Role of the criteria based on preoperative serological indexes of AFP and GGT in predicting long-term survival of patients with hepatocellular carcinoma after liver transplantation / 器官移植

Objective To evaluate the role of preoperative serological indexes in predicting long-term survival and tumor recurrence of hepatocellular carcinoma (HCC) patients after liver transplantation, aiming to explore its significance in expanding the Milan criteria. Methods Clinical data of 669 recipients undergoing liver transplantation for HCC were retrospectively analyzed. The optimal cut-off value was calculated by the receiver operating characteristic (ROC) curve. The risk factors affecting the overall survival and recurrence-free survival rates of HCC patients after liver transplantation were identified by univariate and multivariate regression analyses. The correlation between preoperative serum liver enzymes and pathological characteristics in HCC patients was analyzed. The predictive values of alpha-fetoprotein (AFP) combined with γ -glutamyl transferase (GGT) and different liver transplant criteria for the survival and recurrence of HCC patients after liver transplantation were compared. Results Exceeded Milan criteria, total tumor diameter (TTD) > 8 cm, AFP > 200 ng/mL and GGT > 84 U/L were the independent risk factors for the overall survival and recurrence-free survival rates of HCC patients after liver transplantation (all P < 0.05). Correlation analysis showed that preoperative serum GGT level was correlated with TTD, number of tumor, venous invasion, microsatellite lesions, capsular invasion, tumor, node, metastasis (TNM) stage, Child-Pugh score and exceeded Milan criteria (all P < 0.05). Milan-AFP-GGT-TTD (M-AGT) criteria were proposed by combining Milan criteria, TTD with serum liver enzyme indexes (AFP and GGT). The 5-year overall survival and recurrence-free survival rates of HCC recipients who met the M-AGT criteria (111 cases of exceeded Milan criteria) were significantly higher than those who met Hangzhou criteria (both P < 0.05), whereas had no significant difference from their counterparts who met the University of California at San Francisco (UCSF) criteria (both P > 0.05). Conclusions Preoperative serological indexes of AFP and GGT could effectively predict the long-term survival and tumor recurrence of HCC patients after liver transplantation. Establishing the M-AGT criteria based on serological indexes contributes to expanding the Milan criteria, which is convenient and feasible.

Aristolochic acids exposure was not the main cause of liver tumorigenesis in adulthood

Aristolochic acids (AAs) have long been considered as a potent carcinogen due to its nephrotoxicity. Aristolochic acid I (AAI) reacts with DNA to form covalent aristolactam (AL)-DNA adducts, leading to subsequent A to T transversion mutation, commonly referred as AA mutational signature. Previous research inferred that AAs were widely implicated in liver cancer throughout Asia. In this study, we explored whether AAs exposure was the main cause of liver cancer in the context of HBV infection in mainland China. Totally 1256 liver cancer samples were randomly retrieved from 3 medical centers and a refined bioanalytical method was used to detect AAI-DNA adducts. 5.10% of these samples could be identified as AAI positive exposure. Whole genome sequencing suggested 8.41% of 107 liver cancer patients exhibited the dominant AA mutational signature, indicating a relatively low overall AAI exposure rate. In animal models, long-term administration of AAI barely increased liver tumorigenesis in adult mice, opposite from its tumor-inducing role when subjected to infant mice. Furthermore, AAI induced dose-dependent accumulation of AA-DNA adduct in target organs in adult mice, with the most detected in kidney instead of liver. Taken together, our data indicate that AA exposure was not the major threat of liver cancer in adulthood.

Clinical Value of Platelet and Its Parameters Combined with Tumor Markers in Preoperative Differentiation of Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma / 肿瘤防治研究

Objective To evaluate the value of PLT and its parameters combined with AFP, CA199, CA125 and CEA on the preoperative differential diagnosis of hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC). Methods We analyzed retrospectively 274 patients with liver cancer who underwent surgery in the Second Hospital of Lanzhou University. They were divided into 229 cases in HCC group and 45 cases in ICC group according to postoperative pathological results. The differences of PLT, its parameters and tumor markers between the two groups were compared. ROC curve was used to evaluate the differential diagnosis effect on HCC and ICC by significantly different indicators in single and combined forms. The best scheme was verified in the patients with determined and undetermined preoperative diagnosis. Results Compared with HCC group, the levels of PLT, PCT, CA199 and CA125 in ICC group were higher (P < 0.05) and the level of AFP was lower (P < 0.05). The diagnostic analysis results of ROC curve showed that in single test, the AUC of AFP for HCC diagnosis was the largest (0.827). The AUC of the combined groups was higher than the single groups of tumor markers; the AUC of the PCT+AFP+CA199+CA125 group was the highest in all combination groups, and AUC was 0.891. The verification of the best combination group showed that the AUC was 0.924 in the preoperative determined diagnosis group and 0.854 in the undetermined diagnosis group. Conclusion Tumor markers in combination with PLT and PCT can increase the preoperative differential diagnosis efficacy of HCC and ICC. The combination of PCT, AFP, CA199 and CA125 before operation is helpful to further determine the diagnosis and plan the operation scheme.

Evaluation of the performance of SPINK1/SPP1in diagnosis of hepatocellular carcinoma, alone or in combination / 西安交通大学学报(医学版)

【Objective】 To evaluate the performance of SPINK1/SPP1 in diagnosis of hepatocellular carcinoma (HCC) alone or in combination. 【Methods】 A total of 419 serum samples were collected and divided into four groups: normal control (n=93), chronic hepatitis B (CHB) (n=72), HBC related liver cirrhosis (LC) (n=77), and hepatocellular carcinoma (HCC) (n=177). Serum concentrations of SPINK1 and SPP1 were determined by ELISA kits. All parameters were first analyzed by significance tests among the groups. To distinguish tumors from non-tumors, a combination model was generated by multivariable binary Logistic regression using a comprehensive control group which consisted of the normal, the CHB and the LC groups. The performance of each indicator was judged by comparison of AUC, sensitivity, specificity and accuracy. 【Results】 The serum levels of SPINK1 and SPP1 were both significantly higher in HCC group than in all the others (P0.05), was lower than that of the combination model (P=0.042 9 and P0.05). 【Conclusion】 The data identified SPINK1 and SPP1 as novel tumor biomarkers with greater robust efficiency than the currently used AFP for detection of hepatocellular carcinoma, alone or in combination.

Alpha Fetoprotein Delivered Drugs Targeting Therapy of Cancer / 中国生物化学与分子生物学报

Alpha fetoprotein (AFP) is a highly expressed protein during fetal development. It’ s a shuttle protein that transports nutrients to embryonic cells. Similarly, during the development of malignant tumors such as liver cancer, tumor cells also express high levels of AFP and its receptors. They uptake AFP and its delivered substances through AFP receptors. Therefore, AFP can be combined with anticancer drugs to attack tumor cells selectively. There are several ways of AFP to deliver drugs, which can be noncovalently bound with drugs, and the drugs are wrapped in the hydrophobic pocket of AFP; they can also combine with drugs through covalent bonds, or use AFP to connect with nanoparticles and liposomes to improve the effect of drug delivery. AFP delivered drugs can be effectively released in the low pH environment of cancer cells. In order to avoid the risk of AFP carcinogenesis, drugs can be delivered by modifying AFP or using AFP fragments. Because AFP delivered drugs targeting therapy mainly attacks cancer cells that expressed AFP receptor, it has little effect on normal cells. AFP delivred drugs can not only promote the absorption of drugs by tumor cells, enhance the anti-cancer activity of drugs, but also overcome the problem of multidrug resistance (MDR). In addition, studies have found that AFP delivered drugs also have the effect of immunotherapy. AFP delivered drugs can not only activate T cell receptors, eliminate immune tolerance and inhibit tumor growth, but also inhibit myeloid derived suppressor cells (MDSCs), activate NK cells and T cells, thus destroying cancer cells and preventing cancer stem cell metastasis. Therefore, AFP delivery of drug is a new therapy combining immunotherapy and targeted chemotherapy, and it may become a strategy for cancer treatment in the future.

Gold nanorods-mediated efficient synergistic immunotherapy for detection and inhibition of postoperative tumor recurrence

Tumor recurrence after surgery is the main cause of treatment failure. However, the initial stage of recurrence is not easy to detect, and it is difficult to cure in the late stage. In order to improve the life quality of postoperative patients, an efficient synergistic immunotherapy was developed to achieve early diagnosis and treatment of post-surgical tumor recurrence, simultaneously. In this paper, two kinds of theranostic agents based on gold nanorods (AuNRs) platform were prepared. AuNRs and quantum dots (QDs) in one agent was used for the detection of carcinoembryonic antigen (CEA), using fluorescence resonance energy transfer (FRET) technology to indicate the occurrence of

Structural and Gene Characterization of a New Antifungal Peptide Obtained from Penicillium crustosum FP11 Strain

A novel antifungal peptide, PcAFP (6.48 kDa, pI 8.83 ), was obtained from the culture supernatant of the fungus Penicillium crustosum . The gene encoding the PcAFP peptide was isolated b ased on its homologue in Penicillium chrysogenum , PgAFP. PcAFP is a small, cystine-rich peptide, and th e mature peptide consists of 58 amino acid residues. The i mmature P. crustosum antifungal protein (AFP) showed 95.65% identity to the antifungal prote in of P. chrysogenum , while the mature peptide showed 98.28% identity with PgAFP. Molecular modeling of the tertiary structure of the mature peptide revealed details of the conserved stru cture of the AFPs, such as the ? -barrel motif stabilized by three disulfide bonds and the ? -core motif. Analysis of the extract by 16% tricine SD S- PAGE showed a 6.9 kDa peptide, which was close to the pr edicted molecular mass of the mature peptide of 6.48 kDa. Assays of antimicrobial activity , performed by broth microdilution using the crude extract obtained from the culture medium, showe d activity against Candida albicans . These results demonstrate the conservation of the PcAPF gene and the high level of identity with the PgAFP antifungal protein of P. chrysogenum . Given these structural and biochemical characteristics, PcAFP could be a potential candidate for future investigations that may aid in the development of new antifungal compounds.

Value of Serum AFP for Differential Diagnosis of Digestive System Malignancies

Background: Now a days, Cancer is a major health problemworldwide. Common malignant disease of digestive systemincludes carcinoma oesophagus, carcinoma stomach,carcinoma colon, hepatocellular carcinoma, carcinoma biliarytree, and pancreatic carcinoma. In Bangladesh, there are a fewstudies to evaluate diagnostic value of serum AFP as tumourmarker for GIT malignancies.Aim of the Study: To evaluate the diagnostic value(sensitivity, specificity, positive and negative predictive valuesas well as accuracy) of serum AFP in different malignancies ofdigestive system.Methods: This cross-sectional study was carried out at thedepartment of Gastroenterology of Bangabandhu Sheikh MujibMedical University, Dhaka, Bangladesh from October 2012 toJune 2014. A total of 200 patients with primary digestivesystem malignancies in the age group of 22 to 76 years wereincluded in this study. Malignancy of the included patients werehistologically proven and serum AFP level was measured byimmunoassay method. Serum AFP level >15 ng/ml wasconsidered as positive. Data was collected using questionnaireand clinical information data sheet. Sensitivity, specificity,positive and negative predictive values as well as accuracy ofserum AFP have shown.Results: Mean elevation of Serum AFP found to be muchhigher in advanced case than localized malignancy. Sensitivity,specificity, positive and negative predictive values as well asaccuracy of serum AFP for carcinoma stomach was 5%,73.75%, 4.55%, 75.64% and 60% respectively. Sensitivity,specificity, positive and negative predictive values as well asaccuracy of serum AFP for carcinoma colon was 0%, 72.15%,0%, 73.08% and 57% respectively. Sensitivity, specificity,positive and negative predictive values as well as accuracy ofserum AFP for hepatocellular carcinoma was 87.5%, 98.68%,95.45%, 96.15% and 96% respectively. Sensitivity, specificity,positive and negative predictive values as well as accuracy ofserum AFP for carcinoma Pancreas was 0%, 74.12%, 0%,80.77% and 63% respectively. Sensitivity, specificity, positiveand negative predictive values as well as accuracy of serumAFP for carcinoma gallbladder was 0%, 72.5%, 0%, 74.36%and 58% respectively.Conclusion: Serum AFP level has important role for diagnosisof hepatocellular carcinoma. But has no significant role for thecarcinoma of stomach, carcinoma colon, carcinoma pancreasand carcinoma gallbladder. This study stresses the need ofbroad-based work to detect the actual value of serum AFP fordifferential diagnosis of digestive system malignancies.

Availability of AFP Specimen Collection Kits and Data Tools in Health Facilities in Selected States in Nigeria

Background: Acute flaccid paralysis (AFP) surveillance was adopted globally as a key strategy for monitoring the progress of the polio eradication initiative. The main objective of AFP surveillance is to detect the presence of circulating wild-type poliovirus and other subtypes of polioviruses. Stool specimen collection kits for AFP surveillance and data tools, regrettably are not always available in health facilities, and thus cause gaps in specimen collection and proper documentation which could ultimately lead to under-reporting of cases. Methods: This survey was undertaken to determine the availability of stool collection kits and data capturing tools in health facilities in some randomly selected states in Nigeria. The main aim was to relate the findings with the quality of the surveillance system in the areas visited and an overall indication of the functionality of the process in the country. Results: The outcome of the study found only 32,598 (74.7%) health facilities out of the 43,644 health facilities who visited and had stool specimen collection kits, while of the 43,582 health facilities visited, only 38,029 (87.3%) health facilities had data tools. Conclusions: Gaps were noticed in the supply of key AFP surveillance components to the health facilities visited, which by extension could apply to those not visited. Countries that are still polio-endemic will have to regularly survey their facilities for the availability of these very important materials. The methodology can be adapted to other diseases to evaluate the strength of the surveillance system.

Role of Beta HCG and AFP in Prediction of Hypertensive Disorder in Pregnancy in Second Trimester- A Hospital Based Prospective Study

Background: Pre-eclampsia is an important cause of maternal and neonatal complication and death. If hypertension in pregnancy is diagnosed at an early age, we can provide an efficient care to mother for good outcome of pregnancy. The aim of this study to evaluated the role of B-HCG and AFP as predictors of HDP. Methods: This prospective Investigation study was conducted on 100 pregnant women attending the antenatal clinic in Department of Obstetrics and Gynaecology, Jaipur. Estimation of serum β-HCG and AFP was done by ELISA technique. Then there finding were correlated with the value of serum β-HCG and AFP in second trimester to see whether there is any relation between levels of serum β- HCG and AFP in second trimester and development of HDP. Results: ‘Out of 100 women, 5 i.e. 5% were <20 years of age, maximum i.e. 62 (62%) were in 21-25 years of age group, 25 (25%) were in 26-30 years of age group and 8 (8%) were in 31-35 years age of group. Significantly higher mean S. β-HCG (mIU/ml) was observed in HDP group i.e. 13450.5±3420.8 as compared to 7732±2024 in normotensive group and a test of full model was statistically significant indicating that the predictors reliably distinguish between HDP group and normotensive group (Chi square 55.328, df 4, p<.001). Conclusion: We conclude from this study the measurement of serum β-HCG and AFP should be routinely done in second trimester of pregnancy, to predict the occurrence of HDP for better fetomaternal outcome.

Effect of PIVKA-Ⅱ and AFP levels on the prognosis of patients with HBV infection-related hepatocellular carcinoma / 中国实用内科杂志

OBJECTIVE: To evluated the prognostic potential of preoperative PIVKA-Ⅱ and AFP to the patients of HBV infection-related hepatocellular carcinoma(HCC) after radical resection. METHODS: Chronic HBV infection-related HCC patients who undergone resection in the Affiliated Cancer Hospital of Zhengzhou University from 2009 to 2013 with competed data of clinical information,laboratory results and follow-up records were enrolled our study. Finaly, a total of 107 subjects entered our research. PIVKA-Ⅱ was quantitatively measured by Chemiluminescence methods. Kaplan-Meier survival analysis and the Cox proportional hazards model were used to analyze the factors which can affect patient's post surgery survival. RESULTS: Kaplan-Meier survival curve analysis showed that the 1-,2-,3-year survival rate of the patients with high PIVKA-Ⅱ level were 56%, 28% and 16%, respectively, much poor than that of patients with low PIVKA-Ⅱ level, the 1-,2-,3-year survival rate for the latter were 73%, 54% and 46%, respectively(P = 0.002). The 1-,2-,3-year survival rates for patients with high AFP levels were 58%, 35% and 25%, respectively, and the the 1-,2-,3-year survival rates for patients with low AFP levels were 83%, 63% and 51%, respectively(P = 0.006). Multivariate factor results showed that high PIVKA-Ⅱ levels, high AFP levels, the presence of portal vein tumor thrombus and incomplete capsular were independent risk factors for prognosis,HR(95% CI) were 1.99(1.15-3.45), 2.03(110-3.76), 2.72(1.53-4.83) and 2.07(1.07-4.00), respectively. In addition, the prognosis would got worse with the superposition of four independent risk factors. CONCLUSION: Preoperative PIVKA-Ⅱ and AFP levels are associated with HCC patients' s poor post surgery prognosis.

Clinicopathological characteristics of gastric cancer with enteroblastic differentiation / 中国肿瘤临床

Objective: To investigate the clinicopathological features and molecular phenotypes of gastric cancer with enteroblastic dif-ferentiation (GCED). Methods: A retrospective analysis of 337 patients with gastric adenocarcinoma diagnosed by the pathology de-partment of the First Affiliated Hospital of Zhejiang University in March 2013-2017 was conducted. Of them, 8 patients were diag-nosed with gastric carcinoma with intestinal blastocyte differentiation. All the patients were elderly, including 6 men and 2 women. The onset age was 68-83 years (mean 76.6 years). Two cases had serum AFP≥200 μg/L before treatment. According to the histopatho-logical morphology, the immunophenotype was analyzed by immunohistochemistry, the SALL4 gene was detected using reverse tran-scription-polymerase chain reaction (RT-PCR), and the relevant literature was reviewed. Results: Microscopically, all cases had primi-tive enteroid structures, consisting of cubic or columnar cells with clear cytoplasm, and immunohistochemical staining showed positivi-ty for either AFP and GPC3 or SALL4. The expression of SALL4 mRNA was significantly increased by RT-PCR. Follow-up from 1 to 5 years showed that 5 patients had liver and other organ metastases, 2 patients died, and 1 patient survived without a tumor. Conclusions:GCED is a rare invasive gastric adenocarcinoma with a worse prognosis than that of normal intestinal adenocarcinoma. The treatment of general intestinal adenocarcinoma has little effect. There are some characteristic changes in histology. It would be helpful for diag-nosis and differential diagnosis if clinicians are familiar with the tumor spectrum and genetic characteristics. Target therapy for an origi-nal marker, such as SALL4, has a bright future.

Primary Pelvic Peritoneal Yolk Sac Tumor in the Post-Pubertal Female: a Case Report with Literature Review

Yolk sac tumors are rare malignant germ cell neoplasms that usually arise from the gonads. Extragonadal yolk sac tumors (EGYSTs) frequently occur in the mediastinum in post-pubertal females. EGYSTs in the pelvis are extremely rare, and to date, only thirteen cases have been reported in the English literature. Among them, the primary EGYST of the pelvic peritoneum in post-pubertal females has only been reported in ten cases. The present case describes a 26-year-old female diagnosed with primary peritoneal yolk sac tumor located in the rectouterine pouch. We report clinical and tumor imaging features, including ultrasound, computed tomography (CT), magnetic resonance images (MRI), positron emission tomography-computed tomography (PET-CT), and present a review of the literature.

Effect of transforming growth factor β signaling on the stem cell-mediated liver regeneration in mice after partial hepatectomy / 上海交通大学学报（医学版）

Objective • To explore the effect of inhibiting transforming growth factor β (TGF-β) signaling pathway on the stem cell-mediated liver regeneration in mice after partial hepatectomy (PH). Methods • Eighteen C57BL/6 male mice were selected to establish the model of hepatectomy. mRNA and protein levels of the signal molecules in TGF-β pathway, as well as stem cell markers α-fetoprotein (AFP) and leucine-rich repeat-containing G-protein coupled receptor 5 (LGR5) in the liver tissues were detected before (PH0) and on the 1st (PH1), 3rd (PH3) and 7th (PH7) day after operation. Then, additional 32 mice were assigned into inhibitor group [PH+SB-431542, 10 mg/(kg•d)] and control group (PH+normal saline). The mice were sacrificed on the 1st (PH1) and 3rd (PH3) day after operation and liver remnants were obtained. Realtime-PCR, Western blotting, and immunofluorescence staining were used to detect the expressing variation of TGF-β signaling pathway, AFP and LGR5. Results • The mRNA and protein expression of TGF-β1, phosphorylated SMAD2 (p-SMAD2) protein, Afp mRNA, the number of AFP immune-positive cells and Lgr5 mRNA were upregulated significantly after PH, peaked at PH3 (P<0.05) and recovered to pre-operative level at PH7. Compared with control group, the above indices were all obviously inhibited in inhibitor group at PH3 (P<0.05). Conclusion • TGF-β signaling pathway may regulate the stem cell-mediated liver regeneration in mice after PH.

Prediction of microvascular invasion in hepatocellular carcinoma patients by preoperative neutrophil-lymphocyte ratio and cancer-related factors / 中华肝胆外科杂志

Objective To predict the presence of MVI,the general clinicopathological of HCC patients' data of the preoperative neutrophil-lymphocyte ratio (NLR),platelet-lymphocyte ratio (PLR),altplatelet ratio (APRI) were evaluated.Methods 143 cases of HCC patients who underwent radical resection and ≤ 5 cm of tumor diameter in Chifeng Clinical Medical School of Inner Mongolia Medical University from January 2011 to December 2014 were analysed retrospectively and followed up.The relationship between NLR,PLR,APRI and other clinical parameters was evaluated.Results According to ROC Curve,the NLR truncation value was 2.00,PLR to 115.00,APRI 1.6.The single factor analysis of x2 test showed that NLR (x2=6.419;P＜0.05),APRI (x2=3.975;P＜0.05),AFP (x2=33.37;P＜0.05),Degree of differentiation (x2 =9.839;P＜0.05) were significant differences between MVI positive (MVI+) and negative (MVI-) groups,and the difference was statistically significant;Logistic regression multifactor analysis showed that NLR (OR 2.678;95％ CI 1.033～6.944;P＜0.05) and AFP (OR 1.724;95％CI 1.023～2.905;P＜0.05) are independent predictors of MVI.Conclusion Preoperative NLR and AFP are convenient,economical and reliable hematological indices for predicting the presence of MVI in HCC patients.

Analytical Performance of New ARCHITECT AFP Assay: Comparison with the Current Assay

Alpha-fetoprotein (AFP) is frequently used for hepatocellular carcinoma (HCC) diagnosis and surveillance. Although the current ARCHITECT AFP (List number 7K67) assay range is 0–350 ng/mL, all samples with test results between 200 and 350 ng/mL must be diluted and retested until their levels are <200 ng/mL. A new ARCHITECT AFP (8100/3P36) assay with a dynamic range of up to 2000 ng/mL has been introduced. The aim of this study was to perform a method comparison between the current ARCHITECT AFP assay and the new assay. The precision study showed excellent results for both high and low controls. There was a positive correlation between the two assay systems and clinical samples. The new ARCHITECT AFP assay with a wide assay range demonstrated good analytical performance. Therefore, the current ARCHITECT AFP assay could be replaced by the new assay, which is more convenient and minimizes manual labor.

The clinicopathological characteristics and prognosis of 30 patients with hepatoid ade-nocarcinoma of stomach / 中国肿瘤临床

Objective:To review the clinicopathological characteristics and analyze the prognostic factors of hepatoid adenocarcinoma of stomach(HAS).Methods:From August 2012 to June 2017,30 patients with HAS were diagnosed in Daycare of Peking University Cancer Hospital.Clinicopathological data and follow-up information of these patients were retrospectively collected and analyzed.Re-sults:The median age of these 30 patients was 58 years at diagnosis,with a male-to-female ratio of 2.75:1.Twenty-nine patients were confirmed to have lymph node metastases and 7 patients had distant metastases.Ten patients died because of the cancer within the follow-up period.The 1-and 3-year survival rates were 60% and 52%,respectively.Cox multivariate regression revealed that elevated serum CA199 levels,higher lymph node staging,not having undergone radical surgery,and stronger immunohistochemical(IHC)stain-ing intensity of alpha fetoprotein(AFP)were independent poor prognostic factors.Conclusions:Elevated serum CA199 levels,lymph node staging,and IHC staining intensity of AFP are verified in this study as independent risk factors of poor outcome in HAS patients. Early detection and diagnosis of the disease may improve the clinical prognosis.Multidisciplinary team discussions are important in making therapy decisions and radical surgery should be performed whenever possible.

Observation the clinical efficacy of Apatinib combined with the second line chemotherapy in advanced gas-tric cancer with positive AFP / 实用医学杂志

Objective To investigate the difference of clinical curative effect of Apatinib combined with second line chemotherapy between AFP positive gastric cancer and AFP negative gastric cancer.Methods The da-ta of 78 patients that met the inclusion criteria with advanced gastric cancer from January 2015 to June 2017 were collected from the Second Affiliated Hospital of Zhengzhou University.According to the blood serum AFP levels be-fore treatment(including chemotherapy,surgery)the patients were divided into the AFP positive group(AFPGC) and the AFP negative group(NAFPGC),excluding the impact of other factors.Analysing the difference of the clin-ical effect with apatinib combined with second line chemotherapy in the two groups. Results Getting rid of other factors that may affect the efficacy of chemotherapy,we administered apatinib combined with docetaxel or irinote-can regimen as second line therapy for gastric cancer.The AFP positive group was treated for 2 cycles,4 cycles,in which ORR and DCR were significantly better than that of the AFP negative group(P<0.05).The OS of the AFP positive group and the AFP negative group was 5.5 months,6 months(P = 0.747). No significant adverse reac-tions occurred in the two groups. Conclusion Chemotherapy curative effect of the AFP positive group of apatinib combined with docetaxel or irinotecan is obviously better than that of the AFP negative group in short term,but no obvious difference in long term effect.

The correlation between YKL-40,sCD40L,AFP and coronary heart disease / 国际检验医学杂志

Objective To study the chitin enzyme protein(YKL-40),sCD40L,AFP and the correlation of hypertension with cor-onary heart disease(CHD).Methods 75 cases of elderly patients with CHD were selected as observation group,and then were di-vided into hypertension group and non hypertension group according to the blood pressure.103 cases of healthy elderly were select-ed as control group.ELISA method was used to detect YKL-40 and sCD40L,and AFP was detected by chemiluminescence immuno-assay.Results Clinical data comparison revealed that the relative risk of CHD with hypertension group and non hypertension of hy-perlipidemia,drinking,smoking,diabetes mellitus,were 1.56,1.33,1.23,1.15 times,data show that relative risk of CHD with hy-pertension were much greater than CHD without hyperlipidemia.The concentration of YKL-40 in CHD with hypertension(92.66± 12.04)ng/mL was significant higher than that in CHD without hypertension (57.08 ± 10.07 )ng/mL,and the concentration of sCD40L in CHD with hypertension (186.59 ± 69.63 )ng/mL was significant higher than that in CHD without hypertension (128.14±48.37)ng/mL(P 0.05).Conclusion The levels of YKL-40,CD40L and AFP in the peripheral blood of elderly patients with CHD were significantly increased.And the concentration of sCD40L and YKL-40 was positively correlated with hy-pertension,which can be used to assess the stability and prognosis of CHD.

Expression and clinical significance of CXC chemokine receptors 1 and 2 and CXCL8 in primary hepatocellular carcinoma / 中华微生物学和免疫学杂志

Objective To investigate the expression and clinical significance of CXC chemokine receptors 1 and 2 (CXCR1 and CXCR2) and CXCL8 in peripheral blood mononuclear cells (PBMCs) and liver biopsy tissues from patients with primary hepatocellular carcinoma (PHC).Methods Serum specimens were collected from 36 patients with PHC, 30 patients with liver cirrhosis and 28 healthy subjects.Quantitative real-time polymerase chain reaction (qRT-PCR) was performed to measure the expression of CXCR1, CXCR2 and CXCL8 at mRNA level in PBMCs.Streptavidin-perosidase (SP) immunohistochemistry was used to detect the expression of CXCR1, CXCR2 and CXCL8 at protein level in liver biopsy tissues.Levels of C-reactive protein (CRP), alpha-fetoprotein (AFP) and ferritin (FER) in the serum specimens were detected by chemiluminescence immunoassay.Then the correlations between these markers were analyzed.Results All of the results showed that the expression of CXCR1, CXCR2 and CXCL8 at mRNA level in PBMCs from the PHC group were higher than those of the healthy control group (P<0.01) as well as those of the liver cirrhosis group (P<0.05).Up-regulated expression of CXCR1, CXCR2 and CXCL8 in patients with PHC were associated with the depth of tumor invasion, lymph node or distant metastasis, clinical stage and levels of CRP, AFP and FER in serum (P<0.05).The expression of CXCR1, CXCR2 and CXCL8 at protein level in liver biopsy tissues were also significantly increased in the PHC group in comparison with those of the healthy control group as indicated by the result of SP immunohistochemistry (P<0.05).Conclusion Levels of CXCR1, CXCR2 and CXCL8 in the patients with PHC are significantly increased and positively correlated with the levels of AFP, FER and CRP in serum, suggesting that the signal transduction process mediated by CXCR1, CXCR2 and their common ligand CXCL8 may play a key role in the pathological process of PHC.This study may provide a potential new strategy for immune intervention in hepatocellular cancer.