Gene expressions and copy numbers associated with metastatic phenotypes of uterine cervical cancer

BACKGROUND: A better understanding of the development of metastatic disease and the identification of molecular markers for cancer spread would be useful for the design of improved treatment strategies. This study was conducted to identify gene expressions associated with metastatic phenotypes of locally advanced cervical carcinomas and investigate whether gains or losses of these genes could play a role in regulation of the transcripts. Gene expressions and copy number changes were determined in primary tumors from 29 patients with and 19 without diagnosed lymph node metastases by use of cDNA and genomic microarray techniques, respectively. RESULTS: Thirty-one genes that differed in expression between the node positive and negative tumors were identified. Expressions of eight of these genes (MRPL11, CKS2, PDK2, MRPS23, MSN, TBX3, KLF3, LSM3) correlated with progression free survival in univariate analysis and were therefore more strongly associated with metastatic phenotypes than the others. Immunohistochemistry data of CKS2 and MSN showed similar relationships to survival. The prognostic genes clustered into two groups, suggesting two major metastatic phenotypes. One group was associated with rapid proliferation, oxidative phosphorylation, invasiveness, and tumor size (MRPS23, MRPL11, CKS2, LSM3, TBX3, MSN) and another with hypoxia tolerance, anaerobic metabolism, and high lactate content (PDK2, KLF3). Multivariate analysis identified tumor volume and PDK2 expression as independent prognostic variables. Gene copy number changes of the differentially expressed genes were not frequent, but correlated with the expression level for seven genes, including MRPS23, MSN, and LSM3. CONCLUSION: Gene expressions associated with known metastatic phenotypes of cervical cancers were identified. Our findings may indicate molecular mechanisms underlying development of these phenotypes and be useful as markers of cancer spread. Gains or losses of the genes may be involved in development of the metastatic phenotypes in some cases, but other mechanisms for transcriptional regulation are probably important in the majority of tumors

Anvendelser av Relative Value Units for radiologi: en litteraturgjennomgang

I denne litteraturstudien ønsker jeg å kartlegge bruken av RVUs som basis for statistikk innen fagfeltet radiologi i USA og analysere hvilke anvendelsesområder denne har som styringsverktøy for ledere ved radiologiske avdelinger. Jeg har satt opp følgende spørsmål for å belyse denne problemstillingen: 1. Hva er kjennetegnene ved denne litteraturen og kan den tematisk grupperes i ulike kategorier? 2. Hvilke arbeidsfelt innen radiologi dekker denne litteraturen? 3. Hvilke typer data relatert til RVUs presenteres i denne litteraturen og hvordan anvendes RVU-dataene? Som metode har jeg benyttet litteratur- og fakta-søk og gjennomgangen av de mest relevante artiklene er grunnlaget for å besvare spørsmålene. Jeg har funnet at det er tre ulike kategorier av artikler. Første kategori omfatter artikler som har en teoretisk innfallsvinkel til RVUs fra Medicares føderale RBRVS. Andre kategori er artikler som omhandler faktiske studier av klinisk radiologisk produksjon hvor RVUs fra RBRVS er sentrale for datagrunnlaget. Siste litteraturkategori inneholder publikasjoner som beskriver alternative RVU-systemer som kan kvantifisere og verdsette legers ikke-kliniske arbeidsoppgaver. Litteraturen dekker over to arbeidsfelt. Det første er radiologenes kliniske produksjon, dvs. tolkning av bildediagnostiske undersøkelser og utførelse av ulike typer prosedyrer. Det andre feltet er de ikke-kliniske arbeidsoppgavene som f.eks. administrasjon og ledelse, forskning, undervisning og kvalitetsarbeid. Det presenteres tre typer data i litteraturgrunnlaget. For den kliniske arbeidsfeltet finner jeg kostnadsindekser og produksjonsindekser basert på RVUs fra RBRVS. For de ikke-kliniske arbeidsoppgavene får en institusjonsspesifikke data fra alternative RVU-systemer som eksempelvis akademiske RVUs eller RTUs (relative teaching units). RVU-data fra begge arbeidsfelt inngår i statistikk som beskriver aktivitet. Her perker tre anvendelsesområder seg ut: 1. Oversikt over løpende utvikling hvor en måler opp mot seg selv. 2. Trender over tid. 3. Benchmarking på ulike nivå

Neurosarcoidosis resembling multiple meningiomas: A misleading presentation of the disease and diagnostic challenge

Sarcoidosis is characterized by the presence of noncaseating granulomatous inflammation in the affected organs. Neurosarcoidosis denotes the involvement of the nervous system and can be either isolated or coexisting with extraneural systemic inflammation. The diagnosis of isolated neurosarcoidosis may be challenging due to unspecific symptoms and similar appearances with other disease processes. This report presents an uncommon case of intracranial sarcoidosis mimicking multiple meningiomas. Familiarity with the spectrum of magnetic resonance imaging findings in neurosarcoidosis is crucial to prevent interpretive errors which may in turn lead to an inappropriate diagnosis and treatment

Routine pelvic MRI using phased-array coil for detection of extraprostatic tumour extension: accuracy and clinical significance

Objectives To determine the accuracy and assess the clinical significance of surface-coil 1.5-T magnetic resonance imaging (MRI) for the detection of locally advanced prostate cancer (PCa). Methods Between December 2007 and January 2010, we examined 209 PCa patients (mean age = 62.5 years) who were consecutively treated with robot-assisted laparoscopic prostatectomy and prospectively staged by MRI. One hundred and thirty-five patients (64.6 %) had locally advanced disease. Conventional clinical tumour stage and MRI-assessed tumour stage were compared with histopathological tumour stage (pT). Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and overall accuracy (OA) were calculated using pT as the “gold standard”. Overstaged and understaged cases at MRI were reviewed. Results Sensitivity, specificity, PPV, NPV and OA for the detection of locally advanced disease were 25.9, 95.9, 92.1, 41.2 and 50.5 % and 56.3, 82.2, 85.4, 50.4 and 65.4 % for clinical staging and MRI, respectively. Among patients understaged at MRI, the resection margins were free in 64.4 % of the cases (38/59). Conclusions Although the accuracy was limited, the detection of locally advanced disease improved substantially when MRI was added to routine clinical staging. The majority of the understaged patients nevertheless achieved free margins. When assessing the clinical significance of MRI staging the extent of extraprostatic extension has to be considered. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited