4项凝血指标联合CA125检测对良恶性卵巢肿瘤辅助诊断的价值分析

目的探讨4项凝血指标凝血酶时间(TT)、纤维蛋白原(FIB)、D-二聚体(D-D)、血小板计数(PLT)联合糖类抗原(CA)125检测对良恶性卵巢肿瘤辅助诊断的价值。方法比较62例卵巢癌患者(卵巢癌组)与62例良性肿瘤患者(良性肿瘤组),以及不同国际妇产科协会(FIGO)分期卵巢癌患者,不同病理类型卵巢癌患者中CA125、4项凝血指标水平;采用受试者工作特征(ROC)曲线分析联合检测对良恶性卵巢肿瘤辅助诊断的价值。结果卵巢癌组CA125、TT、FIB、D-D、PLT水平均明显高于良性肿瘤组,差异有统计学意义(P<0.05);卵巢癌早期(FIGO分期Ⅰ~Ⅱ期)患者CA125、FIB水平低于卵巢癌晚期(FIGO分期Ⅲ~Ⅳ期)患者,差异有统计学意义(P<0.05),而TT、D-D、PLT水平比较,差异无统计学意义(P>0.05)。不同病理类型患者之间CA125、D-D水平比较,差异有统计学意义(P<0.05);CA125、TT、FIB、D-D、PLT单项指标对于良恶性卵巢肿瘤具有辅助诊断价值,5项指标联合检测对卵巢癌诊断的ROC曲线下面积为0.982,特异度为100.00%,诊断价值更高。结论CA125及4项凝血指标联合检测比单项指标检测对良恶性卵巢肿瘤具有更高的辅助诊断价值。     

血清STIP-1、CA125a和CA125b诊断子宫腺肌病的临床价值

目的观察血清磷酸化应激诱导蛋白1(STIP-1)、CA125a和CA125b对子宫腺肌病的诊断价值。方法选择2018年1月至2019年12月在该院就诊、病理确诊为子宫腺肌病的患者93例为子宫腺肌病组。选择同期在该院健康体检者49例为健康对照组。观察两组研究对象血清STIP-1、CA125a、CA125b和CA125水平的变化及对子宫腺肌病的诊断效能;观察血清STIP-1、CA125a和CA125b水平与子宫腺肌病严重程度、痛经的关系,以及STIP-1、CA125a和CA125b之间的相关性。结果子宫腺肌病组患者血清STIP-1、CA125a、CA125b和CA125水平明显高于健康对照组(P<0.01)。血清STIP-1、CA125a和CA125b水平对子宫腺肌病的诊断效能明显优于CA125(P<0.05);STIP-1、CA125a、CA125b三者联合检测的灵敏度为94.6%,特异度为91.8%,受试者工作特征曲线下面积(AUC)为0.975,均明显高于STIP-1、CA125a和CA125b单项检测,而STIP-1、CA125a和CA125b3项单项检测的灵敏度、特异度、AUC差异均无统计学意义(P>0.05)。子宫腺肌病患者血清STIP-1、CA125a和CA125b水平随着病理分级升高而升高,有痛经的患者血清STIP-1、CA125a和CA125b水平高于无痛经的患者(P<0.05)。子宫腺肌病患者血清STIP-1水平与CA125a(r=0.761,P<0.01)和CA125b水平(r=0.814,P<0.01)呈正相关,而CA125a水平与CA125b水平呈正相关(r=0.786,P<0.01)。结论血清STIP-1、CA125a和CA125b参与了子宫腺肌病的病理生理过程,在诊断子宫腺肌病时具有较高的诊断效能,值得临床推广。     

基于实验与蒙特卡罗模拟法探究125I粒子间剂量衰减

目的 研究多颗¹²⁵I放射性粒子间剂量衰减规律.方法 利用Geant 4软件包进行蒙特卡罗模拟单颗粒子和多颗粒子周围剂量分布,将模拟结果与TG43-U1报告中推荐剂量计算方法所得结果进行对比,并利用实验测得数据验证蒙特卡罗模拟结果.结果 单颗粒子周围剂量分布的蒙特卡罗模拟结果与TG43-U1计算和实验结果差值分别在±3%和±5%以内.多颗粒子的蒙特卡罗模拟结果对比TG43-U1线性叠加结果,粒子间剂量衰减为3.8%~13.2%,平均剂量衰减为7.2%,实验所得结果与蒙特卡罗模拟结果差值在6%以内.结论 空间中存在多颗放射性¹²⁵I粒子时,由于粒子间的相互影响导致7%左右的剂量衰减,其最大值可超过13%,在人体组织中剂量衰减值会更大.因此,利用TG43-U1方法进行线性叠加计算临床中的剂量分布不够精确.     

不同活度125I粒子植入抑制兔VX2肝癌机制研究

目的：探讨125I粒子组织间植入诱导肝癌细胞凋亡的机制。比较不同活度125I粒子组织间植入诱导肿瘤细胞凋亡、抑制肿瘤细胞增殖的作用强度。方法将24只兔VX2肝癌模型随机分为3组,分别植入不同初始活度的125I粒子：0 mCi组（对照组,n=8）、0.7 mCi组（n=8）及1.0 mCi组（n=8）。5周后处死实验兔,取出肿瘤病灶,检测125I粒子对肿瘤细胞凋亡、肿瘤生长相关因子表达的影响及caspase-3活性改变。结果不同初始活度125I粒子均可使肿瘤细胞凋亡率上升, Bcl-2、VEGF表达下调,Bax表达上调,1.0 mCi 125I粒子组作用均更加明显（P＜0.05）。不同初始活度125I粒子可增加肿瘤组织中caspase-3活性,两治疗组间差异无明显统计学意义（P＞0.05）。结论125I粒子植入后不仅通过诱导肿瘤细胞凋亡抑制肿瘤生长、增殖,还影响凋亡相关基因及编码蛋白表达,抑制肿瘤细胞新生血管生成。     

内镜下肝外胆管癌及壶腹癌125I粒子置入腔内持续照射方法研究

目的探讨晚期肝外胆管癌及壶腹癌采用^125Ⅰ粒子置入治疗的方法和价值。方法12例经B超、CT、磁共振检查确诊或拟诊为肝外胆管癌及壶腹癌的患者，采用十二指肠镜行ERCP检查，并取活检行病理检查，确定恶性肿瘤的病变长度，行病变段胆管扩张后置入金属支架，引流胆汁。于支架置入7-14d后采用相应的自制粒子载体将^125Ⅰ粒子置入，行腔内持续近距离放射治疗。术后随访6-32个月，进行B超及内镜复查。结果12例患者均顺利完成操作，无手术并发症。术后随访，超声及内镜结果与术前无明显变化，12例均存活，2例已存活32个月。结论内镜下肝外胆管癌及壶腹癌^125Ⅰ粒子腔内持续照射，是治疗晚期恶性肿瘤的安全有效的方法。     

卵巢癌患者血清VEGF、CA125的表达及其与疾病进展的关系

选取90例卵巢疾病患者和50例健康女性为研究对象,根据患者是否出现淋巴结转移将卵巢癌患者分为A组和B组,并对患者进行临床分期,分别对比分析患者的CA125、VEGF水平。结果卵巢组患者血清中CA125、VEGF水平均显著高于卵巢良性组与健康组,差异对比均具有统计学意义(P<0.05)。卵巢良性组CA125水平显著高于健康组(P<0.05),但是两组VEGF水平并无明显差异(P>0.05)。出现淋巴结转移的卵巢癌患者血清CA125、VEGF水平均显著高于淋巴结未转移者,差异对比具有统计学意义(P<0.05)。IV期患者CA125、VEGF水平均显著高于I~III期患者(P<0.05)。而III期患者的血清CA125、VEGF水平均显著高于I~II期患者(P<0.05)。卵巢癌患者血清CA125、VEGF水平明显偏高,联合检测患者血清CA125、VEGF水平可有效提高临床诊断卵巢癌的特异度、灵敏度,为准确评估患者的病情提供重要依据。     

CA724 is a novel factor for predicting the unresectability in pancreatic adenocarcinoma

This study aimed to assess the relationship between serum CA724 levels and the unresectability of pancreatic adenocarcinoma. A total of 302 patients with pancreatic adenocarcinoma were analyzed for the potential association between serum CA724 levels and the unresectability of pancreatic adenocarcinoma. Serum CA724 levels in patients with unresectable pancreatic adenocarcinoma were remarkably higher than those with resectable pancreatic adenocarcinoma (P < 0.001). Patients with elevated serum CA724 levels exhibited a 12.27-fold higher risk of unresectability than those with normal serum CA724 levels after adjusting for age, sex, and tumor location (95% CI = 5.28-28.51, P < 0.001). The analysis of receiver operating characteristics demonstrated that CA724 had superior predictive value to other tumor markers (AUC was 0.77 ± 0.03, 0.65 ± 0.04, and 0.62 ± 0.04 for CA724, CA125, and CA199, respectively). CA724 appeared to be a better predictor of unresectability than CA199 and CA125.     

HPV-16 E6 promotes cell growth of esophageal cancer via downregulation of miR-125b and activation of Wnt/β-catenin signaling pathway

High-risk human papillomavirus (HPV) is a possible cause of esophageal cancer. However, the molecular pathogenesis of HPV-infected esophageal cancer remains unclear. The expression levels of some microRNAs including miR-125b have been negatively correlated with HPV infection, and miR-125b downregulation is associated with tumorigenesis. In addition, Wnt/β-catenin signaling pathway has been suggested to play an important role in esophageal cancer (EC). We examined miR-125b and Wnt/β-catenin signaling pathway in HPV-16 E6 promoted tumor progression in EC. HPV-16 E6 transfection decreased markedly the expression levels of miR-125b and promoted the colony formation in the Eca 109 and Kyse 150 cell lines, and restoration of miR-125b expression level antagonized the increased colony formation in HPV-16 E6 transfected cell lines. We also demonstrated that overexpression of E6 upregulated the Wnt/β-catenin signaling activity via modulating the multiple regulators including TLE1, GSK3β, and sFRP4. Overexpression of miR-125b restored the expression levels of these proteins. Expression of miR-125b was lower in HPV-16 E6 positive esophageal cancer tissues, and was negatively correlated with E6 mRNA levels. Our results indicate that HPV-16 E6 promotes tumorigenesis in EC via down-regulation of miR-125b, and this underlying mechanism may be involved in the activation of the Wnt/β-catenin signaling pathway.     

Combination of cyst fluid CEA and CA 125 is an accurate diagnostic tool for differentiating mucinous cystic neoplasms from intraductal papillary mucinous neoplasms

Background/objectivesDespite advances in imaging techniques, diagnosis and management of pancreatic cystic lesions still remains challenging. The objective of this study was to determine the utility of cyst fluid analysis (CEA, CA 19-9, CA 125, amylase, and cytology) in categorizing pancreatic cystic lesions, and in differentiating malignant from benign cystic lesions.MethodsA retrospective analysis of 68 patients with histologically and clinically confirmed cystic lesions was performed. Cyst fluid was obtained by surgical resection (n = 45) or endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) (n = 23). Cyst fluid tumor markers and amylase were measured and compared between the cyst types.ResultsReceiver operating characteristic (ROC) curve analysis of the tumor markers demonstrated that cyst fluid CEA provided the greatest area under ROC curve (AUC) (0.884) for differentiating mucinous versus non-mucinous cystic lesions. When a CEA cutoff value was set at 67.3 ng/ml, the sensitivity, specificity and accuracy for diagnosing mucinous cysts were 89.2%, 77.8%, and 84.4%, respectively. The combination of cyst fluid CEA content >67.3 ng/ml and cyst fluid CA 125 content >10.0 U/ml segregated 77.8% (14/18) of mucinous cystic neoplasms (MCNs) from other cyst subtypes. On the other hand, no fluid marker was useful for differentiating malignant versus benign cystic lesions. Although cytology (accuracy 83.3%) more accurately diagnosed malignant cysts than CEA (accuracy 65.6%), it lacked sensitivity (35.3%).ConclusionsOur results demonstrate that cyst fluid CEA can be a helpful marker in differentiating mucinous from non-mucinous, but not malignant from benign cystic lesions. A combined CEA and CA 125 approach may help segregate MCNs from IPMNs.