BACKGROUND Pancreatic cancer is a highly aggressive malignancy with a dismal prognosis,primarily due to its late diagnosis.Current gold-standard diagnostic methods,such as tissue histopathological examination,are inva...BACKGROUND Pancreatic cancer is a highly aggressive malignancy with a dismal prognosis,primarily due to its late diagnosis.Current gold-standard diagnostic methods,such as tissue histopathological examination,are invasive and carry risks of complications(e.g.,bleeding,infection,pancreatic fistula),limiting their routine use.Serum tumor markers[carbohydrate antigen 19-9(CA-19-9),carcinoem-bryonic antigen(CEA)]have been widely studied for non-invasive screening,but their single use lacks sufficient sensitivity and specificity for early detection.Emerging research suggests that inflammatory and stromal-related molecules,such as soluble intercellular adhesion molecule-1(sICAM-1)(involved in tumor cell adhesion and metastasis)and chitinase-3-like protein 1(CHI3 L1)(a marker of tissue remodeling and inflammation),may complement traditional markers in improving diagnostic accuracy.However,their combined utility in pancreatic cancer diagnosis,particularly for differentiating early-stage tumors,remains unclear.AIM To explore the application value of serum tumor markers(CA-19-9,CEA)and serum sICAM-1 and CHI3 L1 in the early diagnosis of pancreatic cancer.METHODS From October 2021 to October 2024,51 patients with pancreatic cancer were selected for the pancreatic cancer group,and 51 healthy examinees were selected for the healthy group during the same period.The value of serum tumor markers in combination with serum sICAM-1 and CHI3 L1 for the early diagnosis of pancreatic cancer was assessed.RESULTS Comparison of age,gender,body mass index,and drinking and smoking histories between the two groups was not statistically significant(P>0.05);serum tumor marker(CA-19-9,CEA),serum sICAM-1 and CHI3 L1 levels were higher in the pancreatic cancer group(P<0.05);pancreatic cancer patients of stage II had higher serum tumor marker(CA-19-9,CEA),serum sICAM-1,and CHI3 L1 values(P<0.05);serum tumor markers,serum sICAM-1,and CHI3 L1 were positively correlated with pancreatic cancer(P<0.05)and showed a positive correlation with stage I and stage II.Pancreatic cancer showed a positive correlation(P<0.05);multifactor logistic regression analysis showed that serum tumor markers(CA-19-9,CEA),serum sICAM-1 and CHI3 L1 were independent risk factors for pancreatic cancer(P<0.05);serum tumor markers(CA-19-9,CEA),serum sICAM-1,serum tumor marker(CA-19-9,CEA)and serum sICAM-1 and CHI3 L1 had area under the curves(AUCs)of 0.750,0.724,0.585,and 0.562 for pancreatic cancer diagnosis,respectively;AUCs for stage I diagnosis were 0.766,0.752,0.622,and 0.572 and for stage II diagnosis were 0.783,0.758,0.626,and 0.671,respectively,and the AUCs for the combined diagnosis of pancreatic cancer,stage I pancreatic cancer,and stage II pancreatic cancer were 0.782,0.824,and 0.862,respectively(P<0.05).CONCLUSION The combined detection of serum tumor markers with serum sICAM-1 and serum CHI3 L1 can significantly improve the accuracy and sensitivity of the diagnosis of pancreatic cancer and its different stages.展开更多
BACKGROUND Tumor progression in patients with esophageal precancerous lesions(EPLs)or early esophageal carcinoma(EEC)is typically confined in both extent and location.Prompt and effective intervention significantly im...BACKGROUND Tumor progression in patients with esophageal precancerous lesions(EPLs)or early esophageal carcinoma(EEC)is typically confined in both extent and location.Prompt and effective intervention significantly improves treatment outcomes and prognosis for these individuals.AIM To determine the effect of endoscopic submucosal dissection(ESD)on efficacy,serum tumor markers(STMs),and 6-month postoperative recurrence rate in patients with either EPL or EEC.METHODS This study initially enrolled 120 patients with EPL or EEC,who were admitted from April 2021 to April 2024.Participants were divided into the control group(60 cases),which underwent thoracotomy,and the research group(60 cases)which received ESD treatment.The comparative analysis involved information regarding the efficacy(dissection area and resection rate per unit time),complications(delayed bleeding,wound infection,esophageal reflux,and postoperative esophageal stenosis),surgery-related parameters(bleeding volume,operation duration,and hospital length of stay),STMs[carcinoembryonic antigen(CEA),carbohydrate antigen 724(CA724),and tumor-specific growth factor(TSGF)],and the 6-month postoperative recurrence rate of the two groups.RESULTS Data indicated statistically higher dissection area and resection rate per unit of time in the research group than in the control group.Meanwhile,the research group demonstrated a notably lower overall incidence rate of complications,bleeding volume,operation duration,and hospital length of stay.Further,the CEA,CA724,and TSGF were markedly reduced in the research group after treatment,which were statistically lower compared to the baseline and those of the control group.Finally,during the follow-up,a comparable 6-month postoperative recurrence rate was determined in the two groups.CONCLUSION ESD is clinically effective and safe for EPL and EEC and can significantly restore abnormally increased levels of STMs.展开更多
Hepatocellular carcinoma （HCC） is one of the most frequent malignant tumors and is the second most common cause of cancer death in China. Therefore, it is very important to detect this disease and the recurrence at ...Hepatocellular carcinoma （HCC） is one of the most frequent malignant tumors and is the second most common cause of cancer death in China. Therefore, it is very important to detect this disease and the recurrence at its earlier period. Serum tumor markers, as the effective method for detecting hepatocellular carcinoma for a long time, could be divided into 4 categories： oncofetal antigens and glycoprotein antigens; enzymes and isoenzymes; genes; and cytokines. Serum alpha fetoprotein （AFP） is the most widely used tumor marker in detecting patients with hepatocellular carcinoma, and has been proven to have capability of prefiguring the prognosis. However, it has been indicated that AFP-L3 and DCP excel AFP in differentiating hepatocellular carcinoma from nonmalignant hepatopathy and detecting small hepatocellular carcinoma. Some tumor markers, such as human cervical cancer oncogene and human telomerase reverse transcriptase mRNA, have also been indicated to have higher accuracies than AFP. Furthermore, some other tumor markers, such as glypican-3, gamma-glutamyl transferase Ⅱ, alpha-Ifucosidase, transforming growth factor-beta1, tumorspecific growth factor, have been indicated to be available supplementaries to AFP in the detection. AFP mRNA has been shown to correlate with the metastasis and recurrence of HCC, and it may be the most useful marker to prefigure the prognosis. Some other markers, such as gamma-glutamyl transferase mRNA, vascular endothelial growth factor, and interleukin-8, could also be used as available prognostic indicators, and the simultaneous determination of AFP and these markers may detect the recurrence of HCC at its earlier period.展开更多
BACKGROUND Although the current conventional treatment strategies for esophageal carcinoma(EC)have been proven effective,they are often accompanied by serious adverse events.Therefore,it is still necessary to continue...BACKGROUND Although the current conventional treatment strategies for esophageal carcinoma(EC)have been proven effective,they are often accompanied by serious adverse events.Therefore,it is still necessary to continue to explore new therapeutic strategies for EC to improve the clinical outcome of patients.AIM To elucidate the clinical efficacy of concurrent chemoradiotherapy(CCRT)with thalidomide(THAL)and S-1(tegafur,gimeracil,and oteracil potassium capsules)in the treatment of EC as well as its influence on serum tumor markers(STMs).METHODS First,62 patients with EC treated at the Zibo 148 Hospital between November 2019 and November 2022 were selected and grouped according to the received treatment.Among these,30 patients undergoing CCRT with cis-platinum and 5-fluorouracil were assigned to the control group(Con),and 32 patients receiving CCRT with THAL and S-1 were assigned to the research group(Res).Second,inter-group comparisons were carried out with respect to curative efficacy,incidence of drug toxicities,STMs[carbohydrate antigen 125(CA125)and macrophage inflammatory protein-3α(MIP-3α)],angiogenesis-related indicators[vascular endothelial growth factor(VEGF);VEGF receptor-1(VEGFR-1);basic fibroblast growth factor(bFGF);angiogenin-2(Ang-2)],and quality of life(QoL)[QoL core 30(QLQ-C30)]after one month of treatment.RESULTS The analysis showed no statistical difference in the overall response rate and disease control rate between the two patient cohorts;however,the incidences of grade I–II myelosuppression and gastrointestinal reactions were significantly lower in the Res than in the Con.Besides,the post-treatment CA125,MIP-3α,VEGF,VEGFR-1,bFGF,and Ang-2 Levels in the Res were markedly lower compared with the pre-treatment levels and the corresponding post-treatment levels in the Con.Furthermore,more evident improvements in QLQ-C30 scores from the dimensions of physical,role,emotional,and social functions were determined in the Res.CONCLUSION The above results demonstrate the effectiveness of THAL+S-1 CCRT for EC,which contributes to mild side effects and significant reduction of CA125,MIP-3α,VEGF,VEGFR-1,bFGF,and Ang-2 Levels,thus inhibiting tumors from malignant progression and enhancing patients’QoL.展开更多
BACKGROUND Early recurrence(ER)is associated with dismal outcomes in patients undergoing radical resection for pancreatic ductal adenocarcinoma(PDAC).Approaches for predicting ER will help clinicians in implementing i...BACKGROUND Early recurrence(ER)is associated with dismal outcomes in patients undergoing radical resection for pancreatic ductal adenocarcinoma(PDAC).Approaches for predicting ER will help clinicians in implementing individualized adjuvant therapies.Postoperative serum tumor markers(STMs)are indicators of tumor progression and may improve current systems for predicting ER.AIM To establish an improved nomogram based on postoperative STMs to predict ER in PDAC.METHODS We retrospectively enrolled 282 patients who underwent radical resection for PDAC at our institute between 2019 and 2021.Univariate and multivariate Cox regression analyses of variables with or without postoperative STMs,were performed to identify independent risk factors for ER.A nomogram was constructed based on the independent postoperative STMs.Receiver operating characteristic curve analysis was used to evaluate the area under the curve(AUC)of the nomogram.Survival analysis was performed using Kaplan-Meier survival plot and log-rank test.RESULTS Postoperative carbohydrate antigen 19-9 and carcinoembryonic antigen levels,preoperative carbohydrate antigen 125 levels,perineural invasion,and pTNM stage III were independent risk factors for ER in PDAC.The postoperative STMs-based nomogram(AUC:0.774,95%CI:0.713-0.835)had superior accuracy in predicting ER compared with the nomogram without postoperative STMs(AUC:0.688,95%CI:0.625-0.750)(P=0.016).Patients with a recurrence nomogram score(RNS)>1.56 were at high risk for ER,and had significantly poorer recurrence-free survival[median:3.08 months,interquartile range(IQR):1.80-8.15]than those with RNS≤1.56(14.00 months,IQR:6.67-24.80),P<0.001).CONCLUSION The postoperative STMs-based nomogram improves the predictive accuracy of ER in PDAC,stratifies the risk of ER,and identifies patients at high risk of ER for tailored adjuvant therapies.展开更多
Objective: To explore the diagnostic value of serum tumor markers CEA, AFP, CA199, CA125, CA153, CYFRA21, CA724, and NSE in invasive breast cancer. Methods: A total of 314 patients with invasive breast cancer from Bao...Objective: To explore the diagnostic value of serum tumor markers CEA, AFP, CA199, CA125, CA153, CYFRA21, CA724, and NSE in invasive breast cancer. Methods: A total of 314 patients with invasive breast cancer from Baoding First Central Hospital between January 2021 and December 2022, and 31 patients with benign breast diseases (including mastitis, breast fibroadenoma, breast adenosis, adenoma of the breast, benign phyllodes tumor of the breast, and intraductal papilloma) were randomly selected as the control group. The levels of CEA, AFP, CA199, CA125, CA153, CYFRA21, CA724, and NSE were measured using electrochemiluminescence. Results: The serum concentrations of CEA, CA153, and CYFRA21 showed significant statistical differences between the invasive breast cancer group and the benign breast disease group (P < 0.01). ROC curve analysis revealed that CA153 had the highest sensitivity for diagnosing invasive breast cancer, while CEA had the highest specificity, at 84.4% and 77.4%, respectively. When multiple tumor markers were used for the diagnosis of invasive breast cancer, the combination of CEA and CA153 showed the highest specificity at 90.3%, while the combination of CEA and CYFRA21 had the highest sensitivity at 88.2%. The combined detection of CEA, CYFRA21, and CA153 had the largest area under the curve (AUC) on the ROC curve, at 0.802, indicating that the combination of these three markers provided the best diagnostic performance for invasive breast cancer. Conclusion: CEA, CA153, and CYFRA21 can be used for the diagnosis of invasive breast cancer, and the combined detection of these three markers offers the best diagnostic efficacy for invasive breast cancer.展开更多
BACKGROUND Rectal cancer requires accurate preoperative assessment of T stage and differentiation grade for treatment planning.Traditional imaging and serum markers have limitations in diagnostic accuracy.AIM To evalu...BACKGROUND Rectal cancer requires accurate preoperative assessment of T stage and differentiation grade for treatment planning.Traditional imaging and serum markers have limitations in diagnostic accuracy.AIM To evaluate the predictive value of dynamic contrast-enhanced-magnetic resonance imaging(DCE-MRI)parameters and serum biomarkers[carbohydrate antigen(CA)19-9,CA125]for determining T stage and differentiation grade in rectal cancer.METHODS We conducted a retrospective review of clinical data from 126 patients who were pathologically diagnosed with rectal cancer between January 2021 to June 2024.Each patient underwent DCE-MRI scans and serum tests for CA19-9 and CA125.Receiver operating characteristic curves were utilized to assess the diagnostic value of DCE-MRI parameters,including volume transfer constant(Ktrans),rate constant(Kep),and volume fraction of extravascular extracellular space(Ve),as well as serum biomarkers for staging and grading rectal cancer.The DeLong test algorithm was employed to evaluate differences in diagnostic performance among the various indicators.RESULTS There were statistically higher levels of Ktrans,Ve,CA19-9,and CA125 serum concentrations of patients with advanced T stages and on poorly differentiated tumors than that in patients with low stages and moderate to high differentiation(P<0.05).Combined use of Ktrans and Ve for T stage diagnosis showed an area under the curve(AUC)of 0.892[95%confidence interval(CI):0.832-0.952],which increased to 0.923(95%CI:0.865-0.981)when combined with serum biomarkers.For grades differentiation,the combined DCE-MRI parameters had an AUC of 0.883(95%CI:0.821-0.945),which rose to 0.912(95%CI:0.855-0.969)when combined with serum markers.According to the Delong test,the combined diagnostic method performed better than a single diagnostic method(P<0.05).CONCLUSION The combined application of DCE-MRI functional parameters and serum tumor markers can significantly improve the diagnostic accuracy of T staging and differentiation degree of rectal cancer,providing a new approach to improve the preoperative assessment system of rectal cancer.This combined diagnostic model has important clinical application value,but further validation is needed through large-scale multicenter studies.展开更多
BACKGROUND Early detection of advanced cystic mucinous neoplasms[(A-cMNs),defined as high-grade dysplasia or malignancy]of the pancreas is of great significance.As a simple and feasible detection method,serum tumor ma...BACKGROUND Early detection of advanced cystic mucinous neoplasms[(A-cMNs),defined as high-grade dysplasia or malignancy]of the pancreas is of great significance.As a simple and feasible detection method,serum tumor markers(STMs)may be used to predict advanced intraductal papillary mucinous neoplasms(IPMNs)and mucinous cystic neoplasms(MCNs).However,there are few studies on the usefulness of STMs other than carbohydrate antigen(CA)19-9 for early detection of A-cMNs.AIM To study the ability of five STMs-CA19-9,carcinoembryonic antigen(CEA),CA125,CA724,and CA242 to predict A-cMNs and distinguish IPMNs and MCNs.METHODS We mainly measured the levels of each STM in patients pathologically diagnosed with cMNs.The mean levels of STMs and the number of A-cMN subjects with a higher STM level than the cutoff were compared respectively to identify the ability of STMs to predict A-cMNs and distinguish MCNs from IPMNs.A receiver operating characteristic curve with the area under curve(AUC)was also created to identify the performance of the five STMs.RESULTS A total of 187 patients with cMNs were identified and 72 of them showed AcMNs.We found that CA19-9 exhibited the highest sensitivity(SE)(54.2%)and accuracy(76.5%)and a moderate ability(AUC=0.766)to predict A-cMNs.In predicting high-grade dysplasia IPMNs,the SE of CA19-9 decreased to 38.5%.The ability of CEA,CA125,and CA724 to predict A-cMNs was low(AUC=0.651,0.583,and 0.618,respectively).The predictive ability of CA242 was not identified.The combination of STMs improved the SE to 62.5%.CA125 may be specific to the diagnosis of advanced MCNs.CONCLUSION CA19-9 has a moderate ability,and CEA,CA125,and CA724 have a low ability to predict A-cMNs.The combination of STM testing could improve SE in predicting A-cMNs.展开更多
BACKGROUND Advanced gastric cancer(AGC)remains a challenging malignancy with poor prognosis.The combination of oxaliplatin and trastuzumab has shown promising results in AGC treatment.This study aimed to investigate t...BACKGROUND Advanced gastric cancer(AGC)remains a challenging malignancy with poor prognosis.The combination of oxaliplatin and trastuzumab has shown promising results in AGC treatment.This study aimed to investigate the effects of oxaliplatin and trastuzumab combination therapy on serum tumor markers and T lymphocyte subsets in patients with AGC and to explore their potential as predictive biomarkers for treatment response.AIM To investigate the impact of oxaliplatin and trastuzumab combination therapy on serum markers and T cell subsets in patients with AGC.METHODS This prospective study enrolled 60 patients with AGC.All patients received oxaliplatin(130 mg/m^(2),every 3 weeks)and trastuzumab(8 mg/kg loading dose,followed by 6 mg/kg every 3 weeks)for six cycles.Serum carcinoembryonic antigen(CEA),cancer antigen 19-9(CA19-9),and cancer antigen 72-4(CA72-4)were measured before and after treatment.T-lymphocyte subsets,including CD3+,CD4+,CD8+,and CD4+/CD8+ratios,were also evaluated.The clinical response was assessed using the Response Evaluation Criteria in Solid Tumors version 1.1.RESULTS After six cycles of treatment,the CEA,CA19-9,and CA72-4 serum levels significantly decreased compared to baseline levels(P<0.001).The percentages of CD3+and CD4+T lymphocytes increased significantly(P<0.05),whereas the percentage of CD8+T lymphocytes decreased(P<0.05).The CD4+/CD8+ratio also significantly increased after treatment(P<0.05).Patients with a higher decrease in serum tumor markers(≥50%reduction)and a higher increase in CD4+/CD8+ratio(≥1.5-fold)showed better clinical response rates(P<0.05).CONCLUSION Oxaliplatin and trastuzumab combination therapy effectively reduced serum tumor marker levels and modulated T lymphocyte subsets in patients with AGC.Combination therapy not only has a direct antitumor effect,but also enhances the immune response in patients with AGC.Serum tumor markers and T lymphocyte subsets may serve as potential predictive biomarkers for treatment response in patients with AGC receiving combination therapy.展开更多
BACKGROUND Gastric cancer(GC)is one of the most common cancers worldwide.Morbidity and mortality have increased in recent years,making it an urgent issue to address.La-paroscopic radical surgery(LRS)is a crucial metho...BACKGROUND Gastric cancer(GC)is one of the most common cancers worldwide.Morbidity and mortality have increased in recent years,making it an urgent issue to address.La-paroscopic radical surgery(LRS)is a crucial method for treating patients with GC;However,its influence on tumor markers is still under investigation.The data of 194 patients treated at Chongqing University Cancer Hospital bet-ween January 2018 and January 2019 were retrospectively analyzed.Patients who underwent traditional open surgery and LRS were assigned to the control(n=90)and observation groups(n=104),respectively.Independent sample t-tests andχ2 tests were used to compare the two groups based on clinical efficacy,changes in tumor marker levels after treatment,clinical data,and the incidence of posto-perative complications.To investigate the association between tumor marker levels and clinical efficacy in patients with GC,three-year recurrence rates in the two groups were compared.RESULTS Patients in the observation group had a shorter duration of operation,less in-traoperative blood loss,an earlier postoperative eating time,and a shorter hospital stay than those in the control group(P<0.05).No significant difference was observed between the two groups regarding the number of lymph node dissections(P>0.05).After treatment,the overall response rate in the control group was significantly lower than that in the observation group(P=0.001).Furthermore,after treatment,the levels of carbohydrate antigen 19-9,cancer antigen 72-4,carcinoembryonic antigen,and cancer antigen 125 decreased significantly.The observation group also exhibited a significantly lower incidence rate of postoperative complications compared to the control group(P<0.001).Additionally,the two groups did not significantly differ in terms of three-year survival and recurrence rates(P>0.05).CONCLUSION LRS effectively treats early gastric cancer by reducing intraoperative bleeding,length of hospital stays,and postoperative complications.It also significantly lowers tumor marker levels,thus improving the short-term prognosis of the disease.展开更多
[Aims]This study aims to explore the relationship between epidermal growth factor receptor(EGFR)mutations and clinical characteristics,as well as serum tumor markers,in patients with non-small cell lung cancer(NSCLC),...[Aims]This study aims to explore the relationship between epidermal growth factor receptor(EGFR)mutations and clinical characteristics,as well as serum tumor markers,in patients with non-small cell lung cancer(NSCLC),and to assess the implications of these findings.[Methods]The study included 105 NSCLC patients diagnosed at the Seventh Affiliated Hospital of Sun Yat-sen University between January 2020 and November 2024.Based on EGFR gene testing results,the patients were divided into two groups:the mutation group(63 patients)and the wild-type group(42 patients).The clinical characteristics of both groups were compared,and the associations between serum blood tumor markers(carcinoembryonic antigen[CEA],carbohydrate antigen 125[CA125],carbohydrate antigen 199[CA199],squamous cell carcinoma antigen[SCCA])and EGFR mutations were analyzed.[Results]In the mutation group,the proportion of females and non-smokers was significantly higher compared to the wild-type group(P<0.05).Moreover,the mutation group exhibited a higher positive rate of CEA(P<0.05)and a lower positive rate of SCCA(P<0.05)compared to the wild-type group.Spearman correlation analysis revealed significant relationship between EGFR mutation status and patient gender,smoking history,CEA,and SCCA(P<0.05).Multivariate logistic regression analysis identified smoking history,CEA,and SCCA as independent factors influencing EGFR mutations.[Conclusion]EGFR mutations are significantly associated with patient gender,smoking history,CEA,and SCCA in NSCLC.Clinical characteristics and monitoring of serum CEA and SCCA levels may provide valuable insights for predicting EGFR mutation status.展开更多
文摘BACKGROUND Pancreatic cancer is a highly aggressive malignancy with a dismal prognosis,primarily due to its late diagnosis.Current gold-standard diagnostic methods,such as tissue histopathological examination,are invasive and carry risks of complications(e.g.,bleeding,infection,pancreatic fistula),limiting their routine use.Serum tumor markers[carbohydrate antigen 19-9(CA-19-9),carcinoem-bryonic antigen(CEA)]have been widely studied for non-invasive screening,but their single use lacks sufficient sensitivity and specificity for early detection.Emerging research suggests that inflammatory and stromal-related molecules,such as soluble intercellular adhesion molecule-1(sICAM-1)(involved in tumor cell adhesion and metastasis)and chitinase-3-like protein 1(CHI3 L1)(a marker of tissue remodeling and inflammation),may complement traditional markers in improving diagnostic accuracy.However,their combined utility in pancreatic cancer diagnosis,particularly for differentiating early-stage tumors,remains unclear.AIM To explore the application value of serum tumor markers(CA-19-9,CEA)and serum sICAM-1 and CHI3 L1 in the early diagnosis of pancreatic cancer.METHODS From October 2021 to October 2024,51 patients with pancreatic cancer were selected for the pancreatic cancer group,and 51 healthy examinees were selected for the healthy group during the same period.The value of serum tumor markers in combination with serum sICAM-1 and CHI3 L1 for the early diagnosis of pancreatic cancer was assessed.RESULTS Comparison of age,gender,body mass index,and drinking and smoking histories between the two groups was not statistically significant(P>0.05);serum tumor marker(CA-19-9,CEA),serum sICAM-1 and CHI3 L1 levels were higher in the pancreatic cancer group(P<0.05);pancreatic cancer patients of stage II had higher serum tumor marker(CA-19-9,CEA),serum sICAM-1,and CHI3 L1 values(P<0.05);serum tumor markers,serum sICAM-1,and CHI3 L1 were positively correlated with pancreatic cancer(P<0.05)and showed a positive correlation with stage I and stage II.Pancreatic cancer showed a positive correlation(P<0.05);multifactor logistic regression analysis showed that serum tumor markers(CA-19-9,CEA),serum sICAM-1 and CHI3 L1 were independent risk factors for pancreatic cancer(P<0.05);serum tumor markers(CA-19-9,CEA),serum sICAM-1,serum tumor marker(CA-19-9,CEA)and serum sICAM-1 and CHI3 L1 had area under the curves(AUCs)of 0.750,0.724,0.585,and 0.562 for pancreatic cancer diagnosis,respectively;AUCs for stage I diagnosis were 0.766,0.752,0.622,and 0.572 and for stage II diagnosis were 0.783,0.758,0.626,and 0.671,respectively,and the AUCs for the combined diagnosis of pancreatic cancer,stage I pancreatic cancer,and stage II pancreatic cancer were 0.782,0.824,and 0.862,respectively(P<0.05).CONCLUSION The combined detection of serum tumor markers with serum sICAM-1 and serum CHI3 L1 can significantly improve the accuracy and sensitivity of the diagnosis of pancreatic cancer and its different stages.
文摘BACKGROUND Tumor progression in patients with esophageal precancerous lesions(EPLs)or early esophageal carcinoma(EEC)is typically confined in both extent and location.Prompt and effective intervention significantly improves treatment outcomes and prognosis for these individuals.AIM To determine the effect of endoscopic submucosal dissection(ESD)on efficacy,serum tumor markers(STMs),and 6-month postoperative recurrence rate in patients with either EPL or EEC.METHODS This study initially enrolled 120 patients with EPL or EEC,who were admitted from April 2021 to April 2024.Participants were divided into the control group(60 cases),which underwent thoracotomy,and the research group(60 cases)which received ESD treatment.The comparative analysis involved information regarding the efficacy(dissection area and resection rate per unit time),complications(delayed bleeding,wound infection,esophageal reflux,and postoperative esophageal stenosis),surgery-related parameters(bleeding volume,operation duration,and hospital length of stay),STMs[carcinoembryonic antigen(CEA),carbohydrate antigen 724(CA724),and tumor-specific growth factor(TSGF)],and the 6-month postoperative recurrence rate of the two groups.RESULTS Data indicated statistically higher dissection area and resection rate per unit of time in the research group than in the control group.Meanwhile,the research group demonstrated a notably lower overall incidence rate of complications,bleeding volume,operation duration,and hospital length of stay.Further,the CEA,CA724,and TSGF were markedly reduced in the research group after treatment,which were statistically lower compared to the baseline and those of the control group.Finally,during the follow-up,a comparable 6-month postoperative recurrence rate was determined in the two groups.CONCLUSION ESD is clinically effective and safe for EPL and EEC and can significantly restore abnormally increased levels of STMs.
文摘Hepatocellular carcinoma （HCC） is one of the most frequent malignant tumors and is the second most common cause of cancer death in China. Therefore, it is very important to detect this disease and the recurrence at its earlier period. Serum tumor markers, as the effective method for detecting hepatocellular carcinoma for a long time, could be divided into 4 categories： oncofetal antigens and glycoprotein antigens; enzymes and isoenzymes; genes; and cytokines. Serum alpha fetoprotein （AFP） is the most widely used tumor marker in detecting patients with hepatocellular carcinoma, and has been proven to have capability of prefiguring the prognosis. However, it has been indicated that AFP-L3 and DCP excel AFP in differentiating hepatocellular carcinoma from nonmalignant hepatopathy and detecting small hepatocellular carcinoma. Some tumor markers, such as human cervical cancer oncogene and human telomerase reverse transcriptase mRNA, have also been indicated to have higher accuracies than AFP. Furthermore, some other tumor markers, such as glypican-3, gamma-glutamyl transferase Ⅱ, alpha-Ifucosidase, transforming growth factor-beta1, tumorspecific growth factor, have been indicated to be available supplementaries to AFP in the detection. AFP mRNA has been shown to correlate with the metastasis and recurrence of HCC, and it may be the most useful marker to prefigure the prognosis. Some other markers, such as gamma-glutamyl transferase mRNA, vascular endothelial growth factor, and interleukin-8, could also be used as available prognostic indicators, and the simultaneous determination of AFP and these markers may detect the recurrence of HCC at its earlier period.
文摘BACKGROUND Although the current conventional treatment strategies for esophageal carcinoma(EC)have been proven effective,they are often accompanied by serious adverse events.Therefore,it is still necessary to continue to explore new therapeutic strategies for EC to improve the clinical outcome of patients.AIM To elucidate the clinical efficacy of concurrent chemoradiotherapy(CCRT)with thalidomide(THAL)and S-1(tegafur,gimeracil,and oteracil potassium capsules)in the treatment of EC as well as its influence on serum tumor markers(STMs).METHODS First,62 patients with EC treated at the Zibo 148 Hospital between November 2019 and November 2022 were selected and grouped according to the received treatment.Among these,30 patients undergoing CCRT with cis-platinum and 5-fluorouracil were assigned to the control group(Con),and 32 patients receiving CCRT with THAL and S-1 were assigned to the research group(Res).Second,inter-group comparisons were carried out with respect to curative efficacy,incidence of drug toxicities,STMs[carbohydrate antigen 125(CA125)and macrophage inflammatory protein-3α(MIP-3α)],angiogenesis-related indicators[vascular endothelial growth factor(VEGF);VEGF receptor-1(VEGFR-1);basic fibroblast growth factor(bFGF);angiogenin-2(Ang-2)],and quality of life(QoL)[QoL core 30(QLQ-C30)]after one month of treatment.RESULTS The analysis showed no statistical difference in the overall response rate and disease control rate between the two patient cohorts;however,the incidences of grade I–II myelosuppression and gastrointestinal reactions were significantly lower in the Res than in the Con.Besides,the post-treatment CA125,MIP-3α,VEGF,VEGFR-1,bFGF,and Ang-2 Levels in the Res were markedly lower compared with the pre-treatment levels and the corresponding post-treatment levels in the Con.Furthermore,more evident improvements in QLQ-C30 scores from the dimensions of physical,role,emotional,and social functions were determined in the Res.CONCLUSION The above results demonstrate the effectiveness of THAL+S-1 CCRT for EC,which contributes to mild side effects and significant reduction of CA125,MIP-3α,VEGF,VEGFR-1,bFGF,and Ang-2 Levels,thus inhibiting tumors from malignant progression and enhancing patients’QoL.
基金Supported by National Natural Science Foundation of China,No.82373012.
文摘BACKGROUND Early recurrence(ER)is associated with dismal outcomes in patients undergoing radical resection for pancreatic ductal adenocarcinoma(PDAC).Approaches for predicting ER will help clinicians in implementing individualized adjuvant therapies.Postoperative serum tumor markers(STMs)are indicators of tumor progression and may improve current systems for predicting ER.AIM To establish an improved nomogram based on postoperative STMs to predict ER in PDAC.METHODS We retrospectively enrolled 282 patients who underwent radical resection for PDAC at our institute between 2019 and 2021.Univariate and multivariate Cox regression analyses of variables with or without postoperative STMs,were performed to identify independent risk factors for ER.A nomogram was constructed based on the independent postoperative STMs.Receiver operating characteristic curve analysis was used to evaluate the area under the curve(AUC)of the nomogram.Survival analysis was performed using Kaplan-Meier survival plot and log-rank test.RESULTS Postoperative carbohydrate antigen 19-9 and carcinoembryonic antigen levels,preoperative carbohydrate antigen 125 levels,perineural invasion,and pTNM stage III were independent risk factors for ER in PDAC.The postoperative STMs-based nomogram(AUC:0.774,95%CI:0.713-0.835)had superior accuracy in predicting ER compared with the nomogram without postoperative STMs(AUC:0.688,95%CI:0.625-0.750)(P=0.016).Patients with a recurrence nomogram score(RNS)>1.56 were at high risk for ER,and had significantly poorer recurrence-free survival[median:3.08 months,interquartile range(IQR):1.80-8.15]than those with RNS≤1.56(14.00 months,IQR:6.67-24.80),P<0.001).CONCLUSION The postoperative STMs-based nomogram improves the predictive accuracy of ER in PDAC,stratifies the risk of ER,and identifies patients at high risk of ER for tailored adjuvant therapies.
基金Beijing-Tianjin-Hebei Precision Medicine Project of Natural Science Foundation of Hebei Province(H2019104018)and the Science and Technology Bureau of Baoding City(2141ZF261)。
文摘Objective: To explore the diagnostic value of serum tumor markers CEA, AFP, CA199, CA125, CA153, CYFRA21, CA724, and NSE in invasive breast cancer. Methods: A total of 314 patients with invasive breast cancer from Baoding First Central Hospital between January 2021 and December 2022, and 31 patients with benign breast diseases (including mastitis, breast fibroadenoma, breast adenosis, adenoma of the breast, benign phyllodes tumor of the breast, and intraductal papilloma) were randomly selected as the control group. The levels of CEA, AFP, CA199, CA125, CA153, CYFRA21, CA724, and NSE were measured using electrochemiluminescence. Results: The serum concentrations of CEA, CA153, and CYFRA21 showed significant statistical differences between the invasive breast cancer group and the benign breast disease group (P < 0.01). ROC curve analysis revealed that CA153 had the highest sensitivity for diagnosing invasive breast cancer, while CEA had the highest specificity, at 84.4% and 77.4%, respectively. When multiple tumor markers were used for the diagnosis of invasive breast cancer, the combination of CEA and CA153 showed the highest specificity at 90.3%, while the combination of CEA and CYFRA21 had the highest sensitivity at 88.2%. The combined detection of CEA, CYFRA21, and CA153 had the largest area under the curve (AUC) on the ROC curve, at 0.802, indicating that the combination of these three markers provided the best diagnostic performance for invasive breast cancer. Conclusion: CEA, CA153, and CYFRA21 can be used for the diagnosis of invasive breast cancer, and the combined detection of these three markers offers the best diagnostic efficacy for invasive breast cancer.
文摘BACKGROUND Rectal cancer requires accurate preoperative assessment of T stage and differentiation grade for treatment planning.Traditional imaging and serum markers have limitations in diagnostic accuracy.AIM To evaluate the predictive value of dynamic contrast-enhanced-magnetic resonance imaging(DCE-MRI)parameters and serum biomarkers[carbohydrate antigen(CA)19-9,CA125]for determining T stage and differentiation grade in rectal cancer.METHODS We conducted a retrospective review of clinical data from 126 patients who were pathologically diagnosed with rectal cancer between January 2021 to June 2024.Each patient underwent DCE-MRI scans and serum tests for CA19-9 and CA125.Receiver operating characteristic curves were utilized to assess the diagnostic value of DCE-MRI parameters,including volume transfer constant(Ktrans),rate constant(Kep),and volume fraction of extravascular extracellular space(Ve),as well as serum biomarkers for staging and grading rectal cancer.The DeLong test algorithm was employed to evaluate differences in diagnostic performance among the various indicators.RESULTS There were statistically higher levels of Ktrans,Ve,CA19-9,and CA125 serum concentrations of patients with advanced T stages and on poorly differentiated tumors than that in patients with low stages and moderate to high differentiation(P<0.05).Combined use of Ktrans and Ve for T stage diagnosis showed an area under the curve(AUC)of 0.892[95%confidence interval(CI):0.832-0.952],which increased to 0.923(95%CI:0.865-0.981)when combined with serum biomarkers.For grades differentiation,the combined DCE-MRI parameters had an AUC of 0.883(95%CI:0.821-0.945),which rose to 0.912(95%CI:0.855-0.969)when combined with serum markers.According to the Delong test,the combined diagnostic method performed better than a single diagnostic method(P<0.05).CONCLUSION The combined application of DCE-MRI functional parameters and serum tumor markers can significantly improve the diagnostic accuracy of T staging and differentiation degree of rectal cancer,providing a new approach to improve the preoperative assessment system of rectal cancer.This combined diagnostic model has important clinical application value,but further validation is needed through large-scale multicenter studies.
基金National Natural Science Foundation of China,No.81770642the Shanghai Association for Science and Technology,China,No.19411951602.
文摘BACKGROUND Early detection of advanced cystic mucinous neoplasms[(A-cMNs),defined as high-grade dysplasia or malignancy]of the pancreas is of great significance.As a simple and feasible detection method,serum tumor markers(STMs)may be used to predict advanced intraductal papillary mucinous neoplasms(IPMNs)and mucinous cystic neoplasms(MCNs).However,there are few studies on the usefulness of STMs other than carbohydrate antigen(CA)19-9 for early detection of A-cMNs.AIM To study the ability of five STMs-CA19-9,carcinoembryonic antigen(CEA),CA125,CA724,and CA242 to predict A-cMNs and distinguish IPMNs and MCNs.METHODS We mainly measured the levels of each STM in patients pathologically diagnosed with cMNs.The mean levels of STMs and the number of A-cMN subjects with a higher STM level than the cutoff were compared respectively to identify the ability of STMs to predict A-cMNs and distinguish MCNs from IPMNs.A receiver operating characteristic curve with the area under curve(AUC)was also created to identify the performance of the five STMs.RESULTS A total of 187 patients with cMNs were identified and 72 of them showed AcMNs.We found that CA19-9 exhibited the highest sensitivity(SE)(54.2%)and accuracy(76.5%)and a moderate ability(AUC=0.766)to predict A-cMNs.In predicting high-grade dysplasia IPMNs,the SE of CA19-9 decreased to 38.5%.The ability of CEA,CA125,and CA724 to predict A-cMNs was low(AUC=0.651,0.583,and 0.618,respectively).The predictive ability of CA242 was not identified.The combination of STMs improved the SE to 62.5%.CA125 may be specific to the diagnosis of advanced MCNs.CONCLUSION CA19-9 has a moderate ability,and CEA,CA125,and CA724 have a low ability to predict A-cMNs.The combination of STM testing could improve SE in predicting A-cMNs.
文摘BACKGROUND Advanced gastric cancer(AGC)remains a challenging malignancy with poor prognosis.The combination of oxaliplatin and trastuzumab has shown promising results in AGC treatment.This study aimed to investigate the effects of oxaliplatin and trastuzumab combination therapy on serum tumor markers and T lymphocyte subsets in patients with AGC and to explore their potential as predictive biomarkers for treatment response.AIM To investigate the impact of oxaliplatin and trastuzumab combination therapy on serum markers and T cell subsets in patients with AGC.METHODS This prospective study enrolled 60 patients with AGC.All patients received oxaliplatin(130 mg/m^(2),every 3 weeks)and trastuzumab(8 mg/kg loading dose,followed by 6 mg/kg every 3 weeks)for six cycles.Serum carcinoembryonic antigen(CEA),cancer antigen 19-9(CA19-9),and cancer antigen 72-4(CA72-4)were measured before and after treatment.T-lymphocyte subsets,including CD3+,CD4+,CD8+,and CD4+/CD8+ratios,were also evaluated.The clinical response was assessed using the Response Evaluation Criteria in Solid Tumors version 1.1.RESULTS After six cycles of treatment,the CEA,CA19-9,and CA72-4 serum levels significantly decreased compared to baseline levels(P<0.001).The percentages of CD3+and CD4+T lymphocytes increased significantly(P<0.05),whereas the percentage of CD8+T lymphocytes decreased(P<0.05).The CD4+/CD8+ratio also significantly increased after treatment(P<0.05).Patients with a higher decrease in serum tumor markers(≥50%reduction)and a higher increase in CD4+/CD8+ratio(≥1.5-fold)showed better clinical response rates(P<0.05).CONCLUSION Oxaliplatin and trastuzumab combination therapy effectively reduced serum tumor marker levels and modulated T lymphocyte subsets in patients with AGC.Combination therapy not only has a direct antitumor effect,but also enhances the immune response in patients with AGC.Serum tumor markers and T lymphocyte subsets may serve as potential predictive biomarkers for treatment response in patients with AGC receiving combination therapy.
基金The study was reviewed and approved by the Ethics Committee of the Chongqing University Cancer Hospital(Approval No.CZLS2023170-A).
文摘BACKGROUND Gastric cancer(GC)is one of the most common cancers worldwide.Morbidity and mortality have increased in recent years,making it an urgent issue to address.La-paroscopic radical surgery(LRS)is a crucial method for treating patients with GC;However,its influence on tumor markers is still under investigation.The data of 194 patients treated at Chongqing University Cancer Hospital bet-ween January 2018 and January 2019 were retrospectively analyzed.Patients who underwent traditional open surgery and LRS were assigned to the control(n=90)and observation groups(n=104),respectively.Independent sample t-tests andχ2 tests were used to compare the two groups based on clinical efficacy,changes in tumor marker levels after treatment,clinical data,and the incidence of posto-perative complications.To investigate the association between tumor marker levels and clinical efficacy in patients with GC,three-year recurrence rates in the two groups were compared.RESULTS Patients in the observation group had a shorter duration of operation,less in-traoperative blood loss,an earlier postoperative eating time,and a shorter hospital stay than those in the control group(P<0.05).No significant difference was observed between the two groups regarding the number of lymph node dissections(P>0.05).After treatment,the overall response rate in the control group was significantly lower than that in the observation group(P=0.001).Furthermore,after treatment,the levels of carbohydrate antigen 19-9,cancer antigen 72-4,carcinoembryonic antigen,and cancer antigen 125 decreased significantly.The observation group also exhibited a significantly lower incidence rate of postoperative complications compared to the control group(P<0.001).Additionally,the two groups did not significantly differ in terms of three-year survival and recurrence rates(P>0.05).CONCLUSION LRS effectively treats early gastric cancer by reducing intraoperative bleeding,length of hospital stays,and postoperative complications.It also significantly lowers tumor marker levels,thus improving the short-term prognosis of the disease.
文摘[Aims]This study aims to explore the relationship between epidermal growth factor receptor(EGFR)mutations and clinical characteristics,as well as serum tumor markers,in patients with non-small cell lung cancer(NSCLC),and to assess the implications of these findings.[Methods]The study included 105 NSCLC patients diagnosed at the Seventh Affiliated Hospital of Sun Yat-sen University between January 2020 and November 2024.Based on EGFR gene testing results,the patients were divided into two groups:the mutation group(63 patients)and the wild-type group(42 patients).The clinical characteristics of both groups were compared,and the associations between serum blood tumor markers(carcinoembryonic antigen[CEA],carbohydrate antigen 125[CA125],carbohydrate antigen 199[CA199],squamous cell carcinoma antigen[SCCA])and EGFR mutations were analyzed.[Results]In the mutation group,the proportion of females and non-smokers was significantly higher compared to the wild-type group(P<0.05).Moreover,the mutation group exhibited a higher positive rate of CEA(P<0.05)and a lower positive rate of SCCA(P<0.05)compared to the wild-type group.Spearman correlation analysis revealed significant relationship between EGFR mutation status and patient gender,smoking history,CEA,and SCCA(P<0.05).Multivariate logistic regression analysis identified smoking history,CEA,and SCCA as independent factors influencing EGFR mutations.[Conclusion]EGFR mutations are significantly associated with patient gender,smoking history,CEA,and SCCA in NSCLC.Clinical characteristics and monitoring of serum CEA and SCCA levels may provide valuable insights for predicting EGFR mutation status.
