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Beyond Laparoscopy: Embracing a Scarless Solution for Gallstones "The Notes". 超越腹腔镜手术:胆结石的无疤痕解决方案 "笔记"。
Pub Date : 2024-11-01 DOI: 10.29271/jcpsp.2024.11.1393
Abdul Sami Arain, Muhammad Aliyan Ahmed Sheikh, Ali Ahmed Khoso

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无效。
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引用次数: 0
Detection of Hyperdiploidy from Cerebrospinal Fluid in B-Cell Acute Lymphoblastic Leukaemia. 从脑脊液中检测 B 细胞急性淋巴细胞白血病患者的超二倍体。
Pub Date : 2024-11-01 DOI: 10.29271/jcpsp.2024.11.1394
Emine Goktas, Sinan Demircioglu

Null.

无效。
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引用次数: 0
Clinical Effectiveness of Green Tea Extracts as a Local Haemostatic Agent Following Mandibular Molar Extraction. 绿茶提取物作为下颌臼齿拔除术后局部止血剂的临床效果。
Pub Date : 2024-11-01 DOI: 10.29271/jcpsp.2024.11.1281
Mashail M M Hamid, Seham Saleh Al-Amer, Jamilah Dhafer Alahmari, Budoor Ahmed Assiri, Taghreed A Majrashi, Atiya A Khan

Objective: To determine the clinical effectiveness of different green tea extracts (GTEs) in reducing bleeding after extraction of mandibular molars.

Study design: Randomised controlled trial. Place and Duration of the Study: College of Dentistry, King Khalid University, Abha, Saudi Arabia, from October to December 2022.

Methodology: A total of 64 patients were selected from those who attended dental clinics at the College of Dentistry, King Khalid University for extraction of their mandibular molars. They were equally and randomly divided into a control and three test groups by asking the patient to choose a numbered piece of paper. In the first group, normal saline-soaked sterile gauze was used after the tooth extraction while in the three test groups, different GTEs (methanolic GTE, aqueous GTE, and tannin isolated from the green tea) were applied. Monitoring of the bleeding by observing the extraction socket was carried out at regular intervals of five minutes until the oozing subsided, and then once an hour after that.

Results: Each group had 16 patients. The mean of bleeding stop-minutes was significantly different among the groups (61.56 minutes for the control group, 7.50 minutes 8.44 minutes and 5.62 minutes for the test groups, p <0.001). The median of bleeding stop-minutes of the control group was significantly higher than all test groups (p <0.001). The number of patients in whom bleeding was continued one hour after surgery was significantly higher in the control group (p = 0.005). Moreover, tannin has the greatest haemostatic effect compared to aqueous and methanolic GTEs.

Conclusion: Significant haemostatic effect has been shown by all GTEs. Tannin isolated from green tea has shown a significantly higher haemostatic effect than to the aqueous and methanolic extracts.

Key words: Bleeding, Green tea extracts, Haemostasis, Tannin isolate, Molar extraction.

研究目的研究设计:随机对照试验。研究地点和时间:研究地点和时间:沙特阿拉伯阿布哈哈立德国王大学牙科学院,2022 年 10 月至 12 月:从哈立德国王大学牙科学院牙科诊所就诊的下颌臼齿拔除患者中选取 64 名患者。通过让患者选择一张有编号的纸片,将他们平均、随机地分为对照组和三个试验组。第一组在拔牙后使用生理盐水浸泡过的无菌纱布,而三个测试组则使用不同的 GTE(甲醇 GTE、水性 GTE 和从绿茶中分离出的单宁酸)。通过观察拔牙窝来监测出血情况,每隔 5 分钟观察一次,直到渗出停止,之后每小时观察一次:结果:每组有 16 名患者。结果:每组有 16 名患者,各组的平均止血时间有显著差异(对照组为 61.56 分钟,试验组为 7.50 分钟、8.44 分钟和 5.62 分钟,P):所有 GTE 都具有明显的止血效果。与水提取物和甲醇提取物相比,从绿茶中分离出的单宁具有明显更高的止血效果:出血 绿茶提取物 止血 单宁分离 摩尔萃取
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引用次数: 0
Congenital Anomalies of the Kidney and Urinary Tract in Patients with Hirschsprung Disease. 赫氏普隆病患者的肾脏和泌尿道先天性异常。
Pub Date : 2024-11-01 DOI: 10.29271/jcpsp.2024.11.1334
Muniba Mehmood, Jamshed Akhtar, Naima Zamir

Objective: To determine the frequency and types of congenital anomalies of the kidney and urinary tract (CAKUT) in patients with Hirschsprung disease.

Study design: An observational cross-sectional study. Place and Duration of the Study: Department of Paediatric Surgery, National Institute of Child Health, Karachi, Pakistan, from June to December 2022.

Methodology: All patients with biopsy-proven Hirschsprung disease were included. Ultrasound was done to find out the anatomical and structural anomalies of the kidney and urinary tract. Functional assessment was done by renal function tests and MAG3 radioisotope scan where indicated. Fisher's exact test was applied to find out the association. A p ≤0.05 was taken as significant.

Results: Out of a total of 83, 15 (18.0%) patients had CAKUT. The mean age of the study population was 5.5 ± 2.3 years. It included 61 (73.5%) males and 22 (26.5%) females. No significant association was found between the type of Hirschsprung disease and CAKUT (p = 0.7). The gender distribution between CAKUT patients was also insignificant (p = 0.7). Renal hypoplasia was the most common anomaly found in six patients followed by hydronephrosis due to pelvi-ureteric junction obstruction in four children. All of these children were asymptomatic. Five male patients had undescended testis.

Conclusion: Nearly a fifth of the children with Hirschsprung disease had CAKUT of whom renal dysplasia was the most common anomaly. There was no gender predilection and patients were asymptomatic regarding the urinary system. A routine ultrasound abdomen is a good screening investigation for identifying CAKUT.

Key words: Hirschsprung disease, Kidney and urinary tract, Congenital diseases of the urinary tract, Congenital anomalies.

研究目的研究设计: 观察性横断面研究。研究地点和时间研究地点和时间:巴基斯坦卡拉奇国立儿童健康研究所小儿外科部,2022年6月至12月:方法:纳入所有经活检证实患有赫氏胃肠病的患者。通过超声波检查发现肾脏和泌尿道的解剖和结构异常。功能评估通过肾功能检查和 MAG3 放射性同位素扫描(如有必要)进行。采用费舍尔精确检验找出相关性。结果:在83名患者中,15名(18.0%)患有CAKUT。研究对象的平均年龄为(5.5 ± 2.3)岁。其中男性 61 人(73.5%),女性 22 人(26.5%)。赫氏胃肠病的类型与 CAKUT 之间无明显关联(p = 0.7)。CAKUT患者的性别分布也不明显(p = 0.7)。肾发育不全是最常见的异常情况,有 6 名患儿,其次是肾盂输尿管连接处梗阻导致的肾积水,有 4 名患儿。所有这些患儿均无症状。五名男性患者的睾丸未降:结论:近五分之一的赫氏普隆病患儿患有 CAKUT,其中肾发育不良是最常见的异常。没有性别偏好,患者在泌尿系统方面没有任何症状。常规腹部超声波检查是识别CAKUT的良好筛查方法:赫氏病 肾脏和泌尿系统 泌尿系统先天性疾病 先天性畸形
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引用次数: 0
Effect of Tissue Fragments Remain in the Karman Cannula on the Histopathological Diagnosis of Abnormal Uterine Bleeding. 卡曼套管中残留的组织碎片对异常子宫出血组织病理学诊断的影响
Pub Date : 2024-11-01 DOI: 10.29271/jcpsp.2024.11.1390
Omer Tammo, Elif Celik, Enes Celik, Denizhan Bayramoglu, Suleyman Yildiz

The aim of this study was to perform histopathological analysis of residual material in the cannula by endometrial sampling using a Carmen injector, and to compare the results. The study was conducted in the Department of Gynaecology, Mardin Training and Research Hospital, Artuklu/Mardin, Turkiye, from December 2021 to June 2022. The study group consisted of 104 patients who presented to the outpatient clinic with complaints of abnormal uterine bleeding. Endometrial curettage material was collected from all patients using a Carmen injector. The collected material was discharged into the pathology container (Group 1). Subsequently, the residual material remaining in the injector was placed in a separate pathology container (Group 2). Specimens were sent to the pathology laboratory with buffered formol. The pathological evaluation was performed by the same pathologist without revealing the patients' names. Comparative histopathological results of the patients in Group 1 and Group 2 were found to be fully compatible in 64.4% of the patients. In 35.6% of the patients, the histopathological results were different from each other between Group 1 and Group 2. Pathological results were different from each other in 21.2% of patients with incompatible pathology results. In Group 1, 16.7% of the patients were over-diagnosed, while 7.7% of the patients were over-diagnosed in Group 2. It would be beneficial to carefully remove the material remaining in the cannula and send it for pathological examination as it may affect the histopathological results. Key Words: Abnormal uterine bleeding, Probe curettage, Karman cannula, Histopathological evaluation.

本研究旨在通过使用卡门注射器进行子宫内膜取样,对套管中的残留物进行组织病理学分析,并对结果进行比较。研究于 2021 年 12 月至 2022 年 6 月在土耳其阿尔图克鲁/马尔丁的马尔丁培训与研究医院妇科进行。研究对象包括104名因异常子宫出血而到门诊就诊的患者。使用卡门注射器收集所有患者的子宫内膜刮除材料。收集到的材料被排放到病理容器中(第 1 组)。随后,残留在注射器中的材料被放入一个单独的病理容器中(第 2 组)。标本用缓冲甲醇送至病理实验室。病理评估由同一病理学家进行,不透露患者姓名。第 1 组和第 2 组患者的组织病理学结果对比显示,64.4% 的患者完全吻合。35.6%的患者的组织病理学结果在第一组和第二组之间存在差异。21.2%的患者病理结果不一致。在第一组中,16.7%的患者被过度诊断,而在第二组中,7.7%的患者被过度诊断。 小心清除插管中残留的物质并送去做病理检查是有益的,因为这可能会影响组织病理学结果。关键字异常子宫出血 探针刮宫 卡曼套管 组织病理学评估
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引用次数: 0
Tumour Load in Advanced Ovarian Cancer Patients and Its Validation by Radiological Peritoneal Cancer Index (PCI) Score. 晚期卵巢癌患者的肿瘤负荷及其放射学腹膜癌指数 (PCI) 评分的验证。
Pub Date : 2024-11-01 DOI: 10.29271/jcpsp.2024.11.1309
Uzma Chishti, Humaira Aziz, Imrana Masroor, Aliya Begum Aziz

Objective: To compare the radiological peritoneal cancer index (PCI) score to the surgical PCI score for validating it as a non-invasive method to predict surgical outcomes.

Study design: A descriptive study. Place and Duration of the Study: Department of Obstetrics and Gynaecology of the Aga Khan University Hospital, Karachi, Pakistan from September 2021 to May 2022.

Methodology: All successive patients diagnosed with advanced-stage ovarian cancer were enrolled in the research. Prior to surgery, the severity of ovarian cancer was evaluated using the Sugarbaker Peritoneal Cancer Index score derived from radiological imaging. The score was compared to the surgical PCI score determined during the surgery. The correlation between the scores and residual tumour status was confirmed.

Results: The study included a total of 26 patients. The mean age of patients was 50.17 years, with a standard deviation of 11.04. Five (19.2%) patients underwent surgery first, whereas 21(80.8%) needed interval debulking surgery after receiving chemotherapy in the neoadjuvant setting. The interclass correlation value among radiological and surgical (PCI) was 0.52, with a 95% confidence interval ranging from 0.17 to 0.75. The Bland-Altman plot displays the agreement amongst the PCI scores, indicating a bias of 1.115 with a 95% confidence interval of 4.61. Surgical exploration revealed zero residual disease in 90% of persons with a PCI score <10. Patients with a PCI score <10 had significantly brief operative time and reduced blood loss compared to those with a score >10. Patients with a PCI score below 10 had also fewer complications.

Conclusion: PCI is an efficient means for anticipating the success of surgery and the existence of residual disease without invasive measures. This can be very helpful in deciding the best time for surgery.

Key words: Peritoneal cancer index, Advanced ovarian cancer, Carcinomatosis, Prognosis, Tumour load.

研究目的比较放射学腹膜癌指数(PCI)评分和手术PCI评分,以验证其作为预测手术结果的无创方法的有效性:描述性研究。研究地点和时间:巴基斯坦卡拉奇阿迦汗大学医院妇产科,2021年9月至2022年5月:所有连续确诊为晚期卵巢癌的患者均纳入研究。手术前,使用放射成像得出的苏加贝克腹膜癌指数评分评估卵巢癌的严重程度。该评分与手术中确定的手术 PCI 评分进行了比较。评分与残留肿瘤状态之间的相关性得到了证实:研究共包括 26 名患者。患者的平均年龄为 50.17 岁,标准差为 11.04。5名患者(19.2%)首先接受了手术,而21名患者(80.8%)在接受新辅助化疗后需要进行间歇性切除手术。放射学和手术(PCI)的类间相关值为 0.52,95% 置信区间为 0.17 至 0.75。Bland-Altman图显示了PCI评分之间的一致性,显示偏差为1.115,95%置信区间为4.61。在 PCI 评分为 10 分的患者中,90% 的手术探查结果显示残留病灶为零。PCI评分低于10分的患者并发症也较少:PCI是一种无需采取侵入性措施即可预测手术成功与否以及是否存在残余疾病的有效方法。结论:PCI 是在不采取侵入性措施的情况下预测手术成功率和是否存在残留疾病的有效手段,这对决定最佳手术时间非常有帮助:腹膜癌指数 晚期卵巢癌 癌变 预后 肿瘤负荷
{"title":"Tumour Load in Advanced Ovarian Cancer Patients and Its Validation by Radiological Peritoneal Cancer Index (PCI) Score.","authors":"Uzma Chishti, Humaira Aziz, Imrana Masroor, Aliya Begum Aziz","doi":"10.29271/jcpsp.2024.11.1309","DOIUrl":"10.29271/jcpsp.2024.11.1309","url":null,"abstract":"<p><strong>Objective: </strong>To compare the radiological peritoneal cancer index (PCI) score to the surgical PCI score for validating it as a non-invasive method to predict surgical outcomes.</p><p><strong>Study design: </strong>A descriptive study. Place and Duration of the Study: Department of Obstetrics and Gynaecology of the Aga Khan University Hospital, Karachi, Pakistan from September 2021 to May 2022.</p><p><strong>Methodology: </strong>All successive patients diagnosed with advanced-stage ovarian cancer were enrolled in the research. Prior to surgery, the severity of ovarian cancer was evaluated using the Sugarbaker Peritoneal Cancer Index score derived from radiological imaging. The score was compared to the surgical PCI score determined during the surgery. The correlation between the scores and residual tumour status was confirmed.</p><p><strong>Results: </strong>The study included a total of 26 patients. The mean age of patients was 50.17 years, with a standard deviation of 11.04. Five (19.2%) patients underwent surgery first, whereas 21(80.8%) needed interval debulking surgery after receiving chemotherapy in the neoadjuvant setting. The interclass correlation value among radiological and surgical (PCI) was 0.52, with a 95% confidence interval ranging from 0.17 to 0.75. The Bland-Altman plot displays the agreement amongst the PCI scores, indicating a bias of 1.115 with a 95% confidence interval of 4.61. Surgical exploration revealed zero residual disease in 90% of persons with a PCI score <10. Patients with a PCI score <10 had significantly brief operative time and reduced blood loss compared to those with a score >10. Patients with a PCI score below 10 had also fewer complications.</p><p><strong>Conclusion: </strong>PCI is an efficient means for anticipating the success of surgery and the existence of residual disease without invasive measures. This can be very helpful in deciding the best time for surgery.</p><p><strong>Key words: </strong>Peritoneal cancer index, Advanced ovarian cancer, Carcinomatosis, Prognosis, Tumour load.</p>","PeriodicalId":94116,"journal":{"name":"Journal of the College of Physicians and Surgeons--Pakistan : JCPSP","volume":"34 11","pages":"1309-1314"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Post-Neutralisation Activated Clotting Time and Postoperative Transfusions in Cardiac Surgery Outcome. 心脏手术结果中的中和后活化凝血时间和术后输血。
Pub Date : 2024-11-01 DOI: 10.29271/jcpsp.2024.11.1280
Muhammad Arslan Zahid, Syed Shabbir Ahmed, Muhammad Saad Yousuf, Sadique Ali Wadho, Muhammad Irfan Akhtar, Mohammad Hamid

Objective: To assess the impact of post-protamine neutralisation activated clotting time (ACT) values on postoperative outcomes including chest drain output, transfusion requirements, and CICU stay, in patients undergoing cardiac surgery.

Study design: Observational comparative study. Place and Duration of the Study: Department of Anaesthesiology, The Aga Khan University Hospital, Karachi, Pakistan, from February to August 2023.

Methodology: Ethical approval was obtained to collect data from elective cardiac surgery patients' charts. A sequential sampling approach analysed the baseline and post-protamine neutralisation ACT values, categorising patients into two groups. Group A maintained ACT within 10% of baseline, while Group B deviated. The outcomes measured included transfusion needs, chest drain output, additional protamine, cardiac intensive care unit (CICU) stay, and postoperative reopening. Statistical analysis included mean, median, frequency, t-test / Mann-Whitney U test, and Chi-square test.

Results: The study comprised 101 patients (39 in Group A, 62 in Group B), with similar baseline health. No significant differences were found in tranexamic acid use, CICU stay, chest drain output, or transfusion rates between the groups (p >0.05).

Conclusion: Maintaining ACT within 10% of baseline post-protamine neutralisation results in similar intraoperative and postoperative outcomes, suggesting potential benefits in avoiding the aggressive protamine therapy and ensuring haemostasis in cardiac surgery.

Key words: Coronary Artery bypass grafting, Cardiopulmonary bypass, Activated clotting time (ACT), Heparin, Postoperative bleeding, Blood transfusions.

目的:评估前列腺素中和后活化凝血时间(ACT)值对心脏手术患者术后结果的影响,包括胸腔引流管输出量、输血需求和重症监护病房住院时间:评估接受心脏手术的患者在氯胺酮中和后活化凝血时间(ACT)值对术后结果(包括胸腔引流管排出量、输血需求和重症监护病房住院时间)的影响:观察比较研究。研究地点和时间:巴基斯坦卡拉奇阿迦汗大学医院麻醉科,2023 年 2 月至 8 月:从择期心脏手术患者的病历中收集数据已获得伦理批准。采用顺序抽样法分析了基线和前列腺素中和后的 ACT 值,将患者分为两组。A 组患者的 ACT 值保持在基线值的 10%以内,B 组患者的 ACT 值偏离基线值。测量的结果包括输血需求、胸腔引流管排出量、额外的质胺、心脏重症监护室(CICU)住院时间和术后再次开胸。统计分析包括平均值、中位数、频率、t 检验/曼-惠特尼 U 检验和卡方检验:研究对象包括 101 名患者(A 组 39 人,B 组 62 人),他们的基线健康状况相似。两组患者在氨甲环酸使用量、重症监护室住院时间、胸腔引流管排出量和输血率方面无明显差异(P>0.05):结论:将原胺中和后的ACT维持在基线的10%以内可获得相似的术中和术后结果,这表明在心脏手术中避免积极的原胺治疗和确保止血具有潜在的益处:关键词: 冠状动脉旁路移植术、心肺旁路、活化凝血时间(ACT)、肝素、术后出血、输血。
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引用次数: 0
Outcomes of Double-Face Buccal Mucosal Urethroplasty for Treating Anterior Urethral Stricture in Adult Males. 双面颊黏膜尿道成形术治疗成年男性前尿道狭窄的疗效
Pub Date : 2024-11-01 DOI: 10.29271/jcpsp.2024.11.1343
Tanzeel Ur Rahman Gazder, Syed Saeed Abidi, Syed Rabiullah, Mazahir Zulfiqar, Usman Qamar, Manzoor Hussain

Objective: To assess the results of double-face buccal mucosal graft urethroplasty (BMG) for treating anterior urethral stricture in adult males.

Study design: An observational study. Place and Duration of the Study: Department of Urology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan, from 2021 to 2022.

Methodology: The inclusion criteria were adult males, aged 15 to 70 years, with a previous surgical procedure for hypospadias and the presence of long penile and bulbar strictures measuring over 2 cm, resulting from a straddle injury. Forty-three patients were selected who underwent urethroplasty in 2021 and completed a one-year follow-up in 2022. Uroflowmetry (UFM) and the International Index of Erectile Function (IIEF) assessment data were obtained from the patients' medical records. Success was defined as the patient attaining catheter freedom and achieving a maximum flow rate exceeding 15 ml/sec after one year.

Results: The mean UFM at one year was 20.89 ml/s. Four patients underwent endo-urological intervention (direct visual internal urethrotomy), and one patient needed a second double-face urethroplasty. After one year, the double-face BMG urethroplasty achieved an overall success rate of 88.4%.

Conclusion: Double-face BMG urethroplasty is a reliable and effective surgical technique for the treatment of near obliterative or obliterative long anterior urethral strictures.

Key words: Buccal mucosal graft urethroplasty, Direct visual internal urethrotomy, Anterior urethral stricture, Buccal mucosal graft, Urethral dilatation.

研究目的评估双面颊粘膜移植尿道成形术(BMG)治疗成年男性前尿道狭窄的效果:观察性研究。研究地点和时间:研究地点和时间:巴基斯坦卡拉奇信德泌尿外科和移植研究所泌尿外科,2021 年至 2022 年:纳入标准:年龄在 15 至 70 岁之间的成年男性,曾接受过尿道下裂手术治疗,存在因跨部损伤导致的超过 2 厘米的长阴茎和球部狭窄。43名患者于2021年接受了尿道成形术,并于2022年完成了为期一年的随访。从患者的病历中获取了尿流测定法(UFM)和国际勃起功能指数(IIEF)的评估数据。成功的定义是患者一年后不再使用导尿管,且最大尿流率超过15毫升/秒:结果:一年后的平均最大流速为 20.89 毫升/秒。四名患者接受了泌尿内科干预(直视内尿道切开术),一名患者需要进行第二次双面尿道成形术。一年后,双面 BMG 尿道成形术的总体成功率为 88.4%:结论:双面BMG尿道成形术是治疗近闭塞性或闭塞性长前尿道狭窄的一种可靠有效的手术技术:颊黏膜移植尿道成形术 直视内尿道切开术 前尿道狭窄 颊黏膜移植 尿道扩张术
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引用次数: 0
The Efficacy and Safety of Trastuzumab in the Metastatic Breast Cancer. 曲妥珠单抗治疗转移性乳腺癌的有效性和安全性
Pub Date : 2024-11-01 DOI: 10.29271/jcpsp.2024.11.1378
Xinli Wang, Yan Xue

The aim of this study was to explore the efficacy and safety of Trastuzumab-Deruxtecan (T-DXd) in metastatic breast cancer (mBC). This retrospective observational study was conducted between January 2021 and 2023. Patients' clinical and pathological characteristics and previous medicinal treatments were reviewed. The efficacy of T-DXd and its influencing factors, as well as the adverse reactions of T-DXd were also observed. The median age of the patients was 43 years, and the median number of treatment lines was 4. In the overall population, the objective response rate (ORR) was 72.7%, the disease control rate (DCR) was 90.9%, and the median progression-free survival (mPFS) was six months. Among them, two patients temporarily discontinued treatment after two cycles of T-DXd due to financial reasons, but their disease remained stable for 5 and 8 months, respectively. Efficacy was better in patients with HER-2 amplification, who had not previously used antibody drug conjugates (ADC) drugs, were sensitive to anti-HER-2 treatment, and had ≤3 lines of therapy. Common adverse reactions during T-DXd treatment included gastrointestinal reactions such as nausea, vomiting, diarrhoea, and constipation, as well as haematological toxicities, decreased appetite, hair loss, and fatigue. Some patients experienced gastritis, abnormal liver function, and weight gain, but none of the patients developed interstitial pneumonia. T-DXd can achieve significant and durable survival benefits with controllable safety in patients with HER2-positive or HER2 low-expressing mBC. Key Words: Metastatic breast cancer, Trastuzumab-Deruxtecan, Efficacy, Safety.

本研究旨在探讨曲妥珠单抗-德鲁司康(T-DXd)对转移性乳腺癌(mBC)的疗效和安全性。这项回顾性观察研究在 2021 年 1 月至 2023 年期间进行。研究回顾了患者的临床和病理特征以及既往的药物治疗。还观察了 T-DXd 的疗效及其影响因素,以及 T-DXd 的不良反应。患者的中位年龄为43岁,中位治疗次数为4次。总体客观反应率(ORR)为72.7%,疾病控制率(DCR)为90.9%,中位无进展生存期(mPFS)为6个月。其中有两名患者在接受两个周期的T-DXd治疗后因经济原因暂时中止治疗,但他们的病情分别在5个月和8个月后保持稳定。对于HER-2扩增、既往未使用过抗体药物共轭物(ADC)药物、对抗性HER-2治疗敏感且治疗次数≤3次的患者,疗效更好。T-DXd治疗期间常见的不良反应包括恶心、呕吐、腹泻和便秘等胃肠道反应,以及血液学毒性、食欲下降、脱发和疲劳。一些患者出现胃炎、肝功能异常和体重增加,但没有患者出现间质性肺炎。T-DXd可为HER2阳性或HER2低表达的mBC患者带来显著、持久的生存获益,且安全性可控。关键字转移性乳腺癌 曲妥珠单抗-德鲁司康 疗效 安全性
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引用次数: 0
Diagnosis of Benign and Malignant Breast Nodules by Conventional Ultrasound in Combination with S-Detect Technology and Elastic Imaging. 传统超声结合 S-Detect 技术和弹性成像诊断良性和恶性乳腺结节。
Pub Date : 2024-10-01 DOI: 10.29271/jcpsp.2024.10.1154
Boyuan Xing, Chenghui Fu, Zishu Yang

Objective: To determine the diagnostic value of conventional ultrasound combined with S-Detect and elastic imaging technology in differentiating between benign and malignant breast nodules.

Study design: Observational study. Place and Duration of the Study: Department of Ultrasound Imaging, Yichang Central People's Hospital, Yichang, China, from October 2019 to October 2022.

Methodology: The study included all breast nodules diagnosed using ultrasound, with patients undergoing conventional ultrasound for BI-RADS classification, elasticity score, and S-Detect examination. Benign and malignant breast nodules were classified according to the three tests and their combinations. The diagnostic sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and area under curve (AUV) of those alone and combinations were calculated and compared.

Results: Of the three methods, BI-RADS, elasticity score, and S-Detect, BI-RADS had the highest accuracy (89.29%), elasticity score had the highest specificity (96.20%), and S-Detect had the highest sensitivity (93.92%). The accuracy of combined groups were higher than that of the single group. When combined with elasticity score, the AUC of the new BI-RADS increased from 0.882 to 0.917 (p <0.001); and combined with S-Detect, the AUC of the new BI-RADS increased from 0.882 to 0.927 (p <0.001).

Conclusion: The combination of conventional ultrasound BI-RADS classification with elasticity score or S-Detect technology has a higher diagnostic efficacy for breast nodules, which can improve breast cancer detection and provide valuable diagnostic evidence for clinical practice.

Key words: S-Detect technology, Ultrasound elastic imaging, Elasticity scoring, Elasticity strain ratio value, Breast tumour.

研究目的确定传统超声结合 S-Detect 和弹性成像技术在区分乳腺结节良性和恶性方面的诊断价值:观察性研究。研究地点和时间:宜昌市中心人民医院超声影像科,2019年10月至2022年10月:研究纳入所有使用超声诊断的乳腺结节,患者接受常规超声BI-RADS分级、弹性评分和S-Detect检查。良性和恶性乳腺结节根据三种检查及其组合进行分类。计算并比较了单独检测和组合检测的诊断敏感性、特异性、准确性、阳性预测值、阴性预测值和曲线下面积(AUV):在 BI-RADS、弹性评分和 S-Detect 三种方法中,BI-RADS 的准确性最高(89.29%),弹性评分的特异性最高(96.20%),S-Detect 的灵敏度最高(93.92%)。综合组的准确率高于单一组。当结合弹性评分时,新 BI-RADS 的 AUC 从 0.882 增加到 0.917(p 结论:新 BI-RADS 的 AUC 从 0.882 增加到 0.917:将传统超声 BI-RADS 分级与弹性评分或 S-Detect 技术相结合,对乳腺结节有更高的诊断效果,可提高乳腺癌的检出率,为临床实践提供有价值的诊断依据:S-Detect 技术 超声弹性成像 弹性评分 弹性应变比值 乳腺肿瘤
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Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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