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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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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 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 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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To establish a time-resolved fluorescence immunochromatographic assay for quantitative determination of carbohydrate antigen 19-9 (CA19-9) in serum, we prepared CA19-9 test strips by integrating double-antibody sandwich method and fluorescence immunochromatography technique. Carboxy fluorescent microspheres and nitrocellulose membrane were used as carriers for labeling and coating CA19-9 pairing antibodies. We optimized the process by adjusting the amount of labeling and coating antibody. According to the linear range, lowest detection limit and precision, We evaluated the time-resolved fluorescence immunochromatographic assay of CA19-9. When the amount of labeled antibody was 80 μg for 20 μL fluorescent microspheres, and the concentration of coated antibody on the test line was 1.5 mg/mL, the optimal reaction time was 15 minutes. Assay linear range was 12.5 to 800 U/mL and the minimum detection limit was 6.32 U/mL. The Within-run and between-run coefficient of variation were less than 15%. Average recovery rate was 101%. By detecting 50 clinical samples in parallel with Roche electrochemical luminescence detection kit, correlation coefficient was 0.980 6. The experiment, initially established a fluorescence immunochromatographic detection method to quantitative detection of serum CA19-9, which has a good clinical application prospect.
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Objective: To investigate the application value of high frequency color Doppler flow imaging(CDFI)combined with serum fibrinogen(FIB)and sugar antigen 19-9(CA199)in the preoperative diagnosis of breast cancer.Methods: The clinical data of 226 patients with space occupying lesion of breast were analyzed retrospectively.According to the confirmed situation of postoperative pathological examination,they were divided into breast cancer group(158 cases)and breast disease group(68 cases).All patients received examination of preoperative CDFI and detections of preoperative serum FIB and CA199,and the values of single CDFI examination and it combined with detection of serum FIB and CA199 in preoperative diagnosis of breast cancer were compared.Results: In breast cancer group(158 patients),the ultrasonographic images of 146 patients showed the lumps were hypoechoic or weak echoes,irregular shape and uneven surface,and showed the change of lump appeared cauliflower shape,lobulated or crab foot shape.And the levels of serum FIB and CA199 of breast cancer group were significantly higher than those of breast disease group(t=6.821,t=20.061,P＜0.05),respectively.The sensitivity,negative predictive value and diagnostic coincidence rate of CDFI examination combined with detections of FIB and CA199 for diagnosis of breast cancer were 89.24％,79.76％and 92.04％,respectively.And these were significantly higher than those of single CDFI examination(x2=100.148,x2=37.666,x2=79.636,P＜0.05),respectively.Conclusion: The value of high frequency CDFI examination combined with serum FIB and CA199 in the preoperative diagnosis of breast cancer is significantly higher than that of single examination and single detection,and it has clinical application value.
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Objective To investigate the effect of preoperative carbohydrate antigen 19-9 (CA19-9) levels on the prognosis of hepatocellular carcinoma (HCC) patients with different α-fetoprotein (AFP) levels. Methods The medical records and follow-up data of 3 791 HCC patients undergoing hepatectomy in our hospital from Jan. 4, 2008 to Dec. 31, 2010 were prospectively collected. When 400 ng/mL was taken as the cut-off value of preoperative AFP level and 32 U/mL as the cut-off value of preoperative CA19-9 level, the patients were divided into four groups: double positive group (DP group), CA19-9 single positive group [SP (CA19-9) group], AFP single positive group [SP (AFP) group] and double negative group (DN group). The tumor characteristics of the patients in the four groups were compared. Kaplan-Meier analysis and log-rank test were used to analyze the overall survival (OS) and disease-free survival (DFS) of each group. Univariate and multivariate analyses were performed using Cox proportional hazards model to screen the independent factors influencing the prognosis of HCC patients. Results Patients in the four groups had different tumor characteristics. Compared with the DN group, the tumor maximal diameters of patients in the SP (AFP) and DP groups were significantly larger, the percentages of patients with Edmondson-Steiner grade III- were significantly higher and the positive rates of microvascular invasion (MVI) were significantly higher (P<0.01), and the proportion of multiple tumor in the DP group was significantly higher (P<0.05); while the tumor maximal diameter in the SP (CA19-9) group was significantly smaller (P<0.05), and the proportion of multiple tumor was significantly higher (P<0.01). The 1-, 3- and 5-year OS rates of patients in the DN group, SP (CA19-9) group, SP (AFP) group and DP group were decreased successively (P<0.01). The 1-, 3- and 5-year DFS rates of patients in the DN group were the highest (P<0.01), while those in the DP group were the lowest (P<0.01); there were no significant differences in the 1-, 3- or 5-year DFS rates between the SP (CA19-9) and SP (AFP) groups. The stratified analysis of preoperative AFP levels showed that the 1-, 3- and 5-year OS rates and DFS rates in the CA19-9<32 U/mL group were significantly higher than those in the CA19-9≥32 U/mL group. Multivariable analysis showed that AFP≥400 ng/mL, CA19-9≥32 U/mL, intraoperative bleeding≥600 mL, tumor maximal diameter≥5 cm, multiple tumor, absence of tumor capsule, MVI, and Edmondson-Steiner grade III- were independent risk factors of OS (P<0.05); hepatitis B surface antigen (＋), AFP≥400 ng/mL, CA19-9≥32 U/mL, tumor maximal diameter≥5 cm, multiple tumor, absence of tumor capsule, and MVI were independent risk factors of DFS (P<0.05). Conclusion Preoperative serum AFP≥400 ng/mL and CA19-9≥32 U/mL are independent risk factors of OS and DFS in HCC patients. Preoperative CA19-9 level is an important indicator to further assess the prognosis of HCC patients with different AFP levels.
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Objective To investigate the clinical significance of joint application of carcinoembryionic and carbohydrate antigen 19-9 for improving the prognosis of patients with gallbladder cancer.Methods A retrospective analysis of clinical-pathological features and prognosis were conducted including 390 patients with gallbladder cancer,who were treated from January 2003 to December 2013 at Eastern Hepatobiliary Surgery Hospital of Second Military Medical University.The clinical value of joint application of careinoembryionic and carbohydrate antigen 19-9 in prognosis was explored.The survival of patients was followed up by telephone or outpatient.Continuous variables were indicated as median (average) and categorical variables were expressed as number(n).Mann-Whitney U test was applied for continuous variables.Categorical variables were compared by the Chi-square test or Fisher probability method.The survival curve was drawn by the Kaplan-Meier method.The univariate analysis and multivariate analysis of prognosis were respectively done using the Log-rank test and COX regression model.Results Of the 390 patients,327 had complete data.The median (range) follow-up time was 49 (1-123) months.Both carcinoembryionic and carbohydrate antigen 19-9 could be used to predict prognosis of gallbladder cancer.A linear combination of carcinoembryionic and carbohydrate antigen 19-9 was significantly better(0.9365) than carbohydrate antigen 19-9 (0.7619) as well as carcinoembryionic (0.7937) alone in term of specificity.Preoperative blood test carcinoembryionic and carbohydrate antigen 19-9 nature showed double-negative group had the best prognosis,with a median survival of 27.06 months,R0 radical rate was 86.1％.Doublepositive group had the worst prognosis,with a median survival of 6.17 months,R0 radical rate was 45.1％.Conclusions Combinations of pretherapeutic tumor makers carcinoembryionic and carbohydrate antigen 19-9 can improve the accuracy of predicting prognostic in patients with gallbladder cancer,and the clinical application is practical.
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Objective To analyze the clinical characteristics and enhancement pattern on contrast-enhanced ultrasound (CEUS) of combined hepatocellular-cholangiocarcinoma (cHCC-CC).Methods A total of 49 patients who were pathologically confirmed as cHCC-CC by surgery and underwent CEUS examination in Southwest Hospital Affiliated to Third Military Medical University from January 2005 to February 2015 were retrospectively enrolled.There were 3 enhancement patterns on CEUS:hepatocellular carcinoma (HCC) pattern,cholangiocarcinoma (CC) pattern and indeterminate pattern.The proportions of HCC pattern and CC pattern of cHCC-CC were compared by x2 test.And the proportions of tumour maker elevation [(alpha-fetoproteins,AFP) and/or (carbohydrate antigen,CA19-9)] in accordance or discordance with enhancement patterns were compared by x2 test.Results Among the 49 cHCC-CC patients,44 were male and 5 were female.Mean age was (52.3 ± 9.8) years old (range:28-74 years old).Of all cases,41 (83.7％,41/49) patients had single nodule.Mean size of nodule was (5.3 ± 3.5) cm (range:1.5-13.8 cm),and the size of 51.0％ (25/49) lesions were ＜ 5 cm.Totally 34 (69.4％,34/49) patients had pathologically diagnosed cirrhosis.AFP elevation was found in 31 (63.3％,31/49) patients,CA19-9 elevation was found in 12 (24.5％,12/49) patients,simultaneous elevation of both AFP and CA19-9 was found in 9 (18.4％,9/49) patients.The percentages of CC pattern and HCC pattern were 51.0％ (25/49) and 44.9％ (22/49) respectively.And there was no significant difference between the two patterns (x2=0.368,P=0.544).In 9 patients with simultaneous elevation of both AFP and CA19-9,CC pattern was observed in 5 patients and HCC pattern was noted in 4 patients.There were 12 (24.5％,12/49) patients with tumor marker elevation (AFP or CA19-9) in discordance with enhancement patterns on CEUS.Among the 12 cases,9 cases with AFP elevation were CC patterns on CEUS and 3 cases with CA19-9 elevation were HCC patterns on CEUS.Simultaneous elevation of tumor makers (AFP and CA19-9) or tumor mark elevation (AFP or CA19-9) in discordance with enhancement patterns on CEUS was found in 21 (42.9％,21/49) patients,which was significantly more than simultaneous elevation of AFP and CA19-9 alone (18.4％,9/49) (x2=6.918,P=0.009).Conclusions Clinical characteristics of patients with cHCC-CC were similar to that of patients with HCC.The proportion of HCC pattern and CC pattern was comparable.Combination of test of tumor makers (AFP and CA19-9) and enhancement pattern on CEUS maybe helpful for the diagnosis of cHCC-CC.
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Objective To observe the changes of the levels of serum hemoglobin (HGB),vascular endothelial growth factor (VEGF),carcinoembryonic antigen (CEA),carbohydrate antigen 19-9 (CA19-9) and carbohydrate antigen 125 (CA125) in patients with gastric cancer before and after chemotherapy;and to investigate the correlation between the changes of the levels of the serum indexes and the effect of chemotherapy.Methods A total of 100 patients with gastric cancer were selected from June 2015 to June 2016 in the Central Hospital of Tongchuan Mining Bureau.All patients were treated with the primary chemotherapy regimen with fluorouracil and paclitaxel.The levels of serum HGB,VEGF,CEA,CA19-9 and CA125 were detected before and after one cycle of chemotherapy.The curative effect was evaluated after two cycles of chemotherapy.Results Among the 100 patients after two cycles of chemotherapy,there were 25 cases with partial remission (effective group),37 cases with stable disease(stable disease group) and 38 cases with progressive disease (progressive disease group).There was no significant differences in serum HGB level of the 100 patients before and after chemotherapy (P ＞ 0.05),but the levels of serum VEGF,CEA,CA19-9 and CA125 after chemotherapy were significantly lower than those before chemotherapy (P ＜0.05).There was no significant difference in serum HGB,VEGF,CEA,CA19-9 and CA125 levels among the three groups before chemotherapy (P ＞ 0.05).The levels of serum HGB,VEGF,CEA,CA19-9 and CA125 after chemotherapy were significantly lower than those before chemotherapy in the effective group (P ＜ 0.05).There was no significant difference in the levels of serum HGB,VEGF,CEA,CA19-9 and CA125 before and after chemotherapy in the stable disease group (P ＞ 0.05).There was no significant difference in the levels of serum HGB,VEGF,CEA and CA19-9 before and after chemotherapy in the progressive disease group (P ＞ 0.05);but the level of serum CA125 after chemotherapy was significantly higher than that before chemotherapy (P ＜ 0.05).The levels of serum HGB,VEGF,CEA,CA19-9 and CA125 in the effective group were significantly lower than those in the stable disease group and the progressive disease group after chemotherapy (P ＜ 0.05).There was no significant difference in serum HGB,VEGF and CA19-9 levels between the stable disease group and the progressive disease group (P ＞ 0.05);but the levels of serum CEA and CA125 in stable disease group were significantly lower than those in the progressive disease group after chemotherapy (P ＜ 0.05).Multiple regression analysis showed that the changes of the levels of serum CEA,CA19-9,CA125 and VEGF were significantly correlated with the effect of chemotherapy (P ＜ 0.05);the sequence of the correlation was CEA,CA19-9,CA125 and VEGF.There was no significant correlation between the serum HGB level and the effect of chemotherapy (P ＞0.05).Conclusion The changes of serum CEA,CA19-9,CA125 and VEGF levels were correlated with the effect of chemotherapy in patients with gastric cancer.Detecting serum CEA,CA19-9,CA125 and VEGF levels is helpful to predict the effect of chemotherapy.
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Objective To investigate the treatment efficacy of capecitabine combined with TACE for hepatic metastases after colorectal carcinoma resection.Methods The clinical data of 94 patients who were treated for hepatic metastases after colorectal carcinoma resection from June 2012 to December 2014 were retrospectively analyzed.The patients were divided into the combined group (48 patients) who underwent combined treatment of transcatheter arterial chemoembolization (TACE) and capecitabine,and the control group (46 patients) who were treated with TACE alone.The drug toxicities induced by chemotherapy in patients of the two groups were noted.The short-term outcomes and serum tumor markers were compared at 3-months after completion of TACE.All the patients were followed up and their overall survival was recorded.Results There was no significant difference in the frequency of TACE between the two groups (P ＞ 0.05).There were significant differences in the short-term outcomes at 3-month after completion of TACE (Z =2.000,P ＜ 0.05).The RR (complete response + partial response) and CBR (complete response + partial response + stable disease) were higher in the combined group than those in the control group [(52.1％ vs.32.0％) and (95.8％ vs.87.0％),respectively],although the differences were not statistically significant (both P ＞0.05).There were greater declines in CEA and CA19-9 levels at 3-month after completion of TACE in the combined group than the control group [(47.1 ± 10.3 vs.35.1 ±8.4) μg/L,(78.7 ± 19.6 vs.65.3 ± 17.0) kU/L],but the differences were not significant (t1 =5.776,t2 =7.849,both P ＜ 0.05).Toxic reactions were more common in the combined group than those in the control group,which included bone marrow suppression (39.6％ vs.30.4％) and peripheral neuritis (47.9％ vs.34.8％).Again,the differences were not significant (P ＞ 0.05).The median survivals were 17.3 months and 13.5 months,and 1-year survival rates were 72.9％ and 52.1％ in the combined group and the control group,respectively (x2 =4.325,P ＜ 0.05).There were significant differences in the survival between the two groups (x2 =4.097,P ＜ 0.05).Conclusions Capecitabine combined with TACE produced better treatment results for hepatic metastases after colorectal carcinoma resection.The short-term outcomes of the combined treatment was suDerior to TACE alone,and the treatment toxicities could be tolerated.
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Objective To investigate the treatment efficacy of capecitabine combined with TACE for hepatic metastases after colorectal carcinoma resection.Methods The clinical data of 94 patients who were treated for hepatic metastases after colorectal carcinoma resection from June 2012 to December 2014 were retrospectively analyzed.The patients were divided into the combined group (48 patients) who underwent combined treatment of transcatheter arterial chemoembolization (TACE) and capecitabine,and the control group (46 patients) who were treated with TACE alone.The drug toxicities induced by chemotherapy in patients of the two groups were noted.The short-term outcomes and serum tumor markers were compared at 3-months after completion of TACE.All the patients were followed up and their overall survival was recorded.Results There was no significant difference in the frequency of TACE between the two groups (P ＞ 0.05).There were significant differences in the short-term outcomes at 3-month after completion of TACE (Z =2.000,P ＜ 0.05).The RR (complete response + partial response) and CBR (complete response + partial response + stable disease) were higher in the combined group than those in the control group [(52.1％ vs.32.0％) and (95.8％ vs.87.0％),respectively],although the differences were not statistically significant (both P ＞0.05).There were greater declines in CEA and CA19-9 levels at 3-month after completion of TACE in the combined group than the control group [(47.1 ± 10.3 vs.35.1 ±8.4) μg/L,(78.7 ± 19.6 vs.65.3 ± 17.0) kU/L],but the differences were not significant (t1 =5.776,t2 =7.849,both P ＜ 0.05).Toxic reactions were more common in the combined group than those in the control group,which included bone marrow suppression (39.6％ vs.30.4％) and peripheral neuritis (47.9％ vs.34.8％).Again,the differences were not significant (P ＞ 0.05).The median survivals were 17.3 months and 13.5 months,and 1-year survival rates were 72.9％ and 52.1％ in the combined group and the control group,respectively (x2 =4.325,P ＜ 0.05).There were significant differences in the survival between the two groups (x2 =4.097,P ＜ 0.05).Conclusions Capecitabine combined with TACE produced better treatment results for hepatic metastases after colorectal carcinoma resection.The short-term outcomes of the combined treatment was suDerior to TACE alone,and the treatment toxicities could be tolerated.
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Abstract Increased serum CA 19-9 levels in patients with nonmalignant diseases have been investigated in previous reports. This study evaluates the clinical significance of serum CA 19-9 elevation in pulmonary nontuberculous mycobacterial disease and pulmonary tuberculosis. The median CA 19-9 level was higher in patients with pulmonary nontuberculous mycobacterial disease than in patients with pulmonary tuberculosis (pulmonary nontuberculous mycobacterial disease: 13.80, tuberculosis: 5.85, p < 0.001). A multivariate logistic regression analysis performed in this study showed that Mycobacterium abscessus (OR 9.97, 95% CI: 1.58, 62.80; p = 0.014) and active phase of pulmonary nontuberculous mycobacterial disease (OR 12.18, 95% CI: 1.07, 138.36, p = 0.044) were found to be risk factors for serum CA 19-9 elevation in pulmonary nontuberculous mycobacterial disease. The serum CA 19-9 levels showed a tendency to decrease during successful treatment of pulmonary nontuberculous mycobacterial disease but not in pulmonary tuberculosis. These findings suggest that CA 19-9 may be a useful marker for monitoring therapeutic responses in pulmonary nontuberculous mycobacterial disease, although it is not pulmonary nontuberculous mycobacterial disease-specific marker.
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Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , /blood , Lung Diseases/blood , Mycobacterium Infections, Nontuberculous/classification , Anti-Bacterial Agents/administration & dosage , Biomarkers/blood , Drug Therapy, Combination , Lung Diseases/drug therapy , Lung Diseases/microbiologyABSTRACT
Objective Our retrospective study was aimed to analyze the clinical value of serum CEA and CA19-9 in patients with chole-lithiasis.Methods The clinical data of 98 patients with cholelithiasis and 44 patients with inguinal hernia received treatment in our hospital from February 2011 to February 2015 were retrospectively analyzed.The expressive levels of CEA and CA19-9 of the patients were detected and compared.The important roles of CEA and CA19-9 in the patients with cholelithiasis were analyzed.Results The levels of CEA,CA19-9 and inflammatory factors in normal group and control group had no statistical differences (P>0.05).The levels of CEA,CA19-9 and inflam-matory factors in rising group were higher than those in control group (P0.05),but the levels of CEA,CA19-9,inflammatory factors in rising group were obvi-ously decreased( P<0.05) .Conclusion The levels of CEA and CA19-9 in patients with cholelithiasis had correlation with inflammation of biliary tract,which will increased by severe choleithiasis.
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Objective To evaluate the significance of the expression of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) as prognostic indicators for patients with stage Ⅱ colorectal cancer. Methods A total of 285 patients with stage Ⅱcolorectal cancer who underwent potentially curative surgery were enrolled in the study. A high CEA level was defined as a level exceeding 5 ng/ml and a high CA19-9 level was defined as a level exceeding 37 U/ml. Patients were followed up every 3 months to review CEA and CA19-9 levels. Two years later, the chest and abdominal CT examination were performed every 3 months, and then every 6 months until 5 years. Results Out of these 285 patients, 99 (42.60%) patients had high CEA levels, 25 (8.77 %) patients had high CA19-9 levels, and 12 (4.21 %) patients had both high CEA and CA19-9 levels. The overall survival rates of patients with both high CEA and CA19-9 levels were significantly worse than those of others (P< 0.05). During the study, 51 recurrences were diagnosed. There were 22 hepatic recurrences, 10 pulmonary recurrences, 9 local recurrences, 8 lymph node recurrences, and 2 peritoneal recurrences. CT, CEA and CA19-9 were the first abnormal examinations in 30, 5 and 8 recurrent patients, respectively. In 27 % of recurrent patients, the recurrence was detected earlier by CEA and CA19-9 than that by CT. Conclusions The detection of preoperative CEA and CA19-9 levels is useful for predicting the prognosis after potentially curative surgery in patents with stage Ⅱ colorectal cancer. For early detection of occult recurrence of colorectal cancer, tumor markers are relevant.
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Elevated carbohydrate antigen (CA) 19-9 can indicate malignancies of the gastrointestinal, pancreatic, and biliary tracts, and be found in a pulmonary sequestration. A 30-year-old man visited Seoul National University Bundang Hospital due to elevated CA 19-9 levels, representing pulmonary sequestration of the bilateral lower lobes, which were connected with each other. We performed left lower lobectomy and division of the systemic arteries. After operation, CA 19-9 levels decreased to normal range, even though a small amount of sequestrated lung remained in the right lower lobe. It is not uncommon that presence of pulmonary sequestration might elevate serum CA 19-9 levels; however, horseshoe type bilateral pulmonary sequestration is very rare.
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Adult , Humans , Arteries , Biliary Tract , Bronchopulmonary Sequestration , Lung , Reference Values , SeoulABSTRACT
Objective To explore the clinical significance of the serum cell-free DNA on early diagnosis and prognostic value of patients with cervical carcinoma. Methods Forty-five patients with cervical carcinoma and 50 healthy women from May 2012 to February 2014 were selected from the Central Hospital of Ezhou. Serum cell-free DNA(cf-DNA),carbohydrate antigen125(CA125),carbohydrate antigen19-9(CA19-9), squamous cell carcinoma antigen( SCC ),β-human chorionic gonadotropin( β--HCG ) were detected by electrochemiluminescence analyzer. Results The levels of serum cf-DNA,SCC,β-HCG of patients in the cervical carcinoma group were(178. 8 ± 43. 4)μg/ L,(0. 7 ± 0. 3)μg/ L,(1. 3 ± 0. 4)kU/ L respectively, higher than those in health women((1 354. 7 ± 267. 2)μg/ L,(1. 4 ± 0. 4)μg/ L,(5. 2 ± 0. 6)kU/ L),and the differences were significant(t = 30. 690,9. 709,37. 614;P < 0. 001). Serum cf-DNA level of patients with Ⅱ-Ⅲperiod cervical carcinoma was(2 538. 8 ± 775. 3)μg/ L,higher than patients with Ⅰ period((1 244. 7 ± 253. 6)μg/ L;t = 8. 191,P < 0. 001). The area under the curve of ROC of serum cf-DNA,CA125,CA19-9, SCC,β-HCG were 0. 951 6,0. 638 2,0. 614 4,0. 805 7,0. 753 1 respectively and the AUC of serum cf-DNA was the largest. The sensibility,specificity,accuracy of cf-DNA were 75. 56% ,99. 13% ,93. 36% and 28. 32% , 93. 24% ,64. 26% in terms of CA125. Meanwhile,the sensibility,specificity,accuracy of CA19-9 were 19. 75% , 94. 47% ,67. 28% and 38. 87% ,88. 53% ,80. 16% in terms of SCC. The sensibility,specificity,accuracy of β-HCG were 43. 28% ,86. 21% ,77. 83% respectively. Conclusion Serum cf-DNA has high sensibility, specificity and accuracy in early diagnosis and prognostic value of patients with cervical carcinoma and it is worthy of clinical promotion.
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Objective To study the diagnostic value of CT combined with serum carbohydrate antigen 19-9(CA19-9), carcinoembryonic antigen(CEA), carbohydrate antigen 125(CA125)in diagnosis of pancreatic cancer.Methods 68 patients with pancreatic occupying lesions were selected and they were divided into pancre -atic cancer group(n=43)and non-pancreatic cancer group(n=25)according to pathological diagnosis.34 cases from physical examination were set as the control group .All patients received CT examination and the consistency between CT diagnosis and pathological results was analyzed .Serum CA19-9, CEA, and CA125 were detected by chemiluminescence method.The sensitivity, specificity and accuracy of CT combined serum CA 19-9, CEA, CA125 were analyzed.Results Among the 68 cases, 35 cases were pancreatic cancer diagnosed by CT , and the CT diagnosis was not ideal compared with pathological results .Nonparametric test found that serum CA 19-9, CEA and CA125 in pancreatic cancer group were higher than those of the non-pancreatic cancer group and the control group, and the difference had statistical significance ( P0.05 ) .Conclusion CT diagnosis had high susceptibility and low specificity ,CT combined with serum CA19-9,CEA, and CA125 can improve accuracy of pancreatic cancer diagnosis .
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Objective To analyse effect of ShenQi FuZheng injection on serum carbohydrate antigen 19-9(CA19-9), C-reaction protein(CRP) and CD4 +lymphocyte subsets in patients after laparoscopic radical resection of colon cancer.Methods 58 patients after laparoscopic radical resection of colon cancer were collected.All patients were randomly divided into experimental group and control group according to the different drugs, 29 cases in each group.Patients were given the corresponding drug treatment after operation, after the treatment, the serum levels of CA19-9, CRP and venous blood T lymphocyte level were detected in all patients.Results Compared with before treatment, CA19-9 and CRP level in serum were lower (P<0.05) , CD4 +cells, CD4 +/CD8 +, and NK cells were higher(P<0.05);Compared with control group after treatment, the serum CA19-9 and CRP level were lower in the experimental group (P<0.05); the levels of venousblood CD4 +cells, CD4 +/CD8 +and NK cells were higher in the experimental group (P<0.05).Conclusion ShenQi FuZheng injection can significantly reduce the serum CRP and CA19-9 levels in patients after laparoscopic radical resection of colon cancer, improve the levels of venous blood CD4 +cells, CD4 +/CD8 +and NK cells, improve immune function, and have a guiding significance for clinica.