Abstract:
BACKGROUND:Integrated molecular pathology (IMP) approaches based on DNA mutational profiling accurately determine pancreatic cyst malignancy risk in patients lacking definitive diagnoses following endoscopic ultrasound imaging with fine-needle aspiration of fluid for cytology. In such cases, IMP 'low-risk' and 'high-risk' diagnoses reliably predict benign and malignant disease, respectively, and provide improved risk stratification for malignancy than a model of the 2012 International Consensus Guideline (ICG) recommendations. Our objective was to determine if initial adjunctive IMP testing influenced future real-world pancreatic cyst management decisions for intervention or surveillance relative to ICG recommendations, and if this benefitted patient outcomes. METHODS:Analysis of data from the previously described National Pancreatic Cyst Registry. Associations between real-world decisions (intervention vs. surveillance), ICG model recommendations (surgery vs. surveillance) and IMP diagnoses (high-risk vs. low-risk) were evaluated using 2 × 2 tables. Kaplan Meier and hazard ratio analyses were used to assess time to malignancy. Odds ratios (OR) for surgery decision were determined using logistic regression. RESULTS:Of 491 patients, 206 received clinical intervention at follow-up (183 surgery, 4 chemotherapy, 19 presumed by malignant cytology). Overall, 13 % (66/491) of patients had a malignant outcome and 87 % (425/491) had a benign outcome at 2.9 years' follow-up. When ICG and IMP were concordant for surveillance/surgery recommendations, 83 % and 88 % actually underwent surveillance or surgery, respectively. However, when discordant, IMP diagnoses were predictive of real-world decisions, with 88 % of patients having an intervention when ICG recommended surveillance but IMP indicated high risk, and 55 % undergoing surveillance when ICG recommended surgery but IMP indicated low risk. These IMP-associated management decisions benefitted patient outcomes in these subgroups, as 57 % had malignant and 99 % had benign outcomes at a median 2.9 years' follow-up. IMP was also more predictive of real-world decisions than ICG by multivariate analysis: OR 11.4 (95 % CI 6.0 - 23.7) versus 3.7 (2.4 - 5.8), respectively. CONCLUSIONS:DNA-based IMP diagnoses were predictive of real-world management decisions. Importantly, when ICG and IMP were discordant, IMP influence benefitted patients by increasing confidence in surveillance and surgery decisions and reducing the number of unnecessary surgeries in patients with benign disease.
journal_name
Diagn Patholjournal_title
Diagnostic pathologyauthors
Loren D,Kowalski T,Siddiqui A,Jackson S,Toney N,Malhotra N,Haddad Ndoi
10.1186/s13000-016-0462-xsubject
Has Abstractpub_date
2016-01-20 00:00:00pages
5issn
1746-1596pii
10.1186/s13000-016-0462-xjournal_volume
11pub_type
杂志文章abstract:BACKGROUND:Histologic grade is the most important predictor of the clinical outcome of non-muscle invasive (Ta, T1) papillary urothelial carcinoma (NMIPUCa), but its ambiguous criteria diminish its power to predict recurrence/progression for individual patients. We attempted to find an objective and reproducible histol...
journal_title:Diagnostic pathology
pub_type: 杂志文章,多中心研究
doi:10.1186/s13000-017-0639-y
更新日期:2017-07-24 00:00:00
abstract:BACKGROUND:Advancing knowledge in molecular pathogenesis of hepatocellular carcinoma (HCC) opens up new horizons in the diagnostic, prognostic and therapeutic perspectives. Assessing the expression of molecular targets prior to definitive treatment is gaining importance in clinical practice. In this study, we investiga...
journal_title:Diagnostic pathology
pub_type: 杂志文章
doi:10.1186/s13000-017-0649-9
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:GATA-binding protein 3 (GATA3) has been identified as a sensitive marker for breast carcinoma but its sensitivity in primary genital extramammary Paget diseases (EMPDs) has not been well studied. METHODS:Here we investigated immunohistochemical expression of GATA3 in 72 primary genital EMPDs (35 from female...
journal_title:Diagnostic pathology
pub_type: 杂志文章
doi:10.1186/s13000-017-0638-z
更新日期:2017-07-10 00:00:00
abstract:BACKGROUND:Malignant gastrointestinal neuroectodermal tumor (GNET) is an extremely rare entity that was first described by Zambrano et al. in 2003 as "Clear cell sarcoma-like tumor of the gastrointestinal tract". It shares some of the histological features of clear cell sarcoma (CCS) but lacks the immunohistochemical r...
journal_title:Diagnostic pathology
pub_type: 杂志文章,评审
doi:10.1186/s13000-017-0620-9
更新日期:2017-03-20 00:00:00
abstract:BACKGROUND:Adult granulosa cell tumors of the ovary (GCTs) are sex cord stromal tumors of unpredictable behaviour. Up to now, the prediction of the relapsing/malignant potential remains difficult. CD56 (NCAM) in GCTs was previously described in only two studies. However, the expression of its isoforms was not examined....
journal_title:Diagnostic pathology
pub_type: 杂志文章
doi:10.1186/1746-1596-3-29
更新日期:2008-07-09 00:00:00
abstract:BACKGROUND:Hyalinizing clear cell carcinoma (HCCC) is a rare low-grade tumour of salivary glands that was first described as a distinct entity in 1994 by Milchgrub et al. EWSR1-ATF1 fusion was found to be specific for this tumour. The majority of the reported cases of HCCC arise from minor salivary glands within the or...
journal_title:Diagnostic pathology
pub_type: 杂志文章
doi:10.1186/s13000-017-0659-7
更新日期:2017-09-25 00:00:00
abstract:BACKGROUND:This study is to investigate the expression of progranulin (PGRN) in systemic lupus erythematosus (SLE) patients and the effect of glucocorticoid (GC) treatment on its expression. METHODS:Thirty newly diagnosed severe SLE patients and 30 healthy subjects were enrolled in this study. The serum levels of PGRN...
journal_title:Diagnostic pathology
pub_type: 杂志文章
doi:10.1186/1746-1596-8-88
更新日期:2013-05-23 00:00:00
abstract:BACKGROUND:The Eastern Quebec Telepathology Network (called Réseau de Télépathologie de l'Est du Québec in French) was created to provide uniform diagnostic telepathology services in a huge territory with low population density. We report our first 3-year experience. METHODS:The network was funded equally by the Québe...
journal_title:Diagnostic pathology
pub_type: 杂志文章
doi:10.1186/1746-1596-9-S1-S1
更新日期:2014-01-01 00:00:00
abstract:BACKGROUND:Primary central nervous system (CNS) diffuse large B-cell lymphoma (DLBCL) is a rare intracranial tumor, defined as DLBCL arising from the brain, spinal cord, leptomeninges and eye, with an overall annual incidence of 5 cases per million. The primary CNS anaplastic variant of DLBCL (A-DLBCL) is even less com...
journal_title:Diagnostic pathology
pub_type: 杂志文章
doi:10.1186/s13000-019-0826-0
更新日期:2019-05-20 00:00:00
abstract::Non-necrotizing epithelioid granulomas have been described in association with many primary tumors. In such cases, they are designated as sarcoid-like reaction. Although it is more seen in carcinomas than in sarcomas, it is very rarely reported in renal carcinoma. Here, we describe a rare association of prominent peri...
journal_title:Diagnostic pathology
pub_type: 杂志文章
doi:10.1186/1746-1596-7-28
更新日期:2012-03-18 00:00:00
abstract:BACKGROUND:Spontaneous isolated dissection of the superior mesenteric artery (SMA) can lead to bowel ischemia, aneurysm rupture, or even death. Studies have suggested that mechanical or hemodynamic stress on the vascular wall of the SMA may be a contributor, but its pathogenesis is unclear. CASE PRESENTATION:A 57-year...
journal_title:Diagnostic pathology
pub_type: 杂志文章
doi:10.1186/s13000-017-0664-x
更新日期:2017-10-16 00:00:00
abstract:BACKGROUND:The occurrence of malignant lymphoma after delivery is an extremely rare event. Although several cases of Hodgkin lymphoma and B cell lymphoma and a few cases of peripheral T cell lymphoma (PTCL) after delivery have been reported, there are no report of autopsy cases of PTCL in the puerperal period. CASE PR...
journal_title:Diagnostic pathology
pub_type: 杂志文章
doi:10.1186/s13000-018-0707-y
更新日期:2018-05-22 00:00:00
abstract:BACKGROUND:ALCAM (activated leukocyte cell adhesion molecule, CD166, MEMD) is a transmembrane protein of immunoglobulin superfamily (Ig-SF) and plays an important role in human malignant melanoma progression and formation of locoregional and distant metastases. The study using melanoma cell lines showed that overexpres...
journal_title:Diagnostic pathology
pub_type: 杂志文章
doi:10.1186/s13000-015-0331-z
更新日期:2015-07-02 00:00:00
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journal_title:Diagnostic pathology
pub_type: 杂志文章
doi:10.1186/s13000-015-0284-2
更新日期:2015-05-02 00:00:00
abstract:BACKGROUND:Acute promyelocytic leukemia is a cytogenetically well defined entity. Nevertheless, some features observed at diagnosis are related to a worse outcome of the patients. METHODS:In a prospective study, we analyzed peripheral (PB) leukocyte count, immunophenotype, methylation status of CDKN2B, CDKN2A and TP73...
journal_title:Diagnostic pathology
pub_type: 杂志文章
doi:10.1186/1746-1596-7-75
更新日期:2012-06-28 00:00:00
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journal_title:Diagnostic pathology
pub_type: 杂志文章
doi:10.1186/1746-1596-8-52
更新日期:2013-03-28 00:00:00
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journal_title:Diagnostic pathology
pub_type: 杂志文章
doi:10.1186/s13000-015-0369-y
更新日期:2015-07-28 00:00:00
abstract:BACKGROUND:Gliomas are aggressive tumors of the central nervous system that rely on production of growth factors for tumor progression. Interleukin 8 (IL-8) is up-regulated in gliomas to promote angiogenesis and proliferation. The aim of this study was to evaluate the association of the IL-8 -251 T/A and +781 C/T polym...
journal_title:Diagnostic pathology
pub_type: 杂志文章
doi:10.1186/s13000-015-0378-x
更新日期:2015-08-07 00:00:00
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journal_title:Diagnostic pathology
pub_type: 杂志文章,meta分析,评审
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更新日期:2013-07-15 00:00:00
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journal_title:Diagnostic pathology
pub_type: 杂志文章,评审
doi:10.1186/1746-1596-8-194
更新日期:2013-12-02 00:00:00
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journal_title:Diagnostic pathology
pub_type: 杂志文章,评审
doi:10.1186/1746-1596-9-149
更新日期:2014-07-17 00:00:00
abstract::Over two million Americans are afflicted with schizophrenia, a debilitating mental health disorder with a unique symptomatic and epidemiological profile. Genomics studies have hinted towards candidate schizophrenia susceptibility chromosomal loci and genes. Modern proteomic tools, particularly mass spectrometry and ex...
journal_title:Diagnostic pathology
pub_type: 杂志文章
doi:10.1186/1746-1596-1-11
更新日期:2006-07-17 00:00:00
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journal_title:Diagnostic pathology
pub_type: 杂志文章
doi:10.1186/1746-1596-9-118
更新日期:2014-06-16 00:00:00
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journal_title:Diagnostic pathology
pub_type: 杂志文章
doi:10.1186/1746-1596-7-57
更新日期:2012-05-28 00:00:00
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journal_title:Diagnostic pathology
pub_type: 评论,社论
doi:10.1186/1746-1596-7-13
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:MicroRNA-100 (miR-100) has been demonstrated to be downregulated in bladder cancer tissues, and enforced expression of this miRNA may inhibit cell growth and colony formation of human bladder cancer 5637 cells in vitro. However, the clinical significance of miR-100 in human bladder cancer has not yet been elu...
journal_title:Diagnostic pathology
pub_type: 杂志文章
doi:10.1186/1746-1596-7-159
更新日期:2012-11-22 00:00:00
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journal_title:Diagnostic pathology
pub_type: 杂志文章
doi:10.1186/1746-1596-8-191
更新日期:2013-11-21 00:00:00
abstract:BACKGROUND:Transbronchial needle aspiration (TBNA) is a minimally invasive procedure performed to diagnose lymph node (LN) adenopathy. TBNA with and without endobronchial ultrasound (EBUS) guidance has a high diagnostic yield for malignant LN enlargement, but the value for diagnosing benign LN enlargement has been less...
journal_title:Diagnostic pathology
pub_type: 杂志文章
doi:10.1186/s13000-020-00958-4
更新日期:2020-04-15 00:00:00
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journal_title:Diagnostic pathology
pub_type: 杂志文章
doi:10.1186/1746-1596-7-16
更新日期:2012-02-14 00:00:00
abstract:BACKGROUND:Preventive and therapeutic options for renal failure are still limited. Gene expression profile analysis is powerful in the identification of biological differences between end stage renal failure patients and healthy controls. Previous studies mainly used variance/regression analysis without considering var...
journal_title:Diagnostic pathology
pub_type: 杂志文章
doi:10.1186/1746-1596-9-137
更新日期:2014-07-05 00:00:00