A strengthening the reporting of observational studies in epidemiology (STROBE)

Abstract

Paget disease is a complex disorder that can be identified in the breast (mammary Paget disease) or in other locations (extramammary Paget's disease) such as ano-genital skin (Paget disease of the vulva -PVD). This condition is associated with low mortality, but a late diagnosis and recurrence can negatively impact the prognosis. Therefore, the main objective of this study is to evaluate if the human epididymis protein 4 (HE4) and cancer antigen125 (CA125) can promote recognition of PVD in early stages and during the relapses. we have conducted a prospective, observational and laboratory-based study, that included 50 patients, whose 25 healthy women represented the control group and 25 PVD patients, which have been operated in our Oncology Institute, from May 2017 to September 2019. Both in the control group and in PVD patients, the CA-125 and HE4 were evaluated before surgery and after 6 months. Finally, a comparison of markers serum level, both between before/after surgery and with control group, and a ROC (Receiver Operating Characteristic) curve were performed. Dosing the markers in PVD patients, 3/25 (12%) showed a higher value of CA125 and 11/25 (44%) an increased HE4. In addition, after surgical treatment there were no statistically significant difference between levels of CA-125 ( P = .3) and HE4 ( P = .19). On the other hand, comparing HE4 in PVD patients with the control group, a statistically significant difference was found ( P -value = .0036). Contrary, comparing CA-125 in PVD patients with the control group ( P -value= .1969), no statistically significant difference was evidenced. Moreover, ROC (Receiver Operating Characteristic) curve showed low sensitivity and specificity for CA125 with area under curve (AUC) = 0.5608. Instead, the ROC curve of HE4 revealed a sensitivity and specificity of 76% and 88% respectively (AUC = 0.7408) using a cut-off at 90 pmol/L. Despite the limited cases, our data showed that CA125 is not a sensitive marker for PVD. On the other hand, in 44% of PVD we’ve seen an increase in HE4. So, this could be a starting point for further research that could confirm the possibility to use this marker in order to support PVD early identification.

Aggressive Angiomyxoma of the Lower Female Genital Tract in Pregnancy: A Review of the MITO Rare Tumors Group

“…In case of persistence of positive margins, adjuvant therapy with GnRH analogues (e.g., triptorelin) is recommended until clinical negativity and for at least 6–9 months after surgery. The use of an aromatase inhibitor (letrozole) or a selective estrogen receptor modulator (SERM—e.g., tamoxifen, raloxifen) has been proposed as a second-line hormonal therapy in non-pregnant patients [ 10 , 11 , 12 , 38 ]. The role of radiotherapy is limited, and there is no evidence in the literature that adjuvant radiotherapy lowers the recurrence rate.…”

“…In pregnant women, DAM typically presents as an indolent polypoidal mass, frequently with consistent dimensions, arising from the genitalia or perineum. Due to its appearance, DAM is often misdiagnosed as other more frequent conditions, such as a Bartholin’s cyst, lipoma, labial cyst, Gartner’s duct cyst, condyloma acuminata, vaginal prolapse, or an unspecified tumor [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 ]. The diagnosis is performed by the pathologist and not by the clinician, thanks to immunohistochemistry, which is essential to distinguish DAM from other benign stromal tumors of the lower genital tract.…”

SPUR: psychometric properties of a patient-reported outcome measure of medication adherence in type 2 diabetes

“…This study has been reported using the Strengthening the Reporting of Observational Studies in Epidemiology cross-sectional checklist. 21 The preliminary arm recruited patients from community pharmacies in Southwest London whereby study procedures were conducted by community pharmacists.…”

“…The study was conducted as a multi-arm, non-interventional, cross-sectional study of patients with type 2 diabetes in England from August 2019 to May 2021. This study has been reported using the Strengthening the Reporting of Observational Studies in Epidemiology cross-sectional checklist 21. The preliminary arm recruited patients from community pharmacies in Southwest London whereby study procedures were conducted by community pharmacists.…”

A Positive Dermcidin Expression Is an Unfavorable Prognostic Marker for Extramammary Paget’s Disease

“…Tissue specimens of the tumor were obtained from patients who underwent surgery at our institution. Because of the rarity of this malignant cutaneous tumor [14], it is sometimes difficult for a diagnosis of extramammary Paget's disease to be made, especially as it is hard to distinguish the disease from the pagetoid phenomenon. To exclude a pagetoid phenomenon, perianal extramammary Paget's disease was evaluated via GCDFP15+ and CK20-to determine the correctness of the diagnosis of extramammary Paget's disease.…”