孤立性肺结节的CT形态学特征结合GSI模式的诊断学研究

本研究探讨CT联合能谱成像(GSI)模式诊断孤立性肺结节的临床价值。选取经肺穿刺活检或手术病理学证实的肺孤立性结节患者110例(110个肺结节),对患者的CT平扫、GSI平扫资料进行分析。根据病理学结果分为良性组(炎性结节、非典型腺瘤样增生)41例、恶性组(肺癌小结节)69例,对比两组患者的肺小结节形态学特征综合评分、动静脉期的能谱曲线斜率、40 keV CT值、标准化碘浓度(NIC)的差异。结果显示,恶性组患者的毛刺征和棘突征、分叶征、血管集束征、胸膜凹陷征、支气管征、病灶内钙化、病灶强化值及孤立性肺结节形态学特征总分均高于良性组(P<0.05);恶性组患者的动脉期、静脉期的能谱曲线斜率、40 keV CT值、NIC均低于良性组(P<0.05)。肺部孤立性恶性结节的形态学特征与肺部良性结节差异显著,恶性结节的能谱曲线斜率、40 keV CT值、NIC值与良性结节差异明显。因此,综合分析结节的形态学特征及GSI参数对其良恶性诊断具有重要意义。     

颈动脉超声联合CT和血清miR-124、miR-155对颈动脉狭窄患者继发性脑梗的风险预测价值

本文探讨了颈动脉超声检查联合CT和血清微小RNA-124(miR-124)、微小RNA-155(miR-155)对颈动脉狭窄患者继发性脑梗的风险预测价值。以43例颈动脉狭窄患者为颈动脉狭窄组,正常志愿者43例为正常组,用RT-PCR法检测miR-124、miR-155表达,采用颈动脉超声检查颈动脉狭窄,采用CT检查颈部血管。结果显示,与正常组相比,颈动脉狭窄组miR-124、miR-155表达升高(P<0.05)。与超声、CT检查相比,超声检查联合CT检查颈动脉狭窄准确率、诊断价值较高(P<0.05)。本研究认为,颈动脉超声、CT、miR-124、miR-155对颈动脉狭窄的诊断价值较高,且可用于预测继发性脑梗的风险,预测价值较为理想。     

颈动脉超声定量参数联合血清miR-128b、miR-146a对急性缺血性脑卒中的诊断价值及对预后的评价意义

本研究选取了112例急性缺血性脑卒中(AIS)患者作为观察组,另选取112例健康体检者作为对照组。用彩色多普勒超声检测所有对象的颈动脉,并对血清miR-128b、miR-146a水平进行测定,结果发现观察组颈内动脉收缩期峰值血流速度(PSV)、miR-146a低于对照组,舒张末期血流速度(EDV)、颈动脉内膜中层厚度(IMT)、miR-128b高于对照组(P0.05)。颈动脉超声定量参数与两种血清生物标志物联合诊断AIS的AUC为0.898,大于任一单一指标;PSV、EDV、IMT、miR-128b、miR-146a与AIS患者预后(mRs评分)显著相关(P0.05)。颈动脉超声定量参数与两种血清生物标志物联合预测AIS患者预后敏感度达71.43%,特异度达90.48%。颈动脉超声定量参数、血清miR-128b、miR-146a在诊断AIS及预测预后方面具有较高应用价值。     

CT联合血清HCY、β2-M在下肢动脉狭窄闭塞性疾病中的诊断价值

本文对CT联合血清同型半胱氨酸（HCY）、β2-微球蛋白（β2-M）在下肢动脉狭窄闭塞性疾病中的诊断价值进行分析。选取上海市金山区中西医结合医院收治的120例疑似下肢动脉狭窄闭塞性疾病患者进行研究，选取同期健康体检者120例作为对照组，对患者进行CT检查、血清HCY和β2-M水平检查，并比较了CT诊断下肢动脉狭窄闭塞情况、两组患者血清HCY和β2-M水平，以明确CT、HCY、β2-M诊断价值及误诊率、漏诊率。结果显示，120例疑似患者中，CT检测出646节段病变血管，其中轻度狭窄155节段，中度狭窄257节段，重度狭窄143节段，血管完全闭塞91节段；研究组患者血清HCY、β2-M水平明显高于对照组，两组比较差异有统计学意义（P<0.05）；HCY的AUC为0.863，截断值>21.75（μmol/L），诊断敏感性为79.00%，特异性为80.00%，β2-M的AUC为0.837，截断值>2.98（μmol/mL），诊断敏感性为75.25%，特异性为65.21%；CT诊断阳性率为67.50%，HCY诊断阳性率为69.17%，β2-M诊断阳性率为67.50%，三者联合诊断阳性率为82.50%，联合诊断阳性率高于CT、HCY、β2-M单独诊断阳性率（P<0.05）；CT、HCY、β2-M单一检测对下肢动脉狭窄闭塞性疾病均有较高灵敏度、特异性及准确度，但三者联合诊断灵敏度、特异性及准确度最高，误诊率、漏诊率最低。本文证实了采用CT联合血清HCY、β2-M诊断下肢动脉狭窄闭塞性疾病诊断灵敏度、特异性及准确度高，误诊率、漏诊率低。     

虚拟导航超声支气管镜灌洗液miRNA在不同大体分型肺癌患者体内表达差异及诊断周围型肺癌的效能研究

本文探讨了虚拟导航超声支气管镜灌洗液微小RNA(miRNA)在不同大体分型肺癌患者体内的表达差异及诊断周围型肺癌(PLC)的效能。选取65例中心型肺癌(CLC)患者(中心型组)及65例PLC患者(周围型组),均检测miR-1260b、miR-135a-3p、miR-299-3p、miR-3175及癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)表达。周围型组miR-1260b低于中心型组,miR-135a-3p、miR-3175高于中心型组(P<0.05);miR-1260b、miR-135a-3p、miR-3175与CEA、NSE相关,且与PLC显著相关(P<0.05);miR-1260b、miR-135a-3p联合诊断PLC的AUC高于单独诊断;miR-1260b、miR-135a-3p、miR-299-3p、miR-3175联合诊断PLC转移的效能高于单独诊断。故可知PLC和CLC患者虚拟导航超声支气管镜灌洗液中miR-1260b、miR-135a-3p、miR-3175表达存在差异,联合检测对PLC具有重要诊断价值。而且miR-1260b、miR-135a-3p、miR-299-3p、miR-3175联合检测可预测PLC转移,为临床诊治提供依据。     

增强CT联合血清指标诊断结直肠癌的价值

本文探讨癌胚抗原(CEA)、糖类抗原19-9(CA19-9)、胰岛素样生长因子结合蛋白-3(IGFBP-3)及增强CT在结直肠癌中的联合诊断效果。选取100例结直肠癌患作为观察组,同时选取结直肠良性肿瘤患者60例作为对照组,检测血清CEA、CA19-9、IGFBP-3,同时给予增强CT检查。观察组血清CEA和CA19-9高于对照组(P<0.05),而IGFBP-3低于对照组(P<0.05);TNM分期Ⅲ~Ⅳ和Ⅰ~Ⅱ患者血清CEA、CA19-9和IGFBP-3差异比较有统计学意义(P<0.05);增强CT联合血清指标联合诊断灵敏性为89.00%、特异性为90.00%;增强CT诊断结直肠癌T分期、N分期与病理结果Kappa值分别为0.696和0.790(P<0.05)。CEA、CA19-9、IGFBP-3联合增强CT是一种具有较高效能的结直肠癌诊断方法。     

血清CEA、CYFRA21-1、pro-GRP、NSE检测在肺癌预后评估中的意义

目的总结分析血清CEA、CYFRA21-1、pro-GRP、NSE检测在肺癌预后评估中的意义。方法选择粤北人民医院收治的60例肺癌患者(肺癌组)、60例肺部良性病变患者(良性组)、60例健康体检正常者(对照组)为研究对象,空腹采集血液样本,测定CEA、CYFRA21-1、pro-GRP、NSE水平差异。结果肺癌组患者(其中非小细胞肺癌Ⅰ、Ⅱ期首选手术联合化疗,Ⅲ、Ⅳ期非细胞肺癌及小细胞肺癌首选化疗)后的CEA、CYFRA21-1、pro-GRP、NSE水平明显低于治疗前,(P0.05);肺癌组患者的CEA、CYFRA21-1、pro-GRP、NSE水平明显高于良性组及对照组,(P0.05)。结论联合检测血清中CEA、CYFRA21-1、pro-GRP、NSE对准确评估肺癌患者预后具有重要意义,临床值得推广使用。     

基于双源CT血管造影技术评估MMP-9、PAF及Lp-PLA2与冠状动脉斑块性质的关系

冠状动脉粥样硬化性心脏病是威胁健康的常见病之一,本研究选取我院2017年2月~2018年12月确诊的206例冠心病患者,其中急性冠脉综合征(acute coronary syndrome,ACS)患者114例(ACS组)、稳定型心绞痛(stable angina pectoris,SAP)患者92例(SAP组),用双源CT血管造影技术检测患者的斑块性质,并检测了血清明胶酶B(MMP-9)、血小板活化因子(PAF)及脂蛋白相关磷脂酶2(Lp-PLA2)浓度,分析MMP-9、PAF及Lp-PLA2与斑块性质间的关系。结果显示,ACS组患者斑块面积和偏心指数均大于SAP组(P<0.05);ACS组患者血清MMP-9、PAF及Lp-PLA2的水平均高于SAP组(P<0.05);ACS组患者易损斑块的比例明显高于SAP组(P<0.05)。所有易损斑块患者血清MMP-9、PAF及Lp-PLA2的水平均高于稳定斑块的患者,且差异具有统计学意义(P<0.05)。患者冠状动脉斑块偏心指数与血清MMP-9、PAF及Lp-PLA2浓度呈正相关关系(P<0.05)。因此,通过双源CT血管造影技术观察冠状动脉粥样硬化斑块性质,结合血清MMP-9、PAF及Lp-PLA2浓度,可以对患者的病情进行评估。血清MMP-9、PAF及Lp-PLA2浓度与斑块的性质及不稳定性有关,可为预测患者冠状动脉斑块性质提供参考。     

定量能谱CT多参数成像诊断多发性骨髓瘤价值及临床意义

本文探讨能谱CT多参数成像定量分析对多发性骨髓瘤(MM)的诊断价值及与实验室指标、疾病分期的关系。选取MM患者62例作为研究组,另随机选取同期健康者62例作为对照组,均行能谱CT检查。结果发现,研究组40 keV、50 keV、60 keV、70 keV、80 keV、90 keV、100 keV能量水平的CT值、能谱曲线斜率均低于对照组(P<0.05);上述能量水平的CT值、能谱曲线斜率联合诊断的AUC为0.875;40~100 keV能量水平的CT值、能谱曲线斜率与Hb呈正相关,与CREA、BUN、β2-MG、疾病分期呈负相关(P<0.05)。因此能谱CT多参数成像定量分析在MM诊断方面具有较高价值,且与患者Hb、CREA、BUN、β2-MG水平、疾病分期密切相关。     

经阴道常规超声结合剪切波弹性成像技术联合血清癌胚抗原对子宫内膜癌的诊断价值

探讨经阴道常规超声+剪切波弹性成像(SWE)技术联合血清癌胚抗原(CEA)对子宫内膜癌的诊断价值。选取子宫内膜病变患者152例,均接受病理检查、经阴道常规超声和SWE检查,并检测血清CEA水平。根据病理检查结果将患者分为恶性组和良性组。比较两组经阴道常规超声指标(子宫内膜厚度、RI、PI)、SWE指标(Emean、Esd、Emax)及血清CEA水平;ROC曲线分析各指标单独及联合诊断子宫内膜癌的价值。结果显示,89例患者诊断为子宫内膜癌(恶性组),63例患者诊断为子宫内膜良性病变(良性组)。恶性组子宫内膜厚度大于良性组,RI、PI均低于良性组,Emean、Esd、Emax及血清CEA水平均高于良性组(P<0.05)。子宫内膜厚度、Emean、Esd、Emax、CEA、RI、PI均是子宫内膜癌的危险因素(P<0.05)。联合诊断子宫内膜癌的AUC均高于单独诊断,说明经阴道常规超声+SWE技术联合血清CEA检测对子宫内膜癌具有较高诊断价值。     

miR-638 is a new biomarker for outcome prediction of non-small cell lung cancer patients receiving chemotherapy

MicroRNAs (miRNAs), a class of small non-coding RNAs, mediate gene expression by either cleaving target mRNAs or inhibiting their translation. They have key roles in the tumorigenesis of several cancers, including non-small cell lung cancer (NSCLC). The aim of this study was to investigate the clinical significance of miR-638 in the evaluation of NSCLC patient prognosis in response to chemotherapy. First, we detected miR-638 expression levels in vitro in the culture supernatants of the NSCLC cell line SPC-A1 treated with cisplatin, as well as the apoptosis rates of SPC-A1. Second, serum miR-638 expression levels were detected in vivo by using nude mice xenograft models bearing SPC-A1 with and without cisplatin treatment. In the clinic, the serum miR-638 levels of 200 cases of NSCLC patients before and after chemotherapy were determined by quantitative real-time PCR, and the associations of clinicopathological features with miR-638 expression patterns after chemotherapy were analyzed. Our data helped in demonstrating that cisplatin induced apoptosis of the SPC-A1 cells in a dose- and time-dependent manner accompanied by increased miR-638 expression levels in the culture supernatants. In vivo data further revealed that cisplatin induced miR-638 upregulation in the serum derived from mice xenograft models, and in NSCLC patient sera, miR-638 expression patterns after chemotherapy significantly correlated with lymph node metastasis. Moreover, survival analyses revealed that patients who had increased miR-638 levels after chemotherapy showed significantly longer survival time than those who had decreased miR-638 levels. Our findings suggest that serum miR-638 levels are associated with the survival of NSCLC patients and may be considered a potential independent predictor for NSCLC prognosis.     

Clinical evaluation of serum neuron-specific enolase levels in patients with lung cancer

Serum neuron-specific enolase (NSE) levels were studied in 105 patients with malignant neoplasms (lung cancer 38, others 67), 13 patients with various benign diseases and 7 healthy adults. The mean serum NSE level in adult control subjects was 7.4 +/- 0.8 ng/ml, and cut off level was decided 10 ng/ml. Serum NSE levels were elevated in 14/38 (37%) of patients with lung cancer and in 14/67 (21%) of patients with the other malignant neoplasms. In patients with benign diseases, serum NSE level was elevated only in one patient with pituitary adenoma. In 7 patients with small cell lung cancer, the positive rate was higher (86%) than in those with non-small cell lung cancer (26%), and serum NSE levels were higher than 25 ng/ml except one case. There was no correlation between serum NSE and CEA (carcinoembryonic antigen) levels in patients with small cell lung cancer, also in patients with lung cancer. The measurement of serum NSE level seemed to be useful for diagnosis in patients with small cell lung cancer.     

螺旋CT成像联合血清copeptin、IL-18水平检测在急性脑梗死患者神经功能及预后评估中的应用价值

本文选取74例急性脑梗死(ACI)患者作为研究对象,入院时根据美国国立卫生院卒中量表(NIHSS)评分分为重度组(NIHSS评分＞15分,n=21)、中度组(NIHSS评分5?15分,n=24)、轻度组(NIHSS评分＜5分,n=29),均接受血清copeptin和IL-18水平检测及螺旋CT成像检查.结果发现,随AC...     

多层螺旋CT灌注成像评价介入性热化疗治疗中晚期肝癌的价值

为探讨多层螺旋CT灌注成像(CT perfusion imaging,CTPI)在评价介入性热化疗对中晚期肝癌疗效方面的应用价值,本文分析了72例采用介入性热化疗的中晚期肝癌患者在治疗前后的CTPI灌注参数和血清肿瘤学标志物水平。通过与治疗前数据比较,发现治疗后癌灶区CTPI灌注参数明显改善,血清肿瘤标志物明显降低。CTPI灌注参数、血清肿瘤学标志物在碘油完全沉积和部分沉积组、客观缓解和未缓解组均表现出显著的统计学差异。Pearson相关分析结果显示CTPI灌注参数与肝癌血清肿瘤标志物之间存在显著相关性。由此可见,CTPI灌注参数可有效反映介入性热化疗前后晚期肝癌患者的动脉血供变化,为临床疗效评估提供有价值的参考。     

miR-98 suppresses melanoma metastasis through a negative feedback loop with its target gene IL-6

Dysregulated microRNA (miRNA) expression has a critical role in tumor development and metastasis. However, the mechanism by which miRNAs control melanoma metastasis is unknown. Here, we report reduced miR-98 expression in melanoma tissues with increasing tumor stage as well as metastasis; its expression is also negatively associated with melanoma patient survival. Furthermore, we demonstrate that miR-98 inhibits melanoma cell migration in vitro as well as metastatic tumor size in vivo. We also found that IL-6 is a target gene of miR-98, and IL-6 represses miR-98 levels via the Stat3-NF-κB-lin28B pathway. In an in vivo melanoma model, we demonstrate that miR-98 reduces melanoma metastasis and increases survival in part by reducing IL-6 levels; it also decreases Stat3 and p65 phosphorylation as well as lin28B mRNA levels. These results suggest that miR-98 inhibits melanoma metastasis in part through a novel miR-98-IL-6-negative feedback loop.