目的探讨术前细胞角蛋白19片段(cytokeratin fragment 19,CYFRA21-1)联合癌胚抗原(carcinoembryonic antigen,CEA)检测对T2期非小细胞肺癌患者淋巴结转移的预测价值。方法回顾性分析2020年1月至2022年10月在首都医科大学附属北京胸科医...目的探讨术前细胞角蛋白19片段(cytokeratin fragment 19,CYFRA21-1)联合癌胚抗原(carcinoembryonic antigen,CEA)检测对T2期非小细胞肺癌患者淋巴结转移的预测价值。方法回顾性分析2020年1月至2022年10月在首都医科大学附属北京胸科医院接受手术治疗的448例T2期非小细胞肺癌患者的临床病理资料,根据术前肿瘤标志物CYFRA21-1、CEA的表达水平将其分为高表达组(CYFRA21-1≥6ng/ml或CEA≥6ng/ml,168例)和低表达组(CYFRA21-1<6ng/ml且CEA<6ng/ml,280例),比较两组患者的性别、年龄、吸烟史、病理类型、肿瘤大小及位置、淋巴结转移发生率和侵及程度。结果高表达组淋巴结转移发生率为51.19%(86/168),明显高于低表达组的28.21%(79/280),差异有显著性(P<0.001)。进一步分析显示肿瘤标志物高表达率在N2组为54.74%(52/95),N1组为48.57%(34/70),N0组为28.98%(82/283),不同淋巴结侵及程度组间比较差异均有显著性(P<0.001)。结论CYFRA21-1和CEA表达水平与T2期非小细胞肺癌淋巴结转移的发生率和侵及程度相关,术前检测CYFRA21-1和CEA可评估T2期非小细胞肺癌患者的淋巴结转移风险,对术中有针对性的淋巴结清扫及术后优化辅助治疗具有重要的参考价值。展开更多
AIM： To evaluate the diagnostic potential of cytokeratin-19 （CK-19） mRNA for the detection of disseminated tumor cells in blood, bone marrow and peritoneal lavage in patients with ductal adenocarcinoma of the pancr...AIM： To evaluate the diagnostic potential of cytokeratin-19 （CK-19） mRNA for the detection of disseminated tumor cells in blood, bone marrow and peritoneal lavage in patients with ductal adenocarcinoma of the pancreas. METHODS： Sixty-eight patients with pancreatic cancer （/7 = 37）, chronic pancreatitis （n = 16）, and non-pancreatic benign surgical diseases （/7 = 15, control group） were included in the study. Venous blood was taken preoperatively, intraoperatively and at postoperative d 1 and 10. Preoperative bone marrow aspirates and peritoneal lavage taken before mobilization of the tumor were analyzed. All samples were evaluated for disseminated tumor cells by CK-19-specific nested-PCR and quantitative fluorogenic RT-PCR. RESULTS： CK-19 mRNA expression was increased in 24 （64%） blood samples and 11 （30%） of the peritoneal lavage samples in the patients with pancreatic cancer. In 15 （40%） of the patients with pancreatic cancer, disseminated tumor cells were detected in venous blood and bone marrow and/or peritoneal lavage. In the peritoneal lavage, the detection rates were correlated with the tumor size and the tumor differentiation. CK-19 levels were increased in pT3/T4 and moderately/poorly differentiated tumors （G2/G3）. Pancreatic cancer patients with at least one CK-19 mRNA-positive sample showed a trend towards shorter survival. Pancreatic cancer patients showed significantly increased detection rates of disseminated tumor cells in blood and peritoneal lavage compared to the controls and the patients with chronic pancreatitis. CONCLUSION： Disseminated tumor cells can be detected in patients with pancreatic ductal adenocarcinorna by CK-19 fluorogenic RT-PCR. In peritoneal lavage, detection rate is correlated with tumor stage and differentiation. In the clinical use, CK-19 is suitable for the distinction between malignant and benign pancreatic disease in combination with other tumor-specific markers.展开更多
Background: We used transcatheter arterial infusion chemotherapy (TAI) for patients with T1G3 and greater than T2 bladder cancer, which was diagnosed after extensive and deep transurethral resection of bladder tumor (...Background: We used transcatheter arterial infusion chemotherapy (TAI) for patients with T1G3 and greater than T2 bladder cancer, which was diagnosed after extensive and deep transurethral resection of bladder tumor (TUR-BT), and we investigated the utility of serum cytokeratin 19 fragment (CYFRA) as a predictive factor of the response to therapy. Material and Methods: From November 2001 to November 2010, 56 patients (46 males and 10 females) with pathologically confirmed T1 G3 or greater than T2 bladder cancer after TUR-BT underwent two courses of TAI of cisplatin, methotrexate and doxorubicin as neoadjuvant setting. Then, patients underwent evaluation TUR-BT. Thereafter, the bladder was preserved in patients with superficial or undetectable tumors on TUR-BT. Advanced cases and residual bladder tumor cases were treated with total cystectomy or systemic chemotherapy. CYFRA levels were measured before and after performing TAI. Results: With this therapy, the 5-year survival rate was 85.7% in pT1G3, 82.3% in pT2, and 66.6% in greater than pT3 cases. Bladder preservation with no recurrence was observed in 58.7% of the patients. Grade III adverse events included leucopenia (6/56 patients: 10.7%). Serum CYFRA levels significantly decreased with treatment (in 4/6 patients with elevated CYFRA levels). Conclusion: These results suggest that although total cystictomy is usually indicated for T1G3 bladder cancers, bladder preservation and control of micrometastases can be achieved by performing TAI after extensive and deep TUR-BT. Our results also suggest the utility of monitoring serum CYFRA to assess the response to therapy.展开更多
文摘目的探讨术前细胞角蛋白19片段(cytokeratin fragment 19,CYFRA21-1)联合癌胚抗原(carcinoembryonic antigen,CEA)检测对T2期非小细胞肺癌患者淋巴结转移的预测价值。方法回顾性分析2020年1月至2022年10月在首都医科大学附属北京胸科医院接受手术治疗的448例T2期非小细胞肺癌患者的临床病理资料,根据术前肿瘤标志物CYFRA21-1、CEA的表达水平将其分为高表达组(CYFRA21-1≥6ng/ml或CEA≥6ng/ml,168例)和低表达组(CYFRA21-1<6ng/ml且CEA<6ng/ml,280例),比较两组患者的性别、年龄、吸烟史、病理类型、肿瘤大小及位置、淋巴结转移发生率和侵及程度。结果高表达组淋巴结转移发生率为51.19%(86/168),明显高于低表达组的28.21%(79/280),差异有显著性(P<0.001)。进一步分析显示肿瘤标志物高表达率在N2组为54.74%(52/95),N1组为48.57%(34/70),N0组为28.98%(82/283),不同淋巴结侵及程度组间比较差异均有显著性(P<0.001)。结论CYFRA21-1和CEA表达水平与T2期非小细胞肺癌淋巴结转移的发生率和侵及程度相关,术前检测CYFRA21-1和CEA可评估T2期非小细胞肺癌患者的淋巴结转移风险,对术中有针对性的淋巴结清扫及术后优化辅助治疗具有重要的参考价值。
文摘AIM： To evaluate the diagnostic potential of cytokeratin-19 （CK-19） mRNA for the detection of disseminated tumor cells in blood, bone marrow and peritoneal lavage in patients with ductal adenocarcinoma of the pancreas. METHODS： Sixty-eight patients with pancreatic cancer （/7 = 37）, chronic pancreatitis （n = 16）, and non-pancreatic benign surgical diseases （/7 = 15, control group） were included in the study. Venous blood was taken preoperatively, intraoperatively and at postoperative d 1 and 10. Preoperative bone marrow aspirates and peritoneal lavage taken before mobilization of the tumor were analyzed. All samples were evaluated for disseminated tumor cells by CK-19-specific nested-PCR and quantitative fluorogenic RT-PCR. RESULTS： CK-19 mRNA expression was increased in 24 （64%） blood samples and 11 （30%） of the peritoneal lavage samples in the patients with pancreatic cancer. In 15 （40%） of the patients with pancreatic cancer, disseminated tumor cells were detected in venous blood and bone marrow and/or peritoneal lavage. In the peritoneal lavage, the detection rates were correlated with the tumor size and the tumor differentiation. CK-19 levels were increased in pT3/T4 and moderately/poorly differentiated tumors （G2/G3）. Pancreatic cancer patients with at least one CK-19 mRNA-positive sample showed a trend towards shorter survival. Pancreatic cancer patients showed significantly increased detection rates of disseminated tumor cells in blood and peritoneal lavage compared to the controls and the patients with chronic pancreatitis. CONCLUSION： Disseminated tumor cells can be detected in patients with pancreatic ductal adenocarcinorna by CK-19 fluorogenic RT-PCR. In peritoneal lavage, detection rate is correlated with tumor stage and differentiation. In the clinical use, CK-19 is suitable for the distinction between malignant and benign pancreatic disease in combination with other tumor-specific markers.
文摘Background: We used transcatheter arterial infusion chemotherapy (TAI) for patients with T1G3 and greater than T2 bladder cancer, which was diagnosed after extensive and deep transurethral resection of bladder tumor (TUR-BT), and we investigated the utility of serum cytokeratin 19 fragment (CYFRA) as a predictive factor of the response to therapy. Material and Methods: From November 2001 to November 2010, 56 patients (46 males and 10 females) with pathologically confirmed T1 G3 or greater than T2 bladder cancer after TUR-BT underwent two courses of TAI of cisplatin, methotrexate and doxorubicin as neoadjuvant setting. Then, patients underwent evaluation TUR-BT. Thereafter, the bladder was preserved in patients with superficial or undetectable tumors on TUR-BT. Advanced cases and residual bladder tumor cases were treated with total cystectomy or systemic chemotherapy. CYFRA levels were measured before and after performing TAI. Results: With this therapy, the 5-year survival rate was 85.7% in pT1G3, 82.3% in pT2, and 66.6% in greater than pT3 cases. Bladder preservation with no recurrence was observed in 58.7% of the patients. Grade III adverse events included leucopenia (6/56 patients: 10.7%). Serum CYFRA levels significantly decreased with treatment (in 4/6 patients with elevated CYFRA levels). Conclusion: These results suggest that although total cystictomy is usually indicated for T1G3 bladder cancers, bladder preservation and control of micrometastases can be achieved by performing TAI after extensive and deep TUR-BT. Our results also suggest the utility of monitoring serum CYFRA to assess the response to therapy.
