目的 研究血清KL-6（Krebs von den lungen-6）作为生物标志物对CTD肺间质病变诊断、影像表现及活动性评估的价值。方法75例CTD患者分为合并肺间质病变组（44例）、不合并肺间质病变组（31例），而合并肺间质病变组再按肺CT影像分型及...目的 研究血清KL-6（Krebs von den lungen-6）作为生物标志物对CTD肺间质病变诊断、影像表现及活动性评估的价值。方法75例CTD患者分为合并肺间质病变组（44例）、不合并肺间质病变组（31例），而合并肺间质病变组再按肺CT影像分型及分级再分别分为3组，按肺间质病变活动与非活动分为2组。以ELISA法测定血清KL-6浓度，数据不服从正态分布，用独立样本非参数检验比较各组间的差异。结果CTD肺间质病变组的血清KL-6浓度[（1 118±877）U/ml]明显高于不合并肺间质病变组[（253±144）U/ml]，差异具有统计学意义（Z=-6.047，P〈0.01）。以500 U/ml为阳性标准，血清KL-6浓度对CTD合并肺间质病变诊断的敏感性、特异性、阳性预测值、阴性预测值分别为72.7%、87.1%、88.9%、69.2%。在合并肺间质病变组的影像分型中，寻常型间质性肺炎（UIP型，蜂窝病变为主）、非特异性间质性肺炎（NSIP型，毛玻璃与网格病变为主）与未定型分组间的血清KL-6浓度[分别为（1 104±843）U/ml、（1 242±1 039）U/ml、（815±400）U/ml]差异无统计学意义（χ2=0.35，P=0.84）。但合并肺间质病变组的影像病变累积分级中，病变分布范围广的患者血清KL-6浓度[（1 910±918）U/ml]较病变分布范围窄组的血清KL-6浓度[（459±268）U/ml]更高（Z=-4.364，P〈0.01）。肺间质病变活动组患者的血清KL-6浓度[（1 478±917）U/ml]也较肺间质病变非活动组[（598±475）U/ml]的高（Z=-3.915，P〈0.01）。结论血清KL-6浓度测定有利于CTD肺间质病变的诊断及肺病变范围及活动度的评估。展开更多
目的:探讨甘利欣联合阿奇霉素治疗对支原体肺炎伴急性肝功能损害患儿血清炎症因子、Ⅱ型肺泡表面抗原-6(KL-6)及核因子-κB(NF-κB)水平的影响。方法:选取86例支原体肺炎伴急性肝功能损害患儿为受试对象,随机数字表法分成研究组和对照组...目的:探讨甘利欣联合阿奇霉素治疗对支原体肺炎伴急性肝功能损害患儿血清炎症因子、Ⅱ型肺泡表面抗原-6(KL-6)及核因子-κB(NF-κB)水平的影响。方法:选取86例支原体肺炎伴急性肝功能损害患儿为受试对象,随机数字表法分成研究组和对照组各43例。对照组中途脱落1例,共42例有效病例入组,予以常规对症治疗+阿奇霉素疗法;研究组中途脱落3例,共40例有效病例入组,在对照组治疗基础上联合甘利欣静脉滴注疗法。观察对比两组受试患儿治疗前后血清炎症因子[白细胞介素-6(IL-6)、白细胞介素-12(IL-12)及肿瘤坏死因子-α(TNF-α)]、血清KL-6、血清NF-κB、肝功能指标[血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)]变化情况,记录其发热、咳嗽、肺部湿罗音等消失时间差异。结果:治疗4w后,两组患儿IL-6[(44.5±6.2)pg/m L vs(60.3±6.6)pg/m L]、IL-12[(42.4±6.2)pg/m L vs(52.1±6.8)pg/m L]、TNF-α[(128.6±44.8)ng/L vs(201.4±51.8)ng/L]等血清炎症因子检测结果、ALT[(46.8±9.5)U/I vs(83.6±9.8)U/I]、AST[(62.2±10.1)U/I vs(84.8±10.2)U/I]、TBIL[(38.2±8.5)μmol/L vs(49.3±9.0)μmol/L]等肝功能指标检测结果及血清KL-6[(5.9±0.6)pg/m L vs(6.5±0.7)pg/m L]、NF-κB[(7.8±0.4)pg/m L vs(8.1±0.3)pg/m L]水平均较治疗前显著降低,且研究组小于对照组,差异有统计学意义(P<0.05)。研究组患儿治疗后发热、咳嗽、肺部湿罗音等消失时间均显著短于对照组患儿,差异有统计学意义(P<0.05)。结论:甘利欣联合阿奇霉素疗法可在促进支原体肺炎伴急性肝功能损害患儿病情转归、改善其血清炎症因子、调节肺功能、肝功能状态等方面发挥积极作用。展开更多
AIM： To assess histochemical expression of KL-6 and its clinicopathological significance in carcinoma of the ampulla of Vater. METHODS： Ampullary carcinoma tissues were collected from 38 patients who underwent pancr...AIM： To assess histochemical expression of KL-6 and its clinicopathological significance in carcinoma of the ampulla of Vater. METHODS： Ampullary carcinoma tissues were collected from 38 patients who underwent pancreatoduodenectomy or local resection. Tissues were subjected to immunohistochemical analysis using KL-6 antibody. RESULTS： Positive staining of ampullary carcinoma cells was observed in 26 （68.4%） cases. Staining was not found in the surrounding non-cancer regions of the ampullary tissues. Remarkable KL-6 expression was observed in invasive carcinoma cells in pancreatic and duodenal tissues and in metastatic carcinoma cells in lymph nodes. Positive KL-6 expression was related to lymph node metastasis （P = 0.020）, pancreatic invasion （P = 0.016）, duodenal invasion （P = 0.034）, and advanced stage of TNM clinical classification （P = 0.010）. Survival analysis showed that positive expression of KL-6 was related to a poorer prognosis （P = 0.029）. CONCLUSION： The aberrant expression of KL-6 mucin is significantly related to unfavorable behaviors of cardnoma of the ampulla of Vater.展开更多
文摘目的:探讨甘利欣联合阿奇霉素治疗对支原体肺炎伴急性肝功能损害患儿血清炎症因子、Ⅱ型肺泡表面抗原-6(KL-6)及核因子-κB(NF-κB)水平的影响。方法:选取86例支原体肺炎伴急性肝功能损害患儿为受试对象,随机数字表法分成研究组和对照组各43例。对照组中途脱落1例,共42例有效病例入组,予以常规对症治疗+阿奇霉素疗法;研究组中途脱落3例,共40例有效病例入组,在对照组治疗基础上联合甘利欣静脉滴注疗法。观察对比两组受试患儿治疗前后血清炎症因子[白细胞介素-6(IL-6)、白细胞介素-12(IL-12)及肿瘤坏死因子-α(TNF-α)]、血清KL-6、血清NF-κB、肝功能指标[血清丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)]变化情况,记录其发热、咳嗽、肺部湿罗音等消失时间差异。结果:治疗4w后,两组患儿IL-6[(44.5±6.2)pg/m L vs(60.3±6.6)pg/m L]、IL-12[(42.4±6.2)pg/m L vs(52.1±6.8)pg/m L]、TNF-α[(128.6±44.8)ng/L vs(201.4±51.8)ng/L]等血清炎症因子检测结果、ALT[(46.8±9.5)U/I vs(83.6±9.8)U/I]、AST[(62.2±10.1)U/I vs(84.8±10.2)U/I]、TBIL[(38.2±8.5)μmol/L vs(49.3±9.0)μmol/L]等肝功能指标检测结果及血清KL-6[(5.9±0.6)pg/m L vs(6.5±0.7)pg/m L]、NF-κB[(7.8±0.4)pg/m L vs(8.1±0.3)pg/m L]水平均较治疗前显著降低,且研究组小于对照组,差异有统计学意义(P<0.05)。研究组患儿治疗后发热、咳嗽、肺部湿罗音等消失时间均显著短于对照组患儿,差异有统计学意义(P<0.05)。结论:甘利欣联合阿奇霉素疗法可在促进支原体肺炎伴急性肝功能损害患儿病情转归、改善其血清炎症因子、调节肺功能、肝功能状态等方面发挥积极作用。
基金Supported by Grants-in-aid From the Ministry of Education, Science, Sports, and Culture of Japan and a grant for Hi-Tech Research from Tokai University
文摘AIM： To assess histochemical expression of KL-6 and its clinicopathological significance in carcinoma of the ampulla of Vater. METHODS： Ampullary carcinoma tissues were collected from 38 patients who underwent pancreatoduodenectomy or local resection. Tissues were subjected to immunohistochemical analysis using KL-6 antibody. RESULTS： Positive staining of ampullary carcinoma cells was observed in 26 （68.4%） cases. Staining was not found in the surrounding non-cancer regions of the ampullary tissues. Remarkable KL-6 expression was observed in invasive carcinoma cells in pancreatic and duodenal tissues and in metastatic carcinoma cells in lymph nodes. Positive KL-6 expression was related to lymph node metastasis （P = 0.020）, pancreatic invasion （P = 0.016）, duodenal invasion （P = 0.034）, and advanced stage of TNM clinical classification （P = 0.010）. Survival analysis showed that positive expression of KL-6 was related to a poorer prognosis （P = 0.029）. CONCLUSION： The aberrant expression of KL-6 mucin is significantly related to unfavorable behaviors of cardnoma of the ampulla of Vater.
