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基于血清学指标的联合模型诊断代偿期肝硬化轻微型肝性脑病的价值 被引量:3
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作者 刘尚豪 祖红梅 +65 位作者 黄燕 郭小青 向慧玲 党彤 李晓燕 严兆兰 李雅静 刘菲 孙佳 宋瑞欣 闫俊卿 叶青 王晶 孟宪梅 王海英 江振宇 黄磊 孟繁平 张国 王文娟 杨少奇 呼圣娟 阮继刚 雷创 汪清海 田宏玲 郑琦 李异玲 王宁宁 崔会鹏 王滟萌 瞿章书 袁敏 刘益军 陈颖 夏玉香 刘娅媛 刘莹 曲素萱 陶弘 石瑞春 杨小婷 金丹 苏丹 杨永峰 叶伟 刘娜 唐荣瑜 张权 刘琴 邹高亮 李子月 赵彩彦 赵倩 张清格 高华方 孟涛 李婕 吴卫华 王健 杨传龙 吕卉 刘川 王福生 福军亮 祁小龙 《中华检验医学杂志》 CAS CSCD 北大核心 2023年第1期52-61,共10页
目的探讨血清学指标对代偿期肝硬化轻微型肝性脑病(MHE)的诊断价值,构建基于血清学指标的联合模型并评估其对MHE的诊断价值。方法前瞻性、多中心研究。选取2021年10月至2022年8月来自我国15个省(自治区、直辖市)的23家医院就诊的代偿期... 目的探讨血清学指标对代偿期肝硬化轻微型肝性脑病(MHE)的诊断价值,构建基于血清学指标的联合模型并评估其对MHE的诊断价值。方法前瞻性、多中心研究。选取2021年10月至2022年8月来自我国15个省(自治区、直辖市)的23家医院就诊的代偿期肝硬化患者263例。收集患者临床资料及实验室检查结果,并计算终末期肝病模型(MELD)评分。使用基线血氨测量值/正常参考值上限(AMM-ULN)集中校正各中心血氨测量结果,以我国《肝硬化肝性脑病诊疗指南》标准,数字连接试验-A、数字符号试验均异常作为诊断MHE的标准。基于R语言caret包将患者随机(7∶3)分为训练集(n=185)和验证集(n=78)。通过Logistic回归构建诊断MHE的联合模型;受试者工作特征曲线下面积(AUC)、Hosmer-Lemeshow拟合优度检验及校准曲线图评估诊断性能,并用Bootstrap法(n=200)进行内部验证;Delong检验比较AUC之间的差异。结果训练集中,MHE占37.8%(70/185),MHE组AMM-ULN、白蛋白、血小板、碱性磷酸酶、国际标准化比值、终末期肝病模型评分以及教育年限与无MHE组比较,差异有统计学意义(P均<0.05)。多因素Logistic回归分析显示,AMM-ULN(OR=1.78,95%CI 1.05~3.14,P=0.038)和MELD评分(OR=1.11,95%CI 1.04~1.20,P=0.002)是MHE的独立危险因素,AUC分别为0.663和0.625。联合AMM-ULN、MELD评分和教育年限的联合模型诊断MHE的AUC为0.755,特异度和敏感度分别为85.2%和55.7%。Hosmer-Lemeshow拟合优度检验表明模型具有较好的校准度(P=0.733),联合模型内部验证AUC为0.752。Delong检验显示联合模型诊断效能优于单独使用血氨(P=0.020)和MELD评分(P=0.003)。验证集中,联合模型诊断MHE的AUC为0.794,Hosmer-Lemeshow拟合优度检验显示有较好的校准度(P=0.841)。结论基于AMM-ULN、MELD评分和教育年限的联合模型可提高对MHE的诊断价值。 展开更多
关键词 肝性脑病 肝硬化 血氨 终末期肝病模型评分 诊断模型
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HER3-targeted therapeutic antibodies and antibody-drug conjugates in non-small cell lung cancer refractory to EGFR-tyrosine kinase inhibitors
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作者 Margaret E.Larsen hui lyu Bolin Liu 《Chinese Medical Journal Pulmonary and Critical Care Medicine》 2023年第1期11-17,共7页
Human epidermal growth factor receptor 3(HER3)is a unique member of the human epidermal growth factor receptor(HER/EGFR)family,since it has negligible kinase activity.Therefore,HER3 must interact with a kinase-profici... Human epidermal growth factor receptor 3(HER3)is a unique member of the human epidermal growth factor receptor(HER/EGFR)family,since it has negligible kinase activity.Therefore,HER3 must interact with a kinase-proficient receptor to form a heterodimer,leading to the activation of signaling cascades.Overexpression of HER3 is observed in various human cancers,including non-small cell lung cancer(NSCLC),and correlates with poor clinical outcomes in patients.Studies on the underlying mechanism demonstrate that HER3-initiated signaling promotes tumor metastasis and causes treatment failure in human cancers.Upregulation of HER3 is frequently observed in EGFR-mutant NSCLC treated with EGFR-tyrosine kinase inhibitors(TKIs).Increased expression of HER3 triggers the so-called EGFR-independent mechanism via interactions with other receptors to activate“by-pass signaling pathways”,thereby resulting in resistance to EGFR-TKIs.To date,no HER3-targeted therapy has been approved for cancer treatment.In both preclinical and clinical studies,targeting HER3 with a blocking an-tibody(Ab)is the only strategy being examined.Recent evaluations of an anti-HER3 Ab-drug conjugate(ADC)show promising results in patients with EGFR-TKI-resistant NSCLC.Herein,we summarize our understanding of the unique biology of HER3 in NSCLC refractory to EGFR-TKIs,with a focus on its dimerization partners and subsequent activation of signaling pathways.We also discuss the latest development of the therapeutic Abs and ADCs targeting HER3 to abrogate EGFR-TKI resistance in NSCLC. 展开更多
关键词 Human epidermal growth factor receptor 3(HER3) Epidermal growth factor receptor-tyrosine kinase inhibitors(EGFR-TKI) Resistance ANTIBODY Antibody-drug conjugate(ADC) Non-small cell lung cancer(NSCLC)
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Epigenetic mechanism of Survivin dysregulation in human cancer 被引量:13
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作者 hui lyu Jingcao Huang +1 位作者 Zhimin He Bolin Liu 《Science China(Life Sciences)》 SCIE CAS CSCD 2018年第7期808-814,共7页
Survivin(coding gene BIRC5) is a dual functional protein acting as a critical inhibitor of apoptosis(IAP) and key regulator of cell cycle progression. It is usually produced in embryonic tissues during development and... Survivin(coding gene BIRC5) is a dual functional protein acting as a critical inhibitor of apoptosis(IAP) and key regulator of cell cycle progression. It is usually produced in embryonic tissues during development and undetectable in most adult tissues.Overexpression of Survivin frequently occurs in various human cancers and increased Survivin correlates with poor clinic outcome, tumor recurrence, and therapeutic resistance. Because of its selective expression in tumor, but not normal tissues,Survivin has been recognized as an attractive target for cancer treatment. Although several therapeutic approaches targeting Survivin are actively under clinical trials in human cancers, to date no Survivin-targeted therapy has been approved for cancer treatment. Numerous studies have devoted to uncovering the underlying mechanism resulting in Survivin dysregulation at multiple levels, such as transcriptional and post-transcriptional regulation. The current article provides a literature review on the transcriptional and epigenetic regulation of Survivin expression in human cancers. We focus on the impact of DNA methylation and histone modifications, including specific lysine methylation, demethylation, and acetylation on the expression of Survivin.The latest development of epigenetic approaches targeting Survivin for cancer treatment are also discussed. 展开更多
关键词 SURVIVIN EPIGENETICS DNA methylation histone modification cancer therapy
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Understanding the biology of HER3 receptor as a therapeutic target in human cancer 被引量:8
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作者 hui lyu Amy Han +2 位作者 Erik Polsdofer Shuang Liu Bolin Liu 《Acta Pharmaceutica Sinica B》 SCIE CAS CSCD 2018年第4期503-510,共8页
HER3 belongs to the human epidermal growth factor receptor(HER) family which also includes HER1/EGFR/erb B1,HER2/erb B2,and HER4/erb B4. As a unique member of the HER family,HER3 lacks or has little intrinsic tyrosine... HER3 belongs to the human epidermal growth factor receptor(HER) family which also includes HER1/EGFR/erb B1,HER2/erb B2,and HER4/erb B4. As a unique member of the HER family,HER3 lacks or has little intrinsic tyrosine kinase activity. It frequently co-expresses and forms heterodimers with other receptor tyrosine kinases(RTKs) in cancer cells to activate oncogenic signaling,especially the PI-3 K/Akt pathway and Src kinase. Elevated expression of HER3 has been observed in a wide variety of human cancers and associates with a worse survival in cancer patients with solid tumors.Studies on the underlying mechanism implicate HER3 expression as a major cause of treatment failure in cancer therapy. Activation of HER3 signaling has also been shown to promote cancer metastasis. These data strongly support the notion that therapeutic inactivation of HER3 and/or its downstream signaling is required to overcome treatment resistance and improve the outcomes of cancer patients. 展开更多
关键词 HER3 DIMERIZATION Cell signaling Therapeutic resistance Tumor metastasis Targeted therapy
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