胰腺癌早期症状隐匿，缺乏特异性，易被忽视，患者就诊时多为进展期，手术切除率特别是根治性手术切除率较低，远期疗效不佳。近20年来，尽管新的影像诊断技术及综合治疗手段不断问世，给许多恶性肿瘤的治疗开创了崭新的局面，但却未从根本上改变胰腺癌诊治的窘境。胰腺癌总体疗效较差，但早期病例根治术后仍可使其生存率明显延长。据美国对1989～1995年1340家医院的100313例胰腺癌的统计，Ⅰ期胰腺癌的5年生存率为32.8%。日本的全国统计资料显示，Ⅰ期胰腺导管癌的术后5年生存率达61%。可见，提高胰腺癌远期疗效的关键仍在于早期诊断。目前，影像学检查是胰腺癌最常用的检查手段，对影像学检查呈现出一些细微变化而难以定性的患者，下述方法可成为早期诊断的佐证。
【Abstract】Objective To search for valuable serum tumor markers in diagnosis and prognosis of pancreatic carcinoma. Methods Seven kinds of serum tumor markers including AFP,CEA,CA50, CA15-3,CA19-9,CA72-4 and CA125 were detected in 62 patients with pancreatic carcinoma by Auto DELFIA and IRMA, 16 patients with other gastrointestinal tumors and 16 patients with benign diseases served as control. And 19 patients after pancreatectomy were followed up. Results Among these 7 kinds of tumor markers, CA19-9,CA50 and CA125 were valuable in diagnosis of pancreatic carcinoma. CA19-9 was the most valuable one, whose sensitivity and specificity were 90.6% and 86.7% respectively. After resection of the tumor, the 3 markers tended to decrease significantly. Conclusion Serum CA19-9,CA50 and CA125 were valuable in diagnosis and following up of pancreatic carcinoma.
Objective To evaluate diagnostic value of tumor marker — the serum neuron specific enolase (NSE) in patients with suspected small cell lung cancer with lung pathological diagnosis as the gold standard. Methods A search in The Cochrane Library, PubMed, OVID, MEDLINE, EMbase, Cancerlit, China National Knowledge Infrastructure (CNKI), and CBM, was conducted from 1966 to 2008. Hand searches and additional searches were also conducted. Criteria for inclusion were established based on validity criteria for diagnostic research published by the Cochrane Methods Group on Screening and Diagnostic Tests. Subsequently, the characteristics of the included articles were appraised and extracted. Statistical analysis was performed employing Revman 4.2 software. Heterogeneity of the included articles was tested, which was used to select the proper effect model to calculate pooled weighted sensitivity and specificity. The Summary Receiver Operating Characteristic (SROC) curve was performed and the area under the curve (AUC) was calculated. Finally, sensitivity analysis was performed. Results Six articles entered this meta-analysis: four English articles, one Japanese article and one Chinese article. The quality level of the articles was C. the studies involving 2,366 patients (579 SCLC and 1,847 NSCLC patients that were diagnosed by using the gold standard) were included. The meta-analysis reported that the heterogeneity among studies was high (P=0.005, I2=70.4%), pooled sensitivity was 0.59, 95%CI 0.55 to 0.64, and pooled specificity was 0.88, 95%CI 0.87 to 0.90. The likelihood ratio was 8.17 and 0.31, respectively. The summary ROC of the meta-disc software and the area under the curve was 0.905 0. These data suggested that NSE had a relatively high false negative rate (41%) and a relatively low false positive rate (12%). Conclusion The tumor marker NSE is has diagnostic value of small cell lung cancer, but more high quality trials are required.
Objective To evaluate the diagnostic value of serum neuron specific enolase (NSE) in patients with small cell lung cancer. Methods We searched MEDLINE, EMBASE, The Cochrane Library and other databases (1966 to March 2007) to collect studies which evaluated the diagnostic value of NSE in patients with small cell lung cancer. The heterogeneity of included studies was tested by the Cochrane Collaboration’s software RevMan 4.2. The Summary Receiver Operating Characteristic (SROC) curve and meta-analyses were performed by MetaDisc. Results Fifteen studies involving 4221 patients (672 SCLC and 3549 NSCLC patients, all diagnosed by the gold standard) were included. Meta-analyses showed that the heterogeneity among studies was high (P=0.000 2, I2=66.1%), the pooled sensitivity was 0.67 (95%CI 0.64 to 0.71) and the pooled specificity was 0.91 (95%CI 0.90 to 0.92). Subgroup analyses indicated that 4 of the studies which used the reagent supplied by The Academy of Military Medical Sciences (P=0.33, I2=13.4%, AUC= 0.9672, SE=0.0393) and another 4 which used the reagent supplied by Roche (P=0.23, I2=29.9%, AUC=0.8311, SE=0.0836) had no heterogeneity. Conclusion NSE could be regarded as one of the reference tests in patients with small cell lung cancer, but more high quality trials are required.
ObjectiveTo systematically review the value of human epididymis protein 4 (HE4) in early diagnosis of endometrial cancer. MethodsDatabases including The Cochrane Library (Issue 1, 2013), PubMed, MEDLINE (Ovid), CNKI, CBM and WanFang Data were electronically searched for relevant studies on HE4 versus the golden standard (pathological examination) in the diagnosis of endometrial cancer from inception to April 2013. Meanwhile, relevant journals were also manually searched. Two reviewers independently screened literature according to the inclusion and exclusion criteria, and evaluated the included studies using the QUADAS items. Then, meta-analysis was performed using RevMan 5.1 and Meta-DiSc 1.0. ResultsFinally, a total of 16 studies involving 2 299 women (1 088 endometrial cancer patients diagnosed according to the golden standard, of which, 504 with benign uterine disease and 707 with normal cervical) were included. The results of meta-analysis showed that, as for HE4 in early diagnosis of endometrial cancer (SEN=57%, 95%CI 0.54 to 0.60; SPE=92%, 95%CI 0.91 to 0.94; +LR=6.92, 95%CI 5.00 to 9.58;-LR=0.46, 95%CI 0.39 to 0.55; DOR=18.38, 95%CI 12.21 to 27.69; AUC=0.881 7). ConclusionThe current study indicates that serum HE4 is more sensitive and low specific when applied in patients with endometrial cancer, which is worth of being used in clinic. Due to the limitation of low quality of the included studies, more high quality trials are required to verify the above conclusion.
Ultra-sensitive and quantitative analysis of proteins, nucleic acid, virus and other biochemical species are critical technologies for effective dianosis of disease, as well as medical studies. Silicon nanowires field-effect transistor (SiNWs-FET) biosensor is one of the most promising powerful platforms for label-free, real-time, ultra-sensitive detection of analyte. Here, the working principle of SiNWs-FET biosensor and the applications of SiNWs-FET biosensors in medicine were introduced. Moreover, the methods for enhancing the sensitivity of SiNWs-FET biosensor were discussed. Lastly, the prospecting of SiNWs-FET biosensor was presented.
Retinoblastoma (RB), the most common primary intraocular malignancy in infants and young children, poses a serious threat to visual function and the life of children when systemic metastasis occurs. Circular RNA (circRNA) is a recently discovered class of non-coding RNA that mainly functions as competitive endogenous RNA by regulating gene expression through competing with microRNA. circRNA can function as oncogenes or tumor suppressors, regulating various biological processes in RB cells, such as proliferation, migration, apoptosis, autophagy, and drug resistance, thereby providing new therapeutic targets for RB. In addition, the differential expression of circRNA in tumor tissues or exosomes is expected to be a potential biomarker for RB. Further studies and explorations are still needed for the functions and regulatory mechanisms of circRNA in RB to reveal their precise roles in organisms and potential clinical applications.