Assessment of information value of metabolic indicators in patients with colorectal cancer

2020 ◽  
Vol 15 (16) ◽  
pp. 79-87
Author(s):  
M. V. Krasnoselsky ◽  
◽  
T. M. Popovskaya ◽  
L.G. Raskin ◽  
◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Initial Data ◽  
Information Content ◽  
Small Sample ◽  
Information Value ◽  
Alternative Methods ◽  
High Density Lipoproteins ◽  
Analytical Relationship ◽  
Statistical Distributions ◽  
Adequate Treatment

Introduction. The problem of assessing the information value of indicators of the condition of patients is of a general medical nature in connection with the fundamental importance of the results of clinical examination of patients for making a diagnosis and choosing an adequate treatment tactics. The research is aimed at finding effective methods for assessing the information content of controlled indicators. Materials and methods. We examined 32 patients diagnosed with colorectal cancer. Metabolic disorders were studied on the eve of surgery and on the 14th day after surgery. To assess carbohydrate metabolism, the content of glucose (GLUCGOD) and lactate (LACT) in blood serum was studied. To assess lipid metabolism, total cholesterol (CHOL), alpha-lipoproteins (HDLC) (high-density lipoproteins), beta-lipoproteins (LDL) (low-density lipoproteins), triglycerides (TRIG) were studied. The level of the following amino acids was de-termined: methionine, cysteine, taurine, phenylalanine, tyrosine, tryptophan, glutamate, glutamine, citruline, aspartate, asparagine, arginine, ornithine, alanine, leucine, isoleucine, valine, histidine, threonine, lysine, gydroxine, serin. The calculation of correlations between the indicators is carried out. Results. In connection with the known shortcomings of the widely used method for assessing the information content of indicators by calculating the Kullback measure, a search for alternative methods that satisfy the requirements formulated in the work was carried out. The proposed method is based on a special procedure for statistical processing of the measurement results of a set of controlled indicators before and after the operation. A simple analytical relationship has been obtained that effectively detects differences in the statistical distributions of the values of the controlled indicators that appear in connection with the operation. In addition, a method for assessing the informativeness of indicators in a small sample of initial data is proposed. The method is based on identify-ing the dynamics of correlations between indicators as a result of surgery. Conclusion. Effective methods for assessing the informativeness of controlled indicators are proposed, which reveal differences in the statistical distributions of indicator values that appear in connection with the operation. Key words: Colorectal cancer; Measures for assessing the information value of indicators; A small sample of initial data.

scholarly journals Use of Antiplatelet Agents Decreases the Positive Predictive Value of Fecal Immunochemical Tests for Colorectal Cancer but Does Not Affect Their Sensitivity

2021 ◽  
Vol 11 (6) ◽  
pp. 497
Author(s):  
Yoonsuk Jung ◽  
Eui Im ◽  
Jinhee Lee ◽  
Hyeah Lee ◽  
Changmo Moon
Keyword(s):  
Colorectal Cancer ◽  
Large Scale ◽  
Screening Program ◽  
Antiplatelet Agents ◽  
Population Based ◽  
Small Sample ◽  
Antithrombotic Agents ◽  
Predictive Values ◽  
Prescription Rates ◽  
Small Sample Sizes

Previous studies have evaluated the effects of antithrombotic agents on the performance of fecal immunochemical tests (FITs) for the detection of colorectal cancer (CRC), but the results were inconsistent and based on small sample sizes. We studied this topic using a large-scale population-based database. Using the Korean National Cancer Screening Program Database, we compared the performance of FITs for CRC detection between users and non-users of antiplatelet agents and warfarin. Non-users were matched according to age and sex. Among 5,426,469 eligible participants, 768,733 used antiplatelet agents (mono/dual/triple therapy, n = 701,683/63,211/3839), and 19,569 used warfarin, while 4,638,167 were non-users. Among antiplatelet agents, aspirin, clopidogrel, and cilostazol ranked first, second, and third, respectively, in terms of prescription rates. Users of antiplatelet agents (3.62% vs. 4.45%; relative risk (RR): 0.83; 95% confidence interval (CI): 0.78–0.88), aspirin (3.66% vs. 4.13%; RR: 0.90; 95% CI: 0.83–0.97), and clopidogrel (3.48% vs. 4.88%; RR: 0.72; 95% CI: 0.61–0.86) had lower positive predictive values (PPVs) for CRC detection than non-users. However, there were no significant differences in PPV between cilostazol vs. non-users and warfarin users vs. non-users. For PPV, the RR (users vs. non-users) for antiplatelet monotherapy was 0.86, while the RRs for dual and triple antiplatelet therapies (excluding cilostazol) were 0.67 and 0.22, respectively. For all antithrombotic agents, the sensitivity for CRC detection was not different between users and non-users. Use of antiplatelet agents, except cilostazol, may increase the false positives without improving the sensitivity of FITs for CRC detection.

Methylated DNA markers for monitoring palliative chemotherapy response in advanced colorectal cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e15511-e15511
Author(s):  
Mojun Zhu ◽  
Douglas W. Mahoney ◽  
Kelli Burger ◽  
Patrick H. Foote ◽  
Karen A. Doering ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Treatment Response ◽  
Systemic Therapy ◽  
Small Sample Size ◽  
High Sensitivity ◽  
Response Assessment ◽  
Small Sample ◽  
Chemotherapy Response ◽  
Continuous Variables ◽  
Methylated Dna

e15511 Background: Aberrantly methylated DNA marker (MDM) candidates are strongly associated with primary colorectal cancer (CRC) before treatment and detect CRC recurrence with high sensitivity when assayed from plasma. The relationship of these MDMs in association to chemotherapy treatment response is unknown. Methods: In a prospective cohort of patients receiving systemic therapy for advanced CRC, peripheral blood was collected serially during restaging visits. 15 patients were retrospectively identified to have partial response (PR), stable disease (SD) and progressive disease (PD) to treatment (n=5 for each group) based on the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. Using paired samples from each patient before and after response assessment, we analyzed 11 MDMs ( GRIN2D, ZNF671, ANKRD13B, QKI, VAV3, JAM3, SFMBT2, CHST2, ZNF568, FER1L4 and CNNM1) to assess correlation with treatment response. Cell-free DNA was extracted and bisulfite treated before MDMs were quantified by target enrichment long-probe quantitative-amplified signal assay and normalized to a methylated sequence of B3GALT6. Continuous variables are summarized as a median with corresponding interquartile ranges (IQR) and comparisons between subgroups were based on the Wilcox Rank Sums test. Results: The median interval between pre- and post-response assessment visits was 69 days (IQR: 63-83 days) and the level of tumor burden at pre-assessment was similar across all response types (Table 1). Patients with PD had higher levels of methylated GRIN2D, ZNF671 and ANKRD13B than those with PR or SD at baseline and may offer additional prognostic value over CEA which was similar in the PR and PD groups before treatment (Table 1). Elevation of pre-assessment MDMs preceded radiographic evidence of disease progression by 82 days (IQR 69-83 days). Conclusions: Three MDMs, GRIN2D, ZNF671 and ANKRD13B, were found to reflect treatment response (PD vs. PR + SD) as shown in the table. Although this pilot study was limited by a small sample size, it demonstrated the feasibility of using plasma-based MDMs in monitoring treatment response to systemic therapy for advanced CRC and should be compared to CEA in a larger study.[Table: see text]

scholarly journals A Novel Classification Method for Syndrome Differentiation of Patients with AIDS

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Yufeng Zhao ◽  
Liyun He ◽  
Qi Xie ◽  
Guozheng Li ◽  
Baoyan Liu ◽  
...  
Keyword(s):  
Small Sample Size ◽  
Gaussian Mixture ◽  
Multiple Instance Learning ◽  
Small Sample ◽  
Alternative Methods ◽  
Syndrome Differentiation ◽  
Bayes Rule ◽  
Classification Rules ◽  
Average Precision ◽  
Quality Classification

We consider the analysis of an AIDS dataset where each patient is characterized by a list of symptoms and is labeled with one or more TCM syndromes. The task is to build a classifier that maps symptoms to TCM syndromes. We use the minimum reference set-based multiple instance learning (MRS-MIL) method. The method identifies a list of representative symptoms for each syndrome and builds a Gaussian mixture model based on them. The models for all syndromes are then used for classification via Bayes rule. By relying on a subset of key symptoms for classification, MRS-MIL can produce reliable and high quality classification rules even on datasets with small sample size. On the AIDS dataset, it achieves average precision and recall 0.7736 and 0.7111, respectively. Those are superior to results achieved by alternative methods.

scholarly journals Characterization of Thermophysical Properties of Phase Change Materials Using Unconventional Experimental Technologies

Energies ◽  
2020 ◽  
Vol 13 (18) ◽  
pp. 4687
Author(s):  
Arnold Martínez ◽  
Mauricio Carmona ◽  
Cristóbal Cortés ◽  
Inmaculada Arauzo
Keyword(s):  
Thermal Properties ◽  
Phase Change ◽  
Thermophysical Properties ◽  
Phase Change Materials ◽  
Small Sample ◽  
Alternative Methods ◽  
Accurate Estimation ◽  
Inhomogeneous Materials ◽  
Scanning Calorimetry

The growing interest in developing applications for the storage of thermal energy (TES) is highly linked to the knowledge of the properties of the materials that will be used for that purpose. Likewise, the validity of representing processes through numerical simulations will depend on the accuracy of the thermal properties of the materials. The most relevant properties in the characterization of phase change materials (PCM) are the phase change enthalpy, thermal conductivity, heat capacity and density. Differential scanning calorimetry (DSC) is the most widely used technique for determining thermophysical properties. However, several unconventional methods have been proposed in the literature, mainly due to overcome the limitations of DSC, namely, the small sample required which is unsuitable for studying inhomogeneous materials. This paper presents the characterization of two commercial paraffins commonly used in TES applications, using methods such as T-history and T-melting, which were selected due to their simplicity, high reproducibility, and low cost of implementation. In order to evaluate the reliability of the methods, values calculated with the proposed alternative methods are compared with the results obtained by DSC measurements and with the manufacturer’s technical datasheet. Results obtained show that these non-conventional techniques can be used for the accurate estimation of selected thermal properties. A detailed discussion of the advantage and disadvantage of each method is given.

Su1567 Adequate Treatment for Early Colorectal Cancer Diagnosed by Magnifying Endoscopy

2011 ◽  
Vol 73 (4) ◽  
pp. AB307
Author(s):  
Fumio Ishida ◽  
Shin-Ei Kudo ◽  
Nobunao Ikehara ◽  
Hideyuki Miyachi ◽  
Yoshiki Wada ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Magnifying Endoscopy ◽  
Early Colorectal Cancer ◽  
Adequate Treatment

scholarly journals HIGH RUMINATION AND LOW AMINO ACIDS ARE ASSOCIATED WITH AN INCREASED RISK OF METABOLIC SYNDROME

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S955-S955
Author(s):  
Jessie Alwerdt ◽  
Yuan Tian ◽  
Andrew D Patterson ◽  
Martin Sliwinski
Keyword(s):  
Metabolic Syndrome ◽  
Physiological Response ◽  
Alternative Methods ◽  
High Density Lipoproteins ◽  
Thought Processes ◽  
Increased Risk ◽  
Logistic Regressions ◽  
Middle Aged Adults ◽  
Everyday Stress ◽  
Different Levels

Abstract Metabolic syndrome (MetS) is an increasing epidemic worldwide. Identifying modifiable behaviors that intersect with the association between MetS and associated metabolites could result in alternative methods to prevent those at risk for MetS. Here we investigate the moderation of ruminating thought processes between metabolites and MetS. Rumination has been linked to exacerbating the physiological response of stress and increasing the risk for poor health outcomes, such as hypertension. Data consisted of 180 middle-aged adults from Bronx, NY. MetS was calculated based on the NIH guidelines using waist, triglycerides, high-density lipoproteins, blood pressure, and glucose. Using NMR-based metabolomics, 26 serum metabolites were obtained. The Rumination-Reflection Questionnaire measured rumination of thoughts. Interactions between rumination and each metabolite were conducted with logistic regressions (e.g., Valinexrumination). Overall, significant moderation occurred with the greatest effect involving different levels of phenylalanine, betaine, creatine, and isoleucine with higher rumination in relation to the increased probability for MetS. The greatest risk for MetS was in those who were high ruminators and had low values of these AAs. Therefore, within those who are high ruminators, an increase in these AAs may be beneficial in improving the risk for MetS. Further, in those who are low ruminators, minimal moderation occurred. AAs disturbance has been linked with MetS in past studies, as well as in mental health. These results suggest that ways of handling thoughts that are intertwined with everyday stress may exacerbate these associations and could benefit with modification.

Racial differences in the pattern of hematologic toxicity in the treatment of colorectal cancer.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 679-679
Author(s):  
Olalekan O. Oluwole ◽  
William Wu ◽  
Steven N. Wolff ◽  
Kenneth R. Hande
Keyword(s):  
Colorectal Cancer ◽  
Racial Differences ◽  
Statistical Significance ◽  
Dihydropyrimidine Dehydrogenase ◽  
Univariate Analysis ◽  
Small Sample ◽  
Categorical Variables ◽  
Hematological Toxicity ◽  
Hematologic Toxicity ◽  
Grade 3

679 Background: 5-fluorouracil (5-FU), a synthetic fluoropyrimidine, is a critical component of chemotherapy in many cancers. Its metabolites inhibit Thymidylate Synthetase (TS) causing cessation of DNA synthesis and are misincorporated into DNA and RNA causing ineffective DNA repair and faulty mRNA splicing. The rate limiting step in the catabolism of 5-FU is by the Dihydropyrimidine Dehydrogenase enzyme (DPD) which catabolizes over 80% of 5-FU. Patients with near total DPD enzymatic deficiency develop life threatening toxicity after a single administration and those with less severe deficiency will have delayed elimination of 5-FU and slowly accumulate active metabolites leading to toxicities. Methods: We conducted a pilot retrospective cohort study of African American (AA) and Caucasian patients treated for colorectal cancer over a 9 year period, 2000 – 2008, in this IRB approved study. The primary outcome of interest was the rate of development of grade 3 or 4 neutropenia (Absolute Neutrophil Count <1000/uL = grade 3 and <500/uL = grade 4). Descriptive and univariate analysis were done. To test for differences between AA and Caucasians, we computed independent t-test for continuous and Fisher’s exact test for categorical variables. Relative Risk (RR) and p-values were computed. All statistics were done with SPSS v19 software. Results: There were 66 evaluable patients (40 men, 26 women), 40 AA, 24 Caucasians and 2 of other races. Thirty-eight patients (15 Caucasians and 23 AA) received 5-FU containing chemotherapy. The two groups were comparable in baseline characteristics. AA were more likely to develop grade 3-4 hematological toxicity. Nine of 23 AA (39.1%) and one of 15 Caucasians (6.7%) developed grade 3-4 hematological toxicity. RR 8.56, 95% confidence interval 0.95 – 421.06 (p-value of 0.0561) Conclusions: These results suggest that AA were more likely than Caucasians to have severe hematologic toxicity with the use of 5-FU containing chemotherapy. This difference did not meet statistical significance due to small sample size and few numbers of events in the Caucasian arm. A larger prospective study is needed to further evaluate the observed difference.

An observational study of a team management approach for first-line XELOX therapy in patients with advanced/recurrent colorectal cancer: The SMILE study (the study of metastatic colorectal cancer to investigate impact of learning effect).

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 554-554
Author(s):  
Michio Nakamura ◽  
HIroshi Matsuoka ◽  
Yoshihisa Shibata ◽  
Yoshinori Munemoto ◽  
Hiroyuki Okuda ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Observational Study ◽  
Small Sample Size ◽  
Depression Scale ◽  
Dose Intensity ◽  
Small Sample ◽  
Management Approach ◽  
First Line ◽  
Fighting Spirit ◽  
Supportive Interventions

554 Background: Although oral chemotherapies such as XELOX are widely favored for convenience and flexibility, these have several disadvantages such as drug non-compliance and delayed discovery of adverse events. So we designed a multicenter, prospective, observational study to evaluate the efficacy of supportive interventions in first-line XELOX for colorectal cancer (CRC) patients (pts). Methods: CRC pts undergoing first-line XELOX (+Bevacizumab) therapy practicing one or more of supportive interventions as follows: 1) a telephone follow-up (TF), 2) instruction on dosage and administration by a pharmacist, 3) skin care instruction by a nurse, and 4) pts education by a doctor were eligible. The objective was to evaluate the incident rate of grade 2 or worse hand-foot syndrome (HFS), QoL, safety, and efficacy. QoL was assessed at baseline, 2, 4, 5 and 8 cycles after the treatment started, using the Hospital Anxiety and Depression Scale (HADS) and the Mental adjustment to cancer scale (MAC). Results: From April 2011 to September 2012, 80 pts were enrolled from 14 institutes. The characteristics were as follows: male/female: 46/34, age median: 63 (36-75), and supportive intervention 1)/2)/3)/4): 36/68/73/78. The incidence of grade 2 or worse HFS during 6 months were 11.1% (n=4) for those received TF (n=36), and 20.5% (n=9) for those received other intervention except TF (n=44). Relative dose intensity (RDI) was 75.7% (TF+/-: 77.7/74.3%) in oxaliplatin and 77.5% (TF+/-: 80.2/75.3%) in capecitabine, respectively. Although a tendency of the QoL score improvement about anxiety, fighting spirit and helplessness in a TF group was observed during the periods from start of therapy to 4 courses, there were no significant differences compared to other interventions except TF. Conclusions: We confirmed that HFS incidence was mitigated in a TF group. In regard to QoL, although we could not show the statistical differences due to some limitations of this study such as small sample size and non-randomized, it was indicated that TS had the potential to improve several QoL about anxiety, fighting spirit, and helplessness. Clinical trial information: UMIN000007185.

Molecular profiling of TOPO1: A way to evaluate irinotecan treatment in colorectal cancer?

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 546-546
Author(s):  
Julia Marie Cunningham ◽  
Petra Prins ◽  
Brian Conkright ◽  
Simina Boca ◽  
Shruti Rao ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Small Sample Size ◽  
Predictive Marker ◽  
Molecular Profiling ◽  
Small Sample ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Control Group ◽  
Similar Response ◽  
Second Line

546 Background: Front-line chemotherapy for metastatic colorectal cancer (mCRC) consists of a fluoropyrimidine backbone plus either oxaliplatin (FOLFOX or XELOX) or irinotecan (FOLFIRI or XELIRI). Large, prospective trials enrolling chemotherapy-naïve patients (pts) show FOLFOX and FOLFIRI treatment to be equivalent with similar response rates. Methods: Irinotecan inhibits TOPO1, which is now a candidate marker for irinotecan treatment benefit. Thus, we retrospectively analyzed TOPO1 expression level in 49 pts with mCRC who were treated with irinotecan-containing regimens at the Lombardi Comprehensive Cancer Center between 2009 and 2014. Patient characteristics and outcomes were compiled through chart review and the effect of TOPO1 expression on clinical outcomes was assessed. TOPO1 expression in tumor tissue from each pt was analyzed using a commercially available molecular profiling (MP) service (Caris Life Sciences). Results: The median overall survival (OS) for all pts was 33.9 months (mo), defined as the time from metastasis to death or censorship. When grouped by “high” or “low” TOPO1 expression, as defined by Caris at the time of the testing, 29 pts were high-expressers and 20 were low-expressers. High TOPO1 expressers receiving irinotecan (n = 22) had a median OS of 27.2 mo, compared with median 41.5 mo for low-expressers (n = 14) (p = 0.27). Irinotecan is conventionally given as second-line therapy. The median OS of pts receiving second-line irinotecan was 38.2 mo for high-expressers [n = 11] vs. 68.5 mo for low-expressers [n = 5]) (p = 0.32). Conclusions: Our limited data do not support the use of TOPO1 expression levels as a predictive marker for irinotecan therapy in mCRC. However, our conclusions are limited by small sample size, lack of a control group to distinguish prognostic from predictive markers, and timing of TOPO1 measurement, which in many cases was after irinotecan therapy. Physicians currently lack an evidence-based way to choose between potentially efficacious regimens for mCRC. More rigorous studies are needed to assess the benefit of MP in mCRC care. We are currently planning a prospective study with the hope of validating the use of TOPO1 expression as a predictive marker for treatment of this disease.

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