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1.
Medicine (Baltimore) ; 99(8): e19277, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32080139

RESUMO

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.


Assuntos
Neoplasias Colorretais/terapia , Fidelidade a Diretrizes , Guias de Prática Clínica como Assunto , Indicadores de Qualidade em Assistência à Saúde , Idoso de 80 Anos ou mais , Antígeno Carcinoembrionário/sangue , Continuidade da Assistência ao Paciente , Diagnóstico por Imagem , Endoscopia Gastrointestinal , Feminino , Humanos , Masculino , Sangue Oculto , Estudos Retrospectivos
2.
BMC Med Genet ; 21(1): 28, 2020 02 10.
Artigo em Inglês | MEDLINE | ID: mdl-32041551

RESUMO

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.


Assuntos
Detecção Precoce de Câncer , Gastrite Atrófica/sangue , MicroRNAs/sangue , Neoplasias Gástricas/sangue , Adulto , Antígeno Carcinoembrionário/sangue , Diagnóstico Diferencial , Feminino , Gastrite Atrófica/genética , Gastrite Atrófica/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Pepsinogênio A/sangue , Neoplasias Gástricas/genética , Neoplasias Gástricas/patologia
3.
J Cardiothorac Surg ; 15(1): 7, 2020 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-31915034

RESUMO

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.


Assuntos
Granuloma/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico por imagem , Recidiva Local de Neoplasia/diagnóstico por imagem , Idoso , Antígeno Carcinoembrionário/sangue , Diagnóstico Diferencial , Reações Falso-Positivas , Feminino , Fluordesoxiglucose F18 , Granuloma/etiologia , Granuloma/cirurgia , Humanos , Neoplasias Pulmonares/sangue , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/sangue , Recidiva Local de Neoplasia/cirurgia , Pneumonectomia , Ácido Poliglicólico/efeitos adversos , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons , Compostos Radiofarmacêuticos , Suturas/efeitos adversos
4.
Yonsei Med J ; 61(1): 15-19, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31887795

RESUMO

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.


Assuntos
Progressão da Doença , Fragmentos de Peptídeos/metabolismo , Neoplasias Gástricas/metabolismo , Neoplasias Gástricas/patologia , Adulto , Idoso , Antígenos Glicosídicos Associados a Tumores/sangue , Biomarcadores Tumorais/sangue , Antígeno Carcinoembrionário/sangue , Estudos de Casos e Controles , Feminino , Proteínas Ligadas por GPI/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Fragmentos de Peptídeos/sangue , Prognóstico , Curva ROC , Proteínas Recombinantes/sangue , Proteínas Recombinantes/metabolismo , Sensibilidade e Especificidade , Neoplasias Gástricas/sangue , Neoplasias Gástricas/diagnóstico
5.
Clin Biochem ; 74: 60-68, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31669510

RESUMO

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.


Assuntos
Biomarcadores Tumorais/sangue , Neoplasias Colorretais/sangue , Neoplasias Colorretais/diagnóstico , /sangue , Adenoma/sangue , Pólipos Adenomatosos/sangue , Idoso , Antígenos Glicosídicos Associados a Tumores/sangue , Biomarcadores Tumorais/genética , Antígeno Carcinoembrionário/sangue , Estudos de Coortes , Neoplasias do Colo/sangue , Detecção Precoce de Câncer , Feminino , Humanos , Modelos Logísticos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Curva ROC , Reação em Cadeia da Polimerase em Tempo Real , Análise de Sequência de DNA
6.
Medicine (Baltimore) ; 98(44): e17696, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689796

RESUMO

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.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Antígeno Carcinoembrionário/sangue , Neoplasias Colorretais/tratamento farmacológico , Neoplasias Colorretais/patologia , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/secundário , Adulto , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Quimioterapia Adjuvante , Neoplasias Colorretais/sangue , Feminino , Humanos , Neoplasias Hepáticas/sangue , Neoplasias Hepáticas/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Análise de Sobrevida
7.
J Biochem Mol Toxicol ; 33(12): e22404, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31593341

RESUMO

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.


Assuntos
Antioxidantes/uso terapêutico , Aporfinas/uso terapêutico , Carcinoma Hepatocelular/induzido quimicamente , Carcinoma Hepatocelular/tratamento farmacológico , Dietilnitrosamina/farmacologia , Neoplasias Hepáticas/induzido quimicamente , Neoplasias Hepáticas/tratamento farmacológico , Extratos Vegetais/uso terapêutico , Animais , Apoptose/efeitos dos fármacos , Antígeno Carcinoembrionário/sangue , Caspase 3/metabolismo , Proliferação de Células/efeitos dos fármacos , Citocromos c/metabolismo , Fígado/efeitos dos fármacos , Fígado/patologia , Masculino , Estresse Oxidativo/efeitos dos fármacos , Peumus/química , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , RNA Mensageiro/efeitos dos fármacos , Ratos , Ratos Wistar , Ganho de Peso , alfa-Fetoproteínas/análise , Proteína X Associada a bcl-2/metabolismo
8.
Medicine (Baltimore) ; 98(40): e17310, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31577724

RESUMO

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.


Assuntos
Fibrinogênio/análise , Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais , Antígeno Carcinoembrionário/sangue , Feminino , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Invasividade Neoplásica , Recidiva Local de Neoplasia , Prognóstico , Modelos de Riscos Proporcionais
9.
Zhonghua Wei Chang Wai Ke Za Zhi ; 22(10): 966-971, 2019 Oct 25.
Artigo em Chinês | MEDLINE | ID: mdl-31630495

RESUMO

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.


Assuntos
Neoplasias Colorretais/cirurgia , Diabetes Mellitus Tipo 2/diagnóstico , Adenocarcinoma/sangue , Adenocarcinoma/complicações , Adenocarcinoma/diagnóstico , Adenocarcinoma/cirurgia , Idoso , Índice de Massa Corporal , Antígeno Carcinoembrionário/sangue , Estudos de Casos e Controles , Neoplasias Colorretais/sangue , Neoplasias Colorretais/complicações , Neoplasias Colorretais/diagnóstico , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/imunologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Linfócitos T Reguladores/imunologia , Microambiente Tumoral/fisiologia
10.
Med Sci Monit ; 25: 7770-7783, 2019 Oct 17.
Artigo em Inglês | MEDLINE | ID: mdl-31619663

RESUMO

BACKGROUND Our previous research revealed that membrane type 1-matrix metalloproteinase (MT1-MMP) is overexpressed and plays a crucial role in gastric cancer (GC) progression. Exosomes are important for GC carcinogenesis, and the exosomal contents are ideal biomarkers. However, the expression of exosomal MT1-MMP mRNA in serum and its potential significance in GC remains unclear. MATERIAL AND METHODS The expression of exosomal MT1-MMP mRNA in serum of patients with GC, chronic gastritis, or atypical hyperplasia, and healthy controls was detected using real-time quantitative RT-PCR. Serum CEA, CA19-9, and CA72-4 were also measured by electrochemiluminescence assay. RESULTS Exosomes were isolated and identified in serum, and serum exosomal MT1-MMP mRNA was found to be higher in patients with GC compared with healthy controls and patients with chronic gastritis or atypical hyperplasia (all P<0.05). Serum exosomal MT1-MMP mRNA was significantly correlated with tumor diameter, differentiation, Borrmann type, invasion depth, lymphatic metastasis, distal metastasis, and TNM stage. The AUC of exosomal MT1-MMP mRNA was 0.788 (95% CI: 0.714-0.850) with 63.9% sensitivity and 87.1% specificity, and was higher than that of CEA (0.655 (95% CI: 0.573-0.730)). The combination of 2 markers gave an AUC of 0.821 (95% CI: 0.750-0.878), which was better than with the individual marker. The sensitivity, specificity, and positive and negative predictive values were 75.6%, 83.9%, 94.7%, and 47.3%, respectively. Moreover, the multiple logistic regression model showed that tumor diameter, differentiation, invasion depth, and exosomal MT1-MMP mRNA were the risk factors for lymphatic metastasis in GC. CONCLUSIONS Our results characterized serum exosomal MT1-MMP mRNA in GC, providing a foundation for discovering serum exosomes-targeted biomarkers for GC diagnosis.


Assuntos
Exossomos/genética , Metaloproteinase 14 da Matriz/genética , RNA Mensageiro/sangue , Neoplasias Gástricas/enzimologia , Adulto , Antígenos Glicosídicos Associados a Tumores/sangue , Biomarcadores Tumorais/sangue , Biomarcadores Tumorais/genética , Antígeno CA-19-9/sangue , Antígeno Carcinoembrionário/sangue , Progressão da Doença , Exossomos/metabolismo , Feminino , Humanos , Metástase Linfática , Masculino , Metaloproteinase 14 da Matriz/sangue , Pessoa de Meia-Idade , RNA Mensageiro/genética , Neoplasias Gástricas/sangue , Neoplasias Gástricas/genética
11.
J Coll Physicians Surg Pak ; 29(10): 962-966, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31564271

RESUMO

OBJECTIVE: To explore the diagnostic value of carbohydrate antigen 19-9 (CA 19-9) and carcinoembryonic antigen (CEA) for the diagnosis of intrahepatic cholangiocarcinoma (ICC). STUDY DESIGN: Case control study. PLACE AND DURATION OF STUDY: First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China, from June 2016 to March 2018. METHODOLOGY: Patients with ICC (n = 51) diagnosed by histological examination after surgery were matched 1:4 to control subjects (n = 204) based on age (±2 years), gender, and ethnicity. Serum CA 19-9 and CEA levels were determined and compared. Receiver operating characteristic (ROC) curves were generated, and areas under the receiver operating characteristic curve (AUC) were calculated. The cutoff values, sensitivities, specificities, and Youden index values were calculated and compared. RESULTS: The levels of CA 19-9 and CEA were elevated in the ICC patients relative to control subjects (p <0.001). CA 19-9 and CEA showed diagnostic efficacy for ICC, with AUC values of 0.6916 and 0.6376, respectively. The cutoff value, sensitivity, specificity, and Youden index for CA 19-9 were 26 U/ml, 58.82%, 83.82%, and 0.4262, respectively. The cutoff value, sensitivity, specificity, and Youden index for CEA were 1.95 ng/ml, 90.2%, 35.29%, and 0.2549, respectively. The combination of CA 19-9 and CEA exhibited the best diagnostic efficacy, with the sensitivity, specificity, and Youden index being 90.2%, 88.24%, and 0.7844, respectively. CONCLUSION: Combined CA 19-9 and CEA levels have diagnostic value for ICC. The combination of CA 19-9 and CEA can assist surveillance and diagnosis of ICC prior to surgery.


Assuntos
Neoplasias dos Ductos Biliares/sangue , Biomarcadores Tumorais/sangue , Colangiocarcinoma/sangue , Adulto , Idoso , Antígeno Ca-125/sangue , Antígeno CA-19-9/sangue , Antígeno Carcinoembrionário/sangue , Estudos de Casos e Controles , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade
12.
Clin Lab ; 65(9)2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31532112

RESUMO

BACKGROUND: The current study aims to detect the differential expression of lncRNA UCA1 in serum of patients with gastric cancer and a normal control group and to explore its efficacy and significance in clinical diagnosis of gastric cancer. METHODS: The expression of UCA1 in serum of gastric cancer and normal control group was detected by real-time fluorescence quantitative PCR, and its correlation with clinicopathological characteristics of gastric cancer was analyzed. The diagnostic efficacy of UCA1 in gastric cancer was evaluated by ROC curve and risk score analysis, and compared with carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), carbohydrate antigen 72-4 (CA72-4), and alpha fetoprotein. RESULTS: The expression of UCA1 in serum of patients with gastric cancer was significantly higher than that of the normal control group. The expression level was not correlated with age, gender, clinical stage, lymph node metastasis, and distant metastasis, but negatively correlated with the differentiation of cancer cells. The area under the curve of UCA1 in the diagnosis of gastric cancer was 0.759 (95% CI: 0.612 - 0.906). The sensitivity and specificity were 93.20% and 78.63%, respectively. Compared with CA9-9, CEA and CA72-4, the sensitivity of diagnosis increased significantly. CONCLUSIONS: In summary, the high expression of UCA1 in serum of gastric cancer may be a potential biomarker for clinical diagnosis of gastric cancer.


Assuntos
Adenocarcinoma/genética , Biomarcadores Tumorais/genética , RNA Longo não Codificante/genética , Neoplasias Gástricas/genética , Adenocarcinoma/sangue , Adenocarcinoma/diagnóstico , Adulto , Idoso , Antígenos Glicosídicos Associados a Tumores/sangue , Biomarcadores Tumorais/sangue , Antígeno CA-19-9/sangue , Antígeno Carcinoembrionário/sangue , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Curva ROC , Neoplasias Gástricas/sangue , Neoplasias Gástricas/diagnóstico , alfa-Fetoproteínas/metabolismo
13.
World J Gastroenterol ; 25(33): 4945-4958, 2019 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-31543685

RESUMO

BACKGROUND: Carcinoembryonic antigen (CEA) is a commonly used biomarker in colorectal cancer. However, controversy exists regarding the insufficient prognostic value of preoperative serum CEA alone in rectal cancer. Here, we combined preoperative serum CEA and the maximum tumor diameter to correct the CEA level, which may better reflect the malignancy of rectal cancer. AIM: To assess the prognostic impact of preoperative CEA/tumor size in rectal cancer. METHODS: We retrospectively reviewed 696 stage I to III rectal cancer patients who underwent curative tumor resection from 2007 to 2012. These patients were randomly divided into two cohorts for cross-validation: training cohort and validation cohort. The training cohort was used to generate an optimal cutoff point and the validation cohort was used to further validate the model. Maximally selected rank statistics were used to identify the optimum cutoff for CEA/tumor size. The Kaplan-Meier method and log-rank test were used to plot the survival curve and to compare the survival data. Univariate and multivariate Cox regression analyses were used to determine the prognostic value of CEA/tumor size. The primary and secondary outcomes were overall survival (OS) and disease-free survival (DFS), respectively. RESULTS: In all, 556 patients who satisfied both the inclusion and exclusion criteria were included and randomly divided into the training cohort (2/3 of 556, n = 371) and the validation cohort (1/3 of 556, n = 185). The cutoff was 2.429 ng/mL per cm. Comparison of the baseline data showed that high CEA/tumor size was correlated with older age, high TNM stage, the presence of perineural invasion, high CEA, and high carbohydrate antigen 19-9 (CA 19-9). Kaplan-Meier curves showed a manifest reduction in 5-year OS (training cohort: 56.7% vs 81.1%, P < 0.001; validation cohort: 58.8% vs 85.6%, P < 0.001) and DFS (training cohort: 52.5% vs 71.9%, P = 0.02; validation cohort: 50.3% vs 79.3%, P = 0.002) in the high CEA/tumor size group compared with the low CEA/tumor size group. Univariate and multivariate analyses identified CEA/tumor size as an independent prognostic factor for OS (training cohort: hazard ratio (HR) = 2.18, 95% confidence interval (CI): 1.28-3.73, P = 0.004; validation cohort: HR = 4.83, 95%CI: 2.21-10.52, P < 0.001) as well as DFS (training cohort: HR = 1.47, 95%CI: 0.93-2.33, P = 0.096; validation cohort: HR = 2.61, 95%CI: 1.38-4.95, P = 0.003). CONCLUSION: Preoperative CEA/tumor size is an independent prognostic factor for patients with stage I-III rectal cancer. Higher CEA/tumor size is associated with worse OS and DFS.


Assuntos
Antígeno Carcinoembrionário/sangue , Protectomia , Neoplasias Retais/mortalidade , Reto/patologia , Carga Tumoral , Adulto , Idoso , Idoso de 80 Anos ou mais , Intervalo Livre de Doença , Feminino , Seguimentos , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Período Pré-Operatório , Prognóstico , Neoplasias Retais/sangue , Neoplasias Retais/cirurgia , Reto/cirurgia , Estudos Retrospectivos , Adulto Jovem
14.
Oncol Rep ; 42(5): 2057-2064, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31545443

RESUMO

The interaction between tumor necrosis factor receptor superfamily, member 4 (OX40) on T cells and the OX40 ligand (OX40L) on antigen­presenting cells (APCs) is a pivotal step for T­cell activation and the promotion of antitumor immunity. However, it is hypothesized that soluble OX40 (sOX40) in blood suppresses T­cell activation by blocking the OX40/OX40L interaction. In the present study, the association between blood sOX40 levels and the clinical characteristics of advanced colorectal cancer (CRC) patients was investigated. Blood was collected from 22 patients with advanced CRC. Blood sOX40 levels were determined by enzyme­linked immunosorbent assay (ELISA). Messenger RNA (mRNA) expression encoding OX40 or cytokines was analyzed by quantitative RT­PCR. Blood sOX40 levels were positively correlated with the blood levels of carbohydrate antigen (CA) 19­9, carcinoembryonic antigen (CEA), C­reactive protein (CRP) and soluble programmed cell death ligand­1 (PD­L1) in patients but negatively correlated with the blood levels of albumin. Blood sOX40 levels were not correlated with the mRNA expression of interferon (IFN)­gamma, interleukin (IL)­6, IL­10 and IL­4 in the peripheral blood mononuclear cells (PBMCs) of the patients and were not correlated with the frequency of programmed cell death­1 (PD­1) expressing CD4+, CD8+ and CD56+ cells. Notably, according to both univariate and multivariate analyses, high blood sOX40 levels were significantly correlated with a reduced survival time in patients. Although activated Jurkat cells (a human T cell line) exhibited an upregulation of sOX40 production and OX40 mRNA expression, the OX40 mRNA expression of the PBMCs of patients was not correlated with blood sOX40 levels. High blood levels of sOX40 were correlated with a reduced survival time in patients with advanced CRC, possibly associated with the suppression of antitumor immunity by sOX40.


Assuntos
Neoplasias Colorretais/mortalidade , Receptores OX40/sangue , Receptores OX40/genética , Regulação para Cima , Adulto , Idoso , Idoso de 80 Anos ou mais , Antígenos Glicosídicos Associados a Tumores/sangue , Proteína C-Reativa/metabolismo , Antígeno Carcinoembrionário/sangue , Neoplasias Colorretais/genética , Neoplasias Colorretais/imunologia , Feminino , Regulação Neoplásica da Expressão Gênica , Humanos , Células Jurkat , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Compostos Organotiofosforados/sangue , Albumina Sérica Humana/metabolismo , Análise de Sobrevida
15.
Biosens Bioelectron ; 142: 111533, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31377573

RESUMO

In this work, we provided a novel strategy of antibody-free biomarker analysis by in-situ synthesized molecularly imprinted polymers (MIPs) on movable valve microfluidic paper-based electrochemical device (Bio-MIP-ePADs) for clinical detection of biomarkers. The newly movable valves on the device enable continuous and convenient delivery of fluid, which guarantee the performance for fabricating MIPs structure during long time electropolymerization. Moreover, this strategy can directly detect antigens by taking advantage of molecular imprinting on paper-based device, which greatly decreases the cost during clinical testing, reduces the tedious washing procedure and does not need to consider the preservation of the antibody in enzyme linked immunosorbent assay (ELISA). This feature makes the chip suitable for the on-site family treatment or commercial products. To further validate the applicability of this proposed method for clinical diagnostic testing, carcinoembryonic antigen (CEA) was applied as prototyping model target for the clinical analysis. The proposed Bio-MIP-ePADs were cheap, easy to prepare, disposable and provided reliable analysis by comparing with ELISA. We hope the application of this technology will open up a new avenue to the point-of-care testing (POCT).


Assuntos
Técnicas Biossensoriais/instrumentação , Antígeno Carcinoembrionário/sangue , Dispositivos Lab-On-A-Chip , Impressão Molecular/instrumentação , Polímeros/química , Técnicas Eletroquímicas/instrumentação , Desenho de Equipamento , Humanos , Papel , Testes Imediatos , Polimerização , Polímeros/síntese química
16.
Medicine (Baltimore) ; 98(31): e16511, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31374012

RESUMO

Blood-based biomarkers, such as carcinoembryonic antigen (CEA), and saliva-based biomarkers, such as mRNA, have emerged as potential liquid biopsies for non-invasive detection of many cancers. However, current tests typically use single type of biomarkers, and their sensitivity and specificity is often unsatisfactory.In this study, we developed a novel biomarker panel that measures both CEA level in blood and GREB1 and FRS2 levels in saliva to achieve high sensitivity and high specificity in detecting Non-Small Cell Lung Cancer (NSCLC).In the discovery phase, we achieved sensitivity of 96.67% and specificity of 93.33% for 30 NSCLC patients and 30 healthy controls. To further evaluate the prediction performance of our biomarker panel, we applied it to an independent set of 15 NSCLC cancer patients and 25 healthy controls. The sensitivity and specificity of our test reached 93.33% and 80.00% respectively.Our study discovered that the combined analysis of CEA and mRNA can be a novel liquid-biopsy technology for non-invasive detection of NSCLC.


Assuntos
Biomarcadores Tumorais/análise , Antígeno Carcinoembrionário/análise , Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Proteínas Adaptadoras de Transdução de Sinal/análise , Idoso , Área Sob a Curva , Antígeno Carcinoembrionário/sangue , Carcinoma Pulmonar de Células não Pequenas/enzimologia , Feminino , Humanos , Masculino , Proteínas de Membrana/análise , Pessoa de Meia-Idade , Proteínas de Neoplasias/análise , Curva ROC , Saliva/enzimologia
17.
Clin Lab ; 65(8)2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31414747

RESUMO

BACKGROUND: Tumor marker assays have played a crucial role for screening cancers and monitoring cancer patients, as they reflect the status and prognosis of patients. Alpha fetoprotein (AFP), prostate specific antigen (PSA), and carcinoembryonic antigen (CEA) are the most commonly used tumor marker proteins. The MARK BTM immunoassay system is a novel platform based on magnetic nanoparticles and electrochemical immunoassay. METHODS: The analytical performance of MARK BTM immunoassay system for determination of AFP, PSA, and CEA are evaluated. Comparisons of methods are also conducted by comparing the assay results of MARK BTM immunoassay system to that of cobas e 801 system. RESULTS: The MARK BTM immunoassay system provides within-run, between-run, and between-day precisions for the three tumor markers, ranging from 1.13 - 7.46%. Data measured by the MARK BTM immunoassay system show high correlation with that of the cobas e 801 system, with a linear slope ranging from 0.966 to 1.042 and a correlation coefficient of r > 0.996 for the three markers. CONCLUSIONS: These results show that the MARK BTM immunoassay system can be used for the quantitative measurements of AFP, PSA, and CEA in clinical practice.


Assuntos
Biomarcadores Tumorais/sangue , Antígeno Carcinoembrionário/sangue , Técnicas Eletroquímicas/métodos , Imunoensaio/métodos , Antígeno Prostático Específico/sangue , alfa-Fetoproteínas/análise , Técnicas Eletroquímicas/instrumentação , Humanos , Imunoensaio/instrumentação , Reprodutibilidade dos Testes
18.
Nanotechnology ; 30(49): 495501, 2019 Dec 06.
Artigo em Inglês | MEDLINE | ID: mdl-31443101

RESUMO

With the capability of inducing small particle sizes of supported metal in graphite oxide (GO), the γ-ray irradiation method applied for preparing graphite oxide-gold (GO-Au) nanocomposites as electrochemical immunosensors has attracted specific attention recently. To study the accurate factors influencing the precise morphology and final performance of the prepared composites in the γ-irradiation system, we proposed a facile method to investigate the evolution of the GO structure, size and dispersion of Au nanoparticles (AuNPs) produced with the addition of isopropyl alcohol to the system. The GO-Au nanocomposites were characterized by Fourier transform infrared spectroscopy, x-ray diffraction spectra, Raman spectra, x-ray photoelectron spectroscopy and high resolution transmission electron microscopy. These nanocomposites with sandwich morphology exhibited an excellent immunosensor performance with a low detection limit of 15.8 pg ml-1 (S/N = 3) and a wide linear range from 1 to 40 ng ml-1 for detecting carcinoembryonic antigens. The enhanced biosensing performance is attributed to the synergistic effect of γ-irradiation and the precise structure of GO, which endows the smaller size and more uniform distribution of AuNPs on the GO as well as the good signal amplification capability. Furthermore, adopting the γ-irradiation method and use of GO as a precursor is propitious for application in large-scale production because of its high-efficiency and high-yielding characteristics.


Assuntos
Técnicas Biossensoriais , Antígeno Carcinoembrionário/sangue , Ouro/química , Imunoensaio , Nanopartículas Metálicas/química , Nanocompostos/química , 2-Propanol/química , Anticorpos Imobilizados/química , Técnicas Eletroquímicas , Raios gama , Grafite/química , Humanos , Limite de Detecção , Nanopartículas Metálicas/efeitos da radiação , Nanopartículas Metálicas/ultraestrutura , Nanocompostos/efeitos da radiação , Nanocompostos/ultraestrutura , Óxidos/química
19.
J Med Case Rep ; 13(1): 237, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31366404

RESUMO

BACKGROUND: Serum carcinoembryonic antigen levels are often elevated in patients with malignant diseases. However, the etiology of elevated serum carcinoembryonic antigen levels may be extremely difficult to determine considering that this finding may occasionally occur in patients with benign diseases. Apocrine hidrocystomas, which are typically small and found on the face, are benign cystic lesions of apocrine sweat glands. CASE PRESENTATION: A 58-year-old Japanese man was referred to us because of high serum carcinoembryonic antigen levels (15.9 ng/mL) found incidentally during a routine medical checkup. A physical examination revealed a hemispherical mass approximately 5 cm in diameter on his left thigh. Magnetic resonance imaging of the region showed a multilocular cystic mass with clear margins and a smooth surface, suggesting a cystic tumor. He underwent local mass resection. Pathological examination of the resected mass revealed an apocrine hidrocystoma with luminal cells, which tested immunohistochemically positive for carcinoembryonic antigen. Postoperatively, serum carcinoembryonic antigen levels returned to normal. This report is the first to describe an apocrine hidrocystoma associated with high serum carcinoembryonic antigen levels. CONCLUSIONS: An apocrine hidrocystoma can cause elevation of serum carcinoembryonic antigen levels. Despite its rarity, apocrine hidrocystoma should be considered in the differential diagnosis of conditions causing high serum carcinoembryonic antigen levels. In addition, skin diseases deserve more careful attention for patients with high serum carcinoembryonic antigen levels.


Assuntos
Hidrocistoma/patologia , Neoplasias das Glândulas Sudoríparas/patologia , Antígeno Carcinoembrionário/sangue , Proteínas Ligadas por GPI/sangue , Hidrocistoma/sangue , Hidrocistoma/diagnóstico , Hidrocistoma/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias das Glândulas Sudoríparas/sangue , Neoplasias das Glândulas Sudoríparas/diagnóstico , Neoplasias das Glândulas Sudoríparas/cirurgia , Coxa da Perna
20.
Saudi J Kidney Dis Transpl ; 30(4): 898-904, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31464247

RESUMO

Chronic kidney disease (CKD) is one of the most important noncommunicable diseases. Abnormal concentration of some tumor markers were found in a spectrum of nonmalignant diseases such as benign ovarian tumors, breast diseases, chronic hepatitis, cirrhosis, diseases of the bile duct, and in CKD. Hence, the present study was undertaken to evaluate carbohydrate antigen (CA) 15-3, carcinoembryonic antigen (CEA), CA 19-9, and human chorionic gonadotropin (HCG) concentrations in advanced stages of CKD (Stage 4 and 5) patients who are not on dialysis and with no known malignancy. Patients included 40 CKD patients and 40 healthy controls. CA 15-3, CEA, CA 19-9, and HCG in serum were estimated by enzyme-linked immunosorbent assay method. The differences in tumor marker levels between the controls and advanced stages of CKD (Stage 4 and 5) were assessed using one-way analysis of variance using the Statistical Package for the Social Sciences for Windows version 16.5. CKD patients had significantly elevated levels of CEA, HCG, CA 19-9, and CA 15-3 compared to the control group (P = 0.001). There was no difference in the tumor markers levels between CKD Stage 4 and 5. Elevation in serum tumor markers may be a possibility in patients with CKD even in the situations of the absence of a malignancy. This may be due to an alteration in their metabolism in CKD and reduction of glomerular filtration rate leading to impaired excretion. Hence, it may be prudent to exercise caution in the interpretation of serum tumor markers as a representative for underlined malignancy in patients of CKD.


Assuntos
Biomarcadores Tumorais/sangue , Insuficiência Renal Crônica/sangue , Adulto , Antígeno CA-19-9/sangue , Antígeno Carcinoembrionário/sangue , Estudos de Casos e Controles , Gonadotropina Coriônica/sangue , Feminino , Humanos , Rim/fisiopatologia , Masculino , Pessoa de Meia-Idade , Mucina-1/sangue , Eliminação Renal , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/fisiopatologia , Regulação para Cima
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