TNM staging of colorectal cancer should be reconsidered by T stage weighting

AIM: To verify that the T stage has greater weight than the N stage in the staging of colorectal cancer.

^(18)F-FDG PET/CT for malignant small intestinal neoplasms

In this paper, 18F-FDG PET/CT data of 19 malignant SINs (small intestinal neoplasms) were consecutively reviewed. Nnine patients accepted PET/CT scan for preoperative diagnosis and staging, while ten patients presented follow-up after treatment and restaging. The results were correlated with abdomen enhanced CT and surgical pathological findings. Abdominal pain and weight loss were the most common findings. About 16% SINs located in the duodenum, 52% in the jejunum and 32% in the ileum. Lymphoma was the most frequent neoplasms. PET/CT revealed residual or recurrent malignant SINs in 5 patients who had negative or non-definite findings by abdomen CT and demonstrated extra-abdomen metastasis in 3 patients. Clinical decisions of treatment were changed for 6 patients after PET/CT examinations. The 18F-FDG PET/CT were better than CT in accuracy, negative predictive value and positive predictive value (89.5% vs 68.4%, 100% vs 66.7%, and 81.8% vs 69.2%, respectively). Whole body 18F-FDG PET/CT may be an effective molecular imaging method for staging and restaging of malignant SINs.

Low-dose spectral insufflation computed tomography protocol preoperatively optimized for T stage esophageal cancer-preliminary research experience

AIM To evaluate the T stage of esophageal squamous cell carcinoma(ESCC) using preoperative low-dose esophageal insufflation computed tomography(EICT).METHODS One hundred and twenty ESCC patients confirmed by surgery or esophagoscopy were divided into three groups. Groups B and C were injected with 300 mgI/kg contrast medium for automatic spectral imaging assist(GSI assist), while group A underwent a conventional 120 kVp computed tomography(CT) scan with a 450 mg I/kg contrast medium injection. EICT was performed in group C. Group A was reconstructed with filtered back projection, and groups B and C were reconstructed with 50% adaptive statistical iterative reconstruction. The contrast-to-noise ratio of lesion-to-mediastinal adipose tissue and the radiation dose were measured. Specific imaging features were observed, and T stage ESCCs were evaluated.RESULTS The sensitivity and accuracy of the T1/2 stage were higher in group C than in groups A and B(sensitivity: 43.75% vs 31.82% and 33.33%; accuracy: 54.29% vs 46.67% and 52.50%, respectively). With regard to the T3 stage, the sensitivity and specificity in group C were higher than those in groups A and B(sensitivity: 56.25% vs 41.17% and 44.44%; specificity: 73.68% vs 67.86% and 63.64%, respectively). The diagnostic sensitivity, specificity and accuracy of the T4 stage were similar among all groups. There were no significant differences in volume CT dose index [(5.91 ± 2.57) mGy vs(3.24 ± 1.20) vs(3.65 ± 1.77) mGy], doselength product [(167.10 ± 99.08) mGy·cm vs(113.24 ± 54.46) mGy·cm vs(117.98 ± 32.32) mGy·cm] and effective dose [(2.52 ± 1.39) vs(1.63 ± 0.76) vs(1.73 ± 0.44) mSv] among the groups(P > 0.05). However, groups B and C received similar effective doses but lower iodine loads than group A [(300 vs 450) mgI/kg].CONCLUSION EICT combined with GSI assist allows differential diagnosis between the T1/2 and T3 stages. The ability to differentially diagnose the T3 and T4 stages of medullary ESCC can be improved by quantitatively and qualitatively analyzing the adipose tissue in front of the vertebral body.

Is there a role for surgery in stage ⅢA-N2 non-small cell lung cancer?

The role of surgery in stage ⅢA-N2 non-small cell lung cancer(NSCLC) remains controversial.Most important prognostic factors are mediastinal downstaging and complete surgical resection.Different restaging techniques exist to evaluate response after induction therapy and these are subdivided into non-invasive,invasive and alternative or minimally invasive techniques.In contrast to imaging or functional studies,remediastinoscopy provides pathological evidence of response after induction therapy.Although techn...

Pancreatic Neuroendocrine Neoplasms: Correlation between MR Features and Pathological Tumor Grades

This study investigated the accuracy of MRI features in differentiating the pathological grades of pancreatic neuroendocrine neoplasms（PNENs）. A total of 31 PNENs patients were retrospectively evaluated, including 19 cases in grade 1, 5 in grade 2, and 7 in grade 3. Plain and contrastenhanced MRI was performed on all patients. MRI features including tumor size, margin, signal intensity, enhancement patterns, degenerative changes, duct dilatation and metastasis were analyzed. Chi square tests, Fisher＇s exact tests, one-way ANOVA and ROC analysis were conducted to assess the associations between MRI features and different tumor grades. It was found that patients with older age, tumors with higher TNM stage and without hormonal syndrome had higher grade of PNETs（all P〈0.05）. Tumor size, shape, margin and growth pattern, tumor pattern, pancreatic and bile duct dilatation and presence of lymphatic and distant metastasis as well as MR enhancement pattern and tumor-topancreas contrast during arterial phase were the key features differentiating tumors of all grades（all P〈0.05）. ROC analysis revealed that the tumor size with threshold of 2.8 cm, irregular shape, pancreatic duct dilatation and lymphadenopathy showed satisfactory sensitivity and specificity in distinguishing grade 3 from grade 1 and grade 2 tumors. Features of peripancreatic tissue or vascular invasion, and distant metastasis showed high specificity but relatively low sensitivity. In conclusion, larger size, poorlydefined margin, heterogeneous enhanced pattern during arterial phase, duct dilatation and the presence of metastases are common features of higher grade PNENs. Plain and contrast-enhanced MRI provides the ability to differentiate tumors with different pathological grades.

Spontaneous regression of stage Ⅲ neuroblastoma: A case report

BACKGROUND Neuroblastoma(NB) is the most common type of extracranial solid tumour in children. The overall prognosis of NB is poor, but at the same time, NB shows significant clinical diversity. NB can demonstrate spontaneous regression or can differentiate into benign ganglioneuroma.CASE SUMMARY This study retrospectively analyzed the clinical data of a patient with spontaneous regression of stage Ⅲ NB who was admitted in May 2015. Studies of the spontaneous regression of NB published from October 1946 to September 2019 were retrieved through Pub Med. The clinical manifestations, diagnosis,treatment, and follow-up results were analysed.CONCLUSION Spontaneous regression of stage Ⅲ NB is rare in the clinic. The report of this case is an important supplement to the study of the spontaneous regression of NB.

Further Discussion on the Three Methods for the Stage-Treatment of Parkinson's Disease

Based on the long-term clinical practice and scientific researches on the three methods for the stage-treatment of Parkinson＇s disease put forward by the author in the early years, this essay further discusses the division of the three stages of Parkinson＇s disease. Early stage： Appearance of the early symptoms and signs of Parkinson＇s disease, but short in duration and mild in severity, which do not affect the social communications, daily life and work of the patient; and their modified Hoehn ＆ Yahr grading is 1,0-1.5. Mid stage： With the symptoms and signs of Parkinson＇s disease getting worse and affecting the social communications, daily life and work of the patient, those who have their modified Hoehn ＆ Yahr grading 2-3 need medical treatment. Late stage： The patients have severe clinical symptoms of Parkinson＇s disease, and Levodopa preparation is insufficient for them to maintain their daily life; and their modified Hoehn ＆ Yahr grading is 4-5. The three treating methods are： TCM medical treatment adopted at the early stage; the combined treatment of Chinese and western medicine at the mid stage; and comprehensive treatment with multi-theraoies at the late stage.

Down-staging depth score to predict outcomes in locally advanced rectal cancer achieving ypl stage after neoadjuvant chemo-radiotherapy versus de novo stage pl cohort:A propensity score-matched analysis

Objective：Prognosis of patients with locally advanced rectal cancer（LARC）but achieving yp T1–2N0 stage after neoadjuvant concurrent chemo-radiotherapy（CRT）has been shown to be favorable.This study aims to determine whether the long-term outcome of yp T1–2N0 cases can be comparable to that of p T1–2N0 cohort that received definitive surgery for early disease.Method：From January 2008 to December 2013,449 consecutive patients with rectal cancer were treated and their outcome maintained in a database.Patients with LARC underwent total mesorectal excision（TME）surgery at4–8 weeks after completion of CRT,and those achieving stage yp I were identified as a group.As a comparison,stage p I group pertains to patients whose initially limited disease was not upstaged after TME surgery alone.After propensity score matching（PSM）,comparisons of local regional control（LC）,distant metastasis-free survival（DMFS）,disease-free survival（DFS）and overall survival（OS）were performed using Kaplan-Meier analysis and log-rank test between yp I and p I groups.Down-staging depth score（DDS）,a novel method of evaluating CRT response,was used for subset analysis.Results：Of the 449 patients,168 matched cases were generated for analysis.Five-year LC,DMFS,DFS and OS for stage p I vs.yp I groups were 96.7%vs.96.4%（P=0.796）,92.7%vs.73.6%（P=0.025）,91.2%vs.73.6%（P=0.080）and 93.1%vs.72.3%（P=0.040）,respectively.In the DDS-favorable subset of the yp I group,LC,DMFS,DFS and OS resulted in no significant differences in comparison with the p I group（P=0.384,0.368,0.277 and0.458,respectively）.Conclusions：LC was comparable in both groups;however,distant metastasis developed more frequently in down-staged LARC than de novo early stage cases,reflecting the need to improve the efficacy of systemic treatment despite excellent pathologic response.DDS can be an indicator to identify a subset of the yp I group whose longterm oncologic outcomes are as good as those of stage p I cohort.

MRI基于2023版国际妇产科联盟分期评估子宫内膜癌进展

子宫内膜癌(EC)是常见妇科恶性肿瘤;MRI对EC评估具有重要价值。2023年国际妇产科联盟(FIGO)分期做出重大修订,以更细致地对EC进行风险分层,也使MRI面临新的挑战。本文就MRI基于2023版FIGO分期评估EC进展进行综述。

CT影像组学联合临床及CT特征预测胸腺上皮肿瘤TNM分期

目的观察CT影像组学联合临床及CT特征预测胸腺上皮肿瘤(TET)TNM分期的价值。方法回顾性分析216例经手术病理证实的单发TET患者,以其中151例TNMⅠ期为早期组,将27例TNMⅢ期及38例Ⅳ期归为晚期组(n=65)。采用单因素分析组间临床资料及胸部CT表现。分别基于平扫(NECT)及增强CT(CECT)提取并筛选最佳影像组学特征,建立预测TET TNM分期的影像组学模型RM_(NECT)、RM_(CECT),联合组间差异有统计学意义的临床及CT特征构建RM_(NECT-临床)、RM_(CECT-临床)及RM_(NECT-临床-CT)、RM_(CECT-临床-CT)。按7∶3比例将患者分为训练集(n=151)及验证集(n=65),采用重复5折交叉验证法于训练集训练模型,并于验证集验证其效能。结果组间临床症状及CT所示病灶周围脂肪浸润、纵隔淋巴结肿大、胸腔积液差异均有统计学意义(P均<0.05)。分别基于NECT及CECT筛选出2个及9个最佳影像组学特征,以之构建相应模型。验证集中,RM_(NECT-临床)-CT预测TET TNM分期的AUC(0.864)高于RM_(NECT)及RM_(NECT-临床)(AUC=0.634、0.721,Z=3.081、2.937,P=0.002、0.003),RM_(CECT-临床-CT)的AUC(0.920)高于RM_(CECT)及RM_(CECT-临床)(AUC=0.689、0.751,Z=2.698、2.390,P=0.007、0.017)。结论CT影像组学联合临床及CT特征能有效预测TET TNM分期。

基于倾向性评分匹配的T_(4a)期胃癌腔镜辅助与开腹手术近期疗效的对比分析

目的:探讨T_(4a)期胃癌行腹腔镜辅助D2根治术的近期疗效。方法:采用倾向性评分匹配,分析2014年1月至2020年12月为T_(4a)期胃腺癌患者行D2淋巴结清扫的临床资料。将患者分为开腹组(n=362)与腹腔镜组(n=134),通过倾向性评分匹配对数据进行1∶1匹配,匹配容差设为0.03。最终获得两组病例各134例。比较两组手术情况、术后并发症、术后炎性指标变化及2年总生存率。结果:倾向性匹配后,两组基线资料具有可比性(P>0.05)。两组术后首次进食时间、住院时间、并发症情况差异均无统计学意义(P>0.05);腹腔镜组与开腹组手术时间[240(203.75,256.25)min vs.140(120,190)min,P<0.05]、术中出血量[200(100,300)mL vs.200(200,300)mL,P<0.05]、淋巴结清扫数量[20.5(17,27.25)vs.16(10,23),P<0.05]、切口长度[5(5,6)cm vs.12(10,15)cm,P<0.05]、术后排气时间[4(3,6)d vs.5(3,6)d,P<0.05]、术后下床活动时间[2(2,3)d vs.3(2,3)d,P<0.05]差异均有统计学意义。两组术前中性粒细胞-淋巴细胞比值、血小板-淋巴细胞比值、淋巴细胞-单核细胞比值差异无统计学意义(P>0.05),术后血小板-淋巴细胞比值差异无统计学意义,腹腔镜组中性粒细胞-淋巴细胞比值低于开腹组,淋巴细胞-单核细胞比值高于开腹组,差异有统计学意义。开腹组与腹腔镜组术后2年总生存率为53.3%与48.3%,差异无统计学意义(P=0.211)。结论:对于T_(4a)期胃癌,腹腔镜手术后并发症发生率、2年生存率与开腹手术相当,但腹腔镜手术具有创伤小、美观、术后康复快的优势。

不同化疗方案联合腹腔镜远端胃癌D2根治术对进展期胃癌患者疗效及血清sEC、IGF、CEA水平的影响

目的研究不同化疗方案联合腹腔镜远端胃癌D2根治术对进展期胃癌患者的疗效及血清可溶性E2钙粘连蛋白(sEC)、胰岛素样生长因子(IGF)、癌胚抗原(CEA)水平的影响。方法选择2020年3月至2023年6月收治的进展期胃癌患者150例,按照随机数字表法分成2组,其中对照组75例采用奥沙利铂和卡培他滨方案化疗联合腹腔镜远端胃癌D2根治术治疗,观察组75例采用多西他赛、奥沙利铂联合卡培他滨方案化疗(DOX方案)联合腹腔镜远端胃癌D2根治术治疗。观察比较2组围术期指标及化疗前后血清sEC、IGF、CEA水平和2组近期疗效、术后并发症发生情况。结果观察组术后肛门排气时间、术后第一次进食流质饮食时间和术后住院时间均短于对照组(P<0.05)。化疗后,sEC、IGF、CEA水平均下降,且观察组下降更显著(P<0.05,P<001)。观察组近期疗效显著高于对照组(P<0.05)。观察组术后并发症总发生率低于对照组(P<001)。结论DOX方案联合腹腔镜远端胃癌D2根治术治疗进展期胃癌效果较好,术后并发症发生率低,可以作为进展期胃癌患者的治疗备选方案。

基于MRI影像组学构建PD-1/PD-L1抑制剂治疗dMMR/MSI-H直肠癌疗效的预测模型

目的:探讨MRI影像组学模型在程序性细胞死亡蛋白-1(PD-1)/程序性细胞死亡-配体1(PD-L1)抑制剂联合全程新辅助治疗(TNT)局部进展期直肠癌(LARC)的疗效预测价值。方法:收集河南中医药大学第一附属医院PD-1/PD-L1抑制剂联合TNT治疗的80例错配修复基因缺陷(dMMR)/微卫星高度不稳定(MSI-H)基因型中低位LARC患者的临床和影像资料。将入组患者按7∶3比例分为训练集和测试集,提取影像组学特征,从中筛选并构建影像组学模型。描绘影像组学模型的Rad-score与病理金标准之间的受试者工作特征(ROC)曲线,计算曲线下面积(AUC),并评价模型的诊断效能。采用决策曲线分析(DCA)计算风险阈值的范围,并评估临床获益情况。收集湖南省人民医院25例dMMR/MSI-H基因型LARC患者的影像资料作为外部验证集。结果:训练集、测试集及外部验证集三者之间的临床特征无统计学差异(P>0.05)。经过降维处理、t检验及一致性检验以及LASSO交叉验证后,筛选出一阶偏度特征和体积2个特征构建影像组学模型。训练集、测试集和外部验证集的影像组学预测模型ROC曲线的AUC、灵敏度、特异度、阳性预测值和阴性预测值分别为0.920、97.1%、85.7%、91.9%、94.7%;0.885、80.0%、88.9%、92.3%、72.7%;0.875、87.5%、88.9%、93.3%、80.0%。DCA曲线显示,当风险阈值范围为0%~82%时,采用影像组学模型预测LARC患者为病理完全缓解(pCR)的获益大于将所有患者都视为pCR或者无病理完全缓解(npCR)。结论:基于MRI影像组学构建的dMMR/MSI-H型局部进展期直肠癌PD-1/PD-L1抑制剂联合全程新辅助放化疗疗效预测模型,有较大潜力为不同基因分型的直肠癌患者制定个体化治疗策略提供量化依据。

基于超声影像组学特征列线图模型术前鉴别早期与中晚期宫颈鳞癌

目的 观察基于经阴道超声影像组学特征建立的列线图模型术前鉴别早期与中晚期宫颈鳞癌的价值。方法 回顾性收集经术后病理证实的227例宫颈鳞癌患者,利用3D-Slicer软件于术前经阴道声像图中勾画ROI,提取并经冗余性分析、最小绝对收缩和选择算子(LASSO)和10折交叉验证筛选影像组学特征,构建影像组学模型并得到Radscore评分;利用多因素logistic回归纳入Radscore及临床资料构建列线图模型。比较2个模型术前鉴别早期与中晚期宫颈鳞癌的受试者工作特征曲线下面积(AUC);评估列线图模型的校准度及临床收益。结果 最终纳入18个超声影像组学特征;以之构建术前鉴别早期与中晚期宫颈鳞癌的影像组学模型在训练集和验证集的AUC分别为0.839和0.744;联合年龄、流产次数及Radscore评分构建的列线图模型在训练集和验证集的AUC分别为0.882和0.773。DeLong检验结果显示,上述2模型在训练集的AUC差异有统计学意义(P<0.05)。Hosmer-Lemeshow检验显示,列线图模型在训练集和验证集的校准度均佳(χ^(2)=5.053、7.063,P均>0.05);决策曲线分析(DCA)显示其在0.01~1.00阈值区间净收益相对较大。结论 基于经阴道超声影像组学特征的列线图模型可于术前较好地鉴别早期与中晚期宫颈鳞癌。

多序列MRI影像组学预测宫颈鳞状细胞癌临床分期

目的观察多序列MRI影像组学预测宫颈鳞状细胞癌(CSCC)临床分期的价值。方法回顾性收集经病理证实的190例单发CSCC患者,将其中67例国际妇产科联盟(FIGO)分期ⅠB~ⅡA者归为早期组、123例FIGOⅡB~ⅢC者归为中晚期组。按6∶4比例将所有患者分为训练集(n=114,含早期亚组40例及中晚期亚组74例)和测试集(n=76,含早期亚组27例及中晚期亚组49例)。以单因素及logistic回归分析筛选临床相关影响因素并构建临床模型。基于治疗前盆腔MR T2WI、弥散加权成像(DWI)、动态对比增强(DCE)-T1WI提取及筛选最佳影像组学特征并构建影像组学模型,包括T2WI、DWI、DCE-TWI及联合序列模型,并基于后者及临床模型建立临床-影像组学模型。绘制受试者工作特征曲线,计算曲线下面积(AUC),评估各模型的预测效能;计算综合判别改善(IDI)指数,比较各模型在训练集的诊断效能,以决策曲线分析(DCA)评价其临床价值。结果中晚期亚组鳞状细胞癌抗原在训练集及测试集均高于早期亚组(P均<0.05),以之构建临床模型。临床、T2WI、DWI、DCE-TWI、联合序列及临床-影像组学模型预测训练集CSCC临床分期的AUC分别为0.66、0.71、0.78、0.81、0.88及0.89,在测试集分别为0.62、0.64、0.72、0.73、0.77及0.76。训练集中,临床-影像组学模型的预测效能高于联合序列模型(IDI=0.19,P<0.05),而此二者的预测效能均高于其他模型(IDI=0.19~0.47,P均<0.05)。阈值分别为0.02~1.00和0.05~1.00时,联合序列模型及临床-影像组学模型在训练集的临床净收益均较高。结论多序列MRI影像组学可有效预测CSCC临床分期;结合临床资料有助于提高诊断效能。

MR多模态成像在直肠癌TN分期及手术方式选择中的应用

目的探讨MR多模态成像在直肠癌TN分期及手术方式选择中的应用价值。方法回顾性分析我院2020年1月—2022年5月396例直肠癌患者的MR征象,以此进行术前TN分期并模拟制定手术方式,分析手术前后TN分期的准确性,并比较拟定手术方式与实际手术方式的一致性。结果MR多模态成像辅助术前拟定直肠癌T分期的符合率为90.15%,与术后病理结果的一致性较高(K=0.82,P<0.01),且对于T2~T4分期的诊断准确率较高;N分期的符合率为71.46%,与术后病理结果的一致性适中(K=0.53,P<0.01)。MR多模态成像辅助拟定手术方式的符合率为89.14%,与实际术式一致性较高(K=0.79,P<0.01),且对于直肠癌各种术式拟定的准确率均较高。结论MR多模态成像对直肠癌的术前TN分期以及手术方式的制定有较高的临床价值。

肺癌组织中MTA1、VEGF-C表达水平与患者临床分期及预后的相关性

【目的】探讨肺癌组织中转移相关基因1(MTA1)、血管内皮生长因子C(VEGF-C)表达水平及其与患者临床分期及预后的相关性。【方法】回顾分析本院收治的85例肺癌患者的临床资料,收集患者的肺癌组织及癌旁组织,采用免疫组化法检测MTA1、VEGF-C阳性表达情况,采用PCR荧光定量法检测MTA1、VEGF-C表达水平,比较不同临床病理参数、预后结局患者的MTA1、VEGF-C阳性表达率。【结果】肺癌组织MTA1、VEGF-C阳性表达率及两者表达水平均高于癌旁组织,差异有统计学意义(P<0.05)。不同TNM分期、肿瘤直径及分化、淋巴结转移、脉管侵犯、预后情况患者的MTA1、VEGF-C阳性表达率及表达水平比较,差异均有统计学意义(P<0.05)。MTA1及VEGF-C阳性表达患者24个月累积无进展生存率分别低于两者阴性表达患者,差异有统计学意义(P<0.05)。肺癌组织中MTA1、VEGF-C表达水平与肿瘤TNM分期、肿瘤直径、淋巴结转移、脉管侵犯、预后结局均呈正相关(P<0.05),与分化程度呈负相关(P<0.05)。【结论】MTA1、VEGF-C在肺癌组织内多呈阳性表达,其表达水平与肿瘤病理分期、肿瘤直径、预后等密切相关。

那不勒斯预后评分对青年肺腺癌患者预后的预测价值分析

目的探讨那不勒斯预后评分(NPS)对青年肺腺癌患者的预后预测价值。方法回顾性分析2017年11月至2022年12月收治的青年肺腺癌患者110例的临床资料,根据NPS分为低危组(0分)27例、中危组(1~2分)58例和高危组(3~4分)25例,比较3组患者临床资料。采用Kaplan-Meier和Cox回归分析评估NPS对预后的影响。结果3组TNM分期、乳酸脱氢酶、SII、癌胚抗原水平及手术、化疗、靶向治疗患者所占比例比较差异有统计学意义(P<0.05,P<0.01);年龄、性别、吸烟史、婚姻状态、体质量指数、血小板/淋巴细胞比率、神经元特异性烯醇化酶比较差异无统计学意义(P>0.05)。Kaplan-Meier生存分析曲线显示高危组患者总生存期和无进展生存期明显短于低危组和中危组(P<0.01)。TNM分期、手术、化疗和NPS分级是影响青年肺腺癌患者总生存期的独立影响因素(P<0.05,P<0.01)。结论NPS对青年肺腺癌患者的预后有良好预测价值。

青年乳腺癌与中老年乳腺癌患者临床及病理特征比较

目的探究青年与中老年乳腺癌患者临床及病理特征。方法选择2020年4月至2022年4月收治的乳腺癌患者120例,依照年龄分为青年组(≤35岁)48例与中老年组(>35岁)72例。比较2组患者一般资料和临床病理特征。结果2组发病部位和肿瘤结节个数比较差异均无统计学意义(P>0.05)。2组T分期、N分期和组织学分级及雌激素受体、孕激素受体阳性率、C-erbB-2蛋白表达、分子分型比较差异均有统计学意义(P<0.05,P<0.01)。2组术后12个月和24个月生存率比较差异无统计学意义(P>0.05)。结论青年乳腺癌与中老年乳腺癌在临床特征和分子分型方面均有着较大差异,需引起临床高度重视,以便尽早诊断、及时治疗。

常规磁共振成像联合弥散加权成像诊断直肠癌术前分期的准确性及漏诊误诊原因

目的 针对常规磁共振成像(MRI)联合弥散加权成像(DWI)诊断直肠癌术前分期的准确性及漏诊、误诊的原因进行探讨。方法 回顾性选取我院收治的58例直肠癌患者作为研究对象,选取时间为2020年1月至2023年2月。所有患者均接受常规MRI序列联合DWI检查、病理检查,金标准为病理检查结果。比较所有患者经术前常规MRI联合DWI、病理检查对肿瘤侵犯的深度(T分期)、淋巴结转移情况(N分期)的检出结果;统计术前常规MRI联合DWI成像检查T、N分期的诊断效能,并对相关影像学图片进行分析。结果 病理结果显示,58例直肠癌患者中T1分期13例,T2分期16例,T3分期19例,T4分期10例;N0分期24例,N1分期18例,N2a分期7例,N2b分期9例。常规MRI联合DWI成像检查结果显示,58例直肠癌患者中T1分期10例,T2分期15例,T3分期17例,T4分期16例;N0分期22例,N1分期20例,N2a分期8例,N2b分期8例,其结果均与病理结果较为接近;患者术前应用常规MRI联合DWI成像检查T分期、N分期总体的特异度、灵敏度、准确度均较高。结论 临床可根据常规MRI联合DWI诊断结果及影像学特点综合评估直肠癌患者术前肿瘤分期。