ObjectiveTo investigate the values of serum CEA and CA19-9 in predicting postoperative recurrence and metastasis and prognosis for gastric cancer.
MethodsPreoperative serum levels of CEA and CA19-9 were measured by electrochemiluminescence assay in 136 patients with gastric cancer. The relationships of serum CEA level, CA19-9 level to clinicopathologic features, postoperative recurrence and metastasis, and prognosis of gastric cancer were analyzed. Kaplan-Meier method (log-rank test) was used to survival analysis.
ResultsThere were 67 patients with postoperative recurrence and metastasis in 136 patients with gastric cancer. The positive rate was 48.5% (66/136) for CEA and 43.4% (59/136) for CA19-9. There was a significant correlation between CEA level and T stage, TNM stage, lymph node metastasis, or vascular invasion (P=0.011, P=0.018, P=0.021, P=0.024). There was a significant correlation between CA19-9 level and T stage or lymph node metastasis (P=0.018, P=0.045). The rate of postoperative recurrence and metastasis was 60.6% (40/66) in positive CEA, 61.0% (36/59) in positive CA19-9, 38.6% (27/70) in negative CEA, and 40.3% (31/77) in negative CA19-9, respectively. The rate of postoperative recurrence and metastasis in the positive CEA or positive CA19-9 was significantly higher than those in the negative CEA or negative CA19-9 (P=0.010, P=0.016). Kaplan-Meier analysis showed that patients with positive CEA or positive CA19-9 had worse survival than those with negative CEA or CA19-9 (P=0.003, P=0.007).
ConclusionsCEA and CA19-9 have important values in detecting recurrence and metastasis, predicting patient survival after gastric cancer surgery. Combined analysis of these markers is considered to be helpful for improving the prediction of the postoperative recurrence and metastasis and prognosis of gastric cancer.
Objective To assess the combined management of lower limb chronic venous diseases according to the CEAP classification. Methods One hundred and twenty patients were classified according to the CEAP classification. Based on clinical presentation and image study, all patients were treated with combined management plan including oppression, medication and surgery. Results All 120 patients (135 limbs) were followed up in clinic, the local recurrence rate was 18.52%(25/135). Conclusion CEAP classification expounds the developing process of lower limb chronic venous diseases. With CEAP, we can avoid the blind spot in the treatment and expand the extent of combined therapy. Accordingly, CEAP classification is useful in the treatment and diagnosis of chronic venous diseases.
Objective To observe the expression of Ezrin protein in primary carcinoma of gallbladder tissue and the levels of CEA and CA19-9 in serum of patients with primary carcinoma of gallbladder, and to explore the relationship between the expressions of these measurements and clinicopathologic characteristics. Methods Immunohistochemistry was applied to analyze the expression of Ezrin protein in primary carcinoma of gallbladder and chronic cholecystitis tissue. The levels of CEA and CA19-9 in serum and clinicopathologic characteristics of all including patients were detected with clinical measurement. All data were analyzed statistically. Results ①The positive rates of Ezrin protein in primary carcinoma of gallbladder and chronic cholecystitis tissue were 66.7% （40/60） and 30.8%（4/13）, respectively (χ2=5.57, Plt;0.05). ②There was no difference between the expression of Ezrin protein in primary carcinoma of gallbladder tissue and age or gender (Pgt;0.05). However, difference was significant between the Ezrin expression and degree of difference, pNevin stages, pTNM stages, lymph node metastasis or distant metastasis (Plt;0.05). ③There were no differences between the positive rates of CEA and CA19-9 in primary carcinoma of gallbladder and age or gender (Pgt;0.05). However, differences were significant between the positive rates of CEA and CA19-9 and pNevin stages, pTNM stages, degree of difference, lymph node metastasis or distant metastasis (Plt;0.05). ④There was some relationship between the expression of Ezrin protein and the positive rate of CEA (rs=0.213, Plt;0.05), but not with the positive rate of CA19-9 (rs=0.081, Pgt;0.05). Conclusions The high expression of Ezrin protein may promote the invasion and metastasis in primary carcinoma of gallbladder. It could be possible to decide the outcome of primary carcinoma of gallbladder through the combined analysis on the expression of Ezrin protein and the serum levels of CEA and CA19-9.
Objective To Evaluation of Accuracy and Quality of Diagnostic Test of CEA for the Diagnosis of NSCLC in Chinese Patients. Methods We searched Chinese Biological Medicine Database (CBM, 1978 to 2009) and China National Knowledge Infrastructure (CNKI, 1994 to 2009). Diagnostic tests of CEA for the diagnosis of NSCLC were included. Data were extracted, and the quality of included studies was evaluated according to the six criteria of diagnostic tests. The heterogeneity test and The Summary Receiver Operating Characteristic (SROC) curve and meta-analyses were performed by MetaDisc. Results A total of 84 relevant articles were retrieved and 11 were included in our review. Eleven studies involving 925 patients (861 NSCLC patients, all diagnosed by the gold standard) were included. Meta-analyses showed that the heterogeneity among studies was high (P=0.000 2, I2=69.1%), the pooled sensitivity was 0.542 and the pooled specificity was 0.869. Subgroup analyses indicated that 5 of the studies which used the ECLIA (P=0.376, I2=5.4%, AUC= 0.748 3) and 4 of the studies which lung adenocarcinoma (P=0.186, I2=37.6%, AUC=0.900 2) and 4 of the studies which lung squamous cell carcinoma (P=0.955，I2=0.00%, AUC=0.762 0) had no heterogeneity. serum CEA is low sensitive and high specific on the diagnosis of NSCLC. The sensitivity and diagnostic accuracy rate of CEA were higher in adenocarcionoma than squamous cell cance. Conclusion CEA could be regarded as one of the reference tests in patients with NSCLC, Serum CEA is more sensitive and specific than lung squamous cell carcinoma on lung adenocarcinoma. but more high quality trials are required.
Objective To investigate the clinical effectiveness of the total Flavones of Hippophae Rhamnoides L. (TFH) and compare its cost-effectiveness ratio with enalapril in patients with essential hypertension. Methods Among 3 971 staff members in two universities, 155 eligible patients with blood pressure (BP) ≥160/100 mmHg were screened and included in this study. By using a random number table, the patients were randomized to the two groups: TFH was given to the treatment group while enalapril in the control group. At the end of the six week, BP, total cost and cost-effectiveness ratio were measured in both TFH and enalapril groups. Results After six weeks, blood pressures in the TFH and enalapril groups decreased by 12.7±11.6/8.1±5.1 mmHg and 15.2±9.7/10.1±7.3 mmHg respectively, while the improvement rates of BP were 73.24% (52/71) and 74.65% (53/71) respectively. There were no differences between TFH and enalapril groups in lowering BP amplitude and total effectiveness rate. The incidence of side effect in TFH group was 11.27% (8/71), which was significantly lower than that of enalapril 29.6% (21/71). The total cost of TFH group was 9 294.6 RMB with the cost effectiveness ratio of 732/1 147 RMB per mmHg and 179 RMB per case. In the enalapril group, the total cost added up to 13 236 RMB with cost effectiveness ratio of 870/1 310 per mmHg and 250 RMB per case. Sensitivity analysis indicated that TFH was better than enalapril with respect to clinical economic value even when enalapril price dropped to 1.8 RMB for tablet (5 mg). Conclusion Compared with enalapril, TFH is an effective and economic drug in treating patients with hypertension.
ObjectiveTo systematically review the diagnostic value of the combined test of serum CA153, CA125 and CEA in detection of breast cancer.
MethodsClinical diagnostic tests about CA153, CA125 and CEA in patients with breast cancer were retrieved in PubMed, EMbase, CBM, The Cochrane Library (Issue 3, 2014), CNKI, VIP, and WanFang Data from January 1st, 2004 to April 16st, 2014. References of included literature were also retrieved. Literature screening according to the inclusion and exclusion criteria, data extraction and methodological quality assessment were completed by two reviewers independently. Meta-analysis was then conducted using Meta-Disc 1.4 software.
ResultsA total of 21 studies involving 4 263 subjects were enrolled. In all studies, the results of meta-analysis indicated that:the DOR, AUC and Q index of the single test (CA153) were 18.71 (95%CI 11.62 to 30.11), 0.858 9, and 0.789 7; while those of the combined test (CA153, CA125 and CEA) were 37.95 (95%CI 21.97 to 65.57), 0.959 1, 0.903 1. Compared with the single test, the diagnostic efficacy of the combined test was higher (Z=3.675, P=0.001 5).
ConclusionCompared with the detection of CA153 alone, the combined detection of CA125, CA153 and CEA has higher efficacy and accuracy in the diagnosis of breast cancer.
