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Objective: To determine the total and age-specific cut-off values of total prostate specific antigen (tPSA) and the ratio of free PSA divided total PSA (fPSA/tPSA) for screening prostate cancer in China. Methods: Based on the Chinese Colorectal, Breast, Lung, Liver, and Stomach cancer Screening Trial (C-BLAST) and the Tianjin Common Cancer Case Cohort (TJ4C), males who were not diagnosed with any cancers at baseline since 2017 and received both tPSA and fPSA testes were selected. Based on Cox regression, the overall and age-specific (ï¼60, 60-ï¼70, and ≥70 years) accuracy and optimal cut-off values of tPSA and fPSA/tPSA ratio for screening prostate cancer were evaluated with time-dependent receiver operating characteristic curve (tdROC) and area under curve (AUC). Bootstrap resampling was used to internally validate the stability of the optimal cut-off value, and the PLCO study was used to externally validate the accuracy under different cut-off values. Results: A total of 5 180 participants were included in the study, and after a median follow-up of 1.48 years, a total of 332 prostate cancer patients were included. In the total population, the tdAUC of tPSA and fPSA/tPSA screening for prostate cancer were 0.852 and 0.748, respectively, with the optimal cut-off values of 5.08 ng/ml and 0.173, respectively. After age stratification, the age specific cut-off values of tPSA in the <60, 60-<70, and ≥70 age groups were 3.13, 4.82, and 11.54 ng/ml, respectively, while the age-specific cut-off values of fPSA/tPSA were 0.153, 0.135, and 0.130, respectively. Under the age-specific cut-off values, the sensitivities of tPSA screening for prostate cancer in males <60, 60-70, and ≥70 years old were 92.3%, 82.0%, and 77.6%, respectively, while the specificities were 84.7%, 81.3%, and 75.4%, respectively. The age-specific sensitivities of fPSA/tPSA for screening prostate cancer were 74.4%, 53.3%, and 55.9%, respectively, while the specificities were 83.8%, 83.7%, and 83.7%, respectively. Both bootstrap's internal validation and PLCO external validation provided similar results. The combination of tPSA and fPSA/tPSA could further improve the accuracy of screening. Conclusion: To improve the screening effects, it is recommended that age-specific cut-off values of tPSA and fPSA/tPSA should be used to screen for prostate cancer in the general risk population.
Subject(s)
Early Detection of Cancer , Prostate-Specific Antigen , Prostatic Neoplasms , Humans , Male , Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/blood , Prostate-Specific Antigen/blood , Aged , Middle Aged , Early Detection of Cancer/methods , Age Factors , ROC Curve , China , Sensitivity and Specificity , Mass Screening/methods , Area Under CurveABSTRACT
AIM: To assess the association of quantitative computed tomography (CT) features on admission with acute pancreatitis (AP) severity, and to explore the performance of combined CT and laboratory markers for predicting severe AP (SAP). MATERIALS AND METHODS: Data from 208 AP patients were reviewed retrospectively. Pancreas volume, the area of extrapancreatic inflammation, extrapancreatic fluid collection volume, and number were calculated based on CT images on admission. Laboratory biomarkers within 24 h of admission were collected. Interobserver agreement for CT measurements was measured by calculating interclass correlation coefficient (ICC). The associations of quantitative CT features with AP severity were evaluated. Predictive models for SAP were constructed based on CT and laboratory markers. Performances of single marker and the models were evaluated using receiver operating characteristic (ROC) curve and area under the ROC curve (AUC). RESULTS: Pancreas volume, area of extrapancreatic inflammation, extrapancreatic fluid collection volume, and number were significantly different between severe and non-severe AP groups. In predicting SAP, the AUCs of quantitative CT indicators ranged from 0.72 to 0.79; the AUCs of laboratory biomarkers were between 0.53 and 0.66. The combined model of area of extrapancreatic inflammation, serum calcium, and haematocrit yielded an AUC of 0.84, significantly higher than that of the laboratory model, single CT, or laboratory marker. Interobserver agreements for quantitative CT indicators were excellent, with ICC ranging from 0.91 to 0.98. CONCLUSION: Quantitative CT features on admission were significantly associated with AP severity; the combination of extrapancreatic inflammation area, serum calcium, and haematocrit could be taken as a new method for predicting SAP.
Subject(s)
Pancreatitis , Humans , Pancreatitis/diagnostic imaging , Pancreatitis/complications , Retrospective Studies , Acute Disease , Calcium , Severity of Illness Index , Predictive Value of Tests , Biomarkers , Tomography, X-Ray Computed/methods , ROC Curve , Inflammation/complications , PrognosisABSTRACT
About 8 dental schools were founded by Chinese dentists during modern times (1909-1949) in China. Only one still worked after the founding of the People's Republic of China, which was one of the three dental schools founded by dentist Situ Bo. There were no systematic researches on Situ Bo's participation in dentistry education. This paper analyzes the founder's experience in dentistry and in the two schools he founded at the beginning, focusing on the background and process of the schools' construction, management, teaching, teachers and students training, etc. The results show that the establishment of the first two dental schools have laid important foundation for the establishment and development of Shanghai Dental College by the reserve of trained professional teachers and accumulated valuable experience in running schools. The systematic review of this history will help us better understand the establishment and development of Shanghai Dental College and the efforts in dentistry education made by dentists growed up in modern China, as well as the early development process of stomatology.
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Professor Mao Xiejun wrote a report about dental education of China in 1935. From 1948 to 1950, he published three articles containing the educational idea of "developing dentistry into stomatology". When he served as the director of the Faculty of Dentistry of Peking University Medical School in July 1950, he proposed to rename the Faculty of Dentistry into the Faculty of Stomatology,which were approved by the Ministry of Health and the Ministry of Education of the People's Republic of China in one month. The Chinese Medical Association established the Society of Stomatology the next year. Later, dentistry was successively changed into stomatology, and medical content was integrated into dental education, which was of great significance and far-reaching influence. During the developments of the thought of stomatological education in China, Professor Mao Xiejun evidently played a pivotal role. In this paper, the formation process of the thoughts of stomatological education related to professor Mao Xiejun's contribution is elucidated through studying the archives, personal letters, and historical documents, so as to enrich the researches on the history of stomatology in China and to facilitate better understanding and promoting the development of stomatology.
Subject(s)
Oral Medicine , Humans , Oral Medicine/education , Education, Dental , China , UniversitiesABSTRACT
BACKGROUND: This study investigated the anatomical characteristics of the ramus intermedius (RI) and its correlation with the proximal diameter of the branch vessels of the left coronary artery (LCA) using coronary computed tomography angiography (CCTA). MATERIALS AND METHODS: We screened patients who underwent CCTA from January to September 2021 and randomly enrolled 267 with RI (RI group) and 134 without RI (control group). We evaluated the anatomical features of RI (distribution, proximal diameter, length). We measured the proximal diameter of the anterior interventricular branch of the left coronary artery (LAD) and the circumflex branch of the left coronary artery (LCX). We compared the differences between groups in the proximal diameter of LAD and LCX and the correlation between gender and each parameter of the LCA (LAD, LCX, RI) within the RI group. In addition, we compared the correlation between the distribution characteristics of RI and the proximal diameter of LAD and LCX within the RI group. RESULTS: The LAD and LCX proximal diameters in the RI group were significantly smaller than those in the control group (p < 0.05). Comparisons within the RI group showed the following results: the RI distribution, RI diameter and length, and the LCX proximal diameter were not significantly different between male and female patients (p > 0.05), and the LAD proximal diameter was significantly larger in male than in female patients (p < 0.05). There were statistically significant differences in the LAD and LCX proximal diameters between the different RI distribution groups (p < 0.05). Based on the pairwise comparison, there were significant differences in the LAD (LCX) proximal diameter between the RI-beside- -the-LAD (LCX) group and the RI-middle group, as well as between the RI-beside- -the-LAD (LCX) group and the RI-beside-the-LCX (LAD) group (p < 0.05). CONCLUSIONS: A CCTA accurately evaluated the anatomical characteristics of an RI, which has an impact on the proximal diameter of the branch vessels of the LCA (i.e. LAD and LCX), the degree of influence of which is correlated with the RI distribution.
Subject(s)
Coronary Artery Disease , Coronary Vessels , Humans , Male , Female , Coronary Vessels/diagnostic imaging , Computed Tomography Angiography , Coronary Angiography , Heart , Tomography, X-Ray ComputedABSTRACT
Eight dental schools were founded by Chinese dentists during modern times (1909-1949) in China, but only one of them still works. This article analyzes the establishment processes, faculty and student trainings in some of these dental schools, combining with the social background and management system at that time, to explore the difficulties encountered by Chinese dentists in founding dental schools before 1949.
Subject(s)
Dentists , Schools, Dental , Humans , ChinaABSTRACT
OBJECTIVE: The aim of this study is to investigate the clinical value of low-dose spiral CT (LDCT), plasma miR-200b, and miR-200c combined screening for lung cancer screening in the physical examination population. PATIENTS AND METHODS: From January 2016 to December 2018, the Physical Examination Center of our hospital underwent low-dose spiral CT lung cancer screening for 10,823 people aged ≥40 years. The quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) was used to detect the relative expressions of miR-200b and miR-200c in plasma, analyze the imaging characteristics of suspicious nodules in the lung and the relative expressions of miR-200b and miR-200c in plasma. RESULTS: A total of 2,919 pulmonary nodules were detected in the 10823 physical examination population, with a total detection rate of 26.97%, including 1523 males and 1396 females. 1081 positive nodules were detected with a detection rate of 9.99%. According to the Lung-RADS classification, the number of type 2 nodules was the highest, with a detection rate of 22.13%. Meanwhile, the rate of type 3 nodules was 3.15%, and the rate of type 4 nodules was 1.69%. The sensitivity, accuracy, and negative predictive value of LDCT, miR-200b, and miR-200c in the diagnosis of lung cancer were significantly improved compared with the individual tests, which were 94.74%, 90.16%, and 95.88%, respectively. CONCLUSIONS: Low-dose spiral CT combined with plasma miR-200b and miR-200c for lung cancer screening in the physical examination population can help to detect lung cancer patients with early symptoms that are not significant, and achieve early diagnosis and early treatment.
Subject(s)
Early Detection of Cancer/methods , Lung Neoplasms/diagnostic imaging , MicroRNAs/genetics , Tomography, Spiral Computed/methods , Adult , Aged , Female , Humans , Lung Neoplasms/genetics , Lung Neoplasms/pathology , Male , Mass Screening/methods , MicroRNAs/blood , Middle Aged , Predictive Value of Tests , Real-Time Polymerase Chain Reaction , Sensitivity and SpecificityABSTRACT
A series of regulations and policies for Dental Practitioner Qualification were issued during modern times (1906-1949) in China from local to national levels, in which the certification for qualification had been largely based on dental education and training experiences. The present article reviews the evolution and progression of dental practitioner qualification management, as well as its relationship to dental education before 1949, which may hopefully provide a historical background for the development of modern dentistry and enhance the understanding of the current management process for dental practitioner qualifications in China.
Subject(s)
Dentists , Professional Role , Certification , China , Education, Dental , HumansABSTRACT
Objective: To investigate and analyze the energy metabolism characteristics and the correlation between energy metabolism and the risk of secondary bacterial infection in patients with hepatitis B virus-related chronic liver disease (HBV-CLD). Methods: Data of 183 cases admitted to the Mengchao Hepatobiliary Hospital of Fujian Medical University from November 2017 to November 2020 were retrospectively analyzed. 79 cases of chronic hepatitis B, 51 cases of hepatitis B-related liver cirrhosis, and 53 cases of hepatitis B-related liver failure were collected. Among them patients with liver failure and decompensated liver cirrhosis were defined as severe liver disease group. The Quark RMR indirect calorimetry (COSMED Corporation, Italy) was used to exam the patients' energy metabolism condition, and the incidences of secondary bacterial infection of the patients during hospitalization were recorded. Shapiro-Wilk test and normal QQ plot were used to analyze the normal distribution of continuous variable data, which was consistent with the normal distribution and was described by mean ± standard deviation. In addition, if it did not conform to the normal distribution, the median and interquartile distance were used to describe it. Levene's test was used to test the homogeneity of variance of the data, which was consistent with the normal distribution. The t-test was used to compare the means of the two groups of samples. One-way analysis of variance was used to compare the mean values of the three groups of samples, and then the Tukey's test was used to compare the two groups. If the variance was uneven or did not conform to the normal distribution, the Wilcoxon rank sum test was used to compare the differences between the two groups. Kruskal-Wallis test (H test) was used to compare the differences between the three groups of samples, and then the Dunnett's test (Z test) was used for comparison between the two groups. Categorical variable data were analyzed using chi-square test. Logistic regression analysis was used to screen independent risk factors, and the criteria for variable inclusion (P < 0.05). Results: The respiratory entropy (RQ) and non-protein respiratory entropy (npRQ) of the three groups had statistically significant difference (P < 0.05). Among them, the RQ and npRQ of the chronic hepatitis B group were higher than hepatitis B-related liver cirrhosis group and hepatitis B-related liver failure group. There were statistically significant differences in fat oxidation rate (FAT%) and carbohydrate oxidation rate (CHO%) between the three groups (P < 0.05). Compared with hepatitis B-related liver cirrhosis group and hepatitis B-related liver failure group, chronic hepatitis B group (P < 0.05) had lower FAT% and higher CHO%. There were no statistically significant differences in the measured and predicted resting energy expenditure and protein oxidation rate (PRO%) between the three groups. The incidence of secondary bacterial infection in patients with severe liver disease was 48.39% (45/93). Compared with the non-infected group, the RQ and npRQ values ââof the infected group were significantly decreased (P < 0.05), while FAT% was significantly increased (P < 0.05). Logistic regression analysis showed that glutamyltransferase, cholesterol, and npRQ were independent risk factors for secondary bacterial infections in patients with severe liver disease. Glutamyltransferase elevation, and cholesterol and npRQ depletion had suggested an increased risk of secondary bacterial infection. Subgroup analysis of patients with hepatitis B-related liver failure also showed that compared with non-infected group, RQ value and npRQ value of secondary bacterial infection group were significantly decreased (P < 0.05), while FAT% was significantly increased (P < 0.05). Conclusion: Patients with hepatitis B virus-related chronic liver disease generally have abnormal energy metabolism. Low RQ, npRQ, CHO% and high FAT% are related to the severity of the disease; while npRQ reduction is related to the risk of secondary bacterial infection in patients with severe liver disease, and thus can be used as a clinical prognostic indicator.
Subject(s)
Bacterial Infections , Hepatitis B, Chronic , Energy Metabolism , Hepatitis B virus , Hepatitis B, Chronic/complications , Hepatitis B, Chronic/epidemiology , Hepatitis B, Chronic/metabolism , Humans , Liver/metabolism , Liver Cirrhosis/epidemiology , Liver Cirrhosis/metabolism , Retrospective StudiesABSTRACT
Topological superconductors (TSCs) are unconventional superconductors with bulk superconducting gap and in-gap Majorana states on the boundary that may be used as topological qubits for quantum computation. Despite their importance in both fundamental research and applications, natural TSCs are very rare. Here, combining state of the art synchrotron and laser-based angle-resolved photoemission spectroscopy, we investigated a stoichiometric transition metal dichalcogenide (TMD), 2M-WS2 with a superconducting transition temperature of 8.8 K (the highest among all TMDs in the natural form up to date) and observed distinctive topological surface states (TSSs). Furthermore, in the superconducting state, we found that the TSSs acquired a nodeless superconducting gap with similar magnitude as that of the bulk states. These discoveries not only evidence 2M-WS2 as an intrinsic TSC without the need of sensitive composition tuning or sophisticated heterostructures fabrication, but also provide an ideal platform for device applications thanks to its van der Waals layered structure.
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OBJECTIVE: To evaluate metabolic parameters of primary lesions examined by 18F-FDG PET/CT (18Fluorodeoxyglucose Positron Emission Tomography /Computed Tomography), including maximum standard uptake value (SUVmax), metabolic volume (MTV), and total lesion glycolysis (TLG). PATIENTS AND METHODS: 79 patients with endometrial cancer were selected as the subjects. They were diagnosed by histopathology in our hospital for the first time from January 2016 to December 2018. All the patients were examined by 18F-FDG PET/CT. Retrospective statistical analysis was carried out to evaluate different expression of metabolic parameters examined by 18F-FDG PET/CT of different clinicopathologic factors in endometrial cancer. Spearman correlation analysis was also used. RESULTS: SUVmax, TLG and MTV were correlated with FIGO staging, tissue grading, depth of myometrial invasion, and lymph node metastasis. SUVmax, TLG and MTV in lymph node metastasis group had high clinical staging, low differentiation and myometrial invasion depth >1/2, which were significantly higher than those in no lymph node metastasis group (low clinical staging, high differentiation and myometrial invasion depth ≤1/2). TLG had the greatest difference(p<0.001). TLG and MTV were correlated with histopathological classification (p<0.05). The expression levels of SUVmax, MTV and TLG of primary lesions were negatively correlated with the positive expression of ER and PR in tumor tissues (p<0.05), and significantly positively correlated with positive expression of HER -2 and Ki-67 (p<0.01). The expression of ER, PR, HER-2 and KI-67 in tumor tissues was correlated with tissue grading, clinical staging, depth of muscular layer infiltration, cervical tissue involvement and lymph node metastasis (p<0.05). CONCLUSIONS: Metabolic parameters of primary lesions examined by 18F-FDG PET/CT has a good correlation with its clinicopathological features. They can provide reference for the preoperative formulation of treatment plan for endometrial cancer, so as to reduce the risk of surgery and improve the prognosis of patients.
Subject(s)
Endometrial Neoplasms/diagnostic imaging , Positron Emission Tomography Computed Tomography , Adult , Aged , Endometrial Neoplasms/metabolism , Endometrial Neoplasms/surgery , Female , Fluorodeoxyglucose F18 , Humans , Immunohistochemistry , Middle AgedABSTRACT
OBJECTIVE: This study aimed at investigating the effect of atorvastatin on the expression of TLR4 and NF-κB in brain tissue of stroke rats and its protective effect on brain. MATERIALS AND METHODS: Sixty SD rats were selected. The control group (n=20) was raised without treatment. MCAO was used in the experimental group (n=20) and model group (n=20) for stroke modeling. The experimental group was treated with atorvastatin intragastric administration, while the model group received no treatment. The blood lipid level was detected by a full-automatic biochemical analyzer. The expression levels of TLR4 and NF-κB proteins were detected by Western-Blot (WB), and the mRNA expression of NF-κB and TLR4 in brain tissues was detected by real-time quantitative fluorescence (qtPCR). The neurological deficit score was performed. RESULTS: TC, TG, LDL-C in blood lipid indexes of the experimental group and the model group were remarkably higher than those of control group, while HDL-C was remarkably lower than that of control group (p<0.05). After treatment, TC, TG, LDL-C in the experimental group gradually decreased, while HDL-C concentration gradually increased (p<0.05). The expression of TLR4 and NF-κB protein in the experimental group was significantly lower than that in the model group (p<0.01) but significantly higher than that in the control group (p< 0.01). The expression of TLR4 and NF-κB mRAN in the experimental group was also considerably lower than that in the model group (p<0.01) but higher than that in the control group (p<0.01). After atorvastatin treatment, the neurological deficit score of the experimental group was remarkably lower than that of the model group (p<0.001). CONCLUSIONS: Atorvastatin can effectively reduce the expression of TLR4 and NF-κB in brain tissue of stroke rats, and has a certain protective effect on cerebral nerve function, which is expected to be the first choice for stroke treatment in the future.
Subject(s)
Atorvastatin/pharmacology , Brain/drug effects , NF-kappa B/antagonists & inhibitors , Protective Agents/pharmacology , Stroke/drug therapy , Toll-Like Receptor 4/antagonists & inhibitors , Administration, Oral , Animals , Atorvastatin/administration & dosage , Brain/metabolism , NF-kappa B/genetics , NF-kappa B/metabolism , Protective Agents/administration & dosage , Rats , Rats, Sprague-Dawley , Stroke/metabolism , Toll-Like Receptor 4/genetics , Toll-Like Receptor 4/metabolismABSTRACT
Original documents of professional practices and research preserved on the stomatological journals demonstrated the development of stomatology. In this review article, we made an analysis on the progression of the scientific stomatological journals in modern China. The development of stomatology were influenced by the social and environmental factors. Evolutionary process of stomatology in modern China, which could be divided into 4 stages named as embryonic, development, stagnation and recovery stages, showed a development history from merely tooth extraction and prosthodontic treatment to sophisticated multiple disciplines.
Subject(s)
Oral Medicine , Periodicals as Topic , China , Dental Care , Humans , ProsthodonticsABSTRACT
The professional journals of stomatology, which were dedicated to spread of theoretical knowledge and medical practices, has demonstrated their important value for studying the development of stomatology. The historical details of these stomatological journals published in modern China from 1840 to 1949, such as publication background, chief founders, aims, main features and the contents of articles, are of great importance for investigating not only the humanistic features, but also the development of stomatology in China. Twenty-three professional journals of stomatology in modern China and 2 260 articles published in them have been verified through text analysis and archives. The features and functions of these journals were further analyzed in order to enrich the humanities and historical research of modern Chinese stomatology.
Subject(s)
Oral Medicine , Periodicals as Topic/history , China , History, 19th Century , History, 20th CenturyABSTRACT
Perfluoroalkyl and polyfluoroalkyl substances (PFASs) have gained increasingly global attention in recent years. Due to their unique amphiphilic properties and stability, PFASs are recognized as highly persistent, toxic, and environmentally bioaccumulative. Among several physicochemical technologies, adsorption has been extensively used and proved to be an effective method for removing PFASs from aqueous environment. In this review article, the technical feasibility of the use of different adsorbents, such as activated carbon, ion exchange resins, minerals, molecularly imprinted polymer (MIP), carbon nanotubes (CNTs), and a wide range of potentially low-cost biosorbents, for PFASs removal from water or wastewater is critically reviewed. The evaluation and comparison of their PFASs sorption behavior in terms of kinetics and isotherms is presented. The mechanisms involved in PFASs adsorption processes, such as diffusion, electrostatic interaction, hydrophobic interaction, ion exchange and hydrogen bond, are discussed. The effects of the parameters variability on sorption process are highlighted. Based on the literature reviewed, a few recommendations for future research on PFASs adsorption are also elaborated. Capsule: The adsorption behavior and mechanisms of perfluoroalkyl and polyfluoroalkyl substances (PFASs) on various adsorbents are reviewed.
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Objective: To observe the dynamic changes of serum cryptococcal capsular polysaccharide antigen (CrAg) titer and chest CT of pulmonary cryptococcosis (PC) after antifungal therapy. Methods: A retrospective study was performed for patients with PC admitted to the Department of Pulmonary and Critical Care Medicine of the First Affiliated Hospital of Wenzhou Medical University from January 2015 to April 2018. Serum CrAg titers and Chest CT examination were performed for all the cases before and after treatment. The difference between immunocompetent hosts group and immunocompromised hosts group were compared and analyzed. Results: Eighty-two patients with PC including 46 male (56.1%) and 36 (43.9%) female were enrolled. Fifty-two (63.4%) patients were proven PC and thirty (36.6%) patients were probable PC. Forty-five (54.9%) patients had underlying diseases. Fifty-four (65.9%) patients were immunocompetent hosts and twenty-eight (34.1%) patients were immunocompromised hosts. The mean duration of treatment was (7.9±2.4) months and the mean follow-up was (24.0±10.0) months. Improvement (≥75%) in chest CT were found in 64.8% of the cases in immunocompetent group and 67.9% in immunocompromised group after 6 months' treatment. Improvement (≥75%) was found in 88.9% of the cases with patchy infiltrates or consolidation and only 63.0% in nodular or mass-like type and mixed patterns of PC. The serum CrAg titer of 55 cases ranged from 1â¶4 to 1â¶160 before treatment (median 1â¶40) and decreased for all cases after treatment. The serum CrAg titer became negative in 20 cases at last. Mean time of serum CrAg titer turning negative was (11.8±8.1) months. The serum CrAg titer became negative or decreased to 1â¶1 in 24 cases after treatment cessation, of whom the serum CrAg titer ranged from 1â¶5 to 1â¶160 before treatment (median 1â¶20). The serum CrAg titer of 31 cases ranged from 1â¶4 to 1â¶640 before treatment (median 1â¶64), of whom the serum CrAg detections were still positive after treatment cessation, and CrAg titer was 1â¶10 (ranged from 1â¶2 to 1â¶160). Conclusions: In PC, chest CT improves after antifungal treatment, and the infiltrates or consolidation type of PC resolves faster than nodular or mass-like shadows and mixed patterns in CT. The serum CrAg titer decreases after antifungal treatment.
Subject(s)
Cryptococcosis , Antifungal Agents , Antigens, Fungal , Female , Humans , Male , Polysaccharides , Retrospective Studies , Tomography, X-Ray ComputedABSTRACT
Objective: To determine whether relative abundance of epidermal growth factor receptor (EGFR) mutations in plasma predicts clinical response to epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) in patients with advanced lung adenocarcinoma. Methods: In this prospective study, adult patients with advanced lung adenocarcinoma were enrolled in our hospital from 1 April 2016 to 1 January 2017. EGFR mutations in tumor tissues were detected by ADx-amplification refractory mutation system (ADx-ARMS). EGFR mutations of plasma free tumor DNA were detected by ADx-ARMS and ADx-super amplification refractory mutation system (ADx-SuperARMS) at the same time. Patients with EGFR-mutant in tumor tissues and receiving EGFR-TKIs were finally enrolled. Plasma mutation-positive patients with both methods were high abundance group.Patients with positive mutations by ADx-SuperARMS but negative by ADx-ARMS were medium abundance group. Mutation-negative patients with both methods were recognized as low abundance group. The correlation between EGFR mutation abundance and clinical response to EGFR-TKIs were analyzed. Results: Among 71 patients enrolled, 42 harbored EGFR mutations in plasma were detected by ADx-ARMS, while 53 were found by ADx-SuperARMS.There were 42 patients in high abundance group, 11 in medium group while the other 18 in low group. The objective response rates (ORRs) were 69.0%, 7/11 and 10/18 in high, medium and low groups, respectively. The difference was significant between high and low abundances groups (P=0.006). Median progression-free survival (PFS) in high, medium and low groups were 11.0, 8.5 and 9.0 monthes, respectively (P<0.001). In patients with tumor 19-Del, the ORRs were 70.4%, 5/7 and 6/11 in high, medium and low abundance groups, respectively. The median PFS of high abundance group was significantly longer than the other two groups (12.0 monthes vs 9.0, 9.0 monthes). As to subjects with L858R mutation, the ORRs were 10/15, 2/4 and 3/6, respectively, with median PFS 9.6, 5.5 and 9.5 monthes. Conclusions: The relative abundance of EGFR mutations in plasma predicts clinical response to EGFR-TKIs in patients with advanced lung adenocarcinoma. The higher the mutation abundance is, the better the efficacy of EGFR-TKIs is.
Subject(s)
Adenocarcinoma of Lung/drug therapy , Adenocarcinoma of Lung/genetics , ErbB Receptors/genetics , Lung Neoplasms/drug therapy , Lung Neoplasms/genetics , Protein Kinase Inhibitors/pharmacology , Protein Kinase Inhibitors/therapeutic use , Adenocarcinoma of Lung/enzymology , Adenocarcinoma of Lung/pathology , Adult , DNA, Neoplasm/blood , DNA, Neoplasm/genetics , Humans , Lung Neoplasms/enzymology , Mutation , Progression-Free Survival , Prospective StudiesABSTRACT
Objective: To compare the diagnostic value of the old "ABC" method [serum pepsinogen(PG) combined with Helicobacter pylori (Hp) IgG antibody] and the new "ABC" method [serum pepsinogen plus gastrin-17(G-17)] in screening gastric cancer and its precancerous condition. Methods: Serum PG, G-17 and Hp-IgG were quantified by enzyme-linked immunosorbent assay (ELISA) in 278 subjects. Subjects were grouped according to the criteria of two methods. The gastroscopy and pathological biopsy were gold standard. Results: The positive rate of old "ABC" method was 74.46% (207/278), which was 54.68% of new "ABC" method (151/278). For the diagnosis of gastric cancer, the sensitivity and specificity of the old "ABC" method were 90.74% and 29.46% respectively, with diagnostic coincidence rate 41.37%. The sensitivity and specificity of the new "ABC" method were 92.59% and 54.46% respectively, with diagnostic coincidence rate 61.87%. As to the diagnosis of pre-cancerous state, the sensitivity and specificity of the old "ABC" method were 75.81% and 36.00%, with diagnostic coincidence rate 58.03%. The sensitivity and specificity of the new "ABC" method were 62.10% and 75.00%, with diagnostic coincidence rate 67.86%. Conclusions: Compared with the old "ABC" method, the new "ABC" method has higher sensitivity, specificity and diagnostic coincidence rate for the diagnosis of gastric cancer, yet higher specificity and lower sensitivity for the diagnosis of precancerous conditions.