Clinical Utility and Economic Impact of Conventional Transbronchial Needle Aspiration of Mediastinal Lymphadenopathies in Bronchogenic Carcinoma

Naval, Jorge Castelao; Alonso, José L.; Carrasco, J. Gallardo; Hernández, Ignacio Sánchez; Sánchez, Carlos Almonacid; Francés, J. Fernández; Barrio, Pilar Resano; Andrés, Olga Mediano San

doi:10.1016/j.arbr.2013.01.005

Cited by 6 publications

(2 citation statements)

References 29 publications

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“…Therefore, melatonin attenuates ER stress-induced resistance to doxorubicin, possibly by regulating the PI3K/AKT pathway and increasing CHOP levels. In melanoma cancer, the PI3K/AKT/mTOR signaling pathway influences this cancer type and prevents tumor progression [118][119][120]. Cell viability is significantly decreased in B16F10 melanoma cells through the PI3K/ AKT/mTOR pathway after treatment with melatonin combined with thapsigargin or tunicamycin, compared to no treatment or treatment with melatonin alone [121].…”

Section: Melatonin In Cancermentioning

confidence: 99%

Melatonin and endoplasmic reticulum stress: relation to autophagy and apoptosis

Fernández

Ordóñez

Reíter

et al. 2015

Journal of Pineal Research

412

301

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Endoplasmic reticulum (ER) is a dynamic organelle that participates in a number of cellular functions by controlling lipid metabolism, calcium stores, and proteostasis. Under stressful situations, the ER environment is compromised, and protein maturation is impaired; this causes misfolded proteins to accumulate and a characteristic stress response named unfolded protein response (UPR). UPR protects cells from stress and contributes to cellular homeostasis re-establishment; however, during prolonged ER stress, UPR activation promotes cell death. ER stressors can modulate autophagy which in turn, depending of the situation, induces cell survival or death. Interactions of different autophagy-and apoptosis-related proteins and also common signaling pathways have been found, suggesting an interplay between these cellular processes, although their dynamic features are still unknown. A number of pathologies including metabolic, neurodegenerative and cardiovascular diseases, cancer, inflammation, and viral infections are associated with ER stress, leading to a growing interest in targeting components of the UPR as a therapeutic strategy. Melatonin has a variety of antioxidant, anti-inflammatory, and antitumor effects. As such, it modulates apoptosis and autophagy in cancer cells, neurodegeneration and the development of liver diseases as well as other pathologies. Here, we review the effects of melatonin on the main ER stress mechanisms, focusing on its ability to regulate the autophagic and apoptotic processes. As the number of studies that have analyzed ER stress modulation by this indole remains limited, further research is necessary for a better understanding of the crosstalk between ER stress, autophagy, and apoptosis and to clearly delineate the mechanisms by which melatonin modulates these responses.

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Section: Melatonin In Cancermentioning

confidence: 99%

Melatonin and endoplasmic reticulum stress: relation to autophagy and apoptosis

Fernández

Ordóñez

Reíter

et al. 2015

Journal of Pineal Research

412

301

View full text Add to dashboard Cite

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“…MS and thoracic surgery are standard methods for confirming undiagnosed mediastinal lymph nodes . However, drawbacks to these techniques include their invasiveness, the need for clinical admission, the requirement of general anaesthesia and higher costs . Although EUS‐FNA is a minimally invasive method for assessing intrathoracic lymph node enlargement, it is ineffective for evaluating the right paratracheal and hilar lymph nodes …”

Section: Introductionmentioning

confidence: 99%

Endobronchial ultrasound‐guided transbronchial needle biopsy for the diagnosis of intrathoracic lymph node metastases from extrathoracic malignancies: A meta‐analysis and systematic review

Yang

Shi

et al. 2014

Respirology

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Intrathoracic lymph node metastases in patients with extrathoracic malignancies are a common clinical manifestation. Several studies evaluating intrathoracic lymph node metastases in patients with extrathoracic malignancy by using the endobronchial ultrasoundguided transbronchial needle aspiration (EBUS-TBNA) have been reported. The objective of this meta-analysis is to investigate the diagnostic value of EBUS-TBNA for diagnosing intrathoracic lymph node metastases in patients with extrathoracic malignancies. We systematically searched Cochrane Library, Medline and Embase for relevant studies published prior to May 2013. Studies specifically designed to evaluate the diagnostic accuracy of EBUS-TBNA for intrathoracic lymph node metastases in patients with an extrathoracic malignancy were selected. Diagnostic accuracy metaanalysis was conducted by pooling estimates of sensitivity, specificity, negative likelihood ratio (NLR), positive likelihood ratio (PLR) and diagnostic odds ratios (DOR) derived from a summary receiver operating characteristic (SROC) analysis of the original studies. Six studies were included, which provided a dataset of 533 patients. EBUS-TBNA pooled estimates had 0.85 sensitivity (95% confidence interval (

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A Systematic Review of Health Economic Evaluations of Diagnostic Biomarkers

Oosterhoff¹,

Maas²,

Steuten

2015

Appl Health Econ Health Policy

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BackgroundDiagnostic biomarkers have multiple applications along the care process and have a large potential in optimizing treatment decisions. However, many diagnostic biomarkers struggle to gain market access and obtain appropriate coverage because of a lack of evidence on their health economic impact.ObjectivesThe aim was to review the (methodological) characteristics of recent economic evaluations on diagnostic biomarkers and examine whether these studies dealt with specific issues such as different payer perspectives, preference heterogeneity, and multiple applications in subpopulations.MethodsThe PubMed database and the National Health Service Economic Evaluation Database were searched. Full economic evaluations published after 2009 assessing diagnostic biomarkers for the main non-communicable diseases in middle-income or high-income countries were considered eligible. Empirical and methodological study characteristics were summarized, as was the handling of specific issues related to the economic evaluation of personalized medicine.ResultsThirty-three economic evaluations were included, of which 25 were model-based analyses. The number of strategies compared ranged from two to 17 per study, and was especially large in studies assessing genetic testing in patients and their relatives. Cost-effectiveness results were most sensitive to test accuracy and costs of the biomarker (N = 7), the relative risk of an event (N = 4), and the proportion of people accepting genetic testing (N = 2). One study incorporated patient preferences, and none of the studies considered different payer perspectives, cost sharing arrangements or variable opportunity costs due to population density variability.ConclusionsPublished health economic evaluations of biomarkers used for diagnosing, staging diseases, and guiding treatment selection are characterized by a large number of comparators to model the potential clinical applications and to determine their value. Assessing outcomes beyond health as well as specific issues, such as different payer perspectives and patient preferences, is crucial to fully capture the potential health economic impact of diagnostic biomarkers and to inform value-based reimbursement.

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Clinical Utility and Economic Impact of Conventional Transbronchial Needle Aspiration of Mediastinal Lymphadenopathies in Bronchogenic Carcinoma

Cited by 6 publications

References 29 publications

Melatonin and endoplasmic reticulum stress: relation to autophagy and apoptosis

Melatonin and endoplasmic reticulum stress: relation to autophagy and apoptosis

Endobronchial ultrasound‐guided transbronchial needle biopsy for the diagnosis of intrathoracic lymph node metastases from extrathoracic malignancies: A meta‐analysis and systematic review

A Systematic Review of Health Economic Evaluations of Diagnostic Biomarkers

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