Objective:To explore the diagnostic value of C-TIRADS combined with artificial intelligence-assisted diagnosis S-Detect technology in the differential diagnosis of thyroid nodules.Methods:A total of 237 thyroid nodules patients (237 thyroid nodules)with ultrasound examination and definitive pathologic results in Henan Cancer Hospital from April to September 2020 were retrospectively analyzed. The nodules were diagnosed according to C-TIRADS guidelines, and then by S-Detect technology combined with C-TIRADS guidelines. The ROC curve was plotted with the pathological results as the gold standard, and the area under the ROC curve, sensitivity, specificity and accuracy of the diagnosis results between the two groups were compared.Results:Among the 237 thyroid nodules, 105 were benign and 132 were malignant.The area under the ROC curve of C-TIRADS diagnosis alone and C-TIRADS diagnosis combined with artificial intelligence were 0.869 and 0.942 respectively, the difference between the two groups was statistically significant (χ 2=36.11, P<0.001); When Category 4A was used as the cutoff value of benign and malignant differential diagnosis, the specificity and accuracy of C-TIRADS classification of artificial intelligence-assisted diagnosis was significantly higher than that of C-TIRADS alone, and the difference was statistically significant(83.81% vs 47.62%, 90.72% vs 75.53%, all P<0.05). Conclusions:C-TIRADS combined with artificial intelligence-assisted diagnosis S-Detect technology has a high efficiency in the diagnosis of thyroid nodules and can improve the specificity and accuracy of thyroid nodules diagnosis and reduce unnecessary biopsy.

Objective: To investigate the effect of fried food intake on the pathogenesis of gastric cancer and precancerous lesions. Methods: From 2005 to 2013, the residents aged 40-69 years from 11 counties/cities where cancer screening of upper gastrointestinal cancer were conducted in rural areas of Henan province as the subjects (82 367 cases). The information such as demography and lifestyle was collected. The residents were screened with endoscopic examination. The biopsy sampleswere diagnosed pathologically, according to pathological diagnosis criteria, the subjects with high risk were divided into the groups with different pathological degrees. The multivariate ordinal logistic regression analysis was used to analyze the relationship between the frequency of fried food intake and gastric cancer and precancerous lesions. Results: The study coverd 46 425 males and 35 942 females, with a age of (53.46±8.07)years. The study collected 6 707 cases of normal stomach, 2 325 cases of low grade intraepithelial neoplasia, 226 cases of high grade intraepithelial neoplasia and 331 cases of gastric cancer. Multivariate logistic regression analysis showed that, compared with those whoeat fried food less than one time per week, fried foods intake (<2 times/week: OR=1.89, 95%CI: 1.57-2.28; ≥ 2 times/week: OR=1.91, 95%CI: 1.66-2.20) were a risk factor for gastric cancer and precancerous lesions after adjustment for age, sex, marital status, educational level, body mass index (BMI), smoking and drinking status. Conclusion The intake of fried food is a risk factor for gastric cancer and precancerous lesions. Therefore, reducing the intake of fried food can prevent the occurrence of gastric carcinoma and precancerous lesions.

Objective:To evaluate the value of a novel multiphase three-dimensional deep learning neural network of computer-aided diagnosis (CAD) used in LDCT lung cancer screening.Methods:Eight thousand eight hundred and fifty volunteers with 1 111 nodules were enrolled in the lung cancer screening from November of 2013 to December of 2017, and the baseline LDCT imaging data of volunteers accompanied with clinical information were retrospectively analyzed. All volunteers in this study were designed to receive LDCT test at least once. All the imaging of volunteers were read through the methods of visual detectioin (VD), CAD, and VD Combined CAD. The criteria of the true pulmonary nodule was determinated by the consistent opinion of two specialists in chest imaging（in case of disagreement, the decision should made by the third chief physician). In terms of the numbers, types or Lung-RADS categories of nodules, the detection rate, missed diagnosis rate and false positive rate of pulmonary nodules or lung cancer among three methods were compared, and the rates between groups were compared by χ 2test. Results:Compared with VD or CAD ,the detection rate of nodules in the CAD combined VD was significantly increased (95.7% , 94.2%, vs. 80.1% P<0.05 ), and the rate of missed diagnosis was significantly reduced (5.8%, 4.3% vs. 19.9% ，χ2=101.650, 128.500 ，P<0.05); Compared with VD, the methods of CAD or VD combined CAD significantly increased the the detection rates of Lung-RADS categories (χ2 =25.083,23.449, P=0.000, 0.000) or different types of nodules (χ2=6.955,6.821, P=0.031, 0.033), but there was no statistically significant difference between CAD and VD combined CAD for Lung-RADS categories and different types of nodules (all P>0.05); Compared with VD and VD combined CAD, the positive prediction rate of CAD for lung cancer was significantly reduced, and the rate of missed diagnosis and false positive rate were significantly increased, but there was no significant difference between VD and VD combined CAD in the prediction rate, missed diagnosis rate and false positive rate of lung cancer. Conclusion:The method of CAD combined VD can reduce the detection of false positive nodules and improve the detection rate of true pulmonary nodules,which is the preferred method using in LDCT lung cancer screening for city population.

Objective:To describe the cancer incidences and mortalities in Henan cancer registries in 2013.Methods:Registration data were evaluated according to the criteria of quality control of cancer registry,and the qualified data were analyzed based on areas(urban/rural), gender,age and cancer sites.The age-standardized rates were applied according to Segi's population and the fifth Chinese population census in 2000.Results:The total coverage of population from 19 qualified cancer registries data was 16,225,815(15.13%),Among which,8,370, 772(51.59%)were males and 7,855,043(48.41%)were females;and 2,819,817(17.38%)live in urban areas and 13,405,998(82.62%) live in rural areas.The crude incidence rate in Henan was 250.34/105(males:264.35/105,females:235.42/105),whereas the age-standardized incidence rates by Chinese standard population and by world standard population were 208.66/105and 207.25/105,respectively.The cumulative incidence rate(0-74 years old)was 24.31%.The cancer mortality in Henan was 161.05/105(males:185.50/105,females:134.98/105),whereas the age-standardized mortality by Chinese standard population and by world standard population were 131.18/105and 131.52/105,respectively.The cumulative mortality rate(0-74 years old)was 15.05%.Cancer incidence and mortality rates were increasing by age, reaching the peak values at 80 age group and 85 plus age group,respectively.Lung cancer,gastric cancer,esophageal cancer,liver cancer and colorectal cancer were the most common cancers ranked by the incidence rate,and the most common cause of cancer death was lung cancer,followed by gastric cancer,esophageal cancer,liver cancer and colorectal cancer.Incidence rate and mortality rate of breast cancer ranked the first and the fifth among the females,respectively.Conclusion:Cancer incidence and mortality rates were higher in the rural areas and in males than in the urban areas and in females.Lung cancer,digestive system cancers,and female breast cancer are the major cancer types that require attention for the prevention and control in Henan.

OBJECTIVETo evaluate effect of screening of esophageal cancer at rural areas in Henan province.

METHODSAt rural areas with high incidence of upper gastrointestinal carcinoma in Henan province total of 88,263 persons with 40 to 69 years old were set to the target population of the screening by the 12 cities and countries and endoscope and pathology diagnosis were performed during 2009-2013. For patients with precancerous lesions, follow-up visits were conducted and defined as follows: once in three years for patients with mild dysplasia, once per year for moderate hyperplasia patients, the patients with severe intraepithelial neoplasia/carcinoma in situ should be treat, at least once per year for those one who didn't under treatment. The result data of screening were summarized and detection rates of esophagus hyperplasia, carcinoma in situ, early and middle-late cancer were calculated, as well as the early diagnosis rate. The result between first round and follow-up screening was compared.

RESULTSTarget population were examined in first round screening. There were 8,434 persons with above mild dysplasia and the detection rate was 9.56%, among them there were 7,224 (8.18%) cases with light-middle hyperplasia, 789 (0.89%) cases with serious dysplasia or cancer in situ, 239 (0.27%) cases with early cancer and 182 (0.21%) cases with middle-late cancer. The sum of serious dysplasia or cancer in situ and early cancer was 1 028 and the early detection rate was 84.96% (1,028/1,210). From 2012 to 2013, the follow-up screening for persons with light-middle hyperplasia which should be followed 4,230 cases, there were 2 853 people to take in screening and compliance was 67.45%. Total of 94 cases were diagnosed with cancer in situ or early cancer. The detection rate and the early detection rate were 3.29% and 100%, respectively. The rates of detection and early detection in phase of follow-up screening were statistically significantly higher than that in first round screening respectively (P<0.001).

CONCLUSIONAt rural areas of high incidence upper gastrointestinal carcinoma in Henan province, the screening with endoscope had good effect and strengthening the follow-up screening could increase the effect.

Early Detection of Cancer ; Esophageal Neoplasms ; Humans ; Incidence ; Rural Population ; Time-to-Treatment

OBJECTIVETo evaluate the association between high sensitivity C-reactive protein (hsCRP) and breast cancer incidence among the non-diabetic females in a large-scale cohort study in Kailuan group.

METHODSThe Kailuan cohort was established on May 1, 2006. Baseline information on demography, lifestyle, medical history, and anthropometry, i.e., body height and weight, were collected during the baseline interview, and breast cancer incidence, mortality and other related outcome information were obtained by follow-up every two years and the related health condition database information were collected every year. Multivariable Cox proportional-hazards regression model was used to calculate the hazard ratios (HRs) and 95%CI (confidence interval) between the level of hsCRP at baseline interview and breast cancer incidence adjusted for age group, body mass index (BMI), marital status (married and single) and tobacco smoking (smokers and non-smokers) when appropriate.

RESULTSBy Dec 31, 2011, a total of 17 402 females were enrolled in the cohort. There were 85 286 person-years of follow-up with a mean follow-up period of (58.81 ± 4.52) months. A total of 75 incident breast cancer cases were collected. Subjects with the highest level (>3 mg/L) of hsCRP at baseline interview were associated with a significantly increased risk of breast cancer (adjusted HR = 1.80, 95%CI = 1.03-3.15) compared with those with the lowest level (<1 mg/L).

CONCLUSIONSElevated levels of hsCRP at baseline interview may be associated with an increased risk of breast cancer among non-diabetic females. Further follow-up and etiological exploration will help to evaluate the association between the hsCRP level and the risk of breast cancer more reliably.

Body Mass Index ; Breast Neoplasms ; diagnosis ; epidemiology ; metabolism ; C-Reactive Protein ; metabolism ; Cohort Studies ; Diabetes Mellitus ; Female ; Humans ; Incidence ; Middle Aged ; Proportional Hazards Models ; Prospective Studies ; Risk ; Risk Factors ; Smoking

Disability-adjusted life years (DALYs) has been increasingly used to estimate burden of disease worldwide. By giving a particular attention to DALYs, the objectives of the study were to review various data sources and to conduct an extended estimation on the burden of cancer in China. Based on the publications released by the GLOBOCAN 2008 program and the Global Burden of Disease 2010 (GBD 2010) program, we reviewed the methodological information and gathered DALY data associated with burden of cancer in China, and then we extracted and summarized the data and conducted an extended analysis. From a methodological perspective, both of the programs applied the utility weights mainly from populations other than China. The data from GLOBOCAN 2008 suggests that liver cancer has replaced lung cancer and became the leading cancer in males in China when using DALY rather than mortality rate as the indicator (6.3 million and 5.4 million DALYs, respectively); although the ranking is different, data from the GBD 2010 project shows DALYs caused by liver cancer is comparable to that associated with lung cancer (7.9 million and 8.0 million, respectively). The years lived with disability (YLDs) comprised 26% and 12% of the total DALYs associated with breast cancer and colorectal cancer in China. Both projects suggest that liver cancer might have become or is becoming the leading contributor to males' DALYs in China. There are indications that, along with economic development, YLD will play a more important role in estimation of burden of cancer in China; it suggests that China should consider introducing DALY into the estimation system as early as possible. It also suggests that research on quality of life and utility associated with the major cancers in China need to be systematically conducted to facilitate more accurate DALY estimation.
China ; Cost of Illness ; Disabled Persons ; Humans ; Liver Neoplasms ; Male ; Neoplasms ; Quality of Life ; Quality-Adjusted Life Years ; Regression Analysis ; Research

Objective:To explore the clinical application value of S-Detect intelligent assistant diagnosis technology in the diagnosis of suspicious thyroid nodules.Methods:A total of 153 patients who were diagnosed as TI-RADS 3-4 according to the ACR TI-RADS standard by ultrasound examination in Henan Provincial Cancer Hospital from September 2019 to December 2019 were included in the study. Differential diagnosis of benign and malignant thyroid nodules were made by senior doctors, junior doctors and S-Dectect technology, respectively. Then using pathological results as the standard, receiver operating charateric curve(ROC) curves were plotted to compare the area under curve (AUC), sensitivity, specificity and accuracy of S-Detect, senior and junior doctor groups, as well as their combinations.Results:Of the 153 patients with thyroid nodules, 108 cases(108 nodules) were comfirmed benign and 45 cases(45 nodules) were malignant afeer operation. The diagnostic sensitivity, specificity and accuracy of S-Detect were 77.78%, 87.04%, 84.31%. They were higher than junior doctors(68.89%, 79.63%, 76.47%), but lower than senior doctors(84.44%, 94.44%, 91.50%). The diagnostic sensitivity, specificity and accuracy in junior doctors combined with S-Detect were significantly improved(77.78%, 85.18%, 83.01%). The area under curve of S-Detect diagnosis was higher in the group of junior doctors combined with S-Detect (0.815) than that in the group of junior doctors (0.743), and the difference was statistically significant (χ 2=8.332, P=0.004). There was no statistically significant difference (χ 2=0.095, P=0.756) in the AUC of diagnosis between the group of senior doctors combined with S-Detect(0.901) and senior doctors(0.894). Using pathological results as the "gold standard" , the highest consistency of diagnosis was found in the senior doctors combined with S-Detect(Kappa=0.797). Conclusions:S-Detect technology has a high accuracy in the differential diagnosis of thyroid nodules. With the aid of this technology, it can improve the specificity and accuracy of diagnosis for the junior doctors.

Objective:To explore the value of intravoxel incoherent motion (IVIM) DWI in preoperative prediction of angiolymphatic invasion in esophageal squamous cell carcinoma (ESCC).Methods:From April 2016 to April 2019, 63 ESCC patients who planned to undergo resection of esophageal cancer were prospectively collected at Henan Cancer Hospital.According to the postoperative pathological results, 63 patients were divided into angiolymphatic invasion group (30 cases) and no angiolymphatic invasion group (33 cases). All patients underwent IVIM sequence and routine MRI examination before operation. The ADC, true diffusion coefficient (D), pseudodiffusion coefficient (D *) and pseudodiffusion fraction (f) were measured. The differences of parameter values between ESCC with and without angiolymphatic invasion were analyzed using Student′s t test or Wilcoxon rank sum test.The logistic regression was used to analyze the significance of various parameters. For the parameters with statistical significance, the ROC curves were performed to evaluatethe diagnostic performance of parameters for identifying angiolymphatic invasion.The Z test was used to compare the area under the ROC curves(AUC) of parameters. Results:The difference of ADC, D and f values between angiolymphatic invasion group and no angiolymphatic invasion group were statistically signi?cant ( t=4.476, 5.033 and 5.712 respectively, all P<0.001). The D * values showed no statistically signi?cant di?erence ( Z=0.184, P=0.854). The logistic regression analysis showed that D (OR=9.042) and f (OR=26.221) were in correlation with angiolymphatic invasion. The ROC analyses demonstrated that the AUCs of ADC, D and f values in predicting angiolymphatic invasion of ESCC were 0.787, 0.822 and 0.853, respectively. D combined with f had highest AUC (0.917) in predicting the angiolymphatic invasion of ESCC, sensitivity and specificity were 93.3% and 75.8%. D combined with f showed better diagnostic performance than the D and the f value, and the difference were statistically significant ( Z=2.403, 2.289, P=0.016, 0.022). Conclusions:IVIM can be used as an effective functional imaging modality for preoperative evaluation and prediction of the angiolymphatic invasion of ESCC. D value combined with f value can further improve prediction performance of angiolymphatic invasion.

Ob jective It has been reported by some prospective studies that C-reactive protein (CRP ) is associated with cancer risk .However, the correlation between CRP and digestive system cancers has not been evaluated in Chinese females .We conducted a large population-based cohort study to investigate whether elevated level of CRP in serum is associated with an increased risk of digestive system cancers in Chinese women.Metho ds From the Chinese Kailuan Female Cohort , 19,437 women were enrolled in this study in July 2006, and all of the subjects were followed up through 2014.At the baseline investigation , the serum levels of high-sensitivity CRP ( hsCRP ) were tested for all subjects , and demographic information and risk factor data were collected .Multivariable Cox proportional hazards regression model was used to calculate the hazard ratios ( HR ) and 95%confidence intervals ( 95%CI ) for the baseline levels of hsCRP after adjusting for age, marital status, smoking, drinking, body mass index ( BMI), diabetes and physical activity, and risk of digestive system tumors (including colorectal cancer, stomach cancer, pancreas cancer, liver and gallbladder cancer, and other cancers).Results By Dec 31, 2014, a total of 100 incident cancer cases were observed , including 47 colorectal cancers , 17 stomach cancers , and altogether 29 pancreas , liver and gallbladder cancers .All the subjects investigated were divided into three groups according to the level of hsCRP (<1 mg/L, 1-3 mg/L and >3 mg/L) .The 8-year cumulative incidence of digestive system cancers were 405/100 000, 520/100 000 and 787/100 000 in these 3 groups, respectively (Log rank test χ2=8.37, P=0.015 ) .Compared to those with lower hsCRP levels (<1 mg/L ) , the women with higher hsCRP (>3 mg/L) had a significantly increased risk of pancreas , liver and gallbladder cancers ( HR =2.70, 95%CI =1.06-6.91;Ptrend=0.036).Conclusions Elevated levels of hsCRP at baseline may be associated with increased risk of certain digestive system cancers .