The potential biomarkers for thromboembolism detected by SELDI-TOF-MS

Introduction

Few studies were concerned about searching for specific biomarkers for thromboembolic (arterial and venous) diseases by the use of Surface-Enhanced Laser Desorption/Ionization Time-of-Flight Mass Spectrometry (SELDI-TOF-MS).

Materials and Methods

We screened for potential biomarkers in 69 plasma samples, including samples from 20 patients with idiopathetic deep vein thrombosis (DVT), 20 patients with acute myocardial infarction (AMI), and 29 healthy controls without a history of thromboembolism. Pretreated plasma samples were analyzed on the Protein Biology System IIc plus SELDI-TOF-MS (Ciphergen Biosystems, Fremont, CA). Proteomic spectra of mass to charge ratio (m/z) were generated by the application of plasma to immobilized metal affinity capture (IMAC-3) ProteinChip arrays activated with copper.

Results

A pattern of three biomarkers (m/z: 2 667, 5 914, and 6 890 Da, respectively) with a total accuracy of 100% was selected based on their collective contribution to the optimal separation between patients with AMI and healthy controls. Another spattern consisting of only one biomarker (m/z: 5 914 Da) could totally discriminate patients with DVT and control subjects. For further analysis between patients with AMI and those with DVT, a pattern of four biomarkers (m/z: 3 418, 5 271, 33 378, and 68 125 Da, respectively) was selected with a total accuracy of 82.5%.

Conclusions

Plasma proteomic profiling with SELDI-TOF-MS and ProteinChip technologies provides high sensitivity and specificity in discriminating patients with thrombosis and healthy subjects. The discovered biomarkers might show great potential for early diagnosis of thromboembolic diseases.     

Case-Control Comparison of Conventional End-Hole versus Balloon-Occlusion Microcatheter Prostatic Artery Embolization for Treatment of Symptomatic Benign Prostatic Hyperplasia

PurposeTo compare procedural metrics and clinical improvement for prostatic artery embolization (PAE) performed with a balloon-occlusion (BO) versus end-hole (EH) microcatheter in patients with benign prostatic hyperplasia.Materials and MethodsRetrospective review was performed of 129 patients undergoing PAE with 100–300 μm Embosphere microspheres from April 2013 through August 2018. Microcatheter selection was nonrandom, based on prostatic artery anatomy. Five technical failures and 5 microcatheter crossover cases were excluded. BO group (n = 46, age 72.8 y ± 9.0, gland volume 184 mL ± 83, 42% in retention) and EH group (n = 73, age 76.0 y ± 9.0, gland volume 190 mL ± 116, 44% in retention) were compared using procedural metrics (excluding 30 EH learning-curve cases); symptomatic improvement at 3, 6, and 12 months after PAE; voiding trial success; and adverse events (reported used Clavien-Dindo classification).ResultsProcedural and fluoroscopy times were lower in the BO group (n = 46) vs EH group (n = 43) (152.0 min ± 34.0 vs 172.8 min ± 47.9, P < .02; 37.8 min ± 12.9 vs 50.3 min ± 18.9, P < .001). Collaterals coiled, contrast material used, and injected particle volume were similar for both groups (P = NS). International Prostate Symptom Score improvement was similar for BO group (n = 25) (before PAE 23.5 ± 6.5, 12 months after PAE 7.6 ± 6.8) and EH group (n = 30) (before PAE 20.9 ± 5.9, 12 months after PAE 6.6 ± 5.2) (P = NS). Quality-of-life improvements were also similar (BO: before PAE 4.5 ± 1.2, 12 months after PAE 1.4 ± 0.9; EH: before PAE 4.1 ± 1.0, 12 months after PAE 0.9 ± 0.7), as were 12-month postvoid residual improvements, voiding trial failure rates (EH 12%, BO 8%), and adverse event rates (grade II, III: EH 15%, BO 11%) (P = NS for all).ConclusionsBO microcatheter use in PAE did not affect injected particle volume, contrast material use, or protective coiling and did not impact symptomatic improvement, postvoid residual improvement, voiding trial success, or adverse events after PAE. Lower procedure and fluoroscopy times with BO microcatheter were likely due to selection bias.     

Germline Testing of Patients With Non–small Cell Lung Cancers Demonstrating Incidentally Uncovered BRCA2 Apparent Pathogenic Germline Variants

Tumor next generation sequencing (NGS) is used to interrogate nearly every non–small cell lung cancer (NSCLC) for the purpose of identifying actionable genetic alterations. Occasionally, tumor NGS also uncovers “incidental” apparent pathogenic germline variants (PGVs), with BRCA2 being among the most common of those. If germline testing confirms a BRCA2 PGV in a patient with NSCLC, therapies targeting that BRCA2 PGV might be considered, if the patient has exhausted standard NSCLC therapeutic options. Surveillance and preventive therapies for BRCA2-related cancers would be recommended or considered for that patient, as well as for family members found to carry that same BRCA2 PGV. Here, I offer my perspective related to the evidence supporting and against germline testing in patients with NSCLCs that show incidental BRCA2 apparent PGVs. I use an example to underscore how important it is to explain to patients, before tumor NGS, the possibility of uncovering an incidental PGV. I also review the myriad uncertainties related to identifying a BRCA2 PGV, when the sole indication for germline testing was the uncovering of the incidental BRCA2 apparent PGV.     

Retrograde–Antegrade Accelerated Trap Obliteration: A Modified Approach to Transvenous Eradication of Gastric Varices

This series presents a hybrid technique for obliteration of gastric varices (GVs) termed retrograde–antegrade accelerated trap obliteration that employs sclerosant agent instillation under concurrent inflow and outflow vessel occlusion with coils or plugs. Six patients (mean age, 56 y) with GVs were treated in 2014 and 2015. Technical success rate was 100%. Five patients completed 30-day follow-up. There were no procedure-related complications, and clinical success rate was 100%, with no bleeding recurrence over a mean follow-up of 298 days ± 178. GV obliteration rate was 100% (n = 4) at a mean of 157 days ± 158. This limited experience suggests that the described technique represents a viable approach to GV obliteration.