ObjectiveTo compare the expressive differences of plasma Kerbs von den lungen-6 (KL-6) in patients with idiopathic interstitial pneumonia (IIP) and connective tissue disease associated secondary interstitial pneumonia (CTD-SIP), and analyze the clinical significances.MethodsThe clinical data and peripheral blood of 399 inpatients with interstitial pneumonia and 50 healthy controls were collected from January 2011 to December 2014 in Nanjing Drum Tower Hospital. The level of plasma KL-6 was measured by chemiluminescence immunoassay method. The subjects were divided into IIP (n=233) group and CTD-SIP (n=166) group, usual interstitial pneumonia (UIP) pattern and non-UIP pattern, and stable (S) UIP group and acute exacerbation (AE) UIP group. Statistical analyses were performed by using IBM SPSS 19.0 (SPSS, Inc., Chicago IL, USA) to compare the differences of plasma KL-6 in groups.ResultsThere were more male subjects (61.8%) in the IIP group, and the average age of (62.3±12.5) years was significantly older (both P<0.01). Plasma KL-6 levels in the IIP ［(1 822.7±1 505.2) U/ml) and the CTD-SIP group ［(1 846.7±1 625.3) U/ml］ were significantly higher than the healthy control group ［(190.2±88.7) U/ml］ (both P<0.001). However, there was no any difference of KL-6, white blood cell count (WBC), lactate dehydrogenase (LDH), C-reactive protein (CRP) and erythrocyte sedimentation rate between the IIP and the CTD-SIP group. The level of plasma KL-6 was positively correlated to WBC, LDH and CRP in the IIP group (r=0.159, P=0.016; r=0.380, P<0.001; r=0.158, P=0.015, respectively); and it was positively correlated to LDH and CRP in the IIP group (r=0.187, P=0.016 and r=0.068, P=0.032) in the CTD-SIP group. There was no significant difference of plasma KL-6 between the UIP and non-UIP subgroups (P>0.05). The difference of plasma KL-6 between the S-UIP and AE-UIP subgroup was significant (P<0.001 and P=0.023). There was no any significant difference of plasma KL-6 among the subgroups with CTD patients (primary Sjögren’s syndrome, n=90; rheumatoid arthritis, n=20; polymyositis/dermatomyositis, n=26; undifferentiated connective tissue disease, n=10; anti-neutrophil cytoplasmic antibody associated vasculitis, n=15 and systemic sclerosis, n=5) (P=0.785 2).ConclusionsPlasma KL-6 may be a useful biomarker for interstitial pneumonia. It can show the disease activities, but is not able to distinguish IIP from SIP.
In order to investigate the possible involvement of the antigen CA50 in patients with colorectal carcinoma， the carbohydrated antigen CA50 in serum was examined in 30 normal individual， 27 patients with benign colorectal diseases and 66 patients with colorectal carcinoma by immunoradiometric assay (IRMA). The results showed that the serum CA50 in patients with colorectal carcinoma was significantly higher than that in patients with benign colorectal diseases and normal individual (Ｐ＜0.01). It was significantly declined after radical operation (Ｐ＜0.01). However， no significant change was noted after palliative operation (Ｐ＞0.05) and elevation was noted in patients with tumor recurrence. The results suggest that the measurement of serum CA50 may be an useful marker for diagnosis and prognostic evaluation in patients with colorectal carcinoma.
Objective To observe the expression of Ezrin protein in primary carcinoma of gallbladder tissue and the levels of CEA and CA19-9 in serum of patients with primary carcinoma of gallbladder, and to explore the relationship between the expressions of these measurements and clinicopathologic characteristics. Methods Immunohistochemistry was applied to analyze the expression of Ezrin protein in primary carcinoma of gallbladder and chronic cholecystitis tissue. The levels of CEA and CA19-9 in serum and clinicopathologic characteristics of all including patients were detected with clinical measurement. All data were analyzed statistically. Results ①The positive rates of Ezrin protein in primary carcinoma of gallbladder and chronic cholecystitis tissue were 66.7% （40/60） and 30.8%（4/13）, respectively (χ2=5.57, Plt;0.05). ②There was no difference between the expression of Ezrin protein in primary carcinoma of gallbladder tissue and age or gender (Pgt;0.05). However, difference was significant between the Ezrin expression and degree of difference, pNevin stages, pTNM stages, lymph node metastasis or distant metastasis (Plt;0.05). ③There were no differences between the positive rates of CEA and CA19-9 in primary carcinoma of gallbladder and age or gender (Pgt;0.05). However, differences were significant between the positive rates of CEA and CA19-9 and pNevin stages, pTNM stages, degree of difference, lymph node metastasis or distant metastasis (Plt;0.05). ④There was some relationship between the expression of Ezrin protein and the positive rate of CEA (rs=0.213, Plt;0.05), but not with the positive rate of CA19-9 (rs=0.081, Pgt;0.05). Conclusions The high expression of Ezrin protein may promote the invasion and metastasis in primary carcinoma of gallbladder. It could be possible to decide the outcome of primary carcinoma of gallbladder through the combined analysis on the expression of Ezrin protein and the serum levels of CEA and CA19-9.
ObjectiveTo explore the expression of periostin in bronchoalveolar lavage fluid (BALF) of patients with dermatomyositis-related interstitial lung disease (DM-ILD) and rheumatoid arthritis-related interstitial lung disease (RA-ILD).MethodsA total of 44 patients with DM-ILD and 28 patients with RA-ILD were underwent bronchoalveolar lavage. Cells in BALF were collected and analyzed by absolute different cell counts. The level of periostin and Krebs von den Lungen-6 (KL-6) were tested by enzyme linked immunosorbent assay. Results of high resolution CT of patients were scored. Thirty patients without interstitial lung disease (ILD) served as a control group.ResultsLevels of periostin and KL-6 were significantly increased in BALF of patients with DM-ILD and RA-ILD compared with control group (all P<0.05). Levels of periostin were positively correlated with lymphocyte counts and levels of KL-6 in BALF (allP<0.05). Furthermore, levels of periostin were significantly correlated with high resolution CT scores (P<0.05).ConclusionsLevels of periostin are increased in patients with DM-ILD and RA-ILD. Periostin might be served as an indicator of CTD-ILD.
Objective To evaluate the value of bile and serum CA19-9 in diagnosing biliary tract carcinoma. Methods Bile and serum CA199 and CEA were determined by radioimmunoassay (RIA). Results The dividing value of bile CA199 is 12 000 kU/L, and its sensitivity and specificity were 85.71%, 73.91% respectively. The dividing value of bile CEA is 480 μg/L, and its corresponding indexes were 57.14% and 77.17%. The false positive rate of bile CA19-9 and CEA were 26.09% and 22.83%. Serum CA19-9 sensitivity, specificity were 80.00% and 85.11%; the corresponding indexes of serum CEA were 68.57% and 82.97%. Conclusion CA19-9 is an effective tumor marker in diagnosing, deciding whether the tumor has been radically resected and in monitoring its response to the treatment.
【Abstract】ObjectiveTo study the expressions of matrix metalloproteinase 2 (MMP2) and carbohydrate antigen 50 (CA50) in colorectal carcinoma, cancer-adjacent mucosa （2 cm from the nether edge of tumor）, cancerdistant mucosa （5 cm from the nether edge of tumor） and normal colorectal mucosa, and to elucidate their effects on the development of colorectal carcinoma. MethodsThe expressions of MMP2 and CA50 were detected immunohistochemically in 40 cases of colorectal carcinoma, cancer-adjacent mucosa, cancer-distant mucosa and 10 cases of normal colorectal mucosa. Results①The expression intensity and positive rates of MMP-2 and CA50 increased significantly in turn by normal mucosa, cancer-distant mucosa, cancer-adjacent mucosa and colorectal carcinoma. ②The expression of MMP2 was correlated with CA50 in colorectal carcinoma. ③The expression of CA50 in colorectal carcinoma was closely associated with tumor differentiation, and the expression of MMP2 in colorectal carcinoma was closely associated with differentiation and Dukes stages as well. ConclusionOver expression of MMP2 facilitates the malignant progress of colorectal carcinoma; CA50 is a reliable marker of malignance in colorectal carcinoma; CA50 and MMP2 may have synergetic effects on the development of colorectal carcinoma.
ObjectiveTo investigate the clinical significance of levels of serum salivary Krebs von den Lungen 6 (KL-6) and matrix metalloproteinase-9 (MMP-9) in predicting the prognosis of patients with acute respiratory distress syndrome (ARDS). MethodsFrom January 2020 to December 2023, 100 ARDS patients who received treatment in our hospital were included as the study group, and 59 healthy professionals who underwent health checkup were selected as the control group. And the levels of serum KL-6 and MMP-9 were measured on the day of admission. According to the oxygenation index (OI) results, the study group was separated into mild group (38 cases), moderate group (33 cases), and severe group (29 cases); Based on 28-day intensive care unit (ICU) survival status, the study group was divided into a survival group of 69 cases and a death group of 31 cases. Enzyme-Linked Immunosorbent Assay (ELISA) method was applied to detect the levels of serum KL-6 and MMP-9. Pearson correlation was applied to analyze the correlation between serum KL-6 and MMP-9 levels and OI in the death group. Logistic regression was applied to analyze the influencing factors of prognostic mortality in ARDS patients. Receiver operating characteristic (ROC) curve was applied to analyze the predictive value of serum KL-6 and MMP-9 levels for prognostic mortality in ARDS patients. ResultsCompared with the control group, the levels of serum KL-6 and MMP-9 in the study group were notably increased, and the levels of serum KL-6 and MMP-9 in the severe ARDS group were notably higher than those in the moderate and mild groups. The levels of serum KL-6 and MMP-9 in the moderate group were notably higher than those in the mild group, the OI in the survival group was greatly higher than that in the death group, and the acute physiology and chronic health evaluationⅡ (APACHE II) score, KL-6, and MMP-9 in the survival group were greatly lower than those in the death group (P<0.05). Pearson analysis showed that serum KL-6 and MMP-9 levels were negatively correlated with OI (P<0.05). Logistic analysis showed that APACHE II score, KL-6, and MMP-9 were risk factors for prognostic mortality in ARDS patients (P<0.05). ROC curve showed that the AUC of serum KL-6 and MMP-9 levels in predicting prognostic mortality in ARDS patients was 0.809 and 0.816, respectively, with cutoff value of 510.44 U/ml and 317.15μg/L, respectively. The area under the ROC curve (AUC) predicted by the combination of the two was 0.935, greatly higher than that of KL-6 (Z=2.133, P=0.033) and MMP-9 (Z=2.164, P=0.030) alone. ConclusionsThe levels of serum KL-6 and MMP-9 in ARDS patients are greatly upregulated and increase with the severity of the disease. The combination of the two has certain predictive value for the prognostic mortality of ARDS patients.
Objective To investigate the impact and mechanisms of periostin (POSTN), Krebs von den Lungen-6 (KL-6), pulmonary surfactant protein A (SP-A), and pulmonary surfactant protein D (SP-D) on the diagnosis and disease assessment of idiopathic pulmonary fibrosis (IPF), and conduct a comparative analysis. Methods From October 2022 to October 2023, a total of 55 patients diagnosed with IPF and treated at the Third Affiliated Hospital of Anhui Medical University were enrolled as an IPF group. Additionally, 30 patients with bacterial pneumonia and 30 healthy individuals undergoing concurrent health examinations during the same period were selected as a pneumonia control group and a healthy control group, respectively. All participants underwent enzyme-linked immunosorbent assay to measure serum levels of POSTN, KL-6, SP-A, and SP-D, along with pulmonary function tests. The IPF patients also underwent high-resolution computed tomography (HRCT) and echocardiography to quantify HRCT scores and pulmonary artery systolic pressure (PASP). Receiver operating characteristic (ROC) curves were plotted to analyze the significance of serum POSTN, KL-6, SP-A, and SP-D levels in IPF diagnosis. Pearson and Spearman correlation tests were used to analyze the relationships between these biomarkers and pulmonary function, PASP, and HRCT scores. Results Serum concentrations of POSTN, KL-6, SP-A, and SP-D were significantly elevated in the IPF group compared with the pneumonia group and the healthy controls (P<0.05), while serum levels of SP-A and SP-D were notably higher in the pneumonia group compared with the healthy control group (P<0.05). Within the IPF group, serum POSTN levels were negatively correlated with forced expiratory volume in the first second as a percentage of predicted value (FEV1%pred) and diffusion capacity of the lung for carbon monoxide as a percentage of predicted value (DLCO%pred) (P<0.05); KL-6 and SP-D levels were also negatively correlated with FEV1%pred, forced vital capacity as a percentage of predicted value (FVC%pred), and DLCO%pred (P<0.05); and the concentration of SP-A was negatively correlated with DLCO%pred and positively correlated with PASP (P<0.05). Additionally, serum levels of POSTN, KL-6, and SP-A in the IPF group showed significant positive associations with HRCT scores (P<0.01). Conclusions POSTN is a valuable serum biomarker for IPF, exhibiting the highest sensitivity and specificity among the four serum markers, with diagnostic performance superior to KL-6, SP-A, and SP-D. POSTN, KL-6, SP-A, and SP-D can all be used for the diagnosis and assessment of IPF.