ObjectiveTo investigate the relationship between the nodule manifestation of malignant pleural lesions under medical thoracoscopy and pleural fluid biochemistry and tumor marker levels. MethodsA total of 110 patients with malignant pleura, including 90 cases of lung cancer, 18 cases of malignant mesothelioma, 1 case of diffuse large B-cell lymphoma, and 1 case of ovarian serous carcinoma, who were hospitalized in the Department of Respiratory and Critical Care Medicine, East Hospital of Shandong Provincial Hospital from February 2011 to January 2022 were selected as the study subjects. The pleural nodule manifestation was divided into 6 layers were according to the number of pleural nodules in the medical thoracoscopic field, they were divided into 6 layers: non-nodular group, nodular group (pleural nodules of different sizes were distributed); The nodular group was further divided into nodular scattered group (total number of pleural nodules in all fields under thoracoscopy ≤10) and nodular diffuse group (total number of pleural nodules in all fields under thoracoscopy >10); The nodular diffuse group was further divided into the multiple nodules diffused group (the total number of pleural nodules >10 under thoracoscopy and ≤10 nodules in a single microscopic field) and the nodular diffuse patchwork group (the total number of pleural nodules >10 under thoracoscopy and >10 nodules in a single microscopic field). Four biochemical items of pleural fluid, pleural fluid lactate dehydrogenase (LDH), adenosine deaminase (ADA), glucose (GLU), protein quantification (TP) levels and pleural fluid carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125) levels, serum CEA, and serum cytokeratin fragment 19 (CYFRA21-1) levels were measured to compare the expression levels of indicators between the non-nodular group and the nodular group, the nodular scattered group and the nodular diffuse group, the multiple nodules diffused group and the nodular diffuse patchwork group.ResultsThe LDH level in pleural fluid of nodular group was significantly higher than that of non-nodular group (P<0.01). The LDH level in pleural fluid of diffuse nodular group was higher than that of scattered nodular group (P<0.05). Compared to those in multiple nodules diffused group, the levels of LDH and ADA in pleural fluid of nodules patchy diffused group were significantly increased (P<0.01), and the GLU level was decreased (P<0.05). However, there were no statistically significant differences in the length of disease, smoking index, TP in pleural fluid, CEA in pleural fluid, CA125 in pleural fluid, CEA in serum and CYFRA21-1 in serum between the paired groups.ConclusionsThere were differences in the expression levels of LDH, ADA and GLU in pleural fluid of different degrees of malignant pleural lesions. The higher the degree of pleural lesions, the higher the levels of LDH and ADA in pleural fluid and the lower the levels of GLU in pleural fluid.
Objective To explore the value of preoperative detection of soluble fragments of cytokeratin-19 (CYFRA21-1), carcinoembryonic antigen (CEA), and postoperative detection of nuclear proliferation associated antigen Ki67 in prognostic evaluation of non-small cell lung cancer patients. Methods The clinicopathological data and follow-up results of patients with non-small cell lung cancer treated in the Department of Thoracic Surgery of the First Affiliated Hospital of Xiamen University in 2017 were collected. CYFRA21-1>3.39 ng/mL was defined as positive, and CEA>5 ng/mL was defined as positive. The receiver operating characteristic curve (ROC curve) of Ki67 expression level was drawn. The maximum area under the curve (AUC) was the cutoff value of Ki67 expression level, and the Ki67 expression level greater than its cutoff value was defined as positive. Cox regression analysis was used to determine the independent risk factors for poor prognosis in patients with non-small cell lung cancer. Results Finally 248 patients were collected, including 125 males and 123 females, with a median age of 61 years (ranging from 30 to 81 years) at the time of surgery. Univariate analysis showed that positive CYFRA21-1, high expression of Ki67, positive CEA, age≥60 years at operation, distant metastasis, lymph node metastasis, maximum tumor diameter>3 cm, and TNM stage Ⅲ were associated with poor prognosis in patients with non-small cell lung cancer. When combined detection of preoperative tumor markers and postoperative Ki67, the prognosis of all negative patients was the best, and that of all positive patients was the worst. Cox regression analysis showed that positive CEA+positive CYFRA21-1+high expression of Ki67 was an independent risk factor for poor prognosis in patients with non-small cell lung cancer (P<0.05). Conclusion The combined detection of preoperative serum CYFRA21-1, CEA, and postoperative Ki67 has important value in evaluating the prognosis of non-small cell lung cancer patients.
ObjectiveTo explore the values of CA19-9, CA242, CEA, and CA125 single or combined detection on clinical diagnosis and prognosis for patients with pancreatic cancer. MethodsSerum tumor markers CA199, CA242, CEA, and CA125 of 63 patients with pancreatic cancer, 33 patients with cancer of bile duct, and 27 patients with benign pancreatic disease were detected, and those patients were followed up after operation. ResultsThe levels of CA19-9, CA242, CEA, and CA125 in patients with pancreatic cancer were significantly higher than those in patients with benign pancreatic disease and cancer of bile duct (Plt;0.05). The sensitivity of CA19-9 alone was the highest in the four tumor markers for the patients with pancreatic cancer 〔79.4% (50/63)〕, but the specificity (61.9%) was lower than that of CA242 (83.3%) and CEA (80.0%). The specificity of combined detection of CA199+CA242+CEA was the highest 〔93.3% (56/60)〕. The level of CA19-9 in carcinoma of body/tail of pancreas was significantly higher than that of carcinoma of pancreas head or whole pancreas (Plt;0.05). The serum levels of CA19-9 and CA242 in patients with stage Ⅳ were significantly higher than those in stage Ⅰ or Ⅱ/Ⅲ (Plt;0.05). Fifteen patients were lost to follow up, 48 patients were followed up 2－12 months with an average 6 months. The levels of CA242 and CA199 in patients with pancreatic cancer on 0.5 month and 3 months after operation were lower than those before operation (Plt;0.05). ConclusionsSingle detection of CA19-9 can improve the diagnostic sensitivity, and combined detection of tumor markers CA199+CA242+CEA can improve the diagnostic specificity. CA19-9 or CA242 is a valuable marker for evaluating treatment effects and estimating prognosis.
Objective To summarize progress of imagings and tumor markers in preoperative TN staging of colorectal cancer. Methods The domestic and international published literatures related to application of imagings such as EUS, CT, and MRI and tumor markers such as CEA, CA19-9, and CA-242 in preoperative TN staging of colorectal cancer were collected and reviewed. Results The imagings and tumor markers have different values in the preoperative TN staging of colorectal cancer, but the value of a single application is limited. The combination of imagings and tumor markers could improve the diagnostic accuracy of the preoperative TN staging of colorectal cancer. Conclusion In clinical work, combination of imagings and tumor markers should be selected basing on actual situation of patients so as to improve accuracy of preoperative TN staging of colorectal cancer, and guide clinical treatment and improve prognosis of patients.
【Abstract】 Objective To evaluate the relationship between multiple tumor biomarkers and idiopathic pulmonary fibrosis ( IPF) , and analyze the prognostic value of these biomarkers in IPF. Methods Clinical data of 43 confirmed IPF patients with no evidence of malignant disaeses, admitted in Peking Union Medical College Hospital between January 2000 and June 2010, were retrospectively analyzed. All IPF patients had detected serum alpha fetoprotein ( AFP) , cancer antigen 50 ( CA50) , cancer antigen 24-2( CA24-2) , carcinoembryonic antigen ( CEA) , carbohydrate antigen 19-9 ( CA19-9) , cancer antigen 125( CA125) , cancer antigen 15-3 ( CA15-3) , tissue polypeptide antigen ( TPA) , neuron specific enolase( NSE) , and cytokeratin-19-fragment ( Cyfra211) . Results The serum levels of CEA, CA19-9, CA125,CA15-3, and TPA were obviously higher than normal range, while the serum levels of AFP, CA50, CA24-2,NSE, and Cyfra211 were within normal range. Neither tumor biomarkers had correlation with 6-minute walk distance, FVC% pred, TLC% pred, DLCO/VA, PaO2 , PaO2 /FiO2 , P( A-a) O2 , BALF cell differentiation counting,or CD4 /CD8. The patients with increased CA19-9 level had shorter survival time than those with normal CA19-9 level ( P lt; 0. 05) . There was no significant difference in survival time between the patients with increased CEA/TPA levels and those with normal CEA/TPA levels( P gt;0. 05) , neither between the patients with glucocorticoid treatment and those with non-glucocorticoid treatment ( P gt; 0. 05) . Conclusions Multiple tumor biomarkers, especially CA19-9, increase in IPF patients. The degrees of those increases arenot associated with the severity of disease, but closely relate to prognosis, and may also indicate the progression. The increases of multiple tumor biomarkers may be a sign of poor prognosis of IPF with no evidence of malignant disaeses.
ObjectiveTo summarize the domestic and abroad articles related to the research on the relation between miRNA-221/222 and thyroid cancer, and explore the important effects of miRNA-221/222 in diagnosis and treatment of thyroid cancer. MethodsDomestic and international publications involving the relationship of miRNA-221/222 to thyroid cancer were screened and reviewed. ResultsMiRNA-221/222 is a tumor marker with high specificity and sensitivity in thyroid cancer. It has important significance for diagnosis, treatment and prognosis of thyroid cancer. ConclusionMiRNA-221/222 is not only related to diagnosis of thyroid cancer, but also have provided a new research direction and method for gene therapy of thyroid cancer．
ObjectiveTo investigate the diagnosis, treatment, and prognosis of the postoperative intestinal obstruction of gastrointestinal cancer. MethodThe clinical data of 58 patients with postoperative intestinal obstruction of gastrointestinal cancer from January 2011 to January 2013 were analyzed retrospectively. ResultsIn 58 patients with postoperative intestinal obstruction, there were 46 cases of incomplete intestinal obstruction, 12 cases of complete obstruction. Seventeen cases were treated conservatively and 41 cases were accepted laparotomy. The surgical exploration found that there were 4 cases of strangulated abdominal internal hernia, 4 cases of volvulus, 1 case of stercoral obstruction, 2 cases of intussusception, 9 cases of adhesive intestinal obstruction, and 21 cases of tumor recurrence. There were 32 patients with high tumor markers before laparotomy, including 19 cases of tumor recurrence. Fourteen cases had no obvious tumor lesions detected by PET-CT, but recurrence and metastasis were found by surgical exploration. ConclusionsThe recurrent postoperative intestinal obstruction of gastrointestinal cancer mostly means recurrence and metastasis, with poor prognosis. Early laparotomy may improve the prognosis and the quality of life, elevated tumor markers have some links with tumor recurrence and PET-CT is not sensitive for multiple nodular metastases.
Objective Toa nalyzed ifferentialp roteine xpressiono fc holangiocarcinomai np eripheralb loodb yproteomics technology, and to investigate the significance of proteomics technology in early diagnosis of bile ductmalignancy.M ethods Serum proteinf rom 58p atientsw ithc holangiocarcinomaa nd5 8c ontrols( 20p atientsw ithcholecystolithiasis and 38 healthy people) were detected by surface enhanced laser desorption/ionization-time offlight-mass spectrometry (SELDI-TOF-MS). Ciphergen protein chip software was used to identify proteinic spectra.R esults Comparedw itht hes pectrao fs erum proteini nc ontrolg roup,t herew ere1 0d ifferentiallye xpressedproteins in bile duct carcinoma group, among which three proteins with relative molecular masses of 5. 900 X 10’，9.08 0X 1 0’a nd1 1.86 3X 1 0’w ereu p-regulated( Plt;1 0-’)ands evenp roteinsw ithr elativem olecularm asseso f6.9 59X 1 0’，14.0 00X 1 0’，14.1 29X 1 0’，14.3 02X 1 0’，17.5 57X 10’，17.6 90X 1 0’a nd2 8.5 52X 1 0’w ered ownregulated(Plt; 10-’)。The average concentration of protein with the relative molecular mass of 11. 863 X 10’ incholangiocarcinoma group was eight times more than that in controls group. At the stage I of cholangiocarcinoma,thee xpressiono fp roteinp ointw itha r elativem olecularm asso f5 .90 0X1 0’w ass ignificantlyh ighert hant hosep atientsat the stage III and stage fV (Plt;10-’)，while there were no statistical difference of expression between diffeent clinical stages for the other 9 proteins points. And there were no significant expression differences of the above10 proteins between the patients with and without jaundice following cholangiocarcinoma. Instead, another threeproteinsw ithr elativem olecularm asseso f7 .25 5X 1 03，12.36 4X 1 0’a nd1 5.8 73X 1 03w ered etectedt oh aved ifferentproteine xpressions.A nda llo fth em showedh ighe xpressionsin j aundiceg roup( Plt;10-5).C onclusion Thereare remarkable differences of the expressions of serum proteins in peripheral blood in patients with cholangiocarcinoma.T hep roteinp ointw itha r elativem olecularm asso f1 1.86 3X 1 0’m ayb ea p otentialb iomarkerfo re arlyd iagnosisof cholangiocarcinoma
【摘要】 目的 〖JP2〗探讨血管内皮生长因子（VEGF）联合血清肿瘤标志物对肺癌早期诊断意义。 方法 2008年1月-〖JP〗2009年8月收治的92例患者中肺癌患者64例，采集静脉血清标本采用酶联免疫法检测其VEGF水平。 结果 64例肺癌与28例非肺癌患者VEGF表达水平分别为（255.72±566.00）、（299.46±795.8） pg/mL，两者比较无统计学意义（Pgt;0.05）；43例中晚期肺癌VEGF值（125.07±68.2） pg/mL，表达显著高于12例早期肺癌（196.00±260.60） pg/mL （Plt;0.05）；CEA与CYFRA21-1的表达对判断26例发生胸膜转移的肺癌有统计学意义（Plt;0.05）。 结论 结合血清VEGF水平和常规肿瘤标志物，可评估现状及临床分期，VEGF结合CEA与CYFRA21-1表达水平为预测肺癌患者早期发生胸膜转移提供理论依据。【Abstract】 Objective To evaluate the effect of combined detection value of serum vascular endothelial growth factor (VEGF) and tumor markers on early diagnosis of lung cancer. Method Intravenous serum levels of VEGF and tumor markers were assayed by ELISA in 92 patients including 64 lung cancer from January 2008 to August 2009. Results The difference in serum levels of VEGF between the 64 patients with lung cancer [(255.72±566.0) pg/mL] and 28 health adult [(299.46±795.8) pg/mL] was not significant (Pgt;0.05). The level of VEGF in 43 patients with middle and late lung cancer [(125.07±68.2) pg/mL] was significantly higher than that in the 12 patients with early lung cancer [(196.00±260.60) pg/mL] (Plt;0.05). There were statistical significance in expression of serum CEA and CYFRA21-1 on diagnosis in 26 patients having lung cancer with early metastasis pleural fluid (Plt;0.05). Conclusion Combined diagnostic of serum VEGF and tumor markers can assess the state of an illness and clinical stage, and the serum levels of serum VEGF,CEA and CYFRA21-1 may be a good predictor for lung cancer with early metastasis pleural fluid.