scholarly journals Diagnostic performance of the calcium/phosphate ratio for primary hyperparathyroidism in southwest China

2021 ◽  
Author(s):  
Mengting Yin ◽  
Qianhui Liu ◽  
Qingzhong Wang ◽  
Yong He ◽  
Guixing Li
Keyword(s):  
Calcium Phosphate ◽  
Primary Hyperparathyroidism ◽  
Diagnostic Performance ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Southwest China ◽  
Biochemical Marker ◽  
25 Oh Vitamin D ◽  
Study Participants ◽  
Pth Level

Background: The diagnosis of primary hyperparathyroidism (PHPT) remains a challenge because of increased asymptomatic PHPT or patients with normocalcaemic PHPT (NPHPT). In addition, some primary hospitals in China have no equipment to measure PTH levels. Therefore, an additional, simple, and inexpensive laboratory biochemical marker is urgently needed. The calcium/phosphate (Ca/P) ratio and chloride/phosphate (Cl/P) ratio have been proposed as suitable tools to diagnose PHPT in Europe; however, the Ca/P ratio has never been tested in China. We aimed to conduct a confirmatory study to explore the diagnostic performance of the Ca/P ratio for PHPT in China. Methods: From January 2015 to December 2020, a total of 155 patients who underwent parathyroidectomy (143 PHPT patients and 12 NPHPT patients) and 153 controls were enrolled in this single-center, retrospective study. Serum calcium, phosphate, parathyroid hormone, 25-OH vitamin D, chloride, ALT, AST, eGFR, and creatinine levels were recorded for all the study participants. Pairwise comparisons were made between groups, and the diagnostic performance of the Ca/P ratio was determined using receiver operating characteristic (ROC) analysis. Results: Patients with PHPT had a higher Ca/P ratio than controls (P < 0.001). A Ca/P ratio above 2.94 with a sensitivity of 95.5% and specificity of 98.7% can distinguish PHPT patients from healthy individuals. This index was positively correlated with the PTH level (r = 0.875, P < 0.001). Conclusion: The Ca/P ratio is an ideal and inexpensive indicator for diagnosing PHPT in China when using a cutoff value of 2.94.

scholarly journals The «cut-off point» of vitamin D: a method of suppressing excessive secretion of PTH

2019 ◽  
Vol 16 (3) ◽  
pp. 88-93 ◽  
Author(s):  
Liudmila A. Suplotova ◽  
Valeria A. Avdeeva ◽  
Ekaterina A. Pigarova ◽  
Liudmila Ya. Rozhinskaya
Keyword(s):  
Vitamin D ◽  
Roc Analysis ◽  
Vitamin D Levels ◽  
The Subject ◽  
The Russian Federation ◽  
Excessive Secretion ◽  
Study Participants ◽  
Working Out ◽  
Pth Level

BACKGROUND: The subject of discussion is the issue of the separation point, which determines sufficient levels of vitamin D for bone health. When determining the adequate reference range of vitamin D, researchers are mainly guided by the results of research, where the level of 25(OH)D is determined, at which the PTH level decreases and reaches a plateau. AIM: To establish the cut-off point of vitamin D by suppressing excessive secretion of PTH. MATERIALS AND METHODS: Observational, single-site, single-stage, selective, uncontrolled study of the search for vitamin D levels by the effect on PTH secretion in residents of Tyumen region was conducted (n = 176). All selected study participants determined the level of 25(OH)D and PTH in serum. The calculation of the cut-off point was carried out using the method of searching for changes in the correlation dependence of PTH on the level of vitamin D, followed by verification of the data obtained using ROC analysis. RESULTS: A mathematical analysis of the dependence of 25(OH)D and PTH showed the cut-off point of vitamin D, equal to 23.6 ng/ml. CONCLUSION: The cut-off point of 23.6 ng/ml is optimal for suppressing excessive PTH secretion. The data obtained may be an incentive for further working out the cut-off point of vitamin D for the Russian population and can be used to clarify the classification of deficiency, insufficiency and optimal levels of vitamin D for the population of the Russian Federation.

scholarly journals Use of Radiomics to Improve Diagnostic Performance of PI-RADS v2.1 in Prostate Cancer

2021 ◽  
Vol 10 ◽  
Author(s):  
Mou Li ◽  
Ling Yang ◽  
Yufeng Yue ◽  
Jingxu Xu ◽  
Chencui Huang ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Diagnostic Performance ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Training Set ◽  
Combined Model ◽  
Contrast Enhanced ◽  
Apparent Diffusion ◽  
Validation Set

ObjectiveTo investigate whether a radiomics model can help to improve the performance of PI-RADS v2.1 in prostate cancer (PCa).MethodsThis was a retrospective analysis of 203 patients with pathologically confirmed PCa or non-PCa between March 2015 and December 2016. Patients were divided into a training set (n = 141) and a validation set (n = 62). The radiomics model (Rad-score) was developed based on multi-parametric MRI including T2 weighted imaging (T2WI), diffusion weighted imaging (DWI), apparent diffusion coefficient (ADC) imaging, and dynamic contrast enhanced (DCE) imaging. The combined model involving Rad-score and PI-RADS was compared with PI-RADS for the diagnosis of PCa by using the receiver operating characteristic curve (ROC) analysis.ResultsA total of 112 (55.2%) patients had PCa, and 91 (44.8%) patients had benign lesions. For PCa versus non-PCa, the Rad-score had a significantly higher area under the ROC curve (AUC) [0.979 (95% CI, 0.940–0.996)] than PI-RADS [0.905 (0.844–0.948), P = 0.002] in the training set. However, the AUC between them was insignificant in the validation set [0.861 (0.749–0.936) vs. 0.845 (0.731–0.924), P = 0.825]. When Rad-score was added to PI-RADS, the performance of the PI-RADS was significantly improved for the PCa diagnosis (AUC = 0.989, P &lt; 0.001 for the training set and AUC = 0.931, P = 0.038 for the validation set).ConclusionsThe radiomics based on multi-parametric MRI can help to improve the diagnostic performance of PI-RADS v2.1 in PCa.

scholarly journals Chromogranin A as a marker of neuroendocrine neoplasia: an Italian Multicenter Study

2007 ◽  
Vol 14 (2) ◽  
pp. 473-482 ◽  
Author(s):  
Maria Chiara Zatelli ◽  
Mirella Torta ◽  
Antonette Leon ◽  
Maria Rosaria Ambrosio ◽  
Massimo Gion ◽  
...  
Keyword(s):  
Chromogranin A ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Biochemical Marker ◽  
Predictive Values ◽  
Multicenter Observational Study ◽  
Diagnostic Usefulness ◽  
Low Sensitivity ◽  
Active Disease

Elevated circulating chromogranin A (CgA) levels are found in neuroendocrine tumors (NETs), but the diagnostic usefulness of this marker is still debatable. To assess the role of CgA for the diagnosis of gastroenteropancreatic (GEP) NETs and the identification of metastatic patients, an Italian multicenter observational study has been performed. CgA was evaluated in 202 GEP NET patients by IRMA and ELISA. The cutoffs for diagnosis and presence of metastases were identified by receiver-operating characteristic (ROC) curve. We found good correlation between IRMA and ELISA. The ROC analysis identified a cutoff of 53 ng/ml for IRMA and 16 U/l for ELISA as discriminating between controls and patients with active disease (sensitivity 71.3 and 84%; specificity 71 and 85% respectively). Metastases were present in 123 patients, having significantly higher CgA levels than patients without metastases. ROC analysis identified a cutoff of 146 ng/ml for IRMA and 67.3 U/l for ELISA as discriminating between patients with and without metastases (sensitivity 57 and 63.3%; specificity 55.6 and 71.4% respectively). For pancreatic NETs positive and negative predictive values were 84 and 78% respectively (90% specificity and 68% sensitivity). We found lower CgA levels in patients with extensive metastatic spread than in those with liver metastases only. These data assess the role of CgA evaluation in GEP NETs, and demonstrate that higher CgA levels associate with metastatic disease, confirming that CgA levels can provide a helpful practical biochemical marker for the clinical management of NETs, but with low sensitivity and specificity.

scholarly journals Circulating Platelet-Derived Extracellular Vesicles Are a Hallmark of Sars-Cov-2 Infection

Cells ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 85
Author(s):  
Giuseppe Cappellano ◽  
Davide Raineri ◽  
Roberta Rolla ◽  
Mara Giordano ◽  
Chiara Puricelli ◽  
...  
Keyword(s):  
Extracellular Vesicles ◽  
Diagnostic Performance ◽  
Predictive Power ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Distress Syndrome ◽  
Healthy Controls ◽  
Blood Samples ◽  
Reliable Test ◽  
Novel Biomarkers

Sars-Cov-2 infection causes fever and cough that may rapidly lead to acute respiratory distress syndrome (ARDS). Few biomarkers have been identified but, unfortunately, these are individually poorly specific, and novel biomarkers are needed to better predict patient outcome. The aim of this study was to evaluate the diagnostic performance of circulating platelets (PLT)-derived extracellular vesicles (EVs) as biomarkers for Sars-Cov-2 infection, by setting a rapid and reliable test on unmanipulated blood samples. PLT-EVs were quantified by flow cytometry on two independent cohorts of Sars-CoV-2+ (n = 69), Sars-Cov-2− (n = 62) hospitalized patients, and healthy controls. Diagnostic performance of PLT-EVs was evaluated by receiver operating characteristic (ROC) curve. PLT-EVs count were higher in Sars-Cov-2+ compared to Sars-Cov-2− patients or HC. ROC analysis of the combined cohorts showed an AUC = 0.79 and an optimal cut-off value of 1472 EVs/μL, with 75% sensitivity and 74% specificity. These data suggest that PLT-EVs might be an interesting biomarker deserving further investigations to test their predictive power.

RECEIVER OPERATING CHARACTERISTIC ANALYSIS OF INTRAOPERATIVE PARATHYROID HORMONE MONITORING TO DETERMINE OPTIMUM SENSITIVITY AND SPECIFICITY: ANALYSIS OF 896 CASES

2019 ◽  
Vol 25 (11) ◽  
pp. 1117-1126
Author(s):  
Christina S. Foley ◽  
Edwina C. Moore ◽  
Mira Milas ◽  
Eren Berber ◽  
Joyce Shin ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Receiver Operating Characteristic ◽  
Sensitivity And Specificity ◽  
Roc Curve ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Intraoperative Parathyroid Hormone ◽  
Receiver Operating

Objective: While intraoperative parathyroid hormone (IOPTH) monitoring with a ≥50% drop commonly guides the extent of exploration for primary hyperparathyroidism (pHPT), receiver operating characteristic (ROC) analysis has not been performed to determine whether other criteria yield better sensitivity and specificity. The aim of this study was to identify the optimum percent change of IOPTH following removal of the abnormal parathyroid pathology, in order to predict biochemical cure. Secondary aims were to identify patient subgroups with increased area under the ROC curve (AUC) and the need for moderated criteria. Methods: A retrospective review was performed on patients undergoing primary parathyroid surgery for sporadic pHPT between 1999 and 2010 at a tertiary center for endocrine surgery. Eight hundred and ninety-six patients with primary hyperparathyroidism were included. Multigland disease (MGD) was defined as the intraoperative detection of more than 1 enlarged hypercellular gland or persistent disease after single gland excision. ROC analysis was used to determine the value with the best performance at predicting MGD, following bilateral exploration. Results: MGD was diagnosed in 174 patients (19.4%). ROC analysis demonstrated an AUC of 0.69. An IOPTH drop of 72% was the point of optimal discrimination with a sensitivity of 55% and specificity of 76% for predicting MGD. Subgroup analysis by preoperative calcium, preoperative PTH, localization studies, or pre- and post-excision IOPTH, did not identify any factors associated with an improved AUC. Conclusion: To our knowledge, this is the first study to use ROC analysis in a large patient cohort. An IOPTH drop of 72% was found to have optimal discriminating ability. We failed to identify a subset of patients for whom there was substantial improvement in the AUC, sensitivity, or specificity. Abbreviations: AUC = area under the ROC curve; BE = bilateral neck exploration; FE = focal parathyroid exploration; IOPTH = intraoperative parathyroid hormone; MGD = multigland disease; MIBI = Tc99m-sestamibi I-123 subtraction single-photon emission computed tomography/computed tomography; pHPT = primary hyperparathyroidism; ROC = receiver operating characteristic; SGD = single gland disease; US = surgeon-performed neck ultrasound

PARATHYROID HORMONE SECRETION IN DISORDERS OF CALCIUM METABOLISM STUDIED BY MEANS OF EDTA

1974 ◽  
Vol 75 (2) ◽  
pp. 286-296 ◽  
Author(s):  
J. H. Lockefeer ◽  
W. H. L. Hackeng ◽  
J. C. Birkenhäger
Keyword(s):  
Parathyroid Hormone ◽  
Primary Hyperparathyroidism ◽  
Calcium Metabolism ◽  
Hormone Secretion ◽  
Parathyroid Tissue ◽  
Small Mass ◽  
Idiopathic Hypercalciuria ◽  
List Type ◽  
Immunoreactive Parathyroid Hormone ◽  
Pth Level

ABSTRACT In 22 of 28 cases of primary hyperparathyroidism (PHP) the rise in the serum immunoreactive parathyroid hormone (IRPTH or PTH) level observed in response to lowering of the serum calcium by EDTA, exceeded that obtained in 8 control subjects. In 5 of these 22 patients who were studied again after parathyroidectomy the supranormal response was abolished. Fifteen of these 22 hyper-responsive PHP patients had basal IRPTH levels not exceeding the highest level in the controls and that of other groups of patients investigated (idiopathic hypercalciuria, non-parathyroid hypercalcaemia, operated PHP). Fourteen of the 22 hyper-reactive patients with PHP did not show hypocalcaemia during the infusion of EDTA. The extent of the release of PTH elicited by EDTA in cases of PHP does not as yet allow a prediction of the amount of pathological parathyroid tissue present, although all the PHP patients showing a normal release of PTH had a relatively small mass of parathyroid tissue (up to about 1 g) subsequently removed. In 9 cases of nephrolithiasis (8 of whom had idiopathic hypercalciuria) and in 7 cases of non-parathyroid hypercalcaemia, a normal PTH release was found.

scholarly journals Fully Automated Colorimetric Analysis of the Optic Nerve Aided by Deep Learning and Its Association with Perimetry and OCT for the Study of Glaucoma

2021 ◽  
Vol 10 (15) ◽  
pp. 3231
Author(s):  
Marta Gonzalez-Hernandez ◽  
Daniel Gonzalez-Hernandez ◽  
Daniel Perez-Barbudo ◽  
Paloma Rodriguez-Esteve ◽  
Nisamar Betancor-Caro ◽  
...  
Keyword(s):  
Distribution Function ◽  
Deep Learning ◽  
Optic Nerve ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Learning Models ◽  
Colorimetric Analysis ◽  
Cirrus Oct ◽  
And Function ◽  
Usual Pattern

Background: Laguna-ONhE is an application for the colorimetric analysis of optic nerve images, which topographically assesses the cup and the presence of haemoglobin. Its latest version has been fully automated with five deep learning models. In this paper, perimetry in combination with Laguna-ONhE or Cirrus-OCT was evaluated. Methods: The morphology and perfusion estimated by Laguna ONhE were compiled into a “Globin Distribution Function” (GDF). Visual field irregularity was measured with the usual pattern standard deviation (PSD) and the threshold coefficient of variation (TCV), which analyses its harmony without taking into account age-corrected values. In total, 477 normal eyes, 235 confirmed, and 98 suspected glaucoma cases were examined with Cirrus-OCT and different fundus cameras and perimeters. Results: The best Receiver Operating Characteristic (ROC) analysis results for confirmed and suspected glaucoma were obtained with the combination of GDF and TCV (AUC: 0.995 and 0.935, respectively. Sensitivities: 94.5% and 45.9%, respectively, for 99% specificity). The best combination of OCT and perimetry was obtained with the vertical cup/disc ratio and PSD (AUC: 0.988 and 0.847, respectively. Sensitivities: 84.7% and 18.4%, respectively, for 99% specificity). Conclusion: Using Laguna ONhE, morphology, perfusion, and function can be mutually enhanced with the methods described for the purpose of glaucoma assessment, providing early sensitivity.

scholarly journals Quantitative Assessment of the Echogenicity of a Breast Tumor Predicts the Response to Neoadjuvant Chemotherapy

Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3546
Author(s):  
Katarzyna Sylwia Dobruch-Sobczak ◽  
Hanna Piotrzkowska-Wróblewska ◽  
Piotr Karwat ◽  
Ziemowit Klimonda ◽  
Ewa Markiewicz-Grodzicka ◽  
...  
Keyword(s):  
Neoadjuvant Chemotherapy ◽  
Treatment Response ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Quantitative Measure ◽  
Malignant Cell ◽  
Breast Cancer Patients ◽  
The Third ◽  
Leibler Divergence

The aim of the study was to improve monitoring the treatment response in breast cancer patients undergoing neoadjuvant chemotherapy (NAC). The IRB approved this prospective study. Ultrasound examinations were performed prior to treatment and 7 days after four consecutive NAC cycles. Residual malignant cell (RMC) measurement at surgery was the standard of reference. Alteration in B-mode ultrasound (tumor echogenicity and volume) and the Kullback-Leibler divergence (kld), as a quantitative measure of amplitude difference, were used. Correlations of these parameters with RMC were assessed and Receiver Operating Characteristic curve (ROC) analysis was performed. Thirty-nine patients (mean age 57 y.) with 50 tumors were included. There was a significant correlation between RMC and changes in quantitative parameters (KLD) after the second, third and fourth course of NAC, and alteration in echogenicity after the third and fourth course. Multivariate analysis of the echogenicity and KLD after the third NAC course revealed a sensitivity of 91%, specificity of 92%, PPV = 77%, NPV = 97%, accuracy = 91%, and AUC of 0.92 for non-responding tumors (RMC ≥ 70%). In conclusion, monitoring the echogenicity and KLD parameters made it possible to accurately predict the treatment response from the second course of NAC.

scholarly journals Urinary Metabolomics Study of Patients with Bicuspid Aortic Valve Disease

Molecules ◽  
2021 ◽  
Vol 26 (14) ◽  
pp. 4220
Author(s):  
Massimo Chessa ◽  
Mario Panebianco ◽  
Sara Corbu ◽  
Milena Lussu ◽  
Angelica Dessì ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Bicuspid Aortic Valve ◽  
Metabolic Pathways ◽  
Congenital Heart ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Molecular Fingerprint ◽  
Metabolomics Study ◽  
Cardiovascular Anomalies ◽  
Potential Use

Bicuspid aortic valve (BAV) is the most common congenital heart defect responsible for valvular and aortic complications in affected patients. Causes and mechanisms of this pathology are still elusive and thus the lack of early detection biomarkers leads to challenges in its diagnosis and prevention of associated cardiovascular anomalies. The aim of this study was to explore the potential use of urine Nuclear Magnetic Resonance (NMR) metabolomics to evaluate a molecular fingerprint of BAV. Both multivariate and univariate statistical analyses were performed to compare the urinary metabolome of 20 patients with BAV with that of 24 matched controls. Orthogonal partial least squared discriminant analysis (OPLS-DA) showed statistically significant discrimination between cases and controls, suggesting seven metabolites (3-hydroxybutyrate, alanine, betaine, creatine, glycine, hippurate, and taurine) as potential biomarkers. Among these, glycine, hippurate and taurine individually displayed medium sensitivity and specificity by receiver operating characteristic (ROC) analysis. Pathway analysis indicated two metabolic pathways likely perturbed in BAV subjects. Possible contributions of gut microbiota activity and energy imbalance are also discussed. These results constitute encouraging preliminary findings in favor of the use of urine-based metabolomics for early diagnosis of BAV.

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