Objective To summarize progress of imagings and tumor markers in preoperative TN staging of colorectal cancer. Methods The domestic and international published literatures related to application of imagings such as EUS, CT, and MRI and tumor markers such as CEA, CA19-9, and CA-242 in preoperative TN staging of colorectal cancer were collected and reviewed. Results The imagings and tumor markers have different values in the preoperative TN staging of colorectal cancer, but the value of a single application is limited. The combination of imagings and tumor markers could improve the diagnostic accuracy of the preoperative TN staging of colorectal cancer. Conclusion In clinical work, combination of imagings and tumor markers should be selected basing on actual situation of patients so as to improve accuracy of preoperative TN staging of colorectal cancer, and guide clinical treatment and improve prognosis of patients.
ObjectiveTo summarize the domestic and abroad articles related to the research on the relation between miRNA-221/222 and thyroid cancer, and explore the important effects of miRNA-221/222 in diagnosis and treatment of thyroid cancer. MethodsDomestic and international publications involving the relationship of miRNA-221/222 to thyroid cancer were screened and reviewed. ResultsMiRNA-221/222 is a tumor marker with high specificity and sensitivity in thyroid cancer. It has important significance for diagnosis, treatment and prognosis of thyroid cancer. ConclusionMiRNA-221/222 is not only related to diagnosis of thyroid cancer, but also have provided a new research direction and method for gene therapy of thyroid cancer．
目的 通过检测脑胶质瘤患者血清中胰岛素生长因子-1（IGF-1）和胶质纤维酸性蛋白（GFAP）的表达，探讨其与胶质瘤分级及预后评估的关系。 方法 2010年12月－2011年11月，采用双抗体一步夹心法分别测定A、B两组共40例不同级别脑胶质瘤患者术前、术后血清中IGF-1和GFAP浓度。 结果 高级别胶质瘤患者组血清中IGF-1浓度显著高于低级别胶质瘤组（P=0.009 0）；血清GFAP浓度显著低于低级别胶质瘤组（P＜0.000 1）。经手术治疗后且疗效评价为有效的胶质瘤患者，其血清中IGF-1、GFAP浓度较术前水平显著下降（P＜0.001 0）。结论 IGF-1、GFAP是两种较好的脑胶质瘤血清标志物，在其分级及预后评估中具有重要的临床应用价值。
Objective To summarize the research progress of microRNA （miRNA） as a tumor marker in peripheral blood. Methods The domestic and international published literatures about circulating miRNA as a tumor marker in recent years were reviewed. Results The miRNA expression has universality，stability and specificity，and it is related to the occurrence and development of viarous diseases. Conclusion Circulating miRNA shows a broad application prospect in clinical diagnosis， treatment， and prognosis of tumor and other diseases.
Objective Toa nalyzed ifferentialp roteine xpressiono fc holangiocarcinomai np eripheralb loodb yproteomics technology, and to investigate the significance of proteomics technology in early diagnosis of bile ductmalignancy.M ethods Serum proteinf rom 58p atientsw ithc holangiocarcinomaa nd5 8c ontrols( 20p atientsw ithcholecystolithiasis and 38 healthy people) were detected by surface enhanced laser desorption/ionization-time offlight-mass spectrometry (SELDI-TOF-MS). Ciphergen protein chip software was used to identify proteinic spectra.R esults Comparedw itht hes pectrao fs erum proteini nc ontrolg roup,t herew ere1 0d ifferentiallye xpressedproteins in bile duct carcinoma group, among which three proteins with relative molecular masses of 5. 900 X 10’，9.08 0X 1 0’a nd1 1.86 3X 1 0’w ereu p-regulated( Plt;1 0-’)ands evenp roteinsw ithr elativem olecularm asseso f6.9 59X 1 0’，14.0 00X 1 0’，14.1 29X 1 0’，14.3 02X 1 0’，17.5 57X 10’，17.6 90X 1 0’a nd2 8.5 52X 1 0’w ered ownregulated(Plt; 10-’)。The average concentration of protein with the relative molecular mass of 11. 863 X 10’ incholangiocarcinoma group was eight times more than that in controls group. At the stage I of cholangiocarcinoma,thee xpressiono fp roteinp ointw itha r elativem olecularm asso f5 .90 0X1 0’w ass ignificantlyh ighert hant hosep atientsat the stage III and stage fV (Plt;10-’)，while there were no statistical difference of expression between diffeent clinical stages for the other 9 proteins points. And there were no significant expression differences of the above10 proteins between the patients with and without jaundice following cholangiocarcinoma. Instead, another threeproteinsw ithr elativem olecularm asseso f7 .25 5X 1 03，12.36 4X 1 0’a nd1 5.8 73X 1 03w ered etectedt oh aved ifferentproteine xpressions.A nda llo fth em showedh ighe xpressionsin j aundiceg roup( Plt;10-5).C onclusion Thereare remarkable differences of the expressions of serum proteins in peripheral blood in patients with cholangiocarcinoma.T hep roteinp ointw itha r elativem olecularm asso f1 1.86 3X 1 0’m ayb ea p otentialb iomarkerfo re arlyd iagnosisof cholangiocarcinoma
Objective To explore the independent risk factors for tumor invasiveness of ground-glass nodules and establish a tumor invasiveness prediction model. Methods A retrospective analysis was performed in 389 patients with ground-glass nodules admitted to the Department of Thoracic Surgery in the First Hospital of Lanzhou University from June 2018 to May 2021 with definite pathological findings, including clinical data, imaging features and tumor markers. A total of 242 patients were included in the study according to inclusion criteria, including 107 males and 135 females, with an average age of 57.98±9.57 years. CT data of included patients were imported into the artificial intelligence system in DICOM format. The artificial intelligence system recognized, automatically calculated and output the characteristics of pulmonary nodules, such as standard diameter, solid component size, volume, average CT value, maximum CT value, minimum CT value, central CT value, and whether there were lobulation, burr sign, pleural depression and blood vessel passing. The patients were divided into two groups: a preinvasive lesions group (atypical adenomatoid hyperplasia/adenocarcinoma in situ) and an invasive lesions group (minimally invasive adenocarcinoma/invasive adenocarcinoma). Univariate and multivariate analyses were used to screen the independent risk factors for tumor invasiveness of ground-glass nodules and then a prediction model was established. The receiver operating characteristic (ROC) curve was drawn, and the critical value was calculated. The sensitivity and specificity were obtained according to the Yorden index. Results Univariate and multivariate analyses showed that central CT value, Cyfra21-1, solid component size, nodular nature and burr of the nodules were independent risk factors for the diagnosis of tumor invasiveness of ground-glass nodules. The optimum critical value of the above indicators between preinvasive lesions and invasive lesions were –309.00 Hu, 3.23 ng/mL, 8.65 mm, respectively. The prediction model formula for tumor invasiveness probability was logit (P)=0.982–(3.369×nodular nature)+(0.921×solid component size)+(0.002×central CT value)+(0.526×Cyfra21-1)–(0.0953×burr). The areas under the curve obtained by plotting the ROC curve using the regression probabilities of regression model was 0.908. The accuracy rate was 91.3%. Conclusion The logistic regression model established in this study can well predict the tumor invasiveness of ground-glass nodules by CT and tumor markers with high predictive value.
ObjectiveTo explore the values of CA19-9, CA242, CEA, and CA125 single or combined detection on clinical diagnosis and prognosis for patients with pancreatic cancer. MethodsSerum tumor markers CA199, CA242, CEA, and CA125 of 63 patients with pancreatic cancer, 33 patients with cancer of bile duct, and 27 patients with benign pancreatic disease were detected, and those patients were followed up after operation. ResultsThe levels of CA19-9, CA242, CEA, and CA125 in patients with pancreatic cancer were significantly higher than those in patients with benign pancreatic disease and cancer of bile duct (Plt;0.05). The sensitivity of CA19-9 alone was the highest in the four tumor markers for the patients with pancreatic cancer 〔79.4% (50/63)〕, but the specificity (61.9%) was lower than that of CA242 (83.3%) and CEA (80.0%). The specificity of combined detection of CA199+CA242+CEA was the highest 〔93.3% (56/60)〕. The level of CA19-9 in carcinoma of body/tail of pancreas was significantly higher than that of carcinoma of pancreas head or whole pancreas (Plt;0.05). The serum levels of CA19-9 and CA242 in patients with stage Ⅳ were significantly higher than those in stage Ⅰ or Ⅱ/Ⅲ (Plt;0.05). Fifteen patients were lost to follow up, 48 patients were followed up 2－12 months with an average 6 months. The levels of CA242 and CA199 in patients with pancreatic cancer on 0.5 month and 3 months after operation were lower than those before operation (Plt;0.05). ConclusionsSingle detection of CA19-9 can improve the diagnostic sensitivity, and combined detection of tumor markers CA199+CA242+CEA can improve the diagnostic specificity. CA19-9 or CA242 is a valuable marker for evaluating treatment effects and estimating prognosis.
ObjectiveTo establish and internally validate a predictive model for poorly differentiated adenocarcinoma based on CT imaging and tumor marker results. MethodsPatients with solid and partially solid lung nodules who underwent lung nodule surgery at the Department of Thoracic Surgery, the Affiliated Brain Hospital of Nanjing Medical University in 2023 were selected and randomly divided into a training set and a validation set at a ratio of 7:3. Patients' CT features, including average density value, maximum diameter, pleural indentation sign, and bronchial inflation sign, as well as patient tumor marker results, were collected. Based on postoperative pathological results, patients were divided into a poorly differentiated adenocarcinoma group and a non-poorly differentiated adenocarcinoma group. Univariate analysis and logistic regression analysis were performed on the training set to establish the predictive model. The receiver operating characteristic (ROC) curve was used to evaluate the model's discriminability, the calibration curve to assess the model's consistency, and the decision curve to evaluate the clinical value of the model, which was then validated in the validation set. ResultsA total of 299 patients were included, with 103 males and 196 females, with a median age of 57.00 (51.00, 67.25) years. There were 211 patients in the training set and 88 patients in the validation set. Multivariate analysis showed that carcinoembryonic antigen (CEA) value [OR=1.476, 95%CI (1.184, 1.983), P=0.002], cytokeratin 19 fragment antigen (CYFRA21-1) value [OR=1.388, 95%CI (1.084, 1.993), P=0.035], maximum tumor diameter [OR=6.233, 95%CI (1.069, 15.415), P=0.017], and average density [OR=1.083, 95%CI (1.020, 1.194), P=0.040] were independent risk factors for solid and partially solid lung nodules as poorly differentiated adenocarcinoma. Based on this, a predictive model was constructed with an area under the ROC curve of 0.896 [95%CI (0.810, 0.982)], a maximum Youden index corresponding cut-off value of 0.103, sensitivity of 0.750, and specificity of 0.936. Using the Bootstrap method for 1000 samplings, the calibration curve predicted probability was consistent with actual risk. Decision curve analysis indicated positive benefits across all prediction probabilities, demonstrating good clinical value. ConclusionFor patients with solid and partially solid lung nodules, preoperative use of CT to measure tumor average density value and maximum diameter, combined with tumor markers CEA and CYFRA21-1 values, can effectively predict whether it is poorly differentiated adenocarcinoma, allowing for early intervention.