Background
Chromogranin A (CgA) is a valuable biomarker for detection and follow-up of patients with neuroendocrine neoplasms (NENs). However, various comorbidities may influence serum CgA, which ...decreases its diagnostic accuracy. We aimed to investigate which laboratory parameters are independently associated with increased CgA in real-life setting and to develop a scoring system, which could improve the diagnostic accuracy of CgA in detecting patients with NENs.
Methods
This retrospective study included 55 treatment naïve patients with NENs and160 patients with various comorbidities but without NEN (nonNENs). Scoring system (CgA-score) was developed based on
z
-scores obtained from receiver operating curve analysis for each parameter that was associated with elevated serum CgA in nonNENs.
Results
CgA correlated positively with serum BUN, creatinine, α2-globulin, red-cell distribution width, erythrocyte sedimentation rate, plasma glucose and correlated inversely with hemoglobin, thrombocytes and serum albumin. Serum CgA was also associated with the presence of chronic renal failure, arterial hypertension and diabetes and the use of PPI. In the entire study population, CgA showed an area under the curve of 0.656. Aforementioned parameters were used to develop a CgA-score. In a cohort of patients with CgA-score <12.0 (
N
= 87), serum CgA >156.5 ng/ml had 77.8% sensitivity and 91.5% specificity for detecting NENs (AUC 0.841, 95% CI 0.713–0.969,
P
< 0.001). Serum CgA had no diagnostic value in detecting NENs in patients with CgA-score >12.0 (AUC 0.554, 95% CI 0.405–0.702,
P
= 0.430).
Conclusions
CgA-score encompasses a wide range of comorbidities and represents a promising tool that could improve diagnostic performance of CgA in everyday clinical practice.
Usage of complementary and alternative medicine (CAM) is steadily increasing
over the last decades, gaining medical, economic and sociological importance. The aim of the present
study was to assess ...the use of complementary and alternative therapies in cancer patients. A cross-sectional,
descriptive survey design was used to collect data through an anonymous questionnaire. A
total of 267 patients were included in the study. The prevalence of CAM use among cancer patients in
this study was 60.3%. It was found that 61 heterogeneous CAM therapies were used, the most popular
among patients being naturopathy/folk medicine. In multivariate logistic regression analysis, independent
predictors of CAM use were high income, divorced status, female sex and younger age. In
conclusion, considering the fact that a large proportion of patients used at least one CAM approach,
we need to continue our efforts to improve the patient-oncologist communication in order to deliver
most reliable information to patients and to better understand the possible standard medicine-CAM
interactions. According to results of the latest studies, CAM therapies that help manage pain, nausea,
fatigue, anxiety, and other symptoms should be integrated into the patient overall care.
The aim of this study was to analyze microphthalmia-associated transcription factor (MITF) as a marker for the detection of circulating melanoma cells, determine its prognostic value in melanoma ...patients, and compare it with tyrosinase. Blood samples from 201 melanoma patients in all stages of the disease and 40 healthy volunteers were analyzed. RNA was isolated from mononuclear cell fraction of the blood and assayed by reverse transcription-PCR for the expression of MITF and tyrosinase. All samples from healthy volunteers were negative for both MITF and tyrosinase. Out of 201 blood samples from melanoma patients 32 were positive for MITF, 20 for tyrosinase, and four for both MITF and tyrosinase. Analysis of MITF as an additional marker to tyrosinase allowed for detection of circulating melanoma cells in a larger number of melanoma patients in comparison to tyrosinase analysis alone (48 vs. 20 positive). A positive value of MITF was associated with shorter progression-free (P=0.005) and overall survival (P=0.042). A positive value of tyrosinase was associated with shorter overall survival (P=0.012), whereas there was no significant association between the value of tyrosinase and progression-free survival. The value of MITF was selected with multivariate analysis as the independent prognostic factor for progression-free survival, whereas the only independent prognostic factor for overall survival was the stage of disease. This study has shown that MITF is a specific marker for detection of circulating melanoma cells that has a prognostic value in melanoma patients. Determination of MITF in addition to tyrosinase improved the detection of circulating melanoma cells in melanoma patients.
Fibrodysplasia ossificans progressiva (FOP) is an extremely rare genetic disorder with diffuse extra-skeletal bone formation. The genetic mutation responsible for FOP has recently been discovered and ...is connected with excessive activation of bone morphogenetic protein receptor. This disease usually begins with typical ossification pattern in early childhood, causing increasing disability and making patients totally disabled by the age of 30. Ectopic ossification develops spontaneously and can be triggered by any trauma and even intramuscular injections. The symptoms of FOP are often misdiagnosed as cancer, causing unnecessary biopsies, which can precipitate further progressive heterotopic ossification. There is no effective treatment for this severe condition. Radiotherapy can be helpful in impeding ossification, although the strict evidence for that is lacking. There are only two reports in the literature referring to the use of radiotherapy in treatment of FOP. Herein, we present a 35-year-old patient successfully treated with small doses of fractionated radiotherapy in several courses. This case indicates that radiotherapy can be useful in treating patients with FOP.
The aim of this study was to examine the quality of life (QoL) in 40 Croatian metastatic melanoma patients who had completed at least first-line treatment and to see if there was a correlation ...between QoL parameters and serum lactate dehydrogenase (LDH). LDH levels were measured and all patients clinically examined between April and September 2013. Two QoL questionnaires were used for patient self-evaluation: the European Organization for Research and Treatment of Cancer Quality of life Questionnaire (EORTC QLQ-C30) and the Dartmouth Primary Care Cooperative Research Network and the World Organization of National Colleges, Academies, and Academic Associations of General Practitioners/Family Physicians (COOP/WONCA) charts. The average EORTC QLQ-C30 score for global health status (GHS) was 41.204. The average scores for functional scales were high, with the exception of emotional functioning (65.02). Blood LDH levels positively correlated with the Eastern Cooperative Oncology Group (ECOG) status (r = 0.415; p < 0.01) and pain (r = 0.345; p < 0.05), but not with any functional or COOP/WONCA scores. Global health status (GHS) positively correlated with patient age at the time of evaluation (r = 0.386; p < 0.05) and age at the time when metastatic disease had been diagnosed (r = 0.366; p < 0.05). Quality of life for the studied group of metastatic melanoma patients in Croatia can be considered generally good, with the exception of emotional functioning and symptoms of fatigue, dispnoea, insomnia, and financial difficulties.
In Regard to Lee et al Murgic, Jure; Grgurevic, Lovorka; Grazio, Simeon ...
International journal of radiation oncology, biology, physics,
12/2020, Letnik:
108, Številka:
5
Journal Article
Secondary angiosarcoma is an aggressive tumor that can develop in breast cancer patients treated with conserving therapy and radiotherapy. The symptoms can be misleading, whereas mammography and ...fine-needle aspiration (FNA) are typically negative in early stage of the disease. A high grade of clinical suspicion is very important for early diagnosis. A case of angiosarcoma involving breast parenchyma in a patient treated with quadrantectomy and radiotherapy for T1cN1Mx breast carcinoma is presented.
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