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| 1 | CA19-9 antigen levels can distinguish between benign and malignant pancreaticobiliary disease显示文摘BACKGROUND:CA19-9 is a carbohydrate tumor-associated antigen which is frequently upregulated in pancreatobiliary neoplasia.However,it may also be elevated in patients with jaundice in the absence of a tumor due to biliary obstruction,and in other non-hepato-pancreatico-biliary conditions.This study aimed to evaluate whether CA19-9 levels could accurately differentiate between benign and malignant pancreatobiliary disease.METHODS:All patients referred to a single surgeon for investigation of pancreaticobiliary disease in 2003 in whom a firm diagnosis had been established were included.For malignant disease,a histological diagnosis was required but for benign disease a firm radiological diagnosis was deemed adequate.The patients were divided into 4 categories:pancreatic adenocarcinoma(PCa);cholangiocarcinoma(CCa);chronic pancreatitis(CP)and biliary calculous disease(Calc).Bilirubin and alkaline phosphatase levels corresponding to the point of assessment of CA19-9 were also noted.RESULTS:Final diagnoses were made of pancreatic adenocarcinoma(PCa,n=73),cholangiocarcinoma(CCa,n=19),ampullary carcinoma(Amp,n=7),neuroendocrine carcinoma(Neu,n=4),duodenal carcinoma(Duo,n=3),chronic pancreatitis(CP,n=115),and biliary calculous disease(Calc,n=27).Median CA19-9 levels(U/ml)were:PCa,653;CCa,408;Duo,403;Calc,27;CP,19;Neu,10.5;Amp,8(reference range:0-37).The CA19-9 levels were significantly greater for malignant than for benign disease,could differentiate PCa from CCa/Duo,and were significantly higher in unresectable than in resectable PCa.The sensitivity,specificity,positive predictive value(PPV)and negative predictive value(NPV)for CA19-9 were 84.9%,69.7%,67.7%and 86.1%,respectively.A ROC analysis provided an area under the curve for CA19-9 of 0.871(0.820-0.922),giving an optimal CA19-9 of 70.5 U/ml for differentiating benign from malignant pathology.Using this cut-off,the sensitivity was 82.1%,while specificity,PPV and NPV improved to 85.9%,81.3%and 86.5%,respectively.When standard radiology was included(US/ CT/MRCP)in the decision process,the results improved to 97.2%,88.7%,86.6%,and 97.7%.For benign disease,the CA19-9 correlated directly with the serum bilirubin,but for malignant disease,CA19-9 levels were elevated independent of the bilirubin level.CONCLUSIONS:CA19-9 is useful in the differentiation of pancreatobiliary disease and when using an optimized cut-off and combining with routine radiology,the diagnostic yield is improved significantly,thus stressing the importance of a multi-disciplinary approach to pancreatobiliary disease. | Gareth Morris-Stiff Mary Teli Nicky Jardine Malcolm CA Puntis | 2009 | Hepatobiliary & Pancreatic Diseases International2009，8，6： | 33 |
| 2 | Prognostic values of tumor endothelial markers in patients with colorectal cancer显示文摘AIM: Tumor endothelial markers (TEMs) are a newly discovered family of endothelial markers associated with tumor specificangiogenesis. This study sought to examine the levels of expression (qualitatively and quantitatively)for TEMs in human colon cancer.METHODS: Human colorectal cancer tissues (n = 48)and normal background tissues (n = 31) were obtained after surgery. RNA was extracted from frozen sections for gene amplification. The expression of TEMs (TEM-1to TEM-8) was assessed using RT-PCR and their transcript levels were determined using real-time-quantitative PCR(Q-RT-PCR).RESULTS: TEM-1 (P = 0.01), TEM-7 (P = 0.04), TEM-7R(P= 0.03), TEM-8 (P = 0.001) significantly raised in colon cancer tissues compared with the levels detected in normal background tissues. The expressions of TEM-2 and TEM-6were found to be not significantly different between tumor tissues and normal tissues (P>0.05). Patients who had cancer penetrating into and through the muscularis propria of the bowel wall and developed nodal involvement(Dukes C) exhibited significantly higher levels of TEM -8compared to patients who were node negative (P<0.05).TEM-7 and TEM-7R showed high level of transcripts in Dukes C, but they were not statistically significant.CONCLUSION: The level of the expression of TEM-1,TEM-7, TEM-7R and TEM-8 (but not TEM-2 and TEM-6)were associated with both nodal involvement and disease progression, and may therefore, have a prognostic value in colorectal cancer. | KA Rmali MCA Puntis WG Jiang | 2005 | World Journal of Gastroenterology2005，11，9： | 7 |
| 3 | Prospective multicentre randomised controlled trial of early enteral nutrition for patients undergoing major upper gastrointestinal surgical resection显示文摘 | Rachael Barlow Patricia Price Thomas D. Reid Sarah Hunt Geoffrey W.B. Clark Timothy J. Havard Malcolm C.A. Puntis Wyn G. Lewis | 2011 | Clinical Nutrition2011，，5： | 2 |
| 4 | Diagnosis,prevention,and management of catheter related bloodstream infection during long term parenteral nutrition显示文摘 | Hodge D Puntis JW | 2002 | Arch Dis Child Fetal Neonatal Ed2002，87，1： | 1 |
| 5 | Preparation and Handling of Powdered Infant Formula: A Commentary by the ESPGHAN Committee on Nutrition显示文摘 | Carlo Agostoni Irene Axelsson Olivier Goulet Berthold Koletzko Kim F. Michaelsen John W. L. Puntis Jacques Rigo Raanan Shamir Hania Szajewska Dominique Turck Yvan Vandenplas Lawrence T. Weaver | 2004 | Journal of Pediatric Gastroenterology and Nutrition2004，，4： | 1 |
| 6 | Hepatocyte growth factor/scatter factor,liver regeneration and cancer metastasis显示文摘 | Jiang WG Hallett MB Puntis MCA | 1993 | Br J Surg1993，80，11： | 1 |
| 7 | Tumour-associated angiogenesis in human colorectal cancer显示文摘 | Rmali KA Puntis MC Jiang WG | 2007 | Colorectal Dis2007，9，1： | 1 |
| 8 | Skin colonization by Malassezia in neonates and infants显示文摘 | Ashbee HR Leck AK Puntis JW | 2002 | Infect Control Hosp Epidemiol2002，23，4： | 1 |
| 9 | Tumou-associated angiogenesis in human colorectalr显示文摘 | Rmali KA Puntis MC Jiang WC | 2007 | Colorectal Dis2007，9，1： | 1 |
| 10 | Tumour-associated angiogenesis in human colorectal cancer显示文摘 | Rmali KA Puntis MC Jiang WG | 2007 | Colorectal Dis2007，9，1： | 1 |
| 11 | TEM-8 and tubule for- mation in endothelial cells, its potential role of its vW/TM do- mains显示文摘 | Rmali K A Puntis M C Jiang W G | 2005 | Bioehem Biophys Res Commun2005，334，： | 1 |
| 12 | Staff Training:a Key Factor in Reducing Intravascular Catheter Sepsis显示文摘 | Puntis J W Holden C E Smallman S | 1991 | Arch Dis Child1991，66，3： | 1 |
| 13 | The Need for Nutrition Support Teams in Pediatric Units: A Commentary by the ESPGHAN Committee on Nutrition显示文摘 | Carlo Agostoni Irene Axelsson Virginie Colomb Olivier Goulet Berthold Koletzko Kim F Michaelsen John W. L Puntis Jacques Rigo Raanan Shamir Hania Szajewska Dominique Turck | 2005 | Journal of Pediatric Gastroenterology and Nutrition2005，，1： | 1 |
| 14 | Tumour associated angiogenesis in human coloreet cancer 显示文摘 | Rmali KA Puntis MC Jiang WG | 2007 | Colorectal Dis2007，9，1： | 1 |
| 15 | Hepatocyte growth factor/scatter factor,liver regeneration and cancer metastasis显示文摘 | Jiang WG Hallett MB Puntis MCA | 1993 | Br J Surg1993，80，11： | 1 |
| 16 | Immune dysfunction in patients with obstructive jaundice,mediators and implications for treatments显示文摘 | Jiang WG Puntis MC | 1997 | HPB Surg1997，10，3： | 1 |
| 17 | Diagnosis,prevention and management of catheter related blood stream infection during long term parenteral nutrition显示文摘 | Hodge D Puntis JW | 2002 | Arch Dis Child Fetal Neonatal Ed2002，87，1： | 1 |
| 18 | Plasma cytokine levels and monocyte activation in patients with obstructive jaundice显示文摘 | Jiang WG | 1996 | J Gastroenterol Hepatol1996，11，： | 1 |
| 19 | Molecular and cellular basis of cancer invasion and metastasis: Implications for treatment 显示文摘 | Jiang WG Puntis MCA Hallett MB | 1994 | Br J Surg1994，81，11： | 1 |
| 20 | Prebiotic Oligosaccharides in Dietetic Products for Infants: A Commentary by the ESPGHAN Committee on Nutrition显示文摘 | Carlo Agostoni Irene Axelsson Olivier Goulet Berthold Koletzko Kim F. Michaelsen John W. L. Puntis Jacques Rigo Raanan Shamir Hania Szajewska Dominique Turck | 2004 | Journal of Pediatric Gastroenterology and Nutrition2004，，5： | 1 |
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