153 Prognostic Role of the Low Tri-Iodothyronine Syndrome in Brain Tumor Patients

Abstract INTRODUCTION Reduced triiodothyronine (T3) concentrations were implicated in worse prognosis of brain tumor patients. We investigated the association of thyroid hormone concentrations with health-related quality of life (HRQoL), discharge outcomes and prognosis of brain tumor patients. METHODS Two-hundred and thirty brain tumor patients (70% women) before brain tumor surgery were evaluated for HRQoL (ERTC QLQ-C30 and QLQ-BN20 questionnaires); and thyroid function profile. The Low tri-iodothyronine (T3) syndrome was defined as T3 concentration below the reference range. Unfavorable hospital discharge outcomes were determined as Glasgow outcome scale score of = 3. Follow-up continued until November, 2015. RESULTS >Seventy-four percent of patients had Low T3 syndrome. After adjusting for the brain tumor histological diagnosis, patients' age, gender and functional status, lower free T3 concentrations were associated with worse HRQOL on the QLQ-C30 Global health status (ß = 0.302, P = 0.017), Emotional functioning (ß = 0.422, p<.001) and Cognitive functioning (ß = 0.259, P = 0.042) domains, and with greater symptom severity on the QLQ-BN20 Fatigue (ß = −0.238, p = .041), Motor dysfunction (ß = −0.283, P = 0.013) and Weakness of legs (ß = −0.269. P = 0.027) domains. Preoperative Low T3 syndrome increased risk for unfavorable discharge outcomes adjusting for age, gender and histological diagnosis (OR = 2.944, 95%CI [1.314-6.597], p = .009). In all patients, lower total (p = .038) and free (p = .014) T3 concentrations were associated with greater mortality adjusting for age, gender, extent of resection, adjuvant treatment and histological diagnosis. The Low T3 syndrome was associated with greater 5-year mortality for glioma patients (HR = 2.197; 95%CI [1.160-4.163], p = .016) and with shorter survival (249 [260] vs. 352 [399] days; p = .029) of high grade glioma patients independent of age, gender, extent of resection and adjuvant treatment. CONCLUSION The Low T3 syndrome is common in brain tumor patients and is associated with worse health status, impaired emotional and physical aspects of HRQoL and worse discharge outcomes. The Low T3 syndrome is associated with shorter survival of glioma patients.

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Biomarkers and focused ultrasound: the future of liquid biopsy for brain tumor patients

Journal of Neuro-Oncology ◽

10.1007/s11060-021-03837-0 ◽

2021 ◽

Author(s):

Jordina Rincon-Torroella ◽

Harmon Khela ◽

Anya Bettegowda ◽

Chetan Bettegowda

Keyword(s):

Brain Tumor ◽

Brain Tumors ◽

Liquid Biopsy ◽

Focused Ultrasound ◽

Modern Medicine ◽

Detection Methods ◽

Liquid Biopsies ◽

Tumor Patients ◽

Clinical Trial Registries ◽

Increased Risk

Abstract Introduction Despite advances in modern medicine, brain tumor patients are still monitored purely by clinical evaluation and imaging. Traditionally, invasive strategies such as open or stereotactic biopsies have been used to confirm the etiology of clinical and imaging changes. Liquid biopsies can enable physicians to noninvasively analyze the evolution of a tumor and a patient’s response to specific treatments. However, as a consequence of biology and the current limitations in detection methods, no blood or cerebrospinal fluid (CSF) brain tumor-derived biomarkers are used in routine clinical practice. Enhancing the presence of tumor biomarkers in blood and CSF via brain-blood barrier (BBB) disruption with MRI-guided focused ultrasound (MRgFUS) is a very compelling strategy for future management of brain tumor patients. Methods A literature review on MRgFUS-enabled brain tumor liquid biopsy was performed using Medline/Pubmed databases and clinical trial registries. Results The therapeutic applications of MRgFUS to target brain tumors have been under intense investigation. At high-intensity, MRgFUS can ablate brain tumors and target tissues, which needs to be balanced with the increased risk for damage to surrounding normal structures. At lower-intensity and pulsed-frequency, MRgFUS may be able to disrupt the BBB transiently. Thus, while facilitating intratumoral or parenchymal access to standard or novel therapeutics, BBB disruption with MRgFUS has opened the possibility of enhanced detection of brain tumor-derived biomarkers. Conclusions In this review, we describe the concept of MRgFUS-enabled brain tumor liquid biopsy and present the available preclinical evidence, ongoing clinical trials, limitations, and future directions of this application.

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Preoperative evaluation of basal free triiodothyronine in patients undergoing coronary artery bypass grafting surgery. Does it help?

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v11i2.13668 ◽

2015 ◽

Vol 11 (2) ◽

pp. 1-7

Author(s):

Kaushal Kishore Tiwari ◽

Alfredo Guiseppe Cerillo ◽

Simona Storti ◽

Stefano Bevilacqua ◽

Aldo Clerico ◽

...

Keyword(s):

Multivariate Analysis ◽

Cardiac Output ◽

Univariate Analysis ◽

Hospital Death ◽

Base Line ◽

Low T3 Syndrome ◽

Low Cardiac Output ◽

Low T3 ◽

Increased Risk ◽

The Impact

noBackground & Objectives: The postoperative Low T3 syndrome has been considered as a possible source of reduced myocardial contractility, resulting in increased mortality after CABG. Effect of preoperative Low T3 has not been well studied in patients undergoing CABG surgery. Aim of our study is to evaluate effect of preoperative Low T3 syndrome in patients undergoing CABG surgery.Materials & Methods: Six hundred and six patients undergoing CABG were included in this prospective study. The impact of the base-line FT3 concentration and of preoperative low T3 syndrome on the risk of postoperative low cardiac output and hospital death was analyzed.Results: Fifteen patients (2.3%) postoperatively and 159 (26.2%) developed major complications. At univariate analysis a reduced EF, the presence of peripheral vascular disease, the NYHA class, the surgical urgency, the aortic cross-clamp time, the CPB time and the FT3 concentration at admission were significantly associated with low CO and higher mortality. At multivariate analysis, the CPB time, an emergency procedure, a reduced LVEF, and the fT3 concentration were independently related to the development of low CO. However, in multivariate analysis low EF, and the fT3 concentration were the only predictors of hospital death.Conclusion: We conclude that preoperative low EF and low T3 syndrome independently causes low cardiac output and higher mortality in patients undergoing CABG. Therefore, all patients undergoing CABG should be evaluated for low T3 syndrome and patients with low T3 syndrome should be considered at increased risk. Appropriate preoperative T3 replacement therapy could decrease the postoperative complications in patients undergoing CABG.JCMS Nepal. 2015; 11(2):1-7

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Polymorphism in miRNA target sites of CEP-63 and CEP-152 ring complex influences expression of CEP genes and favors tumorigenesis in glioma

Future Oncology ◽

10.2217/fon-2020-1034 ◽

2021 ◽

Author(s):

Ishrat Mahjabeen ◽

Yusra Maqsood ◽

Ramsha Abbasi ◽

Malik Waqar Ahmed ◽

Mahmood Akhtar Kayani

Keyword(s):

Brain Tumor ◽

Amplification Refractory Mutation System ◽

Healthy Controls ◽

Nucleotide Polymorphisms ◽

Tumor Patients ◽

Single Nucleotide ◽

Tissue Samples ◽

Mutant Genotype ◽

Normal Tissues ◽

Increased Risk

Purpose: The present study was designed to screen the genetic polymorphisms and expression profiling of CEP-152 and CEP-63 genes in brain tumor patients. Methods: The amplification refractory mutation system PCR technique (ARMS-PCR) was used for mutation analysis using 300 blood samples of brain tumor patients and 300 overtly healthy controls. For expression analysis, 150 brain tumor tissue samples along with adjacent uninvolved/normal tissues (controls) were collected. Results: A significantly higher frequency of the mutant genotype of the CEP-152 single nucleotide polymorphism (rs2169757) and CEP-63 single nucleotide polymorphisms (rs9809619 and rs13060247) was observed in patients versus overtly healthy controls. The authors' results showed highly significant deregulation of CEP-152 (p < 0.0001) and CEP-63 (p < 0.0001) in glioma/meningioma tumor tissues versus adjacent normal tissue. Conclusion: The present study showed that variations in CEP-152 and CEP-63 genes were associated with an increased risk of brain tumor.

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388 Prognostic Value of N-Terminal Pro-B-Type Natriuretic Peptide Concertation in Brain Tumor Patients: A 5-Year Follow up Study

Neurosurgery ◽

10.1093/neuros/nyx417.388 ◽

2017 ◽

Vol 64 (CN_suppl_1) ◽

pp. 293-293

Author(s):

Adomas Bunevicius ◽

Vytenis Deltuva ◽

Edward R Laws ◽

Giorgio Iervasi ◽

Arimantas Tamasauskas

Keyword(s):

Brain Tumor ◽

Hospital Discharge ◽

Natriuretic Peptide ◽

Mortality Risk ◽

Depression Scale ◽

High Grade Glioma ◽

Histological Diagnosis ◽

Unfavorable Outcome ◽

Tumor Patients

Abstract INTRODUCTION Increased N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentration predicts poor prognosis of non-CNS cancer patients. We evaluated the association of NT-proBNP concentration with disease severity, discharge outcomes and prognosis of patients undergoing elective craniotomy for brain tumor. METHODS From January, 2010 until September, 2011 two-hundred and forty-five patients (mean age 55.05 ± 14.62 years) admitted for brain tumor surgery were evaluated for NT-proBNP serum concentration. Outcome at hospital discharge was evaluated with the Glasgow Outcome Scale (GOS). Ninety-four patients were also evaluated for cognitive functioning (Mini Mental State Examination or MMSE), functional status (Barthel Index or BI) and depressive symptom severity (Hospital Anxiety and Depression scale or HADS). Follow-up continued until November, 2015. RESULTS >The majority of patients were diagnosed with meningioma (37%) and high-grade glioma (20%). NT-proBNP concentrations was elevated in 80 (33%) patients. Greater NT-proBNP concentration was associated with lower BI (rho = −0.305) and MMSE scores (rho = −0.314) and with greater HADS-Depression score (rho = 0.240). NT-proBNP concentrations above the reference range ( = 157 ng/l) was associated with greater odds for unfavorable outcome at hospital discharge (GOS score = 3) adjusting for age, gender and histological diagnosis (HR = 2.268 95%CI [1.04-3.493], P = 0.039). NT-proBNP concentration above the median value ( = 93.15 ng/L) was associated with greater 90-day (HR = 4.416, 95%CI [1.157 16.851], P = 0.03) and 5-year (HR = 1.687; 95%CI [1.038-2.743], P = 0.035) mortality risk controlling for age, gender, histological diagnosis and adjuvant therapy. CONCLUSION Greater pre-operative NT-proBNP concentration is associated with worse health status, unfavorable outcome at hospital discharge and greater mortality risk of brain tumor patients.

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Self-reported comprehensive health status of adult brain tumor patients using the Health Utilities Index

Cancer ◽

10.1002/(sici)1097-0142(19970715)80:2<258::aid-cncr14>3.0.co;2-t ◽

1997 ◽

Vol 80 (2) ◽

pp. 258-265 ◽

Cited By ~ 33

Author(s):

Anthony C. Whitton ◽

Helen Rhydderch ◽

William Furlong ◽

David Feeny ◽

Ronald D. Barr

Keyword(s):

Brain Tumor ◽

Health Status ◽

Adult Brain ◽

Health Utilities Index ◽

Tumor Patients ◽

Health Utilities ◽

Comprehensive Health

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Self-reported comprehensive health status of adult brain tumor patients using the health utilities index

Cancer ◽

10.1002/(sici)1097-0142(19980301)82:5<995::aid-cncr31>3.0.co;2-u ◽

1998 ◽

Vol 82 (5) ◽

pp. 995-995

Author(s):

Ahmed N. Abbasi

Keyword(s):

Brain Tumor ◽

Health Status ◽

Adult Brain ◽

Health Utilities Index ◽

Tumor Patients ◽

Health Utilities ◽

Comprehensive Health

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Genetic and expression variations of cell cycle pathway genes in brain tumor patients

Bioscience Reports ◽

10.1042/bsr20190629 ◽

2020 ◽

Vol 40 (5) ◽

Author(s):

Anum Zehra Naqvi ◽

Ishrat Mahjabeen ◽

Saima Ameen ◽

Malik Waqar Ahmed ◽

Asad Ullah Khan ◽

...

Keyword(s):

Brain Tumor ◽

Gene Polymorphism ◽

Immunohistochemical Analysis ◽

Significant Negative Correlation ◽

Down Regulation ◽

Tumor Patients ◽

Ki 67 ◽

Mutant Genotype ◽

Tumor Risk ◽

Increased Risk

Abstract The present study was designed to determine the association between the genetic polymorphisms/expression variations of RB1 and CCND1 genes and brain tumor risk. For this purpose, 250 blood samples of brain tumor patients along with 250 controls (cohort I) and 96 brain tumor tissues (cohort II) with adjacent control section were collected. Mutation analysis of RB1 (rs137853294, rs121913300) and CCND1 (rs614367, rs498136) genes was performed using ARMS-PCR followed by sequencing, and expression analysis was performed using real-time PCR and immunohistochemistry. The results showed homozygous mutant genotype of RB1 gene polymorphism, rs121913300 (P=0.003) and CCND1 gene polymorphism rs614367 (P=0.01) were associated significantly with brain tumor risk. Moreover, significant down-regulation of RB1 (P=0.005) and up-regulation of CCND1 (P=0.0001) gene was observed in brain tumor sections vs controls. Spearman correlation showed significant negative correlation between RB1 vs proliferation marker, Ki-67 (r = −0.291*, P<0.05) in brain tumors. Expression levels of selected genes were also assessed at protein level using immunohistochemical analysis (IHC) and signification down-regulation of RB1 (P=0.0001) and up-regulation of CCND1 (P=0.0001) was observed in brain tumor compared with control sections. In conclusion, it is suggested that polymorphisms/expression variations of RB1 and CCND1 genes may be associated with increased risk of brain tumor.

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