• 제목/요약/키워드: Predictive marker

검색결과 119건 처리시간 0.023초

Comparison of the accuracy of neutrophil CD64 and C-reactive protein as a single test for the early detection of neonatal sepsis

  • Choo, Young-Kwang;Cho, Hyun-Seok;Seo, In-Bum;Lee, Hyeon-Soo
    • Clinical and Experimental Pediatrics
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    • 제55권1호
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    • pp.11-17
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    • 2012
  • Purpose: Early identification of neonatal sepsis is a global issue because of limitations in diagnostic procedures. The objective of this study was to compare the diagnostic accuracy of neutrophil CD64 and C-reactive protein (CRP) as a single test for the early detection of neonatal sepsis. Methods: A prospective study enrolled newborns with documented sepsis (n=11), clinical sepsis (n=12) and control newborns (n=14). CRP, neutrophil CD64, complete blood counts and blood culture were taken at the time of the suspected sepsis for the documented or clinical group and at the time of venipuncture for laboratory tests in control newborns. Neutrophil CD64 was analyzed by flow cytometry. Results: CD64 was significantly elevated in the groups with documented or clinical sepsis, whereas CRP was not significantly increased compared with controls. For documented sepsis, CD64 and CRP had a sensitivity of 91% and 9%, a specificity of 83% and 83%, a positive predictive value of 83% and 33% and a negative predictive value of 91% and 50%, respectively, with a cutoff value of 3.0 mg/dL for CD64 and 1.0 mg/dL for CRP. The area under the receiver-operating characteristic curves for CD64 index and CRP were 0.955 and 0.527 ($P$ <0.01), respectively. Conclusion: These preliminary data show that diagnostic accuracy of CD64 is superior to CRP when measured at the time of suspected sepsis, which implies that CD64 is a more reliable marker for the early identification of neonatal sepsis as a single determination compared with CRP.

Predictive value of C-reactive protein in response to macrolides in children with macrolide-resistant Mycoplasma pneumoniae pneumonia

  • Seo, Young Ho;Kim, Jang Su;Seo, Sung Chul;Seo, Won Hee;Yoo, Young;Song, Dae Jin;Choung, Ji Tae
    • Clinical and Experimental Pediatrics
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    • 제57권4호
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    • pp.186-192
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    • 2014
  • Purpose: The prevalence of macrolide-resistant Mycoplasma pneumoniae (MRMP) has increased worldwide. The aim of this study was to estimate the proportion of MRMP in a tertiary hospital in Korea, and to find potential laboratory markers that could be used to predict the efficacy of macrolides in children with MRMP pneumonia. Methods: A total of 95 patients with M. pneumoniae pneumonia were enrolled in this study. Detection of MRMP was based on the results of specific point mutations in domain V of the 23S rRNA gene. The medical records of these patients were reviewed retrospectively and the clinical course and laboratory data were compared. Results: The proportion of patients with MRMP was 51.6% and all MRMP isolates had the A2063G point mutation. The MRMP group had longer hospital stay and febrile period after initiation of macrolides. The levels of serum C-reactive protein (CRP) and interleukin-18 in nasopharyngeal aspirate were significantly higher in patients who did not respond to macrolide treatment. CRP was the only significant factor in predicting the efficacy of macrolides in patients with MRMP pneumonia. The area under the curve for CRP was 0.69 in receiver operating characteristic curve analysis, indicating reasonable discriminative power, and the optimal cutoff value was 40.7 mg/L. Conclusion: The proportion of patients with MRMP was high, suggesting that the prevalence of MRMP is rising rapidly in Korea. Serum CRP could be a useful marker for predicting the efficacy of macrolides and helping clinicians make better clinical decisions in children with MRMP pneumonia.

Plasma Soluble CD30 as a Possible Marker of Adult T-cell Leukemia in HTLV-1 Carriers: a Nested Case-Control Study

  • Takemoto, Shigeki;Iwanaga, Masako;Sagara, Yasuko;Watanabe, Toshiki
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권18호
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    • pp.8253-8258
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    • 2016
  • Elevated levels of soluble CD30 (sCD30) are linked with various T-cell neoplasms. However, the relationship between sCD30 levels and the development of adult T-cell leukemia (ATL) in human T-cell leukemia virus type 1 (HTLV-1) carriers remains to be clarified. We here investigated whether plasma sCD30 is associated with risk of ATL in a nested case-control study within a cohort of HTLV-1 carriers. We compared sCD30 levels between 11 cases (i.e., HTLV-1 carriers who later progressed to ATL) and 22 age-, sex- and institution-matched control HTLV-1 carriers (i.e., those with no progression). The sCD30 concentration at baseline was significantly higher in cases than in controls (median 65.8, range 27.2-134.5 U/mL vs. median 22.2, range 8.4-63.1 U/mL, P=0.001). In the univariate logistic regression analysis, a higher sCD30 (${\geq}30.2U/mL$) was significantly associated with ATL development (odds ratio 7.88 and the 95% confidence intervals 1.35-45.8, P = 0.02). Among cases, sCD30 concentration tended to increase at the time of diagnosis of aggressive-type ATL, but the concentration was stable in those developing the smoldering-type. This suggests that sCD30 may serve as a predictive marker for the onset of aggressive-type ATL in HTLV-1 carriers.

Relationship Between the Prohibitin 3' Untranslated Region C > T Gene Polymorphism and Cancer Susceptibility - Results of a Meta-analysis

  • Zhou, Tian-Biao;Yin, Sheng-Sheng;Huang, Jian-Jian;Ou, Chao
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권7호
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    • pp.3319-3323
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    • 2012
  • Objective: The results from the published studies on the association between prohibitin 3' untranslated region C > T gene polymorphism and cancer risk are conflicting. This meta-analysis was performed to evaluate the relationship with cancer susceptibility overall, and to explore whether the T allele or TT genotype could become a predictive marker for cancer risk. Methods: Association studies were identified from the databases of PubMed, Embase, and Cochrane Library as of March 1, 2012, and eligible investigations were synthesized using the meta-analysis method. Results were expressed with odds ratios (OR) for dichotomous data, and 95% confidence intervals (CI) were also calculated. Results: Six investigations were identified for the analysis of association between the prohibitin 3' untranslated region C > T gene polymorphism and cancer risk, covering of 1,461 patients with cancer and 1,197 controls. There was a positive association between the T allele and cancer susceptibility (OR=1.20, 95% CI: 1.03-1.39, P=0.02), and CC homozygous might play a protective role (OR=0.80, 95% CI: 0.68-6.11, P=0.95). In the sub-group analysis, prohibitin 3' untranslated region C > T gene polymorphism and cancer risk appeared associated with the risk of breast cancer, but not ovarian cancer. Conclusions: Our results indicate that T allele is a significant genetic molecular marker to predict cancer susceptibility and CC genotype is protective, especially for breast cancer. However, more investigations are required to further clarify the association of the prohibitin 3' untranslated region C > T gene polymorphism with cancer susceptibility.

Evaluation of Renal Function Using the Level of Neutrophil Gelatinase-Associated Lipocalin is Not Predictive of Nephrotoxicity Associated with Cisplatin-Based Chemotherapy

  • Kos, F. Tugba;Sendur, Mehmet Ali Nahit;Aksoy, Sercan;Celik, Huseyin Tugrul;Sezer, Sevilay;Civelek, Burak;Yaman, Sebnem;Zengin, Nurullah
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권2호
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    • pp.1111-1114
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    • 2013
  • Background: For early detection of renal damage during the usage of cisplatin based chemotherapy, changes in renal function should be monitored carefully. In recent years, neutrophil gelatinase-associated lipocalin, a small polypeptide molecule, has shown promise as a marker of acute renal failure. The aim of this present study was to assess possible risk prediction of cisplatin-induced nephrotoxicity using serum NGAL. Materials and Methods: A total of 34 consecutive patients with documented serum creatinine at least 24 hours before every cycle of cisplatin-based chemotherapy were included in the study. Demographic and medical data including age, performance status, tumor characteristics and comorbid diseases were collected from medical charts. Renal function was evaluated at least 48 hours before the treatment and at the end of the treatment based on the Modification of Diet in Renal Disease (MDRD) formula. Before and after cisplatin infusion serum NGAL levels were measured for the first and 3rd cycles of chemotherapy. Results: The median age of the study population was 54 (32-70) years. Fifteen patients (41.1%) were treated on an adjuvant basis, whereas 19 patients (58.9%) were treated for metastatic disease. There was no correlation of serum NGAL levels with serum creatinine (r=0.20, p=0.26) and MDRD (r=-0.12, p=0.50) and creatinine clearance-Cockcroft-Gault (r=-0.22, p=0.22) after cisplatin infusion at the end of the 3rd cycle of chemotherapy. Conclusions: In our study, serum NGAL levels were not correlated with the cisplatin induced nephrotoxicity. Further prospective studies are needed to conclude that serum NGAL level is not a good surrogate marker to predict early cisplatin induced nephrotoxicity.

운동선수의 베타3-아드레날린성 수용체 유전자의 Trp64Arg 다형성이 혈압, 신체조성 및 골밀도에 미치는 영향 (The Effect of Trp64Arg Polymorphism in the ${\beta}_3$-Adrenergic Receptor Gene on Blood Pressure, Body Composition and Bone Mineral Density in Athletes)

  • 정인근;오상덕;김태욱;강병용;하남주;하남주
    • 약학회지
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    • 제49권1호
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    • pp.44-50
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    • 2005
  • The purpose of this study was to investigate the relationship between Trp64Arg polymorphism in the ${\beta}_3$-adrenergic receptor gene and complex phenotypes such as blood pressure, body compositions and bone parameters in young men about 20 years, and to collect the fundamental data in designing the exercise program. Eighty healthy young men including 41 controls and 39 athletes were recruited, Trp64Arg polymorphism in the ${\beta}_3$-adrenergic receptor gene was genotyped by PCR-RFLP method. By association study, there were no significance in genotype and allele frequencies of Trp64Arg polymorphism in the ${\beta}_3$-adrenergic receptor gene between controls and athletes, respectively (p>0.05). When the relationship between physiological parameters and Trp64Arg polymorphism in the ${\beta}_3$-adrenergic receptor gene was tested, this polymorphism was significantly associated with 3th lumber and left femoral neck Z-score values in controls (p<0.05), but these associations were not detected in athletic groups (p>0.05). It is likely that Trp64Arg polymorphism in the ${\beta}_3$-adrenergic receptor gene is a genetic marker for the bone mineral density index in young men, but environmental factors such as exercise modify the significant effect of this polymorphism. Thus, our results suggest that Trp64Arg polymorphism in the ${\beta}_3$-adrenergic receptor gene may be applicable as a predictive marker for osteoporosis in Korean young men, and regular exercise may prevent the disadventageous effect of this polymorphism for bone mineral density in male athletic group.

Fecal Calprotectin Assay at an Early Stage of Treatment Can Be Used as a Surrogate Marker to Predict Clinical Remission and Mucosal Healing in Pediatric Crohn's Disease

  • Lee, Yeoun Joo;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제25권5호
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    • pp.396-405
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    • 2022
  • Purpose: This study evaluated the predictive role of fecal calprotectin (FC) measured at an early stage of treatment for monitoring clinical remission (CR) after six months and endoscopic remission (ER) after one year of treatment in pediatric Crohn's disease (CD). Methods: This retrospective study included 45 patients who simultaneously underwent ileocolonoscopy and FC testing during follow-up. FC levels were measured before and after six weeks of treatment. CR was assessed after six months of treatment using Pediatric Crohn' s Disease Activity Index and acute-phase reactants. ER was assessed after one year using the Simple Endoscopic Score for Crohn's Disease. Results: Twenty-nine (64.4%) patients used oral prednisolone for remission induction and 16 (35.6%) patients used anti-tumor necrosis factor-alpha. Thirty (66.7%) patients achieved CR, while 24 (53.3%) achieved ER. The FC level measured after six weeks of treatment could predict CR (χ2=9.15, p=0.0025) and ER (χ2=12.31, p=0.0004). The δFC could predict CR (χ2=7.91, p=0.0049), but not ER (χ2=1.85, p=0.1738). With a threshold of ≤950.4 ㎍/g, FC at week six could predict CR with 76.7% sensitivity and 73.3% specificity. The area under the curve (AUC) was 0.769 (standard error 0.0773, p=0.0005). The same threshold predicted ER with 87.5% sensitivity and 71.4% specificity. The AUC was 0.774 (standard error 0.074, p=0.0002). Conclusion: FC assay at an early stage of treatment can be used as a surrogate marker to predict CR and mucosal healing in pediatric CD.

자궁경부암 및 난소암 환자 재발진단과 치료반응평가에 있어서 FDG-PET의 역할: 양전자방출단층촬영, 복부전산화단층촬영 및 종양표지자 판독의 비교 분석 (Role of FDG-PET in the Diagnosis of Recurrence and Assessment of Therapeutic Response in Cervical Cancer and Ovarian Cancer Patients: Comparison of Diagnostic Report between PET, Abdominal a and Tumor Marker)

  • 한유미;최재걸;강병철
    • Nuclear Medicine and Molecular Imaging
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    • 제42권3호
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    • pp.201-208
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    • 2008
  • 목적; 복부 전산화단층촬영(CT) 및 종양표지자와 비교를 통하여 자궁경부암 및 난소암의 재발을 진단하고 치료에 대한 반응을 평가하는데 FDG를 이용한 양전자단층촬영(PET)이 어떤 역할을 하고 있는지 알아보고 앞으로 환자의 주요 추적검사방법이 될 수 있는지에 대해 알아보고자 하였다. 대상 및 방법; 2006년 5월 1일부터 2007년 10월 31일 사이에 FDG-PET를 시행한 환자 중 비슷한 시기에 복부 CT를 시행 받은 67명 환자 103예를 대상으로 하였다(자궁경부암 42예, 난소암 51예). PET, CT 및 혈중 종양표지자에 대한 판독을 후향적으로 서로 비교하였다. 세 검사에서 모두 양성을 보이거나 추적검사상 병변이 커지거나 조직검사 및 기타 검사에서 양성을 보일 때를 재발이라고 정의하여 세 검사방법의 판독에서의 차이를 분석하였다. 자궁경부암군과 난소암군으로 나누어 PET와 복부 CT 종양 표지자에 대한 진단의 민감도, 특이도, 양성 및 음성예측도를 알아보았다. 결과; 재발로 진단된 예는 37예였다. 자궁경부암에서 재발로 진단되었던 경우가 11예(9명)였으며 민감도는 각각 100%(11/11), 54.5%(6/11), 81.1%(9/11)로 PET가 가장 높았고, 특이도는 각각 93.6%(29/31), 93.6%(29/31), 100% (31/31)로 종양표지자가 가장 높았다. 난소암의 재발 진단은 26예(15명)였으며 민감도는 각각 96.2%(25/26), 84.6% (22/26), 80.8%(21/26)로 PET가 가장 높았고, 특이도는 세 검사에서 94.3%(33/35)로 동일하였다. CT에 비하여 PET에서 복강내 전이를 6예를 더 진단하였고 4예의 종격동임파절 및 폐전이를 더 진단할 수 있었으며 2예의 쇄골상와임파절과 1예의 액와임파절의 전이를 더 진단하였다. 재발환자의 분석에서 PET는 복부 외 장기의 재발을 발견할 수 있었고 복부내 재발의 경우에도 CT보다 더 민감하게 재발부위를 찾을 수 있었던 반면 CT의 도움 없이는 정확한 위치 측정이 어려웠다. CT는 잔여종양과 양성섬유화의 구분 및 조직간의 경계부위에서 종양의 구분이 어려웠고 복부 이외 장기의 전이를 발견할 수 없었다. 결론; PET는 자궁경부암과 난소암 진단에서 CT에 비해 적용 부위가 크고 조직 대조도가 커 민감도가 높은 검사법으로서 치료 후 잔여 종양의 여부나 재발을 진단하는 데 필수적이 검사법이 될 것으로 사료된다.

Predictive Role of the Neutrophil Lymphocyte Ratio for Invasion with Gestational Trophoblastic Disease

  • Guzel, Ali Irfan;Kokanali, Mahmut Kuntay;Erkilinc, Selcuk;Topcu, Hasan Onur;Oz, Murat;Ozgu, Emre;Erkaya, Salim;Gungor, Tayfun
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권10호
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    • pp.4203-4206
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    • 2014
  • Purpose: The objective of this study was to assess the predictive role of the neutrophil/lymphocyte ratio (NLR) for invasion of gestational trophoblastic disease (GTD). Materials and Methods: A retrospective analysis was conducted on 127 women who were managed at our clinic for GTD. Of all patients, 8 showed invasion according to histological examination. The clinical parameters of patients with invasive GTD (Group 1; n=8) were compared with patients who showed no invasion (Group 2; n=119). All underwent a prior uterine evacuation and followed up by regular assessment of ${\beta}$-hCG titers. Results: Demographic and obstetric history and pre-evacuation hCG levels of the patients showed no statistically significantly difference between the groups (p>0.05). The mean gestational weeks (GW), size of the GTD and NLR levels were statistically significantly higher in the invasive GTD group (p<0.05). Correlations between invasion and gestational weeks, size of GTD, post-evacuation chemotherapy and NLR were evident. ROC curve analysis demonstrated that GW, size of GTD and NLR may be discriminative parameters in predicting invasion of GTD. Conclusions: To the best of our knowledge, this is the first study evaluating the predictive role of NLR in invasion of GTD. In conclusion, we think that pretreatment NLR can be used as a biomarker of invasion in GTD.

Prognostic Value of Preoperative Serum CA 242 in Esophageal Squamous Cell Carcinoma Cases

  • Feng, Ji-Feng;Huang, Ying;Chen, Qi-Xun
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권3호
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    • pp.1803-1806
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    • 2013
  • Purpose: Carbohydrate antigen (CA) 242 is inversely related to prognosis in many cancers. However, few data regarding CA 242 in esophageal cancer (EC) are available. The aim of this study was to determine the prognostic value of CA 242 and propose an optimum cut-off point in predicting survival difference in patients with esophageal squamous cell carcinoma (ESCC). Methods: A retrospective analysis was conducted of 192 cases. A receiver operating characteristic (ROC) curve for survival prediction was plotted to verify the optimum cuf-off point. Univariate and multivariate analyses were performed to evaluate prognostic parameters for survival. Results: The positive rate for CA 242 was 7.3% (14/192). The ROC curve for survival prediction gave an optimum cut-off of 2.15 (U/ml). Patients with CA 242 ${\leq}$ 2.15 U/ml had significantly better 5-year survival than patients with CA 242 >2.15 U/ml (45.4% versus 22.6%; P=0.003). Multivariate analysis showed that differentiation (P=0.033), CA 242 (P=0.017), T grade (P=0.004) and N staging (P<0.001) were independent prognostic factors. Conclusions: Preoperative CA 242 is a predictive factor for long-term survival in ESCC, especially in nodal-negative patients. We conclude that 2.15 U/ml may be the optimum cuf-off point for CA 242 in predicting survival in ESCC.