Diagnostic Value of Anti-gp210 Combined with Indirect Serum Markers for Predicting Histological Staging in Patients with Primary Biliary Cholangitis

2019 ◽  
Author(s):  
Jing Wang ◽  
Fengrong Hu ◽  
Chuangye He ◽  
Zengshan Li ◽  
Xiaofeng Liu ◽  
...  
Keyword(s):  
Diagnostic Value ◽  
Serum Markers ◽  
Primary Biliary Cholangitis ◽  
Histological Staging

scholarly journals MECHANISMS IN ENDOCRINOLOGY: Hypophysitis: diagnosis and treatment

2018 ◽  
Vol 179 (3) ◽  
pp. R151-R163 ◽  
Author(s):  
Mamta N Joshi ◽  
Benjamin C Whitelaw ◽  
Paul V Carroll
Keyword(s):  
Imaging Techniques ◽  
Immunosuppressive Agents ◽  
Treatment Strategies ◽  
Rare Condition ◽  
Diagnostic Value ◽  
Serum Markers ◽  
Hormone Deficiency ◽  
Pituitary Hormone ◽  
Pituitary Mass ◽  
Pituitary Antibodies

Hypophysitis is a rare condition characterised by inflammation of the pituitary gland, usually resulting in hypopituitarism and pituitary enlargement. Pituitary inflammation can occur as a primary hypophysitis (most commonly lymphocytic, granulomatous or xanthomatous disease) or as secondary hypophysitis (as a result of systemic diseases, immunotherapy or alternative sella-based pathologies). Hypophysitis can be classified using anatomical, histopathological and aetiological criteria. Non-invasive diagnosis of hypophysitis remains elusive, and the use of currently available serum anti-pituitary antibodies are limited by low sensitivity and specificity. Newer serum markers such as anti-rabphilin 3A are yet to show consistent diagnostic value and are not yet commercially available. Traditionally considered a very rare condition, the recent recognition of IgG4-related disease and hypophysitis as a consequence of use of immune modulatory therapy has resulted in increased understanding of the pathophysiology of hypophysitis. Modern imaging techniques, histological classification and immune profiling are improving the accuracy of the diagnosis of the patient with hypophysitis. The objective of this review is to bring readers up-to-date with current understanding of conditions presenting as hypophysitis, focussing on recent advances and areas for future development. We describe the presenting features, investigation and diagnostic approach of the patient with likely hypophysitis, including existing conventional techniques and those in the research/development arena. Hypophysitis usually results in acute and persistent pituitary hormone deficiency requiring long-term replacement. Management of hypophysitis includes control of the inflammatory pituitary mass using a variety of treatment strategies including surgery and medical therapy. Glucocorticoids remain the mainstay of medical treatment but other immunosuppressive agents (e.g. azathioprine, rituximab) show benefit in some cases, but there is a need for controlled studies to inform practice.

Limited diagnostic value of serum inflammatory biomarkers in the diagnosis of fracture-related infections

2020 ◽  
Vol 102-B (7) ◽  
pp. 904-911
Author(s):  
Irene K. Sigmund ◽  
Maria Dudareva ◽  
Daniel Watts ◽  
Mario Morgenstern ◽  
Nicholas A. Athanasou ◽  
...  
Keyword(s):  
Decision Tree ◽  
Cell Count ◽  
Diagnostic Value ◽  
Serum Markers ◽  
Consensus Definition ◽  
Preoperative Serum ◽  
Diagnostic Decision ◽  
Wbc Count ◽  
Sensitivity Specificity ◽  
Serum Crp

Aims The aim of this study was to evaluate the diagnostic value of preoperative serum CRP, white blood cell count (WBC), percentage of neutrophils (%N), and neutrophil to lymphocyte ratio (NLR) when using the fracture-related infection (FRI) consensus definition. Methods A cohort of 106 patients having surgery for suspected septic nonunion after failed fracture fixation were studied. Blood samples were collected preoperatively, and the concentration of serum CRP, WBC, and differential cell count were analyzed. The areas under the curve (AUCs) of diagnostic tests were compared using the z-test. Regression trees were constructed and internally cross-validated to derive a simple diagnostic decision tree. Results Using the FRI consensus definition, 46 patients (43%) were identified as infected. Sensitivity, specificity, and AUC of CRP were 67% (95% confidence interval (CI) 52% to 80%), 61% (95% CI 47% to 74%), and 0.64 (95% CI 0.54 to 0.74); of WBC count were 17% (95% CI 9% to 31%), 95% (95% CI 86% to 99%), and 0.57 (95% CI 0.50 to 0.62); of %N 13% (95% CI 6% to 26%), 87% (95% CI 76% to 93%), and 0.50 (95% CI 0.43 to 0.56); and of NLR 28% (95% CI 17% to 43%), 80% (95% CI 68% to 88%), and 0.54 (95% CI 0.46 to 0.63), respectively. A better performance of serum CRP was shown in comparison to the leucocyte count (p = 0.006), %N (p < 0.001), and NLR (p = 0.001). A statistically lower serum CRP level was shown in patients with an infection caused by a low virulence microorganism in comparison to high virulence bacteria (p = 0.008). We found that a simple decision tree approach using only low serum neutrophils (< 3.615 × 109/l) and low CRP (< 2.45 mg/l) may allow better identification of aseptic cases. Conclusion The evaluated serum inflammatory markers showed limited diagnostic value in the preoperative diagnosis of FRI when using the uniform FRI Consensus Definition. Therefore, they should remain as suggestive criteria in diagnosing FRI. Although CRP showed a higher performance in comparison to the other serum markers, it is insufficiently accurate to diagnose a septic nonunion, especially when caused by low virulence microorganisms. Cite this article: Bone Joint J 2020;102-B(7):904–911.

scholarly journals Serum miR-101-3p combined with pepsinogen contributes to the early diagnosis of gastric cancer

2020 ◽  
Author(s):  
Weiwei Zeng ◽  
Shuxiang Zhang ◽  
Lei Yang ◽  
Wenchao Wei ◽  
Jie Gao ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Early Diagnosis ◽  
Roc Analysis ◽  
Operating Characteristic ◽  
Diagnostic Marker ◽  
Diagnostic Value ◽  
Serum Markers ◽  
Enzyme Linked Immunosorbent Assay ◽  
Submucosal Infiltration ◽  
Normal Controls

Abstract Background: This study aimed to explore the diagnostic value of serum miR-101-3p combined with pepsinogen (PG) on early diagnosis of gastric cancer (GC). Methods: A total of 61 atrophic gastritis (AG) and 86 GC patients, and 50 healthy volunteers were enrolled. The serum expression of miR-101-3p was measured by qRT-PCR. The serum content of carcinoembryonic antigen (CEA) was measured by Electrochemiluminescence immunoassay. The serum contents of PGI and PGII were measured by Enzyme linked immunosorbent assay. The diagnostic value of serum markers on AG and GC was analyzed by receiver operating characteristic (ROC) analysis. Results: The expression of miR-101-3p, the content of PGI and the ratio of PGI/II were significantly decreased, and the content of PGII was significantly increased in AG patients compared with those in normal controls. The changes of the above serum indicators were more obvious in GC patients than those in AG patients. The content of CEA was significantly higher in GC patients than that in AG patients. In addition, the expression of miR-101-3p was negatively associated with the submucosal infiltration in GC patients. MiR-101-3p exhibited high diagnostic value on AG (AUC 0.8493, sensitivity 80.33%, specificity 80%) and GC (AUC 0.8749, sensitivity 72.09%, specificity 86.49%). MiR-101-3p + PGI + PGI/II (AUC 0.856, sensitivity 80.23%, specificity 77.05%) exhibited a high diagnostic value in distinguishing between AG and GC. Conclusions: MiR-101-3p was a potential diagnostic marker for AG and GC. MiR-101-3p + PGI + PGI/II was effective in distinguishing between AG and GC.

scholarly journals High serum VE-cadherin and vinculin concentrations are markers of the disruption of vascular integrity during acute aortic dissection

2021 ◽  
Author(s):  
Shiyue Wang ◽  
Yuchen He ◽  
Xin Li ◽  
Shijie Xin ◽  
Jian Zhang ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Diagnostic Value ◽  
Serum Markers ◽  
High Serum ◽  
Vascular Endothelial ◽  
Characteristic Analysis ◽  
Vascular Integrity ◽  
Refractory Pain ◽  
Visceral Malperfusion

Abstract Background In the present study, we measured the serum vascular endothelial cadherin (VEC) and vinculin (Vcn) concentrations in patients with acute aortic dissection (AAD) to evaluate their diagnostic value for this condition. Methods One hundred patients with AAD and 60 matched controls were included in the study. The serum concentrations of VEC and Vcn were measured using enzyme-linked immunosorbent assays. Results The serum VEC and Vcn concentrations were significantly higher in participants with AAD than in healthy controls. Receiver operating characteristic analysis generated areas under the curves for VEC and Vcn that were diagnostic for AAD (0.604 and 0.665, respectively). The optimal cut-off values were 3.986 ng/µL and 128.1 pg/mL, the sensitivities were 43.0% and 35.0%, and the specificities were 73.3% and 90.0%, respectively. In addition, the use of a combination of serum VEC and Vcn increased the AUC to 0.739, with a sensitivity of 56.0% and a specificity of 76.7%. A high serum Vcn concentration was associated with a higher risk of poor visceral malperfusion in participants with AAD (odds ratio [OR] = 1.007, 95% confidence interval [CI]: 1.001–1.013, p = 0.014). In participants with refractory pain, the adjusted OR for the serum VEC concentration increased to 1.172 (95% CI: 1.010–1.361; p = 0.036), compared with participants without refractory pain. Conclusion This study is the first to show the diagnostic value of serum VEC and Vcn for AAD and their relationships with the clinical characteristics of patients with AAD. Thus, VEC and Vcn are potential serum markers of AD.

scholarly journals Diagnostic Value of Serum Markers Combined with TVCDS in Ovarian Cancer Patients Treated with Bushen Yiqi Quyu Prescription

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Wei Qin ◽  
Fengmin Jiang ◽  
Tao Zhang
Keyword(s):  
Detection Rate ◽  
Clinical Stage ◽  
Diagnostic Value ◽  
Serum Markers ◽  
Control Group ◽  
Observation Group ◽  
Before And After ◽  
Sensitivity Specificity ◽  
Combined Detection ◽  
Cox 1

Background. To compare the diagnostic value of serum markers human epididymal protein 4 (HE4) and cyclooxygenase-1 (COX-1) combined with transvaginal color Doppler sonography (TVCDS) in ovarian cancer (OC) treated with Bushen Yiqi Quyu prescription. Methods. A total of 232 OC patients treated at the hospital from January 2018 to October 2020 were randomly divided into an observation group (n = 116) and control group (n = 116). The control group was treated with essential Western medication, and the observation group was treated with essential Western medication and Bushen Yiqi Quyu prescription. The clinical efficacy of the two groups was compared. The levels of HE4 and COX-1 were compared between the two groups before and after treatment. The ultrasonic features of TVCDS were compared between the two groups before and after treatment. The ROC curve was drawn to compare the sensitivity, specificity, and accuracy of single and combined detection of HE4, COX-1, and TVCDS in the observation group. Results. The total effective rate of the observation group was significantly higher than that of the control group. After treatment, HE4 and COX-1 levels in both groups were considerably lower than those before treatment, and in the observation group, they decreased significantly than in the control group. HE4 and COX-1 were positively correlated with the clinical stage of OC. The higher the clinical stage, the higher the levels of HE4 and COX-1. After treatment, there was no significant difference in tumor location and the boundary between the two groups. There were statistically significant differences in tumor echo, nature, morphology, calcification, internal blood flow, and lymph node metastasis, and the difference in the observation group was more evident than in control group. The sensitivity, specificity, accuracy, positive detection rate, and negative detection rate of combined detection were higher than those of single detection. Conclusions. Bushen Yiqi Quyu prescription has certain curative effects in the treatment of OC patients, which can significantly reduce the level of tumor markers and improve the symptoms of OC patients. The combined detection of HE4, COX-1, and TVCDS has high sensitivity, specificity, and accuracy, which can effectively detect OC and reduce missed diagnosis and misdiagnosis.

Diagnostic Value of Serum Kallikrein-Related Peptidases 6 and 10 Versus CA125 in Ovarian Cancer

2011 ◽  
Vol 21 (4) ◽  
pp. 625-632 ◽  
Author(s):  
Mustafa Abdel Hafiz El Sherbini ◽  
Maha Mohamed Sallam ◽  
Emtiaz Abdel Kawy Shaban ◽  
Amr Hassan El-Shalakany
Keyword(s):  
Ovarian Cancer ◽  
Diagnostic Value ◽  
Maternity Hospital ◽  
Serum Markers ◽  
Enzyme Linked Immunosorbent Assay ◽  
Diagnostic Specificity ◽  
Preoperative Serum ◽  
Specificity And Sensitivity ◽  
Serum Ca125 ◽  
Oncology Unit

Objectives:To assess the diagnostic value of serum KLK6 and KLK10 in patients with ovarian tumor in comparison to serum CA125.Methods:Based on clinical and sonographic findings, 90 patients were consecutively recruited at the Gynecological Oncology Unit, Ain Shams University Maternity Hospital. Preoperative serum KLK6 and/or KLK10 were determined by enzyme-linked immunosorbent assay technique. The patients' final diagnoses were those of the histopathological reports.Results:There were 27 malignant versus 63 benign cases. Serum markers' diagnostic specificity and sensitivity were 80.3/72.7, 56.8/64.0, and 39.53/58.3 for CA125, KLK6, and KLK10, respectively. Combination of CA125 with either of the other 2 markers revealed diagnostic enhancement with KLK10 (85.37/73.00) but not with KLK6 (42.86/86.36).Conclusions:In ovarian cancer, serum KLK6 and KLK10 may have much lower overall sensitivities than serum CA125. However, whereas serum KLK6 may improve the sensitivity of CA125, serum KLK10 may have the highest specificity among the 3 markers.

scholarly journals Meta-Analysis of Antinuclear Antibodies in the Diagnosis of Antimitochondrial Antibody-Negative Primary Biliary Cholangitis

2019 ◽  
Vol 2019 ◽  
pp. 1-12 ◽  
Author(s):  
Qian Zhang ◽  
Zhiqiang Liu ◽  
Shanshan Wu ◽  
Weijia Duan ◽  
Sha Chen ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Antinuclear Antibodies ◽  
Meta Analysis ◽  
High Specificity ◽  
Diagnostic Value ◽  
Cochrane Library ◽  
Primary Biliary Cholangitis ◽  
Summary Receiver Operating Characteristic ◽  
Random Effects Models ◽  
Antimitochondrial Antibody

Objective. The diagnostic value of antinuclear antibodies (ANAs) including anti-gp210 and anti-sp100 for primary biliary cholangitis/cirrhosis (PBC) has been widely reported. However, their diagnostic performances for antimitochondrial antibody- (AMA-) negative PBC were less well elucidated. Therefore, the aim of the current meta-analysis was to evaluate the diagnostic accuracy of ANAs in patients with AMA-negative PBC. Materials and Methods. Literature on the diagnostic value of biomarkers for AMA-negative PBC was systematically searched in PubMed, MEDLINE, EMBASE, and the Cochrane Library. The qualities of the retrieved studies were assessed by the Quality Assessment of Diagnostic Accuracy Studies-version 2 (QUADAS-2) scale. Pooled sensitivity and specificity of the biomarkers were calculated with random-effects models. The areas under the summary receiver operating characteristic (AUSROC) curves were used to evaluate the overall diagnostic performance of ANAs. Results. A total of 11 studies (400 AMA-negative PBC patients and 6217 controls) were finally included in the meta-analysis. ANAs had an overall sensitivity of 27% (95% CI: 20%, 35%) and specificity of 98% (95% CI: 97%, 99%). The pooled sensitivities for anti-gp210 and anti-sp100 were 23% (95% CI: 13%, 37%) and 25% (95% CI: 13%, 43%), respectively, and their specificities were 99% (95% CI: 97%, 100%) and 97% (95% CI: 93%, 98%), respectively. Conclusions. ANAs exhibited high specificity but low sensitivity and therefore could be used as reliable biomarkers to reduce the necessity of liver histology.

The diagnostic accuracy of biomarkers for diagnosis of primary biliary cholangitis (PBC) in anti-mitochondrial antibody (AMA)-negative PBC patients: a review of literature

2017 ◽  
Vol 56 (1) ◽  
Author(s):  
Federica de Liso ◽  
Caterina Matinato ◽  
Mariangela Ronchi ◽  
Rita Maiavacca
Keyword(s):  
Diagnostic Value ◽  
Serum Biomarkers ◽  
Primary Biliary Cholangitis ◽  
Nuclear Pore ◽  
Biliary Cirrhosis ◽  
Mean Values ◽  
Nuclear Antigens ◽  
Diagnostic Role ◽  
New Biomarkers ◽  
Mitochondrial Antibody

AbstractPrimary biliary cholangitis (PBC), also known as primary biliary cirrhosis, is an autoimmune disease of the liver characterized by anti-mitochondrial antibodies (AMA) in 90%–95% of patients. The aim of this study was to evaluate the diagnostic value of several serum biomarkers in patients with PBC but negative for AMA. Some antinuclear antibodies (ANA) pattern, detected by indirect immunofluorescence (IIF), such as multiple nuclear dot (MND) and rim-like patterns are well-known to be specific for PBC. The corresponding nuclear antigens are the components of the nuclear pore complex (Gp210 for rim-like pattern) and Sp100, PML proteins (for MND pattern) detectable by immunoblotting and ELISA methods. More recently, new biomarkers have been evaluated in order to improve the diagnostic sensitivity, such as kelch-like 12 (KLHL12) and hexokinase-1. Considering these different serum biomarkers, studies evaluating their diagnostic role in AMA-negative PBC patients compared to AMA-positive ones and controls were included in this review. Pooled sensitivity and specificity were 37% and 85%, respectively. The overall PPV and NPV mean values were 45% and 83%. Even if all biomarkers are very specific for PBC, the overall sensitivity was poor and therefore is necessary to identify a marker with a greater sensitivity for PBC in AMA-negative patients.

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