ABSTRACT
Results of the IMbrave150 clinical study showed that atezolizumab plus bevaci-zumab have better overall survival and progression-free survival than sorafenib in the treatment of hepatocellular carcinoma patients. However, hepatocellular carcinoma patients with esophageal varices were not included in the IMbrave150 clinical study mainly considering the bleeding risk of patients undergoing treatment of bevacizumab. The authors introduce the atezolizumab plus bevaci-zumab treatment of an advanced hepatocellular carcinoma patient with moderate esophageal varices. By reducing the dose of bevacizumab, the patient achieved an excellent curative effect.
ABSTRACT
Objective To investigate the clinical value of combined detection of serum carcinoembryonic an-tigen(CEA) ,carbohydrate antigen-125 (CA125) ,cytokeratin 19 fragment antigen (CYFRA21-1) ,squamous cell carcinoma(SCC) antigen ,neuron-specific enolase(NSE) and plasma progastrin-releasing peptid(ProGRP) in the diagnosis ,pathological typing and clinical staging in lung cancer .Methods The serum CEA ,CA125 , CYFRA21-1 ,SCC ,NSE levels and plasma ProGRP level were detected by adopting the chemiluminescent mi-croparticle immunoassay method in 378 cases of lung cancer ,200 cases of benign lung diseases and 200 people undergoing healthy physical examination .Results The levels and positive rates of CEA ,CA125 ,CYFRA21-1 , SCC ,NSE and ProGRP in the patients with lung cancer were significantly higher than those in the patients with benign lung diseases and healthy control group ,the difference was statistically significant (P<0 .05);in the single index detection ,the biomarkers of highest positive rate in adenocarcinoma ,squamous cell carcinoma and small cell lung carcinoma were CEA ,CYFRA21-1 and SCC ,NSE and ProGRP respectively .The sensitivi-ty ,specificity ,accuracy ,negative predictive value and positive predictive value of combined detection of these 6 indexes were 92 .86％ ,85 .00％ ,88 .17％ ,92 .64％ and 85 .40％ respectively ,except the specificity and positive predictive value were slightly decreased ,the levels of other indexes were higher than those of single index de-tection .The aresa under the receiver operating characteristic (ROC) curves of CEA ,CA125 ,CYFRA21-1 ,SCC ,NSE and ProGRP were 0 .775 ,0 .778 ,0 .891 ,0 .585 ,0 .710 and 0 .620 respectively .The area under ROC curves of the combined detection was 0 .950 .The positive rates of CA125 ,CYFRA21-1 ,NSE and the combined detection in the patients with stage Ⅲ ,Ⅳof lung cancer were obviously higher those in the patients with stageⅠand Ⅱof lung cancer ,the difference was statistically significant (P<0 .05);the combined detection obviously improved the positive rates for the diagnosis in the patients with different stages of lung cancer .Conclusion The combined detection of CEA ,CA125 ,CYFRA21-1 ,SCC ,NSE and ProGRP is conducive to improve the di-agnosis performance and early detection rate for lung cancer ,differentially diagnosing different pathological types of lung cancer and judge the clinical stage of lung cancer .The combined detection of 6 tumor biomarkers is an ideal diagnosis index of lung cancer .