Cross Validation of the Monoclonal Antibody Das-1 in Identification of High-Risk Mucinous Pancreatic Cystic Lesions

Das, Koushik K.; Geng, Xin; Brown, Jeffrey W.; Morales-Oyarvide, Vicente; Huynh, Tiffany G.; Pergolini, Ilaria; Pitman, Martha B.; Ferrone, Cristina R.; Efishat, Mohammad Al; Haviland, Dana; Thompson, Elizabeth; Wolfgang, Christopher L.; Lennon, Anne Marie; Allen, Peter J.; Lillemoe, Keith D.; Fields, Ryan C.; Hawkins, William G.; Liu, Jingxia; Castillo, Carlos Fernández del; Das, Kiron M.; Mino‐Kenudson, Mari

doi:10.1053/j.gastro.2019.05.014

Cited by 51 publications

(46 citation statements)

References 47 publications

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“…Furthermore, the use of 10‐fold cross‐validation substantiates the validity of the model. The 10‐fold cross‐validation was used to validate the model, which divides the raw data into 10 groups (10‐fold); each subset data are used as a verification set, and the remaining K − 1 subset data are used as a training set, so that K models are obtained 24 . Cross‐validation effectively utilizes limited data, making the test results of the model more robust.…”

Section: Discussionmentioning

confidence: 99%

A novel nomogram to predict all‐cause readmission or death risk in Chinese elderly patients with heart failure

Yang

Tao

et al. 2020

ESC Heart Failure

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Aims Elderly patients with heart failure (HF) are associated with frequent all-cause readmission or death. The present study sought to develop an accurate and easy-to-use model to predict all-cause readmission or death risk in Chinese elderly patients with HF. Methods and resultsThis was a prospective cohort study in patients with HF aged 65 or older. Demographic, comorbidity, laboratory, and medication data were collected. A Cox regression model was used to identify factors for the prediction of readmission or death at 30 days and 1 year. A nomogram was developed with bootstrap validation. Of the included 854 patients, the cumulative all-cause readmission and mortality rates were 10.5% and 11.6% at 30 days and 34.9% and 19.7% at 1 year, respectively. The independent risk factors associated with both 30 day and 1 year readmission or death were older age, stroke, diastolic blood pressure < 60 mmHg, body mass index ≤ 18.5 kg/m 2 , lower estimated glomerular filtration rate, and BNP > 400 pg/mL (all P < 0.05). Anaemia, abnormal neutrophils, and admission without angiotensin-converting enzyme inhibitors/angiotensin receptor blockers were the specific independent risk factors of 30 day all-cause readmission or death (all P < 0.05), whereas serum sodium ≤ 140 mmol/L and admission without beta-blockers were the specific independent risk factors of 1 year all-cause readmission or death (all P < 0.05). The Cindex of the 30 day and 1 year diagnosis prediction model was 0.778 [95% confidence interval (CI) 0.693-0.862] and 0.738 (95% CI 0.640-0.836), respectively. Conclusions We developed accurate and easy-to-use nomograms to predict all-cause readmission or death in Chinese elderly patients with HF. The nomograms will assist in reducing the all-cause readmission and mortality rates.

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Section: Discussionmentioning

confidence: 99%

A novel nomogram to predict all‐cause readmission or death risk in Chinese elderly patients with heart failure

Yang

Tao

et al. 2020

ESC Heart Failure

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“…This unique immunoreactivity has been demonstrated on resected pancreas specimens with HGD-IPMN and PDAC, leading to the most recent study evaluating its applicability to preoperatively sampled cyst fluid [52]. Das et al investigated 169 patients with pancreatic cystic lesions across 4 institutions and found that non-mucinous and low-risk cysts displayed little reactivity, whereas HGD-IPMN and MCN lesions had significantly higher reactivity (p < 0.001), with a sensitivity of 88.3% and a specificity of 92.7% when stratifying for HGD or invasive malignancy [52]. Based on their internal comparative evaluation, Das-1 reactivity has significant potential in distinguishing HGD or malignancy.…”

Section: Cep and Mab Das-1mentioning

confidence: 96%

“…The murine Das-1 monoclonal antibody (mAb) was created to react with a normal colon epithelial protein (CEP), based on the observation that these cell types are not normally present in gastric and pancreatic epithelium and are prone to developing invasive carcinoma when present [51]. This unique immunoreactivity has been demonstrated on resected pancreas specimens with HGD-IPMN and PDAC, leading to the most recent study evaluating its applicability to preoperatively sampled cyst fluid [52]. Das et al investigated 169 patients with pancreatic cystic lesions across 4 institutions and found that non-mucinous and low-risk cysts displayed little reactivity, whereas HGD-IPMN and MCN lesions had significantly higher reactivity (p < 0.001), with a sensitivity of 88.3% and a specificity of 92.7% when stratifying for HGD or invasive malignancy [52].…”

Section: Cep and Mab Das-1mentioning

confidence: 99%

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Stratifying Intraductal Papillary Mucinous Neoplasms by Cyst Fluid Analysis: Present and Future

Hao

Takahashi

Snyder

et al. 2020

IJMS

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A significant proportion of patients with intraductal papillary mucinous neoplasms (IPMNs) undergo surgical resection in order to prevent or treat pancreatic cancer at the risk of significant perioperative morbidity. Efforts have been made to stratify the potential risk of malignancy based on the clinical and radiographic features of IPMN to delineate which cysts warrant resection versus observation. An analysis of the cyst fluid obtained by preoperative endoscopic examination appears to be correlative of cyst type and risk, whereas serum markers and radiographic findings have not yet reached a level of sensitivity or specificity that proves they are clinically meaningful. In this review, we investigate the current cyst fluid analysis studies and present those that have shown promise in effectively stratifying high-risk versus low-risk lesions. While new cyst fluid markers continue to be identified, additional efforts in testing panels and marker composites in conjunction with clinical algorithms have also shown promise in distinguishing dysplasia and the risk of malignancy. These should be tested prospectively in order to determine their role in guiding the surveillance of low-risk lesions and to evaluate the new markers detected by proteomics and genetic sequencing.

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“…Confocal laser endomicroscopy showed to be superior to cyst fluid CEA and cytology, and new parameters (e.g., papillary epithelial width, darkness) may be evaluated to detect high-grade dyplasia in IPMNs [ 44 , 45 , 46 , 47 , 48 ]. For example, evaluation of cyst fluid CEA may differentiate between mucinous and non-mucinous cystic neoplasm (CEA > 192 ng/mL suggests an MCN), yet it is not helpful in distinguishing MCNs versus IPMNs or benign versus HGD lesions [ 45 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 ]. Following cell death, genetic materials are released into the cystic fluid making the detection of IPMN-associated DNA mutations possible.…”

Section: State-of-the-art Managementmentioning

confidence: 99%

Intraductal Pancreatic Mucinous Neoplasms: A Tumor-Biology Based Approach for Risk Stratification

Nasca

Chiaravalli

Piro

et al. 2020

IJMS

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Pancreatic ductal adenocarcinoma is one of the most lethal human cancers. Its precursor lesions include pancreatic intra-epithelial neoplasia, mucinous cystic neoplasm, and intraductal papillary mucinous neoplasm (IPMN). IPMNs usually present as an incidental finding at imaging in 2.6% of the population and, according to the degree of dysplasia, they are classified as low- or high-grade lesions. Since the risk of malignant transformation is not accurately predictable, the management of these lesions is based on morphological and clinical parameters, such as presence of mural nodule, main pancreatic duct dilation, presence of symptoms, or high-grade dysplasia. Although the main genetic alterations associated to IPMNs have been elucidated, they are still not helpful for disease risk stratification. The growing body of genomic and epigenomic studies along with the more recent development of organotypic cultures provide the opportunity to improve our understanding of the malignant transformation process, which will likely deliver biomarkers to help discriminate between low- and high-risk lesions. Recent insights on the topic are herein summarized.

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Cross Validation of the Monoclonal Antibody Das-1 in Identification of High-Risk Mucinous Pancreatic Cystic Lesions

Cited by 51 publications

References 47 publications

A novel nomogram to predict all‐cause readmission or death risk in Chinese elderly patients with heart failure

A novel nomogram to predict all‐cause readmission or death risk in Chinese elderly patients with heart failure

Stratifying Intraductal Papillary Mucinous Neoplasms by Cyst Fluid Analysis: Present and Future

Intraductal Pancreatic Mucinous Neoplasms: A Tumor-Biology Based Approach for Risk Stratification

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