Bi2WO6, an environmentally friendly material with certain electrochemiluminescence (ECL) properties, has been used as a novel ECL luminescent material. In the present work, bismuth tungstate (Bi2WO6) ...was composited with bismuth bromide (BiOBr) to form a S-type heterojunction with a flower like morphology where the Bi2WO6 core was wrapped with BiOBr outer shell. The interface of the heterojunction is closely contacted, which can promote electron transfer, improve conduction and enhance ECL emission to a certain extent. The BiOBr/Bi2WO6 (BBW) heterojunction with K2S2O8 as a co-reactant demonstrates cathodic ECL emission at 550–800 nm in the potential range of −1.8–0 V. Cu2O@Ag with a special sea urchins morphology was introduced into the system to catalyze the reduction of S2O82− to generate more SO4•−, which further enhances the ECL emission. The ECL immunosensor constructed with the heterojunction for CA19–9 detection exhibits a robust linear relationship in the concentration range from 0.1 mU·mL−1 to 100 U·mL−1 and detection limit as low as 87.6 μU·mL−1. The immunosensor successfully detected CA19–9 in serum, showing great application potential in the clinical practice.
•BiOBr/Bi2WO6 heterostructures flower-like have certain electroluminescent properties.•BiOBr/Bi2WO6 exhibits cathodic ECL emission in the potential range of −1.8–0 V.•Cu2O@Ag as co-reaction promoter can effectively amplify the ECL response.
Papillary carcinoma is considered the most common thyroid malignancy. This cancer often presents with a good prognosis. This report introduces a patient with papillary thyroid carcinoma with multiple ...metastases and elevated CA19-9 levels. The 65-year-old male patient presented with weight loss. Gastrointestinal investigations were normal. CA19-9 levels were requested and reported as high. Additionally, blurred vision was present, and metastasis to the choroid was mentioned. Imaging revealed a mass in the left lobe of the thyroid. Fine-needle aspiration was performed, and the histopathology report confirmed papillary thyroid carcinoma. The patient underwent a thyroidectomy and was subsequently treated with iodine-131. Initial tests showed low thyroglobulin levels and high anti-thyroglobulin antibody levels. CA19-9 levels also showed an increasing trend in serial tests. Three months later, the patient experienced abdominal pain, generalized bone pain, neck pain, and right shoulder swelling. Further investigations confirmed metastases from papillary thyroid carcinoma. The patient also developed speech problems and memory loss, with brain metastasis evident in magnetic resonance imaging. The patient underwent ten sessions of brain radiotherapy and was subsequently prescribed sorafenib. During the course of treatment, the patient contracted COVID-19 and passed away due to the resulting pneumonia. In papillary thyroid carcinoma, it is important to take diagnostic measures to rapidly detect metastatic forms in case of any new symptoms. Additionally, if anti-thyroglobulin antibodies are present, CA19-9 can be used as a tumor marker.
An 80-year-old man with jaundice and fatigue was referred to our hospital. A laboratory examination revealed increased levels of hepatobiliary enzymes, and CA19-9 levels increased to 29,512 U/mL. ...Based on the findings of imaging examination and laboratory data, the patient was diagnosed with acute cholecystitis and choledocholithiasis. The possibility of malignancy could not be ruled out because of the high levels of CA19-9. Antibiotic administration was commenced, and the common bile duct stone was endoscopically removed. One month after treatment, the CA19-9 level decreased to within the normal range. One year after treatment, imaging examinations did not reveal any malignancy.
A 62-yearold man presented with pain in his lower right abdomen. Computed tomography（CT） revealed a cystic lesion in the ileocecal region. A preoperative blood examination indicated anelevated level ...of serum CA19-9 （351.5 U/mL）. The possibility of a malignant tumor in the ileocecalregion prompted laparoscopic surgery, which confirmed the presence of a cyst attached to the appendixand a 10 cm ileal duplication located 200 cm from the Treitz ligament. Subsequently, a partial resectionof the ileum was performed. Pathological examination of the specimen revealed that the ileal duplication consisted of ileal tissue, exhibiting a fullthickness structure resembling the intestinal tract. Moreover, a connection was established between the cyst and the ileal duplication, confirming their continuity.The patient was diagnosed with a tubular and cystic gastrointestinal duplication without any malignantcharacteristics. Tubular and cystic gastrointestinal duplications are rare conditions, often accompaniedby elevated preoperative tumor markers. The absence of malignancy in such cases is even rarer,prompting this case report alongside a comprehensive review of the existing literature
A 20-year-old man with a history of left abdominal pain since junior high school consulted our hospital for upper abdominal pain persisting for 2 weeks. Laboratory examination revealed no ...abnormalities, except an elevation of the serum levels of the tumor markers carbohydrate Antigen 19-9 (CA19-9) to 4,642 U/mL and carbohydrate antigen 125 (CA125) to 439 U/mL. Computed tomography and magnetic resonance imaging demonstrated a giant multilocular splenic cystic mass measuring 23 × 20 cm. The imaging findings revealed no evidence of malignancy. Preoperative aspiration cytology of the cyst was diagnosed to have no evidence of malignancy. The CA19-9 and CA125 concentrations in the cystic fluid were markedly elevated to 1,590,000 U/mL and > 5,000 U/mL, respectively. A giant splenic cyst with high serum levels of CA19-9 and CA125 was diagnosed, and laparoscopic splenectomy was performed. First, the cyst content was aspirated to maintain a good surgical field, and laparoscopic splenectomy was subsequently completed safely. Histologically, the patient was diagnosed as an epidermoid cyst of the spleen, with no evidence of malignancy. The serum levels of CA19-9 and CA125 decreased to the normal range postoperatively. Splenic cysts with high serum levels of CA19-9 and CA125 are rare ; here, we report this case together with a review of the literature.
To identify predictive factors associated with operative morbidity, mortality, and survival outcomes in patients with borderline resectable (BR) or locally advanced (LA) pancreatic ductal ...adenocarcinoma (PDAC) undergoing total neoadjuvant therapy (TNT).
The optimal preoperative treatment sequencing for BR/LA PDA is unknown. TNT, or systemic chemotherapy followed by chemoradiation (CRT), addresses both occult metastases and positive margin risks and thus is a potentially optimal strategy; however, factors predictive of perioperative and survival outcomes are currently undefined.
We reviewed our experience in BR/LA patients undergoing resection from 2010 to 2017 following TNT assessing operative morbidity, mortality, and survival in order to define outcome predictors and response endpoints.
One hundred ninety-four patients underwent resection after TNT, including 123 (63%) BR and 71 (37%) LA PDAC. FOLFIRINOX or gemcitabine along with nab-paclitaxel were used in 165 (85%) and 65 (34%) patients, with 36 (19%) requiring chemotherapeutic switch before long-course CRT and subsequent resection. Radiologic anatomical downstaging was uncommon (28%). En bloc venous and/or arterial resection was required in 125 (65%) patients with 94% of patients achieving R0 margins. The 90-day major morbidity and mortality was 36% and 6.7%, respectively. Excluding operative mortalities, the median, 1-year, 2-year, and 3-year recurrence-free survival (RFS) overall survival (OS) rates were 23.5 (58.8) months, 65 (96)%, 48 (78)%, and 32 (62)%, respectively. Radiologic downstaging, vascular resection, and chemotherapy regimen/switch were not associated with survival. Only 3 factors independently associated with prolonged survival, including extended duration (≥6 cycles) chemotherapy, optimal post-chemotherapy CA19-9 response, and major pathologic response. Patients achieving all 3 factors had superior survival outcomes with a survival detriment for each failing factor. In a subset of patients with interval metabolic (PET) imaging after initial chemotherapy, complete metabolic response highly correlated with major pathologic response.
Our TNT experience in resected BR/LA PDAC revealed high negative margin rates despite low radiologic downstaging. Extended duration chemotherapy with associated biochemical and pathologic responses highly predicted postoperative survival. Potential modifications of initial chemotherapy treatment include extending cycle duration to normalize CA19-9 or achieve complete metabolic response, or consideration of chemotherapeutic switch in order to achieve these factors may improve survival before moving forward with CRT and subsequent resection.
Prognostic and predictive factors in pancreatic cancer Dell'Aquila, Emanuela; Fulgenzi, Claudia Angela Maria; Minelli, Alessandro ...
Oncotarget,
2020-Mar-10, 2020-03-10, 20200310, Letnik:
11, Številka:
10
Journal Article
Odprti dostop
Pancreatic cancer is one of the leading causes of cancer death worldwide. Its high mortality rate has remained unchanged for years. Radiotherapy and surgery are considered standard treatments in ...early and locally advanced stages. Chemotherapy is the only option for metastatic patients. Two treatment regimens, i. e. the association of 5-fluorouracil- irinotecan-oxaliplatin (FOLFIRINOX) and the association of nab-paclitaxel with gemcitabine, have been shown to improve outcomes for metastatic pancreatic adenocarcinoma patients. However, there are not standardized predictive biomarkers able to identify patients who benefit most from treatments. CA19-9 is the most studied prognostic biomarker, its predictive role remains unclear. Other clinical, histological and molecular biomarkers are emerging in prognostic and predictive settings. The aim of this review is to provide an overview of prognostic and predictive markers used in clinical practice and to explore the most promising fields of research in terms of treatment selection and tailored therapy in pancreatic cancer.
Carbohydrate antigen 19-9 (CA19-9) is a prognostic marker for patients with pancreatic cancer (PC), but its value as a treatment biomarker is unclear.
Although CA19-9 is an established prognostic ...marker for patients with PC, it is unclear how CA19-9 monitoring should be used to guide multimodality treatment and what level of change in CA19-9 constitutes a meaningful treatment response.
CA19-9 measurements at diagnosis (pretx), after completion of all planned neoadjuvant therapy (preop), and after surgery (postop) were analyzed in patients with localized PC who had an elevated CA19-9 (≥35 U/dL) at diagnosis. Patients were classified by: 1) quartiles of pretx CA19-9 (Q1-4); 2) proportional changes in CA19-9 (ΔCA19-9) after the completion of neoadjuvant therapy; 3) normalization (CA19-9 <35 U/dL) of preop CA19-9; and 4) normalization of postop CA19-9.
Among 131 patients, the median overall survival (OS) was 30 months; 68 months for the 33 patients in Q1 of pretx CA19-9 (<80 U/dL) compared with 25 months for the 98 patients in Q2-4 (P = 0.03). For the 98 patients in Q2-4, preop CA19-9 declined (from pretx) in 86 (88%), but there was no association between the magnitude of ΔCA19-9 and OS (P = 0.77). Median OS of the 98 patients who did (n = 29) or did not (n = 69) normalize their preop CA19-9 were 46 and 23 months, respectively (P = 0.02). Of the 69 patients with an elevated preop CA19-9, 32 (46%) normalized their postop CA19-9. Failure to normalize preop or postop CA19-9 was associated with a 2.77-fold and 4.03-fold increased risk of death, respectively (P < 0.003) as compared with patients with normal preop CA19-9.
Following neoadjuvant therapy, normalization of CA19-9, rather than the magnitude of change, is the strongest prognostic marker for long-term survival.
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