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The full texts of the remaining articles were screened for expression prevalence of the targets of interest.
In this comprehensive systematic literature review and meta-analysis, we reported on expression prevalence of the hypoxia-related proteins GLUT1, CAIX, CXCR4, and IGF1R in breast cancer and carcinoma in situ, benign breast disease and normal breast tissue.
For screening purposes, specificity of the target of interest should be high and for application in a diagnostic setting, expression prevalence of the target in breast cancer should be sufficient.
*p-values obtained using meta-regression (linear mixed model with subgroup indicators as fixed and the individual studies as random effects); ref: reference category for the meta-regression result; N: Maximum number of studies evaluated for pooled estimate or meta regression; prev.: expression prevalence of the investigated target.
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The marked lower expression prevalence of CAIX, GLUT1 and CXCR4 in benign breast disease and normal breast tissue is thus highly promising.
For studies investigating membranous staining patterns only, we found a pooled expression prevalence of 23% (CI 17-31%, 20 studies; Additional file 5: Figure S1A) and the studies providing best evidence for evaluation of molecular imaging targets showed a pooled prevalence of 38% (CI 17-65%, 6 studies; Additional file 6: Figure S1B).
Concerning C. canephora, we observed an expression prevalence of PR-10 genes in late stages of fruit development (SE3 e SE4; Additional File 8).
Expression prevalence of CAIX increased with histological grade (16% in grade II (p < 0.001) and 30% in grade III (p < 0.001) versus 4% in grade I; Additional file 7: Figure S1C), and tumor size (15% in T2 (p < 0.001) and 30% in T3 (p < 0.001) versus 12% in T1; Additional file 8: Figure S1D).
Pooled expression prevalence rates of carcinoma in situ were at least comparable to (GLUT1 and IGF1R) or higher than (CAIX and CXCR4) invasive carcinoma, albeit based on few studies.
Hence, the lower target binding affinity of MT201 may be compensated by a higher expression level and prevalence of the Ep-CAM over the HER-2 target.
We have shown that human expression prevalence and patterns of hypoxia-related markers support their potential as molecular imaging targets, with promising specificity.
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