Diagnosis Value of Colposcope Combined with Serum Squamous Cell Carcinoma Antigen, Carbohydrate Antigen 125, and Carcinoembryonic Antigen for Moderate to Advanced Cervical Cancer Patients Treated with Modified Fuzheng Peiyuan Decoction

Objective. To explore the diagnosis value of colposcope combined with serum squamous cell carcinoma antigen (SCC-Ag), carbohydrate antigen 125 (CA125), and carcinoembryonic antigen (CEA) for moderate to advanced cervical cancer patients treated with modified Fuzheng Peiyuan decoction. Methods. The clinical data of 43 moderate to advanced cervical cancer patients treated in Suzhou Hospital of Traditional Chinese Medicine from July 2018 to July 2019 were selected for the retrospective analysis, and 43 healthy women undergoing physical examination in our medical center in the same period were selected as the control group. The cervical cancer patients accepted the modified Fuzheng Peiyuan decoction treatment, the detection of SCC-Ag, CA125, and CEA and colposcope examination were performed to all research subjects, and the changes in indicators such as KPS scores and lesion perfusion parameters in cervical cancer patients before and after treatment were monitored, so as to analysis the clinical diagnosis value of combined diagnosis in treated patients. Results. After treatment, the mean KPS scores were greatly higher and various blood perfusion parameters of lesions and serum SCC-Ag, CA125, and CEA levels were remarkably lower than before ( P value <0.001 for all); the area under the curve of combined test was significantly larger than that of single test, and the sensitivity and specificity of the combined test were the highest; and after medication, the total incidence rate of toxic and side effects was 11.63%. Conclusion. Fuzheng Peiyuan decoction has significant effect in treating moderate to advanced cervical cancer, and colposcope combined with serum test presents more accurate and credible diagnosis results and has great significance for future treatment, which shall be promoted and applied.

The Value of CT-based Radiomics Nomogram in Differential Diagnosis of Different Histological Types of Gastric Cancer

Purpose: To establish and verify a nomogram based on computed tomography (CT) radiomics analysis to predict the histological types of gastric cancer preoperatively for patients with surgical indications.Methods: A sum of 143 patients with gastric cancer in Sir Run Run Shaw Hospital from January 2019 to December 2020 (differentiated type: 46 cases; undifferentiated type: 97 cases) were included into this retrospective study, and were randomly divided into training (n=99) and test cohort (n=44). The least absolute shrinkage and selection operator(LASSO) was used for feature selection while the multivariate Logistic regression method was used for radiomics model and nomogram building. The area under curve(AUC) was used for performance evaluation in this study.Results: The radiomics model got AUCs of 0.755 (95%CI, 0.650-0.859) and 0.71 (95%CI,0.543-0.875) for histological prediction in the training and test cohorts, respectively. The radiomics nomogram based on radiomics features and Carbohydrate antigen 125 (CA125) achieved an AUC of 0.777 (95%CI:0.679-0.875) in the training cohort with 0.726 (95%CI:0.559-0.893) in the test cohort. The calibration curve of the radiomics nomogram also showed good results. The decision curve analysis(DCA) shows that the radiomics nomogram is clinically practical.Conclusion: The radiomics nomogram established and verified in this study showed good performance for the preoperative histological prediction of gastric cancer, which might contribute to the formulation of a better clinical treatment plan.

Carbohydrate Antigen 125: A Biomarker at the Crossroads of Congestion and Inflammation in Heart Failure

Because heart failure (HF) is more lethal than some of the common malignancies in the general population, such as prostate cancer in men and breast cancer in women, there is a need for a cost-effective prognostic biomarker in HF beyond natriuretic peptides, especially concerning congestion, the most common reason for the hospitalisation of patients with worsening of HF. Furthermore, despite diuretics being the mainstay of treatment for volume overload in HF patients, no randomised trials have shown the mortality benefits of diuretics in HF patients, and appropriate diuretic titration strategies in this population are unclear. Recently, carbohydrate antigen (CA) 125, a well-established marker of ovarian cancer, emerged as both a prognostic indicator and a guide in tailoring decongestion therapy for patients with HF. Hence, in this review the authors present the molecular background regarding the role of CA125 in HF and address valuable clinical aspects regarding the relationship of CA125 with both prognosis and therapeutic management in HF.

The Effect of Letrozole Combined with Dydrogesterone for Endometriosis in China: A Meta-Analysis

Purpose. To discuss the effects of dydrogesterone combined with letrozole on the effectiveness, sex hormone levels, and serological indicators in patients with endometriosis. This study is registered with PROSPERO (CRD42020213172). Methods. We searched relevant randomized controlled trials (RCTs) through PubMed, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang, and VIP Database. The standardized mean differences (SMDs), the mean differences (MDs), or odds ratios (ORs) with their 95% confidence intervals (95% CIs) were computed to be outcome indicators, including total effectiveness, Vascular Endothelial Growth Factor (VEGF) level, Carbohydrate Antigen 125 (CA125) level, Follicle-Stimulating Hormone (FSH) level, Luteinizing Hormone (LH) level, estrogen (E2) level, progesterone (P) level, interleukin-6 (IL-6) level, and tumor necrosis factor-a (TNF-a) level. Results. A total of 19 RCTs involving 1,591 patients were included in this study. Our results showed that letrozole combined with dydrogesterone can significantly reduce the levels of VEGF (SMD -2.23, 95% CI -2.39 to -2.07; p < 0.00001 ), CA125 (MD -10.53, 95% CI -11.19 to -9.88; p < 0.00001 ), E2 (SMD -1.64, 95% CI -1.81 to -1.47; p < 0.00001 ), P (MD -5.11, 95% CI -6.26 to -3.96; p < 0.00001 ), IL-6 (MD -4.41, 95% CI -5.16 to -3.67; p < 0.00001 ), and TNF-a (MD -5.67, 95% CI -6.34 to -5.00; p < 0.00001 ) in patients with endometriosis compared with the control group. In addition, the results indicated that total effectiveness was significantly higher in the experiment group (OR 6.21, 95% CI 4.17 to 9.24; p < 0.00001 ) compared to the control. However, there was no significant difference between FSH and LH levels in both groups ( p > 0.05 ). Conclusion. This combination therapy can effectively decrease the levels of VEGF, CA125, E2, P, IL-6, and TNF-a and increase the total effectiveness when comparing with the control group.

Carbohydrate Antigen 125 Supplements Carbohydrate Antigen 19-9 for the Prediction of Invasive Intraductal Papillary Mucinous Neoplasms of the Pancreas

BackgroundIntraductal papillary mucinous neoplasm (IPMN) is a disease with malignant potential. IPMNs of the pancreas are mainly managed according to radiographic indications, which lack accuracy in defining grades of IPMNs. Therefore, other indications such as serological biomarkers should be employed to predict the invasiveness of IPMNs.MethodsWe investigated preoperative serum levels of CA19-9, CA125 and CEA of 381 surgical patients with a definite pathological diagnosis of IPMN from July 2010 to December 2019 at Shanghai Cancer Center. We calculated the Youden indices of each point of receiver operating characteristic (ROC) curves to find the most appropriate cut-off values of CA19-9, CA125 and CEA in recognizing malignant IPMNs. Serological biomarker differences were correlated with grades and biological behaviours of IPMNs. Diagnostic indices of these serum biomarkers were calculated.ResultsMalignant group had higher serum levels of CA19-9, CA125 and CEA. According to ROC curves, the most appropriate cut-off value of CA125 were readjusted to 13.5 U/ml while the cut-off values of CA19-9 and CEA remained 37 U/ml and 5.3 ng/l as them mostly be employed. Besides, CA19-9 elevation was significantly associated with vascular invasion and perineural infiltration. We found CA125 may predict invasive IPMN in CA19-9 negative subgroup according to ROC curve. ConclusionsSerological biomarkers are useful and sensitive indications for recognizing invasive IPMNs. CA19-9 has the upmost diagnostic indices among all regularly used serum biomarkers in differentiating malignant and benign IPMNs. CA19-9 should be combined with CA125 to form a more favourable biomarker panel for IPMNs malignancy prediction.

Elevated N6-Methyladenosine RNA Levels in Peripheral Blood Immune Cells: A Novel Predictive Biomarker and Therapeutic Target for Colorectal Cancer

Effective biomarkers for the diagnosis of colorectal cancer (CRC) are essential for improving prognosis. Imbalance in regulation of N6-methyladenosine (m6A) RNA has been associated with a variety of cancers. However, whether the m6A RNA levels of peripheral blood can serve as a diagnostic biomarker for CRC is still unclear. In this research, we found that the m6A RNA levels of peripheral blood immune cells were apparently elevated in the CRC group compared with those in the normal controls (NCs) group. Furthermore, the m6A levels arose as CRC progressed and metastasized, while these levels decreased after treatment. The area under the curve (AUC) of the m6A levels was 0.946, which was significantly higher than the AUCs for carcinoembryonic antigen (CEA; 0.817), carbohydrate antigen 125 (CA125; 0.732), and carbohydrate antigen 19-9 (CA19-9; 0.771). Moreover, the combination of CEA, CA125, and CA19-9 with m6A levels improved the AUC to 0.977. Bioinformatics and qRT-PCR analysis further confirmed that the expression of m6A modifying regulator IGF2BP2 was markedly elevated in peripheral blood of CRC patients. Gene set variation analysis (GSVA) implied that monocyte was the most abundant m6A-modified immune cell type in CRC patients’ peripheral blood. Additionally, m6A modifications were negatively related to the immune response of monocytes. In conclusion, our results revealed that m6A RNA of peripheral blood immune cells was a prospective non-invasive diagnostic biomarker for CRC patients and might provide a valuable therapeutic target.

Prognostic Significance of Carbohydrate Antigen 125 in Acute Heart Failure: A Prospective Comparative Study With N-terminal Pro-B-type Natriuretic Peptide

Background: In acute heart failure (AHF), elevated carbohydrate antigen 125 (CA125) and N-terminal pro-B-type natriuretic peptide (NTproBNP) have shown to correlate with adverse events. We sought to quantify their prognostic usefulness in predicting the 6-month combined endpoint of death/heart failure readmission.Methods: The study includes 352 patients admitted for AHF. The primary endpoint was 6-month combined endpoint of death/AHF rehospitalization. CA125 and NTproBNP were dichotomized according to the best cut-offs to predict 6-month primary endpoint. By multivariate Cox regression analysis, the independent association of CA125 and NTproBNP with the primary endpoint was assessed, and their incremental prognostic utility evaluated by net reclassification improvement (NRI) and integrated discrimination improvement (IDI) index. Results: A total of 47 (13.4%) deaths and 113 (32.1%) AHF rehospitalizations were identified at 6-month follow-up. The subjects with CA125≥39.7 U/ml and NTproBNP≥3900 pg/ml had significantly higher cumulative event rates (56.1% vs. 33.3% and 53.3% vs. 33.8%, both P<0.001). Elevated CA125 (HR 1.93; 95%CI [1.32-2.83]; P=0.001) was associated with higher HR than NTproBNP≥3900 pg/ml (HR 1.71; 95%CI [1.19-2.48]; P=0.004) after adjusting for established risk factors. Elevated CA125 still independently predicted adverse events when both CA125 and NTproBNP were entered together in the same multivariate model. Furthermore, risk reclassification analyses demonstrated significant improvements in NRI of 22.3% (P=0.014) and IDI of 2.7% (P=0.012) when adding CA125 to the base model + NTproBNP.Conclusions: Elevated CA125 and NTproBNP predicted adverse outcomes in AHF patients. CA125 added prognostic value to NTproBNP, and thus, their combination conferred greater predictive capacity.

Propofol-Based Total Intravenous Anesthesia is Associated with Better Survival than Desflurane Anesthesia in Epithelial Ovarian Cancer Surgery: A Retrospective Cohort Study

Background: Previous studies have shown that anesthetic techniques can affect outcomes of cancer surgery. We investigated the association between anesthetic techniques and patient outcomes after elective epithelial ovarian cancer surgery.Methods: This was a retrospective cohort study of patients who received elective open surgery for epithelial ovarian cancer between January 2009 and December 2014. Patients were grouped according to the administration of propofol or desflurane anesthesia. Kaplan–Meier analysis was performed, and survival curves were constructed from the date of surgery to death. Univariate and multivariate Cox regression models were used to compare hazard ratios for death after propensity matching. Subgroup analyses were performed for age, body mass index, preoperative carbohydrate antigen-125 level, International Federation of Gynecology and Obstetrics staging, and operation and anesthesia time.Results: In total, 165 patients (76 deaths, 46.1%) who received desflurane anesthesia and 119 (30 deaths, 25.2%) who received propofol anesthesia were eligible for analysis. After propensity matching, 104 patients were included in each group. In the matched analysis, patients who received propofol anesthesia had better survival with a hazard ratio of 0.52 (95% confidence interval, 0.33–0.81; p = 0.005). Subgroup analyses also showed significantly better survival with old age, high body mass index, elevated carbohydrate antigen-125 level, advanced International Federation of Gynecology and Obstetrics stage, and prolonged operation and anesthesia time in the matched propofol group. In addition, patients administered with propofol anesthesia had less postoperative recurrence and metastasis than those administered with desflurane anesthesia in the matched analysis.Conclusion: Propofol anesthesia was associated with better survival in patients who underwent elective epithelial ovarian cancer open surgery. Prospective studies are warranted to evaluate the effects of propofol anesthesia on oncological outcomes in patients with epithelial ovarian cancer.

Prognostic significance of carbohydrate antigen 125 in acute heart failure: a prospective comparative study with N-terminal pro-B-type natriuretic peptide

Background In acute heart failure (AHF), elevated carbohydrate antigen 125 (CA125) and N-terminal pro-B-type natriuretic peptide (NTproBNP) have shown to correlate with adverse events. We sought to quantify their prognostic usefulness in predicting the 6-month combined endpoint of death/heart failure readmission. Methods The study includes 352 patients admitted for AHF. The primary endpoint was 6-month combined endpoint of death/AHF rehospitalization. CA125 and NTproBNP were dichotomized according to the best cut-offs to predict 6-month primary endpoint. By multivariate Cox regression analysis, the independent association of CA125 and NTproBNP with the primary endpoint was assessed, and their incremental prognostic utility evaluated by net reclassification improvement (NRI) and integrated discrimination improvement (IDI) index. Results A total of 47 (13.4%) deaths and 113 (32.1%) AHF rehospitalizations were identified at 6-month follow-up. The subjects with CA125 ≥ 39.7 U/ml and NTproBNP ≥ 3900 pg/ml had significantly higher cumulative event rates (56.1% vs. 33.3% and 53.3% vs. 33.8%, both P < 0.001). Elevated CA125 (HR 1.93; 95%CI [1.32–2.83]; P = 0.001) was associated with higher HR than NTproBNP ≥ 3900 pg/ml (HR 1.71; 95%CI [1.19–2.48]; P = 0.004) after adjusting for established risk factors. Elevated CA125 still independently predicted adverse events when both CA125 and NTproBNP were entered together in the same multivariate model. Furthermore, risk reclassification analyses demonstrated significant improvements in NRI of 22.3% (P = 0.014) and IDI of 2.7% (P = 0.012) when adding CA125 to the base model + NTproBNP. Conclusions Elevated CA125 and NTproBNP predicted adverse outcomes in AHF patients. CA125 added prognostic value to NTproBNP, and thus, their combination conferred greater predictive capacity.