1.Relationship of immune response with intestinal flora and metabolic reprogramming in patients with non-small cell lung cancer.
Rui GUO ; Zhe HE ; Fan LIU ; Hui-Zhen PENG ; Li-Wei XING
Acta Physiologica Sinica 2025;77(2):289-299
Numerous research conducted in recent years has revealed that gut microbial dysbiosis, such as modifications in composition and activity, might influence lung tissue homeostasis through specific pathways, thereby promoting susceptibility to lung diseases. The development and progression of lung cancer, as well as the effectiveness of immunotherapy are closely associated with gut flora and metabolites, which influence immunological and inflammatory responses. During abnormal proliferation, non-small cell lung cancer cells acquire more substances and energy by altering their own metabolic pathways. Glucose and amino acid metabolism reprogramming provide tumor cells with abundant ATP, carbon, and nitrogen sources, respectively, providing optimal conditions for tumor cell proliferation, invasion, and immune escape. This article reviews the relationship of immune response with gut flora and metabolic reprogramming in non-small cell lung cancer, and discusses the potential mechanisms by which gut flora and metabolic reprogramming affect the occurrence, development, and immunotherapy of non-small cell lung cancer, in order to provide new ideas for precision treatment of lung cancer patients.
Humans
;
Gastrointestinal Microbiome/immunology*
;
Carcinoma, Non-Small-Cell Lung/therapy*
;
Lung Neoplasms/therapy*
;
Immunotherapy
;
Metabolic Reprogramming
2.Clinical Characteristics and Risk Factors of Coronary Artery Disease in Patients with Hypertension and Persistent Atrial Fibrillation.
Jia-Qi BAI ; Yi-Ning LIU ; Rui-Zhe LI ; Zong-Bin LI
Chinese Medical Sciences Journal 2025;40(3):171-179
BACKGROUND AND OBJECTIVE: Hypertension (HT) and atrial fibrillation (AF) are highly prevalent cardiovascular conditions that frequently coexist. Coronary artery disease (CAD) is a major global cause of mortality. The co-occurrence of HT, AF, and CAD presents significant management challenges. This study aims to explore the clinical characteristics and risk factors associated with CAD in patients with HT and persistent AF (HT-AF). METHODS: In this retrospective cross-sectional study, data were collected from 384 hospitalized HT-AF patients at the People's Liberation Army General Hospital between January 2010 and December 2019. CAD diagnosis was confirmed by coronary angiography or computed tomography angiography. Clinical characteristics and comorbidities were compared between patients with and without CAD. Multivariate logistic regression analyses were performed to identify independent risk factors associated with CAD development. RESULTS: The prevalence of CAD among HT-AF patients was 66.41% (255/384). Cardiovascular complications, particularly heart failure (44.7% vs 25.6%, P < 0.05), were significantly more prevalent in the CAD group than in the non-CAD group. Only age was identified as an independent risk factor for CAD (adjusted OR: 1.047; 95% CI: 1.022-1.073; P = 0.000). Of all HT-AF patients, 54.7% had a CHA2DS2-VASc score of ≥4, indicating high stroke risk. There was a slightly higher anticoagulant usage rate in the CAD group than those without CAD (8.6% vs 4.7%, P = 0.157), and the overall anticoagulant usage remained low. CONCLUSION: There is a high prevalence of CAD among hospitalized HT-AF patients, among whom age is the sole independent risk factor for CAD. Despite a high stroke risk, the utilization of oral anticoagulants is alarmingly low.
Humans
;
Atrial Fibrillation/epidemiology*
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Coronary Artery Disease/etiology*
;
Hypertension/epidemiology*
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Male
;
Female
;
Risk Factors
;
Middle Aged
;
Retrospective Studies
;
Cross-Sectional Studies
;
Aged
;
Prevalence
3.Predictive value of bpMRI for pelvic lymph node metastasis in prostate cancer patients with PSA≤20 μg/L.
Lai DONG ; Rong-Jie SHI ; Jin-Wei SHANG ; Zhi-Yi SHEN ; Kai-Yu ZHANG ; Cheng-Long ZHANG ; Bin YANG ; Tian-Bao HUANG ; Ya-Min WANG ; Rui-Zhe ZHAO ; Wei XIA ; Shang-Qian WANG ; Gong CHENG ; Li-Xin HUA
National Journal of Andrology 2025;31(5):426-431
Objective: The aim of this study is to explore the predictive value of biparametric magnetic resonance imaging(bpMRI)for pelvic lymph node metastasis in prostate cancer patients with PSA≤20 μg/L and establish a nomogram. Methods: The imaging data and clinical data of 363 patients undergoing radical prostatectomy and pelvic lymph node dissection in the First Affiliated Hospital of Nanjing Medical University from July 2018 to December 2023 were retrospectively analyzed. Univariate analysis and multivariate logistic regression were used to screen independent risk factors for pelvic lymph node metastasis in prostate cancer, and a nomogram of the clinical prediction model was established. Calibration curves were drawn to evaluate the accuracy of the model. Results: Multivariate logistic regression analysis showed extrocapusular extension (OR=8.08,95%CI=2.62-24.97, P<0.01), enlargement of pelvic lymph nodes (OR=4.45,95%CI=1.16-17.11,P=0.030), and biopsy ISUP grade(OR=1.97,95%CI=1.12-3.46, P=0.018)were independent risk factors for pelvic lymph node metastasis. The C-index of the prediction model was 0.834, which indicated that the model had a good prediction ability. The actual value of the model calibration curve and the prediction probability of the model fitted well, indicating that the model had a good accuracy. Further analysis of DCA curve showed that the model had good clinical application value when the risk threshold ranged from 0.05 to 0.70.Conclusion: For prostate cancer patients with PSA≤20 μg/L, bpMRI has a good predictive value for the pelvic lymph node metastasis of prostate cancer with extrocapusular extension, enlargement of pelvic lymph nodes and ISUP grade≥4.
Humans
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Male
;
Prostatic Neoplasms/diagnostic imaging*
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Lymphatic Metastasis
;
Retrospective Studies
;
Nomograms
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Prostate-Specific Antigen/blood*
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Lymph Nodes/pathology*
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Pelvis
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Predictive Value of Tests
;
Prostatectomy
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Lymph Node Excision
;
Risk Factors
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Magnetic Resonance Imaging
;
Logistic Models
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Middle Aged
;
Aged
4.Development of a High-throughput Sequencing Platform for Detection of Viral Encephalitis Pathogens Based on Amplicon Sequencing
Li Ya ZHANG ; Zhe Wen SU ; Chen Rui WANG ; Yan LI ; Feng Jun ZHANG ; Hui Sheng LIU ; He Dan HU ; Xiao Chong XU ; Yu Jia YIN ; Kai Qi YIN ; Ying HE ; Fan LI ; Hong Shi FU ; Kai NIE ; Dong Guo LIANG ; Yong TAO ; Tao Song XU ; Feng Chao MA ; Yu Huan WANG
Biomedical and Environmental Sciences 2024;37(3):294-302
Objective Viral encephalitis is an infectious disease severely affecting human health.It is caused by a wide variety of viral pathogens,including herpes viruses,flaviviruses,enteroviruses,and other viruses.The laboratory diagnosis of viral encephalitis is a worldwide challenge.Recently,high-throughput sequencing technology has provided new tools for diagnosing central nervous system infections.Thus,In this study,we established a multipathogen detection platform for viral encephalitis based on amplicon sequencing. Methods We designed nine pairs of specific polymerase chain reaction(PCR)primers for the 12 viruses by reviewing the relevant literature.The detection ability of the primers was verified by software simulation and the detection of known positive samples.Amplicon sequencing was used to validate the samples,and consistency was compared with Sanger sequencing. Results The results showed that the target sequences of various pathogens were obtained at a coverage depth level greater than 20×,and the sequence lengths were consistent with the sizes of the predicted amplicons.The sequences were verified using the National Center for Biotechnology Information BLAST,and all results were consistent with the results of Sanger sequencing. Conclusion Amplicon-based high-throughput sequencing technology is feasible as a supplementary method for the pathogenic detection of viral encephalitis.It is also a useful tool for the high-volume screening of clinical samples.
5.To explore the mechanism of acetaminophen liver injury in children based on MCJ as the target
Zhe LI ; Liu JI ; Rui WANG ; Li WANG ; Hua LI
Chinese Journal of Postgraduates of Medicine 2024;47(11):1013-1019
Objective:To explore the characteristics of drug-induced liver injury induced by acetaminophen (APAP) in children, and to clarify the mechanism of improving APAP liver injury in children on targeting MCJ.Methods:The C57BL/6 young and adult mice and mouse liver parenchymal AML-12 cells were used in the prospective study. Forty C57BL/6 young mice of 3 to 4 weeks and 40 C57BL/6 adult mice of 6 to 8 weeks were randomly divided into 5 groups (control 0 h group, APAP 3 h group, APAP 6 h group, APAP 12 h group, APAP 24 h group), 8 rats in each group and intraperitoneally injected with APAP (300 mg/kg) to replicate drug-induced liver injury (DILI) model. The serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were detected. Hematoxylin-eosin staining (H&E) staining was used to observe the pathological change of liver tissue. The oxidative damage indexes lactate dehydrogenase (LDH), malondialdehyde (MDA), glutathione (GSH), superoxide dismutase (SOD) of liver tissue homogenate were detected. The expression of MCJ protein was detected by Western blot. Mouse liver parenchymal AML-12 cells were transfected with MCJ interference sequence and APAP to construct hepatocyte injury model. Hepatocyte viability, LDH and SOD levels were measured.Results:As shown in the animals results, after 3 h of APAP administration, ALT and AST levels were increased significantly in young mice, compared with adult mice: (105.25 ± 18.38) U/L vs. (37.38 ± 15.75) U/L, (87.38 ± 30.68) U/L vs. (28.50 ± 19.44)U/L, which suggested that the time liver necrosis occurred in young mice was earlier than that of adult mice. Moreover, the levels of LDH and MDA were significantly increased, while GSH and SOD were significantly decreased after 3 h of APAP in young mice, compared with adult mice, (1 231.38 ± 183.94) U/L vs. (810.50 ± 190.64) U/L, (19.63 ± 3.58) nmol/mg vs. (16.50 ± 3.51) nmol/mg, (39.75 ± 4.62) nmol/mg vs. (53.63 ± 13.07) nmol/mg, (51.38 ± 6.37)% vs. (63.25 ± 9.13)% ( P<0.01), and the levels of MCJ protein were significantly increased. After MCJ knockdown, hepatocyte viability and LDH, SOD levels of mouse liver parenchymal AML-12 cells were significantly improved compared with APAP model group ( P<0.01). Conclusions:APAP liver injury was more common in young mice than in adult mice. Knockdown MCJ expression may ameliorate APAP liver injury in young mice. MCJ may serve as a target for early intervention of APAP liver injury in children, which provide new therapeutic targets and strategies for APAP liver injury in children.
6.Alterations in functional complexity of brain regions in autism spectrum disorder patients and correlations with the predicted brain age
Tianzi MENG ; Heran LI ; Shuting LIU ; Zhe LIU ; Yingnan WANG ; Rui LYU ; Haichen ZHAO ; Guangyu ZHANG ; Lemin HE ; Zhen ZHANG ; Xiaotao CAI
Chinese Journal of Medical Imaging Technology 2024;40(9):1319-1322
Objective To observe the alterations in functional complexity of brain regions in autism spectrum disorder(ASD)patients and correlations with the predicted brain age.Methods Open brain resting-state functional MRI(rs-MRI)data of 93 ASD patients and 96 typically developing adolescents(healthy subjects)were downloaded.The functional complexity in brain regions were extracted with self-developed virtual digital brain software,and the alterations in functional complexity of brain regions in ASD patients and correlations with their ages were analyzed.Two networks were prospectively trained with data of 65 ASD patients and 67 healthy subjects as the training set to predict brain age,and the results were evaluated,and the predicting errors were compared using test set,i.e.the other 28 ASD patients and 29 healthy subjects.Results Compared to healthy subjects,on the basis of anatomical automatic labeling(AAL)atlas,ASD patients exhibited significantly reduced functional complexity based on Shannon entropy in the left precuneus,left cuneus and right parahippocampal gyrus.Conversely,functional complexity of ASD patients based on permutation entropy significantly increased in the left cuneus and right cerebellar Crus Ⅱ region.The left hippocampus showed reduced functional complexity based on Pearson correlation coefficient,while the left middle temporal gyrus showed increased functional complexity based on Pearson correlation coefficient.The functional complexity in brain regions of ASD patients were not closely correlated with ages(all|r|<0.4).According to the trained fully connected network,the predicted brain ages of ASD patients and healthy subjects in test set were all lower than their physiological ages,but no significant difference was found between the prediction errors of ASD patients and healthy subjects(P=0.283).Conclusion Functional complexity changed in some brain region functions in ASD patients.The predicted brain ages of ASD patients based on the obtained fully connected network were on the low side,but not obviously affected by the alterations of functional complexity in brain regions.
7.Research progress of antibody technology in rapid detection of foodborne pathogens.
Meilin QUAN ; Fei LI ; Jinyan LIU ; Tingting WANG ; Rui NIAN ; Wenshuai LIU ; Ming ZHANG ; Zhe CHI
Chinese Journal of Biotechnology 2024;40(11):3985-4005
Foodborne pathogens are one of the major factors leading to food safety issues, causing harm to the national economy and people's livelihood. Achieving rapid detection of foodborne pathogens is currently a key strategy for preventing and controlling foodborne diseases. Antibodies naturally possess high specificity and sensitivity, serving as preferred tools for specific recognition of foodborne pathogens. We list the main methods for detecting foodborne pathogens, introduce the evolution and development of polyclonal antibodies, monoclonal antibodies, and genetically engineered antibodies, and review the application of different antibody technologies in the rapid detection of foodborne pathogens. Furthermore, we recognize that the combination of antibody technology and other foodborne pathogen detection methods is currently a reliable means to improve detection performance. Finally, we elaborate on the existing limitations of different antibodies and summarize the current research status and potential issues, aiming to provide a theoretical basis and practical ideas for the development of rapid detection of foodborne pathogens.
Foodborne Diseases/prevention & control*
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Food Microbiology
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Antibodies, Monoclonal/biosynthesis*
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Antibodies/immunology*
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Humans
;
Food Contamination/analysis*
8.Effects of staged acupuncture on endometrial receptivity and anxiety in patients with recurrent implantation failure of thin endometrium based on "thoroughfare vessel is the sea of blood" theory.
Li-Wei XING ; Zhe HE ; Yu-Huan SUN ; Ming HE ; Shun YU ; Yang CHEN ; Jin-Long XU ; Rui MEI ; Rong ZHAO
Chinese Acupuncture & Moxibustion 2023;43(3):289-293
OBJECTIVE:
To compare the clinical efficacy between staged acupuncture based on "thoroughfare vessel is the sea of blood" theory combined with routine hormone replacement cycle treatment and routine hormone replacement cycle treatment for patients with recurrent implantation failure (RIF) of thin endometrium.
METHODS:
A total of 72 RIF patients with thin endometrium were randomly divided into an observation group and a control group, 36 cases in each group. The patients in the control group were treated with routine hormone replacement cycle treatment. Based on the treatment of the control group, the patients in the observation group were treated with staged acupuncture based on "thoroughfare vessel is the sea of blood" theory. The main acupoints were Neiguan (PC 6) and Gongsun (SP 4), and the supplementary acupoints were selected according to the menstrual cycle and syndrome differentiation; the acupuncture was given once every other day, 3 times a week, for 3 consecutive menstrual cycles. The thickness and shape of endometrium, and Hamilton anxiety scale (HAMA) score were observed at implantation window before and after treatment; the clinical pregnancy rate, live birth rate and cycle cancellation rate were compared between the two groups; the correlation between endometrial thickness and HAMA score was analyzed.
RESULTS:
Compared before treatment, the endometrial thickness in the two groups and the proportion of type A+B endometrium in the observation group were increased (P<0.05), and the HAMA scores in the two groups were decreased (P<0.05) after treatment. The above indexes in the observation group were superior to those in the control group (P<0.05). The clinical pregnancy rate and live birth rate in the observation group were higher than those in the control group (P<0.05), and the cycle cancellation rate was lower than that in the control group (P<0.05). There was a negative correlation between endometrial thickness and HAMA score (P<0.05).
CONCLUSION
Based on the routine hormone replacement cycle treatment, the addition use of staged acupuncture based on "thoroughfare vessel is the sea of blood" theory could improve the thickness and shape of endometrium, relieve anxiety, increase the clinical pregnancy rate and live birth rate, and reduce the cycle cancellation rate in RIF patients with thin endometrium. The curative effect is superior to the routine hormone replacement cycle treatment alone.
Female
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Pregnancy
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Humans
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Anxiety
;
Anxiety Disorders
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Acupuncture Therapy
;
Endometrium
;
Hormones
9.Analysis of the relationship between PI-RADS scores and the pathological results of targeted biopsy based on MRI.
Ya Min WANG ; Jin Wei SHANG ; Lai DONG ; Ling Hui LIANG ; Rui Zhe ZHAO ; Chao LIANG ; Shang Qian WANG ; Wei XIA ; Gong CHENG ; Li Xin HUA
Chinese Journal of Oncology 2023;45(11):942-947
Objective: To analyze the relationship between Prostate Imaging Reporting and Data System (PI-RADS) scores and the pathological results of transperineal magnetic resonance-ultrasound fusion guided biopsy. Methods: The clinical data, magnetic resonance imaging (MRI) results and prostate puncture biopsies of 517 patients who were assigned to PI-RADS score of 4 or 5 and underwent transperineal magnetic resonance-ultrasound fusion guided biopsy at The First Affiliated Hospital of Nanjing Medical University from June 2019 to March 2022 were retrospectively analyzed. Patients were divided into the PI-RADS 4 and PI-RADS 5 groups according to their PI-RADS scores and were stratified by their prostate specific antigen (PSA) values (PSA<10 ng/ml vs. PSA 10-20 ng/ml). The pathological negative rates from the biopsy, the distribution of the grade groups according to the grading system by World Health Organization/International Society of Urological Pathology (WHO/ISUP), the detection rates of prostate cancer (PCa) and clinically significant prostate cancer (CsPCa)between the groups were compared. Results: 369 patients with a PI-RADS score of 4 and 148 patients with a PI-RADS score of 5 were included in our research. The overall detection rates of PCa and CsPCa were 77.8% (402/517) and 66.7% (345/517), respectively. In the PI-RADS 4 group, patients with prostate negative biopsies or in WHO/ISUP 1, 2, 3, 4, or 5 grade groups accounted for 28.2%, 12.7%, 20.1%, 17.1%, 18.4% and 3.5%, respectively, whereas in the PI-RADS 5 group the rates were 7.4%, 6.8%, 22.3%, 22.3%, 26.4%, and 14.9%, respectively. The difference was statistically significant (P<0.001). The detection rates of PCa and CsPCa in the PI-RADS 4 group [71.8% (265/369) vs. 59.1% (218/369), P<0.001] were lower than those of the PI-RADS 5 group [92.6% (137/148) vs. 85.8% (127/148), P<0.001]. In the PI-RADS 4 group, the proportion of patients classified into WHO/ISUP 4-5 grade groups was lower than that of patients in the PI-RADS 5 group [22.0% (81/369) vs 41.2% (61/148) (P<0.001)]. The detection rates of PCa and CsPCa in the PSA<10 ng/ml stratification were less than that in the PSA 10-20 ng/ml stratification[74.1% (281/379) vs. 87.7% (121/138), P=0.001], and [60.9% (231/379) vs. 82.6% (114/138), P<0.001]. For patients with PSA<10 ng/ml, the detection rates of PCa and CsPCa in the PI-RADS 4 group were less than those in the PI-RADS5 group [70.9% (217/306) vs. 87.7% (64/73), P=0.003], and [56.2% (172/306) vs. 80.8% (59/73), P<0.001]. For those with a PSA value of 10-20 ng/ml, the detection rates of PCa and CsPCa in the PI-RADS 4 group were less than those in the PI-RADS 5 group [76.2% (48/63) vs. 97.3% (73/75), P<0.001], and [73.0% (46/63) vs. 90.7% (68/75), P=0.006]. There were statistically significant differences in the proportions of patients with prostate negative biopsy and those falling into WHO/ISUP grade groups 1, 2, 3, 4, or 5 (P<0.001) between the PI-RADS 4 group and the PI-RADS 5 group in both stratifications. Conclusions: In this study, the detection rates of CsPCa and PCa in the PI-RADS 4 group were less than those in the PI-RADS 5 group. With the increase of PI-RADS scores, the detection rate of high-grade PCa increased. The same results held for patients with PSA<10 ng/ml or with PSA 10-20 ng/ml.
Male
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Humans
;
Prostatic Neoplasms/pathology*
;
Prostate-Specific Antigen/analysis*
;
Magnetic Resonance Imaging/methods*
;
Retrospective Studies
;
Image-Guided Biopsy/methods*
10.Evaluation of the application value of seven tumor-associated autoantibodies in non-small cell lung cancer based on machine learning algorithms.
Ying HAO ; Li Na WU ; Yi Tong LYU ; Yu Zhe LIU ; Xiao Song QIN ; Rui ZHENG
Chinese Journal of Preventive Medicine 2023;57(11):1827-1838
Objective: Based on the diagnostic model established and validated by the machine learning algorithm, to investigate the value of seven tumor-associated autoantibodies (TAABs), namely anti-p53, PGP9.5, SOX2, GAGE7, GBU4-5, MAGEA1 and CAGE antibodies in the diagnosis of non-small cell lung cancer (NSCLC) and to differentiate between NSCLC and benign lung nodules. Methods: This was a retrospective study of clinical cases. Model building queue: a total of 227 primary patients who underwent radical lung cancer surgery in the Department of Thoracic Surgery, Shengjing Hospital of China Medical University, from November 2018 to June 2021 were collected as the NSCLC group, and 120 cases of benign lung nodules, 122 cases of pneumonia and 120 healthy individuals were selected as the control groups. External validation queue: a total of 100 primary patients who underwent radical lung cancer surgery in the Department of Thoracic Surgery, Shengjing Hospital of China Medical University, from May 2022 to December 2022 were collected as the NSCLC group, and 36 cases of benign lung nodules, 32 cases of pneumonia and 44 healthy individuals were selected as the control groups. In addition, NSCLC was divided into early (stage 0-ⅠB) and mid-to-late (stage ⅡA-ⅢB) subgroups. The levels of 7-TAABs were detected by enzyme immunoassay, and serum concentrations of CEA and CYFRA21-1 were detected by electrochemiluminescence. Four machine learning algorithms, XGBoost, Lasso logistic regression, Naïve Bayes, and Support Vector Machine are used to establish classification models. And the best performance model was chosen based on evaluation metrics and a multi-indicator combination model was established. In addition, an online risk evaluation tool was generated to assist clinical applications. Results: Except for p53, the levels of rest six TAABs, CEA and CYFRA21-1 were significantly higher in the NSCLC group (P<0.05). Serum levels of anti-SOX2 [1.50 (0.60, 10.85) U/ml vs. 0.8 (0.20, 2.10) U/ml, Z=2.630, P<0.05] and MAGEA1 antibodies [0.20 (0.10, 0.43) U/ml vs. 0.10 (0.10, 0.20) U/ml, Z=2.289, P<0.05], CEA [3.13 (2.12, 5.64) ng/ml vs. 2.11 (1.25, 3.09) ng/ml, Z=3.970, P<0.05] and CYFRA21-1 [4.31(2.37, 7.14) ng/ml vs. 2.53(1.92, 3.48) ng/ml, Z=3.959, P<0.05] were significantly higher in patients with mid-to late-stage NSCLC than in early stages. XGBoost model was used to establish a multi-indicator combined detection model (after removing p53). 6-TAABs combined with CYFRA21-1 was the best combination model for the diagnosis of NSCLC and early NSCLC. The optimal diagnostic thresholds were 0.410, 0.701 and 0.744, and the AUC was 0.828, 0.757 and 0.741, respectively (NSCLC vs. control, NSCLC vs. benign lung nodules, early NSCLC vs. benign lung nodules) in model building queue, and the AUC was 0.760, 0.710 and 0.660, respectively (NSCLC vs. control, NSCLC vs. benign lung nodules, early NSCLC vs. benign lung nodules) in external validation queue. Conclusion: In the diagnosis of NSCLC, 6-TAABs is superior to that of traditional tumor markers CEA and CYFRA21-1, and can compensate for the shortcomings of traditional tumor markers. For the differential diagnosis of NSCLC and benign lung nodule, "6-TAABs+CYFRA21-1" is the most cost-effective combination, and plays an important role in prevention and screening for early lung cancer.
Humans
;
Carcinoma, Non-Small-Cell Lung/surgery*
;
Lung Neoplasms/diagnosis*
;
Retrospective Studies
;
Autoantibodies
;
Bayes Theorem
;
Tumor Suppressor Protein p53
;
Carcinoembryonic Antigen
;
Antigens, Neoplasm
;
Biomarkers, Tumor
;
Algorithms
;
Pneumonia

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