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Hepatocellular carcinoma (HCC) is a common malignant tumor with high incidence and mortality rates in China. Most patients are diagnosed at an advanced stage when seeking medical treatment. Interventional therapy is the main local treatment for HCC. As a new interventional material, CalliSpheres drug-eluting microspheres have more advantages than iodipin in traditional transcatheter chemoembolization, and hepatic artery infusion chemotherapy has higher rates of remission and translation. A series of targeted drugs, such as lenvatinib, donafinib, and apatinib have been approved for application in the treatment of advanced HCC. Immune checkpoint inhibitors have made breakthroughs in the treatment of advanced HCC. Various new drugs are emerging, with clinical studies on various combinations of different therapeutic drugs being gaining new findings. This article aims to discuss the recent applications and clinical research progress of interventional therapy, targeted therapy and immunotherapy in the treatment of advanced HCC so as to provide a reference for the decision-making of HCC.
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Objective:To investigate the correlation between microRNA-497 (miR-497) expression and invasion and metastasis and prognosis of colorectal cancer (CRC).Methods:The expression of miR-497 in 93 CRC patients (CRC group), 30 colorectal adenoma polyps (colorectal adenomatous polyp group) and 30 healthy patients (normal control group)were detected by real-time fluorescence quantitative polymerase chain reaction (qRT-PCR); meanwhile, the content of serum carcinoembryonic antigen (CEA) was detected by chemiluminescence; After 3 years follow-up, the expression of miR-497 was measured again; the correlation between the expression of miR-497 and the clinicopathological characteristics and prognosis of CRC was analyzed.Results:The expression of miR-497 in CRC group was significantly lower than that at the end of postoperative treatment, adenomatous polyps group and normal control group ( P<0.01), and the content of CEA in CRC group was significantly higher than that at the end of postoperative treatment, adenomatous polyps group and normal control group ( P<0.01); At the end of postoperative treatment, the expression of serum miR-497 in CRC group was lower than that in normal control group ( P<0.05), and the content of serum CEA was higher than that in normal control group ( P<0.05). The diagnosis positive rate of serum miR497 expression in CRC group was significantly higher than that of serum CEA ( P<0.01), and they showed no correlation ( r=0.232, P>0.05). The pre-and post-operative serum miR-497 expression levels in the recurred and metastasis group were significantly lower than those in the no postoperative recurrence and metastasis group ( P<0.01). The preoperative expression of miR-497 was related to the differentiation degree of CRC, tumor node metastasis (TNM) stage, lymph node metastasis, distant metastasis and survival period ( P<0.01), but not with the age, sex, tumor size and location of the patients ( P>0.05). Cox multivariate analysis showed that tumor differentiation, TNM stage, preoperative miR-497 expression, lymph node metastasis and distant metastasis were all independent risk factors influencing prognosis of CRC patients ( P<0.05); The survival rate of 1, 2, 3 years in the miR-497 low expression group was lower than that in the miR-497 high expression group ( P<0.05). Conclusions:The preoperative low serum miR-497 expression levels are closely relative with invasion and metastasis and poor prognosis of CRC, and can be a prognostic indicator of CRC. The reduced postoperative serum miR-497 expression levels may be a predictor of the postoperative recurrence and metastasis of CRC.
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Objective To investigate the application value of combined detection of antikeratin (AKA) antibody,anti-cyclic citrullinated peptide(anti-CCP) antibody,anti-RA33 antibody,RF and ESR in the diagnosis of rheumatoid arthritis(RA).Methods One hundred cases of RA and 60 cases of suspected RA in our hospital from June 2014 to May 2015 were collected.One hundred and twenty cases of non-RA other autoimmune diseases served as the control group.The indirect immunofluorescence assay (IFA) was used to detect anti-KA antibody,anti-CCP antibody and anti-RA33 antibody were detected by using ELISA.The rate scatter turbid assay was used to detect RF.The Westergren method was used to detect ESR.The diagnostic performance of each diagnostic indicator was evaluated.Results The detection rates of anti-KA antibody,anti-CCP antibody,anti-RA33 antibody,RF and ESR in the RA group were in turn 64%,75%,44%,84% and 51% respectively,the detection rate(sensitivity) of 5-indicator parallel detection were 97%, the specificity of 5-indicator series detection was 89.2%;in the suspected RA group,the detection rates of 5-indicator were in turn 16.7%, 31.7%,13.3%,20%,15% respectively,which in the control group were in turn 0.8%,2.5%,1.7%,0.8% and 5.8% respectively.The detection rates of 5-indicator in the RA group was significantly higher than that in the suspected RA group,showing extremely significant difference (P<0.001),the detection rate of 5-indicator had extremely significant difference between the suspected RA group and control group (P<0.001),the sensitivity of five-indicator parallel detection was 97%,which was significantly higher than that of single indicator detection (P<0.05),the detection specificity of 5-indicator series detection was up to 100%,which was also significantly higher than that of single indicator detection (P<0.05),the missed diagnosis rate of parallel detection was minimal,while the negative predictive value was highest,the misdiagnosis rate of series detection was lowest,the positive predictive value was highest,the Youden index of parallel detection was largest.Conclusion The single detection of anti-CCP antibody and RF have good sensitivity and specificity, but 5-indicator combined detection has higher sensitivity and specificity,which can better reduce the missed diagnosis rate and misdiagnosis rate,can greatly improve the efficiency of diagnosis,and has an important clinical significance for the early diagnosis of RA.
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Objective To investigate the relationship between quantitative detection of T lymphoma invasion and metastasis inducing factor (Tiaml) mRNA and invasion,metastasis and prognosis of patients with colorectal cancer.Methods The quantitative expression of Tiam1 mRNA in cancer tissues in colorectal cancers (n =97),in tissues of colorectal adenomatous polyposis (n =49) and normal control (n =30) were detected with real-time fluorescence quantitative-polymerase chain reaction (PCR).The relationship between the quantitative expression of Tiam1 mRNA in colorectal cancer tissues and the invasion,metastasis and the prognosis were analyzed.Results The levels of Tiam1 mRNA expression in the colorectal cancer group,were significantly higher than those in colorectal adenomatous polyposis group and normal controlgroup [(14.45±4.87)2-△△△Ct vs (3.77 ±3.15)2-△△Ct,(1.06 ±0.65)2-△△Ct,P ＜0.01].The levels of Tiam1 mRNA expression in the adenomatous polyposis with high grade intraepithelial neoplasia were signifiCantly higher than those in the adenomatous polyposis with low grade intraepithelial neoplasia [(5.26 ±2.45)2-△△Ct vs (3.78 ±2.19)2-△△Ct,P ＜0.01],which were both significantly higher than those in the adenomatous polyposis with no intraepithelial neoplasia [(2.13 ± 1.64)2-△△Ct,P ＜0.05 or P ＜ 0.01].The levels of Tiam1 mRNA expression in colorectal cancer group were positively related to the differentiated degree of tumor,depth of invasion,lymph node metastasis,tumor node metastasis (TNM) stages and the postoperative recurrence (P ＜ 0.01),and were negatively related to the postoperative survival time (P ＜0.01).Multivariate Cox regression analysis revealed that levels of Tiam1 mRNA expression in cancer tissues were independent prognostic factor for colorectal cancer (Exp =4.043).Conclusions The high Tiam1 mRNA expression levels in cancer tissues are closely related to invasion,metastasis and poor prognosis of colorectal cancer,and may be a prognostic indicator of colorectal cancer.The increase expression of Tiam1 mRNA in colorectal adenomatous polyposis may be related to colorectal tumorigenesis.
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Objective To investigate the relationship between the changes of expression of T lymphoma invasion and metastasis inducing factor 1 (Tiam1) mRNA and lymph node micrometastasis and prognosis in patients with node-negative colorectal cancer(CRC).Methods From June 2008 to August 2010,a total of 63 patients with lymph node-negative CRC,20 patients with lymph node-positive CRC and 25 patients with colorectal benign lesions were enrolled.The relative quantity expression (RQ) of Tiam1 mRNA in CRC cancer tissues and colorectal benign lesions were detected by real-time quantitative polymerase chain reaction (PCR).The lymph node micrometastasis was determined by cytokeratin 20 detection in lymph nodes tissues.The five-year postoperative prognosis was evaluated by followed-up in the patients with lymph node-negative CRC.The correlation between the expression of Tiam1 mRNA and lymph node micrometastasis and prognosis was analyzed.The t-test,univariate analysis,multivariate analysis and Log-rank test were performed for statistical analysis.Results Lymphnode micrometastasis occurred in 33 from 63 patients with lymph node-negative CRC.The RQ of Tiam1 mRNA in the patients with lymph node-positive CRC was 9.84±-2.36,which was higher than that of patients with lymph node-negative CRC (5.15±3.58),and the difference was statistically significant (t=5.479,P＜0.01).The RQ of Tiam1 mRNA of these two groups were both higher than that of colorectal benign lesion (0.30± 0.21),and the difference was statistically significant(t=20.169,6.745;both P＜0.01).The RQ of Tiam1 mRNA of positive lymph node micrometastasis group was 6.30±1.95,which was higher than that of negative lymph node micrometastasis group (3.88 ± 1.63),and the difference was statistically significant (t=5.330,P＜0.01).In the patients with lymph node-negative CRC,the lower degree of tumor difference,the deeper invasion,the shorter survival time after surgery and postoperative recurrence and metastasis were related with the higher RQ of Tiam1 mRNA in tumor tissues (t=2.536,3.112,3.213,2.676;all P＜0.05).Univariate analysis revealed that the expression of Tiam1 mRNA in cancer tissues was correlated with lymph node micrometastases(x2=11.878,P =0.001).Multivariate analysis showed that it was an independent risk factors of lymph node micrometastases in CRC (relative risk:9.782).The five-year postoperative cumulative survival rate of high Tiaml mRNA expression group was 75.8 ％,which was lower than that of low expression group (97.1 ％),and the difference was statistically significant (x2 =4.575,P＜0.05).Conclusions Tiam1 may participate in the regulation of lymph node metastasis in CRC.Elevated expression of Tiam1 promotes lymph node metastasis and is closely relatived with poor prognosis of node-negative CRC,and which can be considered as an indicator of prognosis.
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Objective To investigate the correlation between quantitative detection of human telomerase reverse transcriptase (hTERT) mRNA in peripheral blood and metachronous liver metastasis and prognosis of colorectal cancer (CRC).Methods The quantitative expression of hTERT mRNA in pre-and post-operative peripheral blood were detected with real-time fluorescence quantitative real-time polymerase chain reaction (RT-PCR) in 168 patients with CRC and normal controls.The postoperative 3 years,prognosis of the CRC patients were followed-up.The relationship between peripheral blood hTERT mRNA expression levels and the metachronous liver metastasis and prognosis of CRC were analyzed.Results The hTERT mRNA expressions in preoperative,6 month postoperative peripheral blood in postoperative liver metastases group were significantly higher than those in the postoperative non-metachronous liver metastases group in the same term [(8.35 ± 5.86) (2-△ △Ct) vs (4.42 ± 2.88) (2-△ △Ct),(1.87 ± 1.85) (2-△ △Ct) vs (1.03 ± 0.92) (2-△△Ct),P ＜ 0.01].The hTERT mRNA expressions in preoperative peripheral blood of CRC group were positively related to the differentiated degree of tumor,tumor size,lymph node metastasis(P ＜ 0.05 or P ＜ 0.01),and were negatively related to the postoperative survival(P ＜ 0.01).Univariate analysis revealed that hTERT mRNA expressions in preoperative and 6 months postoperative peripheral blood were all correlated with postoperative liver metastases from CRC.Multivariate Cox analysis showed that they were independent risk factors for postoperative CRC liver metastases(EXP =4.282,9.171).The 3 year survival rate of the postoperative CRC liver metastases group was significantly lower than that of the postoperative non-CRC liver metastases group.Conclusions hTERT mRNA expressions in preoperative peripheral blood are related to the important pathologic feature,postoperative liver metastasis and prognosis of CRC.hTERT mRNA expressions in preoperative and 6 months postoperative peripheral blood might be a predictive biomarker for CRC metachronous liver metastases.The elevation of hTERT mRNA expression levels in postoperative peripheral blood were related to postoperative CRC liver metastasis.
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Objective To investigate the correlation of the expression of human telomerase reverse transcriptase (hTERT) mRNA in peripheral and portal vein blood to liver metastasis and prognosis of patients with colorectal cancer (CRC).Methods From January 2009 to April 2011,a total of 181 patients diagnosed as primary CRC and received radical resection were enrolled.The relative quantitative expression of hTERT mRNA in preoperative peripheral blood and intraoperative portal vein blood were detected by real-time fluorescence quantitative reverse transcription-polymerase chain reaction (RT-PCR).All the patients were followed up for three years after operation.The relative quantitative expression of hTERT mRNA in peripheral blood before operation and intraoperative portal vein blood were compared between patients with synchronous liver metastasis (18 cases) and without synchronous liver metastasis (163 cases); between metachronous liver metastases (29 cases) and without metachronous liver metastases (152 cases).The relationship between the expression of hTERT mRNA in intraoperative portal vein blood and clinicopathological features of patients with CRC was analyzed.The t-test was used.Univariate and Multivariate Cox analysis were used for risk analysis of metachronous liver metastases.Log-rank test was used for comparisons of survival rate between the group with high hTERT mRNA expression in intraoperative portal vein blood during operation and the group with low expression.Results The relative quantitative expression of hTERT mRNA in preoperative peripheral blood and intraoperative portal vein blood in synchronous liver metastases group (8.04±3.79 and 11.88±4.19) was higher than that of no synchronous liver metastases group (4.30±2.81 and 4.94±3.37,t=5.159 and 8.084; both P＜0.01).The relative quantitative expression of hTERT mRNA in preoperative peripheral blood and intraoperative portal vein blood in metachronous liver metastases group (7.16±3.08 and 9.83 ± 2.96) was higher than that of no synchronous liver metastases group (4.11±2.58 and 4.56±3.09,t=5.648 and 8.467;both P＜0.01).The hTERT mRNA expression in intraoperative portal vein blood of patients with CRC changed significantly with the differentiated degree of tumor,tumor size,different invasion degree of tumor,lymph node metastasis,recurrence after operation,survival time (t =2.987,2.281,2.135,5.070,5.431 and 6.803,all P＜0.05).Univariate analysis revealed that the expression of hTERT mRNA in preoperative peripheral blood and intraoperative portal vein blood both were correlated with postoperative metachronous liver metastases (x2=9.522 and 16.393,both P＜0.01).Multivariate Cox analysis showed that both of them were independent risk factors (relative risk (RR)=4.286 and 9.783).The two-and three-year survival rates of the patients with high hTERT mRNA expression levels in intraoperative portal vein blood were 64.6 ％ and 52.3 ％,and those of low expression group were 91.4 ％ and 85.3 ％,and the differences between two groups in two-and three-year survival rate were statistically significant (x2 =5.313,P＜0.05; x2 =8.925,P＜0.01).Conclusions The expression of hTERT mRNA in intraoperative portal vein blood was closely correlated with the important pathologic features,prognosis and liver metastasis of patients with CRC and its predictive value of postoperative CRC metachronous liver metastases was higher than the expression of hTERT mRNA in preoperative peripheral blood.The hTERT mRNA in intraoperative portal vein blood can be a postoperative prognostic marker of patients with CRC.
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Objective To explore sonographic manifestation of fetal malformations of cortical development.Methods From August 2012 to January 2014 three hundred and twenty-five pregnancy women referred to our institution for fetal brain MRI,which were diagnosed or suspected of central nervous system abnormalities by prenatal ultrasound examination.Results In 325 of cases,14 cases (4％) were diagnosed of malformations of cortical development.Ten eases were indicated by prenatal ultrasound,including three cases of heterotopic gray matter,six cases of microcephaly and one case of hemimegalencephaly; four cases were missed by prenatal ultrasound,including two cases of schizencephaly,one case of tuberous sclerosis,and one case of hypoplasia.Conclusions Cortical malformations can be diagnosed by prenatal ultrasonography based on typical imaging characteristics.Prenatal ultrasound combined with MRI is a powerful tool in diagnosing fetal malformations of cortical development.
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Objective To investigate the relationship between juxtapapillary duodenal diverticular (JPDD) and choledocholithiasis,and the effects of JPDD on endoscopic sphinctemtomy(EST) in treatment of choledocholithiasis.Methods Fifty-one cases of choledocholithiasis combined with JPDD (choledocholithiasis combined with JPDD group) and 210 cases of choledocholithiasis without JPDD (choledocholithiasis without JPDD group) were treated by EST,and the clinical data of patients in the two groups were retrospectively analyzed.The relationship between JPDD and choledocholithiasis was studied.The JPDD' influence on the intubation success rate of endoscopic retrograde cholangiopancreatography (ERCP),the success rate of the stone removal by EST and complication were analyzed.Results The incidences of choledocholithiasis in patients of JPDD diameter ＜ 1 cm,1-3 cm and ＞ 3 cm were 39.3％(11/28),53.2％ (33/62) and 7/8 respectively.The larger the JPDD diameter,the higher the incidence of choledocholithiasis,and there was statistical difference (P ＜ 0.01).The incidence of choledocholithiasis in peripheral type JPDD was significantly higher than that in parallel type and circumvolution type [81.0％(17/21) vs.41.9％(26/62) and 8/15],and there were statistical differences (P ＜0.05).There was no statistical difference in the intubation success rate of ERCP between the two groups (P ＞ 0.05),but the success rate of the stone removal by EST in choledocholithiasis combined with JPDD group was significantly lower than that in choledocholithiasis without JPDD group [91.8％ (45/49) vs.99.5％ (208/209)].The incidence of EST incision bleeding was significantly higher than that in choledocholithiasis without JPDD group [11.1％ (5/45) vs.1.9％ (4/208)],and there was statistical difference (P ＜ 0.01) ; there were statistical differences in the incidences of others complication between the two groups (P ＞ 0.05).Logistic regression analysis showed that JPDD was independent risk factor for EST incision bleeding (P =0.043).Conclusions JPDD is relative with choledocholithiasis.JPDD makes EST a little more difficult and risky,while EST is still a safe and effective therapy for choledocholithiasis patients combined with JPDD.
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Objective To investigate the correlation between expression of human telomerase reverse transcriptase (hTERT) mRNA in peripheral blood and postoperative recurrence and prognosis in the patients with advanced colorectal cancer (CRC).Methods The preoperative and 1 month postoperative quantitative expression of hTERT mRNA in peripheral blood in 85 patients with advanced CRC were detected with real-time fluorescence quantitative real-time fluorescence quantitative polymerase chain reaction (RTPCR).The quantitative expression of hTERT mRNA in peripheral blood in 30 normal controls were also detected.The postoperative prognosis was followed-up,and the quantitative expression of hTERT mRNA in peripheral blood in the patients with recurred CRC and the patients without recurred CRC were detected repeatedly.The factors that affected the preoperative hTERT mRNA expression were analyzed.The relationship was investigated between the hTERT mRNA expression levels and postoperative recurrence and prognosis in the patients with advanced CRC.Results The hTERT mRNA expression levels in peripheral blood in advanced CRC group were significantly higher than those in the normal controls [(6.22 ±5.85)2-△△Ct vs (0.45 ±0.27)2-△△Ct,(P ＜0.01)],and were significantly decreased at the time point of 1 month after the operation (P ＜ 0.01).The hTERT mRNA expression levels in the postoperative recurred CRC group were significantly higher than those in the 1 month postoperation group and no recurrence CRC group [(5.07 ± 2.87)2-△△Ct vs (1.83 ± 1.08)2-△△Ct,(2.15 ± 1.49)2-△△Ct,(P ＜0.01)].Univariate analysis revealed that preoperative high hTERT mRNA expression levels in peripheral blood were related to the differentiated degree of tumor,tumor size,lymph node metastasis ratio,and liver metastasis (P ＜ 0.05 or P ＜ 0.01).Multivariate logistic regression analysis revealed that differentiated degree of the tumor,lymph node metastasis,and liver metastasis were independent risk factors for the elevation of preoperative hTERT mRNA expression in the advanced CRC.Elevated preoperative hTERT mRNA expression was positively related to the postoperative recurrence rate,and was negatively related to postoperative survival rate.Conclusions Preoperative hTERT mRNA expression levels in peripheral blood were related to the important pathologic features in patients with advanced CRC,and might be a valuable prognostic factor.Postoperatively elevated hTERT mRNA expression in peripheral blood was related to recurrence of advanced CRC.
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Objective To investigate the correlation between serum soluble epithelial cadherin (sE-cad) and postoperative recurrence and prognosis in patients with advanced gastric cancer.Methods The level of serum sE-cad in 85 patients with advanced gastric cancer (advanced gastric cancer group) was detected by ELISA technique preoperative and postoperative 1 month,and compared with 30 healthy controls(control group).The patients in advanced gastric cancer group were followed up for 3 years,the level of serum sE-cad in recurrent patients and non-recurrent patients was compared.Results The level of serum sE-cad in advanced gastric cancer group preoperative was significantly higher than that in control group [(24.3 ± 14.8) μ g/L vs.(9.4 ± 3.8) μ g/L,P ＜ 0.01].The level of serum sE-cad in advanced gastric cancer group was significantly decreased postoperative 1 month [(12.5 ± 6.4) μ g/L vs.(24.3 ± 14.8) μ g/L,P ＜0.01].The level of serum sE-cad in recurrent patients was significantly higher than that in non-recurrent patients and postoperative 1 month [(20.7 ±9.8)μg/L vs.(12.5 ±6.4),(14.8 ±6.2) μg/L,P＜0.01].Univariate analysis revealed that preoperative high serum sE-cad level was related with tumor size,differentiated degree,lymph node metastasis ratio,depth of tumor invasion (P ＜0.05),but had no relationship with histological type(P＞ 0.05).Elevated preoperative serum sE-cad level negatively affected the postoperative survival rate and recurrence rate.Multivariate Logistic regression anaiysis revealed that preoperative serum sE-cad level was an independent risk factor for postoperative 3 years survival rate in advanced gastric cancer (HR =2.068,P =0.013).Conclusions Preoperative elevated serum sE-cad level is related with pathologic features in patients with advanced gastric cancer,and may be an important prognostic factor.Postoperative monitoring the level of serum sE-cad is useful for evaluating the prognosis and recurrence.
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Objective To determine whether prenatal ultrasonography (US) score is more effective than renal pelvic anterior posterior diameter (PAPD) for the prognostic evaluation of fetal hydronephrosis.Methods Fetuses with hydronephrosis (PAPD≥ 10 mm) were examined by prenatal US in the third trimester.PAPD,renal parenchyma thickness (RPT) and pelvicaliceal morphology (PM) were measured and graded from 0 to 3 score on the basis of severity of hydronephrosis,then the total US score of each kidney was obtained.According to the follow-up results after birth,all the cases were divided into two groups:physiological and pathological hydronephrosis.Via Z test,paired comparison was made to analyze area under the curve (AUC) of US score and each of the other three factors.Results Confirmed by postnatal US and other clinical examinations,of 198 kidneys (158 cases ) with hydronephrosis,139 (70.20％ ) were physiological hydronephrosis and 59 (29.80％ ) were pathological hydronephrosis.AUC of PAPD,RPT,PM,US score was 0.897 (minimum),0.957,0.944 and 0.982 (maximum) respectively,and there was significant difference between AUC of US score and each of the other three ( P ＜0.05).US score was the best approach for differential diagnosis of fetal hydronephrosis.Conclusions Prenatal US score is more effective and accurate than the single factor (PAPD,RPT,PM) to differentiate fetal physiological and pathological hydronephrosis.It was a new quantitative method to evaluate the prognosis of fetal hydronephrosis,and should be disseminated and applied clinically.
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ObjectiveTo study the correlation between preoperative serum angiopoietin-2 (Ang2) levels and lymph node metastasis in early gastric cancer(EGC).MethodsPreoperative serum Ang-2 and CEA levels in 62 patients with EGG and 30 normal controls were measured by ELISA technique respectively.The metastasis of lymph node in these cases were determined by HE staining.The relation between preoperative serum Ang-2 levels and lymph node metastasis in EGC and pathologic characterization was investigated.ResultsCompared with normal controls,preoperative serum Ang-2 levels in EGC group were significantly elevated [( 282.5 ± 110.6 ) μg/L vs ( 187.4 ± 32.7 ) μg/L,P ＜ 0.01].Preoperative serum Ang-2 levels in node-positive gastric cancer group was significantly higher than that in the node-negative gastric cancer group [(34 7.2 ± 79.5 ) μg/L vs (265.6 ± 90.2) μg/L,P ＜ 0.01],while CEA levels changed a little.Preoperative serum Ang-2 levels in the EGC group presented marked correlation with the differentiated degree of the tumor tissue,tumor size,depth of tumor invasion but it had no correlation with the histological type.Preoperative serum Ang-2 levels were an independent high-risk factor of lymph node metastasis in EGC according to multivariate logistic regression analysis.ConclusionsPreoperative serum Ang-2 levels may be a good clinical predictor for lymph node metastasis of EGC,which is useful for the treatment direction.
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Objective To study the difference and clinical significance of serum Angiopoietin-2 (Ang-2) level in gastric cancer, precancerous disease and the changes in post operation follow-up patients.MethodsSerum Ang-2 and CEA levels were detected with ELISA method in 158 gastric cancer patients, 31 chronic astrophic gastritis patients, 38 gastric adenomatous polyp patients, 28 chronic gastritis patients with benign gastric ulcer and 30 healthy controls.The changes of serum Ang2 levels in 131 patients with radical gastrectomy were measured in 2-year post-operational followed-up and the prognosis was also evaluated.The correlation between serum Ang-2 level and the pathologic character of gastric cancer was analyzed.ResultsThe serum Ang-2 and CEA levels of gastric cancer group were (331.8± 64.3) μg/L and (42.6 ± 37.3) μg/L, respectively, which were significantly higher than those of healthy control group [(187.4±32.7) μg/L and (4.2±3.1) μg/L]and benign gastric ulcer group [(197.3±35.4) μg/L and (4.5±3.2) μg/L](all P ＜0.01).The serum Ang-2 level in chronic astrophic gastritis group was also markedly increased (P＜0.05), however there was no significant change in CEA level.There was no obvious change of Ang-2 and CEA level in gastric adenomatous polyp group (P＞0.05).Pre-operation serum Ang-2 levels of the relapse group and the metastasis group were significantly higher than that of no relapse group (P＜0.05).Post-operation serum Ang-2 level of no relapse group decreased to normal range in 1 month and without obvious increase in 2 years follow-up.The serum Ang-2 level of the relapse group also decreased to normal range in 1 month post-operation, while which was significantly higher than that of no relapse group and normal control group from 6 months to 2 years after operation (P＜0.01).Serum Ang-2 level of the metastasis group was markedly higher than that of no relapse group and normal control group during 2 years after operation (P＜0.01).The 2-year survival rate of no relapse group was significant higher than that of relapse group and metastasis group.The change of serum Ang-2 level was correlated with in the gastric cancer differentiation degree, TNM pathologic classification, lymphatic metastasis, distant metastasis, the depth of invasion and the tumor size (P＜0.01), however not correlated with histopathology type and the location of tumor.ConclusionSerum Ang-2 level may be a new and valuable gastric cancer marker, which will help to monitor tumor relapse, migration and prognosis assessment.
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Objective To study the differential diagnostic value of soluble epithelial cadherin (sE-cad) in malignant and benign ascites. Methods The concentrations of sE-cad and carcino-embryonic antigen (CEA) in abdominal cavity synovia patients with benign diseases (31 cases), benign ascites(82 cases) and malignant ascites(119 cases) were ineasured by ELISA technique. Results The concentrations of sE-cad and CEA in malignant ascites patients were significantly higher than those in benign ascites patients and abdominal cavity synovia patients (P < 0.01). The sensitivity, negative predictive value and totally accurate rate of sE-cad was 89.9%, 86.8% and 92.5% respectively,which was significantly higher than those of CEA(68.1%, 65.8% and 76.6%)(P < 0.05). sE-cad in malignant ascites showed a certain tissue specificity. Conclusion sE-cad is an useful tumor marker in differential diagnosis of benign and malignant ascites.
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Objective To evaluate the clinical value and effectiveness of ultrasound screening for fetal chromosomal abnormalitie in the middle and late pregnancy. Methods Fetuses who were detected with abnormal ultrasound findings during the middle and late pregnancy, and high risk of maternal serum screening underwent amnioeentesis or eordocentesis for fetal chromosome karyotypes. Results (1) A total of 31 cases with fetal malformation diagnosed by ultrasound were analysed for fetal chromosome karyotypes, and 8 (25.8%) cases were proved with fetal abnormal chromosome karyotypes. There were 3 cases of cervical springwater cyst accompany with edema,and all were fetal abnormal chromosome karyotypes. There were 3 cases of cervical pachyderma,and 2 were fetal abnormal chromosome karyotypes. There was one case with multiple malformations, one with Dandy-Walker malformation and one with holoprosencephaly malformation,all were revealed fetal abnormal chromosome karyotypes. (2) A total of 516 cases with high risk of Down's syndrome and trisomy 18 by maternal serum screening were analysed for fetal chromosome karyotypes,and 14(2.710%) cases were proved with fetal abnormal chromosome karyotypes, which include 7 cases of Down's syndrome and 7 cases of other fetal abnormal chromosome karyotypes. (3) A total of 544 (516 + 28)cases with high risk by the combination of ultrasound and maternal serum screening were analysed for fetal chromosome karyotypes, and 21 (3.86%) cases were proved with fetal abnormal chromosome karyotypes, the rate of detection higher than only maternal serum screening 42.43%.Conclusions Fetal structure abnormalities were the effective ultrasound signs for fetus chromosomal abnormalities screening in the middle and late pregnancy. The combination of ultrasound and maternal serum screening can improve the rate of fetus chromosomal abnormalities screening and be an effective way to retrieve false-positive and lower risk of maternal serum screening.
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Objective To observe the normal configuration and size of the third ventricle in the second and third trimester fetuses in a normal population by ultrasonography. Methods The third ventricular width and configuration were obtained by antenatal ultrasonography in 765 fetuses with gestational age between 27 weeks and term.The relationship Between the width and the gestational age was analyzed.Results The third ventricle width 0～3 mm and showed the increased tendency; the correlation coefficient ( r ) between the width of the third ventricle and the gestationl week was 0.473 ( P＜0.01).The third ventricle was seen as a single echogenic line in 8(4.8%) of 165 fetuses, 145(61.5%) of all fetuses had parallel echogenic lines outlining a fluid-filled lumen, the V-shaped configuration of the third ventricle was seen in 12(7.3%) of the fetuses.Conclusions The third ventricle width shows the increased tendency in the second and third trimester.The parallel echogenic line becomes the prominent ultrasonography appearance in the second and third trimester fetuses.It's usefull to observe the normal ultrasonic apperance of the third ventricle in diagnosing the fetal central nervous abnormities.
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Objective To evaluate the hemodynamic features of VX_2 tumor and peri-neoplastic liver parenchyma with low mechanical index gray-scale contrast enhancement.Methods Ultrasound contrast agent SonoVue((0.1) ml/kg) was applied respectively in 8 VX_2-bearing rabbits by intravenous bolus injection.Corresponding parameters of the time-intensity curve:time to enhancement(ET),time to peak intensity(PIT),peak signal intensity(PSI) and mean transit time(MTT) were measured using low mechanical index contrast gray-scale imaging and Wash-in/Wash-out time-intensity curve software.Results Gray-scale imaging delineated clearly the dynamic enhancement of the VX_2 tumor and the surrounding liver parenchyma.The ET and PIT were definitely earlier,the PSI lower and the MTT absolutely shorter in VX_2 tumors than those in the liver parenchyma.There were significant differences of parameters derived from the time-intensity curve between VX_2 tumors and liver parenchyma(P
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Objective To evaluate the diagnostic value of three dimensional transvaginal sonograpy( 3D TVS) for uterine cavity lesions.Methods Two dimensional transvaginal sonography(2D TVS) and 3D TVS were performed on 46 patients with irregular vaginal bleeding.The diagnosis were compared with the results of pathology and hysteroscopy.Results Of 46 patients,16 cases were diagnosed as endometrial hyperplasia,12 cases as endometrial polyp,9 cases as submucous myoma,3 cases as endometrial cancer, and the remaining 6 cases as normal secretive phase.To endometrial hyperplasia,the specificity,sensitivity,accuracy of 2D TVS and 3D TVS was 66.7% , 93.7% , 76.1% and 90.0% ,100%, 93.5% respectively.To endometrial polyp,the specificity,sensitivity,accuracy of 2D TVS and 3D TVS was 88.2% , 58.3% , 80.4% and 100%, 83.3% , 95.7% respectively.Conclusions 3D TVS improves the diagnosis of uterine cavity lesions,3D TVS combined with 2D TVS is the first choice for uterine cavity lesions.
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Objective To evaluate the role of interventional ultrasound technique in prenatal diagnosis of fetal chromosomal abnormalities.Methods Percutaneous ultrasound-monitored amniocentesis and cordocentesis were performed on 186 pregnant women with indicantions for prenatal diagnosis to detect karyotype of the fetus.Results All the cases were punctured successfully.Percutaneous ultrasound-monitored amniocentesis was performed in 105 pregnant women.The archievement rate of the aminiotic fluid was 97.1%,and the detection rate of the chromosomal abnormality was 8.8%.Percutaneous ultrasound-monitored cordocentesis were performed in 81 pregnant women.The archievement rate of the cord blood was 98.8%,and the detection rate of the chromosomal abnormality was 5.0%.There was no significant deviation between them.The valid indications of the puncture included the abnormal serology screening results of pregnant women,the history of abnormal deliveries,the history of the trisomy 21,and the abnormal fetus detected by ultrasound,the last of which was higher than the other indications at the detection of the chromosomal abnormality.Conclusions Interventional ultrasound technique proves to be valid in the prenatal diagnosis,and ultrasound detection of abnormal fetus indicates the possibility of the fetal chromosomal abnormality.