Diagnostic value of 5 serum biomarkers for hepatocellular carcinoma with different epidemiological backgrounds:A large-scale,retrospective study

Objective:Hepatocellular carcinoma(HCC)is a lethal global disease that requires an accurate diagnosis.We assessed the potential of 5 serum biomarkers(AFP,AFU,GGT-II,GPC3,and HGF)in the diagnosis of HCC.Methods:In this retrospective study,we measured the serum levels of each biomarker using ELISAs in 921 participants,including 298 patients with HCC,154 patients with chronic hepatitis(CH),122 patients with liver cirrhosis(LC),and 347 healthy controls from 3 hospitals.Patients negative for hepatitis B surface antigen and hepatitis C antibody(called"NBNC-HCC")and patients positive for the above indices(called"HBV-HCC and HCV-HCC")were enrolled.The selected diagnostic model was constructed using a training cohort(n=468),and a validation cohort(n=453)was used to validate our results.Receiver operating characteristic analysis was used to evaluate the diagnostic accuracy.Results:Theα-L-fucosidase(AFU)/α-fetoprotein(AFP)combination was best able to distinguish NBNC-HCC[area under the curve:0.986(95%confidence interval:0.958–0.997),sensitivity:92.6%,specificity:98.9%]from healthy controls in the test cohort.For screening populations at risk of developing HCC(CH and LC),the AFP/AFU combination improved the diagnostic specificity for early-stage HCC[area under the curve:0.776(0.712–0.831),sensitivity:52.5%,specificity:91.6%in the test group].In all-stage HBV-HCC and HCV-HCC,AFU was also the best candidate biomarker combined with AFP[area under the curve:0.835(0.784–0.877),sensitivity 69.1%,specificity:87.4%in the test group].All results were verified in the validation group.Conclusions:The AFP/AFU combination could be used to identify NBNC-HCC from healthy controls and hepatitis-related HCC from at-risk patients.

常规免疫的时间选择及其后的花粉病的发病危险

Background: Suggestions that immunisation influences allergic disease risk, ei ther positively (pertussis) or negatively (BCG)-are of concern for vaccination policy. Aims: To determine whether DTP, MMR, and BCG vaccination in infancy infl uenced hay fever risk. Methods: Case-control study of 7098 hay fever cases and controls, within two primary care databases. One control per case was matched fo r practice, age, and sex. Odds ratios (OR)were derived using conditional logisti c regression. Results: Compared to those completing in month 5 (base group) (39. 3%), DTP unvaccinated children (4.3%) had a similar risk of hay fever (OR = 0. 94, 95%Cl 0.73 to 1.23). However, those completing after 12months (4.2%) had a reduced risk (OR = 0.60, 95%Cl 0.45 to 0.76) compared to the base group. Compa red to those vaccinated in month 14 (base group) (29.5%), MMR unvaccinated chil dren (2.3%) had an OR of 0.79 (95%Cl 0.58 to 1.08). Completion of MMR after tw o years was associated with reduced hay fever risk (OR = 0.62, 95%Cl 0.48 to 0. 80) compared to the base group. The effects of late immunisation with DTP and MM R were independent. Those vaccinated with BCG by age 2 (2.4%) had an odds ratio of 1.28 (95%Cl 0.96 to 1.70). Adjustment for consulting behaviour, social fact ors, or sibship size did not alter these associations. Conclusions: Immunisation against DTP or MMR does not increase the risk of hay fever. The lower confidenc e limit for BCG vaccination contradicts the hypothesised protective effect. The reduced risk of hay fever among children immunised late may be explained by a th ird factor causing both postponement and reduced risk such as intercurrent febri le illnesses.

Fruit and vegetable consumption,cardiovascular disease,and all-cause mortality in China

Evidence about the response patterns of fruit and vegetable consumption with the risk of cardiovascular disease(CVD)and allcause mortality was inconsistent.These associations were examined using a large-scale,population-based Chinese cohort comprising 100,728 participants.A food-frequency questionnaire was used to assess fruit and vegetable consumption.Outcomes were ascertained by interviewing individuals or their proxies and checking hospital records or death certificates.Cox proportional hazards regression was used to calculate hazard ratios(HRs)with 95% confidence intervals(CIs).At the 736,668 person-years of follow-up,3,677 CVD cases and 5,466 deaths were identified.The multivariable-adjusted HRs for CVD across increasing quartiles of total fruit and vegetable consumption were 1(reference),0.94(95%CI=0.85-1.04),0.89(95%CI=0.80-0.98),and 0.85(95%CI=0.77-0.95).Moreover,participants in the highest quartile displayed a 13% lower risk of all-cause mortality(HR=0.87;95%CI=0.80-0.95).A nonlinear dose-response relation was found for CVD,without additional benefits beyond a consumption of600 g d-1,whereas the all-cause mortality risk decreased along with higher consumption,with a linear trend.These associations remained significant for fruit consumption but not for vegetable consumption.Our findings indicated that greater fruit and vegetable consumption was significantly associated with a lower risk of CVD and all-cause mortality.Increasing fruit and vegetable consumption,especially fruit,in the general population would prevent CVD and premature mortality.