scholarly journals Risk Models Based On Populations In High-Risk Areas of Oesophageal Cancer In China For Improving The Oesophageal Cancer Diagnosis Rate

2021 ◽  
Author(s):  
Guodong Yang ◽  
Xiaogang Yu ◽  
Xiaoqi Long ◽  
Xiaoming Zhang ◽  
Weiwei Du ◽  
...  
Keyword(s):  
High Risk ◽  
Oesophageal Cancer ◽  
Narrow Band Imaging ◽  
Precancerous Lesions ◽  
Characteristic Curve ◽  
Univariate Analysis ◽  
High Risk Population ◽  
Severe Dysplasia ◽  
Risk Areas ◽  
Early Oesophageal Cancer

Abstract Background: To improve the diagnostic efficiency of early oesophageal cancer, it is of great significance to develop an effective risk prediction model. This study aimed to identify a high-risk population with oesophageal squamous cell carcinoma (ESCC) based on a population screening model.Methods: From 120 target townships randomly selected from 150 villages selected in Nanchong City, Sichuan Province, China, from Jan 2016 to Sep 2019, a total of 6409 subjects were screened. Each patient underwent standard endoscopy and narrow band imaging (NBI) and iodine staining indicator biopsies to evaluate oesophageal cancer and precancerous lesions. Before endoscopy, the subjects completed a questionnaire about ESCC risk factors. Variables were evaluated by univariate analysis, and variables significantly related to ESCC were extracted by using a logistic regression model. We used the Akaike information criterion to develop the final model structure and the coding form of variables with multiple metrics. We developed two sets of models to define severe dysplasia and above (SDA) and moderate dysplasia and above (MDA) as prognostic events, respectively. Results: The areas under the receiver operating characteristic curve (AUROC) were0.896 (95%CI, 0.888-0.903) and 0.825 (95% CI, 0.816-0.835) for our SDA and MDA models, respectively. MDA-related and SDA-related factors included age, sex, cigarette smoking, alcohol drinking, pharyngeal foreign body sensation, swallowing obstruction, pain behind the sternum, and discomfort behind the breastbone.Conclusions: we developed an easy-to-use model to identify individuals with high risk of dysplasia or oesophageal cancer in high-risk areas of oesophageal cancer in China.

scholarly journals Insights on safety and efficacy of renal artery denervation for uncontrolled-resistant hypertension in a high risk population with chronic kidney disease: first Italian real-world experience

2021 ◽  
Author(s):  
Federico Marin ◽  
Simone Fezzi ◽  
Alessia Gambaro ◽  
Francesco Ederle ◽  
Gianluca Castaldi ◽  
...  
Keyword(s):  
High Risk ◽  
Medical Therapy ◽  
Resistant Hypertension ◽  
Univariate Analysis ◽  
Daily Practice ◽  
Renal Sympathetic Denervation ◽  
High Risk Population ◽  
Safety And Efficacy ◽  
Renal Artery Denervation

Abstract Aims To evaluate the safety and efficacy of catheter-based radiofrequency renal sympathetic denervation (RSD) in a daily practice population of patients with uncontrolled resistant hypertension, on top of medical therapy. Methods Consecutive unselected patients with uncontrolled resistant hypertension undergoing RSD were enrolled. Office and ambulatory blood pressure (BP) measurements were collected at baseline and 3, 6 and 12 months after RSD. Efficacy was assessed even in patients with an estimated glomerular filtration rate (eGFR) below 45 mL/min/1.73 m2. Patients were defined as responders if systolic BP decreased by at least 5 mmHg at ambulatory BP or by 10 mmHg at office BP at their last follow-up visit. Results Forty patients with multiple comorbidities underwent RSD from 2012 to 2019. Baseline office and ambulatory BP was 159.0/84.9 ± 26.2/14.9 mmHg and 155.2/86.5 ± 20.9/14.0 mmHg, respectively. At 12-month follow up a significant reduction in office and ambulatory systolic BP, respectively by − 19.7 ± 27.1 mmHg and by − 13.9 ± 23.6 mmHg, was observed. BP reduction at 12-month follow-up among patients with eGFR < 45 mL/min was similar to that obtained in patients with higher eGFR. Twenty-nine patients (74.4%) were responders. Combined hypertension, higher ambulatory systolic BP and lower E/E’ at baseline emerged as predictors of successful RSD at univariate analysis. No major complications were observed and renal function (was stable up to 12 months), even in patients with the lowest eGFR values at baseline. Conclusion RSD is safe and feasible in patients with uncontrolled resistant hypertension on top of medical therapy, even in a high-risk CKD population with multiple comorbidities, with a significant reduction in systolic BP and a trend towards a reduction in diastolic BP lasting up to 12 months. Graphic abstract

scholarly journals Associations between cancer family history and esophageal cancer and precancerous lesions in high-risk areas of China

2022 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Jiachen Zhou ◽  
Kexin Sun ◽  
Shaoming Wang ◽  
Ru Chen ◽  
Minjuan Li ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Family History ◽  
High Risk ◽  
Precancerous Lesions ◽  
Cancer Family ◽  
Cancer Family History ◽  
Risk Areas

Endoscopic diagnosis of laryngeal cancer and precancerous lesions by narrow band imaging

2010 ◽  
Vol 125 (3) ◽  
pp. 288-296 ◽  
Author(s):  
X-G Ni ◽  
S He ◽  
Z-G Xu ◽  
L Gao ◽  
N Lu ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Laryngeal Cancer ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Precancerous Lesions ◽  
Type I ◽  
Severe Dysplasia ◽  
Laryngeal Lesions ◽  
Type V

AbstractObjective:To investigate the characteristics of the laryngeal mucosal microvascular network in suspected laryngeal cancer patients, using narrow band imaging, and to evaluate the value of narrow band imaging endoscopy in the early diagnosis of laryngeal precancerous and cancerous lesions.Patients and methods:Eighty-five consecutive patients with suspected precancerous or cancerous laryngeal lesions were enrolled in the study. Endoscopic narrow band imaging findings were classified into five types (I to V) according to the features of the mucosal intraepithelial papillary capillary loops assessed.Results:A total of 104 lesions (45 malignancies and 59 nonmalignancies) was detected under white light and narrow band imaging modes. The sensitivity and specificity of narrow band imaging in detecting malignant lesions were 88.9 and 93.2 per cent, respectively. The intraepithelial papillary capillary loop classification, as determined by narrow band imaging, was closely associated with the laryngeal lesions' histological findings. Type I to IV lesions were considered nonmalignant and type V lesions malignant. For type Va lesions, the sensitivity and specificity of narrow band imaging in detecting severe dysplasia or carcinoma in situ were 100 and 79.5 per cent, respectively. In patients with type Vb and Vc lesions, the sensitivity and specificity of narrow band imaging in detecting invasive carcinoma were 83.8 and 100 per cent, respectively.Conclusion:Narrow band imaging is a promising approach enabling in vivo differentiation of nonmalignant from malignant laryngeal lesions by evaluating the morphology of mucosal capillaries. These results suggest endoscopic narrow band imaging may be useful in the early detection of laryngeal cancer and precancerous lesions.

scholarly journals The Lack of Association Between Bacille Calmette-Guerin Vaccination and Clustering of Aboriginals with Tuberculosis in Western Canada

2005 ◽  
Vol 12 (3) ◽  
pp. 134-138 ◽  
Author(s):  
Victoria J Cook ◽  
Eduardo Hernández-Garduño ◽  
Dennis Kunimoto ◽  
Earl S Hershfield ◽  
E Anne Fanning ◽  
...  
Keyword(s):  
High Risk ◽  
Aboriginal People ◽  
Univariate Analysis ◽  
Transmitted Disease ◽  
High Risk Population ◽  
Western Canada ◽  
Bacille Calmette Guerin ◽  
Major Health Problem ◽  
Bcg Vaccination ◽  
Culture Positive

BACKGROUND: Tuberculosis (TB) remains a major health problem for Aboriginal people in Canada, with high rates of clustering of active TB cases. Bacille Calmette-Guérin (BCG) vaccination has been used as a preventive measure against TB in this high-risk population.OBJECTIVE: The study was designed to determine if BCG vaccination in Aboriginal people influenced recent TB transmission through an analysis of the clustering of TB cases.METHODS: A retrospective analysis of all culture-positive Mycobacterium tuberculosis cases in Aboriginal people in western Canada (1995 to 1997) was performed. Isolates were analyzed using standard methodology for restriction fragment length polymorphism and spoligotyping.RESULTS: Of 256 culture-positive Aboriginal TB cases, BCG status was confirmed in 216 (84%) cases; 34% had been vaccinated with BCG, 57% were male and 56% were living on-reserve. Patients who had been vaccinated with BCG were younger than unvaccinated individuals (mean age 32.4±1.65 years versus 45.0±1.8 years, P<0.0001). Clustering was found in 62% of cases: 59% of non-BCG vaccinated cases were clustered versus 68% of those vaccinated with BCG (P=0.16). Younger patients (younger than 60 years of age) were more likely to be clustered in the univariate analysis (P<0.01). When age, sex, province, and HIV and reserve status were controlled for, BCG vaccination was not associated with clustering (OR 1.3, 95% CI 0.7 to 2.6).CONCLUSIONS: BCG vaccinated Aboriginal people were no less likely to have active TB from recently transmitted disease. BCG vaccination appears to have limited value in preventing clustering of TB cases within this high-risk community.

Circulating tumor DNA methylation profiles enable early diagnosis, prognosis prediction, and screening for colorectal cancer

2020 ◽  
Vol 12 (524) ◽  
pp. eaax7533 ◽  
Author(s):  
Huiyan Luo ◽  
Qi Zhao ◽  
Wei Wei ◽  
Lianghong Zheng ◽  
Shaohua Yi ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
High Risk ◽  
Prediction Model ◽  
Prospective Cohort ◽  
Learning Algorithm ◽  
Precancerous Lesions ◽  
Circulating Tumor Dna ◽  
High Risk Population ◽  
Tumor Dna ◽  
Normal Controls

Circulating tumor DNA (ctDNA) has emerged as a useful diagnostic and prognostic biomarker in many cancers. Here, we conducted a study to investigate the potential use of ctDNA methylation markers for the diagnosis and prognostication of colorectal cancer (CRC) and used a prospective cohort to validate their effectiveness in screening patients at high risk of CRC. We first identified CRC-specific methylation signatures by comparing CRC tissues to normal blood leukocytes. Then, we applied a machine learning algorithm to develop a predictive diagnostic and a prognostic model using cell-free DNA (cfDNA) samples from a cohort of 801 patients with CRC and 1021 normal controls. The obtained diagnostic prediction model discriminated patients with CRC from normal controls with high accuracy (area under curve = 0.96). The prognostic prediction model also effectively predicted the prognosis and survival of patients with CRC (P < 0.001). In addition, we generated a ctDNA-based molecular classification of CRC using an unsupervised clustering method and obtained two subgroups of patients with CRC with significantly different overall survival (P = 0.011 in validation cohort). Last, we found that a single ctDNA methylation marker, cg10673833, could yield high sensitivity (89.7%) and specificity (86.8%) for detection of CRC and precancerous lesions in a high-risk population of 1493 participants in a prospective cohort study. Together, our findings showed the value of ctDNA methylation markers in the diagnosis, surveillance, and prognosis of CRC.

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