Objective To investigate the diagnostic value of tumor marker combining the probability of malignancy model in pulmonary nodules. Methods A total of 117 patients with pulmonary nodules diagnosed between January 2013 and January 2016 were retrospectively analyzed. Seventy-six cases of the patients diagnosed with cancer were selected as a lung cancer group. Forty-one cases of the patients diagnosed with benign lesions were selected as a benign group. Tumor markers were detected and the probability of malignancy were calculated. Results The positive rate of carcinoembryonic antigen (CEA), cancer antigen 125 (CA125), neuron-specific enolase (NSE), cytokeratin marker (CYFRA21-1), and the probability of malignancy in the lung caner group were significantly higher than those of the benign group. The sensitivity, specificity, and accuracy of CEA, CA125, NSE, CYFRA21-1 combined detection were 72.37%, 73.17%, and 72.65%, respectively. Using the probability of malignancy model to calculate each pulmonary nodules, the area under ROC curve was 0.743 which was higher than 0.7; and 28.5% was selected as cut-off value based on clinical practice and ROC curve. The sensitivity, specificity, and accuracy of the probability of malignancy model were 63.16%, 78.05%, and 68.68%, respectively. The sensitivity, specificity, and accuracy of tumor marker combining the probability of malignancy model were 93.42%, 68.29%, and 92.31%, respectively. The sensitivity and accuracy of tumor marker combining the probability of malignancy model were significantly improved compared with tumor markers or the probability of malignancy model single detection (P<0.01). Conclusion The tumor marker combining the probability of malignancy model can improve the sensitivity and accuracy in diagnosis of pulmonary nodules.
Objective The article introduces the present status of the application of comparative proteomics in study of tumor marker. Methods This essay review the present status and advances of the application of comparative proteomics in study of tumor marker through refer considerable literatures about proteome, proteomics and tumor marker. Results Follow the study of human genome deepening; the paradox between the finiteness of genes’ number and stability of genes’ structure and the variety of the life phenomena is more conspicuous. Then, the study of proteomics was pushed to the advancing front of life science research. The application of comparative proteomics to tumor research becomes a hot spot nowadays. Conclusion Screening tumor marker via comparative proteomics is an extremely promising research.
ObjectiveTo study the preoperative evaluation value of serum tumor markers (CA72-4, CEA, CA199 and CA125) in patients with gastric cancer. MethodsSerum levels of tumor markers (CA72-4, CEA, CA199 and CA125) and clinical pathological data of 70 patients with gastric cancer before operation who underwent surgical treatment in the Gastrointestinal Surgery Department of Second Affiliated Hospital of Kunming Medical University in June 2013 to 2014 June were retrospectively analyzed. ResultsThere were some connection between the concentration of the serum CA72-4 and the tumor diameter, TNM staging, invasion depth, and the number of lymph node metastasis (P < 0.05), between CA199 and tumor size, TNM staging, and invasion depth (P < 0.05), between CEA, CA125 and tumor diameter, TNM staging and distant metastasis (P < 0.05), but the CA72-4, CA72-4, CEA and CA125 had nothing to do with patient' age and gender. ConclusionThe serum tumor markers of CA724, CEA, CA199, and CA125 have clinical application value in preoperative evaluation of gastric cancer.
To study the expressions of CA19-9 and CA125 and their clinicopathologic significancesin gallbladder adenocarcinoma , pericancerous tissues and chronic cholecystitis. Methods EnVisionTM immunohistochemist ry was used for assaying the expressive levels of CA1929 and CA125 in the routinely paraffin2embedded sections of specimens f rom gallbladder adenocarcinoma ( n = 108) , pericancerous tissues ( n = 46) , and chronic cholecystitis ( n = 35) . Results The positive rates of CA19-9 and CA125 were significantly higher in gallbladder adenocarcinoma ( 49. 1 % , 51. 9 %) than those in pericancerous tissues ( 26. 1 % , 15. 2 %) and chronic cholecystitis(14. 3 % , 5. 7 %) , respectively ( Plt; 0. 01) . The positive rates of CA19-9 and CA125 were significantly lower in thecases of adenomatous canceration , maximal diameter lt; 2 cm , no-metastasis of lymph node and no-invasion of regional tissues than those in the ones of low-differentiated adenocarcinoma , maximal diameter ≥2 cm , metastasis oflymph node and invasion of regional tissues ( Plt; 0. 05 , Plt; 0. 01 ) . The consistence of CA19-9 and CA125 expressivelevels was found in gallbladder adenocarcinoma (χ2 = 44. 69 , Plt; 0. 01) . Conclusion The expressions of CA19-9 andCA125 may be important tumor markers to reflect the carcinogenesis , progression , biological behaviors and prognosis of gallbladder adenocarcinoma.
Objective To evaluate the diagnostic value of serum pro-gastrin-releasing peptide (Pro-GRP) in patients with small cell lung cancer. Methods We searched MEDLINE, EMBASE, The Cochrane Library and other databases (1966 to Sept 2009) to collect studies which evaluated the diagnostic value of Pro-GRP in patients with small cell lung cancer. The heterogeneity of the included studies was tested by the Cochrane Collaboration’s software RevMan 4.2. The Summary Receiver Operating Characteristic (SROC) curve and meta-analyses were performed by MetaDisc. Results A total of 256 relevant articles were retrieved and 19 were included in our review. Eleven studies involving 1 447 patients were included. Meta-analyses showed that the heterogeneity among studies was high (P﹤0.000 01, I2=69.3%), the pooled sensitivity was 0.717 and the pooled specificity was 0.963. Subgroup analyses indicated that 9 of the studies which used the LD (Limited diseases) SCLC group (P=0.003, I2=65.5%, SEN=0.637, SPE=0.968, SROC AUC=0.724 3) had heterogeneity and ED (Extensive diseases) SCLC group (P=0.2, I2=27.0%, SEN=0.766, SPE=0.968, SROC AUC=0.935 5) had no heterogeneity. And 15 of the studies of Pro-GRP which were determined by acmmercial sandwich ELISA (Japan) group (P=0.000 1, I2=68.5%) had heterogeneity. Three of the studies of Pro-GRP which were determined by ELISA (Germany) group (P=0.948 7, I2=0.001%) had no heterogeneity. Conclusion Pro-GRP could be regarded as one of the reference tests in patients with small cell lung cancer, but higher quality trials are required.
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.
Objective To systematically review the diagnostic value of combined detection of K-ras gene mutation in peripheral blood and serum tumor markers for pancreatic cancer. Methods Databases including PubMed, The Cochrane Library (Issue 3, 2016), Elsevier, BMJ, CBM, CNKI and WanFang Data were searched from 2000 to March 2016 to collect diagnostic tests about the diagnostic value of combined detection of K-ras gene mutation in peripheral blood and serum tumor markers in pancreatic cancer. Two reviewers independently screened literature, extracted data and assessed the methodological quality of included studies. Then, meta-analysis was performed using RevMan 5.3 software. Results A total of 23 studies involving 2 071 patients were included. The results of meta-analysis showed that the sensitivity (SE) and specificity (SP) of K-ras gene mutation in peripheral blood were 65% and 92% respectively in the diagnosis for pancreatic cancer. The results of the detection of tumor marker CA19-9 were 78% and 81% respectively. The SE and SP indexes in the parallel and serial combinations of CA19-9 together with CA242 were 85%, 72%, 70% and 83% respectively. And the SE, SP indexes in the parallel and serial combinations of K-ras gene mutation combined detection with CA19-9 were 90%, 63%, 47% and 96%. The positive likelihood ratio of the parallel combination of K-ras gene mutation in peripheral blood and CA19-9 (+LR=10.89) was higher than the other three detection methods, while the negative likelihood ratio of the serial combination of K-ras gene mutation in peripheral blood and CA19-9 (-LR=0.15) was lower than the other three detection methods, which indicated that the combined detection of K-ras gene mutation in peripheral blood and and CA19-9 had a better diagnostic performance than the single dectection of K-ras gene mutation or CA19-9 or the combined detection of CA19-9 and CA242 respectively. Comparing the area under curve (AUC) of SROC curve of the two combined diagnoses, the results showed that the diagnostic value of the parallel combination of K-ras gene mutation in peripheral blood and CA19-9 (AUC=0.87) was higher than that of the parallel combination of serum tumor markers CA19-9 and CA242. Conclusion Current evidence indicates that the combined detection of K-ras gene mutation and and tumor marker CA19-9 levels in peripheral blood can improve the diagnostic accuracy for pancreatic cancer. Due to the limited quantity and quality of included studies, above conclusions need to be verified by conducting more high quality studies.
Objective To evaluate diagnostic value of tumor marker — the serum neuron specific enolase (NSE) in patients with suspected small cell lung cancer with lung pathological diagnosis as the gold standard. Methods A search in The Cochrane Library, PubMed, OVID, MEDLINE, EMbase, Cancerlit, China National Knowledge Infrastructure (CNKI), and CBM, was conducted from 1966 to 2008. Hand searches and additional searches were also conducted. Criteria for inclusion were established based on validity criteria for diagnostic research published by the Cochrane Methods Group on Screening and Diagnostic Tests. Subsequently, the characteristics of the included articles were appraised and extracted. Statistical analysis was performed employing Revman 4.2 software. Heterogeneity of the included articles was tested, which was used to select the proper effect model to calculate pooled weighted sensitivity and specificity. The Summary Receiver Operating Characteristic (SROC) curve was performed and the area under the curve (AUC) was calculated. Finally, sensitivity analysis was performed. Results Six articles entered this meta-analysis: four English articles, one Japanese article and one Chinese article. The quality level of the articles was C. the studies involving 2,366 patients (579 SCLC and 1,847 NSCLC patients that were diagnosed by using the gold standard) were included. The meta-analysis reported that the heterogeneity among studies was high (P=0.005, I2=70.4%), pooled sensitivity was 0.59, 95%CI 0.55 to 0.64, and pooled specificity was 0.88, 95%CI 0.87 to 0.90. The likelihood ratio was 8.17 and 0.31, respectively. The summary ROC of the meta-disc software and the area under the curve was 0.905 0. These data suggested that NSE had a relatively high false negative rate (41%) and a relatively low false positive rate (12%). Conclusion The tumor marker NSE is has diagnostic value of small cell lung cancer, but more high quality trials are required.
Objective To study the usefulness of combined detection of 4 tumor markers in patients with recrudescent and metastatic breast cancer. Methods The serum levels of CA153, CEA, TPS and CA125 were determined by chemiluminescence immunoassay. A total of 1245 subjects entered the study. Sensitivities of the tests were evaluated in 1 000 patients with breast cancer (102 preoperative patients and 898 postoperative patients) and 245 with benign breast disease. Results The serum levels of CA153, CEA and TPS were significantly elevated in preoperative patients compared with metastatic patients (Plt;0.001). The serum levels of CA153, CEA, TPS and CA125 were significantly elevated in metastatic patients compared with non-metastatic patients (Plt;0.001). The sensitivity of the 4 tumor markers were significantly elevated in metastatic patients compared with preoperative and postoperative non-metastatic patients (Plt;0.05). The sensitivity of combined detection of the 4 tumor markers were 56.72% and 94.68% in preoperative patients and metastatic patients, respectively. The CEA elevation was bly correlated with CA153 and TPS levels (all P=0.000 1, r=0.410 and 0.396, respectively). Conclusion Combined detection of the 4 tumor markers may play a guiding role in post-therapeutic monitoring of breast cancer in progressive, recrudescent and metastatic patients.
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.