Objective To investigate the value of tumor type M2 pyruvate kinase ( M2-PK) in the differential diagnosis of pleural effusion. Methods A total of 146 patients with pleural effusion during January 2006 to December 2008 were recruited at the department of respiratory medicine of the Shantou Affiliated Hospital and the First Affiliated Hospital of Sun Yat-sen Medical College. Pleural effusion was malignant in 72 cases ( 52 cases with lung cancer and 20 cases with metastatic lung cancer) and benign in 74 cases ( 54 cases with infective pleural effusion and 20 with transudation effusion) . The patients were divided into a malignant pleural effusion group, an infective pleural effusion group, and a transudation group.Then the infective group was further divided into subgroups of tuberculosis pleural effusion group andparapneumonic effusion group. The concentration of tumor M2-PK in pleural fluid obtained during the first thoracocentesis was measured by enzyme-linked immunosorbent assay( ELISA) . Results The concentration of tumor M2-PK was significantly higher in the malignant pleural effusion group compared with the benignpleural effusion groups ( P lt; 0. 01) . Significant differences were also found in the concentration of tumor M2-PK between malignant pleural effusion caused by lung cancer and metastatic lung cancer( P lt; 0. 05) .When the cutoff value of tumor M2-PK was set at 18. 68 U/mL, the sensitivity, specificity, and accuracy for the diagnosis of malignant pleural effusion was 87. 6% , 86. 0% , and 87. 4%, respectively. Furthermore,the detection of tumor M2-PK in combination with CEA showed better diagnostic sensitivity( 96. 0% ) ,specificity ( 85. 0% ) , and accuracy ( 91. 1% ) . Conclusions The detection of tumor M2-PK in pleural effusion is of some clinical significance in the differential diagnosis of benign and malignant pleural effusion.The detection of tumor M2-PK in combination with CEA is a good diagnostic tool with high sensitivity andspecificity.
【Abstract】 Objective To evaluate the relationship between multiple tumor biomarkers and idiopathic pulmonary fibrosis ( IPF) , and analyze the prognostic value of these biomarkers in IPF. Methods Clinical data of 43 confirmed IPF patients with no evidence of malignant disaeses, admitted in Peking Union Medical College Hospital between January 2000 and June 2010, were retrospectively analyzed. All IPF patients had detected serum alpha fetoprotein ( AFP) , cancer antigen 50 ( CA50) , cancer antigen 24-2( CA24-2) , carcinoembryonic antigen ( CEA) , carbohydrate antigen 19-9 ( CA19-9) , cancer antigen 125( CA125) , cancer antigen 15-3 ( CA15-3) , tissue polypeptide antigen ( TPA) , neuron specific enolase( NSE) , and cytokeratin-19-fragment ( Cyfra211) . Results The serum levels of CEA, CA19-9, CA125,CA15-3, and TPA were obviously higher than normal range, while the serum levels of AFP, CA50, CA24-2,NSE, and Cyfra211 were within normal range. Neither tumor biomarkers had correlation with 6-minute walk distance, FVC% pred, TLC% pred, DLCO/VA, PaO2 , PaO2 /FiO2 , P( A-a) O2 , BALF cell differentiation counting,or CD4 /CD8. The patients with increased CA19-9 level had shorter survival time than those with normal CA19-9 level ( P lt; 0. 05) . There was no significant difference in survival time between the patients with increased CEA/TPA levels and those with normal CEA/TPA levels( P gt;0. 05) , neither between the patients with glucocorticoid treatment and those with non-glucocorticoid treatment ( P gt; 0. 05) . Conclusions Multiple tumor biomarkers, especially CA19-9, increase in IPF patients. The degrees of those increases arenot associated with the severity of disease, but closely relate to prognosis, and may also indicate the progression. The increases of multiple tumor biomarkers may be a sign of poor prognosis of IPF with no evidence of malignant disaeses.
Objective To investigate the serum level of surfactant protein D ( SP-D) in patients with chronic obstructive pulmonary disease ( COPD) and its clinical significance. Methods Serumlevels of SP-D in patients with acute exacerbations of COPD ( n = 29) , stable COPD ( n = 26) , and control subjects ( n = 19 ) were measured by ELISA. Multiple regression modeling was performed to determine the independent relationship between SP-D and lung function variables. Results The serum SP-D levels were significantly increased in the patients who experienced an acute exacerbation [ ( 70. 6 ±20. 7) ng/mL] compared with the patients with stable COPD and the control subjects [ ( 47. 9 ±13. 3) ng/mL and ( 31. 2 ±11. 4) ng/mL] ( both P lt; 0. 01) . The serum SP-D levels in the patients with stable COPD increased significantly than the control subjects ( P lt; 0. 01) . Smoking index and staging of COPD were positively related to SP-D level. Serum SP-D levels were also found to be inversely related to FEV1% pred in stable COPD. Conclusion Serum SP-D may be a potential diagnostic and staging biomarker for COPD.
Objective To evaluate the influences of myocardial injury markers on the short-term and long-term mortality after coronary artery bypass grafting (CABG), so as to provide valuable references for clinical prognosis assessment. Methods Literature was electronically searched in CBM, PubMed, OVID, EMbase and CNKI from the date of their establishment to August 2011, meanwhile the manual searches were also performed to systemize the papers. According to the Cochrane Handbook for systematic reviews, the studies were screened by two reviewers independently, the quality of the included studies was evaluated, the data were extracted, and meta-analysis was conducted using RevMan5.0 software. Results A total of 10 observational studies including creatine kinase-myocardial band (CK-MB) and cardiac troponin I (cTnI), and the patients involved were 10 793 totally. Results of meta-analysis showed that the increasing release of CK-MB was associated with an increasing short-term mortality risk of both on-pump (RR=2.88, 95%CI 1.94 to 4.28, Plt;0.000 01) and off-pump group (RR=3.64, 95%CI 1.07 to 12.42), P=0.04). Also the increasing release of CK-MB was associated with an increasing long-term mortality risk of both on-pump (RR=2.55, 95%CI 1.91 to 3.40, Plt;0.000 01) and off-pump group (RR=3.36, 95%CI1.46 to 7.72, P=0.004). The increasing release of cTnI was also associated with an increasing risk of both short-term mortality (RR=6.45, 95%CI 2.50 to 16.66, Plt;0.1) and long-term mortality (RR=4.18, 95%CI 2.78 to 6.28, Plt;0.1). Conclusion The evidence shows that the increasing release of both CK-MB and cTnI is associated with an increasing risk of the short-term and long-term mortality.
Objective To explore the solutions of problems with the ROC analysis for different types data. Method Two kinds of ROC analyses of three cardiac infarction markers, cTNT, CK-MB mass and MYO, were performed with the ROC program developed by Yunnan Provincial Clinical Laboratory Center. Results The distribution of prime data had a large range, which produced a bad analysis result. After logarithmic transformation, the prime data that had smaller range now can be analyzed with full-span method. The results were similar to the ROC analyzed with the overlapped data. Conclusions We should choose different statistical method depend on the distribution of data when we performed ROC analyses.
【摘要】 目的 探讨炎性标志物高敏C反应蛋白(highsensitivity creaction protein ,hsCRP)、纤维蛋白原(fibrinogen, FIB)与P波离散度(P wave dispersion, PWD)的关系。 方法 回顾分析2005年1〖CD3/5〗8月收治的102例心脏病住院患者的临床资料,分别测量PWD和获得hsCRP、FIB血浓度,对比分析炎性标志物和PWD之间的关系。 结果 心脏病住院患者的PWD (408±93) ms、hsCRP (368±317) mg/L和FIB (411±294) g/L均较正常值高。PWD异常组和正常组的血hsCRP分别为(482±211)、(193±093) mg/L,差异有统计学意义(Plt;001)；血FIB分别为(510±348)、(251±129) g/L,差异有统计学意义(Plt;005)。血hsCRP增高组PWD(549±96) ms，较正常组(285±74) ms显著增大(Plt;001),血FIB增高组PWD(479±68) ms，较正常组(359±87) ms显著增大(Plt;005)。PWD与血hsCRP成正相关(相关系数R=0418,Plt;005)；PWD与血FIB成正相关(相关系数R=0292,Plt;005)。 结论 PWD与血炎性标志物密切相关,血炎性标志物增高的患者PWD增大。【Abstract】〓Objective〓〖WT5”BZ〗To investigate the relationship between P wave dispersion (PWD) and inflammatory marker (serum highsensitivity creaction protein, hsCRP and fibronogen,FIB). Methods Retrospectively measure PWD of 102 inpatients with heart diseases,and get the results of the hsCRP and FIB. Results The average PWD (408±93) ms of 102 inpatients is higher than normal value,the average hsCRP (368±317) mg/L and FIB (411±294) g/L are higher than normal value. The serum concentration of the hsCRP and FIB increase significantly in abnormal PWD subgroup than normal PWD subgroup, respectively [(482±211) mg/L vs (193±093) mg/L, Plt;001 and (510±348) g/L vs (251±129) g/L, Plt;005)]. The PWD of the serum highconcentration hsCRP and FIB subgroup increase than normalconcentration subgroup significantly, respectively [(549±96) ms vs (285±74) ms, Plt;001 and (479±68) ms vs (359±87) ms,Plt;005] PWD has positive relationship with hsCRP(R=08,Plt;005)and FIB (R=0292,Plt;005). Conclusions PWD has good relationship with serum inflammtory makers, PWD increases with the ascending of concentration of the serum hsCRP and FIB.
Objective To summarize the research progress of microRNA （miRNA） as a tumor marker in peripheral blood. Methods The domestic and international published literatures about circulating miRNA as a tumor marker in recent years were reviewed. Results The miRNA expression has universality，stability and specificity，and it is related to the occurrence and development of viarous diseases. Conclusion Circulating miRNA shows a broad application prospect in clinical diagnosis， treatment， and prognosis of tumor and other diseases.
ObjectiveTo examine and compare the value of procalcitonin (PCT), C-reactive protein (CRP) and interleukin (IL)-6 in diagnosing fetal sepsis in premature neonates. MethodsPreterm neonates with premature rupture of membrane between January 2010 and September 2012 were screened, and the serum levels of PCT, CRP and IL-6 were detected in the first day of life. All preterm neonates were divided into two groups according to the development of sepsis (45 cases with sepsis and 39 cases without sepsis). ResultsThe levels of PCT, CRP and IL-6 in premature neonates with sepsis were all significantly higher than those without sepsis. The cut-off value of PCT in diagnosis of sepsis was 2.14 μg/L, with a sensitivity and specificity of 76% and 85% respectively; the cut-off value of CRP in diagnosis of sepsis was 7.90 mg/L, with a sensitivity and specificity of 67% and 61% respectively. For IL-6, the cut-off value in diagnosis of sepsis was 13.80 ng/L, and its sensitivity and specificity were high to 90% and 94%, respectively. ConclusionIL-6 is the most reliable biochemical marker for the detection of early-onset sepsis in preterm neonates with premature rupture of membrane.
ObjectiveTo explore the clinical significance of plasma biomarkers of prethrombotic state in lung cancer patients. Methods90 patients with lung cancer (lung cancer group) and 90 normal controls (control group) of Han population in Shanghai Pulmonary Hospital from June 2010 to June 2012 were recruited in the study. Enzyme-linked immunosorbent assay (ELISA) was used to detect the plasma levels of von willebrand factor(vWF),P-selectin,and thrombin-antithrombine complex (TAT). Coagulation indicators were detected by ACLTOP full automatic coagulation analyzer. Solidification method was used to detect the plasma levels of prothrombin time (PT),activated partial thromboplastin time (APTT) and fibrinogen (FIB). Turbidimetric immunoassay was used to detect D-dimer concentration,and chemiluminescence substrate was used to assay antithrombin Ⅲ (AT-Ⅲ). ResultsIn the lung cancer group,the plasma levels of vWF,P-selectin,TAT,D-dimer and FIB were significantly higher than those in the control group (P<0.05),and the plasma levels of APTT and AT-Ⅲ were lower than those in the control group(P<0.05),while there was no significant difference in plasma PT level(P>0.05). In stage Ⅳ lung cancer subgroup,the plasma levels of vWF,P-selectin,TAT,D-dimer and FIB were significantly higher than those in the stage Ⅲ subgroup or the stage Ⅰ+Ⅱ subgroup (P<0.05). And the plasma levels of PT and APTT were significantly lower than those in the stage Ⅲ subgroup or the stage Ⅰ+Ⅱ subgroup (P<0.05). ConclusionThe patients with lung cancer exist obvious prethrombotic state. AT-Ⅲ,vWF, D-dimer, FIB,TAT,P-selectin and APTT can be used as reliable hematol markers in early diagnosis of prethrombotic state. vWF,P-selectin,TAT and D-dimer have higher sensitivity and specificity.
ObjectiveTo summarize the research progress of mucinous breast cancer (MBC). MethodsLiteratures about the recent studies of MBC were reviewed. ResultsMBC was one of special subtype of infiltrating breast cancer. According to the mucus ingredient in the ratio of the mass, MBC was divided into pure mucinous breast cancer (PMBC) and mixed mucinous breast cancer (MMBC). Compared to infiltrating ductal cancer-not otherwise specified (IDC-NOS), MBC showed higher positive expression rates of estrogen receptor (ER) and progestrogen receptor (PR), with reduced lymph node metastasis rate and better prognosis. PMBC had lower lymph node metastasis rate and better outcome than MMBC. ConclusionsThere is significant difference about clinical and pathological characteristics between MBC and IDC-NOS. Researches are generally believed that MBC is an uncommon breast neoplasm which is associated with a good prognosis.