Effect of Shenqi Fuzheng Injection combined with chemotherapy on peripheral blood cell level, tumor markers and immune function in patients with gastric cancer

Objective:To investigate the effects of Shenqi Fuzheng Injection combined with chemotherapy on peripheral blood cell level, tumor markers and immune function in patients with gastric cancer.Methods: Eighty patients with gastric cancer admitted to our hospital from May 2016 to October 2017 were selected as the research object and randomly divided into observation group and control group, 40 cases in each group. Control group was treated by DCF chemotherapy, while the observation group by Shenqi Fuzheng Injection based on the DCF chemotherapy. The levels of peripheral blood cells, tumor markers and immune function indexes in both groups were detected and compared before and after treatment.Results: There were no significant differences in serum RBC, WBC, PLT, Hb, NSE, CYFRA21-1, CA199, CEA, CD3+, CD4+, CD8+ and CD4+/CD8+ levels before treatment in both groups. Compared with the pretreatment group, the levels of RBC, WBC, PLT and Hb in both groups decreased to some extent after treatment, and the levels in the observation group were significantly higher than those in the control group;Compared with the same group before treatment, the levels of NSE, CYFRA21-1, CA199 and CEA in the two groups were significantly decreased, and the observation group was significantly lower than the control group;CD3+, CD4+, CD4+/CD8+ levels in control group and observation group increased to some extent after treatment, and the levels in observation group were significantly higher than those in control group. The levels of CD8+ in both groups after treatment were significantly lower than those before treatment, and the observation group was significantly lower than the control group after treatment. The above data for statistical analysis had significant differences.Conclusions: Shenqi Fuzheng injection combined with chemotherapy helps to clear and kill cancer cells, enhance immunity and reduce hematological toxicity after chemotherapy, which can be used as an adjuvant chemotherapy for gastric cancer.

Effects of Shenqi Fuzheng injection combined with chemotherapy on peripheral blood, immune function and tumor markers in patients with breast cancer

Objective: To investigate the effects of Shenqi Fuzheng Injection Combined with chemotherapy on peripheral blood, immune function and tumor markers in patients with breast cancer. Methods: A total of 92 cases of breast cancer treated by modified radical mastectomy in our hospital from January 2017 to December 2017 were selected as the research subjects and were randomly divided into 46 cases in the observation group and 46 cases in the control group. The patients in the control group began chemotherapy after 2 weeks of surgery, and the observation group was given Shenqi Fuzheng Injection on the basis of the control group. The levels of leukocyte, platelet, hemoglobin, T cell subgroup, carcinoembryonic antigen (CEA), cancer antigen 153 (CA153) and carbohydrate antigen 125 (CA125) were measured and compared of patients in two groups. Results: Before treatment, there was no significant difference in white blood cell, platelet and hemoglobin between the two groups. After treatment, the white blood cells, platelets and hemoglobin in the observation group were (3.56±0.10)×109/L, (137.47±23.58)×109/L, (116.72±15.75) g/L, and the white cells, platelets and hemoglobin in the control group were (2.85±0.18)×109/L, (126.76±21.34)×109/L, (103.36±20.51) g/L, respectively, all the indexes decreased than before treatment, moreover the decrease of control group is more obvious than observation group, and the difference was statistically significant. Before treatment, there was no significant difference in CD3+, CD4+, CD8+and CD4+/CD8+between the two groups. After treatment, the CD3+, CD4+and CD4+/CD8+in the observation group were (58.02±12.77)%, (50.79±7.45)% and (2.13±0.69), which were significantly higher than those before the treatment, and increased compared with the control group in the corresponding period, the difference was statistically significant. Before treatment, there was no significant difference in CEA, CA153 and CA125 between the two groups. After treatment, the CEA, CA153 and CA125 of the observation group were (16.70±3.71) μg/L, (13.11±3.70) U/mL and (11.25±1.73) U/mL, and in the control group they were (21.71±4.24) μg/L, (20.31±4.21) U/mL and (17.78±2.36) U/mL, respectively, the CEA, CA153 and CA125 in two groups were all lower than those before treatment, and the indexes of the observation group were decreased more significantly than those of the control group, the differences were statistically significant. Conclusion: Shenqi Fuzheng Injection Combined with chemotherapy in peripheral blood and immune function significantly improved in patients with breast cancer, and a significant decrease in the level of tumor markers.

Expression of CD44v6 gene in normal human peripheral blood

AIM: To investigate if CD44v6 could be used as a molecular marker of cancer progression and metastasis through the detection of CD44v6 gene expression in normal human peripheral blood.METHODS: RNA was extracted from the peripheral blood mononuclear cells of 50 healthy donors, the expression of CD44v6 was investigated using reverse transcriptasepolymerase chain reaction (RT-PCR).RESULTS: CD44v6 mRNA was detected in 58% of healthy volunteers under the proper controls.CONCLUSION: Our results suggest that the measurement of CD44v6 expression in peripheral blood by RT-PCR is not suitable for detection of circulating tumor cells.

Combined measurement of serum tumor markers in patients with hepatocellular carcinoma

ＣｏｍｂｉｎｅｄｍｅａｓｕｒｅｍｅｎｔｏｆｓｅｒｕｍｔｕｍｏｒｍａｒｋｅｒｓｉｎｐａｔｉｅｎｔｓｗｉｔｈｈｅｐａｔｏｃｅｌｕｌａｒｃａｒｃｉｎｏｍａＣＡＩＷｅｎＸｉｕ，ＺＨＥＮＧＨｕｉ，ＳＨＥＮＧＪｉａｎａｎｄＹＥＱｉｎｇＬｉｎＳｕｂｊｅｃｔｈ...

Clinical significance and prognostic value of tumor necrosis factor-α and dickkopf related protein-1 in ankylosing spondylitis

BACKGROUND Ankylosing spondylitis(AS)frequently occurs in people aged 30-45 years,and its prevalence is generally believed to be between 0.1%and 1.4%globally.At present,the“gold standard”for diagnosis of AS requires the provision of pelvic X-rays,which makes it more difficult to perform in population-based epidemiological studies.Therefore,the identification of serological indicators related to the diagnosis,treatment,and prognosis of AS patients is of great significance.AIM To analyze the therapeutic,diagnostic significance and prognostic value of dickkopf-related protein-1(DKK-1)and tumor necrosis factor-α(TNF-α)in AS.METHODS A total of 113 patients with active AS were selected as the research group,and 100 healthy subjects who underwent physical examination were selected as the control group.The levels of DKK-1 and TNF-α in peripheral blood in the two groups were compared.The diagnostic and predictive values of DKK-1 and TNF-α for AS were analyzed with ROC curves,and the factors influencing AS recurrence were analyzed with COX regression.RESULTS Before treatment,the research group showed lower DKK-1 levels but higher TNF-αlevels than the control group(both aP<0.05).In the research group,DKK-1 was up-regulated and TNF-αwas down-regulated after 12 wk of treatment(aP<0.05).The area under the curve,sensitivity and specificity of DKK-1 combined with TNF-αfor diagnosing AS were 0.934,82.30%and 97.00%,respectively.Before treatment,the area under the curve,cutoff value,sensitivity and specificity of DKK-1 for predicting the curative effect were 0.825,68.42 pg/mL,73.68%and 80.00%,respectively,and those of TNF-αwere 0.863,32.79 ng/L,92.11%and 77.33%,respectively.DKK-1 and TNF-αlevels after treatment were closely related to the curative effect(aP<0.05).C-reactive protein,the Bath Ankylosing Spondylitis Disease Activity Index,DKK-1,and TNF-αwere risk factors for AS recurrence(aP<0.05).CONCLUSION DKK-1 and TNF-αare effective in the diagnosis and treatment of AS and are risk factors for its recurrence.In addition,DKK-1 may be a potential target for the diagnosis of AS.

外周血炎症指数与乳腺癌腋窝淋巴结转移的相关性分析

目的 探讨外周血炎症相关指数与乳腺癌腋窝淋巴结转移的相关性。方法 回顾性收集2018年1月—2023年8月就诊于兰州大学第二医院浸润性乳腺癌患者的首次就诊临床资料,计算外周血相关炎症指数,分析各项指数与腋窝淋巴结转移的相关性。结果 共收集了328例患者的临床资料,单因素分析显示,体重指数、肿瘤直径、癌胚抗原、癌胚抗原125、系统炎症反应指数和泛免疫炎症值在腋窝淋巴结转移组和非腋窝淋巴结转移组之间差异有统计学意义(P<0.05)。多因素分析发现肿瘤直径、泛免疫炎症值、系统炎症反应指数、体重指数、组织学分级Ⅲ级和癌胚抗原125是腋窝淋巴结转移的独立危险因素。受试者操作特征曲线中泛免疫炎症值的曲线下面积为0.634,最佳临界值为110.37。系统炎症反应指数的曲线下面积为0.639,最佳临界值为0.554。结论 泛免疫炎症值和系统炎症反应指数与浸润性乳腺癌腋窝淋巴结转移相关,可以作为乳腺癌腋窝淋巴结转移的潜在预测指标。

低剂量CT联合外周血循环肿瘤细胞在肺癌早期诊断中的价值研究

目的 探究低剂量CT联合外周血循环肿瘤细胞(CTC)在肺癌早期诊断中的价值。方法 选取2019年12月~2022年12月期间本院收治的75例早期肺癌患者,作为肺癌组,同期选取于本院进行治疗的59例肺部良性病变患者为对照组,收集两组患者的临床资料。所有患者均进行低剂量CT扫描,并检测CTC水平,Logistic回归分析明确影响肺癌发生的因素,根据受试者工作特征(ROC)曲线分析低剂量CT与CTC检测对肺癌早期诊断的预测价值。结果 肺癌组有分叶征、毛刺征及胸膜凹陷征人数均高于对照组(P<0.05);肺癌组有吸烟史、CTC阳性人数均高于对照(P<0.05);经Logistic回归分析,有吸烟史、毛刺征、胸膜凹陷征及CTC阳性是影响肺癌发生的独立危险因素(P<0.05);经RDC分析显示,分叶征诊断肺癌早期的AUC值为0.747,95%CI为0.664~0.818;胸膜凹陷征的AUC值为0.789,95%CI为0.710~0.854,CTC预测的AUC值为0.840,95%CI为0.767-0.898,三者联合预测的AUC值为0.878,95%CI为0.811~0.928。结论 低剂量CT表现中分叶征、胸膜凹陷征及CTC对于肺癌早期诊断均有一定的参考价值,三者联合用于肺癌的早期诊断具有更高的价值。

支气管肺泡灌洗液4种新型肿瘤标志物检测对周围型肺癌的诊断价值

目的探讨支气管肺泡灌洗液(BALF)和血清中4种新型肿瘤标志物热休克蛋白90α(HSP90α)、谷胱甘肽S转移酶P1(GSTP1)、泛素特异性肽酶8(USP8)、几丁质酶3样蛋白1(CHI3L1)在周围型肺癌诊断中的临床价值。方法采用酶联免疫吸附法检测100例周围型肺癌住院患者及50例肺部良性疾病患者BALF和血清中HSP90α、GSTP1、USP8、CHI3L1的浓度。分析4种肿瘤标志物含量与不同细胞类型、患者年龄、肺癌分期之间的相关性,以及对周围型肺癌的诊断敏感性和特异性。结果肺癌患者BALF中HSP90α平均浓度显著高于肺部良性疾病显著(P<0.05),诊断敏感性为77.0%,特异性为82.0%;肺癌患者血清中HSP90α平均浓度与肺部良性疾病患者比较差异无统计学意义(P>0.05)。肺癌患者BALF中CHI3L1平均浓度显著高于肺部良性疾病显著(P<0.05),诊断敏感性为72.0%,特异性为80.0%;肺癌患者血清中CHI3L1平均浓度与肺部良性疾病患者比较差异无统计学意义(P>0.05)。小结节肺癌(原发病灶≤1cm)患者BALF中HSP90α及CHI3L1平均浓度与肺部良性疾病患者比较差异无统计学意义(P>0.05)。肺癌患者BALF及血清中USP8、GSTP1平均浓度与肺部良性疾病患者比较差异无统计学意义(P>0.05)。肺癌患者BALF及血清中4种肿瘤标志物浓度与年龄、肺癌分型(腺癌或鳞癌)、肺癌分期(Ⅰ-Ⅳ期)等因素无相关性;CHI3L1在肺癌患者BALF中的浓度与原发灶直径有一定相关性(P<0.05),Pearson相关系数为0.203;其他3种肺癌标志物在BALF、血清中的浓度与肿瘤原发灶直径无相关性。结论检测BALF中HSP90α及CHI3L1浓度对周围型肺癌的诊断有一定价值,且优于血清肿瘤标志物。

粪便隐血试验联合肿瘤标志物检测在结直肠癌中的临床应用价值

目的:分析粪便隐血试验与肿瘤标志物联合检测在结直肠癌中的应用价值,以提高结直肠癌的早期诊断水平。方法:选取医院收治的120例结直肠癌患者,将其纳入观察组,另选同期入院的50例结肠良性增生患者,将其纳入对照组。以术后病理检测作为金标准,分析粪便隐血试验、肿瘤标志物检测及联合检测的检出率,比较两组血清中癌胚抗原(CEA)、碳水化合物抗原50(CA50)、CA199以及CA724含量及相关性,分析单项检测与联合检测的灵敏度、特异度。结果:联合检测的检出率明显高于粪便隐血试验和肿瘤标志物单项检测,差异有统计学意义(x^2=9.351,x^2=5.400;P<0.05);血清肿瘤标志物CEA、CA50、CA199和CA724含量比较,观察组均高于对照组,差异有统计学意义(t=32.824,t=30.561,t=39.960,t=42.717;P<0.001);CEA与CA50、CA199和CA724呈正相关(r=0.756,r=0.618,r=0.624;P<0.001);CA50与CA199、CA724呈正相关(r=0.705,r=0.683;P<0.001);CA199与CA724呈正相关(r=0.655,P<0.001)。早期患者(Duke分期Ⅰ期+Ⅱ期)血清肿瘤标志物(CEA、CA50、CA199和CA724)含量均低于晚期患者(Duke分期Ⅲ期+Ⅳ期),差异有统计学意义(t=52.160,t=26.711,t=33.525,t=45.691;P<0.001)。三种检测方法的灵敏度比较,联合检测均高于粪便隐血试验和肿瘤标志物两种单项检测,差异有统计学意义(x^2=9.720,x^2=5.653;P<0.001);特异度比较,差异无显著性。结论:对结直肠癌患者进行粪便隐血试验、肿瘤标志物联合检测,可显著提高检出率,利于早期诊断、早期治疗结直肠癌,具有临床应用价值。

血清NSE表达水平对肺癌的诊断及治疗价值

目的:探讨血清肿瘤标志物神经元特异性烯醇化酶(NSE)对肺癌的诊断、评估化疗敏感性及病情监测的临床价值。方法:采用酶联免疫分析方法检测96例肺癌患者、60例肺部良性疾病患者和60例健康对照组血清NSE水平。结果:肺癌患者血清NSE水平显著高于肺部良性疾病患者及健康人(P<0.001),其中小细胞肺癌(SCLC)患者NSE水平显著高于肺腺癌及肺鳞癌(P<0.001)。SCLC中扩展性病变血清NSE水平明显高于局限性病变,而非小细胞肺癌(NSCLC)组血清NSE水平同NSCLC临床分期无关联性(P>0.05)。NSCLC组和SCLC组NSE阳性者肺癌近期化疗有效率(66.67%和87.10%)高于NSE阴性者(33.33%和40.00%)(P<0.05)。结论:血清NSE是一种有效的肺癌肿瘤标志物。

Cytokeratin和CD133在肺腺癌患者外周血中的联合检测及临床病理分析

目的联合检测肺腺癌患者外周血中细胞角蛋白(cytokeratin,CK,肺腺癌循环肿瘤细胞阳性)和CD133基因(肺癌干细胞标志物)的表达,探讨二者在评估肺腺癌预后的临床价值。方法选取2014年6月至2016年6月昆明总医院心胸外科和宣威市第一人民医院心胸外科的178例未化疗的肺腺癌手术患者,中位年龄59岁,其中男性78例,女性100例。收集患者术前外周血标本10 m L,细胞块法和CK(免疫细胞化学法)用于检测CTC,PCR法用于检测CD133表达。免疫组化法检测肺腺癌组织中CK、Vimentin(Vim)、TTF-1、Ki-67、CD133的表达,并分析与外周血CK和CD133表达的关系。根据外周血CK和CD133的检测结果,将病例分为CK/CD133双阳性组和非双阳性组,统计学分析两组间临床病理因素的差异。结果 178例肺腺癌患者外周血CTC(CK阳性)的检出率为48.3%(86/178),与癌组织中Ki-67、Vim表达显著正相关(P<0.05);外周血的CD133阳性表达率为66.9%(119/178),与癌组织Vim、CD133表达显著正相关(P<0.05);外周血CK/CD133双阳组53例(29.8%),双阳组淋巴结转移率显著增高,肺腺癌组织学分化级别显著降低,临床分期显著提高,转移率显著增高(P<0.05)。结论肺腺癌患者外周血中CK与CD133双阳性表达提示外周血存在干性特征的循环肿瘤细胞,表明预后不良,联合检测CK与CD133可用于肺腺癌患者预后监测和指导治疗。

RT-PCR寻找大肠癌患者外周血早期分子标记物的研究

目的:探求大肠癌患者早期诊断的外周血分子标记物,为大肠癌临床筛查提供早期、可靠、简便易行的有效方法．方法:采用RT-PCR检测28例大肠癌、8例腺瘤中重度不典型增生、18例腺瘤轻度不典型增生、11例炎性息肉患者和10例正常对照者的外周血中CK-20,GST-π,hTERT,survivin及 skp2的mRNA表达情况．结果:大肠癌、腺瘤中重度不典型增生、腺瘤轻度不典型增生、炎性息肉组和正常对照组hTERT mRNA表达的阳性率分别为 82．1％(23/28)、87．5％(7/8)、27．8％(5/11)、 9．1％(1/11)、10％(1/10),大肠癌组及腺瘤中重度不典型增生组与其他各组之间差别显著 (P<0．05);survivin mRNA在大肠癌、腺瘤中重度不典型增生组、腺瘤轻度不典型增生组的阳性率分别是64．2％(18/28)、50%(4/8)、 11．1％(2/18),炎性息肉组及正常组未见表达, 大肠癌组与腺瘤中重度不典型增生组无差别, 与腺瘤轻度不典型增生组、炎性息肉及正常组之间差别显著(P<0．05);而CK-20,GST-π, skp2 mRNA在各组之间表达无统计学意义(均 P>0．05)．结论:RT-PCR检测大肠癌患者外周血hTERT, survivin mRNA的表达对大肠癌的早期诊断有意义,可望成为早期诊断的分子标记物．

非小细胞肺癌患者血清多项肿瘤标志联合检测的临床意义

目的：评价癌胚抗原（CEA）、鳞状细胞癌相关抗原（SCC-Ag）、细胞角蛋白21-1片段（CYFRA21-1）、糖类抗原125（CA125）、糖类抗原153（CA153）和神经元特异性烯醇华酶（NSE）等6项标志联合检测,在非小细胞肺癌（non-small cell lung cancer,NSCLC）的临床诊断、预后及评价疗效等方面的临床意义。方法：收集284例NSCLC患者的临床资料及肿瘤标志水平,评价标志水平与病情的关系。统计学分析采用SPSS10.0软件,用Kaplan-Merier法计算生存率和无肿瘤生存率,用Log-rank法进行差异检验,对单因素分析中P〈0.3的预后因素使用Cox比例风险回归进行多因素分析。结果：肿瘤标志CEA的总阳性率为42.6%,CYFRA21-1为54.2%,SCC为12.6%,CA125为51.8%,CA153为39.4%,NSE为16.5%。6项标志联合检查的总阳性率为80.3%。CEA、CA153阳性患者的化疗疗效较差,而NSE阳性患者的化疗疗效较好。出现转移或病情进展的患者中,73.1%出现阴性标志和（或）经治疗已转为阴性的标志转为阳性。全组患者的中位无病生存期为12.98（2-22）个月,中位生存期为17.69（6-22）个月。结论：CEA、SCC-Ag、CYFRA21-1、CA125、CA153和NSE等6项标志在NSCLC患者中有较高的阳性率。多项标志联合检测的阳性率远高于任一标志单独检测的阳性率。

参芪扶正注射液联合最佳支持治疗对中晚期非小细胞肺癌患者外周血miR221、肿瘤标志物及生存质量的影响

目的探讨参芪扶正注射液联合最佳支持治疗对中晚期非小细胞肺癌(NSCLC)患者外周血miR221、肿瘤标志物及生存质量的影响。方法将94例中晚期非小细胞肺癌患者随机分为对照组与研究组各47例。对照组给予最佳支持治疗,研究组在对照组治疗基础上联合参芪扶正注射液治疗,2组均持续治疗4周。统计2组治疗前后中医证候积分,检测2组治疗前后外周血miR221表达水平、血清肿瘤标志物水平,评价2组治疗前后肺癌治疗功能评估量表(FACT-L)评分。结果治疗后,2组中医证候积分及研究组外周血miR221表达水平及血清癌胚抗原(CEA)、糖类抗原125(CA125)、细胞角蛋白19片段抗原(CYFRA21-1)、神经元特异性烯醇化酶(NSE)水平均较治疗前显著降低(P均<0.05),且研究组各指标均显著低于对照组(P均<0.05);研究组FACT-L评分显著高于对照组(P<0.05)。结论参芪扶正注射液联合最佳支持治疗可减轻中晚期非小细胞肺癌患者临床症状,下调外周血miR221及肿瘤标志物水平,提高生存质量。

胃癌患者外周血和肿瘤组织中LIM域特有蛋白1的表达及其临床意义

目的探讨胃癌患者外周血和肿瘤组织中LIM域特有蛋白1(LMO1)、基质金属蛋白酶(MMP)9、上皮型钙黏素(E-cadherin)蛋白的表达及其临床意义。方法选取经病理学检查确诊的150例胃癌患者(研究组),以及年龄和性别相匹配的50名行健康体格检查者(对照组)。取肿瘤和癌旁组织石蜡标本经免疫组织化学染色检测肿瘤组织LMO1、MMP-9、E-cadherin蛋白的表达情况,采用ELISA法测定研究组术前、术后1个月和对照组的外周血中LMO1、MMP-9、E-cadherin蛋白表达量。结果研究组胃癌组织中LMO1、MMP-9的表达阳性率显著高于癌旁正常组织(P值均<0.01),E-cadherin表达阳性率显著低于癌旁正常组织(P<0.01)。研究组术前外周血中LMO1、MMP-9水平显著高于同组术后1个月和对照组(P值均<0.05),E-cadherin水平显著低于同组术后1个月和对照组(P值均<0.05);而研究组术后1个月上述各项指标与对照组间的差异均无统计学意义(P值均>0.05)。胃癌组织LMO1蛋白表达与淋巴结转移有关(χ~2=4.894,P<0.05)。研究组胃癌组织与外周血中LMO1表达呈正相关(r=0.351 2,P<0.001)。研究组术前外周血LMO1与MMP-9呈正相关(r=0.273 4,P<0.001),与E-cadherin呈负相关(r=-0.186 6,P=0.022)。结论监测外周血LMO1可能对反映胃癌患者的疾病状态有帮助。

血清NKX2-1蛋白在原发性肺癌患者中的诊断价值

目的:探讨血清中NKX2-1(NKX同源框-1)蛋白在原发性肺癌诊断中的临床价值。方法:2009年5月至2010年12月,检测以肺部肿块初次就诊的61例原发性肺癌患者(肺癌组)血清NKX2-1和癌胚抗原(CEA)蛋白的表达,并与49例健康成年人(正常对照组)比较,验证NKX2-1蛋白诊断肺癌的准确性,分析NKX2-1在原发性肺癌中的诊断价值。结果:肺癌组血清NKX2-1蛋白表达(1.4206±0.1257)ng/ml高于正常对照组(0.7646±0.0734)ng/ml,两者比较差异有统计学意义(P<0.01);经ROC分析显示:NKX2-1对原发性肺癌有较好的诊断准确性(曲线下面积为0.859);Kappa验证NKX2-1蛋白(Kappa值为0.586)对原发性肺癌的诊断一致性高于CEA(Kappa值为0.396),而且NKX2-1结合CEA蛋白可提高肺癌诊断的准确性(Kappa值为0.704;灵敏度及特异度分别为83.6%和87.0%)。结论:血清NKX2-1蛋白是诊断原发性肺癌较为敏感和特异的指标;NKX2-1与CEA结合可提高原发性肺癌诊断的准确性。

外周血microRNA-23b作为胃癌筛查分子标志物的价值和应用研究

目的观察和分析外周血microRNA-23b作为胃癌筛查分子标志物的应用价值。方法选取100例接受胃镜病理活检者作为研究对象,根据检查结果将其分为三组,确诊为胃癌者列为胃癌组,共纳入46例;确诊为胃癌前病变者列为癌前病变组,共纳入28例;胃粘膜检查结果基本正常者列为对照组,共纳入26例。应用定量real time PCR检测技术对三组研究对象外周血样本中的miRNA-23b表达水平进行检测和比较。结果对照组研究对象的外周血样本的Log2△Ct值显著高于癌前病变组(P<0.05),而且癌前病变组的Log2△Ct值显著高于胃癌组(P<0.05);胃癌组、癌前病变组和对照组研究对象外周血样本中的miRNA-23b表达阳性率分别为71.7%、32.1%和3.8%,胃癌组的阳性率显著高于癌前病变组(P<0.05),癌前病变组显著高于对照组(P<0.05)。与胃镜活检结果对比,其阳性预测值为76.7%,阴性预测值为77.2%。结论胃癌患者外周血中miRNA-23b表达水平可反映患者病情的进展程度,且其诊断效率较高,有望成为用于胃癌早期筛查的新型分子标志物。

参芪扶正注射液联合化疗对乳腺癌患者外周血象、免疫功能及肿瘤标志物的影响

目的:探讨参芪扶正注射液与化疗联合应用对乳腺癌患者外周血象、免疫功能及肿瘤标志物的影响。方法:选取2017年1月～2017年12月于我院行乳腺癌改良根治术的92例乳腺癌患者,随机分为观察组(n=46例)和对照组(n=46例),对照组患者于术后2周开始化疗,观察组在对照组的基础上给予参芪扶正注射液,检测并比较两组患者的白细胞、血小板、血红蛋白、T细胞亚群、癌胚抗原(CEA)、癌抗原153(CA153)、糖类抗原125(CA125)水平。结果:治疗前,两组患者的白细胞、血小板、血红蛋白均无统计学差异(P>0.05);治疗后,两组白细胞、血小板、血红蛋白水平均比治疗前降低,且对照组较观察组降低更明显,差异均有统计学意义(P<0.05)。两组治疗前的CD3^+、CD4^+、CD8^+、CD4^+/CD8^+水平均无统计学差异(P>0.05);治疗后,观察组的CD3^+、CD4^+、CD4^+/CD8^+较治疗前的水平明显升高,较同期对照组亦明显升高,差异均有统计学意义(P<0.05)。治疗前,两组CEA、CA153、CA125均无统计学差异(P>0.05);治疗后,两组CEA、CA153、CA125水平均较治疗前明显降低,且观察组较对照组降低更明显,差异均有统计学意义(P<0.05)。结论:参芪扶正注射液联合化疗可显著改善乳腺癌患者的外周血象及免疫功能,并明显降低体内肿瘤标志物水平。

Midkine mRNA在食管鳞癌患者外周血中的表达及其临床意义

目的:探讨靶基因中期因子(MK)在食管鳞癌患者外周血中的表达及其与食管鳞癌生物学行为的关系。方法:采用巢式RT-PCR方法检测54例食管鳞癌患者外周血的MK mRNA。10例正常健康志愿者外周血为阴性对照,11例食管鳞癌肿瘤组织为阳性对照。结果:54例食管鳞癌患者外周血MK mRNA阳性率为61.11%(33/54),并与食管鳞癌患者淋巴结转移有显著相关性(P<0.05),而健康成人外周血则无一例出现阳性。结论:应用巢式RT-PCR方法检测食管癌患者外周血中的MKmRNA具有较高的敏感性和特异性,它有望成为判断食管鳞癌恶性程度、转移、复发和监测疗效的客观指标。

循环血中肿瘤标志物检测的进展及其临床意义

肿瘤标志物 (tumormarker)是指由肿瘤组织产生的存在于肿瘤组织 ,或分泌至血液或其他体液 ,或因肿瘤组织刺激 ,由宿主细胞产生而含量明显高于正常参考值的一类物质 .随着医学的发展 ,近年来出现了许多通过循环血中的肿瘤标志物及其活性来诊断恶性肿瘤的新方法 ,如 :端粒酶活性、性激素受体、特异性mRNA、谷胱甘肽转移酶 μ基因、rDNA转录活性、血粘附分子和肿瘤相关基因及其表达产物等 .