ABSTRACT
Objective:To screen the serum exosomal microRNAs differentially expressed in early pancreatic cancer patients and evaluate the diagnostic value of exosomal hsa-let-7f-5p.Methods:From January 2019 to January 2020, 19 patients with early pancreatic cancer (early pancreatic cancer group) and 16 patients with chronic mass-forming pancreatitis (pancreatitis group) were selected from Affiliated Hospital of Nanjing University of Chinese Medicine who underwent surgery and were confirmed by pathology. Serum samples of the two groups of patients were collected. At the same time, serum samples of 19 healthy volunteers were selected as the normal control group. The exoEasy Maxi Kit was used to isolate serum exosomes. The structural characteristics of exosomes were observed by transmission electron microscopy (TEM). The particle size of exosomes was observd by nanoparticle tracking analysis. CD 63 and CD 81, the specific protein marker on the surface of exosomes, were identified by western blotting. The total RNA of exosomes was extracted by the miRNeasy Serum/Plasma Kit, and a small RNA library was constructed after quality inspection. With reference to the small RNA database, the differentially expressed exosomal microRNAs in early pancreatic cancer group, pancreatitis group and normal control group were filtered out. The miRNA candidates were validated by quantitative polymerase chain reaction (qPCR) and different expressions of them were analyzed. The role of target genes and metabolic pathways of candidate miRNAs in the occurrence and development of early pancreatic cancer were analyzed by gene ontology (GO) and Kyoto Encyclopeda of Genes and Genomes(KEGG) enrichment pathway. Results:The isolated serum exosomes can be seen to have cup-like vesicle with the double lipid layer by TEM. The main peak of the particle size of target exosomes was about 150 nm. The expression of exosome specific protein markers CD 63 and CD 81 was positive. Comparing the expression of miRNAs among early pancreatic cancer group, pancreatitis group and normal control group, the specific tumor marker exosomal hsa-let-7f-5p was screened out in this study, and its expression in early pancreatic cancer group was significantly higher than that in pancreatitis group and normal control group (both P values <0.05). Receiver operating characteristic curve analysis (ROC) showed that the area under curve (AUC) of exosomal hsa-let-7f-5p to distinguish pancreatic cancer from pancreatitis was 0.843 (95% CI 0.640-1.000). The sensitivity and specificity were 100% and 81.82% respectively. The AUC for distinguishing pancreatic cancer from normal controls was 1.000 (95% CI 1.000-1.000), and both sensitivity and specificity were 100%. The diagnostic efficiency of exosomal hsa-let-7f-5p was equivalent to that of CA19-9 ( P>0.05). The GO analysis results showed that target genes of exosomal hsa-let-7f-5p were mainly involved in complement activation lectin pathway in biological processes, and the proteins expressed by target genes were mainly distributed in cilium, and molecules mostly functioned by combining with nitric-oxide synthase. The KEGG pathway enrichment analysis showed that the target genes were closely related to MAPK signaling pathway. Conclusions:Serum exosomal hsa-let-7f-5p has the potential to be a diagnostic biomarker for early pancreatic cancer.
ABSTRACT
Background: The predictive value of different prognostic biomarkers has been studied in various cancer types. Aims and Objectives: The purpose of this study was to examine the degree of risk and prognostic significance of pretreatment neutrophil-to-lymphocyte ratio (NLR) and carbohydrate antigen (CA) 19-9 levels in patients with metastatic pancreatic cancer (PC) and reveal its relevance with survival. Materials and Methods: Clinical and laboratory data of 118 patients with metastatic PC at the time of diagnosis were retrospectively analyzed. The overall survival (OS) was estimated according to the Kaplan–Meier method. To determine the prognostic factors affecting PC, the Cox regression analysis was performed. Results: The average age of the patients was 67 ± 9.57 years. The patients were analyzed during the follow-up period, and their average OS was 12 months (95% confidence interval [CI] = 9.73–14.26). The cutoff value was 3.54 (area under the curve [AUC] = 0.653, 95% CI = 0.56–0.73, P = 0.006) for NLR and 437 (AUC = 0.670, 95% CI = 0.57–0.75, P = 0.002) for CA19-9. Statistically significant difference was found between CA19-9 (P < 000.1) and NLR (P < 000.1) and OS. Analysis of multivariate Cox regression showed that NLR (hazard ratio [HR] = 2.17, 95% CI = 1.17–4.03, P = 0.013) and CA19-9 (HR = 1.81, 95% CI = 1.08–3.03, P = 0.022) were important prognostic factors in OS analysis. Conclusion: Pretreatment NLR and CA19-9 levels were found to be reliable estimative markers for poor prognosis in patients with metastatic PC. Our findings revealed that NLR and CA19-9 levels can be used to estimate the survival of patients with PC. We believe that our findings will shed light on the management of treatment protocols for patients diagnosed with metastatic PC
ABSTRACT
Background: Carbohydrate antigen (CA) 19-9 is considered as a tumor marker in biliary-pancreatic malignancy. Though a high level may indicate the presence of a malignant disorder, it may rise even in benign condition. Similarly, the value may be normal even in malignant condition.Methods: An observational comparative study was conducted in the Department of Surgery of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from 01 June 2016 to 31 May 2017 to find out the sensitivity and specificity of CA 19-9 as a tumor marker in pancreatic malignancy in our perspective and to find out a cut-off value of CA 19-9 which might prove as a definitive indication of pancreatic malignancy.Results: The study shows when the cut off value of CA 19-9 is 37 U/ml. The sensitivity, specificity, positive and negative predictive values (PPV and NPV) were 77.8%, for all four characteristics respectively. But if the serum CA 19-9 threshold used to diagnose pancreatic cancer was raised to 100 and 120, sensitivity decreased to 72.2% and 66.7% and NPV decreased to 76.2% and 73.9% respectively. However, specificity increased to 88.9% and 94.4% and PPV increased to 86.7% and 92.3% respectively.Conclusions: Serum CA 19-9 level may be considered as an important determinant in the diagnosis of malignant pancreatic diseases and to assess the resectability of the lesions preoperatively, but other adjuncts are necessary in the overall management of pancreatic diseases.
ABSTRACT
Objective To explore the four tumor markers of alpha-fetoprotein ( AFP ), α-L-fucosidase( AFU), carbohydrate antigen 199 ( CA199) and carcinoembryonic antigen ( CEA) and their combined use for primary hepatocellular carcinoma (HCC) diagnosis and treatment value. Methods From February 2016 to August 2018,92 patients with primary hepatocellular carcinoma (HCC group),79 patients with benign liver disease (chronic hepatitis and cirrhosis group) and 99 healthy adults (control group) were selected as subjects. The serum levels of four tumor markers in different populations were compared. Results The serum levels of four tumor markers ( AFP ( 192. 4 ± 89. 3) μg／L、AFU( 78. 6 ± 25. 8) U／L、CA199 (107. 2 ± 59. 5) U／mL、 CEA ( 37. 9 ± 14. 9) μg／L) were significantly higher than those of benign liver disease group(AFP( 17. 4 ± 6. 3) μg／L、AFU( 35. 4 ± 17. 2) U／L、CA199( 29. 3± 15. 2) U／mL、CEA( 4. 9 ±1. 7) μg／L) and normal people( AFP(4. 8±1. 1) μg／L、AFU(12. 2±3. 6) U／L、CA199( 6. 4± 2. 3) U／mL、CEA(1. 8±0. 4) μg／L) . There differences had significant ( all P＜0. 05) . The abnormal rate of single factor in hepatocellular carcinoma group ( AFP 84. 8%, AFU 52. 2%, CA199 41. 3%, CEA35. 9%) was significantly higher than that in benign liver disease group ( AFP 15. 2%, AFU 19. 0%, CA19916. 5%, CEA13. 9%) and normal group (AFP 4. 0%,AFU 5. 0%,CA199 3. 0%,CEA 6. 0% ug／L),the difference was statistically significant ( all P＜0. 05) . The highest sensitivity was AFP ( 84. 8%) and the highest specificity was AFP and CA199 (91. 0%). The sensitivity of combined detection was 94. 6% higher than that of single index ( AFP 84. 8%, AFU52. 2%, CA199 41. 3%, CEA35. 9%) . Conclusion The combined detection of AFP,AFU,CA199 and CEA can increase the sensitivity of diagnosis of hepatocellular carcinoma and reduce the rate of missed diagnosis, which will be beneficial to the early diagnosis and treatment of hepatocellular carcinoma.
ABSTRACT
Objective@#To investigate the clinical value of serum pepsinogen (PG), carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9) in diagnosis, prognosis evaluation and postoperative monitoring of gastric cancer.@*Methods@#A total of 100 patients diagnosed by the gastroscope in the Third People's Hospital of Hefei from January 2016 to October 2018 were selected. The patients were divided into the non-atrophic gastritis group (50 cases) and the gastric cancer group (50 cases) according to histopathological results. Enzyme linked immunosorbent assay (ELISA) was used to detect the levels of serum PGI and PGII. The ratio of PGI and PGII ratio (PGR) was calculated. Radioimmunoassay was used to detect CEA and CA19-9 levels.@*Results@#Serum PGI and PGR in the gastric cancer group were lower than those in the non-atrophic gastritis group [PGI: (96±35) μg/L vs. (144±44) μg/L; PGR: 7±3 vs. 11±5], and there was a significant difference (t = 3.861, P < 0.01; t = 3.043, P = 0.003]. Serum CEA and CA19-9 in the gastric cancer group were higher than those in the non-atrophic gastritis group [(7.5±4.8) ng/ml vs. (1.5±0.6) ng/ml, (49.7±29.4) U/ml vs. (8.7±2.6) U/ml], and there were statistical differences (t = 3.100, P = 0.003; t = 3.139, P = 0.002). Serum PGR of the gastric cancer group was decreased in TNM Ⅲ-Ⅳ stage, poorly differentiated adenocarcinoma and lymph node metastasis (t = 2.185, P = 0.034; t = 2.197, P = 0.033; t = 2.130, P = 0.038); CA19-9 of the gastric cancer group was increased in TNM stage (Ⅲ-Ⅳ stage) and lymph node metastasis (t = 2.405, P = 0.020; t = 2.076, P = 0.043). There were no statistical differences in PGⅠ, PGⅡ and CEA of gastric cancer patients with different clinicopathological characteristics (all P > 0.05). Serum PGⅠ [(46±23) μg/L] and PGⅡ [(8±5) μg/L] were decreased in the postoperative gastric cancer group (t = 4.263, P < 0.01; t = 5.830, P < 0.01). Serum CEA and CA19-9 of the postoperative metastatic group were higher than those of the postoperative non-metastatic group [(35.3±14.5) ng/ml vs. (3.6±2.2) ng/ml, (126±57) U/ml vs. (27±12) U/ml].@*Conclusion@#Combined detection of serum PGⅠ, PGⅡ, CEA and CA19-9 could be used for the diagnosis and prognosis evaluation of gastric cancer, and it has a certain clinical value for postoperative metastasis monitoring of gastric cancer.
ABSTRACT
Objective To investigate the clinical value of serum pepsinogen (PG), carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9) in diagnosis, prognosis evaluation and postoperative monitoring of gastric cancer. Methods A total of 100 patients diagnosed by the gastroscope in the Third People's Hospital of Hefei from January 2016 to October 2018 were selected. The patients were divided into the non-atrophic gastritis group (50 cases) and the gastric cancer group (50 cases) according to histopathological results. Enzyme linked immunosorbent assay (ELISA) was used to detect the levels of serum PGI and PGII. The ratio of PGI and PGII ratio (PGR) was calculated. Radioimmunoassay was used to detect CEA and CA19-9 levels. Results Serum PGI and PGR in the gastric cancer group were lower than those in the non-atrophic gastritis group [PGI: (96±35) μg/L vs. (144±44) μg/L; PGR: 7±3 vs. 11±5], and there was a significant difference (t=3.861, P<0.01; t=3.043, P=0.003]. Serum CEA and CA19-9 in the gastric cancer group were higher than those in the non-atrophic gastritis group [(7.5 ±4.8) ng/ml vs. (1.5 ±0.6) ng/ml, (49.7±29.4) U/ml vs. (8.7±2.6) U/ml], and there were statistical differences (t= 3.100, P= 0.003; t= 3.139, P= 0.002). Serum PGR of the gastric cancer group was decreased in TNM Ⅲ-Ⅳ stage, poorly differentiated adenocarcinoma and lymph node metastasis (t= 2.185, P= 0.034; t= 2.197, P= 0.033; t= 2.130, P=0.038); CA19-9 of the gastric cancer group was increased in TNM stage (Ⅲ-Ⅳ stage) and lymph node metastasis (t= 2.405, P= 0.020;t= 2.076, P= 0.043). There were no statistical differences in PGⅠ, PGⅡand CEA of gastric cancer patients with different clinicopathological characteristics (all P> 0.05). Serum PGⅠ[(46±23)μg/L] and PGⅡ[(8±5)μg/L] were decreased in the postoperative gastric cancer group (t=4.263, P<0.01; t=5.830, P<0.01). Serum CEA and CA19-9 of the postoperative metastatic group were higher than those of the postoperative non-metastatic group [(35.3±14.5) ng/ml vs. (3.6±2.2) ng/ml, (126±57) U/ml vs. (27±12) U/ml]. Conclusion Combined detection of serum PGⅠ, PGⅡ, CEA and CA19-9 could be used for the diagnosis and prognosis evaluation of gastric cancer, and it has a certain clinical value for postoperative metastasis monitoring of gastric cancer.
ABSTRACT
Objective To investigate the diagnosis of colon cancer patients and the prediction of postoperative recurrence and metastasis in patients with colon cancer by serum angiopoietin-2 (Ang-2) , vascular endothelial growth factor (VEGF) , carbohydrate antigen 199 and carcinoembryonic antigen CEA. Methods 100 patients with colon cancer, 100 patients with benign colonic lesions and 100 healthy subjects were examined. The levels of Ang-2, VEGF, CA19-9 and CEA in serum were detected, and the diagnosis and postoperative recurrence and metastasis of colon cancer were investigated. Results The levels of serum Ang-2, VEGF, CA19-9 and CEA in colon cancer group were higher than those in benign lesions and healthy controls (P < 0.05). The levels of Ang-2, VEGF, CA19-9 and CEA were detected. The sensitivity and specificity of each index were significantly higher in the diagnosis of colon cancer. The preoperative recurrence and metastasis rates of patients with positive Ang-2, VEGF, CA19-9 and CEA were higher than those of the negative patients respectively. Survival analysis showed a statistically significant difference in the time of distant metastasis between different expression states (P < 0.05). Conclusion The detection of serum levels of Ang-2, VEGF, CA19-9 and CEA has clinical significance for the diagnosis of colon cancer. Combined detection can improve the diagnostic efficiency; the levels of Ang-2, VEGF, CA19-9 and CEA in serum before surgery colon cancer is associated with recurrence and metastasis, and combined testing can help to assess tumor metastasis.
ABSTRACT
Objective To investigate the effect of preoperative carbohydrate antigen 19-9 (CA19-9) levels on the prognosis of hepatocellular carcinoma (HCC) patients with different α-fetoprotein (AFP) levels. Methods The medical records and follow-up data of 3 791 HCC patients undergoing hepatectomy in our hospital from Jan. 4, 2008 to Dec. 31, 2010 were prospectively collected. When 400 ng/mL was taken as the cut-off value of preoperative AFP level and 32 U/mL as the cut-off value of preoperative CA19-9 level, the patients were divided into four groups: double positive group (DP group), CA19-9 single positive group [SP (CA19-9) group], AFP single positive group [SP (AFP) group] and double negative group (DN group). The tumor characteristics of the patients in the four groups were compared. Kaplan-Meier analysis and log-rank test were used to analyze the overall survival (OS) and disease-free survival (DFS) of each group. Univariate and multivariate analyses were performed using Cox proportional hazards model to screen the independent factors influencing the prognosis of HCC patients. Results Patients in the four groups had different tumor characteristics. Compared with the DN group, the tumor maximal diameters of patients in the SP (AFP) and DP groups were significantly larger, the percentages of patients with Edmondson-Steiner grade III- were significantly higher and the positive rates of microvascular invasion (MVI) were significantly higher (P<0.01), and the proportion of multiple tumor in the DP group was significantly higher (P<0.05); while the tumor maximal diameter in the SP (CA19-9) group was significantly smaller (P<0.05), and the proportion of multiple tumor was significantly higher (P<0.01). The 1-, 3- and 5-year OS rates of patients in the DN group, SP (CA19-9) group, SP (AFP) group and DP group were decreased successively (P<0.01). The 1-, 3- and 5-year DFS rates of patients in the DN group were the highest (P<0.01), while those in the DP group were the lowest (P<0.01); there were no significant differences in the 1-, 3- or 5-year DFS rates between the SP (CA19-9) and SP (AFP) groups. The stratified analysis of preoperative AFP levels showed that the 1-, 3- and 5-year OS rates and DFS rates in the CA19-9<32 U/mL group were significantly higher than those in the CA19-9≥32 U/mL group. Multivariable analysis showed that AFP≥400 ng/mL, CA19-9≥32 U/mL, intraoperative bleeding≥600 mL, tumor maximal diameter≥5 cm, multiple tumor, absence of tumor capsule, MVI, and Edmondson-Steiner grade III- were independent risk factors of OS (P<0.05); hepatitis B surface antigen (＋), AFP≥400 ng/mL, CA19-9≥32 U/mL, tumor maximal diameter≥5 cm, multiple tumor, absence of tumor capsule, and MVI were independent risk factors of DFS (P<0.05). Conclusion Preoperative serum AFP≥400 ng/mL and CA19-9≥32 U/mL are independent risk factors of OS and DFS in HCC patients. Preoperative CA19-9 level is an important indicator to further assess the prognosis of HCC patients with different AFP levels.
ABSTRACT
Objective: To investigate the application value of high frequency color Doppler flow imaging(CDFI)combined with serum fibrinogen(FIB)and sugar antigen 19-9(CA199)in the preoperative diagnosis of breast cancer.Methods: The clinical data of 226 patients with space occupying lesion of breast were analyzed retrospectively.According to the confirmed situation of postoperative pathological examination,they were divided into breast cancer group(158 cases)and breast disease group(68 cases).All patients received examination of preoperative CDFI and detections of preoperative serum FIB and CA199,and the values of single CDFI examination and it combined with detection of serum FIB and CA199 in preoperative diagnosis of breast cancer were compared.Results: In breast cancer group(158 patients),the ultrasonographic images of 146 patients showed the lumps were hypoechoic or weak echoes,irregular shape and uneven surface,and showed the change of lump appeared cauliflower shape,lobulated or crab foot shape.And the levels of serum FIB and CA199 of breast cancer group were significantly higher than those of breast disease group(t=6.821,t=20.061,P＜0.05),respectively.The sensitivity,negative predictive value and diagnostic coincidence rate of CDFI examination combined with detections of FIB and CA199 for diagnosis of breast cancer were 89.24％,79.76％and 92.04％,respectively.And these were significantly higher than those of single CDFI examination(x2=100.148,x2=37.666,x2=79.636,P＜0.05),respectively.Conclusion: The value of high frequency CDFI examination combined with serum FIB and CA199 in the preoperative diagnosis of breast cancer is significantly higher than that of single examination and single detection,and it has clinical application value.
ABSTRACT
Objective To investigate the clinical value of combined detection of serum carcinoembryonic antigen (CEA),carbohydrate antigen 199 (CA199) and tumor type M2 pyruvate kinase (TuM2-PK) for the diagnosis of early colon cancer.Methods A total of 137 patients with colon cancer in the First Affiliated Hospital of Yunnan University of Traditional Chinese Medicine from February 2014 to November 2016 were selected as observation group,87 patients with benign colon disease were selected as control group,and 75 healthy subjects were selected as health group.The levels of serum CEA and CA199 were detected by electrochemiluminescence,and serum TuM2-PK level was determined by quantitative enzyme-linked immunosorbent assay.The diagnostic value of single and combined detection on early colon cancer were compared.Results The levels and positive expression rate of serum CEA,CA199 and TuM2-PK in the observation group were significantly higher than those in the control group and the health group(P ＜0.05).There was no significant difference in the levels and positive expression rate of serum CEA,CA 199,TuM2-PK between the control group and the health group (P ＜ 0.05).The sensitivity and Youden index of combined detection of CEA,CA199 and TuM2-PK were better than those of single or two indexes detection(P ＜0.05).The specificity of combined detection of CEA,CA199 and TuM2-PK was better than that of single detection and combined detection of CEA,CA199 (P ＜ 0.05).The combined detection of two or three indexes in CEA,CA199 and TuM2-PK had certain diagnostic value for colon cancer,the area under the receiver operating characteristic curve ≥0.70;and the area under the receiver operating characteristics curve of the combined detection of CEA,CA199 and TuM2-PK was the largest.Conclusion The combined detection of CEA,CA199 and TuM2-PK has the high diagnostic value for colon cancer.
ABSTRACT
Objective To establish the time-resolved fluoroimmunoassay(TRFIA)of CA199 based on Mag-netic Microspheres(Nano-TRFIA).Methods Based on a sandwich-type immunoassay format,analytes in sam-ples were captured by magnetic particles coated with anti-CA199 antibody B1 and"sandwiched"by anti-CA199 antibody B7 labeled with europium chelates.A total of 90 serum samples were analysed by this new method. Results The sensitivity was 0.2 U/mL,the intra.and inter.assay CV of the Nano-TRFIA were 4.84% and 8.32% respectively,and the average recovery rate was 97.91%.The cross-reacting rates with alpha fetopro-tein and CA125 were negligible.The labeled B1 with Magnetic Microspheres was at least stable for three months at 4 ℃.Serum samples from patients and healthy blood donors were analyzed,the linear correlation of TRFIA and ECLIA measurements was positive(Y = 0.969 8X+ 4.015 3).As the gold standard of ECLIA, Nano-TRFIA had two false positive.Conclusion The newly developed Nano-TRFIA based on Magnetic Mi-crospheres technique was highly sensitive,stable and specific in the immuno-determination of serum CA199. The results showed that the methods of Nano-TRFIA based on Magnetic Microspheres could be used for the clinic.
ABSTRACT
To establish a time-resolved fluorescence immunochromatographic assay for quantitative determination of carbohydrate antigen 19-9 (CA19-9) in serum, we prepared CA19-9 test strips by integrating double-antibody sandwich method and fluorescence immunochromatography technique. Carboxy fluorescent microspheres and nitrocellulose membrane were used as carriers for labeling and coating CA19-9 pairing antibodies. We optimized the process by adjusting the amount of labeling and coating antibody. According to the linear range, lowest detection limit and precision, We evaluated the time-resolved fluorescence immunochromatographic assay of CA19-9. When the amount of labeled antibody was 80 μg for 20 μL fluorescent microspheres, and the concentration of coated antibody on the test line was 1.5 mg/mL, the optimal reaction time was 15 minutes. Assay linear range was 12.5 to 800 U/mL and the minimum detection limit was 6.32 U/mL. The Within-run and between-run coefficient of variation were less than 15%. Average recovery rate was 101%. By detecting 50 clinical samples in parallel with Roche electrochemical luminescence detection kit, correlation coefficient was 0.980 6. The experiment, initially established a fluorescence immunochromatographic detection method to quantitative detection of serum CA19-9, which has a good clinical application prospect.
ABSTRACT
Objective To clarify the expression of DEPTOR in rectal cancer,and to further explore the relationship between the expres-sion level of DEPTOR and histopathology and prognosis,in order to provide reference for the clinical diagnosis and treatment of rectal cancer. Methods The clinical data of 102 patients who underwent radical resection of rectal cancer in our hospital from January 2011 to January 2013 were analyzed retrospectively.The expression of DEPTOR in cancer tissues and adjacent tissues were evaluated by immunohistochemis-try and immunoblotting.The patients were divided into high expression group and low expression group by the median value of integrated opti-cal density(IOD);the relationship between the expression level of DEPTOR and clinical,histopathology and prognosis was analyzed. Results The results ofImmunohistochemistry and immunoblotting showed that the expression level of DEPTOR in cancer tissues was higher than that in adjacent tissues,the differences were significant(P<0.05). Univariate analysis showed that there was no significant differences in gender, age,and BMI(P>0.05),and there were significant differences in tumor diameter,T stage,N stage,and differentiation between the high-ex-pression and low-expression group (P<0.05).The independent influencing factors of DEPTOR expression was analyzed by the Logistic re-gression model,which showed that T stage and tumor diameter were independent influencing factors of high expression of DEPTOR.Compared with low expression group,the serum CEA level in patients with high expression group was higher,the differences was statistically significant ( P < 0.05 ). There was no significant difference in serum CA199 level between the expression group and the low expression group (P>0.05).Spearman correlation analysis showed that the expression level of DEPTOR was positively correlated with serum CEA level in rectal cancer patients (r=0.509,P<0.01).Compared with low expression group,the 5-year cumulative recurrence rate and the 5-year cumulative mortality rate in the high-expression group of DEPTOR were higher,the differences were statistically significant ( P <0.05). Conclusion DEPTOR is highly expressed and is associated with the degree of disease progression in rectal cancer,its elevation suggests a poor prognosis.
ABSTRACT
Objective To study the value of CA19-9,s-ULBP2 and Dkk1 in the diagnosis of pancreatic cancer and the correlation. Methods From January 2016 to May 2017,56 patients with pancreatic cancer in our hospital were selected,45 healthy subjectsand 33 patients with benign pancreatic diseaseswere enrolled in this study.The differences of serum CA19-9,Dkk1 and s-ULBP2 expression and their relationship with clinicopatholog-ical parameters were compared between the three groups. The diagnostic value of CA19-9,s-ULBP2,Dkk1 and joint detection was analyzed.Results The serum levels of CA19-9,s-ULBP2 and Dkk1 in patients with pancreat-ic cancer were significantly higher than those in the benign pancreatic disease group and the healthy control group (P<0.05).CA19-9 and s-ULBP2 are related to TNM staging and histological differentiation,and CA19-9 is also related to tumor location.Joint test was higher than any of the individual indicators.Conclusion CA19-9,s-ULBP2 and Dkk1 are closely related to pancreatic cancer,and the combined detection of the three can improve the diag-nostic accuracy of pancreatic cancer.
ABSTRACT
Objective To investigate the treatment efficacy of capecitabine combined with TACE for hepatic metastases after colorectal carcinoma resection.Methods The clinical data of 94 patients who were treated for hepatic metastases after colorectal carcinoma resection from June 2012 to December 2014 were retrospectively analyzed.The patients were divided into the combined group (48 patients) who underwent combined treatment of transcatheter arterial chemoembolization (TACE) and capecitabine,and the control group (46 patients) who were treated with TACE alone.The drug toxicities induced by chemotherapy in patients of the two groups were noted.The short-term outcomes and serum tumor markers were compared at 3-months after completion of TACE.All the patients were followed up and their overall survival was recorded.Results There was no significant difference in the frequency of TACE between the two groups (P ＞ 0.05).There were significant differences in the short-term outcomes at 3-month after completion of TACE (Z =2.000,P ＜ 0.05).The RR (complete response + partial response) and CBR (complete response + partial response + stable disease) were higher in the combined group than those in the control group [(52.1％ vs.32.0％) and (95.8％ vs.87.0％),respectively],although the differences were not statistically significant (both P ＞0.05).There were greater declines in CEA and CA19-9 levels at 3-month after completion of TACE in the combined group than the control group [(47.1 ± 10.3 vs.35.1 ±8.4) μg/L,(78.7 ± 19.6 vs.65.3 ± 17.0) kU/L],but the differences were not significant (t1 =5.776,t2 =7.849,both P ＜ 0.05).Toxic reactions were more common in the combined group than those in the control group,which included bone marrow suppression (39.6％ vs.30.4％) and peripheral neuritis (47.9％ vs.34.8％).Again,the differences were not significant (P ＞ 0.05).The median survivals were 17.3 months and 13.5 months,and 1-year survival rates were 72.9％ and 52.1％ in the combined group and the control group,respectively (x2 =4.325,P ＜ 0.05).There were significant differences in the survival between the two groups (x2 =4.097,P ＜ 0.05).Conclusions Capecitabine combined with TACE produced better treatment results for hepatic metastases after colorectal carcinoma resection.The short-term outcomes of the combined treatment was suDerior to TACE alone,and the treatment toxicities could be tolerated.
ABSTRACT
Objective To investigate the treatment efficacy of capecitabine combined with TACE for hepatic metastases after colorectal carcinoma resection.Methods The clinical data of 94 patients who were treated for hepatic metastases after colorectal carcinoma resection from June 2012 to December 2014 were retrospectively analyzed.The patients were divided into the combined group (48 patients) who underwent combined treatment of transcatheter arterial chemoembolization (TACE) and capecitabine,and the control group (46 patients) who were treated with TACE alone.The drug toxicities induced by chemotherapy in patients of the two groups were noted.The short-term outcomes and serum tumor markers were compared at 3-months after completion of TACE.All the patients were followed up and their overall survival was recorded.Results There was no significant difference in the frequency of TACE between the two groups (P ＞ 0.05).There were significant differences in the short-term outcomes at 3-month after completion of TACE (Z =2.000,P ＜ 0.05).The RR (complete response + partial response) and CBR (complete response + partial response + stable disease) were higher in the combined group than those in the control group [(52.1％ vs.32.0％) and (95.8％ vs.87.0％),respectively],although the differences were not statistically significant (both P ＞0.05).There were greater declines in CEA and CA19-9 levels at 3-month after completion of TACE in the combined group than the control group [(47.1 ± 10.3 vs.35.1 ±8.4) μg/L,(78.7 ± 19.6 vs.65.3 ± 17.0) kU/L],but the differences were not significant (t1 =5.776,t2 =7.849,both P ＜ 0.05).Toxic reactions were more common in the combined group than those in the control group,which included bone marrow suppression (39.6％ vs.30.4％) and peripheral neuritis (47.9％ vs.34.8％).Again,the differences were not significant (P ＞ 0.05).The median survivals were 17.3 months and 13.5 months,and 1-year survival rates were 72.9％ and 52.1％ in the combined group and the control group,respectively (x2 =4.325,P ＜ 0.05).There were significant differences in the survival between the two groups (x2 =4.097,P ＜ 0.05).Conclusions Capecitabine combined with TACE produced better treatment results for hepatic metastases after colorectal carcinoma resection.The short-term outcomes of the combined treatment was suDerior to TACE alone,and the treatment toxicities could be tolerated.
ABSTRACT
Objective To investigate the value of detection of human epididymal epithelial secretory protein (HE4) ,carbohy-drate antigen (CA125) and carbohydrate antigen (CA199) in the early diagnosis of ovarian cancer .Methods The clinical data of patients admitted to the hospital from June 2014 to August 2016 were collected from Renmin Hospital of Wuhan University .Ac-cording to the postoperative pathology ,the patients were divided into ovarian cancer group and ovarian benign tumor group .There were 90 cases in ovarian cancer group and 94 cases in ovarian benign tumor group ,98 cases of healthy women in the physical exami-nation center of this hospital were selected as healthy control group .HE4 was detected by ELISA ,serum CA125 and CA199 were detected by chemiluminescence method .Results Compared with healthy control group ,the tumor markers of serum HE4 ,CA125 and CA199 levels were significantly increased (P<0 .01) ,and HE4 and CA125 levels increased more significantly .Compared with ovarian benign tumor group ,the levels of HE4 and CA125 significantly increased in ovarian cancer group ,the difference was statisti-cally significant (P<0 .01) ,and the increase of CA199 less(P<0 .05) .Compared with healthy control group ,the levels of CA125 and CA199 in the benign ovarian tumor group were significantly increased (P<0 .05) .Correlation analysis showed that there were strong correlations between the 3 indexes of HE4 ,CA125 and CA199 in the ovarian cancer group(P<0 .01) .The sensitivity of ser-um CA125 was highest (87 .8% ) in the detection of single marker of ovarian cancer ,while the specificity of serum HE4 was the highest(95 .7% ) .The sensitivity of combined detection of serum HE4 ,CA125 and CA199 was the highest (96 .7% ) ,but the speci-ficity was poor (61 .0% ) .Conclusion Combined detection of serum HE4 ,CA125 and CA199 could significantly improve the early detection rate of ovarian cancer ,but the specificity must be combined with other laboratory tests ,comprehensive analysis and diag-nosis .
ABSTRACT
Objective To analyze the clinical characteristics and enhancement pattern on contrast-enhanced ultrasound (CEUS) of combined hepatocellular-cholangiocarcinoma (cHCC-CC).Methods A total of 49 patients who were pathologically confirmed as cHCC-CC by surgery and underwent CEUS examination in Southwest Hospital Affiliated to Third Military Medical University from January 2005 to February 2015 were retrospectively enrolled.There were 3 enhancement patterns on CEUS:hepatocellular carcinoma (HCC) pattern,cholangiocarcinoma (CC) pattern and indeterminate pattern.The proportions of HCC pattern and CC pattern of cHCC-CC were compared by x2 test.And the proportions of tumour maker elevation [(alpha-fetoproteins,AFP) and/or (carbohydrate antigen,CA19-9)] in accordance or discordance with enhancement patterns were compared by x2 test.Results Among the 49 cHCC-CC patients,44 were male and 5 were female.Mean age was (52.3 ± 9.8) years old (range:28-74 years old).Of all cases,41 (83.7％,41/49) patients had single nodule.Mean size of nodule was (5.3 ± 3.5) cm (range:1.5-13.8 cm),and the size of 51.0％ (25/49) lesions were ＜ 5 cm.Totally 34 (69.4％,34/49) patients had pathologically diagnosed cirrhosis.AFP elevation was found in 31 (63.3％,31/49) patients,CA19-9 elevation was found in 12 (24.5％,12/49) patients,simultaneous elevation of both AFP and CA19-9 was found in 9 (18.4％,9/49) patients.The percentages of CC pattern and HCC pattern were 51.0％ (25/49) and 44.9％ (22/49) respectively.And there was no significant difference between the two patterns (x2=0.368,P=0.544).In 9 patients with simultaneous elevation of both AFP and CA19-9,CC pattern was observed in 5 patients and HCC pattern was noted in 4 patients.There were 12 (24.5％,12/49) patients with tumor marker elevation (AFP or CA19-9) in discordance with enhancement patterns on CEUS.Among the 12 cases,9 cases with AFP elevation were CC patterns on CEUS and 3 cases with CA19-9 elevation were HCC patterns on CEUS.Simultaneous elevation of tumor makers (AFP and CA19-9) or tumor mark elevation (AFP or CA19-9) in discordance with enhancement patterns on CEUS was found in 21 (42.9％,21/49) patients,which was significantly more than simultaneous elevation of AFP and CA19-9 alone (18.4％,9/49) (x2=6.918,P=0.009).Conclusions Clinical characteristics of patients with cHCC-CC were similar to that of patients with HCC.The proportion of HCC pattern and CC pattern was comparable.Combination of test of tumor makers (AFP and CA19-9) and enhancement pattern on CEUS maybe helpful for the diagnosis of cHCC-CC.
ABSTRACT
Objective To investigate the clinical significance of joint application of carcinoembryionic and carbohydrate antigen 19-9 for improving the prognosis of patients with gallbladder cancer.Methods A retrospective analysis of clinical-pathological features and prognosis were conducted including 390 patients with gallbladder cancer,who were treated from January 2003 to December 2013 at Eastern Hepatobiliary Surgery Hospital of Second Military Medical University.The clinical value of joint application of careinoembryionic and carbohydrate antigen 19-9 in prognosis was explored.The survival of patients was followed up by telephone or outpatient.Continuous variables were indicated as median (average) and categorical variables were expressed as number(n).Mann-Whitney U test was applied for continuous variables.Categorical variables were compared by the Chi-square test or Fisher probability method.The survival curve was drawn by the Kaplan-Meier method.The univariate analysis and multivariate analysis of prognosis were respectively done using the Log-rank test and COX regression model.Results Of the 390 patients,327 had complete data.The median (range) follow-up time was 49 (1-123) months.Both carcinoembryionic and carbohydrate antigen 19-9 could be used to predict prognosis of gallbladder cancer.A linear combination of carcinoembryionic and carbohydrate antigen 19-9 was significantly better(0.9365) than carbohydrate antigen 19-9 (0.7619) as well as carcinoembryionic (0.7937) alone in term of specificity.Preoperative blood test carcinoembryionic and carbohydrate antigen 19-9 nature showed double-negative group had the best prognosis,with a median survival of 27.06 months,R0 radical rate was 86.1％.Doublepositive group had the worst prognosis,with a median survival of 6.17 months,R0 radical rate was 45.1％.Conclusions Combinations of pretherapeutic tumor makers carcinoembryionic and carbohydrate antigen 19-9 can improve the accuracy of predicting prognostic in patients with gallbladder cancer,and the clinical application is practical.
ABSTRACT
Objective To investigate the value of detection of human epididymal epithelial secretory protein (HE4) ,carbohy-drate antigen (CA125) and carbohydrate antigen (CA199) in the early diagnosis of ovarian cancer .Methods The clinical data of patients admitted to the hospital from June 2014 to August 2016 were collected from Renmin Hospital of Wuhan University .Ac-cording to the postoperative pathology ,the patients were divided into ovarian cancer group and ovarian benign tumor group .There were 90 cases in ovarian cancer group and 94 cases in ovarian benign tumor group ,98 cases of healthy women in the physical exami-nation center of this hospital were selected as healthy control group .HE4 was detected by ELISA ,serum CA125 and CA199 were detected by chemiluminescence method .Results Compared with healthy control group ,the tumor markers of serum HE4 ,CA125 and CA199 levels were significantly increased (P<0 .01) ,and HE4 and CA125 levels increased more significantly .Compared with ovarian benign tumor group ,the levels of HE4 and CA125 significantly increased in ovarian cancer group ,the difference was statisti-cally significant (P<0 .01) ,and the increase of CA199 less(P<0 .05) .Compared with healthy control group ,the levels of CA125 and CA199 in the benign ovarian tumor group were significantly increased (P<0 .05) .Correlation analysis showed that there were strong correlations between the 3 indexes of HE4 ,CA125 and CA199 in the ovarian cancer group(P<0 .01) .The sensitivity of ser-um CA125 was highest (87 .8% ) in the detection of single marker of ovarian cancer ,while the specificity of serum HE4 was the highest(95 .7% ) .The sensitivity of combined detection of serum HE4 ,CA125 and CA199 was the highest (96 .7% ) ,but the speci-ficity was poor (61 .0% ) .Conclusion Combined detection of serum HE4 ,CA125 and CA199 could significantly improve the early detection rate of ovarian cancer ,but the specificity must be combined with other laboratory tests ,comprehensive analysis and diag-nosis .