• First report to attempt to assess ECa aggressiveness with magnetic resonance spectroscopy (MRS). • MRS can differentiate type I from type II ECa. • MRS can differentiate ECa from BLs-ESm. • MRS cannot differentiate different stages of ECa or different grades of ECa. • Cho/water increased with the increase of tumour stage and size.

BackgroundAcinar cell carcinoma (ACC) is a rare pancreatic epithelial malignancy that poses a significant threat. However, there are few related clinical studies. The present study aimed to analyze the imaging and pathological features of ACC to provide a reference for better diagnosis and treatment planning.MethodsThirty-nine with ACC, referred to Qianfoshan Hospital, Qilu Hospital and Provincial Hospital in Shandong Province from December 2012 to December 2020, were enrolled. Their imaging and clinicopathological features were analyzed. They were followed up for 1 year, and Cox regression was used to analyze the factors affecting patient prognosis.ResultsACC was more common in the middle-aged and elderly and peaked at approximately 60 years. The clinical manifestations of the patients were mostly flatulence and upper abdomen pain. The tumor was located in the head of the pancreas in 19 cases, with an average size of 5.8 cm. We found nerve invasion and liver metastasis in one case each. 8 patients showed irregular amorphous tumor calcification on plain computed tomography and 5 showed high and low signals on T1- and T2-weighted images, respectively. Immunohistochemistry revealed 100.0% positive rates for CK, β-catenin, and Ki-67. Thirty-three patients underwent surgical resection, and the 2-year overall mortality rate was 25.6%. Cox analysis revealed that smoking was an independent risk factor affecting patient prognosis.ConclusionAn in-depth understanding of the imaging and clinicopathological features of ACC is conducive to better diagnosis and treatment planning for ACC and subsequent improvement in patient prognosis.

The aim of the present study was to evaluate whether MRI features are able to predict massive hemorrhage of patients with placenta accreta spectrum (PAS). A total of 40 patients with suspected PAS after ultrasound examination were subjected to MRI. Of these, 29 patients were confirmed as having PAS. MRI data were analyzed independently by two radiologists in a blinded manner. Inter-observer agreement was determined. The 29 confirmed patients were divided into two groups (moderate and massive hemorrhage) according to the estimated blood loss (EBL) and blood transfusion, and the MRI features were compared between the two groups. The EBL, as well as blood transfusion, between the patients with and without each MRI feature were compared. The inter-observer agreement between the two radiologists for the 11 MRI features had statistical significance (P<0.05). Intra-placental thick dark bands and markedly heterogeneous placenta were the most important MRI features in predicting massive hemorrhage and blood transfusion (P<0.05). The difference in EBL between the patients with and without focal defect of the uteroplacental interface (UPI) was significant (P<0.05). The differences in blood transfusion between the patients with and without myometrial thinning, disruption of the inner layer of the UPI, increased placental vascularity and increased vascularity at the UPI were significant (P<0.05). These results indicate that MRI features may predict massive hemorrhage of patients with PAS, which may be helpful for pre-operative preparation of PAS patients.

Objective: To analyze the expression of tumor infiltrating lymphocytes (TILs) and immune biomarkers to investigate their prognostic value in patients with Clear cell renal cell carcinoma (ccRCC). Methods: This retrospective study enrolled 152 patients who were pathologically diagnosed with ccRCC between March 2010 and December 2018 at our institute. All tumor tissue sections were collected, and immunohistochemical staining was performed to calculate the expression of CD4, CD8, PD-1 and PD-L1. Univariate and multivariate Cox proportional hazards regression analysis was used to evaluate the prognostic value of biomarkers on survival. The association of clinicopathological variables and biomarkers were tested by Chi-squared test, Fisher’s exact test or Student’s t-test. Results: In univariable analysis, increased tumor-infiltrating of CD8+ T cells and PD-L1 positive cells were associated with poor overall survival (OS) and disease-free survival (DFS). In multiple analysis, increased CD8+T cells was an independent prognostic factor for poor DFS (p=0.009) and increased PD-L1 was independent prognostic factors for poor OS (p=0.030). Conclusion: This study showed some TILs and biomarkers can provide some prognostic data for clinical subsequent therapy for patients with ccRCC.