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Role of endoscopic ultrasound and cyst fluid tumor markers in diagnosis of pancreatic cystic lesions

World Journal of Gastrointestinal Endoscopy 2022年第6期14卷 402-415页

作者： Hussein Hassan Okasha Abeer Abdellatef Shaimaa Elkholy Mohamad-sherif Mogawer Ayman Yosry Magdy Elserafy Eman Medhat Hanaa Khalaf Magdy Fouad Tamer Elbaz Ahmed Ramadan Mervat E Behiry Kerolis Y William Ghada Habib Mona Kaddah Haitham Abdel-Hamid Amr Abou-Elmagd Ahmed Galal Wael A Abbas Ahmed Youssef Altonbary Mahmoud El-Ansary Aml E Abdou Hani Haggag Tarek Ali Abdellah Mohamed A Elfeki Heba Ahmed Faheem Hani M Khattab Mervat El-Ansary Safia Beshir Mohamed El-Nady Department of Internal Medicine and Hepatogastroenterology Kasr Al-Aini HospitalsCairo UniversityKasr Al-Aini HospitalsCairo UniversityCairo 11451Egypt Department of Endemic Diseases Cairo UniversityCairo 11451Egypt Department of Tropical Medicine and Gastroenterology Minia UniversityMinia 61511Egypt Department of Internal Medicine Kasr Al-Aini HospitalsCairo UniversityCairo 11562Egypt Department of Gastroenterology Armed forces College of MedicineCairo 11451Egypt Endoscopy and Internal Medicine Consultant at Dr/Ahmed Galal Endoscopy Center Alexandria 35516Egypt Department of Internal Medicine Faculty of MedicineAssuit UniversityAssuit 71111Egypt Department of Gastroenterology and Hepatology Mansoura UniversityMansoura 35511Egypt Department of Gastroenterology and Hepatology Theodor Bilharz Research InstituteCairo 11451Egypt Department of Microbiology and Immunology Faculty of Medicine for girls Al-Azhar UniversityCairo 11451Egypt Department of Internal Medicine Faculty of MedicineAin shams UniversityCairo 11451Egypt Department of Internal Medicine Bani-suef UniversityBani-suefBani-suef 62511Egypt Department of Pathology Faculty of MedicineCairo UniversityCairo 11451Egypt Department of Clinical Pathology Faculty of MedicineCairo UniversityCairo 11451Egypt Department of Environmental Medicine&Clinical Pathology National Research CentreCairo 11451Egypt

BACKGROUND Pancreatic cystic lesions(PCLs) are common in clinical practice. The accurate classification and diagnosis of these lesions are crucial to avoid unnecessary treatment of benign lesions and missed opportunities for early treatment of potentially malignant *** To evaluate the role of cyst fluid analysis of different tumor markers such as cancer antigens [e.g., cancer antigen(CA)19-9, CA72-4], carcinoembryonic antigen(CEA), serine protease inhibitor Kazal-type 1(SPINK1), interleukin 1 beta(IL1-β), vascular endothelial growth factor A(VEGF-A), and prostaglandin E2(PGE2)], amylase, and mucin stain in diagnosing pancreatic cysts and differentiating malignant from benign *** This study included 76 patients diagnosed with PCLs using different imaging modalities. All patients underwent endoscopic ultrasound(EUS) and EUS-fine needle aspiration(EUS-FNA) for characterization and sampling of different *** The mean age of studied patients was 47.4 ± 11.4 years, with a slight female predominance(59.2%). Mucin stain showed high statistical significance in predicting malignancy with a sensitivity of 87.1% and specificity of 95.56%. It also showed a positive predictive value and negative predictive value of 93.1% and 91.49%, respectively(P < 0.001). We found that positive mucin stain, cyst fluid glucose, SPINK1, amylase, and CEA levels had high statistical significance(P < 0.0001). In contrast, IL-1β, CA 72-4, VEGF-A, VEGFR2, and PGE2 did not show any statistical significance. Univariate regression analysis for prediction of malignancy in PCLs showed a statistically significant positive correlation with mural nodules, lymph nodes, cyst diameter, mucin stain, and cyst fluid CEA. Meanwhile, logistic multivariable regression analysis proved that mural nodules, mucin stain, and SPINK1 were independent predictors of malignancy in cystic pancreatic *** EUS examination of cyst morphology with cytopathological analysis and cyst fluid ana

关键词： Pancreatic cystic neoplasm Mucinous cystic neoplasm Intraductal papillary mucinous neoplasm Mucin stain Amylase

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什么是婚姻?

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法哲学与法社会学论丛 2016年第1期21卷 207-249页

作者： [美]谢里夫·吉尔吉斯罗伯特·P.乔治 [美]赖安·T.安德森肖潇(译) 普林斯顿大学哲学系耶鲁大学法学院圣母大学北京市天银律师事务所

什么是婚姻?对于这个问题,人们持有两种对立的观点:1.异性婚姻观(conjugal view):婚姻是一男一女的结合,男女双方赋予彼此永恒且专一的承诺,此承诺天然地(内在地)通过共同生育和抚养孩子来实现。配偶之间以夫妻性行为来成就和更新双方... 详细信息

什么是婚姻?对于这个问题,人们持有两种对立的观点:1.异性婚姻观(conjugal view):婚姻是一男一女的结合,男女双方赋予彼此永恒且专一的承诺,此承诺天然地(内在地)通过共同生育和抚养孩子来实现。配偶之间以夫妻性行为来成就和更新双方的结合;夫妻性行为构成人类生殖过程中的行动部分,这使得配偶间的结合成为以生殖为目的的结合。

关键词：本质属性同居关系修正主义者道德规范一夫一妻制

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流式细胞DNA研究能否预测子宫内膜增生的预后

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世界核心医学期刊文摘（妇产科学分册） 2006年第2期2卷 13-13页

作者： sherif L.S. Totongy M. Tawfeek M. A.M. Badawy 朱晓明 Department of Obstetrics and Gynecology Mansoura University Hospitals Mansoura Egypt

Objectives: The study is investigating the relation of the ploidy pattern and cell cycle kinetics to different types of endometrial hyperplasia to select the high-risk women who will need strict follow up surveillance. Study design: An observational study of 152 patients with endometrial hyperplasia. Endometrial samples were subjected to flowcytometric study of the nuclear DNA content to determine the ploidy pattern and cell cycle kinetics. Results: The mean age of women was 46.3 ±3.6 years. 15.8%of women were nulliparae, 36.8%were diabetic and 43.6%were hypertensive. 48.7%of women were obese (BMI >30). Most of endometrial samples (88.2%) were simple endometrial hyperplasia without atypia. The cell cycle kinetics in different types of endometrial hyperplasia shows that there were significant statistical differences as regards the S-phase fraction and proliferative index (PI) between typical and atypical hyperplasia. Conclusion: The study of cell cycle kinetics by flowcytometry might help in picking up, among all women with endometrial hyperplasia, the group of patients who need further close and strict follow up by endometrial pathologic study. This is going to minimize the cost and invasiveness of surveillance of patients with various grades of endometrial hyperplasia.

关键词：子宫内膜增生 DNA 非典型增生随访监测未产妇观察性研究含量检测增殖指数病理学研究研究

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