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Adjusting CA19-9 values to predict malignancy in obstructive jaundice:Influence of bilirubin and C-reactive protein

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World Journal of Gastroenterology 2012年第31期18卷 4150-4155页

作者： Gaetano La Greca Maria Sofia Rosario Lombardo Saverio Latteri Agostino Ricotta Stefano Puleo Domenico Russello Department of Surgical Sciences Organ Transplantation and Advanced TechnologiesUniversity of Catania95125 CataniaItaly

AIM:To find a possible relationship between inflammation and CA19-9 tumor marker by analyzing data from patients with benign jaundice(BJ) and malignant jaundice(MJ).METHODS:All patients admitted for obstructive jaundice,in the period 2005-2009,were prospectively enrolled in the study,obtaining a total of 102 *** admission,all patients underwent complete standard blood test examinations including C-reactive protein(CRP),bilirubin,*** were considered eligible for the study when they presented obstructive jaundice confirmed by instrumental examinations and increased serum bilirubin levels(total bilirubin > 2.0 mg/dL).The standard cut-off level for CA19-9 was 32 U/mL,whereas for CRP this was 1.5 mg/*** CA19-9 level was adjusted by dividing it by the value of serum bilirubin or by the CRP *** patients were divided into 2 groups,MJ and BJ,and after the adjustment a comparison between the 2 groups of patients was ***,specificity and positive predictive values were calculated before and after the ***:Of the 102 patients,51 were affected by BJ and 51 by *** CA19-9 levels were found in 71.7% of the *** the group of 51 BJ patients there were 29(56.9%) males and 22(43.1%) females with a median age of 66 years(range 24-96 years),whereas in the MJ group there were 24(47%) males and 27(53%) females,with a mean age of 70 years(range 30-92 years).Pathologic CA19-9 serum level was found in 82.3% of *** levels were pathologic in 66.6% of the patients with BJ and in 49% with *** and CA19-9 average levels were significantly higher in MJ compared with BJ(P = 0.000 and P = 0.02),while the CRP level was significantly higher in BJ(P = 0.000).Considering a CA19-9 cut-off level of 32 U/mL,82.3% in the MJ group and 54.9% in the BJ group were positive for CA19-9(P = 0.002).A CA19-9 cut-off of 100 U/mL increases the difference between the two groups:35.3% in BJ and 68.6% in MJ(P = 0.0007).Adjusting the CA1

关键词： tumor marker CA19-9 C-reactive protein Bilirubin Pancreato-biliary malignancy Biliary stones

Expression of CD44v6 gene in normal human peripheral blood

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World Journal of Gastroenterology 2005年第23期11卷 3591-3594页

作者： JianSong Dong-ShengZhang JieZheng DepartmentofPathology InstituteofMolecularPathologyMedicalSchoolofSoutheastUniversityNanjing210009JiangsuProvinceChina

AIM: To investigate if CD44v6 could be used as a molecular marker of cancer progression and metastasis through the detection of CD44v6 gene expression in normal human peripheral ***: RNA was extracted from the peripheral blood mononuclear cells of 50 healthy donors, the expression of CD44v6 was investigated using reverse transcriptasepolymerase chain reaction (RT-PCR).RESULTS: CD44v6 mRNA was detected in 58% of healthy volunteers under the proper ***: Our results suggest that the measurement of CD44v6 expression in peripheral blood by RT-PCR is not suitable for detection of circulating tumor cells.

关键词： CD44v6 Peripheral blood tumor marker

CT diagnosis of recurrence after pancreatic cancer:Is there a pattern?

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World Journal of Gastroenterology 2011年第9期17卷 1126-1134页

作者： Tobias Heye Nicola Zausig Miriam Klauss Reinhard Singer Jens Werner Gtz Martin Richter Hans-Ulrich Kauczor Lars Grenacher Department of Diagnostic and Interventional Radiology University Hospital Department of Surgery University Hospital Department of Diagnostic and Interventional Radiology Katharinen Hospital

AIM:To investigate predilection sites of recurrence of pancreatic cancer by computed tomography(CT)in follow-up after surgery. METHODS:Seventy seven patients with recurrence after pancreatic cancer surgery were retrospectively *** operative technique,R-status,T-stage and development of tumor markers were evaluated. Two radiologists analyzed CT scans with consensus *** of local recurrence,lymph node recurrence and organ metastases were *** and progression of findings on follow-up CT were con-sidered as reference standard. RESULTS:The mean follow-up interval was 3.9± 1.8 mo,with a mean relapse-free interval of 12.9± 10.4 *** predominant site of recurrence was local (65%),followed by lymph node(17%),liver metastasis (11%)and peritoneal carcinosis(7%).Local recurrence emerged at the superior mesenteric artery(n=28),the hepatic artery(n=8),in an area defined by the surrounding vessels:celiac trunk,portal vein,inferior vena cava(n=22),and in a space limited by the mesenteric artery,portal vein and inferior vena cava(n=17). Lymph node recurrence occurred in the mesenteric root and left lateral to the *** was confirmed by surgery(n=22)and follow-up CT(n=55).tumor markers[carbohydrate antigen 19-9(CA19-9),carcinoembryonic antigen(CEA)]increased in accordance with signs of recurrence in most cases(86%CA19-9;79.2% CEA). CONCLUSION:Specific changes of local and lymph node recurrence can be found in the course of the cardinal peripancreatic *** superior mesenteric artery is the leading structure for recurrence.

关键词： Pancreatic cancer Recurrence Computed tomography Follow-up tumor marker

Sandwich ELISA for detecting urinary Survivin in bladder cancer

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Chinese Journal of Cancer Research 2013年第4期25卷 375-381页

作者： Xuefeng Li Yaming Wang Jianjun Xu Qingyun Zhang Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education) Department of Clinical LaboratoryPeking University Cancer Hospital&Institute

Objective： Survivin as a tumor marker in the diagnosis of bladder cancer has not been completely confirmed yet and there are few reports about using Survivin enzyme-linked immunosorbent assay （ELISA） kit to detect the urine of bladder cancer patients. This study aimed to develop a Survivin ELISA and validate its value in the detection of bladder cancer. Methods： Through square matrix titration, different combinations of coating antibody and detecting antibody, a Survivin ELISA was constructed. This assay was evaluated according to intra-assay precision, inter-assay precision and minimum detectable dose （MDD）. Survivin levels were detected and analyzed in 102 bladder cancer patients and 102 healthy people by established ELISA. Then cutoff value was defined according to the analysis of receiver operating characteristic （ROC） curve. The sensitivity and specificity of detection were calculated on the basis of cutoff value to diagnose bladder cancer patients. Furthermore, the value of Survivin expression detected by ELISA among different clinicopathological characteristics of patients was also compared. Results： Through optimization of different conditions, intra-assay precision was 8.39%, inter-assay precision 8.57% and MDD 0.0625 ng/mL in this assay. When the optical density at 450 nm （OD 450 ） was 0.09, it could get the optimized diagnostic cutoff value. According to this value, the sensitivity and specificity of diagnosis in bladder cancer patients were 70.6% and 89.2%, respectively. The associations between patients＇ clinical variables and OD 450 were not significant except tumor numbers in patients. Conclusions： This experiment has preliminarily developed a Survivin ELISA and confirmed Survivin as a biomarker which owned a practical and significant value in the diagnosis of bladder cancer.

关键词： Survivin bladder cancer enzyme-linked immunosorbent assay (ELISA) tumor marker diagnosis

Utility of squamous cell carcinoma antigen, carcinoembryonic antigen, Cyfra 21-1 and neuron specific enolase in lung cancer diagnosis： a prospective study from China

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Chinese Medical Journal 2011年第20期124卷 3244-3248页

作者： SONG Wei-an LIU Xi TIAN Xiao-dong WANG Wei LIANG Chao-yang ZHANG Tao GUO Jun-tang PENG Yang-hong ZHOU Nai-kang Department of Thoracic Surgery Chinese People＇s Liberation Army General Hospital Beijing 100853 China Department of Thoracic Surgery Navy General Hospital Beijing 100037 China

Background Early detection and diagnosis is urgent for the sake of effective treatment strategy for lung cancer. However, a convenient, economical and relatively precise method is not available. We here report a prospective study to find the possible value of the combined use of four popular tumor markers in the early diagnosis of lung cancer among patients with suspicious nodules in the lung. Methods Six hundred and sixty inpatients with suspicious nodules in the lung were divided into a lung cancer group and a benign pulmonary tumor group according to post-operative histological examinations. Serum levels of four tumor markers including squamous cell carcinoma antigen （SCC）, carcinoembryonic antigen （CEA）, Cyfra 21-1 and neuron specific enolase （NSE） were assayed for each patient. Receiver operating characteristic （ROC） curves were constructed for each tumor marker. The power of lung cancer diagnosis of each tumor marker, as well as a combination of them were analyzed and compared. Results The serum levels （median, range） of SCC, CEA, Cyfra 21-1 and NSE were 0.44 （0.01-35.70） ng/ml, 2.49 （0.30-26.78） ng/ml, 2.30 （0.82-73.33） ng/ml and 10.54 （0.10-56.41） ng/ml respectively in lung cancer group, and were 0.32 （0.01-0.90） ng/ml, 1.60 （0.20-8.93） ng/ml, 1.41 （0.72-4.82） ng/ml and 9.36 （6.56-24.24） ng/ml respectively in the benign pulmonary tumor group. The difference in each tumor marker between the two groups was significant （P 〈0.05）. The ROCs of SCC, CEA, Cyfra 21-1 and NSE were 0.702 （95% CI, 0.654-0.751）, 0.611 （95% CI, 0.563-0.659）, 0.650 （95% Cl, 0.601-0.700） and 0.598 （95% Cl, 0.542-0.654） respectively, indicating very low power of these four tumor markers. When a combination of SCC, CEA, Cyfra 21-1 and NSE were empfoyed, the diagnosis power was strengthened. Conclusion SCC, CEA, Cyfra 21-1 and NSE are valuable in the early diagnosis of lung cancer among suspicious nodules in the lung, especially when they were assayed together for one patient.

关键词： lung neoplasm tumor marker diagnosis

Prospective study of MMP7 serum levels in the diagnosis of cholangiocarcinoma

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World Journal of Gastroenterology 2010年第37期16卷 4697-4703页

作者： Kawin Leelawat Siriluck Narong Jerasak Wannaprasert Thawee Ratanashu-ek Department of Surgery Rajavithi Hospital College of Medicine Department of Surgery Rangsit University

AIM: To determine whether the serum level of matrix metalloproteinase-7 (MMP7) has the potential to diagnosis cholangiocarcinoma from benign biliary tract diseases. METHODS: This study was performed according to the PRoBE (a prospective-specimen-collection, retrospectiveblinded-evaluation) design. A total of 187 patients with obstructive jaundice were consecutively enrolled. After the diagnostic status of these patients was ascertained, their levels of serum MMP7 were assayed and compared with serum carbohydrate antigen 19-9 (CA19-9). This was conducted in a blinded case (cholangiocarcinoma)control (benign biliary tract disease) setup. RESULTS: MMP7 and CA19-9 serum levels were significantly elevated in cholangiocarcinoma patients (P markers for differentiating cholangiocarcinoma from benign biliary tract obstructive diseases.

关键词： Carbohydrate antigen 19-9 Cholangiocarcinoma Matrix metalloproteinase-7 Sensitivity Specificity tumor marker

Autoimmune pancreatitis associated with a large pancreatic pseudocyst

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World Journal of Gastroenterology 2006年第36期12卷 5904-5906页

作者： Thilo Welsch Jrg Kleeff Irene Esposito Markus W Büchler Helmut Friess Department of Surgery University of Heidelberg Heidelberg Germany Department of Pathology University of Heidel-berg Heidelberg Germany

Pancreatic cystic lesions comprise various entities with different histopathological characteristics and their dif-ferential diagnosis is often a challenge for clinicians. Autoimmune pancreatitis (AIP) is usually not considered in the differential diagnosis of cystic lesions, but often mimics the morphological aspects of pancreatic neo-plasm. We report the case of a 64-year-old male patient with a cystic pancreatic head lesion (diameter 5 cm) and stenosis of the distal bile duct requiring repeated stent-ing. Because of the clinical presentation together with moderate elevation of serum CA19-9 and massive eleva-tion of cyst fluid CA19-9 (122.695 U/L; normal range: tumor markers and cyst fluid cytology lack high accuracy to clearly differentiate cystic pancreatic lesions. Although AIP is rarely associated with pseudocysts, the disease has to be considered in the differential diagnosis of cys-tic pancreatic lesions. Early examination of serum IgG, IgG4 and auto-antibodies might save these patients from unnecessary endoscopical and surgical procedures.

关键词： Pseudocyst Autoimmune pancreatitis Pancreatic cancer tumor marker CEA CA19-9

Special Expression of Thy-1 in Different Malignant tumors

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Chinese Journal of Cancer Research 2010年第1期22卷 73-79页

作者： Jin-feng Chen Ai-ping Lu Nan Wu Li-jian Zhang Yue Yang Key Laboratory of Carcinogenesis and Translational Research （Ministry of Education Department of Thoracic Surgery Department of Pathology Peking University School of Oncology Beijing Cancer Hospital ＆ Institute Beijing 100142 China

Objective： To investigate the expression status of Thy-1 in malignant cancerous tissues and to evaluate whether Thy-1 could be a potential tumor marker. Methods： Immunohistochemistry method was used to examine Thy-1 expressions in different malignant tumor tissues. We used a monoclonal antibody specific for Thy-1 and the indirect Catalysis Signal Amplification method. With the help of tissue microarray （TMA）, we examined expression the status of Thy-1 in 1451 different types of malignant tumor tissues, 144 normal tissues and benign lesions. Results： All the malignant tumor cells were grouped as one group （malignant cells group） and normal or benign tumor tissue cells as another group （normal cells group）. Among the entire 1451 malignant cases group, positive Thy-1 expression with diffuse and strong staining was observed in 734 （734/1451; 50.59%） cases. In the benign cases only 6 chronic cervicitis cases showed weak staining for Thy-1. All the normal tissue showed negative staining. One-Way ANVOA analysis showed F value between these two groups was 147.229 （P〈0.0001）. Conclusion： A significantly stronger expression of Thy-1 in malignant tumors was observed. Special overexpression of Thy-1 in malignant tumors suggests that Thy-1 might be a potential novel tumor marker with respect to cancer progression. Chronic cervicitis has some relationship with cervix carcinoma. When it develops into atypical hyperplasia, it will be a precancerous lesion for cervix carcinoma. In this research we found weak staining for Thy-1 in chronic cervicitis lesion, so Thy-1 may play a crucial role in carcinogenesis for cervix carcinoma. The research about the relationship between Thy-1 expressions in cancer cells and in precancerous lesion will provide some clues to understand the mechanism for carcinogenesis process.

关键词： Thy-1/CD90 Malignant tumor tumor marker

Serum Pepsinogen and Osteopontin for Gastric Cancer Screening

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Chinese Journal of Cancer Research 2007年第3期19卷 153-158页

作者：宫月华孙丽萍袁媛 Cancer Institute the First Affiliated Hospital China Medical University

Objective： To investigate the value of combined assay of serum pepsinogen （PG） and osteopontin （OPN） levels for gastric cancer screening. Methods： Fasting serum pepsinogen Ⅰ, Ⅱ and OPN concentration were measured by ELISA in 570 subjects. The cut off points for PG and OPN were determined using ROC. Results： Using serum PGI concentration 〈80 ng/ml, Ⅰ, Ⅱ ration 〈5.0 and OPN concentration ≥34 ng/ml or ≥30.44 ng/ml （based on ROC） for gastric cancer screening had superior specificity, positive and negative predictive values compared with PG or OPN screening only. The sensitive and specificity of combining serum PG and OPN assay were both more than 70% compared with PG or OPN screening alone. Conclusion： Combining serum PG and OPN assay for gastric cancer screening is superior to PG or OPN level only. This may be a new method for gastric cancer mass screening.

关键词： Gastric cancer Cancer screening Serology tumor marker