血清肿瘤标志物DR-70TM对恶性肿瘤的诊断价值

目的　探讨病人血清肿瘤标志物DR - 70 TM 的检测对恶性肿瘤的诊断价值。方法　采用DR - 70诊断试剂盒 ,应用ELISA技术对各种恶性肿瘤患者测定其血清DR - 70 TM含量 ,并设正常人对照组进行对比。结果　恶性肿瘤组 112例 ,DR - 70 TM 阳性率为 81 3% ,健康人对照组 5 4例 ,阳性率为 9 3% ,两组比较有显著性差异(P <0 0 1)。结论　检测DR - 70 TM对多种恶性肿瘤的早期诊断有一定参考价值 ,可进一步深入研究。     

Usefulness of magnetic resonance angiography for diagnosis of scimitar syndrome in early infancy

This study evaluated the feasibility and accuracy of the magnetic resonance angiography (MRA) evaluation of scimitar syndrome in early infancy in 4 subjects. MRA imaging was successful, with excellent imaging quality to evaluate the main and lobar pulmonary artery branches, lobar pulmonary veins, scimitar vein, and systemic-pulmonary collateral arteries in all subjects. There was good agreement between findings with MRA, x-ray angiography (n = 3), surgical inspection (n = 3), and autopsy (n = 1).     

Usefulness of serum adenosine deaminase activity in the early diagnosis of Mycoplasma pneumonia

It is sometimes difficult to clinically diagnose mycoplasma pneumonia at an early stage before the rise of titer of antibody to Mycoplasma pneumoniae. Mycoplasma pneumonia may be related with T-lymphocyte activity, and its inflammatory process is different from that of bacterial pneumonia. Adenosine deaminase (ADA) activity is a predominant T-lymphocyte enzyme, and its plasma activity is high in diseases in which cellular immunity is stimulated. In this study, we have investigated 31 cases with pneumonia (11 cases of mycoplasma pneumonia and 20 cases of bacterial pneumonia) within 10 days after onset to evaluate the usefulness of ADA measurement in the diagnosis of mycoplasma pneumonia. Serum ADA activity in the group of mycoplasma pneumonia was 32.1 +/- 12.0 U/l (63.9-18.8 U/l), that of non-mycoplasma pneumonia 12.5 +/- 3.3 (4.6-18.6) U/l, and that of normal control 14.0 +/- 3.4 (6.3-19.3) U/l. ADA activity of the group of mycoplasma pneumonia was significantly higher than those of non-mycoplasma pneumonia and normal control (p less than 0.001). This results suggest that serum ADA activity in patients with acute pneumonia may be useful for the early diagnosis of mycoplasma pneumonia.     

Usefulness of surveillance programmes for early diagnosis of hepatocellular carcinoma in clinical practice

Background/Aims: Surveillance programmes (SPs) for hepatocellular carcinoma (HCC) in patients with cirrhosis intend to diagnose the tumour in its early stages when an effective therapy can be applied. The aims of this study have been to compare the survival of patients with HCC being diagnosed or not in SPs, and to establish a more accurate profile of the best target population. Methods: From January 1996 to June 2005, 290 patients with HCC were included. The relationship between being diagnosed or not in an SP and survival has been analysed in a univariate analysis. Pretreatment variables found to be significant predictors of survival in univariate analysis were included in a multivariate analysis. Results: The mean survival for patients diagnosed in SPs (27 months, 16.6–37.4) was significantly longer than in patients being diagnosed out of these programmes (6 months, 2.6–9.4) (P=0.001). Child–Pugh class A [β 1.4, 95% confidence interval (CI) 1.14–1.78; P=0.0002] and being diagnosed in SPs (β 0.4, 95% CI 0.3–0.6; P=0.0003) became the only independent predictive factors of longer survival. Conclusions: SPs for HCC allow the detection of small tumours and the application of intention‐to‐cure therapies, which improves survival. However, these programmes do not improve prognosis in patients with advanced cirrhosis.     

Usefulness of serum lipase for early diagnosis of post-endoscopic retrograde cholangiopancreatography pancreatitis

BACKGROUND Post-endoscopic retrograde cholangiopancreatography(ERCP) pancreatitis(PEP)is new onset acute pancreatitis after ERCP. This complication is sometimes fatal.As such, PEP should be diagnosed early so that therapeutic interventions can be carried out. Serum lipase(s-Lip) is useful for diagnosing acute pancreatitis.However, its usefulness for diagnosing PEP has not been sufficiently investigated.AIM This study aimed to retrospectively examine the usefulness of s-Lip for the early diagnosis of PEP.METHODS We retrospectively examined 4192 patients who underwent ERCP at our two hospitals over the last 5 years. The primary outcomes were a comparison of the areas under the receiver operating characteristic(ROC) curves(AUCs) of s-Lip and serum amylase(s-Amy), s-Lip and s-Amy cutoff values based on the presence or absence of PEP in the early stage after ERCP via ROC curves, and the diagnostic properties [sensitivities, specificities, positive predictive values(PPV),and negative predictive value(NPV)] of these cutoff values for PEP diagnosis.RESULTS Based on the eligibility and exclusion criteria, 804 cases were registered. Over the entire course, PEP occurred in 78 patients(9.7%). It occurred in the early stage after ERCP in 40 patients(51.3%) and in the late stage after ERCP in 38 patients(48.7%). The AUCs were 0.908 for s-Lip [95% confidence interval(CI): 0.880-0.940,P 0.001] and 0.880 for s-Amy(95%CI: 0.846-0.915, P 0.001), indicating both are useful for early diagnosis. By comparing the AUCs, s-Lip was found to be significantly more useful for the early diagnosis of PEP than s-Amy(P = 0.023).The optimal cutoff values calculated from the ROC curves were 342 U/L for s-Lip(sensitivity, 0.859; specificity, 0.867; PPV, 0.405; NPV, 0.981) and 171 U/L for sAmy(sensitivity, 0.859; specificity, 0.763; PPV, 0.277; NPV, 0.979).CONCLUSION S-Lip was significantly more useful for the early diagnosis of PEP. Measuring sLip after ERCP could help diagnose PEP earlier; hence, therapeutic interventions can be provided earlier.     

Usefulness of determining creatine kinase BB isoenzyme activity in early diagnosis of myocardial infarction

The value of radioimmunoassay for creatine kinase BB isoenzyme (CK-BB) determination in early diagnosis of acute myocardial infarction was estimated. The clinical material consisted of 35 randomly selected patients admitted to a coronary care unit during the 4 h after chest pain suspected for myocardial infarction. In all patients standard 12 lead electrocardiograms were obtained on admission and at 24, 48 and 72 hours after admission. Blood samples for CK-BB analysis were collected on admission and at 4 hourly intervals for 48 h after admission. Aspartate aminotransferase (GOT) activity was determined in all patients on admission and in samples obtained at 24 and 48 hours. The patients were classified to 3 groups according to electrocardiographic and clinical findings. The first group consisted of 10 patients whose electrocardiograms fulfilled the criteria of transmural infarction. The electrocardiograms of 10 patients of the second group fulfilled the criteria of subendocardial infarction. The remaining 15 patients made up a third group of coronary insufficiency. The activity of CK-BB at various time intervals after chest pain in all groups was compared in order to estimate the value of this method for differentiation of the 3 causes of coronary pain. The frequency of positive results (the values exceeding upper limits of normal range for healthy people) at various time intervals after pain obtained with both enzymatic methods was compared in order to estimate the sensitivity of analysed method.(ABSTRACT TRUNCATED AT 250 WORDS)     

肿瘤标志物在肺癌引起胸腔积液诊断中的应用进展

胸腔积液是一个常见的临床表现.其良恶性的判断与治疗、预后密切相关.许多方法和指标都曾尝试用于恶性胸腔积液的诊断,各有利弊.随着分子生物学和实验技术的迅速发展,新的诊断指标和检测方法不断涌现.肿瘤标志物包括肿瘤相关抗原,肿瘤相关蛋白等,对于肺癌引起的胸腔积液的鉴别诊断具有重要的意义.     

内镜超声检查术对胰腺肿瘤早期诊断的价值

目的探讨内镜超声检查术（EUS）、管内超声检查术（IDUS）及超声内镜引导下细针穿刺术（EUS-FNA）对胰腺肿瘤早期诊断的价值。方法回顾性分析和比较188例胰腺小占位病灶的EUS、IDUS、EUS—FNA及其他影像学检查结果。结果（1）EUS诊断小胰腺癌的准确率是95．6％（44／46）,优于B超58．6％（27／46）、CT77．4％（24／31）、MRI76．2％（16／21）及内镜逆行胰胆管造影术（ERCP）85．3％（29／34）。小胰腺癌EUS声像图主要表现为类圆形、边界清楚、边缘不规则的低回声肿块,内部回声多均匀。（2）25例胰腺小占位病灶行IDUS检查,其准确率是100．0％（25／25）,明显优于B超32．0％（8／25）、CT52．9％（9／17）及MRI57．9％（11／19）等检查。（3）18例胰腺小占位病灶行EUS—FNA,其准确率是66．7％（12／18）。（4）EUS诊断胰腺假性囊肿的准确率是100．0％（27／27）,明显优于13超52．0％（13／25）、CT66、7％（12／18）、MRI82．4％（14／17）及ERCP78．9％（15／19）;对胰腺囊性肿瘤分类鉴别诊断总的准确率是57．7％（15／26）,优于B超19．2％（5／26）、CT36．4％（8／22）、MRI37．5％（6／16）及ERCP50．0％（7／14）等检查。结论EUS、IDUS及EUS-FNA对胰腺肿瘤的早期诊断具有重要价值。     

Distinctive microRNAs in esophageal tumor: early diagnosis,prognosis judgment,and tumor treatment

Esophageal tumor (ET) is aggressive and has poor prognosis. Although the incidence of ET has been reduced by the changing tumor profile, the 5‐year survival and mortality rate of ET has not significantly changed, and the outlook has remained bleak. Therefore, new molecular markers for early diagnosis and prognosis judgment are urgently required. In recent years, tumor has been widely regarded as genetic disease along with epigenetic abnormalities. DNA methylation, histone deacetylation, chromatin remodeling, gene imprinting, and noncoding RNA regulation are the major parts of epigenetic regulation. Mounting evidence exists that miRNAs (microRNA), a class of small, endogenous, and non‐protein‐coding RNAs, provide a novel tool for early clinical diagnosis, prognosis judgment, and gene therapy of ET. In this review, we provide a general overview of the connection between miRNA profiles and their target genes. We also describe in detail in ET from the aspect of clinical insights, the potential application of miRNAs as biomarkers, potential diagnostic and therapeutic tools.     

Usefulness of tumor marker CA-125 serum levels for the follow-up of therapeutic responses in tuberculosis patients with and without serositis

The aim of this study was to determine the usefulness of cancer antigen 125 (CA-125) serum levels in patients with tuberculosis (TB) with and without tuberculous serositis. A total of 64 TB patients with a mean age of 58.17 ± 19.05 years were enrolled in this observational case series study. All patients underwent blood sampling for the measurement of CA-125 serum levels before treatment. If the CA-125 serum levels were found to be elevated, the patients underwent blood sampling in the initial treatment phase, continuation treatment phase, and every 6 months thereafter for 2 years. The treatment outcomes of the pulmonary TB group were evaluated using chest radiography and sputum examinations, and those of the tuberculous serositis group were evaluated on the basis of the amounts of fluid determined by ultrasound. All patients in the tuberculous serositis group and 45% of the patients in the pulmonary TB group had elevated CA-125 serum levels before treatment. The pretreatment mean CA-125 serum level was significantly higher in the tuberculous serositis group than in the pulmonary TB group. CA-125 serum levels decreased along with improvement in anti-TB treatment outcomes in both the groups. In conclusion, the CA-125 serum levels in combination with clinical responses, chest radiography, and sputum examinations, can offer better monitoring of therapeutic responses in anti-TB treatment.     

Usefulness of cytological examinations for the diagnosis of thoracic tumours and early detection of bronchial carcinoma

A total of 18020 samples taken from 5812 patients were cytologically examined. The presence of thoracic tumour has been reliably verified in 1585 patients, of whom 1482 were cases of primary tumour. Cytological analysis gave positive results in 55 to 84 per cent of these cases (depending on the number of examinations). In 36 to 49% of tumours cases, the existence of neoplasm was revealed by cytology alone. The diagnostic value of cytology, applied to routine material, is 3 to 6 times higher than that of bronchoscopic biopsy. In 76% of parallel examinations the histological type could be ascertained cytologically. The authors are convinced that cytological examination is the most reliable method for the diagnosis of micro- and small carcinomas. The early detection of bronchial carcinoma is discussed in detail. The chronology of examinations (cytology or biopsy for histology) is determined in each individual case by their usefulness and harmlessness for the patient. Mass X-ray examinations, as also examinations by general practitioners and chest physicians, should always include a search for possible tumours and hence cytological analyses. The existing network of cytological laboratories should therefore be extended.     

Usefulness of rapid quantitative measurement of myoglobin and troponin T in early diagnosis of acute myocardial infarction.

BACKGROUND: New equipment, the Cardiac Reader(TM), which can measure blood concentrations of troponin T (T) and myoglobin (M) in only 15 min at the bedside was evaluated for early diagnosis of acute myocardial infarction (AMI). METHODS AND RESULTS: A total of 34 consecutive patients with AMI who came to hospital within 24 h after onset were studied. Blood samples were collected from the patients at admission and 6, 12, 24, 48 h after onset to qualitatively and quantitatively measure T, M and creatine kinase-MB fraction. There were 20 patients with positive results by qualitative troponin T test and 29 with positive results by quantitative test. Of the patients who visited hospital within 3 h of onset, 17% were positive by the qualitative test and 67% cases had positive results in the quantitative test. The patients were divided into 2 groups according to the flow grade in the infarct-related coronary artery. In the TIMI 0-1 group (n=28), serum myoglobin concentrations were higher than in the TIMI 3-4 group (n=6) at admission and at their peak. CONCLUSION: The rapid quantitative test of T and M is useful for early diagnosis of AMI and as an indicator of its severity, which can be evaluated from the myoglobin concentration in the hyper-acute phase.     

肿瘤标志物联合检测在肺癌早期诊断中的应用

目的：探讨外周血肿瘤标志物癌胚抗原（CEA）、神经元特异性烯醇化酶（NSE）、细胞角质蛋白19片段（CYFRA21-1）、糖链抗原125（CA125）、糖链抗原19-9（CA19-9）、糖链抗原15-3（CA15-3）联合检测在肺癌早期诊断中的应用价值。方法：采用Elecsys2010电化学发光仪检测80例肺癌患者,55例肺部良性疾病患者,40例健康人血清中CEA、NSE、CYFRA21-1、CA125、CA19-9、CA153等肿瘤标志物的水平。结果：肺癌患者中CEA、NSE、CYFRA21-1、CA125、CA19-9、CA153等6种标志物显著高于正常对照组及肺部良性疾病组,差异有统计学意义（P〈0.01）。6项标志物不同组合对不同分期肺癌检出的敏感性均高于单项标志物。其中第6种CY-FRA21-1＋CA125＋NSE和第7种CYFRA21-1＋CA125＋NSE＋CEA组合的敏感性较其他组合均高,特别是对早期患者检出率明显提高,但第7种方式成本较高且6、7两种方式检出率差异无统计学意义。结论：CYFRA21-1＋CA125＋NSE联合检测能提高肺癌的早期诊断率。     

外周血基因标志监测肝癌微小转移的临床价值

肝癌(Hepatocellular carcinoma，HCC)是由病毒、化学致癌物等多病因作用以及经启动、促进，演变多阶段的发病过程。因癌基因或癌相关基因激活、抗癌基因失活或胚胎期某些基因重新复活等诸多因素引起肝细胞生长失控，出现持续增殖而致癌变，其中基因状态与调控和表达关系密切。利用生物芯片对肝癌发展过程中12600个基因分析，显示癌变早期有90多