Downregulation of miR-9 correlates with poor prognosis in colorectal cancer

IntroductionmicroRNAs (miRNAs) are frequently dysregulated in many human cancers including colorectal cancer (CRC) and are useful candidate biomarkers in liquid biopsy of cancer for their stability in the blood.MethodsWe compared the expression of microRNA-9 (miR-9) in tissues (n = 357) and sera (n = 109) of CRC patients to determine whether miR-9 in serum reflects that in the cancer tissue in parallel. Also, we examined the miR-9 role in CRC by in vitro functional studies in four CRC cell lines.ResultsOn multivariate analysis of colorectal cancer tissues and sera, miR-9 low expressions were significantly associated pN stage (tissues; p < 0.01, serum; p = 0.013), and clinical stage (tissues; p < 0.01, serum; p = 0.031). Moreover, patients with low miR-9 expression had shorter survival than those with high miR-9 expression (log-rank test, tissue; p = 0.021, serum; p = 0.011). miR-9 level in serum reflects that in the tumor. The CRC cells with low miR-9 expression was significantly increased cell proliferation, migration, invasion and colony formation than cells with high miR-9 expression.ConclusionSerum miR-9 is an useful early detection marker in liquid biopsy of CRC and overexpression of miR-9 in CRC may be a novel prognostic marker as well.     

血清AFP、CEA、CA199、SF联检对原发性肝癌的诊断价值

目的:应用化学发光标记免疫法联合检测四项肿瘤标志物对肝脏疾病的癌变诊断价值。方法:以化学发光标记免疫法对肝癌组56例、肝硬化组40例、肝炎组47例及正常对照组30例的血清甲胎蛋白(AFP)、癌胚抗原(CEA)、CA199和铁蛋白(SF)进行联检。结果:肝癌组AFP、CEA、SF,肝硬化组AFP、SF相应指标与正常对照组相应指标比较,均具有非常显著性差异或显著性差异(P<0. 01或P<0. 05),但肝炎组无显著性差异(P>0 05)。同时血清CEA、CA199、SF联检对原发性肝癌与转移性肝癌有显著性差异。结论:应用多项指标联检对肝脏疾病的癌变(尤其是原发性肝癌)的检出率可达95%以上,同时对原发性肝癌与转移性肝癌有很好的鉴别作用。     

The role of P2X7 receptor in prognosis and metastasis of colorectal cancer

PurposeColorectal cancer (CRC) is one of the leading causes of cancer mortality in the world. P2X7 receptor (P2X7R), encoded by the P2rx7 gene, is a trimeric ion channel activated by extracellular Adenosine triphosphate and is widely expressed in various types of tissues and tumors to regulate inflammation, cell proliferation, or death. The discovery of new biomarkers and understanding the role of P2X7R in CRC are therefore critical to improving the prognosis and treatment of CRC.Materials and methodsP2X7R expression was analyzed in CRC tumor samples and normal colorectal tissues from 97 patients and various colon cancer cell lines. The correlation of tumor antigens, survival periods, and P2X7R expression were documented.ResultsP2X7R^High and P2X7R^Low populations were observed in CRC patients. P2X7R^High patients had relatively shorter survival periods, higher levels of serum carcinoembryonic antigen, and greater numbers of advanced tumors. In addition, P2X7R expression had a significant up-regulation in metastatic CRC and metastatic CRC cell lines, which indicates that P2X7R expression is positively associated with metastasis.ConclusionsP2X7R expression might be a potential biomarker for prognosis and metastasis of CRC.     

Reduced levels of hydroxylated, polyunsaturated ultra long-chain fatty acids in the serum of colorectal cancer patients: implications for early screening and detection

Background

There are currently no accurate serum markers for detecting early risk of colorectal cancer (CRC). We therefore developed a non-targeted metabolomics technology to analyse the serum of pre-treatment CRC patients in order to discover putative metabolic markers associated with CRC. Using tandem-mass spectrometry (MS/MS) high throughput MS technology we evaluated the utility of selected markers and this technology for discriminating between CRC and healthy subjects.

Methods

Biomarker discovery was performed using Fourier transform ion cyclotron resonance mass spectrometry (FTICR-MS). Comprehensive metabolic profiles of CRC patients and controls from three independent populations from different continents (USA and Japan; total n = 222) were obtained and the best inter-study biomarkers determined. The structural characterization of these and related markers was performed using liquid chromatography (LC) MS/MS and nuclear magnetic resonance technologies. Clinical utility evaluations were performed using a targeted high-throughput triple-quadrupole multiple reaction monitoring (TQ-MRM) method for three biomarkers in two further independent populations from the USA and Japan (total n = 220).

Results

Comprehensive metabolomic analyses revealed significantly reduced levels of 28-36 carbon-containing hydroxylated polyunsaturated ultra long-chain fatty-acids in all three independent cohorts of CRC patient samples relative to controls. Structure elucidation studies on the C28 molecules revealed two families harbouring specifically two or three hydroxyl substitutions and varying degrees of unsaturation. The TQ-MRM method successfully validated the FTICR-MS results in two further independent studies. In total, biomarkers in five independent populations across two continental regions were evaluated (three populations by FTICR-MS and two by TQ-MRM). The resultant receiver-operator characteristic curve AUCs ranged from 0.85 to 0.98 (average = 0.91 ± 0.04).

Conclusions

A novel comprehensive metabolomics technology was used to identify a systemic metabolic dysregulation comprising previously unknown hydroxylated polyunsaturated ultra-long chain fatty acid metabolites in CRC patients. These metabolites are easily measurable in serum and a decrease in their concentration appears to be highly sensitive and specific for the presence of CRC, regardless of ethnic or geographic background. The measurement of these metabolites may represent an additional tool for the early detection and screening of CRC.     

五项肿瘤标志物联合检测对食管癌诊治的临床评价

探讨肿瘤标志物癌胚抗原(CEA)、糖类抗原19-9(CA19-9)、CA724、细胞角蛋白19片断(CYFRA21-1)和鳞状上皮细胞癌抗原(SCC)联合检测对食管癌诊断、治疗及预后判断的临床价值.用电化学发光免疫分析法(ECLIA)和微粒子酶联免疫测定法(MEIA)检测102例食管癌患者术前和90例术后血清中CEA、CA19-9、CA724、CYFRA21-1和SCC含量.102例食管癌患者血清中5项肿瘤标志物含量均明显高于对照组,随病程增加,阳性率增高.检测90例食管癌患者,术前阳性指标与术后比较,有显著性差异(P＜0.01).五项肿瘤标志物联合检测阳性率为77.5%,高于单项指标检测阳性率,有显著性差异(P＜0.01).血清CEA、CA19-9、CA724、CYFRA21-1和SCC水平动态联合监测可用于食管癌辅助诊断、疗效观察、以及对病期及预后的判断.     

Diagnostic value of carcinoembryonic antigen and carcinoma antigen 19-9 for colorectal carcinoma

Objective: The purpose of this study was to evaluate the diagnostic efficiency of colorectal carcinoma (CRC) with the tumor markers Carcinoembryonic Antigen (CEA) and Carbohydrate Antigen 19-9 (CA 19-9), in addition to investigating whether CA 19-9 can be used to screen the disease process in patients with CRC who had no elevation of CEA levels. Methods: Serum levels of CEA and CA 19-9 were measured in: 138 patients with CRC; 111 patients with benign colorectal diseases. The diagnostic value was performed using the logistic regression equation and receiver operating characteristic curves (ROC). Results: The serum levels of CEA and CA 19-9 in the patients with CRC were significantly higher than those in the patients with benign colorectal diseases (P < 0.001). Receiver operating characteristic curves (ROC) in the patients with CRC versus those with benign colorectal disease yielded the optimal cut-off value of 3.36 ng/ml for CEA and 23.9 U/ml for CA 19-9, respectively. The area under ROC curve (AUC) was 0.789 for CEA, 0.690 for CA 19-9 and 0.900 for the combination of the two tumor markers. The combination resulted in a higher Youden index and a sensitivity of 85.3%. Conclusion: The combined detection of serum CEA and CA 19-9 could play a pivotal role in the diagnosis of CRC, and could drastically improve the sensitivity for the diagnosis of CRC. CA 19-9 might be a tumor biomarker in addition to CEA for CRC.     

多项血清肿瘤标志物联合检测在肺癌诊断中的价值

评价多项肿瘤标志物(TM)在肺癌诊断的应用价值,以期设计出简单而有效的TM组合方式,提高肺癌的诊断率.经回顾分析CEA、CYFRA21-1、NSE、SCC、TPS和CA125对253例肺癌(含肺鳞癌、腺癌和小细胞肺癌)患者的诊断灵敏度以及对123例肺部良性疾病和100名正常人群(对照组)中的特异性,根据其表达特性设计多种组合分析方式并评价其应用价值.结果表明,鳞癌、腺癌的NSE、小细胞肺癌的SCC检测结果与肺部良性疾病组无显著性差异(P＞0.05);肺癌组其余各组织类型肺癌TM均明显高于肺部良性疾病组和对照组(P＜0.05).而肺部良性疾病组和对照组之间无显著性差异(P＞0.05).单项TM检测仅对特定类型的肺癌有较高的灵敏度,而对肺癌的总体灵敏度普遍较低.多项TM联合分析虽可提高灵敏度,但对肺部良性疾病的特异性有所下降,其中NSE CYFRA21-1、NSE CYFRA21-1 SCC和CEA NSE CYFRA21-1三种组合,对各种组织类型肺癌都有较高的灵敏度,对良性疾病的特异性也可保持在88%以上,具有较高的实用价值.     

Overexpression of Arginase-1 is an indicator of poor prognosis in patients with colorectal cancer

AimArginase-1 (Arg-1) metabolizes l-arginine to l-ornithine and urea. It has been documented to have a role in various malignancies. However, the relationship between Arg-1 expression and clinicopathological characteristics of colorectal cancer (CRC) patients remains to be elucidated. The present study aimed to analyze the expression and prognostic value of Arg-1 in patients with CRC.Material and methodsThe mRNA and protein expressions of Arg-1 in fresh colorectal cancer tissue specimens and the corresponding noncancerous tissue specimens were examined by RT-qPCR (n = 24) and western blot analysis (n = 17). Arg-1 expression levels were determined in paraffin-embedded CRC tissue specimens (n = 236) by immunohistochemistry. The associations of Arg-1 expression and clinicopathological features and clinical prognosis in 236 CRC patients were analyzed.ResultsThe expression levels of Arg-1 were significantly higher in the CRC tissues compared with the matched noncancerous tissues, and elevated Arg-1 expression was remarkably associated with stage III-IV tumors (P = 0.007), lymph node metastasis (P = 0.019) and a plasma albumin concentration <35 g/l (P = 0.022). Kaplan-Meier analysis indicated that Arg-1 overexpression was associated with adverse prognoses for overall survival (OS) (P < 0.001) and disease-free survival (DFS) (P < 0.001) in all cases. Further analysis revealed that the patients with high Arg-1 expression had significantly shorter OS and DFS at the advanced stages (III + IV) (P = 0.032 for OS, and P = 0.012 for DFS) but not at the early stages (I + II) (P = 0.194 for OS, and P = 0.065 for DFS). Multivariate analysis revealed that Arg-1 overexpression was an independent prognostic factor for OS (P = 0.002) and DFS (P < 0.001) in patients with CRC.ConclusionThe data indicated that Arg-1 overexpression in CRC may be a marker that can discriminate subgroups of patients with a poor prognosis.     

血清NSE、CEA、CYFRA21-1联检对肺癌的诊断价值

目的:探讨联检血清肿瘤标志物神经元特异性烯醇化酶(NSE)、癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)对肺癌的诊断价值.方法:采用电化学发光法检测102例肺癌患者和50例良性肺病患者血清NSE、CEA、CYFRA21-1的含量.结果:肺癌患者血清NSE、CEA、CYFRA21-1水平均明显高于良性肺病患者,差异有统计学意义(P＜0.01).三种血清标志物的分布有明显的病理倾向性.NSE在小细胞癌中表达水平较高,其敏感性为59.4%; CEA在腺癌中表达水平较高,其敏感性为61.5%;而CYFRA21-1则在鳞癌中表达水平较高,其敏感性为64.5%.联检可提高检测肺癌的敏感性.结论:三种血清肿瘤标志物对于肺癌的辅助诊断有一定的临床意义,联检NSE、CEA和CYFRA21-1可以提高肺癌的诊断敏感性,为肺癌的早期诊断、病理分型提供可靠的依据.     

miR-424-5p promotes the proliferation and metastasis of colorectal cancer by directly targeting SCN4B

BackgroundColorectal cancer (CRC) is one of the most common malignancies worldwide usually diagnosed at advanced stages which causes poor prognosis of patients. Therefore, novel diagnostic biomarkers and therapeutic targets are urgently needed.Materials and methodsmiR-424-5p was identified through integrated analysis of three public databases. Loss-of-function experiments in HT29 and SW480 cells and mouse xenograft models were performed to explore the regulatory role of miR-424-5p in CRC. Bioinformatics analysis was used for predicting targets of miR-424-5p and its functional and pathway enrichment analysis.ResultsmiR-424-5p expression was significantly upregulated in CRC tissues and cell lines and associated with prognosis of CRC patients. Experiments in vitro and in vivo showed miR-424-5p promotes CRC cell proliferation and metastasis by directly inhibiting SCN4B. Besides, CRC cells secret miR-424-5p into peripheral blood through exosomes and circulating exosomal miR-424-5p could discriminate CRC patients with early stage from healthy people with AUC value of 0.82.ConclusionsmiR-424-5p serves as an oncogene in CRC and circulating exosomal miR-424-5p is a novel potential diagnostic biomarker of CRC patients.     

Combined detection of preoperative serum CEA,CA19-9 and CA242 improve prognostic prediction of surgically treated colorectal cancer patients

We assessed the prognostic significance of preoperative serum carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9) and carbohydrate antigen 242 (CA242) levels in surgically treated colorectal cancer patients. The relationship of preoperative serum CEA, CA19-9 and CA242 levels with disease characteristics was investigated in 310 patients. Correlation between tumor markers was investigated using Pearson correlation test. Univariate and multivariate survival analyses were used to study the relationship between preoperative tumor markers and prognosis [disease free survival (DFS) and overall survival (OS)]. Kaplan-Meier analysis with log rank test was used to assess the impact of tumor marker levels on survival. Positive rate of preoperative serum CEA, CA19-9 and CA242 were 54.84%, 47.42% and 37.10%, respectively. High preoperative CEA level was associated with tumor size (P = 0.038), T stage (P < 0.001) and AJCC stage (P = 0.002). High preoperative CA19-9 level was associated with tumor AJCC stage (P = 0.023). Preoperative CA242 positively correlated with CEA (P < 0.001) and CA19-9 (P < 0.001). Combining the three markers was of independent prognostic value in CRC (HR = 2.532, 95% CI: 1.400-4.579, P = 0.002 for OS; and HR = 2.366, 95% CI: 1.334-4.196, P = 0.003 for DFS). Combined detection of preoperative serum CEA, CA19-9 and CA242 is of independent prognostic value for management of CRC patients treated surgically.     

81例CT引导下经皮肺穿刺活检标本临床病理结果

目的:分析CT引导下经皮肺穿刺活检标本的临床病理学及免疫组织化学诊断,结合血清肿瘤标志物检测探讨其对肺部占位性病变的诊断价值.方法:回顾性分析81例肺部占位性病变患者CT引导下肺穿刺活检标本病理学、25例免疫组织化学诊断及73例血清肿瘤标志物癌胚抗原(carcinoembryonic antigen,CEA),细胞角蛋白19片段(cytokeratin-19-fragment,CYFRA21-1),神经元特异性烯醇化酶(neuron-specific enolase,NSE)检测结果.结果:81例CT引导下肺穿刺活检标本组织病理学诊断率为96.3％,其中恶性病变53例(腺癌29例,鳞癌20例,小细胞癌1例,未明确类型的非小细胞肺癌1例,其他类型肺癌1例,胸腺恶性肿瘤1例);良性病变25例(炎性包块7例,结核5例,肺炎7例,硅沉着病3例,炎性假瘤2例,神经鞘瘤1例);25例行免疫组织化学检查的病例中诊断恶性肿瘤24例(腺癌13例,鳞癌8例,小细胞癌1例,未确定分型2例),其中P63及CK5/6在鳞癌阳性率为87.5％,TTF-1及CK-7在腺癌阳性率为69.2％和76.9％,差异有统计学意义(P＜0.05);CEA,CYF RA21-1,NSE及3项联合对肺癌诊断的灵敏度分别为54.9％,68.6％,37.3％,80.4％.结论:CT引导下经皮肺穿刺活检标本病理诊断阳性率高,结合免疫组织化学及血清肿瘤标志物联合检测可为肺癌的诊断及病理分型提供辅助性参考依据.     

基于WCX纳米磁珠的血清蛋白指纹图谱模型在大肠癌诊断中的应用

目的: 探讨蛋白指纹图谱技术筛选大肠癌(CRC)患者血清中可用于诊断的特异性标志物。方法: 采用弱阳离子纳米磁性微球捕获血清中的蛋白,ProteinChip PBS II-C型蛋白质芯片阅读仪检测绘制成蛋白指纹图谱。所有蛋白指纹图谱采用Biomarker Wizard 3.1分析之后,用Biomarker Patterns 软件识别最终用于诊断的蛋白标志物,并优化组合建立诊断模型。结果: 在大肠癌患者和对照组之间找到68个差异蛋白峰(P<0.01),其中质荷比(m/z)为2 870.7、3 084.0、9 180.5和13 748.8的蛋白峰可用于建立大肠癌的诊断模型。该诊断模型能很好地把大肠癌患者从正常人群中区分出来,其敏感性为92.85%(91/98),特异性为91.25%(73/80)。经双盲实验验证,该模型对大肠癌诊断的敏感性为86.95%(40/46),特异性为85.00%(34/40)。结论: 采用纳米磁性微球与蛋白质芯片阅读仪联用的蛋白指纹图谱技术可以检测大肠癌患者血清中的特异性蛋白标志物,并建立敏感性和特异性均较高的大肠癌诊断模型。     

能谱CT最佳单能图像与肿瘤标志物联合检测在周围型肺癌患者临床诊断中的应用

目的:探析能谱CT最佳单能图像联合血清CEA、NSE、CYFRA21-1、SCCA检测在周围型肺癌（PLC）诊断中的应用价值。方法:选取中国医科大学附属第一医院2019年1月~2020年1月收治的240例疑似PLC患者为研究对象。患者入院后均行CT检查及血清肿瘤标志物检测,测定CEA、NSE、CYFRA21-1、SCCA水平。以病理结果为PLC判定的金标准,评价CT联合血清CEA、NSE、CYFRA21-1、SCCA检测在PLC诊断中的应用价值。结果:疑似PLC患者中恶性病变130例,良性病变110例。恶性病变组的CEA、NSE、CYFRA21-1、SCCA水平显著高于良性病变组（P<0.001）;腺癌患者的CEA、CYFRA21-1、SCCA水平与鳞癌患者相比存在统计学差异（P<0.001）;CT联合肿瘤标志物检测的敏感度和特异性显著优于血清肿瘤标志物检测或CT检查（P<0.001）。结论:能谱CT最佳单能图像联合血清CEA、NSE、CYFRA21-1、SCCA检测诊断PLC的价值较高,其准确度高于单一检测。     

联检CA15-3、CEA、TSGF及放射性核素骨显像对乳腺癌骨转移诊断的临床意义

目的:探讨联检血清肿瘤标志物和放射性核素骨显像对诊断乳腺癌骨转移的临床价值.方法:应用化学发光免疫检测技术检测了 124 例乳腺癌患者血清CA15-3、CEA、TSGF三种肿瘤标志物,应用SPECT对所有患者全身进行骨扫描检查,以明确有无转移.结果:124 例患者中38 例临床诊断为乳腺癌骨转移,乳腺癌骨转移组患者血清CA15-3、CEA、TSGF显著高于未转移组和正常对照组(P＜0.01),其阳性预测值分别为76.78%、80%和82.14%,阴性预测值分别为82.41%、86.74%和84.29%.结论:CA15-3、CEA、TSGF具有诊断乳腺癌骨转移的临床价值,而联检肿瘤标志物结合全身骨扫描可以提高乳腺癌骨转移诊断的准确性.     

Novel potential biomarkers for pancreatic cancer – A systematic review

BackgroundIt is estimated that in developed countries the incidence rate of pancreatic cancer (PC) will continue to rise and by 2020 will be the second most fatal cancer. The mortality of PC patients closely parallels the incidence rate, as this malignancy remains asymptomatic until it reaches an advanced stage of disease. Thus, novel biochemical markers that improve the management of PC patients are necessary. The aim of the work that follows is to investigate whether selected inflammatory mediators might be used in the diagnosis of PC, with the aim of improving the prognosis for PC patients.MethodsWe performed a thorough search for literature pertaining to our investigation via the MEDLINE/PubMed database.ResultsIt has been proved that certain in?ammatory mediators might be involved in tumor progression, such as growth, proliferation, migration and angiogenesis of tumor cells. In the present review, we summarized and referred to a number of original papers concerning the clinical significance of selected cytokines and specific inflammatory proteins such as C-reactive protein, as well as of various matrix metalloproteinases and their tissue inhibitors, as potential biomarkers for PC in comparison to well-established tumor markers for this malignancy.ConclusionPresented proteins might be potential biomarkers in the diagnosis and progression of PC.     

非小细胞肺癌患者血清中纤维母细胞生长因子受体表达意义及其与血清肿瘤标志物的相关性研究

目的 研究非小细胞肺癌患者血清中纤维母细胞生长因子受体(fibroblast growth factor receptor-1,FGFR1)表达意义及其与血清肿瘤标志物的相关性。方法 研究对象选取我院收治的非小细胞肺癌患者65例,并选取同期14例肺良性病变患者、25例原发性肝癌患者及35名健康体检者作为对照组,应用实时荧光定量聚合酶链反应法检测各组受试者血清FGFR1 DNA表达水平,采用电化学发光法检测肺癌患者血清癌胚抗原(carcinoembryonic antigen,CEA)、细胞角蛋白(cytokeratin-19-fragment,Cyfra21-1)以及神经特异性烯醇化酶(neuron specific enolase,NSE)水平。比较各组血清FGFR1 DNA表达水平的差异并进行ROC曲线分析血清FGFR1水平诊断肺癌的准确性。采用Pearson相关性分析法分析肺癌患者血清FGFR1表达水平与CEA、Cyfra21-1及NSE的相关性。结果 单因素方差分析显示:各组血清FGFR1 DNA表达水平差异具有统计学意义(F=249.38,P<0.001);且肺癌患者血清FGFR1 DNA表达水平明显高于良性病变组(t=11.41,P<0.01)、肝癌组(t=9.09,P<0.01)及健康组(t=36.96,P<0.01);不同临床特征肺癌患者血清FGFR1 DNA表达水平具有明显差异,其中鳞癌患者血清FGFR1表达水平明显高于腺癌和其他肺癌(F=45.22,P<0.001),晚期(Ⅲ~Ⅳ)肺癌患者明显高于早期(Ⅰ~Ⅱ)肺癌患者(F=171.11,P<0.001),淋巴结转移阳性患者明显高于阴性患者(F=125.34,P<0.001)。ROC曲线分析显示:AUC=0.904>0.5具有诊断价值,最佳诊断临界值为1.79×10^5copies/μL,灵敏度为94.65%,特异性为82.76%。Pearson相关性分析显示:鳞癌患者血清FGFR1表达与CEA、Cyfra21-1及NSE均呈明显正相关(P<0.05),其中与Cyfra21-1的相关性最大(r=0.528);腺癌患者血清FGFR1表达与CEA呈弱相关关系(r=0.145,P=0.03),与Cyfra21-1、NSE均无明显相关性;其他类型肺癌患者血清FGFR1表达与CEA、Cyfra21-1及NSE均无明显相关性(P>0.05)。结论 肺癌患者血清FGFR1表达具有显著的临床意义,在肺癌的诊断中具有较高的诊断效能,另外FGFR1的表达与血清肿瘤标志物具有明显相关性,进一步表明其在肺癌的诊断、病理分型及预后的评估等方面具有重要临床意义。     

血清CEA、CA125、CA724联检对卵巢癌的诊断价值

目的:探讨用肿瘤标志物癌胚抗原(CEA)、糖类抗原125(CA125)、糖类抗原724(CA724)联检对卵巢癌的临床评价。方法:采用电化学发光法测定28例卵巢癌及37例正常人血清。结果:以单一指标阳性作为诊断标准CEA、CA125、CA724对卵巢癌的敏感性分别为25.0%、42.8%、32.1%,特异性分别为91.4%、97.2%、86.5%,联检结果二项或二项以上阳性作为标准则本文患者的诊断灵敏度为78.6%、特异性为83.8%。结论:联检血清CEA、CA125与CA724对卵巢癌的辅助诊断有较高的临床应用价值。     

Diagnostic utility of clinical and biochemical parameters in pancreatic head malignancy patients with normal carbohydrate antigen 19-9 levels

BackgroundCarbohydrate antigen (CA)19-9 that is the most widely used biomarker for pancreatic cancer has certain limitations in diagnosis, which results in a tough job to distinguish pancreatic cancer from benign tumors with normal CA19-9. The aim of this study was to investigate the diagnostic utility of clinical parameters and serum markers in patients with pancreatic head masses but without elevated CA19-9.MethodsRetrospectively, 106 (69 malignant, 37 benign) of 487 patients admitted for pancreatic head masses were enrolled with CA19-9 level of <37u/ml. Clinical parameters and serum biomarkers were assessed. Among the patients with pancreatic head mass, male individuals (p=0.025) and elder individuals (p<0.001) were more likely to have cancer; and cancer patients were more likely to present with abdominal-pain (p=0.023), weight-loss (p=0.013) and jaundice (p<0.001). Serum bilirubin levels among malignancies, including total bilirubin (p<0.001), direct bilirubin (p<0.001) and indirect bilirubin (p<0.001), were considerably higher than those of benign ones. Logistic regression further concluded that age-distribution, abdominal-pain and direct-bilirubin were three independent factors correlating with final diagnosis. However, CEA (p=0.156) was not sufficient enough to exclude pancreatic cancer.ConclusionsIn patients with pancreatic head masses and CA19-9 of <37u/ml, age-distribution, abdominal-pain and direct bilirubin might be helpful in differential diagnosis. CEA was insufficient for exclusion of malignancy.     

VEGF、CA15-3、CA125和CEA在乳腺癌预后判断中的表达及意义

目的：探讨血清血管内皮生长因子（VEGF）、CA15-3、CA125和CEA水平在乳腺癌预后判断中的临床意义。方法：免疫组化（S-P）法动态监测93例乳腺癌患者的VEGF水平,化学发光免疫分析检测CA15-3、CA125和CEA的水平,并与40例正常对照组的各项指标进行比较,分析其与临床分期、治疗效果和复发转移的关系。结果：乳腺癌组的VEGF随乳腺癌（Ⅰ～Ⅳ）期依次升高,有淋巴结转移者较无转移患者高,差异有统计学意义（P〈0.01）;乳腺癌患者中（Ⅲ、Ⅳ）期的CA15-3、CA125和CEA水平也明显高于正常对照组和（Ⅰ、Ⅱ）期患者组,有淋巴结转移患者显著高于无淋巴结转移患者,差异均有统计学意义（P〈0.05）;随访中发现复发者各项指标均比无复发者高;VEGF、CA15-3、CA125和CEA的表达与临床分期、腋窝淋巴结状况有关（P〈0.01）,但与患者年龄、肿瘤大小和肿瘤病理学类型无关（P〉0.05）。结论：VEGF、CA15-3、CA125和CEA的联检对于判断乳腺癌的分期、转移情况及治疗效果有一定意义,可以指导临床对乳腺癌的诊疗工作。