BACKGROUND: The differential diagnosis of solid lesions located at the pancreatic head is very important for choosing therapies and setting up surgical tactics. This study was designed to evaluate the clinical signifi...BACKGROUND: The differential diagnosis of solid lesions located at the pancreatic head is very important for choosing therapies and setting up surgical tactics. This study was designed to evaluate the clinical significance of combined measurement of multiple serum tumor markers and the application of the receiver-operating characteristic (ROC) curves in the differential diagnosis of solid lesions located at the pancreatic head. METHODS: The serum levels of CA19-9, CA242, CA50 and carcinoembryonic antigen (CEA) in 112 patients with carcinoma of the pancreatic head and 38 patients with focal chronic pancreatitis in the pancreatic head were measured with ELISA. The sensitivity, specificity, positive likelihood ratio (PLR) and negative likelihood ratio (NLR) of the four serum tumor markers were calculated. The ROC curves for the four serum tumor markers were constructed and the area under the curve (AUC) was calculated. RESULTS: The AUCs of CA19-9, CA242, CA50 and CEA were 0.805, 0.749, 0.738 and 0.705; the PLRs were 1.91, 3.43, 5.09 and 5.46; and the NLRs were 0.41, 0.56, 0.59 and 0.71, respectively. Combined measurements increased the diagnostic specificity, and parallel combined testing increased the diagnostic sensitivity. CONCLUSIONS: Combined measurement of serum tumor markers CA19-9, CA242, CA50 and CEA is valuable in differential diagnosis of solid lesions located at the pancreatic head, and CA19-9 has the best diagnostic ability. Combined measurements can increase the specificity of diagnosis. Evaluation with the ROC curve is better than the sensitivity or specificity alone and the results are more integrated and objective.展开更多
AIM:To evaluate the multiple biomarkers of colorectal tumor and their potential usage in early diagnosis of colorectal METHODS:Multiple biomarkers (DNA contents, AgNOR,PCNA, p53, c-erbB-2) in 10 normal colorectal muco...AIM:To evaluate the multiple biomarkers of colorectal tumor and their potential usage in early diagnosis of colorectal METHODS:Multiple biomarkers (DNA contents, AgNOR,PCNA, p53, c-erbB-2) in 10 normal colorectal mucosae, 37 colorectal adenomas and 55 colorectal cancers were analyzed quantitatively in the computed processing imaging system.Discrimination patterns were employed to evaluate the significance of single and multiple indices in diagnosis of colorectal cancers.RESULTS:The mean values of the analyzed parameters increased in order of the normal mucosa, adenoma and adenocarcinoma, and this tendency reflected the progression of colorectal malignancy. The parameters including DNA index,positive rates, densities of AgNOR, c-erbB-2, and p53,shape and density of nucleus were relatively valuable for diagnoses. Then a diagnostic discrimination model was established.The samples were confirmed with the model,the sensitivity rates in cancer group and adenoma group were 96.36% and 89.19%, respectively.The value of proliferating cell nuclear antigen (PCNA) in early diagnosis of colorectal cancers was uncertain.CONCLUSION:The quantitative evaluation of some parameters for colorectal tumor can provide reproducible data for differential diagnosis.The established diagnostic discrimination model may be of clinicopathological value,and can make the early diagnosis of colorectal cancer possible.展开更多
Objective:To study the diagnostic value of multiple tumor markers in malignant ovarian neoplasm.Methods:Sera obtained from 430 patients with ovarian masses (110 cases were malignant ovarian tumors,320 cases were benig...Objective:To study the diagnostic value of multiple tumor markers in malignant ovarian neoplasm.Methods:Sera obtained from 430 patients with ovarian masses (110 cases were malignant ovarian tumors,320 cases were benign ovarian tumors) before operation,and from 50 healthy women as control.Serologic examination of tumor markers included CA125,TSGF,SA,CEA,AFP,HCG and Fer.Results:The serum levels of CA125,TSGF,SA and Fer in patients with ovarian cancer were higher than those in patients with benign ovarian tumors (P<0.05),also in control group (P<0.05).In the diagnostic value of application for malignant ovarian neoplasm,CA125,TSGF and SA were better than the others.The sensitivity,specificity and accuracy in diagnosis of ovarian cancer were 86.4%,82.8%and 83.7% respectively for CA125 alone,78.2%,81.3%and 80.5% for TSGF alone,74.5%,81.9%and 80.0% for SA alone,whereas 95.5%,45.6%and 58.4% for multiple tumor markers combined in which 1 or more indices showed positive,93.6%,80.6%and 84.0% for that in which 2 or more indices showed positive,and 87.3%,90.3%and 89.5% for that in which 3 or more indices show positive.Conclusion:multiple tumor markers examination could improve the diagnosis of ovarian cancer,and examination of CA125,TSGF and SA combined is most ideal.展开更多
BACKGROUND Early detection of advanced cystic mucinous neoplasms[(A-cMNs),defined as high-grade dysplasia or malignancy]of the pancreas is of great significance.As a simple and feasible detection method,serum tumor ma...BACKGROUND Early detection of advanced cystic mucinous neoplasms[(A-cMNs),defined as high-grade dysplasia or malignancy]of the pancreas is of great significance.As a simple and feasible detection method,serum tumor markers(STMs)may be used to predict advanced intraductal papillary mucinous neoplasms(IPMNs)and mucinous cystic neoplasms(MCNs).However,there are few studies on the usefulness of STMs other than carbohydrate antigen(CA)19-9 for early detection of A-cMNs.AIM To study the ability of five STMs-CA19-9,carcinoembryonic antigen(CEA),CA125,CA724,and CA242 to predict A-cMNs and distinguish IPMNs and MCNs.METHODS We mainly measured the levels of each STM in patients pathologically diagnosed with cMNs.The mean levels of STMs and the number of A-cMN subjects with a higher STM level than the cutoff were compared respectively to identify the ability of STMs to predict A-cMNs and distinguish MCNs from IPMNs.A receiver operating characteristic curve with the area under curve(AUC)was also created to identify the performance of the five STMs.RESULTS A total of 187 patients with cMNs were identified and 72 of them showed AcMNs.We found that CA19-9 exhibited the highest sensitivity(SE)(54.2%)and accuracy(76.5%)and a moderate ability(AUC=0.766)to predict A-cMNs.In predicting high-grade dysplasia IPMNs,the SE of CA19-9 decreased to 38.5%.The ability of CEA,CA125,and CA724 to predict A-cMNs was low(AUC=0.651,0.583,and 0.618,respectively).The predictive ability of CA242 was not identified.The combination of STMs improved the SE to 62.5%.CA125 may be specific to the diagnosis of advanced MCNs.CONCLUSION CA19-9 has a moderate ability,and CEA,CA125,and CA724 have a low ability to predict A-cMNs.The combination of STM testing could improve SE in predicting A-cMNs.展开更多
Background:With the increasing prevalence of lung cancer,it has become imperative to identify reliable biomarkers that can aid in early detection and prognosis assessment.Therefore,we sought to investigate the potenti...Background:With the increasing prevalence of lung cancer,it has become imperative to identify reliable biomarkers that can aid in early detection and prognosis assessment.Therefore,we sought to investigate the potential utility of six serum tumor markers as diagnostic and prognostic tools for lung cancer patients.By analyzing a large cohort of patients with different stages and subtypes of lung cancer,we hoped to shed light on the predictive value and accuracy of each marker individually,as well as their combined performance.This study should not only provide valuable insights into the biology and pathogenesis of lung cancer but also pave the way for personalized treatment strategies based on individual patient profiles.Methods:The serum levels of the tumor markers progastrin-releasing peptide(ProGRP),carcinoembryonic antigen(CEA),neuron-specific enolase(NSE),cytokeratin 19 fragment(CYFRA21-1),carbohydrate antigen 19-9(CA19-9)and squamous cell carcinoma antigen(SCCA)were meticulously assessed in a cohort comprising 324 individuals diagnosed with lung cancer and an additional 51 patients with benign lung disease.The measurements were conducted using cutting-edge techniques such as ELISA,electrochemical luminescence,and chemiluminescence methods.Differences between groups and the impact of these markers on lung cancer diagnosis were analyzed.Results:The serum levels of ProGRP,NSE,and CEA were significantly higher in lung cancer patients than in patients with benign lung disease(p<0.01).NSE had the highest sensitivity for squamous cell carcinomas(SC),while CEA had the highest sensitivity for adenocarcinomas(AC).ProGRP and NSE had higher sensitivities than other markers for small cell carcinomas(SCC).Combining the six tumor markers resulted in higher sensitivities for SC(70.6%),AC(77.4%),and SCC(80%)compared with any single test.Receiver operator characteristic analysis showed that ProGRP and NSE had a greater area under the curve(AUC)in SCC(0.886 and 0.775)than SC and AC,while CEA had a higher AUC in AC(0.716),and NSE had a higher AUC than other markers in SC(0.719).Conclusions:ProGRP and NSE are effective serum tumor markers for SCC,whereas CEA and NSE may aid in the diagnosis of AC and SC.Combining the detection of ProGRP,NSE,CYFRA21-1,CEA,and SCCA significantly improves sensitivity when diagnosing lung cancer.展开更多
Objective To explore the clinical significance of serum level of pro gastrin releasing peptide 31 98 (ProGRP31 98) for small cell lung cancer (SCLC), in comparison with neuron specific enolase (NSE). Methods S...Objective To explore the clinical significance of serum level of pro gastrin releasing peptide 31 98 (ProGRP31 98) for small cell lung cancer (SCLC), in comparison with neuron specific enolase (NSE). Methods Serum level of ProGRP31 98 and NSE was measured by ELISA respectively in 30 patients with SCLC, 30 with non small cell lung cancer (NSCLC), 15 with benign lung diseases and 15 normal subjects, additionally, 10 SCLC patients after having treatment with chemotherapy were included. The receiver operating characteristic (ROC) curve was used to set the cut off value and evaluate the diagnostic accuracy. Results The serum level of ProGRP31 98 was higher in patients with SCLC than that in other groups. The SCLC patients with extensive disease had a higher value than the patients with limited disease. In SCLC patients with distant metastases, it was also higher than in those without. Increase in serum ProGRP31 98 and NSE was both seen in SCLC patients, but for the former one, the increase was of much greater compared to the normal controls. Given the cut off value for ProGRP31 98 was 40ng·L -1 and for NSE 8μg·L -1 , their sensitivity of diagnosis in SCLC was 73% and 60%, respectively. The area under ROC curve of ProGRP31 98 was significantly larger than that of NSE. All patients responded to chemotherapy showed marked decrease in ProGRP31 98. Conclusion ProGRP31 98 is a more specific and sensitive marker than NSE in the diagnosis of SCLC.展开更多
Background Early detection and diagnosis is urgent for the sake of effective treatment strategy for lung cancer. However, a convenient, economical and relatively precise method is not available. We here report a prosp...Background Early detection and diagnosis is urgent for the sake of effective treatment strategy for lung cancer. However, a convenient, economical and relatively precise method is not available. We here report a prospective study to find the possible value of the combined use of four popular tumor markers in the early diagnosis of lung cancer among patients with suspicious nodules in the lung. Methods Six hundred and sixty inpatients with suspicious nodules in the lung were divided into a lung cancer group and a benign pulmonary tumor group according to post-operative histological examinations. Serum levels of four tumor markers including squamous cell carcinoma antigen （SCC）, carcinoembryonic antigen （CEA）, Cyfra 21-1 and neuron specific enolase （NSE） were assayed for each patient. Receiver operating characteristic （ROC） curves were constructed for each tumor marker. The power of lung cancer diagnosis of each tumor marker, as well as a combination of them were analyzed and compared. Results The serum levels （median, range） of SCC, CEA, Cyfra 21-1 and NSE were 0.44 （0.01-35.70） ng/ml, 2.49 （0.30-26.78） ng/ml, 2.30 （0.82-73.33） ng/ml and 10.54 （0.10-56.41） ng/ml respectively in lung cancer group, and were 0.32 （0.01-0.90） ng/ml, 1.60 （0.20-8.93） ng/ml, 1.41 （0.72-4.82） ng/ml and 9.36 （6.56-24.24） ng/ml respectively in the benign pulmonary tumor group. The difference in each tumor marker between the two groups was significant （P 〈0.05）. The ROCs of SCC, CEA, Cyfra 21-1 and NSE were 0.702 （95% CI, 0.654-0.751）, 0.611 （95% CI, 0.563-0.659）, 0.650 （95% Cl, 0.601-0.700） and 0.598 （95% Cl, 0.542-0.654） respectively, indicating very low power of these four tumor markers. When a combination of SCC, CEA, Cyfra 21-1 and NSE were empfoyed, the diagnosis power was strengthened. Conclusion SCC, CEA, Cyfra 21-1 and NSE are valuable in the early diagnosis of lung cancer among suspicious nodules in the lung, especially when they were assayed together for one patient.展开更多
基金This study was supported by a grant from Clinical Subject of Ministry of Health of China (2004-2006-2).
文摘BACKGROUND: The differential diagnosis of solid lesions located at the pancreatic head is very important for choosing therapies and setting up surgical tactics. This study was designed to evaluate the clinical significance of combined measurement of multiple serum tumor markers and the application of the receiver-operating characteristic (ROC) curves in the differential diagnosis of solid lesions located at the pancreatic head. METHODS: The serum levels of CA19-9, CA242, CA50 and carcinoembryonic antigen (CEA) in 112 patients with carcinoma of the pancreatic head and 38 patients with focal chronic pancreatitis in the pancreatic head were measured with ELISA. The sensitivity, specificity, positive likelihood ratio (PLR) and negative likelihood ratio (NLR) of the four serum tumor markers were calculated. The ROC curves for the four serum tumor markers were constructed and the area under the curve (AUC) was calculated. RESULTS: The AUCs of CA19-9, CA242, CA50 and CEA were 0.805, 0.749, 0.738 and 0.705; the PLRs were 1.91, 3.43, 5.09 and 5.46; and the NLRs were 0.41, 0.56, 0.59 and 0.71, respectively. Combined measurements increased the diagnostic specificity, and parallel combined testing increased the diagnostic sensitivity. CONCLUSIONS: Combined measurement of serum tumor markers CA19-9, CA242, CA50 and CEA is valuable in differential diagnosis of solid lesions located at the pancreatic head, and CA19-9 has the best diagnostic ability. Combined measurements can increase the specificity of diagnosis. Evaluation with the ROC curve is better than the sensitivity or specificity alone and the results are more integrated and objective.
基金Supported by the Education Fund for Scientific Research in Fujian Province,No.97A068
文摘AIM:To evaluate the multiple biomarkers of colorectal tumor and their potential usage in early diagnosis of colorectal METHODS:Multiple biomarkers (DNA contents, AgNOR,PCNA, p53, c-erbB-2) in 10 normal colorectal mucosae, 37 colorectal adenomas and 55 colorectal cancers were analyzed quantitatively in the computed processing imaging system.Discrimination patterns were employed to evaluate the significance of single and multiple indices in diagnosis of colorectal cancers.RESULTS:The mean values of the analyzed parameters increased in order of the normal mucosa, adenoma and adenocarcinoma, and this tendency reflected the progression of colorectal malignancy. The parameters including DNA index,positive rates, densities of AgNOR, c-erbB-2, and p53,shape and density of nucleus were relatively valuable for diagnoses. Then a diagnostic discrimination model was established.The samples were confirmed with the model,the sensitivity rates in cancer group and adenoma group were 96.36% and 89.19%, respectively.The value of proliferating cell nuclear antigen (PCNA) in early diagnosis of colorectal cancers was uncertain.CONCLUSION:The quantitative evaluation of some parameters for colorectal tumor can provide reproducible data for differential diagnosis.The established diagnostic discrimination model may be of clinicopathological value,and can make the early diagnosis of colorectal cancer possible.
文摘Objective:To study the diagnostic value of multiple tumor markers in malignant ovarian neoplasm.Methods:Sera obtained from 430 patients with ovarian masses (110 cases were malignant ovarian tumors,320 cases were benign ovarian tumors) before operation,and from 50 healthy women as control.Serologic examination of tumor markers included CA125,TSGF,SA,CEA,AFP,HCG and Fer.Results:The serum levels of CA125,TSGF,SA and Fer in patients with ovarian cancer were higher than those in patients with benign ovarian tumors (P<0.05),also in control group (P<0.05).In the diagnostic value of application for malignant ovarian neoplasm,CA125,TSGF and SA were better than the others.The sensitivity,specificity and accuracy in diagnosis of ovarian cancer were 86.4%,82.8%and 83.7% respectively for CA125 alone,78.2%,81.3%and 80.5% for TSGF alone,74.5%,81.9%and 80.0% for SA alone,whereas 95.5%,45.6%and 58.4% for multiple tumor markers combined in which 1 or more indices showed positive,93.6%,80.6%and 84.0% for that in which 2 or more indices showed positive,and 87.3%,90.3%and 89.5% for that in which 3 or more indices show positive.Conclusion:multiple tumor markers examination could improve the diagnosis of ovarian cancer,and examination of CA125,TSGF and SA combined is most ideal.
基金National Natural Science Foundation of China,No.81770642the Shanghai Association for Science and Technology,China,No.19411951602.
文摘BACKGROUND Early detection of advanced cystic mucinous neoplasms[(A-cMNs),defined as high-grade dysplasia or malignancy]of the pancreas is of great significance.As a simple and feasible detection method,serum tumor markers(STMs)may be used to predict advanced intraductal papillary mucinous neoplasms(IPMNs)and mucinous cystic neoplasms(MCNs).However,there are few studies on the usefulness of STMs other than carbohydrate antigen(CA)19-9 for early detection of A-cMNs.AIM To study the ability of five STMs-CA19-9,carcinoembryonic antigen(CEA),CA125,CA724,and CA242 to predict A-cMNs and distinguish IPMNs and MCNs.METHODS We mainly measured the levels of each STM in patients pathologically diagnosed with cMNs.The mean levels of STMs and the number of A-cMN subjects with a higher STM level than the cutoff were compared respectively to identify the ability of STMs to predict A-cMNs and distinguish MCNs from IPMNs.A receiver operating characteristic curve with the area under curve(AUC)was also created to identify the performance of the five STMs.RESULTS A total of 187 patients with cMNs were identified and 72 of them showed AcMNs.We found that CA19-9 exhibited the highest sensitivity(SE)(54.2%)and accuracy(76.5%)and a moderate ability(AUC=0.766)to predict A-cMNs.In predicting high-grade dysplasia IPMNs,the SE of CA19-9 decreased to 38.5%.The ability of CEA,CA125,and CA724 to predict A-cMNs was low(AUC=0.651,0.583,and 0.618,respectively).The predictive ability of CA242 was not identified.The combination of STMs improved the SE to 62.5%.CA125 may be specific to the diagnosis of advanced MCNs.CONCLUSION CA19-9 has a moderate ability,and CEA,CA125,and CA724 have a low ability to predict A-cMNs.The combination of STM testing could improve SE in predicting A-cMNs.
文摘Background:With the increasing prevalence of lung cancer,it has become imperative to identify reliable biomarkers that can aid in early detection and prognosis assessment.Therefore,we sought to investigate the potential utility of six serum tumor markers as diagnostic and prognostic tools for lung cancer patients.By analyzing a large cohort of patients with different stages and subtypes of lung cancer,we hoped to shed light on the predictive value and accuracy of each marker individually,as well as their combined performance.This study should not only provide valuable insights into the biology and pathogenesis of lung cancer but also pave the way for personalized treatment strategies based on individual patient profiles.Methods:The serum levels of the tumor markers progastrin-releasing peptide(ProGRP),carcinoembryonic antigen(CEA),neuron-specific enolase(NSE),cytokeratin 19 fragment(CYFRA21-1),carbohydrate antigen 19-9(CA19-9)and squamous cell carcinoma antigen(SCCA)were meticulously assessed in a cohort comprising 324 individuals diagnosed with lung cancer and an additional 51 patients with benign lung disease.The measurements were conducted using cutting-edge techniques such as ELISA,electrochemical luminescence,and chemiluminescence methods.Differences between groups and the impact of these markers on lung cancer diagnosis were analyzed.Results:The serum levels of ProGRP,NSE,and CEA were significantly higher in lung cancer patients than in patients with benign lung disease(p<0.01).NSE had the highest sensitivity for squamous cell carcinomas(SC),while CEA had the highest sensitivity for adenocarcinomas(AC).ProGRP and NSE had higher sensitivities than other markers for small cell carcinomas(SCC).Combining the six tumor markers resulted in higher sensitivities for SC(70.6%),AC(77.4%),and SCC(80%)compared with any single test.Receiver operator characteristic analysis showed that ProGRP and NSE had a greater area under the curve(AUC)in SCC(0.886 and 0.775)than SC and AC,while CEA had a higher AUC in AC(0.716),and NSE had a higher AUC than other markers in SC(0.719).Conclusions:ProGRP and NSE are effective serum tumor markers for SCC,whereas CEA and NSE may aid in the diagnosis of AC and SC.Combining the detection of ProGRP,NSE,CYFRA21-1,CEA,and SCCA significantly improves sensitivity when diagnosing lung cancer.
文摘Objective To explore the clinical significance of serum level of pro gastrin releasing peptide 31 98 (ProGRP31 98) for small cell lung cancer (SCLC), in comparison with neuron specific enolase (NSE). Methods Serum level of ProGRP31 98 and NSE was measured by ELISA respectively in 30 patients with SCLC, 30 with non small cell lung cancer (NSCLC), 15 with benign lung diseases and 15 normal subjects, additionally, 10 SCLC patients after having treatment with chemotherapy were included. The receiver operating characteristic (ROC) curve was used to set the cut off value and evaluate the diagnostic accuracy. Results The serum level of ProGRP31 98 was higher in patients with SCLC than that in other groups. The SCLC patients with extensive disease had a higher value than the patients with limited disease. In SCLC patients with distant metastases, it was also higher than in those without. Increase in serum ProGRP31 98 and NSE was both seen in SCLC patients, but for the former one, the increase was of much greater compared to the normal controls. Given the cut off value for ProGRP31 98 was 40ng·L -1 and for NSE 8μg·L -1 , their sensitivity of diagnosis in SCLC was 73% and 60%, respectively. The area under ROC curve of ProGRP31 98 was significantly larger than that of NSE. All patients responded to chemotherapy showed marked decrease in ProGRP31 98. Conclusion ProGRP31 98 is a more specific and sensitive marker than NSE in the diagnosis of SCLC.
文摘Background Early detection and diagnosis is urgent for the sake of effective treatment strategy for lung cancer. However, a convenient, economical and relatively precise method is not available. We here report a prospective study to find the possible value of the combined use of four popular tumor markers in the early diagnosis of lung cancer among patients with suspicious nodules in the lung. Methods Six hundred and sixty inpatients with suspicious nodules in the lung were divided into a lung cancer group and a benign pulmonary tumor group according to post-operative histological examinations. Serum levels of four tumor markers including squamous cell carcinoma antigen （SCC）, carcinoembryonic antigen （CEA）, Cyfra 21-1 and neuron specific enolase （NSE） were assayed for each patient. Receiver operating characteristic （ROC） curves were constructed for each tumor marker. The power of lung cancer diagnosis of each tumor marker, as well as a combination of them were analyzed and compared. Results The serum levels （median, range） of SCC, CEA, Cyfra 21-1 and NSE were 0.44 （0.01-35.70） ng/ml, 2.49 （0.30-26.78） ng/ml, 2.30 （0.82-73.33） ng/ml and 10.54 （0.10-56.41） ng/ml respectively in lung cancer group, and were 0.32 （0.01-0.90） ng/ml, 1.60 （0.20-8.93） ng/ml, 1.41 （0.72-4.82） ng/ml and 9.36 （6.56-24.24） ng/ml respectively in the benign pulmonary tumor group. The difference in each tumor marker between the two groups was significant （P 〈0.05）. The ROCs of SCC, CEA, Cyfra 21-1 and NSE were 0.702 （95% CI, 0.654-0.751）, 0.611 （95% CI, 0.563-0.659）, 0.650 （95% Cl, 0.601-0.700） and 0.598 （95% Cl, 0.542-0.654） respectively, indicating very low power of these four tumor markers. When a combination of SCC, CEA, Cyfra 21-1 and NSE were empfoyed, the diagnosis power was strengthened. Conclusion SCC, CEA, Cyfra 21-1 and NSE are valuable in the early diagnosis of lung cancer among suspicious nodules in the lung, especially when they were assayed together for one patient.
