LTA,CEA,NSE,Cyfra 21-1对肺癌诊断价值的探讨

目的 探讨 L TA、CEA、NSE和 Cyfra2 1- 1对肺癌诊断价值。方法 清晨空腹抽取临床确诊肺癌患者 12 4例、转移性肺癌 9例和良性肺部疾病 3 4例患者静脉血 7ml,分别用放射免疫法和乳胶凝集试验法 ,检测血清中上述癌性标志物水平。结果 :L TA、CEA、NSE和 Cyfra2 1- 1,在肺癌的阳性率分别为 60 %、8%、3 1%和 4 3 % ;特异性分别为 88%、10 0 %、84 %和 97% ,CEA和 Cyfra2 1-1较高 ;阳性率和敏感性组间差异有统计学意义。 L TA对肺癌细胞类型和是否手术无诊断意义。结论 L TA对肺癌具有一定的诊断价值 ,但特异性差于 Cyfra2 1- 1;

Obesity promotes oxidative stress and exacerbates blood-brain barrier disruption after high-intensity exercise

Purpose: The purpose of this study was to investigate the effects of obesity and high-intensity acute exercise on oxidant-antioxidant status,neurotrophic factor expression, and blood-brain barrier(BBB) disruption.Methods: Twenty-four healthy, untrained men(12 non-obese(mean 14.9% body fat) and 12 obese subjects(mean 29.8% body fat)) performed20 min of continuous submaximal aerobic exercise at 85% maximal oxygen consumption. Blood sampling was performed to examine the oxidant-antioxidant status(reactive oxygen species(ROS) and superoxide dismutase(SOD)), neurotrophic factors(brain-derived neurotrophic factor(BDNF) and nerve growth factor(NGF)), and BBB disruption(S100β and neuron-specific enolase) before and after acute exercise.Results: The obese group showed significantly higher pre-exercise serum ROS levels and significantly lower pre-exercise serum SOD levels than the non-obese group(p < 0.05). Serum ROS, SOD, BDNF, NGF, and S100β levels were significantly increased post-exercise compared with pre-exercise levels in both the non-obese and the obese groups(p < 0.05). The obese group showed significantly higher serum ROS, BDNF, NGF,and S100β levels post-exercise compared to the non-obese group(p < 0.05).Conclusion: Our study suggests that episodic vigorous exercise can increase oxidative stress and blood neurotrophic factor levels and induce disruption of the BBB. Moreover, high levels of neurotrophic factor in the blood after exercise in the obese group may be due to BBB disruption,and it is assumed that oxidative stress was the main cause of this BBB disruption.

Resection of the uncinate process of the pancreas due to a ganglioneuroma

A 33-year-old woman who presented with epigastric discomfort and diarrhea underwent an abdominal ultrasound(US).This investigation and subsequent contrastenhanced computed tomography,magnetic resonance imaging and endoscopic US with fine needle aspiration (FNA)revealed a 40 mm well-circumscribed mass in the uncinate process of the pancreas.Findings were suggestive of a mucinous or solid-cystic pseudopapillary tumor of the pancreas,although other lesions such as a nonfunctioning neuroendocrine tumor could not be ruled out.FNA samples were negative for malignant cells,but of limited value due to poor cellularity.It was decided to surgically remove the tumor because malignancy could not be discounted.Multiple intraoperative biopsies were suggestive of mesenchymal tumor and consequently a conservative resection(uncinatectomy)was performed. The postoperative course was uneventful.The definitive diagnosis was ganglioneuroma.Immunocytochemistry showed positive staining with vimentin,S-100 protein, neurofilament and neuron-specific enolase.Ganglioneuroma is a rare benign tumor that can also present as a pancreatic tumor.Uncinatectomy is feasible,safe and a good surgical technique for the treatment of nonmalignant tumors located in the uncinate process of the pancreas.

Simultaneous large cell neuroendocrine carcinoma and adenocarcinoma of the stomach

A large cell neuroendocrine carcinoma(LCNEC) of the stomach is very rare.A 76-year-old Japanese man was admitted to our hospital because of epigastralgia and nausea.Endoscopy revealed 2 large tumors in the stomach.He did not have multiple endocrine neoplasia typeⅠor Zollinger-Ellison syndrome.Imaging modalities,including computed tomography and magnetic resonance imaging,revealed no other tumors.Gastrectomy,cholecystectomy,and lymph node dissection were performed.The resected stomach had 2 tumors:one was an antral ulcerated type 3 tumor measuring 5 cm x 5 cm,and the other was a polypoid type 1 tumor measuring 6 cm x 6 cm x 3 cm in the fundus.Microscopically,the antral ulcerated tumor was a well differentiated adenocarcinoma with deep invasion.The fundus polypoid tumor was a LCNEC,being composed of malignant large cells arranged in trabecular and nested patterns.The tumor cells were large and the nuclei were vesicular.Nucleoli were frequently present,and there were many mitotic figures,apoptotic bodies,and necrotic areas.Much lymphovascular permeation was seen.Seven out of 29 dissected lymph nodes showed metastatic foci;6 were from the LCNEC and 1 from theadenocarcinoma.Many intravascular tumor emboli of LCNEC were seen in the peritoneum around the lymph nodes.Mucins were present in the adenocarcinoma but not in the LCNEC.Immunohistochemically,the LCNEC tumor cells were positive for pancytokeratins,synaptophysin(50%positive) ,chromogranin A(10% positive) ,Ki-67(90%labeled) ,and platelet-derived growth factor-α(80%positive) .They were negative for KIT,p53,CD56,and neuron-specific enolase.The non-cancerous stomach showed a normal number of endocrine cells.The patient is now treated with adjuvant chemotherapy.

Clinical relevance of neuroendocrine differentiation in lung adenocarcinoma

Objective:The aim of our study was to investigate the prevalence and clinical relevance of neuroendocrine(NE) differentiation in lung adenocarcinoma.Methods:Eighty-six adenocarcinoma paraffin-embedded specimens and cases which were followed up completely for 3 years,were obtained from 86 patients(35 men and 51 women) who underwent surgical resection for pathologically supported adenocarcinoma in the Cancer Hospital of Tianjin Medical University,from June 2005 to December 2006.Immunohistochemical EnVision two-step method was used to detect the expression of neuron-specific enolase(NSE),synaptophysin(SYN) and chromogranin A(CGA).All data were analyzed using SPSS statistics software and Kaplan-Meier survival curves were constructed,meanwhile,we conducted a Log-rank test.Results:All patients with lung adenocarcinoma,35 cases with NE differentiation(40.7%).The statistical analysis showed that the positive rate of NE differentiation in lung adenocarcinoma was significantly associated with cancer recurrence and histological differentiation.In addition,CGA,NSE and SYN positive rates were 27.9%,50.0%,43.0%,respectively.A statistically significant difference was found between positive expression of SYN and other clinicopathological parameters,such as pathological type,histological differentiation,lymph node metastasis,postoperative recurrence and 3-year survival rate(P = 0.001) and so on.Conclusion:NE differentiation can be used as a metastatic potentially indicator of biological behavior of lung adenocarcinoma,and combined detection of NSE and SYN markers may be recommended to examine NE differentiation of lung adenocarcinoma.Positive expression of SYN indicates poor prognosis.

Neuroendocrine carcinoma of the pancreas with soft tissue metastasis

Neuroendocrine carcinoma(NEC) of the pancreas is rare.We report the case of a 34-year-old man with pancreatic NEC with soft tissue metastasis.The patient presented with right upper abdominal discomfort.Computed tomography revealed a low-density heterogeneous mass in the tail and body of the pancreas that encroached on the greater curvature of the stomach and spleen.We performed exploratory laparotomy and total pancreatectomy with splenectomy and total gastrectomy.Histopathological analysis showed spindleshaped cells with scanty cytoplasm and hyperchromatic nuclei,confirming a primary pancreatic NEC.One month after the surgery,the patient experienced leg swelling.Positron emission tomography-computed tomography revealed high uptake of fludeoxyglucose in the left leg,and the leg was amputated.Histopathological analysis confirmed metastasis of pancreatic NEC.The patient was followed up and received chemotherapy(etoposide and cisplatin).One month after amputation,the level of tumor marker neuron-specific enolase was 142.70 μg/L and computed tomography scan revealed an aggravated metastatic lesion.The patient suffered from unbearable pain and we treated him with odynolysis.Four months postoperatively,the patient died of respiratory failure.

Analysis of clinicopathological and immunohistochemical features of 15 cases with olfactory neuroblastoma

Objective:We studied the clinicopathological and immunohistochemical features of olfactory neuroblastoma(ONB).Methods:The clinic pathological data and immunohistochemical features of 15 cases with ONB were analyzed retrospectively,and the related literatures were reviewed.Results:The tumors were all located in the nasal cavity in 15 cases.According to Kadish's staging system,7 cases were in stage A,5 cases in stage B,and 3 cases in stage C.The morphological features showed small round or ovoid tumor cells divided into pieces or trabeculae by connective tissues which were rich in capillaries.The tumor cells had round or oval nuclei and fine chromatins and lack of cytoplasma.Flexner rosette and Homer-Wright rosette were found in some cases.Acidophilic fibrins were composed of cytoplasmic projection among tumor cells.All cases were positive for NSE,Syn,CgA,1 case was positive for Vimentin,2 cases were positive for S-100,while CKpan,LCA and HMB45 were all negative.Conclusion:ONB is a type of very rare malignant tumors,which could be diagnosed by pathology,and immunohistochemistry is helpful in the diagnosis and differential diagnosis.

Stem cells modified by brain-derived neurotrophic factor to promote stem cells differentiation into neurons and enhance neuromotor function after brain injury

Objective： To promote stem cells differentiation into neurons and enhance neuromotor function after brain injury through brain-derived neurotrophic factor （BDNF） induction. Methods： Recombinant adenovirus vector was applied to the transfection of BDNF into human-derived umbilical cord mesenchymal stem cells （UCMSCs）. Enzyme linked immunosorbent assay （ELISA） was used to determine the secretion phase of BDNF. The brain injury model of athymic mice induced by hydraulic pressure percussion was established for transplantation of stem cells into the edge of injury site. Nerve function scores were obtained, and the expression level of transfected and non-transfected BDNF, proportion of neuron specific enolase （NSE） and glial fibrillary acidic protein （GFAP）, and the number of apoptosis cells were compared respectively. Results： The BDNF expression achieved its stabilization at a high level 72 hours after gene transfection. The mouse obtained a better score of nerve function, and the proportion of the NSE-positive cells increased significantly （P〈0.05）, but GFAP-positive cells decreased in BDNF- UCMSCs group compared with the other two groups （P〈0.05）. At the site of high expression of BDNF, the number of apoptosis cells decreased markedly. Conclusion： BDNF gene can promote the differentiation of the stem cells into neurons rather than glial cells, and enhance neuromotor function after brain injury.