Expression of immune cell markers and tumor markers in patients with cervical cancer

Advances in immunotherapy for gynecological malignancies

To date, surgery, chemotherapy and radiotherapy are mainly used to treat or remove gynecological malignancies. However, these approaches have their limitations when facing complicated female diseases such as advanced cervical and endometrial cancer (EC), chemotherapy-resistant gestational trophoblastic neoplasia and platinum-resistant ovarian cancer. Instead, immunotherapy, as an alternative, could significantly improve prognosis of those patients receiving traditional treatments, with better antitumor activities and possibly less cellular toxicities. Its' development is still not fast enough to meet the current clinical needs. More preclinical studies and larger-scale clinical trials are required. This review aims to introduce the landscape and up-to-date status of immunotherapy against gynecological malignancies, with a discussion of the challenges and future direction.

High Serum Squamous Cell Carcinoma Antigen Level Associated with Remission of Mild/Moderate Dysplasia of the Esophagus: A Nested Case–Control Study

Background

The esophageal epithelial dysplasia is the precancerous lesion. This study aimed to investigate the association between the serum squamous cell carcinoma antigen (SCCA) and the remission of esophageal squamous mild or moderate dysplasia.

Methods

We performed a nested case–control study. Patients with mild/moderate dysplasia of the esophageal squamous epithelium were enrolled in this study during the years of 2013–2015 and received a follow-up endoscopy during 2017–2018. With the comparison between baseline and follow-up diagnosis, the patients were divided into regression/stable and progression groups. A predictive model for the outcome of dysplasia was comprised of the variables of SCCA, age, sex, education level, and baseline dysplasia grade. A receiver operating characteristic (ROC) curve was used to estimate the diagnostic efficacy of the regression status of dysplasia under the predictive model.

Results

There were 146 patients enrolled in this study. 100 patients experienced a regression or stable status of dysplasia and 46 patients had a progressed status. Increased age, low education level, and moderate dysplasia were the risk factors of progression. With an 0.1 μg/L increase, SCCA was associated with a 0.90-fold risk (95% CI 0.81, 0.99) of progression. In the predictive model, the area under ROC curve was 0.78. The cut-off values of predictive probability of combined factors for progression, were 0.40 and 0.32 for males and females, respectively.

Conclusions

Increased serum SCCA concentration was associated with regressed severity of mild and moderate dysplasia of the esophageal mucosa. Further studies were warranted and SCCA concentration was a potential biomarker for the dysplasia prognosis.

The value of HPV genotypes combined with clinical indicators in the classification of cervical squamous cell carcinoma and adenocarcinoma

Background

To investigate the differences in HPV genotypes and clinical indicators between cervical squamous cell carcinoma and adenocarcinoma and to identify independent predictors for differentiating cervical squamous cell carcinoma and adenocarcinoma.

Methods

A total of 319 patients with cervical cancer, including 238 patients with squamous cell carcinoma and 81 patients with adenocarcinoma, were retrospectively analysed. The clinical characteristics and laboratory indicators, including HPV genotypes, SCCAg, CA125, CA19-9, CYFRA 21–1 and parity, were analysed by univariate and multivariate analyses, and a classification model for cervical squamous cell carcinoma and adenocarcinoma was established. The model was validated in 96 patients with cervical cancer.

Results

There were significant differences in SCCAg, CA125, CA19-9, CYFRA 21–1, HPV genotypes and clinical symptoms between cervical squamous cell carcinoma and adenocarcinoma (P < 0.05). Logistic regression analysis showed that SCCAg and HPV genotypes (high risk) were independent predictors for differentiating cervical squamous cell carcinoma from adenocarcinoma. The AUC value of the established classification model was 0.854 (95% CI: 0.804–0.904). The accuracy, sensitivity and specificity of the model were 0.846, 0.691 and 0.899, respectively. The classification accuracy was 0.823 when the model was verified.

Conclusion

The histological type of cervical cancer patients with persistent infection of high-risk HPV subtypes and low serum SCCAg levels was more prone to being adenocarcinoma. When the above independent predictors occur, the occurrence and development of cervical adenocarcinoma should be anticipated, and early active intervention treatment should be used to improve the prognosis and survival of patients.

Expression Profile Analysis and Image Observation of miRNA in Serum of Patients with Obstructive Sleep Apnea-Hypopnea Syndrome

The expression profile and image observation of miRNA in serum of patients with obstructive sleep apnea-hypopnea syndrome were investigated. Bioinformatics methods were used to explore the molecular mechanism of obstructive sleep apnea-hypopnea syndrome (OSAHS)-related hypertension and explore the differentially expressed core miRNAs and regulatory factors, providing a theoretical basis for seeking molecular targets for clinical diagnosis and treatment. The miRNA datasets of patients with OSAHS and those with hypertension were downloaded from the public database to obtain differentially expressed miRNAs and explore the biological processes and pathways involved in the target genes. The core miRNAs and competitive endogenous RNA (ceRNA) transcription factors (TFs) were obtained by database mining and Cytoscape network analysis. The results showed that 2,579 differentially expressed miRNAs were obtained from the GSE112093 dataset. Seven upregulated miRNAs (hsa-miR-7107-5p, hsa-miR-7110-5p, hsa-miR-595, hsa-miR-1268b, hsa-miR-3064-5p, hsa-miR-68565p, and hsa-miR-1180-3p) and one downregulated miRNA (hsa-miR-22-3p) were obtained from the GSE112093 dataset. It is proved that hsa-miR-22-3p, hsa-miR-595, hsa-miR-6856-5pKcnq1ot1, neat1, Tsix, ERG, kdm2b, and Runx1 may be involved in the pathogenesis of OSAHS-related hypertension, which provided a theoretical basis for the mechanism research and clinical treatment of OSAHS.

Value of combined detection of serum tumor markers and M2-PK in colorectal cancer screening

BACKGROUND

Colorectal cancer (CRC) is a highly malignant tumor with a significant increase in incidence and fatality rate year by year. Great attention has been paid to early screening for colorectal cancer. However, due to the non-specific clinical symptoms and complicated mechanisms of CRC, its early screening is not easy.

AIM

To explore the value of serum carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA) combined with tumor M2 pyruvate kinase (M2-PK) in the screening of CRC.

METHODS

Eighty patients with CRC and 75 patients with benign colorectal diseases treated at our hospital from January 1, 2018 to October 10, 2020 were selected. In addition, 90 healthy controls were also included. All subjects were tested for serum CA19-9, CEA, and M2-PK. The differences in serum CA19-9, CEA, and M2-PK levels between the three groups were compared, and the receiver operating characteristic (ROC) curve was used to assess the performance of serum CA19-9, CEA, and M2-PK levels, either alone or in combination, in CRC screening.

RESULTS

The results of one-way variance showed that the differences in serum CEA, CA19-9, and TuM2-PK were statistically significant among the three groups (P < 0.05); the levels of serum CEA, CA19-9, and TuM2-PK in the CRC group were significantly higher than those of the other two groups (P < 0.05). ROC curve analysis showed that the area under the ROC curve (AUC) values of serum CEA, CA19-9, and TuM2-PK for the diagnosis of CRC were 0.72, 0.69, and 0.85, respectively. The sensitivity of combined detection of CEA + CA19-9 + TuM2-PK was 90%, which was significantly higher than that of other combinations (P < 0.05).

CONCLUSION

The detection of serum tumor markers combined with M2-PK can effectively improve the sensitivity of the diagnosis of CRC, and may play an important role in the early screening of this malignancy.