论著

纳布啡联合环泊酚或丙泊酚在老年患者无痛胃肠镜中应用效果分析

Application effect of nalbuphine combined with ciprofol or propofol in painless gastroscopy in elderly patients

:1152-1158
 
目的 对比纳布啡联合环泊酚、纳布啡联合丙泊酚应用于老年患者无痛胃镜中的效果。方法 选取厦门市中医院2021年10月至2022年10月收治的180例老年患者(均行无痛胃肠镜检查)为研究对象,按照随机数表法分组,其中A组90例患者给予纳布啡联合环泊酚,B组90例患者给予纳布啡联合丙泊酚,对比两组患者麻醉相关指标、血流动力学、围术期不良反应。结果 两组患者诱导量、诱导时间、追加次数、总追加量、苏醒时间、恢复室停留时间对比差异均无统计学意义(t=1.486、0.830、1.157、0.941、0.906、1.403,均P>0.05);重复测量方差分析结果显示,分组因素间收缩压(SBP)(F=30.019,P<0.001)、心率(HR)(F=282.057,P<0.001)、SpO2(F=64.518,P<0.001)、;时间因素SBP(F=21.780,P<0.001)、HR(F=345.118,P<0.001)、SpO2(F=41.762,P<0.001);分组与时间交互时间因素SBP(F=12.941,P<0.001)、HR(F=193.295,P<0.001)、SpO2(F=13.546,P<0.001),差异均有统计学意义。折线图直观显示,A组患者SBP、HR、SpO2、较B组低。;A组患者围术期不良反应发生率(20.00%)低于B组患者(56.67%)(χ2=25.593,P<0.001)。结论 两种麻醉方案应用于老年无痛胃肠镜,麻醉效果相近,环泊酚复合纳布啡血流动力学更稳定,且围术期不良反应的发生率较低。
Objective To compare the effects of nalbuphine combined with ciprofol and nalbuphine combined with propofol on painless gastroscopy in elderly patients. Methods A total of 180 elderly patients(all underwent painless gastroscopy)admitted to Xiamen Traditional Chinese Medicine Hospital from October 2021 to October 2022 were selected as the study subjects.They were randomly divided into groups using a random number table method.Among them,90 patients in Group A were given a combination of nalbuphine and ciprofol,while 90 patients in Group B were given a combination of nalbuphine and propofol.Anesthesia related indicators,hemodynamics,and perioperative adverse reactions were compared between the two groups.There was no statistically significant difference in the induction amount,induction time,number of additional times,total additional amount,awakening time,and recovery room stay time between the two groups of patients(t=1.486,0.830,1.157,0.941,0.906,1.403,all P>0.05).The results of repeated measures analysis of variance showed that there were statistically significant differences among the grouping factors,including SBP(F=30.019,P<0.001),HR(F=282.057,P<0.001),SpO2(F=64.518,P<0.001),time factors SBP(F=21.780,P<0.001),HR(F=345.118,P<0.001),SpO2(F=41.762,P<0.001),and interaction factors SBP(F=12.941,P<0.001),HR(F=193.295,P<0.001),and SpO2(F=13.546,P<0.001).The line chart visually shows that the SBP,HR,SpO2 of Group A patients were lower than those of Group B.The incidence of perioperative adverse reactions in Group A patients(20.00%)was lower than that in Group B patients(56.67%)(χ2=25.593,P<0.001). Conclusions The two anesthesia regimens used for elderly painless gastroscopy have similar anesthesia effects,with more stable hemodynamics of ciprofol combined with nalbuphine,and a lower incidence of perioperative adverse reactions.
中医研究

中医“治未病”思想在肉芽肿性乳腺炎防治中的应用

The application of the thought of 'Treating Disease Before Its Onset' in the prevention and treatment of granulomatous mastitis

:1113-1116
 
肉芽肿性小叶性乳腺炎(GLM)是一种临床较为难治的、慢性、炎症性的疾病,虽不会影响患者的生命,但是对患者的生理、心理造成了一定程度的影响,近年来该病的发病率有逐年上升的趋势。“治未病”是中医的基本思想之一,在疾病的预防、诊治方面具有重要意义。该文尝试将中医“治未病”思想应用于GLM的预防和治疗中,试图构建独特的中医预防GLM质量管理模式,以期为GLM防治提供新的思路。
Granulomatous lobular mastitis(GLM)is a chronic,inflammatory disease that is difficult to treat.Although it does not affect the patient's life,it has a certain degree of physiological and psychological impact on the patient,and in recent years the incidence of this disease has been increasing year by year.“Treating Disease Before Its Onset” is one of the basic ideas of Chinese medicine,which is of great significance in the prevention,diagnosis and treatment of diseases.In this paper,we try to apply the idea of “Treating Disease Before Its Onset” in Chinese medicine to the prevention and treatment of GLM,and attempt to construct a unique quality management model of Chinese medicine for the prevention of GLM,with a view to providing new ideas for the prevention and treatment of GLM.
专家述评

长链非编码RNA在消化道肿瘤中的研究进展

Long non-coding RNAs in human gastrointestinal cancer

:1105-1112
 
在过去的几十年中,随着RNA生物学的深入研究,越来越多的证据表明,非编码RNA(ncRNA)对包括癌症在内的多种疾病进展起着关键作用,同时在作为生物标志物和治疗靶点方面表现出了巨大的潜力。在全球范围内,消化道(GI)肿瘤是肿瘤相关死亡的主要原因,目前消化道肿瘤晚期患者的生存率依然很低。既往大量研究报道了ncRNA中,特别是长链非编码RNA(lncRNA)在消化道肿瘤发生发展中发挥重要作用。本文将着重阐述lncRNA在消化道肿瘤分子生物学中的作用,旨在为深入理解lncRNA在消化道肿瘤发生发展机制以及临床转化应用提供新的思路和线索。
In recent decades,an increasing body of evidence has pointed to the pivotal roles of non-coding RNAs(ncRNAs),particularly long non-coding RNAs(lncRNAs),in the development of various diseases,including cancer.Meanwhile,ncRNAs have been shown great potential as biomarker and therapeutic target.Gastrointestinal(GI)cancers are a leading cause of cancer-related mortality globally and the survival rate of advanced GI cancer patients is still very low.Extensive research has underscored the significant involvement of lncRNAs in the initiation and progression of GI cancers.This review aims to offer a comprehensive overview of lncRNAs,shedding light on their roles in the molecular biology of GI cancers.By synthesizing previous studies,this review seeks to provide new insights into the mechanisms underlying lncRNAs' contribution to GI cancer development and their potential clinical applications.
论著

无痛消化内镜下高频电刀治疗对胃癌前病变的应用效果及复发率的影响

The application effect and recurrence rate of high-frequency electric knife therapy under painless digestive endoscopy on gastric precancerous lesions

:1314-1318
 
目的 探讨无痛消化内镜下高频电刀治疗对胃癌前病变的应用效果及复发率的影响。方法 选取甘肃医学院附属医院2017年1月—2020年1月收治的120例胃癌前病变患者进行回顾性分析,依照其手术治疗方案将其分为两组,各60例。对照组采取常规内镜黏膜下剥离术,观察组患者采取无痛消化内镜下高频电刀剥离治疗。对比两组的切除速度、切除面积、治愈性切除率、完全及整块切除率,对患者进行3年随访,记录其复发情况,并对比两组患者并发症情况。结果 两组的切除面积、治愈性切除率、完全切除率及整块切除率对比差异无统计学意义(P>0.05),观察组切除速度为(27.34±8.58)mm2/min,高于对照组的(15.54±4.52)mm2/min,差异有统计学意义(P<0.05)。两组患者术后3年的总复发率(28.33% vs 30.00%)对比差异无统计学意义(P>0.05)。观察组感染、穿孔等相关并发症发生率为3.33%,低于对照组的15.00%(P<0.05)。结论 无痛消化内镜下高频电刀与常规内镜黏膜下剥离术治疗胃癌前病变相比具有显著疗效。但无痛消化内镜下高频电刀治疗可提升切除速度,降低并发症发生率。
Objective To explore the application effect and recurrence rate of painless endoscopic high-frequency electrocautery on gastric precancerous lesions.Methods A total of 120 patients with precancerous gastric cancer admitted to the Affiliated Hospital of Gansu Medical College from January 2017 to January 2020 were selected for retrospective analysis and divided into two groups according to their surgical treatment plan,with 60 patients in each group.The control group underwent conventional endoscopic submucosal dissection,and the patients in the observation group received painless digestive endoscopic high-frequency electric knife dissection.The resection speed,resection area,curative resection rate,complete and bulk resection rate were compared of the two groups,the patients were followed up for 3 years to record the recurrence rate,and the complications of the two groups of patients were also compared.Results There were no differences in resection area,curative resection rate,complete resection rate and total resection rate between the two groups(P>0.05).The resection speed in the observation group was(27.34±8.58)mm2/min,which was higher than that in the control group(15.54±4.52)mm2/min(P<0.05).There was no difference in the total recurrence rate(28.33% vs 30.00%)at 3 years after surgery between the two groups(P>0.05).The incidence of infection,perforation and other related complications in the observation group was 3.33%,lower than that in the control group(15.00%)(P<0.05).Conclusion sCompared with conventional endoscopic submucosal dissection,high-frequency electric knife under painless digestive endoscopy has significant efficacy in the treatment of gastric precancerous lesions.However,painless endoscopic high-frequency electrosurgical treatment can improve the resection speed and reduce the incidence of complications such as infection,perforation and bleeding.
论著

核磁弥散成像及ADC值在肝内非肿瘤性病变诊断与鉴别诊断中的价值

The value of diffusion weighted imaging and ADC value in the diagnosis and differential diagnosis of non neoplastic liver lesions

:1303-1307
 
目的 探讨与分析核磁弥散成像(DWI)及表观弥散系数(ADC)值在肝内非肿瘤性病变诊断与鉴别诊断中的价值。方法 选择2020年8月—2023年5月厦门大学附属第一医院收治的120例肝脏占位性病变患者为研究对象,所有患者均给予常规MRI与DWI,记录图像质量、信号特征,计算ADC值,评价诊断效能。结果 120例患者中,病理诊断为肝内非肿瘤性病变70例(非肿瘤组:肝脓肿32例、肝囊肿28例、肝炎性假瘤10例),肝内肿瘤性病变50例(肿瘤组:肝血管瘤38例,肝癌12例)。非肿瘤组与肿瘤组的图像质量优良率分别为94.29%(66/70)与88.00%(44/50),组间比较差异无统计学意义(χ2=1.509,P>0.05)。非肿瘤组的磁共振信号特征多为高信号(62.86%),肿瘤组多为低信号(60.00%),两组比较差异有统计学意义(χ2=45.691,P<0.05)。在b值为400 s/mm2和800 s/mm2条件下,非肿瘤组的ADC值(0.84±0.17、0.77±0.14)均低于肿瘤组(1.29±0.24、1.19±0.34),差异有统计学意义(t=12.029、9.302,P<0.05)。DWI判断为肝内非肿瘤性病变68例,DWI在肝内非肿瘤性病变的鉴别诊断灵敏度与特异度分别为95.71%(67/70)和98.00%(49/50),ROC曲线显示DWI在肝内非肿瘤性病变的诊断曲线下面积为0.895。结论 DWI在肝内非肿瘤性病变中的图像显示质量高,可通过信号特征与ADC判断病灶状况,对鉴别肝内非肿瘤性病变具有较高的诊断效能。
Objective To investigate and analyze the value of diffusion weighted imaging(DWI)and apparent diffusion coefficient(ADC)in the diagnosis and differential diagnosis of non neoplastic liver lesions.Methods A total of 120 patients with liver focal lesions admitted to the First Affiliated Hospital of Xiamen University from August 2020 to may 2023 were selected.All patients were given conventional MRI and DWI,the image quality and signal characteristics were recorded,the ADC value was calculated,and the diagnostic efficiency was evaluated.Results Among the 120 patients,70 cases were pathologically diagnosed as non neoplastic lesions(non tumor group,32 cases of liver abscess,28 cases of liver cyst,10 cases of hepatitis pseudotumor),and 50 cases were neoplastic lesions(tumor group,38 cases of hepatic hemangioma,12 cases of liver cancer).The excellent and good image quality rates of non tumor group and tumor group were 94.29%(66/70)and 88.00%(44/50),respectively,and there was no significant difference between the two groups(χ2=1.509,P>0.05).The MRI signal characteristics of non tumor group were mostly high signal(62.86%),while the tumor group were mostly low signal(60.00%),and the difference between the two groups was statistically significant(χ2=45.691,P<0.05).When the b value was 400 s/mm2 and 800 s/mm2,the ADC value of non tumor group(0.84±0.17,0.77±0.14)was significantly lower than that of tumor group.The difference was statistically significant(t=12.029,9.302,P<0.05).Sixty-eight patients were diagnosed as non neoplastic lesions by DWI.The sensitivity and specificity of DWI in the differential diagnosis of non neoplastic lesions were 95.71%(67/70)and 98.00%(49/50),respectively.The ROC curve shows that the area under the diagnostic curve of DWI for non tumor lesions in the liver was 0.895.Conclusion sDWI has high image quality in the diagnosis of non neoplastic lesions in the liver.Doctors can judge the status of lesions by signal characteristics and ADC,which has high diagnostic efficiency in the identification of non neoplastic lesions in the liver.
综述

基于Hedgehog信号通路的中医药干预慢性萎缩性胃炎的研究进展

Research about Chinese medicine intervention in chronic atrophic gastritis based on the Hedgehog signaling pathway

:1255-1263
 
慢性萎缩性胃炎是常见的胃癌前病变,不仅治疗过程漫长,治疗难度大,而且患者依从性欠佳。不仅会对患者的生理、心理健康和生活质量造成严重不良的影响,还会给患者家属造成负担,成为临床上不可忽视的难题。但是本病发病机制目前尚未完全明确,临床治疗还未达成共识。文章综述了近10年基于Hedgehog信号通路的中医药干预慢性萎缩性胃炎的研究概况。中医药调控Hedgehog信号通路辨证论治是治疗慢性萎缩性胃炎的一种独具特色的疗法,近年来有关基于Hedgehog信号通路的中医药干预治疗慢性萎缩性胃炎的报道越来越多。文章主要通过遵循疾病本虚标实的病性,以脾胃虚弱为本,瘀血、气滞、湿热、痰浊等为标,探讨选方治疗对慢性萎缩性胃炎的影响,认为中医药联合Hedgehog信号通路实行现代化发展能够有效干预治疗慢性萎缩性胃炎,以期为进一步临床研究与应用提供参考。
Chronic atrophic gastritis,a common precancerous lesion of gastric cancer,requires a long-term treatment and is difficult to cure.Therefore,it usually leads to decreased patient compliance.It will not only have a serious adverse impact on the patient’s physical and mental health and quality of life,but also cause a burden to the patient’s family,which has become a difficult problem that can not be ignored clinically.However,the pathogenesis has not yet been totally clarified,not to mention a consensus on the clinical treatment.This paper reviews the research revolving around Chinese medicine intervention in chronic atrophic gastritis based on the Hedgehog signaling pathway in the last decade.It’s creative therapy of chronic atrophic gastritis that utilizing Traditional Chinese Medicine to regulate and control Hedgehog signaling pathway,which has been increasingly reported in recent years.This paper is based on “deficiency in origin” and “excess in superficiality” principle.Concretely,spleen-stomach vacuity is characterized by deficiency in origin,and excess in superficiality manifests blood stasis,qi stagnation,dampness-heat and phlegm turbidity as excess in superficiality.By this way,the paper explores the effect of prescription selection on chronic atrophic gastritis.It is believed that the modern therapy that combines traditional Chinese medicine with Hedgehog signaling pathway can tackle chronic atrophic gastritis,thus providing a reference for further clinical trials and practices.
论著

DCE-MRI多参数定量特征对乳腺癌腋窝淋巴结转移风险的预测研究

Prediction of risk of axillary lymph node metastasis in breast cancer by DCE-MRI multi-parameter quantitative feature

:1450-1455
 
目的 探讨动态对比增强磁共振成像(DCE-MRI)多参数定量特征对乳腺癌腋窝淋巴结转移(ALNM)风险的预测价值。方法 回顾性收集2020年3月—2022年11月在佛山市高明区人民医院经手术病理确诊的155例乳腺癌患者临床资料,根据患者是否发生ALNM分为ALNM 组(n=39)和无ALNM 组(n=116)。采用单因素分析和多因素Logistic回归分析乳腺癌发生ALNM的影响因素。结果 ALNM组和无ALNM 组患者的肿块质地、肿块直径、肿块部位、肿块形状、肿块内部强化特征等指标比较差异无统计学意义(t/χ2=2.249、0.977、1.369、0.524、2.158,P>0.05)。两组患者肿块表观扩散系数(ADC)值、腋窝淋巴结(ALN)短径、肿块边缘、动态增强时间-信号强度曲线(TIC)曲线等指标比较,差异有统计学意义(t/χ2=6.573、9.873、29.441、2.031,P<0.05)。二元Logistic回归模型结果显示,肿块ADC值、ALN 短径(≥5 mm)、TIC曲线(流出型)为乳腺癌ALNM发生的危险因素(OR=0.251、0.106、0.002,P<0.05)。结论 DCE-MRI多参数定量特征中,乳腺癌患者的肿块ADC值低、ALN 短径(≥5 mm)、TIC曲线(流出型)为乳腺癌ALNM发生的危险因素。
Objective To investigate the predictive value of multi-parameter quantitative features of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in the risk of axillary lymph node metastasis(ALNM)in breast cancer.Methods Clinical data of 155 patients with breast cancer diagnosed by surgery and pathology in Foshan Gaoming District People's hospital from March 2020 to November 2022 were retrospectively collected.According to whether the patients had ALNM,they were divided into ALNM group(n=39)and non-ALNM group(n=116).Univariate analysis and multiple Logistic regression models were used to explore the influencing factors of ALNM in breast cancer.Results There was no significant difference in mass texture,mass diameter,mass location,mass shape and internal enhancement between the ALNM group and the non-ALNM group(t/χ2=2.249,0.977,1.369,0.524,2.158,P>0.05).There were significant differences in ADC value,ALN short diameter,tumor margin and TIC curve between the two groups(t/χ2=6.573,9.873,29.441,2.031,P<0.05).Binary Logistic regression model showed that ADC value,ALN short diameter(≥5 mm)and tumor margin(blur)were risk factors for the occurrence of breast cancer ALNM(OR=0.251,0.106,0.002,P<0.05).Conclusions Among the multi-parameter quantitative features of DCE-MRI,the ADC value of breast cancer,the short diameter of ALN(≥5 mm),and the edge of the tumor(blur)are the risk factors for the occurrence of ALNM in breast cancer.
专家述评

基于MRI的人工智能技术在乳腺癌新辅助治疗疗效评估中的应用与进展

Application and progress of MRI-based artificial intelligence technology in evaluating the response to neoadjuvant therapy for breast cancer

:1381-1388
 
乳腺癌是女性最常见的原发恶性肿瘤之一。目前,通过采用综合治疗手段,包括手术、新辅助治疗、辅助放化疗等多种手段,乳腺癌已成为疗效最佳的实体肿瘤之一。其中,新辅助治疗(NAT)包括新辅助化疗、靶向治疗和内分泌治疗,目的是使肿瘤降期、保乳、保腋窝,并可观察药物敏感性,是当前乳腺癌综合治疗中非常重要的组成部分,其治疗疗效对患者手术方式的选择和预后至关重要。尽管病理学评价在评估NAT疗效方面被公认为金标准,但其局限性在于只能通过有创手段在治疗后进行,无法在治疗前对患者做出准确预测。磁共振成像(MRI)作为一项广泛使用的乳腺成像技术,在评估NAT疗效中扮演着关键角色。近年来,人工智能技术,尤其是影像组学(Radiomics)和深度学习(Deep Learning),在医学影像分析领域取得了显著进展。这些技术能够从医学图像中提取大量肉眼难以识别的特征,揭示病变内部的微观结构和生物学行为,全面反映肿瘤的异质性,这不仅有助于临床医生更准确地区分良、恶性肿瘤,还能对恶性肿瘤的预后进行更为精确的评估。本文系统综述了近年来基于MRI的人工智能技术在乳腺癌新辅助治疗疗效评估中的应用研究,旨在促进人工智能在NAT临床实践中的应用和发展,为乳腺癌NAT治疗策略的优化和个性化医疗的实现提供科学依据。
Breast cancer is one of the most common primary malignant tumors in women.Currently,breast cancer has become one of the most effective solid tumors by using comprehensive treatment methods,including surgery,neoadjuvant therapy,adjuvant radiotherapy and chemotherapy.Among them,neoadjuvant therapy(NAT),including neoadjuvant chemotherapy,targeted therapy and endocrine therapy,is a very important part of the current comprehensive treatment of breast cancer.It aims to reduce the tumor stage,preserve the breast,preserve the armpit,and observe the drug sensitivity.Its therapeutic effect is crucial to the choice of surgical methods and prognosis of patients.Although pathological evaluation is recognized as the gold standard in evaluating the response to NAT,its limitation is that it can only be performed after treatment by invasive means,and cannot accurately predict response before treatment.As a widely used breast imaging technology,magnetic resonance imaging(MRI)plays a key role in evaluating the response to NAT.However,traditional MRI evaluation methods are limited by the individual differences of interobserver and the low repeatability of evaluation results,which affects the accuracy of efficacy evaluation to a certain extent.In recent years,artificial intelligence technology,especially radiomics and deep learning,has made significant progress in the field of medical image analysis.These techniques can extract a large number of features that are difficult to be recognized by the naked eye from medical images,reveal the internal microstructure and biological behavior of the lesion,and fully reflect the heterogeneity of the tumor.This not only helps clinicians to distinguish benign and malignant tumors more accurately,but also makes a more accurate assessment of the prognosis of malignant tumors.This article reviews the application and progress of MRI-based artificial intelligence technology in evaluating the response to neoadjuvant therapy for breast cancer in the past five years,aiming to promote the application and development of artificial intelligence in NAT clinical practice,and provide a scientific basis for the optimization of NAT treatment strategy and the realization of personalized medicine for breast cancer.
论著

MAML1与胃癌进展和预后相关性的生物信息学分析

Association between MAML1 and progression, prognosis in gastric cancer based on bioinformatics analysis

:56-63
 
目的 通过多种生物信息学方法分析MAML1在GC患者中的表达及与临床特征、预后和免疫治疗疗效的相关性。方法 利用TCGA数据库分析胃癌组织与正常胃黏膜组织中的MAML1表达水平;Kaplan-Meier在线工具对胃癌数据集GSE15459进行分析,阐明MAML1与患者临床特征及分期、治疗疗效的相关性;STRING软件预测与MAML1表达相关的基因,并用FUNRICH软件评估其富集的分子生物学功能和信号通路;TIMER和GEPIA数据库探索MAML1表达水平与肿瘤浸润免疫细胞及其相应基因标记集之间的关系。结果 MAML1在GC组织中的表达水平高于正常组织(P<0.001),且其表达水平与III期、有淋巴结转移、无远处转移的患者生存期相关(P<0.05),而与I、II和IV期、无淋巴结转移和有远处转移的患者生存期无相关性(P>0.05)。MAML1的相关作用基因主要分布在细胞核、参与转录调控,并且主要富集在雄激素受体、C-MYB转录因子和HIF-2α转录调控等相关的信号通路。MAML1表达水平与B细胞、CD4+ T细胞、巨噬细胞的表达水平存在正相关关系(P<0.05),但与肿瘤纯度、CD8+ T细胞、中性粒细胞、树突状细胞无相关性(P>0.05)。结论 MAML1有可能成为GC患者较差的临床预后标志物之一,其潜在分子机制可能与转录调控调节肿瘤微环境有关。
Objective To investigate the expression of MAML1 and its relationship with clinical characteristics, prognosis and the efficiency of immunotherapy in patients with GC. Methods MAML1 expression profile was observed by TCGA database. Kaplan-Meier survival analysis was applied to evaluate the correlation between the expression of MAML1 and clinical characteristics, prognosis and treatment efficiency of patients in GSE15459 dataset. MAML1-associated genes were predicted by STRING and were enriched in GO and KEGG by FUNRICH software. The relationship between MAML1 expression and markers of tumor infiltrated cells were explored by TIMER and GEPIA database. Results MAML1 was abnormally upregulated in GC tissues compared to normal gastric tissues (P<0.001). MAML1 expression was significantly associated with the overall survival of patients in stage III, with lymph node metastasis and without distant metastasis (P<0.001). There was no significant difference between MAML1 expression and the overall survival of patients in stage I, II, IV, without lymph node metastasis and with distant metastasis (P>0.05). MAML1-assoicated genes were mainly located at the nucleus, mediating transcriptional regulation and mainly enriching in androgen receptor, C-MYB transcription factor and HIF-2α transcription regulation and other related signaling pathways. MAML1 expression was positively related with the expression of B cell, CD4+ T cell and macrophages (P<0.05), but without significant difference with tumor purity, CD8+ T cell, neutrophils and dendritic cells (P>0.05). Conclusions MAML1 could be used as a marker of clinical prognosis of patients with GC. The potential molecular mechanism might be associated with its function in transcriptional regulation and changes in tumor microenvironment.
论著

数字乳腺三维断层融合摄影技术联合MR波谱在乳腺高危病灶诊断中的应用

Application of digital breast tomosynthesis combined with MR wave in the diagnosis of high-risk breast lesions

:52-55
 
目的 探究数字乳腺三维断层融合摄影技术(DBT)联合MR波谱在乳腺高危病灶诊断中的应用。方法 选取2020年6月—2021年6月来我院进行乳腺钼靶X线摄影并诊断为BI-RADS 4级及以上的100例乳腺高危病灶患者为研究对象,对入选患者行MR波谱及DBT检查,分析MR波谱征象及DBT乳腺病变摄影特征,以病理结果为标准,评价MR波谱与DBT及两者联用对乳腺高危病灶的诊断疗效。结果 DBT敏感度、特异度、阳性预测值、阴性预测值均高于MR波谱;DBT漏诊率、误诊率均低于MR波谱漏诊率、误诊率,2组诊断方法比较(P<0.05)。MR波谱及DBT对≥2 cm恶性病变的病理诊断结果符合率比较,差异均无统计学意义(P>0.05)。MR波谱及DBT对乳腺良性病变、恶性病变<2 cm诊断结果符合率比较,DBT对乳腺高危患者的病理诊断结果符合率高于MR波谱(P<0.05)。结论 乳腺高危病灶诊断中选择DBT可对乳腺高危病灶诊断中做出准确的分析和判断,对乳腺高危病灶诊断更具有应用价值,值得临床采纳。
Objective To explore the application of digital breast tomosynthesis (DBT) combined with MR wave in the diagnosis of high-risk breast lesions. Methods A total of 100 patients with breast high-risk lesions diagnosed as BI-RADS 4 or above by mammography in our hospital from June 2020 to June 2021 were selected as the research objects. The selected patients were examined by MR spectrum and DBT. The signs of MR spectrum and the photographic characteristics of DBT breast lesions were analyzed. Based on the pathological results, the diagnostic efficacy of MR spectrum, DBT and their combination in the diagnosis of breast high-risk lesions was evaluated. Results The sensitivity, specificity, positive predictive value and negative predictive value of DBT were higher than those of MR spectrum; the missed diagnosis rate and misdiagnosis rate of DBT were lower than those of MR spectrum (P<0.05). There was no significant difference in the coincidence rate of MR spectrum and DBT in the pathological diagnosis of malignant lesions ≥ 2 cm (P>0.05). The coincidence rate of MR spectrum and DBT in the diagnosis of benign and malignant breast lesions<2 cm was higher than that of MR spectrum (P<0.05). Conclusions Selecting DBT in the diagnosis of breast high-risk lesions can make accurate analysis and judgment in the diagnosis of breast high-risk lesions. It has higher application value in the diagnosis of breast high-risk lesions and is worthy of clinical adoption.
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