Papillary tumor of the pineal region: Case report and review of the literature

Papillary tumor of the pineal region is a rare neuroepithelial tumor characterized by papillary architecture and epithelial cytology, immunopositivity for cytokeratin and ependymal differentiation. It is considered grade II–III by the World Health Organization and was first described by Jouvet in 2003. We present a 34-year-old male with headaches, blurred vision and normal examination. Radiological study showed a nodulocystic lesion in the pineal region compatible with pineocytoma. Surgery was performed using an infratentorial supracerebellar approach, finding a cystic tumor in the quadrigeminal cistern which was completely resected. Histopathology reported a papillary tumor of the pineal region. The patient made good progress without adjuvant therapy, and after 57 months of follow-up he remained asymptomatic and free of recurrence. A review of the literature was performed to collect all the cases published with gross total resection and no complementary treatment. In conclusion, there is still much to be learned about the pathogenesis, prognosis and management of this tumor.     

小鼠肝大部切除后肝再生组织中c—myc、ZHX2及AFP基因表达的变化

目的:利用小鼠肝大部切除后肝再生动物模型,测定c-myc、ZHX2、AFP基因在肝再生过程不同阶段的表达,研究肝脏再生的细胞和分子生物学机制及病理学意义.方法:利用分叶顺次肝大部切除技术,建立小鼠肝再生动物模型,在不同的时间节点,运用荧光定量PCR手段.检测再生肝脏组织中c-myc、ZHX2、AFP激活后的表达特征.结果:在肝再生的启动阶段,c-myc表达上调.在随后的肝脏再生的持续增殖阶段,ZHX2的表达首先下调,然后再恢复到正常水平.AFP的表达为持续上调.结论:c-myc、ZHX2、AFP基因在肝脏再生不同阶段的依次激活、不同表达趋势的内在联系,初步揭示了彼此之间协同作用的可能及潜在的信号转导途径.     

联合检测AFP、CEA和CA199对原发性肝癌的诊断价值及护理

目的探讨AFP、CEA、CA199联检对原发性肝癌的诊断价值。方法均采用化学发光法,测定40例原发性肝癌患者和50例健康对照组的血清AFP、CEA、CA199水平。结果原发性肝癌组血清AFP、CEA、CA199水平明显高于健康对照组(P<0.01)。原发性肝癌组血清AFP、CEA、CA199单独检测时的敏感性分别为67.5%、27.5%和50%,联合检测AFP和CEA或CA199可使检测的敏感性提高到85.0%和90.0%,三者联合检测敏感性达95%,对血清AFP阴性的标本,CA199、CEA敏感性分别为53.8%、23.1%。结论AFP、CEA、CA199联检可以大大提高原发性肝癌尤其是AFP阴性的诊断率。同时加强护理尤为重要。     

急性弛缓性麻痹监测筛检指标的探讨

以15岁以下的儿童发生不明原因的急性弛缓性麻痹(简称"AFP")为监测对象筛检脊灰,虽保持着高的灵敏度,但不具有特异度,假阳性率很高。为找出特异性高、操作性强的筛检指标,我们对1991年全省发生的818例AFP病例进行研究。
在818例AFP中,脊灰和非脊灰AFP好发于5岁以下年龄组;87.63%的脊灰病例在发病早期有发热症状,而非脊灰AFP为45.99%。以年龄和发病早期有发热史为指标做筛检试验,并联试验中,灵敏度很高,但特异度仍然很低;用5岁以下(包括5岁)年龄组和发病早期有发热史做串联试验,其灵敏度为81.44%,特异度为65.54%,从ROC曲线上看,把指标定在这里较为理想。从卫生经济角度考虑、着眼于实际工作,对AFP病例开展监测,其对象应为5岁以下儿童,同时伴有早期发热者应视为脊灰高危人群,作为"第一重点"处理。     

血清AFP与胃癌临床病理间关系分析

目的探讨血清AFP与胃癌临床病理之间的关系,增强对血清AFP阳性胃癌的认识。方法应用放射免疫分析法测定我院2008年1月～9月收治的152例胃癌患者血清AFP值．观察AFP阳性胃癌与AFP阴性胃癌临床病理间的差异。结果胃癌患者中血清AFP阳性的表达率为14％．患者性别、年龄、肿瘤位置及直径在血清AFP阳性与阴性胃癌间无显著差异眇0．05）;浸润深度、分化程度、临床分期,淋巴结、肝转移在血清AFP阳性与阴性胃癌间有显著性差异fP〈0．05）。结论血清AFP阳性胃癌临床病理特殊．恶性程度高,易出现淋巴结、肝转移。AFP应作为胃癌患者术前的常规检查。     

原发性肝癌患者血清甲胎蛋白和a-L-岩藻糖苷酶联合检测的临床价值

目的探讨血清甲胎蛋白（AFP）和a-L-岩藻糖苷酶（AFU）联合检测对原发性肝癌诊断的临床价值。方法对95例原发性肝癌、41例良性肝病和30例健康体检者血清AFP和AFU同步测定并进行对照。结果原发性肝癌患者血清AFP、AFU水平及阳性率均明显高于健康对照组及良性肝病组,差异有统计学意义（P〈0.05）;联合检测的敏感性和诊断准确性均比单项检测高。结论联合检测血清中的AFP和AFU对原发性肝癌的诊断具有重要价值。     

肝癌实验室诊断指标的选择及最佳阈值探讨

目的探讨血清甲胎蛋白（AFP）、岩藻糖苷酶（AFU）、抗胰蛋白酶（α-AT）与血清铁蛋白（SF）在原发性肝癌（PHC）诊断中的应用价值,并应用受试者工作特征（ROC）曲线对其最佳阈值进行确定。方法对78例PHC患者及同期体检中心健康体检的88例员工进行血清4项指标检测,应用ROC曲线进行分析。结果AFP、AFU、α-AT与SF在PHC患者组均显著性增高,差异有统计学意义（P＜0.01）。应用ROC曲线分析,确定AFP、AFU、α-AT与SF的阈值分别为246ng/mL、29U/L、180.0和404ng/mL,阈值处AFP、AFU、α-AT与SF的灵敏度分别为62.5%、64.6%、78.1%和72.4%,特异性分别为85.4%、78.0%、60.5%和67.4%,AFP、AFU、α-AT、SF及4者联合检测的ROC曲线下面积分别为0.82、0.77、0.69、0.74和0.88。结论AFP、AFU、α-AT与SF可作为PHC的实验室检测指标,4者联合检测可明显提高PHC的诊断效率。     

不同化学发光分析仪检测AFP的结果比较

目的使用MPC-1微孔板单光子计数仪与ACCESS化学发光仪同时测定血清AFP,探讨不同免疫分析系统检测结果的可比性与准确性。方法ACCESS化学发光仪与MPC-1微孔板单光子计数仪同时对患者血清做AFP定量检测。结果患者血清AFP含量正常及<300μg/L时,两仪器存在较好的相关性;AFP浓度较高(>300μg/L)时,两者存在显著性差异(P<0.01)。结论使用类似于MPC-1微孔板单光子计数仪在为肝癌高危人群检测AFP时,如结果>300μg/L,需用全自动发光仪检测。     

Rapid diagnosis of premature rupture of membranes using a new kit employing anti-AFP monoclonal antibody

A kit using mouse monolconal antibody against human alpha-fetoprotein (anti-AFP kit) has been developed. Cervical secretion (n=34) and vaginal fluid (n=15) was obtained from 30 pregnant volunteers. All 31 specimens obtained from women with intact membranes tested negative while all 18 specimens from women with premature rupture of membranes (PROM) tested positive. The newly developed kit allowed rapid and accurate diagnosis. We compared the kit results with those obtained by pH determination (nitrazine, bromthymol blue test) and measurement of AFP concentrations by enzyme-linked immunoassay (EIA). Correspondence to: S. Fujimoto