Showing papers in "Expert Opinion on Medical Diagnostics in 2008"
TL;DR: The most promising AKI biomarkers include neutrophil gelatinase-associated lipocalin, IL-18, kidney injury molecule-1 and liver-type fatty acid binding protein.
Abstract: BACKGROUND: Acute kidney injury (AKI) represents a common and devastating problem in clinical medicine. The lack of early biomarkers for AKI has led to a delay in initiating potentially effective therapies. OBJECTIVE: Identification of novel urinary biomarkers for AKI that have progressed to the clinical phase of the biomarker discovery process. METHODS: A literature review (PubMed, MedLine) from 2000 to the present. RESULTS/CONCLUSIONS;: The most promising AKI biomarkers include neutrophil gelatinase-associated lipocalin, IL-18, kidney injury molecule-1 and liver-type fatty acid binding protein. Studies to validate the sensitivity and specificity of these biomarkers in clinical samples from large cohorts and from multiple clinical situations are in progress, facilitated by the development of commercial tools for their measurement.
112 citations
TL;DR: This review includes studies about different biomarkers for endometriosis and their potential for the non-surgical diagnosis of this disease and some of the markers investigated showed a good specificity, none of them showed a high sensitivity.
Abstract: Background: Diagnosis of endometriosis is surgical through laparoscopy, which is invasive, costly and associated with potential complications. Objectives: A non-invasive test for diagnosis of endometriosis will focus the use of laparoscopy on women who are highly suspected of having endometriosis. This review includes studies about different biomarkers for endometriosis and their potential for the non-surgical diagnosis of this disease. Methods: This review covers studies that investigated different biomarkers in blood or endometrium. Studies that identified definite cutoff points and evaluated the diagnostic performance of the biomarker as a blood test for endometriosis are focused on. Results/conclusions: Some of the markers investigated showed a good specificity, none of them showed a high sensitivity. More multi-center studies involving larger numbers of patients are required to identify the most useful biomarker.
71 citations
TL;DR: Determination of thymidine kinase helps to monitor the follow-up of solid tumours and haematological malignancies as well as indicating the efficacy of adjuvant and palliative chemotherapy.
Abstract: Thymidine kinase 1 (TK 1-fetal) is a cell cycle-dependent marker that increases dramatically during the S-phase of the cell cycle. In this review, the authors discuss serum levels of thymidine kinase in a variety of neoplasias. Determination of thymidine kinase helps to monitor the follow-up of solid tumours and haematological malignancies as well as indicating the efficacy of adjuvant and palliative chemotherapy. Elevated levels of thymidine kinase must always be interpreted together with a detailed knowledge of the patient's condition because nonspecific elevations of serum levels (inflammatory and autoimmune diseases) must be excluded.
70 citations
TL;DR: The current clinical approach to the molecular diagnosis and clinical management of LHON is summarized, with the provision of low-vision aids, registration with the relevant social services and an important role for genetic counselling.
Abstract: Background: Leber hereditary optic neuropathy (LHON) is a cause of inherited blindness that typically presents with bilateral, painless, subacute visual failure in young adult males. Males are about four times more likely to be affected than females and 95% of LHON carriers become affected before the age of 50. Affected patients may have characteristic ocular fundal appearances and have evidence of optic nerve dysfunction in the form of impaired colour vision (dyschromatopsia), dense visual field defects (central or caecocentral scotoma) and abnormal visual electrophysiology. Objectives: To summarise the current clinical approach to the molecular diagnosis and clinical management of LHON. Methods: To review the literature and present a review of current understanding. Results/conclusions: The diagnosis of LHON is usually confirmed by molecular genetic analysis for one of three common mitochondrial DNA (mtDNA) mutations that all affect genes coding for complex I subunits of the respiratory chain: m.3460G >...
68 citations
TL;DR: TBI biomarkers could have a significant impact on patient care by assisting in the diagnosis, risk stratification and management of TBI and could provide major opportunities for the conduct of clinical research, including confirmation of injury mechanism(s) and drug target identification.
Abstract: Background: Advances in the understanding of human biochemistry and physiology have provided insight into new pathways by which we can understand traumatic brain injury (TBI). Increased sophistication of laboratory techniques and developments in the field of proteomics has led to the discovery and rapid detection of new biomarkers not previously available. Objective: To review recent advances in biomarker research for traumatic brain injury, describe the features of the ideal biomarker and to explore the potential role of these biomarkers in improving clinical management of brain injured patients. Methods: Through a literature review of recent research on TBI biomarkers and through experience with TBI research, important elements of biomarker development are described together with potential applications to patient care. Conclusions: TBI biomarkers could have a significant impact on patient care by assisting in the diagnosis, risk stratification and management of TBI. Biomarkers could provide major opport...
60 citations
TL;DR: Multispectral techniques, along with other developments in digital analysis, will allow pathologists to deliver appropriate quantitative and multiplexed analyses in a reproducible and timely manner.
Abstract: Background: The current appreciation of the biological complexity of disease has led to increasing demands on pathologists to provide clinically relevant, quantitative morphological and molecular information while preserving cellular and tissue context. This can be technically challenging, especially when signals of interest are colocalized. With fluorescence-based methods, sensitivity and quantitative reliability may be compromised by spectral cross-talk between labels and by autofluorescence. In brightfield microscopy, overlapping chromogenic signals pose similar imaging difficulties. Approach: These challenges can be addressed using commercially available multispectral imaging technologies attached to standard microscope platforms, or alternatively, integrated into whole-slide scanning instruments. Assessment: Multispectral techniques, along with other developments in digital analysis, will allow pathologists to deliver appropriate quantitative and multiplexed analyses in a reproducible and timely mann...
46 citations
TL;DR: The most promising uses of quantum dots for translational research are reviewed, ranging from multiplexed immunofluorescence, targeted drug delivery coupled with disease visualization, tumor and sentinel organs localization and long-term cell tracing.
Abstract: Background: Nanotechnology is an emerging field that could have a significant impact on cancer diagnosis, treatment and analysis. Quantum dots represent one of the most interesting nanotechnology-based platforms, and their unique properties make them a potentially versatile tool for molecular diagnostics. Objectives: Here, the most promising uses of quantum dots for translational research are reviewed, ranging from multiplexed immunofluorescence, targeted drug delivery coupled with disease visualization, tumor and sentinel organs localization and long-term cell tracing. Finally, potential future directions for quantum dots as both a diagnostic and therapeutic tool in biomedical research will be explored. Conclusions: The use of quantum dots in biomedical applications is accelerating owing to their unique physical attributes, imaging capabilities, and potential for therapeutic delivery.
38 citations
TL;DR: The DPP-IV family, which is probably linked directly to the pathogenesis of cancer, holds significant promise for exploitation in the diagnostic arena.
Abstract: Background: The dipeptidyl peptidase-IV (DPP-IV) family has outgrown its humble origins as a simple enzymatic activity cleaving dipeptides from peptides with an accessible N-terminal penultimate proline with no clear role in metabolism. It is now understood to play a critical role in regulating signaling capacity of chemokines, neuropeptides and other extracellular messengers in addition to playing direct roles by means of non-enzymatic interactions to regulate the local extracellular proliferative environment. Consequently, examination of DPP-IV family representation and activity in immune and oncogenic processes has become a major focus. Objectives: To review the evidence for DPP-IV family members as markers of malignancy. Methods: Overview of published data. Results/conclusion: The DPP-IV family, which is probably linked directly to the pathogenesis of cancer, holds significant promise for exploitation in the diagnostic arena.
30 citations
TL;DR: Critical analysis of all published data regarding PBC serology between 1985 and 2007 was performed in order to suggest a diagnostic algorithm for the serological diagnosis of PBC, and molecular-based assays have been developed for the detection of P BC-specific ANA.
Abstract: Background: Primary biliary cirrhosis (PBC) is an autoimmune liver disease of unknown etiology characterized by the presence of antimitochondrial antibodies (AMA) in 90 – 95% of patients. AMA are directed against members of 2-oxo-acid dehydrogenase complex, including mainly the E2 subunit of pyruvate dehydrogenase, the E2 subunit of branched chain 2-oxo-acid dehydrogenase complex and the E2 subunit of the oxoglutarate dehydrogenase complex. Apart from AMA, PBC is characterized by the presence of PBC-specific antinuclear antibodies (ANA). The molecular targets of these PBC-specific ANA have been characterized as gp210, lamin B receptor, nucleoporin 62, sp100 and promyelocytic leukemia proteins. Objective: To discuss the molecular diagnostics of PBC in the context of AMA and PBC-specific ANA detection by the use of conventional and ‘new’ novel technologies. Methods: Critical analysis of all published data regarding PBC serology between 1985 and 2007 was performed in order to suggest a diagnostic algorithm f...
27 citations
TL;DR: The mutation spectrum in PXE is summarized and a strategy to optimize mutation detection in this difficult disorder is outlined.
Abstract: Pseudoxanthoma elasticum (PXE), an autosomal recessive disorder with considerable phenotypic variability, mainly affects the eyes, skin and cardiovascular system, and is characterized by ectopic mineralization of elastic fibers of connective tissues. Since the identification of the ABCC6 gene (ATP-binding cassette family C member 6), which encodes a putative transmembrane transporter (ABCC6), as the site of mutations responsible for PXE, a number of researchers have disclosed mutations spanning the entire gene. An important advance in the ability to identify mutations has been the identification of two closely related pseudogenes and identifying sequence differences between the coding gene and the pseudogenes allowing accurate sequencing. In this review, the mutation spectrum in PXE is summarized and a strategy to optimize mutation detection in this difficult disorder is outlined.
26 citations
TL;DR: The most important findings and challenges of the next few years will include optimized 'anatomy' of QDs ensuring their optimal size and stability, solving of short-term and long-term toxicity issues in QD in vivo applications and development of QD-adapted imaging systems able to explore in full QD advantages over organic dyes.
Abstract: Background: Semiconductor fluorescent or metallic nanocrystal quantum dots (QDs) engineered with the bottom–top approaches provide several unique properties that make them superior imaging probes or contrast agents. Targeted fluorescent QDs make possible previously unachievable sensitivity of detection by tagging them with biomarkers. Recent advances in the QDs' surface treatment and/or encapsulation have made them stable in crude biological fluids, tissues and in vivo applications. Objective: To try to determine the main trends of fluorescent QD development in the next 5 years and identify the areas of medical diagnostics where their use will provide breakthrough results in the near future. Methods: A brief overview is provided of techniques for preparing fluorescent QD conjugates to make them stable in biological environments, and their applications to detection of viruses, bacteria and in vitro and in situ molecular diagnostics are described. Emerging areas of fluorescent QDs in vivo applications and r...
TL;DR: Clinical studies with liposome radiopharmaceuticals demonstrated that a wide variety of tumors could be detected with good sensitivity and specificity, and performed equal to or better than infection imaging agents that are approved at present.
Abstract: Background: Nanoparticles are increasingly being incorporated into the design of diagnostic imaging agents. Significant research efforts have been conducted with one class of lipid nanoparticle (liposomes) radiolabeled with gamma-emitting radionuclides as radiopharmaceuticals for scintigraphic imaging of cancer, inflammation/infection and sentinel lymph node detection. Objective: This article reviews the current literature with special emphasis on the clinical studies performed with liposome radiopharmaceuticals for detection of tumors, infectious/inflammatory sites or metastatic lymph nodes. Future uses of liposome radiopharmaceuticals are also described. Methods: Characteristics required of the radionuclide, liposome formulation and radiolabeling method for an effective radiopharmaceutical are discussed. A description of the procedures and instrumentation for conducting an imaging study with liposome radiopharmaceutical is included. Clinical studies using liposome radiopharmaceuticals are summarized. Fu...
TL;DR: Clinical trial designs and adaptive analysis plans for the prospective design of pivotal trials of new therapeutics and companion diagnostics are reviewed, finding that effective co-development requires careful prospective planning of the design and analysis strategy for pivotal clinical trials.
Abstract: Background: Developments in genomics and biotechnology provide unprecedented opportunities for the development of effective therapeutics and companion diagnostics for matching the right drug to the right patient. Effective co-development involves many new challenges with increased opportunity for success as well as delay and failure. Objective: Clinical trial designs and adaptive analysis plans for the prospective design of pivotal trials of new therapeutics and companion diagnostics are reviewed. Conclusions: Effective co-development requires careful prospective planning of the design and analysis strategy for pivotal clinical trials. Randomized clinical trials continue to be important for evaluating the effectiveness of new treatments, but the target populations for analysis should be prospectively specified based on the companion diagnostic. Post hoc analyses of traditionally designed randomized clinical trials are often deeply problematic. Clear separation is generally required of the data used for de...
TL;DR: The emerging role of molecular imaging in the development of improved therapeutic strategies that provide better patient selection for therapeutic personalization and which therapies have the greatest chance of success given the individual patient's disease genetic, and phenotypical profile is reviewed.
Abstract: Background: New therapies targeted to specific tumor pathways are entering the clinic. The need for in vivo monitoring of resulting molecular changes, particularly with respect to the tumor microenvironment, is growing. Molecular imaging is evolving to include a variety of imaging methods to enable in vivo monitoring of cellular and molecular processes. Objectives: This article reviews the emerging role of molecular imaging in the development of improved therapeutic strategies that provide better patient selection for therapeutic personalization (i.e., determine which therapies have the greatest chance of success given the individual patient's disease genetic, and phenotypical profile). Methods: To illustrate the utility of integrating molecular imaging into therapy development strategies, current and emerging applications of nuclear molecular imaging strategies were compared with conventional strategies. Proposed methods of integrating molecular imaging techniques into cancer therapeutic development and ...
TL;DR: Alternative NMR/MRI techniques have improved specificity for the detection of lesions and provided more quantitative information about MS, and optical techniques including OCT and CARS microscopy are opening up new ways for diagnosis and mechanistic study of myelin diseases.
Abstract: Background: Multiple sclerosis (MS) is a chronic disabling disorder histopathologically characterized by inflammation, demyelination and axonal loss Conventional MRI has made most contributions to the diagnosis of MS However, it is not sufficiently sensitive and specific to reveal the extent and severity of the damage in the disease Other nuclear magnetic resonance (NMR) techniques including magnetic resonance spectroscopy, magnetization transfer imaging, diffusion weighted and diffusion tensor imaging, and functional MRI have provided additional information that improves the diagnosis and understanding of MS Optical techniques including optical coherence tomography (OCT) and coherent anti-Stokes Raman scattering (CARS) microscopy have shown promise in diagnosis and mechanistic study of myelin diseases Objective: To review new imaging techniques and their potential in diagnosis of MS Method : The principles of three imaging techniques (MRI, OCT and CARS) and their applications to MS studies are desc
TL;DR: The p53 gene is the most frequently mutated gene in cancer and accordingly has been the subject of intensive investigation for almost 30 years as mentioned in this paper, which has long been recognised that analysis of p53 has considerable potential as a tool for use in both diagnostic and prognostic settings and some significant progress has been made in both of these arenas.
Abstract: Background: The p53 gene is the most frequently mutated gene in cancer and accordingly has been the subject of intensive investigation for almost 30 years. Loss of p53 function due to mutations has been unequivocally demonstrated to promote cancer in both humans and in model systems. As a consequence, there exists an enormous body of information regarding the function of normal p53 in biology and the pathobiological consequences of p53 mutation. It has long been recognised that analysis of p53 has considerable potential as a tool for use in both diagnostic and, to a greater extent, prognostic settings and some significant progress has been made in both of these arenas. Objective: To provide an overview of the biology of p53, particularly in the context of uses of p53 as a diagnostic tool. Methods: A literature review focused upon the methods and uses of p53 analysis in the diagnosis of sporadic cancers, rare genetic disorders and in detection of residual disease. Conclusion: p53 is currently an essential ...
TL;DR: MUC4 expression is a specific marker of epithelial tumors and its expression correlates positively with the degree of differentiation in several cancers, being expressed in the earliest dysplastic lesions preceding several malignancies, including lethal pancreatic cancer.
Abstract: Background: Mucins are high molecular mass glycoproteins whose role in diagnosis, prognosis and therapy is being increasingly recognized owing to their altered expression in a variety of carcinomas. MUC4, a membrane-bound mucin encoded by a gene located on chromosome locus 3q29, is aberrantly expressed in several cancers including those of the bile duct, breast, colon, esophagus, ovary, lung, prostate, stomach and pancreas. Objective: This review considers the potential use of the MUC4 expression pattern in the diagnosis and prognosis of various cancers. Results/conclusion: MUC4 expression is a specific marker of epithelial tumors and its expression correlates positively with the degree of differentiation in several cancers. Importantly, MUC4 has emerged as a specific marker of dysplasia, being expressed in the earliest dysplastic lesions preceding several malignancies, including lethal pancreatic cancer. The presence of MUC4-specific antibodies in the serum and of the transcript in peripheral blood monon...
TL;DR: There will be an increased demand for accurate and early diagnosis of ADPKD in the not so distant future, and several classes of promising disease-modifying drugs are being tested in clinical trials and, if proved effective, some of them will be used in early disease.
Abstract: Background: Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease and accounts for 5 – 10% of end stage renal disease. Mutations of two genes, PKD1 and PKD2, account for ∼ 85 and ∼ 15% of cases, respectively. Objective: This paper reviews the clinical features of ADPKD, highlights the current roles for image- and molecular-based diagnostics, and the potential for new innovations to improve the clinical diagnostics for ADPKD. Methods: This paper reviews the literature on the clinical features, differential diagnosis, and image- and molecular-based diagnostics for ADPKD. Results/conclusion: At present, presymptomatic diagnosis of ADPKD in subjects born with 50% risk is typically performed by renal ultrasonography. Renal MRI, with improved sensitivity for detecting smaller cysts, is a promising modality. There is also a clear role for molecular diagnostics, especially in patients with equivocal imaging results, in those with a negative family history and in younger...
TL;DR: The authors discuss the essential aspects of minimum-invasive early diagnosis of colorectal cancer based on CTC, including the current techniques for patient preparation, data acquisition, image display and interpretation, the CTC performance for screening, preoperative staging, and navigation surgery.
Abstract: Background: Computed tomographic colonography (CTC) is less expensive, less time-consuming and better tolerated for patients than is optical colonoscopy. At present, CTC has a diagnostic performanc...
TL;DR: Nipple-aspirate fluids can be obtained non-invasively from the breast in most women and represent a promising biological tool to assess metabolic and molecular changes of cells lining the ducts from which breast cancer arises.
Abstract: Background: Breast cancer, a complex and multifactorial disease, is the most commonly diagnosed malignancy that affects women. Methods of breast cancer detection that are available at present have well-described limitations; the intraductal approaches directly assess the microenvironment of the breast. Objective: The aim of this overview is to highlight the application of nipple-aspirate fluid studies in the field of biomarker discovery, useful for early detection and prevention of breast cancer risk. Conclusion: Nipple-aspirate fluids can be obtained non-invasively from the breast in most women and represent a promising biological tool to assess metabolic and molecular changes of cells lining the ducts from which breast cancer arises.
TL;DR: Fine-needle biopsy is a rapid, minimally invasive technique, widely used for the investigation and diagnosis of lesions in a variety of body sites, and should be the first-line diagnostic modality for confirmation of clinically and/or radiologically suspected metastases in melanoma patients.
Abstract: Fine-needle biopsy (FNB) is a rapid, minimally invasive technique, widely used for the investigation and diagnosis of lesions in a variety of body sites. It is a procedure with high diagnostic accuracy for metastatic melanoma, with a sensitivity of 92.1% and a specificity of 99.2% in a recent large study. Although at present FNB has virtually no role in the initial diagnosis of pigmented primary cutaneous tumors, recent evidence suggests that it should be the first-line diagnostic modality for confirmation of clinically and/or radiologically suspected metastases in melanoma patients. As the specimen procured by FNB can be examined within minutes of performing the procedure, an on-demand FNB service with rapid communication of results to the patient's treating clinician enables a more efficient and cost effective approach to the multidisciplinary management of melanoma patients. In the future, it is likely that molecular analysis of very small amounts of tumor tissue obtained by FNB will provide an accurat...
TL;DR: Assessment of drug activity in intact tumor cells and tumor cell gene expression signatures are considered to have greatest potential for the development of versatile predictive tests.
Abstract: Background: The selection of cancer drugs for an individual patient is still based mostly on cancer type and stage. Predictive tests are needed to make individualized and more efficient pharmacological cancer treatment possible. Objective: To provide an overview of available, possible future development and principles for development of predictive tests for individualized selection of cancer drugs. Methods: Overview of published data. Results/conclusion: Despite increased knowledge in cancer biology, only limited progress has been made in the development and use of predictive tests. However, rapid progress in this field will be possible using already available and emerging technologies, but requires a paradigm shift in principles for the development and use of cancer drugs. Assessment of drug activity in intact tumor cells and tumor cell gene expression signatures are considered to have greatest potential for the development of versatile predictive tests.
TL;DR: The authors believe that cytokines may contribute importantly to cancer management in the future; to more likely to indicate prognosis, to identify patients who might benefit from a particular treatment, to monitor treatment response and disease recurrence, and, finally, possibly as part of a larger panel of tumour markers, to improve diagnosis.
Abstract: Background: Cytokines and cytokine receptors contribute importantly to each step of cancer development and progression, and deregulated levels of cytokines and cytokine receptors can be detected in cancer patients locally and systemically. Objective: This review aims to outline and discuss the current status of cytokines and their receptors as potential diagnostic, prognostic, predictive and risk indicators, exemplified in cervical, ovarian, breast, prostate, colorectal, gastric, and non-small cell lung cancers and in sarcomas. Methods: The Medline database was searched for articles on the relevant cancers, published in the English language, using combinations of the following keywords: cytokine, interleukin, growth factor, diagnostic, prognostic, predictive, serum, ascitic and expression. The searches yielded over 2000 papers, and an arbitrary selection of the cited literature was made to present the developments in the field. Results/conclusion: Cytokines, unspecific by definition, present certain patte...
TL;DR: The imaging, biofluid, quantitative motor and cognitive measures that have been shown to reflect the progression of HD are reviewed and the need for systematic head-to-head comparison of candidate markers is highlighted.
Abstract: No treatments have yet been shown to slow the progression of the inherited neurodegenerative disorder Huntington's disease (HD) in humans, but several attempts at disease modification in animal models have been successful. Human clinical trials based on present clinical measures would require unfeasibly large subject numbers, particularly in premanifest HD mutation carriers, and the main aim of biomarker research in HD is to enable the development of surrogate end points to enable such trials to be conducted. In this article, the imaging, biofluid, quantitative motor and cognitive measures that have been shown to reflect the progression of HD are reviewed. A conceptual framework and pipeline for evaluating the large number of potential HD biomarkers is presented, and the need for systematic head-to-head comparison of candidate markers is highlighted.
TL;DR: In this article, molecular markers are focused on that have been tested for the following purposes: monitoring for acute rejection; identifying steroid-resistant rejections; and monitoring for clinical transplant tolerance.
Abstract: Background: Long-term graft loss is still a major problem in renal transplantation. The occurrence of acute rejection episodes and impaired response of the patient to anti-rejection therapy can lead to adverse graft outcome in both the short term and the long term. At present, clinical parameters and morphologic assessment of the renal biopsy serve as the basis for assessment of risk for graft failure. Objective: The goal is to establish biomarkers in renal graft biopsies, urine samples and peripheral blood that predict or detect acute rejection and stable graft conditions, and that provide information regarding prognosis. Methods: In this review, molecular markers are focused on that have been tested for the following purposes: monitoring for acute rejection; identifying steroid-resistant rejections; and monitoring for clinical transplant tolerance. Conclusion: mRNA expression patterns and markers related to inflammatory cell types and their products in graft biopsies, urine sediments and peripheral bloo...
TL;DR: There is an urgent need to look for a new and specific marker for gallbladder cancer that will help to detect this cancer at an early stage so as to alter its poor prognosis.
Abstract: Background: Gallbladder carcinoma is an uncommon neoplasm that shows widespread geographic and gender variation. Complete surgical resection offers the only chance of cure, which is often not possible owing to the advanced stage of the disease at presentation. Early diagnosis is not yet possible despite advances in imaging modalities. A biomarker is a substance used as an indicator of a biological state. It is a characteristic that is measured objectively as an indicator of normal biological processes, pathological processes, or response to a therapeutic intervention. So far there is no known definite and specific marker of gallbladder cancer. Objectives: To find out important biomarkers of carcinoma of the gallbladder that will help in early diagnosis of this disease. Methods: A review of literature was carried out and important biomarkers were identified. Results/conclusions: The list of the biomarkers that has been evaluated is exhaustive. Important ones are CA 242, CA 19-9, CA 15-3, CA 125, CA 50, CA ...
TL;DR: Experimental data supporting the view that HPV-associated HNSCC deserves to be recognized as a distinct disease in the clinic and as such needs to be appropriately diagnosed are focused on.
Abstract: The link between human papillomaviruses and human cervical cancers has long been established. However, human papillomaviruses (HPVs) are now being detected in another type of cancer, not previously associated with this virus, head and neck squamous cell carcinoma (HNSCC). This review will focus on experimental data supporting the view that HPVs contribute to the etiology of a subset of HNSCC. We further put forth the argument that HPV-associated HNSCC deserves to be recognized as a distinct disease in the clinic and as such needs to be appropriately diagnosed. We offer an overview of studies that have helped dissect the role of HPVs in HNSCC and that may be helpful in the development of new diagnostic tools for discriminating this type of HNSCC.
TL;DR: Without an HCMV vaccine, diagnosis of primary infection in the mother and of congenital infection inThe fetus/newborn are key factors for management of congenitals HCMv infection.
Abstract: Background: The socio-economic burden associated with congenital human cytomegalovirus (HCMV) infection is well recognized. Nevertheless, women are neither informed nor tested for HCMV antibody, an...
TL;DR: Standardization of methods will allow for the uniform detection of microscopic disease in the peripheral blood of patients with MBC and provide prognostic information that will allow appropriate risk stratification and modification of the current staging system for advanced disease.
Abstract: Background: Metastatic breast cancer (MBC) is incurable and any treatment is considered palliative. Occult dissemination of tumor cells is responsible for recurrent MBC in patients who have undergone resection of their primary tumor. The presence of circulating tumor cells (CTCs) in patients with MBC predicts progression-free and overall survival. Moreover, this prognostic value is independent of the line of therapy. Methods to detect and enumerate CTCs vary in sensitivity and specificity, and lack the standardization required for direct comparison between methods. Objective: To review the methods of detecting CTCs, the prognostic implications of CTCs, and opportunities to exploit the properties of CTCs to develop individualized therapy. Methods: The coupling of antibodies to immunomagnetic beads has facilitated the detection of low-frequency CTCs in peripheral blood of cancer patients. Results/conclusion: Standardization of methods will allow for the uniform detection of microscopic disease in the periph...
TL;DR: In this article, the authors provide an overview of factors contributing to method-related differences in hCG measurements and how to overcome these drawbacks and conclude that in routine clinical situations assays are preferred that measure all r...
Abstract: Background: Clinical management of pregnancy, pregnancy-related disorders and trophoblastic tumors is dependent on immunoassay measurements of the complex analyte human chorionic gonadotropin (hCG). Differences in hCG results using different methods affect clinical interpretation with potentially adverse consequences for patient care. Objectives/method: To provide an overview of factors contributing to method-related differences in hCG measurements and how to overcome these drawbacks. Results/conclusion: Six recently established highly purified and molar unit calibrated World Health Organization Reference Reagents for important hCG variants provide means for in-depth characterization of diagnostic immunoassays for hCG. For different clinical applications in pregnancy and cancer, appropriate epitopes and specificities of pairs of monoclonal antibodies against hCG in immunoassays have been clearly defined. This led to the conclusion that in routine clinical situations assays are preferred that measure all r...