The role of prolactin gradient and normalized ACTH/prolactin ratio in the improvement of sensitivity and specificity of selective blood sampling from inferior petrosal sinuses for differential diagnostics of ACTH-dependent hypercorticism

2013 ◽  
Vol 59 (4) ◽  
pp. 3-10 ◽  
Author(s):  
Zh E Belaia ◽  
L Ia Rozhinskaia ◽  
G A Mel'nichenko ◽  
I I Sitkin ◽  
L K Dzeranova ◽  
...  
Keyword(s):  
Operating Characteristic ◽  
Diagnostic Value ◽  
Blood Sampling ◽  
Research Centre ◽  
Differential Diagnostics ◽  
Study Cohort ◽  
Catheter Position ◽  
Characteristic Curves

The present study included patients with confirmed diagnosis of ACTH-dependent hypercorticism admitted to the Department of Neuroendocrinology and Osteopathies, Endocrinological Research Centre, between 2008 and 2012. Selective blood sampling from the inferior petrosal sinuses was performed with the stimulation by decompressin administered intravenously at a dose of 8 mcg. The normalized ACTH/prolactin ratio was calculated by dividing the maximum ACTH gradient following decompressin stimulation by the ipsilateral prolactin gradient. The cut off values were calculated from the operating characteristic curves as follows: 1.5 for the prolactin gradient (sensitivity 92.5%, specificity 100%) and 1.18 for the normalized ACTH/prolactin ratio (sensitivity 85.9%; 95% CI 76.8-93.4, specificity 100%; 95% CI 60.9-100). In the study cohort (n=70), the normalized ACTH/prolactin ratio proved to be a more specific but less sensitive parameter than the routine analysis of the ACTH gradient (sensitivity 98.4%, specificity 83.3%). Areas under the operating characteristic curves were on the whole identical. However, comparison of the diagnostic value of selective blood sampling from the inferior petrosal sinuses in combination of the determination of the prolactin gradient and normalized ACTH/prolactin ratio with the results obtained in the patients in whom the catheter position was not controlled (n=47) revealed the advantages of the former approach in terms of both the number of unverified causes of hypercorticism (1 versus 6) and the area under the operating characteristic curves 0.964 (95% CI 0.897-1.032) among 70 patients and 0.910 (95% CI 0.821-0.998) among the first 47 patients (included in the analysis confined to the confirmed cases). It is concluded that the determination of the prolactin gradient and calculation of the normalized ACTH/prolactin ratio allow to increase the diagnostic value of selective blood sampling from the inferior petrosal sinuses under decompressin stimulation. This inference is especially true of doubtful cases.

scholarly journals Component resolved diagnosis of egg yolk is an indispensable part of egg allergy

2021 ◽  
Vol 49 (2) ◽  
pp. 6-14
Author(s):  
Huang Lunhui ◽  
Shao Yanhong ◽  
Li Shaoshen ◽  
Bao Huijing ◽  
Liu Yunde ◽  
...  
Keyword(s):  
Operating Characteristic ◽  
Egg Yolk ◽  
Specific Ige ◽  
Diagnostic Value ◽  
Egg White ◽  
Enzyme Linked Immunosorbent Assay ◽  
Egg Allergy ◽  
Component Resolved Diagnosis ◽  
Allergen Components

Introduction and objectives: It was urgent to explain the role of egg yolk allergen sensitization to the egg allergic population and we would evaluate the diagnostic value of allergen components in whole eggs, including egg white and egg yolk.Materials and methods: Firstly, we collected 99 positive and 21 negative sera against egg allergy. Then we used modified enzyme linked immunosorbent assay (ELISA) to survey specific IgE (sIgE) to all-proven and single component in eggs, Ovomucoid (Gal d 1), Ovalbumin (Gal d 2), Ovotransferrin (Gal d 3), Lysozyme C (Gal d 4), Serum Albumin (Gal d 5), and YGP42(Gal d 6) in allergic and non-allergic populations. Last but not least, we studied the sIgE reactivities to egg allergen components by receiver operating characteristic (ROC) analysis.Results: Among egg-allergic individuals, nearly 10% were sensitized to five of six egg allergen components, and the cross-reaction frequency between two egg yolk allergens with Gal d 1 was about 30% in the groups diagnosed with egg allergy or non-allergy. The best component-combination diagnosis in egg allergy of Gal d 1+ Gal d 6 demonstrated the largest area under curve (AUC) of 0.994.Conclusions: Our results suggested that there were individual differences in allergenicity of different egg allergen components, especially in the samples negative to egg allergy diagnosed but sensitive to egg yolk components. It was indicated that component resolved diagnosis of egg yolk improved the value for egg allergy management indispensably.

scholarly journals Expression Analysis of Circulating miR-22, miR-122, miR-217 and miR-367 as Promising Biomarkers of Acute Lymphoblastic Leukemia

2021 ◽  
Author(s):  
Fatemeh hosseinpour-soleimani ◽  
Gholamreza Khamisipour ◽  
Zahra Derakhshan ◽  
Bahram Ahmadi
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Lymphoblastic Leukemia ◽  
Area Under The Curve ◽  
Diagnostic Value ◽  
Healthy Individuals ◽  
Quantitative Real Time Pcr ◽  
Expression Levels

Abstract Background Currently, the role of serum-based biomarkers such as microRNAs in cancer diagnosis has been extensively established. This study aimed to determine expression levels of bioinformatically selected miRNAs and whether they can be used as biomarkers or a new therapeutic target in patients with Acute Lymphoblastic Leukemia (ALL). Materials and Methods The expression levels of serum miR-22, miR-122, miR-217, and miR-367 in 21 ALL patients and 21 healthy controls were measured using quantitative real-time PCR. The receiver operating characteristic (ROC) curve and the associated area under the curve (AUC) was used to assess candidate miRNAs' diagnostic value as a biomarker. Results The results showed that miR-217 was markedly decreased in patients with ALL compared to controls. Moreover, miR-22, miR-122, and miR-367 were found to be upregulated. Furthermore, ROC analysis showed that serum miR-217 and miR-367 could differentiate ALL patients from the healthy individuals, while miR-22 has approximate discriminatory power that requires further investigation. Conclusion Collectively, the results suggested that miR-217 may play a tumor suppressor role in ALL, whereas miR-22, miR-122, and miR-367 could function as an oncogene. Overall, miR-22, miR-217, and miR-367 could be considered possible biomarkers for the early diagnosis of ALL.

scholarly journals Circulating lncRNA DLG1-AS1 in Plasma as a Novel Diagnostic Marker for Esophageal Squamous Cell Carcinoma (ESCC)

2020 ◽  
Author(s):  
Xiuqin Wei ◽  
Qiang Gao ◽  
Wei Jia ◽  
Chao Ma ◽  
Mei Xue ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Esophageal Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Operating Characteristic ◽  
Early Stage ◽  
Diagnostic Value ◽  
Healthy Controls ◽  
Healthy Control

Abstract BACKGROUND: Esophageal squamous cell carcinoma (ESCC) in some cases can be diagnosed as esophageal varices (EV). DLG1-AS1 promotes cervical cancer, while its function is other malignancies remains unknown. Our aim for this study is to study the role of DLG1-AS1 in esophageal squamous cell carcinoma.METHODS: Plasma levels of DLG1-AS1 in 66 early stage ESCC patients, 60 EV patients and 60 healthy controls were measured by RT-qPCR. Receiver operating characteristic (ROC) curve was applied to analyze the diagnostic value of DLG1-AS1 for early stage ESCC. Relationship between miR-145 and DLG1-AS1 was analyzed by overexpression experiments. Proliferation of cells was determined by CCK-8 assay. RESULTS: DLG1-AS1 was upregulated in ESCC, but not in EV patients compared with healthy control. DLG1-AS1 overexpression distinguished ESCC patients from healthy controls and EV patients. Plasma miR-145 was inversely correlated with DLG1-AS1 in ESCC patients. Moreover, DLG1-AS1 overexpression resulted in the downregulation of miR-145, while miR-145 mimic transfection did not significantly alter DLG1-AS1. Overexpression of DLG1-AS1 mediated the promoted, while overexpression of miR-145 resulted in inhibited proliferation of ESCC cells. The role of DLG1-AS1 overexpression was inhibited by miR-145 mimic transfection. CONCLUSION: Therefore, DLG1-AS1 may promote ESCC under the repression of miR-145.

scholarly journals Downregulated Expression of hsa_circ_0005556 in Gastric Cancer and Its Clinical Significance

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Liangwei Yang ◽  
Yu Yu ◽  
Xiuchong Yu ◽  
Jiaming Zhou ◽  
Zhiping Zhang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Roc Curve ◽  
Noncoding Rna ◽  
Operating Characteristic ◽  
Diagnostic Value ◽  
Circular Rnas ◽  
Normal Tissues ◽  
Potential Biomarker ◽  
Polymerase Chain

Background. Gastric cancer (GC) has a poor prognosis due to the lack of ideal tumor markers. Circular RNAs (circRNAs) are a novel type of noncoding RNA related to the occurrence of GC. Among our research, we investigated the role of hsa_circ_0005556 in GC. Materials and Methods. The expression of hsa_circ_0005556 of 100 paired GC tissues and adjacent normal tissues was detected using quantitative reverse transcription-polymerase chain reaction (qRT-PCR). A receiver operating characteristic (ROC) curve was established to evaluate the diagnostic value of hsa_circ_0005556. The correlation between the expression of hsa_circ_0005556 and corresponding clinicopathological characteristic was explored. Results. hsa_circ_0005556 was significantly downregulated in GC tissues contrasted with adjacent normal tissues (n=100, p<0.001). The areas under the ROC curve (AUC) of hsa_circ_0005556 were up to 0.773, while 64% sensitivity and 82% specificity, respectively. Moreover, its expression levels were significantly associated with differentiation (p=0.001), TNM stage (p=0.013), and lymphatic metastasis (p=0.039). GC patients of high hsa_circ_0005556 levels had a longer overall survival (OS) than those of the low group (p=0.047). Conclusion. hsa_circ_0005556 is a potential biomarker for GC, which may guide judgment of the indication of endoscopic treatment for early gastric cancer (EGC).

MULTISPIRAL COMPUTER TOMOGRAPHY IN DIAGNOSTICS OF PATIENTS WITH THE PATHOLOGY OF ASCENDING DEPARTMENT OF THE AORTA IN BEFORE AND POSTOPERATIVE PERIOD

2018 ◽  
pp. 28-35
Author(s):  
E. P. Yasakova ◽  
V. S. Pykhteev ◽  
S. A. Belash ◽  
E. I. Zyablova ◽  
V. A. Porkhanov
Keyword(s):  
Computed Tomography ◽  
Aortic Valve ◽  
Postoperative Period ◽  
Diagnostic Value ◽  
Ascending Aorta ◽  
Postoperative Results ◽  
Transcatheter Aortic Valve ◽  
Technical Issues

This review presents current information on the diagnosis of patients with pathology of the ascending aorta in the pre and postoperative period using multispiral computed tomography. The authors paid attention to the importance of valuation of the valvular apparatus elements, the geometry of the root of the aorta (effective coaptation height, Henle triangles, aortic regurgitation area, etc.), the features of which are necessary for the surgeon to solve technical issues of the forthcoming operation. A comparison of the diagnostic value of multispiral computed tomography and transthoracic echocardiography with respect to the visualization of valvular structures is shown. The role of multispiral computed tomography in the planning of transcatheter aortic valve replacement and the determination of results after intervention is described. With the help of multispiral computed tomography, assessing the state of the ascending aorta, the aortic root and aortic valve elements, the surgeon has an opportunity to choose the optimal variant of the valve-preserving operation and to evaluate postoperative results in the preoperative period.

scholarly journals Comparing Five-Year and Lifetime Risks of Breast Cancer in the Prospective Family Study Cohort

2020 ◽  
Author(s):  
Robert J MacInnis ◽  
Julia A Knight ◽  
Wendy K Chung ◽  
Roger L Milne ◽  
Alice S Whittemore ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Confidence Interval ◽  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Statistical Tests ◽  
Lifetime Risk ◽  
Study Cohort ◽  
Characteristic Curves ◽  
Receiver Operating Characteristic Curves ◽  
Receiver Operating

Abstract Background Clinical guidelines often use predicted lifetime risk from birth to define criteria for making decisions regarding breast cancer screening rather than thresholds based on absolute 5-year risk from current age. Methods We used the Prospective Family Cohort Study of 14,657 women without breast cancer at baseline in which, during a median follow-up of 10 years, 482 women were diagnosed with invasive breast cancer. We examined the performances of the IBIS and BOADICEA risk models when using alternative thresholds by comparing predictions based on 5-year risk with those based on lifetime risk from birth and remaining lifetime risk. All statistical tests were two-sided. Results Using IBIS, the areas under the receiver-operating characteristic curves were 0.66 (95% confidence interval = 0.63 to 0.68) and 0.56 (95% confidence interval = 0.54 to 0.59) for 5-year and lifetime risks, respectively (Pdiff&lt;0.001). For equivalent sensitivities, the 5-year incidence almost always had higher specificities than lifetime risk from birth. For women aged 20–39 years, 5-year risk performed better than lifetime risk from birth. For women aged 40 years or more, receiver-operating characteristic curves were similar for 5-year and lifetime IBIS risk from birth. Classifications based on remaining lifetime risk were inferior to 5-year risk estimates. Results were similar using BOADICEA. Conclusions Our analysis shows that risk stratification using clinical models will likely be more accurate when based on predicted 5-year risk compared with risks based on predicted lifetime and remaining lifetime, particularly for women aged 20–39 years.

scholarly journals Differential diagnostics of adrenal incidentalomas

2011 ◽  
Vol 57 (6) ◽  
pp. 3-8
Author(s):  
D G Bel'tsevich ◽  
T V Soldatova ◽  
N S Kuznetsov ◽  
O V Remizov ◽  
A V Vorontsov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Research Centre ◽  
Differential Diagnostics ◽  
Specific Method ◽  
Suppression Test ◽  
Ct Density ◽  
The Relationship ◽  
Malignancy Potential

We have analysed the results of radiological investigations (USI, CT, and MRT) involving 177 patients given surgical treatment at the Endocrinological Research Centre during 2006-2010. In addition, the study included measurement of cortisol levels in the dexamethasone suppression test, fractionated metanephrins, and the relationship between aldosterone levels and plasma rennin activity (in the patients presenting with arterial hypertension). Twenty two patients underwent tumour puncture. Seventy six (55.9%) of the 136 patients having incidentalomas were found to have no indications for the surgical intervention (because of the absence of hormonal activity and low malignancy potential of the neoplasm). The follow-up period averaged 24.9±19 months. The choice of indications for the surgical treatment should be based on the results of standardized hormonal studies and the determination of malignancy potential using the native CT density above 20 UH as the principal criterion. Differential diagnostics by USI, MRT, and descriptive CT is believed to be inadequate. USI may be applied as a highly specific method for the detection of cysts and myelolopomas. Native CT density should be taken into consideration for the interpretation of the results of fractionated metanephrin measurements. Diagnosis of pheochromocytoma is very unlikely in the patients presenting with low CT density. Puncture biopsy is indicated only when the presence of metastases in the adrenal glands is suspected.

scholarly journals The Role of Serum Fibrinogen in Predicting Reinfection after DAIR (debridement, antibiotics, and implant retention) Treatment of Periprosthetic Joint Infections

2021 ◽  
Author(s):  
Dacheng Zhao ◽  
He Jinwen ◽  
Wang Xingwen ◽  
Zhao Xiaobing ◽  
Bin Geng ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Joint Infection ◽  
Diagnostic Value ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Joint Infections ◽  
Implant Retention

Abstract Background Fibrinogen (FIB) has been used to differentiate periprosthetic joint infection (PJI) from aseptic loosening. The purpose of this study was to evaluate the diagnostic value of FIB in predicting postoperative reinfection in patients with debridement, antibiotics and implant retention (DAIR). Methods We retrospectively analyzed the patients who were admitted to DAIR from January 2013 to August 2019 for consideration of PJI readmission. Subgroups were divided into subgroups based on whether there was reinfection after DAIR treatment, and the diagnostic value of serum fibrinogen, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) before DAIR treatment was analyzed by receiver operating Characteristic curve (ROC). To evaluate the diagnostic value of FIB in predicting postoperative reinfection in DAIR patients. Results FIB expression was different in acute PJI patients and chronic PJI patients treated with DAIR (4.03 VS 3.08; P < .05, 4.28 VS 3.68; P < .05). In patients with acute PJI treated with DAIR, the sensitivity and specificity of FIB were 81.82% and 83.33%, respectively, significantly higher than CRP (sensitivity, 72.73%; Specificity, 50%; P < .05), while the specificity was higher than ESR (specificity,41.67%; P < .05). In patients with chronic PJI treated with DAIR, the sensitivity and specificity of FIB were 80.00% and 66.66%, respectively, significantly higher than CRP (sensitivity, 53.33%; Specificity, 66.66%; P < .05), ESR (sensitivity was 66.00%; Specificity, 16.66 %; P < .05). Conclusion FIB can predict reinfection after DAIR treatment for acute or chronic PJI. Considering the low success rate of DAIR treatment for chronic PJI, it should be chosen carefully.

scholarly journals Diagnostic value of cystatin C for the early diagnosis of diabetic nephropathy

2021 ◽  
pp. 79-85
Author(s):  
V. N. Vasilkova ◽  
I. Yu. Pchelin ◽  
E. P. Naumenka ◽  
Ya. A. Borovets ◽  
Yu. I. Yarets ◽  
...  
Keyword(s):  
Diabetic Nephropathy ◽  
Early Diagnosis ◽  
Cystatin C ◽  
Diagnostic Value ◽  
Diabetic Patients ◽  
Risk Of Mortality ◽  
Patients With Diabetes ◽  
Reliable Marker

Objective: to assess the clinical significance of cystatin C in the early diagnosis of diabetic nephropathy.Materials and methods. We examined 449 patients with type 1 and type 2 diabetes mellitusolder than 25 years. The laboratory examination of the patients included the measurement of cystatin, creatinine in the blood serum, GFR calculation according to the CKD-EPI equation, and the determination of albuminuria levels.Results. The role of cystatin C as a reliable marker of diabetic nephropathy has been demonstrated: the level of cystatin C ≥ 0.72 mg/L with sensitivity of 90.8 %, specificity of 88.9 %, was associated with a decline of renal function in the diabetic patients (ROC AUC = 0.951).Conclusion. The determination of the level of cystatin C, alone or in conjunction with creatinine, will help to more accurately diagnose GFR and assess the risk of mortality and renal complications in patients with diabetes mellitus.

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