1,721,074 research outputs found
Accuracy of serum HER2 and CA 15-3 together in early detection of breast cancer recurrence. A preliminary case-control study
No full textBackground: Breast cancer is the most common female cancer worldwide, and the 5-year recurrence rates range from 7% to 13%, according to the stage (I-III) of the disease. Because late detection of metastases can contribute to the failure of primary treatment, their early identification has a substantial impact on adequate therapy and prognosis. In this setting, several serum tumor markers (TM) and tissue-extracting prognostic factors have been tested. Unfortunately, none has shown such a sensitivity to be recommended as a routine test. Human epidermal growth factor receptor 2 (HER2) is a transmembrane glycoprotein with intracellular tyrosine kinase activity, that can also be measured in the blood. The monoclonal antibody of the cancer antigen (CA) 15-3 assay recognizes an epitope localized in a mucine glycoprotein encoded by the gene MUC1, and this protein is overexpressed in BC cells and shed into the bloodstream. The purpose of this study was to evaluate the usefulness of HER2 and CA 15-3 serum levels measurements in the early detection of cancer recurrence in women who underwent curative surgery for stage I-II BC invasive ductal carcinoma of the breast.
Materials and Methods: Nineteen women (median age 62 years, range 38-74) who underwent curative surgery for stage I-II BC and developed distant metastases during follow-up (cases) were enrolled in the study. Controls were 21 age- and stage-matched patients at the time of surgery, in whom a recurrence was excluded by whole body 18F-FDG-PET/CT. All patients had undergone serum HER2 and CA 15-3 measurements using two-site sandwich immunoassay and direct chemiluminescent technology. The cut-off limit was 32 U/mL and 15 ng/mL for CA 15-3 and HER2, respectively. The chi-squared test was used to compare results.
Results: The results (HER2 vs. CA 15-3) were the following: sensitivity 52.6% vs. 36.8% (p=0.022), specificity 81.0 vs. 76.2% (p=0.39), positive predictive value 71.4% (95% CI 45.3-88.3) vs. 58.3% (95% CI 31.9-80.7) (p=0.054), negative predictive value 65.4% (95% CI 46.2-80.6) vs. 57.1% (95% CI 39.1-73.5) (p=0.19), accuracy 67.5% vs. 57.5% (p=0.14). The prevalence was the same (47.5%). With the combination of CA 15-3 and HER2, the sensitivity, specificity and accuracy reached 63.1% (p=0.15), 85.7% (p=0.34), and 75.0% (p=0.21), respectively.
Conclusions: In the early detection of distant metastases in patients with BC, the sensitivity of both serum HER2 and CA 15-3 was low. HER2 was more sensitive than CA 15-3 (52.6% vs. 36.8%, p=0.02), but the combination of HER2 and CA 15-3 did not improve significantly (p=NS) the results, and thus is not recommended
Flow cytometry analysis of circulating endothelial cells in women with breast cancer. Preliminary results
No full textLogistic regression model based on serum CEA, CA 15-3, IGFBP-3, and IL-2R measurement in predicting the presence of axillary lymph node metastases in patients with breast cancer
No full textBackground: Approximately 25% of patients with breast cancer (BC) may present with axillary lymph node metastases (NMs) at the time of surgery. Unfortunately, no preoperative imaging studies are available in detecting NMs before sentinel node biopsy, which is considered a routine technique for staging patients. More than 50% of patients had early-stage (stage 0-1) BC, but an early prediction of NMs could be useful in selecting patients scheduled for neoadjuvant chemotherapy and more personalized surgery. A number of serum tumor markers (STMs) have been proposed in the pre- and postoperative management of patients with BC, and the most widely used were carcinoembryonic antigen (CEA), and cancer-specific cancer antigen (CA) 15-3. More recently, relatively new STMs, including insulin-like growth factor binding protein-3 (IGFBP-3) and interleukin-2 receptor (IL-2R), have been suggested. The aim of this study was to evaluate the sensitivity and specificity of serum CEA, CA 15-3, IGFBP-3, and IL-2R in predicting the presence of NMs in patients with pT1-2 BC.
Patients and Methods: A group of 34 women with confirmed pN1-2 BC (cases) and 33 age-matched node-negative (pN0) control patients were retrospectively enrolled in the study. All patients underwent serum CEA, CA 15-3, IGFBP-3, and IL-2R measurement using radioimmunoassay (CEA) or chemiluminescent immunoassay, respectively.
Results: At univariate analysis, the sensitivity, specificity, and accuracy were the following: 47.1%, 36.4%, 41.8% (CEA); 50%, 48.5%, 49.3% (CA 15-3); 55.9%, 45.4%, 55.2% (IGFBP-3); 52.9%, 48.5%, 50.7% (IL-2R). The IGFBP-3 was the best NMs prediction marker in the univariate analysis, and the area under the curve (AUC) was 0.65. In the multivariate logistic regression analysis, model with IGFBP-3 and IL-2R showed a better predictive value (AUC=0.69), corresponding to a sensitivity and specificity of 70.6% and 66.7%, respectively.
Conclusion: In patients with BC, serum IGFBP-3 and IL-2R measurement in combination improves both sensitivity and specificity of STMs in predicting the presence of NMs, and can be useful in selecting patients with elevated risk of having positive sentinel node biopsy
Immunoassay of thyroid peroxidase autoantibodies: diagnostic performance in automated third generation methods. A multicentre evaluation.
No full textRelationship between bone mineral density, PTH, 25(OH)D and IGF-1 serum levels in elderly men with osteoporosis: results from a preliminary study
No full textBackground: Osteoporosis is relatively rare among men, but represents one of the leading causes of morbidity and mortality among elderly men. The precocious recognition of patients at increased risk of fracture is still a challenge for physicians. In this preliminary study we evaluated the relationship between bone mineral density (BMD), parathyroid hormone (PTH), 25-Hydroxyvitamin D [25(OH)D] and insulin-like growth factor-1 (IGF-1) serum levels in a group of osteoporotic men (≥65 years old).
Patients and Methods: A group of 15 elderly men (median age 68 years, range 65-74 years) with confirmed osteoporosis (LS T-score below ‒2SD) underwent PTH, 25(OH)D and IGF-1 serum levels measurement. As previously reported, PTH was analyzed by an immunometric assay (Intact PTH Bridge, Adaltis, Bologna, Italy) with a detection limit 10 pg/mL and inter- and intra-assay CV of 4% and 3.5%, respectively. 25(OH)D was determined by a radioimmunoassay (RIA) (25-hydroxyvitamin D 125I RIA kit, DiaSorin, Stillwater, MN, USA), detection limit 5 nmol/L and inter- and intra-assay CV of 9%. Serum IGF-I was measured by a immunoradiometric method (IGF-1 kit, Immunotech, Marseille, France) with detection limit 10 ng/mL and inter- and intra-assay CV of 11% and 4%, respectively. The evaluation of lumbar spine (LS) bone mineral density (BMD) was obtained with dual-energy X-ray absorptiometry (DXA) in all patients.
Results: The results were the following: LS-BMD=0.777±0.060 g/cm2, PTH=75.2±8.3 pg/mL, 25(OH)D=365.1±134.4 nmol/L, IGF-1=201.3±55.3 ng/mL. No correlation was found between age and LS-BMD (R=‒0.034, p=0.91), PTH (R=0.276, p=0.31), 25(OH)D (R=‒0.235, p=0.40), IGF-1 (R=0.219, p=0.43). No correlation between 25(OH)D and BMD (R=0.278, p=0.32), PTH (R=0.036, p=0.88), IGF-1 (R=0.032, p=0.91), and between IGF-1 and PTH (R=0.292, p=0.29). There was e significant inverse relationship between BMD and both PTH (R=‒0.511, p=0.047) and IGF-1 (R=‒0.662, p=0.007)
High-resolution ultrasonography, US-guided fine-needle aspiration cytology and flow cytometry in the diagnosis of recurrent lymphoma
No full textBackground: High-resolution ultrasonography (US) is the imaging technique usually used in differentiating between benign/reactive enlarged lymph nodes from malignancy (e.g. node metastasis, lymphoma), and US-guided fine-needle aspiration cytology (FNAC) and flow cytometry (FC) significantly improve US accuracy. The aim of this study was to evaluate the usefulness of high-resolution US, US-guided FNAC and FC together in the diagnosis of recurrent lymphoma.
Patients and Methods: One-hundred and eight consecutive patients with suspected recurrent lymphoma underwent neck US and US-guided FNAC with FC in a single session. There were 63 women (58.3%) and 45 men (41.7%) with a median age of 54 years (range 18-77 years). Inadequate or unclear specimen requiring repeated FNAC were excluded. Large nodes (>15 mm), hypoechoic echotexiture, round shape, and well-defined borders represented US sign of malignancy. The cells were harvested from the samples obtained for FC examination, which was performed by using an automatic t cytofluorometer, gated by using the forward- and side-scatter histograms, and the samples were stained for the panel of antibodies, including CD5, CD10, CD19, CD23, Kappa, Lambda, Mu, and CD45. All patients underwent surgical excision and subsequent histopathological examination of the removed lymph node.
Results: Final pathology showed the presence of a primary or recurrent lymphoma in 64 (59.3%) patients, and a benign disease in 44 (40.7%) patients. The results are reported in the Table below.
The sensitivity ranged from 84.4% to 76.5% (p=0.28) and the specificity from 86.4% to 75.5% (p=0.11), while the accuracy did not differ (80.6%). The combination of US, FNAC and FC reached 87.5% sensitivity, 88.9% specificity, and 89.0% accuracy. The area under the receiver operating characteristic (ROC) curve was 0.72 (95% CI 0.63-0.81).
Conclusions: All patients with suspicious lymphoadenopathy on US should undergo US-guided FNAC, but FC gives a low improvement (p=NS) to results
VALUTAZIONE DELLO STATO EMOCOAGULATIVO DEL PAZIENTE CHIRURGICO NEL DECORSO POST-OPERATORIO
No full textCirculating PTH, vitamin D and IGF-I levels in relation to bone mineral density in elderly women.
No full textAge and reduced bone mineral density (BMD) represent major risk factors for vertebral fracture risk, especially in postmenopausal women, and measurement of BMD is currently considered of value in estimating bone mineralization. BMD correlates with demographics and anthropometric parameters, as well as with several markers of bone metabolism and calcium-regulating hormones, such as leptin, osteoprotegerin, parathyroid hormone (PTH), vitamin D, insulin-like growth factor-I (IGF-I) and sex steroid hormones. The aim of this study was to evaluate the relationship between PTH, 25(OH) vitamin D [25(OH)D], IGF-I and BMD in a selected group of elderly women. Thirty-one postmenopausal women over age 65, who were not estrogen, vitamin D or bisphosphonate users and did not have a history of fracture, bone disease or malignancy, were prospectively enrolled in the study. All the patients underwent lumbar spine dual-energy x-ray absorptiometry (DXA) and serum calcium, creatinine, PTH, 25(OH)D and IGF-I measurements. As expected, a weakly inverse correlation between age and 25(OH)D (R= –0.50, p=0.020), and between BMD and PTH (R= –0.48, p=0.027) was found. There was a strong relationship between IGF-I and BMD (R=0.64, p=0.0016), and between age and IGF-I (R= –0.70, p<0.001), while IGF-I did not correlate with 25(OH)D (R= –0.16, p=0.48) or BMI (R= –0.089, p=0.70). In conclusion, in this selected group of elderly women, we found a strong relationship of increased bone resorption, expressed as BMD, to calcium-regulating hormones PTH and IGF-I, while 25(OH)D and BMI seem to be independent of bone mineralization status
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