grading systems
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2022 ◽  
pp. 106689692110701
Author(s):  
Zaid H. Khoury ◽  
Mohamed Sultan ◽  
Ahmed S. Sultan

This systematic review and meta-analysis aims to provide a robust qualitative and quantitative analysis of the different systems used to assess the grade of oral epithelial dysplasia (OED). This study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyzes (PRISMA) statement. Six electronic databases were searched for primary research published over the past four decades. Overall quality and level of evidence were based on the Johns Hopkins Research Evidence Appraisal Tool, while evidence of heterogeneity was determined by the Q-statistic and I^2 statistic. Evidence of publication bias was determined using Egger's regression and the Rank correlation tests. A total of 170 records were identified. Only 9 primary research articles were included in the qualitative systematic review. Four studies (4/9) were included in the final quantitative meta-analysis. The grading systems analyzed included the WHO, binary, Ljubljana, Smith and Pindborg, Brothwell, and the oral intraepithelial neoplasia. The results demonstrate the binary system to be superior to the WHO system in grading OED, by providing better inter-observer agreement, however, the substantial error among the inter-observer κ values analyzed indicates the significance of this finding to be of minimal impact. Lack of reliable reproducibility of the grading systems and lack of common effect size (heterogeneity analysis) were noted.


2022 ◽  
pp. 10-15
Author(s):  
Waseem Al-Jameel ◽  
S. S. Al-Mahmood ◽  
A. M. Al-Saidya

Background and Aim: Squamous cell carcinoma (SCC) is the most common form of carcinoma in cattle. Histopathological grading systems have been utilized over several decades for estimating the malignancy of cattle SCCs. This study aimed to detect p53 and Mdm2 expression in different SCC cases in cattle and correlate their expression with the SCC histopathological grading. Materials and Methods: Cattle SCC cases were collected at the Veterinary Teaching Hospital in Nineveh. The SCC grading system categorized the cases histologically based on their differentiation grade into three groups: Well, moderately, and poorly differentiated. The SCC cases were subsequently verified for p53 and Mdm2 immunoexpression. Results: Fourteen of 16 examined cattle SCC samples tested positive for p53 expression. Moreover, 15 out of the 16 SCC samples tested positive for Mdm2 expression. The increased immunoreactivity of both p53 and Mdm2 was associated with a poor histological grading of the cattle SCC. There is a positive correlation between the nuclear expression of p53 and Mdm2, and the degree of differentiation and the number of mitotic figures in the examined cattle SCC samples. Conclusion: Our results demonstrate an increased p53 and Mdm2 expression in cattle SCC cases characterized by poor histopathological grading, thus suggesting an essential role of these molecules in the development of moderately and poorly differentiated SCC in cattle.


Diagnostics ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 2369
Author(s):  
Lucia Santorelli ◽  
Martina Stella ◽  
Clizia Chinello ◽  
Giulia Capitoli ◽  
Isabella Piga ◽  
...  

Due its ability to provide a global snapshot of kidney physiology, urine has emerged as a highly promising, non-invasive source in the search for new molecular indicators of disease diagnosis, prognosis, and surveillance. In particular, proteomics represents an ideal strategy for the identification of urinary protein markers; thus, a urinomic approach could also represent a powerful tool in the investigation of the most common kidney cancer, which is clear cell Renal Cell Carcinoma (ccRCC). Currently, these tumors are classified after surgical removal using the TNM and nuclear grading systems and prognosis is usually predicted based upon staging. However, the aggressiveness and clinical outcomes of ccRCC remain heterogeneous within each stratified group, highlighting the need for novel molecular indicators that can predict the progression of these tumors. In our study, we explored the association between the urinary proteome and the ccRCC staging and grading classification. The urine proteome of 44 ccRCC patients with lesions of varying severity was analyzed via label-free proteomics. MS data revealed several proteins with altered abundance according to clinicopathological stratification. Specifically, we determined a panel of dysregulated proteins strictly related to stage and grade, suggesting the potential utility of MS-based urinomics as a complementary tool in the staging process of ccRCC.


2021 ◽  
Vol 10 (12) ◽  
pp. 830-839 ◽  
Author(s):  
Greg Robertson ◽  
Robert Wallace ◽  
A. Hamish R. W. Simpson ◽  
Sarah P. Dawson

Aims Assessment of bone mineral density (BMD) with dual-energy X-ray absorptiometry (DXA) is a well-established clinical technique, but it is not available in the acute trauma setting. Thus, it cannot provide a preoperative estimation of BMD to help guide the technique of fracture fixation. Alternative methods that have been suggested for assessing BMD include: 1) cortical measures, such as cortical ratios and combined cortical scores; and 2) aluminium grading systems from preoperative digital radiographs. However, limited research has been performed in this area to validate the different methods. The aim of this study was to investigate the evaluation of BMD from digital radiographs by comparing various methods against DXA scanning. Methods A total of 54 patients with distal radial fractures were included in the study. Each underwent posteroanterior (PA) and lateral radiographs of the injured wrist with an aluminium step wedge. Overall 27 patients underwent routine DXA scanning of the hip and lumbar spine, with 13 undergoing additional DXA scanning of the uninjured forearm. Analysis of radiographs was performed on ImageJ and Matlab with calculations of cortical measures, cortical indices, combined cortical scores, and aluminium equivalent grading. Results Cortical measures showed varying correlations with the forearm DXA results (range: Pearson correlation coefficient (r) = 0.343 (p = 0.251) to r = 0.521 (p = 0.068)), with none showing statistically significant correlations. Aluminium equivalent grading showed statistically significant correlations with the forearm DXA of the corresponding region of interest (p < 0.017). Conclusion Cortical measures, cortical indices, and combined cortical scores did not show a statistically significant correlation to forearm DXA measures. Aluminium-equivalent is an easily applicable method for estimation of BMD from digital radiographs in the preoperative setting. Cite this article: Bone Joint Res 2021;10(12):830–839.


2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Elisabeth Brogren ◽  
Jack Besjakov ◽  
Anna Åkesson ◽  
Isam Atroshi

Abstract Background Symptomatic osteoarthritis of the basal joint of the thumb (trapeziometacarpal joint) is a common disabling condition mainly affecting women. It is frequently treated with complete removal of the trapezium with or without soft-tissue interposition. There is limited evidence about whether removal of the trapezium affects stability of the wrist joint and increases the risk of developing wrist osteoarthritis. The aim of this study was to evaluate the long-term prevalence of OA in wrists with previous trapeziectomy compared to wrists with intact trapezium. Methods Patients treated with surgery for trapeziometacarpal osteoarthritis at one orthopedic department were invited 10–29 (mean 17) years postoperatively for bilateral radiographic examination. We included radiographs from 114 hands with trapeziectomy and 46 hands with intact trapezium; 38 patients had unilateral trapeziectomy and intact contralateral trapezium. The radiographs were blinded so that the intact trapezium or the trapezial space after trapeziectomy was not visible. The radiographs were then evaluated for radiocarpal/midcarpal osteoarthritis independently by two assessors using three different osteoarthritis grading systems, including the Kellgren–Lawrence classification. The patients rated their satisfaction with the function of each of their hands on a visual analog scale (VAS) from 0 to 100 (higher score better). Results The prevalence of osteoarthritis ranged from 20 to 26%, mostly mild (Kellgren–Lawrence grade 1). The prevalence of osteoarthritis did not differ between wrists with previous trapeziectomy and those with intact trapezium, both in the whole cohort and in the subgroup of patients with unilateral trapeziectomy and intact contralateral trapezium. There was no significant difference in hand function VAS scores between hands with previous trapeziectomy and hands with intact trapezium in the whole cohort or in the subgroup. Conclusions Removal of the trapezium as treatment for basal thumb osteoarthritis does not increase the risk of developing wrist osteoarthritis in the long term.


Author(s):  
Jeff Cain ◽  
Melissa Medina ◽  
Frank Romanelli ◽  
Adam Persky

2021 ◽  
pp. 45
Author(s):  
Kamil Krupa

Introduction: Intervertebral disc (IVD) degeneration is considered to be one of the main pathophysiological causes of low back pain. Several grading systems have been developed for both morphological and radiological assessment. The aim of this study was to assess the morphological and radiological characteristics of IVD degeneration and validate popular radiological Pfirrmann scale against morphological Thompson grading system. Methodology: Full spinal columns (vertebrae L1-S1 and IVD between them) were harvested from cadavers through an anterior dissection. MRI scans of all samples were conducted. Then, all vertebral columns were cut in the midsagittal plane and assessed morphologically. Result: A total of 100 lumbar spine columns (446 IVDs) were included in the analysis of the degeneration grade. Morphologic Thompson scale graded the majority of discs as grade 2 and 3 (44.2% and 32.1%, respectively), followed by grade 4 (16.8%), grade 1 (5.8%), and grade 5 (1.1%). The Radiologic Pfirrmann grading system classified 44.2% of discs as grade 2, 32.1% as grade 3, 16.8% as grade 4, 5.8% as grade 1, and 1.1% as grade 5. The analysis on the effect of age on degeneration revealed significant, although moderate, positive correlation with both scales. Analysis of the agreement between scales showed weighted Cohen’s kappa equal to 0.61 (p < 0.001). Most of the disagreement occurred due to a 1-grade difference (91.5%), whereas only 8.5% due to a 2-grade difference. Conclusion: With the increase in the prevalence of IVD disease in the population, reliable grading systems of IVD degeneration are crucial for spine surgeons in their clinical assessment. While overall there is an agreement between both grading systems, clinicians should remain careful when using Pfirmann scale as the grades tend to deviate from the morphological assessment.


2021 ◽  
pp. 40
Author(s):  
Dominik Taterra

Introduction: The correct spatial distribution and high negative charge of glycosaminoglycans (GAGs) within the intervertebral disc (IVD) are responsible for discs water imbibition, proper osmotic pressure, and as such IVD’s physiological swelling behaviors and compressive properties. The aim of this study was to investigate the association of the concentration and distribution of GAG with IVD degeneration as measured by Pfirrmann et al. and Thompson et al. grading systems. Methodology: Full spinal columns (vertebrae L1-S1 and IVD between them) were harvested from fresh cadavers through an anterior dissection. MRI scans were taken of all spinal columns and were assessed using Pfirrmann grading system. All vertebral columns were cut in the midsagittal plane. The level of degeneration was assessed morphologically using Thompson et al. grading system. Samples from five regions of the L5/S1 IVDs were taken for GAG concentration analyses. Standard curve spectrophotometry was utilized for this purpose. Result: One hundred lumbar spine columns (L1-S1) were harvested from cadavers. Radiologic assessment using the Pfirrmann grading system and morphological Thompson grading system classified majority of discs as grade 3 and 4. A total of 478 samples from five regions of L5/S1 IVDs were included in the analysis of GAG content. The samples from the nucleus pulposus showed on average the highest concentration of GAG, although the differences were not statistically significant. The one-way analysis of variance (ANOVA) showed no statistically significant differences in the mean GAG mass between different Pfirrmann grades (F = 1.85, p = 0.13) and between different Thompson grades (F = 1.17, p = 0.33). Conclusion: Our study showed no association between GAG concentration levels and degeneration grade of the IVD as measured by radiological Pfirrmann and morphological Thompson grading systems.


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