目的评价3.0T磁共振动态对比增强成像(dynamic contrast-enhanced magnetic resonance imaging,DCEMRI)及扩散加权成像(diffusion-weighted imaging,DWI)在绒毛状腺瘤和直肠癌鉴别诊断中的作用。方法收集2015年3月-2016年3月在新疆医科...目的评价3.0T磁共振动态对比增强成像(dynamic contrast-enhanced magnetic resonance imaging,DCEMRI)及扩散加权成像(diffusion-weighted imaging,DWI)在绒毛状腺瘤和直肠癌鉴别诊断中的作用。方法收集2015年3月-2016年3月在新疆医科大学附属肿瘤医院经病理证实的10例绒毛状瘤患者和30例直肠癌患者作为实验组,选取14例正常人作为对照组,两组均行3.0T DCE-MRI及DWI检查。比较两组容积转运常数(Volume transfer constant,K^(trans))、速率常数(Rate constant,K_ep)、容积百分数(Volume per unit tissue volume,V_e)及表观扩散系数(Apparent diffusion coefficient,ADC),并分析ADC值对绒毛状腺瘤与直肠癌的诊断效能。结果对照组与实验组患者的K^(trans)、K_ep、V_e及ADC值差异均有统计学意义(P<0.01)。以ADC<0.905×10^(-3)mm^2/s为鉴别直肠癌与绒毛状腺瘤的界值,其敏感性为84.6%,特异性为87.5%。结论 K^(trans)、K_ep、V_e及ADC值对绒毛状腺瘤和直肠癌的鉴别诊断具有参考价值。展开更多
By using silver colloid staining technique,nucleolar organizer region-associated proteins(AgNORs)were studied quantatively in paraffin sections of 12 casesof polypoid adenomas,10 cases of villous adenomas,22 cases of ...By using silver colloid staining technique,nucleolar organizer region-associated proteins(AgNORs)were studied quantatively in paraffin sections of 12 casesof polypoid adenomas,10 cases of villous adenomas,22 cases of colonadenocarcinomas,and 10 cases of normal colonic mucosa as control.The resultsshowed that the mean number of AgNORs per nucleus in the villous adcnoma was similarto that of adenocaranoma,which significantly exceeded those of the normal mucosa andthe polypoid adenoma.The granules of AgNORs in adcnocarcinoma were much largerand more irregular in sizc and shape.It is suggested that benign villous adenoma is akind of lesion between polypoid adenoma and adenocarcinoma,and AgNOR techniquemay be very helpful in differential diagnosis of colon tumors.展开更多
BACKGROUND Villous adenomas of the urinary tract are uncommon. They are morphologically similar to and difficult to differentiate from their counterpart in the colon. The histogenesis and malignant potential are uncer...BACKGROUND Villous adenomas of the urinary tract are uncommon. They are morphologically similar to and difficult to differentiate from their counterpart in the colon. The histogenesis and malignant potential are uncertain.CASE SUMMARY A 63-year-old woman was admitted to our hospital with a mass in the urethral orifice. Gross and microscopic pathological examination was suggestive of urethral villous adenoma with focal well-differentiated adenocarcinoma. The whole urethra and part of the bladder were excised. No further treatment was offered. Carcinoembryonic antigen, cytokeratin 7, cytokeratin 20, epithelial membrane antigen, and p53 protein were positive, and the ratio of Ki-67 was 60%. After follow-up at 11 mo, the patient was cured and had no recurrence.CONCLUSION Immunohistochemistry is important for differential diagnosis of villous adenoma of the urinary system. Complete surgical resection of the urinary tract is curative.展开更多
AIM: To evaluate risk factors for local recurrence after endoscopic mucosal resection of colorectal adenomas > 20 mm.METHODS: Retrospective data analysis of 216 endoscopic mucosal resections for colorectal adenomas...AIM: To evaluate risk factors for local recurrence after endoscopic mucosal resection of colorectal adenomas > 20 mm.METHODS: Retrospective data analysis of 216 endoscopic mucosal resections for colorectal adenomas > 20 mm in 179 patients(40.3% female; median age 68 years; range 35-91 years). All patients had at least 1 follow-up endoscopy with a minimum control interval of 2 mo(mean follow-up 6 mo/2.0-43.4 mo). Possible factors associated with local recurrence were analyzed by univariate and multivariate analysis. RESULTS: Median size of the lesions was 30 mm(20-70 mm),69.0% were localized in the right-sided(cecum,ascending and transverse) colon. Most of the lesions(85.6%) showed a non-pedunculated morphology and the majority of resections was in piecemeal technique(78.7%). Histology showed carcinoma or high-grade intraepithelial neoplasia in 51/216(23.6%) lesions including 4 low risk carcinomas(pT1 a,L0,V0,R0- G1/G2). Histologically proven recurrence was observed in 33/216 patients(15.3%). Patient age>65 years,polyp size>30 mm,non-pedunculated morphology,localization in the right-sided colon,piecemeal resection and tubular-villous histology were found as associated factors in univariate analysis. On multivariate analysis,only localization in the rightsided colon(HR = 6.842/95%CI:1.540-30.394; P=0.011),tubular-villous histology(HR = 3.713/95%CI: 1.617-8.528;P=0.002) and polyp size>30 mm(HR=2.563/95%CI:1.179-5.570; P=0.017) were significantly associated risk factors for adenoma recurrence. CONCLUSION: Meticulous endoscopic follow-up is warranted after endoscopic mucosal resection of adenomas localized in the right-sided colon larger than > 30 mm,with tubular-villous histology.展开更多
文摘目的评价3.0T磁共振动态对比增强成像(dynamic contrast-enhanced magnetic resonance imaging,DCEMRI)及扩散加权成像(diffusion-weighted imaging,DWI)在绒毛状腺瘤和直肠癌鉴别诊断中的作用。方法收集2015年3月-2016年3月在新疆医科大学附属肿瘤医院经病理证实的10例绒毛状瘤患者和30例直肠癌患者作为实验组,选取14例正常人作为对照组,两组均行3.0T DCE-MRI及DWI检查。比较两组容积转运常数(Volume transfer constant,K^(trans))、速率常数(Rate constant,K_ep)、容积百分数(Volume per unit tissue volume,V_e)及表观扩散系数(Apparent diffusion coefficient,ADC),并分析ADC值对绒毛状腺瘤与直肠癌的诊断效能。结果对照组与实验组患者的K^(trans)、K_ep、V_e及ADC值差异均有统计学意义(P<0.01)。以ADC<0.905×10^(-3)mm^2/s为鉴别直肠癌与绒毛状腺瘤的界值,其敏感性为84.6%,特异性为87.5%。结论 K^(trans)、K_ep、V_e及ADC值对绒毛状腺瘤和直肠癌的鉴别诊断具有参考价值。
文摘By using silver colloid staining technique,nucleolar organizer region-associated proteins(AgNORs)were studied quantatively in paraffin sections of 12 casesof polypoid adenomas,10 cases of villous adenomas,22 cases of colonadenocarcinomas,and 10 cases of normal colonic mucosa as control.The resultsshowed that the mean number of AgNORs per nucleus in the villous adcnoma was similarto that of adenocaranoma,which significantly exceeded those of the normal mucosa andthe polypoid adenoma.The granules of AgNORs in adcnocarcinoma were much largerand more irregular in sizc and shape.It is suggested that benign villous adenoma is akind of lesion between polypoid adenoma and adenocarcinoma,and AgNOR techniquemay be very helpful in differential diagnosis of colon tumors.
文摘BACKGROUND Villous adenomas of the urinary tract are uncommon. They are morphologically similar to and difficult to differentiate from their counterpart in the colon. The histogenesis and malignant potential are uncertain.CASE SUMMARY A 63-year-old woman was admitted to our hospital with a mass in the urethral orifice. Gross and microscopic pathological examination was suggestive of urethral villous adenoma with focal well-differentiated adenocarcinoma. The whole urethra and part of the bladder were excised. No further treatment was offered. Carcinoembryonic antigen, cytokeratin 7, cytokeratin 20, epithelial membrane antigen, and p53 protein were positive, and the ratio of Ki-67 was 60%. After follow-up at 11 mo, the patient was cured and had no recurrence.CONCLUSION Immunohistochemistry is important for differential diagnosis of villous adenoma of the urinary system. Complete surgical resection of the urinary tract is curative.
文摘AIM: To evaluate risk factors for local recurrence after endoscopic mucosal resection of colorectal adenomas > 20 mm.METHODS: Retrospective data analysis of 216 endoscopic mucosal resections for colorectal adenomas > 20 mm in 179 patients(40.3% female; median age 68 years; range 35-91 years). All patients had at least 1 follow-up endoscopy with a minimum control interval of 2 mo(mean follow-up 6 mo/2.0-43.4 mo). Possible factors associated with local recurrence were analyzed by univariate and multivariate analysis. RESULTS: Median size of the lesions was 30 mm(20-70 mm),69.0% were localized in the right-sided(cecum,ascending and transverse) colon. Most of the lesions(85.6%) showed a non-pedunculated morphology and the majority of resections was in piecemeal technique(78.7%). Histology showed carcinoma or high-grade intraepithelial neoplasia in 51/216(23.6%) lesions including 4 low risk carcinomas(pT1 a,L0,V0,R0- G1/G2). Histologically proven recurrence was observed in 33/216 patients(15.3%). Patient age>65 years,polyp size>30 mm,non-pedunculated morphology,localization in the right-sided colon,piecemeal resection and tubular-villous histology were found as associated factors in univariate analysis. On multivariate analysis,only localization in the rightsided colon(HR = 6.842/95%CI:1.540-30.394; P=0.011),tubular-villous histology(HR = 3.713/95%CI: 1.617-8.528;P=0.002) and polyp size>30 mm(HR=2.563/95%CI:1.179-5.570; P=0.017) were significantly associated risk factors for adenoma recurrence. CONCLUSION: Meticulous endoscopic follow-up is warranted after endoscopic mucosal resection of adenomas localized in the right-sided colon larger than > 30 mm,with tubular-villous histology.