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1.
Medicine (Baltimore) ; 100(3): e24378, 2021 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-33546078

RESUMO

RATIONALE: Primary periampullary duodenal cancer accounts for 3% to 17% of periampullary cancers. There are no previous reports of metachronous primary colon and periampullary duodenal cancer. PATIENT CONCERNS: We present a case of primary periampullary duodenal cancer that occurred metachronously after colon cancer. DIAGNOSES: Imaging and endoscopic examinations, serum tumor marker levels, and pathology confirmed metachronous colon and periampullary duodenal cancer, with 14-month interval between the diagnoses of the 2 malignancies. INTERVENTION: The patient received right hemicolectomy combined with mFOLFOX6 chemotherapy for colon cancer and pancreatoduodenectomy for periampullary duodenal cancer. OUTCOMES: The patient has been followed up for 6 years since the pancreatoduodenectomy and shows no signs of recurrence or metastasis. LESSONS: The risk of developing a second malignancy may be associated with the site of the first tumor. Patients with right colon cancer may have particularly high risk of developing small intestinal cancer, including duodenal cancer. Early detection and active surgical treatments can improve prognosis. Long-term regular follow-up is necessary to detect new malignancies occurring after the diagnosis colon cancer.


Assuntos
Neoplasias Duodenais/patologia , Segunda Neoplasia Primária/patologia , Dor Abdominal/etiologia , Idoso , Antígenos Glicosídicos Associados a Tumores/análise , Antígenos Glicosídicos Associados a Tumores/sangue , Antígeno Carcinoembrionário/análise , Antígeno Carcinoembrionário/sangue , Neoplasias Duodenais/diagnóstico , Humanos , Masculino , Segunda Neoplasia Primária/diagnóstico , Prognóstico , Ultrassonografia/métodos
2.
Anal Chem ; 93(3): 1489-1497, 2021 01 26.
Artigo em Inglês | MEDLINE | ID: mdl-33326204

RESUMO

Enzyme-linked immunosorbent assay (ELISA) is the gold standard method for protein biomarkers. However, scaling up ELISA for multiplexed biomarker analysis is not a trivial task due to the lengthy procedures for fluid manipulation and high reagent/sample consumption. Herein, we present a highly scalable multiplexed ELISA that achieves a similar level of performance to commercial single-target ELISA kits as well as shorter assay time, less consumption, and simpler procedures. This ELISA is enabled by a novel microscale fluid manipulation method, composable microfluidic plates (cPlate), which are comprised of miniaturized 96-well plates and their corresponding channel plates. By assembling and disassembling the plates, all of the fluid manipulations for 96 independent ELISA reactions can be achieved simultaneously without any external fluid manipulation equipment. Simultaneous quantification of four protein biomarkers in serum samples is demonstrated with the cPlate system, achieving high sensitivity and specificity (∼ pg/mL), short assay time (∼1 h), low consumption (∼5 µL/well), high scalability, and ease of use. This platform is further applied to probe the levels of three protein biomarkers related to vascular dysfunction under pulmonary nanoparticle exposure in rat's plasma. Because of the low cost, portability, and instrument-free nature of the cPlate system, it will have great potential for multiplexed point-of-care testing in resource-limited regions.


Assuntos
Proteína C-Reativa/análise , Antígeno Carcinoembrionário/análise , Ensaio de Imunoadsorção Enzimática , Interleucina-6/análise , Técnicas Analíticas Microfluídicas , Antígeno Prostático Específico/análise , Biomarcadores/análise , Humanos
3.
Anal Chem ; 93(3): 1764-1770, 2021 01 26.
Artigo em Inglês | MEDLINE | ID: mdl-33372772

RESUMO

Organic dyes are typically applied as photosensitizers in photoelectrochemical (PEC) cells but have not been reported in polarity-reversal-mode PEC sensors with excellent sensitivity and accuracy. Herein, an elegant and robust PEC biosensor for carcinoembryonic antigen (CEA) has been designed by photocurrent polarity switching of CdTe quantum dots (QDs), which is obtained by embedding methylene blue (MB) into amplified double-stranded DNA (dsDNA) anchored to the superparamagnetic Fe3O4@SiO2. The target-triggered Exo III-assisted cyclic amplification strategy and in situ magnetic enrichment enable the remarkable sensitivity. The extraction of target-analogue single-stranded DNA (output DNA) contributes to high selectivity resulting from the elimination of possible interferences in real samples or matrixes. Particularly, this exclusive polarity-reversal-mode PEC aptasensing can efficiently eliminate the false-positive or false-negative signals, leading to accurate measurements. Moreover, different from the probes and layer-by-layer assembled photoelectric beacons on electrodes in advance, this rational split-type approach is doomed to help the PEC biosensor with additional merits of convenient fabrication, short time consumption, wider linearity, as well as outstanding reproducibility and stability in practical applications. In light of the ability of MB acting as a kind of signal probe in typical electrochemical sensors, certainly, this ingenious design can not only be extended to a wide variety of target monitoring but also provide new ideas for the construction of high-performance electrochemical and PEC biosensors.


Assuntos
Técnicas Biossensoriais , Antígeno Carcinoembrionário/análise , DNA/química , Técnicas Eletroquímicas , Azul de Metileno/química , Compostos de Cádmio/química , Compostos Férricos/química , Humanos , Fenômenos Magnéticos , Tamanho da Partícula , Processos Fotoquímicos , Pontos Quânticos/química , Dióxido de Silício/química , Propriedades de Superfície , Telúrio/química
4.
Am J Med Sci ; 360(3): 236-242, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32423747

RESUMO

BACKGROUND: The etiology of pleural effusions often remained unknown notwithstanding surgical pleural biopsy and further clinical observation. A better understanding of clinical characteristics of patients with idiopathic pleural effusion (IPE) may improve the ability to differentiate between IPEs and cytology-negative malignant pleural effusions (MPEs) and facilitate the identification of patients requiring invasive investigation. However, little is known about the clinical factors that can help distinguish patients with IPE from those with cytology-negative MPE. MATERIALS AND METHODS: Patients who were diagnosed with IPE or cytology-negative MPE between 2010 and 2017 were enrolled in this retrospective study. Clinical, laboratory and radiologic characteristics were compared between patients with IPE and cytology-negative MPE. Diagnostic performances of predictors for IPE were assessed using receiver operating characteristic curves. RESULTS: Of 146 patients undergoing pleural biopsy owing to cytology-negative pleural effusion of uncertain cause, MPE was confirmed in 54 patients. IPE was ultimately diagnosed in 22 patients. Multivariate analysis demonstrated that a minimal amount of pleural effusion (odds ratio [OR] = 12.41, P = 0.039), presence of pleural nodularity (OR = 0.01, P < 0.001) and pleural fluid carcinoembryonic antigen levels less than 14 ng/mL (OR = 87.59, P = 0.002) were independent factors for distinguishing IPEs from cytology-negative MPEs. A combination of the absence of pleural nodularity with pleural fluid carcinoembryonic antigen levels less than 14 ng/mL yielded an area under the curve of 0.94 (sensitivity = 91% and specificity = 96%). CONCLUSIONS: Using these readily available parameters to identify IPE in patients with cytology-negative exudative effusion of unknown cause can help guide decision-making when choosing to perform an invasive pleural biopsy or to take a conservative approach.


Assuntos
Derrame Pleural Maligno/diagnóstico , Derrame Pleural/diagnóstico , Idoso , Biópsia , Antígeno Carcinoembrionário/análise , Diagnóstico Diferencial , Exsudatos e Transudatos/química , Exsudatos e Transudatos/citologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Derrame Pleural/patologia , Derrame Pleural Maligno/patologia , Curva ROC , Radiografia Torácica , Estudos Retrospectivos , Toracentese , Toracoscopia , Tomografia Computadorizada por Raios X
5.
Environ Toxicol ; 35(9): 971-981, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32302048

RESUMO

Hepatocellular carcinoma (HCC) ranks the sixth position among various cancers worldwide. Recent research shows that natural and dietary compounds possess many therapeutic effects. Citral is a monoterpene aldehyde that contains geranial and neral. The present study was considered to study the role of citral against N-nitrosodiethylamine (NDEA)-induced HCC via modulation of antioxidants and xenobiotic-metabolizing enzymes in vivo. NDEA-alone-administered group II animals profoundly showed increased tumor incidence, reactive oxygen species, liver marker enzyme levels, serum bilirubin levels, tumor markers of carcinoembryonic antigen, α-fetoprotein, proliferative markers of argyrophilic nucleolar organizing regions, proliferating cell nuclear antigen (PCNA) expressions, phase I xenobiotic-metabolic enzymes and simultaneously decreased antioxidants, and phase II enzymes levels. Citral (100 mg/kg b.w.) treatment significantly reverted the levels in group III cancer-bearing animals when compared to group II cancer-bearing animals. In group IV animals, citral-alone administration did not produce any adverse effect during the experimental condition. Based on the results, citral significantly inhibits the hepatocellular carcinogenesis through restoring the antioxidants and phase II xenobiotic-enzyme levels; thereby, it strongly proves as an antiproliferative agent against rat HCC.


Assuntos
Monoterpenos Acíclicos/uso terapêutico , Antineoplásicos Fitogênicos/uso terapêutico , Antioxidantes/metabolismo , Carcinoma Hepatocelular/tratamento farmacológico , Neoplasias Hepáticas Experimentais/tratamento farmacológico , Animais , Antígeno Carcinoembrionário/análise , Carcinoma Hepatocelular/enzimologia , Carcinoma Hepatocelular/patologia , Linhagem Celular Tumoral , Dietilnitrosamina , Humanos , Testes de Função Hepática , Neoplasias Hepáticas Experimentais/enzimologia , Neoplasias Hepáticas Experimentais/patologia , Masculino , Antígeno Nuclear de Célula em Proliferação/metabolismo , Ratos , Ratos Wistar , alfa-Fetoproteínas/análise
6.
Talanta ; 214: 120716, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-32278406

RESUMO

Carcinoembryonic antigen (CEA), as one of the common tumor markers, is a human glycoprotein involved in cell adhesion and is expressed during human fetal development. Since the birth of human, CEA expression is largely inhibited, with only low levels in the plasma of healthy adults. Generally, CEA will overexpressed in many cancers, including gastric, breast, ovarian, lung, and pancreatic cancers, especially colorectal cancer. As one of the important tumor markers, the detection of CEA has great significance in differential diagnosis, condition monitoring and therapeutic evaluation of diseases. Conventional CEA testing typically uses immunoassay methods. However, immunoassay methods require complex and expensive instruments and professional personnel to operate. Moreover, radioactive element may cause certain damage to the human body, which limits their wide application. In the past few years, biosensors, especially aptamer-based biosensors, have attracted extensive attention due to their high sensitivity, good selectivity, high accuracy, fast response and low cost. This review briefly classifies and describes the advance in optical and electrochemical aptamer biosensors for CEA detection, also explains and compares their advantages and disadvantages.


Assuntos
Aptâmeros de Nucleotídeos/química , Técnicas Biossensoriais , Antígeno Carcinoembrionário/análise , Técnicas Eletroquímicas , Humanos , Tamanho da Partícula , Propriedades de Superfície
7.
Zhonghua Wai Ke Za Zhi ; 58(3): 225-229, 2020 Mar 01.
Artigo em Chinês | MEDLINE | ID: mdl-32187927

RESUMO

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.


Assuntos
Neoplasias Císticas, Mucinosas e Serosas/diagnóstico , Neoplasias Pancreáticas/diagnóstico , Adulto , Idoso , Antígeno Ca-125/análise , Antígeno CA-19-9/análise , Antígeno Carcinoembrionário/análise , Feminino , Humanos , Masculino , Proteínas de Membrana/análise , Pessoa de Meia-Idade , Pâncreas/patologia , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
8.
Clin Chem ; 66(2): 342-351, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-32040577

RESUMO

BACKGROUND: Dysregulation of N6-methyladenosine (m6A) is associated with various human diseases including cancer. This study aimed to evaluate the level of m6A as a biomarker for gastric cancer (GC) diagnosis. METHODS: Peripheral blood samples were collected from 100 GC patients, 30 benign gastric disease (BGD) patients, and 75 healthy controls (HCs). Levels of m6A in total RNA and expression of m6A-related proteins were analyzed. RESULTS: The m6A levels in peripheral blood RNA were significantly increased in the GC group compared with those in the BGD or HC groups; moreover, levels increased with the progression and metastasis of GC and decreased in GC patients after surgery. The area under the curve (AUC) for m6A in the GC group was 0.929 (95% CI, 0.88-0.96), which is markedly greater than the AUCs for carcinoembryonic antigen (CEA; 0.694) and carbohydrate antigen 199 (CA199; 0.603). The combination of CEA and CA199 with m6A improved the AUC to 0.955 (95% CI, 0.91-0.98). The expressions of m6A demethylases ALKBH5 and FTO were significantly downregulated in the GC group compared with the HC group. Coculture with GC cells increased the m6A of RNA in promyelocytic (HL-60) and monocytic (THP-1) leukemia cells and nontumorigenic human peripheral blood B lymphocyte cells (PENG-EBV). Furthermore, a xenograft model enhanced the m6A in peripheral blood RNA of mice. Accordingly, expressions of ALKBH5 and FTO were decreased both in vitro and in vivo. CONCLUSIONS: Level of m6A in peripheral blood RNA is a promising noninvasive diagnostic biomarker for GC patients.


Assuntos
Adenosina/análogos & derivados , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/genética , Adenosina/sangue , Adenosina/genética , Adulto , Idoso , Homólogo AlkB 5 da RNA Desmetilase/análise , Homólogo AlkB 5 da RNA Desmetilase/metabolismo , Dioxigenase FTO Dependente de alfa-Cetoglutarato/análise , Dioxigenase FTO Dependente de alfa-Cetoglutarato/metabolismo , Animais , Antígenos Glicosídicos Associados a Tumores/análise , Área Sob a Curva , Biomarcadores Tumorais/sangue , Biomarcadores Tumorais/genética , Antígeno Carcinoembrionário/análise , Progressão da Doença , Feminino , Humanos , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Nus , Pessoa de Meia-Idade , RNA Mensageiro/sangue , RNA Mensageiro/genética , Ensaios Antitumorais Modelo de Xenoenxerto
9.
Pathol Res Pract ; 216(3): 152834, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32001055

RESUMO

PURPOSE: The clinical importance of tissue CEA levels for predicting tumor response to preoperative chemoradiotherapy (CRT) for rectal cancer has not been studied. METHODS: Serum CEA levels and tissue CEA expressions for 117 patients who underwent preoperative CRT for rectal cancer, were prospectively collected and analyzed at a tertiary university hospital RESULTS: The median follow-up time was 49 months (range, 3-61 months), and the 5-year disease-free survival (DFS) rate was 68.3 %. In multivariate analysis, serum CEA (log-transformed value) [odds ratio (OR) = 0.741, 95 % confidence interval (CI) 1.588-40.422, P =  0.021], tissue CEA/GAPDH ratio (OR = 3.673, 95 % CI 1.316-12.081, P =  0.019), and tumor circumferentiality (OR = 2.960, 955 CI, 1.101-8.999, P =  0.040) were the independent predictors for good tumor response to CRT. Serum CEA level was significant prognostic factor for DFS (P =  0.004) in multivariate analysis. However, tissue CEA was not associated with DFS. CONCLUSIONS: Both serum and tissue CEA were significant factors for predicting good tumor response following preoperative CRT. However, tissue CEA was not associated with the oncologic outcome. The possibility of radiologic resistance of high CEA tumors is expected to be investigated through further studies.


Assuntos
Biomarcadores Tumorais/análise , Antígeno Carcinoembrionário/análise , Radioterapia/métodos , Neoplasias Retais/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Quimiorradioterapia Adjuvante/métodos , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Terapia Neoadjuvante/métodos , Valor Preditivo dos Testes , Neoplasias Retais/patologia , Resultado do Tratamento
10.
Ann Biol Clin (Paris) ; 78(1): 93-107, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-32108587

RESUMO

The measurement performance of 13 biochemistry parameters (CEA, CA 19-9, amylase, lipase, sodium, potassium, chloride, creatinine, glucose, protein, albumin, LDH, triglycerides) was tested in a panel of biological fluids other than blood and urine (peritoneal, pleural, pancreatic fluids ...). Our protocol, based on a risk analysis, allowed us to justify our choices and compare the performance obtained with those of the serum or plasma matrix already validated. Thus, the coefficients of variation obtained in body fluids are comparable. The assessment of accuracy (spiking and dilution tests) shows the absence of bias, which is consistent with the absence of matrix effect. The linearity studied by dilution tests shows that the upper limits of the measurement interval communicated by the supplier are applicable to body fluids. The absence of contamination and stability have been also confirmed. All analytes are stable for 3 days at room temperature, 7 days between 2 and 8̊C, and 6 months at -20̊C; except LDH and lipase. For most analytes, at least one interference (hemolysis, icterus, lipemia) was found. Finally, a bibliographical study, confronted with the experience of prescribers, led us to define optimal thresholds to help interpret patients' results. In conclusion, this work has allowed us to validate analytical methods for body fluids testing after relying on their comparability to the blood matrix. We have also been able to adapt our practices and finally be accredited according to the standard NF IN ISO 15189.


Assuntos
Biomarcadores/análise , Líquidos Corporais/química , Técnicas de Laboratório Clínico , Albuminas/análise , Albuminas/metabolismo , Amilases/análise , Amilases/metabolismo , Biomarcadores/metabolismo , Líquidos Corporais/metabolismo , Antígeno CA-19-9/análise , Antígeno CA-19-9/metabolismo , Antígeno Carcinoembrionário/análise , Antígeno Carcinoembrionário/metabolismo , Cloretos/análise , Cloretos/metabolismo , Técnicas de Laboratório Clínico/métodos , Técnicas de Laboratório Clínico/normas , Creatinina/análise , Creatinina/metabolismo , Glucose/análise , Glucose/metabolismo , Humanos , L-Lactato Desidrogenase/análise , L-Lactato Desidrogenase/metabolismo , Lipase/análise , Lipase/metabolismo , Potássio/análise , Potássio/metabolismo , Proteínas/análise , Proteínas/metabolismo , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Sódio/análise , Sódio/metabolismo , Temperatura , Triglicerídeos/análise , Triglicerídeos/metabolismo
11.
Bioelectrochemistry ; 132: 107452, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31927189

RESUMO

A novel electrochemical immunosensor was developed for label-free detection of carcinoembryonic antigen (CEA) as a cancer biomarker. The designed immunosensor was based on CEA antibody (anti-CEA) anchored with core shell Fe3O4@Au nanoparticles which were immobilized on a screen-printed carbon electrode modified with manganese dioxide decorating on graphene nanoplatelets (SPCE/GNP-MnO2/Fe3O4@Au-antiCEA). The SPCE was placed onto a home-made electrode holder for easy handling. The approach was based on direct binding of CEA to a fixed amount of anti-CEA on the modified electrode for the specific detection using linear sweep voltammetry (LSV) and electrochemical impedance spectroscopy (EIS) monitored in a solution containing 5 mM [Fe(CN)63-/4-] prepared in 0.1 M phosphate buffer at pH 7.4. The difference in signal response owing to the redox reaction of [Fe(CN)6]3-/4- before and after interaction with CEA was regarded as the immunosensor response corresponding directly to the CEA concentration. Under optimized conditions, the linear range of 0.001-100 ng/mL, and the detection limits of 0.10 pg/mL (LSV) and 0.30 pg/mL (EIS) were evaluated. The applicability of the immunosensor was verified by well-corresponding determination of CEA in diluted human serum samples by electrochemiluminescence (ECL) immunoassay. Therefore, the proposed immunosensor could be suitable enough for a real sample analysis of CEA.


Assuntos
Técnicas Biossensoriais , Antígeno Carcinoembrionário/análise , Grafite/química , Nanopartículas de Magnetita/química , Compostos de Manganês/química , Óxidos/química , Carbono/química , Eletrodos , Humanos , Limite de Detecção
12.
J Clin Pathol ; 73(2): 102-106, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31462450

RESUMO

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.


Assuntos
Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico , Mucinas/análise , Cisto Pancreático/química , Cisto Pancreático/patologia , Inclusão em Parafina , Biomarcadores/análise , Antígeno Carcinoembrionário/análise , Humanos , Cisto Pancreático/cirurgia , Valor Preditivo dos Testes , Estudos Prospectivos , Reprodutibilidade dos Testes , Estudos Retrospectivos , Fixação de Tecidos
13.
Ann Surg ; 271(2): 212-218, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31188200

RESUMO

OBJECTIVE: To determine overall survival and disease-free survival in selected patients with nonresectable liver-only colorectal cancer receiving liver transplantation. BACKGROUND: Patients with nonresectable colorectal cancer receiving palliative chemotherapy has a 5-year overall survival of about 10%. Liver transplantation provided an overall survival of 60% in a previous study (SECA-I). Risk factors for death were carcinoembryonic antigen (CEA) >80 µg/L, progressive disease on chemotherapy, size of largest lesion>5.5 cm, and less than 2 years from resection of the primary tumor to transplantation. METHODS: In this prospective (SECA-II) study, we included colorectal cancer patients with nonresectable liver-only metastases determined by computed tomography (CT)/magnetic resonance imaging/positron emission tomography scans and at least 10% response to chemotherapy. Time from diagnosis to liver transplant was required to be more than 1 year. RESULTS: At a median follow-up of 36 months, Kaplan-Meier overall survival at 1, 3, and 5 years were 100%, 83%, and 83%, respectively. Disease-free survival at 1, 2, and 3 years were 53%, 44%, and 35%, respectively. Overall survival from time of relapse at 1, 2, and 4 years were 100%, 73%, and 73%, respectively. Recurrence was mainly slow growing pulmonary metastases amenable to curative resection. Fong Clinical Risk Score of 1 to 2 at the time of diagnosis resulted in longer disease-free survival than score 3 to 4 (P = 0.044). Patients included in the present study had significantly better prognostic factors than the previous SECA-I study. CONCLUSION: Liver transplantation provides the longest overall survival reported in colorectal cancer patient with nonresectable liver metastases. Improved selection criteria give patients with nonresectable colorectal liver metastases a 5-year overall survival comparable to other indications for liver transplantation.


Assuntos
Neoplasias Colorretais/patologia , Neoplasias Hepáticas/mortalidade , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/cirurgia , Transplante de Fígado/mortalidade , Adulto , Idoso , Antineoplásicos/uso terapêutico , Biomarcadores Tumorais/análise , Antígeno Carcinoembrionário/análise , Progressão da Doença , Intervalo Livre de Doença , Feminino , Humanos , Neoplasias Hepáticas/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Análise de Sobrevida
14.
Gastroenterol Hepatol ; 43(1): 1-8, 2020 Jan.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31753518

RESUMO

INTRODUCTION: Despite advances in imaging techniques, in many cases they are insufficient to establish the diagnosis of pancreatic cystic lesions (PCL). There are few publications in our setting that evaluate the combination of several methods obtained by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA). The aim of the study was to evaluate the overall utility of EUS-FNA in the diagnosis of PCL. MATERIAL AND METHODS: Retrospective study based on a database updated prospectively of a cohort of patients referred for EUS-FNA due to PCL detected in an imaging test. The sensitivity, specificity and diagnostic yield of carcinoembryonic antigen (CEA), cytology and viscosity were studied to detect mucinous lesions. RESULTS: From November 2013 to April 2018, 122 EUS were performed for PCL. EUS-FNA was performed in 94/122 (77%) and 21/122 (17.2%) patients were operated on. We included 33/122 patients who had diagnostic confirmation by histology, imaging (serous cyst with typical pattern) or clinical evolution. The study of the ROC curve determined the cutoff point ≥419 ng/ml to differentiate mucinous/non-mucinous cystic lesions. The diagnostic yield of CEA was 87.5% (21/24), cytology 81.8% (27/33) and viscosity 84.4% (27/32). The three parameters in combination obtained the best result (30/33, 90.9%). CONCLUSION: The combination of CEA analysis, cytology and viscosity of pancreatic fluid obtained by EUS-FNA increases the performance in the diagnosis of mucinous pancreatic cystic lesions, with it being greater than 90%.


Assuntos
Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico , Cisto Pancreático/patologia , Adulto , Idoso , Biomarcadores/análise , Antígeno Carcinoembrionário/análise , Carcinoma Ductal Pancreático/sangue , Carcinoma Ductal Pancreático/diagnóstico por imagem , Carcinoma Ductal Pancreático/patologia , Estudos de Coortes , Aspiração por Agulha Fina Guiada por Ultrassom Endoscópico/estatística & dados numéricos , Feminino , Proteínas Ligadas por GPI/análise , Humanos , Masculino , Pessoa de Meia-Idade , Mucinas/química , Cisto Pancreático/sangue , Cisto Pancreático/diagnóstico por imagem , Cisto Pancreático/cirurgia , Neoplasias Pancreáticas/sangue , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/patologia , Curva ROC , Estudos Retrospectivos , Sensibilidade e Especificidade , Viscosidade
15.
Biosens Bioelectron ; 150: 111880, 2020 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-31748194

RESUMO

Novel optical labels for biosensing in near-infrared (NIR) region (especially between 800 and 900 nm) are arousing much attention for higher penetrating capability, less scattering and lowered autofluorescent background. Herein, a water-soluble electrochemiluminophore with effective electrochemiluminescence (ECL) around 815 nm is developed via doping dual-stabilizers-capped CdTe nanocrystals (NCs) with Co2+ species in a growth-doping way. The Co2+-doped CdTe NCs not only can preserve the highly-passivated surface states of dual-stabilizers-capped CdTe NCs, but also exhibit efficient red-shifted photoluminescence (PL) and ECL into the promising optical NIR window of 800-900 nm. A spectrum-based ultrasensitive NIR ECL immunosensor is consequently fabricated with the Co2+-doped CdTe NCs as tags for the first time, which can selectively and sensitively determine human carcinoembryonic antigen with a wide linearity range from 1 fg/mL to 10 pg/mL and a low limit of detection at 0.2 fg/mL (S/N = 3). This work opens a way to screen novel NIR electrochemiluminophore as well as to modulate the ECL performance of NCs via surface doping and engineering.


Assuntos
Compostos de Cádmio/química , Antígeno Carcinoembrionário/análise , Cobalto/química , Nanopartículas/química , Telúrio/química , Técnicas Biossensoriais/métodos , Técnicas Eletroquímicas/métodos , Humanos , Raios Infravermelhos , Limite de Detecção , Medições Luminescentes/métodos
16.
Anal Chim Acta ; 1096: 61-68, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-31883592

RESUMO

Sensitive and reliable detection of biomarkers is of vital importance in tumor early detection and clinical therapy. A novel fluorescent/electrochemical dual-responsive immunosensing platform for reliable and sensitive quantification of biomarkers was designed based on cation-exchange reaction. To construct such a versatile platform, the model analyte, carcinoembryonic antigen (CEA), was captured by magnetic Fe3O4 nanoparticles bound with primary antibodies (Fe3O4-Ab1) and then recognized by the detection antibodies conjugated complex containing poly(amidoamine) (PAMAM), carbon nanotube (CNT) and carboxyl functionalized CdSe nanocrystals (NCs) (CNT-PAMAM-CdSe NCs-Ab2). Via ligand exchange, the stable CdSe nanocrystals were easily functionalized with carboxylate ion (CdSe-COO-) and showed high hydrophilicity. The CdSe-COO- was effectively and densely conjugated to CNT coated dendrimer PAMAM that possesses large specific surface area. Finally, the target CEA was detected based on cation-exchange reaction (CER) by adding Ag+ to release thousands of cations Cd2+, which were detected by fluorescence and electrochemistry simultaneously. The electrochemical measurement was performed by directly detecting Cd2+ through square wave voltammetry (SWV), which displayed an excellent correlation with CEA from 5 pg/mL to 50 ng/mL, with a limit of detection (LOD) of 1.7 pg/mL. The fluorescence detection was implemented since free Cd2+ could trigger the weak fluorescence metal-sensitive dyes (Rhod-5N) to generate extremely high fluorescence signal. The fluorescence results showed the LOD for CEA detection was 0.25 pg/mL with a calibration curve range from 1 pg/mL to 20 ng/mL. The dual signal outputs showed an attractively self-correcting ability, which provides the capability of avoiding false positive signal and making the detection result more reliable. The proposed dual-responsive platform holds great promises for biomarkers detection in clinical diagnostics and therapy.


Assuntos
Anticorpos Imobilizados/química , Técnicas Biossensoriais/métodos , Compostos de Cádmio/química , Antígeno Carcinoembrionário/sangue , Nanopartículas/química , Compostos de Selênio/química , Antígeno Carcinoembrionário/análise , Cátions/química , Dendrímeros/química , Técnicas Eletroquímicas/métodos , Corantes Fluorescentes/química , Humanos , Imunoensaio/métodos , Limite de Detecção , Nanopartículas de Magnetita/química , Nanotubos de Carbono/química , Espectrometria de Fluorescência/métodos
17.
Luminescence ; 35(4): 503-511, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31868303

RESUMO

Washing is a standard step for enzyme-linked immunosorbent assays (ELISA) performed on a paper-based chip, in which nonspecific-binding antibodies and antigens should be removed completely from the paper surface. In this study, a novel three-dimensional (3D) washing strategy using a heating ring-oven was carried out on a paper-based chip. Compared with a plane washing mode by a ring-oven, this 3D washing strategy obtained a lower background, as gravity played an important role in the washing step. The paper-based chip was placed on a 3D plastic holder and the waste area was connected to a heating ring. Use of a heating waste area meant that the nonspecific-binding protein was continuously carried to the waste area through gravity and capillary action. The angle between the plastic holder and the ring plane was carefully selected. The effect of washing on different parts of the detection area was investigated by upconversion fluorescence and chemiluminescence (CL). This novel 3D washing strategy was performed for carcinoembryonic antigen detection through CL and a lower detection limit of 2 pg ml-1 was obtained. This approach provides an effective washing strategy to remove nonspecific-binding antibody from a paper-based immunodevice.


Assuntos
Antígeno Carcinoembrionário/análise , Ensaio de Imunoadsorção Enzimática , Dispositivos Lab-On-A-Chip , Papel , Calefação , Humanos , Medições Luminescentes
18.
Acta Clin Croat ; 59(2): 216-222, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33456107

RESUMO

In colorectal carcinoma, carcinoembryonic antigen (CEA) is a recommended marker for surveillance after curative resection. The aim of the present study was to determine the association of preoperative CEA with recurrence of colorectal carcinoma in our population. The study included 55 patients with all operable stages of colorectal adenocarcinoma treated during the 2012-2014 period, evaluated retrospectively and followed-up for recurrence for 2 years. Data on the baseline (preoperative) CEA levels were retrieved from patient files. On data analysis, SPSS 16.0 was used. In patients with normal preoperative CEA, the rate of recurrence was significantly low (p=0.008) and the likelihood of no recurrence 1.55-fold greater as compared to patients with raised initial CEA levels (p=0.028). In patients with raised preoperative CEA, the risk of recurrence was 5.26-fold greater as compared to those with normal CEA levels (p=0.028). A significant weak positive correlation (rs=0.297) was found between raised CEA and recurrence. A highly significant (p=0.002) moderate positive correlation was recorded in patients aged <50 and moderate positive correlation of borderline significance in males (rs=0.324, p=0.058). Sensitivity was 94.4% and specificity 32.4% in predicting recurrence. Accordingly, preoperative elevated CEA showed a significant weak positive correlation with recurrence while normal preoperative CEA moderately decreased the likelihood of recurrence.


Assuntos
Antígeno Carcinoembrionário , Neoplasias Colorretais , Recidiva Local de Neoplasia , Antígeno Carcinoembrionário/análise , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/patologia , Neoplasias Colorretais/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/diagnóstico , Recidiva Local de Neoplasia/patologia , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos
19.
Med Sci Monit ; 25: 9864-9874, 2019 Dec 22.
Artigo em Inglês | MEDLINE | ID: mdl-31865362

RESUMO

BACKGROUND Acute coronary syndrome (ACS) occurs approximately every 40 seconds, and was an underlying cause of death in 1 out of every 7 deaths. More accurate indicators are needed to distinguish patients with ACS from patients manifesting negative changes in electrocardiogram (ECG) and myocardial enzymes. This study aimed to investigate whether the expression of platelet carcinoembryonic antigen cell adhesion molecule-5 (CEACAM5/CEA/CD66e) could help predict ACS. MATERIAL AND METHODS We enrolled 82 participants (mean age 60 years, 33 females and 49 males). The expression of CEA on washed human platelets was assessed using two-color flow cytometry. The CEA levels on platelets and in serum of these 82 consecutive patients were detected using two-color whole-blood flow cytometry analysis and a custom-made Luminex multiplex assay, respectively. RESULTS CEA was expressed on the surface of human platelets. The expression of platelet CEA (P<0.01), but not serum CEA (P=0.30), was significantly higher in patients with ACS compared to patients with normal coronary artery. Increased platelet CEA levels could serve as a new independent indicator for ACS (P=0.0003). Platelet CEA testing (P=0.000002), as well as cardiac troponin I (cTnI) (P=0.0005), can diagnose ACS with high sensitivity and specificity, and, combined with cTnI (P<0.0001), can improve the diagnostic value. CONCLUSIONS Platelet CEA expression was higher in individuals presenting with ACS. Hence, platelet CEA might be a novel and reliable biomarker for ACS. Large-scale studies are needed to confirm this hypothesis.


Assuntos
Síndrome Coronariana Aguda/diagnóstico , Antígeno Carcinoembrionário/metabolismo , Síndrome Coronariana Aguda/sangue , Idoso , Biomarcadores/sangue , Plaquetas/química , Antígeno Carcinoembrionário/análise , Eletrocardiografia , Feminino , Citometria de Fluxo/métodos , Proteínas Ligadas por GPI/análise , Proteínas Ligadas por GPI/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Soro/química , Troponina I/metabolismo
20.
ACS Appl Mater Interfaces ; 11(46): 43031-43038, 2019 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-31675205

RESUMO

Coordination polymers (CPs) as fascinating materials have been explored in a number of fields due to their diverse properties. In this work, we demonstrate the feasibility of CPs in the facile fabrication of multifunctional composites for establishing an immunoassay. To this end, a zinc(II)-based CP (ZnCP) with adenine as a bridge ligand was employed to integrate with alkaline phosphatase (ALP) and anticarcinoembryonic antigen (anti-CEA) antibody, which produces ALP/anti-CEA@ZnCPs. Benefiting from the adaptive inclusion property of ZnCPs, the integrated ALP and anti-CEA can maintain their original catalytic activity and capture ability to target antigen, respectively. This allows the ALP/anti-CEA@ZnCPs to be a detection antibody for performing an immunoassay. Meanwhile, ZnCP as a host can effectively protect the loaded ALP and anti-CEA against harsh environments. On this basis, by using iron(II)-phenanthroline complex as a signal amplifier, a colorimetric immunoassay for CEA detection was developed, and a low detection limit of 21.1 pg/mL has been achieved. This immunoassay was successfully applied to determine CEA levels in serum samples with good recovery and precision. We believe that this study can not only provide a new method for CEA detection but also open up a new way for the rational design and fabrication of multifunctional composites.


Assuntos
Fosfatase Alcalina/química , Anticorpos/química , Antígeno Carcinoembrionário/análise , Complexos de Coordenação/química , Zinco/química , Colorimetria , Humanos , Imunoensaio , Limite de Detecção
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