Efficient triage of high-risk human papillomavirus (hrHPV)-positive women is essential to avoid unnecessary referrals and overtreatment. This study evaluates the diagnostic accuracy of the commercially available DNA methylation panel, GynTect® (ASTN1, DLX1, ITGA4, RXFP3, SOX17, and ZNF671), in cervical cytology samples from 146 women for detecting cervical intraepithelial neoplasia grade 3 (CIN3) or cervical carcinoma (CC). This analysis focuses particularly on the performance of the ZNF671 methylation marker (ZNF671^m) within the panel.

The positive rates of all triage markers-hrHPV, TCT, HPV16/18, GynTect®, and ZNF671^m-correlated with increasing severity of CIN lesions (Chi-squared test for trend, P < 0.01). ZNF671^m exhibited the highest Area Under the Curve (AUC) of 0.811 (95% CI: 0.734-0.888) for identifying CIN3 + cases, closely followed by GynTect® (AUC 0.800, 95% CI: 0.721-0.878). Among 102 hrHPV-positive women, employing GynTect® or ZNF671^m instead of TCT yielded identical sensitivity (0.84; 95% CI: 0.69-1.01) but enhanced specificity (86% and 90%, respectively) for detecting CIN3 +. Adding HPV16/18 to the triage strategy maintained similar outcomes. Additionally, ZNF671^m showed a significant risk difference (60.0%; 95% CI 42.8-77.1%) for detecting CIN3 +, on par with GynTect® (57.6%; 95% CI 37.9-71.2%).

ZNF671^m within the GynTect® panel demonstrates robust triage performance in diagnosing CIN3 + cases, with efficacy comparable to the full panel. These findings suggest that ZNF671^m could be a promising alternative for cytologic triage, warranting further validation.

To explore the added value of quantitative parameters derived from routine chest contrast-enhanced computed tomography (CECT) in distinguishing malignant from benign solid pulmonary nodules (SPNs).

Eighty-one SPNs pathologically confirmed as benign or malignant with preoperative nonenhanced chest and CECT scans were retrospectively analyzed. Quantitative parameters [CT attenuation value of nonenhanced phase (AV_N), value of arterial phase (AV_A), value of venous phase (AV_V), their differentials (△AV_A-N, △AV_V-N, △AV_V-A), diameter] and qualitative CT features [lobulation, spiculation, vacuolar sign, pleural depression sign, vascular convergence, edge clarity] were obtained. Inter-group comparisons for clinical/imaging variables used t-tests/Mann-Whitney U tests or Chi-square/Fisher's tests. Three multivariate logistic regression models (qualitative, quantitative, and combined models) were developed and evaluated through five-fold cross-validation, DeLong tests (Bonferroni-corrected α = 0.0167), decision/calibration curves, and Bootstrap-based threshold sensitivity analysis (1000 iterations; 0.1-0.9 thresholds). Subgroup ROC analyses assessed age/diameter effects (stratified by mean/median).

Malignant SPNs showed higher age and greater AV_A, AV_N, AV_V, △AV_A-N, △AV_V-N, diameter (P < 0.05). AV_V showed the strongest discriminatory power among quantitative parameters (AUC = 0.779). The qualitative model incorporated vascular convergence, pleural depression sign, and lobulation, while the quantitative model included AV_V. Cross-validation yielded mean AUCs of 0.877 ± 0.019, 0.790 ± 0.081, and 0.900 ± 0.042 for the qualitative, quantitative, and combined model respectively. The combined model surpassed the qualitative model (P = 0.016), demonstrating better calibration and decision curve performance. Bootstrap analysis identified 0.4 as the optimal sensitivity-specificity threshold. Subgroup AUCs were 0.945/0.860 (mean-age strara) and 0.903/0.912 (median-diameter strata).

Quantitative CECT parameters, particularly AV_V, aid in discriminating malignant SPNs. Combining AV_V with qualitative features enhances diagnostic accuracy for malignancy risk assessment.

Subcutaneous panniculitis-like T-cell lymphoma (SPTCL) is a rare subtype of cutaneous lymphoma, and the standard of care for SPTCL has not been well-defined. This retrospective study analyzed the efficacy of the CHOP-regimen in newly-diagnosed SPTCL patients in China. The study reviewed 32 SPTCL patients treated at Peking Union Medical College Hospital over the last two decades. The median age of these patients was 27 years. Among them, 56.3% were female. Sixteen patients had a PIT score ≥ 2, and 28.1% patients had concurrent hemophagocytic lymphohistiocytosis. Histopathology typically showed a lobular panniculitis with individual adipocytes surrounded by atypical lymphocytes, usually with a CD3⁺, CD4^-, CD8⁺, CD56^- phenotype. Twenty-eight patients (87.5%) received CHOP-like regimen as the first-line treatment. The ORR and CR rate of induction therapy were only 42.9% and 35.7%, respectively. The median PFS and OS were 3.2 months and 147.5 months. Factors, concurrent HLH and PIT ≥ 2, were indicators of shorter PFS in univariate analysis. This study showed that CHOP-like regimen was inadequate as a first-line treatment for SPTCL, emphasizing the need for alternative therapeutic strategies.

Perineal wound complications after abdominoperineal resection (APR) for low rectal cancer remain a significant challenge. Effective reconstruction methods are critical to reducing morbidity and improving outcomes.

To compare the effectiveness of primary closure versus Limberg flap reconstruction in managing perineal defects post-abdominoperineal resection.

Sixty patients undergoing APR for rectal cancer were randomized into two groups. Fifty-four patients completed the study and were analyzed (26 in the primary closure group and 28 in the Limberg flap group). Baseline characteristics, including mean age, gender distribution, cancer stage, and neoadjuvant chemoradiation status, were recorded. Primary outcomes included uncomplicated wound healing, while secondary outcomes assessed complications, wound healing time, and hospital stay. Statistical significance was set at p < 0.05.

The average age of the participants was 68.04 ± 11.50 years, with an average weight of 74.42 ± 12.47 kg and a mean Body Mass Index (BMI) of 27.31 ± 3.90 kg/m². Males comprised 57.4% of the sample, 38.9% of whom had diabetes, and nearly 80% underwent neoadjuvant chemoradiation therapy. The Limberg flap group exhibited significantly lower complication rates (17.9% compared to 42.3%, p = 0.02), reduced wound healing times (6.14 ± 2.07 days compared to 8.12 ± 4.01 days, p = 0.03), and shorter hospitalization durations (7.68 ± 2.96 days compared to 11.35 ± 6.27 days, p = 0.008). Among diabetic patients in the primary closure cohort, there are significant differences in the rates of complications, infections, and wound dehiscence (p < 0.02, p < 0.02, p < 0.01, respectively).

Limberg flap reconstruction offers superior outcomes compared to primary closure for perineal reconstruction following APR.

Parents facing child's life-threatening diseases like cancer encounter a myriad of emotional challenges, often exacerbated by communication barriers. This study designed to explore the significance of effective communication and emotions' management in improving the well-being and quality of life of these parents. The research was conducted on a sample of 133 families of children with cancer, and the results were displayed after statistical processing and data analysis with R statistical software. The results of the study confirm with statistically significant data, the importance of the communication and emotions' management of the parents during the disease of their children, and the need of a multidisciplinary approach involving healthcare providers, psychologists, social workers, and support groups. Thus, 74.5% of the respondents stating that they receive help from their partners during the period of childhood cancer and 76.7% could also communicate and receive help from the other family members. The key findings are characterized by high specificity as it is a part of a unique study that reveals particular aspects of the Greek parent's behavior, communication, and psychosocial problems during the period of their child's illness.

Robot-assisted partial nephrectomy (RAPN) has become the standard treatment for small renal tumors, offering better perioperative outcomes than open surgery. However, objective evaluations of the RAPN learning curve are limited. While the Trifecta criteria-comprising negative surgical margins, no perioperative complications, and warm ischemia time (WIT) ≤ 25 min-are commonly used to assess surgical outcomes, they are inadequate for continuous proficiency assessment. This study aimed to evaluate the RAPN learning curve using the cumulative sum (CUSUM) method based on Trifecta achievement and its components. We retrospectively analyzed 119 RAPN cases performed by three surgeons at a single institution between 2017 and 2022. All surgeons (≥ 30 cases; ≥ 15 year experience) were included. CUSUM charts were created using Trifecta achievement rates with thresholds (p₀ = 0.4, p₁ = 0.8), and further analysis was performed on individual components. Distinct learning curve transitions were observed only in Surgeon B, with proficiency achieved at the 9th case for complication rates and the 4th case for overall Trifecta achievement. No clear transitions were seen in WIT or surgical margins, or in any component for Surgeons A and C. These findings suggest that Surgeons A and C may have already attained proficiency before the study period. The CUSUM method offers a practical tool for visualizing and quantifying individual learning curves in RAPN based on clinically relevant criteria. Despite some limitations, CUSUM enables continuous, surgeon-specific assessment. Future studies should integrate additional metrics to develop more comprehensive training programs and improve surgical safety and outcomes.

This study sought to construct and validate a prognostic nomogram for predicting cause-specific survival (CSS) in patients with nasal cavity squamous cell carcinoma (NCSCC). We conducted a retrospective analysis of clinical data from NCSCC patients registered in the SEER database between 2007 and 2015. Statistical analyses were performed to assess CSS rates and identify prognostic factors. The study cohort comprised 580 NCSCC patients, with CSS probabilities of 89.1%, 74.8%, and 63.6% at 1, 3, and 5 years, respectively. Multivariate Cox regression analysis identified age, American Joint Committee on Cancer (AJCC) stage, and radiotherapy administration as independent prognostic factors significantly associated with CSS. The accuracy of the prediction was evaluated using the C-index and calibration curve. Decision curve analysis (DCA) was utilized to compare the nomogram with the AJCC stage system in order to assess its superiority. We developed and validated a predictive model for 1-, 3-, and 5-year CSS in NCSCC based on a large retrospective cohort. The nomogram demonstrates clinical utility in guiding individualized treatment strategies and patient management.

Patients with locally advanced resectable (LAR) gastric/gastroesophageal junction (G/GEJ) adenocarcinomas have a high recurrence risk despite pre- and post-operative treatment. In the PLAGAST prospective study (NCT02674373), we investigated the ability of circulating tumor DNA (ctDNA) to predict treatment response and improve risk stratification. Plasma samples were prospectively collected before neoadjuvant therapy (NAT), during-NAT, post-NAT, and post-surgery. The primary endpoint was recurrence-free survival (RFS), and the secondary endpoints were overall survival (OS), tumor regression grade (TRG), and pathological tumor stage. ctDNA positivity decreased over these four therapeutic timelines (69.6%, 51.2%, 26.8%, and 20%, respectively). ctDNA-positivity was associated with significantly worse outcomes during-NAT (RFS: HR = 6.17, P = 0.002; OS: HR = 4.71, P = 0.022), post-NAT (RFS: HR = 5.26, P = 0.001; OS: HR = 7.35, P = 0.001) and after surgery (RFS: HR = 12.94, P < 0.0001; OS: HR = 14.54, P < 0.0001). Patients with early ctDNA clearance during NAT had better outcomes compared to those who cleared ctDNA post-NAT, while patients who remained ctDNA-positive pre-, during-, and post-NAT had worse outcomes (RFS: HR = 18.57, P = 0.01; OS: HR = 16.06, P = 0.007). Our data suggests that longitudinal ctDNA monitoring is prognostic of patient outcomes and may guide therapeutic decision-making in patients with LAR G/GEJ adenocarcinoma.

The preoperative detection of abdominal adhesions could influence surgical planning; however, imaging features of abdominal adhesions are minimally described in the veterinary literature. The purpose of this retrospective, diagnostic case-control study is to determine the preoperative CT imaging signs associated with surgically-confirmed, severe adhesions in dogs with abdominal masses. Dogs undergoing contrast-enhanced CT and surgery for abdominal masses from 2012 to 2022 were included in the study. Surgical records were evaluated and retrospectively reviewed by a board-certified surgeon to determine the severity of adhesions as pertaining to surgical planning and/or complications. The CTs of dogs with severe adhesions were mixed with age and weight-matched controls for review by a board-certified veterinary radiologist. A review of the literature on both people and animals determined the imaging features tested. The signs tested were fat stranding, fat stranding with vascular enhancement or vascular crowding, loss of fat planes (properitoneal fat sign), focal peritoneal enhancement with or without an alteration in visceral contour, loculation of fluid, and enhancing peritoneal bands. The presence of fat stranding (sensitivity 60.5; specificity 72.1), fat stranding with vascular enhancement (sensitivity 53.5, specificity 81.4), and loculation of peritoneal effusion (sensitivity 25.5; specificity 95.3) were significantly associated with the presence of adhesions at surgery. Loculation of peritoneal effusion surrounding the nondependent margin of an abdominal mass can alert imagers to the presence of severe adhesions. The absence of any of the signs tested does not exclude the presence of adhesions, especially in the retroperitoneum.

Objective: To evaluate the functional outcomes and postoperative complications associated with modified Toupet-like (mToupet-like) anastomosis following proximal gastrectomy for patients with gastric tumors. Methods: After proximal gastrectomy, barbed sutures (2-3 stitches) in the seromuscular layer were used to secure the anterior wall of the stomach at a distance of 1-2 cm from the closure line and the posterior wall of the esophagus at a distance of 5.0 cm from the closure line. The remnant stomach was then positioned posterior to the esophagus on the greater curvature side. Esophagogastric anterior wall anastomosis (manual or circular stapling) was performed at the greater curvature of the remnant stomach, 3 cm distal to the gastroesophageal fixation point. A Toupet-like folding procedure was conducted by folding the reconstructed gastric fundus and wall anteriorly from behind the esophagus and embedding the esophagus within a 270° wrap at the site of stomach-esophagus fixation. Results: Twelve patients with gastric tumors underwent proximal partial gastrectomy with mToupet-like anastomosis in the Department of Gastric Surgery at Zhejiang Cancer Hospital from January to March 2024. Among them, 10 diagnosed as upper gastric adenocarcinoma, and 2 diagnosed as gastric gastrointestinal stromal tumors. The cohort included nine male patients and three female patients, aged 46 to 77 years old, with a body mass index (BMI) ranging from 19.7 to 27.3 kg/m². The maximum tumor diameter was less than 4 cm, and the predicted residual gastric volume exceeded one-half. Laparoscopic surgery was performed in 11 patients, while only 1 patient underwent open surgery. The mean duration of mToupet-like anastomosis was 48.3±8.7 minutes with an estimated intraoperative blood loss was 53.0±11.2 ml. All the 12 patients successfully achieved R0 resection. Among these patietns, the median postoperative hospital stay was 8.5 (7.0, 11.0) days, and the average hospitalization cost was 5.0±0.2 ten thousand yuan. No Clavien-Dindo grade II or higher complications were observed during the perioperative period. Patients were followed up for 6 to 8 months after operation, and no cases of reflux esophagitis were detected by gastroscopy, and no patient required long-term oral proton pump inhibitors. Conclusions: mToupet-like anastomosis for digestive tract reconstruction after proximal gastrectomy is a safe and feasible technique, demonstrating favorable preliminary efficacy.