Serum Ca Levels Research Articles

Association between daily consumption of spicy food and bone mineral density in middle-aged and older adults: a cross-sectional study.

Background: Many studies have reported the effects of spicy food on human health, but no studies have been conducted on the impact of long-term spicy food consumption on bone mineral density (BMD). This study aimed to investigate the impact of daily consumption of spicy food on BMD in the population aged 50 years and older. Methods: This cross-sectional study was conducted from 2020 to 2022 in Jiangxi Province, China. This study investigated the differences in BMD between non-consumers and daily spicy food consumers in adults aged 50-85 years. A multiple linear regression model was used to investigate the association between spicy food consumption and BMD of the total lumbar spine (LS), femoral neck (FN), and total hip, as well as biochemical markers of bone metabolism (BMBM) levels. Results: The results showed that daily consumption of spicy food was negatively associated with total LS BMD (β = -0.013, P = 0.015). Subgroup analyses showed this negative association was more pronounced among smokers and drinkers compared to non-smokers (β: -0.006 vs. -0.042; P for interaction <0.05) and non-drinkers (β: -0.004 vs. -0.037; P for interaction <0.05). In addition, according to the daily frequency of spicy food consumption, the daily spicy food consumers were categorized into one meal per day, two meals per day, and three meals per day groups. Further analysis revealed that the negative association between spicy food and total LS BMD was progressively stronger as the frequency of daily consumption of spicy food increased (P for trend <0.05). For BMBM, daily consumption of spicy food was positively associated with serum PINP levels and negatively associated with serum Ca and serum Mg levels. Conclusions: Our study suggested that daily consumption of spicy food was associated with lower LS BMD in middle-aged and older Chinese adults, and this association was more pronounced in the smoking and drinking populations. The adverse effects of spicy food on LS BMD become progressively stronger with increasing frequency of daily consumption of spicy food. In addition, daily consumption of spicy food was associated with higher PINP levels and lower serum Ca and Mg levels.

CDH3 Is an Effective Serum Biomarker of Colorectal Cancer Distant Metastasis Patients.

Few robust biomarkers are available for distant metastatic colorectal cancer (CRC) patients. Aberrant high expression of CDH3 has been reported in advanced CRC patients, but the value of CDH3 as a biomarker for the diagnosis and prognosis of distant metastatic CRC patients remains to be evaluated. In this study, we explored the serum levels of CDH3 in different stages of CRC patients and sought to determine whether serum CDH3 serves as an independent biomarker for distant metastatic CRC patients. We analyzed the serum CDH3 levels by ELISA in a cohort of CRCs (n=96) and normal controls (n=28). We compared the serum CDH3 levels between normal controls and different stages of CRCs. As a potential diagnostic marker of distant metastatic CRC, the specificity and sensitivity of serum CDH3 were evaluated. Multivariate analysis was also performed to determine whether serum CDH3 was an independent risk factor. Moreover, the changes of serum CDH3 levels were monitored and analyzed before and after palliative chemotherapy. Serum levels of CDH3, CA24-2, CA19-9, CA72-4, and CEA were significantly elevated in distant metastatic CRCs. CA24-2 (r=0.24, P=0.01), CA19-9 (r=0.20, P=0.03), CA72-4 (r=0.64, P<0.0001), and CEA (r=0.31, P=0.0012) all had a certain correlation with CDH3. After three cycles of palliative chemotherapy, levels of CDH3, CA24-2, CA19-9, CA72-4, and CEA of partial response CRCs were reduced to 38.8% (95% confidence interval [CI]: 30.95%-53.77%), 57.73% (95% CI: 2.085%-73.83%), 50.33% (95% CI: 9.935%-79.42%), 74.74% (95% CI: 25.21%-88.00%), and 59.16% (95% CI: 12.65%-83.56%) of baseline, respectively. The areas under the receiver operating characteristic curves of CDH3, CA24-2, CA19-9, CA72-4, and CEA with chemotherapy response were 0.900, 0.597, 0.635, 0.608, and 0.507, respectively. Serum CDH3 is an effective serum biomarker for the diagnosis of distant metastatic CRCs and monitoring response to palliative chemotherapy in distant metastatic CRCs.

Evaluation of the Effect of Transurethral Resection of Bladder Tumors in the Treatment of Bladder Cancer and its Impact on CA19-9 and CA125 Levels

Objective: To evaluate the impact of transurethral resection of bladder tumors on surgical outcomes and serum tumor markers CA19-9 and CA125 in patients with bladder cancer. Methods: 80 patients with bladder cancer admitted to our hospital were selected and divided into two groups according to different treatment methods, with 40 cases in each group. The control group underwent open resection of bladder tumor, and the observation group adopted transurethral resection of bladder tumors. The two groups’ surgical indicators and levels of serum tumor markers CA19-9 and CA125 before and after treatment were observed and compared. Results: The operation time, bladder irrigation time, and intraoperative bleeding volume of the observation group were less than those of the control group, and the difference was statistically significant (P &lt; 0.05); Before surgery, there was no statistically significant difference in serum CA19-9 and CA125 levels (P &gt; 0.05). After surgery, the serum CA19-9 and CA125 levels of the two groups of patients were significantly lower than those before surgery. Moreover, the serum CA19-9 and CA125 levels in the observation group were significantly lower than those in the control group after surgery (P &lt; 0.05). Conclusion: Transurethral resection of bladder tumors in the treatment of bladder cancer can significantly improve various surgical indicators and reduce the levels of bladder cancer tumor markers CA19-9 and CA125. The surgical effect and prognosis are good and it is worthy of clinical application and promotion.

Clinical benefits of pulmonary resection for lung metastases from pancreatic cancer.

Systemic chemotherapy is generally used for metastatic pancreatic cancer; however, pulmonary resection may be a treatment option for lung oligometastases from pancreatic cancer. The current study aimed to clarify the oncological outcomes and clinical benefits of pulmonary resection for lung metastases. Of 510 patients who underwent pancreatic resection for pancreatic cancer, 44 patients with recurrence of isolated lung metastases and one patient with simultaneous lung metastases were evaluated. Of the 45 patients, 20 patients were selected as candidates for pulmonary resection based on clinical factors such as recurrence-free interval (RFI) from pancreatectomy to lung metastases, number of lung metastases, and serum CA19-9 level. The post-recurrent survival of patients with pulmonary resection was significantly better than that of patients without pulmonary resection. Fourteen of the 20 patients with pulmonary resection developed tumor recurrence with a median disease-free survival (DFS) of 15 months. Univariate analyses revealed that an RFI from pancreatectomy to lung metastases of ≥28 months was associated with better DFS after pulmonary resection. Of the 14 patients with an RFI of ≥28 months, pulmonary resection resulted in prolonged chemotherapy-free interval in 12 patients. Furthermore, repeat pulmonary resection for recurrent tumors after pulmonary resection led to further cancer-free interval in some cases. Although many patients had tumor recurrence after pulmonary resection, pulmonary resection for lung metastases from pancreatic cancer may provide prolonged cancer-free interval without the need for chemotherapy. Pulmonary resection should be performed for the patients with a long RFI from pancreatectomy to lung metastases.

Synchronous or Metastatic Gastric and Ovarian Malignancies: A Diagnostic Challenge

Primary ovarian carcinoma is the prevailing form of cancer in the female reproductive system, leading to a substantial number of cancer-related fatalities globally. One of the major obstacles encountered in diagnosing this condition is distinguishing between primary gastrointestinal tumors and tumors that have metastasized from the ovaries, since they may exhibit similar histological characteristics. This case report underscores the difficulties involved in determining whether multiple tumors originate primarily or are a result of metastasis. We report a case of a 65-year-old female who presented with abdominal pain and was found to have a large multiloculated cystic mass in the right ovary and a poorly detected left ovary on ultrasound and CT scan. Her serum CA125 level was elevated. She underwent exploratory laparotomy and frozen section analysis of the right ovarian and gastric tumors. The histopathological diagnosis was mucinous cystadenocarcinoma of the ovary and well differentiated adenocarcinoma of the stomach. She also underwent hysterectomy with left salpingo-oophorectomy, which revealed mucinous cystadenocarcinoma of the left ovary. Immunohistochemical staining for specific markers, including CK7, CK20, CDX2, and PAX8, was conducted to identify the origin of the adenocarcinoma. The results revealed that both ovarian and gastric tumors showed a positive expression for CK7, while CK20 was negative in the gastric tumor but positive in the ovarian tumor. Furthermore, both CDX2 and PAX8 were negative in both the gastric and ovarian tumors. These findings provide valuable insights into the differential diagnosis and help to distinguish the possible sources of the adenocarcinoma. This case emphasizes the significance of histopathological examination and immunohistochemistry profiling in accurately diagnosing and determining the primary tumor site. Recognizing the primary tumor and its immunohistochemistry profile aids in guiding treatment strategies and predicting patient prognosis, leading to improved management and outcomes. Keywords Ovarian carcinoma, Gastric carcinoma, Immunohistochemistry

Calcium, phosphorus, magnesium levels in frequent respiratory tract infections

Background It was well documented that calcium (Ca), phosphorus (P), and magnesium (Mg) participate in many physiological processes. We aimed to study the changing trend of serum levels of Ca, P, and Mg in frequent respiratory tract infections (FRTI) in children. Methods A retrospective study was performed in our centre. A total of 213 FRTI cases and 33 controls were enrolled in our study. We analyzed the correlation between serum Ca/P/Mg levels and inflammatory indexes by using Spearman correlation analysis. Standard mean difference (SMD) was applied to test the differences of serum Ca/P/Mg levels between FRTI subgroups and controls. In terms of the findings of SMD between Ca/P/Mg status between FRTI subgroups and controls, receiver operating characteristics (ROC) curve analysis was further applied to test the association between serum Ca level and bronchitis, parainfluenza virus infection, influenza B virus infection and cytomegalovirus infection. Results Serum Ca level was significantly associated with white blood cell (WBC), platelet (PLT) and procalcitonin (PCT) (p = 0.006; p < 10−4; p = 0.004). Serum P level was markedly associated with eryhtrocyte sedimentation rate (ESR) and PCT (p = 0.018; p < 10−4). Controls showed significantly lower serum Ca level than that among bronchitis (p = 0.001), parainfluenza virus infection (p = 0.027), influenza B virus infection (p = 0.017), cytomegalovirus infection (p = 0.029), and two pathogens infected (p = 0.020). ROC curve analysis showed that serum Ca level was significantly associated with bronchitis (p = 0.047) and influenza B virus infection (p = 0.049). Conclusions Serum levels of Ca and P may reflect the inflammatory status in children with FRTI. Alteration of serum Ca level may predict the risk of bronchitis and influenza B virus infection. Keeping the homeostasis of Ca, P, and Mg may be important for the prevention and treatment of FRTI.

Changes in serum tumor markers in type 2 diabetes mellitus with microalbuminuria.

The objective of this study was to investigate changes in serum tumor markers in type 2 diabetes mellitus (T2DM) with microalbuminuria and analyze the relationship between tumor markers and microalbuminuria. A total of 956 T2DM patients aged 40-70 years hospitalized in the Department of Endocrinology, Xinhua Hospital, China, affiliated with Shanghai Jiaotong University School of Medicine, were enrolled from January 2018 to December 2020. The sample comprised 313 T2DM patients with microalbuminuria and 643 T2DM patients with normal urinary microalbumin levels. After assessing the changes in serum tumor markers in T2DM with microalbuminuria, we analyzed the risk of microalbuminuria by the serum tumor marker category using multiple logistic regression analysis. Serum CEA, CA199, CA125, CA153, CA211, SCC, CA242, and CA50 levels were significantly higher in T2DM patients with microalbuminuria than in those without microalbuminuria, while serum AFP levels were lower in the microalbuminuria group (P < 0.05). Following adjustment of confounders, serum CEA, CA211, and SCC were independently associated with microalbuminuria in T2DM. An ROC curve was used to estimate the cutoff point of tumor markers for microalbuminuria. Taking the values under the cutoff points as a reference, values for CEA, CA211, and SCC above the cutoff points indicated a significantly high risk of microalbuminuria. The OR of increased CEA for microalbuminuria was 2.006 (95%CI 1.456-2.765), the OR of increased CA211 for microalbuminuria was 1.505 (95%CI 1.092-2.074), and the OR of increased SCC for microalbuminuria was 1.958 (95%CI 1.407-2.724). Several serum tumor markers were related to microalbuminuria in T2DM. Serum tumor markers such as CEA, SCC, and CA211 may indicate early diabetic nephropathy, particularly when elevated in combination.

Combination of serum CST1 and HE4 for early diagnosis of endometrial cancer

Purpose Optimal serological biomarkers have been absent for the early diagnosis of endometrial cancer, to date. In this study, we aimed to define the diagnostic performances of individual and combined detection of serum cysteine protease inhibitor 1 (CST1) with traditional tumor markers, including glycated antigen 125 (CA125) and human epididymis protein 4 (HE4), in patients with early-stage endometrial cancer (EC). Methods The performances of individual and combined detection of serum CST1, HE4, and CA125 were evaluated by enzyme-linked immunosorbent assay (ELISA) and chemiluminescent immunoassay, respectively. A training data set of 67 patients with early EC, 67 patients with endometrial benign lesion (EBL), and 67 healthy controls (HC) was used to develop a predictive model for early EC diagnosis, which was validated by an independent validation data set. Results In the training data set, serum CST1 and HE4 levels in the early EC group were significantly higher than in EBL/HC groups (P &lt; 0.05), while there was no significant difference of serum CA125 level between the early EC and EBL/HC groups (P &gt; 0.05). Serum CST1 and HE4 exhibited areas under the curve (AUC) of 0.715 with 31.3% sensitivity at 90.3% specificity, and 0.706 with 23.9% sensitivity at 95.5% specificity, respectively. Combined detection of serum CST1 and HE4 exhibited an AUC of 0.788 with 49.3% sensitivity at 92.5% specificity. The combination of serum CST1 and HE4 showed promise in diagnosis. Conclusion CST1 is a prospective serological biomarker for early EC diagnosis, and the combination of CST1 and HE4 contributes to the further improvement in the diagnosis of patients with early-stage EC.

Therapeutic effects of Huayu Jiedu formula on endometriosis via downregulating GATA 6 expression

BackgroundEndometriosis (EMs) is a common chronic inflammatory disease which is characterized by multiple clinical symptoms and high recurrence rate due to the absence of effective therapies. Huayu Jiedu Formula (HYJDF), is a traditional Chinese medicine prescription with five major herbs. It has been used as traditional medicine to treat EMs for more than twenty years and exerted a good therapeutic effect. However, the underlying mechanism is unclear. Here we aim to observe the effects of HYJDF on EMs and investigate the therapeutic mechanism. MethodsThe extract components of HYJDF were identified and quantified by an UHPLC-QE-MS method. Network pharmacology was used to obtain the core targets of HYJDF for the treatment of EMs and the specific biologic processes involved. A total of 68 EMs cases were randomly divided into control (gestrinone) and observation (HYJDF) groups. The overall effectiveness, pain scores, cyst-size changes, serum CA125 levels, quality-of-life scores, safety, and adverse events were evaluated before and after treatment. For the mechanism research, DNA methylation-chip analysis was performed to determine the differential genes. EMs mice models and human ectopic stromal cells (ESCs) were treated with HYJDF and its pharmaceutical serum, respectively. The ectopic foci was measured via H&E staining while the expressions of the target genes were verified by real-time PCR and Western blot analysis. The inflammatory cytokine levels in the peritoneal fluid of mice were detected by ELISA. The proliferative potential of cells was analyzed by MTS whereas the apoptosis and cell cycle were determined through flow analysis. ResultsThe total number of components detected in positive and negative ion modes was 839 and 597, respectively. Network pharmacology suggested that HYJDF treated EMs through DNA methylation. We found that HYJDF and gestrinone exerted good therapeutic effect with no obvious difference, but the HYJDF treatment group had fewer side effects. GATA 6, which was hypomethylated and abundant in endometriotic cells, potently induced inflammatory response. This finding indicated the important role of GATA 6 in EMs development. Moreover, HYJDF ameliorated inflammatory response (i.e., reduced the levels of IL-1β and PGE2 in peritoneal fluid), suppressed ESCs proliferation, and increased cell apoptosis by down-regulating GATA 6 expression. ConclusionWe demonstrated that HYJDF has anti-inflammation activity and increased cell apoptosis through the reduction of GATA 6 expression in ectopic tissues, which showed good therapeutic effect without any obvious side effects. These findings suggest that HYJDF may be a new and efficient traditional Chinese medicine for the treatment of EMs.

A case of ductal carcinoma in situ (DCIS) with markedly elevated CA15-3 levels requiring 2 years of diagnosis

BackgroundCA15-3 is often elevated in breast cancer recurrence and rarely in ductal carcinoma in situ (DCIS). We report a case of DCIS with elevated CA15-3 levels, which was diagnosed after over 2 years of follow-up.Case presentationA 74-year-old woman presented with a left-sided breast mass and pain. Redness, swelling, and induration were observed in the left breast. Ultrasonography revealed a non-mass lesion in the left 3 o'clock position, skin thickening, and axillary lymphadenopathy. Serum CA15-3 levels were markedly high at 640 U/mL, suggesting inflammatory breast cancer. However, biopsies showed no malignancy. We diagnosed chronic mastitis with elevated CA15-3 levels and followed up with magnetic resonance imaging and a biopsy, as needed. Finally, DCIS was diagnosed 27 months after the first visit. She underwent a left mastectomy and a sentinel lymph node biopsy; DCIS had spread 6.5 cm and was immunohistochemically positive for CA15-3. No metastasis was found in the lymph nodes, but incidental Hodgkin lymphoma was observed. Postoperative normalization of CA15-3 levels indicated that she had DCIS with elevated CA15-3 levels. The patient underwent chemotherapy for Hodgkin lymphoma postoperatively, and there was no evidence of recurrence 1 year after surgery.ConclusionHigh CA15-3 levels can also be observed in DCIS, indicating that CA15-3 should not be used solely in breast cancer staging.

Association of serum tumor markers with serous effusion in systemic lupus erythematosus

The objective of this study was to investigate the relationship between serum tumor markers and serous effusion in systemic lupus erythematosus (SLE) patients, thereby contributing preliminary data on the utility of these tumor markers in diagnosing serous effusion. In this retrospective analysis, clinical data of SLE patients were extracted from electronic medical records. This included the levels of serum tumor markers, including pro-gastrin-releasing peptide, neuron-specific enolase (NSE), cytokeratin-19 fragments (CYFRA 21-1), various carbohydrate antigens (CA 153, CA 125, CA 19-9), along with carcinoembryonic antigen, and alpha-fetoprotein. Positivity of tumor markers was established based on serum levels surpassing the upper threshold of the respective reference ranges. This study included 149 eligible patients with SLE, of whom 38 (25.50%) had serous effusion, and the prevalence of pleural, pericardial, and peritoneal effusions was 11.41%, 14.77%, and 6.71%, respectively. The analysis revealed that patients with serous effusion had higher scores on the SLE Disease Activity Index 2000 (SLEDAI 2000) than those without serous effusion. Notably, this disparity remained significant when the serositis score was excluded from the SLEDAI 2000 calculation. The positivity rate and serum levels of CA 125 were higher in patients with serous effusion and pleural effusion. Patients with pericardial effusion demonstrated an elevated CYFRA 21-1 positivity rate and serum CA 125 and CYFRA 21-1 levels compared to patients without pericardial effusion. CA 125 and NSE were higher both in terms of positivity rate and serum levels for patients with peritoneal effusion. Through receiver operating characteristic curve analysis, a moderate relationship was discerned between the conjoined levels of CYFRA 21-1 and CA 125 and the occurrence of pericardial effusion. Additionally, CA 125, NSE, and their combination revealed the moderate diagnostic ability of peritoneal effusion. In summary, this study observed elevated serum levels of various tumor markers in SLE patients exhibiting serous effusion, which is likely attributable to lupus-induced inflammation. These findings suggest that serum tumor markers can be valuable in diagnosing pericardial and peritoneal effusions.

Effects of natural orifice transluminal endoscopic radical resection of the colon and targeted therapy on immune response and blood CA199 and CA242 levels in colorectal cancer.

To examine the effect of natural orifice transluminal endoscopic radical resection combined with targeted therapy on the immune system and serum levels of CA199 and CA242 in individuals with colorectal cancer. We enrolled 90 patients admitted to our hospital with a diagnosis of colorectal cancer between February 2020 and May 2022 and divided them into 2 groups according to the treatment methods: observation group (n = 45) and control group (n = 45). Patients in the control group underwent conventional laparoscopic radical resection of the colon followed by targeted therapy, whereas those in the observation group underwent natural orifice transluminal endoscopic radical resection of the colon and targeted therapy. Serum CA199 and CA242 levels, incidence of adverse events, clinical efficacy, perioperative indicators, and immune function indicators were compared between the 2 groups. The objective response rate (ORR) and disease control rate (DCR) were significantly higher in the observation group than in the control group (60.00% vs 35.6%, P = .020, and 91.1% vs 64.44%, P = .002, respectively). Compared with the control group, the observation group was associated with less blood loss (P = .003), shorter operation time (P = .011), shorter first exhaust time (P = .042), shorter borborygmus recovery time (P = .042), and shorter length of hospital stay (P = .020). After treatment, the CD3 + (P = .020), CD4 + (P = .008), and CD4+/CD8 + (P = .035) counts were lower, whereas the IgG (P = .014), IgM (P = .019), and IgA (P = .038) counts were higher in the observation group than in the control group. CA199 (P = .009) and CA242 (P = .001) levels were lower in the observation group than in the control group. The groups did not differ significantly in the incidence of adverse events (P = .842). The combination of natural orifice transluminal endoscopic radical resection for colorectal cancer and targeted therapy can shorten hospital stay, improve immune function, lower serum levels of CA199 and CA242, and exhibit good clinical efficacy.

Anti-oxidant effects of herbal residue from Shengxuebao mixture on heat-stressed New Zealand rabbits

Heat stress can lead to hormonal imbalances, weakened immune system, increased metabolic pressure on the liver, and ultimately higher animal mortality rates. This not only seriously impairs the welfare status of animals, but also causes significant economic losses to the livestock industry. Due to its rich residual bioactive components and good safety characteristics, traditional Chinese medicine (TCM) residue is expected to become a high-quality feed additive with anti-oxidative stress alleviating function. This study focuses on the potential of Shengxuebao mixture herbal residue (SXBR) as an anti-heat stress feed additive. Through the UPLC (ultra performance liquid chromatography) technology, the average residue rate of main active ingredients from SXBR were found to be 25.39%. SXBR were then added into the basal diet of heat stressed New Zealand rabbits at the rates of 5% (SXBRl), 10% (SXBRm) and 20% (SXBRh). Heat stress significantly decreased the weight gain, as well as increased neck and ear temperature, drip loss in meat, inflammation and oxidative stress. Also, the hormone levels were disrupted, with a significant increase in serum levels of CA, COR and INS. After the consumption of SXBR in the basal diet for 3 weeks, the weight of New Zealand rabbits increased significantly, and the SXBRh group restored the redness value of the meat to a similar level as the control group. Furthermore, the serum levels T3 thyroid hormone in the SXBRh group and T4 thyroid hormone in the SXBRm group increased significantly, the SXBRh group showed a significant restoration in inflammation markers (IL-1β, IL-6, and TNF-α) and oxidative stress markers (total antioxidant capacity, HSP-70, MDA, and ROS) levels. Moreover, the real-time fluorescence quantitative PCR analysis found that, the expression levels of antioxidant genes such as Nrf2, HO-1, NQO1, and GPX1 were significantly upregulated in the SXBRh group, and the expression level of the Keap1 gene was significantly downregulated. Additionally, the SXBRm group showed significant upregulation in the expression levels of HO-1 and NQO1 genes. Western blot experiments further confirmed the up-regulation of Nrf2, Ho-1 and NQO1 proteins. This study provides a strategy for the utilization of SXBR and is of great significance for the green recycling of the TCM residues, improving the development of animal husbandry and animal welfare.

Preoperative work-up and results of parathyroidectomy plus auto-transplantation for the elderly with secondary hyperparathyroidism

BackgroundTotal parathyroidectomy for secondary hyperparathyroidism has low morbidity and mortality rates and requires a special workup in the preoperative period. MethodsNeck echography and technetium-99m-sestamibi scintigraphy were performed preoperatively. Cardiac echography, a thallium-201 myocardial perfusion scan, and cardiac catheterization were performed if necessary. During surgery, we removed all the parathyroid glands and the upper thymus and autotransplanted 100 mg of the smallest gland into the subcutaneous tissue of the forearm. ResultsThe success rate in three months after total parathyroidectomy was 91.7% without mortality. In the elderly (age ≤65 years, n = 35), bone pain, skin itching, general weakness, and insomnia improved three months after surgery, and grip strength increased significantly. One year after parathyroidectomy, the serum levels of Ca, P, alkaline phosphatase, and intact parathyroid hormone were all within the normal ranges. Except for the bone mineral density (BMD) of the radial distal one-third, the BMD of the lumbar spine (L2 to L4), femoral neck, femoral global, and radial global increased significantly. Furthermore, the bone density T-scores of the lumbar spine (L2 to L4), femoral neck, femoral global, radial distal one-third, and radial global improved significantly. ConclusionsAfter a meticulous preoperative workup, parathyroidectomy plus autotransplantation can be performed safely for the treatment of symptomatic secondary hyperparathyroidism in the elderly to improve their quality of life and decrease their incidence of bone fractures.

OGC P05 18FDG-PET-CT is superior to CT in detecting locoregional and distant recurrence after oesophago-gastrectomy for distal oesophageal/gastro-oesophageal junctional cancer

Abstract Background Recurrent oesophageal and gastro-oesophageal junctional cancers (OGJC) are associated with poor survival. Evaluation of symptoms, monitoring of tumour markers, and spiral computed tomography (CT) can be used in postoperative surveillance to identify potential recurrence. 18FDG-PET-CT may be used when CT is equivocal despite positive clinical and biochemical markers, and may enable early diagnosis of recurrent disease. We hypothesise that 18FDG-PET-CT is superior to CT in identifying recurrent OGJC and may have a role in routine surveillance post-oesophago-gastrectomy. Methods Patients with recurrent OGJC after two-stage oesophago-gastrectomy performed in a single, tertiary, specialist UK cancer centre, who were investigated for suspected recurrence with 18FDG-PET-CT and CT within 1 month of each other, up to 5 years after primary resection were included. Demographic details including age, tumour staging (TNM classification), histological subtype, resection margin status, and serum CA19-9 and CEA levels at the time of recurrence were collected. Radiology reports were reviewed to determine whether recurrence was identified on CT, 18FDG-PET-CT or both. Statistical analyses were performed on the Datatab platform. Sensitivity of both imaging modalities at identifying recurrence was calculated. Results A total of n=65 (58 male, 7 female) patients were included. Locoregional, distant, and both locoregional and distant recurrence were identified in n=17 (26.2%), n=22 (33.8%) and n=26 (40.0%) patients respectively. 18FDG-PET-CT (63/65, 96.9% sensitivity) was superior to CT (57/63, 87.7% sensitivity) in detecting all recurrence (p=0.02) and distant recurrence (100% compared to 81.8% sensitivity). Eight patients had recurrence identified on 18FDG-PET-CT, but not by CT (n=4 distant recurrence, n=1 locoregional recurrence, n=3 distant and locoregional recurrence). Of n=5 patients who received treatment for recurrence, n=3 had single-site recurrence. Median survival following detection in this subgroup was 2 years. Conclusions This study demonstrated that 18FDG-PET-CT was significantly more sensitive than CT in detecting all recurrent OGJC, and distant recurrence. This modality may have a role in surveillance following oesophago-gastrectomy for OGJC. Its greater sensitivity may enable early diagnosis of recurrence when performed following identification of clinical or biochemical features suspicious for recurrent disease. This could enable appropriate patients to undergo further systemic anti-cancer therapy to treat recurrence, prevent further disease progression and improve survival. Further studies considering economic and logistical factors including availability of equipment to perform a higher volume of scans are required to support these findings.

Prediction of Prognosis in Pancreatic Cancer According to Methionyl-tRNA Synthetase 1 Expression as Determined by Immunohistochemical Staining.

The serum level of CA 19-9 is a prognostic marker for pancreatic ductal adenocarcinoma (PDAC). We evaluated the ability of the expression level of methionyl-tRNA synthetase 1 (MARS1)-which facilitates cancer growth by modulating protein synthesis and the cell cycle-to predict the prognosis of PDAC. Immunohistochemical (IHC) staining was performed on pancreatic specimens obtained from patients with PDAC who were undergoing surgery. High MARS1 expression was defined as equal to, or greater than, that in normal acinar cells. Low MARS1 expression was defined as weaker than in normal acinar cells, and stronger than in the pancreatic duct epithelium. Univariate and multivariate analyses were performed on other factors related to prognosis. Among 137 PDAC patients, no significant differences in baseline characteristics were found between those with high (n = 82) and low (n = 55) MARS1 expression. The median overall survival time of patients with high MARS1 expression was shorter than that of those with low expression (15.2 versus 17.2 months, log-rank test p = 0.044). The median disease-free survival (DFS) was not significantly different between the two groups. However, the DFS was shorter in patients with high than in those with low MARS1 expression (8.9 versus 11.2 months, log-rank test p = 0.067). In a multivariate analysis, lymph node metastasis and high MARS1 expression were associated with a poor prognosis of PDAC. Elevated MARS1 expression detected by IHC staining is associated with a poor prognosis of PDAC, suggesting that MARS1 has potential as a prognostic marker.

Identifying tumor markers-stratified subtypes (CA-125/CA19-9/carcinoembryonic antigen) in cervical adenocarcinoma.

There is a lack of research evaluating the effect of tumor markers for prognosis in cervical adenocarcinoma. We aimed to develop and validate a preoperative tumor-marker-based model including clinicopathological factors to clarify the prognostic value of endocervical adenocarcinoma. A total of 572 patients with cervical adenocarcinoma who were staged at the International Federation of Gynecology and Obstetrics (FIGO) IA-IIA were reviewed retrospectively. Preoperative serum carcinoembryonic antigen (CEA), carbohydrate antigen (CA)-125 and CA19-9 levels were measured. The survival and recurrence patterns were analyzed according to the tumor-marker-related stratification. The predictive values of biomarkers and clinical variables were assessed with Cox regression and competing risk models. Patients with elevated preoperative tumor markers had evidently poor overall survival and recurrence-free survival. The triple-elevated tumor marker (TETM) subgroup had the worst overall survival and progression-free survival than the triple-negative tumor marker (TNTM) subgroup and the single-elevated tumor marker (SETM) subgroup. The most important predictors for overall survival were elevated tumor markers, FIGO-stage, tumor differentiation, lymphovascular space invasion (LVSI) and lymph nodes metastasis. The most important predictors for recurrence-free survival were elevated tumor markers, FIGO-stage, tumor differentiation, LVSI and deep stromal invasion. Stratified analysis showed that elevated CA-125 and CA19-9 were significantly associated with postoperative distant metastasis. A decision curve analysis confirmed that a combination of tumor markers as predictors significantly outperformed the other common predictors used (FIGO-stage, intermediate and high-risk factors, tumor differentiation, lymph nodes). Elevated preoperative serum CEA, CA-125, and CA19-9 levels exhibited poor overall survival and recurrence-free survival in cervical adenocarcinoma patients. Combined preoperative serum CA-125 and CA19-9 independently predicted distant metastasis in patients with endocervical adenocarcinoma.

Correlation of raised serum CA-125 level with laparotomy and histopathology findings of ovarian tumour in a tertiary level hospital

Correlation of raised serum CA-125 level with laparotomy and histopathology findings of ovarian tumour in a tertiary level hospital

Axillary Lymph Node Metastasis from Ovarian Carcinoma: A Systematic Review of the Literature.

Axillary lymph node metastasis is a rare stage IV ovarian carcinoma manifestation. This manuscript aims to systematically review the literature regarding axillary lymph node metastasis from ovarian carcinoma. We searched three medical internet databases (PubMed, Scopus, and Web of Science) for relevant articles published until 22 July 2023. Cases describing supraclavicular or intramammary lymph node metastases and concurrent metastasis to the breast were excluded. After applying eligibility/inclusion and exclusion criteria, twenty-one manuscripts describing twenty-five cases were included from the English literature. Data were collected and analyzed regarding demographic, clinical, laboratory, radiological, histopathological, and oncological characteristics. We analyzed the clinical and oncological characteristics of patients with axillary lymph node metastasis from ovarian carcinoma, presented either as an initial diagnosis of the disease or as a recurrent disease. The analysis we performed showed a significant difference only in the serum CA-125 level (p = 0.004) between the two groups. There was no observed difference in womens' survival.

Role of magnetic resonance imaging to differentiate between borderline and malignant serous epithelial ovarian tumors.

We aimed to differentiate serous borderline ovarian tumors (SBOT) from serous epithelial ovarian carcinomas (SEOC) using morphological and functional MRI findings, to improve the patient management. We retrospectively investigated 24 ovarian lesions diagnosed with SBOT and 64 ovarian lesions diagnosed with SEOC. Additional to the demographic and morphological findings T2W signal intensity ratio, mean apparent diffusion coefficient (ADCmean) and total apparent diffusion coefficient (ADCtotal) values were analyzed and compared between two groups. Bilaterality, pelvic free fluid presence, serum CA-125 level (U/mL), presence of pelvic peritoneal implant were in favor of SEOC. Lower maximum size of solid component and solid size to maximum size ratio, dominantly cystic and solid-cystic appearance, exophytic growth pattern, presence of papiller projection and papillary architecture and internal branching pattern, higher T2W signal intensity ratio, ADCmean and ADCtotal values were in favor of SBOT. Our study revealed that morphological and functional imaging findings were valuable in differentiating BSOT from SEOC.