Nontherapeutic Risk Factors of Different Grouped Stage IIIC Breast Cancer Patients’ Mortality: A Study of the US Surveillance, Epidemiology, and End Results Database

Effect of quantitative parameters of contrast-enhanced ultrasound on the long-term prognosis of patients with chronic coronary syndrome

Background

Ultrasound is one of the most commonly used examination methods in patients with coronary artery disease (CAD) and is valuable in evaluating patient prognosis. Although contrast-enhanced ultrasound (CEUS) can assess more in depth the vascular lesions of patients, there is still a lack of relevant research on the value of quantitative parameters of CEUS in predicting the long-term prognosis of patients with chronic coronary syndrome (CCS), thus, we designed this study.

Methods

From January 2016 to December 2017, a total of 473 patients with CCS admitted to Yueyang People's Hospital were retrospectively enrolled. The patients were followed up for five years. According to whether the patients had major adverse cardiovascular events (MACE), patients were divided into the MACE group (n=113) and the control group (n=360). The CEUS was performed to detect the myocardial perfusion status. The value of quantitative parameters of CEUS in predicting the MACE in patients with CCS was analyzed using the receiver operating characteristic (ROC) curve.

Results

Peak intensity of contrast agent at platform stage, rising rate of microbubble reperfusion, and left ventricular ejection fraction (LVEF) were found to be valuable in predicting the risk of MACE in patients with CCS. Among them, the peak intensity of contrast agent at platform stage had the highest predictive value, and the area under the curve (AUC) was 0.860 [95% confidence interval (CI): 0.827-0.894, P<0.001]. Multivariate logistics regression analysis showed that the peak intensity of contrast agent at platform stage <4.54 dB and rising rate of microbubble reperfusion <0.275 s were independent risk factors of MACE in patients with CCS. The relative risks were 12.238 (95% CI: 6.632-22.585) and 5.724 (95% CI: 3.149-10.405), respectively.

Conclusions

Quantitative parameters of CEUS can be used as predictors of MACE in patients with CCS, and strengthening the management of such high-risk patients may be beneficial to reduce the incidence of MACE.

Association between the apparent diffusion coefficient and the preoperative chemotherapy response of patients with locally advanced gastric cancer

Background

The apparent diffusion coefficient is a parameter measured by magnetic resonance imaging (MRI). Studies in breast cancer and osteosarcoma have shown that the apparent diffusion coefficient has a good correlation with the efficacy of neoadjuvant chemotherapy. However, to date, no studies have evaluated the association between the apparent diffusion coefficient and the preoperative chemotherapy response of patients with locally advanced gastric cancer.

Methods

The data of 143 patients with locally advanced gastric cancer admitted to Zhejiang Medical and Health Group Quzhou Hospital (Zhejiang Quhua Hospital) from January 2018 to January 2019 were retrospectively collected. All the patients underwent preoperative chemotherapy and dynamic enhanced MRI to analyze the correlation between the apparent diffusion coefficient and preoperative chemotherapy response.

Results

Compared to the control group, the apparent diffusion coefficient of the objective remission group was significantly increased [(1.16±0.26) ×10^-3 vs. (0.95±0.26) ×10^-3 mm²/s, P<0.001]; the rate of the apparent diffusion coefficient >1.095×10^-3 mm²/s was significantly increased (61.29% vs. 30.00%, P<0.001). The apparent diffusion coefficient was valuable in predicting objective remission after preoperative chemotherapy in patients with locally advanced gastric cancer, the area under the curve (AUC) was 0.708 [95% confidence interval (CI): 0.621-0.796, P<0.001], the best diagnostic cut-off value was 1.095×10^-3 mm²/s, and the sensitivity and specificity were 0.613 and 0.700, respectively. The multivariate logistics regression analysis showed that the apparent diffusion coefficient of >1.095×10^-3 mm²/s was associated with the objective response of patients with locally advanced gastric cancer after preoperative chemotherapy [P=0.004, relative risk =3.135 (95% CI: 1.452-6.768)]. The apparent diffusion coefficient was valuable in predicting the non-recurrence of locally advanced gastric cancer patients, and the AUC was 0.647 (95% CI: 0.557-0.738, P=0.003). The apparent diffusion coefficient was also valuable in predicting the postoperative survival of patients with locally advanced gastric cancer, and the AUC was 0.630 (95% CI: 0.537-0.723, P=0.007).

Conclusions

The elevated apparent diffusion coefficient was associated with objective remission of the preoperative chemotherapy response and prognosis of patients with locally advanced gastric cancer.