A re-analysis of the prostate, lung, colorectal, and ovarian (PLCO) cancer screening trial accounting for ovarian cancer (OVCA) heterogeneity.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 5564-5564
Author(s):  
Sarah Madhu Temkin ◽  
Eric A Miller ◽  
Goli Samimi ◽  
Christine D Berg ◽  
Paul Pinsky ◽  
...  
Keyword(s):  
Usual Care ◽  
Stage I ◽  
Screening Tests ◽  
Low Grade ◽  
Tumor Type ◽  
Significant Difference ◽  
Cancer Screening Trial ◽  
Poorly Differentiated ◽  
Tumor Types

5564 Background: A mortality benefit from screening for OVCA has not been demonstrated, but screening efficacy could differ for histologic subtypes. We re-analyzed PLCO evaluating whether OVCA detection and outcomes were affected by the heterogeneous biologic behavior of this disease. Methods: Type 2 tumors (moderately/poorly differentiated serous and adenocarcinoma) were compared to all other tumor (OT) types (low grade serous and endometrioid, clear cell, other, low malignancy potential) (LMP). We examined differences in the distribution of tumor types and stage by study arm and method of diagnosis [screen detected (SD) and interval detected (ID) (i.e. assigned to screening but diagnosed between screening tests)]. Stage distribution and survival were analyzed. Results: Among the entire PLCO population, 531 women were diagnosed with OVCA during the study; 282 (53%) in the screening arm and 249 (47%) in the usual care arm. Of the tumors able to be characterized (n=408; 77%), 74% (n=300) were Type 2 and 26% OT (n=108). In the screening arm, 70% of tumors diagnosed were Type 2 compared to 78% in usual care (p=0.07). Overall, survival was significantly better for OT tumors compared to Type 2 tumors (p<0.01) but there was no difference in survival by study arm for either tumor type separately (Type 2: p=0.50; OT: p=0.23). Within the screening arm, 30% of Type 2 tumors were SD compared to 54% of OT tumors (p=0.02) (see Table). Only 15% of Type 2 SD tumors were Stage I/II, compared to 82% of SD OT tumors (p<0.01). Stage at diagnosis was similar among Type 2 patients whether they were SD or ID (p=0.56) and there was no difference in survival (p=0.56). Conclusions: A significant difference in tumor types by study arm was not observed. However, within the screening arm, Type 2 tumors were less likely to be SD or Stage I/II compared to OT tumors. Survival for Type 2 tumors was similar regardless of method of diagnosis. [Table: see text]

scholarly journals Separation of Low- Versus High-grade Crohn’s Disease-associated Small Bowel Carcinomas is Improved by Invasive Front Prognostic Marker Analysis

2019 ◽  
Vol 14 (3) ◽  
pp. 295-302 ◽  
Author(s):  
Giovanni Arpa ◽  
Federica Grillo ◽  
Paolo Giuffrida ◽  
Gabriella Nesi ◽  
Catherine Klersy ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Stage I ◽  
Low Grade ◽  
Invasive Front ◽  
Poorly Differentiated Clusters ◽  
Small Bowel Carcinoma ◽  
Poorly Differentiated ◽  
Tumour Budding

Abstract Background and Aims Crohn’s disease-associated small bowel carcinoma is a rare event, usually reported to have a severe prognosis. However, in previous investigations we have found a minority of cases displaying a relatively favourable behaviour, thus outlining the need to improve the histopathological prediction of Crohn’s disease-associated small bowel carcinoma prognosis. Methods As in recent studies on colorectal cancer, a substantial improvement in prognostic evaluations has been provided by the histological analysis of the tumour invasive front; we therefore systematically analysed the tumour budding and poorly differentiated clusters in the invasive front of 47 Crohn’s disease-associated small bowel carcinomas collected through the Small Bowel Cancer Italian Consortium. Results Both tumour budding and poorly differentiated cluster analyses proved highly effective in prognostic evaluation of Crohn’s disease-associated small bowel carcinomas. In addition, they retained prognostic value when combined with two other parameters, i.e. glandular histology and stage I/II, both known to predict a relatively favourable small bowel carcinoma behaviour. In particular, association of tumour budding and poorly differentiated clusters in a combined invasive front score allowed identification of a minor subset of cancers [12/47, 25%] characterised by combined invasive front low grade coupled with a glandular histology and a low stage [I or II] and showing no cancer-related death during a median follow-up of 73.5 months. Conclusions The improved distinction of lower- from higher-grade Crohn’s disease-associated small bowel carcinomas provided by invasive front analysis should be of potential help in choosing appropriate therapy for these rare and frequently ominous neoplasms.

scholarly journals Global sagittal spinal alignment in patients with degenerative low-grade lumbar spondylolisthesis

2019 ◽  
Vol 27 (3) ◽  
pp. 230949901988519
Author(s):  
Hiroto Kobayashi ◽  
Kenji Endo ◽  
Yasunobu Sawaji ◽  
Yuji Matsuoka ◽  
Hirosuke Nishimura ◽  
...  
Keyword(s):  
Sacral Slope ◽  
Low Grade ◽  
Spinal Alignment ◽  
Sagittal Spinal Alignment ◽  
Significant Difference ◽  
Degenerative Lumbar Spondylolisthesis ◽  
Lumbar Spondylolisthesis ◽  
Type 3

Purpose: Global sagittal spinal alignment undergoes changes on the basis of sagittal malalignment (trunk inclined forward) in natural degenerative progression. We hypothesized that this change would associate with the disease state of the degenerative lumbar spondylolisthesis (DS). This study aimed to evaluate the global sagittal spinal alignment of low-grade DS by classifying in accordance with sagittal vertical axis (SVA). Methods: The DS group was classified into three types according to the adult spinal deformity classification: type 1, SVA < 40 mm; type 2, 40 mm ≤ SVA < 95 mm; and type 3, 95 mm ≤ SVA. Age and sagittal spinal parameters (thoracic kyphosis, lumbar lordosis (LL), sacral slope (SS), pelvic tilt (PT), and pelvic incidence (PI)) were compared among three types. Results: There were statistically significant differences in age, LL, PI, and PT among the three types. In comparison between two types, there was a statistically significant difference between type 1 and type 2 and between type 1 and type 3, but not between type 2 and type 3 in these parameters. PI tended to increase as the type increases. Furthermore, there was significant difference between types 1 and 3. Conclusion: We evaluated the features of the DS types classified by sagittal alignment. Large PI is one of the risk factors for SVA deterioration of DS. PI may be involved in the onset and progression of DS.

scholarly journals Cerebrospinal Fluid MicroRNA Signatures as Diagnostic Biomarkers in Brain Tumors

Cancers ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 1546 ◽  
Author(s):  
Alena Kopkova ◽  
Jiri Sana ◽  
Tana Machackova ◽  
Marek Vecera ◽  
Lenka Radova ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Brain Tumor ◽  
Brain Tumors ◽  
Low Grade ◽  
Tumor Type ◽  
Tumor Patients ◽  
Primary Tumors ◽  
Mirna Profiling ◽  
Tumor Types ◽  
Cns Malignancies

Central nervous system (CNS) malignancies include primary tumors that originate within the CNS as well as secondary tumors that develop as a result of metastatic spread. Circulating microRNAs (miRNAs) were found in almost all human body fluids including cerebrospinal fluid (CSF), and they seem to be highly stable and resistant to even extreme conditions. The overall aim of our study was to identify specific CSF miRNA patterns that could differentiate among brain tumors. These new biomarkers could potentially aid borderline or uncertain imaging results onto diagnosis of CNS malignancies, avoiding most invasive procedures such as stereotactic biopsy or biopsy. In total, 175 brain tumor patients (glioblastomas, low-grade gliomas, meningiomas and brain metastases), and 40 non-tumor patients with hydrocephalus as controls were included in this prospective monocentric study. Firstly, we performed high-throughput miRNA profiling (Illumina small RNA sequencing) on a discovery cohort of 70 patients and 19 controls and identified specific miRNA signatures of all brain tumor types tested. Secondly, validation of 9 candidate miRNAs was carried out on an independent cohort of 105 brain tumor patients and 21 controls using qRT-PCR. Based on the successful results of validation and various combination patterns of only 5 miRNA levels (miR-30e, miR-140, let-7b, mR-10a and miR-21-3p) we proposed CSF-diagnostic scores for each tumor type which enabled to distinguish them from healthy donors and other tumor types tested. In addition to this primary diagnostic tool, we described the prognostic potential of the combination of miR-10b and miR-196b levels in CSF of glioblastoma patients. In conclusion, we performed the largest study so far focused on CSF miRNA profiling in patients with brain tumors, and we believe that this new class of biomarkers have a strong potential as a diagnostic and prognostic tool in these patients.

scholarly journals Prevalence of Depressive Symptoms in the Elderly Population Diagnosed with Type 2 Diabetes Mellitus

2020 ◽  
Vol 17 (10) ◽  
pp. 3553
Author(s):  
Beata Dziedzic ◽  
Zofia Sienkiewicz ◽  
Anna Leńczuk-Gruba ◽  
Ewa Kobos ◽  
Wiesław Fidecki ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Depressive Symptoms ◽  
Outpatient Clinic ◽  
Elderly Population ◽  
The Elderly ◽  
Screening Tests ◽  
Significant Difference

Introduction: A sharp rise in the population of elderly people, who are more prone to somatic and mental diseases, combined with the high prevalence of type 2 diabetes mellitus and diabetes-associated complications in this age group, have an impact on the prevalence of depressive symptoms. Aim of the work: The work of the study was the evaluation of the prevalence of depressive symptoms in the elderly population diagnosed with type 2 diabetes mellitus. Materials and methods: The pilot study was conducted in 2019 among 200 people diagnosed with type 2 diabetes mellitus, aged 65 years and above, receiving treatment in a specialist diabetes outpatient clinic. The study was based on a questionnaire aimed at collecting basic sociodemographic and clinical data and the complete geriatric depression scale (GDS, by Yesavage) consisting of 30 questions. Results: The study involved 200 patients receiving treatment in a diabetes outpatient clinic. The mean age of the study subjects was 71.4 ± 5.0 years. The vast majority of the subjects (122; 61%) were women, with men accounting for 39% of the study population (78 subjects). A statistically significant difference in the GDS (p < 0.01) was shown for marital status, body mass index (BMI), duration of diabetes, and the number of comorbidities. Patients with results indicative of symptoms of mild and severe depression were found to have higher BMI, longer disease duration, and a greater number of comorbidities. There were no statistically significant differences in the level of HbA1c. Conclusions: In order to verify the presence of depressive symptoms in the group of geriatric patients with diabetes mellitus, an appropriate screening programme must be introduced to identify those at risk and refer them to specialists, so that treatment can be promptly initiated. Screening tests conducted by nurses might help with patient identification.

scholarly journals Serum IL-17, IL-23, and TGF-βLevels in Type 1 and Type 2 Diabetic Patients and Age-Matched Healthy Controls

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Azam Roohi ◽  
Mina Tabrizi ◽  
Farzaneh Abbasi ◽  
Asal Ataie-Jafari ◽  
Behrouz Nikbin ◽  
...  
Keyword(s):  
Serum Levels ◽  
Diabetic Patients ◽  
Low Grade ◽  
Healthy Controls ◽  
Type 2 Diabetic Patients ◽  
Significant Difference ◽  
Type 1 Diabetic Patients ◽  
Type 2 Diabetic

Type 1 diabetes is recognized as an autoimmune inflammatory disease and low grade inflammation is also observed in type 2 diabetic patients. Interleukin 17 (IL-17) is a new player in inflammation. Th17 cells, as the main source of IL-17, require transforming growth factorβ(TGF-β) and interleukin 23 (IL-23). The aim of this study was to investigate serum IL-17, IL-23 and TGF-βlevels in diabetic patients and controls. In this case-control study, serum levels of IL-17, IL-23, and TGF-βwere measured in 24 type 1 diabetic patients and 30 healthy controls using the ELISA method. Simultaneously, the same methodology was used to compare serum concentration of these three cytokines in 38 type 2 diabetic patients and 40 healthy controls. There was no significant difference between serum levels of IL-17 and IL-23 cytokines between cases and controls. However, TGF-βwas significantly lower in type 1 diabetic patients (P<0.001). Serum IL-17 and IL-23 levels demonstrate no association with type 1 and type 2 diabetes, but, in line with previous studies, TGF-βlevels were lower in type 1 diabetic patients.

Microbiota and epigenetic regulation of inflammatory mediators in type 2 diabetes and obesity

2014 ◽  
Vol 5 (1) ◽  
pp. 33-43 ◽  
Author(s):  
M. Remely ◽  
E. Aumueller ◽  
D. Jahn ◽  
B. Hippe ◽  
H. Brath ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Lactic Acid ◽  
Lactic Acid Bacteria ◽  
Gut Microbiota ◽  
Epigenetic Regulation ◽  
Control Group ◽  
Low Grade ◽  
Type 2 Diabetics ◽  
Significant Difference

Metabolic syndrome is associated with alterations in the structure of the gut microbiota leading to low-grade inflammatory responses. An increased penetration of the impaired gut membrane by bacterial components is believed to induce this inflammation, possibly involving epigenetic alteration of inflammatory molecules such as Toll-like receptors (TLRs). We evaluated changes of the gut microbiota and epigenetic DNA methylation of TLR2 and TLR4 in three groups of subjects: type 2 diabetics under glucagon-like peptide-1 agonist therapy, obese individuals without established insulin resistance, and a lean control group. Clostridium cluster IV, Clostridium cluster XIVa, lactic acid bacteria, Faecalibacterium prausnitzii and Bacteroidetes abundances were analysed by PCR and 454 high-throughput sequencing. The epigenetic methylation in the regulatory region of TLR4 and TLR2 was analysed using bisulfite conversion and pyrosequencing. We observed a significantly higher ratio of Firmicutes/ Bacteroidetes in type 2 diabetics compared to lean controls and obese. Major differences were shown in lactic acid bacteria, with the highest abundance in type 2 diabetics, followed by obese and lean participants. In comparison, F. prausnitzii was least abundant in type 2 diabetics, and most abundant in lean controls. Methylation analysis of four CpGs in the first exon of TLR4 showed significantly lower methylation in obese individuals, but no significant difference between type 2 diabetics and lean controls. Methylation of seven CpGs in the promoter region of TLR2 was significantly lower in type 2 diabetics compared to obese subjects and lean controls. The methylation levels of both TLRs were significantly correlated with body mass index. Our data suggest that changes in gut microbiota and thus cell wall components are involved in the epigenetic regulation of inflammatory reactions. An improved diet targeted to induce gut microbial balance and in the following even epigenetic changes of pro-inflammatory genes may be effective in the prevention of metabolic syndrome.

scholarly journals A retrospective study on prophylactic regional lymphadenectomy versus nodal observation only in the management of dogs with stage I, completely resected, low-grade cutaneous mast cell tumors

2021 ◽  
Author(s):  
Silvia Sabattini ◽  
Matti Kiupel ◽  
Riccardo Finotello ◽  
Damiano Stefanello ◽  
Eugenio Faroni ◽  
...  
Keyword(s):  
Mast Cell ◽  
Stage I ◽  
Low Grade ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Mast Cell Tumors ◽  
Regional Lymphadenectomy ◽  
Significant Difference ◽  
Cutaneous Mast Cell ◽  
Prophylactic Lymphadenectomy

Abstract Background. While lymphadenectomy of metastatic 27 lymph nodes (LNs) has been associated with improved outcome, the clinical utility of prophylactic lymphadenectomy in dogs with stage I cutaneous mast cell tumors (cMCTs) remains a controversial topic. To assess the therapeutic role of lymphadenectomy of uninvolved regional LNs, the long-term outcome of cMCT-bearing dogs with cytologically negative and surgically unresected regional LNs (observation only, OO) was compared with that of dogs with a surgically resected and histologically negative regional LNs (prophylactic regional lymphadenectomy, PRL).Results. A retrospective analysis of 64 dogs with a low-grade, completely resected stage I cMCT was performed: (54.7%) dogs were subjected to OO and 29 (45.3%) underwent PRL. Dogs were monitored for a median of 813 and 763 days in the OO group and PRL group, respectively. The number of dogs undergoing MCT progression was significantly higher in the OO group (P = 0.028) and curve comparison revealed a tendency to a better time to progression in the PRL group (P = 0.058). No significant difference in survival time (P = 0.294) was observed between dogs in the OO and PRL groups.Conclusions. Our results showed that lack of immediate lymphadenectomy was associated with a higher risk for tumor progression. This preliminary judgement, reinforced by the findings that lymphadenectomy was well tolerated in all cases, and that histopathology provides the definitive assessment of the nodal pathological status, may suggest that prophylactic lymphadenectomy is indicated in the management of stage I MCTs. Larger prospective studies are warranted for generating clinical evidence of this latter hypothesis.

scholarly journals Unlike PD-L1, PD-1 Is Downregulated on Partial Immune Cells in Type 2 Diabetes

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Peng Sun ◽  
Qingyan Jin ◽  
Shengnan Nie ◽  
Shijie Jia ◽  
Yuanyuan Li ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Immune Cells ◽  
Mononuclear Cells ◽  
Regulatory Element ◽  
Immune Therapy ◽  
Low Grade ◽  
Peripheral Blood Mononuclear ◽  
Significant Difference ◽  
Diabetes Patients

Introduction. Type 2 diabetes is a worldwide disease which is associated with chronic, low-grade inflammation. The PD-1/PD-L1 pathway has been reported to be a negative regulatory element in immune homeostasis and to be involved in many diseases. Materials and Methods. Peripheral blood mononuclear cells (PBMCs) were obtained from type 2 diabetes patients (n=23) and healthy donors (n=20). The PD-L1 and PD-1 expressions on corresponding immune cells were evaluated by flow cytometry. Results. The PD-L1 expression on corresponding immune cells has no significant difference between these two groups. We showed the downregulated PD-1 expression in type 2 diabetes patients. The correlation analysis indicated that the PD-1 on NK cells has a positive correlation with insulin and diabetes duration. And an inverse correlation has been shown between the PD-1 expression on monocytes and BMI (body mass index). Conclusions. The results in this article suggest that PD-1, unlike PD-L1, might participate in the progression of type 2 diabetes. This investigation will provide evidence for the potential immune therapy for T2D.

Bone Metastases From Thyroid Carcinoma

2000 ◽  
Vol 124 (10) ◽  
pp. 1440-1447
Author(s):  
Satish K. Tickoo ◽  
Anastassios G. Pittas ◽  
Michael Adler ◽  
Melissa Fazzari ◽  
Steven M. Larson ◽  
...  
Keyword(s):  
Bone Metastasis ◽  
Thyroid Carcinoma ◽  
Bone Metastases ◽  
Tumor Type ◽  
Metastatic Tumors ◽  
Thyroid Carcinomas ◽  
Hürthle Cell ◽  
Significant Difference ◽  
Poorly Differentiated ◽  
Worse Prognosis

Abstract Context.—Only limited information exists on the pathologic aspects of thyroid carcinomas with bone metastases, most large studies having concentrated mainly on their clinical features. Objective.—To study in detail the morphologic features of thyroid carcinomas with skeletal metastases. Design.—Seventy-nine cases of thyroid carcinoma with bone metastases treated at Memorial Sloan-Kettering Cancer Center, New York, NY, between 1964 and 1998 were investigated, with emphasis on the pathology of the primary and/or metastatic tumors and comparison of the morphologic features of the tumors at both the sites, wherever possible. The tumors were also compared for various clinical parameters. Results.—The cohort consisted of 22 papillary, 17 follicular, 16 insular, 10 anaplastic, 9 Hürthle cell, and 5 medullary carcinomas. Of these cases, 68% had poorly differentiated or undifferentiated features in the primary and/or metastatic tumors. The metastatic tumors were better differentiated than the primary in one third of the cases (6 of 18). Only one case showed a less differentiated metastasis. The overall 5- and 10-year survival probabilities after the bone metastases were 29% and 13%, respectively (Kaplan-Meier method). Although both the tumor type and differentiation seemed to affect survivals after bone metastasis (P = .007 and .012, respectively) (log-rank test), this was primarily due to the much worse prognosis in the cases of anaplastic and medullary carcinoma. Cases of Hürthle cell carcinoma showed the longest median survival. There was no significant difference in survival among patients up to or older than 45 years at the time of metastases (P = .31). Conclusions.—Most thyroid carcinomas with bone metastases are of papillary type, and most have poorly differentiated or undifferentiated features. The influence of the microscopic tumor type and tumor differentiation on survival after bone metastasis primarily appears to be due to the much worse prognosis among anaplastic and medullary carcinomas. Age at diagnosis of bone metastases does not influence survivals.

Characterization of astrocytomas, meningiomas, and pituitary adenomas by phosphorus magnetic resonance spectroscopy

1991 ◽  
Vol 74 (3) ◽  
pp. 447-453 ◽  
Author(s):  
Douglas L. Arnold ◽  
Joseph F. Emrich ◽  
Eric A. Shoubridge ◽  
Jean-Guy Villemure ◽  
William Feindel
Keyword(s):  
Magnetic Resonance ◽  
Pituitary Adenomas ◽  
Resonance Spectroscopy ◽  
Low Grade ◽  
Normal Brain ◽  
Tumor Type ◽  
Content Type ◽  
Tumor Types ◽  
Fine Print

✓ Phosphorus magnetic resonance (MR) spectroscopy allows noninvasive measurement of phosphate-containing compounds and pH within brain cells. The authors obtained localized phosphorus MR spectra from 10 normal brains, four low-grade astrocytomas, six glioblastomas, four meningiomas, and three pituitary adenomas and found differences in the spectra of each tumor type. Compared to normal brain, the spectra from low-grade astrocytomas showed a significant reduction of the phosphodiester (PDE) peak. Glioblastomas were characterized by a significant reduction of the PDE peak, elevation of the phosphomonoester (PME) peak, and a relatively alkaline intracellular pH. The spectra from meningiomas and pituitary adenomas were markedly different from the glial tumors. Meningiomas showed significant reductions in phosphocreatine, PDE, and inorganic phosphate, as well as a relatively alkaline pH. Pituitary adenomas resembled meningiomas, but had a much higher PME peak. Although the number of tumors studied was small, there appears to be a characteristic spectrum associated with these different tumor types. The present findings can be useful in the preoperative identification of these tumors and in furthering understanding of their growth and metabolism in vivo.

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