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1.
Zhonghua Wai Ke Za Zhi ; 58(3): 225-229, 2020 Mar 01.
Artículo en Chino | MEDLINE | ID: mdl-32187927

RESUMEN

Objective: To examine clinic pathological features of mucinous cystic neoplasms (MCN) of the pancreas and explore the prognosis factors associated with malignant transformation of MCN of the pancreas. Methods: This multicenter retrospective study included all patients with pancreatic MCN underwent surgery at Department of Pancreatic Surgery, Zhongshan Hospital of Fudan University between January 2008 and December 2018 and patients with MCN who confirmed by postoperative pathology from Multicenter Pancreatic Cystic Tumor Database. There were 50 males (14.4%) and 297 females (85.6%) and the mean age was 48.6 years (range: 24-77 years). According to the pathological results, all patients were divided into benign lesion group (including MCN and which associated with low/medium grade dysplasia) and malignant lesion group (including MCN with high-grade dysplasia or invasive carcinoma) . The preoperative clinical pathology and imaging features of the two groups were analyzed, and the risk factors associated with malignant transformation of MCN were statistically analyzed. Results: This multicenter retrospective study included 347 patients. Twenty-four of the 347 patients were malignant, including 7 males and 17 females. Univariate analysis showed that age, gender, carcino-embryonic antigen (CEA) , CA19-9, CA125, tumor maximum diameter, and tumor location were remarkably different in the two groups (P<0.05) . Logistic regression analysis found that the preoperative tumor maximum diameter (OR=1.023, 95% CI: 1.002-1.045, P=0.035) was an independent risk factor for MCN malignant transformation. Conclusions: Age, gender, CEA, CA19-9, CA125, tumor maximum diameter, and tumor location are important features of MCN malignant lesions.The maximum diameter of the preoperative tumor is an independent risk factor for MCN malignant transformation.


Asunto(s)
Neoplasias Quísticas, Mucinosas y Serosas/diagnóstico , Neoplasias Pancreáticas/diagnóstico , Adulto , Anciano , Antígeno Ca-125/análisis , Antígeno CA-19-9/análisis , Antígeno Carcinoembrionario/análisis , Femenino , Humanos , Masculino , Proteínas de la Membrana/análisis , Persona de Mediana Edad , Páncreas/patología , Pronóstico , Estudios Retrospectivos , Factores de Riesgo , Adulto Joven
2.
BMC Med Genet ; 21(1): 28, 2020 02 10.
Artículo en Inglés | MEDLINE | ID: mdl-32041551

RESUMEN

BACKGROUND: This study aimed to explore the diagnostic value of serum miR-101-3p combined with pepsinogen (PG) on early diagnosis of gastric cancer (GC). METHODS: A total of 61 atrophic gastritis (AG) and 86 GC patients, and 50 healthy volunteers were enrolled. The serum expression of miR-101-3p was measured by qRT-PCR. The serum content of carcinoembryonic antigen (CEA) was measured by Electrochemiluminescence immunoassay. The serum contents of PGI and PGII were measured by Enzyme linked immunosorbent assay. The diagnostic value of serum markers on AG and GC was analyzed by receiver operating characteristic (ROC) analysis. RESULTS: The expression of miR-101-3p, the content of PGI and the ratio of PGI/II were significantly decreased, and the content of PGII was significantly increased in AG patients compared with those in normal controls. The changes of the above serum indicators were more obvious in GC patients than those in AG patients. The content of CEA was significantly higher in GC patients than that in AG patients. In addition, the expression of miR-101-3p was negatively associated with the submucosal infiltration in GC patients. MiR-101-3p exhibited high diagnostic value on AG (AUC 0.8493, sensitivity 80.33%, specificity 80%) and GC (AUC 0.8749, sensitivity 72.09%, specificity 86.49%). MiR-101-3p + PGI + PGI/II (AUC 0.856, sensitivity 80.23%, specificity 77.05%) exhibited a high diagnostic value in distinguishing between AG and GC. CONCLUSIONS: MiR-101-3p was a potential diagnostic marker for AG and GC. MiR-101-3p + PGI + PGI/II was effective in distinguishing between AG and GC.


Asunto(s)
Detección Precóz del Cáncer , Gastritis Atrófica/sangre , MicroARNs/sangre , Neoplasias Gástricas/sangre , Adulto , Antígeno Carcinoembrionario/sangre , Diagnóstico Diferencial , Femenino , Gastritis Atrófica/genética , Gastritis Atrófica/patología , Humanos , Masculino , Persona de Mediana Edad , Pepsinógeno A/sangre , Neoplasias Gástricas/genética , Neoplasias Gástricas/patología
3.
Medicine (Baltimore) ; 99(8): e19277, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32080139

RESUMEN

Evidence-based guidelines for the correct management of cancer patients are developed on the idea that timely care can improve health prognoses and quality of life.The aim of this paper is to evaluate the adherence of clinical pathways to clinical guidelines provided at the hospital level, for colorectal cancer care.By using a retrospective observational study, we proposed a method for associating each patient to a healthcare provider and modeling adherence as a latent construct governed by a set of 10 influential indicators. These indicators measure the adherence to specific guidelines for diagnosis, surgical treatment, chemotherapy, and follow-up. The model used was that of the item response theory (IRT). When evaluating providers, the IRT allows for a comparison of indicators in terms of their discriminating ability and difficulty, and in terms of their adherence to guidelines. The IRT results were compared with non-latent methods: numerator-based weight and denominator-based weight.A strong degree of coherence of the indicators in measuring adherence, and a high level of overall agreement between latent and non-latent methods were noted. The IRT approach demonstrated similar providers' evaluations between endoscopy and histological assessment indicators. The greatest discriminating ability among providers could be attributed to all diagnostic exams, while the lowest was associated with follow-up endoscopies. The most difficult indicator to achieve was fecal occult blood test, while follow-up imaging was the easiest.In a decision-making framework, valuable indications can be derived from the use of IRT models rather than weighting methods. Using IRTs, we were able to highlight the principal indicators in terms of strength of discrimination, and to isolate those that merely duplicated information.


Asunto(s)
Neoplasias Colorrectales/terapia , Adhesión a Directriz , Guías de Práctica Clínica como Asunto , Indicadores de Calidad de la Atención de Salud , Anciano de 80 o más Años , Antígeno Carcinoembrionario/sangre , Continuidad de la Atención al Paciente , Diagnóstico por Imagen , Endoscopía Gastrointestinal , Femenino , Humanos , Masculino , Sangre Oculta , Estudios Retrospectivos
4.
J Cardiothorac Surg ; 15(1): 7, 2020 Jan 08.
Artículo en Inglés | MEDLINE | ID: mdl-31915034

RESUMEN

BACKGROUND: Fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT is the most sensitive non-invasive imaging method for the detection of tumor metastasis and recurrence, but sometimes reveals false-positive results. Herein, we report two cases of false-positive results on PET/CT scans along with elevated serum carcinoembryonic antigen (CEA) levels, mimicking local recurrence after pulmonary segmentectomy. CASE PRESENTATION: Case 1; A 75-year-old woman underwent thoracoscopic left basal segmentectomy for primary lung cancer. Follow-up at 6 months after the surgery revealed serum CEA level elevation and chest CT showed a nodule measuring 25 × 22 mm in the residual left lower lobe. PET/CT revealed FDG uptake in the nodule diagnosed as local recurrence of lung cancer, and the patient underwent partial resection of the nodule. Microscopic examination of the resected specimen revealed granuloma caused by polyglycolic acid (PGA) sheet. Case 2; A 58-year-old man underwent VATS right S1 segmentectomy for lung metastasis from rectal carcinoma. Serum CEA levels gradually increased after surgery, and PET/CT revealed FDG uptake in the stump diagnosed as local recurrence of the lung metastasis. The patient underwent completion lobectomy 6 months after the segmentectomy, and the pathology of the resected specimen revealed an inflammatory granuloma caused by PGA suture. CONCLUSIONS: Although suture and stapler granulomas have been reported, granuloma caused by PGA sheets has never been reported. Postoperative recurrence of lung cancer should be diagnosed with not only PET/CT scans and serum tumor markers but also pathological findings, to avoid unnecessary treatment such as chemotherapy, radiation, and difficult reoperation.


Asunto(s)
Granuloma/diagnóstico por imagen , Neoplasias Pulmonares/diagnóstico por imagen , Recurrencia Local de Neoplasia/diagnóstico por imagen , Anciano , Antígeno Carcinoembrionario/sangre , Diagnóstico Diferencial , Reacciones Falso Positivas , Femenino , Fluorodesoxiglucosa F18 , Granuloma/etiología , Granuloma/cirugía , Humanos , Neoplasias Pulmonares/sangre , Neoplasias Pulmonares/cirugía , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/sangre , Recurrencia Local de Neoplasia/cirugía , Neumonectomía , Ácido Poliglicólico/efectos adversos , Tomografía Computarizada por Tomografía de Emisión de Positrones , Radiofármacos , Suturas/efectos adversos
5.
Acta Cytol ; 64(1-2): 124-135, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31509835

RESUMEN

Pancreatic cysts are increasingly detected on imaging studies. Accurate determination of the cyst type is important to provide appropriate care for the patients. It is also very clear that not one single modality can provide adequate diagnostic information. A multidisciplinary approach is the key to the diagnosis of pancreatic cysts. In this setting, the role of ancillary testing, which includes biochemical testing (carcinoembryonic antigen and amylase levels in the cyst), molecular testing (e.g., KRAS, GNAS, VHL, and CTNB1), and/or immunohistochemical tests are very important to obtain an accurate diagnosis. This review will discuss helpful ancillary tests in common pancreatic cyst neoplasms and how to approach the diagnosis of pancreatic cysts.


Asunto(s)
Carcinoma Ductal Pancreático/diagnóstico , Biopsia por Aspiración con Aguja Fina Guiada por Ultrasonido Endoscópico/métodos , Quiste Pancreático/diagnóstico , Neoplasias Pancreáticas/diagnóstico , Antígeno Carcinoembrionario/metabolismo , Carcinoma Ductal Pancreático/genética , Carcinoma Ductal Pancreático/metabolismo , Análisis Mutacional de ADN/métodos , Humanos , Inmunohistoquímica/métodos , Mutación , Quiste Pancreático/genética , Quiste Pancreático/metabolismo , Neoplasias Pancreáticas/genética , Neoplasias Pancreáticas/metabolismo , Proteínas Proto-Oncogénicas p21(ras)/genética
6.
J Clin Pathol ; 73(2): 102-106, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31462450

RESUMEN

AIMS: The cell block technique for assessing endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) specimens from pancreatic mucinous cystic lesions (MCLs) was systematically evaluated for the first time, including comparisons with three traditional methods of assessing such specimens. METHODS: The prospective arm comprised EUS-FNA specimens from EUS-suspected pancreatic MCLs. The retrospective arm comprised EUS-FNA specimens from pancreatic MCLs surgically resected before the study start. For each specimen, these data points were collected: macroscopic likelihood of mucin, cyst fluid carcinoembryonic antigen (CEA) level and presence of mucin in air-dried, direct smears and in cell block preparations. RESULTS: The prospective and retrospective arms of the study comprised 80 and 30 EUS-FNA specimens, respectively. Seven prospective cases led to surgical resections during the study, and therefore, 37 EUS-FNA specimens were confirmed to have originated from MCLs. In the prospective arm, macroscopic mucin was suspected, cyst fluid CEA level exceeded 192 ng/mL, mucin was detected in direct smears and cell block preparations in 78%, 30%, 39% and 73% of cases, respectively. Of the 37 specimens confirmed to originate from MCLs, macroscopic mucin assessment, cyst fluid CEA level, direct smear mucin assessment and cell block mucin assessment had sensitivities for diagnosing MCL of 87%, 45%, 45% and 81%, respectively. CONCLUSIONS: Cell block preparations are as likely to identify mucin from pancreatic MCLs as macroscopic assessment but are twice as likely to diagnose MCL than direct smears and fluid CEA biochemistry. The cell block technique is easy for sample collection and processing especially because these are identical for solid and cystic pancreatic lesions.


Asunto(s)
Biopsia por Aspiración con Aguja Fina Guiada por Ultrasonido Endoscópico , Mucinas/análisis , Quiste Pancreático/química , Quiste Pancreático/patología , Adhesión en Parafina , Biomarcadores/análisis , Antígeno Carcinoembrionario/análisis , Humanos , Quiste Pancreático/cirugía , Valor Predictivo de las Pruebas , Estudios Prospectivos , Reproducibilidad de los Resultados , Estudios Retrospectivos , Fijación del Tejido
7.
Oral Maxillofac Surg ; 24(1): 127-132, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31828452

RESUMEN

BACKGROUND: Mucinous adenocarcinoma (MAC) rarely occurs in the salivary glands, especially in the labial gland. MACs arising from the salivary glands are characterized by an aggressive behavior due to high invasiveness and a high rate of regional lymph node metastasis. CASE PRESENTATION: Here, we report a case of MAC arising from the lower lip, shown to have elevated serum carcinoembryonic antigen (CEA) levels by the medical checkup. The tumor showed aggressive behavior and serum CEA levels increased with repeated recurrence. CEA has been shown to have surprisingly diverse functions in cell adhesion, intracellular and intercellular signaling, and complex biological processes such as cancer progression, inflammation, angiogenesis, and metastasis. A MAC arising from the salivary glands may have a poor prognosis because CEA is highly expressed. CONCLUSIONS: Generally, serum CEA levels have not been used as tumor markers for salivary gland malignancies; however, it may be useful for MAC arising from salivary glands. We recommend prospective research to determine whether serum CEA estimation is useful as a component of routine pre-treatment workup for MACs arising from the salivary glands.


Asunto(s)
Adenocarcinoma Mucinoso , Biomarcadores de Tumor , Antígeno Carcinoembrionario , Humanos , Labio , Recurrencia Local de Neoplasia , Pronóstico , Estudios Prospectivos
8.
Radiol Med ; 125(3): 257-264, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31823295

RESUMEN

OBJECTIVE: To investigate the PET/CT findings in lung invasive adenocarcinoma with minor components of micropapillary or solid contents and its association with lymph node metastasis. MATERIALS AND METHODS: A total of 506 lung invasive adenocarcinoma (≤ 3 cm) patients who underwent a PET/CT examination and resection surgery were included. According to the proportion of solid/micropapillary components, the patients were classified into three groups: solid/micropapillary-negative (SMPN) (n = 258), solid/micropapillary-minor (SMPM; > 5% not predominant) (n = 158) and solid/micropapillary-predominant (SMPP; > 5% most dominant) (n = 90). The patients' PET/CT findings, including SUVmax, MTV, TLG and CT characteristics, and other clinical factors were compared by one-way ANOVA test. Logistic regression analysis was done to identify the most predictive findings for lymph node metastasis. RESULTS: The value of SUVmax, MTV, TLG and tumor size was highest in SMPP group, followed by SMPM and SMPN group (P < 0.001).The areas under the curve for SUVmax, MTV and TLG for node metastasis were 0.822, 0.843 and 0.835, respectively. Univariate analysis found that the SMPP and SMPM group had more lymph node metastasis than the SMPN group (P < 0.001). Furthermore, the lymph node metastasis group had higher CEA, SUVmax, MTV, TLG, tumor size and more pleural invasion (P < 0.001). Logistic regression analysis found that SMPP pathological type, SMPM pathological type, higher CEA and male patients were risk factors for lymph node metastasis (P < 0.01). CONCLUSIONS: Lung invasive adenocarcinoma with micropapillary or solid contents had higher SUVmax, MTV, TLG and tumor size and was associated with lymph node metastasis, even if they were not predominant.


Asunto(s)
Adenocarcinoma del Pulmón/diagnóstico por imagen , Adenocarcinoma Papilar/diagnóstico por imagen , Neoplasias Pulmonares/diagnóstico por imagen , Adenocarcinoma del Pulmón/clasificación , Adenocarcinoma del Pulmón/patología , Adenocarcinoma del Pulmón/secundario , Adenocarcinoma Papilar/clasificación , Adenocarcinoma Papilar/patología , Adenocarcinoma Papilar/secundario , Anciano , Análisis de Varianza , Área Bajo la Curva , Antígeno Carcinoembrionario , Femenino , Humanos , Neoplasias Pulmonares/clasificación , Neoplasias Pulmonares/patología , Metástasis Linfática , Masculino , Persona de Mediana Edad , Invasividad Neoplásica , Tomografía Computarizada por Tomografía de Emisión de Positrones , Análisis de Regresión , Estudios Retrospectivos , Factores de Riesgo , Factores Sexuales , Carga Tumoral
9.
Gastroenterology ; 158(1): 238-252, 2020 01.
Artículo en Inglés | MEDLINE | ID: mdl-31585122

RESUMEN

BACKGROUND & AIMS: We studied interactions among proteins of the carcinoembryonic antigen-related cell adhesion molecule (CEACAM) family, which interact with microbes, and transforming growth factor beta (TGFB) signaling pathway, which is often altered in colorectal cancer cells. We investigated mechanisms by which CEACAM proteins inhibit TGFB signaling and alter the intestinal microbiome to promote colorectal carcinogenesis. METHODS: We collected data on DNA sequences, messenger RNA expression levels, and patient survival times from 456 colorectal adenocarcinoma cases, and a separate set of 594 samples of colorectal adenocarcinomas, in The Cancer Genome Atlas. We performed shotgun metagenomic sequencing analyses of feces from wild-type mice and mice with defects in TGFB signaling (Sptbn1+/- and Smad4+/-/Sptbn1+/-) to identify changes in microbiota composition before development of colon tumors. CEACAM protein and its mutants were overexpressed in SW480 and HCT116 colorectal cancer cell lines, which were analyzed by immunoblotting and proliferation and colony formation assays. RESULTS: In colorectal adenocarcinomas, high expression levels of genes encoding CEACAM proteins, especially CEACAM5, were associated with reduced survival times of patients. There was an inverse correlation between expression of CEACAM genes and expression of TGFB pathway genes (TGFBR1, TGFBR2, and SMAD3). In colorectal adenocarcinomas, we also found an inverse correlation between expression of genes in the TGFB signaling pathway and genes that regulate stem cell features of cells. We found mutations encoding L640I and A643T in the B3 domain of human CEACAM5 in colorectal adenocarcinomas; structural studies indicated that these mutations would alter the interaction between CEACAM5 and TGFBR1. Overexpression of these mutants in SW480 and HCT116 colorectal cancer cell lines increased their anchorage-independent growth and inhibited TGFB signaling to a greater extent than overexpression of wild-type CEACAM5, indicating that they are gain-of-function mutations. Compared with feces from wild-type mice, feces from mice with defects in TGFB signaling had increased abundance of bacterial species that have been associated with the development of colon tumors, including Clostridium septicum, and decreased amounts of beneficial bacteria, such as Bacteroides vulgatus and Parabacteroides distasonis. CONCLUSION: We found expression of CEACAMs and genes that regulate stem cell features of cells to be increased in colorectal adenocarcinomas and inversely correlated with expression of TGFB pathway genes. We found colorectal adenocarcinomas to express mutant forms of CEACAM5 that inhibit TGFB signaling and increase proliferation and colony formation. We propose that CEACAM proteins disrupt TGFB signaling, which alters the composition of the intestinal microbiome to promote colorectal carcinogenesis.


Asunto(s)
Antígeno Carcinoembrionario/genética , Carcinogénesis/genética , Neoplasias Colorrectales/genética , Microbioma Gastrointestinal/fisiología , Transducción de Señal/genética , Animales , Bacterias/genética , Bacterias/aislamiento & purificación , Antígeno Carcinoembrionario/metabolismo , Neoplasias Colorrectales/microbiología , Neoplasias Colorrectales/mortalidad , Modelos Animales de Enfermedad , Heces/microbiología , Proteínas Ligadas a GPI/genética , Proteínas Ligadas a GPI/metabolismo , Mutación con Ganancia de Función , Regulación Neoplásica de la Expresión Génica , Células HCT116 , Humanos , Metagenómica , Ratones , Ratones Transgénicos , Dominios Proteicos/genética , Receptor Tipo I de Factor de Crecimiento Transformador beta/metabolismo , Proteína Smad4/genética , Proteína Smad4/metabolismo , Esferoides Celulares , Análisis de Supervivencia , Factor de Crecimiento Transformador beta/metabolismo
10.
Yonsei Med J ; 61(1): 15-19, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31887795

RESUMEN

PURPOSE: The purpose of this study was to assess the diagnostic and prognostic value of serum progastrin-releasing peptide (ProGRP) in patients with gastric cancer (GC). MATERIALS AND METHODS: A total of 150 patients with GC (89 males and 61 females) were recruited, including those with stage I (n=28), stage II (n=33), stage III (n=50), and stage IV (n=39) disease; 50 healthy controls and 66 patients with benign gastric diseases were also enrolled. Levels of serum ProGRP, carcinoembryonic antigen (CEA), and carbohydrate antigen 72-4 (CA72-4) were measured in all subjects. RESULTS: Serum ProGRP levels were significantly higher in GC patients than in controls (p<0.001), and ProGRP was significantly correlated with tumor size, tumor node metastasis stage, differentiation, invasion depth, and lymph node metastasis (p< 0.005). ProGRP levels were significantly decreased after chemotherapy (p<0.001). Receiver operating characteristic curves revealed a sensitivity and specificity for serum ProGRP in GC of 85.9% and 81.2%, respectively. ProGRP levels were positively correlated with CA72-4 and CEA (r=0.792 and 0.688, p<0.05, respectively). Combined detection of ProGRP, CEA, and CA72-4 showed the best diagnostic power for GC. CONCLUSION: ProGRP may be useful as a potential biomarker for GC diagnosis and therapy.


Asunto(s)
Progresión de la Enfermedad , Fragmentos de Péptidos/metabolismo , Neoplasias Gástricas/metabolismo , Neoplasias Gástricas/patología , Adulto , Anciano , Antígenos de Carbohidratos Asociados a Tumores/sangre , Biomarcadores de Tumor/sangre , Antígeno Carcinoembrionario/sangre , Estudios de Casos y Controles , Femenino , Proteínas Ligadas a GPI/sangre , Humanos , Masculino , Persona de Mediana Edad , Fragmentos de Péptidos/sangre , Pronóstico , Curva ROC , Proteínas Recombinantes/sangre , Proteínas Recombinantes/metabolismo , Sensibilidad y Especificidad , Neoplasias Gástricas/sangre , Neoplasias Gástricas/diagnóstico
11.
Beijing Da Xue Xue Bao Yi Xue Ban ; 51(6): 1071-1077, 2019 Dec 18.
Artículo en Chino | MEDLINE | ID: mdl-31848507

RESUMEN

OBJECTIVE: To evaluate the diagnostic value of 18F-FDG PET/CT and tumor markers (CEA,CA19-9,CA24-2) in detection for recurrence and metastasis of postoperative colorectal moderately differentiated adenocarcinoma. METHODS: Fifty-five patients were enrolled in this study. All of the patients were tested with serum CEA within 2 weeks when they underwent 18F-FDG PET/CT scan, and some patients were tested with serum CA19-9 and CA24-2 simultaneously. According to the pathology and clinical results of their follow-up, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 18F-FDG PET/CT and tumor markers were calculated based on different divided groups, respectively. RESULTS: According to the pathology and the results of their clinical follow-up, the sensitivity of 18F-FDG PET/CT, CEA, CA19-9, CA24-2 and the combination of those three tumor markers were 95.74%, 68.09%, 28.57%, 40.00% and 74.47%, respectively. The specificity of 18F-FDG PET/CT, CEA, CA19-9, CA24-2 and the combination of those three tumor markers were 75.00%, 50.00%, 66.67%, 71.43% and 50.00%, respectively. The positive predictive valueof 18F-FDG PET/CT, CEA, CA19-9, CA24-2 and the combination of those three tumor markers were 95.74%, 88.89%, 85.71%, 88.89% and 89.74%, respectively. The negative predictive value of 18F-FDG PET/CT, CEA, CA19-9, CA24-2 and the combination of those three tumor markers were 75.00%, 26.67%, 11.42%, 17.24%, 25.00%, respectively. The accuracy of 18F-FDG PET/CT, CEA, CA19-9, CA24-2 and the combination of those three tumor markers were 92.73%, 65.47%, 32.65%, 44.68% and 70.91%, respectively. There were 2 cases of false positive and 2 cases of false negative in 18F-FDG PET/CT. CONCLUSION: 18F-FDG PET/CT has high value in detecting recurrence and metastasis of postoperative colorectal carcinoma. Tumor markers have the positive value to imply the recurrence and metastasis of postoperative colorectal carcinoma and are useful to indicate when to perform the 18F-FDG PET/CT. The combination of tumor markers could improve the diagnostic efficiency to some extent.


Asunto(s)
Adenocarcinoma , Neoplasias Colorrectales , Adenocarcinoma/diagnóstico , Biomarcadores de Tumor , Antígeno CA-19-9 , Antígeno Carcinoembrionario , Neoplasias Colorrectales/diagnóstico , Fluorodesoxiglucosa F18 , Humanos , Recurrencia Local de Neoplasia , Tomografía Computarizada por Tomografía de Emisión de Positrones , Tomografía de Emisión de Positrones , Recurrencia
12.
Clin Biochem ; 74: 60-68, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31669510

RESUMEN

BACKGROUND: Colorectal cancer (CRC) is one of the most common cancers worldwide, and emerging lines of evidence have implicated circular RNAs (circRNAs), a novel class of endogenous noncoding RNAs, in CRC development. However, whether plasma circRNAs might be novel diagnostic biomarkers for CRC remains unclear. METHODS: We investigated the plasma levels of selected circRNAs by quantitative real-time PCR (qRT-PCR). The presence of the candidate circRNAs was confirmed through RNase R assays, qRT-PCR and DNA sequencing, and their diagnostic value was evaluated using a receiver operating characteristic (ROC) curve. RESULTS: The plasma levels of three circRNAs (circ-CCDC66, circ-ABCC1 and circ-STIL) were significantly decreased in CRC patients (n = 45) compared with healthy controls (n = 61). The ROC curve analysis showed that the area under the ROC curve (AUC) of the three-circRNA panel was 0.780, which is higher than that of traditional protein biomarkers, such as carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9). Combining the circRNA panel with CEA and CA19-9 might improve the ability to diagnose CRC (AUC = 0.855). In addition, the plasma circ-ABCC1 level was related to tumor growth and progression, and the plasma circ-CCDC66 and circ-ABCC1 levels were decreased in precursor lesions of CRC, including colon adenomas and adenomatous polyps. More importantly, circ-CCDC66 and circ-STIL were found to be useful for diagnosing early-stage CRC, and the three-circRNA panel improved the ability to diagnose CEA-negative and CA19-9-negative CRC. CONCLUSION: Our study provides the first identification of a panel of three plasma circRNAs that could serve as a novel and independent diagnostic biomarker for CRC.


Asunto(s)
Biomarcadores de Tumor/sangre , Neoplasias Colorrectales/sangre , Neoplasias Colorrectales/diagnóstico , /sangre , Adenoma/sangre , Pólipos Adenomatosos/sangre , Anciano , Antígenos de Carbohidratos Asociados a Tumores/sangre , Biomarcadores de Tumor/genética , Antígeno Carcinoembrionario/sangre , Estudios de Cohortes , Neoplasias del Colon/sangre , Detección Precóz del Cáncer , Femenino , Humanos , Modelos Logísticos , Metástasis Linfática , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Curva ROC , Reacción en Cadena en Tiempo Real de la Polimerasa , Análisis de Secuencia de ADN
13.
J Biochem Mol Toxicol ; 33(12): e22374, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31702096

RESUMEN

The main purpose of the current study is to reveal the anticancer action of limonin against benzo(a)pyrene [B(a)P]-treated lung carcinogenesis in Swiss albino mice and A549 lung cancer cells. B(a)P was orally supplemented (50 mg/kg body weight) twice a week for four weeks induction of lung cancer in mice. The lung weight, body weight, incidence of tumor, lipid peroxidation, carcinoembryonic antigen (CEA), enzymatic and nonenzymatic antioxidants (superoxide dismutase, GPx, glutathione, glutathione reductase, catalase, and glutathione S-transferase), serum marker enzymes (aryl hydroxylase, lactate dehydrogenase, 5'-nucleotidases, and γ-glutamyl transpeptidase), and inflammatory mediators (interleukin-1ß, interleukin-6, and tumor necrosis factor-α) were estimated. Moreover, a histopathological study of lung tissues was supported by the biochemical analysis. Furthermore, the anticancer activity of limonin on A549 cells was measured by cell viability, production of reactive oxygen species (ROS), apoptotic morphological changes by AO/EtBr staining. Additionally, the status of apoptosis protein (caspase-9 and -3) expressions was analyzed by the colorimetric analysis. B(a)P-induced mice showed increased lipid peroxidation, CEA, serum marker enzymes and inflammatory cytokines levels with simultaneously decreased in the nonenzymatic and enzymatic antioxidants levels. Limonin supplements significantly reverted back to all these changes in this manner, showing the efficiency of anticancer effect. Furthermore, our in vitro study also supported the anticancer effect of the treatment of limonin-enhanced apoptosis by loss of cell viability, improved ROS production, apoptotic morphological changes, and apoptosis protein expression were analyzed. Overall, these results suggest the anticancer potential of limonin against B(a)P-induced lung cancer in Swiss albino mice and A549 lung cancer cells.


Asunto(s)
Anticarcinógenos/uso terapéutico , Antioxidantes/uso terapéutico , Apoptosis/efectos de los fármacos , Benzo(a)pireno/farmacología , Carcinogénesis/inducido químicamente , Carcinogénesis/efectos de los fármacos , Proliferación Celular/efectos de los fármacos , Limoninas/uso terapéutico , Neoplasias Pulmonares/prevención & control , Células A549 , Animales , Benzo(a)pireno/administración & dosificación , Antígeno Carcinoembrionario/metabolismo , Caspasa 3/metabolismo , Caspasa 9/metabolismo , Supervivencia Celular/efectos de los fármacos , Citocinas/metabolismo , Humanos , Peroxidación de Lípido/efectos de los fármacos , Neoplasias Pulmonares/patología , Ratones , Ratones Endogámicos C57BL , Estrés Oxidativo/efectos de los fármacos , Especies Reactivas de Oxígeno/metabolismo , Carga Tumoral
14.
Medicine (Baltimore) ; 98(44): e17696, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31689796

RESUMEN

Liver resection (LR) is the standard procedure for treating colorectal cancer (CRC) hepatic metastasis; however, LR associated with a high recurrence incidence. This study aimed to determine an optimal post-LR adjuvant chemotherapeutic strategy to improve overall long-term patient outcomes. A retrospective study of 490 patients who had undergone curative LR for CRC hepatic metastasis was performed. Patients who underwent post-LR adjuvant chemotherapy demonstrated high overall survival (OS) rates (hazard ratio [HR] = 0.58, P = .002) but not high recurrence-free survival (RFS) rates (HR = 1.02, P = .885). Moreover, OS was significantly longer in patients who underwent 5-fluorouracil + leucovorin (5-FU/LV; HR = 0.63, P = .039), oxaliplatin-based chemotherapy (HR = 0.45, P < .001), or irinotecan-based chemotherapy with bevacizumab (HR = 0.64, P = .040) than in those who did not. Among patients with carcinoembryonic antigen (CEA) levels of <5 ng/mL at 1 month after LR, significant differences were noted only in those who underwent 5-FU/LV (HR = 0.58, P = .035) and oxaliplatin-based chemotherapy (HR = 0.38, P < .001). In conclusion, perioperative CEA levels are crucial in prognosis and treatment of patients with CRC hepatic metastasis after LR. Additionally, certain regimens of adjuvant chemotherapy alongside post-LR CEA levels may provide beneficial results.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Antígeno Carcinoembrionario/sangre , Neoplasias Colorrectales/tratamiento farmacológico , Neoplasias Colorrectales/patología , Neoplasias Hepáticas/tratamiento farmacológico , Neoplasias Hepáticas/secundario , Adulto , Anciano , Anciano de 80 o más Años , Protocolos de Quimioterapia Combinada Antineoplásica/administración & dosificación , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Quimioterapia Adyuvante , Neoplasias Colorrectales/sangre , Femenino , Humanos , Neoplasias Hepáticas/sangre , Neoplasias Hepáticas/cirugía , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Análisis de Supervivencia
15.
Int J Health Policy Manag ; 8(12): 732-733, 2019 12 01.
Artículo en Inglés | MEDLINE | ID: mdl-31779302

RESUMEN

Abrishami, Oortwijn, and Hofman (AOH) attribute to me a position I do not hold and an argument I did not make. The purpose of this note is make clear what my position actually is and to clarify the main differences between health technology assessment (HTA) and cost-effectiveness analysis (CEA).


Asunto(s)
Antígeno Carcinoembrionario , Evaluación de la Tecnología Biomédica , Análisis Costo-Beneficio , Humanos
16.
Chem Commun (Camb) ; 55(100): 15101-15104, 2019 Dec 28.
Artículo en Inglés | MEDLINE | ID: mdl-31782436

RESUMEN

Herein, we have designed bifunctional composite nanospheres for carcinoembryonic antigen (CEA) sensing and targeted drug delivery, based on carbon dot loaded silica nanoparticles coated with DNA-cross-linked hydrogels. As a result, highly sensitive and selective CEA detection was achieved in vitro, and an effective cytotoxic effect was realized in vivo after loading doxorubicin.


Asunto(s)
Antígeno Carcinoembrionario/análisis , ADN/química , Hidrogeles/química , Nanopartículas/química , Animales , Antibióticos Antineoplásicos/química , Antibióticos Antineoplásicos/uso terapéutico , Carbono/química , Doxorrubicina/química , Doxorrubicina/uso terapéutico , Portadores de Fármacos/química , Células Hep G2 , Humanos , Ratones , Ratones Desnudos , Microscopía Confocal , Neoplasias/diagnóstico , Neoplasias/tratamiento farmacológico , Puntos Cuánticos/química , Dióxido de Silicio/química , Trasplante Heterólogo
17.
J Biochem Mol Toxicol ; 33(12): e22404, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31593341

RESUMEN

Discovering the utmost effective and targeted chemotherapy for hepatocellular carcinoma is still a significant challenge. In the present study, diethylnitrosamine was used as a liver carcinogen and boldine a compound of boldo. We anticipated the hypothesis that boldine endow antiproliferative and promote apoptosis on hepatocarcinoma rats. We analyzed that boldine alters the tumor biomarkers and liver markers enzyme levels. Also, we determined boldine modulate the enzymatic and nonenzymatic antioxidant activities, as well as messenger RNA and protein expressions of Bcl2, Bax, and cleaved caspase 3 by reverse transcription polymerase chain reaction and Western blot analysis, respectively. It was also manifested by histopathology studies in liver tissues of HCC rats. Our finding suggested that boldine has antioxidant activity, and moreover, also contributes apoptotic nature by upregulating the protein expression of Bax, and cleaved caspase 3. Our data accomplishes that boldine a candidate drug has dynamic therapeutic activity and suitable for the treatment of HCC.


Asunto(s)
Antioxidantes/uso terapéutico , Aporfinas/uso terapéutico , Carcinoma Hepatocelular/inducido químicamente , Carcinoma Hepatocelular/tratamiento farmacológico , Dietilnitrosamina/farmacología , Neoplasias Hepáticas/inducido químicamente , Neoplasias Hepáticas/tratamiento farmacológico , Extractos Vegetales/uso terapéutico , Animales , Apoptosis/efectos de los fármacos , Antígeno Carcinoembrionario/sangre , Caspasa 3/metabolismo , Proliferación Celular/efectos de los fármacos , Citocromos c/metabolismo , Hígado/efectos de los fármacos , Hígado/patología , Masculino , Estrés Oxidativo/efectos de los fármacos , Peumus/química , Proteínas Proto-Oncogénicas c-bcl-2/metabolismo , ARN Mensajero/efectos de los fármacos , Ratas , Ratas Wistar , Aumento de Peso , alfa-Fetoproteínas/análisis , Proteína X Asociada a bcl-2/metabolismo
18.
Anticancer Res ; 39(10): 5721-5724, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31570473

RESUMEN

BACKGROUND/AIM: This study aimed to identify risk factors for recurrence of patients with stage III colorectal cancer by assessing clinicopathological features. PATIENTS AND METHODS: The study included 231 patients with stage III colorectal cancer who underwent curative resection between 2006 and 2012 at the Department of Surgery of the Jikei University Hospital, Tokyo, Japan. Clinicopathological data of the patients were retrospectively evaluated. RESULTS: The recurrence rate was 27.7% (64/231) in the study group. The univariate analysis for recurrence identified five risk factors: site of primary tumor (rectal cancer), surgical procedure (open surgery), preoperative serum CEA level (>5 ng/ml), preoperative serum CA19-9 level (>37 U/ml), and number of metastatic lymph nodes (over three metastases). The multivariate analysis for recurrence identified three risk factors: rectal cancer, preoperative serum CEA level >5.0 ng/ml 95%, and more than three metastatic lymph nodes. CONCLUSION: The risk factors for stage III colorectal cancer recurrence seem to be rectal cancer, preoperative serum CEA level >5.0 ng/ml, and more than three metastatic lymph nodes.


Asunto(s)
Neoplasias Colorrectales/patología , Recurrencia Local de Neoplasia/patología , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores de Tumor/metabolismo , Antígeno CA-19-9/metabolismo , Antígeno Carcinoembrionario/metabolismo , Neoplasias Colorrectales/metabolismo , Femenino , Humanos , Japón , Ganglios Linfáticos/metabolismo , Ganglios Linfáticos/patología , Metástasis Linfática/patología , Masculino , Recurrencia Local de Neoplasia/metabolismo , Estadificación de Neoplasias/métodos , Pronóstico , Estudios Retrospectivos , Factores de Riesgo
19.
Medicine (Baltimore) ; 98(40): e17310, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31577724

RESUMEN

BACKGROUND: Increasing evidence has revealed that plasma fibrinogen may serve as a prognostic indicator in multiple malignancies. However, there have been some conflicting findings on the prognostic value of plasma fibrinogen in gastric cancer (GC). We conducted a meta-analysis to explore the correlation between plasma fibrinogen and clinic outcome in GC. METHODS: A comprehensive literature search was conducted using the Embase, the Web of Science, the Cochrane library, and PubMed databases. Combined hazard ratios (HRs) and odds ratios (ORs) with 95% confidence intervals (CIs) were used to investigate the impact of elevated plasma fibrinogen on the prognosis and clinicopathological features of patients with GC. RESULTS: A total of 11 studies involving 8315 patients were selected for this meta-analysis. The pooled results suggested that elevated plasma fibrinogen in GC patients was related to worse overall survival (OS) (HR = 1.57, 95% CI: 1.36-1.81, P < .001) and recurrence-free survival (RFS) (HR = 2.54; 95% CI: 1.19-5.41, P = .016). Additionally, a high level of fibrinogen was closely correlated with advanced tumor stage (OR = 2.14, 95% CI: 1.83-2.50, P < .001), lymph node metastasis (OR = 1.81, 95% CI: 1.56-2.11, P < .001), distant metastasis (OR = 1.48, 95% CI: 1.12-1.94, P = .005), deeper tumor invasion (OR = 2.25, 95% CI: 1.47-3.45, P < .001) and high carcinoembryonic antigen (OR = 1.41, 95% CI: 1.18-1.68, P < .001). However, there was no significant association between plasma fibrinogen and the differentiation grade (OR = 1.00, 95% CI: 0.86-1.17, P = .967). The Egger regression test indicated evidence of publication bias for OS. CONCLUSION: Elevated plasma fibrinogen could be a potential predictor for worse OS and RFS in GC patients and a significant risk factor associated with aggressive clinical features.


Asunto(s)
Fibrinógeno/análisis , Neoplasias Gástricas/mortalidad , Neoplasias Gástricas/patología , Adulto , Anciano , Anciano de 80 o más Años , Biomarcadores de Tumor , Antígeno Carcinoembrionario/sangre , Femenino , Humanos , Metástasis Linfática , Masculino , Persona de Mediana Edad , Clasificación del Tumor , Invasividad Neoplásica , Recurrencia Local de Neoplasia , Pronóstico , Modelos de Riesgos Proporcionales
20.
Zhonghua Wei Chang Wai Ke Za Zhi ; 22(10): 966-971, 2019 Oct 25.
Artículo en Chino | MEDLINE | ID: mdl-31630495

RESUMEN

Objective: To analyze the clinicopathological features of type 2 diabetes mellitus complicated with colorectal cancer (DCRC). Methods: A case-control study was conducted. Inclusion criteria: (1) hospitalized patients receiving fibrocolonoscopy; (2) adenocarcinoma and mucinous adenocarcinoma diagnosed by pathology; (3) with preoperative cTNM clinical staging; (4) colorectal cancer patients undergoing surgical treatment; (5) with postoperative pTNM staging; (6) no smoking or drinking habits. Exclusion criteria: (1) familial adenomatous polyposis (FAP); (2) Lynch syndrome; (3) carcinoma of anal canal and perianal carcinoma; (4) multiple primary cancer; (5) with serious cardiocerebrovascular diseases or multiple organ failure. Clinicopathlogical data of 32 DCRC patients who were diagnosed and treated in Peking University Shougang Hospital from December 2017 to December 2018 were retrospectively collected and analyzed. Forty nondiabetic colorectal cancer (CRC) patients during the same period were selected as control group according to the sex ratio and the age difference less than 5 years. Student's t test and χ(2) test were used to compare the difference between the two groups in baseline clinicopathological data, clinical test results, tumor markers and infiltration status of T cells in tumor immune microenvironment. Results: Among 32 DCRC patients, 24 were males and 8 were females with a mean age of (63.0±1.7) years; among 40 CRC patients, 30 were males and 10 were females with a mean age of (60.5±1.6) years. The duration of diabetes mellitus in DCRC patients (from the diagnosis of diabetes mellitus to the diagnosis of colorectal cancer) was (9.2±1.3) years. The body mass index (BMI) of DCRC group was significantly higher than that of CRC group [(24.8±0.6) kg/m(2) vs. (23.2±0.4) kg/m(2), t=2.372, P=0.020]. There were no significant differences in other baseline data (sex, age, primary site of tumor, R0 resection rate, pathological stage, pathological type, differentiation degree of tumor, preoperative intestinal obstruction) between the two groups (all P>0.05). Serum triglyceride level in DCRC group was higher than that in CRC group [(2.1±0.2) mmol/L vs. (1.5±0.1) mmol/L, t=3.085, P=0.003], while hemoglobin [(120.3±5.2) g/L vs. (132.7±2.8) g/L, t=-2.224, P=0.029], anti- thrombin III [(94.2±3.7)% vs. (103.5±2.4)%, t=-2.197, P=0.031], and red blood cell count [(4.2±0.1)×10(12)/L vs. (4.5±0.1)×10(12)L, t=-2.055, P=0.044] were all lower than those in CRC group. The preoperative carcinoembryonic antigen (CEA) level in DCRC group was higher than that in CRC group [(50.3±21.8) µg/L vs. (5.6±1.0) µg/L, t=2.339, P=0.022]. There were no significant differences in preoperative levels of other four tumor molecular markers (CA199, CA242, CA724 and CA125) between the two groups (all P>0.05). The expression of Foxp3 [specific markers of CD4+, CD25+ regulatory T cells (Treg)] in DCRC group was higher than that in CRC group [(82.7±6.2) cell/HPF vs. (62.6±4.9) cell/HPF, t=2.586, P=0.012]. There were no significant differences in the infiltration of CD4, CD8, PD-1 and PD-L1 positive cells between two groups (all P>0.05). Conclusions: The average diabetic history of DCRC patients is nearly 10 years. They have higher BMI and serum CEA level, and more Treg cell infiltration in the tumor. Close attention should be paid to these patients in clinical practice.


Asunto(s)
Neoplasias Colorrectales/cirugía , Diabetes Mellitus Tipo 2/diagnóstico , Adenocarcinoma/sangre , Adenocarcinoma/complicaciones , Adenocarcinoma/diagnóstico , Adenocarcinoma/cirugía , Anciano , Índice de Masa Corporal , Antígeno Carcinoembrionario/sangre , Estudios de Casos y Controles , Neoplasias Colorrectales/sangre , Neoplasias Colorrectales/complicaciones , Neoplasias Colorrectales/diagnóstico , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/inmunología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Linfocitos T Reguladores/inmunología , Microambiente Tumoral/fisiología
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