Investigation of the Distribution of Fetal Nasal Bone Percentile Values in First-Trimester Fetal Anomaly Screening

INTRODUCTION: We aim to determine the fetal nasal bone length (NBL) percentile values that can be used in the prediction of the fetal anomaly at 11-14 weeks of gestation in a low-risk population. METHODS: Our prospective and cross-sectional study included four hundred and eighty-six singleton pregnancies who applied for the first-trimester aneuploidy screening test at 11-14 weeks of gestation. We excluded pregnant women with fetal structural or chromosomal anomaly, nuchal translucency >3mm, an absent nasal bone, and in utero fetal death. Reference and percentile values of the NBL were calculated separately for 11,12,13,and 14. gestational weeks. RESULTS: Standard NBL measurements were performed in 486 pregnancies according to inclusion and exclusion criteria. Median NBL values were computed for each gestational age (GA), for 11,12,13 and 14. weeks of gestation was found 1.6mm (range=1.1-2.5), 1.8mm (range=1.1-3.0), 2.0mm (range=1.4-3.1), and 2.2mm (range=1.7-2.8), respectively. A positive significant correlation was found between NBL and the crown-rump length (CRL) (NBL (mm) = [0.02xCRL(mm)] + 0.73, r=.483; p<.001). The 5th percentile of NBL for GA was calculated, for 11,12, 13, and 14. weeks of gestation was found 1.2mm,1.4mm,1.5mm, and 1.7mm respectively. DISCUSSION AND CONCLUSION: We revealed the reference value of NBL for each gestational week in the first trimester of the low-risk population. The data obtained in our study can be used in the screening of genetic syndromes, especially Down syndrome, associated with nasal bone hypoplasia. Our reference value of NBL for the first trimester in singleton pregnancy varies from both previous racial and ethnic groups studies, and other Turkish studies

The correlates of benefit from neoadjuvant chemotherapy before surgery in non-small-cell lung cancer: a metaregression analysis

Background: Although neoadjuvant chemotherapy (NCT) is widely used, it is not clear which subgroup of locally advanced non-small-cell lung cancer (NSCLC) patients should be treated with this approach, and if a particular benefit associated with NCT exists. In this study, we aimed to investigate the potential correlates of benefit from NCT in patients with NSCLC.Methods: All randomized clinical trials (RCTs) utilizing a NCT arm (without radiotherapy) versus a control arm before surgery were included for metaregression analysis. All regression analyses were weighed for trial size. Separate analyses were conducted for trials recruiting patients with different stages of disease. Previously published measures of treatment efficacy were used for the purpose of this study, regardless of being published in full text or abstract form.Results: A total of 14 RCTs, consisting of 3,615 patients, were selected. Histology, stage, various characteristics of the NCT protocol, and different trial features including trial quality score were not associated with the benefit of NCT. However, in trials of stage 3 disease only, there was a greater benefit in terms of reduction in mortality from NCT, if protocols with three chemotherapeutics were used (B = -0.18, t = -5.25, P = 0.006).Conclusions: We think that patients with stage 3 NSCLC are served better with NCT before surgery if protocols with three chemotherapy agents or equally effective combinations are used. In addition, the effect of neoadjuvant chemotherapy is consistent with regard to disease and patient characteristics. This finding should be tested in future RCTs or individual patient data meta-analyses. © 2012 Bozcuk et al.; licensee BioMed Central Ltd