NSCLC患者血清sB7-H3和CYFRA21-1检测及临床应用

目的 探讨血清可溶性B7-H3（sB7-H3）和细胞角蛋白19片段抗原（CYFRA21-1）检测对非小细胞肺癌（non-small cell lung cancer,NSCLC）的诊断价值.方法 分别采用 ELISA和电化学发光法检测 72 例 NSCLC及 68 例肺部良性病患者血清sB7-H3 和 CYFRA21-1水平.结果 NSCLC 患者血清sB7-H3水平及阳性率[（98.34±35.17）ng/ml,61.11%]均明显高于肺部良性病患者[（70.89±20.62）ng/ml,7.32%];NSCLC 患者血清CYFRA21-1 水平及阳性率[（15.08±7.98）ng/ml,66.67%]均明显高于肺部良性病患者[（3.21±2.65）ng/ml,4.41%];差异均具有统计学意义（P〈0.05）.NSCLC 经TNM分期后,随着肿瘤分级级别的升高,sB7-H3水平[Ⅰ/Ⅱ期、Ⅲ期和Ⅳ期分别为（85.21±36.14）ng/ml、（98.62±＋40.38）ng/ml和（107.17±41.66）ng/ml],CYFRA21-1水平和[Ⅰ/Ⅱ期、Ⅲ期和Ⅳ期分别为（10.23±5.65）ng/ml、（15.52±6.84）ng/ml和（18.08±5.93）ng/ml]也升高.sB7-H3 和 CYFRA21-1联检后,灵敏度和一致性增高,特异性降低.结论 sB7-H3 和 CYFRA21-1对 NSCLC 有一定的辅助诊断价值,另外,或可应用于对TNM的分期,联检可提高对NSCLC的阳性诊断.     

可溶型B7-H3在原发性肝细胞癌患者血清中的表达及临床意义

目的 检测协同刺激分子B7-H3在肝细胞癌患者血清及组织中的表达,并探讨其临床意义.方法 选取原发性肝细胞癌63例患者的癌组织和血清标本;5例肝血管瘤的瘤旁组织作为正常肝组织对照;同期收取50例健康体检人员外周血标本为正常对照.采用ELISA检测肝癌患者和正常人血清中可溶型B7-H3(sB7-H3)的含量,免疫组化检测正常肝组织和肝细胞癌组织中B7-H3的表达.结果 肝细胞癌患者外周血清sB7-H3含量为(4143.47±976,27) pg/mL,显著高于正常对照组(2076.18±605.42)pg/mL(P ＜0.05);且其表达水平与临床分期,是否远处转移及肝癌组织中是否阳性表达B7-H3等参数有关(P＜0.05),与年龄、性别、组织学类型、淋巴结转移及肿瘤大小等临床病理参数无关;与血清学指标CA19-9呈明显正相关(P＜0.05),但与AFP和CEA水平无相关性.结论 肝癌患者血清中sB7-H3表达明显高于正常人,B7-H3表达与疾病临床病理指标相关,表明检测sB7-H3可能对原发性肝癌的诊断有一定价值.     

sB7-H3、CEA和CYFRA21-1联检对肺癌的诊断价值

目的:探讨血清中可溶性B7-H3(sB7-H3)、癌胚抗原(CEA)和细胞角蛋白19片段(CYFRA21-1)三项标志物检测对肺癌的诊断价值。方法:采用电化学发光法检测肺癌组(68例)、肺良性疾病组(75例)和健康对照组(65例)的血清CEA和CYFRA21-1,采用ELISA对血清sB7-H3进行检测,对肺癌患者sB7-H3、CEA和CYFRA21-1水平与临床分期关系进行统计分析。结果:肺癌组三项肿瘤标志物均显著地高于肺良性疾病组和健康对照组(P<0.05)、sB7-H3对肺癌诊断的敏感性为61.76%,特异性为92.14%;CEA敏感性为45.8%,特异性为90.0%;CYFRA21-1敏感性为66.18%,特异性为90.0%;三项标志物联检敏感性为98.53%,特异性为88.34%、sB7-H3、CEA和CYFRA21-1随着临床分期的增加而升高。结论:sB7-H3、CEA和CYFRA21-1可提供确切的临床价值,这些肿瘤标志物可应用于对肺癌诊断,三者联检对肺癌的诊断、鉴别诊断及临床分期等方面具有重要的临床意义。     

sB7-H4蛋白和CA125联检在卵巢癌患者中的应用价值

目的:探讨联检血清可溶性B7-H4蛋白(sB7-H4)和CA125水平在卵巢癌诊断中的应用价值.方法:采用ELISA测定51例卵巢癌患者、89例卵巢良性疾病患者和105例健康对照者血清sB7-H4水平,同时测定血清CA125水平,并对结果进行比较分析.结果:卵巢癌组血清sB7-H4、CA125水平均显著高于卵巢良性疾病组和健康对照组,差异有统计学意义(P<0.01);sB7-H4在早期卵巢癌(Ⅰ期～Ⅱ期)阳性率高于CA125,两者联检可提高诊断卵巢癌的敏感性.结论:sB7-H4是一种较好的预测早期卵巢癌的肿瘤标志物,其联检CA125有助于卵巢癌的早期诊断.     

血液系统恶性肿瘤患者血清可溶性B7-H4的检测及其临床意义

目的:探讨部分血液系统恶性肿瘤患者血清可溶性B7-H4的水平及临床意义。方法:在建立了检测可溶性B7-H4(sB7-H4)ELISA夹心法的基础上对65例白血病患者、34例淋巴瘤患者、12例多发性骨髓瘤患者血清SB7-H4水平进行了检测,并采用50例健康体检者血清sB7-H4水平作为对照。结果:正常体检者、白血病患者、淋巴瘤患者和多发性骨髓瘤患者血清sB7-H4浓度分别为(31.62±9.85)μg/L、(31.82±9.91)μg/L、(38.81±10.34)μg/L和(29.28±7.04)μg/L,其中健康体检者与白血病患者和多发性骨髓瘤患者血清sB7-H4水平差异无统计学意义,与淋巴瘤患者血清sB7-H4水平差异有统计学意义(P0.01)。结论:sB7-H4与淋巴瘤的发病有关,而与白血病和多发性骨髓瘤无直接相关,检测sB7-H4对淋巴瘤的辅助诊断具有一定的临床意义。     

人可溶性B7-H3酶联试剂盒的研制及在肝病患者血清中水平的检测

目的:建立定量检测人的可溶性B7-H3(sB7-H3)酶联检测试剂盒,并分析肝病患者外周血中sB7-H3水平及其临床意义。方法:在已获得2株识别位点不同的小鼠抗人B7-H3单克隆抗体(4H7和2E6)基础上,采用单抗4H7为包被抗体,以经生物素标记的抗体2E6为检测抗体,以重组人可溶性B7-H3为标准品,建立可溶性B7-H3分子的酶标检测方法。在此基础上对健康献血者和不同肝病患者的血清样本进行了检测并分析其临床意义。结果:研制了sB7-H3酶联检测试剂盒,检测的线性范围是8.192～2 000 ng/L,批内、批间变异系数分别为3.35%和6.97%。酶标检测板在4℃放置1个月,变异系数(CV%)<±8.6,回收率为94%～117%,特异性试验显示无交叉反应,提示该检测试剂盒具有良好的灵敏度、稳定性和特异性。用该试剂盒分析不同肝病患者外周血sB7-H3水平后发现,(1)乙肝患者以及乙肝合并肝硬化或肝癌患者与健康对照组之间并不存在差异(P>0.05);(2)重症肝炎患者血清B7-H3水平低于健康对照组(P=0.0183);(3)血吸虫性肝硬化患者血清B7-H3水平显著高于健康对照组(P<0.01)。结论:建立了灵敏、特异的人sB7-H3酶联检测试剂盒,对肝病患者检测的结果表明,不同的肝病患者外周血sB7-H3表达水平不同,显示该试剂盒具有潜在的应用价值。     

胰腺癌B7-H4与相关血清肿瘤标志物的预后价值研究

目的:分析胰腺癌患者肿瘤组织B7-H4表达水平与术前血清中癌胚抗原(CEA)、糖类抗原(CA)199及CA242等肿瘤标志物表达水平的相关性,同时探讨其在胰腺癌中的临床应用价值。方法:采用抗人B7-H4单克隆抗体免疫组化染色方法测定188例胰腺癌患者手术切除组织中B7-H4表达水平。同时利用电化学发光法检测术前血清中CEA、CA199及CA242浓度。结果:胰腺癌患者术前血清CEA水平与胰腺癌原发灶、淋巴结及远端转移分期(TNM)及远端转移相关(P<0.05)。胰腺癌患者术前血清CA199及CA242水平与胰腺癌患者年龄及远端转移相关(P<0.05)。CA199与术后生存期相关(P<0.05)。胰腺癌患者肿瘤组织B7-H4表达水平与血清CEA表达存在显著正相关(P<0.05),与其他肿瘤标志物之间无显著相关性(P>0.05)。在胰腺癌患者术后6个月生存的预测分析中,B7-H4染色积分的曲线下面积(AUC)明显高于CEA和CA242(P<0.05);B7-H4染色积分联合术前血清CA199的AUC明显高于术前血清CA199(P<0.05),而与B...     

血清可溶性B7-H4在淋巴瘤患者诊断中的临床意义

目的：探讨血清可溶性B7-H4（sB7-H4）在淋巴瘤患者检测中的临床意义。方法：用ELISA夹心法检测52例淋巴瘤患者与50例健康者血清sB7-H4水平。结果：霍奇金病、非霍奇金淋巴瘤患者血清sB7-H4水平分别为（45.66±12.48μg/L、50.24±14.52μg/L）明显高于健康者水平（26.47±10.35μg/L）,差异有统计学意义（P〈0.01）。结论：sB7-H4与淋巴瘤的发病有关,对淋巴瘤的辅助诊断具有一定的临床意义。     

CA50、CA19-9、CEA联检在胰腺疾病诊断中的价值

目的 :分析CA19- 9、CEA和CA5 0在胰腺疾病诊断中的价值。方法 :4 6 9例胰腺疾病患者采用放射免疫分析测定血清CA5 0水平。采用电化学发光法测定血清CA19- 9和CEA水平。结果 :诊断胰腺癌 ,CA19- 9敏感性和特异性分别为 92 5 7%和 90 73% ;联合检测CA19- 9、CEA、CA5 0其敏感性提高为97 6 4 %。阳性诊断率为 99 16 %。结论 :采用以CA19- 9为主的肿瘤标志物联合检测 ,对胰腺疾病 ,特别是胰腺癌的诊断有着极其重要的意义。     

四种肿瘤标志物联合检测对胃癌的诊断价值

对已确诊的胃癌患者于术前测量其相关血清肿瘤标志物,分析不同的联合检测对胃癌的诊断价值,选出临床诊断胃癌敏感性最佳的组合。用电化学发光免疫分析法和酶联免疫法测定56例胃癌患者及30名健康对照组的血清CEA、CA19-9、CA72-4、MG7-Ag(胃癌抗原)。结果显示,对照组CEA为2.1±0.8μg/L,CA19-9为14.5±7.3U/mL,CA72-4为4.2±1.3mU/L,MG7-Ag为2.8±1.0μg/L。胃癌患者术前CEA为28.4±91.2μg/L,CA19-9为35.9±71.9U/mL,CA72-4为9.8±40.8U/mL,MG7-Ag为3.6±4.4μg/L。胃癌患者术前血清4项肿瘤标志物中的CEA和CA72-4较对照组有明显增高,有显著性差异(P<0.05)。经分析,4项血清肿瘤标志物的组合中,第11、9、8组合(见正文表3)的敏感性分别是69.6%、63.9%、63.6%。结论是CEA、CA72-4联合检测对胃癌诊断有意义,CEA与CA72-4、MG7-Ag的组合为首选。     

协同刺激分子B7-H3在重症肌无力患者外周血中的表达

目的:检测重症肌无力(MG)患者外周血中协同刺激分子B7-H3的表达,并探讨其临床意义。方法:收集35例MG患者和44例健康对照(HC)外周血标本,采用免疫荧光标记,流式细胞检测外周血单个核细胞模型B7-H3(mB7-H3)的表达,ELISA法检测MG和HC血浆中可溶性B7-H3(sB7-H3)的含量。结果:MG患者外周血T淋巴细胞、单核细胞和B淋巴细胞上mB7-H3低水平表达,与HC无差异;MG患者外周血sB7-H3浓度为(2.166±0.958)ng/mL,显著低于HC(3.379±0.768)ng/mL;全身型MG(GMG)sB7-H3的浓度为(1.664±0.699)ng/mL,低于眼肌型MG(OMG)(2.396±0.985)ng/mL;并发胸腺异常的MG sB7-H3浓度为(1.593±0.441)ng/mL,低于胸腺正常MG(2.364±1.014)ng/mL;MGsB7-H3含量与QMGS评分呈负相关(r=-0.4189,P=0.012);免疫细胞mB7-H3与血浆sB7-H3无相关性。结论:MG患者sB7-H3表达下调,与疾病严重程度相关;在不同病理类型MG患者体内存在差异性表达,提示该分子可能参与了MG的免疫病理进程。     

血清AFP、CA19-9、CEA单项及三者联合检验对原发性肝癌早期诊断与治疗的意义对比

目的 探讨血清AFP、CA19-9、CEA单项及三者联合检验对原发性肝癌早期诊断与治疗的意义。方法 抽取2015年6月~2016年6月我院就诊的原发性肝癌患者50例设置为实验组,另同期收集50例健康体检者设置为常规组,对比两组受检者的血清AFP、CA19-9、CEA水平。结果 实验组的AFP、CEA、CA19-9的检验值分别为（58.25±6.21）ng/ml、（16.24±2.10）μg/L、（48.56±5.65）U/L,常规组分别为（2.30±0.62）ng/ml、（2.58±0.65）μg/L、（12.98±1.81）U/L,实验组检验值均高于常规组,差异具有统计学意义（P＜0.05）。结论 对原发性肝癌患者给予血清AFP、CA19-9、CEA单项与三者联合检验方式的意义显著,便于为疾病诊疗提供相关的参考资料。     

胃癌患者手术前后血清SE-CAD、CEA和CA19-9检测的临床意义

目的:探讨了胃癌患者手术治疗前后血清SE-CAD、CEA和CA19-9水平的变化及意义.方法:分别应用酶免法和放免法测定了32例胃癌患者手术治疗前后血清SE-CAD、CEA和CA19-9水平的变化,并与30名正常健康人作比较.结果:胃癌患者手术前血清SE-CAD、CEA和CA19-9水平显著地高于正常人组(P＜0.01),手术治疗后6个月则与正常人组比较无显著性差异(P＞0.05).结论::检测胃癌患者血清中SE-CAD、CEA和CA19-9水平的变化对临床观察预后有重要的临床价值.     

CA19-9、CA72-4和CEA在阿帕替尼治疗胃癌患者中的变化及意义

目的 探讨阿帕替尼治疗前后胃癌患者血清糖链抗原19-9(carbohydrate antigen 19-9,CA19-9)、糖链抗原72-4(carbohydrate antigen 72-4,CA72-4)和癌胚抗原(carcinoembryonic antigen,CEA)的变化及其与临床疗效的关系.方法 选取我院收治的62例晚期胃癌患者作为研究对象,回顾性分析阿帕替尼治疗前后患者血清中CA19-9、CA72-4和CEA的水平,并根据临床疗效部分缓解(PR)、稳定(SD)和进展(PD)的例数,计算疾病缓解率(RR)和疾病控制率(DCR),并分为疾病控制(DC)组和非DC组,比较各组治疗前后血清CA19-9、CA72-4和CEA水平变化,并比较两组之间治疗前后各指标水平差异.结果 阿帕替尼治疗后血清CA19-9和CA72-4水平显著降低(P＜0.05),而CEA无显著性变化(P＞0.05).阿帕替尼治疗晚期胃癌的PR率为3.22％,SD率为41.94％,PD率为54.84％.阿帕替尼治疗后,DC组血清CA19-9、CA72-4和CEA水平显著下降(P＜0.05),而非DC组CA19-9、CA72-4无显著性差异(P＞0.05),CEA水平显著升高(P＜0.05).治疗前,DC组和非DC组CA19-9、CA72-4和CEA水平无显著性差异(P＞0.05),治疗后DC组三个指标水平均显著低于非DC组(P＜0.05).对患者用药不良反应发生率分析,结果显示无严重不良反应终止治疗病例.结论 血清CA19-9、CA72-4和CEA水平在阿帕替尼治疗后病情得到控制的胃癌患者中显著降低,可用于阿帕替尼治疗胃癌的效果评价.     

胃癌患者血清CEA、CA19—9及CA72—4联检的临床价值探讨

目的：探讨血清CEA、CA19—9及CA72—4联检在胃癌诊断、病情监测及疗效观察中的价值。方法：采用电化学发光技术检测36例正常对照组、42例良性胃病、55例胃癌患者血清CEA、CA19—9、CA72—4的含量，并对胃癌患者进行治疗前后三种肿瘤标志物的含量变化监测随防。结果：胃癌患者血清CEA、CA19—9、CA72—4的阳性率明显高于正常对照组及良性胃病组，差异有显著性（P〈0．01）。胃癌患者治疗后三种肿瘤标志物含量及阳性率较治疗前有明显下降，差异有显著性（P〈0．01）。三者联检的敏感性、准确性均显著提高（P〈0．01）。结论：血清CEA、CA19-9、CA72—4联检有助于提高胃癌诊断的敏感性、同时对疗效观察及术后监测有重要意义。     

血清肿瘤标志物联检在结直肠癌诊断中的价值

目的:研究结直肠癌患者血清中多种肿瘤标志物的变化及联检在诊断中的价值.方法:采用电化学发光免疫分析对101例结肠癌、89例直肠癌患者进行血清CEA、CA19-9、CA72-4和CYFRA21-1共四项肿瘤标志物的检测,并与50例健康者进行对比,分析其临床诊断价值.结果:190例结、直肠癌患者的CEA、CYFRA21-1...     

Soluble CD276 (B7-H3) is released from monocytes, dendritic cells and activated T cells and is detectable in normal human serum

Expression of membrane CD276 (mB7-H3) has been reported on dendritic cells (DCs), monocytes, activated T cells, and various carcinoma cells. However, reports concerning its in vivo function have been inconsistent. Moreover, whether there is a soluble form of this protein is not known. In this study, using a sensitive dual monoclonal antibody sandwich enzyme-linked immunosorbent assay (ELISA) to detect the soluble form of B7-H3 (sB7-H3), we demonstrated the release of sB7-H3 by monocytes, DCs, activated T cells, and various mB7-H3+ but not mB7-H3- carcinoma cells. Release from cells was blocked by addition of a matrix metalloproteinase inhibitor (MMPI), which concomitantly caused the accumulation of B7-H3 on the cell surface. To determine the level of circulating sB7-H3, more than 200 serum samples were included in the study. The results indicated that sB7-H3 was present at high levels in all serum samples. Western blotting of sB7-H3 from cell culture supernatants or sera of healthy donors indicated that the molecular size was approximately 16 kDa. Soluble B7-H3 was able to bind to the B7-H3 receptor (B7-H3R) on activated T cells, which showed that sB7-H3 is a functionally active form. These results indicate that release of sB7-H3 from the cell surface is mediated by a matrix metalloproteinase and probably regulates B7-H3R/B7-H3 interactions in vivo. Cleavage of sB7-H3 to an active soluble form would alter both proximal and distal cellular responses.     

Clinical significance and prognostic value of CA72-4 compared with CEA and CA19-9 in patients with gastric cancer

Carcinoembryonic antigen (CEA) and CA 19-9 are both widely used in the follow up of patients with gastrointestinal cancer. More recently another tumor marker, named CA 72-4 has been identified and characterized using two different monoclonal antibodies B72.3 and CC49. Several reports evaluated CA 72-4 as a serum tumor marker for gastric cancer and compared its clinical utility with that of CEA or CA 19-9; few reports concerned its prognostic value. In the present study, CA 72-4 is evaluated and compared with CEA and CA 19-9 in various populations of patients with gastric cancer and benign disease; for 52 patients with gastric adenocarcinoma and 57 patients without neoplastic disease CEA, CA 19-9 and CA 72-4 were evaluated before treatment. Sensitivity of the tumor markers CA 72-4, CA 19-9 and CEA at the recommended cut-off level in all 52 patients were 58%, 50% the sensitivity increased to 75%. of these markers, for non metastatic patients, multivariate analyses indicated that none of the markers were significant, when adjusted for gender and age (which were indicators of poor prognosis); patients with abnormal values of CA72-4 tended to have shorter survival than patients with normal values (p<0.07). In the metastatic population, only high values of CA19-9 (p<0.02) and gender (women) p<0.03) were indicators of poor prognosis in univariate analysis; multivariate analysis revealed that both CA72-4 (p=0.034) and CA19-9 p=0.009), adjusted for gender were independent prognostic factors. However, CA72-4 lost significance (p=0.41) when adjusted for CA19-9 and gender, indicating that CA19-9 provides more prognostic information than CA72-4. When limited to the metastatic male population with normal values of CA 19-9 and CEA, CA 72-4 pretherapeutic positive levels were associated with a worse prognosis (p<0.005). In conclusion, this study suggests that the addition of CA 72-4 to CEA and/or CA 19-9 could improve sensitivity in gastric cancer. The prognostic role of this marker is not yet clearly demonstrated but its usefulness in the monitoring of gastric cancer should be taken into account.