Malignant Lesions Research Articles

Label-Free Monitoring of Endometrial Cancer Progression Using Multiphoton Microscopy.

Endometrial cancer is the most common gynecological cancer in the developed world. However, the accuracy of current diagnostic methods is still unsatisfactory and time-consuming. Here, we presented an alternate approach to monitoring the progression of endometrial cancer via multiphoton microscopy imaging and analysis of collagen, which is often overlooked in current endometrial cancer diagnosis protocols but can offer a crucial signature in cancer biology. Multiphoton microscopy (MPM) based on the second-harmonic generation and two-photon excited fluorescence was introduced to visualize the microenvironment of endometrium in normal, hyperplasia without atypia, atypical hyperplasia, and endometrial cancer specimens. Furthermore, automatic image analysis based on the MPM image processing algorithm was used to quantify the differences in the collagen morphological features among them. MPM enables the visualization of the morphological details and alterations of the glands in the development process of endometrial cancer, including irregular changes in the structure of the gland, increased ratio of the gland to the interstitium, and atypical changes in the glandular epithelial cells. Moreover, the destructed basement membrane caused by gland proliferation and fusion is clearly shown in SHG images, which is a key feature for identifying endometrial cancer progression. Quantitative analysis reveals that the formation of endometrial cancer is accompanied by an increase in collagen fiber length and width, a progressive linearization and loosening of interstitial collagen, and a more random arrangement of interstitial collagen. Observation and quantitative analysis of interstitial collagen provide invaluable information in monitoring the progression of endometrial cancer. Label-free multiphoton imaging reported here has the potential to become an in situ histological tool for effective and accurate early diagnosis and detection of malignant lesions in endometrial cancer.

O-309 Safety and fertility potential of residual ovarian cortex surrounding borderline tumors in women of reproductive age

Abstract Study question How do borderline ovarian tumors (BOTs) at different oncological stages affect safety (presence of occult lesions) and quality of the ovarian reserve? Summary answer The ovarian follicle pool is decreased in women with BOTS, especially at younger age, and oncological safety is compromised in more advanced oncological stages. What is known already The clinical decision-making balancing the type of surgical treatment (radical or fertility-sparing) with the the risk of recurrence is still controversial for women diagnosed with BOTs at different oncological stages. The same is for the use of adjuvant techniques like oocyte or ovarian tissue cryopreservation to optimize the likelihood of fertility recovery. The prevalence of occult lesions in healthy-looking ovarian cortex, which may be managed by surgery or cryopreservation, has not been analyzed in all tumor types. Moreover, the status of the ovarian follicle pool may be affected by tumoral masses, making fertility preservation even more challenging in these patients. Study design, size, duration Multicentric retrospective study involving Cliniques Universitaires Saint Luc in Brussels (Belgium) and Macedonio Melloni hospital in Milan (Italy). Forty-two women at reproductive age (15-45 years) diagnosed with borderline ovarian tumors (BOTs), including 24 serous, 14 mucinous and 4 endometrioid BOTs were included. Participants/materials, setting, methods Histological samples of ovarian cortex surrounding tumors were analyzed to characterize the follicle pool (follicle density, classification and atresia rates) and results were compared with an aged-matched population of 45 subjects with non-ovarian pathologies. Any occult malignant lesions in healthy-looking cortex were investigated using tumor-specific markers (cytokeratin 7 and mucin 1), while immune system infiltration was quantified by CD3 for tumor-infiltrating lymphocytes (TILs) and CD68 for tumor associated macrophages (TAMs). Main results and the role of chance Occult ovarian lesions were observed in 5 out of 39 cases (12.8%). These included one mucinous stage-I BOT (1/13), one serous stage-I BOT (1/13), and 3 advanced-stage serous BOTs (3/11). Three 3 cases were excluded from the analysis because no cortex was available. Notably, follicle density was significantly lower in subjects diagnosed with ovarian tumors than in controls (p < 0.001) at a younger age, while no difference was detected in older patients. Significantly greater follicle atresia was encountered in the ovarian tumor group than in controls (20.1 ± 8.8% vs 9.2 ± 9.4%, p < 0.001) at all ages, but no difference was detected in follicle classification parameters (primordial and growing follicle rates). Mucinous BOTs exhibited lower follicle density than serous BOTs (98.8 ± 152.8 vs 225.8 ± 220.7, p < 0.01), although no age difference was evidenced. Although mucinous BOTS had also significantly bigger volume than serous BOTs, no significant correlation between follicle density and tumoral volume was found. Other factors like tumor microenvironment may play a role in ovarian follicle pool damage. Both TILs and TAMs were found in ovarian tumors irrespective of histotype, but no link was established with the status of the ovarian reserve. Limitations, reasons for caution Although this study helped to elucidate the risk profile of different types of epithelial ovarian tumors, observing that late-stage BOTs ran a 27% (3/11) risk of occult ovarian lesions, further research is needed to identify predictive markers. Wider implications of the findings Personalized counseling for fertility preservation is required in case of BOTs. Fertility-sparing surgery and adjuvant gamete preservation should be considered, balancing any oncological risks against tumor stage and histotype and fertility potential, especially at a younger age. Trial registration number NA

Classification of the presence of malignant lesions on mammogram using deep learning

Classification of the presence of malignant lesions on mammogram using deep learning

The Role of CT in Differentiating the Non Pediatric Renal and Adrenal Region Fatty Masses

Abstract Background CT is indicated in many abdominal conditions because of its excellent morphological resolution and its ability to image many different structures, such as abdominal viscera, pelvic organs, lungs and bones, with a single examination. Aim of the Work The aim of this study is to highlight the accuracy of multi-detector computed tomography scan in diagnosing the different fatty lesions of the renal and adrenal regions by comparing the CT study of the benign lesions with their follow up CT scan and comparing the CT study of the malignant cases with their histo-pathological results. Patients and Methods The study was conducted on 34 patients most of them had unrelated complaints(incidental findings) and were referred to Radiology department, Theodor Bilharz Research Institute. Their age ranged from 20 years to 81 years old (mean age 56.35 years±13.61). Most of the patients were males 21cases while female were 13 cases. The patients were referred from oncology, general surgery, and urology departments of Theodor Bilharz Research Institute hospital as well as the outpatient clinics to perform MDCT in the period from September 2021 to June 2022. Results MDCT examinations were done for 34 patients and concluded that MDCT should be used in the first place in the course of diagnostic procedures of patients with renal and adrenal region fatty lesions and this was justified by an overall diagnostic accuracy of 100% for benign lesions and 82% for malignant lesions, where MDCT could correctly diagnose (33/34) cases and only 1 case was misdiagnosed, confirming the ability of MDCT to show up the accurate diagnosis, the exact location, extent of tumor, along with involvement of adjacent organs and vessels. Conclusion It also has a high accuracy in differentiation of malignant from benign lesions and detection of lymph node involvement & metastasis. There by improving the prognosis.

The value of 68Ga-PSMA PET/CT in the diagnosis of intracapsular prostate cancer with a poor prognosis

ObjectiveTo evaluate the diagnostic value of 68Ga-prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT) for intracapsular prostate cancer with a poor prognosis (PPC) and no extracapsular invasion or distant metastasis.MethodsThe PET/CT images and clinical data of 221 patients were retrospectively analyzed. These patients all had clear pathological results. The maximum standard uptake value (SUVmax) of the main lesions was measured at the postprocessing workstation and was tested for correlation with the pathological score. The diagnostic accuracy was calculated using the receiver operating characteristic (ROC) curve, and the best diagnostic threshold was calculated. The correlation between SUVmax and the International Society of Urological Pathology Grade Group (GG) was also analyzed.ResultsThe pathological results of the 221 patients were 48 benign lesions and 173 malignant lesions, including 81 PPC. Low-, intermediate-, and high-risk prostate cancers made up 21.97% (38/173), 54.33% (94/173), and 23.70% (41/173) of the malignant lesions, respectively. SUVmax and GG were positively correlated (r = 0.54, P < 0.01). The best SUVmax thresholds for 68Ga-PSMA PET/CT for the diagnosis of intracapsular PC and PPC were 7.95 and 13.94, respectively; the specificities were 0.83 and 0.85, the negative predictive values were 0.55 and 0.87, and the areas under the ROC curves were 0.88 and 0.88, respectively.Conclusion68Ga-PSMA PET/CT has high specificity and NPV in the diagnosis of intracapsular PPC, but the sensitivity for the diagnosis of intracapsular low-risk PC is low, which may cause some cases to be undetected.

Gastric-type glandular lesions of the female genital tract excluding the cervix: emerging pathological entities.

In the last two decades or so, a spectrum of benign, premalignant and malignant cervical glandular lesions exhibiting gastric differentiation has been described, with gastric-type adenocarcinoma representing the most common human papillomavirus (HPV)-independent cervical adenocarcinoma. More recently, limited literature has reported a variety of gastric-type glandular lesions at other sites within the female genital tract and, as in the cervix (the most common site for these lesions), a spectrum of benign, premalignant and malignant lesions has been proposed. We provide an update and review of the emerging spectrum of gastric-type glandular lesions at female genital tract sites other than the cervix. In the endometrium, putative gastric-type glandular lesions include mucinous metaplasia of gastric-type, atypical mucinous proliferation of gastric-type and gastric-type adenocarcinoma. Similarly in the vagina, gastric-type adenosis, atypical adenosis and adenocarcinoma have been described. There have also been occasional reports of gastric-type lesions involving the ovary and fallopian tube. We provide guidance on how to recognise gastric-type lesions morphologically and immunophenotypically and stress that sometimes these lesions occur at more than one site within the female genital tract (synchronous/multifocal gastric-type lesions of the female genital tract), sometimes in association with Peutz-Jeghers syndrome.

Differentiation of benign and malignant lesions in Bethesda III and IV thyroid nodules via dual-energy computed tomography quantitative parameters and morphologic features.

Thyroid nodules (TNs) cytologically defined as category Bethesda III and IV pose a major diagnostic challenge before surgery, demanding new methods to reduce unnecessary diagnostic thyroid lobectomies for patients with benign TNs. This study aimed to assess whether a model combining dual-energy computed tomography (DECT) quantitative parameters with morphologic features could reliably differentiate between benign and malignant lesions in Bethesda III and IV TNs. Data from 77 patients scheduled for thyroid surgery for Bethesda III and IV TNs (malignant =48; benign =29) who underwent DECT scans were reviewed. DECT quantitative parameters including normalized iodine concentration (NIC), attenuation on the slope of spectral Hounsfield unit (HU) curve, and normalized effective atomic number (Zeff) were measured in the arterial phase (AP) and venous phase (VP). DECT quantitative parameters and morphologic features were compared between the malignant and benign cohorts. The receiver operating characteristic curve was performed to compare the performances of significant DECT quantitative parameters, morphologic features, or the models combining the DECT parameters, respectively, with morphologic features. A nomogram was constructed from the optimal performance model, and the performance was evaluated via the calibration curve and decision curve analysis. The areas under the receiver operating characteristic curve with 95% confidence interval (CI) of the NIC in the AP (AP-NIC), slope of spectral HU curve in the AP, and NZeff in the AP were 0.749 (95% CI: 0.641-0.857), 0.654 (95% CI: 0.530-0.778), and 0.722 (95% CI: 0.602-0.842), respectively. The model combining AP-NIC with enhanced blurring showed the highest diagnostic performance, with an area under the receiver operating characteristic curve (AUC), sensitivity, and specificity of 0.808, 0.854, and 0.655, respectively; it was then used to construct a nomogram. The calibration curve showed that the discrepancy between the prediction of the nomogram and actual observations was less than 5%. The decision curve analysis indicated the nomogram had a positive net benefit in threshold risk ranges of 14% to 58% or 60% to 91% for malignant Bethesda III and IV TNs. The model combining AP-NIC with enhanced blurring could reliably differentiate between benign and malignant lesions in Bethesda III and IV TNs.

Combination of IVIM with DCE-MRI for diagnostic and prognostic evaluation of breast cancer

PurposeTo identify the most effective combination of DCE-MRI (Ktrans,Kep) and IVIM (D,f) and analyze the correlations of these parameters with prognostic indicators (ER, PR, and HER2, Ki-67 index, axillary lymph node (ALN) and tumor size) to improve the diagnostic and prognostic efficiency in breast cancer. MethodsThis is a prospective study. We performed T1WI, T2WI, IVIM, DCE-MRI at 3 T MRI examinations on benign and malignant breast lesions that met the inclusion criteria. We also collected pathological results of corresponding lesions, including ER, PR, and HER2, Ki-67 index, axillary lymph node (ALN) and tumor size. The diagnostic efficacy of DCE-MRI, IVIM imaging, and their combination for benign and malignant breast lesions was assessed. Correlations between the DCE-MRI and IVIM parameters and prognostic indicators were assessed. ResultsOverall,59 female patients with 62 lesions (22 benign lesions and 40 malignant lesions) were included in this study. The malignant group showed significantly lower D values (p < 0.05) and significantly higher Ktrans, Kep, and f values (p < 0.05). The AUC values of DCE, IVIM, DCE + IVIM were 0.828, 0.882, 0.901. Ktrans, Kep, D and f values were correlated with the pathological grade (p < 0.05); Ktrans was negatively correlated with ER expression (r = −0.519, p < 0.05); Kep was correlated with PR expression and the Ki-67 index (r = −0.489, 0.330, p < 0.05); the DCE and IVIM parameters showed no significant correlations with the HER2 and ALN (p > 0.05). Tumor diameter was correlated with the Kep, D and f values (r = 0.246, −0.278, 0.293; p < 0.05). ConclusionIVIM and DCE-MRI allowed differential diagnosis of benign and malignant breast lesions, and their combination showed significantly better diagnostic efficiency. DCE- and IVIM-derived parameters showed correlations with some prognostic factors for breast cancer.

Why do a lung biopsy for benign lesions?

Transthoracic needle biopsy of lung lesions is a well-established procedure for the diagnosis of lung lesions. The literature focuses on the diagnosis of malignant lesions with an often reported accuracy rate of more than 90%. Experience showed that biopsy can identify sometimes incidentally, also benign lesions. There are many reasons why a biopsy is performed for a "benign lesion." First of all, it may be an unexpected diagnosis, as some benign pathologies may have misleading presentations, that are very similar to lung cancer, otherwise the reason is only to make a diagnosis of exclusion, which leads to the benign pathology already being considered in the differential diagnosis. This study was designed as a retrospective single-center study. We selected from our database all the lung biopsies performed under CT guidance, from 2015 to 2019 and retrospectively analysed the histological data. We selected only benign lesions describing the imaging feature and differential diagnosis with lung malignancy. In our patient population, among the 969 of them that underwent biopsy, we identified 93 benign lesions (10%). Hamartomas, granulomas, slow-resolving pneumonia and cryptogenic organizing pneumonia are the pathologies that most frequently can misinterpratedas lung cancer. In this brief report we want to show the percentage and type of benign lesions that are found in our lung trans-thoracic biopsy population. Among these, we identified the three most frequent benign lesions that most frequently enter the differential diagnosis with lung malignant lesions describing the classic and atypical imaging findings.

Identifying regulatory elements and their RNA-binding proteins in the 3' untranslated regions of papillomavirus late mRNAs.

Human papillomaviruses (HPVs) infect cutaneous and mucosal epithelia to cause benign (warts) and malignant lesions (e.g. cervical cancer). Bovine papillomaviruses (BPVs) infect fibroblasts to cause fibropapillomas but can also infect cutaneous epithelial cells. For HPV-1, -16, -31 and BPV-1, cis-acting RNA elements in the late 3' untranslated region (3'UTR) control expression of virus proteins by binding host cell proteins. The present study compared the effects on gene expression of the cis-acting elements of seven PV late 3'UTRs (HPV-6b, -11, -16, -31 and BPV-1, -3 and -4) representing a range of different genera and species and pathological properties. pSV-beta-galactosidase reporter plasmids containing the late 3'UTRs from seven PVs were transiently transfected into cervical adenocarcinoma HeLa cells, and reporter gene expression quantified by reverse transcription-quantitative PCR and a beta-galactosidase assay. All elements inhibited gene expression in keratinocytes. Cancer-related types HPV-16 and -31, had the greatest inhibitory activity whereas the lowest inhibition was found in the non-cancer related types, BPV-3 and HPV-11. Using RBPmap version 1.1, bioinformatics predictions of factors binding the elements identified proteins which function mainly in mRNA splicing. Markedly, in terms of protein binding motifs, BPV late 3'UTR elements were similar to those of HPV-1a but not to other HPVs. Using HPV-1a as a model and siRNA depletion, the bioinformatics predictions were tested and it was found that PABPC4 was responsible for some of the 3'UTR repressive activity. The data revealed candidate proteins that could control PV late gene expression.

The Role of CT Perfusion in Differentiating Benign Versus Malignant Focal Pulmonary Lesions

The Role of CT Perfusion in Differentiating Benign Versus Malignant Focal Pulmonary Lesions

Eccrine hidrocystomas: A distinct clinicopathologic entity and a potential mimicker of malignancy—A case series with a review of the literature

Abstract Purpose: Eccrine hidrocystomas are a rare, benign cystic lesion of the skin primarily found in the head and neck region, with a predilection for the periorbital area in adult females. These cysts typically present as small, tense, thin-walled structures ranging from 1 to 6 mm in size, occurring either as solitary entities or in multiples. Despite their benign nature, eccrine hidrocystomas pose diagnostic challenges due to their resemblance to malignant lesions both clinically and in imaging studies. This study aims to explore the varied clinical presentations of eccrine hidrocystoma and discuss the complexities associated with its diagnosis. Materials and Methods: Five cases were included in the study along with a comprehensive review of the existing literature. We emphasize the importance of accurate and early diagnosis for appropriate management. The clinical manifestations of eccrine hidrocystoma often overlap with features suggestive of malignancy, underscoring the necessity for meticulous histopathological examination to definitively differentiate between these entities. This differentiation is crucial as it impacts treatment decisions and patient outcomes. Conclusion: In conclusion, our study underscores the diagnostic dilemmas posed by eccrine hidrocystoma, highlights its potential mimicry of malignancy, and emphasizes the significance of histopathological evaluation in achieving accurate diagnosis and guiding management strategies.

A contrast-enhanced computed tomography-based radiomics nomogram for preoperative differentiation between benign and malignant cystic renal lesions.

There is lack of discrimination as to traditional imaging diagnostic methods of cystic renal lesions (CRLs). This study aimed to evaluate the value of machine learning models based on clinical data and contrast-enhanced computed tomography (CECT) radiomics features in the differential diagnosis of benign and malignant CRL. There were 192 patients with CRL (Bosniak class ≥ II) enrolled through histopathological examination, including 144 benign cystic renal lesions (BCRLs) and 48 malignant cystic renal lesions (MCRLs). Radiomics features were extracted from CECT images taken during the medullary phase. Using the light gradient boosting machine (LightGBM) algorithm, the clinical, radiomics and combined models were constructed. A comprehensive nomogram was developed by integrating the radiomics score (Rad-score) with independent clinical factors. Receiver operating characteristic (ROC) curves were plotted. The corresponding area under the curve (AUC) value was worked out to quantify the discrimination performance of the three models in training and validation cohorts. Calibration curves were worked out to assess the accuracy of the probability values predicted by the models. Decision curve analysis (DCA) was worked out to assess the performance of models at different thresholds. Maximum diameter and Bosniak class were independent risk factors of patients with MCRL in the clinical model. Twenty-one radiomics features were extracted to work out a Rad-score. The performance of the clinical model in the training cohort was AUC =0.948, 95% confidence interval (CI): 0.917-0.980, and the performance in the validation cohort was AUC =0.936, 95% CI: 0.859-1.000 (P<0.05). The performance of the radiomics model in the training cohort was AUC =0.990, 95% CI: 0.979-1.000, and the performance in the validation cohort was AUC =0.959, 95% CI: 0.903-1.000 (P<0.05). Compared with the above models, the combined radiomics nomogram had an AUC of 0.989 (95% CI: 0.977-1.000) in the training cohort and an AUC of 0.962 (95% CI: 0.905-1.000) in the validation cohort (P<0.05), showing the best diagnostic efficacy. The radiomics nomogram integrating clinical independent risk factors and radiomics signature improved the diagnostic accuracy in differentiating between BCRL and MCRL, which can provide a reference for clinical decision-making and help clinicians develop individualized treatment strategies for patients.

A contrast-enhanced computed tomography-based radiomics nomogram for preoperative differentiation between benign and malignant cystic renal lesions.

There is lack of discrimination as to traditional imaging diagnostic methods of cystic renal lesions (CRLs). This study aimed to evaluate the value of machine learning models based on clinical data and contrast-enhanced computed tomography (CECT) radiomics features in the differential diagnosis of benign and malignant CRL. There were 192 patients with CRL (Bosniak class ≥ II) enrolled through histopathological examination, including 144 benign cystic renal lesions (BCRLs) and 48 malignant cystic renal lesions (MCRLs). Radiomics features were extracted from CECT images taken during the medullary phase. Using the light gradient boosting machine (LightGBM) algorithm, the clinical, radiomics and combined models were constructed. A comprehensive nomogram was developed by integrating the radiomics score (Rad-score) with independent clinical factors. Receiver operating characteristic (ROC) curves were plotted. The corresponding area under the curve (AUC) value was worked out to quantify the discrimination performance of the three models in training and validation cohorts. Calibration curves were worked out to assess the accuracy of the probability values predicted by the models. Decision curve analysis (DCA) was worked out to assess the performance of models at different thresholds. Maximum diameter and Bosniak class were independent risk factors of patients with MCRL in the clinical model. Twenty-one radiomics features were extracted to work out a Rad-score. The performance of the clinical model in the training cohort was AUC =0.948, 95% confidence interval (CI): 0.917-0.980, and the performance in the validation cohort was AUC =0.936, 95% CI: 0.859-1.000 (P<0.05). The performance of the radiomics model in the training cohort was AUC =0.990, 95% CI: 0.979-1.000, and the performance in the validation cohort was AUC =0.959, 95% CI: 0.903-1.000 (P<0.05). Compared with the above models, the combined radiomics nomogram had an AUC of 0.989 (95% CI: 0.977-1.000) in the training cohort and an AUC of 0.962 (95% CI: 0.905-1.000) in the validation cohort (P<0.05), showing the best diagnostic efficacy. The radiomics nomogram integrating clinical independent risk factors and radiomics signature improved the diagnostic accuracy in differentiating between BCRL and MCRL, which can provide a reference for clinical decision-making and help clinicians develop individualized treatment strategies for patients.

The diagnostic accuracy of conventional breast ultrasound in Diagnosing Malignant Breast Lesions Taking Histopathology as Gold Standard

The diagnostic accuracy of conventional breast ultrasound in Diagnosing Malignant Breast Lesions Taking Histopathology as Gold Standard

Regrese lichen planus: a case report

Lichen planus is a chronic inflammatory autoimmune disease. The incidence of the disease is higher than other dermatoses. Clinically, it may present in different forms, the most common being the reticular form. Lichen planus may be precancerous and may develop into a malignant lesion. Although topical corticosteroids are the first choice for treatment, many different topical or systemic agents can be used. The aim of this case report is to discuss the clinical features of lichen planus.

Diagnostic value of ultrasound-guided fine-needle aspiration cytology in the pathological natures of thyroid nodules: A retrospective study.

Thyroid nodules, a clinical disease with high incidence, include benign and malignant types. This study aims to evaluate the diagnostic value of ultrasound-guided fine-needle aspiration cytology (US-FNAC) in determining the pathological nature of thyroid nodules and to conduct an in-depth analysis of its diagnostic efficacy across nodules of varying sizes. This retrospective study identified 116 patients undergoing thyroidectomy in Zibo Central hospital from January 2022 to March 2023, with 98 meeting the study's inclusion criteria. All patients received ultrasound and US-FNAC examinations before surgery to analyze the ultrasonic features of thyroid nodules. The diagnosis results of pathological natures obtained by US-FNAC were analyzed with the result of post-operative pathological examination as the gold standard. The patients were divided into four groups according to the median and quartile of nodular diameters to explore the diagnostic efficacy of US-FNAC for the pathological natures of thyroid nodules with various diameters and comprehensively evaluate its application value. The evaluation tool of diagnostic efficacy was the receiver operator characteristic (ROC) curve. A total of 98 puncture nodules were evaluated, with a diameter of 0.8-5.2 cm. Post-operative pathological examination showed 10 (10.20%) benign and 88 (89.80%) malignant lesions. The ultrasound examination showed 14 (14.29%) benign and 84 (85.71%) suspected malignant lesions. The US-FNAC results showed 2 cases (2.04%) of type I, 9 cases (9.18%) of type II, 3 cases (3.06%) of type III, 29 cases (29.59%) of type IV, 39 cases (39.80%) of type V, and 16 cases (16.33%) of type VI, including 9 (9.18%) benign and 84 (85.72%) malignant lesions and 5 (5.10%) uncertain pathological natures. According to the median and quartile of nodular diameters, specifically, 1.90 (1.60, 2.30) cm, 93 nodules with decided pathological natures were divided into groups Q1 (n = 24, ≤1.6 cm), Q2 (n = 26, 1.7-1.9 cm), Q3 (n = 24, 2.0-2.3 cm), and Q4 (n = 19, >2.3 cm). The results of ROC analysis showed that the area under the curve (AUC), sensitivity, and specificity of US-FNAC diagnosis were 0.894, 98.80%, and 80.00%, respectively. The AUCs of US-FNAC in groups Q1, Q2, Q3, and Q4 were 0.978, 1.000, 0.977, and 0.971. The AUCs of Q1 group, Q2 group, Q3 group and Q4 group were all > 0.9, and US-FNAC had high diagnostic efficiency for the pathological properties of thyroid nodules with different diameters. US-FNAC has a high diagnostic efficiency for the pathological properties of thyroid nodules. Whether the nodule diameter has an effect on the accuracy of this method requires more clinical evidence.

Comparative Assessment of miR-185-5p and miR-191-5p Expression: From Normal Endometrium to High-Grade Endometrial Cancer.

Endometrial cancer (EC) is a significant cause of cancer-related deaths in women. MicroRNAs (miRs) play a role in cancer development, acting as oncogenes or tumor suppressors. This study evaluated the diagnostic potential of hsa-miR-185-5p and hsa-miR-191-5p in EC and their correlation with clinical and histopathological features. A cross-sectional study analyzed formalin-fixed, paraffin-embedded tissue samples from 59 patients: 18 with EC, 21 with endometrial hyperplasia (EH), 17 with normal endometrium (NE), and 3 with endometrial polyps (EPs). Quantitative reverse transcription-polymerase chain reaction and TaqMan probes were used for miR expression analysis. The Shapiro-Wilk test was used to analyze the normal distribution of the data. Subsequently, parametric or non-parametric tests were used to evaluate the associations between the expression levels of each miR and clinical parameters. Both miRs were underexpressed in some precursor and malignant lesions compared to certain NE subtypes and benign lesions. Specifically, hsa-miR-185-5p showed underexpression in grade 3 EC compared to some NE and EH subtypes (FC: -57.9 to -8.5, p < 0.05), and hsa-miR-191-5p was underexpressed in EH and EC compared to secretory endometrium and EPs (FC: -4.2 to -32.8, p < 0.05). SETD1B, TJP1, and MSI1 were common predicted target genes. In conclusion, hsa-miR-185-5p and hsa-miR-191-5p are underexpressed in EC tissues, correlating with histopathological grades, highlighting their potential as diagnostic biomarkers and their role as tumor suppressors in EC.

Expression of epithelial growth factor receptor as a protein marker in oral reticular and erosive lichen planus

BackgroundOral lichen planus (OLP) is a chronic inflammatory mucosal disease that is classified as a premalignant condition. Epithelial growth factor receptor (EGFR) is associated with tumorigenesis and tumor progression and is overexpressed in several oral malignant disorders. Despite the association of EGFR overexpression with oral potentially malignant lesions, few studies have analyzed its expression in OLP, showing controversial results. This study aimed to compare the expression of EGFR as a protein marker in Reticular and Erosive OLP.MethodsThis descriptive-analytical cross-sectional was conducted on 15 paraffin blocks of reticular lichen planus lesions, 16 paraffin blocks of erosive OLP lesions, and 8 paraffin blocks of inflammatory fibrous hyperplasia lesions as the control group (39 in total). After immunohistochemical staining for EGFR, samples were simultaneously observed by two maxillofacial pathologist, and the percentage of stained cells, intensity of staining, pattern of staining, and the location of stained cells were obtained.ResultsThe Mann-Whitney-U test showed that there was no significant difference in the mean percentage of stained cells between erosive OLP and reticular OLP (P-value = 0.213) and between reticular OLP and control group (P-value = 0.137), but there was a significant difference between erosive OLP and control group (P-value = 0.035). Fisher’s exact test showed that there was no significant difference between the frequency distribution of staining patterns in three types of lesions (P-value = 0.90). Kruskal-Wallis test showed that there was no significant difference between the intensity of staining in the three groups (P-value = 0.19) and also there was no significant difference between the location of stained cells in different layers of the epithelium in the three groups (P-value = 0.90).ConclusionsThe results of this study showed that in comparison of reticular OLP, erosive OLP, and the control group there was a significant difference just between erosive OLP and control group in the percentage of stained cells.

A case of lung metastasis from gastric cancer presenting as ground-glass opacity dominant nodules

BackgroundMost metastatic lung tumors present as solid nodules on chest computed tomography (CT). In contrast, ground-glass opacity on chest computed tomography usually suggests low-grade malignant lesions such as adenocarcinoma in situ or atypical adenomatous hyperplasia of the lung.Case presentationA 75-year-old woman with a history of gastric cancer surgery approximately 5 years prior was referred to the Department of Thoracic Surgery at our hospital because of two newly appearing pulmonary ground-glass opacity-dominant nodules on chest computed tomography. She had two ground-glass opacities in the right lower lobe, one in the S6 segment was 12 mm and the other in the S10 segment was 8 mm. On chest computed tomography 15 months prior to referral, the lesion in the S6 segment was 8 mm, and the lesion in the S10 segment was 2 mm. She was suspected to have primary lung cancer and underwent wide-wedge resection of the nodule in the S6 segment. In the resected specimen, polygonal tumor cells infiltrated the alveolar septa, with some tumor cells exhibiting signet ring cell morphology. Based on morphological similarities to the tumor cells of previous gastric cancers and the results of immunostaining, the patient was diagnosed with lung metastases of gastric cancer.ConclusionsPulmonary nodules in patients with a history of cancer in other organs, even if ground-glass opacity is predominant, should also be considered for the possibility of metastatic pulmonary tumors if they are growing rapidly.