Development and validation of a gene expression test to identify hard‐to‐heal chronic venous leg ulcers. BJS 2019; 106: 1035-1042.
Published: 16th May 2019
Authors: D. C. Bosanquet, A. J. Sanders, F. Ruge, J. Lane, C. A. Morris, W. G. Jiang et al.
Chronic venous leg ulcers pose a significant burden to healthcare systems, and predicting wound healing is challenging. The aim of this study was to develop a genetic test to evaluate the propensity of a chronic ulcer to heal.
Sequential refinement and testing of a gene expression signature was conducted using three distinct cohorts of human wound tissue. The expression of candidate genes was screened using a cohort of acute and chronic wound tissue and normal skin with quantitative transcript analysis. Genes showing significant expression differences were combined and examined, using receiver operating characteristic (ROC) curve analysis, in a controlled prospective study of patients with venous leg ulcers. A refined gene signature was evaluated using a prospective, blinded study of consecutive patients with venous ulcers.
The initial gene signature, comprising 25 genes, could identify the outcome (healing versus non‐healing) of chronic venous leg ulcers (area under the curve (AUC) 0·84, 95 per cent c.i. 0·73 to 0·94). Subsequent refinement resulted in a final 14‐gene signature (WD14), which performed equally well (AUC 0·88, 0·80 to 0·97). When examined in a prospective blinded study, the WD14 signature could also identify wounds likely to demonstrate signs of healing (AUC 0·73, 0·62 to 0·84).
A gene signature can identify people with chronic venous leg ulcers that are unlikely to heal.Full text
You may also be interested in
Authors: A. Saratzis, N. E. M. Jaspers, B. Gwilym, O. Thomas, A. Tsui, R. Lefroy et al.
Predicting reamputation risk in patients undergoing lower extremity amputation due to the complications of peripheral artery disease and/or diabetes. BJS 2019; 106: 1026-1034.
Authors: J. M. Czerniecki, M. L. Thompson, A. J. Littman, E. J. Boyko, G. J. Landry, W. G. Henderson et al.
Health gains, costs and cost‐effectiveness of a population‐based screening programme for abdominal aortic aneurysms. BJS 2019; 106: 1043-1054.
Authors: N. Nair, G. Kvizhinadze, G. T. Jones, R. Rush, M. Khashram, J. Roake et al.
Randomized clinical trial
Randomized clinical trial of endovenous laser ablation versus direct and indirect radiofrequency ablation for the treatment of great saphenous varicose veins. BJS 2019; 106: 998-1004.
Authors: S. A. S. Hamann, L. Timmer‐de Mik, W. M. Fritschy, G. R. R. Kuiters, T. E. C. Nijsten, R. R. Bos et al.
Meta‐analysis of the outcomes of treatment of internal carotid artery near occlusion. BJS 2019; 106: 665-671.
Authors: A. J. A. Meershoek, E. E. Vries, D. Veen, H. M. Ruijter, G. J. Borst, A. Garcia‐Pastor et al.
Contemporary prevalence of carotid stenosis in patients presenting with ischaemic stroke. BJS 2019; 106: 872-878.
Authors: S. F. Cheng, M. M. Brown, R. J. Simister, T. Richards
Baseline findings of the population‐based, randomized, multifaceted Danish cardiovascular screening trial (DANCAVAS) of men aged 65–74 years. BJS 2019; 106: 862-871.
Authors: J. S. Lindholt, L. M. Rasmussen, R. Søgaard, J. Lambrechtsen, F. H. Steffensen, L. Frost et al.
Randomized clinical trial
Randomized clinical trial of mechanochemical and endovenous thermal ablation of great saphenous varicose veins. BJS 2019; 106: 548-554.
Authors: S. Vähäaho, O. Mahmoud, K. Halmesmäki, A. Albäck, K. Noronen, P. Vikatmaa et al.
Meta‐analysis of long‐term survival after elective endovascular or open repair of abdominal aortic aneurysm. BJS 2019; 106: 523-533.
Authors: R. M. A. Bulder, E. Bastiaannet, J. F. Hamming, J. H. N. Lindeman
Mortality prediction following non‐traumatic amputation of the lower extremity. BJS 2019; 106: 879-888.
Authors: D. C. Norvell, M. L. Thompson, E. J. Boyko, G. Landry, A. J. Littman, W. G. Henderson et al.
Meta‐analysis of clinical trials examining the benefit of structured home exercise in patients with peripheral artery disease. BJS 2019; 106: 319-331.
Authors: J. Golledge, T. P. Singh, C. Alahakoon, J. Pinchbeck, L. Yip, J. V. Moxon et al.
Cost‐effectiveness analysis of a randomized clinical trial of early versus deferred endovenous ablation of superficial venous reflux in patients with venous ulceration. BJS 2019; 106: 555-562.
Authors: D. M. Epstein, M. S. Gohel, F. Heatley, X. Liu, A. Bradbury, R. Bulbulia et al.