• Title/Summary/Keyword: Prognosis prediction

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Controversies in Usefulness of EEG for Clinical Decision in Epilepsy: Cons. (간질 치료에서 뇌파의 임상적 유용성에 관한 논란: 부정적 관점에서)

  • Lee, Seo-Young;Lee, Sang-Kun;Kim, Nam Hee
    • Annals of Clinical Neurophysiology
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    • v.9 no.2
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    • pp.69-74
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    • 2007
  • Electroencephalogram (EEG) is a representative diagnostic tool in epilepsy. However, there are several points of debate on the role of EEG in diagnosis and management of epilepsy. We suggest that EEG has some limitations for differential diagnosis from nonepileptic episodic diseases, classification of epilepsy, prediction of recurrence, and evaluation of treatment response. Interictal EEG cannot diagnose or exclude epilepsy because interictal epileptic discharge (IED) is frequently absent in epilepsy and can appear in nonepileptic conditions. Although EEG is helpful in classification of epilepsy, focal spikes in generalized epilepsy and secondary bilateral synchrony in localization related epilepsy cause interrater disagreement. It is controversial whether EEG predicts recurrence after the first seizure in adults. The predictive value of EEG in antiepileptic drug (AED) withdrawal is not absolute. The prognosis after AED withdrawal depends on epilepsy syndrome. Many studies could not confirm the value of EEG in assessing the treatment response. After all, epilepsy is clinically diagnosed and assessed. Interictal EEG alone does not provide decisive information and routine follow-up of EEG is not recommended.

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Circulating DNA in Egyptian Women with Breast Cancer

  • Ibrahim, Iman Hassan;Kamel, Mahmoud M;Ghareeb, Mohamed
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.6
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    • pp.2989-2993
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    • 2016
  • The commonest cancer in Egyptian females occurs in the breast cfDNA is a non-invasive marker for tumor detetion and prognostic assessment in many types of cancer including breast cancer. This study aimed to assess the role of cfDNA and its fragmentation pattern in breast cancer prognosis and treatment response. Forty female patients with malignant breast tumors and a comparable group of healthy blood donors were enrolled prospectively. cfDNA levels and fragmentation patterns were investigated after cfDNA extraction, gel electrophoresis and gel analysis. The percentage of breast cancer patients positive for cfDNA (92.5%) was significantly higher than that of controls (55%). Also, mean concentration of cfDNA was significantly higher than in the control group (P<0.05). Most Her-2 positive patients had long cfDNA fragments, this being significant as compared to Her-2 negative patients (P<0.05). Metastasis was also positively linked to significantly higher cfDNA (P<0.05) and the mean cfDNA integrity index was significantly higher in non-responders compared to treatment responders (P<0.05). In conclusion, both qualitative and quantitative aspects of cfDNA and its different fragments in breast cancer patients could be related to prognosis, metastasis and treatment response. Long cfDNA fragments could be particularly useful for prediction purposes.

A Korean Case of Neonatal Nemaline Myopathy Carrying KLHL40 Mutations Diagnosed Using Next Generation Sequencing

  • Suh, Yoong-a;Sohn, Young Bae;Park, Moon Sung;Lee, Jang Hoon
    • Neonatal Medicine
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    • v.28 no.2
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    • pp.89-93
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    • 2021
  • Nemaline myopathy is a genetically heterogeneous neuromuscular disorder and one of the most common congenital myopathies. The clinical manifestations usually vary depending on the age of onset. Neonatal nemaline myopathy has the worst prognosis, primarily due to respiratory failure. Several genes associated with nemaline myopathy have been identified, including NEB, ACTA1, TPM3, TPM2, TNNT1, CFL2, KBTBD13, KLHL40, KLHL41, LMOD3, and KBTBD13. Here, we report a neonatal Korean female patient with nemaline myopathy carrying compound heterozygous mutations in the gene KLHL40 as revealed using next generation sequencing (NGS). The patient presented with postnatal cyanosis, respiratory failure, dysphagia, and hypotonia just after birth. To identify the genetic cause underlying the neonatal myopathy, NGS-based gene panel sequencing was performed. Compound heterozygous pathogenic variants were detected in KLHL40: c.[1405G>T];[1582G>A] (p. [Gly469cys];[Glu528Lys]). NGS allows quick and accurate diagnosis at a lower cost compared to traditional serial single gene sequencing, which is greatly advantageous in genetically heterogeneous disorders such as myopathies. Rapid diagnosis will facilitate efficient and timely genetic counseling, prediction of disease prognosis, and establishment of treatments.

Analysis of Domestic Research Trends on Artificial Intelligence-Based Prognostics and Health Management (인공지능 기반 건전성 예측 및 관리에 관한 국내 연구 동향 분석)

  • Ye-Eun Jeong;Yong Soo Kim
    • Journal of Korean Society for Quality Management
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    • v.51 no.2
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    • pp.223-245
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    • 2023
  • Purpose: This study aim to identify the trends in AI-based PHM technology that can enhance reliability and minimize costs. Furthermore, this research provides valuable guidelines for future studies in various industries Methods: In this study, I collected and selected AI-based PHM studies, established classification criteria, and analyzed research trends based on classified fields and techniques. Results: Analysis of 125 domestic studies revealed a greater emphasis on machinery in both diagnosis and prognosis, with more papers dedicated to diagnosis. various algorithms were employed, including CNN for image diagnosis and frequency analysis for signal data. LSTM was commonly used in prognosis for predicting failures and remaining life. Different industries, data types, and objectives required diverse AI techniques, with GAN used for data augmentation and GA for feature extraction. Conclusion: As studies on AI-based PHM continue to grow, selecting appropriate algorithms for data types and analysis purposes is essential. Thus, analyzing research trends in AI-based PHM is crucial for its rapid development.

Machine learning application in ischemic stroke diagnosis, management, and outcome prediction: a narrative review (허혈성 뇌졸중의 진단, 치료 및 예후 예측에 대한 기계 학습의 응용: 서술적 고찰)

  • Mi-Yeon Eun;Eun-Tae Jeon;Jin-Man Jung
    • Journal of Medicine and Life Science
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    • v.20 no.4
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    • pp.141-157
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    • 2023
  • Stroke is a leading cause of disability and death. The condition requires prompt diagnosis and treatment. The quality of care provided to patients with stroke can vary depending on the availability of medical resources, which in turn, can affect prognosis. Recently, there has been growing interest in using machine learning (ML) to support stroke diagnosis and treatment decisions based on large medical data sets. Current ML applications in stroke care can be divided into two categories: analysis of neuroimaging data and clinical information-based predictive models. Using ML to analyze neuroimaging data can increase the efficiency and accuracy of diagnoses. Commercial software that uses ML algorithms is already being used in the medical field. Additionally, the accuracy of predictive ML models is improving with the integration of radiomics and clinical data. is expected to be important for improving the quality of care for patients with stroke.

Prognostic Value of C-Reactive Protein in Esophageal Cancer: a Meta-analysis

  • Zheng, Tian-Liang;Cao, Ke;Liang, Cui;Zhang, Kai;Guo, Hai-Zhou;Li, De-Ping;Zhao, Song
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.19
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    • pp.8075-8081
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    • 2014
  • Background: The classical inflammatory biomarker, C-reactive protein (CRP), has been identified to be related to progression of esophageal cancer. Some research showed that elevated pretreatment serum CRP indicated a poor prognosis, but results have been inconsistent. Materials and Methods: We searched the Medline, Embase and the Cochrane Central Search Library for suitable studies and a meta-analysis of eleven (1,886 patients) was conducted to examine the relationship between elevated serum CRP level and overall survival (OS) in esophageal cancer cases. Moreover, correlation analyses were conducted to assess links between pretreatment serum CRP level and tumor node metastasis (TNM) stage as well as T, N, M grade, respectively. Results: The pooled analysis showed that elevated pretreatment serum CRP level was significantly associated with poorer overall survival (HR 2.09, 95%CI 1.52-2.87, p<0.01). Subgroup analyses were conducted by "country", "cut-off value", "treatment" and "number of patients", and no single factor could alter the result. Elevated pretreatment serum CRP was significantly correlated with more advanced TNM stage and T, N, M grade respectively. Conclusions: Elevated pretreatment serum CRP levels are associated with poorer prognosis in esophageal cancer patients, and could serve as a useful biomarker for outcome prediction.

Prognostic Value of Vascular Endothelial Growth Factor Expression in Resected Gastric Cancer

  • Liu, Lei;Ma, Xue-Lei;Xiao, Zhi-Lan;Li, Mei;Cheng, Si-Hang;Wei, Yu-Quan
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.7
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    • pp.3089-3097
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    • 2012
  • Background and Aims: Vascular endothelial growth factor (VEGF) is a potential prognostic biomarker for patients with resected gastric cancer. However, its role remains controversial. The objective of this study was to conduct a systematic review and meta-analysis of published literature. Methods: Relevant literature was identified using Medline and survival data from published studies were collected following a methodological assessment. Quality assessment of eligible studies and meta-analysis of hazard ratio (HR) were performed to review the correlation of VEGF overexpression with survival and recurrence in patients with gastric cancer. Results: Our meta-analysis included 44 published studies with 4,794 resected patients. VEGF subtype for the prediction of overall survival (OS) included tissue VEGF (HR=2.13, 95% CI 1.71-2.65), circulating VEGF (HR=4.22, 95% CI 2.47-7.18), tissue VEGF-C (HR=2.21, 95% CI 1.58-3.09), tissue VEGF-D (HR=1.73, 95% CI 1.25-2.40). Subgroup analysis showed that HRs of tissue VEGF for OS were, 1.78 (95% CI 0.90-3.51) and 2.31 (95% CI 1.82-2.93) in non-Asians and Asians, respectively. The meta-analysis was also conducted for disease free survival (DFS) and disease specific survival (DSS). Conclusion: Positive expression of tissue VEGF, circulating VEGF, VEGF-C and VEGF-D were all associated with poor prognosis in resected gastric cancer. However, VEGF demonstrated no significant prognostic value for non-Asian populations. Circulating VEGF may be better than tissue VEGF in predicting prognosis.

Overexpression of Semaphorin4D Indicates Poor Prognosis and Prompts Monocyte Differentiation toward M2 Macrophages in Epithelial Ovarian Cancer

  • Chen, Ying;Zhang, Lei;Lv, Rui;Zhang, Wen-Qi
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.10
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    • pp.5883-5890
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    • 2013
  • Previously, we demonstrated overexpression of semaphorin4D (SEMA4D, CD100) to be closely related to tumor angiogenesis in epithelial ovarian cancers (EOCs). However, the function and expression of SEMA4D in the EOC microenvironment has yet to be clarified in detail. In this study, we confirmed that overexpression of SEMA4D in primary tumors and ascites was related to low differentiation, platinum resistance and a refractory status (P<0.05), while high M2 macrophage count and percentage were evident in EOC patients with advanced FIGO stage and platinum resistance (P<0.05), using immunohistochemistry, enzyme-linked immunosorbent assay (ELISA), and fluorescence-activated cell sorting (FACS), respectively. The data showed correlations of SEMA4D expression and M2 macrophage counts in primary tumors and M2 macrophage percentage in ascites (r=0.281 and 0.355, each P<0.05). In the Cox proportional hazard mode, SEMA4D expression was an independent indicator of overall survival (OS) and progression-free survival (PFS) for EOC patients. Furthermore, higher expression of SEMA4D in ovarian cancer cell lines (SKOV3, A2780, and SW626) and their supernatants were found than that in a human primary cultured ovarian cell and its supernatant by reversed transcript PCR (RT-PCR), Western blotting and ELISA, respectively. Interestingly, peripheral blood monocytes (MOs) tended towards the M2-polarized macrophage phenotype ($CD163^{high}$) in vitro after human recombined soluble SEMA4D protein stimulation. These findings suggest that SEMA4D might possibly serve as a reliable tool for early and accurate prediction of EOC poor prognosis and could playan important role in promoting tumor dissemination and metastasis in the EOC microenvironment. Thus SEMA4D and its role in macrophage polarization in EOC warrants further study.

Associations of ABCB1 and XPC Genetic Polymorphisms with Susceptibility to Colorectal Cancer and Therapeutic Prognosis in a Chinese Population

  • Yue, Ai-Min;Xie, Zhen-Bin;Zhao, Hong-Feng;Guo, Shu-Ping;Shen, Yu-Hou;Wang, Hai-Pu
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.5
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    • pp.3085-3091
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    • 2013
  • Associations between ABCB1 and XPC genetic polymorphisms and risk of developing colorectal cancer (CRC) as well as clinical outcomes in CRCs with chemotherapy were investigated. A case-control study was performed on the ABCB1 C3435T, G2677T/A and XPC Lys939Gln polymorphisms in 428 CRC cases and 450 hospitalbased, age and sex frequency-matched controls using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assays. We observed that the ABCB1 3435CT or CC+CT variants were significantly linked with increasing risk of developing CRC (adjusted OR (95% CI): 1.814 (1.237-2.660), P=0.0022; adjusted OR (95% CI): 1.605 (1.117-2.306), P=0.0102, respectively). Moreover, the distribution frequency of XPC AC genotype or AC+CC genotypes also showed a tendency towards increasing the suscepbility for CRC (P=0.0759 and P=0.0903, respectively). Kaplan-Meier curves showed that the ABCB1 C3435T variant was associated with a tendency toward longer progression-free survival (PFS) (n=343, Log-rank test: P=0.063), and the G2677T/A variant genotypes (GT+TT+GA+AA) with a tendency for longer OS in postoperative oxaliplatin-based patients (n=343, Log-rank test: P=0.082). However, no correlation of the XPC Lys939Gln polymorphism was found with PFS and OS in patients with postoperative oxaliplatin-based chemotherapy (n=343). Our study indicated that ABCB1 polymorphisms might be candidate pharmacogenomic factors for the prediction of CRC susceptibility, but not for prognosis with oxaliplatin chemosensitivity in CRC patients.

Clinical Significance of Detecting Lymphatic and Blood Vessel Invasion in Stage II Colon Cancer Using Markers D2-40 and CD34 in Combination

  • Lai, Jin-Huo;Zhou, Yong-Jian;Bin, Du;Qiangchen, Qiangchen;Wang, Shao-Yuan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.3
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    • pp.1363-1367
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    • 2014
  • This research was conducted to compare differences in colon cancer lymphatic vessel invasion (LVI) with D2-40 antibody labeling and regular HE staining, blood vessel invasion (BVI) with CD34 antibody labeling and HE staining and to assess the possibility of using D2-40-LVI/CD34-BVI in combination for predicting stage II colon cancer prognosis and guiding adjuvant chemotherapy.Anti-D2-40 and anti-CD34 antibodies were applied to tissue samples of 220 cases of stage II colon cancer to label lymphatic vessels and small blood vessels, respectively. LVI and BVI were assessed and multivariate COX regression analysis was performed for associations with colon cancer prognosis. Regular HE staining proved unable to differentiate lymphatic vessels from blood vessels, while D2-40 selectively labeled lymphatic endothelial cell cytosol and CD34 was widely expressed in large and small blood vessels of tumors as well as normal tissues. Compared to regular HE staining, D2-40-labeling for LVI and CD34-labeling for BVI significantly increased positive rate (22.3% vs 10.0% for LVI, and 19.1% vs 9.1% for BVI). Multivariate analysis indicated that TNM stage, pathology tissue type, post-surgery adjuvant chemotherapy, D2-40-LVI, and CD34-BVI were independent factors affecting whole group colon cancer prognosis, while HE staining-BVI, HE staining-LVI were not significantly related. When CD34-BVI/D2-40-LVI were used in combination for detection, the risk of death for patients with two or one positive results was 5.003 times that in the LVI(-)&BVI(-) group (95% CI 2.365 - 9.679). D2-40 antibody LVI labeling and CD34 antibody BVI labeling have higher specificity and accuracy than regular HE staining and can be used as molecular biological indicators for prognosis prediction and guidance of adjuvant chemotherapy for stage II colon cancer.