The glycosaminoglycan hyaluronan (HA) plays an important role in tumor progression. However, its biological and clinical significance in papillary thyroid cancer (PTC) remains unknown. Immunohistochemistry was performed to examine HA expression in tissues from PTC patients. Two PTC cell lines were treated with HA synthesized inhibitor against HA production to assess its function. Serum HA levels from 107 PTC patients, 30 Hashimoto thyroiditis patients, and 45 normal controls (NC) were measured by chemiluminescence immunoassay. HA levels in fine needle aspiration (FNA) washouts obtained from thyroid nodules and lymph nodes (LNs) were measured by chemiluminescence immunoassay. Area under the curve (AUC) was computed to evaluate HA’s clinical value. HA was highly expressed in PTC. Reducing HA production significantly inhibited PTC cell proliferation and invasion. Importantly, serum HA levels in PTC were significantly higher than those in NCs and Hashimoto thyroiditis and allowed distinguishing of thyroid cancers from NCs with high accuracy (AUC = 0.782). Moreover, elevated serum HA levels in PTC correlate with LN metastasis. HA levels in FNA washouts from PTC patients were significantly higher than those in benign controls, with a high AUC value (0.8644) for distinguishing PTC from benign controls. Furthermore, HA levels in FNA washouts from metastatic LN were significantly higher than those in nonmetastatic LN, with a high AUC value (0.8007) for distinguishing metastatic LNs from nonmetastatic LNs. HA levels in serum and FNA washout exhibited a potential significance for PTC diagnosis and an indicator for LN metastasis in patients with PTC.

目的 探讨丝裂原活化蛋白激酶(MAPK)/细胞外调节蛋白激酶(ERK)信号通路在逆转乳腺癌内分泌治疗耐药中的作用.方法 采用人乳腺癌细胞系MCF-7和T47D分别建立他莫昔芬治疗耐药细胞株MCF-7/TAMR和T47D/TAMR.分析MCF-7细胞与MCF-7/TAMR细胞、T47D细胞与T47D/TAMR细胞增殖能力和MAPK/ERK信号通路分子表达情况的差异.分析丝裂原活化蛋白激酶激酶(MEK)抑制剂U0126抑制MAPK/ERK信号通路后,对MCF-7/TAMR和T47D/TAMR细胞增殖的抑制作用、细胞周期分布以及转录因子表达的影响.结果 与MCF-7细胞和T47D细胞比较,MCF-7/TAMR细胞和T47D/TAMR细胞的增殖速度显著加快(P<0.05),克隆形成能力显著增强(P<0.0001),MAPK/ERK信号通路分子[ERK、磷酸化细胞外调节蛋白激酶(pERK)和c-MYC]表达量显著增高.采用MEK抑制剂U0126抑制MAPK/ERK信号通路后,MCF-7/TAMR细胞和T47D/TAMR细胞的增殖速度显著减慢(P<0.0001),细胞周期发生停滞,MAPK/ERK信号通路的转录因子类固醇受体共激活因子(SRC-1)、E26转录因子-2(ETS-2)和c-JUN基因的相对表达量明显降低(P<0.01).结论 抑制MAPK/ERK通路可逆转乳腺癌细胞的内分泌治疗耐药,或可为制定内分泌治疗耐药乳腺癌患者的治疗方案提供新的思路.

目的 探讨骨肿瘤患者血清骨代谢指标的水平及其在辅助诊断中的临床价值.方法 纳入2021年1-12月该院76例骨肿瘤患者(骨肿瘤组)和40例健康体检者(健康组)作为研究对象.根据病理检查结果将骨肿瘤组进一步分为良性组(29例)、中间型组(17例)和恶性组(30例).比较不同组别之间血清钙(Ca)、磷(P)、碱性磷酸酶(ALP)、Ⅰ型胶原羧基端肽β特殊序列(β-CTx)、骨钙素N端中分子(OCN-MID)、甲状旁腺素(PTH)、25-羟基维生素D(25-OH-VD)和总Ⅰ型胶原氨基端延长肽(TP1NP)水平的差异.绘制受试者工作特征(ROC)曲线分析各指标单独及联合检测对骨肿瘤的诊断价值.采用Spearman相关分析评估指标间的相关性.结果 骨肿瘤组血清β-CTx、P、ALP水平高于健康组,25-OH-VD水平低于健康组,差异均有统计学意义(P<0.01);两组血清Ca、OCN-MID、PTH、TP1NP水平比较,差异均无统计学意义(P>0.05).ROC曲线分析结果显示,β-CTx、25-OH-VD、P、ALP诊断骨肿瘤的曲线下面积(AUC)分别为0.750、0.799、0.810、0.647;β-CTx、25-OH-VD、P联合检测时的AUC最大(0.879),优于两两联合及单项指标应用时的诊断效能,对应灵敏度为75.00％,特异度为90.00％.骨肿瘤患者血清β-CTx与P水平呈正相关(r=0.55,P<0.01),25-OH-VD与P水平呈负相关(r=-0.26,P<0.05);而良性组、中间型组、恶性组血清β-CTx、25-OH-VD和P水平比较,差异均无统计学意义(P>0.05).结论 血清β-CTx、25-OH-VD和P水平联合检测对骨肿瘤诊断具有较高价值,可为临床诊断和动态监测提供一定参考.

目的 探讨前列腺特异性抗原同源异构体2(p2PSA)及其相关指标前列腺健康指数(PHI)在前列腺癌诊断中的意义.方法 检测50例前列腺癌患者和46例非前列腺癌患者的血清p2PSA、总前列腺特异性抗原(t-PSA)、游离前列腺特异性抗原(f-PSA),计算f-PSA％、p2PSA％和PHI.采用受试者工作特征(ROC)曲线评价各项指标诊断前列腺癌的价值.将前列腺癌患者分为中分化腺癌组(Gleason评分≤7分,32例)和低/未分化癌组(Gleason评分>7分,18例),比较各项指标的差异.结果 前列腺癌组年龄、t-PSA、f-PSA％、p2PSA、p2PSA％和PHI与非前列腺癌组比较,差异均有统计学意义(P<0.05),2个组之间f-PSA差异无统计学意义(P>0.05).ROC曲线分析结果显示,PHI、p2PSA％、p2PSA、f-PSA％和t-PSA诊断前列腺癌的曲线下面积(AUC)分别为0.870、0.837、0.762、0.671、0.652.PHI、p2PSA％对前列腺癌的诊断价值优于f-PSA％和t-PSA.低/未分化癌组f-PSA、p2PSA、f-PSA％和PHI均高于中分化腺癌组(P<0.05),2个组之间p2PSA％及t-PSA差异均无统计学意义(P>0.05).结论 PHI诊断前列腺癌的价值优于目前常用的t-PSA和f-PSA％,可作为前列腺癌的辅助诊断指标应用于临床.

目的 回顾性分析并探讨接种乙型肝炎(简称乙肝)疫苗与新生儿乙型肝炎表面抗原(HBsAg)一过性阳性的关系.方法 对进行HBsAg检测的178例新生儿资料进行回顾性分析,对疫苗接种后的HBsAg阳性发生率、"乙肝二对半"模式、HBsAg浓度及与接种时间的关系等进行了统计分析,通过胆红素干扰试验排除新生儿黄疸对HBsAg检测的影响,根据新生儿血容量进行乙肝疫苗体外稀释,检测其HBsAg浓度.结果 178例新生儿共检测184次,检出HBsAg阳性16例,其中11例为乙肝疫苗引起的HBsAg阳性,3例为母婴垂直传播引起的HBsAg阳性,2例不确定.新生儿乙肝疫苗接种后HBsAg阳性主要发生于接种疫苗后0～7d,与疫苗接种后8～14 d及15～31 d比较,HBsAg的阳性率差异有统计学意义(P值分别为0.046、0.032).疫苗接种后的HBsAg浓度为0.12(0.07～0.25) IU/mL,属低值水平.接种疫苗后0～2d,HBsAg浓度最高,之后逐渐下降.乙肝疫苗接种后11例以HBsAg单项阳性为主,其中3例同时伴乙型肝炎表面抗体(HBsAb)阳性,不同于乙肝病毒感染后常见血清模式.将乙肝疫苗1:600稀释后检测HBsAg为0.13 IU/mL,与乙肝疫苗引起的HBsAg阳性浓度[0.12(0.07 ～0.25) IU/mL]近似.干扰试验显示383.9 μmol/L总胆红素、29.9 μmol/L直接胆红素不影响HBsAg检测.结论 接种乙肝疫苗2周内的新生儿发生HBsAg一过性阳性的可能性较大,建议HBsAg检测在乙肝疫苗接种2周后再进行.

Objective To establish the biological reference intervals about the main parameters of blood cells among pregnant women in our laboratory.Methods A total of 331 pregnant women who had normal and term delivery were enrolled.According to their medical records,their 2 reports of pregnancy routine blood cell tests were obtained. The results were analyzed statistically,and the biological reference intervals were calculated by SAS 8.1 software. Results There was statistical significance in all parameters of pregnancy routine blood cell tests between the first and third trimesters (P <0.05).The results of biological reference intervals showed that the 2 sets of data about platelet (PLT),monocyte percentage (M%)and basophilic granulocyte percentage (B %)were all within current biological reference intervals,then the current biological reference intervals could be used for pregnancy.The 2 sets of data about hematocrit (HCT)and eosinophile granulocyte percentage (E %)could be combined to new biological reference intervals.The biological reference intervals for red blood cell count (RBC),hemoglobin (Hb),white blood cell count (WBC),neutrophile granulocyte percentage (N %) and lymphocyte percentage (L %) should be established according to different trimesters.Conclusions The newly established biological reference intervals are appropriate to reflect the physiological changes during pregnancy,and can guide the clinical diagnosis and treatment effectively.

Objective To investigate the relationship between hepatitis B e antigen(HBeAg) and alanine aminotransferase(ALT) levels among chronic hepatitis B(CHB) patients with different loads of hepatitis B virus(HBV) DNA,and to provide the reference for clinical treatment.Methods A total of 214 CHB patients with ALT within normal range and 200 healthy subjects with HBsAg-negtive and normal ALT levels were enrolled.The ALT levels′ differences were compared among HBeAg(+) group of CHB patients,HBeAg(-) group of CHB patients and healthy subjects.The 214 cases of CHB patients with normal ALT levels were classified into 3 groups according to HBV DNA load(GroupⅠ: HBV DNA103 IU/mL,Group Ⅱ:103 IU/mL≤HBV DNA104 IU/mL and Group Ⅲ: HBV DNA≥104 IU/mL).ALT levels and the positive rate of HBeAg of these groups were analyzed.Results Among the 214 CHB patients,the ALT levels of HBeAg(+) group and HBeAg(-) group were higher than that of the healthy group(P0.01),and the ALT levels of HBeAg(+) group were higher than those of HBeAg(-) group(P0.05).The positive rate of HBeAg of Group Ⅰwas significantly lower than those of Group Ⅱ and Group Ⅲ(P0.05).The ALT levels of Group Ⅲ were significantly higher than those of Group Ⅰ and Group Ⅱ(P0.05).Conclusions The ALT level is at the upper limit of normal range,and the positive rate of HBeAg is rather high in CHB patients with ALT within the normal range and HBV DNA≥104 IU/mL,which suggests that more attention should be paid for the patients in the clinical course of treatment.

目的评价实时PCR和第2代杂交捕获法(HC-Ⅱ)对不同宫颈病变高危型人乳头瘤病毒(HPV)检测的临床价值。方法采用实时荧光PCR与HC-Ⅱ检测158例宫颈病变患者宫颈脱落细胞中的高危型HPV,比较两者的检测结果。结果HC-Ⅱ和PCR检测高危型HPV的阳性率分别为69.0%和72.8%,二者总符合率85%(134/158);两种方法检测高度鳞状上皮细胞病变的阳性率均明显高于炎症(P均<0.05);其中115例PCR阳性标本中,HPV16阳性率为31.3%,HPV18为11.3%,HPV16、18均阳性为12.2%。结论PCR与HC-Ⅱ检测高危型HPV有较好的相关性;HPV-DNA检测可作为预防和早期诊断子宫颈癌的主要筛查手段;PCR检测HPV16/18可作为宫颈癌筛查经济、有效的方法。