Lacrimal gland

泪腺
  • 文章类型: Journal Article
    背景:典型的瞬时受体电位通道在癌细胞增殖中起着至关重要的作用。虽然在下颌下腺中的TRPC6亚型检测以及该腺体中一些TRPC通道的相关性已在动物模型中得到证实,其在人类泪腺和颌下腺的组织学检测,以及相关的肿瘤,缺乏系统的研究。在人类中研究TRPC6可能会导致新的治疗选择。本研究旨在通过免疫组织化学方法检测人生理泪腺和颌下腺以及腺样囊性癌和粘液表皮样癌中的TRPC6。
    方法:检查了7个固定的身体供体和6个癌症患者的样本。然后将从颌下腺和泪腺收集的十个组织样品处理成组织学载玻片并用苏木精-伊红染色。肿瘤样品作为切片提供。通过免疫组织化学确定TRPC6的存在,这是通过用初级TRPC6抗体间接检测进行的,二级HRP偶联抗体和色原二氨基联苯胺。
    结果:结果证实所有10个生理腺体样品中的TRPC6表达:所有样品均显示具有不同强度的免疫组织化学信号。没有观察到明显的性别特异性差异。在六个下颌下腺样囊性癌和粘液表皮样癌样本中的四个中检测到TRPC6,尤其是在肿瘤细胞的细胞质和细胞核中。排泄管始终显示TRPC6。粘液小管,它们的核和脂肪细胞的核通常没有信号,而浆液性腺泡和它们的核显示弱TRPC6信号。
    结论:在腺体组织中发现TRPC6在唾液腺功能和钙稳态中的作用是进一步研究其在腺样囊性癌和唾液腺粘液表皮样癌中的肿瘤发展意义的基础。TRPC6可以作为治疗这些肿瘤的靶点。然而,TRPC6与颌下腺及泪腺疾病的相关性有待进一步探讨。
    BACKGROUND: Canonical transient receptor potential channels play a crucial role in cancer cell proliferation. While TRPC6 subtype detection in submandibular glands and the relevance of some TRPC channels in this gland have been shown in animal models, its histological detection in human lacrimal and submandibular glands, as well as related tumors, lacks systematic study. Studying TRPC6 in humans could lead to new therapeutic options. This research aimed to immunohistochemically detect TRPC6 in human samples of physiological lacrimal and submandibular glands and of adenoid cystic carcinoma and mucoepidermoid carcinoma.
    METHODS: Seven fixed body donors and samples of six cancer patients were examined. The ten tissue samples collected from the submandibular and lacrimal glands were then processed into histological slides and stained with hematoxylin-eosin. Tumor samples were provided as sections. TRPC6 presence was determined by immunohistochemistry, which was performed by indirect detection with a primary TRPC6 antibody, a secondary HRP-conjugated antibody and the chromogen diaminobenzidine.
    RESULTS: Results confirm TRPC6 expression in all ten physiological gland samples: all samples showed a immunohistochemical signal with varying intensity. No significant gender-specific differences could be observed. TRPC6 was detected in four of six submandibular adenoid cystic carcinoma and the mucoepidermoid carcinoma samples, especially in tumor cells\' cytoplasma and nuclei. Excretory ducts consistently showed TRPC6. Mucous tubules, their nuclei and the nuclei of adipocytes generally showed no signal while serous acini and their nuclei showed a weak TRPC6 signal.
    CONCLUSIONS: The discovery of TRPC6 in glandular tissue indicates a role in salivary gland function and calcium homeostasis is a basis for further research into its significance for tumor development in adenoid cystic carcinoma and mucoepidermoid carcinoma of salivary glands. TRPC6 could be used as a target for treatment of these tumors. However, the correlation between TRPC6 and submandibular and lacrimal gland diseases requires further exploration.
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  • 文章类型: Journal Article
    目的:目前的泪腺病变活检诊断方法需要通过上眼睑折痕或外侧角切开术皮肤切口进行眼眶切开术。我们描述了一种通过结膜外侧穹窿解决这些病变的新手术技术。
    方法:回顾性病例系列,所有患者均接受了泪腺病变的切开或切除诊断性活检的外侧穹窿眼眶切开术。该手术涉及在远离泪小管开口的外侧穹窿中的结膜切口。和骨内手术走廊进入泪腺。
    结果:研究队列包括16名患者(3名男性,13名女性),平均年龄48.3岁(范围,24.0-78,9年)。取样的病变涉及14例患者的眶叶,1例患者的睑叶,1例患者的整个腺体。在所有病例中均获得组织病理学诊断。术后,1例患者(6.3%)出现新的中度内收缺陷,结膜瘢痕粘连松解术后恢复.3例患者(18.8%)经历了短暂的轻度内收或外展限制。没有与手术相关的新的或更严重的上睑下垂或干眼症。术后随访的平均时间为1.3年(中位数为1.0年,范围,0.6-4.7年)。
    结论:侧眼穹窿切开术成功获取具有组织病理学诊断价值的活检标本。它提供了经结膜进入泪腺的途径,而不会损害排泄的泪小管或眼睑支持系统的移位。
    OBJECTIVE: Current practice for diagnostic biopsy of lacrimal gland lesions entails an orbitotomy procedure via an upper eyelid crease or lateral canthotomy skin incision. We describe a novel surgical technique to address these lesions via the lateral conjunctival fornix.
    METHODS: Retrospective case series of all patients who underwent a lateral fornix orbitotomy procedure for incisional or excisional diagnostic biopsy of lacrimal gland lesions. The procedure involves a conjunctival incision in the lateral fornix remote from the openings of the lacrimal ductules, and an intraperiosteal surgical corridor to access the lacrimal gland.
    RESULTS: The study cohort included 16 patients (3 male, 13 female) with a mean age of 48.3 years (range, 24.0-78,9 years). The sampled lesions involved the orbital lobe in 14 patients, the palpebral lobe in 1 patient, and the entire gland in 1 patient. A histopathological diagnosis was obtained in all cases. Postoperatively, new moderate adduction deficit developed in one patient (6.3%) that recovered after adhesiolysis of the conjunctival scar. 3 patients (18.8%) experienced transient mild limitation of adduction or abduction. There was no new or worse ptosis or dry eye disease related to the surgery. The mean length of postoperative follow-up was 1.3 years (median 1.0 years, range, 0.6-4.7 years).
    CONCLUSIONS: The lateral fornix orbitotomy approach was successful in obtaining biopsy specimens of histopathological diagnostic value. It provides transconjunctival access to the lacrimal gland without damage to the excretory lacrimal ductules or displacement of the eyelid support system.
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  • 文章类型: Journal Article
    目的:阐明眼眶炎症性疾病(OID)的治疗反应,我们分析了类固醇疗法的治疗效果,使用改善疾病的抗风湿药(DMARDS),和生物制品在我们的三级转诊中心队列。方法:我们收集了所有接受非特异性眼眶炎症(NSOI)(n=111)和IgG4-ROD(n=13)治疗的患者的临床和人口统计学数据,分别于2008年至2020年在我中心进行了描述性统计分析。NSOI根据位置分为特发性泪腺炎(DA)(n=78)或典型的特发性眼眶肌炎(n=32)。结果:首次临床表现的平均年龄在亚组之间存在显着差异(IOI:49.5±18,IgG4-ROD:63.2±14,p=0.0171)。在所有检查的OID中,63例患者(50%)使用皮质类固醇获得完全缓解(FR)(NSOI53%/IgG4-ROD31%)。相比之下,经典肌炎表现出明显更高的反应(76%).用于肌炎的疾病改善药物(DMARDS)仅达到33%的FR(NSOI57%)和66%的反应不充分(NSOI43%)。生物制剂(利妥昔单抗)显着更有效:23例患者中有19例(82%)完全缓解,只有4例(17%)没有完全反应,需要进行眼眶照射或眼眶减压手术。
    Objective: To clarify the therapy response in orbital inflammatory diseases (OID), we analyzed the treatment effects of steroid therapy, the use of disease-modifying antirheumatic drugs (DMARDS), and biologicals in our tertiary referral center cohort. Methods: We collected the clinical and demographic data of all patients treated for non-specific orbital inflammation (NSOI) (n = 111) and IgG4-ROD (n = 13), respectively at our center from 2008 to 2020 and analyzed them with descriptive statistics. NSOI were sub-grouped according to the location into either idiopathic dacryoadenitis (DAs) (n = 78) or typical idiopathic orbital myositis (n = 32). Results: Mean age at first clinical manifestation was significantly different between subgroups (IOI: 49.5 ± 18, IgG4-ROD: 63.2 ± 14, p = 0.0171). Among all examined OID, 63 patients (50%) achieved full remission (FR) with corticosteroids (NSOI 53%/IgG4-ROD 31%). In contrast, classic myositis showed a significantly higher response (76%). Disease-modifying drugs (DMARDS) for myositis accomplished only 33% FR (NSOI 57%) and 66% did not respond sufficiently (NSOI 43%). The biologic agent (Rituximab) was significantly more efficient: 19 of 23 patients (82%) achieved full remission and only 4 (17%) did not respond fully and needed orbital irradiation or orbital decompressive surgery.
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  • 文章类型: Journal Article
    免疫球蛋白G4(IgG4)相关疾病是一种临床实体,其特征是血清IgG4浓度升高和各种器官中IgG4免疫阳性浆细胞浸润,包括眼科病变。2014年建立了IgG4相关眼科疾病诊断标准(IgG4-ROD),并描述了受影响最大的眼部附属器组织,如泪腺。三叉神经和眼外肌,但不要提到视神经病变,眼科病变最严重的指征。我们回顾了已发表的IgG4相关疾病视神经病变的病例报告(n=44),在很多情况下,视力下降后恢复良好,如全身性皮质类固醇治疗,利妥昔单抗,和眼眶手术。然而,一些病人没有康复,特别是当治疗前的视力低至光感或更少时。在这里,我们提出了2023年修订的IgG4-ROD诊断标准,其中包括提醒不要忽视视神经病变。2014年诊断标准将黏膜相关淋巴组织(MALT)淋巴瘤作为IgG4-ROD与眼眶淋巴瘤关系的重要鉴别诊断。2023年修订版将医生的注意力转向MALT淋巴瘤以外的淋巴瘤,考虑到2014年的标准可能过于强调MALT淋巴瘤.
    Immunoglobulin G4 (IgG4)-related disease is a clinical entity characterized by elevated serum IgG4 concentrations and infiltration of IgG4-immunopositive plasmacytes in various organs, including ophthalmic lesions. Diagnostic criteria for IgG4-related ophthalmic disease (IgG4-ROD) were established in 2014 and describe the most affected ocular adnexal tissues such as lacrimal glands, trigeminal nerves and extraocular muscles, but do not mention optic neuropathy, the most severe indication of ophthalmic lesions. We reviewed published case reports of optic neuropathy in IgG4-related disease (n = 44), and in many cases, decreased visual acuities recovered well following treatment such as systemic corticosteroids, rituximab, and orbital surgery. However, some patients did not recover, especially when pretreatment visual acuities were as low as light perception or less. Herein, we propose a 2023 revised diagnostic criteria for IgG4-ROD, which include a reminder not to overlook optic neuropathy. The 2014 diagnostic criteria specify mucosa-associated lymphoid tissue (MALT) lymphoma as an important differential diagnosis for the relationship between IgG4-ROD and orbital lymphoma. The 2023 revision directs physicians\' attention toward lymphomas other than MALT lymphoma, considering that the 2014 criteria might have placed too much emphasis on MALT lymphoma.
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  • 文章类型: Journal Article
    Src家族激酶(SFKs),包括Src,Fyn和Yes,在发育和癌症中发挥重要作用。尽管第一次被发现是YES-一种相伴的Protein,SFKs对Yap的调控仍然知之甚少。这里,通过单细胞分析和遗传谱系追踪,我们表明泪腺中C末端Src激酶(Csk)的全上皮消融释放了广泛的Src信号,但在腺泡祖细胞被基底膜的肌上皮细胞屏蔽时,会特别引起腺泡祖细胞的挤压和凋亡。Csk突变体可以通过组成活跃的Yap进行表型复制,并通过删除Yap或Taz来拯救,表明Src和Yap信号之间存在显著的功能重叠。尽管Src诱导的酪氨酸磷酸化一直被认为可以调节Yap活性,我们发现突变Yap和Taz中的这些酪氨酸残基不能扰乱小鼠发育或减轻Csk泪腺表型。相比之下,Yap失去Hippo信号传导依赖性丝氨酸磷酸化,并在Csk突变体中易位到细胞核中。进一步的化学遗传学研究表明,急性抑制Csk可增强Crk/CrkL磷酸化和Rac1活性,而去除Crk/CrkL或Rac1/Rap1可改善Csk突变表型。这些结果显示Src通过Crk/CrkL-Rac/Rap轴控制Hippo-Yap信号传导以促进细胞挤出。
    Src family kinases (SFKs), including Src, Fyn and Yes, play important roles in development and cancer. Despite being first discovered as the Yes-associated protein, the regulation of Yap by SFKs remains poorly understood. Here, through single-cell analysis and genetic lineage tracing, we show that the pan-epithelial ablation of C-terminal Src kinase (Csk) in the lacrimal gland unleashes broad Src signaling but specifically causes extrusion and apoptosis of acinar progenitors at a time when they are shielded by myoepithelial cells from the basement membrane. Csk mutants can be phenocopied by constitutively active Yap and rescued by deleting Yap or Taz, indicating a significant functional overlap between Src and Yap signaling. Although Src-induced tyrosine phosphorylation has long been believed to regulate Yap activity, we find that mutating these tyrosine residues in both Yap and Taz fails to perturb mouse development or alleviate the Csk lacrimal gland phenotype. In contrast, Yap loses Hippo signaling-dependent serine phosphorylation and translocates into the nucleus in Csk mutants. Further chemical genetics studies demonstrate that acute inhibition of Csk enhances Crk/CrkL phosphorylation and Rac1 activity, whereas removing Crk/CrkL or Rac1/Rap1 ameliorates the Csk mutant phenotype. These results show that Src controls Hippo-Yap signaling through the Crk/CrkL-Rac/Rap axis to promote cell extrusion.
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  • 文章类型: Journal Article
    本研究的目的是研究c-Jun氨基末端激酶(JNK)和基质金属蛋白酶-2(MMP-2)在介导白细胞介素-1β(IL-1β)对泪腺肌上皮细胞(MECs)功能的影响中的作用。分离自α-平滑肌肌动蛋白-绿色荧光蛋白(SMA-GFP)转基因小鼠的MEC单独用IL-1β处理或在存在JNK抑制剂SP600125的情况下处理,或ARP100,一种MMP-2抑制剂。测量GFP强度和细胞大小/面积,在第七天,SMA,Calponin,和pro-MMP-2蛋白水平和MEC收缩进行评估。在基线,对照和处理的细胞在GFP强度或细胞大小方面没有差异。从第2天开始,并在第4天和第7天继续,在IL-1β处理的样品中,GFP强度和细胞大小显着降低,这些作用在抑制JNK或MMP-2后得到缓解。与对照相比,在IL-1β处理的样品中,SMA和钙蛋白的水平较低,JNK和MMP-2抑制剂逆转了这一趋势。IL-1β处理的样品中pro-MMP-2蛋白水平升高,JNK抑制剂消除了这种作用。最后,催产素诱导的MEC收缩在IL-1β处理的样品中减少,JNK和MMP-2抑制剂都逆转了这种作用。我们的数据表明,IL-1β使用JNK/MMP-2途径来改变MEC功能,这可能是与缺乏房水的干眼症相关的眼泪减少的原因。
    The aim of the present study is to investigate the role of c-Jun N-terminal kinase (JNK) and matrix metalloproteinase-2 (MMP-2) in mediating the effects of interleukin-1β (IL-1β) on the function of lacrimal gland myoepithelial cells (MECs). MECs isolated from an α-smooth muscle actin-green fluorescent protein (SMA-GFP) transgenic mouse were treated with IL-1β alone or in the presence of SP600125, a JNK inhibitor, or ARP100, an MMP-2 inhibitor. The GFP intensity and the cell size/area were measured, and on day 7, the SMA, calponin, and pro-MMP-2 protein levels and the MEC contraction were assessed. At baseline, the control and treated cells showed no differences in GFP intensity or cell size. Starting on day 2 and continuing on days 4 and 7, the GFP intensity and cell size were significantly lower in the IL-1β-treated samples, and these effects were alleviated following inhibition of either JNK or MMP-2. Compared with the control, the levels of SMA and calponin were lower in the IL-1β-treated samples, and both the JNK and MMP-2 inhibitors reversed this trend. The pro-MMP-2 protein level was elevated in the IL-1β-treated samples, and this effect was abolished by the JNK inhibitor. Finally, oxytocin-induced MEC contraction was diminished in the IL-1β-treated samples, and both the JNK and MMP-2 inhibitors reversed this effect. Our data suggest that IL-1β uses the JNK/MMP-2 pathways to alter MEC functions, which might account for the diminished tears associated with aqueous-deficient dry eye disease.
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  • 文章类型: Journal Article
    目的:小熊猫目前是Caniformaia亚目中唯一幸存的Ailuidae家族成员。在这项研究中,我们提供解剖学数据,形态计量学,眶区的组织学和组织化学检查,眼睑,眶腺,和来自弗罗茨瓦夫动物园的两名成年男性Ailurusfulgensfulgens的眼衣,波兰。
    方法:该研究涉及眼球和选定的眼睛附属器官的形态计量学分析,随着骨骼轨道的分析,包括它的形态计量学,宏观,和微观评估。显微镜评估包括组织学和组织化学染色,前者涉及苏木精和伊红(H&E),Movatpentachrome,Picro-Mallory三色,Fontana-Masson,后者包括PAS,ABpH1.0,ABpH2.5;ABpH2.5/PAS,HDI。
    结果:上眼睑(UE)和下眼睑(LE)表现出发育良好的骶骨腺,皮脂腺,和特征性的简单肺泡腺(产生粘液分泌)。存在泪腺的眼睑部分。仅在上眼睑观察到单个淋巴滤泡。第三眼睑(SGTE)的浅表腺体是多叶腺泡复合物,可产生粘液分泌,并包含在许多淋巴结聚集体的小叶间导管内。第三眼睑(TE)呈T形,由透明组织组成,含有ALT。泪腺(LG)还显示出多叶腺泡复合物,产生粘液分泌,只有一个淋巴滤泡.角膜由4层组成,因为鲍曼的膜不存在。证明了由7-10层上皮细胞组成的Vogt栅栏。瞳孔在静止时水平呈卵形(死后)。括约肌瞳孔和扩张器瞳孔发育良好。宏观上,透明绒毡层表现为乳白色,非乳白色的新月形。组织学上,脉络膜透明绒毡层由5至9层松散堆积的卵圆细胞组成。视网膜的组成与陆地夜间食肉动物的组成相似。
    结论:我们的研究结果表明,小熊猫的眼睛和眼眶区域的解剖特征与Musteloidea分支中描述的相似,以及犬科和乌尔西科。
    OBJECTIVE: The red panda is currently the only surviving member of the Ailuridae family in the Caniformia suborder. In this study, we provide data on anatomical, morphometric, histological and histochemical examination of the orbital region, eyelids, orbital gland, and eye tunics in two adult males Ailurus fulgens fulgens from the Wroclaw Zoological Garden, Poland.
    METHODS: The study involved morphometric analysis of the eyeball and selected accessory organs of the eye, along with analysis of the bony orbit, including its morphometry, macroscopic, and microscopic evaluation. Microscopic evaluation encompassed histological and histochemical staining, with the former involving hematoxylin & eosin (H&E), Movat pentachrome, picro-Mallory trichrome, Fontana-Masson, and the latter including PAS, AB pH 1.0, AB pH 2.5; AB pH 2.5/PAS, and HDI.
    RESULTS: The upper (UE) and lower (LE) eyelids presented well-developed tarsal glands, sebaceous glands, and a characteristic simple alveolar gland (producing a mucous secretion). The palpebral part of the lacrimal gland was present. A single lymphoid follicle was observed only in the upper eyelids. The superficial gland of the third eyelid (SGTE) was a multilobar acinar complex that produces mucous secretion and is contained within the interlobular ducts of numerous aggregates of lymph nodes. The third eyelid (TE) was T-shaped and composed of hyaline tissue, containing CALT. The lacrimal gland (LG) also revealed a multilobar acinar complex that produced mucous secretion, with a single lymphoid follicle. The cornea consisted of 4 layers, as Bowman\'s membrane was absent. The Vogt palisades composed of 7-10 layers of epithelial cells were demonstrated. The pupil was horizontally ovoid at rest (post-mortem). The sphincter pupil and the dilator pupil were well developed. Macroscopically, the tapetum lucidum appeared as a milky, non-opalescent crescent. Histologically, the choroidal tapetum lucidum cellulosum consisted of 5 to 9 layers of loosely packed oval cells. The retina showed a composition similar to that of terrestrial nocturnal carnivores.
    CONCLUSIONS: The results of our research indicate that the anatomical features of the eye and orbital region in the red panda share similarities with those described in the Musteloidea clade, as well as the Canidae and Ursidae families.
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  • 文章类型: Journal Article
    腺苷酸环化酶(AC)是一组将腺苷-5'-三磷酸(ATP)转化为环状腺苷3'的酶,5单磷酸盐(cAMP),细胞对激素和神经递质的反应中一种重要而普遍存在的信号分子。有九种跨膜(tmAC)形式,已被广泛研究;然而,第十,可溶性AC(sAC)的特征不那么广泛。眼睛是体内代谢最活跃的部位之一,在那里发现了大量的sAC,使其成为新疗法和生物标志物的目标。在角膜中,AC在内皮细胞功能中起作用,这对维持基质脱水至关重要,因此,清晰度。在视网膜上,AC与轴突细胞生长和存活有关。由于这些细胞在青光眼和损伤中不可逆转地受损,该分子可能为未来的治疗提供焦点。青光眼管理的另一个潜在领域是房水产生的来源,睫状体,其中AC也已确定。进一步了解泪腺功能对于治疗干眼症至关重要,一种常见的衰弱状态。sAC与泪液产生有关,可以作为治疗靶点。总的来说,ACs是一个令人兴奋的眼部健康研究领域,为未来的医学治疗和诊断提供多种途径。这篇综述论文探讨了AC在眼睛中的不同作用及其作为创新治疗目标的潜力。
    Adenylyl cyclases (ACs) are a group of enzymes that convert adenosine-5\'-triphosphate (ATP) to cyclic adenosine 3\',5\' monophosphate (cAMP), a vital and ubiquitous signalling molecule in cellular responses to hormones and neurotransmitters. There are nine transmembrane (tmAC) forms, which have been widely studied; however, the tenth, soluble AC (sAC) is less extensively characterised. The eye is one of the most metabolically active sites in the body, where sAC has been found in abundance, making it a target for novel therapeutics and biomarking. In the cornea, AC plays a role in endothelial cell function, which is vital in maintaining stromal dehydration, and therefore, clarity. In the retina, AC has been implicated in axon cell growth and survival. As these cells are irreversibly damaged in glaucoma and injury, this molecule may provide focus for future therapies. Another potential area for glaucoma management is the source of aqueous humour production, the ciliary body, where AC has also been identified. Furthering the understanding of lacrimal gland function is vital in managing dry eye disease, a common and debilitating condition. sAC has been linked to tear production and could serve as a therapeutic target. Overall, ACs are an exciting area of study in ocular health, offering multiple avenues for future medical therapies and diagnostics. This review paper explores the diverse roles of ACs in the eye and their potential as targets for innovative treatments.
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  • 文章类型: Journal Article
    目的:这项研究对超声弹性成像(USE)检测患有原发性干燥综合征(pSS)的个体的泪腺受累的有效性进行了全面评估。
    方法:对包括PubMed在内的多个数据库进行了全面搜索,Cochrane图书馆,EMBASE,万方,WebofScience,和中国国家知识基础设施,收集2000年1月1日至2023年10月1日在诊断PSS中应用USE的相关文献。汇总数据用于计算灵敏度,特异性,和诊断赔率比。使用了几个汇总指标来评估SWE在检测PSS方面的表现,包括接收器工作特性曲线下的面积,诊断赔率比,敏感性,和特殊性。
    结果:五项相关研究共包括273名患者。剪切波弹性成像(SWE)显示出0.88的合并敏感性(95%CI0.77-0.94)和0.94(95%CI0.88-0.98)的特异性,受试者工作特征曲线下面积为0.97(95%CI0.95-0.98)。SWE的阳性似然比为15.86(95%CI6.99-36.00),阴性似然比为0.13(95%CI0.07-0.25)。未观察到发表偏倚的证据(p=0.70)。
    结论:SWE在检测患有pSS的个体的泪腺受累方面具有显著的精确度。
    OBJECTIVE: This research conducted a comprehensive evaluation of the effectiveness of ultrasonic elastography (USE) in detecting lacrimal gland involvement in individuals suffering from primary Sjögren\'s syndrome (pSS).
    METHODS: A comprehensive search was undertaken across multiple databases including PubMed, the Cochrane Library, EMBASE, Wanfang, Web of Science, and the Chinese National Knowledge Infrastructure, to gather relevant literature pertaining to the application of USE in diagnosing pSS from January 1, 2000, to October 1, 2023. Pooled data were used to calculate sensitivity, specificity, and diagnostic odds ratios. Several summary metrics were used to evaluate SWE\'s performance in detecting pSS, including the area under the receiver operating characteristic curve, diagnostic odds ratios, sensitivities, and specificities.
    RESULTS: Five pertinent studies included a total of 273 patients. Shear wave elastography (SWE) demonstrated a pooled sensitivity of 0.88 (95% CI 0.77-0.94) and specificity of 0.94 (95% CI 0.88-0.98), with an area under the receiver operating characteristic curve of 0.97 (95% CI 0.95-0.98). SWE exhibited a positive likelihood ratio of 15.86 (95% CI 6.99-36.00) and a negative likelihood ratio of 0.13 (95% CI 0.07-0.25). No evidence of publication bias was observed (p = 0.70).
    CONCLUSIONS: SWE demonstrates a remarkable degree of precision in detecting lacrimal gland involvement in individuals suffering from pSS.
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  • 文章类型: Journal Article
    目的:为了研究基于Dixon磁共振成像(MRI)的眼外肌(EOMs)定量参数的价值,眶内脂肪(IF),甲状腺相关眼病(TAO)分期患者的泪腺(LGs)。
    方法:回顾性纳入接受DixonMRI治疗前评估的200名TAO患者(211只眼活跃,189只眼不活跃),并分为训练组(169只眼活跃,151只眼不活跃)和验证组(42只眼活跃,38只眼不活跃)。最大,意思是,和信号强度比(SIR)的最小值,脂肪分数(FF),和EOM的水分数(WF),如果,在训练队列中,测量和比较活动组和非活动组之间的LGs。二元Logistic回归分析,接收机工作特性曲线分析,Delong检验用于进一步的统计分析,视情况而定。
    结果:与非活动TAO相比,活跃的TAO表现出显著更大的EOM-SIRmax,EOM-SIRmean,EOM-SIRmin,IF-SIRmax,IF-SIRmean,LG-SIRmax,LG-SIRmean,EOM-WFmean,EOM-WFmin,IF-WFmax,IF-WFmean,和LG-WFmean和更低的EOM-FFmax,EOM-FFmean,IF-FFmean,IF-FFmin,和LG-FF平均值(所有p<0.05)。EOM-SIRmean,LG-SIRmean,和LG-FF平均值与活性TAO独立相关(所有p<0.05)。EOM-SIRmean的组合,LG-SIRmean,和LG-FFmean值比单独的EOM-SIRmean值在两个训练中的分期TAO表现更好(AUC,0.820vs0.793;p=0.016)和验证(AUC,0.751vs0.733,p=0.341)队列。
    结论:基于DixonMRI的EOM参数,LGs,和IF可用于区分活性和非活性TAO。多个参数的集成可以进一步改进分级性能。
    在这项研究中,作者探讨了EOM定量参数的综合值,如果,和来自DixonMRI的LGs在TAO患者分期中,这可以支持建立适当的治疗计划。
    结论:EOM的定量参数,LGs,和IF对于分期TAO是有用的。EOM-SIRmean,LG-SIRmean,发现LG-FF平均值与活性TAO独立相关。眼眶组织的联合评估提高了评估TAO活性的能力。
    OBJECTIVE: To investigate the value of Dixon magnetic resonance imaging (MRI)-based quantitative parameters of extraocular muscles (EOMs), intraorbital fat (IF), and lacrimal glands (LGs) in staging patients with thyroid-associated ophthalmopathy (TAO).
    METHODS: Two hundred patients with TAO (211 active and 189 inactive eyes) who underwent Dixon MRI for pretreatment evaluation were retrospectively enrolled and divided into training (169 active and 151 inactive eyes) and validation (42 active and 38 inactive eyes) cohorts. The maximum, mean, and minimum values of the signal intensity ratio (SIR), fat fraction (FF), and water fraction (WF) of EOMs, IF, and LGs were measured and compared between the active and inactive groups in the training cohort. Binary logistic regression analysis, receiver operating characteristic curve analysis, and the Delong test were used for further statistical analyses, as appropriate.
    RESULTS: Compared with inactive TAOs, active TAOs demonstrated significantly greater EOM-SIRmax, EOM-SIRmean, EOM-SIRmin, IF-SIRmax, IF-SIRmean, LG-SIRmax, LG-SIRmean, EOM-WFmean, EOM-WFmin, IF-WFmax, IF-WFmean, and LG-WFmean and lower EOM-FFmax, EOM-FFmean, IF-FFmean, IF-FFmin, and LG-FFmean values (all p < 0.05). The EOM-SIRmean, LG-SIRmean, and LG-FFmean values were independently associated with active TAO (all p < 0.05). The combination of the EOM-SIRmean, LG-SIRmean, and LG-FFmean values showed better performance than the EOM-SIRmean value alone in staging TAO in both the training (AUC, 0.820 vs 0.793; p = 0.016) and validation (AUC, 0.751 vs 0.733, p = 0.341) cohorts.
    CONCLUSIONS: Dixon MRI-based parameters of EOMs, LGs, and IF are useful for differentiating active from inactive TAO. The integration of multiple parameters can further improve staging performance.
    UNASSIGNED: In this study, the authors explored the combined value of quantitative parameters of EOMs, IF, and LGs derived from Dixon MRI in staging TAO patients, which can support the establishment of a proper therapeutic plan.
    CONCLUSIONS: The quantitative parameters of EOMs, LGs, and IF are useful for staging TAO. The EOM-SIRmean, LG-SIRmean, and LG-FFmean values were found to independently correlate with active TAO. Joint evaluation of orbital tissue improved the ability to assess TAO activity.
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