Significance of Serum Pepsinogens as a Biomarker for Gastric Cancer and Atrophic Gastritis Screening: A Systematic Review and Meta-Analysis

Background

Human pepsinogens are considered promising serological biomarkers for the screening of atrophic gastritis (AG) and gastric cancer (GC). However, there has been controversy in the literature with respect to the validity of serum pepsinogen (SPG) for the detection of GC and AG. Consequently, we conducted a systematic review and meta-analysis to assess the diagnostic accuracy of SPG in GC and AG detection.

Methods

We searched PubMed, Embase, and the Chinese National Knowledge Infrastructure (CNKI) for correlative original studies published up to September 30, 2014. The summary sensitivity, specificity, positive diagnostic likelihood ratio (DLR+), negative diagnostic likelihood ratio (DLR-), area under the summary receiver operating characteristic curve (AUC) and diagnostic odds ratio (DOR) were used to evaluate SPG in GC and AG screening based on bivariate random effects models. The inter-study heterogeneity was evaluated by the I² statistics and publication bias was assessed using Begg and Mazumdar’s test. Meta-regression and subgroup analyses were performed to explore study heterogeneity.

Results

In total, 31 studies involving 1,520 GC patients and 2,265 AG patients were included in the meta-analysis. The summary sensitivity, specificity, DLR+, DLR-, AUC and DOR for GC screening using SPG were 0.69 (95% CI: 0.60–0.76), 0.73 (95% CI: 0.62–0.82), 2.57 (95% CI: 1.82–3.62), and 0.43 (95% CI: 0.34–0.54), 0.76 (95% CI: 0.72–0.80) and 6.01 (95% CI: 3.69–9.79), respectively. For AG screening, the summary sensitivity, specificity, DLR+, DLR-, AUC and DOR were 0.69 (95% CI: 0.55–0.80), 0.88 (95% CI: 0.77–0.94), 5.80 (95% CI: 3.06–10.99), and 0.35 (95% CI: 0.24–0.51), 0.85 (95% CI: 0.82–0.88) and 16.50 (95% CI: 8.18–33.28), respectively. In subgroup analysis, the use of combination of concentration of PGI and the ratio of PGI:PGII as measurement of SPG for GC screening yielded sensitivity of 0.70 (95% CI: 0.66–0.75), specificity of 0.79 (95% CI: 0.79–0.80), DOR of 6.92 (95% CI: 4.36–11.00), and AUC of 0.78 (95% CI: 0.72–0.81), while the use of concentration of PGI yielded sensitivity of 0.55 (95% CI: 0.51–0.60), specificity of 0.79 (95% CI: 0.76–0.82), DOR of 6.88 (95% CI: 2.30–20.60), and AUC of 0.77 (95% CI: 0.73–0.92). For AG screening, the use of ratio of PGI:PGII as measurement of SPG yielded sensitivity of 0.69 (95% CI: 0.52–0.83), specificity of 0.84 (95% CI: 0.68–0.93), DOR of 11.51 (95% CI: 6.14–21.56), and AUC of 0.83 (95% CI: 0.80–0.86), the use of combination of concentration of PGI and the ratio of PGI:PGII yield sensitivity of 0.79 (95% CI: 0.72–0.85), specificity of 0.89 (95% CI: 0.85–0.93), DOR of 24.64 (95% CI: 6.95–87.37), and AUC of 0.87 (95% CI: 0.81–0.92), concurrently, the use of concentration of PGI yield sensitivity of 0.46 (95% CI: 0.38–0.54), specificity of 0.93 (95% CI: 0.91–0.95), DOR of 19.86 (95% CI: 0.86–456.91), and AUC of 0.86 (95% CI: 0.52–1.00).

Conclusion

SPG has great potential as a noninvasive, population-based screening tool in GC and AG screening. In addition, given the potential publication bias and high heterogeneity of the included studies, further high quality studies are required in the future.     

Aquaporin 5 Plays a Role in Estrogen-Induced Ectopic Implantation of Endometrial Stromal Cells in Endometriosis

Aquaporin 5 (AQP5) participates in the migration of endometrial cells. Elucidation of the molecular mechanisms associated with AQP5-mediated, migration of endometrial cells may contribute to a better understanding of endometriosis. Our objectives included identifying the estrogen-response element (ERE) in the promoter region of the AQP5 gene, and, investigating the effects of AQP5 on ectopic implantation of endometrial cells. Luciferase reporter assays and electrophoretic mobility shift assay (EMSA) identified the ERE-like motif in the promoter region of the AQP5 gene. After blocking and up-regulating estradiol (E₂) levels, we analysed the expression of AQP5 in endometrial stromal (ES) cells. After blocking E₂ /or phosphatidylinositol 3 kinase(PI3K), we analysed the role of AQP5 in signaling pathways. We constructed an AQP5, shRNA, lentiviral vector to knock out the AQP5 gene in ES cells. After knock-out of the AQP5 gene, we studied the role of AQP5 in cell invasion, proliferation, and the formation of ectopic endometrial implants in female mice. We identified an estrogen-response element in the promoter region of the AQP5 gene. Estradiol (E₂) increased AQP5 expression in a dose-dependent fashion, that was blocked by ICI182,780(an estrogen receptor inhibitor). E₂ activated PI3K /protein kinase B(AKT) pathway (PI3K/AKT), that, in turn, increased AQP5 expression. {"type":"entrez-nucleotide","attrs":{"text":"LY294002","term_id":"1257998346","term_text":"LY294002"}}LY294002(PI3K inhibitor) attenuated estrogen-enhanced, AQP5 expression. Knock-out of the AQP5 gene with AQP5 shRNA lentiviral vector significantly inhibited E₂-enhanced invasion, proliferation of ES cells and formation of ectopic implants. Estrogen induces AQP5 expression by activating ERE in the promoter region of the AQP5gene, activates the PI3K/AKT pathway, and, promotes endometrial cell invasion and proliferation. These results provide new insights into some of the mechanisms that may underpin the development of deposits of ectopic endometrium.     

长期施肥对黑土大豆根瘤菌群体结构和多样性的影响

为揭示长期施肥对黑土大豆根瘤菌群体结构和多样性的影响,采用BOX-PCR、IGS-PCR-RFLP和16S r DNA基因序列分析法,对分离自黑龙江省7种长期不同施肥处理的254株大豆根瘤菌进行了遗传多样性和系统发育分析,结合土壤理化性质分析了大豆根瘤菌群体结构和多样性与土壤因子间的关系。7种处理分别为不施肥(CK)、有机肥(OM)、单施氮肥(N1)、单施2倍氮肥(N2)、氮肥+有机肥(N1+OM)、氮肥磷肥混施(N1P1)和2倍氮肥磷肥混施(N2P2)。系统发育分析结果表明,所有供试菌株均为慢生根瘤菌属(Bradyrhizobium),其中大部分菌株与日本慢生大豆根瘤菌(Bradyrhizobium japonicum)相似性最高,少部分菌株与辽宁慢生大豆根瘤菌(Bradyrhizobium liaoningense)相似性最高。BOX-PCR聚类分析结果表明,供试菌株在70%相似性水平上分为15个群,在与施肥处理相关性分析中分为3个群体,分别对应于不施化肥处理(CK和OM)、化学氮肥处理(N1、N2、N1+OM)、氮肥磷肥处理(N1P1和N2P2)。典范对应分析结果表明,土壤p H、速效氮和速效磷与根瘤菌群体结构相关性极显著(P=0.002,0.004,0.002)。不同施肥措施下大豆根瘤菌的多样性有明显差异:N2P2处理的丰富度指数和Shannon-Wiener指数显著高于其他处理;OM处理的Simpson指数最高;N1和N2处理的3种多样性指数都显著低于其他处理。通径分析结果表明,p H、速效磷对多样性指数有较高的直接正效应;速效氮通过p H的间接负效应影响多样性指数。本研究表明,长期施用化肥改变了根瘤菌群体结构,单施氮肥减少大豆根瘤菌多样性,而氮肥磷肥混施则有助于提高大豆根瘤菌多样性。     

Estimates of subtropical forest biomass based on airborne LiDAR and Landsat 8 OLI data

 快速、定量、精确地估算区域森林生物量一直是森林生态功能评价以及碳储量研究的重要问题。该研究基于机载激光雷达(LiDAR)点云与Landsat 8 OLI多光谱数据, 借助江苏省常熟市虞山地区55块调查样地数据, 首先提取并分析了87个特征变量(53个OLI特征变量, 34个LiDAR特征变量)与森林地上、地下生物量的Pearson’s相关系数以进行变量优选, 然后利用多元逐步回归法建立森林生物量估算模型(OLI生物量估算模型和LiDAR生物量估算模型), 并与基于两种数据建立的综合生物量估算模型的结果进行比较, 讨论预测结果及其精确性。结果表明: 3种模型(OLI模型、LiDAR模型和综合模型)在所有样地无区分分析时, 地上和地下生物量的估算精度均达到0.4以上, 基于不同森林类型(针叶林、阔叶林、混交林)分析时地上和地下生物量的估算精度均有明显提高, 达到0.67及以上。利用分森林类型模型估算生物量, 综合生物量估算模型精度(地上生物量: R²为0.88; 地下生物量: R²为0.92)优于OLI生物量估算模型(地上生物量: R²为0.73; 地下生物量: R²为0.81)和LiDAR生物量估算模型(地上生物量: R²为0.86; 地下生物量: R²为0.83)。     

免疫组织化学在淋巴组织疾病诊断中的应用与结果评价

目的提高对合理应用免疫组化标记及正确评价免疫组化结果重要性的认识。方法回顾性分析3例淋巴组织疾病的临床资料,进行组织形态学观察并增加相关抗体标记予以鉴别诊断。结果例l为弥漫大B细胞性淋巴瘤,梭形细胞变异型,误诊为未分化肉瘤与形态学观察遗漏中心和中心母细胞特征的淋巴样细胞,没考虑到淋巴瘤的梭形细胞形态变异以及免疫标记的选择失误有关。例2为急性淋巴结T区增生误诊为T细胞淋巴瘤与忽略患者临床信息及对免疫组化阳性细胞量变及强弱评价有误相关。例3为经典型霍奇金淋巴瘤误诊为间变性大细胞淋巴瘤与对霍奇金淋巴瘤组织形态认识不足及淋巴瘤标记抗体的配伍不当有关。结论淋巴组织疾病的诊断建立在形态学、免疫组化、临床资料和遗传学基础上,免疫组化标记的选择与结果的正确分析对淋巴瘤确诊至关重要。     

Palmitate Inhibits SIRT1-Dependent BMAL1/CLOCK Interaction and Disrupts Circadian Gene Oscillations in Hepatocytes

Elevated levels of serum saturated fatty acid palmitate have been shown to promote insulin resistance, increase cellular ROS production, and trigger cell apoptosis in hepatocytes during the development of obesity. However, it remains unclear whether palmitate directly impacts the circadian clock in hepatocytes, which coordinates nutritional inputs and hormonal signaling with downstream metabolic outputs. Here we presented evidence that the molecular clock is a novel target of palmitate in hepatocytes. Palmitate exposure at low dose inhibits the molecular clock activity and suppresses the cyclic expression of circadian targets including Dbp, Nr1d1 and Per2 in hepatocytes. Palmitate treatment does not seem to alter localization or reduce protein expression of BMAL1 and CLOCK, the two core components of the molecular clock in hepatocytes. Instead, palmitate destabilizes the protein-protein interaction between BMAL1-CLOCK in a dose and time-dependent manner. Furthermore, we showed that SIRT1 activators could reverse the inhibitory action of palmitate on BMAL1-CLOCK interaction and the clock gene expression, whereas inhibitors of NAD synthesis mimic the palmitate effects on the clock function. In summary, our findings demonstrated that palmitate inhibits the clock function by suppressing SIRT1 function in hepatocytes.     

Complete Genome Sequence of a High Lipid-Producing Strain of Mucor circinelloides WJ11 and Comparative Genome Analysis with a Low Lipid-Producing Strain CBS 277.49

The genome of a high lipid-producing fungus Mucor circinelloides WJ11 (36% w/w lipid, cell dry weight, CDW) was sequenced and compared with that of the low lipid-producing strain, CBS 277.49 (15% w/w lipid, CDW), which had been sequenced by Joint Genome Institute. The WJ11 genome assembly size was 35.4 Mb with a G+C content of 39.7%. The general features of WJ11 and CBS 277.49 indicated that they have close similarity at the level of gene order and gene identity. Whole genome alignments with MAUVE revealed the presence of numerous blocks of homologous regions and MUMmer analysis showed that the genomes of these two strains were mostly co-linear. The central carbon and lipid metabolism pathways of these two strains were reconstructed and the numbers of genes encoding the enzymes related to lipid accumulation were compared. Many unique genes coding for proteins involved in cell growth, carbohydrate metabolism and lipid metabolism were identified for each strain. In conclusion, our study on the genome sequence of WJ11 and the comparative genomic analysis between WJ11 and CBS 277.49 elucidated the general features of the genome and the potential mechanism of high lipid accumulation in strain WJ11 at the genomic level. The different numbers of genes and unique genes involved in lipid accumulation may play a role in the high oleaginicity of strain WJ11.     

MicroRNA-203 Is a Prognostic Indicator in Bladder Cancer and Enhances Chemosensitivity to Cisplatin via Apoptosis by Targeting Bcl-w and Survivin

Resistance to cisplatin-based chemotherapy is a major cause of treatment failure in advanced bladder cancer (BC) patients. There is increasing evidence that microRNAs are involved in the development and progression of BC. However, little is known about the function of microRNAs in predicting the effect of adjuvant chemotherapy on BC survival and regulating response to cisplatin. To address this issue, we employed RT-qPCR to evaluate the clinical significance of miR-203 expression in 108 tissues of BC patients receiving cisplatin-based adjuvant chemotherapy, and performed in vitro studies to explore chemotherapeutic sensitivity to cisplatin in miR-203 overexpressing BC cells. We found miR-203 levels were significantly lower in BC progression group than non-progression group (P<0.001). ROC curve analysis illustrated miR-203 could significantly distinguish progressed patients from those without progression (P<0.001), yielding an area under the ROC curve of 0.839 (95% CI, 0.756–0.903). Moreover, low miR-203 expression correlated with shortened progression free survival (PFS) and overall survival (OS) of BC patients, and was an independent prognostic factor. Overexpression of miR-203 in 5637 and T24 BC cells could decrease cell viability, enhance cisplatin cytotoxicity, and promote apoptosis. Western blotting and luciferase reporter assay showed Bcl-w and Survivin were direct downstream targets of miR-203. There was also a significant inverse association between miR-203 and Bcl-w or Survivin expression in BC tissues (r = -0.781, -0.740, both P<0.001). In conclusion, decreased miR-203 predicts progression and poor prognosis for BC patients treated with cisplatin-based chemotherapy while miR-203 overexpression can enhance cisplatin sensitization by promoting apoptosis via directly targeting Bcl-w and Survivin.