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001-es BibID:	BIBFORM087410
Első szerző:	Gatselis, Nikolaos K.
Cím:	Golgi protein-73 : a biomarker for assessing cirrhosis and prognosis of liver disease patients / Nikolaos K. Gatselis, Tamás Tornai, Zakera Shums, Kalliopi Zachou, Asterios Saitis, Stella Gabeta, Roger Albesa, Gary L. Norman, Mária Papp, George N. Dalekos
Dátum:	2020
ISSN:	1007-9327
Megjegyzések:	Abstract BACKGROUND Reliable biomarkers of cirrhosis, hepatocellular carcinoma (HCC), or progression of chronic liver diseases are missing. In this context, Golgi protein-73 (GP73) also called Golgi phosphoprotein-2, was originally defined as a resident Golgi type II transmembrane protein expressed in epithelial cells. As a result, GP73 expression was found primarily in biliary epithelial cells, with only slight detection in hepatocytes. However, in patients with acute or chronic liver diseases and especially in HCC, the expression of GP73 is significantly up-regulated in hepatocytes. So far, few studies have assessed GP73 as a diagnostic or prognostic marker of liver fibrosis and disease progression. AIM To assess serum GP73 efficacy as a diagnostic marker of cirrhosis and/or HCC or as predictor of liver disease progression. METHODS GP73 serum levels were retrospectively determined by a novel GP73 ELISA (QUANTA Lite? GP73, Inova Diagnostics, Inc., Research Use Only) in a large cohort of 632 consecutive patients with chronic viral and non-viral liver diseases collected from two tertiary Academic centers in Larissa, Greece (n=366) and Debrecen, Hungary (n=266). Aspartate aminotransferase (AST)/Platelets (PLT) ratio index (APRI) was also calculated at the relevant time points in all patients. Two hundred and three patients had chronic hepatitis B, 183 chronic hepatitis C, 198 alcoholic liver disease, 28 autoimmune cholestatic liver diseases, 15 autoimmune hepatitis, and 5 with other liver-related disorders. The duration of follow-up was 50 (57) mo [median (interquartile range)]. The development of cirrhosis, liver decompensation and/or HCC during follow-up were assessed according to internationally accepted guidelines. In particular, the surveillance for the development of HCC was performed regularly with ultrasound imaging and alpha-fetoprotein (AFP) determination every 6 mo in cirrhotic and every 12 mo in non-cirrhotic patients. RESULTS Increased serum levels of GP73 (> 20 units) were detected at initial evaluation in 277 out of 632 patients (43.8%). GP73-seropositivity correlated at baseline with the presence of cirrhosis (96.4% vs 51.5%, P < 0.001), decompensation of cirrhosis (60.3% vs 35.5%, P < 0.001), presence of HCC (18.4% vs 7.9%, P < 0.001) and advanced HCC stage (52.9% vs 14.8%, P = 0.002). GP73 had higher diagnostic accuracy for the presence of cirrhosis compared to APRI score [Area under the curve (AUC) (95%CI): 0.909 (0.885-0.934) vs 0.849 (0.813-0.886), P = 0.003]. Combination of GP73 with APRI improved further the accuracy (AUC: 0.925) compared to GP73 (AUC: 0.909, P = 0.005) or APRI alone (AUC: 0.849, P < 0.001). GP73 levels were significantly higher in HCC patients compared to non-HCC [22.5 (29.2) vs 16 (20.3) units, P < 0.001) and positively associated with BCLC stage [stage 0: 13.9 (10.8); stage A: 17.1 (16.8); stage B: 19.6 (22.3); stage C: 32.2 (30.8); stage D: 45.3 (86.6) units, P < 0.001] and tumor dimensions [very early: 13.9 (10.8); intermediate: 19.6 (18.4); advanced: 29.1 (33.6) units, P = 0.004]. However, the discriminative ability for HCC diagnosis was relatively low [AUC (95%CI): 0.623 (0.570-0.675)]. Kaplan-Meier analysis showed that the detection of GP73 in patients with compensated cirrhosis at baseline, was prognostic of higher rates of decompensation (P = 0.036), HCC development (P = 0.08), and liver-related deaths (P < 0.001) during follow-up. CONCLUSION GP73 alone appears efficient for detecting cirrhosis and superior to APRI determination. In combination with APRI, its diagnostic performance can be further improved. Most importantly, the simple GP73 measurement proved promising for predicting a worse outcome of patients with both viral and non-viral chronic liver diseases.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk
Megjelenés:	World Journal of Gastroenterology. - 26 : 34 (2020), p. 5130-5145. -
További szerzők:	Tornai Tamás István (1984-) (belgyógyász) Shums, Zakera Zachou, Kalliopi Saitis, Asterios Gabeta, Stella Albesa, Roger Norman, Gary L. Papp Mária (1975-) (belgyógyász, gasztroenterológus) Dalekos, George N.
Internet cím:	Intézményi repozitóriumban (DEA) tárolt változat
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001-es BibID:	BIBFORM065752
Első szerző:	Papp Mária (belgyógyász, gasztroenterológus)
Cím:	Presepsin teardown : pitfalls of biomarkers in the diagnosis and prognosis of bacterial infection in cirrhosis / Maria Papp, Tamas Tornai, Zsuzsanna Vitalis, Istvan Tornai, David Tornai, Tamas Dinya, Andrea Sumegi, Peter Antal-Szalmas
Dátum:	2016
Megjegyzések:	AIM: Bacterial infections are frequent complications in cirrhosis with significant mortality. Early laboratory diagnosis is essential but challenging. We aimed to evaluate the diagnostic and prognostic value of presepsin in cirrhosis associated bacterial infections. METHODS: 216 patients with cirrhosis were enrolled. At admission, presence of bacterial infections and level of plasma presepsin, serum CRP and PCT were evaluated. Patients were followed for three months to assess the possible association between presepsin level and short-term mortality. RESULTS: 34.7% of patients had bacterial infection. Presepsin levels were significantly higher in patients with infection than without (median, 1002 vs. 477 pg/mL, p<0.001), increasing with the severity of infection (organ failure[OF]Yes vs. No: 2358 vs. 710 pg/mL, p<0.001). Diagnostic accuracy of presepsin for severe infections was similar to PCT and superior to CRP (AUC-ROC: 0.85, 0.85 and 0.66, respectively, p=NS for presepsin vs. PCT and p<0.01 for presepsin vs. CRP). At the optimal cut-off value of presepsin>1206 pg/mL sensitivity, specificity, PPV and NPV were as follows: 87.5%, 74.5%, 61.8% and 92.7%. The accuracy of presepsin, however, decreased in advanced stage of the disease or in the presence of renal failure, most probably because of the significantly elevated presepsin levels in non-infected patients. 28-day mortality rate was higher among patients with >1277 pg/mL compared to those with ?1277 pg/mL (46.9% vs. 11.6%, p<0.001). In a binary logistic regression analysis, however, only PCT [OR: 1.81, (95%CI: 1.09?3.01), p=0.022] but neither presepsin and nor CRP were independent risk factor for 28-day mortality after adjusting with MELD score and leukocyte count.CONCLUSION: Presepsin is a valuable new biomarker for defining severe infections in cirrhosis proving same efficacy as PCT. However, it is not a useful marker of short-term mortality.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban presepsin cirrhosis bacterial infection organ failure mortality
Megjelenés:	World Journal of Gastroenterology 22 : 41 (2016), p. 1-14. -
További szerzők:	Tornai Tamás István (1984-) (belgyógyász) Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus) Tornai István (1954-) (belgyógyász, gasztroenterológus) Tornai Dávid (1989-) (hepatológia, biomarker kutatás) Dinya Tamás (1974-) (sebész szakorvos, onkológus szakorvos) Sümegi Andrea (1969-) (biológus) Antal-Szalmás Péter (1968-) (laboratóriumi szakorvos)
Internet cím:	Intézményi repozitóriumban (DEA) tárolt változat
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001-es BibID:	BIBFORM069781
Első szerző:	Tornai Tamás István (belgyógyász)
Cím:	Gut barrier failure biomarkers are associated with poor disease outcome in patients with primary sclerosing cholangitis / Tamas Tornai, Eszter Palyu, Zsuzsanna Vitalis, Istvan Tornai, David Tornai, Peter Antal-Szalmas, Gary L. Norman, Zakera Shums, Gabor Veres, Antal Dezsofi, Gabriella Par, Alajos Par, Peter Orosz, Ferenc Szalay, Peter L. Lakatos, Maria Papp
Dátum:	2017
ISSN:	1007-9327
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:	World Journal of Gastroenterology. - 23 : 29 (2017), p. 5412-5421. -
További szerzők:	Pályu Eszter (1983-) Vitális Zsuzsanna (1963-) (belgyógyász, gasztroenterológus) Tornai István (1954-) (belgyógyász, gasztroenterológus) Tornai Dávid (1989-) (hepatológia, biomarker kutatás) Antal-Szalmás Péter (1968-) (laboratóriumi szakorvos) Norman, Gary L. Shums, Zakera Veres Gábor (orvos) Dezsőfi Antal Pár Gabriella Pár Alajos Orosz Péter (Miskolc) Szalay Ferenc (belgyógyász) Lakatos Péter (Semmelweis Egyetem) Papp Mária (1975-) (belgyógyász, gasztroenterológus)
Pályázati támogatás:	OTKA-115818 OTKA MTA-Bolyai János Kutatási Ösztöndíj Egyéb ÚNKP-16-3 Egyéb
Internet cím:	Intézményi repozitóriumban (DEA) tárolt változat DOI
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