肝癌相关抗原HAg18—1ELISA诊断药盒对肿瘤病人血清学诊断的临床意义

本文报告用ＨＡｇ１８－１ ＥＬＩＳＡ诊断药盒测定肝细胞肝癌病人，胃、肠、肺、乳腺等多种恶性肿瘤病人血清及对肿瘤组织浸液的ＨＡｇ１８－１阳性率，其数值分别为８０．０％－８６．１％、４４．２％－７６．２％和６２．０％。肝细胞肝癌的阳性率最高，在多种恶性肿瘤病人中广泛交叉存在、且血清阳性的６个病例手术探查肝脏正常。但ＨＡｇ１８－１在术后临床无病阶段的多种恶性肿瘤病人及非肿瘤对照者阳性率很低，分别为４．１     

肝癌相关抗原HAg18—1 ELISA诊断药盒在血清学诊断中的应用

应用HAg 18-1 ELIsA诊断药盒,对原发性肝癌(PHc)、肝炎及肝炎伴有肝硬化、其他癌(肺癌、胃癌、结肠癌)以及正常人,共400例,进行了血清学的检测。结果显示:HAg 18-1 ELISA阳性检测率,PHC为81％,肝炎及伴有肝硬化为30％,肺癌为36％,胃癌为28％,结肠癌为12％,正常人为0。PHC组HAg 18-1 ELISA检测阳性率显著高于其他各组(P<0.05)。此外PHC 80例中有56例同时伴有AFP的检测,其中AFP 17/56阴性,17例阴性中HAg 18-1 ELISA检测阳性10例(59％),故对AFP检测PHC具有明显协同和补充诊断价值。此药盒操作简便,易于推扩,对PHC的临床诊断和普查提供了新方法。     

肝癌相关抗原HAg18的研究及其应用

用抗人肝癌单克隆抗体HAb18亲和层析纯化相应抗原,经SDS-PAGE及免疫印迹试验证实其分子量为61kD。抗原活性条带经高碘酸钠氧化及氯仿-甲醇-冰乙酸处理抗原无丢失,但经胰蛋白酶酶解后失活。PAS及苏丹Ⅲ染色均为阴性。用HAb18ELISA双抗体夹心法可检测肝癌病人血清中抗原水平,阳性率为65.1％(250/384)。HAb18配伍另一肝癌单克隆抗体,制成ELA快速诊断盒,肝癌检出率提高至70.6％(271/384)。免疫酶斑点测定HAg18与AFP、铁蛋白、C-EA无交叉。故认为HAb18是一新的肝癌蛋白性抗原。     

血清TSGF与AFP联合检测对良恶性肝病的诊断价值

恶 性肿瘤特异性生长因子 (ＴＳＧＦ)是一种和恶性肿瘤增殖有关的血清学肿瘤标记物 ,它具有检测瘤谱广、灵敏度高等优点 ,成为目前使用较广的一种肿瘤筛选指标[1 ] 。但不同肿瘤的ＴＳＧＦ含量与阳性率差别较大[2 ] 。ＡＦＰ曾被认为是最好的肝癌诊断指标 ,但其阳性率仅有 60 %～ 70 % ,即我国有 30 %～ 40 %属ＡＦＰ阴性肝癌患者[3] 。本文对良恶性肝病患者血清ＴＳＧＦ及ＡＦＰ的含量进行测定 ,意在探讨二者联合检测诊断原发性肝癌的价值。1　材料和方法1 .1　对象1 .1 .1　对照组 :50例健康体检者 ,其中男 32例 ,女 1 8例 ,年龄 2 0岁～ …     

血清TSGF,AFP,GGT检测对肝癌诊断的意义

肝癌患者早期很少临床表现,难于发现,恶性程度高易转移,死亡率高。目前检测肝癌的方法较少,放射免疫法检测血清中的甲胎蛋白(AFP)的含量。特异性高,阳性率达80 %左右,有少部份不产生AFP的肝癌病人则AFP阴性,使患者失去了及时的治疗机会。我们用组合方式检测血清中恶性肿瘤相关物质(TSGF)、AFP、γ-谷氨酰基转移酶(GGT)的含量对提高肝癌诊断的敏感性和特异性有较大的价值,对肝癌的早期诊断十分必要。现将结果报告如下。1　对象和方法1 1　对象　患者组为本院住院肝癌患者10 0例(男78,女2 2 ) ,年龄(4 5～70 )岁,肝硬化患者10 0例(男6…     

循环miRNA监测肝细癌的研究

肝癌是目前临床上最常见的恶性肿瘤之一,其早期诊断的困难导致了后期治疗的不理想化,因此肝癌的死亡率常年居高不下。现有的研究结果显示,多种miRNA的表达在正常人群和肝癌患者群体的组织甚至体液中的表达量有很大的差异。miRNA可能在肝脏肿瘤的发生发展中起到了至关重要的作用。本文就肝脏的生理功能、肝细胞癌的发生发展、常规诊断、miRNA与肝癌的关系等方面的研究作一综述。     

CYFRA21-1、CA724、AFP联合检测对原发性肝癌的诊断价值

探讨血清CYFRA21-1、CA724、AFP联合检测对原发性肝癌（PHC）的诊断价值。选取PHC患者65例、肝硬化患者47例、正常对照组40名,应用电化学发光免疫分析技术检测其血清CYFRA21—1、CA724、AFP水平。结果表明：PHC患者血清AFP、CYFRA21—1、CA724阳性率分别为72．3％、44．6％、35．4％;AFP、CYFRA21-1和CA724三项联合检测阳性率有显著提高,达95．4％,与单-AFP阳性率相比有显著性差异（P〈0．05）,而特异性无明显下降（P〉0．05）。AFP、CY-FRA21-1和CA724联合检测对原发性肝癌的诊断具有良好的临床应用价值。     

血清TSGF与AFP联检对肝癌诊断的实验探讨

恶性肿瘤特异性生长因子(TSGF)是一种和恶性肿瘤增殖有关的血清学肿瘤标记物,它具有检测瘤谱广、灵敏度高等优点,但不同肿瘤的TSGF含量与阳性率差别较大.AFP曾被认为是最好的原发性肝癌标志,但阳性率也仅有60%-70%,且我国肝癌有30%-40%属AFP阴性.我们检测了良恶性肝病患者血清TSGF及AFP的含量,以探讨两者联合检测诊断原发性肝癌的价值.     

AFP,CEA,SF,CA19—9,CA72—4联检对肝癌诊断的临床意义

为了提高肝癌诊断的阳性率,我们开展AFP、CEA、SF、CA19-9、CA72-4五种肿瘤标志物,对肝癌进行联合检测,探讨其在临床的意义,现将结果报告如下。 对象和方法 一、对象:100例肝癌患者(男75,女25),全部为我院住院病人,年龄18～71岁。平均54岁。均经病理、CT等确诊为原发性肝细胞肝癌。 二、方法: (一)标本收集:均取晨空腹静脉血3ml,分离     

联合检测AFU与AFP对原发性肝癌的诊断价值

原发性肝癌(PHC)是常见恶性肿瘤之一,AFP对PHC的诊断有重要价值,但阳性率只有60～70％;AFU作为诊断PHC新的标志物,其阳性率亦只有70～80％。本文同时检测AFU和AFP,可提高诊断阳性率。 1 材料与方法 1.1 检测对象 PHC组121例,其中男107例,女14例,年龄22～76岁,平均43.2岁,诊断标准按中国抗癌协会1990年制定的原发性肝癌诊疗标准诊断,并排除转移性肝癌,其中7例经活检、21例经手术病理证实;对照组为本院血库体检正常的献血员50例,其中男39例,女11例,年龄20～46岁,平均32.7岁。     

8-hydroxydeguanosine and nitrotyrosine are prognostic factors in urinary bladder carcinoma

Oxidative stress markers and peroxiredoxins are connected to cancer. A large set of urinary bladder carcinomas were studied for the expression of nitrotyrosine and 8-hydroxydeguanosine (8OHdG), two markers indicating oxidative damage. Serum and urine 8-OHdG were assessed in a subset of patients. We also analysed immunohisto-chemically the expression of nrf2, keap1, all six peroxiredoxins (prx) and thioredoxin (trx) in these tumors. 15 % of the cases showed 8OHdG and 36 % nitrotyrosine positivity. Expression of nitrotyrosine and 8OHdG associated with a poor prognosis (p=0.050, p=0.011, respectively). Peroxiredoxin positivity ranged from 39 % to 84 % lowest expression being for prx 4 and highest for prx 3. Prx 4 expression associated with a poor prognosis (p=0.025) with high grade (p=0.044) and larger tumors (p=0.023). Cytoplasmic trx positivity was seen in 91 % and nuclear in 59 % of tumors. Nuclear and cytoplasmic trx associated with each other (p<0.001), and nuclear trx associated with prx 6 (p=0.001), prx 2 (p<0.001), and prx 5 (p<0.001). 8OHdG associated with nuclear trx positivity (p=0.002), inversely with prx 1 (p=0.025) and with keap1 (p=0.020). Nuclear nrf2 was associated with nitrotyrosine (p=0.042). The results show that the amount of oxidative stress in urinary bladder tumors affects the prognosis of the patients. Of antioxidative enzymes, prx4 associated with an unfavourable prognosis. Selective inhibition of prx4 expression might then be one additional option of treatment of bladder cancer.     

Value of Islet 1 and PAX8 in identifying metastatic neuroendocrine tumors of pancreatic origin

Neuroendocrine tumors can present as liver metastases before discovery of the primary tumor. Islet 1 and PAX8 have recently been proposed as markers for neuroendocrine tumors of pancreatic origin. In this study, we compared the utility of Islet 1 and PAX8 in distinguishing pancreatic neuroendocrine tumors from neuroendocrine tumors of other sites and determined the usefulness of an immunohistochemical panel, including TTF1, CDX2, Islet 1 and/or PAX8, in identifying metastatic pancreatic neuroendocrine tumors. A total of 110 primary neuroendocrine tumors (33 pancreatic, 31 pulmonary, 23 ileal, 14 rectal, and 9 gastric) and 73 metastatic neuroendocrine tumors (28 pancreatic, 5 pulmonary, 37 ileal, 1 rectal, 1 colonic, and 1 duodenal) were studied. Islet 1 and PAX8 were positive in 27/33 (82%) and 29/33 (88%), respectively, of primary pancreatic neuroendocrine tumors, and in 19/28 (68%) and 15/28 (54%), respectively, of metastatic pancreatic neuroendocrine tumors. No cases of primary (0/23) or metastatic (0/37) ileal neuroendocrine tumors were positive with either Islet 1 or PAX8. There was Islet 1 positivity in 2/31 (6%) primary pulmonary, 12/14 (86%) primary rectal, and 1/1 metastatic rectal neuroendocrine tumors, and PAX8 positivity in 7/31 (23%) primary pulmonary, 11/14 (79%) primary rectal, and 2/9 (22%) primary gastric neuroendocrine tumors. ROC curve analysis incorporating sensitivity and specificity data of immunohistochemical panels for metastatic pancreatic neuroendocrine tumors showed that a four-stain panel, including Islet 1, PAX8, TTF1, and CDX2 significantly outperformed a three-stain panel composed of PAX8, TTF1, and CDX2 (P=0.019), and also showed a trend for better performance compared with a three-stain panel composed of Islet 1, TTF1, and CDX2 (P=0.072). Both Islet 1 and PAX8 are reliable immunohistochemical markers for pancreatic neuroendocrine tumors and would be useful adjuncts to other markers (TTF1, CDX2) currently used to work up a metastatic neuroendocrine tumor of unknown primary.     

High serum levels of soluble CD8 in insulin-dependent diabetes.

In type 1 (insulin-dependent) diabetes mellitus (IDDM) CD8+ T cells represent the majority of lymphocytes which infiltrate the pancreatic islets during beta cell destruction. Soluble CD8 antigen (sCD8) has been shown to correlate with CD8 cell subset activation. In this study we measured by ELISA sCD8 levels in sera from: 33 newly diagnosed IDDM patients; 29 type 1 diabetics with duration of disease more than 1 year; 37 healthy siblings of IDDM patients; 19 healthy controls. Sera from both groups of IDDM patients and from healthy siblings exhibited soluble CD8 mean levels significantly higher than controls (P = 0.0001, P < 0.003, P < 0.03 respectively). Soluble CD8 levels above the normal range (mean +/- 2 s.d. of controls) were found in a percentage of newly diagnosed subjects (54.5%) significantly higher than in subjects with a long-standing duration of disease (6.9%, P < 0.0005) and healthy siblings (16.2%, P < 0.002). Our results suggest that the raised levels of soluble CD8 near to diabetes onset may indicate the activation of CD8+ T cells probably responsible for the autoimmune beta cell destruction.     

TNF-α-238G/A基因多态性与原发性肝癌的关系

目的 探讨肿瘤坏死因子-α（TNF-α）基因启动子-238G/A多态性与原发性肝癌（PHC）的相关关系.方法 应用聚合酶链反应-限制性片段长度多态性法（PCR-RFLP）检测100例PHC患者和150例健康对照者TNF-α基因启动子-238G/A多态性.结果 TNF-α-238基因型GG、GA频率在PHC组和对照组分别为95.3%和4.7%,88%和12%;等位基因G、A频率在PHC组和对照组分别为97.7%和4.7%,94%和6%.两组差异均有显著性（P＜0.05）,携带GA基因型个体患PHC的风险约是GG基因型的2.786倍（OR=2.786,95%CI=1.057～7.343）.结论 TNF-α-238G/A基因多态性与PHC的发病有相关性,A等位基因可能是PHC的遗传易感基因.     

Interleukin 8 is a surrogate marker for rapid diagnosis of bacteriuria

Urinary tract infection (UTI) is one of the most common sources of infection in children under 5. Rapid diagnosis is a need to avoid complications of UTI. The goal of the present study was to evaluate the use of urinary interleukin 8 (IL8) as a rapid laboratory method for diagnosis of UTI. A total of 116 children were included in the study. They were complaining of different diseases with pyuria. In addition twenty healthy children were included as control subjects. Urine samples were subjected to full chemical, cytological and bacteriological examinations. In addition, urinary IL8 was measured. Patients showed significantly elevated urine IL-8 levels (80-820 pg/ml) compared to control subjects (6-10 pg/ml) (p < 0.0001). There was significant correlation between interleukin 8 level and white blood cells counts in urine (p = 0.039). The mean +/- SD of urinary IL-8 was significantly increased 165.8 +/- 115.1 in urine with bacterial growth (Staphylococcus species and Escherichia coli) p < 0.001 than in urine without growth. Urine with Escherichia coli (E. coli) growth had significantly higher IL 8 level than growth with other types of organisms. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value had higher level for IL8 compared to other parameters in urine examination i.e., nitrite, WBCs and RBCs (85.7%, 60%, 64%, 87%, 64% respectively). This study highlights that bacteriuria is associated with higher level of urinary interleukin 8 than pyuria without bacteriuria. Thus from this study we can conclude that IL8 can be used as rapid surrogate marker for rapid laboratory diagnosis of urosepsis.     

The clinical efficacy of Bladder Chek NMP22 in urothelial cancer

The purpose of this study is to investigate the clinical efficacy of a quick test for NMP22 (Nuclear Matrix Protein 22), Bladder Chek NMP22, as a screening test for urothelial cancers. The subjects include 51 cases(43 cases with pathologically confirmed bladder cancer, and 8 cases with upper urothelial cancer). Bladder Chek NMP22 revealed false positive in the urine with more than 1 x 10(5)/microliter of erythrocytes and 1 x 10(3)/microliter of white blood cells. Thus, showing that Bladder Chek NMP22 was not relatively affected by the contaminated erythrocytes and white blood cells, compared with other conventional methods to detect urinary malignant disease. In 51 cases diagnosed of having pathologically urothelial cancers, the sensitivity of Bladder Chek NMP22 was 56.8%. Bladder Chek NMP22 demonstrated more excellent sensitivity than the other methods. The positivity of Grade3 patients was 68.4%, 68.4% and 63.2% by Bladder Chek NMP22, NMP22 ELISA and urinary cytology. In contrast, the positivity rate for the patients with Grade1 stage was 58.3%, 33.3% and 8.3%. There is no significance of positivity rate between each examination in patients with high grade cancer. However Bladder Chek NMP22 demonstrated the higher positivity in patients with low grade cancer. Bladder Chek NMP22 test could be an easy and confidential method to detect urothelial cancers, especially with low grade, as a screening examination.     

Flow-cytometric algorithm on fine-needle aspirates for the clinical workup of patients with lymphadenopathy

To analyze the value and limitations of flow cytometry (FCM) in the investigation of patients with lymphadenopathy, a retrospective study of 196 patients, referred for fine-needle aspiration (FNA) cytology, was carried out in Canberra, Australian Capital Territory, Australia, between 1992–1997. Complete cytological, flow-cytometric, and outcome (clinical and histological) data were available on all the cases. The FNA appearances were read in conjunction with FCM findings. The following cytological categories were recognized: benign, 78 cases (39.8%); indeterminate, 9 cases (4.6%); and malignant, 109 cases (55.6%). None of the 78 cytologically benign cases had malignant outcome. All 109 cytologically malignant cases had malignant histology, and 8/9 of the cytologically indeterminate FNAs had malignant histology. The cytologically malignant category contained 106 B-cell lymphomas and three T-cell lymphomas. All 65 B-cell lymphomas with K light chain predominance had K/L ratio greater than 3/1, and all 34 B-cell lymphomas with L light chain predominance had an L/K ratio greater than 2/1. Clonality was therefore established for K/L and L/K at 3/1 and 2/1, respectively. When K/L and L/K ratios were below these figures (7 cases), other parameters, including the proportion of CD20 and the dual expression of CD19/CD10 and CD20/CD5, were used to determine the nature of the aspirate. In the B-cell lymphomas without demonstrable light chain restriction, CD20 positivity in excess of 85%, CD19/CD10 positivity of more than 18%, or CD20/CD5 positivity greater than 35% were independently diagnostic of B-cell lymphoma. In the T-cell lymphomas, greater than 90% of the cells were T cells, and aberrant T-cell antigen expression with loss of at least one pan-T-cell antigen was detected. In conclusion, the sensitivity of diagnosis of malignancy, false-negative rate, and predictive value of malignant diagnosis with combined FNA cytology and FCM were 99%, 0%, and 100%, respectively. Diagn. Cytopathol. 1998; 19:274–278. © 1998 Wiley-Liss, Inc.     

CD44 and p53 immunoexpression patterns in NF1 neoplasms - indicators of malignancy and infiltration

Neurofibromatosis type 1 (NF1) provides a unique system to evaluate the complete range of neoplastic expressions, from encapsulated benignity to invasiveness and malignancy. This study was aimed at determining whether CD44 and p53 may serve as indicators of malignant progression of neurofibroma. CD44, a transmembrane glycoprotein receptor for hyaluronic acid, and participates in cell-extracellular matrix interactions and migration. CD44 may play a vital role, either through under or overexpression, with invasion and metastases of tumors, altering their ability to infiltrate the adjacent tissue. The tumor suppressor gene, p53, has also been implicated in malignant progression of various human tumors including malignant peripheral nerve sheath tumors (MPNST). A total of 44 tumors from 33 patients with NF1 were evaluated with an anti-human CD44H, CD44 splice variant v6 and anti-p53 monoclonal antibodies. Morphologic expression patterns of expression were evaluated for CD44 while semiquantitative criteria were applied to assess, p53 nuclear positivity. Immunoexpression of p53 was markedly higher in 12 of 16 MPNST (75%). Thirteen of 28 (46%) benign neurofibroma also had some expression of p53 above ‘normal level'', although much lower than the MPNST. Plexiform neurofibroma did not differ from other benign lesions in their expression of p53. Our results suggest that p53 mutation as evidenced by immunohistochemical overexpression is a factor in malignant transformation and progression of neurofibroma. 70% of benign neurofibroma demonstrated some, usually focal, CD44 positivity. The pattern of CD44 expression in plexiform neurofibroma was revealing, as it was maximal in the ‘nonencapsulated’ portions of the tumors. Eight of 11 (72%) locally infiltrative cutaneous neurofibroma and 13 of 16 (81%) MPNST exhibited diffuse CD44 positivity. CD44v6 expression was positive in control tissues but was not identified in any of tumor samples. Also, within the confines of encapsulated tumors CD44 expression is limited, while in poorly circumscribed neurofibroma CD44 expression is upregulated. This is interpreted as a reflection of the interaction of CD44+ tumor cells with extracellular matrix, hence facilitating infiltrative behavior.