ObjectiveTo investigate the radiomics features to distinguish invasive lung adenocarcinoma with micropapillary or solid structure. MethodsA retrospective analysis was conducted on patients who received surgeries and pathologically confirmed invasive lung adenocarcinoma in our hospital from April 2016 to August 2019. The dataset was randomly divided into a training set [including a micropapillary/solid structure positive group (positive group) and a micropapillary/solid structure negative group (negative group)] and a testing set (including a positive group and a negative group) with a ratio of 7∶3. Two radiologists drew regions of interest on preoperative high-resolution CT images to extract radiomics features. Before analysis, the intraclass correlation coefficient was used to determine the stable features, and the training set data were balanced using synthetic minority oversampling technique. After mean normalization processing, further radiomics features selection was conducted using the least absolute shrinkage and selection operator algorithm, and a 5-fold cross validation was performed. Receiver operating characteristic (ROC) curves were depicted on the training and testing sets to evaluate the diagnostic performance of the radiomics model. ResultsA total of 340 patients were enrolled, including 178 males and 162 females with an average age of 60.31±6.69 years. There were 238 patients in the training set, including 120 patients in the positive group and 118 patients in the negative group. There were 102 patients in the testing set, including 52 patients in the positive group and 50 patients in the negative group. The radiomics model contained 107 features, with the final 2 features selected for the radiomics model, that is, Original_ glszm_ SizeZoneNonUniformityNormalized and Original_ shape_ SurfaceVolumeRatio. The areas under the ROC curve of the training and the testing sets of the radiomics model were 0.863 (95%CI 0.815-0.912) and 0.857 (95%CI 0.783-0.932), respectively. The sensitivity was 91.7% and 73.7%, the specificity was 78.8% and 84.0%, and the accuracy was 85.3% and 78.4%, respectively. ConclusionThere are differences in radiomics features between invasive pulmonary adenocarcinoma with or without micropapillary and solid structures, and the radiomics model is demonstrated to be with good diagnostic value.
Objective The aim of present study was to investigate the protective effect of vitamin U on renal toxicity induced by sodium valproate (VPA) and provide laboratory data for clinical application of VPA. Methods In this study, 48 female rats were used. These animals were randomly divided into 4 groups: control group (group A), vitamin U group (group B), VPA group (group C), vitamin U+ VPA group (group D). Group A was given the same amount of normal saline, group B was given Vit U 50 mg/(kg·d), group C was given VPA 300 mg/(kg·d) and group D was given Vit U 50 mg/(kg·d) firstly, then VPA 300 mg/(kg·d) after 1 hours by gavage. After 2 or 4 weeks of continuous administration, the kidneys were collected from these rats after blood collection. Total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), serum creatinine (Cr), urea (BUN) and uric acid (UA) were detected by automatic biochemical analyzer. Result ① Blood lipid. There were significant differences in TC and LDL between the group A and group C (P<0.05), and the level of TC and LDL in group C were significantly higher. ② Serum biochemical indexes of renal function. There was no significant difference in Cr, UA and BUN four groups at 2w (P>0.05). At 4w, compared with the other three groups, the Cr, BUN and UA level of VPA group were significantly higher (P<0.05). But there was no significant difference between the group A and the group D. ③ Pathological morphology of renal tissue. At 2w, there was no obvious abnormality in renal structures among the four groups. At 4w, inflammatory lesions were only seen in VPA group, and mild inflammatory cell infiltration were seen in other three groups. Conclusion VPA can lead to a higher level of blood lipid. The renal toxicity induced by VPA may have a certain relationship with the time of drug exposure, and vitamin U has a protective effect on the renal toxicity induced by VPA.
ObjectiveTo investigate the radiological and clinicopathological factors affecting the postoperative recurrence of early lung adenocarcinoma with micropapillary/solid structure.MethodsA total of 198 patients undergoing surgical resection for early stage lung adenocarcinoma in the First Affiliated Hospital of Nanjing Medical University from January 2016 to August 2019 were enrolled, including 100 males and 98 females, aged 28-82 (53.5±9.5) years. All patients were allocated to a recurrence group (n=21) and a non-recurrence group (n=177) according to postoperative recurrence status. Correlations of imaging and clinical features and clinical outcomes were analyzed to determine prognostic significance.ResultsThe mean follow-up time was 27.0±11.2 months. There was no statistical difference in the imaging features of tumor maximum diameter in mediastinal window (P=0.014), C/T ratio (P=0.001), bronchial positive sign (P=0.015), pathological features of vascular invasion (P=0.024) and postoperative chemotherapy (P<0.001) between the two groups. In multivariate analysis, vascular invasion was the only independent prognostic factor (OR=0.146, P=0.047).ConclusionVascular invasion is an independent risk factor for postoperative recurrence of early-stage lung adenocarcinoma with micropapillary/solid structure.
ObjectiveTo evaluate the clinical feasibility and safety of CT-guided percutaneous microwave ablation for peripheral solitary pulmonary nodules.MethodsThe imaging and clinical data of 33 patients with pulmonary nodule less than 3 cm in diameter treated by CT-guided microwave ablation treatment (PMAT) in our hospital from July 2018 to December 2019 were retrospectively analyzed. There were 21 males and 12 females aged 38-90 (67.6±13.4) years. Among them, 26 patients were confirmed with lung cancer by biopsy and 7 patients were clinically considered as partial malignant lesions. The average diameter of 33 nodules was 0.6-3.0 (1.8±0.6) cm. The 3- and 6-month follow-up CT was performed to evaluate the therapy method by comparing the diameter and enhancement degree of lesions with 1-month CT manifestation. Short-term treatment analysis including complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD) was calculated according to the WHO modified response evaluation criteria in solid tumor (mRECIST) for short-term efficacy evaluation. Eventually the result of response rate (RR) was calculated. Progression-free survival was obtained by Kaplan–Meier analysis.ResultsCT-guided percutaneous microwave ablation was successfully conducted in all patients. Three patients suffered slight pneumothorax. There were 18 (54.5%) patients who achieved CR, 9 (27.3%) patients PR, 4 (12.1%) patients SD and 2 (6.1%) patients PD. The short-term follow-up effective rate was 81.8%. Logistic analysis demonstrated that primary and metastatic pulmonary nodules had no difference in progression-free time (log-rank P=0.624).ConclusionPMAT is of high success rate for the treatment of solitary pulmonary nodules without severe complications, which can be used as an effective alternative treatment for nonsurgical candidates.