Diagnostic and economic value of carcinoembryonic antigen,carbohydrate antigen 19-9,and carbohydrate antigen 72-4 in gastrointestinal cancers

BACKGROUND The diagnostic and economic value of carcinoembryonic antigen(CEA),carbohydrate antigen 19-9(CA19-9)and CA72-4 for gastrointestinal malignant tumors lacked evaluation in a larger scale.AIM To reassess the diagnostic and economic value of the three tumor biomarkers.METHODS A retrospective analysis of all 32857 subjects who underwent CEA,CA19-9,CA72-4,gastroscopy and colonoscopy from October 2006 to May 2018 was conducted.Then,we assessed the discrimination and clinical usefulness.Total cost,cost per capita and cost-effectiveness ratios were used to evaluate the economic value of two schemes(gastrointestinal endoscopy for all people without blood tests vs both gastroscopy and colonoscopy when blood tests were positive).RESULTS The analysis of 32857 subjects showed that CEA was a qualified biomarker for colorectal cancer(CRC),while the diagnostic efficiencies of CA72-4 were catastrophic for all gastrointestinal cancers(GICs).Regarding early diagnosis,only CEA could be used for early CRC.The combination of biomarkers didn’t greatly increase the area under the curve.The economic indicators of CEA were superior to those of CA19-9,CA72-4 and any combination.At the threshold of 1.8μg/L to 10.4μg/L,all four indicators of CEA were lower than those in the scheme that conducted gastrointestinal endoscopy only.Subgroup analysis implied that the health checkup of CEA for people above 65 years old was economically valuable.CONCLUSION CEA had qualified diagnostic value for CRC and superior economic value for GICs,especially for elderly health checkup subjects.CA72-4 was not suitable as a diagnostic biomarker.

Mechanism of aluminum corrosion in LiFSI-based electrolyte at elevated temperatures

Lithium bis(fluorosulfonyl)imide(LiFSI) is a promising replacement for lithium hexafluorosphate due to its excellent properties. A solution to the corrosion of aluminum(Al) current collectors by LiFSI at elevated temperatures is essential. The mechanisms of Al corrosion in LiFSI-based electrolyte at 45 ℃ were studied with density functional theory calculations and spectroscopic investigations. It is found that the irregular, loose and unprotected AlF3 materials caused by the dissolution of co-generated Al(FSI)3 can exacerbate Al corrosion with the increase of temperature. Lithium bis(oxalate)borate(LiBOB) can effectively inhibit the Al corrosion with a robust and protective interphase;this can be attributed to the interfacial interactions between the Al foil and electrolyte. Boron-containing compounds promote the change from AlF3 to LiF, which further reinforces interfacial stability. This work allows the design of an interface to Al foil using LiFSI salt in lithium-ion batteries.