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Sayal AP, Tyndel F, Hakim SW, Yan P, Micieli JA. Isolated Anterior Optic Nerve and Vitreous Metastases From Esophageal Cancer. J Neuroophthalmol 2024; 44:e47-e48. [PMID: 35921331 DOI: 10.1097/wno.0000000000001701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Aman P Sayal
- Faculty of Medicine (APS), University of Toronto, Toronto, Canada; Division of Neurology (FT), Department of Medicine, University of Toronto, Toronto, Canada; Department of Laboratory Medicine and Pathobiology (SWH), University of Toronto, Toronto, Canada; Department of Ophthalmology and Vision Sciences (PY, JAM), University of Toronto, Toronto, Canada; and Kensington Vision and Research Centre (PY, JAM), Toronto, Canada
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Sun J, Wu S, Mou Z, Wen J, Wei H, Zou J, Li Q, Liu Z, Xu SH, Kang M, Ling Q, Huang H, Chen X, Wang Y, Liao X, Tan G, Shao Y. Prediction model of ocular metastasis from primary liver cancer: Machine learning-based development and interpretation study. Cancer Med 2023; 12:20482-20496. [PMID: 37795569 PMCID: PMC10652349 DOI: 10.1002/cam4.6540] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 08/21/2023] [Accepted: 09/05/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Ocular metastasis (OM) is a rare metastatic site of primary liver cancer (PLC). The purpose of this study was to establish a clinical predictive model of OM in PLC patients based on machine learning (ML). METHODS We retrospectively collected the clinical data of 1540 PLC patients and divided it into a training set and an internal test set in a 7:3 proportion. PLC patients were divided into OM and non-ocular metastasis (NOM) groups, and univariate logistic regression analysis was performed between the two groups. The variables with univariate logistic analysis p < 0.05 were selected for the ML model. We constructed six ML models, which were internally verified by 10-fold cross-validation. The prediction performance of each ML model was evaluated by receiver operating characteristic curves (ROCs). We also constructed a web calculator based on the optimal performance ML model to personalize the risk probability for OM. RESULTS Six variables were selected for the ML model. The extreme gradient boost (XGB) ML model achieved the optimal differential diagnosis ability, with an area under the curve (AUC) = 0.993, accuracy = 0.992, sensitivity = 0.998, and specificity = 0.984. Based on these results, an online web calculator was constructed by using the XGB ML model to help clinicians diagnose and treat the risk probability of OM in PLC patients. Finally, the Shapley additive explanations (SHAP) library was used to obtain the six most important risk factors for OM in PLC patients: CA125, ALP, AFP, TG, CA199, and CEA. CONCLUSION We used the XGB model to establish a risk prediction model of OM in PLC patients. The predictive model can help identify PLC patients with a high risk of OM, provide early and personalized diagnosis and treatment, reduce the poor prognosis of OM patients, and improve the quality of life of PLC patients.
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Affiliation(s)
- Jin‐Qi Sun
- Fuxing Hospital, The Eighth Clinical Medical CollegeCapital Medical UniversityBeijingPeople's Republic of China
| | - Shi‐Nan Wu
- Department of OphthalmologyThe First Affiliated Hospital of Nanchang University, Jiangxi Branch of the National Clinical Research Center for Ocular DiseaseNanchangPeople's Republic of China
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Eye Institute of Xiamen UniversitySchool of Medicine, Xiamen UniversityXiamenPeople's Republic of China
| | - Zheng‐Lin Mou
- Department of OphthalmologyThe First Affiliated Hospital of Nanchang University, Jiangxi Branch of the National Clinical Research Center for Ocular DiseaseNanchangPeople's Republic of China
| | - Jia‐Yi Wen
- Department of OphthalmologyThe First Affiliated Hospital of Nanchang University, Jiangxi Branch of the National Clinical Research Center for Ocular DiseaseNanchangPeople's Republic of China
| | - Hong Wei
- Department of OphthalmologyThe First Affiliated Hospital of Nanchang University, Jiangxi Branch of the National Clinical Research Center for Ocular DiseaseNanchangPeople's Republic of China
| | - Jie Zou
- Department of OphthalmologyThe First Affiliated Hospital of Nanchang University, Jiangxi Branch of the National Clinical Research Center for Ocular DiseaseNanchangPeople's Republic of China
| | - Qing‐Jian Li
- Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Eye Institute of Xiamen UniversitySchool of Medicine, Xiamen UniversityXiamenPeople's Republic of China
| | - Zhao‐Lin Liu
- Department of OphthalmologyThe First Affiliated Hospital of University of South China, Hunan Branch of The National Clinical Research Center for Ocular DiseaseHengyangPeople's Republic of China
| | - San Hua Xu
- Department of OphthalmologyThe First Affiliated Hospital of Nanchang University, Jiangxi Branch of the National Clinical Research Center for Ocular DiseaseNanchangPeople's Republic of China
| | - Min Kang
- Department of OphthalmologyThe First Affiliated Hospital of Nanchang University, Jiangxi Branch of the National Clinical Research Center for Ocular DiseaseNanchangPeople's Republic of China
| | - Qian Ling
- Department of OphthalmologyThe First Affiliated Hospital of Nanchang University, Jiangxi Branch of the National Clinical Research Center for Ocular DiseaseNanchangPeople's Republic of China
| | - Hui Huang
- Department of OphthalmologyThe First Affiliated Hospital of Nanchang University, Jiangxi Branch of the National Clinical Research Center for Ocular DiseaseNanchangPeople's Republic of China
| | - Xu Chen
- Department of Ophthalmology and Visual SciencesMaastricht UniversityMaastrichtNetherlands
| | - Yi‐Xin Wang
- School of Optometry and Vision SciencesCardiff UniversityCardiffUK
| | - Xu‐Lin Liao
- Department of Ophthalmology and Visual SciencesThe Chinese University of Hong KongHong KongPeople's Republic of China
| | - Gang Tan
- Department of OphthalmologyThe First Affiliated Hospital of University of South China, Hunan Branch of The National Clinical Research Center for Ocular DiseaseHengyangPeople's Republic of China
| | - Yi Shao
- Department of OphthalmologyThe First Affiliated Hospital of Nanchang University, Jiangxi Branch of the National Clinical Research Center for Ocular DiseaseNanchangPeople's Republic of China
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Xiong X, Rong R, Tang LY, Sun T, Pan YC, Shu HY, Zhang LJ, Ge QM, Liang RB, Shao Y. The Predictive Value of CA-125 and Hb for Ocular Metastasis in Hepatocellular Carcinoma Patients. Cancer Manag Res 2022; 14:3405-3415. [PMID: 36504761 PMCID: PMC9733439 DOI: 10.2147/cmar.s363115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 08/01/2022] [Indexed: 12/12/2022] Open
Abstract
Objective To explore the risk factors of ocular metastasis (OM) in patients with hepatocellular carcinoma (HCC) by analyzing the demographic characteristics and serum markers. Methods From July 2002 to December 2012, 1064 HCC patients were included in our study. The chi-squared test and Student's t-test were used to assess the difference between OM and any other metastasis (NOM). Receiver operating curve (ROC) was used to analyze the diagnostic value of serum biomarkers in HCC patients with OM. Results The incidence of OM in HCC patients was 1.88% in our research. There are no significant differences in age, gender, or histopathology in the OM group and the group without any metastasis. Binary logistic regression analysis presented that compared with the patients without cancer metastasis, carbohydrate antigen 125 (CA-125) and hemoglobin (Hb) were risk factors in hepatocellular carcinoma patients with OM (P < 0.05). The ROC curve analysis showed that the areas under the CA-125, Hb, and CA125+Hb curves were 0.877, 0.554, and 0.431, and the cutoff values of CA-125 and Hb each were 115.78 u/mL and 120.50 g/L. Conclusion Our data suggest that CA-125 and Hb are risk indicators in hepatocellular carcinoma patients with OM, and that CA-125+Hb has potentially greater utility in diagnosing hepatocellular carcinoma.
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Affiliation(s)
- Xin Xiong
- Department of Pathology and Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Centre of Natural Ocular Disease Clinical Research Center, Nanchang, Jiangxi, 330006, People’s Republic of China
| | - Rong Rong
- Eye Center of Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People’s Republic of China
| | - Li-Ying Tang
- Department of Ophthalmology, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian Province, 361004, People’s Republic of China
| | - Tie Sun
- Department of Pathology and Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Centre of Natural Ocular Disease Clinical Research Center, Nanchang, Jiangxi, 330006, People’s Republic of China
| | - Yi-Cong Pan
- Department of Pathology and Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Centre of Natural Ocular Disease Clinical Research Center, Nanchang, Jiangxi, 330006, People’s Republic of China
| | - Hui-Ye Shu
- Department of Pathology and Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Centre of Natural Ocular Disease Clinical Research Center, Nanchang, Jiangxi, 330006, People’s Republic of China
| | - Li-Juan Zhang
- Department of Pathology and Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Centre of Natural Ocular Disease Clinical Research Center, Nanchang, Jiangxi, 330006, People’s Republic of China
| | - Qian-Min Ge
- Department of Pathology and Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Centre of Natural Ocular Disease Clinical Research Center, Nanchang, Jiangxi, 330006, People’s Republic of China
| | - Rong-Bin Liang
- Department of Pathology and Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Centre of Natural Ocular Disease Clinical Research Center, Nanchang, Jiangxi, 330006, People’s Republic of China
| | - Yi Shao
- Department of Pathology and Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Centre of Natural Ocular Disease Clinical Research Center, Nanchang, Jiangxi, 330006, People’s Republic of China,Correspondence: Yi Shao, Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, No. 17, Yong Wai Zheng Street, Dong Hu District, Nanchang, Jiangxi, 330006, People’s Republic of China, Tel/Fax +86 791-88692520, Email
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Yu K, Tang J, Wu JL, Li B, Wu SN, Zhang MY, Li QY, Zhang LJ, Pan YC, Ge QM, Shu HY, Shao Y. Risk factors for intraocular metastasis of primary liver cancer in diabetic patients: Alpha-fetoprotein and cancer antigen 125. World J Diabetes 2021; 12:158-169. [PMID: 33594335 PMCID: PMC7839172 DOI: 10.4239/wjd.v12.i2.158] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/26/2020] [Accepted: 12/10/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND In rare instances, primary liver cancer can be associated with intraocular metastasis (IOM).
AIM To investigate the correlation between a diverse range of clinical characteristics and IOM in diabetic patients with primary liver cancer, and to determine potential risk factors in predicting IOM.
METHODS We recruited a total of 722 diabetic patients with primary liver cancer. The differences between the IOM and non-intraocular metastasis (NIOM) groups in these patients were assessed using the chi-squared test and Student’s t-test. Binary logistic regression analysis was subsequently used to determine risk factors. Finally, the diagnostic value of IOM in this cohort with primary liver cancer was analyzed by receiver operating characteristic (ROC) curve analysis.
RESULTS In all, 13 patients had IOM. There were no remarkable intergroup differences with respect to age, sex, histopathological sub-types, or blood biochemical parameters. However, the IOM group had significantly higher alpha-fetoprotein (AFP) and cancer antigen 125 (CA125) values than the NIOM group. Binary logistic regression identified AFP and CA125 to be significant risk factors for IOM in diabetic patients with primary liver cancer. ROC curve analysis showed that the area under the curve values for AFP and CA125 were 0.727 and 0.796, with the cut-off values of 994.20 ng/mL and 120.23 U/mL, respectively. The sensitivity and specificity for AFP were 92.3% and 59.9%, while those for CA125 were 84.6% and 70.1%, respectively.
CONCLUSION Elevated AFP and CA125 represent significant risk factors for IOM in diabetic patients with primary liver cancer.
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Affiliation(s)
- Kang Yu
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Jing Tang
- Department of Oncology, The Affiliated Zhuzhou Hospital Xiangya Medical College, Central South University, Zhuzhou 412000, Hunan Province, China
| | - Jie-Li Wu
- Department of Ophthalmology, Xiang’an Hospital of Xiamen University, Xiamen 361102, Fujian Province, China
| | - Biao Li
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Shi-Nan Wu
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Meng-Yao Zhang
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Qiu-Yu Li
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Li-Juan Zhang
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Yi-Cong Pan
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Qian-Min Ge
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Hui-Ye Shu
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Yi Shao
- Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
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Binkley EM, Sampson AD, Syed NA, Boldt HC. Metastatic Squamous Cell Carcinoma of the Tonsil Mimicking Choroidal Melanoma. Ocul Oncol Pathol 2020; 6:405-409. [PMID: 33447590 DOI: 10.1159/000510288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 07/12/2020] [Indexed: 11/19/2022] Open
Abstract
We describe a case of a 53-year-old man with a history of metastatic squamous cell carcinoma of the tonsil who presented with a large, dome-shaped, choroidal mass in the left eye with concern for extra-ocular extension. Standardized echography showed a choroidal mass with low-to-medium internal reflectivity, pockets of very low reflectivity, positive angle kappa, and 1+ vascularity that were concerning for primary choroidal melanoma. Biopsy of the lesion was consistent with metastatic squamous cell carcinoma of the tonsil rather than melanoma. This is only the second reported case of metastatic squamous cell carcinoma to the choroid presenting with a large vascular tumor with echographic characteristics consistent with choroidal melanoma. The unique vascularity present in some cases of squamous cell carcinoma of the tonsil may explain the vascularity and large height of this patient's lesion. Tumor fine-needle aspiration biopsy can play an important role in patients with choroidal lesions in the setting of unusual primary tumors.
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Affiliation(s)
- Elaine M Binkley
- Department of Ophthalmology and Visual Science, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Aron D Sampson
- Department of Ophthalmology and Visual Science, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Nasreen A Syed
- Department of Ophthalmology and Visual Science, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.,Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - H Culver Boldt
- Department of Ophthalmology and Visual Science, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
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