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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors report their experience of the clinical application of monitoring serum CEA levels in breast tumours, obtained by a new direct method of determination. A total of 242 patients were studied: 124 with benign tumours, 75 with primary carcinoma in various stages; and 43 who had previously undergone to surgery for breast carcinoma. The analysis of pre-surgical specimens demonstrate consistently normal values for the benign tumors, whereas patients with malignant tumours had positive values in 40 p. 100 of cases. Significant differences in values were seen between benign tumours and Stage II malignant tumours, and between Stage II and Stage III tumours, whereas there was no significant difference between benign forms and Stage I, and between Stage III and Stage IV. In patients with metastases, followed up after surgery, the CEA was positive in 94 p. 100 of the cases. In the opinion of the authors, CEA levels do not seem to be useful for the early diagnosis of malignant breast tumours but are important, harmless and inexpensive, in the follow-up of patients who have undergone surgery for breast neoplasms.
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PMID:[CEA and breast neoplasms: application of a personal method for determination of CEA in the clinical study of 242 patients (author's transl)]. 48 32

Carcinoembryonic antigen was determined before treatment in 101 patients with adenocarcinoma of the uterus. If 2.5 ng/ml is accepted as the upper normal value, 34% of the patients with cancer of the corpus had elevated levels. Only 7% had values exceeding 5 ng/ml. The highest recorded value in endometrial carcinoma was 8.5 ng/ml. In adenocarcinoma of the cervix 68% had values over 2.5 ng/ml and a direct correlation between nodal metastases and plasma elevation of CEA was found. The highest recorded value for endocervical cancer was 108 ng/ml. No patient with localized disease had a value over 4.0 ng/ml. It is concluded that adenocarcinomas of the cervix and corpus have different biological properties, and that in adenocarcinoma of the cervix determination of CEA is a reliable indicator of the extent of disease.
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PMID:Studies on carcinoembryonic antigen levels in patients with adenocarcinoma of the uterus. 58 61

The usefulness of the CEA as an indicator of recurrence and a guide to selected second-look surgery was evaluated from a retrospective analysis of 358 patients with colorectal cancer and from a prospective experience with 16 patients all of whom had been admitted for second-look surgery because of postoperative elevations of CEA only. Our previous experience had shown that after curative resection the CEA usually returned to normal levels (less than 5 ng/ml) within one month, but became elevated at time of clinically obvious recurrence being very high in patients with liver metastases, but only moderately elevated or normal in patients with local recurrence. All 16 patients had previously had curative resection of colorectal cancer; 13 in the rectum or rectosigmoid and three in the right colon. There were 13 Dukes' C and three Dukes' B cancers. All had been followed clinically and by CEA testing at three monthly intervals and were considered free of disease (NED) at time of CEA elevation. The median disease free interval was 13 months (range 4-57 months) and the median CEA prompting admission for second-look operation was 21 ng/ml (range 10-56 ng/ml). The sites of recurrence were liver in six, lung in two and localized disease in six. Two patients had negative exploration for recurrence and were found to have cholelithiasis only (one of these later died of metastases). Resection for cure was done in seven and palliative resection or biopsy only was done in nine patients. At this time, four patients are NED (12-37 months), five are living with disease (10-16 months) and seven have died of disease (2-12 months). The CEA test provides a method of early detection of recurrence and may permit surgical retrieval in selected patients and earlier initiation of palliation in other patients. The longterm effects in patient salvage remain to be defined.
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PMID:Use of CEA as an indicator of early recurrence and as a guide to a selected second-look procedure in patients with colorectal cancer. 69 33

The monitoring power of CEA during cryotherapeutic management was investigated in a group of 39 patients with inoperable cancer of the rectum. By the results it is concluded that the determination of serial serum CEA levels during cryosurgery is not only a useful parameter of the results of local treatment but also a sensitive indicator of tumor metastases.
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PMID:[Carcinoembryonic antigen as a control parameter in cryosurgical treatments of patients with rectal carcinoma]. 70 May 93

CEA plasma levels obtained prior to definitive surgery in patients with colorectal cancer in our hands have predictive ability. An elevated CEA greater than 2.5 ng/ml recorded by our laboratory means an increased risk of subsequent local recurrence or of later metastatic disease. The question as to whether or not this is additive as a prognostic variable when tested against careful histopathological staging remains. As a monitor, CEA will detect recurrence. Again, the problem as to how accurate this is remains. If we use two consecutive elevations of plasma CEA greater than 2.5 ng/ml as a criteria, we encounter about 15% false positives which must be weighed against finding disease significantly earlier in about one-third of the patients followed. Our data for second-look procedures indicate clearly that when used in patients with an elevated CEA laparotomy may be useful and further studies showed the presence of disease in 11 of 14 patients with an elevation following surgery for two consecutive tests were greater than 2.5 ng/ml. Two were operable. The significance of these findings is described.
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PMID:Pre- and postoperative uses of CEA. 70 9

A rising CEA level is accepted as a sensitive indicator of recurrent colorectal carcinoma. In order to assess its efficacy in monitoring responses to chemotherapy in disseminated disease, 47 patients with documented metastatic colorectal cancer were studied. All had pretreatment CEA determinations and 40/47 (85%) patients had CEA levels greater than 4.0 ng/ml. Patients with hepatic metastases had the highest CEA values and none were found to have levels less than 4.0 ng/ml. Thirty patients received chemotherapy and had serial CEA determinations. 4/30 (13.3%) demonstrated probable tumor regression, 7/30 (23.3%) had stable disease, while 19/30 (63.3%) showed disease progression. CEA titers declined in all four responders, but in only one instance did the level fall to below 4.0 ng/ml and provide evidence of a tumor response not appreciated clinically. The only cytotoxic drugs effecting tumor regressions were 5-FU and 5-FUDR. CEA levels usually rose as disease progressed, but once elevated, absolute values did not correlate directly with tumor burden. The further usefulness of CEA assays in monitoring disseminated colorectal cancer awaits the development of improved chemotherapeutic agents.
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PMID:Carcinoembryonic antigen (CEA) as a monitor of chemotherapy in disseminated colorectal cancer. 70 11

Circulating CEA levels were determined in 102 patients wtih histologically proven pancreatic carcinoma and 26 patients with chronic pancreatitis. In the group with pancreatic carcinoma eleven patients had resectable tumors, the mean CEA in the nonjaundiced patients was 10 +/- 5 ng/ml while the mean value in jaundiced patients in this group was 27 +/- 40. Thirty-four patients with nonmetastatic locally unresectable disease had a mean serum CEA of 25 +/- 52 with a range of 1 to 250 ng/ml. Twenty-one percent had values of 5 ng/ml or less. The mean value in 57 patients with metastatic disease was 97 +/- 194 with a range of 0.05 to 1000 ng/ml and 19 percent had values of 5 ng/ml or less. Survival of patients with locally unresectable or metastatic carcinoma was significantly longer in those patients who had a normal CEA at the time of diagnosis. Circulating CEA in the metastatic group was much lower in patients with nonhepatic metastases as well as in those with well differentiated adenocarcinoma histology. Twenty-three patients with chronic pancreatitis and normal serum bilirubin had a mean CEA value of 5.3 +/- 4 ng/ml with 65% of values being 5 ng/ml or less but the CEA ranged from 4.6 to 27 in three who were jaundiced.
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PMID:Circulating carcinoembryonic antigen in pancreatic carcinoma. 70 16

Elevated plasma CEA levels were observed in 14.2% (2/14) of preoperative patients, 7.9% (3/38) of postoperative patients, and 70.9% (83/117) of patients with metastatic disease. Within these respective groups the simultaneous measurement of hCG, three polyamines and three minor nucleosides further enhanced the detection rates to 69.2%, 54.2%, and 98.6%. It was observed that in patients with at least one elevated CEA, measurement of sequential CEA levels paralleled the clinical course of metastatic disease in 25 patients. Prior to therapy for metastatic disease CEA levels greater than 5 ng/ml were associated with lower response rates and a shorter time to treatment failure than were levels less than or equal to 5 ng/ml. This effect was enhanced in patients also having an elevated hCG level. Hepatic and osseous involvement were associated with a greater incidence of CEA elevations than were pulmonary or soft tissue sites of involvement.
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PMID:Clinical correlation between CEA and breast cancer. 70 22

Plasma CEA levels have been determined in 92 normal women and 768 women with benign or malignant breast diseases. Only one of 92 normal women had a CEA level above 5 ng/ml. Of 253 women with benign breast diseases (gross cystic disease, adenofibroma, fibrosis, etc.) only one had a CEA level above 5 ng/ml. Ninety-four percent of the above two groups of women had CEA levels below 3 ng/ml. Of 164 women operated upon for Columbia Clinical Classification Stage A or B breast carcinoma, preoperative CEA levels were above 5 ng/ml in seven (4%). Patients with a preoperative CEA level above 3 ng/ml seemed to have an increased incidence of tumor recurrence. Elevated CEA levels (greater than 10 ng/ml) in our postmastectomy population of 288 patients have correlated with development of metastases in 14 of 46 subjects. Of 216 patients under treatment for metastatic breast carcinoma, CEA levels above 10 ng/ml have been detected in 15 percent of patients with soft tissue metastases, 38% of patients with visceral metastases and 50% of patients with osseous metastases. Of metastatic breast carcinoma patients with CEA levels above 10 ng/ml serial measurements have correlated with the patients response to therapy, progressively increasing in treatment failures and decreasing in treatment responders.
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PMID:Evaluation of carcinoembryonic antigen as a plasma monitor for human breast carcinoma. 70 23

Preoperative and serial postoperative CEA determinations have become widely accepted tools to aid the early detection of recurrent colorectal cancer. The panel modification of the direct leukocyte migration test (LMT) has proved to be an excellent monitor in these tumor patients. In this study LMT and CEA-RIA were compared. Peripheral blood leukocytes were pulsed with a high dose (2.5 and 0.5 mg/ml) of 3 m KCl extracts of five different colorectal tumors as well as with one 3m KCL extract of normal colonic mucosa. Patients showing a pathologic migration index (less than 0.80 and greater than 1.17) of 3 or more out of five tumor extracts were considered to be "positives." With this test mode 51 of 59 (86%) patients with resectable tumors were reactive, while only 24 of 69 (41%) yielded elevated CEA values. Both LMT and CEA-RIA were positive in 12 of the 13 patients with nonresectable tumors. After curative surgery most patients' leukocyte migration and CEA values were in tne normal range. Of the nine patients with localized tumor recurrence, eight were LMT reactive and five showed elevated CEA values. Of five patients with distant metastases, four demonstrated a positive reaction in the LMT and five a rise in CEA levels. The combination of the LMT with the CEA-RIA promises to improve the detection of recurrent colorectal cancer before the appearance of clinical evidence of recurrence.
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PMID:[Leukocyte migration test and determination of carcinoembryonic antigens in the postoperative follow-up care of colon and rectum carcinoma]. 75 90


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