Improving early diagnosis of multiple endocrine neoplasia type 1 by assessing the gastrointestinal symptoms,hypercalcemia,and elevated serum gastrin

Despite advancements in the field,early diagnosis of multiple endocrine neoplasia type 1(MEN1)remains unachievable.This letter to the editor highlighted the importance of carefully assessing gastrointestinal symptoms,hypercalcemia,and elevated serum gastrin levels,as suggested by Yuan et al in their paper.They focused on a patient with recurrent abdominal pain and diarrhea whose diagnostic path led to establishing a MEN1 diagnosis within a year.This emphasized the need for clinicians to consider MEN1 in patients with similar presentations,particularly when gastrointestinal symptoms persist or recur after discontinuation of proton pump inhibitors,especially knowing that early recognition and intervention are crucial for improving patient outcomes.

Clinical significance of peripheral blood UL16 and DR-70 for the early diagnosis and prognostic evaluation of colorectal cancer

BACKGROUND Early diagnosis of colorectal cancer(CRC)is of great significance to improve the survival rate and quality of life of patients,but early diagnosis of CRC requires more sensitive techniques.Peripheral blood UL16-binding protein 2(ULBP2)and human fibrinogen degradation products(DR-70)are the main indicators for the diagnosis of malignant tumors.AIM To assess ULBP2 and DR-70 potential for the early diagnosis and prognostic evaluation of CRC to provide a reference.METHODS This study involved 60 patients with early-stage CRC(CRC group),50 patients with benign colorectal tumors(benign group),and 50 healthy patients(control group)enrolled at the Affiliated Hospital of Jiangnan University and Jiangsu Province Official Hospital between January,2020 and January,2022.ULBP2 and DR-70 levels in the blood were determined and differences among the three groups and early diagnostic values for CRC were determined.Patients with CRC were divided into the good prognosis and poor prognosis groups,and ULBP2 and DR-70 levels in the blood and diagnostic values were compared.RESULTS ULBP2 and DR-70 serum levels were significantly higher in the CRC group than in the control and benign groups(P<0.05);however,no significant differences were observed between the benign and control groups(P>0.05).Among the 60 patients with CRC followed up for two years,two died(3.33%)and 15 exhibited tumor metastasis,progression,or recurrence(25.00%).ULBP2 and DR-70 serum levels were significantly higher in the poor prognosis group than in the good prognosis group(P<0.05).A receiver operating characteristic curve was plotted.Area under the curve,sensitivity,and specificity of serum ULBP2 with DR-70 for the early diagnosis of CRC were higher than those of the single serum indices(P<0.05)in both the good and poor prognosis groups.CONCLUSION ULBP2 and DR-70 serum levels were significantly high in patients with early-stage CRC.They improved the diagnostic rate of early-stage CRC and predicted patient prognosis,thereby showing clinical application potential.

Early diagnosis of esophageal cancer:How to put“early detection”into effect?

This editorial comments on the article by Qu et al in a recent edition of World Journal of Gastrointestinal Oncology,focusing on the importance of early diagnosis in managing esophageal cancer and strategies for achieving“early detection”.The five-year age-standardized net survival for esophageal cancer patients falls short of expectations.Early detection and accurate diagnosis are critical strategies for improving the treatment outcomes of esophageal cancer.While advancements in endoscopic technology have been significant,there seems to be an excessive emphasis on the latest high-end endoscopic devices and various endoscopic resection techniques.Therefore,it is imperative to redirect focus towards proactive early detection strategies for esophageal cancer,investigate the most cost-effective screening methods suitable for different regions,and persistently explore practical solutions to improve the five-year survival rate of patients with esophageal cancer.

Early diagnosis of pancreatic cancer: Shedding light on an unresolved challenge

Diagnosing early-stage pancreatic cancer(PC)remains a clinical challenge.Hence,studying novel imaging aspects that could enhance the diagnostic accuracy of malignant pancreatic precursor lesions is imperative.This article aims to un-derscore the promising role of emerging imaging aspects that may facilitate the earlier diagnosis of PC,thereby improving its management and prognosis.

Early diagnosis of renal pelvis villous adenoma:A case report

BACKGROUND Villous adenoma is a rare tumor in the urinary system that usually occurs in the bladder.It is extremely uncommon in the renal pelvis.Most of the previously reported cases have been diagnosed with severe hydronephrosis associated with renal parenchyma atrophy prior to surgery.Because of its rarity,available information on the pathogenesis,diagnosis,treatment and prognosis of the disease is limited.We reported a case of kidney stones with hydronephrosis.During percutaneous nephroscopic lithotripsy,a renal pelvis tumor was found.Biopsy confirmed that the tumor was a villous adenoma of the renal pelvis.CASE SUMMARY A 68-year-old female was admitted to the hospital due to right kidney stones with right hydronephrosis.After admission,a urinary system plain computed tomography scan was performed,which revealed right kidney stones with right hydronephrosis and right upper ureteral dilatation.Multiple new cauliflower-like papillary masses were then discovered in the renal pelvis and calyces during right percutaneous nephroscopic lithotripsy.Biopsy results indicated villous adenoma with high-grade glandular intraepithelial neoplasia.The patient underwent laparoscopic radical resection of the right kidney and ureter.Based on histopathological and immunohistochemical examination,the patient was diagnosed with villous adenoma without adenocarcinoma.CONCLUSION Villous adenoma is rare in the urinary system.We reported a case of renal pelvis villous adenoma,which may provide useful information for the early diagnosis and treatment of this tumor.

Application of surface-enhanced laser desorption/ionization time-of-flight-based serum proteomic array technique for the early diagnosis of prostate cancer

Aim： To identify the serum biomarkers of prostate cancer （PCa） by protein chip and bioinformatics. Methods： Serum samples from 83 PCa patients and 95 healthy men were taken from a mass screening in Changchun, China. Protein profiling was carried out using surface-enhanced laser desorption/ionization time-of-flight mass spectrometry （SELDI-TOF MS）. The data of spectra were analyzed using two bioinformatics tools. Results： Eighteen serum differential proteins were identified in the PCa group compared with the control group （P 〈 0.01）. There were four proteins at the higher serum level and 14 proteins at the lower serum level in the PCa group. A decision tree classification algorithm that used an eight-protein mass pattern was developed to correctly classify the samples. A sensitivity of 92.0 % and a specificity of 96.7 % for the study group were obtained by comparing the PCa and control groups. Conclusion： We identified new serum biomarkers of PCa. SELDI-TOF MS coupled with a decision tree classification algorithm will provide a highly accurate and innovative approach for the early diagnosis of PCa. （Asian J Androl 2006 Jan; 8： 45-51）

Early diagnosis and prediction of severity in acute pancreatitis using the urine trypsinogen-2 dipstick test:A prospective study

AIM： To evaluate the use of the trypsinogen-2 dipstick （Actim Pancreatitis） test for early diagnosis and prediction of severity in acute pancreatitis （AP）. METHODS： Ninety-two patients with AP were included in this study. The control group was 25 patients who had acute abdominal pain from non-pancreatic causes. Urine trypsinogen-2 dipstick test （UTDT） and conventional diagnostic tests were performed in all patients. Patients were divided by the Atlanta classification into two groups as having mild or severe pancreatitis. RESULTS： UTDT was positive in 87 （94.6%） of the AP patients and in two （8%） controls （P 〈 0.05）. Positive UTDT was found in 61 （92.4%） of 66 （71.7%） patients with mild pancreatitis and in all （100%） of the 26 （28.3%） with severe pancreatitis （P 〉 0.05）. UTDT positivity lasted longer in severe pancreatitis compared with that in mild pancreatitis （6.2 ＋ 2.5 d vs 2.0 ＋ 1.43 d, P 〈 0.05）. The sensitivity, specificity, positive predictive value, negative predictive value （NPV）, positive likelihood ratio （PLR） and negative likelihood ratio （NLR） of UTDT were 91%, 72%, 96.6%, 70.4%, 3.4 and 0.1, respectively. CONCLUSION： UTDT is a simple, rapid and reliable method for use on admission. It has high specificity and low NLR for early diagnosis and prediction of severity in AP. However, its relatively low NPV does not allow trypsinogen-2 dipstick test to be a stand-alone tool for diagnosis of acute pancreatitis; the use of other conventional diagnostic tools remains a requirement.

Advances in early diagnosis and therapy of pancreatic cancer

BACKGROUND: Pancreatic cancer remains a devastating disease with a 5-year survival rate of less than 5%. Recent advances in diagnostic methods and therapeutic approaches have increased the possibility of improving the existing poor prognosis. DATA SOURCES: English-language articles reporting early diagnosis and therapy of pancreatic cancer were searched from the MEDLINE and PubMed databases, Chinese-language articles were from CHKD (China Hospital Knowledge Database) RESULT: The current literature about pancreatic cancer was reviewed from three aspects: statistics, screening and early detection, and therapy. CONCLUSIONS: Early detection and screening of pancreatic cancer currently should be limited to high risk patients Surgical resection is the only curative approach available, with some recent improvement in outcomes. Gemcitabine has been a standard treatment during the last decade. Gemcitabine based combination treatment, especially combined with newer molecular targeted agents, is promising. The rationale for radiotherapy is controversial, but with the recent development of modern radiation delivery techniques, radiotherapy should be intensified. Patients with borderline pancreatic cancer could benefit from neoadjuvant therapy but more evidence is needed and the best neoadjuvant regimen is still to be determined.

Gastrointestinal polyposis with esophageal polyposis is useful for early diagnosis of Cowden's disease

Cowden's disease, one of the several hamartoma syndromes, is characterized by hyperplastic lesions and hamartomas distributed in the whole body. About thirty percent of patients with Cowden's disease have been reported to be complicated by malignant tumors. Based on the criteria of the International Cowden Consortium, this disease is mainly diagnosed as trichilemmoma of the face and oral mucosal papillomatosis. However, Cowden's disease patients themselves often do not recognize trichilemmoma of the face and oral mucosal papillomatosis. We report a case of Cowden's disease in a 33-year-old female patient who was diagnosed based on the characteristic findings at gastrointestinal endoscopy. Clinically, the patient was aware of having bloody stools. Multiple polyps found endoscopically in the esophagus, stomach, ileum, colon and rectum showed histopathologically hamartomatous changes and epithelial hyperplasia. Physical examination revealed oral papillomatosis and facial trichilemmomas. A germline mutation in exon 8 of the phosphatase and tensin homolog deleted on chromosome ten (PTEN) gene was found in this case. It was a point mutation of C to T at codon 1003 (CGA→TGA, arginine→stop codon). The characteristic findings on gastrointestinal endoscopy led us to a diagnosis of Cowden's disease. It has been reported that gastrointestinal polyposis with esophageal polyposis is found in about 85.7% of Japanese patients with Cowden's disease. The characteristic findings on gastrointestinal endoscopy can be a useful diagnostic clue to Cowden's disease.

Improved early diagnosis of cystadenocarcinoma of the pancreas

BACKGROUND: Cystadenocarcinoma of the pancreas is insensitive to radiotherapy and chemotherapy, and surgery is at present the definitive treatment. Early and accurate diagnosis of cystadenocarcinoma is crucial for increasing the five-year survival rate and the resectable rate. There is no definitive and effective method of early diagnosis of cystadenocarcinoma of the pancreas in China and other countries. METHODS: We compared endoscopic ultrasonography-guided (EUS-guided) fine needle aspiration biopsy combined with cyst fluid carcinoembryonic antigen (CEA), CA19-9 examination with computed tomography (CT), B-ultrasonography (B-US) and serum CEA and CA19-9, to explore methods of early diagnosis of cystadenocarcinoma of the pancreas. Retrospective analysis was made on the clinical data of 126 cases of benign pancreatic lesion (90 cases) and cystadenocarcinoma (36). RESULTS: The sensitivity of B-US and CT for cystadenocarcinoma was 52.8% and 77.8%, while the specificity was 78.9% and 86.7%, respectively. When measurement of CEA and CA19-9 of cyst fluid was combined with EUS-guided fine needle aspiration biopsy, the sensitivity was 94.4%, higher than that of B-US and CT (P<0.05). The sensitivity of cyst fluid CEA, CA19-9 examinations was considerably higher than that of serum CEA, CA19-9 (P<0.05). Upper gastrointestinal barium meal and endoscopic retrograde cholangiopancreatography (ERCP) had low sensitivity and specificity. CONCLUSIONS: EUS-guided fine needle aspiration biopsy combined with examination of cyst fluid CEA, CA19-9 is a credible means for early diagnosis of cystadenocarcinoma of the pancreas. B-US, CT and serum CEA, CA19-9 measurements are in common use, their findings are also very important.

Early diagnosis of pancreatic cancer:What strategies to avoid a foretold catastrophe

While great strides in improving survival rates have been made for most cancers in recent years,pancreatic ductal adenocarcinoma(PDAC)remains one of the solid tumors with the worst prognosis.PDAC mortality often overlaps with incidence.Surgical resection is the only potentially curative treatment,but it can be performed in a very limited number of cases.In order to improve the prognosis of PDAC,there are ideally two possible ways:the discovery of new strategies or drugs that will make it possible to treat the tumor more successfully or an earlier diagnosis that will allow patients to be operated on at a less advanced stage.The aim of this review was to summarize all the possible strategies available today for the early diagnosis of PDAC and the paths that research needs to take to make this goal ever closer.All the most recent studies on risk factors and screening modalities,new laboratory tests including liquid biopsy,new imaging methods and possible applications of artificial intelligence and machine learning were reviewed and commented on.Unfortunately,in 2022 the results for this type of cancer still remain discouraging,while a catastrophic increase in cases is expected in the coming years.The article was also written with the aim of highlighting the urgency of devoting more attention and resources to this pathology in order to reach a solution that seems more and more unreachable every day.

GEAR CRACK EARLY DIAGNOSIS USING BISPECTRUM DIAGONAL SLICE

A study of bispectral analysis in gearbox condition monitoring is presented.The theory of bispectrum and quadratic phase coupling (QPC) is first introduced, and then equationsfor computing bispectrum slices are obtained. To meet the needs of online monitoring, a simplifiedmethod of computing bispectrum diagonal slice is adopted. Industrial gearbox vibration signalsmeasured from normal and tooth cracked conditions are analyzed using the above method. Experimentsresults indicate that bispectrum can effectively suppress the additive Gaussian noise andchracterize the QPC phenomenon. It is also shown that the 1-D bispectrum diagonal slice can capturethe non-Gaussian and nonlinear feature of gearbox vibration when crack occurred, hence, this methodcan be employed to gearbox real time monitoring and early diagnosis.

Comparison of plasma microRNA-1 and cardiac troponin T in early diagnosis of patients with acute myocardial infarction

BACKGROUND:Early reperfusion can effectively treat acute myocardial infarction(AMI) and reduce the mortality signif icantly. This study aimed to compare the role of plasma microRNA-1(miR-1) and cardiac troponin T(cTnT) in early diagnosis of AMI patients.METHODS:From May 2011 to May 2012,plasma samples were collected from 56 AMI patients and 28 non-AMI controls. The expression of plasma miR-1 was measured by quantitative reverse transcription-polymerase chain reaction(qRT-PCR),and the level of plasma cTnT was measured using electrochemiluminescence-based methods on an Elecsys 2010 Immunoassay Analyzer. SPSS 16.0 was used for the statistical analysis of the results. Data were expressed as mean±standard deviation unless otherwise described. The differences about clinical characteristics between the AMI patients and controls were tested using Student's t test or Fisher's exact test. The Mann-Whitney U test was conducted to compare the expression of microRNAs between the AMI patients and controls. MicroRNAs expression between different intervals of the AMI patients was compared using Wilcoxon's signed-rank test. The receiver operating characteristic(ROC) curve was established to discriminate the AMI patients from the controls.RESULTS:In the present study,the expression of plasma miR-1 was signifi cantly increased in the AMI patients compared with the healthy controls(P<0.01). The plasma miR-1 in the AMI patients decreased to the normal level at 14 days(P>0.05). The expression of plasma miR-1 was not related to the clinical characteristics of the study population(P>0.05). ROC curve analyses demonstrated that miR-1 was specifi c and sensitive for the early diagnosis of AMI,but not superior to cTnT.CONCLUSION:Plasma miR-1 could be used in the early diagnosis of AMI,but it is similar to cTnT.

Application of empirical mode decomposition in early diagnosis of magnetic memory signal

In order to eliminate noise interference of metal magnetic memory signal in early diagnosis of stress concentration zones and metal defects, the empirical mode decomposition method combined with the magnetic field gradient characteristic was proposed. A compressive force periodically acting upon a casing pipe led to appreciable deformation, and magnetic signals were measured by a magnetic indicator TSC-1M-4. The raw magnetic memory signal was first decomposed into different intrinsic mode functions and a residue, and the magnetic field gradient distribution of the subsequent reconstructed signal was obtained. The experimental results show that the gradient around 350 mm represents the maximum value ignoring the marginal effect, and there is a good correlation between the real maximum field gradient and the stress concentration zone. The wavelet transform associated with envelop analysis also exhibits this gradient characteristic, indicating that the proposed method is effective for early identifying critical zones.

Early Diagnosis of Epithelial Ovarian Cancer with cDNA Microarry

Objective： To investigate the roles of tumor suppressor genes- PTEN, nm23H1, VEGF165, Tiaml, MMP-2, Timp2, HE4 and S 100A4 in tumorigenesis and progression of epithelial ovarian cancer（EOC） and develop a novel method for the early diagnosis of EOC. Methods： We observed the different expression profiles of those genes in normal ovary（n=5） and ovarian cancer tissue （n=20） by cDNA microarray. Results： In EOC, PTEN, Timp2 and nm23Hl genes were down-regulated （CY-3/CY-5〈0.5）, compared with the normal ovary, whereas Tiaml, VEGFI65, MMP-2, HE4 and S100A4 genes were up-regulated （CY-3/CY-5〉2.0）. Among them, HE4 gene was remarkably elevated （CY-3/CY-5〉5.0）. Their expression was correlated with clinicopathological staging of EOC（P〈0.01）. Conclusion： Those genes are closely linked to the pathogenesis and progression of EOC. cDNA microarray is an effective technique to screen molecular biological markers and predict the metastastic potential of EOC in early diagnosis.

Lactation mastitis: Promising alternative indicators for early diagnosis

Although lactation mastitis(LM)has been extensively researched,the incidence rate of LM remains a salient clinical problem.To reduce this incidence rate and achieve a better prognosis,early and specific quantitative indicators are particularly important.It has been found that milk electrolyte concentrations(chloride,potassium,and sodium)and electrical conductivity(EC)significantly change in the early stages of LM in an animal model.Several studies have evaluated EC for the detection of subclinical mastitis in cows.EC,chloride,and sodium content of milk were more accurate for predicting infection status than were other variables.In the early stages of LM,lactic sodium,chloride,and EC increase,but potassium decreases.However,these indicators have not been reported in the diagnosis of LM in humans.This review summarizes the pathogenesis and the mechanism of LM in terms of milk electrolyte concentration and EC,and aim to provide new ideas for the detection of sub-clinical mastitis in humans.

Role of ranulas in early diagnosis of Sjögren’s syndrome: A case report

BACKGROUND Although the presentations of Sjögren’s syndrome(SS)are variable,ranging from mild dryness to wider systemic involvement,ranulas as early clinical signs were scarcely reported.Here,we present an adult patient with SS,who developed a unilateral simple ranula and was diagnosed primary SS 3 years later.We also provide a review of cases of SS and ranulas from 1980 to 2020.CASE SUMMARY A 22-year-old girl was found to have a left painless floor-of-mouth lesion 3 years ago,without obvious trauma or inducement.The diagnosis of a unilateral(left)simple ranula was made,and the ranula was surgically treated.Within 3 years after the ranula surgery,she developed acute lymphadenectasis in unilateral parotid twice without inducement,and ultrasonic examination revealed diffuse lesions in bilateral parotids and submandibular glands,which strongly suggested SS.Serologic tests and the unstimulated whole saliva flow rate confirmed the SS diagnosis.CONCLUSION Our study underlines that ranulas are early clinical signs of SS.As early diagnosis and early intervention of SS are important to obtain better outcomes,our findings underline the need for histopathological test after sublingual adenectomy and imaging detection of exocrine glands for the patients with ranulas.

Early Diagnosis of Keratoconus with Orbscan-ⅡAnterior System

Orbscan- anterior system was used for early diagnosis of keratoconus.4 8Eyes of 2 4 patients with suspicious keratoconus were examined by Orbscan- anterior system from Dec. 1999to Dec. 2 0 0 0 and followed up.The values of Diff and anterior chamber depth (ACD) were recorded.Results indicated that values of Diff and ACD were increased in4 eyes of2 patients with keratoconus trend during follow- up.Taking advantage of Orbscan- anterior system to observe the values of Diff and ACD can early diagnose the sub- clinical keratoconus.The values of Diff and ACD can sensitively report the progression of keratoconus.

Early diagnosis and bioimaging of lung adenocarcinoma cells/organs based on spectroscopy machine learning

Early diagnosis and fast detection with a high accuracy rate of lung cancer are important to improve the treatment effect.In this research,an early fast diagnosis and in vivo imaging method for lung adenocarcinoma are proposed by collecting the spectral data from normal and patients'cells/tissues,such as Fourier infrared spectroscopy(FTIR),UV-vis absorbance,and fluorescence spectra using anthocyanin.The FTIR spectra of human normal lung epithelial cells(BEAS-2B cells)and human lung adenocarcinoma cells(A549 cells)were collected.After the data is cleaned,a feature selection algorithm is used to select important wavelengths,and then,the classification models of support vector machine(SVM)and the grid search method are used to select the optimal model parameters(accuracy:96.89%on the training set and 88.57%on the test set).The optimal model is used to classify all samples,and the accuracy is 94.37%.Moreover,the anthocyanin was prepared and used for the intracellular absorbance and fluorescence,and the optimized algorithm was used for classification(accuracy:91.38%on the training set and 80.77%on the test set).Most importantly,the in vivo cancer imaging can be performed using anthocyanin.The results show that there are differences between lung ade-nocarcinoma and normal lung tissues at the molecular level,reflecting the accuracy,intui-tiveness,and feasibility of this algorithm-assistant anthocyanin imaging in lung cancer diagnosis,thus showing the potential to become an accurate and effective technical means for basic research and clinical diagnosis.

Early diagnosis of primary gallbladder carcinoma

Objective: To improve early diagnosis of primary gallbladder carcinoma (PGC) and the understanding of its pathogenesis, pathological stages and progno- sis. Methods: The data from 679 patients with PGC trea- ted in our hospital from 1956 to 1998 were analyzed retrospectively. Results: The incidence of PGC has been increasing in recent years, and the treatment is not satisfactory. Upon diagnosis, most patients with PGC were at ad- vanced stage. PGC was usually found in elderly women. The ratio of man to woman was 1:3. The gallstone, closely related to PGC, was found in 60% of the patients with PGC. The diagnostic accordance rate before and after operation was Iow. In most pa- tients, PGC was found unexpectedly during opera- tion for gallstone or acute cholecystitis. Many pa- tients with PGC missed the opportunity of diagnosis and therapy because doctor only noticed the diagnosis of gallstone. Pathological classification revealed that PGC in most patients (84.4%) were adenocarcino- ma. Imaging helped to find early-stage cases and im- prove prognosis. Conclusions: Understanding of pathogenesis, patho- logical stages and prognosis of PGC and proper use of various examinations are essential to the early di- agnosis and treatment of the disease.