血清YKL-40及sLOX-1水平与急性缺血性脑梗死患者短期预后的相关性研究

目的 探讨血清甲壳质酶蛋白-40(YKL-40)及可溶性凝集素样氧化型低密度脂蛋白受体-1(sLOX-1)水平与急性缺血性脑梗死患者短期预后的相关性.方法 收集2017年6月至2020年6月我院诊治的急性缺血性脑梗死患者168例,依据患者脑梗死体积分为大梗死组(n = 36)、中梗死组(n = 77)、小梗死组(n= ...     

血清YKL-40和CA125联合检测在卵巢癌诊断中的应用

目的探讨血清YKL-40和CA125联合检测在卵巢癌诊断中的应用价值。方法分别用酶免分析法（EIA）和微粒子酶免分析法（MEIA）测定39例卵巢癌、27例卵巢良性肿瘤及40例健康对照妇女血清YKL-40和CA125水平,YKL-40以健康对照组95％可信区间的上限值为阳性,比较YKL-40和CA125在三组间、卵巢癌病人不同临床分期和手术治疗前后水平和阳性率的差异。结果正常对照组血清YKL-40水平的95％可信区间的上限值为71．9ng／mL;卵巢癌患者血清YKL-40水平及阳性率显著高于卵巢良性肿瘤组和对照组（t〉4．83,P〈0．01）,而卵巢良性肿瘤组和对照组之间差异无统计学意义（t=0．96,P〉0．05）。Ⅲ／Ⅳ期卵巢癌患者血清YKL-40水平显著高于Ⅰ／Ⅱ期患者（167．9ng／mL vs 87．7ng／mL,t=1．86,P〈0．01）。卵巢癌患者术后第3天和第7天血清YKL-40水平显著低于术前水平（t〉2．92,P〈0．01）;未能手术切除的患者血清YKL-40水平显著高于手术切除者（t=4．06,P〈0．01）。YKL-40联合CA125诊断卵巢癌的灵敏度为87．2％,特异性为91．0％,阳性预测值为85．0％,阴性预测值为92.4％;YKL-40与CA125联合诊断早期卵巢癌的灵敏度从CA125单指标的33．3％提高到66．7％。结论YKL-40是一种新的诊断卵巢癌的肿瘤标志物,联合YKL-40与CA125检测可提高对早期卵巢癌诊断的灵敏度。     

上皮性卵巢癌患者肿瘤组织及血清中YKL-40的表达及临床意义

目的探讨甲壳质酶蛋白40（YKL-40）在上皮性卵巢肿瘤发生发展中的作用。方法 （1）免疫组化法检测20例上皮性良性卵巢肿瘤、10例交界性卵巢肿瘤及30例卵巢癌组织中YKL-40的表达情况。（2）酶联免疫吸附法检测三组患者血清中YKL-40的水平。结果 （1）YKL-40在卵巢癌组织的阳性表达率高于良性组（P〈0.05）;交界组与卵巢癌组无差异（P〉0.05）,但卵巢癌组YKL-40染色强度高于交界组（P〈0.05）;早期卵巢癌（Ⅰ、Ⅱ期）组织中阳性表达率低于晚期卵巢癌（Ⅲ、Ⅳ期）组织中阳性表达率（P〈0.05）,YKL-40组织中表达水平与卵巢癌临床分期呈正相关（P〈0.05）。（2）上皮性良性卵巢肿瘤、交界性卵巢肿瘤及卵巢癌患者中,血清YKL-40的中位数分别为41.42、44.34、130.25（μg/L）。卵巢癌组血清YKL-40水平高于前二组,差异有统计学意义（P〈0.05）,前二组比较差异无统计学意义。卵巢癌患者血清YKL-40浓度与临床分期及CA125浓度呈正相关（P〈0.05）。结论 YKL-40蛋白可能参与了卵巢肿瘤的发生发展过程。     

血清YKL-40对非酒精性脂肪肝肝纤维化的预测作用

目的探讨非酒精性脂肪肝患者血清中YKL-40水平及在肝纤维化程度评价中的价值。方法2017年7月至2019年7月于我院就诊的NAFLD患者142例,根据是否发生肝纤维化分为纤维化组(n=60)与非纤维化组(n=82),另纳入40例健康体检者作为健康对照组,采用放射免疫分析法测定血清中透明质酸(HA)、III型前胶原(PC III)、IV型胶原(CIV)及层粘连蛋白(LN)水平。采用双夹心抗体ELISA法检测血清YKL-40水平。结果三组研究对象年龄、性别、BMI指数等一般性资料差异无统计学意义(P>0.05);健康对照组、S0~S4期血清YKL-40水平随着肝纤维化分期的不断增加而不断升高(P<0.05)。血清YKL-40水平与NFS、FIB-4、APRI评分均呈显著正相关关系,具有统计学意义(P<0.05)。ROC分析结果表明,当Cutoff值为158 ng/mL时,YKL-40对NAFLD患者肝纤维化诊断价值最高,其AUC、灵敏度、特异性、PPV、NPV等均高于传统肝纤维化指标,差异具有统计学意义(P<0.05)。结论血清YKL-40在非酒精性脂肪肝患者中水平明显升高,对肝纤维化具有良好的预测价值。     

基于Pearson相关系数的血清YKL-40水平与哮喘指标相关性研究的Meta分析

目的 利用Meta分析的方法,基于Pearson相关系数评估血清YKL-40水平与支气管哮喘相关实验室指标、哮喘患者基线特征的相关性.方法 通过搜索Pubmed、OVID、Cochrane数据库,检索时间为建库至2020年10月,最终根据纳入标准筛选文献.评估纳入文献质量及提取必要数据后,采用Revman 5.3软件进行Meta分析.结果 最终纳入14篇文献,参与项目的受试者共4125例.文献质量较高.Meta分析结果提示血清YKL-40水平与哮喘患者年龄、BMI、吸烟史、肺功能指标存在相关性,与血嗜酸性粒细胞绝对值、IgE、FeNO、血中性粒细胞绝对值无关.结论 血清YKL-40可能一定程度上反映哮喘患者肺损伤程度,却与IL-13以外的Th2免疫反应机制无关.     

血清YKL-40蛋白水平与非肌层浸润性膀胱癌复发的临床关系研究

目的:探讨患者血清YKL-40蛋白水平与非肌层浸润性膀胱癌(non muscle-invasive bladder cancer, NMIBC)复发的临床关系.方法:选取76例NMIBC患者,其中34例为术后随访两年内确诊复发患者、42例为术后随访两年未见复发患者,及健康对照组31例,采取清晨血清样本,采用酶联接免疫吸附剂测定法(ELISA)检测患者血清中YKL-40水平.结果:NMIBC患者血清YKL-40水平显著高于健康对照组(P<0.001),同时,NMIBC复发组患者血清YKL-40水平高于非复发组(P=0.001).结论:血清YKL-40蛋白水平在非肌层浸润性膀胱癌复发中有着较高的临床诊断价值,可作为监测患者术后复发的一种新分子标志物,为患者术后相关后续治疗提供参考.     

急性脑梗死患者血清超敏肌钙蛋白-T检测及其临床意义

正急性脑梗死易引起继发性心脏损害,表现为心脏功能的紊乱及心电活动的改变,这在临床上称为脑心综合症。已有一些研究表明,10%～27%急性脑梗死患者血清肌钙蛋白含量升高[1-3]。为探讨急性脑梗死患者血清超敏肌钙蛋白含量升高与脑梗死的诊断和预后的关系。本文对66例急性脑梗死患者和50名健康查体者血清超敏肌钙蛋白hs-TNT含量进行了分析。     

C-反应蛋白、血清淀粉样蛋白A和YKL-40在小儿复发性肺炎中的联合检测作用

目的 探讨C-反应蛋白(C-reactive protein,CRP)、血清淀粉样蛋白A(serum amyloid A,SAA)和人软骨糖蛋白39(human cartilage glycoprotein 39,YKL-40)在小儿复发性肺炎中的表达及联合检测作用.方法 选取2016年5月至2017年4月本院收治的小儿复发性肺炎患儿50例为观察一组,本院收治的首次肺炎发作患儿50例为观察二组,和同期体检健康儿50例为对照组.收集受试儿血清并检测血清中CRP、SAA和YKL-40水平.结果 与对照组相比,观察一组和观察二组患儿血清CRP、SAA和YKL-40显著升高;经常规治疗后,观察一组和观察二组患儿血清CRP、SAA和YKL-40水平显著降低,差异具有统计学意义(P＜0.05).患儿血清CRP、SAA和YKL-40联合检出率显著高于各指标单独检出率.结论 CRP、SAA和YKL-40在小儿复发性肺炎患儿血清中呈过表达状态,且CRP、SAA和YKL-40联合检测及实时监测对于诊断重症肺炎具有重要的临床意义.     

急性脑梗死患者治疗前后血清Hcy和hs-CRP检测的临床意义

目的:探讨了急性脑梗死患者治疗前后血清同型半胱氨酸(Hcy)和超敏C-反应蛋白(hs-CRP)水平的变化及意义.方法:应用免疫比浊法和化学发光法对40例急性脑梗死患者进行了血清Hcy和hs-CRP水平检测,并与35名正常健康人作比较.结果:在治疗前急性脑梗死患者血清Hcy和hs-CRP水平非常显著地高于正常人组(P＜0.01),且与梗死灶面积呈正相关(P＜0.05),经治疗后一周则与正常人组比较无显著差异(P＞0.05).结论:检测急性脑梗死患者血清Hcy和hs-CRP水平的变化对判断病情和评价疗效均具有重要的临床价值.     

双抗体夹心法测定血清YKL-40在肝硬化中的诊断价值研究

探讨肝硬化(liver cirrhosis,LC)患者外周血中血清YKL-40(壳多糖酶3样蛋白1)蛋白水平及其在LC中的诊断意义。采用ELISA方法共检测112例LC患者以及114例健康者血清中YKL-40蛋白水平,并进一步分析其在LC中的诊断价值及其与LC患者肝功能和现有肝纤维化指标的相关性。LC组血清YKL-40蛋白水平高于正常对照组(P0.001);将LC组和对照组作比较,ROC曲线分析血清YKL-40蛋白对LC的诊断效能,曲线下面积(area under the curve,AUC)为0.934(95%置信区间为:0.904~0.964),YKL-40在cutoff值为92.25ng/mL时,敏感度为81.3%,特异度为90.4%;通过相关性分析发现血清YKL-40蛋白水平与肝功能Child-Pugh分级和FIB-4指数正相关。YKL-40对LC具有良好的诊断效力,能辅助诊断LC并有助于判断LC的严重程度。     

Increased immunohistochemical expression of YKL-40 in the spleen of patients with portal hypertension

YKL-40 has been identified as a growth factor in connective tissue cells and also a migration factor in vascular smooth muscle cells. To a large extent, the increase of serum YKL-40 is attributed to liver fibrosis and asthma. However, the relationship of the expression and clinical/prognostic significance of YKL-40 to the splenomegaly of patients with portal hypertension is unclear. In the present study, the expression of YKL-40 was studied by immunohistochemistry in 48 splenomegaly tissue samples from patients with portal hypertension and in 14 normal spleen specimens. All specimens were quickly stored at -80°C after resection. Primary antibodies YKL-40 (1:150 dilution, rabbit polyclonal IgG) and MMP-9 (1:200 dilution, rabbit monoclonal IgG) and antirabbit immunoglobulins (HRP K4010) were used in this study. The relationship of clinicopathologic features with YKL-40 is presented. The expression of YKL-40 indicated by increased immunochemical reactivity was significantly up-regulated in splenomegaly tissues compared to normal spleen tissues. Overexpression of YKL-40 was found in 68.8% of splenomegaly tissues and was significantly associated with Child-Pugh classification (P = 0.000), free portal pressure (correlation coefficient = 0.499, P < 0.01) and spleen fibrosis (correlation coefficient = 0.857, P < 0.01). Further study showed a significant correlation between YKL-40 and MMP-9 (correlation coefficient = -0.839, P < 0.01), indicating that YKL-40 might be an accelerator of spleen tissue remodeling by inhibiting the expression of MMP-9. In conclusion, YKL-40 is an important factor involved in the remodeling of spleen tissue of portal hypertension patients and can be used as a therapeutic target for splenomegaly.     

High serum YKL-40 level in a cohort of octogenarians is associated with increased risk of all-cause mortality

YKL-40 is secreted by macrophages, neutrophils, chondrocytes, endothelial-, vascular smooth muscle- and cancer cells. Interleukin (IL)-6 stimulates YKL-40 production in human in vivo studies. High serum YKL-40 is associated with poor prognosis in patients with inflammatory diseases and cancer. We studied whether serum YKL-40 was associated with systemic low-level inflammation, an immune risk phenotype, and mortality in relatively healthy 80-year old humans. Serum YKL-40, IL-6 and tumour necrosis factor (TNF)-alpha were measured by enzyme-linked immunosorbent assays (ELISAs) in octogenarians (n = 151) and serum YKL-40 in 18-30-year-olds (n = 89). Fifty-one of the octogenarians died during the 6-year follow-up. Serum YKL-40 in octogenarians was higher compared to the level in young people (median 116 versus 31 microg/l, P < 0.0005). Serum YKL-40 correlated with serum IL-6 in elderly women (Spearman's rho = 0.30, P = 0.009) and men (rho = 0.25, P = 0.003), but only with serum TNF-alpha (rho = 0.23, P = 0.05) and C-reactive protein (CRP) (rho = 0.57, P < 0.0005) among the elderly women. In addition, high serum level of YKL-40 was associated with a low CD4 : CD8 cell ratio. Univariate analysis of serum YKL-40 (logarithmically transformed and divided by tertiles) showed significant association with all-cause mortality [tertile 3: hazard ratio (HR) = 2.38, 95% confidence interval (CI): 1.19-4.78, P = 0.02]. The effect persisted after adjusting for potential confounders (sex, smoking, body mass index, chronic disease and anti-inflammatory medicine). These results suggest that serum YKL-40 is a prognostic and sensitive biomarker of all-cause mortality in octogenarians.     

磁共振联合磁敏感加权成像评估急性脑梗死的临床价值

目的:探讨磁共振成像（MRI）联合磁敏感加权成像（SWI）评估急性脑梗死预后的临床价值。方法:采用随机数字表法将100例急性脑梗死患者分为观察组（n=50）和对照组（n=50）。对照组行MRI检查,观察组行MRI联合SWI检查。比较两组患者的疾病检出率、脑微出血检出情况。结果:观察组疾病检出率显著高于对照组（96.0% vs 78.0%, P<0.05）;观察组脑微出血检出率显著高于对照组（64.0% vs 12.0%, P<0.05）;观察组的出血检出面积为（972.83±110.54） mm2,显著高于对照组的（532.71±110.53） mm2（P<0.05）。观察组脑梗死面积诊断评分显著小于对照组（P<0.05）。入院15 d后,观察组神经功能缺损程度评分明显低于对照组（P<0.05）;观察组神经功能缺损程度稳定率及好转率显著高于对照组（P<0.05）。结论:MRI联合SWI检查对急性脑梗死疾病的检出率明显较高,能够准确预测脑微出血,有助于制定正确的临床治疗方案,改善急性脑梗死患者的预后。     

Overexpression of YKL-40 is an independent prognostic marker in gastric cancer

YKL-40 is a growth factor for connective tissue cells and a migration factor for endothelial cells. Elevated serum level of YKL-40 has been associated with poor prognosis in many cancers. However, the status of YKL-40 expression and its clinical/prognostic significance in gastric cancer are unclear. In this study, the expression of YKL-40 was studied by immunohistochemistry in gastric cancer tissue microarray containing 172 primary gastric cancer cases and 70 adjacent nonneoplastic mucosa specimens. The correlations between YKL-40 expression and clinicopathologic features, as well as activation of PI3K/Akt pathways were addressed. Expression of YKL-40 was significantly higher in gastric cancer tissues than that in adjacent nonneoplastic tissues. Overexpression YKL-40 was found in 28.4% of gastric cancers and was significantly associated with tumor invasion (P = .007) and lymph node metastasis (P = .009). For survival study, overexpression of YKL-40 was significantly associated with worse outcome (P = .001). When known clinical variables were added to a multivariate analysis, TNM stage, tumor size, and overexpression of YKL-40 emerged as independent prognostic factors. Further study indicated that the oncogenic function of YKL-40 might be through the activation of Akt pathway. These results suggest that overexpression of YKL-40 is correlated with the aggressive behavior of tumor cells, which could be used as an independent molecular marker for the predicting poor prognosis of patients with gastric cancer.     

Increased tissue immunoexpression of YKL-40 protein in high grade serous ovarian cancers

YKL-40 is a glycoprotein secreted by numerous human cells, such as cartilage, synovial, and endothelial cells. The biological role of YKL-40 has not yet been fully unveiled, however, its participation is perceived in angiogenesis, growth, proliferation, differentiation, and remodeling processes. The primary goal of our study was to evaluate possible differences in tissue immunoexpression of YKL-40, assumed between high grade and low-grade ovarian cancers and between the above-mentioned cancer types and benign lesions. Another purpose was to find out whether immunoexpression of the studied protein could correlate with the tumor proliferation process, evaluated by Ki-67 immunoexpression.The analysis comprised 45 women, diagnosed and treated for epithelial ovarian tumors at the Medical University of Lodz between 1997 and 2002. YKL-40 protein immunoexpression was semiquantitatively assessed, whereas immunoexpression of Ki-67 was evaluated using a computer image analysis system. Significantly higher immunoexpression values of both examined proteins were observed in high-grade serous ovarian cancers vs. low-grade and benign tumors. Moreover, a significant positive correlation was identified between the immunoexpressions of YKL-40 and Ki-67 proteins in the studied groups of tumors.In conclusion, the obtained data suggest an overt prominence of TKL-40 tissue immunoexpression of YKL-40 in high-grade serous ovarian tumors, which could then be approached as a helpful, additional marker to identify more aggressive ovarian cancers.