Startseite CA199 and CEA expression levels, and minimally invasive postoperative prognosis analysis in esophageal squamous carcinoma patients
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CA199 and CEA expression levels, and minimally invasive postoperative prognosis analysis in esophageal squamous carcinoma patients

  • Cheng Ji , Lingjia Ji , Fei Wang , Anping Zhang und Liang Shen EMAIL logo
Veröffentlicht/Copyright: 27. Mai 2025

Abstract

Background

This study explores the factors related to the expression levels of carbohydrate antigen 199 (CA199) and carcinoembryonic antigen (CEA) and their association with poor postoperative prognosis in patients with esophageal squamous cell carcinoma (ESCC) who underwent minimally invasive resection.

Methods

Eighty patients with ESCC who underwent minimally invasive surgery were divided into two groups: 40 with poor prognosis (recurrence) and 40 with good prognosis (no recurrence). Additionally, 80 healthy subjects were selected as a control group. Serum CA199 and CEA levels were measured before surgery and 3 and 6 months postoperatively.

Results

The serum CA199 and CEA levels in the experimental group were significantly higher than in the control group (P < 0.05). Patients with poor prognoses within the experimental group had higher CA199 and CEA levels than those with good prognoses (P < 0.05). In the poor prognosis group, CA199 and CEA levels at 6 months were significantly higher than at 3 months post-surgery (P < 0.05).

Conclusion

Poor prognosis in ESCC patients after minimally invasive resection may be influenced by factors such as lymph node metastasis, lesion length, and tumor location. Elevated CA199 and CEA levels postoperatively can serve as predictors of poor prognosis in patients with ESCC.

1 Introduction

With the aging of the population and lifestyle changes, malignant tumors have become one of the leading causes of death in China. According to a survey [1], China’s standardized cancer incidence rate is 201.7/100,000, ranking 68th in the world; at the same time, China’s standardized cancer mortality rate is 130.1/100,000, ranking 12th globally. Esophageal squamous cell carcinoma (ESCC) is one of the most common and fatal malignant tumors in China. It lacks early typical symptoms, is mostly in the middle and late stages when diagnosed, and has a very poor prognosis [2]. Endoscopy, as a major screening technology, can detect ESCC early, but its invasiveness, severe side effects, and dependence on the skills of endoscopists limit its widespread application. People more easily accept simple blood tests and have broad clinical application prospects. Surgery is the main treatment for ESCC. With the development of minimally invasive surgery, thoracoscopic esophagectomy is becoming more and more widely used. For patients who cannot undergo surgery, radiotherapy and chemotherapy are important treatments to control disease progression, which can effectively shrink tumors and reduce the rate of metastasis. Biological and targeted therapy have also shown certain effects in improving the condition. Endoscopic local injection chemotherapy and endoscopic ablation therapy have shown good safety and application prospects in recent years. Treatment can significantly improve the 5-year survival rate for early-stage lesions, and endoscopic minimally invasive resection or ablation therapy is a potential intervention strategy [3,4].

Tumor markers (TM) are closely related to the occurrence and development of malignant tumors and exist in the peripheral blood, other body fluids, or tissues of tumor patients [5]. It can be detected through radioimmunoassay technology, immunofluorescence technology of fluorescently labeled probes, enzyme-linked immunosorbent assay, chemiluminescence immunoassay, chemiluminescence immunoassay, time-resolved fluorescence immunoassay technology, and other methods. TM is divided into tumor embryonic antigens, carbohydrates and glycoproteins, ectopic hormones, enzymes and isozymes, tumor antigens, oncogenes, tumor suppressor gene protein products, etc. Its expression level can help diagnose malignant tumors, monitor recurrence, or evaluate disease efficacy and prognosis [6]. An ideal TM should have high sensitivity and specificity and be able to localize and differentially diagnose tumors. No ESCC-specific TM has been found yet, and biomarkers such as carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC), and Cyfra21-1 are common methods for clinical auxiliary diagnosis of ESCC [7].

Carbohydrate antigen 19-9 (CA 19-9). CA199 is a mucin antigen with a relative molecular mass of 10,000 in the form of monosialoganglioside [8]. The serum levels of CA199 are elevated in gastrointestinal tumors such as esophageal cancer, gastric cancer, colorectum, etc., but there is a lack of specific evidence to diagnose esophageal cancer [9].

CEA was first discovered in 1965 and is one of the earliest discovered and most studied TMs [10]. Some studies have shown that the increase in serum CEA has certain significance for the diagnosis and prognosis of ESCC and can be used as an auxiliary clinical diagnostic indicator for ESCC [11].

The single diagnostic value of TMs is low, and combined diagnosis can improve sensitivity and specificity. Studies have shown that when single CEA, SCC, Cyfra21-1, and NSE tests were performed on patients with esophageal cancer, the positive rates were 36.0, 53.5, 26.7, and 24.4%, respectively. When combined with detection, its sensitivity and specificity can reach 82.6 and 83.7% [12]. It is reported that the positive rates of Cyfra21-1, CA199, and SCC for esophageal cancer are 58.1, 40.5, and 31.1%, respectively [13]. It can be seen that the joint detection of multiple TMs can significantly improve diagnostic efficiency.

Minimally invasive resection is an important way to treat ESCC. It is suitable for treating esophageal cancer of different stages and locations and is of great significance in prolonging the survival of patients [14,15]. However, some studies have pointed out that due to the large tumor lesions and wide range of tumor invasion, ESCC patients still have a high risk of recurrence after minimally invasive resection, which seriously affects the prognosis [16,17]. Therefore, it is important to explore the factors that may influence the poor postoperative prognosis of ESCC patients who undergo minimally invasive resection. Studies have shown that the poor postoperative prognosis of patients with stage III thoracic esophageal cancer may be related to the patient’s age, gender, and TNM stage [18,19,20].

However, the influencing factors obtained from the above studies cannot guide the formulation of intervention measures for patients with poor prognosis of ESCC. This study explores the expression levels of CA199 and CEA in ESCC patients who underwent minimally invasive resection and explores the factors associated with the impact of these two TMs on poor postoperative prognosis. It aims to lay a clinical data foundation for reducing the occurrence of adverse prognostic reactions in future ESCC patients.

2 Information and methods

2.1 Normal information

Eighty patients collected from June 2022 to January 2024 underwent minimally invasive cutting in our hospital and completed 1 year of follow-up after surgery as the experimental group. The clinical data of 40 patients in the experimental group were selected in the experimental group, as a poor prognosis group. The clinical data of esophageal squamous carcinoma patients who received minimally invasive resection during the hospital received minimally invasive resection during the same period and completed a one-year follow-up (uncompromising) is used as a good prognosis group. At the same time, 80 health tests were selected as the control group. This study has passed the ethical approval of our court.

2.2 Inclusion criteria

Diagnostic standards meet the “Guidelines for Standardizing the Diagnosis and Treatment of esophageal cancer” [21]. The diagnostic criteria of esophageal squamous carcinoma are related to the diagnosis of esophageal squamous carcinoma.

  1. Anophayal surgical pathological examination is diagnosed as esophageal squamous carcinoma

  2. first time of surgical treatment

  3. Complete information.

2.3 Exclusion criteria

  1. Those who have mental illness or intellectual developmental disorders.

  2. Severe liver and kidney insufficiency or heart failure and severe organ dysfunction.

  3. Combined serious coronary heart disease and diabetes.

  4. Autoimmune or connective tissue disease.

  5. Acute phase of cerebral infarction.

  6. Malignant tumors

  7. Those who have received surgery, radiotherapy, or chemotherapy.

3 Method

3.1 Prognostic assessment methods

The examination results are recorded at 3, 6, 9, and 12 months of follow-up. CA199 and CEA levels were measured at 3 and 6 months after surgery. If recurrence is indicated by CT or pathological examination, it is classified as a poor prognosis and is included in the poor group; otherwise, it is included in the good group.

3.2 Baseline data: Designed and compiled by the researcher

① General information: Gender (male, female), age, TNM stage. [Stage I, stage II, and stage III refer to the tumor TNM stage revised by the American Joint Committee on Cancer (AJCC) [7]. Stage I: the lesion length is <3 cm and invades the mucosa and submucosa and has no local lymph node metastasis. Stage II: The lesion is 3–5 cm long and invades part of the muscle layer without lymph node metastasis. Stage III: The length of the lesion is >5 cm, and it invades the whole muscle layer or has external invasion, and there is local lymph node metastasis.] The degree of differentiation (poor differentiation, moderate differentiation, and high differentiation refers to the World Health Organization (WHO) [8] esophageal cancer histological differentiation standards). Lymph node metastasis (present or absent), lesion length, and tumor location (upper, middle, and lower segment).

② Laboratory test data: 3 mL of fasting venous blood was collected from the patient before surgery, 3 months, and 6 months after surgery, and centrifuged (speed: 3,000 rpm, centrifugal radius: 15 cm, centrifugation time: 10 min). The upper serum was separated, and enzyme-linked immunoassay was used to determine carbohydrate antigen 199 (CA199) levels and CEA. The kits were purchased from Shanghai Enzyme Biotechnology Co., Ltd. and operated according to the instructions.

3.3 Statistical analysis

The data in this study were analyzed and processed by SPSS21.0 statistical software. The measurement data were expressed as (average ± SD), the t-test was used, and the count data were expressed as the % rate. The χ2 test was adopted. The logistic regression model was used to analyze the impact of CEA and CA199 on the prognosis of patients with ESCC. The receiver operating characteristic (ROC) curve was used to analyze the effectiveness of CEA and CA199 in predicting poor prognosis in patients with ESCC. P < 0.05 indicates that the difference is statistically significant.

We used logistic regression analysis to observe the correlation of adverse prognostic factors. The postoperative prognosis of patients with ESCC who underwent minimally invasive resection was taken as the dependent variable, where poor outcomes were assessed as ‘0’ and good outcomes as ‘1’. The independent variables included all clinical variables, as shown in Table 1, and CEA and CA199 levels from Table 3 were individually analyzed through single-factor logistic regression. P-values were relaxed to <0.2, and qualified variables (lesion length, lymph node metastasis, tumor location, CA199, and CEA) were included as independent variables to establish a multiple regression model.

Table 1

Comparison of general clinical data of patients

Index Experimental group (n = 80) Control group (n = 80) t/x 2 P
Poor prognosis group (n = 40) Good prognosis group (n = 40)
Average age 56.95 ± 8.72 56.43 ± 8.67 56.40 ± 6.74 0.267 0.790
Gender (male/female) 19/21 23/17 45/35 0.802 0.370
Lesion length (cm) 5.03 ± 1.02 3.25 ± 0.83 8.561 <0.001
TNM stage [n (%)] 0.840 0.657
Phase II 8 (20.00) 6 (15.00)
Phase Ⅲ 18 (45.00) 22 (55.00)
Phase Ⅳ 14 (35.00) 12 (30.00)
Differentiation [n (%)] 0.216 0.898
Poorly differentiated 8 (20.00) 9 (22.50)
Moderately differentiated 15 (37.50) 16 (40.00)
Highly differentiated 17 (42.50) 15 (37.50)
Tumor location 11.823 0.003
Upper section 16 (40.00) 3 (7.50)
Middle section 15 (37.50) 25 (62.50)
Lower section 9 (22.50) 12 (30.00)
Lymph node metastasis 6.050 0.014
Yes 13 (32.50) 4 (10.00)
No 27 (67.50) 36 (90.00)
  1. Ethical approval: This study was approved by the ethical committee of Nantong First People’s Hospital. Informed consent was obtained from all participants.

4 Results

4.1 Comparison of clinical data

We compared the groups’ general clinical data of selected patients (Table 1). Compared to the lesion length, lymph node metastasis, and tumor location between the poor prognosis group and the good prognosis group, the differences were statistically significant (P < 0.05), and the TNM stage and degree of differentiation were comparable (P > 0.05). Moreover, the gender, age, and other information between groups are comparable (P > 0.05).

4.2 Comparison of CEA and CA199 in the experimental group and control group

We measured CEA and CA199 levels between the two groups. The results showed (Table 2 and Figure 1) that the serum CEA and CA199 levels of the experimental group were higher than those of the control group (P < 0.05).

Table 2

Comparison of the two indices among the two groups (x ± s)

Index Experimental group (n = 80) Control group (n = 80) t/x 2 P
CEA (pg/L) 14.04 ± 2.51 1.82 ± 0.21 43.394 <0.001
CA199 (U/mL) 42.66 ± 7.66 19.15 ± 3.52 24.944 <0.001

Note: CA199: carbohydrate antigen 199; CEA, carcinoembryonic antigen.

Figure 1 
                  Violin plot for comparison of CEA and CA199 levels among two groups. This figure illustrates the distribution and differences in CEA and CA199 levels between the two groups using a violin plot, highlighting each group’s central tendency and variability.
Figure 1

Violin plot for comparison of CEA and CA199 levels among two groups. This figure illustrates the distribution and differences in CEA and CA199 levels between the two groups using a violin plot, highlighting each group’s central tendency and variability.

4.3 Comparison of CEA and CA199 in the poor and good prognosis groups

We also compared the expressions of CEA and CA199 in the experimental group’s poor prognosis and good prognosis. The results showed (Table 3 and Figure 2) that 3 months after surgery, the CEA and CA199 levels in the poor prognosis group and the good prognosis group were comparable (P > 0.05). Six months after surgery, the serum CEA and CA199 levels of the poor prognosis group were higher than those of the good prognosis group (P < 0.05). In the poor prognosis group, CEA and CA199 levels 6 months after surgery were higher than those 3 months after surgery (P < 0.05).

Table 3

Comparison of the levels of CEA and CA199 in the poor and good prognosis group (x ± s)

Index Time Poor prognosis group (n = 40) Good prognosis group (n = 40) t/x 2 P
CEA (pg/L) Before surgery 14.08 ± 2.58 14.03 ± 2.49 0.088 0.930
3 months after surgery 3.05 ± 0.65* 3.01 ± 0.61* 0.284 0.777
6 months after surgery 5.96 ± 1.14* 3.85 ± 1.52* 7.024 0.000
CA199 (U/mL) Before surgery 42.71 ± 7.71 42.64 ± 7.67 0.041 0.968
3 months after surgery 23.05 ± 4.25* 23.07 ± 4.18* -0.021 0.983
6 months after surgery 31.52 ± 5.74* 24.11 ± 4.23* 6.573 0.000

*Note: Means comparison within-group before surgery, P < 0.05.

Figure 2 
                  ROC curve analysis. It demonstrates the diagnostic performance of the selected biomarkers, showing sensitivity versus 1-specificity across different thresholds.
Figure 2

ROC curve analysis. It demonstrates the diagnostic performance of the selected biomarkers, showing sensitivity versus 1-specificity across different thresholds.

4.4 Logistics regression analysis of related factors with poor prognosis effects

The results showed that lymph node metastasis, long lesions, upper segment tumors, CA199, and CEA overexpression were all factors affecting the poor prognosis of patients with ESCC after minimally invasive resection (P < 0.05) (Table 4).

Table 4

Results of univariate and multivariate logistic regression analysis

Index OR (95% CI) univariate analysis P value univariate analysis OR (95% CI) multivariate analysis P value multivariate analysis
Age 0.993 (0.943–1.045) 0.785
Lesion length 0.127 (0.053–0.304) <0.001 0.025 (0.001–0.403) 0.009
stage 1.294 (0.467–3.590) 0.620
Differentiation 1.630 (0.477–5.565) 0.436
Location 8.889 (2.215–35.665) 0.002 42.002 (3.803–198.118) 0.044
Lymph node metastasis 0.231 (0.068–0.787) 0.019 0.113 (0.001–0.457) 0.035
CEA 0.303 (0.180–0.508) <0.001 0.225 (0.064–0.792) 0.020
CA199 0.727 (0.632–0.837) <0.001 0.708 (0.524–0.955) 0.024

4.5 Predictive performance analysis

ROC curve analysis showed that the AUC)of serum CEA and CA199 in predicting poor prognosis in patients with ESCC were 0.868 and 0.860, respectively. It is suggested that these two indicators have high predictive value in the prognosis assessment of ESCC.

5 Discussion

At this stage, surgery is the main method for treating esophageal cancer. According to relevant research reports, esophageal cancer still has a high recurrence rate after surgical treatment, among which the recurrence rate of esophageal adenocarcinoma is as high as 50.00%. In comparison, the recurrence rate of ESCC is 34.00–79.00% [22].

Clinically, minimally invasive resection can improve the therapeutic effect of ESCC. However, some studies have pointed out that some patients have a higher recurrence rate after minimally invasive resection, which increases the risk of poor prognosis [23]. Some researchers [10] conducted a follow-up analysis on patients with thoracic ESCC who underwent radical resection, and the results showed that the postoperative recurrence rate was 34.6%[24]. It is suggested that ESCC patients have a higher risk of poor prognosis after surgery.

Therefore, it is necessary to find factors related to poor prognosis after minimally invasive resection of ESCC. Under these conditions, finding sensitive indicators to monitor patient’s condition changes after ESCC surgery is the key to improving prognosis and survival rates. CEA is a tumor embryonic antigen with acidic glycoprotein as the main component [25], and CA199 is a mucin antigen with a relative molecular mass of 10,000 in the form of monosialoganglioside [26].

The results of this study show that lymph node metastasis, long lesions, and upper segment tumors are all factors affecting the poor prognosis of ESCC patients after minimally invasive resection.

The reasons are analyzed as follows. ① Lymph node metastasis: lymph from each esophageal segment of the body will normally be injected into nearby lymph nodes, making lymph node dissection more difficult during minimally invasive resection. Especially when metastasis occurs in the thoracic lymph nodes, it is very likely to move up to the upper mediastinal lymph nodes and metastasize to the abdominal lymph nodes. However, effective dissection cannot be performed during minimally invasive surgery, resulting in some tumor cells remaining in the body, increasing the risk of poor prognosis [27,28]. In this regard, it is recommended that patients with preoperative lymph node metastasis should focus on lymph node dissection during minimally invasive resection. At the same time, corresponding adjuvant treatment can be taken after surgery to improve further the clinical treatment effect, which may have a positive significance in reducing the risk of poor prognosis in ESCC patients after minimally invasive resection.

② Longer lesion length: On the one hand, the long diameter of the tumor can affect the surgical resection rate; on the other hand, the size of the tumor is related to the degree of infiltration and lymph node metastasis. As the diameter of the tumor increases, the risk of lymph node metastasis increases, and the degree of tumor infiltration will continue to increase, affecting the patient’s prognosis [29]. In this regard, it is recommended that ESCC patients with long lesions increase the surgical resection length during minimally invasive resection to clear the lesions as much as possible to improve the prognosis.

③ Upper segment tumors: Most ESCC in the upper thoracic segment are in the T4 stage, and the tumors often invade the structures around the esophagus. Moreover, the operation is more difficult and riskier since the upper chest segment is connected to the trachea and recurrent laryngeal nerve. The surgical margins are prone to residual cancer tissue, which increases the risk of poor patient prognosis [30,31]. In this regard, it is recommended that the scope of surgical resection and lymph node dissection should be determined based on the actual tumor location of ESCC patients to improve the effect of surgical treatment and improve the prognosis of patients.

④ Serum CA199 and CEA are overexpressed: CA199 and CEA are markers related to esophageal cancer. If the preoperative serum CA199 and CEA expression in ESCC patients is too high, it may indicate that the tumor is severely malignant and has poor biological behavior. It mostly manifests as infiltrative growth and easily invades the serosa, which directly affects the effect of minimally invasive surgical treatment and increases the risk of poor prognosis for patients [31,32,33]. In this regard, it is recommended that for patients with over-expressed serum CA199 and CEA before surgery, adjuvant treatment can be performed before surgery to reduce the levels of CA199 and CEA. Waiting until the ideal state is reached before performing surgery may have positive significance in reducing the poor prognosis of ESCC patients after minimally invasive resection.

In this study, CA199 and CEA levels 6 months after surgery were also used for correlation analysis. The results also suggest that the postoperative increases in CA199 and CEA levels can be used as predictors of poor prognosis in patients with ESCC after minimally invasive resection. ROC curve analysis showed that the AUC of serum CEA and CA199 in predicting poor prognosis in patients with ESCC were 0.868 and 0.860, respectively. It is suggested that these two indicators have high predictive value in the prognosis assessment of ESCC.

This study also has some limitations. The sample size of this study was too small, and it was a single-center study. The sample size can be expanded, and multicenter studies can be conducted. This study only focused on two types of TM, and more TMs can be combined for future research. To explore the relationship between TM and ESCC in more depth and to provide clinical help for the prognosis of ESCC patients.

In summary, lymph node metastasis, lesion length, tumor location, and serum CA199 and CEA levels may be factors affecting the poor prognosis of ESCC patients after minimally invasive resection. In this regard, clinical practice should select the most appropriate treatment measures based on the patient’s situation to improve the patient’s prognosis.

  1. Funding information: This study is funded by Clinical medicine special research fund project of Nantong University (No. 2023JY002) and Research Project of Municipal Health Commission of Nantong (No. MS2023037).

  2. Author contributions: Cheng Ji contributed to the study design, data collection, and manuscript writing. Lingjia Ji assisted with data analysis. Fei Wang contributed to statistical analysis. Anping Zhang provided clinical expertise. Liang Shen supervised the project and provided critical revisions.

  3. Conflict of interest: The authors state no conflict of interest.

  4. Data availability statement: The datasets generated during and/or analyzed during the current study are available from the corresponding author upon reasonable request.

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Received: 2024-05-25
Revised: 2024-12-11
Accepted: 2024-12-12
Published Online: 2025-05-27

© 2025 the author(s), published by De Gruyter

This work is licensed under the Creative Commons Attribution 4.0 International License.

Artikel in diesem Heft

  1. Research Articles
  2. Network pharmacological analysis and in vitro testing of the rutin effects on triple-negative breast cancer
  3. Impact of diabetes on long-term survival in elderly liver cancer patients: A retrospective study
  4. Knockdown of CCNB1 alleviates high glucose-triggered trophoblast dysfunction during gestational diabetes via Wnt/β-catenin signaling pathway
  5. Risk factors for severe adverse drug reactions in hospitalized patients
  6. Analysis of the effect of ALA-PDT on macrophages in footpad model of mice infected with Fonsecaea monophora based on single-cell sequencing
  7. Development and validation of headspace gas chromatography with a flame ionization detector method for the determination of ethanol in the vitreous humor
  8. CMSP exerts anti-tumor effects on small cell lung cancer cells by inducing mitochondrial dysfunction and ferroptosis
  9. Predictive value of plasma sB7-H3 and YKL-40 in pediatric refractory Mycoplasma pneumoniae pneumonia
  10. Antiangiogenic potential of Elaeagnus umbellata extracts and molecular docking study by targeting VEGFR-2 pathway
  11. Comparison of the effectiveness of nurse-led preoperative counseling and postoperative follow-up care vs standard care for patients with gastric cancer
  12. Comparing the therapeutic efficacy of endoscopic minimally invasive surgery and traditional surgery for early-stage breast cancer: A meta-analysis
  13. Adhered macrophages as an additional marker of cardiomyocyte injury in biopsies of patients with dilated cardiomyopathy
  14. Association between statin administration and outcome in patients with sepsis: A retrospective study
  15. Exploration of the association between estimated glucose disposal rate and osteoarthritis in middle-aged and older adults: An analysis of NHANES data from 2011 to 2018
  16. A comparative analysis of the binary and multiclass classified chest X-ray images of pneumonia and COVID-19 with ML and DL models
  17. Lysophosphatidic acid 2 alleviates deep vein thrombosis via protective endothelial barrier function
  18. Transcription factor A, mitochondrial promotes lymph node metastasis and lymphangiogenesis in epithelial ovarian carcinoma
  19. Serum PM20D1 levels are associated with nutritional status and inflammatory factors in gastric cancer patients undergoing early enteral nutrition
  20. Hydromorphone reduced the incidence of emergence agitation after adenotonsillectomy in children with obstructive sleep apnea: A randomized, double-blind study
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  22. The first-line antihypertensive nitrendipine potentiated the therapeutic effect of oxaliplatin by downregulating CACNA1D in colorectal cancer
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  24. Modulatory effects of Lycium barbarum polysaccharide on bone cell dynamics in osteoporosis
  25. Mechanism research on inhibition of gastric cancer in vitro by the extract of Pinellia ternata based on network pharmacology and cellular metabolomics
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  27. Clinical analysis of ten cases of HIV infection combined with acute leukemia
  28. Investigating the cardioprotective potential of quercetin against tacrolimus-induced cardiotoxicity in Wistar rats: A mechanistic insights
  29. Clinical observation of probiotics combined with mesalazine and Yiyi Baitouweng Decoction retention enema in treating mild-to-moderate ulcerative colitis
  30. Diagnostic value of ratio of blood inflammation to coagulation markers in periprosthetic joint infection
  31. Sex-specific associations of sex hormone binding globulin and risk of bladder cancer
  32. Core muscle strength and stability-oriented breathing training reduces inter-recti distance in postpartum women
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  38. The correlation between epithelial–mesenchymal transition classification and MMP2 expression of circulating tumor cells and prognosis of advanced or metastatic nasopharyngeal carcinoma
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  40. A cross-sectional study: Relationship between serum oxidative stress levels and arteriovenous fistula maturation in maintenance dialysis patients
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  42. Identifying early screening factors for depression in middle-aged and older adults: A cohort study
  43. Perform tumor-specific survival analysis for Merkel cell carcinoma patients undergoing surgical resection based on the SEER database by constructing a nomogram chart
  44. Unveiling the role of CXCL10 in pancreatic cancer progression: A novel prognostic indicator
  45. High-dose preoperative intraperitoneal erythropoietin and intravenous methylprednisolone in acute traumatic spinal cord injuries following decompression surgeries
  46. RAB39B: A novel biomarker for acute myeloid leukemia identified via multi-omics and functional validation
  47. Impact of peripheral conditioning on reperfusion injury following primary percutaneous coronary intervention in diabetic and non-diabetic STEMI patients
  48. Clinical efficacy of azacitidine in the treatment of middle- and high-risk myelodysplastic syndrome in middle-aged and elderly patients: A retrospective study
  49. The effect of ambulatory blood pressure load on mitral regurgitation in continuous ambulatory peritoneal dialysis patients
  50. Expression and clinical significance of ITGA3 in breast cancer
  51. Single-nucleus RNA sequencing reveals ARHGAP28 expression of podocytes as a biomarker in human diabetic nephropathy
  52. rSIG combined with NLR in the prognostic assessment of patients with multiple injuries
  53. Toxic metals and metalloids in collagen supplements of fish and jellyfish origin: Risk assessment for daily intake
  54. Exploring causal relationship between 41 inflammatory cytokines and marginal zone lymphoma: A bidirectional Mendelian randomization study
  55. Gender beliefs and legitimization of dating violence in adolescents
  56. Effect of serum IL-6, CRP, and MMP-9 levels on the efficacy of modified preperitoneal Kugel repair in patients with inguinal hernia
  57. Effect of smoking and smoking cessation on hematological parameters in polycythemic patients
  58. Pathogen surveillance and risk factors for pulmonary infection in patients with lung cancer: A retrospective single-center study
  59. Necroptosis of hippocampal neurons in paclitaxel chemotherapy-induced cognitive impairment mediates microglial activation via TLR4/MyD88 signaling pathway
  60. Celastrol suppresses neovascularization in rat aortic vascular endothelial cells stimulated by inflammatory tenocytes via modulating the NLRP3 pathway
  61. Cord-lamina angle and foraminal diameter as key predictors of C5 palsy after anterior cervical decompression and fusion surgery
  62. GATA1: A key biomarker for predicting the prognosis of patients with diffuse large B-cell lymphoma
  63. Influencing factors of false lumen thrombosis in type B aortic dissection: A single-center retrospective study
  64. MZB1 regulates the immune microenvironment and inhibits ovarian cancer cell migration
  65. Integrating experimental and network pharmacology to explore the pharmacological mechanisms of Dioscin against glioblastoma
  66. Trends in research on preterm birth in twin pregnancy based on bibliometrics
  67. Four-week IgE/baseline IgE ratio combined with tryptase predicts clinical outcome in omalizumab-treated children with moderate-to-severe asthma
  68. Single-cell transcriptomic analysis identifies a stress response Schwann cell subtype
  69. Acute pancreatitis risk in the diagnosis and management of inflammatory bowel disease: A critical focus
  70. Effect of subclinical esketamine on NLRP3 and cognitive dysfunction in elderly ischemic stroke patients
  71. Interleukin-37 mediates the anti-oral tumor activity in oral cancer through STAT3
  72. CA199 and CEA expression levels, and minimally invasive postoperative prognosis analysis in esophageal squamous carcinoma patients
  73. Efficacy of a novel drainage catheter in the treatment of CSF leak after posterior spine surgery: A retrospective cohort study
  74. Comprehensive biomedicine assessment of Apteranthes tuberculata extracts: Phytochemical analysis and multifaceted pharmacological evaluation in animal models
  75. Relation of time in range to severity of coronary artery disease in patients with type 2 diabetes: A cross-sectional study
  76. Dopamine attenuates ethanol-induced neuronal apoptosis by stimulating electrical activity in the developing rat retina
  77. Correlation between albumin levels during the third trimester and the risk of postpartum levator ani muscle rupture
  78. Factors associated with maternal attention and distraction during breastfeeding and childcare: A cross-sectional study in the west of Iran
  79. Mechanisms of hesperetin in treating metabolic dysfunction-associated steatosis liver disease via network pharmacology and in vitro experiments
  80. The law on oncological oblivion in the Italian and European context: How to best uphold the cancer patients’ rights to privacy and self-determination?
  81. The prognostic value of the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and prognostic nutritional index for survival in patients with colorectal cancer
  82. Factors affecting the measurements of peripheral oxygen saturation values in healthy young adults
  83. Comparison and correlations between findings of hysteroscopy and vaginal color Doppler ultrasonography for detection of uterine abnormalities in patients with recurrent implantation failure
  84. The effects of different types of RAGT on balance function in stroke patients with low levels of independent walking in a convalescent rehabilitation hospital
  85. Causal relationship between asthma and ankylosing spondylitis: A bidirectional two-sample univariable and multivariable Mendelian randomization study
  86. Correlations of health literacy with individuals’ understanding and use of medications in Southern Taiwan
  87. Correlation of serum calprotectin with outcome of acute cerebral infarction
  88. Comparison of computed tomography and guided bronchoscopy in the diagnosis of pulmonary nodules: A systematic review and meta-analysis
  89. Curdione protects vascular endothelial cells and atherosclerosis via the regulation of DNMT1-mediated ERBB4 promoter methylation
  90. The identification of novel missense variant in ChAT gene in a patient with gestational diabetes denotes plausible genetic association
  91. Molecular genotyping of multi-system rare blood types in foreign blood donors based on DNA sequencing and its clinical significance
  92. Exploring the role of succinyl carnitine in the association between CD39⁺ CD4⁺ T cell and ulcerative colitis: A Mendelian randomization study
  93. Dexmedetomidine suppresses microglial activation in postoperative cognitive dysfunction via the mmu-miRNA-125/TRAF6 signaling axis
  94. Analysis of serum metabolomics in patients with different types of chronic heart failure
  95. Diagnostic value of hematological parameters in the early diagnosis of acute cholecystitis
  96. Pachymaran alleviates fat accumulation, hepatocyte degeneration, and injury in mice with nonalcoholic fatty liver disease
  97. Decrease in CD4 and CD8 lymphocytes are predictors of severe clinical picture and unfavorable outcome of the disease in patients with COVID-19
  98. METTL3 blocked the progression of diabetic retinopathy through m6A-modified SOX2
  99. The predictive significance of anti-RO-52 antibody in patients with interstitial pneumonia after treatment of malignant tumors
  100. Exploring cerebrospinal fluid metabolites, cognitive function, and brain atrophy: Insights from Mendelian randomization
  101. Development and validation of potential molecular subtypes and signatures of ocular sarcoidosis based on autophagy-related gene analysis
  102. Widespread venous thrombosis: Unveiling a complex case of Behçet’s disease with a literature perspective
  103. Uterine fibroid embolization: An analysis of clinical outcomes and impact on patients’ quality of life
  104. Discovery of lipid metabolism-related diagnostic biomarkers and construction of diagnostic model in steroid-induced osteonecrosis of femoral head
  105. Serum-derived exomiR-188-3p is a promising novel biomarker for early-stage ovarian cancer
  106. Enhancing chronic back pain management: A comparative study of ultrasound–MRI fusion guidance for paravertebral nerve block
  107. Peptide CCAT1-70aa promotes hepatocellular carcinoma proliferation and invasion via the MAPK/ERK pathway
  108. Electroacupuncture-induced reduction of myocardial ischemia–reperfusion injury via FTO-dependent m6A methylation modulation
  109. Hemorrhoids and cardiovascular disease: A bidirectional Mendelian randomization study
  110. Cell-free adipose extract inhibits hypertrophic scar formation through collagen remodeling and antiangiogenesis
  111. HALP score in Demodex blepharitis: A case–control study
  112. Assessment of SOX2 performance as a marker for circulating cancer stem-like cells (CCSCs) identification in advanced breast cancer patients using CytoTrack system
  113. Risk and prognosis for brain metastasis in primary metastatic cervical cancer patients: A population-based study
  114. Comparison of the two intestinal anastomosis methods in pediatric patients
  115. Factors influencing hematological toxicity and adverse effects of perioperative hyperthermic intraperitoneal vs intraperitoneal chemotherapy in gastrointestinal cancer
  116. Endotoxin tolerance inhibits NLRP3 inflammasome activation in macrophages of septic mice by restoring autophagic flux through TRIM26
  117. Review Articles
  118. The effects of enhanced external counter-pulsation on post-acute sequelae of COVID-19: A narrative review
  119. Diabetes-related cognitive impairment: Mechanisms, symptoms, and treatments
  120. Microscopic changes and gross morphology of placenta in women affected by gestational diabetes mellitus in dietary treatment: A systematic review
  121. Review of mechanisms and frontier applications in IL-17A-induced hypertension
  122. Research progress on the correlation between islet amyloid peptides and type 2 diabetes mellitus
  123. The safety and efficacy of BCG combined with mitomycin C compared with BCG monotherapy in patients with non-muscle-invasive bladder cancer: A systematic review and meta-analysis
  124. The application of augmented reality in robotic general surgery: A mini-review
  125. The effect of Greek mountain tea extract and wheat germ extract on peripheral blood flow and eicosanoid metabolism in mammals
  126. Neurogasobiology of migraine: Carbon monoxide, hydrogen sulfide, and nitric oxide as emerging pathophysiological trinacrium relevant to nociception regulation
  127. Plant polyphenols, terpenes, and terpenoids in oral health
  128. Laboratory medicine between technological innovation, rights safeguarding, and patient safety: A bioethical perspective
  129. End-of-life in cancer patients: Medicolegal implications and ethical challenges in Europe
  130. The maternal factors during pregnancy for intrauterine growth retardation: An umbrella review
  131. Intra-abdominal hypertension/abdominal compartment syndrome of pediatric patients in critical care settings
  132. PI3K/Akt pathway and neuroinflammation in sepsis-associated encephalopathy
  133. Screening of Group B Streptococcus in pregnancy: A systematic review for the laboratory detection
  134. Giant borderline ovarian tumours – review of the literature
  135. Leveraging artificial intelligence for collaborative care planning: Innovations and impacts in shared decision-making – A systematic review
  136. Cholera epidemiology analysis through the experience of the 1973 Naples epidemic
  137. Case Reports
  138. Delayed graft function after renal transplantation
  139. Semaglutide treatment for type 2 diabetes in a patient with chronic myeloid leukemia: A case report and review of the literature
  140. Diverse electrophysiological demyelinating features in a late-onset glycogen storage disease type IIIa case
  141. Giant right atrial hemangioma presenting with ascites: A case report
  142. Laser excision of a large granular cell tumor of the vocal cord with subglottic extension: A case report
  143. Rapid Communication
  144. Biological properties of valve materials using RGD and EC
  145. Letter to the Editor
  146. Role of enhanced external counterpulsation in long COVID
  147. Expression of Concern
  148. Expression of concern “A ceRNA network mediated by LINC00475 in papillary thyroid carcinoma”
  149. Expression of concern “Notoginsenoside R1 alleviates spinal cord injury through the miR-301a/KLF7 axis to activate Wnt/β-catenin pathway”
  150. Expression of concern “circ_0020123 promotes cell proliferation and migration in lung adenocarcinoma via PDZD8”
  151. Corrigendum
  152. Corrigendum to “Empagliflozin improves aortic injury in obese mice by regulating fatty acid metabolism”
  153. Corrigendum to “Comparing the therapeutic efficacy of endoscopic minimally invasive surgery and traditional surgery for early-stage breast cancer: A meta-analysis”
  154. Corrigendum to “The progress of autoimmune hepatitis research and future challenges”
  155. Retraction
  156. Retraction of “miR-654-5p promotes gastric cancer progression via the GPRIN1/NF-κB pathway”
  157. Special Issue Advancements in oncology: bridging clinical and experimental research - Part II
  158. Unveiling novel biomarkers for platinum chemoresistance in ovarian cancer
  159. Lathyrol affects the expression of AR and PSA and inhibits the malignant behavior of RCC cells
  160. The era of increasing cancer survivorship: Trends in fertility preservation, medico-legal implications, and ethical challenges
  161. Bone scintigraphy and positron emission tomography in the early diagnosis of MRONJ
  162. Meta-analysis of clinical efficacy and safety of immunotherapy combined with chemotherapy in non-small cell lung cancer
  163. Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part IV
  164. Exploration of mRNA-modifying METTL3 oncogene as momentous prognostic biomarker responsible for colorectal cancer development
  165. Special Issue The evolving saga of RNAs from bench to bedside - Part III
  166. Interaction and verification of ferroptosis-related RNAs Rela and Stat3 in promoting sepsis-associated acute kidney injury
  167. Special Issue Exploring the biological mechanism of human diseases based on MultiOmics Technology - Part II
  168. Dynamic changes in lactate-related genes in microglia and their role in immune cell interactions after ischemic stroke
  169. A prognostic model correlated with fatty acid metabolism in Ewing’s sarcoma based on bioinformatics analysis
  170. Special Issue Diabetes
  171. Nutritional risk assessment and nutritional support in children with congenital diabetes during surgery
  172. Correlation of the differential expressions of RANK, RANKL, and OPG with obesity in the elderly population in Xinjiang
  173. Special Issue Biomarker Discovery and Precision Medicine
  174. CircASH1L-mediated tumor progression in triple-negative breast cancer: PI3K/AKT pathway mechanisms
Heruntergeladen am 10.9.2025 von https://www.degruyterbrill.com/document/doi/10.1515/med-2024-1127/html
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