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Lafuente-Ganuza P, Lequerica-Fernandez P, Carretero F, Escudero AI, Martinez-Morillo E, Sabria E, Herraiz I, Galindo A, Lopez A, Martinez-Triguero ML, Alvarez FV. A more accurate prediction to rule in and rule out pre-eclampsia using the sFlt-1/PlGF ratio and NT-proBNP as biomarkers. Clin Chem Lab Med 2021; 58:399-407. [PMID: 31734648 DOI: 10.1515/cclm-2019-0939] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 10/12/2019] [Indexed: 12/16/2022]
Abstract
Background The management of potential pre-eclamptic patients using the soluble FMS-like tyrosine kinase 1 (sFlt-1)/ placental growth factor (PlGF) ratio is characterised by frequent false-positive results. Methods A retrospective cohort study was conducted to identify and validate cut-off values, obtained using a machine learning model, for the sFlt-1/PlGF ratio and NT-proBNP that would be predictive of the absence or presence of early-onset pre-eclampsia (PE) in singleton pregnancies presenting at 24 to 33 + 6 weeks of gestation. Results For the development cohort, we defined two sFlt-1/PlGF ratio cut-off values of 23 and 45 to rule out and rule in early-onset PE at any time between 24 and 33 + 6 weeks of gestation. Using an sFlt-1/PlGF ratio cut-off value of 23, the negative predictive value (NPV) for the development of early-onset PE was 100% (95% confidence interval [CI]: 99.5-100). The positive predictive value (PPV) of an sFlt-1/PlGF ratio >45 for a diagnosis of early-onset PE was 49.5% (95% CI: 45.8-55.6). When an NT-proBNP value >174 was combined with an sFlt-1/PlGF ratio >45, the PPV was 86% (95% CI: 79.2-92.6). In the validation cohort, the negative and positive values were very similar to those found for the development cohort. Conclusions An sFlt-1/PlGF ratio <23 rules out early-onset PE between 24 and 33 + 6 weeks of gestation at any time, with an NPV of 100%. An sFlt-1/PlGF ratio >45 with an NT-proBNP value >174 significantly enhances the probability of developing early-onset PE.
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Affiliation(s)
- Paula Lafuente-Ganuza
- Clinical Biochemistry, Laboratory Medicine, Hospital Universitario Central de Asturias, Avenida de Roma, s/n, 33011 Oviedo, Spain
| | - Paloma Lequerica-Fernandez
- Clinical Biochemistry, Laboratory Medicine, Hospital Universitario Central de Asturias, Avenida de Roma, s/n, 33011 Oviedo, Spain
| | | | - Ana I Escudero
- Obstetrics and Gynaecology Department, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Eduardo Martinez-Morillo
- Clinical Biochemistry, Laboratory Medicine, Hospital Universitario Central de Asturias, Avenida de Roma, s/n, 33011 Oviedo, Spain
| | - Enric Sabria
- Obstetrics and Gynaecology Department, Hospital-Residencia Sant Camil, Barcelona, Spain
| | - Ignacio Herraiz
- Fetal Medicine Unit, Maternal and Child Health and Development Network, Department of Obstetrics and Gynaecology, University Hospital 12 de Octubre, Complutense University of Madrid, Madrid, Spain
| | - Alberto Galindo
- Fetal Medicine Unit, Maternal and Child Health and Development Network, Department of Obstetrics and Gynaecology, University Hospital 12 de Octubre, Complutense University of Madrid, Madrid, Spain
| | - Ana Lopez
- Clinical Laboratory, University Hospital 12 de Octubre, Madrid, Spain
| | | | - Francisco V Alvarez
- Clinical Biochemistry, Laboratory Medicine, Hospital Universitario Central de Asturias, Avenida de Roma, s/n, 33011 Oviedo, Spain
- Department of Biochemistry and Molecular Biology, Universidad de Oviedo, Oviedo, Spain
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de Vicente JC, Torre-Iturraspe A, Gutierrez AM, Lequerica-Fernandez P. Immunohistochemical comparative study of the odontogenic keratocysts and other odontogenic lesions. Med Oral Patol Oral Cir Bucal 2010; 15:e709-15. [DOI: 10.4317/medoral.15.e709] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2009] [Accepted: 01/13/2010] [Indexed: 11/05/2022] Open
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de Vicente JC, Olay S, Lequerica-Fernandez P, Sánchez-Mayoral J, Junquera LM, Fresno MF. Expression of Bcl-2 but not Bax has a prognostic significance in tongue carcinoma. J Oral Pathol Med 2006; 35:140-5. [PMID: 16454809 DOI: 10.1111/j.1600-0714.2006.00378.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Among the molecular mechanisms involved in carcinogenesis, defects in the regulation of programmed cell death (apoptosis) make important contributions to the pathogenesis and progression of cancer. Apoptosis regulatory genes include the antiapoptotic bcl-2 gene and the proapoptotic bax gene. The aim of this study was to determine the spectrum of Bax and Bcl-2 expression, and to correlate these findings with clinicopathologic variables and prognosis. METHODS In this study we have evaluated the immunohistochemical expression of Bcl-2 and Bax proteins in a series of 35 squamous cell carcinomas of the tongue. RESULTS Immunoreactivity for Bax was detected in 37.1% and for Bcl-2 in 8.6% of cells, and for both proteins the staining was cytoplasmic and granular. Bcl-2 and Bax expression was mainly seen in peripheral cells of epithelial tumor islands with decreasing immunoreactivity toward the center of the neoplastic nests. Bax immunoexpression was significantly correlated with histologic grading (P=0.05), but not with the remaining clinicopathologic variables. Bcl-2 immunoreactivity was significantly correlated with N-stage (P=0.01) and survival. Patients with Bcl-2-negative tumors [mean survival: 73.97 months; 95% confidence interval (CI): 59-88] vs. Bcl-2-positive ones (mean survival: 17.67 months; 95% CI: 6-29) had a longer survival (P=0.01; odds ratio=6.9). CONCLUSIONS Bcl-2 is associated with aggressive disease, neck lymph node metastasis, and poor prognosis. Whereas Bax is related with histologic grade.
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Affiliation(s)
- Juan Carlos de Vicente
- Servicio de Cirugía Maxilofacial, Hospital Universitario Central de Asturias, Facultad de Medicina y Odontología, Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Oviedo, Spain.
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