Objective: To investigate the clinical value of preoperative serum levels of carbohydrate antigens (CA19-9, CA50, CA242, CA125) and carcino-embryonic antigen (CEA) in predicting resectability of pancreatic head cancer. Methods: The clinical data of 104 patients with cancer in the head of the pancreas admitted between January 2014 and December 2015 were analyzed retrospectively. The serum tumor markers associated with the resectability of pancreatic head cancer were picked up, and their predictive values for the resectability of pancreatic head cancer were determined by receiver operating characteristic curve (ROC) and the area under ROC curve (AUC). Results: All the 104 patients received surgical exploration, by which, the tumors in 54 cases were considered resectable (resectable group), and in 50 cases were unresectable (unresectable group). The preoperative serum CA50 and CEA levels showed significant difference between the two groups (both P>0.05), while the preoperative serum CA19-9, CA242 and CA125 levels in unresectable group were significantly higher than those in resectable group (317.99 kU/L vs. 152.98 kU/L; 67.81 kU/L vs. 39.36 kU/L; 71.53 kU/L vs. 29.22 kU/L, all P<0.05). ROC analysis showed that both CA19-9 and CA125 had predictive significance for the resectability of pancreatic head cancer, with the optimal cut-off value of 236.13 kU/L and 16.44 kU/L, and AUC of 0.667 and 0.678 respectively, while lone detection of CA242 had no predictive significance for the resectability of pancreatic head cancer (AUC=0.609, P=0.085). The sensitivity and specificity for predicting resectability of pancreatic head cancer were increased by combined detection of CA19-9 and CA125. Conclusion: Preoperative serum CA19-9 and CA125 levels can be used as auxiliary indicators for estimating the resectability of pancreatic head cancer, and their combined detection may increase the diagnostic sensitivity and specificity.

Objective: To investigate the expression and action of long non-coding RNA XIST in pancreatic cancer tissue. Methods: The XIST expressions in specimens of 56 paired pancreatic cancer and adjacent normal pancreatic tissues as well as in normal human pancreatic duct epithelial cells (HPDE) and 7 different pancreatic cancer cell lines (sPC-3, BxPC-3, Capan-1, CFPAC-1, Hs766T, Panc-1 and SW1990) were examined by real-time quantitative PCR. The relations of XIST expression with the clinicopathologic factors of pancreatic cancer patients were analyzed; in pancreatic cancer cells with high XIST expression after interference by XIST siRNA, the viability and proliferation were detected by MTT and BrdU assay, and protein expressions of Ki-67 and PCNA were determined by Western blot analysis. Results: The XIST expression in pancreatic cancer tissue was significantly higher than that in adjacent normal pancreatic tissues (2.452 vs. 0.9729, P<0.001), and high XIST expression was significantly associated with tumor stage (P=0.016) and lymph node metastasis (P=0.032) of the patients. The XIST expression levels in all 7 types of pancreatic cell lines were significantly higher than that in HPDE cells (all P<0.05), in which, XIST expression level was about 2.5-fold higher in SW1990 cells than that in HPDE cells. In SW1990 cells after XIST siRNA interference for 48 h compared with untreated SW1990 cells, the viability (0.812 vs. 1.215) and proliferation ability (0.708 vs. 1.007) were significantly reduced, and protein expressions of Ki-67 ((0.467 vs. 1.027) ) and PCNA (0.600 vs. 0.997) were significantly down-regulated (all P<0.05). Conclusion: XIST expression is increased in pancreatic cancer tissue and its overexpression can promote the growth of pancreatic cancer cells, and the mechanism may be associated with its regulating Ki-67 and PCNA expressions.

Objective: To investigate the factors for Budd-Chiari syndrome (BCS) with complicated portal vein thrombosis (PVT) . Methods: The clinical data of 28 patients diagnosed as BCS with complicated PVT (PVT group) in the First Affiliated Hospital of Zhengzhou University from January in 2010 to December 2015, and 40 patients diagnosed as BCS without PVT (non-PVT group) in the same period by random pick were retrospectively analyzed. The risk factors for BCS with complicated PVT were screened by univariate analysis and unconditional Logistic regression model. The diagnostic efficiency of each risk factor was analyzed by receiver operating characteristic curve (ROC) and the area under ROC curve (AUC), and their optimal cut-off values were also determined. Results: Univariate analysis showed that the velocity of the portal vein blood flow and the hemoglobin level were significantly lower and the D-dimer (DD) level and splenic thickness were significantly higher in PVT group than those in non-PVT group (all P<0.05); the results of unconditional Logistic regression model analysis identified that DD level, velocity of the portal vein blood flow and splenic thickness were independent risk factors for BCS with complicated PVT (OR=31.67, 0.61 and 1.23, all P<0.05). ROC curve demonstrated that the velocity of the portal vein blood flow had no diagnostic value for BCS with complicated PVT (AUC<0.5), while the AUC of DD level and splenic thickness for prediction of BCS with complicated PVT was 0.724 and 0.673 with the optimal cut-off value of 0.283 μg/L and 49.5 mm, respectively. Conclusion: Serum DD level, velocity of the portal vein blood flow, and splenic thickness are independent risk factors for BCS with complicated PVT, and the possibility of PVT is increased especially in BCS patients with DD level higher than 0.283 μg/L or splenic thickness greater than 49.5 mm.