Benign esophageal lesions have a wide spectrum of clinical and pathologic features. Understanding the endoscopic and pathologic features of esophageal lesions is essential for their detection, differential diagnosis, ...Benign esophageal lesions have a wide spectrum of clinical and pathologic features. Understanding the endoscopic and pathologic features of esophageal lesions is essential for their detection, differential diagnosis, and management. The purpose of this review is to provide updated features that may help physicians to appropriately manage these esophageal lesions. The endoscopic features of 2997 patients are reviewed. In epithelial lesions, the frequency of occurrence was in the following order: glycogenic acanthosis, heterotopic gastric mucosa, squamous papilloma, hyperplastic polyp, ectopic sebaceous gland and xanthoma. In subepithelial lesions, the order was as follows: hemangioma, leiomyoma, dysphagia aortica and granular cell tumor. Most benign esophageal lesions can be diagnosed according to their endoscopic appearance and findings on routine biopsy, and submucosal lesions, by endoscopic resection. Management is generally based upon the confidence of diagnosis and whether the lesion causes symptoms. We suggest endoscopic resection of all granular cell tumors and squamous papillomas because, while rare, these lesions have malignant potential. Dysphagia aortica should be considered in the differential diagnosis of dysphagia in the elderly.展开更多
Background： The criterion of two target lesions per organ in the Response Evaluation Criteria in Solid Tumors （RECIST） version I. 1 is an arbitrary one, being supported by no objective evidence. The optimal number ...Background： The criterion of two target lesions per organ in the Response Evaluation Criteria in Solid Tumors （RECIST） version I. 1 is an arbitrary one, being supported by no objective evidence. The optimal number of target lesions per organ still needs to be investigated. We compared tumor responses using the RECIST 1.1 （measuring two target lesions per organ） and modified RECIST I. 1 （measuring the single largest lesion in each organ） in patients with small cell lung cancer （SCLC）. Methods： We reviewed medical records of patients with SCLC who received first-line treatment between January 2004 and December 2014 and compared tumor responses according to the two criteria using computed tomography. Results： There were a total of 34 patients who had at least two target lesions in any organ according to the RECIST 1.1 during the study period. The differences in the percentage changes of the sum of tumor measurements between RECIST 1.1 and modified RECIST 1.1 were all within 13%. Seven patients showed complete response and fourteen showed partial response according to the RECIST I.I. The overall response rate was 61.8%. When assessing with the modified RECIST 1.1 instead of the RECIST 1.1, tumor responses showed perfect concordance between the two criteria （k= 1.0）. Conclusions： The modified RECIST 1.I showed perfect agreement with the original RECIST 1.I in the assessment of tumor response of SCLC. Our result suggests that it may be enough to measure the single largest target lesion per organ for evaluating tumor response.展开更多
Cancer is one of the leading causes of death worldwide and breast cancer is the most commonly diagnosed cancer among women. An increased incidence of different types of breast cancer has been reported. This study was ...Cancer is one of the leading causes of death worldwide and breast cancer is the most commonly diagnosed cancer among women. An increased incidence of different types of breast cancer has been reported. This study was designed to evaluate the different types of breast cancer and its possible risk of neoplasmic transformation to an advanced malignant stage from a benign tumor. The histochemical patterns of collagen fibers in the benign and malignant breast lesions were evaluated. From the 50 tissue samples, 25 were malignant breast lesions and 25 were benign breast tumor. Hematoxylin and Eosin (HE), Van Gieson staining were performed to detect a benign and malignant tumor as well as collagen fibers. We found that significant cases after age of 35 were associated with ductal carcinoma while most of the cases within the age of 25 years were associated with fibrocystic changes. The intensity of collagen fiber was higher to Ductal Carcinoma while negative and less intense for Fibroblastic changes. Furthermore, a consistent association of other lesions, such as Lobular Carcinoma, Fibroadenoma, Papilloma and Fat necrosis and noticeable staining for collagen was observed for the different lesion. Our study suggested that women with age of 25 with benign lesion of fibrocystic change and ductal carcinoma are highly susceptible to develop advanced malignant tumor with age. Therefore, quantitative measurement of collagen fiber and regular follow-up are recommended to avoid the possible risk of developing advanced malignant lesions.展开更多
目的系统评价超声造影(contrast-enhanced ultrasound,CEUS)对局灶性睾丸病变的诊断价值。方法检索PubMed、Embase、Cochrane Library、Web of Science、中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方、维普(VIP)数据库,收集从建...目的系统评价超声造影(contrast-enhanced ultrasound,CEUS)对局灶性睾丸病变的诊断价值。方法检索PubMed、Embase、Cochrane Library、Web of Science、中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方、维普(VIP)数据库,收集从建库至2023年8月10日发表的关于CEUS诊断局灶性睾丸病变的相关文献,根据纳入和排除标准筛选文献、提取数据,并行文献质量评价,采用RevMan5.4、Meta disc1.4及Stata15.0软件分析CEUS在睾丸肿瘤与肿瘤样病变、肿瘤良恶性两个方面的诊断效能。结果最终纳入13篇文献共712个病灶。Meta分析结果显示,CEUS诊断睾丸肿瘤与肿瘤样病变的合并敏感度、特异度、阳性似然比、阴性似然比分别为0.95(95%CI:0.87~0.98)、0.84(95%CI:0.73~0.91)、5.8(95%CI:3.3~10.2)、0.06(95%CI:0.02~0.17),合并受试者工作特征曲线下面积为0.94(95%CI:0.92~0.96);CEUS诊断睾丸良恶性病变的合并敏感度、特异度、阳性似然比、阴性似然比分别为0.95(95%CI:0.85~0.99)、0.81(95%CI:0.65~0.90)、4.9(95%CI:2.5~9.6)、0.06(95%CI:0.02~0.20),合并受试者工作特征曲线下面积为0.96(95%CI:0.94~0.97)。结论CEUS对局灶性睾丸病变具有较高的诊断价值,能为临床诊疗提供参考。展开更多
Accurate prognosis in patients with lung cancer is important for clinical decision making and treatment selection. The TNM staging system is currently the main method for establishing prognosis. Using this system, pat...Accurate prognosis in patients with lung cancer is important for clinical decision making and treatment selection. The TNM staging system is currently the main method for establishing prognosis. Using this system, patients are grouped into one of four stages based on primary tumor extent, nodal disease, and distant metastases. However, each stage represents a range of disease extent and may not on its own be the best reflection of individual patient prognosis. 18F-fluorodeoxyglucose_positron emission tomography （18F-FDG-PET） can be used to evaluate the metabolic tumor burden affecting the whole body with measures such as metabolic rumor volume （MTV） and total lesion glycolysis （TLG）. MTV and TLG have been shown to be significant prognostic factors in patients with lung cancer, independent of TNM stage. These metabolic tumor burden measures have the potential to make lung cancer staging and prognostication more accurate and quantitative, with the goal of optimizing treatment choices and outcome predictions.展开更多
文摘Benign esophageal lesions have a wide spectrum of clinical and pathologic features. Understanding the endoscopic and pathologic features of esophageal lesions is essential for their detection, differential diagnosis, and management. The purpose of this review is to provide updated features that may help physicians to appropriately manage these esophageal lesions. The endoscopic features of 2997 patients are reviewed. In epithelial lesions, the frequency of occurrence was in the following order: glycogenic acanthosis, heterotopic gastric mucosa, squamous papilloma, hyperplastic polyp, ectopic sebaceous gland and xanthoma. In subepithelial lesions, the order was as follows: hemangioma, leiomyoma, dysphagia aortica and granular cell tumor. Most benign esophageal lesions can be diagnosed according to their endoscopic appearance and findings on routine biopsy, and submucosal lesions, by endoscopic resection. Management is generally based upon the confidence of diagnosis and whether the lesion causes symptoms. We suggest endoscopic resection of all granular cell tumors and squamous papillomas because, while rare, these lesions have malignant potential. Dysphagia aortica should be considered in the differential diagnosis of dysphagia in the elderly.
文摘Background： The criterion of two target lesions per organ in the Response Evaluation Criteria in Solid Tumors （RECIST） version I. 1 is an arbitrary one, being supported by no objective evidence. The optimal number of target lesions per organ still needs to be investigated. We compared tumor responses using the RECIST 1.1 （measuring two target lesions per organ） and modified RECIST I. 1 （measuring the single largest lesion in each organ） in patients with small cell lung cancer （SCLC）. Methods： We reviewed medical records of patients with SCLC who received first-line treatment between January 2004 and December 2014 and compared tumor responses according to the two criteria using computed tomography. Results： There were a total of 34 patients who had at least two target lesions in any organ according to the RECIST 1.1 during the study period. The differences in the percentage changes of the sum of tumor measurements between RECIST 1.1 and modified RECIST 1.1 were all within 13%. Seven patients showed complete response and fourteen showed partial response according to the RECIST I.I. The overall response rate was 61.8%. When assessing with the modified RECIST 1.1 instead of the RECIST 1.1, tumor responses showed perfect concordance between the two criteria （k= 1.0）. Conclusions： The modified RECIST 1.I showed perfect agreement with the original RECIST 1.I in the assessment of tumor response of SCLC. Our result suggests that it may be enough to measure the single largest target lesion per organ for evaluating tumor response.
文摘Cancer is one of the leading causes of death worldwide and breast cancer is the most commonly diagnosed cancer among women. An increased incidence of different types of breast cancer has been reported. This study was designed to evaluate the different types of breast cancer and its possible risk of neoplasmic transformation to an advanced malignant stage from a benign tumor. The histochemical patterns of collagen fibers in the benign and malignant breast lesions were evaluated. From the 50 tissue samples, 25 were malignant breast lesions and 25 were benign breast tumor. Hematoxylin and Eosin (HE), Van Gieson staining were performed to detect a benign and malignant tumor as well as collagen fibers. We found that significant cases after age of 35 were associated with ductal carcinoma while most of the cases within the age of 25 years were associated with fibrocystic changes. The intensity of collagen fiber was higher to Ductal Carcinoma while negative and less intense for Fibroblastic changes. Furthermore, a consistent association of other lesions, such as Lobular Carcinoma, Fibroadenoma, Papilloma and Fat necrosis and noticeable staining for collagen was observed for the different lesion. Our study suggested that women with age of 25 with benign lesion of fibrocystic change and ductal carcinoma are highly susceptible to develop advanced malignant tumor with age. Therefore, quantitative measurement of collagen fiber and regular follow-up are recommended to avoid the possible risk of developing advanced malignant lesions.
文摘Accurate prognosis in patients with lung cancer is important for clinical decision making and treatment selection. The TNM staging system is currently the main method for establishing prognosis. Using this system, patients are grouped into one of four stages based on primary tumor extent, nodal disease, and distant metastases. However, each stage represents a range of disease extent and may not on its own be the best reflection of individual patient prognosis. 18F-fluorodeoxyglucose_positron emission tomography （18F-FDG-PET） can be used to evaluate the metabolic tumor burden affecting the whole body with measures such as metabolic rumor volume （MTV） and total lesion glycolysis （TLG）. MTV and TLG have been shown to be significant prognostic factors in patients with lung cancer, independent of TNM stage. These metabolic tumor burden measures have the potential to make lung cancer staging and prognostication more accurate and quantitative, with the goal of optimizing treatment choices and outcome predictions.
