Serum antithyroglobulin antibody levels are not a good predictive factor on detection of disease activity in patients with papillary thyroid carcinoma

Objective: Thyroglobulin antibodies (TgAb) are detected in thyroid cancer patients up to 25%. We investigated the prognostic value of TgAb positivity in patients with papillary thyroid carcinoma (PTC) after initial therapy. Patients and Methods: A database of 109 consecutive patients who underwent total thyroidectomy and therapeutic lateral neck dissection followed by remnant ablation for PTC between January 1989 and December 2014 was reviewed We recorded the patients' all serum Tg and TgAb levels over time to establish changing trends. Patients were classified as either positive or negative according to serum TgAb levels. The recurrence or persistence rates in both groups were compared. Results: Of the 109 patients enrolled 14 patients had TgAb positivity. Thirty-two (29.3%) showed disease recurrence or persistent disease during 101 months of follow-up. Twenty-seven of 95 patients (28.4%) with negative TgAb had persistent or recurrent disease, whereas 5 of 14 patients (35.7%) with positive TgAb had persistence or recurrence (P = 0.57). No significant difference in disease-free survival (115.3 ± 10.8 vs. 224.1 ± 16.6 months, P = 0.78) and overall survival (P = 0.59) was observed between TgAb positive and TgAb negative patients. Conclusions: TgAb status is not useful as a prognostic and predictive factor for clinical outcomes in patients with PTC in our experience

Evaluate “Rifampicin Resistance” as Surrogate Marker for Rapid Detection of MDR-TB Using Real-Time PCR Directly on FNAC Samples of Tuberculous Lymphadenitis.

Background: India has the dubious distinction of having second largest burden of MDR-TB cases in the world. According to WHO, MDR-TB is defined as resistance to isoniazid and rifampicin, the two most important drugs for treatment of TB. “Rifampicin resistance” is recommended as surrogate marker for MDR-TB by WHO, as at least, 90% of all rifampicin-resistant clinical isolates are also found resistant to isoniazid. Localization of genetic alterations in the 81-bp “Rifampicin Resistance-Determining Region” of rpoB gene in 96% of rifampicin resistant strains make it particularly amenable for early detection of MDR-TB by molecular techniques like Real-Time PCR. Aim: Evaluation of “rifamipicin resistance” as surrogate marker for rapid detection of MDR-TB using Real-Time PCR directly on FNAC samples of tuberculous lymphadenitis (TBLN). Materials and Methods: Eighty cases of TBLN undergoing anti-tubercular treatment (ATT) and 10 lymphadenitis cases of non-tuberculous origin (controls) were included in the study. To evaluate “rifamipicin resistance” as surrogate marker for rapid detection of MDR-TB, Real-Time PCR and conventional Drug Susceptible Testing (DST) were carried out. Results: Eighteen samples were identified as MDR-TB cases by DST. Real-Time PCR picked up mutated ropB gene in 17 cases out of these 18 MDR-TB cases. Conclusion: “Rifampicin resistance” is an efficient surrogate marker for timely detection of MDR-TB using rapid, accurate and sensitive molecular technique like Real-Time PCR.

Absolute lymphocyte count as a surrogate marker for CD4 counts after six months of HAART initiation in a resource-limited setting in India.

Background & objectives: Owing to the ever-expanding access to HAART (highly active anti-retroviral therapy) in resource-limited settings, there is a need to evaluate alternate markers like absolute lymphocyte count (ALC) as a surrogate for CD4 counts. This study was done to assess the usefulness of ALC as a surrogate marker for CD4 counts in monitoring HIV-infected patients after HAART initiation. Methods: In this study, 108 HIV-positive adult patients of both sexes fulfilling the inclusion criteria were included. CD4 and ALC were recorded at baseline. After initiation on HAART, these patients were followed up at three month intervals. Results: ALC and CD4 counts were positively correlated (Spearman correlation coefficient= 0.553). After six months of HAART, the sensitivity of an ALC increase as a marker for CD4 count increase at six months was 82 per cent, specificity was 100 per cent, PPV was 100 per cent and NPV was 31 per cent. Area under the corresponding ROC curve for CD4 increase of >100 cells/μl was 0. 825 ± 0.053. Interpretation & conclusions: ALC may be a useful surrogate marker in predicting an increase in CD4 counts as a response to HAART, but of questionable value in predicting a decrease in CD4 counts.

The clinical significance of new surrogate markers of hypertension / 대한내과학회지

Recently, the management of hypertension has focused on the prevention of target organ damage to organs such as the heart, kidney, brain, and blood vessels. To detect subclinical organ damage, several novel surrogate markers were established after amassing considerable evidence. Left ventricular hypertrophy, diastolic dysfunction measured by echocardiography, carotid intima-media thickness, ankle-brachial index, pulse wave velocity, central blood pressure, estimated glomerular filtration rate, and microalbuminuria have been proposed as new parameters to detect subclinical organ damage in patients with hypertension. The European guidelines for the management of arterial hypertension, published in 2007, suggested that risk stratification based on using new surrogate markers was important for classifying the stage of hypertension and choosing appropriate anti-hypertensive drugs. Therefore, these surrogate markers should be checked in the early phase of hypertension and their clinical importance considered in daily practice.

Expression of gp120 as surrogate marker in HIV infection / Expresión de gp120 como marcador de progresión en la infección por VIH

Ninety seven patients infected with HIV -1 were studied to evaluate the expression of gp120 in peripheral blood CD4+ T lymphocytes as a surrogate marker of disease progression, analyzing correlation of it with viral load, T cell subsets, expression of activation markers, HAAR T and clinical signs and symptoms. In patients who had not received any antiretroviral therapy (naive), expression of gp120 had a positive correlation with expression of CD95 in CD4+ T lymphocytes (p=0.0409) and a negative correlation with CD4+ T lymphocytes percentage (p=0.0183) and absolute values (p=0.0165), and with percentage of naüve CD4+ T cells (p=0.0126). In patients under highly active antiretroviral therapy (HAAR T) those correlations were not present. Expression of gp 120 had good correlations with some known surrogate markers of disease progression in naüve patients, but its low level of expression and the fact that those correlations disappear when HAAR T is initiated, limit the use of it as an independent surrogate marker.

Se estudiaron 97 pacientes infectados con VIH-1 para determinar gp120 en células TCD4+ de sangre periférica como un marcador de progresión de enfermedad y su correlación con carga viral, subpoblaciones de células T, marcadores de activación, terapia antiretroviral, síntomas y signos clínicos. En los pacientes quienes no habían recibido terapia antiretroviral (vírgenes), la expresión de gp120 tenía una correlación positiva con la expresión de CD95 en los linfocitos TCD4+: (p=0,0409) y una correlación negativa con el porcentaje de linfocitos TCD4+ (p=0,0183) con los valores absolutos (p=0.0165) y con el porcentaje de células TCD4+ vírgenes (p=0.0126). En los pacientes con alta terapia antiretroviral estas correlaciones no estaban presentes. La expresión de gp120 tuvo buena correlación con algunos marcadores de progresión de enfermedad en pacientes vírgenes, pero su bajo nivel de expresión y el hecho de que esta correlación desaparece cuando la terapia antiretroviral es iniciada, limita su uso como marcador independiente de progresión.

Study on Serologic Test for Syphilis as a Surrogate Marker for Human Immunodeficiency Virus Infection among Korean Blood Donors / 대한수혈학회지

BACKGROUND: Serologic test for syphilis(STS) is an old traditional donor screening test for preventing transfusion-transmitted syphilis. By conducting STS, history taking for donors and refrigeration of blood, transfusion associated syphilis is very rare at present. This study evaluated the usefulness of the STS as a surrogate marker for preventing the transfusion of human immunodeficiency virus(HIV) via the transfusion of infectious window-period blood in Korean blood donors. METHODS: Demographic and laboratory information on blood donations made between January 1997 and December 1998 in 16 Korean Red Cross Blood Centers was analyzed. STS positive rate of 239 HIV-infected people and blood donors in 1999 were investigated. RESULTS: Of 4,808,297 donations over 2-year period, 3,956 (0.08%) were positive in STS and 40 (0.0008%) were anti-HIV confirmed positive. Of those, two were simultaneously positive for STS and anti-HIV. Among donations, Anti-HIV positive donations were 64 times more likely to be STS positive(odds ratio=63.9) and positive predictive value (PPV) of STS for anti-HIV was 0.05%. Fourteen of 239 HIV-infected people were STS positive. CONCLUSION: STS positivity was higher in anti-HIV positive donors, but the PPV of STS for anti-HIV was low. STS as a donor screening test is considered as a poor marker for preventing post-screening HIV infections and the usefulness of STS must be evaluated in its own value.

Prevalence of Viral Hepatitis Markers and Effectiveness of ALT as a Surrogate Marker in Volunteer Donors / 대한수혈학회지

BACKGROUND: The major serious risk of blood transfusion is post-transfusion hepatitis. Currently HBsAg, anti-HCV and serum alanine aminotransferase (ALT) assays are screened for potential blood donors to prevent transfusion associated hepatitis in Korea. But the effectiveness of serum ALT as a surrogate marker for the screening of non-A, non-B hepatitis is controversial. The present study was designed to evaluate the prevalence of hepatitis markers in Korean blood donors and the usefulness of ALT as a surrogate marker. METHODS: The prevalence rates of anti-HCV and HBsAg were analyzed by age, sex and ALT cut-off level in 405,931 blood donors. The current anti-HCV EIA (LG HCD 3.0 ) comparing to anti-HCV confirmatory immunoblot assay (LG HCD confirm ) and ALT test were evaluated. RESULTS: The positive rate of HBsAg was 3.32% and higher in male across all age group (p<0.01). The rate increased as age increases up to thirties and decreased thereafter. The positive rate of anti-HCV was 0.24% in EIA, and higher in female across all age group except for teenage group (p<0.01). The rate increased as age increases up to fifties (p<0.01). Results of immunoblot assay showed 64% disaccordance with that of EIA and the rate of disaccord was high in female and young age group. The rate of mixed infection of hepatitis B and C was 0.003%. ALT level was within normal range in 95.2% of donors, and the prevalences of HBsAg and anti-HCV were higher as ALT increased above normal level (p<0.01). The sensitivity of ALT in identifying hepatitis C was 34.5% at 45 IU/L, and 22.8% at 65 IU/L. The most accurate cut-off level of ALT for hepatitis C was 23 IU/L in Receiver-Operating Characteristic (ROC) plot and the sensitivity and specificity were 65.5% and 79.9% at that level. CONCLUSION: In contrast to HBsAg, the prevalence rate of anti-HCV showed different pattern in that it was higher in female and continuously increased up to fifties. Confirmatory assay for hepatitis C should be done for the high false positivity of current anti-HCV EIA. The sensitivity and positive predictive value of ALT was so poor that ALT was not found to be useful as a surrogate marker for hepatitis C, but the discontinuance of ALT testing of blood donors needs to be evaluated by further studies.