Objective:To evaluate the efficacy of neoadjuvant chemotherapy before and after neoadjuvant chemotherapy for intermediate and advanced breast cancer using 3.0T MR and ultrasound in combination with tumour markers(CEA,...Objective:To evaluate the efficacy of neoadjuvant chemotherapy before and after neoadjuvant chemotherapy for intermediate and advanced breast cancer using 3.0T MR and ultrasound in combination with tumour markers(CEA,CA-153,CA125),and to provide therapeutic references for the clinicians,so as to better satisfy the needs of treatment for intermediate and advanced breast cancer patients.Methods:The team collected 30 patients who were diagnosed with intermediate and advanced breast cancer by biopsy and received neoadjuvant chemotherapy,and divided them into sensitive and insensitive groups according to the MP grading of postoperative pathological results.The team retrospectively analysed the changes in the values of serum CEA,CA-153,and CA 125 before and after the neoadjuvant chemotherapy,the changes in the average ADC of the lesions before and after the observation by MRI,and the changes in the volume and size of lesions before and after the observation by ultrasonography to assess the effects of neoadjuvant chemotherapy individually,and the results of neoadjuvant chemotherapy were evaluated individually.The effect of neoadjuvant chemotherapy was assessed independently.Each of the above was evaluated independently,and the accuracy of each item was calculated by comparing the evaluation results with the pathological examination results,and the accuracy of the single item was compared with the accuracy of the three combined tests to determine whether the combined evaluation was more consistent.Results:All three examination and testing methods can achieve high accuracy,and the combined evaluation of the three is more accurate than the evaluation of the single way,and the difference is statistically significant(P<0.05).Conclusion:In neoadjuvant chemotherapy for breast cancer patients,the combined assessment of MR,CDFI and tumour markers can more comprehensively and accurately assess the effect of ADC,and more accurately guide the clinical treatment and determine the prognosis.展开更多
BACKGROUND Compare the diagnostic performance of ultrasound(US),magnetic resonance imaging(MRI),and serum tumor markers alone or in combination for detecting ovarian tumors.AIM To investigate the diagnostic value of U...BACKGROUND Compare the diagnostic performance of ultrasound(US),magnetic resonance imaging(MRI),and serum tumor markers alone or in combination for detecting ovarian tumors.AIM To investigate the diagnostic value of US,MRI combined with tumor markers in ovarian tumors.METHODS The data of 110 patients with ovarian tumors,confirmed by surgery and pathology,were collected in our hospital from February 2018 to May 2023.The dataset included 60 cases of benign tumors and 50 cases of malignant tumors.Prior to surgery,all patients underwent preoperative US and MRI examinations,as well as serum tumor marker tests[carbohydrate antigen 125(CA125),human epididymis protein 4(HE4)].The aim of the study was to compare the diagnostic performance of these three methods individually and in combination for ovarian tumors.RESULTS This study found statistically significant differences in the ultrasonic imaging characteristics between benign and malignant tumors.These differences include echo characteristics,presence or absence of a capsule,blood flow resistance index,clear tumor shape,and blood flow signal display rate(P<0.05).The apparent diffusion coefficient values of the solid and cystic parts in benign tumors were found to be higher compared to malignant tumors(P<0.05).Additionally,the time-intensity curve image features of benign and malignant tumors showed significant statistical differences(P<0.05).The levels of serum CA125 and HE4 in benign tumors were lower than those in malignant tumors(P<0.05).The combined use of US,MRI,and tumor markers in the diagnosis of ovarian tumors demonstrates higher accuracy,sensitivity,and specificity compared to using each method individually(P<0.05).CONCLUSION US,MRI,and tumor markers each have their own advantages and disadvantages when it comes to diagnosing ovarian tumors.However,by combining these three methods,we can significantly enhance the accuracy of ovarian tumor diagnosis,enabling early detection and identification of the tumor’s nature,and providing valuable guidance for clinical treatment.展开更多
BACKGROUND Pancreatic cancer(PC)mortality remains high despite advances in therapy.Combination chemoradiotherapy offers modest survival benefit over monotherapy with either.Fiducial markers serve as needed landmarks f...BACKGROUND Pancreatic cancer(PC)mortality remains high despite advances in therapy.Combination chemoradiotherapy offers modest survival benefit over monotherapy with either.Fiducial markers serve as needed landmarks for imageguided radiotherapy(IGRT).Traditionally,these markers were placed surgically or percutaneously with limitations of each.Endoscopic ultrasound-guided placement overcomes these limitations.AIM To evaluate the safety,efficacy,and feasibility of endoscopic ultrasound(EUS)-guided fiducial placement for PC undergoing IGRT.METHODS Articles were searched in MEDLINE,PubMed,and Ovid journals.Pooling was conducted by fixed and random effects models.Heterogeneity was assessed using Cochran’s Q test based upon inverse variance weights.RESULTS Initial search identified 1024 reference articles for EUS-guided fiducial placement in PC.Of these,261 relevant articles were reviewed.Data was extracted from 11 studies(n=820)meeting inclusion criteria.Pooled proportion of successful placement was 96.27%(95%CI:95.35-97.81)with fiducial migration rates low at 4.33%(95%CI:2.45-6.71).Adverse event rates remained low,with overall pooled proportion of 4.85%(95%CI:3.04-7.03).CONCLUSION EUS-guided placement of fiducial markers for IGRT of PC is safe,feasible,and efficacious.The ability to target deep structures under direct visualization while remaining minimally invasive are added benefits.Moreover,the ability to perform fine needle aspiration or celiac plexus neurolysis add value and increase patient-care efficiency.Whether EUS-guided fiducial placement improves outcomes in IGRT or offers any mortality benefits over traditional placement remains unknown and future studies are needed.展开更多
BACKGROUND Preoperative neoadjuvant chemoradiation therapy(NACRT)is applied for resectable pancreatic cancer(RPC).To maximize the efficacy of NACRT,it is essential to ensure the accurate placement of fiducial markers ...BACKGROUND Preoperative neoadjuvant chemoradiation therapy(NACRT)is applied for resectable pancreatic cancer(RPC).To maximize the efficacy of NACRT,it is essential to ensure the accurate placement of fiducial markers for image-guided radiation.However,no standard method for delivering fiducial markers has been established to date,and the nature of RPC during NACRT remains unclear.AIM To determine the feasibility,safety and benefits of endoscopic ultrasound-guided(EUS)fiducial marker placement in patients with RPC.METHODS This was a prospective case series of 29 patients(mean age,67.5 years;62.1%male)with RPC referred to our facility for NACRT.Under EUS guidance,a single gold marker was placed into the tumor using either a 19-or 22-gauge fine-needle aspiration needle.The differences in daily marker positioning were measured by comparing simulation computed tomography and treatment computed tomography.RESULTS In all 29 patients(100%)who underwent EUS fiducial marker placement,fiducials were placed successfully with only minor,self-limiting bleeding during puncture observed in 2 patients(6.9%).NACRT was subsequently administered to all patients and completed in 28/29(96.6%)cases,with one patient experiencing repeat cholangitis.Spontaneous migration of gold markers was observed in 1 patient.Twenty-four patients(82.8%)had surgery with 91.7%(22/24)R0 resection,and two patients experienced complete remission.No inflammatory changes around the marker were observed in the surgical specimen.The daily position of gold markers showed large positional changes,particularly in the superior-inferior direction.Moreover,tumor location was affected by food and fluid intake as well as bowel gas,which changes daily.CONCLUSION EUS fiducial marker placement following NACRT for RPC is feasible and safe.The RPC is mobile and is affected by not only aspiration,but also food and fluid intake and bowel condition.展开更多
Objective:To study the effect of high-intensity focused ultrasound (HIFU) combined with radiotherapy on tumor malignancy in patients with advanced pancreatic cancer and the corresponding side effects.Methods:A total o...Objective:To study the effect of high-intensity focused ultrasound (HIFU) combined with radiotherapy on tumor malignancy in patients with advanced pancreatic cancer and the corresponding side effects.Methods:A total of 84 patients with advanced pancreatic cancer treated in our hospital between May 2013 and March 2016 were selected and randomly divided into HIFU group and IGRT group, HIFU group accepted high-intensity focused ultrasound combined with radiotherapy and IGRT group received radiotherapy alone. 4 weeks after treatment, the levels of tumor markers, liver and kidney function indexes, perineural invasion-related molecules and cytokines in serum as well as the levels of immune cells in peripheral blood were determined.Results:4 weeks after treatment, serum CA199, CA242, OPN, NGAL, RBP4, NGF, TrkA, p75, BDNF and TrkB levels of HIFU group were significantly lower than those of IGRT group, serum IL-2, TNF-α, IFN-γ and IL-13 levels as well as peripheral blood NKT cell and CD4+T cell levels were significantly higher than those of IGRT group, and serum ALT, AST, Cr and BUN levels were not significantly different from those of IGRT group.Conclusion:HIFU combined with radiotherapy treatment of advanced pancreatic cancer can more effectively kill cancer cells, inhibit pancreatic cancer cell invasion to the peripheral nerve and enhance the antitumor immune response mediated by NKT cells and CD4+T cells.展开更多
基金Weifang Science and Technology Development Programme Project(Medicine)(2021YX144)Weifang Municipal Health Commission Chinese Medicine Research Project(WFZYY2024-1-014).
文摘Objective:To evaluate the efficacy of neoadjuvant chemotherapy before and after neoadjuvant chemotherapy for intermediate and advanced breast cancer using 3.0T MR and ultrasound in combination with tumour markers(CEA,CA-153,CA125),and to provide therapeutic references for the clinicians,so as to better satisfy the needs of treatment for intermediate and advanced breast cancer patients.Methods:The team collected 30 patients who were diagnosed with intermediate and advanced breast cancer by biopsy and received neoadjuvant chemotherapy,and divided them into sensitive and insensitive groups according to the MP grading of postoperative pathological results.The team retrospectively analysed the changes in the values of serum CEA,CA-153,and CA 125 before and after the neoadjuvant chemotherapy,the changes in the average ADC of the lesions before and after the observation by MRI,and the changes in the volume and size of lesions before and after the observation by ultrasonography to assess the effects of neoadjuvant chemotherapy individually,and the results of neoadjuvant chemotherapy were evaluated individually.The effect of neoadjuvant chemotherapy was assessed independently.Each of the above was evaluated independently,and the accuracy of each item was calculated by comparing the evaluation results with the pathological examination results,and the accuracy of the single item was compared with the accuracy of the three combined tests to determine whether the combined evaluation was more consistent.Results:All three examination and testing methods can achieve high accuracy,and the combined evaluation of the three is more accurate than the evaluation of the single way,and the difference is statistically significant(P<0.05).Conclusion:In neoadjuvant chemotherapy for breast cancer patients,the combined assessment of MR,CDFI and tumour markers can more comprehensively and accurately assess the effect of ADC,and more accurately guide the clinical treatment and determine the prognosis.
文摘BACKGROUND Compare the diagnostic performance of ultrasound(US),magnetic resonance imaging(MRI),and serum tumor markers alone or in combination for detecting ovarian tumors.AIM To investigate the diagnostic value of US,MRI combined with tumor markers in ovarian tumors.METHODS The data of 110 patients with ovarian tumors,confirmed by surgery and pathology,were collected in our hospital from February 2018 to May 2023.The dataset included 60 cases of benign tumors and 50 cases of malignant tumors.Prior to surgery,all patients underwent preoperative US and MRI examinations,as well as serum tumor marker tests[carbohydrate antigen 125(CA125),human epididymis protein 4(HE4)].The aim of the study was to compare the diagnostic performance of these three methods individually and in combination for ovarian tumors.RESULTS This study found statistically significant differences in the ultrasonic imaging characteristics between benign and malignant tumors.These differences include echo characteristics,presence or absence of a capsule,blood flow resistance index,clear tumor shape,and blood flow signal display rate(P<0.05).The apparent diffusion coefficient values of the solid and cystic parts in benign tumors were found to be higher compared to malignant tumors(P<0.05).Additionally,the time-intensity curve image features of benign and malignant tumors showed significant statistical differences(P<0.05).The levels of serum CA125 and HE4 in benign tumors were lower than those in malignant tumors(P<0.05).The combined use of US,MRI,and tumor markers in the diagnosis of ovarian tumors demonstrates higher accuracy,sensitivity,and specificity compared to using each method individually(P<0.05).CONCLUSION US,MRI,and tumor markers each have their own advantages and disadvantages when it comes to diagnosing ovarian tumors.However,by combining these three methods,we can significantly enhance the accuracy of ovarian tumor diagnosis,enabling early detection and identification of the tumor’s nature,and providing valuable guidance for clinical treatment.
文摘BACKGROUND Pancreatic cancer(PC)mortality remains high despite advances in therapy.Combination chemoradiotherapy offers modest survival benefit over monotherapy with either.Fiducial markers serve as needed landmarks for imageguided radiotherapy(IGRT).Traditionally,these markers were placed surgically or percutaneously with limitations of each.Endoscopic ultrasound-guided placement overcomes these limitations.AIM To evaluate the safety,efficacy,and feasibility of endoscopic ultrasound(EUS)-guided fiducial placement for PC undergoing IGRT.METHODS Articles were searched in MEDLINE,PubMed,and Ovid journals.Pooling was conducted by fixed and random effects models.Heterogeneity was assessed using Cochran’s Q test based upon inverse variance weights.RESULTS Initial search identified 1024 reference articles for EUS-guided fiducial placement in PC.Of these,261 relevant articles were reviewed.Data was extracted from 11 studies(n=820)meeting inclusion criteria.Pooled proportion of successful placement was 96.27%(95%CI:95.35-97.81)with fiducial migration rates low at 4.33%(95%CI:2.45-6.71).Adverse event rates remained low,with overall pooled proportion of 4.85%(95%CI:3.04-7.03).CONCLUSION EUS-guided placement of fiducial markers for IGRT of PC is safe,feasible,and efficacious.The ability to target deep structures under direct visualization while remaining minimally invasive are added benefits.Moreover,the ability to perform fine needle aspiration or celiac plexus neurolysis add value and increase patient-care efficiency.Whether EUS-guided fiducial placement improves outcomes in IGRT or offers any mortality benefits over traditional placement remains unknown and future studies are needed.
基金the JSPS KAKENHI Grant[Grant-in Aid for Scientific Research(B)],No.15H04913。
文摘BACKGROUND Preoperative neoadjuvant chemoradiation therapy(NACRT)is applied for resectable pancreatic cancer(RPC).To maximize the efficacy of NACRT,it is essential to ensure the accurate placement of fiducial markers for image-guided radiation.However,no standard method for delivering fiducial markers has been established to date,and the nature of RPC during NACRT remains unclear.AIM To determine the feasibility,safety and benefits of endoscopic ultrasound-guided(EUS)fiducial marker placement in patients with RPC.METHODS This was a prospective case series of 29 patients(mean age,67.5 years;62.1%male)with RPC referred to our facility for NACRT.Under EUS guidance,a single gold marker was placed into the tumor using either a 19-or 22-gauge fine-needle aspiration needle.The differences in daily marker positioning were measured by comparing simulation computed tomography and treatment computed tomography.RESULTS In all 29 patients(100%)who underwent EUS fiducial marker placement,fiducials were placed successfully with only minor,self-limiting bleeding during puncture observed in 2 patients(6.9%).NACRT was subsequently administered to all patients and completed in 28/29(96.6%)cases,with one patient experiencing repeat cholangitis.Spontaneous migration of gold markers was observed in 1 patient.Twenty-four patients(82.8%)had surgery with 91.7%(22/24)R0 resection,and two patients experienced complete remission.No inflammatory changes around the marker were observed in the surgical specimen.The daily position of gold markers showed large positional changes,particularly in the superior-inferior direction.Moreover,tumor location was affected by food and fluid intake as well as bowel gas,which changes daily.CONCLUSION EUS fiducial marker placement following NACRT for RPC is feasible and safe.The RPC is mobile and is affected by not only aspiration,but also food and fluid intake and bowel condition.
文摘Objective:To study the effect of high-intensity focused ultrasound (HIFU) combined with radiotherapy on tumor malignancy in patients with advanced pancreatic cancer and the corresponding side effects.Methods:A total of 84 patients with advanced pancreatic cancer treated in our hospital between May 2013 and March 2016 were selected and randomly divided into HIFU group and IGRT group, HIFU group accepted high-intensity focused ultrasound combined with radiotherapy and IGRT group received radiotherapy alone. 4 weeks after treatment, the levels of tumor markers, liver and kidney function indexes, perineural invasion-related molecules and cytokines in serum as well as the levels of immune cells in peripheral blood were determined.Results:4 weeks after treatment, serum CA199, CA242, OPN, NGAL, RBP4, NGF, TrkA, p75, BDNF and TrkB levels of HIFU group were significantly lower than those of IGRT group, serum IL-2, TNF-α, IFN-γ and IL-13 levels as well as peripheral blood NKT cell and CD4+T cell levels were significantly higher than those of IGRT group, and serum ALT, AST, Cr and BUN levels were not significantly different from those of IGRT group.Conclusion:HIFU combined with radiotherapy treatment of advanced pancreatic cancer can more effectively kill cancer cells, inhibit pancreatic cancer cell invasion to the peripheral nerve and enhance the antitumor immune response mediated by NKT cells and CD4+T cells.
