Clinical value of contrast-enhanced ultrasound in early diagnosis of small hepatocellular carcinoma (≤ 2 cm)

BACKGROUND

Hepatocellular carcinoma (HCC) is the most common type of primary liver malignancy. Contrast-enhanced ultrasound (CEUS) uses contrast microbubbles during ultrasound, allowing the detection and characterization of malignant focal liver lesions with much higher diagnostic accuracy than conventional ultrasound; however, there are few reports focusing on the pattern of enhancement of CEUS for the diagnosis of HCC smaller than 2 cm.

AIM

To investigate the clinical value of CEUS in the early detection of small HCC with high risk factors.

METHODS

A total of 395 patients with 632 nodules at high risk of HCC, who underwent regular follow-up at Xuhui Dahua Hospital from January 2007 to December 2021, were retrospectively examined. Conventional ultrasonography combined with CEUS was adopted to analyze the echo, size, location, and enhancement characteristics of benign and malignant nodules, as well as the enhancement methods for HCC with different diameters.

RESULTS

The follow-up rate and duration were 92.15% (364/395) and 51.28 ± 45.09 mo, respectively. Conventional ultrasonography combined with CEUS revealed 65 (11.80%) nodules with a follow-up diagnosis of HCC, 19 (3.45%) dysplastic nodules, and 467 (84.75%) benign cirrhotic hyperplastic nodules. Among 65 cases of confirmed HCC, 40 (61.54%) were transformed from hypoechoic nodules, 9 (13.85%) from hyperechoic nodules, and the remaining 16 (24.62%) from isoechoic nodules. Significant differences in CEUS characteristics were found among cirrhotic nodules, dysplastic nodules, and HCC nodules at each phase. Significant differences in the enhancement mode were observed between nodules ≤ 1 cm and those 1-2 cm. The smaller the HCC nodule, the later the contrast agent began to flush and the longer the duration of contrast enhancement.

CONCLUSION

Conventional ultrasonography combined with CEUS could identify small HCC and help monitor patients with an early diagnosis of HCC. Significant differences in the enhancement mode are noted between nodules ≤ 1 cm and those 1-2 cm.

Chest computed tomography findings of the Omicron variants of SARS-CoV-2 with different cycle threshold values

BACKGROUND

The Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mainly infects the upper respiratory tract. This study aimed to determine whether the probability of pulmonary infection and the cycle threshold (Ct) measured using the fluorescent polymerase chain reaction (PCR) method were related to pulmonary infections diagnosed via computed tomography (CT).

AIM

To analyze the chest CT signs of SARS-CoV-2 Omicron variant infections with different Ct values, as determined via PCR.

METHODS

The chest CT images and PCR Ct values of 331 patients with SARS-CoV-2 Omicron variant infections were retrospectively collected and categorized into low (< 25), medium (25.00-34.99), and high (≥ 35) Ct groups. The characteristics of chest CT images in each group were statistically analyzed.

RESULTS

The PCR Ct values ranged from 13.36 to 39.81, with 99 patients in the low, 155 in the medium, and 77 in the high Ct groups. Six abnormal chest CT signs were detected, namely, focal infection, patchy consolidation shadows, patchy ground-glass shadows, mixed consolidation ground-glass shadows, subpleural interstitial changes, and pleural changes. Focal infections were less frequent in the low Ct group than in the medium and high Ct groups; these infections were the most common sign in the medium and high Ct groups. Patchy consolidation shadows and pleural changes were more frequent in the low Ct group than in the other two groups. The number of patients with two or more signs was greater in the low Ct group than in the medium and high Ct groups.

CONCLUSION

The chest CT signs of patients with pulmonary infection caused by the Omicron variants of SARS-CoV-2 varied depending on the Ct values. Identification of the characteristics of Omicron variant infection can help subsequent planning of clinical treatment.

Identification of functional genes regulating gastric cancer progression using integrated bioinformatics analysis

BACKGROUND

Gastric cancer (GC) is one of the most common cancers and has a poor prognosis. Treatment of GC has remained unchanged over the past few years.

AIM

To investigate the potential therapeutic targets and related regulatory biomarkers of GC.

METHODS

We obtained the public GC transcriptome sequencing dataset from the Gene Expression Omnibus database. The datasets contained 348 GC tissues and 141 healthy tissues. In total, 251 differentially expressed genes (DEGs) were identified, including 187 down-regulated genes and 64 up-regulated genes. The DEGs' enriched functions and pathways include Progesterone-mediated oocyte maturation, cell cycle, and oocyte meiosis, Hepatitis B, and the Hippo signaling pathway. Survival analysis showed that BUB1, MAD2L1, CCNA2, CCNB1, and BIRC5 may be associated with regulation of the cell cycle phase mitotic spindle checkpoint pathway. We selected 26 regulated genes with the aid of the protein-protein interaction network analyzed by Molecular Complex Detection.

RESULTS

We focused on three critical genes, which were highly expressed in GC, but negatively related to patient survival. Furthermore, we found that knockdown of BIRC5, TRIP13 or UBE2C significantly inhibited cell proliferation and induced cell apoptosis. In addition, knockdown of BIRC5, TRIP13 or UBE2C increased cellular sensitivity to cisplatin.

CONCLUSION

Our study identified significantly upregulated genes in GC with a poor prognosis using integrated bioinformatics methods.