scholarly journals Predictive value of endoscopic ultrasonography for regression of gastric low grade and high grade MALT lymphomas after eradication of Helicobacter pylori

Gut ◽  
2001 ◽  
Vol 48 (4) ◽  
pp. 454-460 ◽  
Author(s):  
S Nakamura
Keyword(s):  
Helicobacter Pylori ◽  
Endoscopic Ultrasonography ◽  
Predictive Value ◽  
Low Grade ◽  
High Grade

Complete Remission of Primary High-Grade B-Cell Gastric Lymphoma After Cure of Helicobacter pylori Infection

2001 ◽  
Vol 19 (7) ◽  
pp. 2041-2048 ◽  
Author(s):  
Andrea Morgner ◽  
Stephan Miehlke ◽  
Wolfgang Fischbach ◽  
Wolfgang Schmitt ◽  
Hans Müller-Hermelink ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Complete Remission ◽  
B Cell ◽  
Gastric Lymphoma ◽  
Eradication Therapy ◽  
Lymph Node Involvement ◽  
Low Grade ◽  
Resected Stomach ◽  
High Grade ◽  
H Pylori

PURPOSE: Treatment of low-grade gastric mucosa-associated lymphoid tissue lymphoma by eradication of Helicobacter pylori is reported to result in complete lymphoma remission in approximately 75% of cases. The effect that cure of the infection has on the course of a primary high-grade gastric lymphoma is largely uncertain. The aim of this study was to report the effect of cure of H pylori infection exerted in patients with high-grade B-cell gastric lymphoma. PATIENTS AND METHODS: Eight patients (4 males and 4 females; age range, 26 to 85 years) with H pylori infection and high-grade lymphoma received eradication therapy before planned treatment. The effect of H pylori eradication on the course of high-grade lymphoma was assessed by analysis of surgical specimens (n = 2) or endoscopic biopsies (n = 6). RESULTS: H pylori eradication was successful in all patients and led to complete remission of the lymphoma in seven patients. One patient has experienced partial remission. Two patients were referred to surgery, one of whom (stage II1E) had lymph node involvement, and the histologic work-up of the resected stomach revealed residual infiltrates of a low-grade lymphoma, which prompted consolidation chemotherapy. In one patient (initially stage I1E), abdominal lymphoma developed 6 months after eradication therapy, which regressed completely after chemotherapy. In four patients, no further treatment was given. Six patients continue in complete remission (range, 6 to 66 months). CONCLUSION: Primary high-grade B-cell gastric lymphoma in stages IE through IIE1 associated with H pylori may regress completely after successful cure of the infection. Prospective trials are needed to investigate this treatment in larger numbers of patients.

scholarly journals Application of the Paris Reporting System for Urine Cytology: The Three-Year Experience of a Single Tertiary Care Institute in Thailand

2022 ◽  
pp. 1-8
Author(s):  
Bantita Phruttinarakorn ◽  
Sirithep Plumworasawat ◽  
Jitchai Kayankarnnavee ◽  
Jirasit Lualon ◽  
Atcharaporn Pongtippan
Keyword(s):  
Urothelial Carcinoma ◽  
Predictive Value ◽  
Diagnostic Category ◽  
Malignant Neoplasm ◽  
Urine Cytology ◽  
Malignant Neoplasms ◽  
Low Grade ◽  
High Grade ◽  
Sensitivity Specificity

<b><i>Introduction:</i></b> Urothelial carcinoma is one of the most common human cancers, both in Thailand and worldwide. Urine cytology is a screening tool used to detect urothelial carcinoma. The Paris System for Reporting Urinary Cytology (TPSRUC) was first published in 2016 to standardize the procedures, reporting, and management of urothelial carcinoma. Diagnostic categories include negative for high-grade urothelial carcinoma (NHGUC), atypical urothelial cells (AUCs), suspicious for HGUC (SHGUC), HGUC, low-grade urothelial neoplasm, and other malignancies. <b><i>Material and Methods:</i></b> In a retrospective review, urine cytology specimens from 2016 to 2019 were reevaluated using the TPSRUC. The risk of high-grade malignant neoplasm (ROHM) for each diagnostic category was calculated. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of prediction of high-grade malignant neoplasms were evaluated for cases with histological follow-up specimens. <b><i>Results:</i></b> In total, 2,178 urine cytology specimens were evaluated, of which 456 cases had follow-up histological specimens. The ROHM in each diagnostic category was as follows: NHGUC, 17.4%; AUC, 49.9%; SHGUC, 81.2%; HGUC, 91.3%; and other malignant neoplasms, 87.5%. The sensitivity, specificity, PPV, NPV, and accuracy for high-grade malignant neoplasm prediction were 63%, 92.8%, 89%, 73.1%, and 78.5% when AUC was included as malignant in the comparison and 82.6%, 74.7%, 75.1%, 82.3%, and 78.5% when AUC was not considered malignant. <b><i>Conclusions:</i></b> TPSRUC provides reliable results that are reproducible by different interpreters and is a helpful tool for the detection of HGUC.

scholarly journals Predicting high-grade prostate cancer at initial biopsy: clinical performance of the ExoDx (EPI) Prostate Intelliscore test in three independent prospective studies

2021 ◽  
Author(s):  
Erik Margolis ◽  
Gordon Brown ◽  
Alan Partin ◽  
Ballentine Carter ◽  
James McKiernan ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Predictive Value ◽  
Validation Studies ◽  
Characteristic Curve ◽  
Randomized Study ◽  
Specific Antigen ◽  
Low Grade ◽  
High Grade ◽  
Grade Group ◽  
Initial Biopsy

Abstract Background The ability to discriminate indolent from clinically significant prostate cancer (PC) at the initial biopsy remains a challenge. The ExoDx Prostate (IntelliScore) (EPI) test is a noninvasive liquid biopsy that quantifies three RNA targets in urine exosomes. The EPI test stratifies patients for risk of high-grade prostate cancer (HGPC; ≥ Grade Group 2 [GG] PC) in men ≥ 50 years with equivocal prostate-specific antigen (PSA) (2–10 ng/mL). Here, we present a pooled meta-analysis from three independent prospective-validation studies in men presenting for initial biopsy decision. Methods Pooled data from two prospective multi-site validation studies and the control arm of a clinical utility study were analyzed. Performance was evaluated using the area under the receiver-operating characteristic curve (AUC), negative predictive value (NPV), positive predictive value (PPV), sensitivity, and specificity for discriminating ≥ GG2 from GG1 and benign pathology. Results The combined cohort (n = 1212) of initial-biopsy subjects had a median age of 63 years and median PSA of 5.2 ng/mL. The EPI AUC (0.70) was superior to PSA (0.56), Prostate Cancer Prevention Trial Risk Calculator (PCPT-RC) (0.62), and The European Randomized Study of Screening for Prostate Cancer (ERSPC) (0.59), (all p-values <0.001) for discriminating GG2 from GG1 and benign histology. The validated cutoff of 15.6 would avoid 23% of all prostate biopsies and 30% of “unnecessary” (benign or Gleason 6/GG1) biopsies, with an NPV of 90%. Conclusions EPI is a noninvasive, easy-to-use, urine exosome–RNA assay that has been validated across 3 independent prospective multicenter clinical trials with 1212 subjects. The test can discriminate high-grade (≥GG2) from low-grade (GG1) cancer and benign disease. EPI effectively guides the biopsy-decision process independent of PSA and other standard-of-care factors.

Correlation of Swede score colposcopy scoring system and histopathological results in patients with high-risk HPV infection other than HPV16 and 18

2019 ◽  
Vol 30 (1) ◽  
pp. 35-40
Author(s):  
Murat Alan ◽  
Ilker Gunyeli ◽  
Murat Gultekin ◽  
Muzaffer Sancı ◽  
Kunter Yuce
Keyword(s):  
High Risk ◽  
Predictive Value ◽  
Scoring System ◽  
Hpv Infection ◽  
Low Grade ◽  
High Grade ◽  
Epithelial Lesions ◽  
Sensitivity Specificity ◽  
Histopathological Results ◽  
High Risk Hpv

ObjectiveTriage with HPV genotyping has some caveats and debates for HPV positive cases other than 16 and 18. The Swede score colposcopic scoring system has not previously been evaluated in this group of patients.ObjectiveTo use the Swede score colposcopic scoring system to compare scores and final histopathological results in women who have undergone colposcopy owing to infection with high risk-HPVs other than HPV16 and 18 and to establish new cut-off values to predict pre-malignant lesions in this group of patients.MethodsThis study was conducted in 613 women undergoing colposcopic evaluation because of abnormal cervical cytology together with high-risk HPV infection. All patients referred were evaluated by an expert colposcopist, given a Swede score (using the Swede score colposcopic scoring system) by using five variables (acetowhiteness, margins plus surface, vessel pattern, lesion size, and iodine staining), and had at least one biopsy procedure (either colposcopically directed or by a loop electrical excision procedure). Sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio values, and receiver operating characteristic curves for each clinico-pathological variable to detect low-grade and high-grade squamous intra-epithelial lesions, and any squamous cell abnormality (low-grade + high-grade squamous intra-epithelial lesions) were evaluated individually.ResultsFinal histopathological results of the patients were normal in 53.2% of cases, low-grade lesions in 32.5% of cases, and high-grade lesions in 14.4% of cases. Swede score was ≥8 (median 7.97) for high-grade lesions and ≥5 (median 5.06) for low-grade lesions. The area under the curve values (95% CI) of Swede scores for low-grade and high-grade squamous intra-epithelial lesions, and low-grade + high grade lesions were 0.92, 0.98, and 0.96, respectively. A Swede score cut-off value ≥6 had a sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratios of 92%, 98%, 93%, 98%, and 50 (22.6 to 110.8), respectively, for high-grade lesions at the final pathology (P<0.001). One high-risk HPV type (except 16 and 18) was no better than another for calculating the median Swede score during colposcopy (P=0.43).ConclusionsThe Swede score colposcopic scoring system appears to be a useful tool for evaluating atypical cervical cytology in women with high-risk HPV infection other than HPV types 16 and 18.

High-risk Human Papilloma Virus Testing Improves Diagnostic Performance to Predict Moderate- to High-grade Anal Intraepithelial Neoplasia in Human Immunodeficiency Virus–infected Men Who Have Sex With Men in Low-to-Absent Cytological Abnormalities

2019 ◽  
Vol 69 (12) ◽  
pp. 2185-2192 ◽  
Author(s):  
Pompeyo Viciana ◽  
Yusnelkis Milanés-Guisado ◽  
María Fontillón ◽  
Ana Domínguez Castaño ◽  
César Sotomayor ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
High Risk ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
Composite Endpoint ◽  
Low Grade ◽  
High Grade ◽  
Hpv Testing ◽  
Immunodeficiency Virus ◽  
Sex With Men

Abstract Background Screening methods for anal squamous intraepithelial lesions (SILs) are suboptimal. We aimed to determine the diagnostic performance of a composite endpoint comprising anal liquid-based cytology (aLBC) and high-risk human papillomavirus (HR-HPV) testing to predict histological high-grade SILs (hHSILs). Methods From the SeVIHanal cohort, human immunodeficiency virus (HIV)–infected men who have sex with men (MSM) who had an aLBC with concomitant HR-HPV testing were included. hHSILs were determined by high-resolution anoscopy (HRA)–guided biopsy. Results A total of 705 visits obtained from 426 patients were included. The prevalence of HR-HPV among aLBC results were 51.9% (133/215) normal, 87.9% (20/232) low-grade SILs (LSILs), and 90.9% (149/164) high-grade SILs; P (linear association) < .001. Low prevalence of hHSILs was only observed for the composite aLBC/HR-HPV testing endpoint “normal/noHR-HPV” (10%) and “LSIL/noHR-HPV” (4%). The prognostic values (95% confidence interval) for HR-HPV to predict hHSILs in normal cytology were positive predictive value (PPV), 29.3% (25.6%–33.3%); negative predictive value (NPV), 90.2% (82.8%–94.7%); sensitivity, 83% (69.2%–92.4%); and specificity, 44.1% (36.4%–51.9%). Corresponding figures for cytologic LSILs were PPV, 39.2% (37.4%–41.1%); NPV, 96.4% (78.9%–99.5%); sensitivity, 98.8% (93.3%–99.9%); and specificity, 17.9% (12.1%–24.9%). A positive interaction and a synergistic effect for the composite endpoint were observed (relative excess risk = 1.50, attributable proportion of histological results to interaction = 0.17, synergy index = 1.24). Conclusions HRA should not be indicated in the setting of LSILs/noHR-HPV following aLBC-based screening. In contrast, HIV-infected MSM with normal aLBC/HR-HPV infection should be considered for HRA. Clinical Trials Registration NCT03713229.

scholarly journals Clinical Performance of the ExoDx (EPI) Prostate Intelliscore Test to Predict High-grade Prostate Cancer at Initial Biopsy: A Pooled Analysis of Three Independent Prospective Studies.

2020 ◽  
Author(s):  
Erik Margolis ◽  
Gordon Brown ◽  
Alan Partin ◽  
Ballentine Carter ◽  
James McKiernan ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Predictive Value ◽  
Validation Studies ◽  
Task Force ◽  
African Ancestry ◽  
Low Grade ◽  
High Grade ◽  
Cut Point ◽  
Non Invasive ◽  
Initial Biopsy

Abstract BACKGROUND The ability to discriminate indolent from clinically significant prostate cancer (PC) in the initial biopsy setting remains an important health issue. ExoDx Prostate(IntelliScore) (EPI), is a non-invasive exosome based liquid biopsy test that quantifies three RNA targets in exosomes from urine. The EPI test is used to help stratify patients for risk of high grade prostate cancer, HGPC (≥ GG2 PC) in men 50 years or older with PSA in the gray zone (2–10 ng/mL). The EPI test has been extensively validated and is included in the NCCN guidelines for prostate cancer early detection. Here we present a pooled meta-analysis from three independent prospective validation studies in men presenting for initial biopsy decision. Age range and PSA level subgroups were also analyzed for EPI performance.METHODS Pooled data from two prospective multi-site validation studies and the control arm of a clinical utility study were analyzed. The data from these three independent trials is presented for men 50 years or older with PSA 2–10 ng/ml presenting for their initial prostate biopsy as well as a subgroup of patients between 55–69 years as recommended by the USPSTF (United States Preventative Services Task Force) and PSA greater than 3 ng/mL as per NCCN 2020 guidelines. Diagnostic needle biopsy outcomes were compared with the EPI score, PSA and both the Prostate Cancer Prevention Trial (PCPT 2.0) and the European Randomized Study of Screening for Prostate Cancer (ERSPC) risk calculators. Performance was evaluated using the area under the receiver operating characteristic curve (AUC), negative predictive value (NPV), positive predictive value (PPV), sensitivity and specificity for discriminating ≥ GG2 from GG1 and benign pathology.RESULTS The combined cohort (n = 1212) of initial biopsy subjects had a median age of 63 years, median PSA 5.2 ng/mL and 17% African ancestry. The positive biopsy rate was 52% for ≥ GG1, 30% ≥GG2 and 14% ≥GG3. The EPI AUC of 0.70 was superior to PSA (AUC:0.56), PCPTRC (AUC: 0.62), and ERSPC (AUC: 0.59), (all p-values < 0.001) for discriminating GG2 from GG1 and benign histology. The previously validated cut-point of 15.6 (or alternative 20) would avoid 23% (or 34%) of all prostate biopsies and 30% (or 43%) of “unnecessary” (benign or Gleason 6/GG1) biopsies, with an NPV of 90% (89%). Across the total cohort (n = 1212), only 2.3% (28/1212) or 3.8% (46/1212) of patients would experience delayed detection of ≥ GG2 at the < 15.6 or < 20 threshold, respectively and for GG3, 1% (12/1212) and 1.5% (19/1212) at either cut-point would be delayed. Comparable results were identified when either the USPSTF 55–69 year age limit or NCCN PSA greater than 3 ng/mL were applied.CONCLUSIONS EPI is a non-invasive, easy to use, urine exosome-RNA assay that has been validated across 3 independent prospective multi-center clinical trials with 1212 patients. The test can discriminate high-grade (≥GG2) from low-grade (GG1) cancer and benign disease and performs equally well in the larger cohort as well as across the USPSTF and NCCN restricted subgroups. EPI effectively guides the biopsy decision process and improves identification of HGPC independent of PSA and other standard of care factors.

Clinical Relevance of ASC-H Cytologies: Experience in a Single Tertiary Hospital

2016 ◽  
Vol 60 (3) ◽  
pp. 217-224 ◽  
Author(s):  
Cristina Díaz del Arco ◽  
Mª Carmen Sanabria Montoro ◽  
Dolores García López ◽  
Eva Rodríguez Escudero ◽  
Mª Jesús Fernández Aceñero
Keyword(s):  
Predictive Value ◽  
False Negative ◽  
Tertiary Hospital ◽  
Pap Smears ◽  
Low Grade ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Negative Results ◽  
Intraepithelial Lesion ◽  
Clinical Records

Objectives: To review the cases of atypical squamous cells (ASC), cannot exclude squamous intraepithelial lesion (ASC-H) diagnosed at a single institution and to discuss the interpretation challenges and clinical management of these cases. Study Design: The ASC-H cases diagnosed at our institution from 2006 to 2015 were studied retrospectively; of 159,000 Pap smears, there were 959 cases of ASC of undetermined significance (ASC-US) and 148 cases of ASC-H. We have reviewed the clinical records of the ASC-H cases, and data have been analyzed using SPSS 20.0. Results: Median age was 43.1 years; 49.6% of the patients had previous cervical cytologies, and 55.9% of them were negative. Following ASC-H diagnosis, another smear was obtained in 97.1% of the cases and in 67.6% a biopsy was performed. Biopsy revealed low-grade dysplasia in 18.8% of the cases, high-grade dysplasia in 27.8%, and infiltrating carcinoma in 2.3%. Patients with significant lesions in histology were younger than patients with negative results (p = 0.08). A diagnosis of ASC-H/squamous intraepithelial lesion in the repeated cytology had a sensitivity of 74.2%, specificity of 39.6%, positive predictive value of 44.8%, and negative predictive value of 70% for the diagnosis of dysplasia. Conclusions: ASC-H diagnosis is associated with a high incidence of histological high-grade lesions. A repeat cytology can aid in the selection of high-risk patients, but there may be false-negative results.

Liquid-based cervical cytology ThinPrep screening in Hungary

2014 ◽  
Vol 155 (18) ◽  
pp. 708-714
Author(s):  
Mihály Bak ◽  
Mária Séberné Éll ◽  
Melinda Bóka ◽  
Zsuzsanna Veleczki ◽  
Tibor Nyári ◽  
...  
Keyword(s):  
Positive Predictive Value ◽  
Human Papilloma Virus ◽  
Predictive Value ◽  
Human Papilloma Virus Infection ◽  
Cervical Cytology ◽  
Low Grade ◽  
High Grade ◽  
Squamous Intraepithelial Lesion ◽  
Papilloma Virus ◽  
Intraepithelial Lesion

Introduction: Liquid-based cervical cytology has been developed as an alternative for conventional Papanicolaou cervical cytology. Aim: The aim of this study was to determine the quality assurance of liquid-based cervical cytology. Method: 4573 cervical cytology smears were classified according to the Bethesda (2001) system. Human papilloma virus infection was detected and subtyped from reflex test using real-time polymerase chain reaction. Results: 4573 smears were classified according to the Bethesda (2001) system. Negative diagnosis was made in 2323 cases (50.8%), non neoplastic in 2017 cases (44.1%), and positive for intraepithelial lesions or malignancy in 233 cases (5.1%). Unsatisfactory smear for diagnosis was found in 43 cases (0.9%), low-grade squamous intraepithelial lesion in 87 cases (1.9%), high-grade squamous intraepithelial lesion in 24 cases (0.5%), and carcinoma in 23 cases (0.5%). Fifty-nine of the cases were histologically verified and 4 falsely negative cases were detected. The sensitivity, specificity and the positive predictive value were 93.2%, 100% and 100%, respectively. Compared to an identical time periods of the previous three years, the low- and high-grade squamous intraepithelial lesion increased from 0.82% to 2.51%. Eighty one human papilloma virus tests were performed with a positive predictive value of 99%. Conclusions: The auditing values of the liquid-bases cervical cytology results meet the proposed threshold values. Liquid-bases cervical cytology is an alternative cervical cytology and it seems to be significantly better than conventional Papanicolaou cervical cytology in all parameters. Orv. Hetil., 2014, 155(18), 708–714.

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