Objective To evaluate the value of 3-D reconstruction in multi-detector spiral CT urography (MDCTU) for diagnosing upper urinary tract diseases (UUTDs) by means of both diagnostic sensitivity and ROC curve. Methods A total of 41 patients with UUTD were collected. All of them took MDCTU as well as reconstructions including MPR, MIP and VR. Compared with golden standards, the diagnostic value of MDCTU, MPR, MIP and VR were evaluated using both diagnostic sensitivity and ROC curve. Results a) A total of 49 upper urinary tract lesions were detected in those 41 patients; b) For UUTD, the localization diagnostic sensitivities of MPR, MIP, and VR were 48/49 (98.0%), 27/49 (53.2%), and 19/49 (38.8%), respectively; while their qualitative diagnostic sensitivities were 47/49 (95.9%), 17/49 (34.7%), and 13/49 (26.5%), respectively; the differences between MPR and the others were significantly (Plt;0.05); c) For distinguishing benign from malignant lesions, the Az value (area under ROC curve) of MPR, MIP, and VR were 0.998, 0.736 and 0.669, respectively; the differences between MPR and the others were significant (Plt;0.05); and d) MPR was completely the same as MDCTU in both diagnostic sensitivity and Az value. Conclusion The common 3-D reconstructions in MDCTU were different in value. MPR is highest in the diagnostic efficiency, which is similar to MDCTU, and is regarded as the basis of diagnosis; while MIP and VR are more stereo and intuitive. So it shows that the comprehensive application of CTU 3-D reconstructions has important value for diagnosing UUTD and distinguishing benign from malignant.
Objective To analyze and screen the risk factors of both immunohistochemistry and pathology for lung cancer lymphatic metastasis, and to build a mathematical model for preliminary evaluation. Methods By conducting retrospective studies, the information of lung cancer patients in the General Hospital of Air Force from 2009 to 2011 were collected. Both single and multiple unconditional logistic regression analyses were applied to screen total 27 possible factors for lymphatic metastasis. After the factors with statistical significance were selected, the relevant mathematical model was built and then evaluated by means of receiver operating characteristic (ROC) analysis. Results A total of 216 patients were included. The single analyses on 27 possible factors showed significant differences in the following 10 factors: pathological grade (P=0.00), age (P=0.00), tumor types (P=0.01), nm23 (P=0.00), GSTII (P=0.01), TTF1 (P=0.01), MRP (P=0.01), CK14 (P=0.02), CD56 (P=0.02), and EGFR (P=0.03). The multiple factors unconditional logistic regression analyses on those 10 risk factors screened 4 relevant factors as follows: pathological grade (OR=2.34), age (OR=1.02), nm23 (OR=1.66), and EGFR (OR=1.47). Then a mathematical diagnostic model was established based on those 4 identified risk factors, and the result of ROC analysis showed it could improve the diagnostic sensitivity and specificity compared with the single factor mathematical diagnostic model. Conclusion Pathological grade, age, nm23, and EGFR are related with lung cancer lymphatic metastasis, and all of them are the risk factors which have higher adjuvant diagnostic value for lung cancer lymphatic metastasis.