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)

A comparative study on 150 cases of alpha fetoprotein (AFP) nonproducing primary liver cancer (PLC) in subclinical and moderate stages and 133 cases of intrahepatic solid space-occupying lesion (SOL) other than PLC was undertaken. All were operated and proven by pathology. The results indicated that in the intrahepatic SOL patients with negative serum AFP the diagnosis of PLC could be established if any one of the following items was confirmed: (1) Definite evidence of liver cirrhosis; (2) Hypoecho or inhomogeneous echo sonodensity on ultrasonography plus positive serum HBsAg; (3) Positive 99mTc-PMT liver scan (4) No overfilling of SOL on blood pool scintiscan plus positive HBsAg; (5) No enhancement after injection of contrast medium on computed tomography plus positive HBsAg. The positive rates of the above items in PLC and non-PLC groups were: (1) 73.2% vs. 0.9%, (2) 48.1% vs. 9.6%, (3) 64.3% vs. 14.3%, (4) 27.3% vs. 3.9% and (5) 34.6% vs. 0%, respectively. Statistically, these differences were significant. In conclusion, according to the above mentioned criteria, detection rate of over 90% with over 85% specificity can be obtained for AFP negative PLC.
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PMID:[Early diagnosis of alpha fetoprotein nonproducing primary liver cancer]. 169 35

This article presents 14 patients of single-nodular minute hepatocellular carcinoma (HCC less than or equal to 2 cm) with coexisting cirrhosis. Of these nine patients were discovered by alpha-fetoprotein (AFP) mass screening or health check-up; and five by follow-up observations of chronic liver disease. All the 14 patients received radical resection with no operative mortality. The 1-5 year survival rates after resection were 100% (14/14), 100% (12/12), 100% (11/11), 100% (9/9), and 100% (7/7), respectively. This study demonstrates that the key point of further improvement in the detection of minute HCC lies in the establishment of diagnosis at a relatively low AFP level (less than 200 ng/ml). Realtime ultrasonography is the diagnostic modality of first choice in screening and monitoring. Surgery is strongly indicated for minute HCC with compensated liver function; Limited resection is the main type of resection for minute HCC with liver cirrhosis. The present data also indicate that HCC is not always multicentric in origin, even in patients with liver cirrhosis Intrahepatic spreading rather than multicentric origin may play a more important role in the multinodular pattern of HCC.
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PMID:[Diagnosis, treatment and prognosis of single-nodular minute hepatocellular carcinoma]. 169 22

To elucidate the cell biological significance of ras oncogene, the expression of ras-p21 was analyzed in 53 cases of liver tissues including 34 cases of hepatocellular carcinoma (HCC), by using immunohistochemical method. In result, 22 (65%) cases of 34 HCC and 34 (79%) cases of 43 liver cirrhosis were positive for p21, whereas all of chronic hepatitis and normal livers were negative. Especially, comparative study between the expression of p21 and clinicopathological background of HCC revealed that p21 was prominently expressed in well differentiated form, nodular type, small liver cancer, and the cases showing AFP levels below 400 ng/ml. From these results, it was indicated that ras oncogene might play an important role in malignant transformation of hepatocytes or differentiation of HCC.
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PMID:[The expression of ras p21 product in hepatocellular carcinoma]. 170 Jan 76

The present study is based on the assay of four markers (AFP, CEA, TPA, Ca 19-9) using IRMA methods in 36 normal subjects, 44 cirrhosis and 66 HCC patients. Parametric and non parametric tests were used to test differences and correlations. ROC curves and discriminant functions were also elaborated. Normal 95% "cut-off" was determined by the "boostrap" method yielding: CEA 3.4 ng/ml; Ca 19-9 55 U/ml; TPA 58U/l and AFP 5.2 ng/ml. In HCC patients the values of the four markers were, on average, significantly different from those of normal subjects. However, only AFP and TPA exhibited high diagnostic accuracy (90%) for detection of the tumor. Higher than normal mean values for all markers were, also observed in cirrhotic patients. Only AFP yielded effective discrimination between HCC and cirrhosis. The positive prediction for the presence of the tumor on cirrhotic ground was 95% for AFP values higher than 18.5 ng/ml, with a 78% negative predictive value with a 6 ng/ml threshold. Association of AFP with TPA showed only a marginal diagnostic improvement. Results were not improved at all by combining CEA and Ca 19-9 with AFP and/or TPA. In conclusion, AFP is and remains the best marker for HCC and the only one effective in discriminating of HCC from cirrhosis. TPA may be considered a valid alternative if cirrhosis is not present. CEA and Ca19-9 are of no use.
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PMID:AFP, CEA, CA 19-9 and TPA in hepatocellular carcinoma. 170 5

Forty-nine liver disease patients (7 chronic persistent hepatitis, CPH; 10 chronic active hepatitis, CAH; 13 liver cirrhosis, LC; 9 primary hepatocellular carcinoma, PHC, without LC; and 10 PHC with associated LC) and 20 controls were assessed for their serum alpha-L-fucosidase (ALF) and alpha-fetoprotein (AFP) levels and several routine liver injury parameters. Tumor diameter in those with hepatic cancer was assessed by angio-CT. Only ALF and AFP were significantly greater in patients with PHC and PHC + LC patients as compared to patients with LC alone. At an accepted cutoff level of 500 ng/ml, the AFP level provided 43% false negative tests. On the other hand, an ALF level exceeding 740 mumol/hr/ml provided a sensitivity of 84% with a specificity of 94%. No relationship between the ALF level and Child's criteria or with any liver injury parameter was evident. Considering all individual values, the ALF, rather than the AFP, correlated with tumor size. This finding suggests the ALF level may be of value in the early detection of PHC as well as in the follow-up of patients treated for PHC.
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PMID:Serum alpha-L-fucosidase. A more sensitive marker for hepatocellular carcinoma? 171 99

Markers for hepatocellular cancer include the best and worst of cancer detection. Although hepatocellular cancer is relatively infrequent compared to other cancers in the western world, HCC has a very high incidence in parts of Asia and Africa. It is estimated to be one of the most common cancer worldwide. High risk factors for HCC include previous hepatitis B infection, heavy alcohol consumption, cirrhosis, and aflatoxin exposure. Alpha fetoprotein may be the best human cancer marker that appears in the serum, but levels of this marker are often not elevated until the tumor is beyond surgical treatment. No other serum or tissue marker is particularly useful. Screening of high-risk populations in China has detected previously undiagnosed HCC in 1,000 of 5 million individuals tested and has led to an increase in survival from 5.5 to 61.6% with surgical resection over those who are later diagnosed with HCC without screening. Elevations of AFP due to yolk sac tumors may be differentiated from those due to HCC on the basis of Concanavalin A reactivity. Immunodetection using radiolabeled anti-AFP and immunoscintigraphy have given inconsistent results that are not as sensitive as ultrasonography in detecting HCC in the liver. Various enzymes, isoenzymes, and other markers may be useful as adjuncts to diagnosis in selected cases, but are not generally as good as AFP alone. If a patient has an AFP-producing tumor, the serum levels of AFP provide an excellent means of monitoring its progression. If the serum AFP levels drop to normal and stay there, cure is almost certain. If, however, the serum AFP level does not fall at the normal catabolic rate after therapy, or subsequently rises, regrowth of metastases are indicated. Immunotherapy using anti-AFP has not been shown to induce remission, but experimental studies indicate that drug-conjugated anti-AFP is effective in inhibiting growth of AFP-producing tumors. Clinical trials using drug-conjugated anti-AFP are now underway. Monoclonal antibodies have not yet identified the "antigens" useful for the diagnosis or treatment of HCC, but epitopes identified by monoclonal antibodies have been studied experimentally in rats which indicate multiple cellular lineages to HCC in cases of experimental chemically induced hepatocarcinoma.
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PMID:Markers for hepatocellular carcinoma. 171 67

Activity of glycolipid sulfotransferase (cerebroside sulfotransferase) in serum was elevated in 21 (33%) of 63 patients with hepatocellular carcinoma (HCC, mean +/- S.E., 349 +/- 32 pmol/ml per h, n = 63, P less than 0.001) compared to healthy subjects (172 +/- 12, n = 85). Ho significant elevation of the sulfotransferase level was observed in liver cirrhosis (219 +/- 28, n = 10) in which many of biochemical HCC markers increase concomitantly. The elevation of sulfotransferase was independent of the production of alpha-fetoprotein and of aminotransferase levels in HCC, providing complementary value for alpha-fetoprotein-negative HCC cases. However, the sulfotransferase levels (234 +/- 21, n = 32, P less than 0.01) in sera from patients with renal cell carcinoma, in whose involved tissues the enzyme was demonstrated to increase markedly, were less than in HCC.
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PMID:Elevated serum level of glycolipid sulfotransferase in patients with hepatocellular carcinoma. 171 32

The serum levels of tumour marker CA 125 were measured in 162 patients with various digestive tract malignancies and in 155 patients with benign digestive tract diseases. The highest frequency of elevated CA 125 values (greater than 35 U ml-1) was found in patients with liver cancer (78%), but the level was equally often elevated in liver cirrhosis (78%). Two-thirds of the patients with biliary tract cancer had an increased CA 125 concentration, while four patients with benign biliary diseases had an elevated value. The serum level of CA 125 was elevated in only 20% of 60 patients with primary colorectal cancer, and in none of those with local disease (Dukes A or B). The CA 125 concentration seldom increased in patients with recurrent colorectal carcinoma. Twenty-three per cent of 44 patients with gastric cancer had an elevated CA 125 value. Two of 33 patients with benign colorectal and one of 68 patients with benign gastric diseases had an increased CA 125 concentration. The serum values of CA 125 showed no correlation with those of tumour markers alphafetoprotein (AFP), carcinoembryonic antigen (CEA) or CA 19-9. AFP was superior to the other markers in the diagnosis of liver diseases, while CA 19-9 showed the greatest accuracy in gastric diseases. In colorectal diseases, CEA had a higher sensitivity, but a lower specificity than CA 125 and CA 19-9. CA 125 and CA 19-9 had similar sensitivities for biliary tract cancer.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Tumour marker CA 125 in patients with digestive tract malignancies. 171 1

Des-gamma-carboxy prothrombin (DCP) was evaluated as a serological marker for hepatocellular carcinoma (HCC), particularly in patients with early HCC. In 1192 patients with various diseases, plasma DCP levels were measured by a newly developed enzyme immunoassay method using an anti-DCP monoclonal antibody. Of the 254 patients with HCC, 143 (56%) had abnormal DCP levels of greater than 0.1 AU/ml. In contrast, elevated DCP levels were rarely observed in patients with chronic hepatitis, liver cirrhosis, metastatic liver cancer, and other malignant tumors. Because no correlation was observed between DCP and alpha-fetoprotein (AFP), the combined measurement of these two complementary markers appears to be useful in the diagnosis of HCC. Since normal levels were observed in 29 of 30 patients (97%) with small liver tumors measuring 2 cm or less in diameter, the diagnostic application of the DCP assay to small liver tumors is limited. However, in patients with tumors larger than 2 cm, the plasma DCP assay may even be more useful than AFP. Among 46 patients with liver cirrhosis or chronic hepatitis who subsequently developed HCC, significantly increased DCP and AFP levels were observed in nine patients (20%) and 14 patients (30%), respectively, when a tumor was detected. When the results of both assays were combined, 19 patients (41%) had elevated levels of one or both markers. Although the plasma DCP assay alone is not sensitive enough to detect early small liver cancers, it could be applied as a complementary tumor marker together with AFP.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Clinical usefulness of des-gamma-carboxy prothrombin assay in early diagnosis of hepatocellular carcinoma. 172 Oct 19

Alpha-fetoprotein (AFP) was detected, by Ouchterlony immunodiffusion technique, in 81.5% of patients with histologically confirmed diagnosis of hepatocellular carcinoma. The test gave negative results with 35 cases of acute viral hepatitis, 7 haemochromatosis, 6 micronodular cirrhosis and 2 cholangiocellular carcinoma. Curiously, one patient with postnecrotic cirrhosis, a well recognized sequela of viral hepatitis, whose liver cell regeneration also showed "atypical changes", was AFP positive. AFP was not detected in sera from the general population which comprised 1029 male blood donors, 144 antenatal and 106 maternity cases. The only exception was the case of a woman who aborted a 5-month old foetus. A follow-up serum sample taken 3 months later was, however, negative for AFP. The frequency of hepatitis B surface antigen (HBsAg) detection in patients with hepatocellular carcinoma (25.9%) was 4 to 5 times higher than that in the general population. This strong association between HBsAg and primary liver cancer in countries where liver tumours are often AFP secretors suggests a role for hepatitis B virus, not only in the aetiology of the cancer, but also in the reactivation of the gene encoding this foetal protein.
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PMID:A study of alpha-fetoprotein in primary liver cancer in Tanzania. 172 52


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