Struma ovarii-associated pseudo-Meigs−syndrome with concomitant abdominopelvic tuberculosis masquerading as ovarian malignancy / Philippine Journal of Obstetrics and Gynecology

@#Pseudo-Meigs' syndrome (PMS) is a rare disease characterized by the triad of (1) an ovarian neoplasm, other than a fibroma or thecoma, (2) ascites, and (3) pleural effusion. Tumors such as struma ovarii, mucinous and serous cystadenomas, and germ cell tumors have been linked with the condition. Due to its clinical features combined with the elevation of serum cancer antigen 125 (CA-125) levels, it is often mistaken and treated as a malignant ovarian tumor. Ascites or pleural effusion could be massive leading to various life-threatening complications. Despite its presentation, this entity has an excellent prognosis when surgical excision of the tumor is performed. This article presents an unusual case of a 41-year-old gravida 10 para 10 (10-0-0-9) who was diagnosed with a case of struma ovarii associated PMS with concomitant abdominopelvic tuberculosis and elevated CA-125 resembling an ovarian malignancy.

Diagnosis accuracy of PCA3 level in patients with prostate cancer: a systematic review with meta-analysis

ABSTRACT Background: The diagnostic value and suitability of prostate cancer antigen 3 (PCA3) for the detection of prostate cancer (PCa) have been inconsistent in previous studies. Thus, the aim of the present meta-analysis was performed to systematically evaluate the diagnostic value of PCA3 for PCa. Materials and Methods: A meta-analysis was performed to search relevant studies using online databases EMBASE, PubMed and Web of Science published until February 1st, 2019. Ultimately, 65 studies met the inclusion criteria for this meta-analysis with 8.139 cases and 14.116 controls. The sensitivity, specificity, positive likelihood ratios (LR+), negative likelihood ratios (LR−), and other measures of PCA3 were pooled and determined to evaluate the diagnostic rate of PCa by the random-effect model. Results: With PCA3, the pooled overall diagnostic sensitivity, specificity, LR+, LR−, and 95% confidence intervals (CIs) for predicting significant PCa were 0.68 (0.64-0.72), 0.72 (0.68-0.75), 2.41 (2.16-2.69), 0.44 (0.40-0.49), respectively. Besides, the summary diagnostic odds ratio (DOR) and 95% CIs for PCA3 was 5.44 (4.53-6.53). In addition, the area under summary receiver operating characteristic (sROC) curves and 95% CIs was 0.76 (0.72-0.79). The major design deficiencies of included studies were differential verification bias, and a lack of clear inclusion and exclusion criteria. Conclusions: The results of this meta-analysis suggested that PCA3 was a non-invasive method with the acceptable sensitivity and specificity in the diagnosis of PCa, to distinguish between patients and healthy individuals. To validate the potential applicability of PCA3 in the diagnosis of PCa, more rigorous studies were needed to confirm these conclusions.

Tissue trauma and inflammatory response following laparoscopic versus abdominal hysterectomy: a prospective randomized clinical trial

Background: Laparoscopic surgery is associated with more favorable clinical outcome than conventional open surgery. This might be related to the magnitude of tissue trauma and tissue stress response. This study compares the intensity of tissue injury by assessing plasma C-reactive protein (CRP), lactic dehydrogenase (LDH), and cancer antigen 125 (CA 125) in patients undergoing laparoscopic hysterectomy compared to abdominal hysterectomy.Methods: This study was conducted at Ain Shams University Maternity Hospital from May 2018 to February 2020. 74 women candidate for hysterectomy were recruited and randomized into two groups: group A included 37 cases who underwent abdominal hysterectomy, and group B included 37 cases that underwent laparoscopic hysterectomy.Results: CRP, LDH and CA125 significantly increased post-operatively in both groups. Postoperative mean serum CRP, LDH and CA125 were significantly higher in the laparotomy group (10.84±2.47, 262.21±76.77, and 13.41±2.6 respectively) compared to laparoscopy group (7.92±2.25, 148.53±43.56, 11.79±2.77 respectively) (p<0.05).Conclusions: Surgery is a significant cause of tissue injury that can be assessed by specific markers. We suggest that laparoscopic surgery causes less tissue damage as assessed by lower postoperative CRP and LDH values, which might account for the earlier recovery and reduced hospital stay in laparoscopic surgery.

Role of cancer antigen-125 in diagnosing malignant adnexal masses: a prospective observational study

Background: Adnexal masses present a diagnostic and therapeutic dilemma across age-groups. This study aimed to evaluate the performance of cancer antigen-125 (CA-125) in distinguishing between benign and malignant adnexal masses.Methods: This was a prospective, observational, single tertiary-care center study, done in North India from January, 2011 till December, 2012. Serum CA-125 levels was obtained preoperatively in consecutive patients presenting with ultrasonography confirmed adnexal masses. The cut-off value between benign and malignant was taken as 35 IU/ml. Histopathological diagnosis was obtained in all patients.Results: A total of 126 patients presented with adnexal masses, of which 100 were enrolled (mean age: 37.5±14.4 years, range: 18-80 years). Most of the masses were benign 81% (malignant=19%). Dermoid cyst (25.9%) and endometriomas (21%) were the most common benign masses. Serous (21%) and mucinous cystadeno-carcinoma (15.8%) were the most common malignant masses, more often seen in elderly, married, parous and post-menopausal patients. Mean CA-125 levels were significantly higher in malignant masses (257.30 [105.68-408.92] versus 19.26 [16.53-22.00], p<0.001). Overall sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CA-125 for diagnosing malignant adnexal mass was 94.7%, 87.65%, 64.28%, 98.6%, and 88.91% respectively. The same was 100%, 85.1%, 54.5%, 100%, 87.3% in premenopausal and 85.7%, 100%, 100%, 93.3%, 95.2% in postmenopausal women respectively.Conclusion: Benign masses form the bulk of the adnexal masses in all age groups. CA-125 levels has high sensitivity and negative predictive value in premenopausal patients while as high specificity and positive predictive value in postmenopausal patients.

Dosagem sérica do marcador tumoral CA 15. 3 em cadelas portadoras de neoplasias mamárias pelo método de eletroquimioluminescência / Serum dosage of the tumor marker Ca 15. 3 in bitches presenting mammary neoplasia with the chemiluminescence method

The objective of the present study was to analyze the serum levels of the tumor marker Ca15.3 in healthy bitches and those with mammary neoplasms, correlating results with tumor type, clinical staging, time until presentation, and presence of ulceration and vascularization. For the study, 30 bitches with mammary tumors and 30 healthy bitches (control group) were selected. Histopathology was performed for identification of tumor type, and blood was collected for measurement of serum concentration of the marker via the chemiluminescence method using a commercial kit. A higher frequency of malignant neoplasms was observed (76.7%), with a higher quantity of carcinoma in mixed tumor (26.7%). Regarding serum concentration of the marker Ca15.3, there was no difference in serum values when comparing the means from bitches with neoplasia and healthy bitches, nor when comparing the other characteristics. The majority of results for serum concentration of Ca15.3, whether in bitches with neoplasia or in healthy bitches, was zero. It is concluded that the measurement of the marker Ca15.3 using the chemiluminescence method and commercial kits for humans did not offer significant results that would make this method or this marker a useful tool for patient monitoring and evaluation of the prognosis of bitches with mammary neoplasms.(AU)

Clinical Usefulness of Cancer Antigen (CA) 125, Human Epididymis 4, and CA72-4 Levels and Risk of Ovarian Malignancy Algorithm Values for Diagnosing Ovarian Tumors in Korean Patients With and Without Endometriosis

BACKGROUND: Tumor markers are useful for detection and preoperative evaluation of ovarian tumors. We evaluated the clinical usefulness of cancer antigen (CA) 125, human epididymis 4 (HE4), and CA72-4 levels and Risk of Ovarian Malignancy Algorithm (ROMA) values for differential diagnosis of malignant and borderline tumors among suspected ovarian tumors, and the effects of endometriosis on these tumor markers. METHODS: In a total of 266 patients (213, 14, and 39 with benign, borderline and malignant tumors, respectively), CA125, HE4, and CA72-4 levels were measured, and ROMA values were calculated. Medians of each marker were compared among the three groups. The area under the ROC curve (AUC), sensitivity, and specificity were calculated to analyze the diagnostic performance of each marker. RESULTS: All markers were significantly higher in the malignant group than in the benign group. HE4 levels and ROMA values were significantly higher in the malignant group than in the borderline group. ROMA value had the highest AUC for distinguishing the malignant and borderline groups from the benign group in premenopausal (0.773) and postmenopausal (0.927) patients. CA125 level was significantly higher in patients with endometriosis than in those without (P<0.001), whereas HE4 and CA72-4 levels were not affected by endometriosis (P=0.128 and 0.271, respectively). CONCLUSIONS: ROMA value is the best marker to distinguish malignant and borderline tumors from benign tumors in pre- and postmenopausal patients. HE4 and CA72-4 levels provide information on possible CA125 elevation due to endometriosis.

Biomarcadores mamarios en procesos metastásicos en mujeres ecuatorianas / Breast biomarkers in metastatic processes in Ecuadorian women

Resumen Introducción: Los biomarcadores tumorales CA 15-3 y CEA son predictores de metástasis en el cáncer de mama; no obstante, existe división de criterios de las ventajas de determinarlos de forma individual o conjunta. Objetivo: Evaluar la asociación de los biomarcadores tumorales CA 15-3 y CEA, por separado y en conjunto, en relación a la enfermedad metastásica en mujeres ecuatorianas con cáncer de mama. Métodos: Se realizó un estudio de prevalencia, en base a la información obtenida de las historias clínicas de 90 mujeres con cáncer de mama. Se identificaron los marcadores (CA 15-3, CEA y el conjunto de los dos (CA 15-3 ­ CEA) y se buscó la asociación con presencia o no de metástasis mediante prueba exacta de Fisher e índice Kappa de Cohen. Además, se determinó la sensibilidad, especificidad y valores predictivos positivos y negativos de cada marcador tumoral y en conjunto. Resultados: La prevalencia de carcinoma ductal invasivo en etapas localmente avanzadas de IIB a IIIC fue 77.8%. El sistema óseo y pulmonar fueron lugares frecuentes de invasión. De manera individual y conjunta existe una relación estadísticamente significativa (P <0.05) entre el valor de los biomarcadores y la presencia de procesos metastásicos, siendo CA15-3 y CA15-3-CEA los de mayor concordancia. CA15-3 presentó sensibilidad (S) 55% y especificidad (E) 91%. CEA tuvo (S) 30%; (E) 96%. En conjunto presentaron (S) 40%; (E) 100%. Conclusiones: La presencia de metástasis y mayor carga tumoral se correlacionan con la positividad de los biomarcadores tumorales CA 15-3-CEA, lo cual refuerza la utilidad clínica de evaluar los dos biomarcadores en conjunto.

Background: CA 15-3 and CEA tumor markers are metastasis predictors in breast cancer; however, criteria of the advantages in determining them in an individual or joint way are still not consensual. Objective: To evaluate the association of CA 15-3 and CEA tumor markers, in individual or joint way, in Ecuadorian patients diagnosed with metastatic breast cancer. Methods: A prevalence study was carried out, based on the information obtained from the medical records of 90 women with breast cancer. The markers CA 15-3, CEA were identified individually and together (CA 15-3 - CEA) and the association between the presence or absence of metastasis was established by using Fisher's exact test and Cohen's Kappa index. In addition, the sensitivity, specificity, positive and negative predictive values of each tumor marker as individual element and as a whole were determined Results: The prevalence of invasive ductal carcinoma in locally advanced stages from IIB to IIIC was 77.8%. The bone and lung system were frequent sites of cancer spread. There was a statistically significant relation (p<0.05) between the individual or whole biomarkers values and the presence of metastatic processes, being CA 15-3 and CA 15-3-CEA the ones with the highest concordance. CA 15-3 presented 55% sensitivity and 91% specificity. CEA presented 30% sensitivity and 96% specificity. As a whole, those have 40% sensitivity and 100% specificity. Conclusions: A higher tumor burden and metastatic development correlate with CA15-3-CEA biomarker positivity as a set, reinforcing the clinical benefit of evaluating both biomarkers simultaneously

Anti-Cancer Potential Of Polysaccharide Isolated From Methanolic Extract Of Tinospora Cordifolia Stem Bark

Objective: The exploration of the anticancer potential of polysaccharide isolated from the methanolic extract of Tinospora cordifolia (T. cordifolia) stem bark against breast cancer in DMBA-induced female albino Wistar rat models were examined by various hematological parameters. Methods: Analysis of Red blood cell (RBC), White blood cell (WBC) and platelet level, Tumor markers Carcino Embryonic Antigen (CEA) and Cancer Antigen 15.3 (CA 15.3) in the serum, was done in the normal, cancer and compound treated rats using specific kits. Histological studies were performed to examine the changes in the tissue morphology and cell patterns in breast tissue. Results: The decreased levels of RBC, WBC and platelets in 7,12-Dimethylbenz [a] anthracene (DMBA)-induced breast cancer (Group III) animals were revived to the normal conditions in polysaccharide treated breast cancer (Group IV) animals as that of normal (Group I). The level of tumor markers CEA and CA 15.3, was found elevated in serum of DMBA-induced breast cancer groups (Group III) when compared to their levels in the normal groups (Group I) whereas polysaccharide treatment (Group IV) prevented this rise in the levels of tumor markers. The histological studies on the breast tissue samples of all the groups showed the appropriate features where the normal (Group I) animals were characterized with normal cells uniformly arranged without any change in orientation and morphology, DMBA-induced cancer (Group III) animals showed an improper orientation of cells arranged as glandular structures, as nest, or cords of various sizes or as solid sheets foci of necrosis in some areas with margins infiltrating, pushing, circumcised or mixed and the polysaccharide treated (Group IV) animals showed results resembling that of the normal (Group I) animals. Conclusion: Thus, polysaccharide is proved as an effective chemo preventive agent against breast cancer.

Comparison of serum cancer antigen 125, human epididymis protein 4, ROMA, and CPH-I for diagnosis of ovarian cancer in Chinese patients with ovarian mass / 南方医科大学学报

OBJECTIVE@#To compare the performance of serum cancer antigen 125 (CA125), human epididymis protein 4 (HE4), Risk of Ovarian Malignancy Algorithm (ROMA) and Copenhagen index (CPH-I) for differential diagnosis of benign and malignant diseases in patients with ovarian mass.@*METHODS@#We retrospectively analyzed the data of 719 women with pelvic mass, and the performance of preoperative serum levels of CA125 and HE4, ROMA and CPH-I for differential diagnosis of the masses was compared.@*RESULTS@#Of the 710 women analyzed, 531 were diagnosed with benign ovarian lesions, 44 with borderline ovarian tumors (BOTs), 119 with epithelial ovarian cancers (EOCs), and 25 with non-EOCs. In differentiating ovarian cancer (OC) and BOT from benign lesions, the area under the receiver-operator characteristic (ROC) curve (AUC) was 0.854 for HE4, 0.856 for ROMA, 0.854 for CPH-I, and 0.792 for CA125, demonstrating better diagnostic performance of HE4, ROMA, and CPH-I than CA125 alone; the diagnostic sensitivity was 56.9% for HE4, 70.2% for CA125, 69.1% for ROMA, and 63.8% for CPH-I; the specificity was the best with HE4 (94.4%) and CPH-I (94.7%). In sub-analysis of EOC benign lesions, the AUCs of HE4, ROMA, and CPH-I increased to 0.946, 0.947, and 0.943, respectively, all greater than that of CA125 (0.888). In other sub-analyses, HE4, ROMA, and CPH-I all showed greater AUCs than CA125 alone.@*CONCLUSIONS@#This study confirms the accuracy of HE4, ROMA, and CPH-I for differentiating malignant from benign ovarian mass, and all these 3 tests show better performance than CA125. Furthermore, HE4 and CPH-I is superior to ROMA and CA125 in terms of specificity, while CA125 and ROMA have better diagnostic sensitivities.

Prognostic values of preoperative serum CA199 and NSE on esophageal squamous cell carcinoma patients / 中华疾病控制杂志

Objective To explore the effects of preoperative serum cancer antigen 19-9 (CA19-9) and neuron-specific enolase (NSE) on the prognosis of patients with esophageal squamous cell carcinoma (ESCC). Methods This prospective study enrolled 176 patients with ESCC. 2 test was used to analyze the relationship between CA19-9, NSE and general clinical features. Survival curves were estimated using Kaplan-Meier method and comparisons were performed using the log-rank test. The Cox proportional hazards model was performed for multivariate analyses of overall survival (OS) and disease free survival (DFS). Results The patients with both high CA19-9 and NSE had the poor prognosis compared with those had both low CA19-9 and NSE (OS: HR=2.310, 95% CI: 1.208-4.418; DFS:HR=2.354, 95% CI：1.265-4.381). Compared to the separate detection of the two markers, the combined detection of CA19-9 and NSE was more accurate in the prognosis prediction of patients with ESCC (OS:C-index=0.686; DFS:C-index=0.684). Conclusions Preoperative serum CA19-9 and NSE were risk factors for the prognosis of patients with ESCC. Combined detection had higher accuracy of prediction of prognosis in patients with ESCC.

PCA3 rs544190G>A and prostate cancer risk in an eastern Chinese population

ABSTRACT Background: The association of prostate cancer antigen 3 (PCA3) polymorphism (SNP, rs544190G>A) with metastatic prostate cancer in European descent has been reported. Our aim of the current study was to re-validate the effect of PCA3 polymorphism on prostate cancer risk in an Eastern Chinese population and then estimate possible genetic discrepancies among population. Materials and Methods: Taqman assay was employed to determine genotype of SNP rs544190 in 1015 ethnic Han Chinese patients with prostate cancer and 1032 cancer-free controls. Simultaneously, odds ratios (OR) and 95% confidence intervals (95%CI) for risk relationship were calculated by logistic regression models. Results: The statistically significant relationship between PCA3 rs544190G>A and higher prostate cancer risk was not found. Stratification analysis revealed that there was no remarkable association of rs544190 variant AG/AA genotype with prostate cancer risk in every subgroup, except for patients with Gleason score ≤7(3+4). Conclusion: Although the results demonstrated that SNP rs544190 was not involved in prostate cancer risk in Eastern Chinese descent, unlike in European population, these might have clinical implications on prostate cancer heterogeneity around the World. To validate these findings, well-designed studies with different ethnic populations are warranted.

Diagnostic value of copeptin and cancer antigen 125 in acute heart failure patients with atrial fibrillation and their correlations with short-term cardiovascular events / 中华危重病急救医学

Objective To evaluate the diagnostic value of copeptin and cancer antigen 125 (Ca-125) in acute heart failure (AHF) patients with atrial fibrillation, and to explore the relationship between copeptin, Ca-125 and short-term cardiovascular events. Methods A total of 376 patients with acute left heart failure or permanent atrial fibrillation admitted to the Department of Cardiology of First Affiliated Hospital of Nanjing Medical University from January 2016 to January 2018 were enrolled as the study group. According to whether having atrial fibrillation or not, 376 patients were divided into atrial fibrillation group (n = 108), AHF group (n = 134) and AHF with atrial fibrillation group (n = 134). 102 healthy persons in the same period were enrolled as healthy control group. Copeptin, Ca-125, N-terminal pro-brain natriuretic peptide (NT-proBNP) within 24 hours after admission or on the day of physical examination were determined, and cardiac function indexes including left atrial diameter (LAD), left ventricular diameter (LVD) and left ventricular ejection fraction (LVEF) at 1 week after admission or on the day of physical examination were determined. Correlation analysis among above indexes was conducted by Pearson correlation analysis. Receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic value of copeptin and Ca-125 in AHF with atrial fibrillation. Results Compared with the healthy control group, copeptin, Ca-125, NT-proBNP, LAD, and LVD in atrial fibrillation group, AHF group and AHF with atrial fibrillation group showed a tendency of gradual increase [copeptin (pmol/L): 12.43±4.36, 18.77±5.29, 32.82±7.07 vs. 6.68±1.94; Ca-125 (kU/L): 18.82±7.39, 27.97±11.47, 61.37±25.49 vs. 4.43±1.74; NT-proBNP (ng/L): 1 070.87±428.84, 1 734.13±725.09, 2 745.92±709.91 vs. 570.40±213.87; LAD (mm): 37.24±6.35, 41.31±7.94, 46.24±10.96 vs. 33.29±4.53; LVD (mm): 49.46±5.19, 52.51±8.09, 55.96±6.49 vs. 45.99±6.26, all P < 0.05], and LVEF showed a tendency of gradual decrease (0.52±0.11, 0.46±0.10, 0.41±0.09 vs. 0.57±0.08, all P < 0.05), indicating that the deterioration of all indexes in AHF patients with atrial fibrillation was more obvious. Correlation analysis showed that copeptin was positively correlated with LAD (r = 0.479, P = 0.012) and LVD (r = 0.513, P = 0.005), and it was negatively correlated with LVEF (r = -0.626, P < 0.001). Ca-125 was positively correlated with LAD (r = 0.479, P = 0.011) and LVD (r = 0.513, P = 0.028), and it was negatively correlated with LVEF (r = -0.645, P = 0.019). ROC curve analysis showed that the area under ROC curve (AUC) of copeptin, Ca-125, NT-proBNP and copeptin combined with Ca-125 in the diagnosis of AHF with atrial fibrillation was 0.750, 0.623, 0.647 and 0.842, respectively, with diagnostic value on AHF with atrial fibrillation. The diagnostic value of copeptin combined with Ca-125 was the largest, with a sensitivity of 72.64% and a specificity of 92.47%. Compared with the healthy control group, the incidence of cardiovascular events after 3 months of follow-up in the atrial fibrillation group, AHF group and AHF with atrial fibrillation group was significantly increased [6.5% (7/108), 9.0% (12/134), 30.6% (41/134) vs. 1.0% (1/102), χ2 = 56.574, P = 0.000], indicating that patients with AHF and atrial fibrillation were more likely to have cardiovascular events. Copeptin combined with Ca-125 showed a significant positive correlation with short-term cardiovascular events (r = 0.641, P = 0.004). Conclusions The combination of copeptin and Ca-125 has a higher diagnostic accuracy for AHF patients with atrial fibrillation. Copeptin and Ca-125 were positively correlated with short-term cardiovascular events. It may be used to assess the prognosis of AHF patients with atrial fibrillation.

Detection and clinical value of serum growth differentiation factor 15 and gastric cancer antigen 724 in gastric cancer patients / 国际检验医学杂志

Objective To investigate the change and clinical significance of growth differentiation factor 15 (GDF15) and gastric cancer antigen 724 (CA724) in serum of patients with gastric cancer .Methods Serum levels of GDF15 in serum of 30 patients with gastric cancer were detected by ELISA .The levels of serum gas-tric CA724 were measured by electrochemiluminescence ,and 32 cases of benign gastric lesions and 30 healthy controls were compared .Results The levels of serum GDF15 and CA724 in patients with gastric cancer were (1 .58 ± 0 .53)ng/mL and (40 .80 ± 5 .20) IU/mL ,respectively .The levels of serum GDF15 and CA724 in pa-tients with benign gastric lesions were (0 .26 ± 0 .11) ng/mL ,(12 .90 ± 2 .30) IU/mL (P<0 .01) .The levels of GDF15 and CA724 in normal control group were (0 .17 ± 0 .08)ng/mL and (3 .80 ± 0 .90)IU/mL respectively . The levels of serum GDF15 and CA724 in gastric cancer group were significantly higher than those in benign gastric lesions and normal control group (P<0 .01) .The level of serum GDF15 was closely related to tumor size ,TNM stage and lymph node metastasis (P<0 .05) .The sensitivity of gastric cancer was 83 .3％ ,the spe-cificity was 83 .9％ and the AUC was 0 .837 .The sensitivity of CA724 was 90 .0％ ,the specificity was 76 .5％and the AUC was 0 .886 .The combined detection of AUC was 0 .920 ,which was significantly higher than that of single detection .Conclusion GDF15 is associated with the development and progression of gastric cancer .Combined detection of GDF15 and CA724 in serum is helpful for early diagnosis of gastric cancer and progno-sis .

Serum EPCA-2 and HK2 level in early diagnosis of patients with prostate cancer / 国际检验医学杂志

Objective To investigate the clinical value of prostate cancer antigen-2(EPCA-2) and human glandular kallikrein 2(HK2) in early diagnosis in patients with prostate cancer .Methods Sixty-one patients with prostate cancer admitted to this hospital from June 2015 to January 2017 were selected and other 37 healthy subjects undergoing physical examination were selected as the control group .The fasting peripheral venous blood at morning was collected from all the subjects entering the groups for separating the serum .The serum EPCA-2 and HK2 levels were measured by adopting the enzyme linked immunosorbent assay (ELISA) . The changes of serum EPCA-2 and HK2 levels ,positive rates of EPCA-2 and HK2 ,changes of serum EPCA-2 and HK2 levels in different clinical stages ,and the specificity and sensitivity of EPCA-2 and HK2 combined detection were compared between the two groups .Results Serum EPCA-2 and HK2 levels in the study group were higher than those in the control group ,the difference was statistically significant (P<0 .05);The posi-tive rates of EPCA-2 and HK2 in the study group were higher than those in the control group ,the difference was statistically significant (P<0 .05);Serum EPCA-2 and HK2 levels in the stage Ⅲ - Ⅳ of the study group were higher than those in the stage Ⅰ - Ⅱ ,the difference was statistically significant (P<0 .05);The specific-ity and sensitivity of EPCA-2 plus HK2 were higher than those of EPCA-2 and HK2 single detection ,the difference was statistically significant (P<0 .05) .Conclusion The combined detection of serum EPCA-2 and HK2 in the patients with prostate cancer has higher specificity and higher sensitivity ,so EPCA-2 and HK2 have the important clinical value for the early diagnosis in the patients with prostate cancer .

Prostate cancer antigen 3 moderately improves diagnostic accuracy in Chinese patients undergoing first prostate biopsy / 亚洲男科学杂志(英文版)

Prostate cancer antigen 3 (PCA3) is a biomarker for diagnosing prostate cancer (PCa) identified in the Caucasian population. We evaluated the effectiveness of urinary PCA3 in predicting the biopsy result in 500 men undergoing initial prostate biopsy. The predictive power of the PCA3 score was evaluated by the area under receiver operating characteristic (ROC) curve (AUC) and by decision curve analysis. PCA3 score sufficed to discriminate positive from negative prostate biopsy results but was not correlated with the aggressiveness of PCa. The ROC analysis showed a higher AUC for the PCA3 score than %fPSA (0.750 vs 0.622, P = 0.046) in patients with a PSA of 4.0-10.0 ng ml-1.

Levels of Serum CA125, hs-CRP, and TNF-α in Patients with Chronic Heart Failure, and the Association with Cardiac Function / 中国医科大学学报

Objective To detect changes in serum cancer antigen 125 (CA125),tumor necrosis factor-alpha (TNF-α),and high-sensitivity C-reactive protein (hs-CRP) in patients with chronic heart failure (CHF),before and after treatment,and to examine the relationship between CA125 and cardiac function.Methods From June 2015 to December 2016,84 patients with CHF in our hospital were selected as the observation group and 72 healthy persons were selected as the control group.Fasting venous blood CA125,TNF-α,and hs-CRP levels were measured before and after treatment.The cardiac left ventricular ejection fraction (LVEF) was measured in both groups using echocardiography.Results The levels of CA125,TNF-α,and hs-CRP in the contml group were significantly lower than those in the observation group.The LVEF in the control group was significantly higher than in the observation group (P ＜ 0.05).After heart failure treatment,the levels of CA125,TNF-α,and hs-CRP significantly decreased in the observation group,and LVEF showed marked improvement (P ＜ 0.05).Analysis showed that the serum CA 125 level in patients with CHF was positively correlated with TNF-α and hs-CRP levels,and was negatively correlated with LVEF.Conclusion The levels of CA125,TNF-α,and hs-CRP in patients with CHF could have potential for the evaluation of CHF status and treatment results.

The value of HE4, CA125, and ROMA model in diagnosis of the ovarian carcinoma / 重庆医学

Objective To explore the value of human epididymis protein 4(HE4),cancer antigen 125(CA125) and the risk of ovarian malignancy algorithm(ROMA) in the diagnosis of ovarian cancer.Methods Electrochemical luminescence and Enzymelinked immunosorbent assay (ELISA) were used to determine the levels of serum HE4,CA125 in 56 patients with ovarian carcinoma,73 cases of ovarian benign tumor and 50 health women,and the ROMA was calculated by HE4 and CA125 levels depending on the menopause state,drawing the receiver operating characteristics(ROC) curve and calculating the area under the curve(AUC).Results The average levels of the HE4,CA125 and the value of the ROMA were (345.33±605.03)pmol/L,(701.46±1 500.30) U/mL,(58.72±31.00) ％ in the ovarian carcinoma group,(53.84± 14.68)pmol/L,(44.25±45.81)U/mL,(10.80± 6.75) ％ in the ovarian benign tumor group,and (46.03±10.26)pmol/L,(17.39±10.64)U/mL,(6.92±3.85)％ in the health control group respectively,compared with the benign tumor group and the health control group,the ovarian carcinoma group were higher in HE4,CA125 and the ROMA value,and the difference were significantly (P＜0.05),whereas compared in the ovarian benign group and the health group,except the CA125 was higher in the benign group and the difference had statistical significance(P＜0.05),the HE4 level and the value of the ROMA had no statistical significance(P＞0.05).The sensitivities of the HE4,CA125 and ROMA were 71.43％,76.79 ％,89.28％,the specificities were 93.15 ％,53.42％,94.52 ％ and the ROC-AUCs were 0.930,0.809,0.937 respectively.When the specificity for the diagnosis of the ovarian carcinoma was 95.00％,the sensitivities of the HE4,CA125 and ROMA were 80.40％,53.60％,83.90％ respectively.Conclusion HE4 and CA125 combined detection to calculate the ROMA can elevate the sensitivity and specificity for the ovarian carcinoma diagnosis.

Evaluation of PCA3 and multiparametric MRI's: collective benefits before deciding initial prostate biopsy for patients with PSA level between 3-10ng/mL

ABSTRACT Objective To analyze the contribution of multiparametric MRI and PCA3 assay, pre- decision of initial biopsy in PSA level between 3-10 ng/mL patients with normal digital rectal examination(DRE). Materials and Methods PSA level 3-10 ng/mL ,patients, with normal DRE results and no previous prostate biopsy history, were included in this study. Each patient underwent multiparametric MRI one week before biopsy. Urine sample taking for PCA3 examination preceded the biopsy. Systematic and targeted biopsies were conducted. Patients with high PSA levels were seperated into two groups as: high PCA3 scored and low PCA3 scored. Then each group was divided into two sub-groups as: MRI lesion positive and negative. Tumor incidence, positive predictive values(PPV) and negative predictive values(NPV) were calculated. Results 53 patients were included between February 2013 and March 2014.Mean age 61.22 ± 1.06. Mean PSA value 5.13 ± 0.19 ng / mL. Mean PCA3 score 98.01 ± 23.13 and mean prostate size was 48.96 ± 2.67 grams. Fourty nine patients had both PCA3 score and multiparametric MRI. The PCA3’s PPV value was 58.33%. If multiparametric MRI lesions are added to high PCA3 scores , the PPV appears to elevate to 91.66%. NPV of PCA3 was 96%. NPV was 95% when there was no lesion in the multiparametric MRI with low PCA3 scores. Sensitivity was 91.66% , specificity was 95% respectively. Conclusion Adding multimetric MRI can also support biopsy decision for patients with high PCA3 value. When PCA3 value is low, patients can be survailled without any need to take a MRI.

Clinicopathological characteristics of patients of certain molecular subtypes and elevated postoperative cancer antigen 15.3 levels and its correlation with menopausal status.

Context: It is well established that breast cancer subtypes differ in their outcome and treatment response. Aim: To observe tumor characteristics of different molecular subgroup and patients with postoperative (PO) raised cancer antigen 15.3 (CA 15.3) group and variation of tumor nature between pre‑ and post‑menopausal breast cancer patients. Materials and Methods: Blood samples and tumor blocks were collected from 95 nonmetastatic female breast cancer patients. Immunohistochemical stains for estrogen receptors (ER), progesterone receptor (PR), and HER2/Neu were used to classify molecular subtypes. CA 15.3 level was detected by ELISA. Significance levels were ascertained by Pearson Chi‑square test. Results: Prevalence of luminal A tumor with grade 3 was high. Triple negative and ER positive (ER+) types showed tumors with high grade and high lymph node (LN) metastasis. More nodal involvement was noticed in patients with PO raised CA 15.3. In addition, premenopausal patients with triple‑negative and ER+ subtypes exhibited more aggressive tumors which were characterized by high grade and large numbers of LN metastasis. Conclusion: Clinicopathological characteristics of certain molecular subtypes and influence of menopausal status on it can predict disease recurrence or overall survival of breast cancer patients.

Clinical application of combined detection of HE4 and CA125 in patients with endometriosis / 国际检验医学杂志

Objective To investigate the application value of single or combined detection of HE4 and CA125 in the differentia‐tion diagnosis of endometriosis .Methods The detection results of serum HE4 and CA125 levels in 105 cases of patients with ovari‐an endometriosis (endometriosis group) ,53 cases of patients with (ovarian malignant group) tumor and 64 healthy women undergo‐ing the healthy physical examination(control group) were performed the retrospective and statistical analysis .Results The positive rates of serum HE4 in the endometriosis group ,ovarian malignant tumor group and control group were 57 .1% ,90 .6% and 12 .5%respectively with statistically significant difference among them (P< 0 .05) .The positive rates of serum CA125 in the above 3 groups were 44 .8% ,92 .5% and 14 .0% respectively ,and the differences were statistically significant(P<0 .05) .(3)The sensitivity and specificity of 70 pmol/L≤ HE4<150 pmol/L for diagnosing endometriosis were 57 .14% and 53 .86% respectively ,which of 35 U/mL≤CA125<150 U/mL for diagnosing endometriosis were 44 .76% and 61 .24% .But the sensitivity and specificity of their combined detection were 70 .32% and 60 .38% .There were statistically significant differences of sensitivity and specificity among single and combined detecion of HE4 and CA125(P<0 .05) .Conclusion Serum HE4 and CA125 levels are significantly elevated in the patients with endometriosis ,their combined detection could further raise the sensitivity for diagnosing endometriosis .