目的:探讨急性冠脉综合征(acute coronary syndrome,ACS)患者血清补体C1肿瘤坏死因子相关蛋白家族12(complement C1 tumor necrosis factor-associated protein family 12,CTRP12)水平与影响ACS及冠脉病变严重程度因素的关系。方法:选择...目的:探讨急性冠脉综合征(acute coronary syndrome,ACS)患者血清补体C1肿瘤坏死因子相关蛋白家族12(complement C1 tumor necrosis factor-associated protein family 12,CTRP12)水平与影响ACS及冠脉病变严重程度因素的关系。方法:选择2021年11月—2022年8月于江苏省丹阳市人民医院心血管内科行冠状动脉造影的患者共116例,其中ACS 81例,非ACS 35例。收集血液标本检测血清CTRP12及其他血液生化指标。心脏超声测量心外膜脂肪厚度(epicardial fat thickness,EFT)。比较两组血清CTRP12水平和EFT,分析CTRP12与其他因素的相关性。采用SYNTAX(Synergy between PCI with TAXUSTM and Cardiac Surgery)评分评估冠脉病变严重程度,将其分为SYNTAX评分≤22分和SYNTAX评分>22分,Logistic回归分析影响ACS及冠脉病变严重程度的因素。结果:ACS组患者男性比例、吸烟比例、EFT、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、WBC计数、中性粒细胞计数、单核细胞计数均高于非ACS组(均P<0.05),血清CTRP12水平低于非ACS组(P<0.05),EFT较非ACS组增加(P<0.05)。ACS组患者中SYNTAX评分≤22分者血清CTRP12水平高于SYNTAX评分>22分者(P<0.05),EFT小于SYNTAX评分>22分者(P<0.05)。相关性分析提示CTRP12与EFT呈负相关(r=-0.557,P<0.05)。Logistic回归提示CTRP12和EFT是ACS的独立影响因素(β=-2.107、1.607,均P<0.05)。CTRP12和EFT是ACS患者冠脉病变严重程度的影响因素(β=-1.085、1.740,均P<0.05),在校正年龄、性别、BMI、吸烟、糖尿病、高血压、LDL-C后,CTRP12和EFT仍是ACS患者冠脉病变严重程度的影响因素(β=-1.033、2.109,均P<0.05)。结论:ACS患者血清CTRP12水平显著降低,且与EFT呈负相关。EFT是ACS及冠脉病变严重程度的独立危险因素,而CTRP12为ACS的保护因素。展开更多
BACKGROUND Simple hepatic cysts are relatively common in adults, and mostly appear asasymptomatic incidental radiologic findings. Occasionally, a large cyst will causesymptoms. Elevations in the serum biomarkers prote...BACKGROUND Simple hepatic cysts are relatively common in adults, and mostly appear asasymptomatic incidental radiologic findings. Occasionally, a large cyst will causesymptoms. Elevations in the serum biomarkers protein induced by vitamin Kabsence (PIVKA)-II, cancer antigen (CA) 12-5, and CA19-9 are often associatedwith malignant tumors in the liver or bile ducts. This is the first report to describea case of hepatic cyst with elevated levels of PIVKA-II and CA12-5.CASE SUMMARY An 84-year-old Chinese woman was admitted with gradual abdominal distension.Her symptoms started 1 year ago, and she had poor appetite and a weight loss of5 kg within the past 2 wk. She denied any symptoms associated with abdominalpain, fever and chills, nausea and vomiting, etc. The abdomen was enlarged, morein the right upper quadrant, without tenderness. Laboratory examination showedsignificantly increased serum levels of PIVKA-II, CA12-5, and CA19-9. Acomputed tomography scan revealed multiple round cysts in the liver with clearboundaries. The largest cyst was 20.1 cm × 12.2 cm × 19.6 cm in size, located in theright lobe of the liver with mild dilatation of the intrahepatic bile duct, but therewas no contrast enhancement. Percutaneous drainage on the largest hepatic cystand polycinnamol sclerosing agent injection into the cyst cavity were performed.After treatment, the patient’s symptoms relieved and the elevated serum tumormakers reduced to the normal levels dramatically.CONCLUSION The present report identifies an unusual case of a giant hepatic cyst with markedelevation of serum tumor marker levels of PIVKA-II, CA12-5, and CA19-9. Aftertreatment, these three serum markers dramatically decreased to normal levels.The mechanisms for the elevation of these tumor markers may be as follows: (1) Agiant hepatic cyst compresses the liver, causing injury to the hepatocytes, whichmay lead to secretion of a large amount of PIVKA-II;and (2) Some tumorassociatedantigens, such as carcinoembryonic antigen, CA19-9, CA12-5, andCA15-3, are expressed on inflammatory cells.展开更多
文摘目的:探讨急性冠脉综合征(acute coronary syndrome,ACS)患者血清补体C1肿瘤坏死因子相关蛋白家族12(complement C1 tumor necrosis factor-associated protein family 12,CTRP12)水平与影响ACS及冠脉病变严重程度因素的关系。方法:选择2021年11月—2022年8月于江苏省丹阳市人民医院心血管内科行冠状动脉造影的患者共116例,其中ACS 81例,非ACS 35例。收集血液标本检测血清CTRP12及其他血液生化指标。心脏超声测量心外膜脂肪厚度(epicardial fat thickness,EFT)。比较两组血清CTRP12水平和EFT,分析CTRP12与其他因素的相关性。采用SYNTAX(Synergy between PCI with TAXUSTM and Cardiac Surgery)评分评估冠脉病变严重程度,将其分为SYNTAX评分≤22分和SYNTAX评分>22分,Logistic回归分析影响ACS及冠脉病变严重程度的因素。结果:ACS组患者男性比例、吸烟比例、EFT、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、WBC计数、中性粒细胞计数、单核细胞计数均高于非ACS组(均P<0.05),血清CTRP12水平低于非ACS组(P<0.05),EFT较非ACS组增加(P<0.05)。ACS组患者中SYNTAX评分≤22分者血清CTRP12水平高于SYNTAX评分>22分者(P<0.05),EFT小于SYNTAX评分>22分者(P<0.05)。相关性分析提示CTRP12与EFT呈负相关(r=-0.557,P<0.05)。Logistic回归提示CTRP12和EFT是ACS的独立影响因素(β=-2.107、1.607,均P<0.05)。CTRP12和EFT是ACS患者冠脉病变严重程度的影响因素(β=-1.085、1.740,均P<0.05),在校正年龄、性别、BMI、吸烟、糖尿病、高血压、LDL-C后,CTRP12和EFT仍是ACS患者冠脉病变严重程度的影响因素(β=-1.033、2.109,均P<0.05)。结论:ACS患者血清CTRP12水平显著降低,且与EFT呈负相关。EFT是ACS及冠脉病变严重程度的独立危险因素,而CTRP12为ACS的保护因素。
文摘BACKGROUND Simple hepatic cysts are relatively common in adults, and mostly appear asasymptomatic incidental radiologic findings. Occasionally, a large cyst will causesymptoms. Elevations in the serum biomarkers protein induced by vitamin Kabsence (PIVKA)-II, cancer antigen (CA) 12-5, and CA19-9 are often associatedwith malignant tumors in the liver or bile ducts. This is the first report to describea case of hepatic cyst with elevated levels of PIVKA-II and CA12-5.CASE SUMMARY An 84-year-old Chinese woman was admitted with gradual abdominal distension.Her symptoms started 1 year ago, and she had poor appetite and a weight loss of5 kg within the past 2 wk. She denied any symptoms associated with abdominalpain, fever and chills, nausea and vomiting, etc. The abdomen was enlarged, morein the right upper quadrant, without tenderness. Laboratory examination showedsignificantly increased serum levels of PIVKA-II, CA12-5, and CA19-9. Acomputed tomography scan revealed multiple round cysts in the liver with clearboundaries. The largest cyst was 20.1 cm × 12.2 cm × 19.6 cm in size, located in theright lobe of the liver with mild dilatation of the intrahepatic bile duct, but therewas no contrast enhancement. Percutaneous drainage on the largest hepatic cystand polycinnamol sclerosing agent injection into the cyst cavity were performed.After treatment, the patient’s symptoms relieved and the elevated serum tumormakers reduced to the normal levels dramatically.CONCLUSION The present report identifies an unusual case of a giant hepatic cyst with markedelevation of serum tumor marker levels of PIVKA-II, CA12-5, and CA19-9. Aftertreatment, these three serum markers dramatically decreased to normal levels.The mechanisms for the elevation of these tumor markers may be as follows: (1) Agiant hepatic cyst compresses the liver, causing injury to the hepatocytes, whichmay lead to secretion of a large amount of PIVKA-II;and (2) Some tumorassociatedantigens, such as carcinoembryonic antigen, CA19-9, CA12-5, andCA15-3, are expressed on inflammatory cells.
