简介：摘要：目的探讨女性体检人群癌胚抗原(carcinoembryonicantigen,CEA)与代谢综合征(metabolicsyndrome,MetS)的关联性。方法选取2014年1月至2015年12月到本院健康管理中心体检的11337名女性体检者,将研究对象的癌胚抗原水平按四分位数分为4个亚组,通过构建logistic回归模型,分析癌胚抗原与代谢综合征及其组分之间的关系。结果代谢综合征患者检出率为16.4%,代谢综合征患者中癌胚抗原水平异常者占7.1%,高于一般体检人群(3.2%),且代谢组分个数增加,癌胚抗原水平有增高趋势。多因素logistic回归分析显示,癌胚抗原水平越高者,代谢综合征的患病风险越高(χ2=18.374,P

简介：摘要目的探讨血清神经元特异性烯醇化酶(NSE)、细胞角蛋白19片段抗原21-1(CYFRA21-1)及血清癌胚抗原在老年肺癌诊断中的应用效果。方法选取2017年5月至2021年4月福建省级机关医院七区呼吸科收治并经病理证实为肺癌的207例老年患者为肺癌组，男174例，女33例，年龄(57.26±5.57)岁，年龄范围为46～72岁，另选取同期至福建省级机关医院体检的207名健康老年人为健康组，男166名，女41名，年龄(59.85±6.06)岁，年龄范围为49～73岁。比较两组血清NSE、CYFRA21-1、癌胚抗原肿瘤标志物水平，比较不同肺癌分型患者血清NSE、CYFRA21-1、癌胚抗原肿瘤标志物水平，比较联合检测与单独检测肺癌组血清NSE、CYFRA21-1、癌胚抗原的效果评价。结果肺癌组血清NSE[(20.14±5.37)μg/L]、CYFRA21-1[(9.71±7.44)μg/L]、癌胚抗原肿瘤标志物水平[(12.28±8.51)μg/L]均高于健康组[(5.62±2.59)μg/L、(2.18±0.83)μg/L、(2.36±1.01)μg/L]，差异有统计学意义(P<0.05)。小细胞肺癌患者的NSE[(33.14±7.25)μg/L]高于肺鳞癌[(26.78±4.39)μg/L]、肺腺癌患者[(19.68±7.51)μg/L]，肺鳞癌患者的CYFRA21-1水平[(15.22±8.74)μg/L]高于小细胞肺癌[(5.01±4.13)μg/L]、肺腺癌患者[(9.15±6.91)μg/L]，肺腺癌患者的癌胚抗原水平[(23.82±10.94)μg/L]高于小细胞肺癌[(8.21±7.67)μg/L]、肺鳞癌患者[(16.27±9.33)μg/L]，差异有统计学意义(P<0.05)。肺癌组患者血清NSE、CYFRA21-1、癌胚抗原3种联合检测的灵敏度、特异度及准确性显著高于单独检测，差异有统计学意义(P<0.05)。结论血清NSE、CYFRA21-1、癌胚抗原联合检测在老年肺癌诊断及分型鉴别诊断中应用效果显著，值得临床借鉴。

简介：摘要目的探讨周围型肺癌血清中基质金属蛋白酶（MMP-9）、鳞状细胞癌抗原（SCC）、角蛋白19片段（CYFRA21-1）、癌胚抗原（CEA）、神经元烯醇化酶（NSE）的水平变化及临床意义。方法选择2017年1月至2020年1月台州恩泽医疗中心（集团）路桥医院收治的周围型肺癌患者68例作为观察组，选择同期肺部良性疾病患者65例作为观察1组、同期健康体检者65例作为对照组。比较三组受试者血清MMP-9、CYFRA21-1、SCC、NSE、CEA水平，对比上述指标单独检测与联合检测诊断周围型肺癌的敏感性、特异性。结果观察组血清MMP-9、CYFRA21-1、SCC、NSE、CEA水平［（14.98±2.10）ng/mL、（17.13±2.71）ng/mL、（1.98±0.41）μg/mL、（24.13±2.10）ng/mL、（17.10±2.10）ng/mL］均高于观察1组［（9.12±1.41）ng/mL、（10.12±1.58）ng/mL、（1.37±0.31）μg/mL、（16.31±1.78）ng/mL、（12.13±1.79）ng/mL］和对照组［（5.10±0.68）ng/mL、（6.02±0.94）ng/mL、（0.71±0.11）μg/mL、（11.10±1.02）ng/mL、（8.13±1.02）ng/mL］，差异均有统计学意义（F1=932.781，F2=737.100，F3=368.591，F4=989.851，F5=462.291，均P<0.05）；Ⅰ~Ⅱ期患者MMP-9、CYFRA21-1、SCC、NSE、CEA水平［（11.12±2.10）ng/mL、（9.12±1.85）ng/mL、（1.52±0.21）μg/mL、（18.12±3.02）ng/mL、（7.52±1.02）ng/mL］均低于Ⅲ~Ⅳ期患者［（15.89±2.18）ng/mL、（21.56±2.11）ng/mL、（2.04±0.31）μg/mL、（28.15±2.62）ng/mL、（15.12±1.55）ng/mL］，差异均有统计学意义（t1=9.013，t2=25.146，t3=7.714，t4=14.586，t5=22.705，均P<0.05）；联合检测的敏感性（83.33%）、特异性（86.67%）均高于单项检测MMP-9（50.00%、59.68%）、CEA（50.00%、61.29%）、CYFRA21-1（66.67%、58.06%）、SCC（50.00%、54.84%）、NSE（66.67%、58.06%），差异均有统计学意义（均P<0.05）。结论周围型肺癌患者的血清MMP-9、CYFRA21-1、SCC、NSE、CEA水平均明显升高，对诊断周围型肺癌具有重要价值，上述指标联合检测可提高临床诊断周围型肺癌的准确率。

简介：摘要目的探讨微小RNA(miR-495-3p)与尿路上皮癌胚抗原1(UCA1)在甲状腺乳头状癌(PTC)中的作用。方法2019年9月至2020年4月，福建医科大学附属第二医院甲状腺乳腺外科采集肿瘤标本，将取得的40对PTC组织作为实验组，与之对应40对癌旁正常组织作为对照组。采用实时荧光定量聚合酶链反应(RT-qPCR)检测40对甲状腺乳头状癌组织及癌旁正常组织中miR-495-3p与UCA1的表达水平，并采用Pearson分析法进行相关性分析。在TPC-1中加入miR-495-3p抑制剂，用RT-qPCR检测UCA1的表达，两样本比较采用t检验。结果在PTC组织中miR-495-3p的表达低于癌旁正常组织(0.78±0.11比1.37±0.64，t＝5.741，P<0.01)，差异有统计学意义，且miR-495-3p的表达水平与肿瘤的淋巴结转移明显相关(0.74±0.07，t＝2.187, P<0.05)。在PTC组织中UCA1的表达高于癌旁正常组织(1.04±0.26比0.97±0.16，t＝17.88，P<0.05)，差异有统计学意义，且UCA1的表达水平与肿瘤的淋巴结转移(1.134±0.174，t＝2.254, P<0.05)、腺外侵犯(0.82±0.06，t＝0.773, P<0.05)相关。PTC中miR-495-3p与UCA1的表达水平呈负相关(r＝-0.371，P<0.05)。抑制TPC-1中miR-495-3p的表达，提高实验组UCA1的表达水平(1.00±0.01比3.25±0.05，t＝5.665，P<0.01)。结论miR-495-3p可负调控UCA1，从而在PTC进展中发挥作用。

简介：AbstractObjective:To clarify whether the serum squamous cell carcinoma antigen (SCCA) levels of patients with inverted papilloma (IP) are different from patients with nasal polyps (NP) and rhinitis.Materials and methods:Serum SCCA levels were measured in 30 patients with IP and 30 patients with NP at one day before surgery and seven days after surgery and measured in 28 patients with rhinitis.Results:Elevated serum SCCA levels (>1.5 ng/ml) were found in 80.0% of patients in the IP group, 6.7% of patients in the NP group and 14.3% of patients in the rhinitis group, which was a significant difference. The medians of serum SCCA levels in the IP, NP and rhinitis groups were 3.9, 0.8 and 1.1 ng/ml, respectively, which was a significant difference. The SCCA level in IP group was not significantly correlated according to Krouse Staging. There was a significant difference in serum SCCA levels between the pre- and postoperative stages in the IP group, at 3.9 and 0.8 ng/ml, respectively, while in the NP group the levels were 0.8 and 1.0 ng/ml, not significantly different. With regard to the IP diagnosis in the IP and NP group based on the SCCA level (>1.5 ng/ml), sensitivity and specificity was 80.0% and 93.3%, respectively.Conclusions:The serum SCCA level in patients with IP was elevated and then it decreased after surgery. This was different from NP and rhinitis patients who mostly had normal levels, which did not change.

简介：摘要目的探讨奥西替尼对晚期肺腺癌一线酪氨酸激酶抑制剂（TKI）耐药患者的疗效及癌胚抗原（CEA）、血管内皮生长因子（VEGF）表达的影响。方法选择2017年6月至2019年6月金华广福肿瘤医院接诊的晚期一线TKI耐药肺腺癌患者（T790M检测阴性或拒测）72例作为研究对象。按照随机数字表法分为观察组和对照组各36例。对照组采用传统培美曲塞+顺铂（AP）方案治疗，观察组采用甲磺酸奥西替尼靶向治疗。在治疗前和治疗4周后，记录两组患者血清CEA、VEGF水平以及治疗4周后患者治疗效果、不良反应发生情况和治疗6个月、1年、2年后各时间点生存率情况。结果观察组患者有效率、控制率分别为80.6%（29/36）、94.4%（34/36），明显高于对照组的58.3%（21/36）、75.0%（27/36），差异均有统计学意义（χ2=4.193、5.261，均P<0.05）。两组治疗前血清CEA、VEGF水平差异均无统计学意义（均P>0.05），两组治疗后血清CEA、VEGF水平均有明显降低（均P<0.05），观察组血清CEA、VEGF水平分别为（5.36±0.33）U/mL、（121.56±11.57）ng/L，均明显低于对照组的（8.25±0.54）U/mL、（163.68±14.59）ng/L（t=27.399、13.572，均P<0.001）。观察组不良反应发生率为19.4%（7/36），明显低于对照组的44.4%（16/36）（χ2=5.173，P=0.011）。观察组患者6个月、1年、2年总生存率分别为94.29%、77.14%、60.00%，对照组患者6个月、1年、2年总生存率分别为91.43%、54.29%、34.29%，两组6个月生存率差异无统计学意义（χ2=0.352，P=0.251），观察组1年、2年生存率均明显高于对照组（χ2=4.058，P=0.044；χ2=4.644，P=0.031）。结论奥西替尼靶向治疗一线TKI耐药的晚期肺腺癌疗效显著，可有效抑制血清CEA、VEGF表达，延长患者生存期，具有临床应用价值。

简介：摘要探讨微RNA-21（miR-21）与癌胚抗原（CEA）、神经特异性烯醇化酶(NES)及CYFRA21-1对非小细胞肺癌（NSCLC）预后预测的临床价值。NSCLC患者确诊时已经错过最佳手术时间，化疗成为最主要的治疗手段，但患者生存率并未得到明显提升。实验室血清学指标检测具有样本易获得、操作方便、价格低廉、无创伤以及可连续监测等各种优点，可用来进行评估NSCLC患者的预后情况。其中，miR-21与CEA、NSE及CYFRA21-1是临床上常用于预测NSCLC疗效和预后的血清学指标。

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简介：AbstractBackground:Hepatitis B core-related antigen (HBcrAg) is a promising disease-monitoring marker for chronic hepatitis B (CHB). We investigated correlations between HBcrAg with antiviral efficacy and virological and histological variables.Methods:One hundred and forty-five CHB patients from the mainland of China between August 2013 and September 2016 who underwent liver biopsy received entecavir therapy and had paired liver biopsy at 78 weeks. We analyzed correlations between HBcrAg and virological and histological variables in hepatitis B e antigen (HBeAg)-positive and HBeAg-negative patients. We also explored the predictors of HBeAg loss after 78 weeks of antiviral therapy. Pearson correlation analysis and logistic forward stepwise regression were the main statistic methods.Results:HBeAg-positive patients (n = 93) had higher baseline HBcrAg (median 7.4 vs. 5.3 log10 U/mL P < 0.001) and greater HBcrAg declines (median 1.6 vs. 0.9 log10 U/mL P= 0.007) than HBeAg-negative patients after 78 weeks of therapy. At baseline, HBcrAg correlated with hepatitis B virus (HBV) DNA in both HBeAg-positive (r = 0.641, P < 0.001) and -negative patients (r = 0.616, P < 0.001), with hepatitis B surface antigen (HBsAg) in HBeAg-positive patients (r = 0.495, P < 0.001), but not with anti-hepatitis B virus core antibody (anti-HBc). Weak correlations existed between HBcrAg, histology activity index (HAI; r = 0.232, P= 0.025), and Ishak fibrosis score (r= -0.292, P= 0.005) in HBeAg-positive patients. At 78 weeks, significant correlations existed only between HBcrAg and anti-HBc in HBeAg-positive (r = -0.263, P = 0.014) and HBeAg-negative patients (r= -0.291, P= 0.045). Decreased HBcrAg significantly correlated with reduced HBV DNA (r= 0.366, P= 0.001; r= 0.626, P < 0.001) and HBsAg (r = 0.526, P = 0.001; r = 0.289, P = 0.044) in HBeAg-positive and -negative patients, respectively, and with reduced HAI in HBeAg-positive patients (r = 0.329, P = 0.001). Patients with HBeAg loss (n = 29) showed a larger reduction in HBcrAg than those without (median 2.3 vs. 1.3 log10 U/mL, P = 0.001). In multivariate analysis, decreased HBcrAg was an independent predictor of HBeAg loss (P = 0.005).Conclusions:HBcrAg reflects viral replication and protein production. Decreased HBcrAg could predict HBeAg loss after antiviral therapy.Trial registration:Clinical Trials.gov: NCT01962155; https://www.clinicaltrials.gov/ct2/show/NCT01962155?term=NCT01962155&draw=2&rank=1

简介：摘要目的研究结核分枝杆菌Rv0446c的抗原表位及其免疫原性，为结核病的免疫诊断技术及疫苗研发提供候选抗原及表位。方法利用生物信息学软件TE-predict和IEDB的T细胞表位预测软件对结核分枝杆菌抗原Rv0446c进行T细胞表位预测，用ELISPOT实验检测表位在2019年1月到2020年12月期间来自佛山市第四人民医院和福州肺科医院的结核病患者（50例）、肺部疾病患者（39例）及健康志愿者（55例）中的免疫反应性。将60只6周龄BALB/c小鼠随机分成10组，每组6只，分别采用PBS、血蓝蛋白（KLH）、高剂量结核分枝杆菌抗原Ag85B（50 μg/只）、低剂量Ag85B（20 μg/只）、高计量P120、低剂量P120、高计量P121、低剂量P121、高剂量P123、低剂量P123（P120、P121、P123高剂量为100 μg/只、低剂量为50 μg/只）多肽对其皮下免疫，每只小鼠免疫3次，每次间隔2周，末次免疫后4周，应用ELISA方法检测各组小鼠脾细胞产生的IFN-γ、IL-2、IL-4、IL-10细胞因子水平。结果预测的7条表位多肽中，ELISPOT试验筛选出4条阳性T细胞表位多肽P120、P121、P122、P123，在结核病患者中检测灵敏度和特异度分别为30.0%、18.0%、6.0%、22.0%和96.8%、98.9%、100%、96.8%。与对照PBS组和KLH组比较，P120多肽能刺激小鼠产生较高水平的IFN-γ、IL-4、IL-10，P121多肽刺激小鼠产生较高水平的IFN-γ和IL-4（均P<0.05），P123多肽刺激小鼠产生较高水平的IFN-γ（均P<0.05）。P120、P121、P123多肽刺激小鼠产生的IL-2的水平高于PBS组低于Ag85B-L组和Ag85B-H组（均P<0.05），但与KLH组差异无统计学意义（均P>0.05）。结论Rv0446c蛋白及其T细胞表位具有较好的免疫原性及免疫反应性，能刺激机体产生强烈的细胞免疫应答，可用于结核病的临床诊断技术研究和新型结核亚单位疫苗的构建。

简介：AbstractMany factors have been identified as having the ability to affect the sensitivity of rapid antigen detection (RAD) tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study aimed to identify the impact of sample processing on the sensitivity of the RAD tests. We explored the effect of different inactivation methods, viral transport media (VTM) solutions, and sample preservation on the sensitivity of four RAD kits based on two SARS-CoV-2 strains. Compared with non-inactivation, heat inactivation significantly impacted the sensitivity of most RAD kits; however, β-propiolactone inactivation only had a minor effect. Some of the VTM solutions (VTM2, MANTACC) had a significant influence on the sensitivity of the RAD kits, especially for low viral-loads samples. The detection value of RAD kits was slightly decreased, while most of them were still in the detection range with the extension of preservation time and the increase of freeze-thaw cycles. Our results showed that selecting the appropriate inactivation methods and VTM solutions is necessary during reagent development, performance evaluation, and clinical application.

简介：AbstractBackground:Zoonotic schistosomiasis, caused by Schistosoma japonicum, remains a major public health problem in the Philippines. This study aimed to evaluate the commercially available rapid diagnostic point-of-care circulating cathodic antigen (POC-CCA) test in detecting individuals infected with S. japonicum in a human cohort from an endemic area for schistosomiasis japonica in the Philippines.Methods:Clinical samples were collectedin 18 barangays endemic for S. japonicum infection in Laoang and Palapag municipalities, Northern Samar, the Philippines, in 2015. The presence of CCA in filter-concentrated urine samples (n = 412) was evaluated using the commercial kits and the results were converted to images, which were further analyzed by ImageJ software to calculate R values. The diagnostic performance of the immunochromatographic POC-CCA test was compared using the Kato-Katz (KK) procedure, in-house enzyme-linked immunosorbent assays (ELISAs) and droplet digital (dd) PCR assays as reference.Results:The POC-CCA test was able to detect S. japonicum-infected individuals in the cohort with an eggs per gram of faeces (EPG) more than or equal to 10 with sensitivity/specificity values of 63.3%/93.3%. However, the assay showed an inability to diagnose schistosomiasis japonica infections in all cohort KK-positive individuals, of which the majority had an extremely low egg burden (EPG: 1-9). The prevalence of S. japonicum infection in the total cohort determined by the POC-CCA test was 12.4%, only half of that determined by the KK method (26.2%). When compared with the ELISAs and ddPCR assays as a reference, the POC-CCA assay was further shown to be a test with low sensitivity. Nevertheless, the assay exhibited significant positive correlations with egg burden determined by the KK technique and the target gene copy number index values determined by the ddPCR assays within the entire cohort.Conclusions:By using in silico image analysis, the POC-CCA cassette test could be converted to a quantitative assay to avoid reader-variability. Because of its low sensitivity, the commercially available POC-CCA assay had limited potential for determining the status of a S. japonicum infection in the target cohort. The assay should be applied with caution in populations where schistosome parasites (especially S. japonicum) are present at low infection intensity.

简介：摘要膜性肾病是一种免疫性肾小球疾病。自发现中性内肽酶是膜性肾病的足细胞抗原以来，M型磷脂酶A2受体和1型血小板反应蛋白7A域等足细胞抗原的研究，对原发性膜性肾病的临床诊治产生了重要影响。近期，Exostosin 1和Exostosin 2、神经细胞黏附分子1、神经源性表皮生长因子样分子1、信号素3B和原钙黏蛋白7等新抗原的发现，成为膜性肾病精准诊治的潜在靶点。现就膜性肾病足细胞抗原特点、致病机制及临床意义进行综述。

简介：摘要肺癌目前全面进入免疫治疗新时代，但是单一的一种免疫疗法仍无法满足免疫微环境的复杂状况，不同免疫联合方案成为克服免疫耐药的有效手段。癌-睾丸抗原（CTA）是一种几乎只在恶性肿瘤中表达的特异性极高的肿瘤抗原，能够产生强大的抗肿瘤免疫反应，是新型免疫治疗中很有希望的靶点。文章就CTA在肺癌中的表达、功能和免疫治疗应用等方面的研究进展进行综述。

简介：摘要：临床用血只检测ABO血型和Rh抗D同型已经不能满足临床用血安全，RH系统输注不匹配的血液容易产生抗体，患者发生溶血等血清学反应。

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简介：AbstractBackground:The complement system plays an important role in the immune response to transplantation, and the diagnostic significance of peritubular capillary (PTC) C4d deposition (C4d+) in grafts is controversial. The study aimed to fully investigate the risk factors for PTC C4d+ and analyze its significance in biopsy pathology of kidney transplantation.Methods:This retrospective study included 124 cases of kidney transplant with graft biopsy and donor-specific antibody (DSA) testing from January 2017 to December 2019 in a single center. The effects of recipient pathological indicators, eplet mismatch (MM), and DSAs on PTC C4d+ were examined using univariate and multivariate logistic regression analyses.Results:In total, 35/124 (28%) were PTC C4d+, including 21 with antibody-mediated rejection (AMR), eight with renal tubular injury, three with T cell-mediated rejection, one with glomerular disease, and two others. Univariate analysis revealed that DSAs (P < 0.001), glomerulitis (P < 0.001), peritubular capillaritis (P < 0.001), and human leukocyte antigen (HLA) B eplet MM (P = 0.010) were the influencing factors of PTC C4d+. According to multivariate analysis, DSAs (odds ratio [OR]: 9.608, 95% confidence interval [CI]: 2.742-33.668, P < 0.001), glomerulitis (OR: 3.581, 95%CI: 1.246-10.289, P = 0.018), and HLA B eplet MM (OR: 1.166, 95%CI: 1.005-1.353, P= 0.042) were the independent risk factors for PTC C4d+. In receiver operating characteristic curve analysis, the area under the curve was increased to 0.831 for predicting PTC C4d+ when considering glomerulitis, DSAs, and HLA B eplet MM. The proportions of HLA I DSAs and PTC C4d+ in active antibody-mediated rejection were 12/17 and 15/17, respectively; the proportions of HLA class II DSAs and PTC C4d+ in chronic AMR were 8/12 and 7/12, respectively. Furthermore, the higher the PTC C4d+ score was, the more serious the urinary occult blood and proteinuria of recipients at the time of biopsy.Conclusions:PTC C4d+ was mainly observed in AMR cases. DSAs, glomerulitis, and HLA B eplet MM are the independent risk factors for PTC C4d+.