020SF-106
文摘BACKGROUND Pleural effusions occur for various reasons,and their diagnosis remains challenging despite the availability of different diagnostic modalities.Medical thoracoscopy(MT)can be used for both diagnostic and therapeutic purposes,especially in patients with undiagnosed pleural effusion.AIM To assess the diagnostic efficacy and safety of MT in patients with pleural effusion of different causes.METHODS Between January 1,2012 and April 30,2021,patients with pleural effusion underwent MT in the Department of Respiratory Medicine,The Second Affiliated Hospital of Xi’an Jiaotong University(Shaanxi,China).According to the discharge diagnosis,patients were divided into malignant pleural effusion(MPE),tuberculous pleural effusion(TBPE),and inflammatory pleural effusion(IPE)groups.General information,and tuberculosis-and effusion-related indices of the three groups were analyzed.The diagnostic yield,diagnostic accuracy,performance under thoracoscopy,and complications of patients were compared among the three groups.Then,the significant predictive factors for diagnosis between the MPE and TBPE groups were analyzed.RESULTS Of the 106 patients enrolled in this 10-year study,67 were male and 39 female,with mean age of 57.1±14.184 years.Among the 74 thoracoscopy-confirmed patients,41(38.7%)had MPE,21 had(19.8%)TBPE,and 32(30.2%)were undiagnosed.Overall diagnostic yield of MT was 69.8%(MPE:75.9%,TBPE:48.8%,and IPE:75.0%,with diagnostic accuracies of 100%,87.5%,and 75.0%,respectively).Under thoracoscopy,single or multiple pleural nodules were observed in 81.1%and pleural adhesions in 34.0%with pleural effusions.The most common complication was chest pain(41.5%),followed by chest tightness(11.3%)and fever(10.4%).Multivariate logistic regression analyses showed effusion appearance[odds ratio(OR):0.001,95%CI:0.000-0.204;P=0.010]and carcinoembryonic antigen(OR:0.243,95%CI:0.081-0.728;P=0.011)as significant for differentiating MPE and TBPE,with area under the receiver operating characteristic curve of 0.977(95%CI:0.953-1.000;P<0.001).CONCLUSION MT is an effective,safe,and minimally invasive procedure with high diagnostic yield for pleural effusion of different causes.
文摘ObjectiveTo investigate the diagnostic value of 18F-fluorodeoxyglucose positron emission tomography （18F-FDG PET） in the as-sessment of myocardial viability in patients with known coronary artery disease （CAD） when compared to99mTc single photon emission computed tomography （SPECT） and echocardiography, with invasive coronary angiography as the gold standard.MethodsThirty patients with diagnosed CAD met the selection criteria, with 10 of them （9 men, mean age 59.5 ± 10.5 years） undergoing all of these imaging proce-dures consisting of SPECT and PET, echocardiography and invasive angiography. Diagnostic sensitivity of these less invasive modalities for detection of myocardial viability was compared to invasive coronary angiography. Inter- and intra-observer agreement was assessed for di-agnostic performance of SPECT and PET.ResultsOf all patients with proven CAD, 50% had triple vessel disease. Diagnostic sensitivity of SPECT, PET and echocardiography was 90%, 100% and 80% at patient-based assessment, respectively. Excellent agreement was achieved between inter-observer and intra-observer agreement of the diagnostic value of SPECT and PET in myocardial viability （k= 0.9）. Conclusion18F-FDG PET has high diagnostic value in the assessment of myocardial viability in patients with known CAD when com-pared to SPECT and echocardiography. Further studies based on a large cohort with incorporation of18F-FDG PET into patient management are warranted.
基金Supported by grants from the National Natural Science Foundation of China(No.82104952,No.82004240)Special project for clinical research of health industry of Shanghai Municipal Health Commission(No.202140172)+1 种基金Special project of medical innovation research of Shanghai Science and Technology Commission(No.21Y11923600)the Shanghai Office of Traditional Chinese Medicine Development(No.ZY2018-2020-RCPY-2009).
文摘Objective To explore the correlation between macrophages and interleukin-10(IL-10 in the peripheral blood of breast cancer(BC)patients and the diagnostic value of joint detection.Methods BC patients(n=50)and healthy controls(n=40)were prospectively recruited.The percentage of circulating cluster of differentiation 14(CD 14)macrophage cells was analyzed by flow cytometry,and an enzyme-linked immunosorbent assay(ELISA)was used to detect IL-10 expression levels.Receiver operating characteristic(ROC)curves were used to verify the diagnostic value of the models based on the expression of CD14 macrophage cell populations and IL-10.In addition,the association between model expression and clinicopathological characteristics was investigated.Another 30 patients with BC and 30 with benign breast disease were selected to validate the IL-10 and CD14 macrophage joint detection model using the same method.Results CD14 macrophage and IL-10 expression levels in BC patients were higher than those in healthy controls(P<0.05).The ROC curve showed that the area under the curve(AUC)of CD14+macrophages combined with IL-10 was 0.830,the sensitivity was 72.0%,and the specificity was 87.5%.Its diagnostic efficiency was better than all other single and joint detections.Correlation analysis of clinicopathological features showed that IL-10 and CD14+macrophage joint detection was significantly correlated with tumor size,tumor-node-metastasis(TNM)stage,and lymph node,estrogen receptor(ER),and Ki-67 expression(P<0.05).The validation analysis results were consistent with the test results.Conclusion Peripheral blood macrophages can be an independent diagnostic marker for BC.Joint detection of CD14-macrophages and IL-10 suggests poor prognosis,which has unlimited potential to guide BC development and provides a new theory for studying tumor-associated macrophages in BC.
基金Key Medical Science Research Project of Hebei Health and Family Planning Commission(20181153).
文摘[Objectives]To explore the relationship between neutrophil percentage to albumin ratio(NPAR),monocyte to high density lipoprotein ratio(MHR),fasting blood glucose(GLU)and CAD+T2DM and its diagnostic value.[Methods]A total of 3937 patients who underwent coronary angiography in the Affiliated Hospital of Chengde Medical University from January 2016 to December 2018 were collected.The patients with Gensini score>0 and diabetes were selected as the experimental group(CAD+T2DM,n=756),and the patients with Gensini score=0 and without diabetes were taken as the control group(n=388),with a total of 1144 cases.The patient's medical record number,sex,age,contact number,biochemical test results,cardiac color ultrasound,coronary artery imaging and other data were recorded.NPAR,MHR,and GLU were calculated.A binary Logistic regression model was established combined with the receiver operating characteristic(ROC)curve.The predictive value of single index and joint test for CAD+T2DM was analyzed.[Results]The serum levels of NPAR,MHR and GLU in CAD+T2DM were significantly higher than those in the control group.Binary Logistic regression analysis showed that serum NPAR,MHR and GLU were risk factors for CAD+T2DM(P<0.05).The final prediction model is P=1/[1+e-(-3.722+0.014×NPAR+0.51×MHR+0.461×GLU)].ROC curve showed that the area under the curve of serum NPAR,MHR and GLU was 0.739,0.628 and 0.852,respectively,and the prediction probability of combined detection was 0.882,which was significantly higher than that of single index.[Conclusions]There was a close correlation between serum NPAR,MHR,GLU and CAD+T2DM in patients with coronary heart disease.The combined application of these indexes can significantly improve the predictive value of CAD+T2DM.
基金Supported by National Key Research and Development Program of China,No.2020YFC2002700CAMS Initiative for Innovative Medicine,No.2016-I2M-1-007National Natural Science Foundation of China,No.81972010,and No.81500003.
文摘BACKGROUND Colorectal cancer(CRC)is a highly malignant cancer with a high incidence and mortality in China.It is urgent to find a diagnostic marker with higher sensitivity and specificity than the traditional approaches for CRC diagnosis.AIM To provide new ideas for the diagnosis of CRC based on serum proteomics.METHODS Specimens from 83 healthy people,62 colon polyp(CRP)patients,and 101 CRC patients were analyzed by matrix-assisted laser desorption/ionization time-offlight mass spectrometry.The diagnostic value of the profiles of differentially expressed proteins was then analyzed.RESULTS Compared with the healthy control group,CRC patients had elevated expression of 5 proteins and reduced expression of 14 proteins.The area under the curve(AUC)for a differentially expressed protein with a mass-to-charge ratio of 2022.34 was the largest;the AUC was 0.843,which was higher than the AUC of 0.717 observed with carcinoembryonic antigen(CEA),and the sensitivity and specificity of this identified marker were 75.3%and 79.5%,respectively.After cross-validation,the accuracy of diagnosis using levels of this differentially expressed protein was 82.37%.Compared with the CRP group,the expression of 3 proteins in the serum of CRC patients was elevated and 11 proteins were expressed at reduced levels.Proteins possessing mass-to-charge ratio values of 2899.38 and 877.3 were selected to establish a classification tree model.The results showed that the accuracy of CRC diagnosis was 89.5%,the accuracy of CRP diagnosis was 81.6%,and the overall accuracy of this approach was 86.3%.The overall sensitivity and specificity of diagnosis using the proteomics approach were 81.8%and 66.75%,respectively.The sensitivities and specificities of diagnoses based on CEA and carbohydrate antigen 19-9 expression were 55.6%and 91.3%and 65.4%and 65.2%,respectively.CONCLUSION We demonstrated that serum proteomics may be helpful for the detection of CRC,and it may assist clinical practice for CRC diagnosis.
文摘Serum pancreatic tissue carcinoma antigen (PCA) was measured by ELISA in 396 patients with pancreatic carcinoma (PC) and other diseases diagnosed by clinical examination, histopathology and operation. Serum PCA more than 300 U/ml was considered as diagnostic value for PC and 30-299 U/ml as probable index for PC. The sensitivity of PCA for PC was 78.2% (43/55), and the specifity 94.6%. The positive rate of PCA in other diseases were 0-13.3%. Combining the determination of PCA with B-mode ultrasonic scanning (BU). CT and/or ERCP (endos-copic retrograde cholangiopancreatography) may increase the diagnostic rate of PC to 89-91%, and with the "cocktail" of CA19-9, CEA (carcino-embryonic antigen) and RNase-C, PC be diagnosed in 88.9%. Therefore, it is suggest that PCA si a promising tumor market of PC with high sensitivity and relative specificity.
文摘Objective:To compare and analyze the clinical diagnostic value of multi-slice spiral CT and enhanced MRI for primary liver cancer(PLC),and to summarize the imaging findings.Methods:The research subjects in this article were 50 patients with PLC who were admitted to our hospital from 2017 April to 2018 September.After the patients were admitted,they were examined by multi-slice spiral CT and enhanced MRI scanning,and the pathological diagnosis results were followed up.Relevant information was reviewed and analyzed.Results:The detection rate of multi-slice spiral CT was higher than that of MRI in the portal venous phase lesion detection.The difference was statistically significant(P<0.05).The detection rate of lesions in the arterial phase and delayed phase was not statistically significant(P>0.05);the diagnostic accuracy of multi-slice spiral CT was 85.96%,and the diagnostic accuracy of enhanced MRI scanning was 91.11%,which was not statistically significant(P>0.05).MRI scans showed the capsules of primary liver cancer better than CT,but the difference was not statistically significant(P>0.05).Conclusion:In conclusion,both multi-slice spiral CT and enhanced MRI can be used for the effective diagnosis of primary liver cancer intrahepatic lesions.The diagnostic value of the two is equivalent,but enhanced MRI has a slightly higher diagnostic accuracy and can be used as the preferred method.
文摘Objective To investigate the value of special examination in the diagnosis of thumb syndactyly. Methods Fourteen cases of thumb deformities were detected preoperatively by X-ray plain film, angiography and ultrasound examination. The deformities of bone, hemokinesis of thumbs and its blood supply were analysed. The results were compared with their pathological changes during the operation. The deformity was corrected by operations of bone resection, reconstruction of tendon insertion site and preservation of main arteries. Results There were bone deformities 13 cases, abnormal or absent tendon insertion of the main thumb 14 cases. The nutrient of the deformity thumb was supplied by main trunk artery in 11 cases. Conclusion Angiography and ultrasonic examination play an important role in the diagnosis of thumb syndactyly. It can help determine appropriate surgical procedure so that secondary deformities can be prevented after operation. 3 refs,5 figs.
文摘To compare the diagnostic value of four signs for superior labrum anterior and posterior (SLAP) lesions of the shoulder.Methods The physical examination was performed randomly on 81 cases with abnormalities of the shoulder.There were four tests,including Kibler anterior sliding test,Liu crank test,O’Brien active compression test and Kim biceps load test Ⅱ.The arthroscopic examination were also performed.The result of the arthroscopic examination was considered as a golden standard,so that we could estimate the diagnosis value of the four tests according to the method of evaluation of diagnosis test on clinical epidemiology,their sensitivity,specificity,positive and negative predictive value,accuracy.Results There were 21 cases diagnosed as SLAP lesions by arthroscopy.The diagnosis value of Kim biceps load test Ⅱ was the highest among the four tests,in which 19 of true positive,59 of true negative,1 of false positive,only 2 of false negative cases;while the sensitivity was 90.48%,specificity was 98.33%,positive predictive value was 95.00%,negative predictive value was 96.72%,and accuracy was 96.30%.However the sensitivity,specificity,positive predicitive value,negative predictive vale and accuracy of Kibler anterior sliding test were 76.19%,96.67%,88.89%,92.06%,91.33%;and those of Liu crank test were 85.71%,93.33%,81.82%,94.92%,91.35%;those of O’Brien active compression test were 80.95%,91.66%,77.27%,93.22%,88.89%.Conclusion Kim Biceps load test Ⅱ may be the best for clinical diagnosis of SLAP lesions of the shoulder.9 refs,4 figs,2 tabs.
文摘BACKGROUND Gastric cancer is a global health concern that poses a significant threat to human well-being.AIM To detecting serum changes in carcinoembryonic antigen(CEA),carbohydrate antigens(CA)724,CA242,and CA19-9 expression among patients with gastric cancer.METHODS Eighty patients diagnosed with gastric cancer between January 2020 and January 2023 were included in the observation group,while 80 patients with benign gastric diseases were included in the control group.Both groups were tested for tumor markers(CA724,CEA,CA242,and CA19-9].Tumor marker indicators(CA724,CEA,CA242,and CA19-9)were compared between the two groups,assessing positive rates of tumor markers across various stages in the observation group.Additionally,single and combined detection of various tumor markers were examined.RESULTS The sensitivity,specificity,accuracy,positive predictive value,and negative predictive value observed for the combined detection of CA724,CEA,CA242,and CA19-9 were higher than those of CA724,CEA,CA242,and CA19-9 individually.Therefore,the combined detection of CA724,CEA,CA242,and CA19-9 has a high diagnostic accuracy and could reduce the occurrence of missed or misdiagnosed cases,facilitating the early diagnosis and treatment of patients.CONCLUSION CA724,CEA,CA242,and CA19-9 serum levels in gastric cancer patients significantly surpassed those in non-gastric cancer patients(P<0.05).Their combined detection can improve the diagnostic accuracy for gastric cancer,warranting clinical promotion.
文摘Background A free running asthma screening test is usually used for screening exercise-induced bronchoconstriction.The total serum allergen IgE level can reveal the patient＇s atopy characteristics.Our study is to evaluate the diagnostic values of the combination of the two tests in asthmatic children and compare this new diagnostic method with the Intemational Study of Asthma and Allergies in Childhood （ISSAC） questionnaires and the bronchial provocation test,which are popular diagnostic tool for pediatric asthma.Methods A total of 773 school children were recruited in this study.The children＇s asthma was diagnosed by means of a combination of the free running asthma screening test and total serum allergen IgE level.The new diagnostic method value was assessed using receiver operating characteristic （ROC） curves and compared with other diagnostic tools such as ISSAC questionnaires and the bronchial provocation test.Results The AUC of this new diagnostic method was higher than 0.9.When the cut-off value of total serum allergen IgE level was ≥47 KU/L,the sensitivity and the specificity were 71.4％ and 85.1％,respectively,which were better than those of either the ISSAC questionnaires or bronchial provocation test.Conclusion The combination of the free running asthma screening test and total serum allergen IgE level may be an effective diagnostic tool for children＇s asthma.
基金supported by a grant from the Science and Technology Project of Guangdong Province(No.2016A020215136)。
文摘Background:Since the diagnostic value of aldosterone to renin ratio(ARR)calculated by plasma renin concentration(PRC)or plasma renin activity(PRA)is still inconclusive,we conducted a meta-analysis by systematically reviewing relevant literature to explore the difference in the diagnostic efficacy of ARR calculated by PRC or PRA,so as to provide guidance for clinical diagnosis.Methods:We searched PubMed,Embase,and Cochrane Library from the establishment of the database to March 2021.We included studies that report the true positive,false positive,true negative,and false negative values for the diagnosis of primary aldosteronism,and we excluded duplicate publications,research without full text,incomplete information,or inability to conduct data extraction,animal experiments,reviews,and systematic reviews.STATA 15.1 was used to analyze the data.Results:The pooled results showed that ARR(plasma aldosterone concentration[PAC]/PRC)had a sensitivity of 0.82(95%confidence interval[CI]:0.78-0.86),a specificity of 0.94(95%CI:0.92-0.95),a positive-likelihood ratio(LR)of 12.77(95%CI:7.04-23.73),a negative LR of 0.11(95%CI:0.07-0.17),and symmetric area under the curve(SAUC)of 0.982,respectively.Furthermore,the diagnostic odds ratio(DOR)of ARR(PAC/PRC)was 180.21.Additionally,the pooled results showed that ARR(PAC/PRA)had a sensitivity of 0.91(95%CI:0.86-0.95),a specificity of 0.91(95%CI:0.90-0.93),a positive LR of 7.30(95%CI:2.99-17.99),a negative LR of 0.10(95%CI:0.04-0.26),and SAUC of 0.976,respectively.The DOR of ARR(PAC/PRA)was 155.52.Additionally,we conducted a subgroup analysis for the different thresholds(<35 or≥35)of PAC/PRC.The results showed that the DOR of the cut-off≥35 groups was higher than the cut-off<35 groups(DOR=340.15,95%CI:38.32-3019.66;DOR=116.40,95%CI=23.28-581.92).Conclusions:The research results suggest that the determination of ARR(PAC/PRC)and ARR(PAC/PRA)was all effective screening tools for PA.The diagnostic accuracy and diagnostic value of ARR(PAC/PRC)are higher than ARR(PAC/PRA).In addition,within a certain range,the higher the threshold,the better the diagnostic value.
