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Objective: To analyze the serum carbohydrate antigen 125 (CA125) level and its influencing factors in male silicosis patients with pulmonary heart disease. Methods: In October 2021, data of 38 male patients with simple silicosis (silicosis group), 28 cases of silicosis with pulmonary heart disease (pulmonary heart disease group), and 27 healthy controls (control group) in the same age group were collected in inpatient and outpatient of Nanjing Occupational Disease Prevention and Control Hospital from January 2017 to December 2020. The serum CA125 levels of the three groups were compared, and the correlation between disease-related indexes and serum CA125 in silicosis patients with pulmonary heart disease was analyzed, as well as the influencing factors of pulmonary heart disease and serum CA125 levels in silicosis patients. Results: The serum CA125 level[ (19.95±7.52) IU/ml] in pulmonary heart disease group was higher than that in silicosis group[ (12.98±6.35) IU/ml] and control group[ (9.17±5.32) IU/ml] (P<0.05). There was no significant difference in serum CA125 level between the silicosis group and the control group (P>0.05). Serum CA125 levels were positively correlated with blood uric acid and fasting blood glucose in silicosis patients with pulmonary heart disease (r=0.39, 0.46, P<0.05). Serum CA125 level was a risk factor for silicosis patients with pulmonary heart disease (OR=1.13, 95%CI: 1.02-1.24, P<0.05). Dust exposure time, lactate dehydrogenase and smoking history were positively correlated with serum CA125 level in silicosis patients (P<0.05) . Conclusion: The serum CA125 level of male silicosis patients with pulmonary heart disease is significantly increased, and the level of CA125 is correlated with the level of fasting blood glucose and blood uric acid.
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Humans , Male , Pulmonary Heart Disease , Blood Glucose , Uric Acid , Silicosis/complications , Risk FactorsABSTRACT
Objective:To investigate the clinical application value of plasma SEPT9 gene methylation combined with serum carcinoembryonic antigen (CEA) and carbohydrate antigen 724 (CA724) in the diagnosis of colorectal cancer.Methods:A total of 219 patients with colorectal diseases in Baoji Central Hospital and Yunnan Province New Kun Hua Hospital from May 2018 to October 2021 were selected, including 149 cases of colorectal cancer and 70 cases of colorectal polyp diagnosed by pathology. A total of 100 healthy people in the same period were selected as the healthy control group. The methylation of SEPT9 gene in plasma was measured by using real-time fluorescent polymerase chain reaction (PCR), and the levels of serum CEA and CA724 were measured by using electrochemiluminescence. The expressions of three indicators in each group were compared, and the effect of every single indicator and the combination of the three indicators on the diagnosis of colorectal cancer was analyzed by using receiver operating characteristic (ROC) curve.Results:The positive rate of SEPT9 gene methylation in colorectal cancer group (74.50%, 111/149) was higher than that in colorectal polyp group (22.86%, 16/70) and healthy control group (1.00%, 1/100), and the difference was statistically significant ( P < 0.001). The positive rate of CEA in colorectal cancer group (46.98%, 70/149) was higher than that in colorectal polyp group (40.00%, 28/70) and the healthy control group (3.00%, 3/100) and the difference was statistically significant ( P < 0.001). The positive rate of CA724 in colorectal cancer group (38.93%, 58/149) was higher than that in colorectal polyp group (32.86%, 23/70) and the healthy control group (2.00%, 2/100), and the difference was statistically significant ( P < 0.001). The area under the curve (AUC) of ROC of SEPT9 gene methylation, CEA and CA724 in the single diagnosis of colorectal cancer was 0.823 (95% CI 0.753-0.891), 0.788 (95% CI 0.725-0.852) and 0.689 (95% CI 0.624-0.754), respectively. The optimal cut-off Ct value of SEPT9 gene methylation in the diagnosis of colorectal cancer was 36.5, the sensitivity was 90.30%, and the positive predictive value was 84.68%, which were higher than those of CEA and CA724. The optimal cut-off value of CEA in the diagnosis of colorectal cancer was 8.80 ng/ml, and the specificity (77.50%) and negative predictive value (78.48%) were higher than those of SEPT9 gene methylation and CA724. The sensitivity (97.66%), positive predictive value (93.98%), negative predictive value (81.25%) and AUC (0.846, 95% CI 0.749-0.944) of the combined detection of the three indexes taking the optimal cut-off value of every single indicator were higher than those of the single indicator. Conclusions:The combined detection of plasma SEPT9 gene methylation, CEA and CA724 in the diagnosis of colorectal cancer has high sensitivity and accuracy. The three combined detection can complement each other and improve the diagnostic efficiency, which is of high clinical value for the diagnosis of colorectal cancer.
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Objective:To screen the serum exosomal microRNAs differentially expressed in early pancreatic cancer patients and evaluate the diagnostic value of exosomal hsa-let-7f-5p.Methods:From January 2019 to January 2020, 19 patients with early pancreatic cancer (early pancreatic cancer group) and 16 patients with chronic mass-forming pancreatitis (pancreatitis group) were selected from Affiliated Hospital of Nanjing University of Chinese Medicine who underwent surgery and were confirmed by pathology. Serum samples of the two groups of patients were collected. At the same time, serum samples of 19 healthy volunteers were selected as the normal control group. The exoEasy Maxi Kit was used to isolate serum exosomes. The structural characteristics of exosomes were observed by transmission electron microscopy (TEM). The particle size of exosomes was observd by nanoparticle tracking analysis. CD 63 and CD 81, the specific protein marker on the surface of exosomes, were identified by western blotting. The total RNA of exosomes was extracted by the miRNeasy Serum/Plasma Kit, and a small RNA library was constructed after quality inspection. With reference to the small RNA database, the differentially expressed exosomal microRNAs in early pancreatic cancer group, pancreatitis group and normal control group were filtered out. The miRNA candidates were validated by quantitative polymerase chain reaction (qPCR) and different expressions of them were analyzed. The role of target genes and metabolic pathways of candidate miRNAs in the occurrence and development of early pancreatic cancer were analyzed by gene ontology (GO) and Kyoto Encyclopeda of Genes and Genomes(KEGG) enrichment pathway. Results:The isolated serum exosomes can be seen to have cup-like vesicle with the double lipid layer by TEM. The main peak of the particle size of target exosomes was about 150 nm. The expression of exosome specific protein markers CD 63 and CD 81 was positive. Comparing the expression of miRNAs among early pancreatic cancer group, pancreatitis group and normal control group, the specific tumor marker exosomal hsa-let-7f-5p was screened out in this study, and its expression in early pancreatic cancer group was significantly higher than that in pancreatitis group and normal control group (both P values <0.05). Receiver operating characteristic curve analysis (ROC) showed that the area under curve (AUC) of exosomal hsa-let-7f-5p to distinguish pancreatic cancer from pancreatitis was 0.843 (95% CI 0.640-1.000). The sensitivity and specificity were 100% and 81.82% respectively. The AUC for distinguishing pancreatic cancer from normal controls was 1.000 (95% CI 1.000-1.000), and both sensitivity and specificity were 100%. The diagnostic efficiency of exosomal hsa-let-7f-5p was equivalent to that of CA19-9 ( P>0.05). The GO analysis results showed that target genes of exosomal hsa-let-7f-5p were mainly involved in complement activation lectin pathway in biological processes, and the proteins expressed by target genes were mainly distributed in cilium, and molecules mostly functioned by combining with nitric-oxide synthase. The KEGG pathway enrichment analysis showed that the target genes were closely related to MAPK signaling pathway. Conclusions:Serum exosomal hsa-let-7f-5p has the potential to be a diagnostic biomarker for early pancreatic cancer.
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@#AIM: To investigate the secretion levels of serum tumor markers neuron specific enolase(NSE), glycoprotein antigen CA153 and CA199 in patients with retinoblastoma(RB).<p>METHODS: Data of 42 RB patients who received chemotherapy at Shenzhen People's Hospital between October 2017 and October 2019 were collected. The RB group was regrouped according to early and mid-term/advanced stages, and single/double eye involvement, the levels of serum tumor markers were compared between these subgroups and different genders.<p>RESULTS: The levels of tumor markers NSE, CA153 and CA199 in the advanced group were higher than those in the early and mid-term groups(49.69±18.45ng/mL <i>vs</i> 36.18±14.92ng/mL, 22.38±12.03U/mL <i>vs</i> 15.10±8.32U/mL, 46.44±18.76U/mL <i>vs </i>30.21±24.03U/mL, <i>P</i><0.05), but there was no statistically significant difference in expression between the groups of different genders and single and binocular involvement(<i>P</i>>0.05).<p>CONCLUSION: Serum NSE, CA153 and CA199 are significantly increased in advanced group than early and mid-term group, and they are of great significance in the diagnosis and treatment of RB. The difference between NSE in single and double eyes is worthy of further study.
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Background: The predictive value of different prognostic biomarkers has been studied in various cancer types. Aims and Objectives: The purpose of this study was to examine the degree of risk and prognostic significance of pretreatment neutrophil-to-lymphocyte ratio (NLR) and carbohydrate antigen (CA) 19-9 levels in patients with metastatic pancreatic cancer (PC) and reveal its relevance with survival. Materials and Methods: Clinical and laboratory data of 118 patients with metastatic PC at the time of diagnosis were retrospectively analyzed. The overall survival (OS) was estimated according to the Kaplan–Meier method. To determine the prognostic factors affecting PC, the Cox regression analysis was performed. Results: The average age of the patients was 67 ± 9.57 years. The patients were analyzed during the follow-up period, and their average OS was 12 months (95% confidence interval [CI] = 9.73–14.26). The cutoff value was 3.54 (area under the curve [AUC] = 0.653, 95% CI = 0.56–0.73, P = 0.006) for NLR and 437 (AUC = 0.670, 95% CI = 0.57–0.75, P = 0.002) for CA19-9. Statistically significant difference was found between CA19-9 (P < 000.1) and NLR (P < 000.1) and OS. Analysis of multivariate Cox regression showed that NLR (hazard ratio [HR] = 2.17, 95% CI = 1.17–4.03, P = 0.013) and CA19-9 (HR = 1.81, 95% CI = 1.08–3.03, P = 0.022) were important prognostic factors in OS analysis. Conclusion: Pretreatment NLR and CA19-9 levels were found to be reliable estimative markers for poor prognosis in patients with metastatic PC. Our findings revealed that NLR and CA19-9 levels can be used to estimate the survival of patients with PC. We believe that our findings will shed light on the management of treatment protocols for patients diagnosed with metastatic PC
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Background: Carbohydrate antigen (CA) 19-9 is considered as a tumor marker in biliary-pancreatic malignancy. Though a high level may indicate the presence of a malignant disorder, it may rise even in benign condition. Similarly, the value may be normal even in malignant condition.Methods: An observational comparative study was conducted in the Department of Surgery of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from 01 June 2016 to 31 May 2017 to find out the sensitivity and specificity of CA 19-9 as a tumor marker in pancreatic malignancy in our perspective and to find out a cut-off value of CA 19-9 which might prove as a definitive indication of pancreatic malignancy.Results: The study shows when the cut off value of CA 19-9 is 37 U/ml. The sensitivity, specificity, positive and negative predictive values (PPV and NPV) were 77.8%, for all four characteristics respectively. But if the serum CA 19-9 threshold used to diagnose pancreatic cancer was raised to 100 and 120, sensitivity decreased to 72.2% and 66.7% and NPV decreased to 76.2% and 73.9% respectively. However, specificity increased to 88.9% and 94.4% and PPV increased to 86.7% and 92.3% respectively.Conclusions: Serum CA 19-9 level may be considered as an important determinant in the diagnosis of malignant pancreatic diseases and to assess the resectability of the lesions preoperatively, but other adjuncts are necessary in the overall management of pancreatic diseases.
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Objective: To explore the prognostic factors for the breast cancer patients with spinal metastasis, and establish a prognostic scoring model. Methods: A total of 160 breast cancer patients with spinal metastasis in Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from January 2008 to January 2016 were retrospectively identified. The clinical characteristics and prognosis were analyzed by univariate and multivariate survival analysis to explore the prognostic factors. And then a prognostic scoring model was developed according to the regression coefficient for each independent prognostic factor. Results: The 160 breast cancer patients with spinal metastasis whose average age was 56.8 years (range 22-82 years) were identified, and the median follow-up was 40 (24, 55) months. The multivariate Cox analysis showed that the patients' general condition, hormone receptor expression, visceral metastasis, and serum carbohydrate antigen 125 (CA125) level significantly influenced survival (P<0.05). According to the regression coefficients, a survival prediction scoring model comprising these factors was established, which ranged from 0 to 6 points. Three risk groups with different prognoses were identified : low risk group (0-1 point), intermediate risk group (2-4 points), and high risk group (5-6 points). Conclusion: The general condition, hormone receptor expression, visceral metastasis, and serum CA125 level were independent prognostic factors for the breast cancer patients with spinal metastasis. And the prognostic scoring model comprising these four clinical factors can effectively predict the patients' prognoses.
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Objective To analyze the clinical significance of elevated serum carbohydrate antigen 724 (CA724) in gout patients. Methods The clinical data of 271 gout patients, 63 ankylosing spondylitis patients, 40 psoriatic arthritis patients, 67 osteoarthritis patients and 280 healthy controls in our hospital from Jul. 2016 to Jun. 2019 were retrospectively analyzed. The positive rates and levels of serum CA724 were compared among gout patients and ankylosing spondylitis patients, psoriatic arthritis patients, osteoarthritis patients and healthy controls. According to the clinical symptoms and signs, gout patients were also divided into acute-stage group (n=53) and chronic-stage group (n=218); the serum CA724 levels were compared between the two groups and the correlation between serum CA724 level with white blood cell count and C-reactive protein (CRP) was analyzed in acute-stage gout patients. According to the serum CA724 level, gout patients were divided into elevated serum CA724 group (n=63) and normal serum CA724 group (n=208), and the serum uric acid, triglyceride, and high-density lipoprotein were compared between the two groups. Results The positive rate of serum CA724 in gout patients was significantly higher than those in ankylosing spondylitis patients, psoriatic arthritis patients, osteoarthritis patients and healthy controls (P<0.05, P<0.01). Serum CA724 in gout patients was significantly higher than those in osteoarthritis patients and healthy controls (P<0.05, P<0.01). Serum CA724 in acute-stage gout patients was significantly higher than that in chronic-stage gout patients (P<0.01), and it was positively correlated with white blood cell count and CRP (both P<0.01). The levels of serum uric acid and triglyceride in gout patients with elevated serum CA724 were significantly higher than those in patients with normal serum CA724 (P<0.01, P<0.05), while the level of high-density lipoprotein was significantly lower than that in normal serum CA724 group (P<0.01). Conclusion Serum CA724 level is increased in some gout patients, and serum CA724 is correlated with acute gout attack and inflammation.
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Abstract Membranous nephropathy is a glomerular disease that causes nephrotic syndrome. Absent phospholipase A2 receptor antibodies and absent staining with IgG4 may be linked to malignancy-associated MN. Here we present a case that defies that suggestion. A 42-year-old female presented with anasarca. Kidney biopsy revealed membranous nephropathy, stained positive for IgG but negative for IgG4. Absent phospholipase A2 receptor antibodies was negative. Abdominal tomography revealed a partial thrombosis of the left ovarian vein which raised suspicion for ovarian cancer. Even though her ovaries did not uptake FDG on PET scan, a carbohydrate antigen-125 was ordered. She had extremely high levels of carbohydrate antigen-125 which was unexpected in the course of benign events. Thorax CT, endoscopy, colonoscopy, mammography, and positron emission tomography were clear in terms of malignancy. Samples from both pleural effusion and ascites were consistent with transudate. Tuberculosis tests were negative. Cytology samples were negative for malign cells. Exploratory surgery was planned but rejected by the patient. She was treated as primary disease with cyclosporine and methylprednisolone. Rituximab was off-limits due to insurance rules. She had prompt and excellent response. Steroids were tapered and stopped at sixth month and cyclosporine at twelfth month. In her 36 months of drug-free follow up there has been no disease recurrence or a sign of cancer. Even when all odds are towards malignancy-associated membranous nephropathy, primary disease is still a possibility. We need better markers for malignancy-associated membranous nephropathy.A very high level of CA-125 does not necessarily mean cancer.
Resumen La nefropatía membranosa es una enfermedad glomerular que causa el síndrome nefrótico. La ausencia de anticuerpos contra el receptor de fosfolipasa A2 y de tinción para IgG4 puede deberse a una nefropatía membranosa asociada a cáncer. A continuación, se presenta un caso que desafía esta sugerencia. Una paciente de 42 años realizó una consulta por anasarca. A partir de la biopsia de riñón, se diagnosticó nefropatía membranosa con tinción positiva para IgG, pero negativa para IgG4. No se detectó la presencia de anticuerpos contra el receptor de fosfolipasa A2. La tomografía abdominal reveló una trombosis parcial en la vena ovárica izquierda, lo cual generó sospecha de cáncer de ovario. Si bien los ovarios no mostraron absorción de FDG en la tomografía por emisión de positrones, se solicitó una prueba de antígeno carbohidrato 125. Se le detectaron niveles elevados del antígeno carbohidrato 125, lo cual no es esperable en casos de eventos benignos. La tomografía computarizada de tórax, endoscopía, colonoscopía, mamografía y tomografía por emisión de positrones no mostraron tumores. Las muestras de derrame pleural y de ascitis fueron indicativas de trasudado. Las pruebas de tuberculosisarrojaron resultados negativos. El examen citológico fue negativo para células malignas. Se sugirió una cirugía exploradora, pero la paciente no aceptó. Se la trató con ciclosporina y metilprednisolona por enfermedad primaria. No se utilizó rituximab por reglas de su cobertura médica. La paciente tuvo una excelente respuesta al tratamiento de forma rápida. Los esteroides se disminuyeron de forma progresiva y se suspendieron a los seis meses, y la ciclosporina, a los doce meses. Durante los 36 meses de seguimiento sin medicación no ha habido recidiva ni signos de cáncer. Incluso cuando existen grandes probabilidades de que se trate de una nefropatía membranosa asociada a cáncer, aún es posible que se trate de una enfermedad primaria. Es necesario contar con mejores marcadores de nefropatía membranosa asociada a cáncer. Un nivel elevado de CA-125 no necesariamente es indicador de cáncer.
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Epithelial ovarian cancer (EOC) has the highest mortality rate among the gynecological malignancies. Because of its early symptoms are not obvious and lack of effective screening methods, more than 70％ patients have been diagnosed at late stage (stage Ⅲ-Ⅳ). Although the 5-year progression-free survival (PFS) of EOC was prolonged with the improvement of treatment methods, its prognosis was still poor, and 50％-95％ patients relapsed within 2 years after treatment. Human epididymis protein 4 (HE4) and carbohydrate antigen 125 (CA125) are widely used in the evaluation of diagnosis, treatment efficacy and prognosis of EOC, but the evaluation effect of both HE4 and CA125 is rarely reported. Therefore, it is necessary to summarize the research progress of HE4 and CA125 in evaluating the diagnosis, treatment efficacy and prognosis of EOC.
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Objective@#To investigate the clinical value of serum pepsinogen (PG), carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9) in diagnosis, prognosis evaluation and postoperative monitoring of gastric cancer.@*Methods@#A total of 100 patients diagnosed by the gastroscope in the Third People's Hospital of Hefei from January 2016 to October 2018 were selected. The patients were divided into the non-atrophic gastritis group (50 cases) and the gastric cancer group (50 cases) according to histopathological results. Enzyme linked immunosorbent assay (ELISA) was used to detect the levels of serum PGI and PGII. The ratio of PGI and PGII ratio (PGR) was calculated. Radioimmunoassay was used to detect CEA and CA19-9 levels.@*Results@#Serum PGI and PGR in the gastric cancer group were lower than those in the non-atrophic gastritis group [PGI: (96±35) μg/L vs. (144±44) μg/L; PGR: 7±3 vs. 11±5], and there was a significant difference (t = 3.861, P < 0.01; t = 3.043, P = 0.003]. Serum CEA and CA19-9 in the gastric cancer group were higher than those in the non-atrophic gastritis group [(7.5±4.8) ng/ml vs. (1.5±0.6) ng/ml, (49.7±29.4) U/ml vs. (8.7±2.6) U/ml], and there were statistical differences (t = 3.100, P = 0.003; t = 3.139, P = 0.002). Serum PGR of the gastric cancer group was decreased in TNM Ⅲ-Ⅳ stage, poorly differentiated adenocarcinoma and lymph node metastasis (t = 2.185, P = 0.034; t = 2.197, P = 0.033; t = 2.130, P = 0.038); CA19-9 of the gastric cancer group was increased in TNM stage (Ⅲ-Ⅳ stage) and lymph node metastasis (t = 2.405, P = 0.020; t = 2.076, P = 0.043). There were no statistical differences in PGⅠ, PGⅡ and CEA of gastric cancer patients with different clinicopathological characteristics (all P > 0.05). Serum PGⅠ [(46±23) μg/L] and PGⅡ [(8±5) μg/L] were decreased in the postoperative gastric cancer group (t = 4.263, P < 0.01; t = 5.830, P < 0.01). Serum CEA and CA19-9 of the postoperative metastatic group were higher than those of the postoperative non-metastatic group [(35.3±14.5) ng/ml vs. (3.6±2.2) ng/ml, (126±57) U/ml vs. (27±12) U/ml].@*Conclusion@#Combined detection of serum PGⅠ, PGⅡ, CEA and CA19-9 could be used for the diagnosis and prognosis evaluation of gastric cancer, and it has a certain clinical value for postoperative metastasis monitoring of gastric cancer.
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Objective@#To explore the diagnostic value of combined detection of serum human epididymis protein 4 (HE4) and carbohydrate antigen 125 (CA125) for ovarian epithelial cancer.@*Methods@#Patients who underwent surgery for the adnexal tumor at Shanxi Provincial Cancer Hospital from January 2012 to December 2017 were enrolled. According to the postoperative pathological results, these patients were divided into the ovarian epithelial cancer group (494 cases) and benign ovarian disease group (462 cases). The serum expressions of HE4 and CA125 in the two groups were detected by enzyme-linked immunosorbent assay (ELISA) and chemiluminescence immunoassay. The diagnostic value of detection of HE4 and CA125 alone or in combination for ovarian epithelial cancer was analyzed.@*Results@#The median levels (P 25 - P 75) of serum CA125 and HE4 in ovarian epithelial cancer group were 273.34 U/ml (39.34 U/ml, 709.74 U/ml) and 199.08 pmol/L (75.81 pmol/L, 449.20 pmol/L), which were higher than those in ovarian benign disease group [16.30 U/ml (6.30 U/ml, 53.60 U/ml) and 39.54 pmol/L (29.57 pmol/L, 53.80 pmol/L)] (both P < 0.05). There was a positive correlation between serum CA125 and HE4 levels in ovarian epithelial cancer group (r = 0.481, P < 0.01). Serum CA125 and HE4 levels in patients with stage Ⅲ and Ⅳ were higher than those in patients with stage Ⅰ and Ⅱ (both P < 0.05), and serum CA125 and HE4 levels in patients with poor differentiation were higher than those in patients with moderate differentiation (P < 0.05). Compared with CA125, the specificity and positive predictive value of serum HE4 for the diagnosis of ovarian epithelial cancer were higher (both P < 0.01). Compared with HE4 alone, the sensitivity of CA125 combined with HE4 increased (P = 0.004) and the specificity decreased (P = 0.044). When both CA125 and HE4 were positive for positive results, compared with HE4 alone, the specificity and positive predictive value increased (both P < 0.01), but the sensitivity decreased (both P < 0.01). In patients with CA125+ HE4-, the sensitivity and specificity decreased, while in CA125- HE4+ patients, the specificity was elevated, but the difference was not statistically significant (P = 0.892). When one of CA125 and HE4 was positive for positive results, the sensitivity and negative predictive value increased (both P < 0.01), but the specificity and positive predictive value decreased (both P < 0.01). The area under the curve of serum CA125 and HE4 combined detection was 0.911, indicating its clinical diagnostic value was better than that of the two alone.@*Conclusions@#In the diagnosis of epithelial ovarian cancer, the specificity of serum HE4 is higher than that of CA125, but the sensitivity is lower than that of CA125. The combined detection of HE4 and CA125 is more conducive to improve the diagnostic accuracy of ovarian epithelial cancer.
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Objective To explore the diagnostic value of combined detection of serum human epididymis protein 4 (HE4) and carbohydrate antigen 125 (CA125) for ovarian epithelial cancer. Methods Patients who underwent surgery for the adnexal tumor at Shanxi Provincial Cancer Hospital from January 2012 to December 2017 were enrolled. According to the postoperative pathological results, these patients were divided into the ovarian epithelial cancer group (494 cases) and benign ovarian disease group (462 cases). The serum expressions of HE4 and CA125 in the two groups were detected by enzyme-linked immunosorbent assay (ELISA) and chemiluminescence immunoassay. The diagnostic value of detection of HE4 and CA125 alone or in combination for ovarian epithelial cancer was analyzed. Results The median levels (P 25-P 75) of serum CA125 and HE4 in ovarian epithelial cancer group were 273.34 U/ml (39.34 U/ml, 709.74 U/ml) and 199.08 pmol/L (75.81 pmol/L, 449.20 pmol/L), which were higher than those in ovarian benign disease group [16.30 U/ml (6.30 U/ml, 53.60 U/ml) and 39.54 pmol/L (29.57 pmol/L, 53.80 pmol/L)] (both P< 0.05). There was a positive correlation between serum CA125 and HE4 levels in ovarian epithelial cancer group (r=0.481, P<0.01). Serum CA125 and HE4 levels in patients with stage Ⅲ and Ⅳ were higher than those in patients with stageⅠand Ⅱ (both P<0.05), and serum CA125 and HE4 levels in patients with poor differentiation were higher than those in patients with moderate differentiation (P< 0.05). Compared with CA125, the specificity and positive predictive value of serum HE4 for the diagnosis of ovarian epithelial cancer were higher (both P< 0.01). Compared with HE4 alone, the sensitivity of CA125 combined with HE4 increased (P= 0.004) and the specificity decreased (P= 0.044). When both CA125 and HE4 were positive for positive results, compared with HE4 alone, the specificity and positive predictive value increased (both P< 0.01), but the sensitivity decreased (both P< 0.01). In patients with CA125+ HE4-, the sensitivity and specificity decreased, while in CA125-HE4+patients, the specificity was elevated, but the difference was not statistically significant (P= 0.892). When one of CA125 and HE4 was positive for positive results, the sensitivity and negative predictive value increased (both P<0.01), but the specificity and positive predictive value decreased (both P<0.01). The area under the curve of serum CA125 and HE4 combined detection was 0.911, indicating its clinical diagnostic value was better than that of the two alone. Conclusions In the diagnosis of epithelial ovarian cancer, the specificity of serum HE4 is higher than that of CA125, but the sensitivity is lower than that of CA125. The combined detection of HE4 and CA125 is more conducive to improve the diagnostic accuracy of ovarian epithelial cancer.
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Objective To explore the four tumor markers of alpha-fetoprotein ( AFP ), α-L-fucosidase( AFU), carbohydrate antigen 199 ( CA199) and carcinoembryonic antigen ( CEA) and their combined use for primary hepatocellular carcinoma (HCC) diagnosis and treatment value. Methods From February 2016 to August 2018,92 patients with primary hepatocellular carcinoma (HCC group),79 patients with benign liver disease (chronic hepatitis and cirrhosis group) and 99 healthy adults (control group) were selected as subjects. The serum levels of four tumor markers in different populations were compared. Results The serum levels of four tumor markers ( AFP ( 192. 4 ± 89. 3) μg／L、AFU( 78. 6 ± 25. 8) U／L、CA199 (107. 2 ± 59. 5) U／mL、 CEA ( 37. 9 ± 14. 9) μg／L) were significantly higher than those of benign liver disease group(AFP( 17. 4 ± 6. 3) μg／L、AFU( 35. 4 ± 17. 2) U／L、CA199( 29. 3± 15. 2) U／mL、CEA( 4. 9 ±1. 7) μg／L) and normal people( AFP(4. 8±1. 1) μg／L、AFU(12. 2±3. 6) U／L、CA199( 6. 4± 2. 3) U／mL、CEA(1. 8±0. 4) μg／L) . There differences had significant ( all P＜0. 05) . The abnormal rate of single factor in hepatocellular carcinoma group ( AFP 84. 8%, AFU 52. 2%, CA199 41. 3%, CEA35. 9%) was significantly higher than that in benign liver disease group ( AFP 15. 2%, AFU 19. 0%, CA19916. 5%, CEA13. 9%) and normal group (AFP 4. 0%,AFU 5. 0%,CA199 3. 0%,CEA 6. 0% ug／L),the difference was statistically significant ( all P＜0. 05) . The highest sensitivity was AFP ( 84. 8%) and the highest specificity was AFP and CA199 (91. 0%). The sensitivity of combined detection was 94. 6% higher than that of single index ( AFP 84. 8%, AFU52. 2%, CA199 41. 3%, CEA35. 9%) . Conclusion The combined detection of AFP,AFU,CA199 and CEA can increase the sensitivity of diagnosis of hepatocellular carcinoma and reduce the rate of missed diagnosis, which will be beneficial to the early diagnosis and treatment of hepatocellular carcinoma.
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Objective To investigate the diagnosis of colon cancer patients and the prediction of postoperative recurrence and metastasis in patients with colon cancer by serum angiopoietin-2 (Ang-2) , vascular endothelial growth factor (VEGF) , carbohydrate antigen 199 and carcinoembryonic antigen CEA. Methods 100 patients with colon cancer, 100 patients with benign colonic lesions and 100 healthy subjects were examined. The levels of Ang-2, VEGF, CA19-9 and CEA in serum were detected, and the diagnosis and postoperative recurrence and metastasis of colon cancer were investigated. Results The levels of serum Ang-2, VEGF, CA19-9 and CEA in colon cancer group were higher than those in benign lesions and healthy controls (P < 0.05). The levels of Ang-2, VEGF, CA19-9 and CEA were detected. The sensitivity and specificity of each index were significantly higher in the diagnosis of colon cancer. The preoperative recurrence and metastasis rates of patients with positive Ang-2, VEGF, CA19-9 and CEA were higher than those of the negative patients respectively. Survival analysis showed a statistically significant difference in the time of distant metastasis between different expression states (P < 0.05). Conclusion The detection of serum levels of Ang-2, VEGF, CA19-9 and CEA has clinical significance for the diagnosis of colon cancer. Combined detection can improve the diagnostic efficiency; the levels of Ang-2, VEGF, CA19-9 and CEA in serum before surgery colon cancer is associated with recurrence and metastasis, and combined testing can help to assess tumor metastasis.
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Objective To discuss the clinical value of IL-6 combined with CA125 and HE4 as a new association marker in the diagnosis of early ovarian cancer.Methods The expression of IL-6, CA125 and HE4 in 21 cases of early ovarian cancer (stageⅠ-Ⅱ), 36 cases of advanced ovarian cancer (stageⅢ-Ⅳ), 40 cases of benign ovarian tumor and 40 healthy women were measured by the Roche automatic chemiluminescence analyzer (electrochemiluminescence).The sensitⅣity, specificity, positive predictive value, negative predictive value and ROC curves were used to evaluate the diagnostic value.Results The serum levels of IL-6, CA125 and HE4 in patients with ovarian cancer were significantly higher than those in the benign ovarian tumor and the healthy control (P＜0.05).The sensitⅣity, specificity, positive predictive value and negative predictive value of IL-6 combined with CA125 and HE4 were respectively 85.7％, 90％, 81.8％, 92.3％in the diagnosis of early ovarian cancer (stageⅠ-Ⅱ) patients and respectively 94.4％, 97.5％, 97.1％and 95.1％for advanced ovarian cancer (stageⅢ-Ⅳ) patients.For IL-6 combined with CA125 and HE4, the ROC AUC was respectively 0.955 4 and 0.974 0 for early ovarian cancer (stageⅠ-Ⅱ) patients and advanced ovarian cancer (stageⅢ-Ⅳ) patients.It performed significantly better than any single test of IL-6, CA125 and HE4 and the 2-marker combination of CA125+HE4.Conclusion The marker panel, IL-6, CA125 and HE4, shows higher sensitⅣity, positive predictive value and ROC AUC.It is an ideal serum marker combination for the diagnosis of early ovarian cancer (stageⅠ-Ⅱ) patients, which can improve the diagnostic efficiency of early ovarian cancer.
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Objective To investigate the clinical value of serum pepsinogen (PG), carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9) in diagnosis, prognosis evaluation and postoperative monitoring of gastric cancer. Methods A total of 100 patients diagnosed by the gastroscope in the Third People's Hospital of Hefei from January 2016 to October 2018 were selected. The patients were divided into the non-atrophic gastritis group (50 cases) and the gastric cancer group (50 cases) according to histopathological results. Enzyme linked immunosorbent assay (ELISA) was used to detect the levels of serum PGI and PGII. The ratio of PGI and PGII ratio (PGR) was calculated. Radioimmunoassay was used to detect CEA and CA19-9 levels. Results Serum PGI and PGR in the gastric cancer group were lower than those in the non-atrophic gastritis group [PGI: (96±35) μg/L vs. (144±44) μg/L; PGR: 7±3 vs. 11±5], and there was a significant difference (t=3.861, P<0.01; t=3.043, P=0.003]. Serum CEA and CA19-9 in the gastric cancer group were higher than those in the non-atrophic gastritis group [(7.5 ±4.8) ng/ml vs. (1.5 ±0.6) ng/ml, (49.7±29.4) U/ml vs. (8.7±2.6) U/ml], and there were statistical differences (t= 3.100, P= 0.003; t= 3.139, P= 0.002). Serum PGR of the gastric cancer group was decreased in TNM Ⅲ-Ⅳ stage, poorly differentiated adenocarcinoma and lymph node metastasis (t= 2.185, P= 0.034; t= 2.197, P= 0.033; t= 2.130, P=0.038); CA19-9 of the gastric cancer group was increased in TNM stage (Ⅲ-Ⅳ stage) and lymph node metastasis (t= 2.405, P= 0.020;t= 2.076, P= 0.043). There were no statistical differences in PGⅠ, PGⅡand CEA of gastric cancer patients with different clinicopathological characteristics (all P> 0.05). Serum PGⅠ[(46±23)μg/L] and PGⅡ[(8±5)μg/L] were decreased in the postoperative gastric cancer group (t=4.263, P<0.01; t=5.830, P<0.01). Serum CEA and CA19-9 of the postoperative metastatic group were higher than those of the postoperative non-metastatic group [(35.3±14.5) ng/ml vs. (3.6±2.2) ng/ml, (126±57) U/ml vs. (27±12) U/ml]. Conclusion Combined detection of serum PGⅠ, PGⅡ, CEA and CA19-9 could be used for the diagnosis and prognosis evaluation of gastric cancer, and it has a certain clinical value for postoperative metastasis monitoring of gastric cancer.
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Objective: To analyze the clinical features of ovarian fibrothecoma complicated with ascites and high level of CA125. and to explore the causes of elevated CA125 level and its significance in identifying benign and malignant ovarian tumors. Methods: The clinical data of one patient with varian fibrothecoma complicated with ascites and high level of senim CA125; combined with relevant literature review, the clinical characteristics, diagnosis and treatment process, and the significance of CA125 in the differential diagnosis of benign and malignant ovarian tumors were analyzed. Results: The patient was admitted to hospital due to vaginal bleeding for 4 months and pelvic mass for 1 month. The diagnosis result was pelvic and abdominal mass arising from ovarian according to the preoperative color Doppler ultrasound, enhanced CT» serum CA125 level and physical examination, and was highly suspected as ovarian malignant tumor. Surgery treatment was performed; based on the intraoperative rapid pathological results and postoperative slow pathology, the patient was diagnosed as ovarian fibrothecoma; the operation was successful. The patient recovered well and discharged from hospital. The serum CA125 level was decreased to the normal range 1 month after operation. Conclusion; Identification and quantitative analysis of the glycosylation modification and specific glycan structure of CA125 from different sources can significantly improve the diagnostic specificity of CA125 for benign and malignant ovarian tumors.
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Objective: To investigate the value of risk ovarian malignancy algorithm (ROMA) in evaluation of the risk of epithelial ovarian cancer and its association with the clinical pathological stages, and to provide a basis for the clinical diagnosis and treatment and prognosis analysis of epithelial ovarian cancer.Methods: The clinical materials of 135 patients with ovarian tumor confirmed by paraffin section pathology after operation were retrospectively analyzed. The patients were divided into benign ovarian tumor group(n=66), epithelial ovarian cancer group(n=58) and non-epithelial ovarian cancer group(n=11).According to the cutoff values of HE4,CA125,and ROMA of the patients in various groups,the positive rates of HE4,CA125,and ROMA of the patients in various groups were calculated.Based on the serum levels of human epididymis protein 4(HE4) and carbohydrate antigen 125(CA125) detected before operation of the patients in various groups, the relationships between the positive rates of serum HE4, CA125 and ROMA and the clinical stages of the patients with ovarian cancer;their diagnosis efficacies in the patients with ovarian cancer were evaluated. Results: The serum CA125, HE4 levels and ROMA value of the patients in epithelial ovarian cancer group were significantly higher than those in benign ovarian tumor group and non-epithelial ovarian cancer group (P0.05). Among the three indexes, ROMA had the highest diagnostic efficacy index and CA125 had the lowest.Conclusion: The diagnostic value of ROMA for evaluating the risk of epithelial ovarian cancer was higher than those of CA125 and HE4, which has a better diagnostic value for the postmenopausal patients and can improve the early diagnosis efficiency of ovarian cancer.
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[Abstract] Objective To analyze the difference of the carbohydrate antigen 242 (CA242) results measured by Luminex flow cytometry fluorescence immunoassay with different calibrations and different ambient temperatures, so as to evaluate the effect of ambient temperature on the measurement results. Methods Two CA242 samples with different concentrations (median- and high-value) were selected and the determination was repeated at 11 temperature points (18.3, 20.1, 21.5, 22.2, 24.1, 25.0, 25.4, 26.5, 27.4, 28.5, and 30.0 ℃) for 5 times by Luminex flow cytometry fluorescence immunoassay. The average value of the detection result at the calibration temperature (25 ℃) was taken as the reference value, and the biases of the detection results at different ambient temperatures were calculated. Forty-nine CA242 specimens covering high-, median- and low-values were examined at 20, 25 and 30 ℃ by Luminex flow cytometry fluorescence immunoassay, and the results were compared and correlation analysis was carried out. Results The biases of the median- and high-value samples at 18.3 ℃ were －35.6% and －29.4%, respectively. The difference between the measurement results at 20 ℃ and 25 ℃ was significant for the 49 specimens (P0.001), and there was a linear correlation between them (Y＝0.676 9X＋0.374 7, R2＝0.990 5). The difference of measurement results was significant between 30 ℃ and 25 ℃ (P0.001), and there was a linear correlation between them (Y＝0.896 6X＋0.227 0, R2＝0.999 4). Conclusion Too low or too high ambient temperature has a negative effect on the determination of CA242 by Luminex flow cytometry fluorescence immunoassay. The ambient temperature should be kept relatively constant and controlled within the range of calibration temperature ±4 ℃.