Performance Evaluation of Combined Detection of Serum CEA,CYFRA21-1,CA125,and NSE in Patients with Lung Cancer by Fluorescence Flow Cytometry

Objective:To investigate the effect of combined detection of serum carcinoembryonic antigen(CEA),cytokeratin 19 fragment(CYFRA21-1),cancer antigen 125(CA125),and neuron-specific enolase(NSE)in patients with lung cancer by fluorescence flow cytometry.Methods:From August 2019 to July 2022,200 patients with lung cancer diagnosed by pathology in our hospital were retrospectively analyzed.2 mL venous blood was collected in a fasting state and centrifuged to separate the serum(containing human chorionic gonadotropin antibody[anti-hCG antibody],hepatitis B surface antibody[anti-HBs antibody],and CEA).Results:The sensitivities of CEA and CYFRA21-1 detected via enzyme-linked immunosorbent assay(ELISA)were 100%,and the detection limits were 0.5 ng/mL and 0.1 ng/mL,respectively;the sensitivities of CA125 and NSE detected via flow cytometry were 100%,and the detection limits were 10 U/mL and 2 ng/mL,respectively.Compared with ELISA,the sensitivities of CA125 and NSE detected via flow cytometry were higher.When the concentration of CEA was 10-40 ng/mL,the sensitivities of the three markers CYFRA21-1,CA125,and NSE showed no significant changes(P>0.05);when the concentration of CEA was 40-80 ng/mL,the sensitivity of CEA significantly decreased(P<0.01),but the sensitivities of the three markers CYFRA21-1,CA125,and NSE showed no significant changes(P>0.05);when the concentration of CEA was 80-200 ng/mL,the sensitivities of all four markers showed no significant changes(P>0.05).Conclusion:Compared with the double-antibody sandwich ELISA,fluorescence flow cytometry has certain advantages,including high sensitivity,good precision,short detection time,low sample usage,and low medical cost;thus,it is worthy of clinical promotion.

The Potential Clinical Significance of the Serum Iron and Ferritin Status in Lung Cancer Patients

Background An increasing number of studies have shown that iron,one of the indispensable trace elements in the human body,is closely related to the occurrence and development of cancer.However,few studies have clearly demonstrated the role of the iron levels in lung cancer patients,or the potential effects of inflammation on iron levels.Methods The clinical data for lung cancer patients and non-lung cancer participants were retrospectively analyzed.The serum iron and ferritin levels were measured and compared using a rank-sum test.The correlation between the serum iron/ferritin and C-reactive protein(CRP)was analyzed by rank correlation.The cut-off values for continuous variables were obtained by the receiver operating characteristic curve(ROC)method.An analysis of potential prognostic factors in lung cancer patients was conducted by univariate and multivariate survival analyses.Results The serum iron levels in patients with extensive small-cell lung cancer(SCLC)were lower than those with limited-stage SCLC,and the levels of serum ferritin and CRP in those with extensive SCLC were higher than those with limited-stage SCLC.Similarly,the serum iron levels in patients with stage IV non-small cell lung cancer(NSCLC)were lower than those of patients with stageⅠ-Ⅲdisease,and the levels of serum ferritin and CRP in those with stage IV NSCLC were higher than those in stagesⅠ-Ⅲ.The serum iron level was negatively correlated with the level of CRP,while the serum ferritin level was positively correlated with CRP.The stage of lung cancer,but not the serum iron/ferritin level,was an independent prognostic factor in lung cancer patients.Conclusions The serum iron and ferritin levels are associated with the staging of lung cancer.The later stages of lung cancer are associated with a lower serum iron level,a higher serum ferritin level,and a higher CRP level.Inflammation may play an important role in regulating the serum iron and ferritin levels in lung cancer patients.

Evaluation of serum and pleural levels of endostatin and vascular epithelial growth factor in lung cancer patients with pleural effusion

Objective:To evaluate the diagnostic value of endostatin(ES),vascular endothelial growth factor (VEGF) and careinoembryonie antigen(CEA) in both serum and pleural effusion of lung cancer patients.Methods:Levels of ES,VEGF and CEA in 52 malignant pleural effusion due to lung cancer and 50 patients with non-malignant disease were measured by using sandwich enzymelinked immunosorbent assay and microparticle enzyme immunoassay.Results:The ES.VEGF and CEA levels in pleural effusion and serum,and their ratio(F/S) were higher in lung cancer group than that in benign group,and the differences were statistically significant(P【0.05).The diagnostic efficiency of ES+VEGF for lung cancer was superior to either single detection.The diagnostic efficiency of ES+VEGK+CEA was superior to either ES+VEGF or ES+CEA.Conclusions: The results suggest that ES,VEGF and CEA might be useful in the differentiation between benign and malignant pleural effusion due to lung cancer.In comparison with either single determination of concentration in serum or pleural fluid,the couiljined detection of two or three markers is of important clinical significance in the diagnosis of lung cancer.

Expression of endostatin in serum and bronchoalveolar lavage fluid in patients with lung cancer

Objective To evaluate the expression of endostatin in bronchoalveolar lavage fluid (BALF) and serum in patients with lung cancer,and to analysis the relationship between endostatin expression and clinical prognosis as well as pathophysiological characteristics. Methods The samples of serum and BALF were obtained from 57

Serum Amyloid A Protein: A Potential Biomarker Correlated With Clinical Stage of Lung Cancer

Objective To identify serum diagnosis or progression biomarkers in patients with lung cancer using protein chip profiling analysis. Method Profiling analysis was performed on 450 sera collected from 213 patients with lung cancer, 19 with pneumonia, 16 with pulmonary tuberculosis, 65 with laryngeal carcinoma, 55 with laryngopharyngeal carcinoma patients, and 82 normal individuals. A new strategy was developed to identify the biomarkers on chip by trypsin pre-digestion. Results Profiling analysis demonstrated that an 11.6kDa protein was significandy elevated in lung cancer patients, compared with the control groups （P〈0.001）. The level and percentage of 11.6kDa protein progressively increased with the clinical stages Ⅰ-Ⅳ and were also higher in patients with squamous cell carcinoma than in other subtypes. This biomarker could be decreased after operation or chemotherapy. On the other hand, 11.6kDa protein was also increased in 50% benign diseases of lung and 13% of other cancer controls. After trypsin pre-digestion, a set of new peptide biomarkers was noticed to appear only in the samples containing a 11.6kDa peak. Further identification showed that 2177Da was a fragment of serum amyloid A （SAA, MW 11.6kDa）. Two of the new peaks, 1550Da and 1611Da, were defined from the same protein by database searching. This result was further confirmed by partial purification of 11.6kDa protein and MS analysis. Conclusion SAA is a useful biomarker to monitor the progression of lung cancer and can directly identify some biomarkers on chip.

Implication of serum levels of interleukin-18 and nitric oxide in tumor growth and metastasis of non-small cell lung cancer

To study the effect of IL-18 and nitric oxide(NO) on the growth and metastasis of non-small cell lung cancer (NSCLC).Methods Serum IL-18 and nitrate and nitrite levels in 82 patients with NSCLC and 20 healthy control subjects were measured by using ELISA and Griess.Results The levels of serum IL-18 were (334.2±31.0)ng/L in NSCLC patients and (151.3±22.0)ng/L in control subjects,respectively.The levels of nitrate and nitrite were (237.1±21.0)μmol/L in NSCLC patients and (44.2±15.0)μmol/L in control subjects.The levels of serum IL-18 and nitrate and nitrite were not related with age,gender,histological types in patients with NSCLC.The levels of serum IL-18 was closely associated with TNM stage,lymph node metastasis and distal metastasis,but not with its degree and organ types of metastasis.There was a negative correlation between the levels of serum IL-18 and nitrate and nitrite.Conclusion Serum IL-18 and nitrate and nitrite levels may be useful to evaluate the prognosis of the patients with NSCLC.16 refs,2 tabs.

Pattern Recognition Methods Combined with Raman Spectra Applied to Distinguish Serums from Lung Cancer Patients and Healthy People

Raman spectroscopy was used to distinguish the serums from lung cancer patients and healthy people, through spectral pretreatment method combined with pattern recognition methods including principal component analysis (PCA), partial least squares-discriminant analysis (PLS-DA), un-correlated linear discriminant analysis (ULDA), etc. Through the comparisons of the results, it can be found that ULDA and LDA combined with multiple scatter correction (MSC) pretreatment method successfully distinguish the patients of lung cancer and healthy people. The method has academic significance and promising clinical application value.

Prognostic role of pretreatment serum ferritin concentration in lung cancer patients:A meta-analysis

BACKGROUND The association between pretreatment serum ferritin concentration(SFC)and long-term survival in lung cancer remains unclear now.AIM To identify the prognostic value of pretreatment SFC in lung cancer patients based on current evidence.METHODS The PubMed,EMBASE and Web of Science databases were searched from inception to May 29,2022 for relevant studies.The primary endpoint was overall survival(OS)and the hazard ratios(HRs)with corresponding 95%confidence intervals(CIs)were combined to assess the predictive role of pretreatment SFC for long-term survival of lung cancer patients.The data were then extracted and assessed on the basis of the Reference Citation Analysis(https://www.reference citationanalysis.com/).RESULTS Twelve retrospective studies involving 1654 patients were analyzed.The results manifested that increased pretreatment SFC was associated with worse OS(HR=1.09,95%CI:1.03-1.15,P=0.004).Subgroup analysis stratified by the country(China vs non-China)showed similar results.However,subgroup analysis stratified by tumor type revealed inconsistent results(lung cancer:HR=1.39,P=0.008;small cell lung cancer:HR=1.99,P=0.175;non-small cell lung cancer:HR=1.03,P=0.281).CONCLUSION Pretreatment SFC might serve as a promising prognostic indicator in lung cancer patients and elevated pretreatment SFC predicts worse prognosis.However,more high-quality studies with big sample sizes are still needed to further verify its prognostic value in lung cancer.

SERUM LIPID-BOUND SIALIC ACID IN LUNG CANCER PATIENTS

Serum lipid-bound sialic acid (LSA) assay was evaluated for differential diagnosis between benign and malignant pulmonary disease.Mean serum LSA for normal controls was 13.7±3.7 mg/dl and the upper limit of the normal value was set at 19.8 mg/dl (95% confidence limit,one side).The specificity was 97.l% (95% confidence interval was 93.8%, 100.0%).The mean for benign pulmonary disease was 1 7.l±5.l mg/dl,the specificity was 89.l% (95% confidence interval was 80.9%,97.3%), and the sensitivity was 10.9%.The mean for malignant pulmonary disease was 27.l±7.9 mg/dl, and the sensitivity was 93.3%(95% confidence interval was 88.5%, 98.1%).The serum LSA levels for different malignant pulmonary diseases were different between small cell carcinoma and adenocarcinoma. The results indicate that serum LSA assay might be used as tumor marker to differentiate lung cancer from normal subjects or benign lung disease.

Preoperative Serum Krebs Von Den Lungen-6 and Surfactant Protein-D Levels in Non-Small Cell Lung Cancer Patients with Interstitial Pneumonia

We retrospectively analyzed the prognostic significance of preoperative serum Krebs von den Lungen-6 (KL-6) surfactant protein-D (SP-D) levels in non-small cell lung cancer (NSCLC) patients with interstitial pneumonia (IP). We enrolled 41 NSCLC patients with IP who have undergone curative surgery. Prognostic significance of serum KL-6 and SP-D levels was examined. We found a significant relationship between serum KL-6 and SP-D levels in NSCLC patients with IP. However, the 5-year survival of patients with high serum KL-6 level was poor, whereas serum SP-D level was not related to patients’ survival. Univariate analysis revealed that there was a trend towards an association between serum KL-6 level and patients’ prognosis but this did not reach statistical significance. This might be due to small number of study patients. In conclusion, there is a possibility that serum KL-6 level is a prognostic marker regardless of the presence of IP.

The prognostic value of serum C-reactive protein-bound serum amyloid A in early-stage lung cancer

Background:Elevated levels of serum C-reactive protein(CRP) have been reported to have prognostic significance in lung cancer patients.This study aimed to further identify CRP-bound components as prognostic markers for lung cancer and validate their prognostic value.Methods:CRP-bound components obtained from the serum samples from lung cancer patients or healthy controls were analyzed by differential proteomics analysis.CRP-bound serum amyloid A(CRP-SAA) was evaluated by coimmunoprecipitation(IP).Serum samples from two independent cohorts with lung cancer(retrospective cohort,242patients;prospective cohort,222 patients) and healthy controls(159 subjects) were used to evaluate the prognostic value of CRP-SAA by enzyme-linked immunosorbent assay.Results:CRP-SAA was identified specifically in serum samples from lung cancer patients by proteomic analysis.CRP binding to SAA was confirmed by co-IP in serum samples from lung cancer patients and cell culture media.The level of CRP-SAA was significantly higher in patients than in healthy controls(0.37 ± 0.58 vs.0.03 ± 0.04,P < 0.001).Elevated CRP-SAA levels were significantly associated with severe clinical features of lung cancer.The elevation of CRPSAA was associated with lower survival rates for both the retrospective(hazard ration[HR]= 2.181,95%confidence interval[CI]= 1.641-2.897,P < 0.001) and the prospective cohorts(HR = 2.744,95%CI = 1.810-4.161,P < 0.001).Multivariate Cox analysis showed that CRP-SAA was an independent prognostic marker for lung cancer.Remarkably,in stages l-ll patients,only CRP-SAA,not total SAA or CRP,showed significant association with overall survival in two cohorts.Moreover,univariate and multivariate Cox analyses also showed that only CRP-SAA could be used as an independent prognostic marker for early-stage lung cancer patients.Conclusion:CRP-SAA could be a better prognostic marker for lung cancer than total SAA or CRP,especially in earlystage patients.

Discovery and identification of Serum Amyloid A protein elevated in lung cancer serum

Two hundred and eighteen serum samples from 175 lung cancer patients and 43 healthy individuals were analyzed by using Surface Enhaced Laser Desorption/Ionization Time of Flight Mass Spectrome- try (SELDI-TOF-MS). The data analyzed by both Biomarker Wizard? and Biomarker Patterns? software showed that a protein peak with the molecular weight of 11.6 kDa significantly increased in lung cancer. Meanwhile,the level of this biomarker was progressively increased with the clinical stages of lung cancer. The candidate biomarker was then obtained from tricine one-dimensional sodium dodecyl sul- fate-polyacrylamide gel electrophoresis by matching the molecular weight with peaks on WCX2 chips and was identified as Serum Amyloid A protein (SAA) by MALDI/MS-MS and database searching. It was further validated in the same serum samples by immunoprecipitation with commercial SAA antibody. To confirm the SAA differential expression in lung cancer patients, the same set of serum samples was measured by ELISA assay. The result showed that at the cutoff point 0.446(OD value)on the Receiver Operating Characteristic (ROC) curve, SAA could better discriminate lung cancer from healthy indi- viduals with sensitivity of 84.1% and specificity of 80%. These findings demonstrated that SAA could be characterized as a biomarker related to pathological stages of lung cancer.

Association between folate intake, serum folate levels and the risk of lung cancer： a systematic review and meta-analysis

Background Folate plays a critical role in nucleotide synthesis and DNA methylation, and was considered to be associated with anti-carcinogenesis. Results from studies that concern the relationship between the folate intake or serum folate levels and lung cancer risk showed no consistency, which requires our further comprehensive meta- analysis. Methods Systematic literature search was conducted to identify the relevant studies （published prior to February 2013） according to standard protocol. Estimated effects were calculated under both random-effects and fixed-effects models. Heterogeneity between studies and publication bias were also evaluated. Results A total of 4390 cases and 6138 controls from 6 case-control studies revealed a significant overall inverse association between folate intake and lung cancer risk （OR = 0.74, 95% CI = 0.65-0.84, P〈 0.001）. Summary of 1438 cases and 2582 controls from 4 case-control studies and 44 cases out of a cohort of 1988 participants suggested a marginal association without significance （OR = 0.78, 95% CI = 0.60-1.02, P = 0.075） between high serum folate levels and less lung cancer susceptibility; however, subgroup analysis about population-based case-control studies showed that high serum folate levels significantly associated with the reduced lung cancer risk （OR = 0.76, 95% CI = 0.58-1.00, P = 0.048）. Conclusion Higher folate intake can be a protective factor against lung cancer risk, and higher serum folate level is probably associated with reduced lung cancer risk in marginal manner, though more studies are warranted to confirm these associations.

Pharmacological Effects of Serum Containing Chinese Medicine Bushen Huayu Jiedu Compound Recipe (补肾化瘀解毒复方) in Lung Cancer Drug-resistance Cells

Objective： To explore the pharmacologic effects of Chinese medicine Bushen Huayu Jiedu Compound Recipe （补肾化瘀解毒复方,BSHYJDR） in drug-resistance cells of lung cancer. Methods： Human lung adenocarcinoma A549/DDP cell strain was selected, serum pharmacology and flow cytometer （FCM） method were adopted, $180 tumor-bearing mice and normal mice were given, through gastrogavage, different doses of a decocted concentration of BSHYJDR. Serum from the abdominal aorta was taken to observe the effect of drug-serum on cisplatin （DDP） concentration, free Ca^2＋ concentration and the expression of lung drug-resistance protein LRP-56 in A549/DDP cells. Results： Compared with the drug-resistance group, the intracellular DDP concentration in the group taking a high dose and the normal group of Chinese medicine showed significant difference （P〈0.05）, while no significant difference was found in the low-dose group （P〉0.05）. Compared with the drug-resistance group, the Ca^2＋ concentration in cells and the expression of LRP in lung cancer drug-resistance cells A549/DDP of the high-dose group, the low-dose group and the normal group of Chinese medicine were significantly different （all P〈0.01）, the LRP expression of the normal group was obviously higher than that of the drug-resistance group （P〈0.05）. Cenclusien： It was indicated that serum containing Chinese medicine BSHYJDR in the tumor-bearing mice and the normal mice had certainly different, tumor-bearing mice serum containing could improve drug concentration in lung cancer drug-resistance cells, prevent the inflow and release of Ca^2＋, and inhibit the expression of the drug-resistance gene in the lung cancer drug-resistance cells, which might be the mechanism of BSHYJDR in enhancing the efficacy in reversing and inhibiting tumor.

Effects of combined treatment of bronchial arterial chemoembolization and radioactive particle implantation on tumor markers and T lymphocyte subsets in locally advanced non-small cell lung cancer

Objective: To investigate the effects of bronchial arterial chemoembolization combined with radioactive particle implantation on the level of serum tumor markers and T lymphocyte subsets in patients with locally advanced non-small cell lung cancer. Methods: A total of 91 cases of locally advanced non-small cell lung cancer patients according to the random data table were divided into the control group (n=45) and observation group (n=46) according to the random data table. Patients in the control group was treated with bronchial arterial chemoembolization, on the basis of the control group, patients in the observation group were treated with radioactive particle implantation, the serum tumor markers and T lymphocyte subsets of the two groups were compared before and after treatment. Results: The levels of CEA, NSE, CA125, CD4+, CD8+, CD4+/CD8+ and NK in the two groups before the treatment were not statistically significant. Compared with the group before treatment, levels of CEA, NSE, CA125and CD8+ of the two groups after treatment were significantly decreased, and after treatment the level of CEA, NSE, CA125and CD8+ in the observation group was significantly lower than those of the control group;The levels of CD4+, CD4+/CD8+ and NK in the two groups after treatment were significantly higher than those in the group before treatment, and the observation group levels were significantly higher than those of the control group. Conclusion: Bronchial artery embolization combined with radioactive particle implantation for locally advanced non-small cell lung cancer, can effectively reduce the serum tumor markers level, improve the level of T cell subsets of patients, has important clinical value.

Serum cytokine levels in patients with advanced non-small cell lung cancer： correlation with clinical outcome of erlotinib treatment

Background Serum expression of cytokines may provide information about the clinical outcome of advanced non-small cell lung cancer （NSCLC） patients. This study aimed to investigate the relationship between serum cytokine levels and the clinical outcome of erlotinib treatment in a second or third line setting in patients with advanced NSCLC.

Prolonged progression-free survival and overall survival are associated with diabetes mellitus but inversely associated with levels of blood glucose in patients with lung cancer

Background:Previous studies have provided conflicting evidence about the increased overall survival(OS)in lung cancer patients with diabetes mellitus(DM)compared with those without DM.This study assessed progression-free survival(PFS)/OS in lung cancer patients with or without DM and tentatively analyzed the impact of blood glucose levels on PFS/OS in lung cancer patients.Methods:Data were collected from lung cancer patients based upon admission records from January 2010 to January 2012 and follow-up records from January 2010 to January 2015 in the Department of Pulmonary Medicine,Zhongshan Hospital,Fudan University,Shanghai.The data included patient sex,age,body mass index(BMI),smoking status,history of DM,level of blood glucose,pathological type,clinical stage of cancer,chemotherapy regimen,and history of anti-DM drugs.The Cox regression model and Kaplan-Meier method were used for the analysis of hazard factors and PFS/OS.For comparison of PFS/OS in lung cancer with or without DM,patients were divided into three groups:lung cancer with DM,lung cancer without DM but with elevated level of blood glucose,lung cancer without DM or elevated level of blood glucose.Results:In total,the data from 200 lung cancer patients(138 males/62 females,aged 29.0 to 78.0 years,mean 60.0±8.6 years)were collected.For the comparison of PFS/OS in lung cancer patients with or without DM,patients were divided into three groups:lung cancer with DM(n=31);lung cancer without DM but with elevated levels of blood glucose(n=40);and lung cancer without both DM and elevated levels of blood glucose(n=128),whereas 1 patient dropped out of the study.All the patients underwent complete chemotherapy and were followed up for 36.0 to 60.0 months.Kaplan-Meier survival analysis showed that lung cancer patients with DM had increased PFS and OS compared with those without DM(log-rank,P<0.05,P<0.01);the median PFS in lung cancer with DM was 12.0 months(95%confidence interval[CI],4.0-16.0)vs.6.0 months in those without DM(95%CI,5.8-6.3);and the median OS in lung cancer patients with DM was 37.0 months(95%CI,29.0-46.6)vs.12.0 months in those without DM(95%CI,10.9-13.1).For the other two groups of patients without DM,there was a trend toward a shorter PFS and OS in patients with elevated blood glucose compared with those without elevated blood glucose.Cox regression showed that PFS in lung cancer patients was favorably associated with the usage of anti-DM drugs,BMI,clinical stage of cancer,and chemotherapy regimen(all P<0.05)but was inversely associated with the level of blood glucose(P<0.05).Conclusions:Lung cancer patients with DM have prolonged PFS and OS compared with those without DM,and the level of blood glucose was inversely associated with PFS.The current results indicate that PFS may be a meaningful intermediate endpoint for OS and that the levels of blood glucose hopefully represent a prognostic factor in lung cancer patients.

血清甲状腺激素、NLR及CRP/ALB与肺癌术后谵妄的关系

目的分析血清甲状腺激素、中性粒细胞淋巴细胞比值(NLR)及C反应蛋白/白蛋白比值(CRP/ALB)与肺癌术后谵妄的关系。方法选取2021年1月至2022年12月于北京市第六医院进行肺癌根治术患者118例作为研究对象。根据ICU意识混乱评分法进行谵妄评估,有35例患者发生术后谵妄(谵妄组),83例患者术后未发生谵妄(非谵妄组)。分析影响肺癌患者术后谵妄的单因素,采用多元Logistic回归分析影响肺癌术后谵妄的多因素;比较谵妄组不同谵妄程度患者血清甲状腺激素、CRP/ALB、NLR水平;采用Pearson相关系数分析血清甲状腺激素、CRP/ALB、NLR与肺癌术后谵妄的相关性。结果两组性别、合并患有高血压、ASA分级以及T_4、TSH、FT_4水平等指标比较,差异无统计学意义(P>0.05);两组年龄、合并患有糖尿病、睡眠障碍以及T_(3)、FT_(3)、CRP/ALB、NLR水平比较,差异有统计学意义(P<0.05);经多元Logistic回归分析显示:年龄≥60岁、合并患有糖尿病、睡眠障碍以及T_(3)<1.31 nmol/L、FT_(3)<5.15 pmol/L、CRP/ALB>0.120、NLR≥7.79均是影响肺癌发生术后谵妄的危险因素(P<0.05);轻度、重度术后谵妄患者T_4、TSH、FT_4水平比较,差异无统计学意义(P>0.05);轻度术后谵妄患者T_(3)、FT_(3)水平高于重度术后谵妄患者,CRP/ALB、NLR水平低于重度术后谵妄患者,差异均有统计学意义(P<0.05);Pearson相关性分析显示:T_(3)、FT_(3)与肺癌术后谵妄呈负相关,CRP/ALB、NLR与肺癌术后谵妄呈正相关(P<0.05)。结论肺癌根治术患者术后T_(3)、FT_(3)、CRP/ALB、NLR水平与术后谵妄发生有一定关联,通过检测上述指标水平可为临床评估术后谵妄严重程度提供参考资料。

非小细胞肺癌患者血清中Caspase-1与IL-1β的表达水平及临床相关性研究

目的探讨非小细胞肺癌(non-small cell lung cancer,NSCLC)患者血清中半胱天冬氨酸蛋白酶-1(Caspase protease-1,Caspase-1)与促炎因子白介素-1β(Interleukin1β,IL-1β)的表达水平与临床病理特征及诊断价值的关系。方法选取2022年9月至2023年9月就诊于该院符合纳排标准的NSCLC患者60例为研究组;同期选取30例健康人群为对照组。比较两组血清中Caspase-1、IL-1β的表达并分析其与NSCLC病理特征的相关性,P<0.05表示差异有统计学意义。结果研究组Caspase-1、IL-1β水平明显高于对照组(P<0.001)。肿瘤直径(cm)≥3、Ⅲ-Ⅳ期及淋巴结转移者的Caspase-1、IL-1β水平分别高于<3cm、Ⅰ-Ⅱ期及无淋巴结转移者;女性、右肺病变及远处转移者的IL-1β水平高于男性、左肺病变及无远处转移者(P<0.05)。二元Logistic回归分析示Caspase-1和IL-1β水平的升高是NSCLC发生的独立危险因素(P<0.001)。受试者工作特征(Receiver operating characteristics,ROC)曲线示Caspase-1、IL-1β、二者联合诊断NSCLC的ROC曲线下面积大小(AUC)及其95%CI分别为:0.903(0.836~0.969)、0.925(0.872~0.978)、0.981(0.956~1.000),敏感度分别为:95.0%、85.0%、90.0%,特异度分别为:73.3%、83.3%、96.7%;提示Caspase-1和IL-1β联合检测NSCLC效果最优(P<0.001)。结论血清Caspase-1、IL-1β在NSCLC中表达升高,与临床病理特征密切相关,是NSCLC发生的独立危险因素,二者联合检测对NSCLC的诊断价值更高,是潜在的NSCLC肿瘤标志物。

低剂量CT结合SHOX2、RASSF1A甲基化在肺癌早期预警中的应用

目的探讨低剂量CT结合Ras相关区域家族蛋白1A(RASSF1A)、矮小同源盒基因2(SHOX2)甲基化在肺癌早期预测中的应用价值。方法选取2021年1月~2023年1月我院90例拟行肺结节手术患者,根据手术病理学分为肺良性结节组和肺癌组。2组均于术前行低剂量CT检查、SHOX2、RASSF1A甲基化检测,采用Kappa指数分析上述检查结果与手术病理学一致性,分析低剂量CT、SHOX2、RASSF1A甲基化与血清肿瘤标志物[癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、鳞状细胞癌抗原(SCC-Ag)、细胞角蛋白19片段(CYFRA21)]对肺癌诊断效能,采用Spearman低剂量CT检查、SHOX2、RASSF1A甲基化与临床病理特征相关性。结果低剂量CT、SHOX2、RASSF1甲基化及三者联合分别确定40例、43例、46例、58例肺癌,三者联合与手术病理学诊断肺癌效能一致性Kappa值为0.951;三者联合诊断肺癌敏感度96.67%、准确度97.78%均高于三者单一诊断效能(P<0.05);肺癌患者血清CEA、SCC、NSE、CYFRA21水平均高于肺良性结节患者(P<0.05);低剂量CT联合SHOX2、RASSF1甲基化诊断肺癌效能的AUC为0.983,近似于四种血清肿瘤标志物诊断肺癌效能的AUC 0.933;不同肿瘤直径、临床分期、组织学分化肺癌患者低剂量CT检出率及SHOX2、RASSF1A甲基化阳性率比较差异有统计学意义(P<0.05);肺癌患者低剂量CT检出率、SHOX2及RASSF1A甲基化阳性率与肿瘤直径、临床分期呈正相关,与组织学分化呈负相关(P<0.05)。结论低剂量CT联合SHOX2及RASSF1A甲基化可用于肺癌早期预警中,临床可通过其进行早期诊断、评估病情进展程度,以针对性展开后续治疗,改善预后。