scholarly journals Utilidad del recuento de plaquetas en el diagnóstico del cáncer de ovario

2021 ◽  
Vol 81 (04) ◽  
pp. 354-364
Author(s):  
Linder Mariano Díaz Colmenarez ◽  
◽  
Belkys Carolina Zambrano Ramón ◽  
Daniel Alejandro Omaña Carrero ◽  
Manuel Santos Luque
Keyword(s):  
Platelet Count ◽  
Receiver Operating Characteristic ◽  
Diagnostic Performance ◽  
Operating Characteristic ◽  
Ovarian Tumors ◽  
Observational Research ◽  
Ca 125 ◽  
Benign Tumors ◽  
Pathology Report ◽  
Receiver Operating

Objective: To evaluate the usefulness of the platelet count and CA-125 in the discrimination between malignant and bening ovarian tumors at the Hospital Universitario de Los Andes, in a period of 5 years. Methods: Retrospective observational research. 419 patient medical stories coded as ovarian tumors were reviewed. The definitive pathology report was used as the gold standard test. Multiple statistical parameters of diagnostic performance were calculated from 2x2 tables and receiver operating characteristic (ROC) curves were plotted. Results: The mean platelet count: with invasive malignant ovarian tumors was 386/nl (CI 95 % 362-409), in benign tumors it 243/nl (CI 95 % 235-251) and in borderline tumors 237/nl (CI 95 % 198-276). Although the area under the curve receiver operating characteristic was higher for platelet count compared to CA125 levels (0.880 vs 0.790) this difference was not statistically significant. Among the mucinous tumors, the malignant ones did not present an elevated CA-125, but an elevated platelet count. Highest PPV of the platelet count was 95.6 % for > 350 / nl in postmenopausal women and 100 % for > 400/nl (p <0.001). Conclusion: The platelet count seems to have a similar utility to CA-125 to discriminate malignant from benign tumors and could improve diagnostic performance when both preoperative values are combined. Keywords: Platelets, Thrombocytosis, Ovary, Tumor, Cancer, CA-125, Diagnostic accuracy, Menopause.

scholarly journals Clinical validation of urine 3-methoxytyramine as a biomarker of neuroblastoma and comparison with other catecholamine-related biomarkers

2016 ◽  
Vol 54 (2) ◽  
pp. 264-272 ◽  
Author(s):  
Leo Lam ◽  
Gerald A Woollard ◽  
Lochie Teague ◽  
James S Davidson
Keyword(s):  
Receiver Operating Characteristic Curve ◽  
Receiver Operating Characteristic ◽  
Diagnostic Performance ◽  
Homovanillic Acid ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Tumour Marker ◽  
Tumour Markers ◽  
Operating Characteristic Curve ◽  
Receiver Operating

Background Urinary dopamine, homovanillic acid and 4-hydroxy-3-methoxymandelic acid are established tests for diagnosis and monitoring of neuroblastic disease. We compared the diagnostic performance of total urinary 3-methoxytyramine, the O-methylated product of dopamine, to these three established tumour markers. Methods Urinary 3-methoxytyramine, dopamine, homovanillic acid and 4-hydroxy-3-methoxymandelic acid were measured by high-performance liquid chromatography with electrochemical detection on consecutive urine samples from histologically proven neuroblastic patients and controls. Patients with neuroblastic disease were further classified as untreated, advancing, residual or absent disease based on clinical and radiological criteria. Receiver operating characteristic curve analysis was used to compare the diagnostic performance of the four tumour markers. Results Urinary 3-methoxytyramine was well correlated with established tumour markers and its concentration correlated with disease activity. It was the most commonly elevated tumour marker in neuroblastic disease and showed similar sensitivity to dopamine and homovanillic acid. The diagnostic utility of urinary 3-methoxytyramine as measured by area under the receiver operating characteristic curve was similar to dopamine and homovanillic acid. Conclusion Our results support the use of urinary 3-methoxytyramine as a tumour marker in the diagnosis and the monitoring of neuroblastoma disease.

scholarly journals Laboratory and Clinical Performance of the ADVIA Centaur Anticyclic Citrullinated Peptide Assay for Rheumatoid Arthritis Diagnosis

2018 ◽  
Vol 142 (12) ◽  
pp. 1554-1559 ◽  
Author(s):  
Banseok Kim ◽  
Yongjung Park ◽  
Jin-Su Park ◽  
Kyoung Ja Jang ◽  
Hyo Jun Ahn ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Receiver Operating Characteristic Curve ◽  
Receiver Operating Characteristic ◽  
Diagnostic Performance ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Cutoff Values ◽  
Operating Characteristic Curve ◽  
Citrullinated Peptide ◽  
Receiver Operating

Context.— Anticyclic citrullinated peptide antibodies are important serologic markers for the diagnosis of rheumatoid arthritis. Several kinds of test reagents for automated immunoassay systems have been developed and used in recent years. Objective.— To evaluate the analytic and diagnostic performance of the new ADVIA Centaur anticyclic citrullinated peptide assay (Siemens Healthineers, Erlangen, Germany) compared with the Elecsys assay (Roche Diagnostics, Mannheim, Germany). Design.— A total of 576 serum samples were collected from subjects, including 156 patients (27%) with rheumatoid arthritis. Precision performance and analytical measurement range for the ADVIA assay were evaluated. Diagnostic performance of the 2 assays was compared based on sensitivity, specificity, and area under the receiver operating characteristic curves. Results.— The ADVIA assay showed a within-laboratory imprecision of 3.4% coefficient of variation for levels of 3.36 and 24.99 U/mL. This assay was demonstrated to be linear from 0.4 to 180.0 U/mL. With default cutoff values, sensitivity and specificity for diagnosing rheumatoid arthritis were 71.2% and 97.9%, respectively, for the ADVIA assay and 73.1% and 96.9%, respectively, for the Elecsys assay. With the best cutoff values from the analyses of the receiver operating characteristic curve, the sensitivity of the 2 assays was the same at 75.6%. However, the specificity of the ADVIA assay was 96.4%, whereas that of the Elecsys assay was 94.3%. The area under the receiver operating characteristic curve value for the ADVIA assay was 0.867, which was not significantly different from that of the Elecsys assay (0.865). Conclusions.— The ADVIA Centaur anticyclic citrullinated peptide assay showed good analytic and diagnostic performance in diagnosing rheumatoid arthritis.

scholarly journals A Prospective Study of the Prevalence of Nonclassical Congenital Adrenal Hyperplasia among Women Presenting with Hyperandrogenic Symptoms and Signs

2008 ◽  
Vol 93 (2) ◽  
pp. 527-533 ◽  
Author(s):  
Héctor F. Escobar-Morreale ◽  
Raul Sanchón ◽  
José L. San Millán
Keyword(s):  
Congenital Adrenal Hyperplasia ◽  
Receiver Operating Characteristic ◽  
Diagnostic Performance ◽  
Operating Characteristic ◽  
Adrenal Hyperplasia ◽  
Hydroxylase Deficiency ◽  
Cutoff Value ◽  
Basal Serum ◽  
17 Hydroxyprogesterone ◽  
Receiver Operating

Abstract Context: The diagnosis of the polycystic ovary syndrome requires the exclusion of nonclassical congenital adrenal hyperplasia (NCAH). Objective: Our objective was to evaluate the actual prevalences of 21-hydroxylase and 11β-hydroxylase deficiencies among women presenting with hyperandrogenic complaints. Settings: This study was performed at an academic hospital. Patients: A total of 270 consecutive unselected women presenting with hyperandrogenic symptoms were prospectively recruited. Interventions: Basal and ACTH-stimulated 11-deoxycortisol and 17-hydroxyprogesterone concentrations were measured. Main Outcome Measures: The prevalences of 21-hydroxylase and 11β-hydroxylase deficiencies were calculated, and the diagnostic performance of basal serum 17-hydroxyprogesterone levels for the screening of NCAH was evaluated by receiver operating characteristic curve analysis. Results: Six of the 270 patients had 21-hydroxylase-deficient NCAH that was confirmed by CYP21 genotyping, whereas no patient was diagnosed with 11β-hydroxylase deficiency, for an overall NCAH prevalence of 2.2% (95% confidence limits 0.5–3.9%). According to receiver operating characteristic analysis, a single basal serum 17-hydroxyprogesterone determination has a 0.97 (95% confidence interval: 0.934–1.008) chance of detecting NCAH in hyperandrogenic women. In our experience, the most appropriate cutoff value for the detection of NCAH is a 17-hydroxyprogesterone above 1.7 ng/ml, showing a 100% sensitivity and a 88.6% specificity. Five of the six 21-hydroxylase-deficient NCAH patients carried a severe CYP21 allele requiring genetic counseling and highlighting the importance of excluding this disorder among hyperandrogenic patients. Conclusions: The prevalence of NCAH among hyperandrogenic patients from Spain is 2.2%. Basal serum 17-hydroxyprogesterone measurements have an excellent diagnostic performance, yet the cutoff value should be established in each laboratory to avoid false-negative results.

A Proteomics Panel for Predicting Optimal Primary Cytoreduction in Stage III/IV Ovarian Cancer

2009 ◽  
Vol 19 (9) ◽  
pp. 1535-1538 ◽  
Author(s):  
Signe Risum ◽  
Estrid Høgdall ◽  
Svend A. Engelholm ◽  
Eric Fung ◽  
Lee Lomas ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Receiver Operating Characteristic ◽  
Sensitivity And Specificity ◽  
Operating Characteristic ◽  
Risk Index ◽  
Stage Iii ◽  
Ca 125 ◽  
Ovarian Cancer Risk ◽  
Incomplete Cytoreduction ◽  
Receiver Operating

The objective of this prospective study was to evaluate CA-125 and a 7-marker panel as predictors of incomplete primary cytoreduction in patients with stage III/IV ovarian cancer (OC). From September 2004 to January 2008, serum from 201 patients referred to surgery for a pelvic tumor was analyzed for CA-125. In addition, serum was analyzed for 7 biomarkers using surface-enhanced laser desorption/ionization time-of-flight mass spectrometry. These biomarkers were combined into a single-valued ovarian-cancer-risk index (OvaRI). CA-125 and OvaRI were evaluated as predictors of cytoreduction in 75 stage III/IV patients using receiver operating characteristic curves.Complete primary cytoreduction (no macroscopic residual disease) was achieved in 31% (23/75) of the patients. The area under the receiver operating characteristic curve was 0.66 for CA-125 and 0.75 for OvaRI.The sensitivity and specificity of CA-125 for predicting incomplete cytoreduction were 71% (37/52) and 57% (13/23), respectively (P = 0.04). The sensitivity and specificity of OvaRI for predicting incomplete cytoreduction were 73% (38/52) and 70% (16/23), respectively (P = 0.001). In conclusion, CA-125 and an index of 7 biomarkers were found to be predictors of cytoreduction. However, future studies of biomarkers are anticipated to promote early diagnosis and provide prognostic information to guide treatment of OC patients. In addition, new biomarkers might also play a role in predicting outcome from primary surgery in OC patients.

scholarly journals CA 125 DAN RISK OF MALIGNANCY INDEX (RMI)2 SEBAGAI PREDIKTOR KEGANASAN TUMOR OVARIUM TIPE EPITEL

2018 ◽  
Vol 11 (1) ◽  
pp. 18
Author(s):  
Aditiyono Aditiyono Aditiyono ◽  
Ali Budi Harsono ◽  
Herman Susanto
Keyword(s):  
Ovarian Cancer ◽  
Receiver Operating Characteristic ◽  
Roc Curve ◽  
Gold Standard ◽  
Area Under Curve ◽  
Operating Characteristic ◽  
Ca 125 ◽  
Chi Square ◽  
Numeric Data ◽  
Receiver Operating

Keganasan ovarium memiliki angka morbiditas dan mortalitas yang tinggi karena umumnya ditemukan pada stadium lanjut. Penelitian ini bertujuan untuk mengetahui spesifitas dan sensitivitas CA 125 dan RMI2 dalam menentukan keganasan kista ovarium jenis epitel. Kadar CA 125 dan RM12 kemudian dilihat histopatologinya sebagai gold standard. Penelitian ini merupakan uji diagnostik, dilakukan di RSUP dr. Hasan Sadikin Bandung periode April s.d. September 2017. Sampel berjumlah 90 dengan 47 berkategori jinak dan 43 berkategori ganas berdasarkan hasil histopatologinya. Analisis data dilakukan secara univariat dan bivariat. Data kategorik diuji dengan uji chi-square atau uji Exact Fisher. Data numerik digunakan uji-t tidak berpasangan atau uji Mann Whitney. Sensitivitas dan spesifisitas data numerik disajikan dalam kurva Receiver Operating Characteristic (ROC). Berdasarkan kurva ROC maka diperoleh nilai area under curve (AUC). Hasil penelitian menunjukkan nilai median CA 125 kelompok ganas dibanding kelompok jinak (142,2 vs 61,030) bermakna secara statistik p = 0,000 (nilai p < 0,05), cut off point CA 125 adalah 99,9 U/mL dengan nilai sensitivitas 76,7% dan nilai spesifisitas 61,7%. Nilai median RMI2 kelompok ganas lebih besar dibandingkan dengan kelompok jinak (1676,8 vs 125) bermakna secara statistik p = 0,000 (nilai p < 0,05), cut off point RMI2 pada penelitian ini adalah 212,7 dengan sensitivitas 86% dan spesifisitas 70,2%. Nilai sensitivitas RMI2 dengan cut off point 200 adalah 88% dan spesifisitas 63,87%. Kesimpulan penelitian ini adalah CA125 adalah biomarker yang berguna untuk memprediksi keganasan ovarium, dengan nilai cut off point 99,9 ng/mL. Hal ini sangat berguna bila digunakan kombinasi CA 125 dengan hasil pemeriksaan Ultrasonografi (USG) dan status menopause atau dikenal dengan Risk Malignancy Index (RMI2 cut off point > 200 ) dengan sensitivitas 86%, spesifisitas 63,87% dan akurasi 74,4%.   The malignancy of ovarian cancer has high level of morbidity and mortality due to the fact that it is commonly found in advanced stage. This research is aimed to find out the specificity and sensitivity of C125 and RMI2 in determining the malignancy of epithelial ovarian cysts. The level of CA 125 and RM12 is then histopathology-measured as a gold standard. This research is a diagnostic study conducted in Hasan Sadikin Hospital Bandung during April until September 2017. Sample consists of 90 patients with 47 patients belong to low-malignancy group and 43 patients belong to high-malignancy group based on its histopathology. Data analysis is conducted by using univariate and bivariate. Categorical data is tested by using chi-square or Exact Fisher. Numeric data is tested by using unpaired t test or Mann Whitney. Sensitivity and specificity of numeric data is displayed in Receiver Operating Characteristic (ROC) curve. The ROC curve shows the value of area under curve (AUC). The result shows that the median of CA125 of the high-malignancy group compared to the low-malignancy group is (142,2 vs 61,030) which statistically means p = 0,000 (value p < 0,05), cut off point CA125 is 99,9 U/mL with sensitivity value 76,7% and specificity value 61,7%. The median of RMI2 of high-malignancy group is bigger compare to the low-malignancy group (1676,8 vs 125) which statistically means p = 0,000 (value p < 0,05), cut off point RMI2 of this research is 212,7 with sensitivity value 86% and specificity value 70,2%. The sensitivity value of RMI2 with cut off points 200 is 88% and the specificity value is 63,87%. This research concludes that CA125 is a useful biomarker to predict the malignancy of ovarian cancer with cut off point 99,9ng/mL. It will be very useful if it is combined with CA125 with Ultrasonography (USG) examination and menopause status or known as Risk Malignancy Index (RMI cut off point > 200) with sensitivity 86%, specificity 63,87% and accuracy 74,4%.

scholarly journals A multicenter comparison of [18F]flortaucipir, [18F]RO948, and [18F]MK6240 tau PET tracers to detect a common target ROI for differential diagnosis

2021 ◽  
Author(s):  
Antoine Leuzy ◽  
Tharick A. Pascoal ◽  
Olof Strandberg ◽  
Philip Insel ◽  
Ruben Smith ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Receiver Operating Characteristic ◽  
Diagnostic Performance ◽  
Operating Characteristic ◽  
Regions Of Interest ◽  
Data Driven ◽  
Youden Index ◽  
Pet Tracers ◽  
Tau Pet ◽  
Receiver Operating

Abstract Purpose This study aims to determine whether comparable target regions of interest (ROIs) and cut-offs can be used across [18F]flortaucipir, [18F]RO948, and [18F]MK6240 tau positron emission tomography (PET) tracers for differential diagnosis of Alzheimer’s disease (AD) dementia vs either cognitively unimpaired (CU) individuals or non-AD neurodegenerative diseases. Methods A total of 1755 participants underwent tau PET using either [18F]flortaucipir (n = 975), [18F]RO948 (n = 493), or [18F]MK6240 (n = 287). SUVR values were calculated across four theory-driven ROIs and several tracer-specific data-driven (hierarchical clustering) regions of interest (ROIs). Diagnostic performance and cut-offs for ROIs were determined using receiver operating characteristic analyses and the Youden index, respectively. Results Comparable diagnostic performance (area under the receiver operating characteristic curve [AUC]) was observed between theory- and data-driven ROIs. The theory-defined temporal meta-ROI generally performed very well for all three tracers (AUCs: 0.926–0.996). An SUVR value of approximately 1.35 was a common threshold when using this ROI. Conclusion The temporal meta-ROI can be used for differential diagnosis of dementia patients with [18F]flortaucipir, [18F]RO948, and [18F]MK6240 tau PET with high accuracy, and that using very similar cut-offs of around 1.35 SUVR. This ROI/SUVR cut-off can also be applied across tracers to define tau positivity.

scholarly journals Thrombopoietin Level Predicts Response to Treatment with Eltrombopag and Romiplostim in Immune Thrombocytopenia

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 734-734
Author(s):  
Hanny Al-Samkari ◽  
David J. Kuter
Keyword(s):  
Logistic Regression ◽  
Platelet Count ◽  
Receiver Operating Characteristic ◽  
Treatment Response ◽  
Research Funding ◽  
Immune Thrombocytopenia ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Baseline Serum ◽  
Receiver Operating

Abstract Introduction : Thrombopoietin receptor agonists (TPO-RAs) are used to treat immune thrombocytopenia (ITP), but predicting clinical response to TPO-RAs before initiation is not possible. As ITP is both a disorder of increased platelet destruction and inadequate platelet production and because endogenous thrombopoietin (TPO) levels are typically normal or only slightly elevated in ITP patients (Makar et al, 2013), we hypothesized an inverse relation between baseline endogenous TPO level and probability of response to TPO-RAs. If a relation exists, obtaining TPO levels prior to TPO-RA therapy would be highly clinically useful in the treatment planning of patients with ITP given that the baseline platelet count, receipt of treatment, and disease duration do not significantly affect TPO level in ITP patients (Mukai et al, 1996, Makar et al, 2013). To determine whether endogenous thrombopoietin (TPO) levels predict treatment response to TPO-RAs we performed a retrospective analysis of ITP patients with known baseline TPO levels who received TPO-RAs. Methods : TPO-RA treatment and disease-related data were collected for ITP patients with a baseline TPO level treated with eltrombopag or romiplostim. Response fraction (RF) (proportion of platelet counts on therapy that were ≥50×109/L and least 20×109/L higher than pretreatment baseline) was determined for each patient. Multiple logistic regression was used to model the probability of three classes of treatment response [overall (RF>0.0), moderate (RF≥0.5), and superior (RF≥0.8)] based on TPO level. A generalized linear model with logit transformation was used to predict RF based on TPO level. All models controlled for duration of disease, number of prior therapies, and splenectomy status. Receiver operating characteristic (ROC) analysis was performed to identify optimal TPO thresholds for response and correlations between TPO level and various response characteristics were analyzed. Results : 67 patients (37 receiving eltrombopag and 46 receiving romiplostim; 16 patients had discrete treatment episodes with each drug) were included. Baseline patient characteristics are summarized in Table 1. Logistic regression models demonstrated a significant predictive relation between TPO level and probability of all classes of treatment response as illustrated in Figure 1 and Figure 2. TPO level was significantly inversely correlated with all response classes; correlation coefficients and odds ratios for each class of response (per 10 pg/mL TPO increase) are given in Table 2. Generalized linear modeling demonstrated a significant predictive relationship between TPO level and response fraction for both romiplostim (P<0.001) and eltrombopag (P<0.001) (Figure 3). There was no statistically significant relation between RF or any class of response and any of the other independent variables in any model. TPO level was inversely correlated with both RF [treatment with eltrombopag, r=-0.673 (P<0.001); treatment with romiplostim, r=-0.571 (P<0.001)] and median platelet count [treatment with eltrombopag, r=-0.446 (P=0.020); treatment with romiplostim, r=-0.317 (P<0.068)]. Utilizing Youden's index, receiver operating characteristic (ROC) analysis identified TPO thresholds of ≤136 pg/mL (eltrombopag) and ≤209 pg/mL (romiplostim) as optimally discriminating between responders and non-responders. Most non-responders had high TPO levels but did respond after addition of low-dose (5-15 mg daily) prednisone. Eltrombopag non-responders who responded to combination eltrombopag and prednisone had a median (range) TPO level of 155 (93-223) pg/mL, and romiplostim non-responders who responded to combination romiplostim and prednisone had a median (range) TPO level of 391 (150-1147) pg/mL. Conclusions : TPO levels predict response to eltrombopag and romiplostim in ITP patients, with lower levels predicting improved probability and magnitude of response. ITP patients with normal TPO levels are likely to clinically respond to either eltrombopag or romiplostim, those with modest elevations of TPO are more likely to respond to romiplostim than eltrombopag, and those with extreme elevations in TPO are unlikely to respond to either agent. Therefore, obtaining a baseline serum TPO level in any ITP patient in whom TPO-RA agonist therapy is anticipated may be clinically useful. Disclosures Al-Samkari: Agios: Consultancy. Kuter:Bioverativ: Consultancy, Research Funding; Principia: Research Funding; Amgen Inc.: Consultancy; Pfizer: Consultancy; Dova Pharmaceuticals: Consultancy, Membership on an entity's Board of Directors or advisory committees; Protalex: Research Funding; ONO: Consultancy; Novartis: Consultancy; Syntimmune: Consultancy; Argenx: Consultancy; Rigel: Consultancy, Research Funding; BMS: Research Funding.

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