Lung metastases are more common in metastatic disease in differentiated thyroid carcinoma (DTC). Because of its insidious onset and slow development, clinical diagnosis is relatively difficult. Some possible diagnostic methods for detecting the lung metastasis of DTC including serological examination, radionuclide imaging and other medical imaging patterns are discussed in this paper. The progress and the current situation about investigation of those modalities which are in the early diagnosis, recurrent and clinical evaluation for the lung metastasis of DTC are briefly reviewed. Therefore, it is expected to promote DTC with lung metastasis to a higher diagnostic level.
ObjectiveTo understand the prevalence of iliac vein stenosis in crowds without lower extremityvenous disease and symptoms (abbreviated as asymptomatic crowd) and patients with lower extremity varicose vein and analyze relevant to factors of iliac vein stenosis. MethodsAccording to the inclusion and exclusion criteria, the CT imaging data and clinical informations of objects in the department of vascular surgery, the First Affiliated Hospital of Chongqing Medical University from 2020 to 2021 were collected. The objects included the patients with lower extremity varicose vein in the department of vascular surgery of this hospital and asymptomatic crowds in the physical examination center of this hospital. The occurrence of iliac vein stenosis of the objects was compared and the relevant to risk factors affecting the occurrence of iliac vein stenosis were analyzed. ResultsA total of 268 subjects who met the criteria were included in this study, the iliac vein stenosis was occurred in 63 (23.5%) subjects. there were 162 asymptomatic crowds and 106 patients with lower extremity varicose vein. The incidence of iliac vein stenosis was higher in the patients with lower extremity varicose vein than that in the asymptomatic crowds [36.8% (39/106) versus 14.8% (24/162), χ2=17.212, P<0.001]. The results of multivariate logistic regression analysis showed that the female crowds had a higher risk of iliac vein stenosis as compared with the male crowds [OR=3.131, 95%CI (1.188, 8.257), P=0.021] and the crowds with higher body mass index (BMI) had a lower risk of iliac vein stenosis [OR=0.802, 95%CI (0.666, 0.966), P=0.020] in the asymptomatic crowds, as well as the risk of iliac vein stenosis was decreased in the older patients with lower extremity varicose vein [OR=0.946, 95%CI (0.901, 0.993), P=0.026]. ConclusionFrom the results of this study, the incidence of iliac vein stenosis is not low, and the incidence rate of patient with lower extremity varicose vein is higher than that of asymptomatic crowd, and there may be associated with gender, age, or BMI.
The main purpose of this study is to evaluate the clinical value of 18F-fluorodeoxyglucose (18F-FDG) metabolism imaging in accurate staging and prognosis prediction before treatment of cervical cancer. 18F-FDG single photon emission computed tomography (SPECT/CT) was performed before treatment on 27 patients with cervical cancer and was analyzed retrospectively. All the images were analyzed by image fusion software. Meanwhile, primary tumor size and T/B, lymph nodes size and T/B were measured by software. Comparison of the relationship between primary tumor T/B of cervix and clinic pathological factors was performed using SPSS17.0. The diagnosis was established according to pathology results of surgery or/and multi-modalities of imaging and clinical following up. The results showed that the primary tumor T/B value of cervix was 5.9 (3.2). With the increased clinical stage, T/B of primary tumor value was significantly increased (P<0.05). The T/B value in patients ≥Ⅱa stage was significantly higher than those of ≤Ⅰb stage. There were no significant correlations between T/B value and primary tumor size, lymph-node metastasis, and histological type (P>0.05). Thirteen lymph nodes were detected by 18F-FDG imaging in 27 patients with cervical cancer. For diagnosing lymph nodes metastasis, the sensitivity, specificity, accuracy, positive and negative predictive value by 18F-FDG imaging were 75.0%, 78.9%, 77.8%, 60.0% and 88.2%, respectively. The T/B value of all lymph nodes was 6.3 (3.5), in which T/B value of distant metastasis was significantly higher than that of the pelvic metastasis (P<0.05). There were no significant correlations between T/B value and the size of lymph nodes (P>0.05). Uterine body uptaking FDG were discovered in 17 patients and 15 cases were then pathologically proved. Two of 15 cases were cancerous invasion of uterine body, and the other 13 cases were physiological changes of endometrial, and the T/B value of the former was significantly higher than that of the latter (P<0.05). There were positive correlation between invasion of uterine body and lymph nodes metastasis (P<0.05). In conclusion, 18F-FDG imaging has an obvious value for the diagnosis of outside pelvic and distant lymph node metastasis, uterine body infiltrated, and accurate staging. Primary focal T/B value of cervical cancer associates with the clinical stage, which can reflect the risk of patients, and were useful to preliminarily predict the prognosis of cervical cancer.
ObjectiveTo compare the safety and comfort of patients with or without postoperative gastric tube placement after esophageal cancer surgery, and analyze the cost and nursing time of gastric tube placement. Methods The patients with esophageal cancer undergoing minimally invasive surgery in West China Hospital of Sichuan University in 2021 were enrolled. The patients were divided into a gastric tube indwelling group and a non gastric tube indwelling group according to whether the gastric tube was indwelled after the operation. The safety and comfort indicators of the two groups were compared. Results A total of 130 patients were enrolled. There were 66 patients in the gastric tube indwelling group, including 53 males and 13 females, aged 61.80±9.05 years and 64 patients in the non gastric tube indwelling group, including 55 males and 9 females, aged 64.47±8.00 years. Six patients in the non gastric tube indwelling group needed to place gastric tube 1 to 3 days after the operation due to their condition. There was no statistical difference in the incidence of postoperative complications between the two groups (P>0.05). The subjective comfort of patients in the gastric tube indwelling group was significantly lower than that in the non gastric tube indwelling group (P<0.001), and the incidence of foreign body sensation in the throat of patients in the gastric tube indwelling group was higher than that in the non gastric tube indwelling group (P<0.001). The average nursing time in the gastric tube indwelling group was about 59.58 minutes, and the average cost of gastric tube materials and nursing was 378.24 yuan per patient. Conclusion No gastric tube used after operation for appropriate esophageal cancer patients will not increase the incidence of postoperative complications (pulmonary infection, anastomotic leakage, chylothorax), but can increase the comfort of patients, save cost and reduce nursing workload, which is safe, feasible and economical.