目的探究浆细胞性乳腺炎(PCM)患者超声弹性应变率(SR)值与血清雌二醇(E2)、催乳素(PRL)水平、Ki-67阳性表达率相关性及在预后评估应用价值。方法选择PCM女性患者108例,年龄21~44岁,平均年龄31.03岁。均给予抗生素、微波治疗,持续治疗4...目的探究浆细胞性乳腺炎(PCM)患者超声弹性应变率(SR)值与血清雌二醇(E2)、催乳素(PRL)水平、Ki-67阳性表达率相关性及在预后评估应用价值。方法选择PCM女性患者108例,年龄21~44岁,平均年龄31.03岁。均给予抗生素、微波治疗,持续治疗4周。治疗后统计患者出现并发症、复发等不良事件发生例数,并根据预后情况进行分组。均于入院时、治疗4周后行超声弹性图像检查,检测血清E2、PRL水平和Ki-67阳性表达率。对比两组SR、血清E2、PRL水平、Ki-67阳性表达率,应用Pearson分析SR与血清E2、PRL水平、Ki-67阳性表达率相关性,应用Logistic回归分析探究预后影响因素,应用受试者工作特性(ROC)曲线评价SR对PCM患者预后的评估价值。结果根据治疗后出现并发症、复发等预后情况将患者分为预后良好组(n=85)、预后不良组(n=23)。预后良好组入院时、治疗4周后SR低于预后不良组(3.95±0.53 vs 4.21±0.46;t=2.143,P=0.034。2.67±0.38 vs 2.96±0.42;t=3.175,P=0.002);预后良好组入院时、治疗4周后血清E2、PRL水平、Ki-67阳性表达率低于预后不良组(t=3.854、3.303、4.438、3.484,χ^2=4.644、4.849,P<0.05)。经Pearson相关性分析,PCM患者入院时、治疗4周后SR与血清E2、PRL水平、Ki-67阳性表达率呈正相关(P<0.05);Logistic回归分析可知,乳头状态、分期、SR、血清E2、PRL水平、Ki-67阳性表达率是PCM患者预后重要影响因素(P<0.05)。ROC曲线分析显示,治疗4周后SR AUC为0.751,大于入院时SR(0.727);当截断值>2.90时,灵敏度为69.57%,特异度为74.12%。结论PCM患者SR与血清E2、PRL水平、Ki-67阳性表达率呈正相关,在预后评估中具有一定应用价值。展开更多
Schwannomas are peripheral nerve tumors that are typically solitary and benign.Their diagnosis is largely based on surgically resected specimens.Recently,a number of case reports have indicated that retroperitoneal sc...Schwannomas are peripheral nerve tumors that are typically solitary and benign.Their diagnosis is largely based on surgically resected specimens.Recently,a number of case reports have indicated that retroperitoneal schwannomas could be diagnosed with endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA).We report the diagnosis of three cases of schwannoma using EUS-FNA.Subjects were two males and one female,ages 22,40,and 46 years,respectively,all of whom were symptom-free.Imaging findings showed well-circumscribed round tumors.However,as the tumors could not be diagnosed using these findings alone,EUS-FNA was performed.Hematoxylin-eosin staining of the resulting tissue fragments revealed bland spindle cells with nuclear palisading.There was no disparity in nuclear sizes.Immunostaining revealed S-100 protein positivity and all cases were diagnosed as schwannomas.Ki-67 indexes were 3%-15%,2%-3%,and 3%,respectively.No case showed any signs of malignancy.As most schwannomas are benign tumors and seldom become malignant,we observed these patients without therapy.All tumors demonstrated no enlargement and no change in characteristics.Schwannomas are almost always benign and can be observed following diagnosis by EUS-FNA.展开更多
AIM: To evaluate the efficacy of endoscopic ultrasonography-guided fine needle aspiration(EUS-FNA) for grading pancreatic neuroendocrine tumors(PNETs).METHODS: A total of 22 patients were diagnosed with PNET by EUS-FN...AIM: To evaluate the efficacy of endoscopic ultrasonography-guided fine needle aspiration(EUS-FNA) for grading pancreatic neuroendocrine tumors(PNETs).METHODS: A total of 22 patients were diagnosed with PNET by EUS-FNA between October 2001 and December 2013 at Fukushima Medical University Hospital.Among these cases,we targeted 10 PNET patients who were evaluated according to the World Health Organization(WHO) 2010 classification.Surgery was performed in eight patients,and chemotherapy was performed in two patients due to multiple liver metastases.Specimens obtained by EUS-FNA were first stained with hematoxylin and eosin and then stained with chromogranin,synaptophysin,CD56,and Ki-67.The specimens were graded by the Ki-67 index according to the WHO 2010 classification.Specimens obtained by surgery were graded by the Ki-67 indexand mitotic count(WHO 2010 classification).For the eight specimens obtained by EUS-FNA,the Ki-67 index results were compared with those obtained by surgery.In the two cases treated with chemotherapy,the effects and prognoses were evaluated.RESULTS: The sampling rate for histological diagnosis by EUS-FNA was 100%.No adverse effects were observed.The concordance rate between specimens obtained by EUS-FNA and surgery was 87.5%(7/8).Fo r t h e t w o c a s e s t re a t e d w i t h c h e m o t h e ra p y,case 1 received somatostatin analog therapy and transcatheter arterial infusion(TAI) targeting multiple liver metastases.Subsequent treatment consisted of everolimus.During chemotherapy,the primary tumor remained unconfirmed,although the multiple liver metastases diminished dramatically.Case 2 was classified as neuroendocrine carcinoma(NEC) according to the Ki-67 index of a specimen obtained by EUS-FNA; therefore,cisplatin and irinotecan therapy was started.However,severe adverse effects,including renal failure and diarrhea,were observed,and the therapy regimen was changed to cisplatin and etoposide.TAI targeting multiple liver metastases was performed.Although the liver metastases diminished,the展开更多
文摘目的探究浆细胞性乳腺炎(PCM)患者超声弹性应变率(SR)值与血清雌二醇(E2)、催乳素(PRL)水平、Ki-67阳性表达率相关性及在预后评估应用价值。方法选择PCM女性患者108例,年龄21~44岁,平均年龄31.03岁。均给予抗生素、微波治疗,持续治疗4周。治疗后统计患者出现并发症、复发等不良事件发生例数,并根据预后情况进行分组。均于入院时、治疗4周后行超声弹性图像检查,检测血清E2、PRL水平和Ki-67阳性表达率。对比两组SR、血清E2、PRL水平、Ki-67阳性表达率,应用Pearson分析SR与血清E2、PRL水平、Ki-67阳性表达率相关性,应用Logistic回归分析探究预后影响因素,应用受试者工作特性(ROC)曲线评价SR对PCM患者预后的评估价值。结果根据治疗后出现并发症、复发等预后情况将患者分为预后良好组(n=85)、预后不良组(n=23)。预后良好组入院时、治疗4周后SR低于预后不良组(3.95±0.53 vs 4.21±0.46;t=2.143,P=0.034。2.67±0.38 vs 2.96±0.42;t=3.175,P=0.002);预后良好组入院时、治疗4周后血清E2、PRL水平、Ki-67阳性表达率低于预后不良组(t=3.854、3.303、4.438、3.484,χ^2=4.644、4.849,P<0.05)。经Pearson相关性分析,PCM患者入院时、治疗4周后SR与血清E2、PRL水平、Ki-67阳性表达率呈正相关(P<0.05);Logistic回归分析可知,乳头状态、分期、SR、血清E2、PRL水平、Ki-67阳性表达率是PCM患者预后重要影响因素(P<0.05)。ROC曲线分析显示,治疗4周后SR AUC为0.751,大于入院时SR(0.727);当截断值>2.90时,灵敏度为69.57%,特异度为74.12%。结论PCM患者SR与血清E2、PRL水平、Ki-67阳性表达率呈正相关,在预后评估中具有一定应用价值。
文摘Schwannomas are peripheral nerve tumors that are typically solitary and benign.Their diagnosis is largely based on surgically resected specimens.Recently,a number of case reports have indicated that retroperitoneal schwannomas could be diagnosed with endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA).We report the diagnosis of three cases of schwannoma using EUS-FNA.Subjects were two males and one female,ages 22,40,and 46 years,respectively,all of whom were symptom-free.Imaging findings showed well-circumscribed round tumors.However,as the tumors could not be diagnosed using these findings alone,EUS-FNA was performed.Hematoxylin-eosin staining of the resulting tissue fragments revealed bland spindle cells with nuclear palisading.There was no disparity in nuclear sizes.Immunostaining revealed S-100 protein positivity and all cases were diagnosed as schwannomas.Ki-67 indexes were 3%-15%,2%-3%,and 3%,respectively.No case showed any signs of malignancy.As most schwannomas are benign tumors and seldom become malignant,we observed these patients without therapy.All tumors demonstrated no enlargement and no change in characteristics.Schwannomas are almost always benign and can be observed following diagnosis by EUS-FNA.
文摘AIM: To evaluate the efficacy of endoscopic ultrasonography-guided fine needle aspiration(EUS-FNA) for grading pancreatic neuroendocrine tumors(PNETs).METHODS: A total of 22 patients were diagnosed with PNET by EUS-FNA between October 2001 and December 2013 at Fukushima Medical University Hospital.Among these cases,we targeted 10 PNET patients who were evaluated according to the World Health Organization(WHO) 2010 classification.Surgery was performed in eight patients,and chemotherapy was performed in two patients due to multiple liver metastases.Specimens obtained by EUS-FNA were first stained with hematoxylin and eosin and then stained with chromogranin,synaptophysin,CD56,and Ki-67.The specimens were graded by the Ki-67 index according to the WHO 2010 classification.Specimens obtained by surgery were graded by the Ki-67 indexand mitotic count(WHO 2010 classification).For the eight specimens obtained by EUS-FNA,the Ki-67 index results were compared with those obtained by surgery.In the two cases treated with chemotherapy,the effects and prognoses were evaluated.RESULTS: The sampling rate for histological diagnosis by EUS-FNA was 100%.No adverse effects were observed.The concordance rate between specimens obtained by EUS-FNA and surgery was 87.5%(7/8).Fo r t h e t w o c a s e s t re a t e d w i t h c h e m o t h e ra p y,case 1 received somatostatin analog therapy and transcatheter arterial infusion(TAI) targeting multiple liver metastases.Subsequent treatment consisted of everolimus.During chemotherapy,the primary tumor remained unconfirmed,although the multiple liver metastases diminished dramatically.Case 2 was classified as neuroendocrine carcinoma(NEC) according to the Ki-67 index of a specimen obtained by EUS-FNA; therefore,cisplatin and irinotecan therapy was started.However,severe adverse effects,including renal failure and diarrhea,were observed,and the therapy regimen was changed to cisplatin and etoposide.TAI targeting multiple liver metastases was performed.Although the liver metastases diminished,the
