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18F-prostate specific membrane antigen positron emission tomography/computerized tomography for lymph node staging in medium/high risk prostate cancer: A systematic review and meta-analysis

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中华医学杂志(英文版) 2024年第8期137卷 949-958页

作者： Lv Zhengtong Song Liuqi Wang Miao Hou Huimin Li Haodong Wang Xuan Wang Jianye Wang Jianlong Liu Ming Beijing 100029 Department of Urology Beijing Hospital National Center of Gerontology Institute of Geriatric Medicine Chinese Academy of Medical Sciences Beijing 100730 China Peking University Fifth School of Clinical Medicine Peking University China-Japan Friendship School of Clinical Medicine

Background: Lymph node staging of prostate cancer (PCa) is important for planning and monitoring of treatment.18F-prostate specific membrane antigen positron emission tomography/computerized tomography (18F-PSMA PET/CT) has several advantages over68Ga-PSMA PET/CT, but its diagnostic value requires further investigation. This meta-analysis focused on establishing the diagnostic utility of18F-PSMA PET/CT for lymph node staging in medium/high-risk PCa.Methods: We searched the EMBASE, PubMed, Cochrane library, and Web of Science databases from inception to October 1, 2022. Prostate cancer,18F, lymph node, PSMA, and PET/CT were used as search terms and the language was limited to English. We additionally performed a manual search using the reference lists of key articles. Patients and study characteristics were extracted and the QUADAS-2 tool was employed to evaluate the quality of included studies. Sensitivity, specificity, the positive and negative likelihood ratio (PLR and NLR), diagnostic odds ratio (DOR), area under the curve (AUC), and 95% confidence interval (CI) were used to evaluate the diagnostic value of18F-PSMA PET/CT. Stata 17 software was employed for calculation and statistical analyses.Results: A total of eight diagnostic tests including 734 individual samples and 6346 lymph nodes were included in this meta-analysis. At the patient level, the results of each consolidated summary were as follows: sensitivity of 0.57 (95% CI 0.39-0.73), specificity of 0.95 (95% CI 0.92-0.97), PLR of 11.2 (95% CI 6.6-19.0), NLR of 0.46 (95% CI 0.31-0.68), DOR of 25 (95% CI 11-54), and AUC of 0.94 (95% CI 0.92-0.96). At the lesion level, the results of each consolidated summary were as follows: sensitivity of 0.40 (95% CI 0.21-0.62), specificity of 0.99 (95% CI 0.95-1.00), PLR of 40.0 (95% CI 9.1-176.3), NLR of 0.61 (95% CI 0.42-0.87), DOR of 66 (95% CI 14-311), and AUC of 0.86 (95% CI 0.83-0.89).Conclusions: 18F-PSMA PET/CT showed moderate sensitivity but high specificity in lymph node staging of medium/high-risk PCa. The

关键词： 18F-PSMA PET/CT diagnostic test Lymph node Meta-analysis Prostate cancer

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Peritoneal fluid indocyanine green test for diagnosis of gut leakage in anastomotic leakage rats and colorectal surgery patients

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World Journal of Gastrointestinal Surgery 2024年第6期16卷 1825-1834页

作者： Yu Huang Tian-Yang Li Jie-Feng Weng Hui Liu Yu-Jie Xu Shuai Zhang Wei-Li Gu Department of Surgery Guangzhou First People's HospitalGuangzhou 510180Guangdong ProvinceChina

BACKGROUND Application of indocyanine green(ICG)fluorescence has led to new developments in gastrointestinal surgery.However,little is known about the use of ICG for the diagnosis of postoperative gut leakage(GL).In addition,there is a lack of rapid and intuitive methods to definitively diagnose postoperative GL.AIM To investigate the effect of ICG in the diagnosis of anastomotic leakage in a surgical rat GL model and evaluate its diagnostic value in colorectal surgery patients.METHODS Sixteen rats were divided into two groups:GL group(n=8)and sham group(n=8).Approximately 0.5 mL of ICG(2.5 mg/mL)was intravenously injected postoperatively.The peritoneal fluid was collected for the fluorescence test at 24 and 48 h.Six patients with rectal cancer who had undergone laparoscopic rectal cancer resection plus enterostomies were injected with 10 mL of ICG(2.5 mg/mL)on postoperative day 1.Their ostomy fluids were collected 24 h after ICG injection to identify the possibility of the ICG excreting from the peripheral veins to the enterostomy stoma.Participants who had undergone colectomy or rectal cancer resection were enrolled in the diagnostic test.The peritoneal fluids from drainage were collected 24 h after ICG injection.The ICG fluorescence test was conducted using OptoMedic endoscopy along with a near-infrared fluorescent imaging system.RESULTS The peritoneal fluids from the GL group showed ICG-dependent green fluorescence in contrast to the sham group.Six samples of ostomy fluids showed green fluorescence,indicating the possibility of ICG excreting from the peripheral veins to the enterostomy stoma in patients.The peritoneal fluid ICG test exhibited a sensitivity of 100%and a specificity of 83.3%for the diagnosis of GL.The positive predictive value was 71.4%,while the negative predictive value was 100%.The likelihood ratios were 6.0 for a positive test result and 0 for a negative result.CONCLUSION The postoperative ICG test in a drainage tube is a valuable and simple technique for the diagnosis of GL.Hence,it should

关键词： Gut leakage Indocyanine green Anastomotic leakage model diagnostic test diagnostic technique

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diagnostic and economic value of carcinoembryonic antigen,carbohydrate antigen 19-9,and carbohydrate antigen 72-4 in gastrointestinal cancers

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World Journal of Gastroenterology 2023年第4期29卷 706-730页

作者： Hai-Ning Liu Can Yao Xiao-Fan Wang Ning-Ping Zhang Yan-Jie Chen Dong Pan Guo-Ping Zhao Xi-Zhong Shen Hao Wu Tao-Tao Liu Department of Gastroenterology and Hepatology Zhongshan HospitalFudan UniversityShanghai 200032China Department of Gastroenterology and Hepatology Minhang District Central HospitalFudan UniversityShanghai 201199China Department of Internet Technology Center Zhongshan HospitalFudan UniversityShanghai 200032China Chinese National Human Genome Center at Shanghai Zhujiang HospitalCentral LabInstitute of Plant Physiology and EcologyShanghai Institute for Biological SciencesShanghai 200032China

BACKGROUND The diagnostic and economic value of carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9)and CA72-4 for gastrointestinal malignant tumors lacked evaluation in a larger scale.AIM To reassess the diagnostic and economic value of the three tumor biomarkers.METHODS A retrospective analysis of all 32857 subjects who underwent CEA,CA19-9,CA72-4,gastroscopy and colonoscopy from October 2006 to May 2018 was conducted.Then,we assessed the discrimination and clinical usefulness.Total cost,cost per capita and cost-effectiveness ratios were used to evaluate the economic value of two schemes(gastrointestinal endoscopy for all people without blood tests vs both gastroscopy and colonoscopy when blood tests were positive).RESULTS The analysis of 32857 subjects showed that CEA was a qualified biomarker for colorectal cancer(CRC),while the diagnostic efficiencies of CA72-4 were catastrophic for all gastrointestinal cancers(GICs).Regarding early diagnosis,only CEA could be used for early CRC.The combination of biomarkers didn’t greatly increase the area under the curve.The economic indicators of CEA were superior to those of CA19-9,CA72-4 and any combination.At the threshold of 1.8μg/L to 10.4μg/L,all four indicators of CEA were lower than those in the scheme that conducted gastrointestinal endoscopy only.Subgroup analysis implied that the health checkup of CEA for people above 65 years old was economically valuable.CONCLUSION CEA had qualified diagnostic value for CRC and superior economic value for GICs,especially for elderly health checkup subjects.CA72-4 was not suitable as a diagnostic biomarker.

关键词： diagnostic test Economic analysis Cost-effectiveness analysis Decision curve analysis

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Role of Ultrasound Lung Comets in the Diagnosis of Acute Heart Failure in Emergency Department: A Systematic Review and Meta-analysis

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Biomedical and Environmental Sciences 2018年第8期31卷 596-607页

作者： LIAN Rui ZHANG Guo Chao YAN Sheng Tao SUN Li Chao ZHANG Su Qiao ZHANG Guo Qiang Department of Emergency Medicine China-Japan Friendship Hospital Department of General Surgery China-Japan Friendship Hospital

Objective A new technique of transthoracic lung ultrasonography(TLS) has emerged and demonstrated promising results in acute heart failure diagnosis at an early stage. However, the diagnostic value of ultrasound lung comets(ULCs) for acute heart failure(AHF) performed in busy emergency department(ED) is uncertain. The present meta-analysis aimed to assess the diagnostic efficiency of ULCs in AHF. Methods We conducted a search on online journal databases to collect the data on TLS performed for diagnosing AHF published up to the end of July 2017. The sensitivity, specificity, positive likelihood ratio(PLR), negative likelihood ratio(NLR), and summary receiver operating characteristic(SROC) curve were calculated. The post-test probability of AHF was calculated by using Bayes analysis. Results We enrolled a total of 15 studies involving 3,309 patients. The value of sensitivity, specificity, PLR, NLR, DOR, area under the SROC curve, and Q* index was 85%, 91%, 8.94, 0.14, 67.24, 0.9587, and 0.9026, respectively. We detected significant heterogeneity among included studies, and therefore, all these results were analyzed under the random-effect model. We also explored possible sources of heterogeneity among the studies by using meta-regression analysis. Results suggest that the time interval between patient’s admission to bedside TLS examination was closely related to TLS accuracy. Conclusion This meta-analysis demonstrated that detecting ULCs is a convenient bedside tool and has high accuracy for early AHF diagnosis in ED. TLS could be recommended to be applied for early diagnosis of AHF in ED.

关键词： Transthoracic lung ultrasonography Lung comets sign Dyspnea Acute heart failure diagnostic test Meta-analysis

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Accuracy of three diagnostic tests used alone and in combination for detecting Helicobacter pylori infection in patients with bleeding gastric ulcers

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Chinese Medical Journal 2003年第12期116卷 1821-1826页

作者：廖健仲李嘉龙赖永智黄世鸿李瑞成吴启华涂天健陈振宽白其卉 Divisions of Gastroenterology Cathay General Hospital Divisions of Gastroenterology and Pathology Cathay General Hospital Department of Epidemiology

Objective Accuracy of diagnostic methods for detecting Helicobacter pylori (H. pylori) infection among patients with bleeding peptic ulcers has not been thoroughly investigated. The aim of this study was to compare the diagnostic tests and their combined usage in detection of H. pylori infection in patients with bleeding gastric ulcers and without the use of nonsteroidal anti-inflammatory drugs.Methods A total of 57 patients who presented with bleeding gastric ulcers by endoscopy were enrolled. The status of H. pylori was identified by performing the rapid urease test (RUT), histology and 13C-labeled urea breath test (UBT). The criteria for having H. pylori infection was a minimum of two positive tests.Results The prevalence of H. pylori infection in our patient group was 80.7%. Among the three tests used: RUT, histology, and UBT, sensitivities were 56.5%, 97.8% and 100%, while specificities were 100%, 45.5% and 81.8%, respectively. The overall accuracies of the tests were 78.3%, 71.6% and 90.9%, respectively. Although UBT obtained significantly higher accuracy than histology (P=0.02) as opposed to RUT (P=0.11), UBT had significantly higher sensitivity than RUT (Ptests, more accuracy (98.9%) was achieved when both UBT and histology were used to confirm the diagnosis of the other. Conversely, failure to use combined tests generated the potential of missing a proper H. pylori diagnosis.Conclusions UBT is superior to the other two tests in bleeding gastric ulcers. RUT lacks sensitivity for detection of H. pylori infection. However, the concomitant use of UBT and histology seems to be more accurate when gastric ulcers present with bleeding.

关键词： diagnostic test Helicobacter pylori breath test gastric ulcer

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Pupil constriction can alter the accuracy of dark room provocative test

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Chinese Medical Journal 2009年第21期122卷 2620-2623页

作者： WANG Bing-song WANG Ning-li Nathan Congdon LEI Kun Baskaran Mani Tongren Eye Center Beijing Tongren Hospital Capital Medical University Beijing 100730 China Department of Ophthalmology Beijing Shijitan Hospital Beijing 100038 China Department of Ophthalmology and Visual Science Chinese University of Hong Kong Hong Kong China Singapore National Eye Center Singapore

Background Primary angle-closure glaucoma （PACG） is a major cause of visual morbidity in East Asia. Dark-room provocative test （DRPT） has been used to determine which narrow angles have the risk to develop angle closure. However, the accuracy of DRPT might be altered because that after emerging from the dark room, the configuration of the angle is affected by the light of the slit-lamp and the appositionally closed angle reopens. The aim of this study was to examine the pupillary diameter in different light conditions and use it as a parameter to assess the accuracy of dark-room provocative test. Methods Patients with suspected primary angle-closure glaucoma undergoing DRPT were recruited. The anterior chamber angle was examined by anterior segment optical coherence tomography under the following conditions：（1） in standard room illumination; （2） after short-term dark-adaptation and （3） after DRPT. Mean values of pupil size and numbers of appositionally closed angle under different conditions were compared. Results A total of 47 eyes of 47 patients were analyzed. The pupil size after DRPT was smaller than that after short-term dark-adaptation （P 〈0.001） and smaller than that in standard room illumination （P=0.026）. The numbers of appositionally closed angles after short-term dark-adaptation were significantly larger than those after DRPT （P 〈0.001）. There was no significant difference between the numbers of appositionally closed angles in standard room illumination and after DRPT （P=-0.157）. Conclusions Constriction of pupil size immediately after prolonged dark room provocative test may lead to change in the angle configuration, which may lead to false negative results. We suggest a modified protocol of recording intraocular pressure immediately after DRPT and performing gonioscopy following short-term dark adaptation to improve the accuracy of angle closure assessment.

关键词： angle closure glaucoma diagnostic test biometry

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Sensitivity,specificity and predictive values of anterior chamber tap in cases of bacterial endophthalmitis

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Eye and Vision 2017年第1期4卷 100-105页

作者： Carl Sjoholm-Gomez de Liano Vidal F.Soberon-Ventura Guillermo Salcedo-Villanueva Abril Santos-Palacios Jose Luis Guerrero-Naranjo Jans Fromow-Guerra Gerardo García-Aguirre Virgilio Morales-Canton Raul Velez-Montoya Retina Department Asociación para Evitar la Ceguera en MexicoHospital“Dr.Luis Sanchez Bulnes”IAPMexico CityMexico Universidad Popular Autonoma del Estado de Puebla PueblaMexico Ophthalmology Department Macula Retina ConsultantsMexico CityMexico

Background:To assess the sensitivity,specificity,positive predictive value and negative predictive value of anterior chamber tap for the diagnosis of bacterial endophthalmitis on a population with high prevalence.Methods:Retrospective,single centre,case series study.We reviewed all medical records with clinical diagnosis of bacterial endophthalmitis in our hospital from January 1st,2000 to December 31st 2014.From each record,we documented general demographic data,best corrected visual acuity and vitreous and aqueous tap microbiological results.All cases were further divided according to the endophthalmitis aetiology to perform individual calculations of sensitivity,specificity,positive predictive value,negative predictive value,accuracy and prevalence.We used the results of the vitreous tap as the gold standard for diagnosis of bacterial endophthalmitis.We excluded those records in which the aqueous and vitreous samples were not taken simultaneously or had an incomplete microbiological report.Significance were assessed with chi squared statistics,with an alpha value of 0.05 for statistical significance.Results:A total of 190 cases fulfilled the inclusion/exclusion criteria.Positive culture rate from vitreous samples was 64.74%.Positive culture rate from aqueous sample was 32.11%.Bacteria isolated from aqueous samples matched those isolated from vitreous samples 78.68%of the time.The overall sensitivity was 38.21%,specificity:75.51%,positive predictive value:79.66%,negative predictive value:32.74%(p=0.08).Subgroup analysis showed that anterior chamber taps in cases of post-surgical endophthalmitis had a moderate to low sensitivity(37.73%),high specificity(93%)and high positive predictive value(95%)(p<0.04).Conclusion:The sensitivity and specificity of anterior chamber tap are low and should not be used for critical therapeutic decisions in patients with suspected bacterial endophthalmitis.In cases of post-surgical endophthalmitis,the result of an anterior chamber tap could be used for therapeutic guidance,but only

关键词： Aqueous humour Endophthalmitis Anterior chamber tap diagnostic test Vitreous tap Aqueous sampling Sensibility Sensitivity

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γ干扰素释放试验对结核性淋巴结炎的诊断价值研究（英文）

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Chinese Medical Sciences Journal 2019年第4期34卷 233-240页

作者：刘昕超叶素素王文泽张月秋张丽帆潘晓承周子月张妙颜刘江浩梁智勇刘晓清北京协和医院感染科北京协和医院病理科国际临床流行病学网临床流行病学单位北京协和医院内科

Objective The aim of this study was to evaluate the diagnostic performance of T-SPOT.TB for tuberculous lymphadenitis.Methods Suspected tuberculous lymphadenitis patients between September 2010 and September 2018 who had both peripheral blood T-SPOT.TB test and lymph node biopsy were retrospectively enrolled in this study.The cutoff value of T-SPOT.TB test for peripheral blood was set as 24 spot forming cell(SFC)/106 periphreral blood monocyte cell(PBMC)according to the instruction of testing kits.The gold standard for diagnosis of TBL was the combination of microbiology results,histopathology results and patient's response to anti-TB treatment.diagnostic efficacy of T-SPOT.TB was evaluated,including sensitivity,specificity,accuracy,predictive values,and likelihood ratio.Results Among 91 patients who met the inclusion criteria,we excluded 8 cases with incomplete clinical information and 6 cases who lost to follow-up.According to the gold standard,there were 37 cases of true TBL(9 confirmed TBL and 28 probable TBL),30 cases of non-TBL,and 10 cases of clinically indeterminate diagnosis who were excluded from the final analyses.The T-SPOT.TB tests yielded 43 cases of positive response and 24 cases of negative response.The sensitivity,specificity,accuracy,positive predictive value(PPV),negative predictive value(NPV),positive likelihood ratio(PLR)and negative likelihood ratio(NLR)of peripheral blood T-SPOT.TB for diagnosing TBL were 89.2%,66.7%,79.1%,76.7%,83.3%,2.68 and 0.16,respectively.The number of SFCs of T-SPOT.TB in TBL patients[432(134-1264)/106 PBMCs]was higher than that in non-TBL patients[0(0-30)/106 PBMCs]with a significant difference(Z=-5.306,Pdiagnostic test for TBL with a high sensitivity and negative predictive value.

关键词： Tuberculous lymphadenitis(TBL) T-SPOT.TB diagnostic test sensitivity specificity

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The Study of Ischemic Stroke

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Journal of Clinical and Nursing Research 2021年第3期5卷 103-106页

作者： Yun Wang Biomedicine and Pharmacy University of Central Lancashire PrestonLancashire PR11LJUK

This study focuses on the pathology of ischemic stroke and the analysis of the disease.Ischemic stroke has become a serious disease that damages the health of the elderly year by year.Therefore,the continual analysis of ischemic stroke is able to make the disease be better prevented and effectively treated.This review contains diagnosis testing,treatment and prognoses,and analyzes the pros and cons of each method in each part.The prognostics treatment of patients is certainly an important part to be considered because most of patients are elderly.How to relieve the suffering of patients and help patients regain health are also the key points of this review.This review then records an interview of a patient who has the ischemic stroke and HIV.The interview mainly discusses the continuous treatment after left the hospital and the psychological.The patient affirmed some new treatments and also posed some psychological burden.In general,medical staff not only need to think of treating the patienfs body,but also need to pay attention to the patienfs psychological condition.

关键词： Ischemic stroke Epidemiology Atherosclerosis diagnostic test

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基于实时RT-PCR方法决策油菜菌核病防治(英文)

基于实时RT-PCR方法决策油菜菌核病防治(英文)

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第十二届国际油菜大会

作者： L.Ruck E.Pic F.Chaubron D.Makowski A.Penaud F.Caceres B.Bammé N.Honoré L.Jouanneau D.Wagner R.Bronsaer P.Simonin A.Merrien CETIOM-Centre de Grignon BP 4-78850 Thiverval GrignonFrance Cambrex Bio Science Clermont-Ferrand SAS-63360 Saint Beauzire-France Unité MIA INRA 78352 Jouy en Josas-France UMR Agronomie INRA INA-PG 78850 Thiverval Grignon-France

上世纪90年代以来,预防性杀菌剂在油菜菌核病防治中得到广泛应用。由于茎腐病每十年只造成1至2次严重产量损失,在多数情况下,使用杀菌剂并没有起到作用。为了减少化学杀菌剂的应用及其对环境造成的负面影响,CETIOM提出了一种用来快速测... 详细信息

上世纪90年代以来,预防性杀菌剂在油菜菌核病防治中得到广泛应用。由于茎腐病每十年只造成1至2次严重产量损失,在多数情况下,使用杀菌剂并没有起到作用。为了减少化学杀菌剂的应用及其对环境造成的负面影响,CETIOM提出了一种用来快速测定受染花瓣比率的花瓣检测法(Taverne et al,2003)。结果表明,根据气候条件,这种检测方法可以使农民减少农药使用次数155%,但不造成产量损失。为了评估Cambrex Bio Science Clermont-Ferrand提出的实时PCR较之平板检测方法的优越性,2006年我们进行了一系列新的试验。通过测定收获时的发病率来评估上述两种检测方法的敏感性和特异性。在预备试验中,用100个花瓣样品检测,得出的结果表明这两种方法的效果相当。.根据这些结果,为省时,在我们的试验方案中我们准备用基于分子生物学的方法代替平板检测法来分析油菜花瓣。

关键词： winter oilseed rape Sclerotinia sclerotiorum diagnostic test real time PCR decision making tools.

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