Monitoring Disease Progression In Patients Research Articles

SAT-438 - Utility of SomaSignalTM panels for drug response and monitoring disease progression in patients with advanced fibrosis due to non-alcoholic steatohepatitis

SAT-438 - Utility of SomaSignalTM panels for drug response and monitoring disease progression in patients with advanced fibrosis due to non-alcoholic steatohepatitis

The role of Hepatitis B Core Antibody: Significance and Clinical practice

Hepatitis B infection remains a global health problem, with progression to acute-chronic hepatitis, severe liver failure, and death making hepatitis B one of the most serious infections worldwide. The disease is most widely transmitted from an infected mother to her baby, after exposure to infected blood or body fluids or unsafe sexual contact. Pregnant women, adolescents, and all adults at high risk for chronic infection are recommended to be screened for hepatitis B. Serological tests allow the distinction between acute and chronic hepatitis. Meanwhile, the molecular tests performed provide detection and quantification of viral DNA, genotyping, drug resistance, and pre-core/core mutation analysis to confirm infection and follow monitoring disease progression in patients with chronic hepatitis B. Because, the current treatment is only based on nucleotide analogs and pegylated interferons that save lives by decreasing liver cancer death, liver transplant, slowing or reversing the progression of liver disease as well as the virus infectivity. In this review, we clearly light the role of Hepatitis B Core Antibody, therefore clinicians understand the need to screen for hepatitis B core antigen (Anti-HBc), proper interpretation of HBV biomarkers, and that “anti-HBc only” indicates HBV exposure, lifelong persistence of cccDNA with incomplete infection control, and potential risk for reactivation. Key words: Hepatitis B virus (HBV), Hepatitis B Core Antibody (Anti-HBc/HbcAb).

Potential screening indicators for early diagnosis of NAFLD/MAFLD and liver fibrosis: Triglyceride glucose index-related parameters.

ImportanceHomeostatic model assessment for insulin resistance (HOMA-IR) and triglyceride glucose (TyG) index–related parameters [TyG index, triglyceride glucose–waist circumference (TyG-WC), triglyceride glucose–waist-to-height ratio (TyG-WHtR), and triglyceride glucose–body mass index (TyG-BMI)] are gradually considered as convenient and alternative indicators for insulin resistance in various metabolic diseases, but the specific diagnostic capacity and the comparison of the parameters in non-alcoholic fatty liver disease (NAFLD), metabolic-associated fatty liver disease (MAFLD), and liver fibrosis remain uncertain.ObjectiveTo comprehensively assess and compare the diagnostic accuracy of the above parameters in NAFLD, MAFLD, and liver fibrosis and identify the appropriate indicators.MethodsA total of 1,727 adults were enrolled from the 2017–2018 National Health and Nutrition Examination Surveys. Logistic regressions were used to identify the parameters significantly associated with NAFLD, MAFLD, and liver fibrosis; receiver operating characteristic (ROC) curves were used to evaluate and compare their diagnostic capacity. Subgroup analyses were conducted to validate the concordance, and the optimal cutoff values were determined according to the Youden’s indexes.ResultsSignificant differences were observed between quartile-stratified HOMA-IR and TyG index–related parameters across the NAFLD, MAFLD, and liver fibrosis (P < 0.05). All variables were significantly predictive of different disease states (P < 0.05). The top three AUC values are TyG-WC, TyG-WHtR, and TyG-BMI with AUCs of 0.815, 0.809, and 0.804 in NAFLD. The optimal cutoff values were 822.34, 4.94, and 237.77, respectively. Similar values and the same trend of the above three indexes could be observed in MAFLD and liver fibrosis. Subgroup analyses showed consistent results with the primary research, despite some heterogeneity.ConclusionsTyG-WC, TyG-WHtR, and TyG-BMI can be used for early screening of NAFLD and MAFLD. These three parameters and HOMA-IR were more suitable for assessing metabolic risks and monitoring disease progression in patients with NAFLD.

Abstract 1954: Circulating tumor cell kinetics and rare cell morphology monitor disease progression in patients with metastatic colorectal cancer

Abstract As the world’s third most common cancer and second leading cause of oncology-related deaths, colorectal cancer (CRC) poses a variety of clinical challenges. CRC is marked by its extensive solid tumor heterogeneity and the difficulties in longitudinally monitoring a patient’s disease status. Being a minimally invasive prognostic tool, the liquid biopsy has immense potential to improve current clinical practice by providing real-time personalized information over the course of treatment. Utilizing the High-Definition Single Cell Assay (HDSCA) workflow, we employed a “no cell left behind approach” to analyze peripheral blood samples from metastatic CRC (mCRC) patients at various timepoints during treatment. We highlight the circulating rare cell population present in the liquid biopsy of mCRC patients, showing the spatial and temporal heterogeneities of CTCs. We observed a significant association between CTC subcategorization based on morphological differences and survival, emphasizing the heterogeneity within the CTC classification. Moreover, considering the time of sample collection in relation to the clinical scenario is critical in determining the prognostic relevance of static cellular enumerations as well as the change in cell populations over time. Through the integration of cellular morphology in a time-based analysis, the liquid biopsy can provide insight into the pathophysiology of mCRC by highlighting the complexity of the disease to monitor treatment response. Citation Format: Sachin Narayan. Circulating tumor cell kinetics and rare cell morphology monitor disease progression in patients with metastatic colorectal cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1954.

Gadoxetic acid-enhanced MRI in primary sclerosing cholangitis: added value in assessing liver function and monitoring disease progression

PurposeTo investigate the added value of gadoxetic acid-enhanced MRI in monitoring liver function and disease progression in patients with primary sclerosing cholangitis (PSC).MethodsWe retrospectively identified 104 consecutive patients (75 males; mean age 41.98 ± 12.5 years) with confirmed diagnosis of PSC who underwent 227 gadoxetic acid-enhanced MRI examinations between January 2008 and May 2019. Relative enhancement (RE) of the liver was correlated with the results of liver function tests (LFTs), scoring models (Model for End-Stage Liver Disease (MELD) score, Mayo Risk Score (MRS), Amsterdam-Oxford model (AOM)), and qualitative MRI findings. In addition, results were analyzed separately for excretory MRI examinations (n = 164) and nonexcretory examinations (n = 63) depending on excretion of gadoxetic acid into the common bile duct in the hepatobiliary phase (HBP).ResultsThere was a significant correlation of RE with MRS (r = − 0.652), MELD score (r = − 0.474), AOM (r = − 0.468), and LFTs (P < 0.001). RE and albumin were significantly higher in the excretory group whereas scoring models, bilirubin, aspartate aminotransferase, alkaline phosphatase, and international normalized ratio were lower (P < 0.001). RE was lower in segments with absent HBP gadoxetic acid excretion into dilated bile ducts, reduced HBP parenchymal enhancement, atrophy, T2 hyperintensity, and bile duct abnormalities (P < 0.001).ConclusionRelative enhancement of the liver in gadoxetic acid-enhanced MRI can be used to evaluate global and regional liver function and monitor disease progression in patients with PSC. Hepatobiliary phase gadoxetic acid biliary excretion appears to be a reproducible qualitative parameter for evaluating disease severity that can be easily integrated into routine clinical practice.

Multivariable logistic and linear regression models for identification of clinically useful biomarkers for osteoarthritis

Osteoarthritis (OA) is the most common chronic degenerative joint disease which causes substantial joint pain, deformity and loss of activities of daily living. Currently, there are over 500 million OA cases worldwide, and there is an urgent need to identify biomarkers for early detection, and monitoring disease progression in patients without obvious radiographic damage to the joint. We have used regression modelling to describe the association of 19 of the currently available biomarkers (predictors) with key radiographic and clinical features of OA (outcomes) in one of the largest and best characterised OA cohort (NIH Osteoarthritis Initiative). We demonstrate that of the 19 currently available biomarkers only 4 (serum Coll2-1 NO2, CS846, COMP and urinary CTXII) were consistently associated with established radiographic and/or clinical features of OA. These biomarkers are independent of one another and provide additional predictive power over, and above established predictors of OA such as age, gender, BMI and race. We also show that that urinary CTXII had the strongest and consistent associations with clinical symptoms of OA as well as radiographic evidence of joint damage. Accordingly, urinary CTXII may aid in early diagnosis of OA in symptomatic patients without radiographic evidence of OA.

Cardiac Involvement by Burkitt Lymphoma in a 49-Year-Old Man.

Malignant metastases are among the most common cardiac masses. We report a rare case of cardiac involvement by Burkitt lymphoma in a 49-year-old man who presented with a 2-month history of dyspnea and palpitations. A transthoracic echocardiogram revealed 2 intracardiac masses in the right atrium (one of which partially encased the tricuspid valve), myocardial infiltration, and pericardial disease. Results of pleural fluid cytology and flow cytometry confirmed involvement by Burkitt lymphoma. Subsequent chemotherapy markedly reduced the intracardiac tumor burden and resolved the patient's presenting symptoms. Our case highlights the importance of cardiac imaging in diagnosing systemic illness, initiating early and appropriate treatment, and monitoring disease progression in patients with intracardiac Burkitt lymphoma.

P.68 - Correlation of serum biomarkers and magnetic resonance spectroscopy (MRS) in monitoring disease progression in patients with mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) due to mtDNA A3243G mutation

P.68 - Correlation of serum biomarkers and magnetic resonance spectroscopy (MRS) in monitoring disease progression in patients with mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS) due to mtDNA A3243G mutation

Fibrinogen: A Marker in Predicting Diabetic Foot Ulcer Severity.

Aims. To examine whether fibrinogen levels are a valuable biomarker for assessing disease severity and monitoring disease progression in patients with diabetic foot ulcer (DFU). Methods. A retrospective study was designed to examine the utility of fibrinogen in estimating disease severity in patients with DFU admitted to our hospital between January 2015 and January 2016. In total, 152 patients with DFU were enrolled in the study group, and 52 age and gender matched people with diabetes but no DFU were included as the control group. DFU severity was assessed using Wagner criteria. Results. Patients with DFU were divided into 2 subgroups based on the Wagner criteria. Mean fibrinogen values were significantly higher in patients with DFU grade ≧ 3 compared to those with DFU grades 1-2 (5.23 ± 1.37 g/L versus 3.61 ± 1.04 g/L). Using ROC statistic, a cut-off value of 5.13 g/L indicated the possible amputation with a sensitivity of 81.8% and a specificity of 78.9% (positive predictive value [PPV] 78.6%, negative predictive value [89.0%]). Fibrinogen values were found to be correlated with CRP levels, neutrophil, and WBC count. Conclusions. Fibrinogen levels might be a valuable tool for assessing the disease severity and monitoring the disease progression in patients with DFU.

Responsiveness of the Motor Function Measure in Patients With Spinal Muscular Atrophy

ObjectiveTo assess the ability of the Motor Function Measure (MFM) to detect changes in the progression of spinal muscular atrophy (SMA). DesignObservational, retrospective, multicenter cohort study. SettingSeventeen departments of pediatric physical medicine. ParticipantsVolunteer patients with SMA (N=112) aged 5.7 to 59 years with no treatment other than physical therapy and nutritional or respiratory assistance. InterventionsNot applicable. Main Outcome MeasuresThe distributions of the MFM scores (total score and 3 subscores) were analyzed per SMA subtype. The relationships between scores and age were studied. The slopes of score changes (reflecting MFM responsiveness) were estimated in patients with at least 6 months' follow-up and 2 MFMs. Hypothetical sample sizes for specific effect sizes in clinical trial scenarios are given. ResultsIn 12 patients with SMA type 2 and 19 with SMA type 3 (mean ± SD follow-up, 25.8±19mo), there was a moderate inverse relationship between age and the MFM total score. Patients with less than 6 months' follow-up showed little score changes. Patients with longer follow-ups showed a slow deterioration (−0.9 points/y for type 2 and −0.6 points/y for type 3). Substantial responsiveness was obtained with the MFM Dimension 2 subscore (proximal and axial motricity) in patients with SMA type 2 (standardized response mean [SRM]=1.29), and with the MFM Dimension 1 subscore (standing and transfers) in patients with SMA type 3 aged 10 to 15 years (SRM=.94). ConclusionsIf further confirmed by larger studies, these preliminary results on the relative responsiveness of the MFM in SMA will foster its use in monitoring disease progression in patients who participate in clinical trials.

Transient elastography in chronic hepatitis B: an Asian perspective.

Transient elastography (TE) is a new non-invasive tool for assessing liver stiffness, which is correlated with the histologic stage of liver fibrosis. Many studies have reported a good accuracy of TE in predicting significant fibrosis and an optimal accuracy in predicting cirrhosis. Furthermore, the potential role of TE in screening the general population has also been proven. TE thus helps physicians to decide treatment strategies, predict prognosis, and monitor disease progression in patients with chronic liver disease and to screen the general population to identify high risk patients with potential liver disease. However, most data on the clinical roles of TE have been gathered in European patients with chronic hepatitis C (CHC), because TE was first developed in France. Accordingly, much data on the usefulness of TE in patients with CHC has accumulated. Recently, however, vigorous efforts have been made to apply TE to patients with chronic hepatitis B (CHB), and TE has also proved to have acceptable accuracy in diagnosing liver fibrosis and cirrhosis in these patients. Thus, we focused on TE in the Asian population with CHB in comparison with the European population with CHC and found that the diagnostic performance and cutoff values were different between the 2 populations possibly as a result of several different confounders between Asian and European populations (the etiology of chronic liver disease, histologic features, major fluctuation in alanine aminotransferase levels, and the prevalence of high body mass index and metabolic syndrome). Therefore, further studies tailored to the Asian population with CHB should be performed before the widespread application of TE in Asian populations with CHB.