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多肿瘤标志物诊断模型对老年非小细胞肺癌胸膜转移的临床诊断研究 被引量:7
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作者 田应选 余敏 +5 位作者 孙莉 南巧峰 聂新宇 尚文丽 任小平 于娇 《实用老年医学》 CAS 2019年第6期540-543,共4页
目的比较不同肿瘤标志物对老年非小细胞肺癌(NSCLC)胸膜转移的诊断价值,并筛选最佳诊断效能标志物及标志物组合。方法选取我院内科胸腔镜诊断为NSCLC胸膜转移的老年病人60例为肺癌组,另选取同期各类良性胸腔积液病人49例为对照组。检测... 目的比较不同肿瘤标志物对老年非小细胞肺癌(NSCLC)胸膜转移的诊断价值,并筛选最佳诊断效能标志物及标志物组合。方法选取我院内科胸腔镜诊断为NSCLC胸膜转移的老年病人60例为肺癌组,另选取同期各类良性胸腔积液病人49例为对照组。检测2组病人胸腔积液中的癌胚抗原(CEA)、细胞角质蛋白19片段(CYFRA21-1)、神经烯醇化酶(NSE)、糖类抗原(CA)125、CA199、CA153的表达水平。采用Logistic逐步回归法纳入2组间差异有统计学意义的肿瘤标志物并建立函数诊断模型,进行预测分类、串联诊断试验及绘制受试者工作特征曲线等方法筛选出诊断效能最佳的标志物及标志物组合。结果2组间CEA、CYFRA21-1、NSE、CA125、CA199、CA153的表达水平差异均有统计学意义(P<0.05或P<0.01)。经Logistic多元回归分析筛选出评分较高的5种标志物串联组成的诊断模型为:CEA+NSE+CYFRA21.1、CYFRA21.1+NSE+CA125、CEA+CYFRA21.1+CA199、CEA+NSE+CA125+CA199及NSE+CYFRA21.1+CA125+CA199,其中CYFRA21.1+NSE+CA125具有更高的诊断效能。结论胸腔积液肿瘤标志物检测对NSCLC的胸膜转移有定性诊断价值,由标志物串联组成的诊断模型对胸膜转移恶性胸腔积液有临床辅助诊断价值,可为老年晚期肺癌病人提供无创、特异的诊断方法。 展开更多
关键词 老年人 非小细胞肺癌 肿瘤标志物 诊断模型 无创方法 胸膜转移
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支气管镜灌洗术在老年重症肺部感染治疗中的临床价值 被引量:28
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作者 李红艳 艾文婷 +2 位作者 田应选 隋永杰 杜洁 《中华老年多器官疾病杂志》 2018年第1期25-28,共4页
目的探讨支气管镜灌洗术在治疗老年重症肺部感染中的应用价值。方法入选陕西省人民医院呼吸内科住院部及重症医学科2013年5月至2016年5月收治的118例老年重症肺部感染患者,根据患者选择的治疗方式分为观察组与对照组,各59例。对照组采... 目的探讨支气管镜灌洗术在治疗老年重症肺部感染中的应用价值。方法入选陕西省人民医院呼吸内科住院部及重症医学科2013年5月至2016年5月收治的118例老年重症肺部感染患者,根据患者选择的治疗方式分为观察组与对照组,各59例。对照组采用常规经验性治疗,观察组在常规治疗基础上应用支气管镜灌洗术,比较两组患者基本资料及治疗后的临床疗效(血气指标、体温正常时间及住院时间)。采用SPSS 19.0软件对数据进行统计分析,根据数据类型,组间比较采用t检验或χ~2检验。结果两组治疗前基线资料比较,差异无统计学意义(P>0.05)。观察组治疗后各血气指标与治疗前比较,氧分压(PaO2)、血氧饱和度(SaO_2)、氧合指数(氧分压/吸入氧浓度,PaO_2/FiO_2)均较高,二氧化碳分压(PaCO_2)、C-反应蛋白(CRP)、白细胞(WBC)均较低,差异有统计学意义;与对照组比较,PaO_2[(86.30±4.27)vs(74.56±3.84)mm Hg]、SaO_2[(94.06±1.38)%vs(88.56±1.25)%]和PaO_2/FiO_2[(253.42±26.32)vs(227.34±20.01)]显著高于对照组,PaCO_2[(45.57±1.46)vs(53.46±0.53)mm Hg]、CRP[(8.58±0.74)vs(12.52±0.96)mg/L]、WBC[(7.64±2.15)×10~9vs(10.38±2.58)×10~9/L]显著低于对照组,差异有统计学意义(P<0.01)。治疗后观察组体温恢复至正常所需时间[(8.34±3.42)vs(11.52±5.03)d]及住院时间[(15.32±3.28)vs(19.21±6.54)d]显著低于对照组,差异均有统计学意义(P<0.01)。治疗后观察组总有效率为89.83%,显著高于对照组72.88%,差异有统计学意义(P<0.05)。手术中患者总体耐受性良好,无严重并发症发生。结论联合采用支气管镜肺泡灌洗术治疗老年重症肺部感染疗效显著,具有较高的临床应用价值。 展开更多
关键词 老年人 支气管镜灌洗术 重症肺部感染
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培美曲塞联合顺铂治疗老年肺腺癌疗效 被引量:10
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作者 田应选 刘凌华 +5 位作者 余蕾 尚文丽 任小平 朱建飞 孙莉 余敏 《中华老年多器官疾病杂志》 2018年第1期21-24,共4页
目的研究培美曲塞(pemetrexed)联合顺铂一线治疗方案对老年肺腺癌患者的临床疗效。方法回顾性分析陕西省人民医院2010年1月至2016年6月老年呼吸科、胸外科和肿瘤内科采用培美曲塞联合顺铂方案的肺腺癌住院患者76例,对照组为同期采用吉... 目的研究培美曲塞(pemetrexed)联合顺铂一线治疗方案对老年肺腺癌患者的临床疗效。方法回顾性分析陕西省人民医院2010年1月至2016年6月老年呼吸科、胸外科和肿瘤内科采用培美曲塞联合顺铂方案的肺腺癌住院患者76例,对照组为同期采用吉西他滨联合顺铂和多西他赛联合顺铂方案的肺腺癌住院患者31例,比较两组患者近期和远期疗效。采用SPSS 22.0统计软件对数据进行处理,组间比较采用t检验、χ~2检验或Fisher确切概率法。Kaplan-Meier法绘制生存曲线,Log Rank法比较组间差别。结果两组均无完全缓解(CR)患者,部分缓解(PR)患者比例差异无统计学意义(P>0.05)。培美曲塞组患者疾病控制率(DCR)为68.42%(52/76),病变进展(PD)患者比例为31.58%(24/76),疾病进展时间(TTP)为(12.8±2.9)个月,3年生存率为31.58%(24/76);对照组患者DCR为54.83%(17/31),PD患者比例为45.16%(14/31),TTP为(10.6±1.8)个月,3年生存率为19.35%(6/31)。相比对照组患者,培美曲塞组患者DCR较高,PD患者比例低,TTP和3年生存率优于对照组,差异有统计学意义(P<0.05)。Log Rank检验结果也表明培美曲塞组患者远期生存率略优于对照组,差异具有统计学意义(χ~2=3.97,P<0.05)。结论对于表皮生长因子受体(EGFR)野生型的晚期老年肺腺癌患者,培美曲塞联合顺铂方案是较好的可接受治疗方案,患者进展风险低于其他标准治疗方案,且可获得较长的生存期。 展开更多
关键词 老年人 药物疗法 肺癌 培美曲塞
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免疫治疗对老年非小细胞肺癌合并COPD病人气道高反应和肺功能的影响 被引量:2
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作者 霍树芬 尚文丽 +5 位作者 田应选 孙莉 任小平 王君 康慧芳 温红侠 《实用老年医学》 CAS 2022年第5期473-477,共5页
目的探讨程序性细胞死亡受体1/程序性细胞死亡配体1(PD-1/PD-L1)抑制剂治疗对老年非小细胞肺癌(NSCLC)合并COPD病人气道高反应和肺功能的影响。方法纳入30例接受PD-1/PD-L1抑制剂免疫治疗的NSCLC病人,分为合并COPD组和未合并COPD组,收... 目的探讨程序性细胞死亡受体1/程序性细胞死亡配体1(PD-1/PD-L1)抑制剂治疗对老年非小细胞肺癌(NSCLC)合并COPD病人气道高反应和肺功能的影响。方法纳入30例接受PD-1/PD-L1抑制剂免疫治疗的NSCLC病人,分为合并COPD组和未合并COPD组,收集治疗前后呼出气一氧化氮(FeNO)和肺功能指标,并进行统计学分析。结果30例病人中19例合并COPD,11例未合并COPD。治疗前,2组FeNO水平差异无统计学意义(P>0.05);治疗后,COPD组FeNO水平较治疗前显著升高,且明显高于非COPD组,差异均有统计学意义(P<0.01)。COPD组治疗后FEV1、FVC水平较治疗前均明显升高(P<0.05)。非COPD组治疗前后FVC和FEV1水平比较,差异无统计学意义(P>0.05)。2组治疗前后改良呼吸困难指数(mMRC)问卷评分或COPD评估测试(CAT)评分差异均无统计学意义(P>0.05),治疗期间无COPD急性加重发生。结论PD-1/PD-L1抑制剂免疫治疗可改变NSCLC合并COPD病人的FeNO水平和肺功能,且不会使COPD恶化。 展开更多
关键词 程序性细胞死亡受体1/程序性细胞死亡配体1抑制剂 非小细胞肺癌 慢性阻塞性肺疾病 呼出气一氧化氮 肺功能
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Detection of lung adenocarcinoma using magnetic beads based matrix-assisted laser desorption/ionization time-of-flight mass spectrometry serum protein profiling 被引量:13
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作者 LIN Xiu-li YANG Shuan-ying +5 位作者 DU Jie tian ying-xuan BU Li-na HUO Shu-fen WANG Feng-peng NAN Yan-dong 《Chinese Medical Journal》 SCIE CAS CSCD 2010年第1期34-39,共6页
Background Recently, due to the rapid development of proteomic techniques, great advance has been made in many scientific fields. We aimed to use magnetic beads (liquid chip) based matrix-assisted laser desorption/i... Background Recently, due to the rapid development of proteomic techniques, great advance has been made in many scientific fields. We aimed to use magnetic beads (liquid chip) based matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS) technology to screen distinctive biomarkers for lung adenocarcinoma (adCA), and to establish the diagnostic protein profiles. Methods Using weak cation exchange magnetic beads (MB-WCX) to isolate and purify low molecular weight proteins from sera of 35 lung adCA, 46 benign lung diseases (BLDs) and 44 healthy individuals. The resulting spectra gained by anchor chip-MALDI-TOF-MS were analyzed by ClinProTools and a pattern recognition genetic algorithm (GA). Results In the working mass range of 800-10 000 Da, 99 distinctive peaks were resolved in lung adCA versus BLDs, while 101 peaks were resolved in lung adCA versus healthy persons. The profile gained by GA that could distinguish adCA from BLDs was comprised of 4053.88, 4209.57 and 3883.33 Da with sensitivity of 80%, specificity of 93%, while that could separate adCA from healthy control was comprised of 2951.83 Da and 4209.73 Da with sensitivity of 94%, specificity of 95%. The sensitivity provided by carcinoembryonic antigen (CEA) in this experiment was significantly lower than our discriminatory profiles (P 〈0.005). We further identified a eukaryotic peptide chain release factor GTP-binding subunit (eRF3b) (4209 Da) and a complement C3f (1865 Da) that may serve as candidate biomarkers for lung adCA. Conclusion Magnetic beads based MALDI-TOF-MS technology can rapidly and effectively screen distinctive proteins/polypeptides from sera of lung adCA patients and controls, which has potential value for establishing a new diagnostic method for lung adCA. 展开更多
关键词 magnetic beads matrix-assisted laser desorption/ionization-mass spectrometry lung adenocarcinoma SERUM PROTEOMICS
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Study of differential proteins in lung adenocarcinoma using laser capture microdissection combined with liquid chip-mass spectrometry technology
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作者 BU Li-na YANG Shuan-ying +10 位作者 LI Feng-tao SHANG Wen-li ZHANG Wei HUO Shu-fen NAN Yan-dong tian ying-xuan DU Jie LIN Xiu-li LIU Yan-feng LIN Yu-rong RONG Biao-xue 《Chinese Medical Journal》 SCIE CAS CSCD 2010年第22期3309-3313,共5页
Background In recent years the proportion of lung adenocarcinoma (adCA) which occurs in lung cancer patients has increased. Using laser capture microdissection (LCM) combined with liquid chip-mass spectrometry tec... Background In recent years the proportion of lung adenocarcinoma (adCA) which occurs in lung cancer patients has increased. Using laser capture microdissection (LCM) combined with liquid chip-mass spectrometry technology, we aimed to screen lung cancer biomarkers by studying the proteins in the tissues of adCA. Methods We used LCM and magnetic bead based weak cation exchange (MB-WCX) to separate and purify the homogeneous adCA cells and normal cells from six cases of fresh adCA and matched normal lung tissues. The proteins were analyzed and identified by matrix assisted laser desorption/ionization time-of-fight mass spectrometry (MALDI-OF-MS). We screened for the best pattern using a radial basic function neural network algorithm. Results About 2.895x10s and 1.584x10s cells were satisfactorily obtained by LCM from six cases of fresh lung adCA and matched normal lung tissues, respectively. The homogeneities of cell population were estimated to be over 95% as determined by microscopic visualization. Comparing the differentially expressed proteins between the lung adCA and the matched normal lung group, 221 and 239 protein peaks, respectively, were found in the mass-to-charge ration (M/Z) between 800 Da and 10 000 Da. According to ttest, the expression of two protein peaks at 7521.5 M/Zand 5079.3 M/Z had the largest difference between tissues. They were more weakly expressed in the lung adCA compared to the matched normal group. The two protein peaks could accurately separate the lung adCA from the matched normal lung group by the sample distribution chart. A discriminatory pattern which can separate the lung adCA from the matched normal lung tissue consisting of three proteins at 3358.1 M/Z, 5079.3 M/Z and 7521.5 M/Z was established by a radial basic function neural network algorithm with a sensitivity of 100% and a specificity of 100%. Conclusions Differential proteins in lung adCA were screened using LCM combined with liquid chip-mass spectrometry technology, and a biomarker model was established. It is possible that this technology is going to become a powerful tool in screening and early diagnosis of lung adCA. 展开更多
关键词 lung adenocarcinoma laser capture microdissection magnetic beads mass spectrometry
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