非小细胞肺癌患者血清IL-17和IL-21水平变化及临床意义

目的 测定非小细胞肺癌(NSCLC)患者术前术后血清中IL-17、IL-21水平变化,探讨IL-17、IL-21水平在NSCLC诊断及预后中的临床意义.方法 采用酶联免疫分析法测定54名NSCLC患者术前以及术后血清IL-17、IL-21水平,随机选择30名健康志愿者作为正常对照组,检测其血清IL-17、IL-21水平并与之进行对比.结果 与正常对照组比较,NSCLC患者术前血清IL-17、IL-21水平差异具有统计学意义(P<0.01),术后差异无统计学意义(P>0.05).NSCLC患者术后与术前比较,血清IL-17水平明显降低(P<0.05),血清IL-21水平明显升高(P<0.05).晚期NSCLC患者血清IL-17水平高于早期NSCLC患者(P<0.05),而IL-21水平则低于早期NSCLC患者(P<0.05).结论 NSCLC患者血清中IL-17、IL-21水平变化与手术、NSCLC病程相关,监测IL-17、IL-21水平对NSCLC的治疗和预后有一定的指导意义.     

Diagnostic Value and Prognostic Significance of Pleural C-Reactive Protein in Lung Cancer Patients with Malignant Pleural Effusions

Purpose

C-reactive protein (CRP) has been implicated in various inflammatory and advanced malignant states. Increased serum CRP (s-CRP) levels have been shown to be associated with independent prognostic factors for survival in patients with advanced lung cancer. However, only few studies have focused on the role of CRP in pleural effusions. This study aimed to evaluate the diagnostic and prognostic value of pleural CRP (p-CRP) in lung cancer patients with malignant pleural effusion (MPE).

Materials and Methods

Pleural effusion (PE) samples were collected from patients with MPE (68 lung cancers; 12 extrathoracic tumors), and from 68 patients with various benign conditions (31 with pneumonia; 37 with tuberculosis). Concentrations of p- and s-CRP were measured by enzyme-linked immunosorbent assay. CRP level in pleural fluid and its association with survival were examined.

Results

p-CRP levels correlated with s-CRP levels (r=0.82, p<0.0001). For the differential diagnosis of MPE and benign PE, the area under the receiver operating characteristic curve was greater for p-CRP (0.86) than for s-CRP (0.77). High p-CRP expression significantly correlated with shorter overall survival (p=0.006). P-CRP was independent prognostic factor significantly associated with overall survival on multivariated analysis (p=0.0001). The relative risk of death for lung cancer patients with high p-CRP levels was 3.909 (95% confidence interval, 2.000-7.639).

Conclusion

P-CRP is superior to s-CRP in determining pleural fluid etiology. Quantitative measurement of p-CRP might be a useful complementary diagnostic and prognostic test for lung cancer patients with MPE.     

原发性肺癌患者外周血PD-1淋巴细胞亚型检测与临床预后的关系研究

目的检测原发性肺癌患者外周血PD-1淋巴细胞亚型,并进行临床随访,分析其与临床预后的关系。方法采集2015年1月至2016年11月在河南省肿瘤医院呼吸内科诊治的35例可疑原发性肺癌患者的血液学标本,并进行外周血淋巴细胞亚型分析以及PD-1表达,然后进行临床随访。结果 35例患者中,31例患者最终病理确诊为原发性肺癌(腺癌23例,鳞癌3例,小细胞肺癌5例),剩余4例患者为炎症。CD3+CD8+T细胞比例数值高、CD4+/CD8+的比值低、PD-1+/PBMC比例高的患者近期疗效越好。未发现治疗前淋巴细胞亚型比例异常患者与正常患者之间存在PFS的差异。结论在本项回顾性小样本研究中,发现原发性肺癌治疗前特定淋巴细胞亚型与近期疗效相关,尤其是PD-1+PBMC比例升高的患者近期疗效更佳。需要进一步前瞻性大样本研究验证。     

血清NSE、CEA、CYFRA21-1联检对肺癌的诊断价值

目的:探讨联检血清肿瘤标志物神经元特异性烯醇化酶(NSE)、癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)对肺癌的诊断价值.方法:采用电化学发光法检测102例肺癌患者和50例良性肺病患者血清NSE、CEA、CYFRA21-1的含量.结果:肺癌患者血清NSE、CEA、CYFRA21-1水平均明显高于良性肺病患者,差异有统计学意义(P＜0.01).三种血清标志物的分布有明显的病理倾向性.NSE在小细胞癌中表达水平较高,其敏感性为59.4%; CEA在腺癌中表达水平较高,其敏感性为61.5%;而CYFRA21-1则在鳞癌中表达水平较高,其敏感性为64.5%.联检可提高检测肺癌的敏感性.结论:三种血清肿瘤标志物对于肺癌的辅助诊断有一定的临床意义,联检NSE、CEA和CYFRA21-1可以提高肺癌的诊断敏感性,为肺癌的早期诊断、病理分型提供可靠的依据.     

Endothelial Dysfunction and Circulating Microparticles from Patients with Obstructive Sleep Apnea

Endothelial dysfunction is involved in vascular complications of obstructive sleep apnea (OSA). In this study, circulating microparticles (MPs) from patients with OSA-induced nocturnal desaturations were characterized and their effects on endothelial function were evaluated. Two age-matched groups of patients undergoing polysomnography for OSA were compared: 35 desaturators with a 3% oxyhemoglobin desaturation index (ODI) ≥ 10 events per hour of sleep and 27 nondesaturators with ODI <10 events per hour. MPs were characterized by flow cytometry and then either used to treat in vitro human endothelial cells or to study endothelial function in mice. Circulating MPs did not differ between groups, but MPs from granulocytes and activated leukocytes (CD62L⁺) were found at higher levels in desaturators. In vitro, MPs from desaturators reduced endothelial nitric oxide (NO) production by enhancing phosphorylation of endothelial NO synthase at the site of inhibition and expression of caveolin-1. CD62L⁺ MPs positively correlated with ODI. Endothelial NO production negatively correlated with both CD62L⁺ MPs and ODI. MPs from desaturators increased expression of endothelial adhesion molecules including E-selectin, ICAM-1 and ITGA5, and cyclooxygenase 2. Moreover, injection of MPs from desaturators into mice impaired endothelium-dependent relaxation in aorta and flow-induced dilation in small mesenteric arteries. This study demonstrates an association between endothelial dysfunction and increased circulating levels of CD62L⁺ MPs. This may initiate atherogenic processes in patients with OSA and severe nighttime hypoxia.Obstructive sleep apnea (OSA) is a highly prevalent disease characterized by recurrent episodes of partial or complete obstruction of the upper airways during sleep, leading to repeated falls in oxygen saturation. There is growing evidence in support of an independent association between OSA and cardiovascular diseases,¹ particularly for sleep disordered breathing accompanied by marked nocturnal oxygen desaturations.^2,3 Various pathophysiological mechanisms have been proposed to contribute to the pathogenesis of vascular morbidity, including autonomic dysfunction, hypercoagulability, inflammation, oxidative stress, and endothelial dysfunction.⁴ An impairment of endothelial function has been recently demonstrated in patients with OSA and nocturnal desaturations compared with matched OSA patients without desaturations.⁵ Very recently, it was shown that OSA directly affects the vascular endothelium by promoting inflammation and oxidative stress, and decreasing nitric oxide (NO) availability and repair capacity, as shown by reduced circulating levels of endothelial progenitor cells.⁶Microparticles (MPs) are small membrane vesicles that are shed from cells in response to activation and apoptosis. The number, cellular source, and composition of MPs are altered in various disease states including diabetes, metabolic syndrome, sepsis, and pre-eclampsia.^7,8,9,10 Recent data suggested that MPs might play a major role in interactions with circulating cells or the components of the vessel wall. MPs have been implicated in coagulation, inflammation, and vascular function.¹¹ With regard to OSA, Geiser et al¹² did not report an increase of platelet-derived MPs despite enhanced in vivo platelet activation. Recently, Ayers et al¹³ found that procoagulant, platelet-, and leukocyte-derived MPs were significantly increased in patients with OSA with marked nocturnal desaturations (>7.5 oxygen desaturations per hour).To our knowledge, the role of circulating MPs in the regulation of endothelial dysfunction in OSA is unknown. Thus, the aims of this study were to characterize circulating MPs from patients with OSA according to their cellular origins and determine in vitro effects of MPs from OSA patients on endothelial cells with respect to NO and superoxide anion (O₂⁻) productions and the expression of adhesion and proinflammatory molecules involved in inflammation. Finally, MPs were injected into mice intravenously to test their pathophysiological relevance.     

肺癌患者血清MIC-1升高的临床价值

目的 研究巨噬细胞抑制因子-1（MIC-1）血清水平在肺癌诊断中的临床应用价值.方法 采用双抗体夹心ELISA法检测256例肺癌患者、44例肺良性疾病患者及229例正常对照人群血清MIC-1浓度,采用电化学发光免疫分析仪及化学发光免疫分析仪分别检测肺癌患者血清CEA、CA125、NSE、CYFRA21-1和SCC浓度.结果 肺癌组患者血清中MIC-1浓度显著高于正常对照组（P＜0.001）和肺良性疾病组（P ＜0.001）;根据ROC曲线和正常人群的MIC-1血清水平,设1000pg/mL为诊断肺癌的临界值,MIC-1检测肺癌的敏感性和特异性分别为69.5％和96.5％;在不同病理类型中,血清MIC-1对小细胞癌的诊断敏感性高于鳞癌和腺癌,低分化组患者血清MIC-1水平明显高于高分化＋中分化组（P＜0.05）;MIC-1诊断肺癌的敏感性优于已有标志物CEA、CA125、NSE、SCC和CYFRA21-1;在肺癌早期（I期和II期）阶段,MIC-1诊断敏感性优于五种标志物的联合诊断（I期：66.7％vs 50.0％,II期：72.7％ vs 69.0％）;六种标志物联合诊断则能使I期和II期肺癌诊断敏感性分别提高至77.1％和85.5％.结论 本研究在较大样本量中证实MIC-1在肺癌诊断中的临床应用价值,提示其可能成为比较理想的肺癌诊断及筛查标志物.     

肿瘤M2-PK和NSE联检在小细胞肺癌诊断中的价值

目的：探讨肿瘤M2型丙酮酸激酶（Tumor M2-PK）和神经元特异性烯醇化酶（NSE）在小细胞肺癌（SCLC）早期诊断中的价值。方法：采用酶联免疫吸附法和电化学发光免疫分析仪（Eleesys2010）分别检测32例SCLC患者及50例肺良性疾病患者外周血中Tumor M2-PK和NSE的含量。结果：SCLC患者Tumor M2-PK和NSE水平明显高于肺良性疾病患者，差异有统计学意义（P〈0．01）。单个检测Tumor M2-PK、NSE及联检Tumor M2-PK和NSE（Tumor M2-PK＋NSE）的敏感性分别为46．9％（15／32）、59．4％（19／32）及68．8％（22／32），特异性分别为92％（46／50）、90％（45／50）及84％（42／50）。结论：Tumor M2-PK和NSE对于小细胞肺癌的辅助诊断有一定的临床意义。联检Tumor M2-PK和NSE可提高小细胞肺癌的诊断敏感性。     

肺癌患者血清脂联素水平变化及其临床研究

目的 探讨血清脂联素在肺癌患者中的临床应用价值.方法 用放射免疫法检测58例肺癌患者和50例健康体检者的血清脂联素水平.结果 肺癌患者脂联素水平显著低于健康对照组（P＜0.01）;肺癌分期之间差异无统计学意义（P＞0.05）;小细胞癌与腺癌和鳞癌比较,血清脂联素水平差异有统计学意义（P＜0.05）;肺癌远处转移癌组与未远处转移癌组比较差异有统计学意义（P＜0.01）.结论 低血清脂联素水平与肺癌的发生及远处转移相关,脂联素水平测定在未来可能成为肺癌患者预防、诊断和治疗的一个新的血清学指标.     

肺癌患者外周血循环肿瘤细胞与NSE、CEA以及CYFRA21-1水平的研究

目的 研究外周血循环肿瘤细胞(CTC)、CEA、NSE以及CYFRA21-1分别在小细胞肺癌(SCLC)和非小细胞肺癌(NSCLC)患者外周血中水平的关系.探究一种肺癌早期诊断的联合检测方案.方法 收集肺癌的患者89例,其中已明确的小细胞肺癌患者26例,非小细胞肺癌患者63例.同时选取20例肺部良性疾病患者和30例同时...     

Prognostic Value of 18F-Fluorodeoxyglucose Positron Emission Tomography in Patients with Resectable Pancreatic Cancer

Purpose

We evaluated the prognostic value of ¹⁸F-2-fluoro-2-deoxyglucose positron emission tomography (FDG PET) in patients with resectable pancreatic cancer.

Materials and Methods

We retrospectively reviewed the medical records of pancreatic cancer patients who underwent curative resection, which included 64 consecutive patients who had preoperative FDG PET scans. For statistical analysis, the maximal standardized uptake value (SUVmax) of primary pancreatic cancer was measured. Survival time was estimated by the Kaplan-Meier method, and Cox''s proportional hazard model was used to determine whether SUVmax added new predictive information concerning survival together with known prognostic factors. p<0.05 indicated statistical significance.

Results

Overall survival (OS) and disease-free survival (DFS) were respectively 42.9 months (27.6-58.2; 95% CI) and 14.9 months (10.1-19.7; 95% CI). When subjects were divided into two groups according to SUVmax with a cutoff value of 3.5, the high SUVmax group (n=32; SUVmax >3.5) showed significantly shorter OS and DFS than the low SUVmax group. Multivariate analysis of OS and DFS showed that both high SUVmax and poor tumor differentiation were independent poor prognostic factors.

Conclusion

Our study showed that degree of FDG uptake was an independent prognostic factor in pancreatic cancer patients who underwent curative resection.     

肺癌患者手术及化疗前后血脂水平的变化及意义

目的探讨肺癌患者血总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、甘油三酯(TG)及化疗前后或手术前后水平的变化及其意义。方法测定600例肺癌组患者血脂水平与对照组比较;并对不同类型肺癌间血脂水平进行比较。同时观察患者化疗、手术前后血脂水平变化。结果肺癌患者TC、LDL-C、HDL-C均较对照组明显减低,而两组间血TG水平无明显差异。化疗及手术后肺癌组患者,血TC、LDL-C、HDL-C及TG水平均较化疗前明显升高,但差异无统计学意义(P>0.05)。结论肺癌患者存在低血胆固醇倾向,化疗或手术治疗可以提高血清TC及LDL-C水平。     

血清SCC、NSE、CYFRA21-1及CEA联合检测在肺癌诊断中的价值

目的探讨血清SCC、NSE、CYFRA21-1及CEA联合检测在肺癌的诊断价值。方法采用电化学发光免疫分析法测定血清SCC、NSE、CYFRA21-1及CEA水平及其组合,评价其在肺癌诊断中的价值。结果肺癌组四项指标显著高于对照组和肺良性疾病组,差异有统计学意义（P〈0.05）;不同病理类型的肺癌四项检测指标,差异有统计学意义（P〈0.05）;但四项指标联合检测敏感性明显高于任一个单项肿瘤标志物。结论单项肿瘤标志物对肿瘤的诊断价值有限。四项标志物联合检测有利于肺癌的早期诊断。     

肺癌患者血清TSGF、CEA、CYFRA21—1和NSE水平的临床价值

目的:探讨血清TSGF、CEA、CYFRA21-1和NSE水平的临床价值。方法:采用放射免疫分析测定了179例肺癌、48例肺良性病变和51例正常对照组的血清TSGF、CEA、CYFRA21-1和NSE的水平。结果:在NSCLC中,37例I～II期鳞癌血清中TSGF、CEA和NSE水平与肺良性病变无明显差异(P均>0.05),32例I～II期腺癌血清中NSE也与肺良性病变无明显差异(P>0.05);其余,NSCLC和SCLC血清中TSGF、CEA、CY-FRA21-1和NSE水平明显增高,均与肺良性病变具有明显差异(P<0.05～0.01),从总体而言,随着病变的严重程度增加,肺癌标志物水平也增高。51例正常对照组血清TSGF、CEA、CYFRA21-1和NSE水平分别为(64.1±14.8)U/ml,(3.51±1.1)ng/ml,(2.6±1.4)ng/ml和(5.1±3.6)ng/ml。结论:肺癌的诊断中,以血清CY-FRA21-1测定为最佳,其次为TSGF和CEA,最差NSE,故肺癌标志物的联检是诊断肺癌的最佳选择。     

Evaluation of Circulating Tumor Cells and Serological Cell Death Biomarkers in Small Cell Lung Cancer Patients Undergoing Chemotherapy

Serological cell death biomarkers and circulating tumor cells (CTCs) have potential uses as tools for pharmacodynamic blood-based assays and their subsequent application to early clinical trials. In this study, we evaluated both the expression and clinical significance of CTCs and serological cell death biomarkers in patients with small cell lung cancer. Blood samples from 88 patients were assayed using enzyme-linked immunosorbent assays for various cytokeratin 18 products (eg, M65, cell death, M30, and apoptosis) as well as nucleosomal DNA. CTCs (per 7.5 ml of blood) were quantified using Veridex CellSearch technology. Before therapeutic treatment, cell death biomarkers were elevated in patients compared with controls. CTCs were detected in 86% of patients; additionally, CD56 was detectable in CTCs, confirming their neoplastic origin. M30 levels correlated with the percentage of apoptotic CTCs. M30, M65, lactate dehydrogenase, and CTC number were prognostic for patient survival as determined by univariate analysis. Using multivariate analysis, both lactate dehydrogenase and M65 levels remained significant. CTC number fell following chemotherapy, whereas levels of serological cell death biomarkers peaked at 48 hours and fell by day 22, mirroring the tumor response. A 48-hour rise in nucleosomal DNA and M30 levels was associated with early response and severe toxicity, respectively. Our results provide a rationale to include the use of serological biomarkers and CTCs in early clinical trials of new agents for small cell lung cancer.Small cell lung cancer (SCLC) is initially chemosensitive but invariably relapses with a chemoresistant phenotype.¹ A number of molecularly targeted therapies have been evaluated attempting to improve outcome, but none have succeeded to date.² Ideally, early clinical trials should incorporate validated pharmacodynamic biomarkers, conducted to good clinical laboratory practice, that demonstrate both proof of mechanism (drug hits target) and proof of concept (tumor responds to drug).³ Although possible, serial biopsies are rare in SCLC, and the tissue obtained often insufficient for extensive molecular profiling. Thus, there is a pressing need for blood-based biomarkers that report therapeutic response.Assays of drug-induced cell death are potential proof of concept biomarkers for multiple therapeutics.⁴ The M30 Apoptosense and M65 assays (Peviva, Bromma, Sweden) detect cytokeratin (CK) 18, expressed in epithelial but not hematopoietic cells, and released into the blood following cytoskeletal disassembly and degradation during apoptotic and/or necrotic cell death.⁵ The M30 antibody recognizes a caspase-cleaved neoepitope of CK18 that is only revealed during apoptosis, whereas the M65 assay detects full length and cleaved forms of CK18 reporting apoptosis and necrosis.⁶ Nucleosomal DNA (nDNA) results from cleavage of chromatin by apoptotic endonucleases into membrane bound DNA fragments that are phagocytosed by macrophages and subsequently released into the blood.⁷ nDNA release is also detected when levels of apoptosis overwhelm macrophage capacity for phagocytosis and a more necrotic cell fate ensues.⁷ We have previously validated these cell death biomarkers^8,9 and optimized them for application to a busy, clinical setting.⁶ Here we report on the behavior and clinical utility of these assays in patients with SCLC.Importantly, cell death assays may report host toxicity in addition to tumor response. However, circulating tumor cell (CTC) numbers can, in theory, be used to directly evaluate drug effect on malignant cells.¹⁰ The cytometric approach using CellSearch technology (Veridex Inc., Huntingdon Valley, PA) is now approved by the Food and Drug Administration for clinical decision-making in patients with metastatic breast, colorectal and prostate cancers.^11,12,13 This is the first report on the use of this technology platform for CTC enumeration in patients with SCLC and the first direct comparison of serological biomarkers of cell death and cell death in CTCs.This study was conducted to evaluate cell death assays (M30, M65, and nDNA) and CTC profiles in patients with SCLC undergoing standard chemotherapy, as a prelude to their incorporation as biomarkers in early clinical trials. The hypothesis tested was that increases in cell death biomarkers immediately following therapy would predict outcome and that given the metastatic potential of SCLC high numbers of CTCs would be detectable. The results from this study are most encouraging for the development of CTCs as pharmacodynamic biomarkers in SCLC, provide novel insights into the clinical significance of serological cell death assays, and demonstrate agreement between measures of cell death at the molecular and cellular level in this disease.     

Leukocyte Activation and Circulating Leukocyte-Derived Microparticles in Preeclampsia

Problem  Preeclampsia shows characteristics of an inflammatory disease including leukocyte activation. Analyses of leukocyte-derived microparticles (MP) and mRNA expression of inflammation-related genes in leukocytes may establish which subgroups of leukocytes contribute to the development of preeclampsia.
Method of Study  Blood samples were obtained from preeclamptic patients, normotensive pregnant and non-pregnant controls. sL-selectin and elastase were measured by ELISA. mRNA was isolated from leukocytes and gene expression was determined by multiplex ligation-dependent probe amplification (MLPA). MP were characterized by flow cytometry.
Results  Altered concentrations of sL-selectin and elastase confirmed leukocyte activation in preeclampsia. These leukocytes showed up-regulation of Nuclear Factor of Kappa light chain gene enhancer in B Cells inhibitor (NFκB-1A) and cyclin-dependent kinase inhibitor (CDKN)-1A compared with normotensive pregnant women. interleukin-1 Receptor Antagonist (IL-1RA) and tumor necrosis factor (TNF)-R1 were increased compared with those in non-pregnant controls. Monocyte-derived MP were elevated in preeclamptic patients compared with pregnant women. The numbers of cytotoxic T-cell-derived and granulocyte-derived MP were elevated compared with those of non-pregnant women.
Conclusion  Leukocytes are activated in preeclampsia. A pro-inflammatory gene expression profile is not prominent, although differences in mRNA expression can be detected. Increased levels of particular subsets of leukocyte-derived MP reflect activation of their parental cells in preeclampsia.     

肺癌患者手术治疗前后sE-CAd和血浆可溶性P-选择素联检的临床意义

目的:探讨了肺癌患者手术治疗前后,血清可溶性上皮钙粘蛋白(sE-CAd)和可溶性P-选择素的变化。方法:应用酶联法测定了34例肺癌患者血sE-CAd和P-选择素含量,并与35名正常健康人作比较。结果:肺癌患者在手术前sE-CAd、P-选择素水平非常显著地高于正常人水平(P<0.01),手术治疗后6个月复发者sE-CAd、P-选择素水平持续异常,未复发者sE-CAd、P-选择素水平恢复正常。结论:血sE-CAd、P-选择素含量的变化与肺癌患者的病情和预后密切相关,有一定的临床实用价值。     

血清CEA、CYFRA21-1、NSE、SCC和ProGRP联合检测在肺癌诊断中的价值

目的探讨癌胚抗原（CEA）、细胞角蛋白19片段（CYFRA21-1）、神经元特异性烯醇化酶（NSE）、鳞状细胞癌抗原（SCC）和胃泌素释放肽前体（ProGRP）在肺癌诊断中的价值。方法采用电化学发光法和酶联免疫法对228例肺癌患者、100例肺良性疾病患者及100例健康对照组者CEA、CYFRA21-1、NSE、SCC和ProGRP的含量进行检测及比较。结果肺癌组血清CEA、CYFRA21-1、ProGRP的水平明显高于肺良性疾病组和健康对照组（P〈0.05）。肺癌肿瘤标志物的血清水平与其病理类型相关,血清CEA水平在腺癌时显著升高（中位数8.64,四分位数2.72-44.76,P〈0.05）,ProGRP水平在小细胞肺癌中显著升高（中位数152.00,四分位数46.00-1209.00,P〈0.05）,而血清SCC水平则在鳞癌时显著升高（中位数1.30,四分位数0.80-2.55,P〈0.05）。Ⅲ、Ⅳ期肺癌的血清CEA、CYFRA21-1、NSE和SCC水平明显高于Ⅰ、Ⅱ期肺癌（P〈0.05）。ProGRP＋CEA＋SCC联合检测对肺癌诊断的灵敏度、特异性和约登指数分别为75.9%、81.5%和0.574,灵敏度和约登指数大于各单项标志物的检测。结论 CEA对腺癌、ProGRP对小细胞肺癌以及SCC对鳞癌具有较大的辅助诊断价值,联合检测可明显提高肺癌的灵敏度,为早期诊断治疗提供有力的证据。     

Serum Levels of Polyamines in Cancer Patients

Serum polyamines were determined by Samejima's method.
Total putrescine, cadaverine and spermidine in healthy adults were 0.29±0.08, 0.11 ± 0.08. and 0.43 ± 0.15 nmoles/ml. respectively. Spermidine was not detected in the serum by this method. About half of total polyamines existed in free form in the serum. No significant elevation of serum polyamines was observed in chronic hepatitis and liver cirrhosis. Increased serum putrescine was observed in some cases of malignancies, such as hepatomas (0.76 nmoles/ml. 0.62 nmoles/ml), pharyngeal carcinoma (0.66 nmoles/ml), peritonitis carcinoma (0.60 nmoles/ml) and colon carcinoma (0.45 nmoles/ml). Determination of serum polyamines. especially of putrescine, may provide a potential indicator in some cases of malignancy.     

血清三叶因子3水平对结直肠癌诊断的价值

目的 探究血清三叶因子3(trefoil factor 3,TFF3)水平在结直肠癌诊断中的价值.方法 收集180例受试者(89例结直肠癌患者,44例结直肠息肉患者和47例健康对照者)血清,采用酶联免疫吸附法测定血清TFF3水平.将结直肠癌组血清TFF3水平与对照组作对比,绘制ROC曲线,评估血清TFF3作为肿瘤标志物对结直肠癌的诊断价值.结果 结直肠癌患者血清TFF3水平[12.35(9.72～13.92)ng/mL]显著高于结直肠息肉组(3.18±0.18ng/mL,P<0.05)和健康对照组(3.14±0.11ng/mL,P<0.05);与健康对照组相比,结直肠息肉组患者血清TFF3水平的升高差异无统计学意义(P>0.05).血清TFF3诊断结直肠癌的ROC曲线下面积为0.889,在cut-off值为4.6149ng/mL时,血清TFF3对结直肠癌的诊断灵敏度和特异性分别为73.7％和91.8％.淋巴结转移和分化程度低的结直肠癌患者,其血清TFF3水平显著升高(P<0.05).结论 本研究显示血清TFF3是一个能够有效诊断结直肠癌的血清标志物,具有一定的临床诊断价值.     

The Prognostic Value of Residual Volume/Total Lung Capacity in Patients with Chronic Obstructive Pulmonary Disease

The prognostic role of resting pulmonary hyperinflation as measured by residual volume (RV)/total lung capacity (TLC) in chronic obstructive pulmonary disease (COPD) remains poorly understood. Therefore, this study aimed to identify the factors related to resting pulmonary hyperinflation in COPD and to determine whether resting pulmonary hyperinflation is a prognostic factor in COPD. In total, 353 patients with COPD in the Korean Obstructive Lung Disease cohort recruited from 16 hospitals were enrolled. Resting pulmonary hyperinflation was defined as RV/TLC ≥ 40%. Multivariate logistic regression analysis demonstrated that older age (P = 0.001), lower forced expiratory volume in 1 second (FEV₁) (P < 0.001), higher St. George Respiratory Questionnaire (SGRQ) score (P = 0.019), and higher emphysema index (P = 0.010) were associated independently with resting hyperinflation. Multivariate Cox regression model that included age, gender, dyspnea scale, SGRQ, RV/TLC, and 6-min walking distance revealed that an older age (HR = 1.07, P = 0.027), a higher RV/TLC (HR = 1.04, P = 0.025), and a shorter 6-min walking distance (HR = 0.99, P < 0.001) were independent predictors of all-cause mortality. Our data showed that older age, higher emphysema index, higher SGRQ score, and lower FEV₁ were associated independently with resting pulmonary hyperinflation in COPD. RV/TLC is an independent risk factor for all-cause mortality in COPD.

Graphical Abstract

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