Predictor Of Tumor Growth Research Articles

The value of diffusion-weighted imaging in the natural history of meningiomas: a predictor of tumor growth.

The general trend in meningioma treatment is shifting from surgery to active surveillance. However, the natural history of meningioma still needs to be clarified, and a simple, practical method is needed to identify fast-growing tumors. The authors aimed to determine whether diffusion-weighted imaging (DWI) could be a valuable imaging modality for predicting meningioma growth. Consecutive asymptomatic patients with a meningioma diagnosed on MRI and followed up at the authors' institution between July 2011 and July 2019 were eligible for inclusion in this retrospective study. Univariable and multivariable Cox regression analyses were used to explore whether the relative apparent diffusion coefficient (rADC) was an independent predictor of meningioma growth. Correlations between tumor growth rate (TGR), tumor volume doubling time (VDT), Ki-67, and rADC were assessed using the Pearson correlation coefficient. The predictive ability of rADC was evaluated using receiver operating characteristic (ROC) curves and validated with internal validation data. Sixty-four patients (47 females, 17 males) with a mean age of 62.2 ± 1.4 years were included in this study. Univariable and multivariable analyses revealed that rADC was an independent predictor of meningioma growth (p < 0.05). ROC curve analysis showed that baseline rADC had good predictive power for growing meningiomas (AUC = 0.88, 95% CI 0.78-0.96), as well as slow- or fast-growing meningiomas (AUC = 0.83, 95% CI 0.59-0.98). Moreover, rADC still had a good ability to discriminate between growing and nongrowing meningiomas in the validation set (AUC = 0.85, 95% CI 0.64-1.00). In the 20 patients with tumor growth, baseline rADC was moderately negatively correlated with TGR (r = -0.50, p = 0.02) and strongly positively correlated with VDT (r = 0.63, p = 0.003). Moreover, Ki-67 was significantly associated with rADC in 8 patients who had undergone surgery (r = -0.75, p = 0.03). In asymptomatic meningiomas, the lower the rADC at baseline, the faster the TGR and the shorter the VDT. DWI could be a valuable tool in predicting meningioma growth in asymptomatic patients.

Wait and Scan Management of Intra-canalicular Vestibular Schwannomas: Analysis of Growth and Hearing Outcome

To report on the results of intracanalicular vestibular schwannomas (ICVS) that were managed by wait and scan and to analyze the possible predictors of tumor growth and hearing deterioration throughout the observation period. A retrospective case series. Quaternary referral center for skull base pathologies. Patients with sporadic ICVS managed by wait and scan. Serial resonance imaging (MRI) with size measurement and serial audiological evaluation. Tumor growth defined as 2 mm increase of maximal tumor diameter, further treatment, and hearing preservation either maintain initial modified Sanna hearing class, or maintain initial serviceable hearing (class A/B). 339 patients were enrolled. The mean follow-up was 36.5±31.7 months with a median of 24 months. Tumor growth occurred in 141 patients (40.6%) either as slow growth (SG) in 26.3% of cases or fast growth (FG) in 15.3% of cases. Intervention was performed in only 64 cases (18.8%). Out of 271 patients who underwent hearing analysis, 86 patients (33.5%) showed hearing deterioration to a lower hearing class of the modified Sanna classification. Tumor growth and older age were predictors of hearing deterioration. Of the 125 cases with initial serviceable hearing (Class A/B), 91 cases (72.8%) maintained serviceable hearing at last follow-up. Tumor growth and a worse initial pure tone average (PTA) were predictors of hearing deterioration. Wait and scan management of ICVS is a viable option and only 18.8% of patients needed further treatment. Hearing tends to deteriorate over time.

Prognostic value of matrix metalloproteinases and transforming growth factor – β in kidney cancer

Purpose of the study. The study's objective is to investigate the expression level of tissue and serum markers of oncogenesis and nephrofibrosis transforming growth factor beta (TGF‑β) and matrix metalloproteinase‑9 (MMP‑9) in patients operated for various stages of renal cell carcinoma.Materials and methods. The study prospectively included medical data of 60 patients with kidney cancer with T1–3N0M0 who received surgical treatment in the Clinic of Urologynamed after S. R. Mirotvortsev of the State Medical University from 2016 to 2019. The patients were divided into 3 groups: Group 1 included 20 patients who underwent laparoscopic kidney resection; Group 2–20 patients who underwent laparoscopic nephrectomy; Group 3–20 patients who underwent open nephrectomy. The control group consisted of 15 healthy volunteers without chronic kidney diseases. All patients signed an informed consent to participate in the study. All patients at the preoperative stage, in the early (7–10 days) and remote postoperative periods (after 1 and 2 years) were tested by solid‑phase ELISA on a StatFax 4200 analyzer using eBiosence and Cloud‑Clone Corp reagent kits for the serum concentration of oncogenesis markers MMP‑9 and TGF‑β1.Results. Initial increase of MMP‑9 concentration was detected in all groups of PCC patients compared to the control group (p ≤ 0.05). According to the results of ROC analysis, this indicator has high specificity and sensitivity for prognosis of preoperative stage of renal cell carcinoma. The sensitivity and specificity of MMP‑9 were 87.5 % and 62 %, respectively, and the diagnostically significant level of MMP‑9 was 958 ng/ml. A comprehensive analysis of the content of MMP‑9 and TGF‑β1 oncogenesis markers in serum and tumor cells revealed the correlation of these indicators in various biological objects.Conclusion. Markers of oncogenesis and nephrofibrosis TGF‑β1 and MMP‑9 provide an opportunity for non‑invasive monitoring of tumor progression and probability of metastasis in the clinical setting. Serum MMP‑9 are a reliable predictor of tumor growth. Serum TGF‑β1 concentration isn't a sufficiently reliable marker of tumor progression.

Stress as a predictor of tumor growth and development of metastases.

e24124 Background: The aims of this study were to examine; the predictors of perceived stress; and the associations between perceived stress and tumor growth and development of metastases as well as the mediational role of inflammatory biomarkers. Methods: This study is prospective in design. A battery of questionnaires, including a sociodemographic characteristic and the Perceived Stress Scale, was collected at baseline from patients diagnosed with solid tumors at various stages of treatment. Disease progression was measured over a 12-month period. Poverty threshold was determined using the U.S. Department of Health &amp; Human Services 2020 poverty guidelines. Computerized tomography and Magnetic Resonance Imaging scans were assessed for disease progression between baseline and 12 months using Response Evaluation Criteria in Solid Tumors. Blood was collected and serum levels of IL-2, IL-1a, IL-1b, TNF-a, IL-6, and IL-8 were assessed. The predictors of stress include sociodemographic and disease specific characteristics. Primary outcomes were tumor growth and development of metastases. Descriptive statistics, correlations, and ordinal and linear regression were performed to assess the aims. Results: Of 159 patients diagnosed with cancer, 47.8% were male, mean age was 62.97 (SD = 10.35), 89.3% were Caucasian, and 13.8% met poverty guidelines. Significant predictors of stress were age (b=-.151, p=0.029, 95% C.I.=-2.86-.016) and income below the poverty threshold (b= 5.615, p=0.007, 95% C.I.=1.596-9.635). Gender was the only sociodemographic and disease specific factor significantly associated with disease progression. After adjusting for gender, greater perceived stress was associated with tumor growth and development of metastases (p =0.029), accounting for 33.3% of the variance. Circulating cytokines were significantly related to disease progression [IL-1a, p=0.020; IL-1b, p=0.011; IL-6, p&lt;0.001; and IL-8, p&lt;0.001] but not stress [IL-1a, p=0.369; IL-1b p=0.292; IL-2, p=0.470; IL6 p=0.406; and IL8, p=0.401]. Conclusions: Future research should evaluate inflammation in the tumor microenvironment as well as neutrophils and tumor suppressor genes as potential mediators between stress and disease progression.

MRI Monitoring of Residual Vestibular Schwannomas: Modeling and Predictors of Growth.

The aim was to model residual Vestibular Schwannoma (VS) over time to identify prognostic factors of postsurgical growth. Multicenter retrospective study. Tertiary referral centers. A group of 135 patients who underwent incomplete resection for VS between January 2010 and December 2018. On magnetic resonance imaging (MRI) examinations at baseline (1 year after surgery), patients included were divided into two groups: near-total resection (NTR, <25 mm × 2 mm) and subtotal resection (STR, greater volume). Monitoring of residual VS volume. 3D volumetric segmentation of residual tumors was performed on every MRI examination at baseline and during follow-up to model volume changes over time using the Lambda-Mu-Sigma method. The study followed-up 127 patients (median age: 56 yr) over a median follow-up of 39 months. Most VS residues (76.7%; 89/116) showed no growth at 5 years. Only 27 (23.3%) residues showed signs of regrowth (increase in volume >0.05 cm). The extent of resection is a predictor of tumor growth (odds ratio [OR] = 4.85; for STR over NTR; p = 0.003), but the growth rate was significantly different between STR and NTR residues (p < 0.001). At first, over 2 years after surgery, STR residues decreased (-1.0% volume per year), whereas NTR ones grew (+8% per year). Then, both residues showed sign of regrowth. Postoperative recommendations should now include the natural history of VS residue after resection: even though the growth rate differs between STR and NTR residues, most VS residues showed no growth.

Elderly Patients with Intracranial Meningioma: Surgical Considerations in 228 Patients with a Comprehensive Analysis of the Literature

Improved life expectancy and advanced diagnostic tools including computed tomography and magnetic resonance imaging have increased the awareness and diagnosis of intracranial meningiomas in the elderly population. The risk/benefit ratio of surgery in elderly patients with intracranial meningioma has not been clearly defined because of the lack of objective measurement tools. We aimed to understand the risk factors associated with postsurgical outcomes and how these risk factors affected postsurgical outcomes in elderly patients with intracranial meningioma. We retrospectively evaluated 1372 patients, who were operated on for intracranial meningioma, using our prospectively collected database. The same senior author operated on all patients at 2 different tertiary clinics. Patients' clinical charts, presurgical postcontrast T1-weighted magnetic resonance images, operative reports, and pathology reports were reviewed. The relevant literature was also reviewed. Higher age, higher American Society of Anesthesiologists class, presence of comorbidities, tumor location, larger initial tumor size, and presence of peritumoral edema were all associated with postsurgical complications in elderly patients with intracranial meningioma. Age ≥50 years wasthe strongest predictor of postsurgical systemic complications, whereas higher American Society of Anesthesiologists class was the strongest predictor of postsurgical neurologic complications. A literature review showed higher morbidity and mortality of elderly patients with intracranial meningioma. Initial tumor size and postsurgical MIB-1 labeling index were higher in the elderly patients, both of which were predictors of tumor growth. Even though elderly patients operated on for intracranial meningioma had higher morbidity and mortality compared with younger patients, surgery is still much more beneficial than wait-and-see strategy in elderly patients.

Анеуплоїдія букальних епітеліальних клітин: феномен чи потенційна загроза

Aneuploidy is regarded today [1] as a result of reducing and lengthening of large areas (translocations) chromosome movement. Most aneuploid cells die immediately, but the few that survived have thousands of genes dose of which is not the same as in normal cells. Coordinated team of enzymes, providing the synthesis of deoxyribonucleic acid (DNA) and its integrity, breaks in the double helix, have gaps, further destabilizing the genome. The higher the degree of unstable cells aneuploidy the more likely tumor cells will be in the end result. A probability of tumors in the genetic defect presence is not predictable.The aim of the study – to leart the contraction and extension of chromosomal motion on large areas.Materials and Methods. Modern materials used for dental prostheses include crosslinked polymers and somonomery materials to be relatively intact cells of oral mucosa. However, only acrylic detachable plate implants contain potentially hazardous substances, methyl esters of methacrylic acid, which, according to laboratory data, were protoplasmic poisons. But researchers observed the effect of only high doses of unrealistic dentures. The DNA cytometry technology fi xes chromosomal lesions that can potentially cause the development of the tumor and which is likely to be a predictor of tumor growth. DNA content in nuclei of buccal epithelium cells was determined using fl ow cytometry.Results and Discussion. The indicators of cell cycle indicators buccal epithelium in 70 people were studied. Among them 23 patients on the background of the hypothesis of the plate crypt prosthesis, 23 – with the prosthetics on the basis of thermoplastic plastics. The comparison group consisted of 24 clinically healthy people without defects in dentition. Criteria for inclusion were patients with severe systemic diseases, tobacco smoking, burdened allergic history, complete absence of teeth, prosthetic stomatitis, chronic generalized periodontitis in acute condition, refusal of the patient to participate in the survey. The subject of the study was the buccal epithelium of the mucous membrane of the patient’s oral cavity, since the superfi cial epithelium is the main structural and functional component of the mucous membrane. An unexpected damage to the cell cycle during treatment with acrylic prosthesis bases was the detection of aneuploid epithelium, which was detected in 2 patients. These cells are genetically unstable and a sign of readiness for tumor growth and the presence of aneuploidy is associated with more serious complications and is a marker of an adverse prognosis. The study describes aneuploid cells, but there is still a question: is this a phenomenon or a potential threat? We did not fi nd any patient with acrylic prosthesis in whom the development of oral cavity was diagnosed, but it is necessary to know that the duration of using prosthetics was up to 2 years, which does not allow completely evaluating the oncogenic risk of this category of patients.Conclusions. Aneuploidy is a serious violation of DNA that is fi xed when using acrylic dentures. Potential carcinogenicity of this phenomenon requires further study.

Enhanced Antitumor Efficacy of a Vascular Disrupting Agent Combined with an Antiangiogenic in a Rat Liver Tumor Model Evaluated by Multiparametric MRI

A key problem in solid tumor therapy is tumor regrowth from a residual viable rim after treatment with a vascular disrupting agent (VDA). As a potential solution, we studied a combined treatment of a VDA and antiangiogenic. This study was approved by the institutional ethical committee for the use and care of laboratory animals. Rats with implanted liver tumors were randomized into four treatment groups: 1) Zd6126 (Zd); 2) Thalidomide (Tha); 3) Zd in combination with Tha (ZdTha); and 4) controls. Multiparametric MRIs were performed and quantified before and after treatment. Circulating endothelial progenitor cells (EPCs) and plasma stromal cell-derived factor-1α (SDF-1α) were monitored. Tumor apoptosis, necrosis, and microvessels were verified by histopathology. A single use of Zd or Tha did not significantly delay tumor growth. The combined ZdTha showed enhanced antitumor efficacy due to synergistic effects; it induced a cumulative tumor apoptosis or necrosis, which resulted in significant delay in tumor growth and reduction in the viable tumor rim; it also reduced tumor vessel permeability; and it improved tumor hemodynamic indexes, most likely via a transient normalization of tumor vasculature induced by Tha. A stepwise linear regression analysis showed that the apparent diffusion coefficient was an independent predictor of tumor growth. We found no significant increases in Zd-induced circulating EPCs or plasma SDF-1α. ZdTha showed improved therapeutic efficacy in solid tumors compared to either agent alone. The therapeutic effects were successfully tracked in vivo with multiparametric MRI.

Somatotroph Tumor Progression during Pegvisomant Therapy: A Clinical and Molecular Study

Context: There is concern that pegvisomant could be associated with a higher risk of tumor growth. The rate and possible determinants of this tumor growth are unknown. Objective: The objective of the study was to investigate the clinical, immunohistological, and molecular factors conditioning tumor growth in patients taking pegvisomant. Design and Setting: This was a cross-sectional study performed from 2004 to 2010 in four university hospitals in Spain. Patients: Seventy-five acromegalic patients with active disease resistant to somatostatin analogs treated with pegvisomant were followed up for a mean of 29 ± 20 months. Main Outcome Measures: Magnetic resonance images before initiation of pegvisomant, at 6 months, and then yearly were examined in all patients. Immunohistological and molecular studies were performed in tumors that grew. Results: A significant increase in tumor size was observed in five patients (6.7%). Absence of previous irradiation (P = 0.014) and shorter duration of prepegvisomant somatostatin analog therapy (P &amp;lt; 0.001) were associated with an increased risk of tumor growth. A stepwise multivariate linear regression analysis (R2 = 0.334, P &amp;lt; 0.001) identified the duration of somatostatin analog therapy prior to pegvisomant (beta = −4.509, P = 0.014) as the only significant predictor of tumor growth. In those tumors that grew, GH expression and insulin receptor expression were higher (P = 0.033 in both cases) than in the control group. Conclusions: No previous radiotherapy, shorter duration of prepegvisomant somatostatin analog therapy, and higher tumor expression of GH and insulin receptor could be risk factors for tumor growth during pegvisomant therapy.