Diagnostic accuracy of contrast enhanced computed tomography (CECT) in detection of necrosis in acute pancreatitis by taking surgical findings as gold standard.

OBJECTIVE: To determine the diagnostic accuracy of contrast-enhanced computed tomography in the detection of necrosis in acute pancreatitis by taking surgical findings as the gold standard. METHODS: The descriptive cross-sectional study was conducted at Radiology and Surgery departments of the Jinnah Postgraduate Medical Centre, Karachi, from January 1 to June 30, 2016, and comprised patients of either gender having severe clinical pancreatitis with symptoms lasting >72 hours without showing improvement. Computed tomography scan was performed with slice thickness of 3mm. Multiple detector scan of abdomen with contrast was done. Data was analysed using SPSS 19. RESULTS: Of the 191 patients, 97 (50.8%) were female, and 129 (67.50%) were aged >40 years, with an overall mean age of 39.65±11.67 years. Mean duration of the symptoms was 85.61±6.41 hours. Contrast-enhanced computed tomography scan's sensitivity was 71.4%, specificity 87%, positive predictive value 83.33%, negative predictive value 76.99% and over all diagnostic accuracy was 79.5%. CONCLUSIONS: The diagnostic accuracy of contrast-enhanced computed tomography was found to be high in detecting necrosis in acute pancreatitis cases.

Increased NID1 Expression among Breast Cancer Lung Metastatic Women; A Comparative Analysis between Naive and Treated Cases.

BACKGROUND: Lungs are the second most common reported site of distant metastasis in Breast cancer after bone. Mostly the studies were conducted in cell lines and animal model. To date, there is no blood biomarker reported that could determine the breast cancer progression in terms of lung metastasis. OBJECTIVE: The aim of this study is to determine Nidogen-1 (NID1)'s mRNA and protein expressions in non-invasive blood samples of breast cancer, in early (II) and lung metastasis advanced stages (III & IV) of naive and treated groups. To determine the functional association of NID1, we employed an in silico analysis, STRING database version 11. METHODS: A total of n = 175 cases of breast cancer were recruited in our study. Real time quantitative PCR and ELISA were performed to analyze the mRNA and protein expressions of NID1 respectively. An in silico method is also used to assess NID1's interactome. Some significant patents related to this topic were also studied and discussed in this research paper. RESULTS: The results show high levels of NID1's mRNA in the naive group (Group A) as compared to treated group (Group B). Similar trend of increased NID1's protein expressions was also observed among naive and treated groups, respectively. Our results also show the significant impact of treatment on NID1's gene and protein expressions. In silico analysis has revealed the functional association of NID1 with its different interactome protein partners. CONCLUSION: The increased expression of NID1 in early to advanced naive as compared to the treated groups with lung metastasis makes it a promising marker which has pro-metastatic role in breast cancer.

Cancer Cell-derived Secretory Factors in Breast Cancer-associated Lung Metastasis: Their Mechanism and Future Prospects.

In Breast cancer, Lung is the second most common site of metastasis after the bone. Various factors are responsible for Lung metastasis occurring secondary to Breast cancer. Cancer cellderived secretory factors are commonly known as 'Cancer Secretomes'. They exhibit a prompt role in the mechanism of Breast cancer lung metastasis. They are also major constituents of hostassociated tumor microenvironment. Through cross-talk between cancer cells and the extracellular matrix components, cancer cell-derived extracellular matrix components (CCECs) such as hyaluronan, collagens, laminin and fibronectin cause ECM remodeling at the primary site (breast) of cancer. However, at the secondary site (lung), tenascin C, periostin and lysyl oxidase, along with pro-metastatic molecules Coco and GALNT14, contribute to the formation of pre-metastatic niche (PMN) by promoting ECM remodeling and lung metastatic cells colonization. Cancer cell-derived secretory factors by inducing cancer cell proliferation at the primary site, their invasion through the tissues and vessels and early colonization of metastatic cells in the PMN, potentiate the mechanism of Lung metastasis in Breast cancer. On the basis of biochemical structure, these secretory factors are broadly classified into proteins and non-proteins. This is the first review that has highlighted the role of cancer cell-derived secretory factors in Breast cancer Lung metastasis (BCLM). It also enumerates various researches that have been conducted to date in breast cancer cell lines and animal models that depict the prompt role of various types of cancer cell-derived secretory factors involved in the process of Breast cancer lung metastasis. In the future, by therapeutically targeting these cancer driven molecules, this specific type of organ-tropic metastasis in breast cancer can be successfully treated.