• Asian Pacific Journal of Cancer Prevention
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• v.16 no.16
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• pp.6923-6928
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• 2015

Background: Early detection of various kinds of cancers nowadays is needed including colorectal cancer due to the highly significant effects in improving cancer treatment. The aim of this study was to evaluate the potential value of adiponectin, visfatin and resistin as early biomarkers for colorectal cancer patients. Materials and Methods: Serum levels of adiponectin, visfatin and resistin were measured by a sandwich-enzyme-linked (ELISA) assay technique in 114 serum samples comprising 34 patients with colorectal cancer (CRC), 27 with colonic polyps (CP), 24 with inflammatory bowel disease (IBD) and 29 healthy controls. The diagnostic accuracy of each serum marker was evaluated using receiver-operating characteristic (ROC) curve analysis. Results: The mean concentration of adiponectin was significantly higher in CRC and CP groups than IBD and control groups (P-value <0.05). Also the mean concentration of serum resistin was significantly elevated in the IBD and control groups compared to CRC and CP groups (P-value = 0.014). However, no significant difference was noted in patients of the CRC and CP groups. On the other hand, the mean concentration of visfatin was significantly elevated in CRC and control groups compared to CP and IBD groups (P-value = 0.03). ROC analysis curves for the studied markers revealed that between CRC and IBD groups serum level of adiponectin had a sensitivity of 76.7% and a specificity of 76% at a cut off value of 3940, +LR being 3.2 and -LR 0.31 with AUC 0.852, while serum level of adiponectin between CP and IBD had a sensitivity of 77.8% and a specificity of 75% at a cut off value of 3300, with +LR=3.11 and -LR = 0.3 with AUC 0.852. On the other hand the serum level of visfatin between CRC and CP groups had a sensitivity of 65.5% and a specificity of 66.7 at a cut off value of 2.4, +LR being 1.67 and -LR 0.52 with AUC 0.698. Also the serum level of resistin had a sensitivity of 62.5% and a specificity of 70.3% at a cut off value of 24500, with +LR=2.1 and -LR = 0.53 with AUC 0.685 between control and other groups. On the other hand by comparing control vs CP groups resistin had a sensitivity of 81.8% and a specificity of 70.8% at a cut off value of 17700, with +LR=2.8 and -LR = 0.26 with AUC 0.763 while visfatin had a sensitivity of 68.2% and a specificity of 70.8% at a cut off value of 2.7, with +LR=2.34 and -LR = 0.0.45 with AUC 0.812. Conclusions: These findings support potential roles of adiponectin, visfatin and resistin in early detection of CRC and discrimination of different groups of CRC, CP or IBD patients from normal healthy individuals.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.11
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• pp.5427-5432
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• 2012

Background and Purpose: Ovarian cancer is the leading cause of death among gynecologic cancers because of the lack of effective early detection methods. Accuracies of the human epididymis protein 4 (HE4) and mesothelin in detecting ovarian cancer have never been systematically assessed. The current systematic review aimed to tackle this issue. Methods: MEDLINE, EMBASE, and Cochrane databases were searched (September 1995-November 2011) for studies on the diagnostic performances of HE4 and mesothelin in differentiating ovarian cancer from other benign gynecologic diseases. QUADAS items were used to evaluate the qualities of the studies. Meta-DiSc software was used to handle data from the included studies and to examine heterogeneity. All included studies for diagnostic performance were combined with sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratios (DORs) with 95% confidence intervals (CIs), summary receiver operating characteristic (SROC) curves, and areas under the SROC curves (AUC). Results: A total of 18 studies and 3,865 patients were eligible for the final analysis. The pooled sensitivity estimates for HE4 (74.4%) were significantly higher than those for mesothelin (49.3%). The pooled specificity estimates for mesothelin (94.5%) were higher than those for HE4 (85.8%). The pooled DOR estimates for HE4 (26.22) were higher than those for mesothelin (24.01). The SROC curve for HE4 showed better diagnostic accuracy than that for mesothelin. The PLR and NLR of HE4 were 6.33 (95% CI: 3.58 to 11.18) and 0.27 (95% CI: 0.21 to 0.34), respectively. The PLR and NLR for mesothelin were 11.0 (95% CI: 6.21 to 19.59) and 0.51 (95% CI: 0.42 to 0.62), respectively. The combination of the two tumor markers or their combination with CA-125 increased sensitivity and specificity to different extents. Conclusion: The diagnostic accuracy of HE4 in differentiating ovarian cancer from other benign gynecologic diseases is better than that of soluble mesothelin-related protein. Combinations of two or more tumor markers show more sensitivity and specificity.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.9
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• pp.4745-4749
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• 2012

The diagnosis of malignant mesothelioma (MM) remains a clinical challenge and the fluorescence in situ hybridization (FISH) assay has been reported to be one promising tool. The present meta-analysis aimed to establish the overall diagnostic accuracy of FISH for diagnosing MM. After a systematic review of English language studies, the sensitivity, specificity and other measures of accuracy of FISH in the diagnosis of MM were pooled using random-effects models. Summary receiver operating characteristic curves were applied to summarize overall test performance. Nine studies met our inclusion criteria, the pooled sensitivity and specificity for FISH for diagnosing MM being 0.72 (95% CI 0.67-0.76) and 1.00 (95% CI 0.98-1.00), respectively. The positive likelihood ratio was 34.5 (95% CI 14.5-82.10), the negative likelihood ratio was 0.24 (95% CI 0.16-0.36), and the diagnostic odds ratio was 204.9 (95% CI 76.8-546.6), the area under the curve being 0.99. Our data suggest that the FISH assay is likely to be a useful diagnostic tool for confirming MM. However, considering the limited studies and patients included, further large scale studies are needed to confirm these findings.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.9
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• pp.4469-4475
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• 2012

Background: The potential use of hypomethylation of Long INterspersed Element 1 (LINE-1) and Alu elements (Alu) as a biomarker has been comprehensively assessed in several cancers, including head and neck squamous cell carcinoma (HNSCC). Failure to detect occult metastatic head and neck tumors on radical neck lymph node dissection can affect the therapeutic measures taken. Objective: The aim of this study was to investigate the LINE-1 and Alu methylation status and determine whether it can be applied for detection of occult metastatic tumors in HNSCC cases. Methods: We used the Combine Bisulfite Restriction Analysis (COBRA) technique to analyse LINE-1 and Alu methylation status. In addition to the methylation level, LINE-1 and Alu loci were classified based on the methylation statuses of two CpG dinucleotides in each allele as follows: hypermethylation ($^mC^mC$), hypomethylation ($^uC^uC$), and 2 forms of partial methylation ($^mC^uC$ and $^uC^mC$). Sixty-one lymph nodes were divided into 3 groups: 1) non-metastatic head and neck cancer (NM), 2) histologically negative for tumor cells of cases with metastatic head and neck cancer (LN), and 3) histologically positive for tumor cells (LP). Results: Alu methylation change was not significant. However, LINE-1 methylation of both LN and LP was altered, as demonstrated by the lower LINE-1 methylation levels (p<0.001), higher percentage of $^mC^uC$ (p<0.01), lower percentage of $^uC^mC$ (p<0.001) and higher percentage of $^uC^uC$ (p<0.001). Using receiver operating characteristic (ROC) curve analysis, $%^uC^mC$ and $%^mC^uC$ values revealed a high level of AUC at 0.806 and 0.716, respectively, in distinguishing LN from NM. Conclusion: The LINE-1 methylation changes in LN have the same pattern as that in LP. This epigenomic change may be due to the presence of occult metastatic tumor in LN cases.

• Investigative Magnetic Resonance Imaging
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• v.21 no.3
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• pp.154-161
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• 2017

Purpose: To evaluate the diagnostic performance of diffusion-weighted steady-state free precession (DW-SSFP) in comparison to diffusion-weighted echo-planar imaging (DW-EPI) for differentiating the neoplastic and benign osteoporotic vertebral compression fractures. Materials and Methods: The subjects were 40 patients with recent vertebral compression fractures but no history of vertebroplasty, spine operation, or chemotherapy. They had received 3-Tesla (T) spine magnetic resonance imaging (MRI), including both DW-SSFP and DW-EPI sequences. The 40 patients included 20 with neoplastic vertebral fracture and 20 with benign osteoporotic vertebral fracture. In each fracture lesion, we obtained the signal intensity normalized by the signal intensity of normal bone marrow (SI norm) on DW-SSFP and the apparent diffusion coefficient (ADC) on DW-EPI. The correlation between the SI norm and the ADC in each lesion was analyzed using linear regression. The optimal cut-off values for the diagnosis of neoplastic fracture were determined in each sequence using Youden's J statistics and receiver operating characteristic curve analyses. Results: In the neoplastic fracture, the median SI norm on DW-SSFP was higher and the median ADC on DW-EPI was lower than the benign osteoporotic fracture (5.24 vs. 1.30, P = 0.032, and 0.86 vs. 1.48, P = 0.041, respectively). Inverse linear correlations were evident between SI norm and ADC in both neoplastic and benign osteoporotic fractures (r = -0.45 and -0.61, respectively). The optimal cut-off values for diagnosis of neoplastic fracture were SI norm of 3.0 in DW-SSFP with the sensitivity and specificity of 90.4% (95% confidence interval [CI]: 81.0-99.0) and 95.3% (95% CI: 90.0-100.0), respectively, and ADC of 1.3 in DW-EPI with the sensitivity and specificity of 90.5% (95% CI: 80.0-100.0) and 70.4% (95% CI: 60.0-80.0), respectively. Conclusion: In 3-T MRI, DW-SSFP has comparable sensitivity and specificity to DW-EPI in differentiating the neoplastic vertebral fracture from the benign osteoporotic vertebral fracture.

• Investigative Magnetic Resonance Imaging
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• v.24 no.1
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• pp.38-45
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• 2020

Background: Differentiation of cerebellopontine angle (CPA) schwannoma from meningioma is often a difficult process to identify. Purpose: To identify imaging features for distinguishing CPA schwannoma from meningioma and to investigate the usefulness of susceptibility-weighted imaging (SWI) in differentiating them. Materials and Methods: Between March 2010 and January 2015, this study pathologically confirmed 11 meningiomas and 20 schwannomas involving CPA with preoperative SWI were retrospectively reviewed. Generally, the following MRI features were evaluated: 1) maximal diameter on axial image, 2) angle between tumor border and adjacent petrous bone, 3) presence of intratumoral dark signal intensity on SWI, 4) tumor consistency, 5) blood-fluid level, 6) involvement of internal auditory canal (IAC), 7) dural tail, and 8) involvement of adjacent intracranial space. On CT, 1) presence of dilatation of IAC, 2) intratumoral calcification, and 3) adjacent hyperostosis were evaluated. All features were compared using Chi-squared tests and Fisher's exact tests. The univariate and multivariate logistic regression analysis were performed to identify imaging features that differentiate both tumors. Results: The results noted that schwannomas more frequently demonstrated dark spots on SWI (P = 0.025), cystic consistency (P = 0.034), and globular angle (P = 0.008); schwannomas showed more dilatation of internal auditory meatus and lack of calcification (P = 0.008 and P = 0.02, respectively). However, it was shown that dural tail was more common in meningiomas (P < 0.007). In general, dark spots on SWI and dural tail remained significant in multivariate analysis (P = 0.037 and P = 0.012, respectively). In this case, the combination of two features showed a sensitivity and specificity of 80% and 100% respectively, with an area under the receiver operating characteristic curve of 0.9. Conclusion: In conclusion, dark spots on SWI were found to be helpful in differentiating CPA schwannoma from meningioma. It is noted that combining dural tail with dark spots on SWI yielded strong diagnostic value in differentiating both tumors.

• Journal of the korean academy of Pediatric Dentistry
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• v.45 no.3
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• pp.354-362
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• 2018

Periogen is a new caries activity test using real-time polymerase chain reaction. The aim of this study was to assess the validity of Periogen by evaluating the correlation with dmft, dmfts indices and comparing with Cariview and caries risk assessment tool (CAT). 83 children under 6 participated in this study. Dmft, dmfts indices and CAT were collected through an examination of oral health status. Plaque samples for Periogen and Cariview were collected and manipulated according to the manufactures' instructions. The correlation coefficient of Periogen, Cariview and CAT with the dmfts index were 0.38, 0.56 and 0.66 in each (p < 0.01). The sensitivity of Periogen, Cariview and CAT were 43%, 76% and 95% and specificity were 80%, 72% and 74% respectively. Area under curve under the receiver operating characteristic curves in each method indicated 0.69, 0.81 and 0.85. CAT and Cariview were more effective in evaluation the risk of dental caries than Periogen so far. To be used Periogen clinically, more improvements for higher validity were needed.

• Journal of Trauma and Injury
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• v.33 no.1
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• pp.13-17
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• 2020

Purpose: Accurate and appropriate prehospital field triage is essential for a trauma system. The Korean trauma system (established in 2014) uses the trauma field triage algorithm of the United States Centers for Disease Control and Prevention (CDC). This study evaluated the suitability of the CDC field triage criteria for major trauma cases (injury severity score >15) in Korea. Methods: This retrospective cohort study evaluated trauma patients who presented at the authors' regional trauma center from January 1 to May 7, 2017. The undertriage and overtriage rates of each CDC field triage step were calculated. Receiver operating characteristic curves were constructed, and the area under the curve (AUC) was evaluated for each step. Results: Among the 1,009 enrolled patients, 168 (16.7%) had major trauma. The undertriage/overtriage rates of each step (steps I, II, III, and IV) of CDC field triage were 9.2%/47.4%, 6.3%/50.8%, 4.5%/59.4%, and 5.3%/78.9%, respectively. The AUC values of each CDC triage step were 0.722, 0.783, 0.791, and 0.615, respectively. The AUC values of the separate components of each step (physiologic criteria, anatomic criteria, mechanism-of-injury criteria, and special considerations) were 0.722, 0.648, 0.647, and 0.456, respectively. Conclusions: The CDC field triage system is acceptable, but not ideal, for Korean trauma care. If we follow the protocol, it would be preferable to omit step IV. The Korean Triage and Acuity Scale may be a good indicator for in-hospital triage. However, a new triage protocol that is simple to estimate on-scene while having good performance should be developed.

• Radiation Oncology Journal
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• v.33 no.2
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• pp.126-133
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• 2015

Purpose: To evaluate the outcomes of adjuvant radiotherapy (RT) and to analyze prognostic factors of survival in the International Federation of Gynecology and Obstetrics (FIGO) IB-IIA uterine cervical cancer. Materials and Methods: We retrospectively reviewed the medical records of 148 patients with FIGO IB-IIA uterine cervical cancer who underwent surgery followed by adjuvant RT at the Yonsei Cancer Center between June 1997 and December 2011. Adjuvant radiotherapy was delivered to the whole pelvis or an extended field with or without brachytherapy. Among all patients, 57 (38.5%) received adjuvant chemotherapy either concurrently or sequentially. To analyze prognostic factors, we assessed clinicopathologic variables and metabolic parameters measured on preoperative 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). To evaluate the predictive performance of metabolic parameters, receiver operating characteristic curve analysis was used. Overall survival (OS) and disease-free survival (DFS) were analyzed by the Kaplan-Meier method. Results: The median follow-up period was 63.2 months (range, 2.7 to 206.8 months). Locoregional recurrence alone occurred in 6 patients, while distant metastasis was present in 16 patients, including 2 patients with simultaneous regional failure. The 5-year and 10-year OSs were 87.0% and 85.4%, respectively. The 5-year and 10-year DFSs were 83.8% and 82.5%, respectively. In multivariate analysis, pathologic type and tumor size were shown to be significant prognostic factors associated with both DFS and OS. In subset analysis of 40 patients who underwent preoperative PET/CT, total lesion glycolysis was shown to be the most significant prognostic factor among the clinicopathologic variables and metabolic parameters for DFS. Conclusion: Our results demonstrated that adjuvant RT following hysterectomy effectively improves local control. From the subset analysis of preoperative PET/CT, we can consider that metabolic parameters may hold prognostic significance in early uterine cervical cancer patients. More effective systemic treatments might be needed to reduce distant metastasis in these patients.

• Journal of Korean Foot and Ankle Society
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• v.19 no.2
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• pp.51-57
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• 2015

Purpose: Minimal incision distal metatarsal osteotomy (MIDMO) is known to be an effective surgical procedure for mild to moderate hallux valgus. However, the result of MIDMO on moderate to severe hallux valgus is controversial; therefore, we investigated the radiological and clinical results of MIDMO on moderate to severe hallux valgus. Materials and Methods: We reviewed 51 feet (48 patients) with moderate to severe hallux valgus. The mean age was 67.0 years and the mean follow-up period was 32.2 months. Radiological data of hallux valgus angle, first intermetatarsal angle, and distal metatarsal articular angle on plain radiographs were analyzed. Recurrence, union, lateral translation of distal fragment and angulation were also analyzed. The clinical data were obtained using American Orthopaedic Foot and Ankle Society (AOFAS) score of preoperation and last follow-up. Receiver operating characteristic (ROC) curve was used to determine a cut-off value. Results: The mean hallux valgus angle measured at preoperation was $37.7^{\circ}$ and $15.9^{\circ}$ at last follow-up. The mean first intermetatarsal angle of preoperation and last follow-up were $15.2^{\circ}$ and $8.3^{\circ}$. The mean distal metatarsal articular angle changed from $12.6^{\circ}$ at preoperation to $7.8^{\circ}$ at last follow-up. Preoperative hallux valgus angle (p=0.0051) and distal metatarsal articular angle (p=0.0078) were statistically significant factors affecting postoperative AOFAS score. Cut-off value of each was $37^{\circ}$ and 13o, respectively. Lateral translation of distal fragment in 5 recurrent cases was 23.0% compared to 45.3% of 46 non-recurrent cases. The result was statistically significant and the cut-off value was 38%. Conclusion: Sufficient lateral translation over 38% in MIDMO on moderate to severe hallux valgus patients with preoperative hallux valgus angle under $37^{\circ}$ and distal metatarsal articular angle under $13^{\circ}$ can lead to good clinical results without recurrence.