Tumor Marker Levels Research Articles

Efficacy and Adverse Reactions of Carboplatin, Nab-Paclitaxel Regimen Combined with Atezolizumab in the Treatment of Non-Small Cell Lung Cancer

We attempt to study the efficacy and adverse reactions of carboplatin, nab-paclitaxel regimen combined with atezolizumab in non-small cell lung cancer treatment. We randomly selected 120 non-small cell lung cancer patients who received therapy in our hospital from January 2019 to December 2021 and divided them into two groups, 60 cases respectively. Treated control group with carboplatin and paclitaxel combined with pembrolizumab, while observation group with carboplatin and albumin paclitaxel combined with pembrolizumab. Compared both groups on the efficacy, incidence of adverse reactions, levels of peripheral blood lymphocyte subsets and serum tumor markers. After treatment, observation group possessed higher objective remission rate and disease control rate than control group (p<0.05); observation group had lower adverse reactions rate during the treatment period than control group (p<0.05); observation group had higher cluster of differentiation 3+, cluster of differentiation 4+ and cluster of differentiation 4+/cluster of differentiation 8+ values than control group, but it possessed lower cluster of differentiation 8+ values than control group (p<0.05). Observation group had lower cytokeratin 19 fragment antigen 21-l, squamous cell carcinoma antigen, carbohydrate antigen 125 and carcinoembryonic antigen levels than control group (p<0.05). Carboplatin, nab-paclitaxel regimen combined with atezolizumab in treating non-small cell lung cancer patients can effectively alleviate and control their disease, reduce the risk of adverse reactions during the treatment process and improve the body’s immune function, which is worthy of promotion.

Percutaneous transhepatic cholangial drainage combined with intra-tumoral iodine-125 seeds implantation and chemotherapy for locally progressive pancreatic head cancer with obstructive jaundice.

To investigate the clinical efficacy of percutaneous transhepatic cholangial drainage (PTCD) combined with intra-tumoral iodine-125 (125I) particle implantation and chemotherapy in the treatment of locally advanced pancreatic head cancer (LAPHC) with obstructive jaundice. Twenty-one patients with LAPHC with obstructive jaundice were selected, and routine examination before surgery to determine location of obstruction and degree of bile duct dilatation was performed. All 21 patients underwent PTCD first, and usual examinations, including liver and kidney function, were re-examined after operation. When the liver function recovered significantly, patients were treated with seed implantation and systemic chemotherapy after surgery. Clinical efficacy and complications of 21 patients were observed, and changes in survival time and serum level of tumor markers were analyzed. After combined treatment, there were 3 cases of complete response (CR), 12 cases of partial response (PR), 3 cases of stable disease (SD), and 3 cases of progressive disease (PD) in 21 patients. The overall effective rate was 71.43%, and the local control rate was 85.71%. The pain relief was statistically significant one month after treatment, compared with that before treatment (VAS scores: 6.76 ±2.25 vs. 3.25 ±1.92, p < 0.001), and the rate of pain relief was 71.43% (15/21). In all patients, jaundice, abdominal pain, and abdominal distension improved to different degrees after surgery, and the skin pruritus disappeared. Bilirubin and transaminase improved to varying degrees 3 days, 1 week, and 4 weeks after treatment (p < 0.05). Cancer antigen 199 (CA-199), carcinoembryonic antigen (CEA), and cancer antigen 125 (CA-125) after combination therapy, achieved statistically significant differences (t = 9.525, 10.378, 3.262, respectively, p < 0.05). The overall survival time of 21 patients was 11.6 months, ranging from 3.9 to 22.6 months. For LAPHC patients with obstructive jaundice, PTCD combined with particle implantation and chemotherapy is clinically effective in improving the quality of life and prolonging survival.

The Relationship Between D-dimer and Prognosis in the Patients with Serum Alpha-Fetoprotein-Positive Gastric Cancer: A Retrospective Cohort Study.

Background:Alpha-fetoprotein-positive gastric cancer (AFPGC) is a subtype of gastric cancer that is rare in clinical practice and extremely malignant. Malignant tumors are often associated with hemorrhage, thrombosis, and even disseminated intravascular coagulation (DIC). The D-dimer test is used as a sensitive index in the diagnosis of DIC and fresh thrombosis in malignant tumors. Therefore, this study aims to investigate the relationship between D-dimer values and the clinical characteristics and prognosis of patients with serum AFPGC (AFP ⩾ 15 μg/L) patients.Methods:Overall, 120 healthy subjects and 120 AFP-negative gastric cancer (AFP < 15μg/L) patients from May 2017 to July 2018 at the Shanxi Cancer Hospital served as the control group in this retrospective cohort study. Additionally, 120 patients with pretreatment advanced serum AFP were chosen to analyze clinicopathologic features and factors that affect prognosis. The predictor was the D-dimer, and the outcome variable was overall survival (OS). Other variables included age, sex, tumor site, T-stage, distant metastasis, and preoperative serum tumor biomarkers. Differences in OS rate were analyzed by GraphPad Prism 9.2.0.332. The Cox regression model was used for univariate and multivariate analysis.Results:In comparison to AFP-negative gastric cancer, we discovered that D-dimer had a meaningfully higher presentation in patients with AFPGC (P < .001). Based on D-dimer median levels, the AFPGC patients were divided into two groups, including 39 patients with low D-dimer (<1000 ng/mL) and 81 patients with high D-dimer (⩾1000 ng/mL). The variables, including T-stage, distant metastasis, and expression of HER2, were associated with the value of D-dimer. The D-dimer levels were weakly related to the levels of tumor markers. The differences in AFPGC patients, with an OS rate of 30.76% for patients with low D-dimer (<1000) and 12.30% with high D-dimer (⩾1000; P = .0027), were statistically significant. Cox multivariate analysis of various parameters indicated that T-stage, distant metastasis, vascular embolism, level of D-dimer, and tumor biomarkers of AFP were independent risk factors for survival.Conclusion:Serum D-dimer levels may be a valuable indicator for predicting AFPGC metastasis and progression.

Growing teratoma syndrome after surgery for ovarian immature teratoma

Growing teratoma syndrome (GTS) is a condition characterized by tumor growth during or after chemotherapy for a germ cell tumor, albeit with normal tumor marker levels in the absence of histopathological evidence of immature teratoma components. We encountered a 10-cm large GTS lesion in the para-aorti nodes after fertility-preserving surgery for a grade 3 ovarian immature teratoma. The patient was a 20 year old woman who presented to the hospital with complaints of abdominal pain and swelling. Imaging examination revealed an ovarian tumor mass measuring 24 cm in the abdominal cavity, suspected to be composed of a mixture of fat and other components. The α-fetoprotein (AFP) levels were elevated at 853 ng/mL. We elected to perform fertility-preserving surgery. The surgical findings included a tumor in the right ovary, which was excised without rupture with adnexectomy. The histopathological diagnosis was grade 3 immature teratoma. Palpation of the pelvic and para-aortic lymph node areas did not reveal significant lymphadenopathy. Subsequently, a para-aortic node metastasis (major axis: 8 cm) was discovered before chemotherapy (19 days after surgery). We confirmed that there was no swelling before surgery and assumed that the immature teratoma had recurred. Chemotherapy was initiated, and the serum AFP levels normalized after 4 courses of bleomycin, etoposide, and cisplatin (BEP) therapy. However, the para-aortic node metastasis had grown further (major axis: 10 cm). Another open surgery was performed. The nodal mass was completely excised and pathology revealed only mature teratoma. Growing teratoma syndrome should be considered in the setting of a recurrent mass with negative tumor markers.

Short-Term Efficacy of Tislelizumab with Carboplatin/Cisplatin Pemetrexed in Advanced Lung Adenocarcinoma and its Effect on Tumor Markers

We attempt to study the short-term efficacy of tislelizumab+carboplatin/cisplatin+pemetrexed in advanced lung adenocarcinoma and its effect on tumor markers. Retrospectively analyzed the clinical data of 68 advanced lung adenocarcinoma patients admitted to our hospital from May 2019 to June 2021 and divided them into control group (n=34) and study group (n=34). Treated control group with carboplatin or cisplatin+pemetrexed, while treated study group with tislelizumab+carboplatin or cisplatin+pemetrexed. Compared both groups on total clinical response rate, serum tumor marker levels and immune function indexes before treatment and after 6 mo treatment. Study group had higher total effective rate than control group (p<0.05); after 6 mo treatment, study group had lower serum carbohydrate antigen 125, carbohydrate antigen 199 and carcinoembryonic antigen levels than control group (p<0.05). Meanwhile, study group had higher cluster of differentiation 3, cluster of differentiation 4 and cluster of differentiation 4/cluster of differentiation 8 than control group, while lower cluster of differentiation 8 than control group (p<0.05). Tislelizumab plus carboplatin or cisplatin plus pemetrexed therapy in advanced lung adenocarcinoma can improve short-term efficacy, reduce serum tumor marker levels and improve immune function.

Prognostic Significance of the Serosal Invasion in Hepatocellular Carcinoma

Background: The prognostic significance of serosal invasion (SI) was not clarified in patients with hepatocellular carcinoma (HCC). We investigated the impact of serosal invasion (SI) for the long-term outcome after curative surgical resection in patients with HCC. Methods: In total, 783 consecutive patients with HCC who underwent curative surgical resection without any preoperative treatment were histologically evaluated for SI. Patients with SI were classified into two groups: positive for SI (pSI; n=333) and negative for SI (nSI; n=450). Clinicopathologic features, disease-free survival (DFS), and overall survival (OS) were compared between patients with pSI and nSI. Results: The pSI group showed more aggressive tumor characteristics, such as higher tumor marker levels (alpha-fetoprotein, P=.023; protein induced by vitamin K absence-II, P=.016), larger tumor size (P<.001), higher prevalence of microvascular invasion (P=.002), and poorer differentiation (P=.002), than the nSI group. In survival analysis, 5-year DFS was 48.1%, 61.2% in the pSI, nSI, respectively (P<.001), while 5-year OS was 74.8%, 86.1%, respectively (P=.002). In multivariate analysis, SI was an independent prognostic factor for DFS (P=.043) and OS (P=.042). Conclusions: The SI was associated with more aggressive clinicopathologic characteristics and a higher risk of poor survival. Therefore, intensive careful follow-up is essential for patients with pSI after curative surgical resection in patients with HCC.

Correlations of FUT3 gene polymorphisms with colon polyps

ABSTRACT Objective: To explore the relationship between fut3 gene polymorphism and colonic polyps. Methods: Two hundred patients with colonic polyps and 200 healthy people in our hospital in recent 3 years were taken as the research objects, as the disease group and the control group, respectively. The disease group was divided into cancerous colonic polyps group (n = 50) and non-cancerous colonic polyps group (n = 150). The peripheral blood nucleated cells of the subjects were collected and isolated. The fut3 gene polymorphism was obtained by sequencing and analyzed combined with the expression of fut3 gene and the level of tumor markers. Results: The frequency of allele C at rs2561796 locus in the disease group was significantly higher than that in the control group (P < 0.05). The frequency of Ag genotype at rs441158 locus in the disease group was significantly higher than that in the control group, and the frequency of Ca genotype at rs2561796 locus was significantly lower than that in the control group (P < 0.05). In the disease group, the frequency of AA + Ag in the dominant model at rs441158 was significantly higher than that in the control group, and the frequency of Ca + AA in the invisible model at rs2561796 was significantly higher than that in the control group (P < 0.05). The frequency of CGC haplotype in the disease group was higher than that in the control group (P < 0.05). The linkage disequilibrium of rs441158 and rs2561796 loci of fut3 gene was high (d‘ = 0.423). The genotype of rs372725 of fut3 gene was correlated with the expression of fut3 gene (P < 0.05). The expression of fut3 gene in patients with CC genotype was significantly higher than that in patients with other genotypes (P < 0.05). Conclusion: fut3 gene polymorphism is associated with the susceptibility and carcinogenesis of colonic polyps.

Effects of Traditional Chinese Medicine for Vaginal Lavage Combined with Psychological Intervention in Postoperative Patients with Cervical Cancer

Purpose To explore the effects of traditional Chinese medicine for vaginal lavage combined with psychological intervention on the immune function and clinical efficacy in patients with cervical cancer. Methods Patients with cervical cancer treated in our hospital from January 2020 to May 2021 were included in this study. All patients were treated with traditional Chinese medicine for vaginal lavage combined with psychological nursing intervention. The treatment outcomes of the patients were observed, and the quality-of-life scores and depression of the patients before and after treatment were compared. Changes in T-lymphocyte subset-related indicators, changes in blood routine-related indicators, and changes in the detection level of tumor markers were compared with anxiety scores. Results After treatment, depression and anxiety were significantly reduced and the patient's quality of life significantly improved. After treatment, the patient's CD3+, CD4+, and CD4+/CD8+ proportions were dramatically higher than before treatment (P < 0.05), there was no significant difference in CD8+ proportion before and after treatment (P > 0.05), and the white blood cell (WBC), hemoglobin (Hb), platelet (PLT) of patients, and the level of tumor marker (CA125) after treatment were immensely lower than before treatment (P < 0.05). Conclusions Treating patients with cervical cancer with traditional Chinese medicine for vaginal lavage combined with psychological nursing can effectively improve the patient's immune function, effectively reduce the level of tumor marker CA125, increase the level of T-lymphocyte subsets, and improve the bone marrow hematopoietic function.

Safety of Anlotinib Capsules Combined with PD-1 Inhibitor Camrelizumab in the Third-Line Treatment of Advanced Non-Small-Cell Lung Cancer and Their Effect on Serum Tumor Markers.

Objective To explore the safety of anlotinib capsules combined with the PD-1 inhibitor (camrelizumab) in the third-line treatment of advanced non-small-cell lung cancer (NSCLC) and their effect on serum tumor markers. Methods 88 patients with advanced NSCLC treated in the Oncology Department of our hospital from December 2018 to December 2019 were selected as research subjects and randomly and equally split into the single treatment group (STG) and combined treatment group (CTG). The levels of serum tumor markers after treatment were detected in both groups, and the incidence of adverse reactions during treatment was recorded. Results Compared with the STG, CTG achieved obviously higher total effective rate (P < 0.05), lower total incidence of adverse reactions (P < 0.05), lower levels of serum tumor markers and average CFS score (P < 0.001), and higher average KPS score (P < 0.001). Conclusion Application of anlotinib capsules combined with the PD-1 inhibitor (camrelizumab) in the third-line treatment of advanced NSCLC can effectively reduce the levels of serum tumor markers and cancer fatigue degree of patients, with a better effect than that of simple anlotinib treatment. In addition, further research of the combined treatment is helpful to establish a better therapeutic regimen for patients with advanced NSCLC.

PERITONEAL CARCINOMATOSIS SECONDARY TO OVARIAN CANCER: IMAGING FINDINGS

Summary: Peritoneal lesions are a relatively common site of metastases, particularly from tumors of the abdomen and pelvis, which generally carry a poor prognosis, often with a signicant impact on treatment. One of the tumors implicated in peritoneal metastasis is ovarian cancer. Ovarian cancer is the fth most commonly diagnosed cancer among women worldwide and the second most common gynecologic malignancy. Despite clinical screening, ovarian cancer in more than 60% of those affected is diagnosed at an advanced stage with a reported 5-year survival rate of 37% (stage III disease) or 25% (stage III disease). IV). Therefore, ovarian cancer is one of the deadliest cancers affecting women. Ovarian tumors are classied according to the origin of the tumor into epithelial tumors (serous and mucinous tumors, endometrioid and clear cell carcinomas, Brenner's tumor), germ cell tumors (mature and immature teratomas, dysgerminoma, endodermal sinus tumor, carcinoma embryonic), sex cord - stromal tumors (brothecoma; granulosa cell, sclerosing stroma and Sertoli-Leydig cell tumors) and metastatic tumors. Metastases to the ovary are relatively common with a documented incidence of 5% to 30% of all malignant ovarian masses. Ovarian cancer metastases differ from other tumors: they are primarily peritoneal rather than parenchymal in location. These implants are usually isodense in tomography, in relation to the viscera, which makes their detection difcult. For this, a multidisciplinary approach is used, such as physical examination, tumor marker levels and diagnostic images. Such as CT, magnetic resonance imaging (MRI) and positron emission tomography (PET). Objective: Describes ovarian metastasis in a patient with no signicant history, emphasizing peritoneal lesions, through a clinical case. Design: Prospective, observational in a single center. Methodology: This is a systematic review of ovarian metastasis, detailing its clinical characteristics and short-term complications. The information and images obtained belong to the medical personnel in charge of the case, whose reinforcements are provided by the Excel, Word and JPG statistical package.

Tumor-Specificity Growth Factor Combined with Tumor Markers in Nuclear Medicine Imaging to Identify Prostate Cancer Osteonosus.

Objective This study has explored the application value of malignant tumor SPE growth factor (TSGF) combined with tumor markers (TM) (TSGF + TM) in nuclear medicine imaging to identify prostate cancer osteonosus (PCO). Methods A retrospective analysis for 70 patients with prostate cancer and bone disease admitted to our hospital was performed, 30 healthy persons in the same period were selected as the control group, and the advantages and disadvantages of various examinations were analyzed. All patients were diagnosed with PET whole body bone imaging. Suspicious lesions could be examined by MRI or CT. According to the results of imaging examination, patients were divided into 40 cases of malignant prostate cancer and 30 cases of benign prostate cancer. All the patients underwent 18F-FDG-PET imaging, alpha-fetoprotein (AFP), and TSGF + TM determination. The case diagnosis results were compared and analyzed, and the sensitivity (SEN), specificity (SPE), and accuracy (ACC) of various detection methods were calculated. The SEN, SPE, and ACC of positron emission tomography (PET) were 90.9%, 57.8%, and 81.2%, respectively; those of TM were 79.2%, 94.6%, and 69.8%, respectively; and those of TSGF + TM were 95.9%, 100%, and 97.3%, respectively. The accuracy of combined diagnosis of tumors can reach 100%. The AFP and TSGF levels of serum TM were compared and analyzed, and it was found that the benign lesion group and the malignant lesion group showed significant increases compared with the control group, and the difference between the malignant lesion group and the control group was obvious (P < 0.05). SGF combined with TM could obtain a more definite diagnosis in PCO. Conclusion TSGF + TM combined with 18F-FDG-PET imaging showed important clinical value to diagnose the PCO. The imaging accuracy of TSGF + TM combined with 18F-FDG-PET is 97.3%, and the specificity of tumor diagnosis is 100%. Therefore, the TSGF + TM applied in medical imaging and identification of PCO was worthy of clinical promotion.

Clinical characteristics, treatment patterns and relapse in patients with clinical stage IS testicular cancer

PurposeClinical stage I (CSI) testicular germ cell tumors (TGCT) represents disease confined to the testis without metastasis and CSIS is defined as persistently elevated tumor markers (TM) after orchiectomy, indicating subclinical metastatic disease. This study aims at assessing clinical characteristics and oncological outcome in CSIS.MethodsData from five tertiary referring centers in Germany were screened. We defined correct classification of CSIS according to EAU guidelines. TM levels, treatment and relapse-free survival were assessed and differences between predefined groups (chemotherapy, correct/incorrect CSIS) were analyzed with Fisher’s exact and Chi-square test.ResultsOut of 2616 TGCT patients, 43 (1.6%) were CSIS. Thereof, 27 were correctly classified (cCSIS, 1.03%) and 16 incorrectly classified (iCSIS). TMs that defined cCSIS were in 12 (44.4%), 10 (37%), 3 (11.1%) and 2 (7.4%) patients AFP, ß-HCG, AFP plus ß-HCG and LDH, respectively. In the cCSIS group, six patients were seminoma and 21 non-seminoma. Treatment consisted of active surveillance, carboplatin-mono AUC7 and BEP (bleomycin, etoposide and cisplatin). No difference between cCSIS and iCSIS with respect to applied chemotherapy was found (p = 0.830). 5-year relapse-free survival was 88.9% and three patients (11%) in the cCSIS group relapsed. All underwent salvage treatment (3xBEP) with no documented death.ConclusionAround 1% of all TGCT were classified as cCSIS patients. Identification of cCSIS is of critical importance to avoid disease progression and relapses by adequate treatment. We report a high heterogeneity of treatment patterns, associated with excellent long-term survival irrespective of the initial treatment approach.

Unresectable primary hepatic adenosquamous carcinoma successfully treated with systemic and transcatheter hepatic arterial injection chemotherapies followed by conversion surgery: a case report and literature review

BackgroundPrimary hepatic adenosquamous carcinoma (ASC) is a type of tumor that has the features of both adenocarcinoma and squamous cell carcinoma (SCC). The prognosis for patients with ASC is poor, as the chemotherapy has been ineffective so far.Case presentationHere, we report a case of a 62-year-old male patient who presented with high fever. The tumor marker levels were high, and abdominal dynamic computed tomography showed a liver tumor and distant lymph node metastases. Upon further investigation, needle biopsy of the liver tumor showed a primary hepatic SCC. Because the SCC was unresectable, the patient was treated with tegafur/gimeracil/oteracil (S-1) and transcatheter hepatic arterial injection (TAI) of cisplatin. After chemotherapy, a surgical resection performed on the remaining liver tumor, made the patient cancer-free. After the operation, the liver tumor was confirmed as primary hepatic ASC. Subsequently, the patient was administered postoperative adjuvant chemotherapy, which prevented its recurrence.ConclusionsDue to the lack of an effective treatment for primary hepatic ASC, its prognosis is poor. Here, we suggest that a chemotherapy combination of 5-fluorouracil (S-1) and cisplatin along with conversion surgery might be an effective way for treating primary hepatic ASC. Our experience from this case shall be valuable to clinicians around the world involved in the treatment of primary hepatic ASC.

Effect of radiotherapy on tumor markers and serum immune-associated cells in patients with esophageal cancer*

Abstract Objective This study aimed to investigate the effect of radiotherapy on serum immune-associated cells and tumor markers in patients with esophageal cancer. Methods A total of 87 patients with esophageal cancer admitted to our hospital between October 2016 and July 2020 were selected as the observation group, and all patients received radiotherapy. A total of 87 healthy volunteers who underwent physical examination at our hospital during the same period were selected as the control group in order to compare the changes in serum immune-associated cells and tumor markers between the two groups. Results The levels of carcinoembryonic antigen (CEA), cancer antigen (CA) 125, CA72-4, C-terminus of cytokeratin (CYFRA) 21-1, and squamous cell carcinoma (SCC) antigen in the observation group before radiotherapy were higher than those in the control group, and the differences were significant (P &lt; 0.05). The levels of CEA, CA125, CA72-4, CYFRA21-1, and SCC antigen in the research group after radiotherapy were significantly lower than those before radiotherapy, but were still significantly higher than those in the control group (P &lt; 0.05). The levels of CD3+, CD4+, CD4+/CD8+, and natural killer cells in the research group before and after radiotherapy were significantly lower, while the levels of Treg and CD8+ cells were significantly higher than those in the control group (P &lt; 0.05). The levels of CD3+, CD4+, and CD4+/CD8+ cells in the observation group after radiotherapy were lower, while the levels of CD8+ cells were significantly higher than those before radiotherapy (P &lt; 0.05). Conclusion Radiotherapy can effectively reduce the level of serum tumor markers in patients with esophageal cancer; these antigens and cells can be used as tumor markers of esophageal cancer in order to determine its prognosis. However, radiotherapy has adverse effects on the immune function of the body. The reasons behind this need to be further studied and analyzed.

A systematic review and meta-analysis on the efficacy of Compound Kushen Injection in 3 kinds of digestive tract tumor.

Chemotherapy has become the main means to prolong the life of patients with advanced digestive tract cancer; however, it is associated with serious toxicity and side effects. Compound Kushen Injection (CKI) is a pure Chinese herbal preparation, which can assist chemotherapy, inhibit tumor cell proliferation, and reduce adverse reactions of chemotherapy. In this study, we systematically evaluated reports of CKI as an adjuvant to chemotherapeutic treatment of digestive tract cancer in recent years and provided evidence for clinical diagnosis and treatment. The databases of PubMed, Chinese Biomedical Literature (CBM), China National Knowledge Infrastructure (CNKI) and Web Of Science were searched for clinical randomized controlled trials (RCTs) related to adjuvant chemotherapy with CKI in the treatment of advanced gastrointestinal tumors published from January 2000 to September 2021. After screening the qualified literatures, RevMan 5.4 software was used to evaluate the bias of the included literatures and perform meta-analysis. A total of 12 articles were included in the selection, incorporating 1080 study participants in all; meta-analysis results showed that application of the CKI in the process of chemotherapy for digestive tract tumors could improve the efficacy [odds ratio (OR) =3.11; 95% confidence interval (CI): 2.26 to 4.47, Z=7.00, P<0.00001], increase the patients' median survival time (months) (OR =3.00; 95% CI: 1.47 to 4.52, Z=3.84, P=0.0001), increase the level of CD3+ [mean difference (MD) =4.11; 95% CI: 3.24 to 4.98], CD4+ level (MD =8.24; 95% CI: 3.72 to 12.76), reduce the CD8+ level (MD =-5.42; 95% CI: -8.09 to -2.76), reduce the tumor markers carcinoembryonic antigen (CEA; MD =-14.26; 95% CI: -14.81 to -13.71), CA199 (MD =-138.87; 95% CI: -143.21 to -132.52), and reduce the adverse reactions of chemotherapy: leukopenia (OR =0.28; 95% CI: 0.19 to 0.43), thrombocytopenia (OR =0.38; 95% CI: 0.24 to 061), decreased hemoglobin (OR =0.55; 95% CI: 0.31 to 0.98), and nausea and vomiting symptoms (OR =0.35; 95% CI: 0.24 to 0.53). Adjuvant chemotherapy with CKI in the treatment of digestive tract tumors can effectively improve the symptoms of patients, improve immunity, reduce the level of serum tumor markers, improve efficacy, and reduce toxic and side effects.

Clinicopathological characteristics of IgG4-related lung disease

BackgroundImmunoglobulin G4-related lung disease (IgG4-RLD) is a rare entity. We retrospectively analyzed the clinical and histopathological characteristics of patients with pathologically confirmed IgG4-RLD to improve the diagnosis rate and reduce the risk of misdiagnosis.MethodsWe screened the pathological reports of 4838 patients with pulmonary surgery and/or biopsy specimens from April 2017 to April 2021 at Sun Yat-Sen Memorial Hospital affiliated with Sun Yat-Sen University, and specimens from 65 patients with suspected IgG4-RLD were subjected to immunohistochemical staining for IgG4 and IgG. Finally, 10 patients with definite IgG4-RLD that was pathologically confirmed were enrolled and analyzed.ResultsThe incidence of pathologically confirmed IgG4-RLD was 0.2% (10/4838). The ten patients had an average age of 59.7 years at diagnosis, and the male-to-female ratio was 9:1. The initial clinical manifestations were nonspecific, and cough was the most common symptom (4/10). More than one organ was involved in most patients (8/10), and mediastinal/hilar lymph node involvement was often observed (7/10). Serum IgG4 was analyzed in 6 patients and found to be elevated. Serum tumor marker levels were within the normal range or were slightly elevated. Computed tomography (CT) of the chest and/or 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET-CT) imaging revealed that 5 patients had a mixed type, 3 patients had the solid nodular type, and 2 patients had the bronchovascular type. All pulmonary masses and large nodules with solid patterns had spiculated margins and inhomogeneous enhancement with or without pleural indentation and a lobulated appearance. Abundant lymphoplasmacytic cell infiltration and fibrosis were observed in all patients. The expression of IgG4 and IgG was upregulated in the pulmonary sections. Seven patients were treated with glucocorticoids with or without additional immunosuppressants and responded well.ConclusionsThe results of our study suggest that multiple imaging findings, an elevated serum IgG4 concentration, and no significant increase in serum tumor biomarkers could provide diagnostic support for IgG4-RLD, especially for isolated IgG4-RLD or IgG4-RLD that includes other organ involvement that does not aid in establishing the diagnosis.

Clinical Study of Gefitinib for Non-Small Cell Lung Cancer

Objective: To evaluate the clinical efficacy of gefitinib in non-small cell lung cancer. Methods: A total of 45 patients with non-small cell lung cancer who received treatment in Taizhou Second People’s Hospital from January 2018 to January 2020 were selected as the subjects in this study, in which all of them were treated with gefitinib. Its efficacy and safety were evaluated. Results: The objective response rate was 53.33% and the disease control rate was 84.44%. After treatment, the levels of tumor markers were measured again, of which the levels of CA125 and CEA were significantly lower than before (P &lt; 0.05). After treatment, the patients’ CD3+, CD4+, and CD4+/CD8+ were significantly lower than those before treatment, and CD8+ was significantly higher (P &lt; 0.05). Conclusion: Gefitinib, which is a targeted therapy for non-small cell lung cancer, can reduce the level of serum tumor markers and improve the immune function. The curative effect is good, but more emphasis should be on the adverse reactions caused by a single drug use.

A Nonlinear Association between Tongue Fur Thickness and Tumor Marker Abnormality: A Cross-Sectional Study.

Background Many associations between tongue fur and different physiological and biochemical indexes have been revealed. However, the relationship between tongue fur and tumor markers remains unexplored. Methods We collected the medical examination reports of 1625 participants. Participants were residents of Chengdu, China, undergoing routine health checkups at the health management center of the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine between December 2018 and September 2020. The participants' tongue fur thickness was measured using the DAOSH four-diagnostic instrument. Tumor marker levels, including t-PSA, AFP, CEA, CA125, and CA199, were measured in the clinical laboratory. Curve-fitting and multivariable logistic regression were used to analyze the association between tongue fur thickness and tumor marker abnormality. Results Curve-fitting showed that the relationship between tongue fur thickness and abnormal tumor marker rate was nonlinear, similar to a U shape. As the tongue fur thickness value increased, the abnormal tumor marker probability initially decreased and then increased. Logistic regression showed that, in the crude model, compared with the thin tongue fur group, the odds ratios (ORs) and 95% confidence intervals (CIs) of the less or peeling tongue fur group and thick tongue fur group for tumor marker abnormality were 1.79 (1.02–3.17) and 1.70 (1.13–2.54), respectively. After adjusting gender, age, body mass index (BMI), smoking history, drinking history, tongue color, the form of the tongue, and fur color, the ORs and 95% CIs of the less or peeling tongue fur group and thick tongue fur group were 1.93 (1.04–3.57) and 1.82 (1.17–2.81), respectively. Conclusions Excessive or very little tongue fur is associated with tumor marker abnormality. Further cross-sectional studies are needed to evaluate the clinical value of tongue fur for cancer diagnosis and screening.

Effect of Bevacizumab Combined with Neoadjuvant Chemotherapy in Advanced Ovarian Cancer and the Occurrence of Adverse Reactions

Objective: To explore the effect of bevacizumab combined with neoadjuvant chemotherapy in advanced ovarian cancer and the occurrence of adverse reactions. Methods: A total of 80 patients with advanced ovarian cancer, treated in Affiliated People’s Hospital of Inner Mongolia Medical University from June 2019 to December 2020, were randomly divided into two groups. In the chemotherapy group, 40 patients were treated with neoadjuvant chemotherapy, while in the combined group, another 40 patients were treated with bevacizumab combined with neoadjuvant chemotherapy. The therapeutic effects were compared at the end of the treatment cycle. Results: There was no significant difference in the levels of CA125, CEA, and VEGF between the two groups before treatment. However, after the treatment cycle, the levels of CA125, CEA, and VEGF in the combined group were significantly better than those in the chemotherapy group (P &lt; 0.05). At the same time, the incidence of adverse reactions of the chemotherapy group was 67.50%, which was significantly higher than that of the combined group (35.00%; P &lt; 0.05). Conclusion: Bevacizumab combined with neoadjuvant chemotherapy for patients with advanced ovarian cancer has significant curative effect. The combined therapy reduces the levels of tumor markers and inflammatory factors, improves patients’ quality of life, as well as reduces adverse reactions. It has high clinical promotion value.

Effect of Combining Early Chemotherapy with Zhipu Liujunzi Decoction under the Concept of Strengthening and Consolidating Body Resistance for Gastric Cancer Patients and Nursing Strategy.

Objective To explore the clinical efficacy of combining early chemotherapy with Zhipu Liujunzi decoction under the concept of strengthening and consolidating body resistance for gastric cancer patients and nursing strategy. Methods The clinical data of 100 patients undergoing radical gastrectomy in our hospital from July 2019 to July 2020 were selected for the retrospective analysis, and the patients were divided into the control group and experimental group according to different treatment methods, with 50 cases in each group. Early chemotherapy after surgery was given to patients in the control group, and on the basis of the aforesaid treatment and under the concept of strengthening and consolidating body resistance, patients in the experimental group took Zhipu Liujunzi decoction and received the nursing strategy, so as to compare their effective rate, adverse reaction rate (ARR), immune function indicators, KPS scores, and nursing satisfaction scores. Results After treatment, the experimental group obtained significantly higher objective remission rate (ORR) and disease control rate (DCR) (P < 0.05), lower carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) levels (P < 0.001), higher immune parameters levels (P < 0.001), higher KPS scores and lower TCM symptom scores (P < 0.001), lower PSQI scores, SAS scores, and SDS scores (P < 0.001) and higher nursing satisfaction scores (P < 0.001), and lower total accidence rate of toxic side effects (P < 0.05) than the control group. Conclusion Under the concept of strengthening and consolidating body resistance, combining early chemotherapy with Zhipu Liujunzi decoction is a reliable method for improving the immune function and quality of life for gastric cancer patients with higher safety. Such a strategy greatly reduces the tumor marker levels in patients. Further research will be conducive to establishing a better solution for gastric cancer patients.