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Fan FY, Ding WZ, Liu FY, Cheng ZG, Han ZY, Yu XL, Liang P, Yu J. [Spatial distribution pattern of local tumor progression analysis after microwave ablation of hepatocellular carcinoma based on three-dimensional magnetic resonance imaging]. Zhonghua Gan Zang Bing Za Zhi 2024; 32:208-213. [PMID: 38584101 DOI: 10.3760/cma.j.cn501113-20231123-00219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Objective: To investigate the spatial distribution pattern of local tumor progression (LTP) for hepatocellular carcinoma (HCC) ≤5 cm after microwave ablation. Methods: A retrospective analysis was performed on 169 HCCs with matched MRI before and after ablation from December 2009 to December 2019. A tumor MRI was reconstructed using three-dimensional visualization technology. LTP was classified as contact or non-contact, early or late stage, according to whether LTP was in contact with the edge of the ablation zone and the occurrence time (24 months). The tumor-surrounded area was divided into eight quadrants by using the eight-quadrant map method. An analysis was conducted on the spatial correlation between the quadrant where the ablative margin (AM) safety boundary was located and the quadrant where different types of LTP occurred. The t-test, or rank-sum test, was used for the measurement data. 2-test for count data was used to compare the difference between the two groups. Results: The AM quadrant had a distribution of 54.4% LTP, 64.2% early LTP stage, and 69.1% contact LTP, suggesting this quadrant was much more concentrated than the other quadrants (P < 0.001). Additionally, the AM quadrant had only 15.2% of non-contact type LTP and 17.1% of late LTP, which was not significantly different from the average distribution probability of 12.5% (100/8%) among the eight quadrants (P = 0.667, 0.743). 46.6% of early contact type LTP was located at the ablation needle tip, 25.2% at the body, and 28.1% at the caudal, while the location distribution probabilities of non-early contact LTP were 34.8%, 31.8%, and 33.3%, respectively. Conclusion: LTP mostly occurs in areas where the ablation safety boundary is the shortest. However, non-contact LTP and late LTP stages exhibit the feature of uniform distribution. Thus, this type of LPT may result from an inadequate non-ablation safety boundary.
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Affiliation(s)
- F Y Fan
- Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China Chinese PLA Medical School, Beijing 100853, China
| | - W Z Ding
- Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
| | - F Y Liu
- Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China Chinese PLA Medical School, Beijing 100853, China
| | - Z G Cheng
- Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China Chinese PLA Medical School, Beijing 100853, China
| | - Z Y Han
- Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
| | - X L Yu
- Chinese PLA Medical School, Beijing 100853, China
| | - P Liang
- Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China Chinese PLA Medical School, Beijing 100853, China
| | - J Yu
- Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China Chinese PLA Medical School, Beijing 100853, China
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Wang WJ, Xia B, Dong YM, He PP, Cheng ZW, Ma FQ, Wang CH, Liu FY, Hu WM, Wang FP, Zhao YF, Li HZ, Fu JL. [Correlation analysis between Pirani score and talo-navicular angle,calcaneo-cuboid angle and tibio-calcaneall angle of infant clubfoot under ultrasound]. Zhonghua Wai Ke Za Zhi 2024; 62:210-215. [PMID: 38291636 DOI: 10.3760/cma.j.cn112139-20230712-00005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
Objective: To explore the evaluation effect of ultrasonography and Pirani score on tarsal deformity, treatment effect and pseudo-correction of congenital clubfoot in infants and young children, and the correlation between the two methods. Methods: This is a retrospective case series study. The clinical data of 26 children (40 feet) with congenital clubfoot who were evaluated by ultrasonography in the Third Affiliated Hospital of Zhengzhou University from January 2020 to January 2023 were retrospectively collected. There were 16 males and 10 females. The age at the first ultrasound examination was (M(IQR)) 9.0 (18.0) days (range: 1 to 46 days). All patients were treated with Ponseti method by the same physician. The Pirani scores before and after treatment and at the last examination, and the talonavicular angle, calcaneocuboid angle and tibiocalcaneal angle measured by ultrasound were collected, and the treatment and follow-up were recorded. Paired sample t test, repeated measures analysis of variance or Kruskal-Wallis test were used for data comparison, and Spearman correlation analysis was used for correlation analysis. The receiver operating characteristic curve was used to calculate the efficacy of ultrasound in evaluating different Pirani scores. Results: The number of plaster fixation in 26 children was 4.0 (1.0) times (range: 2 to 8 times). The medial talonavicular angle and posterior tibiocalcaneal angle were significantly improved after treatment and at the last follow-up compared with those before treatment, and the differences were statistically significant (all P<0.01). There was no difference in lateral calcaneocuboid angle before and after treatment and at the last follow-up (F=1.971, P>0.05). Pseudo-correction occurred in 2 cases (2 feet) during the treatment, with an incidence of 5%. Correlation analysis showed that there was a moderate positive correlation between talonavicular angle and Pirani midfoot score (r=0.480, P<0.01). There was no correlation between calcaneocuboid angle and Pirani midfoot score (r=0.114, P=0.105). There was a moderate negative correlation between tibial heel angle and Pirani hindfoot score (r=-0.566, P<0.01). The cut-off point of Pirani midfoot score of 1.5 was 38.78°, the sensitivity was 0.90, the specificity was 0.56, and the area under the curve was 0.75. The cut-off value of angle was 27.51 °, the sensitivity was 0.16, the specificity was 0.92, and the area under the curve was 0.44.The cut-off points of Pirani midfoot score of 3.0 were 45.08°and 9.96°, the sensitivity was 0.94 and 0.91, the specificity was 0.37 and 0.42, and the area under the curve was 0.59 and 0.62, respectively. The cut-off values of Pirani hindfoot score of 2.0 and 3.0 were 167.46° and 160.15°, respectively. The sensitivity was 0.75 and 0.67, the specificity was 0.81 and 0.83, and the area under the curve was 0.78 and 0.71, respectively. Conclusion: Ultrasound can complement with Pirani score, visually and dynamically observe the morphology and position changes of talonavicular joint, calcaneocuboid joint and tibiotalocalcaneal joint, monitor the recovery and pseudo-correction of tarsal bones, and better evaluate the therapeutic effect.
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Affiliation(s)
- W J Wang
- Orthopaedic Department, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - B Xia
- Orthopaedic Department, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Y M Dong
- Emergency Department, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - P P He
- Department of Ultrasound,the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Z W Cheng
- Medical Record Department, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - F Q Ma
- Orthopaedic Department, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - C H Wang
- Department of Ultrasound,the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - F Y Liu
- Orthopaedic Department, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - W M Hu
- Orthopaedic Department, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - F P Wang
- Orthopaedic Department, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Y F Zhao
- Orthopaedic Department, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - H Z Li
- Department of Ultrasound,the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - J L Fu
- Orthopaedic Department, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
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Pang C, Li JM, Wang Z, Luo YC, Cheng ZG, Han ZY, Liu FY, Yu XL, Liang F, Xi HQ, Zheng RQ, Cheng W, Wei Q, Yu SY, Li QY, He GZ, Yu J, Liang P. Age-Dependent Female Survival Advantage in Hepatocellular Carcinoma: A Multicenter Cohort Study. Clin Gastroenterol Hepatol 2024; 22:305-314. [PMID: 37659766 DOI: 10.1016/j.cgh.2023.07.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 07/17/2023] [Accepted: 07/25/2023] [Indexed: 09/04/2023]
Abstract
BACKGROUND & AIMS Hepatocellular carcinoma (HCC) has a higher incidence in males, but the association of sex with survival remains controversial. This study aimed to examine the effect of sex on HCC survival and its association with age. METHODS Among 33,238 patients with HCC from 12 Chinese tertiary hospitals, 4175 patients who underwent curative-intent hepatectomy or ablation were analyzed. Cancer-specific survival (CSS) was analyzed using Cox regression and Kaplan-Meier methods. Two propensity score methods and multiple mediation analysis were applied to mitigate confounding. To explore the effect of estrogen, a candidate sex-specific factor that changes with age, female participants' history of estrogen use, and survival were analyzed. RESULTS There were 3321 males and 854 females included. A sex-related disparity of CSS was present and showed a typical age-dependent pattern: a female survival advantage over males appeared at the perimenopausal age of 45 to 54 years (hazard risk [HR], 0.77; 5-year CSS, 85.7% vs 70.6%; P = .018), peaked at the early postmenopausal age of 55 to 59 years (HR, 0.57; 5-year CSS, 89.8% vs 73.5%; P = .015), and was not present in the premenopausal (<45 y) and late postmenopausal groups (≥60 y). Consistent patterns were observed in patients after either ablation or hepatectomy. These results were sustained with propensity score analyses. Confounding or mediation effects accounted for only 19.5% of sex survival disparity. Female estrogen users had significantly longer CSS than nonusers (HR, 0.74; 5-year CSS, 79.6% vs 72.5%; P = .038). CONCLUSIONS A female survival advantage in HCC depends on age, and this may be associated with age-dependent, sex-specific factors.
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Affiliation(s)
- Chuan Pang
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China; Department of General Surgery, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Jian-Ming Li
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Zhen Wang
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Yan-Chun Luo
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Zhi-Gang Cheng
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Zhi-Yu Han
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Fang-Yi Liu
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Xiao-Ling Yu
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Feng Liang
- Department of General Surgery, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Hong-Qing Xi
- Department of General Surgery, First Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Rong-Qin Zheng
- Department of Medical Ultrasound, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Wen Cheng
- Department of Ultrasound, Harbin Medical University Cancer Hospital, Harbin City, China
| | - Qiang Wei
- Department of Ultrasound, The Second Hospital of Nanjing, Nanjing, China
| | - Song-Yuan Yu
- Department of Wuhan University of Science and Technology, Tianyou Hospital, Wuhan, China
| | - Qin-Ying Li
- Department of Ultrasound, Puyang Hospital of Traditional Chinese Medicine of Henan Province, Puyang, China
| | - Guang-Zhi He
- Department of Ultrasound, University of Chinese Academy of Sciences Shenzhen Hospital, Shenzhen, China
| | - Jie Yu
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.
| | - Ping Liang
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China.
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Wang L, Li X, Dong XJ, Yu XL, Zhang J, Cheng ZG, Han ZY, Liu FY, Yu J, Liang P. Dendritic cell-cytokine killer combined with microwave ablation reduced recurrence for hepatocellular carcinoma compared to ablation alone. Technol Health Care 2024:THC230871. [PMID: 38393935 DOI: 10.3233/thc-230871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
BACKGROUND Several international practice guidelines have recommended local ablation as the first-line treatment for early-stage hepatocellular carcinoma (HCC). OBJECTIVE This study aims to investigate the synergetic anti-tumor impact of dendritic cell-cytokine killer (DC-CIK) combined with microwave ablation (MWA) for HCC. METHODS This retrospective study included 1,141 patients from the American Joint Committee on Cancer stage I-II HCC, who were treated with therapeutic MWA. The immunotherapy group encompassing 40 patients received additional immunotherapy with DC-CIK, whereas the control group consisting of 1,101 patients was treated with MWA alone. Propensity score matching (PSM) with ratio of 1:3 was employed to balance selection bias. The oncological outcome and immune status were measured after combination therapy. RESULTS The immunotherapy group patients exhibited significant longer disease-free survival (DFS, primary HCC: p= 0.036; recurrent HCC: p= 0.026). For patients with primary HCC, the recurrence frequency was reduced (p= 0.002), and recurrence interval (19 months vs. 9 months, p< 0.001) was prolonged in the immunotherapy group. Subgroup analysis revealed that patients ⩽ 60 years old, moderately-differentiated HCC, or co-infected with Hepatitis B Virus (HBV) had a significant benefit over DFS in the immunotherapy group. After combination therapy, the serum CD3+ (p= 0.049), CD8/CD28+ (p= 0.045) were elevated. CONCLUSION Combination therapy with DC-CIK and MWA can significantly reduce the recurrence and prolong DFS, especially for patients ⩽ 60 years old or with moderately-differentiated HCC or co-infected with HBV.
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Affiliation(s)
- Luo Wang
- School of Medicine, Nankai University, Tianjin, China
| | - Xin Li
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xue-Juan Dong
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xiao-Ling Yu
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Jing Zhang
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Zhi-Gang Cheng
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Zhi-Yu Han
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Fang-Yi Liu
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Jie Yu
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Ping Liang
- School of Medicine, Nankai University, Tianjin, China
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
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Cai Q, Qian TG, Zhao QY, Feng SY, Yang Q, Luo YC, Dai YQ, Liang P, Yu XL, Liu FY, Han ZY, Du QW, Li X, Yu J. Percutaneous microwave ablation versus sclerotherapy for large hepatic hemangioma: a multi-center cohort study. Int J Hyperthermia 2024; 41:2285705. [PMID: 38269491 DOI: 10.1080/02656736.2023.2285705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 11/15/2023] [Indexed: 01/26/2024] Open
Abstract
OBJECTIVE The study aimed to compare the effectiveness and safety of ultrasound-guided microwave ablation (MWA) and percutaneous sclerotherapy (PS) for the treatment of large hepatic hemangioma (LHH). METHODS This retrospective study included 96 patients who underwent MWA (n = 54) and PS (n = 42) as first-line treatment for LHH in three tertiary hospitals from January 2016 to December 2021. Primary outcomes were technique efficacy rate (volume reduction rate [VRR] > 50% at 12 months), symptom relief rate at 12 months and local tumor progression (LTP). Secondary outcomes included procedure time, major complications, treatment sessions, cost and one-, two-, three-year VRR. RESULTS During a median follow-up of 36 months, the MWA group showed a higher technique efficacy rate (100% vs. 90.4%, p = .018) and symptom relief rate (100% vs. 80%, p = .123) than the PS group. The MWA group had fewer treatment sessions, higher one-, two- and three-year VRR, lower LTP rate (all p < .05), longer procedure time and higher treatment costs than the PS group (both p < .001). MWA shared a comparable major complications rate (1.8% vs. 2.4%, p = .432) with PS. After multivariate analysis, the lesion's heterogeneity and maximum diameter >8.1 cm were independent risk factors for LTP (all p < .05). In the PS group, lesions with a cumulative dose of bleomycin > 0.115 mg/cm3 had a lower risk of LTP (p = .006). CONCLUSIONS Both MWA and PS treatments for large hepatic hemangioma are safe and effective, with MWA being superior in terms of efficacy.
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Affiliation(s)
- Qian Cai
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital & Chinese PLA Medical College, Beijing, China
| | - Tong-Gang Qian
- Department of Ultrasound, Zunhua People's Hospital, Zunhua, China
| | - Qi-Yu Zhao
- Department of Ultrasound, Zhejiang University School of Medicine & the First Hospital of Zhejiang Province, Hangzhou, China
| | - Shun-You Feng
- Department of Ultrasound, Zunhua People's Hospital, Zunhua, China
| | - Qiao Yang
- Department of Ultrasound, Zunhua People's Hospital, Zunhua, China
| | - Yan-Chun Luo
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital & Chinese PLA Medical College, Beijing, China
| | - Yu-Qing Dai
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital & Chinese PLA Medical College, Beijing, China
| | - Ping Liang
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital & Chinese PLA Medical College, Beijing, China
| | - Xiao-Ling Yu
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital & Chinese PLA Medical College, Beijing, China
| | - Fang-Yi Liu
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital & Chinese PLA Medical College, Beijing, China
| | - Zhi-Yu Han
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital & Chinese PLA Medical College, Beijing, China
| | - Qiao-Wei Du
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital & Chinese PLA Medical College, Beijing, China
| | - Xin Li
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital & Chinese PLA Medical College, Beijing, China
| | - Jie Yu
- Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital & Chinese PLA Medical College, Beijing, China
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Guo MH, Dou JP, Zheng L, Liu FY, Yu J, Cheng ZG, Yu XL, Che Y, Wang SR, Cong ZB, Bai N, Liu C, Hao Y, Yu MA, Xu ZF, Han ZY, Liang P, Chen L. Ultrasound-guided microwave ablation versus surgery for solitary T1bN0M0 papillary thyroid carcinoma: a prospective multicenter study. Eur Radiol 2024; 34:569-578. [PMID: 37548692 DOI: 10.1007/s00330-023-09908-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 03/24/2023] [Accepted: 05/02/2023] [Indexed: 08/08/2023]
Abstract
OBJECTIVE Microwave ablation (MWA) has emerged as a minimally invasive technology for papillary thyroid microcarcinoma (PTMC), but it has not been widely applied to treat T1bN0M0 PTC with high-level evidence. This study was designed to compare the real-world efficacy and safety of MWA or surgery for treating T1bN0M0 PTC. METHODS From December 2019 to April 2021, 123 continuous unifocal T1bN0M0 PTC patients without lymph node metastasis (LNM) or distant metastasis (DM) were included from 10 hospitals. Patients were allocated into the MWA or surgery group based on their willingness. The main outcomes were local tumour progression (LTP), new thyroid cancer, LNM, and DM. The secondary outcomes included changes in tumour size and volume, complications, and cosmetic results. Subgroup analyses were conducted to identify influencing factors. RESULTS Fifty-two patients chose MWA, and 71 patients chose surgery. Patients had similar demographic information and tumour characteristics in the two groups. The follow-up durations after MWA and surgery were 10.6 ± 4.2 and 10.4 ± 3.4 months, respectively. The LNM rate was 5.8% in the MWA group and 1.4% in the surgery group (p = 0.177). No LTP, new thyroid cancer, or distant metastasis (DM) occurred in either group. Five (9.6%) of the 52 patients in the MWA group and 8 (11.3%) of the 71 patients in the surgery group had complications (p = 0.27). Better cosmetic results were found in the MWA group (p < 0.01). CONCLUSION MWA achieved comparable short-term treatment efficacy with surgery. MWA might be an optional choice for surgery for low-risk T1bN0M0 PTC but concerns about LNM need to be studied further. CLINICAL RELEVANCE STATEMENT MWA achieved comparable short-time treatment efficacy with surgery. MWA might be an optional choice for surgery for low-risk T1bN0M0 PTC. KEY POINTS • MWA achieved comparable short-term treatment efficacy with surgery. MWA might be an optional choice for surgery for low-risk T1bN0M0 PTC but concerns about LNM need to be studied further. • The complication rate in the surgery group was higher than that in the MWA group without a significant difference. • There was no statistically significant difference in the LNM rate between the MWA and surgery groups.
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Affiliation(s)
- Mo-Han Guo
- Department of Otolaryngology-Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
| | - Jian-Ping Dou
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Lin Zheng
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Fang-Yi Liu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Jie Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Zhi-Gang Cheng
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Xiao-Ling Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Ying Che
- Department of Ultrasound, the First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Shu-Rong Wang
- Department of Medical Ultrasound, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China
| | - Zhi-Bin Cong
- Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China
| | - Nan Bai
- Department of Surgery, Beijing Jishuitan Hospital, Beijing, China
| | - Cun Liu
- Department of Ultrasound, Jinan Central Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Ying Hao
- Department of Ultrasound, Mudanjiang Tumor Hospital, Mudanjiang, China
| | - Ming-An Yu
- Department of Interventional Ultrasound Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Zhi-Feng Xu
- First Department of Surgery, Hebei Hospital of Traditional Chinese Medicine, Shijiazhuang, China
| | - Zhi-Yu Han
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Ping Liang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China.
| | - Lei Chen
- Department of Otolaryngology-Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China.
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Xiao F, Li JM, Han ZY, Liu FY, Yu J, Xie MX, Zhou P, Liang L, Zhou GM, Che Y, Wang SR, Liu C, Cong ZB, Liang P. Multimodality US versus Thyroid Imaging Reporting and Data System Criteria in Recommending Fine-Needle Aspiration of Thyroid Nodules. Radiology 2023; 307:e221408. [PMID: 37367448 DOI: 10.1148/radiol.221408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
Background Current guidelines recommend the use of conventional US for risk stratification and management of thyroid nodules. However, fine-needle aspiration (FNA) is often recommended in benign nodules. Purpose To compare the diagnostic performance of multimodality US (including conventional US, strain elastography, and contrast-enhanced US [CEUS]) with the American College of Radiology Thyroid Imaging Reporting and Data System (TI-RADS) in the recommendation of FNA for thyroid nodules to reduce unnecessary biopsies. Materials and Methods In this prospective study, 445 consecutive participants with thyroid nodules from nine tertiary referral hospitals were recruited between October 2020 and May 2021. With univariable and multivariable logistic regression, the prediction models incorporating sonographic features, evaluated with interobserver agreement, were constructed and internally validated with bootstrap resampling technique. In addition, discrimination, calibration, and decision curve analysis were performed. Results A total of 434 thyroid nodules confirmed at pathologic analysis (259 malignant thyroid nodules) in 434 participants (mean age, 45 years ± 12 [SD]; 307 female participants) were included. Four multivariable models incorporated participant age, nodule features at US (proportion of cystic components, echogenicity, margin, shape, punctate echogenic foci), elastography features (stiffness), and CEUS features (blood volume). In recommending FNA in thyroid nodules, the highest area under the receiver operating characteristic curve (AUC) was 0.85 (95% CI: 0.81, 0.89) for the multimodality US model, and the lowest AUC was 0.63 (95% CI: 0.59, 0.68) for TI-RADS (P < .001). At the 50% risk threshold, 31% (95% CI: 26, 38) of FNA procedures could be avoided with multimodality US compared with 15% (95% CI: 12, 19) with TI-RADS (P < .001). Conclusion Multimodality US had better performance in recommending FNA to avoid unnecessary biopsies than the TI-RADS. Clinical trial registration no. NCT04574258 © RSNA, 2023 Supplemental material is available for this article.
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Affiliation(s)
- Fan Xiao
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (F.X., J.M.L., Z.Y.H., F.Y.L., J.Y., P.L.); Department of Cadet Corps, Chinese PLA Medical School, Beijing, China (F.X.); Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (M.X.X.); Department of Ultrasound, Third Xiangya Hospital, Central South University, Hunan, China (P.Z.); Department of Ultrasound, Aero-space Center Hospital, Beijing, China (L.L.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (G.M.Z.); Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W.); Department of Ultrasound, Jinan Central Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China (C.L.); and Department of Ultrasound, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China (Z.B.C.)
| | - Jian-Ming Li
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (F.X., J.M.L., Z.Y.H., F.Y.L., J.Y., P.L.); Department of Cadet Corps, Chinese PLA Medical School, Beijing, China (F.X.); Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (M.X.X.); Department of Ultrasound, Third Xiangya Hospital, Central South University, Hunan, China (P.Z.); Department of Ultrasound, Aero-space Center Hospital, Beijing, China (L.L.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (G.M.Z.); Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W.); Department of Ultrasound, Jinan Central Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China (C.L.); and Department of Ultrasound, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China (Z.B.C.)
| | - Zhi-Yu Han
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (F.X., J.M.L., Z.Y.H., F.Y.L., J.Y., P.L.); Department of Cadet Corps, Chinese PLA Medical School, Beijing, China (F.X.); Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (M.X.X.); Department of Ultrasound, Third Xiangya Hospital, Central South University, Hunan, China (P.Z.); Department of Ultrasound, Aero-space Center Hospital, Beijing, China (L.L.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (G.M.Z.); Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W.); Department of Ultrasound, Jinan Central Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China (C.L.); and Department of Ultrasound, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China (Z.B.C.)
| | - Fang-Yi Liu
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (F.X., J.M.L., Z.Y.H., F.Y.L., J.Y., P.L.); Department of Cadet Corps, Chinese PLA Medical School, Beijing, China (F.X.); Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (M.X.X.); Department of Ultrasound, Third Xiangya Hospital, Central South University, Hunan, China (P.Z.); Department of Ultrasound, Aero-space Center Hospital, Beijing, China (L.L.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (G.M.Z.); Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W.); Department of Ultrasound, Jinan Central Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China (C.L.); and Department of Ultrasound, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China (Z.B.C.)
| | - Jie Yu
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (F.X., J.M.L., Z.Y.H., F.Y.L., J.Y., P.L.); Department of Cadet Corps, Chinese PLA Medical School, Beijing, China (F.X.); Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (M.X.X.); Department of Ultrasound, Third Xiangya Hospital, Central South University, Hunan, China (P.Z.); Department of Ultrasound, Aero-space Center Hospital, Beijing, China (L.L.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (G.M.Z.); Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W.); Department of Ultrasound, Jinan Central Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China (C.L.); and Department of Ultrasound, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China (Z.B.C.)
| | - Ming-Xing Xie
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (F.X., J.M.L., Z.Y.H., F.Y.L., J.Y., P.L.); Department of Cadet Corps, Chinese PLA Medical School, Beijing, China (F.X.); Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (M.X.X.); Department of Ultrasound, Third Xiangya Hospital, Central South University, Hunan, China (P.Z.); Department of Ultrasound, Aero-space Center Hospital, Beijing, China (L.L.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (G.M.Z.); Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W.); Department of Ultrasound, Jinan Central Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China (C.L.); and Department of Ultrasound, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China (Z.B.C.)
| | - Ping Zhou
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (F.X., J.M.L., Z.Y.H., F.Y.L., J.Y., P.L.); Department of Cadet Corps, Chinese PLA Medical School, Beijing, China (F.X.); Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (M.X.X.); Department of Ultrasound, Third Xiangya Hospital, Central South University, Hunan, China (P.Z.); Department of Ultrasound, Aero-space Center Hospital, Beijing, China (L.L.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (G.M.Z.); Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W.); Department of Ultrasound, Jinan Central Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China (C.L.); and Department of Ultrasound, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China (Z.B.C.)
| | - Lei Liang
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (F.X., J.M.L., Z.Y.H., F.Y.L., J.Y., P.L.); Department of Cadet Corps, Chinese PLA Medical School, Beijing, China (F.X.); Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (M.X.X.); Department of Ultrasound, Third Xiangya Hospital, Central South University, Hunan, China (P.Z.); Department of Ultrasound, Aero-space Center Hospital, Beijing, China (L.L.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (G.M.Z.); Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W.); Department of Ultrasound, Jinan Central Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China (C.L.); and Department of Ultrasound, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China (Z.B.C.)
| | - Gui-Ming Zhou
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (F.X., J.M.L., Z.Y.H., F.Y.L., J.Y., P.L.); Department of Cadet Corps, Chinese PLA Medical School, Beijing, China (F.X.); Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (M.X.X.); Department of Ultrasound, Third Xiangya Hospital, Central South University, Hunan, China (P.Z.); Department of Ultrasound, Aero-space Center Hospital, Beijing, China (L.L.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (G.M.Z.); Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W.); Department of Ultrasound, Jinan Central Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China (C.L.); and Department of Ultrasound, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China (Z.B.C.)
| | - Ying Che
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (F.X., J.M.L., Z.Y.H., F.Y.L., J.Y., P.L.); Department of Cadet Corps, Chinese PLA Medical School, Beijing, China (F.X.); Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (M.X.X.); Department of Ultrasound, Third Xiangya Hospital, Central South University, Hunan, China (P.Z.); Department of Ultrasound, Aero-space Center Hospital, Beijing, China (L.L.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (G.M.Z.); Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W.); Department of Ultrasound, Jinan Central Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China (C.L.); and Department of Ultrasound, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China (Z.B.C.)
| | - Shu-Rong Wang
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (F.X., J.M.L., Z.Y.H., F.Y.L., J.Y., P.L.); Department of Cadet Corps, Chinese PLA Medical School, Beijing, China (F.X.); Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (M.X.X.); Department of Ultrasound, Third Xiangya Hospital, Central South University, Hunan, China (P.Z.); Department of Ultrasound, Aero-space Center Hospital, Beijing, China (L.L.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (G.M.Z.); Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W.); Department of Ultrasound, Jinan Central Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China (C.L.); and Department of Ultrasound, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China (Z.B.C.)
| | - Cun Liu
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (F.X., J.M.L., Z.Y.H., F.Y.L., J.Y., P.L.); Department of Cadet Corps, Chinese PLA Medical School, Beijing, China (F.X.); Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (M.X.X.); Department of Ultrasound, Third Xiangya Hospital, Central South University, Hunan, China (P.Z.); Department of Ultrasound, Aero-space Center Hospital, Beijing, China (L.L.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (G.M.Z.); Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W.); Department of Ultrasound, Jinan Central Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China (C.L.); and Department of Ultrasound, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China (Z.B.C.)
| | - Zhi-Bin Cong
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (F.X., J.M.L., Z.Y.H., F.Y.L., J.Y., P.L.); Department of Cadet Corps, Chinese PLA Medical School, Beijing, China (F.X.); Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (M.X.X.); Department of Ultrasound, Third Xiangya Hospital, Central South University, Hunan, China (P.Z.); Department of Ultrasound, Aero-space Center Hospital, Beijing, China (L.L.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (G.M.Z.); Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W.); Department of Ultrasound, Jinan Central Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China (C.L.); and Department of Ultrasound, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China (Z.B.C.)
| | - Ping Liang
- From the Department of Interventional Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (F.X., J.M.L., Z.Y.H., F.Y.L., J.Y., P.L.); Department of Cadet Corps, Chinese PLA Medical School, Beijing, China (F.X.); Department of Ultrasound Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (M.X.X.); Department of Ultrasound, Third Xiangya Hospital, Central South University, Hunan, China (P.Z.); Department of Ultrasound, Aero-space Center Hospital, Beijing, China (L.L.); Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China (G.M.Z.); Department of Ultrasound, The First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W.); Department of Ultrasound, Jinan Central Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China (C.L.); and Department of Ultrasound, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China (Z.B.C.)
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Zheng L, Dou JP, Han ZY, Liu FY, Yu J, Cheng ZG, Yu XL, Wang H, Cong ZB, Wang SR, Yu MA, Xu ZF, Che Y, Nan B, Liu C, Hao Y, Wang X, Liu Y, Zhou Y, Liang P. Microwave Ablation for Papillary Thyroid Microcarcinoma with and without US-detected Capsule Invasion: A Multicenter Prospective Cohort Study. Radiology 2023; 307:e220661. [PMID: 36880949 DOI: 10.1148/radiol.220661] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
Background Microwave ablation (MWA) has achieved favorable results in the treatment of papillary thyroid microcarcinoma (PTMC) confined in glandular parenchyma. However, studies on the outcome of MWA for PTMC with US-detected capsular invasion remain unclarified in the literature. Purpose To compare the feasibility, effectiveness, and safety of MWA in the treatment of PTMC with and without US-detected capsular invasion. Materials and Methods Participants from 12 hospitals with a PTMC maximal diameter of 1 cm or less without US- or CT-detected lymph node metastasis (LNM) who planned to undergo MWA were enrolled in this prospective study between December 2019 and April 2021. All tumors were evaluated with preoperative US and were divided into those with and those without capsular invasion. The participants were observed until July 1, 2022. The primary end points, including technical success and disease progression, and the secondary end points, including treatment parameters, complications, and tumor shrinkage during follow-up, were compared between the two groups, and multivariable regression was performed. Results After exclusion, 461 participants (mean age, 43 years ± 11 [SD]; 337 women) were included: 83 with and 378 without capsular invasion. After one participant with capsular invasion aborted MWA because of technical failure, 82 participants with and 378 participants without capsular invasion (mean tumor volume, 0.1 mL ± 0.1 vs 0.1 mL ± 0.1; P = .07) were analyzed with a mean follow-up period of 20 months ± 4 (range, 12-25 months) and 21 months ± 4 (range, 11-26 months), respectively. In those with and those without capsular invasion, comparable technical success rates were achieved (99% [82 of 83] vs 100% [378 of 378], P = .18), with one and 11 complications, respectively (1% [one of 82] vs 3% [11 of 378], P = .38). There was no evidence of differences in disease progression (2% [one of 82] vs 1% [four of 378]; P = .82) or tumor shrinkage (mean, 97% ± 8 [SD] vs 96% ± 13; P = .58). Conclusion Microwave ablation was feasible in the treatment of papillary thyroid microcarcinoma with US-detected capsular invasion and showed comparable short-term efficacy with or without the presence of capsular invasion. © RSNA, 2023 Clinical trial registration no. NCT04197960 Supplemental material is available for this article.
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Affiliation(s)
- Lin Zheng
- From the Department of Interventional Ultrasound, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (L.Z., J.P.D., Z.Y.H., F.Y.L., J.Y., Z.G.C., X.L.Y., P.L.); Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China (H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C., X.W.); Department of Medical Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W., Y.L.); Department of Interventional Ultrasound Medicine, China-Japan Friendship Hospital, Beijing, China (M.A.Y.); First Department of Surgery, Hebei Hospital of Traditional Chinese Medicine, Shijiazhuang, China (Z.F.X., Y.Z.); First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Surgery, Beijing Jishuitan Hospital, Beijing, China (B.N.); Department of Ultrasound, Central Hospital Affiliated to Shandong First Medical University, Jinan, China (C.L.); and Department of Ultrasound, Mudanjiang Tumor Hospital, Mudanjiang, China (Y.H.)
| | - Jian-Ping Dou
- From the Department of Interventional Ultrasound, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (L.Z., J.P.D., Z.Y.H., F.Y.L., J.Y., Z.G.C., X.L.Y., P.L.); Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China (H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C., X.W.); Department of Medical Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W., Y.L.); Department of Interventional Ultrasound Medicine, China-Japan Friendship Hospital, Beijing, China (M.A.Y.); First Department of Surgery, Hebei Hospital of Traditional Chinese Medicine, Shijiazhuang, China (Z.F.X., Y.Z.); First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Surgery, Beijing Jishuitan Hospital, Beijing, China (B.N.); Department of Ultrasound, Central Hospital Affiliated to Shandong First Medical University, Jinan, China (C.L.); and Department of Ultrasound, Mudanjiang Tumor Hospital, Mudanjiang, China (Y.H.)
| | - Zhi-Yu Han
- From the Department of Interventional Ultrasound, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (L.Z., J.P.D., Z.Y.H., F.Y.L., J.Y., Z.G.C., X.L.Y., P.L.); Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China (H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C., X.W.); Department of Medical Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W., Y.L.); Department of Interventional Ultrasound Medicine, China-Japan Friendship Hospital, Beijing, China (M.A.Y.); First Department of Surgery, Hebei Hospital of Traditional Chinese Medicine, Shijiazhuang, China (Z.F.X., Y.Z.); First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Surgery, Beijing Jishuitan Hospital, Beijing, China (B.N.); Department of Ultrasound, Central Hospital Affiliated to Shandong First Medical University, Jinan, China (C.L.); and Department of Ultrasound, Mudanjiang Tumor Hospital, Mudanjiang, China (Y.H.)
| | - Fang-Yi Liu
- From the Department of Interventional Ultrasound, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (L.Z., J.P.D., Z.Y.H., F.Y.L., J.Y., Z.G.C., X.L.Y., P.L.); Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China (H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C., X.W.); Department of Medical Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W., Y.L.); Department of Interventional Ultrasound Medicine, China-Japan Friendship Hospital, Beijing, China (M.A.Y.); First Department of Surgery, Hebei Hospital of Traditional Chinese Medicine, Shijiazhuang, China (Z.F.X., Y.Z.); First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Surgery, Beijing Jishuitan Hospital, Beijing, China (B.N.); Department of Ultrasound, Central Hospital Affiliated to Shandong First Medical University, Jinan, China (C.L.); and Department of Ultrasound, Mudanjiang Tumor Hospital, Mudanjiang, China (Y.H.)
| | - Jie Yu
- From the Department of Interventional Ultrasound, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (L.Z., J.P.D., Z.Y.H., F.Y.L., J.Y., Z.G.C., X.L.Y., P.L.); Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China (H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C., X.W.); Department of Medical Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W., Y.L.); Department of Interventional Ultrasound Medicine, China-Japan Friendship Hospital, Beijing, China (M.A.Y.); First Department of Surgery, Hebei Hospital of Traditional Chinese Medicine, Shijiazhuang, China (Z.F.X., Y.Z.); First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Surgery, Beijing Jishuitan Hospital, Beijing, China (B.N.); Department of Ultrasound, Central Hospital Affiliated to Shandong First Medical University, Jinan, China (C.L.); and Department of Ultrasound, Mudanjiang Tumor Hospital, Mudanjiang, China (Y.H.)
| | - Zhi-Gang Cheng
- From the Department of Interventional Ultrasound, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (L.Z., J.P.D., Z.Y.H., F.Y.L., J.Y., Z.G.C., X.L.Y., P.L.); Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China (H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C., X.W.); Department of Medical Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W., Y.L.); Department of Interventional Ultrasound Medicine, China-Japan Friendship Hospital, Beijing, China (M.A.Y.); First Department of Surgery, Hebei Hospital of Traditional Chinese Medicine, Shijiazhuang, China (Z.F.X., Y.Z.); First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Surgery, Beijing Jishuitan Hospital, Beijing, China (B.N.); Department of Ultrasound, Central Hospital Affiliated to Shandong First Medical University, Jinan, China (C.L.); and Department of Ultrasound, Mudanjiang Tumor Hospital, Mudanjiang, China (Y.H.)
| | - Xiao-Ling Yu
- From the Department of Interventional Ultrasound, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (L.Z., J.P.D., Z.Y.H., F.Y.L., J.Y., Z.G.C., X.L.Y., P.L.); Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China (H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C., X.W.); Department of Medical Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W., Y.L.); Department of Interventional Ultrasound Medicine, China-Japan Friendship Hospital, Beijing, China (M.A.Y.); First Department of Surgery, Hebei Hospital of Traditional Chinese Medicine, Shijiazhuang, China (Z.F.X., Y.Z.); First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Surgery, Beijing Jishuitan Hospital, Beijing, China (B.N.); Department of Ultrasound, Central Hospital Affiliated to Shandong First Medical University, Jinan, China (C.L.); and Department of Ultrasound, Mudanjiang Tumor Hospital, Mudanjiang, China (Y.H.)
| | - Hui Wang
- From the Department of Interventional Ultrasound, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (L.Z., J.P.D., Z.Y.H., F.Y.L., J.Y., Z.G.C., X.L.Y., P.L.); Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China (H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C., X.W.); Department of Medical Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W., Y.L.); Department of Interventional Ultrasound Medicine, China-Japan Friendship Hospital, Beijing, China (M.A.Y.); First Department of Surgery, Hebei Hospital of Traditional Chinese Medicine, Shijiazhuang, China (Z.F.X., Y.Z.); First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Surgery, Beijing Jishuitan Hospital, Beijing, China (B.N.); Department of Ultrasound, Central Hospital Affiliated to Shandong First Medical University, Jinan, China (C.L.); and Department of Ultrasound, Mudanjiang Tumor Hospital, Mudanjiang, China (Y.H.)
| | - Zhi-Bin Cong
- From the Department of Interventional Ultrasound, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (L.Z., J.P.D., Z.Y.H., F.Y.L., J.Y., Z.G.C., X.L.Y., P.L.); Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China (H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C., X.W.); Department of Medical Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W., Y.L.); Department of Interventional Ultrasound Medicine, China-Japan Friendship Hospital, Beijing, China (M.A.Y.); First Department of Surgery, Hebei Hospital of Traditional Chinese Medicine, Shijiazhuang, China (Z.F.X., Y.Z.); First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Surgery, Beijing Jishuitan Hospital, Beijing, China (B.N.); Department of Ultrasound, Central Hospital Affiliated to Shandong First Medical University, Jinan, China (C.L.); and Department of Ultrasound, Mudanjiang Tumor Hospital, Mudanjiang, China (Y.H.)
| | - Shu-Rong Wang
- From the Department of Interventional Ultrasound, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (L.Z., J.P.D., Z.Y.H., F.Y.L., J.Y., Z.G.C., X.L.Y., P.L.); Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China (H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C., X.W.); Department of Medical Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W., Y.L.); Department of Interventional Ultrasound Medicine, China-Japan Friendship Hospital, Beijing, China (M.A.Y.); First Department of Surgery, Hebei Hospital of Traditional Chinese Medicine, Shijiazhuang, China (Z.F.X., Y.Z.); First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Surgery, Beijing Jishuitan Hospital, Beijing, China (B.N.); Department of Ultrasound, Central Hospital Affiliated to Shandong First Medical University, Jinan, China (C.L.); and Department of Ultrasound, Mudanjiang Tumor Hospital, Mudanjiang, China (Y.H.)
| | - Ming-An Yu
- From the Department of Interventional Ultrasound, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (L.Z., J.P.D., Z.Y.H., F.Y.L., J.Y., Z.G.C., X.L.Y., P.L.); Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China (H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C., X.W.); Department of Medical Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W., Y.L.); Department of Interventional Ultrasound Medicine, China-Japan Friendship Hospital, Beijing, China (M.A.Y.); First Department of Surgery, Hebei Hospital of Traditional Chinese Medicine, Shijiazhuang, China (Z.F.X., Y.Z.); First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Surgery, Beijing Jishuitan Hospital, Beijing, China (B.N.); Department of Ultrasound, Central Hospital Affiliated to Shandong First Medical University, Jinan, China (C.L.); and Department of Ultrasound, Mudanjiang Tumor Hospital, Mudanjiang, China (Y.H.)
| | - Zhi-Feng Xu
- From the Department of Interventional Ultrasound, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (L.Z., J.P.D., Z.Y.H., F.Y.L., J.Y., Z.G.C., X.L.Y., P.L.); Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China (H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C., X.W.); Department of Medical Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W., Y.L.); Department of Interventional Ultrasound Medicine, China-Japan Friendship Hospital, Beijing, China (M.A.Y.); First Department of Surgery, Hebei Hospital of Traditional Chinese Medicine, Shijiazhuang, China (Z.F.X., Y.Z.); First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Surgery, Beijing Jishuitan Hospital, Beijing, China (B.N.); Department of Ultrasound, Central Hospital Affiliated to Shandong First Medical University, Jinan, China (C.L.); and Department of Ultrasound, Mudanjiang Tumor Hospital, Mudanjiang, China (Y.H.)
| | - Ying Che
- From the Department of Interventional Ultrasound, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (L.Z., J.P.D., Z.Y.H., F.Y.L., J.Y., Z.G.C., X.L.Y., P.L.); Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China (H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C., X.W.); Department of Medical Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W., Y.L.); Department of Interventional Ultrasound Medicine, China-Japan Friendship Hospital, Beijing, China (M.A.Y.); First Department of Surgery, Hebei Hospital of Traditional Chinese Medicine, Shijiazhuang, China (Z.F.X., Y.Z.); First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Surgery, Beijing Jishuitan Hospital, Beijing, China (B.N.); Department of Ultrasound, Central Hospital Affiliated to Shandong First Medical University, Jinan, China (C.L.); and Department of Ultrasound, Mudanjiang Tumor Hospital, Mudanjiang, China (Y.H.)
| | - Bai Nan
- From the Department of Interventional Ultrasound, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (L.Z., J.P.D., Z.Y.H., F.Y.L., J.Y., Z.G.C., X.L.Y., P.L.); Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China (H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C., X.W.); Department of Medical Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W., Y.L.); Department of Interventional Ultrasound Medicine, China-Japan Friendship Hospital, Beijing, China (M.A.Y.); First Department of Surgery, Hebei Hospital of Traditional Chinese Medicine, Shijiazhuang, China (Z.F.X., Y.Z.); First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Surgery, Beijing Jishuitan Hospital, Beijing, China (B.N.); Department of Ultrasound, Central Hospital Affiliated to Shandong First Medical University, Jinan, China (C.L.); and Department of Ultrasound, Mudanjiang Tumor Hospital, Mudanjiang, China (Y.H.)
| | - Cun Liu
- From the Department of Interventional Ultrasound, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (L.Z., J.P.D., Z.Y.H., F.Y.L., J.Y., Z.G.C., X.L.Y., P.L.); Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China (H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C., X.W.); Department of Medical Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W., Y.L.); Department of Interventional Ultrasound Medicine, China-Japan Friendship Hospital, Beijing, China (M.A.Y.); First Department of Surgery, Hebei Hospital of Traditional Chinese Medicine, Shijiazhuang, China (Z.F.X., Y.Z.); First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Surgery, Beijing Jishuitan Hospital, Beijing, China (B.N.); Department of Ultrasound, Central Hospital Affiliated to Shandong First Medical University, Jinan, China (C.L.); and Department of Ultrasound, Mudanjiang Tumor Hospital, Mudanjiang, China (Y.H.)
| | - Ying Hao
- From the Department of Interventional Ultrasound, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (L.Z., J.P.D., Z.Y.H., F.Y.L., J.Y., Z.G.C., X.L.Y., P.L.); Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China (H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C., X.W.); Department of Medical Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W., Y.L.); Department of Interventional Ultrasound Medicine, China-Japan Friendship Hospital, Beijing, China (M.A.Y.); First Department of Surgery, Hebei Hospital of Traditional Chinese Medicine, Shijiazhuang, China (Z.F.X., Y.Z.); First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Surgery, Beijing Jishuitan Hospital, Beijing, China (B.N.); Department of Ultrasound, Central Hospital Affiliated to Shandong First Medical University, Jinan, China (C.L.); and Department of Ultrasound, Mudanjiang Tumor Hospital, Mudanjiang, China (Y.H.)
| | - Xue Wang
- From the Department of Interventional Ultrasound, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (L.Z., J.P.D., Z.Y.H., F.Y.L., J.Y., Z.G.C., X.L.Y., P.L.); Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China (H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C., X.W.); Department of Medical Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W., Y.L.); Department of Interventional Ultrasound Medicine, China-Japan Friendship Hospital, Beijing, China (M.A.Y.); First Department of Surgery, Hebei Hospital of Traditional Chinese Medicine, Shijiazhuang, China (Z.F.X., Y.Z.); First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Surgery, Beijing Jishuitan Hospital, Beijing, China (B.N.); Department of Ultrasound, Central Hospital Affiliated to Shandong First Medical University, Jinan, China (C.L.); and Department of Ultrasound, Mudanjiang Tumor Hospital, Mudanjiang, China (Y.H.)
| | - Ying Liu
- From the Department of Interventional Ultrasound, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (L.Z., J.P.D., Z.Y.H., F.Y.L., J.Y., Z.G.C., X.L.Y., P.L.); Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China (H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C., X.W.); Department of Medical Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W., Y.L.); Department of Interventional Ultrasound Medicine, China-Japan Friendship Hospital, Beijing, China (M.A.Y.); First Department of Surgery, Hebei Hospital of Traditional Chinese Medicine, Shijiazhuang, China (Z.F.X., Y.Z.); First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Surgery, Beijing Jishuitan Hospital, Beijing, China (B.N.); Department of Ultrasound, Central Hospital Affiliated to Shandong First Medical University, Jinan, China (C.L.); and Department of Ultrasound, Mudanjiang Tumor Hospital, Mudanjiang, China (Y.H.)
| | - Ying Zhou
- From the Department of Interventional Ultrasound, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (L.Z., J.P.D., Z.Y.H., F.Y.L., J.Y., Z.G.C., X.L.Y., P.L.); Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China (H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C., X.W.); Department of Medical Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W., Y.L.); Department of Interventional Ultrasound Medicine, China-Japan Friendship Hospital, Beijing, China (M.A.Y.); First Department of Surgery, Hebei Hospital of Traditional Chinese Medicine, Shijiazhuang, China (Z.F.X., Y.Z.); First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Surgery, Beijing Jishuitan Hospital, Beijing, China (B.N.); Department of Ultrasound, Central Hospital Affiliated to Shandong First Medical University, Jinan, China (C.L.); and Department of Ultrasound, Mudanjiang Tumor Hospital, Mudanjiang, China (Y.H.)
| | - Ping Liang
- From the Department of Interventional Ultrasound, Chinese PLA General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China (L.Z., J.P.D., Z.Y.H., F.Y.L., J.Y., Z.G.C., X.L.Y., P.L.); Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, China (H.W.); Department of Electrodiagnosis, the Affiliated Hospital to Changchun University of Traditional Chinese Medicine, Changchun, China (Z.B.C., X.W.); Department of Medical Ultrasound, Yantai Hospital of Shandong Wendeng Orthopaedics & Traumatology, Yantai, China (S.R.W., Y.L.); Department of Interventional Ultrasound Medicine, China-Japan Friendship Hospital, Beijing, China (M.A.Y.); First Department of Surgery, Hebei Hospital of Traditional Chinese Medicine, Shijiazhuang, China (Z.F.X., Y.Z.); First Affiliated Hospital of Dalian Medical University, Dalian, China (Y.C.); Department of Surgery, Beijing Jishuitan Hospital, Beijing, China (B.N.); Department of Ultrasound, Central Hospital Affiliated to Shandong First Medical University, Jinan, China (C.L.); and Department of Ultrasound, Mudanjiang Tumor Hospital, Mudanjiang, China (Y.H.)
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Liu FY, Ji Q, Wang YL, Chen JM, Dong LL, Ding WJ, Lai H, Wang CS. [Surgical treatment for obstructive hypertrophic cardiomyopathy: a five-year single-center experience of 421 cases]. Zhonghua Wai Ke Za Zhi 2023; 61:201-208. [PMID: 36650965 DOI: 10.3760/cma.j.cn112139-20221129-00505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Objectives: To examine the short-term and mid-term effects of surgical treatment of obstructive hypertrophic cardiomyopathy (HCM) in one center. Methods: The perioperative data and short-term follow-up outcomes of 421 patients with obstructive HCM who received surgical treatment at Department of Cardiac Surgery, Zhongshan Hospital, Fudan University from January 2017 to December 2021 were analyzed retrospectively. There were 207 males and 214 females, aged (56.5±11.7) years (range: 19 to 78 years). Preoperative New York Heart Association (NYHA) classification included 45 cases of class Ⅱ, 328 cases in class Ⅲ, and 48 cases in class Ⅳ. Fifty-eight patients were diagnosed with latent obstructive HCM and 257 patients had moderate or more mitral regurgitation with 56 patients suffering from intrinsic mitral valve diseases. All procedures were completed by a multidisciplinary team, including professional echocardiologists involving in preoperative planning for proper mitral valve management strategies and intraoperative monitoring. A total of 338 patients underwent septal myectomy alone, and 59 patients underwent mitral valve surgery along with myectomy. A single transaortic approach was used in 355 patients, and a right atrial-atrial septal/atrial sulcus approach was used in 51 other patients. Long-handled minimally invasive surgical instruments were used for the procedures. Student t test, Wilcoxon rank sum test, χ2 test or Fisher exact test were used to compare the data before and after surgery. Results: The aortic cross-clamping time of septal myectomy alone was (34.3±8.5) minutes (range: 21 to 94 minutes). Eighteen patients had intraoperative adverse events and underwent immediate reoperation, including residual obstruction (10 patients), left ventricular free wall rupture (4 patients), ventricular septal perforation (3 patients), and aortic valve perforation (1 patient). Four patients died during hospitalization, and 11 patients developed complete atrioventricular block requiring permanent pacemaker implantation. After discharge, 384 (92.1%) patients received a follow-up visit with a median duration of 9 months. All follow-up patients survived with significantly improved NYHA classifications: 216 patients in class Ⅰ and 168 patients in class Ⅱ (χ2=662.73, P<0.01 as compared to baseline). At 6 months after surgery, follow-up echocardiography showed that the thickness of the ventricular septum ((13.6±2.5) mm vs. (18.2±3.0) mm, t=23.51, P<0.01) and the peak left ventricular outflow tract gradient ((12.0±6.3) mmHg vs. (93.4±19.8) mmHg, 1 mmHg=0.133 kPa, t=78.29, P<0.01) were both significantly lower than baseline values. Conclusion: The construction of the surgical team (including echocardiography experts), proper mitral valve management strategies, identification and management of sub-mitral-valve abnormalities, and application of long-handled minimally invasive surgical instruments are important for the successful implementation of septal myectomy with satisfactory short-and medium-term outcomes.
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Affiliation(s)
- F Y Liu
- Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai Municipal Institute for Cardiovascular Diseases, Shanghai 200032, China
| | - Q Ji
- Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai Municipal Institute for Cardiovascular Diseases, Shanghai 200032, China
| | - Y L Wang
- Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai Municipal Institute for Cardiovascular Diseases, Shanghai 200032, China
| | - J M Chen
- Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai Municipal Institute for Cardiovascular Diseases, Shanghai 200032, China
| | - L L Dong
- Department of Cardiac Ultrasound Diagnosis, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - W J Ding
- Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai Municipal Institute for Cardiovascular Diseases, Shanghai 200032, China
| | - H Lai
- Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai Municipal Institute for Cardiovascular Diseases, Shanghai 200032, China
| | - C S Wang
- Department of Cardiac Surgery, Zhongshan Hospital, Fudan University, Shanghai Municipal Institute for Cardiovascular Diseases, Shanghai 200032, China
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Dai YQ, Liang P, Wang J, Luo YC, Yu XL, Han ZY, Liu FY, Li X, Tan SL, Wang Z, Wu C, Li JM, Yu J. Microwave ablation without subsequent lumpectomy versus breast-conserving surgery for early breast cancer: a propensity score matching study. Int J Hyperthermia 2023; 40:2186325. [PMID: 36944374 DOI: 10.1080/02656736.2023.2186325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
PURPOSE To compare the efficacy of ultrasound-guided percutaneous microwave ablation (MWA) without subsequent lumpectomy and breast-conserving surgery (BCS) in patients with early breast cancer (BC). MATERIALS AND METHODS This retrospective cohort study enrolled 106 patients with early BC (T0/1/2 N0/1 M0) treated by MWA (n = 21) or BCS (n = 85) from October 2014 to December 2020. Propensity score matching (PSM) was performed to balance the baseline characteristics between MWA and BCS groups. The tumor progression, overall survival (OS), disease-specific survival (DSS), complications, and cosmetic results were compared. RESULTS After PSM, there were 21 patients with balanced baseline characteristics in each group. After a median follow-up of 43 months (range, 15-89 months), there was no significant difference in tumor progression (10% vs 2%, p = 0.18), OS (96% vs 99%, p = 0.36), DSS (100% vs 99%, p > 0.99), and complications (0% vs 19%, p = 0.58). The operation time of MWA was shorter (60 min vs 101 min, p < 0.001) than that of BCS. For the management of metastatic lymph nodes, five (5/21, 24%) patients with six metastatic nodes underwent ablation in the MWA group and three patients (3/21, 14%) with six metastatic nodes underwent axillary lymph node dissection in the BCS group. All the patients in the MWA group reported excellent cosmetic results, but 29% of BCS patients expressed dissatisfaction with breast asymmetry (10%) and scar formation (19%) (p < 0.001). CONCLUSION This pilot study indicated that in selected early BC patients, microwave ablation without subsequent lumpectomy had comparable tumor control effect with breast-conserving surgery and better cosmetic results at an intermediate follow-up.HighlightsMWA without subsequent lumpectomy has a comparable interim survival effect and better cosmetic results as BCS in the treatment of selected early breast cancer.MWA has the potential to be a viable and promising therapeutic option for breast cancer patients reluctant or intolerant to surgery with the advantage of minimal invasion.
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Affiliation(s)
- Yu-Qing Dai
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Ping Liang
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Jiandong Wang
- Department of Breast Surgery, Chinese PLA Medical College, Beijing, China
| | - Yan-Chun Luo
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xiao-Ling Yu
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Zhi-Yu Han
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Fang-Yi Liu
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xin Li
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Shui-Lian Tan
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Zhen Wang
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Chong Wu
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Jian-Ming Li
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Jie Yu
- Department of Ultrasound, Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
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Ding WZ, Wei H, Wu JP, Cheng ZG, Han ZY, Liu FY, Yu J, Liang P. Liver cirrhosis and tumor location can affect the range of intrahepatic microwave ablation zone. Int J Hyperthermia 2023; 40:2181843. [PMID: 36854449 DOI: 10.1080/02656736.2023.2181843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND The range of an ablation zone (AZ) plays a crucial role in the treatment effect of microwave ablation (MWA). The aim of this study was to analyze the factors influencing the AZ range. METHODS Fourteen factors in four areas were included: patient-related factors (sex, age), disease-related factors (tumor location, liver cirrhosis), serological factors (ALT, AST, total protein, albumin, total bilirubin, direct bilirubin, and platelets), and MWA parameters (ablation time, power, and needle type). Multiple sequence MRI was used to delineate AZ by three radiologists using 3D Slicer. MATLAB was used to calculate the AZ length, width, and area of the largest section. Linear regression analysis was used to analyze influencing factors. Moreover, a subgroup analysis was conducted for patients with viral hepatitis. RESULT 220 patients with 290 tumors were included between 2010-2021. In addition to MWA parameters, cirrhosis and tumor location were significant factors that influenced AZ (p < 0.001). The standardized coefficient (beta) of cirrhosis (cirrhosis vs. non-cirrhosis) was positive, which meant cirrhosis would lead to a decrease in AZ range. The beta of tumor location (near the hepatic hilar zone, intermediate zone, and periphery zone) was negative, indicating that AZ range decreased as the tumor location approached the hepatic hilum. For viral hepatitis patients, Fibrosis 4 (FIB4) score was a significant factor influencing AZ (p < 0.001), and the beta was negative, indicating that AZ range decreased as FIB4 increased. CONCLUSION Liver cirrhosis, tumor location, and FIB4 affect the AZ range and should be considered when planning MWA parameters.
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Affiliation(s)
- Wen-Zhen Ding
- Fifth Medical Center of Chinese, PLA General Hospital, Beijing, China
| | - Hao Wei
- School of Biological Science and Medical Engineering, Southeast University, Nanjing, Jiangsu, China
| | - Jia-Peng Wu
- Fifth Medical Center of Chinese, PLA General Hospital, Beijing, China
| | - Zhi-Gang Cheng
- Fifth Medical Center of Chinese, PLA General Hospital, Beijing, China
| | - Zhi-Yu Han
- Fifth Medical Center of Chinese, PLA General Hospital, Beijing, China
| | - Fang-Yi Liu
- Fifth Medical Center of Chinese, PLA General Hospital, Beijing, China
| | - Jie Yu
- Fifth Medical Center of Chinese, PLA General Hospital, Beijing, China
| | - Ping Liang
- Fifth Medical Center of Chinese, PLA General Hospital, Beijing, China
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Liu FY, Feng XM, Ji XL, Su XL. [Cluster classification and clinical prognostic modeling based on m6A RNA methylation regulators in liver cancer]. Zhonghua Gan Zang Bing Za Zhi 2022; 30:962-969. [PMID: 36299190 DOI: 10.3760/cma.j.cn501113-20200727-00428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: Cluster classification based on m6A methylation regulators and construct prognostic evaluation model. Methods: Utilizing consensus cluster to classify the liver cancer samples form TCGA based on the expression of 13 m6A methylation regulators, and verify the function and prognostic significance of the clustered subtypes. Marker genes were further screened to construct a risk prediction model for evaluating the prognosis of liver cancer patients. Results: The two clustered subtypes based on m6A methylation regulators showed significant differences in the prognosis value of liver cancer patients (P=0.048), and 38 prognostic markers related to m6A methylation in liver cancer were screened from the subgroup with poor prognosis. Two m6A regulatory genes, YTHDF1 and YTHDF2, are proved with adverse prognosis by univariate cox analysis (P<0.05, Hazard ratio>1). We used Lasso regression method to build risk assessment model and effectively predicted the prognosis status of liver cancer patients within 4 years (4-year AUC=0.685, 3-year AUC=0.669). Moreover, the assessment model was validated in another dataset of Asia liver cancer patients. Conclusion: The study provided ideas for studying m6A methylation in liver cancer, and the risk prediction model can be used to evaluate the short-term prognosis of liver cancer patients.
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Affiliation(s)
- F Y Liu
- Clinical Medical Research Center, the Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010010, China College of Life Sciences, Inner Mongolia University, Hohhot 010010, China Inner Mongolia Key Laboratory of Medical Cell Biology, Hohhot 010010, China
| | - X M Feng
- Clinical Medical Research Center, the Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010010, China
| | - X L Ji
- Infectious Disease, the Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010010, China
| | - X L Su
- Clinical Medical Research Center, the Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010010, China Inner Mongolia Key Laboratory of Medical Cell Biology, Hohhot 010010, China
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Kouli O, Murray V, Bhatia S, Cambridge WA, Kawka M, Shafi S, Knight SR, Kamarajah SK, McLean KA, Glasbey JC, Khaw RA, Ahmed W, Akhbari M, Baker D, Borakati A, Mills E, Thavayogan R, Yasin I, Raubenheimer K, Ridley W, Sarrami M, Zhang G, Egoroff N, Pockney P, Richards T, Bhangu A, Creagh-Brown B, Edwards M, Harrison EM, Lee M, Nepogodiev D, Pinkney T, Pearse R, Smart N, Vohra R, Sohrabi C, Jamieson A, Nguyen M, Rahman A, English C, Tincknell L, Kakodkar P, Kwek I, Punjabi N, Burns J, Varghese S, Erotocritou M, McGuckin S, Vayalapra S, Dominguez E, Moneim J, Salehi M, Tan HL, Yoong A, Zhu L, Seale B, Nowinka Z, Patel N, Chrisp B, Harris J, Maleyko I, Muneeb F, Gough M, James CE, Skan O, Chowdhury A, Rebuffa N, Khan H, Down B, Fatimah Hussain Q, Adams M, Bailey A, Cullen G, Fu YXJ, McClement B, Taylor A, Aitken S, Bachelet B, Brousse de Gersigny J, Chang C, Khehra B, Lahoud N, Lee Solano M, Louca M, Rozenbroek P, Rozitis E, Agbinya N, Anderson E, Arwi G, Barry I, Batchelor C, Chong T, 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Wyn-Griffiths F, Brew A, Kaur G, Soni D, Tickle A, Akbar Z, Appleyard T, Figg K, Jayawardena P, Johnson A, Kamran Siddiqui Z, Lacy-Colson J, Oatham R, Rowlands B, Sludden E, Turnbull C, Allin D, Ansar Z, Azeez Z, Dale VH, Garg J, Horner A, Jones S, Knight S, McGregor C, McKenna J, McLelland T, Packham-Smith A, Rowsell K, Spector-Hill I, Adeniken E, Baker J, Bartlett M, Chikomba L, Connell B, Deekonda P, Dhar M, Elmansouri A, Gamage K, Goodhew R, Hanna P, Knight J, Luca A, Maasoumi N, Mahamoud F, Manji S, Marwaha PK, Mason F, Oluboyede A, Pigott L, Razaq AM, Richardson M, Saddaoui I, Wijeyendram P, Yau S, Atkins W, Liang K, Miles N, Praveen B, Ashai S, Braganza J, Common J, Cundy A, Davies R, Guthrie J, Handa I, Iqbal M, Ismail R, Jones C, Jones I, Lee KS, Levene A, Okocha M, Olivier J, Smith A, Subramaniam E, Tandle S, Wang A, Watson A, Wilson C, Chan XHF, Khoo E, Montgomery C, Norris M, Pugalenthi PP, Common T, Cook E, Mistry H, Shinmar HS, Agarwal G, Bandyopadhyay S, Brazier B, Carroll L, Goede A, Harbourne A, Lakhani A, Lami M, Larwood J, Martin J, Merchant J, Pattenden S, Pradhan A, Raafat N, Rothwell E, Shammoon Y, Sudarshan R, Vickers E, Wingfield L, Ashworth I, Azizi S, Bhate R, Chowdhury T, Christou A, Davies L, Dwaraknath M, Farah Y, Garner J, Gureviciute E, Hart E, Jain A, Javid S, Kankam HK, Kaur Toor P, Kaz R, Kermali M, Khan I, Mattson A, McManus A, Murphy M, Nair K, Ngemoh D, Norton E, Olabiran A, Parry L, Payne T, Pillai K, Price S, Punjabi K, Raghunathan A, Ramwell A, Raza M, Ritehnia J, Simpson G, Smith W, Sodeinde S, Studd L, Subramaniam M, Thomas J, Towey S, Tsang E, Tuteja D, Vasani J, Vio M, Badran A, Adams J, Anthony Wilkinson J, Asvandi S, Austin T, Bald A, Bix E, Carrick M, Chander B, Chowdhury S, Cooper Drake B, Crosbie S, D Portela S, Francis D, Gallagher C, Gillespie R, Gravett H, Gupta P, Ilyas C, James G, Johny J, Jones A, Kinder F, MacLeod C, Macrow C, Maqsood-Shah A, Mather J, McCann L, McMahon R, Mitham E, Mohamed M, Munton E, Nightingale K, O'Neill K, Onyemuchara I, Senior R, Shanahan A, Sherlock J, Spyridoulias A, Stavrou C, Stokes D, Tamang R, Taylor E, Trafford C, Uden C, Waddington C, Yassin D, Zaman M, Bangi S, Cheng T, Chew D, Hussain N, Imani-Masouleh S, Mahasivam G, McKnight G, Ng HL, Ota HC, Pasha T, Ravindran W, Shah K, Vishnu K S, Zaman S, Carr W, Cope S, Eagles EJ, Howarth-Maddison M, Li CY, Reed J, Ridge A, Stubbs T, Teasdaled D, Umar R, Worthington J, Dhebri A, Kalenderov R, Alattas A, Arain Z, Bhudia R, Chia D, Daniel S, Dar T, Garland H, Girish M, Hampson A, Kyriacou H, Lehovsky K, Mullins W, Omorphos N, Vasdev N, Venkatesh A, Waldock W, Bhandari A, Brown G, Choa G, Eichenauer CE, Ezennia K, Kidwai Z, Lloyd-Thomas A, Macaskill Stewart A, Massardi C, Sinclair E, Skajaa N, Smith M, Tan I, Afsheen N, Anuar A, Azam Z, Bhatia P, Davies-kelly N, Dickinson S, Elkawafi M, Ganapathy M, Gupta S, Khoury EG, Licudi D, Mehta V, Neequaye S, Nita G, Tay VL, Zhao S, Botsa E, Cuthbert H, Elliott J, Furlepa M, Lehmann J, Mangtani A, Narayan A, Nazarian S, Parmar C, Shah D, Shaw C, Zhao Z, Beck C, Caldwell S, Clements JM, French B, Kenny R, Kirk S, Lindsay J, McClung A, McLaughlin N, Watson S, Whiteside E, Alyacoubi S, Arumugam V, Beg R, Dawas K, Garg S, Lloyd ER, Mahfouz Y, Manobharath N, Moonesinghe R, Morka N, Patel K, Prashar J, Yip S, Adeeko ES, Ajekigbe F, Bhat A, Evans C, Farrugia A, Gurung C, Long T, Malik B, Manirajan S, Newport D, Rayer J, Ridha A, Ross E, Saran T, Sinker A, Waruingi D, Allen R, Al Sadek Y, Alves do Canto Brum H, Asharaf H, Ashman M, Balakumar V, Barrington J, Baskaran R, Berry A, Bhachoo H, Bilal A, Boaden L, Chia WL, Covell G, Crook D, Dadnam F, Davis L, De Berker H, Doyle C, Fox C, Gruffydd-Davies M, Hafouda Y, Hill A, Hubbard E, Hunter A, Inpadhas V, Jamshaid M, Jandu G, Jeyanthi M, Jones T, Kantor C, Kwak SY, Malik N, Matt R, McNulty P, Miles C, Mohomed A, Myat P, Niharika J, Nixon A, O'Reilly D, Parmar K, Pengelly S, Price L, Ramsden M, Turnor R, Wales E, Waring H, Wu M, Yang T, Ye TTS, Zander A, Zeicu C, Bellam S, Francombe J, Kawamoto N, Rahman MR, Sathyanarayana A, Tang HT, Cheung J, Hollingshead J, Page V, Sugarman J, Wong E, Chiong J, Fung E, Kan SY, Kiang J, Kok J, Krahelski O, Liew MY, Lyell B, Sharif Z, Speake D, Alim L, Amakye NY, Chandrasekaran J, Chandratreya N, Drake J, Owoso T, Thu YM, Abou El Ela Bourquin B, Alberts J, Chapman D, Rehnnuma N, Ainsworth K, Carpenter H, Emmanuel T, Fisher T, Gabrel M, Guan Z, Hollows S, Hotouras A, Ip Fung Chun N, Jaffer S, Kallikas G, Kennedy N, Lewinsohn B, Liu FY, Mohammed S, Rutherfurd A, Situ T, Stammer A, Taylor F, Thin N, Urgesi E, Zhang N, Ahmad MA, Bishop A, Bowes A, Dixit A, Glasson R, Hatta S, Hatt K, Larcombe S, Preece J, Riordan E, Fegredo D, Haq MZ, Li C, McCann G, Stewart D, Baraza W, Bhullar D, Burt G, Coyle J, Deans J, Devine A, Hird R, Ikotun O, Manchip G, Ross C, Storey L, Tan WWL, Tse C, Warner C, Whitehead M, Wu F, Court EL, Crisp E, Huttman M, Mayes F, Robertson H, Rosen H, Sandberg C, Smith H, Al Bakry M, Ashwell W, Bajaj S, Bandyopadhyay D, Browlee O, Burway S, Chand CP, Elsayeh K, Elsharkawi A, Evans E, Ferrin S, Fort-Schaale A, Iacob M, I K, Impelliziere Licastro G, Mankoo AS, Olaniyan T, Otun J, Pereira R, Reddy R, Saeed D, Simmonds O, Singhal G, Tron K, Wickstone C, Williams R, Bradshaw E, De Kock Jewell V, Houlden C, Knight C, Metezai H, Mirza-Davies A, Seymour Z, Spink D, Wischhusen S. Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study. Lancet Digit Health 2022; 4:e520-e531. [PMID: 35750401 DOI: 10.1016/s2589-7500(22)00069-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 01/07/2022] [Accepted: 04/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications. METHODS We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC). FINDINGS In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]). INTERPRETATION In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required. FUNDING British Journal of Surgery Society.
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Wang Z, Liu M, Zhang DZ, Wu SS, Hong ZX, He GB, Yang H, Xiang BD, Li X, Jiang TA, Li K, Tang Z, Huang F, Lu M, Chen JA, Lin YC, Lu X, Wu YQ, Zhang XW, Zhang YF, Cheng C, Ye HL, Wang LT, Zhong HG, Zhong JH, Wang L, Chen M, Liang FF, Chen Y, Xu YS, Yu XL, Cheng ZG, Liu FY, Han ZY, Tang WZ, Yu J, Liang P. Microwave ablation versus laparoscopic resection as first-line therapy for solitary 3-5-cm HCC. Hepatology 2022; 76:66-77. [PMID: 35007334 DOI: 10.1002/hep.32323] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 12/22/2021] [Accepted: 12/22/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND AND AIMS The study objective was to compare the effectiveness of microwave ablation (MWA) and laparoscopic liver resection (LLR) on solitary 3-5-cm HCC over time. APPROACH AND RESULTS From 2008 to 2019, 1289 patients from 12 hospitals were enrolled in this retrospective study. Diagnosis of all lesions were based on histopathology. Propensity score matching was used to balance all baseline variables between the two groups in 2008-2019 (n = 335 in each group) and 2014-2019 (n = 257 in each group) cohorts, respectively. For cohort 2008-2019, during a median follow-up of 35.8 months, there were no differences in overall survival (OS) between MWA and LLR (HR: 0.88, 95% CI 0.65-1.19, p = 0.420), and MWA was inferior to LLR regarding disease-free survival (DFS) (HR 1.36, 95% CI 1.05-1.75, p = 0.017). For cohort 2014-2019, there was comparable OS (HR 0.85, 95% CI 0.56-1.30, p = 0.460) and approached statistical significance for DFS (HR 1.33, 95% CI 0.98-1.82, p = 0.071) between MWA and LLR. Subgroup analyses showed comparable OS in 3.1-4.0-cm HCCs (HR 0.88, 95% CI 0.53-1.47, p = 0.630) and 4.1-5.0-cm HCCs (HR 0.77, 95% CI 0.37-1.60, p = 0.483) between two modalities. For both cohorts, MWA shared comparable major complications (both p > 0.05), shorter hospitalization, and lower cost to LLR (all p < 0.001). CONCLUSIONS MWA might be a first-line alternative to LLR for solitary 3-5-cm HCC in selected patients with technical advances, especially for patients unsuitable for LLR.
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Affiliation(s)
- Zhen Wang
- Department of Interventional Ultrasound, PLA Medical College & Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
- Guangxi Clinical Research Center for CRC, Department of Gastrointestinal Surgery, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Miao Liu
- Graduate School of Chinese PLA General Hospital, Beijing, China
| | - De-Zhi Zhang
- Abdominal Ultrasound Department, the First Hospital of Jilin University, Changchun, China
| | - Song-Song Wu
- Department of Ultrasonography, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Zhi-Xian Hong
- Department of Hepatobiliary Surgery, PLA Medical College & Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Guang-Bin He
- Department of Ultrasound, Xijing Hospital, the Fourth Military Medical University, Xian, China
| | - Hong Yang
- Department of Ultrasound, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Bang-de Xiang
- Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Xiao Li
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Tian-An Jiang
- Department of Ultrasound Medicine, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Kai Li
- Department of Ultrasound, Guangdong Key Laboratory of Liver Disease Research, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Zhe Tang
- Department of Surgery, the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, P. R. China
| | - Fei Huang
- Department of General Surgery, the Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Man Lu
- Ultrasound Medical Center, Sichuan Cancer Hospital Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Ji-An Chen
- Department of General Surgery, the Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yu-Cheng Lin
- Department of Ultrasonography, Shengli Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Xiao Lu
- Department of Ultrasound, Xijing Hospital, the Fourth Military Medical University, Xian, China
| | - Yu-Quan Wu
- Department of Ultrasound, the First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xiao-Wu Zhang
- Department of Interventional Therapy, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ye-Fan Zhang
- Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chao Cheng
- Department of Ultrasound Medicine, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Huo-Lin Ye
- Department of Ultrasound, Guangdong Key Laboratory of Liver Disease Research, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Lan-Tian Wang
- Department of Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, P. R. China
| | - Hua-Ge Zhong
- Guangxi Clinical Research Center for CRC, Department of Gastrointestinal Surgery, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Jian-Hong Zhong
- Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Lu Wang
- Ultrasound Medical Center, Sichuan Cancer Hospital Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Miao Chen
- Department of Radiology, Guangxi Medical University Cancer Hospital, Guangxi Medical University, Nanning, P. R. China
| | - Fang-Fang Liang
- Department of Medical Oncology, the First Affiliated Hospital of Guangxi Medical University, Nanning, P. R. China
| | - Yi Chen
- Guangxi Clinical Research Center for CRC, Department of Gastrointestinal Surgery, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Yan-Song Xu
- Department of Emergency, the First Affiliated Hospital of Guangxi Medical University, Nanning, P. R. China
| | - Xiao-Ling Yu
- Department of Interventional Ultrasound, PLA Medical College & Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Zhi-Gang Cheng
- Department of Interventional Ultrasound, PLA Medical College & Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Fang-Yi Liu
- Department of Interventional Ultrasound, PLA Medical College & Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Zhi-Yu Han
- Department of Interventional Ultrasound, PLA Medical College & Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Wei-Zhong Tang
- Guangxi Clinical Research Center for CRC, Department of Gastrointestinal Surgery, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Jie Yu
- Department of Interventional Ultrasound, PLA Medical College & Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Ping Liang
- Department of Interventional Ultrasound, PLA Medical College & Fifth Medical Center of Chinese PLA General Hospital, Beijing, China
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Huang Q, Liu FY, Mao NY, Sun JY, Dong M, Xie H, Liu F, Zhang H, Yu XL, Dong JP, Xu W, Huang F. [Application of oral fluid in SARS-CoV-2 nucleic acid and antibody detection]. Zhonghua Yu Fang Yi Xue Za Zhi 2022; 56:355-359. [PMID: 35381659 DOI: 10.3760/cma.j.cn112150-20211211-01146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This study aimed to explore the application value of new biological specimen oral fluid in SARS-CoV-2 nucleic acid and antibody detection. Oral fluid and paired respiratory and blood specimens from 7 confirmed cases of two COVID-19 cluster epidemic were collected in Beijing from October to November 2021. SARS-CoV-2 virus and IgG antibody were detected by real time PCR kits and serum antibody detection reagents, and SARS-CoV-2 IgG antibody in oral fluids was detected by a new established method of magnetic particle chemiluminescence. The results showed that the nucleic acid amplification test of SARS-CoV-2 on nasopharyngeal swabs, throat swabs and oral fluid specimens from 3 confirmed cases of COVID-19 was positive, among which the Ct value for ORF1a/b and N gene of oral fluid samples in 2 cases was close to that of throat swab, and the Ct value of oral fluid sample for 1 case was higher than that of throat swab. The complete genome sequence of one oral fluid specimen was obtained, which belonged to the VOC/Delta variant strain. The SARS-CoV-2 IgG antibodies of the paired oral fluid and serum were all positive, and the S/CO values of oral fluid were all lower than those of serum. The series of oral fluid results showed that SARS-CoV-2 IgG antibody level increased from 11 to 32 days after the onset of the disease.
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Affiliation(s)
- Q Huang
- School of Public Health, Capital Medical University, Beijing 100069, China Institute of Preventive Immunization, Beijing Center for Disease Control and Prevention/Beijing Academy for Preventive Medicine/Beijing Institute of Tuberculosis Control Research and Prevention, Beijing 100013, China
| | - F Y Liu
- Department of Microbiology Laboratory, Beijing Haidian Center for Disease Control and Prevention, Beijing 100094, China
| | - N Y Mao
- Institute for Viral Disease Control and Prevention, Chinese Centers for Disease control and Prevention, Beijing 102206, China NHC Key Laboratory for Medical Virology and Viral Diseases, Beijing 102206, China
| | - J Y Sun
- Department Infectious Disease, Beijing Haidian Hospital, Beijing 100080, China
| | - M Dong
- Institute of Preventive Immunization, Beijing Center for Disease Control and Prevention/Beijing Academy for Preventive Medicine/Beijing Institute of Tuberculosis Control Research and Prevention, Beijing 100013, China
| | - H Xie
- Institute of Preventive Immunization, Beijing Center for Disease Control and Prevention/Beijing Academy for Preventive Medicine/Beijing Institute of Tuberculosis Control Research and Prevention, Beijing 100013, China
| | - F Liu
- Department of Microbiology Laboratory, Beijing Haidian Center for Disease Control and Prevention, Beijing 100094, China
| | - H Zhang
- Department of Microbiology Laboratory, Beijing Haidian Center for Disease Control and Prevention, Beijing 100094, China
| | - X L Yu
- Institute of Preventive Immunization, Beijing Center for Disease Control and Prevention/Beijing Academy for Preventive Medicine/Beijing Institute of Tuberculosis Control Research and Prevention, Beijing 100013, China
| | - J P Dong
- Department Infectious Disease, Beijing Haidian Hospital, Beijing 100080, China
| | - Wenbo Xu
- Institute for Viral Disease Control and Prevention, Chinese Centers for Disease control and Prevention, Beijing 102206, China NHC Key Laboratory for Medical Virology and Viral Diseases, Beijing 102206, China
| | - Fang Huang
- School of Public Health, Capital Medical University, Beijing 100069, China Institute of Preventive Immunization, Beijing Center for Disease Control and Prevention/Beijing Academy for Preventive Medicine/Beijing Institute of Tuberculosis Control Research and Prevention, Beijing 100013, China
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Ding W, Wang Z, Liu FY, Cheng ZG, Yu X, Han Z, Zhong H, Yu J, Liang P. A Hybrid Machine Learning Model Based on Semantic Information Can Optimize Treatment Decision for Naïve Single 3-5-cm HCC Patients. Liver Cancer 2022; 11:256-267. [PMID: 35949294 PMCID: PMC9218628 DOI: 10.1159/000522123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 11/28/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Tumor recurrence is an abomination for hepatocellular carcinoma (HCC) patients receiving local treatment. PURPOSE The aim of the study was to build a hybrid machine learning model to recommend optimized first treatment (laparoscopic hepatectomy [LH] or microwave ablation [MWA]) for naïve single 3-5-cm HCC patients based on early recurrence (ER, ≤2 years) probability. METHODS This retrospective study collected 20 semantic variables of 582 patients (LH: 300, MWA: 282) from 13 hospitals with at least 24 months follow-up. Both groups were divided into training, validation, and test set, respectively. Five algorithms (logistics regression, random forest, neural network, stochastic gradient boosting, and eXtreme Gradient Boosting [XGB]) were used for model building. A model with highest area under the receiver operating characteristic curve (AUC) in a validation set of LH and MWA was selected to connect as a hybrid model which made decision based on ER probability. Model testing was performed in a comprehensive set comprising LH and MWA test sets. RESULTS Four variables in each group were selected to build LH and MWA models, respectively. LH-XGB model (AUC = 0.744) and MWA-stochastic gradient method (AUC = 0.750) model were selected for model building. In the comprehensive set, a treatment confusion matrix was established based on recommended and actual treatment. The predicted ER probabilities were comparable with the actual ER rates for various types of patients in matrix (p > 0.05). ER rate of patients whose actual treatment consistent with recommendation was lower than that of inconsistent patients (LH: 21.2% vs. 46.2%, p = 0.042; MWA: 26.3% vs. 54.1%, p = 0.048). By recommending optimal treatment, the hybrid model can significantly reduce ER probability from 38.2% to 25.6% for overall patients (p < 0.001). CONCLUSIONS The hybrid model can accurately predict ER probability of different treatments and thereby provide reliable evidence to make optimal treatment decision for patients with single 3-5-cm HCC.
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Yu J, Cheng ZG, Han ZY, Liu FY, Zheng RQ, Cheng W, Wei Q, Yu SY, Li QY, He GZ, Luo YC, Yu XL, Liang P. Period-Dependent Survival Benefit of Percutaneous Microwave Ablation for Hepatocellular Carcinoma: A 12-Year Real-World, Multicentric Experience. Liver Cancer 2022; 11:341-353. [PMID: 35978603 PMCID: PMC9294937 DOI: 10.1159/000522134] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 11/28/2021] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Although microwave ablation (MWA) is a promising technique for hepatocellular carcinoma (HCC) treatment, its 10-year efficacy is unknown. OBJECTIVE The objective of the study was to assess whether the advances in MWA for HCC translated into a real-world survival benefit. METHODS This retrospective study included 2,354 patients with Barcelona Clinic Liver Cancer (BCLC) stage 0 to B from 5 hospitals, with at least 2 years of follow-up for all the patients. Recurrence and survival were analyzed using the Kaplan-Meier method with time-period stratification. RESULTS A total of 5,326 HCCs (mean diameter, 2.9 cm ± 1.2) underwent 4,051 sessions of MWA with a median follow-up of 61.3 (0.6-169.5 range) months during 3 periods (2007-2010, 2011-2014, and 2015-2018). Technical success was achieved in 5,194 (97.5%) tumors with significant improvement over time, especially for >3.0-cm HCC (p < 0.001). Local tumor progression (LTP) showed no period-dependent advance, with >3.0-cm HCC and perivascular location being the risk factors for LTP. The median intrahepatic metastasis time was 27.6 (95% confidence interval [CI]: 25.2-28.8) months, with 5- and 10-year occurrence rates of 68.8% and 79.4%, respectively. The 5- and 10-year overall survivals were 63.9% and 41.1%, respectively, and BCLC stage 0, A, and all B patients showed an observable survival improvement over time (p < 0.001). The median disease-free survival time increased from 19.4 (95% CI: 16.5-22.6) months in 2007-2010 to 28.1 (95% CI: 25.9-32.3) months in 2015-2018. The improved survival for early recurrent (≤2 years) patients was period-dependent, as verified by Cox regression analyses. The major complications rate per procedure was 3.0% (122/4,051). CONCLUSIONS These real-world data show that MWA provided an upward trend in survival for HCC patients with BCLC stage 0-B over a 12-year follow-up period. An encouraging clear survival benefit in early recurrent patients was also observed.
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Affiliation(s)
- Jie Yu
- Department of Interventional Ultrasound, PLA Medical College& 5th Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Zhi-Gang Cheng
- Department of Interventional Ultrasound, PLA Medical College& 5th Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Zhi-Yu Han
- Department of Interventional Ultrasound, PLA Medical College& 5th Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Fang-Yi Liu
- Department of Interventional Ultrasound, PLA Medical College& 5th Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Rong-Qin Zheng
- Department of Medical Ultrasound, Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Wen Cheng
- Department of Ultrasound, Harbin Medical University Cancer Hospital, Harbin City, China
| | - Qiang Wei
- Department of Ultrasound, The Second Hospital of Nanjing, Nangjing, China
| | - Song-Yuan Yu
- Department of Wuhan University of Science and Technology, Tianyou Hospital, Wuhan, China
| | - Qin-ying Li
- Department of Ultrasound, Puyang Hospital of Traditional Chinese Medicine of Henan Province, Puyang, China
| | - Guang-zhi He
- Department of Ultrasound, University of Chinese Academy of Sciences Shenzhen Hospital, Shenzhen, China
| | - Yan-chun Luo
- Department of Interventional Ultrasound, PLA Medical College& 5th Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Xiao-Ling Yu
- Department of Interventional Ultrasound, PLA Medical College& 5th Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Ping Liang
- Department of Interventional Ultrasound, PLA Medical College& 5th Medical Center of Chinese PLA General Hospital, Beijing, China,*Ping Liang,
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Zheng L, Liu FY, Yu J, Cheng ZG, Yu XL, Dong XC, Han ZY, Liang P. Thermal ablation for papillary thyroid microcarcinoma located in the isthmus: a study with 3 years of follow-up. Future Oncol 2022; 18:471-480. [PMID: 35048734 DOI: 10.2217/fon-2021-0463] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Aims: To analyze the outcomes of thermal ablation for isthmic papillary thyroid microcarcinoma (PTMC). Patients & methods: Data for 21 isthmic-PTMC patients who underwent microwave ablation under ultrasound guidance were retrospectively collected. General information on patients and characteristics of tumors were collected. The technical effectiveness, tumor recurrence and volume changes and postoperative complications were recorded during the follow-up. Comparisons with 105 nonisthmic-PTMCs were done. Results: The technical effectiveness was 100%. No recurrence or lymph node metastases were detected. Tumor volume decreased significantly with a volume reduction rate of 1.00 ± 0.01 (range: 0.99 to 1.0) at the final evaluation and seven cases (31.8%) were completely resolved. No complication was encountered. No statistical differences were observed in terms of complications, recurrence or the volume reduction rate compared with the nonisthmic group (all p > 0.05). Conclusions: Percutaneous microwave ablation is an effective treatment strategy for isthmic-PTMC.
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Affiliation(s)
- Lin Zheng
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Fang-Yi Liu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Jie Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Zhi-Gang Cheng
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Xiao-Ling Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Xiao-Cong Dong
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Zhi-Yu Han
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Ping Liang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
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Wang Z, Yu XL, Zhang J, Cheng ZG, Han ZY, Liu FY, Dou JP, Kong Y, Dong XJ, Zhao QX, Yu J, Liang P, Tang WZ. Huaier granule prevents the recurrence of early-stage hepatocellular carcinoma after thermal ablation: A cohort study. J Ethnopharmacol 2021; 281:114539. [PMID: 34428522 DOI: 10.1016/j.jep.2021.114539] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 08/03/2021] [Accepted: 08/17/2021] [Indexed: 06/13/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Clinical trials have demonstrated that Trametes robinophila Murr (Huaier granule) can inhibit recurrence and metastasis after hepatocellular carcinoma (HCC) resection, but its efficacy as an adjuvant therapy after thermal ablation of early HCC is unknown. AIM OF THE STUDY To analyze the prognostic value and side effects of Huaier granules in HCC patients undergoing thermal ablation. MATERIALS AND METHODS Clinical information from 340 eligible subjects with early-stage HCC who were admitted to our department from September 1, 2008 to January 1, 2019 was extracted from the electronic medical record database. They were divided into the thermal ablation + TCM group and the thermal ablation group. Differences in their overall survival (OS), progression-free survival (PFS), extrahepatic metastatic rate (EMR), and therapeutic side effects (TSEs) between the two groups were compared. Beneficiaries of the integrated treatment and adequate treatment length were predicted. RESULTS The median follow-up was 32.5 months (range 2-122 months). The 1-year, 3-year and 5-year OS rates in the integrated treatment group and the control group were 93.2% vs. 92.6%, 54.5% vs. 51.4%, 23.5% vs. 19.7% (p = 0.110, HR 0.76(0.54-1.07)). The 1-year, 3-year and 5-year PFS rates were 78.8% vs. 69.4%, 50.6% vs. 40.6%, 35.3% vs. 26.5%, respectively (p = 0.020, HR 0.67(0.48-0.94)). The median OS (35 vs. 31 months) and PFS (24 vs. 12.5 months) were longer in the integrated treatment group. The EMR in the integrated treatment group was significantly lower than that in the control group (p = 0.018, HR 0.49 (0.27-0.89)). Patients with any two of the following three factors might be predicted to be beneficiaries of the integrated treatment, including younger than 65 years (p =0.039, HR 0.70 (0.50-0.98)), single tumor (p = 0.035, HR 0.70 (0.50-0.98), and tumor size ≤3 cm (p = 0.029, HR 0.69 (0.50-0.96). Patients with continuous oral administration of TCM following ablation had a lower probability of recurrence and metastasis within 2 years (p = 0.015, HR 0.67 (0.49-0.93)). Although the integrated treatment group reported a higher incidence of nausea and emesis, there were no significant differences between the two groups. CONCLUSION TCM following ablation may prolong PFS and suppress recurrence in patients with HCC, with continuous oral administration for more than 2 years maybe experience a greater benefit. The TSEs of the treatment are mild and can be tolerated.
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Affiliation(s)
- Zhen Wang
- Department of Gastrointestinal Surgery, Affiliated Tumor Hospital, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, PR China; Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, 100853, China
| | - Xiao-Ling Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, 100853, China
| | - Jing Zhang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, 100853, China
| | - Zhi-Gang Cheng
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, 100853, China
| | - Zhi-Yu Han
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, 100853, China
| | - Fang-Yi Liu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, 100853, China
| | - Jian-Ping Dou
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, 100853, China
| | - Yi Kong
- Department of Clinical Laboratory Medicine, Chinese PLA General Hospital & Postgraduate Medical School, Beijing, 100853, China; Department of Clinical Laboratory Medicine, Jining First People's Hospital, Jining, Shandong Province, 272000, PR China
| | - Xue-Juan Dong
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, 100853, China
| | - Qin-Xian Zhao
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, 100853, China
| | - Jie Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, 100853, China.
| | - Ping Liang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, 100853, China.
| | - Wei-Zhong Tang
- Department of Gastrointestinal Surgery, Affiliated Tumor Hospital, Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region, 530021, PR China; Guangxi Clinical Research Center for Colorectal Cancer, Nanning, Guangxi Zhuang Autonomous Region, 530021, PR China.
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Yin J, Wu JB, Qi C, Yao DH, Zheng JR, Ding LH, Zhu LL, Liu FY, Mei LY, Wu K. [Investigation on high-frequency hearing loss of noise workers in an automobile factory]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2021; 39:543-546. [PMID: 34365770 DOI: 10.3760/cma.j.cn121094-20200529-00301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the high-frequency hearing loss (HFHL) of workers in an automobile factory and its influencing factors, so as to provide a scientific basis for occupational health management of noise workers. Methods: From March to July 2019, 2647 workers from an automobile factory were selected as the research objects by cluster sampling method. The basic personal information (such as gender, age, education level, height, weight, etc.) , history of ear disease, the history of detonation, history of exposure to ototoxic drugs, history of exposure to occupational noise, etc., were investigated by questionnaire and occupational health examination. Chi-square test was used to compare the detection rates of HFHL in different populations, and multivariate logistic regression model was used to analyze the influencing factors of HFHL. Results: The noise level of 2647 individual workers ranged from 75.0 dB (A) to 92.0 dB (A) , with an average of (84.14±2.47) dB (A) . The detection rate of HFHL was 17.2% (456/2647) . There were significant differences in the the detection rate of HFHL among workers of different gender, age, educational level, working age, noise exposure level, diabetes history, detonation history, smoking and drinking workers (P<0.05) . Multivariate logistic regression analysis showed that male, age ≥30 years old, smoking and noise exposure were risk factors for HFHL (P<0.05) . Conclusion: The detection rate of HFHL in automobile factory workers is high. Gender, age, smoking and noise are the influencing factors of HFHL. It is necessary to strengthen the noise control in the workplace and guide workers to choose healthy lifestyle.
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Affiliation(s)
- J Yin
- Shiyan Occupational Disease Prevention and Control Hospital, Shiyan 442001, China
| | - J B Wu
- Shiyan Occupational Disease Prevention and Control Hospital, Shiyan 442001, China
| | - C Qi
- Shiyan Occupational Disease Prevention and Control Hospital, Shiyan 442001, China
| | - D H Yao
- Shiyan Occupational Disease Prevention and Control Hospital, Shiyan 442001, China
| | - J R Zheng
- Shiyan Occupational Disease Prevention and Control Hospital, Shiyan 442001, China
| | - L H Ding
- Shiyan Occupational Disease Prevention and Control Hospital, Shiyan 442001, China
| | - L L Zhu
- Shiyan Occupational Disease Prevention and Control Hospital, Shiyan 442001, China
| | - F Y Liu
- Shiyan Occupational Disease Prevention and Control Hospital, Shiyan 442001, China
| | - L Y Mei
- Hubei Center forDisease Control and Prevention, Wuhan 430070, China
| | - K Wu
- Shiyan Occupational Disease Prevention and Control Hospital, Shiyan 442001, China
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Chen ST, Han ZY, Ling P, Yu XL, Cheng ZG, Liu FY, Jiang H, Yu J. Percutaneous thermal ablation versus open liver resection for recurrent hepatoblastoma: a retrospective study. Int J Hyperthermia 2021; 38:1086-1091. [PMID: 34286633 DOI: 10.1080/02656736.2021.1941310] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The survival of children with recurrent hepatoblastoma (RHB) is still unsatisfactory and the treatment for relapsed patients is challenging. PURPOSE To compare short-term results between open liver resection (OLR) and percutaneous thermal ablation (TA) in the treatment of RHB and provide evidence to support the treatment options for such patients. METHODS A retrospective data of 21 patients with RHB in two Chinese centers were analyzed from January 2013 to May 2019. The baseline indicators and clinical effect of the two groups of children were compared. RESULTS There was no statistical difference in baseline indicators between the two groups of children, and complete remission (CR) was achieved after comprehensive treatment. The median follow-up time was 30 months (IQR 38.5 months) in the TA group, and 23 months (IQR 21.7 months) in OLR group (p = .57). The 2-year OS rates were 92.3% in the percutaneous TA group and 87.5% in the OLR group (p = .68, HR = 1.6, 95% confidence interval [CI]: 0.2-12.4). The 2-year EFS rates were 66.7%, in the TA group and 50.0% in the OLR group (p = .51, HR = 0.6, 95% CI: 0.2-2.6). Compared with the OLR group, TA group had shorter operation time (3.5 ± 1.8 vs. 0.5 ± 0.1, p < .001) and postoperative hospitalization time (11.8 ± 3.0 vs. 9.5 ± 6.8 d, p = .045). No major complications occurred in both groups. CONCLUSIONS Ultrasound-guided percutaneous TA for RHB is a safe and effect treatment option for children. It has comparable effect with surgery within 2 years after treatment. Particularly, due to its minimally invasive advantage, it needs shorter operation and hospitalization time. Percutaneous ablation may be an alternative minimally invasive treatment for RHB children.
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Affiliation(s)
- Si-Tong Chen
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, PR China
| | - Zhi-Yu Han
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, PR China
| | - Ping Ling
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, PR China
| | - Xiao-Ling Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, PR China
| | - Zhi-Gang Cheng
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, PR China
| | - Fang-Yi Liu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, PR China
| | - Hong Jiang
- Department of Pediatric Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, PR China
| | - Jie Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, PR China
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22
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Dou JP, Yu J, Cheng ZG, Liu FY, Yu XL, Hou QD, Liu F, Han ZY, Liang P. Symptomatic aseptic necrosis of benign thyroid lesions after microwave ablation: risk factors and clinical significance. Int J Hyperthermia 2021; 38:815-822. [PMID: 34039239 DOI: 10.1080/02656736.2021.1930203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Symptomatic aseptic necrosis (SAN) followed by nodule rupture is a kind of severe complications after thermal ablation for benign thyroid nodules (BTN). No studies are available to evaluate its pathologic process, clinical manifestations, risk factors and effectiveness of therapies after microwave ablation (MWA). METHODS From 2012 to 2019, 398 patients who received MWA for BTN were retrospectively reviewed. Clinical data included baseline patient characteristics, imaging features (internal vascularity and the proportion of the solid component), ablation power and time, complications and prognosis were collected and documented. RESULTS Ten patients (2.51%) experienced post-MWA SAN, eight patients with nodule rupture and the other two without. The mean time from MWA to SAN symptom was 8.6 days and to rupture was 16.3 days. The initial symptoms of SAN patients were neck bulging, swelling and discomfort. Patients would go through nodule rupture once the nodule contents extended into the extrathyroidal area with the discontinuity of the anterior thyroid capsule, and fistula formed unavoidably in this condition. Incision drainage was effective for rupture and early treatment of non-steroidal anti-inflammatory drug might cure the early-stage SAN. Multivariate analysis showed sex (OR = 0.13; 95% CI: 0.03, 0.61; p=.03) was the risk factor leading to SAN and males were more vulnerable to SAN. CONCLUSION SAN after MWA came earlier and initially illustrated as neck bulging, swelling and discomfort. Early detection and early treatment might prevent the rupture of nodules. Once the breakdown of thyroid capsule occurred, rupture of ablated nodules out of skin was unavoidable and invasive procedures might be the most effective treatment.
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Affiliation(s)
- Jian-Ping Dou
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Jie Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Zhi-Gang Cheng
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Fang-Yi Liu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Xiao-Ling Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Qi-di Hou
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Fang Liu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Zhi-Yu Han
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Ping Liang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
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23
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Yu J, Wang H, Cheng ZG, Liu FY, Li QY, He GZ, Luo YC, Yu XL, Han ZY, Liang P. A multicenter 10-year oncologic outcome of ultrasound-guided percutaneous microwave ablation of clinical T1 renal cell carcinoma: will it stand the test of time? Eur Radiol 2021; 32:89-100. [PMID: 34195888 DOI: 10.1007/s00330-021-07900-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 02/11/2021] [Accepted: 03/16/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVES We updated the experience on percutaneous microwave ablation for renal cell carcinoma with five-center data and long-term follow-up. METHODS This retrospective study reviewed the T1N0M0 renal cell carcinoma patients who underwent microwave ablation between April 2006 and December 2019. Clinicopathological and procedural data were collected. Technical effectiveness and complications were assessed, and the Kaplan-Meier method was used for cancer-specific survival, disease-free survival, overall survival, and local neoplastic process analyses. RESULTS A total of 323 consecutive patients (mean age, 62.9 years ± 14.0) with 371 biopsy-proved tumors (mean diameter, 2.9 cm ± 1.2) were enrolled, and 42.6% of the tumors were located adjacent to collecting system/bowel and technical effectiveness was achieved in 360 (97.0%) tumors. For 275 cT1a patients, during median follow-up time of 66.0 months (IQR, 58.4-73.6), 10-year local neoplastic processes, cancer-specific survival, disease-free survival, and overall survival rates were 1.9%, 87.4%, 71.8, and 67.5%, respectively. For 48 cT1b patients, during the median follow-up time of 30.4 months (IQR, 17.7-44.8), 5-year local tumor progression, cancer-specific survival, disease-free survival, and overall survival rates were 11.3%, 91.4%, 69.1, and 89.2%, respectively. Major complications showed no differences between cT1a (3.5%) and cT1b (6.9%) patients (p = 0.28). A clinical risk stratification system was developed based on multivariable model to predict DFS and CSS with c-indexes of 0.78 (95% CI: 0.71-0.85) and 0.77 (95% CI: 0.65-0.90), respectively. CONCLUSIONS With matured follow-up at five institutions, ultrasound-guided percutaneous microwave ablation is a reliable treatment option for cT1a renal cell carcinoma even in dangerous location and appears to be promising for cT1b tumors. KEY POINTS • To our knowledge, this is the first multicenter cohort of long-term oncologic outcomes with percutaneous MWA of cT1 RCC. • The predicting model we developed is accurate to predict the long-term DFS and CSS, which can help to provide a better MWA prognostication over routinely available clinical information. • The available evidence shows that microwave ablation of clinical stage T1 RCC is safe and reliable with promising long-term oncologic outcomes, especially for cT1a RCC with excellent 10-year results.
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Affiliation(s)
- Jie Yu
- Department of Interventional Ultrasound, PLA Medical College & Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Hui Wang
- Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, Jilin, 130000, China
| | - Zhi-Gang Cheng
- Department of Interventional Ultrasound, PLA Medical College & Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Fang-Yi Liu
- Department of Interventional Ultrasound, PLA Medical College & Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Qin-Ying Li
- Department of Ultrasound, Puyang Hospital of Traditional Chinese Medicine of Henan Province, No. 135 Shengli East Road, Puyang, 457000, Henan Province, China
| | - Guang-Zhi He
- Department of Ultrasound, University of Chinese Academy of Sciences Shenzhen Hospital, 4253 Songbai Road, Matian Street, Guangming District, Shenzhen, Guangdong Province, China
| | - Yan-Chun Luo
- Department of Interventional Ultrasound, PLA Medical College & Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Xiao-Ling Yu
- Department of Interventional Ultrasound, PLA Medical College & Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Zhi-Yu Han
- Department of Interventional Ultrasound, PLA Medical College & Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Ping Liang
- Department of Interventional Ultrasound, PLA Medical College & Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
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Yu J, Yu XL, Cheng ZG, Hu B, Han ZY, Liu FY, Hu ZQ, Wang H, Dong J, Pan J, Yang B, Sai X, Guo AT, Liang P. Percutaneous microwave ablation of renal cell carcinoma: practice guidelines of the ultrasound committee of Chinese medical association, interventional oncology committee of Chinese research hospital association. Int J Hyperthermia 2021; 37:827-835. [PMID: 32635839 DOI: 10.1080/02656736.2020.1779356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Imaging-guided percutaneous microwave ablation (MWA) with high thermal efficiency comprises rapid, successful management of small renal cell carcinomas (RCCs) in selected patients. Ultrasound Committee of Chinese Medical Association, Interventional Oncology Committee of Chinese Research Hospital Association developed evidence-based guidelines for MWA of RCCs after systematically reviewing the 1969-2019 literature. Systematic reviews, meta-analyses, randomized controlled trials, cohort, and case-control studies reporting MWA of RCCs were included and levels of evidence assessed. Altogether, 146 articles were identified, of which 35 reported percutaneous MWA for T1a RCCs and 5 articles for T1b RCCs. Guidelines were established based on indications, techniques, safety, and effectiveness of MWA for RCCs, with the goal of standardizing imaging-guided percutaneous MWA treatment of RCCs. Key points Microwave ablation is recommended for managing small renal cell carcinoma in selected patients. Imaging protocols are tailored based on the procedural plan, guidance, and evaluation. Patient's selection evaluation, updated technique information, clinical efficacy, and complications are recommended to standardize management. A joint task force (multidisciplinary team) summarized the key elements of the standardized report.
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Affiliation(s)
- Jie Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China.,State Key Laboratory of Kidney Disease, The Chinese PLA General Hospital, Beijing, China.,Ultrasound Committee of Chinese Medical Association, Beijing, China.,Interventional Oncology Committee of Chinese Research Hospital Association, Beijing, China
| | - Xiao-Ling Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China.,Ultrasound Committee of Chinese Medical Association, Beijing, China.,Interventional Oncology Committee of Chinese Research Hospital Association, Beijing, China
| | - Zhi-Gang Cheng
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China.,Ultrasound Committee of Chinese Medical Association, Beijing, China.,Interventional Oncology Committee of Chinese Research Hospital Association, Beijing, China
| | - Bing Hu
- Ultrasound Committee of Chinese Medical Association, Beijing, China.,Interventional Oncology Committee of Chinese Research Hospital Association, Beijing, China.,Department of Ultrasound in Med, 6th People's Hospital of Shanghai Jiaotong, University, Shanghai, China
| | - Zhi-Yu Han
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China.,Ultrasound Committee of Chinese Medical Association, Beijing, China.,Interventional Oncology Committee of Chinese Research Hospital Association, Beijing, China
| | - Fang-Yi Liu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China.,Ultrasound Committee of Chinese Medical Association, Beijing, China.,Interventional Oncology Committee of Chinese Research Hospital Association, Beijing, China
| | - Zhi-Quan Hu
- Department of Ultrasound, Medical Imaging Union Hospital of Tongji Medical College of HUST Wuhan, China
| | - Hui Wang
- Ultrasound Committee of Chinese Medical Association, Beijing, China.,Interventional Oncology Committee of Chinese Research Hospital Association, Beijing, China.,Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China
| | - Jun Dong
- Department of Urology, Chinese PLA General Hospital, Beijing, China
| | - Jie Pan
- Interventional Oncology Committee of Chinese Research Hospital Association, Beijing, China.,Department of Radiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Bo Yang
- Department of Oncology, Chinese PLA General Hospital, Beijing, China
| | - Xiaoyong Sai
- Chinese PLA General Hospital, Beijing, China.,National Clinical Research Center for Geriatric Diseases, Institute of Geriatrics, Beijing, China
| | - Ai-Tao Guo
- Department of Pathology, Chinese PLA General Hospital, Beijing, China
| | - Ping Liang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China.,State Key Laboratory of Kidney Disease, The Chinese PLA General Hospital, Beijing, China.,Ultrasound Committee of Chinese Medical Association, Beijing, China.,Interventional Oncology Committee of Chinese Research Hospital Association, Beijing, China
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25
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Liu FY, Zhang Q, Guo XX, Song X, Zhang CX. [Study on the mechanism of resistance to cypermethrin in Culex pipiens pallens using proteomics]. Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi 2021; 33:189-194. [PMID: 34008367 DOI: 10.16250/j.32.1374.2020347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To compare the differentially expressed proteins between cypermethrin-resistant and -sensitive Culex pipiens pallens, so as to unravel the mechanism underlying the resistance to cypermethrin in Cx. p. pallens. METHODS A quantitative proteomic analysis was performed among cypermethrin-sensitive and -resistant isolates of Cx. p. pallens using isobaric tags for relative and absolute quantification (iTRAQ) labeling coupled with liquid chromatography with tandem mass spectrometry (LC-MS/MS). RESULTS A total of 164 differentially expressed proteins were identified between cypermethrin-sensitive and -resistant isolates of Cx. p. pallens, including 54 up-regulated proteins and 110 down-regulated proteins. A large number of cuticular proteins, larval cuticular proteins, pupal cuticular proteins and cuticular structural constituent proteins, which are associated with cytoskeletal structure and components, were differentially expressed between cypermethrin-sensitive and -resistant isolates of Cx. p. pallens. Thirteen proteins, which were involved in energy production and conversion, translation, ribosomal structure and biogenesis, lipid transport and metabolism, post-translational modification, protein turnover, chaperones, cytoskeleton and intracellular transportation, were validated to be differentially expressed between cypermethrin-sensitive and -resistant isolates of Cx. p. pallens, which may serve as potential markers of cypermethrin resistance. CONCLUSIONS Multiple insecticide resistance mechanisms contribute to the resistance to cypermethrin in Cx. p. pallens, including cuticular resistance and metabolic resistance, and the cuticular protein genes and cytochrome P450 enzymes may play an important role in the resistance of Cx. p. pallens to cypermethrin.
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Affiliation(s)
- F Y Liu
- Shandong Institute of Parasitic Diseases, Shandong First Medical University & Shandong Academy of Medical Sciences, Jining 272000, China.,Clinical Laboratory, Affiliated Hosptial of Jining Medical University, China
| | - Q Zhang
- Jining Municipal Hospital of Traditional Chinese Medicine, Shandong Province, China
| | - X X Guo
- Shandong Institute of Parasitic Diseases, Shandong First Medical University & Shandong Academy of Medical Sciences, Jining 272000, China
| | - X Song
- Shandong Institute of Parasitic Diseases, Shandong First Medical University & Shandong Academy of Medical Sciences, Jining 272000, China
| | - C X Zhang
- Shandong Institute of Parasitic Diseases, Shandong First Medical University & Shandong Academy of Medical Sciences, Jining 272000, China
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Tu LK, Nie ML, Fu J, Liu FY, Chen YK, Sun JM, Wang HY. Comparing the efficacy of endovascular treatment for iliac vein compression syndrome with or without acute deep venous thrombosis: A single-center retrospective study. Vascular 2021; 30:341-348. [PMID: 33853455 DOI: 10.1177/17085381211003776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND To compare the efficacy of endovascular treatment for iliac vein compression syndrome (IVCS) with or without acute deep venous thrombosis of lower extremity. METHODS This study retrospectively analyzed the clinical data of 300 IVCS patients, who received endovascular treatment between January 2013 and December 2017. According to whether IVCS was complicated by deep venous thrombosis or not, these patients were divided into non-thrombotic iliac vein lesion group (NIVL group, n = 127) and post-thrombotic iliac vein lesion group (PIVL group, n = 173). After endovascular treatment, all patients were followed up to assess the symptoms improvement and to evaluate the patency of iliac vein. RESULTS The technical success rate was 98% (294/300), and percutaneous transluminal angioplasty with stenting was adopted in 294 cases. The incidence of perioperative complications was 36.33% (109/300), but no severe complications occurred. During a mean follow-up of 22.3 months (range 6-30 months), 9(6.82%, 9/132) patients in PIVL group had recurrence of deep venous thrombosis, but nobody had deep venous thrombosis and varicose veins recurrence in NIVL group. The effective rate of endovascular treatment in NIVL group and PIVL group was 96.88% and 90.15% (P = 0.050), while the cumulative primary patency of iliac vein in NIVL group was significantly higher than that in PIVL group (P = 0.008). CONCLUSIONS The endovascular treatment is an effective, feasible, safe method for treating IVCS. There is no difference in the efficacy of IVCS patients with or without deep venous thrombosis, but the medium and long-term patency of patients with deep venous thrombosis is lower than that in patients without deep venous thrombosis.
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Affiliation(s)
- L K Tu
- Department of Gastroenterology, University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - M L Nie
- Department of Abdominal Wall, Hernia and Vascular Surgery, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - J Fu
- Department of Abdominal Wall, Hernia and Vascular Surgery, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - F Y Liu
- Department of Abdominal Wall, Hernia and Vascular Surgery, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Y K Chen
- Department of Abdominal Wall, Hernia and Vascular Surgery, Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - J M Sun
- Department of Gastroenterology, University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - H Y Wang
- Department of Gastroenterology, University-Town Hospital of Chongqing Medical University, Chongqing, China
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An C, Li WZ, Huang ZM, Yu XL, Han YZ, Liu FY, Wu SS, Yu J, Liang P, Huang J. Small single perivascular hepatocellular carcinoma: comparisons of radiofrequency ablation and microwave ablation by using propensity score analysis. Eur Radiol 2021; 31:4764-4773. [PMID: 33399908 PMCID: PMC8213545 DOI: 10.1007/s00330-020-07571-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 11/17/2020] [Accepted: 11/27/2020] [Indexed: 01/31/2023]
Abstract
Objectives We aimed to compare the therapeutic outcomes of radiofrequency ablation (RFA) and microwave ablation (MWA) as first-line therapies in patients with small single perivascular hepatocellular carcinoma (HCC). Methods A total of 144 eligible patients with small (≤ 3 cm) single perivascular (proximity to hepatic and portal veins) HCC who underwent RFA (N = 70) or MWA (N = 74) as first-line treatment were included. The overall survival (OS), disease-free survival (DFS), and local tumor progression (LTP) rates between the two ablation modalities were compared. The inverse probability of treatment weighting (IPTW) method was used to reduce selection bias. Subgroup analysis was performed according to the type of hepatic vessels. Results After a median follow-up time of 38.2 months, there were no significant differences in OS (5-year OS: RFA 77.7% vs. MWA 74.6%; p = 0.600) and DFS (5-year DFS: RFA 24.7% vs. MWA 40.4%; p = 0.570). However, a significantly higher LTP rate was observed in the RFA group than the MWA group (5-year LTP: RFA 24.3% vs. MWA 8.4%; p = 0.030). IPTW-adjusted analyses revealed similar results. The treatment modality (RFA vs. MWA: HR 7.861, 95% CI 1.642–37.635, p = 0.010) was an independent prognostic factor for LTP. We observed a significant interaction effect of ablation modality and type of peritumoral vessel on LTP (p = 0.034). For patients with periportal HCC, the LTP rate was significantly higher in the RFA group than in the MWA group (p = 0.045). However, this difference was not observed in patients with perivenous HCC (p = 0.116). Conclusions In patients with a small single periportal HCC, MWA exhibited better tumor control than RFA. Key Points • Microwave ablation exhibited better local tumor control than radiofrequency ablation for small single periportal hepatocellular carcinoma. • There was a significant interaction between the treatment effect of ablation modality and type of peritumoral vessel on local tumor progression. • The type of peritumoral vessel is vital in choosing ablation modalities for hepatocellular carcinoma. Supplementary Information The online version contains supplementary material available at 10.1007/s00330-020-07571-5.
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Affiliation(s)
- Chao An
- Department of Minimal Invasive Intervention, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Wang-Zhong Li
- Department of Nasopharyngeal Carcinoma, Sun Yat-Sen University Cancer Center, Guangzhou, 510060, China
| | - Zhi-Mei Huang
- Department of Minimal Invasive Intervention, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Xiao-Ling Yu
- Department of Interventional Ultrasound, State Key Laboratory of Kidney Disease, The Chinese PLA General Hospital, Beijing, 100853, China
| | - Yu-Zhi Han
- Department of Interventional Ultrasound, State Key Laboratory of Kidney Disease, The Chinese PLA General Hospital, Beijing, 100853, China
| | - Fang-Yi Liu
- Department of Interventional Ultrasound, State Key Laboratory of Kidney Disease, The Chinese PLA General Hospital, Beijing, 100853, China
| | - Song-Song Wu
- Shengli Clinical Medical College of Fujian Medical University, Fuzhou, 350001, China
| | - Jie Yu
- Department of Interventional Ultrasound, State Key Laboratory of Kidney Disease, The Chinese PLA General Hospital, Beijing, 100853, China
| | - Ping Liang
- Department of Interventional Ultrasound, State Key Laboratory of Kidney Disease, The Chinese PLA General Hospital, Beijing, 100853, China
| | - Jinhua Huang
- Department of Minimal Invasive Intervention, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.
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Yang Q, Yu XL, Wang Y, Cheng ZG, Han ZY, Liu FY, Qian TG, Yu J, Liang P. Predictive effects of a combined indicator in patients with hepatocellular carcinoma after thermal ablation. J Cancer Res Ther 2020; 16:1038-1050. [PMID: 33004745 DOI: 10.4103/jcrt.jcrt_1080_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Aim This study aimed to investigate the predictive power of the combination of Systemic Immune-Inflammation Index (SII) and albumin-bilirubin (ALBI) grade in prognosis outcomes of early-stage hepatocellular carcinoma (HCC) after thermal ablation. Materials and Methods This retrospective study was reviewed and approved by our institutional review board, and written informed consent was obtained from each patient. According to the Milan criteria, a total of 405 treatment-naïve patients with clinicopathologically confirmed HCC were enrolled who subsequently underwent thermal ablation from 2011 to 2016. The outcomes of overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival (RFS) were statistically analyzed. Results The median follow-up time of this study was 45.1 months (range, 1.3-83.2 months). After thermal ablation in patients with SII-ALBI Grades 1, 2, and 3, the cumulative 5-year OS rates were 81.7%, 63.2%, and 26.9%; the 5-year CSS rates were 82.4%, 67.5%, and 26.9%; and the 5-year RFS rates were 49.3%, 44.6%, and 25.3%, respectively (all P < 0.001). On multivariate Cox regression analyses, SII-ALBI was independently associated with the three outcomes after adjustment for various confounders (all P < 0.05). In addition, SII-ALBI played a predictive role in OS, CSS, and RFS for patients with negative alpha-fetoprotein (AFP) (P < 0.05). Compared with SII and ALBI, the AUCs for the prediction of OS and CSS using SII-ALBI were superior to single indicator (bothP < 0.05). Conclusion Elevated preablation SII-ALBI is associated with shorter OS, CSS, and RFS in patients with early-stage HCC. Our indicator showed the potential to be a supplement tool for patients with negative AFP during follow-up.
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Affiliation(s)
- Qi Yang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Xiao-Ling Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Ying Wang
- Department of Ultrasound, The Second Affiliated Hospital of Qiqihar Medical College, Qiqihar, China
| | - Zhi-Gang Cheng
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Zhi-Yu Han
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Fang-Yi Liu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Tong-Gang Qian
- Department of Ultrasound, Zunhua People's Hospital, Hebei Province, Zunhua 064200, China
| | - Jie Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Ping Liang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
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Han ZY, Dou JP, Cheng ZG, Liu FY, Yu J, Yu XL, Liang P. Efficacy and safety of percutaneous ultrasound-guided microwave ablation for cervical metastatic lymph nodes from papillary thyroid carcinoma. Int J Hyperthermia 2020; 37:971-975. [PMID: 32781871 DOI: 10.1080/02656736.2020.1805128] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Zhi-Yu Han
- Department of Interventional Ultrasonics, General Hospital of Chinese PLA, Beijing, China
| | - Jian-Ping Dou
- Department of Interventional Ultrasonics, General Hospital of Chinese PLA, Beijing, China
| | - Zhi-Gang Cheng
- Department of Interventional Ultrasonics, General Hospital of Chinese PLA, Beijing, China
| | - Fang-Yi Liu
- Department of Interventional Ultrasonics, General Hospital of Chinese PLA, Beijing, China
| | - Jie Yu
- Department of Interventional Ultrasonics, General Hospital of Chinese PLA, Beijing, China
| | - Xiao-Ling Yu
- Department of Interventional Ultrasonics, General Hospital of Chinese PLA, Beijing, China
| | - Ping Liang
- Department of Interventional Ultrasonics, General Hospital of Chinese PLA, Beijing, China
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Zhang YX, Zhang XH, Yu XL, Han ZY, Yu J, Liu FY, Cheng ZG, Liang P. Prognosis of microwave ablation for hepatocellular carcinoma: does age make a difference? Int J Hyperthermia 2020; 37:688-695. [PMID: 32558602 DOI: 10.1080/02656736.2020.1778198] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Objective: Hepatocellular carcinoma (HCC) is a notable threat to the longevity of elderly people. However, there is no trial to study the prognosis of these elderly patients after microwave ablation (MWA) treatment. This study investigated whether elderly patients with HCC benefit from MWA similar to younger patients.Materials and methods: Patients who underwent ultrasound-guided percutaneous MWA were included and divided into four age groups and the prognosis was compared. The senior group (Group S, ≥75 years) was then compared with the younger group (Group Y, <75 years) after a 1:1 propensity score matching was applied. The prognostic outcomes were evaluated and Cox analysis was performed to determine the factors associated with survival.Results: The four age groups showed a statistically different distribution in terms of sex, size of liver nodules, and the Charlson comorbidity index. Although Group S had a higher Charlson comorbidity index, no significant differences were found between Group S and Group Y in the rates of complete ablation and major complications as well as overall survival and progression-free survival after matching. Cox analysis demonstrated that the size of tumors and Child Pugh grade rather than age or Charlson comorbidity index were significant prognostic factors for overall survival.Conclusion: The elderly patients with HCC, even though associated with more comorbidities, may achieve acceptable prognostic outcomes following MWA, which are not worse than their younger counterparts.
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Affiliation(s)
- Yi-Xuan Zhang
- Medical School of Chinese PLA, Beijing, China.,Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Xue-Hua Zhang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Xiao-Ling Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Zhi-Yu Han
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Jie Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Fang-Yi Liu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Zhi-Gang Cheng
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Ping Liang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China.,National Clinical Research Centre for Geriatric Diseases, the Second Medical Centre, Chinese PLA General Hospital, Beijing, China
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Guo Z, Fan D, Liu FY, Kong CY, Tang QZ. [Effects of maslinic acid on isoproterenol-induced myocardial fibrosis in mice]. Zhonghua Yi Xue Za Zhi 2020; 100:1820-1825. [PMID: 32536130 DOI: 10.3760/cma.j.cn112137-20190924-02105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the effect of maslinic acid (MA) on isoproterenol (ISO)-induced myocardial fibrosis in mice. Methods: ISO was used to induce myocardial fibrosis in adult male C57BL/6 mice, and MA was administered for two weeks to detect the effects of MA on cardiac function and fibrosis. Molecular changes of fibrosis markers and signaling pathways were detected by RT-PCR and western blotting. Phosphate buffer saline (PBS), PBS+SB203580 (p38 MAPK inhibitor), PBS+MA, ISO, ISO+SB203580, ISO+MA were added to the primary cultured rat fibroblasts. Cells were collected after 48 h for subsequent detection. Results: In this study, the mouse model of myocardial fibrosis was successfully established. The left ventricular faction shortening (FS) and maximum rate of rise and maximum rate of fall of pressure in left ventricular chamber (±dp/dt) of the ISO+MA group were significantly higher than those of the ISO group ((35.1±1.8)% vs (28.5±2.6)%, (7 256±153) mmHg/s vs (6 402±240) mmHg/s, (7 156±163) mmHg/s vs (6 319±219) mmHg/s, all P<0.05). The levels of interstitial and perivascular collagen deposition in the ISO+MA group were higher than those in the ISO group (P<0.05), the relative mRNA levels of COL-1, COL-3 and TGF-β in the ISO+MA group were significantly lower than those in the ISO group, with the relative expression levels of 1.70±0.24 vs 3.69±0.34, 1.72±0.56 vs 4.84±0.82, 1.52±0.19 vs 2.64±0.29, respectively (all P<0.05). The phosphorylation levels of p38 MAPK, Smad3 and protein expression level of TGF-β1 in ISO+MA group were lower than those in ISO group (relative expression levels were 1.67±0.35 vs 2.61±0.58, 1.68±0.23 vs 2.52±0.19,1.56±0.15 vs 2.48±0.26, respectively, all P<0.05). The results of in vitro cell experiments showed that the mRNA levels of COL-1, COL-3 and TGF-β in the SB203580 and MA groups were significantly lower than those in the ISO group (relative expression levels were 2.25±0.51, 2.16±0.48 vs 5.29±1.21; 1.58±0.34, 1.69±0.29 vs 4.97±1.32; 1.41±0.31, 1.55±0.38 vs 3.53±0.56, respectively, all P<0.05). The phosphorylation levels of p38 MAPK and Smad3 in the SB203580 MA groups was significantly lower than those in the ISO group, and the protein expression level of TGF-β1 was lower than that in the ISO group (1.81±0.18, 1.77±0.16 vs 2.56±0.32; 1.85±0.21, 1.81±0.17 vs 2.48±0.37; 1.84±0.24, 1.72±0.17 vs 2.52±0.29, all P<0.05). Conclusion: Maslinic acid can inhibit the phosphorylation of p38 MAPK, thereby preventing the canonical TGF-β1/Smads fibrosis signaling pathway to achieve an anti-fibrosis role.
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Affiliation(s)
- Z Guo
- Department of Cardiology, Renmin Hospital of Wuhan University; Cardiovascular Research Institute of Wuhan University; Hubei Key Laboratory of Cardiology, Wuhan 430060, China
| | - D Fan
- Department of Cardiology, Renmin Hospital of Wuhan University; Cardiovascular Research Institute of Wuhan University; Hubei Key Laboratory of Cardiology, Wuhan 430060, China
| | - F Y Liu
- Department of Cardiology, Renmin Hospital of Wuhan University; Cardiovascular Research Institute of Wuhan University; Hubei Key Laboratory of Cardiology, Wuhan 430060, China
| | - C Y Kong
- Department of Cardiology, Renmin Hospital of Wuhan University; Cardiovascular Research Institute of Wuhan University; Hubei Key Laboratory of Cardiology, Wuhan 430060, China
| | - Q Z Tang
- Department of Cardiology, Renmin Hospital of Wuhan University; Cardiovascular Research Institute of Wuhan University; Hubei Key Laboratory of Cardiology, Wuhan 430060, China
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32
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Zhai HY, Zhou QF, Dou JP, Liu FY, Zhu XY, Yu J, Liang P. Hepatic Microwave Ablation-Induced Tumor Destruction and Animal End Point Survival Can Be Improved by Suppression of Heat Shock Protein 90. J Ultrasound Med 2020; 39:1223-1232. [PMID: 31880357 DOI: 10.1002/jum.15212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 11/13/2019] [Accepted: 12/11/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To investigate the effect of heat shock protein 90 (HSP90) modulation on tumor necrosis, apoptosis, tumor growth delay, and end point survival by combining microwave ablation (MWA) with an HSP90 inhibitor in a nude mouse model. METHODS This study was approved by the Ethics Committee. Forty mice with HepG2 subcutaneous xenograft tumors (10 ± 1 mm) were randomized into 4 groups: (1) no treatment, (2) MWA only, (3) the HSP90 inhibitor ganetespib only, and (4) ganetespib combined with MWA. Tumors were harvested 24 hours after treatment, and gross coagulation diameters were measured. The effect of ganetespib on HSP90 and caspase 3 expression in the periablational rim was assessed. Another 40 mice with the same tumors and groupings were observed after treatment. Tumor growth curve and Kaplan-Meier survival analyses were performed with a tumor diameter of 2.2 cm and 40 days of survival as the defined survival end points. RESULTS Combination treatment significantly increased the coagulation size compared to tumors treated with MWA or ganetespib alone (P < 0.05). The combination of MWA and ganetespib decreased HSP90 expression and increased cleaved caspase 3 expression 24 hours after treatment. Compared with MWA or ganetespib only, combination treatment could lengthen the end point survival and reduce the tumor growth rate. CONCLUSIONS Modulation of HSP production can improve MWA-induced tumor apoptosis and destruction, reduce residual tumor growth rates, and prolong end point survival.
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Affiliation(s)
- Hong-Yan Zhai
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
- Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China
| | - Qun-Fang Zhou
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Jian-Ping Dou
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Fang-Yi Liu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Xin-Yuan Zhu
- Cardiovascular Surgery, Tianjin Medical University General Hospital, Tianjin, China
| | - Jie Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Ping Liang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
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Cui R, Wang XH, Ma C, Liu T, Cheng ZG, Han ZY, Liu FY, Yu XL, Yu J, Liang P. Comparison of Microwave Ablation and Transarterial Chemoembolization for Single-Nodule Hepatocellular Carcinoma Smaller Than 5cm: A Propensity Score Matching Analysis. Cancer Manag Res 2020; 11:10695-10704. [PMID: 31920380 PMCID: PMC6934117 DOI: 10.2147/cmar.s213581] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 10/27/2019] [Indexed: 12/29/2022] Open
Abstract
Purpose To compare overall survival (OS) and progression-free survival (PFS) between microwave ablation (MWA) and transarterial chemoembolization (TACE) for solitary hepatocellular carcinoma (HCC) smaller than 5 cm. Methods Patients with solitary HCC smaller than 5cm who initially underwent MWA or TACE were identified in Chinese PLA General Hospital from June 2010 to October 2015. Propensity score matching (PSM) was performed with a 1:1 matching protocol. OS and PFS were compared by using the log-rank test. After matching, subgroup analysis based on tumor size (≤3cm/3.1–5cm) was also conducted. Prognostic factors for OS and PFS were assessed with Cox proportional hazard regression model. Results A total of 202 patients (MWA, n=120; TACE, n=82) were identified. After matching, 116 patients were included (58 patients for each treatment group). MWA provided significantly better OS and PFS than TACE for both the entire cohort (OS, P<0.001; PFS, P<0.001) and the matched cohort (OS, P=0.015; PFS, P<0.001). Subgroup analysis showed that among patients with tumor of 3cm or less, the MWA group had significantly better OS (P=0.027) and PFS (P=0.008) than the TACE group. Multivariate Cox regression analysis showed TACE was associated with worse OS (hazard ratio, 2.385; 95% CI: 1.427, 3.985; P=0.001) and PFS (hazard ratio, 2.567; 95% CI: 1.820, 3.622; P<0.001). Conclusion MWA outperformed TACE for solitary HCC smaller than 5cm in OS and PFS. For single tumors less than 5cm, especially those smaller ones (≤3cm), priority should be given to MWA when making treatment options between MWA and TACE.
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Affiliation(s)
- Rui Cui
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing 100853, People's Republic of China.,Department of Ultrasonography, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou 510000, People's Republic of China
| | - Xiao-Hui Wang
- Department of Ultrasonography, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, People's Republic of China
| | - Chao Ma
- Department of Ultrasonography, Qiqihaer Hospital of Chinese Medicine, Qiqihaer 161000, People's Republic of China
| | - Tong Liu
- Department of Ultrasonography, Hebei Chest Hospital, Shijiazhuang 050000, People's Republic of China
| | - Zhi-Gang Cheng
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing 100853, People's Republic of China
| | - Zhi-Yu Han
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing 100853, People's Republic of China
| | - Fang-Yi Liu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing 100853, People's Republic of China
| | - Xiao-Ling Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing 100853, People's Republic of China
| | - Jie Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing 100853, People's Republic of China
| | - Ping Liang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing 100853, People's Republic of China
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Cui R, Yu J, Han ZY, Liu FY, Yu XL, Liang P. Ultrasound-Guided Percutaneous Microwave Ablation for Substernal Goiter: Initial Experience. J Ultrasound Med 2019; 38:2883-2891. [PMID: 30900322 DOI: 10.1002/jum.14992] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 02/12/2019] [Accepted: 02/18/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVES To preliminarily evaluate the safety, effectiveness, and feasibility of microwave ablation (MWA) for substernal goiter (SSG) in select patients and to provide a relevant treatment reference for further studies. METHODS From April 2017 to December 2017, 10 patients with SSG were treated by MWA. All patients were followed for at least 3 months to observe the therapeutic effects and complications. Therapeutic effects were assessed at follow-up for the relief of patients' symptoms, resolution of the cosmetic grade, and volume reduction rate (VRR) of SSG. Possibly related factors for the 3-month VRR of the nodules were analyzed. RESULTS The study included 9 female patients and 1 male patient with a mean age ± SD of 56.8 ± 10.1 years (range, 34-70 years). The mean volume of the nodules was 52.9 ± 27.9 mL (range, 23.7-122.6 mL). The nodule volume was significantly reduced at the 3-month follow-up (17.5 ± 9.5 mL; P < .05). The mean 3-month VRR of the index nodule was 66.7% ± 7.1%. A higher ablated portion-to-nodule ratio 1 day after MWA predicted a higher 3-month VRR (Spearman r = 0.646; P = .044). The mean symptom score (from 4.5 ± 1.7 to 1.5 ± 1.0; P = .005) and cosmetic grade (from 3.3 ± 0.5 to 2.2 ± 0.4; P = .004) declined significantly 3 months after the procedure. No complications or unexpected side effects were observed. CONCLUSIONS Our preliminary results support the effectiveness and safety of MWA for local control of SSG. This technology can be applied in select patients with SSG who are ineligible for surgery.
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Affiliation(s)
- Rui Cui
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Jie Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Zhi-Yu Han
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Fang-Yi Liu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Xiao-Ling Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Ping Liang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
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Zhai HY, Liang P, Yu J, Cao F, Kuang M, Liu FY, Liu FY, Zhu XY. Comparison of Sonazoid and SonoVue in the Diagnosis of Focal Liver Lesions: A Preliminary Study. J Ultrasound Med 2019; 38:2417-2425. [PMID: 30680779 DOI: 10.1002/jum.14940] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 12/10/2018] [Accepted: 12/30/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE This study aimed to compare the efficacy of Sonazoid and SonoVue in subjects with focal liver lesions. METHODS The patients who had untreated focal solid liver lesions confirmed by B-mode ultrasonography were eligible for the study. The target lesion and whole liver were scanned by gray scale ultrasonography; then, contrast-enhanced ultrasonography was performed, and the results were evaluated blindly. The main end point was accuracy improvement with postcontrast versus precontrast ultrasound examination for diagnosis of the target lesion of interest as malignant or benign against the reference standard. RESULTS There were 65 patients with 65 hepatic tumors enrolled in the study. The improvement of diagnostic accuracy was 0.30 in the Sonazoid group and 0.16 in the SonoVue group (95% confidence interval, -0.828-0.168; P = .24). Using 20% as the noninferiority margin, the upper limit of the 95% confidence interval (0.168) was less than 0.20. The number of lesions detected during the whole-liver scanning in the Sonazoid group was significantly more than that detected in the SonoVue group (P = .024). CONCLUSION The diagnosis value of Sonazoid is noninferior to SonoVue, and this new contrast agent can improves the whole-liver image quality.
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Affiliation(s)
- Hong-Yan Zhai
- Department of Interventional Ultrasound, The General Hospital of Chinese People's Liberation Army, Beijing, China
- Department of Ultrasound, Tianjin Medical University General Hospital, Tianjin, China
| | - Ping Liang
- Department of Interventional Ultrasound, The General Hospital of Chinese People's Liberation Army, Beijing, China
| | - Jie Yu
- Department of Interventional Ultrasound, The General Hospital of Chinese People's Liberation Army, Beijing, China
| | - Feng Cao
- Department of Cardiovascular, The General Hospital of Chinese People's Liberation Army, Beijing, China
| | - Ming Kuang
- Department of Medical Ultrasound, Division of Interventional Ultrasound, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Feng-Yong Liu
- Department of Interventional Radiology, The General Hospital of Chinese People's Liberation Army, Beijing, China
| | - Fang-Yi Liu
- Department of Interventional Ultrasound, The General Hospital of Chinese People's Liberation Army, Beijing, China
| | - Xin-Yuan Zhu
- Department of Cardiovascular Surgery, Tianjin Medical University General Hospital, Tianjin, China
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Dong LN, Yu XL, Cheng ZG, Han ZY, Liu FY, Chen G, Luo YC, Yu J, Liang P. Comparison of parallel and crossed placement of antennas in microwave ablation of 3-5 cm hepatocellular carcinoma. Abdom Radiol (NY) 2019; 44:2293-2300. [PMID: 30919040 DOI: 10.1007/s00261-019-01959-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE To evaluate the effects of ablation strategies on local tumor progression (LTP) after microwave ablation (MWA) of hepatocellular carcinomas (HCCs) measuring 3-5 cm. MATERIALS AND METHODS Between December 2011 and May 2017, 71 HCC patients with 71 nodules treated by ultrasound(US)-guided percutaneous MWA were divided into parallel (group A) and crossed (group B) antenna placement groups. All patients underwent MWA using two antennas with four insertions. LTP and overall survival (OS) rates were compared between the two groups. RESULTS The median follow-up time was 16.8 months. There was no significant difference in the complete ablation rate and treatment sessions between the two groups. LTP was diagnosed in 8 of 48 nodules (16.7%) in group A and 1 of 23 nodules (4.3%) in group B, with no significant difference between two groups (P = 0.115). The 1-, 2-, and 3-year OS rates were 88.5%, 79%, and 71.8% in group A and 93.8%, 87.5%, and 87.5% in group B, respectively (P = 0.236). Multivariate analysis showed that the tumor diameter (P = 0.017), the distance between the antennas (P = 0.032), and the total emission time (P = 0.015) were associated with LTP. CONCLUSIONS There were trends with lower LTP and improved OS in group B, despite the lack of statistically significant differences between the two strategies at a level of P < 0.05. The increase of distance between antennas and total emission time will facilitate reductions in LTP rate.
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Affiliation(s)
- Li-Nan Dong
- Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Xiao-Ling Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Zhi-Gang Cheng
- Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Zhi-Yu Han
- Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Fang-Yi Liu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Gang Chen
- Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Yan-Chun Luo
- Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Jie Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
| | - Ping Liang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
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Ren C, Liu SR, Wu WB, Yu XL, Cheng ZG, Liu FY, Liang P. Experimental and Preliminary Clinical Study of Real-Time Registration in Liver Tumors During Respiratory Motion Based on a Multimodality Image Navigation System. Technol Cancer Res Treat 2019; 18:1533033819857767. [PMID: 31390948 PMCID: PMC6686313 DOI: 10.1177/1533033819857767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Purpose: To develop a fusion imaging system that combines ultrasound and computed tomography for real-time tumor tracking and to validate the accuracy of performing registration via this approach during a specific breathing phase. Materials and Methods: The initial part of the experimental study was performed using iodized oil injection in pig livers and was focused on determining the accuracy of registration. Eight points (A1-4 and B1-4) at different positions and with different target sizes were selected as target points. During respiratory motion, we used our self-designed system to perform the procedure either with (experimental group, E) or without (control group, C) the respiratory monitoring module. The registration errors were then compared between the 2 groups and within group E. The second part of this study was designed as a preliminary clinical study and was performed in 18 patients. Screening was performed to determine the combination of points on the body surface that provided the highest sensitivity to respiratory motion. Registration was performed either with (group E) or without (group C) the respiratory monitoring module. Registration errors were compared between the 2 groups. Results: In part 1 of this study, there were fewer registration errors at each point in group E than at the corresponding points in group C (P < .01). In group E, there were more registration errors at points A1 and B1 than at the other points (P < .05). There was no significant difference in registration errors among the remaining points. During part 2 of the study, there was a significant difference in the registration errors between the 2 groups (P < .01). Conclusions: Real-time fusion registration is feasible and can be accurately performed during respiratory motions when using this system.
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Affiliation(s)
- Chao Ren
- 1 Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Shi-Rong Liu
- 2 Peking University Third Hospital, Beijing, China
| | - Wen-Bo Wu
- 3 Baihui Weikang Medical Robot Technology Co, Ltd, Beijing, China
| | - Xiao-Ling Yu
- 1 Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Zhi-Gang Cheng
- 1 Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Fang-Yi Liu
- 1 Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Ping Liang
- 1 Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
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Dong YZ, Liu FY, Guo YC. [Clinical analysis of the double-wing flap for treatment of toe syndactyly]. Zhonghua Wai Ke Za Zhi 2018; 56:906-909. [PMID: 30497117 DOI: 10.3760/cma.j.issn.0529-5815.2018.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the clinical effect of double-wing flap for the treatment of toe syndactyly. Methods: Retrospective analysis of 47 patients (60 syndactyly toes) who underwent double-wing flap to reconstruct toe web space in orthopedics department of the Third Affiliated Hospital of Zhengzhou University from February 2010 to October 2017.There were 21 males and 26 females, with an average age of 18.9 months (range: 10-48 months). All patients were treated with zigzag incisions to separate the toe syndactylys without skin grafts.The condition of wound healing and appearance of toes were observed. Results: The average follow-up time was 62.3 months (range: 6 to 80 months). There were no complications such as hematoma, infection, flap necrosis and no flexion contracture and obvious scar hyperplasia in all the 47 cases, 4 of the 60 webs developed web creep.All webs had good appearance with 45 degrees inclination from the dorsal to the metatarsal side and had good flexion and abduction function. Conclusions: The double-wing flap is a simple and safe operation for toe syndactyly which has a good clinical effect.
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Affiliation(s)
- Y Z Dong
- Orthopedics Department, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
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Liu XJ, Wang BY, Ren YC, Zhao Y, Liu DC, Zhang DD, Chen X, Liu LL, Cheng C, Liu FY, Zhou QG, Chen GZ, Hong SH, Liu D, Hu SQ, Zhang M, Hu DS. [A cohort study on body mass index and risk of all-cause mortality among hypertensive population]. Zhonghua Liu Xing Bing Xue Za Zhi 2018; 39:914-919. [PMID: 30060304 DOI: 10.3760/cma.j.issn.0254-6450.2018.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the relationship between body mass index (BMI) and all-cause mortality in hypertensive population. Methods: All participants were selected from a prospective cohort study based on a rural population from Henan province, China. Cox proportional hazards regression models were used to estimate the associations of different levels of BMI stratification with all-cause mortality. Restricted cubic spline models were used to detect the dose-response relation. Results: Among the 5 461 hypertensive patients, a total of 31 048.38 person-years follow-up was conducted. The median of follow-up time was 6 years, and 589 deaths occurred during the follow-up period. Compared to normal weight group (18.5 kg/m(2)<BMI<24.0 kg/m(2)) the multivariate-adjusted hazard ratios for all-cause mortality associated with BMI levels (<18.5 kg/m(2), 24-28 kg/m(2), and ≥28 kg/m(2)) were 0.83 (95%CI: 0.37-1.87), 0.81 (95%CI: 0.67-0.97), and 0.72 (95%CI: 0.56-0.91), respectively. The dose-response analysis showed a nonlinear, reverse "S" shaped relationship (non-linearity P<0.001). Conclusion: Overweight or obese might have a protective effect on all-cause mortality in hypertensive population, which supports the "obesity paradox" phenomenon.
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Affiliation(s)
- X J Liu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - B Y Wang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Y C Ren
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Y Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - D C Liu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - D D Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - X Chen
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - L L Liu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - C Cheng
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - F Y Liu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen 518060, China
| | - Q G Zhou
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen 518060, China
| | - G Z Chen
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen 518060, China
| | - S H Hong
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen 518060, China
| | - D Liu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen 518060, China
| | - S Q Hu
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen 518060, China
| | - M Zhang
- Department of Preventive Medicine, Shenzhen University Health Sciences Center, Shenzhen 518060, China
| | - D S Hu
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China
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Dou JP, Yu J, Yang XH, Cheng ZG, Han ZY, Liu FY, Yu XL, Liang P. Outcomes of microwave ablation for hepatocellular carcinoma adjacent to large vessels: a propensity score analysis. Oncotarget 2018; 8:28758-28768. [PMID: 28430634 PMCID: PMC5438689 DOI: 10.18632/oncotarget.15672] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2016] [Accepted: 02/01/2017] [Indexed: 02/07/2023] Open
Abstract
The aim of this study was to retrospectively compare the long-term efficacy of MW ablation as a curative therapy for hepatocellular carcinoma(HCC) adjacent to large vessels(≥3 mm) with that in safe location. Between 2010 and 2016, 406 patients diagnosed with early-stage HCC at Chinese PLA general hospital were enrolled. One-to-one matched pairs between the vessel group and the safe group were generated using propensity score matching. The associations of treatment strategy with overall survival and local tumor progression were determined by Cox regression. Before matching, 113 patients were classified into the vessel group and 293 patients were classified into the vessel group. The patients in the vessel group were more frequently classified as larger tumor size (P<0.05) and higher AFP level (P<0.05) than patients in the safe group. After propensity score matching, 113 pairs of well-matched HCC patients were selected from different treatment groups. No significant differences were found in local tumor progression, overall survival and complication rates for MW ablation as a first-line treatment for the early-stage HCC between two groups. In conclusion, MW ablation provides an effective and safe way to treat early-stage HCC adjacent to large vessels.
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Affiliation(s)
- Jian-Ping Dou
- Department of Interventional Ultrasound, Chinese People's Liberation Army (PLA) General Hospital, Beijing, 100853, China
| | - Jie Yu
- Department of Interventional Ultrasound, Chinese People's Liberation Army (PLA) General Hospital, Beijing, 100853, China
| | - Xiao-Huan Yang
- Department of Interventional Ultrasound, Chinese People's Liberation Army (PLA) General Hospital, Beijing, 100853, China
| | - Zhi-Gang Cheng
- Department of Interventional Ultrasound, Chinese People's Liberation Army (PLA) General Hospital, Beijing, 100853, China
| | - Zhi-Yu Han
- Department of Interventional Ultrasound, Chinese People's Liberation Army (PLA) General Hospital, Beijing, 100853, China
| | - Fang-Yi Liu
- Department of Interventional Ultrasound, Chinese People's Liberation Army (PLA) General Hospital, Beijing, 100853, China
| | - Xiao-Ling Yu
- Department of Interventional Ultrasound, Chinese People's Liberation Army (PLA) General Hospital, Beijing, 100853, China
| | - Ping Liang
- Department of Interventional Ultrasound, Chinese People's Liberation Army (PLA) General Hospital, Beijing, 100853, China
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An C, Hu ZL, Liang P, Cheng ZG, Han ZY, Yu J, Liu FY. Ultrasound-guided percutaneous microwave ablation vs. surgical resection for thoracoabdominal wall implants from hepatocellular carcinoma: intermediate-term results. Int J Hyperthermia 2017; 34:1067-1076. [PMID: 29161924 DOI: 10.1080/02656736.2017.1402131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE The aims of this study were to compare the clinical outcomes between ultrasound (US)-guided percutaneous microwave ablation (MWA) and surgical resection (SR) in patients with thoracoabdominal wall implants from hepatocellular carcinom (HCC) and to identify the prognostic factors associated with the two treatment methods. MATERIALS AND METHODS A total of 47 patients (mean age, 56.7 ± 15.9 years, range, 18-78 years; 34 men and 13 women) with 61 thoracoabdominal wall HCC seeding were included from April 2007 to May 2017. Twenty-five patients underwent US-guided MWA and 22 patients underwent SR. Survival, recurrence and liver function were compared between the two groups. Effect of changes in key parameters (i.e. overall survival (OS), disease-free survival (DFS) and local tumour reoccurrence-free (LTRF)) was statistically analysed with the log-rank test. Univariate and multivariate analyses were performed on several clinicopathological variables to identify factors affecting long-term outcome and recurrence. RESULTS The OS, DFS and LTRF after MWA were comparable to those of SR (p =0.493, p = 0.578 and p =0.270, respectively). Estimated 5-year overall survival rates were 63% after MWA and 48.1% after SR; for disease-free survival, estimated 5-year rates were 67.5% after MWA and 48.8% after SR; estimated 24-month LTRF rates were 71.3% after MWA and 87.8% after SR. The MWA group had less surgical time (p = <0.001), estimated blood loss (p = <0.001) and post-operative hospitalisation (p = 0.032) and cost (p = 0.015). Multivariate analysis showed remnant intrahepatic tumour (p =0.007), Child Pugh grade (p = 0.009) and metastasis (p= <0.001), were predictors for survival rate. CONCLUSIONS Ultrasound-guided percutaneous MWA is a safe and effective treatment method for metastatic HCC on the thoracoabdominal wall with similar outcomes to SR. Residual intrahepatic HCC, Child Pugh grade and distant metastasis are predictors for survival.
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Affiliation(s)
- Chao An
- a Department of Interventional Ultrasound , Chinese PLA General Hospital , Beijing , China
| | - Zi-Long Hu
- a Department of Interventional Ultrasound , Chinese PLA General Hospital , Beijing , China
| | - Ping Liang
- a Department of Interventional Ultrasound , Chinese PLA General Hospital , Beijing , China
| | - Zhi-Gang Cheng
- a Department of Interventional Ultrasound , Chinese PLA General Hospital , Beijing , China
| | - Zhi-Yu Han
- a Department of Interventional Ultrasound , Chinese PLA General Hospital , Beijing , China
| | - Jie Yu
- a Department of Interventional Ultrasound , Chinese PLA General Hospital , Beijing , China
| | - Fang-Yi Liu
- a Department of Interventional Ultrasound , Chinese PLA General Hospital , Beijing , China
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Li TS, Qi Y, Wang Y, Wang YX, Liu FY, Dai L, Xia GG. [Extensive burns complicated with infective endocarditis and septic pulmonary embolism: case report and literature review]. Zhonghua Jie He He Hu Xi Za Zhi 2017; 39:773-778. [PMID: 27784495 DOI: 10.3760/cma.j.issn.1001-0939.2016.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To improve the clinical recognition of infective endocarditis (IE) and septic pulmonary embolism (SPE) in patients with extensive burns. Methods: A case of large area burn complicated with IE and SPE confirmed by blood cultures and echocardiography was described. A literature review was performed with "burn" and "infective endocarditis" as the Chinese key words in Wanfang database; with "burn" and "infective endocarditis" as Mesh terms in PubMed. Results: The patient was a 37-year-old male with large area burn, who presented with fever and hemoptysis. Blood cultures were positive for methicillin resistant Staphylococcus aureus (MRSA). Echocardiography disclosed vegetations located in the tricuspid valve. Multiple wedge-shaped lesions were found on chest CT. From January 1978 to December 2015, 26 related articles were retrieved and 134 burned patients complicated with endocarditis were reported, of which, 97 cases were IE and 1 case with SPE. Of the 134 cases, 120 cases were dead, 12 cases cured and 2 cases unknown. The mortality was 89.6%. Conclusions: There was a high mortality of burned patients complicated with IE. SPE should be considered for patients with multiple peripheral nodules in both lungs and a positive blood culture. Combination and prolonged anti-infective therapy may increase the treatment success and reduce the risk of recurrence.
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Affiliation(s)
- T S Li
- Department of Respiratory and Critical Care Medicine, Beijing Jishuitan Hospital, Beijing 100035, China
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Dou JP, Yu J, Han ZY, Liu FY, Cheng ZG, Liang P. Microwave ablation for hepatocellular carcinoma associated with Budd-Chiari syndrome after transarterial chemoembolization: an analysis of ten cases. Abdom Radiol (NY) 2017; 42:962-968. [PMID: 27688061 DOI: 10.1007/s00261-016-0923-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
PURPOSE To evaluate the feasibility, efficacy, and safety of microwave ablation (MWA) in the treatment of hepatocellular carcinoma associated with Budd-Chiari syndrome (BCS) after transarterial chemoembolization (TACE). METHODS A total of 10 patients (mean 50.0 ± 7.5 years) with 15 BCS-associated HCC lesions were retrospectively evaluated. All patients received MWA treatment for residual tumors after 1 to 3 sessions of TACE. The diagnosis of residual tumors was confirmed by at least two types of enhanced imaging. CEUS images were performed to confirm the residual lesions and guide the placement of antenna before MWA. Thermal monitoring and artificial pleural effusion or ascites were used to guarantee ablative accuracy and safety for patients with tumors adjacent to vital structures. Technical success, technique efficacy, local tumor progression, survival rate, and the incidence of complications were comprehensively analyzed. RESULTS Technical success and technique effectiveness were achieved in all patients. Thirteen lesions achieved complete ablation for the first time, and 2 lesions needed two sessions. Thermal monitoring was used in 2 patients, artificial pleural effusion was used in 1 patient, and artificial ascites in 2 patients. In a median follow-up of 34.5 months (range 21-52 months), no LTP was founded in all patients. Intrahepatic recurrence was found in 5 patients. 1-, 2-, 3-, and 4-year survival rates were 100%, 100%, 74.1%, and 37.0%, respectively. No major or minor complications were observed. CONCLUSION Microwave ablation is a feasible and effective way to treat residual tumors after TACE treatment in patients with BCS-associated HCC.
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Affiliation(s)
- Jian-Ping Dou
- Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Jie Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Zhi-Yu Han
- Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Fang-Yi Liu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Zhi-Gang Cheng
- Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Ping Liang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
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Dou JP, Yu J, Cheng ZG, Han ZY, Liu FY, Yu XL, Liang P. Ultrasound-Guided Percutaneous Microwave Ablation for Hepatocellular Carcinoma in the Caudate Lobe. Ultrasound Med Biol 2016; 42:1825-1833. [PMID: 27126238 DOI: 10.1016/j.ultrasmedbio.2016.03.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 03/16/2016] [Accepted: 03/22/2016] [Indexed: 06/05/2023]
Abstract
Treatment for liver tumors in the caudate lobe is challenging because of their location and complex anatomy. This study was intended to evaluate the feasibility, efficacy and tolerability of ultrasound-guided percutaneous microwave (MW) ablation for treating hepatocellular carcinoma (HCC) in the caudate lobe. From December 2011 to May 2015, a total of 20 patients (mean age: 62 ± 11 y) with HCC in the caudate lobe were enrolled in this study. Patient characteristics and tumor features were analyzed. The epigastric approach, intercostal approach and the combination were used in 4, 14 and 2 patients, respectively. Contrast-enhanced ultrasound (CEUS) guidance and temperature monitoring were applied as ancillary techniques. Ethanol injection was performed for tumors adjacent to the inferior vena cava or hepatic hilum. Contrast images were performed to evaluate treatment response after ablation. Technical success, technique efficacy, local tumor progression and complications were documented. Technique efficacy was achieved in 18 patients (18/20, 90%). Two patients received (125)I brachytherapy as palliative therapy for residual tumors that could not be ablated technically after the first ablation. Technical success was achieved in 16 patients (16/20, 80%). In 2 patients, ablation was completed after two sessions. CEUS was applied in 5 patients and temperature monitoring in 2 patients. Eight patients received an ethanol injection during ablation. Eleven patients achieved a minimum 5-mm safety margins. Local tumor progression was detected in 3 patients (16.7%, 3/18) during a median follow-up of 18.4 mo (range: 3-45 mo). Tumors in these 3 patients were all larger than 2.0 cm. No major or minor complications were observed. In conclusion, ultrasound-guided percutaneous microwave ablation combined with CEUS, temperature monitoring, and ethanol injection is a tolerable and relatively effective treatment for HCC in the caudate lobe.
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Affiliation(s)
- Jian-Ping Dou
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Jie Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Zhi-Gang Cheng
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Zhi-Yu Han
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Fang-Yi Liu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Xiao-Ling Yu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
| | - Ping Liang
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China.
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Mu MJ, Yu J, Liang P, Yu XL, Han ZY, Cheng ZG, Liu FY, Zhai HY, Li X. [Long-term effects of ultrasound-guided microwave ablation in the treatment of small renal cell carcinoma]. Nan Fang Yi Ke Da Xue Xue Bao 2016; 36:622-627. [PMID: 27222174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To evaluate the long-term efficacy of microwave ablation in the treatment of small renal cell carcinoma (RCC). METHODS We retrospectively analyzed 140 cases of small cell renal carcinoma (151 lesions with a mean diameter of 2.8±0.8 cm) treated between April, 2006 and October, 2015 with ultrasound-guided microwave ablation with cooled-shaft needle antenna. One microwave ablation antenna was used for tumors less than 2 cm in diameter and 2 antennas were used for larger tumors. The patients received enhanced ultrasound and CT/MRI examinations at 1, 3, and 6 months after the operation and every 6 months thereafter. The overall survival, disease-free survival, and local tumor progression rate of the patients were evaluated. RESULTS The response rate of treatment (complete ablation at one month on enhanced images) was 100% in these patients. The local tumor progression rates at 1, 3, and 5 years were 0.9%, 2.0%, and 7.1%, respectively, and the 1-, 3-, and 5-year distant metastasis rates were 1.6%, 2.5%, and 7.9%, respectively. The overall survival rates of the patients at 1, 3, and 5 years were 98.4%, 94.8%, 89.5%, respectively, with disease-free survival rates of 98.4%, 93.0%, and 83.1%, respectively. No major complications occurred in these cases, and multivariate analysis showed that the tumor number (P=0.015) and tumor growth patterns (P=0.049) were independent risk factors that adversely affected the long-term outcome after surgery. CONCLUSION Our data show that microwave ablation is a safe and effective modality for treatment of renal cell carcinoma.
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Affiliation(s)
- Meng-Juan Mu
- Department of Interventional Ultrasound, General Hospital of PLA, Beijing 100853, China.E-mail:
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Chen JX, Cai GY, Chen XM, Liu H, Chen X, Peng YM, Liu FY, Li Z, Shi SZ. Effect of TIMP1 transfection on PTEN expression in human kidney proximal tubular cells. Genet Mol Res 2015; 14:17373-83. [PMID: 26782378 DOI: 10.4238/2015.december.21.6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
To explore the role of metalloproteinase-1 (TIMP-1) tissue inhibitor in the mechanisms of kidney aging, we observed the effects of sense and antisense transfection of TIMP-1 and of metalloproteinase (MMP) inhibitors on phosphatase and tensin homolog (PTEN), vascular endothelial growth factor (VEGF), and Flk-1 expression in TIMP-1 transgenic human proximal tubular epithelial cells (HKCs). Transfected HKCs were co-incubated with 100 μM MMP-2 and MMP-9 inhibitor III for 24 h to affect enzyme inhibition. TIMP-1, MMP-2, MMP-9, PTEN, VEGF, and Flk-1 mRNA expression was detected by reverse transcription-polymerase chain reaction. PTEN, VEGF, and Flk-1 protein expression in cells of each experimental group was measured by indirect immunofluorescence. We found that PTEN expression was up-regulated (P < 0.05) in the sense TIMP-1-transfected group (P < 0.05) compared with the non-transfected and empty vector groups, and that expression of VEGF and Flk-1 was down-regulated (P < 0.05). In contrast, the antisense TIMP-1 transgenic group showed the opposite results (P < 0.05). No significant differences in expression of PTEN, VEGF, or Flk-1 were observed among the MMP- 2/MMP-9 inhibitor III, non-transfected, and empty vector groups (P > 0.05). These results suggest that in the progression of renal aging, high expression of TIMP-1 up-regulates PTEN expression through an MMP-independent pathway, and subsequently down-regulates the expression of VEGF and Flk-1, indicating that PTEN and TIMP-1 are involved in the aging-associated impairment of renal angiogenesis. Our study provides a theoretical basis for further exploration of the mechanism underlying TIMP- 1 participation in renal aging progression.
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Affiliation(s)
- J X Chen
- Department of Nephrology, the Second Xiangya Hospital of Central South University, Changsha, China
| | - G Y Cai
- Department of Geriatric Nephrology, General Hospital of PLA, Beijing, China
| | - X M Chen
- Department of Geriatric Nephrology, General Hospital of PLA, Beijing, China
| | - H Liu
- Department of Nephrology, the Second Xiangya Hospital of Central South University, Changsha, China
| | - X Chen
- Department of Nephrology, the Second Xiangya Hospital of Central South University, Changsha, China
| | - Y M Peng
- Department of Geriatric Nephrology, General Hospital of PLA, Beijing, China
| | - F Y Liu
- Department of Nephrology, the Second Xiangya Hospital of Central South University, Changsha, China
| | - Z Li
- Department of Nephrology, the Second Xiangya Hospital of Central South University, Changsha, China
| | - S Z Shi
- Department of Nephrology, the Second Xiangya Hospital of Central South University, Changsha, China
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Wei Y, Yu XL, Liang P, Cheng ZG, Han ZY, Liu FY, Yu J. Guiding and controlling percutaneous pancreas biopsies with contrast-enhanced ultrasound: target lesions are not localized on B-mode ultrasound. Ultrasound Med Biol 2015; 41:1561-1569. [PMID: 25819468 DOI: 10.1016/j.ultrasmedbio.2015.01.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 01/11/2015] [Accepted: 01/19/2015] [Indexed: 06/04/2023]
Abstract
The aim of the study described here was to prospectively investigate the clinical and practical value of percutaneous contrast-enhanced ultrasound (CEUS)-guided biopsy of pancreatic lesions that are not definitively localized by B-mode ultrasound (US). Fifty-three patients underwent CEUS-guided biopsy. The rate of satisfactory percutaneous biopsy was 96.23% (51/53) with a median number of puncture attempts per patient of 3.0, and the diagnostic accuracy in satisfactory sampling was 96.08% (49/51). The sensitivity of CEUS-guided biopsy in diagnosing malignancy was 90.48% (38/42). There was only one major complication in our study, a patient (1/51, 1.96%) with biliary peritonitis. For pancreatic lesions that are not definitively localized by B-mode US, puncture guided by CEUS could improve accuracy, lower the incidence of complications and avoid unnecessary biopsy.
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Affiliation(s)
- Ying Wei
- Department of Interventional Ultrasound, General Hospital of Chinese People's Liberation Army, Beijing, China
| | - Xiao-Ling Yu
- Department of Interventional Ultrasound, General Hospital of Chinese People's Liberation Army, Beijing, China.
| | - Ping Liang
- Department of Interventional Ultrasound, General Hospital of Chinese People's Liberation Army, Beijing, China
| | - Zhi-Gang Cheng
- Department of Interventional Ultrasound, General Hospital of Chinese People's Liberation Army, Beijing, China
| | - Zhi-Yu Han
- Department of Interventional Ultrasound, General Hospital of Chinese People's Liberation Army, Beijing, China
| | - Fang-Yi Liu
- Department of Interventional Ultrasound, General Hospital of Chinese People's Liberation Army, Beijing, China
| | - Jie Yu
- Department of Interventional Ultrasound, General Hospital of Chinese People's Liberation Army, Beijing, China
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Xu SC, Man BY, Jiang SZ, Feng DJ, Gao SB, Chen CS, Liu M, Yang C, Zhang C, Bi D, Liu FY, Meng X. Sapphire-based graphene saturable absorber for long-time working femtosecond lasers. Opt Lett 2014; 39:2707-2710. [PMID: 24784083 DOI: 10.1364/ol.39.002707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
We report a long-time working femtosecond laser using metal-free sapphire-based graphene as a saturable absorber (SA). The sapphire-based graphene yielded excellent nonlinear saturable absorption properties and was demonstrated to be suitable as an SA for an ultrafast solid-state laser. Stable mode-locked pulses of 325 fs were obtained at a central wavelength of 1032 nm with a repetition rate of 66.3 MHz. At pump power of 8.23 W the average output power was 1.78 W and the highest pulse energy reached 26.8 nJ with a peak power of 72.6 kW. Our work opens up a facile route for making reliable graphene SA in the mode-locking technique and also displays an exciting prospect in making low-cost and ultrafast lasers.
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Lu T, Liang P, Wu WB, Xue J, Lei CL, Li YY, Sun YN, Liu FY. Integration of the Image-Guided Surgery Toolkit (IGSTK) into the Medical Imaging Interaction Toolkit (MITK). J Digit Imaging 2013; 25:729-37. [PMID: 22535192 DOI: 10.1007/s10278-012-9477-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The development cycle of an image-guided surgery navigation system is too long to meet current clinical needs. This paper presents an integrated system developed by the integration of two open-source software (IGSTK and MITK) to shorten the development cycle of the image-guided surgery navigation system and save human resources simultaneously. An image-guided surgery navigation system was established by connecting the two aforementioned open-source software libraries. It used the Medical Imaging Interaction Toolkit (MITK) as a framework providing image processing tools for the image-guided surgery navigation system of medical imaging software with a high degree of interaction and used the Image-Guided Surgery Toolkit (IGSTK) as a library that provided the basic components of the system for location, tracking, and registration. The electromagnetic tracking device was used to measure the real-time position of surgical tools and fiducials attached to the patient's anatomy. IGSTK was integrated into MITK; at the same time, the compatibility and the stability of this system were emphasized. Experiments showed that an integrated system of the image-guided surgery navigation system could be developed in 2 months. The integration of IGSTK into MITK is feasible. Several techniques for 3D reconstruction, geometric analysis, mesh generation, and surface data analysis for medical image analysis of MITK can connect with the techniques for location, tracking, and registration of IGSTK. This integration of advanced modalities can decrease software development time and emphasize the precision, safety, and robustness of the image-guided surgery navigation system.
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Affiliation(s)
- Tong Lu
- Department of Interventional Ultrasound, Chinese PLA General Hospital, Beijing, China
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Löffler H, Fechter A, Liu FY, Poppelreuther S, Krämer A. DNA damage-induced centrosome amplification occurs via excessive formation of centriolar satellites. Oncogene 2012; 32:2963-72. [PMID: 22824794 DOI: 10.1038/onc.2012.310] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Centrosome amplification is a frequent phenomenon in malignancies and may facilitate tumorigenesis by promoting chromosomal instability. On the other hand, a centrosome inactivation checkpoint comprising centrosome amplification leading to elimination of cells by mitotic catastrophe has been described in response to DNA damage by ionizing radiation or cytostatic drugs. So far, the exact nature of DNA damage-induced centrosome amplification, which might be overduplication or fragmentation of existing centrosomes, has been controversial. To solve this controversy, we have established a method to distinguish between these two possibilities using A549 cells expressing photoconvertible CETN2-Dendra2. In response to various DNA-damaging treatments, centrosome amplification but not fragmentation was observed. Moreover, centrosome amplification was preceded by excessive formation of centrin-containing centriolar satellites, which were identified as de novo-generated atypical centrin dots staining positive for centriolar satellite markers but negative or only weakly positive for other established centrosomal markers, and which could be verified as centriolar satellites using immunogold electron microscopy. In line with this notion, disruption of dynein-mediated recruitment of centrosomal proteins via centriolar satellites suppressed centrosome amplification after DNA damage, and excessive formation of centriolar satellites could be inhibited by interference with Chk1, a known mediator of centrosome amplification in response to DNA damage. In conclusion, we provide a model in which a Chk1-mediated DNA damage checkpoint induces excessive formation of centriolar satellites constituting assembly platforms for centrosomal proteins, which subsequently leads to centrosome amplification.
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Affiliation(s)
- H Löffler
- Clinical Cooperation Unit Molecular Hematology/Oncology, German Cancer Research Center (DKFZ) and Department of Internal Medicine V, University of Heidelberg, Heidelberg, Germany
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