坏死性小肠结肠炎的X线表现（附141例报道）

目的：总结坏死性小肠结肠炎的X线表现。方法：回顾性分析141例经临床证实的坏死性小肠结肠炎病例,怀疑或已诊断为坏死性小肠结肠炎者在首次腹平片后,根据病情每6～24小时复查腹平片,动态观察病情发展及转归。结果：小肠胀气扩张72例,部分肠管狭窄变细、形态僵直38例,局部胃肠道见＂泡沫征＂者12例,肠壁囊样积气者25例,肠壁线样积气者6例,肠壁囊样积气及线样积气者13例,门静脉积气者8例,气腹者21例。结论：坏死性小肠结肠炎的早期X线表现为肠管僵直、狭窄;进展期典型X线表现为肠壁积气及门静脉积气。X线检查为本病的首选检查方法。     

乳腺X线摄影与超声在早期老年乳腺癌诊断中的对比研究

目的:比较乳腺X线摄影与超声在早期老年乳腺癌诊断中区别与应用价值。方法:选择2014年8月至2016年6月在我院就诊的老年早期乳腺癌患者为研究对象,回顾性分析比较乳腺X线摄影检查结果与乳腺超声在乳腺癌及腋窝淋巴结的辅助诊断中的诊断确诊率,分析其区别与价值。结果:(1)乳腺X线摄影比超声对钙化更敏感,而超声比乳腺X线摄影对肿物检出率更高。(2)对于直径在0.5-2.0 cm之间的小肿瘤,超声检出率比乳腺X线摄影高;而对于肉眼及查体可扪及的乳腺大肿物(直径2.0 cm),二者的检出率无明显差异。(3)乳腺X线摄影与超声对乳腺癌诊断率无明显差异,乳腺X线摄影+超声对乳腺癌的准确率高于乳腺X线摄影。结论:两种方法在老年早期乳腺癌的辅助检查中各有优缺点,二者联合应用可达到增加诊断准确率之目的。     

腔内三维超声与宫腔镜检查对残角子宫畸形的诊断价值

目的:探讨腔内三维超声与宫腔镜检查对残角子宫畸形的诊断价值。方法:收集2009年3月~2013年3月我院收治的疑似残角子宫畸形的患者,分别行腔内三维超声和宫腔镜检查,以病理诊断结果为"金标准",比较两组检查结果的差异。结果:三维超声的灵敏度与宫腔镜比较,差异有统计学意义(P0.05),两组的特异度、准确性、阳性预测值、阴性预测值差异无统计学意义(P0.05);三维超声检查阳性检出率80.65%,阴性检出率19.35%,宫腔镜检查阳性检出率59.68%,阴性检出率40.32%,两组检出率差异无统计学意义(X2=0.498,P0.05)。结论:腔内三维超声诊断残角子宫畸形具有无创、操作简便的特点,但是漏诊率高于宫腔镜结果。     

超声联合钼靶X线对直径小于1 cm的乳腺癌诊断价值分析

目的:探讨超声联合钼靶X线对直径小于1 cm的乳腺癌诊断价值。方法:选择我院2012年1月至2017年12月收治的66例乳腺疾病患者,所有患者术前均经钼靶X线及彩色多普勒超声检查,分析其病理结果,分析钼靶X线、彩色多普勒超声及二者联合对乳腺肿块的检查结果(边缘毛刺征、血管、淋巴结、微小钙化),比较其对乳腺癌的灵敏度、特异度、准确度、阳性预测值及阴性预测值。结果:66例患者中,经病理检查发现恶性肿瘤34例,良性肿瘤32例。与病理检测相比,彩色多普勒超声联合钼靶X线对乳腺肿块的良恶性检出率无差异性(P0.05),而彩色多普勒超声,钼靶X线的良恶性检出率均显著降低(P0.05)。彩色多普勒超声与钼靶X线良恶性检出率对比无差异(P0.05),但均低于彩色多普勒超声联合钼靶X线的检出率(P0.05)。彩色多普勒超声与钼靶X线对乳腺癌的边缘毛刺征的检出率对比无统计学意义(P0.05);彩色多普勒超声对血管和淋巴结的检出率明显高于钼靶X线,而微小钙化的检出率明显低于钼靶X线,对比差异有统计学意义(P0.05)。彩色多普勒超声联合钼靶X线的灵敏度、特异度、准确度、阳性预测值及阴性预测值均明显高于彩色多普勒超声及钼靶X线(P0.05),钼靶X线及彩色多普勒超声间对比无统计学意义(P0.05)。结论:彩色多普勒超声与钼靶X线对直径小于1 cm乳腺癌的诊断各有优势,二者联合应用的诊断价值优于单一诊断方法。     

肠道屏障功能监测在判断NEC患儿预后中的应用价值

目的 探讨肠道屏障功能生化指标在新生儿坏死性小肠结肠炎(NEC)患儿预后判断中的应用价值。方法 研究共纳入正常新生儿32例作为对照组,NEC患儿78例,收集新生儿血清学标本,应用中生金域JY-DLT肠道屏障功能分析系统检测肠道屏障功能生化指标:D-乳酸、二胺氧化酶(DAO)、内毒素(LPS),同时检测WBC、PLT、CRP、PCT等实验室指标,评估肠道屏障功能生化指标在NEC患儿预后判断中的应用价值。结果 (1)NEC组患儿D-乳酸、DAO、LPS、WBC、CRP、PCT水平均高于正常新生儿,PLT低于正常新生儿,差异有统计学意义(均P0.05);(2)非治愈组NEC患儿WBC、CRP和PCT水平均高于治愈组,PLT低于治愈组,但差异均无统计学意义(均P0.05);(3)非治愈组NEC患儿D-乳酸、DAO、LPS水平均高于治愈组,差异有统计学意义(均P0.05);(4)D-乳酸、DAO、LPS在NEC患儿预后判断中具有较高的诊断价值,AUC分别为0.838、0.763和0.804,诊断的cut-off值分别为46.15 U/L、8.635 mg/L和6.455 U/L。结论 肠道屏障功能生化指标:D-乳酸、DAO和LPS在预测NEC患儿结局中具有较高的诊断价值,优于传统的实验室指标。     

缺氧诱导因子在新生儿坏死性小肠结肠炎中的作用机制研究

该文探讨了缺氧诱导因子-1α(hypoxia inducible factor-1α,HIF-1α)在新生儿坏死性小肠结肠炎(neonatal necrotizing enterocolitis,NEC)中的作用机制。收集8例NEC患儿小肠组织作为疾病组和6例胃肠道畸形患儿小肠组织作为对照组。将40只7日龄的C57BL/6新生鼠(WT)分为NEC组(WT/NEC,n=20)和对照组(WT/DF,n=20),40只7日龄C57BL/6背景的谷氧还原蛋白1(glutaredoxin1,Grx1)基因敲除鼠(Grx1~(–/–))分为NEC组(Grx1~(–/–)/NEC,n=20)和对照组(Grx1~(–/–)/DF,n=20)。Western blot检测人和小鼠肠组织HIF-1α、小鼠肠组织血管内皮生长因子A(vascular endothelial growth factor A,VEGFA);qRT-PCR检测小鼠肠道血管内皮生长因子VEGFA mRNA,免疫荧光染色检测人和小鼠肠组织HIF-1α。结果显示,NEC患儿小肠组织中HIF-1α表达量较对照组显著降低(P0.05);WT/NEC小鼠小肠组织HIF-1α和VEGFA蛋白表达量较WT/DF显著降低(P0.05);WT/NEC组小肠组织中VEGFA表达量较WT/DF组显著降低(P0.05),Grx1~(–/–)/NEC组VEGFA表达量较WT/NEC组显著升高(P0.05);HIF-1α主要表达于小肠上皮细胞,NEC患儿肠组织和NEC小鼠肠组织中HIF-1α免疫荧光染色强度均较各自对照组显著降低,而Grx1基因敲除显著提高了NEC小鼠肠组织HIF-1α免疫荧光染色强度。该研究结果表明,HIF-1α在NEC患儿和NEC小鼠中有重要作用,其机制可能与肠道微血管的发育相关。     

X线钼靶摄影和彩超诊断早期乳腺癌比较研究

目的:探讨X线钼靶摄片和彩色多普勒超声对早期乳腺癌的诊断价值.方法:回顾性分析经手术病理证实的76例直径＜1cm较早期乳腺癌的影像学表现,比较两种检查方法的诊断准确性.结果:X线钼靶摄片和彩色多普勒超对早期乳腺癌的诊断符合率分别为92.7%和80.01%,对＞40岁的早期乳腺癌患者的诊断符合率分别为97.1%和75.9%.检出率X线钼靶摄影均明显高于彩超,差异有统计学意义(P＜0.01).结论:钼靶X线撮片和超声都是乳腺疾病最常用的诊断方法,乳腺钼靶摄片对早期乳腺癌的检出率更高,尤其适合于对40岁以上女性的诊断.     

新生鼠坏死性小肠结肠炎肠道菌群变化及意义

目的探讨新生鼠坏死性小肠结肠炎(NEC)时肠道菌群变化,旨在阐明肠道菌群在NEC发病中的作用,为探讨新生儿NEC的发病机制及寻求有效的防治措施提供理论依据。方法SD新生大鼠出生48 h开始给予鼠乳代用品人工喂养,100%氮气缺氧90 s,4℃冷刺激10 min,每天2次,连续3 d,建立新生SD大鼠NEC模型。40只新生SD大鼠随机分成NEC模型组(A组)和正常对照组(B组)。每组动物各20只。在最后一次缺氧、冷刺激后24 h空腹断头处死大鼠,留取回盲部近端肠管组织进行肠组织损伤评分,组织学评分≥2确定为NEC;实验前后留取两组新生鼠粪便,按照张秀荣方法进行肠道菌群检测。实验前后比较采用配对t检验,组间比较采用方差分析,α=0.05为显著性检验标准。结果模型组新生鼠相继出现腹泻、腹胀、萎靡、活动减少,生长减慢,对照组新生大鼠进食及排便均正常,无腹胀及胃潴留,活动度良好,皮下脂肪丰满。模型组新生大鼠NEC的发生率为100%(20/20),对照组无1例发生NEC。实验组和对照组肠损伤病理评分(x±s)分别为:3.25±0.85、0.45±0.51,t=12.622,P<0.01。模型组和对照组新生鼠实验前肠道细菌总数,杆菌、球菌总数,G 杆菌、G 球菌,G-杆菌、G-球菌数差异均无显著性,肠道菌群中杆菌和球菌的比例都在正常范围中。实验结束时,正常对照组新生大鼠肠道菌群总数明显增多,其中以G 杆菌增加为主;G-杆菌属及G 球菌属菌数占肠道菌群的比率在实验前后差异无显著性;模型组新生大鼠肠道群总数亦明显增多,而且明显高于正常对照组。实验结束时肠道菌群数量,其中主要是G 球菌显著增加,而G 杆菌却较对照组明显减少,与实验前相比,明显下降,差异有显著性;模型组实验结束时肠道菌群中杆菌和球菌比值减少、倒置。结论NEC发病前正常肠道菌群已发生质和量的变化,肠道菌群紊乱在NEC发病机制中起关键作用;及时纠正肠道菌群紊乱可能会降低新生大鼠发生NEC危险性。     

老年慢性阻塞性肺疾病患者肺部感染病原菌与肠道定植菌的关系

目的探讨老年慢性阻塞性肺疾病(COPD)患者肺部感染病原菌与肠道定植菌的关系,为后续研究提供参考。方法选择2018年7月至2019年7月我院呼吸内科收治的60例COPD患者作为研究对象,根据是否合并肺部感染将患者分为感染组(n=38)和未感染组(n=22)。收集患者痰和粪便标本进行细菌培养,比较两组患者痰和粪便细菌检出情况,并对痰培养及粪便培养结果进行直线相关回归分析。结果感染组患者痰标本中铜绿假单胞菌、肺炎克雷伯菌、鲍曼不动杆菌及大肠埃希菌检出率高于未感染组(均P0.05)。感染组患者粪便标本中铜绿假单胞菌、肺炎克雷伯菌、鲍曼不动杆菌、阴沟肠杆菌、肠球菌、金黄色葡萄球菌检出率高于未感染组,肺炎链球菌检出率低于未感染组(均P0.05)。感染组患者粪便中各细菌检出率与痰培养细菌检出率呈正相关(r=0.745,P=0.009)。未感染组患者粪便中各细菌检出率与痰培养细菌检出率无显著相关性。结论老年COPD合并肺部感染患者病原菌与肠道定植菌具有一定相关性,临床治疗中应重视COPD患者肠道微生态平衡以降低肺部感染发生率。     

经阴道彩色多普勒超声诊断异位妊娠的临床价值分析

目的:探讨经阴道彩色多普勒超声诊断用于诊断异位妊娠的检出率与准确率,为其临床应用提供参考。方法:选取2016年1月-2017年12月我院收治的疑似异位妊娠患者174例,依据随机数字表方法将其分为观察组和参考组,每组87例。参考组应用经腹部彩色多普勒超声予以诊断,观察组采用经阴道彩色多普勒超声进行诊断,比较两组的检出率与准确率。结果:观察组检出率为96.5%,明显高于参考组(86.2%,P0.05);观察组的准确率达97.6%,明显高于参考组(85.7%,P0.05)。在对大病灶的诊断中,两组的诊断准确率比较差异无统计学意义(P0.05);在小病灶诊断中,观察组的诊断准确率为97.6%,明显高于参考组(76.9%,P0.05)。观察组在胎囊型和飘浮型中的诊断率均明显的高于参考组(P0.05);在包块型的诊断中,两组诊断准确率比较差异无统计学意义(P0.05)。结论:与经腹部彩色多普勒超声相比,经阴道彩色多普勒超声诊断应用于异位妊娠中具有较高的检出率与准确率,尤其针对一些较小的病灶诊断有优势。     

Comparison of the clinical application value of mo-targeted X-ray,color doppler ultrasound and MRI in preoperative comprehensive evaluation of breast cancer

ObjectiveTo investigate the clinical application value of the Mo-targeted X-ray examination, color Doppler ultrasound and magnetic resonance imaging (MRI) in the diagnosis and preoperative comprehensive evaluation of breast cancer.MethodsAmong 170 breast cancer patients, they underwent Mo-targeted X-ray examination, color Doppler ultrasound and MRI before surgery to evaluate the lesions in breast, axillary lymph nodes and the availability of breast-conserving surgery.ResultsThe detection rates using color Doppler ultrasound examination and MRI were higher than that in the Mo-targeted X-ray examination, which were 90%, 94% and 82%, respectively (P < 0.01 or 0.05). With the result of pathological examination as the golden criteria, we found that specificities of Mo-targeted X-ray examination, color Doppler ultrasound examination and MRI in evaluating the metastasis in axillary lymph nodes were similar (85.11%, 77.66% and 79.79%; P > 0.05). Before surgery, the sensitivities and accuracies of the color Doppler ultrasound examination and MRI were higher than those using the Mo-targeted X-ray examination, which were 73.21%, 82.14%, and 28.57%, 76.00%, 80.67% and 64.00% (P < 0.01 or 0.05). Before surgery, the accuracy rate of MRI in evaluating the breast-conserving surgery was higher than those of Mo-targeted X-ray examination and color Doppler ultrasound (92.00%, 83.33% and 84.67%; P < 0.05).ConclusionCombined application of Mo-targeted X-ray examination, color Doppler ultrasound and MRI shows a higher accuracy in diagnosis of breast cancer and evaluation of axillary lymph node metastasis, which is conducive to the selection of surgical methods.     

多层螺旋CT检查与腹部X线平片对急性肠梗阻的诊断价值比较研究

目的:研究比较多层螺旋CT(MSCT)检查与腹部X线平片对急性肠梗阻(AIO)的诊断价值。方法:选择2016年1月到2018年4月间在蚌埠医学院附属阜阳医院接受手术治疗的200例AIO患者作为研究对象,对所有患者先常规予以腹部X线平片诊断,12h后再通过MSCT为患者实施诊断,对比两种方法的诊断结果、诊断体验效果以及漏诊率和误诊率。结果:MSCT的肠梗阻检出率为94.50%,明显较腹部X线平片的69.00%更高(P0.05)。MSCT所诊断的肠梗阻中,梗阻类型为绞窄型及梗阻病因为肠肿瘤者均占100.00%,较腹部X线平片的36.21%和54.26%明显更高(P0.05)。MSCT的诊断舒适度评分、图像清晰度评分较腹部X线平片明显更高,而操作复杂度评分较腹部X线平片明显更低(P0.05)。MSCT的漏诊率、误诊率分别为4.00%、1.50%,较腹部X线平片的22.00%、9.00%明显降低(P0.05)。结论:对于AIO患者,MSCT较腹部X线平片具有更高的诊断价值,诊断体验效果更好,漏诊率和误诊率偏低。     

高频肺部超声结合分区域扫查早期鉴别新生儿肺透明膜病及湿肺的研究

摘要 目的：探讨高频肺部超声结合分区域扫查早期鉴别新生儿肺透明膜病（HMD）及湿肺（TTN）的临床价值。方法：选取2019年1月～2020年7月因呼吸窘迫进入我院新生儿重症监护室的163例新生儿作为研究对象,患儿均接受X线和高频肺部超声检查,采用最终临床诊断作为金标准,采用受试者工作曲线（ROC）计算超声和X线诊断HMD和TTN的灵敏度、特异性、阳性预测值、阴性预测值、曲线下面积（AUC）、95％CI。结果：超声诊断HMD的灵敏度、特异性、阳性预测值、阴性预测值、AUC均高于X线检查。Z检验显示超声与X线诊断HMD的AUC存在统计学意义（Z=3.996,P=0.001）。超声诊断TTN的灵敏度、特异性、阳性预测值、阴性预测值、AUC均高于X线。Z检验显示,超声与X线诊断TTN的AUC存在统计学差异（Z=4.188,P＜0.001）。结论：高频肺部超声结合分区域扫查早期鉴别新生儿肺透明膜病及湿肺的临床价值高于X线,值得临床推广应用。     

术前经直肠腔内三维超声诊断复杂性肛瘘内口、分型的临床价值及对手术疗效的影响

摘要 目的：探讨术前经直肠腔内三维超声诊断复杂性肛瘘内口、分型的临床价值及对手术疗效的影响。方法：选择2021年1月至2022年6月我院收治拟行手术治疗的复杂性肛瘘患者84例,按照数字随机法分为研究组和对照组,每组42例。对照组术前行经直肠腔内常规超声检查,研究组术前行经直肠腔内三维超声检查。比较两组肛瘘内口术前诊断准确率、Parks分型检出准确率、手术疗效、住院时间、创口愈合时间,术前与术后肛门功能、术后并发症发生情况及复发率。结果：研究组肛瘘内口术前诊断准确率显著高于对照组（P<0.05）。研究组括约肌间型、经括约肌型、括约肌上型、括约肌外型术前诊断准确率显著高于对照组（P<0.05）。研究组治愈率为66.67%,显著高于对照组的42.86%（P<0.05）。研究组患者术后6个月肛门失禁Wexner 评分均显著低于对照组（P<0.05）,研究组患者住院时间、创面愈合时间均短于对照组（P<0.05）。两组术后并发症发生率、6个月内复发率比较无统计学差异（P>0.05）。结论：经直肠腔内三维超声诊断能够准确诊断肛瘘内口、瘘管走行,有利于提升复杂性肛瘘总体治疗效果,保护肛门功能。     

Run-Off Computed Tomography Angiography (CTA) for Discriminating the Underlying Causes of Intermittent Claudication

AimTo evaluate run-off computed tomography angiography (CTA) of abdominal aorta and lower extremities for detecting musculoskeletal pathologies and clinically relevant extravascular incidental findings in patients with intermittent claudication (IC) and suspected peripheral arterial disease (PAD). Does run-off CTA allow image-based therapeutic decision making by discriminating the causes of intermittent claudication in patients with suspected peripheral arterial disease PAD?ResultsWhile focused on vascular imaging, CTA image quality was sufficient for evaluation of the MSK system in all cases. The underlying cause of IC was diagnosed in run-off CTA as vascular, MSK and a combination in n = 138 (65%), n = 10 (4%), and n = 66 (31%) cases, respectively. Specific vascular or MSK therapy was recorded in n = 123 and n = 9 cases. In n = 82, no follow-up was possible. Clinically relevant extravascular incidental findings were detected in n = 65 patients (30%) with neoplasia, ascites and pleural effusion being the most common findings.DiscussionRun-off CTA allows identification of vascular, MSK, and combined causes of IC in patients with suspected PAD and can guide specific therapy. CTA also allowed confident detection of crEVIF although detection did not necessarily trigger workup or treatment.     

Intestinal Fatty Acid-Binding Protein as a Diagnostic Marker for Complicated and Uncomplicated Necrotizing Enterocolitis: A Prospective Cohort Study

Background

Early NEC symptoms are non-specific and diagnostic tests lack discriminative power. Intestinal fatty acid-binding protein (I-FABP), mainly located in small bowel enterocytes, is released into the blood following NEC-associated enterocyte disruption. Aim of this prospective cohort trial was to determine the diagnostic value of I-FABP measured in plasma (I-FABPp) and urine (I-FABPu) for the presence of NEC, to evaluate I-FABP levels during NEC development, and to assess its prognostic value for the progression from suspected to complicated disease.

Methods

Between 2010 and 2012 we prospectively enrolled neonates with suspected NEC. We measured I-FABP levels eight-hourly from onset of suspected NEC for at least 48 hours, or until surgery. NEC diagnosis was confirmed radiologically or during operation. We defined NEC as complicated if it resulted in surgery and/or death. We determined disease course and diagnostic I-FABP cut-off points.

Results

The study comprised 37 neonates (24M, 13F), gestational age 28 (24–36) weeks, birth weight 1190 (570–2,400) grams. We found significantly higher I-FABPp and I-FABPu levels in NEC patients (n = 22) than in patients with other diagnoses (n = 15). Cut-off values for diagnosing NEC were 9 ng/mL I-FABPp and 218 ng/mL I-FABPu, with corresponding likelihood ratios (LRs) of 5.6 (95% CI 0.89–35) and 5.1 (95% CI 0.73–36), respectively. I-FABP levels were highest in the first eight hours after symptom onset and gradually decreased over time. Cut-off values for complicated disease were 19 ng/mL I-FABPp and 232 ng/mL I-FABPu, with LRs of 10 (95% CI 1.6–70) and 11 (95% CI 1.6–81), respectively.

Conclusions

Both plasma and urinary I-FABP levels specifically identify NEC in preterm infants prior to appearance of diagnostic radiological signs suggestive for NEC. Moreover, serial I-FABP measurements accurately predict development of complicated disease.     

钼靶X射线与彩色多普勒超声对乳腺癌的影像学特征及诊断价值比较分析

摘要 目的：探讨乳腺癌患者钼靶X射线与彩色多普勒超声（CDUs）的影像学特征及联合应用的诊断价值。方法：前瞻性选取 2018年1月至2021年6月收入安徽医科大学附属巢湖医院且疑似为乳腺癌患者120例,所有患者均接受钼靶X射线与CDUs技术检查,以手术病理为金标准,分别观察钼靶X射线与CDUs对不同大小乳腺癌的诊断价值、比较乳腺癌钼靶X射线与CDUs的影像特征,探讨钼靶X射线及CDUs单独应用及联合应用的诊断效能。结果：120例患者确诊乳腺癌者106例,证实为良性病变者14例。对于不同直径的乳腺癌诊断比较中,CDUs检查直径<1 cm病灶31个（29.25%）,钼靶X射线检查直径<1 cm病灶23个（21.70%）,组间比较具有统计学差异（P<0.05）;对于直径>3 cm病灶,钼靶X射线检查22个（20.75%）,CDUs检查为14个（13.21%）,组间比较具有统计学差异（P<0.05）。乳腺癌钼靶X射线与CDUs的影像特征比较显示,钼靶X射线对于点状微小钙化检查72个（67.92%）、边缘模糊伴毛刺病灶检查84个（79.25%）,二者征象检出率明显高于CDUs检查40个（37.36%）、47个（44.34%）,组间比较具有统计学差异（P<0.05）;CDUs对于肿块影检查个（76.42%）、增粗血管影或血流信号异常病灶检查79个（74.53%）,二者征象检出率明显高于钼靶X射线检查54（50.94%）个、57（53.77%）个,组间比较具有统计学差异（P<0.05）。钼靶X射线及CDUs诊断效能研究显示钼靶X射线联合CDUs技术检查的敏感度、特异度、准确度、阴性预测值（NPV）以及阳性预测值（PPV）分别为93.40%、93.41%、95.83%、64.29%及76.98%,均高于钼靶X射线的83.02%、88.89%、80.19%、15.81%及51.88%,亦高于CDUs技术的78.30%、75.47%、85.83%、28.57%及30.98%,多组数据单因素方差分析具有统计学差异（P<0.05）。结论：钼靶X射线与CDUs技术在诊断乳腺癌方面各有优缺点,二者联合检查利于提升对乳腺癌的诊断准确性,减少误诊漏诊的情况发生。     

Diagnostic performance of mycologic and serologic methods in a cohort of patients with suspected sporotrichosis

BackgroundThe gold standard for the sporotrichosis diagnosis is culture; however, serologic approaches have been recently implemented to aid in the sporotrichosis diagnosis. Nevertheless, the clinical consequences of the introduction of serologic tests are poorly addressed.AimsTo correlate the results of culture and serology of patients with suspected sporotrichosis.MethodsA retrospective study of 198 patients with suspected sporotrichosis was conducted. Information about culture isolation of Sporothrix from clinical samples and antibody detection by an enzyme-linked immunosorbent assay (ELISA) were obtained from the medical records of the patients.ResultsPositive culture and antibody detection was observed in the samples of 84 patients (42.4%). Forty-one samples (20.7%) showed negative results with both techniques and divergent results were obtained in the samples of 73 patients (36.9%). False negative results in the ELISA were observed with 23 patients (31.5%), 78.3% of them with less than 30 days of infection (p = 0.0045). Among the initial false positive ELISA in the sera of 50 patients, four samples in culture yielded the growth of Sporothrix, and 27 improved with itraconazole. At the end of follow-up, a diagnosis of proven or probable sporotrichosis was established in 139 patients, and possible sporotrichosis in 11 patients. The treatment of the patients with probable sporotrichosis with antifungal drugs resulted in clinical cure for these individuals.ConclusionsThese two techniques are complementary in the diagnosis of sporotrichosis, making diagnosis and clinical decision more precise.