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Prevalence of hepatocarcinoma-related hepatitis B virus mutants in patients in grey zone of treatment

World Journal of Gastroenterology 2019年第38期25卷 5883-5896页

作者： Ana Isabel Gil-García Antonio Madejón Irene Francisco-Recuero Ana López-López Emiliana Villafranca Miriam Romero Araceli García Antonio olveira rocío mena Juan Ramón Larrubia Javier García-Samaniego Hepatology Unit Hospital Universitario La PazMadrid 28046Spain Centro de Investigación Biomédica en Red Instituto de Salud Carlos IIIMadrid 28029Spain Instituto de Investigación del Hospital Universitario la Paz Madrid 28046Spain Biochemistry Department Faculty of MedicineUniversidad Autónoma de MadridMadrid 28029Spain Instituto de Genética Médica y Molecular Hospital Universitario La PazMadrid 28046Spain Translational Hepatology Unit Hospital General Universitario de GuadalajaraGuadalajara 19002Castilla-La ManchaSpain

BACKGRoUND Antiviral treatment of patients with chronic hepatitis B(CHB)in the grey zone of treatment comands risk management in order to optimize the health *** this sense,the identification of HBV mutants related with an increased risk of hepatocellular carcinoma(HCC)could be useful to identify subpopulations with potential indication of antiviral *** To analyze the prevalence/persistence of hepatitis B virus(HBV)preS and basal core promoter(BCP)/precore/core variants associated to HCC development in CHB patients in the grey *** Work was designed as a longitudinal retrospective study,including 106 plasma samples from 31 patients with CHB in the grey zone of treatment:Hepatitis B e antigen negative,HBV-DNA levels between 12-20000 IU/mL,normal or discordant transaminase levels during follow up and mild/moderate necroinflammatory activity in liver biopsy or Fibroscan(up to 9.5 kPa).Serum HBVDNA was tested using the Abbott Real Time HBV Assay and the BCP/precore/core and the hepatitis B surface antigen(HBsAg)coding regions were analyzed in positive samples by PCR/bulk-sequencing to identify the HCCrelated HBV *** High-risk HCC related mutants were detected in 24(77%)patients:19(61%)in the BCP/precore/core,and 7(23%)in the HBsAg coding region(2 preS1 and 5 preS2 deletions).The prevalence of preS deletions was genotype-dependent:3/5(60%)patients with preS2 deletions and 1/2 with preS1 deletions were infected with the HBV-E *** HBV-E was the most prevalent in sub-Saharan patients,a correlation between preS deletions and ethnicity was also found:6/8(75%)sub-Saharan vs 1/19(5%)Caucasian patients had preS deletions(P=0.00016).Remarkably,this correlation was maintained in those patients infected with HBV-A,a minor genotype in sub-Saharan patients:2/2 patients infected with HBV-A from West Africa vs 0/6 of Caucasian origin had preS *** HCC related variants were the major strains and persisted over time(up to 48 mo).Pa

关键词： Hepatitis B virus Hepatocellular carcinoma PreS deletions Hepatitis B virus treatment Grey zone

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Thyroid Nodule: Alpha Score 2.0 Classification for FNAB Selection, Multicentric Study in Latin America

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open Journal of Radiology 2021年第4期11卷 160-174页

作者： Glenn mena Maria Cristina Chammas Carlos Mario Gonzalez Vasquez Lylian rocío Villagómez Marco Alfredo Muñoz Pico Patricio Alejandro Montalvo Santiago mena-Bucheli Julio olmedo Elizabeth Quintero Pedro Henrique de Marqui Moraes osmar Cassio Saito Hubertino Diaz Denise Romero Gabriela Velalcazar Angel Ramón Sosa Fleitas Yamil oliver Quevedo ontaneda Victor Ricardo Chara Alpha Imagen Radiología e Intervencionismo Quito Ecuador Hospital das Clínicas Faculdade de Medicina da Universidade de Sã o Paulo S&#227 o Paulo Brasil Hospital Pablo Tobón Uribe Medellin Colombia Hospital del Instituto Ecuatoriano de Seguridad Social Quito Sur Quito Ecuador Hospital San Francisco de Quito Quito Ecuador Hospital Edgardo Rebagliati Martins Lima Perú Hospital Carlos Andrade Marín Quito Ecuador Hospital de Clínicas San José de San Martín Buenos Aires Argentina Hospital Universitario de Los Andes Mérida Venezuela Hospital de la Policía Quito Ecuador Hospital Sisol Tacna Perú

Introduction: To perform a Latin-American multicentric study for the prediction of benign and malignant thyroid nodules using Alpha Score, and to compare it with ACR TIRADS® and Bethesda®. Materials and Methods: A pro... 详细信息

ong>Introduction:ong> To perform a Latin-American multicentric study for the prediction of benign and malignant thyroid nodules using Alpha Score, and to compare it with ACR TIRADS® and Bethesda®. ong>Materials and Methods:ong> A prospective multicentric study in 10 radiological hospitals and institutions of Latin America was performed and 818 thyroid nodules were analyzed by ultrasound and classified by using both ACR TIRADS® and Alpha Score;fine-needle aspiration biopsy was performed when needed and classified with Bethesda. The relationships between predictors were analyzed by using binary logistic regression, statistical significance was defined by a p-value of 0.05, with an error margin of 4% and 95% confidence intervals. ong>Results:ong> Alpha Score 2.0 establishes five types of malignant predictors: microcalcifications, irregular borders, taller-than-wide shape, predominant solid texture and hypoechogenicity;a diameter equal to or greater than 1.5 cm adds an extra point to the final score. Resulting classification divides TNs into 4 categories: benign (1.9%), low suspicion (8.7%), mild suspicion (13.6%) and high suspicion (75.7%) of malignancy probability;sensitivity of 82%, specificity of 74%, the positive predictive value of 94%, the negative predictive value of 51%, the statistical accuracy of 81%, odds ratio of 108.89 and correlation with ACR TIRADS of 0.77 and Bethesda of 0.91.ong> Conclusions: ong>Alpha Score 2.0 has superior diagnostic accuracy and performance compared to the previously published Alpha Score and is able to classify a benign TN in a precise, safe and accurate way, avoiding unnecessary FNABs or determining the necessity of FNAB in cases of moderate to high suspicion of malignancy.

关键词： Thyroid Cancer-Clinical Radiology-Imaging Thyroid Nodule Alpha Score TIRADS® Thyroid Ultrasonography

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Thyroid Nodule: Alpha Score 2.0 Classification for FNAB Selection, Multicentric Study inLatin America

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open Journal of Radiology（放射学期刊） 2021年第4期

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