The Experts below are selected from a list of 13287 Experts worldwide ranked by ideXlab platform
Manuel Monreal - One of the best experts on this subject based on the ideXlab platform.
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screening for Occult Cancer in patients with acute deep vein thrombosis or pulmonary embolism
Journal of Thrombosis and Haemostasis, 2004Co-Authors: Manuel Monreal, A W A Lensing, Martin H Prins, Montserrat Bonet, J Fernandezllamazares, Jordi Muchart, Paolo Prandoni, Angel J JimenezAbstract:Summary. Patients with acute venous thromboembolism have an increased risk for Occult malignancy. Limited screening for these malignancies has become common practice but little is known about its usefulness. This is a prospective cohort follow-up study in consecutive patients with acute venous thromboembolism. All patients underwent a routine clinical evaluation for malignancy, if negative, followed by a limited diagnostic work-up consisting of abdominal and pelvic ultrasound and laboratory markers for malignancy. Clinical follow-up was conducted to detect screening failures. The routine clinical evaluation was performed in 864 patients and revealed malignancy in 34 (3.9%) of them. Among the remaining 830 patients the limited diagnostic work-up revealed 13 further malignancies. During follow-up, Cancer became symptomatic in 14 patients who were negative for Cancer at screening (sensitivity of limited diagnostic work-up, 48.1%). Malignancies that were identified by the limited diagnostic work-up were early stage in 61% of cases vs. 14% in cases occurring during follow-up. Most patients with Occult Cancer had idiopathic venous thromboembolism and were older than 70 years. A limited diagnostic work-up for Occult Cancer in patients with venous thromboembolism has the capacity to identify approximately one-half of the malignancies. Identified malignancies were predominantly in an early stage.
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extensive screening for Occult malignant disease in idiopathic venous thromboembolism a prospective randomized clinical trial
Journal of Thrombosis and Haemostasis, 2004Co-Authors: Andrea Piccioli, Manuel Monreal, A W A Lensing, Martin H Prins, Anna Falanga, G L Scannapieco, M Ieran, M Cigolini, G B Ambrosio, A GirolamiAbstract:Patients with symptomatic idiopathic venous thromboembolism and apparently Cancer-free have an approximate 10% incidence of subsequent Cancer. Apparently Cancer-free patients with acute idiopathic venous thromboembolism were randomized to either the strategy of extensive screening for Occult Cancer or to no further testing. Patients had a 2-year follow-up period. Of the 201 patients, 99 were allocated to the extensive screening group and 102 to the control group. In 13 (13.1%) patients, the extensive screening identified Occult Cancer. In the extensive screening group, a single (1.0%) malignancy became apparent during follow-up, whereas in the control group a total of 10 (9.8%) malignancies became symptomatic [relative risk, 9.7 (95% CI, 1.3-36.8; P < 0.01]. Overall, malignancies identified in the extensive screening group were at an earlier stage and the mean delay to diagnosis was reduced from 11.6 to 1.0 months (P < 0.001). Cancer-related mortality during the 2 years follow-up period occurred in two (2.0%) of the 99 patients of the extensive screening group vs. four (3.9%) of the 102 control patients [absolute difference, 1.9% (95% CI, -5.5-10.9)]. Although early detection of Occult Cancers may be associated with improved treatment possibilities, it is uncertain whether this improves the prognosis.
Mark J Smyth - One of the best experts on this subject based on the ideXlab platform.
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opposing roles for il 23 and il 12 in maintaining Occult Cancer in an equilibrium state
Cancer Research, 2012Co-Authors: Michele W L Teng, Matthew D Vesely, Helene Duret, Nicole Mclaughlin, Jennifer E Towne, Robert D Schreiber, Mark J SmythAbstract:Cancer immunoediting, the process by which the immune system controls tumor growth and shapes tumor immunogenicity, consists of 3 stages: elimination, equilibrium, and escape. The molecular mechanisms that underlie the equilibrium phase, during which the immune system maintains tumor dormancy, remain incompletely defined. Here, we investigated the length of the equilibrium phase during immune control of methycholanthrene (MCA)-induced or p53 mutant Cancers and showed the critical and opposing roles of interleukin (IL)-23 and IL-12 in maintaining Cancer cells in a state of immune-mediated dormancy. Inhibition of IL-23p19 was shown to reduce the malignant potential of lesions established by MCA inoculation, whereas inhibition of IL-12/23p40 enhanced tumor outgrowth. Furthermore, agonistic anti-CD40 antibody treatment mimicked the effects of anti-IL-23p19 monoclonal antibody treatment. Other cytokines such as IL-4, IL-17, TNF, and IFNαβ, which are known to play important roles either in MCA tumorigenesis or in the elimination phase of Cancer immunoediting, did not play critical roles in maintaining the equilibrium phase. Taken together, our findings show opposing roles for IL-23 and IL-12 in determining the outgrowth versus dormancy of Occult neoplasia and suggest a potential long-term danger in using IL-12/23p40 antibodies for treating human autoimmune inflammatory disorders. Cancer Res; 72(16); 3987–96. ©2012 AACR.
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adaptive immunity maintains Occult Cancer in an equilibrium state
Nature, 2007Co-Authors: Catherine M Koebel, William Vermi, Jeremy B Swann, Nadeen Zerafa, Scott J Rodig, Lloyd J Old, Mark J SmythAbstract:The capacity of immunity to control and shape Cancer, that is, Cancer immunoediting, is the result of three processes that function either independently or in sequence: elimination (Cancer immunosurveillance, in which immunity functions as an extrinsic tumour suppressor in naive hosts); equilibrium (expansion of transformed cells is held in check by immunity); and escape (tumour cell variants with dampened immunogenicity or the capacity to attenuate immune responses grow into clinically apparent Cancers). Extensive experimental support now exists for the elimination and escape processes because immunodeficient mice develop more carcinogen-induced and spontaneous Cancers than wild-type mice, and tumour cells from immunodeficient mice are more immunogenic than those from immunocompetent mice. In contrast, the equilibrium process was inferred largely from clinical observations, including reports of transplantation of undetected (Occult) Cancer from organ donor into immunosuppressed recipients. Herein we use a mouse model of primary chemical carcinogenesis and demonstrate that equilibrium occurs, is mechanistically distinguishable from elimination and escape, and that neoplastic cells in equilibrium are transformed but proliferate poorly in vivo. We also show that tumour cells in equilibrium are unedited but become edited when they spontaneously escape immune control and grow into clinically apparent tumours. These results reveal that, in addition to destroying tumour cells and sculpting tumour immunogenicity, the immune system of a naive mouse can also restrain Cancer growth for extended time periods.
Agnes Y Y Lee - One of the best experts on this subject based on the ideXlab platform.
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screening for Occult Cancer in unprovoked venous thromboembolism
The New England Journal of Medicine, 2015Co-Authors: Marc Carrier, Alejandro Lazolangner, Sudeep Shivakumar, Vicky Tagalakis, Ryan Zarychanski, Susan Solymoss, Nathalie Routhier, James D Douketis, Kim Danovitch, Agnes Y Y LeeAbstract:BackgroundVenous thromboembolism may be the earliest sign of Cancer. Currently, there is a great diversity in practices regarding screening for Occult Cancer in a person who has an unprovoked venous thromboembolism. We sought to assess the efficacy of a screening strategy for Occult Cancer that included comprehensive computed tomography (CT) of the abdomen and pelvis in patients who had a first unprovoked venous thromboembolism. MethodsWe conducted a multicenter, open-label, randomized, controlled trial in Canada. Patients were randomly assigned to undergo limited Occult-Cancer screening (basic blood testing, chest radiography, and screening for breast, cervical, and prostate Cancer) or limited Occult-Cancer screening in combination with CT. The primary outcome measure was confirmed Cancer that was missed by the screening strategy and detected by the end of the 1-year follow-up period. ResultsOf the 854 patients who underwent randomization, 33 (3.9%) had a new diagnosis of Occult Cancer between randomizat...
Martin H Prins - One of the best experts on this subject based on the ideXlab platform.
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screening for Occult Cancer in patients with acute deep vein thrombosis or pulmonary embolism
Journal of Thrombosis and Haemostasis, 2004Co-Authors: Manuel Monreal, A W A Lensing, Martin H Prins, Montserrat Bonet, J Fernandezllamazares, Jordi Muchart, Paolo Prandoni, Angel J JimenezAbstract:Summary. Patients with acute venous thromboembolism have an increased risk for Occult malignancy. Limited screening for these malignancies has become common practice but little is known about its usefulness. This is a prospective cohort follow-up study in consecutive patients with acute venous thromboembolism. All patients underwent a routine clinical evaluation for malignancy, if negative, followed by a limited diagnostic work-up consisting of abdominal and pelvic ultrasound and laboratory markers for malignancy. Clinical follow-up was conducted to detect screening failures. The routine clinical evaluation was performed in 864 patients and revealed malignancy in 34 (3.9%) of them. Among the remaining 830 patients the limited diagnostic work-up revealed 13 further malignancies. During follow-up, Cancer became symptomatic in 14 patients who were negative for Cancer at screening (sensitivity of limited diagnostic work-up, 48.1%). Malignancies that were identified by the limited diagnostic work-up were early stage in 61% of cases vs. 14% in cases occurring during follow-up. Most patients with Occult Cancer had idiopathic venous thromboembolism and were older than 70 years. A limited diagnostic work-up for Occult Cancer in patients with venous thromboembolism has the capacity to identify approximately one-half of the malignancies. Identified malignancies were predominantly in an early stage.
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extensive screening for Occult malignant disease in idiopathic venous thromboembolism a prospective randomized clinical trial
Journal of Thrombosis and Haemostasis, 2004Co-Authors: Andrea Piccioli, Manuel Monreal, A W A Lensing, Martin H Prins, Anna Falanga, G L Scannapieco, M Ieran, M Cigolini, G B Ambrosio, A GirolamiAbstract:Patients with symptomatic idiopathic venous thromboembolism and apparently Cancer-free have an approximate 10% incidence of subsequent Cancer. Apparently Cancer-free patients with acute idiopathic venous thromboembolism were randomized to either the strategy of extensive screening for Occult Cancer or to no further testing. Patients had a 2-year follow-up period. Of the 201 patients, 99 were allocated to the extensive screening group and 102 to the control group. In 13 (13.1%) patients, the extensive screening identified Occult Cancer. In the extensive screening group, a single (1.0%) malignancy became apparent during follow-up, whereas in the control group a total of 10 (9.8%) malignancies became symptomatic [relative risk, 9.7 (95% CI, 1.3-36.8; P < 0.01]. Overall, malignancies identified in the extensive screening group were at an earlier stage and the mean delay to diagnosis was reduced from 11.6 to 1.0 months (P < 0.001). Cancer-related mortality during the 2 years follow-up period occurred in two (2.0%) of the 99 patients of the extensive screening group vs. four (3.9%) of the 102 control patients [absolute difference, 1.9% (95% CI, -5.5-10.9)]. Although early detection of Occult Cancers may be associated with improved treatment possibilities, it is uncertain whether this improves the prognosis.
A W A Lensing - One of the best experts on this subject based on the ideXlab platform.
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screening for Occult Cancer in patients with acute deep vein thrombosis or pulmonary embolism
Journal of Thrombosis and Haemostasis, 2004Co-Authors: Manuel Monreal, A W A Lensing, Martin H Prins, Montserrat Bonet, J Fernandezllamazares, Jordi Muchart, Paolo Prandoni, Angel J JimenezAbstract:Summary. Patients with acute venous thromboembolism have an increased risk for Occult malignancy. Limited screening for these malignancies has become common practice but little is known about its usefulness. This is a prospective cohort follow-up study in consecutive patients with acute venous thromboembolism. All patients underwent a routine clinical evaluation for malignancy, if negative, followed by a limited diagnostic work-up consisting of abdominal and pelvic ultrasound and laboratory markers for malignancy. Clinical follow-up was conducted to detect screening failures. The routine clinical evaluation was performed in 864 patients and revealed malignancy in 34 (3.9%) of them. Among the remaining 830 patients the limited diagnostic work-up revealed 13 further malignancies. During follow-up, Cancer became symptomatic in 14 patients who were negative for Cancer at screening (sensitivity of limited diagnostic work-up, 48.1%). Malignancies that were identified by the limited diagnostic work-up were early stage in 61% of cases vs. 14% in cases occurring during follow-up. Most patients with Occult Cancer had idiopathic venous thromboembolism and were older than 70 years. A limited diagnostic work-up for Occult Cancer in patients with venous thromboembolism has the capacity to identify approximately one-half of the malignancies. Identified malignancies were predominantly in an early stage.
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extensive screening for Occult malignant disease in idiopathic venous thromboembolism a prospective randomized clinical trial
Journal of Thrombosis and Haemostasis, 2004Co-Authors: Andrea Piccioli, Manuel Monreal, A W A Lensing, Martin H Prins, Anna Falanga, G L Scannapieco, M Ieran, M Cigolini, G B Ambrosio, A GirolamiAbstract:Patients with symptomatic idiopathic venous thromboembolism and apparently Cancer-free have an approximate 10% incidence of subsequent Cancer. Apparently Cancer-free patients with acute idiopathic venous thromboembolism were randomized to either the strategy of extensive screening for Occult Cancer or to no further testing. Patients had a 2-year follow-up period. Of the 201 patients, 99 were allocated to the extensive screening group and 102 to the control group. In 13 (13.1%) patients, the extensive screening identified Occult Cancer. In the extensive screening group, a single (1.0%) malignancy became apparent during follow-up, whereas in the control group a total of 10 (9.8%) malignancies became symptomatic [relative risk, 9.7 (95% CI, 1.3-36.8; P < 0.01]. Overall, malignancies identified in the extensive screening group were at an earlier stage and the mean delay to diagnosis was reduced from 11.6 to 1.0 months (P < 0.001). Cancer-related mortality during the 2 years follow-up period occurred in two (2.0%) of the 99 patients of the extensive screening group vs. four (3.9%) of the 102 control patients [absolute difference, 1.9% (95% CI, -5.5-10.9)]. Although early detection of Occult Cancers may be associated with improved treatment possibilities, it is uncertain whether this improves the prognosis.
