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Objective To evaluate the clinical significance of the clinical diagnosis and efficacy monitoring of serum gastrin-releasing peptide precursor (ProGRP) in small cell lung cancer (SCLC) patients.Methods A total of 4032 patients were admitted to a hospital from March 2015 to August 2017, determining serum ProGRP concentrations of 144 patients with small cell lung cancer, 1618 patients with the non-small cell lung tumor group, 42 patients with benign lung tumors, 231 with extrapulmonary malignant tumors, 275 with extrapulmonary benign disease, 1, 402 with benign lung disease, and 320 healthy patients.Analysis and evaluation of ProGRP values before and after treatment in patients with SCLC changes and the correlation of tumor size.Results Serum ProGRP levels in small cell lung cancer group were higher than those in each group.U test shows P<0.05 in each group.U test shows P<0.05 in patients with renal failure and healthy controls;prolonged ProGRP values in patients with small cell lung cancer were higher than the limited period.U test shows P<0.05.Serum ProGRP U-test shows P<0.05 between before and after treatment in small cell lung cancer progression and remission groups.Serum ProGRP U-test shows P>0.05 between before and after treatment in small cell lung cancer stable group.Serum ProGRP concentration and tumor mass in small cell lung cancer The size is consistent.Compared with healthy control group, the lung non-small cell tumor group, lung benign tumor group, extrapulmonary malignant tumor group, intrapulmonary benign disease group conduct U test, showing P>0.05.Conclusion Serum ProGRP is a specific tumor marker of SCLC without the interference of renal failure.It can be used as an auxiliary basis for SCLC staging, monitoring prognosis, and evaluating clinical efficacy of important indicators.
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Objective To observe the level changes and clinical diagnostic value of follicular statin -1 (FSTL1)in the serum of patients with different types of acute coronary syndrome(ACS).Methods Collected the clinical diagnosis of acute coronary syndrome patients 98 cases,which contained ST segment elevation my-ocardial infarction(STEMI)in 34 cases,non ST elevation myocardial infarction(NSTEMI)in 28 cases,unsta-ble angina pectoris(UA)in 36 cases,while the examination resuLts of healthy people as a control group of 20 cases.The Venous blood was collected and the FSTL1 levels of the 4 groups were detected by ELISA.Results The levels of Serum FSTL1 in ACS group was significantly higher than that in normal control group(P<0.05).Serum FSTL1 of the ACS group were significant correlated with Gensini score,cTNT,hs-CRP(related coefficient:0.210,0.236,0.219 separately).The AUC of FSTL1 was 0.910(95% CI:0.832 -0.988),which was lower than cTNT.The best cut-off value of FSTL1 as a biomarker was 5.65 μg/L(specificity:84.2% and sensitivity:77.5%).Moreover the combination of FSTL1,HDL and cTNT exhibited significantly higher AUC=0.945(95% CI:0.909 -0.981)than did other biomarkers alone or pair combinations.Conclusion In pa-tients with acute coronary syndrome,serum FSTL1 levels has a positive correlation with the degree of coro-nary stenosis and inflammation reaction,and has certain value in the diagnosis of acute coronary syndrome.
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Objective To evaluate the diagnostic performances of seven estimation formulas for glomerular filtration rate (GFR) in pre-operative patients with renal cell carcinoma.Methods A total of 386 pre-operative patients with renal cell carcinoma in the first affiliated hospital of Chongqing medical university from January 2012 to October 2014 were selected.All the patients' GFRs were measured by the renal dynamic imagingwith 99mTc-DTPA as reference (rGFR) and the seven GFR estimation equations (eGFR) were compared with the rGFR respectively.Their correlations and consistencies were observed with spearman correlation analysis and Bland and Altman analysis.The diagnostic sensitivity,specificity and likelihood ratios were calculated and the eGFR accuracies were assessed with receiver operator curve (ROC) analysis.Results The correlations between the rGFR and eGFRs were significantly (P<0.001).In addition,CKD-EPI-Asian Crea and Ruijin formula were more accurate than others in different stages with larger ROC area in diagnosing renal cell carcinoma.Conclusion There were significant correlations between the eGFRs and rGFR,but some deviations existed.CKD-EPI-Asian Crea and Ruijin formula were more suitable for assessment of eGFR of pre-operative patients with renal cell carcinoma.However,both of these equations had a few limitations.
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Objective To evaluate the diagnostic value of combination detection of alpha-fetoprotein (AFP),Golgi protein 73 (GP73) and a-L-fucosidase (AFU) for early hepatocellular carcinoma (HCC).Methods A total of 222 patients with liver diseases in this hospital from March 2016 to March 2017 were collected and divided into the early stage HCC group (74 cases),late stage HCC group (27 cases),liver cirrhosis group (74 cases) and chronic hepatitis B group (47 cases),and contemporaneous 49 individuals undergoing physical examination were selected as the healthy control group.The levels of serum GP73,AFP and AFU were detected in each group.The ROC curve was drawn.The diagnostic values of single detection and combined detection of 3 indicators for diagnosing early HCC were evaluated.Results The serum GP73,AFP and AFU levels in the early stage HCC group were significantly higher than those in the liver cirrhosis group,chronic hepatitis B group and healthy control group (P<0.05).In the HCC screening,the area under the curve (AUC) of AFP ROC curve for singly diagnosing HCC was 0.910(95%CI:0.864-0.936),AUC of GP73 and AFP combined diagnosis was maximal [0.925 (95% CI:0.889-0.950)] and the sensitivity was the highest (95.0%).In the differentiation diagnosis between early HCC and liver cirrhosis,AUC of GP73 for single diagnosis was maximal [0.842(95%CI:0.746-0.879)] and the specificity was the highest (86.5%);AUC of GP73 and AFU combined diagnosis was maximal[0.901(95%CI:0.788-0.907)].Conclusion GP73 and AFP for combined detection of HCC can increase the diagnostic efficiency of HCC screening.GP73 and AFU combined diagnosis can increase the diagnosis efficiency of early HCC,which has an important significance for the differentiation diagnosis between early HCC and liver cirrhosis.
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Objective To explore the value of serum ischemia modified albumin (IMA) level in assessment of disease severity for patients with chronic obstructive pulmonary disease (COPD).Methods A total of 81 cases of patients with COPD treated in our hospital from September 2015 to March 2016 were selected (COPD group),including 51 cases of patients with acute exacerbation of COPD and 30 cases of patients with stable of COPD.Meanwhile,30 volunteers without COPD were collected as control group.Serum levels of IMA were detected and compared among different groups.Correlations between serum level of IMA and serum level of myoglobin (MYO),troponin T (TNT) and C reactive protein (CRP),and white blood cell (WBC) count were analyzed respectively.A receiver operating characteristic (ROC) curve was also plotted to investigate the diagnostic value of serum IMA level for diagnosing COPD.Results Serum level of IMA in the COPD group was higher than that in the control group [84.1 (79.1,88.5) U/L vs.73.1 (70.2,75.1)U/L],serum level of IMA in patients with acute exacerbation of COPD was higher than that of patients with stable of COPD [85.5 (82.3,89.4)U/L vs.78.1 (75.9,83.0)U/L],serum levels of IMA in patients with acute exacerbation and stable of COPD both were higher than that in the control group,there were statistically significant differences (P<0.05).The serum level of IMA was positively related with serum level of MYO in patients with COPD (r=0.554,P =0.00).ROC curve indicated when the cutoff value was set as 76.55 U/L,the sensitivity and specificity of serum level of IMA for diagnosing COPD was 88.5% and 80.0% respectively,and area under the ROC curve was 0.88.Conclusion Serum level of IMA could be a valuable indicator for clinically assessing disease severity of patients with COPD,which deserves further study through expanding samples size.
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BACKGROUND: Measurement uncertainty characterizes the dispersion of the quantity values attributed to a measurand. Although this concept was introduced to medical laboratories some years ago, not all medical researchers are familiar with it. Therefore, the evaluation and expression of measurement uncertainty must be highlighted using a practical example. METHODS: In accordance with the procedure for evaluating and expressing uncertainty, provided by the Joint Committee for Guides in Metrology (JCGM), we used plasma glucose (Glu) as an example and defined it as the measurand. We then analyzed the main sources of uncertainty, evaluated each component of uncertainty, and calculated the combined uncertainty and expanded uncertainty with 2 budgets for single measurements and continuous monitoring, respectively. RESULTS: During the measurement of Glu, the main sources of uncertainty included imprecision, within-subject biological variance (BVw), calibrator uncertainty, and systematic bias. We evaluated the uncertainty of each component to be 1.26%, 1.91%, 5.70%, 0.42%, and -2.87% for within-run imprecision, between-day imprecision, BVw, calibrator uncertainty, and systematic bias, respectively. For a single specimen, the expanded uncertainty was 7.38% or 6.1+/-0.45 mmol/L (kappa=2); in continuous monitoring of Glu, the expanded uncertainty was 13.58% or 6.1+/-0.83 mmol/L (kappa=2). CONCLUSIONS: We have demonstrated the overall procedure for evaluating and reporting uncertainty with 2 different budgets. The uncertainty is not only related to the medical laboratory in which the measurement is undertaken, but is also associated with the calibrator uncertainty and the biological variation of the subject. Therefore, it is helpful in explaining the accuracy of test results.
Subject(s)
Humans , Blood Chemical Analysis/methods , Clinical Chemistry Tests/methods , Glucose/analysis , Models, Statistical , Quality Control , UncertaintyABSTRACT
BACKGROUND: Measurement uncertainty characterizes the dispersion of the quantity values attributed to a measurand. Although this concept was introduced to medical laboratories some years ago, not all medical researchers are familiar with it. Therefore, the evaluation and expression of measurement uncertainty must be highlighted using a practical example. METHODS: In accordance with the procedure for evaluating and expressing uncertainty, provided by the Joint Committee for Guides in Metrology (JCGM), we used plasma glucose (Glu) as an example and defined it as the measurand. We then analyzed the main sources of uncertainty, evaluated each component of uncertainty, and calculated the combined uncertainty and expanded uncertainty with 2 budgets for single measurements and continuous monitoring, respectively. RESULTS: During the measurement of Glu, the main sources of uncertainty included imprecision, within-subject biological variance (BVw), calibrator uncertainty, and systematic bias. We evaluated the uncertainty of each component to be 1.26%, 1.91%, 5.70%, 0.42%, and -2.87% for within-run imprecision, between-day imprecision, BVw, calibrator uncertainty, and systematic bias, respectively. For a single specimen, the expanded uncertainty was 7.38% or 6.1+/-0.45 mmol/L (kappa=2); in continuous monitoring of Glu, the expanded uncertainty was 13.58% or 6.1+/-0.83 mmol/L (kappa=2). CONCLUSIONS: We have demonstrated the overall procedure for evaluating and reporting uncertainty with 2 different budgets. The uncertainty is not only related to the medical laboratory in which the measurement is undertaken, but is also associated with the calibrator uncertainty and the biological variation of the subject. Therefore, it is helpful in explaining the accuracy of test results.
Subject(s)
Humans , Blood Chemical Analysis/methods , Clinical Chemistry Tests/methods , Glucose/analysis , Models, Statistical , Quality Control , UncertaintyABSTRACT
Objective:To explore how smoking can effect serum lipids.Methods:2008 healthy adults were divided into two groups by questionnaire,smoking group and non-smoking group.The effects of other possibly relative factors were corrected also by covariance analysis.Results:After considering or adjusting the effects of other possibly relative factors,the changes in lipoid metabolism were shown:serum TG level increased and HDL-C,TC/HDL-C,LDL-C/HDL-C decreased.When smoking was quited,TG decreased and HDL-C increased.These indices were significant compared with smokers.Conclusion:The results suggest that smoking is an affective factor independent of gender.Stop smoking would ameliorate the abnormality of serum lipid.
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Objective:To discuss the changes of lipid metabolism in impaired glucose tolerance (IGT) indivi duals.Methods:IGT individuals were divided into four groups by hypertension and obesity (IGT individuals without hypertension and obesity,IGT individuals with hypertension,IGT individuals with obesity,IGT individuals with hypertension and obesity).Healthy adults were as control.Serum lipids were tested.Results:Levels of TC,TG,LDL-C,TC/HDL-C of IGT individuals were higher than healthy adults,and level of HDL-C was lower than healthy adult.Conclusion:The changes of the lipid metabolism of IGT individuals was like diabetic type 2 individuals.
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Objective:To evaluate the diagnostic effect of OGTT for DM and IGT when FBG is normal.Methods:To eliminate some patients with DM,acute diseases,surgery,acute or chronic hepatitis,pregnancy and the diseases that could affect metabolism of sugar by questionnaire,Other patients were tested OGTT.According to the level of 2h PG,they are classified into three groups:DM group,IGT group,and control group.Results:There are 91/292(31.2%)patients of DM and 466/514(90.7%) patients of IGT whose FBG≤6.0mmol/L and the rate was 2.96% and 15.2% respectively among 3071 normal FBG.Conclusion:The patients with hypertension,overweight and age more than 40 years old should test 2hPG to diagnose the DM and IGT even though FBG is normal.