Serum free sialic acid as a marker of alcohol abuse

BACKGROUND: Previous studies have shown that serum total sialic acid (TSA) concentration significantly increases during alcohol abuse. Chronic ethanol consumption impairs glycosylation of many proteins. The increased desialylation rate of serum glycoproteins is one of the effects of alcohol abuse. The aim of this study was to investigate the diagnostic value of free sialic acid (FSA) as a marker of alcohol abuse. METHODS: We determined serum FSA concentrations in the group of 156 alcoholic subjects and 35 healthy control subjects by means of a modification of the thiobarbituric acid method. The alcoholic group was divided into subgroups according to their history of abuse. RESULTS: The FSA concentration was significantly higher in alcoholic subjects than in healthy controls. The subjects who consumed alcohol for longer than a week showed significantly higher FSA level than those who consumed alcohol for a shorter period. The serum FSA concentration was significantly higher in alcoholic subjects with elevated markers of liver dysfunction. The diagnostic accuracy of FSA was high, although it did not differ from TSA, and was limited by its low sensitivity. CONCLUSIONS: This study shows that FSA concentration in the sera of alcoholic subjects is increased. The low diagnostic sensitivity is accompanied by high specificity, however the accuracy is high and similar to the accuracy of TSA. Free sialic acid does not seem to be a better marker of alcohol abuse than TSA and current markers.     

Comparative study of serum lipid-bound sialic acid and carcinoembryonic antigen in patients with lung cancer

Serum LSA and CEA levels were measured in 86 patients with lung cancer, 56 patients with benign pulmonary diseases and 127 normal subjects. The results showed that the diagnostic accuracy rate of LSA for lung cancer (82.4%) was higher than that of CEA (67.6%). LSA was more useful than CEA for diagnosis and differantial diagnosis of lung cancer. CEA was more sensitive to adenocarcinoma of the lung. While LSA was sensitive to small cell lung cancer and squamous cell lung cancer as well. LSA levels and positive rate were related to the stages of lung cancer. LSA was more helpful than CEA for evaluating the status of disease and staging patients. The changes of LSA levels in 33 patients with lung cancer were related to the results of chemotherapy. LSA was superior to CEA for monitoring therapy. Combinative determination of both two markers was better than that of single marker.     

Serum sialic acid in young type-1 diabetic patients

It is well established that serum total sialic acid (TSA) is elevated in patients with type-2 diabetes mellitus (NIDDM) compared to non-diabetics. However, it is not clear whether serum TSA is also elevated in type-1 diabetic patients (IDDM). Twenty-one type-1 patients were studied along with age and sex matched normal non-diabetic subjects (ten males and 11 females). Their ages were 24.8+/-3.4 years (20-30) and 23.5+/-3.9 years (18-30) respectively. The duration of diabetes mellitus was 12.6+/-6.7 years (1-24) with a HBA1c of 9.0+/-2.2% (6.0-14.9). There was no significant difference in serum TSA of the type-1 diabetic patients 689+/-107 mg/l versus 670+/-119 mg/l in the normal subjects. Nor was there a significant correlation between serum TSA with patient age (r = -0.31), urine albumin/creatinine ratio (ACR) (r = 0.25), HBA1c (r = 0.36), plasma random glucose (r = -0.04) or diabetes duration (r = -0.09) in the diabetic patients. However, there was a significant correlation between serum TSA and mean daily insulin dose (r = 0.51, P<0.02) and also serum cholesterol and triglyceride (r = 0.58, P<0.01 and r = 0.49, P<0.04, respectively) in the type-1 diabetic patients. In summary, we conclude that serum TSA is not elevated in young type-1 diabetic patients compared with normal age and sex matched control subjects. However, the relationship between serum TSA and serum lipids and also mean daily insulin dose merits further research.     

Predictive value of relative changes in serum total sialic acid level for response to neoadjuvant chemotherapy in patients with locally advanced breast carcinoma

The aim of this study was to determine whether relative changes in total serum sialic acid (TSA) levels are associated with response to neoadjuvant chemotherapy in locally advanced breast carcinoma (LABC) patients. Forty-seven patients with stage III-B breast carcinoma and 20 healthy subjects (controls) were included to the study. TSA levels were determined in serum from patients at baseline and after completion of preoperative chemotherapy. Pathological responses to chemotherapy were determined on specimens of modified radical mastectomy underwent in responders. Association between the relative changes in serum TSA levels and the pathological response to chemotherapy was investigated. The baseline mean serum TSA level of LABC patients was 88.6+/-0.6 mg/dl and 66.9+/-0.7 mg/dl for the control group (p<0.0001). After 3 cycles chemotherapy, the serum levels of TSA were markedly decreased with pathological partial response (pPR) (73.8+/-1.0 mg/dl) and complete response (pCR) (68.1+/-1.9 mg/dl) compared to baseline values (p<0.05). In 8 non-responders, mean TSA value was 88.9+/-1.1 mg/dl (p=0.9 for pretreatment vs posttreatment TSA levels). Of 39 responders, 6 had pathological complete response (pCR) and remaining had pathological partial response (pPR). TSA levels derived from patients with pCR and from those with pPR were 68.1+/-1.9 mg/dl and 73.8+/-1.0 mg/dl, respectively (p=0.03). While TSA levels from pCR were not different from those of controls (p=0.4), there was a significant difference between TSA levels from pPR and from controls (p<0.0001). A significant correlation was demonstrated between the relative changes in TSA levels and pathological response (p<0.0001, coefficient of correlation [rs]=0.81). The ROC analysis showed that the discriminating ability was satisfactory and relative decrease by more than 21% in TSA levels indicated a pCR with the sensitivity by 83%, specificity by 76%. In conclusion, there is a significant correlation between the relative changes in TSA levels by chemotherapy and clinical/ pathological response to neoadjuvant chemotherapy in LABC patients.     

血清唾液酸在肝癌患者诊疗中的临床价值

目的：评价血清唾液酸（SA）在肝癌诊断和疗效监测中的临床价值。方法检测2011年1月至2013年1月云南省第三人民医院就诊的163例肝癌（原发性肝癌135例,转移性肝癌28例）、234例其他肝病患者和300名健康人血清 SA含量;采用高、低两个浓度的样本,每日测量4次,连续测量5 d,评价 SA试剂盒的批内和批间变异系数（CV）;用135例原发性肝癌和300名健康人血清 SA检测数据绘制受试者工作特征（ROC）曲线确定 SA的临界值,并评价 SA的诊断价值。同时,对76例肝癌患者治疗前和治疗后1、7、14 d和1、3、6、9个月的 SA 水平进行追踪监测和评价分析。采用 SPSS 17.0进行统计分析。结果低浓度水平样本的批内和日间变异分别为2.4%和3.2%;高水平样本的批内和日间变异分别为2.2%和3.1%。用 ROC曲线确定 SA的临界值为659 mg/L,用其诊断肝癌的敏感度和特异度分别为63.7%（86/135）、94.6%（105/111）。肝癌患者血清 SA水平（726±123）mg/L明显高于其他肝病组（552±128）mg/L和健康对照组（599±62）mg/L,（U值分别为1832.52和887.00,均P〉0.01）。随访76例原发性肝癌患者,其血清 SA水平在治疗后1周升高（817±139）mg/L,（t=-3.272,P〉0.05）;持续到治疗后1个月（782±127）mg/L,（t=-2.694, P〉0.05）;在第3个月时,SA降低至治疗前水平（662±108）mg/L,（t=1.225,P〈0.05）;第6个月时降低至（615±124）mg/L,（t=1.999,P〉0.05）,接近健康对照组水平;有63例肝癌患者 SA水平与治疗前相比降低,与临床病情的符合率为82.9%（63/76,Kappa值=0.79）。有5例肝癌患者在治疗后第9个月复发,SA水平明显增高（939±155）mg/L。结论血清 SA对肝癌的辅助诊断和疗效监测可能有临床价值。     

Effect of grain-moxibustion on neutrophil to lymphocyte ratio and quality of life in patients with advanced gastric cancer

正Objective To observe the effect of grain-moxibustion at Zusanli (ST 36) and Weishu (BL 21) on neutrophil to lymphocyte ratio (NLR) and quality of life (QOL) in patients with advanced gastric cancer.Methods Sixty patients with advanced gastric cancer were randomly divided into an observation group and a control group,30 cases in each.In the control group,conventional chemotherapy regimen combined with symptomatic treatment,such as antiemetic,acid-suppressive,liver-protecting drugs.On     

The association of serum total sialic acid/total protein ratio with diabetic parameters in young type 1 diabetic patients

Abstract Sialic acid is a terminal component of the non-reducing end of carbohydrate chains of glycoproteins and glycolipids. The purpose of this study was to estimate serum total sialic acid (TSA) concentrations and serum TSA/serum total protein (TP) ratios in young type 1 diabetic subjects and to investigate their association with diabetes-related parameters in that population. Twentyfour young type 1 diabetic patients and 20 healthy controls were enrolled in this study. Serum TSA and serum TSA/TP ratio were measured in both groups. Moreover, we looked for correlation among serum TSA, serum TSA/TP ratio and clinically relevant parameters such as urinary albumin excretion, blood pressure, diabetes duration, HbA1c, daily insulin dose, serum lipids and magnesium in type 1 diabetic patients. Serum TSA concentrations and serum TSA/TP ratio showed no statistical difference between patients and controls (p>0.05). While serum TSA concentrations only correlated with urinary albumin excretion (r=0.44, p=0.028), serum TSA/TP ratio correlated with diastolic blood pressure (r=0.48, p=0.015), diabetes duration (r=0.46, p=0.022) and urinary albumin excretion (r=0.53, p=0.007) in the diabetic subjects. We concluded that serum TSA/TP ratio might be a better indicator than serum TSA as an index of diabetic complications.     

Transferrin sialic acid contents of patients with hereditary hemochromatosis

Recent evidence suggests that asialotransferrin may enhance hepatic uptake of trivalent metal ions through the asialoglycoprotein-receptor pathway. In hereditary hemochromatosis, there is preferential uptake of iron by hepatocytes. We purified transferrin from two patients with this disease. Their transferrins had normal electrophoretic patterns and contained normal amounts of sialic acid. We conclude that the preferential uptake of iron by hepatocytes in hereditary hemochromatosis is not due to the presence of asialotransferrin in their plasma.     

Decreased sialic acid content of erythrocytes in patients with aplastic anaemia

The sialic acid content of erythrocytes from patients with aplastic anaemia was determined and compared with those in patients with several haematological disorders and healthy individuals. The sialic acid was released enzymatically with Vibrio cholerae sialidase and quantitated by the thiobarbituric acid method (Aminoff, 1961). The sialic acid content of normal erythrocytes was 538 +/- 31 nmol/ml of packed erythrocytes. That of erythrocytes from patients with aplastic anaemia was 480 +/- 35 nmol/ml of packed erythrocytes, which was significantly lower than normal (P less than 0.01). In contrast, erythrocytes from patients with myeloproliferative disorders showed significantly (P less than 0.05) higher sialic acid contents (564 +/- 45 nmol/ml of packed erythrocytes). These results suggest that some membrane changes occur in erythrocytes in patients with these disorders.     

Significance of serum sialic acid in patients with Crohn's disease.

Serum sialic acid was measured to evaluate the activity of Crohn's disease. The sialic acid levels of patients with Crohn's disease in remission (CRP 0.0 mg/dl) were significantly higher than those of healthy subjects and postoperative patients with Crohn's disease. In patients in remission, serum sialic acid was significantly correlated with hemoglobin, hematocrit, platelet, and rapid turnover protein. Correlations with platelet, retinol-binding protein, and prealbumin were especially strong. From these findings, it was concluded that serum sialic acid level provides a useful index of the activity of Crohn's disease.     

Prognostic value of neutrophil-to-lymphocyte ratio in patients treated with concurrent chemoradiotherapy for locally advanced oesophageal cancer

BackgroundWe performed a retrospective analysis of Asian patients with locally advanced oesophageal cancer to test the hypothesis that an elevated neutrophil-to-lymphocyte ratio is associated with a poor survival rate after definitive concurrent chemoradiotherapy.MethodsIn total, 138 patients diagnosed with locally advanced oesophageal cancer (TNM classification of malignant tumours stage II or III) who were treated with definitive concurrent chemoradiotherapy between January 2005 and December 2010 were retrospectively analysed. Definitive concurrent chemoradiotherapy was performed using two different chemotherapy regimens.ResultsThe median follow-up duration was 39.5 months (range 1.1–93.4). The median progression-free survival was 14.0 months, and the median overall survival was 19.9 months. Compared with the low (<2.0) neutrophil-to-lymphocyte ratio group (n = 43, 31.2%), the high (≥2.0) neutrophil-to-lymphocyte ratio group (n = 95, 68.8%) exhibited significant decreases in the durations of both progression-free survival and overall survival. Using multivariate analysis, an elevated neutrophil-to-lymphocyte ratio was also significantly associated with decreased progression-free survival (HR 1.799; 95% CI, 1.050–3.083; P = 0.032) and overall survival duration (HR 2.115; 95% CI, 1.193–3.749; P = 0.010).ConclusionsThe pretreatment neutrophil-to-lymphocyte ratio is a useful prognostic marker in patients with locally advanced oesophageal cancer treated with definitive concurrent chemoradiotherapy.     

Serum sialic acid levels in cancer, pregnancy and upper respiratory infections

A significant increase in sialic acid content is demonstrable in the sera of cancer patients. Our investigations were performed to find out whether the serum sialic acid level is altered also during pregnancy or with infections of the upper respiratory tract. Our results have revealed a slight increase in sialic acid level to occur only in the last trimester of pregnancy. However, this distinct, though statistically insignificant, increase will not lead to misjudgement in regard to cancer diagnosis, or in case control of this disease. By contrast, in 7 out of 15 patients with infected upper respiratory tract the sialic acid content was clearly above the tolerance limit so that false positive findings may possibly be obtained.     

Statin treatment increases the sialic acid content of LDL in hypercholesterolemic patients

Low density lipoprotein (LDL) with low sialic acid content has been reported to cause intracellular cholesterol accumulation, and therefore desialylation has been proposed to be an atherogenic modification of LDL. However, it is not known whether hypolipidemic treatment has any effect on LDL sialylation. Accordingly, we investigated the sialic acid/apolipoprotein (apo) B ratio of total LDL and its subfractions in 26 moderately hypercholesterolemic patients at baseline and after treatment with statins for 2-3 months. Cholesterol and triglyceride levels were reduced in all apo B-containing lipoproteins, including all LDL subfractions, while the sialic acid ratio was increased in total LDL and in all its subfractions. Cholesterol concentrations and sialic acid ratios were inversely correlated in light and dense LDL subfractions both before and during statin treatment, and the greater the decrease in cholesterol and apo B contents of dense LDL, the higher was the increase in its sialic acid ratio. Furthermore, the lower the baseline sialic acid ratio of dense LDL, the greater was the reduction in its lipid and apo B concentrations. In conclusion, inhibition of cholesterol synthesis by statin treatment increased sialic acid/apo B ratio in LDL proportionately to the decrease of LDL apo B and cholesterol.     

血清唾液酸,岩藻糖和急性期蛋白测定对消化道癌症的诊断意义

目的：研究消化道癌症患者血清唾液酸、岩藻糖和急性期蛋白浓度的变化，探讨其对消化道癌症的诊断意义。方法：研究病例包括５５例消化道癌症，对照组包括６１例消化道良性病患者和５８例健康献血员。血清唾液酸用改良Ａｍｉｎｏｆ法，血清岩藻糖用Ｔｓａｙ法测定，５种急性期蛋白用琼脂单向免疫扩散法测定。结果：消化道癌症组血清唾液酸、岩藻糖、α１酸性糖蛋白（α１ＡＧ）、α１抗胰蛋白酶（α１ＡＴ）和结合珠蛋白（ＨＰ）的浓度显著高于正常人组及消化道良性疾病组（Ｐ＜０．０１），并且血清唾液酸、岩藻糖浓度增高与急性期蛋白呈显著正相关（Ｐ＜０．０１）。而癌症组血清前白蛋白（ＰＡ）和转铁蛋白（ＴＦ）与对照组无显著性差异（Ｐ＞０．０５）。结论：研究提示可以将血清唾液酸、岩藻糖、α１ＡＧ、α１ＡＴ和ＨＰ作为消化道癌症的辅助诊断指标，联合检测上述生化指标，特别是检测血清唾液、岩藻糖和α１—ＡＧ可以提高检出的阳性率、减少误诊率     

肝硬化患者纤维蛋白原结合唾液酸水平的研究

应用饱和硫酸铵制备纯化纤维蛋原,硫代巴妥酸法测定了肝硬化患者纤维蛋白原结合唾液酸(FSA)的水平,结果显示病人的纤维蛋白原结合唾液酸水平23.6±2.6nmul/mg,显著高于正常对照组18.4±3.7mol/mg(P＜0.01),并且凝血酶时间的延长与FSA的升高呈高度正相关(P＜0.01);纤维蛋白单体聚合的速度与纤维蛋白原结合唾液酸成反比.表明纤维蛋白原结合唾液酸的水平可作为诊断肝硬化获得性异常纤维蛋白血症拘理想指标.     

Parenteral nutrition in advanced cancer patients

Parenteral nutrition (PN) is a medical treatment aimed at providing intravenous nutrients in patients in whom gastrointestinal function is partially or totally impaired. An obvious indication of PN in advanced cancer patients is the prevention and/or treatment of malnutrition in hypo-aphagic patients with intestinal failure due to the disease itself or the consequences of antineoplastic treatments. However, PN may also improve compliance with palliative radio/chemotherapy, reduce its side effects, enhance quality of life and prolong survival. A careful evaluation of patients' clinical conditions and families' expectations is mandatory before the decision to initiate PN in ACPs is taken, in order to avoid administration of an inappropriate or even life-threatening medical treatment. Current available evidence indicates that patients expected to die earlier from the underlying tumour rather than from starvation gather no benefit from intravenous nutritional support. Although it is likely that intravenous nutrients provided to feed the patients are also utilized by cancer cells, at present there is no evidence that this translates into a clinically relevant harm to the patient. Fear of tumour growth stimulation must not be a reason for not considering parenteral nutrition in advanced cancer patients. The risk of septic, metabolic and mechanical complications has to be considered when PN support is prescribed, although a specialized and well trained medical and nursing staff may dramatically reduce complication rate. Decisions regarding treatment initiation and its possible withdrawal should be made based on the best available evidence and non on cultural and personal attitudes.