ObjectiveTo investigate the diagnostic value of intra-intestinal angiography CT in patients with anastomotic leakage (AL) after rectal cancer resection.MethodsPatients who admitted to The Department of General Surgery of The No. 900 Hospital of The Joint Logistic Team from January 2013 to October 2018, who were diagnosed with rectal cancer and underwent rectal cancer resection with sphincter preserving surgery, were retrospectively collected in the study. All patients underwent routine imaging examination on the 7th day after rectal cancer operation. The retrograde contrast enema (RCE) was performed to obtain the abdominal X-ray film, then the pelvic CT scan was performed to get the CT image of the intestinal lumen. The films were reviewed by 2 senior radiologists, and the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of RCE and intra-intestinal angiography CT in the diagnosis of AL after rectal cancer resection were evaluated. Evaluated the sensitivity of the CT image feature to predict AL after rectal cancer resection.ResultsThe sensitivity, specificity, PPV, and NPV of RCE in the diagnosis of AL after the rectal cancer resection were 69.23% (18/26), 98.64% (218/221), 85.71% (18/21), and 96.46% (218/226) respectively. The sensitivity, specificity, PPV, and NPV of intra-intestinal angiography CT were 96.15% (25/26), 99.09% (219/221), 92.59% (25/27), and 99.54% (219/220) respectively. The sensitivity and NPV of intra-intestinal angiography CT in diagnosis of AL were significantly higher than those of RCE (P<0.05). The sensitivity of contrast agent leakage to diagnosis of AL was the highest, reaching 96.15% (25/26).ConclusionsThe sensitivity of intra-intestinal angiography CT in the diagnosis of AL is high and the overall diagnostic efficiency is better than RCE, and the leakage of contrast agent is the main imaging feature of AL. It is significant to guide the clinical practice.
ObjectiveTo investigate the value of esophageal activity examination under X-ray fluoroscopy and chest CT in evaluating the resectability of upper thoracic esophageal cancer.MethodsA total of 221 upper thoracic esophageal carcinoma patients underwent radical operation between 2009 and 2015 in our hospital were enrolled, including 141 males and 80 females with a median age of 59 (47-79) years. Preoperative routine esophageal activity examination under X-ray fluoroscopy and chest enhanced CT were performed to determine whether the tumor had external invasion. The results of the two methods were compared with that observed during the operation.ResultsThe number of patients with esophageal activity score 1-6 was 70, 85, 32, 29, 2 and 3, respectively. The area under the receiver operating characteristic (ROC) curve (AUC) of esophageal activity examination was 0.897 (95%CI 0.85-0.93, P<0.001), and the cut off value was >3. According to the ROC curve activity score, 4-6 points were considered as invasion, and 1-3 points were non-invasion. The sensitivity, specificity, accuracy and misdiagnosis rate of esophageal activity examination was 75.0%, 89.3%, 88.2%, 10.7%, respectively, and those of CT scan were 75.0%, 66.8%, 67.4%, 33.2%, respectively. Compared with CT scan, the specificity of esophageal activity examination was higher and the misdiagnosis rate was lower. Compared with the detection during the operation, 86.7% of patients with actual invasion of trachea and 85.7% of patients with actual invasion of other parts were in accordance with the esophageal activity examination results.ConclusionEsophageal activity examination under X-ray fluoroscopy can accurately predict the resectability of upper thoracic esophageal cancer, which is a useful supplement to chest CT examination, especially in the aspect of judging the relationship between lesions and the trachea.
ObjectiveTo evaluate the diagnostic value of artificial intelligence (AI)-assisted diagnostic system for pulmonary cancer based on CT images.MethodsDatabases including PubMed, The Cochrane Library, EMbase, CNKI, WanFang Data and Chinese BioMedical Literature Database (CBM) were electronically searched to collect relevant studies on AI-assisted diagnostic system in the diagnosis of pulmonary cancer from 2010 to 2019. The eligible studies were selected according to inclusion and exclusion criteria, and the quality of included studies was assessed and the special information was identified. Then, meta-analysis was performed using RevMan 5.3, Stata 12.0 and SAS 9.4 softwares. The sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio were pooled and the summary receiver operating characteristic (SROC) curve was drawn. Meta-regression analysis was used to explore the sources of heterogeneity.ResultsTotally 18 studies were included with 4 771 patients. Random effect model was used for the analysis due to the heterogeneity among studies. The results of meta-analysis showed that the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnosis odds ratio and area under the SROC curve were 0.87 [95%CI (0.84, 0.90)], 0.89 [95%CI (0.84, 0.92)], 7.70 [95%CI (5.32, 11.15)], 0.14 [95%CI (0.11, 0.19)], 53.54 [95%CI (30.68, 93.42)] and 0.94 [95%CI (0.91, 0.95)], respectively.ConclusionAI-assisted diagnostic system based on CT images has high diagnostic value for pulmonary cancer, and thus it is worthy of clinical application. However, due to the limited quality and quantity of included studies, above results should be validated by more studies.
ObjectiveTo investigate the level of serum long non-coding RNA antisense non-coding RNA INK4 locus (LncRNA ANRIL) in patients with ulcerative colitis (UC), and to analyze the diagnostic value of serum LncRNA ANRIL level in UC. MethodsA total of 143 UC patients admitted to the First Affiliated Hospital of Henan University of Science and Technology from February 2015 to November 2019 were retrospectively analyzed, and 145 healthy people with normal physical examination in the First Affiliated Hospital of Henan University of Science and Technology were selected as the control group. The relationship between serum LncRNA ANRIL level and PCT/IL-17 level was analyzed, the serum levels of LncRNA ANRIL, PCT, and IL-17 were compared between the two groups, and their diagnostic value for UC was explored.ResultsThe disease degree of 143 UC patients: 41 cases were mild, 59 cases were moderate, and 43 cases were severe; endoscopic grade: 38 cases were grade Ⅰ, 65 cases were grade Ⅱ, and 40 cases were grade Ⅲ. Compared with the control group, the serum levels of LncRNA ANRIL, PCT, and IL-17 were increased in the UC group (P<0.05); the levels of serum LncRNA ANRIL, PCT, and IL-17 in the UC group increased gradually with the increase of disease severity and endoscopic grade (P<0.05). The serum levels of LncRNA ANRIL were positively correlated with the levels of PCT and IL-17 in the UC patients (r=0.596, P<0.001; r=0.492, P<0.001). The area under the curve (AUC) of serum LncRNA ANRIL level in the diagnosis of UC was 0.851, the cut-off value was 1.29, the sensitivity and specificity were 75.5% and 83.4%, respectively. The AUC of serum LncRNA ANRIL combined with PCT in the diagnosis of UC was 0.898, the corresponding sensitivity and specificity were 81.8% and 87.6%, respectively. The sensitivity and diagnostic value of combination of LncRNA ANRIL and PCT were higher than that of serum LncRNA ANRIL alone (Z=2.102, P=0.036). ConclusionsThe serum level of LncRNA ANRIL in UC patients is increased, which has a certain diagnostic value, and it combines with PCT can better predict UC.
Objective To investigate the diagnostic value of nucleotide-binding oligomerization domain-like receptor protein 3 (NLRP3) inflammatory body and sphingosine-1-phosphate (S1P) in early diabetic nephropathy and its progression. Methods A total of 600 diabetic patients who were treated in Shaanxi Provincial People’s Hospital between January 2018 and December 2020 were selected, and the patients were divided into simple diabetes group, early diabetic nephropathy group and clinical diabetic nephropathy group. The expression of NLRP3 messenger RNA (mRNA) in fasting venous blood mononuclear cells was detected by real-time fluorescence quantitative polymerase chain reaction, and the level of S1P was detected by enzyme-linked immunosorbent assay double-antibody sandwich method. Pearson correlation analysis was used to explore the correlation between blood NLRP3 mRNA and S1P levels. The receiver operating characteristic curve was used to evaluate the diagnostic value of blood NLRP3 mRNA and S1P levels in early diabetic nephropathy and clinical diabetic nephropathy. Results Among the 600 diabetic patients, 205 were in the simple diabetes group, 198 in the early diabetic nephropathy group and 197 in the clinical diabetic nephropathy group. There was no significant difference in age and gender among the three groups (P>0.05). The blood levels of NLRP3 mRNA and S1P in the clinical diabetic nephropathy group were higher than those in the early diabetic nephropathy group and the simple diabetes group, the blood NLRP3 mRNA and S1P levels in the early diabetic nephropathy group were higher than those in the simple diabetes group. The differences were statistically significant, and the blood NLRP3 mRNA levels of the three groups were 2.69±0.64 vs. 2.05±0.56 vs. 1.76±0.51, and the S1P levels were (1.49±0.27) vs. (1.16±0.13) vs. (0.89±0.07) μmol/L (P<0.05). There was a positive correlation between blood NLRP3 mRNA and S1P level in patients (r=0.455, P<0.001). Blood NLRP3 mRNA, S1P levels and their combined detection can be used to diagnose whether diabetic patients develop early diabetic nephropathy (area under the receiver operating characteristic curve were 0.645, 0.968, 0.971; P<0.001) and whether it progressed to clinical diabetic nephropathy (area under the receiver operating characteristic curve were 0.825, 0.918, and 0.945; P<0.001). Conclusion Blood NLRP3 mRNA and S1P levels can be used to diagnose early diabetic nephropathy and evaluate its disease progression.
Objective To explore the diagnostic value of contrast-enhanced ultrasonography (CEUS) in axillary and internal mammary lymph node metastasis of invasive breast cancer. Methods A total of 100 patients with invasive breast cancer treated from September 2020 to September 2022 were selected. Preoperative CEUS examination was completed, and the perfusion sequence, enhancement mode and enhancement sequence of lymph nodes were dynamically observed. The CEUS characteristics of metastatic and benign lymph nodes were compared. Using postoperative pathological results as the gold standard, the diagnostic efficacy of CEUS in evaluating lymph node status was analyzed. Results Among the 100 patients, 28 patients were diagnosed with metastatic axillary lymph nodes (ALN) by pathological biopsy. The sensitivity, specificity, accuracy, positive prediction rate and negative prediction rate of CEUS in evaluating ALN status were 71.4%, 87.5%, 83.0%, 69.0% and 88.7%, respectively. In 9 patients, CEUS showed internal mammary lymph node metastasis, and postoperative pathological examination confirmed that 5 patients had internal mammary lymph node metastasis, so the positive predictive rate of CEUS was 55.6%. Conclusion CEUS can evaluate the metastatic status of axillary and internal mammary lymph nodes.
Objective To investigate the clinical application value of GeneXpert Mycobacterium tuberculosis (MTB)/ rifampin (RIF) in urine samples for tuberculosis diagnosis. Methods The patients with clinically highly suspected tuberculosis admitted to West China Hospital of Sichuan University between January 1, 2018 and June 1, 2023 were selected retrospectively. The diagnostic efficacy of urine GeneXpert MTB/RIF detection, such as sensitivity, specificity, positive predictive value, and negative predictive value, were retrospectively analyzed to evaluate its clinical value in the diagnosis of tuberculosis. Correlation analysis was further conducted to explore the correlation between positive levels of GeneXpert MTB/RIF in urine samples and laboratory test indicators. Results A total of 400 patients were included. Among them, 163 cases were in the clinical tuberculosis group and 237 cases were in the clinical non tuberculosis group. In the clinical tuberculosis group, 112 cases were urogenital tuberculosis patients and 51 cases were non-urogenital tuberculosis patients. The sensitivity, specificity, positive predictive value, and negative predictive value of urine GeneXpert MTB/RIF in the diagnosis of tuberculosis were 55.2%, 97.5%, 93.8% and 76.0%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of urine GeneXpert MTB/RIF in the diagnosis of urogenital tuberculosis were 65.2%, 92.0%, 76.0% and 87.2%, respectively, and the diagnostic sensitivity was further improved. Correlation analysis showed that the positive degree of urine GeneXpert MTB/RIF was correlated with the levels of hemoglobin, serum total protein, blood serum albumin, and other indicators. Conclusions Urine GeneXpert MTB/RIF detection offers high sensitivity and specificity in the diagnosis of tuberculosis, especially in urogenital tuberculosis, which is helpful for the early and rapid diagnosis of tuberculosis patients. The positive degree reported by the GeneXpert MTB/RIF in urine may indicate disease severity.