The human leucocyte differentiation antigens (HLDA) workshops: the evolv-ing role of antibodies in research, diagnosis and therapy

The 8th International Workshop on Human Leucocyte Differentiation Antigens (chaired by Zola H and managed by Swart B) was run over a 4-year period and culminated in a conference in December 2004. Here we review the achieve- ments of the HLDA Workshops and provide links to information on CD molecules and antibodies against them, including the 93 new CDs assigned in the 8th Workshop. We consider what remains to be achieved (including an estimate of the number of leucocyte surface molecules still to be discovered), and how the field can best move forward.

Serum IgG response to differentiated antigens of Helicobacter pylori

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Differentiation induced by physiological and pharmacological stimuli leads to increased antigenicity of human neuroblastoma cells

同情的 neuronal 区别与 neuroblastoma (NB ) 的有利预后被联系，早童年的最普通的颅外的稳固的肿瘤。区别代理人在 NB 治疗的临床的协议证明了有用，但是因为唯一的治疗不是足够的在病人导致肿瘤消除，使用他们。因此，互补途径例如免疫疗法，被保证。这里，我们证明 NB 房间线和前 vivo 的那区别孤立肿瘤房间响应生理或药理学刺激与增加的 antigenicity 的获得被联系。这是增加了表面专业的表示表明组织亲和性一级建筑群和 ICAM-1 分子并且由细胞毒素的 T 淋巴细胞(CTL ) 和生来的杀手(NK ) 翻译成 NB 房间的增加的敏感到细胞溶解房间。后者是由形式免疫者 conjugates 的区分的房间的提高的能力的 paralleled 并且把 granzyme B 的增加的数量绑在房间表面。 Wedemonstrate ，第一次那不管使用的刺激，在 NB 的区别状态与由细胞毒素的淋巴细胞启用肿瘤房间的更多的有效消除并且在 NB 病人作为一条辅助途径为导致区别的代理人和免疫疗法的联合申请铺平道路的增加的肿瘤 antigenicity 被联系。

AstragalosideⅣimproves melanocyte differentiation from mouse bone marrow mesenchymal stem cells

Vitiligo results in an autoimmune disorder destructing skin pigment cells,melanocytes(Mcs).This study aimed to investigate whether Astragaloside IV(AIV)could efficiently induce differentiation of bone marrow mesenchymal stem cells(BMMSCs)into Mcs.BMMSCs were induced and differentiated into Mcs with 0.1,0.2,and 0.4 mg/L AIV during 150-day.Morphologic changes of differentiated cells were observed.Levels of some melanocytic specific genes(TRP-1,TRP-2,MART-1,Mitf)were measured with quantitative polymerase chain reaction(qPCR)at 90,120,and 150 days of induction.After 90-day induction,the differentiated cells with 0.4 mg/L AIV demonstrated the typical morphology of Mcs,positive 3,4 dihydroxyphenylalanine staining,and positive staining of TRP-1,TRP-2,MART-1,and Mitf.After 90-and 120-days’induction with 0.4 mg/L AIV,TRP-1 expression was significantly elevated(p<0.01),and TRP-2 expression was significantly increased in 0.4 mg/L AIV-treated group compared to negative control(p<0.01),0.1 mg/L(p<0.01),and 0.2 mg/L(p<0.01)AIV-treated groups.Moreover,MART-1 expression was significantly up-regulated in 0.4 mg/L AIV-treated group compared to negative control,but without difference compared to 0.1 mg/L(p>0.05)and 0.2 mg/L(p>0.05)AIV-treated groups.During 90 to 150-day induction,there were no significant differences for Mitf levels between AIV-treated groups and negative control(p>0.05).In conclusion,90-day induction with 0.4 mg/L AIV up-regulated TRP-1,TRP-2,and MART-1 expression,indicating that AIV can efficiently induce Mcs differentiation from BMMSCs.These results provide experimental and theoretic evidence for AIV application in clinical vitiligo repigmentation treatment.

Relationship between phenotypes of cell-function differentiation and pathobiological behavior of gastric carcinomas

AIM To reveal the correlation between thefunctional differentiation phenotypes of gastriccarcinoma cells and the invasion and metastasisby a new way of cell-function classification.METHODS Surgically resected specimens of361 gastric carcinomas (GC) were investigatedwith enzyme-, mucin-, and tumor-related markerimmunohistochemist ry. According to thedirection of cell-function differentiation,stomach carcinomas were divided into fivefunctionally differentiated types.iation type (AFDT): there were 82 (22.7%)patients including 76 (92.7%) aged 45 years.Sixty-nine (84.1%) cases belonged to theintestinal type. Thirty-eight (46.3%) expressedCD44v6 and 9 (13.6%) of 66 male patientsdeveloped liver metastasis. The 5-year survivalrate of patients in this group (58.5%) was higherMucin secreting function differentiation type(MSFDT): 54 (15%) cases. Fifty-three (98.1%)tumors had penetrated the serosa, 12 (22.2%)expressed ER and 22 (40.7%) expressedCD44v6. The postoperative 5-year survival ratefunction differentiation type (AMPFDT): therewere 180 (49.9%) cases, including 31 (17.2%)aged yanger than 45 years. The tumor was morecommon in women (62, 34.4%,) and expressedmore frequently estrogen receptors (ER) ( 129,81.7%) than other types (P＜0.01). Ovarymetastasis was found in 12 (19.4%) out of 62female subjects. The patients with this type GChad the lowest 5-year survival rate (24.7%)differentiation type (SFDT): 13 (3.6%) cases.Nine (69.2%) tumors of this type derived fromAPUD system, the other 4 (30.7%) were ofdifferent histological differentiation. Sixty percent of the patients survived at least five years.(8.9%) cases. Nineteen (59.4%) cases hadlymph node metastases but no one with liver orovary metastasis. The 5-year survival rate was28.1%.CONCLUSION This new cell-functionclassification of GC is helpful in indicating thecharacteristics of invasion and metastasis of GCwith different cell-function differentiationphenotypes. Further study is needed to disclosethe correlation between the cell-functionaldifferentiation phenotypes and the relevantgenotypes and the biological behavior of gastriccarcinoma.

LRRC25 plays a key role in all-trans retinoic acid-induced granulocytic differentiation as a novel potential leukocyte differentiation antigen

Leukocyte differentiation antigens （LDAs） play important roles in the immune system, by serving as surface markers and participating in multiple biological activities, such as recognizing pathogens, mediating membrane signals, interacting with other cells or systems, and regulating cell differentiation and activation. Data mining is a powerful tool used to identify novel LDAs from whole genome. LRRC25 （leucine rich repeat-containing 25） was predicted to have a role in the function of myeloid cells by a large-scale ＂omics＂ data analysis. Further experimental validation showed that LRRC25 is highly expressed in primary myeloid cells, such as granulocytes and monocytes, and lowly/intermediately expressed in B cells, but not in T cells and almost all NK cells. It was down-regulated in multiple acute myeloid leukemia （AML） cell lines and bone marrow cells of AML patients and up-regulated after all-trans retinoic acid （ATRA）-mediated granulocytic differentiation in AML cell lines and acute promyelocytic leukemia （APL; AML-M3, FAB classification） cells. Localization analysis showed that LRRC25 is a type I transmembrane molecule. Although ectopic LRRC25 did not promote spontaneous differentiation of NB4 cells, knockdown of LRRC25 by siRNA or shRNA and knockout of LRRC25 by the CRISPR-Cas9 system attenuated ATRA-induced termi- nal granulocytic differentiation, and restoration of LRRC25 in knockout cells could rescue ATRA-induced granulocytic differentiation. Therefore, LRRC25, a potential leukocyte differentiation antigen, is a key regulator of ATRA-induced granulocytic differentiation.

Cloning and characterization of a cDNA encoding human differentiation antigen 5D4

A 1 846 bp cDNA is isolated from a human tonsil cell λgt 11 cDNA library (ATCC No. 37546) with mAb 5D4 reactive strongly with human B cell line 3D5, but weakly with human B cell line Daudi and human T cell line Jurkat as a probe. RT-PCR also shows a strong reaction in 3D5 cell and a weak reaction in Daudi and Jurkat cell for 5D4 mRNA. There is an open reading frame from 88 to 1 209 bp in 5D4 cDNA encoding a 374 AA protein. Both the Northern blot analysis and the two consecutive stop codens before start coden demonstrate that the cDNA is a full-length cDNA. Secondary structure prediction suggests that there are a region from 295 to 334 AA in the protein with strong hydrophobicity and a transmembrane helix region with high score from 313 to 334 AA with an orientation from the inside to the outside of the cell.

Study on Cellular Differentiation and Genes Rearrangement of Malignant Lymphoproliferative Disorders

Malignant lymphoproliferative disorders are common diseases characterized by the clonal proliferation of cells derived from the lymphocytes of different developmental stages. The analyses of routine morphology and cytochemistry fail to determine the origin and differentiation stages. The cell differentiation origin of most of malignant lymphoproliferative disorders can be defined by using monoclonal antibodies(McAbs) against the differentiation antigens of lymphocytes, but it is unable to determine the cell origin of a minority of undifferentiated malignancies and also fails to distinguish the malig-

High expression of squamous cell carcinoma antigen in poorly differentiated adenocarcinoma of the stomach: A case report

BACKGROUND Squamous cell carcinoma antigen(SCCA)is regarded as a specific indicator of epithelial malignancies and is widely used in the diagnosis of squamous cell carcinoma(SCC).However,the expression of SCCA in gastric adenocarcinoma has not been studied in detail.CASE SUMMARY A 52-year-old man was admitted to our hospital for a 2.5 cm x 2.5 cm ulcer at the antrum-body junction with dull pain and fullness in the upper abdomen for 2 mo.His pre-surgery serological testing results showed 0.51 ng/mL SCCA(reference interval,<1.5 ng/mL)and 9.9 ng/mL carcinoembryonic antigen(reference range,<4.7 ng/mL).He underwent radical distal gastrectomy and Roux-en Y anastomosis and was diagnosed with poorly differentiated mucinous adenocarcinoma(Lauren classification:Diffuse)by pathological examination of the resected lesion.Immunohistochemistry showed that SCCA was highly expressed in the cytoplasm of cancer cells.After surgery,the patient received an S-1 adjuvant chemotherapy regimen for six cycles containing tegafur,gimeracil,and oteracil potassium.He showed no sign of recurrence or metastasis within 24-mo follow-up.CONCLUSION This is a frontal report of SCCA overexpression in poorly differentiated adenocarcinoma of the stomach.

Differential expression and significance of 5-hydroxymethylcytosine modification in hepatitis B virus carriers and patients with liver cirrhosis and liver cancer

BACKGROUND The relationship between hepatitis B surface antigen(HBsAg)-positive carrier status and liver cancer has been extensively studied.However,the epigenetic changes that occur during progression from HBsAg-positive carrier status or cirrhosis to liver cancer are unknown.The epigenetic modification of DNA hydroxymethylation is critical in tumor development.Further,5-hydroxymethylcytosine(5hmC)is an important base for DNA demethylation and epigenetic regulation.It is also involved in the assembly of chromosomes and the regulation of gene expression.However,the mechanism of action of 5hmC in HBsAgpositive carriers or patients with cirrhosis who develop liver cancer has not been fully elucidated.AIM To investigate the possible epigenetic mechanism of HBsAg-positive carriers and hepatocellular carcinoma(HCC)progression from cirrhosis.METHODS Forty HBsAg-positive carriers,forty patients with liver cirrhosis,and forty patients with liver cancer admitted to the First People's Hospital of Yongkang between March 2020 and November 2021 were selected as participants.Free DNA was extracted using a cf-DNA kit.cfDNA was extracted by 5hmC DNA sequencing for principal component analysis,the expression profiles of the three groups of samples were detected,and the differentially expressed genes(DEGs)modified by hydroxymethylation were screened.Bioinformatic analysis was used to enrich DEGs,such as in biological pathways.RESULTS A total of 16455 hydroxymethylated genes were identified.Sequencing results showed that 32 genes had significant 5hmC modification differences between HBsAg carriers and liver cancer patients,of which 30 were upregulated and 2 downregulated in patients with HCC compared with HBsAg-positive carriers.Significant 5hmC modification differences between liver cirrhosis and liver cancer patients were identified in 20 genes,of which 17 were upregulated and 3 were downregulated in patients with HCC compared with those with cirrhosis.These genes may have potential loci that are undiscovered or unelucidated,which contribute to the development and progression of liver cancer.Analysis of gene ontology enrichment and Kyoto Encyclopedia of Genes and Genomes showed that the major signaling pathways involved in the differential genes were biliary secretion and insulin secretion.The analysis of protein interactions showed that the important genes in the protein-protein interaction network were phosphoenolpyruvate carboxykinase and solute carrier family 2.CONCLUSION The occurrence and development of liver cancer involves multiple genes and pathways,which may be potential targets for preventing hepatitis B carriers from developing liver cancer.

钼靶和超声多普勒结合血清肿瘤标志物诊断早期乳腺癌研究

目的:探讨钼靶、超声多普勒和血清肿瘤标志物中血清前列腺特异抗原(PSA)、血清糖类抗原15-3(CA153)、黏蛋白1(MUC1)、人类生长分化因子3(GDF3)单独及联合检测在早期乳腺癌诊断中的价值。方法:选取2018年1月至2021年12月在唐山市人民医院经病理检查确诊的96例乳腺癌患者(乳腺癌组)和同期在本院接受诊治的70例乳腺良性疾病患者(良性病灶组)以及同时选取在本院体检健康的50名体检者(健康对照组),以术后病理检查为“金标准”,比较钼靶、超声多普勒检查以及血清PSA、CA153、MUC1、GDF3单独及6者联合应用对乳腺癌的诊断价值。结果:乳腺癌组96例乳腺癌患者中有78例乳腺超声诊断为恶性,阳性检出率为81.3%;80例钼靶X射线检查诊断为恶性,阳性检出率为83.1%;乳腺癌组的血清PSA、CA153、MUC1及GDF3的水平明显高于良性病灶组和健康对照组,差异均有统计学意义(t_(良性病灶组)=8.783、10.361、11.258、18.965;t_(健康对照组)=9.564、12.658、12.688、20.163,P<0.05);以乳腺癌作为因变量,血清PSA、CA153、MUC1及GDF3为自变量,进行Logistic回归分析,血清PSA、CA153、MUC1及GDF3是乳腺癌的重要危险因素(OR=1.165、1.168、1.472、1.248,P<0.05);受试者工作特征(ROC)曲线分析各指标单独应用时:乳腺超声、钼靶,血清PSA、CA153、MUC1及GDF3的ROC曲线下面积(AUC)(95%CI)、灵敏度和特异度分别为0.723(0.595~0.851)、82.56%和67.32%,0.761(0.636~0.886)、85.79%和65.36%,0.833(0.726~0.941)、81.48%和85.73%,0.837(0.738~0.926)、61.25%和70.17%,0.768(0.648~0.889)、71.49%和80.87%,0.613(0.469~0.758)、52.94%和50.57%;而6项联合应用时AUC(95%CI)、灵敏度和特异度分别为0.958(0.905~0.999)、96.37%和84.83%,其诊断效能更高。结论:钼靶、超声多普勒和血清PSA、CA153、MUC1、GDF3联合检测效能高于单独检测,有助于早期鉴别和诊断乳腺癌。

Neurogenic potential of NG2 in neurotrauma:a systematic review

Regenerative approaches towards neuronal loss following traumatic brain or spinal cord injury have long been considered a dogma in neuroscience and remain a cutting-edge area of research.This is reflected in a large disparity between the number of studies investigating primary and secondary injury as therapeutic to rgets in spinal co rd and traumatic brain injuries.Significant advances in biotechnology may have the potential to reshape the current state-of-the-art and bring focus to primary injury neurotrauma research.Recent studies using neural-glial factor/antigen 2(NG2)cells indicate that they may differentiate into neurons even in the developed brain.As these cells show great potential to play a regenerative role,studies have been conducted to test various manipulations in neurotrauma models aimed at eliciting a neurogenic response from them.In the present study,we systematically reviewed the experimental protocols and findings described in the scientific literature,which were peer-reviewed original research articles(1)describing preclinical experimental studies,(2)investigating NG2 cells,(3)associated with neurogenesis and neurotrauma,and(4)in vitro and/or in vivo,available in PubMed/MEDLINE,Web of Science or SCOPUS,from 1998 to 2022.Here,we have reviewed a total of 1504 papers,and summarized findings that ultimately suggest that NG2 cells possess an inducible neurogenic potential in animal models and in vitro.We also discriminate findings of NG2 neurogenesis promoted by different pharmacological and genetic approaches over functional and biochemical outcomes of traumatic brain injury and spinal co rd injury models,and provide mounting evidence for the potential benefits of manipulated NG2 cell ex vivo transplantation in primary injury treatment.These findings indicate the feasibility of NG2 cell neurogenesis strategies and add new players in the development of therapeutic alternatives for neurotrauma.

儿童急性呼吸道感染者PA、PSP、CD64、sCD14-ST的变化及其诊断价值

目的 探讨儿童急性呼吸道感染者血前白蛋白(PA)、血清胰石蛋白(PSP)、免疫球蛋白G Fc段受体I(CD64)、可溶性白细胞分化抗原14亚型(sCD14-ST)的变化及其临床诊断价值。方法 回顾性选取2019年9月至2023年3月眉山市四所医院收治的498例儿童急性呼吸道感染患儿作为研究组,根据咽拭子细菌培养结果将其分为细菌感染组232例和非细菌感染组266例;另选取同期体检的健康儿童506例作为对照组。检测所有儿童的血清PA、PSP、外周血sCD14-ST水平、CD64指数。比较三组儿童的临床资料,同时比较研究组和对照组以及细菌感染组和非细菌感染组患儿的血清PA、PSP、外周血sCD14-ST水平、CD64指数;采用受试者工作特征曲线(ROC)分析血清PA、PSP、外周血sCD14-ST水平、CD64指数单独及联合检测对儿童急性呼吸道感染的诊断价值。结果 研究组患儿的血清PA水平明显低于对照组,而血清PSP、外周血sCD14-ST水平、CD64指数则明显高于对照组,差异均有统计学意义(P<0.05);细菌感染组患儿的血清PA水平明显低于非细菌感染组,而血清PSP、外周血sCD14-ST水平、CD64指数则明显高于非细菌感染组,差异均有统计学意义(P<0.05);绘制ROC获得血清PA、PSP、外周血sCD14-ST水平、CD64指数单独及联合检测诊断儿童急性呼吸道感染患儿的AUC分别为0.885、0.780、0.818、0.848、0.934。其中,联合诊断的AUC高于各项单独检测(P<0.05),且联合检测的敏感度和特异度为89.20%,81.40%,诊断价值均较高。结论 儿童急性呼吸道感染者血清PA水平呈低表达,血清PSP、外周血sCD14-ST水平、CD64指数呈高表达;且细菌感染较非细菌感染的儿童急性呼吸道感染患儿血清PA水平降低,而血清PSP、外周血sCD14-ST水平和CD64指数则升高;联合检测血清PA、PSP、外周血sCD14-ST水平、CD64指数有助于诊断儿童急性呼吸道感染。

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。

补肾通脉方对急性ST段抬高型心肌梗死PCI术后凝血-纤溶系统及血脂的影响

目的:观察补肾通脉方对急性ST段抬高型心肌梗死经皮冠状动脉介入术(PCI)术后凝血-纤溶系统及血脂的影响。方法:选取2017年3月—2020年3月南京中医药大学附属徐州中医院收治的92例急性ST段抬高型心肌梗死患者,按照随机分组的方法,将其分为对照组和治疗组,各46例。入组患者均给予标准化内科治疗,治疗组在标准治疗的基础上加用补肾通脉方。观察两组治疗前后纤维蛋白原(FIB)、抗凝血酶Ⅲ(AT-Ⅲ)、组织型纤溶酶原激活物(t-PA)、纤溶酶原活化物抑制剂1(PAI-1)、可溶性白细胞分化抗原40配体(sCD40L)、可溶性细胞间黏附因子-1(sICAM-1)及血脂的变化。结果:治疗前,两组FIB、AT-Ⅲ、t-PA、PAI-1水平比较,差异无统计学意义(P>0.05);治疗后,两组FIB、PAI-1水平下降,AT-Ⅲ、t-PA水平升高,治疗组FIB、PAI-1水平低于对照组,AT-Ⅲ、t-PA水平高于对照组,差异有统计学意义(P<0.05)。治疗前,两组sCD40L、sICAM-1水平比较,差异无统计学意义(P>0.05);治疗后,两组sCD40L、sICAM-1水平均显著下降,治疗组sCD40L、sICAM-1水平低于对照组,差异有统计学意义(P<0.05)。治疗前,两组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平比较,差异无统计学意义(P>0.05);治疗后,两组TC、TG、LDL-C水平均显著下降,HDL-C升高,治疗组TC、TG、LDL-C水平低于对照组,HDL-C水平高于对照组,差异有统计学意义(P<0.05)。结论:在标准化内科治疗基础上加用补肾通脉方能够改善急性ST段抬高型心肌梗死患者PCI术后高凝状态,调节患者体内凝血-纤溶系统平衡,控制炎症反应,降低血脂水平。

sCD14-ST联合IL-6对细菌性呼吸道感染患儿的诊断价值

目的探讨可溶性白细胞分化抗原14亚型(sCD14-ST)联合白细胞介素-6(IL-6)对细菌性呼吸道感染患儿的诊断价值。方法选取2021年4月至2022年4月该院收治的55例细菌性呼吸道感染患儿作为观察组,另选取同期在该院健康体检的55例儿童作为对照组。检测并比较两组sCD14-ST、IL-6水平,采用Pearson相关分析细菌性呼吸道感染患儿sCD14-ST水平与IL-6水平的相关性,采用多因素Logistic回归分析儿童发生细菌性呼吸道感染的危险因素,绘制受试者工作特征曲线分析血清sCD14-ST、IL-6对儿童发生细菌性呼吸道感染的诊断价值。结果观察组血清sCD14-ST、IL-6水平均高于对照组,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,细菌性呼吸道感染患儿血清sCD14-ST水平与IL-6水平呈正相关(r=0.422,P=0.001)。多因素Logistic回归分析结果显示,sCD14-ST>443.82 pg/mL、IL-6>13.75 pg/mL是儿童发生细菌性呼吸道感染的独立危险因素(P<0.05)。2项指标联合诊断儿童发生细菌性呼吸道感染的曲线下面积为0.887(95%CI:0.741~0.975),灵敏度为90.91%,特异度为80.00%。结论sCD14-ST>443.82 pg/mL、IL-6>13.75 pg/mL是儿童发生细菌性呼吸道感染的独立危险因素,2项指标联合检测能提高对儿童发生细菌性呼吸道感染的诊断价值。

DCE-MRI参数联合血清PSA水平对前列腺癌分化程度的鉴别价值

目的分析动态增强磁共振成像(DCE-MRI)参数联合血清前列腺特异性抗原(PSA)水平对前列腺癌分化程度的鉴别价值。方法回顾性分析2020年3月至2023年1月安阳市人民医院收治的148例前列腺癌患者的临床资料,患者均在治疗前行DCE-MRI检查及血清PSA水平检测。根据Gleason评分将前列腺癌患者分为低分化组(评分≥8分)和中高分化组(评分<8分),比较两组患者DCE-MRI参数[速率常数(K_(ep))、转运常数(K^(trans))、血管外细胞外容积分数(V_(e))]和血清PSA水平,并采用受试者工作特征(ROC)曲线分析DCE-MRI参数联合血清PSA水平对前列腺癌分化程度的鉴别价值。结果低分化组K_(ep)、K^(trans)及V_(e)和血清PSA水平均高于中高分化组(P<0.05);DCE-MRI参数联合鉴别的灵敏度、特异度、曲线下面积(AUC)分别为85.00%、67.05%、0.793;DCE-MRI参数和血清PSA水平联合鉴别的灵敏度、特异度、AUC分别为80.00%、88.64%、0.872。结论低分化前列腺癌相较于中高分化前列腺癌K_(ep)、K^(trans)、V_(e)和血清PSA水平更高,且上述指标联合鉴别效能良好,可在临床推广使用。

抗黑色素瘤分化抗原5抗体阳性皮肌炎合并间质性肺疾病亚型:临床特征与预后分析

目的:探讨抗黑色素瘤分化抗原5(MDA5)抗体阳性皮肌炎(DM)并发间质性肺疾病(ILD)患者的临床特征及预后差异。方法:回顾性分析2012年1月—2021年7月收治的272例MDA5阳性DM-ILD患者。分为3组:组1为治疗前确诊为快速进展性ILD(RPILD),组2患者治疗后发生RPILD,组3为病情较轻的ILD。评估3组患者临床特征、治疗策略及糖皮质激素剂量等预后因素。结果:共纳入219例患者。组1患者病程短,发热、抗核抗体和抗Ro-52阳性率高,ESR、CRP水平高,CD3、CD4 T细胞计数低,与另2组患者差异有统计学意义(P<0.05)。组1患者治疗后4~8周死亡率高,组2患者12周后死亡率升高,组3死亡率最低,3组间死亡时间分布的差异有统计学意义(P<0.05)。Cox分析显示,发病年龄、乳酸脱氢酶水平、未用免疫抑制剂和初始激素用量是组1患者预后的独立危险因素,静脉注射免疫球蛋白是组2的保护因素(P<0.05)。组2多数患者肺部恶化时发现病原体。结论:MDA5阳性DM-ILD患者临床表现和预后存在显著异质性,RPILD患者并不能从大剂量激素治疗中获益。

MUM-1、CD138、CD38对慢性子宫内膜炎的诊断价值及其与生殖预后的关系

目的分析多发性骨髓瘤癌基因-1(MUM-1)、白细胞分化抗原(CD)138、CD38在对慢性子宫内膜炎(CE)中的诊断价值及其与生殖预后的关系。方法选取2018年1月至2021年12月因不孕症于山东省济南市第二妇幼保健院生殖健康科就诊,并在山东大学齐鲁医院生殖医学中心接受体外受精-胚胎移植(IVF-ET)的194例患者作为研究对象。所有研究对象术前均接受宫腔镜检查,记录宫腔情况,取子宫内膜组织进行MUM-1、CD138、CD38标志物免疫组织化学染色及子宫内膜活检,并将子宫内膜苏木精-伊红染色法(HE)染色结果作为金标准,免疫组织化学染色结果与HE染色结果的一致性分析使用Kappa检验,分析免疫组织化学染色MUM-1、CD138、CD38单独及3项指标联合检测对CE的诊断效能。根据生殖预后将194例患者分为失败组和成功组,比较失败组和成功组的临床资料,采用多因素Logistic回归分析IVF-ET失败的危险因素。结果HE染色结果显示,194例接受IVF-ET的患者中90例确诊为CE;MUM-1、CD138、CD38单独及3项指标联合检测的免疫组织化学结果与HE染色结果的一致性分析显示,Kappa值分别为0.475、0.537、0.464、0.752(P<0.05);3项指标联合诊断CE的灵敏度、准确度、阳性预测值均高于MUM-1、CD138、CD38单独诊断,差异均有统计学意义(P<0.05);CD38单独诊断CE的灵敏度高于MUM-1、CD138单独诊断,特异度低于MUM-1、CD138单独诊断,差异均有统计学意义(P<0.05)。194例接受IVF-ET的患者中妊娠失败106例,妊娠成功88例。失败组与成功组年龄、体质量指数、不孕年限、月经经期、月经周期,以及基础内膜厚度、基础促卵泡刺激素、基础雌二醇、基础促黄体生成激素水平比较,差异均无统计学意义(P>0.05);失败组继发性不孕、人工流产次数≥1次、CE、MUM-1阳性、CD138阳性、CD38阳性患者比例均高于成功组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,继发性不孕、人工流产次数≥1次、患有CE、MUM-1阳性、CD138阳性、CD38阳性是IVF-ET失败的危险因素(P<0.05)。结论MUM-1、CD138、CD38联合检测可提升对CE的诊断效能,且患有CE、MUM-1阳性、CD138阳性、CD38阳性是IVF-ET失败的危险因素。

经阴道超声联合CEA、CA125、CA153鉴别诊断子宫腔占位性病变良恶性

目的:探讨经阴道超声联合CEA、CA125、CA153鉴别子宫腔占位性病变良恶性的价值.方法:收集2021年2月-2023年5月本院疑似子宫腔占位性病变患者117例临床资料,根据刮宫或术后病理检查结果分为恶性组及良性组,其中恶性组56例,为子宫内膜癌;良性组61例,为子宫内膜良性息肉.比较两组经阴道超声及血清指标差异,受试者工作特征曲线(ROC)分析各指标鉴别诊断子宫腔占位性病变良恶性效能.结果:超声检查收缩期峰值血流速度两组无差异(P>0.05),恶性组阻力指数小于良性组、内膜厚度大于良性组;恶性组血清癌胚抗原(CEA)、糖类抗原125、CA153水平均高于良性组(均P<0.05).ROC曲线结果显示,经阴道超声、血清CEA、CA125、CA153各指标单独或联合应用鉴别诊断子宫腔占位性病良恶性的AUC分别为0.822、0.713、0.728、0.797及0.915,均有价值,但联合诊断价值最高.结论:经阴道超声、血清CEA、CA125、CA153联合应用对宫腔占位性病变良恶性鉴别诊断效能较高,有较好的临床应用价值.