ABSTRACT
Objective To explore the differences of TCM constitutions and lifestyles among the subjects with positive tumor marker screening and those with normal tumor marker screening. Methods Totally 245 subjects with positive tumor marker screening from September 2014 to December 2017 in Weihai area were selected as the observation group and 300 subjects with normal tumor marker screening were selected as the control group. Field questionnaire was used to investigate TCM constitutions and lifestyles. Results In the observation group, the ratio of constitution of yin-yang harmony was significantly lower than the control group, with statistical significance (χ2=207.483, P＜0.001). The ratios of constitution of phlegm-dampness, constitution of blood stasis, constitution of qi deficiency and constitution of qi stagnation were significantly higher than the control group, with statistical significance (P＜0.05). There was statistical significance between the 2 groups in irregular rest, heavy drinking, regular smoking, lack of exercise, irregular diet and partial eclipse (P＜0.05). CEA, a positive indicator of tumor markers in the observation group, was commonly found in constitution of phlegm-dampness (40.43％) and constitution of qi deficiency (22.70％); CA199 was commonly found in constitution of qi stagnation (38.71％) and constitution of qi deficiency (24.19％); AFP was commonly found in constitution of blood stasis (38.46％) and constitution of qi deficiency (23.08％); CA125 was commonly found in constitution of blood stasis (33.33％) and constitution of qi stagnation (19.05％); CYFRA21-1 was commonly found in constitution of phlegm-dampness (54.55％) and constitution of qi deficiency (22.73％); PSA was commonly found in constitution of phlegm-dampness (61.52％) and constitution of damp-heat (23.08％). Conclusion Effectively controling the distribution of TCM constitutions of subjects with positive tumor marker screening in Weihai area and understanding the influence of lifestyles on tumor markers can provide guidance for clinical improvement of patients' biased constitutions and reduction of positive indicators of tumor markers.
ABSTRACT
Objective To investigate the differentiatial diagnostic value of 99Tcm-methoxyisobutylisonitrile ( MIBI ) SPECT combined with localizable CT in the evaluation of oxygen intervention for suspicious lung lesions,and to establish a cost-effective imaging modality in the detection of malignant lung lesions.Methods From September 2008 to March 2009,47 consecutive patients with suspicious malignant lung lesions underwent 99Tcm-MIBI SPECT/CT prospectively. Patients with suspicious pneumonia were treated with antibiotics for about 4 d before imaging. All patients were cannulized with a nostril tube for oxygen inhalation before 99Tc-MIBI injection. SPECT combined with localizable CT of the chest was performed at 10 min and 2 h after 99Tcm-MIBI injection. The uptake ratios of lesion to contralateral normal lung parenchyma(early uptake ratio:EUR and delayed uptake ratio:DUR) were compared using independent-samples ttest. In addition,the diagnostic efficiency of uptake ratios of lung lesions was analyzed with receiver operating characteristic (ROC) curve. Results Forty-seven patients ( primary lung cancers:32,metastatic tumors of the lung:4,benign lung diseases:11 ) had 51 lung lesions,including 39 malignant and 12 benign lung lesions. The sensitivity,specificity,accuracy,positive predictive value (PPV),and negative predictive value (NPV) were 94.9% (37/39),83.3% ( 10/12),92.2% (47/51),94.9% (37/39) and 83.3% ( 10/12),respectively. The EUR of malignant lesions was 2.95 ± 1.16,whereas of benign lesions was 1.43 ±0.33. The DUR of the malignant lesions was 3.19 ± 1.74,whereas of benign lesions was 1.60 ±0.32. Both EUR and DUR were significantly different between malignant and benign lung lesions,respectively (t= -4.44,-3.12,respectively,both P＜0.01). The ROC curve showed that EUR value ≥1.625 provided the sensitivity of 97.4% (38/39) and specificity of 83.3% (10/12); DUR value ≥ 1.75provided the sensitivity of 94.9% (37/39) and specificity of 83.3% (10/12). Conclusion 99Tcm-MIBI SPECT combined with localizable CT imaging in oxygen intervention has a potential value in differentiating malignant from benign lung lesions.