纤维蛋白原降解产物和D-二聚体在大肠癌伴随肝转移中的诊断价值

目的探讨大肠癌伴随肝转移患者的纤维蛋白原降解产物(FDP)和D-二聚体(D-D)检验指标的诊断价值。方法选择2012年6月至2013年6月收治的大肠癌患者80例,分为远处转移组(n=50)和无远处转移组(n=30),选择同期健康体检者80例作为对照组,各组均进行血清FDP和D-二聚体的检测。结果肿瘤组患者的FDP和D-二聚体表达值明显高于对照组,差异有统计学意义(P<0.05)。转移组患者FDP和D-二聚体表达值明显高于无转移组(P<0.05)。转移组患者的FDP和D-二聚体表达阳性率明显高于无转移组,差异有统计学意义(P<0.05)。多因素非条件Logistic回归分析结果显示,FDP和D-二聚体为肝转移的主要独立危险因素(P<0.05)。结论血液高凝状态是促进肿瘤转移的重要条件,高凝状态影响恶性肿瘤的生长和转移,FDP和D-二聚体可作为有效预测大肠癌肝转移的生物学指标。     

妇科肿瘤患者止血潜能的研究

目的:研究妇科肿瘤患者总体止血潜能(overall haemostatic potential,OHP)的变化及其临床意义.方法:检测妇科恶性肿瘤患者(n=65)、良性肿瘤患者(n=60)总体止血潜能(OHP)、总体凝血潜能(OCP)和总体纤溶潜能(OFP),并以52名健康女性作为对照.同时,检测两组患者的血浆纤维蛋白原含量,探讨其与止血潜能的相关性.结果:恶性肿瘤OCP和OHP 值明显增高(P<0.01),而OFP值减低(P<0.01).良性肿瘤患者的OCP和OHP 值明显增高(P<0.01),而OFP值无显著性变化(P>0.05).良、恶性肿瘤两组纤维蛋白原的含量增加(P<0.05),且与OHP的相关性良好(r=0.813、0.795,P<0.01).结论:妇科恶性肿瘤机体止血失衡,机体处于高凝状态,有血栓形成倾向.     

肿瘤化疗对.恶.性肿瘤患者外周血细胞IL-2R表达的影响

目的探讨肿瘤化疗对患者血细胞白细胞介素-2受体(IL-2R)表达水平的影响.方法用流式细胞术检测了413例恶性肿瘤患者外周血淋巴细胞CD+25(IL-2R)细胞检出率,并对肿瘤已化疗和未化疗者的CD+25检出率进行了对比分析.结果肿瘤患者血细胞CD+25检出率显著低于正常对照者(P＜0.01).其中肿瘤化疗者又显著高于未化疗者(P＜0.01).在转移并化疗的患者中,先转移后化疗者又显著高于先化疗后转移者(P＜0.01).在肿瘤化疗患者中,未转移患者CD+25率显著高于已转移患者(P＜0.01).结论肿瘤化疗能提高患者血细胞IL-2R表达率,改善机体免疫状态.     

血清肿瘤特异性生长因子检测对涎腺恶性肿瘤诊断的价值

目的探讨肿瘤特异性生长因子(tumor specific growth factor,TSGF)在涎腺恶性肿瘤诊断中的应用价值.方法采用福建新大陆生物技术有限公司提供的TSGF癌症快速诊断试剂盒测定63例涎腺良性肿瘤、51例非肿瘤疾病及82例涎腺恶性肿瘤患者血清中的TSGF含量.结果涎腺恶性肿瘤患者血清中的TSGF含量及阳性检出率明显高于涎腺良性肿瘤及非肿瘤组患者(P<0.01).不同类型涎腺癌患者TSGF水平差异无显著性.结论血清TSGF检测对涎腺恶性肿瘤的诊断有一定的参考价值.     

宫颈癌组织中Ets-1表达及其与微血管密度的相关性研究

目的 研究宫颈癌组织中原癌基因Ets-1的表达与肿瘤血管生成的关系,探讨Ets-1在宫颈癌发生、发展、侵袭转移中的作用及临床意义.方法 采用免疫组织化SP法检测67例宫颈癌组织中Ets-1的表达及微血管密度(MVD,CD34标记),并进行相关性分析.结果 宫颈癌组织中Ets-1表达阳性率62.7%,正常宫颈组织中无1例阳性着色(P<0.01).宫颈癌组织中MVD计数为37.57±6.77,正常宫颈上皮为14.91±2.55(P<0.01).随Ets-1表达增强MVD显著增高(P<0.01).Ets-1表达随临床分期(P<0.01)、组织学分级(P<0.01)的进展呈增高趋势;有盆腔淋巴结转移及深肌层浸润患者Ets-1的表达高于无盆腔淋巴结转移及浅肌层浸润患者(P<0.01).结论 Ets-1蛋白可通过促进肿瘤血管生成加速肿瘤的生长浸润及转移.检测Ets-1为临床了解宫颈癌生物学行为及判断预后提供了重要参考指标.     

血清肿瘤标志物CEA、CA19-9对结直肠癌的诊断价值

目的 分析血清肿瘤标志物CEA、CA19-9单项或联合检测对结直肠癌患者的临床诊断价值,探讨其在病理分期、淋巴结转移等临床特征方面的意义.方法 酶联免疫法检测160例健康人和158例结直肠癌患者术前两天以及术后两周血清中CEA、CA19-9含量.结果 结直肠癌患者2种血清肿瘤标志物含量明显高于健康人(P<0.01),术前与术后2种血清肿瘤标志物水平比较差异有统计学意义(P<0.05).CEA、CA19-9联合检测敏感度和特异度明显高于各单项检测值.在Dukes A、B、C及D期中,2种肿瘤标志物含量及检测阳性率依次增高,淋巴结转移患者的CA19-9含量高于无淋巴结转移患者(P<0.05).结论 肿瘤标志物CEA、CA19-9联合检测可以提高结直肠癌诊断的敏感度和特异度,并对临床分期、判断淋巴结转移、预测预后及监测复发有一定的指导意义.     

晨尿的对羟苯丙酮酸测定对恶性肿瘤的诊断价值

用生化定性检测方法对451例各种恶性肿瘤患者,46例非癌病人及42例健康人晨尿对羟苯丙酮酸(HPPA)进行测定,结果显示各种恶性肿瘤病人检测的阳性率均明显高于健康对照组及非癌疾病组(P<0.005),对恶性肿瘤的总阳性率为67.85%,特异性为85.23%。对手术、放疗或化疗前后尿中HPPA检测发现,经有效的治疗尤其是手术后,尿中HPPA检测的阳性率明显减低,与治疗前相比有非常显著性差异(P<0.005)。同时,对肿瘤进展、复发及转移患者尿中HPPA检测发现,其阳性申明显高于缓解期、无复发及转移的病人,经统计分析亦有显著性差异(P<0.05~0.005)。所以,检测尿中HPPA不但可作为肿瘤代谢异常的标志物用于肿瘤普查和自查,也可作为病情监测,疗效判定,监测复发或评估预后的一个指标。     

TSGF在临床的应用

目的:比较研究良性肿瘤患者、恶性肿瘤患者及正常人血清中肿瘤相关物质(Tumor Supplied Group ofFactors,TSGF)含量的差异,探讨TSGF测定对恶性肿瘤的诊断价值.方法:通过对79例恶性肿瘤患者,45例良性肿瘤患者,78例正常人(对照组)血清中TSGF含量的测定,比较其组间结果的差异.结果:几种恶性肿瘤患者血清中TSGF阳性率明显高于良性肿瘤患者和正常人,TSGF平均阳性率达79.7%;几种恶性肿瘤患者与良性肿瘤患者血清中TSGF含量差异明显,有显著性意义(P＜0.01);几种恶性肿瘤患者与正常人(对照)比较,TSGF结果差异明显,有显著意义(P＜0.01);良性肿瘤病人与正常人比较,TSGF结果差异无显著意义(P＞0.05).结论:TSGF检测有助于几种恶性肿瘤的诊断与鉴别诊断.     

肝癌、慢性肝炎血清肿瘤坏死因子检测意义探讨

为探讨肿瘤坏死因子在慢性肝病中对疾病过程的影响和治疗前后动态变化,采用双抗体夹心法对171例各类肝病患者血清肿瘤坏死因子(TNF)进行检测,并与60例健康献血者对照.结果显示:慢性肝炎,肝癌病人TNF含量均明显高于健康人(P<0.01)差异非常显著.24例肝炎病人和15例肝癌病人治疗前明显高于治疗后,差异非常显著(P<0.01).     

肾癌中EphA2和EphrinA1的表达及其与微血管密度的关系

目的 探讨EphA2和EphrinA1在肾癌组织中的表达,及其与肿瘤血管生成的关系.方法 应用用免疫组化法检测68例肾癌组织、24例正常肾组织中EphA2和EphfinA1的表达,采用CD34抗体标记微血管内皮细胞,计算微血管密度(MVD).结果 肾癌组织中EphA2和EphrinA1蛋白的表达明显高于正常肾组织(均P<0.01).正常肾组织中MVD为25.23±7.09,肾癌组织中MVD为39.68±7.24,差异有统计学意义(P<0.01).在肾癌组织中,分化程度为2、3级组的EphA2和EphrinA1蛋白表达水平高于分级为1级组(P<0.01,P<0.05),分期为Ⅲ、Ⅳ期组高于Ⅰ、Ⅱ期组(P<0.01,P<0.05),有淋巴结转移组高于无淋巴结转移组(P<0.05);肿瘤直径≥7 cm组的MVD高于<7 cm组(P<0.05),分化程度为2、3级组高于1级组(P<0.01),分期为Ⅲ、Ⅳ期组高于Ⅰ、Ⅱ期组(P<0.05),有淋巴结转移组高于无淋巴结转移组(P<0.01).相关分析结果显示,EphA2、EphrinA1的表达与MVD呈正相关(r分别为0.555和0.485,均P<0.01).结论 EphA2和EphrinA1在肾癌组织中高表达,并与肿瘤的分化程度、临床分期、肿瘤血管生成有关.     

1,6-二磷酸果糖醛缩酶对无水酒精注射治疗原发性肝癌中的观察

目的:探讨血清1,6-二磷酸果糖醛缩酶(FDP-ALD)测定对经皮肝穿无水酒精瘤内注射术(PEI)治疗原发性肝癌的疗效评价.方法:18例共24个肝癌肿瘤结节行PEI治疗,检测治疗后不同时点的血清FDP-ALD和甲胎蛋白(AFP)的变化并进行比较.结果:血清FDP-ALD活性在第1次PEI术后达最高值,随后呈波浪状下降,第8次回到术前水平,提示血清FDP-ALD活性变化可反映肝癌组织的坏死程度.血清AFP浓度治疗后也呈下降趋势,术前、术后比较差异有显著性(P＜0.05).结论:血清FDP-ALD活性测定可用于肝癌PEI的疗效评价,对AFP阴性的肝癌患者也有判断疗效的价值.     

Evaluation of nontumorous tissue damage by transcatheter arterial embolization for hepatocellular carcinoma.

The serial changes in serum hepatic enzyme activities by transcatheter arterial embolization (TAE) were analyzed in 17 patients with hepatocellular carcinoma to estimate the contribution to the value by the damage of tumor or nontumorous hepatic cells. The serum levels of relatively tumor-specific fructose 1,6-diphosphate (FDP) aldolase were elevated after TAE in the cases of both superselective and nonsuperselective TAE that were performed from the segmental and the nonsegmental hepatic artery, respectively, but we found the marked elevation of FDP aldolase in the cases of the superselective TAE. In contrast, the non-tumor-specific fructose 1-phosphate (F1P) aldolase was markedly elevated only in the cases of nonsuperselective TAE. The total amount of FDP aldolase released by TAE correlated significantly with the integrated tumor tissue volume (P less than 0.005), whereas the total amount of F1P aldolase output correlated significantly with the integrated nontumorous tissue volume (P less than 0.005) as defined by lipiodol accumulation on computerized tomography scan. The consequent changes in the total nontumorous liver volumes after TAE were also analyzed by the follow-up computerized tomography scan. The nonsuperselective TAE caused the significant total nontumorous liver atrophy when compared with the superselective TAE. The progression of the total nontumorous liver atrophy correlated significantly with F1P aldolase output by TAE (P less than 0.001) but not with FDP aldolase output. These results suggest that the outputs of FDP and F1P aldolase are useful to estimate the degree of the tumorous and nontumorous tissue damage by TAE, respectively, and F1P aldolase output can be used to predict the progression of liver atrophy caused by TAE.     

Involvement of interleukin-6 in the elevation of plasma fibrinogen levels in lung cancer patients

BACKGROUND: Involvements of interleukin-6 (IL-6) and fibrinogen in cancer development have been independently studied. However, the association of these molecules in cancer patients remains uncertain. This study was conducted to clarify the association according to the clinicopathological characteristics of lung cancer patients. METHODS: Serum IL-6 levels assayed in 339 patients without pleural effusion were assessed according to clinical stage, histological type of the cancer and levels of fibrin (ogen) degradation products (FDP), and C-reactive protein (CRP). RESULTS: Elevations of serum IL-6 levels more than 4 pg/ml were found in 37.8% of all patients. According to the clinical stage and histological type, the elevations were significantly more frequent in the advanced stage (44.7%), in squamous cell (49.1%) and large cell carcinomas (63.6%). Similarly, the frequency of the elevated cases (> 400 mg/dl) and the mean value of the fibrinogen level were also higher in the advanced stage (54.2%, 455.0 mg/dl) and large cell carcinoma (54.6%, 459.3 mg/dl), respectively. The elevations of fibrinogen, FDP and CRP levels were found to be related to those of the IL-6 level. CONCLUSION: In lung cancer, serum IL-6 elevations are particularly frequent in the advanced stages of patients with squamous cell and large cell carcinoma, which are associated with the elevated levels of fibrinogen, suggesting a possibility that IL-6 was involved not only directly, but also indirectly, through regulating plasma fibrinogen with promotion of cancer development in vivo.      

Coagulative and fibrinolytic properties of ascitic fluid associated with ovarian tumors.

Ascitic fluid samples from 19 patients with ovarian carcinoma, 3 with a benign ovarian tumor, and 5 with cirrhosis of the liver were examined for their content of coagulation factors and components of the fibrinolytic system. The concentration of trypsin inhibitors in the ascitic fluid was significantly higher in the presence of carcinoma. Large amounts of FDP were found in the ascitic fluid in all patients with malignant tumors, but not in the other two groups. Determination of FDP may therefore make it possible to differentiate between malignant and nonmalignant ascitic fluid.     

血清微量元素与老年前列腺癌病理分级及临床分期的相关性研究

目的:探讨血清微量元素与老年前列腺癌病理分级及临床分期的相关性。方法:选自我院2013年6月至2017年6月期间收治的老年前列腺癌患者80例、良性前列腺增生患者73例、健康体检者52例。所有研究对象抽取静脉血,分离血清,采用原子吸收分光光度计测定血清微量元素含量。结果:前列腺癌组血清铁和铜含量高于前列腺增生组和对照组,而血清锌含量低于前列腺增生组和对照组（P＜0.05）;前列腺增生组血清铁和铜含量高于对照组,而血清锌含量低于对照组（P＜0.05）。低分化血清铁和铜含量高于中分化和高分化,而血清锌含量低于中分化和高分化（P＜0.05）;中分化血清铁和铜含量高于高分化,而血清锌含量低于高分化（P＜0.05）。T4期血清铁和铜含量高于T3、T2和T1期,而血清锌含量低于T3、T2和T1期（P＜0.05）;T3期血清铁和铜含量高于T2和T1期,而血清锌含量低于T2和T1期（P＜0.05）;T2期血清铁和铜含量高于T1期,而血清锌含量低于T1期（P＜0.05）。血清铁、铜与低分化和T3-T4分期前列腺癌患者呈正相关,而血清锌与低分化和T3-T4分期前列腺癌患者呈负相关。结论:老年前列腺癌血清铁和铜含量升高,而血清锌含量下降,且血清铁、铜与前列腺癌低分化和T3-T4分期呈正相关,而血清锌与其呈负相关。     

肺癌患者凝血指标水平与化疗疗效的关系

目的:探讨肺癌患者血浆中凝血指标水平的变化,并分析其与化疗疗效的关系。方法:收集2010年1月-2013年1月我院初治肺癌患者165例,依照化疗疗效分为有效组（58例）和无效组（107例）,另收集50例体检健康者为对照组。观察肺癌患者及正常对照组血浆的APTT、FIB、TT、D-D、FDP、AT、PT、INR、PLT、PDW水平;对肺癌患者有效组与无效组化疗前后上述凝血指标进行分析比较。结果:肺癌组化疗前PLT、FIB、D-D、FDP水平明显高于对照组（P<0.05）;化疗后有效组FIB、D-D、FDP、PLT及APTT水平较化疗前明显降低,差异有统计学意义（P<0.05）;化疗后无效组FIB、D-D、FDP水平明显高于化疗前,差异有统计学意义（P<0.05）。结论:FIB、D-D、FDP、PLT的水平变化对肺癌的诊断有一定的价值,可作为化疗疗效及预后的有效判断依据之一。     

Effectiveness of managing suspected metastasis using plasma D-dimer testing in gastric cancer patients

Tumor metastasis is closely related to the coagulation system. Tumor metastasis and hypercoagulability promote each other through multiple mechanisms. However, whether coagulation indicators can reflect tumor metastasis remains to be explored. Clinical characteristics of a total of 3447 patients from three tertiary referral centers were collected. Then the diagnostic efficacy of FDP, D-dimer and GC tumor markers [Carcinoembryonic antigen (CEA), Carbohydrate antigen 19-9 (CA19-9) and Carbohydrate antigen 72-4 (CA72-4)] for GC metastases was evaluated by the receiver operating characteristic curve (ROC) analyses. Then we conducted a joint ROC curve analysis. The effects of coagulation parameters and tumor markers on gastric cancer metastasis were assessed using multiple logistic regression analysis. 2049 patients were diagnosed with primary GC, 1398 patients with metastatic GC. Based on comparison of AUC, FDP (cutoff, 1.915) had significantly higher diagnostic efficacy than fibrinogen (P<0.001), CEA (P<0.001), CA199 (P<0.001) and CA724 (P<0.001). No significant difference was observed between D-dimer (cutoff, 0.905) and FDP (P=0.158). The AUC of tumor markers combined with coagulation indexes was higher than that without combination (P<0.001). In multiple logistic regression analysis, age, smoking, D-dimer, FDP, CEA, CA19-9, CA72-4 were found to be significantly associated with GC metastasis (all P<0.001, except for smoking P=0.004). We conclude that plasma FDP and D-dimer may be novel clinical biomarkers for screening metastases of GC.     

Serum hepatocyte growth factor as an index of disease status of patients with colorectal carcinoma.

To evaluate the clinical significance of serum levels of hepatocyte growth factor (HGF) in colorectal cancer patients, we measured the venous and portal concentrations of HGF in 60 patients. The tissue concentrations in the tumour and adjacent normal mucosa were also determined. The serum HGF concentration for the peripheral venous blood of the patients was significantly higher than that in normal controls. The content of HGF in cancer tissue was also significantly higher than that in normal mucosa, and it was correlated with the serum HGF concentration for the peripheral venous blood. The serum concentration of HGF reflected pathological features, including tumour size and lymph node or liver metastasis, and it showed an association with various preoperative nutritional parameters and the preoperative haemoglobin level. The serum HGF concentration was also correlated with the serum concentrations of immunosuppressive acidic protein and interleukin-6, indices of the host''s immunological condition. Serum HGF seems to be a useful index of the disease status of patients with colorectal carcinoma.     

Plaque-forming cell (PFC) technique in the assay of serum blocking activity in lung cancer

The serum blocking activity of 32 patients with lung cancer was assayed by means of PFC technique and half-hemolysis concentration (HC50) test. The results showed that the serum from lung cancer patients had an obvious immunosuppressive effect on antibody production of C3H mice. The PFC number of mice which had received an injection of serum from lung cancer patient was significantly lower than that of the control group which was given an injection of 0.9% saline solution (47.3 +/- 2.9, 89.8 +/- 6.9, P less than 0.01). The serum from patients with various benign lung diseases and healthy adults did not show such immunosuppressive effect (86.5 +/- 8.6, 75.7 +/- 6.0). The results examined by HC50 test also indicated that the antibody level of mice injected with the serum from lung cancer patients was obviously lower than that of control mice (56.3 +/- 3.0, 82.09 +/- 5.0, P less than 0.01). The immunosuppression incidence of serum from lung cancer patients (16/32) was significantly higher than that of serum from patients with benign diseases (3/19) or from healthy adults (2/18). The positive rate of the serum blocking activity in lung cancer patients was 50% which was significantly higher than that of the other two groups. There was no correlation between the immunosuppressive activity and stage or histologic classification of lung cancer. It was also found that higher incidence of immunosuppressive activity was present in the early lung cancer. The result suggests that the serum immunosuppression test using PFC technique be valuable in the early diagnosis of lung cancer.     

The evaluation of fibrinogen behavior in Hodgkin's disease: correlation with clinical stage

Forty-four patients (9 stage II, 15 sage III, 7 stage IV, and 13 in complete remission) with Hodgkin's disease without any clinical coagulation disorder were studied. Fibrinogen behavior was evaluated by measuring fibrinogen level and using 1251-fibrinogen, the half-life, survival and fibrinogen turnover. Platelet count and fibrinogen/fibrin degradation products (FDP) were also assayed. The fibrinogen half-life, survival and turnover were significantly longer and faster, than those found in 10 healthy subjects, in stage II, III and IV subjects (p less than 0.001, p less than 0.001, p less than 0.05 for stage II; p less than 0.001, p less than 0.001, p less than 0.001 for stage III; p less than 0.005, p less than 0.005, p less than 0.001 for stage IV, respectively). In most cases, FDP values were within the normal range, although they were significantly higher than those of control group in stages III and IV. Intravascular coagulation and fibrinolysis were not found in the 13 patients with complete remission. In these patients, the behavior of fibrinogen was normal, suggesting that the parameters studied are related to the presence of the tumor, and can be useful in monitoring the state of remission.