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Objective: To investigate the value of joint detection of soluble triggering receptor expresses on myeloid cells-1(sTREM-1) and procalcitonin (PCT) in the early diagnosis of children with sepsis. Methods: 78 children with sepsis were selected into the sepsis group, 23 children with common infection were selected into the normal infection group. In addition, 25 healthy children selected into the health control group. The levels of sTREM-1, PCT, and C reactive protein (CRP) among the three groups were compared, respectively. And then, the sepsis group were further divided into general sepsis subgroup (32 cases), severe sepsis subgroup (26 cases) and septic shock subgroup (20 cases) according to the degree of sepsis. The levels of sTREM-1, PCT and CRP among the three sepsis subgroups were compared. And the receiver operating characteristic (ROC) curve was adopted to analyze the value that diagnosed children with sepsis by using the three indicators. Results: The levels of sTREM-1, PCT and CRP of sepsis group were significantly higher than those of common infection group and health control group (t=22.071, t=21.508, t=17.870, t=55.167, t=52.070, t=30.359, P<0.05). The differences of sTREM-1 and PCT among various sepsis subgroups were significant (H=22.082, H=39.449, P<0.05), but the difference of CRP level between septic shock subgroup and severe sepsis subgroup was no significant. As the compared result of AUC of ROC of diagnosing sepsis, the AUC of sTREM-1 was maximum (0.88), and its 95% confidence interval (CI) was 0.78-0.98. At the optimum cutoff value of sTREM-1, the sensitivity and specificity were 83.33% and 68%, respectively, and they were higher than those of PCT and CRP, respectively. Besides, the cutoff values of sTREM-1 and PCT were used as standard to carry out joint diagnosis for children with sepsis, and the sensitivity and specificity were 91.03% and 64%, respectively, at this joint diagnosis. Conclusion: The joint detection of sTREM-1 and PCT has higher sensitivity in the early diagnosis of children with sepsis and it has a certain clinical application value.
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Objective To study the plasma heat shock protein 90 alpha (HSP90 α) in the diagnosis of lung cancer.Methods Chose 166 cases of patients with lung cancer,lung cancer group,the same physical examination of 20 cases of normal (control group),application of plasma concentration of HSP90 α enzyme-linked immunoassay detection,chemiluminescence detection of CEA,NSE,SCC and CYFRA21-1,of the two groups of data by t test statistical analysis,compared two groups of plasma HSP90 α level.With plasma HSP90 alpha was greater than 86 ng/ml for the critical value,calculation of HSP90 α testing sensitivity.Patients with lung cancer by histopathologic classification,compare different tumor classification in patients with plasma HSP90 α level.Used Pearman's correlation method to analyse the relationship of HSP90 α,CEA and NSE in patients with lung cancer,between SCC and CYFRA21-1 and used ROC curve to evaluate HSP90 α efficiency to the diagnosis of lung cancer.Results ① In lung cancer group and control group in the indicators HSP90 α,CEA,NSE,SCC and respectively CYFRA21-1 190.33±105.86 vs 41.02±19.73 ng/ml,8.68±5.02 vs 4.02±1.36 ng/ml,36.32±13.16 vs 8.32 ±3.96 ng/ml,6.21±1.62 vs 1.23±0.64 ng/ml,10.63±4.33 vs 3.02±1.66 ng/ml.Compared with control group (t=10.48,8.66,12.36,9.52,15.36,P＜0.01),the difference was statistically significant.② For biological reference range (HSP90 α:0～86 ng/ml,CEA 1.0～5 ng/ml,NSE:1.0～17.5 ng/ml,SCC:0.2～1.6 ng/ml,CYFRA21-1:1.0～2.6 ng/ ml) as the standard in lung cancer group,HSP90 α increased 73.49 ％,CEA increased 19.27 ％,NSE increased 19.27 ％,CYFRA21-1 (21.68％) and SCC increased 29.51％.③ Patients with lung cancer by histopathologic classification,different concentration of tumor classification HSP90 α was no difference (P＞0.05).④Spearman rank correlation analysis showed that HSP90 α levels were positively correlated with CYFRA21-1 (r,=0.44,P＜0.01).The difference was statistically significant (F=14.98,P =0.00).HSP90 α and CEA,NSE,SCC had no relevance.⑤ HSP90 α and CEA,NSE,SCC,CYFRA21-1 the area under the ROC curve (AUC) in the diagnosis of lung cancer were:0.961,0.562,0.731,0.465 and 0.632 best cutoff value were 89.3 ng/ml,6.32 ng/ml,18.63 ng/ml,1.93 ng/ml and 2.36 ng/ml.Sensitivity of 73.49％,52.3％,73.49％,59.6％ and 62.1％,specific degrees respectively.Accuracy of 98.6％,46.3％,66.3％,98.6％ and 46.3％,respectively,88.4％,80.3％,86.9％,87.2％ and 89.2％ of the five joint,the sensitivity of diagnosis of lung cancer and specific degrees respectively 100％ and 75％.Conclusion Using ROC curve analysis showed that HSP90 α plays an auxiliary role in diagnosis of lung cancer,CEA,NSE,CYFRA21-1 and SCC can significantly increase the detection rate of lung cancer.
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Objective To investigate the clinical value of serum glycyl-proline dipeptidyl aminopeptidase(GPDA)combined with carcino-embryonic antigen (CEA),carbohydrate antigen724 (CA724),carbohydrate antigen242 (CA242) in the early diagnosis of gastric cancer.Methods Collected in Changan hospital in patients with gastric cancer and atrophic gastritis patients and healthy subjects 60 cases,by TBA-120FR biochemical analyzer glycyl-proline dipeptidyl aminopeptidase (GPDA),chemiluminescence analyzer to detect the levels of serum CEA,CA724 and CA242,analysis of single detection and joint detection and the differences between the positive rate and sensitivity.Results The detection of GPDA in gastric cancer group was significantly lower than that in atrophic gastritis group and healthy control group,the difference was statistically significant (F=69.532,P=0.000).The results of CEA,CA724 and CA242 in gastric cancer group were higher than those in atrophic gastritis group and healthy control group,the difference was statistically significant (CEA:F=59.926,P=0.001;CA724:F=51.056,P =0.001;CA242:F =72.613,P =0.000).Serum GPDA,CEA,CA724 and CA242 single detection positive rate were 70 ％,45 ％,61.7 ％ and 50 ％.Tumor markers CEA,CA724,CA242 positive rate of three joint detection was 75％.Serum GPDA and tumor markers of CEA,the positive rate of CA724 and CA242 combined detection of four was 86.7％.The positive rate of three and higher than that of single detection,the difference was statistically significant (F=49.635,P=0.003).Serum GPDA,CEA,CA724 and CA242 single detection sensitivity was 70.2 ％,50.2 ％,67.3 ％ and 53.2％.Tumor markers CEA,CA724,CA242 three joint detection sensitivity was 85.6％.Serum GPDA and tumor markers CEA,CA724 and CA242 four joint detection sensitivity was 90.3％.The sensitivity was higher than the three items and the individual tests,and the difference was statistically significant (F=52.016,P =0.001).Conclusion GPDA joint CEA,CA724 and CA242 tumor markers detection can improve the positive rate and sensitivity in early diagnosis of gastric cancer,but it will not reduce the diagnostic specificity,the clinical diagnosis of early gastric cancer has important significance and value.
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Objective To investigate the clinical value of joint detection of six tumor markers in patients with colorectal cancer. Methods Eighty?six patients with colorectal cancer were included in the study group,86 healthy subjects were selected as the control group at the same period. The difference of tumor markers in different groups,tumor stages and prognosis were compared. Results The levels of carcinoembryonic antigen (CEA),carbohydrate antigen 19?9 (CA19?9),carbohydrate antigen 242 (CA242),carbohydrate antigen 72?4 ( CA72?4) , carbohydrate antigen 125 ( CA125 ) and carbohydrate antigen 50 ( CA50 ) in study group were significantly higher than those in the control group (CEA: (22. 5±6. 2)μg/L vs. (2. 2±1. 0)μg/L;CA19?9:(95. 7±27. 3) U/ml vs. (17. 1±9. 5) U/ml;CA242:(29. 5±8. 3) U/ml vs. (6. 0±2. 7) U/ml;CA72?4:(21. 6 ±5. 1) U/ml vs. (3. 6±1. 2) U/ml;CA125:(95. 4±32. 8) U/ml vs. (18. 9±8. 4) U/ml;CA50:(51. 8±20. 6)μg/L vs. (8. 3±3. 7)μg/L,t=29. 98,25. 22,24. 97,31. 86,20. 95,19. 27,P<0. 05). Among the single index detections,the sensitivity and negative predictive value of CA72?4 were the highest ( 61. 6%, 68. 3%) , the specificity of CA19?9 was the highest( 91. 9%) ,the positive predictive value of CEA was the highest ( 80. 4%) . The sensitivity,positive predictive value and negative predictive value of the joint detection were all higher than those in each single index detection (80. 3%,87. 3%,74. 1%). The levels of CEA,CA19?9,CA242,CA72?4, CA125 and CA50 in patients with stage III and IV were significantly higher than those in patients with stageⅠandⅡ(CEA:(32. 7±7. 1)μg/L vs. (15. 9±4. 4)μg/L;CA19?9:(127. 8±33. 7) U/ml vs. (52. 5±13. 8) U/ml;CA242:(40. 3±12. 7) U/ml vs. (23. 5±8. 6) U/ml;CA72?4:(37. 6±10. 2) U/ml vs. (13. 6±4. 1) U/ml;CA125:(128. 9±38. 4) U/ml vs. (59. 7±12. 8) U/ml;CA50:(88. 3±23. 7)μg/L vs. (41. 8±15. 6)μg/L,t=13. 04,13. 32,7. 11,14. 06,10. 99,10. 64,P<0. 05) . The levels of CEA,CA19?9,CA242,CA72?4,CA125 and CA50 in the recurrent metastasis group were significantly higher than those in the non?recurrent metastasis group ( CEA:( 37. 7 ± 8. 6 ) μg/L vs. ( 3. 8 ± 1. 7 ) μg/L;CA19?9:( 110. 5 ± 29. 4 ) U/ml vs. ( 25. 5 ± 13. 8 ) U/ml;CA242:( 33. 6 ± 10. 3 ) U/ml vs. ( 15. 5 ± 6. 6 ) U/ml;CA72?4:( 33. 1 ± 15. 3 ) U/ml vs. ( 9. 3 ± 3. 0 ) U/ml;CA125:(113. 4±31. 7) U/ml vs. (28. 7±7. 8) U/ml;CA50:(55. 4±14. 6)μg/L vs. (16. 8±9. 6)μg/L,t=29. 04,18. 31,9. 86,11. 47,19. 28,14. 65,P<0. 05) . Conclusion The joint detection of six markers can further improve the sensitivity, positive predictive value and negative predictive value of diagnosis, and can provide a more reliable basis for the auxiliary diagnosis of colorectal cancer.
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Objective To investigate the characteristics of EGFR,ALK and ROS1 mutations in patients with non-small cell lung cancer (NSCLC) in South of China and its relationship with clinical features.Methods The tumor tissues and corresponding clinical data of 76 NSCLC patients in South of China from November 2016 to June 2017 were collected.The mutations of EGFR,ALK and ROS1 were detected by ARMS assay with Joint detection kit.Meanwhile,the correlation between gene mutation rate and clinical features was analyzed.Results The mutation rate of EGFR was 67.3％ (42/76) in 76 patients with NSCLC in South of China,19 del and L858R mutations were the main mutation types.There was a co-mutation including 19 del and L858R.The positive rate of ALK gene fusion was 17.1％ (13/76),and 4 cases of ALK gene fusion combined with EGFR mutation were detected.The positive rate of ROS1 gene fusion was 1.3％ (1/76),and there was no co-mutation with other genes.Compared with ROS1,EGFR and ALK mutation rate was higher,the difference was statistically significant (x2 =54.515,P =0.000;x2 =11.329,P =0.001).The mutation rate of EGFR in non-smoking NSCLC patients was significantly higher than that in smokers (x2 =4.578,P=0.032),while the mutation rate of ALK and ROS1 was not statistically significant (x2=0.000,P＞0.05).There was no statistically significant difference in EGFR,ALK and ROS1 gene mutation rates among NSCLC patients of different age,sex and histology (x2 =0.000 ～ 2.219,P＞ 0.05).Conclusion EGFR,ALK and ROS1 gene mutations can be seen in patients with NSCLC in South China,in which EGFR and ALK gene mutation rate is higher.
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Objective To investigate the diagnostic value of serum Cystatin C and 24 h urine microalbumin quantitative exami-nation in the early gestational diabetes kidney.Methods Chose 110 cases of patients from 37 to 40 weeks during pregnancy with gestational diabetes.According to the GFR,patients were divided into GFR moderate decline group A (30 ml/min/1.73m2 ≤GFR0.05).There was positive correlation between levels serum Cys C and urine microalbumin in group A and B (r=0.756,0.725,t=5.209,4.835,P <0.01,respectively).The sensitivity of Cys C and urine microalbumin were 95.2% and 90.5%,sensitivity of the combination of Cys C and urine microalbumin was 100% (χ2 =8.24,7.08,P <0.05,respectively).Conclusion As sensitive indicators of gestational diabetes in the early renal damage stage,joint detection of Cys C and urine microalbumin is of great significance for diagnosis and monitoring of diabe-tes in the early renal damage stage.
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Objective To invetigate the application value of antigen‐antibody joint detection in increasing the detection rate of hepatitis C infection in the patients with hemodialysis .Methods The clinical data of 100 cases of hemodialysis were collected .Hep‐atitis C virus(HCV) core antigen ,HCV antibody and HCV‐RNA were detected by adopting ELISA ,Chemiluminescence and RT‐PCR respectively .The positive expression situation of each detection item in the same specimen was performed statistics .The detec‐tion rates of RNA positive specimen were compared among the single antigen detection ,single antibody detection and joint detection schemes ;at the same time the antigen level of antigen positive specimens ant its RNA copy number were performed the correlation analysis .The antibody levels in the positive antibody specimens were compared between the RNA positive group and the RNA neg‐ative group .Results The single antigen or single antibody detection could cause the missed detection of HCV infection in hemodial‐ysis patients .For the specimens of positive RNA ,the joint detection had the highest detection rate (P0 .05) .Conclusion The joint detection of HCV antigen antibody can effectively increase the detection rate of hepatitis C infection in hemodialysis patients .At the same time the HCV core antigen detection also can be used as one of monitoring indicators for the HCV re -infection in the patients with antibody positive .
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Objective To explore the value of joint detection of serum cystatin C (Cys C) ,retinol‐binding protein(RBP) ,urea ni‐trogen(BUN) and creatinine(Cr) in early diagnosis of nephropathy .Methods A total of 230 cases of inpatients with nephropathy form April 2013 to June 2014 were collected and divided into diabetic nephropathy group (130 cases)and hypertensive nephropathy group(100 cases) .Other 200 healthy individuals were collected as healthy control group .The serum levels of Cys C ,RBP ,BUN and Cr were detected by using the Hitachi 7180 automatic biochemistry analyzer .Results Compared with the healthy control group ,the sertum levels of Cys C ,RBP ,BUN and Cr were significantly increased in the diabetic nephropathy group ,and the serum levels of Cys C and RBP were significantly increased in hypertensive nephropathy group ,there were statistically significant differences (P0 .05) .Positive rates(81 .9% ) of the four indicators in the two nephropathy groups were high‐er than those in the healthy control group ,and the positive rate of joint detection of the four indicators was higher than single detec‐tion in patients with nephropathy .Conclusion Serum RBP and Cys C are sensitive indicators for early renal damage ,and combined with BUN and Cr could increase sensitivity of early diagnosis of nephropathy ,which has significant clinical value .
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Objective To investigate the expressions of amyloid precursor protein and β-microtubule protein,and to study their clinical significance in patients with cerebral infarction.Methods 108 cases of acute cere-bral infarction as the observation group and 60 normal adults as the control group were collected in the study.The expressions of amyloid precursor protein and β-microtubule protein in different clinical characters were detected by western blot.Results The results of observation group [APP:(168.78 ±13.64)μg/L,β-tubulin:(124.64 ± 27.08)μg/L]were significantly higher than those in control group (t =22.81,P <0.01;t =21.08,P <0.01).Their expressions were correlated with CT scores and prognosis.Conclusion The higher expressions of amyloid precursor protein and β-microtubule protein may promote the occurrence and development in patients with cerebral infarction. The joint detection should be helpful to predict the prognosis and direct the treatment.
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Objective To investigate the clinical value of CA125, CA153, HE4 joint detection in diagnosis of gynecological malignancies.Methods 70 cases of gynecological malignancies were selected from our hospital in 2013, 72 cases of benign gynecological diseases selected in the same period, and 70 healthy controls were selected. The expression levels of CA125, CA153 and HE4 were detected and statistically analyzed.Results The positive rate of serum CA125 in the gynecological malignancies group was higher than that in the benign gynecological disease group (p <0.05).The positive rate of serum HE4 in the gynecological malignancies group was higher than that in the benign gynecological disease group (p <0.01).The positive rate of CA125, CA153, HE4 joint detection in the gy-necological malignancies group (up to 72.9%) was also significantly higher than that in the benign gynecological dis-ease group (p <0.01).Conclusion is a single tumor marker with the highest sensitivity and specificity for diagno-sis of gynecological malignancies.CA125, CA153, HE4 joint detection can improve the positive rate of diagnosis of gynecological malignancies.
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Objective To investigate the diagnostic value of CA125 and CA153 for the combined detection of the disease in breast cancer patients.Methods 100 cases of breast cancer patients were selected as the breast cancer group,and the same period 100 cases of benign breast lesions were selected as the benign group,100 cases of normal healthy subjects were selected as the control group.The expression levels of CA125 and CA153 in the three groups were detected.Results CA153 and CA125 levels in the breast cancer group was (78.4 ± 23.76) U/mL,(71.3 ± 24.7) U/mL; The benign group CA153 and CA125 content were (13.4 ± 3.7) U/mL,(20.6 ± 12.4) U/mL;CA153 and CA125 in the normal control group content were (0.9 ± 0.8) U/mL,(19.3 ± 11.3) U/mL; CA153 and CA125 in the breast cancer group were significantly higher than those of the benign group and the normal control group,the difference was statistically significant (F =34.15,28.42,all P ＜ 0.05) ; CA153 and CA125 alone detected in breast cancer detection rate was 31.0 ％,24.0 ％,respectively,combined detection of CA153 and CA125 in breast cancer detection rate was 66.0％,CA153 and CA125 alone detected in breast cancer detection rate was significantly lower than the combined detection CA153 and CA125 in the breast cancer detection rate (F =8.21,P ＜ 0.05).CA153 and CA125 expression of breast cancer patients after treatment than that of before treatment significantly reduced,and compare the data with statistically significant (t =21.82,22.31,all P ＜ 0.05).Conclusion The clinical detection of CA125 and CA153 united can effectively improve the diagnosis of breast cancer effect,combined detection of higher sensitivity and specificity.Meanwhile,the combined detection of breast cancer clinical monitoring also ha ssome significance,which is worthy of clinical application.
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ObjectiveTo investigate the clinical value of CEA, CA19-9, CA242 and CA72-4 four serum tumor markers in colorectal cancer diagnosis, surgery and postoperative evaluation of their. Methods Immunohistochemical assay was used in 80 patients with colorectal cancer and 50 cases of colorectal benign diseases to detect the CEA, CA19-9, CA242 and CA72-4 and other four serum tumor markers, with 2-year follow- up. ResultsFour kinds of serum tumor markers CEA, CA19-9, CA242 and CA72-4 levels in colorectal cancer group were significantly higher than the control group ( P ＜ 0.05 ) ; levels of the four serum tumor markers in patients in Dukes stages C, D were significantly higher than those in Dukes stages A, B;four serum tumor markers were significantly increased in patients with recurrence of metastasis. Conclusion Combined detection of serum CEA, CA19-9, CA242 and CA72-4 has clinical value in diagnosis, surgical treatment evaluation and monitoring of metastasis and recurrence after surgery of colorectal cancer can improve detection sensitivity and specificity.