Background
Macroscopic portal vein thrombosis (PVT) is a major poor prognosis factor in patients with hepatocellular carcinoma (HCC). Inflammation is increasingly recognized to be part of the ...hepatocarcinogenic process and its markers are also prognostically useful.
Aims
To examine the relationship of inflammation biomarkers to the presence of PVT and to survival in PVT patients with HCC.
Methods
A large HCC cohort was examined for the presence of PVT and analyzed retrospectively.
Results
Blood levels of NLR, PLR, ESR, CRP, AFP and GGTP were significantly related to the presence of PVT, but not the Glasgow Index. For patients with low alpha-fetoprotein levels, blood ESR and GGTP levels were also significantly increased in patients with PVT compared with those in patients without PVT. In a Cox regression model, serum GGTP levels had a significantly increased hazard ratio on death (1.52,
p
= 0.008). Kaplan-Meier analysis showed that PVT patients with low serum GGTP levels had significantly longer survival than PVT patients with high GGTP levels (
p
= 0.0041).
Conclusions
Indices of inflammation, especially serum GGTP levels, related significantly to the presence of PVT and to survival in HCC patients with PVT.
Background
The prognosis of HCC depends in large measure on maximum tumor diameter (MTD).
Aims
To examine characteristics of tumor aggressiveness over an MTD range of
<
2 to 8 cm.
Methods
A large ...HCC database was examined retrospectively for trends in serum alpha-fetoprotein (AFP), and percent of patients with macroscopic portal vein thrombosis (PVT) or tumor multifocality.
Results
There was a significant trend to increased serum AFP levels and percent of patients with PVT, for each,
p
< 0.001. Within those trends, there were clearly identifiable sub-trends for variations of AFP or percent PVT patients, associated with specific MTD ranges. Calculation of the fold increase for either AFP or percent PVT patients over distinct MTD ranges showed a greater increase of AFP or percent PVT patients compared with the related MTD increase. Interestingly, the increase in percent PVT was mainly independent of AFP.
Conclusions
Patterns of AFP and PVT increase can be discerned with increasing MTD, which are nonlinear. The greater fold increase in tumor aggressiveness factors compared with MTD suggests that HCCs may change with increasing size to a more aggressive phenotype. Baseline HCC biopsies might therefore be insufficient in future rational HCC management, and repeated liquid biopsies have potential in following HCC evolution and thus choices of therapies.
Abstract
X-ray fluorescence (XRF) is a technique frequently used for the elemental analysis of cultural heritage materials. Depending on components selection (i.e. the primary source, the detector ...and the focusing optics, if present), the analytical performance of the spectrometer, and its consequent suitability for a given purpose, may vary considerably. In this paper, we compare the analytical performance of four different devices, two commercial and two expressly designed by the authors, and we consider two figures of merit: the limit of detection (LOD) and the standard error of regression (SER). The measurements are performed on a set of 19 copper alloy standards.
The Mu2e experiment at Fermilab searches for the charged-lepton flavor violating (CLFV) conversion of a negative muon into an electron in the field of an aluminum nucleus, with a distinctive ...signature of a monoenergetic electron of energy slightly below the muon rest mass (104.967 MeV). The Mu2e goal is to improve by four orders of magnitude the search sensitivity with respect to the previous experiments. Any observation of a CLFV signal will be a clear indication of new physics. The Mu2e detector is composed of a tracker, an electromagnetic calorimeter, and an external veto for cosmic rays surrounding the solenoid. The calorimeter plays an important role in providing particle identification capabilities, a fast online trigger filter, a seed for track reconstruction while working in vacuum, in the presence of 1-T axial magnetic field and in a harsh radiation environment. The calorimeter requirements are to provide a large acceptance for 100-MeV electrons and reach at these energies: 1) a time resolution better than 0.5 ns; 2) an energy resolution <10%; and 3) a position resolution of 1 cm. The calorimeter design consists of two disks, each one made of 674-undoped cesium iodine crystals read by two large area arrays of UV-extended silicon photomultipliers (SiPMs). We report here the construction and the test of the Module-0 prototype. The Module-0 has been exposed to an electron beam in the energy range around 100 MeV at the Beam Test Facility in Frascati. Preliminary results of timing and energy resolution at normal incidence are shown. A discussion of the technical aspects of the calorimeter engineering is also reported in this paper.
Macroscopic portal vein thrombosis (PVT) is a major poor prognosis factor in patients with hepatocellular carcinoma (HCC), but constitute a heterogeneous group.
To examine blood and tumor parameters ...of 1667 HCC patients who had PVT to identify factors that could differentiate different survival subsets.
a large HCC database was examined for presence of patients with PVT and analyzed retrospectively for PVT-associated factors and prognosis.
A logistic regression model was calculated for presence of PVT. Highest odds ratios were found for tumor multifocality and serum albumin levels, as well as serum alpha-fetoprotein (AFP) and bilirubin levels. A Kaplan-Meier and Cox model on survival also showed the highest hazard ratios for tumor multifocality and serum albumin. A model was constructed on all 4 possible combinations of tumor focality and serum albumin in PVT patients. The longest survival group had <2 tumor nodules plus serum albumin >3.5 g/dL. Conversely, the shortest survival group had >2 tumor nodules plus serum albumin <3.5 g/dL. These 2 patient groups differed in maximum tumor diameter and levels of serum AFP, AST and bilirubin.
Combination low tumor focality and high serum albumin identifies prognostically better PVT patient subgroups that might benefit from aggressive therapies.
•Portal vein thrombosis (PVT) is a major poor prognosis factor in HCC patients.•We found that the highest odds ratios for PVT included number of tumor foci and serum albumin levels.•A model was constructed with all 4 possible combinations of these 2 parameters.•The longest survival group had <2 tumor nodules plus normal albumin. Conversely, the shortest survival group had >2 tumor nodules plus low albumin. These 2 PVT groups had a 3-fold difference in survival and had significantly different AFP and bilirubin levels.•These findings provide simple patient selection criteria for treating in PVT patients.
The Mu2e experiment is constructing a calorimeter consisting of 1348 undoped cesium iodide (CsI) crystals in two disks. Each crystal has a dimension of 34 × 34 × 200 mm3 and is readout by a ...large-area silicon photomultipliers array. A series of technical specifications on mechanical and optical parameters was defined according to the calorimeter physics requirements. Preproduction CsI crystals were procured from three firms: Amcrys, Saint-Gobain, and Shanghai Institute of Ceramics. We report the quality assurance on crystal's scintillation properties and their radiation hardness against ionization dose and neutrons. With a fast decay time of about 30 ns and a light output of more than 100 p.e./MeV measured by a bialkali photomultiplier tube, undoped CsI crystals provide a cost-effective solution for Mu2e.
The Mu2e experiment at Fermilab will search for the charged lepton flavor violating neutrino-less conversion of a negative muon into an electron in the field of an aluminum nucleus <xref ...ref-type="bibr" rid="ref1">1 , <xref ref-type="bibr" rid="ref2">2 . The Mu2e detector is comprised of a tracker, an electromagnetic calorimeter, and an external veto for cosmic rays. The calorimeter plays an important role in providing excellent particle identification capabilities, a fast and online trigger filter while aiding the track reconstruction capabilities. The calorimeter requirements are to provide a large acceptance for 100-MeV electrons and reach: 1) a time resolution better than 0.5 ns at 100 MeV; 2) an energy resolution O(10%) at 100 MeV; and 3) a position resolution of about 1 cm. The calorimeter consists of two disks, each one made of 674 pure CsI crystals readout by two large-area <inline-formula> <tex-math notation="LaTeX">2 \times 3 </tex-math></inline-formula> array of UV-extended silicon photomultipliers (Mu2e SiPMs) of <inline-formula> <tex-math notation="LaTeX">6\,\,\times6 </tex-math></inline-formula> mm 2 dimensions. A large-scale prototype has been constructed with 51 preproduction crystals readout by 102 Mu2e SiPMs. It has been tested at the beam test facility in Frascati, demonstrating satisfying results compared to the Mu2e requirements. At the moment of writing, the crystals production phase is halfway through the work, while the SiPM production has been completed. An overview of the characterization tests is also reported, together with a description of the final calorimeter design.
The Mu2e calorimeter is composed by 1400 un-doped CsI crystals coupled to large area UV extended Silicon Photomultipliers arranged in two annular disks. This calorimeter has to provide precise ...information on energy, timing and position. It should also be fast enough to handle the high rate background and it must operate and survive in a high radiation environment. Simulation studies estimated that, in the hottest regions, each crystal will absorb a dose of 300 Gy and will be exposed to a neutron fluency of 6 × 1011 n/cm2 in 3 years of running. Test of un-doped CsI crystals irradiated up to 900 Gy and to a neutron fluency up to 9 × 1011 n/cm2 have been performed at CALLIOPE and FNG ENEA facilities in Italy. We present our study on the variation of light yield (LY) and longitudinal response uniformity (LRU) of these crystals after irradiation. The ionization dose does not modify LRU while a 20% reduction in LY is observed at 900 Gy. Similarly, the neutron flux causes an acceptable LY deterioration (≤ 15%). A neutron irradiation test on different types of SIPMs (two different array models from Hamamatsu and one from FBK) have also been carried out by measuring the variation of the leakage current and the charge response to an ultraviolet led. We concluded that, in the experiment, we will need to cool down the SIPMs to 0 °C reduce the leakage current to an acceptable level.
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