Given the rapid changes in social structure(urbanization),economic structure(industrialization),and demographic structure(population aging)in China,cancer has become a major public health problem1.Extensive evidence h...Given the rapid changes in social structure(urbanization),economic structure(industrialization),and demographic structure(population aging)in China,cancer has become a major public health problem1.Extensive evidence has indicated that screening can decrease cancer mortality,particularly among high-risk groups,and several representative national and regional cancer screening programs have been launched in China to cope with the increasing burden of cancer.展开更多
Objective: European lung cancer screening studies using computed tomography(CT) have shown that a management protocol based on measuring lung nodule volume and volume doubling time(VDT) is more specific for early lung...Objective: European lung cancer screening studies using computed tomography(CT) have shown that a management protocol based on measuring lung nodule volume and volume doubling time(VDT) is more specific for early lung cancer detection than a diameter-based protocol. However, whether this also applies to a Chinese population is unclear. The aim of this study is to compare the diagnostic performance of a volume-based protocol with a diameter-based protocol for lung cancer detection and optimize the nodule management criteria for a Chinese population.Methods: This study has a population-based, prospective cohort design and includes 4000 participants from the Hexi district of Tianjin, China. Participants will undergo low-dose chest CT at baseline and after 1 year. Initially, detected lung nodules will be evaluated for diameter and managed according to a routine diameter-based protocol(Clinical Practice Guideline in Oncology for Lung Cancer Screening, Version 2.2018). Subsequently, lung nodules will be evaluated for volume and management will be simulated according to a volume-based protocol and VDT(a European lung nodule management protocol). Participants will be followed up for 4 years to evaluate lung cancer incidence and mortality. The primary outcome is the diagnostic performance of the European volume-based protocol compared to diameter-based management regarding lung nodules detected using low-dose CT.Results: The diagnostic performance of volume-and diameter-based management for lung nodules in a Chinese population will be estimated and compared.Conclusions: Through the study, we expect to improve the management of lung nodules and early detection of lung cancer in Chinese populations.展开更多
Objective： To identify the differences among preinvasive lesions, minimally invasive adenocarcinomas （MIAs）and invasive pulmonary adenocarcinomas （IPAs） based on radiomic feature analysis with computed tomography...Objective： To identify the differences among preinvasive lesions, minimally invasive adenocarcinomas （MIAs）and invasive pulmonary adenocarcinomas （IPAs） based on radiomic feature analysis with computed tomography（CT）.Methods： A total of 109 patients with ground-glass opacity lesions （GGOs） in the lungs determined by CTexaminations were enrolled, all of whom had received a pathologic diagnosis. After the manual delineation andsegmentation of the GGOs as regions of interest （ROIs）, the patients were subdivided into three groups based onpathologic analyses： the preinvasive lesions （including atypical adenomatous hyperplasia and adenocarcinoma insitu） subgroup, the MIA subgroup and the IPA subgroup. Next, we obtained the texture features of the GGOs. Thedata analysis was aimed at finding both the differences between each pair of the groups and predictors to distinguishany two pathologic subtypes using logistic regression. Finally, a receiver operating characteristic （ROC） curve wasapplied to accurately evaluate the performances of the regression models.Results： We found that the voxel count feature （P〈0.001） could be used as a predictor for distinguishing IPAsfrom preinvasive lesions. However, the surface area feature （P=0.040） and the extruded surface area feature（P=0.013） could be predictors of IPAs compared with MIAs. In addition, the correlation feature （P=0.046） coulddistinguish preinvasive lesions from MIAs better.Conclusions： Preinvasive lesions, MIAs and IPAs can be discriminated based on texture features within CTimages, although the three diseases could all appear as GGOs on CT images. The diagnoses of these three diseasesare very important for clinical surgery.展开更多
Objectives:To evaluate the characteristics and work-up of small to intermediate-sized pulmonary nodules in a Chinese dedicated cancer hospital.Methods:Patients with pulmonary nodules 4–25 mm in diameter detected via ...Objectives:To evaluate the characteristics and work-up of small to intermediate-sized pulmonary nodules in a Chinese dedicated cancer hospital.Methods:Patients with pulmonary nodules 4–25 mm in diameter detected via computed tomography(CT)in 2013 were consecutively included.The analysis was restricted to patients with a histological nodule diagnosis or a 2-year follow-up period without nodule growth confirming benign disease.Patient information was collected from hospital records.Results:Among the 314 nodules examined in 299 patients,212(67.5%)nodules in 206(68.9%)patients were malignant.Compared to benign nodules,malignant nodules were larger(18.0 mm vs.12.5 mm,P<0.001),more often partly solid(16.0%vs.4.7%,P<0.001)and more often spiculated(72.2%vs.41.2%,P<0.001),with higher density in contrast-enhanced CT(67.0 HU vs.57.5 HU,P=0.015).Final diagnosis was based on surgery in 232 out of 314(73.9%)nodules,166 of which were identified as malignant[30(18.1%)stage III or IV]and 66 as benign.In 36 nodules(11.5%),diagnosis was confirmed by biopsy and the remainder verified based on stability of nodule size at follow-up imaging(n=46,14.6%).Among 65 nodules subjected to gene(EGFR)mutation analyses,28(43.1%)cases(EGFR19 n=13;EGFR21 n=15)were identified as EGFR mutant and 37(56.9%)as EGFR wild-type.Prior to surgery,the majority of patients[n=194(83.6%)]received a contrast-enhanced CT scan for staging of both malignant[n=140(84.3%)]and benign[n=54(81.8%)]nodules.Usage of positron emission tomography(PET)-CT was relatively uncommon[n=38(16.4%)].Conclusions:CT-derived nodule assessment assists in diagnosis of small to intermediate-sized malignant pulmonary nodules.Currently,contrast-enhanced CT is commonly used as the sole diagnostic confirmation technique for pre-surgical staging,often resulting in surgery for late-stage disease and unnecessary surgery in cases of benign nodules.展开更多
OBJECTIVE To investigate the value of CT colonography (CTC) in diagnosis and preoperative staging of colorectal carcinoma. METHODS CTC was performed on 33 patients who were suspected of having colorectal carcinoma. Th...OBJECTIVE To investigate the value of CT colonography (CTC) in diagnosis and preoperative staging of colorectal carcinoma. METHODS CTC was performed on 33 patients who were suspected of having colorectal carcinoma. The results of CTC were compared with those of a pathological examination. RESULTS Among the 22 patients who were diagnosed with colorectal carcinoma by CTC, 20 cases were confirmed by pathology. The diagnostic sensitivity and specificity were 100% (20/20) and 84.6% (11/13) respec- tively. The accuracy of showing carcinoma pathologic patterns was 90% (18/20). The sensitivity and specificity were both 100% in the mass type; 77.8% and 100% in the infiltrating type; 100% and 85.7% in the ulcerated type. The accuracy of staging Dukes' carcinoma was 75%. The sensitiv- ity and specificity were 100% and 94.1% for Dukes'A; 80% and 73.3% for Dukes' B; 60% and 100% in Dukes' C; 71.4% and 100% for Dukes' D. CONCLUSION CTC produces a high success rate and provides con- siderable diagnostic information for both an accurate diagnosis of colorectal carcinoma and staging before operation.展开更多
基金supported by grants from the National Key Research and Development Program of China(Grant No.2021YFC2500400)the National Natural Science Foundation of China(Grant Nos.81974439&82204121)+2 种基金the Beijing-Tianjin-Hebei Basic Research Cooperation Special Project(20JCZXJC00090)the Tianjin Health Committee Foundation(Grant No.TJWJ2021MS008)the Tianjin Key Medical Discipline(Specialty)Construction Project(Grant No.TJYXZDXK-009A).
文摘Given the rapid changes in social structure(urbanization),economic structure(industrialization),and demographic structure(population aging)in China,cancer has become a major public health problem1.Extensive evidence has indicated that screening can decrease cancer mortality,particularly among high-risk groups,and several representative national and regional cancer screening programs have been launched in China to cope with the increasing burden of cancer.
基金a part of NELCIN-B3 project. The NELCIN-B3 project is funded by The Royal Netherlands Academy of Arts and Sciences (Grant No. PSA_SA_BD_01)Ministry of Science and Technology of the People’s Republic of China+1 种基金National Key R & D Program of China (Grant No. 2016YFE0103000)the financial support from China Scholarship Council (CSC file No. 201708340072)
文摘Objective: European lung cancer screening studies using computed tomography(CT) have shown that a management protocol based on measuring lung nodule volume and volume doubling time(VDT) is more specific for early lung cancer detection than a diameter-based protocol. However, whether this also applies to a Chinese population is unclear. The aim of this study is to compare the diagnostic performance of a volume-based protocol with a diameter-based protocol for lung cancer detection and optimize the nodule management criteria for a Chinese population.Methods: This study has a population-based, prospective cohort design and includes 4000 participants from the Hexi district of Tianjin, China. Participants will undergo low-dose chest CT at baseline and after 1 year. Initially, detected lung nodules will be evaluated for diameter and managed according to a routine diameter-based protocol(Clinical Practice Guideline in Oncology for Lung Cancer Screening, Version 2.2018). Subsequently, lung nodules will be evaluated for volume and management will be simulated according to a volume-based protocol and VDT(a European lung nodule management protocol). Participants will be followed up for 4 years to evaluate lung cancer incidence and mortality. The primary outcome is the diagnostic performance of the European volume-based protocol compared to diameter-based management regarding lung nodules detected using low-dose CT.Results: The diagnostic performance of volume-and diameter-based management for lung nodules in a Chinese population will be estimated and compared.Conclusions: Through the study, we expect to improve the management of lung nodules and early detection of lung cancer in Chinese populations.
基金supported by the Special Fund of Pharmacy, Radiology and Ecsomatics of Tianjin Medical University Cancer Institute & Hospital (No. Y1507)
文摘Objective： To identify the differences among preinvasive lesions, minimally invasive adenocarcinomas （MIAs）and invasive pulmonary adenocarcinomas （IPAs） based on radiomic feature analysis with computed tomography（CT）.Methods： A total of 109 patients with ground-glass opacity lesions （GGOs） in the lungs determined by CTexaminations were enrolled, all of whom had received a pathologic diagnosis. After the manual delineation andsegmentation of the GGOs as regions of interest （ROIs）, the patients were subdivided into three groups based onpathologic analyses： the preinvasive lesions （including atypical adenomatous hyperplasia and adenocarcinoma insitu） subgroup, the MIA subgroup and the IPA subgroup. Next, we obtained the texture features of the GGOs. Thedata analysis was aimed at finding both the differences between each pair of the groups and predictors to distinguishany two pathologic subtypes using logistic regression. Finally, a receiver operating characteristic （ROC） curve wasapplied to accurately evaluate the performances of the regression models.Results： We found that the voxel count feature （P〈0.001） could be used as a predictor for distinguishing IPAsfrom preinvasive lesions. However, the surface area feature （P=0.040） and the extruded surface area feature（P=0.013） could be predictors of IPAs compared with MIAs. In addition, the correlation feature （P=0.046） coulddistinguish preinvasive lesions from MIAs better.Conclusions： Preinvasive lesions, MIAs and IPAs can be discriminated based on texture features within CTimages, although the three diseases could all appear as GGOs on CT images. The diagnoses of these three diseasesare very important for clinical surgery.
基金supported by a grant from the Royal Netherlands Academy of Arts and Sciences(Grant No.PSA_SA_BD_01)Ministry of Science and Technology of the People’s Republic of China,National Key R&D Program of China(Grant No.2016YFE0103000)。
文摘Objectives:To evaluate the characteristics and work-up of small to intermediate-sized pulmonary nodules in a Chinese dedicated cancer hospital.Methods:Patients with pulmonary nodules 4–25 mm in diameter detected via computed tomography(CT)in 2013 were consecutively included.The analysis was restricted to patients with a histological nodule diagnosis or a 2-year follow-up period without nodule growth confirming benign disease.Patient information was collected from hospital records.Results:Among the 314 nodules examined in 299 patients,212(67.5%)nodules in 206(68.9%)patients were malignant.Compared to benign nodules,malignant nodules were larger(18.0 mm vs.12.5 mm,P<0.001),more often partly solid(16.0%vs.4.7%,P<0.001)and more often spiculated(72.2%vs.41.2%,P<0.001),with higher density in contrast-enhanced CT(67.0 HU vs.57.5 HU,P=0.015).Final diagnosis was based on surgery in 232 out of 314(73.9%)nodules,166 of which were identified as malignant[30(18.1%)stage III or IV]and 66 as benign.In 36 nodules(11.5%),diagnosis was confirmed by biopsy and the remainder verified based on stability of nodule size at follow-up imaging(n=46,14.6%).Among 65 nodules subjected to gene(EGFR)mutation analyses,28(43.1%)cases(EGFR19 n=13;EGFR21 n=15)were identified as EGFR mutant and 37(56.9%)as EGFR wild-type.Prior to surgery,the majority of patients[n=194(83.6%)]received a contrast-enhanced CT scan for staging of both malignant[n=140(84.3%)]and benign[n=54(81.8%)]nodules.Usage of positron emission tomography(PET)-CT was relatively uncommon[n=38(16.4%)].Conclusions:CT-derived nodule assessment assists in diagnosis of small to intermediate-sized malignant pulmonary nodules.Currently,contrast-enhanced CT is commonly used as the sole diagnostic confirmation technique for pre-surgical staging,often resulting in surgery for late-stage disease and unnecessary surgery in cases of benign nodules.
文摘OBJECTIVE To investigate the value of CT colonography (CTC) in diagnosis and preoperative staging of colorectal carcinoma. METHODS CTC was performed on 33 patients who were suspected of having colorectal carcinoma. The results of CTC were compared with those of a pathological examination. RESULTS Among the 22 patients who were diagnosed with colorectal carcinoma by CTC, 20 cases were confirmed by pathology. The diagnostic sensitivity and specificity were 100% (20/20) and 84.6% (11/13) respec- tively. The accuracy of showing carcinoma pathologic patterns was 90% (18/20). The sensitivity and specificity were both 100% in the mass type; 77.8% and 100% in the infiltrating type; 100% and 85.7% in the ulcerated type. The accuracy of staging Dukes' carcinoma was 75%. The sensitiv- ity and specificity were 100% and 94.1% for Dukes'A; 80% and 73.3% for Dukes' B; 60% and 100% in Dukes' C; 71.4% and 100% for Dukes' D. CONCLUSION CTC produces a high success rate and provides con- siderable diagnostic information for both an accurate diagnosis of colorectal carcinoma and staging before operation.
