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Hao YJ, Chang LW, Yang CY, Lo LC, Lin CP, Jian YW, Jiang JK, Tseng FG. The rare circulating tumor microemboli as a biomarker contributes to predicting early colorectal cancer recurrences after medical treatment. Transl Res 2024; 263:1-14. [PMID: 37558203 DOI: 10.1016/j.trsl.2023.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 07/03/2023] [Accepted: 07/28/2023] [Indexed: 08/11/2023]
Abstract
Early prognosis of cancer recurrence remains difficult partially due to insufficient and ineffective screening biomarkers or regimes. This study evaluated the rare circulating tumor microemboli (CTM) from liquid biopsy individually and together with circulating tumor cells (CTCs) and serum CEA/CA19-9 in a panel, on early prediction of colorectal cancer (CRC) recurrence. Stained CTCs/CTM were detected by a microfluidic chip-based automatic rare-cell imaging platform. ROC, AUC, Kaplan-Meier survival, and Cox proportional hazard models regarding 4 selected biomarkers were analyzed. The relative risk, odds ratio, predictive accuracy, and positive/negative predictive value of biomarkers individually and in combination, to predict CRC recurrence were assessed and preliminarily validated. The EpCAM+Hochest+CD45- CTCs/CTM could be found in all cancer stages, where more recurrences were observed in late-stage cases. Significant correlations between CTCs/CTM with metastatic stages and clinical treatment were illustrated. CA19-9 and CTM could be seen as independent risk factors in patient survivals, while stratified patients by grouped biomarkers on the Kaplan-Meier analyses presented more significant differences in predicting CRC recurrences. By monitoring the panel of selected biomarkers, disease progressions of 4 CRC patients during follow-up visits after first treatments within 3 years were predicted successfully. This study unveiled the value of rare CTM on clinical studies and a panel of selected biomarkers on predicting CRC recurrences in patients at the early time after medical treatment, in which the CTM and serum CA19-9 could be applied in clinical surveillance and CRC management to improve the accuracy.
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Affiliation(s)
- Yun-Jie Hao
- Department of Engineering and System Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Lu-Wey Chang
- Department of Engineering and System Science, National Tsing Hua University, Hsinchu, Taiwan
| | - Chih-Yung Yang
- Department of Teaching and Research, Taipei City Hospital, Taipei, Taiwan; Commission for General Education, National United University, Miaoli, Taiwan; General Education Center, University of Taipei, Taipei, Taiwan
| | - Liang-Chuan Lo
- National Genomics Center for Clinical and Biotechnological Applications, Cancer and Immunology Research Center, National Yang-Ming Chiao-Tung University, Taipei, Taiwan
| | - Chien-Ping Lin
- Department of Surgery, Division of Colorectal Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yuan-Wei Jian
- Department of Surgery, Division of Colorectal Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Jeng-Kai Jiang
- Department of Surgery, Division of Colorectal Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Fan-Gang Tseng
- Department of Engineering and System Science, National Tsing Hua University, Hsinchu, Taiwan; Department of Chemistry, Frontier Research Center on Fundamental and Applied Sciences of Matters, National Tsing-Hua University, Hsinchu, Taiwan; Research Center for Applied Sciences, Taipei, Taiwan.
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Zong N, Ngo V, Stone DJ, Wen A, Zhao Y, Yu Y, Liu S, Huang M, Wang C, Jiang G. Leveraging Genetic Reports and Electronic Health Records for the Prediction of Primary Cancers: Algorithm Development and Validation Study. JMIR Med Inform 2021; 9:e23586. [PMID: 34032581 PMCID: PMC8188315 DOI: 10.2196/23586] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 01/07/2021] [Accepted: 01/27/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Precision oncology has the potential to leverage clinical and genomic data in advancing disease prevention, diagnosis, and treatment. A key research area focuses on the early detection of primary cancers and potential prediction of cancers of unknown primary in order to facilitate optimal treatment decisions. OBJECTIVE This study presents a methodology to harmonize phenotypic and genetic data features to classify primary cancer types and predict cancers of unknown primaries. METHODS We extracted genetic data elements from oncology genetic reports of 1011 patients with cancer and their corresponding phenotypical data from Mayo Clinic's electronic health records. We modeled both genetic and electronic health record data with HL7 Fast Healthcare Interoperability Resources. The semantic web Resource Description Framework was employed to generate the network-based data representation (ie, patient-phenotypic-genetic network). Based on the Resource Description Framework data graph, Node2vec graph-embedding algorithm was applied to generate features. Multiple machine learning and deep learning backbone models were compared for cancer prediction performance. RESULTS With 6 machine learning tasks designed in the experiment, we demonstrated the proposed method achieved favorable results in classifying primary cancer types (area under the receiver operating characteristic curve [AUROC] 96.56% for all 9 cancer predictions on average based on the cross-validation) and predicting unknown primaries (AUROC 80.77% for all 8 cancer predictions on average for real-patient validation). To demonstrate the interpretability, 17 phenotypic and genetic features that contributed the most to the prediction of each cancer were identified and validated based on a literature review. CONCLUSIONS Accurate prediction of cancer types can be achieved with existing electronic health record data with satisfactory precision. The integration of genetic reports improves prediction, illustrating the translational values of incorporating genetic tests early at the diagnosis stage for patients with cancer.
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Affiliation(s)
- Nansu Zong
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Victoria Ngo
- University of California Davis Health, Sacramento, CA, United States
| | - Daniel J Stone
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Andrew Wen
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Yiqing Zhao
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Yue Yu
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Sijia Liu
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Ming Huang
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Chen Wang
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
| | - Guoqian Jiang
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, United States
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Xiang H, Long L, Yao Y, Fang Z, Zhang Z, Zhang Y. CalliSpheres Drug-Eluting Bead Transcatheter Arterial Chemoembolization Presents With Better Efficacy and Equal Safety Compared to Conventional TACE in Treating Patients With Hepatocellular Carcinoma. Technol Cancer Res Treat 2019; 18:1533033819830751. [PMID: 30862264 PMCID: PMC6416678 DOI: 10.1177/1533033819830751] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
The aim of this study was to compare the treatment response, survival, liver function,
and adverse event incidence of drug-eluting bead transcatheter arterial chemoembolization
using CalliSpheres microspheres with conventional transcatheter arterial chemoembolization
in patients with hepatocellular carcinoma. Seventy-three patients with hepatocellular
carcinoma who received drug-eluting bead transcatheter arterial chemoembolization (using
CalliSpheres microspheres) or conventional transcatheter arterial chemoembolization
treatment were consecutively enrolled. Treatment response was assessed by modified
Response Evaluation Criteria in Solid Tumors at month 1/month 3/month 6; posttreatment,
liver function indexes, and adverse events were recorded. Progression-free survival and
overall survival were also calculated. Objective response rate of patients at months 1, 3,
and 6, disease control rate of patients and objective response rate of nodules at month 3
were increased in drug-eluting bead transcatheter arterial chemoembolization group
compared with conventional transcatheter arterial chemoembolization group. In addition,
drug-eluting bead transcatheter arterial chemoembolization using CalliSpheres microspheres
was an independent factor for predicting better objective response rate at month 1.
Patients in drug-eluting bead transcatheter arterial chemoembolization group achieved
longer progression-free survival and similar overall survival compared to those in
conventional transcatheter arterial chemoembolization group; Cox proportional hazards
regression model analyses revealed that drug-eluting bead transcatheter arterial
chemoembolization using CalliSpheres microspheres was associated with better
progression-free survival while it did not affect overall survival. Meanwhile, most of the
occurrences of abnormal liver function indexes were similar between 2 groups, whereas
drug-eluting bead transcatheter arterial chemoembolization group had a higher percentage
of patients with total bile acid ≥2 upper limit of normal compared to conventional
transcatheter arterial chemoembolization group at month 1. Moreover, the adverse event
incidences between 2 groups were similar. In conclusion, drug-eluting bead transcatheter
arterial chemoembolization using CalliSpheres microspheres achieves better treatment
response and progression-free survival while equal safety compared to conventional
transcatheter arterial chemoembolization in patients with hepatocellular carcinoma.
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Affiliation(s)
- Hua Xiang
- 1 Department of Interventional Radiology & Vascular Surgery, Hunan Provincial People's Hospital, Changsha, Hunan, China
| | - Lin Long
- 1 Department of Interventional Radiology & Vascular Surgery, Hunan Provincial People's Hospital, Changsha, Hunan, China
| | - Yuanhui Yao
- 1 Department of Interventional Radiology & Vascular Surgery, Hunan Provincial People's Hospital, Changsha, Hunan, China
| | - Zhiyong Fang
- 1 Department of Interventional Radiology & Vascular Surgery, Hunan Provincial People's Hospital, Changsha, Hunan, China
| | - Zhiming Zhang
- 1 Department of Interventional Radiology & Vascular Surgery, Hunan Provincial People's Hospital, Changsha, Hunan, China
| | - Yongjin Zhang
- 1 Department of Interventional Radiology & Vascular Surgery, Hunan Provincial People's Hospital, Changsha, Hunan, China
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Zhou L, Rui JA, Wang SB, Chen SG, Qu Q. Carbohydrate Antigen 19-9 Increases the Predictive Efficiency of a-Fetoprotein for Prognosis of Resected Hepatocellular Carcinoma. Am Surg 2018. [DOI: 10.1177/000313481808400126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Serum α-fetoprotein (AFP) is a classical biomarker for both diagnosis and prognosis of hepatocellular carcinoma (HCC). However, its predictive efficiency for prognosis remains unsatisfactory. This study explores whether integrating AFP and carbohydrate antigen (CA) 19-9/carcinoembryonic antigen (CEA) increase its prognostic efficiency in HCC. A total of 67 HCC patients with complete record of AFP, CA19-9, and CEA, who underwent radical hepatectomy, were included. The sole and combined evaluations for prognostic significance of the three markers were performed. In the first, it was found by one-factor analysis that AFP was a univariate prognostic indicator for disease-free survival, but not overall survival, whereas CEA and CA19-9 were not statistically significant, although the latter was of marginally predictive significance for disease-free survival. Subsequently, it was revealed that combined evaluation of AFP and CA19-9, rather than AFP and CEA, distinguished overall and disease-free survival more effectively, compared with single ones. However, this combination was not significant in multivariate Cox regression analysis, thus needing further validation, especially in large-scale prospective investigations. The addition of vascular invasion to AFP/CA19-9 combination might provide enhanced predictive power for disease-free survival. Collectively, these results preliminarily suggest that CA19-9 increases the predictive efficiency of AFP for prognosis of HCC after resection.
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Affiliation(s)
- Li Zhou
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
| | - Jing-An Rui
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
| | - Shao-Bin Wang
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
| | - Shu-Guang Chen
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
| | - Qiang Qu
- Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China
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Preoperative Carbohydrate Antigen 19-9: Its Neglected Role in Alpha-Fetoprotein-Negative Hepatocellular Carcinoma Patients. J Gastrointest Surg 2017; 21:2025-2032. [PMID: 28840443 DOI: 10.1007/s11605-017-3528-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 07/30/2017] [Indexed: 01/31/2023]
Abstract
PURPOSE The study aimed to investigate the prognostic role of the preoperative carbohydrate antigen 19-9 (CA19-9) level in alpha-fetoprotein (AFP)-negative (AFP < 25 ng/ml) hepatocellular carcinoma (HCC) patients. METHODS From December 2004 to December 2013, 750 patients diagnosed with AFP-negative HCC following curative resection were enrolled. Both univariate and multivariate analyses were performed to clarify the prognostic factors for overall survival (OS) and disease-free survival (DFS). RESULTS The optimal cutoff point for preoperative CA19-9 was 32.6 U/ml, and the value of the area under the curve was 0.640. The 1-, 3-, and 5-year OS rates were 88.4, 72.2, and 57.0%, respectively, for the CA19-9 > 32.6 U/ml group and 97.0, 83.3, and 79.9%, respectively, for the CA19-9 ≤ 32.6 U/ml group (P < 0.001). The 1-, 3-, and 5-year DFS rates were 71.8, 47.7, and 34.8%, respectively, for the CA19-9 > 32.6 U/ml group and 80.8, 63.6, and 55.5%, respectively, for the CA19-9 ≤ 32.6 U/ml group (P < 0.001). The multivariate analysis showed that CA19-9 > 32.6 U/ml was one of the most significant unfavorable predictors of OS and DFS (P < 0.001 for both). CONCLUSIONS Preoperative CA19-9 > 32.6 U/ml is a predictor of dismal prognosis and can be employed as a prognostic marker for patient selection in AFP-negative HCC management.
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Huang Y, Wen Y, Baryeh K, Takalkar S, Lund M, Zhang X, Liu G. Lateral flow assay for carbohydrate antigen 19-9 in whole blood by using magnetized carbon nanotubes. Mikrochim Acta 2017; 184:4287-4294. [PMID: 29200502 DOI: 10.1007/s00604-017-2464-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The authors describe a rapid, low-cost and sensitive approach for the determination of carbohydrate antigen 19-9 (CA 19-9) in whole blood by using magnetized carbon nanotube (MCNT) and lateral flow strip biosensor (LFSB). MCNTs were synthesized by depositing magnetite (Fe3O4) nanoparticles on multiwalled carbon nanotube (CNT) via co-precipitation of ferric and ferrous ions within a dispersion of shortened multiwalled CNTs. Antibody against CA 19-9 (Ab1) was covalently immobilized on the MCNTs and were used to capture CA 19-9 in blood. After magnetic separation, the formed MCNT-Ab1-CA 19-9 complexes are applied to the LFSB, in which a capture antibody (Ab2) and a secondary antibody (Ab3) are immobilized on the test zone and control zone of the LFSB, respectively. The captured MCNTs on the test zone and control zone are producing characteristic brown bands, and this enables CA 19-9 to be visually detected. Quantitation is accomplished by reading the intensities of the bands with a portable strip reader. Under optimized conditions, the assay has a detection limit as low as 30 U⋅mL-1 of CA19-9 in blood. This is below the cutoff value (37 U mL-1) of CA 19-9. The assay duration for blood samples is 35 min. In our perception, the assay represents a rapid and low-cost tool for rapid determination of CA19-9 in blood that holds promise for clinical applications, particularly in limited resource settings.
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Affiliation(s)
- Yan Huang
- Research Center for Bioengineering and Sensing Technology, University of Science & Technology Beijing, Beijing 100083, PR China.,Department of Chemistry and Biochemistry, North Dakota State University, Fargo, North Dakota 58105, United States
| | - Yongqiang Wen
- Research Center for Bioengineering and Sensing Technology, University of Science & Technology Beijing, Beijing 100083, PR China
| | - Kwaku Baryeh
- Department of Chemistry and Biochemistry, North Dakota State University, Fargo, North Dakota 58105, United States
| | - Sunitha Takalkar
- Department of Chemistry and Biochemistry, North Dakota State University, Fargo, North Dakota 58105, United States
| | - Michelle Lund
- Department of Chemistry and Biochemistry, North Dakota State University, Fargo, North Dakota 58105, United States
| | - Xueji Zhang
- Research Center for Bioengineering and Sensing Technology, University of Science & Technology Beijing, Beijing 100083, PR China
| | - Guodong Liu
- Department of Chemistry and Biochemistry, North Dakota State University, Fargo, North Dakota 58105, United States
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Pandiaraja J, Viswanathan S, Antomy TB, Thirumuruganand S, Kumaresan DS. The Role of CA19-9 in Predicting Tumour Resectability in Carcinoma Head of Pancreas. J Clin Diagn Res 2016; 10:PC06-9. [PMID: 27134925 DOI: 10.7860/jcdr/2016/17106.7398] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 01/18/2016] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Carbohydrate antigen 19-9 (CA 19-9) is a tumour associated antigen. Blood levels may be elevated in benign as well as malignant conditions. Its sensitivity (70-90%) and specificity (68-91%) are inadequate for accurate diagnosis. It can be used to predict the extent of disease and outcome after resection. AIM The aim of the present study was to assess the role of CA 19-9 in predicting the resectability of the tumour in the head of pancreas. MATERIALS AND METHODS This was a prospective study which included 30 patients and study period was from May 2012 to October 2014. Data collected from all patients with carcinoma of the head of pancreas on the basis of contrast enhanced computed tomography/Magnetic resonance cholangiopancreaticography. CA 19-9 levels were measured and recorded. Patients who were medically unfit for surgery or those who didn't warrant palliative surgery were excluded from the study. During surgery the operative findings on operability were documented and tabulated against corresponding CA 19-9 levels. RESULTS Of the 30 patients who were operated, 13(43.3%) patients had operable tumours and underwent Whipple's procedure and 17(56.7%) underwent palliative bypass procedure. Of the 30, CA 19-9 levels were elevated in 9(30.0%) and were normal in 21(70.0%). Among 13(43.3%) who had operable tumours, CA 19-9 was elevated in 4(13.3) and was normal in 9(30.0%). Of the 17(56.7%) who had inoperable tumours CA 19-9 was elevated in 5(16.7%) and was normal in 12(40.0%). Among the 17 who had inoperable tumours, 8(47.1%) were diagnosed preoperatively and of them CA 19-9 levels were raised in 2(11.8%) and normal in 6(35.3%). In the group of 9(52.9%) who had inoperable tumours diagnosed intraoperatively, CA 19-9 was raised in 3(17.6%) of them and was normal in the remaining 6(35.3%) of them. CONCLUSION Based on the study findings, it can be stated that there is no significant correlation with resectability of pancreatic adenocarcinoma and CA 19-9 and it doesn't predict vascular involvement and liver metastasis.
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Affiliation(s)
- Jayabal Pandiaraja
- Assistant Professor, Department of General Surgery, Srm Medical College and Hospital , Chennai, Tamilnadu, India
| | - Subramanian Viswanathan
- Professor, Department of General Surgery, Govt. Stanley Medical College and Hospital , Chennai, Tamilnadu, India
| | - Thomas Babu Antomy
- Assistant Professor, Department of General Surgery, Govt. Stanley Medical College and Hospital , Chennai, Tamilnadu, India
| | - Sathyamoorthy Thirumuruganand
- Assistant Professor, Department of General Surgery, Govt. Stanley Medical College and Hospital , Chennai, Tamilnadu, India
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Does the elevation of serum carbohydrate antigen 19-9 level predict poor overall survival in patients with hepatocellular carcinoma? Tumour Biol 2015; 36:8273-4. [PMID: 26515333 DOI: 10.1007/s13277-015-4326-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 10/26/2015] [Indexed: 12/26/2022] Open
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Sun AL. Sensitive electrochemical immunoassay with signal enhancement based on nanogold-encapsulated poly(amidoamine) dendrimer-stimulated hydrogen evolution reaction. Analyst 2015; 140:7948-54. [DOI: 10.1039/c5an01827g] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
A new electrochemical immunosensor with signal enhancement was designed for sensitive detection of disease-related protein (human carbohydrate antigen 19-9, CA 19-9 used in this case).
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Affiliation(s)
- Ai-Li Sun
- Department of Chemistry and Chemical Engineering
- Xinxiang University
- Xinxiang 453000
- P.R. China
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