• 제목/요약/키워드: malignancy

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악성 췌장 병변 진단에서 인공지능기술을 이용한 초음파내시경의 응용 (Application of Endoscopic Ultrasound-based Artificial Intelligence in Diagnosis of Pancreatic Malignancies)

  • 안재희;정회훈;박재근
    • Journal of Digestive Cancer Research
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    • 제12권1호
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    • pp.31-37
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    • 2024
  • Pancreatic cancer is a highly fatal malignancy with a 5-year survival rate of < 10%. Endoscopic ultrasound (EUS) is a useful noninvasive tool for differential diagnosis of pancreatic malignancy and treatment decision-making. However, the performance of EUS is suboptimal, and its accuracy for differentiating pancreatic malignancy has increased interest in the application of artificial intelligence (AI). Recent studies have reported that EUS-based AI models can facilitate early and more accurate diagnosis than other preexisting methods. This article provides a review of the literature on EUS-based AI studies of pancreatic malignancies.

악성종양환자(惡性腫瘍患者)에서 혈청(血淸) Tissue Polypeptide Antigen 치(値)의 임상적(臨床的) 의의(意義)에 관(關)한 연구(硏究) (A Study on the Clinical Significance of Serum Tissue Polypeptide Antigen Levels in Patients with Malignancy)

  • 박성기;문대혁;이명철;조보연;김병국;김노경;고창순;이문호
    • 대한핵의학회지
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    • 제18권1호
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    • pp.1-8
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    • 1984
  • To evaluate the clinical significance of serum tissue polypeptide antigen (TPA) levels in patients with malignancy, serum TP A levels were measured by radioimmunoassay in 49 normal controls, 9 patients of postoperative colon cancer without recurrence and 68 patients with various untreated malignancy, who visited Seoul National University Hospital from February, 1983 to September, 1983. The results were as follows; 1) Serum TPA levels in 49 normal controls were in the range of 22-135 U/L $(74{\pm}28U/L,\;mean{\pm}S.D.)$. There was no sex or age difference. Normal upper limit of serum TPA was defined as 130 U/L (mean+2S.D.). 2) Serum TPA levels in 68 patients with various untreated malignancy (stomach cancer 33 cases, colon cancer 11 cases, lung cancer 10 cases, primary liver cancer 9 cases and metastatic cancer of unknown primary site 5 cases) were in the range of 10-800 U/L $(189{\pm}170U/L,\;mean{\pm}S.D.)$ and significantly elevated, compared with those of normal controls (p<0.005). 3) The sensitivities of serum TPA in various untreated malignancy were 39% in stomach cancer, 55% in colon cancer, 50% in lung cancer, 67% in primary liver cancer and 80% in metastatic cancer of unknown primary site respectively. 4) The sensitivities of serum TPA related to resectability in stomach and colon cancer were 32% in resectable stomach cancer, 50% in unresectable stomach cancer, 29% in resectable colon cancer and 100% in unresectable colon cancer respectively. 5) The mean value of serum TPA levels in 9 patients of postoperative colon cancer without recurrence was $70{\pm}39U/L$ and significantly decreased, compared with that of untreated colon cancer, $180{\pm}150U/L$ U/L (p<0.05). 6) In patients with stomach or colon cancer, there was no significant correlation between serum TP A and serum CEA levels, but simultaneous measurement of serum TPA and serum CEA levels increased sensitivities. From above results, we concluded that serum TPA level is a useful indicator reflecting tumor activity and responses to anticancer treatment in patients with malignancy.

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Clinical Value of Dividing False Positive Urine Cytology Findings into Three Categories: Atypical, Indeterminate, and Suspicious of Malignancy

  • Matsumoto, Kazumasa;Ikeda, Masaomi;Hirayama, Takahiro;Nishi, Morihiro;Fujita, Tetsuo;Hattori, Manabu;Sato, Yuichi;Ohbu, Makoto;Iwam, Masatsugu
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권5호
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    • pp.2251-2255
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    • 2014
  • Background: The aim of this study was to evaluate 10 years of false positive urine cytology records, along with follow-up histologic and cytologic data, to determine the significance of suspicious urine cytology findings. Materials and Methods: We retrospectively reviewed records of urine samples harvested between January 2002 and December 2012 from voided and catheterized urine from the bladder. Among the 21,283 urine samples obtained during this period, we located 1,090 eligible false positive findings for patients being evaluated for the purpose of confirming urothelial carcinoma (UC). These findings were divided into three categories: atypical, indeterminate, and suspicious of malignancy. Results: Of the 1,090 samples classified as false positive, 444 (40.7%) were categorized as atypical, 367 (33.7%) as indeterminate, and 279 (25.6%) as suspicious of malignancy. Patients with concomitant UC accounted for 105 (23.6%) of the atypical samples, 147 (40.1%) of the indeterminate samples, and 139 (49.8%) of the suspicious of malignancy samples (p<0.0001). The rate of subsequent diagnosis of UC during a 1-year follow-up period after harvesting of a sample with false positive urine cytology initially diagnosed as benign was significantly higher in the suspicious of malignancy category than in the other categories (p<0.001). The total numbers of UCs were 150 (33.8%) for atypical samples, 213 (58.0%) for indeterminate samples, and 199 (71.3%) for samples categorized as suspicious of malignancy. Conclusions: Urine cytology remains the most specific adjunctive method for the surveillance of UC. We demonstrated the clinical value of dividing false positive urine cytology findings into three categories, and our results may help clinicians better manage patients with suspicious findings.

Modification of Cutoff Values for HE4, CA125, the Risk of Malignancy Index, and the Risk of Malignancy Algorithm for Ovarian Cancer Detection in Jakarta, Indonesia

  • Winarto, Hariyono;Laihad, Bismarck Joel;Nuranna, Laila
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권5호
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    • pp.1949-1953
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    • 2014
  • Background: CA125 and HE4 are used in calculating Risk of Malignancy Algorithm (ROMA); and Risk of Malignancy Index (RMI). However, studies showed that normal levels of CA125, and HE4 differ among ethnicities such as between Asians and Caucasians, thus affecting the accuracy of the RMI score and ROMA in predicting ovarian malignancy. This study aimed to determine whether new or modified cutoff values for Ca125, HE4, the RMI score, and ROMA resulted in a better prediction of malignancy compared with the previous or standard ones. Materials and Methods: Serum level of CA125 and HE4 from 128 patients with diagnosis of ovarian tumor that had been collected before surgery at Cipto Mangunkusumo General Hospital (CMH) in Jakarta from November 2010 until May 2011 were reviewed and analysed. The standard cutoff values of these biomarkers, RMI, and ROMA were modified by using logistic regression model. The modified cutoff values were compared to the standard cutoff values in terms of sensitivity, specificity, and accuracy. Results: The modified cutoff value of CA125, HE4, RMI score and ROMA were 165.2 U/mL, 103.4 pM, 368.7, 28/54. The sensitivity and specificity of the modified cutoff values CA125, HE 4, RMI score and ROMA in differentiating benign from malignant and borderline were 67% and 75,4%; 73.1% and 85.2%; 73.1% and 80.3%; and 77.6% and 86.9%. While the sensitivity and specificity of the standard cutoff value of CA125; HE4; RMI score; and ROMA were 91% and 24.6%; 83.6% and 65%; 80.6% and 65.6%; and 91.0% and 42.6%. The accuracy of modified cutoff values compared with standard cutoff values were: 71.2% vs 59.3%, 78.9% vs 75% vs, 76.5% vs 73.4%, and 82% vs 67.9%. Conclusions: The new or modified cutoff values of Ca125, HE4, RMI score and ROMA resulted in higher accuracy compared to the previous or standard ones, at the cost of reduced sensitivity.

세침흡인검사 결과 Atypia of Undetermined Significance로 진단된 갑상선 결절에서 악성을 예측할 수 있는 위험인자 (BRAFV600E Mutation is a Strong Preoperative Indicator for Predicting Malignancy in Thyroid Nodule Patients with Atypia of Undetermined Significance Identified by Fine Needle Aspiration)

  • 최혜랑;최보윤;조재훈;임영창
    • Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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    • 제61권11호
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    • pp.600-604
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    • 2018
  • Background and Objectives This study aimed to identify a reliable preoperative predictive factor for the development of thyroid cancer in patients with atypia of undetermined significance (AUS) identified by fine needle aspiration biopsy (FNAB). Subjects and Method This was a retrospective cohort study. Two hundred and ninety-nine patients diagnosed with AUS by preoperative FNAB who underwent curative thyroid surgery at our institution between September 2005 and February 2014 were analyzed. Clinical, radiological and molecular features were investigated as preoperative predictors for postoperative permanent malignant pathology. Results The final pathologic results revealed 36 benign tumors including nodular hyperplasia, follicular adenoma, adenomatous goiter, nontoxic goiter, and lymphocytic thyroiditis, as well as 263 malignant tumors including 1 follicular carcinoma and 1 invasive follicular carcinoma; the rest were papillary thyroid carcinomas. The malignancy rate was 87.9%. The following were identified as risk factors for malignancy by univariate analysis: $BRAF^{V600E}$ gene mutation, specific ultrasonographic findings including smaller nodule size, low echogenicity of the nodule, and irregular or spiculated margin (p<0.05). Multivariate analysis revealed that only $BRAF^{V600E}$ mutation was a statistically significant risk factor for malignancy (p<0.05). When $BRAF^{V600E}$ mutation was positive, 98.5% of enrolled patients developed malignant tumors. In addition, the diagnostic rate of malignancy in these cases was approximately 16-fold higher than BRAF-negative cases. Conclusion Patients with AUS thyroid nodules should undergo $BRAF^{V600E}$ gene mutation analysis to improve diagnostic accuracy and if the mutation is confirmed, surgery is recommended due to the high risk of malignancy.

HIV 감염인의 기대여명과 사망요인 (Life-expectancy and causes of mortality among HIV-infected patients)

  • 송준영
    • 보험의학회지
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    • 제29권1호
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    • pp.4-6
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    • 2010
  • The life expectancy of HIV-infected subjects has improved dramatically since the introduction of highly-active antiretroviral therapy (HAART). Considering that patients with HIV infection are living longer, treatment plans should include those for the accompanying co-morbidities such as cardiovascular diseases, metabolic syndrome, malignancy, etc. This review discusses the impact of HAART on the epidemiology of survival and co-morbidities (malignancy and cardiovascular diseases) among HIV-infected subjects.

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Assessment of Malignancy in Brain Tumors by 3T MR Spectroscopy

  • 최보영;전신수;김범수;이재문;정성택;안창범;오창현;김선일;이형구
    • 대한자기공명의과학회:학술대회논문집
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    • 대한자기공명의과학회 2003년도 제8차 학술대회 초록집
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    • pp.84-84
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    • 2003
  • Purpose: To assess clinical proton MR spectroscopy (MRS) as a noninvasive method for evaluating tumor malignancy at 3T high field system. Materials and methods: Using 3T MRI/MRS system, localized water-suppressed single-voxel technique in patients with brain tumors was employed to evaluate spectra with peaks of N-acetyl aspartate (NAA), choline-containing compounds (Cho), creatine/phosphocreatine (Cr) and lactate. On the basis of Cr, these peak areas were quantificated as a relative ratio.

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Mucoepidermoid Carcinoma 치험 1예 (Mucoepidermoid carcinoma of the lung)

  • 백광제
    • Journal of Chest Surgery
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    • 제19권3호
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    • pp.484-488
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    • 1986
  • Mucoepidermoid carcinoma is one of bronchial adenoma which arising from submucosal gland or mucosal gland of lower respiratory tract. The symptoms of the tumor were produced by bronchial irritation and bronchial obstruction such as coughing, pneumonitis, and atelectasis. The malignancy potency of this tumor was determined by histologic pattern but high grade malignancy was uncommon and so distant metastasis was rare. Three treatment modality such as surgery, radiotherapy, chemotherapy were used for treatment but radiotherapy and chemotherapy were lesser effective than surgery. So Early and radical resection of tumor was recommended. Here we report one case of mucoepidermoid carcinoma which treated with radical resection.

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Clinical Applications of 3T MR Spectroscopy

  • Choe, Bo-Young;Baik, Hyun-Man;Chu, Myung-Ja;Jeun, Sin-Soo;Kang, Sei-Kwon;Chung, Sung-Taek;Park, Chi-Bong;Oh, Chang-Hyun;Lee, Hyoung-Koo
    • 한국의학물리학회:학술대회논문집
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    • 한국의학물리학회 2002년도 Proceedings
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    • pp.345-351
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    • 2002
  • The purpose of this study was to assess clinical proton MR spectroscopy (MRS) as a noninvasive method for evaluating brain tumor malignancy at 3T high field system. Using 3T MRI/MRS system, localized water-suppressed single-voxe1 technique in patients with brain tumors was employed to evaluate spectra with peaks of N-acetyl aspartate (NAA), choline-containing compounds (Cho), creatine/phosphocreatine (Cr) and lactate. On the basis of Cr, these peak areas were quantificated as a relative ratio. The variation of metabolites measurements of the designated region in 10 normal volunteers was less than 10%. Normal ranges of NAA/Cr and Cho/Cr ratios were 1.67${\pm}$018 and 1.16${\pm}$0.15, respectively. NAA/Cr ratio of all tumor tissues was significantly lower than that of the normal tissues (p=0.005), but Cho/Cr ratio of all tumor tissue was significantly higher (p=0.001). Cho/Cr ratio of high-grade gliomas was significantly higher than that of low-grade gliomas (P=0.001). Except 4 menigiomas, lactate signal was observed in all tumor cases. The present study demonstrated that the neuronal degradation or loss was observed in all tumor tissues. Higher grade of brain tumors was correlated with higher Cho/Cr ratio, indicating a significant dependence of Cho levels on malignancy of gliomas. Our results suggest that clinical proton MR spectroscopy could be useful to predict tumor malignancy.

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