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Bin Zhu,1 Junrong Zhang,2 Qingzhu Zheng,1 Binhua Dong,3 Meihua Wang,1 Jin Liu,1 Yingping Cao1 1Department of Clinical Laboratory, Fujian Medical University Union Hospital, Fuzhou, 350001, People’s Republic of China; 2Department of Emergency Surgery, Fujian Medical University Union Hospital, Fuzhou, 350001, People’s Republic of China; 3Laboratory of Gynecologic Oncology, Fujian Provincial Maternity and Children’s Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, 350001, People’s Republic of ChinaCorrespondence: Yingping CaoDepartment of Clinical Laboratory, Fujian Medical University Union Hospital, No. 29, Xinquan Road, Fuzhou City, Fujian Province, People’s Republic of ChinaEmail caoyingping918@sina.comPurpose: The aim of our study was to identify the diagnostic ability of free fatty acids (FFAs) in younger colorectal cancer (CRC) patients by comparing carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9).Methods: Patients screened for CRC at Fujian Medical University Union Hospital from January 2011 to December 2014 were recruited. Patients pathologically diagnosed with CRC or colorectal adenoma (CA) and healthy control participants were included. The enzyme endpoint method was applied to measure FFA levels. Receiver operating characteristic (ROC) curve analysis was performed to further evaluate the diagnostic ability of FFAs.Results: FFA levels in late-stage patients (tumour-node-metastasis (TNM) stages III–IV) were higher than those in early-stage patients (TNM stages I–II) (P=0.02). The FFA levels in CRC patients were higher than those in controls of all ages, those younger than 50 years, males and females (P< 0.001), and this difference was larger for patients younger than 50 years and females than for the all ages group. There was no significant difference in the FFA level between CA patients and healthy participants (P=0.53). The area under the curve (AUC) values of FFA, CEA, CA19-9, FFA+CEA, FFA+CA19-9 and FFA+CEA+CA19-9 distinguished CRC patients from controls at all ages, with values of 0.604, 0.731, 0.640, 0.754, 0.678 and 0.758, respectively; however, in the younger CRC patients (age≤ 50), the AUC values were 0.701, 0.735, 0.669, 0.798, 0.749, and 0.801. The AUC in female patients younger than 50 years was larger than that in males (0.769 vs 0.660), and this value was greater than the value for CEA in males (0.739) and females (0.729).Conclusion: The FFA level not only can complement the predictive ability of the CEA and CA19-9 levels but also has a superior predictive ability in female and younger patients with CRC. FFA levels may have a potential role in triage screening of early CRC.Keywords: free fatty acid, colorectal cancer, colorectal adenoma, sex, younger patients

Qingwei Wu, 1, 2 Lili Yu, 1, 2 Xiaoqing Lin, 1, 2 Qingzhu Zheng, 1, 2 Songgao Zhang, 1, 2 Dunyan Chen, 1, 2 Xiaojie Pan, 1, 3 Yi Huang 1, 2, 4 1Provincial Clinical College, Fujian Medical University, Fuzhou 350001, People’s Republic of China; 2Department of Clinical Laboratory, Fujian Provincial Hospital, Fuzhou 350001, People’s Republic of China; 3Department of Thoracic Surgery, Fujian Provincial Hospital, Fuzhou 350001, People’s Republic of China; 4Center for Experimental Research in Clinical Medicine, Fujian Provincial Hospital, Fuzhou 350001, People’s Republic of ChinaCorrespondence: Yi HuangDepartment of Clinical Laboratory, Fujian Provincial Hospital, Fuzhou 350001, People’s Republic of ChinaEmail hyi8070@126.comPurpose: Circulating microRNAs (miRNAs) have shown the potential for non-invasive diagnosis of various types of malignancies at an early stage. The aim of the study was to explore the feasibility of a combination of 8 serum miRNAs related to non-small-cell lung cancer (NSCLC) with the corresponding serum exosomal miRNAs in early diagnosis for the patients with NSCLC.Methods: We measured 8 serum miRNAs and the corresponding serum exosomal miRNAs including miR-21-5p, miR-126-3p, miR-141-3p, miR-146a-5p, miR-155-5p, miR-222-3p, miR-223-3p, and miR-486-5p in 48 patients with early NSCLC at stages I/II, 32 patients with lung benign lesion (LBL), and 48 healthy control (HC) by quantitative real-time polymerase chain reaction (qRT-PCR).Results: The expression levels of 4 serum miRNAs including miR-21-5p, miR-141-3p, miR-222-3p, and miR-486-5p, and 2 serum exosomal miRNAs including miR-146a-5p and miR-486-5p in the early NSCLC group were significantly different from that in the LBL group and the HC group (P < 0.01). The areas under the receiver operating characteristic curves (AUC) of the 4 serum miRNAs and 2 serum exosomal miRNAs in the early NSCLC group were ≥ 0.697, of which serum exosomal miR-146a-5p and miR-486-5p were 0.813 and 0.886, respectively, and higher than that of the 4 serum miRNAs. Additionally, a combination of 4 serum miRNAs with 2 serum exosomal miRNAs improved the AUC to 0.960 for the patients with NSCLC at early stages, with a sensitivity of 85.42% and a specificity of 92.50%.Conclusion: This study suggests that serum exosomal miRNAs other than serum miRNAs might be preferable biomarkers for the patients with NSCLC at early stages, and a combination of serum miRNAs with serum exosomal miRNAs contributes to the further improvement of early diagnosis for NSCLC.Keywords: serum, exosome, microRNA, non-small-cell lung cancer, early diagnosis

Bin Zhu,1 Binhua Dong,2 Simei Hong,3 Meihua Wang,1 Weichao Dai,4 Qingzhu Zheng,1 Dan Wu,5 Yingping Cao1 1Department of Clinical Laboratorial Examination, Fujian Medical University Union Hospital, Fuzhou, People’s Republic of China; 2Department of Gynecology, Laboratory of Gynecologic Oncology, Fujian Provincial Maternity and Children’s Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, People’s Republic of China; 3Department of Pathology, Fujian Provincial Cancer Hospital, Fuzhou, People’s Republic of China; 4Department of Gynecology, Fujian Medical University Union Hospital, Fuzhou, People’s Republic of China; 5Department of Pathology, Fujian Medical University Union Hospital, Fuzhou, People’s Republic of ChinaCorrespondence: Yingping CaoDepartment of Clinical Laboratorial Examination, Fujian Medical University Union Hospital, NO. 29, Xinquan Road, Fuzhou City, Fujian Province, People’s Republic of ChinaTel +86-591-86218678Email caoyingping@aliyun.comBinhua DongDepartment of Gynecology, Laboratory of Gynecologic Oncology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, NO. 18, Daoshan Road, Fuzhou, Fujian 350001, People’s Republic of ChinaTel +86-591-87558732Fax +86-591-87551247Email dbh18-jy@126.comPurpose: Cervical cancer (CC) is a common malignancy in women. Squamous cell carcinoma antigen (SCC-Ag) and cancer antigen (CA)-125 are widely used to help diagnose CC, but novel tumour markers with superior sensitivity and specificity are needed. α-Actinin 4(ACTN4) is overexpressed in CC, though its diagnostic value for CC is unclear. This study examined the diagnostic value of ACTN4 and SCC-Ag as biomarkers for cervical intraepithelial neoplasia (CIN) 3 or worse.Methods: Women screened for CC at Fujian Medical University Union Hospital were recruited from 2017.1 to 2018.5. Cervical tissues and blood were collected at the same time. Patients pathologically diagnosed as CIN3+ or NILM/CIN1/CIN2 were classified into the case and control groups, respectively. ACTN4 mRNA and protein levels were detected through quantitative PCR and immunohistochemistry, respectively, and ACTN4 and SCC-Ag concentrations were analysed by ELISA. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood rate (PLR), negative likelihood rate (NLR), and Youden index (YI) of ACTN4 and SCC-Ag were evaluated. The optimum cut-off points for ACTN4 and SCC-Ag were determined by receiver operating characteristic (ROC) curve analysis, and accuracy was evaluated by the area under the ROC curve.Results: In total, 105 patients were classified as CIN3+ cases and 106 as controls. The median ACTN4 levels in case and control tissues were 10.6 and 4.15, respectively. The ACTN4 and SCC-Ag concentrations were significantly higher in cases than controls (PACTN4=0.0007; PSCC-Ag=0.0067). The sensitivity, specificity, PPV, NPV, PLR, NLR and YI of ACTN4 were 68.6%, 76.3%, 76.3%, 72.5%, 2.89, 0.41 and 44.9, respectively; SCC-Ag had a similar diagnostic value (P> 0.05), and ACTN4 combined with SCC-Ag had a superior diagnostic value (75.6%, 87.5%, 88.6%, 73.7%, 6.05, 0.28, and 63.1, respectively).Conclusion: Combined ACTN4 and SCC-Ag detection is a promising serological biomarker for patients with CIN3 or worse.Keywords: ACTN4, SCC-Ag, CIN3 or worse, serological biomarker