OBJECTIVES: To evaluate the value of ⁶⁸Ga-DOTATATE and ¹⁸F-FDG PET/CT imaging in staging and treatment decision for gastroenteropancreatic neuroendocrine neoplasms (GEP-NEN). METHODS: This retrospective analysis was conducted in 49 patients with GEP-NEN undergoing ¹⁸F-FDG and ⁶⁸Ga-DOTATATE PET/CT imaging at our hospital from August, 2020 to March, 2023, including 34 newly diagnosed patients and 15 patients with recurrence or metastasis after treatment. GEP-NEN were classified into G1, G2, and G3 neuroendocrine tumors (NET) and neuroendocrine carcinomas (NEC) based on pathological typing. The detection efficiency were classified into 4 patterns based on the number of positive tumor lesions detected by the two tracers: ⁶⁸Ga-DOTATATE>¹⁸F-FDG (A); ⁶⁸Ga-DOTATATE=¹⁸F-FDG (B); ⁶⁸Ga-DOTATATE<¹⁸F-FDG (C); and complementation (D). The value of dual-modality imaging in staging and treatment decision were evaluated by visual analysis. RESULTS: In the 49 patients with GEP-NEN, ⁶⁸Ga-DOTATATE PET/CT was superior to ¹⁸F-FDG PET/CT for detecting systemic tumor lesions (P<0.001) and more sensitive for detecting primary/recurrent lesions, lymph node metastasis, liver metastasis, and bone metastasis (P<0.05), while ¹⁸F-FDG PET/CT had higher detection rates for lung metastasis and peritoneal metastasis (P<0.05). In terms of the detection efficiency, Pattern A was found in 46.9% (23/49) patients, Pattern B in 38.8% (19/49), Pattern C in 12.2% (6/49), and Pattern D in 2.0% (1/49). The complementary value of ¹⁸F-FDG PET/CT to ⁶⁸Ga-DOTATATE PET/CT was 0% in G1 NET patients (0/13), 8.3% in G2 NET patients (2/24), 50% in G3 NET patients (3/6), and 33.3% in NEC patients (2/6). 12.2% (6/49) of the patients had their staging confirmed or changed due to additional lesions detected by ¹⁸F-FDG PET/CT imaging, resulting subsequently in establishment or adjustment of their treatment plans. CONCLUSIONS ⁶⁸Ga-DOTATATE PET/CT imaging should be the primary choice for GEP-NEN patients. Additional ¹⁸F-FDG PET/CT imaging can potentially improve precision of staging and treatment decision-making for G2, G3 and NEC patients but provides virtually no clinical benefits for G1 NET patients.
Humans ; Positron Emission Tomography Computed Tomography/methods* ; Neuroendocrine Tumors/therapy* ; Pancreatic Neoplasms/therapy* ; Retrospective Studies ; Organometallic Compounds ; Stomach Neoplasms/therapy* ; Neoplasm Staging ; Fluorodeoxyglucose F18 ; Intestinal Neoplasms/therapy* ; Female ; Male ; Middle Aged ; Aged ; Adult

Objective To evaluate the value of 68Ga-DOTATATE and 18F-FDG PET/CT imaging in staging and treatment decision for gastroenteropancreatic neuroendocrine neoplasms(GEP-NEN).Methods This retrospective analysis was conducted in 49 patients with GEP-NEN undergoing 18F-FDG and 68Ga-DOTATATE PET/CT imaging at our hospital from August,2020 to March,2023,including 34 newly diagnosed patients and 15 patients with recurrence or metastasis after treatment.GEP-NEN were classified into G1,G2,and G3 neuroendocrine tumors(NET)and neuroendocrine carcinomas(NEC)based on pathological typing.The detection efficiency were classified into 4 patterns based on the number of positive tumor lesions detected by the two tracers:68Ga-DOTATATE>18F-FDG(A);68Ga-DOTATATE=18F-FDG(B);68Ga-DOTATATE<18F-FDG(C);and complementation(D).The value of dual-modality imaging in staging and treatment decision were evaluated by visual analysis.Results In the 49 patients with GEP-NEN,68Ga-DOTATATE PET/CT was superior to 18F-FDG PET/CT for detecting systemic tumor lesions(P<0.001)and more sensitive for detecting primary/recurrent lesions,lymph node metastasis,liver metastasis,and bone metastasis(P<0.05),while 18F-FDG PET/CT had higher detection rates for lung metastasis and peritoneal metastasis(P<0.05).In terms of the detection efficiency,Pattern A was found in 46.9%(23/49)patients,Pattern B in 38.8%(19/49),Pattern C in 12.2%(6/49),and Pattern D in 2.0%(1/49).The complementary value of 18F-FDG PET/CT to 68Ga-DOTATATE PET/CT was 0%in G1 NET patients(0/13),8.3%in G2 NET patients(2/24),50%in G3 NET patients(3/6),and 33.3%in NEC patients(2/6).12.2%(6/49)of the patients had their staging confirmed or changed due to additional lesions detected by 18F-FDG PET/CT imaging,resulting subsequently in establishment or adjustment of their treatment plans.Conclusion 68Ga-DOTATATE PET/CT imaging should be the primary choice for GEP-NEN patients.Additional 18F-FDG PET/CT imaging can potentially improve precision of staging and treatment decision-making for G2,G3 and NEC patients but provides virtually no clinical benefits for G1 NET patients.

Objective:To investigate the current situation and influencing factors of work ability in gynecological cancer patients, so as to provide a reference for occupational rehabilitation management of cancer patients.Methods:A total of 183 gynecological cancer patients who visited the gynecological oncology outpatient department of Women′s Hospital of Nanjing Medical University from November 2022 to March 2023 were selected by the convenience sampling. The General Information Questionnaire, Return-to-Work Self-efficacy Questionnaire, Social Support Rating Scale, the European Organization for Research and Treatment of Cancer Quality of Life Quesionnaire Core 30, Work Ability Index were selected for cross-sectional investigaton. The multiple linear regression analysis was used to explore the influencing factors of work ability in gynecological cancer patients.Results:A total of 189 questionnaires were sent out in this study, and 183 were effectively collected, with an effective recovery rate of 96.83% (183/189). The patients were (44.64 ± 7.06) years old. The scores of the patients were (27.77 ± 7.58) points on Work Ability Index, (4.72 ± 1.14) points on Return-to-Work Self-efficacy Questionnaire, (86.93 ± 23.44) points on Social Support Rating Scale, (79.46 ± 19.53) points on overall health status area and (41.23 ± 27.80) points on the field of fatigue symptoms area of the European Organization for Research and Treatment of Cancer Quality of Life Quesionnaire Core 30. Multiple linear regression analysis showed that fatigue, comorbidities, clinical stage of disease, primary treatment, per capita monthly income of families, return-to-work self efficacy and job nature were independent influencing factors of work ability in gynecological cancer patients ( t values were -10.47-2.86, all P<0.05), which explained 67.9% of the total variance. Conclusions:Clinical medical staff should pay attention to the influencing factors that affect work ability in gynecological cancer patients, in order to take targeted occupational rehabilitation measures to improve their work ability.

Objective:To investigate the current situation and influencing factors of work ability in gynecological cancer patients, so as to provide a reference for occupational rehabilitation management of cancer patients.Methods:A total of 183 gynecological cancer patients who visited the gynecological oncology outpatient department of Women′s Hospital of Nanjing Medical University from November 2022 to March 2023 were selected by the convenience sampling. The General Information Questionnaire, Return-to-Work Self-efficacy Questionnaire, Social Support Rating Scale, the European Organization for Research and Treatment of Cancer Quality of Life Quesionnaire Core 30, Work Ability Index were selected for cross-sectional investigaton. The multiple linear regression analysis was used to explore the influencing factors of work ability in gynecological cancer patients.Results:A total of 189 questionnaires were sent out in this study, and 183 were effectively collected, with an effective recovery rate of 96.83% (183/189). The patients were (44.64 ± 7.06) years old. The scores of the patients were (27.77 ± 7.58) points on Work Ability Index, (4.72 ± 1.14) points on Return-to-Work Self-efficacy Questionnaire, (86.93 ± 23.44) points on Social Support Rating Scale, (79.46 ± 19.53) points on overall health status area and (41.23 ± 27.80) points on the field of fatigue symptoms area of the European Organization for Research and Treatment of Cancer Quality of Life Quesionnaire Core 30. Multiple linear regression analysis showed that fatigue, comorbidities, clinical stage of disease, primary treatment, per capita monthly income of families, return-to-work self efficacy and job nature were independent influencing factors of work ability in gynecological cancer patients ( t values were -10.47-2.86, all P<0.05), which explained 67.9% of the total variance. Conclusions:Clinical medical staff should pay attention to the influencing factors that affect work ability in gynecological cancer patients, in order to take targeted occupational rehabilitation measures to improve their work ability.

[This corrects the article DOI: 10.1016/j.apsb.2022.06.016.].

OBJECTIVE: We aimed to analyze the current indoor radon level and estimate the population risk of radon-induced lung cancer in urban areas of China. METHODS: Using the passive monitoring method, a new survey on indoor radon concentrations was conducted in 2,875 dwellings across 31 provincial capital cities in Chinese mainland from 2018 to 2023. The attributable risk of lung cancer induced by indoor radon exposure was estimated based on the risk assessment model. RESULTS: The arithmetic mean (AM) and geometric mean (GM) of indoor radon concentrations were 65 Bq/m³ and 55 Bq/m³, respectively, with 13.6% of measured dwellings exceeding 100 Bq/m³ and 0.6% exceeding 300 Bq/m³. The estimated number of lung cancer deaths induced by indoor radon exposure was 150,795, accounting for 20.30% (95% CI: 20.21%-20.49%) of the lung cancer death toll. CONCLUSION This study provided the most recent data on national indoor radon levels in urban areas and the attributable risk of lung cancer. These results served as an important foundation for further research on the disease burden of indoor radon exposure and radon mitigation efforts.
Radon/analysis* ; China/epidemiology* ; Air Pollution, Indoor/analysis* ; Lung Neoplasms/etiology* ; Humans ; Cities/epidemiology* ; Air Pollutants, Radioactive/adverse effects* ; Neoplasms, Radiation-Induced/etiology* ; Risk Assessment ; Radiation Monitoring

Objective To explore and compare the efficacy and safety of different transurethral enucle-ation procedures for treating benign prostatic hyperplasia.Methods A retrospective analysis was conducted on the clinical data of 215 patients with benign prostatic hyperplasia admitted to our hospital from January 2021 to May 2023.According to the surgical procedures,they were divided into plasma resection group(n=81),treated with transurethral plasma resection of the prostate,laser resection group(n=92),treated with transurethral laser resection of the prostate,and green laser enucleation group(n=42),treated with transurethral green laser enucle-ation of the prostate.The three groups were compared in terms of perioperative indicators(surgical time,intraop-erative bleeding volume,bladder flushing time,indwelling catheter time,postoperative hemoglobin concentration,and hospital stay),urodynamic indicators(RUV,IPSS score,Qmax,and QOL score),and postoperative compli-cations.Results The green laser enucleation group and laser resection group demonstrated a significantly higher total effective rate compared to the plasma electrosurgery group(P<0.05).The three groups showed no statisti-cally significant difference in hospital stay(P>0.05),but the green laser enucleation group showed a signifi-cantly shorter surgical time compared to the other two group(P<0.05).The green laser enucleation group and laser resection group had superiority in intraoperative bleeding,bladder flushing time,and indwelling catheter time compared to the plasma resection group,and a significantly higher postoperative hemoglobin concentration compared to the plasma resection group(P<0.05).Repeated measurement analysis of variance showed that the three groups all exhibited significantly decreases in RUV,IPSS score,and QOL score(P<0.05),and a signifi-cantly increase in Qmax at 1 month and 3 months after surgery(P<0.05).The laser resection group and green laser enucleation group presented with significant decreases in RUV,IPSS score,and QOL score(P<0.05),and a significantly decrease in Qmax compared to the plasma resection group at 1 month and 3 months after surgery(P<0.05).However,the laser resection group and the green laser enucleation group had no statistically signifi-cant difference in RUV,IPSS score,Qmax,and QOL score at 1 month and 3 months after surgery(P>0.05).The green laser enucleation group had the lowest total incidence of postoperative complications,following by the laser resection group and plasma resection group in order(7.14%vs.21.74%vs.35.80%,P<0.05).Conclusion The three surgical procedures all have good therapeutic effects on benign prostatic hyperplasia.Transurethral laser prostatectomy and green laser enucleation have superiority to those of transurethral plasma resection of the prostate in efficacy and safety,and they can promote early recovery of patients.Transurethral green laser enucleation is the best in safety.

Objective: This study aimed to investigate risk perception among first-degree relatives (FDRs) of patients with colorectal cancer (CRC) and to analyze influencing factors. Methods: 406 FDRs of CRC patients were selected as the participants through convenience sampling. A cross-sectional survey was conducted using the Hamilton Anxiety Scale, Colorectal Cancer Risk Perception Assessment Scale, and Colorectal Cancer Health Belief Scale, and relevant influencing factors were analyzed using univariate analysis and multiple linear regression analysis. Results: Participants had an average age of 41.90±14.76 years. The composition of participants included siblings at 45.9%, parents at 4.2%, and children at 49.4%. The risk perception score of 2.80±0.96 was obtained from participants. The Pearson correlation analysis results demonstrated that the total anxiety score of participants was positively correlated with the total risk perception score (r=0.39, p<.001), and the health belief score was also positively correlated with the risk perception score (r=0.49, p<.001). Moreover, the multiple regression analysis results revealed that the risk perception of participants was mainly affected by their education level, monthly household income per person, health beliefs, and level of anxiety (R2 =0.34, F=21.92, p<.001). Conclusion Healthcare professionals should place greater emphasis on assessing risk perception among participants, with a particular focus on those with lower education levels, lower incomes, and weaker health beliefs. They should also promptly monitor changes in family members' emotions and develop personalized clinical intervention plans based on individual characteristics, aiming to enhance this group's risk awareness and prevent the onset of disease.

Objective:To estimate the lung cancer disease burden of residents caused by indoor radon exposure in living rooms in China, and to provide scientific basis for improving radon prevention and control policies and measures.Methods:Based on the data from the national indoor radon monitoring survey, the study of lung cancer caused by indoor radon, and the basic data such as population and smoking, the attributable burden of disease calculation method was used to estimate the disease burden of lung cancer caused by indoor radon in China.Results:In 2018, it was estimated that the years of life lost due to premature death (YLL), years of life lost due to health disability (YLD) and disability-adjusted life years (DALY) due to indoor radon exposure were 5.109 3 million, 0.052 6 million and 5.161 9 million, respectively. DALY was highest in the 50-54 age group. The disease burden of indoor radon-induced lung cancer in smoking men was more than 9 times that of smoking women, and the disease burden of lung cancer in non-smoking women was more than 5 times that of non-smoking men. Smoking is closely related to the disease burden of indoor radon-induced lung cancer.Conclusions:Indoor radon exposure is a major environmental risk factor associated with lung cancer burden in China. The health hazards of indoor radon require more attention and improved policy measures to address this challenge.

Objective:To estimate the lung cancer disease burden of residents caused by indoor radon exposure in living rooms in China, and to provide scientific basis for improving radon prevention and control policies and measures.Methods:Based on the data from the national indoor radon monitoring survey, the study of lung cancer caused by indoor radon, and the basic data such as population and smoking, the attributable burden of disease calculation method was used to estimate the disease burden of lung cancer caused by indoor radon in China.Results:In 2018, it was estimated that the years of life lost due to premature death (YLL), years of life lost due to health disability (YLD) and disability-adjusted life years (DALY) due to indoor radon exposure were 5.109 3 million, 0.052 6 million and 5.161 9 million, respectively. DALY was highest in the 50-54 age group. The disease burden of indoor radon-induced lung cancer in smoking men was more than 9 times that of smoking women, and the disease burden of lung cancer in non-smoking women was more than 5 times that of non-smoking men. Smoking is closely related to the disease burden of indoor radon-induced lung cancer.Conclusions:Indoor radon exposure is a major environmental risk factor associated with lung cancer burden in China. The health hazards of indoor radon require more attention and improved policy measures to address this challenge.