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Dobrescu R, Picu C, Caragheorgheopol A, Manda D, Ioachim D, Goldstein A, Badiu C. Serum Matrix metalloproteinase-9 (MMP-9) can help identify patients with papillary thyroid cancer at high risk of persistent disease: Value and limitations of a potential marker of neoplasia. Cancer Biomark 2021; 29:337-346. [PMID: 32716342 DOI: 10.3233/cbm-190609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Matrix metalloproteinase-9 (MMP-9) is an important mediator of invasion and metastasis in neoplasia. In thyroid cancer expression levels correlate with aggressiveness but data on peripheral MMP-9 levels are less definitive. OBJECTIVE Prospective study evaluating serum MMP-9 in the diagnosis and prognosis of papillary thyroid cancer. METHODS Serum samples of MMP-9 were drawn before surgery in 185 consecutively enrolled patients with nodular thyroid disease, stratified on pathology as benign disease (N= 88) and papillary thyroid cancer (N= 97). Serum MMP-9 was measured by an immunometric assay. RESULTS MMP-9 levels were not different between benign vs malignant pathology (p= 0.3). In papillary thyroid cancer there was no significant difference in MMP-9 levels between histologies, TNM stage and invasive/non-invasive cancers. High-risk patients with multiple features of aggressiveness had significantly higher MMP-9 levels compared to low-intermediate risk patients (767.5 ± 269.2 ng/ml vs 563.7 ± 228.4 ng/ml, p= 0.019). A cut-off of 806 ng/ml distinguished high from low-intermediate risk patients with a sensitivity of 60% and a specificity of 87.36%, p= 0.018. In patients with available follow-up data (N= 78), MMP-9 was higher in patients who required ⩾ 2 doses of 131I therapy (p= 0.009) and in those with biochemical evidence of persistent disease/who required additional therapy to achieve disease-free status (p= 0.017). CONCLUSION Serum MMP-9 is not useful in the diagnosis of PTC, but preliminary data shows that high pre-surgical serum MMP-9 levels may identify patients at higher risk of persistent disease who require intensive treatment. Large volume prospective studies are required to confirm this observation.
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Affiliation(s)
- Ruxandra Dobrescu
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.,"CI Parhon" National Institute of Endocrinology, Bucharest, Romania
| | - Catalina Picu
- "CI Parhon" National Institute of Endocrinology, Bucharest, Romania.,Faculty of Biology, University of Bucharest, Bucharest, Romania
| | | | - Dana Manda
- "CI Parhon" National Institute of Endocrinology, Bucharest, Romania
| | - Dumitru Ioachim
- "CI Parhon" National Institute of Endocrinology, Bucharest, Romania
| | - Andrei Goldstein
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.,"CI Parhon" National Institute of Endocrinology, Bucharest, Romania
| | - Corin Badiu
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.,"CI Parhon" National Institute of Endocrinology, Bucharest, Romania
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Elias SG, Kok L, Witteman BJM, Goedhard JG, Romberg-Camps MJL, Muris JWM, de Wit NJ, Moons KGM. Published diagnostic models safely excluded colorectal cancer in an independent primary care validation study. J Clin Epidemiol 2016; 82:149-157.e8. [PMID: 27989951 DOI: 10.1016/j.jclinepi.2016.09.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 08/27/2016] [Accepted: 09/06/2016] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To validate published diagnostic models for their ability to safely reduce unnecessary endoscopy referrals in primary care patients suspected of significant colorectal disease. STUDY DESIGN AND SETTING Following a systematic literature search, we independently validated the identified diagnostic models in a cross-sectional study of 810 Dutch primary care patients with persistent lower abdominal complaints referred for endoscopy. We estimated diagnostic accuracy measures for colorectal cancer (N = 37) and significant colorectal disease (N = 141; including colorectal cancer, inflammatory bowel disease, diverticulitis, or >1-cm adenomas). RESULTS We evaluated 18 models-12 specific for colorectal cancer-, of which most were able to safely rule out colorectal cancer: the best model (National Institute for Health and Care Excellence-1) prevented 59% of referrals (95% confidence interval [CI]: 56-63%), with 96% sensitivity (95% CI: 83-100%), 100% negative predictive value (NPV; 95% CI: 99-100%), and an area under the receiver operating characteristics curve (AUC) of 0.86 (95% CI: 0.80-0.92). The models performed less for significant colorectal disease: the best model (Brazer) prevented 23% of referrals (95% CI: 20-26%), with 95% sensitivity (95% CI: 90-98%), 96% NPV (95% CI: 92-98%), and an AUC of 0.73 (95% CI: 0.69-0.78). CONCLUSION Most models safely excluded colorectal cancer in many primary care patients with lower gastrointestinal complaints referred for endoscopy. Models performed less well for significant colorectal disease.
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Affiliation(s)
- Sjoerd G Elias
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, PO Box 85500, Utrecht, GA 3508, The Netherlands.
| | - Liselotte Kok
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, PO Box 85500, Utrecht, GA 3508, The Netherlands
| | - Ben J M Witteman
- Department of Gastroenterology, Gelderse Vallei Hospital, PO Box 9025, Ede, HN 6710, The Netherlands
| | - Jelle G Goedhard
- Department of Gastroenterology, Atrium Medical Center, PO Box 4446, Heerlen, CX 6401, The Netherlands
| | - Mariëlle J L Romberg-Camps
- Department of Gastroenterology, Orbis Medical Center, PO Box 5500, Sittard-Geleen, MB 6130, The Netherlands
| | - Jean W M Muris
- Department of General Practice, Care and Public Health Research Institute (Caphri), Maastricht University, PO Box 616, Maastricht, MD 6200, The Netherlands
| | - Niek J de Wit
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, PO Box 85500, Utrecht, GA 3508, The Netherlands
| | - Karel G M Moons
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, PO Box 85500, Utrecht, GA 3508, The Netherlands
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Wang L, Shen X, Wang Z, Xiao X, Wei P, Wang Q, Ren F, Wang Y, Liu Z, Sheng W, Huang W, Zhou X, Du X. A molecular signature for the prediction of recurrence in colorectal cancer. Mol Cancer 2015; 14:22. [PMID: 25645394 PMCID: PMC4320628 DOI: 10.1186/s12943-015-0296-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 01/14/2015] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Several clinical and pathological factors have an impact on the prognosis of colorectal cancer (CRC), but they are not yet adequate for risk assessment. We aimed to identify a molecular signature that can reliably identify CRC patients at high risk for recurrence. RESULTS Two hundred eighty-one CRC samples (stage II/III) were included in this study. A two-step gene expression profiling study was conducted. First, gene expression measurements from 81 fresh frozen CRC samples were obtained using Affymetrix Human Genome U133 Plus 2.0 Arrays. Second, a focused gene expression assay, including prognostic genes and genes of interest from literature reviews, was performed using 200 fresh frozen samples and a Taqman low-density array (TLDA) analysis. An optimal 31-gene expression classifier for the prediction of recurrence among patients with stage II/III CRC was developed using logistic regression analysis. This gene expression signature classified 58.5% of patients as low-risk and 41.5% as high-risk (P < 0.001). The signature was the strongest independent prognostic factor in the multivariate analysis. The five-year relapse-free survival (RFS) rates for the low-risk patients and the high-risk patients were 88.5% and 41.3% (P < 0.001), respectively. CONCLUSION We identified a 31-gene expression signature that is closely associated with the clinical outcome of stage II/III CRC patients.
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Affiliation(s)
- Lisha Wang
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China. .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China. .,Institute of Pathology, Fudan University, Shanghai, 200032, China.
| | - Xiaohan Shen
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China. .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China. .,Institute of Pathology, Fudan University, Shanghai, 200032, China.
| | - Zhimin Wang
- Department of Genetics, Shanghai-MOST Key Laboratory of Health and Disease Genomics, Chinese National Human Genome Center and Shanghai Industrial Technology Institute, Shanghai, 201203, China.
| | - Xiuying Xiao
- Department of Oncology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, 200127, China.
| | - Ping Wei
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China. .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China. .,Institute of Pathology, Fudan University, Shanghai, 200032, China.
| | - Qifeng Wang
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China. .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China. .,Institute of Pathology, Fudan University, Shanghai, 200032, China.
| | - Fei Ren
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China. .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China. .,Institute of Pathology, Fudan University, Shanghai, 200032, China.
| | - Yiqin Wang
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China. .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China. .,Institute of Pathology, Fudan University, Shanghai, 200032, China.
| | - Zebing Liu
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China. .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China. .,Institute of Pathology, Fudan University, Shanghai, 200032, China.
| | - Weiqi Sheng
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China. .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China. .,Institute of Pathology, Fudan University, Shanghai, 200032, China.
| | - Wei Huang
- Department of Genetics, Shanghai-MOST Key Laboratory of Health and Disease Genomics, Chinese National Human Genome Center and Shanghai Industrial Technology Institute, Shanghai, 201203, China.
| | - Xiaoyan Zhou
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China. .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China. .,Institute of Pathology, Fudan University, Shanghai, 200032, China.
| | - Xiang Du
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China. .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China. .,Institute of Pathology, Fudan University, Shanghai, 200032, China. .,Institutes of Biomedical Sciences, Fudan University, Shanghai, 200032, China.
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Ward ST, Weston CJ, Hepburn E, Damery S, Hejmadi RK, Morton DG, Middleton G, Ismail T, Adams DH. Evaluation of serum lysyl oxidase as a blood test for colorectal cancer. Eur J Surg Oncol 2013; 40:731-8. [PMID: 24246612 DOI: 10.1016/j.ejso.2013.10.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Revised: 10/21/2013] [Accepted: 10/26/2013] [Indexed: 01/03/2023] Open
Abstract
AIMS Lysyl oxidase (LOX) expression is elevated in colorectal cancer (CRC) tissue and associated with disease progression. A blood test may form a more acceptable diagnostic test for CRC although LOX has not previously been measured in the serum. We therefore sought to determine the clinical usefulness of a serum LOX test for CRC in a symptomatic population. METHODS Adult patients referred to a hospital colorectal clinic with bowel symptoms completed a questionnaire and provided a blood sample for serum LOX measurement. Associations between presenting symptoms, serum LOX concentrations and outcomes of investigations were tested by univariate and multivariate analyses to determine if serum LOX was clinically useful in the prediction of CRC. LOX expression in CRC and adjacent colon biopsies was evaluated by ELISA and immunohistochemistry. RESULTS Thirty-one cases of colorectal cancer and 16 high-risk polyps were identified from a total of 962 participants. There was no association between serum LOX concentration and the presence of CRC, high-risk polyps or cancers at any site. LOX expression was significantly increased in CRC tissue compared to adjacent colon. CONCLUSION Despite overexpression of LOX in CRC tissue, elevated serum levels could not be demonstrated. Serum LOX measurement is therefore not a clinically useful test for CRC.
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Affiliation(s)
- S T Ward
- NIHR Biomedical Research Unit and Centre for Liver Research, University of Birmingham, Birmingham B15 2TT, UK; University Hospitals Birmingham, Edgbaston, Birmingham B15 2WB, UK.
| | - C J Weston
- NIHR Biomedical Research Unit and Centre for Liver Research, University of Birmingham, Birmingham B15 2TT, UK
| | - E Hepburn
- NIHR Biomedical Research Unit and Centre for Liver Research, University of Birmingham, Birmingham B15 2TT, UK; University Hospitals Birmingham, Edgbaston, Birmingham B15 2WB, UK
| | - S Damery
- NIHR Biomedical Research Unit and Centre for Liver Research, University of Birmingham, Birmingham B15 2TT, UK
| | - R K Hejmadi
- University Hospitals Birmingham, Edgbaston, Birmingham B15 2WB, UK
| | - D G Morton
- NIHR Biomedical Research Unit and Centre for Liver Research, University of Birmingham, Birmingham B15 2TT, UK; University Hospitals Birmingham, Edgbaston, Birmingham B15 2WB, UK
| | - G Middleton
- NIHR Biomedical Research Unit and Centre for Liver Research, University of Birmingham, Birmingham B15 2TT, UK; University Hospitals Birmingham, Edgbaston, Birmingham B15 2WB, UK
| | - T Ismail
- University Hospitals Birmingham, Edgbaston, Birmingham B15 2WB, UK
| | - D H Adams
- NIHR Biomedical Research Unit and Centre for Liver Research, University of Birmingham, Birmingham B15 2TT, UK
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