5 种肿瘤标志物在胃癌患者血清中的表达及其临床意义

 目的探讨胃癌患者术前血清CEA、CA199、CA724、CA125 和AFP水平及阳性率的临床应用价值。方法采用电化学
发光法测定184 例胃癌患者术前血清CEA、CA199、CA724、CA125 和AFP水平。结果血清CEA 水平及阳性率与肿瘤直径、
浸润范围及期别有关（ P<0.05）;CA199 水平随着肿瘤大小、浸润范围及期别增大而升高（ P<0.05）;CA724水平随着肿瘤直径
增大而升高（ P<0.05）;血清CA125 水平随着肿瘤直径增大、转移淋巴结及期别增高而升高（ P<0.05）;AFP 阳性率随着出现淋
巴结转移、远处转移及期别增高而增高（ P<0.05）。结论术前血清CEA、CA199、CA724、CA125 和AFP 可作为病情监测的指
标,帮助判断肿瘤进展情况。     

CA724、CA125、CA199、CEA在结直肠癌诊断中的价值

目的：：探讨肿瘤标志物糖类抗原724（CA724）、糖类抗原125（CA125）、糖类抗原199（CA199）、癌胚抗原（CEA）在结直肠癌诊断中价值。方法：选择2008年2月～2012年11月我院临床确诊的结直肠癌患者67例为结直肠癌组,同期159例结直肠良性病变为对照组,比较两组CA724、CA125、CA199、CEA血清水平及异常率,比较4种肿瘤标志物单独及联合检测对结直肠癌的诊断方法学评价指标。结果：两组4种肿瘤标志物的血清水平及阳性率比较差异均有统计学意义（P〈0.05）;4种肿瘤标志物中CEA有较高的灵敏度（68.7%）、约登指数（0.586）、阳性预测值（73.0%）及阴性预测值（87.9%）;4种肿瘤标志物联合检测有助于提高检测的灵敏度（86.6%）、约登指数（0.688）及阴性预测值（93.9%）。结论：CA724、CA125、CA199、CEA的联合检测有助于结直肠癌的早期诊断,早期治疗,提高患者的生存率。     

血清CEA、CA19-9、CA242联合检测对大肠癌的诊断价值

目的探讨大肠癌患者血清肿瘤标志物CEA（癌胚抗原）、CA19-9（癌抗原199）、CA242（癌抗原242）单项及多项联合检测对大肠癌患者诊断的临床应用价值。方法分为两组;大肠癌组和健康对照组,采用酶联免疫法对108例大肠癌患者和50名健康人血清CEA、CA19-9、CA242分别进行了检测。结果大肠癌患者血清3种肿瘤标志物含量明显高于健康人（均P〈0.01）,CEA、CA199、CA242联合检测阳性率为85.2%,明显高于各单项检测的阳性率（分别为33.3%、54.6%、61.1%,P〈0、01）,在DukesA、B、C及D期中[1,2],3项肿瘤标志物含量及检测阳性率依次增高（P〈0.05～0.01）.淋巴结转移患者的3项标志物含量及CA19-9、CA242的阳性率均高于无淋巴结转移的患者。结论CEA、CA19-9及CA242肿瘤标志物联合检测可以提高大肠癌诊断的敏感度,并对临床分期、判断淋巴结转移、肿瘤侵袭程度、对进行有效临床治疗,具有一定的指导意义。     

logistic回归和ROC曲线评价4种血清肿瘤标志物在结直肠癌中的诊断价值

目的应用logistic回归和ROC曲线探讨癌胚抗原(CEA)、糖类肿瘤抗原CA125、CA199、CA724实验室诊断指标在诊断结直肠癌(Colorectal Cancer,CRC)中临床价值。方法对156例CRC患者的肿瘤标志物资料进行回顾性分析,同时与145例体检健康者的肿瘤标志物进行比较,应用logistic回归和ROC曲线对各指标进行分析。结果 CRC患者肿瘤标志物与正常人比较,差异有统计学意义;CEA、CA125、CA199、CA724的ROC曲线下面积(AUC)分别为0.667、0.739、0.757、0.630。结论血清CA125及CA199对CRC的诊断具有较高的临床价值。单项指标中以CA199的AUCROC最大,诊断价值最高;系列试验中以CA199+CEA+CA125+CA724作为确诊CRC较好的组合项目;ROC分析结合logistic回归简单有效,尤其适用于多指标联合诊断试验的分析评价,综合运用Logistic回归和ROC曲线分析可提高CRC诊断的准确性。     

四种血清肿瘤标志物在结直肠癌患者中的诊断价值分析

目的:探析四种血清肿瘤标志物联合检测对结直肠癌患者的诊断价值。方法:35例结直肠癌患者和35例体检健康者分别设为观察组对照组。比较两组糖类抗原19-9(CA199)、细胞角蛋白19的可溶性片段(CYFRA211)、癌胚抗原(CEA)及糖类抗原125(CA125)的表达水平及其阳性表达率;比较不同临床分期、有无淋巴结转移及不同病理类型患者之间血清CA199、CYFRA211、CEA、CA125水平差异;分析单项检测与联合检测对结直肠癌患者的诊断价值。结果:观察组患者的血清CA199、CYFRA211、CEA、CA125水平及其阳性表达率均明显高于对照组(P<0.01)。随着临床分期的加重,各血清肿瘤标志物水平上升(P<0.05);随着病理分型的增加,各血清肿瘤标志物水平下降(P<0.05);发生淋巴结转移者的各血清肿瘤标志物水平明显高于未发生淋巴结转移(P<0.05)。血清CA199、CYFRA211、CEA、CA125联合检测的准确率、敏感度、特异性均明显优于单项指标检测(P<0.01)。结论:血清肿瘤标志物可辅助诊治结直肠癌患者,并可指导其病理分型、临床分期及淋巴结转移情况,诊断价值明确。     

血清肿瘤标志物癌胚抗原和糖类抗原在胃癌腹膜转移中的诊断价值

【摘要】目的 探讨血清肿瘤标志物癌胚抗原和糖类抗原在胃癌腹膜转移中的诊断价值,为胃癌腹膜转移的诊断提供理论依据。方法 纳入2014年6月~2017年6月于乐山市人民医院肿瘤科诊治的68例胃癌患者,根据是否发生腹膜转移分为转移组（20例）与非转移组（48例）;手术或化疗前采用全自动免疫分析仪检测血清肿瘤标志物癌胚抗原（Carcinoembryonic antigen,CEA）、糖类抗原CA724、CA242、CA211、CA19 9、CA125水平,比较两组各检测指标血清水平、阳性率。进行Logistic回归分析,绘制受试者特征ROC曲线,比较联合检测以及各指标单独检测的诊断效能。结果 转移组血清CEA、CA724、CA242、CA211、CA19 9、CA125水平均显著高于非转移组,差异均有统计学意义（P＜0.05）; 转移组血清CA724、CA125、CA211阳性率显著高于非转移组,差异均有统计学意义（P＜0.05）,血清CEA、CA242、CA19 9阳性率差异无统计学意义（P＞0.05）;CA724、CA125、CA211联合诊断（Y1）与所有检测指标联合诊断（Y2）ROC曲线下面积（area under the cure ,AUC）值均大于单项指标诊断（P＜0.05）。结论 单项指标中CA125诊断胃癌腹膜转移效能最高,其与CA724、CA211联合诊断可作为胃癌腹膜转移的有效诊断方式。     

血清肿瘤标志物对胃癌淋巴结转移的诊断价值

目的:探讨4项血清肿瘤标志物水平对胃癌淋巴结转移的诊断价值。方法:回顾性分析病理活检确诊为胃癌的584例患者的血清肿瘤标志物水平,根据ROC曲线确定诊断胃癌淋巴结转移的Cut-off值,以提高肿瘤标志物对胃癌淋巴结转移诊断的敏感性。结果: （1）肿瘤直径、淋巴结送检数目及肿瘤浸润深度是影响胃癌患者淋巴结转移的危险因素;（2）胃癌淋巴结转移组患者血清肿瘤标志物水平显著高于无淋巴结转移组;（3）CA-724、CA-199、CA-242及CEA对胃癌淋巴结转移诊断的敏感性分别为64.4%、51.9%、41.9%、41.1%;特异性分别为92.9%、82.8%、86.6%、82.5%;（4）4项血清肿瘤标志物诊断胃癌淋巴结转移的Cut-off值分别为CA-724:6.69 U/mL、CA-199:17.36 U/mL、CA-242:17.20 IU/mL、CEA:3.12 μg/L;其中,单项检测时CA724或者联合检测3项以上血清肿瘤标志物诊断胃癌淋巴结转移的准确性较高;（5）4项肿瘤标志物联合检测对胃癌患者淋巴结转移判别的符合率达到76.6%。结论:血清肿瘤标志物可以用来预测患者是否存在淋巴结转移,CA-724对胃癌淋巴结转移的诊断价值较好,3项以上联合时可以提高诊断的敏感性。     

结直肠癌术前淋巴结转移相关危险因素分析

目的讨论结直肠癌术前淋巴结转移与患者术前临床病理参数及血清肿瘤标志物的相关性。方法搜集陕西省人民医院2014年1月至2019年5月695例结直肠癌患者临床资料,纳入标准:(1)术前内镜取检,活检结果确诊CRC;(2)完整切除肿瘤并且标本进行术后病理活检;(3)患者病历及研究相关资料完整;(4)排除术前行辅助治疗者;(5)排除血液系统及其他原发肿瘤者。收集患者术前临床病理参数及血清肿瘤标志物。收集患者术后切除组织淋巴结转移信息,对数据行回顾性研究分析,选择c2检验进行单因素分析,选择Logistics多因素回归模型对淋巴结转移的高危因素进行分析。结果单因素分析结果提示患者年龄,性别,吸烟史,酗酒史,高血压史,糖尿病史,Hb,Alb与CRC淋巴结转移无相关(P0.05)。术前肠梗阻,肿瘤组织类型,肿瘤分化程度,CEA、CA199与淋巴结转移相关(P0.05)。对有统计学意义的高危因素进行多因素回归分析,术前肠梗阻,肿瘤分化程度,CEA与淋巴结转移相关(P0.05)。结论术前肠梗阻,肿瘤分化程度,CEA是淋巴结转移的独立高危因素。     

肿瘤标志物CEA和CA242及CA199联合检测在胰腺癌患者淋巴结转移和预后中的应用价值

目的探讨肿瘤标志物CEA、CA242及CA199联合检测在胰腺癌患者淋巴结转移和预后中的临床应用意义。方法选取2014年1月至2015年12月本院收治的60例胰腺癌患者作为研究组,另选择同期在本院进行体检的58名健康者作为对照组,比较两组血清CEA、CA242及CA199水平。结果与对照组比较,研究组血清CEA、CA242Ku/L及CA199Ku/L水平均明显升高(P<0.05);与Ⅱ期比较,Ⅲ期和Ⅳ期患者血清CEA、CA242及CA199水平均明显升高(P<0.05);与Ⅲ期比较,Ⅳ期患者血清CEA、CA242及CA199水平均明显升高(P<0.05);与无淋巴结转移患者比较,淋巴结转移患者血清CEA、CA242及CA199水平均明显升高(P<0.05);与生存≥6个月比较,生存<6个月患者血清CEA、CA242及CA199水平均明显升高(P<0.05);血清CEA、CA242、CA199联合检测的灵敏性和特异性均高于各个指标单项检测。结论肿瘤标志物CEA、CA242及CA199联合检测对于胰腺癌患者淋巴结转移及改善患者预后均具有较高的临床参考价值。     

2013例教职工肿瘤标志物阳性率及相关因素分析

目的 了解肿瘤标志物阳性者在体检人群中的分布,对影响肿瘤标志物阳性率的相关因素进行分析.方法 对2013名参加体检的教职工的体检资料进行研究分析,多元logistic回归分析肿瘤标志物阳性率的相关因素.结果2013名体检人群中筛选出阳性率最高的四项肿瘤标志物分别是CA199（1.54%）、CEA（0.99%）、CA125（0.55%）、CA242（0.40%）,其中CEA、CA125的阳性率在不同性别间有差异（P〈0.05）.ALT、年龄是CA199的独立因素;年龄、GLU是CEA的危险因素;DBIL、UA、年龄是肿瘤标志物CA125的相关因素（P〈0.05）.结论 血清肿瘤标志物在健康人群中有一定的阳性率,定期体检对于肿瘤的早期发现具有重要价值.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.