This study aimed to investigate the diagnostic value of calcification detected by computed tomography (CT) for the differentiation of benign and malignant thyroid nodules. This is a retrospective study of 930 consecutive patients (709 women, 221 men; mean age 51 years) with pathologically proven thyroid nodules. The characteristics of calcification on CT images were correlated with the pathological results. A total of 168 patients were pathologically diagnosed with thyroid carcinomas and 762 patients with benign thyroid nodules. Calcification was found in 231 cases (24.84%). The incidence of calcification was significantly higher in patients with thyroid carcinoma (52.38%) than in those with benign nodules (18.77%; P < 0.001). Detection of calcification in diagnosing thyroid carcinoma had a sensitivity of 52.38% (88/168) and specificity of 81.23% (619/762). No significant difference was noticed in the incidence of microcalcification (≤ 2 mm) between malignant and benign nodules (P = 0.305). Calcification is more frequently found in thyroid carcinomas than benign nodules. CT detected-calcification may suggest malignant disease. Further confirmation of the suspected malignancy with fine-needle aspiration or surgery is still needed.
Rectal gastrointestinal stromal tumors (GISTs) are rare, and limited information is available concerning their management and long-term outcomes. We retrospectively evaluated the clinicopathological characteristics, surgical management, and long-term outcomes of rectal GISTs from a single institution.All surgically treated patients with rectal GISTS at the Department of General Surgery, West China Hospital, Sichuan University were identified between January 2005 and May 2014. The overall survival (OS) and disease-free survival (DFS) were assessed by the Kaplan-Meier method.Forty-five patients with rectal GISTs (33 males and 12 females) were identified. Patients presented with rectal bleeding (n = 13; 28.9%) and altered bowel habits (n = 11; 24.4%). The cohort study of 45 patients included 4 very low-risk, 10 lowrisk, 1 intermediate-risk, and 30 high-risk patients. A total of 21, 13, and 11 patients underwent local resection (Group 1), abdominoperineal resection (Group 2), and super-low or low anterior resection (Group 3), respectively. Group 1 had a smaller tumor sizes and shorter distances from the anal verge compared with the other groups (P < 0.05). The one-, three-, and fiveyear DFS rates for the entire cohort study were 90.4%, 69.3%, and 57.0%, respectively. High National Institutes of Health (NIH) risk categories (HR = 1.62) were associated with low DFS rates (P = 0.035). The DFS was significantly improved by imatinib mesylate (IM) adjuvant therapy in the high-risk subgroup (P = 0.001).The type of surgery should be chosen based on the location and size of the rectal GISTs. Adjuvant IM therapy was associated with improved DFS in patients with high-risk tumors, and classification was strongly associated with the patient outcome.
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