Adenocarcinoma
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Publication
Journal: Gut
November/1/2019
Abstract
The International Cancer of the Pancreas Screening Consortium met in 2018 to update its consensus recommendations for the management of individuals with increased risk of pancreatic cancer based on family history or germline mutation status (high-risk individuals).A modified Delphi approach was employed to reach consensus among a multidisciplinary group of experts who voted on consensus statements. Consensus was considered reached if ≥75% agreed or disagreed.

RESULTS
Consensus was reached on 55 statements. The main goals of surveillance (to identify high-grade dysplastic precursor lesions and T1N0M0 pancreatic cancer) remained unchanged. Experts agreed that for those with familial risk, surveillance should start no earlier than age 50 or 10 years earlier than the youngest relative with pancreatic cancer, but were split on whether to start at age 50 or 55. Germline ATM mutation carriers with one affected first-degree relative are now considered eligible for surveillance. Experts agreed that preferred surveillance tests are endoscopic ultrasound and MRI/magnetic retrograde cholangiopancreatography, but no consensus was reached on how to alternate these modalities. Annual surveillance is recommended in the absence of concerning lesions. Main areas of disagreement included if and how surveillance should be performed for hereditary pancreatitis, and the management of indeterminate lesions.

Pancreatic surveillance is recommended for selected high-risk individuals to detect early pancreatic cancer and its high-grade precursors, but should be performed in a research setting by multidisciplinary teams in centres with appropriate expertise. Until more evidence supporting these recommendations is available, the benefits, risks and costs of surveillance of pancreatic surveillance need additional evaluation.
Publication
Journal: Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
October/31/2019
Publication
Journal: Cancer genetics
October/31/2019
Abstract
Hereditary pancreatic cancer has been attributed to variants of several cancer predisposition genes including ATM. While heterozygous pathogenic variants in the ATM gene are implicated as a cause of familial breast and pancreatic cancers to our knowledge ATM whole gene deletions have not been previously reported. We describe a contiguous gene deletion of the ATM locus in a multi-generation family of Italian descent with a strong family history of pancreatic cancer. A deletion of one copy of the entire ATM gene was identified by routine panel testing and further characterized by chromosomal microarray analysis. An 11q22.3 microdeletion of approximately 960 kb was identified that is predicted to result in loss of 10 genes including ATM. The deletion was identified in two additional family members including a presymptomatic daughter and an affected sibling. A normal disomic complement of the 11q22.3 region was detected in a third family member with a history of prostate and pancreatic cancer. Additional family members were not available for testing. Given available evidence that ATM haploinsufficiency can increase cancer risk, we predict that the observed copy number loss has likely contributed to hereditary cancer in this family. However, absence of the familial microdeletion in at least one affected family member suggests that ATM deletions are unlikely the sole contributing factor influencing tumor development in affected individuals. This case highlights 11q22.3 microdeletions of the ATM gene region as a possible risk factor for hereditary cancer, including pancreatic cancer. The same case provides a further cautionary tale for over interpretation of cancer risk associated tumor suppressor microdeletions and suggests that the variant may not be sufficient for tumor development or may modify the cancer risks associated with other, yet unidentified hereditary cancer genes.
Publication
Journal: Expert review of anticancer therapy
October/30/2019
Abstract
Introduction: Today, there is a global consensus that adjuvant treatment is mandatory for stage II and III gastric cancer. What remains controversial, however, is what constitutes the best adjuvant therapy. A comprehensive review including published papers, doi documents and abstracts from the ASCO annual meeting was undertaken to develop this updated review.Areas covered: Adjuvant treatments for stage II or more advanced and potentially curable gastric and gastroesophageal junction (GEJ) adenocarcinoma are, exclusively, reviewed and discussed.Expert opinion: The role of radiation is not yet established for gastric and GEJ cancers. Postoperative chemoradiotherapy offers no survival advantage over chemotherapy alone for patients who undergo D2 surgery. It is not yet clear if neoadjuvant chemoradiotherapy is better than adjuvant chemotherapy. Individualized treatment plans should be determined for many patients as efficacy depends on tumor histology, and toxicity varies enormously among effective options.
Publication
Journal: Cancer discovery
October/29/2019
Abstract
Despite decades of research, efforts to directly target KRAS have been challenging. MRTX849 was identified as a potent, selective, and covalent KRASG12C inhibitor that exhibits favorable drug-like properties, selectively modifies mutant cysteine 12 in GDP-bound KRASG12C and inhibits KRAS-dependent signaling. MRTX849 demonstrated pronounced tumor regression in 17 of 26 (65%) of KRASG12C-positive cell line- and patient-derived xenograft models from multiple tumor types and objective responses have been observed in KRASG12C-positive lung and colon adenocarcinoma patients. Comprehensive pharmacodynamic and pharmacogenomic profiling in sensitive and partially resistant non-clinical models identified mechanisms implicated in limiting anti-tumor activity including KRAS nucleotide cycling and pathways that induce feedback reactivation and/or bypass KRAS dependence. These factors included activation of RTKs, bypass of KRAS dependence, and genetic dysregulation of cell cycle. Combinations of MRTX849 with agents that target RTKs, mTOR, or cell cycle demonstrated enhanced response and marked tumor regression in several tumor models, including MRTX849-refractory models.
Publication
Journal: Acta biochimica et biophysica Sinica
October/25/2019
Abstract
Cisplatin (CDDP)-based chemotherapy is a standard strategy for the clinical treatment of patients with bladder cancer (BC). However, the anti-tumor efficacy of cisplatin is affected by multiple chemoresistance with complex molecular mechanisms. Recent evidence highlights the crucial regulatory roles of metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) in the progression of cancers and development of drug resistance. However, the roles and underlying molecular mechanisms of MALAT1 in cisplatin resistance of the BC cells remain largely unclear. In this study, we firstly demonstrated that MALAT1 expression was up-regulated in the BC tissues compared to the normal adjacent tissues and elevated in the cancer cells compared to the epithelial immortalized cells. Secondly, we found that suppression of MALAT1 enhanced the chemotherapeutic drug sensitivity and inhibited the cisplatin resistance of the BC cells. Thirdly, we showed that MALAT1 affected the cisplatin resistance of the BC cells via regulating the miR-101-3p/VEGF-C pathway. In summary, this study demonstrates that MALAT1, miR-101-3p and VEGF-C form a regulatory axis to affect the chemo-resistance of BC cells to CDDP, and provides novel potential targets for treatment of BC.
Publication
Journal: Cancer gene therapy
October/24/2019
Abstract
Triple-negative breast cancer (TNBC), colon adenocarcinoma (COAD), ovarian cancer (OV), and glioblastoma multiforme (GBM) are common malignant tumors, in which significant challenges are still faced in early diagnosis, treatment, and prognosis. Therefore, further identification of genes related to those malignant tumors is of great significance for the improvement of management of the diseases. The database of the National Center for Biotechnology Information (NCBI) Gene Expression Omnibus (GEO) repository was used as the data source of gene expression profiles in this study. Malignant tumors genes were selected using a feature selection algorithm of maximal relevance and minimal redundancy (mRMR) and the protein-protein interaction (PPI) network. And finally selected 20 genes as potential related genes. Gene Ontology (GO) enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis were performed on the potential related genes, and different tumor-specific genes and similarities and differences between network modules and pathways were analyzed. Further, using the potential cancer-related genes found above in this study as features, a support vector machine (SVM) model was developed to predict high-risk malignant tumors. As a result, the prediction accuracy reached more than 85%, indicating that such a model can effectively predict the four types of malignant tumors. It is demonstrated that such genes found above in this study indeed play important roles in the differentiation of the four types of malignant tumors, providing basis for future experimental biological validation and shedding some light on the understanding of new molecular mechanisms related to the four types of tumors.
Publication
Journal: Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences
October/24/2019
Abstract
To explore the value of the third generation dual-source computed tomography (CT) convolution kernel in display of pulmonary ground-glass nodule (GGN) in transverse image reconstruction. Methods: A total of 52 lung adenocarcinoma patients with lung CT data were selected from February 2018 to January 2019 for this study. The pulmonary CT data were reconstructed by convolutional nucleus B157, Br54, and Br49. The signal-to-noise ratio (SNR), the contrast-to-noise ratio (CNR), and the standard deviation (SD) of the image at the GGN were used as the objective evaluation standard of image quality. Subjective image quality was scored by 2 radiologists from 3 aspects (overall image quality, noise, and lesion outline). Results: Objective image quality evaluation, SNR and CNR of reconstructed convolution kernel Br49 (SNR: 11.36±5.39, CNR: 7.19±4.29), Br54 (SNR: 8.30±3.35, CNR: 5.09±2.86) are greater than those of Bl57 (SNR: 4.18±2.10, CNR: 3.25±1.78; all P<0.01). SD of reconstructed convolution kernel Br49 (61.80±20.17) and Br54 (80.45±20.31) is smaller than that of Bl57 (137.92±31.11, both P<0.01). In the subjective image quality evaluation, the overall image quality score 5.0(4.5, 5.0) of Br54 was higher than that of all other images [Br49: 3.0(3.0, 4.0), Bl57: 3.0(3.0, 3.5); both P<0.05]. The Br54 image showed that the lesion contour ability score 5.0(4.0, 5.0) was higher than all other images [Br49: 4.0(4.0, 5.0), Bl57: 3.0(3.0, 3.0); both P<0.05]; Br49 image noise score 3.0(3.0, 3.0) is the lowest one [Br54 4.0(4.0, 4.0), Bl57 5.0(5.0, 5.0); both P<0.05]. Conclusion: The reasonable selection of CT convolution kernel plays an important role in the subjective and objective image quality of GGN. It is suggested that Br54 should be used as the reconstruction of convolutional kernel in pulmonary ground glass nodules, which is helpful for doctors to find and diagnose GGN.
Publication
Journal: Journal of cellular physiology
October/22/2019
Abstract
Lung adenocarcinoma (LUAD) is one of the most malignant tumor types worldwide. Our objective was to identify a genetic signature that could predict the prognosis of patients with LUAD. We extracted gene data sets from The Cancer Genome Atlas and obtained differentially expressed genes that were highly expressed at every stage. These genes were analyzed using gene set enrichment analysis to obtain four biological processes associated with LUAD. Subsequently, Cox univariate and multivariate analyses were performed to generate four optimized models (G2M checkpoint, E2F targets, mitotic spindle, and glycolysis). We identified a mitotic spindle-related signature (KIF15, BUB1, CCNB2, CDK1, KIF4A, DLGAP5, ECT2, and ANLN), which could be an independent prognostic indicator, to predict the prognosis of patients with LUAD. This new discovery should offer opportunities to explore the pathogenesis of LUAD and prove clinically useful in predicting LUAD patient prognosis.
Publication
Journal: Digestive diseases and sciences
October/19/2019
Publication
Journal: World journal of clinical cases
October/18/2019
Abstract
Submucosal tumor (SMT)-like early-stage gastric cancer (GC) has rarely been reported. It is difficult to consider the possibility of GC and differentiate it from other submucosal lesions.We present the case of a 50-year-old male patient with a 1.6 cm SMT-like flat elevated lesion covered by congested mucosa on the gastric angle. Magnifying endoscopy with narrow-band imaging, endoscopic biopsy, endoscopic ultrasound, and computed tomography were performed for diagnosis. Endoscopic submucosal dissection and gastrectomy with lymph node dissection were performed. The post-resection pathological analysis led to a final diagnosis of GC (Bormann type I, T1bN2M0).GC should be considered when detecting an SMT-like lesion in the stomach.
Publication
Journal: Frontiers in oncology
October/15/2019
Abstract
Background: Pancreatic cancer is highly lethal and aggressive with increasing trend of mortality in both genders. An effective prediction model is needed to assess prognosis of patients for optimization of treatment. Materials and Methods: Seven datasets of mRNA expression and clinical data were obtained from gene expression omnibus (GEO) database. Level 3 mRNA expression and clinicopathological data were obtained from The Cancer Genome Atlas pancreatic ductal adenocarcinoma (TCGA-PAAD) dataset. Differentially expressed genes (DEGs) between pancreatic tumor and normal tissue were identified by integrated analysis of multiple GEO datasets. Univariate and Lasso Cox regression analyses were applied to identify overall survival-related DEGs and establish a prognostic gene signature whose performance was evaluated by Kaplan-Meier curve, receiver operating characteristic (ROC), Harrell's concordance index (C-index) and calibration curve. GSE62452 and GSE57495 were used for external validation. Gene set enrichment analysis (GSEA) and tumor immunity analysis were applied to elucidate the molecular mechanisms and immune relevance. Multivariate Cox regression analysis was used to identify independent prognostic factors in pancreatic cancer. Finally, a prognostic nomogram was established based on the TCGA PAAD dataset. Results: A nine-gene signature comprising MET, KLK10, COL17A1, CEP55, ANKRD22, ITGB6, ARNTL2, MCOLN3, and SLC25A45 was established to predict overall survival of pancreatic cancer. The ROC curve and C-index indicated good performance of the nine-gene signature at predicting overall survival in the TCGA dataset and external validation datasets relative to classic AJCC staging. The nine-gene signature could classify patients into high- and low-risk groups with distinct overall survival and differentiate tumor from normal tissue. Univariate Cox regression revealed that the nine-gene signature was an independent prognostic factor in pancreatic cancer. The nomogram incorporating the gene signature and clinical prognostic factors was superior to AJCC staging in predicting overall survival. The high-risk group was enriched with multiple oncological signatures and aggressiveness-related pathways and associated with significantly lower levels of CD4+ T cell infiltration. Conclusion: Our study identified a nine-gene signature and established a prognostic nomogram that reliably predict overall survival in pancreatic cancer. The findings may be beneficial to therapeutic customization and medical decision-making.
Publication
Journal: Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
October/12/2019
Publication
Journal: Journal of gastrointestinal oncology
October/11/2019
Abstract
Response of pancreatic adenocarcinoma to neoadjuvant chemotherapy (nCT) or chemoradiotherapy (nCRT) may be associated with prognosis, but long-term outcomes based on response to neoadjuvant therapy have not been well evaluated to date.The National Cancer Database was queried for patients with pancreatic adenocarcinoma receiving nCT/nCRT. To evaluate response to nCT/nCRT, comparisons were made from cT and cN stage to the respective post-neoadjuvant therapy ypT and ypN stages. Based on these comparisons, patients were classified as responders, progressors, or non-responders. Statistical analyses included estimation of survival using Kaplan-Meier analysis, as well as multivariable Cox proportional hazards modeling.

Results
Of 2,028 patients, 30% had a response, 32% progressed, and 38% had no response; 1% of patients experienced pathologic complete response (pCR). Responders were more likely to have received multi-agent chemotherapy (P=0.0001) as well as radiotherapy (RT) (P=0.02) in the neoadjuvant setting. Response to nCT/nCRT was also associated with a higher R0 resection rate (P=0.02). At a median follow-up of 49 months, median overall survival (OS) was higher in responders than non-responders or progressors (29.9 vs. 24.3 vs. 22.2 months, P<0.001). The mean OS for patients experiencing pCR was 55.5 months. On multivariable analysis, treatment response was independently associated with OS (P=0.02).

Response to nCT/nCRT independently predicts long-term outcomes following resection of pancreatic adenocarcinoma; higher rates of treatment response were observed for patients receiving neoadjuvant RT as well as neoadjuvant multi-agent chemotherapy. These results may have implications on strategies to improve response rates.
Publication
Journal: BMC gastroenterology
October/11/2019
Abstract
Whether the prognoses of different pathological subtypes of colorectal cancer (CRC) at different stages are distinct is unclear.We extracted data on all cases of CRC from the Surveillance, Epidemiology, and End Results database between 2004 and 2015. The incidence of different pathological subtypes, clinical characteristics, and five-year overall survival (OS) and cause-specific survival (CSS) were analyzed.A total of 384,996 cases diagnosed as adenocarcinoma (AC), mucinous adenocarcinoma (MAC), and signet ring cell carcinoma (SRCC) were included in this analysis. Compared with AC, MAC and SRCC were more likely to reach T4, N2, M1, stages III and IV, and grades III and IV, and patients were generally of a younger age (P < 0.001). Compared with those with AC, patients with MAC and SRCC showed poorer OS (50.6 and 26.8% vs. 60.2%, P < .001), with corresponding HR values of 1.238 (95% CI, 1.213-1.263, P < .001) and 1.592 (95% CI, 1.558-1.627, P < .001), respectively. The MAC and SRCC groups also showed poorer overall CCS (60.9 and 32.5% vs. 67.8%, P < .001), with corresponding HR values of 1.271 (95% CI, 1.242-1.302, P < .001) and 1.724 (95% CI, 1.685-1.765, P < .001), respectively. Compared with patients with AC, those with MAC showed poor OS at every stage and poor CSS at every stage except stage II (P < .05), while patients with SRCC revealed poor OS and CSS at every stage except stage 0 (P < .05).Patients of different pathological subtypes minimally differed at early stages. However, patients with AC have significantly better prognoses in advanced CRC (stages III and IV) than those with MAC or SRCC. Distinct treatment strategies should be applied depending on a particular histological subtype in advanced CRC.
Publication
Journal: Journal of surgical oncology
October/10/2019
Abstract
To assess the prognostic significance of postoperative changes in immune status represented by total lymphocyte count (TLC) and neutrophil-to-lymphocyte ratio (NLR) in resectable pancreatic cancer.Patients who underwent curative pancreatectomy for pancreatic adenocarcinoma were divided into high and low groups according to cut-off values of TLC, and NLR measured preoperatively, immediately after surgery, and 1 or 6 months after surgery. Oncologic outcomes were compared between the two groups at different times, and prognostic roles of TLC and NLR were evaluated.

RESULTS
Of 193 patients, the median follow-up time was 22 months, and median survival was 18 months. Their immunologic status deteriorated within 3 to 4 days after the operation and recovered after that. At 1 and 6 months postoperatively, overall survival rates were significantly lower in the group with high NLR (>2.535 and >3.21, respectively) and low TLC (<1.66 × 109 and <1.62 × 109 /L, respectively). In multiple regression analyses, elevated NLR at postoperative 1 and 6 months and decreased TLC at postoperative 1 month were significant prognosis predictors.

Changes in immune status such as decreased TLC and elevated NLR at postoperative 1 and 6 months are effective prognostic predictors after curative pancreatectomy in patients with pancreatic adenocarcinoma.
Publication
Journal: Surgical endoscopy
October/9/2019
Abstract
Colonoscopies are effective means of detecting and removing precancerous adenomatous polyps. The adenoma detection rate (ADR) is a marker of colonoscopy quality and an independent predictor of colorectal cancer incidence. Focused training interventions may improve an endoscopist's ADR, but the supporting research is limited. This systematic review and meta-analysis identified, critically appraised, and meta-analyzed data from randomized trials (RCTs) evaluating the effect of training interventions on ADRs.Ovid Medline, EMBASE, CENTRAL, Eric, CINAHL, Scopus, Web of Science, and ClinicalTrials.gov were searched for RCTs investigating the effect of an educational intervention on ADRs. Two reviewers independently screened, identified, and extracted trial-level data. Internal validity was assessed in duplicate using the Risk of Bias tool. Our primary outcome was the ADR. Secondary outcomes were advanced ADR, adenocarcinoma detection rate, polyp detection rate, and withdrawal times. Safety outcomes were post-polypectomy bleeding rate and colonoscopy-related perforation rate.

RESULTS
From 2837 screened citations, we identified 3 trials (119 endoscopists) meeting our inclusion criteria. Training interventions were associated with a trend toward increased ADRs (odds ratio 1.16, 95% confidence interval (CI) 1.00-1.34; I2 83%; 3 trials; 119 endoscopists). When limited to screening colonoscopies, the odds ratio for ADRs associated with training interventions was 1.17 (95% CI 1.00-1.36; I2 80%; 3 trials; 119 endoscopists). There was a high level of heterogeneity between the trials' training interventions. Training intervention improved the advanced ADR, adenocarcinoma detection rate, polyp detection rate, and withdrawal times. Safety outcomes were not reported.

A focused training intervention was associated with a strong trend toward increased ADRs among certified endoscopists. While the described training interventions definitely show promise, further efforts around continuing professional developments activities are needed to more consistently improve ADRS among certified endoscopists.
Publication
Journal: Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology
October/9/2019
Publication
Journal: Kyobu geka. The Japanese journal of thoracic surgery
October/7/2019
Abstract
The rate of bronchial anomaly is reported to be about 0.6%.Most of cases showed a displaced bronchus, mostly in the right upper lobe. We experienced lung cancer in a displaced anomalous lingular bronchus. A 76-year-old male was referred to our hospital due to abnormal mass on a chest radiograph. Thoracic computed tomography( CT) revealed a tumor with a maximum diameter of 42 mm in the left lingular segment. Bronchoscopic examination indicated a displaced anomalous right upper bronchus branching from the trachea and left B4+5 branching from the stem of the left lower lobe bronchus. Curetting was performed through the left B4+5, and adenocarcinoma was diagnosed. Lobulation between the upper and lingular segments was noted during surgery, and left lingular segmentectomy was performed. The tumor was histologically diagnosed as adenocarcinoma. The postoperative course was uneventful.
Publication
Journal: Oncogenesis
October/5/2019
Abstract
Ctbp2 is a uniquely targetable oncogenic transcriptional coregulator, exhibiting overexpression in most common solid tumors, and critical to the tumor-initiating cell (TIC) transcriptional program. In the "CKP" mouse pancreatic ductal adenocarcinoma (PDAC) model driven by mutant K-Ras, Ctbp2 haploinsufficiency prolonged survival, abrogated peritoneal metastasis, and caused dramatic downregulation of c-Myc, a known critical dependency for TIC activity and tumor progression in PDAC. A small-molecule inhibitor of CtBP2, 4-chloro-hydroxyimino phenylpyruvate (4-Cl-HIPP) phenocopied Ctbp2 deletion, decreasing tumor burden similarly to gemcitabine, and the combination of 4-Cl-HIPP and gemcitabine further synergistically suppressed tumor growth. Pharmacodynamic monitoring revealed that the 4-Cl-HIPP/gemcitabine combination induced robust and synergistic tumor apoptosis and marked downregulation of the TIC marker CD133 in CKP PDAC tumors. Collectively, our data demonstrate that targeting CtBP represents a fruitful avenue for development of highly active agents in PDAC that cooperate with standard therapy to limit both primary and metastatic tumor burden.
Publication
Journal: Pathology, research and practice
October/5/2019
Abstract
Desmoplastic melanoma (DM) is an uncommon variant of malignant melanoma (MM), histologically characterized by a mainly dermal proliferation of spindled cells within a desmoplastic stroma. Normally, involvement of deeper tissues by DM is the result of direct extension down from the overlying dermis. MM is widely known to harbor a striking potential for morphological and phenotypic variability; among MM morphological variants, pseudoglandular MM is characterized by extensive discohesion within cords and nests of malignant cells and ensuing formation of so-called pseudolumina, thus mimicking adenocarcinoma. We present an exceptional case of DM characterized by intrafascial origin, partly pseudoglandular differentiation, and aberrant experession of cytokeratins in the pseudoglandular component; genetic data from next-generation sequencing supported the final diagnosis of DM, as well as the ontogenetic identity of the pseudoglandular component. Prior to this report, pseudoglandular features had never been described in DM. Additionally, our case is unusual because of the deep origin of the tumor, arising below the subcutaneous fat of the scalp, as well as the aberrant experession of cytokeratins in the pseudoglandular component, thus posing a challenging differential diagnosis with several soft tissue tumors.
Publication
Journal: International journal of medical microbiology : IJMM
October/5/2019
Abstract
Bacterial outer membrane vesicles (OMVs) play a vital role in the mechanism of host-pathogen communication, while emerging evidence suggests that OMVs regulate host immune responses through differentially packaged small noncoding RNAs (sncRNAs) to target host mRNA function. Therefore, we identified differentially packaged sncRNAs in Helicobacter pylori OMVs and showed transfer of OMV sncRNAs to human gastric adenocarcinoma cells in this study. Our data revealed that sncRNAs (sR-2509025 and sR-989262) were enriched in OMVs, and reduced lipopolysaccharide or OMV-induced interleukin 8 (IL-8) secretion by cultured AGS cells. Collectively, these findings are consistent with the hypothesis that sncRNAs in H. pylori OMVs play a novel role in the mechanism of host-pathogen interaction, whereby H. pylori evades the host immune response.
Publication
Journal: Abdominal radiology (New York)
October/4/2019
Abstract
To compare the diagnostic accuracies of MDCT and high-resolution MRI (HR-MRI) for regional nodal metastases with different short-axis diameter ranges in rectal cancer patients.Rectal adenocarcinoma patients who underwent both MDCT and HR-MRI before surgery were included. The maximum short-axis diameters of the nodes were measured, and were classified as benign or malignant on imaging findings. All of the nodes were subdivided as follows: ≤ 5 mm (Group A), > 5 mm and ≤ 10 mm (Group B) , and > 10 mm (Group C). The postoperative pathological reports were used as the standard, and the sensitivity, specificity, accuracy, ROC curve, and AUC value were calculated for each subgroup.A total of 592 nodes were included in the node-to-node evaluation. In Group A, the specificity and accuracy of HR-MRI were significantly higher than those of MDCT (99.28% vs. 93.99%, P < 0.001; 95.78% vs. 89.56%, P = 0.010; respectively). In Group B, the specificity and accuracy of HR-MRI were also higher than those of MDCT (98.36% vs. 55.74%, P < 0.001; 80.45% vs. 66.17%, P < 0.001; respectively). For Groups A and B, the AUCs of MDCT were both 0.65, whereas those of HR-MRI were 0.76 and 0.82, respectively. In Group C, all nine malignant nodes were correctly diagnosed metastases on MDCT, whereas one was misjudged as benign on HR-MRI.The diagnostic value of HR-MRI is superior to that of MDCT, with higher specificity, accuracy, and AUC values for HR-MRI than for MDCT.
Publication
Journal: Annals of translational medicine
October/2/2019
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