搜索到20430篇“ NODES“的相关文章
Management of lateral pelvic lymph nodes in rectal cancer:Is it time to reach an Agreement?
2024年
In this editorial,we proceed to comment on the article by Chua et al,addressing the management of metastatic lateral pelvic lymph nodes(mLLN)in stage II/III rectal cancer patients below the peritoneal reflection.The treatment of this nodal area sparks significant controversy due to the strategic differences followed by Eastern and Western physicians,albeit with a higher degree of convergence in recent years.The dissection of lateral pelvic lymph nodes without neoadjuvant therapy is a standard practice in Eastern countries.In contrast,in the West,preference leans towards opting for neoadjuvant therapy with chemoradiotherapy or radiotherapy,that would cover the treatment of this area without the need to add the dissection of these nodes to the total mesorectal excision.In the presence of high-risk nodal characteristics for mLLN related to radiological imaging and lack of response to neoadjuvant therapy,the risk of lateral local recurrence increases,suggesting the appropriate selection of strategies to reduce the risk of recurrence in each patient profile.Despite the heterogeneous and retrospective nature of studies addressing this area,an international consensus is necessary to approach this clinical scenario uniformly.
Sigfredo E Romero-ZoghbiFernando López-CamposFelipe Couñago
关键词:CHEMORADIOTHERAPY
Clinical Study of Double Contrast-Enhanced Ultrasound Combined with Dye Method and Marker Placement to Identify and Locate Sentinel Lymph Nodes in Patients with Breast Cancer
2024年
Objective: To explore the value of percutaneous ultrasonography combined with transvenous ultrasonography for accurate localization of sentinel lymph nodes and diagnosis of metastatic lymph nodes in patients with breast cancer. Methods: 18 cases of patients with breast cancer attending the Hainan General Hospital from May 2022 to June 2024 who were proposed to undergo axillary lymph node dissection were selected, and the ultrasonographic agent was injected subcutaneously through the areola on the 1st day before the operation, and the marker localization of the manifestation of the Sentinel lymph nodes and draw the lymphatic vessel alignment for drainage on the body surface, and record the manifestation of SLN by conventional ultrasound and dual ultrasonography. At the time of surgery, intraoperative melphalan localization was used to identify the SLN, the difference between the number of ultrasound and melphalan localization was observed, and resection was performed for pathological examination to determine whether they were metastatic or not. Results: There were 8 metastatic lymph nodes and 18 non-metastatic lymph nodes among 31 SLN. A total of 62 SLN were localized by intraoperative melphalan, of which 31 were consistent with ultrasound localization and 31 were not identified by ultrasound. The diagnostic sensitivity of SLN metastasis diagnosed by transcutaneous ultrasonography was 62.50%, specificity was 91.30%, positive predictive value was 71.43%, negative predictive value 87.50%, accuracy was 83.87%, and the AUC was 0.769;the diagnostic sensitivityof transvenous ultrasonography diagnosed was 75.00%, specificity was 75.00%, and the accuracy was 83.87%, 75.00%, specificity 91.30%, positive predictive value 75.00%, negative predictive value 91.30%, accuracy 87.10%, AUC 0.832;dual ultrasonography diagnostic sensitivity 87.50%, specificity 91.30%, positive predictive value 77.78%, negative predictive value 95.45%, accuracy 90.32%. The AUC was 0.894. Conclusion: Transcutaneous ultrasonography combined with transv
Dayan YangLini Gao
关键词:ULTRASOUNDULTRASONOGRAPHY
前哨淋巴结1~2枚阳性乳腺癌患者腋窝非前哨淋巴结的转移情况和相关危险因素
2024年
目的探究与分析前哨淋巴结(SLN)1~2枚阳性乳腺癌患者腋窝非前哨淋巴结(NSLN)的转移情况和相关危险因素。方法选取2018年3月至2022年4月张家港市第一人民医院接受前哨淋巴结活检(SLNB)治疗且经过病理诊断为SLN 1~2枚阳性的早期乳腺癌患者共83例,同时该组患者也进行腋窝淋巴结清扫术(ALND)治疗,对所有患者行相关影像学检查及组织活检,按照是否发生早期乳腺癌腋窝NSLN癌转移,分为阳性组(n=40)及阴性组(n=43),对早期乳腺癌腋窝NSLN癌转移情况进行分析,进行单因素及多因素logistic回归分析探讨影响SLN 1~2枚阳性乳腺癌患者腋窝NSLN的转移情况和相关危险因素。结果腋窝NSLN转移40例(48.2%),作为阳性组,其余43例(51.8%),作为阴性组。两组早期乳腺癌患者肿瘤组织分化程度、肿瘤位置、肿瘤直径、病理类型、Ki-67阳性、HER-2阳性比较,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,肿瘤组织分化程度(中分化)、肿瘤直径(>5 cm)、肿瘤发病位置(外上)、病理类型(浸润性非特殊癌)为影响腋窝NSLN转移的高危因素(P<0.05)。结论肿瘤组织分化程度、直径、病理类型、发病位置可作为影响SLN 1~2枚阳性乳腺癌患者腋窝NSLN转移的高危因素,在临床工作中需要对上述影响因素引起足够的重视。
江飞沈祥耿锋缪志明顾大力
关键词:前哨淋巴结腋窝淋巴结
基于节点重要度的旅游景区指引标志设置研究
2024年
基于公路网特性采用时间-费用阻抗模型得到路段权重,结合节点效率值、节点度值构建路网节点重要度模型;考虑旅游景区对路网节点的影响,评估旅游景区对路网节点的影响程度并确定旅游景区指引标志指引信息,提出旅游景区指引标志设置的具体位置和指引信息;引入可视性指数模型评价旅游景区指引标志设置信息和位置的有效性;最后以神木市周边公路网及景区为例,进行旅游景区指引标志设置方法实例验证。研究表明:在综合考虑旅游景区对路网节点影响的情况下,路网中13个节点的重要度提高;基于节点重要度筛选指引信息后设置的旅游景区指引标志,可视性指数达到了0.822。提出的方法可以有效表征旅游景区对路网节点的影响,为旅游者提供高效、准确的指引信息。
李聪颖史彤彤张洪涛詹立范家豪
关键词:交通工程节点重要度
一种基于决策树的比特币不可达节点发现方法
2024年
不可达节点是指比特币网络中不接收外部连接请求的网络工作节点,发现、验证均较为困难。现有研究大多集中于可达节点,而对不可达节点的研究较少。为此,提出一种基于决策树算法的不可达节点发现方法,可以从大量比特币地址中自动分类发现不可达节点。实验结果表明:所提方法在实验数据集上分类准确率为95.73%,召回率为91.97%;在真实数据上进行实测,并利用网络空间搜索引擎进行验证,所提方法实际分类准确率为53.75%,召回率约为76.86%。对实验中发现不可达节点的总量、地理分布、所属网络服务商等进行统计分析,为比特币监管工作提供有力技术支撑。
李锐光李锐光朱佳伟高家奇徐大伟祝烈煌
关键词:决策树
Target Controllability of Multi-Layer Networks With High-Dimensional Nodes
2024年
This paper studies the target controllability of multilayer complex networked systems,in which the nodes are highdimensional linear time invariant(LTI)dynamical systems,and the network topology is directed and weighted.The influence of inter-layer couplings on the target controllability of multi-layer networks is discussed.It is found that even if there exists a layer which is not target controllable,the entire multi-layer network can still be target controllable due to the inter-layer couplings.For the multi-layer networks with general structure,a necessary and sufficient condition for target controllability is given by establishing the relationship between uncontrollable subspace and output matrix.By the derived condition,it can be found that the system may be target controllable even if it is not state controllable.On this basis,two corollaries are derived,which clarify the relationship between target controllability,state controllability and output controllability.For the multi-layer networks where the inter-layer couplings are directed chains and directed stars,sufficient conditions for target controllability of networked systems are given,respectively.These conditions are easier to verify than the classic criterion.
Lifu WangZhaofei LiGe GuoZhi Kong
阴性淋巴结数对肌层浸润性膀胱癌患者预后的影响
2024年
目的:探讨肌层浸润性膀胱癌(muscle-invasive bladder cancer,MIBC)患者阴性淋巴结数量对预后的影响。方法:回顾性分析厦门大学附属东南医院2015年1月—2020年6月年收治73例接受膀胱根治性切除术的MIBC患者临床病理资料,根据术后是否发生肿瘤复发或死亡分为预后不良组(32例)和预后良好组(41例)。根据术后病理结果计算患者阴性淋巴结总数,绘制受试者工作特征(receiver operating characteristic,ROC)曲线分析阴性淋巴结数对预后的预测作用,单因素和logistic多因素分析MIBC患者预后影响因素,采用Kaplan-Meier风险曲线分析阴性淋巴结数对无复发生存期(recurrence free survival,RFS)和总生存期(overall survival,OS)的影响。结果:73例MIBC患者中,32例肿瘤复发,复发率43.84%,复发时间4~35个月,平均22.72个月;25例死亡,死亡率34.25%,死亡时间8~36个月,平均25.68个月。单因素分析发现肿瘤最大长径≥3 cm、临床分期Ⅲ~Ⅳ期、淋巴结转移、清扫淋巴结数量<23枚、阴性淋巴结数量<18枚与MIBC预后不良相关(P<0.05)。多因素分析发现肿瘤最大长径≥3 cm(OR=9.125,95%CI:1.987~14.371)、临床分期Ⅲ~Ⅳ期(OR=8.377,95%CI:1.965~12.752)、清扫淋巴结数量<23枚(OR=16.346,95%CI:5.081~28.646)、阴性淋巴结数量<18枚(OR=22.043,95%CI:5.625~44.245)是MIBC预后不良的独立危险因素。Kaplan-Meier分析结果显示,阴性淋巴结数量<18枚患者RFS短于阴性淋巴结数量≥18枚患者(χ^(2)=37.610,P<0.001),阴性淋巴结数量<18枚患者OS短于阴性淋巴结数量≥18枚患者(χ^(2)=26.690,P<0.001)。结论:阴性淋巴结数量<18枚是MIBC患者预后不良的危险因素,对患者预后具有预测价值,可以作为临床预后评估指标。
林联拯张汉荣许伟杰李金雨
关键词:膀胱癌淋巴结
皮肤多点靶位固定技术在阴茎癌腹股沟淋巴结清扫中的应用
2024年
目的:探讨通过皮肤多点靶位固定技术联合腹腔镜下腹股沟淋巴结清扫术(LILND)在阴茎癌患者中的应用。方法:回顾性分析安康中心医院泌尿外科2011年9月至2023年10月收治的阴茎癌患者26例,根据术后是否采用靶位固定技术分为研究组16例和对照组10例。研究组术中采取皮肤多点靶位固定技术LILND,对照组采取常规LILND。其中研究组10例经下腹部皮下(LILND-H),6例经下肢股部皮下(LILND-L),对照组6例LILND-H,4例LILND-L。比较组间基线资料、术中出血量、手术时间、淋巴结清扫数目、住院时间、引流管留置时间及并发症。结果:两组切口感染率差异有统计学意义(P<0.05)。研究组LILND-H患者中2例术后发生下肢水肿,1例术后伤口感染,1例淋巴囊肿。研究组LILNDH住院时间和负压引流置管时间分别为(10.30±2.00)d、(6.56±0.97)d,LILND-L住院时间和负压引流置管时间分别为(10.00±1.79)d、(6.42±0.93)d,对照组LILND-H住院时间和负压引流置管时间为(12.67±1.51)d、(8.44±1.42)d,LILND-L住院时间和负压引流置管时间分别为(7.79±0.65)d、(12.75±1.71)d,差异均有统计学意义(P<0.05)。结论:LILND联合皮肤多点靶位固定技术治疗阴茎癌疗效确切,不仅达到良好的瘤控效果,同时恢复快、创伤小、并发症发生率低。
谢蛟魁李均
关键词:阴茎肿瘤淋巴结淋巴结清扫术
甲状腺乳头状癌颈中线淋巴结分区预测对侧中央区淋巴结转移情况的价值研究
2024年
目的分析甲状腺乳头状癌(PTC)患者对侧中央区淋巴结(Cont-CLNs)转移的相关因素,评估颈中线淋巴结(Mid-CLNs)分区在识别Cont-CLNs转移中的临床价值。方法选取2021年1月至2023年6月广东省佛山市第一人民医院进行甲状腺全切除术和双侧中央区颈淋巴清扫术(CND)治疗PTC的125例患者,组织病理学检查评估的主要因素包括:原发肿瘤最大直径、多灶性、被膜侵犯、腺外浸润、桥本氏甲状腺炎、淋巴结转移分区。组间数据比较采用单因素方差分析。利用多因素Logistic回归分析法分析Cont-CLNs转移的危险因素,计算受试者工作特征(ROC)曲线下面积,分析对侧Mid-CLNs转移对Cont-CLNs转移的预测效能。结果125例PTC患者中,107(85.60%)例患者发生Mid-CLNs转移,57.60%(72/125)的患者发生患侧Mid-CLNs转移,28.80%(36/125)的患者发生对侧Mid-CLNs转移。在单因素分析中,多灶性(P=0.004)、被膜侵犯(P=0.002)、腺外浸润(P=0.048)、对侧Mid-CLNs转移(P<0.01)和Ipis-CLNs转移(P=0.043)与Cont-CLNs转移的发生有显著相关性。而Mid-CLNs转移(P=0.422)、患侧Mid-CLNs转移(P=0.856)与Cont-CLNs转移的发生则无相关性。多因素Logistic回归分析发现,Ipis-CLNs转移(P=0.013,OR=2.065)和对侧Mid-CLNs转移(P=0.008,OR=2.072)发生越多,Cont-CLNs转移发生的概率越大。且对侧Mid-CLNs转移阳性对Cont-CLNs转移预测的AUC为0.664(95%CI=0.554~0.774,P=0.006),敏感度为76.19%,特异度为56.60%。结论对侧Mid-CLNs转移是Cont-CLNs转移的独立危险因素,且对预测Cont-CLNs转移具有较为良好的诊断价值。
徐国建邹岚王威
关键词:甲状腺乳头状癌颈淋巴结甲状腺全切除术
宽体能谱CT参数在鉴别诊断肺癌纵隔转移、非转移淋巴结与反应性增生淋巴结中的价值
2024年
目的探讨宽体能谱CT在肺癌纵隔转移淋巴结、非转移淋巴结与反应性增生淋巴结的鉴别诊断价值。方法回顾性分析64例肺癌患者和28例肺部炎性病变患者临床及影像资料,所有患者均行平扫、增强双期能谱CT扫描,分别在70 keV单能量图像及碘基图像上测量转移、非转移、炎性反应性增生三组淋巴结大小、密度、三期IC、NIC、λHU,并用单因素方差、Kruskal-Wallis H秩和检验方法分析比较其差异。结果转移淋巴结短径比非转移淋巴结及反应性增生淋巴结大(P<0.001)。反应性增生淋巴结平扫密度比转移淋巴结高(P<0.001),而与非转移淋巴结差异无统计学意义(P=0.325);增强扫描反应性增生淋巴结动脉期、静脉期CT值均比转移、非转移淋巴结高(P<0.05)。除了动脉期NIC,反应性增生淋巴结与转移淋巴结在平扫IC、NIC、λHU,动脉期IC、λHU,静脉期IC、NIC、λHU均有统计学意义(P<0.05),而反应性增生淋巴结与非转移淋巴结在平扫、动脉期及静脉期的IC、NIC、λHU差异均无统计学意义(P>0.05)。结论肺癌纵隔转移淋巴结碘的定量及能谱曲线斜率基本低于反应性增生淋巴结,能谱CT定量参数鉴别两者有一定诊断效能,而非转移淋巴结与反应性增生淋巴结能谱参数无差异。
郑思捷向佳陈茜彤卢颖欣刘韵陈淮黄绥丹
关键词:肺癌纵隔淋巴结能谱CT

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