Background Distinguishing inverted papilloma （IP） from malignant tumors in the nasal cavity is difficult in a substantial number of cases,thus hindering the administration of appropriate therapeutic strategies.This ...Background Distinguishing inverted papilloma （IP） from malignant tumors in the nasal cavity is difficult in a substantial number of cases,thus hindering the administration of appropriate therapeutic strategies.This study aimed to evaluate whether magnetic resonance imaging （MRI）,including dynamic contrast enhanced MRI （DCE-MRI）,could improve differentiation between IP and malignant tumors,and to identify which MRI features were the best in discriminating IP from malignant tumors in the nasal cavity.Methods Non-enhanced,static,and dynamic contrast enhanced MRI was performed in 88 patients with an IP or a malignant tumor in the nasal cavity that had been confirmed by histological results.MRI features of IP and malignant tumors including side,margin,T1 signal intensity,T1 homogeneity,T2 signal intensity,T2 homogeneity,lobulation signs,convoluted cerebriform pattern,extra-sinonasal involvement,pattern of enhancement,Tpeak,Tmax,Clmax,and TIC type were evaluated and correlated with histological findings.Results There were significant differences between IP and malignant tumors in T2 homogeneity,Iobulation signs,convoluted cerebriform pattern,extra-sinonasal involvement,Tpeak,Tmax and TIC types.A convoluted cerebriform pattern had a higher sensitivity and specificity in diagnosis of IP while washout-type TIC had a higher sensitivity and specificity in diagnosis of malignant tumors in the nasal cavity.Non-enhanced combined with static and dynamic enhancement MRI was significantly superior to non-enhanced combined with static enhancement MRI in the differentiation of IP and malignant tumors in the nasal cavity.Multivariate logistic regression analysis identified that the best MRI features were a convoluted cerebriform pattern,extra-sinonasal involvement,and washout-type TIC for both observers （Wang XY and Zhang ZY）.Conclusion Non-enhanced and static combined with dynamic contrast-enhanced MRI improves differentiation of IP and malignant tumors in the nasal cavity.展开更多
目的探讨鼻腔-鼻窦鳞状细胞癌(sinonasal s q u a m o u s c el l c a r c i n o m a,S NS C C)中细胞角蛋白13(cytokeratin13,CK13)、细胞角蛋白4(cytokeratin 4,CK4)的表达及与肿瘤临床特征的关系。方法应用免疫组化检测42例SNSCC标本...目的探讨鼻腔-鼻窦鳞状细胞癌(sinonasal s q u a m o u s c el l c a r c i n o m a,S NS C C)中细胞角蛋白13(cytokeratin13,CK13)、细胞角蛋白4(cytokeratin 4,CK4)的表达及与肿瘤临床特征的关系。方法应用免疫组化检测42例SNSCC标本(SNSCC组)及癌旁正常黏膜(对照组)中CK13、CK4的表达,应用图像分析仪比较其吸收度值(A值),进行统计学处理。结果 1CK13在对照组、SNSCC组中的阳性表达率为100.00%、30.95%,与肿瘤的分化程度及随访KPS评分呈正相关;2CK4在对照组、SNSCC组中的阳性表达率分别为100.00%、60.95%,与随访KPS评分呈正相关;随着T分级和临床分期的增加,阳性表达率减弱;随着分化程度的降低,阳性表达率依次减弱;在有、无淋巴结转移组织中的表达差异有统计学意义。结论对CK4、CK13进行检测,对SNSCC的预后判断具有重要意义。展开更多
基金This work was supported by Beijing Excellent Talents Foundation （No. 2010D003034000033）, Beijing Municipal Natural Science Foundation （No. 7112030）, and High Levels of Health Technical Personnel in Beijing City （No. 2011-3-047）.
文摘Background Distinguishing inverted papilloma （IP） from malignant tumors in the nasal cavity is difficult in a substantial number of cases,thus hindering the administration of appropriate therapeutic strategies.This study aimed to evaluate whether magnetic resonance imaging （MRI）,including dynamic contrast enhanced MRI （DCE-MRI）,could improve differentiation between IP and malignant tumors,and to identify which MRI features were the best in discriminating IP from malignant tumors in the nasal cavity.Methods Non-enhanced,static,and dynamic contrast enhanced MRI was performed in 88 patients with an IP or a malignant tumor in the nasal cavity that had been confirmed by histological results.MRI features of IP and malignant tumors including side,margin,T1 signal intensity,T1 homogeneity,T2 signal intensity,T2 homogeneity,lobulation signs,convoluted cerebriform pattern,extra-sinonasal involvement,pattern of enhancement,Tpeak,Tmax,Clmax,and TIC type were evaluated and correlated with histological findings.Results There were significant differences between IP and malignant tumors in T2 homogeneity,Iobulation signs,convoluted cerebriform pattern,extra-sinonasal involvement,Tpeak,Tmax and TIC types.A convoluted cerebriform pattern had a higher sensitivity and specificity in diagnosis of IP while washout-type TIC had a higher sensitivity and specificity in diagnosis of malignant tumors in the nasal cavity.Non-enhanced combined with static and dynamic enhancement MRI was significantly superior to non-enhanced combined with static enhancement MRI in the differentiation of IP and malignant tumors in the nasal cavity.Multivariate logistic regression analysis identified that the best MRI features were a convoluted cerebriform pattern,extra-sinonasal involvement,and washout-type TIC for both observers （Wang XY and Zhang ZY）.Conclusion Non-enhanced and static combined with dynamic contrast-enhanced MRI improves differentiation of IP and malignant tumors in the nasal cavity.
文摘目的探讨鼻腔-鼻窦鳞状细胞癌(sinonasal s q u a m o u s c el l c a r c i n o m a,S NS C C)中细胞角蛋白13(cytokeratin13,CK13)、细胞角蛋白4(cytokeratin 4,CK4)的表达及与肿瘤临床特征的关系。方法应用免疫组化检测42例SNSCC标本(SNSCC组)及癌旁正常黏膜(对照组)中CK13、CK4的表达,应用图像分析仪比较其吸收度值(A值),进行统计学处理。结果 1CK13在对照组、SNSCC组中的阳性表达率为100.00%、30.95%,与肿瘤的分化程度及随访KPS评分呈正相关;2CK4在对照组、SNSCC组中的阳性表达率分别为100.00%、60.95%,与随访KPS评分呈正相关;随着T分级和临床分期的增加,阳性表达率减弱;随着分化程度的降低,阳性表达率依次减弱;在有、无淋巴结转移组织中的表达差异有统计学意义。结论对CK4、CK13进行检测,对SNSCC的预后判断具有重要意义。
