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[Mitotic index in the bone marrow of children during the clinical course of acute lymphoblastic leukemia (ALL)].

From 31 children with acute lymphoblastic leukaemia the mitosis index in the bone-marrow was determined before the onset of therapy and during the clinical progress. Initially, the mean white mitosis index lay with 3.4% below that of the normal test persons, it rose significantly in the hematologic full remission and showed a decreasing tendency with a great range of dispersion in the recidive. The most lowered mitosis index was found in the final stage. Strong shifts in the kariologic distributions make a remaining in the prophase of the mitosis evident. The influence of polychemotherapy on the mitosis index and the phases of mitosis is discussed. Correlations between the mitosis index and clinical as well as paraclinical parameters were only to be found with respect to granulocytes and lymphoblasts. The considerable ranges of fluctuations of the mitosis index and the lack of congruity with the clinical progress of ALL allow no ensured assertions to be made for the single patient. It seems to be important in eosinophilia and in leukaemoid reactions.

Bone Marrow Cells↗

Age-related association between body mass index and blood pressure: the Humboldt Study.

OBJECTIVE: To investigate how age modifies the relation between body mass and blood pressure. DESIGN: Community based cross-sectional study. SUBJECTS: 2865 residents aged 6 to 74 years (85.6% of the target population) in the town of Humboldt, Saskatchewan, Canada. MEASUREMENTS: Body mass index [weight (kg)/height (meters)2], and diastolic and systolic blood pressures. RESULTS: Among the subjects, 99.6% were of Caucasian origin. With both sexes, there was a stronger relation between body mass index and diastolic blood pressure in younger age groups than older age groups. In males, the increase in mean blood pressure for a 1-unit increase in body mass index (kg/m2) was 0.72, 0.72, 0.41 and 0.47 mm Hg in the 6-14, 15-34, 35-54 and 55-74 year age groups respectively. In females, the correspondent increase was 0.95, 0.57, 0.46 and 0.43 mm Hg. In females, age also modified the relation between body mass index and the prevalence of high blood pressure. The odds ratios for high blood pressure for a 1-unit increase in body mass index in females was 1.33, 1.21, 1.12 and 1.10 in the 6-14, 15-34, 35-54 and 55-74 year age groups. CONCLUSION: Age significantly modifies the relations of body mass index with mean diastolic blood pressure in both sexes, and with the prevalence of high blood pressure in females. The relations are stronger in children and young adults than in older persons.

Adolescent↗

Population groups: indexing, coverage, and retrieval effectiveness of ethnically related health care issues in health sciences databases.

OBJECTIVES: This study examined methods of accessing (for indexing and retrieval purposes) medical research on population groups in the major abstracting and indexing services of the health sciences literature. DESIGN: The study of diseases in specific population groups is facilitated by the indexing of both diseases and populations in a database. The MEDLINE, PsycINFO, and Embase databases were selected for the study. The published thesauri for these databases were examined to establish the vocabulary in use. Indexing terms were identified and examined as to their representation in the current literature. Terms were clustered further into groups thought to reflect an end user's perspective and to facilitate subsequent analysis. The medical literature contained in the three online databases was searched with both controlled vocabulary and natural language terms. RESULTS: The three thesauri revealed shallow pre-coordinated hierarchical structures, rather difficult-to-use terms for post-coordination, and a blurring of cultural, genetic, and racial facets of populations. Post-coordination is difficult because of the system-oriented terminology, which is intended mostly for information professionals. The terminology unintentionally restricts access by the end users who lack the knowledge needed to use the thesauri effectively for information retrieval. CONCLUSIONS: Population groups are not represented adequately in the index languages of health sciences databases. Users of these databases need to be alerted to the difficulties that may be encountered in searching for information on population groups. Information and health professionals may not be able to access the literature if they are not familiar with the indexing policies on population groups. Consequently, the study points to a problem that needs to be addressed, through either the redesign of existing systems or the design of new ones to meet the goals of Healthy People 2000 and beyond.

Abstracting and Indexing↗

Risk for spontaneous preterm delivery by combined body mass index and gestational weight gain patterns.

BACKGROUND: To investigate whether maternal anthropometric factors interact with one another or with other risk factors, thus modifying the risk of spontaneous preterm delivery. METHODS: We carried out a case-control study of 230 spontaneous preterm births with intact membranes between 24 and 35 weeks gestation and 460 control term births. All the patients had prenatal care at the same institution. Logistic regression analysis was used to test for possible interactions adjusting for potential confounders. RESULTS: A pre-pregnancy body mass index < or = 19.5 Kg/m2 (odds ratio (OR) = 1.68, 95% confidence interval (CI) = 1.20-2.38) and a rate of weight gain < or = 0.37 Kg/week during the second and third trimesters (OR = 2.4, 95% CI = 1.69-3.42) were associated with an increased risk of spontaneous preterm delivery. The risk of spontaneous preterm delivery associated with a low second/third trimester weight gain was greater among patients with a body mass index < or = 19.5 (OR = 5.63, 95% CI = 2.35-13.8) compared to those with a body mass index > 19.5 (OR = 2.45, 95% CI = 1.60-3.75, adjusted p value for interaction = 0.05). The risk of spontaneous premature delivery associated with a maternal pre-pregnancy weight < or = 48 Kg was higher among smokers (OR = 5.81, 95% CI = 1.60-22.9) than among non-smokers (OR = 2.4, 95% CI = 1.53-3.74, adjusted p value for interaction = 0.05). CONCLUSIONS: The risk of spontaneous preterm delivery associated with a low pre-pregnancy body mass index is greater among patients with low rate of gestational weight gain during the second and third trimesters compared to those with a higher rate. The results of this study support the recommendation for increased rates of weight gain to patients with low body mass index compared to those with a higher body mass index.

Adult↗

Clinical impact of oral health indexes in dental extraction of hemophilic patients.

PURPOSE: Periodontal disease in patients with hemorrhagic disorders may lead to severe bleeding during dental treatment. This study evaluated the clinical impact of oral health indexes in hemophilic patients undergoing tooth extraction. PATIENTS AND METHODS: Thirty-one hemophilic patients underwent teeth extractions using autologous fibrin glue and an oral antifibrinolytic drug (epsilon-aminocaproic acid). Oral health indexes (plaque, PI; gingival, GI; and decay-missing-filling-teeth, DMFT index) were evaluated before tooth extraction. RESULTS: Postsurgical bleeding episodes were observed in 6 hemophilic patients (1 severe, 3 moderate, and 2 mild type). The PI and GI index in the bleeding group were 1.8 and 1.7, respectively, and 1.8 for both of the non-bleeding groups (PI, P = .8; GI, P = .56). The global DMFT index was 18 in the bleeding group and 19.6 in the non-bleeding group (P = .67). CONCLUSION: The status of oral health did not interfere with bleeding caused by dental extraction of hemophilic patients.

Adolescent↗

An empirical test of the validity of the Oral Health Status Index (OHSI) on a minority population.

Disease varies in different populations based on sociodemographic variables, and there is limited understanding of this interaction. The purpose of this methodological study was to determine the validity of the Oral Health Status Index, a disease-based index, on a Hispanic population by comparing it with the NIDCR epidemiological measures of disease, with the addition of demographic and behavioral variables. The epidemiologic data were collected according to the criteria defined by the NIDCR, including: a modified Decayed Missing Filled Surfaces Index, gingival inflammation, calculus, and destructive periodontal disease measures. The demographic and behavioral variables were gathered from 240 interviews with Hispanic adults in two community clinics. Bivariate analysis was used to determine relationships between the descriptive epidemiologic, demographic, and behavioral variables and the Oral Health Status Index (OHSI). There were statistically significant differences (p < 0.05) in mean OHSI scores among the demographic variables age, education, income, and place of birth; and the behavioral variables alcohol consumption, flossing, and acculturation. Multiple regression analysis with the OHSI as the dependent variable showed that the statistically significant (p < 0.001) epidemiologic predictors were: percentage of Decayed Teeth/Decayed, Filled Teeth; Number of Replaced Teeth/Missing Teeth; and millimeters of mesial attachment loss. These collectively explained 47.49% of the variance in the regression. The addition of demographic variables to the epidemiologic regression identified age (p < 0.05), gender (p < 0.01), and place of birth (p < 0.01) as significant predictors that explained an additional 4.12% of the variance, collectively bringing the total explained variance to 51.61%. The behavioral variables did not contribute significantly to predicting the OHSI regression score. The Oral Health Status Index in this study is validated by its correlation with both the epidemiologic measures and the demographic variables. This combination of variables separated the Hispanics into Mexicans and Central/South Americans.

Acculturation↗

Refractive keratoplasty in monkeys using intracorneal lenses of various refractive indexes.

The refractive power of the cornea can be altered with an intracorneal lens when it is inserted within a freehand lamellar-pocket incision. The effectiveness of the implant in altering the refractive power of the cornea depends on the refractive index of the intracorneal lens, since little change in the anterior corneal curvature occurs. Thirteen nonhuman primate eyes received intracorneal lenses made of synthetic polymers with refractive indexes ranging from 1.3686 to 1.633. The lidofilcon-B hydrogel (refractive index, 1.3686) lenses created no significant alteration in the refractive power of the cornea. The polymethylmethacrylate (refractive index, 1.4900D) and polysulfone (refractive index, 1.633) lenses created a predictable and significant alteration of corneal power that increased with each implant with a successively higher refractive index. The polymethylmethacrylate lens created a refractive alteration that was approximately 31% of the lens power in air. The polysulfone lens created a corneal power alteration that was approximately 40% of the lens power in air.

Animals↗

Reliable computer-assisted classification of the EEG: EEG variants in index cases and their first degree relatives.

A method which optimizes on global properties of sample recordings is proposed for the definition of and the discrimination between electroencephalogram (EEG) classes. The sample was drawn from students at the University of Heidelberg from 1974 to 1978 and consists of 15 healthy index cases clinically ascertained as belonging to the low voltage EEG group. In addition, the three clinically defined groups: diffuse beta (18 index cases), borderline alpha (12 index cases) and monomorphous alpha (18 index cases) have been included in the study, as well as the first degree relatives of the index cases, thus providing a clinical classification into four groups. The proposed method provides an automatic and reliable classification algorithm using discriminant and cluster analysis. The relation between such an automatized classification and clinical classification schemes is investigated. In particular, the inheritance of the low voltage EEG, the question on sex differences and the question of a simple Mendelian mechanism had been examined. The method of random splittings had been applied for discriminant and cluster analysis. Our findings can be summarized as follows: (1) except for the monomorphous alpha EEG group, the clinical classification shows rather marginal separation (discriminating performance 60% to 75%), while a new and more reliable grouping scheme improves the discriminating performance up to 87% to 91%. The latter scheme leads to the concept of personal channel pattern (PCP) and was compared to the clinical classification scheme by means of contingency tables; (2) only a weak correlation between the clinically and PCP-based groups could be found (Cramér Index: 0.27). Accordingly, we continued to investigate the extent to which the proposed EEG classification scheme can nevertheless explain the genetic mechanisms apparently involved in the low voltage EEG. We thus considered the role of sex differences manifest in our proposed new grouping scheme; (3) males occurred more frequently in the new group 3 and females more frequently in the new group 1. In this regard, a much better correlation of the new groups between mothers and children than between fathers and children was observed; and (4) with help of our new PCP scheme, we have been able to reproduce a simple two gene Mendelian scheme to explain inheritance of the clinical low voltage EEG group. In this PCP-based scheme, the low voltage property does not occur when dominance of a certain gene (called gene A) is absent.

Adult↗

Effect of fetal movement on the amniotic fluid index in diamniotic twin gestations.

Fetal movement changes the size and location of amniotic fluid pockets during measurement of the amniotic fluid index. In singleton gestations, the effect of redistributing the fixed intrauterine fluid volume on the amniotic fluid index is clinically insignificant. In this study, we tested the hypothesis that the index in twin pregnancies is unaffected by fetal movement. A single examiner prospectively determined the amniotic fluid index before and after three discrete episodes of movement by both fetuses of 82 diamniotic twin pregnancies referred for obstetric sonograms between 20 and 38 weeks' menstrual age. A reliable blinded examiner provided a second post-movement measurement as a control. Data were analyzed by the paired t-test. The mean change in the amniotic fluid index after fetal movement was 2.1 +/- 0.2 cm and 3.7 +/- 0.3 cm for post-movement determinations by the same and blinded examiners, respectively (p < .001). Interobserver variation was 3.5 cm. Intraobserver variation was 1.8 cm for the first examiner and 2.2 cm for the second examiner. Therefore, interobserver and intraobserver variation can account for the observed change in the amniotic fluid index following movement of both diamniotic twins.

Amniotic Fluid↗

Indexes of contrast and quantitative significance for comparisons of two groups.

Although boundaries for 'large' and 'small' differences are needed to plan research and interpret results, the diverse indexes of descriptive contrast for the central indexes, A and B, of two groups, have not received intensive attention. For two means, the increment of mid R:A-Bmid R: reflects the slope of a line showing the 'effect', but is altered by different units of measurement. Division of mid R:A-Bmid R: by the common standard deviation produces the standardized increment (SI), which is sometimes called the 'effect size'. Despite many advant ages, it does not contrast the relative magnitudes of A and B. For the latter contrast, the relative change or proportionate increment (mid R:A-Bmid R:/B) is particularly easy to understand, and the relative translocation (mid R:A-Bmid R:/[A+B]) produces a bounded range from -1 to +1. Nevertheless, all indexes of relative magnitude ablate the scales of measurement, thereby increasing difficulty in interpretation. Although seldom applied, proportionate reduction in overall system variance can be highly useful. Its square root leads to eta, the analogue of a correlation coefficient, which corresponds to a standardized slope for the direct increment. The values of eta usually approximate (SI)/2. Although arbitrary levels have been proposed for 'quantitative significance' of the SI, the proportionate reduction in overall system variance is often regarded as ineffectual unless >/=10 per cent. With this belief, minimum boundaries for quantitative significance can often be set at eta>/=0.3 and SI>/=0.6. In indexes of relative magnitude for two proportions (or rates), p(A) and p(B), confusion is produced if q(A) and q(B) are alternatively chosen for the denominators. The odds ratio, (p(A) q(B)/p(B) q(A)), avoids these choices, but is often difficult to interpret. For easy understanding and communication, the preferred index is NNE, the number needed to produce one excess effect, calculated as the inverse of the direct increment, that is, 1/mid R:p(A)-p(B)mid R: The standardized increment, mid R:p(A)-p(B)mid R:/ radical(PQ), (where P is the average of p(A) and p(B) and Q=1-P) could offer a single index applicable to both dimensional and binary data, but when P becomes quite small, that is, <0.01, radical(PQ) requires special calculations and also approaches the value of radicalP. Boundaries of 'quantitative significance' are particularly difficult to establish for comparisons of two rates, because of additional consequences in populational extrapolations and clinical implications. Nevertheless, the principles of quantitative significance can aid the ad hoc construction of boundaries that must be set for medical importance when sample sizes are calculated and when results are interpreted for studies of either efficacy or equivalence.

Clinical Trials as Topic↗

The fucosylation index of alpha-fetoprotein and its usefulness in the early diagnosis of hepatocellular carcinoma.

The serum concentration and degree of fucosylation (fucosylation index) of alpha-fetoprotein (AFP) were determined in serum samples from 258 patients with hepatocellular carcinoma (HCC) and 114 patients with benign liver diseases. When the serum AFP concentration was below 1000 ng/ml, it could not be used as a measure to distinguish between HCC and benign liver diseases. However, the fucosylation index of AFP proved useful for such a purpose. The sensitivity of the analysis using the fucosylation index in total patients with HCC was 69%; the specificity was 96% in benign liver diseases, and the accuracy of this test was 77%. When HCC patients who were grouped according to tumor size (5 cm, 3 cm, and 2 cm in diameter) were analyzed, they all had a fucosylation index significantly higher than that in benign liver disease patients. The mean fucosylation index in 28 patients with a serum AFP concentration below 1000 ng/ml and a tumor diameter less than 3 cm was 26 +/- 30%. Corresponding values for 16 patients with an AFP concentration below 400 ng/ml and a tumor size less than 3 cm and for 8 patients with a concentration below 400 ng/ml and a tumor size less than 2 cm were 32 +/- 31% and 27 +/- 27%, respectively. These values were higher, with statistical significance, than those in patients with benign liver diseases. These data indicate that the measurement of the fucosylation index of AFP is useful for the early diagnosis of HCC.

Biomarkers, Tumor↗

Improving the prognostic value of DNA flow cytometry in breast cancer by combining DNA index and S-phase fraction. A proposed classification of DNA histograms in breast cancer.

To optimize the prognostic value of DNA flow cytometry in breast cancer the authors calculated several parameters from the DNA histogram, including the DNA index, the size and number of aneuploid peaks as well as S-phase and G2/M-phase cell cycle fractions. Of these, DNA index and S-phase fraction (SPF) proved to be the most valuable prognostic indices. DNA aneuploidy was associated with a three-fold risk of death as compared to DNA diploidy (P less than 0.0001). The highest risk of death was associated with hypertetraploid (greater than 2.20) DNA index, whereas a tetraploid DNA index (1.80-2.20) was associated with a relatively low risk. The SPF had significant additional prognostic value in both DNA diploid (P = 0.0002) and DNA aneuploid (P = 0.02) tumors. By combining DNA index and SPF the authors defined three types of DNA histograms, which were associated with favorable, intermediate, and poor prognosis of the patients. DNA diploidy together with low (less than 7%) SPF (type I DNA histogram) was associated with very favorable prognosis, whereas DNA aneuploidy with high DNA index (greater than 2.20) or high (greater than 12%) SPF (type III DNA histogram) was related to the worst prognosis with approximately eight-fold relative risk of death. In a Cox multivariate regression analysis the type of DNA histogram was an independent and most powerful prognostic indicator in breast cancer. The other independent factors in the Cox analysis were primary tumor size, nodal status, and progesterone receptor status.

Aged↗

Deconstructing reconstruction: the OH 62 humerofemoral index.

The humerus and femur of the fossil hominid OH 62 are badly damaged and their lengths are not directly measurable (Johanson et al., 1987). Nevertheless, using relatively intact reference materials from another early hominid, AL 288-1, Johanson et al. (1987) reconstructed the bones to estimate the humerofemoral index, which falls well above the range for modern Homo, above the estimate for AL 288-1, and within the range for Pan paniscus. The reconstruction of missing bone by the method originally employed for OH 62 is broadly reproducible in a representative modern sample of Homo, making possible the estimation of an associated error term intrinsic to this method. Using the approximate variance of the ratio mean (Kish, 1965), shown here to be a good estimator of the sample variance of the humerofemoral index, the analysis of this modern sample extrapolated to other living hominoids gives quite acceptable results. Applied to OH 62, it suggests an error term associated with the estimated humerofemoral index so substantial that it is only possible to situate the index somewhere between the distributions for Homo and Gorilla, and quite possibly not above the index for AL 288-1. On the other hand, the predicted distribution for the humerofemoral index of AL 288-1 is more securely placed between the distributions for Homo and Pan paniscus.

Animals↗

The development and initial validation of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index for systemic lupus erythematosus.

OBJECTIVE: To develop and perform an initial validation of a damage index for systemic lupus erythematosus (SLE). METHODS: A list of items considered to reflect damage in SLE was generated through a nominal group process. A consensus as to which items to be included in an index was reached, together with rules for ascertainment. Each center submitted 2 assessments, 5 years apart, on 2 patients with active and 2 with inactive disease, of whom 1 had increased damage and the other had stable disease. Analysis of variance was used to test the factors physician, time, amount of damage, and activity status. RESULTS: Nineteen physicians completed the damage index on 42 case scenarios. The analysis revealed that the damage index could identify changes in damage seen in patients with both active and inactive disease. Patients who had active disease at both time points had a higher increase in damage. There was good agreement among the physicians on the assessment of damage in these patients. CONCLUSION: This damage index for SLE records damage occurring in patients with SLE regardless of its cause. The index was demonstrated to have content, face, criterion, and discriminant validity.

Health Status Indicators↗

Development of a preliminary index that predicts adverse events after total knee replacement.

OBJECTIVE: We undertook this study to assess the relationships between hospital characteristics, volume of procedures, and perioperative outcomes after total knee replacement (TKR), and to use this information to construct a simple predictive index for perioperative outcomes that incorporates hospital- and patient-level characteristics. METHODS: We studied Medicare beneficiaries who underwent TKR in 4 US states in 2000. Orthopedic surgery administrators from hospitals caring for patients in this sample were surveyed about a range of hospital characteristics. The relationships between these hospital characteristics, patient variables, and 90-day postoperative adverse events (including death, pulmonary embolus, pneumonia, deep wound infection, and acute myocardial infarction) were assessed using generalized estimating equations adjusting for hospital volume. These relationships were assessed in low- and high-risk patient groups. Variables from the final multivariate model were used to create an index that was tested against 90-day adverse event rates. RESULTS: Three hundred twenty-seven (3.6%) of the patients undergoing TKR in our sample experienced an adverse event. In the final multivariate regression models, variables that predicted adverse perioperative events included low hospital volume (fewer than 23 TKRs in the Medicare population per year), absence of a preoperative teaching program, fewer TKRs conducted in a dedicated orthopedic surgery operating room, patient age >70 years, male sex, and at least 1 comorbid condition. The effect of volume on perioperative adverse events was evident both in patients with few risk factors and in patients with several risk factors. An index including the 6 patient and hospital variables discriminated well, with adverse events occurring in 2.0% (95% confidence interval [95% CI] 1.4-2.7%) of patients in the lowest risk category and in 7.4% (95% CI 4.5-12.3%) of patients in the highest risk category (P for trend < 0.001). The index predicted adverse event rates both in hospitals with a low volume of TKRs and in those with a high volume of TKRs. CONCLUSION: Characteristics of hospital care, procedure volume, and patient-level factors are all associated with perioperative outcomes of TKR. A preliminary index combining hospital characteristics and volume is moderately predictive of adverse perioperative outcomes. The index is predictive of outcome in low- and high-volume hospitals.

Aged↗

The value of grip test as an index of autonomic function in hypertension.

The autonomic sympathetic adjustments to sustained handgrip, upright tilt, and the Valsalva maneuver, were tested in a total of 52 patients, 26 with labile and 26 with fixed essential hypertension. Sustained handgrip (SHG) increased arterial pressure, heart rate (HR), cardiac index (CI), and tension time index (TTI) (p less than 0.01), but had no effect on total peripheral resistance index (TPRI) and left ventricular ejection rate index (LVERI) in either group of patients. The response to upright tilt and the Valsalva maneuver was different in the two groups. Upright tilt in labile hypertensives increased diastolic arterial pressure (DAP), mean arterial pressure (MAP), HR, and TPRI (p less than 0.001), and decreased CI, stroke index (SI), and LVERI (p less than 0.01), and had no effect on systolic arterial pressure (SAP). In fixed hypertensives, it decreased (SAP, MAP, CI, SI, and LVERI (p less than 0.001), increased HR (p less than 0.01), and had no effect on DAP and TPRI. The diastolic pressure overshoot of the Valsalva maneuver was attenuated in fixed hypertensives compared to labile hypertensives (P less than 0.001). Also, when the percent changes from control in diastolic and mean arterial pressure, heart rate, and total peripheral resistance index after sustained handgrip and upright tilt between the two groups of patients were compared, only upright tilt brought out the differences between the two groups. The results of this study indicate that upright tilt and the Valsalva maneuver are better predictors of autonomic function in hypertension than the grip test.

Blood Pressure↗

Modeling of X-ray-induced refractive index changes in poly(methyl methacrylate).

The refractive index of bulk poly(methyl methacrylate) samples is modified by X-ray exposure. The intensity of the radiation is distributed over an energy range of 1 to 20 keV with a maximum at 3 keV. For an absorbed dose of about 1 kJ cm(-3), an increase of the refractive index of up to 3x10(-4) is observed. However, for much lower doses of about 10 J cm(-3) a decrease of 4x10(-4) appears. These refractive index changes, as well as the simultaneously arising radiation-induced thickness changes, are detected interferometrically. Based on these observations, on dose calculations, and on literature data, a model is proposed which describes quantitatively the observed refractive index changes. The refractive index increase is caused by a radiation-induced chemical alteration of the polymer composition, while the refractive index decrease is correlated with a decrease of mass density.

Journal Article↗

Increased plasma DNA integrity index in head and neck cancer patients.

Analysis of the length of circulating DNA in plasma has been reported as a marker for solid tumor detection. We assessed the sensitivity and specificity of increased plasma DNA length to identify patients with head and neck squamous cell carcinoma (HNSCC) and monitor posttreatment disease status. Fifty-eight HNSCC patients with paired pre- and postoperative plasma and 47 plasma samples from control subjects were analyzed using quantitative PCR to determine plasma DNA integrity index. We found that the mean DNA integrity index was significantly greater in the plasma from HNSCC patients, 0.24 (95% CI: 0.11, 0.38), when compared to plasma from the control subjects, -2.24 (95% CI: -2.92, -1.56), p < 0.0001 using multivariate analysis. The optimal sensitivity (the value for which sensitivity equals specificity) was found at a plasma DNA integrity index of 0.82: sensitivity, 84.5%; specificity, 83%. However, there was no significant difference noted between pre- and postoperative DNA integrity index in plasma samples from HNSCC patients. This study shows that DNA integrity index in the plasma of the patients with HNSCC is increased in comparison with that in the plasma from non-HNSCC control subjects. Lack of normalization of plasma DNA integrity index after surgical resection implies the persistence of a population of cells with an altered pattern of DNA degradation despite removal of malignancy.

Adult↗