Abstract:
OBJECTIVES:The diagnosis of malignant pleural effusion (MPE) remains a clinical challenge. As a negative regulator of T-cell activation, cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) has been associated with many malignant diseases. However, there is limited data about the relationship between CTLA-4 and MPE. The present study aims to investigate whether CTLA-4 levels may correlate with presence of MPE and to assess its potential diagnostic accuracy relative to that of the established markers carcinoembryonic antigen (CEA) and cytokeratin 19 fragment (CYFRA21-1). METHODS:Pleural effusion samples were collected from 36 patients with MPE and 48 patients with benign pleural effusion (BPE). Pleural levels of CTLA-4 were measured by ELISA; levels of CEA and CYFRA 21-1, by electrochemiluminescence immunoassay. Receiver operating characteristic curves were calculated to evaluate the ability of CTLA-4, CEA and CYFRA 21-1 to differentiate MPE from BPE. RESULTS:Pleural levels of CTLA-4 were significantly higher in MPE than in BPE patients (471.73 ± 378.86 vs. 289.22 ± 173.67 pg/ml, p = 0.004). At a cut-off value of 351.25 pg/ml, the sensitivity and specificity of CTLA-4 in diagnosing MPE were 58.30% and 83.30%, respectively, and the area under the curve was 0.72. Pleural levels of CEA and CYFRA 21-1 were also higher in MPE. Using the combination of CTLA-4, CEA and CYFRA 21-1 increased diagnostic sensitivity to 88.89% and the area under the curve to 0.92. CONCLUSION:The results of this preliminary study suggest that increased levels of CTLA-4 correlate with MPE, and that CTLA-4 may have some diagnostic usefulness when used in combination with conventional tumor markers such as CEA and CYFRA 21-1. These results justify larger, more rigorous studies to validate our findings.
journal_name
Postgrad Medjournal_title
Postgraduate medicineauthors
Chen M,Xie S,Wan C,Zeng N,Wu Y,Qin J,Shen Y,Wen Fdoi
10.1080/00325481.2017.1331112subject
Has Abstractpub_date
2017-08-01 00:00:00pages
644-648issue
6eissn
0032-5481issn
1941-9260journal_volume
129pub_type
杂志文章abstract::Our diagnostic approach to a patient with dysphagia begins with detailed history taking and physical examination. On the basis of findings, a radiographic and/or endoscopic study of the esophagus is done. We usually have barium-swallow radiography done initially, and if the radiographs are equivocal, upper gastrointes...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1992.11701537
更新日期:1992-11-15 00:00:00
abstract::In a case of rheumatic disease, the patient's history and a careful physical examination should yield most of the information needed to identify the specific disorder present. A convenient classification is based on four differentiating features: number of joints affected, acuteness or chronicity of disease, absence o...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1976.11708414
更新日期:1976-12-01 00:00:00
abstract::Joint space infections continue to be among the most common forms of arthritis. Diagnosis can be difficult, particularly in the presence of underlying joint disease. Septic arthritis should be suspected in all patients who present with an acutely swollen joint. Immediate joint aspiration with Gram's stain and culture ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1986.11699270
更新日期:1986-02-01 00:00:00
abstract:OBJECTIVES:Management of cardiovascular (CV) risk is an essential aspect of diabetes care, and acceptable CV risk is a requirement for antidiabetes medications. Dipeptidyl peptidase-4 (DPP-4) inhibitors effectively reduce glycated hemoglobin, with a low risk of hypoglycemia and weight gain. The purpose of this review i...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2015.1095616
更新日期:2015-01-01 00:00:00
abstract::Exercise-induced bronchospasm is a common complication of asthma. Aggressive treatment of this conditions permits patients to maintain full activity despite their illness. Since most asthmatic patients are healthy except for an intermittent respiratory problem, providing them the opportunity to exercise in all weather...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1992.11701232
更新日期:1992-02-15 00:00:00
abstract::Head trauma in the elderly is a major source of morbidity and mortality in this population. Prevention of the primary injury is ideal and requires that the primary care physician understands the neurosensory changes of aging. Failing prevention, rapid diagnosis and efficient management of the traumatized patient are o...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1988.11700292
更新日期:1988-05-15 00:00:00
abstract::Patients with nonpsychotic mental health and emotional problems are commonly seen by primary care physicians. The objective of this study was to expand the Provisional Diagnostic Instrument-4 (PDI-4) to include a short self-report screen for 5 common anxiety-related diagnoses: panic attack (PA), social phobia (SP), ob...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.2011.09.2463
更新日期:2011-09-01 00:00:00
abstract::The case described here illustrates the need to consider milk-alkali syndrome in the differential diagnosis of hypercalcemia, even in this age of histamine2 blockers and mucosal protectors. Thorough history taking and gastrointestinal workup help rule out alternative causes of hypercalcemia, such as cancer, hyperparat...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1993.11701690
更新日期:1993-05-01 00:00:00
abstract::Recent increases in obesity, diabetes, and hypertension, along with the aging of the US population, are driving a dramatic rise in the prevalence of chronic kidney disease (CKD). Despite this increase, the majority of Americans with early-stage CKD remain unaware of their disease. Primary care physicians are at the fo...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2011.09.2473
更新日期:2011-09-01 00:00:00
abstract::Many new, minimally invasive interventional radiology procedures are now viable alternatives to traditional invasive therapy. The radiology procedures can often be performed in the outpatient setting, and although expensive technology may be required, the overall cost to the patient may be lower in the long run. Endov...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2001.06.958
更新日期:2001-06-01 00:00:00
abstract:OBJECTIVES:The clinical significance of hyperplastic polyp-like histologic changes in random biopsy samples ('serrated epithelial change' or SEC) from patients with inflammatory bowel disease (IBD) remains uncertain, with some studies suggesting an increased risk of dysplasia and even carcinoma. Controlled studies are ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2020.1802138
更新日期:2021-01-01 00:00:00
abstract::Flooding of the lungs occurs routinely in drowning victims. The cause of death in 90% of them is hypoxemia caused by water in the lungs. Mouth-to-mouth ventilation is ineffective until the water is removed. The Heimlich maneuver expels aspirated water, vomitus, debris, and other foreign matter. In treating near-drowni...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1988.11700363
更新日期:1988-08-01 00:00:00
abstract::Evidence from epidemiologic, lipid intervention, and coronary angiographic studies demonstrates the importance of high-density lipoprotein cholesterol (HDL-C) in coronary artery disease (CAD) risk. Data from these studies strongly support the measurement of HDL-C in all patients screened for CAD. Patients with low lev...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1990.11704654
更新日期:1990-05-15 00:00:00
abstract::Contrary to popular belief, hypoglycemia is an infrequently encountered condition and its presence is questionable until confirmed by appropriate tests. In ambulatory patients, blood glucose levels obtained during intake of a normal diet are more reliable than those obtained during a glucose tolerance test. If the blo...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1987.11700028
更新日期:1987-11-01 00:00:00
abstract::Prescription opioid analgesics are an important treatment option for patients with chronic pain; however, misuse, abuse and diversion of these medications are a major global public health concern. Prescription opioid analgesics can be abused via intended and non-intended routes of administration, both intact or after ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2016.1120642
更新日期:2016-01-01 00:00:00
abstract::Some skin disorders are more common in blacks than in whites or are so rare in whites as to be almost peculiar to blacks. Pigmentary abnormalities, either dark or light spots, often occur in association with inflammatory skin diseases. Curvature of the hair follicle is thought to be at the root of two other painful co...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1977.11712223
更新日期:1977-06-01 00:00:00
abstract::Primary prophylaxis is advisable for all patients with moderate-sized or large esophageal varices. After the first episode of bleeding, secondary prophylaxis should be initiated to prevent rebleeding. Multiple treatment modalities are available for each circumstance. Optimal regimens have not yet been established but ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2006.11446045
更新日期:2006-09-01 00:00:00
abstract::In public whirlpools, low disinfectant levels and inadequate monitoring are clearly a public health concern. Implementing guidelines published by the Centers for Disease Control seems to be the most reasonable approach to preventing dermatitis in persons who use these facilities. Physicians should be on the alert for ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1991.11701042
更新日期:1991-09-01 00:00:00
abstract::The role of reflux in the development of esophagitis, stricture, and Barrett's esophagus is well recognized. However, reflux is not an infrequent cause of atypical chest pain, chronic pulmonary disorders, and pharyngeal and laryngeal changes. Increased insight into the pathogenesis of reflux and the relationship betwe...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:
更新日期:1996-04-01 00:00:00
abstract::To help you save time in identifying those meetings and courses of greatest interest to you, POSTGRADUATE MEDICINE offers this objectively rated listing as a regular reader service. Each event has been rated on the factors that matter most to you: relevance of the subject to primary care, number of credit hours, cost ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1977.11714671
更新日期:1977-11-01 00:00:00
abstract::A 29-year-old man had a febrile illness accompanied by chest pain and tachycardia. The ECG suggested either myocarditis or acute ischemia. Heart muscle enzymes were normal, the peripheral blood count showed absolute and relative lymphocytosis, and an echocardiogram disclosed a small pericardial effusion. After deferve...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1989.11700655
更新日期:1989-04-01 00:00:00
abstract::Most patients with type 2 diabetes present with comorbid overweight or obesity. Reaching and maintaining acceptable glycemic control is more difficult in overweight and obese patients, and these conditions are associated with increased risk for cardiovascular and other diseases. Glycemic management for these patients ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2010.05.2148
更新日期:2010-05-01 00:00:00
abstract::Abdominal aortic aneurysms are believed to result from several factors, one probably being inflammation that leads to dilatation, plaque deposition, and degeneration of the arterial wall. Most of these aneurysms are asymptomatic, but abdominal or back pain, shock, and a pulsatile abdominal mass indicate rupture. Initi...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1999.08.651
更新日期:1999-08-01 00:00:00
abstract:OBJECTIVE:To evaluate the pharmacokinetics of lisdexamfetamine dimesylate (LDX), a long-acting prodrug stimulant, and mixed amphetamine salts extended-release (MAS XR), alone or with omeprazole, a proton pump inhibitor (PPI). METHODS:This open-label, randomized, 4-period crossover study enrolled healthy adults (18-45 ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,随机对照试验
doi:10.3810/pgm.2009.09.2048
更新日期:2009-09-01 00:00:00
abstract::Thymomas may be discovered during routine evaluation, through reported symptoms, or increasingly, during evaluation for myasthenia gravis. Histologic details of these tumors have little bearing on prognosis or evaluation of malignant potential. Malignancy is determined by evidence of invasion through the tumor capsule...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1986.11699321
更新日期:1986-03-01 00:00:00
abstract::A young man with exertional dyspnea, maculopapular skin lesions, and generalized lymphadenopathy was found to have a posterior mediastinal density on a chest roentgenogram. Sarcoidosis was diagnosed on the basis of lymph node and skin biopsy findings, and corticosteroid therapy was started. After six months of treatme...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1982.11715957
更新日期:1982-01-01 00:00:00
abstract::Hepatitis C virus (HCV) is responsible for most cases of non-A non-B hepatitis and is primarily spread by a parenteral route, although familial, sexual, and maternal transmission may occur rarely. Second-generation assays and the polymerase chain reaction facilitate detection of HCV infection. The association between ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1994-05-01 00:00:00
abstract::Electroconvulsive therapy is controversial and readily arouses the passions of both its supporters and detractors. In this article, Dr Schoen, an internist, discusses various aspects of this 50-year-old technique, including risks, contraindications, and physiologic effects. ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1990.11716347
更新日期:1990-05-01 00:00:00
abstract::Although chronic hepatitis B is a relatively common disease that may have a serious outcome, the outlook is by no means uniformly poor. Alpha interferon therapy may be helpful in up to one third of patients who have hepatitis B e antigen in serum and elevated serum aminotransferase levels. New drugs that may have even...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1995-07-01 00:00:00
abstract::Epidemiologic and clinical evidence clearly documents the relationship between elevated levels of low-density lipoprotein cholesterol (LDL-C) and risk of coronary heart disease (CHD). In order to reduce CHD risk, the National Cholesterol Education Program (NCEP) has identified LDL-C goals that can be achieved through ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.04.2003.suppl26.137
更新日期:2003-04-01 00:00:00