| 1. |
- Bengtsson, Johan, et al.
(författare)
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Correlation between ADC, ADC ratio, and Gleason Grade group in prostate cancer patients undergoing radical prostatectomy : Retrospective multicenter study with different MRI scanners
- 2023
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Ingår i: Frontiers in Oncology. - : Frontiers Media SA. - 2234-943X. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Background: MRI is an important tool in the prostate cancer work-up, with special emphasis on the ADC sequence. This study aimed to investigate the correlation between ADC and ADC ratio compared to tumor aggressiveness determined by a histopathological examination after radical prostatectomy.Methods: Ninety-eight patients with prostate cancer underwent MRI at five different hospitals prior to radical prostatectomy. Images were retrospectively analyzed individually by two radiologists. The ADC of the index lesion and reference tissues (contralateral normal prostatic, normal peripheral zone, and urine) was recorded. Absolute ADC and different ADC ratios were compared to tumor aggressivity according to the ISUP Gleason Grade Groups extracted from the pathology report using Spearman’s rank correlation coefficient (ρ). ROC curves were used to evaluate the ability to discriminate between ISUP 1-2 and ISUP 3-5 and intra class correlation and Bland-Altman plots for interrater reliability.Results: All patients had prostate cancer classified as ISUP grade ≥ 2. No correlation was found between ADC and ISUP grade. We found no benefit of using the ADC ratio over absolute ADC. The AUC for all metrics was close to 0.5, and no threshold could be extracted for prediction of tumor aggressivity. The interrater reliability was substantial to almost perfect for all variables analyzed.Conclusions: ADC and ADC ratio did not correlate with tumor aggressiveness defined by ISUP grade in this multicenter MRI study. The result of this study is opposite to previous research in the field.
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| 2. |
- Ekman, Carl, et al.
(författare)
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Plasma concentrations of growth arrest specific protein 6 and the soluble form of its tyrosine kinase receptor Axl as markers of large abdominal aortic aneurysms.
- 2010
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Ingår i: Clinical Biochemistry. - : Elsevier BV. - 1873-2933 .- 0009-9120. ; 43, s. 110-114
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The tyrosine kinase receptor Axl is expressed in the vasculature and Gas6 is the ligand. The extracellular part of Axl (sAxl) can be found in circulation. The aim of this study was to determine plasma concentrations of Gas6 and sAxl in patients with abdominal aortic aneurysms (AAA) and to evaluate if Gas6 and sAxl can be used as biomarkers. DESIGN AND METHODS: Immunoassays for sAxl and Gas6 were used to investigate plasma from AAA patients. Patients with large (n=123) or small AAA (n=122) were compared with healthy controls (n=141). RESULTS: Gas6 correlated positively and sAxl correlated negatively with AAA size. As a consequence, the calculated Gas6/sAxl ratios correlated even better to AAA size. Forty percent of all patients with a large AAA had higher Gas6/sAxl ratio than any in the control group. DISCUSSION: The Gas6/Axl system might be involved in AAA pathogenesis, and the Gas6/sAxl ratio may be useful as a biomarker.
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| 3. |
- Engström, Gunnar, et al.
(författare)
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Risk of treatment of peripheral arterial disease is related to inflammation-sensitive plasma proteins : a prospective cohort study
- 2004
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Ingår i: Journal of Vascular Surgery. - : Elsevier BV. - 1097-6809 .- 0741-5214. ; 40:6, s. 1101-1105
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Studies in patients with peripheral arterial disease (PAD) have reported an association between inflammatory markers and severity of disease or worsening of symptoms. However, few have studied the prognostic significance of inflammatory markers in asymptomatic subjects, measured many years before the onset of symptomatic PAD requiring treatment (trPAD).MATERIAL AND METHODS: Five inflammation-sensitive plasma proteins (ISPs), including fibrinogen, alpha 1-antitrypsin, haptoglobin, ceruloplasmin, and orosomucoid, were determined in 5619 healthy men (mean age, 46.8 +/- 3.7 years) without walking-induced calf pain. Data for men who subsequently underwent a revascularization procedure because of trPAD (intermittent claudication or critical ischemia) were retrieved from hospital-based registers. Future trPAD was studied in relation to the number of ISPs in the top quartile at the baseline examination.RESULTS: Seventy men (1.2%) underwent revascularization because of trPAD at a mean of 16.5 years after the baseline examination. The proportion with future trPAD was 0.4%, 1.0%, 1.5%, and 3.2%, respectively, for men with 0, 1, 2, and 3 or more ISPs in the top quartile (trend, P < .0001). After adjustment for age, screening year, systolic blood pressure, blood pressure medication, cholesterol concentration, diabetes, smoking, and tobacco consumption the corresponding odds ratios (95% confidence interval [CI]) were 1.00 (reference), 1.5 (CI, 0.7-3.6), 1.9 (CI, 0.8-4.6), and 2.9 (CI, 1.3-6.4), respectively, in these groups (trend, P = .003).CONCLUSION: Elevated ISPs, measured 16 years earlier in apparently healthy men without walking-induced calf pain, were associated with increased risk for development of PAD requiring revascularization.
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| 4. |
- Flondell-Sité, Despina
(författare)
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Circulating biomarkers in patients with abdominal aortic aneurysm
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Abdominal aortic aneurysm (AAA) develops in 3-6% of the population over 65 years and affects mainly men. AAA has a complex etiology involving inflammation, proteolysis, fibrinolysis and coagulation. The general aim of the present thesis was to study the associations between markers of inflammation, proteolysis, fibrinolysis and coagulation with aneurysm size and growth. In paper I associations between markers for these mechanisms and AAA size were evaluated. Patients with AAA had significantly increased levels of several markers ([endothelin] ET-1, [interleukin] IL-6, [tumour necrosis factor] TNF-α, APC-PCI) compared to age matched healthy controls. Correlations existed between aneurysm size, decreased platelet count, increased high sensitive-C-reactive protein, IL-6 and APC-PCI complex levels. In paper II effects of statin treatment were investigated, showing that patients on statins had lower levels of cholesterol, but also of homocysteine, ceruloplasmin, orosomucoid, (matrix metallo-proteinase) MMP-9 and ET-1 in plasma, but higher levels of albumin, and the APC-PCI complex. In paper III relationships between markers of proteolysis, fibrinolysis and coagulation and aneurysm size and growth during follow-up were studied. MMP-2 levels were lower in AAA patients than in healthy controls. Only MMP-2 was related to AAA size. In paper IV relationships between markers of inflammation and endothelial function and aneurysm growth were studied. We confirmed that initial aneurysm diameter is related to yearly AAA growth. Furthermore, age and initial levels of ET-1 were also related to AAA growth during 7 years follow-up. In paper V patterns of systemic biomarkers and their relationship to aneurysm growth during yearly follow-up of patients with AAA were analyzed. Few relationships were demonstrated between the development of mediators and aneurysm growth during annual analysis of this patient material, which was extended compared to the previous analyses. In conclusion, none of the above biomarkers can predict aneurysm growth or replace ultrasound surveillance.
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| 5. |
- Flondell-Sité, Despina, et al.
(författare)
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Cytokines and systemic biomarkers are related to the size of abdominal aortic aneurysms.
- 2009
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Ingår i: Cytokine. - : Elsevier BV. - 1096-0023 .- 1043-4666. ; 46, s. 211-215
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The etiology of abdominal aortic aneurysm (AAA) includes atherosclerotic, inflammatory, immunological and coagulatory mechanisms. The aim of this study was to evaluate associations between markers for some of these mechanisms and AAA-size, in order to identify markers which might later be evaluated in relation to aneurysm growth. Material and methods: Prospectively 360 AAA-patients and an age and sex-matched healthy control group (n=219) were analyzed. AAA-patients were divided in three groups according to AAA-diameter (small <45mm, n=122, medium 45-55mm, n=108, and large >55mm, n=130). Associated diseases, blood pressures and routine laboratory markers were analyzed. Additionally we evaluated endothelin (ET)-1, tumour necrosis factor (TNF)-alpha, interleukin (IL)-6, activated protein C-protein C inhibitor (APC-PCI) complex, and CD40 ligand. Groups were compared with the Kruskall-Wallis test and the Mann-Whitney U test. Results: Of routine markers platelet count was lower (p=0.0006) and creatinine level was higher (p=0.028) in patients with large AAA. Almost all non-routine markers analyzed were highly elevated in AAA-patients compared to the control group. IL-6 (p=0.0002) and thrombin activation measured as APC-PCI (p<0.0001) increased depending on the size of AAA. Conclusion: Many of the analyzed biomarkers were markedly increased in AAA-patients and some were also related to aneurysm size. Whether any of the markers is also associated with aneurysm growth rate should be further evaluated.
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| 6. |
- Flondell-Sité, Despina, et al.
(författare)
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High Levels of Endothelin (ET)-1 and Aneurysm Diameter Independently Predict Growth of Stable Abdominal Aortic Aneurysms
- 2010
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Ingår i: Angiology. - : SAGE Publications. - 0003-3197 .- 1940-1574. ; 61:4, s. 324-328
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Tidskriftsartikel (refereegranskat)abstract
- The etiology of abdominal aortic aneurysm (AAA) includes inflammation and endothelial dysfunction. To evaluate relations between these mechanisms and AAA growth, endothelin (ET)-1, tumor necrosis factor (TNF)-alpha, interleukin (IL)-6, and CD40 ligand were related to yearly AAA growth for 2.9 +/- 1.6 years (mean +/- SD) in 178 patients with conservatively followed AAA. Total number of follow-up years was 491. Abdominal aortic aneurysm diameter increased by 3.3 +/- 4.0 mm during the first year and by 4.9 +/- 4.4 mm during the first 2 years. Median (range) growth was 2.5 (-1.0 to 30.6) mm/year. When patients with AAA growth above or below median were compared, initial AAA diameter (46.1 +/- 5.8 vs 42.0 +/- 8.3 mm; P < .0001), age (75 +/- 7 vs 72 +/- 8 years; P < .029), and initial ET-1 levels (1.31 +/- 0.50 vs 1.13 +/- 0.49 pg/mL; P <.0177) were higher in patients with growth above median. Endothelin 1 (P = .0230) and initial AAA diameter (P = .0019) predicted AAA growth above median in logistic regression. In conclusion, higher initial levels of ET-1 and initial AAA diameter independently predict AAA growth.
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| 7. |
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| 8. |
- Flondell-Sité, Despina, et al.
(författare)
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Markers of proteolysis, fibrinolysis, and coagulation in relation to size and growth rate of abdominal aortic aneurysms.
- 2010
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Ingår i: Vascular and Endovascular Surgery. - : SAGE Publications. - 1938-9116 .- 1538-5744. ; 44:4, s. 262-268
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Tidskriftsartikel (refereegranskat)abstract
- We evaluated whether matrix metalloproteinases (MMPs) 2 and 9, their inhibitors, markers for fibrinolysis, and thrombin activation are associated with diameter and growth of abdominal aortic aneurysms (AAAs). Material and Methods: Matrix metalloproteinases 2 and 9, tissue inhibitor of MMPs (TIMP-1), serpine-1, tPa-serpine-1, and activated protein C- protein C inhibitor (APC-PCI) complex were analyzed in 353 patients with AAA grouped according to AAA size, and 219 gender- and age-matched healthy individuals. Follow-up of AAA growth for up to 7 years was possible in 178 of 353 patients. Results: At baseline, all groups of patients with AAA showed lower levels of MMP-2 and -9, and higher levels of TIMP-1, serpine-1, and t-Pa-serpine-1 than controls. Matrix metalloproteinase 2 correlated inversely and APC-PCI complex correlated directly with AAA diameter. We found no correlations between markers for proteolysis, fibrinolysis, coagulation, and yearly AAA growth. CONCLUSION: Matrix metalloproteinase 2 is lower and APC-PCI higher in patients with larger AAA, but the relevance of the markers for AAA growth is far from clarified.
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| 9. |
- Flondell-Sité, Despina, et al.
(författare)
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Patterns of markers of inflammation, coagulation and vasoconstriction during follow-up of abdominal aortic aneurysms
- 2012
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Ingår i: International Angiology. - 1827-1839. ; 31:3, s. 276-282
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The etiology of abdominal aortic aneurysm (AAA) includes inflammation, coagulation, and endothelial dysfunction. We have prospectively evaluated relations between these mechanisms and AAA growth. Tumour necrosis factor (TNF)-α, interleukin (IL)-6, endothelin (ET)-1, CD40 ligand and the complex formed between activated protein C (APC) and protein C inhibitor (PCI) were measured annually and related to AAA growth during up to 5 years in 206 patients with conservatively followed AAA. METHODS: We evaluated 163 patients up to 1 year, 126 patients up to 2 years, 83 patients up to 3 years, 53 patients up to 4 years, and 33 patients up to 5 years. The total number of patient follow-up years was 458. RESULTS: ET-1 remained unchanged except for a tendency to increase in the third and fourth years of follow-up. TNF-α decreased significantly during the first year and thereafter increased back to baseline values. There were no changes in IL-6, CD40 ligand, and APC-PCI complex. When patients in the highest and lowest quartiles of AAA growth up to 5 years follow-up were compared, APC-PCI complex levels tended to be higher (P=0.06) in the highest quartile of growth at three years (0.45 µg/l [i.q.r. 0.40-0.77] versus 0.28 µg/L [i.q.r. 0.14-0.36]). Δ-values of ET-1 and TNF-α did not show any correlation to growth. The 14 AAA patients that ruptured during follow-up did not differ from patients with non-ruptured AAA regarding biomarkers. CONCLUSION: In conclusion, none of the investigated mediators could be used to predict growth or rupture, or help to prolong intervals between ultrasound examinations in follow-up of AAA patients.
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| 10. |
- Gottsäter, Anders, et al.
(författare)
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Associations Between Statin Treatment and Markers of Inflammation, Vasoconstriction, and Coagulation in Patients With Abdominal Aortic Aneurysm
- 2008
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Ingår i: Vascular and Endovascular Surgery. - : SAGE Publications. - 1938-9116 .- 1538-5744. ; 42:6, s. 567-573
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Tidskriftsartikel (refereegranskat)abstract
- The association of statins with markers of inflammation, vasoconstriction, and coagulation was evaluated in 325 patients with abdominal aortic aneurysm with respect to statin treatment or not. Variables evaluated included routine laboratory markers, lipids, homocysteine, endothelin-1, matrix metalloproteinases (MMP)-2 and -9, and activated protein C-protein C inhibitor (APC-PCI) complex. Statin-treated patients were more often male (85% vs 75%; P = .024) and had ischemic heart disease (57% vs 19%; P < .0001). They showed lower levels of cholesterol (P < .0001), homocysteine (P = .027), MMP-9 (P = .038), and endothelin-1 (P = .005), and higher levels of APC-PCI complex (P = .042). Differences persisted in logistic regression for cholesterol (P < .0001), APC-PCI complex (P = .034), and homocysteine (P = .021). Statin-treated patients with abdominal aortic aneurysm show higher APC-PCI complex and lower homocysteine levels. Whether this translates into lower risk for aneurysm expansion or rupture will be evident from further follow-up.
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