|
|
|
题名
|
作者
|
年代
|
出处
|
被引量
|
| 1 | Is there a real diagnostic impact of elastosonography and contrast-enhanced ultrasonography in the management of thyroid nodules?显示文摘Ultrasonography(US) and the new applications US elastography(USE) and contrast-enhanced US(CEUS) are used in the screening of thyroid nodules,for which fine-needle aspiration biopsy(FNAB) is the best single diagnostic test.The aim of the study was to compare the sensitivity,specificity,positive predictive value(PPV),and accuracy of the four examinations in nodules with cytological and histological diagnoses.The study used data from US,FNAB,USE(elasticity(ELX 2/1) index),and CEUS(Peak index and time to peak(TTP) index) evaluated in 73 thyroid nodules in 63 consecutive patients likely to undergo surgery.Cytological-histological correlation was available for 38 nodules.No correlation emerged between nodule size and cytological results.A significant(P=0.03) positive correlation between cumulative US findings and cytological results was found.In addition,significant correlations between cumulative US findings and cytology(P=0.02) and between cumulative US findings and histology(P<0.0001) were found.US showed the best specificity and PPV,and FNAB the best sensitivity.There was no significant difference in the ELX 2/1 index,Peak index,or TTP index among nodules subdivided according to cytological scores.No significant correlation was found between ELX 2/1 index,Peak index,and TTP index,on the one hand,and nodule size,US cumulative findings,cytology,and histology on the other hand.The sensitivity of the ELX 2/1 index was high,but its specificity was very low.The accuracy and PPV of USE were lower than those of the other procedures.Only the correlation between Peak index and cumulative US findings reached a value close to significance.Our ultimate aim is to minimise unnecessary thyroidectomy.US and FNAB continue to play a central diagnostic role.The use of a US score showed high specificity and PPV.The specificity of FNAB was low in this selected series because of the numbers of indeterminate cytological responses.USE and CEUS are innovative techniques that need to be standardized.The ELX 2/1 index,Peak index,and TTP index seem to be unrelated to histology.The best statistical data on USE and CEUS concerned their sensitivity and PPV,respectively.At present,USE and CEUS are too time-consuming and of limited utility in selecting patients for surgery. | Massimo GIUSTI Davide ORLANDI Giulia MELLE Barbara MASSA Enzo SILVESTRI Francesco MINUTO Gianni TURTULICI | 2013 | Journal of Zhejiang University-Science B(Biomedicine & Biotechnology)2013，14，3： | 17 |
| 2 | Institutional experience of PTH evaluation on fine-needle washing after aspiration biopsy to locate hyperfunctioning parathyroid tissue显示文摘Assaying parathyroid hormone(PTH) in the washing liquid after fine-needle aspiration biopsy(FNAB) seems to be a valid approach to locate parathyroid tissue.PTH-FNAB was evaluated in 47 patients with a clinical picture of primary hyper-parathyroidism(PHP) and ultrasonography(US) suggestive of parathyroid lesion.The patients were subdivided into two groups on the basis of the absence or presence of US thyroid alterations.The result of PTH-FNAB was compared with those of cytology,scintigraphy and,in 24 patients,surgical outcome.PTH-FNAB samples with a value higher than that recorded in the serum and higher than our institutional cut-off were deemed to be probable samples of parathyroid tissue.Cytology proved diagnostic for benign thyroid lesions,non-diagnostic for thyroid lesions,hyperplastic parathyroid tissue,undetermined or malignant thyroid lesions and other lesions in 45%,30%,17%,4%,and 4% of cases,respectively.In 47% of cases,PTH-FNAB indicated that the sample had been taken in parathyroid tissue.In patients without US alterations,the diagnostic accuracy of PTH-FNAB was greater than that of scintigraphy.After surgery,comparison between the results of PTH-FNAB and scintigraphy,in terms of positive predictive value(PPV),revealed the superiority of PTH-FNAB;PPV was 94% for FNAB and 71% for scintigraphy,while sensitivity was 83% and 69%,respectively.PTH-FNAB evaluation after FNAB appears to be more diagnostic than cytology and scintigraphy.Of all the procedures used,PTH-FNAB appears to be the method of choice when the target is US suggestive and reachable.PTH-FNAB appears to be a useful method of guiding surgical intervention. | Massimo GIUSTI Mara DOLCINO Lara VERA Carla GHIARA Francesca MASSARO Laura FAZZUOLI Diego FERONE Michele MUSSAP Francesco MINUTO | 2009 | Journal of Zhejiang University-Science B(Biomedicine & Biotechnology)2009，10，5： | 6 |
| 3 | Clinical epidemiology of chronic viral hepatitis B:A Tuscany real-world large-scale cohort study显示文摘AIM To build a regional database of chronic patients to define the clinical epidemiology of hepatitis B virus(HBV)-infected patients in the Tuscan public health care system.METHODS This study used a cross-sectional cohort design. We evaluated chronic viral hepatitis patients with HBV referred to the outpatient services of 16 hospital units. Information in the case report forms included main demographic data, blood chemistry data, viral hepatitis markers, instrumental evaluations, and eligibility for treatment or ongoing therapy and liver transplantation. RESULTS Of 4015 chronic viral hepatitis patients, 1096(27.3%) were HBV infected. The case report form was correctly completed for only 833 patients(64% males, 36% females; mean age 50.1 ± 15.4). Of these HBV-infected patients, 73% were Caucasian, 21% Asian, 4% Central African, 1% North African and 1% American. Stratifying patients by age and nationality, we found that 21.7% of HBV-infected patients were aged < 34 years(only 2.8% were Italian). The most represented routes of transmission were nosocomial/dental procedures(23%), mother-to-child(17%) and sexual transmission(12%). The most represented HBV genotypes were D(72%) and A(14%). Of the patients, 24.7% of patients were HBe Ag positive, and 75.3% were HBe Ag negative. Of the HBV patients 7% were anti-HDV positive. In the whole cohort, 26.9% were cirrhotic(35.8% aged < 45 years), and 47% were eligible for or currently undergoing treatment, of whom 41.9 % were cirrhotic. CONCLUSION Only 27.3% of chronic viral hepatitis patients were HBV infected. Our results provide evidence of HBV infection in people aged < 34 years, especially in the foreign population not protected by vaccination. In our cohort of patients, liver cirrhosis was also found in young adults. | Cristina Stasi Caterina Silvestri Roberto Berni Maurizia Rossana Brunetto Anna Linda Zignego Cristina Orsini Stefano Milani Liana Ricciardi Andrea De Luca Pierluigi Blanc Cesira Nencioni Donatella Aquilini Alessandro Bartoloni Giampaolo Bresci Santino Marchi Franco Filipponi Piero Colombatto Paolo Forte Andrea Galli Sauro Luchi Silvia Chigiotti Alessandro Nerli Giampaolo Corti Rodolfo Sacco Paola Carrai Angelo Ricchiuti Massimo Giusti Paolo Almi Andrea Cozzi Silvia Carloppi Giacomo Laffi Fabio Voller Francesco Cipriani | 2018 | World Journal of Hepatology2018，10，5： | 3 |
| 4 | 甲状腺不确定结节的回顾性细胞学评估研究(英文)显示文摘目的:回顾性分析了130例甲状腺不确定结节的临床评估和预后,以及组织细胞学检测结果,为甲状腺结节的治疗提供合理的治疗方法。方法:根据英国甲状腺协会2014年分类,回顾性分析了2011年1月至2014年12月130例甲状腺不确定结节(Thy 3)的细胞学检查。将结节分为Thy 3a(非典型特征)和Thy 3f(滤泡病变)两类。比较评估术前生物化学检查、彩色多普勒超声检查(US)、半定量弹性超声成像(USE)、超声造影(CEUS)、细胞学、组织学以及分子生物学突变分析等结果。结论:Thy 3结节的恶性肿瘤发生率较低,且在Thy 3a和Thy 3f之间没有显著差异。使用基于组织学的截取值作为参考可以降低采用手术的治疗方案。在阴性突变的Thy 3a和Thy 3f结节中,当不是所有的仪器检测结果都疑是阳性时,组织学观察应该作为首选。 | Massimo GIUSTI Barbara MASSA Margherita BALESTRA Paola CALAMARO Stefano GAY Simone SCHIAFFINO Giovanni TURTULICI Simonetta ZUPO Eleonora MONTI Gianluca ANSALDO | 2017 | Journal of Zhejiang University-Science B(Biomedicine & Biotechnology)2017，18，7： | 1 |
| 5 | Five-year longitudinal evaluation of quality of life in a cohort of patients with differentiated thyroid carcinoma显示文摘Differentiated thyroid carcinoma(DTC) generally has a favorable outcome.Thyroid disease,treatments,stress,and comorbidity can compromise health-related quality of life(QoL) and indirectly weigh upon the outcome. From 2004 to 2008,we evaluated QoL longitudinally in 128 DTC subjects.During scheduled examinations,subjects were asked to undergo a semi-structured psychiatric interview and five rated inventories.The same examination was conducted in 219 subjects after surgery for benign thyroid pathology.Low scores represent a better QoL.DTC and control subjects were similar in terms of age,male/female ratio,concomitant psychopharmacological treatments,and frequency of psychiatric diseases.In DTC subjects,Billewicz scale(BS) scores showed an increasing trend over time,especially among females.The ad hoc thyroid questionnaire(TQ) scores were similar in both groups and did not change over time,but at the end of the study ad hoc TQ and BS were significantly related.Ad hoc TQ scores were also related to age on entry to the study.In both male and female DTC subjects,Hamilton's tests for anxiety(HAM-A) ,but not for depression(HAM-D),showed an improving trend.At the end of the study,HAM-A and HAM-D scores were comparable to those of the control group.HAM-A and HAM-D were both positively correlated with the stage of cancer and the time between diagnosis and treatment.Only HAM-D correlated with age on entry to the study.Kellner symptom questionnaire(KSQ) item scores were higher in DTC subjects than in controls.The change over time in the items including anxiety,somatization,depression,and hostility was significant.Somatization and hostility were more significantly reduced in DTC females than in DTC males.Hostility scores were significantly lower in DTC subjects than in controls at the end of the study.Somatization and depression were significantly related to staging on diagnosis and age on entry to the study.Our study confirms a wide variation of illness perception in DTC subjects,which is generally unrelated to the favorable clinical follow-up of the disease.Psychological evaluation during long-term follow-up im-proved QoL scores,which reached the same levels noted in subjects with a history of thyroid surgery for benign thyroid pathology.Our data indicate that special attention should be paid to QoL in older DTC subjects and those with more severe staging on diagnosis. | Massimo GIUSTI Giulia MELLE Monica FENOCCHIO Lorenzo MORTARA Francesca CECOLI Valeria CAORSI Diego FERONE Francesco MINUTO Elda RASORE | 2011 | Journal of Zhejiang University-Science B(Biomedicine & Biotechnology)2011，12，3： | 1 |
| 6 | Institutional experience of PTH evaluation on fine-needle washing after aspiration biopsy to locate hyperfunctioning parathyroid tissue显示文摘 | Massimo Giusti Mara Dolcino Lara Vera Carla Ghiara Francesca Massaro Laura Fazzuoli Diego Ferone Michele Mussap Francesco Minuto | 2009 | Journal of Zhejiang University SCIENCE B2009，，5： | 1 |
您所在的机构暂未开通此部分的功能，请联系管理员