
原発性副甲状腺機能亢進症は、カルシウム値の上昇と副甲状腺ホルモンの相対的な上昇を特徴とする疾患である。従来の典型的な症状に加え、非典型的な症状も認められるため、慎重な病歴聴取と検査が重要である。


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That unexpected hypercalcemia could be the tipoff, but it's not always that straightforward. Bone up on these potential symptoms of primary hyperparathyroidism and the workup that should follow.

Stones, Bones, Groans, Moans: Primary Hyperparathyroidism?

原発性副甲状腺機能亢進症の診断と治療

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クッシング症候群の診断には、臨床症状、生化学検査、画像検査が重要である。適切な診断と原因の特定が治療につながる。


Your patient's "round face" might be the first clue that he or she has Cushing syndrome, but there are other symptoms as well. How can you accurately diagnose the condition?

Steps to Take for Diagnosing Cushing Syndrome

クッシング症候群の診断のための手順


2型糖尿病の管理不良患者の約4分の1に高コルチゾール血症が認められ、これらの患者に対する新たな治療アプローチが必要とされる。


Investigators in the CATALYST trial said the findings suggest a potential paradigm shift in managing patients with uncontrolled diabetes.

Hypercortisolism Prevalence High in Poorly Controlled T2D

2型糖尿病の管理不良患者における高コルチゾール血症の高い有病率


カルジオアミロイドーシスは心不全の原因として見逃されがちだが、早期発見と適切な治療が重要である。


Amyloidosis is an underrecognized cause of HFpEF. Pay attention to these red flags.

When Heart Failure Is Actually Cardiac Amyloidosis

心不全がカルジオアミロイドーシスの場合


内膜癌患者の術前血清 CA125、AFP、CEA レベルは予後予測のための独立したバイオマーカーである。これらのバイオマーカーを組み合わせたリスクスコアは、患者の予後を正確に予測することができる。


Objective To determine preoperative serum CA125, CA19-9, CA72-4, CEA, and AFP with prognostic value, and to establish a risk score based on CA125, CEA, AFP levels for predicting the overall survival (OS) and progression-free survival (PFS) of endometrial cancer (EC) patients.

Methods A retrospective cohort study with 2081 EC patients was conducted at Shengjing Hospital of China Medical University. Patient baseline information, tumor characteristics, and data on five serum biomarkers (CA125, CA19-9, CA72-4, CEA, and AFP) were collected. Hazard ratios (HRs) and 95% confidence intervals (CIs) were determined using univariate or multivariate Cox proportional hazard models. log-rank test and Kaplan-Meier analysis were used to compared survival, Data were randomly divided into a training cohort (50%, N = 1041) and an external validation cohort (50%, n = 1040). the least absolute shrinkage and selection operator (Lasso)-Cox regression model was used to screen the independent factors for establishing risk score. And develop nomograms for survival rate prediction.

Results Multivariate analysis showed Elevated CA125 (P<0.0001) AFP (P <0.0001) and CEA(P=0.037) were identified as independent biomarkers for PFS. Increased CA125 (P = 0.003) AFP (P <0.0001) and CEA(P=0.014) were independent factors associated with OS. CA125, AFP and CEA were thus incorporated in an innovative Risk score (RS) by Lasso-Cox regression model, The RS was also an independent indicator for PFS (P<0.0001) and OS (P<0.0001). Furthermore, we developed and validated nomogram based on Cox regression models. The discriminative ability and calibration of the nomograms revealed good predictive ability, as indicated by the calibration plots.

Conclusion This study suggests that the risk score based on preoperative serum levels of CA125, CEA, and AFP was prognostic biomarkers for predicting progression-free survival and overall survival for EC patients. Nomograms based on the RS and clinicopathological features accurately predict Prognosis of EC patients.

### Competing Interest Statement

The authors have declared no competing interest.

*   EC
    :   endometrial cancer
    OS
    :   overall survival
    PFS
    :   progression-free survival
    FIGO
    :   International Federation of Gynecology and Obstetrics
    CA125
    :   carbohydrate antigen 125
    CA19-9
    :   carbohydrate antigen 19-9
    CA72-4
    :   carbohydrate antigen 72-4
    AFP
    :   alpha-fetoprotein
    CEA
    :   carcinoembryonic antigen
    HE4
    :   human epididymal protein 4
    HR
    :   hazard ratio
    CI
    :   confidence interval

Prognostic Significance of preoperative serum CA125, CA19-9, CA72-4, CEA, and AFP in Patients with Endometrial cancer

内膜癌患者の術前血清-ca125-ca19-9-ca72-4-cea-afp-の予後的意義


内膜癌患者の術前血清 CA125、CA19-9、CA72-4、CEA、AFP の予後的意義
