17 research outputs found

    Validation of a deep neural network-based algorithm supporting clinical management of adnexal mass

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    BackgroundConservative management of adnexal mass is warranted when there is imaging-based and clinical evidence of benign characteristics. Malignancy risk is, however, a concern due to the mortality rate of ovarian cancer. Malignancy occurs in 10–15% of adnexal masses that go to surgery, whereas the rate of malignancy is much lower in masses clinically characterized as benign or indeterminate. Additional diagnostic tests could assist conservative management of these patients. Here we report the clinical validation of OvaWatch, a multivariate index assay, with real-world evidence of performance that supports conservative management of adnexal masses.MethodsOvaWatch utilizes a previously characterized neural network-based algorithm combining serum biomarkers and clinical covariates and was used to examine malignancy risk in prospective and retrospective samples of patients with an adnexal mass. Retrospective data sets were assembled from previous studies using patients who had adnexal mass and were scheduled for surgery. The prospective study was a multi-center trial of women with adnexal mass as identified on clinical examination and indeterminate or asymptomatic by imaging. The performance to detect ovarian malignancy was evaluated at a previously validated score threshold.ResultsIn retrospective, low prevalence (N = 1,453, 1.5% malignancy rate) data from patients that received an independent physician assessment of benign, OvaWatch has a sensitivity of 81.8% [95% confidence interval (CI) 65.1–92.7] for identifying a histologically confirmed malignancy, and a negative predictive value (NPV) of 99.7%. OvaWatch identified 18/22 malignancies missed by physician assessment. A prospective data set had 501 patients where 106 patients with adnexal mass went for surgery. The prevalence was 2% (10 malignancies). The sensitivity of OvaWatch for malignancy was 40% (95% CI: 16.8–68.7%), and the specificity was 87% (95% CI: 83.7–89.7) when patients were included in the analysis who did not go to surgery and were evaluated as benign. The NPV remained 98.6% (95% CI: 97.0–99.4%). An independent analysis set with a high prevalence (45.8%) the NPV value was 87.8% (95% CI: 95% CI: 75.8–94.3%).ConclusionOvaWatch demonstrated high NPV across diverse data sets and promises utility as an effective diagnostic test supporting management of suspected benign or indeterminate mass to safely decrease or delay unnecessary surgeries

    Differential analysis for high density tiling microarray data

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    <p>Abstract</p> <p>Background</p> <p>High density oligonucleotide tiling arrays are an effective and powerful platform for conducting unbiased genome-wide studies. The <it>ab initio </it>probe selection method employed in tiling arrays is unbiased, and thus ensures consistent sampling across coding and non-coding regions of the genome. These arrays are being increasingly used to study the associated processes of transcription, transcription factor binding, chromatin structure and their association. Studies of differential expression and/or regulation provide critical insight into the mechanics of transcription and regulation that occurs during the developmental program of a cell. The time-course experiment, which comprises an <it>in-vivo </it>system and the proposed analyses, is used to determine if annotated and un-annotated portions of genome manifest coordinated differential response to the induced developmental program.</p> <p>Results</p> <p>We have proposed a novel approach, based on a piece-wise function – to analyze genome-wide differential response. This enables segmentation of the response based on protein-coding and non-coding regions; for genes the methodology also partitions differential response with a 5' versus 3' versus intra-genic bias.</p> <p>Conclusion</p> <p>The algorithm built upon the framework of Significance Analysis of Microarrays, uses a generalized logic to define regions/patterns of coordinated differential change. By not adhering to the gene-centric paradigm, discordant differential expression patterns between exons and introns have been identified at a FDR of less than 12 percent. A co-localization of differential binding between RNA Polymerase II and tetra-acetylated histone has been quantified at a p-value < 0.003; it is most significant at the 5' end of genes, at a p-value < 10<sup>-13</sup>. The prototype R code has been made available as supplementary material [see Additional file <supplr sid="S1">1</supplr>].</p> <suppl id="S1"> <title> <p>Additional file 1</p> </title> <text> <p>gsam_prototypercode.zip. File archive comprising of prototype R code for gSAM implementation including readme and examples.</p> </text> <file name="1471-2105-8-359-S1.zip"> <p>Click here for file</p> </file> </suppl

    Temporal profile of replication of human chromosomes

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    Chromosomes in human cancer cells are expected to initiate replication from predictably localized origins, firing reproducibly at discrete times in S phase. Replication products obtained from HeLa cells at different stages of S phase were hybridized to cDNA and genome tiling oligonucleotide microarrays to determine the temporal profile of replication of human chromosomes on a genome-wide scale. About 1,000 genes and chromosomal segments were identified as sites containing efficient origins that fire reproducibly. Early replication was correlated with high gene density. An acute transition of gene density from early to late replicating areas suggests that discrete chromatin states dictate early versus late replication. Surprisingly, at least 60% of the interrogated chromosomal segments replicate equally in all quarters of S phase, suggesting that large stretches of chromosomes are replicated by inefficient, variably located and asynchronous origins and forks, producing a pan-S phase pattern of replication. Thus, at least for aneuploid cancer cells, a typical discrete time of replication in S phase is not seen for large segments of the chromosomes

    The histogram summarizes the differential expression profiles in each ENCODE region on each chromosome

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    <p><b>Copyright information:</b></p><p>Taken from "Differential analysis for high density tiling microarray data"</p><p>http://www.biomedcentral.com/1471-2105/8/359</p><p>BMC Bioinformatics 2007;8():359-359.</p><p>Published online 24 Sep 2007</p><p>PMCID:PMC2231405.</p><p></p> Chromosome region specific differential expression is observed across the time-points – 30 percent change on chromosome 8 to no detectable change on chromosome 10. Globally, the highest fraction of differential expression when summarized across all transfrag is observed between 8–32 hours (53.8 percent),. The most statistically significant (FDR ≤12 percent) changes are also observed between 8–32 hours

    A representative density profile of the d-statistic for change in H3K27T histone modification between 0 and 2 hours of retinoic acid treatment for the ENCODE region on chromosome 1

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    <p><b>Copyright information:</b></p><p>Taken from "Differential analysis for high density tiling microarray data"</p><p>http://www.biomedcentral.com/1471-2105/8/359</p><p>BMC Bioinformatics 2007;8():359-359.</p><p>Published online 24 Sep 2007</p><p>PMCID:PMC2231405.</p><p></p> The curves of different colors illustrate differential change for the H3K27T modification in exonic (green), intronic (black) and intergenic (blue) regions. The shift into the negative territory for the d-statistic for all classes of regions suggest is a consistent downward trend for this modification between 0 and 2 hours
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