BACKGROUND Cancer patients often suffer from severe stress reactions psychologically,such as anxiety and depression.Prostate cancer(PC)is one of the common cancer types,with most patients diagnosed at advanced stages ...BACKGROUND Cancer patients often suffer from severe stress reactions psychologically,such as anxiety and depression.Prostate cancer(PC)is one of the common cancer types,with most patients diagnosed at advanced stages that cannot be treated by radical surgery and which are accompanied by complications such as bodily pain and bone metastasis.Therefore,attention should be given to the mental health status of PC patients as well as physical adverse events in the course of clinical treatment.AIM To analyze the risk factors leading to anxiety and depression in PC patients after castration and build a risk prediction model.METHODS A retrospective analysis was performed on the data of 120 PC cases treated in Xi'an People's Hospital between January 2019 and January 2022.The patient cohort was divided into a training group(n=84)and a validation group(n=36)at a ratio of 7:3.The patients’anxiety symptoms and depression levels were assessed 2 wk after surgery with the Self-Rating Anxiety Scale(SAS)and the Selfrating Depression Scale(SDS),respectively.Logistic regression was used to analyze the risk factors affecting negative mood,and a risk prediction model was constructed.RESULTS In the training group,35 patients and 37 patients had an SAS score and an SDS score greater than or equal to 50,respectively.Based on the scores,we further subclassified patients into two groups:a bad mood group(n=35)and an emotional stability group(n=49).Multivariate logistic regression analysis showed that marital status,castration scheme,and postoperative Visual Analogue Scale(VAS)score were independent risk factors affecting a patient's bad mood(P<0.05).In the training and validation groups,patients with adverse emotions exhibited significantly higher risk scores than emotionally stable patients(P<0.0001).The area under the curve(AUC)of the risk prediction model for predicting bad mood in the training group was 0.743,the specificity was 70.96%,and the sensitivity was 66.03%,while in the validation group,the AUC,specificity,and sensitivity were 0.755,66.67%,and 76.19%,respectively.The Hosmer-Lemeshow test showed aχ^(2) of 4.2856,a P value of 0.830,and a C-index of 0.773(0.692-0.854).The calibration curve revealed that the predicted curve was basically consistent with the actual curve,and the calibration curve showed that the prediction model had good discrimination and accuracy.Decision curve analysis showed that the model had a high net profit.CONCLUSION In PC patients,marital status,castration scheme,and postoperative pain(VAS)score are important factors affecting postoperative anxiety and depression.The logistic regression model can be used to successfully predict the risk of adverse psychological emotions.展开更多
In this editorial,we comment on the article by Chen et al.We specifically focus on the risk factors,prognostic factors,and management of brain metastasis(BM)in breast cancer(BC).BC is the second most common cancer to ...In this editorial,we comment on the article by Chen et al.We specifically focus on the risk factors,prognostic factors,and management of brain metastasis(BM)in breast cancer(BC).BC is the second most common cancer to have BM after lung cancer.Independent risk factors for BM in BC are:HER-2 positive BC,triplenegative BC,and germline BRCA mutation.Other factors associated with BM are lung metastasis,age less than 40 years,and African and American ancestry.Even though risk factors associated with BM in BC are elucidated,there is a lack of data on predictive models for BM in BC.Few studies have been made to formulate predictive models or nomograms to address this issue,where age,grade of tumor,HER-2 receptor status,and number of metastatic sites(1 vs>1)were predictive of BM in metastatic BC.However,none have been used in clinical practice.National Comprehensive Cancer Network recommends screening of BM in advanced BC only when the patient is symptomatic or suspicious of central nervous system symptoms;routine screening for BM in BC is not recommended in the guidelines.BM decreases the quality of life and will have a significant psychological impact.Further studies are required for designing validated nomograms or predictive models for BM in BC;these models can be used in the future to develop treatment approaches to prevent BM,which improves the quality of life and overall survival.展开更多
BACKGROUND Colorectal cancer(CRC)is a significant global health issue,and lymph node metastasis(LNM)is a crucial prognostic factor.Accurate prediction of LNM is essential for developing individualized treatment strate...BACKGROUND Colorectal cancer(CRC)is a significant global health issue,and lymph node metastasis(LNM)is a crucial prognostic factor.Accurate prediction of LNM is essential for developing individualized treatment strategies for patients with CRC.However,the prediction of LNM is challenging and depends on various factors such as tumor histology,clinicopathological features,and molecular characteristics.The most reliable method to detect LNM is the histopathological examination of surgically resected specimens;however,this method is invasive,time-consuming,and subject to sampling errors and interobserver variability.AIM To analyze influencing factors and develop and validate a risk prediction model for LNM in CRC based on a large patient queue.METHODS This study retrospectively analyzed 300 patients who underwent CRC surgery at two Peking University Shenzhen hospitals between January and December 2021.A deep learning approach was used to extract features potentially associated with LNM from primary tumor histological images while a logistic regression model was employed to predict LNM in CRC using machine-learning-derived features and clinicopathological variables as predictors.RESULTS The prediction model constructed for LNM in CRC was based on a logistic regression framework that incorporated machine learning-extracted features and clinicopathological variables.The model achieved high accuracy(0.86),sensitivity(0.81),specificity(0.87),positive predictive value(0.66),negative predictive value(0.94),area under the curve for the receiver operating characteristic(0.91),and a low Brier score(0.10).The model showed good agreement between the observed and predicted probabilities of LNM across a range of risk thresholds,indicating good calibration and clinical utility.CONCLUSION The present study successfully developed and validated a potent and effective risk-prediction model for LNM in patients with CRC.This model utilizes machine-learning-derived features extracted from primary tumor histology and clinicopathological variables,demonstrating superior performance and clinical applicability compared to existing models.The study provides new insights into the potential of deep learning to extract valuable information from tumor histology,in turn,improving the prediction of LNM in CRC and facilitate risk stratification and decision-making in clinical practice.展开更多
BACKGROUND Colorectal cancer is a common digestive cancer worldwide.As a comprehensive treatment for locally advanced rectal cancer(LARC),neoadjuvant therapy(NT)has been increasingly used as the standard treatment for...BACKGROUND Colorectal cancer is a common digestive cancer worldwide.As a comprehensive treatment for locally advanced rectal cancer(LARC),neoadjuvant therapy(NT)has been increasingly used as the standard treatment for clinical stage II/III rectal cancer.However,few patients achieve a complete pathological response,and most patients require surgical resection and adjuvant therapy.Therefore,identifying risk factors and developing accurate models to predict the prognosis of LARC patients are of great clinical significance.AIM To establish effective prognostic nomograms and risk score prediction models to predict overall survival(OS)and disease-free survival(DFS)for LARC treated with NT.METHODS Nomograms and risk factor score prediction models were based on patients who received NT at the Cancer Hospital from 2015 to 2017.The least absolute shrinkage and selection operator regression model were utilized to screen for prognostic risk factors,which were validated by the Cox regression method.Assessment of the performance of the two prediction models was conducted using receiver operating characteristic curves,and that of the two nomograms was conducted by calculating the concordance index(C-index)and calibration curves.The results were validated in a cohort of 65 patients from 2015 to 2017.RESULTS Seven features were significantly associated with OS and were included in the OS prediction nomogram and prediction model:Vascular_tumors_bolt,cancer nodules,yN,body mass index,matchmouth distance from the edge,nerve aggression and postoperative carcinoembryonic antigen.The nomogram showed good predictive value for OS,with a C-index of 0.91(95%CI:0.85,0.97)and good calibration.In the validation cohort,the C-index was 0.69(95%CI:0.53,0.84).The risk factor prediction model showed good predictive value.The areas under the curve for 3-and 5-year survival were 0.811 and 0.782.The nomogram for predicting DFS included ypTNM and nerve aggression and showed good calibration and a C-index of 0.77(95%CI:0.69,0.85).In the validation cohort,the C-index was 0.71(95%CI:0.61,0.81).The prediction model for DFS also had good predictive value,with an AUC for 3-year survival of 0.784 and an AUC for 5-year survival of 0.754.CONCLUSION We established accurate nomograms and prediction models for predicting OS and DFS in patients with LARC after undergoing NT.展开更多
Objective:To study the value of serum tumor markers, carbohydrate antigen 125 (CA125), human epididymis secretory protein 4 (HE4) and ovarian cancer risk factor (ROMA) index in elderly patients with ovarian cancer, so...Objective:To study the value of serum tumor markers, carbohydrate antigen 125 (CA125), human epididymis secretory protein 4 (HE4) and ovarian cancer risk factor (ROMA) index in elderly patients with ovarian cancer, so as to provide a choice for clinical diagnosis.Methods:A total of 110 cases of ovarian cancer treated in our hospital in December 2017-December 2015 were selected as malignant group. In addition, 120 cases of benign ovarian tumors in the same period were selected as the benign group, and 92 healthy women who came to the hospital for health examination were selected as the control group. Serum HE4, CA125 levels and positive rates were detected by microparticle enzyme immunochemiluminescence assay, and ROMA index values were combined to assess the risk of ovarian cancer.Results:Malignant group serum CA125, HE4 level and ROMA index were significantly higher than those in the benign group and the control group, the level of CA125 in positive group was higher than control group, but the difference in level of HE4 and ROMA index between benign group and control group was not statistically significant. The positive rates of serum CA125, HE4 and ROMA index in malignant group were 76.4%, 92.7%, 96.4%, which were significantly higher than those in benign group (28.3%, 18.3%, 15%). The negative predictive value, positive predictive value, specificity and sensitivity of CA125 were all lower than those of HE4. The negative predictive value, positive predictive value, specificity and sensitivity of the combined ROMA index were higher than those of single diagnosis.Conclusions: Serum CA125, HE4 and ROMA index in elderly patients with ovarian cancer are significantly higher than those in elderly patients with benign ovarian tumors and healthy women. The combined diagnosis is the highest, with Gao Min's high sensitivity and specificity, which can be popularized in clinical practice.展开更多
In order to develop precision or personalized medicine,identifying new quantitative imaging markers and building machine learning models to predict cancer risk and prognosis has been attracting broad research interest...In order to develop precision or personalized medicine,identifying new quantitative imaging markers and building machine learning models to predict cancer risk and prognosis has been attracting broad research interest recently.Most of these research approaches use the similar concepts of the conventional computer-aided detection schemes of medical images,which include steps in detecting and segmenting suspicious regions or tumors,followed by training machine learning models based on the fusion of multiple image features computed from the segmented regions or tumors.However,due to the heterogeneity and boundary fuzziness of the suspicious regions or tumors,segmenting subtle regions is often difficult and unreliable.Additionally,ignoring global and/or background parenchymal tissue characteristics may also be a limitation of the conventional approaches.In our recent studies,we investigated the feasibility of developing new computer-aided schemes implemented with the machine learning models that are trained by global image features to predict cancer risk and prognosis.We trained and tested several models using images obtained from full-field digital mammography,magnetic resonance imaging,and computed tomography of breast,lung,and ovarian cancers.Study results showed that many of these new models yielded higher performance than other approaches used in current clinical practice.Furthermore,the computed global image features also contain complementary information from the features computed from the segmented regions or tumors in predicting cancer prognosis.Therefore,the global image features can be used alone to develop new case-based prediction models or can be added to current tumor-based models to increase their discriminatory power.展开更多
To determine whether ultrasound features can improve the diagnostic performance of tumor markers in distinguishing ovarian tumors,we enrolled 719 patients diagnosed as having ovarian tumors at Nanfang Hospital from Se...To determine whether ultrasound features can improve the diagnostic performance of tumor markers in distinguishing ovarian tumors,we enrolled 719 patients diagnosed as having ovarian tumors at Nanfang Hospital from September 2014 to November 2016.Age,menopausal status,histopathology,the International Federation of Gynecology and Obstetrics(FIGO)stages,tumor biomarker levels,and detailed ultrasound reports of patients were collected.The area under the curve(AUC),sensitivity,and specificity of the bellow-mentioned predictors were analyzed using the receiver operating characteristic curve.Of the 719 patients,531 had benign lesions,119 had epithelial ovarian cancers(EOC),44 had borderline ovarian tumors(BOT),and 25 had non-EOC.AUCs and the sensitivity of cancer antigen 125(CAI25),human epididymis-specific protein 4(HE4),Risk of Ovarian Malignancy Algorithm(ROMA),Risk of Malignancy Index(RMI1),HE4 model,and Rajavithi-Ovarian Cancer Predictive Score(R-OPS)in the overall population were 0.792,0.854,0.856,0.872,0.893,0.852,and 70.2%,56.9%,69.1%,60.6%,77.1%,71.3%,respectively.For distinguishing EOC from benign tumors,the AUCs and sensitivity of the above mentioned predictors were 0.888,0.946,0.947,0.949,0.967,0.966,and 84.0%,79.8%,87.4%,84.9%,90.8%,89.1%,respectively.Their specificity in predicting benign diseases was 72.9%,94.4%,87.6%,95.9%,86.3%,90.8%,respectively.Therefore,we consider biomarkers in combination with ultrasound features may improve the diagnostic performance in distinguishing malignant from benign ovarian tumors.展开更多
Objective: To investigate the clinical value of ADNEX model in early diagnosis and staging of benign and malignant ovarian tumors. Method: 136 cases of ovarian cancer patients treated in our hospital were retrospectiv...Objective: To investigate the clinical value of ADNEX model in early diagnosis and staging of benign and malignant ovarian tumors. Method: 136 cases of ovarian cancer patients treated in our hospital were retrospectively analyzed using the ADNEX risk model and MRI data. The accuracy of the two diagnostic methods was compared with the results of pathological examination as gold standard. Results: For qualitative assessment, the accuracy and sensitivity of the ADNEX model were 78.70% and 93%, while the accuracy and sensitivity of MRI examination were 80.1%, and 90.7%, respectively. The diagnostic values of the two methods were not statistically different (P > 0.05). For ovarian tumor staging, the ADNEX model was significantly less accurate and specific for staging borderline tumor than MRI examination, although it had significantly higher sensitivity (P 0.05). Conclusion: ADNEX risk model has certain diagnostic and predictive value to distinguish benign from malignant ovarian tumors. It is useful to detect and exclude ovarian tumor. However, for early diagnosis, it is not accurate enough and further study is needed to validate this usefulness.展开更多
It is widely known that cancer is a disease of “old-age”. However available data show that this is not the case for many types of cancers. Incidences of breast and ovarian cancers have varying rates of change with a...It is widely known that cancer is a disease of “old-age”. However available data show that this is not the case for many types of cancers. Incidences of breast and ovarian cancers have varying rates of change with age. Breast cancer data of Arabian-gulf women, show that the incidence rates increase with age and reach a maximum at 39 year. It then declines linearly with age to about 55 years. The rate of increase and its changes with age are similar to those of many other countries. In the premenopausal phase the relationship between incidence and age could be adequately modeled using a linear model for the logarithmic transformations of age and incidence. Similar observations are made for the ovarian cancer incidences. Results: It is shown that the rate of increase in breast and ovarian cancer incidence with respect to age is increasing in the premenopausal ages. Moreover, the burden of the disease with respect to mortality and “Disability Adjusted Life Years” or DALY, varied considerably among the six gulf countries. Conclusions: We conclude, based on the age incidence relationship that the number of cancer cases may double in the next period that follows our study period (1998-2009). Moreover, if the six countries have identical relationship between age and the two types of cancer, there should be an integrated and unified effort to have a common strategy for prevention and control.展开更多
BACKGROUND Low anterior resection syndrome(LARS)is a common complication of anuspreserving surgery in patients with colorectal cancer,which significantly affects patients'quality of life.AIM To determine the relat...BACKGROUND Low anterior resection syndrome(LARS)is a common complication of anuspreserving surgery in patients with colorectal cancer,which significantly affects patients'quality of life.AIM To determine the relationship between the incidence of LARS and patient quality of life after colorectal cancer surgery and to establish a LARS prediction model to allow perioperative precision nursing.METHODS We reviewed the data from patients who underwent elective radical resection for colorectal cancer at our institution from April 2013 to June 2020 and completed the LARS score questionnaire and the European Organization for Research and Treatment of Cancer Core Quality of Life and Colorectal Cancer Module questionnaires.According to the LARS score results,the patients were divided into no LARS,mild LARS,and severe LARS groups.The incidence of LARS and the effects of this condition on patient quality of life were determined.Univariate and multivariate analyses were performed to identify independent risk factors for the occurrence of LARS.Based on these factors,we established a risk prediction model for LARS and evaluated its performance.RESULTS Among the 223 patients included,51 did not develop LARS and 171 had mild or severe LARS.The following quality of life indicators showed significant differences between patients without LARS and those with mild or severe LARS:Physical,role,emotional,and cognitive function,total health status,fatigue,pain,shortness of breath,insomnia,constipation,and diarrhea.Tumor size,partial/total mesorectal excision,colostomy,preoperative radiotherapy,and neoadjuvant chemotherapy were identified to be independent risk factors for LARS.A LARS prediction model was successfully established,which demonstrated an accuracy of 0.808 for predicting the occurrence of LARS.CONCLUSION The quality of life of patients with LARS after colorectal cancer surgery is significantly reduced.展开更多
文摘BACKGROUND Cancer patients often suffer from severe stress reactions psychologically,such as anxiety and depression.Prostate cancer(PC)is one of the common cancer types,with most patients diagnosed at advanced stages that cannot be treated by radical surgery and which are accompanied by complications such as bodily pain and bone metastasis.Therefore,attention should be given to the mental health status of PC patients as well as physical adverse events in the course of clinical treatment.AIM To analyze the risk factors leading to anxiety and depression in PC patients after castration and build a risk prediction model.METHODS A retrospective analysis was performed on the data of 120 PC cases treated in Xi'an People's Hospital between January 2019 and January 2022.The patient cohort was divided into a training group(n=84)and a validation group(n=36)at a ratio of 7:3.The patients’anxiety symptoms and depression levels were assessed 2 wk after surgery with the Self-Rating Anxiety Scale(SAS)and the Selfrating Depression Scale(SDS),respectively.Logistic regression was used to analyze the risk factors affecting negative mood,and a risk prediction model was constructed.RESULTS In the training group,35 patients and 37 patients had an SAS score and an SDS score greater than or equal to 50,respectively.Based on the scores,we further subclassified patients into two groups:a bad mood group(n=35)and an emotional stability group(n=49).Multivariate logistic regression analysis showed that marital status,castration scheme,and postoperative Visual Analogue Scale(VAS)score were independent risk factors affecting a patient's bad mood(P<0.05).In the training and validation groups,patients with adverse emotions exhibited significantly higher risk scores than emotionally stable patients(P<0.0001).The area under the curve(AUC)of the risk prediction model for predicting bad mood in the training group was 0.743,the specificity was 70.96%,and the sensitivity was 66.03%,while in the validation group,the AUC,specificity,and sensitivity were 0.755,66.67%,and 76.19%,respectively.The Hosmer-Lemeshow test showed aχ^(2) of 4.2856,a P value of 0.830,and a C-index of 0.773(0.692-0.854).The calibration curve revealed that the predicted curve was basically consistent with the actual curve,and the calibration curve showed that the prediction model had good discrimination and accuracy.Decision curve analysis showed that the model had a high net profit.CONCLUSION In PC patients,marital status,castration scheme,and postoperative pain(VAS)score are important factors affecting postoperative anxiety and depression.The logistic regression model can be used to successfully predict the risk of adverse psychological emotions.
文摘In this editorial,we comment on the article by Chen et al.We specifically focus on the risk factors,prognostic factors,and management of brain metastasis(BM)in breast cancer(BC).BC is the second most common cancer to have BM after lung cancer.Independent risk factors for BM in BC are:HER-2 positive BC,triplenegative BC,and germline BRCA mutation.Other factors associated with BM are lung metastasis,age less than 40 years,and African and American ancestry.Even though risk factors associated with BM in BC are elucidated,there is a lack of data on predictive models for BM in BC.Few studies have been made to formulate predictive models or nomograms to address this issue,where age,grade of tumor,HER-2 receptor status,and number of metastatic sites(1 vs>1)were predictive of BM in metastatic BC.However,none have been used in clinical practice.National Comprehensive Cancer Network recommends screening of BM in advanced BC only when the patient is symptomatic or suspicious of central nervous system symptoms;routine screening for BM in BC is not recommended in the guidelines.BM decreases the quality of life and will have a significant psychological impact.Further studies are required for designing validated nomograms or predictive models for BM in BC;these models can be used in the future to develop treatment approaches to prevent BM,which improves the quality of life and overall survival.
文摘BACKGROUND Colorectal cancer(CRC)is a significant global health issue,and lymph node metastasis(LNM)is a crucial prognostic factor.Accurate prediction of LNM is essential for developing individualized treatment strategies for patients with CRC.However,the prediction of LNM is challenging and depends on various factors such as tumor histology,clinicopathological features,and molecular characteristics.The most reliable method to detect LNM is the histopathological examination of surgically resected specimens;however,this method is invasive,time-consuming,and subject to sampling errors and interobserver variability.AIM To analyze influencing factors and develop and validate a risk prediction model for LNM in CRC based on a large patient queue.METHODS This study retrospectively analyzed 300 patients who underwent CRC surgery at two Peking University Shenzhen hospitals between January and December 2021.A deep learning approach was used to extract features potentially associated with LNM from primary tumor histological images while a logistic regression model was employed to predict LNM in CRC using machine-learning-derived features and clinicopathological variables as predictors.RESULTS The prediction model constructed for LNM in CRC was based on a logistic regression framework that incorporated machine learning-extracted features and clinicopathological variables.The model achieved high accuracy(0.86),sensitivity(0.81),specificity(0.87),positive predictive value(0.66),negative predictive value(0.94),area under the curve for the receiver operating characteristic(0.91),and a low Brier score(0.10).The model showed good agreement between the observed and predicted probabilities of LNM across a range of risk thresholds,indicating good calibration and clinical utility.CONCLUSION The present study successfully developed and validated a potent and effective risk-prediction model for LNM in patients with CRC.This model utilizes machine-learning-derived features extracted from primary tumor histology and clinicopathological variables,demonstrating superior performance and clinical applicability compared to existing models.The study provides new insights into the potential of deep learning to extract valuable information from tumor histology,in turn,improving the prediction of LNM in CRC and facilitate risk stratification and decision-making in clinical practice.
文摘BACKGROUND Colorectal cancer is a common digestive cancer worldwide.As a comprehensive treatment for locally advanced rectal cancer(LARC),neoadjuvant therapy(NT)has been increasingly used as the standard treatment for clinical stage II/III rectal cancer.However,few patients achieve a complete pathological response,and most patients require surgical resection and adjuvant therapy.Therefore,identifying risk factors and developing accurate models to predict the prognosis of LARC patients are of great clinical significance.AIM To establish effective prognostic nomograms and risk score prediction models to predict overall survival(OS)and disease-free survival(DFS)for LARC treated with NT.METHODS Nomograms and risk factor score prediction models were based on patients who received NT at the Cancer Hospital from 2015 to 2017.The least absolute shrinkage and selection operator regression model were utilized to screen for prognostic risk factors,which were validated by the Cox regression method.Assessment of the performance of the two prediction models was conducted using receiver operating characteristic curves,and that of the two nomograms was conducted by calculating the concordance index(C-index)and calibration curves.The results were validated in a cohort of 65 patients from 2015 to 2017.RESULTS Seven features were significantly associated with OS and were included in the OS prediction nomogram and prediction model:Vascular_tumors_bolt,cancer nodules,yN,body mass index,matchmouth distance from the edge,nerve aggression and postoperative carcinoembryonic antigen.The nomogram showed good predictive value for OS,with a C-index of 0.91(95%CI:0.85,0.97)and good calibration.In the validation cohort,the C-index was 0.69(95%CI:0.53,0.84).The risk factor prediction model showed good predictive value.The areas under the curve for 3-and 5-year survival were 0.811 and 0.782.The nomogram for predicting DFS included ypTNM and nerve aggression and showed good calibration and a C-index of 0.77(95%CI:0.69,0.85).In the validation cohort,the C-index was 0.71(95%CI:0.61,0.81).The prediction model for DFS also had good predictive value,with an AUC for 3-year survival of 0.784 and an AUC for 5-year survival of 0.754.CONCLUSION We established accurate nomograms and prediction models for predicting OS and DFS in patients with LARC after undergoing NT.
文摘Objective:To study the value of serum tumor markers, carbohydrate antigen 125 (CA125), human epididymis secretory protein 4 (HE4) and ovarian cancer risk factor (ROMA) index in elderly patients with ovarian cancer, so as to provide a choice for clinical diagnosis.Methods:A total of 110 cases of ovarian cancer treated in our hospital in December 2017-December 2015 were selected as malignant group. In addition, 120 cases of benign ovarian tumors in the same period were selected as the benign group, and 92 healthy women who came to the hospital for health examination were selected as the control group. Serum HE4, CA125 levels and positive rates were detected by microparticle enzyme immunochemiluminescence assay, and ROMA index values were combined to assess the risk of ovarian cancer.Results:Malignant group serum CA125, HE4 level and ROMA index were significantly higher than those in the benign group and the control group, the level of CA125 in positive group was higher than control group, but the difference in level of HE4 and ROMA index between benign group and control group was not statistically significant. The positive rates of serum CA125, HE4 and ROMA index in malignant group were 76.4%, 92.7%, 96.4%, which were significantly higher than those in benign group (28.3%, 18.3%, 15%). The negative predictive value, positive predictive value, specificity and sensitivity of CA125 were all lower than those of HE4. The negative predictive value, positive predictive value, specificity and sensitivity of the combined ROMA index were higher than those of single diagnosis.Conclusions: Serum CA125, HE4 and ROMA index in elderly patients with ovarian cancer are significantly higher than those in elderly patients with benign ovarian tumors and healthy women. The combined diagnosis is the highest, with Gao Min's high sensitivity and specificity, which can be popularized in clinical practice.
基金The studies mentioned in this paper were supported in part by Grants R01 CA160205 and R01 CA197150 from the National Cancer Institute,National Institutes of Health,USAGrant HR15-016 from Oklahoma Center for the Advancement of Science and Technology,USA.
文摘In order to develop precision or personalized medicine,identifying new quantitative imaging markers and building machine learning models to predict cancer risk and prognosis has been attracting broad research interest recently.Most of these research approaches use the similar concepts of the conventional computer-aided detection schemes of medical images,which include steps in detecting and segmenting suspicious regions or tumors,followed by training machine learning models based on the fusion of multiple image features computed from the segmented regions or tumors.However,due to the heterogeneity and boundary fuzziness of the suspicious regions or tumors,segmenting subtle regions is often difficult and unreliable.Additionally,ignoring global and/or background parenchymal tissue characteristics may also be a limitation of the conventional approaches.In our recent studies,we investigated the feasibility of developing new computer-aided schemes implemented with the machine learning models that are trained by global image features to predict cancer risk and prognosis.We trained and tested several models using images obtained from full-field digital mammography,magnetic resonance imaging,and computed tomography of breast,lung,and ovarian cancers.Study results showed that many of these new models yielded higher performance than other approaches used in current clinical practice.Furthermore,the computed global image features also contain complementary information from the features computed from the segmented regions or tumors in predicting cancer prognosis.Therefore,the global image features can be used alone to develop new case-based prediction models or can be added to current tumor-based models to increase their discriminatory power.
基金grants from Guangdong Science and Technology Department of China(No.2016A020215115)Science and Technology Bureau of Tianhe District,Guangzhou,Guangdong(No.201604KW010)Science and Technology Bureau of Huadu District,Guangzhou,Guangdong(No.HD15CXY006).
文摘To determine whether ultrasound features can improve the diagnostic performance of tumor markers in distinguishing ovarian tumors,we enrolled 719 patients diagnosed as having ovarian tumors at Nanfang Hospital from September 2014 to November 2016.Age,menopausal status,histopathology,the International Federation of Gynecology and Obstetrics(FIGO)stages,tumor biomarker levels,and detailed ultrasound reports of patients were collected.The area under the curve(AUC),sensitivity,and specificity of the bellow-mentioned predictors were analyzed using the receiver operating characteristic curve.Of the 719 patients,531 had benign lesions,119 had epithelial ovarian cancers(EOC),44 had borderline ovarian tumors(BOT),and 25 had non-EOC.AUCs and the sensitivity of cancer antigen 125(CAI25),human epididymis-specific protein 4(HE4),Risk of Ovarian Malignancy Algorithm(ROMA),Risk of Malignancy Index(RMI1),HE4 model,and Rajavithi-Ovarian Cancer Predictive Score(R-OPS)in the overall population were 0.792,0.854,0.856,0.872,0.893,0.852,and 70.2%,56.9%,69.1%,60.6%,77.1%,71.3%,respectively.For distinguishing EOC from benign tumors,the AUCs and sensitivity of the above mentioned predictors were 0.888,0.946,0.947,0.949,0.967,0.966,and 84.0%,79.8%,87.4%,84.9%,90.8%,89.1%,respectively.Their specificity in predicting benign diseases was 72.9%,94.4%,87.6%,95.9%,86.3%,90.8%,respectively.Therefore,we consider biomarkers in combination with ultrasound features may improve the diagnostic performance in distinguishing malignant from benign ovarian tumors.
文摘Objective: To investigate the clinical value of ADNEX model in early diagnosis and staging of benign and malignant ovarian tumors. Method: 136 cases of ovarian cancer patients treated in our hospital were retrospectively analyzed using the ADNEX risk model and MRI data. The accuracy of the two diagnostic methods was compared with the results of pathological examination as gold standard. Results: For qualitative assessment, the accuracy and sensitivity of the ADNEX model were 78.70% and 93%, while the accuracy and sensitivity of MRI examination were 80.1%, and 90.7%, respectively. The diagnostic values of the two methods were not statistically different (P > 0.05). For ovarian tumor staging, the ADNEX model was significantly less accurate and specific for staging borderline tumor than MRI examination, although it had significantly higher sensitivity (P 0.05). Conclusion: ADNEX risk model has certain diagnostic and predictive value to distinguish benign from malignant ovarian tumors. It is useful to detect and exclude ovarian tumor. However, for early diagnosis, it is not accurate enough and further study is needed to validate this usefulness.
文摘It is widely known that cancer is a disease of “old-age”. However available data show that this is not the case for many types of cancers. Incidences of breast and ovarian cancers have varying rates of change with age. Breast cancer data of Arabian-gulf women, show that the incidence rates increase with age and reach a maximum at 39 year. It then declines linearly with age to about 55 years. The rate of increase and its changes with age are similar to those of many other countries. In the premenopausal phase the relationship between incidence and age could be adequately modeled using a linear model for the logarithmic transformations of age and incidence. Similar observations are made for the ovarian cancer incidences. Results: It is shown that the rate of increase in breast and ovarian cancer incidence with respect to age is increasing in the premenopausal ages. Moreover, the burden of the disease with respect to mortality and “Disability Adjusted Life Years” or DALY, varied considerably among the six gulf countries. Conclusions: We conclude, based on the age incidence relationship that the number of cancer cases may double in the next period that follows our study period (1998-2009). Moreover, if the six countries have identical relationship between age and the two types of cancer, there should be an integrated and unified effort to have a common strategy for prevention and control.
基金the Zhejiang Provincial Education Department Project,No.Y202249777 and No.Y201941473.
文摘BACKGROUND Low anterior resection syndrome(LARS)is a common complication of anuspreserving surgery in patients with colorectal cancer,which significantly affects patients'quality of life.AIM To determine the relationship between the incidence of LARS and patient quality of life after colorectal cancer surgery and to establish a LARS prediction model to allow perioperative precision nursing.METHODS We reviewed the data from patients who underwent elective radical resection for colorectal cancer at our institution from April 2013 to June 2020 and completed the LARS score questionnaire and the European Organization for Research and Treatment of Cancer Core Quality of Life and Colorectal Cancer Module questionnaires.According to the LARS score results,the patients were divided into no LARS,mild LARS,and severe LARS groups.The incidence of LARS and the effects of this condition on patient quality of life were determined.Univariate and multivariate analyses were performed to identify independent risk factors for the occurrence of LARS.Based on these factors,we established a risk prediction model for LARS and evaluated its performance.RESULTS Among the 223 patients included,51 did not develop LARS and 171 had mild or severe LARS.The following quality of life indicators showed significant differences between patients without LARS and those with mild or severe LARS:Physical,role,emotional,and cognitive function,total health status,fatigue,pain,shortness of breath,insomnia,constipation,and diarrhea.Tumor size,partial/total mesorectal excision,colostomy,preoperative radiotherapy,and neoadjuvant chemotherapy were identified to be independent risk factors for LARS.A LARS prediction model was successfully established,which demonstrated an accuracy of 0.808 for predicting the occurrence of LARS.CONCLUSION The quality of life of patients with LARS after colorectal cancer surgery is significantly reduced.