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Nomogram prediction of vessels encapsulating tumor clusters in small hepatocellular carcinoma≤3 cm based on enhanced magnetic resonance imaging
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作者 Hui-Lin Chen Rui-Lin He +5 位作者 Meng-Ting Gu Xing-Yu Zhao Kai-Rong Song Wen-Jie Zou Ning-Yang Jia Wan-Min Liu 《World Journal of Gastrointestinal Oncology》 SCIE 2024年第5期1808-1820,共13页
BACKGROUND Vessels encapsulating tumor clusters(VETC)represent a recently discovered vascular pattern associated with novel metastasis mechanisms in hepatocellular carcinoma(HCC).However,it seems that no one have focu... BACKGROUND Vessels encapsulating tumor clusters(VETC)represent a recently discovered vascular pattern associated with novel metastasis mechanisms in hepatocellular carcinoma(HCC).However,it seems that no one have focused on predicting VETC status in small HCC(sHCC).This study aimed to develop a new nomogram for predicting VETC positivity using preoperative clinical data and image features in sHCC(≤3 cm)patients.AIM To construct a nomogram that combines preoperative clinical parameters and image features to predict patterns of VETC and evaluate the prognosis of sHCC patients.METHODS A total of 309 patients with sHCC,who underwent segmental resection and had their VETC status confirmed,were included in the study.These patients were recruited from three different hospitals:Hospital 1 contributed 177 patients for the training set,Hospital 2 provided 78 patients for the test set,and Hospital 3 provided 54 patients for the validation set.Independent predictors of VETC were identified through univariate and multivariate logistic analyses.These independent predictors were then used to construct a VETC prediction model for sHCC.The model’s performance was evaluated using the area under the curve(AUC),calibration curve,and clinical decision curve.Additionally,Kaplan-Meier survival analysis was performed to confirm whether the predicted VETC status by the model is associated with early recurrence,just as it is with the actual VETC status and early recurrence.RESULTS Alpha-fetoprotein_lg10,carbohydrate antigen 199,irregular shape,non-smooth margin,and arterial peritumoral enhancement were identified as independent predictors of VETC.The model incorporating these predictors demonstrated strong predictive performance.The AUC was 0.811 for the training set,0.800 for the test set,and 0.791 for the validation set.The calibration curve indicated that the predicted probability was consistent with the actual VETC status in all three sets.Furthermore,the decision curve analysis demonstrated the clinical benefits of our model for patients with sHCC.Finally,early recurrence was more likely to occur in the VETC-positive group compared to the VETC-negative group,regardless of whether considering the actual or predicted VETC status.CONCLUSION Our novel prediction model demonstrates strong performance in predicting VETC positivity in sHCC(≤3 cm)patients,and it holds potential for predicting early recurrence.This model equips clinicians with valuable information to make informed clinical treatment decisions. 展开更多
关键词 Small hepatocellular carcinoma vessels encapsulating tumor clusters NOMOGRAM Magnetic resonance imaging MULTICENTER
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Preoperatively predicting vessels encapsulating tumor clusters in hepatocellular carcinoma:Machine learning model based on contrast-enhanced computed tomography
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作者 Chao Zhang Hai Zhong +3 位作者 Fang Zhao Zhen-Yu Ma Zheng-Jun Dai Guo-Dong Pang 《World Journal of Gastrointestinal Oncology》 SCIE 2024年第3期857-874,共18页
BACKGROUND Recently,vessels encapsulating tumor clusters(VETC)was considered as a distinct pattern of tumor vascularization which can primarily facilitate the entry of the whole tumor cluster into the bloodstream in a... BACKGROUND Recently,vessels encapsulating tumor clusters(VETC)was considered as a distinct pattern of tumor vascularization which can primarily facilitate the entry of the whole tumor cluster into the bloodstream in an invasion independent manner,and was regarded as an independent risk factor for poor prognosis in hepatocellular carcinoma(HCC).AIM To develop and validate a preoperative nomogram using contrast-enhanced computed tomography(CECT)to predict the presence of VETC+in HCC.METHODS We retrospectively evaluated 190 patients with pathologically confirmed HCC who underwent CECT scanning and immunochemical staining for cluster of differentiation 34 at two medical centers.Radiomics analysis was conducted on intratumoral and peritumoral regions in the portal vein phase.Radiomics features,essential for identifying VETC+HCC,were extracted and utilized to develop a radiomics model using machine learning algorithms in the training set.The model’s performance was validated on two separate test sets.Receiver operating characteristic(ROC)analysis was employed to compare the identified performance of three models in predicting the VETC status of HCC on both training and test sets.The most predictive model was then used to constructed a radiomics nomogram that integrated the independent clinical-radiological features.ROC and decision curve analysis were used to assess the performance characteristics of the clinical-radiological features,the radiomics features and the radiomics nomogram.RESULTS The study included 190 individuals from two independent centers,with the majority being male(81%)and a median age of 57 years(interquartile range:51-66).The area under the curve(AUC)for the combined radiomics features selected from the intratumoral and peritumoral areas were 0.825,0.788,and 0.680 in the training set and the two test sets.A total of 13 features were selected to construct the Rad-score.The nomogram,combining clinicalradiological and combined radiomics features could accurately predict VETC+in all three sets,with AUC values of 0.859,0.848 and 0.757.Decision curve analysis revealed that the radiomics nomogram was more clinically useful than both the clinical-radiological feature and the combined radiomics models.CONCLUSION This study demonstrates the potential utility of a CECT-based radiomics nomogram,incorporating clinicalradiological features and combined radiomics features,in the identification of VETC+HCC. 展开更多
关键词 Hepatocellular carcinoma vessels encapsulating tumor clusters Intratumoral and peritumoral regions Radiomics features Nomog
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A Comparative Study Between Tumor Blood Vessels and Dynamic Contrast-enhanced MRI for Identifying Isocitrate Dehydrogenase Gene 1(IDH1)Mutation Status in Glioma 被引量:4
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作者 Shi-hui LI Nan-xi SHEN +4 位作者 Di WU Ju ZHANG Jia-xuan ZHANG Jing-jing JIANG Wen-zhen ZHU 《Current Medical Science》 SCIE CAS 2022年第3期650-657,共8页
Objective Isocitrate dehydrogenase gene(IDH)mutations are associated with tumor angiogenesis and therefore play an important role in glioma management.This study compared the performance of tumor blood vessels counted... Objective Isocitrate dehydrogenase gene(IDH)mutations are associated with tumor angiogenesis and therefore play an important role in glioma management.This study compared the performance of tumor blood vessels counted from contrast-enhanced 3D brain volume(3D-BRAVO)sequence and dynamic contrast-enhanced(DCE)MRI in differentiating IDH1 status in gliomas.Methods Forty-four glioma patients[16 with IDH1 mutant-type(IDH1-MT),28 with IDH1 wild-type(IDH1-WT)]were retrospectively analyzed.A blood vessel entering a tumor was defined as an intratumoral vessel;a blood vessel adjacent to the edge of a tumor was defined as a peritumoral vessel.Combined vessels were defined as the sum of the intratumoral and peritumoral vessels.DCE-derived metrics of tumor were normalized to the contralateral normal-appearing white matter.Results Intratumoral,peritumoral,and combined tumor blood vessels were all significantly different between IDH1-MT and IDH1-WT gliomas,and the range of area under curves(AUCs)was 0.816–0.855.For DCE-derived parameters,cerebral blood volume,cerebral blood flow,mean transit time,and volume transfer constant were significantly different between IDH1-MT and IDH1-WT gliomas,and the range of AUCs was 0.703–0.756.Combined vessels possessed the best performance for identifying IDH1 mutations in gliomas(AUC:0.855,sensitivity:0.857,specificity:0.812,P<0.001).Conclusion The number of tumor blood vessels has comparable diagnostic performance with DCE-derived parameters for differentiating IDH1 mutations and can serve as a potential imaging biomarker to reflect IDH1 mutations in gliomas. 展开更多
关键词 dynamic contrast-enhanced perfusion GLIOMA isocitrate dehydrogenase gene tumor blood vessel
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Frankincense myrrh attenuates hepatocellular carcinoma by regulating tumor blood vessel development through multiple epidermal growth factor receptor-mediated signaling pathways 被引量:1
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作者 Piao Zheng Zhen Huang +11 位作者 Dong-Chang Tong Qing Zhou Sha Tian Bo-Wei Chen Di-Min Ning Yin-Mei Guo Wen-Hao Zhu Yan Long Wei Xiao Zhe Deng Yi-Chen Lei Xue-Fei Tian 《World Journal of Gastrointestinal Oncology》 SCIE 2022年第2期450-477,共28页
BACKGROUND In traditional Chinese medicine(TCM),frankincense and myrrh are the main components of the antitumor drug Xihuang Pill.These compounds show anticancer activity in other biological systems.However,whether fr... BACKGROUND In traditional Chinese medicine(TCM),frankincense and myrrh are the main components of the antitumor drug Xihuang Pill.These compounds show anticancer activity in other biological systems.However,whether frankincense and/or myrrh can inhibit the occurrence of hepatocellular carcinoma(HCC)is unknown,and the potential molecular mechanism(s)has not yet been determined.AIM To predict and determine latent anti-HCC therapeutic targets and molecular mechanisms of frankincense and myrrh in vivo.METHODS In the present study,which was based on the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(http://tcmspw.com/tcmsp.php),Universal Protein database(http://www.uniprot.org),GeneCards:The Human Gene Database(http://www.genecards.org/)and Comparative Toxicogenomics Database(http://www.ctdbase.org/),the efficacy of and mechanism by which frankincense and myrrh act as anti-HCC compounds were predicted.The core prediction targets were screened by molecular docking.In vivo,SMMC-7721 human liver cancer cells were transplanted as xenografts into nude mice to establish a subcutaneous tumor model,and two doses of frankincense plus myrrh or one dose of an EGFR inhibitor was administered to these mice continuously for 14 d.The tumors were collected and evaluated:the tumor volume and growth rate were gauged to evaluate tumor growth;hematoxylineosin staining was performed to estimate histopathological changes;immunofluorescence(IF)was performed to detect the expression of CD31,α-SMA and collagen IV;transmission electron microscopy(TEM)was conducted to observe the morphological structure of vascular cells;enzyme-linked immunosorbent assay(ELISA)was performed to measure the levels of secreted HIF-1αand TNF-α;reverse transcription-polymerase chain reaction(RT-qPCR)was performed to measure the mRNA expression of HIF-1α,TNF-α,VEGF and MMP-9;and Western blot(WB)was performed to determine the levels of proteins expressed in the EGFR-mediated PI3K/Akt and MAPK signaling pathways.RESULTS The results of the network pharmacology analysis showed that there were 35 active components in the frankincense and myrrh extracts targeting 151 key targets.The molecular docking analysis showed that both boswellic acid and stigmasterol showed strong affinity for the targets,with the greatest affinity for EGFR.Frankincense and myrrh treatment may play a role in the treatment of HCC by regulating hypoxia responses and vascular system-related pathological processes,such as cytokine-receptor binding,and pathways,such as those involving serine/threonine protein kinase complexes and MAPK,HIF-1 and ErbB signaling cascades.The animal experiment results were verified.First,we found that,through frankincense and/or myrrh treatment,the volume of subcutaneously transplanted HCC tumors was significantly reduced,and the pathological morphology was attenuated.Then,IF and TEM showed that frankincense and/or myrrh treatment reduced CD31 and collagen IV expression,increased the coverage of perivascular cells,tightened the connection between cells,and improved the shape of blood vessels.In addition,ELISA,RT-qPCR and WB analyses showed that frankincense and/or myrrh treatment inhibited the levels of hypoxia-inducible factors,inflammatory factors and angiogenesis-related factors,namely,HIF-1α,TNF-α,VEGF and MMP-9.Furthermore,mechanistic experiments illustrated that the effect of frankincense plus myrrh treatment was similar to that of an EGFR inhibitor with regard to controlling EGFR activation,thereby inhibiting the phosphorylation activity of its downstream targets:the PI3K/Akt and MAPK(ERK,p38 and JNK)pathways.CONCLUSION In summary,frankincense and myrrh treatment targets tumor blood vessels to exert anti-HCC effects via EGFR-activated PI3K/Akt and MAPK signaling pathways,highlighting the potential of this dual TCM compound as an anti-HCC candidate. 展开更多
关键词 Hepatocellular carcinoma Frankincense Myrrh Network pharmacology tumor blood vessels Multiple signaling pathways
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Glioma stem cells and the occurrence of tumor blood vessels
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作者 Yude Zhu Qiang Huang 《Discussion of Clinical Cases》 2015年第2期12-22,共11页
Epithelial glioma is the most common brain cancer,accounting for 35.26%-60.69%of intracranial tumors with an average of 44.69%,and it remains the greatest challenge in the field of neurosurgery.The median survival tim... Epithelial glioma is the most common brain cancer,accounting for 35.26%-60.69%of intracranial tumors with an average of 44.69%,and it remains the greatest challenge in the field of neurosurgery.The median survival time of patients with advanced glioma is only 12 to 18 months due to the characteristics of high aggression,and the therapeutic effect was poor though surgery,chemotherapy,and targeted drug therapy being treated.Because of the presence of heterogeneity and the differentiation disorder,only a small number of glioma cells are the source of tumor growth and metastasis,which are highly resistant to traditional treatments.They are deemed as the“seed”tumor cells as they could get rid of the effect of the treatment and reconstruct the organization of tumor.They are also termed as brain tumor stem cell(BTSC)or glioma stem cells(GSCs)since neural stem cells share similar features with them.Recent data reveal that they are directly related with invasion,angiogenesis,tolerance,chemotherapy,recurrence of glioma.Based on the research result by the team,the paper elaborates the characteristics of GSCs and the relationship with the tumor angiogenesis. 展开更多
关键词 Glioma stem cells tumor blood vessels
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Excision of Head and Neck Tumors Combined with Carotid Artery Resection without Arterial Blood Vessel Reconstruction
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作者 Yan Zhang Ming Gao Shuling Li 《Clinical oncology and cancer resexreh》 CAS CSCD 2009年第4期286-289,共4页
OBJECTIVE To summarize our clinical experience in treating31 patients with neck masses undergoing carotid artery resectionwithout arterial anastomosis(vascular reconstruction)in TianjinCancer Hospital during a period ... OBJECTIVE To summarize our clinical experience in treating31 patients with neck masses undergoing carotid artery resectionwithout arterial anastomosis(vascular reconstruction)in TianjinCancer Hospital during a period from 1979 to 2002.METHODS Preoperatively,patients were instructed to applypressure to the carotid artery.Tumor excision combined withcarotid artery resection(TECCAR)was conducted after anaccurate testing of valid cerebral blood supply and compensation.RESULTS Among the study patients,17 were male and 14female,with the age ranging from 14 to 58 years.Of the 31 cases,23 were carotid body tumors(8 malignant),2 vagal body tumors(1 malignant),4 carotid aneurysms,and 2 were metastatic tumorsfrom the cervix involving carotid artery.Of the patients,a subtotalresection of the head and neck masses was conducted in 22 cases.Intraoperative death did not occur,and postoperative CNS orcerebrovascular complications(CVC)were not found.CONCLUSION TECCAR without arterial anastomosis is asafe and feasible procedure.In addition,this method of surgeryhas more advantages in comparison to an arterial anastomosis:i)Tumor resection was more complete.ii)Complications such asthrombus,infection,and lethal hemorrhage etc.,were rare aftersurgery;iii)Postoperative radiotherapy,if needed,would be safeand acceptable;iv)It was a more simplified operational procedure. 展开更多
关键词 颈动脉体 肿瘤医院 动脉血管 切除术 颈部 治疗 中枢神经系统 手术方法
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磁共振弥散成像参数预测肝细胞癌微血管模式的价值
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作者 陈千娟 龙莉玲 +2 位作者 李晨晖 谢金桓 张会婷 《放射学实践》 CSCD 北大核心 2024年第5期577-584,共8页
目的:评估术前磁共振检查中使用两种非高斯弥散模型衍生的定量参数以及常规的表观弥散系数(ADC)预测肝细胞癌(HCC)肿瘤包绕型血管(VETC)及微血管侵犯(MVI)联合表型方面的潜力。方法:前瞻性搜集105例HCC患者,所有患者均在术前两周内进行... 目的:评估术前磁共振检查中使用两种非高斯弥散模型衍生的定量参数以及常规的表观弥散系数(ADC)预测肝细胞癌(HCC)肿瘤包绕型血管(VETC)及微血管侵犯(MVI)联合表型方面的潜力。方法:前瞻性搜集105例HCC患者,所有患者均在术前两周内进行常规序列及多个b值(0~3000 s/mm^(2))的DWI检查。通过弥散后处理技术获得体素内非相干运动(IVIM)模型、弥散峰度成像(DKI)模型的衍生定量参数及常规的ADC值,分别由2位放射科医生测量整个病灶的所有弥散参数的平均值。由2位病理科医师联合VETC和MVI结果对HCC组织的微血管模式进行分类,将其分为3个不同的VETC/MVI(VM)组。比较不同VM分组间各个定量参数的差异,采用受试者工作特征(ROC)曲线评估差异具有统计学意义的定量参数的诊断效能,并采用DeLong检验比较各组AUC值的差异。结果:IVIM-Dstar值、DKI-K值在不同VM分组之间差异均有统计学意义(P<0.001)。VM-组的IVIM-Dstar值、DKI-K值低于VM±和VM+组,差异均有统计学意义(P<0.05)。两两比较结果显示,不同VM分组间的DKI-K值差异均有统计学意义(P均<0.05)。ROC曲线分析结果显示,IVIM-Dstar及DKI-K值鉴别不同VM分组的AUC值分别为0.756、0.863、0.630及0.653、0.802、0.673;IVIM-Dstar值及DKI-K值组成的联合模型鉴别不同VM分组的AUC值分别为0.769、0.896和0.702(P<0.05)。Delong检验结果表明,IVIM-Dstar、DKI-K以及两者组成的联合模型在鉴别不同VM分组的效能方面差异无统计学意义(P>0.05)。结论:磁共振非高斯弥散模型定量参数在术前预测HCC的VETC及MVI联合表型方面具有较好的应用价值。 展开更多
关键词 肝细胞癌 肿瘤包绕型血管 微血管侵犯 磁共振成像 非高斯弥散模型
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基于络病理论的妇科癥瘕的诊治思路与方法
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作者 袁静云 武晓冬 +5 位作者 牟东晓 赵楠琦 丁楠 王昕 董国锋 刘清国 《世界中医药》 CAS 北大核心 2024年第2期191-195,共5页
基于络病理论,妇科癥瘕病变特点与络病相应,其本质属络病。络气瘀滞是其发生的初步阶段,痰、寒、瘀瘀滞于胞络是其临床常见病机,毒损络脉是其加剧发展的原因,络脉空虚是其发生之本。治疗时,应注意“通”“补”兼顾。通过探讨,以期进一... 基于络病理论,妇科癥瘕病变特点与络病相应,其本质属络病。络气瘀滞是其发生的初步阶段,痰、寒、瘀瘀滞于胞络是其临床常见病机,毒损络脉是其加剧发展的原因,络脉空虚是其发生之本。治疗时,应注意“通”“补”兼顾。通过探讨,以期进一步丰富“络病学说”在妇科生殖领域中的理论指导和科学内涵,为临床妇科癥瘕的诊治提供新的思路和方法。 展开更多
关键词 络病理论 癥瘕 妇科 胞宫 络脉 子宫肌瘤 妇科肿瘤 卵巢囊肿
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累及大血管的腹膜后肿瘤处理策略探讨
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作者 屈国伦 曲兴龙 +4 位作者 张洪强 王洪波 王康伟 彭帅(综述) 陈勇(审校) 《中国肿瘤临床》 CAS CSCD 北大核心 2024年第2期98-102,共5页
腹膜后肿瘤(retroperitoneal tumor,RPT)发病较为隐匿,出现症状时肿瘤往往体积较大,多侵犯周围组织与脏器,尤其是腹腔重要血管,是RPT手术主要难点。累及大血管RPT的处理常被很多外科医生视为禁区,但手术仍是目前治疗该病唯一有效的方法... 腹膜后肿瘤(retroperitoneal tumor,RPT)发病较为隐匿,出现症状时肿瘤往往体积较大,多侵犯周围组织与脏器,尤其是腹腔重要血管,是RPT手术主要难点。累及大血管RPT的处理常被很多外科医生视为禁区,但手术仍是目前治疗该病唯一有效的方法,累及大血管RPT的处理决策是提高肿瘤手术切除率的关键。因此,术前对肿瘤累及血管程度的评估,术中对血管重建技术的应用对于肿瘤完整切除至关重要。术前应用影像学检查了解RPT与腹腔大血管之间的关系、浸润情况,手术中良好的术野为处理和控制血管出血创造了有利条件;累及大血管RPT在完整切除时,需要对一些重要的血管进行修复与重建,自体血管的使用技术已日益成熟,人工血管和补片的应用也为手术创造了条件。术前评估、手术策略、术后管理对肿瘤外科医生在累及大血管RPT的患者治疗过程中起着至关重要的作用。 展开更多
关键词 腹膜后肿瘤 累及大血管 策略
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MYCT1在恶性肿瘤及免疫治疗中的研究进展
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作者 孟涵钰 张杨杨 刘晓红 《临床与病理杂志》 CAS 2024年第1期80-86,共7页
MYC靶基因1(MYC target 1,MYCT1)是2003年首次在喉癌中克隆得到的新基因,在喉癌中表达下调,发挥抑癌基因功能。MYCT1不仅对维持机体正常细胞生命活动至关重要,还可通过其异常调控参与肿瘤细胞的增殖、分化、迁移、凋亡和上皮-间充质转化... MYC靶基因1(MYC target 1,MYCT1)是2003年首次在喉癌中克隆得到的新基因,在喉癌中表达下调,发挥抑癌基因功能。MYCT1不仅对维持机体正常细胞生命活动至关重要,还可通过其异常调控参与肿瘤细胞的增殖、分化、迁移、凋亡和上皮-间充质转化等,与肿瘤预后相关。MYCT1在不同类型的恶性肿瘤中发挥不同的作用,显示出癌基因或抑癌基因的功能。MYCT1参与调节肿瘤血管与免疫细胞之间的相互作用,在肿瘤免疫中发挥作用。MYCT1作为潜在的血管生成基因参与调节肿瘤血管的生长,从而影响肿瘤的转移和侵袭;MYCT1还可以影响肿瘤细胞对免疫细胞的免疫逃逸能力。MYCT1可能会成为恶性肿瘤治疗的新靶点。 展开更多
关键词 MYC靶基因1 恶性肿瘤 肿瘤血管 肿瘤免疫
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基于DCE-MRI的3D-MIP重建及多参数评估BI-RADS 4类乳腺肿瘤
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作者 梁泓冰 宁宁 +7 位作者 赵思奇 李远飞 武玥琪 宋清伟 杨洁 高雪 张莫云 张丽娜 《磁共振成像》 CAS CSCD 北大核心 2024年第5期94-101,共8页
目的探讨动态对比增强MRI(dynamic contrast-enhancement MRI,DCE-MRI)瘤周血管特征结合瘤内血流动力学参数在乳腺影像报告和数据系统(breast imaging reporting and data system,BI-RADS)4类肿瘤中的鉴别诊断价值。材料与方法回顾性分... 目的探讨动态对比增强MRI(dynamic contrast-enhancement MRI,DCE-MRI)瘤周血管特征结合瘤内血流动力学参数在乳腺影像报告和数据系统(breast imaging reporting and data system,BI-RADS)4类肿瘤中的鉴别诊断价值。材料与方法回顾性分析2018年8月至2023年3月于大连医科大学附属第一医院行乳腺MRI检查为BI-RADS 4类且病理结果明确肿瘤的女性病例102例,其中良性组43例,恶性组59例。记录患者年龄、病灶最大径(dmax)、乳腺DCE-MRI基本影像学特征、瘤周血管特征及瘤内血流动力学参数值。通过单因素和多因素logistic回归分析比较两组间多参数的差异,利用受试者工作特征(receiver operating characteristic,ROC)曲线以及曲线下面积(area under the curve,AUC)分析瘤周血管特征指标与瘤内参数值联合应用对BI-RADS 4类乳腺良恶性两组肿瘤鉴别的诊断效能。应用DeLong检验对AUC进行比较。结果乳腺良性组和恶性组病例在年龄、dmax、背景实质强化(background parenchymal enhancement,BPE)、纤维腺体组织量(fibroglandular tissue,FGT)、瘤周相邻血管征(adjacent vascular sign,AVS)数目、瘤周血管最大径、患侧瘤周与健侧同一象限血管直径差值(△d)、瘤周血管出现期相以及瘤内容积转移常数(volume transfer constant,K^(trans))、速率常数(flux rate constant,K_(ep))、最大增强斜率(maximum slope of increase,MSI)和时间-信号强度曲线(time-signal intensity curve,TIC)类型的差异均具有统计学意义(P<0.05),而病变位置、信号增强率(signal enhancement ratio,SER)和血管外细胞外间隙容积比(volume fraction of extravascular extra vascular space,V_(e))差异无统计学意义(P>0.05)。通过多因素logistic回归分析结果显示,△d、dmax、MSI和K^(trans)为区分两组间的独立影响因素,其中优势比最大的是MSI值(AUC为0.923)。将瘤周血管特征△d分别与dmax、MSI和K^(trans)进行两者联合模型比较,以△d与MSI联合模型的诊断效能最高(AUC为0.933,敏感度和特异度分别为93.2%和83.7%),且△d联合MSI与△d联合K^(trans)比较的差异具有统计学意义(P=0.001);其他联合指标在两两比较时差异无统计学意义(P>0.05),联合模型高于单独MSI模型的诊断效能。结论瘤周血管特征指标(△d)联合瘤内半定量(MSI)血流动力学参数对评价BI-RADS 4类乳腺肿瘤具有较好的鉴别诊断价值。 展开更多
关键词 乳腺肿瘤 动态对比增强 瘤周血管 最大密度投影 磁共振成像
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替吉奥联合胃肿瘤血管介入栓塞治疗中老年晚期胃癌的临床研究
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作者 李书有 聂荣军 +2 位作者 苏凤婵 韦志松 韦晓娜 《智慧健康》 2024年第3期184-187,192,共5页
目的 探讨替吉奥联合胃肿瘤血管介入栓塞治疗中老年晚期胃癌的临床效果。方法 选取2019年7月—2023年3月广西医科大学附属武鸣医院肿瘤科接收的60例中老年晚期胃癌患者,按数字随机表法分作两组,予以对照组(30例)口服单药替吉奥治疗,予... 目的 探讨替吉奥联合胃肿瘤血管介入栓塞治疗中老年晚期胃癌的临床效果。方法 选取2019年7月—2023年3月广西医科大学附属武鸣医院肿瘤科接收的60例中老年晚期胃癌患者,按数字随机表法分作两组,予以对照组(30例)口服单药替吉奥治疗,予以观察组(30例)替吉奥联合胃肿瘤血管介入栓塞治疗。比较两组患者的血清肿瘤标志物、临床疗效、生存质量及不良反应发生情况。结果 观察组治疗后癌胚抗原(CEA)、糖类抗原125(CA12-5)水平比对照组低(P<0.05);观察组疾病控制率比对照组高(P<0.05);观察组生存质量改善率比对照组高(P<0.05);两组不良反应发生率与对照组比较差异无统计学意义(P>0.05)。结论 替吉奥联合胃肿瘤血管介入栓塞治疗中老年晚期胃癌与单药替吉奥治疗对比,疗效显著,同时可降低血清肿瘤标志物,提升疾病控制率,并进一步改善患者生存质量,且安全性理想。 展开更多
关键词 替吉奥 胃肿瘤血管介入栓塞 晚期胃癌 治疗 疗效
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Chest Wall Hemangiopericytoma-Like Solitary Fibrous Tumor of the Pleura: Case Report with Computed Tomography Findings
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作者 Motohisa Kuwahara Hiroshi Nishimura +5 位作者 Masato Iwami Kazuya Naritomi Masae Mano Koji Inutsuka Keita Tokuishi Akinori Iwasaki 《Advances in Computed Tomography》 2013年第4期129-131,共3页
We present a case report of a 65-year-old woman who underwent resection of a chest wall tumor. In contrast with computed tomography, the tumor exhibited hypervascularity and was fed from the 9th intercostals artery. H... We present a case report of a 65-year-old woman who underwent resection of a chest wall tumor. In contrast with computed tomography, the tumor exhibited hypervascularity and was fed from the 9th intercostals artery. Histologically, the tumor was diagnosed as a cellular variant of solitary fibrous tumor of the pleura, with branching “staghorn” vessels and hypervascularity. The tumor thus resembled a chest wall hemangiopericytoma. 展开更多
关键词 SOLITARY FIBROUS tumor HEMANGIOPERICYTOMA Staghorn vesselS
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Angioarchitecture and CD133^+ tumor stem cell distribution in intracranial hemangiopericytoma A comparative study with meningioma 被引量:2
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作者 Zhongguo Zhang Mingguang Zhao +1 位作者 Zaihua Xu Zhenquan Song 《Neural Regeneration Research》 SCIE CAS CSCD 2011年第34期2687-2693,共7页
Angioarchitecture plays an important role in the malignant development of intracranial hemangiopericytoma. It remains poorly understood whether high frequency of hemorrhage during clinical surgery for intracranial hem... Angioarchitecture plays an important role in the malignant development of intracranial hemangiopericytoma. It remains poorly understood whether high frequency of hemorrhage during clinical surgery for intracranial hemangiopericytoma is associated with angioarchitecture. The present study utilized hematoxylin-eosin staining, and immunohistochemical staining with epithelial membrane antigen, vimentin, CD34, von Willebrand factor (vWF) and CD133 to observe characteristics of angioarchitecture. In addition, silver stains were used to demonstrate changes in reticular fibers in the wall of vessel channels in intracranial hemangiopericytoma and meningioma. Five patterns of angioarchitecture were identified in intracranial hemangiopericytoma, namely tumor cell islands, vasculogenic mimicry, mosaic blood vessels, sprouting angiogenesis, and intussusceptive angiogenesis. Several CD133+ tumor cells were found to form tumor cell islands. A connection between vWF ^+ and vWF channels was detected in the pattern of intussusceptive angiogenesis, and some vimentin^+ tumor cells were embedded in the periodic acid-Schiff positive channel wall. Incomplete threads of reticular fibers formed the walls of larger pseudo-vascular channels and some tumor clumps or scattered tumor cells were detected "floating" in them. The angioarchitecture, specific markers and reticular fibers of intracranial hemangiopericytoma were significantly different from meningioma. Angioarchitecture provides a functional vascular network for vascular evolution in intracranial hemangiopericytoma and contributes to significant intra-operative bleeding. 展开更多
关键词 intracranial hemangiopericytoma ANGIOARCHITECTURE tumor cell islands vasculogenic mimicry mosaic blood vessels sprouting angiogenesis intussusceptive angiogenesis MENINGIOMA CD133
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基于术前MRI征象对微血管转移模式阴性孤立性肝细胞癌的预后价值研究
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作者 傅爱燕 邢金丽 +2 位作者 毛咪咪 张建泉 张涛 《南通大学学报(医学版)》 2023年第6期522-525,共4页
目的 :评估术前MRI征象对微血管侵犯(microvascular invasion, MVI)和血管包绕肿瘤细胞簇(vessels encapsulating tumor clusters, VETC)阴性的孤立性肝细胞癌(hepatocellular carcinoma, HCC)患者行根治性切除术后无复发生存率(recurre... 目的 :评估术前MRI征象对微血管侵犯(microvascular invasion, MVI)和血管包绕肿瘤细胞簇(vessels encapsulating tumor clusters, VETC)阴性的孤立性肝细胞癌(hepatocellular carcinoma, HCC)患者行根治性切除术后无复发生存率(recurrence-free survival rate, RFS)的价值。方法:对99例术前行钆塞酸二钠增强和根治性切除术后经组织病理学证实MVI和VETC均为阴性的HCC患者进行回顾性分析。评估患者的术前MRI征象、术前临床参数及术后病理特征,通过Cox回归分析确定与患者RFS相关的独立危险因素。基于最大选择秩统计法确定最佳截断值,将患者分为高、低风险亚组,采用Kaplan-Meier法和对数秩检验比较两组患者的RFS。结果:在中位随访时间为29.73个月的随访期内,99例MVI和VETC阴性的孤立性HCC患者中,复发35例(35.35%)。多因素Cox回归分析显示,动脉期环状高强化[HR2.405(1.062~5.448), P=0.035]和动脉期瘤周强化[HR 2.672(1.230~5.806), P=0.013]是RFS的独立危险因素。最佳截断值为-0.310,高、低风险亚组之间RFS差异有统计学意义(P=0.002)。结论:术前MRI征象有助于预测微血管转移模式阴性孤立性HCC患者根治性切除术后的RFS,并可实现术后复发风险分层。 展开更多
关键词 肝细胞癌 微血管侵犯 血管包绕肿瘤细胞簇
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血清肿瘤坏死因子-α、白细胞介素-18及转化生长因子-β在老年高血压脑小血管病患者中的水平变化及临床意义
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作者 王为 赵蒙 +1 位作者 李昀 殷宏宇 《当代医学》 2023年第23期141-143,共3页
目的探讨血清肿瘤坏死因子-α(TNF-α)、白细胞介素-18(IL-18)、转化生长因子-β(TGF-β)在老年高血压脑小血管病(CSVD)患者中的水平变化及临床意义。方法选取2018年8月至2020年12月本院收治的120例高血压CSVD患者作为研究对象,按照患... 目的探讨血清肿瘤坏死因子-α(TNF-α)、白细胞介素-18(IL-18)、转化生长因子-β(TGF-β)在老年高血压脑小血管病(CSVD)患者中的水平变化及临床意义。方法选取2018年8月至2020年12月本院收治的120例高血压CSVD患者作为研究对象,按照患者病情程度分为对照组(轻度高血压CSVD)与观察组(中度高血压CSVD),各60例。比较两组患者蒙特利尔认知评估量表(MoCA)评分,血清TNF-α、IL-18、TGF-β、同型半胱氨酸(Hcy)、超敏C反应蛋白(hs-CRP)及总胆固醇(TC)水平。结果观察组执行能力、记忆力、语言、定向等MoCA评分均低于对照组,差异有统计学意义(P<0.05);观察组血清TNF-α、IL-18、Hcy、hs-CRP水平均高于对照组,血清TGF-β水平低于对照组,差异有统计学意义(P<0.05);两组血清TC水平比较差异无统计学意义。结论血清TNF-α、IL-18、TGF-β水平的变化对于诊断老年高血压CSVD患者具有重要临床意义,其水平的高低可反映患者病情严重程度,值得临床借鉴。 展开更多
关键词 高血压脑小血管病 肿瘤坏死因子 白细胞介素-18 转化生长因子-Β
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术前256层螺旋CT双低剂量扫描对结肠癌肿瘤侵犯及肠系膜血管分布的评估价值
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作者 宣建新 刘哲峰 +2 位作者 滕伟 李唯 蔡淑云 《中国医学装备》 2023年第6期47-52,共6页
目的:探究术前256层螺旋CT双低剂量扫描对结肠癌肿瘤侵犯及肠系膜血管分布的评估价值。方法:选取在医院拟行腹腔镜结肠癌根治术的140例患者,采用随机数表法分为双低剂量组与常规剂量组,每组70例。双低剂量组与常规剂量组术前分别行256... 目的:探究术前256层螺旋CT双低剂量扫描对结肠癌肿瘤侵犯及肠系膜血管分布的评估价值。方法:选取在医院拟行腹腔镜结肠癌根治术的140例患者,采用随机数表法分为双低剂量组与常规剂量组,每组70例。双低剂量组与常规剂量组术前分别行256层螺旋CT双低剂量、常规剂量扫描。比较两组图像质量客观及主观评价、辐射剂量,以术后病理组织学诊断结果为“金标准”,分析常规剂量、双低剂量CT评估结肠癌肿瘤侵犯及肠系膜血管分布的准确率。结果:双低剂量组信噪比(SNR)、对比度噪声比(CNR)、噪声、CT值均低于常规剂量组,差异有统计学意义(t=14.415,t=16.045,t=2.163,t=30.096;P<0.05);2名医师对双低剂量组图像质量评分略低于常规剂量组,但两组间无明显统计学差异;双低剂量组剂量长度乘积(DLP)、容积CT剂量指数(CTDIvol)、有效剂量(ED)均低于常规剂量组,差异有统计学意义(t=20.227,t=21.355,t=24.207;P<0.05);双低剂量CT评估淋巴结转移、脉管侵犯、神经侵犯的准确率[(86.21%(25/29)和85.71%(18/21)和94.44%(17/18)]与术后病理比较,差异无统计学意义;双低剂量CT评估肠系膜上静脉组织、动脉分布于肠系膜上静脉背侧、动脉分布于肠系膜上静脉腹侧的准确率分别为98.57%(68/70)、90.32(28/31)和94.59%(35/37)与术后病理比较,差异无统计学意义。结论:结肠癌术前256层螺旋CT双低剂量扫描能提高图像质量,在降低辐射剂量及图像噪声方面具有明显优势,且能够准确评估结肠癌术前肿瘤侵犯及肠系膜血管的分布情况。 展开更多
关键词 结肠癌 256层螺旋CT 低剂量 肿瘤侵犯 肠系膜血管分布
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血流信号外延评估分化型甲状腺癌后被膜外侵犯
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作者 林娴静 何聚馨 +2 位作者 谢丽君 朱丽珊 陈树强 《中国医学影像技术》 CSCD 北大核心 2023年第2期185-188,共4页
目的观察血流信号外延评估分化型甲状腺癌(DTC)后被膜外侵犯的价值。方法纳入290例经手术病理证实的DTC患者,观察术前结节被膜外受侵位置及其超声表现,包括结节大小、形态及有无血流信号外延、接触被膜、突出被膜外及被膜连续性中断等,... 目的观察血流信号外延评估分化型甲状腺癌(DTC)后被膜外侵犯的价值。方法纳入290例经手术病理证实的DTC患者,观察术前结节被膜外受侵位置及其超声表现,包括结节大小、形态及有无血流信号外延、接触被膜、突出被膜外及被膜连续性中断等,并与病理所见进行对比。结果290例DTC患者中,18例(18/290,6.21%)存在前被膜外受侵,26例(26/290,8.97%)后被膜外受侵;后者T分期及淋巴结转移率均高于前者(P均<0.05)。血流信号外延评估DTC后被膜外受侵的敏感度为76.92%,特异度为92.42%,阴性预测值为97.60%,准确率为91.03%。44例存在被膜外受侵的DTC患者中,25例(25/44,56.82%)轻度受侵,19例(19/44,43.18%)重度受侵,轻、重度被膜外受侵DTC超声表现差异均无统计学意义(P均>0.05)。结论血流信号外延可用于评估DTC后被膜外受侵。 展开更多
关键词 甲状腺肿瘤 超声检查 被膜 肿瘤血管
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中药干预肿瘤炎症作用机制研究进展
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作者 蒋境兴 李宁 +3 位作者 李媛媛 康瑞霞 倪艳 郝旭亮 《辽宁中医药大学学报》 CAS 2023年第12期187-191,共5页
肿瘤的发生发展伴随着大量的炎症反应,并且炎症反应能够促进肿瘤的进一步发展,二者相辅相成。肿瘤炎症微环境中存在的大量炎性介质能够通过不同的方式去促进肿瘤的发生发展和侵袭转移,干预肿瘤炎症微环境已成为目前肿瘤治疗的重要策略之... 肿瘤的发生发展伴随着大量的炎症反应,并且炎症反应能够促进肿瘤的进一步发展,二者相辅相成。肿瘤炎症微环境中存在的大量炎性介质能够通过不同的方式去促进肿瘤的发生发展和侵袭转移,干预肿瘤炎症微环境已成为目前肿瘤治疗的重要策略之一,通过对肿瘤炎症的干预能够抑制肿瘤炎症微环境中多种炎症信号通路(NF-κB、STAT3、MAPK通路)的活化,从而降低炎症水平;其次对肿瘤炎症的干预,能够抑制机体的细胞上皮-间质转化(EMT),进一步抑制肿瘤的侵袭和转移;并且干预肿瘤炎症能够抑制肿瘤血管的新生,从而抑制肿瘤的发展。文章将从近年来国内外对肿瘤炎症微环境的最新研究成果出发,从中药防治肿瘤以及改善肿瘤炎症微环境的作用机制展开综述,更好地展现中药治疗肿瘤的优势,以期为后续的研究提供参考。 展开更多
关键词 肿瘤炎症微环境 炎症介质 炎症信号通路 细胞上皮-间质转化 肿瘤血管
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1例胸腔镜联合颈胸入路左肺上沟瘤切除伴锁骨下动脉置换术护理配合
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作者 孙香美 钱晨 +4 位作者 刘静 丁洪瑞 吴荻 季弯弯 崔萌 《齐齐哈尔医学院学报》 2023年第2期192-196,共5页
回顾总结1例胸腔镜联合颈胸入路左肺上沟瘤切除伴锁骨下动脉置换术患者的手术护理配合。术前主要通过术前访视、阅读病案资料及与手术医生沟通后,充分做好了患者的护理评估、物品的准备尤其是人工血管的制备、人力资源的准备、以及术前... 回顾总结1例胸腔镜联合颈胸入路左肺上沟瘤切除伴锁骨下动脉置换术患者的手术护理配合。术前主要通过术前访视、阅读病案资料及与手术医生沟通后,充分做好了患者的护理评估、物品的准备尤其是人工血管的制备、人力资源的准备、以及术前静脉通路的选择、压力性损伤和深静脉脉血栓发生风险的评估和预防措施的落实,为患者做好了充分的术前准备;术中如何做好锁骨下动脉热缺血的管理、人造血管置换的护理配合、以及乳糜漏的观察等护理措施的落实,保证了手术的顺利完成;术后患侧肢体的观察和护理、管路安全的严格落实和患者的转运交接护理措施的落实,使患者安全的返回病房。该手术的成功充分体现了巡回护士统筹、协调能力和洗手护士术中的应急能力,为同类手术积累了较多的手术护理经验。 展开更多
关键词 肺上沟瘤 人工血管置换 锁骨下动脉 护理配合 热缺血管理
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