【Abstract】Objective To compare the reliability of serum tumour specific growth factor (TSGF) with carcinoembryonic antigen (CEA) in the diagnosis of tumour. Methods The patients were divided into two groups according to malignancy and benignity. In benignity, the patients were subdivided into inflammatory and non-inflammatory groups. The levels of TSGF and CEA in the two groups were measured. Results The positive rate of TSGF and CEA in malignant group was 67.41% and 38.84% respectively; that in benign was 24.56% and 2.63% respectively, in which the inflammatory group was 32.35% and 5.88% respectively, and in non-inflammatory group was 18.25% and 0% respectively. The positive rate of TSGF and CEA was higher in malignant than in benign group (P＜0.005). The positive rate of TSGF was higher than CEA in malignant (P＜0.005) and inflammatory group (P＜0.005). Conclusion Serum TSGF is a useful blood marker in the diagnosis of patients with malignancy, and is a more sensitive and broad-spectrum marker than CEA for the diagnosis of tumours. CEA is more specific than TSGF for the diagnosis of tumours. Combined measurement both TSGF and CEA will enhance the diagnostic rate.
Objective To investigate the clinical features of interstitial lung disease (ILD) complicated with severe Pneumocystis pneumonia (PCP). Methods The patients with interstitial lung disease complicated with severe Pneumocystis pneumonia who were admitted to the Respiratory Intensive Care Unit (RICU) of the Department of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital from September 2017 to June 2022 were retrospectively analyzed. Laboratory examinations, imaging features, complications and mortality data were used to analyze the clinical characteristics and prognosis of these patients. Results A total of 17 patients admitted to the RICU were finally enrolled in this study. 16 of the 17 patients had a history of corticoids therapy, and none of the 17 patients had received prophylaxis before the onset of PCP; 58.8% (10/17) of them were ILD secondary to connective tissue disease, and 41.2% (7/17) were idiopathic ILD; all patients were tested positive for P. jirovecii with polymerase chain reaction and/or next-generation metagenomic sequencing in sputum, bronchoalveolar lavage fluid or serum; all patients developed respiratory failure (oxygenation index: 146.8±66.4 mm Hg) after onset; within 24 hours of admission, the pneumonia severity index score was 91.9±20.1 and the Acute Physiology and Chronic Health Evaluation Ⅱ score was 16.1±3.0; imaging findings showed diffuse ground-glass opacity in both lungs on the basis of the original ILD; all patients were treated with trimethoprim-sulfamethoxazole (TMP-SMX) and corticoids, 52.9% (9/17) patients were treated with TMP-SMX + caspofungin + clindamycin; 70.6% (12/17) patients were treated with mechanical ventilation; 76.5% (13/17) patients during hospitalization complicated bacterial infection, 9 cases (52.9%) had viral infection. The 28-day mortality was 64.7% (11/17), and the 90-day mortality was 82.4% (14/17), as of telephone follow-up (July 2022) the overall mortality was 88.2% (15/17). Conclusions ILD patients with severe PCP are progressing rapidly. The clinical manifestations are severe which are the same as acute exacerbation of ILD, with poor prognosis.