Utility and specificity of plasma heat shock protein 90 alpha, CEA, and CA199 as the diagnostic test in colorectal cancer liver metastasis

Evaluating the diagnostic accuracy of heat shock proteins and their combination with Alpha-Fetoprotein in the detection of hepatocellular carcinoma: a meta-analysis

BACKGROUND

A growing body of research suggests that heat shock proteins (HSPs) may serve as diagnostic biomarkers for hepatocellular carcinoma (HCC), but their results are still controversial. This meta-analysis endeavors to evaluate the diagnostic accuracy of HSPs both independently and in conjunction with alpha-fetoprotein (AFP) as novel biomarkers for HCC detection.

METHODS

Pooled statistical indices, including sensitivity, specificity, diagnostic odds ratio (DOR), positive likelihood ratio (PLR), and negative likelihood ratio (NLR) with 95% confidence intervals (CI), were computed to assess the diagnostic accuracy of HSPs, AFP, and their combinations. Additionally, the area under the summary receiver operating characteristic (SROC) curve (AUC) was determined.

RESULTS

A total of 2013 HCC patients and 1031 control subjects from nine studies were included in this meta-analysis. The summary estimates for HSPs and AFP are as follows: sensitivity of 0.78 (95% CI: 0.69-0.85) compared to 0.73 (95% CI: 0.65-0.80); specificity of 0.89 (95% CI: 0.81-0.95) compared to 0.86 (95% CI: 0.77-0.91); PLR of 7.4 (95% CI: 3.7-14.9) compared to 5.1 (95% CI: 3.3-8.1); NLR of 0.24 (95% CI: 0.16-0.37) compared to 0.31 (95% CI: 0.24-0.41); DOR of 30.19 (95% CI: 10.68-85.37) compared to 16.34 (95% CI: 9.69-27.56); and AUC of 0.90 (95% CI: 0.87-0.92) compared to 0.85 (95% CI: 0.82-0.88). The pooled sensitivity, specificity, PLR, NLR, DOR and AUC were 0.90 (95% CI: 0.82-0.95), 0.94 (95% CI: 0.82-0.98), 14.5 (95% CI: 4.6-45.4), 0.11 (95% CI: 0.06-0.20), 133.34 (95% CI: 29.65-599.61), and 0.96 (95% CI: 0.94-0.98) for the combination of HSPs and AFP.

CONCLUSION

Our analysis suggests that HSPs have potential as a biomarker for clinical use in the diagnosis of HCC, and the concurrent utilization of HSPs and AFP shows notable diagnostic effectiveness for HCC.

Thymosin α1 combined with XELOX improves immune function and reduces serum tumor markers in colorectal cancer patients after radical surgery

This study aimed to investigate the efficacy of thymosin α1 combined with XELOX in improving immune function and reducing serum tumor markers in patients with colorectal cancer (CRC) after radical surgery. A total of 180 patients who underwent radical surgery for CRC were divided into two groups: an observation group (n = 94) receiving thymosin α1 in combination with XELOX and a control group (n = 86) receiving XELOX alone. Immune function, inflammatory factor levels, serum tumor markers, and quality of life were assessed before and after treatment. Adverse reactions and recurrence rates were compared between the two groups in 1 and 3 years. Following therapy, there was a notable increase in the levels of CD3+, CD4+, and CD4+/CD8+ in all cohorts, particularly in the observation cohort, when compared to pre-therapy levels. Conversely, CD8+ levels decreased across all cohorts, especially in the observation cohort. Additionally, there was an increase in the levels of IL-2 and IFN-γ in the observation cohort, compared to both pre-therapy and control cohort levels, while IL-6 levels decreased. The presence of CEA, CA242, and CA724 reduced significantly across all cohorts following post-therapy, particularly in the observation cohort. Post-therapy, there was a significant increase in the scoring for role, cognitive, social, emotional, and somatic functions in all cohorts, with the most significant improvement observed in the observation cohort. There were no significant differences in the incidence of side effects across cohorts, while neutropenia events were significantly lower in the observation cohort (32.98%) compared to the control cohort (48.84%). The 12-month recurrence rate showed no statistical significance across cohorts, while the observation cohort had a significantly lower three-year recurrence rate (24.47%) compared to the control cohort (59.30%). Thymosin α1 combined with XELOX is effective in improving immune function, reducing serum tumor markers, and minimizing recurrence in CRC patients after radical surgery. This combination therapy may be a promising new direction for the treatment of CRC.

Metabolomics analysis of amino acid and fatty acids in colorectal cancer patients based on tandem mass spectrometry

Metabolic differences between colorectal cancer (CRC) and NI (NI) play an important role in early diagnoses and in-time treatments. We investigated the metabolic alterations between CRC patients and NI, and identified some potential biomarkers, and these biomarkers might be used as indicators for diagnosis of CRC. In this study, there were 79 NI, 50 CRC I patients, 52 CRC II patients, 56 CRC III patients, and 52 CRC IV patients. MS-MS was used to measure the metabolic alterations. Univariate and multivariate data analysis and metabolic pathway analysis were applied to analyze metabolic data and determine differential metabolites. These indicators revealed that amino acid and fatty acids could separate these groups. Several metabolites indicated an excellent variables capability in the separation of CRC patients and NI. Ornithine, arginine, octadecanoyl carnitine, palmitoyl carnitine, adipoyl carnitine, and butyryl carnitine/propanoyl carnitine were selected to distinguish the CRC patients and NI. And methionine and propanoyl carnitine, were directly linked to different stages of CRC. Receiver operating characteristics curves and variables importance in projection both represented an excellent performance of these metabolites. In conclusion, we assessed the difference between CRC patients and NI, which supports guidelines for an early diagnosis and effective treatment.

Establishment of a nomogram model for prediction of postoperative heterochronous liver metastasis in young and middle-aged patients with rectal cancer

BACKGROUND

The incidence of rectal cancer is increasing year by year. Radical surgery is often used for the treatment of rectal cancer in clinical practice, but postoperative liver metastasis has become an important reason for the increase in mortality. Therefore, establishing a model to predict the trend of metachronous liver metastasis has become a research focus. Nomogram model has been widely used in the medical field, but there has been no widely accepted nomogram model available for prediction of metachronous liver metastasis after rectal cancer surgery.

AIM

To constuct a nomogram model based on the risk factors for postoperative metachronous liver metastasis in young and middle-aged patients with rectal cancer, and to evaluate the performance of the model for predicting the risk of postoperative metachronous liver metastasis, so as to provide some guidance for clinical prevention and treatment.

METHODS

A total of 120 young and middle-aged patients with rectal cancer admitted to our hospital from March 2019 to February 2022 were selected as research subjects to observe the incidence of postoperative heterochronous liver metastasis. Univariate and multivariate Logistic regression analyses were performed to identify the risk factors for postoperative heterochronous liver metastasis and to construct a nomogram model. ROC curve, decision curve, and correction curve analyses were used to verify the value of nomogram model for the prediction of postoperative heterochronous liver metastasis.

RESULTS

The incidence of anomalous liver metastasis 1 year after surgery was 23.33% in 120 young and middle-aged patients with rectal cancer. Low differentiation, lymph node metastasis, depth of invasion (T3/T4), margin width of primary cancer < 2 cm, high expression of peripheral blood telomerase reverse transcriptase (hTERT), and elevated serum levels of carcinoembryonic antigen (CEA), vascular endothelial growth factor (VEGF), lemur tyrosine kinase-3 (LMTK3), squamous cell carcinoma-associated antigen (SCC-Ag), and axon-guided factor-1 (Netrin-1) were identified to be risk factor for postoperative hetero-chronic liver metastasis (P < 0.05). The C-index and area under the curve of the nomogram model were 0.860 and 0.957, respectively, and the net benefit value was high (P < 0.05).

CONCLUSION

Low differentiation, lymph node metastasis, depth of invasion (T3/T4), margin width of primary cancer < 2 cm, high expression of hTERT in peripheral blood, and elevated levels of serum CEA, VEGF, LMTK3, SC-AG and Netrin-1 are risk factors for postoperative xenotemporal liver metastasis in young and middle-aged patients with rectal cancer. Based on the above risk factors, a nomogram model has been established to predict postoperative heterochronous liver metastasis in such patients.