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关键词： dogs   histopathology   mast cell tumours   optical coherence tomography   surgical margins  

摘要： Histopathologic surgical margin assessment in veterinary patients is an imprecise science with assessment limited to a small proportion of the surgical margin due to time and finances. Incomplete excision of canine mast cell tumours (MCTs) alters treatment recommendations and prognosis. Optical coherence tomography (OCT) is a novel imaging modality that has been reported in a single veterinary study for surgical margin assessment. Twenty-five dogs with 34 MCTs were enrolled in a prospective pilot-study to assess the imaging characteristics of canine MCTs with OCT and to evaluate the feasibility and utility of OCT-guided histopathology. All dogs underwent routine surgical excision of MCTs. OCT imaging was used to assess the entire surgical margin prior to placement in formalin. Either normal areas or areas suspected of incomplete MCT excision were inked. Standard histopathologic sectioning and tangential sectioning of inked areas were performed and compared to OCT results. OCT identified MCT near the surgical margin in 10 of 26 specimens (38.4%). Four specimens suspicious for incomplete margins on OCT had incomplete MCT excision that was missed on standard histopathologic sectioning. Six specimens had OCT-guided sections taken as suspicious, which did not show MCT on histopathology. OCT-guided pathology sections were able to detect incompletely excised MCT near the surgical margin with a sensitivity of 90% and specificity of 56.2% in this preliminary study. OCT imaging shows promise for guiding pathologists to areas of interest to improve the diagnostic accuracy of surgical margin assessment in excised canine MCTs.

关键词： Anastomotic leakage   Early detention   Procalcitonine   C-reactive protein   Colorectal surgery  

摘要： Procalcitonin (PCT) and C-Reactive Protein (CRP) are acute-phase reactants that indicate the presence and severity of an infection. The aim of this study was to verify the utility of CRP and PCT as tools for early diagnosis of anastomotic leakage (AL) in patients undergoing elective colorectal surgery. A prospective observational study including 95 patients undergoing elective colorectal surgery with anastomosis, where patients were divided into two groups according to whether or not AL happened. Different variables were compared using a uni- and multivariate analyses to identify the risk factors for AL. Receiver Operating Characteristic (ROC) curves were added to establish a cut-off point for CRP and PCT. The inflammatory marker levels were analysed in other complications different from AL. AL was detected in 11 patients (14%), 7 required an emergency reoperation. The overall morbidity rate was 42.1% and the mortality was 3.2%. In the univariate study, increased CRP on days 3 and 5, male sex and intraoperative complications were significantly associated with AL. In the multivariate study, CRP on day 5 was the only factor related to AL. AUC at ROC curves showed that CRP results >= 15.3 mg/dL on day 3 and 9.1 mg/dL on day 5 were predictors of AL. Normal CRP and PCT values had a high negative predictive value. CRP on postoperative day 5 is a reliable marker for early detection of anastomotic leakage in colorectal surgery. Both CRP and PCT on days 3 and 5 have a high negative predictive value.

关键词： Pancreatic acinar cell carcinoma   Pathological complete response   Cisplatin   Irinotecan  

摘要： Pancreatic acinar cell carcinoma is a rare tumor of the pancreas, and patients with such tumors rarely have a pathological complete response to treatment. Herein, we present a case involving a 48-year-old woman with a pancreatic tail mass. The pancreatic mass was connected to splenic and portal vein thrombosis. Distal pancreatectomy and removal of portal vein tumor thrombosis were performed. Ten months after surgery, multiple liver metastases and local recurrence in the pancreatic bed were detected, and chemotherapy was administered through the administration of a regimen containing both cisplatin and irinotecan. After seven courses of the cisplatin-plus-irinotecan regimen had been administered, computed tomography revealed that the patient had a partial response to treatment. Radical resection of multiple liver metastases and the locally recurrent tumor was performed. Pathological examination did not reveal the presence of carcinoma in any of the resected specimens. Thus, this case involves a pathological complete response in a patient with metastatic pancreatic acinar cell carcinoma who received a regimen containing both cisplatin and irinotecan. Our findings reveal that the administration of the cisplatin-plus-irinotecan regimen may be an option for the management of such tumors.

关键词： Inflammatory breast cancer   Locally advanced breast cancer   Tumor-infiltrating lymphocytes   pCR   PD-L1   CD20   Immuno-oncology   Patient outcomes  

摘要： Purpose This study evaluated epidemiologic and immune factors associated with pathologic complete response (pCR), breast cancer-specific survival (BCSS) and disease-free survival (DFS) outcomes in inflammatory (IBC) and locally advanced breast cancer (LABC) patients. Methods Tumor-infiltrating lymphocytes (TILs) and CD20(+) B-cell frequencies (CD20(+)), and PD-L1 expression on tumor (PD-L1(+)carcinoma cells) and immune (PD-L1(+)TILs) cells were analyzed by immunohistochemistry along with clinicopathologic factors as modifiers of pCR and outcomes in 221 IBC and 162 LABC patients. Analysis included Kaplan-Meier curves and Cox proportional hazard models. Results IBC and LABC display similar levels of TILs, CD20(+), and combined CD20(+) and PD-L1(+)TILs (CD20(+)PD-L1(+)TILs), while LABC contained more PD-L1(+)TILs and PD-L1(+) carcinoma cells. Absence of lymphovascular involvement, high TILs, PD-L1(+) carcinoma cells, and combined CD20(+) and PD-L1(+) carcinoma cells correlated with pCR in IBC and LABC patients. High PD-L1(+)TILs correlated with pCR only in LABC;less lymph node involvement at diagnosis, CD20(+) and CD20(+)PD-L1(+)TILs correlated with pCR only in IBC (P < 0.04, all comparisons). Achievement of pCR in IBC and LABC patients correlated with BCSS and DFS (P < 0.02). In multivariate analyses, pCR remained an independent prognostic factor of improved DFS in IBC and LABC patients, but of BCSS in only LABC. CD20(+)PD-L1(+)TILs remained an independent prognostic factor of improved DFS and BCSS only in IBC. Conclusion CD20(+)PD-L1(+)TILs are an independent prognostic biomarker of improved outcomes in IBC, but not LABC. Selecting IBC patients by CD20 and PD-L1 status could stratify patients and potentially identify those in whom activating CD20 agents and anti-PD-1/PD-L1 therapy could be explored.

关键词： Pathological gambling   Gambling disorder   Predictors   Addictions   Follow-up study   Course  

摘要： We examined the association of baseline social, demographic, and clinical predictor variables with course in 48 older (>= 60 years) and 57 younger (< 40 years) subjects with pathological gambling (PG) in a prospective follow-up study. Weekly gambling activity was tracked and used to categorize PG course. Generalized estimating equation models were used to examine predictors of disordered (i.e., level 2 or 3) gambling. Interaction tests were used to test for differential relationships for older and younger subjects. Predictors of disordered gambling during follow-up included greater severity of PG symptoms, greater severity of depressive symptoms, self-reported childhood neglect, cognitive distortions related to games of chance, and more role limitations due to physical health. Interaction tests showed that the relationships between some risk factors and disordered gambling varied for older and younger adults. Understanding these interrelationships could allow clinicians to more effectively monitor and manage their patients with PG.

关键词： Soft tissue sarcoma   Neoadjuvant radiotherapy   Surgery   Pathological response   Retrospective study  

摘要： Background: Evaluation of response to neoadjuvant radiotherapy (NART) does not consider soft tissue sarcoma (STS) heterogeneity. We aimed to investigate radiological and pathological response of 4 major histotypes. Methods: Extremity or trunk STS patients who received 50 Gy NART between 2009 and 2020 were retrospectively included. Relative variation in tumor size (RVTS) and pathological response were reported in the overall population and in undifferentiated pleomorphic sarcoma (UPS), myxofibrosarcoma (MFS), myxoid liposarcoma (MLS) and synovial sarcoma (SS) patients to identify response modalities of each histotype. Results: Among the 121 included patients, 49, 19, 13 and 11 presented UPS, MFS, MLS and SS. Median RVTS were 0% (IQR -18-+18), +8% (IQR 0-+24), -12% (IQR -20-3) and -11% (IQR -15-9), respectively (p = 0.001). Median viable cells were 10%, 60%, 20% and 70% (p = 0.007). In overall population, pathological complete response and median necrosis were 27.7% and 10% without significant correlation to histotype (p = 0.18 and 0.06). Nineteen (38.8%) UPS specimens presented cysts that were emptied during the sampling process and distorted the microscopic response evaluation. Infiltrative growth pattern was observed in 28% and 38.9% UPS and MFS patients. Five (38.5%) MLS presented mature adipocytes without proven prognostic value. Cysts were observed in 36% of SS specimens. In the absence of initial tumor limits, the great viable cellularity of SS may be overestimated by their nodular aspect. Conclusion: After NART, we highlighted disparate response of UPS, frequent progression of MFS, and confirmed MLS and SS radiosensitivity. Response must be interpreted with caution and consider the histotype-specific patterns. (C) 2021 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

关键词： anorexia   depression   MSRA   polymorphisms   psychopathology  

摘要： The objective is to determine whether variability in the MSRA gene, related to obesity and several psychiatric conditions, may be relevant for psychopathological symptoms common in Anorexia Nervosa (AN) and/or for the susceptibility to the disorder. A total of 629 women (233 AN patients and 396 controls) were genotyped for 14 tag-SNPs. Psychometric evaluation was performed with the EDI-2 and SCL-90R questionnaires. Genetic associations were carried out by logistic regression controlling for age and adjusting for multiple comparisons (FDR method). Two tag-SNPs, rs11249969 and rs81442 (with a pairwise r (2) value of 0.41), were associated with the global EDI-2 score, which measures EDI-related psychopathology (adjusted FDR-q = 0.02 and 0.04, respectively). Moreover, rs81442 significantly modulated all the scales of the SCL-90R test that evaluates general psychopathology (FDR-q values ranged from 4.1E-04 to 0.011). A sliding-window analysis using adjacent 3-SNP haplotypes revealed a proximal region of the MSRA gene spanning 187.8 Kbp whose variability deeply affected psychopathological symptoms of the AN patients. Depression was the symptom that showed the strongest association with any of the constructed haplotypes (FDR-q = 3.60E-06). No variants were found to be linked to AN risk or anthropometric parameters in patients or controls. Variability in the MSRA gene locus modulates psychopathology often presented by AN patients.

关键词： Deep learning   Dilated convolution   Histopathology image   Nuclei segmentation  

摘要： Purpose Increasing cancer disease incidence worldwide has become a major public health issue. Manual histopathological analysis is a common diagnostic method for cancer detection. Due to the complex structure and wide variability in the texture of histopathology images, it has been challenging for pathologists to diagnose manually those images. Automatic segmentation of histopathology images to diagnose cancer disease is a continuous exploration field in recent times. Segmentation and analysis for diagnosis of histopathology images by using an efficient deep learning algorithm are the purpose of the proposed method. Method To improve the segmentation performance, we proposed a deep learning framework that consists of a high-resolution encoder path, an atrous spatial pyramid pooling bottleneck module, and a powerful decoder. Compared to the benchmark segmentation models having a deep and thin path, our network is wide and deep that effectively leverages the strength of residual learning as well as encoder-decoder architecture. Results We performed careful experimentation and analysis on three publically available datasets namely kidney dataset, Triple Negative Breast Cancer (TNBC) dataset, and MoNuSeg histopathology image dataset. We have used the two most preferred performance metrics called F1 score and aggregated Jaccard index (AJI) to evaluate the performance of the proposed model. The measured values of F1 score and AJI score are (0.9684, 0.9394), (0.8419, 0.7282), and (0.8344, 0.7169) on the kidney dataset, TNBC histopathology dataset, and MoNuSeg dataset, respectively. Conclusion: Our proposed method yields better results as compared to benchmark segmentation methods on three histopathology datasets. Visual segmentation results justify the high value of the F1 score and AJI scores which indicated that it is a very good prediction by our proposed model.

关键词： Nasopharyngeal carcinoma   Amide proton transfer   Tumor bearing mice   Response evaluation  

摘要： Objective To investigate the dynamic change of amide proton transfer (APT) imaging before and after irradiation in nasopharyngeal carcinoma (NPC) and the underlying histopathological mechanism. Materials and Methods Tumor-bearing BALB/C nude mouse models were established and randomly divided into three groups: high-dose group (20 Gy/2 fractions), low-dose group (10 Gy/2 fractions), and control group (0 Gy). MRI scanning was performed before irradiation and 3rd, 6th, and 9th day post-irradiation. Scanning sequence included T1 weighted, T2 weighted, and APT. HE staining and TUNEL immunofluorescence detection were performed to detect necrosis and apoptosis. Results After high-dose irradiation, the mean tumor APT values decreased significantly on the 3rd day and 6th day (from 3.83 before radiotherapy to 2.41%, P < 0.001, 3rd day;from 2.41 to 1.80%, P = 0.001, 6th day). For low-dose irradiation, the mean tumor APT values decreased slightly on the 3rd day and 6th day (from 3.52 to 3.13%, P = 0.109, 3rd day;from 3.13 to 3.05%, P = 0.64, 6th day). The mean APT values of nonirradiated tumor changed slightly. In contrast, the average volume of high-dose irradiated tumors did not decrease obviously until the 9th day post-irradiation (from 290 before radiotherapy to 208 mm(3) on the 9th day). The low-dose irradiated tumors showed slow growth, and the nonirradiated tumors showed rapid growth. Subsequent HE staining and TUNEL staining showed obvious necrosis characteristics and higher proportion of positive apoptotic cell nucleus in high-dose irradiated tumors, but not nonirradiated tumors. Conclusion The APT signal intensity decreased after irradiation, which is earlier than the change of tumor volume. What is more, the decrease of APT signal intensity is more significant in high-dose group. Histological analysis showed obvious apoptosis and necrosis histological characteristic in irradiated tumor, which may explain the decrease of APT signal intensity. These results indicate th

关键词： Dentistry