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Chen L.,Taihu Hospital | Wang X.,Taihu Hospital | Bao J.,U.S. Center for Disease Control and Prevention | Geng C.,Taihu Hospital | And 2 more authors.
PLoS ONE | Year: 2014

Objective: To use direct comparative studies or randomised controlled trials to compare the accuracy of cardiac magnetic resonance (CMR) and single-photon emission computed tomography (SPECT) for the detection of obstructive coronary artery disease (CAD). Materials and Methods: Various databases were searched for original articles published prior to June 2013. Studies were selected that performed both CMR and SPECT in the same or randomised patients to detect CAD and that presented sufficient data to allow construction of contingency tables. For each study, the true-positive, false-positive, true-negative, and false-negative values were extracted or derived, and 2x2 contingency tables were constructed. To reduce heterogeneity, the meta-analysis was carried out in two parts: (1) coronary territory-based analysis and (2) patient-based analysis. Results: 10 studies (5 studies based on patient, 4 studies based on coronary territory, and 1 study based on both) were included in the meta-analysis with a total of 1727 patients. The methodological quality was moderate. For part (1), the summary estimates were as follows: for CMR based on patient-a sensitivity of 0.79 (95% confidence interval: 0.72-0.84) and a specificity of 0.75 (0.65-0.83); for SPECT based on patient-a sensitivity of 0.70 (0.59-0.79) and a specificity of 0.76 (0.66-0.83). For part (2), the summary estimates for CMR based on coronary territory were a sensitivity of 0.80 (0.73-0.85) and a specificity of 0.87 (0.81-0.91), and the summary estimates for SPECT based on coronary territory were a sensitivity of 0.67 (0.60-0.72) and a specificity of 0.80 (0.75-0.84). Conclusions: Compared with SPECT, CMR is more sensitive to detect CAD on a per-patient basis. Nonetheless, large scale, well-designed trials are necessary to assess its clinical value on a per-coronary territory basis. © 2014 Chen et al.

Chen L.-H.,Chongqing Medical University | Chen Y.-F.,Chongqing Medical University | Zhang J.-Q.,Chongqing Medical University | Wang W.-W.,Chongqing Medical University | And 2 more authors.
Chinese Journal of Medical Imaging Technology | Year: 2012

Objective: To investigate the possibility of using the apparent diffusion coefficient (ADC) value to differentiate histological subtypes of lung cancers. Methods: Fifty-eight patients with suspected lung cancer (39 men, 19 women) underwent magnetic resonance diffusion-weighted imaging (DWI)of the chest with b factor of 50 and 1000 s/mm 2. ADC values were calculated and correlated with histological subtypes of lung cancers. ROC analysis of ADC value was used to predict histological subtypes. Results: The mean ADC value of small and non-small cell lung cancer was (1.02 ± 0.24) × 10 -3 mm 2/s and (1.03 ± 0.24) × 10 -3 mm 2/s, respectively, while of squamous cell carcinoma and adenocarcinoma was (0.89 ± 0.09) × 10 -3 mm 2/s and (1.10 ± 0.14) × 10 -3 mm 2/s, respectively. ADC value of adenocarcinoma was significantly higher than that of squamous cell carcinoma (P < 0.001). The area under ROC curve was 0.91 ± 0.04 for adenocarcinoma of non-small cell lung cancer. Conclusion: The mean ADC value of lung adenocarcinoma is significantly higher than that of squamous cell carcinoma. ADC value may help to differentiate the histological subtypes of lung cancers. Copyright © 2012 by the Press of Chinese Journal of Medical Imaging Technology.

Chen L.,Chongqing Medical University | Liu M.,Chongqing Medical University | Liu M.,U.S. Center for Disease Control and Prevention | Bao J.,U.S. Center for Disease Control and Prevention | And 5 more authors.
PLoS ONE | Year: 2013

Objective: To perform a meta-analysis exploring the correlation between the apparent diffusion coefficient (ADC) and tumor cellularity in patients. Materials and Methods: We searched medical and scientific literature databases for studies discussing the correlation between the ADC and tumor cellularity in patients. Only studies that were published in English or Chinese prior to November 2012 were considered for inclusion. Summary correlation coefficient (r) values were extracted from each study, and 95% confidence intervals (CIs) were calculated. Sensitivity and subgroup analyses were performed to investigate potential heterogeneity. Results: Of 189 studies, 28 were included in the meta-analysis, comprising 729 patients. The pooled r for all studies was 20.57 (95% CI: 20.62, 20.52), indicating notable heterogeneity (P<0.001). After the sensitivity analysis, two studies were excluded, and the pooled r was 20.61 (95% CI: 20.66, 2 0.56) and was not significantly heterogeneous (P = 0.127). Regarding tumor type subgroup analysis, there were sufficient data to support a strong negative correlation between the ADC and cellularity for brain tumors. There was no notable evidence of publication bias. Conclusions: There is a strong negative correlation between the ADC and tumor cellularity in patients, particularly in the brain. However, larger, prospective studies are warranted to validate these findings in other cancer types. © 2013 Chen et al.

Fan X.,Jimin Hospital | Zhang X.,Jimin Hospital | Shen J.,Jimin Hospital | Zhao H.,Taihu Hospital | And 7 more authors.
PLoS ONE | Year: 2016

Pancreatic cancer is an aggressive disease with dismal prognosis. It is of paramount importance to understand the underlying etiological mechanisms and identify novel, consistent, and easy-to-apply prognostic factors for precision therapy. TUSC3 (tumor suppressor candidate 3) was identified as a potential tumor suppressor gene and previous study showed TUSC3 is decreased in pancreatic cancer at mRNA level, but its putative tumor suppressor function remains to be verified. In this study, TUSC3 expression was found to be suppressed both at mRNA and protein levels in cell line models as well as in clinical samples; decreased TUSC3 expression was associated with higher pathological TNM staging and poorer outcome. In three pairs of cell lines with different NF-κB activity, TUSC3 expression was found to be reversely correlated with NF-κB activity. TUSC3-silenced pancreatic cancer cell line exhibited enhanced potential of proliferation, migration and invasion. In an orthotopic implanted mice model, TUSC3 silenced cells exhibited more aggressive phenotype with more liver metastasis. In conclusion, the current study shows that decreased immunological TUSC3 staining is a factor prognostic of poor survival in pancreatic cancer patients and decreased TUSC3 promotes pancreatic cancer cell proliferation, invasion and metastasis. The reverse correlation between NF-κB activity and TUSC3 expression may suggest a novel regulation pattern for this molecule. © 2016 Fan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Chen L.,Chongqing Medical University | Zhang J.,Chongqing Medical University | Bao J.,Nantong University | Zhang L.,Chongqing Medical University | And 3 more authors.
Journal of Magnetic Resonance Imaging | Year: 2013

Purpose: To perform a meta-analysis to evaluate the diagnostic performance of the diffusion-weighted imaging (DWI) technique in differentiating malignant from benign lung lesions. Materials and Methods: Medical and scientific literature databases were searched for studies that assessed the diagnostic performance of DWI in patients suspected of lung cancer who underwent DWI and biopsy. Only studies in the English or Chinese language and published before September 2011 were considered for inclusion. Methodological quality was assessed by the Quality Assessment of Diagnostic Studies (QUADAS) instrument. Homogeneity was explored by the Chi-square test and inconsistency index. Sensitivities (SEN), specificities, predictive values, diagnostic odds ratio (dOR), and areas under the receiver operator characteristic (ROC) curve were calculated. Potential threshold effect was investigated by using Spearman's correlation coefficient. Publication bias analysis was evaluated by Deeks' asymmetry test. Results: Of 33 eligible studies, 11 were included in the meta-analysis, comprising 755 malignant and 294 benign lesions. Heterogeneity was found to have arisen primarily from threshold effect. The data points from the Deeks' funnel plot indicated the presence of publication bias. Methodological quality was moderate. The pooled weighted SEN with corresponding 95% confidence interval (CI) was 0.80 (95% CI: 0.76, 0.83), SPE was 0.93 (95% CI: 0.91, 0.95), positive likelihood ratio was 9.24 (95% CI: 3.58, 23.83), negative likelihood ratio was 0.24 (95% CI: 0.19, 0.29), and dOR was 46.14 (95% CI: 27.56, 77.26). The area under the ROC curve was 0.91 (95% CI: 0.89, 0.93). Conclusion: DWI is a noninvasive, nonradiative, and accurate technique for distinguishing between malignant and benign lung lesions. However, large-scale randomized control trials are necessary to assess its clinical value and to establish standards of DWI for measurement, analysis, and cutoff values of diagnosis. Copyright © 2012 Wiley Periodicals, Inc.

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