scholarly journals The Clinical Value of the Combined Detection of Enhanced CT, MRI, CEA, and CA199 in the Diagnosis of Rectal Cancer

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Cuijuan Hao ◽  
Yanbin Sui ◽  
Jian Li ◽  
Yunxia Shi ◽  
Zhenxing Zou
Keyword(s):  
Rectal Cancer ◽  
Preoperative Staging ◽  
Clinical Staging ◽  
Control Group ◽  
Clinical Value ◽  
Enhanced Ct ◽  
Malignant Group ◽  
Mri Scans ◽  
Serum Cea ◽  
Combined Detection

Background. To explore the clinical value of enhanced computed tomography (enhanced CT), magnetic resonance imaging (MRI), carcinoembryonic antigen (CEA), and cancer antigen 199 (CA199) in the diagnosis of rectal cancer (RC). Methods. A total of 156 patients with RC confirmed by postoperative pathology admitted to the Affiliated Yantai Yuhuangding Hospital of Qingdao University from March 2018 to November 2020 were included in the malignant group, and 52 patients with chronic proctitis in the benign control group. All patients underwent preoperative enhanced CT, MRI scans, and serum CEA and CA199 tests. The accuracy, sensitivity, and specificity of single and combined enhanced CT, MRI, CEA, and CA199 tests for the clinical staging of RC were calculated. Results. The postoperative pathological diagnosis showed that 35 cases of 156 RC patients were at T1 stage, 29 cases were at T2 stage, 24 cases were at T3 stage, 11 cases were at T4 stage, 23 cases were at N0 stage, 21 cases were at N1 stage, 8 cases were at N2 stage, 3 cases were at M0 stage, and 2 cases were at M1 stage. The positive rate of MRI in the diagnosis of RC was higher than that of enhanced CT. Serum CEA and CA199 levels in the malignant group were significantly increased compared with the benign group. The sensitivity, specificity, and accuracy of the combined detection were significantly higher than those of the single detection. Conclusion. Compared with enhanced CT, MRI has a higher detection rate of T and N stage in patients with RC. Combined enhanced CT, MRI, CEA, and CA199 can provide more accurate diagnosis and preoperative staging of RC patients.

A nomogram based on clinical factors to predict locally advanced stage of rectal cancer.

2013 ◽  
Vol 31 (4_suppl) ◽  
pp. 376-376
Author(s):  
Guoxiang Cai ◽  
Baorong Song ◽  
Liyong Huang ◽  
Ye Xu ◽  
Zuqing Guan ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Neoadjuvant Therapy ◽  
Locally Advanced ◽  
Preoperative Staging ◽  
Advanced Rectal Cancer ◽  
Locally Advanced Rectal Cancer ◽  
Neoadjuvant Radiochemotherapy ◽  
Advanced Stage ◽  
Serum Cea ◽  
Magnetic Resonance Imaging Mri

376 Background: Preoperative staging of rectal cancer is important for designing treatment strategy. The standard treatment for locally advanced rectal cancer is neoadjuvant radiochemotherapy followed by surgery. Magnetic resonance imaging (MRI) and transrectal ultrasonography are major staging approaches with a prediction accuracy of about 70-80% but not widely available in hospitals in China. We sought to define possible clinicopathological predictors and establish a simple nomogram as a reference tool for patients and clinicians to predict stage of rectal cancer and make decisions about neoadjuvant therapy. Methods: Preoperative staging of rectal cancer is important for designing treatment strategy. The standard treatment for locally advanced rectal cancer is neoadjuvant radiochemotherapy followed by surgery. Magnetic resonance imaging (MRI) and transrectal ultrasonography are major staging approaches with a prediction accuracy of about 70-80% but not widely available in hospitals in China. We sought to define possible clinicopathological predictors and establish a simple nomogram as a reference tool for patients and clinicians to predict stage of rectal cancer and make decisions about neoadjuvant therapy. Results: In the training set, 77.1% of patients had locally advanced stage by pathology. The multivariate analysis indicated that tumor size (Odds ratio (OR)=1.55, p< 0.001), differentiation (OR =0.38, p< 0.001), location (OR =1.06, p=0.038), serum CEA (OR =0.24, p< 0.001) and CA19-9 level (OR =0.13, p< 0.001) were associated with tumor stage. A nomogram consisting of these 5 factors was developed and predicted locally advanced stage with a concordance index of 0.756. The concordance index of this nomogram was 0.800 in the validation set. Conclusions: Large tumor size, far from anal verge, poor differentiation, elevated serum CEA and CA19-9 level were high-risk factors of locally advanced stage of rectal cancer. The nomogram based on these clinical factors can predicte locally advanced rectal cancer with a considerable accuracy and thus helpful for making neoadjuvant therapy recommendations.

scholarly journals Combined Detection of Circulating Tumor Cells, α-fetoprotein Heterogene-3 and α-fetoprotein in the Early Diagnosis of HCC for  the Prediction of Efficacy, Prognosis, Recurrence after Microwave Ablation

2020 ◽  
Author(s):  
Jian Zhou ◽  
Yue Zhu ◽  
Yi Li ◽  
Kun Liu ◽  
Fei He ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Early Diagnosis ◽  
Normal Control ◽  
Microwave Ablation ◽  
Normal Control Group ◽  
Control Group ◽  
Research Subjects ◽  
Clinical Value ◽  
Recurrent Group ◽  
Combined Detection

Abstract Background: Early diagnosis can significantly improve treatment outcomes for HCC patients. Microwave ablation (MWA) is an important treatment for HCC, there's a lack of specific tests for prognosis. This study investigated the predictive value of combined of AFP, AFP-L3, CTCs. Methods: 143 HCC patients as research subjects (HCC group), 102 liver cirrhosis patients as liver cirrhosis group, 127 hepatitis patients as hepatitis group, 110 healthy outpatients as normal control group. The levels of AFP, AFP-L3 and CTCs were detected, and ROC curve was used to analyze the clinical value of the detection with single and combined indicators in HCC diagnosis. Results: Compared with cirrhosis group, hepatitis group and normal control group, the levels of AFP, AFP-L3, CTCs in HCC group were significantly higher. AFP, AFP-L3, CTCs of patients in non-recurrent group, CR+PR group and OS>3 group were significantly lower than the recurrent group, SD+PD group, OS<3 years group. Conclusion: Combined detection of AFP, AFP-L3, CTCs can effectively make up for the shortcomings of the detection with single and pairwise indicators. It can’t only diagnose HCC in early, but also has a high clinical value in predicting the short-term efficacy, prognosis and recurrence of HCC patients after MWA treatment.

scholarly journals Clinical value of miR-135 and miR-20a combined with multi-detector computed tomography in the diagnosis of gastric cancer

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Wenwen Han ◽  
Xiangzhen Bu ◽  
Yanli Liu ◽  
Fang Liu ◽  
Yujie Ren ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Computed Tomography ◽  
Correlation Analysis ◽  
Healthy Control Group ◽  
Control Group ◽  
Clinical Value ◽  
Healthy Control ◽  
Pearson's Correlation ◽  
Combined Detection ◽  
Multi Detector Computed Tomography

Abstract Background To study the clinical value of miR-135 and miR-20a combined with multi-detector computed tomography (MDCT) in the diagnosis of gastric cancer (GC). Method A total of 146 patients with GC admitted to our hospital from January 2017 to June 2019 were selected and enrolled in the GC group. Another 103 patients with gastritis received in the same period were selected for the non-GC group. Besides, 95 healthy subjects who received physical examination in our hospital were selected into the healthy control group. Real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to detect the expression of serum miR-135 and miR-20a for each group. MDCT was used for detecting the clinical staging map of the enrolled patients. Pearson’s correlation analysis was used to analyze the correlation between serum miR-135 and miR-20a in patients with GC. The receiver operating characteristic (ROC) curve was drawn to analyze value of miR-135 and miR-20a in the diagnosis of GC. Results Compared with non-GC group and healthy control group, the levels of serum miR-135 and miR-20a increased significantly in the GC group, while no significant difference was found between non-GC group and healthy control group (P > 0.05). Analysis of the relationship with clinical characteristics showed that the expression of serum miR-135 and miR-20a in the GC group was significantly correlated with the progression of GC, TNM stage, degrees of differentiation, status of lymph node metastasis, and distant metastasis (P < 0.01). Pearson’s correlation analysis results showed positive correlations between miR-135 and miR-20a (r = 0.634, P = 0.000). The ROC analysis results showed that the optimal diagnostic values of miR-135 and miR-20a for GC were 7.56 and 5.82 respectively. The area under the curve (AUC) was 0.873 and 0.793 respectively. The 95% confidence interval (CI) was 0.811-0.935 and 0.697-0.890 respectively. The sensitivity and specificity of miR-135 and miR-20a combined with MDCT in the diagnosis of GC were 90.41% and 93.20% respectively. The sensitivity of combined use was significantly higher than that of single detection (P < 0.01). Conclusion There are high expression levels of serum miR-135 and miR-20a in patients with GC. A combined detection of miR-135 and miR-20a with MDCT can improve the diagnostic sensitivity of GC and improve the accuracy of the final diagnosis. Therefore, multiple combined detection is valuable in the diagnosis of GC.

scholarly journals Clinical Diagnostic Value for Colorectal Cancer Based on Serum CEA, CA24-2 and CA19-9

2020 ◽  
Author(s):  
Hui Rao ◽  
Heming Wu ◽  
Qingyan Huang ◽  
Zhikang Yu ◽  
Qunji Zhang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Tumor Markers ◽  
Diagnostic Value ◽  
Carbohydrate Antigen ◽  
Control Group ◽  
Sensitivity Index ◽  
Depth Of Invasion ◽  
Clinical Value ◽  
Braf Mutations ◽  
Serum Cea

Abstract Background To explore the clinical value of a combined detection of serum concentration of carcinoembryonic antigen (CEA), carbohydrate antigen 24-2 (CA24-2), and carbohydrate antigen 19-9 (CA19-9) for colorectal cancer (CRC). Methods The levels of serum tumor markers (CEA, CA24-2 and CA19-9) and clinical characteristics in patients with colorectal cancer were evaluated. In addition, KRAS/NRAS/PIK3CA/BRAF mutations were detected in some patients with colorectal cancer. Results A total of 2,281 patients were recruited in the study, included 1,578 colorectal cancer patients and 703 controls. The levels of CEA, CA24-2 and CA19-9 in colorectal cancer group was significantly higher than control group. The sensitivities of three individual markers were lower than 30%, which individual sensitivity of the tumor markers sorted in descending order was CEA>CA19-9>CA24-2. The specificities of three individual markers were more than 92%, and the specificity sorted in descending order was CA24-2>CA19-9>CEA. The combination of CEA+CA19-9+CA24-2 ranked the highest in sensitivity index and specificity index for colorectal cancer diagnosis. The prediction equation excluding the risk of colorectal cancer was. Probability (normal) = Exp (-5.47 - 0.28CEA - 0.11 CA242 + 0.001 CA199)/ (1+ Exp (-5.47 - 0.28CEA - 0.11 CA242 + 0.001 CA199)). There were no significant differences in age, gender, histology type, differentiation, depth of invasion and TNM stage between mutations in KRAS/NRAS, BRAF and PIK3CA genes or not, respectively. Conclusions Serum CEA, CA24-2, and CA19-9 are valuable noninvasive indicators for prediction the risk of colorectal cancer. We need to look for other, more sensitive tumor markers.

scholarly journals Clinical Diagnostic Value for Colorectal cancer Based on Serum CEA, CA24-2 and CA19-9

2020 ◽  
Author(s):  
Hui Rao ◽  
Heming Wu ◽  
Qingyan Huang ◽  
Zhikang Yu ◽  
Qunji Zhang ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Tumor Markers ◽  
Diagnostic Value ◽  
Prediction Equation ◽  
Carbohydrate Antigen ◽  
Control Group ◽  
Depth Of Invasion ◽  
Clinical Value ◽  
Braf Mutations ◽  
Serum Cea

Abstract Background To explore the clinical value of a combined detection of serum concentration of carcinoembryonic antigen (CEA), carbohydrate antigen 24-2 (CA24-2), and carbohydrate antigen 19-9 (CA19-9) for colorectal cancer (CRC). Methods The levels of serum tumor markers (CEA, CA24-2 and CA19-9) and clinicopathologic features in patients with colorectal cancer in Meizhou People's Hospital were evaluated. In addition, KRAS/NRAS, PIK3CA and BRAF mutations were detected in some patients with colorectal cancer. Results A total of 2,281 patients (1,420 males and 861 females) were recruited in the study, included 1,578 colorectal cancer patients and 703 controls. The levels of CEA, CA24-2 and CA19-9 in colorectal cancer group was significantly higher than control group. The sensitivities of three individual markers were lower than 30%, which individual sensitivity of the tumor markers sorted in descending order were CEA> CA19-9> CA24-2. The specificities of three individual markers were more than 92%, and the specificity sorted in descending order were CA24-2> CA19-9> CEA. The prediction equation excluding the risk of colorectal cancer was. Probability (normal) = Exp (-5.47 - 0.28CEA - 0.11 CA242 + 0.001 CA199)/ (1+ Exp (-5.47 - 0.28CEA - 0.11 CA242 + 0.001 CA199)). There were no significant differences in age, gender, histology type, differentiation, depth of invasion and TNM stage between mutations in KRAS/NRAS , BRAF and PIK3CA genes or not, respectively. Conclusions Serum CEA, ca24-2, and ca19-9 are valuable noninvasive indicators for the detection and screening of patients with early colon cancer. We need to look for other, more sensitive tumor markers.

scholarly journals Diagnostic Value of CYFRA21-1, CA19-9 and SCCAg Detection in Esophageal Cancer

1970 ◽  
Vol 2 (2) ◽  
Author(s):  
Chunran Du ◽  
Yanming Wang ◽  
Shenyan Hou
Keyword(s):  
Esophageal Cancer ◽  
Predictive Value ◽  
Characteristic Curve ◽  
Diagnostic Value ◽  
Clinical Staging ◽  
Control Group ◽  
Cytokeratin 19 ◽  
Study Group ◽  
Significant Difference ◽  
Combined Detection

Objectives To investigate the value of serum cytokeratin 19 fragment (CYFRA21-1), carbohydrate anti-gen 19-9 (CA19-9) and squamous cell carcinoma antigen (SCCAg) in the diagnosis of esophageal cancer. Methods 100 cases of esophageal cancer (study group) and 50 healthy subjects (control group) were recruited in the study, the serum levels of CYFRA21-1, CA19-9 and SCCAg in these patients were detected. Subgroups analysis was performed in study group by clinical staging, and the diagnostic value of CYFRA21-1, CA19-9 and SCCAg in detecting esophageal cancer was analyzed by receiver operating characteristic curve (ROC). Results The serum levels of CYFRA21-1, CA19-9 and SCCAg in study group were significantly higher than those in control group, and those were significantly lower in patients with stageⅠ-Ⅱ disease than those with stage Ⅲ and Ⅳ disease, indicating statistically significant difference (P<0.01); the sensitivity of serum CYFRA21-1, CA19-9 and SCCAg in the diagnosis of esophageal cancer was 82.26%, and specificity was 91.33%,  with positive predictive value being  86.14%, and negative predictive value being 89.57%, and AUC value was 0.864, the combined detection was superior to each measure utilized alone, the difference was significantly significant (P<0.05). Conclusion The combined detection of serum CYFRA21-1, CA19-9, and SCCAg can significantly improve the diagnostic sensitivity and specificity in detecting the esophageal cancer.

scholarly journals Influence of incorrect staging of colorectal carcinoma on oncological outcome: are we playing safely?

2021 ◽  
Author(s):  
Claudia Reali ◽  
Gabriele Bocca ◽  
Ian Lindsey ◽  
Oliver Jones ◽  
Chris Cunningham ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Neoadjuvant Therapy ◽  
Cancer Patients ◽  
Preoperative Staging ◽  
Neoadjuvant Treatment ◽  
Preoperative Imaging ◽  
Resection Margins ◽  
Colorectal Cancers ◽  
Radiological Staging ◽  
N Stage

AbstractAccurate preoperative staging of colorectal cancers is critical in selecting patients for neoadjuvant therapy prior to resection. Inaccurate staging, particularly understaging, may lead to involved resection margins and poor oncological outcomes. Our aim is to determine preoperative imaging accuracy of colorectal cancers compared to histopathology and define the effect of inaccurate staging on patient selection for neoadjuvant treatment(NT). Staging and treatment were determined for patients undergoing colorectal resections for adenocarcinomas in a single tertiary centre(2016–2020). Data were obtained for 948 patients. The staging was correct for both T and N stage in 19.68% of colon cancer patients. T stage was under-staged in 18.58%. At resection, 23 patients (3.36%) had involved pathological margins; only 7 of which had been predicted by pre-operative staging. However, the staging was correct for both T and N stage in 53.85% of rectal cancer patients. T stage was understaged in 26.89%. Thirteen patients had involved(R1)margins; T4 had been accurately predicted in all of these cases. There was a general trend in understaging both the tumor and lymphonodal involvement (T p < 0.00001 N p < 0.00001) causing a failure in administrating NT in 0.1% of patients with colon tumor, but not with rectal cancer. Preoperative radiological staging tended to understage both colonic and rectal cancers. In colonic tumours this may lead to a misled opportunity to treat with neoadjuvant therapy, resulting in involved margins at resection.

The Clinical Value of Periventricular White Matter Hyperintensity on MRI in Sudden Sensorineural Hearing Loss

2021 ◽  
pp. 000348942110189
Author(s):  
Jung Woo Lee ◽  
Deoksu Kim ◽  
Seokhwan Lee ◽  
Sung-Won Choi ◽  
Soo-Keun Kong ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Multivariate Analysis ◽  
White Matter ◽  
Brain Mri ◽  
Sudden Sensorineural Hearing Loss ◽  
White Matter Hyperintensity ◽  
Control Group ◽  
Periventricular White Matter ◽  
Clinical Value ◽  
Hearing Gain

Objectives: To assess the clinical value of periventricular white matter hyperintensity (PWMH) found on brain magnetic resonance imaging (MRI) in patients with sudden sensorineural hearing loss (SSNHL). Methods: In this prospective study, 115 patients who were diagnosed with SSNHL aged between 55 and 75 years were analyzed. All subjects underwent brain MRI and were divided into a PWMH and control groups, depending on the presence of PWMH on MRI. PWMH was subdivided into 3 groups according to severity. Pure-tone average results and hearing gain were compared between the 2 groups before treatment and 2 months after treatment. Hearing improvement was assessed using Sigel’s criteria. Results: A total of 106 patients (43 in the PWMH group and 63 in the control group) finally completed the 2-month follow-up. Average hearing gain in the PWMH group was significantly higher than in the control group (34.8 ± 20.3 and 25.9 ± 20.3, respectively, P = .029). PWMH score 1 showed significantly better hearing levels and hearing gain compared to PWMH score 3 and the control group. Multivariate analysis revealed that younger age, better initial hearing level, and the presence of PVWM score 1 were associated with good recovery. Conclusions: The presence of PWMH score 1 on brain MRI in patients with SSNHL was associated with better treatment response and was a good prognostic factor in a multivariate analysis while the hearing recovery in more severe PWMH (scores 2, 3) was not different from the control group.

scholarly journals Clinical Value and Time Course of Pericoronary Fat Inflammation in Patients with Angiographically Nonobstructive Coronaries: A Preliminary Report

2021 ◽  
Vol 10 (8) ◽  
pp. 1786
Author(s):  
Valeria Pergola ◽  
Marco Previtero ◽  
Annagrazia Cecere ◽  
Vittorio Storer ◽  
Teresa Castiello ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
Preliminary Report ◽  
Time Course ◽  
Coronary Artery Stenosis ◽  
High Sensitivity ◽  
Control Group ◽  
Clinical Value ◽  
Coronary Ct ◽  
Electrocardiographic Changes ◽  
Acute Event

The introduction of high-sensitivity cardiac troponin allowed identifying a proportion of subjects with chest pain and electrocardiographic changes suggestive of myocardial infarction showing <50% coronary artery stenosis. PFAI is a coronary CT marker proved to predict outcome in ischemic heart disease. Based on CMR findings, patients were divided into myocarditis (n = 15), MINOCA (n = 14) and TTS (n = 9) groups. The aim was to estimate the value of pFAI in these groups compared to 12 controls. To evaluate the coronary inflammation “time course,” 20 patients underwent CMR and coronary CT scan within 8 days from the onset, the others within 60 days. There were higher values of pFAI in myocarditis (−86.45 HU), MINOCA (−84.63 HU) and TTS (−84.79 HU) compared to controls (−96.02 HU; p = 0.0077). Among patients who underwent CT within 8 days from onset, the MINOCA had a significantly higher pFAI value (−76.91 HU) compared to the control group (−96.02 HU; p = 0.0001). In the group that underwent CT later than 8 days, elevated pFAI values persisted only in the myocarditis and TTS groups, and there was no difference between MINOCA and controls. Our study shows that in patients with a diagnosis of MINOCA, there is acute coronary inflammation, which is more evident within one week from the acute event but tends to disappear with time.

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