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Unusual recurrence of colon cancer with isolated axillary lymph node metastasis:A case report 认领 引用
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作者 Ali Toffaha Mahmood Al-Dhaheri +5 位作者 Mohammad AL.Zoubi Arwa Abdelrahim Mahir Petkar Ahmed Badr Mohamed Abunada Ayman Ahmed 《Laparoscopic, Endoscopic and Robotic Surgery》 2026年第1期58-61,共4页
The metastatic pattern of colon cancer is typically well characterized,with initial dissemination occurring through regional lymphatics,followed by hematogenous spread.The most frequent sites of metastasis in colorect... The metastatic pattern of colon cancer is typically well characterized,with initial dissemination occurring through regional lymphatics,followed by hematogenous spread.The most frequent sites of metastasis in colorectal cancer(CRC)include regional lymph nodes(50%–70%),liver(35%–50%),lungs(21%),peritoneum(15%),and ovaries(13%).1 Isolated distant lymph node metastasis,particularly in the absence of concurrent systemic disease,is exceedingly rare in CRC.To date,only six cases of isolated axillary lymph node metastasis(ALNM)from colorectal primaries have been documented in the literature.1–6 Even more uncommon is the incidental discovery of malignant cells in anastomotic doughnuts following stoma reversal procedures.Herein,we report a rare case involving both the incidental histopathological detection of tumor cells within doughnuts during stoma closure and the subsequent development of isolated ALNM after curative resection of sigmoid colon carcinoma. 展开更多
关键词 axillary lymph node hematogenous spreadthe axillary lymph node metastasis distant lymph node metastasisparticularly colon cancer regional lymph nodes liver lungs peritoneum colorectal cancer crc include regional lymphaticsfollowed
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Rethinking false-negative rate of sentinel node navigation surgery after non-curative endoscopic submucosal dissection:Insights from SENORITA 2 trial 认领 引用
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作者 Zimeng Wang Zhi Zheng +5 位作者 Jie Yin Guangyong Chen Jun Zhang Peng Li Zhongtao Zhang Shutian Zhang 《Chinese Journal of Cancer Research》 SCIE CAS CSCD 2026年第3期343-346,共4页
We read with great interest the Commentary written by Prof.Eom and Prof.Ryu entitled:“Is sentinel node navigation surgery feasible after non-curative endoscopic resection in patients with early gastric cancer?”.The ... We read with great interest the Commentary written by Prof.Eom and Prof.Ryu entitled:“Is sentinel node navigation surgery feasible after non-curative endoscopic resection in patients with early gastric cancer?”.The authors acknowledge that the“Expert consensus on multidisciplinary management of laparoscopic-endoscopic cooperative surgery combined with sentinel lymph node navigation surgery for early gastric cancer(2026 edition)”represents a meaningful advance in clinical applicability and critically appraises consensus 4,which addresses the role of sentinel node navigation surgery(SNNS)following non-curative endoscopic submucosal dissection(ESD)(1). 展开更多
关键词 sentinel lymph node navigation surgery gastric cancer non curative endoscopic submucosal dissection false negative rate sentinel node navigation surgery Senorita trial early gastric cancer
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Is sentinel node navigation surgery feasible after non-curative endoscopic resection in patients with early gastric cancer? 认领 引用
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作者 Bang Wool Eom Woo Jun Ahn +2 位作者 Hong Man Yoon Young Woo Kim Keun Won Ryu 《Chinese Journal of Cancer Research》 SCIE CAS CSCD 2026年第3期340-342,共3页
An interesting paper reporting the Chinese expert consensus for sentinel node navigation surgery(SNNS)was recently published in Chinese Journal of Cancer Research(CJCR)(1).Along with the increasing proportion of indiv... An interesting paper reporting the Chinese expert consensus for sentinel node navigation surgery(SNNS)was recently published in Chinese Journal of Cancer Research(CJCR)(1).Along with the increasing proportion of individuals with early gastric cancer(EGC),clinical interest in minimally invasive function-preserving surgeries such as SNNS,pylorus-preserving and proximal gastrectomy has gradually increased in East Asia(2).However SNNS remains controversial in clinical practice due to the limited evidence and ongoing debate regarding standardized protocols comparing pylorus-preserving and proximal gastrectomy(3).In this context,a Chinese expert consensus for SNNS is meaningful for the advancement of clinical applicability. 展开更多
关键词 Sentinel node navigation surgery Pylorus preserving gastrectomy Proximal gastrectomy sentinel node navigation surgery snns Early gastric cancer Minimally invasive surgery Chinese expert consensus
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Which lymph node dissection should be performed in advanced distal gastric cancer?A critical assessment of D2 lymphadenectomy 认领 引用
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作者 Giuseppe Brisinda Maria Michela Chiarello +6 位作者 Filomena Misuriello Maria Cariati Giuseppe Tropeano Edoardo Piras Gaia Altieri Giada Bracalente Valerio Papa 《World Journal of Gastrointestinal Surgery》 SCIE 2026年第3期9-23,共15页
Lymph node invasion stands out as the most critical prognostic factor in gastric cancer.The extent of lymph node dissection required during curative gastric cancer surgery has long been debated.Japanese Gastric Cancer... Lymph node invasion stands out as the most critical prognostic factor in gastric cancer.The extent of lymph node dissection required during curative gastric cancer surgery has long been debated.Japanese Gastric Cancer Association was the first to define a classification system for regional gastric lymph node stations,numbering them from No.1 to No.16.This classification was later used to differentiate between different types of lymph node dissection,such as D1,D2 and D3.However,these definitions were often considered too complex to be universally adopted,resulting in wide variations of recommendations from one country to another and making it difficult to compare published studies.Moreover,the optimal extent of lymph node dissection remains uncertain,as the extensive dissections that where initially recommended are associated with significant morbidity without a clear survival benefit.Though gastrectomy with extended D2 lymphadenectomy is classified as a non-standard gastrectomy,its clinical significance has been evaluated in many studies.D2 plus superior mesenteric vein lymph node(No.14v)dissection is recommended when metastasis to No.6 nodes is suspected in the lower stomach,and D2 plus posterior surface of the pancreatic head(No.13)lymph node dissection may be an option in potentially curative gastrectomy for cancer invading the duodenum.No.14v lymph node dissection has been shown to improve overall survival in patients with distal gastric cancer,primarily in patients with clinical stage Ⅲ/Ⅳ distal gastric cancer.Furthermore,D2 plus lymphadenectomy showed a significantly higher 5-year overall survival rate(55.3%vs 43.9%)and a lower recurrence rate(51.5%vs 69.5%)then D2 standard dissection.The quality of lymphadenectomy may influence prognosis in gastric cancer patients.Both hospital volume and surgeon volume were important factors for the quality of radical gastrectomy.The purpose of this review is to support the extension of lymph node dissection based on the existing literature,including a comprehensive review of current definitions of lymphadenectomy.An outcome analysis is performed to assess the need for lymphadenectomy with removal of lymph nodes not included in the standard D2 lymphadenectomy in patients with distal gastric cancer,especially if the tumor is advanced. 展开更多
关键词 Gastric cancer Lymph node dissection Lymph nodes metastases Guidelines Surgery
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Identification of the lymph node metastasis atlas and optimal lymph node dissection strategy in patients with resectable lung invasive mucinous adenocarcinoma:a real-world multicenter study 认领 引用 被引量：3
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作者 Chao Zheng Guo-Chao Zhang +19 位作者 Long Zhang Yu-Zhuo Zhang Jia Jia Shun Xu Wen-Yue Zhao Yang Liu Meng Yue Yue-Ping Liu Shuang-Ping Zhang Yi Shen Qi-Yue Ge Yu-Ning Han Jing Li Hong-Jiang Yan Li-Yan Xue Yu-Shun Gao Feng-Wei Tan Shu-Geng Gao Qi Xue Jie He 《Military Medical Research》 SCIE CAS CSCD 2026年第5期689-705,共17页
Background:Lung invasive mucinous adenocarcinoma(LIMA)is a rare,unique,and heterogeneous subtype of lung cancer whose patterns of lymph node(LN)metastasis are unknown,and a consensus on LN dissection(LND)has not been ... Background:Lung invasive mucinous adenocarcinoma(LIMA)is a rare,unique,and heterogeneous subtype of lung cancer whose patterns of lymph node(LN)metastasis are unknown,and a consensus on LN dissection(LND)has not been reached.This study aimed to evaluate LN metastasis patterns in LIMAs and establish optimal LND strategies.Methods:Data about 19,596 LNs from 1474 LIMA patients collected between January 2010 and December 2021 at 8 lung cancer research centers and tertiary hospitals across China,and data from 5304 LIMA patients between 2004 and 2021 in the SEER database were analysed.Metastasis probabilities were calculated for each LN station to construct a metastasis atlas.Statistical methods,including LOWESS fitting,restricted cubic spline,Kaplan-Meier,and logistic regression analyses,were employed to identify optimal LND strategies.Results:Compared with non-mucinous adenocarcinoma patients,LIMA patients exhibited distinct clinicopathological features and a significantly lower probability of LN metastasis(4.20%vs.7.19%,P0.5)risk patients were 7,14,and 17,respectively.For those with uncertain metastatic risk,dissecting 18 LNs may be the most appropriate and robust strategy.Conclusions:This study systematically revealed the pattern of LIMA-specific LN metastasis and proposed a risk-stratified LND strategy.These recommendations balance the imperatives of accurate staging with the preservation of long-term patient prognosis,offering a practical guideline for surgical decision-making. 展开更多
关键词 Lung invasive mucinous adenocarcinoma(LIMA) Lymph node dissection(LND) Metastasis atlas N-staging Prognosis
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Expert consensus on multidisciplinary management of laparoscopic-endoscopic cooperative surgery combined with sentinel lymph node navigation surgery for early gastric cancer(2026 edition) 认领 引用 被引量：2
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作者 Zhi Zheng Yu Zhao +15 位作者 Rui Xu Zimeng Wang Jie Yin Fandong Meng Kuiliang Liu Guangyong Chen Jun Zhang Peng Li Lin Chen Zhongtao Zhang Shutian Zhang National Clinical Research Center for Digestive Diseases National Key Laboratory of Digestive Health Digestive Endoscopy Branch of Chinese Medical Association Gastroenterologist and Hepatologist Branch of Chinese Medical Doctor Association Chinese Gastric Cancer Association of China Anti-Cancer Association 《Chinese Journal of Cancer Research》 SCIE CAS CSCD 2026年第1期1-26,共26页
With the advancement of surgical techniques and enhanced management of early gastric cancer(EGC),minimally invasive function-preserving surgical approaches have emerged as a common goal for patients and clinicians.Lap... With the advancement of surgical techniques and enhanced management of early gastric cancer(EGC),minimally invasive function-preserving surgical approaches have emerged as a common goal for patients and clinicians.Laparoscopic-endoscopic cooperative surgery combined with sentinel lymph node navigation surgery(LECSSNNS)has drawn increasing interest because of its dual benefits of minimal invasiveness and organ function preservation.However,robust evidence-based support for guiding clinical implementation remains limited.To address this gap,we systematically evaluated available studies on the clinical application of LECS-SNNS in EGC and integrated expert insights to formulate 20 recommendations.These included preoperative assessment,surgical techniques,intraoperative endoscopic procedures,pathological evaluation,postoperative care,and follow-up.This consensus aimed to provide comprehensive guidance for the standardized application of LECS-SNNS,thereby advancing precise,minimally invasive,and function-preserving treatment for EGC. 展开更多
关键词 Sentinel lymph node laparoscopic-endoscopic cooperative surgery navigation surgery early gastric cancer multidisciplinary diagnosis and treatment consensus
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PSMA PET/CT-guided pelvic lymph node dissection in patients with unfavorable intermediate-or high-risk prostate cancer 认领 引用
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作者 Eva Donck Sofie Verbeke +4 位作者 Pieter De Visschere Valérie Fonteyne Charles Van Praet Kathia De Man Nicolaas Lumen 《The Canadian Journal of Urology》 SCIE 2026年第1期83-92,共10页
Objectives:PSMA PET/CT(Prostate-Specific MembraneAntigen Positron Emission Tomography/Computed Tomography)offers improved accuracy in detecting lymph node invasion(LNI)in prostate cancer(PC)patients,potentially reduci... Objectives:PSMA PET/CT(Prostate-Specific MembraneAntigen Positron Emission Tomography/Computed Tomography)offers improved accuracy in detecting lymph node invasion(LNI)in prostate cancer(PC)patients,potentially reducing the need for extended pelvic lymph node dissection(ePLND).This study aims to evaluate a patient-tailored care pathway in which ePLND is performed only in patients with unfavorable intermediate-or high-risk PC who are deemed at risk for LNI based on PSMA PET/CT findings.Methods:In this interventional cohort study,81 patients were managed according to the new care pathway.ePLND was omitted in cases of negative PSMA PET/CT findings(N0M0),while those with positive PSMA PET/CT findings(N1M0)underwent ePLND.A comparator group of 81 patients was selected from a prospectively generated database for comparison.Results:The intervention group experienced a 75% reduction in the number of ePLNDs performed compared to the comparator group(p<0.001).ePLND-related complications were significantly lower in the intervention group(p=0.008).No significant difference was observed in 3-year biochemical-recurrence free survival(BRFS)between the two groups(p=0.958).Conclusion:Omitting ePLND in patients with negative PSMA PET/CT findings(N0M0)leads to a substantial reduction in the number of ePLNDs performed,resulting in a decrease in morbidity,without compromising early oncological outcomes. 展开更多
关键词 prostate cancer PSMA PET/CT radical prostatectomy pelvic lymph node dissection lymph node invasion staging
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A node importance prediction algorithm based on graph attention and contrastive learning 认领 引用
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作者 Jun Ai Yuming Zhang +2 位作者 Zhan Su Chenye Guo Mingsong Li 《Chinese Physics B》 SCIE EI CAS CSCD 2026年第5期671-684,共14页
In complex network analysis,node ranking is vital for propagation prediction,structural optimization,and intervention strategy design,yet existing methods often fail to effectively integrate community information in d... In complex network analysis,node ranking is vital for propagation prediction,structural optimization,and intervention strategy design,yet existing methods often fail to effectively integrate community information in dynamic settings.To address this,this paper proposes a node ranking method that combines graph attention mechanisms with contrastive learning.Community detection is employed to extract node-level community features,and a joint embedding module is designed to fuse global and local structures,thereby incorporating community information into node representations.Based on this,a multi-layer graph attention network adaptively learns node and neighborhood features,while contrastive learning mitigates interference from dynamic evolution and strengthens the model's ability to capture multi-scale structural differences.Experiments on multiple dynamic network datasets show that the proposed method significantly outperforms existing approaches in ranking accuracy,particularly in networks with higher average degrees and clearer community structures.These results validate the effectiveness of the method in enhancing feature representation and modeling multi-scale dynamic node influence. 展开更多
关键词 node importance community features graph attention contrastive learning
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A lymph node-targeted cell-nanoadjuvant conjugate enhances dendritic cell-T cell crosstalk for cancer immunotherapy 认领 引用
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作者 Shuangshuang Hu Wenzhe Yi +6 位作者 Zhiwen Zhao Xindi Qian Linyang Jiang Ying Cao Dan Yan Lesheng Teng Yaping Li 《Acta Pharmaceutica Sinica B》 SCIE CAS CSCD 2026年第6期3876-3891,共16页
Dendritic cell(DC)vaccines represent a promising immunotherapeutic strategy by eliciting potent anti-tumor immunity.However,their clinical application remains limited due to poor lymph node(LN)targeting and inadequate... Dendritic cell(DC)vaccines represent a promising immunotherapeutic strategy by eliciting potent anti-tumor immunity.However,their clinical application remains limited due to poor lymph node(LN)targeting and inadequate T cell activation.Here,we developed an LN-targeted cell-nanoadjuvant conjugate by click-chemistry conjugation of anti-PD-1 antibodies(αPD-1)and Resiquimod(R848)liposomes to DC vaccines(DCVs)(DCV-αPD-1/Lipo)to enhance DC-T cell crosstalk for cancer immunotherapy.DCV-αPD-1/Lipo maintains higher co-stimulatory molecule expression and antigen presentation with enhanced LN targeting efficiency than conventional DC vaccines.The surface-conjugatedαPD-1 increases DC-T cell adhesion by 4.97-fold while amplifying the IFN-γ/IL-12 positive feedback loop,thereby potentiating T cell activity and augmenting effector T cells and other immune cells mediated anti-tumor efficacy.This multifunctional integration of adaptive DC therapy,nanoadjuvants and checkpoint blockade establishes an effective approach for next-generation DC therapy. 展开更多
关键词 Dendritic cell Nanoadjuvant R848 αPD-1 Lymph node T cell DC-T crosstalk Immunotherapy
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Numerical calculation method of virtual nodes in complex structural composites: mechanical properties characterization and numerical simulation of combined Wbraid/Al/Epoxy functional structural materials 认领 引用
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作者 Zhenhui He Enling Tang +3 位作者 Zhe Zhai Wenjin Yao Ruizhi Wang Yafei Han 《Defence Technology（防务技术）》 SCIE EI CAS CSCD 2026年第3期149-165,共17页
Existing numerical methods for complex composites, such as multiscale simulation and neural network algorithms, face significant limitations. Multiscale techniques are often prohibitively expensive for large models, w... Existing numerical methods for complex composites, such as multiscale simulation and neural network algorithms, face significant limitations. Multiscale techniques are often prohibitively expensive for large models, while neural networks struggle to represent underlying microscopic material properties. To overcome these challenges, a meso-micro scale numerical method using a virtual node approach is developed in this study. A Wbraid/Al/Epoxy functional structural material is fabricated, and a representative periodic unit cell is identified based on its architecture. The complex structure is then discretized into nodes, and mechanical interactions are governed by pre-defined computation rules. This virtual node method is systematically compared against both multiscale simulation and a neural network algorithm, with validation provided through mechanical experiments. The results demonstrate that the nodal operation strategy significantly reduces computational resource requirements. By quantifying microscopic bonding with coefficients, explicit interface treatment is avoided, granting the method strong adaptability to lattice materials. The method can simulate extremely complex structures using parameters from simple tests and is suited for large systems. Compared to three-point bending experiments, errors for multiscale, virtual node, and neural network methods were 12.4%, 6.9%, and 34.5%, respectively. Under dynamic compression, the errors were 2.7%, 9.3%, and 15.43%. The virtual node method demonstrated superior accuracy under static conditions, enabling efficient prediction and auxiliary development of complex structural materials. 展开更多
关键词 Functional composites Complex structure Meso-micro scale Virtual node calculation method Numerical simulation
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Robot-assisted post-chemotherapy retroperitoneal lymph node dissection for metastatic non-seminomatous germ cell tumors using two distinct surgical approaches:A tertiary care experience 认领 引用
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作者 Xiangdong Li Wilhem M.S.Teixeira +5 位作者 Renjie Ding Shengjie Guo Hui Han Kai Yao Fangjian Zhou Zhuowei Liu 《Asian Journal of Urology》 CAS CSCD 2026年第1期107-115,共9页
Objective:Robot-assisted post-chemotherapy retroperitoneal lymph node dissection(R-PC-RPLND)is increasingly used as an alternative to open surgery for metastatic testicular cancer.This study aimed to summarize the exp... Objective:Robot-assisted post-chemotherapy retroperitoneal lymph node dissection(R-PC-RPLND)is increasingly used as an alternative to open surgery for metastatic testicular cancer.This study aimed to summarize the experience with lateral and supine approaches in R-PC-RPLND for metastatic non-seminomatous germ cell tumors,applied based on different clinical indications.Methods:We conducted a retrospective analysis of 42 consecutive patients who underwent R-PC-RPLND at our tertiary cancer center from May 2016 to July 2023.Patients were categorized based on the surgical approach used:lateral position(28 patients)or supine position(14 patients).Data on perioperative outcomes,complications,and oncological efficacy were assessed and reported using descriptive statistics.Results:The median patient age was 28.0(interquartile range[IQR]:23.5-30.5)years,and the median body mass index was 22.7(IQR:19.9-24.2)kg/m2.The median operative time was 167.5(IQR:135.0-216.0)min,and the median estimated blood loss was 100.0(IQR:50.0-200.0)mL.Vascular injuries occurred in 4.8% of the cases,with no conversions to open surgery required.Postoperative complications were observed in 14% of the patients,all classified as ClavieneDindo grades IeII.Histopathological examination revealed necrosis or fibrosis in 43% of the cases,teratoma in 31%,and viable germ cell tumor in 26%.During a median follow-up of 22.0(IQR:16.0-30.5)months,17% of the patients experienced relapse,with a median time to relapse of 5.0(IQR:4.0-7.0)months.Conclusion:Both lateral and supine approaches for R-PC-RPLND demonstrated favorable surgical and oncological outcomes,with acceptable operative times,minimal blood loss,low complication rates,and effective oncological control.The choice between these approaches should consider patient-specific factors and surgeon expertise,allowing for tailored treatment that optimizes outcomes. 展开更多
关键词 Testicular cancer Robotic surgery Post-chemotherapy retroperitoneal lymph node dissection Surgical approach
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Virtual histology imaging of lymph nodes via dynamic full-field optical coherence tomography and deep learning to differentiate metastasis 认领 引用
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作者 Shuwei Zhang Houpu Yang +8 位作者 Yiyin Zhang Xiaoxian Li Jin Zhao Yuanyuan Zhang Ping Xue Hua Kang Hongchuan Jiang Wenhui Ren Shu Wang 《Cancer Biology & Medicine》 SCIE CAS CSCD 2026年第3期418-429,共12页
Objective:The current pathological diagnosis of lymph node metastasis is time-consuming,labor-intensive,and dependent on sectioning of paraffin blocks.Herein,in a prospective cohort of patients with breast cancer,we v... Objective:The current pathological diagnosis of lymph node metastasis is time-consuming,labor-intensive,and dependent on sectioning of paraffin blocks.Herein,in a prospective cohort of patients with breast cancer,we validated dynamic full-field optical coherence tomography(D-FFOCT),a virtual pathology tool integrating deep learning for nodal metastasis detection,and offering rapid and label-free histologic approximations of fresh tissues.Methods:In a prospective dual-center cohort of 155 patients with breast cancer,747 freshly bisected lymph node slides were obtained via D-FFOCT.Surgeons interpreted each slide with histopathology as the gold standard.A deep learning model was trained on 28,911 patches(corresponding to 590 slides)and tested on 7,736 patches(corresponding to 157 slides).The results were mapped to the slide level for potential intraoperative evaluation.Results:D-FFOCT strongly correlated with hematoxylin and eosin(H&E)-stained histological images.Surgeons achieved 97.10%specificity in nodal diagnosis with D-FFOCT.The performance of the artificial intelligence(AI)model was not inferior to that of human experts and had a sensitivity/specificity of 87.88%/91.94%and an area under the receiver operating characteristic curve of 0.899 at the slide level.The human–AI collaborative system reduced labor requirements by 75%and increased the specificity by 6.5%,to 98.39%.Conclusions:D-FFOCT has excellent potential as a tool for assessing lymph node metastatic status without tissue preparation or consumption.The integration of D-FFOCT with deep learning decreases labor demands and maintains high accuracy,thereby enabling streamlined nodal prediction independent of routine pathology procedures. 展开更多
关键词 Breast cancer dynamic full field optical coherence tomography lymph nodes AI model metastatic status
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Predicting lymph node metastasis in colorectal cancer using caselevel multiple instance learning 认领 引用
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作者 Ling-Feng Zou Xuan-Bing Wang +4 位作者 Jing-Wen Li Xin Ouyang Yi-Ying Luo Yan Luo Cheng-Long Wang 《World Journal of Gastroenterology》 SCIE CAS 2026年第1期110-125,共16页
BACKGROUND The accurate prediction of lymph node metastasis(LNM)is crucial for managing locally advanced(T3/T4)colorectal cancer(CRC).However,both traditional histopathology and standard slide-level deep learning ofte... BACKGROUND The accurate prediction of lymph node metastasis(LNM)is crucial for managing locally advanced(T3/T4)colorectal cancer(CRC).However,both traditional histopathology and standard slide-level deep learning often fail to capture the sparse and diagnostically critical features of metastatic potential.AIM To develop and validate a case-level multiple-instance learning(MIL)framework mimicking a pathologist's comprehensive review and improve T3/T4 CRC LNM prediction.METHODS The whole-slide images of 130 patients with T3/T4 CRC were retrospectively collected.A case-level MIL framework utilising the CONCH v1.5 and UNI2-h deep learning models was trained on features from all haematoxylin and eosinstained primary tumour slides for each patient.These pathological features were subsequently integrated with clinical data,and model performance was evaluated using the area under the curve(AUC).RESULTS The case-level framework demonstrated superior LNM prediction over slide-level training,with the CONCH v1.5 model achieving a mean AUC(±SD)of 0.899±0.033 vs 0.814±0.083,respectively.Integrating pathology features with clinical data further enhanced performance,yielding a top model with a mean AUC of 0.904±0.047,in sharp contrast to a clinical-only model(mean AUC 0.584±0.084).Crucially,a pathologist’s review confirmed that the model-identified high-attention regions correspond to known high-risk histopathological features.CONCLUSION A case-level MIL framework provides a superior approach for predicting LNM in advanced CRC.This method shows promise for risk stratification and therapy decisions,requiring further validation. 展开更多
关键词 Colorectal cancer Lymph node metastasis Deep learning Multiple instance learning Histopathology
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Lymph node regression grade as a prognostic marker in rectal cancer after neoadjuvant therapy and radical resection 认领 引用
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作者 Yun-Jie Shi Pan-Pan Duan +5 位作者 Qian-Qian Liu Hong-Yan Ru Ya-Jun Huang Wen Xia Ling Chen Xu Li 《World Journal of Gastroenterology》 SCIE CAS 2026年第15期61-72,共12页
BACKGROUND Neoadjuvant chemoradiotherapy(nCRT)followed by radical resection is the standard for locally advanced rectal cancer(LARC).The tumor regression grade(TRG)of the primary tumor is a known prognostic marker,but... BACKGROUND Neoadjuvant chemoradiotherapy(nCRT)followed by radical resection is the standard for locally advanced rectal cancer(LARC).The tumor regression grade(TRG)of the primary tumor is a known prognostic marker,but its value may be limited by lymph node(LN)status.Assessment of treatment response in LNs is not standardized.AIM To determine the prognostic significance of both primary TRG and a novel LN regression grade(LRG)in patients with LARC after nCRT and surgery.METHODS The study cohort included patients with LARC who received nCRT and subsequent radical resection from January 2022 to March 2025.The impacts of TRG and LRG scores were assessed.RESULTS During the study period,155 patients underwent long-course nCRT followed by radical rectal resection.Overall,51(32.9%)patients developed recurrence,and 34(21.9%)patients died over the follow-up period.The 5-year overall survival(OS)was 66.1%,and the 5-year disease-free survival(DFS)was 59.5%.With all patients taken into consideration,TRG had no significant correlation with OS(P=0.11)and DFS(P=0.18).Conversely,TRG was significantly associated with DFS(P=0.01)in the 92 patients with ypN0.After excluding patients without LN metastasis,LRG was significantly associated with OS(P=0.001)and DFS(P=0.04).Furthermore,LRG was an independent predictor for mortality(hazard ratio=1.533,P=0.0002)and recurrence(hazard ratio=1.278,P=0.01).CONCLUSION Among patients with advanced rectal cancer after nCRT,TRG emerged as a predictive factor solely limited to patients with ypN0.In patients with LN metastasis,LRG could have independent prognostic significance. 展开更多
关键词 Rectal cancer Lymph node regression grade Tumor regression grade Neoadjuvant chemoradiotherapy Prognostic marker
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Performance Evaluation of Malicious Node Detection and Mitigation of IoT-Based Trust Model for Wireless Sensor Network 认领 引用
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作者 Anil Kumar Abhay Bhatia +3 位作者 Amit Singh Preeti Rani Vincent Omollo Nyangaresi Mahendihasan S.Heera 《Computers, Materials & Continua》 SCIE EI 2026年第7期1921-1947,共27页
The Internet of Things(IoT)enables seamless real-time monitoring and data exchange across distributed and heterogeneous environments with wireless sensor networks(WSNs).The open architecture and resource constraints o... The Internet of Things(IoT)enables seamless real-time monitoring and data exchange across distributed and heterogeneous environments with wireless sensor networks(WSNs).The open architecture and resource constraints of wireless sensor networks(WSNs)make them highly vulnerable to internal security threats caused by malicious or compromised nodes,particularly in Internet of Things(IoT)environments.To address this issue,we proposed Dynamic Trust Evaluation Model(DTEM),designed to provide a secure,scalable,and efficient framework for IoT-based WSNs.The proposed model identifies the role of trust management in routing,data aggregation,and intrusion detection,including trust-based protocols.DTEM incorporates a lightweight elliptic curve cryptography(ECC)mechanism to ensure secure communication,protect trust information from manipulation,and enhance overall system reliability.In addition,machine learning techniques are employed to improve malicious node classification accuracy.Component-wise analysis demonstrates that the dynamic trust evaluation forms the core detection mechanism,while ECC enhances communication security and machine learning improves malicious node classification accuracy.A large-scale network simulation is conducted to evaluate DTEM’s performance under various attack scenarios.Results demonstrate improved malicious node detection accuracy,higher packet delivery ratios,reduced energy consumption,and lower communication overheads.The proposed DTEM framework proves to be a robust and scalable solution for securing IoT-based wireless sensor networks,making it suitable for real-world applications. 展开更多
关键词 Internet of Things node detection security threats security and protocols wireless sensor network
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Combined multidetector computed tomography and gastrointestinal endoscopy for gastric cancer screening,preoperative staging,and lymph node metastasis detection 认领 引用
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作者 Le-Ping Ye Yan-Ping Zhang +4 位作者 Gang Chen Yi-Xian Wu Cheng-Long He Dong Wang Qiao Mei 《World Journal of Gastrointestinal Oncology》 SCIE 2026年第1期200-210,共11页
BACKGROUND Early screening,preoperative staging,and diagnosis of lymph node metastasis are crucial for improving the prognosis of gastric cancer(GC).AIM To evaluate the diagnostic value of combined multidetector compu... BACKGROUND Early screening,preoperative staging,and diagnosis of lymph node metastasis are crucial for improving the prognosis of gastric cancer(GC).AIM To evaluate the diagnostic value of combined multidetector computed tomography(MDCT)and gastrointestinal endoscopy for GC screening,preoperative staging,and lymph node metastasis detection,thereby providing a reference for clinical diagnosis and treatment.METHODS In this retrospective study clinical and imaging data of 134 patients with suspected GC who were admitted between January 2023 and October 2024 were initially reviewed.According to the inclusion and exclusion criteria,102 patients were finally enrolled in the analysis.All enrolled patients had undergone both MDCT and gastrointestinal endoscopy examinations prior to surgical intervention.Preoperative clinical staging and lymph node metastasis findings were compared with pathological results.RESULTS The combined use of MDCT and gastrointestinal endoscopy demonstrated a sensitivity of 98.53%,specificity of 97.06%,accuracy of 98.04%,positive predictive value of 98.53%,and negative predictive value of 97.06%for diagnosing GC.These factors were all significantly higher than those of MDCT or endoscopy alone(P<0.05).The accuracy rates of the combined approach for detecting clinical T and N stages were 97.06%and 92.65%,respectively,outperforming MDCT alone(86.76%and 79.41%)and endoscopy alone(85.29%and 70.59%)(P<0.05).Among 68 patients with confirmed GC,50(73.53%)were pathologically diagnosed with lymph node metastasis.The accuracy for detecting lymph node metastasis was 66.00%with endoscopy,76.00%with MDCT,and 92.00%with the combined approach,all with statistically significant differences(P<0.05).CONCLUSION The combined application of MDCT and gastrointestinal endoscopy enhanced diagnostic accuracy for GC,provided greater consistency in preoperative staging,and improved the detection of lymph node metastasis,thereby demonstrating significant clinical utility. 展开更多
关键词 Multidetector computed tomography Gastrointestinal endoscopy Gastric cancer Preoperative staging Lymph node metastasis
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Pulmonary sclerosing pneumocytoma with lymph node metastasis and high 18FDG uptake in PET/CT:a rare case report and literature review 认领 引用
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作者 Jingfeng XU Yilei ZHAO +1 位作者 Qiuli WU Feng CHEN 《Journal of Zhejiang University-SCIENCE B》 SCIE CAS CSCD 2026年第2期202-206,共5页
Pulmonary sclerosing pneumocytoma(PSP)was first reported by Liebow and Hubbell(1956).It was initially called pulmonary sclerosing hemangioma(PSH)because it was thought to be derived from endothelial cells with rich va... Pulmonary sclerosing pneumocytoma(PSP)was first reported by Liebow and Hubbell(1956).It was initially called pulmonary sclerosing hemangioma(PSH)because it was thought to be derived from endothelial cells with rich vascularity.However,the 2015 World Health Organization Classification of Lung Tumors removed the term"sclerosing hemangioma,1 since these tumors lack vascular origin(Travis et al.2015),and the renamed tumor was considered a rare and benign lung tumor.However,several reports have described PSP with lymph node metastasis(Soo et al.,2017).Thus,PSP is not always benign and has the potential to metastasize. 展开更多
关键词 literature review endothelial cells pulmonary sclerosing pneumocytoma psp lymph node metastasis pulmonary sclerosing pneumocytoma pulmonary sclerosing hemangioma psh F DG uptake PET CT
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基于改进Node2Vec图神经网络的轴承故障诊断 认领 引用
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作者 谢七月 蒋朝洋 +3 位作者 宋蕾 周育才 付强 王晓丽 《噪声与振动控制》 CSCD 北大核心 2026年第3期90-96,169,共7页
针对传统滚动轴承故障诊断方法复杂、准确率不高且抗噪能力不足的问题,提出一种基于改进图嵌入的图神经网络轴承故障诊断方法。该方法通过对Node2Vec算法进行改进,在对节点邻居点进行随机游走时,加入基于邻居点在图中的权重信息的游走策... 针对传统滚动轴承故障诊断方法复杂、准确率不高且抗噪能力不足的问题,提出一种基于改进图嵌入的图神经网络轴承故障诊断方法。该方法通过对Node2Vec算法进行改进,在对节点邻居点进行随机游走时,加入基于邻居点在图中的权重信息的游走策略,使得模型能够更有针对性捕捉节点关系信息,有效避免传统的图嵌入没有充分考虑边缘交互信息的问题。同时引入对偶图的概念,通过对偶图的构建和数据嵌入,进一步挖掘数据中的信息。实验结果表明,所提出的方法对于凯斯西储大学轴承数据集在无噪声,以及噪声为-5、-10 dB的环境条件下均有较高的诊断准确率;并基于PT500 mini轴承故障试验台进行验证,实验准确率为97.5%,展现了该方法在不同工况下和不同工业环境中的实际应用潜力。 展开更多
关键词 故障诊断 滚动轴承故障 Node2Vec算法 对偶图 图神经网络
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Computed tomography with carcinoembryonic antigen and carbohydrate antigen 19-9 in diagnosing lymph node metastasis of early gastric cancer 认领 引用
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作者 Hong-Zhi Chen Ping Zhang Jun Ma 《World Journal of Gastrointestinal Oncology》 SCIE 2026年第2期112-121,共10页
BACKGROUND Gastric cancer(GC)is the fifth most prevalent and fourth most lethal malignancy globally.China bears a disproportionately high burden,accounting for 44.0%of new cases and 48.6%of deaths worldwide.In early G... BACKGROUND Gastric cancer(GC)is the fifth most prevalent and fourth most lethal malignancy globally.China bears a disproportionately high burden,accounting for 44.0%of new cases and 48.6%of deaths worldwide.In early GC(EGC),the presence of lymph node metastasis(LNM)is a critical prognostic determinant that directly guides therapeutic strategy.While multi-detector computed tomography(CT)and serum biomarkers carcinoembryonic antigen(CEA)/carbohydrate antigen 19-9(CA19-9)are established diagnostic tools,each demonstrates limited efficacy when used independently.This study therefore aims to verify whether a combined diagnostic approach integrating multi-detector CT(MDCT)with serum CEA/CA19-9 can significantly improve the accuracy of LNM detection in EGC patients.AIM To investigate the diagnostic value of CT combined with CEA or CA19-9 for detecting LNM in EGC.METHODS This retrospective study included 120 patients with EGC confirmed by gastroscopic biopsy at our institution(Huai’an Hospital of Huai’an City)between February 2024 and August 2024.Based on postoperative pathological findings,participants were categorized into a LNM group(n=60)and a non-metastasis group(n=60).All patients underwent MDCT scanning and serum CEA and CA19-9 level measurements.The diagnostic efficacy of CT,CEA,and CA19-9 alone and in combination was evaluated using receiver operating characteristic(ROC)curve and Kappa consistency analysis.RESULTS Serum analysis showed significantly elevated CEA and CA19-9 levels and higher positivity rates in the metastasis group(P<0.0001).ROC analysis yielded area under the curves of 0.9443(CEA)and 0.9292(CA19-9),with Kappa values of 0.683 and 0.650,respectively.CT revealed significantly greater short-axis diameter,CT attenuation,blood volume,and permeability in metastatic nodes(P<0.05),whereas blood flow and mean transit time showed no significant differences.CT alone demonstrated 85.00%sensitivity and 95.00%specificity(Kappa=0.800).Combined diagnosis improved sensitivity to 91.67%(CT+CEA)and 90.00%(CT+CA19-9),with specificities of 90.00%and 88.33%,respectively.CONCLUSION The combination of CT with CEA or CA19-9 improves sensitivity for detecting LNM in EGC,supporting personalized treatment planning and demonstrating clinical value. 展开更多
关键词 Computed tomography Carcinoembryonic antigen Carbohydrate antigen 19-9 Gastric cancer Lymph node metastasis
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