Search

BACKGROUND Pancreatic cancer is one of the most common cancers in the world and a major cause of cancer mortality. Therefore, it is extremely important to distinguish between malignant and benign changes quickly and accurately. This single-center study aimed to assess the discriminatory properties of the color Doppler vascularity index (CDVI) in the diagnosis of focal chronic pancreatitis and malignant pancreatic tumors. MATERIAL AND METHODS Seventy-nine patients (42 men, 37 women; age 62.0±13.5 years; 46 adenocarcinomas; 33 pancreatitis) qualified for this study. During endosonographic examination, pancreatic tumors were assessed in the color Doppler option. The dynamic tissue perfusion measurement was used to calculate tissue flow velocity (TFV), tissue perfusion intensity (TPI), and vascularization as the CDVI. RESULTS TFV, TPI, and CDVI were significantly lower in the group with malignant tumors than in the group with pancreatitis (P<0.001). In the receiver operating characteristic analysis, results of TFV=2.181 cm/s, TPI=0.009 cm/s, and CDVI=0.268 allowed for significant prediction of malignant tumors (P<0.001), with sensitivity of 75.8%, 69.7%, and 72.7% and specificity of 91.3%, 93.5%, and 80.4%, respectively, without significant differences between perfusion parameters and CDVI (P=0.07). CONCLUSIONS The findings from this study showed that color Doppler imaging and the use of the CDVI could provide an adjunctive diagnostic approach to distinguish between pancreatic adenocarcinoma and focal chronic pancreatitis. Owing to the possibility of calculating vascularization by non-Doppler methods, the method may be an easier and more accessible diagnostic option for malignant pancreatic tumors than perfusion assessed in external software.

Aim: The study aimed at: 1. Analysis of the relationship between Doppler flow in the selected maternal and fetal vessels and the risk of adverse perinatal outcome (APO); 2. Multivariate logistic regression model for the assessment the risk of APA., Material and Methods: The study population covered 216 pregnant women from Lodz and Kalisz between 2003-2006., Results: In univariate logistic regression model PI&#95;UA significantly influenced the risk of APO. That risk was increasing 1.2 times, if the PI&#95;UA value was 1/10th higher than the measured unit. Abnormal cardiotocography (CTG) pattern was related to 12-times higher risk of APO. In cases of abnormal PI&#95;MCA, the risk of APO was 2.5 times higher than when PI&#95;MCA was within the normal range. Abnormal PI&#95;UA was related to 11.5-times higher risk of APO. Similarly when PIV&#95;DV was abnormal, the risk of APO was 2.3-times higher. Low birth weight (LBW) was connected with the 6-times higher risk of APO. In multivariate logistic regression model, CTG and LBW were the risk factors significantly associated with APA. Abnormal CTG pattern was related to more than 6-times higher increase of the risk of APO, however LBW with nearly 4-times higher risk of APO., Conclusion: Abnormal values of PI in UA and in MCA, abnormal flow in DV and abnormal CTG pattern, as well as low birth weight, had significant influence on the risk of APO. In multivariate analysis only abnormal CTG and low birth weight were the significant factors of APO.

Objective: The risk of metastatic ovarian tumor is significantly higher in case of women with a history of colorectal cancer. Additionally, the possibility of developing ovarian cancer due to congenital mutations in suppressor genes should be assessed., Design: The purpose of the study was to evaluate the clinical presentation and histopathology of adnexal tumors in case of female patients with a history of colorectal adenocarcinoma., Material and Methods: A retrospective study on 13 women (each with a history of colorectal carcinoma, operated due to adnexal tumor between 2004 and 2007), has been conducted. Subject characteristics, ultrasound, CT, serum tumor markers levels, histopathology and findings at surgery were analyzed., Results: Time distance between colorectal cancer surgery and ovarian tumor operation - measured in months -was shorter in cases of malignant neoplasms (10.13 +/- 3.98) than in benign tumors (26.2 +/- 19.37). Ultrasound examination showed solid-cystic adnexal tumors in 8 malignant cases, and ovarian cysts in 5 benign conditions. The use of ultrasound with plasma levels of CEA, CA 19.9 and CA 125 improved the validity of the preoperative differentiation of ovarian masses. Total abdominal hysterectomy with bilateral salphingo-oophorectomy was performed in eleven cases. Unilateral adnexectomy only took place in one case of benign tumor and in one case of disseminated neoplasmatic disease., Conclusions: When evaluating a patient with an adnexal tumor, a history of malignancy strongly suggests a metastatic nature. The use of ultrasound associated with plasma levels of Ca 125, Ca 19-9 and CEA, represents a useful method of preoperative assessment of ovarian tumors.