Serum Folate, MTHFR C677T Polymorphism and Esophageal Squamous Cell Carcinoma Risk

This study examined associations between MTHFR C677T polymorphism and serum folate concentrations with the risk of esophageal precancerous lesions （EPL） and esophageal squamous cell carcinoma （ESCC）. The highest quartile of serum folate concentration significantly decreased the risk of ESCC compared with the lowest quartile （0R=0.11; 95% CI, 0.04-0.33; P〈0.05）. MTHFR 677 C〉T polymorphism was associated with the risk of ESCC by using chi-square tests （P〈0.05）. For the CT genotype, the risk of ESCC significantly increased in study participants with low serum folate concentrations （〈26.92μg/L） compared with participants with high serum folate concentrations （〉26.92 μg/L） by using multinomial logistic regression models. The MTHFR genotype may further modify associations between serum folate concentrations and the risk of ESCC, but it was not significantly associated with the risk of EPL.

Combination of squamous cell carcinoma antigen immunocomplex and alpha-fetoprotein in mid-and long-term prediction of hepatocellular carcinoma among cirrhotic patients

BACKGROUND The combination of alpha-fetoprotein(AFP)and squamous cell carcinoma antigen immunocomplex(SCCA-IgM)have been proposed for its use in the screening of hepatocellular carcinoma(HCC).Current screening programs for all cirrhotic patients are controversial and a personalized screening is an unmet need in the precision medicine era.AIM To determine the role of the combination of SCCA-IgM and AFP in predicting mid-and long-term appearance of HCC.METHODS Two-hundred and three cirrhotic patients(Child A 74.9%,B 21.2%,C 3.9%)were followed-up prospectively every six months to screen HCC by ultrasound and AFP according to European Association for the Study of the Liver guidelines.The estimation cohort was recruited in Italy(30.5%;62/203)and validation cohort from Spain(69.5%;141/203).Patients underwent to evaluate SCCA-IgM by enzyme-linked immunosorbent assay(Hepa-IC,Xeptagen,Italy)and AFP levels at baseline.Patients were followed-up for 60 mo,being censored at the time of the appearance of HCC.RESULTS There were 10.8%and 23.1%of HCC development at two-and five-years followup.Patients with HCC showed higher levels of SCCA-IgM than those without it(425.72±568.33 AU/mL vs 195.93±188.40 AU/mL,P=0.009)during the fiveyear follow-up.In multivariate analysis,after adjusting by age,sex,aspartate transaminase and Child-Pugh,the following factors were independently associated with HCC:SCCA-IgM[Hazard ratio(HR)=1.001,95%CI:1.000-1.002;P=0.003],AFP(HR=1.028,95%CI:1.009-1.046;P=0.003)and creatinine(HR=1.56495%CI:1.151-2.124;P=0.004).The log-rank test of the combination resulted in 7.488(P=0.024)in estimation cohort and 11.061(P=0.004)in the validation cohort,and a 100%of correctly classified rate identifying a low-risk group in both cohorts in the two-year follow-up.CONCLUSION We have constructed a predictive model based on the combination of SCCA-IgM and AFP that provides a new HCC screening method,which could be followed by tailored HCC surveillance for individual patients,especially for those cirrhotic patients belonging to the subgroup identified as low-risk of HCC development.

Clinical applications of squamous cell carcinoma antigenimmunoglobulins M to monitor chronic hepatitis C

Hepatitis C virus(HCV) is the main cause of chronic liver disease and cirrhosis in Western countries. Over time, the majority of cirrhotic patients develop hepatocellular carcinoma(HCC), one of the most common fatal cancers worldwide- fourth for incidence rate. A high public health priority need is the development of biomarkers to screen for liver disease progression and for early diagnosis of HCC development, particularly in the high risk population represented by HCV-positive patients with cirrhosis. Several studies have shown that serological determination of a novel biomarker, squamous cell carcinoma antigen-immunoglobulins M(SCCA-Ig M), might be useful to identify patients with progressive liver disease. In the initial part of this review we summarize the main clinical studies that have investigated this new circulating biomarker on HCV-infected patients, providing evidence that in chronic hepatitis C SCCA-Ig M may be used to monitor progression of liver disease, and also to assess the virological response to antiviral treatment. In the last part of this review we address other, not less important, clinical applications of this biomarker in hepatology.

High expression of squamous cell carcinoma antigen in poorly differentiated adenocarcinoma of the stomach: A case report

BACKGROUND Squamous cell carcinoma antigen(SCCA)is regarded as a specific indicator of epithelial malignancies and is widely used in the diagnosis of squamous cell carcinoma(SCC).However,the expression of SCCA in gastric adenocarcinoma has not been studied in detail.CASE SUMMARY A 52-year-old man was admitted to our hospital for a 2.5 cm x 2.5 cm ulcer at the antrum-body junction with dull pain and fullness in the upper abdomen for 2 mo.His pre-surgery serological testing results showed 0.51 ng/mL SCCA(reference interval,<1.5 ng/mL)and 9.9 ng/mL carcinoembryonic antigen(reference range,<4.7 ng/mL).He underwent radical distal gastrectomy and Roux-en Y anastomosis and was diagnosed with poorly differentiated mucinous adenocarcinoma(Lauren classification:Diffuse)by pathological examination of the resected lesion.Immunohistochemistry showed that SCCA was highly expressed in the cytoplasm of cancer cells.After surgery,the patient received an S-1 adjuvant chemotherapy regimen for six cycles containing tegafur,gimeracil,and oteracil potassium.He showed no sign of recurrence or metastasis within 24-mo follow-up.CONCLUSION This is a frontal report of SCCA overexpression in poorly differentiated adenocarcinoma of the stomach.

High level of preoperative serum fibrinogen is a predictor of poor prognosis in patients with esophageal squamous cell carcinoma

Objective This study aimed to elucidate the association between the level of preoperative serum fibrinogen(PSF)and the prognosis of patients with esophageal squamous cell carcinoma(ESCC).Methods From January 2010 to December 2016,all patients diagnosed with ESCC who underwent surgery in Qingdao Municipal Hospital were analyzed retrospectively.Moreover,the fibrinogen levels of all patients were assessed before surgery,and hyperfibrinogenemia was diagnosed when the fibrinogen level was≥4.0 g/L.The impact of PSF on disease-free survival(DFS)and overall survival(OS)was analyzed using the log-rank method and Cox proportional hazards regression model.P value less than 0.05 was considered statistically significant.Results A total of 336 patients were finally analyzed,and approximately 102 patients(30.36%)were diagnosed with hyperfibrinogenemia before surgery.Hyperfibrinogenemia was associated with older age(≥70 years)(P=0.012),advanced pathological T stage(P=0.003),and lymph node involvement(P=0.024).Univariate analysis showed that patients with hyperfibrinogenemia had shorter DFS(1.96 years vs.3.64 years,P=0.001)and OS(2.27 years vs.4.15 years,P<0.001)than patients without hyperfibrinogenemia.Multivariate analysis confirmed that PSF was an independent factor affecting DFS(risk ratio[RR]:1.35,95%confidence interval[CI]:1.02-1.79,P=0.038)and OS(RR:1.37,95%CI:1.03-1.83,P=0.034)in patients with ESCC.Conclusion For patients with operable ESCC,hyperfibrinogenemia had poor prognosis.Moreover,PSF is an independent prognostic factor for operable ESCC.

Salivary and Serum IgA Evaluation of Patients with Oro-Facial Squamous Cell Carcinoma

Objective: To evaluate salivary and serum levels of Immunoglobulin A (IgA) in patients with oro-facial squamous cell carcinoma. Methods: This is a cross sectional study. Patients with oro-facial squamous cell carcinoma attending the Oral Pathology and Radiotherapy clinics of the University College Hospital, Ibadan, Nigeria were included. Seventy subjects comprising 22 patients with untreated OSCC, 18 patients with OSCC receiving treatment and 30 healthy, age and gender matched individuals were included. Serum and salivary samples from the participants were analysed for IgA levels using ELISA technique. Results: The mean value of serum IgA in OSCC patients receiving treatment was significantly lower compared with healthy controls (p = 0.03), while no significant difference was observed comparing untreated OSCC patients with treated and healthy controls. The salivary IgA levels did not show any significant difference between the three groups (p = 0.73). Also, there was no correlation between serum and salivary levels of IgA among the subjects. Conclusions: Serum IgA appeared to be better index than salivary IgA levels in monitoring response to treatment in patients with oro-facial carcinoma.

Impact of Preoperative Serum Tumor Markers in Patients with Lung Squamous Cell Carcinoma

Background: Several previous researchers have investigated the prognostic value of serum tumor markers, especially carcinoembryonic antigen (CEA). Only a limited number of studies reported the usefulness of serum tumor markers for lung squamous cell carcinoma (SQ). We aimed to examine the significance of serum tumor markers for lung SQ. Methods: Eighty-five lung SQ patients who underwent surgery and followed more than 5-year were included. The ratios of 5-year survivors to all patients in groups with several clinicopathologic factors, including tumor markers, were compared. We also compared the clinicopathologic factors between central type and peripheral type SQ. Results: The majority of patients were male gender and current/ former smokers. Age, pN status, cytokeratin-19 fragment (CYFRA 21-1), squamous cell carcinoma antigen (SCC), and comorbid interstitial pneumonia (IP) were associated with the ratio of 5-year survivors significantly. When patients were compared based on tumor location, high p-stage and CYFRA 21-1 were related to central type SQ. Conclusion: Both SCC and CYFRA 21-1 appeared to be useful prognostic markers for patients with lung SQ. Furthermore, CYFRA 21-1 was related to central type SQ.

Autoantibodies against MMP-7 as a novel diagnostic biomarker in esophageal squamous cell carcinoma

AIM: To evaluate the diagnostic values of serum autoantibodies against matrix metalloproteinase-7 (MMP-7) in patients with esophageal squamous cell carcinoma (ESCC). METHODS: The MMP-7 cDNA was cloned from ESCC tissues, and MMP-7 was expressed and purified from a prokaryotic system. MMP-7 autoantibodies were then measured in sera from 50 patients with primary ESCC and 58 risk-matched controls, using a reverse capture enzyme-linked immunosorbent assay (ELISA) in which autoantibodies to MMP-7 bound to the purified MMP-7 proteins. In addition, MMP-7 autoantibody levels in sera from 38 gastric cancer patients and from control serum samples were also tested. RESULTS: The optimum conditions for recombinant MMP-7 protein expression were determined as 0.04 mmol/L Isopropyl-β-D-Thiogalactopyranoside (IPTG) induction at 37℃ for four hours. The levels of serum autoantibodies against MMP-7 were significantly higher in patients with ESCC than in the matched-control samples (OD450 = 1.69 ± 0.08 vs OD450 = 1.55 ± 0.10, P < 0.001). The area under the receiver operating characteristic (ROC) curve was 0.87. The sensitivity and specificity for detection of ESCC were 78.0% and 81.0%, respectively, when the OD450 value was greater than 1.65. Although the levels of autoantibodies against MMP-7 were also significantly higher in patients with gastric cancer compared to control samples (OD450 = 1.62 ± 0.06 vs OD450 = 1.55 ± 0.10, P < 0.001), the diagnostic accuracy was less significant than in ESCC patients. The area of ROC curve was 0.75, whereas the sensitivity and specificity were 60.5% and 71.7%, respectively, when the cut-off value of OD450 was set at 1.60. CONCLUSION: Serum autoantibody levels of MMP-7 may be a good diagnostic biomarker for esophageal squamous cell carcinoma.

术后血清MMP-2、SCCA1表达水平对鼻腔鼻窦内翻性乳头状瘤术后复发的预测价值

目的探讨术后血清基质金属蛋白酶-2(MMP-2)、鳞状细胞癌抗原1(SCCA1)表达水平对鼻腔鼻窦内翻性乳头状瘤(SNIP)患者术后复发的预测价值。方法回顾性分析手术治疗的SNIP患者65例,根据术后2年内复发情况,将其分为复发组(n=12)和未复发组(n=53)。Elisa法检测手术前后血清MMP-2、SCCA1表达水平。收录临床资料,包括性别、年龄、饮酒史、吸烟史、肿瘤部位、手术方式、术后有无应用5-氟尿嘧啶(5-Fluorouracil,5-FU)、Krouse分期及有无糖尿病、高血压;Logistic回归分析影响SNIP患者术后复发的危险因素;ROC曲线分析术后血清MMP-2、SCCA1表达水平对SNIP患者术后复发的预测价值。结果术后,2组血清MMP-2、SCCA1表达水平均较术前降低(P<0.05),但复发组血清MMP-2、SCCA1表达水平均高于未复发组(P<0.05)。Logistic回归分析显示,有吸烟史、术后未应用5-FU、Krouse分期为T3~T4期、术后血清MMP-2表达水平、SCCA1表达水平是影响SNIP患者术后复发的危险因素(P<0.05)。ROC曲线分析显示,术后血清MMP-2、SCCA1表达水平单独及二者联合预测SNIP患者术后复发的曲线下面积(AUC)分别为0.786、0.800、0.836,敏感度分别为83.33%、75.00%、91.67%,特异度分别为71.70%、79.25%、75.47%。结论术后血清MMP-2、SCCA1表达水平可作为预测SNIP患者术后复发的辅助指标,且二者联合预测的效果更佳。

急性支气管炎患儿血清骨膜蛋白、SCCA表达及临床意义分析

目的检测急性支气管炎患儿血清骨膜蛋白、鳞状上皮细胞癌抗原(SCCA)水平,并探讨二者表达的临床意义。方法回顾性选取2018年10月至2020年4月于山东第二医科大学附属医院住院并接受治疗的78例急性支气管炎患儿为研究对象,纳入支气管炎组,根据疾病严重程度分为轻度52例和重度26例。选取同期健康体检的儿童86名作为对照组。检测并比较支气管炎组与对照组的骨膜蛋白、SCCA水平。比较轻度和重度急性支气管炎患儿的炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)]、肺功能指标[第1秒用力呼气量(FEV1)、FEV1/用力肺活量(FVC)、最大呼气中段流量(MMEF)、最大呼气峰流速(PEF)]水平。采用Pearson法分析重度急性支气管炎患儿血清骨膜蛋白、SCCA水平与炎症因子水平、肺功能指标的相关性;以多因素Logistic回归分析对影响急性支气管炎加重的因素进行分析。结果支气管炎组患儿的血清骨膜蛋白、SCCA水平分别为(409.37±98.24)ng/L、(1.42±0.43)ng/mL,均明显高于对照组[(264.31±82.54)ng/L、(0.95±0.31)ng/mL],差异均有统计学意义(P<0.05)。重度急性支气管炎患儿的血清骨膜蛋白、SCCA、IL-6、TNF-α、hs-CRP水平分别为(524.46±123.94)ng/L、(1.82±0.52)ng/mL、(16.62±4.18)ng/L、(17.62±5.21)ng/L、(18.46±6.02)mg/L,均明显高于轻度急性支气管炎患儿[(348.92±64.28)ng/L、(1.22±0.24)ng/mL、(4.62±1.38)ng/L、(3.83±1.09)ng/L、(9.34±0.71)mg/L],FEV1、FEV1/FVC、MMEF、PEF水平分别为(2.06±0.27)V/L、56.62±6.26、(1.47±0.36)L/s、(4.33±0.62)L/s,均明显低于轻度急性支气管炎患儿[(3.12±0.46)V/L、67.38±6.14、(2.36±0.43)L/s、(5.64±0.71)L/s],差异均有统计学意义(P<0.05)。重度急性支气管炎患儿血清骨膜蛋白、SCCA水平与炎症因子均呈正相关(P<0.05),与肺功能指标均呈负相关(P<0.05)。骨膜蛋白、SCCA是影响急性支气管炎加重的独立危险因素(P<0.05)。结论急性支气管炎患儿血清骨膜蛋白、SCCA水平均显著升高,且随病情加重,血清骨膜蛋白、SCCA水平进一步升高,在急性支气管炎的病情评估中可能有重要作用。

Identification of interleukin-6 (IL-6) and squamous cell carcinoma (SCC) as amniotic fluid-specific markers

Objective: To determine if an amniotic fluid (AF)-specific marker is present and if its concentration changes with the presence of labor. Study Design: Twenty-six healthy women who gave birth to healthy newborns at term during the period from July 2009 to January 2010 were included in the study. Six candidate markers were assessed by commercially available ELISA kits: interleukin (IL)-6, squamous cell carcinoma (SCC) antigen, insulin-like growth factor (IGFBP)-1, osteopontin (OPN), CA125, and sialyl Tn (STN). Results: The AF/maternal serum (MS) measurement based on IL-6 or SCC has proved to be superior to IGFBP-1, CA125, OPN and STN. Women with spontaneous labor at term had significantly higher IL-6 and IGFBP-1 concentrations in AF compared with those without labor. No significant differences were observed in the AF concentrations of SCC, OPN, CA125 and STN between women with labor and those not in labor. Conclusion: Our observation of IL-6 and SCC in AF may open a new area of research to assess their usefulness as biological markers of obstetrical disorders.

紫杉醇脂质体联合顺铂化疗对中晚期宫颈癌患者疗效及对FGFR4、SCCA水平的影响研究

目的探讨紫杉醇脂质体联合顺铂化疗对中晚期宫颈癌患者疗效及对FGFR4、SCCA水平的影响。方法选取2020年5月至2021年10月我院收治的中晚期宫颈癌患者93例,根据不同治疗方案分为观察组(n=48)和对照组(n=45),对照组采用顺铂化疗,观察组采用紫杉醇脂质体联合顺铂化疗。从入院当日开始,21天为1个疗程,治疗2个疗程。比较入院当日及治疗后治疗有效率、血清成纤维细胞生长因子受体(FGFR4)、鳞状细胞癌抗原(SCCA)、血管内皮生长因子(VEGF)水平及不良反应发生率。结果观察组血清FGFR4、SCCA、VEGF水平、不良反应发生率均显著低于对照组,治疗有效率高于对照组,差异有统计学意义(P值均<0.05)。结论紫杉醇脂质体联合顺铂化疗能够有效破坏肿瘤细胞遗传物质及新生血管,抑制肿瘤细胞增殖分化,并诱导其凋亡,从而延缓肿瘤发展进程,提升治疗有效率。

紫杉醇联合洛铂化疗方案对宫颈癌患者血清SCCA、血清肿瘤相关物质、血管内皮生长因子水平的影响

目的:探讨紫杉醇联合洛铂化疗方案对宫颈癌患者血清鳞状上皮细胞癌抗原(Squamous cell carcinoma antigen,SCCA)、血清肿瘤相关物质(Tumor associated material,TAM)、血管内皮生长因子水平(Vascular endothelial growth factor,VEGF)的影响。方法:选取2020年10月至2022年10月于我院接受化疗的82例宫颈癌患者作为研究对象,采用随机数字表法分为对照组与观察组,各41例。对照组采取奈达铂联合紫杉醇术前新辅助化疗,观察组采取洛铂联合紫杉醇术前新辅助化疗。分析比较两组的治疗效果,血清SCCA、TAM、VEGF水平、药物不良反应以及患者满意度。结果:观察组患者总有效率明显高于对照组(P<0.05)。治疗后,两组的血清SCCA、TAM、VEGF水平均明显降低,且观察组的血清SCCA、TAM、VEGF水平均明显低于对照组(P<0.05)。两组的不良反应发生率无明显差异(P>0.05)。观察组总满意度明显高于对照组(P<0.05)。结论:洛铂联合紫杉醇在宫颈癌临床化疗上效果较好,能有效改善血清SCCA、TAM、VEGF水平,药物不良反应较轻。

SCCA与HPV联合检测在宫颈癌诊断中的应用价值

目的探讨血清鳞状细胞癌抗原(SCCA)和人乳头瘤病毒(HPV)联合检测在宫颈癌诊断中的应用价值。方法随机选取2020年1月至2022年12月入襄阳市中心医院就诊的宫颈癌患者60例作为观察组,同时选取来院进行妇科普查的60例已婚女性作为对照组,分别检测两组人群的SCCA和HPV,比较其对宫颈癌的诊断价值。结果观察组的SCCA和HPV阳性率均明显高于对照组,且差异具有统计学意义(P<0.05);鳞癌患者的SCCA明显高于腺癌患者,且差异具有统计学意义(P<0.05)。结论SCCA与HPV联合检测,对宫颈癌早期诊断更有价值。

术前MRI联合SCCA预测子宫颈鳞状细胞癌淋巴结转移的应用

目的:探讨术前核磁共振成像(MRI)联合鳞状细胞癌抗原(squamous cell carcinoma antigen,SCCA)预测早期子宫颈鳞状细胞癌淋巴结转移的价值。方法:纳入2014年10月—2019年5月甘肃省妇幼保健院收治的293例子宫颈鳞状细胞癌ⅠA2~ⅡA2期(FIGO 2009)患者的临床资料。通过logistic回归分析术前淋巴结转移的危险因素,受试者操作特征(ROC)曲线分析术前MRI联合SCCA预测子宫颈鳞状细胞癌淋巴结转移的价值。结果:logistic多因素分析发现,SCCA≥1.74 ng/mL[OR=2.149,95%CI(1.055,4.376),P<0.05]为子宫颈鳞状细胞癌淋巴结转移的独立危险因素。ROC曲线分析,SCCA的截断值为1.74 ng/mL,敏感度为53.70%,特异度为70.60%。MRI淋巴结最长径截断值为0.75 cm,敏感度为53.70%,特异度为69.00%。SCCA联合MRI敏感度将显著提高为90.70%,特异度为36.10%。结论:MRI联合血清SCCA可用于术前预测子宫颈鳞状细胞癌淋巴结转移,为子宫颈鳞状细胞癌治疗方案的选择提供参考依据。

血清SCCAg、NGAL及CA724在不同病理特征子宫内膜癌中的表达意义及其与病情严重程度、淋巴结节转移的相关性分析

目的分析血清鳞状细胞癌抗原(SCCAg)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)及糖类抗原724(CA724)在不同病理特征子宫内膜癌中的表达意义及其与病情严重程度、淋巴结节转移的相关性。方法回顾性选取2020年1月至2022年12月江苏省肿瘤医院接诊的150例子宫内膜癌患者作为研究组,并选择同期健康体检的147名健康女性作为对照组。检测两组研究对象的血清SCCAg、NGAL及CA724的水平,分析不同TNM分期(Ⅰ~Ⅱ期102例,Ⅲ~Ⅳ期48例)、分化程度(高分化105例,中低分化45例)、浸润肌层程度(<1/2为103例,≥1/2为47例)的子宫内膜癌患者血清SCCAg、NGAL及CA724水平的差异性。采用Spearman相关性分析血清SCCAg、NGAL及CA724与子宫内膜癌TNM分期、分化程度的关系。通过受试者工作特征(ROC)曲线下面积(AUC)评价血清SCCAg、NGAL联合CA724对子宫内膜癌患者发生淋巴结节转移的预测效能。结果研究组的血清SCCAg、NGAL及CA724水平分别为(1.75±0.19)μg/L、(296.94±20.44)ng/mL、(19.72±4.05)U/mL,均高于对照组[(1.13±0.15)μg/L、(147.57±15.63)ng/mL、(5.22±1.08)U/mL],差异均有统计学意义(P<0.05)。Ⅲ~Ⅳ期患者的血清SCCAg、NGAL及CA724水平均高于Ⅰ~Ⅱ期,中低分化患者的血清SCCAg、NGAL及CA724水平均高于高分化,子宫肌层浸润≥1/2患者的血清SCCAg、NGAL及CA724水平均高于子宫肌层浸润<1/2,差异均有统计学意义(P<0.05)。经Spearman相关性分析,血清SCCAg、NGAL及CA724水平与子宫内膜癌TNM分期呈正相关(r=0.612、0.457、0.506,P<0.05),与分化程度呈负相关(r=-0.364、-0.412、-0.569,P<0.05)。在150例子宫内膜癌患者中,发生淋巴结节转移26例,占17.33%。经ROC曲线分析,血清SCCAg、NGAL联合CA724预测子宫内膜癌患者发生淋巴结节转移的敏感度为63.12%,特异度为88.75%,AUC为0.889。结论血清SCCAg、NGAL及CA724在不同TNM分期、分化程度、浸润肌层程度的子宫内膜癌患者中差异明显,均与病情严重程度有关,联合预测淋巴结节转移的效能较好。

FPR联合SCCA对ⅡB~ⅣA期宫颈鳞癌患者预后的相关性分析

目的探讨治疗前血清纤维蛋白原/前白蛋白(fibrinogen to prealbumin ratio,FPR)、鳞状细胞癌相关抗原(squamous cell carcinoma associated antigen,SCCA)与ⅡB~ⅣA期宫颈鳞癌患者预后的相关性。方法回顾性分析2015年1月~2020年3月徐州医科大学附属医院收治的129例ⅡB~ⅣA期宫颈鳞癌患者的病例资料。采用单因素、多因素COX回归分析分析影响ⅡB~ⅣA期宫颈鳞癌患者不良预后的危险因素。根据FPR≥截断值和SCCA≥临界值两项预后因素进行综合评分:FPR和SCCA都低的患者得0分,有1个高或两者指标均高的患者得1分。采用Kaplan-Meier法绘制FPR、SCCA、FPR联合SCCA综合评分生存曲线,进行生存分析。采用受试者操作特征(receiver operating characteristic,ROC)曲线分析FPR、SCCA、FPR联合SCCA对ⅡB~ⅣA期宫颈鳞癌患者不良预后的评估价值。结果单因素COX回归分析结果显示,FPR、前白蛋白(prealbumin,PA)、纤维蛋白原(fibrinogen,FIB)、SCCA、淋巴结转移、临床分期和细胞分化是ⅡB~ⅣA期宫颈鳞癌患者无进展生存期(progression free survival,PFS)的影响因素(P<0.05)。多因素COX回归分析结果显示,FPR、SCCA、淋巴结转移是其独立预后因素(P<0.05)。生存分析显示,高FPR、高SCCA组生存率明显低于低FPR、低SCCA组(P<0.05)。FPR联合SCCA评分中,得1分组的生存率明显低于得0分组,其3年PFS分别为70.5%、94.1%;5年PFS分别为54.2%、94.1%(P<0.05)。ROC曲线显示,FPR联合SCCA的曲线下面积(area under curve,AUC)最大,为0.768(95%CI:0.684~0.852,P<0.05),评估预后效果最好。结论FPR联合SCCA是影响ⅡB~ⅣA期宫颈鳞癌患者预后的相关因素,FPR、SCCA水平升高提示预后不良。

康莱特联合培美曲塞加奈达铂密集化疗治疗晚期肺癌的效果及对SCCA、miR-34b、miR-155表达的影响

目的探究康莱特联合培美曲塞加奈达铂密集化疗治疗晚期肺癌的效果。方法选择2020年3月至2021年6月我院收治的80例晚期肺癌患者为研究对象,采用随机数字表法将其分为对照组与观察组,各40例。对照组采用培美曲塞加奈达铂密集化疗治疗,观察组在对照组基础上加康莱特治疗。比较两组的治疗效果。结果观察组的总有效率(RR)、疾病控制率(DCR)高于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组的CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)高于对照组,CD8^(+)低于对照组(P<0.05)。治疗后,观察组的鳞状细胞癌抗原(SCCA)水平及miR-155低于对照组,miR-34b高于对照组(P<0.05)。结论康莱特联合培美曲塞加奈达铂密集化疗治疗晚期肺癌,可有效增强患者免疫功能并提高治疗效果,同时调节SCCA、miR-34b、miR-155表达,值得推广。

宫颈癌患者血清SCC-Ag、NLR水平与临床病理特征及预后关系

目的:探讨宫颈癌患者血清鳞状细胞癌抗原(SCC-Ag)、中性粒细胞与淋巴细胞比值(NLR)与临床病理特征及预后关系。方法:纳入2018年1月-2023年1月本院收治的108例宫颈癌患者为宫颈癌组,宫颈上皮内瘤病变(CIN)患者108例为CIN组,健康体检健康女性108例为对照组。比较3组血清SCC-Ag、NLR水平,分析宫颈癌组血清SCC-Ag、NLR水平与临床病理特征及与预后关系。结果:血清SCC-Ag、NLR水平,宫颈癌组(7.35±1.76、4.65±1.06)、CIN组(2.06±0.53、3.41±0.89)、对照组(0.54±0.12、1.53±0.34)依次降低(P<0.05)。宫颈癌患者血清SCC-Ag、NLR水平与病理类型、FIGO分期、病理分级、肌层浸润深度和盆腔淋巴结转移有关(P<0.05)。Kaplan-Meier显示,SCC-Ag、NLR高表达组总生存率、无病生存率均低于SCC-Ag、NLR低表达组,SCC-Ag高表达+NLR高表达组总生存率、无病生存率最低(均P<0.05)。结论:宫颈癌患者血清SCC-Ag、NLR水平与病理类型、FIGO分期、病理分级和肌层浸润深度等有关,且SCC-Ag、NLR水平越高患者预后越差。

帕博利珠单抗联合化疗治疗晚期不可切除食管鳞状细胞癌的效果

目的探究帕博利珠单抗联合化疗对晚期不可切除食管鳞状细胞癌患者的疗效。方法遴选2019年12月至2022年9月郑州大学第一附属医院收治的晚期食管鳞状细胞癌患者纳入研究,依据治疗方法的不同进行分组,将采用化疗方案(紫杉类+顺铂)治疗的患者纳入化疗组,将采用帕博利珠单抗联合化疗方案的患者纳入免疫联合组,经倾向性评分匹配排除年龄、性别混杂因素,经1:1匹配法两组各纳入34例。比较两组近期实体瘤疗效和生存情况,治疗前后肿瘤标志物[鳞状细胞癌抗原(SCCA)、糖抗原242(CA242)和细胞角蛋白19片段(CYFRA21-1)]、血清可溶性程序性死亡蛋白1/可溶性程序性死亡蛋白配体1(sPD-1/sPD-L1)及人转化生长因子-β1(TGF-β1)水平变化,记录两组药品不良反应。结果免疫联合组疾病客观缓解率(67.65%)高于化疗组(41.18%)(P<0.05),两组疾病控制率(88.24%vs 85.29%)比较差异无统计学意义(P>0.05);免疫联合组总生存期(OS)(11.47±0.33)个月,无病生存期(DFS)(11.03±0.47)个月,1年生存率及无病生存率91.18%、76.47%,化疗组对应为(11.01±0.48)个月、(8.85±1.13)个月、85.29%、61.76%,两组OS比较差异无统计学意义(log rankχ^(2)=0.598,P>0.05),DFS比较差异有统计学意义(log rankχ^(2)=4.216,P<0.05);治疗4个周期后,免疫联合组血清SCCA、CA242和CYFRA21-1水平[分别为(3.14±0.61)ng·mL^(-1),(50.12±6.88)U·mL^(-1),(3.57±0.71)μg·L^(-1)]低于化疗组[分别为(3.81±0.74)ng·mL^(-1),(57.53±7.14)U·mL^(-1),(4.43±0.83)μg·L^(-1)](t=4.074、4.358、4.591,均P<0.05);治疗4个周期后,免疫联合组血清sPD-1/sPD-L1、TGF-β1水平[分别为(0.69±0.07)ng·mL^(-1),(33.47±6.47)ng·mL^(-1)]低于化疗组[分别为(0.75±0.05)ng·mL^(-1),(40.65±7.12)ng·mL^(-1)](t=4.067、4.067,均P<0.05);免疫联合组药品不良反应(胃肠道反应、过敏性皮疹、贫血和肝肾损伤)与化疗组比较,差异无统计学意义(P>0.05)。结论帕博利珠单抗联合化疗治疗食管鳞状细胞癌可明显改善肿瘤标志物水平及血清免疫状态。