Serum M2-pyruvate kinase: A promising non-invasive biomarker for colorectal cancer mass screening

AIM: To explore the value of serum M2-pyruvate kinase (M2-PK) in colorectal cancer (CRC) mass screening. METHODS: We conducted a molecular epidemiology study in Hangzhou, China, from year 2006 to year 2008. Serum samples were collected from 93 CRC, 41 advanced adenomas, 137 adenomas, 47 non-adenomatous polyps, and 158 normal participants in a community setting. Serum M2-PK and carcinoembryonic antigen (CEA) were measured using Enzyme-linked immunosorbent assay. SPSS 16.0 software was used to perform data analysis. Area under the receiver operating characteristic curve (AUC), sensitivity, and specificities were estimated for serum M2-PK in diagnosis of colorectal lesions and compared with CEA. RESULTS: Average serum M2-PK value among 158 normal people was 2.96 U/mL and not affected by gender (P = 0.47) or age (P = 0.59). Average serum M2-PK (U/mL) was 14.75 among stage III and 13.10 among stage?I?and II CRC patients, about 4 times higher than that among normal people. Average serum M2-PK was 8.58, 6.70, 5.13 and 2.51 U/mL among advanced adenoma, adenomas, non-adenomatous polyps, and inflammatory bowel disease patients, respectively. AUC for serum M2-PK was greater than that for CEA among all colorectal lesions. AUC for serum M2-PK was 0.89 (0.84, 0.94) (95% confidence interval), higher than that for CEA [0.70 (0.62-0.79)] in CRC stage?I?and II, 0.89 (0.84-0.94) vs 0.73 (0.63-0.83) in CRC stage III, 0.81 (0.74-0.86) vs 0.63 (0.53 - 0.73) in advanced adenomas, 0.69 (0.64-0.76) vs 0.54 (0.47-0.60) in adenomas, and 0.69 (0.62-0.78) vs 0.58 (0.48-0.68) in non-adenomatous polyps. The diagnostic sensitivity for all colorectal lesions increased with decrease in the cut-off value of serum M2-PK. The diagnostic sensitivity (%) of serum M2-PK was 100.00 for CRC, 95.12 advanced adenoma, 82.48 adenoma, and 82.98 non-adenomatous polyp. There were no CRC cases missed and 40.51% of unnecessary colonoscopies were avoided when the cut-off value was 2.00 U/mL. CONCLUSION: Serum M2-PK can be used as a primary screening test in CRC mass screening. It may be a promising non-invasive biomarker for CRC early detection.

Decreasing trend in prostate cancer with high serum prostate-specific antigen levels detected at first prostate-specific antigen-based population screening in Japan

To clarify the recent trends in prostate-specific antigen （PSA） distribution in men in Japan, we analyzed the PSA distributions of men undergoing PSA-based population screening. We summarized the annual individual data of PSA-based population screening in Kanazawa, Japan, from 2000 to 2011, and analyzed baseline serum PSA values of the participants at the first population screening. Serum PSA distributions were estimated in all participants and those excluding prostate cancer patients according to age. From 2000 to 2011, 19 620 men participated aged 54-69 years old in this screening program. Mean baseline serum PSA level of all participants at the first screening was 2.64 ng m1-1 in 2000, and gradually decreased to approximately 1.30 ng ml-I in 2006. That of participants excluding prostate cancer patients was 1.46 ng m1-1 in 2000, and there was no remarkable change during the study period. The 95t＂ percentiles in the participants excluding prostate cancer patients detected at the first population screening of men aged 54-59, 60-64, and 65-69 years old were 2.90, 3.60, and 4.50 ng m1-1, respectively. After the commencement of population screening, the proportion of prostate cancer patients with high serum PSA levels decreased. However, there were no changes in serum PSA levels in men without prostate cancer. Age-specific PSA reference level of men without prostate cancer in Japan was similar to that in China and Korea.

Equidistant combination wavelength screening and step-by-step phase-out method for the near-infrared spectroscopic analysis of serum urea nitrogen

We applied near-infrared(NIR)spectroscopy with chemometrics for the rapid and reagent-fee analysis of serum urea nitrogen(SUN).The modeling is based on the average effect of multiple sample partitions to achieve parameter selection with stability.A multiparameter optimization platform with Norris derivative filter-partial least squares(Norris-PLS)was developed to select the most suitable mode(d=2,s=33,g=15).Using equidistant combination PLS(EC-PLS)with four parameters(initial wavelength I,number of wavelengths N,number of wavelength gaps G and latent variables LV),we performed wavelength screening after eliminating high-absorption wavebands.The optimal EC-PLS parameters were I=1228 nm,N=26,G=16 and LV=12.The root-mean square error(SEP),correlation coefficient(R_(p))for prediction and ratio of performance-to-deviation(RPD)for validation were 1.03 mmol L^(-1),0.992 and 7.6,respectively.We proposed the wavelength step-by-step phase-out PLS(WSP-PLS)to remove redun-dant wavelengths in the top 100 EC-PLS models with improved prediction performance.The combination of 19 wavelengths was identifed as the optimal model for SUN.The SEP,Rp and RPD in validation were 1.01 mmol L^(-1),0.992 and 7.7,respectively.The prediction effect and wavelength complexity were better than those of EC-PIS.Our results showed that NIR spectroscopy combined with the EC-PLS and WSP-PLS methods enabled the high-precision analysis ofSUN.WSP-PLS is a secondary optimization method that can further optimize any wavelength moc odel obtained through other continuous or discrete strategies to establish a simple and better model.

Study on a noninvasive method for rapid screening Human Serum albumin injectables by Raman spectroscopy

Human serum albumin(HSA)injectable product is a severely afflicted area on drug safety due to its high price and restricted supply.Raman spectroscopy performances high specificity on HSA detection and it is even possible to determine HSA injectable products noninvasively.In this study,we developed a noninvasive rapid screening method for of HSA injectable products by using portable Raman spectrometer.Qualitative models were established by using principal component analysis combined with classical least squares(PCA-CLS)algorithm,while quanti-tative model was established by using partial least squares(PLS)algorithm.Model transfer in different instruments of both the same and different apparatus modules was further discussed in this paper.A total of 34 HSA injectable samples collected from markets were used for verification.The identification results showed 100%accuracy and the predicted concentrations of those identified as true HSA were consistent with their labeled concentrations.The quantitative results also indicated that model transfer was excellent in the same apparatus modules of Raman spectrometer at all concentration levels,and still good enough in the different apparatus modules although the relative standard deviation(RSD)value showed a little increasing trend at low HSA concentration level.In conclusion,the method was proved to be feasible and efficient for screening HSA injections,especially on its screening speed and the consideration of glass containers.Moreover,with inspiring results on the model transfer,the method could be used as a universal screening mean to different Raman instruments.

Current issues and future perspectives of gastric cancer screening

Gastric cancer remains the second leading cause of cancer death worldwide. About half of the incidence of gastric cancer is observed in East Asian countries, which show a higher mortality than other countries. The effectiveness of 3 new gastric cancer screening techniques, namely, upper gastrointestinal endoscopy, serological testing, and “screen and treat” method were extensively reviewed. Moreover, the phases of development for cancer screening were analyzed on the basis of the biomarker development road map. Several observational studies have reported the effectiveness of endoscopic screening in reducing mortality from gastric cancer. On the other hand, serologic testing has mainly been used for targeting the high-risk group for gastric cancer. To date, the effectiveness of new techniques for gastric cancer screening has remained limited. However, endoscopic screening is presently in the last trial phase of development before their introduction to population-based screening. To effectively introduce new techniques for gastric cancer screening in a community, incidence and mortality reduction from gastric cancer must be initially and thoroughly evaluated by conducting reliable studies. In addition to effectiveness evaluation, the balance of benefits and harms must be carefully assessed before introducing these new techniques for population-based screening.

Correlation between Transcutaneous Bilirubinemia and Blood Bilirubinemia in Screening Term Newborn for Neonatal Jaundice at the Essos Hospital Centre (EHC), Yaoundé, Cameroon

Background: Early and non-invasive diagnosis of neonatal hyperbilirubinemia remains critical in dark skinned babies of low resource settings. Objective: To assess correlation/agreement between transcutaneous bilirubin (Tcb) and serum bilirubin (Tsb) values in full term neonates with jaundice. Methodology: An analytical cross-sectional study was conducted at the neonatology unit of the Essos Hospital Centre (EHC) from January to June 2019. All full-term neonates aged 0 to 7 days with suspected jaundice who did not receive phototherapy were eligible for the study. The enrolled neonates in the study were assessed clinically, then with the MBJ20 transcutaneous bilirubinometer (TcB). The MBJ20 transcutaneous bilirubinometer highest measurement over the forehead and the sternum were compared to TsB. Data were entered and then analysed with the CsPro7.2 and R (version 3.6.0) software. Correlation was captured by Bland & Alman plots and Concordance Correlation Coefficient (CCC) estimates. The Pearson correlation coefficient and Student test for paired data were used for descriptions purposes, and the significance level was 5%. Results: We recruited 88 neonates. The sex ratio of the babies included was 1.25 favouring males. Median Post-natal age was 3 days with 62% aged 72 hours or more. The mean TcB corresponding to the maximum average between frontal and sternal measurement was 153 mg/dl ± 48 and the average Tsb was 123.80 mg/dl ± 50.48. A good linear correlation was found between TcB and total serum bilirubin level r = 0.86 [0.80;0.91]. Positive correlation was noted between both (forehead and sternum) TcB measurements sites, namely r = 0.78 and r = 0.86. The Bland & Altman plot measured the bias at -29.68 mg/l (confidence interval at 95%, 21.14 - 80.50). The CCC estimate was 0.2 varying from -0.22 to 0.76 according to TcB measurement threshold and post-natal age. The ROC area under the curve value for a threshold < 100 mg/l equals 90% proving to be a good predictor for this threshold. Conclusion: A good linear correlation was found despite a poor agreement between TcB and Tsb. TcB method systematically overestimated the value of TsB.

Incidence of chromosome abnormalities at a second-trimester genetic amniocentesis for Mainland Chinese women of advanced maternal age:a study of 6,584 cases

Objective:The aim of this study was to calculate the expected incidence of chromosomal aneuploidy at second trimester genetic amniocentesis in China's Mainland in women aged 35 and older. Methods:We reviewed the genetic amniocenteses data in Peking Union Medical College Hospital between January 2001 to June 2011.The indication for genetic amniocentesis was solely advanced maternal age(AMA).A total of 6,584 cases were included in this study.The AMA women was divided into two groups by maternal age,the group of 35-39 years old and the group of≥40 years old.The incidence of fetal Down syndrome was compared between the two groups by chi-square test. Results:A total of 121 cases were diagnosed to be chromosomally abnormal,giving an overall incidence of 18.38‰(121/6,584).The abnormal karyotypes included 111 cases of various aneuploidies and 10 cases with various structural abnormalities.The aneuploidies(mosaicism included) were 59 cases of(47,+ 21),25 cases of (47,+ 18),2 cases of(47,+ 13),8 cases of(45,X),3 cases of(47,XXX),13 cases of(47,XXY) and 1 case of(47,XYY).The karyotype of(47,+21) was the most frequent chromosomal abnormality,with an overall incidence of 8.96‰,account for 53.1%of all aneuploidies.Sex chromosome aneuploidies were the next most common,with a total incidence of 3.80‰.The incidence of fetal Down syndrome was significantly higher in the group of≥40 years old than that of the group of 35-39 years old(P = 0.047). Conclusions:The incidence of chromosomal aneuploidy found in this study is the first data published for China's Mainland and will be helpful for the counseling of pregnant women in this age group.Consideration may be given to prenatal screening versus prenatal diagnosis in women of advanced maternal age in China's Mainland.

Potential of soluble CD26 as a serum marker for colorectal cancer detection

Colorectal cancer is characterized by a low survival rate even though the basis for colon cancer development,which involves the evolution of adenomas to carcinoma,is known.Moreover,the mortality rates continue to rise in economically transitioning countries although there is the opportunity to intervene in the natural history of the adenoma–cancer sequence through risk factors,screening,and treatment.Screening in particular accounted for most of the decline in colorectal cancer mortality achieved in the USA during the period 1975-2000.Patients show a better prognosis when the neoplasm is diagnosed early.Among the variety of screening strategies,the methods range from invasive and costly procedures such as colonoscopy to more low-cost and non-invasive tests such as the fecal occult blood test(guaiac and immunochemical).As a non-invasive biological serum marker would be of great benefit because of the performance of the test,several biomarkers,including cytologic assays,DNA and mRNA,and soluble proteins,have been studied.We found that the soluble CD26(sCD26)concentration is diminished in serum of colorectal cancer patients compared to healthy donors,suggesting the potential utility of a sCD26 immunochemical detection test for early diagnosis.sCD26 originates from plasma membrane CD26 lacking its transmembrane and cytoplasmic domains.Some 90%–95%of sCD26 has been associated with serum dipeptidyl peptidase IV(DPPIV)activity.DPP-IV,assigned to the CD26 cluster,is a pleiotropic enzyme expressed mainly on epithelial cells and lymphocytes.Our studies intended to validate this test for population screening to detect colorectal cancer and advanced adenomas are reviewed here.

Relationship of the preoperative NRS 2002 score,PG-SGA score,and serum indices with postoperative complications in patients with gastric cancer

Objective To examine the utility of the Nutrition Risk Screening 2002(NRS 2002),Patient-Generated Subjective Global Assessment(PG-SGA)and serum factors for the preoperative evaluation of gastric cancer patients.Methods We examined 181 gastric cancer patients treated at the First Affiliated Hospital of Guangxi Medical University from January 2015 to January 2018.Nutritional assessments were administered within 48 h of admission.The body mass index(BMI)and serum factors were measured,and information on preoperative nutritional support and postoperative complications was recorded.Results Both the NRS 2002 and PG-SGA had positive correlations with age(P<0.05),and negative correlations with albumin,prealbumin,transferrin,hemoglobin,BMI,and bodyweight(P<0.05).The NRS 2002 and PG-SGA scores were positively correlated with each other(r=0.683,P<0.01),but had poor consistency(κ=0.357,P<0.01).During the preoperative period,33.2%of patients received nutritional support,mainly enteral nutrition.The nutritional risk group(NRS 2002≥3)received more support than the group without nutritional risk(NRS 2002<3;P<0.05).Patients with nutritional risk or malnutrition who received preoperative nutritional support had fewer postoperative complications than unsupported patients.The overall rate of complications was 12.2%,and the rate of severe complications(gradeⅢor above)was 5.5%.The malnutrition and nutritional risk groups had higher rates of severe complications.Conclusions The combined application of the NRS 2002,PG-SGA,BMI,and serum nutritional indices was useful for the nutritional screening and assessment of preoperative gastric cancer patients.The NRS 2002 and PG-SGA provided guidance on the need for nutritional support during the preoperative period.

基于同步辐射X射线荧光光谱与一维卷积神经网络的癌症筛查方法

癌症是全球范围内引起高发病率与高死亡率的疾病之一。现有癌症检测方法耗时、昂贵、专业人员依赖性强,开发一种无损、快速筛查方法非常重要。在前期工作基础上,发展了基于同步辐射X射线荧光光谱技术(SRXRF)与深度学习技术结合的一种非靶标金属组学方法筛查癌症患者。首先,分析控制组与癌症组共269份血清样本的SRXRF谱线,得到Ca、Mn、Zn、Ge、Br在两类人群中具有代表性差异,可以作为癌症筛查的标志物;其次,对于平均光谱进行归一化(Normalization)、迭代自适应加权惩罚最小二乘法(airPLS)、Savitzky-Golay平滑(SG)、标准正态变换(SNV)的预处理,并建立偏最小二乘判别分析(PLSDA)、K近邻法(KNN)、软独立建模分类法(SIMCA)的化学计量学模型,三种模型对癌症筛查的最优准确率分别为89.89%、93.26%、90.95%;最后,基于像素级光谱,搭建三种一维卷积神经网络(1DCNN)模型,三种模型准确率分别为93.56%、95.24%、93.27%,相对于化学计量学模型均有所提高,增加卷积层的数量有助于数据特征提取,模型准确率提高了1.68%。将三种模型卷积层提取获得的特征进行t-分布随机邻域嵌入算法(tSNE)降维可视化,得到1DCNN提取的特征具有显著可分性,SRXRF结合1DCNN模型开发的非靶标金属组学方法在实现癌症的快速筛查方面具有潜力。

NT与血清β-hCG、PAPP-A、ADAM12单独及联合检测对孕早期DS的诊断价值

目的:探讨颈部透明层厚度(NT)与血清人绒毛膜促性腺激素(β-hCG)、妊娠相关蛋白A(PAPP-A)及解整合素金属蛋白酶12(ADAM12)单独及联合检测对孕早期唐氏综合征(DS)的诊断价值。方法:选取2019年1月—2023年1月在厦门大学附属第一医院杏林分院经羊膜穿刺确诊的47例DS孕妇作为DS组,另选取同期49例产前检查正常的孕产妇作为对照组,检测并比较两组NT及血清β-hCG、PAPP-A、ADAM12水平,并采用受试者工作特征(ROC)曲线分析NT与血清β-hCG、PAPP-A、ADAM12单独及联合检测对DS的诊断价值。结果:DS组NT及血清β-hCG水平高于对照组,PAPP-A、ADAM12水平均低于对照组,差异有统计学意义(P<0.05)。ROC曲线分析显示,NT与血清β-hCG、PAPP-A、ADAM12联合检测诊断DS的曲线下面积为0.993,预测敏感度、特异度分别为95.7%、98.0%,均高于上述指标单独检测。结论:NT与血清β-hCG、PAPP-A、ADAM12检测对孕早期DS均具有一定的诊断价值,且联合应用诊断效果更高,可作为孕早期DS筛查的有效指标。

基于多靶点粪便FIT-DNA联合检测技术的结直肠癌早筛应用研究

目的评价多靶点粪便FIT-DNA联合检测技术在结直肠癌早期筛查中的效果并进一步分析其应用前景。方法选取内蒙古医科大学附属医院就诊人群,每位受试者分别行血清肿瘤标志物检测、多靶点粪便FIT-DNA联合检测、肠镜检查,以接受多靶点粪便FIT-DNA联合检测人群为实验组,以接受肠镜检查及血清肿瘤标志物检测人群为对照组,以病理结果为金标准,评价新型粪便分子检测技术对于结直肠癌筛查的效果,对筛出的阳性人群给予及时干预。结果共分析了115例患者。血清肿瘤标志物检测敏感度63.2%(43/68),特异度74.5%(35/47);肠镜检查敏感度97.1%(66/68),特异度80.7%(38/47);而多靶点粪便FIT-DNA联合检测敏感度89.7%(61/68),特异度87.2%(41/47)。多靶点粪便FIT-DNA联合检测敏感度、特异度等均优于血清肿瘤标志物检测,敏感度虽低于肠镜检查,但相较肠镜检查操作简单,可居家自测。

Diagnostic values of combination of free running asthma screening test and total serum allergen IgE level in children with asthma

Background A free running asthma screening test is usually used for screening exercise-induced bronchoconstriction.The total serum allergen IgE level can reveal the patient＇s atopy characteristics.Our study is to evaluate the diagnostic values of the combination of the two tests in asthmatic children and compare this new diagnostic method with the Intemational Study of Asthma and Allergies in Childhood （ISSAC） questionnaires and the bronchial provocation test,which are popular diagnostic tool for pediatric asthma.Methods A total of 773 school children were recruited in this study.The children＇s asthma was diagnosed by means of a combination of the free running asthma screening test and total serum allergen IgE level.The new diagnostic method value was assessed using receiver operating characteristic （ROC） curves and compared with other diagnostic tools such as ISSAC questionnaires and the bronchial provocation test.Results The AUC of this new diagnostic method was higher than 0.9.When the cut-off value of total serum allergen IgE level was ≥47 KU/L,the sensitivity and the specificity were 71.4％ and 85.1％,respectively,which were better than those of either the ISSAC questionnaires or bronchial provocation test.Conclusion The combination of the free running asthma screening test and total serum allergen IgE level may be an effective diagnostic tool for children＇s asthma.

孕早期超声检测胎儿颈项透明层联合血清β-HCG和PAPP-A检测用于唐氏综合征筛查的价值研究

目的探讨孕早期超声检测胎儿颈项透明层(NT)联合血清人绒毛膜促性腺激素β亚基(β-HCG)和妊娠相关血浆蛋白-A(PAPP-A)检测用于唐氏综合征筛查的价值。方法选取2019~2022年在河源市妇幼保健院妇产科进行孕检的20565例早期妊娠女性作为研究对象,所有纳入研究的孕妇都在孕11~13+6周进行常规超声检查以及相关的超声软指标检测,同时检测血清PAPP-A、β-HCG,并具有完整妊娠结局。对比NT检测、血清检测以及两者联合检测的诊断价值。建立受试者工作特征(ROC)曲线模型,综合评价三种筛查方法的准确性。结果以羊水染色体核型分析为金标准,最终确诊唐氏综合征胎儿22例。血清检测筛查出唐氏综合征高危妊娠1440例,检出率为86.4%(19/22);NT检测筛查出唐氏综合征高危妊娠149例,检出率为31.8%(7/22);联合检测筛查出唐氏综合征高危妊娠436例,检出率为95.5%(21/22)。联合检测的灵敏度、阳性预测值、约登指数均高于NT检测(P<0.05);联合检测的特异度、准确度、阳性预测值、约登指数均高于血清检测(P<0.05)。ROC曲线分析显示,联合检测的曲线下面积(AUC)高于NT检测和血清检测。结论孕早期NT检测联合血清检测用于唐氏综合征筛查的效果比单独NT检测和血清检测效果更佳。

血清蛋白电泳筛查多发性骨髓瘤的价值分析

目的:分析血清蛋白电泳(SPEP)筛查多发性骨髓瘤(MM)的价值。方法:选取2020年1月—2021年12月湘西自治州人民医院收治的疑似MM患者80例作为研究对象,均进行骨髓活检和SPEP检查,以骨髓检查结果为“金标准”,分析SPEP检查对MM的诊断效能。结论:SPEP检查诊断MM的灵敏度为96.00%(72/75),特异度为80.00%(4/5),准确度为95.00%(76/80),阳性预测值为98.63%(72/73),阴性预测值为57.14%(4/7)。结论:SPEP检查对MM的诊断效能较高,可用于MM的筛查。

孕中期母血清总β-人绒毛膜促性腺激素甲胎蛋白游离雌三醇检测在唐氏综合征筛查的应用分析

目的分析在孕中期检测孕妇血清总β-人绒毛膜促性腺激素(β-HCG)、甲胎蛋白(AFP)、游离雌三醇(uE3)水平在唐氏综合征筛查中的临床应用。方法采用回顾性分析,对2020年1月至2023年8月3941例筛查胎儿唐氏综合征孕妇的临床资料进行分析,检测孕妇血清AFP、总β-HCG、uE3水平,对检测结果进行风险评估,对筛查对象进行随访。分析唐氏综合征筛查结果、诊断情况、单一指标与联合检测准确性等。结果筛查结果为高风险阳性70例孕妇,随访确诊为唐氏综合征3例;联合检测的准确率高于血清AFP、uE3、总β-HCG指标单一检测的准确率,血清指标联合检测的漏诊例数为0,误诊67例;血清指标联合检测的灵敏度为100%,特异度98.3%,阳性预测值4.3%,阴性预测值100%。结论在孕中期检测孕妇血清AFP、总β-HCG、uE3水平在唐氏综合征筛查中可作为初步筛查手段,血清指标检测存在高风险阳性,可进行羊膜腔穿刺进一步确诊。

血清TK1联合CEA、CA125、CA19-9检查在消化道肿瘤风险筛查中的应用研究

目的:研究血清胸苷激酶1(TK1)联合癌胚抗原(CEA)、糖类抗原125(CA125)、糖类抗原19-9(CA19-9)检查在消化道肿瘤风险筛查中的应用。方法:回顾性分析2020年1月—2023年1月在萍乡市人民医院进行消化道肿瘤风险筛查的80例体检者病历资料,将检出恶性肿瘤的患者纳入恶性肿瘤组(n=30),检出良性肿瘤的患者30例作为良性肿瘤组,20例健康人群作为健康组。检测三组受检者血清TK1、CEA、CA125、CA19-9的水平,比较三组之间肿瘤标志物水平的差异性,并以受试者操作特征(ROC)曲线评估上述指标单一和联合预测恶性肿瘤的诊断价值。结果:恶性肿瘤组和良性肿瘤组患者的TK1、CEA、CA125、CA19-9的水平均高于健康组(P<0.05),且恶性肿瘤组患者肿瘤标志物水平均高于良性肿瘤组,差异均有统计学意义(P<0.05)。TK1预测患有恶性肿瘤的ROC曲线下面积(AUC)为0.894,敏感度和特异度分别为76.47%、96.43%(P<0.05);CEA预测患者患有恶性肿瘤的AUC为0.859,敏感度和特异度分别为88.24%、64.29%(P<0.05);CA125预测患者患有恶性肿瘤的AUC为0.845,敏感度和特异度分别为68.63%、82.14%(P<0.05);CA19-9预测患者患有恶性肿瘤的AUC为0.845,敏感度和特异度分别为98.04%、57.14%(P<0.05);联合检测具有较高敏感度,为100%。结论:较于健康人群,良性肿瘤和恶性肿瘤患者TK1、CEA、CA125、CA19-9水平均升高,恶性肿瘤患者水平显著升高,单一肿瘤标志物的检测效能较低,易出现假阳性而误诊,而联合检测诊断效能较高。

血清激素联合免疫抗体检测在不孕筛查中的应用观察

目的观察在不孕不育筛查中开展血清激素联合免疫抗体的实际效果。方法选取本院120例不孕患者作为干预组,并在同期纳入120例生育功能正常人群作为参照组,均对其开展血清激素与免疫抗体检测,比较分析两组检测结果。结果干预组血清激素水平高于参照组,差异有统计学意义(P<0.05)。月经周期失调者血清激素水平高于月经周期正常者,差异有统计学意义(P<0.05)。卵巢功能低下者血清激素水平高于卵巢功能正常者,差异有统计学意义(P<0.05)。干预组免疫抗体中抗透明带抗体(ZPAb)、抗子宫内膜抗体(EmAb)抗心磷脂抗体(ACAb)、抗绒毛膜促性腺激素抗体(AhAb)的阳性检出率高于参照组,差异有统计学意义(P<0.05)。继发性不孕免疫抗体中ZPAb、EmAb、ACAb、AhAb的阳性检出率高于原发性不孕,差异有统计学意义(P<0.05)。结论不孕筛查时采用血清激素与免疫抗体检测效果均确切可行,两种联合检测能够有效发挥协同效应,提升临床不孕不育检出率,为后期治疗工作的开展奠定基础,在临床中具有较高的应用价值。

2020-2022年无锡市滨湖区孕妇孕中期唐氏筛查结果分析

目的 分析2020-2022年无锡市滨湖区孕妇孕中期唐氏筛查结果。方法 选取2020-2022年无锡市滨湖区6000例孕中期孕妇为观察对象,均进行唐氏筛查,包括检测其血清甲胎蛋白(AFP)和游离β绒毛膜促性腺激素(free-β-HCG)水平。在筛查软件中输入孕妇的年龄、体质量、孕周、种族、既往病史、血清标志物数值,最后计算出妊娠唐氏筛查风险率,高风险者必要时需配合羊膜腔穿刺抽取羊水细胞来分析染色体核型。结果 6000例孕妇中,唐氏综合征筛查高风险301例(5.02%);正常孕妇组的AFP高于唐氏综合征组、18-三体综合征组,free-β-HCG低于唐氏综合征组,高于18-三体综合征组,组间差异均有统计学意义(P<0.05)。正常孕妇组的AFP均高于唐氏综合征、18-三体综合征等小组的对应值,free-β-HCG低于唐氏综合征组,高于18-三体综合征组(P<0.05)。结论 唐氏综合征筛查作为一种初步的筛查方法,对无锡市滨湖区孕妇孕中期进行唐氏筛查,可以有效地对唐氏综合征、18-三体综合征等染色体疾病进行有效地筛查,可以预测异常胎儿结果和不良妊娠结局并进行科学处理,进而提高出生人口质量。