综述

肝内胆管细胞癌诊治进展

Advances in diagnosis and treatment of intrahepatic cholangiocarcinoma

:100-105
 
肝内胆管细胞癌(ICC)是发病率仅次于肝细胞癌的肝脏恶性肿瘤,它的恶性程度高、术后易复发,且早期无典型症状,大多数患者在确诊时已处于晚期。诊断主要依赖于增强CT、MRI和实验室检查。肝切除术是ICC首选的治疗方法,完整的切缘阴性切除和保留足够残留肝是影响手术预后的重要因素。淋巴结清扫、卡培他滨辅助化疗已被证实对患者有益。局部治疗、分子靶向治疗、免疫治疗等新疗法发展迅速,为晚期ICC患者带来了希望。传统疗法与新疗法的结合为ICC提供新的诊疗思路。
Intrahepatic cholangiocarcinoma(ICC)is the second most common liver malignancy after hepatocellular carcinoma.It is highly malignant,easy to recur after surgery,and has no typical symptoms in the early stage,and most patients are in the late stage when diagnosed.Diagnosis relies on enhanced CT,MRI and laboratory tests.Hepatectomy is the preferred treatment for intrahepatic cholangiocarcinoma.Complete resection with negative margin and adequate residual liver preservation are important factors affecting the prognosis of the operation.Lymph node dissection and adjuvant chemotherapy with capecitabine have been shown to be beneficial for patients.The rapid development of new therapies such as local therapy,molecular targeted therapy and immunotherapy has brought hope to patients with advanced intrahepatic cholangiocarcinoma.The combination of traditional therapy and new therapy provide a new idea for diagnosis and treatment of intrahepatic cholangiocarcinoma.
论著

CT征象在预测亚实性肺腺癌结节侵袭风险中的价值

Value of CT signs in predicting the risk of invasion of subsolid lung adenocarcinoma nodules

:46-51
 
目的 探讨亚实性肺腺癌结节CT征象在预测侵袭风险中的价值。方法 选取经胸部CT检查发现并经病理证实为肺腺癌的亚实性结节共76个病灶,病灶分为侵袭前组与侵袭组2组,分析结节CT征象,行统计学分析,明确亚实性肺腺癌结节侵袭性的预测因素。结果 侵袭前组(包括原位腺癌、微浸润性腺癌)共31例;侵袭组[浸润性腺癌(IAC)]共45例。2组在最大平均直径、结节平均CT值、结节形状、分叶、毛刺、胸膜牵拉征、有无实性成分、肿瘤微血管CT成像征间比较差异有统计学意义(P<0.05),而在空泡征、空气支气管征方面比较差异无统计学意义(P>0.05)。结节最大直径预测浸润性腺癌侵袭性界值为13.63 mm,敏感度、特异度分别为68.9%、96.8%,AUC为0.885;平均CT值预测IAC侵袭性界值为-528 HU,敏感度、特异度分别为84.4%、83.9%,AUC为0.867。回归分析显示病灶最大平均直径(OR=2.015、P=0.01)可以作为浸润性肺腺癌结节的独立预测因子。结论 亚实性肺腺癌结节侵袭前组和侵袭组在最大直径、平均CT值、形状、分叶、毛刺、微血管征存在差异;结节的最大平均直径是IAC的独立预测因子。
Objective To investigate the value of CT signs in predicting the risk of invasion of subsolid lung adenocarcinoma nodules.Methods A total of 76 subsolid pulmonary adenocarcinoma nodules detected by chest CT and pathologically confirmed were selected,and the lesions were divided into pre-invasion group and invasion group.CT signs of nodules were analyzed and statistical analysis was performed to determine the predictive factors of invasion of subsolid pulmonary adenocarcinoma nodules.Results There were 31 cases in the pre-invasion group(including adenocarcinoma in situ and minimally invasive adenocarcinoma)and 45 cases ininvasion group[invasive adenocarcinoma(IAC)].There were significant differences in maximum mean diameter,mean CT value of nodule,nodule shape,lobule,burr,pleural stretch sign,solid component and microvascular CT imaging signs between the two groups(P<0.05),but there were no significant differences in vacuole sign and air bronchial sign between the two groups(P>0.05).The maximum diameter of nodules predicted the invasion boundary of invasive adenocarcinoma was 13.63 mm,the sensitivity and specificity were 68.9% and 96.8%,respectively,and the AUC was 0.885.The mean CT value predicted the invasive boundary of IAC was -528 HU,the sensitivity and specificity were 84.4% and 83.9%,respectively,and the AUC was 0.867.Regression analysis showed that the maximum mean lesion diameter(OR=2.015,P=0.01)was an independent predictor of infiltrating lung adenocarcinoma nodules.Conclusions There were differences in the maximum diameter,mean CT value,shape,lobed,burr and microvascular signs between the pre-invasion group and the invasion group.The maximum mean diameter of nodules was an independent predictor of IAC.
论著

SCCA、HPV-DNA联合阴道镜检查在宫颈鳞状细胞癌筛查中的应用价值

Application value of SCCA,HPV-DNA combined with colposcope in cervical squamous cell carcinoma screening

:75-78
 
目的 探讨鳞状上皮细胞抗原(SCCA)、人乳头瘤病毒(HPV)-DNA联合阴道镜检查在宫颈鳞状细胞癌(SCC)筛查中的应用价值。方法 选择2019年1月1日—2021年12月31日在中山市博爱医院就诊并确诊为SCC的妇女作为研究对象,共纳入100例SCC患者(SCC组),同时选择200例经活检确诊为宫颈慢性炎症的患者(宫颈慢性炎症组)作为阴性对照。采用阴道镜观察研究对象的宫颈情况,并采集研究对象的宫颈组织标本进行HPV-DNA检测。采集研究对象的静脉血,采用化学发光免疫法测定研究对象SCCA的水平。以病理检查结果为金标准,分别对HPV-DNA检测、外周血SCCA两者联用以及阴道镜、HPV-DNA检测、外周血SCCA三者联用进行筛查效果的评价。结果 SCC组研究对象的年龄≥40岁者、出血者、性生活开始年龄≤20岁者比例均高于宫颈慢性炎症患者组;而宫颈慢性炎症患者组疼痛的比例高于SCC患者组,差异均有统计学意义(P<0.01)。χ2检验结果显示,SCC组研究对象的SCCA阳性率高于宫颈慢性炎症组(P<0.001)。阴道镜结合SCCA、HPV-DNA检测筛查SCC的灵敏度和特异度均高于单独使用SCCA和HPV-DNA,并取得较好的约登系数(75%)和Kappa值(0.730)。结论 采用阴道镜结合HPV-DNA、SCCA可有效提高SCC疾病的约登系数与Kappa值,其联合诊断的效能高于单独使用阴道镜、HPV-DNA或SCCA诊断SCC。
Objective To study the application value of squamus cell carcinoma antigen(SCCA)and human papillomavirus(HPV)-DNA combined with colposcope in cervical squamous cell carcinoma(SCC)screening.Methods Women diagnosed with SCC who visited Boai Hospital of Zhongshan city from January 1,2019 to December 31,2021 were selected as research subjects,including 100 patients with SCC(SCC group)and 200 patients with chronic cervical inflammation confirmed by biopsy(chronic cervical inflammation group).The cervix of the subjects was observed by colposcope,and cervical tissue samples were collected for HPV-DNA testing.Venous blood of subjects was collected and SCCA levels were determined by chemiluminescence immunoassay.Using pathological examination results as the gold standard,the screening effect of combination HPV-DNA test and peripheral blood SCCA test,combination colposcope,HPV-DNA test and peripheral blood SCCA were evaluated respectively.Results In SCC group,the proportion of age≥40 years old,bleeding,sexual life age ≤20 years old were higher than those in chronic cervical inflammation group,but chronic cervical inflammation group had higher rate of pain than those in SCC group(P<0.01)by Chi-square test.SCCA positive rate in SCC group was higher than that in chronic cervical inflammation group(P<0.001)by Chi-square test.The sensitivity and specificity of colposcope combined with SCCA and HPV-DNA were higher than those of SCCA and HPV-DNA alone,and better Youden’s coefficient(75%)and Kappa value(0.730)were obtained.Conclusions Colposcope combined with HPV-DNA and SCCA can effectively improve the Youden’s coefficient and Kappa value of SCC disease,and its combined diagnosis efficiency was higher than that of colposcope,HPV-DNA and SCCA alone in the diagnosis of SCC,which has high clinical promotion significance.
论著

82例子宫内膜癌错配修复蛋白表达与临床病理特征的关系

The structure and clinicopathological features of endometrial carcinoma in 82 cases

:44-48
 
目的 探讨子宫内膜癌构成及临床病理特征。方法 以南平市第一医院2020年1月—2022年6月期间收治的82例子宫内膜癌患者为研究对象,收集其临床资料,通过免疫组织化学染色法检测4种错配修复蛋白表达,并分析错配修复蛋白表达与临床病理特征的关系。结果 82例患者中,70例(85.37%)为子宫内膜样癌,病理组织学类型以G1级30例(42.86%)为主,其他类型较为少见。错配修复蛋白表达总缺失率为35.71%,其中MUTL同源物1(MLH1)单独缺失率为2.86%,错配修复蛋白2抗体(MSH2)为4.29%,错配修复蛋白6抗体(MSH6)为14.29%,肿瘤错配修复基因PMS2抗体(PMS2)为14.29%;错配修复表达缺失(dMMR)组患者年龄50岁以上、伴脉管侵犯和淋巴结转移、组织学G3级和FIGO分期Ⅲ期占比高于错配修复表达正常(pMMR)组患者(P<0.05);MSH6蛋白表达缺失易发生在年龄50岁以上、有家族相关疾病史的患者(P<0.05);PMS2蛋白表达缺失易发生在组织学G2级、FIGO分期Ⅲ期、妊娠1次及以上、脉管内癌栓和淋巴结转移的患者(P<0.05)。结论 子宫内膜癌错配修复蛋白表达与其部分临床病理特征存在密切关联,可为患者后续治疗提供有价值的指导。
Objective To investigate the composition and clinicopathological features of endometrial carcinoma.Methods A total of 82 cases of endometrial carcinoma patients admitted to the First Hospital of Nanping City from January 2020 to June 2022 were studied.Epidemiological data were collected,and the expression of 4 mismatch repair proteins were detected by immunohistochemical staining,and their relationship with clinicopathological features was analyzed.Results Among 82 patients,70 cases(85.37%)were endometrioid carcinoma,and 30 cases(42.86%)were mainly G1 grade,other types were rare.The total deletion rate of mismatch repair proteins expression was 35.71%,in which MLH1 alone was 2.86%,MSH2 was 4.29%,MSH6 was14.29% and PMS2 was14.29%.The proportions of dMMR patients over 50 years old,with vascular invasion and lymph node metastasis,G3 grade histology and FIGO stage Ⅲ were significantly higher than those of the pMMR group(P<0.05).The loss of MSH6 protein expression was more likely to occur in patients over 50 years old with a family history of related diseases(P<0.05).The deletion of PMS2 protein expression was more likely to occur in patients with histological G2 grade,FIGO stage III,pregnancy of once or more and intravascular cancer thrombin and lymph node metastasis(P<0.05).Conclusions The expression of mismatch repair proteins in endometrial carcinoma is closely related to some clinicopathological features,which provides valuable guidance for follow-up treatment.
论著

组蛋白去乙酰化酶抑制剂对肝癌诱导自噬的作用

Effect of histone deacetylase inhibitors on hepatocellular carcinoma induced autophagy

:39-43
 
目的 探讨组蛋白去乙酰化酶抑制剂曲古霉素对肝癌细胞增殖凋亡是否存在影响,及该抑制作用是否与自噬相关。方法 采用MTT法检测不同浓度曲古霉素作用于肝癌HepG2细胞24 h、48 h、72 h以后肝癌细胞的增殖能力;使用流式细胞术检测不同浓度曲古霉素对HepG2肝癌细胞周期及凋亡的影响;蛋白印迹法(Western blot, WB)检测不同浓度曲古霉素对肝癌HepG2细胞中Beclin1和Bcl-2蛋白的表达;实时荧光定量 PCR(Real-time PCR, RT-PCR)检测不同浓度曲古霉素对肝癌HepG2细胞中Beclin1和Bcl-2 mRNA的表达。结果 曲古霉素对肝癌HepG2细胞具有增殖抑制作用,与对照组相比较,其差异有统计学意义(P<0.05);通过流式细胞术检测结果显示,曲古霉素作用于肝癌HepG2细胞后,随着浓度的增加,细胞凋亡率显著上升,与对照组相比,差异有统计学意义(P<0.05);RT-PCR及WB实验观察到,Beclin1蛋白和mMRA的表达随着曲古霉素浓度的增加而逐渐升高,Bcl-2蛋白和mMRA的表达随着曲古霉素作用浓度的增加而逐渐降低,且与对照组相比,其差异均有统计学意义(P<0.05)。结论 曲古霉素能抑制肝癌细胞的增殖,而且这种作用机制与诱导肝癌细胞凋亡和自噬作用有相关性。
Objective To investigate whether histone deacetylase inhibitor hachimycin has an effect on the proliferation and apoptosis of hepatocellular carcinoma cells and whether the inhibition is related to autophagy. Methods MTT assay was used to detect the proliferation ability of HepG2 cells treated with hachimycin of different concentrations for 24 h, 48 h and 72 h.Flow cytometry was used to detect the effects of different concentrations of hachimycin on HepG2 hepatoma cell cycle and apoptosis.Western blot (WB) assay was used to detect Beclin1 and Bcl-2 expressions in hepatocellular carcinoma HepG2 cells under different hachimycin concentrations.Beclin1 and Bcl-2 mRNA expressions under different hachimycin concentrations in hepatocellular carcinoma HepG2 cells were detected by RT-PCR. Results Hachimycin inhibited the proliferation of HepG2 cells, compared with the control group, the difference was statistically significant (P<0.05). Flow cytometry results showed that the apoptosis rate of hepatocellular carcinoma HepG2 cells was significantly increased with the increase of hachimycin concentration, compared with the control group, the difference was statistically significant (P<0.05). RT-PCR and WB results showed that Beclin1 protein and mMRA expression gradually increased with the increase of hachimycin concentration, while Bcl-2 protein and mMRA expression gradually decreased, compared with the control group, the differences were statistically significant (P<0.05). Conclusion Hachimycin could inhibit the proliferation of hepatocellular carcinoma cells, and its mechanism was related to the induction of apoptosis and autophagy.
论著

老年食管鳞癌患者单纯放疗和同步放化疗的临床观察

Clinical observation of radiotherapy only and concurrent chemoradiotherapy in elderly patients with esophageal squamous cell carcinoma

:35-38
 
目的 探究老年食管鳞癌患者单纯放疗、同步放化疗临床治疗效果。方法 选我院2018年1月—2020年12月期间90例老年食管鳞癌患者为研究对象,依据不同治疗方式将其分为对照组、观察组,各45例,分别接受单纯放疗、同步放化疗治疗,比较2组治疗效果及治疗安全性。结果 观察组治疗总有效率为75.56%,与对照组60.00%相近(P>0.05);观察组疾病控制率为97.78%,较对照组84.44%高(P<0.05);观察组放射性肺炎、骨髓抑制发生率为24.44%、77.78%,较对照组6.67%、48.89%高;且观察组放射性肺炎、骨髓抑制、放射性食管炎2级占比分别为17.78%、35.56%、57.78%,均较对照组2.22%、8.89%、24.44%高(P<0.05)。结论 在老年食管鳞癌患者治疗中,与单纯放疗相比,同步放化疗可提升疾病控制能力,但会增加治疗不良反应,增加不良反应严重程度,因此在临床治疗中,需慎重选择。
Objective To explore the clinical effect of radiotherapy only and concurrent chemoradiotherapy in elderly patients with esophageal squamous cell carcinoma. Methods Ninety cases of elderly patients with esophageal squamous cell carcinoma in our hospital from January 2018 to December 2020 were selected as research objects.According to different treatment methods, they were divided into control group and observation group, 45 cases in each group.They were treated with radiotherapy and concurrent chemoradiotherapy respectively.The treatment effect and safety of the two groups were compared. Results The total effective rate of the observation group was 75.56%, which was close to the control group (60.00%, P>0.05). The disease control rate of the observation group was 97.78%, which was higher than control group (84.44%, P<0.05). The incidence of radiation pneumonia and bone marrow suppression of the observation group were 24.44% and 77.78%, which were higher than that of the control group (6.67%, 48.89%). The proportion of radiation pneumonia, bone marrow suppression, radiation esophagitis grade 2 of the observation group were 17.78%, 35.78% and 57.78% respectively, higher than that of the control group (2.22%, 8.89%, 24.44% respectively, P<0.05). Conclusion Compared with radiotherapy only, concurrent chemoradiotherapy improved the ability of disease control in elderly patients with esophageal squamous cell carcinoma, but it increased the adverse reactions and aggravated the severity of adverse reactions.Therefore, it is necessary to make a careful choice in clinical treatment.
论著

DNA甲基化位点对肺腺癌预后的作用研究

Effect of DNA methylation sites on prognosis of lung adenocarcinoma

:112-117
 
目的 使用TCGA数据库,探索DNA甲基化位点对肺腺癌的预后影响。方法 使用TCGA数据库,获取肺腺癌病人癌和癌旁组织甲基化表达数据、基因表达数据及临床数据;将人群分为探索组和验证组,使用LASSO在探索人群中筛选对肺腺癌预后有影响的甲基化位点;受试者工作特征曲线用于评估甲基化位点预测效果,并进一步在验证人群中验证。结果 在TCGA数据库中筛选出158个癌和癌旁组织差异表达且与所在基因mRNA表达显著相关的甲基化位点,经LASSO回归分析,cg19378330与肺腺癌预后相关。甲基化位点水平高于中位数的患者,归入高风险组,甲基化位点水平低于中位数的为低风险组。结果发现与低风险组相比,高风险组的死亡风险比低风险组增加了38%(OR=1.38,95% CI=1.16~2.69)。在探索阶段人群中其曲线下面积为0.80(95% CI=0.73~0.88),灵敏度为86.2%。验证人群中也表现出类似结果。结论 甲基化位点cg19378330与肺腺癌具有较显著的关联性,且可以对肺腺癌的风险进行有效的预测。
Objective Using the TCGA database to explore the prognostic effects of DNA methylation sites on lung adenocarcinoma. Methods TCGA database was used to collecting DNA methylation data, gene expression data and clinical data of lung adenocarcinoma patients. The population were divided into the exploratory group and the validation group. The LASSO regression analysis was used to screen the methylation sites associated with the prognosis of lung adenocarcinoma in the exploratory group. Receiver operating characteristic curve was used to evaluate the prediction effect of the model, and further verified in the validation population. Results A total of 158 methylation sites with differential expression and significant correlation with the mRNA expression of the corresponding gene were screened from the TCGA database. With LASSO regression analysis, the DNA methylation sites associated with prognosis of lung adenocarcinoma were cg19378330. Those patients with levels above the median methylation site were assigned to the high-risk group, while those with levels below the median methylation site were assigned to the low-risk group. Patients' death risk in the high-risk group were 38% higher than those in the low-risk group (OR=1.38, 95%CI=1.16-2.69). The area under the curve was 0.80 (95%CI=0.73-0.88) and the sensitivity was 86.2% in the exploratory stage population.Similar results were seen in the validation population. Conclusions The DNA methylation site cg19378330 was significantly associated withthe prognosisof lung adenocarcinoma, and could effectively predict the risk of lung adenocarcinoma.
论著

基于铁死亡相关的lncRNA在肺鳞癌预后的分析

Prognostic analysis based on ferroptosis related lncRNAs in lung squamous cell carcinoma

:113-120
 
目的 探究铁死亡相关的lncRNA在肺鳞状上皮细胞癌(简称肺鳞癌)患者中的预后意义。方法 从美国癌症和肿瘤基因图谱数据库(the Cancer Genome Atlas,TCGA)中下载肺鳞癌数据551例,包括49例正常对照样本和502例肺鳞癌患者样本。筛选出与铁死亡相关基因的共表达的lncRNA,使用单变量Cox回归进一步筛选lncRNA,然后,使用Lasso回归和多元Cox回归分构建铁死亡相关的lncRNA模型。建立基于模型的风险评分,并使用Cox回归测试其是否为独立的预后因素。铁死亡相关lncRNAs的功能富集使用基因本体(Gene Ontology)和京都基因和基因组百科全书(Kyoto Encyclopedia of Genes and Genomes)可视化。结果 4个预后铁死亡相关的lncRNA(AC253536.6,FLJ46906LUCAT,AC022150.2)显著不同,这构建了铁死亡相关的lncRNA模型。此模型将肺鳞癌患者分为低风险组和高风险组。基于模型的风险评分是肺鳞癌患者的显著独立因素(HR =2.116,95%CI=1.513~2.961;P<0.001)。此外,4个lncRNA在铁死亡过程,代谢和肿瘤经典途径中均显著富集。结论 4个铁死亡相关的lncRNAs可能是肺鳞癌患者的分子生物标志物和治疗靶标。
Objective To explore the prognostic significance of ferroptosis related lncRNAs in patients with lung squamous cell carcinoma. Methods Data of 551 lung squamous cell carcinoma cases was downloaded from the Cancer Genome Atlas (TCGA) of the United States, including 49 normal control samples and 502 lung squamous cell carcinoma samples. The lncRNAs co-expressed with genes related to ferroptosis was screened out. Univariate Cox regression was used to further screen out the lncRNAs. Then, Lasso regression and multiple Cox regression were used to construct lncRNA models related to ferroptosis. A model-based risk score system was established and Cox regression was used to test whether it was an independent prognostic factor. The functional enrichment of ferroptosis related lncRNAs were visualized using Gene Ontology and Kyoto Encyclopedia of Genes and Genomes. Results The four prognostic ferroptosis related lncRNAs (AC253536.6, FLJ46906 LUCAT, AC022150.2) were significantly different, and the ferroptosis lncRNAs model was constrncted with them. This model divided lung squamous cell carcinoma patients into low-risk group and high-risk group. The model-based risk score was a significant independent factor for patients with lung squamous cell carcinoma (HR=2.116, 95% CI=1.513-2.961; P<0.001). In addition, the four lncRNAs were significantly enriched in metabolism and tumor classical pathways during the ferroptosis process. Conclusions The four ferroptosis lncRNAs could be molecular biomarkers and therapeutic targets for patients with lung squamous cell carcinoma.
论著

甲状腺乳头状癌碘治疗前短期严重甲减对血脂的影响

Effect of short-term severe hypothyroidism on blood lipids in patients with papillary thyroid carcinoma before iodine therapy

:47-52
 
目的 探讨甲状腺乳头状癌患者在严重短期甲减的状态下甲状腺功能及相关因素对血脂水平的影响。方法 纳入61例通过病理确诊为甲状腺乳头状癌的患者,采集所有患者在手术前与碘治疗前的甲状腺功能水平与血脂水平等资料,比较患者不同性别、年龄、术式、淋巴结转移情况等相关因素对血脂的影响。结果 碘治疗前的全部血脂指标均高于手术前的基线水平;在促甲状腺激素 (TSH)>60 mIU/L组中的总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白A1(APO-A1)、载脂蛋白B(APO-B)、脂蛋白(LP)水平明显高于TSH≤60 mIU/L组;女性患者的甘油三酯(TG)、动脉硬化指数(AI)水平明显低于男性患者,男性组的HDL-C、APO-A1水平低于女性组,年龄>45岁的患者TC水平高于年龄≤45岁的患者,差异均有统计学意义(P均<0.05);不同术式及淋巴结转移分组间的血脂水平未见明显差异(P>0.05);TC水平与游离三碘甲状原氨酸(FT3)、游离甲状腺素(FT4)、甲状腺素(T4)水平呈负相关(r分别为-0.342、-0.370、-0.340),HDL-C、LDL-C及APO-B水平与T4水平呈负相关(r分别为-0.294、-0.354、-0.324),APO-A1水平与FT4、三碘甲状腺原氨酸(T3)、T4水平呈负相关(r分别为-0.306、-0.262、-0.263),LPa水平与T3、T4水平呈负相关(r分别为-0.268、-0.313)。结论 甲状腺乳头状癌碘治疗前短期甲减可以导致全套血脂指标升高,在此甲减状态下程度越严重的甲减可产生越高的血脂水平,同时男性患者与中老年患者也可伴随更高的血脂水平。
Objectives To investigate the influence of thyroid function and related factors on blood lipid levels in patients with papillary thyroid cancer under short-term severe hypothyroidism. Methods Sixty-one patients with papillary thyroid carcinoma diagnosed by pathology were included. The data of thyroid function and blood lipid levels of all patients before operation and iodine treatment were collected. The effects of gender, age, operation mode, lymph node metastasis and other related factors on blood lipid were compared. Results Before iodine treatment, all blood lipid indexes were higher than the baseline level before operation. The levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), apolipoprotein A1 (APO-A1), apolipoprotein B (APO-B), lipoproteins (LP) in the thyroid stimulating hormone (TSH)>60 mIU/L group were significantly higher than those in the TSH≤60 mIU/L group.Triglyceride (TG) and arteriosclerosis index (AI) levels were significantly lower in female patients compared with male patients, HDL-C and APO-A1 levels were lower in male patients compared with female patients, and TC levels were higher in patients aged>45 compared with those aged≤45, with significant differences (all P<0.05). No significant differences were observed in lipid levels among the different surgical procedures and lymph node metastasis subgroups (P>0.05). TC levels were negatively correlated with free triiodothyronines (FT3), free thyroxine (FT4), thyroxine (T4) levels (r=-0.342,-0.370,-0.340,respectively). HDL-C, LDL-C, and APO-B levels were negatively correlated with T4 levels (r=-0.294, -0.354, -0.324,respectively), APO-A1 levels were negatively correlated with FT4, triiodothyronine (T3), T4 levels (r=-0.306,-0.262,-0.263,respectively), and LP levels were negatively correlated with T3 and T4 levels (r=-0.268,-0.313, respectively). Conclusions Short term hypothyroidism before iodine treatment for papillary thyroid cancer could lead to the increase of full set of blood lipid indexes, male patients and middle-aged and elderly patients could also be accompanied by higher blood lipid levels.
论著

液基细胞学检查联合SCCA、CA153检测对宫颈癌诊断的应用研究

Study on the application of liquid-based cytology combined with squamous cell carcinoma antigen and cancer antigen 153 detection in the diagnosis of cervical cancer

:43-46
 
目的 探究液基细胞学检查联合鳞状上皮细胞癌抗原(SCCA)、癌抗原153(CA153)检测对宫颈癌诊断价值。方法 对子宫颈上皮内瘤变患者54例(内瘤变组)、子宫颈癌患者54例(宫颈癌组)及健康体检者54例(对照组)进行液基细胞学、血清SCCA、血清CA153进行检测,以病理活检诊断为金标准。分析液基细胞学检查、血清中SCCA、血清中CA153对宫颈癌诊断价值,并分析联合液基细胞学检查与血清中SCCA、血清中CA153检测的临床价值。结果 内瘤变组和宫颈癌组血清SCCA、CA153水平均高于对照组,宫颈癌组血清SCCA、CA153水平高于内瘤变组(P均<0.05)。单项检测中,液基细胞学检查阳性率高于SCCA、CA153,联合检测阳性率与其他各单项检测相比明显提高(P<0.05)。结论 宫颈癌患者体内SCCA、CA153水平高,液基细胞学检查联合SCCA、CA153检测对宫颈癌早期阳性检出率高。
Objective To explore the diagnostic value of liquid-based cytology combined with squamous cell carcinoma antigen (SCCA) and cancer antigen 153 (CA153) detection in patients with cervical cancer. Methods Liquid-based cytology, serum SCCA, and serum CA153 were detected on 54 patients with cervical intraepithelial neoplasia (neoplasia group), 54 patients with cervical cancer (cancer group), and 54 healthy subjects (control group). Pathological biopsy diagnosis was used as the gold standard. The diagnostic value of liquid-based cytology, serum SCCA, and serum CA153 in cervical cancer was analyzed, and the clinical value of combining liquid-based cytology with serum SCCA and serum CA153 detection was also analyzed. Results The levels of serum SCCA and CA153 in neoplasia group and cancer group were higher than those in control group, and the serum SCCA and CA153 levels in the cancer group were higher than those in the neoplasia group (P<0.05). In the single detection, the positive rate of liquid-based cytology was higher than that of serum SCCA and CA153, and the positive rate of combined detection was significantly higher than those of the single detection (P<0.05). Conclusions Cervical cancer patients have high levels of serum SCCA and CA153. Liquid-based cytology combined with SCCA and CA153 detection has high positive rate for early cervical cancer.
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