Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

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

To assess the utility of changes in the volume of the caudate lobe in the sonographic diagnosis of liver cirrhosis, the authors studied 58 patients with histologically proved cirrhosis, 18 patients with fatty liver, 28 patients with liver metastases, seven patients with lymphomatous liver involvement, and 75 healthy individuals. The longitudinal (CL), transverse (CT), and anteroposterior (CAP) diameters of the caudate lobe and the transverse diameter of the right lobe (RL) were measured, and one-, two-, and three-dimensional caudate lobe indexes and ratios were calculated. The analysis of the diagnostic performance of these criteria, compared by means of receiver-operating characteristic curves, revealed that the ratio of the three-dimensional caudate index (CI3) to the right lobe diameter (CI3/RL = [CL X CT X CAP]/RL) was superior to all other calculated criteria. At a specificity of 95%, the sensitivity of CI3/RL was 94.7%, compared with 73.3% for CT/RL. No significant differences were found between the control group and patients with fatty liver, metastases, or lymphomatous involvement. The study suggests that CI3/RL is the most reliable quantitative criterion for the US diagnosis of liver cirrhosis.
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PMID:Diagnosis of liver cirrhosis with US: receiver-operating characteristic analysis of multidimensional caudate lobe indexes. 264 15

The authors evaluate five-year ultrasonographic material (13,672 examinations) focused on non-cystic liver disease. 8212 examinations (60.1%) were made as part of examinations of the gallbladder, 4919 (36%) as part of examination of the right sub-costal area or other organs and only 541 examinations (3.96%) were focused in the first place on the liver. The total number of examined patients included 7830 women (57.3%) and 5842 men (42.7%). Most frequently the ultrasonographic picture of steatosis was found--in 747 patients (5.46%), cirrhosis of the liver in 45 patients (0.33%), primary carcinoma of the liver was present in 7 patients (0.05%) and tumour metastases in 63 patients (0.46%). The group of women with steatosis comprised 42 diabetic women (32.06%), 78 overweight women (59.5%) and 18 with excessive alcohol intake for several years (13.7%). In the group of men with steatosis there were 48 diabetics (7.79%), 92 overweight (14.9%) and 479 with excessive alcohol intake extending over several years (77.7%). In the group of 34 men with cirrhosis excessive alcohol intake for years was found in 31 (91.2%), in the group of eight women with cirrhosis in five instances (62.5%). In abdominal ultrasonography liver disease must be actively searched for, in particular in patients with long-term alcohol intake, overweight, diabetes and long-term use of various hepatotropic drugs.
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PMID:[Non-cystic diseases of the liver in a 5-year ultrasonographic study]. 266 Apr

Metastases in livers with cirrhosis are a rare event in comparison to metastases in normal livers. This fact is of great importance for clinical differential diagnosis of tumours of the liver. High metalloproteinase inhibitor contents and especially altered lectins or lectin binding sites in cirrhosis of the liver may help to explain the rare event "metastasis in cirrhosis".
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PMID:[Why are metastases in cirrhotic livers so rare?]. 267 14

Consecutive autopsies (5241) performed in the Trieste area and consecutive autopsies (6511) performed in the Tokyo-Chiba area were analyzed to study the frequency of liver metastases in cirrhotics. The Italian material included 500 cases and the Japanese material included 529 cases of liver cirrhosis. Both of these groups were matched for sex and age with a control group. The results were similar in both areas and confirmed the widely held but disputed opinion that metastases in cirrhotic liver are rare. These results seem to be clinically important since they agree with the fact that most neoplasms in cirrhotic liver are primary. From a biologic and epidemiologic point of view, these results call for reconsideration of the complex relationship existing between cancer and liver cirrhosis, in relation to major causative factors such as alcohol and hepatitis B virus (HBV) infection.
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PMID:Relationship between cirrhosis, liver cancer, and hepatic metastases. An autopsy study. 273 92

A case is presented in which a radionuclide liver-spleen scan suggested multiple space-occupying lesions compatible with multiple metastases. Computed axial tomography, however, demonstrated more generalized hypodensity without focal defects, and liver biopsy confirmed the presence of fatty infiltration and cirrhosis. The sensitivity and specificity of liver spleen scans and computed axial tomography scans compared to liver biopsy are reviewed. In the evaluation of hepatic metastases, computed axial tomography scanning should be the diagnostic imaging procedure of choice.
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PMID:Computerized tomography in metastatic evaluation. 275 Jan 80

To further define the clinicopathologic features and determinants of survival, we reviewed the cases of 110 patients with primary hepatic malignancy managed surgically between 1975 and 1986. Presenting signs of symptoms were pain (57%), fatigue (48%), abdominal mass (40%), and weight loss (33%). Twenty-six percent of patients had a history of hepatitis or cirrhosis. Histopathologically, tumors were hepatocarcinoma (72%), fibrolamellar variant (7%), cholangiocarcinoma (9%), mixed (7%), and other (5%). Resectability rate with curative intention was 67%. Exploration and biopsy alone was performed in 27% and palliative resection in 6%. Hospital mortality was 9%, and serious morbidity was 22%. Perioperative morbidity and mortality were significantly associated with operative blood loss. Median survival was 12.6 months, with a 5-year survival of 18%. Median survival after curative resection was 22.8 months, and 5-year survival was 27%. Univariate analysis showed that female sex, normal performance status, well-differentiated tumor, and curative resection were associated with increased survival; cholangiocarcinoma, nodal metastases, cirrhosis, hypocalcemia, prolonged prothrombin time, and increased serum transaminase and alkaline phosphatase were associated with decreased survival. Cox multivariate analysis showed that curative resection, normal performance status, and well-differentiated tumors were associated with increased survival, and prolonged prothrombin time and hypocalcemia were associated with decreased survival.
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PMID:Primary hepatic malignancy: surgical management and determinants of survival. 279 50

The hepatic perfusion index (HPI) may be of value in the diagnosis of liver micro-metastases. However, raised values of HPI also occur in some benign liver conditions (e.g. cirrhosis), thereby weakening the diagnostic power of this test. It has been suggested that infusion of the vaso-active agent angiotensin II might improve the predictive value of dynamic scintigraphy because it has been shown to alter liver perfusion in patients with metastatic liver disease. Basal HPI values were not significantly different in a group of patients with metastases (n = 10) and a group with cirrhosis (n = 9). A significant rise in HPI occurred in the metastatic group using angiotensin II enhancement (p less than 0.01, Wilcoxon test). In the cirrhotic group there was no significant increase in the HPI with angiotensin II enhancement. Within the groups, there was considerable variation in response, with eight of ten metastatic and five of nine cirrhotic patients showing a rise in HPI during an angiotensin II infusion. As a result, there was complete overlap in the angiotensin II enhanced HPI for the two groups. Angiotensin II enhancement of HPI is therefore unlikely to improve the diagnostic power of dynamic scintigraphy in individual patients with established hepatic disease.
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PMID:Clinical evaluation of angiotensin II enhanced perfusion scintigraphy in metastatic liver disease. 281 38

CA-125, a serum marker of epithelial ovarian cancer, was studied by a radioimmunometric method: the sensitivity and specificity of the assay was studied in 260 patients with non ovarian carcinomas and 120 patients with non malignant diseases. The ideal threshold value has been discussed. Levels higher than 20 UI/ml (cut-off value) have been found in 53% of cases. Sensitivity falls to 25% if the cut-off value is 65 UI/ml. The serum levels correlated well with the existence of a metastatic disease (P less than 0.001). A second assay allowed to study in 163 cases the correlation between the variations of the serum level and the clinical evolution; a good correlation was found except in case of stable disease. High levels have also been found in patients with benign diseases, most of all in cases of pneumonia and severe liver cirrhosis.
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PMID:[CA-125 in non-ovarian benign and malignant pathology: study on 380 patients]. 281 61

Accurate detection of intrahepatic metastases, or daughter nodules, of primary hepatocellular carcinoma is of crucial importance. Due to the introduction of infusion hepatic angiography, computed tomography (CT) after Lipiodol (iodized oil) infusion, and intraoperative ultrasound (US), tumors less than 10 mm in diameter are now frequently found. We compared the diagnostic accuracy of these three modalities in the detection of nodules in 45 patients who had hepatocellular carcinoma (confirmed by biopsy). CT with Lipiodol was superior to hepatic angiography in demonstrating nodules when they were overlapped by the primary tumor or very small in size. Intraoperative US demonstrated nodules in four avascular or hypovascular hepatocellular carcinomas, which both hepatic angiography and CT failed to demonstrate. In cases associated with severe liver cirrhosis, differentiation of small nodules from regenerating cirrhotic nodules was sometimes difficult with intraoperative US. The combined use of these three modalities is indispensable for the accurate detection of small nodules of metastatic hepatocellular carcinoma.
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PMID:Metastatic nodules of hepatocellular carcinoma: detection with angiography, CT, and US. 281 41


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