scholarly journals Detection of endometriosis using immunocytochemistry of P450 Aromatase expressions in eutopic endometrial cells obtained from menstrual sloughing: A diagnostic study

2020 ◽  
Author(s):  
Tita Husnitawati Madjid ◽  
Jumadi Jumadi ◽  
Raden Tina Dewi Judistiani ◽  
Bethy Suryawathy Hernowo ◽  
Ahmad Faried
Keyword(s):  
Predictive Value ◽  
Diagnostic Procedure ◽  
Histopathological Examination ◽  
Secondary Level ◽  
Diagnostic Procedures ◽  
Menstrual Blood ◽  
Diagnostic Study ◽  
Endometrial Cells ◽  
P450 Aromatase ◽  
Level Hospital

Abstract Objective. To explore the possibility of a new diagnostic approach of endometriosis based on immunocytochemistry scoring of Aromatase P450 expressions in endometrial cells collected from menstrual sloughing. This is a case control study. Immuncytochemistry scores vs. histopathological examination in one tertiary- and secondary-level hospital in Bandung; two secondary level hospital in Garut and Sumedang, West Java, Indonesia. Thirty five patients with and without endometriosis were enrolled. All subjects had diagnostic procedures for endometriosis suspicion, with addition menstrual blood samples for cytopathological examination. The specimens were sent for immunocytochemistry assessment of P450 Aromatase expressions (ICAPEC). The previous procedure resulted in cut-off point of histo score (H-score), sensitivity, specificity, (+) and (-) ICAPEC predictive value. Results. The P450 Aromatase expression in endometrial cells of women with endometriosis was significantly stronger than without one. The cut-off point of H-scores to detect endometriosis was >4. By this criteria, H-score had 94.6% sensitivity, 90.9% specificity, 92% positive predictive value and 93% negative predictive value. Immunocytochemistry scoring of Aromatase P450 expression in endometrial cells (ICAPEC) derived from menstrual blood specimen was a good candidate as alternatives approach in diagnostic procedure of endometriosis. Application and evaluation in clinical practice would provide the economically benefit in diagnostic procedure.

scholarly journals Detection of endometriosis using immunocytochemistry of P450 Aromatase expressions in eutopic endometrial cells obtained from menstrual sloughing: A diagnostic study

2020 ◽  
Author(s):  
Tita Husnitawati Madjid ◽  
Jumadi ◽  
Raden Tina Dewi Judistiani ◽  
Bethy Suryawathy Hernowo ◽  
Ahmad Faried
Keyword(s):  
Predictive Value ◽  
Diagnostic Procedure ◽  
Histopathological Examination ◽  
Secondary Level ◽  
Diagnostic Procedures ◽  
Menstrual Blood ◽  
Diagnostic Study ◽  
Endometrial Cells ◽  
P450 Aromatase ◽  
Level Hospital

Abstract Objective. To explore the possibility of a new diagnostic approach of endometriosis based on immunocytochemistry scoring of Aromatase P450 expressions in endometrial cells collected from menstrual sloughing. This is a case control study. Immuncytochemistry scores vs. histopathological examination in one tertiary- and secondary-level hospital in Bandung; two secondary level hospital in Garut and Sumedang, West Java, Indonesia. Thirty five patients with and without endometriosis were enrolled. All subjects had diagnostic procedures for endometriosis suspicion, with addition menstrual blood samples for cytopathological examination. The specimens were sent for immunocytochemistry assessment of P450 Aromatase expressions (ICAPEC). The previous procedure resulted in cut-off point of histo score (H-score), sensitivity, specificity, (+) and (-) ICAPEC predictive value.Results. The P450 Aromatase expression in endometrial cells of women with endometriosis was significantly stronger than without one. The cut-off point of H-scores to detect endometriosis was >4. By this criteria, H-score had 94.6% sensitivity, 90.9% specificity, 92% positive predictive value and 93% negative predictive value. Immunocytochemistry scoring of Aromatase P450 expression in endometrial cells (ICAPEC) derived from menstrual blood specimen was a good candidate as alternatives approach in diagnostic procedure of endometriosis. Application and evaluation in clinical practice would provide the economically benefit in diagnostic procedure.

scholarly journals Detection of endometriosis using immunocytochemistry of P450 Aromatase expressions in eutopic endometrial cells obtained from menstrual sloughing: A diagnostic study

2020 ◽  
Author(s):  
Tita Husnitawati Madjid ◽  
Jumadi Jumadi ◽  
Raden Tina Dewi Judistiani ◽  
Bethy Suryawathy Hernowo ◽  
Ahmad Faried
Keyword(s):  
Predictive Value ◽  
Diagnostic Procedure ◽  
Histopathological Examination ◽  
Secondary Level ◽  
Diagnostic Procedures ◽  
Menstrual Blood ◽  
Diagnostic Study ◽  
Endometrial Cells ◽  
P450 Aromatase ◽  
Level Hospital

Abstract Objective. To explore the possibility of a new diagnostic approach of endometriosis based on immunocytochemistry scoring of Aromatase P450 expressions in endometrial cells collected from menstrual sloughing. This is a case control study. Immuncytochemistry scores vs. histopathological examination in one tertiary- and secondary-level hospital in Bandung; two secondary level hospital in Garut and Sumedang, West Java, Indonesia. Thirty five patients with and without endometriosis were enrolled. All subjects had diagnostic procedures for endometriosis suspicion, with addition menstrual blood samples for cytopathological examination. The specimens were sent for immunocytochemistry assessment of P450 Aromatase expressions (ICAPEC). The previous procedure resulted in cut-off point of histo score (H-score), sensitivity, specificity, (+) and (-) ICAPEC predictive value.Results. The P450 Aromatase expression in endometrial cells of women with endometriosis was significantly stronger than without one. The cut-off point of H-scores to detect endometriosis was >4. By this criteria, H-score had 94.6% sensitivity, 90.9% specificity, 92% positive predictive value and 93% negative predictive value. Immunocytochemistry scoring of Aromatase P450 expression in endometrial cells (ICAPEC) derived from menstrual blood specimen was a good candidate as alternatives approach in diagnostic procedure of endometriosis. Application and evaluation in clinical practice would provide the economically benefit in diagnostic procedure.

scholarly journals Expression of Matrix Metalloproteinase-9 and Tissue Inhibitor of Metalloproteinase-1 in Endometriosis Menstrual Blood

Diagnostics ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. 364
Author(s):  
Tita Husnitawati Madjid ◽  
Dennis Fachmi Ardiansyah ◽  
Wiryawan Permadi ◽  
Bethy Hernowo
Keyword(s):  
Matrix Metalloproteinase ◽  
Histopathological Examination ◽  
Uterine Cavity ◽  
Tissue Inhibitor Of Metalloproteinase ◽  
Menstrual Blood ◽  
Control Group ◽  
Tissue Inhibitor ◽  
Endometrial Cells ◽  
Tissue Implantation ◽  
Cell Expression

Endometriosis is a gynecological disease characterized by the presence of endometrial-like tissue outside the uterine cavity. Remodeling of the extracellular matrix (ECM) is a prerequisite for tissue implantation. The presence of matrix metalloproteinase (MMP) and its inhibitor, tissue inhibitor of metalloproteinase-1 (TIMP-1), in shed endometrium cells has a significant role in ECM degradation. A case–control study was performed to find other diagnostic markers using menstrual blood. We examined a sample of 68 women who visited the gynecology clinic in Dr Hasan Sadikin General Hospital, 40% of whom were confirmed to have endometriosis, and the rest tested negative by histopathological examination. All endometriotic cases presented MMP-9 and TIMP-1 expression with different cell distribution. MMP-9 expression in endometriosis patients was increased compared to the controls (p = 0.002). Expression of MMP-9 in >80% of endometrial cells was associated with a higher risk for endometriosis (OR 4.44 95% CI 1.31 to 15.56) compared to MMP-9 expression in 50%–80% of cells. TIMP-1 cell expression in women with endometriosis was lower than in the control group (p = 0.030). Subjects with TIMP-1 expression in 20%–50% of endometrial cells had a higher risk for endometriosis (OR 4.5, 95%CI 1.21–17.42) compared those with TIMP-1 expression in 50%–80% of cells. These expressions levels can be useful to predict endometriosis.

scholarly journals Prediction of Myometrial Invasion in Stage I Endometrial Cancer by MRI: The Influence of Surgical Diagnostic Procedure

Cancers ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 3275
Author(s):  
Wei-Chun Chen ◽  
Le-Tien Hsu ◽  
Yu-Ting Huang ◽  
Yu-Bin Pan ◽  
Shir-Hwa Ueng ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Predictive Value ◽  
Odds Ratio ◽  
Diagnostic Procedure ◽  
Clinical Stage ◽  
Myometrial Invasion ◽  
Diagnostic Procedures ◽  
Clinical Stage Ia ◽  
Fertility Sparing ◽  
Group 2

Young women with endometrial cancer (EC) can choose fertility-sparing treatment for stage 1A disease without myometrial invasion (MI). The surgical diagnostic procedure (SDP) may affect the accuracy of magnetic resonance imaging (MRI) to assess MI. Here, we evaluated different SDP and compared the MI on MRI results with further pathologic results after hysterectomy. We retrospectively collected data on 263 patients with clinical stage IA EC diagnosed between January 2013 and December 2015. Patients were classified into four groups based on SDP, including diagnostic hysteroscopic biopsy (DHB, group 1), operative hysteroscopic partial resection (OHPR, group 2), operative hysteroscopic complete resection (OHCR, group 3), and cervical dilatation and fractional curettage (D&C, group 4). The sensitivity, specificity, diagnostic accuracy, positive predictive value, and negative predictive value of MRI to assess MI were 73.1%, 46.7%, 63.9%, 71.8%, and 48.3%, respectively. Three hysteroscopic procedures (groups 1 to 3) had a trend with a higher odds ratio of discrepancy between MRI and histopathology (p = 0.068), especially in group 2 (odds ratio 2.268, p = 0.032). Here, we found MRI accuracy of MI was better in patients with EC diagnosed with D&C. Three diagnostic procedures using hysteroscopy might interfere with the diagnostic power of MI on MRI.

Effectiveness of ultrasound screening for placenta accreta spectrum using standard ultrasound criteria in a secondary care setting

2022 ◽  
Author(s):  
Miquel Juan-Clar ◽  
Marta Torrent ◽  
Pere Santandreu ◽  
Eva Arejola ◽  
Javier Ibarra ◽  
...  
Keyword(s):  
At Risk ◽  
Predictive Value ◽  
Placenta Accreta ◽  
Placenta Previa ◽  
Transvaginal Ultrasound ◽  
Secondary Level ◽  
Histopathological Analysis ◽  
Ultrasound Screening ◽  
Placenta Accreta Spectrum ◽  
Level Hospital

Objectives: Ultrasound detection of placenta accreta spectrum (PAS) among women at risk is a key goal to reduce obstetric morbidity, but there is scarce information of its performance in real clinical settings. We report the effectiveness of a standardized ultrasound protocol to detect PAS in women with placenta previa in a secondary-level hospital. Methods: A retrospective analysis, including a cohort of 126 women with persistent placenta previa among 27,975 pregnancies between 2008 and 2020. All 126 women underwent standardized transabdominal and transvaginal ultrasound assessing 5 criteria: 1) loss of hypoechoic retroplacental zone and/or myometrial thinning <1 mm; 2) lacunar images with flow >15 cm/sec; 3) thick and bulging placenta; 4) thinning or interruption of the uterine-bladder serous interface; and 5) placental or uterovesical hypervascularity. The presence of at least one criterion was considered a high-risk for PAS. Diagnosis of PAS was confirmed during caesarean section and by histopathological analysis. Results: Among 126 women with placenta previa, 11 (8.7%) cases of PAS were diagnosed, of which 10 were detected prenatally by ultrasound. This resulted in a sensitivity of 90,9%, a specificity of 98,3%, a positive predictive value (PPV) of 83,3%, and negative predictive value (NPV) of 99,1%. Histopathological assessment showed six placenta increta (54.5%), four percreta (36.4%) and one accreta (9.1%). All 10 cases of invasive placenta presented more than three ultrasound criteria. Conclusions: Standardized ultrasound screening protocol in women at risk due to placenta previa in the third trimester was highly effective in detecting PAS in a secondary-level hospital setting.

scholarly journals Detection of endometriosis using immunocytochemistry of P450 Aromatase expressions in eutopic endometrial cells obtained from menstrual sloughing: a diagnostic study

2020 ◽  
Vol 13 (1) ◽  
Author(s):  
Tita Husnitawati Madjid ◽  
Jumadi ◽  
Raden Tina Dewi Judistiani ◽  
Bethy Suryawathy Hernowo ◽  
Ahmad Faried
Keyword(s):  
Diagnostic Study ◽  
Endometrial Cells ◽  
P450 Aromatase

Clinical features and endocrine evaluation of non-functioning pituitary adenomas at a secondary level hospital

2019 ◽  
Author(s):  
Cristina Contreras Pascual ◽  
Paloma Gonzalez Lazaro ◽  
Julia Silva Fernandez ◽  
Val Zaballos Florentino del ◽  
Francisco Javier Gomez Alfonso ◽  
...  
Keyword(s):  
Clinical Features ◽  
Pituitary Adenomas ◽  
Secondary Level ◽  
Level Hospital ◽  
Non Functioning Pituitary Adenomas

scholarly journals Triage of Patients Suspected of COVID-19 in Chronic Hemodialysis: Eosinophil Count Differentiates Low and High Suspicion of COVID-19

2020 ◽  
Vol 10 (1) ◽  
pp. 4
Author(s):  
Romain Vial ◽  
Marion Gully ◽  
Mickael Bobot ◽  
Violaine Scarfoglière ◽  
Philippe Brunet ◽  
...  
Keyword(s):  
Predictive Value ◽  
Eosinophil Count ◽  
Characteristic Curve ◽  
Final Analysis ◽  
Hemodialysis Patients ◽  
Chronic Hemodialysis ◽  
Screening Methods ◽  
Dialysis Session ◽  
Diagnostic Study ◽  
Rt Pcr

Background: Daily management to shield chronic dialysis patients from SARS-CoV-2 contamination makes patient care cumbersome. There are no screening methods to date and a molecular biology platform is essential to perform RT-PCR for SARS-CoV-2; however, accessibility remains poor. Our goal was to assess whether the tools routinely used to monitor our hemodialysis patients could represent reliable and quickly accessible diagnostic indicators to improve the management of our hemodialysis patients in this pandemic environment. Methods: In this prospective observational diagnostic study, we recruited patients from La Conception hospital. Patients were eligible for inclusion if suspected of SARS-CoV-2 infection when arriving at our center for a dialysis session between March 12th and April 24th 2020. They were included if both RT-PCR result for SARS-CoV-2 and cell blood count on the day that infection was suspected were available. We calculated the area under the curve (AUC) of the receiver operating characteristic curve. Results: 37 patients were included in the final analysis, of which 16 (43.2%) were COVID-19 positive. For the day of suspected COVID-19, total leukocytes were significantly lower in the COVID-19 positive group (4.1 vs. 7.4 G/L, p = 0.0072) and were characterized by lower neutrophils (2.7 vs. 5.1 G/L, p = 0.021) and eosinophils (0.01 vs. 0.15 G/L, p = 0.0003). Eosinophil count below 0.045 G/L identified SARS-CoV-2 infection with AUC of 0.9 [95% CI 0.81—1] (p < 0.0001), sensitivity of 82%, specificity of 86%, a positive predictive value of 82%, a negative predictive value of 86% and a likelihood ratio of 6.04. Conclusions: Eosinophil count enables rapid routine screening of symptomatic chronic hemodialysis patients suspected of being COVID-19 within a range of low or high probability.

Comparative analysis of diagnostic procedures for tumor detection rates in paired data

2018 ◽  
Vol 28 (5) ◽  
pp. 1477-1488
Author(s):  
Yaeji Lim ◽  
Ji Soo Choi ◽  
Kiyoun Kim ◽  
Mira Park ◽  
Seonwoo Kim
Keyword(s):  
Positive Predictive Value ◽  
Predictive Value ◽  
Correct Diagnosis ◽  
Disease Status ◽  
Diagnostic Procedures ◽  
Tumor Detection ◽  
Tumor Location ◽  
Test Statistic ◽  
Paired Data ◽  
Detection Rates

Diagnostic procedures are mostly used to detect a particular disease, and each procedure indicates the presence or absence of the disease in an individual. Sensitivity and positive predictive value, which are measures of the effectiveness of a diagnostic procedure, are simply calculated as the proportion of the individuals diagnosed with the disease by the test among the patients with the disease, and of the diseased persons among the individuals in whom the disease was detected by the test, respectively. For a diagnosis with such a binary result, sensitivity and the positive predictive value of diagnostic procedures can be compared using the chi-square statistic. However, in the treatment of cancer patients, it is important not only to diagnose the disease status of an individual patient but also to detect the correct location of the cancer. The tumor location may be incorrectly identified in some subjects diagnosed with cancer. It is therefore of interest whether a procedure that diagnoses cancer also correctly indicates the tumor location. In this paper, we re-define the sensitivity and the positive predictive value of tumor detection as the ratio of the number of cases with a correct diagnosis of the tumor location by the test to the number of cases of cancer, and as the ratio of patients with a correct diagnosis of the tumor location to the number of individuals diagnosed with cancer by the test, respectively. We refer to these parameters as ‘semi-sensitivity’ and ‘semi-positive predictive value’. To compare these ratios between diagnostic procedures, test statistics are developed from binary diagnostic results. Simulation studies conducted to evaluate the nominal level and power are presented, and two sets of example data are also analyzed using the new test statistic.

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