Objective To evaluate the possibility of detection mutations of 〖JP2〗multiple genes in stool for secondary screening for colorectal cancer. Methods Tumor specimens and stool samples from 40 patients with colorectal cancer and 40 normal persons were examined for mutations of p53, K-ras and APC gene by polymerase chain reaction single strand conformation polymorphism (PCR-SSCP) and silver nitrate staining. Results ①The mutation rate of p53, K-ras and APC gene in the tissues and stools of colorectal cancer respectively were 57.50%, 50.00%, 60.00% and 42.86%, 40.00%, 51.43%, and no mutations were found in normal mucosa and stool. ②The mutation ratioes between multiple gene and single gene had significant difference (P＜0.05). ③The sensitivities had no significant difference between faecal occult blood test (FOBT) and multiple gene mutations detection in the diagnosis of colorectal cancer, but the specificity of the latter was higher than FOBT (P＜0.05). Conclusion Detection of multiple gene mutations in stool is a vauble method in the secondary screening for colorectal cancer.
目的 通过检测肝病患者血清甲胎蛋白异质体（AFP-L3）浓度和AFP-L3/血清甲胎蛋白（AFP）比值，分析探讨并联运用两指标在肝细胞癌（HCC）诊断中的价值。 方法 选取2011年3月－11月137例的住院患者血清标本，AFP检测均为阳性。依据病理学诊断，将137例患者分为两组，HCC组92例，良性肝病组45例，后者包括肝硬化结节37例、慢性活动性肝炎8例。采用酶联免疫吸附试验（ELISA）检测所有患者血清AFP-L3浓度；同时运用微量吸附柱法分离血清中的AFP-L3，采用电化学发光法检测分离后的AFP-L3和血清中总AFP浓度，计算AFP-L3/AFP比值。计算采用AFP-L3浓度与AFP-L3/AFP比值以及AFP-L3浓度与AFP-L3/AFP比值两指标并联诊断HCC的灵敏度、特异度、Youden指数等统计学指标，探讨其在原发性肝癌诊断中的价值。 结果 ① HCC组 AFP-L3浓度（109.04 ± 62.51）ng/mL，明显高于良性肝病组（25.96 ± 49.43）ng/mL，差异有统计学意义（t=8.28，P＜0.001）。HCC组血清AFP-L3/AFP比值（17.35 ± 14.48%）高于良性肝病组（5.617 ± 6.38%）, 差异有统计学意义（t=6.545，P＜0.0001）。② 以血清AFP-L3浓度＞38.0 ng/mL作为临界值诊断原发性肝癌的灵敏度为83.69%，特异度为88.88%，以AFP-L3/AFP比值＞10%作为临界值诊断原发性肝癌的灵敏度为83.69%，特异度为95.55%。③ 并联应用血清AFP-L3浓度＞38.0 ng/mL、AFP-L3/AFP＞比值7.5%诊断HCC的灵敏度为97.83%，特异度为84.44%。 结论 并联应运AFP-L3浓度与AFP-L3/AFP比值诊断HCC较应用单一指标诊断特异度稍有下降，但明显提高了诊断的灵敏度，更有利于HCC的早期诊断。
ObjectiveTo investigate the significance of carbohydrate antigen 199 (CA199), alanine aminotransferase (ALT), gamma-glutamyl transferase (γ-GT) levels in the diagnosis of liver damage caused by hyperthyroidism. MethodA total of 106 patients confirmed to have hyperthyroid liver damage between February 2012 and February 2014 were selected to form the hyperthyroidism liver injury group (group A). Ninety-five hyperthyroidism patients without liver damage were regarded as the hyperthyroidism without liver injury group (group B). In the same period, 72 healthy subjects were designated to form the control group (group C). Automatic chemiluminescence detector was used to determine free triiodothyronine, free thyroid hormone and CA199, and automatic biochemical analyzer was adopted to measure the levels of γ-GT and ALT. Then we performed the statistical analysis. ResultsThe levels of serum CA199, γ-GT and ALT in group A were significantly higher than those in group B and group C, and the differences were statistically significant (P<0.05). CA199 and γ-GT levels in group B were significantly higher than those in group C (P<0.05). The area under the receiver operating characteristic curve for CA199, γ-GT, ALT was respectively 0.840, 0.895, and 0.818, the maximum Youden indexes were 0.593, 0.703, and 0.578, with the corresponding critical values 37.25 U/mL, 60.81 U/L, and 43.14 U/L, respectively. The parallel dectection of the three indexes improved Youden index to 0.763. ConclusionsCA199, γ-GT and ALT as diagnosis indexes of hyperthyroidism liver damage have good diagnostic value, and combined detection of the three indexes is more favorable for early diagnosis and prediction.
Lung cancer is the most common malignant tumor in the world and the leading cause of cancer-related death. Due to the lack of effective early diagnosis methods, the prognosis of lung cancer is poor, but compared with advanced lung cancer, the survival rate of early lung cancer is greatly improved. Therefore, early diagnosis of lung cancer is crucial. As a major epigenetic modification, DNA methylation plays an important role in the development of lung cancer. A large number of studies have shown that detection of tumor suppressor gene methylation is an ideal early diagnosis method for lung cancer. With the continuous improvement of detection technology, methylation detection of multiple genes can be achieved. And it is found that multi-gene methylation combined detection of tissue samples obtained by minimally invasive operation such as puncture of diseased tissue and puncture of lymph node tissue, as well as the noninvasive samples such as peripheral blood, bronchoalveolar lavage fluid and sputum have higher detection rate and higher sensitivity and specificity than single gene methylation. It is an ideal method for early diagnosis of lung cancer.
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.
ObjectiveTo sort out the historical evolution of diagnostic screening methods for pancreatic cancer, and to explore how to achieve early diagnosis and treatment of pancreatic cancer in the context of China’s large population base and economic development.MethodsSystematic review was performed. The computer was used to search databases inchuding CNKI, VIP, WanFang Data, Web of Science, PubMed and EMbase. Two researchers independently searched Baidu search engine to collect relevant reports on screening methods and effect evaluation of pancreatic cancer published before February 28, 2018, and a qualitative descroption was made.ResultsA total of 117 articles were included in the study. The exploration of screening methods for pancreatic cancer in China has experienced three stages: germination, enlightenment and growth. Current screening methods include clinical manifestations, imaging screening methods, serum tumor markers and molecular biology gene diagnosis, each of which had its advantages and disadvantages. Single method could not achieve higher specificity and sensitivity, and joint detection had become an inevitable trend. Considering the benefit of practical application, screening among high-risk groups could effectively reduce the population size and achieve accurate screening.ConclusionThere was a big gap between domestic and foreign research in screening for pancreatic cancer. Screening methods are diverse, and joint detection is an inevitable trend. Screening for pancreatic cancer in high-risk population will become a breakthrough under the technical bottleneck.