血清肿瘤标志物检测在肺癌中的临床价值

目的研究肺癌患者血清癌胚抗原(carcinoembryonic antigen,CEA)、神经元特异性烯醇化酶(neuron-spe-cific enolase,NSE)、细胞角蛋白19片段(cytokeratin 19 fragments,CYFRA21-1)水平与肺癌分期、近期疗效的关系。方法5例确诊为肺癌的患者均完成4个周期化疗,化疗前后常规检查血清CEA、NSE、CYFRA21-1,评估其变化。结果 5例患者中血清肿瘤标志物表达阳性者占61.8%,其中小细胞肺癌(SCLC)为69.2%,非小细胞肺癌(NSCLC)为59.5%;血清CEA、NSE、CYFRA21-1表达阳性率:SCLC分别为30.8%、69.2%及7.7%;NSCLC分别为52.4%、14.3%及54.8%。CEA、NSE、CYFRA21-1表达阳性率SCLC广泛期高于局限期,差异有统计学意义(P<0.05);NSCLCⅢB期与Ⅳ期各组间比较,差异有统计学意义(P<0.05)。化疗后血清肿瘤标志物表达水平变化与近期疗效相关。结论血清肿瘤标志物CEA、NSE及CYFRA21-1与肺癌分期、近期疗效有关。肺癌晚期肿瘤标志物表达水平增高,化疗有效率明显下降。     

血清肿瘤标志物在肺癌诊断中的应用价值

目的探讨血清细胞角蛋白19片段21-1(Cyfra21-1)、鳞癌抗原(SCC)、神经元特异性烯醇化酶(NSE)和血浆D-二聚体(D-D)在肺癌诊断中的应用价值。方法探讨2015年12月至2017年12月间陕西省渭南市中心医院收治的82例肺癌患者为肺癌组,58例肺部良性疾病患者为肺部良性疾病组,64例体检健康者为对照组。检测三组受试者血浆D-D以及血清Cyfra21-1、SCC和NSE水平,比较Ⅰ～Ⅱ期和Ⅲ～Ⅳ期肺癌患者的血浆D-D及血清Cyfra21-1、SCC和NSE水平。对肺癌组患者进行1年的随访,根据复发情况分为未复发组和复发组,比较两组患者的血浆D-D及血清Cyfra21-1、SCC和NSE水平。结果肺癌组患者血浆D-D以及血清Cyfra21-1、SCC和NSE水平均高于对照组和肺部良性疾病组,差异均有统计学意义(均P <0. 05)。Ⅲ～Ⅳ期肺癌患者的血浆D-D以及血清Cyfra21-1、SCC和NSE水平均高于Ⅰ～Ⅱ期肺癌患者,差异均有统计学意义(均P <0. 05)。肺癌组患者血浆D-D以及血清Cyfra21-1、SCC和NSE阳性率均高于对照组和肺部良性疾病组,差异均有统计学意义(均P <0. 05)。复发组肺癌患者的血浆D-D以及血清Cyfra21-1、SCC和NSE水平均高于未复发组,差异均有统计学意义(均P <0. 05)。结论联合检测血浆D-D以及血清Cyfra21-1、SCC和NSE对肺癌患者有较佳的临床辅助诊断价值,且有助于评估预后情况。     

五项血清肿瘤标志物联合检测在肺癌诊断中的应用

目的：探讨癌胚抗原（CEA）、神经元特异性烯醇化酶（NSE）、鳞状上皮抗原（SCC）、细胞角蛋白19片段抗原（Cyfra21—1）和糖链抗原125（CA125）5项肿瘤标志物联合检测在肺癌诊断中的价值。方法：采用电化学发光法及酶化学发光法测定81例肺癌、32例良性肺病患者和30例健康人的血清CEA、NSE、SCC、cyfra21—1和CA125水平。结果：肺癌组血清CEA、NSE、SCC、Cyfra21—1和CA125的阳性检出率（分别为49．38％、55．56％、23．46％、62．96％、39．51％）明显高于良性肺病组和健康对照组。肺癌组5项肿瘤标志物阳性率随肿瘤临床分期而升高。其中CEA在肺腺癌中明显升高（P〈0．05），NSE以小细胞癌升高明显（P〈0．05），SCC在肺鳞癌中明显升高（P〈0．01），Cyfra21—1以非小细胞肺癌升高明显（P〈0．01）。5项肿瘤标志物联合检测比单项检测的阳性率和准确性更高。结论：外周血CEA、NSE、SCC、Cyfra21—1和CA125联合检测可提高肺癌的阳性检出率，CEA、NSE、SCC和Cyfra21—1对肺癌病理分型有重要的临床参考价值。     

非小细胞肺癌患者化疗前后血清癌胚抗原细胞角蛋白19片段和糖类抗原125的变化

目的探讨晚期非小细胞肺癌(NSCLC)患者化疗前后血清癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)和糖类抗原(CA125)的变化。方法选取2013年8月至2015年8月间辽宁省本溪市本钢总医院经病理以及细胞学诊断证实的NSCLC患者42例为研究组,化疗前采用酶联免疫法测定患者血清CEA、CYFRA21-1和CA125表达水平,化疗治疗结束3周后再次测定患者血清中CEA、CYFRA21-1和CA125表达水平变化,并行胸部CT检查,根据结果分为化疗有效者(完全缓解+部分缓解)和无效者(病情稳定+疾病进展)。选取同期来院体检的42例健康者为对照组,均排除肺部疾病,与研究组患者血清中CEA、CYFRA21-1和CA125水平变化进行比较。结果研究组患者化疗前血清CEA、CYFRA21-1和CA125水平分别为(38.78±10.37)ng/ml、(3.51±1.37)ng/ml和(37.22±15.39)U/ml,对照组患者分别为(1.86±0.47)ng/ml、(2.0±0.11)ng/ml和(20.1±15.7)U/ml,两组比较差异有统计学意义(P<0.05)。研究组患者化疗前血清CEA、CYFRA21-1和CA125在化疗有效组和无效组中无显著统计学意义(P<0.05)。化疗后血清CEA、CYFRA21-1和CA125在治疗有效组明显低于化疗前,有显著统计学意义(P<0.05);在无效组化疗后血清CEA、CYFRA21-1和CA125表达水平与化疗前相比差异不大,无统计学意义(P>0.05)。结论对临床NSCLC患者进行血清CEA、CYFRA21-1和CA125检测,可有效评估患者临床疗效及预后,为临床NSCLC化疗疗效提供标准依据。     

治疗前血清神经元特异性烯醇化酶水平在预测晚期非小细胞肺癌脑转移及预后中的意义

目的：探讨治疗前血清神经元特异性烯醇化酶（ NSE）水平在预测晚期非小细胞肺癌（ NSCLC）发生脑转移和患者预后的价值。方法回顾性分析128例晚期NSCLC患者的临床病理特征和治疗前血清NSE、癌胚抗原（ CEA）、细胞角蛋白21?1片段（ cyfra 21?1）、白蛋白（ ALB）、白细胞（ WBC）水平与NSCLC患者发生脑转移及其预后的关系。结果128例晚期NSCLC患者中,肺腺癌90例,肺鳞癌30例,大细胞未分化癌8例。血清NSE、CEA和cyfra 21?1的中位水平分别为13．6、7．8和6．1 ng／ml,ALB和WBC水平分别为（35．41±5．60）g／L和（8．16±2．53）×109／ml。多因素Logistic分析结果显示,NSE水平与NSCLC患者脑转移有关（ P＝0．030）。28例脑转移患者和98例无脑转移患者治疗前NSE水平分别为（34．18±28．48）ng／ml和（13．87±4．49）ng／ml,差异有统计学意义（P＜0．05）。治疗前NSE水平升高组和NSE水平正常组患者的中位生存时间分别为3．5个月和10．7个月,差异有统计学意义（P＜0．05）。结论治疗前血清NSE水平与NSCLC患者脑转移和预后有关,可作为晚期NSCLC脑转移的预测因素,治疗前血清NSE高水平提示NSCLC患者预后较差。     

血清人附睾蛋白4检测在非小细胞肺癌诊断中的临床意义

目的探讨血清人附睾蛋白4(HE4)对非小细胞肺癌(NSCLC)的诊断意义。方法选择2013年1月至2015年1月徐州医学院附属连云港医院进行手术治疗的96例NSCLC患者为观察组,另选同期96例健康体检者为对照组,检测两组血清HE4水平,比较手术前不同临床病理特征NSCLC患者血清HE4水平差异。以病理诊断为金标准,绘制血清HE4、血清癌胚抗原(CEA)、细胞角蛋白21-1(CYFRA21-1)对NSCLC诊断的ROC曲线。结果观察组患者手术前血清HE4水平显著高于对照组,差异有统计学意义(P<0.05),且显著高于手术后水平,差异有统计学意义(P<0.05)。手术前不同TNM分期的血清HE4表达水平差异有统计学意义(P<0.05),其中Ⅲ期患者HE4水平显著高于Ⅰ期和Ⅱ期患者,差异有统计学意义(P<0.05)。当血清中HE4、CEA和CYFRA21-1浓度分别为67.75 pmol/L和2.49 ng/ml,2.53 ng/ml时,对NSCLC有最大诊断价值,曲线下面积(AUC)分别为0.887,0.840和0.711。HE4检测灵敏度显著高于CEA和CYFRA21-1,差异有统计学意义(P<0.05)。结论与CEA和CYFRA21-1比较,血清HE4对NSCLC的诊断有较高的敏感性,对NSCLC早期诊断、疗效评估和病情监测具有重要价值。     

血清肿瘤标志物单项及联合检测在肺癌诊断中的临床价值

目的探讨血清癌胚抗原(Carcinoembryonic antigen,CEA)、糖类抗原19-9(CA19-9)、糖类抗原125(CA125)、细胞角蛋白19片断(Cytokeratinfragment 19,CYFRA21-1)、神经特异性烯醇化酶(Neuron-specific enolase,NSE)、鳞状细胞抗原(SCC-Ag)6种肿瘤标志物单项及联合检测在肺癌诊断中的临床价值。方法采用化学发光免疫法检测92例肺癌患者、92例肺良性疾病患者、92例健康体检者的血清CEA、CA19-9、CA125、CYFRA21-1、NSE、SCC-Ag表达水平。结果肺癌患者的血清肿瘤标志物CEA、CA19-9、CA125、CYFRA21-1、NSE、SCC-Ag的表达均明显高于肺良性疾病患者和健康体检者(P均<0.05);6种肿瘤标志物对肺癌诊断的灵敏性和准确度分别为:CEA(51.1%、73.3%)、CY-FRA21-1(58.7%、73.9%)、CA125(38.0%、71.4%))、CA19-9(27.2%、70.3%)、NSE(26.1%、65.9%)、SCC-Ag(35.9%、71.0%),而六者联合检测的灵敏性和准确度分别为92.4%和83.7%,明显高于各单项检测(P<0.05)。结论血清肿瘤标志物CEA、CA19-9、CA125、CYFRA21-1、NSE、SCC-Ag是诊断肺癌较好的标志物,六者联合检测可明显提高肺癌诊断的灵敏性和准确度。     

NSE、CEA及CA125联合检测在肺癌诊断中的价值

目的探讨NSE、CEA及CA125 3种肿瘤标志物联合检测在肺癌诊断中的临床应用价值。方法用R IA法检测25例健康体检者、41例肺癌患者的血清3种肿瘤标志物水平,并对它们的诊断价值进行评价。结果肺癌患者3种肿瘤标志物的均值均显著高于对照组(P<0.05),3种肿瘤标志物联合检测的诊断价值显著提高。结论NSE、CEA及CA125对肺癌的诊断均有意义,而联合检测时诊断肺癌具有较大的临床应用价值。     

血清肿瘤标志物的联合检测在肺癌诊断中的价值

目的：了解3种血清肿瘤标志物在肺癌诊断的应用价值，以提高肺癌的诊断率。方法：应用放射免疫技术，测定62例肺癌患者、43例肺良性疾病患者和正常对照的血清CYFRA2l—l、NSE、CEA的水平。结果：肺癌患者组的3种标志物CYFRA2l—l、NSE、CEA的水平明显高于肺良性疾病患者组和正常对照组(P＜0．01)。其中CYFRA2l—l、NSE、CEA的灵敏度分别为65．4％、29．8％、48．7％，但三者联合检测的灵敏度为94．3％，明显优于3种血清肿瘤标志物的单项测定。结论：血清CYFRA2l—l、NSE、CEA对肺癌的诊断有价值，建议临床工作中采用三者联合检测。     

联合应用多项肿瘤标志诊断卵巢恶性肿瘤的价值

目的探讨CA125等7种肿瘤标志联合应用对卵巢恶性肿瘤的诊断价值。方法对430例卵巢包块手术前患者(卵巢恶性肿瘤110例,卵巢良性肿瘤320例)及50例正常妇女血清应用ELISA法进行检测。检测项目包括糖类抗原CA125(CA125)、肿瘤相关物质(TSGF)、唾液酸(SA)、癌胚抗原(CEA)、甲胎蛋白(AFP)、促性腺激素(hCG)和铁蛋白(Fer)。结果卵巢恶性肿瘤患者血清中CA125、TSGF、SA、CEA、AFP及Fer水平明显高于卵巢良性肿瘤或对照组,F=177.24,P<0.0001;F=52.49,P<0.0001;F=3.38,P=0.0347;F=6.88,P=0.0011;F=34.94,P<0.0001;F=8.23,P=0.0003;F=124.37,P<0.0001。在7项肿瘤标志中,CA125单独诊断价值最大。单独应用CA125诊断卵巢恶性肿瘤的敏感性、特异性及准确性分别为86.4%、82.8%及83.7%。联合应用7项肿瘤标志时,以任意一项及一项以上异常指标为诊断标准时,诊断卵巢恶性肿瘤的敏感性、特异性及准确性分别为95.5%、45.6%和58.4%;以任意两项及两项以上异常指标为诊断标准时,分别为93.6%、80.6%和84.0%;以任意3项及3项以上异常指标为诊断标准时,分别为87.3%、90.3%和89.5%。结论7项肿瘤标志联合检测对提高卵巢恶性肿瘤诊断的敏感性、特异性及准确性有一定意义,其中CA125、TSGF及SA3项肿瘤标志阳性诊断价值最大。     

The predictive value of pre-treatment inflammatory markers in advanced non-small-cell lung cancer

Background

Accurate prediction of outcome in advanced non-small-cell lung cancer (nsclc) remains challenging. Even within the same stage and treatment group, survival and response to treatment vary. We set out to determine the predictive value of inflammatory markers C-reactive protein (crp) and white blood cells (wbcs) in patients with advanced nsclc.

Patients and Methods

Patients were assigned a prognostic index (pi):

• 0 for crp 10 mg/L or less and wbcs 11×10⁹/L or less,
• 1 if one of the two markers was elevated, and
• 2 if both markers were elevated.

We then used chest computed tomography (ct) imaging to evaluate response after 2 cycles of chemotherapy treatment.

Results

Of 134 patients, 46 had a pi of 0; 60, a pi of 1; and 28, a pi of 2. Disease progressed in 41 patients. Progression was significantly more frequent among patients with a pi of 2 (p = 0.008). Median survival was 20.0 months for the pi 0 group, 10.4 months for the pi 1 group, and 7.9 months for the pi 2 group (p < 0.001). The pi was the only significant prognostic factor for survival even after adjustment for performance status, smoking, and weight loss (hazard ratio: 1.57; 95% confidence interval: 1.2 to 2.14; p = 0.004).

Conclusions

Inflammatory state correlates significantly with both chemotherapy response and survival in stage iv nsclc. The pi may provide additional guidance for therapeutic decision-making.     

血清DcR3检测在肝细胞癌中的诊断及预后评估价值

目的:探讨血清诱骗受体3(decoy receptor3,DcR3)对肝细胞癌(hepatocellular carcinoma,HCC)的临床诊断及预后评估的价值。方法:选取2016年1月至2017年12月首都医科大学附属北京同仁医院收治的120例HCC患者作为HCC组,取同期肝脏良性肿瘤患者作为对照组,比较各组血清DcR3水平,以及其与肿瘤分期、预后的关系,采用受试者工作特征曲线(receiver operating characteristic curve,ROC曲线)分析血清DcR3的HCC诊断效能。分析DcR3联合甲胎蛋白(alpha-fetoprotein,AFP)对HCC诊断的灵敏度及特异度。结果:HCC组血清DcR3水平高于对照组,术后其水平逐渐下降;随着肿瘤进展,血清DcR3表达水平逐渐升高。ROC曲线分析发现血清DcR3检测的ROC曲线下面积0.95,DCR3联合AFP检测的阳性率87.5%,大于二者单独检测的阳性率。血清DcR3高表达患者预后较差。结论:血清DcR3检测对HCC具有较高的诊断及预后判断价值;联合检测血清AFP、DcR3可提高诊断HCC的灵敏度。     

Prognostic value of serum biological markers in patients with hepatocellular carcinoma.

PURPOSE: Prognosis of patients with hepatocellular carcinoma (HCC) is assessed by using indexes based on clinical and instrumental parameters. The Cancer of the Liver Italian Program (CLIP) staging system combines the Child-Pugh classification with tumor size, portal invasion, and alpha-fetoprotein and predicts the outcome of HCC patients more precisely than the Okuda staging system. Serum levels of a number of biological variables have been found to be increased in patients with HCC and are associated with different outcomes. Our aims in this study were to test the prognostic role of the serum levels of soluble intercellular adhesion molecule-1 (sICAM-1), soluble interleukin-2 receptor (sIL-2R), interleukin 6 (IL-6), and anti-p53 and to assess whether the addition of any of the above serum markers could further improve the predictive ability of the CLIP score. EXPERIMENTAL DESIGN: Serum levels of sICAM-1, sIL-2R, IL-6, and anti-p53 were assayed in 80 patients with HCC and correlated with their outcomes. Nonparametric procedures were applied to test correlations between serum sICAM-1, sIL-2R, IL-6, anti-p53, and other prognostic factors. For survival analyses, the product-limit method, log-rank test, and Cox proportional hazards model were applied. RESULTS: Only serum levels of sIL-2R correlated with survival, which was longer for patients with lower values (< or =950 units/ml). However, with multivariate analysis sIL-2R did not confirm its predictive role when tested with the CLIP score as a covariate, with a hazard of death of 1.51 (95% confidence interval, 0.76-3.01). CONCLUSIONS: Serum levels of sICAM-1, sIL-2R, IL-6, and anti-p53 are not useful as prognostic factors for HCC in clinical practice. They do not improve the predictive ability of the CLIP score.     

Preoperative serum markers in carcinoma of the rectum and rectosigmoid. II. Prediction of prognosis

The prognostic value of a single preoperative determination of the serum (S) concentration of carcinoembryonic antigen (CEA), tissue polypeptide antigen (TPA) and the carcinoma-associated carbohydrate antigen CA-50, either alone or in combination was evaluated in 327 consecutive patients with carcinoma of the rectum. A strong correlation was found between the serum level of each of these tumour markers separately, and prognosis, both in terms of crude survival in all patients and in disease-free survival in 'potentially cured' patients. The prognostic information provided by S-TPA and S-CA-50 was stronger, however, than that given by S-CEA. In a multivariate approach, S-TPA was found to be most informative. With use of the Cox regression model, the critical serum values that best separated patients in regard to mortality were CEA 18 micrograms/l, TPA 120 U/l and S-CA-50 40 U/ml. The critical values that best discriminated disease-free survival in 'potentially cured' patients were CEA 12 micrograms/l, TPA 110 U/l and S-CA-50 28 U/ml. The clinical usefulness of these and other cut-off levels is discussed.     

Hepatocellualar carcinoma serum markers

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in some areas of the world. In most cases, HCC is diagnosed at a late stage. Therefore, the prognosis of patients with HCC is generally poor. The recommended screening strategy for patients with cirrhosis includes the determination of serum α-fetoprotein (AFP) levels and an abdominal ultrasound every 6 months to detect HCC at an earlier stage. AFP, however, is a marker characterized by poor sensitivity and specificity, and abdominal ultrasound is highly dependent on the operator's experience. In addition to AFP, Lens culinaris agglutinin-reactive AFP (AFP-L3), des-γ-carboxy prothrombin (DCP), glypican-3 (GPC-3), osteopontin (OPN), and several other biomarkers (such as squamous cell carcinoma antigen-immunoglobulin M complexes [SCCA-IgM], alpha-1-fucosidase [AFU], chromogranin A [CgA], human hepatocyte growth factor, insulin-like growth factor) have been proposed as markers for the early detection of HCC. For these markers, we describe the mechanisms of production, and their diagnostic and prognosis roles. None of them is optimal; however, when used together, their sensitivity in detecting HCC is increased. Recent research has shown that some biomarkers have mitogenic and migratory activities in the angiogenesis of HCC and are a factor of tumor growth.     

血清lncRNA HLA-DRB6对宫颈鳞癌预后的预测价值

目的:探讨血清HLA-DRB6在宫颈鳞癌无创筛查和预后预测中的价值.方法:回顾性选择2013年2月就诊于我科的3例宫颈鳞癌患者,选取同期就诊的3例妇科疾病患者(子宫内膜异位症)作为对照组,对两组间的血清样本进行长链非表达RNA(long non-coding RNA,lncRNA)表达谱分析,筛选差异表达lncRNA....     

Clinical value of serum HMGB1 in diagnosis and prognosis of laryngeal squamous cell carcinoma

Autologous hematopoietic stem cell transplantation (AHSCT) is a treatment option for relapsed and recurrent follicular lymphoma (R/R FL); however, its value in the rituximab era remains to be elucidated. To evaluate the safety and clinical outcome of AHSCT for relapsed FL, we present a retrospective series of AHSCT for 30 FL patients (17 male and 13 female) at median age of 49 years. Patients were transplanted in second or subsequent complete or partial response after at least one therapeutic line including chemotherapy and rituximab. Overall, seven patients achieved second or higher complete response (CR) at AHSCT, whereas 23 were transplanted in partial response. Median overall survival (OS) was not reached, whereas progression-free survival (PFS) was 4.8 years. The estimated 10-year OS and PFS were found to be 60 and 33 %, respectively. There was no significant difference in OS and PFS in terms of FLIPI score and disease status at transplant. Median follow-ups from diagnosis and from AHSCT were 4.9 years (range 1.5–18.4 years) and 1.7 years (range 0.03–16.5 years), respectively. Fifteen patients relapsed, and 11 out of them (73 %) died of disease recurrence and chemoresistance. At the last contact, 19 patients are alive: 12 are in CR, whereas seven patients receive salvage regimens due to active lymphoma. AHSCT for relapsed FL patients who were pretreated with rituximab remains a safe procedure with low transplant-related mortality and long-term progression-free survival in about one-third of transplanted patients.     

血清玻粘连蛋白在人脑胶质瘤诊断及预后判定中的应用价值

目的:探讨血清玻粘连蛋白（VTN）在人脑胶质瘤诊断及预后判定中的应用价值。方法:选择2010年1月至2015年6月在我院就诊的163例脑胶质瘤患者作为研究组，同时选择同期健康体检受试者108例作为对照1组，非胶质瘤脑肿瘤患者47例作为对照2组，非肿瘤神经内科疾病患者92例作为对照3组。收集受试者空腹静脉血，检测血清VTN，观察VTN与脑胶质瘤诊断与预后的关系。结果:四组患者VTN水平相比较差异有统计学意义（P<0.05），研究组VTN水平显著高于对照1组、对照2组和对照3组（P<0.05）。ROC显示VTN诊断脑胶质瘤的灵敏度、特异性和AUC分别为0.779、0.907和0.881。患者年龄、病理分级、KPS评分、肿瘤直径、体质指数（BMI）与VTN水平相关（P<0.05），性别、肿瘤部位、病程与VTN水平无相关性（P＞0.05）。多因素Cox分析，结果显示，肿瘤分级（RR=9.872，P<0.001）、VTN水平（RR=4.786，P<0.001）是影响1年无进展生存率的独立因素（P<0.05）。K-M曲线显示，VTN低表达组中位PFS显著高于VTN高表达组（19.2个月 vs 9.9个月，P<0.001）。结论:VTN对诊断脑胶质瘤具有中等临床价值，是一种有用的预后生物标志物。     

食管癌预后相关肿瘤标志物

与食管癌预后相关的肿瘤标志物可分为蛋白质类和糖蛋白类,前者包括细胞角蛋白19片段抗原21-1(CYFRA21-1)、p53抗体等,后者包括鳞状细胞癌抗原、血管内皮生长因子(VEGF)等,对其检测有利于预测食管癌的预后.