Objective: Esophageal cancer tumor biology is best assessed clinically by 2-18Ffluoro-2-deoxy-d-glucose (FDG)-PET. Both FDG-PET maximal positron emission tomography (PET) standardized uptake values ...(SUVmax) and selected tumor markers have been shown to correlate with stage, nodal disease, and survival in esophageal cancer. Interestingly, there is limited data examining the relationship between FDG-PET SUVmax and expression of these tumor markers in esophageal cancer. The purpose of this study was to determine the correlation of tumor markers with FDG-PET SUVmax in esophageal cancer. Methods: FDG-PET SUVmax was calculated in 67 patients with esophageal cancer of which 59 (88%) had adenocarcinoma. Neoadjuvant radiotherapy and/or chemotherapy were administered to 42% (28/67) of patients. Esophageal tumor tissue and surrounding normal tissue was obtained and tissue microarrays were created. Immunohistochemical analysis was performed for five known esophageal cancer tumor markers (GLUT-1, p53, cyclin D1, epidermal growth factor receptor (EGFR), and vascular endothelial growth factor (VEGF)). Assessment of each tumor marker was made by two independent, blinded pathologists using common grading criteria of intensity and percentage of cells stained. A p value <0.05 was considered significant. Results: There were 55 men (82%) and 12 women (18%) with a median age of 63 years (range 40–83). Pathologic staging included stage I (n = 29, 43%), stage II (n = 19, 28%), stage III disease (n = 18, 27%), and stage IV disease (n = 1, 2%). PET SUVmax correlated with T stage (p = 0.001). In patients undergoing surgery without induction therapy, increasing SUVmax values correlated with increased expression of GLUT-1 transporter (p = 0.01). There was no correlation between SUVmax and EGFR, cyclin D1, VEGF, or p53 expression in primary tumor. Conclusions: FDG-PET SUVmax correlates with an increased expression of GLUT-1 transporter in esophageal cancer specimens not subjected to induction therapy. No significant difference in tumor marker expression was noted between patients undergoing induction therapy or surgery alone except p53 expression decreased in primary tumors following induction therapy. Failure of SUVmax values to correlate with known prognostic esophageal cancer tumor markers suggests that FDG-PET may have limited clinical utility in assessing response to therapies targeting these markers.
This cross-sectional study assesses the validity of using the
International Statistical Classification of Diseases and Related Health Problems, Tenth Revision
(
ICD-10
) code for melasma appended to ...a clinic visit to identify adult patients meeting diagnostic criteria for melasma.
Objective The best current noninvasive surrogate for tumor biology is fluorodeoxyglucose positron emission tomography (FDG–PET). Both FDG–PET maximal standardized uptake values and selected tumor ...markers have been shown to correlate with stage, nodal disease, and survival in non–small cell lung cancer (NSCLC). However, there are limited data correlating FDG–PET with tumor markers. The purpose of this study was to determine the correlation of tumor marker expression with FDG–PET maximal standardized uptake values in NSCLC. Methods FDG–PET maximal standardized uptake values were calculated in patients with NSCLC (n = 149). No patient had induction chemoradiotherapy. Intraoperative NSCLC tissue was obtained and tissue microarrays were created. Immunohistochemical analysis was performed for 5 known NSCLC tumor markers (glucose transporter 1, p53, cyclin D1, epidermal growth factor receptor, and vascular endothelial growth factor). Each tumor marker was assessed independently by two pathologists using common grading criteria. Subgroup analysis based on histologic characteristics and regional nodal status was performed. Results FDG–PET correlated with T classification ( P < .0001), N stage ( P = .002), and greatest tumor dimension ( P < .0001). In addition, increasing maximal standardized uptake values correlated with increased expression of glucose transporter 1 ( P < .0001) and p53 ( P = .04) in adenocarcinoma. Epidermal growth factor receptor expression correlated with maximal standardized uptake values without predilection for histologic subtype ( P = .004). Conclusion FDG–PET maximal standardized uptake values correlate with an increased expression of glucose transporter 1 and p53 in lung adenocarcinoma, but not squamous cell cancer. Future studies attempting to correlate FDG–PET with tumor biology will need to consider the effect of different tumor histologic types.
Despite having significantly higher rates of atopic dermatitis, psoriasis, and pigmentary disorders compared to White patients, studies suggest that Asian Americans are underrepresented in outpatient ...dermatology clinics. In this study, we utilize the National Health Interview Survey (NHIS) and prioritize disaggregated analyses to evaluate differences between the most populous Asian American subgroups (Chinese, Filipino, Indian, and “Other”) in utilization of outpatient dermatologic care. We utilized multivariable logistic regression to compare outpatient dermatologic care use between each Asian American subgroup and Non-Hispanic Whites. Out of 96,559 adults, our study included 5264 self-identified Asian American and 91,295 non-Hispanic White adults. Most Asian participants were female, had health insurance, and had incomes > 2 times above the federal poverty line. We found that, compared to 21.4% for NH whites, lifetime prevalence of total body skin exam was highest among Filipino Americans (12.3%) and lowest among Indian Americans (7%). Additionally, all Asian American subgroups had a significantly lower odd than NH Whites of ever having a total body skin exam, with Indian Americans having the lowest odds. While the benefit of TBSEs in Indian Americans is unclear, it is possible that differing cultural perceptions about dermatologic needs, barriers to care, or immigration status may be contributing to the observed difference. Furthermore, the Indian diaspora encapsulates a range of skin tones, risk factors, and behaviors that may differentially influence dermatologic disease risk, similar to trends identified among Hispanic patients (Trepanowski et al. in J Am Acad Dermatol 88:1206–1209, 2023). Additional research utilizing the seven national databases that have been identified as providing disaggregated Asian racial information (Kamal et al. in J Am Acad Dermatol, 2023) may be useful to further illuminate avenues for intervention.
•We queried TriNetX Dataworks - a network of 41 healthcare organizations that provides access to deidentified electronic medical records for over 61 million patients in the U.S•No significant ...difference in immunotherapy utilization based on race or ethnicity•Percent ICI utilization increased for all three cancers from 2015 to 2020•While ICI utilization increased over time, it was consistently significantly lower than the percent of patients with advanced disease•Our findings suggest overall underutilization of ICI's nationwide
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