It is important to segment mass region accurately in a computer-aided diagnosis (CADx) scheme for evaluating the likelihood of malignancy of the mass on ultrasonographic breast image. The purpose of this study was to ...It is important to segment mass region accurately in a computer-aided diagnosis (CADx) scheme for evaluating the likelihood of malignancy of the mass on ultrasonographic breast image. The purpose of this study was to develop a novel level set method for segmentation of breast mass on ultrasonographic image. Our database consisted of 151 ultrasonographic images with 70 malignant and 81 benign breast masses. In a novel level set method, an energy function was defined with region-based, edge-based, and regularizing terms. The region-based term analyzed global information, whereas the edge-based term analyzed local information. The regularizing term also controlled the length of the boundary curve. The region of breast mass was segmented so that the energy based on those terms was minimized. With our proposed method, true positive (TP) ratio, false positive (FP) ratio, jaccard similarity (JS), and Dice similarity coefficient (DSC) were 92.2%, 9.1%, 84.2%, and 91.3%, respectively. These results tended to be substantially higher than those with two conventional segmentation methods. Our proposed method based on the novel level set method was shown to segment mass region accurately on ultrasonographic breast image.展开更多
Purpose: To study the specificity of mammography and ultrasonography separately and in combination for detection of breast masses (ultrasonography-mammography correlation);To study the investigations to evaluate vario...Purpose: To study the specificity of mammography and ultrasonography separately and in combination for detection of breast masses (ultrasonography-mammography correlation);To study the investigations to evaluate various breast masses;To describe suitable indications, advantages and limitations of each technique compared with other available modalities;To study the mimics of breast masses;To have histopathology follow-up and retrospective evaluation with imaging findings to improve diagnostic skills in series of 166 patients complaining of breast mass. Material: The prospective clinical study was carried out in the department of Radiodiagnosis for a period of 2 year extending from December 2010 to December 2012 infemale patients complaining of breast mass. Well informed written consent was obtained from them. Histopathology follow up was obtained from either biopsy or post operative tissue. USG machine: Philips HD 11 XE USG of the breasts and axillary region done in supine position in presence of female attendant;Mammography machine: Allengers machine with Agfa special mammography cassettes. Cranio caudal and Medio-Lateral Oblique views are taken in the presence of female attendant. MRI: PHILIPS 1.5 T machine;CT: SIEMENS duel slice CT machine. Results: Ultrasonography and mammography was done in most of the cases were sufficient to diagnose the lesion in most of the cases especially in benign breast masses. MRI and CT scan was used in special cases to know the extent of the lesions, in mimics of breast masses, bony extensions, primary muscular and bony lesions. Total 166 patients complaining of breast mass in one or both breasts were examined and evaluated with USG and mammography. The lesions were confirmed on histopathology (FNAC/biopsy). Out of 30 diagnosed malignancies two lesions were missed on mammography and four lesions were missed on ultrasonography. One of them was missed on both. For malignancies specificity of mammography is 93.3% and that of ultrasonography is 86.67%. Combining both the modalities specificity is near 97%. Out of total 92 abnormal breasts 12 were missed on USG and 20 were missed on mammography. Combining both the modalities only 2 lesions were missed and were diagnosed on histopathology alone. Overall specificity for USG in breast masses is 86.9% and for mammography it is 78.6%. Combining both the modalities the specificity is 97.6%. The “p” value is obtained which is highly significant for combination of ultrasonography and mammography in comparison with any individual modality (p = 0.0059 & p = 0.0001 respectively). Conclusion: Our study confirms the higher combined sensitivity rate for ultrasonography and mammography for detection of breast masses including malignancies. USG is useful in cystic lesions, ectasias, infections, pregnancy-lactation, and dense breast evaluation and for image guidance, whereas mammography is useful in detecting microcalcifications, spiculated masses for early detection of malignancies and for stereotactic biopsies. To suggest single modality, ultrasonography is better in younger population and BIRAD 1, 2 & 3 lesions. Whereas, mammography is better in older population and BIRAD 4 & 5 lesions. However, sono-mammographic correlation is best in both.展开更多
Cystic lesions are very commonly encountered entities in the breast. </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><spa...Cystic lesions are very commonly encountered entities in the breast. </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Among</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> these, Complex Cystic Breast Masses (CCBM</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">), which contain both anechoic </span><span style="font-family:Verdana;">and echogenic components, can result in a variety of imaging appearances.</span><span style="font-family:Verdana;"> These include cystic lesions with thick walls and/or internal septa, intracystic nodular lesions, and solid-cystic masses of varying com</span><span style="font-family:Verdana;">positions. Ultrasound is the mainstay for evaluating cystic lesions, and thus recognizing the imaging features appropriately and suggesting suitable interventional procedures are </span><span style="font-family:Verdana;">included in their management. In this pictorial essay, we describe the</span><span style="font-family:Verdana;"> wide</span><span style="font-family:Verdana;"> range of ultrasound appearances of CCBMs with a number of clinically encountered examples from our institution. This article would enhance the understanding of readers in possible differentials to be included in their clinical </span><span style="font-family:Verdana;">practice and to suggest appropriate further intervention, when deemed ne</span><span style="font-family:Verdana;">cessary.展开更多
Breast cancer is one of the most commonly diagnosed cancers and one of the most significant sources of cancer mortality. Triple negative breast cancer (TNBC) is a particularly aggressive subtype that has proven diffic...Breast cancer is one of the most commonly diagnosed cancers and one of the most significant sources of cancer mortality. Triple negative breast cancer (TNBC) is a particularly aggressive subtype that has proven difficult to treat with standard chemotherapies. Obesity has also been shown to exacerbate breast cancer, and diagnoses of these two diseases frequently overlap. Both conditions are regulated in part by the fat mass and obesity-associated (FTO) demethylase, an RNA demethylase which may drive breast cancers through epigenetic alterations to gene expression. Methods of inhibiting FTO have been researched in vitro and in vivo as an alternative or adjunct to chemotherapies in multiple cancers, including breast cancer. Translating knowledge of the role of FTO in breast cancer and the development of novel agents may allow for improvements in the treatment of this refractory cancer. This review therefore aims to provide an overview of existing and developing chemical inhibitors of FTO that could be innovatively studied for the treatment of TNBC and associated comorbidity.展开更多
Background: The purpose of this study was to evaluate the association between the body mass index (BMI) of breast cancer patients and non-cancer females of the Eastern Province of Saudi Arabia. Methods: The weight, he...Background: The purpose of this study was to evaluate the association between the body mass index (BMI) of breast cancer patients and non-cancer females of the Eastern Province of Saudi Arabia. Methods: The weight, height and age was obtained from the patient records of 706 newly diagnosed breast cancer patients and of 20,872 non-cancer female patients who consulted the two largest hospitals in the Eastern Province of Saudi Arabia between 2006 and 2012. Factorial analysis of variance (ANOVA) was used to assess the association between the BMI, age and breast cancer status. Results: The mean BMI of the non-cancer females was 29.4 and the percentage of obese patients of the different age groups ranged from 23.9% to 66.5%. The BMI increased significantly with age. The ANOVA revealed that breast cancer patients older than 50 years had a significantly lower BMI compared to their non-cancer counterparts (p = 0.01). Conclusion: Our data confirm the high BMI of the Saudi Arabian female population. The reason for our finding of a lower BMI of postmenopausal breast cancer patients compared to their non-cancer counterparts is unclear. Future studies are warranted to assess the impact of possible confounding factors on the association between obesity and breast cancer risk. An interesting factor to investigate in future studies would particularly be the use of the anti-diabetic and cancer-protective drug metformin considering that diabetes mellitus is endemic in Saudi Arabia with a prevalence of 30%.展开更多
Background: Obesity is a well-known risk factor for breast cancer recurrence and poor prognosis. The objective of this study was to evaluate the effect of body mass index (BMI) on survival in breast cancer patients. M...Background: Obesity is a well-known risk factor for breast cancer recurrence and poor prognosis. The objective of this study was to evaluate the effect of body mass index (BMI) on survival in breast cancer patients. Methods: We performed a retrospective analysis of 50 breast cancer patients treated in our hospital from January 2012 to December 2013. Patients were divided according to body mass index when diagnosed into: normal weight BMI 25 Kg/m2, over weight BMI ≥ 25 Kg/m2 to 2, obesity BMI ≥ 30 Kg/m2. In this study the effect of body mass index on progression free survival (PFS) and overall survival (OS) was evaluated. Results: The disease free survival (DFS) and overall survival (OS) decreased in overweight and obese patients. Both overweight and obesity were predictors for increased risks of breast cancer relapse and mortality with a median disease free survival for overweight 29 mons and obese patients 11 mons and a median overall survival for overweight patients 49 mons and obese patients 39 mons. Conclusion: Obesity and overweight are associated with poorer disease free survival and overall survival in patients with breast cancer.展开更多
Breast cancer is one of the most common and deadliest types of cancer among women and early detection is of major importance to decrease mortality rates. Microcalcification clusters and masses are two major indicators...Breast cancer is one of the most common and deadliest types of cancer among women and early detection is of major importance to decrease mortality rates. Microcalcification clusters and masses are two major indicators of malignancy in the early stages of this disease, when mammography is typically used as the screening technology. Computer-Aided Diagnosis (CAD) systems can support the radiologists’ work, by performing a double-reading process, which provides a second opinion that the physician can take into account in the detection process. This paper presents a CAD model based on computer vision procedures for locating suspicious regions that are later analyzed by artificial neural networks, support vector machines and linear discriminant analysis, to classify them into benign or malignant, based on a set of features that are extracted from lesions to characterize their visual content. A genetic algorithm is used to find the subset of features that provide the greatest discriminant power. Our results show that the SVM presented the highest overall accuracy and specificity for classifying microcalcification clusters, while the NN outperformed the rest for mass-classification in the same parameters. Overall accuracy, sensitivity and specificity were measured.展开更多
BACKGROUND Breast non-mass-like lesions(NMLs)account for 9.2%of all breast lesions.The specificity of the ultrasound diagnosis of NMLs is low,and it cannot be objectively classified according to the 5th Edition of the...BACKGROUND Breast non-mass-like lesions(NMLs)account for 9.2%of all breast lesions.The specificity of the ultrasound diagnosis of NMLs is low,and it cannot be objectively classified according to the 5th Edition of the Breast Imaging Reporting and Data System(BI-RADS).Contrast-enhanced ultrasound(CEUS)can help to differentiate and classify breast lesions but there are few studies on NMLs alone.AIM To analyze the features of benign and malignant breast NMLs in grayscale ultrasonography(US),color Doppler flow imaging(CDFI)and CEUS,and to explore the efficacy of the combined diagnosis of NMLs and the effect of CEUS on the BI-RADS classification of NMLs.METHODS A total of 51 breast NMLs verified by pathology were analyzed in our hospital from January 2017 to April 2019.All lesions were examined by US,CDFI and CEUS,and their features from those examinations were analyzed.With pathology as the gold standard,binary logic regression was used to analyze the independent risk factors for malignant breast NMLs,and a regression equation was established to calculate the efficiency of combined diagnosis.Based on the regression equation,the combined diagnostic efficiency of US combined with CEUS(US+CEUS)was determined.The initial BI-RADS-US classification of NMLs was adjusted according to the independent risk factors identified by CEUS,and the diagnostic efficiency of CEUS combined with BI-RADS(CEUS+BI-RADS)was calculated based on the results.ROC curves were drawn to compare the diagnostic values of the three methods,including US,US+CEUS,and CEUS+BI-RADS,for benign and malignant NMLs.RESULTS Microcalcification,enhancement time,enhancement intensity,lesion scope,and peripheral blood vessels were significantly different between benign and malignant NMLs.Among these features,microcalcification,higher enhancement,and lesion scope were identified as independent risk factors for malignant breast NMLs.When US,US+CEUS,and CEUS+BI-RADS were used to identify the benign and malignant breast NMLs,their sensitivity rates were 82.6%,91.3%,and 87.0%,respectively;their specificity rates were 71.4%,89.2%,and 92.9%,respectively;their positive predictive values were 70.4%,87.5%,and 90.9%,respectively;their negative predictive values were 83.3%,92.6%,and 89.7%,respectively;their accuracy rates were 76.5%,90.2%,and 90.2%,respectively;and their corresponding areas under ROC curves were 0.752,0.877 and 0.903,respectively.Z tests showed that the area under the ROC curve of US was statistically smaller than that of US+CEUS and CEUS+BI-RADS,and there was no statistical difference between US+CEUS and CEUS+BI-RADS.CONCLUSION US combined with CEUS can improve diagnostic efficiency for NMLs.The adjustment of the BI-RADS classification according to the features of contrastenhanced US of NMLs enables the diagnostic results to be simple and intuitive,facilitates the management of NMLs,and effectively reduces the incidence of unnecessary biopsy.展开更多
Identification and quantification of low abundance growth factors and regulators in complex biological samples still present a challenging task in analytical biochemistry. Immunoassays are often used for such purpose ...Identification and quantification of low abundance growth factors and regulators in complex biological samples still present a challenging task in analytical biochemistry. Immunoassays are often used for such purpose but immunoassays face limitation of both availability and qualities of antibody reagents that are necessary for development of immune assays. With genomics data base available, mass spectrometry (MS) can analyze protein tryptic peptides directly for quantitative determination of proteins. In this study, we report a method for detection of matrix metalloproteinase 1 (MMP1), an important extracellular matrix modulator, in human breast cancer cells by quadrupole time-of-flight (Q-TOF) MS. Absolute quantification of MMP1 was conducted using the selected reaction monitoring (SRM) on a triple quadrupole (Triple-Quad) MS via transitions selected from MMP1 tryptic peptides using non isotope labeled MMP1 protein as a titration standard. In comparison with immune based assay, this MS method showed picogram level sensitivity for quantitative determination of MMP1 intotal cell lysates. Our results demonstrated the feasibility of absolute quantification of low abundance proteins using label-free protein standard by mass spectrometry. Therefore, this method provides not only advantages of high sensitivity but also cost saving in comparison with the commonly used mass spectrometry that currently employs isotype labeled proteins for quantitative analysis.展开更多
BACKGROUND Paragonimiasis is a food-borne parasitic infection caused by lung flukes of the genus Paragonimus. Although the most common site of infection is the pleuropulmonary area, the parasite can also reach other p...BACKGROUND Paragonimiasis is a food-borne parasitic infection caused by lung flukes of the genus Paragonimus. Although the most common site of infection is the pleuropulmonary area, the parasite can also reach other parts of the body on its journey from the intestines to the lungs, ending up in locations such as the brain,abdomen, skin, and subcutaneous tissues. Ectopic paragonimiasis is difficult to diagnose due to the rarity of this disease.CASE SUMMARY Here, we report a rare case of simultaneous breast and pulmonary paragonimiasis in a woman presenting painless breast mass and lung nodule with a history of eating raw trout. To confirm the diagnosis, serologic testing and tissue confirmation of the breast mass were performed. The patient was treated with surgical resection of the mass and praziquantel medication.CONCLUSION Ectopic paragonimiasis is difficult to diagnose due to the rarity of this disease.Thus, thorough history-taking and clinical suspicion of parasitic infection are important.展开更多
目的分析基于超声乳腺影像报告和数据系统(Breast Imaging Reporting and Data System,BI-RADS)分类对不同病理类型乳腺肿块诊断的结果。方法方便选取2022年3月—2023年8月在枣庄市台儿庄区人民医院和济南市平阴县中医医院进行检查的74...目的分析基于超声乳腺影像报告和数据系统(Breast Imaging Reporting and Data System,BI-RADS)分类对不同病理类型乳腺肿块诊断的结果。方法方便选取2022年3月—2023年8月在枣庄市台儿庄区人民医院和济南市平阴县中医医院进行检查的74例女性患者为研究对象。以病理检查为金标准,经病理证实乳腺肿块共80个,采用kappa检验分析超声检查与病理结果的一致性。结果病理结果显示,良性肿块61个,恶性肿块19个(kappa值为0.710,P<0.01)。超声BI-RADS分类诊断的灵敏度、特异度、准确度分别为96.72%、84.21%、93.75%。超声BI-RADS对良性肿瘤的诊断符合率均≥85.71%,而对恶性肿瘤诊断中,符合率最低时为75.00%。结论虽然不同病理类型乳腺肿块的超声诊断符合率较高,但在实际操作过程中仍然存在漏诊误诊等情况,故需要临床医师了解超声检查的不足,对超声诊断质量做好把控。展开更多
文摘It is important to segment mass region accurately in a computer-aided diagnosis (CADx) scheme for evaluating the likelihood of malignancy of the mass on ultrasonographic breast image. The purpose of this study was to develop a novel level set method for segmentation of breast mass on ultrasonographic image. Our database consisted of 151 ultrasonographic images with 70 malignant and 81 benign breast masses. In a novel level set method, an energy function was defined with region-based, edge-based, and regularizing terms. The region-based term analyzed global information, whereas the edge-based term analyzed local information. The regularizing term also controlled the length of the boundary curve. The region of breast mass was segmented so that the energy based on those terms was minimized. With our proposed method, true positive (TP) ratio, false positive (FP) ratio, jaccard similarity (JS), and Dice similarity coefficient (DSC) were 92.2%, 9.1%, 84.2%, and 91.3%, respectively. These results tended to be substantially higher than those with two conventional segmentation methods. Our proposed method based on the novel level set method was shown to segment mass region accurately on ultrasonographic breast image.
文摘Purpose: To study the specificity of mammography and ultrasonography separately and in combination for detection of breast masses (ultrasonography-mammography correlation);To study the investigations to evaluate various breast masses;To describe suitable indications, advantages and limitations of each technique compared with other available modalities;To study the mimics of breast masses;To have histopathology follow-up and retrospective evaluation with imaging findings to improve diagnostic skills in series of 166 patients complaining of breast mass. Material: The prospective clinical study was carried out in the department of Radiodiagnosis for a period of 2 year extending from December 2010 to December 2012 infemale patients complaining of breast mass. Well informed written consent was obtained from them. Histopathology follow up was obtained from either biopsy or post operative tissue. USG machine: Philips HD 11 XE USG of the breasts and axillary region done in supine position in presence of female attendant;Mammography machine: Allengers machine with Agfa special mammography cassettes. Cranio caudal and Medio-Lateral Oblique views are taken in the presence of female attendant. MRI: PHILIPS 1.5 T machine;CT: SIEMENS duel slice CT machine. Results: Ultrasonography and mammography was done in most of the cases were sufficient to diagnose the lesion in most of the cases especially in benign breast masses. MRI and CT scan was used in special cases to know the extent of the lesions, in mimics of breast masses, bony extensions, primary muscular and bony lesions. Total 166 patients complaining of breast mass in one or both breasts were examined and evaluated with USG and mammography. The lesions were confirmed on histopathology (FNAC/biopsy). Out of 30 diagnosed malignancies two lesions were missed on mammography and four lesions were missed on ultrasonography. One of them was missed on both. For malignancies specificity of mammography is 93.3% and that of ultrasonography is 86.67%. Combining both the modalities specificity is near 97%. Out of total 92 abnormal breasts 12 were missed on USG and 20 were missed on mammography. Combining both the modalities only 2 lesions were missed and were diagnosed on histopathology alone. Overall specificity for USG in breast masses is 86.9% and for mammography it is 78.6%. Combining both the modalities the specificity is 97.6%. The “p” value is obtained which is highly significant for combination of ultrasonography and mammography in comparison with any individual modality (p = 0.0059 & p = 0.0001 respectively). Conclusion: Our study confirms the higher combined sensitivity rate for ultrasonography and mammography for detection of breast masses including malignancies. USG is useful in cystic lesions, ectasias, infections, pregnancy-lactation, and dense breast evaluation and for image guidance, whereas mammography is useful in detecting microcalcifications, spiculated masses for early detection of malignancies and for stereotactic biopsies. To suggest single modality, ultrasonography is better in younger population and BIRAD 1, 2 & 3 lesions. Whereas, mammography is better in older population and BIRAD 4 & 5 lesions. However, sono-mammographic correlation is best in both.
文摘Cystic lesions are very commonly encountered entities in the breast. </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">Among</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> these, Complex Cystic Breast Masses (CCBM</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">s</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">), which contain both anechoic </span><span style="font-family:Verdana;">and echogenic components, can result in a variety of imaging appearances.</span><span style="font-family:Verdana;"> These include cystic lesions with thick walls and/or internal septa, intracystic nodular lesions, and solid-cystic masses of varying com</span><span style="font-family:Verdana;">positions. Ultrasound is the mainstay for evaluating cystic lesions, and thus recognizing the imaging features appropriately and suggesting suitable interventional procedures are </span><span style="font-family:Verdana;">included in their management. In this pictorial essay, we describe the</span><span style="font-family:Verdana;"> wide</span><span style="font-family:Verdana;"> range of ultrasound appearances of CCBMs with a number of clinically encountered examples from our institution. This article would enhance the understanding of readers in possible differentials to be included in their clinical </span><span style="font-family:Verdana;">practice and to suggest appropriate further intervention, when deemed ne</span><span style="font-family:Verdana;">cessary.
文摘Breast cancer is one of the most commonly diagnosed cancers and one of the most significant sources of cancer mortality. Triple negative breast cancer (TNBC) is a particularly aggressive subtype that has proven difficult to treat with standard chemotherapies. Obesity has also been shown to exacerbate breast cancer, and diagnoses of these two diseases frequently overlap. Both conditions are regulated in part by the fat mass and obesity-associated (FTO) demethylase, an RNA demethylase which may drive breast cancers through epigenetic alterations to gene expression. Methods of inhibiting FTO have been researched in vitro and in vivo as an alternative or adjunct to chemotherapies in multiple cancers, including breast cancer. Translating knowledge of the role of FTO in breast cancer and the development of novel agents may allow for improvements in the treatment of this refractory cancer. This review therefore aims to provide an overview of existing and developing chemical inhibitors of FTO that could be innovatively studied for the treatment of TNBC and associated comorbidity.
文摘Background: The purpose of this study was to evaluate the association between the body mass index (BMI) of breast cancer patients and non-cancer females of the Eastern Province of Saudi Arabia. Methods: The weight, height and age was obtained from the patient records of 706 newly diagnosed breast cancer patients and of 20,872 non-cancer female patients who consulted the two largest hospitals in the Eastern Province of Saudi Arabia between 2006 and 2012. Factorial analysis of variance (ANOVA) was used to assess the association between the BMI, age and breast cancer status. Results: The mean BMI of the non-cancer females was 29.4 and the percentage of obese patients of the different age groups ranged from 23.9% to 66.5%. The BMI increased significantly with age. The ANOVA revealed that breast cancer patients older than 50 years had a significantly lower BMI compared to their non-cancer counterparts (p = 0.01). Conclusion: Our data confirm the high BMI of the Saudi Arabian female population. The reason for our finding of a lower BMI of postmenopausal breast cancer patients compared to their non-cancer counterparts is unclear. Future studies are warranted to assess the impact of possible confounding factors on the association between obesity and breast cancer risk. An interesting factor to investigate in future studies would particularly be the use of the anti-diabetic and cancer-protective drug metformin considering that diabetes mellitus is endemic in Saudi Arabia with a prevalence of 30%.
文摘Background: Obesity is a well-known risk factor for breast cancer recurrence and poor prognosis. The objective of this study was to evaluate the effect of body mass index (BMI) on survival in breast cancer patients. Methods: We performed a retrospective analysis of 50 breast cancer patients treated in our hospital from January 2012 to December 2013. Patients were divided according to body mass index when diagnosed into: normal weight BMI 25 Kg/m2, over weight BMI ≥ 25 Kg/m2 to 2, obesity BMI ≥ 30 Kg/m2. In this study the effect of body mass index on progression free survival (PFS) and overall survival (OS) was evaluated. Results: The disease free survival (DFS) and overall survival (OS) decreased in overweight and obese patients. Both overweight and obesity were predictors for increased risks of breast cancer relapse and mortality with a median disease free survival for overweight 29 mons and obese patients 11 mons and a median overall survival for overweight patients 49 mons and obese patients 39 mons. Conclusion: Obesity and overweight are associated with poorer disease free survival and overall survival in patients with breast cancer.
文摘Breast cancer is one of the most common and deadliest types of cancer among women and early detection is of major importance to decrease mortality rates. Microcalcification clusters and masses are two major indicators of malignancy in the early stages of this disease, when mammography is typically used as the screening technology. Computer-Aided Diagnosis (CAD) systems can support the radiologists’ work, by performing a double-reading process, which provides a second opinion that the physician can take into account in the detection process. This paper presents a CAD model based on computer vision procedures for locating suspicious regions that are later analyzed by artificial neural networks, support vector machines and linear discriminant analysis, to classify them into benign or malignant, based on a set of features that are extracted from lesions to characterize their visual content. A genetic algorithm is used to find the subset of features that provide the greatest discriminant power. Our results show that the SVM presented the highest overall accuracy and specificity for classifying microcalcification clusters, while the NN outperformed the rest for mass-classification in the same parameters. Overall accuracy, sensitivity and specificity were measured.
文摘BACKGROUND Breast non-mass-like lesions(NMLs)account for 9.2%of all breast lesions.The specificity of the ultrasound diagnosis of NMLs is low,and it cannot be objectively classified according to the 5th Edition of the Breast Imaging Reporting and Data System(BI-RADS).Contrast-enhanced ultrasound(CEUS)can help to differentiate and classify breast lesions but there are few studies on NMLs alone.AIM To analyze the features of benign and malignant breast NMLs in grayscale ultrasonography(US),color Doppler flow imaging(CDFI)and CEUS,and to explore the efficacy of the combined diagnosis of NMLs and the effect of CEUS on the BI-RADS classification of NMLs.METHODS A total of 51 breast NMLs verified by pathology were analyzed in our hospital from January 2017 to April 2019.All lesions were examined by US,CDFI and CEUS,and their features from those examinations were analyzed.With pathology as the gold standard,binary logic regression was used to analyze the independent risk factors for malignant breast NMLs,and a regression equation was established to calculate the efficiency of combined diagnosis.Based on the regression equation,the combined diagnostic efficiency of US combined with CEUS(US+CEUS)was determined.The initial BI-RADS-US classification of NMLs was adjusted according to the independent risk factors identified by CEUS,and the diagnostic efficiency of CEUS combined with BI-RADS(CEUS+BI-RADS)was calculated based on the results.ROC curves were drawn to compare the diagnostic values of the three methods,including US,US+CEUS,and CEUS+BI-RADS,for benign and malignant NMLs.RESULTS Microcalcification,enhancement time,enhancement intensity,lesion scope,and peripheral blood vessels were significantly different between benign and malignant NMLs.Among these features,microcalcification,higher enhancement,and lesion scope were identified as independent risk factors for malignant breast NMLs.When US,US+CEUS,and CEUS+BI-RADS were used to identify the benign and malignant breast NMLs,their sensitivity rates were 82.6%,91.3%,and 87.0%,respectively;their specificity rates were 71.4%,89.2%,and 92.9%,respectively;their positive predictive values were 70.4%,87.5%,and 90.9%,respectively;their negative predictive values were 83.3%,92.6%,and 89.7%,respectively;their accuracy rates were 76.5%,90.2%,and 90.2%,respectively;and their corresponding areas under ROC curves were 0.752,0.877 and 0.903,respectively.Z tests showed that the area under the ROC curve of US was statistically smaller than that of US+CEUS and CEUS+BI-RADS,and there was no statistical difference between US+CEUS and CEUS+BI-RADS.CONCLUSION US combined with CEUS can improve diagnostic efficiency for NMLs.The adjustment of the BI-RADS classification according to the features of contrastenhanced US of NMLs enables the diagnostic results to be simple and intuitive,facilitates the management of NMLs,and effectively reduces the incidence of unnecessary biopsy.
文摘Identification and quantification of low abundance growth factors and regulators in complex biological samples still present a challenging task in analytical biochemistry. Immunoassays are often used for such purpose but immunoassays face limitation of both availability and qualities of antibody reagents that are necessary for development of immune assays. With genomics data base available, mass spectrometry (MS) can analyze protein tryptic peptides directly for quantitative determination of proteins. In this study, we report a method for detection of matrix metalloproteinase 1 (MMP1), an important extracellular matrix modulator, in human breast cancer cells by quadrupole time-of-flight (Q-TOF) MS. Absolute quantification of MMP1 was conducted using the selected reaction monitoring (SRM) on a triple quadrupole (Triple-Quad) MS via transitions selected from MMP1 tryptic peptides using non isotope labeled MMP1 protein as a titration standard. In comparison with immune based assay, this MS method showed picogram level sensitivity for quantitative determination of MMP1 intotal cell lysates. Our results demonstrated the feasibility of absolute quantification of low abundance proteins using label-free protein standard by mass spectrometry. Therefore, this method provides not only advantages of high sensitivity but also cost saving in comparison with the commonly used mass spectrometry that currently employs isotype labeled proteins for quantitative analysis.
文摘BACKGROUND Paragonimiasis is a food-borne parasitic infection caused by lung flukes of the genus Paragonimus. Although the most common site of infection is the pleuropulmonary area, the parasite can also reach other parts of the body on its journey from the intestines to the lungs, ending up in locations such as the brain,abdomen, skin, and subcutaneous tissues. Ectopic paragonimiasis is difficult to diagnose due to the rarity of this disease.CASE SUMMARY Here, we report a rare case of simultaneous breast and pulmonary paragonimiasis in a woman presenting painless breast mass and lung nodule with a history of eating raw trout. To confirm the diagnosis, serologic testing and tissue confirmation of the breast mass were performed. The patient was treated with surgical resection of the mass and praziquantel medication.CONCLUSION Ectopic paragonimiasis is difficult to diagnose due to the rarity of this disease.Thus, thorough history-taking and clinical suspicion of parasitic infection are important.
文摘目的分析基于超声乳腺影像报告和数据系统(Breast Imaging Reporting and Data System,BI-RADS)分类对不同病理类型乳腺肿块诊断的结果。方法方便选取2022年3月—2023年8月在枣庄市台儿庄区人民医院和济南市平阴县中医医院进行检查的74例女性患者为研究对象。以病理检查为金标准,经病理证实乳腺肿块共80个,采用kappa检验分析超声检查与病理结果的一致性。结果病理结果显示,良性肿块61个,恶性肿块19个(kappa值为0.710,P<0.01)。超声BI-RADS分类诊断的灵敏度、特异度、准确度分别为96.72%、84.21%、93.75%。超声BI-RADS对良性肿瘤的诊断符合率均≥85.71%,而对恶性肿瘤诊断中,符合率最低时为75.00%。结论虽然不同病理类型乳腺肿块的超声诊断符合率较高,但在实际操作过程中仍然存在漏诊误诊等情况,故需要临床医师了解超声检查的不足,对超声诊断质量做好把控。