目的对照研究计算机辅助检测(computer-aided detection,CAD)自动提取的微钙化多种特征与乳腺导管原位癌(ductal carcinoma in situ,DCIS)不同病理分级的相关性,探讨所有特征对于DCIS不同分级的意义,为开发辅助临床早期诊断和个体化治疗...目的对照研究计算机辅助检测(computer-aided detection,CAD)自动提取的微钙化多种特征与乳腺导管原位癌(ductal carcinoma in situ,DCIS)不同病理分级的相关性,探讨所有特征对于DCIS不同分级的意义,为开发辅助临床早期诊断和个体化治疗DCIS的计算机辅助诊断系统提供参考。方法经本院乳腺钼靶X线摄影检查发现微钙化并经最终病理学证实的203例DCIS患者影像资料,按高、中、低级别病理结果分组,CAD检测微钙化并自动提取反映微钙化形态学、统计学、纹理、分布特征的14个参数,进行对比分析。结果 1所有微钙化特征中,线样分支状钙化数、细颗粒状微钙化率、总数目、簇状分布率、种群密度在低、中、高级别3组间比较和低、高级别2组间比较时差异均具有统计学意义(P<0.01),较高的病理级别容易出现较高的线样分支状钙化数、总数目、簇状分布率、种群密度,较低的病理级别出现细颗粒状微钙化的概率较高。2除线样分支状钙化数外,其余所有特征参数在中级别组和低级别或高级别组间比较时,差异均无统计学意义(P>0.05)。3微钙化的四种分布类型仅在高级别组出现统计学差异,其中簇状分布的出现概率相对较高。结论通过CAD辅助检测DCIS微钙化获得的多种特征参数,与不同生物学行为的病理分级相关性不同,有利于深入研究计算机辅助诊断DCIS,为早期诊断DCIS和临床个性化治疗提供重要的参考依据。展开更多
Purpose: Identifying the source of stone formation in recurrent stone formers has always been a big problem. Material and Methods: In this study kidney stones from 52 patients were submitted to direct examination by s...Purpose: Identifying the source of stone formation in recurrent stone formers has always been a big problem. Material and Methods: In this study kidney stones from 52 patients were submitted to direct examination by scanning electronic microscopy (SEM) after manual fracture and 27 calculi were cultured in Eagle’s Minimum Essential Medium (E-MEM) and Brain-Heart Infusion (BHI) for eight weeks at 37°C in 5% CO2 atmosphere. Twenty-seven powdered and demineralized stones were suspended in sterile PBS, filtered through 0.22 m-pore-size sterile filters Millex (Millipore, Massachusetts, USA) and submitted to DNA extraction (Quiagen-Brazil). Platinum PCR SuperMIX (GIBCO-BRL), primers (Invitrogen), and Ultra Pure Water (Advanced Biotechnologies, Columbia, MD) were used for PCR (Polymerase Chain Reaction), which was generally conducted for 30 or 35 cycles with annealing of primers for 40 sec at 55°C and extension for 1 min at 72°C. Results: In 36 out 52 (69%) kidney stones it was detected the presence of biofilm coating the mineral surface of the stone when examined by SEM, consisting of coccoid particles, isolated or clustered, with diameter of 500 nm or less. Eleven out 27 (41%) kidney stone cultures produced white-colored sediment on the bottom of the tubes after eight-week incubation, revealing tiny structures similar to those observed directly by SEM. These structures were similar in size and morphology to spherical apatite particles previously observed in human kidney stones and named as nanobacteria (NB). No PCR products were observed in the samples. Conclusion: We found a strong correlation between renal stones and calcifying nanoparticles (CNP) in this study and these results open a new insight on this area to explore the etiology of stone formation. Whether NB/CNP are truly microorganisms or self-propagating mineral compounds is still controversial and its contribution, if any, in apatite nucleation and crystal growth remains uncertain.展开更多
文摘Purpose: Identifying the source of stone formation in recurrent stone formers has always been a big problem. Material and Methods: In this study kidney stones from 52 patients were submitted to direct examination by scanning electronic microscopy (SEM) after manual fracture and 27 calculi were cultured in Eagle’s Minimum Essential Medium (E-MEM) and Brain-Heart Infusion (BHI) for eight weeks at 37°C in 5% CO2 atmosphere. Twenty-seven powdered and demineralized stones were suspended in sterile PBS, filtered through 0.22 m-pore-size sterile filters Millex (Millipore, Massachusetts, USA) and submitted to DNA extraction (Quiagen-Brazil). Platinum PCR SuperMIX (GIBCO-BRL), primers (Invitrogen), and Ultra Pure Water (Advanced Biotechnologies, Columbia, MD) were used for PCR (Polymerase Chain Reaction), which was generally conducted for 30 or 35 cycles with annealing of primers for 40 sec at 55°C and extension for 1 min at 72°C. Results: In 36 out 52 (69%) kidney stones it was detected the presence of biofilm coating the mineral surface of the stone when examined by SEM, consisting of coccoid particles, isolated or clustered, with diameter of 500 nm or less. Eleven out 27 (41%) kidney stone cultures produced white-colored sediment on the bottom of the tubes after eight-week incubation, revealing tiny structures similar to those observed directly by SEM. These structures were similar in size and morphology to spherical apatite particles previously observed in human kidney stones and named as nanobacteria (NB). No PCR products were observed in the samples. Conclusion: We found a strong correlation between renal stones and calcifying nanoparticles (CNP) in this study and these results open a new insight on this area to explore the etiology of stone formation. Whether NB/CNP are truly microorganisms or self-propagating mineral compounds is still controversial and its contribution, if any, in apatite nucleation and crystal growth remains uncertain.
