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Among the 43 CK+ informative cases, an overall concordance of 93% between CTCs and the primary tumor was observed with regards to HER2 status. Concordance was observed in 18 of 19 cases with positive HER2 status (positive predictive value of 90%) and 22 of 24 cases with negative HER2 status (negative predictive value of 96%). There was no difference between the numbers of CK+ CTCs detected in the 19 patients with HER2+ status compared to the 24 HER2-cases (median 5 and 9 CTCs, respectively, p = 0.37). Discordance was observed in three cases as shown in Table 2. An overall test sensitivity of 95% and specificity of 92% was observed. A substantial agreement approaching the range of perfect agreement (0.81-1.00) was found using the Cohen's k statistic (k= 0.75) for concordance between HER2 status in the primary tumor and CTCs.

These experiments indicate the potential for biocontrol of Listeria in silage through use of these strains of homofermentative lactobacilli as silage inoculants.

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