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 profiles of 4 acute-phase reactant proteins (APRPs) (haptoglobin (HPT), alpha1 antitrypsin (AAT), alpha1 acid glycoprotein (AGP) and prealbumin (PALB)) have been studied during the evolution of bowel cancer. Serial measurements of these APRPs can add to the information obtained from measurements of the level of CEA and hepatic enzymes during the monitoring of postoperative patients. There is considerable stability in the profile in a given individual in health, Rises of AAT and AGP are associated with metastases. High levels of HPT may suggest involvement of the bowel wall by recurrent cancer. PALB levels tend to reflect the nutritional status. A discriminant function based on the log CEA, AAT and AGP preoperative blood levels can considerably improve on the predictive value attained using CEA levels alone.
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PMID:Acute-phase reactant protein profiles: an aid to monitoring large bowel cancer by CEA and serum enzymes. 1 5

The alpha1 and alpha2-globulins have been studied at various stages in the evolution of colo-rectal cancer. The alph2 was elevated in some primary tumours and rose in metastatic cancer especially when it involved the liver. Some apparently tumour free patients had an unexplained elevation of alph2-globulins. The macroglobulins were not a major constituent of the raised alpha2-globulins. Haptoglobulin levels were found to be a useful indicator of tumour activity, when their level was raised in metastatic cancer it was usually with an antecedent or coincidental rise of plasma CEA. Primary tumours may cause a high haptoglobin response without an elevation of CEA.
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PMID:Alpha-globulins in the surveillance of colorectal cancer. 6 90

Serum AFP was determined serially by radioimmunoassay in 13 patients with ovarian germ cell tumors and in one patient with bilateral pure gonadoblastoma. There were 4 patients with pure dysgerminoma, one with pure endodermal sinus tumor (EST) and 8 with mixed germ cell tumors, all containing EST. The patients with dysgerminoma and gonadoblastoma had normal serum AFP at all times. All patients with tumors containing EST had raised serum AFP, although in most cases it was first determined between 1 and 3 weeks after operation and there was no evidence of metastases. Serum AFP became normal 5 to 7 weeks after operation and began to rise when disease recurred. Serum AFP determinations detected presence of recurrent disease long before it became detectable by other methods. Serum CEA was determined serially by radioimmunoassay in 8 of these patients, including 2 who dies with metastases, and was normal on all occasions.
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PMID:Serum alphafetoprotein (AFP) in diagnosis and management of endodermal sinus (yolk sac) tumor and mixed germ cell tumor of the ovary. 7 54

The current status of treatment for patients with colorectal cancer is suboptimal. Although approximately 80% of patients are amenable to surgery, cure is only possible for 40%. Survival of patients is closely related to disease staging at the time of surgery, being poorer for patients presenting with locally advanced disease or with distant metastases. Patients who undergo curative resections and are categorized as having a high risk of developing recurrence, such as those with regionally involved lymph nodes, should be subjected to studies of adjuvant therapy. Although the definite role of such studies is still under evaluation, there already exist studies of chemotherapy with 5FU, chemoimmunotherapy with 5FU-BCG, and radiation therapy, suggesting the beneficial effect of these treatment modalities based on prolongation of the disease-free interval and survival of patients. The status of available treatments for patients with advanced disease is poor. There exists no single or multidrug regimen capable of producing significant tumor regression to improve the patient's quality of life and survival. Accordingly, the active clinical investigation of newer and potentially effective chemotherapeutic agents should continue. The role of present immunotherapy is not fully determined, although several studies suggest its potential usefulness in the adjuvant and the advanced situations. Serial determinations of CEA are extremely helpful in the postsurgical monitoring of patients receiving adjuvant treatments and also in the follow-up of patients undergoing therapy for overt metastatic disease.
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PMID:Chemotherapy and chemoimmunotherapy of colorectal cancer. Role of the carcinoembryonic antigen. 35 57

The clinical assessment of patients with Stages I and II breast cancer is outlined in Figure 1. A chest x-ray film and serum alkaline phosphatase are the only routine studies indicated. If the serum alkaline phosphatase is abnormal in the presence of otherwise normal liver function studies, a bone scan, liver scan, and CEA should be obtained. Areas of increased radioactivity on bone scan are always evaluated by additional radiographs and in some cases tomograms. The majority of focal areas of increased radioactivity will demonstrate radiographic evidence of benign bone lesions, predominantly degenerative joint disease. Only those focal areas of increased radioactivity that are normal on x-ray film or show radiographic evidence of metastases are considered to be positive for metastatic disease. The results of the liver scan are correlated with the level of CEA. Focal areas of decreased radioactivity associated with a CEA greater than 5 ng per ml are considered to be metastases. In the absence of elevation of the CEA, focal areas of increased radioactivity should be biopsied prior to any further considerations as to definitive therapy. The clinical assessment of patients with Stage III disease is outlined in Figure 2. Patients with this stage of disease have a much greater chance of having clinically occult metastases of sufficient size to be detected by chest x-ray film, serum alkaline phosphatase, and bone scan. If the serum alkaline phosphatase is abnormal, a liver scan and CEA are obtained in an effort to detect liver metastases. The same sequence of events is then followed as suggested for patients with Stages I and II disease. Several new techniques of detecting occult metastases are being evaluated. Biomarkers are the subject of another article in this volume. The use of computerized axial tomography is also being evaluated as a means of detecting lung, liver, and mediastinal metastases. The results of these initial clinical trials should be carefully followed.
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PMID:Preoperative assessment of the patient with breast cancer. 35 93

The radionuclide liver scan is a valuable study for detection of hepatic metastases; however, it has a false-negative rate of between 10 and 30%. In a double-blind study involving 377 patients, we assessed the value of CEA assay as an adjunct to liver scanning for detection of hepatic metastases. Fifty-seven patients studied by both methods were ultimately proven to have liver metastases. All patients with CEA levels above 9 ng/ml and focal defects on liver scan had hepatic tumor involvement, while only 4 of 291 patients with CEA values less than 9 ng/ml and negative scans were later shown to have liver metastases. CEA and liver scan results were discordant for 29 patients with proven hepatic metastases: the radionuclide study was positive in 21 cases with false-negative CEA results, while the CEA assay suggested the presence of metastatic disease in eight of the 12 patients with false-negative liver scans.
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PMID:Carcinoembryonic antigen assay: an adjunct to liver scanning in hepatic metastases detection. 36 Dec 1

A raised level of CEA-like substance has been demonstrated by radioimmunoassay in the urine of patients with bladder carcinoma, in concentrations which increase with a more advanced stage, and in serum of patients with advanced disease. In a 2-year follow-up of patients receiving chemotherapy, a correlation of raised urinary CEA to local recurrence was seen, as well as rising and high serum values with metastases. In the patients who responded to treatment, CEA values became normal. CEA was also located in carcinoma cells from bladder washings in 24--61% of the cases. Combined studies of CEA in serum, urine and cells may be used to study the biology of the tumour and perhpas also in the monitoring of patients with urothelial carcinoma.
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PMID:Carcinoembryonic antigen in serum, urine and cells of patients with bladder carcinoma. 36 85

Tumor-specific immunity to carcinoma of the colon, pancreas and stomach was assayed by tube LAI. Cancers of the colon, pancreas and stomach, were shown to possess organ-type specific neoantigens. In 115 patients with colon cancer, 100%, 75%, 61% with Dukes' A, B and C cancer were LAI positive, respectively. Even a microfocus of in situ cancer in a colon adenoma was sufficient to stimulate measurable tumor-specific immunity in the host. In Dukes' D cancer, 25% of patients with widespread metastasis were positive, whereas 100% with solitary lesions were positive. Reactive leukocytes from patients with colon cancer did not react to extracts of normal bowel mucosa or villous adenoma from LAI-negative patients. Leukocytes from 19% (3 of 16) of patients with colon adenomas reacted to the extract of colon cancer but not normal colon mucosa. Moreover, the LAI-positive response of the patients with colon adenomas or colon cancer is directed to a colon cancer TSA which is linked to beta2-microglobulin. These studies suggest that some colon adenomas express TSA before morphological evidence of cancer. It is not known if the acquisition of a cell surface TSA is an irreversible step toward unrestrained growth and metastasis. In pancreatic cancer, 100% of patients with cancers less than 5 cm and without metastasis were LAI positive, whereas 29% were positive when the cancer was greater than 5 cm or had metastasized. In Patients with stomach cancer, 100% with Stage II and 46% with Stage III and IV cancer were LAI-positive. Leukocytes from patients with other GIT cancers and from patients with inflammatory bowel disease or pancreatitis did not react with extracts of colon, stomach or pancreatic cancer. Leukocytes from patients with metastatic cancer, usually did not react in the tube LAI assay because their surfaces were coated in vivo with TSA. LAI reactivity was present when CEA was not detectable and when CEA levels were elevated LAI activity was often absent. The present study suggests that the automated tube LAI shows sufficient promise to warrant studies to determine its efficacy for the diagnosis of GIT cancers.
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PMID:Tube leukocyte adherence inhibition (LAI) assay in gastrointestinal (GIT) cancer. 37 89

451 patients undergoing surgery for colorectal cancer showed synchronous hepatic metastases in 24.4% (110 cases). Survival of patients with hepatic metastases appears to depend on both the age of the patient and the site of metastatic deposit. A relatively good prognosis group with median survival of 14 months can be separated from the other patients with only 5 months survival. Survival of patients with hepatic metastases can thus be predicted and long-term survival (5 and 10 years) obtained by surgical excision of these metastases. Postoperative CEA determinations will also increase the rate of early surgery for hepatic metastases.
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PMID:[Indication for selective surgical excision of hepatic metastases]. 45 6

Eighty-eight patients with hormone-resistant Stage IV prostate cancer were treated with a five-drug chemotherapy program. Patient demographic data, prior therapy, symptoms, extent of disease, and laboratory studies were analyzed statistically to evaluate the association of these parameters with survival from the onset of chemotherapy. Factors associated with short survival included age greater than 65, severe bone pain, poor performance status, presence of soft tissue metastases, anemia, elevation of serum LDH, SGOT, alkaline and acid phosphatases, and prolactin, and hypoalbuminemia. Race, stage at initial diagnosis, prior radiation therapy, prior orchiectomy, and elevation of CEA had no prognostic association. We suggest that clinical trials of new therapies of hormone-resistant prostate cancer take into account the presence of these prognostic factors in the analysis of the results of therapeutic programs.
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PMID:Prognostic factors in metastatic and hormonally unresponsive carcinoma of the prostate. 47 83


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