[目的]分析乳腺影像报告与数据系统(breast imaging reporting and data system,BI-RADS)4~5类女性中乳腺癌发病风险因素,构建乳腺癌风险预测模型。[方法]收集2019年6月至2023年3月山西省晋城市泽州县妇幼保健院和长治医学院附属和平医...[目的]分析乳腺影像报告与数据系统(breast imaging reporting and data system,BI-RADS)4~5类女性中乳腺癌发病风险因素,构建乳腺癌风险预测模型。[方法]收集2019年6月至2023年3月山西省晋城市泽州县妇幼保健院和长治医学院附属和平医院337例BI-RADS 4~5类35岁以上女性临床及影像资料,经单因素分析后以P<0.05的变量结合最优子集法进行变量筛选,以赤池信息准则(akaike information criterion,AIC)最低的组合构建Logistic回归模型并进行Bootstrap内部验证,采用C指数、Calibration校准曲线、决策曲线(decision curve analysis,DCA)评估预测模型的临床有效性。[结果]体质指数(body mass index,BMI)、生产次数>2次,患有乳腺良性疾病史、致密型乳腺、肿块不规则为乳腺癌的危险因素。Logit(P)=-6.618+0.24BMI+0.606乳腺良性疾病史+0.306致密型乳腺+1.059×生育次数(>2次)+1.814肿块不规则。该模型的C指数为0.811(95%CI:0.731~0.891),H-L拟合优度检验P=0.205(P>0.05),结合校准曲线证明此模型的区分度和校准度良好。[结论]成功构建乳腺癌高危人群风险评估模型,且具有良好的预测价值,有利于识别乳腺癌患者,具备临床参考价值。展开更多
Background Complete tumour resection is important for improving the prognosis of brain tumour patients. However, extensive resection remains controversial because the tumour margin is difficult to be distinguished fro...Background Complete tumour resection is important for improving the prognosis of brain tumour patients. However, extensive resection remains controversial because the tumour margin is difficult to be distinguished from surrounding brain tissue. It has been established that 5-amino-4-0xopentanoic acid （5-aminolevulinic acid, ALA） can be used as a photodynamic diagnostic marker and a photosensitizer for photodynamic therapy in surgical treatment of brain tumours. We investigated the efficacy of ALA photodynamically guided microsurgery and photodynamic therapy on VX2 brain tumour implanted in a rabbit model. Methods Eighty New Zealand rabbits implanted with VX2 brain tumours were randomly assigned to five groups： control, conventional white light microsurgery, a photodynamic therapy group, a photodynamically guided microsurgery group and a group in which guided microsurgery was followed by photodynamic therapy. The VX2 tumour was resected under a surgical microscope. The tumour resection was confirmed with histological analysis. All animals were examined with MRI for presence of any residual tumour tissue. The survival time of each rabbit was recorded. Results All treatment groups showed a significantly extended survival time compared with the control group. Photodynamically guided microsurgery combined with photodynamic therapy significantly prolonged survival time, compared with guided microsurgery alone. MRI and the autopsy results confirmed removal of most of the tumours. Conclusions Our results suggest that photodynamically guided surgery and photodynamic therapy significantly reduce or delay local recurrence, increase the effectiveness of radical resection and prolong the survival time of tumour bearing rabbits. Their combination has the potential to be used as a rapid and highly effective treatment of metastatic brain tumours.展开更多
文摘[目的]分析乳腺影像报告与数据系统(breast imaging reporting and data system,BI-RADS)4~5类女性中乳腺癌发病风险因素,构建乳腺癌风险预测模型。[方法]收集2019年6月至2023年3月山西省晋城市泽州县妇幼保健院和长治医学院附属和平医院337例BI-RADS 4~5类35岁以上女性临床及影像资料,经单因素分析后以P<0.05的变量结合最优子集法进行变量筛选,以赤池信息准则(akaike information criterion,AIC)最低的组合构建Logistic回归模型并进行Bootstrap内部验证,采用C指数、Calibration校准曲线、决策曲线(decision curve analysis,DCA)评估预测模型的临床有效性。[结果]体质指数(body mass index,BMI)、生产次数>2次,患有乳腺良性疾病史、致密型乳腺、肿块不规则为乳腺癌的危险因素。Logit(P)=-6.618+0.24BMI+0.606乳腺良性疾病史+0.306致密型乳腺+1.059×生育次数(>2次)+1.814肿块不规则。该模型的C指数为0.811(95%CI:0.731~0.891),H-L拟合优度检验P=0.205(P>0.05),结合校准曲线证明此模型的区分度和校准度良好。[结论]成功构建乳腺癌高危人群风险评估模型,且具有良好的预测价值,有利于识别乳腺癌患者,具备临床参考价值。
文摘Background Complete tumour resection is important for improving the prognosis of brain tumour patients. However, extensive resection remains controversial because the tumour margin is difficult to be distinguished from surrounding brain tissue. It has been established that 5-amino-4-0xopentanoic acid （5-aminolevulinic acid, ALA） can be used as a photodynamic diagnostic marker and a photosensitizer for photodynamic therapy in surgical treatment of brain tumours. We investigated the efficacy of ALA photodynamically guided microsurgery and photodynamic therapy on VX2 brain tumour implanted in a rabbit model. Methods Eighty New Zealand rabbits implanted with VX2 brain tumours were randomly assigned to five groups： control, conventional white light microsurgery, a photodynamic therapy group, a photodynamically guided microsurgery group and a group in which guided microsurgery was followed by photodynamic therapy. The VX2 tumour was resected under a surgical microscope. The tumour resection was confirmed with histological analysis. All animals were examined with MRI for presence of any residual tumour tissue. The survival time of each rabbit was recorded. Results All treatment groups showed a significantly extended survival time compared with the control group. Photodynamically guided microsurgery combined with photodynamic therapy significantly prolonged survival time, compared with guided microsurgery alone. MRI and the autopsy results confirmed removal of most of the tumours. Conclusions Our results suggest that photodynamically guided surgery and photodynamic therapy significantly reduce or delay local recurrence, increase the effectiveness of radical resection and prolong the survival time of tumour bearing rabbits. Their combination has the potential to be used as a rapid and highly effective treatment of metastatic brain tumours.
