Objective: Multidetector-row computed tomography(MDCT) and serum tumor biomarkers are commonly used to evaluate the preoperative lymph node metastasis and the clinical staging of gastric cancer(GC). This study intends...Objective: Multidetector-row computed tomography(MDCT) and serum tumor biomarkers are commonly used to evaluate the preoperative lymph node metastasis and the clinical staging of gastric cancer(GC). This study intends to evaluate the clinical predictive value of MDCT and serum tumor biomarkers in lymph node metastasis of GC.Methods: The clinicopathologic data of 445 GC patients who underwent radical gastrectomy were retrospectively analyzed to evaluate the diagnostic value of MDCT and serum tumor biomarkers in lymph node metastatic staging of GC before surgery.Results: With the multinomial logistic regression analysis, the independent relative factors of lymph node metastasis of GC were identified as tumor size, depth of tumor invasion, vessel invasion, vascular embolus, and soft tissue invasion. The optimal critical value of the short diameter of lymph nodes detected by MDCT scanning for evaluation of preoperative lymph node metastasis was 6.0 mm, with 75.7% as predictive accuracy of lymph node metastasis compared to the postoperative pathological results of GC patients. In addition, the critical value of the short diameter of lymph nodes combined with serum tumor biomarkers [including carbohydrate antigen(CA)-724 and CA-199] could show an enhancement of predictive sensitivity of lymph node metastasis(up to 89.3%) before surgery.Conclusions: MDCT combined with serum tumor biomarkers should be adopted to improve preoperative sensitivity and accuracy of lymph node metastasis for GC patients.展开更多
AIM To investigate the value of multiparameter joint analysis in the early diagnosis of gastric cancer(GC) in clinical practice.METHODS Concentrations of CEA, CA724 and three kinds of cytokines(TNF-α, IL-6 and IL-8) ...AIM To investigate the value of multiparameter joint analysis in the early diagnosis of gastric cancer(GC) in clinical practice.METHODS Concentrations of CEA, CA724 and three kinds of cytokines(TNF-α, IL-6 and IL-8) in 176 GC patients, 117 atypical hyperplasia patients, and 204 healthy control individuals were used for building the diagnostic model, then 58 GC patients, 41 atypical hyperplasia patients, and 66 healthy control individuals were enrolled independently. The joints of the indicators were analyzed by binary logistic regression analysis method.RESULTS For discriminating the healthy control group and the GC group, IL-6 had the best diagnostic value, and the area under curve(AUC) of joint analysis was 0.95(0.93-0.97). For the early stage and advanced stage GC, the AUC were 0.95(0.92-0.98) and 0.95(0.92-0.97). For discriminating the atypical hyperplasia group and GC group, CA724 had the best diagnostic value, and the AUC of joint analysis was 0.97(0.95-0.99). For the early stage and advanced stage GC groups, the AUC were 0.98(0.96-0.99) and 0.96(0.94-0.98). After evaluation, for discriminating the GC, early stage GC and advanced cancer group from the healthy control group, the diagnostic sensitivity was 89.66%, 84.21% and 92.31%, respectively, and the specificity was 92.42%, 90.91% and 90.91%. For discriminating the GC, early stage GC and advanced cancer groups from the atypical hyperplasia group, the diagnostic sensitivity was 87.93%, 78.95% and 92.31%, respectively, and the specificity was 87.80%, 85.37% and 90.24%.CONCLUSION We have built a diagnostic model including CEA, CA724, IL-6, IL-8, and TNF-α. It may provide potential assistance as a screening method for the early detection of GC.展开更多
AIM To find an accurate and simple predictor for postoperative short-term complications after gastrectomy. METHODS Two hundred and twenty-three patients undergoing gastric cancer resection between October 1,2015 and S...AIM To find an accurate and simple predictor for postoperative short-term complications after gastrectomy. METHODS Two hundred and twenty-three patients undergoing gastric cancer resection between October 1,2015 and September 30,2016 were enrolled in this study. Univariate and multivariate analyses were used toidentify risk factors for complications after gastrectomy. The cutoff values and diagnostic accuracy were examined by receiver operating characteristic curves.RESULTS Sixty-two(27.8%) patients had short-term complications after gastric cancer resection. The postoperative decrease in serum albumin(?ALB) was an independent risk factor for complications(OR = 17.957,95%CI: 6.073-53.095,P < 0.001). The cutoff value was 14.0% and the area under the curve was higher than that of C-reactive protein on postoperative day 3(area under the curve: 0.806 vs 0.709). Patients with ?ALB ≥ 14.0% were more likely to have short-term complications after gastrectomy(46.7% vs 5.0%,P < 0.001),prolonged hospital stay(17.2 ± 10.8 d vs 14.1 ± 4.2 d,P = 0.007) and higher comprehensive complication index(P < 0.001) than those with ?ALB < 14.0%.CONCLUSION Postoperative ?ALB with a cutoff of 14.0% can be used to recognize patients who have high risk of short-term complications following gastric cancer resection.展开更多
AIM: To investigate catalase (KatA) and alkyl hydroperoxide reductase (AhpC) antibodies of Helicobacter pylori as biomarkers for gastric cancer (GC). METHODS: This study included 232 cases and 264 controls. Recombinan...AIM: To investigate catalase (KatA) and alkyl hydroperoxide reductase (AhpC) antibodies of Helicobacter pylori as biomarkers for gastric cancer (GC). METHODS: This study included 232 cases and 264 controls. Recombinant KatA and AhpC proteins were constructed and the levels of antibodies were tested by indirect enzyme-linked immunosorbent assay (ELISA). Logistic regression was applied to analyze the relationships between KatA, AhpC and GC. The chi(2) trend test was used to evaluate the dose-response relationships between serum KatA and AhpC antibody levels and GC. Receiver operating characteristic (ROC) curve was used to evaluate the screening accuracy of KatA and AhpC as biomarkers. Combined analysis was used to observe screening accuracy of predictors for GC. RESULTS: In all subjects, the association between KatA and AhpC and GC risk was significant (P < 0.001) with odds ratio (OR) = 12.84 (95%CI: 7.79-21.15) and OR = 2.4 (95%CI: 1.55-3.73), respectively. KatA and AhpC antibody levels were strongly related to GC risk with a dose-dependent effect (P for trend < 0.001). The area under the ROC (AUC) for KatA was 0.806, providing a sensitivity of 66.81% and specificity of 86.36%; and the AUC for AhpC was 0.615, with a sensitivity of 75.65% and specificity of 45.49%. The AUC was 0.906 for KatA and flagella protein A (FlaA) combined analysis. CONCLUSION: Serum KatA and AhpC antibodies are associated with GC risk and KatA may serve as a biomarker for GC. KatA/FlaA combined analysis improved screening accuracy.展开更多
<strong>Objective: </strong>To investigate the concentration and clinical significance of serum ferritin (SF) in patients diagnosed with advanced gastric cancer before and after treatment. <strong>Me...<strong>Objective: </strong>To investigate the concentration and clinical significance of serum ferritin (SF) in patients diagnosed with advanced gastric cancer before and after treatment. <strong>Methods:</strong> Forty patients with advanced gastric cancer diagnosed by cytology or pathology in our hospital were selected, including 25 males and 15 females, aged from 48 to 85 years, and the median age was 61.0 years. 40 healthy volunteers matched with age and education were selected as the control group. In order to study the changes of SF level in the treatment of advanced gastric cancer, we divided the patients into effective group (efficacy evaluation as partial remission or complete remission), ineffective group (efficacy evaluation as no remission) and recurrence group according to the efficacy after treatment. Then the difference of SF level between different groups and the relationship between SF level and curative effect were analyzed. There was no significant difference in gender and age among all groups. <strong>Results</strong>: The SF levels in the newly diagnosed group, stage III patient group and stage IV patient group were significantly higher than those in the control group. The level of SF in stage IV patients was significantly higher than that in stage III patients. There were significant differences in SF level between the effective treatment group, the newly diagnosed group and the ineffective treatment group, but there was no significant difference in SF level between the newly diagnosed group and the ineffective treatment group. <strong>Conclusion: </strong>SF level has a certain value in the auxiliary diagnosis of gastric cancer, and it also has a certain guiding significance for the evaluation of curative effect and prognosis after treatment.展开更多
目的探讨莫沙必利联合奥美拉唑镁对反流性食管炎患者胃分泌功能、血清人生长素释放多肽(Ghrelin)、瘦素(Leptin)水平的影响作用。方法回顾性选取2022年2月~2023年2月泸县人民医院诊治的180例反流性食管炎患者,根据治疗方案分为奥美拉唑...目的探讨莫沙必利联合奥美拉唑镁对反流性食管炎患者胃分泌功能、血清人生长素释放多肽(Ghrelin)、瘦素(Leptin)水平的影响作用。方法回顾性选取2022年2月~2023年2月泸县人民医院诊治的180例反流性食管炎患者,根据治疗方案分为奥美拉唑镁组(n=86)和联合用药组(n=94)。奥美拉唑镁组使用奥美拉唑镁肠溶片进行治疗,联合用药组在奥美拉唑镁组的基础上联合枸橼酸莫沙必利片进行治疗。比较两组患者的临床疗效;比较两组患者胃分泌功能[胃泌素(GAS)、胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)、胃动素(MOT)、血管活性肠肽(VIP)]变化情况;比较两组患者血清Ghrelin和Leptin水平;比较两组患者治疗期间不良反应情况。结果联合用药组的总有效率(94.68%)显著高于奥美拉唑镁组的总有效率(81.40%),差异有统计学意义(χ^(2)=7.692,P<0.05)。治疗后,两组患者PGⅡ、VIP、Leptin水平显著低于治疗前,且联合用药组PGⅡ、VIP、Leptin水平明显低于奥美拉唑镁组[(14.85±1.73)μg L vs.(21.51±2.11)μg L、(13.41±1.27)pg ml vs.(20.45±1.15)pg ml、(8.11±1.13)pg ml vs.(16.52±2.73)pg ml],差异有统计学意义(t=23.236、38.857、27.416,P<0.05)。治疗后,两组患者GAS、PGⅠ、MOT、Ghrelin水平明显高于治疗前,且联合用药组GAS、PGⅠ、MOT、Ghrelin水平明显高于奥美拉唑镁组[(96.85±5.81)pg ml vs.(78.76±4.87)pg ml、(132.71±11.26)μg L vs.(120.42±10.84)μg L、(280.24±21.67)pg ml vs.(200.56±17.62)pg ml、(26.46±3.41)pg ml vs.(19.64±3.85)pg ml],差异有统计学意义(t=22.527、7.446、26.915、12.602,P<0.05)。治疗期间两组不良反应差异无统计学意义(χ^(2)=1.738,P>0.05)。结论莫沙必利联合奥美拉唑镁治疗反流性食管炎患者临床效果显著,安全性比较好,可以有效改善胃分泌功能,调节血清Ghrelin、Leptin水平平衡,进而改善反流现象,具有良好的临床应用价值。展开更多
The high incidence of gastric cancer (GC) and its consequent mortality rate severely threaten human health. GC is frequently not diagnosed until a relatively advanced stage. Surgery is the only potentially curative tr...The high incidence of gastric cancer (GC) and its consequent mortality rate severely threaten human health. GC is frequently not diagnosed until a relatively advanced stage. Surgery is the only potentially curative treatment. Thus, early screening and diagnosis are critical for improving prognoses in patients with GC. Gastroscopy with biopsy is an appropriate method capable of aiding the diagnosis of specific early GC tumor types; however, the stress caused by this method together with it being excessively expensive makes it difficult to use it as a routine method for screening for GC on a population basis. The currently used tumor marker assays for detecting GC are simple and rapid, but their use is limited by their low sensitivity and specificity. In recent years, several markers have been identified and tested for their clinical relevance in the management of GC. Here, we review the serum-based tumor markers for GC and their clinical significance, focusing on discoveries from microarray/proteomics research. We also review tissue-based GC tumor markers and their clinical application, focusing on discoveries from immunohistochemical research. This review provides a brief description of various tumor markers for the purposes of diagnosis, prognosis and therapeutics, and we include markers already in clinical practice and various forthcoming biomarkers.展开更多
基金supported in part by grants from the Programs of National Natural Science Foundation of China (No. 81572372)National Key Research and Development Program “major chronic non-infectious disease research” (No. 2016YFC1303202)National Key Research and Development Program “precision medicine research” (No. 2017YFC0908304)
文摘Objective: Multidetector-row computed tomography(MDCT) and serum tumor biomarkers are commonly used to evaluate the preoperative lymph node metastasis and the clinical staging of gastric cancer(GC). This study intends to evaluate the clinical predictive value of MDCT and serum tumor biomarkers in lymph node metastasis of GC.Methods: The clinicopathologic data of 445 GC patients who underwent radical gastrectomy were retrospectively analyzed to evaluate the diagnostic value of MDCT and serum tumor biomarkers in lymph node metastatic staging of GC before surgery.Results: With the multinomial logistic regression analysis, the independent relative factors of lymph node metastasis of GC were identified as tumor size, depth of tumor invasion, vessel invasion, vascular embolus, and soft tissue invasion. The optimal critical value of the short diameter of lymph nodes detected by MDCT scanning for evaluation of preoperative lymph node metastasis was 6.0 mm, with 75.7% as predictive accuracy of lymph node metastasis compared to the postoperative pathological results of GC patients. In addition, the critical value of the short diameter of lymph nodes combined with serum tumor biomarkers [including carbohydrate antigen(CA)-724 and CA-199] could show an enhancement of predictive sensitivity of lymph node metastasis(up to 89.3%) before surgery.Conclusions: MDCT combined with serum tumor biomarkers should be adopted to improve preoperative sensitivity and accuracy of lymph node metastasis for GC patients.
基金Supported by Henan Province science and Technology Research Projects,No.162102310041National Key R&D Program of China,No.2016YFC0106604National Natural Science Foundation of China,No.81502591
文摘AIM To investigate the value of multiparameter joint analysis in the early diagnosis of gastric cancer(GC) in clinical practice.METHODS Concentrations of CEA, CA724 and three kinds of cytokines(TNF-α, IL-6 and IL-8) in 176 GC patients, 117 atypical hyperplasia patients, and 204 healthy control individuals were used for building the diagnostic model, then 58 GC patients, 41 atypical hyperplasia patients, and 66 healthy control individuals were enrolled independently. The joints of the indicators were analyzed by binary logistic regression analysis method.RESULTS For discriminating the healthy control group and the GC group, IL-6 had the best diagnostic value, and the area under curve(AUC) of joint analysis was 0.95(0.93-0.97). For the early stage and advanced stage GC, the AUC were 0.95(0.92-0.98) and 0.95(0.92-0.97). For discriminating the atypical hyperplasia group and GC group, CA724 had the best diagnostic value, and the AUC of joint analysis was 0.97(0.95-0.99). For the early stage and advanced stage GC groups, the AUC were 0.98(0.96-0.99) and 0.96(0.94-0.98). After evaluation, for discriminating the GC, early stage GC and advanced cancer group from the healthy control group, the diagnostic sensitivity was 89.66%, 84.21% and 92.31%, respectively, and the specificity was 92.42%, 90.91% and 90.91%. For discriminating the GC, early stage GC and advanced cancer groups from the atypical hyperplasia group, the diagnostic sensitivity was 87.93%, 78.95% and 92.31%, respectively, and the specificity was 87.80%, 85.37% and 90.24%.CONCLUSION We have built a diagnostic model including CEA, CA724, IL-6, IL-8, and TNF-α. It may provide potential assistance as a screening method for the early detection of GC.
基金Supported by the National Natural Science Foundation of China,No.81372364the State Key Program of Nanjing of China,No.ZKX14022
文摘AIM To find an accurate and simple predictor for postoperative short-term complications after gastrectomy. METHODS Two hundred and twenty-three patients undergoing gastric cancer resection between October 1,2015 and September 30,2016 were enrolled in this study. Univariate and multivariate analyses were used toidentify risk factors for complications after gastrectomy. The cutoff values and diagnostic accuracy were examined by receiver operating characteristic curves.RESULTS Sixty-two(27.8%) patients had short-term complications after gastric cancer resection. The postoperative decrease in serum albumin(?ALB) was an independent risk factor for complications(OR = 17.957,95%CI: 6.073-53.095,P < 0.001). The cutoff value was 14.0% and the area under the curve was higher than that of C-reactive protein on postoperative day 3(area under the curve: 0.806 vs 0.709). Patients with ?ALB ≥ 14.0% were more likely to have short-term complications after gastrectomy(46.7% vs 5.0%,P < 0.001),prolonged hospital stay(17.2 ± 10.8 d vs 14.1 ± 4.2 d,P = 0.007) and higher comprehensive complication index(P < 0.001) than those with ?ALB < 14.0%.CONCLUSION Postoperative ?ALB with a cutoff of 14.0% can be used to recognize patients who have high risk of short-term complications following gastric cancer resection.
基金Supported by the National Natural Science Foundation of China,No.81573219Heilongjiang Province Office of Education Foundation,No.12541288
文摘AIM: To investigate catalase (KatA) and alkyl hydroperoxide reductase (AhpC) antibodies of Helicobacter pylori as biomarkers for gastric cancer (GC). METHODS: This study included 232 cases and 264 controls. Recombinant KatA and AhpC proteins were constructed and the levels of antibodies were tested by indirect enzyme-linked immunosorbent assay (ELISA). Logistic regression was applied to analyze the relationships between KatA, AhpC and GC. The chi(2) trend test was used to evaluate the dose-response relationships between serum KatA and AhpC antibody levels and GC. Receiver operating characteristic (ROC) curve was used to evaluate the screening accuracy of KatA and AhpC as biomarkers. Combined analysis was used to observe screening accuracy of predictors for GC. RESULTS: In all subjects, the association between KatA and AhpC and GC risk was significant (P < 0.001) with odds ratio (OR) = 12.84 (95%CI: 7.79-21.15) and OR = 2.4 (95%CI: 1.55-3.73), respectively. KatA and AhpC antibody levels were strongly related to GC risk with a dose-dependent effect (P for trend < 0.001). The area under the ROC (AUC) for KatA was 0.806, providing a sensitivity of 66.81% and specificity of 86.36%; and the AUC for AhpC was 0.615, with a sensitivity of 75.65% and specificity of 45.49%. The AUC was 0.906 for KatA and flagella protein A (FlaA) combined analysis. CONCLUSION: Serum KatA and AhpC antibodies are associated with GC risk and KatA may serve as a biomarker for GC. KatA/FlaA combined analysis improved screening accuracy.
文摘<strong>Objective: </strong>To investigate the concentration and clinical significance of serum ferritin (SF) in patients diagnosed with advanced gastric cancer before and after treatment. <strong>Methods:</strong> Forty patients with advanced gastric cancer diagnosed by cytology or pathology in our hospital were selected, including 25 males and 15 females, aged from 48 to 85 years, and the median age was 61.0 years. 40 healthy volunteers matched with age and education were selected as the control group. In order to study the changes of SF level in the treatment of advanced gastric cancer, we divided the patients into effective group (efficacy evaluation as partial remission or complete remission), ineffective group (efficacy evaluation as no remission) and recurrence group according to the efficacy after treatment. Then the difference of SF level between different groups and the relationship between SF level and curative effect were analyzed. There was no significant difference in gender and age among all groups. <strong>Results</strong>: The SF levels in the newly diagnosed group, stage III patient group and stage IV patient group were significantly higher than those in the control group. The level of SF in stage IV patients was significantly higher than that in stage III patients. There were significant differences in SF level between the effective treatment group, the newly diagnosed group and the ineffective treatment group, but there was no significant difference in SF level between the newly diagnosed group and the ineffective treatment group. <strong>Conclusion: </strong>SF level has a certain value in the auxiliary diagnosis of gastric cancer, and it also has a certain guiding significance for the evaluation of curative effect and prognosis after treatment.
文摘目的探讨莫沙必利联合奥美拉唑镁对反流性食管炎患者胃分泌功能、血清人生长素释放多肽(Ghrelin)、瘦素(Leptin)水平的影响作用。方法回顾性选取2022年2月~2023年2月泸县人民医院诊治的180例反流性食管炎患者,根据治疗方案分为奥美拉唑镁组(n=86)和联合用药组(n=94)。奥美拉唑镁组使用奥美拉唑镁肠溶片进行治疗,联合用药组在奥美拉唑镁组的基础上联合枸橼酸莫沙必利片进行治疗。比较两组患者的临床疗效;比较两组患者胃分泌功能[胃泌素(GAS)、胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)、胃动素(MOT)、血管活性肠肽(VIP)]变化情况;比较两组患者血清Ghrelin和Leptin水平;比较两组患者治疗期间不良反应情况。结果联合用药组的总有效率(94.68%)显著高于奥美拉唑镁组的总有效率(81.40%),差异有统计学意义(χ^(2)=7.692,P<0.05)。治疗后,两组患者PGⅡ、VIP、Leptin水平显著低于治疗前,且联合用药组PGⅡ、VIP、Leptin水平明显低于奥美拉唑镁组[(14.85±1.73)μg L vs.(21.51±2.11)μg L、(13.41±1.27)pg ml vs.(20.45±1.15)pg ml、(8.11±1.13)pg ml vs.(16.52±2.73)pg ml],差异有统计学意义(t=23.236、38.857、27.416,P<0.05)。治疗后,两组患者GAS、PGⅠ、MOT、Ghrelin水平明显高于治疗前,且联合用药组GAS、PGⅠ、MOT、Ghrelin水平明显高于奥美拉唑镁组[(96.85±5.81)pg ml vs.(78.76±4.87)pg ml、(132.71±11.26)μg L vs.(120.42±10.84)μg L、(280.24±21.67)pg ml vs.(200.56±17.62)pg ml、(26.46±3.41)pg ml vs.(19.64±3.85)pg ml],差异有统计学意义(t=22.527、7.446、26.915、12.602,P<0.05)。治疗期间两组不良反应差异无统计学意义(χ^(2)=1.738,P>0.05)。结论莫沙必利联合奥美拉唑镁治疗反流性食管炎患者临床效果显著,安全性比较好,可以有效改善胃分泌功能,调节血清Ghrelin、Leptin水平平衡,进而改善反流现象,具有良好的临床应用价值。
基金Supported by Grants from Chang Gung Memorial Hospital,Taoyuan,Taiwan,No.CMRPF1C0151 and No.CMRPG6D0011
文摘The high incidence of gastric cancer (GC) and its consequent mortality rate severely threaten human health. GC is frequently not diagnosed until a relatively advanced stage. Surgery is the only potentially curative treatment. Thus, early screening and diagnosis are critical for improving prognoses in patients with GC. Gastroscopy with biopsy is an appropriate method capable of aiding the diagnosis of specific early GC tumor types; however, the stress caused by this method together with it being excessively expensive makes it difficult to use it as a routine method for screening for GC on a population basis. The currently used tumor marker assays for detecting GC are simple and rapid, but their use is limited by their low sensitivity and specificity. In recent years, several markers have been identified and tested for their clinical relevance in the management of GC. Here, we review the serum-based tumor markers for GC and their clinical significance, focusing on discoveries from microarray/proteomics research. We also review tissue-based GC tumor markers and their clinical application, focusing on discoveries from immunohistochemical research. This review provides a brief description of various tumor markers for the purposes of diagnosis, prognosis and therapeutics, and we include markers already in clinical practice and various forthcoming biomarkers.
