Objective To explore the value of energy spectrum CT in the diagnosis of breast cancer.Methods Thirty-two hospitalized patients whose American Colledge of Radiology (ACR) breast imaging reporting and data system (BI-RADS) scores were 4-5 by mammography received non-enhanced spectral CT scans.The spectrum images,spectrum curve,lesion's size,morphology were observed,and also the pectoralis major muscle and axillary lymph node metastasis were evaluated and compared with mammography.Results Thirty-two patients were confirmed by pathology,including 16 cases of invasive duct carcinomas,1 case of medullary carcinoma,15 cases of lobular carcinomas,and 11 cases of the pectoralis major muscle invaded,9 cases of the axillary lymph nodes metastasis.ACR BI-RADS scores 4 were 23 cases,5 were 9 cases.Axillary lymph node metastasis and primary tumor spectrum curves were basically the same.Energy spectrum CT showed the lesion's shape,size,the relationship with the pectoralis major muscle and axillary lymph node metastasis.In 40-70 keV spectrum curve breast cancer displayed a downward trend.There were no significant differences between energy spectrum CT and mammography for the lesion's shape,edge,internal calcification and thickening of adjacent skin (P ＞ 0.05).While energy spectrum CT exhibited obvious advantages in demonstrating the pectoralis major muscle invaded and axillary lymph node metastasis (P ＜ 0.05).Conclusion Energy spectrum CT imaging displays greater clinical value for diagnosing breast cancer,and it can provide multi-parameter image for supporting clinical practice.

Objective To explore issues of the human tissue biobank, ranging from its establishment, collection and preservation of samples, quality control, management and application. Methods Development of standardized operational procedures, collection of such samples as fresh frozen tissues from the surgery, paraffin-embedded tissues, whole blood, serum, plasma, and cerebrospinal fluid. Specimens were classified and made aliquots according to different requirements, and then stored at room temperature, -80℃ refrigerator or in liquid nitrogen. Microsoft Access database system was used in the management of these specimens. Results From September 2004 to September 2008, a total of 11 872 samples from patients with benign and malignant diseases were collected and preserved. Among them, 4360 tubes of fresh frozen tissue samples from 2500 cases were provided within and beyond the province. These samples were also applied to DNA, RNA, protein extraction and tissue microarray, and immunohistochemistry-related research. Conclusion Human tissue biobank is highly useful in sharing human tissue resources effectively, as it can provide high quality specimens from benign and malignant diseases and normal control. In addition, it plays a very important role in exploring pathogenesis, developing new technologies for early detection of disease and new therapeutic strategies.

CDISC standard has become a set of global data standards that can be used in clinical study, covering the full life cycle of clinical researches. After nearly 20 years of development and continuous version upgrades, CDISC standard can improve the quality and efficiency of clinical research and drug review, and to facilitate all stakeholders involved in researches to exchange the study data and communicate the outcomes. CDISC standard has been or is to be adopted as standard format in data submission by multiple regulatory authorities, and more widely implemented by the global pharmaceutical community. CDISC standard is gradually adopted in China. The feasibility and roadmap of CDISC standard as the Chinese data submission format requirements are undergoing exploration and piloting further.

Background and purpose:At present, color Doppler ultrasound scoring and radionuclide imaging are two important imaging methods for diagnosing thyroid nodules, but their checking principle is different. Which method is better? Or combining them will be the best method for diagnosing thyroid nodules? This study aimed to compare the value of99mTcO4- combined with99mTc-methoxyisobutylisonitrile (MIBI) imaging, ultrasound scoring method and ultrasound scoring method+99mTcO4-+99mTc-MIBI imaging in diagnosis of thyroid nodules.Methods:The results of ultrasound scoring method and99mTcO4- combined with99mTc-MIBI imaging were compared in 50 patients with 54 thyroid nodules, and then compared with pathological findings. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of the methods were calculated.Results:A total of 54 thyroid nodules were found pathologically including 20 malignant and 34 benign nodules. The sensitivity, specificity, accuracy, PPV and NPV of99mTcO4- combined with99mTc-MIBI imaging were 80.00% (16/20), 70.59% (24/34), 74.07% (40/54), 61.54% (16/26), 85.71% (24/28), re-spectively. Those of ultrasound scoring method were 80.00% (16/20), 88.24% (30/34), 85.16% (46/54), 80.00% (16/20), 88.24% (30/34), respectively. And those of ultrasound scoring method+99mTcO4-+99mTc-MIBI imaging were 100.00% (20/20), 64.71% (22/34), 77.78% (42/54), 62.50% (20/32), 100.00% (22/22), respectively. The sensitivity of ultrasound scoring method+99mTcO4-+99mTc-MIBI imaging was higher than ultrasound scoring method or99mTcO4-+99mTc-MIBI imaging along (100.00%vs 80.00%, 100.00%vs 80.00%,χ2 value was 4.444 4 and 4.444 4,P value was 0.035 0 and 0.035 0, respectively). The specificity of ultrasound scoring method was higher than those of two methods combined together (88.24%vs 64.71%,χ2 value was 5.230 8,P value was 0.022 2). However, no factorial negative thyroid nodule was found by ul-trasound scoring method+99mTcO4-+99mTc-MIBI imaging.Conclusion:Ultrasound scoring method+99mTcO4-+99mTc-MIBI imaging can offer comprehensive diagnosis of thyroid nodules from their structure and function to avoid missed diagnosis.

Objective To investigate the influencing factors of 18F-FDG uptaking in head and neck malignancy by SPECT/CT coincidence imaging. Methods 18F-FDG SPECT/CT coincidence imaging was performed in 32 patients with head and neck malignancy after surgery, radiotherapy or radiotherapy + chemotherapy. The radio of target/no target (T/N) was calculated. The gender, age, fasting blood glucose level, size of tumor, location of tumor, pathological classification, de-gree of cell differentiation and treatment modalities were analyzed between groups. Results The single-factor analysis of variance showed that the T/N value was significantly higher in >70 yeas old, group than that of 41-50 yeas old group and 51-60 yeas old group (P<0.05). The T/N value was significantly lower in tumor size<2 cm group than that of 2-5 cm group and>5 cm group (P<0.05). And it was lower in poor differentiated tumor group than that of. undifferentiated tumor group (P<0.05). There were no significant differences in T/N values between other indicator groups (P>0.05). The multiple linear regression analysis showed that 18F-FDG uptaking in head and neck malignancy (T/N=Y) was related to the age of patients (X2), the diameter of tumor (X4) and the degree of cell differentiation (X9): =-4.389 25+0.053 03 X2+1.617 86 X4+0.718 35 X9. Conclusion Tumor recurrence is more likely to occur in patients with age>70 years old, the diameter of tumor≥2 cm, and the anaplastic head and neck malignancy.We should pay much attention to the diagnosis and follow-up for these pa-tients.

Objective To investigate the incidence and risk factors of chronic post-surgical pain (CPSP) and its effects on the quality of life in a large sample prospective study.Methods A total of 1098 patients of either sex,aged 18-70 yr,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,undergoing elective surgery,were enrolled in the study.Data regarding patient age,gender,body mass index,educational level,marital status,living situations,occupation,pre-surgical pain in the site of surgery,complications,type of surgery,surgery time and anesthesia method were recorded.The highest numeric rating scale scores within 3 days after surgery were also recorded.The patients were followed up at 3,6 and 12 months after surgery to record the development of CPSP.The patients were divided into CPSP group and non-CPSP group according to whether or not CPSP developed.Multivariable logistic regression analysis was performed to identify the risk factors for CPSP,and the quality of life was scored.Results A total of 981 patients completed the 1 year follow-up after surgery,the incidence of CPSP was 35.7％,and the constituent ratio of the distribution of the course was as follows:3 months ≤ postsurgical course ＜ 6 months was 33.1％;6 months ≤ postsurgical course ＜ 12 months was 16.8％;postsurgical course ≥ 12 months was 50.1％.Female,no diabetes mellitus and pre-surgical pain in the site of surgery were the independent risk factors for CPSP (P＜ 0.05).Compared with non-CPSP group,the physiological function score,professional function score,body pain score,vitality score,social function score,mental health score and general health score were significantly decreased (P＜0.01),and no significant change was found in the emotional function score in CPSP group (P＞0.05).Conclusion The probability of development of CPSP is high and the course is long,and the quality of life score is decreased;female,no diabetes mellitus and pre-surgical pain in the site of surgery are the independent risk factors for CPSP.

ObjectiveRetrospectively investigate the characteristics of neoplasma of health checkup participants to find ways to improve cancer detection rate.Methods A total of 186 confirmed cancer patients were enrolled in this study.Personal information,including age,gender,andlocation were collected.The contribution of clinical symptoms,physical examination and laboratory test to cancer detection was investigated.ResultsBiopsy confirmed cancers accounted for 0.133％( 186/140 127 ).Lung (0.036％ ),liver ( 0.017％ ),kidney ( 0.014％ ),colorectal ( 0.013％ ) and gastric cancer ( 0.011％ )were the most commonly found neoplasma.Detection rate of liver cancer in male was significantly higher than that in female (x2 =6.181,P＜0.05 ).Asymptomatic cancer was found in 158 adults (84.9％ ).Ultrasound showed a significantly higher sensitivity to liver,kidney and thyroid cancer than tumor biomarkers.The detection of lung cancer was improved with the combination of X ray,tumor marker( TM ),clinical symptom and low-dose chest CT scan.In 2008,the detection rate for digest system carcinoma (0.083％ ) and lung cancer (x2 =8.538,P＜0.05) was significantly increased (x2 =11.792,P＜0.05).ConclusionsHealth check-up plays an important role in early detection of cancer.The combined use of physical examination,chest X ray,ultrasound test,TM and CT may improve the detection of cancer.

Objective To explore cost effective means for early detection of malignant tumors in individuals undergoing health check-up.Methods This was a retrospective study involving 280,477 participants who had undergone health check-up including essential items from 2012 to 2016 at the Health Assessment and Intervention Research Center of Jiangsu Province.The protocol was composed of four steps.First,essential items were decided and conducted for all health examination participants.Second,cases with a high risk of malignant tumors were collected and additional tests were specified.Third,suspected malignant tumor cases were identified and recommendations for referrals and follow-up were made.Finally,physicians in charge of follow up would urge suspected cases to visit an oncologist,update case files,give regular instructions,and track recall results.Results There were 517 microscopically confirmed cases of malignant tumors,representing a detection rate of 184/100,000(1.84‰)in individuals seeking regular health check-up and of 2,023/100,000 (20.23‰)in those receiving follow ups.The five most prevalent malignant tumors were thyroid cancer (140 cases or 0.499‰),lung cancer(120 cases or 0.428‰),breast cancer(35 cases or 0.374‰),kidney cancer(55 cases or 0.196‰)and prostate cancer (33 cases or 0.177‰).Conclusions Essential examination items in combination with subsequent special tests,specialist referrals and follow ups are a cost effective way for early detection of malignant tumors in people seeking regular health examinations.

Objective:To characterize the histopathological subtypes and their clinicopathological parameters of gender and onset age by common, rare and sparse primary esophageal malignant tumors (PEMT).Methods:A total of 272 437 patients with PEMT were enrolled in this study, and all of the patients were received radical surgery. The clinicopathological information of the patients was obtained from the database established by the State Key Laboratory of Esophageal Cancer Prevention & Treatment from September 1973 to December 2020, which included the clinical treatment, pathological diagnosis and follow-up information of esophagus and gastric cardia cancers. All patients were diagnosed and classified by the criteria of esophageal tumor histopathological diagnosis and classification (2019) of the World Health Organization (WHO). The esophageal tumors, which were not included in the WHO classification, were analyzed separately according to the postoperative pathological diagnosis. The χ 2 test was performed by the SPSS 25.0 software on count data, and the test standard α=0.05. Results:A total of 32 histopathological types were identified in the enrolled PEMT patients, of which 10 subtypes were not included in the WHO classification. According to the frequency, PEMT were divided into common (esophageal squamous cell carcinoma, ESCC, accounting for 97.1%), rare (esophageal adenocarcinoma, EAC, accounting for 2.3%) and sparse (mainly esophageal small cell carcinoma, malignant melanoma, etc., accounting for 0.6%). All the common, rare, and sparse types occurred predominantly in male patients, and the gender difference of rare type was most significant (EAC, male∶ female, 2.67∶1), followed with common type (ESCC, male∶ female, 1.78∶1) and sparse type (male∶ female, 1.71∶1). The common type (ESCC) mainly occurred in the middle thoracic segment (65.2%), while the rare type (EAC) mainly occurred in the lower thoracic segment (56.8%). Among the sparse type, malignant melanoma and malignant fibrous histiocytoma were both predominantly located in the lower thoracic segment (51.7%, 66.7%), and the others were mainly in the middle thoracic segment.Conclusion:ESCC is the most common type among the 32 histopathological types of PEMT, followed by EAC as the rare type, and esophageal small cell carcinoma and malignant melanoma as the major sparse type, and all of which are mainly occur in male patients. The common type of ESCC mainly occur in the middle thoracic segment, while the rare type of EAC mainly in the lower thoracic segment. The mainly sparse type of malignant melanoma and malignant fibrous histiocytoma predominately occur in the lower thoracic segment, and the remaining sparse types mainly occur in the middle thoracic segment.