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Objective:To investigate the clinical values of progastrin-releasing peptide (Pro-GRP), neuron-specific enolase (NSE), cytokeratin 19 fragment antigen 21-1 (CYFRA21-1), squamous cell carcinoma antigen (SCCA) and human human epididymis protein 4 (HE4) detections in the diagnosis of lung cancer patients.Methods:The clinical data of 200 lung cancer patients who were admitted to the Second Affiliated Hospital of Xuzhou Medical University from January 2020 to December 2021 were retrospectively analyzed. According to the pathological type, the patients were divided into lung adenocarcinoma group (80 cases), lung squamous cell carcinoma group (75 cases) and small cell lung cancer group (45 cases). Fifty patients with benign lung diseases and 50 healthy physical examiners who were admitted to the hospital during the same period were selected. All the subjects were tested for the levels of Pro-GRP, NSE, CYFRA21-1, SCCA and HE4, and the differences of each index level in the subjects of different subgroups were compared. The receiver operating characteristic (ROC) curve was drawn, and using pathological diagnosis result as the gold standard, the diagnostic efficacy of each index alone and in combination for lung cancer was compared.Results:The serum levels of Pro-GRP, NSE, CYFRA21-1, SCCA and HE4 in lung cancer group were higher than those in the benign lung diseases group and the healthy control group (all P < 0.001). There were no statistical differences in the levels of serum Pro-GRP, NSE, CYFRA21-1, SCCA and HE4 between the benign lung diseases group and the healthy control group (all P > 0.05). The levels of Pro-GRP, NSE and HE4 in the small cell lung cancer group were higher than those in the lung adenocarcinoma group and the lung squamous cell carcinoma group (all P < 0.05). NSE and HE4 levels in the lung adenocarcinoma group were higher than those in the lung squamous carcinoma group (both P < 0.05), while CYFRA21-1 and SCCA levels were lower than those in the lung squamous carcinoma group (both P < 0.05). The AUC of lung cancer diagnosed by HE4 was the largest (0.813), the AUC of lung adenocarcinoma diagnosed by HE4 was the largest (0.824), the AUC of lung squamous carcinoma diagnosed by CYFRA21-1 was the largest (0.884), and the AUC of small cell lung cancer diagnosed by NSE was the largest (0.959). The AUC of lung cancer diagnosed by combined detection of 5 indicators was 0.951, the AUC of lung adenocarcinoma and small cell lung cancer diagnosed by combined detection of 5 indicators was 0.975 and 0.996, and the AUC of lung squamous cell carcinoma diagnosed by combined detection of CYFRA21-1, SCCA and HE4 was 0.967. Conclusions:The levels of Pro-GRP, NSE, CYFRA21-1, SCCA, HE4 and other indicators have certain clinical values in the diagnosis of lung cancer and its pathological types, and the combined detection of each index is more valuable than a single index.
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Objective:To investigate the application value of preoperative clinical and magnetic resonance imaging (MRI) targetoid enhancement combined with alpha-fetoprotein in evaluating the expression of cytokeratin 19 (CK19) in patients undergoing radical resection for single hepatocellular carcinoma (HCC) without macrovascular invasion.Methods:The retrospective cohort study was conducted. The clinicopathological data of 220 patients who underwent radical resection for single HCC without macrovascular invasion in the General Hospital of Ningxia Medical University from January 2016 to December 2020 were collected. There were 171 males and 49 females, aged (56±11)years. Of the 220 patients, 52 cases showed positive CK19 expression, while 168 cases showed negative CK19 expression. Observation indicators: (1) MRI and immunohistochemical staining results of patients with different status of CK19 expression; (2) comparison of clinical features of patients with different status of CK19 expression; (3) comparison of MRI features in patients with different status of CK19 expression; (4) analysis of influencing factors for CK19 expression in patients and predictive value. The normality of continuous variables was tested using the Shapiro-Wilk test. Measurement data with normal distribution were expressed as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were expressed as M( Q1, Q3), and comparison between groups was conducted using the Mann-Whitney U test. Count data were expressed as absolute numbers and (or) percentages, and comparison between groups was conducted using the chi-square test. Comparison of ordinal data was analyzed by the non-parameter rank sum test. The relevant clinical and imaging features with P<0.05 were included in the binary Logistic regression model. The receiver operating characteristic (ROC) curve was drawn and the area under curve (AUC) was used to evaluate the predictive efficiency of the model. Results:(1) MRI and immunohistochemical staining results of patients with different status of CK19 expre-ssion. Results of MRI examination in patients with positive CK19 expression showed the tumors with low-signal intensity on plain T1-weighted imaging, annular high enhancement in the arterial phase, clear boundaries in the portal venous phase, central enhance-ment in the delayed phase and targetoid high signals on diffusion-weighted imaging (DWI). Immuno-histochemical staining revealed a positive CK19 expression. Results of MRI examination in patients with negative CK19 expression showed the tumors with low-signal intensity on plain T1-weighted imaging, non-annular high enhancement in the arterial phase, unclear boundaries in the portal venous phase, low signals compared with peripheral liver tissue in the delayed phase and uniform high signals on DWI. Immunohistochemical staining revealed a negative CK19 expression. (2) Clinical features of patients with different status of CK19 expression. The neutrophil count and cases with alpha-fetoprotein (AFP) ≥400 μg/L were 3.07(2.21,4.41)×10 9/L and 26 in patients with positive CK19 expression, versus 2.72(2.05, 3.51)×10 9/L and 48 in patients with negative CK19 expression, showing significant differences between them ( Z=?2.06, χ2=8.17, P<0.05). (3) Compari-son of MRI features in patients with different status of CK19 expression. Cases with tumor diameter ≥ 5 cm and cases with tumor showing targetoid enhancement were 34 and 22 in patients with positive CK19 expression, versus 82 and 24 in patients with negative CK19 expression, showing significant differences between them ( χ2=4.38, 18.86, P<0.05). (4) Analysis of influencing factors for CK19 expression in patients and predictive value. Results of multivariate analysis showed that AFP ≥ 400 μg/L and targetoid enhance-ment were independent risk factors for positive CK19 expression in HCC patients [ odds ratio=2.09, 3.23, 95% confidence interval ( CI) as 1.06?4.13, 1.49?6.99, P<0.05]. Results of ROC curve analysis showed that the AUC of targetoid enhancement for predicting positive CK19 expression was 0.64 (95% CI as 0.57?0.71), with the sensitivity and specificity as 42.31% and 85.71%. The AUC of AFP ≥400 μg/L for predicting positive CK19 expression was 0.61 (95% CI as 0.53?0.68), with the sensitivity and specificity as 51.00% and 71.43%. The AUC of targetoid enhancement combined with AFP ≥400 μg/L for predicting positive CK19 expression was 0.69 (95% CI as 0.61?0.77), with the sensitivity and specificity as 67.31% and 63.10%, respectively. Conclusions:Targetoid enhancement and AFP ≥400 μg/L are independent risk factors for positive CK19 expression in patients with single HCC without macrovascular invasion. Their combination has clinical value for preoperative evaluation of CK19 expression.
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Adult body harbors powerful reservoir of stem cells that maintains homeostasis by tissue regeneration and in response to disease and injury. Hair follicle is a dynamic mini organ supporting important biological functions of the body in maintaining homeostasis and skin tissue self-renewal. This study was carried out with the objective of finding the adult stem cells in canine hair follicular tissue. To conduct this study, adult canine skin samples (n=12) irrespective of breed and sex were collected. To characterize the hair follicle stem cells, paraffin sections of canine hair follicles were immunostained with positive hair follicle stem cell markers like Anti- cytokeratin 15 (CK15) and Anti-cytokeratin 19 (CK19) and FITC conjugated and HRP conjugated secondary antibodies were used. Immunoreactivities for CK15 and CK19 were observed in the bulge/isthmus region of hair follicles in between the infundibulum and suprabulbar regions and occupied most part of the peripheral layer of outer root sheath cell. Immunophenotyping of canine Hair Follicle Stem Cells (cHFSCs) in the bulge region of hair follicle helps in confirmation of in vitro culture of cHFSCs from the bulge region which will be further used for translational research
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Objective To investigate the diagnostic value of multi-slice spiral CT (MSCT) perfusion imaging combined with serum cytokeratin 19 fragment antigen 21-1 (CYFRA21-1), carcinoembryonic antigen (CEA) and neuron specific enolase (NSE) for peripheral non-small cell lung cancer (NSCLC). Methods Based on diagnosis, 109 patients with suspected peripheral NSCLC admitted from Aug. 2017 to Aug. 2019 in the Xinxiang Central Hospital were divided into peripheral NSCLC group (n=65) and benign pulmonary nodule group (n=44). Another 56 healthy subjects undergone physical examination during the same period were selected as control group. The parameters of MSCT perfusion imaging and serum levels of CYFRA21-1, CEA and NSE in the 3 groups were compared. The receiver operating curve (ROC) was used to analyze the diagnostic value of MSCT perfusion imaging combined with serous levels of CYFRA21-1, CEA and NSE for peripheral NSCLC. Results The blood volume (BV) was larger in peripheral NSCLC group than those in benign pulmonary nodule group and control group [(10.76±1.26) ml/100 mg vs. (4.01±0.59) ml/100 mg and (2.32±0.42) ml/100 mg]; the same was for surface permeability (PS) [(42.56±5.60) ml/ (100 mg·min) vs. (16.13±1.88) ml/(100 mg·min) and (8.49±0.91) ml/(100 mg·min)]; and for the mean transit time (MTT) of contrast medium [(20.14±3.67) s vs. (12.85±1.49) s and (7.21±0.95) s]. All the BV, PS and contrast medium MTT were higher (larger) in benign pulmonary nodule group than those in control group (P<0.05). The serum level of CYFRA21-1 was higher in peripheral NSCLC group than that in benign pulmonary nodule group and control group [(8.94±1.67) ng/ml vs. (4.73±0.51) ng/ ml and (1.93±0.26) ng/ml]; the same was for the CEA level [(27.91±3.25) ng/ml vs. (7.88±0.92) ng/ml and (2.06±0.47) ng/ml]; and for the NSE level [(19.53±2.16) ng/ml vs. (15.02±1.74) ng/ml and (11.96±1.22) ng/ml]. All the serum levels of CYFRA21-1, CEA and NSE were higher in benign pulmonary nodule group than those in control group (P<0.05). The ROC results showed that the diagnosis of peripheral NSCLC alone and combined with MSCT perfusion imaging, serum levels of CYFRA21-1, CEA and NSE were 0.802, 0.794, 0.698, 0.712 and 0.841, respectively. The diagnostic value of combined detection of the four methods was higher than that of individual detection. Conclusion MSCT perfusion imaging combined with serum levels of CYFRA21-1, CEA and NSE have high diagnostic value for peripheral NSCLC.
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Hair follicle nevus (HFN) is a rare, benign, follicular hamartoma that most frequently presents as a congenital nodule on the face. We experienced a rare case of HFN on the neck of a 14-year-old boy and performed a pilot immunohistochemical study with cytokeratin 19 (CK19) to compare the staining pattern of hair follicles in HFN and its differential diagnoses, accessory tragus, cervical chondrocutaneous branchial remnants (CCBR) and trichofolliculoma. With hematoxylin and eosin stain, HFN showed numerous tiny hair follicles in the dermis with several sebaceous and eccrine glands, and perifollicular fibrous thickening. With CK19 stain, some hair follicles in HFN and CCBR showed positive expression, a few hair follicles in accessory tragus showed weak expression, and no hair follicles in trichofolliculoma showed expression. The present report supports the view that HFN, accessory tragus and CCBR are within the same spectrum of hamartomas.
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Adolescent , Humans , Male , Dermis , Diagnosis, Differential , Eccrine Glands , Eosine Yellowish-(YS) , Hair Follicle , Hair , Hamartoma , Hematoxylin , Keratin-19 , Neck , NevusABSTRACT
@#Introduction: Thyroid carcinoma is classically diagnosed based on certain histological criteria. In some cases, definitive diagnoses may be challenging when morphological features are equivocal. This study evaluated the usefulness of Cytokeratin 19 (CK 19) as an immunohistochemical marker to differentiate the different histological types of malignant thyroid neoplasms, particularly papillary thyroid carcinoma (PTC) from benign thyroid lesions. Materials and Methods: We collected 54 malignant and 65 benign thyroid lesions diagnosed by histology in Universiti Kebangsaan Malaysia Medical Centre between January 2010 and December 2015. All cases were immunohistochemically stained with CK 19 and evaluated by 3 independent observers. The immunostaining patterns were scored based on the intensity and proportion of staining and finally graded as negative, weak positive, moderate positive or strong positive. In addition, the immunostaining scores of the malignant cases were correlated with their TNM pathological tumour stages. Results: Cytokeratin 19 staining expression was higher in malignant than benign thyroid lesions (p < 0.001) which was most prominent among classical PTC. The four PTC cases that showed negative or weak staining were all follicular variant of PTC. Benign conditions were mostly negative or showed weak positivity. There was no correlation between CK 19 expression and TNM primary tumour stage (pT). Conclusion: Cytokeratin 19 is a useful marker in differentiating malignant from benign thyroid conditions particularly the classical PTC, provided its interpretation is by correlation with morphology and takes into consideration the intensity and proportion of positive staining.
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Objective To investigate the clinical value of serum ferritin (SF) combined with 4 tumor mark-ers in the early diagnosis of lung cancer in elderly patients .Methods 185 cases of elderly patients with early-stage lung cancer as lung cancer group ,60 cases of elderly patients with benign lung disease as benign lung disease group ,50 healthy people were enrolled as healthy control group ,compared three groups of subjects of serum SF ,carbohydrate antigen 125 (CA125 ) ,carcinoembryonic antigen (CEA ) ,neuron-specific enolase (NSE) ,cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) expression and sensitivity ,specificity ,ROC curve analysis of the diagnostic index value .Results CA125 ,SF ,CEA ,NSE and CYFRA21-1 in lung cancer group , were higher than those of benign lung disease group and healthy control group ,the difference was statistically significant (P＜0 .05) ;SF ,CA125 ,CEA ,NSE and CYFRA21-1 of the benign lung disease group and healthy control group ,which showed no difference (P＞0 .05) .SF and NSE were the highest in patients with small cell lung cancer ,the difference was statistically significant (P＜0 .05) ,CA125 and CEA were the highest in adeno-carcinoma patients ,the difference was statistically significant (P＜0 .05) ,and CYFRA21-1 was the highest in squamous cell carcinoma patients ,the difference was statistically significant (P＜0 .05) .Compared with the single diagnosis of each index ,the sensitivity of combined detection of the five indicators increased ,the differ-ence was statistically significant (P＜0 .05) ,while the specificity did not change ,the difference was not statis-tically significant(P＞0 .05) .The area under the ROC curve of SF ,CA125 ,CEA ,NSE and CYFRA21-1 was 0 .808 ,0 .762 ,0 .761 ,0 .712 and 0 .781 ,respectively .The area under the ROC curve of the 5 indexes was 0 .915 . Conclusion Serum ferritin combined with 4 tumor markers can improve the diagnostic sensitivity of early eld-erly patients with lung cancer ,and effectively improve the diagnostic value of patients ,thereby contributing to the improvement of the clinical prognosis of patients .
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Objective To investigate the clinical value of tumor specific grow th factor(TSGF),neuron specific enolase(NSE),cytokeratin 19 fragment(CYFRA21-1),squamous cell carcinoma antigen(SCCAg)in the diagnosis of lung cancer.Methods 20 patients with lung cancer,42 patients with lung benign diseases and 54 healthy people undergoing the physical examination in this hospital from September 2014 to November 2016 were served as the lung cancer group,benign diseases group and healthy control group respectively.The Abbott microparticle chemiluminescence instrument was used to detect CYFRA21-1 and SCCA levels,the Roche electrochemical luminescence instrument was used to detect the NSE level and the TSGF level was de-tected by using the Olympus 5400 biochemical analyzer.Then the detection results were statistically analyzed. Results The levels of serum TSGF and NSE in the lung cancer group were higher than those in the lung be-nign diseases group and healthy control group,and the differences were statistically significant(P< 0.05). The serum CYFRA21-1 level of the lung benign disease group was higher than that in the healthy control group(P<0.05).The sensitivity and specificity of TSGF,NSE,CYFRA21-1 and SCCAg combined detection were 90.00% and 93.00% respectively.The area under the ROC curve was 0.959.Conclusion TSGF posses-ses wide spectrum marker characteristics,has a certain value for screening lung cancer,moreover its combined detection with NSE,CYFRA21-1 and SCCAg can increase the accuracy in diagnosis of lung cancer.
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Objective To investigate the clinical value of combined detection of serum carcinoembryonic an-tigen(CEA) ,carbohydrate antigen-125 (CA125) ,cytokeratin 19 fragment antigen (CYFRA21-1) ,squamous cell carcinoma(SCC) antigen ,neuron-specific enolase(NSE) and plasma progastrin-releasing peptid(ProGRP) in the diagnosis ,pathological typing and clinical staging in lung cancer .Methods The serum CEA ,CA125 , CYFRA21-1 ,SCC ,NSE levels and plasma ProGRP level were detected by adopting the chemiluminescent mi-croparticle immunoassay method in 378 cases of lung cancer ,200 cases of benign lung diseases and 200 people undergoing healthy physical examination .Results The levels and positive rates of CEA ,CA125 ,CYFRA21-1 , SCC ,NSE and ProGRP in the patients with lung cancer were significantly higher than those in the patients with benign lung diseases and healthy control group ,the difference was statistically significant (P<0 .05);in the single index detection ,the biomarkers of highest positive rate in adenocarcinoma ,squamous cell carcinoma and small cell lung carcinoma were CEA ,CYFRA21-1 and SCC ,NSE and ProGRP respectively .The sensitivi-ty ,specificity ,accuracy ,negative predictive value and positive predictive value of combined detection of these 6 indexes were 92 .86％ ,85 .00％ ,88 .17％ ,92 .64％ and 85 .40％ respectively ,except the specificity and positive predictive value were slightly decreased ,the levels of other indexes were higher than those of single index de-tection .The aresa under the receiver operating characteristic (ROC) curves of CEA ,CA125 ,CYFRA21-1 ,SCC ,NSE and ProGRP were 0 .775 ,0 .778 ,0 .891 ,0 .585 ,0 .710 and 0 .620 respectively .The area under ROC curves of the combined detection was 0 .950 .The positive rates of CA125 ,CYFRA21-1 ,NSE and the combined detection in the patients with stage Ⅲ ,Ⅳof lung cancer were obviously higher those in the patients with stageⅠand Ⅱof lung cancer ,the difference was statistically significant (P<0 .05);the combined detection obviously improved the positive rates for the diagnosis in the patients with different stages of lung cancer .Conclusion The combined detection of CEA ,CA125 ,CYFRA21-1 ,SCC ,NSE and ProGRP is conducive to improve the di-agnosis performance and early detection rate for lung cancer ,differentially diagnosing different pathological types of lung cancer and judge the clinical stage of lung cancer .The combined detection of 6 tumor biomarkers is an ideal diagnosis index of lung cancer .
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Objective To appraise the analytical capability of flow cytometric bead array for lung cancer markers through the tests of limit of detection,relative standard deviation,specificity,methods comparation and linearity rang.Methods The limit of detection,relative standard deviation,specificity and linearity rang in detection of Carcinoembryonic antigen (CEA),cytokeratin 19 (Cyfra21-1) and neuron specific enolase (NSE) in serum were evaluated by flow cytometer.Western blotting method was ultilized to validate the specificity of antibody-antigen recognization.The interference of hemoglobin,three acyl glycerol and bilirubin on the detection of CEA,Cyfra21-1 and NSE was tested.Compared to electrochemiluminescence immunoassay,the relative error for flow cytometric bead array was assessed.Results Flow cytometric bead array demonstrated that the limit of detection was 1.71 pg/mL for CEA,3.97 pg/mL for cyfra21-1,and 2.27 pg/mL for NSE.The relative standard deviation for intra-assay and inter-assay were below 10％ and 15％,respectively.The pair of antibodies can defferentially recognize antigens.The measurement for CEACAM6,CK18,NSE appeared that there was no significant cross-talking reaction.Three acyl glycerol and bilirubin did not significantly interfere with the detection for serum samples.Hemoglobin of 500 ng/mL can significantly interfere with the detection of Cyfra21-1 (P ＜ 0.05) and NSE (P ＜ 0.05).The correlation coefficient between flow cytometric array and electrochemiluminescence immunoassay was 0.984 2 for serum CEA,0.962 2 for serum cyfra 21-1 and 0.982 0 for serum NSE.The linearity ranged from 355.76 pg/mL to 367.74 ng/mL for CEA,from 87.89 pg/mL to 107.8 ng/mL for cyfra21-1,and from 90.12 pg/mL to 86.07 ng/mL for NSE.Conclusion Flow cytometric array for lung cancer markers may be of use in clinical detection.
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Objective To investigate the combined detection of serum cancer antigen(CEA)blank,carbohydrate antigen 125 (CA125)and cytokeratin 19 fragment(CYFRA21-1),neuron specific enolase(NSE)in the diagnosis of solitary pulmonary nodules. Methods 150 cases of patients with solitary pulmonary nodules diagnosed in our hospital from January 2015 to March 2017 were selected as the research subjects,including 51 lung cancer patients(Lung Cancer Group)and 51 benign lung disease patients(benign group).60 healthy people in the same period were selected as control group.The serum levels of CEA,CA125,CYFRA21-1 and NSE were detected in three groups of patients,and the clinical value of the combined detection of various indexes in the differential diagnosis of solitary pulmonary nodules was analyzed.Results The serum levels of CEA,CA125,CYFRA21-1 and NSE in patients with lung cancer were significantly higher than those in the benign and control groups(P<0.05);The sensitivity of CEA,CA125, CYFRA21-1 and NSE in differential diagnosis of malignant solitary pulmonary nodules was 32.32%,27.27%,33.33% and 40.40%,respectively.The specificity was 62.75%,52.94%,60.78%,70.59,respectively;The sensitivity of CEA + NSE+ CY-FRA21-1+CA125 in the differential diagnosis of malignant solitary pulmonary nodules was 81.82%,the specificity was 88.24%, the rate of missed diagnosis was 18.18%,the misdiagnosis rate was 11.76%,the positive predictive value was 93.10%,and the negative predictive value was 71.43%.Conclusion The combined detection of serum CEA,CA125,CYFRA21-1 and NSE has im-portant clinical value in the differential diagnosis of malignant solitary pulmonary nodules.
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OBJECTIVE:To investigate clinical significance of programmed cell death 5 (PDCD5) protein in serum of pa-tients with lung cancer. METHODS:80 lung cancer inpatients were selected from the First Affiliated Hospital of Shihezi University School of Medicine(hereinafter referred to asour hospital)as lung cancer group;60 healthy volunteers were selected from our hospital at the same period as normal group. ELISA was used to test the expression of PDCD5 protein,and the relationship of PDCD5 protein with clinical pathological features of lung cancer patients were analyzed. RESULTS:The expression of PDCD5 pro-tein in normal group was significantly higher than lung cancer group,with statistical significance (P0.05);it was de-creased as the decrease of tumor differentiation degree,with statistical significance(P<0.05). The expression of PDCD5 protein in patients with carcinoembryonic antigen(CEA)<5.6μmol/L was significantly higher than those with CEA≥5.6μmol/L;the expres-sion of PDCD5 protein in patients with cytokeratin 19 soluble fragment (CYFRA21-1)<5.6 μmol/L was significantly higher than those with CYFRA21-1≥5.6 μmol/L,with statistical significance(P<0.05). The expression of PDCD5 protein in patients with Ⅰ-Ⅱ stage lung cancer was significantly higher than Ⅲ-Ⅳ stage lung cancer patients;the expression of PDCD5 protein in patients without distant metastasis was significantly higher than those with distant metastasis. The expression of PDCD5 protein was in de-creasing as the increase of the number of metastasis site,with statistical significance(P<0.05). CONCLUSIONS:PDCD5 protein in serum of patients with lung cancer shows low expression level,which is related to tumor differentiation degree,tumor marker level as CEA and CYFRA21-1,tumor stage and distant metastasis,etc. The detection of PDCD5 protein may contribute to clinical diagnosis of lung cancer.
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PURPOSE: The roles of circulating tumor cells (CTCs) as predictive and prognostic factors, as well as key mediators in the metastatic cascade, have been investigated. This study aimed to validate a method to quantify CTCs in peripheral blood using a real-time reverse transcriptase polymerase chain reaction (RT-PCR) assay for cytokeratin (CK)-19 and to evaluate the utility of this assay in detecting CTCs in breast cancer patients. MATERIALS AND METHODS: Real-time monitoring PCR of fluorescently labeled specific hybridization probes for CK-19 mRNA was established. Peripheral blood samples from 30 healthy donors, 69 patients with early breast cancer, 47 patients with locally advanced breast cancer, and 126 patients with metastatic breast cancer were prospectively obtained and analyzed for CTC detection. RESULTS: CK-19 mRNA was not detectable in healthy subjects using the real-time RT-PCR method. The detection rates of CK-19 mRNA in breast cancer patients were 47.8% for early breast cancer (33/69), 46.8% for locally advanced breast cancer (22/47), and 61.1% for metastatic breast cancer (77/129). The detection rate of CK-19-positive CTCs in metastatic disease was slightly higher than early or locally advanced breast cancer; however, the detection rate according to disease burden was not statistically different (p=0.097). The detection rate was higher in patients with pleural metastasis (p=0.045). CTC detection was associated with poor survival (p=0.014). CONCLUSION: A highly specific and sensitive CK-19 mRNA-based method to detect CTCs in peripheral blood in breast cancer patients can be used in further prospective studies to evaluate the predictive and prognostic importance of CTCs.
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Female , Humans , Biomarkers, Tumor/blood , Breast Neoplasms/blood , Keratin-19/blood , Neoplastic Cells, Circulating , Prognosis , Prospective Studies , RNA, Messenger/blood , Real-Time Polymerase Chain Reaction , Reverse Transcriptase Polymerase Chain Reaction/methodsABSTRACT
Objective To explore the diagnostic value of combination detection of carcino‐embryonic antigen(CEA ) ,cytokeratin 19 fragment 21‐1(CYFR21‐1) ,neuron‐specific enolase(NSE) in bronchoalveolar lavage fluid (BALF) for early lung cancer and its correlation with clinical effects .Methods 69 cases of lung cancer were included into the lung cancer group and 50 cases of benign pulmonary disease were included into the lung benign disease group .All the patients were given bronchoalveolar lavage(BAL) .The chemiluminescence immunoassay was adopted to detect the levels of CEA ,CYFR21‐1 and NSE in BALF .The changes of tumor markers levels were compared between the two groups and among different clinical curative effects in the patients with lung cancer . Results The levels of CEA ,CYFR21‐1 and NSE in BALF of the lung cancer group were significantly higher than those of the be‐nign pulmonary disease group ,the difference was statistically significant (P < 0 .05) .The levels of tumor markers in the stage Ⅱ of lung cancer were higher than those in the stage Ⅰ of lung cancer ,the difference was statistically significant (P< 0 .05) ;the levels of CEA ,CYFR21‐1 and NSE in BALF were gradually increased with the decrease of clinical effect (P< 0 .05) ;the sensitivity and spe‐cificity of the combined detection of three tumor markers were 62 .3% and 82 .0% respectively ,which were significantly higher than those of any single tumor marker (P< 0 .05) .Conclusion The levels of CEA ,CYFR21‐1 and NSE in BALF of early lung cancer patients are obviously increased ,moreover which is closely correlated with the pathological stage of lung cancer ,the combined detec‐tion could contribute to improve the detection rate of early lung cancer and guide the evaluation of clinical effect .
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Objective To investigate expression of cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) and squamous cell carcinoma antigen (SCC-Ag) in cervical cancer patients with lung metastasis before treatment and their prognostic value. Methods The pretreatment serum expression levels of SCC-Ag and CYFRA21-1 of 72 cervical cancer patients with lung metastasis were measured. Survival rate analysis and Cox proportional hazard model were performed to evaluate the prognostic significance of two pretreatment variables. Results The media survival time (MST) of 72 patients was 14 months, and 38 (52.8 %) patients with pulmonary metastasis occurred in 1 year of treatment. The pretreatment serum SCC-Ag and CYFRA21-1 levels in the patients with tumor diameter over 4 cm or with squamous cell carcinoma were higher than those in the other patients (all P3.3 mg/L) was higher than that in the negative group (13 months vs 19 months, P1.5 mg/L) was also higher than that in the negative group (14 months vs 21 months, P<0.05). The result of Cox regression analysis showed that the tumor diameter (OR = 11.6, P = 0.01), pretreatment serum SCC-Ag (OR= 4.2, P= 0.01) and CYFRA21-1 (OR= 8.2, P= 0.05) levels were independent prognostic factors of overall survival. Conclusion Pretreatment CYFRA 21-1 and SCC-Ag levels may be considered as useful prognostic indicators for cervical cancer patients with lung metastasis.
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Objective To explore the value of detecting serum cytokeratin 19 fragmen 21-1 (CYFRA21-1) and squamous cell carcinoma antigen (SCCAg) in the diagnosis of patients with nasopharyngeal carcinoma.Methods 79 patients with nasopharyngeal carcinoma from October 2013 to October 2015 as case group and 145 patients with nasopharyngeal chronic inflammation as control group were collected.The CYFRA21-1 level was detected by the electrochemical luminescence immunoassay and the SCCAg level was detected by the enzymoimmunoassay.Comparisons of diagnostic value of CYFRA21-1 and SCCAg to nasopharyngeal carcinoma were conducted according to pathological diagnosis.Results The serum CYFRA21-1 and SCCAg levels in case group were (12.37±1.65) g/L and (1.65±0.37) ng/ml,and the control group were (4.26±1.99) g/L and (1.22±0.45) ng/ml,with statistically significant differences (t =8.093,P =0.002;t =4.287,P =0.043).The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of CYFRA21-1 combined with SCCAg in the diagnosis of nasopharyngeal carcinoma were higher than those of CYFRA21-1 and SCCAg respectively,and the difference all were statistically significant (all P ＜ 0.05).Conclusion Detecting serum CYFRA21-1 combined with SCCAg in the diagnosis of nasopharyngeal carcinoma has high sensitivity and good specificity,which can significantly improve the diagnostic accuracy.
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Objective The aim of this study was to assess the clinical value of pro-gastrin releasing peptide (ProGRP) , squamous cell carcinoma antigen (SCC-Ag), cytokeratin 19 fragment antigen 21-1 (Cyfra21-1) and carcino-embryonic antigen (CEA) in the diagnosis and clinical stage of lung cancer in Chinese patients.Methods Patients with lung cancer and benign lesions confirmed by pathology were enrolled in Peking Union Medical College Hospital from January 2013 to October 2014.The serum levels of four tumor markers (ProGRP, SCC-Ag, Cyfra21-1 and CEA) were measured using immunoassays before treatment.The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and the areas under the receiver operating characteristic curve (AUCROC) of these four tumor biomarkers were analyzed for the diagnosis of lung cancer.Results A total of 134 patients were finally analyzed, including 73 patients with lung cancer and the other 61 patients with benign lung disease.The diagnostic sensitivity of serum Cyfra21-1 to lung cancer was 67.1％, the specificity 45.1％, the AUCROC 0.658.The diagnostic sensitivity of the panel including ProGPR, Cyfra21-1 and CEA to lung cancer was 75.3％ , the specificity 57.4％ , the AUCROC 0.702.In the lung cancer group, the AUCROC of ProGRP over 65 ng/L to diagnose small cell lung cancer was 0.954;the AUCROC of SCC-Ag over 1.5 μg/L to diagnose squamous cell lung cancer was 0.788;the AUCROC of Cyfra21-1 to diagnose non-squamous-non-small-cell lung cancer was 0.716.In small cell lung cancer patients, the level of ProGRP in limited-disease small cell lung cancer (LD-SCLC) were significantly higher than that in extensive-disease small cell lung cancer (ED-SCLC) (P =0.005).Conclusion This panel of serum tumor markers including ProGRP, Cyfra21-1 and CEA improves the diagnostic specificity and sensitivity in patients with high-risk lung cancer.The serum CEA level of advanced lung cancer patients is significantly increased.The high level of serum ProGRP predicts the ED-SCLC.
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Ameloblastoma is a benign, locally aggressive tumor originating from the odontogenic epithelium. It manifests as a slow growing swelling, causing expansion of the jaw bones. Radiologically, it presents as a unilocular or multilocular radiolucency exhibiting a characteristic soap bubble or honeycomb appearance. Ameloblastoma exhibits several histologic patterns of which basal cell variant is a rare entity. The present case report is that of a maxillary ameloblastoma exhibiting a basaloid differentiation that may put one in the mind of a basaloid squamous cell carcinoma or a basal cell carcinoma. Confirmation of such rare variants should be done not only based on histopathology but with the help of supplemental immunohistochemical analysis. The present case report helps in exposing a rare variant of ameloblastoma and emphasizes the role of advanced diagnostic aids such as immunohistochemistry in establishing the diagnosis.
ABSTRACT
Objective To investigate the values of combined determination of pleural effusion and serum carcinoembryonic antigen (CEA), cytokeratin 19 fragment (CYFRA21-1), neuron-specific enolase (NSE), and squamous cell carcinoma antigen (SCC-Ag) in diagnosis of lung cancer. Methods 101 patients with pleural effusion were reviewed retrospectively. Expressions of CEA, CYFRA21-1, NSE and SCC-Ag in pleural fluid and serum were detected; the optimum cut-off points resulting from the best sensitivity-specificity balance in the receiver operator characteristic (ROC) curves were constructed. The expressions of the tumor markers were compared among different pathological types of lung cancer. Results The levels of tumor markers in both pleural effusion and serum were significantly higher in patients with lung cancer than the benign group (P < 0.05). The expression levels and positive rate of CEA for lung adenocarcinoma, NSE for small cell lung cancer, and CYFRA21-1and SCC-Ag for pulmonary squamous cell carcinoma were higher than any other single detection (P < 0.05). Combined detection of the tumor markers in pleural fluid and serum improved the detection rate of lung cancer. Conclusions Combined detection of pleural effusion and serum tumor markers has important reference value in the detection of lung cancer and in pathological typing.
ABSTRACT
Objective: To examine the expressions of cytokeratin 19 (CK19) and polymorphic epithelial mucin (MUC1) in peripheral blood of patients with thyroid cancer, and evaluate their clinical value as the biomarkers in the detection of circulating tumor cells and blood micrometastasis. Methods: The flow cytometry (FCM) was used to detect CK19-positive and MUC1-positive cells in peripheral blood of 491 patients with thyroid cancer and 376 patients with nodular goiter. Results: The positive expression rates of CK19 in patients with thyroid cancer and nodular goiter were 35.4% (174/491) and 7.7% (29/376), respectively (P = 0.000); the positive expression rates of MUC1 in patients with thyroid cancer and nodular goiter were 32.8% (161/491) and 3.5% (13/376), respectively (P = 0.000). In univariate analysis, the tumor size, tumor capsule invasion, lymph node metastasis and distant metastasis were significantly associated with the positive expression of CK19 or MUC1 and the positive expressions of both CK19 and MUC1 (P < 0.05). In multivariate analysis, tumor capsule invasion, lymph node metastasis and distant metastasis were independent factors related to the positive expression of CK19 or MUC1 and the positive expressions of both CK19 and MUC1 (P < 0.05). There was a positive correlation between the expressions of CK19 and MUC1 (r = 0.628, P = 0.000). Conclusion: The expressions of CK19 and MUC1 were significantly related to tumor capsule invasion, lymph node metastasis and distant metastasis of thyroid cancer, and these two biomarkers may be helpful to predict the blood micrometastasis and evaluate the prognosis.