Xisheng Liu

Tumor-derived extracellular vesicles (TEVs) are promising autologous cancer vaccines due to their intrinsic tumor-associated antigens. However, their trans

Purpose To investigate the utility of combining clinical and contrasted-enhanced tomography (CECT) parameters for the preoperative evaluation of perineural invasion (PNI) in gallbladder carcinoma (GBC). Methods A total of 134 patients with GBC (male/female, 52/82; age, 64.4 ± 9.7 years) were divided into PNI-positive (n = 63) and PNI-negative groups (n = 71). Clinical characteristics (demographic information, liver function indicators and tumor markers) and CECT parameters (tumor type, tumor size, gallbladder stone, invasion of gallbladder neck/cystic duct, clinical T stage and N stage) were collected and compared between two groups. Binary logistic regression analysis, receiver operating characteristic curves analyses and Delong test were used in further statistical analyses in clinical T3-4 stage (cT3-4) GBC patients. Overall survival (OS) rates after surgery were compared between PNI-negative group and PNI-positive group of cT3-4 GBC patients. Results The majority of GBC patients with PNI were classified as cT3-4 (61/63, 96.8%), while only 3.2% (2/63) of PNI-positive cases were identified at cT1-2. Among cT3-4 GBC, OS was significantly lower in the PNI-positive group than the PNI-negative group after surgery (HR,1.661; 95% CI, 1.044–2.643; P = 0.032). Gender and gallbladder neck/cystic duct invasion were independent predictive factors for cT3-4 GBC patients with PNI. A combination of gender and gallbladder neck/cystic duct invasion showed the best diagnostic performance than that of individual parameters (all P < 0.05). Conclusions Preoperative T staging using CECT enables the initial assessment of PNI status in GBC patients. A combination of gender and gallbladder neck/cystic duct invasion may effectively predict PNI in GBC, particularly in cT3-4 GBC.

Objective: To establish a comprehensive model including MRI radiomics and clinicopathological features to predict post-operative disease-free survival (DFS) in early-stage (pre-operative FIGO Stage IB-IIA) cervical cancer. Methods: A total of 183 patients with early-stage cervical cancer admitted to our Jiangsu Province Hospital underwent radical hysterectomy were enrolled in this retrospective study from January 2013 to June 2018 and their clinicopathology and MRI information were collected. They were then divided into training cohort (n = 129) and internal validation cohort (n = 54). The radiomic features were extracted from the pre-operative T1 contrast-enhanced (T1CE) and T 2 weighted image of each patient. Least absolute shrinkage and selection operator regression and multivariate Cox proportional hazard model were used for feature selection, and the rad-score (RS) of each patient were evaluated individually. The clinicopathology model, T1CE_RS model, T1CE + T2_RS model, and clinicopathology combined with T1CE_RS model were established and compared. Patients were divided into high- and low-risk groups according to the optimum cut-off values of four models. Results: T1CE_RS model showed better performance on DFS prediction of early-stage cervical cancer than clinicopathological model (C-index: 0.724 vs 0.659). T1CE+T2_RS model did not improve predictive performance (C-index: 0.671). The combination of T1CE_RS and clinicopathology features showed more accurate predictive ability (C-index=0.773). Conclusion: The combination of T1CE_RS and clinicopathology features showed more accurate predictive performance for DFS of patients with early-stage (pre-operative IB-IIA) cervical cancer which can aid in the design of individualised treatment strategies and regular follow-up. Advances in knowledge: A radiomics signature composed of T1CE radiomic features combined with clinicopathology features allowed differentiating patients at high or low risk of recurrence.

To evaluate the clinical value of plain magnetic resonance (MR) imaging (including magnetic resonance cholangiopancreatography, MRCP) and coronal liver acquisition with volume acceleration (LAVA) technique in the diagnosis and preoperative assessment of malignant low-level biliary obstruction. Forty-one patients with confirmed malignant low-level biliary obstruction were examined by plain MR, MRCP and coronal LAVA techniques. Group 1, plain MR (including MRCP); group 2, coronal LAVA; group 3, plain MR and coronal LAVA. Assessments included positioning, qualitative diagnosis and preoperative evaluation. The results were compared with pathological, endoscopic retrograde cholangiopancreatography or percutaneous transhepatic cholangiography results. There were 14 pancreatic adenocarcinoma, 12 distal common bile duct carcinoma, 10 ampullary carcinoma, and 5 duodenal carcinoma cases. There was no significant difference in accuracy of the three groups’ positioning diagnoses, 87.8, 90.2, and 92.7 %, respectively. The accuracy of the qualitative diagnoses was lower in group 1 at 78.0 %, but not significantly different in groups 2 and 3 at 92.7 and 95.1 %, respectively (P = 0.031, and 0.039, group 1 vs groups 2 and 3, respectively). Thirty-three patients underwent open surgery. There were 19 adjacent organ involvements, 9 vascular involvements, 13 lymph node metastases and 6 liver metastases. 22 patients were verified surgically and histologically for resectable lesions. Plain MR with coronal LAVA imaging showed 85.4 % accuracy, 90.9 % sensitivity, 78.9 % specificity, 83.3 % positive and 88.2 % negative predictive value for resectability. Plain MR and coronal LAVA techniques are potential noninvasive tools for diagnosis and preoperative assessment of malignant low-level biliary obstruction.