AIM:To investigate whether expressing biliary phenotype predicted poor outcome after the surgical treatment in primary liver cancers. METHODS:Out of 204 patients that underwent liver resection due to hepatocellular ca...AIM:To investigate whether expressing biliary phenotype predicted poor outcome after the surgical treatment in primary liver cancers. METHODS:Out of 204 patients that underwent liver resection due to hepatocellular carcinoma (HCC), liver specimens of 70 patients with HCC were evaluated for biliary components by cytokeratin (CK) 19 immunostain (CK19 - HCC and CK19 + HCC). CK19 positivity was defined as membranous and/or cytoplasmic expression in ≥ 5% of tumor cells with moderate or strong intensity. Patients with other primary liver cancers, such as com- bined HCC and cholangiocarcinoma (cHCC-CC), intrahe- patic cholangiocarcinoma (ICC) who received curative liver resection, were also included in the study. Clinical characteristics of CK19-HCC and CK19 + HCC patients, including survival outcome after curative liver resection, were compared with that of cHCC-CC and ICC patients. RESULTS: The overall survival (OS) rate of CK19 - HCC(n = 49) after the curative surgical treatment was 90.7%, and 80.4% at 1 and 5 years after the resection. OS rate of CK19 + HCC (n = 21) was 74.3%, 28.9% and OS rate of cHCC-CC (n = 22) was 66.7%, 32.2% at 1 and 5 years after the surgery. For ICC (n = 19), 1 and 5-year-OS rate was 50.2% and 14.3% after the cura-tive resection. The OS rates of CK19 + HCC and cHCC-CC were significantly lower than that of CK19-HCC, but higher than the OS rate of ICC (P = 0.000). There was no statistically significant difference in OS rate between CK19 + HCC and cHCC-CC. The disease free survival (DFS) rate of CK19-HCC was 72.0% and 54.5% at 1 and 3 years after the surgical treatment. DFS rate of CK19 + HCC was 53.3%, 34.3% and DFS rate of cHCC- CC was 51.5%, 39.2% at 1 and 3 years after the resection. For ICC, 1 and 3-year-DFS rate was 28.0% and 14.0% after the curative resection. DFS rate of CK19-HCC was significantly higher than that of ICC (P = 0.017), but marginally higher than DFS rate of either CK19 + HCC or cHCC-CC (P = 0.097, P = 0.089, respec-tively). Predictors of outcome after the surgery of primary liver cancer were pathology of the resected mass, existence of microvascular invasion and accompanying satellite nodule. CONCLUSION: Primary liver cancers with biliary components tended to show poorer surgical outcome. This suggested that immuno-phenotype of liver cancers was as important as their morphological classification.展开更多
Objective: To evaluate the diagnostic significance of detecting cytokeratin 19 (CKI9) mRNA by quantitative reverse transcription polymerase chain reaction (RT-PCR) in benign and malignant pleural effusions. Methods: C...Objective: To evaluate the diagnostic significance of detecting cytokeratin 19 (CKI9) mRNA by quantitative reverse transcription polymerase chain reaction (RT-PCR) in benign and malignant pleural effusions. Methods: CK19 mRNA was examined by quantitative RT-PCR and CK19 was detected by Enzyme-linked immunoadsorbent assay (ELISA) in 32 patients with malignant pleural effusions and 35 patients with benign pleural effusions. Results: On the threshold of 200 copies/μl, the positive rate of CK19 mRNA in patients with malignant pleural effusions was 62.5%. The positive rates of CK19 mRNA and CK19 in the malignant pleural effusions were significantly higher than those in the benign group (P<0.01). Furthermore, the positive rate of CK19 mRNA was higher than that of CK19 in the malignant group (P<0.05). Conclusion: Detection of CK19 mRNA can be a promising diagnostic marker in differential diagnosis of benign and malignant pleural effusions.展开更多
Background: We used transcatheter arterial infusion chemotherapy (TAI) for patients with T1G3 and greater than T2 bladder cancer, which was diagnosed after extensive and deep transurethral resection of bladder tumor (...Background: We used transcatheter arterial infusion chemotherapy (TAI) for patients with T1G3 and greater than T2 bladder cancer, which was diagnosed after extensive and deep transurethral resection of bladder tumor (TUR-BT), and we investigated the utility of serum cytokeratin 19 fragment (CYFRA) as a predictive factor of the response to therapy. Material and Methods: From November 2001 to November 2010, 56 patients (46 males and 10 females) with pathologically confirmed T1 G3 or greater than T2 bladder cancer after TUR-BT underwent two courses of TAI of cisplatin, methotrexate and doxorubicin as neoadjuvant setting. Then, patients underwent evaluation TUR-BT. Thereafter, the bladder was preserved in patients with superficial or undetectable tumors on TUR-BT. Advanced cases and residual bladder tumor cases were treated with total cystectomy or systemic chemotherapy. CYFRA levels were measured before and after performing TAI. Results: With this therapy, the 5-year survival rate was 85.7% in pT1G3, 82.3% in pT2, and 66.6% in greater than pT3 cases. Bladder preservation with no recurrence was observed in 58.7% of the patients. Grade III adverse events included leucopenia (6/56 patients: 10.7%). Serum CYFRA levels significantly decreased with treatment (in 4/6 patients with elevated CYFRA levels). Conclusion: These results suggest that although total cystictomy is usually indicated for T1G3 bladder cancers, bladder preservation and control of micrometastases can be achieved by performing TAI after extensive and deep TUR-BT. Our results also suggest the utility of monitoring serum CYFRA to assess the response to therapy.展开更多
目的 探讨2018版肝脏影像报告和数据系统(Liver Imaging Reporting and Data System version 2018,LI-RADS v2018)对肝细胞癌(hepatocellular carcinoma,HCC)细胞角蛋白19(cytokeratin 19,CK19)表达的术前预测及预后评估的价值。材料与...目的 探讨2018版肝脏影像报告和数据系统(Liver Imaging Reporting and Data System version 2018,LI-RADS v2018)对肝细胞癌(hepatocellular carcinoma,HCC)细胞角蛋白19(cytokeratin 19,CK19)表达的术前预测及预后评估的价值。材料与方法 回顾性分析220例术前接受MRI检查并经病理证实为HCC患者的临床、病理及影像资料,包括CK19阳性组59例,CK19阴性组161例。将患者按7∶3比例分为训练集和验证集。通过单因素与多因素logistic回归分析确定CK19阳性表达HCC的独立预测因素并构建列线图评分模型。采用受试者工作特征(receiver operating characteristic,ROC)曲线分析模型诊断效能,绘制校准曲线、决策曲线评价模型的校准性能和临床适用性。计算患者的列线图得分并进行高低风险分组,采用Kaplan-Meier生存曲线分析比较不同亚组患者的总体、早期及晚期无复发生存率。结果 晕状强化(OR=3.432,P=0.045)、环形动脉期高强化(OR=32.073,P=0.017)、靶样扩散受限(OR=12.941,P=0.006)、不光滑肿瘤边缘(OR=4.590,P=0.014)及肝胆期肿瘤-肝实质相对增强比(the relative enhancement ratio,RER)(OR=0.014,P=0.023)是CK19阳性表达HCC的独立预测因素。预测模型在训练集和验证集的曲线下面积(area under the curve,AUC)分别为0.884(95%CI:0.823~0.930)、0.748(95%CI:0.625~0.846),校准曲线、决策曲线显示模型的校准性能和临床适用性较好。CK19阳性与阴性组的总体无复发生存率、高与低风险组的总体、早期及晚期无复发生存率之间均存在显著差异(P<0.05)。结论 晕状强化、环形动脉期高强化、靶样扩散受限结合不光滑肿瘤边缘、肝胆期增强定量参数可对HCC的CK19表达进行术前风险预测,并有助于评估HCC术后复发。展开更多
AIM: To evaluate the diagnostic potential of cytokeratin-19 (CK-19) mRNA for the detection of disseminated tumor cells in blood, bone marrow and peritoneal lavage in patients with ductal adenocarcinoma of the pancreas...AIM: To evaluate the diagnostic potential of cytokeratin-19 (CK-19) mRNA for the detection of disseminated tumor cells in blood, bone marrow and peritoneal lavage in patients with ductal adenocarcinoma of the pancreas. METHODS: Sixty-eight patients with pancreatic cancer (n = 37), chronic pancreatitis (n = 16), and non-pan- creatic benign surgical diseases (n = 15, control group) were included in the study. Venous blood was taken preoperatively, intraoperatively and at postoperative d 1 and 10. Preoperative bone marrow aspirates and peritoneal lavage taken before mobilization of the tumor were analyzed. All samples were evaluated for disseminated tumor cells by CK-19-specific nested-PCR and quantitative fluorogenic RT-PCR. RESULTS: CK-19 mRNA expression was increased in 24 (64%) blood samples and 11 (30%) of the peritoneal lavage samples in the patients with pancreatic cancer. In 15 (40%) of the patients with pancreatic cancer, disseminated tumor cells were detected in venous blood and bone marrow and/or peritoneal lavage. In the peritoneal lavage, the detection rates were correlated with the tumor size and the tumor differentiation. CK-19 levels were increased in pT3/T4 and moderately/poorly differentiated tumors (G2/G3). Pancreatic cancer patients with at least one CK-19 mRNA-positive sample showed a trend towards shorter survival. Pancreatic cancerpatients showed significantly increased detection rates of disseminated tumor cells in blood and peritoneal lavage compared to the controls and the patients with chronic pancreatitis. CONCLUSION: Disseminated tumor cells can be detected in patients with pancreatic ductal adenocar- cinoma by CK-19 fluorogenic RT-PCR. In peritoneal lavage, detection rate is correlated with tumor stage and differentiation. In the clinical use, CK-19 is suitable for the distinction between malignant and benign pancreatic disease in combination with other tumor-specific markers.展开更多
目的探讨术前细胞角蛋白19片段(cytokeratin fragment 19,CYFRA21-1)联合癌胚抗原(carcinoembryonic antigen,CEA)检测对T2期非小细胞肺癌患者淋巴结转移的预测价值。方法回顾性分析2020年1月至2022年10月在首都医科大学附属北京胸科医...目的探讨术前细胞角蛋白19片段(cytokeratin fragment 19,CYFRA21-1)联合癌胚抗原(carcinoembryonic antigen,CEA)检测对T2期非小细胞肺癌患者淋巴结转移的预测价值。方法回顾性分析2020年1月至2022年10月在首都医科大学附属北京胸科医院接受手术治疗的448例T2期非小细胞肺癌患者的临床病理资料,根据术前肿瘤标志物CYFRA21-1、CEA的表达水平将其分为高表达组(CYFRA21-1≥6ng/ml或CEA≥6ng/ml,168例)和低表达组(CYFRA21-1<6ng/ml且CEA<6ng/ml,280例),比较两组患者的性别、年龄、吸烟史、病理类型、肿瘤大小及位置、淋巴结转移发生率和侵及程度。结果高表达组淋巴结转移发生率为51.19%(86/168),明显高于低表达组的28.21%(79/280),差异有显著性(P<0.001)。进一步分析显示肿瘤标志物高表达率在N2组为54.74%(52/95),N1组为48.57%(34/70),N0组为28.98%(82/283),不同淋巴结侵及程度组间比较差异均有显著性(P<0.001)。结论CYFRA21-1和CEA表达水平与T2期非小细胞肺癌淋巴结转移的发生率和侵及程度相关,术前检测CYFRA21-1和CEA可评估T2期非小细胞肺癌患者的淋巴结转移风险,对术中有针对性的淋巴结清扫及术后优化辅助治疗具有重要的参考价值。展开更多
文摘AIM:To investigate whether expressing biliary phenotype predicted poor outcome after the surgical treatment in primary liver cancers. METHODS:Out of 204 patients that underwent liver resection due to hepatocellular carcinoma (HCC), liver specimens of 70 patients with HCC were evaluated for biliary components by cytokeratin (CK) 19 immunostain (CK19 - HCC and CK19 + HCC). CK19 positivity was defined as membranous and/or cytoplasmic expression in ≥ 5% of tumor cells with moderate or strong intensity. Patients with other primary liver cancers, such as com- bined HCC and cholangiocarcinoma (cHCC-CC), intrahe- patic cholangiocarcinoma (ICC) who received curative liver resection, were also included in the study. Clinical characteristics of CK19-HCC and CK19 + HCC patients, including survival outcome after curative liver resection, were compared with that of cHCC-CC and ICC patients. RESULTS: The overall survival (OS) rate of CK19 - HCC(n = 49) after the curative surgical treatment was 90.7%, and 80.4% at 1 and 5 years after the resection. OS rate of CK19 + HCC (n = 21) was 74.3%, 28.9% and OS rate of cHCC-CC (n = 22) was 66.7%, 32.2% at 1 and 5 years after the surgery. For ICC (n = 19), 1 and 5-year-OS rate was 50.2% and 14.3% after the cura-tive resection. The OS rates of CK19 + HCC and cHCC-CC were significantly lower than that of CK19-HCC, but higher than the OS rate of ICC (P = 0.000). There was no statistically significant difference in OS rate between CK19 + HCC and cHCC-CC. The disease free survival (DFS) rate of CK19-HCC was 72.0% and 54.5% at 1 and 3 years after the surgical treatment. DFS rate of CK19 + HCC was 53.3%, 34.3% and DFS rate of cHCC- CC was 51.5%, 39.2% at 1 and 3 years after the resection. For ICC, 1 and 3-year-DFS rate was 28.0% and 14.0% after the curative resection. DFS rate of CK19-HCC was significantly higher than that of ICC (P = 0.017), but marginally higher than DFS rate of either CK19 + HCC or cHCC-CC (P = 0.097, P = 0.089, respec-tively). Predictors of outcome after the surgery of primary liver cancer were pathology of the resected mass, existence of microvascular invasion and accompanying satellite nodule. CONCLUSION: Primary liver cancers with biliary components tended to show poorer surgical outcome. This suggested that immuno-phenotype of liver cancers was as important as their morphological classification.
文摘Objective: To evaluate the diagnostic significance of detecting cytokeratin 19 (CKI9) mRNA by quantitative reverse transcription polymerase chain reaction (RT-PCR) in benign and malignant pleural effusions. Methods: CK19 mRNA was examined by quantitative RT-PCR and CK19 was detected by Enzyme-linked immunoadsorbent assay (ELISA) in 32 patients with malignant pleural effusions and 35 patients with benign pleural effusions. Results: On the threshold of 200 copies/μl, the positive rate of CK19 mRNA in patients with malignant pleural effusions was 62.5%. The positive rates of CK19 mRNA and CK19 in the malignant pleural effusions were significantly higher than those in the benign group (P<0.01). Furthermore, the positive rate of CK19 mRNA was higher than that of CK19 in the malignant group (P<0.05). Conclusion: Detection of CK19 mRNA can be a promising diagnostic marker in differential diagnosis of benign and malignant pleural effusions.
文摘Background: We used transcatheter arterial infusion chemotherapy (TAI) for patients with T1G3 and greater than T2 bladder cancer, which was diagnosed after extensive and deep transurethral resection of bladder tumor (TUR-BT), and we investigated the utility of serum cytokeratin 19 fragment (CYFRA) as a predictive factor of the response to therapy. Material and Methods: From November 2001 to November 2010, 56 patients (46 males and 10 females) with pathologically confirmed T1 G3 or greater than T2 bladder cancer after TUR-BT underwent two courses of TAI of cisplatin, methotrexate and doxorubicin as neoadjuvant setting. Then, patients underwent evaluation TUR-BT. Thereafter, the bladder was preserved in patients with superficial or undetectable tumors on TUR-BT. Advanced cases and residual bladder tumor cases were treated with total cystectomy or systemic chemotherapy. CYFRA levels were measured before and after performing TAI. Results: With this therapy, the 5-year survival rate was 85.7% in pT1G3, 82.3% in pT2, and 66.6% in greater than pT3 cases. Bladder preservation with no recurrence was observed in 58.7% of the patients. Grade III adverse events included leucopenia (6/56 patients: 10.7%). Serum CYFRA levels significantly decreased with treatment (in 4/6 patients with elevated CYFRA levels). Conclusion: These results suggest that although total cystictomy is usually indicated for T1G3 bladder cancers, bladder preservation and control of micrometastases can be achieved by performing TAI after extensive and deep TUR-BT. Our results also suggest the utility of monitoring serum CYFRA to assess the response to therapy.
文摘目的 探讨2018版肝脏影像报告和数据系统(Liver Imaging Reporting and Data System version 2018,LI-RADS v2018)对肝细胞癌(hepatocellular carcinoma,HCC)细胞角蛋白19(cytokeratin 19,CK19)表达的术前预测及预后评估的价值。材料与方法 回顾性分析220例术前接受MRI检查并经病理证实为HCC患者的临床、病理及影像资料,包括CK19阳性组59例,CK19阴性组161例。将患者按7∶3比例分为训练集和验证集。通过单因素与多因素logistic回归分析确定CK19阳性表达HCC的独立预测因素并构建列线图评分模型。采用受试者工作特征(receiver operating characteristic,ROC)曲线分析模型诊断效能,绘制校准曲线、决策曲线评价模型的校准性能和临床适用性。计算患者的列线图得分并进行高低风险分组,采用Kaplan-Meier生存曲线分析比较不同亚组患者的总体、早期及晚期无复发生存率。结果 晕状强化(OR=3.432,P=0.045)、环形动脉期高强化(OR=32.073,P=0.017)、靶样扩散受限(OR=12.941,P=0.006)、不光滑肿瘤边缘(OR=4.590,P=0.014)及肝胆期肿瘤-肝实质相对增强比(the relative enhancement ratio,RER)(OR=0.014,P=0.023)是CK19阳性表达HCC的独立预测因素。预测模型在训练集和验证集的曲线下面积(area under the curve,AUC)分别为0.884(95%CI:0.823~0.930)、0.748(95%CI:0.625~0.846),校准曲线、决策曲线显示模型的校准性能和临床适用性较好。CK19阳性与阴性组的总体无复发生存率、高与低风险组的总体、早期及晚期无复发生存率之间均存在显著差异(P<0.05)。结论 晕状强化、环形动脉期高强化、靶样扩散受限结合不光滑肿瘤边缘、肝胆期增强定量参数可对HCC的CK19表达进行术前风险预测,并有助于评估HCC术后复发。
文摘AIM: To evaluate the diagnostic potential of cytokeratin-19 (CK-19) mRNA for the detection of disseminated tumor cells in blood, bone marrow and peritoneal lavage in patients with ductal adenocarcinoma of the pancreas. METHODS: Sixty-eight patients with pancreatic cancer (n = 37), chronic pancreatitis (n = 16), and non-pan- creatic benign surgical diseases (n = 15, control group) were included in the study. Venous blood was taken preoperatively, intraoperatively and at postoperative d 1 and 10. Preoperative bone marrow aspirates and peritoneal lavage taken before mobilization of the tumor were analyzed. All samples were evaluated for disseminated tumor cells by CK-19-specific nested-PCR and quantitative fluorogenic RT-PCR. RESULTS: CK-19 mRNA expression was increased in 24 (64%) blood samples and 11 (30%) of the peritoneal lavage samples in the patients with pancreatic cancer. In 15 (40%) of the patients with pancreatic cancer, disseminated tumor cells were detected in venous blood and bone marrow and/or peritoneal lavage. In the peritoneal lavage, the detection rates were correlated with the tumor size and the tumor differentiation. CK-19 levels were increased in pT3/T4 and moderately/poorly differentiated tumors (G2/G3). Pancreatic cancer patients with at least one CK-19 mRNA-positive sample showed a trend towards shorter survival. Pancreatic cancerpatients showed significantly increased detection rates of disseminated tumor cells in blood and peritoneal lavage compared to the controls and the patients with chronic pancreatitis. CONCLUSION: Disseminated tumor cells can be detected in patients with pancreatic ductal adenocar- cinoma by CK-19 fluorogenic RT-PCR. In peritoneal lavage, detection rate is correlated with tumor stage and differentiation. In the clinical use, CK-19 is suitable for the distinction between malignant and benign pancreatic disease in combination with other tumor-specific markers.
文摘目的探讨术前细胞角蛋白19片段(cytokeratin fragment 19,CYFRA21-1)联合癌胚抗原(carcinoembryonic antigen,CEA)检测对T2期非小细胞肺癌患者淋巴结转移的预测价值。方法回顾性分析2020年1月至2022年10月在首都医科大学附属北京胸科医院接受手术治疗的448例T2期非小细胞肺癌患者的临床病理资料,根据术前肿瘤标志物CYFRA21-1、CEA的表达水平将其分为高表达组(CYFRA21-1≥6ng/ml或CEA≥6ng/ml,168例)和低表达组(CYFRA21-1<6ng/ml且CEA<6ng/ml,280例),比较两组患者的性别、年龄、吸烟史、病理类型、肿瘤大小及位置、淋巴结转移发生率和侵及程度。结果高表达组淋巴结转移发生率为51.19%(86/168),明显高于低表达组的28.21%(79/280),差异有显著性(P<0.001)。进一步分析显示肿瘤标志物高表达率在N2组为54.74%(52/95),N1组为48.57%(34/70),N0组为28.98%(82/283),不同淋巴结侵及程度组间比较差异均有显著性(P<0.001)。结论CYFRA21-1和CEA表达水平与T2期非小细胞肺癌淋巴结转移的发生率和侵及程度相关,术前检测CYFRA21-1和CEA可评估T2期非小细胞肺癌患者的淋巴结转移风险,对术中有针对性的淋巴结清扫及术后优化辅助治疗具有重要的参考价值。
