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Attanasio U, Di Sarro E, Tricarico L, Di Lisi D, Armentaro G, Miceli S, Fioretti F, Deidda M, Correale M, Novo G, Sciacqua A, Nodari S, Cadeddu C, Tocchetti CG, Palazzuoli A, Mercurio V. Cardiovascular Biomarkers in Cardio-Oncology: Antineoplastic Drug Cardiotoxicity and Beyond. Biomolecules 2024; 14:199. [PMID: 38397436 PMCID: PMC10887095 DOI: 10.3390/biom14020199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/29/2024] [Accepted: 02/03/2024] [Indexed: 02/25/2024] Open
Abstract
Serum biomarkers represent a reproducible, sensitive, minimally invasive and inexpensive method to explore possible adverse cardiovascular effects of antineoplastic treatments. They are useful tools in risk stratification, the early detection of cardiotoxicity and the follow-up and prognostic assessment of cancer patients. In this literature review, we aim at describing the current state of knowledge on the meaning and the usefulness of cardiovascular biomarkers in patients with cancer; analyzing the intricate relationship between cancer and cardiovascular disease (especially HF) and how this affects cardiovascular and tumor biomarkers; exploring the role of cardiovascular biomarkers in the risk stratification and in the identification of chemotherapy-induced cardiotoxicity; and providing a summary of the novel potential biomarkers in this clinical setting.
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Affiliation(s)
- Umberto Attanasio
- Department of Translational Medical Sciences, Federico II University, Via Sergio Pansini 5, 80131 Naples, Italy (E.D.S.); (C.G.T.)
| | - Elena Di Sarro
- Department of Translational Medical Sciences, Federico II University, Via Sergio Pansini 5, 80131 Naples, Italy (E.D.S.); (C.G.T.)
| | - Lucia Tricarico
- Cardiology Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122 Foggia, Italy; (L.T.); (M.C.)
| | - Daniela Di Lisi
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Piazza delle Cliniche 2, 90127 Palermo, Italy; (D.D.L.); (G.N.)
- Division of Cardiology, University Hospital Paolo Giaccone, Via del Vespro 129, 90127 Palermo, Italy
| | - Giuseppe Armentaro
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100 Catanzaro, Italy; (G.A.); (S.M.); (A.S.)
| | - Sofia Miceli
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100 Catanzaro, Italy; (G.A.); (S.M.); (A.S.)
| | - Francesco Fioretti
- Cardiology Section, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Spedali Civili Hospital and University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (F.F.); (S.N.)
| | - Martino Deidda
- Department of Medical Sciences and Public Health, University of Cagliari, 09042 Monserrato, Italy (C.C.)
| | - Michele Correale
- Cardiology Unit, Department of Medical and Surgical Sciences, University of Foggia, Viale Pinto 1, 71122 Foggia, Italy; (L.T.); (M.C.)
| | - Giuseppina Novo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, Piazza delle Cliniche 2, 90127 Palermo, Italy; (D.D.L.); (G.N.)
- Division of Cardiology, University Hospital Paolo Giaccone, Via del Vespro 129, 90127 Palermo, Italy
| | - Angela Sciacqua
- Department of Medical and Surgical Sciences, University Magna Græcia of Catanzaro, Campus Universitario di Germaneto, V.le Europa, 88100 Catanzaro, Italy; (G.A.); (S.M.); (A.S.)
| | - Savina Nodari
- Cardiology Section, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Spedali Civili Hospital and University of Brescia, Piazzale Spedali Civili 1, 25123 Brescia, Italy; (F.F.); (S.N.)
| | - Christian Cadeddu
- Department of Medical Sciences and Public Health, University of Cagliari, 09042 Monserrato, Italy (C.C.)
| | - Carlo Gabriele Tocchetti
- Department of Translational Medical Sciences, Federico II University, Via Sergio Pansini 5, 80131 Naples, Italy (E.D.S.); (C.G.T.)
- Interdepartmental Center of Clinical and Translational Sciences (CIRCET), Federico II University, Via Sergio Pansini 5, 80131 Naples, Italy
- Interdepartmental Hypertension Research Center (CIRIAPA), Federico II University, Via Sergio Pansini 5, 80131 Naples, Italy
- Center for Basic and Clinical Immunology Research (CISI), Federico II University, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Alberto Palazzuoli
- Cardiovascular Diseases Unit, Cardio-thoracic and Vascular Department Le Scotte Hospital, University of Siena, Strada delle Scotte 14, 53100 Siena, Italy;
| | - Valentina Mercurio
- Department of Translational Medical Sciences, Federico II University, Via Sergio Pansini 5, 80131 Naples, Italy (E.D.S.); (C.G.T.)
- Interdepartmental Center of Clinical and Translational Sciences (CIRCET), Federico II University, Via Sergio Pansini 5, 80131 Naples, Italy
- Interdepartmental Hypertension Research Center (CIRIAPA), Federico II University, Via Sergio Pansini 5, 80131 Naples, Italy
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Feng R, Zhang Z, Fan Q. Carbohydrate antigen 125 in congestive heart failure: ready for clinical application? Front Oncol 2023; 13:1161723. [PMID: 38023127 PMCID: PMC10644389 DOI: 10.3389/fonc.2023.1161723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Congestion is the permanent mechanism driving disease progression in patients with acute heart failure (AHF) and also is an important treatment target. However, distinguishing between the two different phenotypes (intravascular congestion and tissue congestion) for personalized treatment remains challenging. Historically, carbohydrate antigen 125 (CA125) has been a frequently used biomarker for the screening, diagnosis, and prognosis of ovarian cancer. Interestingly, CA125 is highly sensitive to tissue congestion and shows potential for clinical monitoring and optimal treatment of congestive heart failure (HF). Furthermore, in terms of right heart function parameters, CA125 levels are more advantageous than other biomarkers of HF. CA125 is expected to become a new biological alternative marker for congestive HF and thereby is expected be widely used in clinical practice.
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Affiliation(s)
- Rui Feng
- Department of Laboratory Medicine, Wuhan Asian Heart Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- School of Medicine, Wuhan University of Science and Technology, Wuhan, China
| | - Zhenlu Zhang
- Department of Laboratory Medicine, Wuhan Asian Heart Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Qingkun Fan
- Department of Laboratory Medicine, Wuhan Asian Heart Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
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3
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Lourenço P, Cunha FM, Elias C, Fernandes C, Barroso I, Guimarães JT, Bettencourt P. CA-125 variation in acute heart failure: a single-centre analysis. ESC Heart Fail 2022; 9:1018-1026. [PMID: 34989167 PMCID: PMC8934914 DOI: 10.1002/ehf2.13758] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 10/24/2021] [Accepted: 11/24/2021] [Indexed: 02/05/2023] Open
Abstract
Aims A decrease in carbohydrate antigen 125 (CA‐125) predicts survival advantage in chronic heart failure (HF); the impact of its variation in acute HF is unknown. We studied the association of CA‐125 decrease with prognosis in acute HF. Methods and results We studied acute hospitalized HF patients. Predictors of admission and discharge CA‐125 were determined by linear regression. Follow‐up was 1 year; endpoint was all‐cause death. The association of admission and discharge CA‐125 with mortality was assessed using a Cox‐regression analysis. A Cox‐regression analysis was also used to assess the prognostic impact of CA‐125 decrease during hospitalization. Analysis was stratified by length of hospital stay (LOS). We studied 363 patients, 51.5% male, mean age 75 ± 12 years, 51.5% ischaemic, 30.0% with preserved ejection fraction, and 57.3% with reduced ejection fraction; patients presented elevated comorbidity burden. Median LOS was 7 (5–11) days. In the subgroup of 262 patients with CA‐125 measured both at admission and at discharge, we reported a significant increase in its levels: 56.0 (26.0–160.7) U/mL to 74.0 (32.3–195.0) U/mL. Independent predictors of admission CA‐125 were higher BNP and lower creatinine. Predictors of discharge CA‐125 were higher discharge BNP, lower discharge albumin, and younger age. Both admission and discharge CA‐125 predicted mortality. During follow‐up, 75 (31.8%) patients died. A decrease in CA‐125 predicted a 68% reduction in the 1 year death risk only in patients with LOS > 10 days. Conclusions Our results suggest that an early re‐evaluation (>10 days) with CA‐125 measurement after an acute HF hospitalization may be of interest in patient management.
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Affiliation(s)
- Patrícia Lourenço
- Internal Medicine DepartmentCentro Hospitalar e Universitário São JoãoPortoPortugal
- Medicine FacultyPorto UniversityPortoPortugal
- Cardiovascular R&D Unit, Medicine FacultyPorto UniversityPortoPortugal
- Heart Failure Clinic of the Internal Medicine DepartmentCentro Hospitalar e Universitário São JoãoPortoPortugal
| | - Filipe M. Cunha
- Endocrinology DepartmentCentro Hospitalar do Tâmega e SousaPortoPortugal
| | - Catarina Elias
- Internal Medicine DepartmentCentro Hospitalar e Universitário São JoãoPortoPortugal
| | | | - Isaac Barroso
- Clinical Pathology DepartmentCentro Hospitalar e Universitário São JoãoPortoPortugal
| | - João T. Guimarães
- Medicine FacultyPorto UniversityPortoPortugal
- Clinical Pathology DepartmentCentro Hospitalar e Universitário São JoãoPortoPortugal
| | - Paulo Bettencourt
- Medicine FacultyPorto UniversityPortoPortugal
- Cardiovascular R&D Unit, Medicine FacultyPorto UniversityPortoPortugal
- Internal Medicine DepartmentHospital CUF PortoPortoPortugal
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4
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Sahin A, Kaya H, Avci O. Cancer antigen-125 is a predictor of mortality in patients with pulmonary arterial hypertension. Clin Biochem 2020; 89:58-62. [PMID: 33382999 DOI: 10.1016/j.clinbiochem.2020.12.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 12/06/2020] [Accepted: 12/22/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Carbohydrate antigen 125 (CA 125), known as a tumor marker for ovarian cancer, has been reported to increase and be associated with severity in heart failure and chronic obstructive pulmonary disease. Patients with pulmonary arterial hypertension may also die due to developing right heart failure. The aim of this study is to evaluate the prognostic role of CA-125 in PAH patients. METHODS A total of 40 consecutive patients with PAH were evaluated prospectively. The mean age of patients was 52 ± 11 years (12% males, 88% females) with a median follow-up period of 16 months. RESULTS After follow-up period, 12 out of 40 patients (30%) died. CA-125 levels were higher among those who died compared to those who survived [78.5 (11.0-292) vs. 27.5 (2.10-138) U/ml, p = 0.001]. The optimal cut-off value of CA-125 to predict mortality was found as 35.29 U/ml, with 85.7% specificity and 75% sensitivity. In multivariable Cox proportional-hazards model with forward stepwise method; CA-125 > 35.32 U/ml on admission (HR = 7.645, 95% CI: 1.356-43.121, p = 0.021), age (HR = 1.132, 95% CI: 1.040-1.233, p = 0.004), TAPSE (HR = 0.740, 95% CI: 0.549-0.998, p = 0.048) and uric acid (HR = 1.444, 95% CI: 1.022-2.042, p = 0.037) remained associated with an increased risk of death. CONCLUSION In this study, we showed for the first time that serum CA-125 values were an independent predictor for the long-term mortality in PAH patients.
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Affiliation(s)
- Anil Sahin
- Cardiology Department, University of Health Sciences Antalya Training and Research Hospital, Antalya, Turkey.
| | - Hakki Kaya
- Cardiology Department, Canakkale Onsekiz Mart University, Canakkale, Turkey.
| | - Onur Avci
- Anesthesiology and Reanimation Department, Sivas Cumhuriyet University, Sivas, Turkey.
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5
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Palazzuoli A, Evangelista I, Nuti R. Congestion occurrence and evaluation in acute heart failure scenario: time to reconsider different pathways of volume overload. Heart Fail Rev 2020; 25:119-131. [PMID: 31628648 DOI: 10.1007/s10741-019-09868-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Although congestion is considered to be the main reason for hospital admission in patients with acute heart failure, a simplistic view considering idro saline retention and total body volume accumulation did not provide convincing data. Clinical congestion occurrence is often the tip of the iceberg of several different mechanisms ranging from increased filling pressure to extravascular fluid accumulation and blood flow redistribution. Therefore, the clinical evaluation is often restricted to a simple physical examination including few and inaccurate signs and symptoms. This superficial approach has led to contradictory data and patients have not been evaluated according to a more realistic clinical scenario. The integration with new diagnostic ultrasonographic and laboratory tools would substantially improve these weaknesses. Indeed, congestion could be assessed by following the most recognized HF subtypes including primitive cardiac defect, presence of right ventricular dysfunction, and organ perfusion. Moreover, there is a tremendous gap regarding the interchangeable concept of fluid retention and redistribution used with a univocal meaning. Overall, congestion assessment should be revised, considering it as either central, peripheral, or both. In this review, we aim to provide different evidence regarding the concept of congestion starting from the most recognized pathophysiological mechanisms of AHF decompensation. We highlight the fact that a better knowledge of congestion is a challenge for future investigation and it could lead to significant advances in HF treatment.
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Affiliation(s)
- Alberto Palazzuoli
- Cardiovascular Diseases Unit, Department of Internal Medicine, S. Maria alle Scotte Hospital, University of Siena, Viale Bracci, Siena, 53100, Italy.
| | - Isabella Evangelista
- Cardiovascular Diseases Unit, Department of Internal Medicine, S. Maria alle Scotte Hospital, University of Siena, Viale Bracci, Siena, 53100, Italy
| | - Ranuccio Nuti
- Cardiovascular Diseases Unit, Department of Internal Medicine, S. Maria alle Scotte Hospital, University of Siena, Viale Bracci, Siena, 53100, Italy
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Shi C, van der Wal HH, Silljé HHW, Dokter MM, van den Berg F, Huizinga L, Vriesema M, Post J, Anker SD, Cleland JG, Ng LL, Samani NJ, Dickstein K, Zannad F, Lang CC, van Haelst PL, Gietema JA, Metra M, Ameri P, Canepa M, van Veldhuisen DJ, Voors AA, de Boer RA. Tumour biomarkers: association with heart failure outcomes. J Intern Med 2020; 288:207-218. [PMID: 32372544 PMCID: PMC7496322 DOI: 10.1111/joim.13053] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 02/18/2020] [Accepted: 02/25/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND There is increasing recognition that heart failure (HF) and cancer are conditions with a number of shared characteristics. OBJECTIVES To explore the association between tumour biomarkers and HF outcomes. METHODS In 2,079 patients of BIOSTAT-CHF cohort, we measured six established tumour biomarkers: CA125, CA15-3, CA19-9, CEA, CYFRA 21-1 and AFP. RESULTS During a median follow-up of 21 months, 555 (27%) patients reached the primary end-point of all-cause mortality. CA125, CYFRA 21-1, CEA and CA19-9 levels were positively correlated with NT-proBNP quartiles (all P < 0.001, P for trend < 0.001) and were, respectively, associated with a hazard ratio of 1.17 (95% CI 1.12-1.23; P < 0.0001), 1.45 (95% CI 1.30-1.61; P < 0.0001), 1.19 (95% CI 1.09-1.30; P = 0.006) and 1.10 (95% CI 1.05-1.16; P < 0.001) for all-cause mortality after correction for BIOSTAT risk model (age, BUN, NT-proBNP, haemoglobin and beta blocker). All tumour biomarkers (except AFP) had significant associations with secondary end-points (composite of all-cause mortality and HF hospitalization, HF hospitalization, cardiovascular (CV) mortality and non-CV mortality). ROC curves showed the AUC of CYFRA 21-1 (0.64) had a noninferior AUC compared with NT-proBNP (0.68) for all-cause mortality (P = 0.08). A combination of CYFRA 21-1 and NT-proBNP (AUC = 0.71) improved the predictive value of the model for all-cause mortality (P = 0.0002 compared with NT-proBNP). CONCLUSIONS Several established tumour biomarkers showed independent associations with indices of severity of HF and independent prognostic value for HF outcomes. This demonstrates that pathophysiological pathways sensed by these tumour biomarkers are also dysregulated in HF.
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Affiliation(s)
- C Shi
- From the, Department of Cardiology, Uni, University Medical Center Groningen, Groningen, the Netherlands.,University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - H H van der Wal
- From the, Department of Cardiology, Uni, University Medical Center Groningen, Groningen, the Netherlands.,University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - H H W Silljé
- From the, Department of Cardiology, Uni, University Medical Center Groningen, Groningen, the Netherlands.,University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - M M Dokter
- From the, Department of Cardiology, Uni, University Medical Center Groningen, Groningen, the Netherlands.,University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - F van den Berg
- From the, Department of Cardiology, Uni, University Medical Center Groningen, Groningen, the Netherlands.,University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - L Huizinga
- From the, Department of Cardiology, Uni, University Medical Center Groningen, Groningen, the Netherlands.,University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - M Vriesema
- From the, Department of Cardiology, Uni, University Medical Center Groningen, Groningen, the Netherlands.,University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - J Post
- From the, Department of Cardiology, Uni, University Medical Center Groningen, Groningen, the Netherlands.,University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - S D Anker
- Department of Cardiology, Berlin-Brandenburg Center for Regenerative Therapies, German Centre for Cardiovascular Research (DZHK) Partner site Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - J G Cleland
- National Heart & Lung Institute, Royal Brompton & Harefield Hospitals, Imperial College, London, UK.,Robertson Institute of Biostatistics and Clinical Trials Unit, University of Glasgow, Glasgow, UK
| | - L L Ng
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.,NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - N J Samani
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.,NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - K Dickstein
- University of Bergen, Stavanger University Hospital, Stavanger, Norway
| | - F Zannad
- Clinical Investigation Center 1433, French Clinical Research Infrastructure Network, Investigation Network Initiative-Cardiovascular and Renal Clinical Trialists, Centre Hospitalier Regional et Universitaire de Nancy, Vandoeuvre les Nancy, France
| | - C C Lang
- Division of Molecular and Clinical Medicine, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK
| | - P L van Haelst
- F. Hoffmann-La Roche Ltd. Diagnostics Division, Basel, Switzerland
| | - J A Gietema
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - M Metra
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Institute of Cardiology, University of Brescia, Brescia, Italy
| | - P Ameri
- Cardiovascular Disease Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy.,IRCCS Italian Cardiovascular Network, Department of Internal Medicine, University of Genova, Genova, Italy
| | - M Canepa
- Cardiovascular Disease Unit, IRCCS Ospedale Policlinico San Martino, Genova, Italy.,IRCCS Italian Cardiovascular Network, Department of Internal Medicine, University of Genova, Genova, Italy
| | - D J van Veldhuisen
- From the, Department of Cardiology, Uni, University Medical Center Groningen, Groningen, the Netherlands.,University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - A A Voors
- From the, Department of Cardiology, Uni, University Medical Center Groningen, Groningen, the Netherlands.,University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - R A de Boer
- From the, Department of Cardiology, Uni, University Medical Center Groningen, Groningen, the Netherlands.,University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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Antígeno carbohidrato 125 en insuficiencia cardiaca. Nueva era en la monitorización y control del tratamiento. Med Clin (Barc) 2019; 152:266-273. [DOI: 10.1016/j.medcli.2018.08.020] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 08/29/2018] [Accepted: 08/31/2018] [Indexed: 12/14/2022]
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Chovanec J, Selingerova I, Greplova K, Antonsen SL, Nalezinska M, Høgdall C, Høgdall E, Søgaard-Andersen E, Jochumsen KM, Fabian P, Valik D, Zdrazilova-Dubska L. Adjustment of serum HE4 to reduced glomerular filtration and its use in biomarker-based prediction of deep myometrial invasion in endometrial cancer. Oncotarget 2017; 8:108213-108222. [PMID: 29296235 PMCID: PMC5746137 DOI: 10.18632/oncotarget.22599] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 10/28/2017] [Indexed: 01/21/2023] Open
Abstract
Background We investigated the efficacy of circulating biomarkers together with histological grade and age to predict deep myometrial invasion (dMI) in endometrial cancer patients. Methods HE4ren was developed adjusting HE4 serum levels towards decreased glomerular filtration rate as quantified by the eGFR-EPI formula. Preoperative HE4, HE4ren, CA125, age, and grade were evaluated in the context of perioperative depth of myometrial invasion in endometrial cancer (EC) patients. Continuous and categorized models were developed by binary logistic regression for any-grade and for G1-or-G2 patients based on single-institution data from 120 EC patients and validated against multicentric data from 379 EC patients. Results In non-cancer individuals, serum HE4 levels increase log-linearly with reduced glomerular filtration of eGFR ≤ 90 ml/min/1.73 m2. HE4ren, adjusting HE4 serum levels to decreased eGFR, was calculated as follows: HE4ren = exp[ln(HE4) + 2.182 × (eGFR-90) × 10-2]. Serum HE4 but not HE4ren is correlated with age. Model with continuous HE4ren, age, and grade predicted dMI in G1-or-G2 EC patients with AUC = 0.833 and AUC = 0.715, respectively, in two validation sets. In a simplified categorical model for G1-or-G2 patients, risk factors were determined as grade 2, HE4ren ≥ 45 pmol/l, CA125 ≥ 35 U/ml, and age ≥ 60. Cumulation of weighted risk factors enabled classification of EC patients to low-risk or high-risk for dMI. Conclusions We have introduced the HE4ren formula, adjusting serum HE4 levels to reduced eGFR that enables quantification of time-dependent changes in HE4 production and elimination irrespective of age and renal function in women. Utilizing HE4ren improves performance of biomarker-based models for prediction of dMI in endometrial cancer patients.
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Affiliation(s)
- Josef Chovanec
- Clinic of Surgical Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic.,Regional Centre of Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Iveta Selingerova
- Regional Centre of Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Kristina Greplova
- Regional Centre of Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic.,Department of Laboratory Medicine, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Sofie Leisby Antonsen
- Gynecologic Clinic, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Monika Nalezinska
- Clinic of Surgical Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Claus Høgdall
- Gynecologic Clinic, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Estrid Høgdall
- Department of Pathology, Danish Cancer Biobank, Herlev University Hospital, Herlev, Denmark
| | - Erik Søgaard-Andersen
- Department of Gynecology and Obstetrics, Aalborg University Hospital, Aalborg, Denmark
| | - Kirsten M Jochumsen
- Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark
| | - Pavel Fabian
- Department of Oncological Pathology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Dalibor Valik
- Regional Centre of Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic.,Department of Laboratory Medicine, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Lenka Zdrazilova-Dubska
- Regional Centre of Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic.,Department of Laboratory Medicine, Masaryk Memorial Cancer Institute, Brno, Czech Republic
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9
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Prognostic value of measuring the diameter and inspiratory collapse of the inferior vena cava in acute heart failure. Rev Clin Esp 2016. [DOI: 10.1016/j.rceng.2015.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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10
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Josa-Laorden C, Giménez-López I, Rubio-Gracia J, Ruiz-Laiglesia F, Garcés-Horna V, Pérez-Calvo JI. [Prognostic value of measuring the diameter and inspiratory collapse of the inferior vena cava in acute heart failure]. Rev Clin Esp 2016; 216:183-90. [PMID: 26774759 DOI: 10.1016/j.rce.2015.11.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 10/24/2015] [Accepted: 11/15/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVES To assess the utility of measuring the diameter and collapse of the inferior vena cava (IVC) in acute heart failure (AHF), its relationship with the prognosis and serum biomarkers of congestion. PATIENTS AND METHODS An observational prospective study was conducted that included 85 patients with AHF, classifying them into 4 groups according to IVC diameter (≤ or >20mm) and inspiratory collapse (< or ≥50%) at admission. The endpoints were mortality due to HF and the combined event of mortality and readmission for HF at 180 days. RESULTS Some 24.7% of the patients had an undilated IVC and ≥50% collapse (group 1); 20% had an undilated IVC and <50% collapse (group 2), 5.9% had a dilated IVC and ≥50% collapse (group 3); and 49.4% had a dilated IVC and <50% collapse (group 4). The lack of inspiratory collapse but not IVC dilation was related to higher concentrations of urea (P=.007), creatinine (P=.004), uric acid (P=.008), NT-proBNP (P=.009) and CA125 (P=.005). Survival free of the combined event at 180 days was lower in those patients with no IVC collapse. CONCLUSIONS Dilation and the absence of the inspiratory collapse of the IVC are common in the context of AHF. The lack of inspiratory collapse of the IVC during the decompensation phase identifies a subgroup of patients with poorer prognosis at 6 months.
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Affiliation(s)
- C Josa-Laorden
- Servicio de Medicina Interna, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, España.
| | - I Giménez-López
- Departamento de Fisiología, Facultad de Medicina, Instituto Aragonés de Ciencias de la Salud (IACS), Zaragoza, España; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, España
| | - J Rubio-Gracia
- Servicio de Medicina Interna, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, España
| | - F Ruiz-Laiglesia
- Servicio de Medicina Interna, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, España
| | - V Garcés-Horna
- Servicio de Medicina Interna, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, España
| | - J I Pérez-Calvo
- Servicio de Medicina Interna, Hospital Clínico Universitario Lozano Blesa, Zaragoza, España; Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, España
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Zhu X, Zhou W, Chen Y, Gao J, Kong F, Liu J, Li Z, Gao J, Bai Y. High serum carbohydrate antigen 125 concentration can predict serous effusion but not gastrointestinal malignancy in male patients. Tumour Biol 2014; 35:5129-35. [PMID: 24671822 DOI: 10.1007/s13277-014-1625-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 01/05/2014] [Indexed: 12/27/2022] Open
Abstract
This study aims to evaluate the diagnostic accuracy of carbohydrate antigen 125 (CA125) in male patients for predicting gastrointestinal malignant diseases. One hundred twenty consecutive male patients underwent CA125 test after admission to the Department of Gastroenterology in Changhai Hospital, the Second Military Medical University, from April to June 2013. Data of age, main symptoms, and final diagnosis were summarized. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), and negative likelihood ratio (NLR) of CA125 for malignancy were estimated, and the receiver operating characteristic (ROC) analysis and the area under the curve (AUC) were also performed to evaluate the diagnostic value of CA125 in male patients. The PPV, NPV, PLR, and NLR of CA125 in malignancy were 55 %, 69 %, 1.90, and 0.71, respectively. However, we found that an elevated serum CA125 level was more common in male patients with serous effusion than those with malignancy. The PPV, NPV, PLR, and NLR of CA125 in serous effusion were 85 %, 96 %, 12.70, and 0.09, respectively. In the ROC analysis, the AUC values for CA125 was 0.96 (95 % confidence interval, 0.93-0.99) for discriminating patients with serous cavity effusion from those without serous effusion. CA125 has a higher accuracy in detecting serous effusion than malignancy in male patients with gastrointestinal diseases. It is of little significance for male patients to perform CA125 test for malignancy.
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Affiliation(s)
- Xian Zhu
- Department of Gastroenterology, Changhai Hospital, Second Military Medical University, 168 Changhai Road, Shanghai, China,
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