Background and purpose:Adenocarcinoma of the esophagogastric junction (AEG) has a high incidence of early recurrence and metastasis after operation. The prognosis of AEG is poor. However, few studies have investigated the recurrence of AEG. The purpose of this study was to clarify the important clinical pathological factors affecting the early recurrence ofⅠ,Ⅱ type of AEG after operation. Thus more active treatment for patients at high risk of recurrence may improve the prognosis.Methods:This study retrospectively reviewed the clinical data from 145 AEG patients who underwent R0 resection during the period from Dec. 2008 to Dec. 2012. Risk factors associated with the early recurrence were analyzed.Results:The mean time to tumor recurrence was 25.4 months after R0 resection, and the 1-year recurrence rate was 38.6%. Univariate analysis showed that the histological grade (degree of tumor differentiation), number of positive lymph nodes, TNM stage and vascular invasion were signiifcantly related with the early recurrence (P<0.05). Logistic multivariate regression analysis showed that only histological grade and vascular invasion were independently related with early tumor recurrence (P<0.05).Conclusion:Histological grade and vascular invasion are independent risk factors for predicting the early tumor recurrence after R0 resection for AEG.

Purpose To analyze the CT features of rare primary renal malignant tumors in children, and to improve the understanding and diagnosis of this disease. Materials and Methods The clinical and imaging data of 18 children with rare primary renal malignant tumors confirmed by pathology were retrospectively analyzed. Plain CT scan and enhanced CT scan were performed in all 18 cases, and their CT features were analyzed. Results For 18 patients, 7 cases were clear cell sarcoma of kidney, the mean diameter of tumor was (10.5±3.6) cm. The plain CT scan showed inhomogeneous low density. Most of the tumors were prominent outside the kidney, with 2 cases of small, patchy calcifications. Enhanced CT scan showed mild, moderate and inhomogeneous enhancement in the cortical stage, with varying degrees of necrosis. It could be seen as fish-like. There was stripe-like enhancement and vascular shadow passing through the lesion, which was further enhanced in the parenchymal phase. In 6 cases of renal cell carcinoma, the average diameter of the tumor was (5.5±1.5) cm. The plain CT scan showed the boundary of the renal tissue was clear and the false capsule, with 4 cases of coarse nodular calcification, and there was a low density cystic necrosis area and a slightly higher density bleeding shadow in the tumor. The enhanced CT scan showed mild and moderate inhomogeneous enhancement in the cortical phase of the lesion, and in the parenchymal phase, it could be slightly lower or slightly higher than that in the cortical phase. In the 5 cases of renal neuroblastoma, the average diameter was (13.9±7.7) cm, plain CT scan showed mixed density, with 2 cases of irregular calcification. Enhanced CT scan showed mild enhancement of the cortical phase of the tumor, and small blood vessels around the mass of the tumor. Some were tortuous and thicken, and the degree of enhancement was increased in parenchymal terms. Conclusion Primary renal malignant tumors in children that our team analyzed are relatively rare. In clinic, we should consider the possibility of these kinds of tumors in children with malignant kidney occupying, so as to reduce missed diagnosis and misdiagnosis.

BACKGROUND: Pneumonia-like primary pulmonary lymphoma (PPL) was commonly misdiagnosed as infectious pneumonia, leading to delayed treatment. The purpose of this study was to establish a computed tomography (CT)-based radiomics model to differentiate pneumonia-like PPL from infectious pneumonia. METHODS: In this retrospective study, 79 patients with pneumonia-like PPL and 176 patients with infectious pneumonia from 12 medical centers were enrolled. Patients from center 1 to center 7 were assigned to the training or validation cohort, and the remaining patients from other centers were used as the external test cohort. Radiomics features were extracted from CT images. A three-step procedure was applied for radiomics feature selection and radiomics signature building, including the inter- and intra-class correlation coefficients (ICCs), a one-way analysis of variance (ANOVA), and least absolute shrinkage and selection operator (LASSO). Univariate and multivariate analyses were used to identify the significant clinicoradiological variables and construct a clinical factor model. Two radiologists reviewed the CT images for the external test set. Performance of the radiomics model, clinical factor model, and each radiologist were assessed by receiver operating characteristic, and area under the curve (AUC) was compared. RESULTS: A total of 144 patients (44 with pneumonia-like PPL and 100 infectious pneumonia) were in the training cohort, 38 patients (12 with pneumonia-like PPL and 26 infectious pneumonia) were in the validation cohort, and 73 patients (23 with pneumonia-like PPL and 50 infectious pneumonia) were in the external test cohort. Twenty-three radiomics features were selected to build the radiomics model, which yielded AUCs of 0.95 (95% confidence interval [CI]: 0.94-0.99), 0.93 (95% CI: 0.85-0.98), and 0.94 (95% CI: 0.87-0.99) in the training, validation, and external test cohort, respectively. The AUCs for the two readers and clinical factor model were 0.74 (95% CI: 0.63-0.83), 0.72 (95% CI: 0.62-0.82), and 0.73 (95% CI: 0.62-0.84) in the external test cohort, respectively. The radiomics model outperformed both the readers' interpretation and clinical factor model ( P <0.05). CONCLUSIONS The CT-based radiomics model may provide an effective and non-invasive tool to differentiate pneumonia-like PPL from infectious pneumonia, which might provide assistance for clinicians in tailoring precise therapy.
Humans ; Retrospective Studies ; Pneumonia/diagnostic imaging* ; Analysis of Variance ; Tomography, X-Ray Computed ; Lymphoma/diagnostic imaging*