Colorectal cancer vaccines: Tumor-associated antigens vs neoantigens

Therapeutic options for the treatment of colorectal cancer(CRC) are diverse but still not always satisfying. Recent success of immune checkpoint inhibition treatment for the subgroup of CRC patients suffering from hypermutated tumors suggests a permanent role of immune therapy in the clinical management of CRC. Substantial improvement in treatment outcome could be achieved by development of efficient patient-individual CRC vaccination strategies. This mini-review summarizes the current knowledge on the two general classes of targets: tumor-associated antigens(TAAs) and tumorspecific antigens. TAAs like carcinoembryonic antigen and melanoma associated antigen are present in and shared by a subgroup of patients and a variety of clinical studies examined the efficacy of different TAA-derived peptide vaccines. Combinations of several TAAs as the next step and the development of personalized TAA-based peptide vaccines are discussed. Improvements of peptidebased vaccines achievable by adjuvants and immunestimulatory chemotherapeutics are highlighted. Finally, we sum up clinical studies using tumor-specific antigens-in CRC almost exclusively neoantigens-which revealed promising results; particularly no severe adverse events were reported so far. Critical progress for clinical outcomes can be expected by individualizing neoantigen-based peptide vaccines and combining them with immunestimulatory chemotherapeutics and immune checkpoint inhibitors. In light of these data and latest developments, truly personalized neoantigen-based peptide vaccines can be expected to fulfill modern precision medicine's requirements and will manifest as treatment pillar for routine clinical management of CRC.

Autoantibodies against tumor-associated antigens for detection of hepatocellular carcinoma

Hepatocellular carcinoma(HCC) is one of the most common tumors worldwide. The survival rate after the onset of symptoms is generally less than one year for the late presentation of HCC, and reliable tools for early diagnosis are lacking. Therefore, novel biomarkers for the early detection of HCC are urgently required. Recent studies show that the abnormal release of proteins by tumor cells can elicit humoral immune responses to self-antigens called tumor-associated antigens(TAAs). The corresponding autoantibodies can be detected before the clinical diagnosis of cancer. Therefore, there is growing interest in using serum autoantibodies as cancer biomarkers. In this review, we focus on the advances in research on autoantibodies against TAAs as serum biomarker for detection of HCC, the mechanism of the production of TAAs, and the association of autoantibodies with patients' clinical characteristics.

Comparisons of voided urine cytology, nuclear matrix protein-22 and bladder tumor associated antigen tests for bladder cancer of geriatric male patients in Taiwan, China

Aim： To compare the results of bladder tumor associated antigen （BTA TRAK）, nuclear matrix protein 22 （NMP 22） and voided urine cytology （VUC） in detecting bladder cancer. Methods： A total of 135 elderly male and 50 healthy volunteers enrolled in this study were classified into three groups： （i） 93 patients with bladder cancer; （ii） 42 patients with urinary benign conditions; and （iii） 50 healthy volunteers. BTA TRAK and NMP 22 kits were used to detect bladder cancer. Voided urine cytology was used to compare the sensitivity and specificity of the screening tests. Results： The sensitivity and specificity of cytology, BTA TRAK and NMP 22 were 24% and 97%, 51% and 73%, 78% and 73%, respectively. The level of NMP 22 increased with tumor grading. The BTA TRAK kit has the lowest sensitivity among the screening tests. The NMP 22 with the best sensitivity can be an adjunct to cytology for evaluating bladder cancer. Conclusion： The NMP 22 test has a better correlation with the grading of the bladder cancer than BTA TRAK. As cytology units are typically not available in hospitals or in outpatient clinics, NMP 22 might be a promising tool for screening bladder cancer.

Proliferating cell nuclear antigen clamp associated factor,a potential proto-oncogene with increased expression in malignant gastrointestinal tumors

Gastrointestinal(GI)cancers,including malignancies in the gastrointestinal tract and accessory organs of digestion,represent the leading cause of death worldwide due to the poor prognosis of most GI cancers.An investigation into the potential molecular targets of prediction,diagnosis,prognosis,and therapy in GI cancers is urgently required.Proliferating cell nuclear antigen(PCNA)clamp associated factor(PCLAF),which plays an essential role in cell proliferation,apoptosis,and cell cycle regulation by binding to PCNA,is a potential molecular target of GI cancers as it contributes to a series of malignant properties,including tumorigenesis,epithelial-mesenchymal transition,migration,and invasion.Furthermore,PCLAF is an underlying plasma prediction target in colorectal cancer and liver cancer.In addition to GI cancers,PCLAF is also involved in other types of cancers and autoimmune diseases.Several pivotal pathways,including the Rb/E2F pathway,NF-κB pathway,and p53-p21 cascade,are implicated in PCLAF-mediated diseases.PCLAF also contributes to some diseases through dysregulation of the p53 pathway,WNT signal pathway,MEK/ERK pathway,and PI3K/AKT/mTOR signal cascade.This review mainly describes in detail the role of PCLAF in physiological status and GI cancers.The signaling pathways involved in PCLAF are also summarized.Suppression of the interaction of PCLAF/PCNA or the expression of PCLAF might be potential biological therapeutic strategies for GI cancers.

HCA520, A NOVEL TUMOR ASSOCIATED ANTIGEN, INVOLVED IN CELL PROLIFERATION AND APOPTOSIS

Objective: Tumor associated antigen encoding gene HCA520 (AF146019) was identified by screening a human hepatocellular carcinoma expressing cDNA library using SEREX technique. In this experiment we studied the effect of HCA520 on cell proliferation and apoptosis. Methods: Gene HCA520 was gained by PCR and transfected into 293 cells. The stable expression cells were obtained by G418 selection. The cell proliferation was measured by [3H]-TdR uptake and apoptosis assay was measured by FACS. Results: Eukaryotic expression plasmid pcDNA3-HCA520 was constructed and its stable transfectants were obtained. Overexpression of HCA520 inhibited the cell proliferation and enhanced cell apoptosis after serum deprivation. Conclusion: HCA520 is a novel tumor associated antigen that can affect cell proliferation and apoptosis.

Clinicopathological significance of human leukocyte antigen F-associated transcript 10 expression in colorectal cancer

BACKGROUND Colorectal cancer(CRC) is a common malignancy of the gastrointestinal tract. The worldwide mortality rate of CRC is about one half of its morbidity. Ubiquitin is a key regulatory factor in the cell cycle and widely exists in eukaryotes. Human leukocyte antigen F-associated transcript 10(FAT10), known as diubiquitin, is an 18 kDa protein with 29% and 36% homology with the N and C termini of ubiquitin. The function of FAT10 has not been fully elucidated, and some studies have shown that it plays an important role in various cell processes.AIM To examine FAT10 expression and to analyze the relationship between FAT10 expression and the clinicopathological parameters of CRC.METHODS FAT10 expression in 61 cases of CRC and para-cancer colorectal tissues was measured by immunohistochemistry and Western blotting. The relationship between FAT10 expression and clinicopathological parameters of CRC was statistically analyzed.RESULTS Immunohistochemical analysis showed that the positive rate of FAT10 expression in CRC(63.93%) was significantly higher than that in tumor-adjacent tissues(9.84%, P < 0.05) and normal colorectal mucosal tissue(1.64%, P < 0.05). Western blotting also indicated that FAT10 expression was significantly higher in CRC than in tumor-adjacent tissue(P < 0.05). FAT10 expression was closely associated with clinical stage and lymphatic spread of CRC. FAT10 expression also positively correlated with p53 expression.CONCLUSION FAT10 expression is highly upregulated in CRC. FAT10 expression is closely associated with clinical stage and lymphatic spread of CRC.

Experimental Studies of Melanin Associated Antigen and Its Relationship with Sympathetic Ophthalmia and Vogt-Kayanagi-Harada Syndrome

Purpose: To discuss the relationship of Bovine Melanin-Associated Antigen (BMAA) to Sympathetic Ophthalmia (SO) and Vogt-Kayanagi-Harada (VKH) syndrome.Methods:BMAA was isolated and purified from bovine iris and ciliary body and MTT method was used to measure the peripheral lymphocyte reactions of SO and VKH syndrome patients to BMAA. 15 cases of SO were included in the SO group with 11 males and 4 females. The average age was 37.5, ranging from 23 to 56 years; 15 patients with VKH syndrome were included in the VHK group with 7 males and 8 females. Their average age was 37.2 years, ranging from 24 to 69 years; 20 normal individuals without ocular and systemic autoimmune diseases were included in the control group.These included 9 males and 11 females, aging from 14 to 28 with an average of 23.8 years.Results: The OD values of each group were as follows: SO controls 0.327+0.032; SO+ BMAA 0.490+0.758; SO+PHA 0.5310+0.918; VKH controls 0.328+0.503; VKH+BMAA 0.430 +0.530; VKH +PHA 0.328 +0.484;Normal controls 0.304 +0.267; Normal +BMAA 0.343+0.326; Normal+PHA 0.477+0.598. The average OD values of peripheral lymphocytes to BMAA stimulation in SO patients and normal controls were 0.490 and 0.343 respectively. The difference was statistically significant, P＜ 0.001; The average OD values of peripheral lymphocytes to BMAA stimulation in SO and VKH syndrome patients were 0.470 and 0.430 respectively. The difference was not statistically significant,P ＞ 0.05.Conclusions:BMAA effectively stimulate the proliferative reaction of peripheral lymphocytes in SO patients and BMAA may act as an antigen and contribute in the pathological process of SO.No difference in proliferative reaction of peripheral lymphocytes was found between SO and VKH syndrome patients after BMAA stimulations and BMAA may be involved in the development of both SO and VKH yndrome.

<i>Mycoplasma hominis</i>Variable Adherence-Associated Antigen: A Major Adhesin and Highly Variable Surface Membrane Protein

Mycoplasma hominis is a member of the genus mycoplasma and has only been isolated from humans. It is most frequently isolated from the urogenital tract in the absence of symptoms, but has been isolated from wounds, brain abscess, inflamed joints, blood and placenta from pregnancy with adverse outcomes (especially preterm birth and occasionally term stillbirth). Controversy surrounds whether this organism is a commensal or a pathogen;however, Mycoplasma hominis has been shown to induce preterm birth and foetal lung injury in an experimental primate model as a sole pathogen. These bacteria are known to exist as a parasitic infection, due to a number of missing synthetic and metabolism pathway enzymes from their minimal genome;therefore, the ability to adhere to host cells is important. Here we provide a review that clarifies the different nomenclature (variable adherence-associated antigen and P50) that has been used to investigate the major surface adhesin for this organism, as well as reported mechanisms responsible for turning off its expression. Variation in the structure of this protein can be used to separate strains into six categories, a method that we were able to use to distinguish and characterise 12 UK strains isolated from between 1983 and 2012. We propose that the Vaa should be used in further investigations to determine if commensal populations and those that are associated with disease utilise different forms of this adhesin, as this is under-studied and identification of pathogenic determinants is overdue for this organism.

THE STUDY OF COLORECTAL CARCINOMA ASSOCIATED ANTIGEN LEA IN CLINICAL PATHOLOGICAL DIAGNOSIS

Objective: To study the expression and the clinical significance of LEA in colorectal carcinoma. Methods: Immunohistochemistry S-P method to detect the expression of LEA and CEA in 140 colorectal cancer specimens and 100 non-cancerous colorectal specimens. Results: The expression of LEA is relative to tumor differentiation degree and exhibits higher selectivity in well-differentiated adeno-carcinoma (P<0.01). CEA has similar selectivity in well, moderately and poorly differentiated adenocarcinoma (P>0.05). Compared with CEA, the expression of LEA has lower positive rate in non-cancerous tissue (P<0.05). The positive rate of LEA in adenoma is much higher than surrounding non-cancerous mucosa and normal mucosa. In normal mucosa the positive rate of LEA is obviously lower than that of CEA (P<0.05). The expression of LEA and CEA has similar rule except in normal mucosa. In histological diagnosis of colorectal cancer the sensitivity of LEA is 82.9% and the specificity is 48%, while the sensitivity of CEA is 88.6% and the specificity is 35%. Conclusion: The expression of LEA is related to the differentiation degree of colorectal cancer tissue. LEA can be used as an auxiliary index for early diagnosis and a reference for the judgment of the malignancy degree of colorectal carcinoma, thus may be a new tumor marker with applicable clinic value.

Preliminary study of the diagnosis of pancreatic cancer with a serum pancreatic cancer－associated antigen

The serum of 40 normal subjects, 61 cases of various malignant diseases except pancreatic cancer,53 cases of various benign diseases and 33 cases of pancreatic cancer was examined with ELISA to determine the serum level of pancreatic cancer-associated ant

Leukocyte function-associated antigen-1 deficiency impairs responses to polymicrobial sepsis

AIM: To determine the role of leukocyte functionassociated antigen-1(LFA-1) in polymicrobial sepsis model in mice.METHODS: Cecal ligation and puncture model was used to study polymicrobial sepsis in wild type and LFA-1 knockout(KO)(= CD11 a KO) mice. Their survivals were examined. Neutrophil recruitment to the abdominal cavity, bacterial tissue load and bacterial killing by neutrophils, tissue cytokine profiles, and serum cytokines were examined. Apoptosis of tissues was assessed using cleaved-caspase 3 and TUNNEL staining. The recruitment of neutrophils to various tissues was assessed using myeloperoxidase staining or measuring myeloperoxidase activity. RESULTS: LFA-1 deficiency significantly decreased survival(P = 0.0024) with the reduction of neutrophil recruitment to the abdominal cavity and higher bacterial load in blood. It was also associated with increased apoptosis in spleen and more organ injuries probed by interleukin-6 m RNA level. However, the deficiency of LFA-1 did not prevent neutrophil recruitment to lung, liver, spleen or kidney, which suggested the existence of LFA-1 independent recruitment mechanism in these organs. CONCLUSION: LFA-1 deficiency did not attenuate neutrophil recruitment to various organs to adequately mitigate secondary tissue injury in sepsis. It was associated with decreased neutrophil recruitment to the abdominal cavity, higher bacterial load, leading to increased mortality in an abdominal, polymicrobial sepsis.

Vitreous Cavity-Associated Immune Deviation Induced by Retinal S Antigen

Purpose: To determine whether the vitreous cavity(VC) supports the induction of deviant immune responses to retinal soluble(S) antigen and to observe the influence of interleukin-1 (IL-1) on the immunologic properties of the VC. Methods: Retinal S antigen was inoculated into the anterior chamber(AC) and the VC in Wistar rats. Seven days after antigen inoculation, the recipient animals were immunized with S antigen and complete Freund's adjuvant. Delayed-type hypersen- sitivity(DTH) was assessed by footpad challenge. To alter systemic immune conditions,IL-1 was administrated by intraperitoneal injection.Results: Antigen-specific DTH did not develop in rats in which S antigen was injected into the AC and the VC. By contrast, when IL-1 administrated systemically, S antigen was injected into the AC and VC elicited strong DTH.Conclusion: The VC supports immune deviation for soluble antigen by acitivity suppressing antigen-Specific DTH. Systemic administration of exogenous IL-1 eliminates the capacity of the VC to support immune deviation to soluble antigen locally injected.

HLA class Ⅱ associated with outcomes of hepatitis B and C infections

Several factors influence the clinical course of hepatitis B virus(HBV)and hepatitis C virus(HCV)infection.The human leukocyte antigen(HLA)system,the major histocompatibility complex(MHC)in humans,has been considered one of the most important host factors with respect to outcomes.To date,conventional genotyping studies have shown that HLA classⅡloci are mainly associated with spontaneous clearance of HBV and HCV.However,the specific HLA locus associated with the outcomes of hepatitis virus infection remains unclear.A recent genome-wide association study(GWAS)using a comprehensive approach for human genotyping demonstrated single nucleotide polymorphisms(SNPs)associated with the outcomes of hepatitis virus infection.Examination of large numbers of cohorts revealed that several SNPs in both HLA-DPA1 and HLADPB1 loci are associated with persistent HBV infection in Asian populations.To date,however,few studies have focused on HLA-DP because polymorphisms of HLA-DP haplotype do not vary greatly as compared with other loci of HLA.There are not enough studies to reveal the function of HLA-DP.GWAS additionally detected candidate SNPs within HLA loci associated with chronic HBV or HCV hepatitis,hepatic fibrosis,and the development of hepatocellular carcinoma.The results of one cohort were not always consistent with those of other cohorts.To solve several controversial issues,it is necessary to validate reported SNPs on HLA loci in global populations and to elucidate the HLA-allele-regulated molecular response to hepatitis virus infection.

Hepatitis B virus persistent infection-related single nucleotide polymorphisms in HLA regions are associated with viral load in hepatoma families

BACKGROUND Genome-wide association studies from Asia indicate that HLA-DP and HLA-DQ loci are important in persistent hepatitis B virus(HBV)infections.One of the key elements for HBV-related carcinogenesis is persistent viral replication and inflammation.AIM To examine genetic and nongenetic factors with persistent HBV infection and viral load in families with hepatocellular carcinoma(HCC).METHODS The HCC families included 301 hepatitis B surface antigen(HBsAg)carriers and 424 noncarriers born before the nationwide vaccination program was initiated in 1984.Five HBV-related single nucleotide polymorphisms(SNPs)—rs477515,rs9272105,rs9276370,rs7756516,and rs9277535—were genotyped.Factors associated with persistent HBV infection and viral load were analyzed by a generalized estimating equation.RESULTS In the first-stage persistent HBV study,all SNPs except rs9272105 were associated with persistent infection.A significantly higher area under the reciprocal operating characteristic curve for nongenetic factors vs genetic factors(P<0.001)suggests that the former play a major role in persistent HBV infection.In the second-stage viral load study,we added 8 HBsAg carriers born after 1984.The 309 HBsAg carriers were divided into low(n=162)and high viral load(n=147)groups with an HBV DNA cutoff of 105 cps/mL.Sex,relationship to the index case,rs477515,rs9272105,and rs7756516 were associated with viral load.Based on the receiver operating characteristic curve analysis,genetic and nongenetic factors affected viral load equally in the HCC family cohort(P=0.3117).CONCLUSION In these east Asian adults,the mechanism of persistent HBV infection-related SNPs was a prolonged viral replication phase.

Host genetic factors affecting hepatitis B infection outcomes:Insights from genome-wide association studies

The clinical outcome of hepatitis B virus(HBV) infection depends on the success or failure of the immune responses to HBV,and varies widely among individuals,ranging from asymptomatic self-limited infection,inactive carrier state,chronic hepatitis,cirrhosis,hepatocellular carcinoma,to liver failure,depending on the success or failure of immune response to HBV.Genome-wide association studies(GWAS) identified key genetic factors influencing the pathogenesis of HBV-related traits.In this review,we discuss GWAS for persistence of HBV infection,antibody response to hepatitis B vaccine,and HBV-related advanced liver diseases.HBV persistence is associated with multiple genes with diverse roles in immune mechanisms.The strongest associations are found within the classical human leukocyte antigen(HLA) genes,highlighting the central role of antigen presentation in the immune response to HBV.Associated variants affect both epitope binding specificities and expression levels of HLA molecules.Several other susceptibility genes regulate the magnitude of adaptive immune responses,determining immunity vs tolerance.HBV persistence and nonresponse to vaccine share the same risk variants,implying overlapping genetic bases.On the other hand,the risk variants for HBV-related advanced liver diseases are largely different,suggesting different host-virus dynamics in acute vs chronic HBV infections.The findings of these GWAS are likely to pave the way for developing more effective preventive and therapeutic interventions by personalizing the management of HBV infection.

Chimeric antigen receptor-engineered T-cell therapy for liver cancer

Background: Chimeric antigen receptor-engineered T-cell(CAR-T) therapy is a newly developed immunotherapy used in the treatment of cancers. Because CAR-T therapy has shown great success in treating CD19-positive hematological malignancies, its application has been explored in the treatment of solid tumors, such as liver cancer. In this review, we discuss the immune characteristics of liver cancer, the obstacles encountered during the application of CAR-T therapy, and preclinical and clinical progress in the use of CAR-T therapy in patients with liver cancer.Data sources: The data on CAR-T therapy related to liver cancers were collected by searching Pub Med and the Web of Science databases prior to December 2017 with the keywords "chimeric antigen receptor","CAR-T", "liver cancer", "hepatocellular carcinoma", and "solid tumor". Additional articles were identified by manual search of references found in the primary articles. The data for clinical trials were collected by searching Clinical Trials.gov.Results: The liver has a tolerogenic nature in the intrahepatic milieu and its tumor microenvironment significantly affects tumor progression. The obstacles that reduce the efficacy of CAR-T therapy in solid tumors include a lack of specific tumor antigens, limited trafficking and penetration of CAR-T cells to tumor sites, and an immunosuppressive tumor microenvironment. To overcome these obstacles, several strategies have emerged. In addition, several strategies have been developed to manage the side effects of CAR-T, including enhancing the selectivity of CARs and controlling CAR-T activity. To date, no clinical trials of CAR-T therapy against HCC have been completed. However, preclinical studies in vitro and in vivo have shown potent antitumor efficacy. Glypican-3, mucin-1, epithelial cell adhesion molecule, carcinoembryonic antigen, and other targets are currently being studied.Conclusions: The application of CAR-T therapy for liver cancer is just beginning to be explored and more research is needed. However, we are optimistic that CAR-T therapy will offer a new approach for the treatment of liver cancers in the future.

Identification of novel HLA-A 0201-restricted epitopes from anterior gradient-2 as a tumor-associated antigen against colorectal cancer

Anterior gradient-2 （AGR2） promotes tumor growth, cell migration and cellular transformation and its enhanced expression is almost completely restricted to malignant tissues, thus making AGR2 an interesting target for the development of immunotherapeutic strategies. We investigated whether the AGR2 molecule comprises human leukocyte antigen （HLA）-A 0201-binding epitopes recognized by human cytotoxic T lymphocytes （CTLs）, which could be targeted in dendritic cell （DC）-based cancer immunotherapy against colorectal cancer （CRC）. We reviewed the sequence of AGR2 for peptides that could potentially bind to HLA-A 0201 with the aid of a computer-based program. Five candidate peptides with different binding scores were synthesized and tested. These peptides were then assessed for their immunogenicity to elicit specific immune responses mediated by CTLs in vitro by means of enzyme-linked immunospot assays and CTL assays. AGR2 was highly expressed in several CRC cell lines, including DK01, DLD1, KM 12C, HCT-8 and HT-29. DCs pulsed with AGR2-P2 （aa 11-19; LLVALSYTL） or AGR2-P4 （aa 127-135; RIMFVDPSL） generated potent CTLs that could lyse T2 cells pulsed with AGR2-P2 or AGR2-P4 and HLA-A0201＋ AGR2-positive CRC cell lines in a strong dose-dependent and HLA-A 0201-restricted manner. In conclusion, these novel epitopes derived from AGR2 protein may be attractive candidates for DC-based immunotherapy for CRC.

宫颈癌癌组织及外周血单个核细胞中MAGE-A3的表达及其临床意义

目的探究宫颈癌癌组织及外周血单个核细胞(PBMC)中黑色素瘤相关抗原-A3(MAGE-A3)表达及临床意义。方法通过方便抽样选取2020-05至2022-05保定市妇幼保健院及河北大学附属医院收治的因宫颈病变拟行宫颈锥切术或广泛性子宫切除术患者96例,根据术后病理结果分为宫颈癌组和子宫颈鳞状上皮内病变(SIL)组,采用免疫组化法检测病变组织MAGE-A3蛋白表达情况。采用实时荧光定量PCR法检测宫颈病变组织及PBMC中MAGE-A3 mRNA表达水平,分析宫颈癌患者癌组织及PBMC中MAGE-A3mRNA表达与血清肿瘤标志物相关性以及癌组织MAGE-A3蛋白表达与临床病理特征关系。结果宫颈癌癌组织MAGE-A3蛋白表达阳性率与FIGO分期、肿瘤的直径大小、分化程度、淋巴结转移、感染高危型HPV有关(P<0.05),与年龄、病理类型无关(P>0.05)。宫颈癌组癌组织和PBMC中MAGE-A3 mRNA表达水平分别为(1.33±0.46)、(1.70±0.49),均显著高于SIL组(0.59±0.20、0.92±0.33)(P<0.05),血清SCC-Ag[(3.87±1.69)ng/ml]、CA-125[(48.62±15.10)U/ml]均显著高于SIL组[(0.70±0.32)ng/ml、(25.36±8.33)U/ml](P<0.05);宫颈癌组癌组织MAGE-A3蛋白表达阳性率(66.07%)显著高于SIL组(30.00%)(P<0.05);宫颈癌患者癌组织、PBMC中MAGE-A3 mRNA表达水平与血清SCC-Ag、CA-125均呈正相关(P<0.05)。结论宫颈癌患者癌组织及PBMC中MAGE-A3表达均上调,且与患者血清肿瘤标志物水平及病情进展有关,MAGE-A3有望成为早期宫颈癌诊断的重要标志物。

临床特征联合血清CA19-9、HE4对子宫内膜异位症相关卵巢癌症的诊断价值

目的 探讨临床特征联合血清糖类抗原(CA) 19-9、人附睾蛋白4 (HE4)对子宫内膜异位症相关卵巢癌症(EAOC)的诊断价值。方法 选择2020年1月至2022年12月在河南中医药大学第三附属医院接受手术且经术后病理确诊为EAOC的43例患者作为观察组,按照1∶2的比例抽取同期在我院手术且经术后证实为卵巢子宫内膜异位症(OEM)的86例患者作为对照组。比较两组患者的临床资料及血清CA125、CA19-9和HE4水平,采用多因素Logistic回归分析影响EAOC的独立风险因素,并采用受试者工作特征曲线(ROC)分析临床特征、CA19-9和HE4诊断EAOC的价值。结果 观察组患者的CA19-9和HE4水平分别为[20.99 (17.06,32.40)] U/mL和[64.47 (55.93,72.01)] U/mL,明显高于对照组的[4.98(2.18,10.86)] U/mL和[43.39(34.61,52.40)] U/mL,差异均有统计学意义(P<0.05);观察组患者的CA125水平为[59.85 (39.51,92.26)] pmol/L,明略高于对照组的[56.58 (39.80,80.68)] pmol/L,但差异无统计学意义(P>0.05)。经多因素Logistic回归分析结果显示,CA19-9、HE4、年龄、肿瘤最长径是影响EAOC的风险因素(P<0.05)。经ROC分析结果显示,年龄、肿瘤最长径、CA19-9、HE4联合检测的曲线下面积(AUC)为0.958,明显高于单独检测(年龄:0.857;肿瘤最长径:0.767;CA19-9:0.767;HE4:0.808)(P<0.05)。结论 CA19-9、HE4、年龄、肿瘤最长径可用于预测EAOC,联合检测可提高诊断效能。

PTEN、CA125、sVEGFR1、NGAL在子宫内膜癌患者血清中的表达及与病理特征的关系

目的 探讨第10号染色体缺失的磷酸酶及张力蛋白同源基因(PTEN)、糖类抗原125(CA125)、可溶性血管内皮生长因子受体-1(sVEGFR1)、中性粒细胞明胶酶相关脂质载运蛋白(NGAL)在子宫内膜癌(EC)患者血清中的表达及与病理特征的关系。方法 选取2019年1月至2021年6月于在邯郸市第一医院行全子宫切除术并经病理诊断的120例EC患者为研究组,选择同期80例良性病变子宫内膜患者为对照组,用酶联免疫吸附法检测并比较2组患者血清PTEN、CA125、sVEGFR1、NGAL水平,收集2组临床病理资料,分析血清PTEN、CA125、sVEGFR1、NGAL与研究组患者病理特征的关系。结果 研究组血清CA125、NGAL水平高于对照组,血清PTEN、sVEGFR1水平低于对照组(P<0.05)。分化程度越低血清CA125、NGAL水平越高,血清PTEN、sVEGFR1水平越低(P<0.05);临床分期Ⅲ~Ⅳ期患者血清PTEN高于Ⅰ~Ⅱ期(P<0.05);临床分期Ⅲ~Ⅳ期、有淋巴结转移、浸润深度≥50%患者血清CA125、NGAL水平升高,血清sVEGFR1水平降低(P<0.05)。血清PTEN与临床分期呈负相关,与分化程度呈正相关(P<0.05);血清CA125、NGAL与临床分期、淋巴结转移、浸润深度呈正相关,与分化程度呈负相关(P<0.05);血清sVEGFR1与临床分期、淋巴结转移、浸润深度呈负相关,与分化程度呈正相关(P<0.05)。结论 CA125、NGAL在EC患者血清中呈高表达,PTEN、sVEGFR1呈低表达,均与EC患者病理特征有一定相关性,可作为EC早期诊断与疾病进展的潜在生物学标志物。