Effect of sublingual dust mite drops on pulmonary function, immunoglobulin and T lymphocyte subsets in patients with allergic rhinitis

Objective:To investigate the effects of sublingual dust mite drops on Pulmonary function, immunoglobulin and T lymphocyte subsets in patients with allergic rhinitis.Methods:One hundred and ten patients with allergic rhinitis treated in our hospital from June 2014 to December 2016 were retrospectively analyzed. According to the treatment methods, the patients were divided into control group and observation group, with 53 cases in control group and 57 cases in observation group. The patients were given oral kastitium and risperidone nasal spray. The observation group was given sublingual dust mite droplet on the basis of the control group. Afterwards, the Pulmonary function, immunoglobulin and T lymphocyte subsets Group level testing.Results: After treatment, the levels of FEV1, FVC and PEF increased significantly in the two groups. After treatment, the levels of FEV1, FVC and PEF in the observation group were (2.97±0.09) L, (3.96±0.07) L and (6.61±0.03) L/S, were significantly higher than the control group;After treatment, the levels of sIgE and T-IgE in both groups were significantly decreased, sIgG4 levels were significantly increased,After treatment, the levels of sIgE and T-IgE in the observation group were (12.22±1.08) kUA/L and (155.32 ± 9.51) kUA/L, respectively, which were significantly lower than those in the control group,The level of sIgG4 was (434.17±12.31) mg/L, which was significantly higher than that of the control group;After treatment, the levels of CD3+, CD4+ and CD4+/CD8+ in both groups were significantly higher than those before treatment, and the levels of CD8+ in the two groups were significantly lower than those before treatment. The levels of CD3+, CD4+ and CD4+/CD8 in the two groups were (65.90±2.11)%, (39.18±0.33)% and (1.75±0.07), respectively, were significantly higher than that of the control group after treatment, the level of CD8+ was (24.13±0.77)%, which was significantly lower than that of the control group Significance.Conclusion: Sublingual dust mite drops can effectively improve pulmonary ventilation in patients with allergic rhinitis, regulate patient immune function, a significant effect, worthy of further clinical application.

Effect of kanglaite injection combined with chemotherapy on tumor factors, angiogenesis and immunoglobulin in patients with lung adenocarcinoma

Objective:To explore the effect of Kanglaite injection combined with chemotherapy on the levels of tumor factors, angiogenesis and immunoglobulin in patients with lung adenocarcinoma.Method: A total of 88 patients with lung adenocarcinoma in our hospital and the Fifth Peoples Hospital of Wuxi from February 2014 to December 2017 were divided randomly into observation group and control group according to the visiting time, 44 cases for each group. The observation group was treated with chemotherapy combined with Kanglaite injection, and the control group was treated with chemotherapy only.Both groups were treated for 6 weeks and then the levels of CEA, CA125, CA199, VEGFA, VEGFB, VEGFC, and IgA, IgM, IgG after treatment in both groups were compared.Result: Before treatment, there were no significant differences in the levels of CEA, CA125 and CA199 between two groups. The level of CEA in the observation group (29.88±7.07) μg/L was lower than that in the control group,and the difference was statistically significant. The levels of CA125 and CA199 after treatment were lower than those before treatment, but with no significant difference. Between the two groups, there was no significant difference of the levels of VEGFA,VEGFB and VEGFC before treatment, the level of VEGFA after treatment in the observation group (80.49±12.29) ng/mL was lower than that in the control group and the difference was statistically significant, and the levels of VEGFB and VEGFC after treatment were also lower than those before treatment, but with no significant difference. The levels of IgA, IgM and IgG before treatment in two groups had no significant difference, The level of IgM after treatment in the observation group (1.52±0.30) g/L was lower than that in the control group, with a statistical difference. The levels of IgA and IgG after treatment were lower than those before treatment, but with no significant difference;No serious adverse reaction was observed after treatment in both groups.Conclusion: Kanglaite injection combined with chemotherapy has a good clinical effect in lung adenocarcinoma, which can effectively inhibit the high expression of tumor markers, reduce angiogenesis, enhance body immunity, and can be recommended for clinical application.

Changes of serum tumor markers, immunoglobulins, TNF-α and hs-CRP levels in patients with breast cancer and its clinical significance

Objective: To study the serum tumor markers, immunoglobulin, TNF-α and hs-CRP in breast cancer in different pathological stages of the concentration, and to analyze the clinical significance of early diagnosis of breast cancer. Methods: A total of 130 patients with breast cancer were divided into stage I, II, III and IV according to clinical pathology. In addition, 40 patients with benign breast disease and 35 healthy subjects were selected as benign breast disease group and control group. Serum tumor markers, immunoglobulins, TNF-αand hs-CRP concentrations were measured and compared of all subjects. Results: There were no significant difference in serum tumor markers, immunoglobulin and inflammatory factors between the control group and the benign breast cancer group. The level of serum tumor markers in breast cancer group was significantly higher than that in control group and benign breast cancer group. The levels of serum CA125, CA153 and CEA were gradually increased with the severity enhancing from stage I and IV of breast cancer, and he difference was statistically significant. The level of serum immunoglobulin in breast cancer group was significantly higher than that in control group and benign breast cancer group. The levels of serum IgG and IgM increased gradually severity enhancing from stage I and IV of breast cancer, and the difference was statistically significant. The level of serum TNF-α and hs-CRP in serum of breast cancer group was significantly higher than that of control group and benign breast cancer group. The serum levels of TNF-α and hs-CRP increased gradually with severity enhancing from stage I and IV of breast cancer, and the difference was statistically significant. Conclusion: The level of serum tumor markers in breast cancer patients is increasing. Humoral and inflammatory responses are activated to varying degrees and increase with the aggregation of disease. They may involve regulating the occurrence and metastasis of breast cancer and regulating the pathophysiological function of patients. Which may be a certain clinical significance for the early diagnosis of breast cancer and disease progression.

Peripheral primitive neuroectodermal tumor of the kidney presenting with pulmonary tumor embolism: A case report

Peripheral primitive neuroectodermal tumor(PNET) of the kidney is a rare, aggressive tumor known for its recurrence and metastatic potential. Despite the frequency of venous extension to the renal veins and inferior vena cava, pulmonary tumor embolism at the initial presentation is not common. We report a case of 22-year-old female with PNET of the kidney who presented with tumor embolism in the inferior vena cava(IVC) and bilateral pulmonary artery. The patient underwent surgical resection and histopathological analysis confirmed the presence of tumor within the IVC and pulmonary arteries. The patient received adjuvant chemotherapy and is currently doing well on follow-up.

Successful Management of Pulmonary Tumor Embolism from Renal Cell Carcinoma

Although invasion of renal cell carcinoma (RCC) into the inferior vena cava is common, pulmonary tumor embolism is rare. We present a case of a pulmonary tumor embolism from type II papillary renal cell carcinoma successfully treated using a staged approach. Such staged procedures are particularly effective in cases of massive renal tumors. Pulmonary tumor embolectomy using normothermic cardiopulmonary bypass is considerably less invasive than under deep hypothermic circulatory arrest.

STUDY ON GLYCOCONJUGATE CHANGES ON CELL SURFACE IN PROGRESSIVE DEVELOPMENT OF PULMONARY TUMOR

Aim: To investigate glycoconjugate changes on the cell surface of proliferative lesions and neoplasms of mice lungs at various stages of tumorigenesis, the relation between progressive development of mouse pulmonary tumors and expression of cell surface saccharide. Materials and methods: Thirty - one male A/J strain mice at 5 weeks of age were treated intraperitoneally with a single injection of 20 - methylcholanthrene (20 - MC), 292 pulmonary lesions including 31 hyperplasias, 145 alveolar adenomas, 61 papillary adenomas, 55 papillary adenocarcinomas and their combined type were obtained. The binding affinities of cells in normal respiratory epithelia and in proliferative lesions to four peroxidases - conjugated lectins, Maclura pomifera agglutinin (MPA), Arachis hypogea agglutinin (PNA), Ricinus communis agglutinin (RCA), and wheat germ agglutinin (WGA) were examined. Results: Cells of hyperplasia and alveolar adenoma showed fairly strong affinity to all the four lectins. However, part of papillary adenoma cells and greater part of papillary adenocarcinoma cells lost their binding affinity to MPA, PNA, and RCA, but not to WGA. The bindings of MPA, PNA and RNA were detected predominently on the luminal surfaces of benign tumors but not on the luminal surfaces of malignant tumors. WGA might bind to varied types of benign and malignant tumors. Pretreated with neuraminidase, the lesions enhanced the staining intensity for the four lectins, the binding sites of WGA to malignant tumor cells were numerous. A distinct difference in lectin binding affinity between hyperplasia / alveolar adenoma/papillary adenoma and papillary adenocarcinoma was clearly shown( x2 = 46.89, P ＜ 0.01, x2 = 36.77, P ＜ 0.01 and x2 = 52.87, P ＜ 0.01 ) in this experiment. The complex glycoconjugates on the cell surface of malignant and benign lesions during the development of pulmonary tumor were changed,malignant tumor cells differed from the surface of benign tumor cells, the levels of total sialic acid were higher in malignant tumor cells than in benign lesions. Conclusions: The expressions of glycoconjugates on cell surface by lectins may assist differential diagnosis of the malignant and benign lung lesions.

Effects of montelukast sodium combined with budesonide on lung function, inflammatory factors and immunoglobulin levels in children with asthma

Objective: To investigate the effects of montelukast sodium combined with budesonide on pulmonary function, inflammatory factors and immunoglobulin in children with asthma. Methods: A total of 100 children with asthma treated in our hospital from May 2013 to November 2016 were randomly divided into control group and observation group. In the control group, budesonide inhalation therapy was given. On the basis of the control group, montelukast sodium treatment was given, pulmonary function, inflammatory factors and immunoglobulin levels in the two groups before and after treatment were measured. Results:Compared with before treatment, the levels of FEV1%, FEF50%, FEF25% and PEF% in the two groups were significantly increased, those in the observation group were higher than in control group;compared with before treatment, IL-10 levels were significantly increased, TNF-α and IL-8 levels were significantly decreased in the two groups after treatment, moreover those in the observation group IL-10 levels were significantly higher than the control group, TNF-α and IL-8 were significantly lower than those in the control group, the difference was statistically significant;Compared with before treatment, IgA and IgM levels were significantly increased in both groups after treatment, IgE levels were significantly decreased, and IgA and IgM levels in the observation group were significantly higher than in the control group, IgE levels were significantly lower than the control group, the difference was statistically. Conclusion: Montelukast sodium combined with budesonide can effectively reduce the inflammation level of children with asthma, improve lung function, enhance immunity, the effect is significant, it is worth further clinical application.

Primary hepatic neuroendocrine tumor with a suspicious pulmonary nodule:A case report and literature review

BACKGROUND Primary hepatic neuroendocrine tumors(PHNETs)are extremely rare tumors originating from neuroendocrine cells.Due to lack of neuroendocrine symptoms and specific radiographic characteristics,PHNETs are challenging to differentiate from other liver tumors.CASE SUMMARY This case involved a 67-year-old male who was admitted with a discovered hepatic mass and a suspicious lung lesion.Primary hepatic carcinoma was initially speculated based on the characteristic magnetic resonance imaging findings.The patient underwent a laparoscopic right partial hepatectomy,and subsequent immunohistochemical examination revealed a HNET.To exclude other potential origins,a positron emission tomography-computed tomography scan and gastrointestinal endoscopy were performed,leading to a final diagnosis of PHNETs.Then we conducted a literature review using the PubMed database,identifying 99 articles and 317 cases related to PHNETs.The characteristics,diagnostic methods,and treatment of PHNETs have been described.Finally,we elaborate on the presumed origins,pathological grades,clinical features,diagnosed methods,and treatments associated with PHNETs.CONCLUSION The diagnosis of PHNETs was primarily an exclusionary process.A definitive diagnosis of PHNETs relied mainly on immunohistochemical markers(chromogranin A,synaptophysin,and cluster of differentiation 56)and exclusion of primary foci in other organs.Radical surgery was the preferred treatment for early-stage tumors.

Small airway immunoglobulin A profile in emphysema-predominant chronic obstructive pulmonary disease

Background:Due to airway remodeling and emphysematous destruction in the lung,the two classical clinical phenotypes of chronic obstructive pulmonary disease(COPD)are emphysema and bronchiolitis.The present study was designed to investigate the levels of small airway immunoglobulin A(IgA)in COPD with“emphysema phenotype.”The study also evaluated the associations between the small airway IgA levels and the severity of disease by the extent of emphysema versus airflow limitation.Methods:Thirty patients(20 with COPD and ten healthy smokers)undergoing lung resection surgery for a solitary peripheral nodule were included.The study was conducted from January 2015 to December 2018 in the Shanxi Dayi Hospital.The presence of small airway IgA expression was determined in the lung by immunohistochemistry.In vivo,Wistar rats were exposed to silica by intratracheal instillation.Rats were sacrificed at 15 and 30 days after exposure of silica(n=10 for each group).We also evaluated airway IgA from rats.Results:Small airway secretory IgA(sIgA),dimeric IgA(dIgA),and dIgA/sIgA of Global Initiative for Chronic Obstructive Lung Disease grade 1–2 COPD patients showed no difference compared with smoking control subjects(5.15±1.53 vs.6.03±0.85;1.94±0.66 vs.1.67±0.04;41.69±21.02 vs.28.44±9.45,all P>0.05).dIgA/sIgA level in the lung of COPD patients with emphysema showed higher levels than that of COPD patients without emphysema(51.89±24.81 vs.31.49±9.28,P=0.03).The percentage of low-attenuation area below 950 Hounsfield units was positively correlated with dIgA/sIgA levels(r=0.45,P=0.047),but not associated with the severity of disease by spirometric measurements(forced expiratory volume in the first second%pred,P>0.05).Likewise,in the rat study,significant differences in sIgA,dIgA,dIgA/sIgA,mean linear intercept,mean alveoli number,and mean airwaythickness of bronchioles(VVairway,allP<0.01)were only observed between control rats and those exposed for 30 days.However,in the group exposed for 15 days,although theVVairwaywas higher than that in normal rats(27.61±2.26 vs.20.39±1.99,P<0.01),there were no significant differences in IgA and emphysema parameters between the two groups(all P>0.05).Conclusion:Airway IgA concentrations in mild and moderate COPD patients are directly associated with the severity of COPD with“emphysema phenotype”preceding severe airway limitation.This finding suggests that small airway IgA might play an important role in the pathophysiology of COPD,especially emphysema phenotype.

Pulmonary tumor thrombotic microangiopathy of hepatocellular carcinoma: A case report and review of literature

BACKGROUND Pulmonary tumor thrombotic microangiopathy(PTTM)is a rare condition in patients with hepatocellular carcinoma(HCC);to date,few cases have been reported.While hepatic dysfunction has been focused on the later stages of HCC,the management of symptoms in PTTM is important for supportive care of the cases.For the better understanding of PTTM in HCC,the information of our recent case and reported cases have been summarized.CASE SUMMARY A patient with HCC exhibited acute and severe respiratory failure.Radiography and computed tomography of the chest revealed the multiple metastatic tumors and a frosted glass–like shadow with no evidence of infectious pneumonia.We diagnosed his condition as acute respiratory distress syndrome caused by the lung metastases and involvement of the pulmonary vessels by tumor thrombus.Administration of prednisolone to alleviate the diffuse alveolar damages including edematous changes of alveolar wall caused by the tumor cell infiltration and ischemia showed mild improvement in his symptoms and imaging findings.An autopsy showed the typical pattern of PTTM in the lung with multiple metastases.CONCLUSION PTTM is caused by tumor thrombi in the arteries and thickening of the pulmonary arterial endothelium leading to the symptoms of dyspnea in terminal staged patients.Therefore,supportive management of symptoms is necessary in the cases with PTTM and hence we believe that the information presented here is of great significance for the diagnosis and management of symptoms of PTTM with HCC.

Dynamic Expression of Tumor Necrosis Factor-α and Vascular Endothelial Growth Factor in Rat Model of Pulmonary Emphysema Induced by Smoke Exposure

In order to explore the roles of tumor necrosis factor-α （TNF-α） and vascular endothelial growth factor （VEGF） in the pathogenesis of pulmonary emphysema, male Wistar rats were randomized into group At, group A2.5 and group A4, each with smoke exposure for 1 month, 2.5 months or 4 months, respectively. Group B t, group B2.5 and group B4 were used as non smoking controls at corresponding time points. TNF-α in bronchoalveolar lavage fluid （BALF） and expression of VEGF in lung tissue was determined by ELISA or by SABC immunohistochemistry assay either. Lung slices were stained with hematoxylin and eosin （HE）. Results showed that in animal with smoke exposure the mean linear interceptor （Lm）, an index of pulmonary emphysema and the content of TNF-α in BALF increased gradually, on contrary, the expression of VEGF in lung tissue decreased （P〈0.05）. This phenomenon was not obvious in animals without smoke exposure. Lm was negatively correlated to the VEGF expression （7=--0.81, P〈0.01） and positively correlated to TNF-α concentration （7 = 0.52, P〈0.004）, which implies that smoke exposure decreased the expression of VEGF and increased the expression of TNF-α. It is plausible to speculate that the imbalance of TNF-α and VEGF may play an important role in the pathogenesis of smoke-induced pulmonary emphysema.

DIAGNOSIS AND TREATMENT OF THE MALIGNANT GESTATIONAL TROPHOBLASTIC TUMOR WITH PULMONARY METASTASIS COMPLICATED WITH PULMONARY TUBERCULOSIS

Objective. To evaluate the diagnosis and treatment for malignant gestational trophoblastic tumor(MGTT) with pulmonary metastasis complicated with pulmonary tuberculosis. Methods. To analyze ten cases of MGTT with pulmonary metastasis complicated with pulmonary tuberculosis in our hospital from 1980 to 1997 retrospectively. Results.From the x ray film, there are great resemblances between MGTT with pulmonary metastasis and pulmonary tuberculosis. Of 10 patients, 7 of them were examined out pulmonary tuberculosis during the chemotherapy of MGTT. Pulmonary tuberculosis appeared six months before chemotherapy in three cases. All of the patients were treated with multiagent chemotherapy. Seven patients achiceved a complete remission, 2 patients developed drug resistance and died of cerebral haemorrhage and cerebral herniation, 1 woman who had achieved a complete remission from MGTT for 14 months died of miliary tuberculosis. Conclusion. It is very important to make differential diagnosis of the MGTT with pulmonary metastasis complicated with pulmonary tuberculosis. Trying to avoid excessive anti tumor treatment owing to mistake pulmonary tuberculosis for pulmonary metastasis, and avoiding missing an opportunity of anti tuberculosis treatment because of missed diagnosis should be emphasized.

Anesthetic management for intraoperative acute pulmonary embolism during inferior vena cava tumor thrombus surgery:A case report

BACKGROUND Acute pulmonary embolism(APE)is a rare and potentially life-threatening condition,even with early detection and prompt management.Intraoperative APE required specific ways for detecting since classic symptoms of APE in the awake patient could not be observed or self-reported by the patient under general anesthesia.CASE SUMMARY A 44-year-old man with a history of hepatic cell carcinoma was admitted for radical nephrectomy and tumor thrombectomy due to a newly found kidney tumor with inferior vena cava(IVC)tumor thrombus.APE that occurred during tumor thrombectomy with hypercapnia and desaturation.The capnography combined with the transesophageal echocardiography(TEE)provided a crucial differential diagnosis during the operation.The patient was continuously managed with aggressive intravenous fluid resuscitation and blood transfusion under continuous cardiac output monitoring to maintain hemodynamic stability.He completed the surgery under stable hemodynamics and was extubated after percutaneous mechanical thrombectomy by a certified cardiologist.There were no significant symptoms and signs or obvious discomfort in the patient’s self-report during visits to the general ward.CONCLUSION Under general anesthesia for IVC tumor thrombus surgery,a sudden decrease in end-tidal carbon dioxide is the initial indicator of APE,which occurs before hemodynamic changes.When intraoperative APE is suspected,TEE is useful in the diagnosis and monitoring before computer tomography pulmonary angiogram.Timely clinical impression and supportive treatment and intervention should be conducted to obtain a better prognosis.

Multifocal neuroendocrine cell hyperplasia accompanied by tumorlet formation and pulmonary sclerosing pneumocytoma:A case report

BACKGROUND Pulmonary tumorlets are nodular hyperplastic neuroendocrine cells(NECs)that extend beyond the basement membrane.They often coexist with other lung diseases such as fibrosis and bronchiectasis,but rarely accompanied by pulmonary sclerosing pneumocytoma(PSP),which has not been reported in the literature.CASE SUMMARY A 54-year-old woman was admitted to the hospital because she had symptoms of bloody sputum for more than 4 mo and hemoptysis for 1 wk.Computed tomography images showed atrophy accompanied by infections in the middle lobe of her right lung.Moreover,numerous nodules were identified in the middle lobe of the right lung.The patient underwent thoracoscopic pneumonectomy of the middle lobe of the right lung,and the resected mass was pathologically confirmed to have bronchiectasis,multifocal NEC hyperplasia accompanied by tumorlet,and PSP.CONCLUSION Our report presents a rare clinical case of bronchiectasis complicated with multifocal NEC hyperplasia,tumorlet,and PSP.

A pulmonary metastatic breast phyllodes tumor and clinicopathology analysis

Objective Breast phyllodes tumors(PTs) are rare fibroepithelial tumors that are characterized by formation of foliation patterns. Behaviorally, only relatively poor prediction of PTs is possible based on their histological appearance. PTs are frequently misdiagnosed because they are difficult to differentiate from soft tissue tumors. In this report, we describe the pathological features of a rare case of PT and review the relevant literature, summarizing the essentials of the diagnosis and differential diagnosis, while attempting to avoid misdiagnosis or missed diagnosis of the tumor to the best of our abilities.Methods We present a case of pulmonary metastatic lobular tumor, analyzing the morphological [hematoxylin-eosin(HE) staining] and immunohistochemical(streptavidin perosidase method, SP) features of the tissue.Results Long spindle-shaped tumor cells were observed using microscopy. The cells were arranged in bundles, with a whirlpool pattern, and braided. The proliferation of the spindle cells was markedly atypical and karyokinesis was elevated. Residual ductal epithelium was detected in some areas, and the margins of the tumor tissues showed invasive growth. Immunohistochemical studies of the spindle-shaped tumor cells were positive for actin, PR, CD10, SMA, Bcl-2, and negative for CKP, S-100, CD34, ER. The Ki-67 index was 40%.Conclusion The spindle cell tumor identified in the lung should first be considered as a metastatic neosplasm, because most soft-tissue sarcomas commonly metastasize through the bloodstream to the lungs. Although malignant breast PTs are rare, a detailed medical history that includes prior surgical history is required to avoid wrongful or missed diagnosis.

A Small Solitary Pulmonary Nodule Discovered by ^(18)F-fluorodeoxyglucose Positron Emission Tomography and CT: Rare Infection Instead of Rare Tumor

THE causes of Cushing＇s syndrome are mainly di- vided into adrenocorticotropic hormone （ACTH） dependent and independent. ACTH dependent hypercortisolism represents excess ACTH se-creting by the pituitary or tumor outside the pituitary; and the latter one is also called as ectopic ACTH syndrome. Thorax is the most common location of causative lesions for ectopic ACTH syndrome, and the size of lesion is too small to be detected in some cases.1＇ 2 Cryptococcal pneumonia usually occurs in immunocompromised patients and excess cortisol production can theoretically produce a state of immunodeficiency. Development of cryptococcal pneumonia concomitant with Cushing syndrome （CS） was rare. Here, we report a case of pulmonary nodule in a patient with CS differentiated with ectopic ACTH-producing tumor. Crypto- coccal pneumonia was diagnosed followinglung resection.

Tumor Necrosis Factor-Alpha (TNF)-308G/A and Interleukin 8(IL-8)-251C/T Polymorphisms in Pulmonary Tuberculosis Patients from Congo

Background: Tuberculosis (TB) is one of the world’s deadliest infectious diseases. Tumor necrosis factor-Alpha (TNF-α) and Interleukin 8 (IL-8) are involved in the pathogenesis of pulmonary TB (PTB). However, the contribution of polymorphisms of these cytokines to PTB susceptibility needed more investigation across geographic regions and ethnic groups. Purpose: The aim of this study was to investigate the association of the TNF-α-308 G/A and IL-8-251T/A polymorphisms with PTB risk in the Congolese population. Methods: This case-control study included 150 PTB patients and 160 control subjects. Blood samples were collected from all participants and were used for the TNF-α-308 G/A and IL-8-251T/A genotyping by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. Odds ratios (OR) were calculated to estimate the potential polymorphism associations. A P level of Results: A significant difference was found between PTB patients and controls regarding the TNF-α-308AA genotype (P = 0.035) distribution. Moreover, this genotype was associated with risk to TB (OR = 7.19, 95% CI = 0.85 - 60.65, P = 0.035). The A allele was significantly more frequent in PTB patients than in controls, and was associated with risk to PTB (OR = 1.68, 95% CI = 1.05 - 2.68, P = 0.014). Regarding the IL-8-251T/A gene, TA and AA genotypes were significantly more frequent in PTB patients compared to controls, and were associated with increased risk to PTB (OR = 2.64, 95% CI = 0.97 - 7.18, P = 0.031 and OR = 3.0, 95% CI = 1.13 - 7.98, P = 0.014, respectively). However, the IL-8-251 A allele was not associated to PTB susceptibility (OR = 0.27, 95% CI = 0.15 - 0.44). Conclusion: TNF-α-308G/A and IL-8-251T/A polymorphisms may be associated to PTB susceptibility in the Congolese population, and the AA genotype of both cytokines could be a risk factor.

Correlation Analysis between Idiopathic Pulmonary Fibrosis and Tumor Markers

The purpose of this study was to investigate the correlation between idiopathic pulmonary fibrosis(IPF)and tumor markers to provide evidence for early screening of precancerous lesions.In our hospital from July 2017 to May 2019,40 patients with IPF treatment were selected as the IPF group,and 40 patients with idiopathic pulmonary fibrosis with lung cancer(IPF-LC)were selected as the IPF-LC group.In the same period,40 healthy physical examinees were used as control group.Different types of patients in the IPF-LC group were divided into lung adenocarcinoma group,small cell lung cancer group and l squamous carcinoma group.The expression levels of tumor markers were detected in the three groups,the positive rates of tumor markers in IPF group,IPF-LC group and their subgroups were compared.The results showed that the levels of neuron specific enolase(NSE),antigen CYFRA211,carcinogenic antigen(CEA)and cancer antigen 125(CA125)in IPF and IPF-LC groups were significantly higher than those in control group(P<0.05).There was no significant difference in CEA and CYFRA211 between IPF-LC group and IPF group.The level of NSE in IPF-LC group was significantly higher than that in IPF group,while the level of CA125 was significantly lower than that in IPF group(P<0.0.5).The difference of positive rate of NES and CA125 in IPF-LC group and IFP group was statistically significant(P<0.05),there was no statistically significant difference in the positive rate of other indicators(P>0.05)The NSE positive rate of IPF group was significantly lower than that of IPF-LC group(P<0.05),the positive rates of other tumor markers were significantly lower than those of each subgroup of IPF-LC group(P<0.05).Therefore,tumor markers in IPF patients showed different degrees of increase,which is worthy of clinical attention.Among them,NSE can be used as an early screening indicator for IPF precancerous lesions.

Tumor-Associated Autoantibodies: Re-Optimization of EarlyCDT-Lung Diagnostic Performance and Its Application to Indeterminate Pulmonary Nodules

Background: Low-dose computed tomography (CT) screening reduces lung cancer mortality but costs are prohibitive for most healthcare budgets due to high false positive rates. An adjunctive test able to distinguish malignant from benign pulmonary nodules would be hugely beneficial. EarlyCDT-Lung measures serum autoantibodies to tumor-associated antigens and has found clinical acceptance to aid early detection of lung cancer for high risk patients. However performance was optimized for screening. The construction of a receiver-operating characteristic (ROC) curve would enable optimization of performance for alternative settings, including nodule malignancy. Methods: A Monte-Carlo search method was used to construct a ROC curve using a case-control cohort, enabling high and low specificity versions of EarlyCDT-Lung to be determined. These were used for a theoretical evaluation of a nodule cohort, and positive predictive value (PPV) was calculated under the assumption of independence of risk source. Patients or their nodules are typically classified into three risk groups: low (0% - 10%), intermediate (10% - 65%) and high (>65%) risk of malignancy. The predicted shift in risk group by application of the high and low specificity versions, along with the current commercial EarlyCDT-Lung, was then estimated. Results: The ROC curve, with an area under the curve of 0.743, was constructed. The high specificity (98%), low specificity (49%) and current commercial (91% specificity) versions of EarlyCDT-Lung re-classified 27%, 23% and 26% of intermediate nodules, respectively, to either a higher (10%, 8% and 10%) or lower (17%, 15% and 16%) risk group. Conclusion: A ROC curve was constructed to allow performance prediction of EarlyCDT-Lung at different specificities in the indeterminate nodule setting. This enabled risk re-classification of intermediate risk nodules, and could therefore facilitate alternative more appropriate intervention. We have shown how a multivariate biomarker test can add to the interpretation of pulmonary nodules and therefore aid patient management.

Heterogeneity of aberrant immunoglobulin expression in cancer cells

Accumulating evidence has shown that immunoglobulin(Ig)is‘unexpectedly’expressed by epithelial cancer cells and that it can promote tumor growth.The main purpose of this study was to explore the components of the cancerous Ig and its possible function.The presence of cancerous Ig in the Golgi apparatus was confirmed by immunofluorescence,indirectly suggesting that the cancerous Ig was processed and packaged in cancer cells.Western blot analysis and ELISA results indicated that cancer cells produced membrane Ig and secreted Ig into the supernatant fraction.The cancerous Ig consists of an a heavy chain and a k light chain.Finally,by analyzing the Ig components pulled down by protein A beads,the cancerous Ig was found to be structurally distinct from normal Ig.The cancerous Ig was truncated or aberrant.Although the underlying mechanism that causes the abnormalities has not been determined,our current discoveries strengthen our previous findings and promise fruitful future explorations.