Carcinoembryonic Antigen Concentration Research Articles

Achieving enhanced sensitivity and accuracy in carcinoembryonic antigen (CEA) detection as an indicator of cancer monitoring using thionine/chitosan/graphene oxide nanocomposite-modified electrochemical immunosensor

The current study has focused on electrochemical immunosensing of carcinoembryonic antigen (CEA) employing an immobilized antibody on a thionine, chitosan, or graphene oxide nanocomposite modified glassy carbon electrode (anti-CEA/THi–CS–GO/GCE) as an indicator of cancer monitoring. THi–CS–GO nanocomposites were made using ultrasonication, and analyses of their morphology and crystal structure using SEM, FTIR, and XRD showed that thionine and chitosan molecules were intercalated with stacking interactions with both the top and bottom of GO nanosheets. Electrochemical experiments revealed anti-CEA, THi–CS–GO/GCE to have exceptional sensitivity and selectivity towards CEA compounds. The detection limit value was established to be 0.8 pg/mL when it was discovered that variations in the decrease peak current were directly proportional to the logarithm concentration of CEA over a wide range from 10-3 to 104 ng/mL. Results of testing the immunosensor's application capability for detecting CEA in a sample of human serum show that ELISA and DPV results are very congruent. The produced immunosensor demonstrated adequate immunosensor precision in determining CEA in prepared genuine samples of human serum and clinical applications.

Smartphone-based photoelectrochemical immunoassay for carcinoembryonic antigen based on BiOCl/CuBi2O4 heterojunction

Photoelectrochemical (PEC) immunoassay has been widely developed for biomarker detection, but most include heavy and expensive instruments that are not suited for portable and on-site detection. In this work, the PEC immunoassay platform for mobile phones was reported for flexible, rapid, low-cost detection of carcinoembryonic antigen (CEA). The PEC detection platform was successfully composed of disposable screen-printed carbon electrodes, a micro-electrochemical workstation, a flashlight (the excitation light source), and a smartphone with a companion software with a micro-electrochemical workstation for rapid and on-site detection of target biomarkers. In this portable smartphone-based PEC system, the S-scheme heterojunction BiOCl/CuBi2O4 was effectively excited due to the efficient electron transfer rate and excellent photocurrent response under visible light. Specifically, the sandwich-type immunoreaction for capturing target biomarkers introduced alkaline phosphatase (ALP) labeled gold nanoparticles (Au NPs). The addition of CEA increased the ascorbic acid (AA) content and enhanced the photocurrent. The proposed immunoassay presented a good linear with the logarithm of CEA concentrations range within 0.01–40 ng mL−1, and the detection limit of 3.5 pg mL−1 (S/N = 3). Therefore, the portable detection platform offered an implementable approach to the development of miniaturized and portable photoelectrochemical detectors and on-site detection technology.

Building of a three-dimensional apta-nano interface using silver nanoflower for photoelectrochemical detection of carcinoembryonic antigen

Enhancing the sensitivity of photoelectrochemical (PEC) assays poses a challenging task. This study proposes a method to improve the sensitivity of PEC assays by creating a three-dimensional (3D) apta-nano interface using silver nanoflowers (AgNFs) with a 3D flower-like structure as a substrate. The aptamer (Apt) was immobilized on the surface of the AgNF-loaded gold nanoparticles (AuNPs) through the dual action of polyA blocking and Au-S bonding. Despite using cadmium sulfide quantum dots (CdS QDs) as the sole photoactive material, the as-prepared photoelectrode still showed excellent sensitivity. Using carcinoembryonic antigen (CEA) as a model target, the variation value of photocurrent (ΔI) exhibited good linear correlation (R2 = 0.9974) with the logarithm of CEA concentration in a wide detection range from 0.001 to 100 ng mL−1, and the detection limit was as low as 0.64 pg mL−1. In the assay of CEA in 1% serum, the recoveries reached 98.70 ∼ 99.63% with a low relative standard derivation (RSD) ranging from 1.11% to 2.05%. This study introduces novel concepts for the development of PEC sensors, potentially enhancing their utility in the clinical detection of disease markers.

Laser-scribing graphene-based electrochemical biosensing devices for simultaneous detection of multiple cancer biomarkers

In this study, a graphene electrochemical sensor based on laser graphene polymer material was proposed to induce graphene formation on polyimide substrates via fiber laser. The laser produces stable power and results to achieve the benefits of consistency, conductivity, and flexibility. The electrochemical three-electrodes were manufactured on polyimide to replace the traditional three-electrodes by achieving small size and portability. An electrode activation is the modification of laser-scribed graphene electrodes (LSG) to facilitate the binding of liver cancer sites. The evaluation is performed by differential pulse Voltammetry (DPV) to detect cancer proteins in the phosphate buffer saline (PBS) buffer and serum. In a serum environment, the concentrations of alpha-fetoprotein (AFP) and Carcinoembryonic antigen (CEA) were detected from 0.75 ng ml−1 to 100 ng ml−1, AFP and CEA electrodes have a good linear range (R2 = 0.96 and R2 = 0.98), indicating the sensor's sensitivity and specificity for cancer detection. In addition, two types of carcinogenic proteins were monitored in the PBS and successfully detected in this experiment. Based on the results, the appropriate LSG sensor may be used for monitoring with limited resources. Electrode manufacturing is simple, fast, low-cost, small in size, convenient to carry, stable, instant detection, and flexible.

Difunctional Magnetic Nanoparticles Employed in Immunochromatographic Assay for Rapid and Quantitative Detection of Carcinoembryonic Antigen.

Immunochromatographic assay (ICA) plays an important role in in vitro diagnostics because of its simpleness, convenience, fastness, sensitivity, accuracy, and low cost. The employment of magnetic nanoparticles (MNPs), possessing both excellent optical properties and magnetic separation functions, can effectively promote the performances of ICA. In this study, an ICA based on MNPs (MNP-ICA) has been successfully developed for the sensitive detection of carcinoembryonic antigen (CEA). The magnetic probes were prepared by covalently conjugating carboxylated MNPs with the specific monoclonal antibody against CEA, which were not only employed to enrich and extract CEA from serum samples under an external magnetic field but also used as a signal output with its inherent optical property. Under the optimal parameters, the limit of detection (LOD) for qualitative detection with naked eyes was 1.0 ng/mL, and the quantitative detection could be realized with the help of a portable optical reader, indicating that the ratio of optical signal intensity correlated well with CEA concentration ranging from 1.0 ng/mL to 64.0 ng/mL (R2 = 0.9997). Additionally, method comparison demonstrated that the magnetic probes were beneficial for sensitivity improvement due to the matrix effect reduction after magnetic separation, and the MNP-ICA is eight times higher sensitive than ICA based on colloidal gold nanoparticles. The developed MNP-ICA will provide sensitive, convenient, and efficient technical support for biomarkers rapid screening in cancer diagnosis and prognosis.

Application of serum gastric function markers and digestive tumor indices to the diagnosis of early gastric cancer and precancerous lesions.

To study the levels of carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 199, CA724, CA242, pepsinogen (PG) I, PGII, gastrin-17 (G-17), the PGI/PGII ratio (PGR), as well as the expression of p27 and Ki67, in patients suffering from early gastric cancer and intraepithelial neoplasia and to provide new markers for the diagnosis of early gastric cancer and precancerous lesions. A retrospective study where the blood serum concentration of CEA, CA199, CA724, CA242, PGI, PGII, G-17 and PGR were tested and also the protein expression of p27 and Ki67 was detected in patients tissues by immunohistochemistry in the Gastrointestinal Endoscopy Center of the Affiliated Hospital of Xuzhou Medical University, Xuzhou, China, from March 2018 to March 2021. Carbohydrate antigen 242 and CA199 levels in tumor tissue significantly differed among the groups. Pepsinogen I levels decreased with increasing disease severity, G-17 levels increased with the aggravation of severity, and p27 expression decreased with the severity. The combination of serum gastric function markers (PGI and G-17) and p27 digestive tumor indices can serve as markers for the diagnosis of early gastric cancer and intraepithelial neoplasia.

An electrochemiluminescence immunosensor based on functionalized metal organic layers as emitters for sensitive detection of carcinoembryonic antigen

The concentration of carcinoembryonic antigen (CEA) is an important indicator for clinical monitoring and diagnosis of tumor. Early sensitive detection of CEA is significant for cancer diagnosis and therapy. In this study, a sensitive electrochemiluminescence (ECL) immunosensor was fabricated based on functionalized metal organic layers (MOLs) for the determination of CEA. In this immunosensor, Au nanoparticles (AuNPs) were grown on ultrathin two-dimensional MOLs via in situ reduction. AuNPs not only can accelerate the electron transfer but also can be used as the labels to conjugate with antibody. The as-prepared AuNPs@Ir-Zr-MOL nanocomposite showed high ECL efficiency and can be used as an ECL emitter owing to the great ECL property of Ir-Zr-MOL. The ECL intensity of AuNPs@Ir-Zr-MOL decreased linearly with the logarithm of CEA concentration in the range from 1.00 pg mL−1 to 100 ng mL−1. And the detection limit was 0.200 pg mL−1 (S/N = 3). What’s more, the as-prepared immunosensor worked well in human blood samples, showing its potential for real analysis.

Facile preparation of Ru nanoassemblies for electrochemical immunoassay of carcinoembryonic antigen in clinical serum

Abnormal expression of carcinoembryonic antigen (CEA) can be used for early diagnosis of various cancers (e.g. colorectal cancer, cervical carcinomas, and breast cancer). In this work, using l-cysteine-ferrocene-ruthenium nanocomposites (L-Cys-Fc-Ru) to immobilize secondary antibody (Ab2) and Au nanoparticles (NPs) as the substrate to ensure accurate capture of primary antibody (Ab1), a signal-on sandwich-like biosensor was constructed in the presence of CEA. Specifically, Ru nanoassemblies (NAs) were first prepared by a facile one-step solvothermal approach as signal amplifiers for the electrical signal of Fc. Based on specific immune recognition, as the increase of CEA concentration, the content of L-Cys-Fc-Ru-Ab2 captured on the electrode surface also increased, thus the signal of Fc gradually increased. Therefore, the quantitative detection of CEA can be realized according to the peak current of Fc. After a series of experiments, it was found that the biosensor has a wide detection range from 1.0 pg mL−1 to 100.0 ng mL−1 and a low detection limit down to 0.5 pg mL−1, as well as good selectivity, repeatability and stability. Furthermore, satisfactory results were also obtained for the determination of CEA in serums, which were comparable to commercial electrochemiluminescence (ECL) method. The developed biosensor shows great potential in clinical applications.

Prognostic Value of Pretreatment Serum Carcinoembryonic Antigen Level in 1130 Patients With Non-small Cell Lung Cancer: A Propensity Score Matching Cohort Study and Cumulative Mate-analysis.

Carcinoembryonic antigen (CEA) is the most frequently used tumor marker for non-small cell lung cancer (NSCLC). The current study aimed to provide the highest-level evidence of the prognostic value of pretreatment serum CEA level for NSCLC through the appropriate statistical methodology and large-sample cohorts. The current retrospective cohort study with 1130 patients with NSCLC treated by thoracic surgery with pretreatment serum CEA concentrations above/below 5ng/mL. Propensity score matching, Kaplan-Miere survival analysis, and Cox proportional hazard regression models were used to study the intergroup variance. The overall/disease-free hazard ratios (HRs) of the current study were combined with the previously published studies using cumulative meta-analysis to provide the highest-level evidence. Intergroup confounding variables were well controlled by propensity score matching, and the survival differences were statistically significant. The Cox univariate analysis showed that the overall and disease-free HRs of the high CEA towards patients with low CEA were 1.595 (95% CI: 1.329-1.863, P = 0.004) and 1.498 (95% CI: 1.271-1.881, P = 0.004). The HRs of multivariate analysis were adjusted to 1.586 (95% CI: 1.398-1.812, P = 0.016) and 1.413 (95% CI: 1.22-1.734, P = 0.022) respectively. The cumulative meta-analysis showed that the cumulative overall HR was in accord with previous studies, and the cumulative disease-free HR turn to be statistically significant. Pretreatment serum CEA level was an independent influence factor of overall/disease-free survival of patients with NSCLC, and even for patients with the same pTNM stages or pathologic stages, it is used for prognosis.

Catalytic hairpin assembly-assisted dual-signal amplification platform for ultrasensitive detection of tumor markers and intelligent diagnosis of gastric cancer

Quantification of extracellular tumor markers has shown great promise for non-invasive cancer diagnosis. Combined detection of multiple tumor markers instead of a single one is valuable for accurate diagnosis. Here, we integrate CRISPR-Cas12a with DNA catalytic hairpin assembly (CHA) to doubly amplify the output signal for detecting microRNA-182 (miR-182), which is overexpressed by gastric cancer patients. Additionally, we develop a CHA system with self-replicating capacity (SRCHA) to realize dual-signal amplification for the detection of carcinoembryonic antigen (CEA), a broad-spectrum tumor marker. The proposed cascade amplification strategies enable ultrasensitive detection of miR-182 and CEA with low LODs of 0.063 fM and 4.8 pg mL−1, respectively. Moreover, we design a ternary “AND” logic gate using different concentrations of miR-182 and CEA as inputs, which demonstrates intelligent diagnosis of gastric cancer staging with a high accuracy of 93.3% in a clinical cohort of 30 individuals. Overall, our study expands the application of CRISPR-Cas12a in biosensing and provides a new diagnostic strategy for non-invasive liquid biopsy of gastric cancer before resorting to a traumatic tissue biopsy.

Performance Evaluation of Combined Detection of Serum CEA, CYFRA21-1, CA125, and NSE in Patients with Lung Cancer by Fluorescence Flow Cytometry

Objective: To investigate the effect of combined detection of serum carcinoembryonic antigen (CEA), cytokeratin 19 fragment (CYFRA21-1), cancer antigen 125 (CA125), and neuron-specific enolase (NSE) in patients with lung cancer by fluorescence flow cytometry. Methods: From August 2019 to July 2022, 200 patients with lung cancer diagnosed by pathology in our hospital were retrospectively analyzed. 2 mL venous blood was collected in a fasting state and centrifuged to separate the serum (containing human chorionic gonadotropin antibody [anti-hCG antibody], hepatitis B surface antibody [anti-HBs antibody], and CEA). Results: The sensitivities of CEA and CYFRA21-1 detected via enzyme-linked immunosorbent assay (ELISA) were 100%, and the detection limits were 0.5 ng/mL and 0.1 ng/mL, respectively; the sensitivities of CA125 and NSE detected via flow cytometry were 100%, and the detection limits were 10 U/mL and 2 ng/mL, respectively. Compared with ELISA, the sensitivities of CA125 and NSE detected via flow cytometry were higher. When the concentration of CEA was 10–40 ng/mL, the sensitivities of the three markers CYFRA21-1, CA125, and NSE showed no significant changes (P > 0.05); when the concentration of CEA was 40–80 ng/mL, the sensitivity of CEA significantly decreased (P < 0.01), but the sensitivities of the three markers CYFRA21-1, CA125, and NSE showed no significant changes (P > 0.05); when the concentration of CEA was 80–200 ng/mL, the sensitivities of all four markers showed no significant changes (P > 0.05). Conclusion: Compared with the double-antibody sandwich ELISA, fluorescence flow cytometry has certain advantages, including high sensitivity, good precision, short detection time, low sample usage, and low medical cost; thus, it is worthy of clinical promotion.

Association of clinical outcomes and the predictive value of T lymphocyte subsets within colorectal cancer patients.

Tumor immunity is a hot topic in tumor research today, and human immunity is closely related to tumor progression. T lymphocyte is an important component of human immune system, and the changes in their subsets may influence the progression of colorectal cancer (CRC) to some extent. This clinical study systematically describes and analyzes the association of CD4+ and CD8+ T-lymphocyte content and CD4+/CD8+ T-lymphocyte ratio with CRC differentiation, clinical pathological stage, Ki67 expression, T-stage, N-stage, carcinoembryonic antigen (CEA) content, nerve and vascular infiltration, and other clinical features, as well as preoperative and postoperative trends. Furthermore, a predictive model is constructed to evaluate the predictive value of T-lymphocyte subsets for CRC clinical features. Strict inclusion and exclusion criterion were formulated to screen patients, preoperative and postoperative flow cytometry and postoperative pathology reports from standard laparoscopic surgery were assessed. PASS and SPSS software, R packages were invoked to calculate and analyze. We found that a high CD4+ T-lymphocyte content in peripheral blood and a high CD4+/CD8+ ratio were associated with better tumor differentiation, an earlier clinical pathological stage, lower Ki67 expression, shallower tumor infiltration, a smaller number of lymph node metastases, a lower CEA content, and a lower likelihood of nerve or vascular infiltration (P < 0.05). However, a high CD8+ T-lymphocyte content indicated an unpromising clinical profile. After effective surgical treatment, the CD4+ T-lymphocyte content and CD4+/CD8+ ratio increased significantly (P < 0.05), while the CD8+ T-lymphocyte content decreased significantly (P < 0.05). Further, we comprehensively compared the merits of CD4+ T-lymphocyte content, CD8+ T-lymphocyte content, and CD4+/CD8+ ratio in predicting the clinical features of CRC. We then combined the CD4+ and CD8+ T-lymphocyte content to build models and predict major clinical characteristics. We compared these models with the CD4+/CD8+ ratio to explore their advantages and disadvantages in predicting the clinical features of CRC. Our results provide a theoretical basis for the future screening of effective markers in reflecting and predicting the progression of CRC. Changes in T lymphocyte subsets affect the progression of CRC to a certain extent, while their changes also reflect variations in the human immune system.

Sensitive photoelectrochemical immunosensor for carcinoembryonic antigen detection based on copolymer of thiophene and thiophene-3-acetic acid modified phosphate-doped Bi2WO6

In this study, PO43− doped Bi2WO6 (BWO-PO) was prepared by hydrothermal method, and then copolymer of thiophene and thiophene-3-acetic acid (P(Th-T3A)) was chemically deposited on the BWO-PO surface. The introduction of PO43− created point defects, greatly improving the photoelectric catalytic performance of Bi2WO6; the copolymer semiconductor could form heterojunction with Bi2WO6 to promote the separation of photo-generated carriers, due to its proper band gap. Furthermore, the copolymer could enhance the light absorption ability and photo-electronic conversion efficiency. Hence, the composite had good photoelectrochemical properties. When it was combined with carcinoembryonic antibody through the interaction of –COOH groups of the copolymer and the end groups of antibody for constructing ITO-based PEC immunosensor, the resulting sensor exhibited superb response to carcinoembryonic antigen (CEA), with a wide linear range of 1 pg/mL−20 ng/mL, and a relatively low detection limit of 0.41 pg/mL. It also showed high anti-interference ability, stability, and simplicity. The sensor has been successfully applied to monitor the concentration of CEA in serum. The sensing strategy can also be applied to the detection of other markers by changing the recognition elements, hence it has good application potential.

Selected Serum Biomarkers (Leptin, Chromogranin A, CA19-9, CEA) in Patients with Pancreatic Neuroendocrine Neoplasm and Associations with Metabolic Syndrome

Metabolic abnormalities are well-known risk factors for many cancers, even though no clearly established link with pancreatic neuroendocrine neoplasms (PanNENs) has yet been investigated. This research aimed to assess the serum levels of leptin, chromogranin A (CgA), carbohydrate antigen 19-9 (CA19-9), and carcinoembryonic antigen (CEA) in patients with PanNENs and to search for associations between PanNENs, these selected serum biomarkers, and metabolic abnormalities in the form of metabolic syndrome (MS). Second, we aimed to investigate whether MS increases the risk of PanNENs. The serum concentrations of biomarkers, metabolic parameters (glucose, cholesterol, triglycerides), and anthropometric measurements (weight, height, BMI) were assessed in 106 patients with PanNENs and 40 healthy volunteers. Patients with PanNENs showed higher serum concentrations of CA19-9, CEA, and CgA in comparison to controls (p < 0.001, p = 0.042, and p = 0.025, respectively). Statistically significant differences in CEA levels were found in PanNENs patients with MS (p = 0.043). PanNENs patients with a BMI ≥ 25 kg/m2 and who were female exhibited significantly higher leptin levels (p < 0.001 and p = 0.013, respectively). Additionally, this study reflects the importance of determining markers. Future research should focus on understanding the impact of metabolic disturbances on PanNENs and accounting for the relationship between PanNENs and MS, such as other malignancies.

A label-free electrochemical immunosensor based on 11-mercaptoundecanoic acid grafted chitosan and poly(N-methylaniline) for the detection of carcinoembryonic antigen

Carcinoembryonic antigen (CEA) is a cancer marker used for monitoring cancer treatment. Herein, a label-free electrochemical immunosensor for determining CEA concentration composed of the thiolated chitosan (tCHI) and the doped poly(N-methylaniline) (dPNMA) is proposed. The tCHI served as a support matrix for the immobilization of CEA antibodies (anti-CEA) and was prepared by using 11-mercaptoundecanoic acid (MUA) as a grafting agent on chitosan (CHI). The excellent electrical conductivity of the dPNMA was utilized as an electron transfer layer for the proposed immunosensor. The successful preparation of the tCHI was confirmed by the attenuated-total reflection Fourier transform spectroscopy (ATR-FTIR), X-ray photoelectron spectroscopy (XPS), and scanning electron microscopy (SEM). Cyclic voltammetry (CV), differential pulse voltammetry (DPV) and electrochemical impedance spectroscopy (EIS) were used to illustrate the performance of the proposed immunosensor. The determination of CEA concentration was relied on the decrease in the DPV current response with increasing CEA concentration from the creation of the antigen–antibody immunocomplex. The proposed immunosensor demonstrated a broad concentration range of 0.01 to 30 ng mL−1 with a low limit of detection (LOD) of 0.01 ng mL−1. In addition, the present sensor exhibited excellent selectivity, reproducibility, and long-term stability, suggesting its potential use to determine CEA in clinical immunoassay.

CA72-4 as a Promising Prognostic and Diagnostic Biomarker in Iraqi Patients with Colorectal Cancer

Colorectal cancer (CRC), the second most fatal cancer and the 3rd most common cancer is expected to cause 0.9 million deaths globally in 2025. Carcinoembryonic antigen (CEA) is currently used in the follow-up of patients with colorectal cancer, and in this study, we are trying to find a better marker than CEA in following up on patients' health and knowing the effectiveness of the treatment used and as a diagnostic marker for colorectal cancer. To determine the significance of Cancer antigen 72-4 (CA72-4) as a prognosis predictor in patients with colorectal cancer, compare its prognostic validity to the CEA biomarker. this case-control study includes (150) participants, 100 patients (59 males and 41 females), and 50 healthy controls (26 males, 24 females). Blood samples were collected from all participants to measure the serum concentrations of CA72-4 and CEA using an enzyme-linked immunosorbent assay (ELISA). Between November 2020 and February 2021 in Baghdad, Iraq, this investigation was conducted at the oncology teaching hospital's gastrointestinal consulting clinic. There was a strong positive relation between CA242 and CEA (R = 0.953, p &lt;0.001) and participants with colorectal cancer had considerably greater levels of CA72-4 than healthy controls (p &lt;0.001). AUC was 0.944, sensitivity was 86%, specificity was 94%, and the cutoff value was 50 U/ml for the CA72-4. while AUC was 0.919, sensitivity was 91%, specificity was 80%, and the cutoff value was 5 ng/ml for the CEA.CA72-4 can serve as a potential prognostic and diagnostic biomarker for colorectal cancer.

Ultrasensitive detection of carcinoembryonic antigen based on exonuclease Ⅲ-assisted recycling and hybridization chain reaction strategies

In this work, we developed a novel ratiometric electrochemical aptasensor for the sensitive detection of carcinoembryonic antigen (CEA). Upon the addition of CEA, the specific binding between CEA and hairpin probe 1 (HP1) could trigger the Exo Ⅲ cleavage reaction and release large amounts of single stranded DNA (S1), which then hybridized with thiolated ferrocene-labeled hairpin probe 3 (Fc-HP3) on the electrode surface. Exo Ⅲ then cyclically digested the resulting duplexes to generate Fc-HP3 fragments on the electrode, accompanying the Fc molecules far away from the electrode surface and the Fc oxidation peak current signal (IFc) decreased. The HCR process was triggered by the Fc-HP3 fragment as an initiator, producing many long DNA sequences for electroactive probe methylene blue (MB) intercalation; thus, the MB oxidation peak current signal (IMB) increased. The IMB/IFc ratio was proportional to the logarithm value of CEA concentration from 100 fg mL−1 to 50 ng mL−1, with a lower detection limit of 30.5 fg mL−1. Furthermore, the aptasensor exhibited good selectivity and stability, with satisfactory reproducibility. Additionally, the developed aptasensor effectively measured CEA in real serum samples, verifying its practical application in biological samples.

Reliable capillary sampling of carcinoembryonic antigen at home: the CASA feasibility study.

Follow-up after colorectal cancer requires frequent surveillance of the tumour marker carcinoembryonic antigen (CEA). Home-based blood sampling could be beneficial in terms of patients' well-being and societal cost-effectiveness. Blood sampling by venepuncture is unsuitable for home-based sampling. The aim of this feasibility study is to evaluate the long-term whole-blood stability of CEA. In this prospective feasibility study capillary blood withdrawal was collected in a Hem-Col® microtube containing a patented stabilization buffer using an internal lithium standard to correct for dilution. Long-term whole-blood stability was considered adequate if the relative bias in CEA concentration between delayed analysis of capillary samples and directly processed venepuncture is within the total error margin of CEA. Twenty two colorectal cancer patients were included to determine the stability of CEA in capillary sampling compared with directly processed (i.e. within 2h) venepuncture sampling. The median time between venous sampling and CEA analysis and capillary sampling and CEA analysis was 2h (interquartile range 1-4h) and 76 h (interquartile range 74-95 h), respectively. A Bland-Altman difference plot excluding outliers showed an overall relative bias of -1.23%. The two capillary samples in our outlier analysis also showed the highest lithium concentrations. Home-based capillary sampling with the use of the Hem-Col® buffer is a feasible method for CEA determination when analysed within 4 days after blood withdrawal, allowing monitoring for colorectal cancer patients from home. High lithium concentrations due to insufficient filling of the Hem-Col® tube suggest less reliable CEA measurements.

Dumbbell-like upconversion nanoparticles synthesized by controlled epitaxial growth for light-heat-color tri-modal sensing of carcinoembryonic antigen

Accurate quantitative analysis of tumor markers in a wide linear range has important practical significance towards complex clinical samples in cancer identification and monitoring of tumor development stages, but remains challenging. Herein, three-layer dumbbell-like upconversion nanoparticles NaErF4:Tm@NaYF4@NaNdF4 (labeled as UCNPs) combined with G-quadruplex (G4) DNAzyme are reported for tri-modal sensing of carcinoembryonic antigen (CEA) in a wide range using upconversion luminescence (UCL), photothermal and catalysis signal readouts. Initially, dumbbell-like UCNPs were controlled synthesized by a three-dimensional epitaxial growth strategy through tuning the concentration of Nd precursors. After surface functionalization, G4zyme-UCNPs-cDNA/Apt-MB was subsequently fabricated by biotin-streptavidin interaction and DNA hybridization. Quantitative detection of CEA was achieved by competitive interaction and magnetic separation, and the intensities of tri-modal signals (light, heat and catalysis-based chrominance) of dissociative probes are linearly related to the concentration of CEA. The results showed that the tri-modal sensing method exhibited a wide linear range (0.005–2000 ng/mL) and low limit of detection (LOD) across three models: the luminescence model (0.005–50 ng/mL, LOD = 0.910 pg/mL), the catalysis model (10–1000 ng/mL, LOD = 0.387 ng/mL), and the temperature model (50–2000 ng/mL, LOD = 1.114 ng/mL). These findings suggest that the tri-modal sensing platform is suitable for use in the analysis of a wide range of complex and diverse clinical samples.

Additional diagnostic value of the monocyte to red blood cell count ratio and the product of lymphocyte count and albumin concentration in lung cancer management.

The present study aimed to evaluate the potential of the monocyte to red blood cell count ratio (MRR), the neutrophil to red blood cell count ratio (NRR), the lymphocyte to red blood cell count ratio (LRR) and the product of lymphocyte count and albumin concentration (LA) for the diagnosis of lung cancer. The cases of 216 patients with newly diagnosed lung cancer and 184 healthy volunteers were retrospectively analysed. The MRR and NRR were found to be higher in patients with lung cancer compared with those in healthy controls, while the LRR and LA were lower. The receiver operating characteristic curve analysis revealed that of the four markers, the MRR and LA yielded a higher area under the curve (AUC) (MRR: AUC, 0.810; 95% CI, 0.768-0.847; and LA: AUC, 0.721; 95% CI, 0.674-0.764). The combination of MRR, LA, carcinoembryonic antigen (CEA) and cytokeratin 19 fragment antigen 21-1 (CYFRA21-1) achieved the highest diagnostic value when compared with other single or combined markers (AUC, 0.882; 95% CI, 0.846-0.912; sensitivity, 81.9%; specificity, 81.0%). As the disease progressed, the MRR tended to increase, while LA exhibited a decreasing trend. Binary logistic regression analysis revealed an increase in the MRR, as well as in CEA and CYFRA21-1 concentrations, and a decrease in the LA, which could all be possible risk factors for lung cancer. Differences in the MRR and LA between patients with early stage (IA-IIIA) lung cancer and healthy controls were observed. Further analysis revealed that the MRR also exhibited the potential to detect early stage (IA-IIIA) lung cancer in the model. The present findings demonstrated that the MRR and LA may be used as auxiliary biomarkers for the diagnosis of lung cancer and could partly indicate disease progression.