Chromogranin a Measurement in Metastatic Well-Differentiated Gastroenteropancreatic Neuroendocrine Carcinoma: Screening for False Positives and a Prospective Follow-Up Study

Background Multiple causes of false-positive chromogranin A (CgA) measurement have been reported that may affect its impact as a surrogate marker of RECIST progression in well-differentiated gastroenteropancreatic neuroendocrine tumors (WDGEPNET). Aims 1) To evaluate the frequency of false-positive CgA results. 2) To prospectively compare CgA variations with RECIST morphological changes in patients without known causes of false-positive CgA measurements. Methods First, the conditions responsible for potentially false-positive CgA measurements were screened in 184 consecutive patients with metastatic WDGEPNET. Secondly, a variation in CgA at a 6-month interval was compared to RECIST results at 6 months in 46 patients. Results Among 184 patients, elevated CgA was found in 130 cases (71%) including 99 patients with at least one cause of a false-positive result. Impaired kidney function as well as medication with proton pump inhibitors were found to be the 2 major causes of false-positive results. The sensitivity and specificity of CgA measurements compared with morphological tumor changes according to the RECIST criteria were 71% and 50%, respectively, at 6 months. Conclusion Routine screening for the causes of false-positive CgA measurements is mandatory in WDGEPNET patients. Our study does not validate the use of CgA as a surrogate marker of tumor progression.

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Whether Keratectasia Area Shown in Corneal Topography Is Appropriate for Evaluating the Effect of Corneal Cross-Linking for Keratoconus: A 12-Month Follow-Up Study

BioMed Research International ◽

10.1155/2019/1762537 ◽

2019 ◽

Vol 2019 ◽

pp. 1-5

Author(s):

Jia Wang ◽

Zhiwei Li ◽

Huankai Zhang ◽

Ning Gao ◽

Guoying Mu

Keyword(s):

Endothelial Cell ◽

Linear Regression ◽

Early Stage ◽

Morphological Changes ◽

Corneal Thickness ◽

Corneal Topography ◽

Cross Linking ◽

Follow Up Study ◽

Before And After

Purpose. To analyze the keratectasia area (KEA) shown in corneal topography before and after corneal cross-linking (CXL) in patients with progressive keratoconus (KC) and figure out whether KEA is appropriate for evaluating the effect of CXL. Methods. A retrospective analysis was conducted in 34 eyes from 24 progressive KC patients who have underwent CXL from 2015 to 2017. Area with K-value more than 47D shown in the corneal topography was marked and identified as KEA. Keratometry (K1, K2, and Kmax), KEA, thinnest corneal thickness (TCT), and endothelial cell density (ECD) were evaluated preoperatively or at months 3, 6, and 12 postoperatively. The changes of KEA before and after operation were evaluated. The relation of KEA and other parameters, including Kmax and TCT, was analyzed. Results. Linear regression model revealed the KEA, Kmax, K1, and K2 decreased after CXL in model y = 0.9622 -0.02408 x (P<0.05), y = 0.9982 -0.003469 x(P<0.05), y = 0.9977 + -0.001347 x(P<0.05), y = 0.9992 + -0.001779 x(P<0.05) (y represents KEA, Kmax, K1, or K2; x represents time (month)). The KEA is significantly decreased in early stage (before month 3) (P<0.05); however, the Kmax, K1, and K2 have no significant decrease in early stage (P= 0.09, 0.19, 0.32). Conclusions. The KEA is more sensitive than K-value in describing the morphological changes of cornea after CXL, especially in early stage after treatment.

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False-Positive Results in Metagenomic Virus Discovery: A Strong Case for Follow-Up Diagnosis

Transboundary and Emerging Diseases ◽

10.1111/tbed.12251 ◽

2014 ◽

Vol 61 (4) ◽

pp. 293-299 ◽

Cited By ~ 23

Author(s):

T. Rosseel ◽

B. Pardon ◽

K. De Clercq ◽

O. Ozhelvaci ◽

S. Van Borm

Keyword(s):

False Positive ◽

Virus Discovery ◽

Strong Case ◽

Positive Results

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Risk for intravesical recurrence of bladder cancer stratified by the results on two consecutive UroVysion fluorescence in situ hybridization tests: a prospective follow-up study in Japan

International Journal of Clinical Oncology ◽

10.1007/s10147-020-01634-9 ◽

2020 ◽

Vol 25 (6) ◽

pp. 1163-1169

Author(s):

Atsushi Ikeda ◽

Takahiro Kojima ◽

Koji Kawai ◽

Shiro Hinotsu ◽

Naoto Keino ◽

...

Keyword(s):

Bladder Cancer ◽

Positive Result ◽

Recurrence Rates ◽

Follow Up Study ◽

Negative Results ◽

Negative Findings ◽

History Of ◽

Muscle Invasive ◽

Positive Results

Abstract Background A previous comparative study in Japan has demonstrated that the two consecutive UroVysion tests are useful tools to detect the presence of bladder cancer during follow-up after transurethral resection, but they also presented their high rates of false-positive results. Here, we aimed to evaluate the relationship between the UroVysion tests and subsequent intravesical recurrence. Methods In the previous study, patients without bladder cancer during the first analysis showed the same examination set repeated 3 months later as the second analysis. In this follow-up study, 326 patients showed negative findings confirmed on cystoscopy during the second UroVysion test. Recurrence-free survival was assessed using a median follow-up of 27 months. Results In the two consecutive UroVysion tests, 214 patients (65.6%) showed negative UroVysion results in both tests, whereas 91 presented a positive result on either tests and 21 patients presented positive results in both tests. During the follow-up, 40 patients (12.3%) had an intravesical recurrence with non-muscle-invasive bladder cancer. The recurrence rates in patients with negative results in both tests, those with one positive result in either tests, and those with positive results in both tests were 8.4%, 16.5%, and 33.3%, respectively. The multivariate analysis indicated that the history of bladder cancer and the consecutive UroVysion test pattern were independent risk factors for recurrence. Conclusions Our data confirmed the effectiveness of two consecutive UroVysion tests in predicting intravesical recurrence after TURBT. Further prospective studies would help determine an appropriate interval for cystoscopy follow-up.

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False positive results in ovarian cancer screening: One year follow-up of psychological status

Psychology and Health ◽

10.1080/08870449408401934 ◽

1994 ◽

Vol 10 (1) ◽

pp. 33-40 ◽

Cited By ~ 27

Author(s):

Jane Wardle ◽

Amanda Pernet ◽

William Collins ◽

Thomas Bourne

Keyword(s):

Ovarian Cancer ◽

Cancer Screening ◽

False Positive ◽

Psychological Status ◽

Ovarian Cancer Screening ◽

One Year ◽

Positive Results

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Somatostatin receptor scintigraphy and chromogranin A assay in staging and follow-up of patients with well-differentiated neuroendocrine tumors

Nuclear Medicine Communications ◽

10.1097/mnm.0b013e328347a895 ◽

2011 ◽

Vol 32 (8) ◽

pp. 731-737 ◽

Cited By ~ 7

Author(s):

Marcel P.M. Stokkel ◽

Daphne D. Rietbergen ◽

Catharina M. Korse ◽

Babs G. Taal

Keyword(s):

Neuroendocrine Tumors ◽

Chromogranin A ◽

Somatostatin Receptor ◽

Somatostatin Receptor Scintigraphy ◽

Receptor Scintigraphy ◽

Well Differentiated

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Home Urine Cultures by the Dip-Strip Method: Results in 289 Cultures

PEDIATRICS ◽

10.1542/peds.58.4.508 ◽

1976 ◽

Vol 58 (4) ◽

pp. 508-512

Author(s):

Jay Y. Gillenwater ◽

Charles H. Gleason ◽

Jacob A. Lohr ◽

Donald Marion

Keyword(s):

False Positive ◽

Urine Specimen ◽

Strip Method ◽

Home Testing ◽

Significant Bacteriuria ◽

Positive Results ◽

Home Administration ◽

At Home

Bacteriuria screening on 289 children was performed by their parents by means of a self-administered dip-strip culture which was inoculated, incubated, and interpreted in the home. Simultaneous pour-plate quantitative cultures and laboratory-tested dip-strip cultures were done on the same urine specimen which had been tested at home. The dip-strip culture was reliable (89%) in detecting significant bacteriuria with home administration and interpretation. Only 1.6% false-positive results occurred in the home testing. The dip-strip home cultures are an effective way for screening or follow-up of patients with bacteriuria.

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FDG-PET for Staging and Follow-up of HIV-Infected Patients with Non Hodgkin Lymphoma and Hodgkin Lymphoma: A Single Center Experience.

Blood ◽

10.1182/blood.v114.22.5014.5014 ◽

2009 ◽

Vol 114 (22) ◽

pp. 5014-5014

Author(s):

Silvia Cantoni ◽

Erika Ravelli ◽

Maria Cristina Moioli ◽

Chiara Rusconi ◽

Vittorio Ruggero Zilioli ◽

...

Keyword(s):

Hiv Infection ◽

Ct Scan ◽

Hodgkin Lymphoma ◽

False Positive ◽

Fdg Pet ◽

False Negative ◽

Hiv Positive ◽

Number Of Patients ◽

Positive Results

Abstract Abstract 5014 Introduction Risk of developing non Hodgkin lymphomas (NHL) is known to be increased among patients (pts) infected by HIV-1 and sporadic non-HIV related cases of Hodgking lymphomas (HL) are also described. HIV-positive pts also feature a virus-related systemic lymphoadenopathy which makes nodal involvement by lymphoma difficult to evaluate using conventional imaging. The role of positron-emission tomography using 18F-fluorodeoxyglucose (FDG-PET) in the staging and evaluation of response to treatment of pts with NHL and HL is well established in immunocompetent pts, while only limited information is available on lymphomas arising in the setting of HIV infection. We report on a retrospective analysis of FDG-PET results in a group of HIV pts with lymphoma, both NHL and HL, followed-up at our hospital. Patients and methods Twelve HIV-positive male pts with a diagnosis of lymphoma (7 high grade and 1 follicular NHL, 4 HL) underwent a total of 22 PET scans. PET results were compared with those obtained by computed tomography (CT). Nine PET were performed at staging, 7 at restaging following chemotherapy, and 6 at follow-up. At diagnosis of lymphoma: median CD4 count was 200 cells/mcL (range 98-451); HIV genome was undetectable in 5/9 pts, in the remaining 4 pts for whom the data was available viral loads ranged from 103 to 1,452,720 copies/mL; 10/12 pts were already receiving HAART, while the remaining 2 pts started treatment upon diagnosis of lymphoma. Results In the majority of cases (17/22 = 77%) results of PET, CT scan and clinical status were concordant, being diagnostic of either lymphoma presence (11/17) or absence (6/17). No false positive results were recorded at follow-up. In 5/22 cases (23%) PET and CT scan were discordant. In 4 cases PET yielded a false negative result; in 2 cases at diagnosis (2 pts with HL) and in 2 cases at follow-up (both in the pt with follicular lymphoma). In the remaining case, a PET-negative CT-positive adenopathy was demonstrated which proved to be reactive in nature at biopsy. Discussion Our results suggest that FDG-PET is useful in the evaluation of lymphoma in the setting of HIV infection, similarly to what has been observed among immunocompetent pts. Although the number of patients is limited, in our experience PET proved to be able to discriminate between reactive and lymphomatous involvement of lymphoid tissue as demonstrated by absence of false positive results in pts evaluated at follow-up. These results need to be confirmed by larger clinical trials. Disclosures No relevant conflicts of interest to declare.

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Immunoscintigraphy with 131I or 111In Labelled OC 125 F(ab')2 Fragments in Patients with Ovarian Carcinoma

The International Journal of Biological Markers ◽

10.1177/172460089000500401 ◽

1990 ◽

Vol 5 (4) ◽

pp. 159-165 ◽

Cited By ~ 2

Author(s):

A. Jiménez-Vicioso ◽

M. Torres ◽

A. Jiménez-Heffernan ◽

M.D. Grana ◽

J.M. Latre ◽

...

Keyword(s):

Ovarian Carcinoma ◽

False Positive ◽

True Positive ◽

Recurrence Analysis ◽

Uterine Myomas ◽

Follicular Cyst ◽

S 100 ◽

B Uptake ◽

Positive Results

To evaluate the clinical usefulness of immunoscintigraphy with OC 125 in ovarian carcinoma, we studied 25 patients suspected of having ovarian carcinoma or in follow-up after surgery. Fourteen patients were studied with 131I-OC 125 F(ab')2 and 11 with 111In-OC 125 F(ab')2. No differences were observed with the use of either radionuclide. Global diagnostic indexes obtained were S = 100%, Sp = 44,5% and A = 81%. The low specificity obtained was remarkable: 5 false positive results in two uterine myomas, one abscess, one follicular cyst and one granulation tissue scar. On the other hand, all lesions of ovarian carcinoma were detected. Analysis of the evolution of tumor/background (T/B) uptake ratios from the first to the second day of exploration revealed a tendency for the ratio to diminish significantly (> 15%) in false positive cases with the exception of the abscess while this did not happen in true positive cases, with the exception of a regional recurrence. Analysis of T/B ratio variations could contribute towards elevating the test's specificity.

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Biliary Brush Cytology Revisited

Acta Cytologica ◽

10.1159/000446149 ◽

2016 ◽

Vol 60 (2) ◽

pp. 167-172 ◽

Cited By ~ 6

Author(s):

Shafqat Mehmood ◽

Asif Loya ◽

Muhammed Aasim Yusuf

Keyword(s):

Cystic Duct ◽

Predictive Value ◽

False Positive ◽

Diagnostic Yield ◽

Biliary Strictures ◽

Brush Cytology ◽

Factors Affecting ◽

Ca 19.9 ◽

Positive Results

Purpose: To evaluate the diagnostic yield of biliary brush cytology and the factors affecting positive results in patients with biliary strictures. Patients and Methods: The medical records of all patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) with biliary brush cytology at our institution from November 2004 to December 2013 were reviewed in this retrospective study. The yield of positive brush cytology and the factors affecting positive yield, such as stricture location, age, gender and preprocedure CA 19.9 level were assessed. The final histopathology, diagnosis obtained by other methods, such as endoscopic ultrasound-guided fine-needle aspiration cytology, CT scan, Tru-Cut biopsy and/or clinical/radiological follow-up were used to identify true- and false-positive/negative results. The brush cytology results were divided into 4 main categories: malignant, benign, atypical cells and inadequate. Results: A total of 1,168 patients underwent ERCP during this 9-year period. Out of these, 142 patients had ERCP and biliary brushings for diagnosis. The mean age of the patients at presentation was 58.7 years (range 23-84 years; 64.8% males). The indication for referral was obstructive jaundice in all patients. Of the 142 patients, 77 (54.2%) had a distal common bile duct (CBD) stricture and 65 (45.8%) had a proximal /complex hilar stricture. The strictures were classified as proximal or distal, based on their relationship with the cystic duct; those below the cystic duct insertion were classified as distal and those above it were considered proximal. The diagnostic yield of brush cytology was 58.5%. The diagnostic yield was higher for proximal than for distal CBD strictures (67 vs. 50%; p = 0.047). It was also higher for females (58 vs. 57.6%; p = 0.94), patients >50 years (60 vs. 50%; p = 0.29) and those with a CA 19.9 level >300 IU/ml (59.4 vs. 55.5%; p = 0.65) but did not reach statistical significance for any of these parameters. Complete follow-up data were available for 96 patients and 46 patients were lost to follow-up. The sensitivity, specificity, positive predictive value and negative predictive value were 65.3, 100, 100 and 27%, respectively. When patients with atypia were included in the group with positive results, the diagnostic yield increased to 65.5% with a diagnostic sensitivity of 68.6%. There were 27 false-negative diagnoses, 10 patients were true-negative and no patients had a false-positive diagnosis. Conclusion: Biliary brush cytology is a safe and simple initial diagnostic procedure in patients with biliary strictures and can be performed at the time of therapeutic ERCP. If performed correctly and then interpreted by a dedicated cytopathologist, it has a good diagnostic yield and sensitivity. We feel that the low rates of success with this technique reported in some earlier studies have led to a feeling that this is not a particularly useful technique. We recommend that this topic should be revisited, and that the technique should be used more often.

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