The expression of HtrA2 and its diagnostic value in patients with hepatocellular carcinoma
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The purpose of this study was to detect the expression of high-temperature requirement A2 (HtrA2) and its diagnostic value in the patients with hepatocellular carcinoma (HCC). The relative serum HtrA2 expression at mRNA and protein level was severally detected by quantitative real-time polymerase chain reaction and western blot analysis in 198 HCC patients and 48 healthy controls. And its association with clinicopathological features was analyzed by chi-square test. The diagnostic value of HtrA2 expression was estimated by establishing a receiver operating characteristic (ROC) curve. Serum HtrA2 was significantly higher in patients with HCC than that in healthy controls both at mRNA and protein levels (P < .05 for both). In addition, the high HtrA2 expression was associated with large tumor size and advanced clinical stage. Furthermore, the value of the area under the ROC curve was 0.808 corresponding with a sensitivity of 65.2% and a specificity of 89.6%, revealed that HtrA2 might be a diagnostic biomarker in HCC. HtrA2 is upregulated and considered to be a potential biomarker for the diagnosis of patients with HCC.Objective To evaluate the accuracy of six laboratory tests for the diagnosis of hyperthyroidism. Methods The levels of TT3,TT4,FT3,FT4,rT3 and s-TSH in 150 patients with hyperthyroidism and 100 normal persons were measured by RIA and IRMA. Receiver operating characteristic (ROC) curve was drawn, and the area under the curve was calculated. Results The area under ROC curve of S s-TSH ,S FT3 ,S TT3 ,S FT4 ,S rT3 and S TT4 was 0.957,0.952,0.933,0.905,0.899 and 0.874 respectively. Conclusions The accuracy of s-TSH and FT3 is the best in diagnosis of hyperthyroidism according to the ROC curve evaluation.
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The receiver operating characteristic (ROC) curve represents characteristics specific to an examination (diagnostic sensitivity and specificity) and is useful for evaluation and comparison of the diagnostic accuracy. However, the ROC curve is not widely used at present. In this symposium, we showed how to draw this curve and its practical utilization, using as examples the diagnosis of the diabetic and impaired glucose tolerance group and the diagnosis of deep-seated fungal infection and acute myocardial infarction. In the ROC curve, true positive is plotted on the vertical axis and false positive on the horizontal axis. This curve is readily drown and visually shows the diagnostic accuracy that can not be clarified by histograms. The advantages of this curve are as follows. 1. Diagnostic accuracy can be compared. 2. The significance of the reference interval in diagnosis can be evaluated. 3. The diagnostic cut-off value can be determined using this curve. 4. Combined with prevalence, the diagnostic probability can be represented quantitatively. The points that require attention are differences in the ROC curve according to selection of subjects (including controls), the time factor (disease stage) and severity (disease condition). By paying attention to these points, the ROC curve can be used as a simple and useful method in laboratory diagnosis. We hope that this curve will be widely used.
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drug allergies, are time consuming and potentially dangerous.Thus many efforts have been made to find safe in vitro techniques to complement skin testing in the diagnosis of drug allergy, one of them being the basophil activating test (BAT). 10BAT has been proved to be useful in the diagnosis of allergy to neuromuscular blocking agents 11 and antibiotics. 12There are several open questions for the application of BAT concerning the optimal drug concentrations and the threshold for positivity, the minimal basophils number to be analysed, drug solubility, blood sample storage and optimal incubation conditions. 10Flow cytometric determinations of basophil activation following stimulation with dipyrone represents an important technique for the in vitro diagnosis of immediate-type allergy and a
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Objective:To search for diagnostic critical value of nail creatinine (NCr) for acute renal failure (ARF) and chronic renal failure (CRF).Methods:Using receiver operating characteristic (ROC) curve method,we analyzed the diagnostic index for ARF and CRF——diagnostic critical value of NCr.Results:Because of individual distributing overlap of the NCr in ARF and CRF and because of the different determinate value for each selected cutoff point,the sensitivity (Se) and specificity (Sp) might vary,there would be differences in area under the ROC curve.The ROC curve area was 78 9 under the 5 cutoff point,and at peak point of the ROC curve the NCr was 84 9.Conclusions:Because ROC curve method combines Se and Sp to estimate the diagnostic critical value of disease index and determine the veracity by the area under the curve,this method has the practical value for clinical diagnosis when ROC curve area is 0 70 9 and NCr was 84 9.
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P50 Background and Purpose: To compare the sensitivity and specificity of quantitative cerebral blood flow (qCBF) vs. time from symptom onset to the measurement of qCBF (Time) as a predictor of cerebral infarction in patients (pts.) with acute ischemic stroke. Methods: 51 pts. with acute ischemic stroke who were assessed with XeCT, CTA and CT within 24 hours of symptom onset were studied. The MCA territory was divided into anterior and posterior divisions (two divisions/pt. for a total of 102 divisions). The average qCBF for each of these divisions was calculated and initial and follow-up CT scans were read for new infarction in both divisions. 24 divisions with evidence of prior infarction on the initial CT were excluded from the analysis. This left a total of 78 divisions available for analysis. Logistic regression was used to generate receiver operating curves (ROC) for both qCBF and Time. The area under each ROC curve is reported. Results: Twenty-one of the 78 (26.9%) divisions without initial infarction on CT had evidence of new infarction on the follow-up CT. The area under the qCBF curve was 0.81 compared with an area of 0.49 under the Time curve (p=0.00025). Excluding patients receiving thrombolytic therapy, (n=11), the area under the qCBF curve was 0.799 and the area under the Time curve was 0.590 (p=0.00004). The area under the ROC curve for qCBF was significantly greater than Time in those patients studied 180 min. (qCBF=0.76, Time=0.50; p=0.01) Conclusion: Quantitative cerebral blood flow measured by XeCT is a better predictor of new infarction on follow-up CT than Time in pts. with acute ischemic stroke. This holds true for time 180 minutes.
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Background and objective: Validity of continuous variable test like total serum IgE is performed by constructing Receiver Operating Characteristic (ROC) curve. ROC curve is a technique for visualizing, organizing and selecting classifiers based on their performance. The study aims to determine the performance and validity of total serum IgE in various allergic diseases, age groups and gender. To select the optimal cut off value that has the best discriminative capability. To assess the sensitivity, specificity, predictive value and likelihood ratio of the selected cut-off points. Materials and method: A diagnostic Receiver Operator Characteristic ROC curvestudy was conducted at Allergy Clinic, Al-Jamhouri Teaching Hospital in Mosul, Iraq on 751 individuals (561 patients with various allergic disorders and 190 healthy non-allergic subjects) ranged in age from 10 to 59 years. Classification of study samples into allergic or healthy groups was done by a committee panel of two qualified and expert allergiologist. A blood sample was taken for estimating total serum IgE by ELISA. Results: The constructed ROC curve of overall sample showed that total serum IgE has moderate accuracy in allergic diseases and the AUC ± SE was 0.730±0.022 with 95% confidence interval (0.686-0.773). Urticaria ROC curve had the maximum AUC (0.742±0.030) and asthma had the minimum AUC (0.720± 0.027). The maximum AUC was detected in the age group 10-19 years and the least one was in age 50-59 years. No difference was found in the estimated AUC in both gender. The optimal cut-off point of total serum IgE was 96 IU/ml in the overall allergic patients and varies between 95 IU/ml (in urticaria) and 115 IU/ml (in rhinitis). Assessment of selected overall cutoff point of total serum IgE reveals the following: sensitivity (79.3%), specificity (61.0%), validity (74.7%), PPV (50.0%), NPV (85.7%), LH+ (2.03), LH-(0.34). Conclusion: Total serum IgE has moderate accuracy in diagnosis of various allergic diseases. Its accuracy is much better in younger patients in comparison to elderly. A cut offpoint of total serum IgE(100±5 IU/ml) was the best classifier. Total IgE is a useful screening rather than a confirmatory test.
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Objective: To evaluate the role of HbA1c in T2DM diagnosis.Methods:251 patients were underwent oral glucose tolerance test(OGTT) and HbA1c measurement.The receiver operating characteristic(ROC) curve was drawing.Results:The optimal cut-point of ROC curve of HbA1c is 7.05%,with sensitivity of 91.1%,specificity of 92.8%,area under the curve(AUC) of 0.971.However,the optimal cut-point of ROC curve of FPG was 6.94mmol/L,with sensitivity of 81%,specificity of 100%,area under the curve(AUC) of 0.944.Conclusion:Compared with FPG(cut-point: 6.94 mmol/L),HbA1c(cut-point: 7.05%) has higher sensitivity but lower specificity.
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P50 Background and Purpose: To compare the sensitivity and specificity of quantitative cerebral blood flow (qCBF) vs. time from symptom onset to the measurement of qCBF (Time) as a predictor of cerebral infarction in patients (pts.) with acute ischemic stroke. Methods: 51 pts. with acute ischemic stroke who were assessed with XeCT, CTA and CT within 24 hours of symptom onset were studied. The MCA territory was divided into anterior and posterior divisions (two divisions/pt. for a total of 102 divisions). The average qCBF for each of these divisions was calculated and initial and follow-up CT scans were read for new infarction in both divisions. 24 divisions with evidence of prior infarction on the initial CT were excluded from the analysis. This left a total of 78 divisions available for analysis. Logistic regression was used to generate receiver operating curves (ROC) for both qCBF and Time. The area under each ROC curve is reported. Results: Twenty-one of the 78 (26.9%) divisions without initial infarction on CT had evidence of new infarction on the follow-up CT. The area under the qCBF curve was 0.81 compared with an area of 0.49 under the Time curve (p=0.00025). Excluding patients receiving thrombolytic therapy, (n=11), the area under the qCBF curve was 0.799 and the area under the Time curve was 0.590 (p=0.00004). The area under the ROC curve for qCBF was significantly greater than Time in those patients studied < 180 minutes (qCBF=0.92, Time=0.51; p=0.02) and > 180 min. (qCBF=0.76, Time=0.50; p=0.01) Conclusion: Quantitative cerebral blood flow measured by XeCT is a better predictor of new infarction on follow-up CT than Time in pts. with acute ischemic stroke. This holds true for time < 180 minutes and > 180 minutes.
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