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
目的:血清游离轻链(free light chain,FLC)在多种疾病中表达异常,但其在肺癌中的表达尚不清楚,本研究旨在探讨血清FLC在肺癌中的表达及诊断价值。方法:选取2021年1至12月湖南师范大学附属湘东医院收治的80例肺癌患者作为肺癌组,另选取...目的:血清游离轻链(free light chain,FLC)在多种疾病中表达异常,但其在肺癌中的表达尚不清楚,本研究旨在探讨血清FLC在肺癌中的表达及诊断价值。方法:选取2021年1至12月湖南师范大学附属湘东医院收治的80例肺癌患者作为肺癌组,另选取同时期的80例健康体检人员作为对照组。收集所有参与者的一般资料、血清κFLC和λFLC水平;收集肺癌组患者住院期间的相关临床指标[血清癌胚抗原(carcinoembryonic antigen,CEA)、细胞角蛋白-19片段抗原(cytokeratin fragment antigen 21-1,CYFRA21-1)水平,以及肿瘤直径、组织学分型、TNM分期、是否有淋巴结转移]。比较肺癌组和对照组血清FLC[κFLC、λFLC、FLC(κ+λ)]的表达水平。将80例肺癌患者按性别、年龄、吸烟史、肿瘤直径、TNM分期、组织学分型、淋巴结转移进行分组,比较组间血清κFLC、λFLC表达水平的差异。采用受试者操作特征(receiver operating characteristic,ROC)曲线评价血清FLC水平单独及联合其他指标在肺癌中的诊断价值。结果:肺癌组血清FLC(κ+λ)、κFLC表达水平均显著高于对照组,差异均有统计学意义(均P<0.001);而2组间血清λFLC表达水平的差异无统计学意义(P>0.05)。不同肿瘤直径、组织学分型、TNM分期的肺癌血清κFLC表达水平差异均无统计学意义(均P>0.05);但是,有淋巴结转移的肺癌患者血清κFLC水平高于无淋巴结转移的肺癌患者,且差异有统计学意义(P=0.033)。不同肿瘤直径、组织学分型肺癌患者的血清λFLC表达水平差异均无统计学意义(均P>0.05);但是,TNM分期III期+IV期、有淋巴结转移的肺癌患者血清λFLC表达水平分别高于TNM分期I期+II期、无淋巴结转移的肺癌患者,差异均有统计学意义(分别P=0.033,P=0.019)。κFLC、CEA诊断肺癌的曲线下面积(area under the curve,AUC)差异无统计学意义(P=0.333)。在2项联合诊断肺癌的指标中,κFLC+CYFRA21-1的诊断效能(AUC=0.875)及敏感性(71.3%)最高。κFLC+λFLC+CEA+CYFRA21-1联合诊断肺癌的AUC为0.915(95%CI 0.860~0.953,P<0.001)。结论:血清FLC在肺癌中高表达,并且与肺癌的浸润和转移有关。血清FLC尤其是κFLC对肺癌的诊断具有价值,FLC、CEA、CYFRA21-1联合检测的诊断效能最佳。展开更多
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.
文摘目的:血清游离轻链(free light chain,FLC)在多种疾病中表达异常,但其在肺癌中的表达尚不清楚,本研究旨在探讨血清FLC在肺癌中的表达及诊断价值。方法:选取2021年1至12月湖南师范大学附属湘东医院收治的80例肺癌患者作为肺癌组,另选取同时期的80例健康体检人员作为对照组。收集所有参与者的一般资料、血清κFLC和λFLC水平;收集肺癌组患者住院期间的相关临床指标[血清癌胚抗原(carcinoembryonic antigen,CEA)、细胞角蛋白-19片段抗原(cytokeratin fragment antigen 21-1,CYFRA21-1)水平,以及肿瘤直径、组织学分型、TNM分期、是否有淋巴结转移]。比较肺癌组和对照组血清FLC[κFLC、λFLC、FLC(κ+λ)]的表达水平。将80例肺癌患者按性别、年龄、吸烟史、肿瘤直径、TNM分期、组织学分型、淋巴结转移进行分组,比较组间血清κFLC、λFLC表达水平的差异。采用受试者操作特征(receiver operating characteristic,ROC)曲线评价血清FLC水平单独及联合其他指标在肺癌中的诊断价值。结果:肺癌组血清FLC(κ+λ)、κFLC表达水平均显著高于对照组,差异均有统计学意义(均P<0.001);而2组间血清λFLC表达水平的差异无统计学意义(P>0.05)。不同肿瘤直径、组织学分型、TNM分期的肺癌血清κFLC表达水平差异均无统计学意义(均P>0.05);但是,有淋巴结转移的肺癌患者血清κFLC水平高于无淋巴结转移的肺癌患者,且差异有统计学意义(P=0.033)。不同肿瘤直径、组织学分型肺癌患者的血清λFLC表达水平差异均无统计学意义(均P>0.05);但是,TNM分期III期+IV期、有淋巴结转移的肺癌患者血清λFLC表达水平分别高于TNM分期I期+II期、无淋巴结转移的肺癌患者,差异均有统计学意义(分别P=0.033,P=0.019)。κFLC、CEA诊断肺癌的曲线下面积(area under the curve,AUC)差异无统计学意义(P=0.333)。在2项联合诊断肺癌的指标中,κFLC+CYFRA21-1的诊断效能(AUC=0.875)及敏感性(71.3%)最高。κFLC+λFLC+CEA+CYFRA21-1联合诊断肺癌的AUC为0.915(95%CI 0.860~0.953,P<0.001)。结论:血清FLC在肺癌中高表达,并且与肺癌的浸润和转移有关。血清FLC尤其是κFLC对肺癌的诊断具有价值,FLC、CEA、CYFRA21-1联合检测的诊断效能最佳。
