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Objective:To investigate the serum level of insulin-like growth factor binding protein 7 (IGFBP7) in patients with gastric cancer and its diagnostic significance.Methods:A total of 100 gastric cancer patients (gastric cancer group) including 49 patients with early gastric cancer (early gastric cancer group) , who were hospitalized in Sun Yat-sen University Cancer Center from May to December 2019 were selected as the research subjects, and 94 physical examination subjects during the same period were selected as the normal control group. The levels of serum IGFBP7 were detected by enzyme-linked immunosorbent assay. At the same time, the laboratory carcinoembryonic antigen (CEA) test results were collected. The relationships between the level of serum IGFBP7 and the clinicopathological features of gastric cancer patients were analyzed. The diagnostic value was evaluated by receiver operating characteristic (ROC) curve.Results:The level of serum IGFBP7 in the gastric cancer group was (1.595±0.159) ng/ml, and that in the normal control group was (1.850±0.328) ng/ml, with a statistically significant difference ( t=-0.26, P<0.001) , and among them, the level of serum IGFBP7 in the early gastric cancer group was (1.601±0.153) ng/ml, and there was a statistically significant difference compared with the normal control group ( t=-0.26, P<0.001) . The level of serum CEA in the gastric cancer group was 2.230 (2.043) ng/ml, and that in the normal control group was 1.805 (1.020) ng/ml, with a statistically significant difference ( U=0.45, P=0.004) , and among them, the level of serum CEA in the early gastric cancer group was 2.220 (1.780) ng/ml, and there was a statistically significant difference compared with the normal control group ( U=0.53, P=0.002) . There were no significant correlations between IGFBP7 and CEA level ( χ2=0.36, P=0.547) , age ( χ2=0.16, P=0.688) , gender ( χ2=0.97, P=0.326) , depth of invasion ( χ2=0.30, P=0.585) , lymph node metastasis ( χ2=0.17, P=0.684) , distant metastasis ( χ2=0.09, P=0.767) and TNM stage ( χ2=0.38, P=0.537) . ROC curve analysis showed that the area under the curve (AUC) of IGFBP7 for gastric cancer diagnosis was 0.84 (95% CI: 0.78-0.89) , the AUC of CEA for gastric cancer diagnosis was 0.62 (95% CI: 0.54-0.70) , and there was a statistically significant difference ( Z=4.33, P<0.001) . The AUC of IGFBP7 combined with CEA for gastric cancer diagnosis was 0.85 (95% CI: 0.79-0.90) . Compared with CEA alone, there was a statistically significant difference ( Z=4.97, P<0.001) . Compared with IGFBP7 alone, there was no statistically significant difference ( Z=1.41, P=0.159) . The AUC of IGFBP7 in the diagnosis of early gastric cancer was 0.84 (95% CI: 0.78-0.91) , the AUC of CEA in the diagnosis of early gastric cancer was 0.66 (95% CI: 0.56-0.75) , and there was a statistically significant difference ( Z=3.11, P=0.002) . The AUC of IGFBP7 combined with CEA in the diagnosis of early gastric cancer was 0.85 (95% CI: 0.78-0.91) . Compared with CEA alone, there was a statistically significant difference ( Z=3.54, P<0.001) . Compared with IGFBP7 alone, there was no statistically significant difference ( Z=1.19, P=0.232) . Conclusion:The serum IGFBP7 level of gastric cancer patients is lower than that of normal controls. Compared with CEA, serum IGFBP7 has better diagnostic value for gastric cancer.
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ObjectiveTo investigate the clinical features of infection in patients with acute-on-chronic liver failure (ACLF) and bacterial infection and the influencing factors for 90-day survival rate. MethodsThe patients with ACLF who were admitted to The Fifth Medical Center of Chinese PLA General Hospital from January 2014 to December 2015 were enrolled, and related clinical data were collected and analyzed, including infection time and site, microbial culture, biochemical parameters and inflammatory markers, and 28- and 90-day prognosis after infection. The t-test or the Mann-Whitney U test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. The life-table method was used to plot survival curves. The indices affecting prognosis in the univariate analysis were further included in the multivariate logistic regression analysis. ResultsA total of 1074 patients with ACLF were admitted, among whom 609 had bacterial infection, and the incidence rate of bacterial infection was 567%. Among these 609 patients, 16 underwent liver transplantation within 90 days and related data statistics were obtained for the remaining 593 patients. As for infection site, among the patients with infection, 70.15% had abdominal infection, 41.15% had pulmonary infection, 11.97% had sepsis, 5.40% had urinary system infection, 4.89% had thoracic infection, and 8.6% had infection at other sites. Among the patients with infection, 64.76% had infection at a single site. The positive rates of microbial culture of ascites, phlegm, urine, and pleural effusion were 22.70%, 52.82%, 40.63%, and 35.71%, respectively. Escherichia coli was the most common bacterium in ascites and accounted for 43.82%; Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii accounted for 22.67%, 2400%, and 22.67%, respectively, in phlegm; Escherichia coli, Klebsiella pneumoniae, and Staphylococcaceae accounted for 33.80%, 29.58%, and 15.49%, respectively, in blood culture. The 90-day survival rate after infection was 38.11% (226/593) in the patients with ACLF, and the multivariate logistic regression analysis showed that age (P=0.006), stage of hepatic encephalopathy (HE) (P＜0001), stage of liver failure (P＜0.001), and acute kidney injury (AKI) (P＜0.001) were independent risk factors for 90-day survival in patients with ACLF and infection. ConclusionThere is a high incidence rate of infection in patients with ACLF. The 90-day survival rate is relatively low, and the presence of AKI, HE stage III or above, and advanced liver failure may indicate poor prognosis.
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Objective:To evaluate the relationship between red blood cell distribution width (RDW) and metabolic syndrome (MS) in patients with impaired glucose tolerance (IGT).Methods:A total of 415 patients with abnormal glucose tolerance were screened by oral glucose tolerance test in Changsha Traditional Chinese Medicine Hospital (Changsha Eighth Hospital) from October 2015 to September 2019. General data were collected and blood routine and biochemical indexes were detected. There were 193 cases in the observation group and 222 cases in the control group. The RDW and other clinical indicators were compared between the two groups, the correlation between RDW and other indicators was analyzed, and the risk factors of metabolic syndrome were analyzed.Results:⑴ The RDW, systolic blood pressure (SBP), diastolic blood pressure (DBP), height (Ht), weight (Wt), waist circumferenc (Wc), triglyceride (TG), cholesterol (CHOL), low density lipoprotein (LDL), creatinine (Cr), uric acid (UA), alanine aminotransferase (ALT), high sensitive C-reactive protein (hs-CRP), body mass index (BMI) of the observation group were significantly higher than those of the control group, while the high density lipoprotein (HDL) was significantly lower than that of the control group, with statistically significant difference ( P<0.05); ⑵ correlation analysis showed that RDW was positively correlated with SBP, DBP, Ht, Wt, Wc, TG, CHOL, Cr, UA, ALT, hs-CRP, BMI, and negatively correlated with HDL ( P<0.05); ⑶ binary logistic regression analysis showed that RDW, Wt, Wc, CHOL, HDL, LDL and hs-CRP were independent risk factors for MS in patients with impaired glucose tolerance. Conclusions:The increase of RDW is a predictor of metabolic syndrome in people with abnormal glucose tolerance, which may provide some reference value for the prevention and treatment of metabolic syndrome.
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Objective:To screen and identify autoantibody biomarker to diagnose patients with nasopharyngeal carcinoma (NPC).Methods:Candidate autoantibodies against tumor-associated antigens were identified from NPC CNE2 cells using serological proteome analysis. Levels of candidate autoantibody biomarkers were measured by enzyme-linked immunosorbent assay (ELISA) in 50 patients with NPC and 80 normal controls recruited from the Cancer Hospital of Shantou University Medical College between July 2014 and January 2015. Receiver operating characteristic curve (ROC) was employed to evaluate diagnostic efficacy.Results:Serological proteome analysis showed that sera from patients with NPC yielded a positive spot, of which was identified as enolase 1 (ENO1). ELISA results showed that the level of serum autoantibody against ENO1 in patients with NPC was significantly higher than that in normal controls [0.165 (0.088, 0.378) vs. 0.100 (0.054, 0.117), Z=4.077, P<0.001]. With the optimum diagnostic cutoff of 0.164, ROC curve showed the diagnostic sensitivity and specificity of autoantibodies against ENO1 were 52.0% and 90.0%, respectively. Measurement of autoantibody against ENO1 demonstrated a positive rate of 75.0% for early stage NPC. Conclusion:Autoantibody against ENO1 may be a potential diagnostic biomarker for NPC.
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Objective To explore the diagnostic value of the combined detection of serum Dickkopf-1 (DKK1 )and EB viral capsid antigen immunoglobulin A (VCA-IgA)in patients with nasopharyngeal carcinoma (NPC).Methods Serum levels of DKK1 and VCA-IgA were measured by enzyme-linked immunosorbent assay (ELISA)for the 80 patients with NPC and 65 normal controls.Receiver operating characteristic (ROC) curve was used to calculate the diagnostic value.Results The serum levels [M(QR )]of DKK1 in patients with NPC were significantly higher than those in normal controls [580.773 (429.1 46 )pg/ml vs.31 6.1 74 (252.965)pg/ml],with a significant difference (Z=4.846,P<0.000 1 ).ROC curves showed that the opti-mum diagnostic cutoff for serum DKK1 was 611.981 pg/ml,with an area under curve (AUC)of 0.734 (95%CI:0.654-0.81 5,50.0% sensitivity,96.9% specificity).Measurement of VCA-IgA demonstrated an AUC of 0.71 4 (95%CI:0.631-0.798,47.5% sensitivity,95.4% specificity).The combined detection of DKK1 and VCA-IgA demonstrated an AUC of 0.849 (95%CI:0.783-0.91 4,76.3%sensitivity,95.4%spe-cificity).For patients with early-stage NPC,the detection effect of combined detection of DKK1 and VCA-IgA was much better than that in normal controls,with a significant difference (χ2 =23.784,P <0.001 ). Conclusion Serum DKK1 has potential diagnostic value for NPC.Combined detection of DKK1 and VCA-IgA may aid the early diagnosis of NPC.
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Objective To explore the association between blood cadmium levels (BCLs) and clinicopathological characteristics of patients with breast cancer.Methods The clinicopathological characteristics and blood specimens of 186 patients diagnosed with breast cancer were collected between July and December 2009.BCLs were detected by graphite-furnace atomizer absorption spectrophotometer.Mann-Whitney U test and Kruskal-Wallis H test were used to compare the BCLs of patients with different clinical characteristics.Spearman rank correlation analysis was used to evaluate the relationships between BCLs and some indices of clinical characteristics.Results The BCLs was 2.280 (1.579) μg/L.The BCLs were significantly different in patients with different age and body mass index (BMI) (Z =-2.075,P =0.038;x2 =7.429,P =0.023).Also,there were significant differences in different T stages (x2 =10.137,P =0.017),M stages (Z =-2.225,P =0.026),clinical stages (x2 =16.060,P =0.001) and human epidermal growth factor receptor-2 (HER-2) status (Z=-2.072,P=0.038).Excepting for age (r =0.126,P =0.066),BCLs were positively associated with BMI,T stage,M stage,clinical stage and HER-2 status (r=0.159,P =0.030;r =0.171,P=0.020;r =0.166,P =0.044;r=0.154,P =0.040;r =0.152,P =0.038).Conclusion The BCLs are associated with some clinicopathological characteristics of breast cancer,and high blood cadmium burden may promote the development of breast cancer.
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Objective To evaluate the diagnostic value of combined detection of serum autoantibodies against against p53 and Bmi-1 in lung cancer (LC).Methods Serum levels of autoantibodies against p53 and Bmi-1 were measured by enzyme-linked immunosorbent assay (ELISA) in 92 patients with LC and 80 normal controls.The combined diagnostic value was evaluated with the receiver operating characteristic (ROC) curve.Results The serum levels of autoantibodies against p53 and Bmi-1 were significantly higher in LC than in normal controls (0.438 ±0.705 vs 0.045 ±0.035,Z =-7.667,P ＜0.01;0.117±0.061 vs 0.068 ±0.031,Z =-7.179,P ＜0.01).The levels of autoantibodies against p53 and Bmi-1 were not related to age,gender,pathological classification,lymph node status or tumor-node-metastasis (TNM) stage (P ＞ 0.05).The combined detection of two autoantibodies provided an enhanced sensitivity of 63.0％,a specificity of 91.2％ and an area under curve (AUC) of 0.881,which showed better diagnostic efficiency compared to individual autoantibodies.Conclusions Combined detection of autoantibodies against p53 and Bmi-1 shows good diagnostic value,which may aid diagnosis of LC.
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Objective To evaluate the diagnostic value of the combination of serum DKK1 (Dickkopf-1 )and P53 autoantibodies in patients with esophageal squamous cell carcinoma (ESCC).Methods Serum levels of DKK1 and P53 autoantibodies were measured by enzyme-linked immunosorbent assay (ELISA) for the 1 26 patients with ESCC and 60 normal controls.Receiver operating characteristics (ROC)was used to calculate the diagnostic efficiency.Results The serum levels of DKK1 and P53 autoantibodies were signifi-cantly higher in ESCC than those in normal controls [(673.09 ±343.82)pg/ml vs (362.05 ±1 48.07)pg/ml, Z =6.1 58,P <0.000 1 ;(0.398 ±0.546)vs (0.069 ±0.050),Z =3.832,P <0.000 1 ].ROC curves showed the optimum diagnostic cutoff for serum DKK1 was 588.77 pg/ml,with an area under curve (AUC)of 0.780 (95%CI:0.71 5 ~0.844,61 .9% sensitivity,95.0% specificity).Measurement of P53 autoantibodies demonstrated an AUC of 0.674 (95%CI:0.598 ~0.750,45.3% sensitivity,95.0% specificity).The com-bination of DKK1 and P53 autoantibodies yielded an AUC of 0.843 (95%CI:0.788 ~0.897,73.8% sensitiv-ity,95.0% specificity).In early-stage ESCC,combined detection of DKK1 and P53 autoantibodies improved the diagnostic power,with an AUC of 0.903 (95%CI:0.845 ~0.961 ,81 .0% sensitivity,95.0% specifici-ty).Conclusion Serum DKK1 and P53 autoantibodies can be used as potential diagnostic biomarkers for the ESCC.Combined detection of them might aid the early diagnosis of ESCC.
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At present,the commonly used tumor markers,with low sensitivity and low specificity,can 't achieve the purpose of early diagnosis.However,autoantibodies against tumox-associated antigens have been detected in the asymptomatic stage of cancer and thus can serve as biomarkers for early cancer diagnosis.Moreover,due to autoantibodies are found in sera,they can he screened easily using a noninvasive approach.The discovery of panels of autoantibodies with high sensitivity and specificity will help to improve the diagnostic and prognostic for the patients with cancer.