Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hepatocellular carcinoma is a very malignant tumor that affects both Caucasian and Oriental populations. In the Caucasian patient, it frequently arises in a background of cirrhosis, most commonly the alcoholic type. In the present study, the alpha-feto-protein level was increased in less than half of the Caucasian patients. In comparison, hepatocellular carcinoma in Oriental patients most often occurs in livers with postinfectious cirrhosis. In the present study, both hepatitis B surface antigen and an increased alpha-fetoprotein level were present in three of four patients. If the tumor is present, however, it appears to behave similarly in both ethnic groups. Without resection, the prognosis is poor, regardless of the presence or absence of underlying cirrhosis or hepatitis B surface antigen status. A tissue diagnosis of hepatocellular carcinoma is most readily made by ultrasonographically guided fine-needle aspiration, which has an 81 percent sensitivity. The most important factor affecting survival is surgical resection. Clearly, the stage at diagnosis is also crucial, but even in more advanced disease, operation can improve survival. It also appears that an increased carcinoembryonic antigen level above normal or a markedly increased alpha-fetoprotein level or both are associated with poor survival. However, whether this is a reflection of tumor size alone, or in fact represents a more aggressive tumor is uncertain and will require further study.
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PMID:Hepatocellular carcinoma. A comparison of Oriental and Caucasian patients. 245 24

A newly established monoclonal radioimmunoassay system (kit II) for carcinoembryonic antigen (CEA) was evaluated in comparison to a conventional polyclonal system (kit I). Among 619 unselected serum samples, approximately 15% were CEA positive with kit I, whereas 27% were positive with kit II; consequently, approximately 12% showed dissociated CEA values to be positive only with kit II. More than 75% of patients with the dissociated values were found to have a malignant disease. Positive rates in normal individuals (266 samples) were less than 5% with both the kit I and kit II and, in those with benign disease were 11.9% with kit II, except for liver cirrhosis in which a quite high positive rate (58%) was obtained. In contrast, a definitely increased positive rate in malignant disease (381 samples) was obtained with kit II (61.4%) in comparison to that with kit I (42.3%). The assessment of technical qualities, such as reproducibility, recovery and dilution tests, demonstrated the excellent performance of kit II.
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PMID:Evaluation of a new monoclonal radioimmunoassay system for carcinoembryonic antigen. 245 36

Over the period of the past 9 years (1980-1988), 320 patients (mean age 60.9 +/- 13.2 years) suffering from various liver diseases have been examined. There were three main groups of patients: (1)--24 patients with primary liver cancer (PLC), 19 of them with hepato- and 5 with cholangiocellular carcinoma, (2)--153 patients with metastatic liver tumors (MLT), and (3)--143 patients with inflammatory liver diseases (ILD). The results of examination of alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), alkaline phosphatase (ALP) and gamma-glutamyl transpeptidase (GMT) in these patients have been analyzed with the aim to evaluate their contribution to the differential diagnostics of tumorous and inflammatory liver processes. For the diagnostics of malignant hepatoma AFP appeared to the most specific test. The significance of other tests for diagnostics of malignant hepatic diseases is obviously limited. These tests are recommended to be considered (in the case of their increase) in close connection with the clinical image and additional examinations. The importance of correlation between cirrhosis and malignant hepatoma is also to be noticed. In spite of all this, we believe that in the case of positivity of the above tests the patients have to be carefully examined and followed up, and that the clinical course and the dynamic of the mentioned tests has to be thoroughly observed. Because of the specificity of values of the AFP-test with malignant hepatoma, we find it useful to perform this test in all patients with chronic liver diseases.
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PMID:Alpha-fetoprotein, carcinoembryonic antigen and various biochemical tests in patients with tumorous and inflammatory liver diseases. 246 43

This study was undertaken in order to compare the ability of 4 tumour markers to discriminate between liver cirrhosis patients with or without hepatocellular carcinoma (HCC). Serum alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), CA 19-9 and tissue polypeptide antigen (TPA) were determined in 63 patients with liver cirrhosis and in 25 patients with HCC in liver cirrhosis. All 4 serum markers were found to be increased in a number of liver cirrhosis patients, regardless of the presence of HCC. AFP was found to be more elevated in HCC patients as compared to the other group; no difference was observed for CA 19-9, CEA and TPA. A significant correlation was detected in HCC patients between AFP and TPA. Significant correlation were detected in all except HCC patients between liver function tests and TPA. We can conclude that AFP determination remains as yet the only suitable marker able to detect HCC in liver cirrhosis. The newly introduced serum marker CA 19-9 is, as previously reported, unhelpful for CEA. TPA can in some instances (i.e. in the absence of an important hepatic cell necrosis or cholestasis) provide a clue to neoplastic growth.
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PMID:Do CA 19-9 and TPA play a minor role as compared to AFP in diagnosing primary hepatocellular carcinoma? 247 97

Combined hepatocellular-cholangiocarcinoma is a rare form of primary liver cancer showing features of both hepatocellular and biliary epithelial differentiation. In a review of 24 cases of this tumor, three histologic types were encountered. Four cases were Type I or "collision tumors," apparently a coincidental occurrence of both hepatocellular carcinoma and cholangiocarcinoma in the same patient. Twelve cases were Type II or "transitional tumors," in which there were areas of intermediate differentiation and an identifiable transition between hepatocellular carcinoma and cholangiocarcinoma. Eight cases were Type III or "fibrolamellar tumors" which resembled the fibrolamellar variant of hepatocellular carcinoma but which also contained mucin-producing pseudoglands. Type III tumors differ from other combined tumors, occurring at a younger age, in the absence of cirrhosis, and having a slightly longer survival. Immunohistochemical (immunoperoxidase) staining for intracellular antigens showed that alpha-fetoprotein is a fairly specific, although insensitive, marker of hepatocellular differentiation in primary liver cancers, being present in 50% of typical hepatocellular carcinomas and in hepatocellular areas in 29% of combined tumors, but in no cholangiocarcinomas or cholangiocellular areas of combined tumors. Keratin is a good marker of biliary epithelial differentiation, being found in 90% of cholangiocarcinomas and in 52% of combined hepatocellular cholangiocarcinomas, but in no hepatocellular carcinomas. Alpha-1-antitrypsin, fibrinogen, IgG, and carcinoembryonic antigen may be found in both hepatocellular carcinoma, cholangiocarcinoma, and in combined tumors; these antigens are therefore of limited use in differential diagnosis.
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PMID:Combined hepatocellular-cholangiocarcinoma. A histologic and immunohistochemical study. 257 78

Recently a glycolipid antigen known as gastrointestinal cancer antigen (GICA) has been proposed as a new seral marker of gastrointestinal and pancreatic tumours. This antigen is specifically recognised by a monoclonal antibody and biologically and immunologically distinguished by carcinoembryonic antigen (CEA). Out of 438 subjects including: 60 blood donors, 205 patients suffering from digestive tract tumours, subdivided into different organs 21 gastric ca's, 60 colon ca's, 100 pancreatic ca's and 24 liver cancers) 173 subjects with inflammatory gastrointestinal complaints, also divided by organ 18 gastric ulcers, 45 inflamed colons, 60 chronic pancreatitis and 50 liver cirrhosis). GICA and CEA radioimmunoassays were carried out (Sorin GICAK and CEAK) to evaluate sensitivity, specificity and predictive accuracy. Normal threshold levels were set at 30 ng/ml for CEA and 40 mu/ml for GICA. These levels represent the mean + 2DS of levels measured in 260 patients hospitalised for various benign and functional complaints and differ from cancer patient results by the largest amount. All blood donors, whether smokers or not, give lower values than these. Results show GICA gives a lower overall number of false positives than CEA (20% as against 9.6%). GICA diagnostic results were more accurate overall for the entire case sample examined. GICA gave higher percentage positives than CEA for individual tumour types: pancreatic ca (82% v 52%), liver cancer (70.8% v 20.8%) and gastric ca (47.6% v 33%). CEA appears to work better than GICA in the case of colorectal ca's (56% v 41%). Both markers were found to be more sensitive in the presence of tumours with metastases. GICA is the best currently available marker of pancreatic tumours thanks to its sensitivity, specificity and predictive accuracy. Although GICA gave good results in cases of liver cancer, these did not exceed those obtained with alpha foetoprotein. In the other cases of digestive tumours examined, a combination of GICA and CEA investigation techniques appears to be the best non-invasive method currently available for patient follow-up.
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PMID:[Comparison between the gastrointestinal tumor antigen and the carcinoembryonic antigen in diseases of the digestive tract]. 258 13

The aim of this study was to test the diagnostic value of ascitic fluid cholesterol and triglycerides concentrations and of serum-ascites albumin concentration gradient in the differentiation between cirrhotic and malignant ascites. These biological parameters were determined, on the one hand in 34 cirrhotic patients, 6 of them having an hepatocellular carcinoma and 6 others having a spontaneous bacterial peritonitis and, on the other hand, in 16 patients with malignant ascites, 13 of them having an abdominal extra-hepatic or pelvic cancer, and 3 others having an extra-abdominal cancer with multiple liver metastases. Ascitic carcinoembryonic antigen assay and ascitic fluid cytology were also done in the 50 patients. In differentiating the cirrhotic patients from those with malignancy, ascitic fluid cholesterol concentration (discriminating value less than 1.1 mmol/l) ascitic fluid triglycerides concentration (discriminating value 0.5 mmol/l) and serum-ascites albumin concentration gradient (discriminating value greater than 11 g/l) allowed a diagnostic efficiency of 0.92, 0.80 and 0.77, respectively. Ascitic fluid cytology showed presence of malignant cells in 3/6 patients with hepatocellular carcinoma associated with cirrhosis, in 9/16 patients having a malignant ascites, and was negative in other patients. Ascitic carcinoembryonic antigen assay was abnormal only in 3/16 patients with malignant ascites. These results suggest that measurement of ascitic fluid cholesterol concentration must be included in the initial evaluation of patients with ascites of unknown origin.
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PMID:[Concentration of lipids in ascitic fluid and the concentration gradient of albumin in blood and ascites: diagnostic significance]. 261 52

Circulating CA 15-3 antigen levels were evaluated in patients with benign diseases and breast cancer patients with no clinical evidence of disease after surgery (NED). Patients with breast cancer NED were followed for tumor recurrence or death during a median of 12.9 months (range 1 to 25 months). CA 15-3 and carcinoembryonic antigen (CEA) were compared in the same breast cancer NED patient population. Elevated CA 15-3 levels (greater than 40 U/ml) were observed in 38 of 1220 patients with benign diseases (3.1%) and in 25 of 350 breast cancer NED patients (7.1%). Elevations of CEA (greater than 5 ng/ml) were observed in 23 patients with breast cancer NED (6.5%). Benign diseases that produced significant elevations of CA 15-3 were chronic hepatitis (42.9%), liver cirrhosis (13.3%), sarcoidosis (16.7%), tuberculosis (9.7%), and systemic lupus erythematosus (6.7%). In breast cancer NED, initial elevations of CA 15-3 were observed in 12 of the 297 patients that remained free of disease during the follow-up, and in 13 of the 40 patients that relapsed (4.0% vs. 32.5%, p less than 0.001). Initial CEA levels were elevated in 16 patients that remained NED and in 7 patients that relapsed (5.3% vs. 17.5%, p less than 0.001). Serial determinations of CA 15-3 in patients continuously NED showed persistent elevations in 4 cases. Three of these exhibited concomitant benign diseases. In relapsing patients, serial tumor marker determinations showed that elevations of CA 15-3 before any other clinical evidence of recurrence occurred significantly more frequently than elevations of CEA (45% vs. 25%, p less than 0.001). Overall, two or more serial elevated values of CA 15-3 were observed in 7 cases, and 6 of them (85%) eventually relapsed. Median survival from study entry was 18.3 months in patients with breast cancer NED that had initial elevated CA 15-3, compared to 25+ months in those with negative CA 15-3 (p less than 0.0001). We conclude that circulating levels of CA 15-3 antigen can be elevated in some patients with non-malignant diseases, and that serial determinations of CA 15-3 may be useful in the postsurgical follow-up of patients with breast cancer when specific types of benign diseases that may cause elevations of the antigen are excluded. Additionally, CA 15-3 is more sensitive than CEA in the early diagnosis of breast cancer recurrences, and the simultaneous assay of CEA does not add information to that of CA 15-3 alone.
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PMID:Circulating CA 15-3 levels in the postsurgical follow-up of breast cancer patients and in non-malignant diseases. 273 Sep 60

c-Hc-4 has been established and maintained for more than seven years. The hepatocellular carcinoma originated in 45-year old man with liver cirrhosis. The cell grew in vitro forming a sheet of monolayered cells and firmly attaching to the inner surface of cultured flasks. Morphologically they showed epithelial-like pattern. The doubling time was about 20 hours. Their modal chromosome number was 58. Serial heterologous transplantation in nude mice was successful. The histological finding was almost the same patterns as those in the primary tumor. The cultured cells produced alpha-fetoprotein (AFP) and carcinoembryonic antigen (CEA).
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PMID:[Establishment of the human hepatocellular carcinoma cell line and its characteristics]. 285 42

Estrogen receptors (ER) were assayed on hepatocellular carcinoma (HCC) and surrounding liver tissue in 30 adult patients. All specimens were obtained at the time of surgery. Cirrhosis of the liver was associated with 28 patients and chronic hepatitis in 2 patients. ERs were detected in 12 of 30 HCCs. The value ranged from 1.4 to 9.2 fmol/mg cytosol protein with the dissociation constant (Kd) value less than 1 nanomol. On the other hand, 13 of 28 cirrhotic livers had measurable amounts of the receptors that ranged from 1.5 to 4.1 fmol/mg cytosol protein. Two livers with chronic hepatitis did not have detectable amounts of ERs. The receptors were not detected in both the tumor and liver in ten patients. The ER titers in HCC did not have any correlation with serum levels of alpha-fetoprotein or carcinoembryonic antigen, hepatitis B virus profiles, and histologic types of the tumor. In the light of the current results, it would be of great interest whether hormone therapy can be used or not as a treatment of naturally occurring HCC in humans.
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PMID:Estrogen receptors in hepatocellular carcinoma. 300 May 73


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