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5.
Rev. esp. med. nucl. imagen mol. (Ed. impr.) ; 35(1): 17-21, ene.-feb. 2016. ilus, tab
Artículo en Español | IBECS | ID: ibc-148679

RESUMEN

Objective. There is still no consensus about whether to perform PET/CT to detect carcinoma in paraneoplastic neurological syndromes (PNS) in patients with or without antibodies. The aim of this study is to determine the diagnostic accuracy of PET/CT and antibodies in patients with PNS. Material and Methods. A retrospective study was conducted on patients with clinically suspected PNS between 2008 and 2013. The association between histopathological findings, paraneoplastic antibodies, and PET/CT findings were evaluated. Sensitivity and specificity for the detection of underlying malignancy were calculated for PET/CT and paraneoplastic antibodies. Results. A total of 42 patients were analyzed. Of these 42 patients, 32 (75%) had a classical PNS, 6 (14%) had positive PET/CT findings, and 34 were tested for the presence of antibodies (anti-Hu Ab, anti-Yo Ab, and anti-Ri Ab). Twenty one of 34 patients had positive antibodies. Of the 6 patients with positive PET/CT findings, 6 had positive histopathological results. Among 21 patients with positive biomarkers, carcinoma was confirmed only in 5 patients. One patient with negative antibodies, but positive PET/CT findings, was diagnosed with a tumor. Gastric carcinoma was detected in 1 patient with negative PET/CT findings and antibodies during follow-up. Based on the results, PET/CT was found to have 85.71% sensitivity, 100% specificity, 100% positive and 97.22% negative predictive values in the detection of tumors. Conclusion. PET/CT has a certain diagnostic accuracy for detecting underlying malignancy in patients with PNS, regardless of the presence of paraneoplastic antibodies (AU)


Objetivo. No hay un criterio unánime para realizar PET/TC en la detección de carcinoma en pacientes de síndrome neurológico paraneoplásico (PNS), con o sin anticuerpos. Nuestro objetivo es buscar la utilidad diagnóstica de la PET/TC y los anticuerpos en pacientes con PNS. Material y métodos. Se examinaron retrospectivamente los pacientes con sospecha clínica de PNS estudiados entre 2008 y 2013. Se evaluó la asociación entre los resultados histopatológicos, los anticuerpos y los resultados de la PET/TC. Se calcularon la sensibilidad y la especificidad de la PET/TC y de los anticuerpos paraneoplásicos para la detección de malignidad. Resultados. Se analizaron un total de 42 pacientes. De ellos 32 pacientes (el 75%) tenían un PNS clásico. A todos se les había realizado PET/TC y 6 (el 14%) tuvieron resultados positivos. Se determinó la presencia de anticuerpos en 34 pacientes (anticuerpos anti-Hu, anticuerpos anti-Yo y anticuerpos anti-Ri). Veintiuno de los cuales dieron positivo. Los 6 pacientes con resultados PET/TC positivos tuvieron resultados histopatológicos positivos. Entre los 21 pacientes con biomarcadores positivos, el carcinoma se confirmó solo en 5 pacientes. A un paciente con resultado negativo para anticuerpos, pero positivo en la PET/TC, se le diagnosticó un tumor. Se detectó carcinoma gástrico en un paciente con resultados negativos en la PET/TC y anticuerpos en el periodo de seguimiento. Según los resultados, se comprobó que la PET/TC tiene un 85,71% de sensibilidad, un 100% de especificidad, con valor predictivo positivo de 100% y valor predictivo negativo de 97,22% en la detección de tumores. Conclusión. La PET/TC tiene un cierto grado de exactitud diagnóstica para detectar malignidad subyacente en pacientes con PNS, sin importar la presencia de anticuerpos paraneoplásicos (AU)


Asunto(s)
Humanos , Masculino , Femenino , Síndromes Paraneoplásicos , Síndromes Paraneoplásicos del Sistema Nervioso , Tomografía de Emisión de Positrones , Adenocarcinoma , Inmunohistoquímica/métodos , Inmunohistoquímica , Estudios Retrospectivos , Sensibilidad y Especificidad , Carcinoma , Medicina Nuclear/métodos
8.
Rev Esp Med Nucl Imagen Mol ; 35(1): 17-21, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-26260889

RESUMEN

OBJECTIVE: There is still no consensus about whether to perform PET/CT to detect carcinoma in paraneoplastic neurological syndromes (PNS) in patients with or without antibodies. The aim of this study is to determine the diagnostic accuracy of PET/CT and antibodies in patients with PNS. MATERIAL AND METHODS: A retrospective study was conducted on patients with clinically suspected PNS between 2008 and 2013. The association between histopathological findings, paraneoplastic antibodies, and PET/CT findings were evaluated. Sensitivity and specificity for the detection of underlying malignancy were calculated for PET/CT and paraneoplastic antibodies. RESULTS: A total of 42 patients were analyzed. Of these 42 patients, 32 (75%) had a classical PNS, 6 (14%) had positive PET/CT findings, and 34 were tested for the presence of antibodies (anti-Hu Ab, anti-Yo Ab, and anti-Ri Ab). Twenty one of 34 patients had positive antibodies. Of the 6 patients with positive PET/CT findings, 6 had positive histopathological results. Among 21 patients with positive biomarkers, carcinoma was confirmed only in 5 patients. One patient with negative antibodies, but positive PET/CT findings, was diagnosed with a tumor. Gastric carcinoma was detected in 1 patient with negative PET/CT findings and antibodies during follow-up. Based on the results, PET/CT was found to have 85.71% sensitivity, 100% specificity, 100% positive and 97.22% negative predictive values in the detection of tumors. CONCLUSION: PET/CT has a certain diagnostic accuracy for detecting underlying malignancy in patients with PNS, regardless of the presence of paraneoplastic antibodies.


Asunto(s)
Anticuerpos Antineoplásicos/sangre , Autoanticuerpos/sangre , Carcinoma/diagnóstico por imagen , Síndromes Paraneoplásicos del Sistema Nervioso/diagnóstico por imagen , Tomografía Computarizada por Tomografía de Emisión de Positrones , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma/sangre , Carcinoma/diagnóstico , Proteínas ELAV/inmunología , Femenino , Radioisótopos de Flúor/análisis , Fluorodesoxiglucosa F18/análisis , Humanos , Linfoma no Hodgkin/sangre , Linfoma no Hodgkin/diagnóstico , Linfoma no Hodgkin/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Proteínas del Tejido Nervioso/inmunología , Antígeno Ventral Neuro-Oncológico , Síndromes Paraneoplásicos del Sistema Nervioso/sangre , Valor Predictivo de las Pruebas , Proteínas de Unión al ARN/inmunología , Radiofármacos/análisis , Estudios Retrospectivos , Sensibilidad y Especificidad , Adulto Joven
9.
Eur Rev Med Pharmacol Sci ; 19(21): 4076-80, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-26592829

RESUMEN

OBJECTIVE: Fibulin-3 is known to play a role in tumor cell malignancy, invasion and metastasis, as well as in the clinical progression of tumors. This study aimed to assess serum fibulin-3 levels in patients with colon cancer compared with healthy controls and its relationship to demographics and tumor pathology. PATIENTS AND METHODS: A total of 80 patients (mean age, 58.99 years; 42% males) with colon cancer and 50 controls (mean age, 57.75; 55% males) were included. Serum levels of fibulin-3 were determined using a commercially available sandwich ELISA (Enzyme-Linked ImmunoSorbent Assay). RESULTS: Preoperative serum fibulin-3 levels were significantly lower in the group of patients with colon cancer (mean, 35.91 ng/mL; range, 10-73 ng/mL) compared with the control group (mean, 96.68 ng/mL; range, 57-168 ng/mL). CONCLUSIONS: It was concluded that fibulin-3 is expressed at a lower level in colon cancer, and it can serve as a marker for advanced colon cancer.


Asunto(s)
Biomarcadores de Tumor/sangre , Carcinoma/sangre , Neoplasias del Colon/sangre , Proteínas de la Matriz Extracelular/sangre , Anciano , Carcinoma/patología , Carcinoma/cirugía , Estudios de Casos y Controles , Neoplasias del Colon/patología , Neoplasias del Colon/cirugía , Progresión de la Enfermedad , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Masculino , Persona de Mediana Edad , Periodo Preoperatorio
10.
Nuklearmedizin ; 54(6): 262-71, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26503832

RESUMEN

UNLABELLED: The aim of this study is to compare FDG and FDG-labeled leukocyte (WBC) PET/CT in the diagnosis of infection using different SUV and visual thresholds for interpretation. Patients, material, method: 49 consecutive patients (27 men, 22 women, mean age: 55.7 years, range: 16-89 years) with suspected musculoskeletal infection (n = 34), vascular graft infection (n = 5), aortitis (n =1 ), endocarditis (n = 1), mass lesion which is suspicious for infection or malignity (n = 6), and fever of unknown origin (n = 2) underwent both FDG and WBC-PET/CT. Images were evaluated by both visual analysis (grade 1-3) according to uptake intensity and quantitative grading (grade 1-3) based on lesion to background SUVmax values. Final diagnosis was made by histopathological, microbiological analysis or clinical-radiological work-up. RESULTS: The diagnosis of infection was made in total 24 patients, of whom 14 were diagnosed by histopathological and the rest by clinical-radiological work-up. WBC-PET/CT imaging with the visual threshold of 1b as infection positivity (for truncal lesions uptake equivalent to liver or lumbar vertebrae uptake; for extremity lesions uptake significantly higher than neighbouring soft tissue uptake or higher than neighbouring bone marrow uptake) was found to have the highest diagnostic accuracy (AUC: 0.874, CI: 0.771-0.997, p < 0.001). The optimal SUV threshold was found to be 8.8 (p = 0.006; sensitivity: 72.7%, specificity: 82.8) and 5.3 (p < 0.001; sensitivity: 81.8%, specificity: 79.3%) for FDG and WBC-PET/CT, respectively by ROC curve analysis. CONCLUSION: WBC-PET/CT is more valuable than FDG PET/CT in the imaging of infection. Visual threshold of >1b seems to be more suitable for detection of infection.


Asunto(s)
Infecciones Bacterianas/diagnóstico , Fluorodesoxiglucosa F18 , Leucocitos/diagnóstico por imagen , Imagen Multimodal/métodos , Tomografía de Emisión de Positrones/métodos , Tomografía Computarizada por Rayos X/métodos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Humanos , Aumento de la Imagen/métodos , Persona de Mediana Edad , Radiofármacos , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Coloración y Etiquetado/métodos , Adulto Joven
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