Prognostic value of posttreatment <Superscript>18</Superscript>F-FDG PET/CT and predictors of metabolic response to therapy in patients with locally advanced cervical cancer treated with concomitant chemoradiation therapy: an analysis of intensity- and volume-based PET parameters

Purpose

To investigate the prognostic value of posttreatment ¹⁸F-FDG PET/CT in patients with locally advanced cervical cancer (LACC) treated with concomitant chemoradiation therapy (CCRT). The secondary aim was to assess the possible role of intensity-based and volume-based PET parameters including SUVmax, SUVmean, MTV and TLG, and clinical parameters including age, pathology, FIGO stage and nodal involvement as factors predicting response to treatment.

Methods

This retrospective study included 82 patients affected by LACC treated with CCRT. All patients underwent ¹⁸F-FDG PET/CT both before and after treatment. The posttreatment PET/CT scans were used to classify patients as complete metabolic responders (CMR) or non-complete metabolic responders (N-CMR) according to the EORTC criteria. Kaplan-Meier analysis was used to evaluate differences in overall survival (OS) between the CMR and N-CMR groups. Student’s t test, Pearson’s chi-squared test and logistic regression were used to investigate the possible value of PET and clinical parameters as predictors of metabolic response to therapy.

Results

Kaplan­Meier analysis showed a highly significant difference in OS between the CMR and N-CMR groups (log-rank test p?<?0.0001). Significant independent predictors of response to therapy were MTV (p?=?0.019, odds ratio?=?1.015, 95% CI?=?1.002–1.028, Nagelkerke R²?=?0.110), TLG (p?=?0.045, odds ratio?=?1.001, 95% CI?=?1.000–1.002, Nagelkerke R²?=?0.081) and nodal involvement (p?=?0.088, odds ratio?=?2.361, 95% CI?=?0.879–6.343, Nagelkerke R²?=?0.051).

Conclusion

¹⁸F-FDG PET/CT-based response assessment using the EORTC criteria reliably predicts OS in LACC patients treated with CCRT. In our cohort of patients, pretreatment MTV and TLG and nodal involvement were predictors of response to therapy. MTV was the best predictor of response. However, its additional risk value seems to be low (MTV odds ratio?=?1.015).

     

A deletion of a novel heat shock gene on the Y chromosome associated with azoospermia

Deletions of the Y chromosome are a significant cause of spermatogenic failure. Three major deletion intervals have been defined and termed AZFa, AZFb and AZFc. Here, we report an unusual case of a proximal AZFb deletion that includes the Y chromosome palindromic sequence P4 and a novel heat shock factor (HSFY). This deletion neither include the genes EIF1AY, RPS4Y2 nor copies of the RBMY1 genes. The individual presented with idiopathic azoospermia. We propose that deletions of the testis-specific HSFY gene family may be a cause of unexplained cases of idiopathic male infertility. This deletion would not have been detected using current protocols for Y chromosome microdeletion screens, therefore we recommend that current screening protocols be extended to include this region and other palindrome sequences that contain genes expressed specifically in the testis.     

Comparison of the indirect immunofluorescent antibody test and the direct agglutination test for serodiagnosis of visceral Leishmaniasis in HIV-infected subjects

One hundred subjects positive for anti-human immunodeficiency virus (HIV) antibodies were tested for anti-Leishmania antibodies by the indirect immunofluorescent antibody test (IFAT) and the direct agglutination test (DAT). Subjects were subsequently followed for two years to monitor the onset of visceral leishmaniasis. Fifteen subjects were positive for anti-Leishmania antibodies in either one or both tests. Eleven were positive only by IFAT, one only by DAT, and three by both tests. During the two-year follow-up period, nine subjects developed visceral leishmaniasis; of these, six were serologically positive, four by IFAT alone and two by both tests. The results indicate that IFAT and DAT have a similar specificity but that IFAT has a higher sensitivity and a greater diagnostic significance.     

Modeling of DR CALUX bioassay response to screen PCDDs, PCDFs, and dioxin-like PCBs in farm milk from dairy herds

A recent issue in the EU legislation is the evaluation of the toxicologically-equivalent contribution of dioxin-like polychlorobiphenyls (DL-PCBs) in addition to that coming from polychlorodibenzodioxins (PCDDs) and polychlorodibenzofurans (PCDFs) as contaminants in foods for a total of 29 congeners. This fact is determining the need to revise analytical criteria both for confirmatory and screening analysis. In this work, a modeling was developed to check the reliability of the outcomes of the DR CALUX bioassay when applied to farm milk samples characterized by large differences in congener patterns. To reproduce some field conditions where DL-PCB contributions up to 90% of total WHO-TEQs (HRGC-HRMS assessment) were recorded in dairy products, goat milk samples from a common bulk were fortified at different TEQ levels with mixtures containing either PCDDs and PCDFs or non-ortho substituted DL-PCBs. Fortification ranged approximately 4.5-15 pgWHO-TEQ/g fat. Based on the results, DR CALUX relative potency value (REP) of DL-PCB 126 was estimated 0.061 against the canonical WHO-TEF of 0.1. The value of 0.061 together with the other DR CALUX REPs from the literature for the remaining 28 congeners were used to model DR CALUX response (C-TEQs) in milk samples with different congener patterns. The theoretical underestimation of DR CALUX data could be mitigated by correcting the latter with the linear correlation experimentally obtained between C-TEQs and the WHO-TEQs. Under these conditions, the use as calibrants of reference samples with different analytical patterns could help those laboratories involved in a high throughput routine to set the most appropriate decision limits to optimize screening output.     

No association between a common single nucleotide polymorphism,rs4141463, in the MACROD2 gene and autism spectrum disorder

The Autism Genome Project (AGP) Consortium recently reported genome‐wide significant association between autism and an intronic single nucleotide polymorphism marker, rs4141463, within the MACROD2 gene. In the present study we attempted to replicate this finding using an independent case–control design of 1,170 cases with autism spectrum disorder (ASD) (874 of which fulfilled narrow criteria for Autism (A)) from five centers within Europe (UK, Germany, the Netherlands, Italy, and Iceland), and 35,307 controls. The combined sample size gave us a non‐centrality parameter (NCP) of 11.9, with 93% power to detect allelic association of rs4141463 at an alpha of 0.05 with odds ratio of 0.84 (the best odds ratio estimate of the AGP Consortium data), and for the narrow diagnosis of autism, an NCP of 8.9 and power of 85%. Our case–control data were analyzed for association, stratified by each center, and the summary statistics were combined using the meta‐analysis program, GWAMA. This resulted in an odds ratio (OR) of 1.03 (95% CI 0.944–1.133), with a P‐value of 0.5 for ASD and OR of 0.99 (95% CI 0.88–1.11) with P‐value = 0.85 for the Autism (A) sub‐group. Therefore, this study does not provide support for the reported association between rs4141463 and autism. © 2011 Wiley‐Liss, Inc.     

Admixture analysis of age at onset in bipolar disorder

The aim of this study was to identify whether age at onset (AAO) identifies Bipolar Disorder (BD) subtypes, and to test whether the subgroups were confirmed by different clinical profiles. Admixture analysis was applied to determine a model that best fit the observed distribution of AAO in 964 BD patients. Three distributions of AAO were identified, and age means were 16.1 (S.D. 4.2), 25.4 (S.D. 2.5) and 32.2 (S.D. 9.5) years. A significant increased rate of suicide attempts, Bipolar I (BD I) caseness, and depressive onset was observed in the early-onset group when compared to those with later-onset by means of χ². Findings from extant studies and our results are remarkably consistent in showing that BD can be subdivided into three groups based on AAO distributions, and that early-onset is associated with higher rates of suicide attempts.