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Association between HLA-B*46: 01 and cutaneous adverse drug reactions in Han Chinese HLA-B* 46:01与汉族皮肤药物不良反应的关系
Pub Date : 2018-09-01 DOI: 10.1097/JBR.0000000000000011
Menglin Jiang, Lanting Wang, Sheng-an Chen, Fanping Yang, H. Xiong, Yu Su, Huizhong Zhu, Z. Qi, Shengying Qin, Xiaoqun Luo, Q. Xing
Abstract The majority of patients who experience cutaneous adverse drug reactions (cADRs) concurrently receive multiple medications, meaning that the causative drug remains unidentified. We explored the association between human leukocyte antigen (HLA) alleles and cADRs, regardless of the allergenic drug, to investigate whether different drug-induced cADRs were associated with the same or similar risk alleles in a Han Chinese population. We genotyped a sample of 146 cADR patients and 230 population controls from the same hospital and systematically analyzed the association between HLA Class I genes and cADRs. The carrier frequency of HLA-B*46:01 in cADR patients was found to be significantly higher than that in population controls (P = .0021, odds ratio [OR] = 2.18, 95% confidence interval [CI]: 1.33–2.58). Subgroup analysis showed that HLA-B*46:01 was significantly associated with urticaria and erythema multiforme (P = .0077, OR = 2.53, 95% CI: 1.30–4.91; and P = .0049, OR = 2.77, 95% CI: 1.39–5.50, respectively). Furthermore, a significant association was also detected between HLA-A*02:01 and erythema multiforme (P = .0038, OR = 2.65, 95% CI: 1.31–5.33). This study is the first to demonstrate that HLA-B*46:01 is a risk allele for cADRs in a Han Chinese population, indicating that screening for HLA-B*46:01 prior to the administration of medication may predict the risk of developing cADRs.
大多数发生皮肤药物不良反应(cADRs)的患者同时接受多种药物治疗,这意味着致病药物仍未确定。我们探讨了人类白细胞抗原(HLA)等位基因与cadr之间的关系,而不考虑致敏药物,以研究不同药物诱导的cadr是否与汉族人群中相同或相似的风险等位基因相关。我们对来自同一医院的146例cADR患者和230例人群对照进行了基因分型,系统地分析了HLA I类基因与cADR之间的关系。发现cADR患者HLA-B*46:01的携带者频率显著高于人群对照组(P =。0021,优势比[OR] = 2.18, 95%可信区间[CI]: 1.33-2.58)。亚组分析显示,HLA-B*46:01与荨麻疹和多形性红斑显著相关(P =。0077, or = 2.53, 95% ci: 1.30-4.91;和P =。0049, OR = 2.77, 95% CI分别为1.39 ~ 5.50)。此外,HLA-A*02:01与多形性红斑之间也存在显著相关性(P =。0038, or = 2.65, 95% ci: 1.31-5.33)。本研究首次证实HLA-B*46:01是中国汉族人群中发生cadr的风险等位基因,表明在给药前筛查HLA-B*46:01可预测发生cadr的风险。
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引用次数: 2
Seeking “protective” and “harmful” immune genes during chronic HIV-1 infection by transcriptome analysis 通过转录组分析寻找慢性HIV-1感染过程中的“保护性”和“有害”免疫基因
Pub Date : 2018-09-01 DOI: 10.1097/JBR.0000000000000015
Lingyan Zhu, C. Qiu, C. Qiu, Ying Wang, Yuan Dong, Linxia Zhang, Weihui Fu, Jun Wei, Xiaoyan Zhang, Jianqing Xu
Abstract Human immunodeficiency virus (HIV)-infected individuals exhibit remarkable transcriptomic variation. Transcriptome analyses of antiretroviral therapy (ART)-free chronically infected HIV-1 patients with different clinical outcomes are likely to aid the development of vaccine and immune therapies. Here, we performed microarray analyses on whole-blood derived RNA from 89 ART-free HIV-1-infected individuals from 2 cohorts. The differentially expressed genes were analyzed between long-term non-progressors, viremic non-progressors and typical progressors, and between elite controllers and non-elite controllers among the long-term non-progressors. Several genes related to T-cell growth, proliferation and differentiation and antiapoptosis were upregulated, whereas interferon-stimulated genes and inflammatory genes were significantly downregulated in long-term non-progressors and viremic non-progressors. The observations above were further confirmed in the set of 261 genes that correlated with disease progression during a 5-year follow-up, which included 51 genes significantly associated with slower disease progression, and 210 genes associated with aggressive disease progression. Overall, our data suggest that it is vital to maintain the homeostasis of the immune system when mounting antiviral immune responses. Immune therapeutics able to reconstruct immune homeostasis are likely to be required for immune reconstitution in the context of ART, such as the administration of interleukin-7, healthy allogenic CD4+ T cells (providing CD4+ T-cell growth factors), or Tregs.
人类免疫缺陷病毒(HIV)感染个体表现出显著的转录组变异。对无抗逆转录病毒治疗(ART)的不同临床结果的慢性感染HIV-1患者的转录组分析可能有助于疫苗和免疫疗法的开发。在这里,我们对来自2个队列的89名无art的hiv -1感染者的全血来源RNA进行了微阵列分析。分析了长期无进展者、病毒血症无进展者和典型进展者以及长期无进展者中精英控制者和非精英控制者之间的差异表达基因。一些与t细胞生长、增殖、分化和抗凋亡相关的基因被上调,而在长期非进展者和病毒血症非进展者中,干扰素刺激基因和炎症基因被显著下调。在5年随访期间,上述观察结果在261个与疾病进展相关的基因中得到进一步证实,其中51个基因与疾病进展较慢显著相关,210个基因与疾病进展积极相关。总的来说,我们的数据表明,在进行抗病毒免疫反应时,维持免疫系统的稳态至关重要。在抗逆转录病毒治疗的背景下,免疫重建可能需要能够重建免疫稳态的免疫疗法,例如给药白介素-7、健康的同种异体CD4+ T细胞(提供CD4+ T细胞生长因子)或Tregs。
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引用次数: 0
GPER1 promotes estrogen receptor negative breast cancer cell migration and invasion via non-genomic activation of c-Src/NF-&kgr;B/focal adhesion kinase cascade GPER1通过非基因组激活c-Src/NF-&kgr;B/局灶黏附激酶级联促进雌激素受体阴性乳腺癌细胞的迁移和侵袭
Pub Date : 2018-09-01 DOI: 10.1097/JBR.0000000000000010
Xiaosa Li, Qing Yan, Xingyan Xu, Weiyu Chen, Ping Li, Qiumei Xiang, Xiaoyang Xu, Xiaodong Fu
Abstract Breast cancer metastasis is the root cause of deaths from breast cancer. Currently, endocrine therapy resistance in estrogen receptor (ER)-positive (ER+) breast cancer remains a major clinical issue. Moreover, ER-negative (ER−) breast cancer is often associated with distant recurrence and death. G-protein-coupled ER (GPER1) participates in endocrine therapy resistance and is involved in the malignant progression of breast cancer. However, the underlying detailed mechanisms remain obscure. Here we investigated the role and mechanism of GPER1 in the activation of focal adhesion kinase (FAK) using ER+ or ER− breast cancer cell lines. In SK-Br-3 cells (ER&agr;−/&bgr;−/GPER1+), both 17&bgr;-estradiol (E2) and the GPER1 agonist G1 resulted in rapid FAK phosphorylation. This action is due to GPER1 interaction with the non-receptor tyrosine kinase c-Src and subsequent activation of nuclear factor kappa B (NF-&kgr;B) signaling. Silencing of GPER1, c-Src or the nuclear factor kappa B p65 subunit blocked E2- or G1-induced SK-Br-3 cell migration and invasion. In MCF-7 cells (ER&agr;+/&bgr;+/GPER1+), silencing of GPER1, but not ER&agr; or ER&bgr;, abolished FAK phosphorylation induced by E2 or G1. In MDA-MB-231 cells (ER&agr;−/&bgr;+/GPER1−), E2 or G1 was also unable to stimulate E2-induced FAK phosphorylation. However, E2 and G1 regained the ability to induce FAK phosphorylation under conditions of overexpression of GPER1. In conclusion, we demonstrated that GPER1, but not ER&agr; or ER&bgr;, mediates FAK phosphorylation induced by E2 via the c-Src/p65 signaling pathway, which enhances cell migration and invasion. These findings may shed light on novel therapeutic strategies based on GPER1/FAK signaling pathways in suppression of breast cancer metastasis.
乳腺癌转移是乳腺癌死亡的根本原因。目前,雌激素受体(ER)阳性(ER+)乳腺癌的内分泌治疗抵抗仍然是一个主要的临床问题。此外,ER阴性(ER−)乳腺癌通常与远处复发和死亡有关。g蛋白偶联内质网(GPER1)参与内分泌治疗抵抗,参与乳腺癌的恶性进展。然而,潜在的详细机制仍然不清楚。本研究利用ER+或ER -乳腺癌细胞系研究了GPER1在局灶黏附激酶(FAK)活化中的作用和机制。在SK-Br-3细胞(ER&agr;−/&bgr;−/GPER1+)中,17&bgr;-雌二醇(E2)和GPER1激动剂G1均导致FAK快速磷酸化。这种作用是由于GPER1与非受体酪氨酸激酶c-Src相互作用以及随后激活核因子κ B (NF-&kgr;B)信号传导。沉默GPER1、c-Src或核因子κ B p65亚基可阻断E2-或g1诱导的SK-Br-3细胞迁移和侵袭。在MCF-7细胞(ER&agr +/&bgr +/GPER1+)中,GPER1沉默,而ER&agr不沉默;或ER&bgr;,消除E2或G1诱导的FAK磷酸化。在MDA-MB-231细胞(ER&agr;−/&bgr;+/GPER1−)中,E2或G1也不能刺激E2诱导的FAK磷酸化。然而,在GPER1过表达的条件下,E2和G1恢复了诱导FAK磷酸化的能力。总之,我们证明了GPER1,而不是ER&agr;或ER&bgr;通过c-Src/p65信号通路介导E2诱导的FAK磷酸化,从而增强细胞迁移和侵袭。这些发现可能揭示了基于GPER1/FAK信号通路抑制乳腺癌转移的新治疗策略。
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引用次数: 1
Acyl-CoA synthetase long-chain 3 regulates AKT phosphorylation and the functional activity of human prostate cancer cells 酰基辅酶a合成酶长链3调控AKT磷酸化和人前列腺癌细胞的功能活性
Pub Date : 2018-09-01 DOI: 10.1097/JBR.0000000000000009
Ke Li, Y. Mao, Wenhan Qiu, Jianwen He, Dejuan Wang, Cheng Hu, Wen-tao Huang, S. Jie, J. Qiu
Abstract Metastasis is the main cause of cancer-specific death in patients with prostate cancer (PCa). Acyl-coenzyme A synthetase long-chain family member 3 (ACSL3) is involved in the metabolic reprogramming of multiple types of cancer cells, but its role in PCa metastasis remains largely unknown. Here, we determined the effect of overexpression or small interfering RNA-mediated depletion of ACSL3 on the migratory and invasive abilities of human PCa cell lines. We also conducted phospho-protein microarray analysis to identify signaling pathway components affected by ACSL3 modulation. Overexpression of ACSL3 promoted the migration and invasion of PCa cells, whereas ACSL3 downregulation had the opposite effects. Mechanistically, phospho-protein analysis showed that ACSL3 regulated the phosphorylation of AKT and the expression of matrix metalloproteinase9. Our results support a potential role for ACSL3 in promoting the metastatic behavior of PCa, possibly via AKT/matrix metalloproteinase9 pathways. Thus, ACSL3 could be a novel target for the development of treatments for PCa.
转移是前列腺癌(PCa)患者癌症特异性死亡的主要原因。酰基辅酶A合成酶长链家族成员3 (ACSL3)参与多种类型癌细胞的代谢重编程,但其在前列腺癌转移中的作用尚不清楚。在这里,我们确定了过表达或小干扰rna介导的ACSL3缺失对人PCa细胞系迁移和侵袭能力的影响。我们还进行了磷酸化蛋白微阵列分析,以确定受ACSL3调节影响的信号通路成分。ACSL3的过表达促进了PCa细胞的迁移和侵袭,而ACSL3的下调则起到相反的作用。磷酸化蛋白分析表明,ACSL3调控AKT磷酸化和基质金属蛋白酶9的表达。我们的研究结果支持ACSL3在促进前列腺癌转移行为中的潜在作用,可能通过AKT/基质金属蛋白酶9途径。因此,ACSL3可能成为PCa治疗发展的新靶点。
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引用次数: 1
Paget's disease of the nipple in males: two case reports and literature review 男性乳头佩吉特病:2例报告及文献复习
Pub Date : 2018-09-01 DOI: 10.1097/JBR.0000000000000012
Jie Wang, Jiaqi Liu, Z. Xing, X. Meng, Menglu Zhang, X. Wang, Xiang Wang
Abstract Male breast cancer accounts for less than 0.5% of all breast cancer, and Paget disease of the breast in males is extremely rare. Here, we report 2 cases of Paget disease of the nipple areola complex with invasive ductal carcinoma as typical examples of male PDB. Case 1 was a 64-year-old man with an altered appearance of the left nipple, itching and redness, without a palpable breast mass at first. Case 2 was a 55-year-old man with a palpable mass in the left breast and histologically confirmed Paget disease of the nipple with invasive ductal carcinoma. Both patients underwent modified radical mastectomy but with different adjuvant therapies and remained well during follow-up with no recurrence. Furthermore, we reviewed all the sporadic cases of male PDB from the literature. This may help contribute to the development of diagnostic strategies and appropriate interventions for male Paget disease of the breast.
男性乳腺癌在所有乳腺癌中所占比例不到0.5%,男性乳腺Paget病极为罕见。在此,我们报告2例乳头乳晕复合物Paget病合并浸润性导管癌为男性PDB的典型病例。病例1是一名64岁男性,左乳头外观改变,瘙痒和发红,最初没有可触及的乳房肿块。病例2为55岁男性,左乳可触及肿块,组织学证实乳头Paget病合并浸润性导管癌。两例患者均行改良根治性乳房切除术,但采用了不同的辅助治疗,随访期间均保持良好,无复发。此外,我们回顾了文献中所有散发的男性PDB病例。这可能有助于发展诊断策略和适当的干预措施,为男性乳腺佩吉特病。
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引用次数: 2
Human microbiome brings new insights to traditional Chinese medicine 人体微生物组为中医带来新见解
Pub Date : 2018-06-01 DOI: 10.1097/JBR.0000000000000007
Ruirui Wang, Lei Zhang, Jingjuan Xu, Zhan Gu, Li Zhang, G. Ji, Bao-cheng Liu
Abstract The human microbiome has become a new frontier of life sciences and plays a crucial role in determining individual and population health. Over thousands of years of medical practice, practitioners of traditional Chinese medicine (TCM) developed an understanding of the importance and activity of commensal microorganisms without access to modern technology. In this review, we examine the theoretical similarities between modern studies of the human microbiome and TCM, and propose feasible strategies to integrate the 2 fields. Advances in our understanding of the human microbiome will also help to modernize the practice of TCM, thereby providing a basis for bridging the gap between modern medicine and TCM.
人体微生物组已成为生命科学的一个新前沿,在决定个体和人群健康方面起着至关重要的作用。在数千年的医学实践中,中医(TCM)的从业者在没有现代技术的情况下,对共生微生物的重要性和活性有了认识。在这篇综述中,我们分析了现代人类微生物组研究与中医之间的理论相似性,并提出了整合这两个领域的可行策略。我们对人体微生物组的理解的进步也将有助于中医实践的现代化,从而为弥合现代医学与中医之间的差距提供基础。
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引用次数: 2
Development of a nomogram to predict overall survival among non-metastatic breast cancer patients in China: a retrospective multicenter study 预测中国非转移性乳腺癌患者总生存率的nomogram:一项回顾性多中心研究
Pub Date : 2018-06-01 DOI: 10.1097/JBR.0000000000000008
Z. Pan, Kai Chen, Peixian Chen, Liling Zhu, Shunrong Li, Qian Li, Fengtao Liu, M. Peng, F. Su, Qiang Liu, G. Ye, M. Zeng, E. Song
Abstract The accurate prediction of overall survival (OS) is important in clinical decision-making for breast cancer treatment. We developed a model to predict the OS of non-metastatic breast cancer patients in China. This multicenter study included 1844 non-metastatic breast cancer patients who underwent breast cancer surgery between January 2009 and December 2011 in 3 tertiary teaching hospitals in China. Data were collected retrospectively from the database of each hospital. We used univariate and multivariate Cox proportional hazard regression analyses to screen for predictors. A nomogram was developed in the training cohort (from Sun Yat-sen Memorial Hospital [SYSMH]), externally validated in 2 validation cohorts (from the First People's Hospital of Foshan [FPHF] and Sun Yat-sen University Cancer Center (SYUCC)), and compared with CancerMath, a mathematical-based model. We used Receiver Operating Characteristic curves and calibration plots to assess the models. At median follow-ups of 65.9, 68.6, and 66.2 months, the 5-year OS rates were 93.0%, 86.7%, and 91.0% in the SYSMH, FPHF, and SYUCC cohorts, respectively. We identified age, T stage, lymph node status, estrogen receptor, and human epidermal growth factor receptor 2 statuses as significant prognostic factors. A nomogram was developed and externally validated in the FPHF (area under the curve = 0.74) and SYUCC (area under the curve = 0.77) cohorts. Calibration plots showed that the predicted OS was consistent with the actual OS. The nomogram outperformed CancerMath in our study population. In summary, we developed a nomogram to predict survival among non-metastatic breast cancer patientsin China. This nomogram is superior to the CancerMath model in Chinese populations.
准确预测总生存期(OS)对乳腺癌治疗的临床决策具有重要意义。我们建立了一个模型来预测中国非转移性乳腺癌患者的OS。本多中心研究纳入了2009年1月至2011年12月在中国3家三级教学医院接受乳腺癌手术的1844例非转移性乳腺癌患者。从各医院的数据库中回顾性收集数据。我们使用单变量和多变量Cox比例风险回归分析筛选预测因子。在培训队列(来自中山纪念医院[SYSMH])中建立nomogram,在两个验证队列(来自佛山市第一人民医院[FPHF]和中山大学肿瘤中心(SYUCC))中进行外部验证,并与基于数学的模型CancerMath进行比较。我们使用接收者工作特性曲线和校准图来评估模型。在中位随访65.9、68.6和66.2个月时,SYSMH、FPHF和SYUCC组的5年OS率分别为93.0%、86.7%和91.0%。我们确定年龄、T分期、淋巴结状态、雌激素受体和人表皮生长因子受体2状态是重要的预后因素。在FPHF(曲线下面积= 0.74)和SYUCC(曲线下面积= 0.77)队列中建立nomogram并进行外部验证。校正图显示,预测OS与实际OS一致。在我们的研究人群中,nomogram表现优于CancerMath。总之,我们开发了一个nomogram来预测中国非转移性乳腺癌患者的生存率。在中国人群中,该模式优于CancerMath模型。
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引用次数: 3
Animal models of T-cell acute lymphoblastic leukemia: mimicking the human disease t细胞急性淋巴细胞白血病动物模型:模拟人类疾病
Pub Date : 2018-06-01 DOI: 10.1097/JBR.0000000000000001
Q. You, H. Su, Jingchao Wang, Jue Jiang, Guoliang Qing, Hudan Liu
Abstract T-cell acute lymphoblastic leukemia (T-ALL) is a heterogeneous group of hematological tumors composed of distinct subtypes that vary in their genetic abnormalities. In the past decade, large-scale genomic analysis has shed new light on providing potentially important oncogenic or tumor suppressive candidates involved in the disease progression. Following in silico analysis, functional studies are usually performed to vigorously investigate the biological roles of candidate genes. For this purpose, animal models faithfully recapitulating the human disease are widely applied to decipher the mechanism underlying T-cell transformation. Conversely, an increased understanding of T-ALL biology, including identification of oncogene NOTCH1, TAL1 and MYC as well as tumor suppressor phosphatase and tensin homolog (PTEN), has significantly improved the development of T-ALL animal models. These progresses have opened opportunities for development of new therapeutic strategy to benefit T-ALL patients. In this review, we particularly summarize the mouse and zebrafish models used in T-ALL research and also the most recent advances from these in vivo studies.
摘要:t细胞急性淋巴细胞白血病(T-ALL)是一种异质性的血液学肿瘤,由不同的亚型组成,其遗传异常各不相同。在过去的十年中,大规模的基因组分析揭示了新的线索,提供潜在重要的致癌或肿瘤抑制候选物参与疾病进展。在计算机分析之后,通常进行功能研究,以大力研究候选基因的生物学作用。为此,忠实地再现人类疾病的动物模型被广泛应用于破译t细胞转化的机制。相反,对T-ALL生物学的进一步了解,包括癌基因NOTCH1、TAL1和MYC以及肿瘤抑制磷酸酶和紧张素同源物(PTEN)的鉴定,显著改善了T-ALL动物模型的开发。这些进展为开发新的治疗策略提供了机会,使T-ALL患者受益。在这篇综述中,我们特别总结了用于T-ALL研究的小鼠和斑马鱼模型以及这些体内研究的最新进展。
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引用次数: 3
Single-cell sequencing leads a new era of profiling transcriptomic landscape 单细胞测序引领了转录组学分析的新时代
Pub Date : 2018-06-01 DOI: 10.1097/JBR.0000000000000003
Huidan Zhang, Naiwen Cui, Yamei Cai, F. Lei, D. Weitz
Understanding the complexity of biological systems requires a comprehensive analysis of their cell populations. Ideally, this should be done at the single cell level, because bulk analysis of the full population obscured many critical details due to artifacts introduced by averaging. However, this has been technically challenging due to the cumbersome procedure, low throughput, and high costs of performing analysis on a single-cell basis. Excitingly, technical improvements in single-cell RNA sequencing are making it economically practical to profile the transcriptomics of large populations of cells at the single-cell level, and have yielded numerous results that address important biological and medical questions. Further development of the technology and data analysis will significantly benefit the biomedical field by unraveling the function of individual cells in their microenvironments and modeling their transcriptional dynamics. Key words: cell transcriptomics; CEL-Seq; Hi-SCL; MARS-Seq; SCRB-Seq; single-cell RNA sequencing; Smart-Seq2; sNuc-seq
理解生物系统的复杂性需要对其细胞群进行全面的分析。理想情况下,这应该在单个细胞水平上完成,因为由于平均引入的伪影,对整个种群的大量分析模糊了许多关键细节。然而,由于在单细胞基础上执行分析的繁琐程序、低吞吐量和高成本,这在技术上具有挑战性。令人兴奋的是,单细胞RNA测序技术的进步使得在单细胞水平上分析大量细胞的转录组学在经济上可行,并且已经产生了许多解决重要生物学和医学问题的结果。该技术和数据分析的进一步发展将通过揭示单个细胞在其微环境中的功能和建模其转录动力学来显着造福生物医学领域。关键词:细胞转录组学;CEL-Seq;Hi-SCL;MARS-Seq;SCRB-Seq;单细胞RNA测序;Smart-Seq2;sNuc-seq
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引用次数: 6
Choice of serum tumor markers in patients with small cell lung cancer: progastrin-releasing peptide, neuron-specific enolase, and carcinoembryonic antigen 小细胞肺癌患者血清肿瘤标志物的选择:原胃泌素释放肽、神经元特异性烯醇化酶和癌胚抗原
Pub Date : 2018-06-01 DOI: 10.1097/JBR.0000000000000002
Lisi Huang, Hai-yan Yan, Longqiaozi Sun, Ying Xu, Donghao Cai, Xiao-hui Li, Xinliang Chen, Xiao-hong Luo, C. Duan
Abstract Lung cancer is a leading cause of cancer-related deaths worldwide. It mainly consists of 2 histological types: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC, including squamous cell carcinoma and adenocarcinoma). The present study aimed to assess the role of serum progastrin-releasing peptide (ProGRP), neuron-specific enolase (NSE), and carcinoembryonic antigen (CEA) and their combinations in the histological diagnosis of lung cancer (specially SCLC), which is of great importance for the initiation of treatment and prognostic implications. Serum ProGRP, NSE, and CEA were determined by the electrochemiluminescence immunoassay (ECLIA) in 66 patients with SCLC, 73 with adenocarcinoma, 44 with squamous cell carcinoma, 45 with non-malignant pulmonary diseases, and 50 healthy controls. Receiver operating characteristic curves were constructed to compare the predictive ability of each biochemical marker and their combined detection models to discriminate among the patients with lung cancers of different histological groups, benign pulmonary diseases and healthy individuals. In the ECLIA detection system, ProGRP showed the sensitivity and specificity for SCLC diagnosis were 71.2% and 91.1% to 93.2%, respectively. Among the markers, the largest area under the ROCs was for ProGRP in discriminating SCLC from benign pulmonary diseases, squamous cell carcinoma and adenocarcinoma (0.815, 0.859, and 0.835, respectively), which indicated that ProGRP was the most efficient marker for identifying SCLC. Besides, ProGRP and NSE exhibited almost equivalent diagnostic performance in discriminating SCLC from benign diseases. As for squamous cell carcinoma, we recommended proGRP, while for adenocarcinoma, the combination of proGRP and CEA was preferred. Remarkably, when ProGRP ⩽ 66 pg/mL, CEA was of great value in diagnosing SCLC and adenocarcinoma. If CEA ⩽ 5 ng/mL, the patient was at higher risk for SCLC, whereas the patient was more likely to be diagnosed with adenocarcinoma. Our study provided promising information about the diagnostic values of serum ProGRP, NSE, CEA in distinguishing SCLC from benign pulmonary diseases and NSCLC, which was of crucial clinical significance in the early diagnosis and therapy of SCLC.
肺癌是全球癌症相关死亡的主要原因。主要包括2种组织学类型:小细胞肺癌(SCLC)和非小细胞肺癌(NSCLC,包括鳞状细胞癌和腺癌)。本研究旨在探讨血清原胃泌素释放肽(ProGRP)、神经元特异性烯醇酶(NSE)和癌胚抗原(CEA)及其联合检测在肺癌(特别是SCLC)的组织学诊断中的作用,这对肺癌的开始治疗和预后具有重要意义。采用电化学发光免疫分析法(ECLIA)测定66例SCLC患者、73例腺癌患者、44例鳞状细胞癌患者、45例非恶性肺部疾病患者和50例健康对照者的血清ProGRP、NSE和CEA。构建受试者工作特征曲线,比较各生化指标及其联合检测模型对不同组织学组肺癌患者、肺部良性疾病患者和健康个体的预测能力。在ECLIA检测系统中,ProGRP诊断SCLC的敏感性为71.2%,特异性为91.1% ~ 93.2%。其中,ProGRP鉴别SCLC与肺部良性疾病、鳞状细胞癌和腺癌的roc下面积最大(分别为0.815、0.859和0.835),提示ProGRP是鉴别SCLC最有效的标志物。此外,ProGRP和NSE在区分SCLC和良性疾病方面表现出几乎相同的诊断性能。对于鳞状细胞癌,我们推荐proGRP,对于腺癌,我们推荐proGRP联合CEA。值得注意的是,当ProGRP≥66 pg/mL时,CEA对SCLC和腺癌的诊断具有重要价值。如果CEA≥5 ng/mL,则患者患SCLC的风险较高,而患者更有可能被诊断为腺癌。我们的研究为血清ProGRP、NSE、CEA在区分SCLC与良性肺部疾病和非小细胞肺癌中的诊断价值提供了有希望的信息,这对SCLC的早期诊断和治疗具有重要的临床意义。
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引用次数: 2
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