Gland cancer is a high-incidence disease that endangers human health,and its early detection and treatment require efficient,accurate,and objective intelligent diagnosis methods.In recent years,the advent of machine l...Gland cancer is a high-incidence disease that endangers human health,and its early detection and treatment require efficient,accurate,and objective intelligent diagnosis methods.In recent years,the advent of machine learning techniques has yielded satisfactory results in intelligent gland cancer diagnosis based on clinical images,significantly improving the accuracy and efficiency of medical image interpretation while reducing the workload of doctors.The focus of this study is to review,classify,and analyze intelligent diagnosis methods for imaging gland cancer based on machine learning and deep learning.This paper briefly introduces some basic imaging principles of multimodal medical images,such as the commonly used computed tomography(CT),magnetic resonance imaging(MRI),ultrasound(US),positron emission tomography(PET),and pathology.In addition,the intelligent diagnosis methods for imaging gland cancer were further classified into supervised learning and weakly supervised learning.Supervised learning consists of traditional machine learning methods,such as K-nearest neighbor algorithm(KNN),support vector machine(SVM),and multilayer perceptron,and deep learning methods evolving from convolutional neural network(CNN).By contrast,weakly supervised learning can be further categorized into active learning,semisupervised learning,and transfer learning.State-of-the-art methods are illustrated with implementation details,including image segmentation,feature extraction,and optimization of classifiers.Their performances are evaluated through indicators,such as accuracy,precision,and sensitivity.In conclusion,the challenges and development trends of intelligent diagnosis methods for imaging gland cancer were addressed and discussed.展开更多
Objective After endoscopic resection of colorectal cancer with submucosal invasion(pT1 CRC),additional surgical treatment is recommended if deep submucosal invasion(DSI)is present.This study aimed to further elucidate...Objective After endoscopic resection of colorectal cancer with submucosal invasion(pT1 CRC),additional surgical treatment is recommended if deep submucosal invasion(DSI)is present.This study aimed to further elucidate the risk factors for lymph node metastasis(LNM)in patients with pT1 CRC,especially the effect of DSI on LNM.Methods Patients with pT1 CRC who underwent lymph node dissection were selected.The Chi-square test and multivariate logistic regression were used to analyze the relationship between clinicopathological characteristics and LNM.The submucosal invasion depth(SID)was measured via 4 methods and analyzed with 3 cut-off values.Results Twenty-eight of the 239 patients presented with LNM(11.7%),and the independent risk factors for LNM included high histological grade(P=0.003),lymphovascular invasion(LVI)(P=0.004),intermediate to high budding(Bd 2/3)(P=0.008),and cancer gland rupture(CGR)(P=0.008).Moreover,the SID,width of submucosal invasion(WSI),and area of submucosal invasion(ASI)were not significantly different.When one,two,three or more risk factors were identified,the LNM rates were 1.1%(1/95),12.5%(7/56),and 48.8%(20/41),respectively.Conclusion Indicators such as the SID,WSI,and ASI are not risk factors for LNM and are subjective in their measurement,which renders them relatively inconvenient to apply in clinical practice.In contrast,histological grade,LVI,tumor budding and CGR are relatively straightforward to identify and have been demonstrated to be statistically significant.It would be prudent to focus on these histological factors rather than subjective measurements.展开更多
Introduction: Canine mammary gland tumor is the most common type of neoplasia in non-ovariectomized bitches. Approximately 50% of tumors are malignant. Neoplasms originating from the mammary gland represent the most c...Introduction: Canine mammary gland tumor is the most common type of neoplasia in non-ovariectomized bitches. Approximately 50% of tumors are malignant. Neoplasms originating from the mammary gland represent the most common neoplastic disease in canines in Veterinary Medicine. Aim: Relate the expression of the receptor to progesterone (PR) with the tumor stage of canine mammary carcinoma. Material and Methods: Analytical-cross-sectional study, samples of paraffinized tumor tissue obtained from 30 canine patients with breast cancer were used. The expression of PR was performed by immunohistochemical labeling, using murine anti-PR (anti-PR Biocare brand). A descriptive analysis was carried out with the results using the SPSS program. Results: The predominant histological subtype of breast cancer was tubular carcinoma with 12 patients, followed by papillary cystic carcinoma with 6 patients, solid carcinoma 5, carcinosarcoma 4 and comedocarcinoma 3. There was a significant trend between breast cancer subtypes, histological grade G1. Among the histopathological findings, the degree of invasion is related to the presence of tumor cells in adjacent lymph nodes, which is why it is a prognostic indicator. The expression of PR in the tumor tissue samples it was 42.8% positive versus 57.14% negative, of which 75% correspond to G1, 8.3% to G2 and 16.6% to G3. With respect to the relationship of the expression of PR vs type of tumor, it was found that 50% correspond to tubular carcinoma, 33.3% to papillary cystic carcinoma, 8.3% to solid carcinoma and 8.3% to comedocarcinoma. Conclusion: The hormone receptor was negative in more than half of the patients and histological grade is significantly associated with tumor subtypes, this study emphasizes the need to introduce receptor testing into our routine clinical practice to offer the best treatment for breast cancer.展开更多
BACKGROUND Secondary malignancies of the thyroid gland are a rare finding in clinical practice.In addition,colorectal metastasis to the thyroid(CMT)is even more infrequently diagnosed.The source of the primary tumor f...BACKGROUND Secondary malignancies of the thyroid gland are a rare finding in clinical practice.In addition,colorectal metastasis to the thyroid(CMT)is even more infrequently diagnosed.The source of the primary tumor follows demographic and ethnic patterns,which reflects the most prevalent malignancies in the different populations.Colorectal cancer is one of the most common types of cancer worldwide;nevertheless,CMT is infrequently diagnosed.Most of them are identified during the follow-up of gastrointestinal primary malignancies.Due to the improvement of image techniques,oncological treatment,and follow-up,survival and consequent diagnosis of metastatic disease are more frequent.Those facts make this entity a diagnostic and therapeutic challenge,due to the lack of information and the difficulties performing clinical trials and research.CASE SUMMARY Here,we present a case report of a patient diagnosed with CMT of adenocarcinoma of the rectum evidenced during follow-up,4 years after neoadjuvant chemoradiotherapy,who had subsequent curative surgical treatment of the primary tumor and inter-current lung bilateral metastases.CONCLUSION Thyroid metastases of extra-thyroid origin are an uncommon finding,even rarer in cases of CMT.The diagnostic process,as well as survival of oncologic patients is improving,and consequently the number of metastases to the thyroid gland is increasing.展开更多
A 68 years old female, was diagnosed as a case of right breast cancer in 2013;grade II/III according to Bloom Richardson grading, Modify radical mastectomy (MRM) was done and the pathology report showed moderately dif...A 68 years old female, was diagnosed as a case of right breast cancer in 2013;grade II/III according to Bloom Richardson grading, Modify radical mastectomy (MRM) was done and the pathology report showed moderately differentiated invasive ductal carcinoma (IDC), stage T3N3M0. Immunohisrochemisty (IHC) findings revealed a tumor with Triple positive. Patient refused to treat by chemotherapy. Patient was given adjuvant trastuzumab (first dose 8 mg/kg, followed by 6 mg/kg every three weeks) for the period of one year (16) cycles after which she went on regular follow up. Exemestane tab for 5 years and radiotherapy (50 gray in 25 fractions) was applying on right breast. One year and half after diagnosed primary breast cancer, patient complained from severe diarrhea 8 times per day watery contents, vomiting and suffered from lower abdominal pain. PET scan for whole body in October 2014 was done;the results showed ascending colon is highly suspicious for malignancy and moderately hypermetabolic left adrenal mass. Subtotal colectomy surgery was done, the pathology report of biopsy revealed low grade malignant neuroendocrine neoplastic lesion stage of T3N1Mo. Physician prescribed octreotide acetate 20 mg I. M monthly due to neuroendocrine lesion. In January 2016, cancer recurrence in the same right breast, IHC revealed ER+, PR−, Her 2+, physician decided to change exemestane to fulvestrant 250 mg s. c for 6 cycles. Radiation therapy was applied 20 gray in 10 fractions on scar. In May 2016, CAP-CT scan result revealed two enlarged left axillary L.N and left soft tissue density adrenal mass (3.0 × 2.3). Excisional lymph node was done which revealed IDC, ER+, PR−, Her 2+. Physician decided to discontinue fulvestrant and switch to exemestane 20 mg monthly. CAP-CT was done in Feb 2017;single left axillary L.N 1 cm, small hypodense lesion (spleen 4 cm), left adrenal lesion (2.2 × 2.6 cm) and osteolytic lesion were noted in iliac areas, so the physician considered those results a metastatic area from breast and prescribed lapatinib 84 tablets. Patient now onoctreotide acetate 20 mg I. M, trastuzumab 440 m, exemestane and lapatinib tablets) monthly, zoledronic acid 4 mg q 3 months, patient now still on follow up with a good condition. Conclusion: Breast cancer metastatic to left adrenal gland which is extremely rare especially when they originate from IDCs. The present case is the seventh breast cancer metastatic to the adrenal gland in the literature up to our search. Neuroendocrine tumor was happened in colon after one year and half which was a rare second primary malignancy (SPM) among female breast cancer.展开更多
The patient was a female, 65 years to feel intermittent discomfort in old. Early in 1996, she began her neck, accompanied with hoarseness. In June, 2000, when she entered our hospital and accepted a physical examinati...The patient was a female, 65 years to feel intermittent discomfort in old. Early in 1996, she began her neck, accompanied with hoarseness. In June, 2000, when she entered our hospital and accepted a physical examination, we found a 3 cm×2 cm tumor at the lower pole of the thyroid gland. Neck CT showed that the mass was located at the inferiorposterior right part of the thyroid gland with a diffuse boundary. MRI showed that the right thyroid cartilage wall was incomplete. Fine-needle aspiration cytology indicated a suspected papillary tumor.展开更多
The thyroid hormones(THs), triiodothyronine(T3) and thyroxine(T4), are essential for survival; they are involved in the processes of development, growth, and metabolism. In addition to hyperthyroidism or hypothyroidis...The thyroid hormones(THs), triiodothyronine(T3) and thyroxine(T4), are essential for survival; they are involved in the processes of development, growth, and metabolism. In addition to hyperthyroidism or hypothyroidism, THs are involved in other diseases. The role of THs in the development and differentiation of mammary epithelium is well established; however, their specific role in the pathogenesis of breast cancer(BC) is controversial. Steroid hormones affect many human cancers and the abnormal responsiveness of the mammary epithelial cells to estradiol(E2) in particular is known to be an important cause for the development and progression of BC. The proliferative effect of T3 has been demonstrated in various types of cancer. In BC cell lines, T3 may foster the conditions for tumor proliferation and increase the effect of cell proliferation by E2; thus, T3 may play a role in the developmentand progression of BC. Studies show that T3 has effects similar to E2 in BC cell lines. Despite controversy regarding the relationship between thyroid disturbances and the incidence of BC, studies show that thyroid status may influence the development of tumor, proliferation and metastasis.展开更多
Gastric adenocarcinoma of fundic gland type(GA-FG) with chief cell differentiation was recently proposed as an extremely rare type of gastric adenocarcinoma. Here, we report 4 cases of GA-FG with chief cell differenti...Gastric adenocarcinoma of fundic gland type(GA-FG) with chief cell differentiation was recently proposed as an extremely rare type of gastric adenocarcinoma. Here, we report 4 cases of GA-FG with chief cell differentiation. Endoscopic features included a submucosal tumor shape or a flat shape, whitish discoloration and dilated vessels on the surface. The tumors were located in the upper or middle third of the stomach. All cases were preoperatively diagnosed as GA-FG by biopsy, and endoscopic submucosal dissection was performed. Resected specimens revealed well-differentiated adenocarcinomas resembling chief cells. Tumor cells were diffusely positive for pepsinogen-Ⅰ, but partially positive for H+/K+-ATPase in scattered locations around the tumor margin. Despite the presence of minimal invasion of the carcinoma into the submucosal layer, which was observed in two cases, neither lymphatic nor venous invasion was detected in any of the cases. Finally, all cases showed less aggressive clinical behavior with low grade malignancy.展开更多
基金Supported by National Natural Science Foundation of China(62102036).
文摘Gland cancer is a high-incidence disease that endangers human health,and its early detection and treatment require efficient,accurate,and objective intelligent diagnosis methods.In recent years,the advent of machine learning techniques has yielded satisfactory results in intelligent gland cancer diagnosis based on clinical images,significantly improving the accuracy and efficiency of medical image interpretation while reducing the workload of doctors.The focus of this study is to review,classify,and analyze intelligent diagnosis methods for imaging gland cancer based on machine learning and deep learning.This paper briefly introduces some basic imaging principles of multimodal medical images,such as the commonly used computed tomography(CT),magnetic resonance imaging(MRI),ultrasound(US),positron emission tomography(PET),and pathology.In addition,the intelligent diagnosis methods for imaging gland cancer were further classified into supervised learning and weakly supervised learning.Supervised learning consists of traditional machine learning methods,such as K-nearest neighbor algorithm(KNN),support vector machine(SVM),and multilayer perceptron,and deep learning methods evolving from convolutional neural network(CNN).By contrast,weakly supervised learning can be further categorized into active learning,semisupervised learning,and transfer learning.State-of-the-art methods are illustrated with implementation details,including image segmentation,feature extraction,and optimization of classifiers.Their performances are evaluated through indicators,such as accuracy,precision,and sensitivity.In conclusion,the challenges and development trends of intelligent diagnosis methods for imaging gland cancer were addressed and discussed.
基金supported by a grant from the National Key Research and Development Program of China(No.2023YFC2507406).
文摘Objective After endoscopic resection of colorectal cancer with submucosal invasion(pT1 CRC),additional surgical treatment is recommended if deep submucosal invasion(DSI)is present.This study aimed to further elucidate the risk factors for lymph node metastasis(LNM)in patients with pT1 CRC,especially the effect of DSI on LNM.Methods Patients with pT1 CRC who underwent lymph node dissection were selected.The Chi-square test and multivariate logistic regression were used to analyze the relationship between clinicopathological characteristics and LNM.The submucosal invasion depth(SID)was measured via 4 methods and analyzed with 3 cut-off values.Results Twenty-eight of the 239 patients presented with LNM(11.7%),and the independent risk factors for LNM included high histological grade(P=0.003),lymphovascular invasion(LVI)(P=0.004),intermediate to high budding(Bd 2/3)(P=0.008),and cancer gland rupture(CGR)(P=0.008).Moreover,the SID,width of submucosal invasion(WSI),and area of submucosal invasion(ASI)were not significantly different.When one,two,three or more risk factors were identified,the LNM rates were 1.1%(1/95),12.5%(7/56),and 48.8%(20/41),respectively.Conclusion Indicators such as the SID,WSI,and ASI are not risk factors for LNM and are subjective in their measurement,which renders them relatively inconvenient to apply in clinical practice.In contrast,histological grade,LVI,tumor budding and CGR are relatively straightforward to identify and have been demonstrated to be statistically significant.It would be prudent to focus on these histological factors rather than subjective measurements.
文摘Introduction: Canine mammary gland tumor is the most common type of neoplasia in non-ovariectomized bitches. Approximately 50% of tumors are malignant. Neoplasms originating from the mammary gland represent the most common neoplastic disease in canines in Veterinary Medicine. Aim: Relate the expression of the receptor to progesterone (PR) with the tumor stage of canine mammary carcinoma. Material and Methods: Analytical-cross-sectional study, samples of paraffinized tumor tissue obtained from 30 canine patients with breast cancer were used. The expression of PR was performed by immunohistochemical labeling, using murine anti-PR (anti-PR Biocare brand). A descriptive analysis was carried out with the results using the SPSS program. Results: The predominant histological subtype of breast cancer was tubular carcinoma with 12 patients, followed by papillary cystic carcinoma with 6 patients, solid carcinoma 5, carcinosarcoma 4 and comedocarcinoma 3. There was a significant trend between breast cancer subtypes, histological grade G1. Among the histopathological findings, the degree of invasion is related to the presence of tumor cells in adjacent lymph nodes, which is why it is a prognostic indicator. The expression of PR in the tumor tissue samples it was 42.8% positive versus 57.14% negative, of which 75% correspond to G1, 8.3% to G2 and 16.6% to G3. With respect to the relationship of the expression of PR vs type of tumor, it was found that 50% correspond to tubular carcinoma, 33.3% to papillary cystic carcinoma, 8.3% to solid carcinoma and 8.3% to comedocarcinoma. Conclusion: The hormone receptor was negative in more than half of the patients and histological grade is significantly associated with tumor subtypes, this study emphasizes the need to introduce receptor testing into our routine clinical practice to offer the best treatment for breast cancer.
文摘BACKGROUND Secondary malignancies of the thyroid gland are a rare finding in clinical practice.In addition,colorectal metastasis to the thyroid(CMT)is even more infrequently diagnosed.The source of the primary tumor follows demographic and ethnic patterns,which reflects the most prevalent malignancies in the different populations.Colorectal cancer is one of the most common types of cancer worldwide;nevertheless,CMT is infrequently diagnosed.Most of them are identified during the follow-up of gastrointestinal primary malignancies.Due to the improvement of image techniques,oncological treatment,and follow-up,survival and consequent diagnosis of metastatic disease are more frequent.Those facts make this entity a diagnostic and therapeutic challenge,due to the lack of information and the difficulties performing clinical trials and research.CASE SUMMARY Here,we present a case report of a patient diagnosed with CMT of adenocarcinoma of the rectum evidenced during follow-up,4 years after neoadjuvant chemoradiotherapy,who had subsequent curative surgical treatment of the primary tumor and inter-current lung bilateral metastases.CONCLUSION Thyroid metastases of extra-thyroid origin are an uncommon finding,even rarer in cases of CMT.The diagnostic process,as well as survival of oncologic patients is improving,and consequently the number of metastases to the thyroid gland is increasing.
文摘A 68 years old female, was diagnosed as a case of right breast cancer in 2013;grade II/III according to Bloom Richardson grading, Modify radical mastectomy (MRM) was done and the pathology report showed moderately differentiated invasive ductal carcinoma (IDC), stage T3N3M0. Immunohisrochemisty (IHC) findings revealed a tumor with Triple positive. Patient refused to treat by chemotherapy. Patient was given adjuvant trastuzumab (first dose 8 mg/kg, followed by 6 mg/kg every three weeks) for the period of one year (16) cycles after which she went on regular follow up. Exemestane tab for 5 years and radiotherapy (50 gray in 25 fractions) was applying on right breast. One year and half after diagnosed primary breast cancer, patient complained from severe diarrhea 8 times per day watery contents, vomiting and suffered from lower abdominal pain. PET scan for whole body in October 2014 was done;the results showed ascending colon is highly suspicious for malignancy and moderately hypermetabolic left adrenal mass. Subtotal colectomy surgery was done, the pathology report of biopsy revealed low grade malignant neuroendocrine neoplastic lesion stage of T3N1Mo. Physician prescribed octreotide acetate 20 mg I. M monthly due to neuroendocrine lesion. In January 2016, cancer recurrence in the same right breast, IHC revealed ER+, PR−, Her 2+, physician decided to change exemestane to fulvestrant 250 mg s. c for 6 cycles. Radiation therapy was applied 20 gray in 10 fractions on scar. In May 2016, CAP-CT scan result revealed two enlarged left axillary L.N and left soft tissue density adrenal mass (3.0 × 2.3). Excisional lymph node was done which revealed IDC, ER+, PR−, Her 2+. Physician decided to discontinue fulvestrant and switch to exemestane 20 mg monthly. CAP-CT was done in Feb 2017;single left axillary L.N 1 cm, small hypodense lesion (spleen 4 cm), left adrenal lesion (2.2 × 2.6 cm) and osteolytic lesion were noted in iliac areas, so the physician considered those results a metastatic area from breast and prescribed lapatinib 84 tablets. Patient now onoctreotide acetate 20 mg I. M, trastuzumab 440 m, exemestane and lapatinib tablets) monthly, zoledronic acid 4 mg q 3 months, patient now still on follow up with a good condition. Conclusion: Breast cancer metastatic to left adrenal gland which is extremely rare especially when they originate from IDCs. The present case is the seventh breast cancer metastatic to the adrenal gland in the literature up to our search. Neuroendocrine tumor was happened in colon after one year and half which was a rare second primary malignancy (SPM) among female breast cancer.
文摘The patient was a female, 65 years to feel intermittent discomfort in old. Early in 1996, she began her neck, accompanied with hoarseness. In June, 2000, when she entered our hospital and accepted a physical examination, we found a 3 cm×2 cm tumor at the lower pole of the thyroid gland. Neck CT showed that the mass was located at the inferiorposterior right part of the thyroid gland with a diffuse boundary. MRI showed that the right thyroid cartilage wall was incomplete. Fine-needle aspiration cytology indicated a suspected papillary tumor.
文摘The thyroid hormones(THs), triiodothyronine(T3) and thyroxine(T4), are essential for survival; they are involved in the processes of development, growth, and metabolism. In addition to hyperthyroidism or hypothyroidism, THs are involved in other diseases. The role of THs in the development and differentiation of mammary epithelium is well established; however, their specific role in the pathogenesis of breast cancer(BC) is controversial. Steroid hormones affect many human cancers and the abnormal responsiveness of the mammary epithelial cells to estradiol(E2) in particular is known to be an important cause for the development and progression of BC. The proliferative effect of T3 has been demonstrated in various types of cancer. In BC cell lines, T3 may foster the conditions for tumor proliferation and increase the effect of cell proliferation by E2; thus, T3 may play a role in the developmentand progression of BC. Studies show that T3 has effects similar to E2 in BC cell lines. Despite controversy regarding the relationship between thyroid disturbances and the incidence of BC, studies show that thyroid status may influence the development of tumor, proliferation and metastasis.
文摘Gastric adenocarcinoma of fundic gland type(GA-FG) with chief cell differentiation was recently proposed as an extremely rare type of gastric adenocarcinoma. Here, we report 4 cases of GA-FG with chief cell differentiation. Endoscopic features included a submucosal tumor shape or a flat shape, whitish discoloration and dilated vessels on the surface. The tumors were located in the upper or middle third of the stomach. All cases were preoperatively diagnosed as GA-FG by biopsy, and endoscopic submucosal dissection was performed. Resected specimens revealed well-differentiated adenocarcinomas resembling chief cells. Tumor cells were diffusely positive for pepsinogen-Ⅰ, but partially positive for H+/K+-ATPase in scattered locations around the tumor margin. Despite the presence of minimal invasion of the carcinoma into the submucosal layer, which was observed in two cases, neither lymphatic nor venous invasion was detected in any of the cases. Finally, all cases showed less aggressive clinical behavior with low grade malignancy.
