Magnetic resonance differentiation between T2 and T1 gallbladder carcinoma: significance of subserosal enhancement on the delayed phase dynamic study

Purpose

The aim of this study is to investigate whether subserosal enhancement on the delayed-phase dynamic magnetic resonance (MR) study (SED) can differentiate T2 from T1 gallbladder carcinoma (GBC).

Methods

The institutional research board approved this retrospective study. Between 1997 and 2006, there were surgically proven 11 T1 and 21 T2 GBC in 30 patients, all of whom had undergone preoperative contrast enhanced dynamic MR study, either with a 2D sequence (n=17) or 3D sequences (n=15). All images were reviewed by two radiologists for the presence of SED, and receiver operating characteristic (ROC) curve analysis was performed. Sensitivity, specificity, positive and negative predictive values were calculated by consensus.

Results

The areas under the ROC curves of the two readers were 0.91 and 0.86, and the kappa value was 0.78. Of the 21 T2 GBC, 18 and 3 showed positive and negative SED, respectively. Of the 11 T1 GBC, 1 and 10 showed positive and negative SED, respectively. The sensitivity, specificity, positive and negative predictive values of SED for diagnosing T2 lesions were 86%, 88%, 91% and 77%, respectively.

Conclusions

In conclusion, SED may be a useful sign to differentiate T2 from T1 GBC, which would affect the preoperative surgical planning of the patients.     

傅里叶变换红外光谱用于胆囊癌细胞及其细胞核结构的基础研究

应用傅里叶变换红外光谱(FTIR)对体外培养胆囊癌细胞、细胞核进行检测,对照胆囊癌组织光谱特征,研究胆囊癌细胞株及细胞核的光谱表现;为红外光谱法诊断胆囊癌奠定细胞学基础。应用美国Nicolet(尼高力)公司5700-Ⅱ型红外光谱仪,组织标本放置于OMNIC采样器表面进行检测,记录红外光谱;体外培养胆囊癌细胞株(GBC-SD)及提取的细胞核涂于欧米采样器表面进行红外检测,记录红外光谱,得到时间轴上体外培养细胞株及细胞核的光谱图;选择特征性光谱与胆囊癌组织光谱进行比对。结果发现胆囊癌细胞株红外光谱特征与相应癌组织光谱特征存在异同。从而可得出结论：将体外培养肿瘤细胞株及提取的肿瘤细胞核,进行FTIR测定是行之有效的细胞红外光谱检测手段,能得到体外培养细胞的红外谱图;胆囊癌组织所表现的红外光谱特征具有胆囊癌细胞本身的红外光谱特征,同时也具有组织自身的复杂特点;FTIR为应用于胆囊癌的定性诊断提供了更加丰富的细胞学基础。     

Laser spectroscopy and imaging of gallbladder stones, tissue and bile

Laser spectroscopic study of billary calculi and tissues is described. Fluorescence spectra of human gallbladder stones, bile and tissues were recorded with streak camera in the frequency and time domain. Potential of fluorescence as a diagnostic tool to discriminate between the intended target and the surrounding tissues and bile is evaluated. Initiation of fragmentation process is visualized by high-speed shadowgraphy, interferometry performed during the laser impact and generation of plasma causing growth and collapse of bubbles.     

磁共振成象诊断出血性胆囊炎——离体及活体研究

在离体研究的基础上,对三个出血性胆囊炎的病人术前做出诊断,出血性胆囊炎可分为混合性及非混合性.在离体实验中,如果血液未与胆汁混合,T₁加权象可发现加于10mL胆汁中的0.2mL的血液表现为高信号区;质子密度加权象可发现加于10mL,胆汁中的0.4mL血液表现为稍高信号区;T₂加权象对此不敏感.如果血液与胆汁完全混合,在所有采用的磁共振成象上均使胆汁信号增高.非混合性出血性胆囊炎的磁共振成象具有特征性:在T₁加权象及质子密度加权象胆囊内有高信号区,T₂加权象此区为等信号、低信号或其中心为低信号周围与胆汁相接的为高信号。混合性出血性胆囊炎在所采用的磁共振成象图象中,相对于肝脏,胆囊内容物表现为均匀高信号,临床资料及胆囊壁、胆囊周围渗出有助于这种出血性胆囊炎的诊断.     

Influence of sialic acid and bacterial sialidase on differential adhesion of Pseudomonas aeruginosa to epithelial cells

Epithelial cell lines from several tissues show a differential sensitivity to Pseudomonas aeruginosa adherence. A549 (lung), HepG2 (liver) and Caco-2 (colon) cells presented an adhesion index of about 3, 1.5 and 5 CFU/cell, respectively, whereas Mz-Ch cell lines (gallbladder cholangiocytes) presented adhesion indexes up to 35. These variations could be associated with the variable amount of sialic acid in cell surface glycoconjugates. Moreover, the presence of free sialic acid in culture media induces the secretion by P. aeruginosa of a sialidase which is able to hydrolyze glycoconjugate-linked sialic acid. As shown with A549 cells, this specific hydrolysis increases bacterial adhesion, probably by unmasking new binding sites onto the cell surface.     

胆囊组织、组织细胞膜及细胞株的FTIR研究

研究了不同病理生理状态的胆囊组织、胆囊组织细胞膜及胆囊癌细胞株的傅里叶变换红外光谱的相关性.结果显示,与正常组织比较,胆囊癌组织中脂质相关谱带(2955,2920,2870,2850和1740 cm-1)与蛋白相关谱带(1550 cm-1)强度降低;胆囊癌细胞株中脂质相关谱带与蛋白相关谱带(1550 cm-1)强度明显增加;胆囊癌组织细胞膜中脂质相关谱带强度明显增加;核酸相关吸收谱带强度变化在胆囊癌组织和胆囊癌细胞株中一致,在细胞膜中消失;I1460/I1400比值在组织、细胞株和细胞膜层面变化一致,与正常组织相比均有所减少.结果表明,与胆囊癌组织相比,胆囊癌细胞株和胆囊癌组织细胞膜的红外光谱发生了显著变化:癌组织的脂类和蛋白质的相对含量降低;癌细胞株的脂质和蛋白相对含量增加;胆囊癌组织细胞膜的脂质和蛋白相对含量升高.从组织、细胞和细胞膜3个层面阐述了癌变的分子光谱变化.I1460/I1400比值的变化在组织、细胞株和细胞膜层面变化一致,对此指标的深入研究有望获得一个良好的临床诊断指标.     

Upregulated plasma and urinary levels of nucleosides as biological markers in the diagnosis of primary gallbladder cancer

We first detected aberrant nucleoside levels in the plasma, urine, bile, and tissues from cases and controls to explore them as biomarkers in the diagnosis of gallbladder cancer. Reversed‐phase high‐performance liquid chromatography was used to assess the levels of ten nucleosides in these samples from gallbladder cancer patients, gallstone patients, and healthy controls. Plasma and urine samples were collected from patients with gallbladder cancer (n = 202), patients with gallstones (n = 203), and healthy controls (n = 205); bile and tissue samples were collected from 91 gallbladder cancer patients, 93 gallstone patients; and 90 were donated after cardiac death. Of the ten nucleosides analyzed, eight urinary nucleosides, five plasma nucleosides, three bile nucleosides, and one tissue nucleoside were significantly upregulated in the gallbladder cancer patients compared to control groups (p < 0.05). Among these upregulated nucleosides, the sensitivity, specificity, and accuracy of urinary nucleosides in the diagnosis of gallbladder cancer patients were 89.4, 97.1, and 95.7%, respectively, those of plasma nucleosides were 91.2, 95.6, and 94.2%, respectively, those of bile nucleosides were 95.3, 96.4, and 95.1%, respectively, and those of tissue nucleosides were 86.2, 93.8, and 92.6%, respectively. These results suggest that nucleosides may be as useful as biological markers for gallbladder cancer.     

Influence of sialic acid and bacterial sialidase on differential adhesion of Pseudomonas aeruginosa to epithelial cells

Epithelial cell lines from several tissues show a differential sensitivity to Pseudomonas aeruginosa adherence. A549 (lung), HepG2 (liver) and Caco-2 (colon) cells presented an adhesion index of about 3, 1.5 and 5 CFU/cell, respectively, whereas Mz-Ch cell lines (gallbladder cholangiocytes) presented adhesion indexes up to 35. These variations could be associated with the variable amount of sialic acid in cell surface glycoconjugates. Moreover, the presence of free sialic acid in culture media induces the secretion by P. aeruginosa of a sialidase which is able to hydrolyze glycoconjugate-linked sialic acid. As shown with A549 cells, this specific hydrolysis increases bacterial adhesion, probably by unmasking new binding sites onto the cell surface.     

胆囊疾病的临床快速诊断红外光谱新方法研究

研究了衰减全反射(ATR)红外光谱法快速检测胆囊癌的灵敏度和特异性, 结果表明, 正常组织和胆囊癌组织的红外光谱存在一系列差别, 减法光谱技术有助于判别胆囊炎和胆囊癌. 统计分析结果表明, 此方法灵敏度为100%(6/6), 特异性为97%(39/40), 准确率为97%(45/46), 说明中红外ATR光谱法是一种可快速、无创检测胆囊癌组织的新方法.     

Optical investigation of dynamics of phenomena of laser-based lithotripsy

Using time-resolved high-speed shadowgraphy, the dynamics of phenomena due to laser-based lithotripsy is studied. Collapsing mechanism of bubble formed therein is investigated. In order to study the mechanism, the optically implemented mathematical morphology is applied. The study of the shape of the plasma and the collapsing region of the bubble of fluid that we are studying can possibly be used for practical application for laser-based lithotripsy.