ObjectiveTo investigate the implication of serum CA19-9 in patients with pulmonary interstitial fibrosis (PF). MethodsOne PF patient was followed up for 5 years, and the levels of serum CA19-9, arterial oxygen pressure and changes of chest CT scanning were recorded and analyzed.Furthermore, another 24 PF patients with the level of serum CA19-9 exceeding the cut-off value (37 U/mL) and 30 healthy controls were recruited, and the pulmonary function was compared between the PF patients and the healthy controls. ResultsDuring the 5-year follow-up, the serum CA19-9 increased gradually from 53.45 U/mL to > 1200 U/mL with progressive reticulation of the lungs proven by the chest CT scanning, and the arterial oxygen pressure in rest without oxygen inhalation decreased from 54 mm Hg to 32 mm Hg.Compared to the healthy controls, the PF patients had significantly higher serum CA19-9 levels [73.8(38.1-1200.0) U/mL vs.6.9(2.0-19.1) U/mL, P < 0.01] and worse diffusion function [55.0(12.7-87.8) mL·min-1·mm Hg-1 vs. 90.4(82.0-134.0) mL·min-1·mm Hg-1, P < 0.05].There was a significantly negative relationship between the elevation of CA19-9 and diffusion function (r=-0.997, P < 0.01). ConclusionSerum CA19-9 may increase in PF patients, which may be an indicator for poor prognosis.
ObjectiveTo investigate the values of serum CEA and CA19-9 in predicting postoperative recurrence and metastasis and prognosis for gastric cancer. MethodsPreoperative serum levels of CEA and CA19-9 were measured by electrochemiluminescence assay in 136 patients with gastric cancer. The relationships of serum CEA level, CA19-9 level to clinicopathologic features, postoperative recurrence and metastasis, and prognosis of gastric cancer were analyzed. Kaplan-Meier method (log-rank test) was used to survival analysis. ResultsThere were 67 patients with postoperative recurrence and metastasis in 136 patients with gastric cancer. The positive rate was 48.5% (66/136) for CEA and 43.4% (59/136) for CA19-9. There was a significant correlation between CEA level and T stage, TNM stage, lymph node metastasis, or vascular invasion (P=0.011, P=0.018, P=0.021, P=0.024). There was a significant correlation between CA19-9 level and T stage or lymph node metastasis (P=0.018, P=0.045). The rate of postoperative recurrence and metastasis was 60.6% (40/66) in positive CEA, 61.0% (36/59) in positive CA19-9, 38.6% (27/70) in negative CEA, and 40.3% (31/77) in negative CA19-9, respectively. The rate of postoperative recurrence and metastasis in the positive CEA or positive CA19-9 was significantly higher than those in the negative CEA or negative CA19-9 (P=0.010, P=0.016). Kaplan-Meier analysis showed that patients with positive CEA or positive CA19-9 had worse survival than those with negative CEA or CA19-9 (P=0.003, P=0.007). ConclusionsCEA and CA19-9 have important values in detecting recurrence and metastasis, predicting patient survival after gastric cancer surgery. Combined analysis of these markers is considered to be helpful for improving the prediction of the postoperative recurrence and metastasis and prognosis of gastric cancer.
Objective This study aimed to investigate the predictive value of preoperative serum CA19-9 level for lymph node micrometastasis in patients with lymph node metastasis-negative gastric cancer and its effect on prognosis. Methods Clinicopathological data were retrospectively collected from 176 cases of gastric cancer who underwent D2 radical surgery in our hospital between January 2006 and December 2011, and also collected the patients’ lymph node tissue specimens. All patients were confirmed by pathologic examination of lymph node metastasis-negative. Quantitative real-time PCR (qRT-PCR) was used to detect the presence of lymph node micrometastasis in lymph node tissues. Sixty cases of gastric cancer were selected to construct the receiver operating characteristic curve (ROC) of preoperative serum CA19-9 level to predict lymph node micrometastasis, then established the threshold value. The remaining 116 cases were used to validate the rationality of this threshold. In addition, we explored the impact of preoperative serum CA19-9 level on the prognosis of patients with lymph node metastasis-negative gastric cancer, and explored the risk factors of lymph node micrometastasis. Results ① Results of ROC curve: the preoperative serum CA19-9 level of 15.5 U/mL was the threshold for predicting lymph node micrometastasis, with a sensitivity of 93.1%, specificity of 63.6%, and area under the curve (AUC) of 0.84 (P=0.003). With 15.5 U/mL as the threshold, 116 patients were divided into positive group and negative group. The lymph node micrometastasis rates in the 2 groups were different, which was higher in the positive group than that in the negative group (P<0.001). ② Effect of preoperative serum CA19-9 level on prognosis: the patients were divided into the positive group and the negative group with 15.5 U/mL as the threshold, and the log-rank test showed that the survival of the negative group was better than that of the positive group (P=0.001). ③ The risk factors for lymph node micrometastasis: the logistic regression model showed that preoperatively positive serum CA19-9 was an independent risk factor for lymph node micrometastasis in patients with gastric cancer [OR=1.860, 95% CI was (1.720, 2.343), P<0.001]. Conclusion Preoperative serum CA19-9 level can be used to predict lymph node micrometastasis in lymph node metastasis-negative patients with gastric cancer.
ObjectiveTo investigate the predictive value of preoperative D-dimer, CA19-9, neutrophil-to-lymphocyte ratio (NLR) in the diagnosis of pancreatic cancer. MethodsThe clinicopathologic data of patients who underwent pancreaticoduodenectomy for pancreatic occupying lesions in the First and Fifth Affiliated Hospitals of Xinjiang Medical University from January 2016 to December 2019 were analyzed retrospectively. According to the pathological characteristics, the patients were divided into pancreatic cancer and pancreatic benign tumour. The gender, age, accompanying diseases, preoperative D-dimer, CA19-9, lymphocyte count, neutrophil count, NLR and so on were compared between them. The receiver operating characteristic (ROC) curves of preoperative D-dimer, CA19-9, and NLR for diagnosis of pancreatic cancer were draw. ResultsA total of 142 patients were collected, including 79 patients with pancreatic cancer and 63 patients with pancreatic benign tumour. Compared with the patients with pancreatic benign tumour, the age was older (P<0.05), the number of neutrophils was more (P<0.05), the number of lymphocytes was less (P<0.05), the preoperative levels of CA19-9 and D-dimer, and the preoperative NLR were higher (P<0.05) for the patients with pancreatic cancer. The multivariate analysis of logistic regression revealed that the preoperative higer CA19-9, D-dimer, and NLR increased the incidence of pancreatic cancer (P<0.05), then the optimal cut-off value of preoperative levels of CA19-9 and D-dimer, and preoperative NLR on diagnosis of pancreatic cancer was 108 U/mL, 306 μg/L and 3.2, respectively, the corresponding area under ROC curve was 0.900, 0.891, 0.768, respectively, and which of combination of preoperative CA19-9, D-dimer, and NLR was 0.931. For the pancreatic cancer patients with preoperative NLR, CA19-9, and D-dimer higher than the optimal cut-off value, the proportions of patients with pTNM stage Ⅲ and lymph node metastasis were higher than those for pancreatic cancer patients with below than optimal cut-off value (P<0.05). ConclusionFrom preliminary study results, preoperative CA19-9, D-dimer, and NLR values have certain values in diagnosis of pancreatic cancer, and diagnostic value of combined detection of 3 indexes is higher than single index.
目的探讨血清CA153、CA125和CA19-9检测对乳腺癌早期诊断的价值。方法采用化学发光免疫法分别检测乳腺癌、乳腺良性疾病患者及正常健康体检者血清CA153、CA125和CA19-9的水平。结果乳腺癌患者血清的CA153、CA125和CA19-9的表达水平及表达阳性率均明显高于正常对照者和乳腺良性疾病患者(Plt;0.01)； 乳腺癌患者术后CA153、CA125及CA19-9表达水平较术前明显下降(Plt;0.01)，与正常对照者比较差异无统计学意义(Pgt;0.05)。结论肿瘤标志物CA153、CA125及CA19-9 对乳腺癌有一定的诊断价值，且可作为监测乳腺癌病情进展、评估治疗疗效及预后的指标。
Objective To observe the expression of Ezrin protein in primary carcinoma of gallbladder tissue and the levels of CEA and CA19-9 in serum of patients with primary carcinoma of gallbladder, and to explore the relationship between the expressions of these measurements and clinicopathologic characteristics. Methods Immunohistochemistry was applied to analyze the expression of Ezrin protein in primary carcinoma of gallbladder and chronic cholecystitis tissue. The levels of CEA and CA19-9 in serum and clinicopathologic characteristics of all including patients were detected with clinical measurement. All data were analyzed statistically. Results ①The positive rates of Ezrin protein in primary carcinoma of gallbladder and chronic cholecystitis tissue were 66.7% （40/60） and 30.8%（4/13）, respectively (χ2=5.57, Plt;0.05). ②There was no difference between the expression of Ezrin protein in primary carcinoma of gallbladder tissue and age or gender (Pgt;0.05). However, difference was significant between the Ezrin expression and degree of difference, pNevin stages, pTNM stages, lymph node metastasis or distant metastasis (Plt;0.05). ③There were no differences between the positive rates of CEA and CA19-9 in primary carcinoma of gallbladder and age or gender (Pgt;0.05). However, differences were significant between the positive rates of CEA and CA19-9 and pNevin stages, pTNM stages, degree of difference, lymph node metastasis or distant metastasis (Plt;0.05). ④There was some relationship between the expression of Ezrin protein and the positive rate of CEA (rs=0.213, Plt;0.05), but not with the positive rate of CA19-9 (rs=0.081, Pgt;0.05). Conclusions The high expression of Ezrin protein may promote the invasion and metastasis in primary carcinoma of gallbladder. It could be possible to decide the outcome of primary carcinoma of gallbladder through the combined analysis on the expression of Ezrin protein and the serum levels of CEA and CA19-9.
目的 报道10例血清CA19-9明显升高的胆管良性疾病病例。方法 回顾性分析2004年1月至2006年3月期间我院收治并经手术证实的10例血清CA19-9明显升高（gt;500 U/ml）的胆管良性病变病例。结果 患者中男4例，女6例，年龄30~85岁，CA19-9为532.32~12 000.00 U/ml，除1例患者CA125轻度升高外，其他患者血清CEA、CA125及AFP均正常。胆总管结石8例，肝内胆管结石1例，原发性硬化性胆管炎1例； 除1例外均存在不同程度阻塞性黄疸。经治疗后8例CA19-9水平在30 d内降至正常，另2例分别于术后2个月和3个月内降至正常。结论 CA19-9在胆管恶性肿瘤诊断方面的意义仍需进一步研究。
Objective To compare the clinicopathological features of hilar cholangiocarcinoma (HCCA) and hilar benign diseases, and then explore the value of carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA) in the differential diagnosis between them. Methods Clinical data of 65 patients (54 patients with HCCA and 11 patients with hilar benign diseases) who were diagnosed as HCCA and received treatment from January 2011 to October 2015 in our hospital were retrospectively analyzed. Comparison of clinical data of HCCA patients and patients with hilar benign diseases in age, gender, disease duration, clinical manifestation, laboratory examination, and imaging examination was performed, and the receiver operating characteristic curve (ROC) was used to explore the value of CA19-9 and CEA in differential diagnosis between hilar benign diseases and HCCA. Results The age, levels of serum CA19-9, CEA, alanine aminotransferase (ALT), total bilirubin (BILT), and direct bilirubin (BILD) of HCCA group were significantly higher than that in benign group (P<0.05). However, the gender, disease duration, clinical manifestations (including jaundice, abdominal discomfort, fever, and weight loss), serum aspartate aminotransferase (AST), serum alkaline phosphatase (ALKP), and imaging findings (including hilar mass, intrahepatic bile duct dilatation, thickening of the bile duct wall, lymph node enlargement, vascular invasion, and gallbladder invasion) had no significant difference between the 2 groups (P>0.05). The ROC curve results showed that, when cut-off point for CA19-9 was 233.15 U/mL, the sensitivity was 56% and specificity was 91%; when cut-off point for CEA was 2.98 ng/mL, the sensitivity was 61% and specificity was 90%. Conclusions For the differential diagnosis between HCCA and hilar benign diseases, the elderly patients with high levels of serum transaminase and bilirubin were more likely to be malignant. It is more likely to be malignant when the serum CA19-9>233.15 U/mL or CEA>2.98 ng/mL.
ObjectiveTo explore the application value of the combined detection of CA19-9, CA72-4, carcinoembryonic antigen (CEA), serum pepsinogen Ⅰ(PGⅠ), serum pepsinogen Ⅱ(PGⅡ), ratio of PGⅠ and PGⅡ (PGR), and gastrin-17 (G17) in the diagnosis of gastric cancer.MethodsOne hundred cases of gastric cancer admitted to the Joint Logistic Support Force 940 Hospital of the People’s Liberation Army from January 2016 to August 2018 were respectively collected as the observation group, 110 cases of benign gastric lesions as the control group during the same period, the levels of serum CA19-9, CA72-4, CEA, PGⅠ, PGⅡ, PGR, and G17 were tested among patients in the two groups, the diagnostic value of single and combined detection (included CA19-9, CA72-4, CEA, PGⅠ, PGⅡ, PGR, and G17) were explored.ResultsThe levels of CA19-9, CA72-4, CEA, and G17 in the observation group were higher than those of the control group (P<0.05), the levels of PGⅠ and PGR were lower than those of the control group (P<0.05). The positive detection rates of CA19-9, CA72-4, CEA, G17, PGⅠ, PGR, and combined detection in the observation group were all higher than those of the control group (P<0.05). The sensitivity and accuracy of the combined detection in the diagnosis of gastric cancer were higher than that of single serum index (P<0.05). The levels of serum CA19-9, CA72-4, CEA, and G17 in the patients of Ⅲ+Ⅳ period, low and moderate degree of differentiation, the tumor diameter was larger than five centimeters, signet-ring cell carcinoma, and distance metastasis of gastric cancer patients were on the high side compared with Ⅰ+Ⅱ period, high differentiation, the tumor diameter was less than or equal to five centimeters, glandular cancer, and no distance metastasis of gastric cancer patients, as well as the levels of serum PGⅠ and PGR on the low side (P<0.05).ConclusionThe combined detection of CA19-9, CA72-4, CEA, PGⅠ, PGⅡ, PGR, and G17 can effectively improve the diagnose rate of gastric cancer, and they are closely related to the pathological characteristics of gastriccancer patients.