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Objective To evaluate the diagnostic value of combined serum tumor marker CA19-9 with CT scanning in the patients with pancreatic cancer.Methods A total of 89 patients with suspected pancreatic cancer diagnosed by CT scanning were selected at our hospital from May 2012 to December 2016.The detected results of serum CA19-9 were recorded,and the specificity,sensitivity,positive and negative predictive value of serum CA19-9 in the diagnosis of pancreatic cancer were statistically calculated and analyzed.The correlations between the pre-and post-operative serum levels of CA19-9 and the survival time in pancreatic cancer patients undergoing operation were analyzed.Results The specificity,sensitivity,positive predictive value and negative predictive value of serum CA19-9 combined with CT scanning in the diagnosis of pancreatic cancer were 97.2％,86.4％,100.0 ％,94.0 ％ respectively.With the increase of preoperative serum levels of CA19-9,the resection rate and median postoperative survival time gradually decreased.Patients with normal serum levels of CA19-9 after operation had longer postoperative survival time than patients with high postoperative serum levels of CA19-9.Conclusions As one of the tumor markers of pancreatic cancer,serum CA19-9 detection has a high diagnostic sensitivity.Combined with CT scanning,serum CA19-9 detection can significantly improve the diagnostic accuracy of pancreatic cancer.Serum CA19-9 can also be used as a mean of efficacy evaluation after radical resection of pancreatic cancer.
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Objective To study the expression of CD62P and carbohydrate antigen 153 (CA153) in peripheral blood of patients with breast cancer, and to explore the value of CD62P and CA153 in the di-agnosis of breast cancer. Methods The CD62P ratio in peripheral blood of 60 patients with breast cancer ( breast cancer group) , 52 patients with breast fibroma ( fibroma group) and 25 healthy volunteers ( control group) was detected by flow cytometry ( FCM) . The serum CA153 level was detected by electro chemilumi-nescence ( ECLIA) , and the relationship between their expression levels and clinicopathological factors of breast cancer patients was analyzed. The sensitivity and specificity of serum CD62P, CA153 and their com-bination in the diagnosis of breast cancer were analyzed by receiver operating characteristic ( ROC) curve. Results ⑴ The expression levels of CD62P and CA153 in breast cancer group were significantly higher than those in fibroma group and control group (P<0. 05), but with no significant difference between fibro-ma group and control group (P>0. 05). ⑵The expression levels of CA153 and CD62P in peripheral blood of breast cancer group were correlated with clinical stage and lymphatic metastasis (all P<0. 05), and the expression levels of CA153 and CD62P were positively correlated (r=0. 514, P<0. 05). ⑶The sensitivity and specificity of combined detection of CD62P and CA153 for breast cancer were higher than those of single detection. Conclusions CD62P is highly expressed in peripheral blood of patients with breast cancer, which may be a new marker for the diagnosis of breast cancer.
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Objective To explore the clinical value of color doppler ultrasonography combined with CA125 and AFP in the early diagnosis of placental abruption.Methods From January 2015 to December 2017,120 patients with placental abruption in the Maternal and Child Health Hospital of Zhoushan were selected as observation group. 120 healthy pregnant individuals were selected as control group.They all received the color Doppler ultrasound and detection of serum CA125 and AFP levels.The clots checking on the surface of placenta post-delivery was conducted at the same time. The statistical analysis was set up to compare two groups according to those tests from the lab reports.Results The levels of serum CA125 and AFP were higher in the observation group compared with those in the control group.In details,the CA125[(69.1 ± 8.9) U/mL] and AFP[(279.8 ± 41.3) μg/L] levels in placental abruption grade Ⅲ were significantly higher than those in gradeⅡ[ CA125 ( 61.6 ± 9.4 ) U/mL, AFP ( 234.9 ± 46.2)μg/L] and gradeⅠ[ CA125 (52.2 ± 8.9) U/mL,AFP(205.7 ± 43.1) μg/L] ( all P<0.01).The positive predictive values of placental abruption by the color Doppler ultrasound alone was 46.7%.The combination of the color Doppler ultrasound with serum CA125 was 81.7%.The combination of the color Doppler ultrasound with serum AFP was 78.3%.The combination of those three tests was increased up to 90.8% ,which was the best pre-diagnosis compared to the color Doppler ultrasound alone and the other two combinations(χ2 =11.67,P<0.01).The detective rate of combination of the color Doppler ultrasound with serum CA125 and AFP was higher than the other two combi-nations(χ2 =12. 56, 12. 64, all P <0. 01 ). Conclusion The levels of serum CA125 and AFP are positively correlated with placental abruption.The combination tests using the color Doppler ultrasound and both serum CA125 and AFP is a novel and sensitive method as to pre-diagnose high risk placental abruption during pregnancy.
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Objective@#To explore the clinical value of color doppler ultrasonography combined with CA125 and AFP in the early diagnosis of placental abruption.@*Methods@#From January 2015 to December 2017, 120 patients with placental abruption in the Maternal and Child Health Hospital of Zhoushan were selected as observation group.120 healthy pregnant individuals were selected as control group.They all received the color Doppler ultrasound and detection of serum CA125 and AFP levels.The clots checking on the surface of placenta post-delivery was conducted at the same time.The statistical analysis was set up to compare two groups according to those tests from the lab reports.@*Results@#The levels of serum CA125 and AFP were higher in the observation group compared with those in the control group.In details, the CA125[(69.1±8.9)U/mL]and AFP[(279.8±41.3)μg/L] levels in placental abruption grade Ⅲ were significantly higher than those in gradeⅡ[CA125(61.6±9.4)U/mL, AFP(234.9±46.2)μg/L] and gradeⅠ[CA125(52.2±8.9)U/mL, AFP(205.7±43.1)μg/L](all P<0.01). The positive predictive values of placental abruption by the color Doppler ultrasound alone was 46.7%.The combination of the color Doppler ultrasound with serum CA125 was 81.7%.The combination of the color Doppler ultrasound with serum AFP was 78.3%.The combination of those three tests was increased up to 90.8%, which was the best pre-diagnosis compared to the color Doppler ultrasound alone and the other two combinations(χ2=11.67, P<0.01). The detective rate of combination of the color Doppler ultrasound with serum CA125 and AFP was higher than the other two combinations(χ2=12.56, 12.64, all P<0.01).@*Conclusion@#The levels of serum CA125 and AFP are positively correlated with placental abruption.The combination tests using the color Doppler ultrasound and both serum CA125 and AFP is a novel and sensitive method as to pre-diagnose high risk placental abruption during pregnancy.
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Objective To investigate the effect of color magnetic resonance imaging (MRI) combined with serum levels of carbohydrate antigen 153 (CA153),carcinoembryonic antigen (CEA) and cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) on the diagnostic efficacy of breast cancer patients.Methods From December 2015 to December 2017,80 cases of breast cancer in our hospital were selected as the observation group.Another 98 patients with benign breast diseases as control group A,and 94 healthy women as control group B.The serum levels of CA153,CEA and CYFRA21-1in the three groups were measured by electrochemiluminescence and the level of the above serum indexes in patients with different disease stages (stage Ⅰ to Ⅱ,Ⅲ to Ⅳ) in the observation group were compared.The 3 groups were examined by color Doppler high frequency ultrasound.The specificity,sensitivity and accuracy of color Doppler ultrasound combined with serum CA153,CEA and CYFRA21-1 or detecting alone in the diagnosis of breast cancer analyzed.Results There were significant differences in the levels of serum CA153,CEA and CYFRA21-1 in the 3 groups (P ＜0.05),and the level of serum CA153,CEA and CYFRA21-1 in the observation group was higher than that in the control group A and the control group B (P ＜ 0.05).The levels of serum CA153,CEA and CYFRA21-1 in patients in stage Ⅲ to Ⅳ of the observation group were higher than those in patients in stage Ⅰ to Ⅱ (P ＜ 0.05).The sensitivity and accuracy of color Doppler ultrasound combined with serum CA153,CEA and CYFRA21-1 in the diagnosis of breast cancer were 96.25％ (77/80) and 84.93％ (231/272),respectively,which were all higher than those of serum CA153,CEA and CYFRA21-1 alone (P ＜ 0.05).And the sensitivity of combined diagnosis was higher than that of color Doppler high frequency ultrasound alone (P ＜ 0.05).Conclusions Color Doppler ultrasound combined with serum levels of CA153,CEA and CYFRA21-1 can significantly improve the sensitivity and accuracy of breast cancer diagnosis,reduce the risk of missed diagnosis,and provide a strong basis for diagnosis and treatment of breast cancer.
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Microwave ablation,as a minimally invasive therapy,causes focal hyperthermic injury to ablated tumors.It also induces anti-tumor immunity which could contribute to another mechanism of tumor destruction.Combination with immunotherapy could further enhance the tumor-specific immunity,lead to stronger inhibitory effects on both primary and metastatic lesions and decrease recurrence and metastasis.Thus,combination of microwave ablation and immunotherapy is a promising approach in the treatment of solid tumors,especially for advanced cancers.This article reviews recent advances in the mechanism and application of immune effect induced by microwave ablation.
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Early identification and diagnosis of hepatocellular carcinoma (HCC) is necessary for improving survival rates of HCC patients. Studies have shown that the abnormal proteins released by tumor cells, i.e., the autoantibodies stimulated by tumor-associated antigens (TAAs), can be detected before a clinical diagnosis of HCC is made, and therefore, such proteins may become the new markers for the early diagnosis of HCC. This article reviews the application of several new autoantibodies to tumor-associated antigens in the diagnosis of HCC and points out that these autoantibodies have promising prospects and clinical significance in the early diagnosis of HCC.
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Although tumor immunotherapy has been proposed for many years,the consensus denoting it as an essential approach for fighting against cancer is reached only in recent years. Tumor immunotherapy can be categorized as active and passive ones. In order to successfully cure cancer,safe and efficient active immunotherapy is required. Dendritic cells (DCs)are not only the bridge linking innate and adaptive immunity,but also the key determinants of the quality of adaptive immunity:immunity versus immune tolerance. Therefore,the safe and efficient DC-based tumor-specific and broad-spectral tumor vaccine has an irreplaceable important position in tumor immunotherapy. Because of the high heterogeneity of DCs, the research on DC-based tumor vaccine has encountered a bottleneck. Here,we reviewed the progress in research on DC-based tumor vaccine and related problems needed to be resolved with the incorporation of our experiences.
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The incidence of prostate cancer ( PCa ) is rising steadily among males in many countries.Serum prostate-specific antigen ( PSA ) is widely applied in clinical diagnosis and screening of PCa.However, the grey area of PSA levels has a low specificity in PCa screening and may lead to a high rate of negative biopsy and overtreatment.The PCA3 gene is strongly and specifically overexpressed in PCa cells and malignant prostate tissue.The gene has been identified as a molecular biomarker for PCa detecting.The diagnostic significance of PCA3, however, is awaiting further researches.In this review, the progress of molecular biological characteristics of PCA3,and its applications in diagnosis and treatment of prostate cancer were discussed.
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Primary hepatic carcinoma is one of the most common cancer in China.There is no accurate and reliable serological diagnostic method could be used for the early diagnosis and prognosis evaluation of primary hepatic carcinoma at present.The detection of autoantibody for tumor associated antigens has high sensitivity and specificity to diagnose cancer.Thus,measurement of autoantibodies of primary hepatic carcinoma is expected to achieve early diagnosis and prognosis evaluation.The research situation and application prospect of these biomarkers are summarized.
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Objective To explore the significance of serum squamous cell carcinoma antigen (SCC-Ag) in the diagnose of recurrent squamous cell carcinoma of cervix, and seek an effective approach to monitor tumor recurrence after treatment as early as possible. Methods All the data were collected from 1 557 patients with cervical squamous cell carcinoma treated in the First Affiliated Hospital of Bengbu Medical College from Jan. 2004 to Dec. 2010, the data of un-controlled cases(patients whose serum level of SCC-Ag failed to decrease to normal level or patients with incomplete tumor extinction)were eliminated, there were 1 394 cases of complete remission were analyzed,the median age was 46 years( rang, 18-72 years). According to International Federation of Gynecology and Obstetrics stages (FIGO, 1994), 71 cases were in stageⅠa, 360 cases stageⅠb, 254 cases stageⅡa, 207 cases stageⅡb, 95 cases stageⅢa, 289 cases stageⅢb, 106 cases stageⅣa and 12 cases stageⅣb. Radical hysterectomy was performed in 685 cases with stageⅠ-Ⅱa, concurrent radiation and chemotherapy was performed in 709 cases with stageⅡb-Ⅳ. Taking serum cut off value of SCC-Ag was 1.95 μg/L, the level ≤1.95 μg/L as SCC-Ag negative expression and>1.95μg/L as SCC-Ag positive expression. The positive expression status of SCC-Ag before treatment, the relationship between the post-treatment recurrence rate after SCC-Ag becoming negative and the clinicopathological features of the patients with cervical squamous cell carcinoma were analyzed, concurrently combined with gynecological check-up, pathological and imaging examination, followed by comparative analysis with the results of monitoring. Results Among 1 394 patients with cervical squamous cell carcinoma, there were 1 169 cases with positive SCC-Ag, the positive expression rate of SCC-Ag before treatment was closely related with the clinical stages and tumor size(all P0.05). The positive expression of SCC-Ag in 1 169 patients before treatment turned negative after treatment, 279 patients with recurrence whose positive expression of SCC-Ag turned negative after treatment, the recurrence rate was closely related with clinical stages, pathological grade, lymphatic metastasis and tumor size(all P5μg/L for patients with central recurrence was 4.2%(4/96), whilein the group of pelvic wall recurrence group was 56.2%(45/80)and in distant metastasis group was 87.4%(90/103). The level of SCC-Ag>5μg/L from the patients with pelvic wall recurrence and distant metastasis were much higher than that of patients with central recurrence (P<0.01), and the same results were shown between distant metastasis group and pelvic wall recurret group (P<0.01). Conclusions SSC-Ag expression in serum of patients with cervical squamous carcinoma is closely related with clinical stages and the tumor size. Dynamic monitoring the level of SSC-Ag could contribute to the early diagnosis for tumor recurrence, but it has some limitations for patients with central recurrence, which should deserve our attention.
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Objective To evaluate the outcomes and prognostic factors of distant metastasis in patients with advanced cervical squamous cell carcinoma treated with concurrent chemoradiotherapy (CCRT). Methods A total of 118 patients with International Federation of Gynecology and Obstetrics (FIGO, 2009 version) stageⅡb-Ⅳa cervical squamous cell carcinoma treated with CCRT between 2006 and 2010 in the Second Affiliated Hospital of Dalian Medical University were analyzed. Their median age was 48 years (range, 23-70 years). FIGO stages were as follows:Ⅱb stage 56 cases,Ⅲa stage 6 cases,Ⅲb stage 52 cases, andⅣa stage 4 cases. Of the all patients, 55 cases showed bulkly tumor (tumor size>4 cm) and 35 cases were pelvic lymph node positive. Forty patients had pretreatment hemoglobin (Hb) levels no greater than 110 g/L. Patients with elevated squamous cell carcinoma antigen (SCC-Ag) >1.5 μg/L before CCRT and at one month after CCRT were 91 cases and 34 cases, respectively. Kaplan-Meier method was used to estimate survival. For the analysis of prognostic factors affecting distant metastasis, log-rank test was used for univariate analysis, and Cox proportional hazard model was used for multivariate analysis. Results Thirty-seven patients were diagnosed with recurrence, 19 cases of whom developed distant metastasis, 13 cases developed loco-regional recurrence and 5 cases had both distant and loco-regional recurrence. The 5-year overall survival rates and distant disease-free survival of all patients were 64.0% and 78.8%, respectively. Two patients had grade 3 acute gastrointestinal toxicity (mainly diarrhea) and 20 cases had grade 3 to 4 hematologic toxicity. Seven patients experienced grade 3 to 4 late toxicity, 5 cases of them were gastrointestinal and 2 cases were genitourinary toxicity. Univariate analysis showed that FIGO stages, SCC-Ag level at one month after treatment, pretreatment hemoglobin level, and pelvic lymph node metastasis were significantly correlated with distant metastasis (all P<0.05). Multivariate analysis showed that FIGO stage, SCC-Ag level at one month after treatment, and pelvic lymph node metastasis were independent prognostic factors for distant metastasis (all P<0.05). Conclusions For stageⅡb-Ⅳa cervical squamous cell carcinoma, the regimen of CCRT was efficacious and safe. The predictive factors for distant metastasis in patients withⅡb-Ⅳa stage squamous cell carcinoma of cervix treated with CCRT included FIGO stage, SCC-Ag level at one month after treatment, and pelvic lymph node metastasis. New treatment strategies should be considered to control distant metastasis for these patients.
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Objective To explore the predictive value of serum CEA and cytokeratin-19 fragments (CYFRA21-1)prior treatment for the epidermal growth factor receptor (EGFR) mutation and efficacy of tyrosine kinase inhibitors ( TKI ) in patients with non-small cell lung cancer.Methods The study was a clinical research.Totally 101 matched tissue and plasma samples were collected from Peking University People′s Hospital from 2012 to 2013.All clinical specimens were analyzed for EGFR mutations in exons of 18, 19, 20 and 21 by ADx-ARMS and direct sequencing, and the serum levels of CEA and CYFRA21-1 were analyzed by ECLI.The correlation between EGFR mutant status and efficacy of EGFR-TKI and clinicopathological parameters were analyzed by χ2 test, Log-rank text and Cox proportional hazards regression model.Results The mutation rate was 60.4%(61/101) by ADx-ARMS and 33.7%(34/101) by direct sequencing.Mutations were more frequently observed in the higher serum CEA level patients(≥5μg/L,78.8%).However, the rates of EGFR mutations of different CEA levels were similar.Among the patients receiving TKI therapy, the efficacy of EGFR-TKI was closely related to serum CYFRA21-1 level prior treatment and EGFR mutation (χ2 =8.903, P =0.003; χ2 =28.590, P <0.001 ).And serum CYFRA21-1 level prior treatment and EGFR mutation were independent factors for EGFR-TKI treatment affecting PFS (RR=0.298, P<0.001;RR=0.086, P<0.001).Conclusion The mutation rate of EGFR was significantly related with the expression level of CEA prior treatment, and serum CEA and CYFRA21-1 levels prior treatment could be potential predictors of EGFR-TKI efficacy.
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PURPOSE: To investigate protein expression and mutations in phosphatase and tensin homolog (PTEN) in patients with stage IB cervical squamous cell carcinoma (CSCC) and the association with clinical-pathologic features, tumor p53 expression, cell proliferation and angiogenesis. METHODS: Women with stage IB CSCC (n=20 - Study Group) and uterine myoma (n=20 - Control Group), aged 49.1±1.7 years (mean±standard deviation, range 27-78 years), were prospectively evaluated. Patients with cervical cancer were submitted to Piver-Rutledge class III radical hysterectomy and pelvic lymphadenectomy and patients in the Control Group underwent vaginal hysterectomy. Tissue samples from the procedures were stained with hematoxylin and eosin for histological evaluation. Protein expression was detected by immunohistochemistry. Staining for PTEN, p53, Ki-67 and CD31 was evaluated. The intensity of PTEN immunostaining was estimated by computer-assisted image analysis, based on previously reported protocols. Data were analyzed using the Student's t-test to evaluate significant differences between the groups. Level of significance was set at p<0.05. RESULTS: The PTEN expression intensity was lower in the CSCC group than in the Control (benign cervix) samples (150.5±5.2 versus 204.2±2.6; p<0.001). Our study did not identify any mutations after sequencing all nine PTEN exons. PTEN expression was not associated with tumor expression of p53 (p=0.9), CD31 (p=0.8) or Ki-67 (p=0.3) or clinical-pathologic features in patients with invasive carcinoma of the cervix. CONCLUSIONS: Our findings demonstrate that the PTEN protein expression is significantly diminished in CSCC. .
OBJETIVO: O objetivo do estudo foi investigar a expressão e mutações do PTEN em pacientes com Carcinoma de Células Escamosas (CCE) de Colo do Útero com estadiamento IB e sua associação com fatores prognósticos, expressão do p53, proliferação celular e angiogênese. MÉTODOS: Mulheres com diagnóstico de CCE de colo uterino em estágio IB (n=20) (casos) e mioma uterino (n=20) (controle) com idade de 49.1±1.7 foram acompanhadas. As pacientes com câncer de colo do útero foram submetidas a histerectomia Piver-Rutledge classe III associada a linfadenectomia pélvica e aquelas com mioma uterino a histerectomia vaginal. Amostras de tumor e colo normal foram retiradas para avaliação histológica e marcação imuno-histoquímica das proteínas PTEN, p53, ki-67 e CD 3. A intensidade imuno-histoquímica do PTEN foi estimada por processamento de imagem digital a partir de protocolos pré-estabelecidos. Os dados foram analisados através do teste de qui - quadrado (χ2). O nível de significância foi considerado quando p < 0,05. RESULTADOS: A expressão do PTEN estava diminuída no grupo de pacientes com CCE em comparação ao grupo controle (150.5±5.2 versus 204.2±2.6; p<0.001). Nenhuma mutação no seqüenciamento genético dos nove exons do PTEN foi encontrada. Não houve associação estatisticamente significativa entre a expressão do PTEN e a expressão do p53 (p=0,969), Ki-67 (p=0.283) e CD 31 (p=0.817) ou fatores prognósticos anátomo-clínicos nas pacientes com carcinoma invasor do colo uterino. CONCLUSÕES: Este estudo demonstrou que o PTEN estava significativamente diminuído nas pacientes com CCE. .
Subject(s)
Adult , Aged , Female , Humans , Middle Aged , /biosynthesis , Carcinoma, Squamous Cell/genetics , PTEN Phosphohydrolase/biosynthesis , PTEN Phosphohydrolase/genetics , Uterine Cervical Neoplasms/genetics , Gene Expression Regulation, Neoplastic , /biosynthesis , Mutation , Prospective Studies , /biosynthesis , Uterine Cervical Neoplasms/pathologyABSTRACT
Liver cancer is one of the most common malignant tumors in the world.The mortality of patients with liver cancer remains high e-ven with increasing progress in therapies.Early diagnosis is helpful for prolonging the survival of patients,so new biomarkers need to be ex-plored for timely diagnosis and treatment of liver cancer.The present research focuses on tumor-associated antigens (TAAs)and their cor-responding autoantibodies as serological biomarkers of liver cancer.The production of autoantibodies and the TAAs and anti-TAAs currently found in the liver cancer tissue are summarized.In addition,it is pointed out that these newly found autoantibodies have relatively high sen-sitivity and specificity for the early diagnosis of liver cancer.
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Objective To investigate the expression and clinical significance of tumor-associated carbohydrate anti-gen sTn in endometrium from patients with atypical hyperplasia of endometrium, endometrial carcinoma and benign the uter-ine lesion. And to analyze the association between sTn and the pathologic stage and grade of endometrial carcinoma. Meth-ods sTn was detected by immunohistochemistry in 193 patient samples, including 93 subjects with endometrial carcinoma, 50 subjects with atypical hyperplasia of endometrium and 50 subjects with benign uterine lesions. Results The positive sTn rate in endometrial carcinoma group was 73.1%,which was significantly different from that in atypical hyperplasia endo-metrium group (32%) and that in benign uterine lesion group (14%), (P＜0.017). sTn positive rate in patients with endometri-al carcinoma was 78.8%which is higher than that in patients with other diseases (P＜0.008 ). The positive rate of sTn in pa-tients with poorly differentiated endometrial carcinoma was significantly higher than that in patients with highly differentiat-ed endometrial carcinoma (P＜0.017). The positive rate of sTn in tissues of tumor infiltration with depth of more than half of myometrial was significantly higher than in tissues of tumor infiltration with depth of equal or less than half of myometrial (P＜0.05). But there was no significant difference in sTn positive rate between the endometrial carcinoma groups with and without lymph node metastasis (P>0.05). Conclusion sTn may play a role in the tumorigenesis and development of endo-metrial carcinoma.
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Objective To assess the diagnostic value of human epididymis secretory protein (HE4) versus CA125 for endometrial cancer.Methods Serum HE4 and CA125 levels were measured by enzyme-linked immunosorbent assay (ELISA) and electrochemiluminescence immunoassay (ECLI) in 35 patients with endometrial cancer,48 patients with benign endometrial disorders and 40 healthy controls.The best cutoff value,sensitivity and specificity were calculated with pathological results as golden standard.Receiver operating characteristic curves were plotted,and areaunderthecurve (ROC-AUC) was used to compare diagnostic value of HE4 and CA125.Results The median value in HE4 in endometrial cancer were 51.46 pmol/L,which was significantly higher than in the healthy and benign disorder controls (25.65 pmol/L and 27.92 pmol/L).However,CA125 levels did not show statistically significant difference among the 3 groups.The ROC-AUC of HE4 for discriminating endometrial cancer between healthy controls and benign disorder controls were 0.922 and 0.759,respectively,which showed higher diagnostic value than CA125 (ROC-AUC of 0.590 and 0.457,respectively).HE4 had a specificity/sensitivity of 87.5％ /86.1％ for distinguishing healthy controls from endometrial cancer,and 95.5％ /50％ for differential diagnosis with benign disorders.Conclusions Measurement of HE4 can be used as a tumor marker for diagnosis of endometrial cancer.
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Objective To establish a novel method for detecting circulating tumor cells (CTCs) in phripheral blood of lung cancer patients with high sensitivity and specificity.Methods Experimental study.42 cases of initial treatment patient who underwent resection and diagnosed to be non-small cell lung cancer by biopsy were studied,including 7 patients at stage Ⅰ,9 patients at stage Ⅱ,16 patients at stage Ⅲ and 10 patients at stage Ⅳ.As a control group,20 cases of healthy volunteers were selected.A series of experiments was conducted to determine the efficiency of tumor cells isolation,in which varied concentration (50,100,200,500,1000 cells) of A549 cells spiked into 2 ml peripheral blood drawn from healthy donors.The blood was removed of unwanted erythrocytes by lysis buffer,and made the rest of nucleated cells incubate with anti-EpCAM magnetic beads,then separated and enriched by a specific detector.All epithelia cells were retained on a slide because of a magnetic force and identified by H&E staining protocol.On the basis of cell recovery rate we calculated the sensitivity of tumor cells isolation.20 blood samples taken from healthy individuals were also detected to validate the specificity of this method.Samples of 42 patients with lung cancer were assayed for CTCs detection by above method.The correction of CTCs quantity with the patients' clinical features,for example,ages,gender,clinical stage,tumor size was analyzed in lung cancer patients by chi-square statistics.The correction of recovery cells with the spiked cells were assayed by linear correlation.Results The recovery rate was ranging from 68％ to 82％ by spiking varying numbers of A549 lung cancer cells into 2ml blood samples of healthy volunteers.Regression analysis of number of recovered vs.spiked A549 cells yielded a regression equation of Y =0.6419X + 8.8875.The number of CTCs detected has signification correlate with the cells spiked (R2 =0.9916,P ＜ 0.05),Eighteen of the 42 patients (43％) were found have CTCs in peripheral blood.The detection rate of lung cancer cells was 0 at stage Ⅰ,the detection rate of lung cancer cells was 11.1％ at stage Ⅱ,the detection rate of lung cancer cells was 62.5％ at stage Ⅲ and the detection rate of lung cancer cells was 70％ at stage Ⅳ.The positive rate of CTCs has no signification correlate with ages and gender of patients and tumor size (P ＞ 0.05),has signification with the clinical stage (P ＜ 0.05).None of the peripheral blood samples of the 20 healthy subjects analyzed was found to have CTCs.Conclusions This novel immunomagnetic separation technology is a sensitive and specific method,which provides a new tool allowing for feasible and specific detection of CTCs in lung cancer patients.The level of CTCs increases with the clinical stage and tumor size increased,which has important value to discover the early stage micrometastasis and redefine the clinical stage.But further multicenter and large sample clinical research are needed to confirm its clinical value.
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Objective To explore the diagnostic value of four tumor markers analyzed with Logistic regression and receiver operator characteristic (ROC) curve in patients with lung cancer.Methods The serum levels of carcinoembryonic antigen (CEA) 、carbohydrate antigen 125 (CA125),cytokeratin 19 fragment (CYFRA21-1) and neuron specific enolase (NSE) were determined by radioimmunoassay in 112 patients with lung cancer and 74 patients with benign pulmonary disease.Four tumor markers were analyzed by Logistic regression and ROC curve.Results The serum levels of CEA,CA125,CYFRA21-1 and NSE in lung cancer patients were [4.53(2.22-11.53)ng/ml,28.97 (11.39-62.10) U/ml,4.05(2.29-8.18)ng/ml,14.11 (11.35-24.12) ng/ml],respectively,which were significantly higher than those in health adults[2.08 (1.45-2.52) ng/ml,12.90 (9.80-19.44) U/ml,1.53 (1.21-2.17) ng/ml,11.38 (9.07-12.80) ng/ml] (all P ＜ 0.01).According to regression equation Y =1/[1 + EXP (4.902-0.394X1-0.627X2-0.165X3)],the area under the ROC curve (AUC),sensitivity,specificity,and accuracy of new variable Y were 0.915 ± 0.020,79.46％,93.24％,and 84.95％,respectively.Conclusions Application of logistic regression and ROC curve increases diagnostic accuracy in lung cancer.
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Objective To investigate serum cancer antigens (CA) 125 expression in different types of ovarian endometriosis and related factors.Methods A total of 182 patients with ovarian endometriosis was collected,then they were divided into two groups:ovarian endometriosis combined with other parts of lesions (A group,88 cases),simple ovarian endometriosis group (B group,94 cases).And selected 100 healthy physical check-up women from the hospital outpatient department were as control group.The serum level of CA125 was detected.The patients' information including body shape,menstrual factors,reproductive activities and disease staging were collected.Chi-square criterion and multivariate binary Logistic regression analysis were completed.Results The serum levels of CA125 in A group,B group and control group were (48.64 ± 33.18),(41.35 ± 23.46),(22.16 ± 13.73) kU/L,respectively,and the positive expression rate of three groups were 64.77％ (57/88),52.13％ (49/94),2.00％ (2/100),respectively,there were significant differences (P ＜ 0.05).The multivariate binary Logistic regression analysis result showed that age of 35-49years,reforming American fertility society of Ⅲ-Ⅳ stage,pelvic adhesion and menorrhalgia were the important factors of positive expression of CA125.Conclusion The serum level of CA125 can be used as the evaluation of the diagnosis and treatment of ovarian endometriosis.