Pancreatic neuroendocrine tumors(pNETs)are a heterogeneous group of tumors with complicated treatment options that depend on pathological grading,clinical staging,and presence of symptoms related to hormonal secretion...Pancreatic neuroendocrine tumors(pNETs)are a heterogeneous group of tumors with complicated treatment options that depend on pathological grading,clinical staging,and presence of symptoms related to hormonal secretion.With regard to diagnosis,remarkable advances have been made:Chromogranin A is recommended as a general marker for pNETs.But other new biomarker modalities,like circulating tumor cells,multiple transcript analysis,microRNA profile,and cytokines,should be clarified in future investigations before clinical application.Therefore,the currently available serum biomarkers are insufficient for diagnosis,but reasonably acceptable in evaluating the prognosis of and response to treatments during follow-up of pNETs.Surgical resection is still the only curative therapeutic option for localized pNETs.However,a debulking operation has also been proven to be effective for controlling the disease.As for drug therapy,steroids and somatostatin analogues are the first-line therapy for those with positive expression of somatostatin receptor,while everolimus and sunitinib represent important progress for the treatment of patients with advanced pNETs.Great progress has been achieved in the combination of systematic therapy with local control treatments.The optimal timing of local control intervention,planning of sequential therapies,and implementation of multidisciplinary care remain pending.展开更多
目的:探讨甲状腺癌(TC)患者血清IL-17、SIL-2R及TG的变化对疾病的临床意义,以期为临床诊疗提供参考。方法:纳入2015年1月~2017年12月我院收治的TC患者设为观察组,另外纳入同期在我院体检的健康体检者设为对照组。对比两组患者外周血IL-1...目的:探讨甲状腺癌(TC)患者血清IL-17、SIL-2R及TG的变化对疾病的临床意义,以期为临床诊疗提供参考。方法:纳入2015年1月~2017年12月我院收治的TC患者设为观察组,另外纳入同期在我院体检的健康体检者设为对照组。对比两组患者外周血IL-17、SIL-2R及TG水平,分析IL-17和SIL-2R与肿瘤分级的相关性,并分析观察组TG与IL-17、SIL-2R的相关性。结果:共纳入观察组62例,对照组55例。两组资料的一般临床资料比较未见统计学差异;观察组患者外周血IL-17(16.4±2.1 vs 8.9±1.5)和SIL-2R(110.6±12.3 vs 70.1±10.8)及TG(237.3±33.9 vs 35.7±3.2)水平均显著高于对照组;观察组外周血IL-17和SIL-2R的水平随着TC患者肿瘤分级的增加不断增加,各个临床分期之间IL-17和SIL-2R的水平存在着差异;观察组患者外周血TG与IL-17及SIL-2R均呈现显著正相关关系,具有统计学意义。结论:TC患者血清IL-17、SIL-2R及TG水平的变化对疾病的早期检测及远期预后具有一定的临床意义。展开更多
AIM:To investigate the diverse characteristics of different pathological gradings of gastric adenocarcinoma (GA) using tumor-related genes.METHODS:GA tissues in different pathological gradings and normal tissues were ...AIM:To investigate the diverse characteristics of different pathological gradings of gastric adenocarcinoma (GA) using tumor-related genes.METHODS:GA tissues in different pathological gradings and normal tissues were subjected to tissue arrays.Expressions of 15 major tumor-related genes were detected by RNA in situ hybridization along with 3' terminal digoxin-labeled anti-sense single strandedoligonucleotide and locked nucleic acid modifying probe within the tissue array.The data obtained were processed by support vector machines by four different feature selection methods to discover the respective critical gene/gene subsets contributing to the GA activities of different pathological gradings.RESULTS:In comparison of poorly differentiated GA with normal tissues,tumor-related gene TP53 plays a key role,although other six tumor-related genes could also achieve the Area Under Curve (AUC) of the receiver operating characteristic independently by more than 80%.Comparing the well differentiated GA with normal tissues,we found that 11 tumor-related genes could independently obtain the AUC by more than 80%,but only the gene subsets,TP53,RB and PTEN,play a key role.Only the gene subsets,Bcl10,UVRAG,APC,Beclin1,NM23,PTEN and RB could distinguish between the poorly differentiated and well differentiated GA.None of a single gene could obtain a valid distinction.CONCLUSION:Different from the traditional point of view,the well differentiated cancer tissues have more alterations of important tumor-related genes than the poorly differentiated cancer tissues.展开更多
Objective: To investigate histo-pathological distribution and clinico-pathological significance in a large Chinese triple-negative breast cancer(TNBC) patients serials based on the latest understanding of its clinico-...Objective: To investigate histo-pathological distribution and clinico-pathological significance in a large Chinese triple-negative breast cancer(TNBC) patients serials based on the latest understanding of its clinico-pathological diversity, and to provide more information to clinicians to improve precision of individualized treatment of TNBC.Methods: A retrospective analysis was performed on patients with TNBC at Breast Disease Center, Peking University First Hospital between January 2010 and December 2019. Histo-and clinico-pathological characteristics were analyzed by Chi-square test and Student's t-test, and prognoses were calculated using KaplanMeier method and a Cox proportionate hazards model. Bonferroni correction was used to correct for multiple comparison.Results: Conventional type of TNBC(c TNBC) were identified in 73.7% of 582 TNBC, while special type of TNBC(s TNBC) were 26.3%, including 71 apocrine carcinoma, 20 medullary carcinoma, 31 metaplastic carcinoma, 18 invasive lobular carcinoma, 7 invasive micropapillary carcinoma, 5 adenoid cystic carcinoma and 1 acinic cell carcinoma. Compared to s TNBC, c TNBC was associated with high histologic grade(P<0.001) and lower androgen receptor(AR) expression(P<0.001). TNM stage of low-grade c TNBC was significantly lower than that of high-grade c TNBC(P=0.002). Although no significant difference, there was a trend that the rate of 5-year disease-free survival(DFS) and 5-year overall survival(OS) were longer in high-grade c TNBC than in high-grade s TNBC(P=0.091 and 0.518), and were longer in low-grade s TNBC than in high-grade s TNBC(P=0.051 and0.350). Metaplastic carcinomas showed larger tumor size(P=0.008) and higher proliferative Ki67 index(P=0.004)than c TNBCs.Conclusions: Results from our cohort imply that sub-categorization or subtyping and histological grading could be meaningful in pathological evaluation of TNBC, and need to be clarified in more large collections of TNBC.展开更多
基于显微成像技术的肿瘤分级对于乳腺癌诊断和预后有着重要的意义,且诊断结果需具备高精度和可解释性。目前,集成Attention的CNN模块深度网络归纳偏差能力较强,但可解释性较差;而基于ViT块的深度网络其可解释性较好,但归纳偏差能力较弱...基于显微成像技术的肿瘤分级对于乳腺癌诊断和预后有着重要的意义,且诊断结果需具备高精度和可解释性。目前,集成Attention的CNN模块深度网络归纳偏差能力较强,但可解释性较差;而基于ViT块的深度网络其可解释性较好,但归纳偏差能力较弱。本文通过融合ViT块和集成Attention的CNN块,提出了一种端到端的自适应模型融合的深度网络。由于现有模型融合方法存在负融合现象,无法保证ViT块和集成Attention的CNN块同时具有良好的特征表示能力;另外,两种特征表示之间相似度高且冗余信息多,导致模型融合能力较差。为此,本文提出一种包含多目标优化、自适应特征表示度量和自适应特征融合的自适应模型融合方法,有效地提高了模型的融合能力。实验表明本文模型的准确率达到95.14%,相比ViT-B/16提升了9.73%,比FABNet提升了7.6%;模型的可视化图更加关注细胞核异型的区域(例如巨型核、多形核、多核和深色核),与病理专家所关注的区域更加吻合。整体而言,本文所提出的模型在精度和可解释性上均优于当前最先进的(state of the art)模型。展开更多
基金Supported by Guangzhou Health and Family Planning Technology Project,No.20191A011096the National Natural Science Foundation of China,No.81602172+1 种基金Guangdong Provincial Science and Technology Plan Projects,No.2016A030313769Guangzhou Science and Technology Plan of Scientific Research Projects,No.201707010323.
文摘Pancreatic neuroendocrine tumors(pNETs)are a heterogeneous group of tumors with complicated treatment options that depend on pathological grading,clinical staging,and presence of symptoms related to hormonal secretion.With regard to diagnosis,remarkable advances have been made:Chromogranin A is recommended as a general marker for pNETs.But other new biomarker modalities,like circulating tumor cells,multiple transcript analysis,microRNA profile,and cytokines,should be clarified in future investigations before clinical application.Therefore,the currently available serum biomarkers are insufficient for diagnosis,but reasonably acceptable in evaluating the prognosis of and response to treatments during follow-up of pNETs.Surgical resection is still the only curative therapeutic option for localized pNETs.However,a debulking operation has also been proven to be effective for controlling the disease.As for drug therapy,steroids and somatostatin analogues are the first-line therapy for those with positive expression of somatostatin receptor,while everolimus and sunitinib represent important progress for the treatment of patients with advanced pNETs.Great progress has been achieved in the combination of systematic therapy with local control treatments.The optimal timing of local control intervention,planning of sequential therapies,and implementation of multidisciplinary care remain pending.
文摘目的:探讨甲状腺癌(TC)患者血清IL-17、SIL-2R及TG的变化对疾病的临床意义,以期为临床诊疗提供参考。方法:纳入2015年1月~2017年12月我院收治的TC患者设为观察组,另外纳入同期在我院体检的健康体检者设为对照组。对比两组患者外周血IL-17、SIL-2R及TG水平,分析IL-17和SIL-2R与肿瘤分级的相关性,并分析观察组TG与IL-17、SIL-2R的相关性。结果:共纳入观察组62例,对照组55例。两组资料的一般临床资料比较未见统计学差异;观察组患者外周血IL-17(16.4±2.1 vs 8.9±1.5)和SIL-2R(110.6±12.3 vs 70.1±10.8)及TG(237.3±33.9 vs 35.7±3.2)水平均显著高于对照组;观察组外周血IL-17和SIL-2R的水平随着TC患者肿瘤分级的增加不断增加,各个临床分期之间IL-17和SIL-2R的水平存在着差异;观察组患者外周血TG与IL-17及SIL-2R均呈现显著正相关关系,具有统计学意义。结论:TC患者血清IL-17、SIL-2R及TG水平的变化对疾病的早期检测及远期预后具有一定的临床意义。
基金Supported by Xiamen Health Bureau,No. 3502z20089009Xiamen Science and Technology Bureau,No. 3502Z20074023Youth Fund of Fujian Health Department,No. 2008-1-52,Fujian Province,China
文摘AIM:To investigate the diverse characteristics of different pathological gradings of gastric adenocarcinoma (GA) using tumor-related genes.METHODS:GA tissues in different pathological gradings and normal tissues were subjected to tissue arrays.Expressions of 15 major tumor-related genes were detected by RNA in situ hybridization along with 3' terminal digoxin-labeled anti-sense single strandedoligonucleotide and locked nucleic acid modifying probe within the tissue array.The data obtained were processed by support vector machines by four different feature selection methods to discover the respective critical gene/gene subsets contributing to the GA activities of different pathological gradings.RESULTS:In comparison of poorly differentiated GA with normal tissues,tumor-related gene TP53 plays a key role,although other six tumor-related genes could also achieve the Area Under Curve (AUC) of the receiver operating characteristic independently by more than 80%.Comparing the well differentiated GA with normal tissues,we found that 11 tumor-related genes could independently obtain the AUC by more than 80%,but only the gene subsets,TP53,RB and PTEN,play a key role.Only the gene subsets,Bcl10,UVRAG,APC,Beclin1,NM23,PTEN and RB could distinguish between the poorly differentiated and well differentiated GA.None of a single gene could obtain a valid distinction.CONCLUSION:Different from the traditional point of view,the well differentiated cancer tissues have more alterations of important tumor-related genes than the poorly differentiated cancer tissues.
基金supported by the National Key R&D Program of China (No.2016YFC0901302)。
文摘Objective: To investigate histo-pathological distribution and clinico-pathological significance in a large Chinese triple-negative breast cancer(TNBC) patients serials based on the latest understanding of its clinico-pathological diversity, and to provide more information to clinicians to improve precision of individualized treatment of TNBC.Methods: A retrospective analysis was performed on patients with TNBC at Breast Disease Center, Peking University First Hospital between January 2010 and December 2019. Histo-and clinico-pathological characteristics were analyzed by Chi-square test and Student's t-test, and prognoses were calculated using KaplanMeier method and a Cox proportionate hazards model. Bonferroni correction was used to correct for multiple comparison.Results: Conventional type of TNBC(c TNBC) were identified in 73.7% of 582 TNBC, while special type of TNBC(s TNBC) were 26.3%, including 71 apocrine carcinoma, 20 medullary carcinoma, 31 metaplastic carcinoma, 18 invasive lobular carcinoma, 7 invasive micropapillary carcinoma, 5 adenoid cystic carcinoma and 1 acinic cell carcinoma. Compared to s TNBC, c TNBC was associated with high histologic grade(P<0.001) and lower androgen receptor(AR) expression(P<0.001). TNM stage of low-grade c TNBC was significantly lower than that of high-grade c TNBC(P=0.002). Although no significant difference, there was a trend that the rate of 5-year disease-free survival(DFS) and 5-year overall survival(OS) were longer in high-grade c TNBC than in high-grade s TNBC(P=0.091 and 0.518), and were longer in low-grade s TNBC than in high-grade s TNBC(P=0.051 and0.350). Metaplastic carcinomas showed larger tumor size(P=0.008) and higher proliferative Ki67 index(P=0.004)than c TNBCs.Conclusions: Results from our cohort imply that sub-categorization or subtyping and histological grading could be meaningful in pathological evaluation of TNBC, and need to be clarified in more large collections of TNBC.
文摘基于显微成像技术的肿瘤分级对于乳腺癌诊断和预后有着重要的意义,且诊断结果需具备高精度和可解释性。目前,集成Attention的CNN模块深度网络归纳偏差能力较强,但可解释性较差;而基于ViT块的深度网络其可解释性较好,但归纳偏差能力较弱。本文通过融合ViT块和集成Attention的CNN块,提出了一种端到端的自适应模型融合的深度网络。由于现有模型融合方法存在负融合现象,无法保证ViT块和集成Attention的CNN块同时具有良好的特征表示能力;另外,两种特征表示之间相似度高且冗余信息多,导致模型融合能力较差。为此,本文提出一种包含多目标优化、自适应特征表示度量和自适应特征融合的自适应模型融合方法,有效地提高了模型的融合能力。实验表明本文模型的准确率达到95.14%,相比ViT-B/16提升了9.73%,比FABNet提升了7.6%;模型的可视化图更加关注细胞核异型的区域(例如巨型核、多形核、多核和深色核),与病理专家所关注的区域更加吻合。整体而言,本文所提出的模型在精度和可解释性上均优于当前最先进的(state of the art)模型。
