RESUMO
Proteins are routinely measured in clinical laboratories for diagnosis, prognosis and therapy monitoring. Nevertheless, both test improvements (performance) and innovations (biomarkers) are needed, and protein N-glycosylation offers a rich source of potential markers. Here, we have analyzed the total serum N-glycome in a matched case-control study (124 cases versus 124 controls) of colorectal cancer patients. The results were validated in an independent sample cohort (both 61 cases versus 61 controls) and further tested in post-operative samples of cured patients. Our results revealed significant differences between patients and controls, with increased size (antennae) and sialylation of the N-glycans in the colorectal cancer patient sera as compared to mainly di-antennary N-glycans in sera from controls. Furthermore, glycan alterations showed strong associations with cancer stage and survival: The five-year survival rate largely varied between patients with an altered serum N-glycome (46%) and an N-glycome similar to controls (87%). Importantly, the total serum N-glycome showed prognostic value beyond age and stage. This clinical glycomics study provides novel serum biomarker candidates and shows the potential of total serum N-glycans as a prognostic panel. Moreover, serum N-glycome changes reverted to a control-like profile after successful treatment as was demonstrated from pre- and post-operative samples.
RESUMO
BACKGROUND: To reduce the high rate of soft tissue complications in the treatment of displaced intra-articular fractures of the calcaneus, several minimally invasive techniques have been developed. Little evidence exists on the clinical outcome of these techniques. METHODS: We performed a study on a cohort of 46 fractures treated by the 3-point distraction technique. In 41 fractures, clinical outcome was available. Fractures were classified according to the Essex-Lopresti and Sanders classifications. The clinical outcome was determined using the 3 most frequently used outcome scores. RESULTS: The clinical outcome of our cohort of percutaneous treated intra-articular calcaneal fractures was good to excellent in 69% with the American Orthopaedic Foot and Ankle Society ankle-hindfoot scale (AOFAS) score. This percentage increases to 100% for tongue type fractures alone but decreases to 52% for joint depression type fractures. Infectious complications occurred in 1 (2.4%) and secondary arthrodesis was needed in 3 fractures (7.3%). The Sanders classification showed no prognostic value. The Essex-Lopresti classification was a strong prognosticator with a median AOFAS score of 92 (interquartile range [IQR], 87.8-97.8) for tongue type fractures and 75 (IQR, 63.0-85.0) for joint depression type fractures (P < .001). CONCLUSION: The treatment of displaced intra-articular calcaneal fractures by the 3-point distraction technique was an acceptable alternative to open surgery and other percutaneous techniques. It had a low amount of infectious complications with comparable outcome to open treatment. The computed tomography-based Essex-Lopresti classification had a strong prognostic value when fractures were treated by the 3-point distraction technique. The results of this study support the use of the 3-point distraction technique, especially in tongue type fractures. LEVEL OF EVIDENCE: Level IV, retrospective case series.
