HRCT features between lepidic-predominant type and other pathological subtypes in early-stage invasive pulmonary adenocarcinoma appearing as a ground-glass nodule

Abstract Background Different pathological subtypes of invasive pulmonary adenocarcinoma (IPA) have different surgical methods and heterogeneous prognosis. It is essential to clarify IPA subtypes before operation and high-resolution computed tomography (HRCT) plays a very important role in this regard. We aimed to investigate the HRCT features of lepidic-predominant type and other pathological subtypes of early-stage (T1N0M0) IPA appearing as a ground-glass nodule (GGN). Methods We performed a retrospective analysis on clinical data and HRCT features of 630 lesions in 589 patients with pathologically confirmed IPA (invasive foci > 5 mm) appearing as pure GGN (pGGN) and mixed GGN (mGGN) with consolidation-to-tumor ratio (CTR) ≤0.5 from January to December 2019. All GGNs were classified as lepidic-predominant adenocarcinoma (LPA) and nonlepidic-predominant adenocarcinoma (n-LPA) groups. Univariate analysis was performed to analyze the differences of clinical data and HRCT features between the LPA and n-LPA groups. Multivariate analysis was conducted to determine the variables to distinguish the LPA from n-LPA group independently. The diagnostic performance of different parameters was compared using receiver operating characteristic curves. Results In total, 367 GGNs in the LPA group and 263 GGNs in the n-LPA group were identified. In the univariate analysis, the CTR, mean CT values, and mean diameters as well as mixed GGN, deep lobulation, spiculation, vascular change, bronchial change, and tumor–lung interface were smaller in the LPA group than in the n-LPA group (P < 0.05). Logistic regression model was reconstructed including the mean CT value, CTR, deep lobulation, spiculation, vascular change, and bronchial change (P < 0.05). Area under the curve of the logistic regression model for differentiating LPA and n-LPA was 0.840 (76.4% sensitivity, 78.7% specificity), which was significantly higher than that of the mean CT value or CTR. Conclusions Deep lobulation, spiculation, vascular change, and bronchial change, CT value > − 472.5 HU and CTR > 27.4% may indicate nonlepidic predominant invasive pulmonary adenocarcinoma in GGNs.

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HRCT Features Between Lepidic-Predominant Type and Other Pathological Subtypes in Early-Stage Invasive Pulmonary Adenocarcinoma Appearing as a Ground-Glass Nodule

10.21203/rs.3.rs-386984/v1 ◽

2021 ◽

Author(s):

Pengju Zhang ◽

Tianran Li ◽

Xuemin Tao ◽

Xin Jin ◽

Shaohong Zhao

Keyword(s):

Logistic Regression Model ◽

Early Stage ◽

Univariate Analysis ◽

Pulmonary Adenocarcinoma ◽

Vascular Change ◽

Ct Value ◽

Predominant Type ◽

Ground Glass Nodule ◽

The Mean ◽

Pathological Subtypes

Abstract Background: We aimed to investigate the high-resolution computed tomography (HRCT) features of lepidic-predominant type and other pathological subtypes of early-stage (T1N0M0) invasive pulmonary adenocarcinoma appearing as a ground-glass nodule (GGN). Methods: We performed a retrospective analysis on clinical data and HRCT features of 630 lesions in 589 patients with pathologically confirmed invasive pulmonary adenocarcinomas presenting as pure GGN and mixed GGN [consolidation-to-tumor ratio (CTR), <0.5] from January to December 2019. All GGNs were classified as lepidic-predominant adenocarcinoma (LPA) and nonlepidic-predominant adenocarcinoma (n-LPA) groups. Univariate analysis was performed to analyze the difference of clinical data and HRCT features between the LPA and n-LPA groups. Multivariate analysis was conducted to determine the variables to distinguish the LPA from n-LPA group independently. The diagnostic performance of different parameters was compared using receiver operating characteristic curves. Results: In total, 367 GGNs in the LPA group and 263 GGNs in the n-LPA group were identified. In the univariate analysis, the CTR, mean computed tomography (CT) values, and mean diameters as well as mixed GGN, deep lobulation, spiculation, vascular change, bronchial change, and tumor–lung interface were smaller in the LPA group than in the n-LPA group (P < 0.05). Logistic regression model was reconstructed including the mean CT value, deep lobulation, and vascular change (P < 0.001), as well as CTR, spiculation, and bronchial change (P < 0.05). Area under the curve of the logistic regression model for differentiating LPA and n-LPA was 0.840 (76.4% sensitivity, 78.7% specificity), which was significantly higher than that of the mean CT value or CTR (both P < 0.05). Conclusions: HRCT features were helpful in differentiating lepidic-predominant type from other subtypes in early-stage GGN invasive pulmonary adenocarcinoma. The mean CT value of <−472.5 HU and CTR of <27.4% were highly suspected in lepidic-predominant invasive pulmonary adenocarcinoma.

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Is it possible to get adequate dose coverage of a clinical target volume (CTV) to account for the possible extra capsular extension in early-stage prostate cancer by low dose rate (LDR) brachytherapy?

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.7_suppl.98 ◽

2011 ◽

Vol 29 (7_suppl) ◽

pp. 98-98

Author(s):

E. P. Saibishkumar ◽

D. Iupati ◽

J. Borg ◽

K. Fernandes

Keyword(s):

Prostate Cancer ◽

Early Stage ◽

Univariate Analysis ◽

Target Volume ◽

Implantation Technique ◽

Prostate Brachytherapy ◽

Exact Test ◽

Ldr Brachytherapy ◽

Adequate Dose ◽

The Mean

98 Background: There is no consensus for the definition and evaluation of CTV in post-implant setting for LDR prostate brachytherapy to account for extra capsular extension in clinically localized prostate cancer. In this study, we defined a CTV and evaluated its dosimetry in the post implant CT/MR scans done at 1 month after the LDR brachytherapy procedure. Methods: The initial consecutive 71 patients who underwent LDR brachytherapy under a single physician at Princess Margaret Hospital from June 2009 to July 2010 were included in this retrospective study. On the post implant MRI, the CTV was created by adding 3mm uniform margins around the prostate but respecting the anatomical boundaries like bone, bladder and rectum. Post implant dosimetry was based on CT/MR fusion using the dosimetric parameters V80, V90, V100, V150, V200, D80, D90 and D100. Implants were qualified as optimal if their V100 was >85% and D90 was >90% for both prostate and CTV. Univariate analysis was performed to evaluate associations of factors with V100 and D90 for the CTV using Wilcoxon rank sum test and Fisher's exact test. Results: The mean (SD) prostate V100 and D90 were 95.5% (4.2) and 117% (10) respectively with only 1 patient having sub optimal implant (V100 <85% and D90 <90%). The mean (SD) V100 and D90 for the CTV were also acceptable at 90.6% (4.9) and 103% (9), respectively. Six patients had V100 <85% and 7 patients had D90 <90% for the CTV. On univariate analysis, edema and seed implantation technique correlated with sub-optimal implant for the CTV. The mean (SD) edema for patients with V100 <85% was 18% (10) and with D90 <90% was 15% (12). The corresponding values for the optimal implants both in terms of V100 and D90 were 3% (13). Patients implanted with exclusively loose seeds (15 patients only) had higher incidence of sub-optimal implants (26%) compared to patients who had strands on the antero-lateral margins (56 patients; 3.5%). Conclusions: In this study, adequate dose coverage of CTV was achieved in most patients with current technique but implants with optimal dosimetry to prostate still may have sub-optimal D90 and V100 for the CTV. No significant financial relationships to disclose.

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Characteristics of circumferential vesico-vaginal fistulas: A cross-sectional and multicentric study

Urogynaecologia ◽

10.4081/uij.2021.269 ◽

2021 ◽

Vol 33 (1) ◽

Author(s):

Moussa Kaboré ◽

Brahima Kirakoya ◽

Adama Ouattara ◽

Clotaire Alexis Marie Kiemdiba Donega Yameogo ◽

Stéphanie Dominique Amida Nama ◽

...

Keyword(s):

Risk Factors ◽

Marital Status ◽

Logistic Regression Model ◽

Analytical Study ◽

Univariate Analysis ◽

Cross Sectional ◽

Multicentric Study ◽

Factors Associated ◽

Two Factors ◽

The Mean

The objective of the study was to determine the risk factors for development of circumferential fistula. We carried out a crosssectional, multicentric and analytical study over 7 years period, from 1st January, 2010 to 31 December, 2016. We compared circumferential and non- circumferential fistula patients in order to determine the risk factors for circumferential fistula development. Circumferential fistula accounted for 20% (91/456) of all vesico-vaginal fistulas. The mean age of the 456 patients was 35.9 years±12.15 (min 15 years; max 72 years). On univariate analysis, factors associated with the risk of circumferential fistula were: residence (P=0.039; OR=1.7), parity (P=0.04; OR=0.47), marital status before fistula (P=0.002; 4.3), duration of labor (P=0.041; OR=2.7) and fistula aetiology (P=0.038; OR=2.54). In a logistic regression model, two factors remained significant: marital status before fistula (P=0.029; OR=0.13) and duration of labor (P=0.017; OR=0.26). Circumferential fistula occurs in urban, primiparous, unmarried women who have been in labor for more than 41 hours.

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Blood Oxygenation Level Dependent Magnetic Resonance Imaging (MRI), Dynamic Contrast Enhanced MRI and Diffusion Weighted MRI for Benign and Malignant Breast Cancer Discrimination: A Preliminary Experience

Cancers ◽

10.3390/cancers13102421 ◽

2021 ◽

Vol 13 (10) ◽

pp. 2421

Author(s):

Roberta Fusco ◽

Vincenza Granata ◽

Mauro Mattace Raso ◽

Paolo Vallone ◽

Alessandro Pasquale De Rosa ◽

...

Keyword(s):

Standard Deviation ◽

Univariate Analysis ◽

Mean Value ◽

Blood Oxygenation ◽

Breast Lesions ◽

Dce Mri ◽

Malignant Lesions ◽

The Mean ◽

And Diffusion ◽

Skewness And Kurtosis

Purpose. To combine blood oxygenation level dependent magnetic resonance imaging (BOLD-MRI), dynamic contrast enhanced MRI (DCE-MRI), and diffusion weighted MRI (DW-MRI) in differentiation of benign and malignant breast lesions. Methods. Thirty-seven breast lesions (11 benign and 21 malignant lesions) pathologically proven were included in this retrospective preliminary study. Pharmaco-kinetic parameters including Ktrans, kep, ve, and vp were extracted by DCE-MRI; BOLD parameters were estimated by basal signal S0 and the relaxation rate R2*; and diffusion and perfusion parameters were derived by DW-MRI (pseudo-diffusion coefficient (Dp), perfusion fraction (fp), and tissue diffusivity (Dt)). The correlation coefficient, Wilcoxon-Mann-Whitney U-test, and receiver operating characteristic (ROC) analysis were calculated and area under the ROC curve (AUC) was obtained. Moreover, pattern recognition approaches (linear discrimination analysis and decision tree) with balancing technique and leave one out cross validation approach were considered. Results. R2* and D had a significant negative correlation (−0.57). The mean value, standard deviation, Skewness and Kurtosis values of R2* did not show a statistical significance between benign and malignant lesions (p > 0.05) confirmed by the ‘poor’ diagnostic value of ROC analysis. For DW-MRI derived parameters, the univariate analysis, standard deviation of D, Skewness and Kurtosis values of D* had a significant result to discriminate benign and malignant lesions and the best result at the univariate analysis in the discrimination of benign and malignant lesions was obtained by the Skewness of D* with an AUC of 82.9% (p-value = 0.02). Significant results for the mean value of Ktrans, mean value, standard deviation value and Skewness of kep, mean value, Skewness and Kurtosis of ve were obtained and the best AUC among DCE-MRI extracted parameters was reached by the mean value of kep and was equal to 80.0%. The best diagnostic performance in the discrimination of benign and malignant lesions was obtained at the multivariate analysis considering the DCE-MRI parameters alone with an AUC = 0.91 when the balancing technique was considered. Conclusions. Our results suggest that the combined use of DCE-MRI, DW-MRI and/or BOLD-MRI does not provide a dramatic improvement compared to the use of DCE-MRI features alone, in the classification of breast lesions. However, an interesting result was the negative correlation between R2* and D.

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Correlation between fundus autofluorescence and visual function in patients with cone-rod dystrophy

Scientific Reports ◽

10.1038/s41598-021-81597-7 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Satoru Kanda ◽

Takumi Hara ◽

Ryosuke Fujino ◽

Keiko Azuma ◽

Hirotsugu Soga ◽

...

Keyword(s):

Visual Field ◽

Significant Relationship ◽

Fundus Autofluorescence ◽

Univariate Analysis ◽

Retrospective Chart Review ◽

Mean Deviation ◽

Wide Field ◽

The Mean ◽

The Relationship ◽

Field Imaging

AbstractThis study aimed to investigate the relationship between autofluorescence (AF) signal measured with ultra-wide field imaging and visual functions in patients with cone-rod dystrophy (CORD). A retrospective chart review was performed for CORD patients. We performed the visual field test and fundus autofluorescence (FAF) measurement and visualized retinal structures with optical coherence tomography (OCT) on the same day. Using binarised FAF images, we identified a low FAF area ratio (LFAR: low FAF/30°). Relationships between age and logMAR visual acuity (VA), central retinal thickness (CRT), central choroidal thickness (CCT), mean deviation (MD) value, and LFAR were investigated. Thirty-seven eyes of 21 CORD patients (8 men and 13 women) were enrolled. The mean patient age was 49.8 years. LogMAR VA and MD were 0.52 ± 0.47 and − 17.91 ± 10.59 dB, respectively. There was a significant relationship between logMAR VA and MD (p = 0.001). LogMAR VA significantly correlated with CRT (p = 0.006) but not with other parameters. Conversely, univariate analysis suggested a significant relationship between MD and LFAR (p = 0.001). In the multivariate analysis, LFAR was significantly associated with MD (p = 0.002). In conclusion, it is useful to measure the low FAF area in patients with CORD. The AF measurement reflects the visual field deterioration but not VA in CORD.

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Patterns of Sequelae in Women with a History of Localized Breast Cancer: Results from the French VICAN Survey

Cancers ◽

10.3390/cancers13051161 ◽

2021 ◽

Vol 13 (5) ◽

pp. 1161

Author(s):

Lidia Delrieu ◽

Liacine Bouaoun ◽

Douae El Fatouhi ◽

Elise Dumas ◽

Anne-Deborah Bouhnik ◽

...

Keyword(s):

Breast Cancer ◽

Latent Class ◽

Early Stage ◽

Current Analysis ◽

Functional Pain ◽

Cognitive Sequelae ◽

History Of ◽

The Mean ◽

Study Participants ◽

Changes Over Time

Breast cancer (BC) remains complex for women both physically and psychologically. The objectives of this study were to (1) assess the evolution of the main sequelae and treatment two and five years after diagnosis in women with early-stage breast cancer, (2) explore patterns of sequelae associated with given sociodemographic, clinical, and lifestyle factors. The current analysis was based on 654 localized BC patients enrolled in the French nationwide longitudinal survey “vie après cancer” VICAN (January–June 2010). Information about study participants was collected at enrollment, two and five years after diagnosis. Changes over time of the main sequelae were analyzed and latent class analysis was performed to identify patterns of sequelae related to BC five years after diagnosis. The mean age (±SD) of study participants at inclusion was 49.7 (±10.5) years old. Six main classes of sequelae were identified two years and five years post-diagnosis (functional, pain, esthetic, fatigue, psychological, and gynecological). A significant decrease was observed for fatigue (p = 0.03) and an increase in cognitive sequelae was reported (p = 0.03). Two latent classes were identified—functional and esthetic patterns. Substantial sequelae remain up to five years after BC diagnosis. Changes in patient care pathways are needed to identify BC patients at a high risk.

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Subcritical Transmission in the Early Stage of COVID-19 in Korea

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18031265 ◽

2021 ◽

Vol 18 (3) ◽

pp. 1265

Author(s):

Yong Sul Won ◽

Jong-Hoon Kim ◽

Chi Young Ahn ◽

Hyojung Lee

Keyword(s):

Incubation Period ◽

Early Stage ◽

Probability Distributions ◽

Likelihood Estimation ◽

Contact Tracing ◽

Statistical Characterization ◽

Serial Interval ◽

Imported Cases ◽

The Mean ◽

Reporting Delays

While the coronavirus disease 2019 (COVID-19) outbreak has been ongoing in Korea since January 2020, there were limited transmissions during the early stages of the outbreak. In the present study, we aimed to provide a statistical characterization of COVID-19 transmissions that led to this small outbreak. We collated the individual data of the first 28 confirmed cases reported from 20 January to 10 February 2020. We estimated key epidemiological parameters such as reporting delay (i.e., time from symptom onset to confirmation), incubation period, and serial interval by fitting probability distributions to the data based on the maximum likelihood estimation. We also estimated the basic reproduction number (R0) using the renewal equation, which allows for the transmissibility to differ between imported and locally transmitted cases. There were 16 imported and 12 locally transmitted cases, and secondary transmissions per case were higher for the imported cases than the locally transmitted cases (nine vs. three cases). The mean reporting delays were estimated to be 6.76 days (95% CI: 4.53, 9.28) and 2.57 days (95% CI: 1.57, 4.23) for imported and locally transmitted cases, respectively. The mean incubation period was estimated to be 5.53 days (95% CI: 3.98, 8.09) and was shorter than the mean serial interval of 6.45 days (95% CI: 4.32, 9.65). The R0 was estimated to be 0.40 (95% CI: 0.16, 0.99), accounting for the local and imported cases. The fewer secondary cases and shorter reporting delays for the locally transmitted cases suggest that contact tracing of imported cases was effective at reducing further transmissions, which helped to keep R0 below one and the overall transmissions small.

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Characteristics and attitudes of family planners in Khartoum, Sudan

Journal of Biosocial Science ◽

10.1017/s002193200001381x ◽

1982 ◽

Vol 14 (1) ◽

pp. 7-16 ◽

Cited By ~ 2

Author(s):

M. A. Khalifa

Keyword(s):

Family Planning ◽

Birth Control ◽

Early Stage ◽

Significant Proportion ◽

Large Family ◽

Capital City ◽

Age Group ◽

African Countries ◽

The Mean ◽

Almost All

SummaryIn a survey of 1475 urban Moslem wives in the age group 15–49 living in the capital city of the Sudan, knowledge of birth control was reported by almost all respondents while a significant proportion had used contraception at least once. The mean age of the users was 32·8 years, their duration of marriage was 15·1 years and their mean number of surviving children was 4·6. Those who had never used contraception had a higher mean age, a longer duration of marriage and more surviving children. Most of the users had an urban residential background and belonged to the high socioeconomic class. They held favourable attitudes to family planning. Although they thought that having a large family (more than five children) was not desirable, their mean preferred family size was no different from that of the never users.The results indicate that contraception is used for the purpose of spacing births rather than limiting their ultimate number. At this early stage of contraceptive adoption in Sudan, the characteristics of the pioneer acceptors are similar to those observed in other African countries.

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Histopathologic-Based Prognostic Factors of Colorectal Cancers Are Associated With the State of the Local Immune Reaction

Journal of Clinical Oncology ◽

10.1200/jco.2010.30.5425 ◽

2011 ◽

Vol 29 (6) ◽

pp. 610-618 ◽

Cited By ~ 551

Author(s):

Bernhard Mlecnik ◽

Marie Tosolini ◽

Amos Kirilovsky ◽

Anne Berger ◽

Gabriela Bindea ◽

...

Keyword(s):

Predictive Accuracy ◽

Early Stage ◽

Univariate Analysis ◽

Prognostic Significance ◽

Tnm Staging ◽

Time Dependent ◽

Colorectal Cancers ◽

Tumor Extension ◽

T Stage ◽

Immune Score

Purpose The prognosis of patients with colorectal cancer has sometimes proved uncertain; thus, the prognostic significance of immune criteria was compared with that of the tumor extension criteria using the American Joint Committee on Cancer/International Union Against Cancer–TNM (AJCC/UICC-TNM) staging system. Patients and Methods We studied the intratumoral immune infiltrates in the center of the tumor and in the invasive margin of 599 specimens of stage I to IV colorectal cancers from two independent cohorts. We analyzed these findings in relation to the degree of tumor extension and to the frequency of recurrence. Results Growth of the primary tumor and metastatic spread were associated with decreased intratumoral immune T-cell densities. Sixty percent of patients with high densities of CD8+ cytotoxic T-lymphocyte infiltrate presented with stage Tis/T1 tumor, whereas no patients with low densities presented with such early-stage tumor. In patients who did not relapse, the density of CD8 infiltrates was inversely correlated with T stage. In contrast, in patients whose tumor recurred, the number of CD8 cells was low regardless of the T stage of the tumor. Univariate analysis showed that the immune score was significantly associated with differences in disease-free, disease-specific, and overall survival (hazard ratio [HR], 0.64, 0.60, and 0.70, respectively; P < .005). Time-dependent receiver operating characteristic curve analysis illustrated the predictive accuracy of the immune parameters (c-index = 65.3%, time-dependent c-index [Cτ] = 66.5%). A final stepwise model for Cox multivariate analysis supports the advantage of the immune score (HR, 0.64; P < .001; Cτ = 67.9%) compared with histopathologic features in predicting recurrence as well as survival. Conclusion Assessment of CD8+ cytotoxic T lymphocytes in combined tumor regions provides an indicator of tumor recurrence beyond that predicted by AJCC/UICC-TNM staging.

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Comparison of the Prognoses of FIGO Stage I to Stage II Adenosquamous Carcinoma and Adenocarcinoma of the Uterine Cervix Treated With Radical Hysterectomy

International Journal of Gynecological Cancer ◽

10.1097/igc.0b013e31826b5d9b ◽

2012 ◽

Vol 22 (8) ◽

pp. 1389-1397 ◽

Cited By ~ 14

Author(s):

Seiji Mabuchi ◽

Mika Okazawa ◽

Yasuto Kinose ◽

Koji Matsuo ◽

Masateru Fujiwara ◽

...

Keyword(s):

Risk Factors ◽

Cervical Cancer ◽

High Risk ◽

Uterine Cervix ◽

Radical Hysterectomy ◽

Adenosquamous Carcinoma ◽

Early Stage ◽

Univariate Analysis ◽

Low Risk ◽

Histological Subtype

ObjectivesTo evaluate the significance of adenosquamous carcinoma (ASC) compared with adenocarcinoma (AC) in the survival of surgically treated early-stage cervical cancer.MethodsWe retrospectively reviewed the medical records of 163 patients with International Federation of Gynecology and Obstetrics stage IA2 to stage IIB cervical cancer who had been treated with radical hysterectomy with or without adjuvant radiotherapy between January 1998 and December 2008. The patients were classified according to the following: (1) histological subtype (ASC group or AC group) and (2) pathological risk factors (low-risk or intermediate/high-risk group). Survival was evaluated using the Kaplan-Meier method and compared using the log-rank test. Multivariate analysis of progression-free survival (PFS) was performed using the Cox proportional hazards regression model to investigate the prognostic significance of histological subtype.ResultsClinicopathological characteristics were similar between the ASC and AC histology groups. Patients with the ASC histology displayed a PFS rate similar to that of the patients with the AC histology in both the low-risk and intermediate/high-risk groups. Neither the recurrence rate nor the pattern of recurrence differed between the ASC group and the AC group. Univariate analysis revealed that patients with pelvic lymph node metastasis and parametrial invasion achieved significantly shorter PFS than those without these risk factors.ConclusionsCharacteristics of the patients and the tumors as well as survival outcomes of ASC were comparable to adenocarcinoma of early-stage uterine cervix treated with radical hysterectomy. Our results in part support that the management of ASC could be the same as the one of AC of the uterine cervix.

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