Analysis on the Effects of CT- and Ultrasound-Guided Percutaneous Transthoracic Needle Biopsy Combined with Serum CA125 and CEA on the Diagnosis of Lung Cancer

The number of patients with lung cancer is difficultly diagnosed in the early stage. The purpose of the study was to investigate the effects of CT- and ultrasound-guided percutaneous transthoracic needle biopsy combined with serum CA125 and CEA on the diagnosis of lung cancer. 120 patients with suspected lung cancer admitted to our hospital from January 2019 to January 2020 were selected and divided into an ultrasound group (n = 60) and CT group (n = 60), according to different percutaneous transthoracic needle biopsy modalities. All patients received serum tumor markers detection, so as to compare the CT- and ultrasound-guided percutaneous transthoracic needle biopsy results and pathology results, levels of serum tumor markers among all patients and the patients with different lung cancer types, and diagnostic efficacy of tumor markers, as well as complication rate (CR) in patients. The sensitivity and specificity of ultrasound-guided percutaneous transthoracic needle biopsy were 0.880 and 0.800, respectively, while those of CT-guided percutaneous transthoracic needle biopsy were 0.909 and 0.625, respectively; the CA125 and CEA levels in the lung cancer group were higher than those in the benign group ( P < 0.001 ); the CA125 and CEA levels of the patients with adenocarcinoma were higher than those with squamous carcinoma, and the CEA levels of the patients with small-cell carcinoma were lower than those with adenocarcinoma ( P < 0.05 ); the sensitivity, specificity, and Youden indexes of CA125 were 0.638, 0.833, and 0.471, respectively, while those of CEA were 0.766, 0.778, and 0.544, respectively; there were no significant differences in CR between the two groups ( P > 0.05 ). CT- and ultrasound-guided percutaneous transthoracic needle biopsy is a safe and feasible diagnostic modality for lung cancer, and its combination with serum CA125 and CEA can significantly improve the accuracy of the detection results, which is worthy of promotion and application in clinical practice.

The Significance of Serum Tumor Markers CEA, CA19-9, CA125, CA15-3 And AFP in Patients Scheduled for Orthotopic Liver Transplantation: Do Elevated Levels Really Mean Malignancy?

AIM AND BACKGROUND: Preparation of the patients for liver transplantation is a meticulous process and includes evaluation of tumor markers to rule out occult malignancy. Present study evaluated the significance of serum tumor markers in patients bound for liver transplantation due to viral and other etiologies of liver failure.PATIENTS AND METHODS: 381 patientswho underwent liver transplantation were included in the study. Demographic data, Model for End stage.Liver Disease (MELD) scores and serum tumor marker levels were prospectively collected.RESULTS: AFP levels were significantly higher in viral etiologies when compared to other etiologies (p<0.05).Ca 19-9 was significantly higher in viral etiologies (p<0.05). Among the viral etiologies HCV related liver failure had higher carcinoembryonic antigen (CEA) and Carbohydrate antigen 19-9 (Ca 19-9) levels (p<0.05). A correlation was found between increasing MELD scores and serum levels of tumor markers (p<0.05)CONCLUSIONS: Tumor markers such as AFP, CEA, Ca 125 and Ca 19-9 can be elevated in end stage liver disease. Their levels vary according to etiology and severity of disease. The diagnostic capabilities of these markers are reduced in end stage liver disease setting but they contribute to the evaluation of the pathophysiology of chronic liver disease. Transplantation can be performed safely in cases with high tumor marker levels provided that any occult malignancy is ruled out by means of imaging and endoscopic techniques. Tumor markers can guide the physician in determining the severity of liver cirrhosis and further studies are needed to validate such a relationship.

Safety of Anlotinib Capsules Combined with PD-1 Inhibitor Camrelizumab in the Third-Line Treatment of Advanced Non-Small-Cell Lung Cancer and Their Effect on Serum Tumor Markers

Objective. To explore the safety of anlotinib capsules combined with the PD-1 inhibitor (camrelizumab) in the third-line treatment of advanced non-small-cell lung cancer (NSCLC) and their effect on serum tumor markers. Methods. 88 patients with advanced NSCLC treated in the Oncology Department of our hospital from December 2018 to December 2019 were selected as research subjects and randomly and equally split into the single treatment group (STG) and combined treatment group (CTG). The levels of serum tumor markers after treatment were detected in both groups, and the incidence of adverse reactions during treatment was recorded. Results. Compared with the STG, CTG achieved obviously higher total effective rate ( P < 0.05), lower total incidence of adverse reactions ( P < 0.05), lower levels of serum tumor markers and average CFS score ( P < 0.001), and higher average KPS score ( P < 0.001). Conclusion. Application of anlotinib capsules combined with the PD-1 inhibitor (camrelizumab) in the third-line treatment of advanced NSCLC can effectively reduce the levels of serum tumor markers and cancer fatigue degree of patients, with a better effect than that of simple anlotinib treatment. In addition, further research of the combined treatment is helpful to establish a better therapeutic regimen for patients with advanced NSCLC.

Clinical value of MRI, serum SCCA, and CA125 levels in the diagnosis of lymph node metastasis and para-uterine infiltration in cervical cancer

Background Cervical cancer shows great differences in depth of invasion, metastasis, and other biological behaviors. The location of the lesion is special, so it is usually difficult to determine the clinical stage. This study aimed to explore the clinical value of magnetic resonance imaging (MRI) and tumor serum markers for the preoperative diagnosis of cervical cancer lymph node metastasis and para-uterine invasion. Methods A total of 200 patients with cervical cancer admitted to our hospital from January 2019 to January 2020 were collected as the research subjects. Comparing the diagnosis results of preoperative MRI scan, serum tumor markers, and postoperative pathological examination using single factor comparison, we determined the MRI scan results, the comprehensive matching rate between serum tumor markers (squamous cell carcinoma antigen (SCCA), carbohydrate antigen 125 (CA125)) and postoperative pathological results, and the differences of sensitivity, specificity, and accuracy in the prediction of lymph node metastasis and para-uterine infiltration of cervical cancer. Results The levels of SCCA and CA125 in patients with para-uterine invasion and lymph node metastasis were higher than those of patients without invasion and metastasis. Among them, the level of SCCA was significantly different (P<0.05). The level of CA125 was not statistically significant (P>0.05), so MRI combined with serum SCCA was selected for combined diagnosis in the later period. The sensitivity, specificity, and accuracy of MRI diagnosis of cervical cancer and para-uterine infiltrating lymph node metastasis and metastasis were 55.2, 91.6, and 89.5% and 55.2, 91.6, and 89.5%, respectively. These data in MRI combined with serum SCCA were 76.3, 95.3, and 94.3% and 63.2, 96.0, and 95.1%, respectively. The accuracy of tumor markers combined with MRI in the diagnosis of cervical cancer lymph node metastasis and para-uterine invasion was higher than that of MRI. Conclusions MRI combined with serum SCCA can more accurately identify cervical cancer lymph node metastasis and para-uterine invasion compared with MRI alone. Tumor marker combined with MRI diagnosis is an important auxiliary method for cervical cancer treatment and can provide comprehensive and reliable clinical evidence for evaluation before cervical cancer surgery.

Clinicopathological Characteristics of LgG4-Related Lung Disease

Background: Immunoglobulin G4-related lung disease (IgG4-RLD) is a rare entity. The aim of this study is to retrospectively analyzed the clinicopathological characteristics of IgG4-RLD pathologically confirmed in order to improve the diagnosis and treatment of the disease.Methods: We screened the pathological reports of 4838 patients with pulmonary surgery and/or biopsy specimens at Sun Yat-sen Memorial Hospital affiliated to Sun Yat-sen University from April 2017 to April 2021, and 65 patients with suspected IgG4-RLD had an immunohistochemical staining for IgG4 and IgG. Finally, 10 patients with definite IgG4-RLD pathologically comfirmed were enrolled and analyzed.Results: The incidence of IgG4-RLD pathologically confirmed was 0.2% (10/4838). Ten patients had a mean age of 59.7 years at diagnosis with a male: female ratio of 9:1. The initial clinical manifestations were lack of specificity and cough was the most common symptom (4/10). More than one organ was involved in most patients (8/10) and lymph node involvement was often seen (7/10). Serum IgG4 were detected and elevated in 6 patients. The levels of serum tumor markers were within normal range or slightly elevated. The chest computed tomography (CT) and/or 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET-CT) findings showed 5 patients of mix type, 3 patients of solid nodular type and 2 patients of bronchovascular type. All pulmonary mass and large nodules with solid pattern had spiculated margins and inhomogeneous enhancement with or without pleural indentation and lobulated appearance. Abundant lymphoplasmacytic infiltration and fibrosis were observed in all patients. The expressions of IgG4 and IgG in the plasma cells were up-regulated in the immunostained sections of lung. Seven patients received prednisone with or without additional immunosuppressive drugs and responded well.Conclusions: Our study suggests that multiple imaging findings combined with elevated serum IgG4 as well as serum tumor markers without significant increase could provide diagnostic support for IgG4-RLD.