Identification of a rare p.G320R alpha-1-antitrypsin variant in emphysema and lung cancer patients

The alpha-1-antitrypsin (A1AT) gene is highly polymorphic, with more than 100 genetic variants identified of which some can affect A1AT protein concentration and/or function and lead to pulmonary and/or liver disease. This study reports on the characterization of a p.G320R variant found in two patients, one with emphysema and the other with lung cancer. This variant results from a single base-pair substitution in exon 4 of the A1AT gene, and has been characterized as P by isoelectric focusing. Functional evaluation of the A1AT p.G320R variant was through comparing specific trypsin inhibitory activity in two patients with pulmonary disorders, carriers of the p.G320R variant, and 19 healthy individuals, carriers of normal A1AT M variants. Results showed that specific trypsin inhibitory activity was lower in both emphysema (2.45 mU/g) and lung cancer (2.07 mU/g) patients than in carriers of the normal variants (range 2.51-3.71 mU/g). This rare A1AT variant is associated with reduced functional activity of A1AT protein. Considering that it was found in patients with severe pulmonary disorders, this variant could be of clinical significance.     

Discovery of Tumor Markers for Gastric Cancer by Proteomics

Gastric cancer (GC) has a high rate of morbidity and mortality among various cancers worldwide. The development of noninvasive diagnostic methods or technologies for tracking the occurrence of GC is urgent, and searching reliable biomarkers is considered.This study intended to directly discover differential biomarkers from GC tissues by two-dimension-differential gel electrophoresis (2D-DIGE), and further validate protein expression by western blotting (WB) and immunohistochemistry (IHC).Pairs of GC tissues (gastric cancer tissues and the adjacent normal tissues) obtained from surgery was investigated for 2D-DIEG.Five proteins wereconfirmed by WB and IHC, including glucose-regulated protein 78 (GRP78), glutathione s-transferase pi (GSTpi), apolipoprotein AI (ApoAI), alpha-1 antitrypsin (A1AT) and gastrokine-1 (GKN-1). Among the results, GRP78, GSTpi and A1ATwere significantlyup-regulated and down-regulated respectively in gastric cancer patients. Moreover, GRP78 and ApoAI were correlated with A1AT for protein expressions.This study presumes these proteins could be candidates of reliable biomarkers for gastric cancer.     

Study of serum haptoglobin and its glycoforms in the diagnosis of hepatocellular carcinoma: a glycoproteomic approach

Increased serum haptoglobin concentration and changes in its glycosylation have been reported in certain cancer types. Information for hepatocellular carcinoma (HCC) has not yet been available. In this study, we aimed to carry out a systematic analysis of serum concentrations of haptoglobin (Hp) and its glycoforms in the patients with HCC and noncancer patients only with chronic liver diseases (CLD) and to examine their clinical values. This study was divided into two major parts, (1) measurement of serum Hp concentration, and investigation of its value in the diagnosis of HCC, and (2) quantitative analysis of Hp glycoforms with alpha-2,6-sialylation and/or alpha-1,6-fucosylation by using lectin affinity purification and 2D gel electrophoresis and investigation of their relationships with tumor stage. The concentrations of serum Hp in HCC patients were significantly higher than those in noncancer patients with CLD. With the use of serum concentrations of Hp and alpha-fetoprotein, a logistic regression (LR) model was developed from the training data set and used to classify the validation cases. At a specificity of 95%, the sensitivity for HCC detection was 79%. Comparing serum concentrations of alpha-2,6-sialylated Hp (S-Hp) and alpha-1,6-fucosylated Hp (F-Hp) between HCC and CLD patients suggests that purification of S-Hp and F-Hp could enrich the glycosylation variants associated with HCC. 2D gel analysis of S-Hp and F-Hp identified a total of 18 glycoforms. A unique pattern of Hp glycoforms comprising both hypersialylated fucosylated and hyposialylated fucosylated species was found in the HCC patients. Serum concentrations of these glycoproteins were significantly higher in the patients with advanced tumors, suggesting their tumor-specific nature. We have shown that serum Hp is a potential biomarker in the diagnosis of HCC. The combined use of Hp and AFP could greatly improve the diagnostic accuracy. A unique pattern of Hp glycoforms with altered sialylation and fucosylation is specific to HCC and associated tumor progression.     

Immunological profiles in workers occupationally exposed to inorganic mercury.

Forty-one male mercury-exposed workers were examined for the serum concentration levels of immunoglobulins (IgG, IgA, IgM), alpha-1-antitrypsin (A1AT), alpha-2-macroglobulin (A2M), ceruloplasmin (CPL) and orosomucoid (ORO). In the period preceding this investigation the mercury concentrations in workplace air ranged from 0.106 to 0.783 mg.m-3, the range of urinary mercury concentrations was from 0.029 to 0.545 mg.1(-1). All but two (IgG and A1AT) of the immune parameters tested were at the levels that were evidently higher than those found in a control group of 55 workers matched by age who lived in a relatively clean area. The percentage of individuals with no value out of the range of normal physiological limits was in the controls almost 80%, in the exposed 36.6% only. These findings confirm the literature data which show that an inhalation exposure to inorganic mercury may evidently have a stimulating effect on some serum proteins in humans.     

Immunological profiles in workers of a power plant burning coal rich in arsenic content

A group of 47 male adults working in a thermal power plant burning coal containing 900 to 1,500 g of arsenic per ton dry weight was examined on the blood serum immunoglobulins IgG, IgA and IgM content and levels of acute reactants alpha-1-antitrypsin (A1AT), alpha-2-macroglobulin (A2M), transferrin (TRF), orosomucoid (ORO) ceruloplasmin (CPL), and lysozyme (LYS). Investigations in the control group comprising 27 workers from another power plant in the same district where the coal content of arsenic was more than 10 times lower were analogous. The inter-group differences in means were evaluated by t-test, differences in the association of values by F-test, and the correlations with age and the length of exposure were assessed using the regression analysis method. The differences in mean IgG, IgA, IgM, LYS and A2M levels between the exposed and control groups of workers were insignificant or of borderline significance only. In contrast, differences in TRF, ORO and particularly CPL levels were statistically highly significant, in all instances P less than 0.001. In the control group, persons with abnormal values in at least two immunobiochemical tests used accounted for 3.7%, in the group of the exposed for 51% (P less than 0.002). All these findings, especially the rise in CPL concentration levels in the exposed group are discussed on the background of the rise in cancer mortality rates found previously in this group of power plant workers.     

血清PTH及肿瘤标志物在类风湿关节炎患者合并骨质疏松症诊断价值分析

摘要 目的：研究血清甲状旁腺激素（PTH）和肿瘤标志物对类风湿性关节炎合并骨质疏松症（RAOP）的诊断价值。方法：选取2019年1月-2021年12月在我院就诊的60例RAOP患者为研究对象,并选取同期在我院就诊的类风湿性关节炎（RA）患者作为对照。比较两组患者血清PTH、甲胎蛋白（AFP）、癌胚抗原（CEA）、癌抗原125（CA125）、癌抗原199（CA199）和癌抗原724（CA724）。通过pearsonr相关系数分析各指标的相关性,通过Logistic回归分析RAOP的影响因素和通过受试者工作特征（ROC）曲线分析各指标对RAOP的诊断价值。结果：（1）RAOP患者血清PTH、CA125和CA199水平均显著高于RA患者（P<0.05）,而血清CA724水平显著低于RA患者（P<0.05）,并且血清AFP和CEA水平与RA患者比较无差异（P>0.05）;（2）RAOP患者血清PTH与血清PTH水平与血清CA125和CA199水平呈正相关（P<0.05）,与血清CA724水平呈负相关（P<0.05）,与血清AFP和CEA水平不相关（P>0.05）;（3）Logistic回归分析显示：血清PTH、CA125、CA199、CA724是影响类风湿性关节炎合并骨质疏松症的独立影响因素（P<0.05）;（4）ROC曲线分析显示：血清PTH、CA125、CA199对RAOP具有诊断价值,诊断敏感性和特异性分别为90.00%和86.97%、80.36 %和78.97 %、75.62 %和75.12 %。结论：血清PTH、CA125和CA199在RAOP患者含量升高,是影响RAOP的独立危险因素,可作为诊断RAOP的指标。     

Linkage Specific Fucosylation of Alpha-1-Antitrypsin in Liver Cirrhosis and Cancer Patients: Implications for a Biomarker of Hepatocellular Carcinoma

Background

We previously reported increased levels of protein-linked fucosylation with the development of liver cancer and identified many of the proteins containing the altered glycan structures. One such protein is alpha-1-antitrypsin (A1AT). To advance these studies, we performed N-linked glycan analysis on the five major isoforms of A1AT and completed a comprehensive study of the glycosylation of A1AT found in healthy controls, patients with hepatitis C- (HCV) induced liver cirrhosis, and in patients infected with HCV with a diagnosis of hepatocellular carcinoma (HCC).

Methodology/Principal Findings

Patients with liver cirrhosis and liver cancer had increased levels of triantennary glycan-containing outer arm (α-1,3) fucosylation. Increases in core (α-1,6) fucosylation were observed only on A1AT from patients with cancer. We performed a lectin fluorophore-linked immunosorbent assay using Aleuria Aurantia lectin (AAL), specific for core and outer arm fucosylation in over 400 patients with liver disease. AAL-reactive A1AT was able to detect HCC with a sensitivity of 70% and a specificity of 86%, which was greater than that observed with the current marker of HCC, alpha-fetoprotein. Glycosylation analysis of the false positives was performed; results indicated that these patients had increases in outer arm fucosylation but not in core fucosylation, suggesting that core fucosylation is cancer specific.

Conclusions/Significance

This report details the stepwise change in the glycosylation of A1AT with the progression from liver cirrhosis to cancer and identifies core fucosylation on A1AT as an HCC specific modification.     

An evaluation of p16INK4a expression in cervical intraepithelial neoplasia specimens, including women with HIV-1

Although several studies have evaluated the role of p16INK4a as a diagnostic marker of cervical intraepithelial neoplasia (CIN) and its association with disease progression, studies regarding the role of p16INK4a in human immunodeficiency virus (HIV)-infected patients remain scarce. The present study was designed to determine the potential utility of p16INK4a as a diagnostic marker for CIN and invasive cervical cancer in HIV-positive and negative cervical specimens. An immunohistochemical analysis of p16INK4a was performed in 326 cervical tissue microarray specimens. Performance indicators were calculated and compared using receiving operating characteristics curve (ROC)/area under the curve. In HIV-1-negative women, the percentage of cells that was positive for p16INK4a expression was significantly correlated with the severity of CIN (p < 0.0001). A ROC curve with a cut-off value of 55.28% resulted in a sensitivity of 89%, a specificity of 81%, a positive predictive value of 91% and a negative predictive value of 78%. HIV-seropositive women exhibited decreased expression of p16INK4a in CIN2-3 specimens compared with HIV-negative specimens (p = 0.031). The ROC data underscore the potential utility of p16INK4a under defined conditions as a diagnostic marker for CIN 2-3 staging and invasive cervical cancer. HIV-1 infection, however, is associated with relatively reduced p16INK4a expression in CIN 2-3.     

血清CD5L对肝脏疾病患者的临床意义研究

摘要 目的：检测CD5L水平在肝脏疾病患者血清中的变化,并分析其临床意义。方法：采用ELISA法检测41例慢性肝炎患者、192例肝硬化患者、69例肝癌患者和136例健康对照血清CD5L水平。全自动生化分析仪测定肝功能指标,Spearman相关性分析用于评估CD5L与肝功能指标的关系。受试者工作曲线（receiver operator characteristic, ROC）分析血清CD5L的潜在诊断价值。结果：与健康对照相比,CD5L水平在肝炎、肝硬化、肝癌患者中显著降低（P<0.01）。肝硬化患者血清CD5L水平较肝炎及肝癌患者显著降低（P<0.01）。肝硬化代偿期和失代偿期患者血清CD5L水平无显著差异。血清CD5L水平与FIB-4指数(肝纤维化评分)呈显著负相关（r=-0.2688,P=0.0001）。Spearman相关性分析结果显示：在肝炎患者中,血清CD5L与总胆红素（T-BIL）、直接胆红素（D-BIL）、间接胆红素（I-BIL）显著正相关;在肝硬化患者中,CD5L与其他肝功指标无显著相关性;在肝癌患者中,CD5L与碱性磷酸酶（ALP）显著正相关。以健康人为对照组,肝硬化患者为病例组,ROC分析显示血清CD5L的诊断特异性为85.3%,敏感性为77.1%。结论：CD5L水平在肝炎、肝硬化及肝癌患者血清中显著降低,且在肝硬化患者中最低。CD5L水平与肝纤维化评分FIB-4指数负相关,可作为监测肝纤维化进展的潜在生物标志物。     

血清ANXA2、ANXA6、ANXA7与乳腺癌患者聚乙二醇多柔比星脂质体相关新辅助化疗方案治疗疗效的关系研究

摘要 目的：探讨血清膜联蛋白A2（ANXA2）、膜联蛋白A6（ANXA6）、膜联蛋白A7（ANXA7）与乳腺癌患者聚乙二醇多柔比星脂质体（PLD）相关新辅助化疗方案治疗疗效的关系。方法：选择2019年11月至2022年12月于山西医科大学第一医院95例行PLD相关新辅助化疗的乳腺癌患者。新辅助化疗前检测所有乳腺癌患者的血清ANXA2、ANXA6、ANXA7水平。单因素和多因素Logistic回归分析影响乳腺癌患者PLD相关新辅助化疗疗效的因素。受试者工作特征（ROC）曲线分析血清ANXA2、ANXA6、ANXA7预测乳腺癌患者PLD相关新辅助化疗疗效的价值。结果：无效组新辅助化疗前血清ANXA2、ANXA6、ANXA7水平均高于有效组（P＜0.05）。TNM分期IIIA期、ER阳性、高水平ANXA2、高水平ANXA6、高水平ANXA7是乳腺癌PLD相关新辅助化疗无效的危险因素（P＜0.05）。血清ANXA2、ANXA6、ANXA7单独检测预测乳腺癌PLD相关新辅助化疗无效的曲线下面积分别为0.783、0.774、0.821,三指标联合检测预测的曲线下面积为0.923,高于各指标单独预测效能。结论：高ANXA2、ANXA6、ANXA7水平及TNM分期ⅢA期、ER阳性均是乳腺癌患者PLD相关新辅助化疗无效的危险因素,联合检测血清ANXA2、ANXA6、ANXA7水平可提高对乳腺癌患者PLD相关新辅助化疗疗效的预测效能。     

腺苷脱氨酶及同工酶对自身免疫病诊断和病情监测的作用

摘要 目的：检测腺苷脱氨酶(ADA)及其同工酶在自身免疫病患者血清中的变化,探讨其诊断和病情监测作用。方法：收集70例系统性红斑狼疮（SLE）、114例类风湿性关节炎(RA)、55例强直性脊柱炎(AS)、及其年龄性别对应的健康血清标本。测定血清总ADA（tADA）、ADA1及ADA2活性。ROC曲线分析其诊断价值。结果：与健康对照相比,ADA活性在SLE患者血清中显著升高[tADA：15（12,20）vs 8（7,10）U/L;ADA1：3.5（2,5）vs 3（2,3）U/L;ADA2：11（8,15）vs 6（5,7）U/L;P<0.01）]。与健康对照相比,RA患者血清中tADA和ADA1活性无显著变化(P>0.05),ADA2活性水平升高[8（5.25,10）vs 7（5,9）U/L,P<0.05）];与健康对照相比,AS患者血清中tADA和ADA1活性无显著变化(P>0.05),ADA2活性升高[7（5,9）vs 6（5,7）U/L,P<0.05）]。ROC分析显示tADA及ADA2对SLE具有较好诊断价值（tADA：88.6%特异性、77.1%敏感性;ADA2：92.9%特异性、68.6%敏感性）。ADA活性对RA及AS患者无诊断价值。spearman相关性分析显示,tADA活性与SLE患者疾病活动度有一定正相关性（r=0.303,P=0.011)。结论：血清tADA活性检测可作为SLE辅助诊断和病情监测指标。     

The functional pathway analysis and clinical significance of miR-20a and its related lncRNAs in breast cancer

BackgroundmiR-20a is a critical molecule in various biological processes and cancer progression procedures. However, its relationships with lncRNAs and their functional pathway analysis in breast tumorigenesis are less intensively studied.MethodsThe expression data from TCGA database and multiple bioinformatics resources were used to check the expression levels, survival curves, interactions and functional illustrations of miR-20a and its related lncRNAs (XIST, H19 and MALAT1) in breast cancer patients. The luciferase reporter assays and Pearson's correlation analyses were utilized to verify the direct regulatory relationship between miR-20a and three lncRNAs (XIST, H19 and MALAT1). In vitro cell proliferation, migration and invasion assays, were performed to check the biological effects of miR-20a and XIST in different breast cancer cell lines. The receiver operating characteristic curve (ROC) analyses were done for evaluating diagnostic values of serum miR-20a and XIST in breast cancer patients.ResultsThe miR-20a expression was significantly up-regulated in both breast cancer samples and serum samples, and correlated with poor survival rate in breast cancer patients. LncRNAs (XIST, H19 and MALAT1) directly bound to hsa-miR-20a and were negatively correlated with hsa-miR-20a expression in breast cancer patient samples. For functional illustrations and downstream signaling pathways analysis, XIST, H19 and MALAT1 mainly shared their regulatory functions in cell motility and interleukin signaling in breast cancer progression. Additionally, over-expression of miR-20a and inhibition of XIST promoted breast cancer cell growth, migration and invasion in vitro, and serum miR-20a and XIST served as potential diagnostic biomarkers for breast cancer with the area under ROC curve (AUC) of 0.87 (95% CI = 0.78 to 0.97), and 0.78 (95% CI = 0.67 to 0.89) respectively.ConclusionsTaken together, these findings provide us novel insights and avenues for utilizing miR-20a and its related lncRNAs as potential diagnostic biomarkers and promising therapeutic targets for breast cancer treatment.     

血清细胞角蛋白19、神经元特异性烯醇化酶及鳞状上皮细胞癌抗原在小细胞肺癌诊断及病情评估中的作用研究

摘要 目的：分析血清细胞角蛋白19（CK19）、神经元特异性烯醇化酶（NSE）及鳞状上皮细胞癌抗原（SCCA）在小细胞肺癌诊断及病情评估中的作用。方法：选择我院自2020年1月至2022年7月收治的85例小细胞肺癌患者作为观察组,另选同期的85例肺部良性疾病患者作为对照组。检测两组血清CK19、NSE、SCCA表达水平,比较两组血清CK19、NSE、SCCA表达水平及其阳性率,使用ROC曲线下面积（AUC）分析上述指标对小细胞肺癌的诊断效能,观察小细胞肺癌不同分期患者血清CK19、NSE、SCCA表达水平的差异性,分析观察组治疗前后血清CK19、NSE、SCCA表达水平的变化情况。结果：观察组血清CK19、NSE、SCCA表达水平均较对照组高（P＜0.05）;观察组血清CK19、NSE和SCCA的阳性率均较对照组高（P＜0.05）;经ROC曲线分析,血清CK19、NSE联合SCCA诊断小细胞肺癌的敏感度为91.23 %,特异度为84.67 %,AUC为0.910;在85例小细胞肺癌患者中,临床分期为局限期33例、广泛期52例;广泛期患者血清CK19、NSE、SCCA表达水平均高于局限期患者（P＜0.05）。结论：血清CK19、NSE联合SCCA诊断小细胞肺癌的效能较好,三者均与患者病情严重程度有关,有利于此病的早期诊断和病情评估,值得进一步研究应用。     

A novel model and molecular therapy for Z alpha-1 antitrypsin deficiency

Animal models that closely resemble human disease can present a challenge. Particularly so in alpha-1 antitrypsin deficiency (α(1)ATD), as the mouse alpha-1 antitrypsin (α(1)AT) cluster encodes five highly related genes compared with the one in humans. The mouse PI2 homologue is closest to the α(1)AT human gene. We have changed the equivalent mouse site that results in the Z variant in man (Glu342Lys) and made both the "M" and "Z" mouse PI2 α(1)AT proteins. We have tested the ability of a small-molecular-weight compound CG to alleviate polymerisation of these mouse α(1)AT proteins as it has been shown to reduce aggregates of Z α(1)AT in man. We found that (1) CG specifically reduces the formation of polymers of recombinant mouse "Z" protein but not "M" protein; (2) whereas there is significantly more α(1)AT secreted from Chinese Hamster Ovary cells transfected with the mouse "M" α(1)AT gene than with the "Z" (20.8?±?3.9 and 6.7?±?3.6, respectively; P?相似文献   

血清降钙素原与传统感染检测指标对细菌性血流感染的临床诊断价值比较

目的比较血清降钙素原(PCT)和传统感染检测指标在细菌性血流感染中的诊断价值。方法选取我院2018年1月至11月59例血培养显示细菌感染阳性患者为血培养阳性组,选取同期63例血培养阴性患者为血培养阴性组,分析两组患者白细胞(WBC)、中性粒细胞(NEU)计数和血清PCT水平,比较PCT、WBC和NEU对细菌性血流感染的诊断阳性率和ROC曲线下面积。结果两组患者WBC、NEU计数和血清PCT水平差异均有统计学意义(均P<0.05),PCT对细菌性血流感染的诊断阳性率和ROC曲线下面积显著大于WBC和NEU(均P<0.05)。PCT诊断细菌性血流感染的灵敏度为96.6%,特异度为95.2%。结论血清PCT对细菌性血流感染具有较高的诊断价值。     

结直肠癌患者血清GDF-15、G-CSF水平与临床病理特征及预后的关系

摘要 目的：探究结直肠癌血清生长分化因子-15（GDF-15）、粒细胞集落刺激因子（G-CSF）水平与患者临床病理参数、预后的关系,并分析其对结直肠癌的诊断价值。方法：采集结直肠癌患者、结直肠腺瘤患者及健康体检志愿者的血清样本,酶联免疫吸附测定（ELISA）实验检测血清GDF-15、G-CSF;分析结直肠癌患者血清GDF-15、G-CSF水平与患者临床病理参数的关系;Kaplan Meier生存曲线分析血清GDF-15、G-CSF水平与患者预后的关系;受试者工作特征曲线（ROC）分析血清GDF-15、G-CSF水平对结直肠癌的诊断价值。结果：结直肠癌患者血清GDF-15、G-CSF水平高于结直肠腺瘤患者及健康体检志愿者（均P<0.05）;血清GDF-15水平与肿瘤直径、分化程度、远处转移及TNM分期相关（均P<0.05）;血清G-CSF水平与肿瘤分化程度、远处转移及TNM分期相关（均P<0.05）;Kaplan Meier生存曲线结果显示,血清GDF-15低表达、G-CSF低表达患者的术后5年总生存率及中位生存时间均分别高于血清GDF-15高表达、G-CSF高表达患者（均P<0.05）;ROC分析结果表明,血清GDF-15、G-CSF有较好的诊断结直肠癌的价值,血清GDF-15、G-CSF联合应用的敏感度、特异度分别为0.876、0.863。结论：结直肠癌患者血清GDF-15、G-CSF水平升高,且均与患者病情恶性进展、不良预后相关;血清GDF-15、G-CSF是诊断结直肠癌的潜在指标。     

The use of receiver operating characteristic (ROC) curves analysis in the evaluation of the diagnostic efficiency of serum pseudouridine as a tumor marker

The biochemical parameters used in this study were: (1) serum pseudouridine, expressed as nmols/mL; (2) pseudouridine index, expressed as mol to mol ratio of serum pseudouridine versus serum creatinine concentration. The receiver operating characteristic (ROC) analysis has been used to exemplify the selection of discriminant values or "cut-off points" to maximize the diagnostic utility of a biochemical tumor marker, serum pseudouridine. This marker has been used in a variety of group population samples, i.e., normal subjects, subjects affected by several nonneoplastic diseases, subjects with neoplastic disorders in less advanced or more advanced stages, and finally in a sample population of patients affected by lymphomas and leukemias of different types. An analysis of the relative ROC curves allowed the selection of cut-off values that maximize the diagnostic efficiency or, alternatively, the diagnostic sensitivity or the diagnostic specificity for pseudouridine parameters, and has allowed the comparison of the two tests to answer the same clinical question.     

腺苷脱氨酶活性对自身免疫性肝病的临床意义研究

摘要 目的：探讨腺苷脱氨酶（ADA）在自身免疫性肝病患者血清中的变化及其临床意义。方法：利用酶法试剂盒检测自身免疫性肝病患者血清中的总ADA（tADA）及其同工酶ADA1和ADA2的活性变化,利用受试者工作曲线（ROC）分析总ADA、ADA1及ADA2活性的诊断价值。利用Spearman相关性分析自身免疫性肝病患者各指标之间的相关性。结果：与对照组相比,tADA和ADA2活性在自身免疫性肝病患者血清中均极显著升高（P<0.001）,ADA1活性有一定程度升高（P=0.035）。不同自身免疫性肝病亚型患者之间的血清tADA、ADA1及ADA2活性均无显著差异。ROC分析显示,血清tADA和ADA2活性具有诊断价值,ADA1活性无诊断价值。tADA活性截断值取13.5 U/L时,诊断特异性为93.3%,敏感性为81.2%。血清ADA2活性截断值取9.5 U/L时,诊断特异性为85.0%,敏感性为83.3%。而ADA1无显著的诊断价值,ADA活性与白蛋白球蛋白比值呈显著负相关（r=-0.41,P=0.004）,与球蛋白水平具有一定程度的正相关（r=0.34,P=0.018）,与ALT呈弱正相关（r=0.29,P=0.042）,与其他指标的相关性均无统计学显著性。结论：血清tADA及ADA2活性在自身免疫性肝病患者血清中显著升高,并且具有一定的诊断价值。     

胰腺癌患者血清CEA、CA242、CA199水平变化及联合诊断的ROC曲线分析

目的:探讨胰腺癌患者血清癌胚抗原(CEA)、糖类抗原242(CA242)、糖类抗原199(CA199)水平变化,并分析上述指标对胰腺癌的联合诊断价值,为胰腺癌的临床诊断提供参考。方法:选择2014年2月至2018年2月我院收治的186例胰腺癌患者(胰腺癌组)、89例胰腺炎患者(胰腺炎组)作为研究对象,并取同期来我院检查的268例健康人作为对照组。比较三组受试者的血清CEA、CA242、CA199水平变化,对比分析血清CEA、CA242、CA199的单一以及联合诊断的准确度、特异度以及灵敏度,并绘制ROC曲线以分析上述指标的诊断价值。结果:三组受试者血清CEA、CA242、CA199水平差异具有统计学意义(P<0.05)。且胰腺炎组和胰腺癌组的血清CEA、CA242、CA199水平明显高于对照组,胰腺癌组患者的血清CEA、CA242、CA199水平明显高于胰腺炎组,差异均有统计学意义(P<0.05)。ROC曲线结果显示,CEA诊断价值最大,CA199诊断价值最小。CEA是胰腺癌单项肿瘤标志物中敏感度最高的,为85.48%;特异度最高的为CA242(96.72%);三项肿瘤标志物联合诊断的准确度增加至92.27%,敏感度增加至95.16%,特异度相比略有下降。结论:与单一肿瘤标记物诊断胰腺癌相比,CEA、CA242、CA199联合诊断的敏感度和准确度均明显升高,可以明显改善胰腺癌的漏诊率,提高患者的生存率,具有较好的临床应用价值。     

Autoimmune thyroiditis with transient thyrotoxicosis: comparison between painful thyroiditis and painless thyroiditis

Clinical and laboratory findings and long-term outcomes in 8 patients (7 women) with autoimmune thyroiditis (AT), aged 34-59 years, who had a painful tender goiter and a transient thyrotoxicosis with a low thyroid radioactive iodine uptake (RAIU), were compared with those in 15 patients (13 women) with painless thyroiditis (PT), aged 23-69 years. Six painful AT and 6 PT patients had a history of prior awareness of goiter. All patients with painful AT had a moderate or marked elevation of erythrocyte sedimentation rate and a positive result for C-reactive protein, while only 3 PT patients (group B) did. There were no significant differences between the mean age, duration of symptoms, white blood cell count, serum triiodothyronine (T3) and thyroxine (T4) concentrations, serum T3/T4 ratio and duration of thyrotoxicosis after the initial examination and prevalences of positive results for antithyroglobulin and -microsomal antibodies in the two diseases. Two of 8 painful AT patients showed a histologically chronic fibrous variant and 6 others showed chronic lymphocytic thyroiditis. All PT patients examined also showed lymphocytic thyroiditis. Two and 5 painful AT patients developed transient and persistent hypothyroidism, respectively, while 8 [7 in group A (normal ESR), 1 in group B] and 3 PT patients (1 in group A, 2 in group B) did, respectively. The mean serum thyroid-stimulating hormone level in the hypothyroid phase in painful AT patients was higher than that in PT patients.(ABSTRACT TRUNCATED AT 250 WORDS)