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BACKGROUND: Yolk sac tumor (YST) is a highly malignant germ cell tumor, a majority of which originate from the gonads and are extremely rare from endometrium. CASE PRESENTATION: Here we present a case of a 42-year-old woman suffered from primary pure yolk sac tumor of the endometrium complicated with situs inversus totalis. The patient presented at our hospital with irregular vaginal bleeding. Imageological examination showed a space-occupying lesion in the cervix and the serum Alpha-fetoprotein (AFP) level was significantly high (more than 1210ng/ml). Then she underwent total hysterectomy, bilateral salpingo-oophorectomy and pelvic lymph node dissection. The subsequent postoperative pathological diagnosis was yolk sac tumor arising from the endometrium. Next, the patient was treated with 6 cycles of chemotherapy with Pingyangmycin, etoposide and cisplatin regimen and was alive without evidence of recurrence or distant metastases for 13 months. CONCLUSIONS: This rare disease needs to be differentiated from endometrial epithelial neoplasia and the significant increase in AFP is helpful for diagnosis. Combined with previous literature reports, comprehensive staging laparotomy or maximum cytoreductive surgery complemented by standard chemotherapy can usually achieve a good efficacy.
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Tumor del Seno Endodérmico , Neoplasias Endometriales , Situs Inversus , Humanos , Femenino , Tumor del Seno Endodérmico/complicaciones , Tumor del Seno Endodérmico/diagnóstico , Tumor del Seno Endodérmico/patología , Adulto , Situs Inversus/complicaciones , Situs Inversus/diagnóstico , Neoplasias Endometriales/complicaciones , Neoplasias Endometriales/diagnóstico , Neoplasias Endometriales/patología , alfa-Fetoproteínas/análisis , Histerectomía/métodosRESUMEN
Transarterial chemoembolization (TACE) is an established therapeutic strategy for intermediate stage Barcelona Clinic Liver Cancer (BCLC) hepatocellular carcinoma (HCC). However, patients who are early refractory to TACE may not benefit from repeated TACE treatment. Our primary objective was to assess the diagnostic value of inflammatory markers in identifying early TACE refractory for patients with early (BCLC 0 and A) or intermediate (BCLC B) stage HCC. We retrospectively reviewed the HCC patients who underwent TACE as the initial treatment in two hospitals. Patients with early TACE refractoriness had significantly poorer median overall survival (OS) (16 vs 40 months, P<0.001) and progression-free survival (PFS) (7 vs 23 months, P<0.001) compared to TACE non-refractory patients. In the multivariate regression analysis, tumor size (P<0.001), bilobular invasion (P=0.007), high aspartate aminotransferase-to-platelet ratio index (APRI) (P=0.007), and high alpha fetoprotein (AFP) level (P=0.035) were independent risk factors for early TACE refractoriness. The predictive model showcasing these factors exhibited high ability proficiency, with an area under curve (AUC) of 0.833 (95%CI=0.774-0.892) in the training cohort, 0.750 (95%CI: 0.640-0.861) in the internal-validation cohort, and 0.733 (95%CI: 0.594-0.872) in the external-validation cohort. Calibration curve analysis revealed good agreement between the actual and predicted probabilities of early TACE refractoriness. Our preliminary study estimated the potential value of inflammatory markers in predicting early TACE refractoriness and provides a predictive model to assist in identifying patients who may not benefit from repeat TACE treatment.
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Biomarcadores de Tumor , Carcinoma Hepatocelular , Quimioembolización Terapéutica , Neoplasias Hepáticas , Humanos , Carcinoma Hepatocelular/terapia , Carcinoma Hepatocelular/sangre , Carcinoma Hepatocelular/diagnóstico , Carcinoma Hepatocelular/patología , Neoplasias Hepáticas/terapia , Neoplasias Hepáticas/sangre , Neoplasias Hepáticas/patología , Neoplasias Hepáticas/diagnóstico , Quimioembolización Terapéutica/métodos , Masculino , Femenino , Persona de Mediana Edad , Estudios Retrospectivos , Anciano , Biomarcadores de Tumor/sangre , Estadificación de Neoplasias , Valor Predictivo de las Pruebas , Adulto , alfa-Fetoproteínas/análisis , alfa-Fetoproteínas/metabolismoRESUMEN
PURPOSE: To evaluate outcomes including safety and efficacy of drug-eluting bead trans-arterial chemo-embolization (DEB-TACE) in the treatment of locally advanced hepatocellular carcinoma (LA-HCC). MATERIALS AND METHODS: In this single-center, retrospective study, we evaluated 471 consecutive patients with LA-HCC who underwent DEB-TACE from 2015 to 2020. Efficacy of DEB-TACE was assessed based on the imaging response using the modified Response Evaluation Criteria in Solid Tumors (mRECIST) and the biochemical response using alpha-fetoprotein (AFP) levels at 1-month follow-up. Adverse events, progression free survival (PFS), and overall survival were also examined. RESULTS: HCC distribution was bilobar in 49% with largest lesion mean size of 4.3 cm ± 3.2, and a majority of patients (46.7%) were Barcelona Club Liver Cancer (BCLC) stage B. Complete radiologic response was achieved in 120 (25.5%) patients, comparable to a reported 28% rate for conventional TACE. Biochemically, 41 (8.7%) patients achieved complete response, and 113 (24%) had a partial response. A total of 59 (12.5%) patients were successfully bridged to liver transplantation. Major adverse events were observed in 3%, while 7.2% experienced post-embolization syndrome. Mean PFS was 6.7 months ± 6.6, and overall survival was 64%, 16.3%, 2.1% at 1, 3, and 5 years, respectively. CONCLUSION: Based on our real world experience at a single center, DEB-TACE remains the locoregional therapy of choice for LA-HCC due to its favorable safety and efficacy profile.
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Carcinoma Hepatocelular , Quimioembolización Terapéutica , Neoplasias Hepáticas , Humanos , Carcinoma Hepatocelular/terapia , Carcinoma Hepatocelular/patología , Carcinoma Hepatocelular/mortalidad , Neoplasias Hepáticas/terapia , Neoplasias Hepáticas/patología , Neoplasias Hepáticas/mortalidad , Masculino , Femenino , Quimioembolización Terapéutica/métodos , Persona de Mediana Edad , Anciano , Estudios Retrospectivos , Resultado del Tratamiento , Adulto , alfa-Fetoproteínas/metabolismo , alfa-Fetoproteínas/análisisRESUMEN
BACKGROUND: Circulating tumor markers with satisfactory sensitivity and specificity play crucial roles in cancer diagnosis and therapy. This prospective study aimed to evaluate the potential of circulating lncRNAs as biomarkers for hepatocellular carcinoma (HCC). METHODS: A total of 74 patients with HCC and 94 healthy controls were enrolled. The expression levels of candidate genes in serum were detected by qRT-PCR. Receiver operating characteristic (ROC) curve analysis and logistic regression were employed to investigate the diagnostic capacity of lncRNAs. The analysis of 3-year overall survival (OS) was conducted using the Kaplan-Meier method and log-rank test. RESULTS: Of the 9 candidate genes, 6 lncRNAs could be stably detected in serum. The expression levels of circulating MALAT1 and HOTTIP in HCC patients were significantly higher than those in controls (P < 0.001). ROC analysis showed that MALAT1 and HOTTIP were more effective than alpha-fetoprotein (AFP) (P < 0.010) in the diagnosis of HCC, with AUCs of 0.896 and 0.899, respectively. Additionally, a panel consisting of MALAT1, HOTTIP, and AFP was constructed to obtain an AUC of 0.968 with a sensitivity of 87.8% and specificity of 94.7% in HCC diagnosis. Moreover, the upregulation of MALAT1 was not only related to multiple tumor lesions, HCV infection, AST level, and AFP level, but also suggested shorter OS. A high expression level of HOTTIP was associated with metastasis. CONCLUSION: Serum MALAT1 and HOTTIP play indicative roles as non-invasive biomarkers for HCC.
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Biomarcadores de Tumor , Carcinoma Hepatocelular , Neoplasias Hepáticas , ARN Largo no Codificante , Humanos , ARN Largo no Codificante/sangre , ARN Largo no Codificante/genética , Carcinoma Hepatocelular/sangre , Carcinoma Hepatocelular/genética , Carcinoma Hepatocelular/diagnóstico , Neoplasias Hepáticas/sangre , Neoplasias Hepáticas/genética , Neoplasias Hepáticas/diagnóstico , Biomarcadores de Tumor/sangre , Biomarcadores de Tumor/genética , Masculino , Femenino , Persona de Mediana Edad , Estudios Prospectivos , Curva ROC , Estudios de Casos y Controles , Pronóstico , alfa-Fetoproteínas/análisis , alfa-Fetoproteínas/metabolismo , Adulto , Regulación Neoplásica de la Expresión GénicaRESUMEN
In this work, SiO2/CNTs photonic crystal beads were constructed by doping CNTs into SiO2 photonic crystals, which have an angle-independent responsive structural color and can be used as bipolar electrodes due to their good electrical conductivity. In addition, the bipolar electrode-electrochemiluminescence (BPE-ECL) experiments and finite element simulation prove that the low driving voltage can trigger the bipolar electrode electrochemical reactions by confinement effect. Inspired by this, it is the first to combine the SiO2/CNTs structural color coding scheme with low-drive voltage induced wireless BPE-ECL imaging based on the confinement effect of microchannels to achieve simultaneous immune detection of ovarian cancer biomarkers (CA125, CEA, AFP). The detection limits of successfully constructed high-throughput BPE-ECL biosensor for AFP, CEA, and CA125 are 0.72 ng/mL, 0.95 ng/mL, and 1.03 U/mL, respectively, and have good stability and specificity, which expands the application of electrochemiluminescence and lays a foundation for the development of electrochemiluminescence coding technology.
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Antígeno Ca-125 , Técnicas Electroquímicas , Mediciones Luminiscentes , Humanos , Antígeno Ca-125/análisis , Técnicas Biosensibles , Antígeno Carcinoembrionario/análisis , Dióxido de Silicio/química , Biomarcadores de Tumor/análisis , Tecnología Inalámbrica , Neoplasias Ováricas/diagnóstico por imagen , alfa-Fetoproteínas/análisis , Femenino , Color , Electrodos , Límite de DetecciónRESUMEN
Alpha-fetoprotein (AFP) is a structural serum glycoprotein that plays vital roles in reproduction and mammalian development. Analysis of serum prolactin (PRL) is considered one of the useful methods for diagnosing pregnancy in Asian elephants. However, the expression profiles of AFP in pregnant and nonpregnant Asian elephants remain unclear, nor is the relationship with PRL. In this study, serum seven gonadal hormones and AFP in three pregnant and seven nonpregnant Asian elephants were analysed by via radioimmunoassay (RIA) and enzyme-linked immunosorbent (ELISA) assay. We found that the mean (±SD) concentration of prolactin (PRL) in pregnant (136.782 ± 30.987 ng/mL) elephants was significantly higher than that in nonpregnant elephants (52.803 ± 21.070 ng/mL; p ≤ 0.0005). The mean (±SD) concentration of AFP in pregnant elephants (11.598 ± 0.824 ng/mL) was significantly higher than that in nonpregnant elephants (7.200 ± 2.283 ng/mL; p ≤ 0.05). Furthermore, the AFP concentration was positively correlated with the PRL concentration in the 10 Asian elephants studied. In conclusion, our findings suggest that serum AFP concentration is a potential biomarker of pregnancy outcomes in Asian elephants.
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Biomarcadores , Elefantes , Resultado del Embarazo , alfa-Fetoproteínas , Animales , Femenino , Embarazo , alfa-Fetoproteínas/análisis , alfa-Fetoproteínas/metabolismo , Elefantes/sangre , Elefantes/fisiología , Biomarcadores/sangre , Resultado del Embarazo/veterinaria , Preñez/sangre , Prolactina/sangreRESUMEN
The relationship between antitumor response and tumor marker changes was evaluated in patients with advanced hepatocellular carcinoma treated with durvalumab plus tremelimumab (Dur/Tre). Forty patients were enrolled in this retrospective evaluation of treatment outcomes. According to the Response Evaluation Criteria for Solid Tumors version 1.1 at 8 weeks, the objective response (OR) rate was 25% and the disease control (DC) rate was 57.5%. The median alpha-fetoprotein (AFP) ratio at 4 weeks was 0.39 in patients who achieved OR at 8 weeks (8W-OR group), significantly lower than the 1.08 in the non-8W-OR group (p = 0.0068); however, it was 1.22 in patients who did not achieve DC at 8 weeks (non-8W-DC group), significantly higher than the 0.53 in the 8W-DC group (p = 0.0006). Similarly, the median des-γ-carboxy-prothrombin (DCP) ratio at 4 weeks was 0.15 in the 8W-OR group, significantly lower than the 1.46 in the non-8W-OR group (p < 0.0001); however, it was 1.23 in the non-8W-DC group, significantly higher than the 0.49 in the 8W-DC group (p = 0.0215). Early changes in tumor markers after Dur/Tre initiation were associated with antitumor response. In particular, changes in AFP and DCP at 4 weeks may offer useful biomarkers for early prediction of both response and progressive disease following Dur/Tre.
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Anticuerpos Monoclonales Humanizados , Anticuerpos Monoclonales , Protocolos de Quimioterapia Combinada Antineoplásica , Carcinoma Hepatocelular , Neoplasias Hepáticas , Precursores de Proteínas , Protrombina , alfa-Fetoproteínas , Humanos , Carcinoma Hepatocelular/tratamiento farmacológico , Carcinoma Hepatocelular/sangre , Neoplasias Hepáticas/tratamiento farmacológico , Neoplasias Hepáticas/sangre , Masculino , Femenino , Anticuerpos Monoclonales Humanizados/uso terapéutico , Persona de Mediana Edad , Anciano , Anticuerpos Monoclonales/uso terapéutico , Precursores de Proteínas/sangre , Estudios Retrospectivos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Biomarcadores de Tumor/sangre , Adulto , Resultado del Tratamiento , Anciano de 80 o más Años , BiomarcadoresRESUMEN
BACKGROUND: Breast cancer remains a leading cause of female mortality worldwide, exacerbated by limited awareness, inadequate screening resources, and treatment options. Accurate and early diagnosis is crucial for improving survival rates and effective treatment. OBJECTIVES: This study aims to develop an innovative artificial intelligence (AI) based model for predicting breast cancer and its various histopathological grades by integrating multiple biomarkers and subject age, thereby enhancing diagnostic accuracy and prognostication. METHODS: A novel ensemble-based machine learning (ML) framework has been introduced that integrates three distinct biomarkers-beta-human chorionic gonadotropin (ß-hCG), Programmed Cell Death Ligand 1 (PD-L1), and alpha-fetoprotein (AFP)-alongside subject age. Hyperparameter optimization was performed using the Particle Swarm Optimization (PSO) algorithm, and minority oversampling techniques were employed to mitigate overfitting. The model's performance was validated through rigorous five-fold cross-validation. RESULTS: The proposed model demonstrated superior performance, achieving a 97.93% accuracy and a 98.06% F1-score on meticulously labeled test data across diverse age groups. Comparative analysis showed that the model outperforms state-of-the-art approaches, highlighting its robustness and generalizability. CONCLUSION: By providing a comprehensive analysis of multiple biomarkers and effectively predicting tumor grades, this study offers a significant advancement in breast cancer screening, particularly in regions with limited medical resources. The proposed framework has the potential to reduce breast cancer mortality rates and improve early intervention and personalized treatment strategies.
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Algoritmos , Biomarcadores de Tumor , Neoplasias de la Mama , Aprendizaje Automático , Humanos , Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/mortalidad , Femenino , Biomarcadores de Tumor/sangre , Pronóstico , Persona de Mediana Edad , Adulto , Anciano , alfa-Fetoproteínas/análisis , Clasificación del Tumor , Inteligencia ArtificialRESUMEN
In electrochemical analysis, developing biosensors that can resist the nonspecific adsorption of interfering biomolecules in human serum remains a huge challenge, which depends on the design of efficient antifouling materials. Herein, 3-aminopropyldimethylamine oxide (APDMAO) biomimetic zwitterions were prepared as antifouling interfaces. Among them, the unique positive and negative charges (N+-O-) of APDMAO promoted its hydrogen bonding with water molecules, forming a firm hydration barrier that endowed it with strong and stable antifouling performance. Meanwhile, its inherent amino groups could copolymerize with the biomimetic adhesive dopamine to form a thin layer of quinone intermediates, providing conditions for the subsequent binding of aptamers and signal probes. Importantly, the biomimetic APDMAO with functional groups and one-step oxidation characteristics solved the challenges of zwitterionic synthesis and modification, as well as improved biocompatibility of the sensing interface, thereby expanding the application potential of zwitterions as antifouling materials in sensing analysis. Thiol-containing alpha-fetoprotein (AFP) aptamers modified with methylene blue (MB) were coupled under controllable potential, greatly reducing the incubation time, which promoted the productization application of biosensors. In addition, the ratio sensing strategy using MB as internal standard factors and concanavalin-silver nanoparticles (ConA-Ag NPs) as signal probes was introduced to reduce background and instrument interferences, thus improving detection accuracy. On this basis, the proposed antifouling electrochemical biosensor achieved sensitive and accurate AFP detection over a wide dynamic range (10 fg/mL-10 ng/mL), with a low detection limit of 3.41 fg/mL (3σ/m). This work provides positive insights into the development of zwitterionic antifouling materials and clinical detection of liver cancer markers in human serum.
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Técnicas Biosensibles , Técnicas Electroquímicas , alfa-Fetoproteínas , Humanos , alfa-Fetoproteínas/análisis , Técnicas Biosensibles/métodos , Técnicas Electroquímicas/métodos , Límite de Detección , Incrustaciones Biológicas/prevención & control , Aptámeros de Nucleótidos/química , Propilaminas/química , Polímeros/químicaRESUMEN
The combination of the photothermal effect and immunoassay serves as a potent tool for crafting cost-effective and user-friendly biosensing systems. To ensure efficient light-to-heat conversion, we integrated three-dimensional-printed (3D printed) technology to devise a novel design. This design functions as the structural support for both the cell phone and laser probe, as well as a means for sample handling. The main body features a three-way cavity structure, securing the test sample at a fixed position to maintain consistent light distance and angle, thereby minimizing testing errors. Card slot insert facilitates precise sample positioning to ensure the adequacy of receiving light. The sample holder's wide front and narrow back design enables the accommodation of fixed samples while providing a broad field of view, with intervals therein effectively preventing cascading heat. Our design employs MB@MOF235 (methylene blue adsorbed by iron terephthalate) as the photothermal reagent, successfully enabling the detection of α-fetoprotein (AFP). The detection range spans from 0.01 to 50 ng/mL, with a lower detection limit (LOD) of 0.032 pg/mL. The detection method, combining simplicity, portability, and visualization, offers a reliable reference for furthering precision medicine toward personalized medicine. Meanwhile, to verify the method's accuracy electrochemical testing was conducted to support the proof using the electro-oxidizing activity of MB.
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Técnicas Biosensibles , Impresión Tridimensional , Teléfono Inteligente , alfa-Fetoproteínas , Inmunoensayo/métodos , Humanos , alfa-Fetoproteínas/análisis , Límite de DetecciónRESUMEN
Hepatocellular carcinoma (HCC) is a leading cause of cancer-related deaths worldwide, mainly associated with liver cirrhosis. Current diagnostic methods for HCC have limited sensitivity and specificity, highlighting the need for improved early detection and intervention. In this study, we used a comprehensive approach involving endogenous peptidome along with bioinformatics analysis to identify and evaluate potential biomarkers for HCC. Serum samples from 40 subjects, comprising 20 HCC cases and 20 patients with liver cirrhosis (CIRR), were analyzed. Among 2568 endogenous peptides, 67 showed significant differential expression between the HCC vs CIRR. Further analysis revealed three endogenous peptides (VMHEALHNHYTQKSLSLSPG, NRFTQKSLSLSPG, and SARQSTLDKEL) that showed far better performance compared to AFP in terms of area under the receiver operating characteristic curve (AUC), showcasing their potential as biomarkers for HCC. Additionally, endogenous peptide IAVEWESNGQPENNYKT that belongs to the precursor protein Immunoglobulin heavy constant gamma 4 was detected in 100% of the HCC group and completely absent in the CIRR group, suggesting a promising diagnostic biomarker. Gene ontology and pathway analysis revealed the potential involvement of these dysregulated peptides in HCC. These findings provide valuable insights into the molecular basis of HCC and may contribute to the development of improved diagnostic methods and therapeutic targets for HCC.
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Biomarcadores de Tumor , Carcinoma Hepatocelular , Cirrosis Hepática , Neoplasias Hepáticas , Péptidos , Humanos , Carcinoma Hepatocelular/sangre , Carcinoma Hepatocelular/diagnóstico , Neoplasias Hepáticas/sangre , Neoplasias Hepáticas/diagnóstico , Cirrosis Hepática/sangre , Cirrosis Hepática/diagnóstico , Biomarcadores de Tumor/sangre , Péptidos/sangre , Masculino , Femenino , Curva ROC , Persona de Mediana Edad , Biología Computacional , Proteómica/métodos , alfa-Fetoproteínas/análisis , alfa-Fetoproteínas/metabolismoRESUMEN
A novel sandwich-type electrochemical immunosensor for the detection of the liver cancer marker alpha-fetoprotein (AFP) in human serum is proposed. The two-dimensional MXene material Ti3C2Tx was first prepared using etching and ultrasonic stripping, and then Ti3C2Tx was used to reduce chloroauric acid to form Ti3C2Tx/AuNP composites which were modified on the surface of the glassy carbon electrodes to form probe-type sensors. The Ti3C2Tx/AuNPs provide a large number of binding sites for the AFP capture antibody (Ab1) and increase the electrochemical reaction active site. The Ti3C2Tx/copper metal-organic frameworks HKUST-1 composite was also prepared by solvothermal method and combined with toluidine blue (TB) and AFP detection antibody (Ab2) to form a labeled sandwich-type electrochemical immunosensor. The sensor achieved trace detection of AFP from 0.1 to 100 ng/mL with a detection limit of 0.073 pg/mL and possesses good selectivity, stability, and reproducibility. The sensor performs well in clinical samples and has good potential for clinical applications.
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Anticuerpos Inmovilizados , Técnicas Biosensibles , Técnicas Electroquímicas , Oro , Límite de Detección , Neoplasias Hepáticas , Nanopartículas del Metal , Estructuras Metalorgánicas , Titanio , alfa-Fetoproteínas , Humanos , alfa-Fetoproteínas/análisis , alfa-Fetoproteínas/inmunología , Neoplasias Hepáticas/sangre , Neoplasias Hepáticas/diagnóstico , Técnicas Electroquímicas/métodos , Oro/química , Nanopartículas del Metal/química , Inmunoensayo/métodos , Estructuras Metalorgánicas/química , Anticuerpos Inmovilizados/inmunología , Titanio/química , Técnicas Biosensibles/métodos , Cloruro de Tolonio/química , Biomarcadores de Tumor/sangre , Detección Precoz del Cáncer/métodos , Electrodos , Cobre/químicaRESUMEN
In contemporary society, developing dependable point-of-care (POC) biosensors for the timely detection of cancer markers is crucial. Among various sensor types, screen-printed electrode (SPE)-based sensors, particularly electrochemical ones, stand out as promising candidates for POC applications. Despite ongoing efforts to create numerous SPE-based sensors, there is a continuous pursuit to enhance their sensitivity and analytical capabilities. This study presents an advanced electrochemical sensor designed to sensitively detect the hepatocellular carcinoma (HCC) marker Alpha-fetoprotein (AFP) in saliva. The sensor employs a gold SPE modified with hydroxyapatite, TiO2 nanoparticles, 1-butyl-3-methylimidazolium bis(trifluoromethyl sulfonyl)imide ionic liquid (IL), and AFP monoclonal antibodies. After thorough characterization and optimization using cyclic voltammetry (CV) and differential pulse voltammetry (DPV), the biosensor exhibited a broad detection range (0.01-400 ng/mL), a low limit of detection (LOD) at 0.058 ng/mL, and demonstrated high selectivity, repeatability, reproducibility, and stability. Furthermore, when tested with spiked human saliva samples, the biosensor displayed excellent recovery and robustness, showcasing its potential for noninvasive and POC diagnosis of HCC. In an environmentally conscious evaluation, the biosensor's greenness was assessed using the AGREE metric, yielding a high score of 0.85. This score indicates the biosensor's alignment with the principles of green analytical chemistry, underlining its eco-friendly attributes. This innovative electrochemical sensor contributes to the ongoing efforts for efficient and reliable POC diagnostic tools and aligns with a broader commitment to developing environmentally friendly solutions.
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Técnicas Biosensibles , Durapatita , Técnicas Electroquímicas , Líquidos Iónicos , Saliva , Titanio , alfa-Fetoproteínas , Líquidos Iónicos/química , Titanio/química , Durapatita/química , Humanos , Técnicas Electroquímicas/métodos , Técnicas Biosensibles/métodos , alfa-Fetoproteínas/análisis , alfa-Fetoproteínas/inmunología , Saliva/química , Límite de Detección , Electrodos , Tecnología Química Verde , Biomarcadores de Tumor/análisisRESUMEN
Tumor markers should be measured regularly and accurately to prevent, diagnose, and monitor cancers efficiently. We aimed to characterize the pre-analytical factors effecting on the analytical performance of point-of-care test (POCT) platform IchromaTM II (Boditech Med Inc., Gangwon-do, Korea) for alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), and prostate specific antigen (PSA) and evaluate their consequences in clinical practice. Based on comprehensive evaluation for the analytical performance of IchromaTM II including precision, linearity, and method comparison performed according to CLSI guidelines, pre-analytical factors of sample types and conditions were extensively analyzed. A total of five sample types [serum, plasma (PL) and whole blood (WB) from EDTA tube, PL and WB from sodium heparin tube] from 40 patients were used for comparing among specimen types. Additionally, stability was assessed up to 21 h at room temperature, refrigerated for 8 days, and frozen for 16 weeks by using 4 levels of pooled patient samples which were measured in triplicate. Precision, linearity and correlation with central laboratory analyzers observed in all three tumor markers were within acceptable criteria. However, variable degrees of percent deviations were observed according to sample type and storage conditions. Only EDTA PL samples presented clinically acceptable percentage biases for all three tumor markers when stored at room temperature or refrigerated condition. Positive bias of CEA and PSA in storage duration until 16 weeks were observed when stored in frozen condition. While IchromaTM II showed an adequate analytical performance as a POCT platform with simple operating procedures for the measurement of tumor markers, clinical laboratories should be aware of stability issues when different types of blood specimens are practically utilized.
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Biomarcadores de Tumor , Humanos , Biomarcadores de Tumor/sangre , Antígeno Prostático Específico/sangre , Antígeno Prostático Específico/análisis , Antígeno Carcinoembrionario/sangre , Antígeno Carcinoembrionario/análisis , Sistemas de Atención de Punto/normas , alfa-Fetoproteínas/análisis , Manejo de Especímenes , Fase PreanalíticaRESUMEN
OBJECTIVES: This study aims to develop and validate machine learning-based diagnostic and prognostic models to predict the risk of distant lymph node metastases (DLNM) in patients with hepatocellular carcinoma (HCC) and to evaluate the prognosis for this cohort. DESIGN: Utilizing a retrospective design, this investigation leverages data extracted from the Surveillance, Epidemiology, and End Results (SEER) database, specifically the January 2024 subset, to conduct the analysis. PARTICIPANTS: The study cohort consists of 15,775 patients diagnosed with HCC as identified within the SEER database, spanning 2016 to 2020. METHOD: In the construction of the diagnostic model, recursive feature elimination (RFE) is employed for variable selection, incorporating five critical predictors: age, tumor size, radiation therapy, T-stage, and serum alpha-fetoprotein (AFP) levels. These variables are the foundation for a stacking ensemble model, which is further elucidated through Shapley Additive Explanations (SHAP). Conversely, the prognostic model is crafted utilizing stepwise backward regression to select pertinent variables, including chemotherapy, radiation therapy, tumor size, and age. This model culminates in the development of a prognostic nomogram, underpinned by the Cox proportional hazards model. MAIN OUTCOME MEASURES: The outcome of the diagnostic model is the occurrence of DLNM in patients. The outcome of the prognosis model is determined by survival time and survival status. RESULTS: The integrated model developed based on stacking demonstrates good predictive performance and high interpretative variability and differentiation. The area under the curve (AUC) in the training set is 0.767, while the AUC in the validation set is 0.768. The nomogram, constructed using the Cox model, also demonstrates consistent and strong predictive capabilities. At the same time, we recognized elements that have a substantial impact on DLNM and the prognosis and extensively discussed their significance in the model and clinical practice. CONCLUSION: Our study identified key predictive factors for DLNM and elucidated significant prognostic indicators for HCC patients with DLNM. These findings provide clinicians with valuable tools to accurately identify high-risk individuals for DLNM and conduct more precise risk stratification for this patient subgroup, potentially improving management strategies and patient outcomes.
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Carcinoma Hepatocelular , Neoplasias Hepáticas , Metástasis Linfática , Aprendizaje Automático , Nomogramas , Programa de VERF , Humanos , Neoplasias Hepáticas/terapia , Neoplasias Hepáticas/patología , Neoplasias Hepáticas/mortalidad , Carcinoma Hepatocelular/patología , Carcinoma Hepatocelular/terapia , Carcinoma Hepatocelular/mortalidad , Carcinoma Hepatocelular/diagnóstico , Masculino , Femenino , Pronóstico , Persona de Mediana Edad , Estudios Retrospectivos , Anciano , Modelos de Riesgos Proporcionales , alfa-Fetoproteínas/metabolismo , alfa-Fetoproteínas/análisis , Estadificación de Neoplasias , AdultoRESUMEN
Hepatocellular carcinoma (HCC) is an extremely rare long-term complication of Budd-Chiari syndrome (BCS) which may occur due to long-term venous congestion causing fibrosis, cirrhosis and subsequent hepatocellular dysplasia or anaplasia. This complication is even rarer in paediatric BCS and warrants early diagnosis for a favourable prognosis. Benign regenerative nodules seen with BCS are difficult to differentiate from malignant nodular lesion of HCC, thereby making serial imaging less sensitive for early diagnosis of HCC in BCS. Surveillance guidelines like adults do not exist in monitoring chronic paediatric BCS due to rarity of this complication. Six monthly serum alpha-fetoprotein monitoring in addition to radiological surveillance improves the sensitivity of early detection of HCC transformation in BCS and should be the way ahead in paediatric BCS as well. We describe a paediatric patient who presented with advanced HCC after 25-month follow-up for BCS.
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Síndrome de Budd-Chiari , Carcinoma Hepatocelular , Neoplasias Hepáticas , Humanos , Síndrome de Budd-Chiari/etiología , Síndrome de Budd-Chiari/diagnóstico , Carcinoma Hepatocelular/diagnóstico , Carcinoma Hepatocelular/complicaciones , Carcinoma Hepatocelular/diagnóstico por imagen , Neoplasias Hepáticas/complicaciones , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/diagnóstico por imagen , Masculino , Niño , alfa-Fetoproteínas/análisis , alfa-Fetoproteínas/metabolismo , Tomografía Computarizada por Rayos XRESUMEN
Herein, an aptamer-luminol modified magnetic graphene oxide and copper-based MOF composite was prepared and used to build a novel target-triggered "turn on" chemiluminescence (CL) sensor for alpha-fetoprotein (AFP) detection. Magnetic graphene oxide (MGO) was functionalized with the complementary sequence of the AFP aptamer (cDNA), and then MGO-cDNA was linked to aptamer modified luminol (Apt-luminol) through the complementary base pairing effect. The functionalized magnetic graphene oxide (MGO-cDNA/Apt-luminol) was prepared as a specific magnetic separation and signal switch material. ZnONPs-Au@CuMOFs shows excellent catalytic performance and was used as a catalyst for the luminol-H2O2 reaction. AFP will specifically recognize and bind to Apt on MGO-cDNA/Apt-luminol when AFP is present, which causes luminol release and triggers the CL reaction. The released luminol encounters ZnONPs-Au@CuMOFs and produces strong CL intensity. Therefore, a novel target-triggered "turn on" CL method with high selectivity and sensitivity for detecting AFP has been established. The linear range and detection limit were 1.0 × 10-4-50 ng mL-1 and 4.2 × 10-5 ng mL-1, respectively. The sensor also exhibited good selectivity, reproducibility and stability, and was finally used for AFP detection in serum samples.
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Aptámeros de Nucleótidos , Cobre , Grafito , Mediciones Luminiscentes , Luminol , alfa-Fetoproteínas , Grafito/química , Luminol/química , alfa-Fetoproteínas/análisis , Aptámeros de Nucleótidos/química , Cobre/química , Mediciones Luminiscentes/métodos , Humanos , Técnicas Biosensibles/métodos , Límite de Detección , Estructuras Metalorgánicas/químicaRESUMEN
Sarcopenia's impact on hepatocellular carcinoma (HCC) outcomes is well-documented, but the effects of pre-sarcopenia remain unclear. This study investigates the impact of pre-sarcopenia on tumor response and survival in patients with unresectable HCC undergoing transarterial chemoembolization (TACE). We retrospectively evaluated muscle volume using the SliceOmatic software in patients with unresectable HCC treated with TACE. Pre-sarcopenia was defined by Japan Society of Hepatology standards (men: 42 cm2/m2; women: 38 cm2/m2). Pre-sarcopenia and non-pre-sarcopenia groups were compared, and Cox proportional hazards model was used to identify survival-influencing variables. Subgroup analysis was conducted stratified by the tumor burden, using serum alpha-fetoprotein (AFP) levels at a diagnostic cutoff value of 200 ng/mL. Of the 100 patients, 39 had pre-sarcopenia. The presence of pre-sarcopenia was not associated with tumor complete response achievement. The median overall survival (OS) was significantly lower in the pre-sarcopenia group (18 months) than in the non-pre-sarcopenia group (30 months; log-rank P = 0.039). Subgroup analysis among 77 patients with AFP < 200 ng/mL revealed that OS was particularly poor in the pre-sarcopenia group (16 vs. 34 months; log-rank P < 0.001). Multivariate analysis identified increased AFP (adjusted hazard ratio [HR] per 10-unit increase 1.142; P < 0.001), higher Model for End-Stage Liver Disease score (adjusted HR per 1-unit increase 1.176; P < 0.001), and pre-sarcopenia (adjusted HR 2.965; P < 0.001) as predictors of shorter OS. Pre-sarcopenia is a significant predictor of increased mortality in patients with unresectable HCC undergoing TACE, especially in those with AFP < 200 ng/mL, suggesting its potential as a target for early intervention.
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Carcinoma Hepatocelular , Quimioembolización Terapéutica , Neoplasias Hepáticas , Sarcopenia , Humanos , Carcinoma Hepatocelular/terapia , Carcinoma Hepatocelular/mortalidad , Carcinoma Hepatocelular/complicaciones , Neoplasias Hepáticas/terapia , Neoplasias Hepáticas/complicaciones , Neoplasias Hepáticas/mortalidad , Neoplasias Hepáticas/patología , Femenino , Masculino , Sarcopenia/etiología , Quimioembolización Terapéutica/métodos , Anciano , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento , alfa-Fetoproteínas/metabolismo , alfa-Fetoproteínas/análisis , Modelos de Riesgos ProporcionalesRESUMEN
OBJECTIVE: To investigate the safety and clinical effect of testis-sparing microsurgery (TSMS) in the treatment of benign testis tumor (BTT). METHODS: We retrospectively analyzed the clinical data on 16 cases of BTT treated in the Department of Andrology of the Affiliated Hospital of Qingdao University from October 2020 to February 2023. The median age of the patients was 23 years. All the tumors were unilateral, 7 in the left and 9 in the right side, with a median diameter of 1.85 cm (1.0ï¼3.5 cm). The patients all underwent color Doppler flow imaging (CDFI), MRI, semen analysis and examination of serum T, alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG) and lactate dehydrogenase (LDH), followed by TSMS. The boundaries between the tumors and normal testis tissue were accurately identified under the microscope, and the tumors and the adjacent normal testis tissue 2 mm from their margins were excised completely. Bipolar coagulation forceps were used for wound hemostasis to maximally preserve the normal testis tissue. The resected specimens were subjected to fast frozen pathology intraoperatively, and the patients were followed up for 14ï¼40 months by regular scrotal CDFI, MRI and examinations of serum T and semen parameters. RESULTS: The levels of serum T, AFP, HCG and LDH and semen parameters were all within the normal range preoperatively. TSMS were successfully completed in all the cases, and all were pathologically confirmed as BTT according to the latest edition of WHO Classification of Tumors: Urinary and Male Genital Tumors. CDFI showed normal blood supply within the testis tissue at 1 month after surgery. No signs of intra-testicular tumor residue, recurrence or metastasis, nor significant changes in the levels of serum T, AFP, HCG or LDH or semen parameters were observed during the follow-up as compared with the baseline. Natural conception was achieved in 2 cases at 16 and 18 months respectively after surgery. CONCLUSION: BTT can be differentially diagnosed by CDFI and MRI before surgery and confirmed by histopathology. TSMS can achieve complete excision of the tumor, maximal sparing of the normal testis tissue and thereby effective preservation of male fertility.
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Microcirugia , Neoplasias Testiculares , Testículo , Humanos , Masculino , Microcirugia/métodos , Neoplasias Testiculares/cirugía , Estudios Retrospectivos , Adulto Joven , Testículo/cirugía , Adulto , alfa-Fetoproteínas/análisis , Tratamientos Conservadores del Órgano/métodosRESUMEN
BACKGROUNDS: Several studies have indicated that BALAD score which includes the HCC tumor markers of HCC, AFP, AFP-L3%, DCP, and serum albumin and bilirubin value were good predictors of HCC patients for all treatment modalities. In this study, we aim to clarify the impact of BALAD score as the prognostic factor for HCC patients after curative surgery. METHODS: This study investigated 578 patients who underwent hepatectomy for HCC between January 2003 and May 2013. Cumulative recurrence rate, overall survival (OS), and clinicopathological parameters were analyzed according to the level of BALAD score. RESULTS: In patients with higher BALAD score, recurrence rate and OS was poor (p = 0.0015 and p < 0.0001, respectively). Multivariate analyses revealed independent risk factors for recurrence to be male (hazard ratio [HR] 1.52, P = 0.011), HCV-antibody positive (HR 1.33, P = 0.019), multiple tumors (HR 2.16, P < 0.0001), microvascular invasion (HR 1.45, P = 0.0035) and higher BALAD score (RR 1.70, P = 0.015). The independent risk factors for OS were multiple tumors (HR 1.52, P = 0.014), microvascular invasion (HR 1.53, P = 0.012), and higher BALAD score (RR 2.51, P = 0.0012). CONCLUSION: BALAD score is associated with high recurrence rate and poor overall survival of the patients who underwent curative liver resection for HCC.