检测尿中巯基筛诊宫颈癌与癌前病变的临床意义

目的:评价检测尿中巯基筛诊宫颈癌前病变、早期宫颈癌、中晚期宫颈癌的临床意义。方法:对1030例宫颈癌前病变、早期宫颈癌、中晚期宫颈癌、非宫颈部位的7种癌以及宫颈正常或宫颈良性炎症妇女,采用子宫颈癌快速自检试剂盒(fast self test-SH for screening cervical cancer,FST-SH)检测其尿中巯基。结果:特异度为94.86%;阳性率、准确度、阳性预测值、阴性预测值、约登指数、阳性似然比,在宫颈癌前病变组为35.71%、87.42%、50.00%、91.11%、0.31、6.95;在早期宫颈癌组为65.87%、87.77%、80.58%、89.78%、0.61、12.82;在中晚期宫颈癌组为80.54%、90.24%、88.17%、91.11%、0.75、15.67;在非宫颈部位的7种癌组为12.41%、60.78%、62.96%、60.59%、0.07、2.41。结论:采用子宫颈癌快速自检试剂盒测定尿中巯基筛诊宫颈癌前病变、早期宫颈癌、中晚期宫颈癌患者,阳性率显著高于非宫颈部位的7种癌(P<0.01),且灵敏度随着病情加重而升高(r=0.99,P<0.05)。根据阳性结果判断为宫颈癌前病变或宫颈癌患者具有较高的准确度和阳性预测值及阳性似然比。根据阴性结果区分为非宫颈癌前病变或宫颈癌患者时具有很高的特异性和阴性预测值。因此,该方法适用于筛诊宫颈癌前病变和宫颈癌,但不适用于筛诊非宫颈部位的7种癌。

X线胸片和CT在发热门诊筛诊聚集人群中SARS的作用

目的 :评估X线胸片及CT在发热门诊对聚集人群筛诊SARS的作用。材料和方法 :分析同一家庭 3例SARS患者胸片及CT的表现。结果 :3例胸片及CT均发现异常 ,其中大片实变 1例 ,毛玻璃样斑片影改变 2例 ;CT表现病变较胸片多而清楚。结论 :X线胸片、CT在发热门诊筛诊聚集人群中SARS具有必不可少的重要作用。

生物标志物在肺癌早筛早诊应用中的研究现状

肺癌是全球范围内恶性程度最高的肿瘤之一。在我国,肺癌的死亡率已连续多年处于首位。早筛早诊是延长肺癌患者生存期的前提。近年来,被认为具有发展前景的液体活检技术逐渐受到关注,其在肺癌早期诊断中的价值值得我们探讨。本文通过综述生物标志物在肺癌筛查和早期诊断中的应用,从多组学寻找特异生物标志物,探讨其在肺癌早期诊断的意义。

从结直肠生理特点与病因源头探讨个性化营养实现早诊早治的技术空间

饮食日益西化致使结直肠癌出现井喷式高发。人体基因甲基化、营养代谢等技术,为癌前病变的早筛早诊,为个性化营养符合主体基因型的早防早治,提供了足够的技术空间。

湖南省结直肠癌早筛早诊现状及思考与探索

结直肠癌是最常见的恶性肿瘤之一,在我国的发病率跃居第二位,严重威胁人类健康。结直肠癌的发生是个长期逐渐进展的过程,由癌前病变发展至癌性病灶有一个较长的“窗口期”,如能在这个时期发现癌前病变,及时处理或结肠镜下治疗,阻止其发生癌变,将大大降低结直肠癌的发生率,明显提高治疗效果,结直肠癌死亡率也将显著下降,因此开展结直肠癌的早筛早诊对于提高结直肠癌患者的5年生存率十分重要,目前国内发达城市已开展结直肠癌的早筛早诊工作取得了初步成效。湖南省开展结直肠癌早筛早诊工作已10年,与国内发达城市相比存在比较大差距,现就湖南省开展结直肠癌早筛早诊现状、结合国内发达城市经验及发达国家开展结直肠癌早筛早诊的文献资料进行分析思考与探索,为更好开展结直肠癌早筛早诊工作提供参考。

Efficacy of leukocyte esterase dipstick test as a rapid test in diagnosis of spontaneous bacterial peritonitis

AIM: To evaluate the efficacy of dipstick test in diagnosis of spontaneous bacterial peritonitis (SBP) in cirrhotic patients who underwent abdominal paracentesis based on the locally available dipstick test. METHODS: There were 200 consecutive samples from cirrhotic patients who underwent abdominal paracentesis. Urine dipstick (Combur10 Test?M, Roche, Mannheim, Germany) was used as a screening test. A manual cell count with differential study was done in all samples by experienced technicians. The polymorphonuclear (PMN) cell count more than 250 cells/mm3 was used as a diagnostic cut off level. One to three plus dipstick results were used as cut off levels for a positive result. The dipstick test results had to be agreed by three experienced readers. The sensitivity, specificity, positive and negative predictive values and accuracy of two different colorimetric cut off scales (1+ and 2+) were calculated and compared. RESULTS: The prevalence of SBP diagnosed by manual cell count was 21.0%. There were 128 specimens that had a true negative result by dipstick. The sensitivity, specificity, positive and negative predictive values and accuracy of 1+ and 2+ cut off scale to diagnose SBP were 88%, 81%, 55%, 96% and 83% respectively, and 63%, 96%, 82%, 81% and 89% respectively. CONCLUSION: Dipstick test can be used as a rapid test for screening of SBP. The higher cut off colorimetric scale has a better specificity and positive predictive value but a lower sensitivity.

Pancreatic ductal adenocarcinoma screening:New perspectives

Pancreatic ductal adenocarcinoma accounts for more than 90% of all pancreatic cancers and its incidence has increased significantly worldwide.Patients with pancreatic ductal adenocarcinoma have a poor outcome and more than 95% of the people affected die from the disease within 12 mo after diagnosis.Surgery is the first-line treatment in the case of resectable neoplasm,but only 20% of patients are candidates for this approach.One of the reasons there are few candidates for surgery is that,during the early phases of the disease,the symptoms are poor or non-specific.Early diagnosis is of crucial importance to improve patient outcome;therefore,we are looking for a good screening test.The screening test must identify the disease in an early stage in order to be effective;having said this,a need exists to introduce the concept of "early" ductal adenocarcinoma.It has been reported that at least five additional years after the occurrence of the initiating mutation are required for the acquisition of metastatic ability of pancreatic adenocarcinoma and patients die an average of two years thereafter.We have reviewed the most recent literature in order to evaluate the present and future perspectives of screening programs of this deadly disease.

A data-mining approach to biomarker identification from protein profiles using discrete stationary wavelet transform

Objective: To develop a new bioinformatic tool based on a data-mining approach for extraction of the most infor- mative proteins that could be used to find the potential biomarkers for the detection of cancer. Methods: Two independent datasets from serum samples of 253 ovarian cancer and 167 breast cancer patients were used. The samples were examined by surface- enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF MS). The datasets were used to extract the informative proteins using a data-mining method in the discrete stationary wavelet transform domain. As a dimensionality re- duction procedure, the hard thresholding method was applied to reduce the number of wavelet coefficients. Also, a distance measure was used to select the most discriminative coefficients. To find the potential biomarkers using the selected wavelet coefficients, we applied the inverse discrete stationary wavelet transform combined with a two-sided t-test. Results: From the ovarian cancer dataset, a set of five proteins were detected as potential biomarkers that could be used to identify the cancer patients from the healthy cases with accuracy, sensitivity, and specificity of 100%. Also, from the breast cancer dataset, a set of eight proteins were found as the potential biomarkers that could separate the healthy cases from the cancer patients with accuracy of 98.26%, sensitivity of 100%, and specificity of 95.6%. Conclusion: The results have shown that the new bioinformatic tool can be used in combination with the high-throughput proteomic data such as SELDI-TOF MS to find the potential biomarkers with high discriminative power.

A survey and evaluation of population-based screening for gastric cancer

Screening and early diagnosis of gastric cancer play important roles in reducing the mortality of gastric cancer. A vast amount of study data on gastric cancer screening and early diagnosis has been accumulated in and out of China in the past decades. The practice of gastric cancer screening has also been efficiently carried out in different countries and regions. However, no widely accepted principle of population screening for gastric cancer has been developed yet. Screening for gastric cancer requires extensive exploration both theoretically and practically. This article focuses on the method and program of gastric cancer screening based on population. Moreover, the current situation of gastric cancer screening and its evaluation are evaluated.

Screening of premalignant and malignant cervical lesions in underdeveloped countries by using Pap smear as routine investigation in outpatient department

Objective: Papanicolou (Pap) smear screening has dramatically reduced the incidence of invasive cervical cancer worldwide. Pap smear screening is still not widely available in developing countries and therefore cannot be used as mass screening tool. This study was designed to establish the role of Pap smear as a routine investigation for females presented to gynecological department. Methods: It was a hospital based study. Patients attending with complaints including irregular vaginal bleeding, vagina discharge, dyspareunia, low backache or lower abdominal pain and primary or secondary infertility were included in the study. All these patients underwent pap smear. Results: Age of females was 25 to 60 years. Ninety females had dysplasia. Mild to moderate dysplasia was positive in 84 females. Six patients had severe dysplasia suspicious for squamous cell carcinoma (SCC) which was confirmed as invasive SCC on biopsy. All patients with mild to moderate dysplasia were regularly followed at 4 to 6 months. Thirty patients were lost during follow up. Forty had negative smear at 6 months, while fourteen having persistent dysplasia on repeated pap smears were referred for biopsies. Histopathology confirmed invasive SCC in five patients while chronic cervicitis was reported in nine patients. Only two of screened patients with high suspicion for cancer showed false negative results. Directed biopsies done in these confirmed invasive SCC. Conclusion: Pap smear is a useful, simple, non-invasive and reliable screening tool for cervical cancer. It may be practiced as a routine investigation in outpatients in developing countries, where mass screening is not available.

The Contribution of Artificial Intelligence Tools in Screening for Cancer of the Cervix

Recently, research into pathological cytology were intended to put in places of artificial intelligence systems based on the development of new diagnostic technologies and the cell image segmentation. These technologies are not intended to substitute the human expert but to facilitate his task. The objective of this work is to develop a method for diagnosing cancer cervical smears using cervical-vaginal segmented to build the authors＇ database and a human supervisor and as an automatic tool manage and monitor the execution of the operation of diagnostic and proposing corrective actions if necessary. The Supervisor Smart is manufactured by the technique of neural networks with a success rate of 43.3% followed by the technique of fuzzy logic with a success rate equal to 56.7% and finally to improve this rate we used neuro-fuzzy approach which has a rate which reaches 94%.

An Effective Diagnosis of Diabetic Retinopathy with Aid of Soft Computing Approaches

DR （diabetic retinopathy） is a most probable reason of blindness in adults, but the only remedy or escape from blindness is that we have to detect DR as early. Several automated screening techniques are used to detect individual lesions in the retina. Still it takes more dependency of time and experts. To overcome those problems and also automatically detect DR in easier and faster way, we took into soft computing approaches in our proposed work. Our proposed work will discuss several amounts of soft computing algorithms, it can detect DR features （landmark and retinal lesions） in an easy manner. Processes includes are： （1） Pre-processing; （2） Optic disc localization and segmentation; （3） Localization of fovea; （4） Blood vessel segmentation; （5） Feature extraction; （6） Feature selection; Finally （7） detection of diabetic retinopathy stages （mild, moderate, severe and PDR）. Our experimental results based on Matlab simulation and it takes databases of STARE and DRIVE. Proposed effective soft computing approaches should improve the sensitivity, specificity and accuracy.

代谢综合征及其成分与宫颈癌相关性的研究进展

宫颈癌是最常见的女性生殖道恶性肿瘤,严重危害女性健康。代谢综合征是以胰岛素抵抗为主的一组疾病,包括肥胖、高血压、血糖升高、血脂紊乱等代谢异常,可诱发多种疾病,被视为恶性肿瘤高发的危险因子。其与宫颈癌的发生、发展及预后的关系,也引起了人们的普遍关注。深入开展这方面的研究将可能为宫颈癌及癌前病变早筛早诊提供新的思路。本文就代谢综合征及其成分与宫颈癌发生发展及预后的相关性作一综述。

Advances in preimplantation genetic diagnosis/screening

Preimplantation genetic diagnosis(PGD)gives couples who have a high risk of transmitting genetic disorders to their baby the chance to have a healthy offspring through embryo genetic analysis and selection.Preimplantation genetic screening(PGS)is an effective method to select euploid embryos that may prevent repeated implantation failure or miscarriage.However,how and to whom PGS should be provided is a controversial topic.The first successful case of PGD of a human being was reported in 1990,and there have been tremendous improvements in this technology since then.Both embryo biopsy and genetic technologies have been improved dramatically,which increase the accuracy and expand the indications of PGD/PGS.