C-12多肿瘤标志物蛋白芯片对老年肺癌的诊断价值

目的 探讨多肿瘤标志物蛋白质芯片检测系统(C-12)在老年肺癌诊断中的临床应用价值.方法 采用C-12检测135例老年肺癌患者(肺癌组)、150例肺良性病变患者(肺良性病变组)、154例无肺部病变及其他肿瘤患者(对照组)12种肿瘤标志物水平.结果 肺癌组C-12检测阳性率明显高于肺良性病变组(P＜0.001)和对照组(P＜0.001).肺癌组糖类抗原19-9(CA199)、癌胚抗原(CEA)、糖类抗原242(CA242)、血清铁蛋白(ferritin)、糖类抗原125(CA125)、糖类抗原153(CA153)阳性率明显高于肺良性病变组(P均＜0.001)和对照组(P均＜0.001).肺癌组CA199、CEA、CA242、β-HCG、CA125、CA153水平较肺良性病变组明显升高(P＜0.01、0.001、0.001、0.05、0.001、0.01)和对照组(P＜0.01、0.001、0.001、0.05、0.001、0.01).在单项肿瘤标志物检测中,以CEA敏感性最高,为46.90%.CA199、CEA、CA242、CA125、CA153联合检测、C-12检测敏感性较单项检测明显提高,分别为65.93%和66.67%.5项联合检测的特异性(94.74%vs 81.32%)、有效性(85.88%vs 81.32%)、5项联合检测阳性预测值(84.76%vs 70.87%)较C-12检测均提高.结论 肺癌组CA199、CEA、CA242、β-HCG、CA125、 CA153水平较肺良性病变组和对照组明显升高.C-12检测对诊断老年肺癌有较高的临床应用价值,CA199、CEA、CA242、CA125、 CA153联合检测可能是诊断老年肺癌更优化的组合.     

肿瘤标志物在肺癌诊断、预后预测中的临床价值

目的分析肿瘤标志物在肺癌诊断及预后预测中的临床应用价值。方法选取肺癌患者68例为观察者,同期参与体检且结果健康者72例为对照组,检测两组血清肿瘤标志物。结果观察组糖类抗原(CA) 125、CA153、癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、细胞角蛋白19片段(CYFRA21-1)水平均明显高于对照组(P<0. 05),小细胞肺癌组CA125、CA153、CEA、NSE、CYFRA21-1阳性率显著高于对照组(P<0. 05);肺鳞癌与肺腺癌组CA125、CA153、CEA、CYFRA21-1阳性率显著高于对照组(P<0. 05),肺鳞癌组CA125、CYFRA21-1阳性率显著高于小细胞肺癌组(P<0. 05),肺腺癌组CA125、CA153、CEA阳性率显著高于小细胞肺癌组(P<0. 05),肺腺癌组CA125、CA153、CEA、CYFRA21-1阳性率与肺鳞癌组比较差异显著(P<0. 05)。统计3年死亡情况,死亡患者中肿瘤标志物阳性率明显高于存活患者(P<0. 05),死亡患者两项及以上肿瘤标志物阳性率明显多于存活患者(P<0. 05)。结论肿瘤标志物可为肺癌患者的诊断及预后预测提供重要信息。     

肺腺癌患者EGFR突变状态与CT影像学及临床特征的关联性研究

目的探讨肺腺癌患者表皮生长因子受体(EGFR)突变状态与CT影像学及临床特征的关联性。方法收集2016-06～2017-12就诊并行EGFR基因检测的149例肺腺癌患者(突变80例,野生型69例)CT影像学及临床资料,比较EGFR突变组与野生型组的CT影像学及临床特征。结果临床特征:女性、无吸烟史、癌胚抗原(CEA)升高的患者EGFR突变率高(P 0. 05)。CT影像学:肿瘤伴有毛刺、胸腔积液的患者EGFR突变率高(P 0. 05)。Logistic回归分析结果提示性别、CEA、毛刺对EGFR突变有预测价值。结论单因素分析结果提示EGFR突变状态与性别、吸烟史、CEA、毛刺及胸腔积液有关联性。Logistic回归分析结果提示女性、CEA升高、毛刺是肺腺癌患者EGFR突变的危险因素。     

肺腺癌患者血清CEA和糖链抗原肿瘤标记物联合测定的临床意义

目的为了探讨85例肺腺癌患者血清CEA和糖链抗原肿瘤标记物水平联合测定的临床意义。方法化学发光免疫分析测定85例肺腺癌、35例肺鳞癌、42例小细胞肺癌和49例良性肺部疾病血清CEA和糖链抗原(CA125、CA199和CA153)水平,并进行了比较性研究。结果 162例肺癌患者中,85例肺腺癌、35例肺鳞癌、42例小细胞肺癌患者血清CEA水平较之49例良性肺部疾病明显增高(P0.001、P0.01和P0.001),以肺腺癌增高最为明显。血清糖链抗原(CA125、CA199和CA153)水平亦然,也以肺腺癌血清CA125、CA199和CA153水平增高最为显著。四项肿瘤标记物的联合测定对85例肺腺癌的敏感性为95.29%和准确性83.76%较之单项肿瘤标记物明显增高(P均0.01),而特异性为75.23%适中。结论四项肿瘤标记物血清CEA和糖链抗原(CA125、CA199和CA153)水平的联合测定,是诊断肺腺癌的有效指标,而且提高了敏感性和准确性。     

血清CEA蛋白联合多因素预测晚期肺腺癌EGFR突变的临床价值

目的探讨血清CEA蛋白和多因素对晚期肺腺癌患者EGFR基因突变的预测价值。方法回顾分析186例肺腺癌性别、吸烟、年龄、肿瘤分期和血清CEA基本资料,探讨上述资料对EGFR基因突变的预测价值。结果女性、不吸烟和Ⅳ期患者,EGFR基因突变率(70.1%、66.1%和61.5%)明显高于男性、吸烟者和ⅢB期患者(45.3%、42.5%和20.0%P0.01);年龄与突变率无关(P0.05)。血清CEA5.0ng/mL比≤5.0ng/mL患者,EGFR基因突变机会更大(P0.01);分析不同CEA浓度梯度,在CEA≤100.0 ng/mL的情况下,EGFR突变率随CEA血清水平升高而升高;当CEA100.0 ng/mL时,EGFR突变率开始下降;绘制ROC曲线得到CEA在5.1ng/mL时,对EGFR基因突变有较高的敏感性74.5%,但特异性偏低;联合性别、吸烟情况及TNM分期,可显著提高敏感性和特异性(91.3%和93.9%)。结论血清CEA蛋白联合性别、吸烟及肿瘤分期在预测肺腺癌EGFR基因突变有较高临床价值,为肺腺癌患者提供靶向治疗依据。     

四种肿瘤标志物诊断乳腺癌的价值探讨

目的比较并评价多项肿瘤标志物在乳腺癌诊断中的敏感性,提高乳腺癌诊断的准确率。方法 200例受试者中查体健康者50例(正常组),乳腺增生患者50例(增生组),乳腺癌患者100例(乳腺癌组)。均行组织特异性多肽抗原(TPS)、癌胚抗原(CEA)、糖类抗原125(CA125)和糖类抗原153(CA153)水平检测。结果乳腺癌组四项标志物水平均明显高于增生组和正常组,P均<0.05;增生组与正常组比较差异无统计学意义。TPS对乳腺癌诊断的敏感度为80.0%,特异性为88.0%;CEA敏感度为40.7%,特异性为86.0%;CA125敏感度为15.3%,特异性为80.0%;CA153敏感度为64.7%,特异性为94.0%。结论在乳腺癌的诊断中TPS和CA153的价值较大;且两者在敏感度和特异性方面有一定互补性。     

腮腺肿瘤患者血清CEA和CA153的表达及意义

采用化学发光免疫法测定31例良性腮腺肿瘤和32例恶性腮腺肿瘤患者血清中血清癌胚抗原(CEA)、糖类抗原(CA)153水平的变化.腮腺恶性肿瘤组患者血清中CEA、CA153的表达水平虽高于良性肿瘤一组,但两者相比,P＞0.05,恶性肿瘤组中CEA的阳性率显著高于良性肿瘤组(P＜0.05).中低分化腺癌患者血清CEA和CA153值均明显升高,肌上皮癌患者血清CEA值均明显升高.我们认为检测血清CEA、CA153在鉴别腮腺肿瘤性质方面有一定的临床应用价值.     

肿瘤标志物联合检测在肺癌诊断的临床意义

目的探讨多种肿瘤标志物联合检测在肺癌诊断中的意义。方法检测42例肺癌患者血清中癌胚抗原(CEA)、糖类抗原19-9(CA19-9)、糖类抗原125(CA125)、糖类抗原15-3(CA15-3)的浓度。并于同期选择50例健康体检者检测同样的项目作为对照分析。结果肺癌组血清肿瘤标志物测定值显著高于对照组。结论 4种肿瘤标志物联合检测对于肺癌的鉴别诊断和治疗方案的确定有重要意义。     

扶正消癥汤联合SOX化疗方案治疗老年胃癌的效果

目的 探究在老年胃癌患者SOX(奥沙利铂+替吉奥)化疗方案中加用扶正消癥汤对治疗效果的影响。方法 前瞻性纳入2018年1月至2021年1月于苏州大学附属第一医院收治的80例老年胃癌患者，采用随机数字表法分为两组，每组40例。对照组实施SOX化疗方案治疗，观察组在对照组基础上加用扶正消癥汤治疗，共治疗6个化疗周期。比较两组治疗前及6个化疗周期后血清肿瘤标志物[糖类抗原(CA)125、癌胚抗原(CEA)、CA199]水平、免疫功能(CD3⁺、CD4⁺、CD4⁺/CD8⁺),统计两组治疗期间毒副反应程度，并比较两组总生存期及无进展生存期。结果 两组治疗6个化疗周期血清肿瘤标志物(CA125、CEA、CA199)水平比治疗前均明显降低，且观察组均明显低于对照组(P<0.05);两组治疗6个化疗周期后免疫功能(CD3⁺、CD4⁺、CD4⁺/CD8⁺)比治疗前均明显升高，且观察组均明显高于对照组(P<0.05);...     

5种肿瘤标志物联合检测对肺癌的诊断价值

目的探讨5种肿瘤标志物联合检测对肺癌的诊断价值。方法采用蛋白质芯片检测系统（C-12）检测81例肺癌患者和85例肺良性病变患者血清中5项肿瘤标志物的水平。结果肺癌组5种肿瘤标志物检测水平值均明显高于肺良性病变组（P〈0.05）。CEA有高的敏感度和特异度（43.21%和100%）。两项、三项及四项联合最优化的组合分别为CEA＋CA242、CEA＋CA242＋CA153、CEA＋CA242＋CA153＋CA199。结论 5种肿瘤标志物的联合检测明显提高了对肺癌诊断的灵敏度和准确性,有一定的临床价值。     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.