Diagnostic Accuracy of Doppler Ultrasound in the Diagnosis of Testicular Carcinoma by Taking Histopathology as Gold Standard

Objective: To determine the diagnostic accuracy of doppler ultrasound in the diagnosis of testicular carcinoma, by taking histopathology as gold standard. Methods: This cross-sectional study was carried out at Radiology department of Liaquat University of Medical and health Sciences (LUMHS), from November 2017 to October 2019. All the clinically diagnosed cases of testicular carcinoma, those who referred for doppler ultrasound and histopathology of testes, were included. After taking informed consent all the study participants underwent testicular histopathology after doppler ultrasound. All of the information was entered into a research proforma. SPSS version 20 was used to analyze the data. Results: Overall, 70 patients of suspected testicular carcinoma were studied. The mean age of the cases was 38.38+4.55 years. Most of the cases 47(67.1%) were poor. As per Doppler ultrasound (U/S) findings out of all 55.7% cases had diagnosed testicular carcinoma, while histopathologically it was observed in 45.7% of the cases. Diagnostic accuracy of Doppler U/S in testicular carcinoma diagnosis was observed to be 77%, followed by sensitivity (SE) 84%, specificity (SP) 71%, positive predictive value (PPV) 78% and negative predictive value (NPV) 84%. Conclusion: Doppler ultrasound observed to be a non-invasive, uncomplicated, lack of pain, effective and easily available diagnostic tool for early diagnosis of testicular carcinoma.

Nationwide trends in in-patient chemotherapy hospitalizations, cost, and mortality for patients with testicular carcinoma.

e17012 Background: Salvage therapy for advanced Testicular Carcinoma involves patients receiving ifosfamide are treated in hospital for risk of neuro-toxicities. We evaluated annual trends to assess the health care burden of testicular patients admitted for chemotherapy, as well as co-morbidities and complications associated with mortality. Methods: The National Inpatient Sample is a nationwide sample of all US hospital discharges. We collected data from the years of 2002 to 2017 on patients with Testicular Carcinoma who were receiving chemotherapy, to capture patients recieving ifosfamide and cisplatin in an in-patient setting. Patients undergoing an autologous stem cell transplant were excluded. Annual trends for inpatient mortality, length of stay, and total costs of admission were assessed. A univariate logistic regression analysis was used to calculate odds ratios (OR) for the effect of comorbid conditions and acute inpatient complications on in-patient mortality. Results: Hospitalizations for ifosfamide and cisplatin based treatment among patients with Testicular Carcinoma remained stable from a weighted national estimate of 2,261 in 2002 to 2,160 in 2017. Length of stay increased from 4.6 days to 5.5 days (p=0.01). Cost of stay increased from $26,140 to $53,193 (p <0.001) when adjusted for inflation. The average age of patients was 32.6 years. In-patient mortality was low at 0.2% in 2002 to <0.1% in 2017. Among comorbid conditions, heart failure was associated with increased mortality (OR 21.9). Among acute complications – acute kidney injury (OR 32.6), infection (OR 15.3), neurotoxicity (OR 12.3) were associated with significantly higher mortality. Conclusions: The increase in cost of stay is out of proportion to increases in length of stay. Indicating a disproportionate increase in financial toxicity for these patients. Patients with underlying heart disease are at increased risk of complications. Care needs to be taken to specifically identify patients at risk for renal failure and infectious complications.[Table: see text]

Downregulation of KIF2C and TEKT2 is Associated with Male Infertility and Testicular Carcinoma

Background: Genes have an important role in spermatogenesis and the maintenance of fertility, and may act as a potential biomarker for the clinical diagnosis of infertility. However, a comprehensive understanding of how these biological processes of infertility are regulated at the molecular level remains to be illustrated. Methods: In the present study, we sought to identify associated genes by reanalyzing separate studies from GEO datasets (GSE45885, GSE45887, and GSE9210) and validation dataset (GSE4797). DEGs were used the limma package. GO and KEGG pathway enrichment analyses were performed using the clusterprofier package. The STRING database was used construct a protein-protein interaction network. The interaction between mRNA and TF was predicted by using miRWalk. At last, the expression levels of hub genes were determined by TCGA data in GEPIA. Results: The results showed that several shared genes significantly associated with azoospermia. Finally, we effectively screen out two genes (KIF2C and TEKT2) for validation by GSE4797 in spermatozoa of infertile men with Johnsen score. Among these two genes, KIF2C and TEKT2 significantly down-regulated in spermatozoa of infertile men. The regulatory network of TF‐miRNA‐target gene was established, we found KIF2C-miRNAs(has-miR-3154,6075,6760-5p,1251-5p,186-sp)-TFs(EP300,SP1) might work in spermatozoa of infertile men.Conclusions: Our study might help to improve our understanding of the mechanisms in azoospermia and provide diagnostic biomarkers and therapeutics targets.