BACKGROUND A noninvasive biomarker with high diagnostic performance is urgently needed for the early diagnosis of colorectal cancer(CRC).AIM To evaluate the diagnostic value of matrix metalloproteinases(MMPs)2,7 and 9...BACKGROUND A noninvasive biomarker with high diagnostic performance is urgently needed for the early diagnosis of colorectal cancer(CRC).AIM To evaluate the diagnostic value of matrix metalloproteinases(MMPs)2,7 and 9 in urine for CRC.METHODS Of 59 healthy controls,47 patients with colon polyps and 82 patients with CRC were included in this study.Carcinoembryonic antigen(CEA)in serum and MMP2,MMP7,and MMP9 in urine were detected.The combined diagnostic model of the indicators was established by binary logistic regression.The receiver operating characteristic curve(ROC)of the subjects was used to evaluate the independent and combined diagnostic value of the indicators.RESULTS The MMP2,MMP7,MMP9,and CEA levels in the CRC group differed significantly from levels in the healthy controls(P<0.05).The levels of MMP7,MMP9,and CEA also differed significantly between the CRC group and the colon polyps group(P<0.05).The area under the curve(AUC)distinguishing between the healthy control and the CRC patients using the joint model with CEA,MMP2,MMP7 and MMP9 was 0.977,and the sensitivity and specificity were 95.10%and 91.50%,respectively.For early-stage CRC,the AUC was 0.975,and the sensitivity and specificity were 94.30%and 98.30%,respectively.For advanced stage CRC,the AUC was 0.979,and the sensitivity and specificity were 95.70%and 91.50%,respectively.Using CEA,MMP7 and MMP9 to jointly established a model distinguishing the colorectal polyp group from the CRC group,the AUC was 0.849,and the sensitivity and specificity were 84.10%and 70.20%,respectively.For early-stage CRC,the AUC was 0.818,and the sensitivity and specificity were 76.30%and 72.30%,respectively.For advanced stage CRC,the AUC was 0.875,and the sensitivity and specificity were 81.80%and 72.30%,respectively.CONCLUSION MMP2,MMP7 and MMP 9 may exhibit diagnostic value for the early detection of CRC and may serve as auxiliary diagnostic markers for CRC.展开更多
AIM To evaluate the efficiency and safety of hepatic artery infusion chemotherapy(HAIC) using raltitrexed or 5-fluorouracil for colorectal cancer(CRC) liver metastasis(CRCLM).METHODS A retrospective analysis of patien...AIM To evaluate the efficiency and safety of hepatic artery infusion chemotherapy(HAIC) using raltitrexed or 5-fluorouracil for colorectal cancer(CRC) liver metastasis(CRCLM).METHODS A retrospective analysis of patients with unresectable CRCLM who failed systemic chemotherapy and were subsequently treated with HAIC at our institute from May 2013 to April 2015 was performed. A total of 24 patients were treated with 5-fluorouracil, and 18 patients were treated with raltitrexed. RESULTS The median survival time(MST) from diagnosis of CRC was 40.8 mo in the oxaliplatin plus raltitrexed(TOMOX) arm and 33.5 mo in the oxaliplatin plus 5-fluorouracil(FOLFOX) arm(P = 0.802). MST from first HAIC was 20.6 mo in the TOMOX arm and 15.4 mo in the FOLFOX arm(P = 0.734). Median progression-free survival(PFS) from first HAIC was 4.9 mo and 6.6 mo, respectively, in the TOMOX arm and FOLFOX arm(P= 0.215). Leukopenia(P = 0.026) was more common in the FOLFOX arm, and hepatic disorder(P = 0.039) was more common in the TOMOX arm. There were no treatment-related deaths in the TOMOX arm and one treatment-related death in the FOLFOX arm. Analysis of prognostic factors indicated that response to HAIC was a significant factor related to survival.CONCLUSION No significant difference in survival was observed between the TOMOX and FOLFOX arms. HAIC treatment with either TOMOX or FOLFOX was demonstrated as an efficient and safe alternative choice.展开更多
AIM To investigate the value of multiparameter joint analysis in the early diagnosis of gastric cancer(GC) in clinical practice.METHODS Concentrations of CEA, CA724 and three kinds of cytokines(TNF-α, IL-6 and IL-8) ...AIM To investigate the value of multiparameter joint analysis in the early diagnosis of gastric cancer(GC) in clinical practice.METHODS Concentrations of CEA, CA724 and three kinds of cytokines(TNF-α, IL-6 and IL-8) in 176 GC patients, 117 atypical hyperplasia patients, and 204 healthy control individuals were used for building the diagnostic model, then 58 GC patients, 41 atypical hyperplasia patients, and 66 healthy control individuals were enrolled independently. The joints of the indicators were analyzed by binary logistic regression analysis method.RESULTS For discriminating the healthy control group and the GC group, IL-6 had the best diagnostic value, and the area under curve(AUC) of joint analysis was 0.95(0.93-0.97). For the early stage and advanced stage GC, the AUC were 0.95(0.92-0.98) and 0.95(0.92-0.97). For discriminating the atypical hyperplasia group and GC group, CA724 had the best diagnostic value, and the AUC of joint analysis was 0.97(0.95-0.99). For the early stage and advanced stage GC groups, the AUC were 0.98(0.96-0.99) and 0.96(0.94-0.98). After evaluation, for discriminating the GC, early stage GC and advanced cancer group from the healthy control group, the diagnostic sensitivity was 89.66%, 84.21% and 92.31%, respectively, and the specificity was 92.42%, 90.91% and 90.91%. For discriminating the GC, early stage GC and advanced cancer groups from the atypical hyperplasia group, the diagnostic sensitivity was 87.93%, 78.95% and 92.31%, respectively, and the specificity was 87.80%, 85.37% and 90.24%.CONCLUSION We have built a diagnostic model including CEA, CA724, IL-6, IL-8, and TNF-α. It may provide potential assistance as a screening method for the early detection of GC.展开更多
AIM: To compare the efficacy and safety of chemoem-bolization alone or chemoembolization combined with hepatic arterial infusion chemotherapy(HAIC),including oxaliplatin(OXA),5-fluorouracil(5-FU) and folinic acid(CF),...AIM: To compare the efficacy and safety of chemoem-bolization alone or chemoembolization combined with hepatic arterial infusion chemotherapy(HAIC),including oxaliplatin(OXA),5-fluorouracil(5-FU) and folinic acid(CF),in inoperable hepatocellular carcinoma(HCC) without distant metastasis. METHODS: Eighty-four inoperable HCC patients were enrolled. Thirty-ninepatient sunderwent chemoembolization alone,and the other 45 patients underwent chemoembolization + HAIC(OXA/5-FU/CF) treatment non-randomly. The progression free survival(PFS),objective response rate(ORR),disease control rate(DCR) and adverse reactions were compared between the two groups.RESULTS: A significant difference in the ORR was observed between the chemoembolization alone and chemoembolization + HAIC groups. There was no statistically significant difference in DCR between the two groups. The median PFS(m PFS) showed a significant difference between the two groups. For patients with BCLC stage A/B disease,with or without vessel invasion,the chemoembolization + HAIC group showed better m PFS when compared to chemoembolization alone,but no significant difference was found in patients with BCLC stage C disease. The parameter of pain(grade Ⅲ-Ⅳ) in the chemoembolization + HAIC group was increased statistically. CONCLUSION: Chemoembolization combined with HAIC with OXA/5-FU/CF may be safe and more effective than chemoembolization alone for inoperable HCC patients without distant metastasis.展开更多
AIM To determine a panel of serum micro RNAs(mi RNAs) that could be used as novel biomarkers for diagnosis of hepatocellular carcinoma(HCC).METHODS We initially screened 9 out of 754 serum mi RNAs by Taq Man Low Densi...AIM To determine a panel of serum micro RNAs(mi RNAs) that could be used as novel biomarkers for diagnosis of hepatocellular carcinoma(HCC).METHODS We initially screened 9 out of 754 serum mi RNAs by Taq Man Low Density Array in two pooled samples respectively from 35 HCC and 35 normal controls, and then validated individually by RT-qP CR in another 114 patients and 114 controls arranged in two phases. The changes of the selected mi RNAs after operation and their prognostic value were examined.RESULTS miR-375, miR-10 a, miR-122 and miR-423 were found to be significantly higher in HCC than in controls(P < 0.0001), and the area under the receiver-operating-characteristic curve for the 4-miR NA panel was 0.995(95%CI: 0.985-1). All the four mi RNAs were significantly reduced after surgical removal of the tumors(P < 0.0001), while still higher than normal controls(at least P < 0.05)CONCLUSION The four serum miR NAs(miR-375, miR-10 a, miR-122 and miR-423) could potentially serve as novel biomarkers for the diagnostic and prognostic of HCC.展开更多
BACKGROUND In early gastric cancer(GC),tumor markers are increased in the blood.The levels of these markers have been used as important indexes for GC screening,early diagnosis and prognostic evaluation.However,specif...BACKGROUND In early gastric cancer(GC),tumor markers are increased in the blood.The levels of these markers have been used as important indexes for GC screening,early diagnosis and prognostic evaluation.However,specific tumor markers have not yet been discovered.Diagnosis based on a single tumor marker has limited significance.The detection rate of GC is still very low.AIM To improve the diagnostic value of blood markers for GC.METHODS We used a multiparameter joint analysis of 77 indexes of malignant GC and gastric polyp(GP),64 indexes of GC and healthy controls(Ctrls).RESULTS By analyzing the data,there are 27 indexes in the final Ctrls vs GC with P values<0.01,the area under the curve(AUC)of albumin is the largest in Ctrls vs GC,and the AUC was 0.907.30 indexes in GP vs GC have P values<0.01.Among them,the D-dimer showed an AUC of 0.729.The 27 indexes in Ctrls vs GC and 30 indexes in GP vs GC were used for binary logistic regression,discriminant analysis,classification tree analysis and artificial neural network analysis model.For the ability to distinguish between Ctrls vs GC,GP vs GC,artificial neural networks had better diagnostic value when compared with classification tree,binary logistic regression,and discriminant analysis.When compared Ctrl and GC,the overall prediction accuracy was 92.9%,and the AUC was 0.992(0.980,1.000).When compared GP and GC,the overall prediction accuracy was 77.9%,and the AUC was 0.969(0.948,0.990).CONCLUSION The diagnostic effect of multi-parameter joint artificial neural networks analysis is significantly better than the single-index test diagnosis,and it may provide an assistant method for the detection of GC.展开更多
AIM In our previous study, we have built a nine-gene(GPC3, HGF, ANXA1, FOS, SPAG9, HSPA1 B, CXCR4, PFN1, and CALR) expression detection system based on the Ge XP system. Based on peripheral blood and Ge XP, we aimed t...AIM In our previous study, we have built a nine-gene(GPC3, HGF, ANXA1, FOS, SPAG9, HSPA1 B, CXCR4, PFN1, and CALR) expression detection system based on the Ge XP system. Based on peripheral blood and Ge XP, we aimed to analyze the results of genes expression by different multi-parameter analysis methods and build a diagnostic model to classify hepatocellular carcinoma(HCC) patients and healthy people.METHODS Logistic regression analysis, discriminant analysis, classification tree analysis, and artificial neural network were used for the multi-parameter gene expression analysis method. One hundred and three patients with early HCC and 54 age-matched healthy normal controls were used to build a diagnostic model. Fiftytwo patients with early HCC and 34 healthy people were used for validation. The area under the curve, sensitivity, and specificity were used as diagnostic indicators.RESULTS Artificial neural network of the total nine genes had the best diagnostic value, and the AUC, sensitivity, and specificity were 0.943, 98%, and 85%, respectively. At last, 52 HCC patients and 34 healthy normal controls were used for validation. The sensitivity and specificity were 96% and 86%, respectively.CONCLUSION Multi-parameter analysis methods may increase the diagnostic value compared to single factor analysis and they may be a trend of the clinical diagnosis in the future.展开更多
BACKGROUND In hepatocellular carcinoma(HCC),abnormal expression of multiple micro RNAs(miRNAs)has been shown to be involved in the malignant biological behavior of liver cancer.The vast majority of liver cancer cases ...BACKGROUND In hepatocellular carcinoma(HCC),abnormal expression of multiple micro RNAs(miRNAs)has been shown to be involved in the malignant biological behavior of liver cancer.The vast majority of liver cancer cases in China are closely related to hepatitis B virus(HBV)infection,but there are few studies on the changes of miRNA expression in the progression from HBV infection to hepatoma.AIM To explore the role of miRNAs in the progression of HBV infection to cirrhosis and even to liver cancer.METHODS We screened differentially expressed miRNAs in 40 HBV cirrhosis,40 normal and15 HCC tissues by using a Taq Man Low Density Array and real time quantitative polymerase chain reaction.To evaluate the power of the selected miRNAs to predict disease,we calculated the area under the receiver-operating-characteristic curves.The overall survival of HBV cirrhosis patients was analyzed via KaplanMeier analysis.RESULTS The levels of miR-375,miR-122 and miR-143 were significantly lower in HBV cirrhosis tissues,while miR-224 was significantly higher than in the controls(P<0.0001).The area under the curves of the receiver-operating-characteristic curve for the 4-miRNA panel was 0.991(95%CI:0.974-1).Patients with a lower expression level of miR-224 or higher expression levels of miR-375,miR-122 and miR-143 had longer overall survival.CONCLUSIONThe four miRNAs(miR-375,miR-122,miR-143 and miR-224)may be helpful for early diagnosis of HBV infection,HBV cirrhosis,and prediction of its overall survival.展开更多
AIM To understand the cellular and molecular changes inperipheral blood that can lead to the development of hepatocellular carcinoma(HCC) and provide new methods for its diagnosis and treatment.METHODS Peripheral bloo...AIM To understand the cellular and molecular changes inperipheral blood that can lead to the development of hepatocellular carcinoma(HCC) and provide new methods for its diagnosis and treatment.METHODS Peripheral blood mononuclear cells were isolated from the peripheral blood of HCC patients and normal controls and then analyzed by flow cytometry. The percentage of transforming growth factor-β(TGF-β)+ regulatory cells(Tregs) in the peripheral blood was measured, and the expression of TGF-β was also determined. Then, the relationship between the changes and the 5-year survival of patients was analyzed. In addition, recombinant human TGF-β(rh TGF-β) and recombinant human interleukin-6 were added to stimulate the cultured cells, and their effects on HCC were evaluated.RESULTS The expression of TGF-β and the percentage of TGF-β+ Tregs in the peripheral blood of HCC patients increased significantly compared with normal controls. Compared with the low TGF-β expression group, the high TGF-β expression group had a significantly lower 5-year survival rate, and the same result was found in the two TGF-β+ Treg groups, suggesting that TGF-β and TGF-β+ Tregs were negatively correlated with the overall survival of the patients. In addition, rh TGF-β promoted the growth of tumor cells and induced high expression levels of IL-6, which further promoted tumor proliferation.CONCLUSION The results showed that TGF-β may promote tumor growth and proliferation by inducing the production of IL-6, and TGF-β and TGF-β+ Tregs may serve as new markers for predicting a poor prognosis in HCC.展开更多
BACKGROUND Transarterial chemoembolization(TACE)and hepatic arterial infusion chemotherapy(HAIC)have shown promising local benefits for advanced hepatocellular carcinoma(HCC).S-1,a composite preparation of a 5-fluorou...BACKGROUND Transarterial chemoembolization(TACE)and hepatic arterial infusion chemotherapy(HAIC)have shown promising local benefits for advanced hepatocellular carcinoma(HCC).S-1,a composite preparation of a 5-fluorouracil prodrug,has proven to be a convenient oral chemotherapeutic agent with definite efficacy against advanced HCC.AIM To evaluate the efficacy and safety of TACE followed by HAIC with or without oral S-1 for treating advanced HCC.METHODS In this single-center,open-label,prospective,randomized controlled trial,117 participants with advanced HCC were randomized to receive TACE followed by oxaliplatin-based HAIC either with(TACE/HAIC+S-1,n=56)or without(TACE/HAIC,n=61)oral S-1 between December 2013 and September 2017.Two participants were excluded from final analysis for withdrawing consent.The primary endpoint was progression-free survival(PFS)and secondary endpoints included overall survival(OS),objective response rate,disease control rate and safety.RESULTS In total,115 participants(100 males and 15 females;mean age,57.7 years±11.9)were analyzed.The median PFS and OS were 5.0 mo(0.4–58.6 mo)(95%confidence interval(CI):3.82 to 6.18)vs 4.4 mo(1.1–54.4 mo)(95%CI:2.54 to 6.26;P=0.585)and 8.4 mo(0.4–58.6 mo)(95%CI:6.88 to 9.92)vs 8.3 mo(1.4–54.4 m)(95%CI:5.71 to 10.96;P=0.985)in the TACE/HAIC+S-1 and TACE/HAIC groups,respectively.The objective response rate and disease control rate were 30.9%vs 18.4%and 72.7%vs 56.7%in the TACE/HAIC+S-1 and TACE/HAIC groups,respectively.Grade 3/4 adverse events had a similar frequency in both treatment groups.CONCLUSION No improvements in tumor response rates,PFS or OS were observed with the addition of S-1 to TACE/HAIC in advanced HCC.Both treatment regimens had a similar safety profile.展开更多
AIM: To investigate the relationship of serum levels of polyunsaturated fatty acid(PUFA) with kinds of cytokines in colorectal cancer(CRC).METHODS: Serum samples of 100 CRC patients were collected. The concentration o...AIM: To investigate the relationship of serum levels of polyunsaturated fatty acid(PUFA) with kinds of cytokines in colorectal cancer(CRC).METHODS: Serum samples of 100 CRC patients were collected. The concentration of total n-3 PUFA which included C18:3 n-3, C20:5 n-3, C22:5 n-3, C22:6 n-3 and the total n-6 PUFA included C18:2 n-6, C18:3 n-6, C20:3 n-6, C20:4 n-6, and C22:5 n-6 were detected onGC-2010 Plus Gas Chromatograph with a Omegawax TM 250 column. Cytokines were detected by Mag Plex TM-C microspheres. P values for the trend were estimated by creating a continuous variable using the median value within quartiles.RESULTS: Interleukin-6(IL-6) showed significantly positive association with the C20:4 n-6(P for trend = 0.004). Interferon gamma(IFN-γ) showed significant positive association with the C22:5 n-3(P for trend = 0.035). IL-8 and matrix metalloproteinase-9(MMP-9) showed significant inverse association with the C22:6 n-3(P for trend = 0.049, and 0.021). MMP-2 showed significant inverse association with the C20:5 n-3(P for trend = 0.008). MMP-7 showed significantly positive association with the ratio of n-6 PUFA and n-3 PUFA(P for trend = 0.008). MMP-7 also showed significantly inverse association with the ratio of C20:4 n-6 and(n-6 PUFA + n-3 PUFA)(P for trend = 0.024). IL-10(P for trend = 0.023) and IL-6(P for trend = 0.036) showed significantly positive association with the ratio of C20:4 n-6 and C20:5 n-3.CONCLUSION: Our data suggested that serum levels of PUFA is related to the inflammation of CRC, and also play different role in regulation of immune response.展开更多
BACKGROUND Hepatocellular carcinoma(HCC)is the fifth most common cancer worldwide.HCC patients suffer from a high mortality-to-incidence ratio and low cure rate since we still have no specific and effective treatment....BACKGROUND Hepatocellular carcinoma(HCC)is the fifth most common cancer worldwide.HCC patients suffer from a high mortality-to-incidence ratio and low cure rate since we still have no specific and effective treatment.Although tremendous advances have been made in the investigation of HCC,the specific mechanisms of the progression of this disease are still only partially established.Hence,more research is needed to elucidate the underlying potential mechanisms to develop effective strategies for HCC.AIM To determine the role of developing brain homeobox 2(Dbx2)gene in promoting the development of HCC.METHODS Dbx2 expression in clinical specimens and HCC cell lines was detected by Western blot(WB)and immunohistochemistry.Gain and loss of Dbx2 function assays were performed in vitro and in vivo.Cell viability assays were used to investigate cell growth,flow cytometry was employed to assess cell cycle and apoptosis,and trans-well assays were conducted to evaluate cell migration,invasion,and metastasis.The expression of key molecules in the sonic hedgehog(Shh)signaling was determined by WB.RESULTS Compared to matched adjacent non-tumorous tissues,Dbx2 was overexpressed in 5 HCC cell lines and 76 surgically resected HCC tissues.Dbx2 overexpression was correlated with large tumor size.Both gain and loss of function assays indicated that Dbx2 promoted HCC cell proliferation by facilitating the transition from G1 to S phase,attenuating apoptosis and promoted HCC proliferation,migration,and invasion in vitro and in vivo.Mechanistically,Dbx2 modulated Shh signaling by enhancing FTCH1 and GLi1 expression in HCC cells that overexpressed Dbx2,which was reversed in HCC cells with Dbx2 knockdown.CONCLUSION Our results indicate that Dbx2 is significantly upregulated in HCC tissues and plays significant roles in proliferation and metastasis of HCC cells by activating the Shh pathway.展开更多
AIM To analyze the survival data between patients diagnosed with right-sided primary(RSP) tumors and patients diagnosed with left-sided primary(LSP) tumors after hepatic arterial infusion chemotherapy(HAIC) at our cen...AIM To analyze the survival data between patients diagnosed with right-sided primary(RSP) tumors and patients diagnosed with left-sided primary(LSP) tumors after hepatic arterial infusion chemotherapy(HAIC) at our center.METHODS A retrospective analysis of pretreated metastatic colorectal cancer patients who received HAIC from May 2006 to August 2015 was conducted. A Cox proportional hazard regression analysis was used to assess the long-term survival outcomes. The mean and median age of patients was 61 years(range 27-85 years). There were 115 males and 53 females in our study.RESULTS One hundred sixty-eight patients were enrolled in this study. The overall response rate was 28.9% in LSP patients and 27.3% in RSP patients. The disease control rate was 76.3% in LSP patients and 69.7% in RSP patients. The median overall survival in response to HAIC was 16.3 mo in the LSP arm and 9.3 mo in the RSP arm(P = 0.164). The median progression-free survival was 5.7 mo in the LSP arm and 4.2 mo in the RSP arm(P = 0.851).CONCLUSION There was no significant difference in survival between LSP patients and RSP patients after HAIC. Further prospective studies are needed to confirm these findings.展开更多
BACKGROUND DNA methylation is a part of epigenetic modification,that is closely related to the growth and development of colorectal cancer(CRC).Specific methylated genes and methylated diagnostic models of tumors have...BACKGROUND DNA methylation is a part of epigenetic modification,that is closely related to the growth and development of colorectal cancer(CRC).Specific methylated genes and methylated diagnostic models of tumors have become current research focuses.The methylation status of circulating DNA in plasma might serve as a potential biomarker for CRC.AIM To investigate genome-wide methylation pattern in early CRC using the Illumina Infinium Human Methylation 850K BeadChip.METHODS The 850K Methylation BeadChip was used to analyze the genome-wide methylation status of early CRC patients(n=5)and colorectal adenoma patients(n=5).Gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathways enrichment analyses were performed on the selected differentially methylated sites to further discover candidate methylation biomarkers in plasma.RESULTS A total of 1865 methylated CpG sites with significant differences were detected,including 676 hypermethylated sites and 1189 hypomethylated sites.The distribution of these sites covered from the 1^(st) to 22^(nd) chromosomes and are mainly distributed on the gene body and gene promoter region.GO and KEGG enrichment analysis showed that the functions of these genes were related to biological regulation,molecular binding,transcription factor activity and signal transduction pathway.CONCLUSION The study demonstrated that the Illumina Infinium Human Methylation 850K BeadChip can be used to investigate genome-wide methylation status of plasma DNA in early CRC and colorectal adenoma patients.展开更多
BACKGROUND Colorectal cancer(CRC)is a highly malignant cancer with a high incidence and mortality in China.It is urgent to find a diagnostic marker with higher sensitivity and specificity than the traditional approach...BACKGROUND Colorectal cancer(CRC)is a highly malignant cancer with a high incidence and mortality in China.It is urgent to find a diagnostic marker with higher sensitivity and specificity than the traditional approaches for CRC diagnosis.AIM To provide new ideas for the diagnosis of CRC based on serum proteomics.METHODS Specimens from 83 healthy people,62 colon polyp(CRP)patients,and 101 CRC patients were analyzed by matrix-assisted laser desorption/ionization time-offlight mass spectrometry.The diagnostic value of the profiles of differentially expressed proteins was then analyzed.RESULTS Compared with the healthy control group,CRC patients had elevated expression of 5 proteins and reduced expression of 14 proteins.The area under the curve(AUC)for a differentially expressed protein with a mass-to-charge ratio of 2022.34 was the largest;the AUC was 0.843,which was higher than the AUC of 0.717 observed with carcinoembryonic antigen(CEA),and the sensitivity and specificity of this identified marker were 75.3%and 79.5%,respectively.After cross-validation,the accuracy of diagnosis using levels of this differentially expressed protein was 82.37%.Compared with the CRP group,the expression of 3 proteins in the serum of CRC patients was elevated and 11 proteins were expressed at reduced levels.Proteins possessing mass-to-charge ratio values of 2899.38 and 877.3 were selected to establish a classification tree model.The results showed that the accuracy of CRC diagnosis was 89.5%,the accuracy of CRP diagnosis was 81.6%,and the overall accuracy of this approach was 86.3%.The overall sensitivity and specificity of diagnosis using the proteomics approach were 81.8%and 66.75%,respectively.The sensitivities and specificities of diagnoses based on CEA and carbohydrate antigen 19-9 expression were 55.6%and 91.3%and 65.4%and 65.2%,respectively.CONCLUSION We demonstrated that serum proteomics may be helpful for the detection of CRC,and it may assist clinical practice for CRC diagnosis.展开更多
BACKGROUND Colorectal cancer(CRC) is the third most common cancer worldwide, and it is the second leading cause of death from cancer in the world, accounting for approximately 9% of all cancer deaths. Early detection ...BACKGROUND Colorectal cancer(CRC) is the third most common cancer worldwide, and it is the second leading cause of death from cancer in the world, accounting for approximately 9% of all cancer deaths. Early detection of CRC is urgently needed in clinical practice.AIM To build a multi-parameter diagnostic model for early detection of CRC.METHODS Total 59 colorectal polyps(CRP) groups, and 101 CRC patients(38 early-stage CRC and 63 advanced CRC) for model establishment. In addition, 30 CRP groups,and 62 CRC patients(30 early-stage CRC and 32 advanced CRC) were separately included to validate the model. 51 commonly used clinical detection indicators and the 4 extrachromosomal circular DNA markers NDUFB7, CAMK1D, PIK3CD and PSEN2 that we screened earlier. Four multi-parameter joint analysis methods:binary logistic regression analysis, discriminant analysis, classification tree and neural network to establish a multi-parameter joint diagnosis model.RESULTS Neural network included carcinoembryonic antigen(CEA), ischemia-modified albumin(IMA),sialic acid(SA), PIK3CD and lipoprotein a(LPa) was chosen as the optimal multi-parameter combined auxiliary diagnosis model to distinguish CRP and CRC group, when it differentiated 59CRP and 101 CRC, its overall accuracy was 90.8%, its area under the curve(AUC) was 0.959(0.934,0.985), and the sensitivity and specificity were 91.5% and 82.2%, respectively. After validation,when distinguishing based on 30 CRP and 62 CRC patients, the AUC was 0.965(0.930-1.000), and its sensitivity and specificity were 66.1% and 70.0%. When distinguishing based on 30 CRP and 32early-stage CRC patients, the AUC was 0.960(0.916-1.000), with a sensitivity and specificity of 87.5% and 90.0%, distinguishing based on 30 CRP and 30 advanced CRC patients, the AUC was 0.970(0.936-1.000), with a sensitivity and specificity of 96.7% and 86.7%.CONCLUSION We built a multi-parameter neural network diagnostic model included CEA, IMA, SA, PIK3CD and LPa for early detection of CRC, compared to the conventional CEA, it showed significant improvement.展开更多
BACKGROUND Gastric cancer is a common malignant tumor.Early detection and diagnosis are crucial for the prevention and treatment of gastric cancer.AIM To develop a blood index panel that may improve the diagnostic val...BACKGROUND Gastric cancer is a common malignant tumor.Early detection and diagnosis are crucial for the prevention and treatment of gastric cancer.AIM To develop a blood index panel that may improve the diagnostic value for discriminating gastric cancer and gastric polyps.METHODS Thirteen tumor-related detection indices,38 clinical biochemical indices and 10 cytokine indices were examined in 139 gastric cancer patients and 40 gastric polyp patients to build the model.An additional 68 gastric cancer patients and 22 gastric polyp patients were enrolled for validation.After area under the curve evaluation and univariate and multivariate analyses.RESULTS Five tumor-related detection indices,12 clinical biochemical indices and 1 cytokine index showed significant differences between the gastric cancer and gastric polyp groups.Carbohydrate antigen(CA)724,phosphorus(P)and ischemia-modified albumin(IMA)were included in the blood index panel,and the area under the curve(AUC)of the index panel was 0.829(0.754,0.905).After validation,the AUC was 0.811(0.700,0.923).Compared to the conventional index CA724,the blood index panel showed significantly increased diagnostic value.CONCLUSION We developed an index model that included CA724,P and IMA to discriminate the gastric cancer and gastric polyp groups,which may be a potential diagnostic method for clinical practice.展开更多
BACKGROUND Early screening for colorectal cancer(CRC)is important in clinical practice.However,the currently methods are inadequate because of high cost and low diagnostic value.AIM To develop a new examination method...BACKGROUND Early screening for colorectal cancer(CRC)is important in clinical practice.However,the currently methods are inadequate because of high cost and low diagnostic value.AIM To develop a new examination method based on the serum biomarker panel for the early detection of CRC.METHODS Three hundred and fifty cases of CRC,300 cases of colorectal polyps and 360 cases of normal controls.Combined with the results of area under curve(AUC)and correlation analysis,the binary Logistic regression analysis of the remaining indexes which is in accordance with the requirements was carried out,and discriminant analysis,classification tree and artificial neural network analysis were used to analyze the remaining indexes at the same time.RESULTS By comparison of these methods,we obtained the ability to distinguish CRC from healthy control group,malignant disease group and benign disease group.Artificial neural network had the best diagnostic value when compared with binary logistic regression,discriminant analysis,and classification tree.The AUC of CRC and the control group was 0.992(0.987,0.997),sensitivity and specificity were 98.9%and 95.6%.The AUC of the malignant disease group and benign group was 0.996(0.992,0.999),sensitivity and specificity were 97.4%and 96.7%.CONCLUSION Artificial neural network diagnosis method can improve the sensitivity and specificity of the diagnosis of CRC,and a novel assistant diagnostic method was built for the early detection of CRC.展开更多
Objective:To investigate the status quo of nursing practice environment,nurses'safety attitude,and occupational well-being,as well as to explore the relationship among the three,so as to provide reference for form...Objective:To investigate the status quo of nursing practice environment,nurses'safety attitude,and occupational well-being,as well as to explore the relationship among the three,so as to provide reference for formulating and implementing corresponding measures.Methods:A cross-sectional survey was conducted from October 2021 to December 2021.A total of 1,939 nurses from five tertiary hospitals in a city were surveyed using the Nurses5 Practice Environment Assessment Scale,Safety Attitudes Questionnaire,and Medical WorkersJ Occupational Wellbeing Scale.The data were analyzed using SPSS 22.0.Results:The total score of nurses5 practice environment was 68.81±27.79 points,which is at a relatively general level;the total score of nurses'safety attitude was 111.28±14.38 points,which is at a moderate level;and the total score of occupational well-being was 62.43±28.17 points,which is relatively high.There was a significant positive correlation between nurses'practice environment and their safety attitudes and occupational well-being(p<0.05).Conclusion:Nurses are the main human resources in hospitals,and their practice environment is closely related to patient safety and their work enthusiasm.An unhealthy practice environment not only affects the quality of care,which leads to patient safety issues,but also their job satisfaction.Nurse managers are encouraged to implement targeted interventions in advance to improve nurses,practice environment,strengthen safety attitudes,and enhance the professional wellbeing of nurses.展开更多
基金Supported by the National Key Research and Development Program of China,No.2020YFC2004604 and 2020YFC2002700.
文摘BACKGROUND A noninvasive biomarker with high diagnostic performance is urgently needed for the early diagnosis of colorectal cancer(CRC).AIM To evaluate the diagnostic value of matrix metalloproteinases(MMPs)2,7 and 9 in urine for CRC.METHODS Of 59 healthy controls,47 patients with colon polyps and 82 patients with CRC were included in this study.Carcinoembryonic antigen(CEA)in serum and MMP2,MMP7,and MMP9 in urine were detected.The combined diagnostic model of the indicators was established by binary logistic regression.The receiver operating characteristic curve(ROC)of the subjects was used to evaluate the independent and combined diagnostic value of the indicators.RESULTS The MMP2,MMP7,MMP9,and CEA levels in the CRC group differed significantly from levels in the healthy controls(P<0.05).The levels of MMP7,MMP9,and CEA also differed significantly between the CRC group and the colon polyps group(P<0.05).The area under the curve(AUC)distinguishing between the healthy control and the CRC patients using the joint model with CEA,MMP2,MMP7 and MMP9 was 0.977,and the sensitivity and specificity were 95.10%and 91.50%,respectively.For early-stage CRC,the AUC was 0.975,and the sensitivity and specificity were 94.30%and 98.30%,respectively.For advanced stage CRC,the AUC was 0.979,and the sensitivity and specificity were 95.70%and 91.50%,respectively.Using CEA,MMP7 and MMP9 to jointly established a model distinguishing the colorectal polyp group from the CRC group,the AUC was 0.849,and the sensitivity and specificity were 84.10%and 70.20%,respectively.For early-stage CRC,the AUC was 0.818,and the sensitivity and specificity were 76.30%and 72.30%,respectively.For advanced stage CRC,the AUC was 0.875,and the sensitivity and specificity were 81.80%and 72.30%,respectively.CONCLUSION MMP2,MMP7 and MMP 9 may exhibit diagnostic value for the early detection of CRC and may serve as auxiliary diagnostic markers for CRC.
基金Supported by Capital Medical Development and Scientific Research Fund,China,No.2014-2-2154
文摘AIM To evaluate the efficiency and safety of hepatic artery infusion chemotherapy(HAIC) using raltitrexed or 5-fluorouracil for colorectal cancer(CRC) liver metastasis(CRCLM).METHODS A retrospective analysis of patients with unresectable CRCLM who failed systemic chemotherapy and were subsequently treated with HAIC at our institute from May 2013 to April 2015 was performed. A total of 24 patients were treated with 5-fluorouracil, and 18 patients were treated with raltitrexed. RESULTS The median survival time(MST) from diagnosis of CRC was 40.8 mo in the oxaliplatin plus raltitrexed(TOMOX) arm and 33.5 mo in the oxaliplatin plus 5-fluorouracil(FOLFOX) arm(P = 0.802). MST from first HAIC was 20.6 mo in the TOMOX arm and 15.4 mo in the FOLFOX arm(P = 0.734). Median progression-free survival(PFS) from first HAIC was 4.9 mo and 6.6 mo, respectively, in the TOMOX arm and FOLFOX arm(P= 0.215). Leukopenia(P = 0.026) was more common in the FOLFOX arm, and hepatic disorder(P = 0.039) was more common in the TOMOX arm. There were no treatment-related deaths in the TOMOX arm and one treatment-related death in the FOLFOX arm. Analysis of prognostic factors indicated that response to HAIC was a significant factor related to survival.CONCLUSION No significant difference in survival was observed between the TOMOX and FOLFOX arms. HAIC treatment with either TOMOX or FOLFOX was demonstrated as an efficient and safe alternative choice.
基金Supported by Henan Province science and Technology Research Projects,No.162102310041National Key R&D Program of China,No.2016YFC0106604National Natural Science Foundation of China,No.81502591
文摘AIM To investigate the value of multiparameter joint analysis in the early diagnosis of gastric cancer(GC) in clinical practice.METHODS Concentrations of CEA, CA724 and three kinds of cytokines(TNF-α, IL-6 and IL-8) in 176 GC patients, 117 atypical hyperplasia patients, and 204 healthy control individuals were used for building the diagnostic model, then 58 GC patients, 41 atypical hyperplasia patients, and 66 healthy control individuals were enrolled independently. The joints of the indicators were analyzed by binary logistic regression analysis method.RESULTS For discriminating the healthy control group and the GC group, IL-6 had the best diagnostic value, and the area under curve(AUC) of joint analysis was 0.95(0.93-0.97). For the early stage and advanced stage GC, the AUC were 0.95(0.92-0.98) and 0.95(0.92-0.97). For discriminating the atypical hyperplasia group and GC group, CA724 had the best diagnostic value, and the AUC of joint analysis was 0.97(0.95-0.99). For the early stage and advanced stage GC groups, the AUC were 0.98(0.96-0.99) and 0.96(0.94-0.98). After evaluation, for discriminating the GC, early stage GC and advanced cancer group from the healthy control group, the diagnostic sensitivity was 89.66%, 84.21% and 92.31%, respectively, and the specificity was 92.42%, 90.91% and 90.91%. For discriminating the GC, early stage GC and advanced cancer groups from the atypical hyperplasia group, the diagnostic sensitivity was 87.93%, 78.95% and 92.31%, respectively, and the specificity was 87.80%, 85.37% and 90.24%.CONCLUSION We have built a diagnostic model including CEA, CA724, IL-6, IL-8, and TNF-α. It may provide potential assistance as a screening method for the early detection of GC.
基金Supported by The Capital Health Development Special Scientific Research Projects,No.2014-2-2154the Single Center Prospective Study,No.NCT01997957
文摘AIM: To compare the efficacy and safety of chemoem-bolization alone or chemoembolization combined with hepatic arterial infusion chemotherapy(HAIC),including oxaliplatin(OXA),5-fluorouracil(5-FU) and folinic acid(CF),in inoperable hepatocellular carcinoma(HCC) without distant metastasis. METHODS: Eighty-four inoperable HCC patients were enrolled. Thirty-ninepatient sunderwent chemoembolization alone,and the other 45 patients underwent chemoembolization + HAIC(OXA/5-FU/CF) treatment non-randomly. The progression free survival(PFS),objective response rate(ORR),disease control rate(DCR) and adverse reactions were compared between the two groups.RESULTS: A significant difference in the ORR was observed between the chemoembolization alone and chemoembolization + HAIC groups. There was no statistically significant difference in DCR between the two groups. The median PFS(m PFS) showed a significant difference between the two groups. For patients with BCLC stage A/B disease,with or without vessel invasion,the chemoembolization + HAIC group showed better m PFS when compared to chemoembolization alone,but no significant difference was found in patients with BCLC stage C disease. The parameter of pain(grade Ⅲ-Ⅳ) in the chemoembolization + HAIC group was increased statistically. CONCLUSION: Chemoembolization combined with HAIC with OXA/5-FU/CF may be safe and more effective than chemoembolization alone for inoperable HCC patients without distant metastasis.
基金Supported by the National Key R&D Program of China,No.2016YFC0106604National Natural Science Foundation of China,No.81502591
文摘AIM To determine a panel of serum micro RNAs(mi RNAs) that could be used as novel biomarkers for diagnosis of hepatocellular carcinoma(HCC).METHODS We initially screened 9 out of 754 serum mi RNAs by Taq Man Low Density Array in two pooled samples respectively from 35 HCC and 35 normal controls, and then validated individually by RT-qP CR in another 114 patients and 114 controls arranged in two phases. The changes of the selected mi RNAs after operation and their prognostic value were examined.RESULTS miR-375, miR-10 a, miR-122 and miR-423 were found to be significantly higher in HCC than in controls(P < 0.0001), and the area under the receiver-operating-characteristic curve for the 4-miR NA panel was 0.995(95%CI: 0.985-1). All the four mi RNAs were significantly reduced after surgical removal of the tumors(P < 0.0001), while still higher than normal controls(at least P < 0.05)CONCLUSION The four serum miR NAs(miR-375, miR-10 a, miR-122 and miR-423) could potentially serve as novel biomarkers for the diagnostic and prognostic of HCC.
基金Supported by the National Key R&D Program of China,No.2016YFC0106604National Natural Science Foundation of China,No.81502591.
文摘BACKGROUND In early gastric cancer(GC),tumor markers are increased in the blood.The levels of these markers have been used as important indexes for GC screening,early diagnosis and prognostic evaluation.However,specific tumor markers have not yet been discovered.Diagnosis based on a single tumor marker has limited significance.The detection rate of GC is still very low.AIM To improve the diagnostic value of blood markers for GC.METHODS We used a multiparameter joint analysis of 77 indexes of malignant GC and gastric polyp(GP),64 indexes of GC and healthy controls(Ctrls).RESULTS By analyzing the data,there are 27 indexes in the final Ctrls vs GC with P values<0.01,the area under the curve(AUC)of albumin is the largest in Ctrls vs GC,and the AUC was 0.907.30 indexes in GP vs GC have P values<0.01.Among them,the D-dimer showed an AUC of 0.729.The 27 indexes in Ctrls vs GC and 30 indexes in GP vs GC were used for binary logistic regression,discriminant analysis,classification tree analysis and artificial neural network analysis model.For the ability to distinguish between Ctrls vs GC,GP vs GC,artificial neural networks had better diagnostic value when compared with classification tree,binary logistic regression,and discriminant analysis.When compared Ctrl and GC,the overall prediction accuracy was 92.9%,and the AUC was 0.992(0.980,1.000).When compared GP and GC,the overall prediction accuracy was 77.9%,and the AUC was 0.969(0.948,0.990).CONCLUSION The diagnostic effect of multi-parameter joint artificial neural networks analysis is significantly better than the single-index test diagnosis,and it may provide an assistant method for the detection of GC.
基金National Key R&D Program of China,No.2016YFC0106604National Natural Science Foundation of China,No.81471761 and No.81501568
文摘AIM In our previous study, we have built a nine-gene(GPC3, HGF, ANXA1, FOS, SPAG9, HSPA1 B, CXCR4, PFN1, and CALR) expression detection system based on the Ge XP system. Based on peripheral blood and Ge XP, we aimed to analyze the results of genes expression by different multi-parameter analysis methods and build a diagnostic model to classify hepatocellular carcinoma(HCC) patients and healthy people.METHODS Logistic regression analysis, discriminant analysis, classification tree analysis, and artificial neural network were used for the multi-parameter gene expression analysis method. One hundred and three patients with early HCC and 54 age-matched healthy normal controls were used to build a diagnostic model. Fiftytwo patients with early HCC and 34 healthy people were used for validation. The area under the curve, sensitivity, and specificity were used as diagnostic indicators.RESULTS Artificial neural network of the total nine genes had the best diagnostic value, and the AUC, sensitivity, and specificity were 0.943, 98%, and 85%, respectively. At last, 52 HCC patients and 34 healthy normal controls were used for validation. The sensitivity and specificity were 96% and 86%, respectively.CONCLUSION Multi-parameter analysis methods may increase the diagnostic value compared to single factor analysis and they may be a trend of the clinical diagnosis in the future.
基金Supported by the National Key R&D Program of China,No.2016YFC0106604.
文摘BACKGROUND In hepatocellular carcinoma(HCC),abnormal expression of multiple micro RNAs(miRNAs)has been shown to be involved in the malignant biological behavior of liver cancer.The vast majority of liver cancer cases in China are closely related to hepatitis B virus(HBV)infection,but there are few studies on the changes of miRNA expression in the progression from HBV infection to hepatoma.AIM To explore the role of miRNAs in the progression of HBV infection to cirrhosis and even to liver cancer.METHODS We screened differentially expressed miRNAs in 40 HBV cirrhosis,40 normal and15 HCC tissues by using a Taq Man Low Density Array and real time quantitative polymerase chain reaction.To evaluate the power of the selected miRNAs to predict disease,we calculated the area under the receiver-operating-characteristic curves.The overall survival of HBV cirrhosis patients was analyzed via KaplanMeier analysis.RESULTS The levels of miR-375,miR-122 and miR-143 were significantly lower in HBV cirrhosis tissues,while miR-224 was significantly higher than in the controls(P<0.0001).The area under the curves of the receiver-operating-characteristic curve for the 4-miRNA panel was 0.991(95%CI:0.974-1).Patients with a lower expression level of miR-224 or higher expression levels of miR-375,miR-122 and miR-143 had longer overall survival.CONCLUSIONThe four miRNAs(miR-375,miR-122,miR-143 and miR-224)may be helpful for early diagnosis of HBV infection,HBV cirrhosis,and prediction of its overall survival.
基金Supported by the National Key R and D Program of China,No.2016YFC0106604the National Natural Science Foundation of China,No.81502591
文摘AIM To understand the cellular and molecular changes inperipheral blood that can lead to the development of hepatocellular carcinoma(HCC) and provide new methods for its diagnosis and treatment.METHODS Peripheral blood mononuclear cells were isolated from the peripheral blood of HCC patients and normal controls and then analyzed by flow cytometry. The percentage of transforming growth factor-β(TGF-β)+ regulatory cells(Tregs) in the peripheral blood was measured, and the expression of TGF-β was also determined. Then, the relationship between the changes and the 5-year survival of patients was analyzed. In addition, recombinant human TGF-β(rh TGF-β) and recombinant human interleukin-6 were added to stimulate the cultured cells, and their effects on HCC were evaluated.RESULTS The expression of TGF-β and the percentage of TGF-β+ Tregs in the peripheral blood of HCC patients increased significantly compared with normal controls. Compared with the low TGF-β expression group, the high TGF-β expression group had a significantly lower 5-year survival rate, and the same result was found in the two TGF-β+ Treg groups, suggesting that TGF-β and TGF-β+ Tregs were negatively correlated with the overall survival of the patients. In addition, rh TGF-β promoted the growth of tumor cells and induced high expression levels of IL-6, which further promoted tumor proliferation.CONCLUSION The results showed that TGF-β may promote tumor growth and proliferation by inducing the production of IL-6, and TGF-β and TGF-β+ Tregs may serve as new markers for predicting a poor prognosis in HCC.
文摘BACKGROUND Transarterial chemoembolization(TACE)and hepatic arterial infusion chemotherapy(HAIC)have shown promising local benefits for advanced hepatocellular carcinoma(HCC).S-1,a composite preparation of a 5-fluorouracil prodrug,has proven to be a convenient oral chemotherapeutic agent with definite efficacy against advanced HCC.AIM To evaluate the efficacy and safety of TACE followed by HAIC with or without oral S-1 for treating advanced HCC.METHODS In this single-center,open-label,prospective,randomized controlled trial,117 participants with advanced HCC were randomized to receive TACE followed by oxaliplatin-based HAIC either with(TACE/HAIC+S-1,n=56)or without(TACE/HAIC,n=61)oral S-1 between December 2013 and September 2017.Two participants were excluded from final analysis for withdrawing consent.The primary endpoint was progression-free survival(PFS)and secondary endpoints included overall survival(OS),objective response rate,disease control rate and safety.RESULTS In total,115 participants(100 males and 15 females;mean age,57.7 years±11.9)were analyzed.The median PFS and OS were 5.0 mo(0.4–58.6 mo)(95%confidence interval(CI):3.82 to 6.18)vs 4.4 mo(1.1–54.4 mo)(95%CI:2.54 to 6.26;P=0.585)and 8.4 mo(0.4–58.6 mo)(95%CI:6.88 to 9.92)vs 8.3 mo(1.4–54.4 m)(95%CI:5.71 to 10.96;P=0.985)in the TACE/HAIC+S-1 and TACE/HAIC groups,respectively.The objective response rate and disease control rate were 30.9%vs 18.4%and 72.7%vs 56.7%in the TACE/HAIC+S-1 and TACE/HAIC groups,respectively.Grade 3/4 adverse events had a similar frequency in both treatment groups.CONCLUSION No improvements in tumor response rates,PFS or OS were observed with the addition of S-1 to TACE/HAIC in advanced HCC.Both treatment regimens had a similar safety profile.
基金Supported by The National High Technology Research and Development Pro-gram 863, NO. 2011AA02A111The Capital Health Development Special Scientific Research Projects, NO. 2014-2-2154+1 种基金China Postdoctoral Science Special Foundation Funded Project, NO. 2014T70963China Postdoctoral Science Foundation Funded Project, NO. 2013M532110
文摘AIM: To investigate the relationship of serum levels of polyunsaturated fatty acid(PUFA) with kinds of cytokines in colorectal cancer(CRC).METHODS: Serum samples of 100 CRC patients were collected. The concentration of total n-3 PUFA which included C18:3 n-3, C20:5 n-3, C22:5 n-3, C22:6 n-3 and the total n-6 PUFA included C18:2 n-6, C18:3 n-6, C20:3 n-6, C20:4 n-6, and C22:5 n-6 were detected onGC-2010 Plus Gas Chromatograph with a Omegawax TM 250 column. Cytokines were detected by Mag Plex TM-C microspheres. P values for the trend were estimated by creating a continuous variable using the median value within quartiles.RESULTS: Interleukin-6(IL-6) showed significantly positive association with the C20:4 n-6(P for trend = 0.004). Interferon gamma(IFN-γ) showed significant positive association with the C22:5 n-3(P for trend = 0.035). IL-8 and matrix metalloproteinase-9(MMP-9) showed significant inverse association with the C22:6 n-3(P for trend = 0.049, and 0.021). MMP-2 showed significant inverse association with the C20:5 n-3(P for trend = 0.008). MMP-7 showed significantly positive association with the ratio of n-6 PUFA and n-3 PUFA(P for trend = 0.008). MMP-7 also showed significantly inverse association with the ratio of C20:4 n-6 and(n-6 PUFA + n-3 PUFA)(P for trend = 0.024). IL-10(P for trend = 0.023) and IL-6(P for trend = 0.036) showed significantly positive association with the ratio of C20:4 n-6 and C20:5 n-3.CONCLUSION: Our data suggested that serum levels of PUFA is related to the inflammation of CRC, and also play different role in regulation of immune response.
基金Supported by the National Natural Science Foundation of China,No.81571781
文摘BACKGROUND Hepatocellular carcinoma(HCC)is the fifth most common cancer worldwide.HCC patients suffer from a high mortality-to-incidence ratio and low cure rate since we still have no specific and effective treatment.Although tremendous advances have been made in the investigation of HCC,the specific mechanisms of the progression of this disease are still only partially established.Hence,more research is needed to elucidate the underlying potential mechanisms to develop effective strategies for HCC.AIM To determine the role of developing brain homeobox 2(Dbx2)gene in promoting the development of HCC.METHODS Dbx2 expression in clinical specimens and HCC cell lines was detected by Western blot(WB)and immunohistochemistry.Gain and loss of Dbx2 function assays were performed in vitro and in vivo.Cell viability assays were used to investigate cell growth,flow cytometry was employed to assess cell cycle and apoptosis,and trans-well assays were conducted to evaluate cell migration,invasion,and metastasis.The expression of key molecules in the sonic hedgehog(Shh)signaling was determined by WB.RESULTS Compared to matched adjacent non-tumorous tissues,Dbx2 was overexpressed in 5 HCC cell lines and 76 surgically resected HCC tissues.Dbx2 overexpression was correlated with large tumor size.Both gain and loss of function assays indicated that Dbx2 promoted HCC cell proliferation by facilitating the transition from G1 to S phase,attenuating apoptosis and promoted HCC proliferation,migration,and invasion in vitro and in vivo.Mechanistically,Dbx2 modulated Shh signaling by enhancing FTCH1 and GLi1 expression in HCC cells that overexpressed Dbx2,which was reversed in HCC cells with Dbx2 knockdown.CONCLUSION Our results indicate that Dbx2 is significantly upregulated in HCC tissues and plays significant roles in proliferation and metastasis of HCC cells by activating the Shh pathway.
基金Supported by Capital Foundation of Medical Development(China)No.2014-2-2154
文摘AIM To analyze the survival data between patients diagnosed with right-sided primary(RSP) tumors and patients diagnosed with left-sided primary(LSP) tumors after hepatic arterial infusion chemotherapy(HAIC) at our center.METHODS A retrospective analysis of pretreated metastatic colorectal cancer patients who received HAIC from May 2006 to August 2015 was conducted. A Cox proportional hazard regression analysis was used to assess the long-term survival outcomes. The mean and median age of patients was 61 years(range 27-85 years). There were 115 males and 53 females in our study.RESULTS One hundred sixty-eight patients were enrolled in this study. The overall response rate was 28.9% in LSP patients and 27.3% in RSP patients. The disease control rate was 76.3% in LSP patients and 69.7% in RSP patients. The median overall survival in response to HAIC was 16.3 mo in the LSP arm and 9.3 mo in the RSP arm(P = 0.164). The median progression-free survival was 5.7 mo in the LSP arm and 4.2 mo in the RSP arm(P = 0.851).CONCLUSION There was no significant difference in survival between LSP patients and RSP patients after HAIC. Further prospective studies are needed to confirm these findings.
基金Supported by National Natural Science Foundation of China,No. 81972010the National Key Research and Development Program of China,No. 2020YFC2002700, and No. 2020YFC2004604
文摘BACKGROUND DNA methylation is a part of epigenetic modification,that is closely related to the growth and development of colorectal cancer(CRC).Specific methylated genes and methylated diagnostic models of tumors have become current research focuses.The methylation status of circulating DNA in plasma might serve as a potential biomarker for CRC.AIM To investigate genome-wide methylation pattern in early CRC using the Illumina Infinium Human Methylation 850K BeadChip.METHODS The 850K Methylation BeadChip was used to analyze the genome-wide methylation status of early CRC patients(n=5)and colorectal adenoma patients(n=5).Gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathways enrichment analyses were performed on the selected differentially methylated sites to further discover candidate methylation biomarkers in plasma.RESULTS A total of 1865 methylated CpG sites with significant differences were detected,including 676 hypermethylated sites and 1189 hypomethylated sites.The distribution of these sites covered from the 1^(st) to 22^(nd) chromosomes and are mainly distributed on the gene body and gene promoter region.GO and KEGG enrichment analysis showed that the functions of these genes were related to biological regulation,molecular binding,transcription factor activity and signal transduction pathway.CONCLUSION The study demonstrated that the Illumina Infinium Human Methylation 850K BeadChip can be used to investigate genome-wide methylation status of plasma DNA in early CRC and colorectal adenoma patients.
基金Supported by National Key Research and Development Program of China,No.2020YFC2002700CAMS Initiative for Innovative Medicine,No.2016-I2M-1-007National Natural Science Foundation of China,No.81972010,and No.81500003.
文摘BACKGROUND Colorectal cancer(CRC)is a highly malignant cancer with a high incidence and mortality in China.It is urgent to find a diagnostic marker with higher sensitivity and specificity than the traditional approaches for CRC diagnosis.AIM To provide new ideas for the diagnosis of CRC based on serum proteomics.METHODS Specimens from 83 healthy people,62 colon polyp(CRP)patients,and 101 CRC patients were analyzed by matrix-assisted laser desorption/ionization time-offlight mass spectrometry.The diagnostic value of the profiles of differentially expressed proteins was then analyzed.RESULTS Compared with the healthy control group,CRC patients had elevated expression of 5 proteins and reduced expression of 14 proteins.The area under the curve(AUC)for a differentially expressed protein with a mass-to-charge ratio of 2022.34 was the largest;the AUC was 0.843,which was higher than the AUC of 0.717 observed with carcinoembryonic antigen(CEA),and the sensitivity and specificity of this identified marker were 75.3%and 79.5%,respectively.After cross-validation,the accuracy of diagnosis using levels of this differentially expressed protein was 82.37%.Compared with the CRP group,the expression of 3 proteins in the serum of CRC patients was elevated and 11 proteins were expressed at reduced levels.Proteins possessing mass-to-charge ratio values of 2899.38 and 877.3 were selected to establish a classification tree model.The results showed that the accuracy of CRC diagnosis was 89.5%,the accuracy of CRP diagnosis was 81.6%,and the overall accuracy of this approach was 86.3%.The overall sensitivity and specificity of diagnosis using the proteomics approach were 81.8%and 66.75%,respectively.The sensitivities and specificities of diagnoses based on CEA and carbohydrate antigen 19-9 expression were 55.6%and 91.3%and 65.4%and 65.2%,respectively.CONCLUSION We demonstrated that serum proteomics may be helpful for the detection of CRC,and it may assist clinical practice for CRC diagnosis.
基金Supported by National Natural Science Foundation of China,No. 81972010National Key Research and Development Program of China,No. 2020YFC2002700National Key Research and Development Program of China,No. 2020YFC2004604。
文摘BACKGROUND Colorectal cancer(CRC) is the third most common cancer worldwide, and it is the second leading cause of death from cancer in the world, accounting for approximately 9% of all cancer deaths. Early detection of CRC is urgently needed in clinical practice.AIM To build a multi-parameter diagnostic model for early detection of CRC.METHODS Total 59 colorectal polyps(CRP) groups, and 101 CRC patients(38 early-stage CRC and 63 advanced CRC) for model establishment. In addition, 30 CRP groups,and 62 CRC patients(30 early-stage CRC and 32 advanced CRC) were separately included to validate the model. 51 commonly used clinical detection indicators and the 4 extrachromosomal circular DNA markers NDUFB7, CAMK1D, PIK3CD and PSEN2 that we screened earlier. Four multi-parameter joint analysis methods:binary logistic regression analysis, discriminant analysis, classification tree and neural network to establish a multi-parameter joint diagnosis model.RESULTS Neural network included carcinoembryonic antigen(CEA), ischemia-modified albumin(IMA),sialic acid(SA), PIK3CD and lipoprotein a(LPa) was chosen as the optimal multi-parameter combined auxiliary diagnosis model to distinguish CRP and CRC group, when it differentiated 59CRP and 101 CRC, its overall accuracy was 90.8%, its area under the curve(AUC) was 0.959(0.934,0.985), and the sensitivity and specificity were 91.5% and 82.2%, respectively. After validation,when distinguishing based on 30 CRP and 62 CRC patients, the AUC was 0.965(0.930-1.000), and its sensitivity and specificity were 66.1% and 70.0%. When distinguishing based on 30 CRP and 32early-stage CRC patients, the AUC was 0.960(0.916-1.000), with a sensitivity and specificity of 87.5% and 90.0%, distinguishing based on 30 CRP and 30 advanced CRC patients, the AUC was 0.970(0.936-1.000), with a sensitivity and specificity of 96.7% and 86.7%.CONCLUSION We built a multi-parameter neural network diagnostic model included CEA, IMA, SA, PIK3CD and LPa for early detection of CRC, compared to the conventional CEA, it showed significant improvement.
基金Supported by National Key Research and Development Program of China,No.2020YFC2002700CAMS Initiative for Innovative Medicine,No.2016-I2M-1-007National Natural Science Foundation of China,No.81972010.
文摘BACKGROUND Gastric cancer is a common malignant tumor.Early detection and diagnosis are crucial for the prevention and treatment of gastric cancer.AIM To develop a blood index panel that may improve the diagnostic value for discriminating gastric cancer and gastric polyps.METHODS Thirteen tumor-related detection indices,38 clinical biochemical indices and 10 cytokine indices were examined in 139 gastric cancer patients and 40 gastric polyp patients to build the model.An additional 68 gastric cancer patients and 22 gastric polyp patients were enrolled for validation.After area under the curve evaluation and univariate and multivariate analyses.RESULTS Five tumor-related detection indices,12 clinical biochemical indices and 1 cytokine index showed significant differences between the gastric cancer and gastric polyp groups.Carbohydrate antigen(CA)724,phosphorus(P)and ischemia-modified albumin(IMA)were included in the blood index panel,and the area under the curve(AUC)of the index panel was 0.829(0.754,0.905).After validation,the AUC was 0.811(0.700,0.923).Compared to the conventional index CA724,the blood index panel showed significantly increased diagnostic value.CONCLUSION We developed an index model that included CA724,P and IMA to discriminate the gastric cancer and gastric polyp groups,which may be a potential diagnostic method for clinical practice.
基金Supported by National Key R and D Program of China,No.2016YFC0106604National Natural Science Foundation of China,No.81502591
文摘BACKGROUND Early screening for colorectal cancer(CRC)is important in clinical practice.However,the currently methods are inadequate because of high cost and low diagnostic value.AIM To develop a new examination method based on the serum biomarker panel for the early detection of CRC.METHODS Three hundred and fifty cases of CRC,300 cases of colorectal polyps and 360 cases of normal controls.Combined with the results of area under curve(AUC)and correlation analysis,the binary Logistic regression analysis of the remaining indexes which is in accordance with the requirements was carried out,and discriminant analysis,classification tree and artificial neural network analysis were used to analyze the remaining indexes at the same time.RESULTS By comparison of these methods,we obtained the ability to distinguish CRC from healthy control group,malignant disease group and benign disease group.Artificial neural network had the best diagnostic value when compared with binary logistic regression,discriminant analysis,and classification tree.The AUC of CRC and the control group was 0.992(0.987,0.997),sensitivity and specificity were 98.9%and 95.6%.The AUC of the malignant disease group and benign group was 0.996(0.992,0.999),sensitivity and specificity were 97.4%and 96.7%.CONCLUSION Artificial neural network diagnosis method can improve the sensitivity and specificity of the diagnosis of CRC,and a novel assistant diagnostic method was built for the early detection of CRC.
文摘Objective:To investigate the status quo of nursing practice environment,nurses'safety attitude,and occupational well-being,as well as to explore the relationship among the three,so as to provide reference for formulating and implementing corresponding measures.Methods:A cross-sectional survey was conducted from October 2021 to December 2021.A total of 1,939 nurses from five tertiary hospitals in a city were surveyed using the Nurses5 Practice Environment Assessment Scale,Safety Attitudes Questionnaire,and Medical WorkersJ Occupational Wellbeing Scale.The data were analyzed using SPSS 22.0.Results:The total score of nurses5 practice environment was 68.81±27.79 points,which is at a relatively general level;the total score of nurses'safety attitude was 111.28±14.38 points,which is at a moderate level;and the total score of occupational well-being was 62.43±28.17 points,which is relatively high.There was a significant positive correlation between nurses'practice environment and their safety attitudes and occupational well-being(p<0.05).Conclusion:Nurses are the main human resources in hospitals,and their practice environment is closely related to patient safety and their work enthusiasm.An unhealthy practice environment not only affects the quality of care,which leads to patient safety issues,but also their job satisfaction.Nurse managers are encouraged to implement targeted interventions in advance to improve nurses,practice environment,strengthen safety attitudes,and enhance the professional wellbeing of nurses.
基金This study was funded by the National Natural Science Foundation of China （Project No. 30571225） and The China National Science-Technology Support Program （Project No. 2006BAD08A08）.
