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کاربرد نوع شرط:
- جایگاه : پژوهشی
- مجله: Asian Pacific Journal of Cancer Prevention
- نوع مقاله: Journal Article
- کلمات کلیدی: Diagnosis,Computed Tomography,magnetic resonance imaging,Sensitivity,small hepatocellular carcinoma
- چکیده:
- چکیده انگلیسی:
Background: Hepatocellular carcinomas (HCCs) less than 2 cm in diameter generally demonstrate a good outcome after curative therapy. However, the diagnosis of small HCC can be problematic and requires one or more dynamic imaging modalities. This study aimed to compare the sensitivity and agreement between CT and MRI for the diagnosis of small HCCs. Methods: CT and/or MRI scans of HCCs (1-2 cm) diagnosed by histopathology or typical vascular pattern according to the 2005 AASLD criteria were blindly reviewed by an abdominal radiologist. The reports were defined as conclusive/typical when arterial enhancement and washout during the portal/delayed phases were observed and as inconclusive when typical vascular patterns were not observed. The sensitivity and Cohen’s kappa (k) for agreement were calculated. Results: In 27 patients, 27 HCC nodules (1-2 cm) were included. Diagnosis with a single-imaging modality (CT or MRI) was 81 % versus 48 % (p = 0.01). The CT sensitivity was significantly higher than MRI (78 % versus 52 %, p = 0.04). Among 27 nodules that underwent both CT and MRI, a discordance in typical enhancement patterns was found (k = 0.319, p = 0.05). In cases with inconclusive CT results, MRI gave only an additional 3.7 % sensitivity to reach a diagnosis. In contrast, further CT imaging following inconclusive MRI results gave an additional 29.6 % sensitivity.Conclusions: A single typical imaging modality is sufficient to diagnose small HCCs. Compared with MRI, multiphasic CT has a higher sensitivity. The limitations of MRI could be explained by the greater need for patient cooperation and the types of MRI contrast agent.- انتشار مقاله: 15-05-1395
- نویسندگان: Korn Lertpipopmetha,Teeravut Tubtawee,Teerha Piratvisuth,Naichaya Chamroonkul
- مشاهده
- جایگاه : پژوهشی
- مجله: Asian Pacific Journal of Cancer Prevention
- نوع مقاله: Journal Article
- کلمات کلیدی: response,Vitamin D pathway polymorphisms,pegylated-interferon,HBeAg-negative,Hepatitis B virus infection
- چکیده:
- چکیده انگلیسی: Background: Vitamin D deficiency is related to poor clinical outcomes in patients with chronic hepatitis B virus
(HBV) infection. Methods: We aimed to investigate the association between the genetic variants in the vitamin D
metabolic pathway and the response to pegylated interferon (Peg-IFN) therapy in patients with HBeAg-negative
chronic HBV infection. One hundred seven patients treated with Peg-IFN for 48 weeks were selected from 13 specialty
hospitals. Eight genotypes of vitamin D cascade genes, including CYP27B1 (rs10877012), DHCR7 (rs12785878),
CYP2R1 (rs2060793, rs12794714) and GC (rs4588, rs7041, rs222020, rs2282679), were found. Results: Eighty-two
patients (83.7%) were infected with HBV genotype C. Eight patients had compensated liver cirrhosis (8.7%). At 24
weeks after treatment discontinuation, 41 patients (42.3%) achieved sustained treatment response, 53 (55.2%) obtained
HBV DNA<2,000 IU/ml, 6 (5.6%) gained HBsAg seroclearance, 2 (1.9%) had HBsAg seroconversion and 69 (64.5%)
exhibited alanine aminotransferase (ALT) normalization. Multivariate analysis revealed that baseline HBsAg level (OR
=0.06, 95% CI: 0.08-0.49, p=0.008) and the GC rs222020 TT genotype (OR=17.72, 95% CI: 1.07-294.38, p=0.04)
independently predicted sustained HBsAg seroclearance. In addition, this genotype was a predictor for normalization of
ALT (OR=4.61, 95%CI: 1.59-13.40, p=0.005) after therapy. The HBsAg levels at baseline and during and post-treatment
tended to be reduced with the GC rs222020 TT compared with the non-TT genotypes. The other studied polymorphisms
were not associated with treatment response. Conclusions: The GC rs222020 TT genotype, which is a variant in the
vitamin D-binding protein gene, could identify HBeAg-negative patients who have a high probability to achieve HBsAg
clearance and ALT normalization after treatment with Peg-IFN.- انتشار مقاله: 09-10-1397
- نویسندگان: Kessarin Thanapirom,Sirinporn Suksawatamnuay,Wattana Sukeepaisarnjaroen,Sombat Treeprasertsuk,Tawesak Tanwandee,Phunchai Charatcharoenwitthaya,Satawat Thongsawat,Apinya Leerapun,Teerha Piratvisuth,Rattana Boonsirichan,Chalermrat Bunchorntavakul,Chaowalit Pattanasirigool,Bubpha Pornthisarn,Supot Tuntipanichteerakul,Ekawee Sripariwuth,Woramon Jeamsripong,Theeranan Sanpajit,Yong Poovorawan,Piyawat Komolmit
- مشاهده