血清DCP、GPC3和HSP70检测对AFP阴性PLC的诊断价值

目的 探讨血清中异常凝血酶原(des-γ-carboxy prothrombin,DCP)、磷脂酰肌醇蛋白聚糖-3(glypican-3,GPC3)和热休克蛋白70 (heat shock protein 70,HSP70)3种肿瘤标志物在甲胎蛋白(alpha-fetoprotein,AFP)阴性原发性肝癌(primary liver carcinoma,PLC)中的诊断价值及联合检测的意义.方法 收集AFP阴性PLC 48例患者,良性肝病40例,健康体检者40例为对照组.检测血清中DCP、GPC3和HSP70的浓度,并进行比较.结果 AFP阴性PLC组患者血清DCP、GPC3和HSP70水平及阳性率均高于良性肝病组及对照组,差异均具有统计学意义(均P ＜0.05).DCP、GPC3和HSP70联合检测对AFP阴性PLC诊断的敏感度、特异度及准确度均高于单独检测(均P＜0.05).结论 DCP、GPC3和HSP70联合检测对AFP阴性PLC的诊断具有重要价值.     

AFP、AFU、GPC3及GP73联合检测对原发性肝癌的诊断意义

目的探讨AFP、AFU、GP73和GPC3联合检测对原发性肝癌(primary hepatic cancer,PHC)的诊断价值。方法收集荆州市中心医院2013年12月至2015年3月收治的PHC患者血清标本45例,肝硬化患者血清标本36例,乙型肝炎患者血清标本54例和健康体检者血清标本50例,分别检测各组研究对象血清AFP、AFU、GP73和GPC3水平,采用ROC曲线分析各标志物诊断PHC的价值。结果 PHC组患者血清AFP、AFU、GP73和GPC3表达水平均显著高于肝硬化组、乙型肝炎组和健康体检组(P<0.05)。肝硬化组和乙型肝炎组患者血清AFP、AFU水平显著高于健康体检组(P<0.05)。肝硬化组患者血清GP73水平显著高于乙型肝炎组患者(P<0.05),乙型肝炎组患者血清GP73水平显著高于健康对照组。联合AFP、AFU、GP73和GPC3检测的ROC曲线下面积为0.922,大于任何单一标志物检测。联合AFP、AFU、GP73和GPC3检测的敏感性、特异性和准确性分别为93.8%,81.5%和90.1%,其中敏感性和准确性明显高于任何单一标志物。结论联合AFP、AFU、GP73和GPC3检测可以显著提高PHC的检出率和准确性,为临床早期诊断PHC提供可靠参考。     

联合检测血清AFP和AFU对原发性肝癌的诊断价值

目的:探讨血清甲胎蛋白(AFP)、α-L-岩藻糖苷酶(AFU)在原发性肝癌(PHC)诊断中的应用价值.方法:对55例PHC和40例其它肿瘤患者,以及40例正常对照者进行AFP、AFU指标联合检测,并分析其对PHC的诊断价值.结果:PHC组血清AFP、AFU的水平显著高于健康对照组及其它肿瘤组(P＜0.05).两种肿瘤标志物的联检阳性率为85.5%,较AFP、AFU单项检测时有明显提高(P＜0.05).结论:肿瘤标志物AFP、AFU对PHC有一定的诊断价值,两种肿瘤标志物联检可提高PHC的阳性诊断率.     

AFP、CEA、GPC3单独及联合检测在原发性肝癌诊断中的应用

目的:探讨3种血清肿瘤标志物甲胎蛋白(AFP)、癌胚抗原(CEA)、磷脂酰肌醇蛋白聚糖3(GPC3)单独及联合检测对原发性肝癌(PHC)的互补诊断价值及对肝癌早期诊断的意义。方法:对我院2009年8月-2011年7月收治的55例PHC,30例肝硬化患者进行单独及联合检测AFP、CEA、GPC3,并选择同期30例正常人作为对照组。采用电化学发光法测定AFP水平,速率法检测CEA水平,ELISA法检测GPC3水平。结果:PHC组血清AFP、CEA和GPC3水平均明显高于肝硬化组及正常对照组,差异有统计学意义(P<0.05)。PHC组患者血清AFP、CEA和GPC3阳性率分别为74.5%、69.1%和78.2%。血清指标AFP联合CEA或者GPC3可使检出率分别提高至81.8%和92.7%。三项指标联合检测PHC的阳性率可高达96.3%。AFP阴性的39例PHC患者中,血清GPC3、CEA阳性率分别为76.9%(30/39)、71.8%(28/39),表明二者对AFP阴性的PHC患者具有较高的诊断互补作用。结论:血清肿瘤标志物AFP、CEA、GPC3对PHC有一定的诊断价值;血清GPC3和AFP联合检测可明显提高PHC的诊断率,优于单项检测,特别是对AFP阴性或AFP呈低浓度PHC更具有诊断价值。     

甲胎蛋白糖类抗原磷脂酰肌醇蛋白聚糖3单独或联合检测在原发性肝癌诊断中的研究

目的探讨甲胎蛋白(AFP)、糖类抗原(CA199)、磷脂酰肌醇蛋白聚糖3(GPC3)三种血清肿瘤标志物单独和(或)联合检测对原发性肝癌(PHC)的互补诊断价值及对肝癌早期诊断的意义。方法对2009年8月至2011年7月收治的55例PHC患者(PHC组)和30例肝硬化患者(肝硬化组)进行单独和(或)联合检测AFP、GPC3和AFU,并同期选择30例正常人作为对照组。采用电化学发光法测定AFP水平,速率法检测CA199水平,采用酶联免疫吸附试验(ELISA)法检测GPC3水平。结果 PHC组患者血清GPC3、CA199和AFP水平均明显高于肝硬化组和正常对照组,差异有统计学意义(P<0.05)。PHC组患者血清GPC3、AFP和CA199阳性率分别为81.8%、74.5%和67.3%,AFP联合CA199和(或)GPC3可使检出率分别提高至78.2%和92.7%,三项指标联合检测PHC的阳性率可高达98.2%。AFP阴性的39例PHC患者中,血清GPC3、CA199阳性率分别为76.9%(30/39)、74.4%(29/39),表明二者对AFP阴性的PHC患者具有较高的诊断互补作用。结论血清肿瘤标志物AFP、CA199和GPC3对PHC有一定的诊断价值。血清GPC3和AFP联合检测可明显提高PHC的诊断率,优于单项检测,特别是对AFP阴性或AFP呈低浓度PHC更具有诊断价值。     

血清肿瘤标志物的联合动态检测在原发性肝癌诊断中的价值

目的 探讨血清肿瘤标志物甲胎蛋白（AFP）、恶性肿瘤特异性生长因子（TSGF）、高尔基体膜蛋白73（GP73）、骨桥蛋白（OPN）联合动态检测在原发性肝癌诊断中的应用价值.方法 选取122例原发性肝癌患者、50例肝脏良性病变患者和50名健康体检者为研究对象,采用电化学发光法检测其血清AFP、TSGF、GP73水平,酶联免疫吸附试验法（ELISA）检测OPN水平,分析血清肿瘤标志物AFP、TSGF、GP73和OPN在原发性肝癌诊断中的临床应用价值.结果 原发性肝癌患者血清AFP、TSGF、GP73和OPN水平明显高于肝脏良性病变患者和健康对照者,差异均有统计学意义（均P＜0.01）;原发性肝癌患者血清肿瘤标志物水平与患者年龄、性别无关（均P＞0.05）,与病灶大小、肿瘤数目、临床分期、腹腔积液、肝硬化、门静脉侵犯、转移、复发、治疗后相关（均P＜0.05）.AFP、TSGF、GP73和OPN单项用于诊断原发性肝癌的敏感度分别为57.38％、68.85％、70.49％、69.67％;AFP＋TSGF、AFP＋TSGF＋GP73的敏感度分别为80.33％、85.25％;4项肿瘤标志物联合检测可使敏感度提高到98.36％,准确度提高到95.65％,与各单项及部分组合检测比较差异均有统计学意义（均P＜0.05）.结论 血清肿瘤标志物AFP、TSGF、GP73和OPN可作为诊断原发性肝癌的辅助手段,4项肿瘤标志物联合检测的敏感性及准确性明显提高,从而减少误诊、漏诊,有利于肝癌的早期诊断、临床早期干预.     

血清Glypican-3检测在肝癌诊断中的临床意义

目的:探讨血清中Glypican-3(GPC3)检测在肝癌诊断中的临床意义。方法:采用鼠抗GPC3(25-358aa)单克隆抗体和兔抗GPC3(379-393aa)多克隆抗体建立双抗夹心ELISA法,对364例原发性肝细胞肝癌、96例慢性乙型肝炎及106例正常人血清中GPC3进行定量。同时采用放射免疫法检测AFP。结果:原发性肝细胞肝癌患者血清GPC3平均浓度为86.96±422ng/mL;慢性乙型肝炎患者血清GPC3平均浓度为11.7±12.23 ng/mL;正常人血清GPC3平均浓度为6.04±9.21 ng/mL。原发性肝细胞肝癌患者血清GPC3含量与慢性乙型肝炎组和正常组比较差异显著(P<0.001),慢性乙型肝炎组和正常组间差异无统计学意义(P>0.05)。当以30 ng/mL为诊断界值时,GPC3诊断肝癌的敏感性和特异性分别为40%和93%。在151例同时检测AFP和GPC3的HCC血清中,AFP阳性率为49%,GPC3阳性率为40%。AFP联合GPC3检测时,能将HCC的检出率提高至72%。结论:血清GPC3可作为一新的肿瘤标志物用于原发性肝细胞肝癌的临床诊断。     

联合检测血清肿瘤标志物对原发性肝癌患者诊断和治疗的临床应用价值

目的:探讨肿瘤标志物甲胎蛋白(AFP)、癌胚抗原(CEA)、CA199、谷氨酸氨基转肽酶(GGT)联合检测对原发性肝癌(PHC)患者诊断及治疗的临床意义.方法:应用化学发光法及全自动生化分析仪对80例原发性肝癌患者和50例肝病患者及70例健康体检者进行AFP、CEA、CA199、GGT检测.结果:原发性肝癌组AFP、CEA、CA199、GGT各项指标均显著高于肝病组和健康体检组,差异具有统计学意义(P＜0.01).联合检测的灵敏度和特异度分别为94.61％、80.75％,与单项检测比较阳性率明显增高,差异具有统计学意义(P＜0.05).结论:血清AFP、CEA、CA199、GGT联合检测可提高原发性肝癌诊断的敏感性,对早期诊断原发性肝癌具有一定的临床应用价值.     

肿瘤相关物质与甲胎蛋白联合检测在原发性肝癌诊断中的应用

目的探讨肿瘤相关物质(TSGF)与甲胎蛋白(AFP)联合检测在原发性肝癌诊断中的价值.方法设原发性肝癌组、继发性肝癌组、肝硬化组、肝炎组及正常对照组共5组,分别行TSGF与AFP联合检测及相关性统计.结果原发性肝癌组TSGF与转移性肝癌组相比无显著性差异,但与其他3组比较,有显著性差异(P＜0.05).原发性肝癌组AFP与其他各组比较,均有显著性差异(P<0.05).结论 TSGF是原发性肝癌的灵敏检测指标,与AFP联检可显著提高原发性肝癌的诊断率.     

AFP、AFU、GGT、ALP联合检测对原发性肝癌诊断价值的观察

目的探讨4种血清肿瘤标志物对肝癌诊断的价值.根据应用的目的,选择相关的血清肿瘤标志物进行联合试验,以提高肝癌诊断的准确性.方法电化学发光法测定甲胎蛋白(AFP),比色法测定a-L-岩藻糖苷酶(AFU)、转肽酶(GGT)和碱性磷酸酶(ALP)的活性.共检测肝脏占位病变者194例,其中,146例为原发与继发性肝癌(病例组),对照组包括肝硬化结节和其他肝病等48例.结果病例组与对照组的AFP均数t检验P＜0.01,差异非常显著.4种标志物单项对肝癌诊断的敏感性依次为GGT＞ALP＞AFP＞AFU,特异性依次为AFP＞AFU＞ALP＞GGT.AFP与其它3种血清标志物进行平行试验的敏感度均有所提高,AFP与其它3种血清标志物进行系列试验的特异度均显著提高.结论 AFP、AFU、GGT、ALP进行联合试验对肝癌诊断有意义,平行试验可提高敏感度,适用于高危人群的肝癌筛检;系列试验可显著提高特异度,有利于临床诊断工作.     

Fat, fiber, fruits, vegetables, and risk of colorectal adenomas

A case-control study was conducted at the National Naval Medical Center (Maryland, USA) from 1994 to 1996 to investigate the possible association between dietary factors and colorectal adenomas. Cases (n = 239) were subjects diagnosed with adenomas (146 new and 93 recurrent) by sigmoidoscopy or colonoscopy. Those with no evidence of adenomas found by sigmoidoscopy were recruited as controls (n = 228). Dietary variables, assessed by a 100-item food frequency questionnaire, were analyzed by the logistic regression model, which was adjusted for age, gender and total energy intake. Variables of fat intake were further adjusted for red meat intake. An increased risk of 7% [odds ratio (OR): 1.07; 95% confidence interval (95% CI): 0.94-1.22] per 5% energy/day from total fat was observed. Every additional 5% unit of oleic acid intake/day significantly increased the adenoma risk by 115% (OR: 2.15; 95% CI: 1.05-4.39). Red meat fat increased the risk by 20% (OR: 1.20; 95% CI: 0.71-2.04), and white meat fat decreased the risk by 67% (OR: 0.33; 95% CI: 0.19-0.95) for every additional 5% unit of respective intake/day. Risk decreased by 41% (OR: 0.59; 95% CI: 0.41-0.86) for every additional 5% unit of fiber intake/day. Vegetable [OR per 100 g of vegetable intake/day: 0.83, 95% CI: 0.67-1.04] and fruit (OR per 100 g of fruit intake/day: 0.92, 95% CI: 0.82-1.03) intake showed an inverse association, and the results are suggestive of an association with the risk for adenomas. In conclusion, a strong positive association between oleic acid intake and colorectal adenoma risk was observed. This is likely to be an indicator of "unhealthy" food (meat, dairy, margarine, mayonnaise, sweet baked food) consumption in this population. Increased intake of dietary fiber was associated with a moderately decreased risk of adenomas.     

Susceptibility of Ureaplasma urealyticum to Tetracycline,Doxycycline, Erythromycin,Roxithromycin, Clarithromycin,Azithromycin, Levofloxacin and Moxifloxacin

Abstract

The in vitro activity of tetracycline, doxycycline, erythromycin, roxithromycin, clarithromycin, azithromycin, levofloxacin and moxifloxacin was tested against 63 clinical isolates of Ureaplasma urealyticum. The minimal inhibitory concentrations (MICs) and the minimal bactericidal concentrations (MBCs) were determined by the broth microdilution method in A7 medium. The miC50 and miC90 of the tested agents after 24 h of incubation were as follows: Tetracycline, 0.5 and 2.0 μg/ml; doxycycline, 0.125 and 0.25 μg/ml; erythromycin, 2.0 and 8.0 μg/ml; roxithromycin, 2.0 and 4.0 μg/ml; clarithromycin, 0.25 and 1.0 μg/ml; azithromycin, 2.0 and 4.0 μg/ml; levofloxacin, 1.0 and 2.0 μg/ml; and moxifloxacin, 0.5 and 0.5 μg/ml, respectively. The MIC values after 24 h and 48 h incubation differed by no more than one dilution for all the agents with the exception of doxycycline (two dilution difference for MIC₉₀). Overall, moxifloxacin was the most active agent in vitro against U. Urealyticum, with the narrowest difference between MIC and MBC values, followed closely by levofloxacin. Clarithromycin was the most active macrolide.     

Occurrence,Efficacy, Metabolism,and Toxicity of Triclosan

Triclosan has broad-spectrum anti-microbial activity against most gram-negative and gram-positive bacteria. It is widely used in personal care products, household items, medical devices, and clinical settings. Due to its extensive use, there is potential for humans in all age groups to receive life-time exposures to triclosan, and, indeed, triclosan has been detected in human tissues and the environment. Data gaps exist regarding the chronic dermal toxicity and carcinogenicity of triclosan, which is needed for the risk assessment of triclosan. The US Food and Drug Administration (FDA) nominated triclosan to the National Toxicology Program (NTP) for toxicological evaluations. Currently, the NTP is conducting several dermal toxicological studies to determine the carcinogenic potential of triclosan, evaluate its endocrine and developmental-reproductive effects, and investigate the potential UV-induced dermal formation of chlorinated phenols and dioxins of triclosan. This paper reviews data on the human exposure, environmental fate, efficacy of anti-microbial activity, absorption, distribution, metabolism and elimination, endocrine disrupting effects, and toxicity of triclosan.     

Tobacco, alcohol, diet, occupation, and carcinoma of the esophagus

Information on occupation, smoking, food and beverage consumption, and medical history were compared between 275 incident cases of carcinoma of the esophagus and 275 neighborhood controls who were matched to the cases on age (within 5 years), race, and sex. Tobacco use, mainly cigarette smoking, was a significant risk factor for carcinoma of the esophagus. Ex-smokers of cigarettes showed a reduced risk relative to those who continued to smoke, and current smokers of two or more packs per day displayed a higher risk than those who smoked less. Alcohol consumption was another significant risk factor for carcinoma of the esophagus; there was a highly significant trend with average daily dose of ethanol. Relative to controls, cases also consumed significantly more fried bacon or ham, less fresh fruits and raw vegetables, and were more likely to prefer white than whole grain bread. Finally, there was a significant association between carcinoma of the esophagus and long-term occupational exposure to metal dust; this association was largely confined to the lower one-third section of the esophagus.     

Age,Race, Sex,Stage, and Incidence of Cutaneous Lymphoma

BackgroundThe incidence of the T- and B-cell CLs has been well documented, but information pertaining to racial incidence by age, and by burden of disease (stage) have not been extensively documented.Materials and MethodsThe SEER 2004-2008 public use database was investigated. The relative incidence of CL in different races and age groups was examined. Univariate and multivariate stepwise logistic regression was performed for the likelihood of presenting at a higher stage.ResultsOf 4496 patients diagnosed with CL between 2004 and 2008; 1713 patients were diagnosed with MF, 1518 with non-MF cutaneous T-cell lymphoma, and 1265 patients with cutaneous B-cell lymphoma. For MF, there was a trend for females to be less likely to present with a higher T-stage (T3-T4) than males (odds ratio [OR], 0.73) on multivariate analysis (P = .06). For race, AA had a significantly increased risk of presenting with higher T-stage (T3-T4) MF (OR, 1.72) on multivariate analysis (P = .02), compared with white patients. For white, AA, Asian/Pacific Islander, and Native American/other/unknown, the mean age at diagnosis was 59.2, 51.5, 51.3, and 53.8. These groups presented at a significantly different age than white (P = .0001, 0.0001, and 0.0006).ConclusionNonwhite racial groups present with MF at an earlier age compared with white, and AA have increased risk of presenting with higher T-stage compared with white. These findings have significant implications regarding need for earlier diagnosis and understanding the reasons for racial disparity in age and stage of presentation.     

Susceptibility of Ureaplasma urealyticum to tetracycline, doxycycline, erythromycin, roxithromycin, clarithromycin, azithromycin, levofloxacin and moxifloxacin

The in vitro activity of tetracycline, doxycycline, erythromycin, roxithromycin, clarithromycin, azithromycin, levofloxacin and moxifloxacin was tested against 63 clinical isolates of Ureaplasma urealyticum. The minimal inhibitory concentrations (MICs) and the minimal bactericidal concentrations (MBCs) were determined by the broth microdilution method in A7 medium. The MIC(50) and MIC(90) of the tested agents after 24 h of incubation were as follows: tetracycline, 0.5 and 2.0 μg/ml; doxycycline, 0.125 and 0.25 μg/ml; erythromycin, 2.0 and 8.0 μg/ml; roxithromycin, 2.0 and 4.0 μg/ml; clarithromycin, 0.25 and 1.0 μg/ml; azithromycin, 2.0 and 4.0 μg/ml; levofloxacin, 1.0 and 2.0 μg/ml; and moxifloxacin, 0.5 and 0.5 μg/ml, respectively. The MIC values after 24 h and 48 h incubation differed by no more than one dilution for all the agents with the exception of doxycycline (two dilution difference for MIC(90)). Overall, moxifloxacin was the most active agent in vitro against U. urealyticum, with the narrowest difference between MIC and MBC values, followed closely by levofloxacin. Clarithromycin was the most active macrolide.     

Cutaneous,gastrointestinal, hepatic,endocrine, and renal side-effects of anti-PD-1 therapy

BackgroundAnti-programmed cell death receptor-1 (PD-1) antibodies represent an effective treatment option for metastatic melanoma as well as for other cancer entities. They act via blockade of the PD-1 receptor, an inhibitor of the T-cell effector mechanisms that limit immune responses against tumours. As reported for ipilimumab, the anti-PD-1 antibodies pembrolizumab and nivolumab can induce immune-related adverse events (irAEs). These side-effects affect skin, gastrointestinal tract, liver, endocrine system and other organ systems. Since life-threatening and fatal irAEs have been reported, adequate diagnosis and management are essential.Methods and findingsIn total, 496 patients with metastatic melanoma from 15 skin cancer centers were treated with pembrolizumab or nivolumab; 242 side-effects were described in 138 patients. In 116 of the 138 patients, side-effects affected the skin, gastrointestinal tract, liver, endocrine, and renal system. Rare side-effects included diabetes mellitus, lichen planus, and pancreas insufficiency due to pancreatitis.ConclusionAnti-PD1 antibodies can induce a plethora of irAEs. The knowledge of them will allow prompt diagnosis and improve the management resulting in decreased morbidity.     

Antitumor activity of halogen analogs of phosphoramide,isophosphoramide, and triphosphoramide mustards,the cytotoxic metabolites of cyclophosphamide,ifosfamide, and trofosfamide

A series of halogen analogs of phosphoramide mustard, isophosphoramide mustard, and triphosphoramide mustard, the cytotoxic metabolites of the antitumor drugs cyclophosphamide, ifosfamide, and trofosfamide, respectively, was evaluated in vitro against human tumor cell lines and in vivo against experimental tumors to investigate the effect of replacement of chlorine with bromine or fluorine on the antitumor activity of the parent phosphoramide mustards. In the experimental tumors L1210 leukemia, B16 melanoma, mammary adenocarcinoma 16/C, and ovarian sarcoma M5076, the antitumor activity of the analogs was observed to be generally comparable with that of the parent mustards when chlorine was replaced by bromine but uniformly lower when chlorine was replaced by fluorine. Furthermore, the monobromo analog of isophosphoramide mustard displayed equal or somewhat greater activity in comparison with cyclophosphamide when evaluated against subcutaneously implanted L1210 leukemia with intraperitoneal drug treatment and against mammary adenocarcinoma 16/C.This work was financially supported by NIH, NCI grant PO1 CA34200