1.Deep learning for accurate lung artery segmentation with shape-position priors
Chao GUO ; Xuehan GAO ; Qidi HU ; Jian LI ; Haixing ZHU ; Ke ZHAO ; Weipeng LIU ; Shanqing LI
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2025;32(03):332-338
Objective To propose a lung artery segmentation method that integrates shape and position prior knowledge, aiming to solve the issues of inaccurate segmentation caused by the high similarity and small size differences between the lung arteries and surrounding tissues in CT images. Methods Based on the three-dimensional U-Net network architecture and relying on the PARSE 2022 database image data, shape and position prior knowledge was introduced to design feature extraction and fusion strategies to enhance the ability of lung artery segmentation. The data of the patients were divided into three groups: a training set, a validation set, and a test set. The performance metrics for evaluating the model included Dice Similarity Coefficient (DSC), sensitivity, accuracy, and Hausdorff distance (HD95). Results The study included lung artery imaging data from 203 patients, including 100 patients in the training set, 30 patients in the validation set, and 73 patients in the test set. Through the backbone network, a rough segmentation of the lung arteries was performed to obtain a complete vascular structure; the branch network integrating shape and position information was used to extract features of small pulmonary arteries, reducing interference from the pulmonary artery trunk and left and right pulmonary arteries. Experimental results showed that the segmentation model based on shape and position prior knowledge had a higher DSC (82.81%±3.20% vs. 80.47%±3.17% vs. 80.36%±3.43%), sensitivity (85.30%±8.04% vs. 80.95%±6.89% vs. 82.82%±7.29%), and accuracy (81.63%±7.53% vs. 81.19%±8.35% vs. 79.36%±8.98%) compared to traditional three-dimensional U-Net and V-Net methods. HD95 could reach (9.52±4.29) mm, which was 6.05 mm shorter than traditional methods, showing excellent performance in segmentation boundaries. Conclusion The lung artery segmentation method based on shape and position prior knowledge can achieve precise segmentation of lung artery vessels and has potential application value in tasks such as bronchoscopy or percutaneous puncture surgery navigation.
2.Research progress on the correlation between carbohydrate antigen 19-9 and pseudomyxoma peritonei
Chinese Journal of Clinical Oncology 2025;52(13):673-677
Pseudomyxoma peritonei(PMP)is a rare malignant peritoneal syndrome characterized by progressive intra-abdominal accumu-lation and redistribution of gelatinous tumor-derived mucins.This disease primarily originates in the appendix or ovaries and exhibits distinct biological behavior and clinicopathological features.Carbohydrate antigen 19-9(CA19-9),a critical tumor biomarker,is significantly correl-ated with the development and progression of PMP.This association renders CA19-9 increasingly valuable in clinical diagnosis and treat-ment.Furthermore,molecular biological characteristics of CA19-9,including structural properties,biosynthetic pathways,and mechanisms in mediating tumor metastasis,are systematically elaborated.These findings highlight the association between CA19-9 expression and PMP pathological grading,clinical prognosis,and therapeutic response monitoring.Additionally,the study thoroughly analyzed the synergistic role of CA19-9,alongside other tumor biomarkers,in PMP management.Based on current evidence,future research directions are proposed.These include the potential application of CA19-9 in early PMP diagnosis,its therapeutic utility as a molecular target,and the exploration of CA19-9-associated signaling pathways in PMP pathogenesis.The insights provide novel perspectives and a theoretical foundation for PMP-based precision medicine.
3.Research progress on the correlation between carbohydrate antigen 19-9 and pseudomyxoma peritonei
Chinese Journal of Clinical Oncology 2025;52(13):673-677
Pseudomyxoma peritonei(PMP)is a rare malignant peritoneal syndrome characterized by progressive intra-abdominal accumu-lation and redistribution of gelatinous tumor-derived mucins.This disease primarily originates in the appendix or ovaries and exhibits distinct biological behavior and clinicopathological features.Carbohydrate antigen 19-9(CA19-9),a critical tumor biomarker,is significantly correl-ated with the development and progression of PMP.This association renders CA19-9 increasingly valuable in clinical diagnosis and treat-ment.Furthermore,molecular biological characteristics of CA19-9,including structural properties,biosynthetic pathways,and mechanisms in mediating tumor metastasis,are systematically elaborated.These findings highlight the association between CA19-9 expression and PMP pathological grading,clinical prognosis,and therapeutic response monitoring.Additionally,the study thoroughly analyzed the synergistic role of CA19-9,alongside other tumor biomarkers,in PMP management.Based on current evidence,future research directions are proposed.These include the potential application of CA19-9 in early PMP diagnosis,its therapeutic utility as a molecular target,and the exploration of CA19-9-associated signaling pathways in PMP pathogenesis.The insights provide novel perspectives and a theoretical foundation for PMP-based precision medicine.
4.Comparison of four-coagulation-tests values in normal pregnant women during early and late pregnancy and the influence of age
Qidi ZHANG ; Yumei WEI ; Xinghui LIU ; Chong QIAO ; Weirong GU ; Yangyu ZHAO ; Huixia YANG
Chinese Journal of Obstetrics and Gynecology 2022;57(10):740-745
Objective:To explore and compare the reference ranges of four coagulation tests in normal pregnant women during early and late pregnancy and the influence of age.Methods:Values of four coagulation tests from 4 974 pregnant women, who gave single birth at Peking University First Hospital, Obstetrics and Gynecology Hospital of Fudan University, West China Second University Hospital, Peking University Third Hospital and Shengjing Hospital of China Medical University from February 2017 to July 2020, were measured and analyzed in this study, including prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fib) and thrombin time (TT). The four normal reference ranges of coagulation during early and late pregnancy phases were expressed as P2.5- P97.5. The difference of two pregnancy phases was compared by non-parametric test of two related samples. And the difference between pregnant women of advanced and non-advanced age in the same pregnancy phase was compared by independent sample non-parametric test. Chi-square test was used to compare the incidence of pregnancy complications in different coagulation reference ranges. Results:The reference ranges of PT of normal pregnant women′s early and late pregnancy were 10.0-13.9 s and 9.6-12.3 s, the reference ranges of APTT were 22.6-35.3 s and 22.4-30.9 s, the reference ranges of Fib were 2.4-5.0 g/L and 3.0-5.7 g/L, the reference ranges of TT were 12.0-19.0 s and 11.5-18.4 s. Compared with early pregnancy, PT, APTT and TT shortened significantly, while the Fib significantly increased in late pregnancy (all P<0.001). PT, APTT and TT of advanced and non-advanced age pregnant women were significantly different (all P<0.01). Compared with the ranges of non-pregnant population, more pregnant women were included in the normal pregnant reference ranges of PT in early pregnancy and APTT in the early and late pregnancy, while the incidence of pregnancy complications had no significant differences (all P>0.05). The incidence of fetal distress was higher and the incidence of preterm birth was lower in the reference range of PT in late pregnancy. The incidence of gestational diabetes mellitus was higher in the early and late gestational Fib reference ranges, and the incidence of hypertensive disorders in pregnancy was higher in the late gestational Fib reference range (all P<0.05). Conclusions:The coagulation function of pregnant women increases significantly with the growth of pregnancy, and there is a significant difference between advanced significantly and non-advanced age pregnant women. The recommended ranges of normal pregnant women′s early and late pregnancy PT are 10.0-13.9 s and 9.6-12.3 s, the recommended ranges of APTT are 22.6-35.3 s and 22.4-30.9 s, the recommended ranges of TT are 12.0-19.0 s and 11.5-18.4 s. The appropriate ranges of normal pregnant women′s early and late pregnancy Fib still need further exploration.

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