Background Serum tumor markers have always been of clinical importance in the diagnosis, monitoring disease progression and therapy efficacy for patients with malignant diseases. However, elevated serum tumor markers ...Background Serum tumor markers have always been of clinical importance in the diagnosis, monitoring disease progression and therapy efficacy for patients with malignant diseases. However, elevated serum tumor markers are found in some benign conditions, especially in chronic kidney disease （CKD）. The elevation of them in CKD might cause confusion and misuse of these tumor markers. We conducted this retrospective study to investigate which of the five widely used tumor markers including carcinoembryonic antigen （CEA）, alpha-fetoprotein （AFP）, cytokeratin 19 fragment antigen 21-1 （Cyfra21-1）, squamous cell carcinoma antigen （SCC） and neuron specific enolase （NSE） are affected markedly by CKD, in order to use them more effectively. Methods Serum tumor marker concentrations, biochemical, hematological parameters, and urinalysis were measured in CKD patients and healthy controls. The positive rate and median tumor markers＇ level in CKD patients and controls, and those in CKD patients stratified by CKD grade were compared using nonparametric rank tests. Correlation analysis of serum tumor markers and other parameters in CKD patients were performed using the Spearman correlation coefficient. Multivariate Logistic regression analysis was used to estimate the important variables that caused elevated serum concentrations of these markers in CKD patients. Results The overall positive rates and serum concentrations of Cyfra21-1, SCC, CEA in CKD group were significantly higher than those in control group. Positive rate and serum concentrations of those tumor markers increased as kidney function decreased. Both univariate analysis and multivariate regression analysis showed that the elevations of those tumor markers were not only associated with kidney function, but also with nutritional status. Conclusions Serum concentrations of Cyfra21-1, SCC, CEA are significantly influenced by kidney function, as well as nutritional status. Therefore, in clinical work, the indices of kidney function and nutrition展开更多
目的分析多房囊性肾细胞癌(MCRCC)及肾细胞癌囊性变(NCRCC)的CT特征,提高对二者鉴别能力。方法回顾性分析经手术病理证实的11例MCRCC和16例NCRCC的CT特征。结果 81.8%(9/11)的MCRCC分布在BosniakⅡF、Ⅲ级,6 2.5%(1 0/1 6)的N C R C C...目的分析多房囊性肾细胞癌(MCRCC)及肾细胞癌囊性变(NCRCC)的CT特征,提高对二者鉴别能力。方法回顾性分析经手术病理证实的11例MCRCC和16例NCRCC的CT特征。结果 81.8%(9/11)的MCRCC分布在BosniakⅡF、Ⅲ级,6 2.5%(1 0/1 6)的N C R C C主要分布在BosniakⅣ级。MCRCC与NCRCC囊壁形态存在差异(P<0.05)。MCRCC均呈多房性改变,NCRCC仅37.5%(6/16)呈多房性改变。72.7%(8/11)MCRCC的囊液CT值≤20HU,81.3%(13/16)的NCRCC囊液CT值>20HU。MCRCC与NCRCC病灶内软组织结节大小存在明显差异(P=0.003)。结论MCRCC与NCRCC的CT表现具有一定特征性,综合分析可提高对两者的鉴别。展开更多
Objective: This study demonstrated that dexamethasone(DEX) protects the endothelial glycocalyx from damage induced by the inflammatory stimulus tumor necrosis factor-α(TNF-α) during severe acute pancreatitis(SAP), a...Objective: This study demonstrated that dexamethasone(DEX) protects the endothelial glycocalyx from damage induced by the inflammatory stimulus tumor necrosis factor-α(TNF-α) during severe acute pancreatitis(SAP), and improves the renal microcirculation. Methods: Ninety mice were evenly divided into 3 groups(Sham, SAP, and SAP+DEX). The SAP mice model was established by ligature of pancreatic duct and intraperitoneal injection of cerulein. Renal perfusion and function, and morphological changes of the glycocalyx were evaluated by laser Doppler velocimetry, electron microscopy, and histopathology(hematoxylin and eosin(H&E) staining), respectively. Serum levels of syndecan-1 and TNF-α were assessed by enzyme-linked immunosorbent assay(ELISA). The proàtectiveì effects of dexamethasone on the glycocalyx and renal microcirculation were evaluated. Results: Significantly high levels of serum TNF-α were detected 3 h after the onset of SAP. These levels might induce degradation of the glycocalyx and kidney hypoperfusion, resulting in kidney microcirculation dysfunction. The application of dexamethasone reduced the degradation of the glycocalyx and improved perfusion of kidney. Conclusions: Dexamethasone protects the endothelial glycocalyx from inflammatory degradation possibly initiated by TNF-α during SAP. This is might be a significant discovery that helps to prevent tissue edema and hypoperfusion in the future.展开更多
文摘Background Serum tumor markers have always been of clinical importance in the diagnosis, monitoring disease progression and therapy efficacy for patients with malignant diseases. However, elevated serum tumor markers are found in some benign conditions, especially in chronic kidney disease （CKD）. The elevation of them in CKD might cause confusion and misuse of these tumor markers. We conducted this retrospective study to investigate which of the five widely used tumor markers including carcinoembryonic antigen （CEA）, alpha-fetoprotein （AFP）, cytokeratin 19 fragment antigen 21-1 （Cyfra21-1）, squamous cell carcinoma antigen （SCC） and neuron specific enolase （NSE） are affected markedly by CKD, in order to use them more effectively. Methods Serum tumor marker concentrations, biochemical, hematological parameters, and urinalysis were measured in CKD patients and healthy controls. The positive rate and median tumor markers＇ level in CKD patients and controls, and those in CKD patients stratified by CKD grade were compared using nonparametric rank tests. Correlation analysis of serum tumor markers and other parameters in CKD patients were performed using the Spearman correlation coefficient. Multivariate Logistic regression analysis was used to estimate the important variables that caused elevated serum concentrations of these markers in CKD patients. Results The overall positive rates and serum concentrations of Cyfra21-1, SCC, CEA in CKD group were significantly higher than those in control group. Positive rate and serum concentrations of those tumor markers increased as kidney function decreased. Both univariate analysis and multivariate regression analysis showed that the elevations of those tumor markers were not only associated with kidney function, but also with nutritional status. Conclusions Serum concentrations of Cyfra21-1, SCC, CEA are significantly influenced by kidney function, as well as nutritional status. Therefore, in clinical work, the indices of kidney function and nutrition
文摘目的分析多房囊性肾细胞癌(MCRCC)及肾细胞癌囊性变(NCRCC)的CT特征,提高对二者鉴别能力。方法回顾性分析经手术病理证实的11例MCRCC和16例NCRCC的CT特征。结果 81.8%(9/11)的MCRCC分布在BosniakⅡF、Ⅲ级,6 2.5%(1 0/1 6)的N C R C C主要分布在BosniakⅣ级。MCRCC与NCRCC囊壁形态存在差异(P<0.05)。MCRCC均呈多房性改变,NCRCC仅37.5%(6/16)呈多房性改变。72.7%(8/11)MCRCC的囊液CT值≤20HU,81.3%(13/16)的NCRCC囊液CT值>20HU。MCRCC与NCRCC病灶内软组织结节大小存在明显差异(P=0.003)。结论MCRCC与NCRCC的CT表现具有一定特征性,综合分析可提高对两者的鉴别。
基金Project supported by the National Natural Science Foundation of China(No.81501644)
文摘Objective: This study demonstrated that dexamethasone(DEX) protects the endothelial glycocalyx from damage induced by the inflammatory stimulus tumor necrosis factor-α(TNF-α) during severe acute pancreatitis(SAP), and improves the renal microcirculation. Methods: Ninety mice were evenly divided into 3 groups(Sham, SAP, and SAP+DEX). The SAP mice model was established by ligature of pancreatic duct and intraperitoneal injection of cerulein. Renal perfusion and function, and morphological changes of the glycocalyx were evaluated by laser Doppler velocimetry, electron microscopy, and histopathology(hematoxylin and eosin(H&E) staining), respectively. Serum levels of syndecan-1 and TNF-α were assessed by enzyme-linked immunosorbent assay(ELISA). The proàtectiveì effects of dexamethasone on the glycocalyx and renal microcirculation were evaluated. Results: Significantly high levels of serum TNF-α were detected 3 h after the onset of SAP. These levels might induce degradation of the glycocalyx and kidney hypoperfusion, resulting in kidney microcirculation dysfunction. The application of dexamethasone reduced the degradation of the glycocalyx and improved perfusion of kidney. Conclusions: Dexamethasone protects the endothelial glycocalyx from inflammatory degradation possibly initiated by TNF-α during SAP. This is might be a significant discovery that helps to prevent tissue edema and hypoperfusion in the future.
