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Clinical Radiology Dec 2020To evaluate the diagnostic performance of whole-body (WB) integrated single photon emission tomography (SPECT)/computed tomography (CT) in detecting bone metastasis (BM)... (Meta-Analysis)
Meta-Analysis
AIM
To evaluate the diagnostic performance of whole-body (WB) integrated single photon emission tomography (SPECT)/computed tomography (CT) in detecting bone metastasis (BM) and to investigate whether WB-SPECT/CT offered any additional benefit value compared to planar bone scintigraphy (PBS) with Tc-hydroxy-methylene diphosphonate or Tc methylene diphosphonate.
MATERIALS AND METHODS
Medline, EMBASE, SCOPUS, Web of Science, and CINAHL were searched systematically up to 28 August 2019. All studies using histopathological analysis and/or follow-up imaging and clinical data as the reference standard were eligible for inclusion.
RESULTS
Eleven studies (1,611 patients) were analysed. Based on patient analysis, the sensitivity, specificity, and area under the curve (AUC) of WB-SPECT/CT were 92% (92% confidence interval [CI], 89-95%), 95% (95% CI, 94-96%), and 0.9835, respectively, in the case of negative equivocal findings for BM, and 94% (95% CI, 91-96%), 94% (95% CI, 92-95%), and 0.9790, respectively, when regarded positive. On a lesion basis, these parameters were 91% (95% CI, 89-94%), 96% (95% CI, 94-97%), and 0.9906, respectively, in the case negative equivocal findings, and 92% (95% CI, 89-94%), 95% (95% CI, 94-97%), and 0.9898, respectively, when regarded positive. Comparing 1,265 patients from eight studies, higher sensitivity (92% versus 74%, p=0.04) and specificity for WB-SPECT/CT against PBS (93% versus 80%, p=0.01) in the case of positive equivocal findings; however, when regarded negative, WB-SPECT/CT demonstrated higher sensitivity (91% versus 70%, p=0.01), but no significant difference was apparent in specificity (94% versus 89%, p=0.07).
CONCLUSION
Compared to PBS, WB-SPECT/CT had superior diagnostic accuracy in BM detection and exhibited a more reliable performance with less equivocal results.
Topics: Bone Neoplasms; Humans; Multimodal Imaging; Radiopharmaceuticals; Technetium Tc 99m Medronate; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed; Whole Body Imaging
PubMed: 32868091
DOI: 10.1016/j.crad.2020.07.026 -
Breast (Edinburgh, Scotland) Dec 2021This meta-analysis aimed to investigate the efficacy and safety of poly (adenosine diphosphate-ribose) polymerase (PARP) inhibitors in BRCA-mutated advanced breast... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
This meta-analysis aimed to investigate the efficacy and safety of poly (adenosine diphosphate-ribose) polymerase (PARP) inhibitors in BRCA-mutated advanced breast cancer patients comprehensively.
METHODS
We conducted a systematic literature research through PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), Embase, China National Knowledge Infrastructure (CNKI), wanfang, China Biology Medicine disc (CBMdisc), and ClinicalTrials.gov from inception to January 2021. Randomized controlled trials (RCTs) with available data comparing PARP inhibitors versus control therapy in BRCA-mutated advanced breast cancer were eligible for analysis. Statistical analyses were performed with Review Manager (RevMan) version 5.4 and R version 4.0.3.
RESULTS
1706 studies were retrieved in total, and 4 RCTs with 1540 patients were eligible for meta-analysis finally. The results showed that progression-free survival (PFS) and overall survival (OS) were significantly improved in germline BRCA-mutated breast cancer patients with PARP inhibitors (HR 0.64, 95% CI [0.56-0.74]; HR 0.86, 95% CI [0.74-0.99], respectively) with no significant heterogeneity across studies (I = 22%, χ p = 0.28; I = 0%, χ p = 0.70, respectively). There was no significant difference in the overall adverse events (AEs), grade≥3 AEs and AEs leading to treatment discontinuation between PARP inhibitor arms and control arms (RR 1.01, 95% CI [0.99-1.02]; RR 0.95, 95% CI [0.83-1.09]; RR 1.17, 95% CI [0.87-1.57], respectively). Based on the available data, PARP inhibitors provided comparable or better results than control arms in improving the quality of life in BRCA-mutated advanced breast cancer patients.
CONCLUSIONS
PARP inhibitors prolonged PFS and OS among patients with BRCA-mutated advanced breast cancer with tolerable safety and improved quality of life.
Topics: Antineoplastic Agents; Breast Neoplasms; Female; Humans; Poly(ADP-ribose) Polymerase Inhibitors; Poly(ADP-ribose) Polymerases; Progression-Free Survival
PubMed: 34455227
DOI: 10.1016/j.breast.2021.08.009 -
Osteoarthritis and Cartilage Jun 2016Ultrasonography (US) demonstrated to be a promising tool for the diagnosis of calcium pyrophosphate dihydrate deposition disease (CPPD). The aim of this systematic... (Review)
Review
OBJECTIVE
Ultrasonography (US) demonstrated to be a promising tool for the diagnosis of calcium pyrophosphate dihydrate deposition disease (CPPD). The aim of this systematic literature review (SLR) was to collect the definitions for the US elementary lesions and to summarize the available data about US diagnostic accuracy in CPPD.
METHODS
We systematically reviewed all the studies that considered US as the index test for CPPD diagnosis without restrictions about the reference test or that provided definitions about US identification of CPPD. Sensitivity and specificity were calculated for each study and definitions were extrapolated. Subgroup analyses were planned by anatomical site included in the index text and different reference standards.
RESULTS
Thirty-seven studies were included in this review. All the studies were eligible for the collection of US findings and all definitions were summarized. US description of elementary lesions appeared heterogeneous among the studies. Regarding US accuracy, 13 articles entered in the meta-analysis. Considering each joint structure, the sensitivity ranged between 0.77 (0.63-0.87) and 0.34 (0.16-0.58) while the specificity varies between 1.00 (0.89-1.00) and 0.92 (0.16-1.00). Considering the reference standards used, the sensibility ranged between 0.34 (0.02-0.65) and 0.87 (0.76-0.99) while specificity ranged between 0.84 (0.52-1.00) and 1.00 (0.99-1.00).
CONCLUSION
US is potentially a useful tool for the diagnosis of CPPD but universally accepted definitions and further testing are necessary in order to assess the role of the technique in the diagnostic process.
Topics: Calcium Pyrophosphate; Chondrocalcinosis; Humans; Ultrasonography
PubMed: 26826301
DOI: 10.1016/j.joca.2016.01.136 -
Journal of Gynecology Obstetrics and... Sep 2022
Corrigendum to "correlation of poly (adenosine diphosphate [ADP]-ribose) polymerase expression and prognosis in ovarian cancer: A systematic review and meta-analysis" [J Gynecol Obstet Hum Reprod 2022;51(4): 102344. Doi: 10.1016/j.jogoh.2022.102344].
PubMed: 35717833
DOI: 10.1016/j.jogoh.2022.102427 -
Osteoarthritis and Cartilage May 2021To examine and compare the accuracy of conventional radiography (CR) and musculoskeletal ultrasonography (US) in the diagnosis of calcium pyrophosphate (CPP) crystals... (Comparative Study)
Comparative Study Meta-Analysis
The diagnostic value of conventional radiography and musculoskeletal ultrasonography in calcium pyrophosphate deposition disease: a systematic literature review and meta-analysis.
OBJECTIVE
To examine and compare the accuracy of conventional radiography (CR) and musculoskeletal ultrasonography (US) in the diagnosis of calcium pyrophosphate (CPP) crystals deposition disease (CPPD).
DESIGN
A systematic search of electronic databases (PubMed, Embase, and Cochrane), conference abstracts and reference lists was undertaken. Studies which evaluated the accuracy of CR and/or US in the diagnosis of CPPD, using synovial fluid analysis (SFA), histology or classification criteria as reference tests were included. Subgroup analyses by anatomic site and by reference test were performed.
RESULTS
Twenty-six studies were included. Using SFA/histology as reference test, CR and US showed an excellent (CR AUC = 0.889, 95%CI = 0.811-0.967) and an outstanding (US AUC = 0.954, 95%CI = 0.907-1.0) diagnostic accuracy (p < 0.01), respectively. Furthermore, US showed a higher sensitivity (0.85, 95%CI = 0.79-0.90 vs 0.47, 95%CI = 0.40-0.55) and only a little lower specificity (0.87, 95%CI = 0.83-0.91 vs 0.95, 95%CI = 0.92-0.97) than CR. A considerable heterogeneity between the studies was found, with adopted reference test being the main source of heterogeneity. In fact, subgroup analysis showed a significant change in the diagnostic accuracy of CR, but not of US, using Ryan and McCarty criteria or SFA/histology as reference test (CR: AUC = 0.956, 95%CI = 0.925-1.0 vs AUC = 0.889, 95%CI = 0.828-0.950, respectively, p < 0.01) (US: AUC = 0.922, 95%CI = 0.842-1.0 vs AUC = 0.957, 95%CI = 0.865-1.0, respectively, p = 0.08) CONCLUSIONS: Although US is more sensitive and a little less specific than CR for identifying CPP crystals, both these two techniques showed a great diagnostic accuracy and should be regarded as complementary to each other in the diagnostic work-up of patients with CPPD.
Topics: Calcium Pyrophosphate; Chondrocalcinosis; Fascia; Humans; Joints; Ligaments, Articular; Muscle, Skeletal; Radiography; Sensitivity and Specificity; Synovial Fluid; Tendons; Ultrasonography
PubMed: 33577959
DOI: 10.1016/j.joca.2021.01.007 -
Oncotarget Aug 2017UGT2B15 (uridine diphosphate-glucuronosyltransferase 2B15) catalyzes the conversion of lipophilic C19 steroid androgens such as dihydrotestosterone (DHT) into...
UGT2B15 (uridine diphosphate-glucuronosyltransferase 2B15) catalyzes the conversion of lipophilic C19 steroid androgens such as dihydrotestosterone (DHT) into water-soluble metabolites that can be excreted. Studies of the association between the gene D85Y polymorphism and prostate cancer have yielded contradictory results. We therefore systematically searched in the PubMed, EMBASE, Science Direct/Elsevier, CNKI, and Cochrane Library databases, and identified six relevant studies with which to perform a meta-analysis of the relation between D85Y polymorphism and prostate cancer risk. Our meta-analysis revealed a significant association between D85Y gene polymorphism and prostate cancer in all genetic models (P<0.05). The combined odds ratios and 95% confidence intervals were as follows: additive model, 0.53 and 0.32-0.88; dominant model, 0.51 and 0.33-0.79; recessive model, 0.76 and 0.60-0.96; co-dominant model, 0.55 and 0.35-0.86; and allele model, 0.70 and 0.55-0.89. These results are consistent with the idea that the D85Y enzyme variant reduces the risk of prostate cancer by efficiently metabolizing dihydrotestosterone (DHT), which is associated with prostate cancer progression.
PubMed: 28881775
DOI: 10.18632/oncotarget.17375 -
PloS One 2016There is a heated debate on whether the prognostic value of NME1 is favorable or unfavorable. Thus, we carried out a meta-analysis to evaluate the relationship between... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
There is a heated debate on whether the prognostic value of NME1 is favorable or unfavorable. Thus, we carried out a meta-analysis to evaluate the relationship between NME1 expression and the prognosis of patients with digestive system neoplasms.
METHODS
We searched PubMed, EMBASE and Web of Science for relevant articles. The pooled odd ratios (ORs) and corresponding 95%CI were calculated to evaluate the prognostic value of NME1 expression in patients with digestive system neoplasms, and the association between NME1 expression and clinicopathological factors. We also performed subgroup analyses to find out the source of heterogeneity.
RESULTS
2904 patients were pooled from 28 available studies in total. Neither the incorporative OR combined by 17 studies with overall survival (OR = 0.65, 95%CI:0.41-1.03, P = 0.07) nor the pooled OR with disease-free survival (OR = 0.75, 95%CI:0.17-3.36, P = 0.71) in statistics showed any significance. Although we couldn't find any significance in TNM stage (OR = 0.78, 95%CI:0.44-1.36, P = 0.38), elevated NME1 expression was related to well tumor differentiation (OR = 0.59, 95%CI:0.47-0.73, P<0.00001), negative N status (OR = 0.54, 95%CI:0.36-0.82, P = 0.003) and Dukes' stage (OR = 0.43, 95%CI:0.24-0.77, P = 0.004). And in the subgroup analyses, we only find the "years" which might be the source of heterogeneity of overall survival in gastric cancer.
CONCLUSIONS
The results showed that statistically significant association was found between NME1 expression and the tumor differentiation, N status and Dukes' stage of patients with digestive system cancers, while no significance was found in overall survival, disease-free survival and TNM stage. More and further researches should be conducted to reveal the prognostic value of NME1.
Topics: Biomarkers, Tumor; Digestive System Neoplasms; Gene Expression Regulation, Neoplastic; Humans; NM23 Nucleoside Diphosphate Kinases; Prognosis
PubMed: 27518571
DOI: 10.1371/journal.pone.0160547 -
BMC Cancer Aug 2019Positron emission tomography (PET) and PET/computed tomography (PET/CT) imaging with 3,4-dihydroxy-6-[F] fluoro-L-phenylalanine (F-FDOPA) has been used in the evaluation... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Positron emission tomography (PET) and PET/computed tomography (PET/CT) imaging with 3,4-dihydroxy-6-[F] fluoro-L-phenylalanine (F-FDOPA) has been used in the evaluation of gliomas. We performed a meta-analysis to obtain the diagnostic and grading accuracy of F-FDOPA PET and PET/CT in patients with gliomas.
METHODS
PubMed, Embase, Cochrane Library and Web of Science were searched through 13 May 2019. We included studies reporting the diagnostic performance of F-FDOPA PET or PET/CT in glioma patients. Pooled sensitivity, specificity, and area under the summary receiver operating characteristic (SROC) curve were calculated from eligible studies on a per-lesion basis.
RESULTS
Eventually, 19 studies were included. Across 13 studies (370 patients) for glioma diagnosis, the pooled sensitivity and specificity of F-FDOPA PET and PET/CT were 0.90 (95%CI: 0.86-0.93) and 0.75 (95%CI: 0.65-0.83). Across 7 studies (219 patients) for glioma grading, F-FDOPA PET and PET/CT showed a pooled sensitivity of 0.88 (95%CI: 0.81-0.93) and a pooled specificity of 0.73 (95%CI: 0.64-0.81).
CONCLUSIONS
F-FDOPA PET and PET/CT demonstrated good performance for diagnosing gliomas and differentiating high-grade gliomas (HGGs) from low-grade gliomas (LGGs). Further studies implementing standardized PET protocols and investigating the grading parameters are needed.
Topics: Adolescent; Adult; Aged; Brain Neoplasms; Child; Data Accuracy; Female; Fluorine Radioisotopes; Formycins; Glioma; Humans; Male; Middle Aged; Neoplasm Grading; Neoplasm Recurrence, Local; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Publication Bias; ROC Curve; Radiopharmaceuticals; Ribonucleotides; Sensitivity and Specificity; Young Adult
PubMed: 31382920
DOI: 10.1186/s12885-019-5938-0 -
Frontiers in Pharmacology 2021Dual antiplatelet therapy combining aspirin with a P2Y12 adenosine diphosphate receptor inhibitor is a therapeutic mainstay for acute coronary syndrome (ACS). However,...
Dual antiplatelet therapy combining aspirin with a P2Y12 adenosine diphosphate receptor inhibitor is a therapeutic mainstay for acute coronary syndrome (ACS). However, the optimal choice of P2Y12 adenosine diphosphate receptor inhibitor in elderly (aged ≥65 years) patients remains controversial. We conducted a meta-analysis to compare the efficacy and safety of ticagrelor and clopidogrel in elderly patients with ACS. We comprehensively searched in Web of Science, EMBASE, PubMed, and Cochrane databases through 29 March, 2021 for eligible randomized controlled trials (RCTs) comparing the efficacy and safety of ticagrelor or clopidogrel plus aspirin in elderly patients with ACS. Four studies were included in the final analysis. A fixed effects model or random effects model was applied to analyze risk ratios (RRs) and hazard ratios (HRs) across studies, and I to assess heterogeneity. A total number of 4429 elderly patients with ACS were included in this analysis, of whom 2170 (49.0%) patients received aspirin plus ticagrelor and 2259 (51.0%) received aspirin plus clopidogrel. The ticagrelor group showed a significant advantage over the clopidogrel group concerning all-cause mortality (HR 0.78, 95% CI 0.63-0.96, I = 0%; RR 0.79, 95% CI 0.66-0.95, I = 0%) and cardiovascular death (HR 0.71, 95% CI 0.56-0.91, I = 0%; RR 0.76, 95% CI 0.62-0.94, I = 5%) but owned a higher risk of PLATO major or minor bleeding (HR 1.46, 95% CI 1.13-1.89, I = 0%; RR 1.40, 95% CI 1.11-1.76, I = 0%). Both the groups showed no significant difference regarding major adverse cardiovascular events (MACEs) (HR 1.06, 95% CI 0.68-1.65, I = 77%; RR 1.04, 95% CI 0.69-1.58, I = 77%). For elderly ACS patients, aspirin plus ticagrelor reduces cardiovascular death and all-cause mortality but increases the risk of bleeding. Herein, aspirin plus ticagrelor may extend lifetime for elderly ACS patients compared with aspirin plus clopidogrel. The optimal DAPT for elderly ACS patients may be a valuable direction for future research studies.
PubMed: 34721032
DOI: 10.3389/fphar.2021.743259 -
International Journal of Surgery... Dec 2018Extensive studies have been carried out to investigate the association between nm23 expression and the prognosis and clinicopathologic significance of various tumors. (Meta-Analysis)
Meta-Analysis
OBJECTIVE
Extensive studies have been carried out to investigate the association between nm23 expression and the prognosis and clinicopathologic significance of various tumors.
METHODS AND MATERIALS
Eligible studies were searched from Embase, China National Knowledge Infrastructure (CNKI), PubMed and Web of Science up to May 2017. In this study, we calculated the pooled hazard ratios (HRs) with 95% confidence intervals (95%CIs) to determine the association between nm23 expression and the prognosis of various tumors.
RESULTS
A total of 49 studies were finally included in the meta-analysis. The pooled HRs were 2.00 (95% CIs: 1.44-2.78) for overall survival (OS), 1.23 (95% CIs: 1.04-1.46) for disease-specific survival or progression-free survival (DFS/PFS), and 2.21 (95% CIs: 1.38-3.57) for survival of recurrence-free survival or metastasis-free survival (RFS/MFS). Moreover, the results indicated that low nm23 expression was significantly correlated with the lymph node metastasis (P = 0.002). For the subgroup analysis, the expression of nm23 in patients at N0 stage was obviously higher than the patients with breast carcinoma at N1-N3 stage [Odds ratio (OR) = 2.07, 95%CI (1.31, 3.26), P = 0.002]. Moreover, the expression of nm23 in the patients at N0 stage was remarkably higher than those at N1-N3 stages in the Chinese patients with breast carcinoma and those with nasopharyngeal carcinoma (P < 0.05). Whereas, no statistical difference was noticed in the expression of nm23 in patients of various age, gender, T stage, histological degree, TNM stage, respectively (P > 0.05).
CONCLUSION
Our study suggests that down-regulation of nm23 is related to poor prognosis in many cancers. The expression of nm23 in cancer tissues may serve as an important factor for evaluating the presence of lymph node metastasis.
Topics: Breast Neoplasms; Female; Humans; Lymphatic Metastasis; NM23 Nucleoside Diphosphate Kinases; Neoplasm Staging; Prognosis
PubMed: 30389538
DOI: 10.1016/j.ijsu.2018.10.035