Pancreatic cancer is a highly malignant digestive system tumor with a poor prognosis.Most pancreatic cancer patients are diagnosed at an advanced stage or even metastasis due to its highly aggressive characteristics a...Pancreatic cancer is a highly malignant digestive system tumor with a poor prognosis.Most pancreatic cancer patients are diagnosed at an advanced stage or even metastasis due to its highly aggressive characteristics and lack of typical early symptoms.Thus,an early diagnosis of pancreatic cancer is crucial for improving its prognosis.Currently,screening is often applied in high-risk individuals to achieve the early diagnosis of pancreatic cancer.Fully understanding the risk factors of pancreatic cancer and pathogenesis could help us identify the high-risk population and achieve early diagnosis and timely treatment of pancreatic cancer.Notably,accumulating studies have been undertaken to improve the detection rate of different imaging methods and the diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA)which is the golden standard for pancreatic cancer diagnosis.In addition,there are currently no biomarkers with sufficient sensitivity and specificity for the diagnosis ofpancreatic cancer to be applied in the clinic. As the only serum biomarkerapproved by the United States Food and Drug Administration, carbohydrateantigen 19-9 (CA19-9) is not recommended to be used in the early screeningof pancreatic cancer because of its limited specificity. Recently, increasingnumbers of studies focused on the discovering of novel serum biomarkersand exploring their combination with CA19-9 in the detection of pancreaticcancer. Besides, the application of liquid biopsy involving circulating tumor cells(CTCs), circulating tumor DNA (ctDNA), microRNAs (miRNAs), and exosomesin blood and biomarkers in urine, and saliva in pancreatic cancer diagnosis aredrawing more and more attention. Furthermore, many innovative technologiessuch as artificial intelligence, computer-aided diagnosis system, metabolomicstechnology, ion mobility spectrometry (IMS) associated technologies, and novelnanomaterials have been tested for the early diagnosis of pancreatic cancer andhave shown promising prospects. Hence, this review 展开更多
目的探讨超声、血清学和BRAF基因检测3种检查方法单独以及联合应用时,对鉴别根据甲状腺影像报告和数据系统(Thyroid Imaging Reporting and Data System,TI-RADS)中已经被报告为TI-RADS 4类结节良恶性的诊断价值。方法回顾性分析经锦州...目的探讨超声、血清学和BRAF基因检测3种检查方法单独以及联合应用时,对鉴别根据甲状腺影像报告和数据系统(Thyroid Imaging Reporting and Data System,TI-RADS)中已经被报告为TI-RADS 4类结节良恶性的诊断价值。方法回顾性分析经锦州医科大学附属第一医院超声医学科检查报告为TI-RADS 4类结节的102例患者,并对这102例患者均进行血清学及BRAF基因检测。根据手术病理及穿刺病理结果将患者分为良性组和恶性组,评估使用不同诊断方法对鉴别甲状腺TI-RADS 4类结节良恶性的诊断效能。结果超声检查结果提示恶性组的图像表现为低回声、内部存在钙化、边界模糊、形态不规则的患者数目多于良性组(P<0.05);恶性组促甲状腺素(TSH)的检验值高于良性组(P<0.05);恶性组BRAF基因产生突变的占比明显多于良性组(P<0.05)。联合使用超声、血清学及BRAF基因检测3种检查技术的准确度(98.04%)、灵敏度(97.22%)、特异度(100.00%)及诊断效能(0.926)均高于应用一种检查技术(P<0.05)。结论联合应用超声、血清学及BRAF基因检测方法对于鉴别TI-RADS 4类甲状腺结节的良恶性更具有临床价值。展开更多
基金This study was supported by Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences(2018PT32014)Chinese Academy of Medical Science Innovation Fund for Medical Science(2017-I2M-1-001).
文摘Pancreatic cancer is a highly malignant digestive system tumor with a poor prognosis.Most pancreatic cancer patients are diagnosed at an advanced stage or even metastasis due to its highly aggressive characteristics and lack of typical early symptoms.Thus,an early diagnosis of pancreatic cancer is crucial for improving its prognosis.Currently,screening is often applied in high-risk individuals to achieve the early diagnosis of pancreatic cancer.Fully understanding the risk factors of pancreatic cancer and pathogenesis could help us identify the high-risk population and achieve early diagnosis and timely treatment of pancreatic cancer.Notably,accumulating studies have been undertaken to improve the detection rate of different imaging methods and the diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA)which is the golden standard for pancreatic cancer diagnosis.In addition,there are currently no biomarkers with sufficient sensitivity and specificity for the diagnosis ofpancreatic cancer to be applied in the clinic. As the only serum biomarkerapproved by the United States Food and Drug Administration, carbohydrateantigen 19-9 (CA19-9) is not recommended to be used in the early screeningof pancreatic cancer because of its limited specificity. Recently, increasingnumbers of studies focused on the discovering of novel serum biomarkersand exploring their combination with CA19-9 in the detection of pancreaticcancer. Besides, the application of liquid biopsy involving circulating tumor cells(CTCs), circulating tumor DNA (ctDNA), microRNAs (miRNAs), and exosomesin blood and biomarkers in urine, and saliva in pancreatic cancer diagnosis aredrawing more and more attention. Furthermore, many innovative technologiessuch as artificial intelligence, computer-aided diagnosis system, metabolomicstechnology, ion mobility spectrometry (IMS) associated technologies, and novelnanomaterials have been tested for the early diagnosis of pancreatic cancer andhave shown promising prospects. Hence, this review
文摘目的探讨超声、血清学和BRAF基因检测3种检查方法单独以及联合应用时,对鉴别根据甲状腺影像报告和数据系统(Thyroid Imaging Reporting and Data System,TI-RADS)中已经被报告为TI-RADS 4类结节良恶性的诊断价值。方法回顾性分析经锦州医科大学附属第一医院超声医学科检查报告为TI-RADS 4类结节的102例患者,并对这102例患者均进行血清学及BRAF基因检测。根据手术病理及穿刺病理结果将患者分为良性组和恶性组,评估使用不同诊断方法对鉴别甲状腺TI-RADS 4类结节良恶性的诊断效能。结果超声检查结果提示恶性组的图像表现为低回声、内部存在钙化、边界模糊、形态不规则的患者数目多于良性组(P<0.05);恶性组促甲状腺素(TSH)的检验值高于良性组(P<0.05);恶性组BRAF基因产生突变的占比明显多于良性组(P<0.05)。联合使用超声、血清学及BRAF基因检测3种检查技术的准确度(98.04%)、灵敏度(97.22%)、特异度(100.00%)及诊断效能(0.926)均高于应用一种检查技术(P<0.05)。结论联合应用超声、血清学及BRAF基因检测方法对于鉴别TI-RADS 4类甲状腺结节的良恶性更具有临床价值。
