scholarly journals Clinical Significance of Serum HE4, CA125, CA724, and CA19-9 in Patients With Endometrial Cancer

2016 ◽  
Vol 16 (4) ◽  
pp. 435-439 ◽  
Author(s):  
Jing Bian ◽  
Xiaoxu Sun ◽  
Bo Li ◽  
Liang Ming
Keyword(s):  
Endometrial Cancer ◽  
Receiver Operating Characteristic ◽  
Predictive Value ◽  
Operating Characteristic ◽  
Area Under The Curve ◽  
International Federation ◽  
Characteristic Analysis ◽  
Predictive Values ◽  
Gynecology And Obstetrics ◽  
Receiver Operating

Purpose: Serum markers with increased sensitivity and specificity for endometrial cancer are required. To date, no good marker has met this standard. The aims of our study were to evaluate the utility of tumor markers HE4, CA125, CA724, and CA19-9 as potential markers in patients diagnosed with endometrial cancer. Methods: Blood samples from 105 patients with endometrial cancer and 87 healthy women were analyzed by Roche electrochemiluminescent immunoassay, and serum values were measured for the following biomarkers: HE4, CA125, CA724, and CA19-9. Results: Serum HE4, CA125, CA724, and CA19-9 concentrations were significantly higher in patients with endometrial cancer, compared with controls ( P < .001). In the receiver operating characteristic analysis, the area under the curve value for combination of HE4, CA125, CA724, and CA19-9 was 82.1% (95% confidence interval: 75.3%-86.2%), the maximum area of the test groups. For all stages of patients with endometrial cancer, HE4 had higher sensitivity (58%), positive predictive value (60%), and negative predictive value (67%) than any other single tumor marker, and in the combination of HE4, CA125, CA724, and CA19-9, the sensitivity and positive predictive values reached 59.1% and 88%, respectively. Meanwhile, the receiver operating characteristic area under the curve of the combination of the 4 markers was significantly increased than any other group, either in stage I or in stage II to IV cases. HE4 and CA125 both correlate with advanced age; in addition, HE4 was related to pathology subtypes and positive adnexal involvement, CA125 was related to International Federation of Gynecology and Obstetrics stage, CA19-9 was related to International Federation of Gynecology and Obstetrics stage, and CA724 was correlated with positive lymph node. Conclusion: Combination of HE4, CA125, CA724, and CA19-9 has the highest value in diagnosing endometrial cancer, and they can be a useful tissue immune marker for patients with endometrial cancer.

scholarly journals Identification of an optimal prolactin threshold to determine prolactinoma size using receiver operating characteristic analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Bianca M. Leca ◽  
Maria Mytilinaiou ◽  
Marina Tsoli ◽  
Andreea Epure ◽  
Simon J. B. Aylwin ◽  
...  
Keyword(s):  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Tumour Size ◽  
Area Under The Curve ◽  
Serum Prolactin ◽  
Pituitary Neoplasms ◽  
Characteristic Analysis ◽  
Roc Curve Analysis ◽  
Baseline Serum ◽  
Receiver Operating

AbstractProlactinomas represent the most common type of secretory pituitary neoplasms, with a therapeutic management that varies considerably based on tumour size and degree of hyperprolactinemia. The aim of the current study was to evaluate the relationship between serum prolactin (PRL) concentrations and prolactinoma size, and to determine a cut-off PRL value that could differentiate micro- from macro-prolactinomas. A retrospective cohort study of 114 patients diagnosed with prolactinomas between 2007 and 2017 was conducted. All patients underwent gadolinium enhanced pituitary MRI and receiver operating characteristic (ROC) analyses were performed. 51.8% of patients in this study were men, with a mean age at the time of diagnosis of 42.32 ± 15.04 years. 48.2% of the total cohort were found to have microadenomas. Baseline serum PRL concentrations were strongly correlated to tumour dimension (r = 0.750, p = 0.001). When performing the ROC curve analysis, the area under the curve was 0.976, indicating an excellent accuracy of the diagnostic method. For a value of 204 μg/L (4338 mU/L), sensitivity and specificity were calculated at 0.932 and 0.891, respectively. When a cut off value of 204 μg/L (4338 mU/L) was used, specificity was 93.2%, and sensitivity 89.1%, acceptable to reliably differentiate between micro- and macro- adenomas.

scholarly journals Assessment of Semi-automated Computed Tomographic Measures of Segmental Perfusion Defects in a Swine Model (Sus scrofa) of Intermediate Coronary Lesions

2020 ◽  
Vol 70 (3) ◽  
pp. 258-265
Author(s):  
Bryan C Ramsey ◽  
Amy E Field ◽  
Dustin M Thomas ◽  
Christopher A Pickett ◽  
Alisa J Leon ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Fractional Flow ◽  
Characteristic Analysis ◽  
Predictive Values ◽  
Computed Tomographic ◽  
Flow Reserve ◽  
Perfusion Defects ◽  
Receiver Operating

Computed tomographic myocardial perfusion (CTP) imaging is a tool that shows promise in emergent settings for defining the hemodynamic significance of coronary artery disease. In this study, we examined the accuracy with which the transmural perfusion ratio (TPR) derived through semiautomated CTP analysis reflected segmental perfusion defects associated with intermediate coronary artery lesions in swine. Lesions (diameter stenosis, 65% ± 11%) of the left anterior descending coronary artery (LAD) were created in 10 anesthetized female swine (weight, 47.5 ± 1.9 kg) by using a pneumatic occlusion device implanted on the LAD. Occluder inflation pressures were adjusted to maintain fractional flow reserve (FFR, 74.3 ± 1.7) during adenosine infusion (140ug/kg/min). Static CTP imaging using a stress-rest protocol and segmental TPR derived from semiautomated CT perfusion software was compared with microsphere-derived TPR (mTPR) by using a 16-segment model and polar mapping. Intermediate LAD stenosis was verified through multiplanar coronary CT angiography. Receiver operating characteristic analysis identified an optimal threshold for segmental perfusion defects for intermediate lesions (TPR threshold, ≤0.80); however, the area under the receiver operating characteristic curve was 0.58, and the overall accuracy was 63%. At this threshold, the sensitivity and specificity were 65% and 61%, and the positive and negative predictive values were 61% and 65%, respectively. Although CTP–TPR illustrated segmental perfusion defects with intermediate lesions, the disparity between CTP–TPR and mTPR measures of segmental perfusion suggests that further advances in analysis software may be necessary to improve the localization of segmental defects for intermediated lesions.

scholarly journals Evaluation of a Novel Plasma (1,3)-β-d-Glucan Detection Assay for Diagnosis of Candidemia in Pediatric Patients

2015 ◽  
Vol 53 (9) ◽  
pp. 3017-3020 ◽  
Author(s):  
Ying Liu ◽  
Feng Chen ◽  
Xiaodong Zhu ◽  
Lisong Shen ◽  
Sean X. Zhang
Keyword(s):  
Positive Predictive Value ◽  
Receiver Operating Characteristic ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Operating Characteristic ◽  
Pediatric Patients ◽  
Receiver Operating Characteristic Analysis ◽  
Area Under The Curve ◽  
Characteristic Analysis ◽  
Detection Assay

We evaluated a novel plasma (1,3)-β-d-glucan (BDG) detection assay for the diagnosis of candidemia in children. The median BDG levels were 73.4 pg/ml in patients with candidemia and <10 pg/ml in patients without candidemia (P< 0.001). Receiver operating characteristic analysis revealed a cutoff point of 14 pg/ml and an area under the curve of 0.802. At these values, the assay demonstrated 68% sensitivity, 91% specificity, 66% positive predictive value, and 91% negative predictive value. Plasma BDG levels were undetectable in 18 candidemia cases.

ATL

2014 ◽  
Vol 24 (4) ◽  
pp. 643-648 ◽  
Author(s):  
Da Zhu ◽  
Xiao-Hui Jiang ◽  
Yun-Hui Jiang ◽  
Wen-Cheng Ding ◽  
Chang-lin Zhang ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Receiver Operating Characteristic ◽  
Test Performance ◽  
Copy Number ◽  
Operating Characteristic ◽  
Area Under The Curve ◽  
Intraepithelial Neoplasia ◽  
Characteristic Analysis ◽  
Diagnostic Test Performance ◽  
Receiver Operating

ObjectiveBiopsy confirmed that cervical intraepithelial neoplasia (CIN) may naturally regress or progress. Currently, the risk assessment for CIN progression to cervical cancer is still not satisfactory in clinical practice. We investigated copy number and protein expression of TP63 and MYC and explored the possibility to use them as progression biomarkers.MethodsCopy numbers of TP63 and MYC, as well as human papilloma virus (HPV) integration status, were determined by fluorescence in situ hybridization in 39 patients with CIN and 66 patients with cervical cancer. Corresponding protein expressions were analyzed by immunohistochemistry. Receiver operating characteristic curves were used to measure the diagnostic test performance for the detection of cervical cancer from CIN. Sensitivity and specificity values of biomarkers were calculated.ResultsThe average copy number and expression of TP63 and MYC, as well as the HPV integration rate, increased in the progression of CIN to cervical cancer. Receiver operating characteristic analysis for detection of cervical cancer resulted in area under the curve (AUC) values of TP63 copy number (AUC, 0.96; 95% confidence interval [CI], 0.91–1.00), MYC copy number (AUC, 0.92; 95% CI, 0.85–0.96), TP63 expression (AUC, 0.73; 95% CI, 0.61–0.85), and HPV-16 integration (AUC, 0.73; 95% CI, 0.60–0.85). MYC expression was not able to statistically distinguish cancer from CIN (P = 0.393). The combinations increased the specificity slightly but not sensitivity. Among them, TP63 amplification showed the best diagnostic performance.ConclusionsAmplification and overexpression of TP63 and MYC, and HPV integration rate, are associated with the transition of CIN to cervical cancer. Future studies on these biomarkers will help to assess the risk of CIN progression.

scholarly journals Value of Fractional Uric Acid Excretion in Differential Diagnosis of Hyponatremic Patients on Diuretics

2008 ◽  
Vol 93 (8) ◽  
pp. 2991-2997 ◽  
Author(s):  
Wiebke Fenske ◽  
Stefan Störk ◽  
Ann-Cathrin Koschker ◽  
Anne Blechschmidt ◽  
Daniela Lorenz ◽  
...  
Keyword(s):  
Uric Acid ◽  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Diuretic Therapy ◽  
Isotonic Saline ◽  
Area Under The Curve ◽  
Characteristic Analysis ◽  
Diagnostic Potential ◽  
Receiver Operating

Abstract Background: The syndrome of inappropriate antidiuresis (SIAD) is the most frequent cause of hyponatremia. Its diagnosis requires decreased serum osmolality, inappropriately diluted urine (e.g. &gt;100 mOsm/kg), clinical euvolemia, and a urinary sodium (Na) excretion (U-Na) more than 30 mmol/liter. However, in hyponatremic patients taking diuretics, this definition is unreliable due to the natriuretic effect of diuretics. Here, we examined the diagnostic potential of alternative laboratory measurements to diagnose SIAD, regardless of the use of diuretics. Methods: A total of 86 consecutive hyponatremic patients (serum Na &lt;130 mmol/liter) was classified based on their history, clinical evaluation, osmolality, and saline response to isotonic saline into a SIAD and a non-SIAD group. U-Na, serum urate concentration, and fractional excretion (FE) of Na, urea, and uric acid (UA) were measured in all subjects. The accuracy to diagnose SIAD was assessed using receiver operating characteristic analysis. Results: A total of 31 patients (36%) had a diagnosis of SIAD, and 55 (64%) were classified as non-SIAD. There were 57 patients (68%) who were on diuretics (15 in the SIAD group, 42 in the non-SIAD group). In the absence of diuretic therapy, SIAD was accurately diagnosed using U-Na (area under the receiver operating characteristic curve 0.96; 0.92–1.02). However, in patients on diuretics, the diagnosis was unreliable (area under the curve 0.85; 0.73–0.97). There, FE-UA performed best compared with all other markers tested (area under the curve 0.96; 0.92–1.12), resulting in a positive predictive value of 100% if a cutoff value of 12% was used. Conclusion: FE-UA allows the diagnosis of SIAD with excellent specificity. Combining the information on U-Na and FE-UA leads to a very high diagnostic accuracy in hyponatremic patients with and without diuretic treatment.

Usefulness of Serum Anti-p53 Antibody Assay for Lung Cancer Diagnosis

2011 ◽  
Vol 135 (12) ◽  
pp. 1570-1575 ◽  
Author(s):  
Yongjung Park ◽  
Yoonjung Kim ◽  
Jong-Han Lee ◽  
Eun Young Lee ◽  
Hyon-Suk Kim
Keyword(s):  
Lung Cancer ◽  
Receiver Operating Characteristic ◽  
Tumor Markers ◽  
Operating Characteristic ◽  
Area Under The Curve ◽  
Control Group ◽  
Cytokeratin 19 ◽  
Characteristic Analysis ◽  
Serum Samples ◽  
Receiver Operating

Context.—Some tumor markers, including carcinoembryonic antigen (CEA) and cytokeratin 19 fragment (CYFRA 21-1), are used for the detection of lung cancer; however, their use is limited because of low sensitivities and high false-positive rates. Objectives.—To investigate the usefulness of an anti-p53 assay in detecting lung cancer and to compare the anti-p53 to CEA and CYFRA 21-1 tumor markers. Design.—Serum samples were collected from 82 patients with lung cancer. Sera were also collected from 79 patients with or without benign pulmonary disease for the control group. All 161 specimens were assayed for CEA, CYFRA 21-1, and anti-p53. The diagnostic performances of these markers were compared using receiver operating characteristic analysis. Results.—The receiver operating characteristic area under the curve values of CYFRA 21-1, CEA, and anti-p53 for discriminating lung cancers from benign or healthy conditions were 0.79, 0.81, and 0.79, respectively. Area under the curve for the 3 markers in combination was 0.90. The sensitivities of those markers for lung cancer detection were respectively 39.0%, 53.7%, and 34.1% at 94.9% specificity, and the cutoff levels at those sensitivities and specificities were 4.5 ng/mL for CYFRA 21-1, 5.4 ng/mL for CEA, and 2.7 U/mL for anti-p53. We found 79.3% positive results for patients with lung cancer by any of the 3 markers, and 12.2% were positive only for anti-p53. All patients without cancer had negative results for 2 or all 3 markers. Conclusions.—Anti-p53 combined with other conventional markers is helpful in increasing the sensitivity and specificity for detecting lung cancer.

scholarly journals 419. Diagnostic Utility of a Ferritin to Procalcitonin Ratio to Differentiate Patients with COVID-19 from Those with Bacterial Pneumonia

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S277-S277
Author(s):  
Katherine C Jankousky ◽  
Peter Hyson ◽  
Jin Huang ◽  
Daniel B Chastain ◽  
Carlos Franco-Paredes ◽  
...  
Keyword(s):  
Receiver Operating Characteristic ◽  
Host Response ◽  
Bacterial Pneumonia ◽  
Operating Characteristic ◽  
Receiver Operating Characteristic Analysis ◽  
University Hospital ◽  
Characteristic Analysis ◽  
The Us ◽  
Test Probability ◽  
Receiver Operating

Abstract Background Accurate, rapid, inexpensive biomarkers are needed to differentiate COVID-19 from bacterial pneumonia, allowing effective treatment and antibiotic stewardship. We hypothesized that the ratio of ferritin to procalcitonin (F/P) reflects greater viral activity and host response with COVID-19 pneumonia, while bacterial pneumonia would be associated with less cytolysis (lower ferritin) and more inflammation (higher procalcitonin), thus a lower F/P ratio. Methods We conducted a retrospective study of adult patients admitted to a single University hospital in the US through May 2020, during the COVID-19 pandemic. We compared F/P ratio of patients diagnosed with COVID-19 or bacterial pneumonia, excluding patients with COVID-19 and bacterial co-infections. In a logistic regression, we controlled for age, sex, body mass index (BMI), diabetes (DM), and hypertension (HTN). We used a receiver operating characteristic analysis to calculate the sensitivity and specificity of F/P values for the diagnosis of COVID-19 versus bacterial pneumonia. Results Of 218 patients with COVID-19 and 17 with bacterial pneumonia, COVID-19 patients were younger (56 vs 66 years, p=0.04), male (66% vs 24%, p=0.009), had higher BMI (31 vs 27 kg/m2, p=0.03), and similar rates of HTN (59% vs 45%, p=0.3) and DM (32% vs 18%, p=0.2). The median F/P ratio was significantly higher in patients with COVID-19 (3195 vs 860, p=0.0003, Figure 1). An F/P ratio cut-off of ≥ 1250 generated a sensitivity of 78% and a specificity of 59% to correctly classify a COVID-19 case (Figure 2). When adjusted for age, gender, BMI, DM, and HTN, a ratio ≥ of 1250 was associated with significantly greater odds of COVID-19 versus bacterial pneumonia (OR: 4.9, CI: 1.5, 16.1, p=0.009). Figure 1. Ferritin to Procalcitonin Ratios of patients with COVID-19 and patients with Bacterial Pneumonia (controls). Figure 2. Receiver Operating Characteristic Analysis of Ferritin to Procalcitonin Ratio Cut-off Values Predicting COVID-19 Diagnosis. Conclusion We observed an elevated F/P ratio in patients with COVID-19 compared to those with bacterial pneumonia. A F/P ratio ≥ 1250 provides a clinically relevant increase in pre-test probability of COVID-19. Prospective studies evaluating the discriminatory characteristics of F/P ratio in larger cohorts is warranted. Disclosures All Authors: No reported disclosures

scholarly journals Lesion-to-background ratio threshold value of SUVmax of simultaneous [68Ga]Ga-PSMA-11 PET/MRI imaging in patients with prostate cancer

2020 ◽  
Vol 11 (1) ◽  
Author(s):  
Jing Zhao ◽  
Bernd Hamm ◽  
Winfried Brenner ◽  
Marcus R. Makowski
Keyword(s):  
Prostate Cancer ◽  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Absolute Threshold ◽  
Threshold Value ◽  
Imaging Findings ◽  
Characteristic Analysis ◽  
Psma Pet ◽  
The Absolute ◽  
Receiver Operating

Abstract Purpose This study aimed to calculate an applicable relative ratio threshold value instead of the absolute threshold value for simultaneous 68Ga prostate-specific membrane antigen/positron emission tomography ([68Ga]Ga-PSMA-11 PET) in patients with prostate cancer (PCa). Materials and methods Our study evaluated thirty-two patients and 170 focal prostate lesions. Lesions are classified into groups according to Prostate Imaging Reporting and Data System (PI-RADS). Standardized uptake values maximum (SUVmax), corresponding lesion-to-background ratios (LBRs) of SUVmax, and LBR distributions of each group were measured based on regions of interest (ROI). We examined LBR with receiver operating characteristic analysis to determine threshold values for differentiation between multiparametric magnetic resonance imaging (mpMRI)-positive and mpMRI-negative lesions. Results We analyzed a total of 170 focal prostate lesions. Lesions number of PI-RADS 2 to 5 was 70, 16, 46, and 38. LBR of SUVmax of each PI-RADS scores was 1.5 (0.9, 2.4), 2.5 (1.6, 3.4), 3.7 (2.6, 4.8), and 6.7 (3.5, 12.7). Based on an optimal threshold ratio of 2.5 to be exceeded, lesions could be classified into MRI-positive lesion on [68Ga]Ga-PSMA PET with a sensitivity of 85.2%, a specificity of 72.0%, with the corresponding area under the receiver operating characteristic curve (AUC) of 0.83, p < 0.001. This value matches the imaging findings better. Conclusion The ratio threshold value of SUVmax, LBR, has improved clinical and research applicability compared with the absolute value of SUVmax. A higher threshold value than the background’s uptake can dovetail the imaging findings on MRI better. It reduces the bias from using absolute background uptake value as the threshold value.

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