肝脏局灶性结节增生的CT和MRI诊断价值的比较

目的探讨肝脏局灶性结节增生(FNH)的CT和MRI及诊断价值。方法回顾性分析31例经手术病理证实为肝脏FNH的CT和MR表现,研究其影像的诊断价值。结果31例FNH的CT和MR中21例表现较为典型,CT平扫等密度,T1WI为等信号,T2WI为等信号或稍高信号;部分病灶可见中央区低密度瘢痕,增强动脉期除中央瘢痕外均明显强化,门静脉期常见明显强化,延时期多为等密度,瘢痕可稍有强化;术前作出正确诊断。10例FNH表现不典型,CT低密度灶,T1WI为低信号,T2WI为高信号,无瘢痕和轻度强化;术前5例诊断为恶性肿瘤,5例诊断为血管瘤。而MRI注射特异性造影剂后能正确诊断为FNH。结论FNH的CT和MR表现在术前进行综合分析,多数可明确诊断。对于不典型表现的FNH,MRI对FHN的诊断价值高于CT。     

细针穿刺细胞学报告双侧跟腱黄色瘤一例

目的:探讨跟腱黄色瘤细胞病理组织病理及磁共振成像(MRI)的表现。方法:回顾性分析1例经活检细胞病理组织病理及临床随访证实的跟腱黄色瘤患者的影像资料,患者均行常规T1加权像(T1WI)、T2加权像(T2WI)及压脂成像。结果:细胞病理检查该患者细胞病理见镜下表现含有多量的组织细胞、黄色瘤细胞和少量Touton巨细胞。黄色瘤细胞为组织细胞吞噬类脂质后所形成,细胞质内有多量空泡,也称为泡沫细胞黄色瘤细胞。组织病理也见Touton巨细胞。核磁检查为双侧跟腱对称性肿胀,内部信号以等T1稍短T2信号为主,内见散在的短T1长T2信号;病灶上、下缘与正常结构逐渐延续,与周围脂肪间隙分界清晰。结论:跟腱黄色瘤的细针穿刺细胞病理学检查较组织病理损伤小时效快特点,具有重要诊断价值。     

胰腺癌的磁共振成像诊断意义的分析

目的对使用磁共振成像诊断胰腺癌的价值进行研究。方法对36例胰腺癌患者磁共振成像影像表现进行分析和研究。结果所有36例胰腺癌患者中,34例患者脂肪抑制T1WI呈低信号,2例呈等信号;30例呈T2WI略高信号,6例患者呈等信号。磁共振胆胰管成像表明,28例患者呈胆总管扩张,34例患者出现胰管扩张。结论磁共振成像在胰腺癌的检查和诊断有一定的作用。     

MRI对脊柱原始神经外胚层肿瘤的诊断价值

目的:探讨MRI对脊柱原始神经外胚层肿瘤(PNET)的诊断价值.资料与方法:回顾性分析经手术病理证实的10例脊柱PNET的MRI(magnetic resonance imaging)资料.结果:10例PNET邻近椎体有不同程度的骨质破坏,7例见椎间孔扩大;10例肿块均位于髓外硬膜下,9例T1W I呈等或低信号,1例T1W I呈稍高信号,T2WI呈等、混杂、稍高信号,7例有囊变,10例均见早期明显强化.结论:脊柱PNET具有较为特征性的MRI表现,MRI对PNET的诊断具有重要价值.     

肺炎性假瘤的X线CT表现(附24例分析)

目的回顾分析24例肺炎性假瘤的X线CT表现及其特点,旨在提高X线CT影像的正确认识和鉴别诊断能力。方法本组24病例中全部进行胸部正侧位检查,其中13例进行CT扫描,9例增强。结果24例均为单发病变,病灶最大径在3～7cm之间,平均4cm;表现为椭圆形者14例,其中有5例呈典型的"桃尖征",病灶边缘光滑整齐者7例,显示浅分叶者5例,表现边缘模糊者9例,24例X线胸片上呈均匀密度影,其中CT表现有小点样钙化灶4例,显示有小泡样低密度影者2例,CT增强有强化。结论肺炎性假瘤首先有急性或慢性肺部感染史,而症状轻、X线变化不大,倍增时间过长,是其重要特点。具有典型的"桃尖征"则是比较可靠的影像表现。     

不典型肺转移瘤多形性CT表现

目的分析不典型肺转移瘤的CT表现,提高对本病的认识。方法回顾性分析41例经临床、病理证实的不典型肺转移瘤的CT表现,探讨其与原发肿瘤组织学的关系。结果空洞型转移15例,钙化型转移6例,转移瘤内含气支气管征5例,孤立型转移3例,栗粒型转移3例,具有分叶、毛刺等原发肿瘤特点型转移5例,支气管内膜转移2例,自发性气胸2例。结论肺转移瘤可以表现多种不典型征象,熟悉这些征象对影像诊断和临床治疗有重要意义。     

周围型胆管细胞癌的CT诊断

目的探讨周围型胆管细胞癌的CT表现及诊断价值。方法回顾性分析13例经病理证实的周围型肝内胆管细胞癌的CT平扫及增强表现。结果13例CT平扫均为低密度病灶;动脉期4例未见强化表现,门脉期和延迟期呈渐进性强化;6例动脉期边缘强化,门脉期和延迟期呈渐进性强化;1例动脉期整个瘤体较明显强化,门脉期和延迟期整个瘤体强化减弱;2例表现为病灶周边轻度强化,门脉期和延迟期呈渐进性强化。结论PCC的CT平扫和增强表现对定性诊断有一定帮助。     

早期股骨头坏死影像表现特点及鉴别诊断

目的:分析早期股骨头坏死影像表现特点,为临床鉴别诊断和治疗方案选择提供参照依据.方法:回顾性分析我院2015年1月至6月诊治的62例早期ONFH患者的影像学资料,对X线片、CT及MRI检查的影像表现特点和鉴别诊断情况进行总结.结果:早期ONFH影像检查普遍可见T1WI像线样低信号和T2WI像高信号改变,表现形态各具特点,其中线条样24例(占38.7％),椭圆形19例(占30.6％),地图形10例(占16.1％),楔形9例(占14.5％),在与类股骨头坏死影像表现进行鉴别诊断中,MRI检查应用效果较为理想.结论:合理选用影像学检查手段,掌握早期ONFH影像表现特点,在与类股骨头坏死鉴别诊断中可获得更为准确的诊断结果,保证治疗的及时性和有效性.     

鼻咽癌患者放疗后核磁共振检查的临床研究

目的探讨MRI对鼻咽癌放射治疗后效果评价的价值。方法对50例经病理确诊的鼻咽癌患者,于放射治疗后行MRI复查,对其MRI检查结果进行回顾性分析,并随访1年。结果MRI可清晰的显示鼻咽癌放疗后病灶变化情况,4例患者MRI显示其形态没有出现明显的改变,其余46例患者均出现不同程度的鼻咽部肿块范围缩小。31例患者在放疗后出现病灶区纤维化改变,T1WI为低信号,T2WI多为低信号,也有少量高信号出现。结论MRI检查能准确反应鼻咽癌放射治疗后病灶范围的变化,可以用于放射治疗鼻咽癌的效果评价,对于鼻咽癌治疗方案的制定有重要的参考价值。     

磁共振DWI对早期脑梗死的诊断价值

目的初步探讨弥散加权像(MWI)技术在诊断急性脑梗死中的应用价值。方法收集22例急性脑梗死患者中超急性期(<6h)3例,急性期(6～24h)19例,均行常规T1MI、T2WI及DWI扫描,并比较病变显示的对比度、边界以及范围,计算病灶的ADC值与rADC值。结果①DWI对于显示病灶的对比度、边界以及范围均优于常规T1MI和T2WI;(2)所有22例病灶的ADC值与rADC值均下降。结论磁共振DWI技术对急性脑梗死病变敏感度高,有很高的诊断价值。     

Nickel Sensitivity Is Associated with GH-IGF1 Axis Impairment and Pituitary Abnormalities on MRI in Overweight and Obese Subjects

Nickel (Ni) is a ubiquitous metal, the exposure of which is implied in the development of contact dermatitis (nickel allergic contact dermatitis (Ni-ACD)) and Systemic Ni Allergy Syndrome (SNAS), very common among overweight/obese patients. Preclinical studies have linked Ni exposure to abnormal production/release of Growth Hormone (GH), and we previously found an association between Ni-ACD/SNAS and GH-Insulin-like growth factor 1 (IGF1) axis dysregulation in obese individuals, altogether suggesting a role for this metal as a pituitary disruptor. We herein aimed to directly evaluate the pituitary gland in overweight/obese patients with signs/symptoms suggestive of Ni allergy, exploring the link with GH secretion; 859 subjects with overweight/obesity and suspected of Ni allergy underwent Ni patch tests. Among these, 106 were also suspected of GH deficiency (GHD) and underwent dynamic testing as well as magnetic resonance imaging for routine follow up of benign diseases or following GHD diagnosis. We report that subjects with Ni allergies show a greater GH-IGF1 axis impairment, a higher prevalence of Empty Sella (ES), a reduced pituitary volume and a higher normalized T2 pituitary intensity compared to nonallergic ones. We hypothesize that Ni may be detrimental to the pituitary gland, through increased inflammation, thus contributing to GH-IGF1 axis dysregulation.     

High SPARC Expression Starting from Dysplasia,Associated with Breast Carcinoma,Is Predictive for Bone Metastasis without Enhancement of Plasma Levels

In order to become established in the skeleton, metastatic cells disseminating from the breast carcinoma need to acquire organ-specific traits. There are no effective predictors for who will develop bone metastasis to guide long-term predictive therapy. Our purpose was to individuate events critical for bone colonization to make a molecular classification of breast carcinoma useful for bone-metastasis outcome. In dysplasia adjacent to carcinoma and in pair-matched specimens of bone metastasis we examined SPARC expression and localization as well as Endothelin 1/ET_AR signals by immunohistochemistry, and the evaluation of plasma levels of SPARC by ELISA was also performed. In patients with breast carcinoma metastasizing to bone, SPARC and Endothelin 1/ET_AR axis were highly expressed from dysplasia until bone metastasis, but the SPARC plasma level was as low as that of normal women, in contrast to patients that never develop bone metastasis, suggesting that circulating SPARC was counter adhesive. Altogether, the early identification of SPARC/Endothelin 1/ET_AR in dysplastic lesions would be important to devise therapies preventing metastasis engraftment, since often carcinoma cells spread to distant organs at the time or even before patients present with cancer.     

CA15.3 Serum Concentrations in Older Women with Infiltrating Ductal Carcinomas of the Breast

Breast cancer is currently becoming a disease of the elderly. We have studied the relation between CA 15.3 serum concentrations and clinical-pathological parameters in 69 women with IDC aged over 70 years (76.3 ± 4.2; range: 71–88; median 76). A group of 205 women with the same tumor but aged <70 years (62.8 ± 4.0; range: 55–70; median 63) was also considered for comparison. Tumor size, axillary lymph node involvement, distant metastasis and histological grade were taken account. Serum CA 15.3 was determined by luminescence assay. CA 15.3 serum concentrations ranged between 6 and 85 U/mL (median 22.9 U/mL), and were higher only in patients with greater (qualitative and quantitative; p: 0.041) tumor size. Our results show that in women with IDCs, and aged over 70 years, serum CA 15.3 serum concentrations are associated exclusively with a greater tumor size, being these findings different to those described in women with the same subtype of tumor considered as a whole or with lower age.     

Expression and Prognostic Significance of CD47–SIRPA Macrophage Checkpoint Molecules in Colorectal Cancer

Despite the confirmed anti-cancer effects of T-cell immune checkpoint inhibitors, in colorectal cancer (CRC) they are only effective in a small subset of patients with microsatellite-unstable tumors. Thus, therapeutics targeting other types of CRCs or tumors refractory to T-cell checkpoint inhibitors are desired. The binding of aberrantly expressed CD47 on tumor cells to signal regulatory protein-alpha (SIRPA) on macrophages allows tumor cells to evade immune destruction. Based on these observations, drugs targeting the macrophage checkpoint have been developed with the expectation of anti-cancer effects against T-cell immune checkpoint inhibitor-refractory tumors. In the present study, 269 primary CRCs were evaluated immunohistochemically for CD47, SIRPA, CD68, and CD163 expression to assess their predictive utility and the applicability of CD47–SIRPA axis-modulating drugs. Thirty-five percent of the lesions (95/269) displayed CD47 expression on the cytomembrane of CRC cells. CRCs contained various numbers of tumor-associated immune cells (TAIs) with SIRPA, CD68, or CD163 expression. The log-rank test revealed that patients with CD47-positive CRCs had significantly worse survival than CD47-negative patients. Multivariate Cox hazards regression analysis identified tubular-forming histology (hazard ratio (R) = 0.23), age < 70 years (HR = 0.48), and high SIRPA-positive TAI counts (HR = 0.55) as potential favorable factors. High tumor CD47 expression (HR = 1.75), lymph node metastasis (HR = 2.26), and peritoneal metastasis (HR = 5.80) were cited as potential independent risk factors. Based on our observations, CD47–SIRPA pathway-modulating therapies may be effective in patients with CRC.     

SPATA18 Expression Predicts Favorable Clinical Outcome in Colorectal Cancer

Dysregulation of mitochondrial quality control has been reported to be associated with cancer and degenerative diseases. SPATA18 (spermatogenesis-associated 18, also known as Mieap) encodes a p53-inducible protein that can induce lysosome-like organelles within mitochondria that eliminate oxidized mitochondrial proteins and has tumor suppressor functions in mitochondrial quality control. In the present study, 268 primary colorectal cancers (CRCs) were evaluated immunohistochemically for SPATA18 expression to assess its predictive utility and its association with cellular proliferation activity. Furthermore, the association with p53 immunoreactivity, a surrogate marker for TP53 mutation, was analyzed. Non-neoplastic colonic mucosa showed cytoplasmic SPATA18 expression. Seventy-two percent of the lesions (193/268) displayed high SPATA18 expression in the cytoplasm of CRC cells. Univariate analyses revealed significant associations between SPATA18 expression and tumor size (p < 0.0001), histological differentiation (p = 0.0017), and lymph node metastasis (p = 0.00039). The log-rank test revealed that patients with SPATA18-high CRCs had significantly better survival than SPATA18-low patients (p < 0.0001). Multivariate Cox hazards regression analysis identified tubular-forming histology (hazard ratio [HR] = 0.25), age < 70 years (HR = 0.50), and SPATA18-high (HR = 0.55) as potential favorable factors. Lymph node metastasis (HR = 1.98) and peritoneal metastasis (HR = 5.45) were cited as potential independent risk factors. Cellular proliferation activity was significantly higher in SPATA18-high tumors. However, no significant correlation was detected between SPATA18 expression and p53 immunoreactivity or KRAS/BRAF mutation status. On the basis of our observations, SPATA18 immunohistochemistry can be used in the prognostication of CRC patients.     

气氛和化学组成对高铁煤灰熔融特性的影响机理

采用灰熔点仪、XRD和热力学模拟,研究气氛和化学组成对高铁煤灰熔融特性的影响机理。研究结果表明,灰熔融温度随铁含量、钙含量或硅铝比增加而降低。弱还原气氛下低钙或低硅铝比煤灰熔融存在明显的初始熔融阶段,熔融过程遵循“软化-熔融”机理,而空气气氛下高钙或高硅铝比煤灰熔融过程属于“熔融-溶解”机理。弱还原气氛下铁含量增加显著促进石英和钙长石熔融,空气气氛下钙含量增加促进刚玉和石英熔融或转化为钙基硅铝盐。弱还原气氛下液相含量随硅铝比或铁含量增加而增加,液相黏度随钙含量或铁含量增加而降低,促进熔融传质;空气气氛下低钙或低硅铝比煤灰中铁存在于含铁固溶体,导致液相黏度高或液相含量低,熔融传质受阻。     

气氛和化学组成对高铁煤灰熔融特性的影响机理

采用灰熔点仪、XRD和热力学模拟,研究气氛和化学组成对高铁煤灰熔融特性的影响机理。研究结果表明,灰熔融温度随铁含量、钙含量或硅铝比增加而降低。弱还原气氛下低钙或低硅铝比煤灰熔融存在明显的初始熔融阶段,熔融过程遵循“软化-熔融”机理,而空气气氛下高钙或高硅铝比煤灰熔融过程属于“熔融-溶解”机理。弱还原气氛下铁含量增加显著促进石英和钙长石熔融,空气气氛下钙含量增加促进刚玉和石英熔融或转化为钙基硅铝盐。弱还原气氛下液相含量随硅铝比或铁含量增加而增加,液相黏度随钙含量或铁含量增加而降低,促进熔融传质;空气气氛下低钙或低硅铝比煤灰中铁存在于含铁固溶体,导致液相黏度高或液相含量低,熔融传质受阻。     

KIAA1217 Promotes Epithelial-Mesenchymal Transition and Hepatocellular Carcinoma Metastasis by Interacting with and Activating STAT3

The survival and prognosis of hepatocellular carcinoma (HCC) are poor, mainly due to metastasis. Therefore, insights into the molecular mechanisms underlying HCC invasion and metastasis are urgently needed to develop a more effective antimetastatic therapy. Here, we report that KIAA1217, a functionally unknown macromolecular protein, plays a crucial role in HCC metastasis. KIAA1217 expression was frequently upregulated in HCC cell lines and tissues, and high KIAA1217 expression was closely associated with shorter survival of patients with HCC. Overexpression and knockdown experiments revealed that KIAA1217 significantly promoted cell migration and invasion by inducing epithelial-mesenchymal transition (EMT) in vitro. Consistently, HCC cells overexpressing KIAA1217 exhibited markedly enhanced lung metastasis in vivo. Mechanistically, KIAA1217 enhanced EMT and accordingly promoted HCC metastasis by interacting with and activating JAK1/2 and STAT3. Interestingly, KIAA1217-activated p-STAT3 was retained in the cytoplasm instead of translocating into the nucleus, where p-STAT3 subsequently activated the Notch and Wnt/β-catenin pathways to facilitate EMT induction and HCC metastasis. Collectively, KIAA1217 may function as an adaptor protein or scaffold protein in the cytoplasm and coordinate multiple pathways to promote EMT-induced HCC metastasis, indicating its potential as a therapeutic target for curbing HCC metastasis.     

miR-205-5p Downregulation and ZEB1 Upregulation Characterize the Disseminated Tumor Cells in Patients with Invasive Ductal Breast Cancer

Background: Dissemination of breast cancer (BC) cells through the hematogenous or lymphogenous vessels leads to metastatic disease in one-third of BC patients. Therefore, we investigated the new prognostic features for invasion and metastasis. Methods: We evaluated the expression of miRNAs and epithelial-to-mesenchymal transition (EMT) genes in relation to CDH1/E-cadherin changes in samples from 31 patients with invasive ductal BC including tumor centrum (TU-C), tumor invasive front (TU-IF), lymph node metastasis (LNM), and CD45-depleted blood (CD45-DB). Expression of miRNA and mRNA was quantified by RT-PCR arrays and associations with clinico-pathological characteristics were statistically evaluated by univariate and multivariate analysis. Results: We did not verify CDH1 regulating associations previously described in cell lines. However, we did detect extremely high ZEB1 expression in LNMs from patients with distant metastasis, but without regulation by miR-205-5p. Considering the ZEB1 functions, this overexpression indicates enhancement of metastatic potential of lymphogenously disseminated BC cells. In CD45-DB samples, downregulated miR-205-5p was found in those expressing epithelial and/or mesenchymal markers (CTC+) that could contribute to insusceptibility and survival of hematogenously disseminated BC cells mediated by increased expression of several targets including ZEB1. Conclusions: miR-205-5p and potentially ZEB1 gene are promising candidates for markers of metastatic potential in ductal BC.