BI-RADS 3级对乳腺病灶患者的诊断结果及影响因素分析

目的:回顾性分析超声BI-RADS 3级对乳腺病灶患者的诊断结果及影响因素。方法:选择2014年8月至2017年8月上海交通大学医学院附属第九人民医院和复旦大学附属华山医院北院收治的168例乳腺病灶患者,回顾性分析其影像学资料及病理分析结果。分析BI-RADS 3级对乳腺病灶的阴性诊断率,采用Kim分级对BI-RADS 3级结果进行重新分级,分析影响BI-RADS分级及重新分级的主要因素。结果:168例BI-RADS 3级乳腺病灶中,159例为良性病变,9例为恶性。168例BI-RADS 3级乳腺病灶的阳性预测值为5.4%(9/168),阴性预测值为94.6%(159/168)。病灶数目、年龄、医师年资、病灶大小对BI-RADS 3级良恶性乳腺病灶判断无明显影响,而BI-RADS 3级恶性乳腺病灶较良性病灶更易触诊(P 0.05)。重新分级发现,124例仍为BI-RADS 3级,44例上升至BI-RADS 4级,重新分级恶性病灶的检出率为100%(9/9),假阳性率为20.8%(35/168)。病灶多发、年龄≥40岁更可能评估为BI-RADS 4级(P0.05),医师年资、病灶大小、病灶触及情况对重新分级无明显影响(P0.05)。结论:BI-RADS 3级对乳腺良性病灶有较高的阴性诊断率,重新分级可提高乳腺恶性病灶的检出率,但会造成较高的假阳性率,影响BI-RADS分级的主要因素为病灶可否扪及,影响重新分级的主要因素为患者年龄及乳腺病灶是否多发。     

Contributions of infant word learning to language development

Infants learn the forms of words by listening to the speech they hear. Though little is known about the degree to which these forms are meaningful for young infants, the words still play a role in early language development. Words guide the infant to his or her first syntactic intuitions, aid in the development of the lexicon, and, it is proposed, may help infants learn phonetic categories.     

Lexical–semantic priming effects during infancy

When and how do infants develop a semantic system of words that are related to each other? We investigated word–word associations in early lexical development using an adaptation of the inter-modal preferential looking task where word pairs (as opposed to single target words) were used to direct infants’ attention towards a target picture. Two words (prime and target) were presented in quick succession after which infants were presented with a picture pair (target and distracter). Prime–target word pairs were either semantically and associatively related or unrelated; the targets were either named or unnamed. Experiment 1 demonstrated a lexical–semantic priming effect for 21-month olds but not for 18-month olds: unrelated prime words interfered with linguistic target identification for 21-month olds. Follow-up experiments confirmed the interfering effects of unrelated prime words and identified the existence of repetition priming effects as young as 18 months of age. The results of these experiments indicate that infants have begun to develop semantic–associative links between lexical items as early as 21 months of age.     

Eco-efficiency and Its xsTerminology

Eco-efficiency has been defined as a general goal of creating value while decreasing environmental impact. Leaving out the normative part of this concept, the empirical part refers to a ratio between environmental impact and economic cost or value. Two basic choices must be made in defining practical eco-efficiency: which variable is in the denominator and which is in the numerator; and whether to specify environmental impact or improvement and value created or cost. Distinguishing between two situations, the general one of value creation and the specific one of environmental improvement efforts, and leaving the numerator-denominator choice to the user, as diverging practices have developed, four basic types of ecoefficiency result: environmental intensity and environmental productivity in the realm of value creation; and environmental improvement cost and environmental cost-effectiveness in the realm of environmental improvement measures.     

乳腺影像报告数据系统对乳腺疾病的诊断价值

目的:探讨BI-RADS(breast imaging reporting and data system)乳腺影像报告数据系统对乳腺疾病的诊断价值。方法:采用彩色多普勒超声对75例乳腺占位性病变患者(均为女性)进行双侧乳腺探查,并采用BI-RADS乳腺影像报告数据系统进行评价。选取患者BI-RADS 3类、4类、5类的94枚病灶进行研究,以组织病理学诊断结果为金标准,来探讨其关系。结果:在94个病灶中BI-RADS诊断为3类32枚,病理学结果证明良性30枚(93.75%),恶性2枚(6.25%);BI-RADS诊断为4类的36枚,病理学结果证明良性24枚(66.67%),恶性12枚(33.33%);BI-RADS诊断为5类的26枚,病理学结果证明良性2枚(7.69%),恶性24枚(92.31%)。结论:BI-RADS乳腺影像报告数据系统可用来对各级病灶进行描述、评估,有利于提高乳腺病变影像诊断的特异性,为临床医生提供了明确的病变信息,为其进行下一步治疗措施起着重要的指导价值。     

超声引导下麦默通微创旋切术在乳腺BI-RADS 3级肿块中的应用进展

麦默通微创旋切术(Mammotome)是目前临床上治疗乳腺BI-RADS 3级肿块常用的手术方式,其优势能够有效彻底清除病灶,而且术后创面恢复快、术口小。但微创手术也有出血、切破皮肤、感染以及病灶残留等相应并发症,可通过术中加入止血药物或者改良手术方式来减少并发症的发生几率。而针对麦默通微创旋切术后残留的热点问题,超声引导下残腔注水试验或者微创旋切术附加小切口均可有效降低病灶残留率。     

声触诊组织定量成像联合声诺维超声造影对乳腺BI-RADS 4类结节的鉴别诊断价值

摘要 目的：探讨声触诊组织定量成像（VTIQ）联合声诺维超声造影对乳腺BI-RADS 4类结节的鉴别诊断价值。方法：将我院2018年6月至2019年12月门诊及住院诊治的90例女性乳腺结节患者作为研究对象,利用VTIQ超声弹性成像技术,获取剪切波速度最大值（SWVmax）、剪切波速度最小值（SWVmin）、剪切波速度平均值（SWVmean）,声诺维超声造影评估病灶回声、形态、血管充盈情况。以手术病理或超声引导穿刺活检病理结果作为金标准,分析VTIQ超声弹性成像联合声诺维超声造影对乳腺BI-RADS 4类结节的鉴别诊断价值。结果：90例患者（90个乳腺结节）中,经手术病理检查62例,经超声引导穿刺活检28例,其中良性结节48例,恶性结节42例。乳腺BI-RADS 4类良性及恶性结节的SWVmax、SWVmin及SWVmean比较有统计学差异（P<0.05）;以SWVmax≥3.83 m/s作为截断点,鉴别诊断乳腺BI-RADS 4类良恶性结节的曲线下面积（AUC）、敏感度、特异度分别为0.875、83.33%、91.67%,均高于SWVmin及SWVmean。SWVmax、声诺维超声造影与联合诊断的准确率比较无统计学差异（P>0.05）。SWVmax联合声诺维超声造影检查在鉴别诊断乳腺BI-RADS 4类良恶性结节的AUC、敏感度、特异度分别为0.914、95.24%、87.50%,诊断效能最佳。结论：声诺维超声造影、VTIQ超声弹性成像在乳腺BI-RADS 4类结节鉴别诊断中有一定的价值,VTIQ超声弹性成像的SWVmax参数诊断效能优于SWVmin及SWVmean,VTIQ超声弹性成像联合声诺维超声造影可提升乳腺BI-RADS 4类结节鉴别诊断效能。     

JUZBOX: A web server for extracting biomedical words from the protein sequence

The recognition of gene/protein names in literature is one of the pivotal steps in the processing of biological literatures for information extraction or data mining. We have compiled a lexicon of biomedical words (conserved patterns/ potential motifs) which has the combination of only 20 alphabets of amino acids. The remaining 6 letters of the English alphabets (B, J, O, U, X, Z) are treated as invalid amino acid characters (to our context), We have jumbled the 6 letters for the sake of usage and convenience and termed as ’JUZBOX‘ and these characters were filtered in the biomedical lexicon. Undoubtedly, the generation of biomedical words from protein sequence using JUZBOX have applications specific for functional annotation.

Availability

JUZBOX is available freely at http://www.spices.res.in/juzbox     

Microcalcifications in breast cancer: From pathophysiology to diagnosis and prognosis

The implementation of mammographic screening programmes in many countries has been linked to a marked increase in early detection and improved prognosis for breast cancer patients. Breast tumours can be detected by assessing several features in mammographic images but one of the most common are the presence of small deposits of calcium known as microcalcifications, which in many cases may be the only detectable sign of a breast tumour. In addition to their efficacy in the detection of breast cancer, the presence of microcalcifications within a breast tumour may also convey useful prognostic information. Breast tumours with associated calcifications display an increased rate of HER2 overexpression as well as decreased survival, increased risk of recurrence, high tumour grade and increased likelihood of spread to the lymph nodes. Clearly, the presence of microcalcifications in a tumour is a clinically significant finding, suggesting that a detailed understanding of their formation may improve our knowledge of the early stages of breast tumourigenesis, yet there are no reports which attempt to bring together recent basic science research findings and current knowledge of the clinical significance of microcalcifications. This review will summarise the most current understanding of the formation of calcifications within breast tissue and explore their associated clinical features and prognostic value.     

Risk stratification of women with false-positive test results in mammography screening based on mammographic morphology and density: A case control study

BackgroundThe long-term risk of breast cancer is increased in women with false-positive (FP) mammography screening results. We investigated whether mammographic morphology and/or density can be used to stratify these women according to their risk of future breast cancerMethodsWe undertook a case-control study nested in the population-based screening programme in Copenhagen, Denmark. We included 288 cases and 288 controls based on a cohort of 4743 women with at least one FP-test result in 1991–2005 who were followed up until 17 April 2008. Film-based mammograms were assessed using the Breast Imaging-Reporting and Data System (BI-RADS) density classification, the Tabár classification, and two automated techniques quantifying percentage mammographic density (PMD) and mammographic texture (MTR), respectively. The association with breast cancer was estimated using binary logistic regression calculating Odds Ratios (ORs) and the area under the receiver operating characteristic (ROC) curves (AUCs) adjusted for birth year and age and invitation round at the FP-screenResultsSignificantly increased ORs were seen for BI-RADS D(density)2-D4 (OR 1.94; 1.30-2.91, 2.36; 1.51-3.70 and 4.01; 1.67-9.62, respectively), Tabár’s P(pattern)IV (OR 1.83; 1.16-2.89), PMD Q(quartile)2-Q4 (OR 1.71; 1.02-2.88, 1.97; 1.16-3.35 and 2.43; 1.41-4.19, respectively) and MTR Q4 (1.97; 1.12-3.46) using the lowest/fattiest category as referenceConclusionAll four methods, capturing either mammographic morphology or density, could segregate women with FP-screening results according to their risk of future breast cancer − using already available screening mammograms. Our findings need validation on digital mammograms, but may inform potential future risk stratification and tailored screening strategies