The combined detection of carcinoembryonic antigen,carcinogenic antigen 125,and carcinogenic antigen 19-9 in colorectal cancer patients

BACKGROUND Hepatic metastases are common and difficult to treat after colorectal cancer(CRC)surgery.The predictive value of carcinoembryonic antigen(CEA),cancer antigen(CA)125 and CA19-9 combined tests for liver metastasis is unclear.AIM To evaluate predictive value of combined tests for CEA,CA125,and CA19-9 levels in patients with liver metastases of CRC.METHODS The retrospective study included patients with CRC alone(50 cases)and patients with CRC combined with liver metastases(50 cases)who were hospitalized between January 2021 and January 2023.Serum CEA,CA125 and CA19-9 levels were compared between the two groups,and binary logistic regression was used to analyze the predictive value of the combination of these tumor markers in liver metastasis.In addition,we performed receiver operating characteristic(ROC)curve analysis to assess its diagnostic accuracy.RESULTS The results showed that the serum CEA,CA125 and CA19-9 levels in the CRC with liver metastasis group were significantly higher than those in the CRC alone group.Specifically,the average serum CEA level in the CRC with liver metastasis group was 162.03±810.01 ng/mL,while that in the CRC alone group was 5.71±9.76 ng/mL;the average serum CA125 levels were 43.47±83.52 U/mL respectively.and 13.5±19.68 U/mL;the average serum CA19-9 levels were 184.46±473.13 U/mL and 26.55±43.96 U/mL respectively.In addition,binary logistic regression analysis showed that CA125 was significant in predicting CRC liver metastasis(P<0.05).ROC curve analysis results showed that the areas under the ROC curves of CEA,CA125 and CA19-9 were 0.607,0.692 and 0.586.CONCLUSION These results suggest that combined detection of these tumor markers may help early detection and intervention of CRC liver metastasis,thereby improving patient prognosis.

Inflammatory response in gastrointestinal cancers:Overview of six transmembrane epithelial antigens of the prostate in pathophysiology and clinical implications

Chronic inflammation is known to increase the risk of gastrointestinal cancers(GICs),the common solid tumors worldwide.Precancerous lesions,such as chronic atrophic inflammation and ulcers,are related to inflammatory responses in vivo and likely to occur in hyperplasia and tumorigenesis.Unfortunately,due to the lack of effective therapeutic targets,the prognosis of patients with GICs is still unsatisfactory.Interestingly,it is found that six transmembrane epithelial antigens of the prostate(STEAPs),a group of metal reductases,are significantly associated with the progression of malignancies,playing a crucial role in systemic metabolic homeostasis and inflammatory responses.The structure and functions of STEAPs suggest that they are closely related to intracellular oxidative stress,responding to inflammatory reactions.Under the imbalance status of abnormal oxidative stress,STEAP members are involved in cell transformation and the development of GICs by inhibiting or activating inflammatory process.This review focuses on STEAPs in GICs along with exploring their potential molecular regulatory mechanisms,with an aim to provide a theoretical basis for diagnosis and treatment strategies for patients suffering from these types of cancers.

Prostate cancer with elevated free prostate-specific antigen density:A case report

BACKGROUND Prostate cancer is the second most common cancer among men worldwide,and prostate-specific antigen(PSA)is often used in clinical practice to screen for prostate cancer.Normal total PSA(tPSA)level initially excludes prostate cancer.Here,we report a case of prostate cancer with elevated free PSA density(fPSAD).CASE SUMMARY A patient diagnosed with benign prostatic hyperplasia underwent prostatectomy,and the postoperative pathological results showed acinar adenocarcinoma of the prostate.The patient is currently undergoing endocrine chemotherapy.CONCLUSION We provide a clinical reference for diagnosis and treatment of patients with normal tPSA but elevated fPSAD.

Serum tumor markers (carcinoembryonic antigen, carbohydrate antigen 19-9, carbohydrate antigen 72-4, carbohydrate antigen 24-2, ferritin) and gastric cancer prognosis correlation

BACKGROUND Gastric cancer is a kind of malignant tumor which is prevalent all over the world.Although some progress has been made in the treatment of gastric cancer,its prognosis is still not optimistic,so it is of great significance to find reliable prog-nostic indicators to guide the treatment and management of patients with gastric cancer.AIM To explore the relationship between serum levels of five biomarkers[carcinoem-bryonic antigen(CEA),carbohydrate antigen(CA)19-9,CA72-4,CA24-2,and ferritin]and prognosis in patients with gastric cancer.METHODS This study included 200 patients with gastric adenocarcinoma,and conducted an in-depth analysis of their baseline characteristics,relationship between tumor markers and staging,and prognosis.The study found that CA19-9 has a signi-ficant correlation with tumor stage,the average levels of CA24-2,CEA,CA72-4 and ferritin were slightly increased disregarding the stage of tumor.Survival analysis showed that increases in CEA,CA19-9,CA24-2,and ferritin were all associated with shortened overall survival of patients.Further multivariate ana-lysis revealed that elevated serum CA72-4 levels were an inde-pendent adverse prognostic factor.RESULTS This study reveals that there is a significant correlation between the expression levels of serum tumor markers CEA,CA19-9,CA72-4,CA24-2 and ferritin in patients with gastric cancer and prognosis,and can be used as important indicators for prognostic evaluation of gastric cancer.In particular,markers that appear abnormally elevated initially may help identify gastric cancer patients with poor prognosis.CONCLUSION Serum CEA and CA19-9 play an important role in the prognosis assessment of gastric cancer,and are effective tools to guide clinical practice and optimize individualized treatment strategies for gastric cancer patients.

Predictive value of CA-153,CA-125 and Apo A for ocular metastasis in menopausal female patients with breast cancer

AIM:To establish a meaningful standard for diagnosing ocular metastasis(OM)in menopausal breast cancer(BC)women,and explore the relationship between CA-153,CA-125,apolipoprotein A,and OM.METHODS:A total of 1362 menopausal female BC patients with OM volunteered to take part in this study between July 2012 and July 2022.Women with BC who are menopausal were found to have an OM incidence of 1.6%.Furthermore,CA-153,CA-125,and apolipoprotein A(Apo A)all contributed to OM in women with BC who are postmenopausal according to binary logistic regression.Receiver operating curve(ROC)analysis was used to assess the diagnostic value of OM in patients with BC.RESULTS:Both CA-153 and CA-153+CA-125 showed a higher sensitivity of 95.45%,whereas CA-153+Apo A illustrated the highest specificity of 99.02%.Moreover,CA-153 and CA-153+CA-125 had higher areas under the curve(AUC)of 0.973.CONCLUSION:The data indicate that the serum concentrations of CA-153 exhibited the most significant predictors of the diagnosis of OM in menopausal women with BC.The current study researches the utility of risk factors in predicting of OM in menopausal BC women and put forward the latest suggestions on their clinical application.

Prediction and analysis of albumin-bilirubin score combined with liver function index and carcinoembryonic antigen on liver metastasis of colorectal cancer

BACKGROUND Colorectal cancer(CRC)is a common malignant tumor,and liver metastasis is one of the main recurrence and metastasis modes that seriously affect patients’survival rate and quality of life.Indicators such as albumin bilirubin(ALBI)score,liver function index,and carcinoembryonic antigen(CEA)have shown some potential in the prediction of liver metastasis but have not been fully explored.AIM To evaluate its predictive value for liver metastasis of CRC by conducting the combined analysis of ALBI,liver function index,and CEA,and to provide a more accurate liver metastasis risk assessment tool for clinical treatment guidance.METHODS This study retrospectively analyzed the clinical data of patients with CRC who received surgical treatment in our hospital from January 2018 to July 2023 and were followed up for 24 months.According to the follow-up results,the enrolled patients were divided into a liver metastasis group and a nonliver metastasis group and randomly divided into a modeling group and a verification group at a ratio of 2:1.The risk factors for liver metastasis in patients with CRC were analyzed,a prediction model was constructed by least absolute shrinkage and selection operator(LASSO)logistic regression,internal validation was performed by the bootstrap method,the reliability of the prediction model was evaluated by subject-work characteristic curves,calibration curves,and clinical decision curves,and a column graph was drawn to show the prediction results.RESULTS Of 130 patients were enrolled in the modeling group and 65 patients were enrolled in the verification group out of the 195 patients with CRC who fulfilled the inclusion and exclusion criteria.Through LASSO regression variable screening and logistic regression analysis.The ALBI score,alanine aminotransferase(ALT),and CEA were found to be independent predictors of liver metastases in CRC patients[odds ratio(OR)=8.062,95%confidence interval(CI):2.545-25.540],(OR=1.037,95%CI:1.004-1.071)and(OR=1.025,95%CI:1.008-1.043).The area under the receiver operating characteristic curve(AUC)for the combined prediction of CRLM in the modeling group was 0.921,with a sensitivity of 78.0%and a specificity of 95.0%.The H-index was 0.921,and the H-L fit curve hadχ^(2)=0.851,a P value of 0.654,and a slope of the calibration curve approaching 1.This indicates that the model is extremely accurate,and the clinical decision curve demonstrates that it can be applied effectively in the real world.We conducted internal verification of one thousand resamplings of the modeling group data using the bootstrap method.The AUC was 0.913,while the accuracy was 0.869 and the kappa consistency was 0.709.The combination prediction of liver metastasis in patients with CRC in the verification group had an AUC of 0.918,sensitivity of 85.0%,specificity of 95.6%,C-index of 0.918,and an H-L fitting curve withχ^(2)=0.586,P=0.746.CONCLUSION The ALBI score,ALT level,and CEA level have a certain value in predicting liver metastasis in patients with CRC.These three criteria exhibit a high level of efficacy in forecasting liver metastases in patients diagnosed with CRC.The risk prediction model developed in this work shows great potential for practical application.

Technetium-99m-methylene diphosphonate single photon emission computed tomography/computed tomography combined with prostate-specific antigen/free prostate-specific antigen ratio for bone metastasis of prostate cancer

BACKGROUND Prostate cancer(PC)is one of the most common malignant tumors in men,and bone metastasis is one of its common complications,which seriously affects the quality of life and prognosis of patients.AIM To investigate the diagnostic value of technetium-99m-methylene diphosphonate(99mTc-MDP)single photon emission computed tomography(SPECT)/CT imaging combined with the serum prostate-specific antigen(PSA)/free PSA ratio for PC bone metastasis(PCBM).METHODS One hundred patients with PC who visited the Hospital of Chengdu University of Traditional Chinese Medicine from January 2020 to January 2022 were recruited as the experimental(Exp)group,while 30 patients with benign prostatic lesions(BPLs)were recruited as the control(Ctrl)group.All patients underwent 99mTc-MDP SPECT/CT imaging and serum PSA/fPSA testing.The SPECT/CT imaging results and serum PSA/fPSA ratios of patients were analyzed to evaluate their diagnostic values for PCBM.RESULTS The difference in general information of the patients was not obvious,showing comparability.The two methods showed no visible differences in negative predictive value and sensitivity for patients with PCBM,but had great differences in positive predictive value and specificity(P<0.05).The PSA/fPSA ratio of patients with PC in the Exp group was lower than those with BPLs,and patients with PCBM had a much lower PSA/fPSA ratio than those without PC(P<0.05).The results confirmed that the combined use of 99mTc-MDP SPECT/CT imaging and serum PSA/fPSA ratio achieved a detection rate of 95%for PCBM.CONCLUSION The combination of 99mTc-MDP SPECT/CT and PSA/fPSA ratio is accurate and reliable for the diagnosis of PCBM,which provides an important reference for clinical practice.

Six transmembrane epithelial antigens of the prostate to illustrate inflammatory response in gastrointestinal cancers

Gastrointestinal cancer(GIC)is a common and widespread form of tumor,with colonoscopy and upper gastrointestinal endoscopy available to detect relevant precancerous polyps and lesions.However,many patients are already in the late stages when first diagnosed with such cancer,resulting in a poor prognosis.Thus,it is necessary to explore new methods and research directions in order to improve the treatment of GIC.Given the specific nature of the gastrointestinal tract,research should focus on the mechanisms of various inflammations and the interactions between food entering and exiting from the gastrointestinal tract and cancer cells.Interestingly,six transmembrane epithelial antigens of the prostates(STEAPs)have been found to be significantly linked to the progression of malignant tumors,associated with intracellular oxidative stress and playing a major role in inflammation with their structure and function.This paper explores the mechanism of STEAPs in the inflammatory response of GIC,providing a theoretical basis for the prevention and early intervention of GIC.The basic properties of the STEAP family as metal reductase are also explained.When it comes to intervention for GIC prevention,STEAPs can affect the activity of Fe^(3+),Cu^(2+) reductase and regulate metal ion uptake in vivo,participating in inflammation-related iron and copper homeostasis.Thus,the mechanism of STEAPs on inflammation is of important value in the prevention of GIC.

New Progress of CA125 Surveillance in Diagnosis and Treatment of Ovarian Cancer

The fatality rate of ovarian cancer (OC) is the highest, and the 5-year survival rate is only 50.8%. For more than 40 years, CA125 has been the most concerned and widely used biomarker of OC in clinical practice. In recent years, many researchers have proposed a reliable strategy of multiple markers combined with CA125 to screen OC to make up for the lack of accuracy of CA125, redefine the biochemical recurrence threshold of CA125, and use mathematical model scores to provide help for the feasibility of treatment and survival prognosis. To fully understand the role of CA125 in OC screening, initial treatment, and recurrence prediction, and summarize the limitations of CA125, this review has summarized the new progress of CA125 in the diagnosis and treatment of OC in recent years which can also provide a reference for clinicians.

CA125、Ang-2在子宫肌瘤患者血清中的表达及其与术后转归的关系

目的探讨糖类抗原125(CA125)、血管生成素-2(Ang-2)在子宫肌瘤患者血清中的表达及其与术后转归的关系,为评估肿瘤活性和预测术后复发风险提供参考。方法选取2019年1月至2020年12月攀枝花市第二人民医院收治的60例接受子宫肌瘤剔除术的患者作为研究对象,设为观察组。另选取同期60例健康体检子宫正常者设为对照组。检测对照组及观察组术前、术后7 d血清CA125、Ang-2水平,并对观察组进行1年的随访。采用Logistic回归分析影响术后复发的危险因素;采用受试者工作特征(ROC)曲线分析血清CA125、Ang-2水平与术后子宫肌瘤复发的预测价值。结果观察组术前血清CA125、Ang-2水平均高于对照组(P<0.05),观察组术后7 d血清CA125、Ang-2水平均低于观察组术前(P<0.05)。观察组术后随访1年,其中复发15例,未复发45例,复发率为25.0%。复发组术后7 d血清CA125、Ang-2水平均高于未复发组(P<0.05)。Logistic回归分析显示,术后7 d血清CA125、Ang-2水平是影响术后复发的独立危险因素(OR=1.032、1.046,P<0.05)。ROC曲线分析显示,术后7 d血清CA125、Ang-2水平对术后肌瘤复发的预测价值较高,曲线下面积分别为0.823、0.841。结论子宫肌瘤患者血清CA125、Ang-2水平高与子宫肿瘤生长及复发有关,可作为评估子宫肌瘤活性和预测术后转归的指标,是影响术后复发的独立危险因素,具有较高的预测价值。

白蛋白结合型紫杉醇联合卡铂治疗晚期卵巢癌的疗效及血清HE4、CA125、淋巴细胞亚群检测的临床意义

目的探讨白蛋白结合型紫杉醇联合卡铂治疗晚期卵巢癌的临床疗效及安全性,分析人附睾蛋白4(HE4)、糖类抗原(CA)125、淋巴细胞亚群检测的临床意义。方法回顾性分析2018年12月至2022年12月该院收治的晚期卵巢癌患者临床资料,对照组(29例)采用紫杉醇脂质体联合卡铂治疗,观察组(29例)采用白蛋白结合型紫杉醇联合卡铂治疗,两组均治疗6个疗程。比较两组客观缓解率(ORR)、疾病控制率(DCR)、不良反应及治疗前后血清HE4、CA125、T淋巴细胞亚群的变化。结果观察组ORR为79.31%,高于对照组的51.72%(χ^(2)=4.884,P=0.027)。观察组DCR为93.10%,高于对照组的79.31%(χ^(2)=4.062,P=0.044)。对照组各项不良反应发生率均高于观察组(P<0.05)。重复测量方差分析结果显示,两组HE4及CA125水平存在组间效应、时间效应和交互效应(P<0.001)。单因素重复测量方差分析结果显示,与治疗前比较,两组患者治疗2、4、6个周期后HE4、CA125水平均下降(P<0.008),多变量方差分析结果显示,观察组治疗2、4、6个周期后HE4、CA125水平均低于对照组(P<0.001)。两组治疗前CD3+、CD4^(+)、CD8^(+)T淋巴细胞比例及CD4^(+)T淋巴细胞/CD8^(+)T淋巴细胞比值比较,差异无统计学意义(P>0.05),治疗后两组CD3+、CD4^(+)淋巴细胞比例及CD4^(+)淋巴细胞/CD8^(+)淋巴细胞比值升高(P<0.05),观察组高于对照组(P<0.05),治疗后两组CD8^(+)T淋巴细胞比例下降,观察组低于对照组(P<0.05)。结论白蛋白结合型紫杉醇联合卡铂治疗晚期卵巢癌患者临床疗效更佳,安全性更好,且可明显降低血清HE4、CA125水平,促进淋巴细胞发挥免疫调节作用,改善机体免疫状态。

超声血流参数联合NLR、CA125、PLR对子宫内膜癌鉴别诊断价值

目的:探讨超声联合中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)NLR、糖类抗原125(CA125)对子宫内膜癌鉴别诊断价值。方法:收集2020年1月-2022年10月本院收治的子宫内膜癌患者92例为内膜癌组,子宫内膜良性病变患者82例为良性病变组,超声检测两组患者血流搏动指数(PI)、阻力指数(RI)、收缩期峰值流速(PSV),检测患者血清NLR、PLR、CA125水平,采用受试者工作特征(AUC)曲线分析各指标对子宫内膜癌鉴别诊断价值。结果:内膜癌组超声血流参数PSV高于对照组,PI、RI低于良性病变组,且内膜癌组Ⅲ-Ⅳ期患者PSV高于Ⅰ-Ⅱ期患者,PI、RI低于Ⅰ-Ⅱ期患者;血清CA125、NLR、PLR水平,内膜癌组均高于良性病变组,且内膜癌组Ⅲ-Ⅳ期患者高于Ⅰ-Ⅱ期患者(均P<0.05);ROC曲线分析显示,超声血流参数、CA125、NLR、PLR及联合应用鉴别诊断子宫内膜癌的曲线下面积分别为0.813、0.892,0.717、0.632、0.952,联合诊断效能最佳,敏感度98.2%。结论:超声血流参数,血清CA125、NLR、PLR在子宫内膜癌患者中发生异常,各指标联合应用对子宫内膜癌的鉴别诊断效力较高,有较好的临床指导价值。

复发性卵巢癌患者术后血清CA125、D-D水平及残留病灶大小对无瘤生存期的影响

目的 探讨复发性卵巢癌患者术后血清糖链抗原125(CA125)、D-二聚体(D-D)水平及残留病灶大小对无瘤生存期的影响。方法 回顾性分析50例复发性卵巢癌患者的临床资料,随访并记录无瘤生存期。统计患者一般资料及术后血清CA125、D-D水平,分析无瘤生存期影响因素;以Pearson相关系数分析术后CA125、D-D水平及残留病灶大小与无瘤生存期的相关性。结果 不同临床分期、分化程度、化疗疗程、CA125、D-D水平及残留病灶大小的患者无瘤生存期比较,差异有统计学意义(P<0.05);COX回归分析显示,术前临床分期、术后CA125水平、术后D-D水平及术后残留病灶大小是复发性卵巢癌患者无瘤生存期的独立影响因素(P<0.05);Pearson相关性分析显示,术后CA125、D-D水平及残留病灶大小与无瘤生存期均呈负相关(P<0.05)。结论 复发性卵巢癌患者术后CA125、D-D水平及残留病灶大小是影响其无瘤生存期的重要因素。

糖类抗原125阴性卵巢癌患者血清人附睾蛋白4、癌胚抗原、神经元特异性烯醇化酶表达水平及与患者预后的关系

目的探讨糖类抗原125(CA125)阴性卵巢癌患者血清人附睾蛋白4(HE4)、癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)表达水平及与患者预后的关系。方法选取107例CA125阴性卵巢癌患者作为观察组,81例良性卵巢肿瘤患者作为对照组。比较两组患者HE4、CEA、NSE表达水平;采用多因素Logistic回归模型分析CA125阴性卵巢癌患者预后的影响因素。结果观察组患者血清HE4、CEA、NSE水平均明显高于对照组,差异均有统计学意义(P﹤0.01)。预后良好与预后不良患者分化程度、临床分期及HE4、CEA、NSE水平比较,差异均有统计学意义(P﹤0.01)。多因素Logistic回归分析结果显示,HE4、CEA、NSE高表达均为CA125阴性卵巢癌患者预后不良的危险因素(P﹤0.05)。结论与良性卵巢肿瘤患者相比,HE4、CEA、NSE在CA125阴性卵巢癌患者中呈高表达,HE4、CEA、NSE表达水平能影响CA125阴性卵巢癌患者的预后,三者水平越低,患者预后越好。

血清CA125、CYFRA21-1、CEA、NSE及ALP联合检测对原发性肺癌患者骨转移的预测价值

目的探究血清糖类抗原125(CA125)、细胞角蛋白19片段抗原21-1(CYFRA21-1)、癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)及碱性磷酸酶(ALP)联合检测对原发性肺癌患者骨转移的预测价值。方法选取肺癌患者104例为观察组,并根据是否发生骨转移分为骨转移组(50例)和无骨转移组(54例)。同时选取100例肺部良性病变者为对照组。收集肺癌患者临床资料,检测所有受试者血清CA125、CYFRA21-1、CEA、NSE及ALP水平。采用受试者工作特征(ROC)曲线分析血清CA125、CYFRA21-1、CEA、NSE、ALP对肺癌患者骨转移的预测价值。采用多因素Logistic回归分析肺癌患者骨转移的影响因素。结果与对照组相比,观察组血清CA125、CYFRA21-1、CEA、NSE、ALP水平显著升高(P<0.05)。骨转移组中临床分期Ⅲ~Ⅳ期患者占比、有淋巴结转移患者占比及血清CA125、CYFRA21-1、CEA、NSE、ALP水平显著高于无骨转移组(P<0.05)。血清CA125、CYFRA21-1、CEA、NSE、ALP预测肺癌患者发生骨转移的AUC分别为0.818、0.816、0.739、0.770、0.771,5种肿瘤标志物联合检测的AUC为0.955,敏感度、特异度、AUC均显著高于各肿瘤标志物单独检测(P<0.05)。多因素Logistic回归分析显示,CA125、CYFRA21-1、CEA、NSE、ALP是影响肺癌患者发生骨转移的危险因素(P<0.05)。结论血清CA125、CYFRA21-1、CEA、NSE、ALP联合检测对原发性肺癌患者骨转移的预测具有较高的价值,联合诊断效能更高。

血清HE4、CA125、TK1水平在卵巢癌患者中的相关性分析

目的探讨人附睾蛋白4(HE4)、糖类抗原125(CA125)和胸苷激酶1(TK1)联合检测在卵巢癌患者中的相关性。方法选择2022年1月—2023年11月本院收治的通过影像及病理活检被明确诊断为卵巢癌的53例患者(卵巢癌组)和良性肿瘤的29例患者(良性对照组)作为研究对象;另选同期健康管理中心接受体检的100名健康妇女作为健康对照组。采用化学发光法检测血清中HE4、CA125和免疫印迹法检测TK1水平,分别比较三组及卵巢癌不同分期血清HE4、CA125、TK1的水平以及ROC曲线对血清HE4、CA125、TK1及联合检测对卵巢癌诊断效能的价值分析。结果卵巢癌患者血清中HE4、CA125、TK1水平均明显高于良性对照组和健康对照组(P<0.05);卵巢癌组中Ⅲ~Ⅳ期患者血清中HE4、CA125、TK1水平均明显高于Ⅰ~Ⅱ期患者(P<0.05),TK1水平在卵巢癌分组中差异无统计学意义(P>0.05);经ROC曲线分析发现,血清中HE4、CA125、TK1联合检测对卵巢癌诊断效能优于三项单独检测。结论卵巢癌患者血清中HE4、CA125、TK1的水平异常表达,且HE4、CA125、TK1三者联合检测的诊断价值效能明显优于单独检测,有助于提高临床对卵巢癌早期筛查的准确率以及协助卵巢癌患者预后的评估,以期提高患者的生存率。

血清CA153,CA125水平与老年Luminal型乳腺癌患者内分泌治疗耐药的关系

目的探究老年Luminal型乳腺癌患者血清糖类抗原153(CA153)、糖类抗原125(CA125)水平与内分泌治疗耐药的相关性。方法选取158例2018年6月至2022年6月于甘肃省肿瘤医院接受乳腺癌内分泌治疗后复查的60岁以上已绝经的Luminal型乳腺癌患者,根据是否出现耐药,分为耐药组(n=104)和敏感组(n=54)。对比两组患者的一般资料,Spearman相关性分析血清CA153、CA125水平与临床病理特征的关系,限制性立方样条模型(RCS)分析血清CA153和CA125水平与内分泌耐药的剂量-反应关系,Logisitic回归分析内分泌治疗耐药的危险因素。以危险因素建立临床预测模型,其中模型一不包含CA153,模型二包含全部因素,对两个预测模型进行ROC分析和Hosmer-Lemeshow检验。结果158例患者内分泌治疗耐药率为65.83%,两组患者的年龄、肿瘤直径、淋巴结转移、T分期、N分期、组织学分级、血清CA153水平、血清CA125水平的差异均具有统计学意义(P<0.05)。血清CA153,CA125水平与年龄、肿瘤直径、淋巴结转移、T分期、N分期均呈正相关,血清CA153,CA125水平与组织学分级呈负相关。调整混杂因素后,血清CA153水平>171.28 U/mL、CA125水平>186.32 U/mL与内分泌治疗耐药具有强相关性。Logistic回归分析结果显示,高龄、肿瘤较大、T分期较高、N分期较高、组织学分级G3、血清CA153水较高、血清CA125水较高均是内分泌治疗耐药的独立危险因素(P<0.05)。模型一的ROC曲线下面积为0.823(95%CI:0.702~0.862),模型二的ROC曲线下面积为0.884(95%CI:0.783~0.891)。Hosmer-Lemeshow检验显示预测模型一P=0.763,预测模型二P=0.975,均提示拟合优度良好。结论血清CA153,CA125水平具有对内分泌治疗耐药的预测价值,血清CA153,CA125水平越高则内分泌治疗耐药风险越高。

肺结核患者血清IP-10、SOCS1及CA125表达意义及其与引发支气管狭窄的相关性分析

目的分析肺结核患者血清γ干扰素诱导蛋白10(IP-10)、细胞因子信号转导抑制物1(SOCS1)及糖类抗原125(CA125)表达意义及其与引发支气管狭窄的相关性。方法回顾性选择2021年1月至2023年1月河北省胸科医院收治的116例肺结核患者作为观察组,同期116名健康体检者作为对照组。根据观察组患者胸部影像学检查结果,分为重度组(n=26)和轻中度组(n=90);通过纤维支气管镜检查及活检,判断患者是否存在支气管狭窄,分为支气管狭窄组(n=42)与单纯肺结核组(n=74)。检测所有入选者血清IP-10、SOCS1及CA125水平,比较血清IP-10、SOCS1及CA125在对照组与观察组、不同严重程度的肺结核患者中的差异性;比较支气管狭窄组与单纯肺结核组第1秒用力呼气量(FEV1)、用力肺活量(FVC)、最大呼气峰流速(PEF);分析血清IP-10、SOCS1及CA125与肺结核患者肺功能相关指标及其并发支气管狭窄的相关性。采用受试者工作特征(ROC)曲线分析血清IP-10、SOCS1及CA125水平预测肺结核患者发生支气管狭窄的效能。结果观察组血清IP-10、CA125水平分别为(95.84±12.58)ng/L、(1.89±0.86)U/mL,均高于对照组[(71.25±5.63)ng/L、(0.74±0.23)U/mL],SOCS1水平为(165.32±7.95)μg/L,低于对照组[(252.54±24.71)μg/L],差异均有统计学意义(P<0.05)。重度组肺结核患者血清IP-10、CA125水平分别为(106.74±15.01)ng/L、(2.67±1.12)U/mL,均高于轻中度组[(89.72±8.16)ng/L、(1.45±0.60)U/mL],SOCS1水平为(154.12±6.07)μg/L,低于轻中度组[(200.75±15.83)μg/L],差异均有统计学意义(P<0.05)。支气管狭窄组FEV1、FVC、PEF均小于单纯肺结核组,差异均有统计学意义(P<0.05)。经Pearson相关性分析,肺结核患者FEV1、FVC、PEF与血清IP-10、CA125水平呈正相关(P<0.05),与SOCS1水平呈负相关(P<0.05)。经ROC曲线分析,血清IP-10、SOCS1联合CA125预测肺结核患者发生支气管狭窄的敏感度为89.12%,特异度为48.63%,曲线下面积为0.924。结论肺结核患者血清IP-10、CA125水平明显升高,SOCS1水平降低,与病情严重程度相关,其联合预测支气管狭窄具有较好的效能。

培美曲塞二钠联合顺铂治疗晚期肺腺癌的疗效及对血清CYFRA21-1、CA125、CEA、NSE的影响分析

目的 探讨培美曲塞二钠联合顺铂治疗晚期肺腺癌的疗效,以及对患者血清细胞角质蛋白19片段抗原(Cytokeratin 19 Fragment Antigen 21-1, CYFRA 21-1)、糖类抗原CA125(Carbohydrate Antigen 125, CA125)、癌胚抗原(Carcinoembryonic Antigen, CEA)、神经元特异性烯醇化酶(Neuron Specific Enolase, NSE)的影响。方法 便利选择建湖县人民医院于2019年1月—2023年12月收治的72例晚期肺腺癌患者为研究对象,以随机数字表法分组,对照组(n=36)采用紫杉醇联合顺铂治疗,观察组(n=36)培美曲塞二钠联合顺铂治疗,比较两组的疗效、血清CYFRA21-1、CA125、CEA、NSE水平以及不良反应发生率。结果 观察组的疾病控制率、客观缓解率分别为88.89%和58.33%,均高于对照组的66.67%、33.33%,差异有统计学意义(χ^(2)=5.143、4.532,P均<0.05)。治疗后,观察组的CYFRA21-1、CA125、CEA、NSE水平均低于对照组,差异有统计学意义(P均<0.05)。观察组的不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论 培美曲塞二钠联合顺铂治疗晚期肺腺癌的疗效可靠,患者肿瘤标志物水平下降明显,且药物不良反应小,安全性高。

血清S100A11、S100A14、CA125与ⅡB~Ⅳ期上皮性卵巢癌患者减瘤术结局的关系及其预测价值分析

目的 探讨ⅡB~Ⅳ期上皮性卵巢癌(EOC)患者血清S100钙结合蛋白A(S100A)11、S100A14和糖类抗原125(CA125)水平与肿瘤细胞减灭术(简称减瘤术)结局的关系及其预测价值。方法 选取2018年6月至2021年6月于该院接受初始减瘤术的ⅡB~Ⅳ期的124例EOC患者作为EOC组及70例卵巢良性病变患者作为病例对照组,并选取同期于该院体检的体检健康者70例作为健康对照组。检测各组血清S100A11、S100A14、CA125水平。根据EOC患者减瘤术结局是否满意,分为满意组(70例)和不满意组(54例)。分析ⅡB~Ⅳ期EOC患者减瘤术结局不满意的影响因素,并评估血清S100A11、S100A14、CA125预测ⅡB~Ⅳ期EOC患者减瘤术结局不满意的临床价值。结果 EOC组血清S100A11、S100A14、CA125水平高于病例对照组及健康对照组,差异有统计学意义(P<0.05)。不满意组美国麻醉医师协会(ASA)分级Ⅲ级、腹水、国际妇产科联盟(FIGO)分期ⅢC~Ⅳ期比例及血清CA125、S100A11、S100A14水平均高于满意组,差异有统计学意义(P<0.05)。FIGO分期ⅢC~Ⅳ期及血清CA125、S100A11、S100A14水平升高是影响EOC患者减瘤术结局不满意的独立危险因素(P<0.05)。血清CA125、S100A11、S100A14及三者联合预测EOC患者减瘤术结局不满意的曲线下面积(95%CI)分别为0.727(0.521~0.910)、0.747(0.507~0.961)、0.755(0.553~0.954)、0.825(0.743~0.913),三者联合检测预测减瘤术结局不满意的价值优于血清CA125、S100A11、S100A14单独检测。结论 ⅡB~Ⅳ期EOC患者血清S100A11、S100A14、CA125水平升高,与减瘤术结局不满意有关,血清CA125、S100A11、S100A14联合检测对减瘤术结局不满意具有较高的预测价值。