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)

The physical, chemical and immunochemical properties of carcinoembryonic antigen (CEA) purified from hepatic metastases of eight tumours, originating in the colon (6), stomach (1) and lung (1), have been examined. Differences were observed in the overall molecular charge, and also in the carbohydrate composition of the different preparations (both total % carbohydrate, and mole % of the individual sugars). Negligible differences in amino acid composition were found. Gel filtration analysis of these CEA preparations and an additional four partially purified preparations (from pancreatic, hepatic, breast and oesophageal tumour tissues) revealed a single CEA-active peak of similar molecular weight (about 200,000-300,000 daltons) in all preparations. Radioimmunoassay data for the twelve CEA preparations indicated that all preparations contain the same antigenic determinants, as detected by our antiserum, but that there are differences in the expression of these determinants in different preparations.
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PMID:Physicochemical and immunochemical properties of carcinoembryonic antigen (CEA) from different tumour sources. 8 70

After a mole has been evacuated there are two ways of treating the condition: routine chemotherapy from the beginning or chemotherapy reserved for selected cases. They offer the same chances of cure. Seeing that the risk of malignancy in our country is 5 per cent and that selective chemotherapy only exposes a small number of patients to the risk of such treatment, we have adopted the scheme of follow-up suggested by Bagshawe and recommended by OERTC. The follow-up is based on radio-immune assay for HCG carried out at regular intervals for two years. Only cases where the level of HCG is higher than 25,000 international units per litre, one month after curettage, or cases where the rise in HCG is associated with metastases, are treated with chemotherapy. In our experience, which is based on 20 cases, we acknowledge the value of radio-immune assaying. It is superior to immunological tests used for pregnancy diagnosis in sensitivity. It also appears to us that systematic treatment routinely administered and treatment based on raised levels of HCG two months after evacuation of a mole are useless. Only 3 cases were treated with chemotherapy out of the 20 cases that were followed up. We have had no malignancy after 2 and 3 years of checking back on the patients. Treatment given routinely from the start would have been unnecessary exposure to the risks of chemotherapy for 17 patients. Had we taken into account the abnormal rise in HCG after 8 weeks we would still have treated 7 patients instead of 3 with the same results as far as cure. We have worked out a graph for the drop in the levels of HCG after a mole has been evacuated. This may serve as a base for criteria for treatment in the future. Cases where the levels of HCG are above the 95 percentile are considered as at risk to evolve into malignant forms of disease. Consequently earlier treatment can be started (before the 6th month) without altering the number of patients who are going to be treated.
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PMID:[Prevention of the malignant form of trophoblastic disease after a hydatidiform mole: systematic or selective chemotherapy]. 18 22

Three hundred and seventeen patients with gestational trophoblastic tumors were investigated and treated between 1957-1973. The risk of trophoblastic tumor was influenced by the outcome of the antecedent pregnancy (hydatidiform mole, non-mole abortion, term delivery) and the ABO blood groups of the mating couple; it was also influenced by the patient's age. The response to treatment with chemotherapy and , where appropriate, with surgery and radiotherapy, was influenced prfoundly by several factors. These included 1) the outcome of the antecedent pregnancy, 2) the total body burden of tumor at the time treatment stated as reflected by the urinary output of human chorionic gonadotrophin (CG), 3) the interval between the antecedent pregnancy and the start of chemotherapy, 4) the ABO groups of the mating couple, 5) the extent of mononuclear cell infiltration in the tumor, 6) the immunological status of the patient at the start of treatment, 7) the size of tumor masses, 8) the site of metastases and particularly the presence of intracranial metastases, and possibly by 9) the age and 10) the parity of the patient. A detailed study of the HLA antigens of the patient, her husband, and antecedent child has shown no positive effect on risk or prognosis. These data provide a basis for a scoring system that allows the prognosis to be defined at the time of diagnosis and facilitates tisk of drug resistance. Applied retrospectively to the cases from which the scoring system was generated, prognostic groups with survival rates ranging from 0-100% can be defined. Unfavorable prognostic factors combine so as to increase the probability of drug resistance.
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PMID:Risk and prognostic factors in trophoblastic neoplasia. 18 54

Serum human chorionic gonadotropin (hCG) was measured by a radioreceptorassay (RRA) and radioimmunoassay (RIA) and serum hCG-beta and hCG-alpha by RIA in 10 patients with intact mole, 3 patients with choriocarcinoma, and 4 patients with hydatidiform mole during treatment. hCG levels by RRA were higher in 5 of 10 molar pregnancies and ranged from 20,900 to 100,000 ng/ml and from 30,000 to 100,000 ng/ml by RIA. hCG levels by RRA and RIA paralleled one another closely during treatment of hydatidiform mole. hCG-alpha was higher than hCG by RRA and RIA and hCG-beta in molar pregnancies, in the uterine venous blood draining a uterine choriocarcinoma, and during chemotherapy of choriocarcinoma. In 2 of 3 choriocarcinoma patients who eventually developed cerebral metastases, hCG-alpha increased while hCG and hCG-beta were declining or negative. hCG-beta was usually lower than hCG or hCG-alpha in all the cases studied. These results demonstrate the production of free alpha and beta subunits in trophoblastic disease. Further, due to the biospecificity, simplicity, and rapidity, the RRA of hCG is a sueful diagnostic aid during treatment of trophoblastic neoplasia until the levels fall to within the sensitivity range of the assay. Finally, the RIA of hCG, hCG-beta, and hCG-alpha, which requires several days, should be performed until they become negative or fall within normal range.
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PMID:Human chorionic gonadotropin and its subunits in hydatidiform mole and choriocarcinoma. 19 42

The role of chemotherapy in the control of placental tumors is examined, both as a separate, single treatment, and as a conjuctive treatment. Its usefulness is most evident in the latter form of approach. In cases of the simple mole, its use is not really justified, and it does not appear to be effective in 9 out of 10 cases. In any therapeutic approach, it is not always effective and can be dangerous in the event of the development of chemoresistance. In cases of invasive mole and tumors where a histological diagnosis has not been made, and where a definite unfavorable prognosis is not evident, a twice weekly administration of methotrexate for a 2-month period after the cure has been clinically, radiologically, and biologically confirmed usually heals the formations. Choriocarcinomata and cases where a histology has not been carried out but where a negative prognosis is evident (extrapulmonary metastases, pulmonary metastases, delays in treatment, or the excretion of high levels of human chorionic gonadotropin), chemotherapy is considered justified with vincristine followed by methotrexate or actinomycin D. Surgical intervention to remove residual lesions may be necessary in these cases.
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PMID:[Chemotherapy in placental tumors]. 19 2

Thirty-five patients with nometastatic gestational trophoblastic neoplasms and 3 patients with metastatic gestational trophoblastic neoplasms were treated primarily with methotrexate and citrovorum factor rescue. The antecedent pregnancy was molar in all patients. The known histologic diagnosis in 34 patients was hydatdiform mole and choriocarcinoma in 3. Up to March 1977, the duration of remissions ranged from 1 to 21 months. Complete and sustained remission was achieved in 91% of patients with nonmetastatic disease and in 2 of the 3 patients with metastases, without evidence of marrow or hepatic and with substantially reduced epithelial toxicity. Response to treatment and the number of courses required to achieve remission were determined solely on the basis of the human chorionic gonadotropin response as measured by the beta subunit radioimmunoassay.
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PMID:Methotrexate with citrovorum factor rescue for gestational trophoblastic neoplasms. 20 93

Nine patients with nevus sebaceus of Jadassohn (NSJ) developed associated morphologically aggressive neoplasms. Four of the tumors were apocrine carcinomas, two of which metastasized to regional lymph nodes, and in one of the two generalized metastases developed. Three tumors were adnexal carcinomas with probable pilar differentiation, but none showed progression of the disease after wide surgical excision. One patient has squamous cell carcinoma and died with generalized metastasis, and one patient had a complex adnexal and squamous cell carcinoma with a large area of anaplastic carcinoma that recurred and invaded the skull.
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PMID:Malignant neoplasms associated with nevus sebaceus of Jadassohn. 52 3

8 patients suffering from malignant melanoma have been found to have various degrees of hypomelanoses of the skin. Depigmentation of the skin and/or hair associated with malignant melanoma may take several forms. Schematically six clinical types are described: - vitiligo-like hypomelanoses distant from cutaneous tumors; - vitiligo-like depigmentation associated with uveitis (incomplete Vogt-Koyanagi); - hypomelanoses in the primary tumor and/or its metastases; - "halo melanoma" in which the hypomelanoses encircles the primary tumor and/or its metastases; - halo nevi around preexisting benign nevocellular nevi; - "non-specific depigmentary phenomen" distant from the primary tumor or its metastases. Histological and ultrastructural studies of the depigmented skin show an absence of melanocytes. The association of hypomelanoses of the skin with malignant melanoma is probably not coincidental. Various hypothesis are discussed as well as the prognostic significance of such an association.
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PMID:[Hypomelanosis of the skin and malignant melanoma (author's transl)]. 75 17

Failure to appreciate the variability in the natural course of choroidal nevi (benign melanomas) has caused the adoption of a misleading cytologic classification of malignant melanomas. This classification is not based on adequate clinical observation, reliable cytologic criteria for malignancy, or sufficient autopsy information. The available evidence suggests that spindle A tumors are benign and that spindel B tumors, although capable of local destruction of the eye, metastasize infrequently. The risk of observation of small melanocytic tumors must be weighed against the risk that early enucleation or other forms of therapy may not favorably affect prognosis. The clinical observations to date at the Bascom Palmer Eye Institute indicate that the risks of observation are low.
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PMID:Problems in the differential diagnosis of choroidal nevi and malignant melanoma. XXXIII Edward Jackson Memorial lecture. 89 74

From 1969-1974 1000 unselected enucleated globes have been examined histopathologically. 277 derive from the University Eye Hospital in Hamburg, 723 from various Eye Hospitals in northern and southern Germany. They originate from 589 men and 408 women, three times the sex was unknown. 86 globes had to be removed from children less than 15 years old. 6 groups of etiologies have been distinguished: trauma (308), histologically confirmed neoplastic disease (281), ocular manifestations of systemic diseases (diabetes mellitus, occlusions of central retinal vessels presumably following generalized vascular disease etc.: 128), "operative ocular disease" (164), primary inflammatory disease (71), miscellaneous (malformations, high myopia, pseudo-glioma and pseudo-melanoma: 48). The etiology "operative ocular disease" consists of 67 primary glaucomas (57 adults, 10 buphthalmus), 41 idiopathic cataracts (7 of these congenital) and 3 primary corneal dystrophies, as well as 53 cases of primary retinal detachment. Among the 281 neoplastic diseases, there are 238 primary intraocular malignant melanomas of the uvea, 18 retinoblastomas, 4 primary reticulumcellsarcomas of the retina, 2 choroidal nevi, 10 intraocular metastases and 9 orbital tumors. 16 enucleations among the 1000 enucleations have been performed for pseudo-gliomas (5 x Coats disease, 5 x persistent primary hyperplastic vitreous, 2 x retrolental fibroplasia, others 4 x). The manifestations of systemic disease are consisting of 68 central retinal vein-occlusions, 30 complications of diabetes mellitus and 10 central retinal artery occlusions as well as 20 other generalized diseases. A primary inflammatory disease led to enucleation 50 times due to an intraocular process, 5 times due to scleritis and 18 times as a consequence of keratitis (including 13 times herpes simplex). As the final clinical cause for enucleation the following categories have been elaborated: secondary glaucomas (416), clinical diagnosis of "tumor" (275), atrophy and phthisis bulbi (118), inflammation (112), acute trauma to 4 weeks after the accident (72), others (7). In conclusion the central role of rubeosis iridis leading to secondary angle closure glaucoma is emphasized. This process presents a challenge to ophthalmologic research. Finally the significance of early surgery for primary angle closure glaucomas and for complete restoration of the anterior chamber after trauma and any intraocular procedure is stressed.
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PMID:[Etiology and final clinical cause for 1000 enucleations. (A clinico-pathologic study) (author's transl)]. 95 59


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