ABSTRACT
OBJECTIVE@#To explore the correlation of plasma N-acetyl-neuraminic acid level with Thrombolysis In Myocardial Infarction (TIMI) risk score and clinical outcomes of patients with acute coronary syndrome (ACS).@*METHODS@#We consecutively enrolled 708 consecutive patients (401 male and 307 female, mean age 63.6±10.6 years) undergoing coronary angiography in our hospital between October, 2018 and July, 2019, including 597 patients with ACS and 111 without ACS (control group). The patients with ACS group were divided into high (=104), moderate (=425) and low (=68) risk groups according to their TIMI risk scores. All the participants were examined for plasma Neu5Ac level using liquid chromatography-tandem mass spectrometry and underwent coronary angiography with their Gensini scores calculated. The patients with ACS were followed up after discharge for a mean of 15 months for the occurrence of major adverse cardiac events (Mace). Binary logistic regression analysis was performed to identify the risk factors of Mace in these patients.@*RESULTS@#Plasma Neu5Ac levels were significantly higher in ACS group than in the control group ( < 0.05). ROC curve analysis showed that plasma Neu5Ac level could assist in the diagnosis of ACS (0.648 [0.597-0.699]) with a sensitivity of 39.2% and a specificity of 86.5% at the cutoff value of 288.50 ng/mL. In the ACS patients, plasma Neu5Ac level was significantly higher in the high-risk group than in the moderate-risk and low-risk groups ( < 0.05) and could assist in the diagnosis of a high risk (0.645 [0.588-0.703]) with a sensitivity of 42.3% and a specificity of 80.1% at the cutoff value of 327.50 ng/ mL. Plasma Neu5Ac was positively correlated with age, serum uric acid, creatinine, lipoprotein a, Ddimer, C-reactive protein, MB isoform of creatine kinase and Gensini score and negatively correlated with high-density lipoprotein level. During the followup, 80 ACS patients experienced Mace, who had significantly higher plasma Neu5Ac level than those without Mace (=517). Logistic regression analysis showed that plasma Neu5Ac level and a history of previous stroke were independent risk factors for the occurrence of Mace.@*CONCLUSIONS@#Plasma Neu5Ac level can provide assistance in the diagnosis and risk stratification of ACS and is an independent risk factor for prognosis of ACS patients.
ABSTRACT
Objective To detect the value of circulating tumor cells(CTCs)in peripheral venous blood in patients with metastatic breast cancer. Methods 50 female patients with advanced advanced metastatic breast can-cer hospitalized in our hospital from May 2016 to December 2016 were enrolled in the research. Patients were divid-ed into oligometastases group and extensive metastasis group through multi-department comprehensive analysis andimaging diagnosis. 10 cases with early stage breast cancer were selected randomly. 10 healthy female volunteers were recruited as control group. After obtaining written informed consent from research subjects ,7.5 mL peripheral blood was drew from patients and volunteers prior to starting a new line of chemotherapy ,surgery or other treat-ment. CTCs counts from Blood samples were detected density gradient centrifugation associate with flow cytometry. Results The base line was formulated as CTCs≥5/7.5 mL positive and CTCs<5/7.5 mL negative. By comparing the positive expression of CTCs in early and advanced metastatic breast cancer(Pa = 0.01,P < 0.05),positive CTCs was associated with advanced metastatic breast cancer. Comparision of the positive expression of CTCs between oligometastases group and the extensive transfer group showed significant difference in the CTCs count be-tween the two groups(Pb = 0.018,P < 0.05). In the corresponding period,no positive CTCs was detected in all healthy volunteers. Conclusion CTCs count was associated with metastatic breast cancer. There was a correlation between tumor metastasis and CTCs count (the more widely metastasis ,the higher the detection rate of CTCs). CTCs may be of relevant value in the diagnosis and treatment ,and prognosis evaluation of metastatic breast cancer.