进展期肺癌肿瘤标记物临床应用价值

目的 :评价进展期肺癌患者血清癌胚抗原 (CEA)、神经元特异性烯醇化酶 (NSE)、细胞角蛋白19片段 (CYFRA2 1 1)水平在肺癌诊断、确定病理类型和病情评估方面的临床价值。方法 :采用生物素酶免法测定 79例ⅢA、ⅢB、Ⅳ期原发性肺癌和术后复发或转移患者血清CEA、NSE、CYFRA2 1 1水平。结果 :79例进展期肺癌患者治疗前CEA、NSE、CYFRA2 1 1明显高于正常对照组。 3项联合检测阳性率达 97 5 %。鳞癌组、腺癌组和小细胞未分化癌组之间肿瘤标记物水平差异有显著性。CEA水平以腺癌组最高 ,NSE水平以小细胞未分化癌组最高 ,CYFRA2 1 1水平以鳞癌组最高。化疗有效者肿瘤标记物水平降低 ,病情进展和肿瘤转移患者则升高。结论 :CEA、NSE、CYFRA2 1 1联合用于肺癌的诊断有极高的特异性和敏感性 ,NSE CYFRA2 1 1与肺癌的病理类型有很好的相关性 ,为无法做病理学检查的患者的治疗提供支持 ,此外在病情监测和疗效判断方面可为临床提供有价值的资料     

血清NSE及其半衰期诊断与监测小细胞肺癌的评价

目的:评价小细胞肺癌(SCLC)患者血清神经元特异性烯醇化酶(NSE)在该病的诊断、化疗和复发中的意义以及NSE半衰期与SCLC复发的关系。方法:用双抗体夹心ELISA法测定NSE含量。结果:NSE诊断SCLC的敏感性、特异性及准确度分别为85.0%、85.3%、88.7%;其中局限期(LS)SCLC和广泛期(ES)SCLC患者的阳性率分别为71.4%、92.3%,NSE半衰期大于20 d者,其复发在发病前为47~183 d前即被发现,NSE的半衰期预测SCLC复发敏感性为80.0%。结论:血清NSE检测对SCLC与NSCLC的鉴别诊断具有重要意义,NSE半衰期预测SCLC复发的敏感性优于NSE含量测定。     

肿瘤标记物联合检测对肺癌的诊断意义

目的：探讨血清CEA、NSE、CA19－9对肺癌的诊断价值。方法：检测经病理确诊的肺癌病人血清CEA、NSE、CA19－9的含量。结果：肺癌患者血清中上述3项指标的水平均较对照组明显增高。结论：CEA对肺癌，NSE、CA19－9对小细胞肺癌有相对高的敏感性及特异性，联合检测有助于肺癌的诊断。     

强脑因子生物学特性的实验研究

目的 探讨强脑因子对大鼠胎鼠脑神经细胞培养物的生物学保护效应 方法 取16日龄Wistar大鼠脑神经细胞经体外培养后,分别进行(1)组织形态学观察:在神经细胞培养物中加入不同剂量强脑因子(1 10和100mg/L),光学显微镜下观察细胞形态学变化 在电子显微镜下观察神经细胞超微结构变比;(2)神经细胞代谢活性检测:应用四唑盐(tetrazolium,MTT)法测定不同剂量强脑因子对神经细胞代谢活性的影响;(3)可溶性蛋白质水平测定:应用Bradford蛋白定量法测定不同剂量强脑因子对神经细胞胞浆内可溶性蛋白质水平的影响;(4)强脑因子抗神经细胞凋亡试验:应用神经元特异性烯醇化酶(neuron-specific enolase,NSE)定量法,测定强脑因子与奥地利产脑活素对NSE活性表达的影响。结果(1)强脑因子可促进神经细胞分化成熟 突起增多并延长、细胞数量增加。(2)在不同剂量强脑因子作用下 神经细胞MTT代谢率增强,细胞浆内蛋白质水平升高 而且随着强脑因子剂量的增加均呈现出明显的剂量依赖关系;促进NSE表达活性,利于神经母细胞分化(3)强脑因子可增强神经细胞抗缺氧作用及抗谷氨酸所致的细胞凋亡效应 且功效强于奥地利产脑活素 结论 在相同实验条件下,强脑因子对体外培养的神经细胞有生物学保护作用,效果优于脑活素     

Hereditary leiomyomatosis and renal cell cancer without cutaneous manifestations in two Japanese siblings

Hereditary leiomyomatosis and renal cell cancer is a rare genetic disorder characterized by cutaneous and uterine leiomyomatosis, and an aggressive type 2 papillary renal cell carcinoma. The disease is caused by a germline mutation in the fumarate hydratase gene. We report a familial hereditary leiomyomatosis and renal cell cancer in two siblings. A 34‐year‐old woman underwent nephrectomy for treatment of a renal cell carcinoma. The patient's sister had been diagnosed with renal cell carcinoma at 28 years‐of‐age and died of the disease. Neither sister had apparent skin tumors. Histopathology of the renal cell carcinomas of the siblings showed tubulocystic and papillary architectures with high nuclear grades. Immunostaining showed no fumarate hydratase expression in either tumor. Genomic DNA sequencing of the patient showed a germline mutation in the fumarate hydratase gene (c.675delT). Although there is no epidemiological information on Asian hereditary leiomyomatosis and renal cell cancer, physicians should be aware that typical cutaneous leiomyomatosis might not always be present in patients with hereditary leiomyomatosis and renal cell cancer.     

Correlation of neuron specific enolase serum concentration and prognosis hi patients with severe head injury

AIM: To eluciate the role of neuron specific enolase(NSE) in predicting prognosis after severe head injury. METHODS: 30 patients with severe head injury were involved into this study, ranging from 26 to 64 years old. Concentration of NSE in serum was measured in all cases within 12 hours after head injury. And prognosis of all patients were evaluated by COS. RESULTS: The concentration of NSE in serum of both groups, with good or poor outcome, were higher than normal group. The concentrations within 12 hours after head injuries had a close relationship with the prognosis. As a serum marker to assess the prognosis, NSE had high positive prediction ratio. CONCLUSION: The finding suggested that NSE may be a promising predictor for assessing the prognosis after severe head injury.     

多种肿瘤标记物检测在肺癌诊断中的意义

【目的】探讨多种肿瘤标记物检测在肺癌诊断中的应用价值。【方法】本院接受治疗的50例肺癌患者为观察对象,同时选取48例肺良性病变者（肺良性病变组）以及42例健康体检者作为对照。观察三组对象血清肿瘤标志物癌胚抗原（CEA）、糖蛋白抗原 CA19‐9（ CA19‐9）、CA125和神经元特异性烯醇化酶（NSE）水平的差异及不同临床特征肺癌患者肿瘤标志物水平的差异。【结果】三组 CEA 、CA19‐9,CA125,NSE 等肿瘤标志物水平由高到低分别为肺癌组、肺良性病变组和健康对照组,且各组之间相比较差异具有显著性（P ＜0．01）;分化程度低、肿瘤直径≥5 cm 、有远处转移的肺癌患者其 CEA 、CA19‐9、CA125和 NSE 水平较高（P ＜0．05）,而不同年龄、性别的肺癌患者上述指标相比较差异无显著性（P ＞0．05）。【结论】患者血清 CEA 、CA19‐9,CA125,NSE 水平与肺癌的分化程度、转移情况密切相关,其检测结果有利于肺癌的早期发现和治疗,具有较好的应用价值。     

肺癌患者血清细胞角蛋白片断21-1、癌抗原153和神经特异性烯醇化酶的测定及应用价值

目的 探讨细胞角蛋白片断21-1（CYFRA21-1）、癌抗原153（CA153）和神经特异性烯醇化酶（NSE）对肺癌的诊断价值.方法 采用放射免疫法单项和联合测定60例肺癌患者血清CYFRA21-1、CA153和NSE的水平.结果 肺癌各组CYFRA21-1、CA125和NSE的含量显著高于健康对照组（t=2.811、2.845、2.901、2.795、2.759、2.811、2.852.、2.799、2.816,均P＜0.01）;鳞癌CYFRA21-1水平高于小细胞未分化癌（t=2.214,P＜0.05）;鳞癌NSE水平低于小细胞未分化癌（t=2.312,P＜0.05）;腺癌CA125水平高于高于鳞癌（t=2.177,P＜0.05）;CYFRA21-1＋CA153＋NSE联合检测肺癌阳性率86.4%,比单项检测的阳性率有明显提高（χ2=3.786,P＜0.05）;三项联合检测的敏感性和阴性预测值均比单项检测有明显提高（χ2=3.846,3.877,均P＜0.05）.结论 CYFRA21-1、CA153、NSE联合测定可以弥补单项指标诊断的漏诊和不足,具有一定的临床应用价值.     

s-NSE对早期判断新生儿急性胆红素脑病的意义

目的探讨血清神经元特异性烯醇化酶（s—NSE）能否作为早期判断急性胆红素脑病（ABE）的生物学指标。方法选择高胆红素血症病儿63例,以24例同期出生的生理性黄疸不明显的足月新生儿作为对照组,测定两组血清总胆红素（TSB）水平,采用电化学发光免疫法测定s—NSE水平。结果不同高胆红素水平的各组sNSE水平比较差异有统计学意义（F=59．813,P〈0．01）,足月儿s—NSE水平与TSB水平间呈显著正相关（r=0．762,P〈0．01）;早产儿组s—NSE水平显著高于同等高胆红素水平的足月儿组（F=56．287,q=2．84,P〈0．05）。结论高胆红素血症病儿sNSE水平显著升高,升高程度与TSB水平和早产因素相关。s—NSE较TSB更有可能成为敏感的判断ABE的生物学指标。     

Hereditary leiomyomatosis and renal cell cancer: a syndrome associated with an aggressive form of inherited renal cancer

PURPOSE: Hereditary leiomyomatosis and renal cell cancer is a recently described hereditary cancer syndrome in which affected individuals are at risk for cutaneous and uterine leiomyomas, and kidney cancer. Our initial experience revealed the aggressive behavior of these renal tumors, often with early metastasis, despite small primary tumor size. We report the clinical characteristics and urological treatment of patients with hereditary leiomyomatosis and renal cell cancer associated renal tumors. MATERIALS AND METHODS: A total of 19 patients with hereditary leiomyomatosis and renal cell cancer associated renal tumors were evaluated. The 11 women and 8 men had a median age at diagnosis of 39 years (range 22 to 67), and a median clinical and radiological followup of 34 months (range 6 to 141). Hereditary leiomyomatosis and renal cell cancer manifestations in patients with renal tumors included cutaneous leiomyomas in 11 of 17 evaluable patients (65%) and uterine leiomyomas in 7 of 7 evaluable females (100%). RESULTS: Median pathological tumor size was 7.8 cm (range 1.5 to 20). Histological subtypes were consistent with hereditary leiomyomatosis and renal cell cancer renal carcinoma. Four of 7 patients with 2.0 to 6.7 cm T1 tumors had spread to regional lymph nodes or metastases at nephrectomy. Overall 9 of 19 patients (47%) presented with nodal or distant metastases. CONCLUSIONS: Renal tumors in patients with hereditary leiomyomatosis and renal cell cancer syndrome are significantly more aggressive than those in patients with other hereditary renal tumor syndromes. In contrast to other familial renal cancer syndromes, the observation of 3 cm or less renal tumors associated with hereditary leiomyomatosis and renal cell cancer is not recommended. Careful followup of affected and at risk individuals in families is necessary.