Diagnostic accuracy of enthesis ultrasound in the diagnosis of early spondyloarthritis

ObjectiveTo determine the sensitivity and specificity of enthesis ultrasound for the diagnostic classification of early spondyloarthritis.MethodsA cross-sectional, blinded and controlled study. Standardised bilateral ultrasound of six entheses (Madrid sonography enthesitis index (MASEI)) was performed. Accepted diagnostic classification criteria were used as the gold standard. Validity was analysed by receiver operating characteristic (ROC) curves. Values of p<0.05 were considered significant.Results113 early spondyloarthritis patients were included (58 women/55 men), 57 non-inflammatory control individuals (29 women/28 men) and 24 inflammatory control individuals (11 women/13 men). The evolution time of spondyloarthritis was 10.9±7.1 months. At least some grade of sacroiliitis on x-ray was present in 59 patients, but only five fulfilled the radiographic sacroiliitis New York criteria. Human leucocyte antigen B27 (HLA-B27) was positive in 42% of patients. No statistical differences were found for the enthesis score among diagnostic spondyloarthritis subtypes form of presentation (axial, peripheral or mixed) or HLA-B27 positivity. The MASEI score achieved statistical significance for gender. The ultrasound score was 23.36±11.40 (mean±SD) in spondyloarthritis patients and 12.26±6.85 and 16.04±9.94 in the non-inflammatory and inflammatory control groups (p<0.001), respectively. The ROC area under the curve was 0.82, and a cut-off point of ≥20 points achieved a likelihood ratio of 5.30 and a specificity of 89.47%.ConclusionsEntheses are affected early in spondyloarthritis, and the incidence of involvement is higher in men and independent of the spondyloarthritis diagnostic subtype, HLA-B27 status or presentation pattern. The enthesis ultrasound score seems to have diagnostic accuracy and may be useful for improving the diagnostic accuracy of early spondyloarthritis.

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Survival in critically ill pediatric surgical patients with elevated PYMS and caloric deficit

10.21203/rs.3.rs-937457/v1 ◽

2021 ◽

Author(s):

Taymi Castro Morales ◽

Alfredo Carlos Rodriguez Portelles ◽

Alberto Ruben Piriz Assa ◽

Arianna Maite Cespedes Romulo

Keyword(s):

Intensive Care ◽

Statistical Significance ◽

Area Under The Curve ◽

Pediatric Intensive Care ◽

Roc Curves ◽

Nutritional Risk ◽

Surgical Patients ◽

Cross Sectional ◽

Nutritional Monitoring ◽

Caloric Deficit

Abstract Introduction: The nutritional counseling of the critical surgical pediatric patient is complex, it requires nutritional monitoring tools to improve their survival. The Pediatric Yorkhill Malnutrition Score (PYMS) is highly valid for determining nutritional risk. In Cuba there are no comparative studies on survival and PYMS. Objective: To determine survival in pediatric surgical patients with high PYMS and caloric deficit. Methods: An observational, prospective, cross-sectional and survival study was carried out in the Pediatric Intensive Care Unit of the Octavio de la Concepción de la Pedraja Pediatric Hospital, Holguín, Cuba, in the period from January 2018 to January 2019. analyzed 21 demographic and nutritional variables. Pearson's correlation coefficient was used for the bivariate variables. Kaplan Mier survival curves and ROC curves were created to determine optimal cut-off points for mortality. Results: All patients who did not survive presented high PYMS (p = 0.001) log Rank: X2 10.5, the patients with better caloric adequacy had better survival (p = 0.513) log Rank: X2 0.428 but without statistical significance. The area under the curve to determine mortality according to the PYMS score was higher (0.891) than caloric deficit (0.468) with a sensitivity of 1 and a specificity of 0.66. Conclusions: The survival of critical surgical pediatric patients with high PYMS and caloric deficit was determined. The non-survivors of the study had an elevated PYMS. The PYMS score is a better predictor of mortality than the caloric deficit. Demonstrating its excellent utility in advising nutritional risk in pediatric intensive care.

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Muscle strength cut-points for metabolic syndrome detection among adults and the elderly from Brazil

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2020-0758 ◽

2021 ◽

Vol 46 (4) ◽

pp. 379-388

Author(s):

Tiago Rodrigues de Lima ◽

David Alejandro González-Chica ◽

Eleonora D’Orsi ◽

Xuemei Sui ◽

Diego Augusto Santos Silva

Keyword(s):

Metabolic Syndrome ◽

Muscle Strength ◽

Lifestyle Modification ◽

Handgrip Strength ◽

Area Under The Curve ◽

Roc Curves ◽

The Elderly ◽

Youden Index ◽

Cross Sectional ◽

Cut Points

We aimed to determine cut-points for muscle strength based on metabolic syndrome diagnosis. This cross-sectional analysis comprised data from 2 cohorts in Brazil (EpiFloripa Adult, n = 626, 44.0 ± 11.1 years; EpiFloripa Aging, n = 365, 71.6 ± 6.1 years). Metabolic syndrome was assessed by relative handgrip strength (kgf/kg). Metabolic syndrome was defined as including ≥3 of the 5 metabolic abnormalities according to the Joint Interim Statement. Optimal cut-points from Receiver Operating Characteristic (ROC) curves were determined. Adjusted logistic regression was used to test the association between metabolic syndrome and the cut-points created. The cut-point identified for muscle strength was 1.07 kgf/kg (Youden index = 0.310; area under the curve (AUC)) = 0.693, 95% CI 0.614–0.764) for men and 0.73 kgf/kg (Youden index = 0.481; AUC = 0.768, 95% confidence interval (CI) = 0.709–0.821) for women (age group 25 to < 50 years). The best cut-points for men and women aged 50+ years were 0.99 kgf/kg (Youden index = 0.312; AUC = 0.651; 95% CI = 0.583–0.714) and 0.58 kgf/kg (Youden index = 0.378; AUC = 0.743; 95% CI = 0.696–0.786), respectively. Cut-points derived from ROC analysis have good discriminatory power for metabolic syndrome among adults aged 25 to <50 years but not for adults aged 50+ years. Novelty: First-line management recommendation for metabolic syndrome is lifestyle modification, including improvement of muscle strength. Cut-points for muscle strength levels according to sex and age range based on metabolic syndrome were created. Cut-points for muscle strength can assist in the identification of adults at risk for cardiometabolic disease.

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Diagnostic accuracy of anthropometric indices in predicting excess body fat among seven to ten-year-old children

Revista Brasileira de Epidemiologia ◽

10.1590/1415-790x201400010019eng ◽

2014 ◽

Vol 17 (1) ◽

pp. 243-254 ◽

Cited By ~ 4

Author(s):

Edineia Aparecida Gomes Ribeiro ◽

Danielle Biazzi Leal ◽

Maria Alice Altenburg de Assis

Keyword(s):

Diagnostic Accuracy ◽

Body Fat ◽

Roc Curves ◽

Cross Sectional Study ◽

The Body ◽

Anthropometric Indices ◽

Cross Sectional ◽

Standardized Residuals ◽

Highly Sensitive ◽

Anthropometric Index

PURPOSE: To evaluate the accuracy of the body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR) in detecting excess body fat among schoolchildren in Florianópolis, Santa Catarina. METHODS: Cross-sectional study with 2,772 schoolchildren aged seven to ten years. Receiver Operating Characteristic (ROC) curves were used to compare the diagnostic accuracy of the BMI, the WC and the WHtR in identifying children with excess body fat (defined as values that were equal to or higher than the 90th percentile of the standardized residuals obtained from the sum of the four skinfolds thickness). Likelihood ratio estimates were used to select, for each anthropometric index, the cut-off points that presented the highest association with excess body fat. RESULTS: The BMI, WC and WHtR performed well in detecting excess body fat, indicated by areas under the ROC curve (AUC) close to 1.0, with slightly higher AUC for the BMI in comparison to the WC and the WHtR concerning both sexes. Highly sensitive and specific cut-off points were derived for the three anthropometric indices. Sensitivity ranged from 85.7 to 92.9% for the BMI, from 78.6 to 89.7% for the WC, and from 78.6 to 89.2% for the WHtR. Specificity ranged from 83.2 to 91.4%, from 75.0 to 90.7%, and from 77.4 to 88.3% for the BMI, the WC and the WHtR, respectively. CONCLUSION: BMI, WC and WHtR can be used as diagnostic tests to identify excess body fat in children from seven to ten years of age.

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What Is the Prevalence of Measles Immunity among Pregnant Women?

American Journal of Perinatology ◽

10.1055/s-0040-1713817 ◽

2020 ◽

Vol 38 (01) ◽

pp. 016-022

Author(s):

Melissa T. Chu Lam ◽

Emily Schmidt-Beuchat ◽

Emma Geduldig ◽

Lois E. Brustman ◽

Katie Hyewon Choi ◽

...

Keyword(s):

New York ◽

Pregnant Women ◽

Characteristic Curve ◽

Private Insurance ◽

Area Under The Curve ◽

Patient Characteristics ◽

Cross Sectional Study ◽

Chi Square ◽

Cross Sectional ◽

Vaccination History

Objective This study aimed to estimate the prevalence of measles immunity in a cohort of pregnant women in New York City and determine if there is a positive correlation of measles immunity with patient demographics, rubella immunity, number of measles, mumps, and rubella vaccine (MMR) doses received, and age at last vaccination. Study Design This is a cross-sectional study of pregnant patients seen at a single institution from January 2019 to May 2019. Patients were classified as measles and rubella immune or nonimmune using commercial immunoglobulin G (IgG) tests. Patient characteristics were compared using t-tests, Chi-square tests, or Fisher's exact tests as appropriate. The association of age at last vaccination with immunity status was assessed using multivariable logistic regression adjusted for age at presentation. The utility of rubella IgG for distinguishing measles immunity was assessed using receiver operating characteristic curve analysis. Results Serologic immunity for measles and rubella was obtained for 1,366 patients. Of these, 1,047 (77%) were measles immune and 1,291 (95%) were rubella immune. Patients born after 1989 were less likely to be immune to measles, while multiparity and private insurance were associated with increased measles immunity. Documentation of MMR vaccination was available for 140 (10%) patients. Of these, 44 (31%) were serologically nonimmune to measles and 9 (6.4%) were nonimmune to rubella. In patients known to have received one dose of MMR, 62% (24/39) were immune to measles with an improvement to 72% (69/96) among those who received two or more doses. Age at last vaccination was not associated with measles immunity. Rubella IgG level was a poor predictor of positive measles titer (area under the curve = 0.59). Conclusion Approximately one of every four pregnant patients is serologically measles nonimmune, even among women with documented MMR vaccination or documented rubella immunity. These findings raise concerns that relying on vaccination history or rubella immune status may not be sufficient to assure protection from infection with measles. If further suggests that measles serology should be added to routine prenatal laboratory testing to identify nonimmune patients that may benefit from postpartum vaccination. Key Points

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Minimal Clinically Important Differences for American Orthopaedic Foot & Ankle Society Score in Hallux Valgus Surgery

Foot & Ankle International ◽

10.1177/1071100716688724 ◽

2017 ◽

Vol 38 (5) ◽

pp. 551-557 ◽

Cited By ~ 37

Author(s):

Hiok Yang Chan ◽

Jerry Yongqiang Chen ◽

Suraya Zainul-Abidin ◽

Hao Ying ◽

Kevin Koo ◽

...

Keyword(s):

Hallux Valgus ◽

Effect Size ◽

Statistical Significance ◽

Area Under The Curve ◽

Mean Difference ◽

P Value ◽

Aofas Score ◽

Level Of Evidence ◽

Cross Sectional ◽

American Orthopaedic

Background: The American Orthopaedic Foot & Ankle Society (AOFAS) score is one of the most common and adapted outcome scales in hallux valgus surgery. However, AOFAS is predominantly physician based and not patient based. Although it may be straightforward to derive statistical significance, it may not equate to the true subjective benefit of the patient’s experience. There is a paucity of literature defining MCID for AOFAS in hallux valgus surgery although it could have a great impact on the accuracy of analyzing surgical outcomes. Hence, the primary aim of this study was to define the Minimal Clinically Important Difference (MCID) for the AOFAS score in these patients, and the secondary aim was to correlate patients’ demographics to the MCID. Methods: We conducted a retrospective cross-sectional study. A total of 446 patients were reviewed preoperatively and followed up for 2 years. An anchor question was asked 2 years postoperation: “How would you rate the overall results of your treatment for your foot and ankle condition?” (excellent, very good, good, fair, poor, terrible). The MCID was derived using 4 methods, 3 from an anchor-based approach and 1 from a distribution-based approach. Anchor-based approaches were (1) mean difference in 2-year AOFAS scores of patients who answered “good” versus “fair” based on the anchor question; (2) mean change of AOFAS score preoperatively and at 2-year follow-up in patients who answered good; (3) receiver operating characteristic (ROC) curves method, where the area under the curve (AUC) represented the likelihood that the scoring system would accurately discriminate these 2 groups of patients. The distribution-based approach used to calculate MCID was the effect size method. There were 405 (90.8%) females and 41 (9.2%) males. Mean age was 51.2 (standard deviation [SD] = 13) years, mean preoperative BMI was 24.2 (SD = 4.1). Results: Mean preoperative AOFAS score was 55.6 (SD = 16.8), with significant improvement to 85.7 (SD = 14.4) in 2 years ( P value < .001). There were no statistical differences between demographics or preoperative AOFAS scores of patients with good versus fair satisfaction levels. At 2 years, patients who had good satisfaction had higher AOFAS scores than fair satisfaction (83.9 vs 78.1, P < .001) and higher mean change (30.2 vs 22.3, P = .015). Mean change in AOFAS score in patients with good satisfaction was 30.2 (SD = 19.8). Mean difference in good versus fair satisfaction was 7.9. Using ROC analysis, the cut-off point is 29.0, with an area under the curve (AUC) of 0.62. Effect size method derived an MCID of 8.4 with a moderate effect size of 0.5. Multiple linear regression demonstrated increasing age (β = −0.129, CI = −0.245, –0.013, P = .030) and higher preoperative AOFAS score (β = −0.874, CI = −0.644, –0.081, P < .001) to significantly decrease the amount of change in the AOFAS score. Conclusion: The MCID of AOFAS score in hallux valgus surgery was 7.9 to 30.2. The MCID can ensure clinical improvement from a patient’s perspective and also aid in interpreting results from clinical trials and other studies. Level of Evidence: Level III, retrospective comparative series.

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Colchicine Use Is Associated with Decreased Prevalence of Myocardial Infarction in Patients with Gout

The Journal of Rheumatology ◽

10.3899/jrheum.111533 ◽

2012 ◽

Vol 39 (7) ◽

pp. 1458-1464 ◽

Cited By ~ 102

Author(s):

DARIA B. CRITTENDEN ◽

R. AARON LEHMANN ◽

LAURA SCHNECK ◽

ROBERT T. KEENAN ◽

BINITA SHAH ◽

...

Keyword(s):

Myocardial Infarction ◽

New York ◽

Statistical Significance ◽

International Classification Of Diseases ◽

Serum Urate ◽

Cross Sectional Study ◽

Cross Sectional ◽

All Cause Mortality ◽

Classification Of Diseases ◽

Level Versus

Objective.The ability of antiinflammatory strategies to alter cardiovascular risk has not been rigorously examined. Colchicine is an antiinflammatory agent that affects macrophages, neutrophils, and endothelial cells, all of which are implicated in the pathogenesis of cardiovascular disease. We examined whether colchicine use was associated with a reduced risk of myocardial infarction (MI) in patients with gout.Methods.We conducted a retrospective, cross-sectional study of all patients with an International Classification of Diseases, 9th ed, code for gout in the electronic medical record (EMR) of the New York Harbor Healthcare System Veterans Affairs network and ≥ 1 hospital visit between August 2007 and August 2008. Hospital pharmacy data were used to identify patients who had filled at least 1 colchicine prescription versus those who had not. Demographics and CV comorbidities were collected by EMR review. The primary outcome was diagnosis of MI. Secondary outcomes included all-cause mortality and C-reactive protein (CRP) level.Results.In total, 1288 gout patients were identified. Colchicine (n = 576) and no colchicine (n = 712) groups had similar baseline demographics and serum urate levels. Prevalence of MI was 1.2% in the colchicine versus 2.6% in the no-colchicine group (p = 0.03). Colchicine users also had fewer deaths and lower CRP levels, although these did not achieve statistical significance. Colchicine effects persisted when allopurinol users were excluded from the analysis.Conclusion.In this hypothesis-generating study, gout patients who took colchicine had a significantly lower prevalence of MI and exhibited trends toward reduced all-cause mortality and lower CRP level versus those who did not take colchicine.

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Comparative Diagnostic Accuracy of the ACE-III, MIS, MMSE, MoCA, and RUDAS for Screening of Alzheimer Disease

Dementia and Geriatric Cognitive Disorders ◽

10.1159/000469658 ◽

2017 ◽

Vol 43 (5-6) ◽

pp. 237-246 ◽

Cited By ~ 31

Author(s):

Jordi A. Matías-Guiu ◽

María Valles-Salgado ◽

Teresa Rognoni ◽

Frank Hamre-Gil ◽

Teresa Moreno-Ramos ◽

...

Keyword(s):

Alzheimer Disease ◽

Diagnostic Accuracy ◽

Area Under The Curve ◽

Cross Sectional Study ◽

Screening Tests ◽

Cross Sectional ◽

Diagnostic Capacity ◽

State Examination ◽

Diagnostic Properties ◽

Addenbrooke’S Cognitive Examination

Background: Our aim was to evaluate and compare the diagnostic properties of 5 screening tests for the diagnosis of mild Alzheimer disease (AD). Methods: We conducted a prospective and cross-sectional study of 92 patients with mild AD and of 68 healthy controls from our Department of Neurology. The diagnostic properties of the following tests were compared: Mini-Mental State Examination (MMSE), Addenbrooke's Cognitive Examination III (ACE-III), Memory Impairment Screen (MIS), Montreal Cognitive Assessment (MoCA), and Rowland Universal Dementia Assessment Scale (RUDAS). Results: All tests yielded high diagnostic accuracy, with the ACE-III achieving the best diagnostic properties. The area under the curve was 0.897 for the ACE-III, 0.889 for the RUDAS, 0.874 for the MMSE, 0.866 for the MIS, and 0.856 for the MoCA. The Mini-ACE score from the ACE-III showed the highest diagnostic capacity (area under the curve 0.939). Memory scores of the ACE-III and of the RUDAS showed a better diagnostic accuracy than those of the MMSE and of the MoCA. All tests, especially the ACE-III, conveyed a higher diagnostic accuracy in patients with full primary education than in the less educated group. Implementing normative data improved the diagnostic accuracy of the ACE-III but not that of the other tests. Conclusions: The ACE-III achieved the highest diagnostic accuracy. This better discrimination was more evident in the more educated group.

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Fat-to-Muscle Ratio: A New Anthropometric Indicator as a Screening Tool for Metabolic Syndrome in Young Colombian People

Nutrients ◽

10.3390/nu10081027 ◽

2018 ◽

Vol 10 (8) ◽

pp. 1027 ◽

Cited By ~ 3

Author(s):

Robinson Ramírez-Vélez ◽

Hugo Carrillo ◽

Jorge Correa-Bautista ◽

Jacqueline Schmidt-RioValle ◽

Emilio González-Jiménez ◽

...

Keyword(s):

Metabolic Syndrome ◽

Large Population ◽

International Diabetes Federation ◽

Area Under The Curve ◽

Bioelectrical Impedance ◽

Roc Curves ◽

Impedance Analysis ◽

Cross Sectional Study ◽

Cross Sectional ◽

Alternative Approach

Fat-to-muscle ratio has been proposed as an alternative approach for assessing body fat. The objective of this study was to explore fat-to-muscle ratio thresholds in metabolic syndrome (MetS) diagnosis; it was hypothesised that the fat-to-muscle ratio is a good predictive indicator of MetS in a large population of young Colombian adults. For this purpose, a cross-sectional study was conducted on 1416 subjects (66.6% female), aged from 18.1 to 25.1. As part of the study, measurements of the subjects’ anthropometric indicators, serum lipid indices, blood pressure, and fasting plasma glucose were taken. Body composition was measured through bioelectrical impedance analysis (BIA). A new variable (ratio of fat mass to muscle mass, in kg) was calculated. Following the International Diabetes Federation (IDF) definition, MetS includes three or more metabolic abnormalities. Receiver operating characteristic (ROC) curves and logistic regression determined the discriminatory ability of the fat-to-muscle ratio to predict MetS. According to the IDF, the best fat-to-muscle ratio cut-off point for detecting MetS in men was 0.225 kg, with an area under the curve (AUC) of 0.83, sensitivity of 80%, and specificity of 70%. For women, the fat-to-muscle ratio cut-off point was 0.495 kg, the AUC was 0.88, and the sensitivity and specificity were 82% and 80%, respectively. In conclusion, our results showed that the fat-to-muscle ratio cut-off points from ROC analyses demonstrate good discriminatory power for detecting MetS in young Colombian adults.

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Assessing cardiovascular risk in ATM heterozygotes

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.64.02.148 ◽

2018 ◽

Vol 64 (2) ◽

pp. 148-153

Author(s):

Elaine Cristina de Almeida Kotchetkoff ◽

Fabíola Isabel Suano de Souza ◽

Fernando Luiz Affonso Fonseca ◽

Sonia Hix ◽

Sergio Aron Ajzen ◽

...

Keyword(s):

Cardiovascular Risk ◽

Independent Predictor ◽

Statistical Significance ◽

Thickness Measurement ◽

Controlled Study ◽

Age Group ◽

Biochemical Tests ◽

Cross Sectional ◽

The Mean ◽

Hs Crp

Summary Objective: To evaluate the carotid intima-media complex (CIMC) thickness and lipid metabolism biomarkers associated with cardiovascular risk (CR) in parents of patients with ataxia-telangiectasia and verify an association with gender. Method: A cross-sectional and controlled study with 29 ATM heterozygotes and 14 healthy controls. Biochemical tests and CIMC thickness measurement were performed. Results: The mean CIMC measurement in heterozygous ATM was 0.72 ± 0.1 mm (minimum: 0.5 mm and maximum: 1.0 mm). Noticed high percentage of amounts above 75 percentile compared to the population referential (16 [76.2%]), without any significant statistical differences between the female and the male gender (11/15 [73.3%] vs. 5/6 [83.3%]; p=0.550). The comparison between heterozygous and controls, stratified by gender, showed that in heterozygous ATMs, women had higher concentrations of HDL-c compared to men, as well as higher values of hs-CRP in relation to the control women. In heterozygous ATMs, stratified by gender, the correlation between HDL-c and hs-CRP was inversely proportional and stronger among women, with a tendency to statistical significance. Conclusion: Heterozygous ATMs did not differ from controls in relation to the biomarkers studied related to CR. However, most of them presented increased CIMC, independent predictor of death, risk for myocardial infarction and stroke, compared to the referential for the same age group. This finding suggests CR in the heterozygous ATM and shows to the need to monitor CIMC thickness and nutritional orientations.

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Inflammatory Breast Carcinoma: Elevated microRNA miR-181b-5p and Reduced miR-200b-3p, miR-200c-3p, and miR-203a-3p Expression as Potential Biomarkers with Diagnostic Value

Biomolecules ◽

10.3390/biom10071059 ◽

2020 ◽

Vol 10 (7) ◽

pp. 1059

Author(s):

Sarah Atef Fahim ◽

Mahmoud Salah Abdullah ◽

Nancy A. Espinoza-Sánchez ◽

Hebatallah Hassan ◽

Ayman M. Ibrahim ◽

...

Keyword(s):

Breast Cancer ◽

Diagnostic Accuracy ◽

Operating Characteristic ◽

Area Under The Curve ◽

Roc Curves ◽

Diagnostic Value ◽

Differentially Expressed Mirnas ◽

E Box ◽

Aggressive Breast Cancer ◽

Potential Biomarkers

Inflammatory breast cancer (IBC) is a rare yet aggressive breast cancer variant, associated with a poor prognosis. The major challenge for IBC is misdiagnosis due to the lack of molecular biomarkers. We profiled dysregulated expression of microRNAs (miRNAs) in primary samples of IBC and non-IBC tumors using human breast cancer miRNA PCR array. We discovered that 28 miRNAs were dysregulated (10 were upregulated, while 18 were underexpressed) in IBC vs. non-IBC tumors. We identified 128 hub genes, which are putative targets of the differentially expressed miRNAs and modulate important cancer biological processes. Furthermore, our qPCR analysis independently verified a significantly upregulated expression of miR-181b-5p, whereas a significant downregulation of miR-200b-3p, miR-200c-3p, and miR-203a-3p was detected in IBC tumors. Receiver operating characteristic (ROC) curves implied that the four miRNAs individually had a diagnostic accuracy in discriminating patients with IBC from non-IBC and that miR-203a-3p had the highest diagnostic value with an AUC of 0.821. Interestingly, a combination of miR-181b-5p, miR-200b-3p, and miR-200c-3p robustly improved the diagnostic accuracy, with an area under the curve (AUC) of 0.897. Intriguingly, qPCR revealed that the expression of zinc finger E box-binding homeobox 2 (ZEB2) mRNA, the putative target of miR-200b-3p, miR-200c-3p, and miR-203a-3p, was upregulated in IBC tumors. Overall, this study identified a set of miRNAs serving as potential biomarkers with diagnostic relevance for IBC.

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