Serum tumor markers (carcinoembryonic antigen, carbohydrate antigen 19-9, carbohydrate antigen 72-4, carbohydrate antigen 24-2, ferritin) and gastric cancer prognosis correlation

BACKGROUND Gastric cancer is a kind of malignant tumor which is prevalent all over the world.Although some progress has been made in the treatment of gastric cancer,its prognosis is still not optimistic,so it is of great significance to find reliable prog-nostic indicators to guide the treatment and management of patients with gastric cancer.AIM To explore the relationship between serum levels of five biomarkers[carcinoem-bryonic antigen(CEA),carbohydrate antigen(CA)19-9,CA72-4,CA24-2,and ferritin]and prognosis in patients with gastric cancer.METHODS This study included 200 patients with gastric adenocarcinoma,and conducted an in-depth analysis of their baseline characteristics,relationship between tumor markers and staging,and prognosis.The study found that CA19-9 has a signi-ficant correlation with tumor stage,the average levels of CA24-2,CEA,CA72-4 and ferritin were slightly increased disregarding the stage of tumor.Survival analysis showed that increases in CEA,CA19-9,CA24-2,and ferritin were all associated with shortened overall survival of patients.Further multivariate ana-lysis revealed that elevated serum CA72-4 levels were an inde-pendent adverse prognostic factor.RESULTS This study reveals that there is a significant correlation between the expression levels of serum tumor markers CEA,CA19-9,CA72-4,CA24-2 and ferritin in patients with gastric cancer and prognosis,and can be used as important indicators for prognostic evaluation of gastric cancer.In particular,markers that appear abnormally elevated initially may help identify gastric cancer patients with poor prognosis.CONCLUSION Serum CEA and CA19-9 play an important role in the prognosis assessment of gastric cancer,and are effective tools to guide clinical practice and optimize individualized treatment strategies for gastric cancer patients.

The combined detection of carcinoembryonic antigen,carcinogenic antigen 125,and carcinogenic antigen 19-9 in colorectal cancer patients

BACKGROUND Hepatic metastases are common and difficult to treat after colorectal cancer(CRC)surgery.The predictive value of carcinoembryonic antigen(CEA),cancer antigen(CA)125 and CA19-9 combined tests for liver metastasis is unclear.AIM To evaluate predictive value of combined tests for CEA,CA125,and CA19-9 levels in patients with liver metastases of CRC.METHODS The retrospective study included patients with CRC alone(50 cases)and patients with CRC combined with liver metastases(50 cases)who were hospitalized between January 2021 and January 2023.Serum CEA,CA125 and CA19-9 levels were compared between the two groups,and binary logistic regression was used to analyze the predictive value of the combination of these tumor markers in liver metastasis.In addition,we performed receiver operating characteristic(ROC)curve analysis to assess its diagnostic accuracy.RESULTS The results showed that the serum CEA,CA125 and CA19-9 levels in the CRC with liver metastasis group were significantly higher than those in the CRC alone group.Specifically,the average serum CEA level in the CRC with liver metastasis group was 162.03±810.01 ng/mL,while that in the CRC alone group was 5.71±9.76 ng/mL;the average serum CA125 levels were 43.47±83.52 U/mL respectively.and 13.5±19.68 U/mL;the average serum CA19-9 levels were 184.46±473.13 U/mL and 26.55±43.96 U/mL respectively.In addition,binary logistic regression analysis showed that CA125 was significant in predicting CRC liver metastasis(P<0.05).ROC curve analysis results showed that the areas under the ROC curves of CEA,CA125 and CA19-9 were 0.607,0.692 and 0.586.CONCLUSION These results suggest that combined detection of these tumor markers may help early detection and intervention of CRC liver metastasis,thereby improving patient prognosis.

Recurrence and influencing factors of hepatitis B surface antigen seroclearance induced by peginterferon alpha-based regimens

BACKGROUND The long-term stability of hepatitis B surface antigen(HBsAg)seroclearance following peginterferon alpha(peg-IFN-α)-based therapy has not been extensively studied,leaving the full potential and limitations of this strategy unclear.AIM To assess HBsAg recurrence after seroclearance achieved by peg-IFN-αregimens.METHODS This prospective,multicenter,observational study was conducted from November 2015 to June 2021 at three Chinese hospitals:The Second Affiliated Hospital of Xi’an Jiaotong University,Ankang Central Hospital,and The Affiliated Hospital of Yan’an University.Participants who achieved HBsAg seroclearance following peg-IFN-α-based treatments were monitored every 4-12 weeks post-treatment for hepatitis B virus(HBV)markers,HBV DNA,and liver function.The primary outcome was HBV recurrence,defined as the reemergence of HBsAg,HBV DNA,or both,at least twice within 4-8 weeks of follow-up.RESULTS In total,121 patients who achieved HBsAg seroclearance were enrolled.After a median follow-up of 84.0(48.0,132.0)weeks,four subjects were lost to follow-up.HBsAg recurrence was detected in 16 patients.The cumulative HBsAg recurrence rate in the intention-to-treat population was 15.2%.Multivariate logistic regression analysis demonstrated that consolidation time<12 weeks[odds ratio(OR)=28.044,95%CI:4.525-173.791]and hepatitis B surface antibody disappearance during follow-up(OR=46.445,95%CI:2.571-838.957)were strong predictors of HBsAg recurrence.HBV DNA positivity and decompensation of liver cirrhosis and hepatocellular carcinoma were not observed.CONCLUSION HBsAg seroclearance following peg-IFN-αtreatment was durable over 84 weeks of follow-up with a cumulative recurrence rate of 15.2%.

Prostate cancer with elevated free prostate-specific antigen density:A case report

BACKGROUND Prostate cancer is the second most common cancer among men worldwide,and prostate-specific antigen(PSA)is often used in clinical practice to screen for prostate cancer.Normal total PSA(tPSA)level initially excludes prostate cancer.Here,we report a case of prostate cancer with elevated free PSA density(fPSAD).CASE SUMMARY A patient diagnosed with benign prostatic hyperplasia underwent prostatectomy,and the postoperative pathological results showed acinar adenocarcinoma of the prostate.The patient is currently undergoing endocrine chemotherapy.CONCLUSION We provide a clinical reference for diagnosis and treatment of patients with normal tPSA but elevated fPSAD.

Hepatitis B surface antigen-negative but hepatitis B envelope antigen-positive false occult hepatitis B virus infection:A case report

BACKGROUND Occult hepatitis B infection(OBI)is characterized by the detection of hepatitis B virus(HBV)DNA in serum(usually HBV DNA<200 IU/mL)or the liver but negativity for hepatitis B surface antigen(HBsAg).The diagnosis of OBI relies on the sensitivity of assays used in the detection of HBV DNA and HBsAg.HBsAg assays with inadequate sensitivity or inability to detect HBV S variants may lead to misdiagnosis of OBI in people with overt HBV infection.CASE SUMMARY We report a HBsAg-negative but hepatitis B envelope antigen-positive patient who had a significant HBV DNA level.The patient was initially diagnosed as having OBI.However,sequence analysis revealed a unique insertion of amino acid residues at positions 120-124 in the S protein,which affects the formation of a disulfide bond that is associated with the formation of a loop.It is well known that there is an overlap between the S protein and Pol protein.We found that this new insertion site occurred in polymerase/reverse transcriptase domain,indi-cating that this insertion might be involved in HBV pathogenicity.The patient was finally diagnosed with a false OBI.CONCLUSION An insertion of amino acid residues at positions 120-124 of the S protein affects the formation of immunodominant epitopes and results in negative HBsAg levels.

IL-1β和TNF-α对体外培养的人RPE细胞FasL蛋白及mRNA表达的影响

目的:观察IL-1β和TNF-α对培养的人RPE细胞FasL蛋白、mRNA表达的影响。方法:流式细胞仪检测暴露于IL-1β和/或TNF-α的RPE细胞FasL的表达,并用mRNA斑点杂交分析mRNA的改变。结果:流式细胞仪显示23.4%培养的RPE细胞表达FasL。IL-1β,TNF-α和二者联合应用后FasL阳性率则分别为25.7%,9.7%和17.2%。mRNA斑点杂交亦证实TNF-α下调FasLmRNA的表达。结论:TNF-α可下调体外培养的人RPE细胞FasL蛋白,mRNA的表达。

移植肾AR时病理诊断与细胞凋亡和Fas/FasL的表达

目的:探讨移植肾急性排斥(AR)时细胞凋亡与Fas和Fas配体(FasL)表达的作用及其临床意义。方法:分别用原位末端标记技术(TUNEL法)和免疫组织化学方法检测26例移植肾AR标本中细胞凋亡和Fas/FasL表达情况。结果:细胞凋亡和Fas/FasL表达主要在AR移植肾小管上皮发生,且凋亡指数和Fas/FasL表达与肾组织病理损伤程度平行,与正常肾对照组和移植肾功能稳定组比较差异显著。结论:肾小管上皮细胞凋亡在AR所致的移植肾损伤中起重要作用,Fas/FasL系统可能参与移植肾AR,是造成肾小管上皮细胞凋亡的重要因素。TUNEL法检测细胞凋亡可作为判断移植肾病理变化和预后的重要指标。

基于Fas/FasL介导的凋亡信号通路研究通管方对输卵管炎性不孕模型大鼠的作用机制

目的:探讨通管方对输卵管炎性不孕(SI)模型大鼠输卵管组织中Fas/FasL通路的影响。方法:采用经阴道内接种混合菌液的方法,建立输卵管炎性不孕大鼠模型。造模后,77只SD雌性大鼠随机分成空白组、假手术组、模型组、妇可靖胶囊组(0.29 g·kg^(-1)·d^(-1))、通管方低剂量组(7.515 g·kg^(-1)·d^(-1))、通管方中剂量组(15.03 g·kg^(-1)·d^(-1))、通管方高剂量组(30.06 g·kg^(-1)·d^(-1)),各组大鼠分别灌胃给药28 d后处死并取材。采用蛋白免疫印迹法(WB)检测SI模型大鼠输卵管组织中Fas、FasL蛋白及Caspase-1的表达水平,酶联免疫吸附法(ELISA)检测SI模型大鼠血清IL-4、IL-10、Caspase-1的表达变化。结果:与空白组比较,模型组血清中IL-4和IL-10的水平均明显降低,血清和输卵管组织中的Caspase-1水平明显升高(P<0.01);与模型组比较,通管方各剂量组和妇可靖胶囊组降低了血清和输卵管组织中的Caspase-1的表达(P<0.01),上调了血清中IL-4和IL-10水平、输卵管组织中Fas和FasL蛋白的表达(P<0.05,P<0.01)。其中,通管方高剂量组的作用均明显优于其他剂量组和妇可靖胶囊组(P<0.05,P<0.01)。结论:通管方可能通过调控Fas/FasL凋亡信号通路而消除SI模型大鼠输卵管炎症。

水飞蓟宾抑制Fas/FasL信号通路对肺结核大鼠炎症损伤及巨噬细胞凋亡的影响

目的:探究水飞蓟宾对肺结核(TB)大鼠肺部炎症损伤、巨噬细胞凋亡的影响,及对死亡受体Fas及其配体FasL的调控作用。方法:采用尾静脉注射结核分枝杆菌(Mtb)法制备TB大鼠模型,并随机分为模型组、水飞蓟宾组、Fas过表达重组蛋白(pcDNA-Fas)组、pcDNA-Fas阴性对照(pcDNA-NC)组、水飞蓟宾+pcDNA-Fas组,每组15只,另取15只大鼠为正常对照组。抗酸染色检测肺组织感染情况;HE染色观察肺组织病理变化;ELISA法检测肺组织TNF-α、IL-6表达;Annexin VFITC/PI双染结合流式细胞术检测肺泡巨噬细胞凋亡率;Western blot检测Fas、FasL、caspase8、caspase3、巨噬细胞炎症蛋白-2(MIP-2)表达水平。结果:与正常对照组相比,模型组大鼠肺组织炎症因子表达、肺泡巨噬细胞凋亡率升高,肺组织Mtb感染及干酪样坏死严重,Fas/FasL介导的caspase8/3凋亡途径活化(P<0.05)。与模型组相比,水飞蓟宾组大鼠肺组织炎症因子表达、肺泡巨噬细胞凋亡率降低,肺组织Mtb感染及干酪样坏死缓解,Fas/FasL介导的caspase8/3凋亡途径活性降低(P<0.05)。pc-DNA-Fas可进一步激活Fas/FasL介导的caspase8/3凋亡途径活化,加重肺组织Mtb感染及干酪样坏死,促进肺组织炎症损伤及巨噬细胞凋亡,并减弱水飞蓟宾发挥的抗Fas/FasL活化、抗炎及抗巨噬细胞凋亡作用(P<0.05)。结论:水飞蓟宾可能通过抑制Fas/FasL信号通路发挥抗Mtb感染、抗肺组织巨噬细胞凋亡及抗肺部炎症损伤作用。

穿心莲内酯通过抑制Fas/FasL信号轴降低子宫内膜癌Ishikawa/DPP细胞对顺铂的耐药性

目的:探讨穿心莲内酯(Andro)调节脂肪酸合成酶(Fas)/脂肪酸合成酶配体(FasL)信号轴对子宫内膜癌Ishikawa细胞顺铂(DDP)耐药性的影响。方法:采用0、5、10、20μg/mL DDP分别处理Ishikawa细胞和顺铂耐药的Ishikawa/DPP细胞,0、5、10、25、50μmol/L Andro处理Ishikawa/DDP细胞,MTT法检测细胞增殖情况并为后续实验选择合适的给药剂量。将Ishikawa/DDP细胞随机分为对照组、DDP组(DDP干预)、Andro组(DDP、Andro干预)、pcDNA3.1-NC组(转染pcDNA3.1+DDP、Andro干预)、pcDNA3.1-Fas/FasL组(转染pcDNA3.1-Fas/FasL+DDP、Andro干预),24 h后,采用qPCR法检测Fas、FasL mRNA的表达,平板克隆形成实验、Transwell实验和流式细胞术分别检测细胞克隆能力、细胞迁移与侵袭和细胞凋亡,WB法检测增殖细胞核抗原(PCNA)、BAX、Bcl-2、MMP-2、PD-L1、多药耐药蛋白-1(MDR-1)及Fas、FasL蛋白表达。结果:DDP以剂量依赖的方式抑制Ishikawa和Ishikawa/DPP细胞增殖,并且与Ishikawa细胞比较,Ishikawa/DPP细胞对DDP的敏感性更低(均P<0.05);Andro以剂量依赖性的方式抑制Ishikawa/DPP细胞的增殖(均P<0.05)。Ishikawa/DPP细胞中Fas、FasL的表达水平均高于Ishikawa细胞(均P<0.05)。选取20μg/mL DDP和25μmol/L Andro为干预剂量,干预时间24h。与对照组比较,DDP组Ishikawa/DPP细胞中PD-L1、MDR-1、Fas、FasL mRNA及蛋白表达水平显著升高(P<0.05),而克隆形成率、迁移与侵袭细胞数、凋亡率差异均无统计学意义(均P>0.05);与DDP组比较,Andro组Ishikawa/DPP细胞中Fas、FasL mRNA表达水平、细胞克隆形成率、迁移与侵袭细胞数、PCNA、Bcl-2、MMP-2、PD-L1、MDR-1、Fas、FasL蛋白表达水平显著降低,BAX蛋白表达水平及凋亡率显著升高(P<0.05或P<0.01),pcDNA3.1-NC组与Andro组类似;与pcDNA3.1-NC组比较,pcDNA3.1-Fas/FasL组Ishikawa/DPP细胞上述指标变化均被逆转(P<0.05)。结论:Andro可能通过抑制Fas/FasL信号轴来抑制Ishikawa/DPP细胞增殖、迁移与侵袭,促进凋亡,从而降低细胞对DDP的耐药性。

疏肝健脾颗粒对大鼠乳腺癌癌前病变组织Fas、FasL表达的影响

目的:观察疏肝健脾颗粒对模型大鼠乳腺癌癌前病变组织Fas、FasL表达的影响,探讨其阻断乳腺癌癌前病变发展的机制。方法:90只SD大鼠,随机分为6组,正常对照组、模型组、三苯氧胺组及疏肝健脾颗粒低剂量组、中剂量组、高剂量组。以雌孕激素与DMBA联合诱导乳腺癌癌前病变模型,各组分别给予生理盐水、三苯氧胺、疏肝健脾颗粒不同剂量干预60 d后,进行组织病理学及Fas、FasL表达的免疫组化检测。结果:模型组大鼠乳腺癌前病变率为69.2%,疏肝健脾颗粒各剂量组及三苯氧胺组的癌前病变发生率均低于模型组(P<0.01),模型组和疏肝健脾颗粒中、低剂量组部分大鼠乳腺组织发生浸润癌。正常对照组大鼠乳腺组织Fas蛋白表达较高,FasL蛋白表达在模型组大鼠乳腺组织表达较高,疏肝健脾颗粒各剂量组和三苯氧胺组Fas蛋白表达增强,FasL蛋白表达减弱,与模型组比较差异显著(P<0.05或P<0.01)。结论:疏肝健脾颗粒可以显著降低DMBA诱导的大鼠乳腺癌癌前病变的发生率,调控乳腺癌癌前病变组织Fas、FasL的表达是其部分作用机制。

Early gastric cancer frequently has high expression of KKLC-1, a cancer-testis antigen

AIM To assess cancer-testis antigens(CTAs) expression in gastric cancer patients and examined their associations with clinicopathological factors.METHODS Eighty-three gastric cancer patients were evaluated in this study. Gastric cancer specimens were evaluated for the gene expression of CTAs, Kitakyushu lung cancer antigen-1(KK-LC-1), melanoma antigen(MAGE)-A1, MAGE-A3 and New York esophageal cancer-1(NYESO-1), by reverse transcription PCR. Clinicopathological background information, such as gender, age, tumor size, macroscopic type, tumor histology, depth of invasion, lymph node metastasis, lymphatic invasion, venous invasion, and pathological stage, was obtained. Statistical comparisons between the expression of each CTA and each clinicopathological background were performed using the χ2 test. RESULTS The expression rates of KK-LC-1, MAGE-A1, MAGE-A3, and NY-ESO-1 were 79.5%, 32.5%, 39.8%, and 15.7%, respectively. In early stage gastric cancer specimens, the expression of KK-LC-1 was 79.4%, which is comparable to the 79.6% observed in advanced stage specimens. The expression of KK-LC-1 was not significantly associated with clinicopathological factors, while there were considerable differences in the expression rates of MAGE-A1 and MAGE-A3 with vs without lymphatic invasion(MAGE-A1, 39.3% vs 13.6%, P = 0.034; MAGE-A3, 47.5% vs 18.2%, P = 0.022) and/or vascular invasion(MAGE-A1, 41.5% vs 16.7%, P = 0.028; MAGE-A3, 49.1% vs 23.3%, P = 0.035) and, particularly, MAGE-A3, in patients with early vs advanced stage(36.5% vs 49.0%, P = 0.044), respectively. Patients expressing MAGE-A3 and NYESO-1 were older than those not expressing MAGE-A3 and NY-ESO-1(MAGE-A3, 73.7 ± 7.1 vs 67.4 ± 12.3, P = 0.009; NY-ESO-1, 75.5 ± 7.2 vs 68.8 ± 11.2, P = 0.042). CONCLUSION The KK-LC-1 expression rate was high even in patients with stage I cancer, suggesting that KK-LC-1 is a useful biomarker for early diagnosis of gastric cancer.

Inflammatory response in gastrointestinal cancers:Overview of six transmembrane epithelial antigens of the prostate in pathophysiology and clinical implications

Chronic inflammation is known to increase the risk of gastrointestinal cancers(GICs),the common solid tumors worldwide.Precancerous lesions,such as chronic atrophic inflammation and ulcers,are related to inflammatory responses in vivo and likely to occur in hyperplasia and tumorigenesis.Unfortunately,due to the lack of effective therapeutic targets,the prognosis of patients with GICs is still unsatisfactory.Interestingly,it is found that six transmembrane epithelial antigens of the prostate(STEAPs),a group of metal reductases,are significantly associated with the progression of malignancies,playing a crucial role in systemic metabolic homeostasis and inflammatory responses.The structure and functions of STEAPs suggest that they are closely related to intracellular oxidative stress,responding to inflammatory reactions.Under the imbalance status of abnormal oxidative stress,STEAP members are involved in cell transformation and the development of GICs by inhibiting or activating inflammatory process.This review focuses on STEAPs in GICs along with exploring their potential molecular regulatory mechanisms,with an aim to provide a theoretical basis for diagnosis and treatment strategies for patients suffering from these types of cancers.

慢性乙型肝炎患者肝组织FasL表达与血清可溶性FasL水平的关系

目的 探讨慢性乙型肝炎患者肝组织中FasL表达与血清可溶性FasL水平的关系。方法 用免疫组化方法检测 60例慢性乙型肝炎患者肝穿组织FasL的表达 ,同时用酶联免疫吸附试验检测血清可溶性FasL。结果 重度慢性乙型肝炎患者血清中sFasL水平 >中度 >轻度 ,各组间差异有显著意义 (P <0 0 1 ) ;慢性乙型肝炎患者肝组织FasL表达的程度和血清sFasL水平与肝组织病变的活动性一致。结论 (1 )肝组织炎症程度加重 ,肝组织FasL抗原的表达增强 ,同时血清中sFasL水平升高 ;(2 )Fas介导的肝细胞凋亡在慢性乙型肝炎的发病机制中起重要作用 。

Fasciola worm and egg-derived antigens:Exploring their diagnostic potential for urogenital schistosomiasis in resource-limited endemic regions

Objective:To evaluate the immunodiagnostic potential of crude Fasciola gigantica-worm(FWA)and egg antigen(FEA)in detecting anti-Schistosoma(S.)haematobium antibodies in sera and urine samples.Methods:This is a cross-sectional diagnostic study.Employing an indirect ELISA,antibodies against these antigens were assessed in samples from infected and non-infected individuals in both schistosomiasis endemic(NE)and non-endemic(NNE)areas,using microscopy as the diagnostic standard.Results:FWA-sera exhibited excellent diagnostic accuracy with an area under the curve(AUC)of 0.957,a sensitivity of 93.75%,and a specificity of 85.42%for discriminating between infected and non-infected individuals in non-endemic areas.FWA-urine also demonstrated robust performance,achieving AUC>0.95,sensitivity>97.0%,and specificity>85.0%in both NE and NNE categories.Notably,S.haematobium-specific antibody levels against FWA were significantly elevated in infected individuals in both endemic and non-endemic areas.FEA-sera exhibited outstanding diagnostic performance with sensitivity exceeding 90%and an AUC of 0.968 in non-endemic samples but not in FEA-urine.Conclusions:FWA-based ELISAs,applicable to both sera and urine,emerge as promising tools for S.haematobium diagnosis in resource-limited settings,offering advantages of high sensitivity and specificity with shared antigens with Fasciola.The superior diagnostic metrics of urine samples suggest their potential as a non-invasive biological sample for diagnostic purposes.

Fas/FasL在复发性自然流产患者中的表达

【目的】探讨复发性自然流产(RSA)患者绒毛滋养细胞FasL的表达以及淋巴细胞Fas表达与正常者有无差异。【方法】应用免疫组化检测RSA患者和正常早孕妇女的绒毛滋养细胞FasL表达,应用流式细胞仪检测其外周血淋巴细胞Fas表达,并进行比较。【结果】免疫组化结果显示,绒毛合体滋养细胞和细胞滋养细胞的胞浆和胞膜上均有FasL表达,FasL在两组的定位无差异,但正常组滋养细胞FasL表达(PU=18.03±4.69)强于RSA组(PU=13.59±3.73),P<0.05。流式细胞仪检测结果表明,CD4+T淋巴细胞的Fas表达两组比较无统计学差异。RSA组CD8+T淋巴细胞的Fas表达为12.32%±2.78%,较正常组(7.78%±2.17%)高,(P<0.01)。RSA组NK细胞Fas表达为14.23%±3.67%,较正常组(8.87%±2.95%)高,(P<0.01)。【结论】不明原因RSA患者的绒毛滋养细胞FasL表达弱于正常者,并且其表达Fas的CD8+T淋巴细胞和NK细胞均较正常妇女增多,表明RSA患者存在CD8+T淋巴细胞和NK细胞的异常激活。Fas/FasL在RSA发病中可能起重要作用。

重症急性胰腺炎患者外周血单个核细胞FasL mRNA和血清可溶性FasL的检测及其对T细胞亚群的调节

目的研究重症急性胰腺炎(SAP)患者外周血单个核细胞(PBMC)中FasL mRNA、血清可溶性FasL(sFasL)的水平,探讨FasL对T淋巴细胞亚群的调节作用。方法收集48例急性胰腺炎病例,其中20例为SAP,28例为轻症急性胰腺炎(MAP),以28例同期健康体检者为正常对照。实时定量PCR检测PBMC中FasL mRNA;ELISA检测血清sFasL水平。同时,采用流式细胞术检测外周血T淋巴细胞亚群。结果与MAP组及正常组相比,SAP组FasL mRNA、sFasL水平明显升高(P<0.05);而MAP组FasL mRNA、sFasL水平较正常组轻度升高(P>0.05)。SAP组CD4+T细胞比率、CD4+/CD8+比值较MAP组及正常组明显降低(P<0.05),且与FasL mRNA、血清sFasL水平呈负相关。结论 SAP患者PBMC中FasL mRNA、血清sFasL明显增加,而CD4+T细胞比率及CD4+/CD8+比值明显降低,FasL可能通过介导T淋巴细胞凋亡起负向调节作用。

Human leukocyte antigen compatibility and incidence of donorspecific antibodies in pediatric liver transplant recipients

BACKGROUND Antibody-mediated rejection following liver transplantation(LT)has been increasingly recognized,particularly with respect to the emergence of de novo donor-specific antibodies(DSAs)and their impact on graft longevity.While substantial evidence for adult populations exists,research focusing on pediatric LT outcomes remains limited.AIM To investigate the prevalence of human leukocyte antigen(HLA)mismatches and DSA and evaluate their association with rejection episodes after pediatric LT.METHODS A cohort of pediatric LT recipients underwent HLA testing at Santa Casa de Porto Alegre,Brazil,between December 2013 and December 2023.Only patients who survived for>30 days after LT with at least one DSA analysis were included.DSA classes I and II and cross-matches were analyzed.The presence of de novo DSA(dnDSA)was evaluated at least 3 months after LT using the Luminex®single antigen bead method,with a positive reaction threshold set at 1000 MFI.Rejection episodes were confirmed by liver biopsy.RESULTS Overall,67 transplanted children were analyzed;61 received grafts from living donors,85%of whom were related to recipients.Pre-transplant DSA(class I or II)was detected in 28.3%of patients,and dnDSA was detected in 48.4%.The median time to DSA detection after LT was 19.7[interquartile range(IQR):4.3-35.6]months.Biopsyproven rejection occurred in 13 patients at follow-up,with C4d positivity observed in 5/13 Liver biopsies.The median time to rejection was 7.8(IQR:5.7-12.8)months.The presence of dnDSA was significantly associated with rejection(36%vs 3%,P<0.001).The rejection-free survival rates at 12 and 24 months were 76%vs 100%and 58%vs 95%for patients with dnDSA anti-DQ vs those without,respectively.CONCLUSION Our findings highlight the importance of incorporating DSA assessment into pre-and post-transplantation protocols for pediatric LT recipients.Future implications may include immunosuppression minimization strategies based on this analysis in pediatric LT recipients.

甲状腺癌组织中凋亡相关蛋白Fas,FasL,Bcl-2和Bax的表达及意义

目的研究凋亡相关蛋白Fas,FasL,Bcl-2和Bax在甲状腺癌组织中的表达及意义。方法应用免疫组织化学,采用TUMEL法,检测34例甲状腺癌及10例结节性甲状腺肿、9例甲状腺腺瘤组织病理标本中的细胞凋亡指数(ApoptosisIndex,AI);并用通用型二步法对凋亡相关蛋白Fas,FasL,Bcl-2和Bax的表达进行检测。结果(1)对照组细胞平均AI(%)为12.39±2.21,甲状腺癌细胞平均AI(%)为20.17±2.68,即肿瘤组的细胞凋亡指数高于对照组,二者有显著性差异(t=4.138>t(0.05),P<0.05)。(2)甲状腺癌组织中Fas,FasL,Bcl-2和Bax蛋白表达显著高于对照组。(3)Fas,FasL,Bcl-2和Bax蛋白表达的阳性率与其病理类型、临床分期无明显关系(P>0.05)。结论甲状腺癌组织中有较高水平细胞凋亡,Fas,FasL,Bcl-2和Bax的表达均明显增强,并且通过参与调节细胞凋亡而与甲状腺癌的发生有关,但与病理类型、临床分期无明显关系。