Intraoperative Squash and Touch Preparation Cytology of Brain Lesions Stained with H+E and Diff-Quik™: A 20-Year Retrospective Analysis and Comparative Literature Review

2017 ◽  
Vol 62 (1) ◽  
pp. 44-53 ◽  
Author(s):  
Makoto Hamasaki ◽  
Karen H.F. Chang ◽  
Kazuki Nabeshima ◽  
Pamela S. Tauchi-Nishi
Keyword(s):  
Comparative Literature ◽  
Metastatic Cancer ◽  
High Sensitivity ◽  
Brain Lesions ◽  
Tumor Subtype ◽  
Sampling Errors ◽  
Squash Preparation ◽  
Diagnostic Efficacy ◽  
Factors Affecting ◽  
Touch Preparation

Objective: Squash preparation (SP) is a rapid technique for the intraoperative assessment of brain lesions. Only a few studies have employed touch preparation (TP) cytology and Diff-QuikTM (DQ) staining in conjunction with SP. Our study aimed to assess the diagnostic efficacy of SP of brain lesions at our institution, ascertain the additional effect of TP and DQ staining, examine factors affecting the sensitivity and specificity of our methods, and compare our findings with those of previous investigations. Study Design: Our database was searched for all SP/TP of brain lesions examined from January 1996 to December 2016. Results: During this 20-year study period, our search revealed 400 brain lesions diagnosed by SP/TP cytology. There were 338 (84.5%) neoplasms and 62 (15.5%) nonneoplastic lesions. The most common neoplasms were glioblastoma multiforme (24.6%), metastatic cancer (18.3%), meningioma (16.9%), astrocytoma (11.5%), lymphoma (8.3%), oligoastrocytoma (3.3%), and pituitary adenoma (3.3%). There was discordance between the SP/TP and histological diagnoses in 19/338 (5.6%) cases, i.e., 12 misclassifications of tumor subtype and 7 sampling errors. No false-positive cases were detected. Conclusion: Brain SP/TP stained with H+E/DQ demonstrated high sensitivity (97.9%), specificity (100%), and overall diagnostic accuracy (95.3%). The combined methods, in particular, aided in the diagnosis of brain tumors prone to smearing artifacts and certain metastatic malignancies.

scholarly journals How to Manage Synchronous Endometrial and Ovarian Cancer Patients?

2021 ◽  
Author(s):  
wonkyo shin ◽  
Sang-yoon Park ◽  
Sokbom Kang ◽  
Myongcheol Lim ◽  
Sang-Soo Seo
Keyword(s):  
Ovarian Cancer ◽  
Multivariate Analysis ◽  
Metastatic Cancer ◽  
Univariate Analysis ◽  
Influential Factors ◽  
Factors Affecting ◽  
Gynecology And Obstetrics ◽  
Aortic Lymph Node ◽  
Risk Patients ◽  
The Difference

Abstract Backgrounds: We aimed to evaluate the prognosis in patients with synchronous endometrial and ovarian cancer (SEOC) by comparing the differences between double primary cancer (DPC) and metastatic cancer (MC). Methods: The medical records of 47 patients diagnosed synchronously with endometrial and ovarian cancer between January 2006 and December 2018 were retrospectively reviewed. Twenty-eight and 19 patients were diagnosed with DPC and MC, respectively. Demographics, recurrence-free survival (RFS), and 5-year overall survival (OS) were compared. The clinical factors affecting survival were evaluated using univariate and multivariate analyses.Results: The demographics were not different between both groups. Endometrioid histology and the International Federation of Gynecology and Obstetrics grade were higher in the MC group than in the DPC group (42.1% vs. 10.7 %; P=0.018, P=0.002, respectively). The ratio of post-operative adjuvant therapy was not different in both groups. Recurrence occurred in five patients with DPC and seven with MC. The difference in RFS was not significantly different (P=0.131) but the OS was different between both groups (P = 0.020). Histology and para-aortic lymph node metastasis were associated wtih RFS in univariate analysis, but no difference was found in multivariate analysis.Conclusions: Although DPC patients had longer OS, multivariate analysis did not identify any influential factors. Focus should be placed on defining the appropriate adjuvant treatment for high-risk patients, which will improve prognosis, rather than on discriminating between DPC and MC.

scholarly journals New Spectrofluorimetric Method with Enhanced Sensitivity for Determination of Paroxetine in Dosage Forms and Plasma

2008 ◽  
Vol 3 ◽  
pp. ACI.S1053 ◽  
Author(s):  
Ibrahim A. Darwish ◽  
Sawsan M. Amer ◽  
Heba H. Abdine ◽  
Lama I. Al-Rayes
Keyword(s):  
High Sensitivity ◽  
Dosage Forms ◽  
Official Method ◽  
Factors Affecting ◽  
Pharmaceutical Tablets ◽  
Enhanced Sensitivity ◽  
Spectrofluorimetric Method ◽  
Relative Standard ◽  
Optimized Conditions

New simple spectrofluorimetric method with enhanced sensitivity has been developed and validated for the determination of the antidepressant paroxetine (PXT) in its dosage forms and plasma. The method was based on nucleophilic substitution reaction of PXT with 4-chloro-7-nitrobenzo-2-oxa-1,3-diazole in an alkaline medium (pH 8) to form a highly fluorescent derivative that was measured at 545 nm after excitation at 490 nm. The factors affecting the reaction was carefully studied and optimized. The kinetics of the reaction was investigated, and the reaction mechanism was presented. Under the optimized conditions, linear relationship with good correlation coefficient (0.9993) was found between the fluorescence intensity and PXT concentration in the range of 80-800 ng ml-1. The limits of detection and quantitation for the method were 25 and 77 ng ml-1, respectively. The precision of the method was satisfactory; the values of relative standard deviations did not exceed 3%. The proposed method was successfully applied to the determination of PXT in its pharmaceutical tablets with good accuracy; the recovery values were 100.2 ± 1.61%. The results obtained by the proposed method were comparable with those obtained by the official method. The proposed method is superior to the previously reported spectrofluorimetric method for determination of PXT in terms of its higher sensitivity and wider linear range. The high sensitivity of the method allowed its successful application to the analysis of PXT in spiked human plasma. The proposed method is practical and valuable for its routine application in quality control and clinical laboratories for analysis of PXT.

Usefulness of SS18-SSX antibody as a diagnostic marker for pulmonary metastatic synovial sarcoma

2021 ◽  
Author(s):  
Kentaro Miura ◽  
Kimihiro Shimizu ◽  
Takashi Eguchi ◽  
Sachie Koike ◽  
Shunichiro Matsuoka ◽  
...  
Keyword(s):  
Synovial Sarcoma ◽  
Specific Antibody ◽  
Diagnostic Marker ◽  
High Sensitivity ◽  
University Hospital ◽  
The Novel ◽  
Diagnostic Efficacy ◽  
Lung Cancers ◽  
Touch Imprint Cytology

Abstract Background The novel SS18-SSX fusion-specific antibody is reported to have high sensitivity and specificity for the diagnosis of primary synovial sarcoma (SS), which often metastasizes to the lung. Thus far, no study has validated the diagnostic efficacy of SS18-SSX antibody for pulmonary metastatic SS, and this is the first study to report these findings. We aimed to investigate the usefulness of the SS18-SSX antibody in the diagnosis of pulmonary metastatic SS. Methods We evaluated the immunohistochemistry of SS18-SSX fusion-specific antibody (E9X9V) in 10 pulmonary metastatic SS cases and the corresponding five primary sites (four limbs and one mediastinum) in five patients (SS diagnosis of was already confirmed by fluorescence in-situ hybridization in the metastatic and primary sites), and in 93 clinical and histologic mimics including 49 non-SS, pulmonary metastatic sarcomas, 39 primary lung cancers, and five intrathoracic solitary fibrotic tumors. All specimens were surgically resected at Shinshu University Hospital during 2001–2019. For primary and metastatic SS, we also evaluated SS18-SSX immunohistochemistry in needle biopsy and touch imprint cytology specimens from the primary site. Results SS18-SSX had stained diffusely strong in all 10 pulmonary metastatic SS cases and the corresponding five primary sites without staining of SS18-SSX in all 93 clinical and histologic mimics (100% sensitivity and 100% specificity). SS18-SSX had sufficiently stained in the biopsy and cytology specimens. Conclusions Immunohistochemistry of the SS18-SSX fusion-specific antibody is useful for the differential diagnosis of pulmonary metastatic SS in clinical practice. This simple and reliable method can replace traditional genomic tests.

Utilization of palliative care in patients with genitourinary malignancies.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 669-669
Author(s):  
Arya Mariam Roy ◽  
Manojna Konda ◽  
Akshay Goel ◽  
Rashmi Verma
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Terminal Illness ◽  
Hospital Admissions ◽  
Metastatic Cancer ◽  
Private Insurance ◽  
Malignant Neoplasm ◽  
The West ◽  
Factors Affecting

669 Background: Palliative care provides support and improves the quality of life of patients who has terminal illness such as cancer. Studies have shown that integrating palliative care into cancer care soon after the diagnosis of metastatic cancer can improve the quality of life and also prolong survival. The objective of the study was to analyze the acceptance of palliative care and to determine the factors affecting the utilization of palliative care in patients with genitourinary (GU) cancers. Methods: The National Inpatient Sample Database for the year 2016 was queried for the data. Patients who were admitted with a principal diagnosis of Malignant Neoplasm of Prostate (MNP), Renal Cell Carcinoma (RCC), Malignant Neoplasm of Ureter (MNU) were identified using ICD-10 codes and those who had Encounter for Palliative Care (PC) was also identified. Results: A total of 58765 hospitalizations were identified with MNP (n=39853), RCC (n=17786), MNU (n= 1126) during the study period. The total PC utilization for the above patients were 6.4% (n= 3785). Among those, 6.7% (n=1186), 6.3% (n=2531), 6.03% (n=68) from the groups RCC, MNP, MNU respectively received PC. The mean age for the PC utilization was 73 years (MNP= 72 yrs, RCA= 63 yrs, UCC= 73 yrs). Females received more PC when compared to males (6.7% vs 6.4%). Among those who had PC 27.4% (n=1029) died in the hospital. Interestingly, patients who had Medicare and Medicaid had more PC encounters when compared to those with private insurance (OR= 1.21, P= 0.001). Patients admitted on the weekend received more PC when compared to those who admitted during weekdays (OR= 1.12, P= 0.001). Patients admitted to hospitals in the West received more PC than other regions (OR= 1.42, P=0.03). Impact of race, teaching vs non-teaching hospital admissions were not found to be statistically significant in the utilization of PC in the above GU cancers. Conclusions: Medicare and Medicaid patients, weekend admissions, admissions to hospitals in the West received more palliative care. Further studies are needed to reveal the role of socioeconomic status and insurance in the utilization of palliative care in GU malignancies.

scholarly journals Efficacy of Monocyte Distribution Width in the Early Diagnosis of Sepsis: A Diagnostic Meta-Analysis

2021 ◽  
Author(s):  
Jiahao Chen ◽  
Qiang Guo
Keyword(s):  
Early Diagnosis ◽  
Large Scale ◽  
Meta Analysis ◽  
Delayed Diagnosis ◽  
Area Under The Curve ◽  
High Sensitivity ◽  
Inexpensive Method ◽  
Diagnostic Efficacy ◽  
Distribution Width ◽  
Non Invasive

Abstract Background: Delayed diagnosis of sepsis urgently requires a fast, convenient, and inexpensive method to improve the early diagnosis of sepsis. Increasing evidence showed that monocyte distribution width (MDW) could be used as a non-invasive biomarker with high sensitivity and specificity for the early diagnosis of sepsis. However, the accuracy and reliability of its diagnosis are still controversial in different studies. Method: A meta-analysis of all available studies regarding the association between MDW and the diagnosis of sepsis was performed to systematically evaluate the diagnostic efficacy of MDW in the prediction of sepsis. Results: The estimated results of all eight studies are as follows: sensitivity, 0.84 (95% CI 0.77, 0.90); specificity, 0.68 (95% CI 0.54, 0.80); PLR, 2.7 (95% CI 1.8, 4.1); NLR, 0.23 (95% CI 0.15, 0.35); DOR is 12 (95% CI 5, 25). The corresponding overall area under the curve is 0.85 (95% CI 0.82, 0.88). Conclusion: In conclusion, this meta-analysis demonstrates that MDW has high accuracy in distinguishing patients with sepsis from healthy controls for early diagnosis of sepsis. However, large-scale prospective studies and joint diagnosis with other indicators are urgently required to confirm our findings and their utilization for routine clinical diagnosis in the future.

scholarly journals Assessment of the Characteristics of Different Kinds of MS Lesions Using Multi-Parametric MRI

2020 ◽  
Vol 7 (4) ◽  
Author(s):  
Asieh Fatemidokht ◽  
Mohammad Hossein Harirchian ◽  
Elham Faghihzadeh ◽  
Abbas Tafakhori ◽  
Mohammad Ali Oghabian
Keyword(s):  
Cerebral Blood Volume ◽  
Magnetization Transfer ◽  
High Sensitivity ◽  
Brain Lesions ◽  
Quantitative Mri ◽  
Tissue Loss ◽  
Magnetization Transfer Ratio ◽  
Post Contrast ◽  
Fluid Attenuated Inversion Recovery ◽  
Best Parameter

Background: Studying different pathological aspects of lesions in multiple sclerosis (MS) patients could be useful to modify the diagnosis and treatment of this neurological disorder. Magnetic resonance imaging (MRI) modalities have the potential to investigate variations in brain tissue because of inflammatory and neurodegenerative processes in various types of MS-related lesions. Objectives: This study was done to investigate the quantitative changes in MRI-based parameters, like perfusion and magnetization transfer ratio (MTR) of different types of brain lesions, to demonstrate the ability of MRI to detect structural and pathological differences in MS lesions. Methods: Quantitative MRI modalities were performed on 18 patients with five different kinds of lesions (T1 holes, acute and chronic white matter (WM), and acute and chronic gray matter (GM) lesions) using a 3 T MRI scanner. The following protocols were used to characterize the pathology of lesions: (I) fluid-attenuated inversion recovery (FLAIR); (II) pre- and post-contrast T1-weighted; (III) dynamic contrast-enhanced (DCE); and (IV) MTR imaging. Quantitative comparison of Ktrans, cerebral blood volume (CBV), cerebral blood flow (CBF), and MTR was done to find the best parameter to distinguish different lesions. Finally, a multivariate classifier was applied to introduce the best parameter to indicate differences in lesions. Results: Five lesions were characterized by perfusion and MTR parameters. The pathological changes were measured, including: (I) the highest value of parameters in both acute WM and GM lesions; (II) the lowest value of four parameters in both chronic WM and GM lesions; (III) MTR had the highest rank among parameters using the classifier. Conclusions: The degree of pathological alterations due to inflammatory and neurodegenerative processes in MS-related lesions was indicated through the used parameters in different kinds of lesions. Inflammation was the dominant process in acute lesions, while neurodegeneration and tissue loss were observed mostly in chronic lesions. Both inflammation and neurodegeneration were detected in T1 holes. Perfusion parameters and MTR were reasonable parameters to describe differences in brain lesions. Thus, it could be confirmed that magnetization transfer imaging (MTI) and DCE-MRI are high-sensitivity methods to detect microstructural changes in the brain and subtle changes in the blood-brain-barrier. Classification of the parameters indicated that MTR was the best biomarker than others to show variations in lesions pathology.

scholarly journals Diagnostic value of HRCT-Thorax for pandemic COVID-19 pneumonia in Pakistan

2020 ◽  
Vol 24 (Supp-1) ◽  
pp. 77-84
Author(s):  
Abdul Rasheed Qureshi ◽  
Zaheer Akhtar ◽  
Muhammad Irfan ◽  
Muhammad Sajid ◽  
Zeeshan Ashraf
Keyword(s):  
High Sensitivity ◽  
Diagnostic Value ◽  
Cross Sectional Study ◽  
Sudden Onset ◽  
High Resolution Computed Tomography ◽  
Diagnostic Efficacy ◽  
Cross Sectional ◽  
Experienced Radiologist ◽  
Variable Extent ◽  
Low Sensitivity

Background: In the scenario of, inadequate testing, the low sensitivity of the COVID-19-PCR test, limited availability of testing kits, and low detection rate, we aimed to investigate the usefulness of high-resolution computed tomography of chest (HRCT) for diagnosing pandemic coronavirus (COVID-19) pneumonia. Objective: To determine the diagnostic efficacy of HRCT thorax in Covid-19 pandemic pneumonia. Materials and Methods: This prospective, cross-sectional study was conducted in the Pulmonology–OPD of Gulab Devi Teaching Hospital, Lahore-Pakistan from 01-04-2020 to 15-07-2020.   121 patients with dry cough, fever, and dyspnea of sudden onset were included while patients with Bronchial Asthma, ILD, Tuberculosis, Bronchiectasis, COPD, and overt heart failure were excluded. Patients were investigated with chest x-ray, HRCT, COVID-PCR, and hematological tests. HRCT films were evaluated by a qualified and experienced radiologist. Findings were summarized, organized and statistical analysis was done by using SPSS-26 software to make an inference. Results: Five patients were diagnosed as non-covid. Out of 116-diagnosed covid-19 patients, 38(32.75%) showed sub-pleural consolidation, 19(16.37%) consolidation with air-bronchogram, 29(25.0%) crazy paving sign, one pleural effusion (0.86%) and 18 cases (15.51%) displayed reticulations. 11cases(9.48%) had isolated ground glass appearances, while all categories showed it to variable extent. 65 patients (56.03%) were PCR-positive while  51(43.96) patients with positive-HRCT findings for COVID-19 pneumonia had negative nasopharyngeal-PCR. HRCT-Thorax revealed sensitivity: 97.41 %, specificity: 80%, PPV: 99.12%, NPV: 57.14%, and diagnostic accuracy of 96.69% for COVID-19 pneumonia. Conclusion: HRCT-Thorax, having high sensitivity and adequate specificity, can provide foundations for evidence-based early diagnosis and quantification of coronavirus pneumonia.  It can be tremendously useful for decision making in   PCR-negative patients and anticipating respiratory improvement or decline by serial scans.

scholarly journals A Circulating Long Noncoding RNA Panel Serves as a Diagnostic Marker for Hepatocellular Carcinoma

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Jinlan Huang ◽  
Yansong Zheng ◽  
Xialin Xiao ◽  
Can Liu ◽  
Jinpiao Lin ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Logistic Regression ◽  
Noncoding Rna ◽  
Predictive Ability ◽  
High Sensitivity ◽  
Clinicopathological Characteristics ◽  
Healthy Controls ◽  
Diagnostic Efficacy ◽  
Noninvasive Biomarker ◽  
Positive Correlations

Background. Circulating long noncoding RNAs (lncRNAs) have been demonstrated to serve as diagnostic biomarkers for various cancers. We aimed to elucidate the diagnostic efficacy of eight serum lncRNAs HULC, MALAT1, Linc00152, PTENP1, PTTG3P, SPRY4-IT1, UBE2CP3, and UCA1 and their combinations for the diagnosis of hepatocellular carcinoma (HCC). Methods. A total of 129 patients with HCC, 49 patients with liver cirrhosis, 27 patients with chronic hepatitis B, and 93 healthy controls were enrolled in this study. The levels of serum lncRNAs were assessed by quantitative real-time polymerase chain reaction. The correlations between serum lncRNAs and clinicopathological characteristics were further analyzed. The receiver operating characteristic (ROC) curve and area under curve (AUC) were utilized to estimate the diagnostic capacity of serum lncRNAs and their combination with AFP for HCC. A logistic regression model was performed to establish a multiple-lncRNA panel. Results. The levels of serum HULC, MALAT1, Linc00152, PTTG3P, SPRY4-IT1, UBE2CP3, and UCA1 were significantly higher in HCC patients than in patients with benign liver diseases and healthy controls, whereas serum PTENP1 was significantly decreased in HCC patients compared with healthy participants. Positive correlations between serum Linc00152 and GGT, serum PTTG3P and GGT, and serum SPRY4-IT1 and ALT were noted in HCC patients. ROC analysis revealed that all these lncRNAs had a significantly predictive value for HCC except for PTENP1. The best performance of single lncRNA was obtained by Linc00152 with an AUC of 0.877. When combined with AFP, the combination of Linc00152 and AFP gained the highest accuracy, yielding an AUC of 0.906. Through logistic regression analysis, the panel consisting of serum linc00152, UCA1, and AFP provided the greatest predictive ability, obtaining an AUC of 0.912 with 82.9% sensitivity and 88.2% specificity. Conclusion. The panel of serum Linc00152, UCA1, and AFP demonstrates a novel and noninvasive biomarker with relatively high sensitivity and specificity for HCC diagnosis.

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