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)

Despite nonspecificity for the diagnosis of colon cancer, the assays for CEA widely studied to date may be useful in the management of patients with colorectal cancer by aiding detection of colonic cancer and especially of widespread metastases to the liver. Use of serial quantitative measurements may also be useful in determining persistence of residual or metastatic tumor after apparently complete surgical resection, in enabling detection of recurrence at an earlier stage than may be otherwise possible, and in helping to evaluate the effects of chemotherapy, provided that the assays are used only in context with complete clinical and laboratory findings, including cancer staging, histopathologic findings, assessment of liver status, and with appreciation of methodologic complexities. Both the further investigation of the clinical use of CEA and the intensified search for more specific markers are encouraged by the findings to date.
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PMID:The present status of DEA in diagnosis, prognosis, and evaluation of therapy. 76 63

Currently, one could summarize this area by saying that we appear to be in a situation where three relatively nonspecific tests detect the majority of patients with metastatic disease, as well as those post-operative patients who are at high risk of relapse. The critical test of their utility for segregating those at risk for relapse from those who are not at high risk will need to be done in a highly select subgroup, e.g., N- patients. Two of these tests, CEA and hCG, also appear to be useful indicators for predicting the probability of responding to combination chemotherapy in metastatic disease. The development and further testing of potentially more specific markers to replace or add to the current matrix is now in progress, Casein, which is a product of the milk synthesis pathway of breast tissue, represents a potentially more specific test than any of those studied to date. HENDRICK and FRANCHIMONT, 1974, have found elevated levels in 21 of 26, or 81%, of patients with metastatic disease, and 8 of 11, or 73%, of patients preoperatively. The test may also reflect the tumor burden since the proportion of patients with elevated levels dropped to 41-50% postoperatively. Further results with this marker are awaited with interest. Other tests such as ferritin, hydroxyproline, or the development of tumor antigen associated immunospecific assays could increase both the specificity and sensitivity of the tests utilized in this field of investigation. Injecting the use of both single marker tests and matrix approaches into routine clinical use in the postoperative setting now appears to be ready for more critical testing. Their use in diagnostic or screening settings, which is the ultimate goal, also needs to be evaluated. Finally, from the practising clinician's viewpoint the data in this discussion should be considered preliminary. It constitutes a status report. Although there is evidence that CEA and hCG are prognostic in metastatic disease, and that subclinical disease is detectable, larger and more tightly controlled studies will be necessary before their routine clinical use can be recommended in breast cancer patients.
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PMID:Biochemical markers in cancer of the breast. 79 22

Specimens from 93 patients with histologically confirmed tumors of the large bowel (53 single, 40 sequential determinations) were investigated by a new CEA radioimmunoassay (double antibody method, direct serum determination). Of the single and preoperative sequential determinations 37-40% were normal (below 2.5 ng/ml), one third was intermediately elevated (2.6-15 ng/ml) and 26-28% were highly pathological leveled (over 15 ng/ml). Following operation, cases with local or regionally confined tumor showed significantly more normal or normalizing CEA levels within 1-6 weeks (17/27), whereas patients with overt metastases developed more pathological or increasingly pathological levels (8/11).
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PMID:[Determination of carcinoembryonic antigen (CEA) in patients with tumors of the large intestine. Experience with a new radioimmunoassay (author's transl)]. 81 66

Since 1972 plasma CEA levels of 25 cancer patients have been assayed to evaluate the reliability of CEA as an early indicator of recurrent gastrointestinal cancer. Identification of significant elevations in CEA levels required definition of exactly what a given value meant. Intraassay and interassay accuracy was determined and graphed as a CEA NOMOGRAM, which measures the observed CEA level against the 95% confidence limits for that observation and thus can be used to identify statistically significant increases. A statistically significant rise above a baseline value established by the NOMOGRAM proved to be a correct indicator of tumor recurrence in 22 (88%) of 25 patients who underwent second-look intraabdominal operations (22 colorectal, 2 gastric, and 1 pancreatic). In each case, other accepted procedures, such as liver enzymes, scans, and x-rays, were nondiagnostic. Of the 22 patients with proved tumor recurrence, 16 (73%) had distant metastases and 6 (27%) had localized tumors. One patient remains tumor-free three years after second-look operation and has had no significant change in CEA levels. More frequent serial CEA determinations combined with sound clinical judgment should facilitate earlier detection of recurrent gastrointestinal cancer.
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PMID:The use of CEA as an early indicator for gastrointestinal tumor recurrence and second-look procedures. 83 30

The liver scan and CEA assay were employed as a composite to increase the accuracy with which hepatic metastases from breast cancer may be detected. The number of false-positive interpretations was markedly reduced in this selected groups of patients. Other combinations of tests were examined and found less effective. In view of the potential benefits found in this study, it appears worthwhile to extend the principles applied here to other groups of patients at different stages of this disease and with other primary tumors.
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PMID:Detection of hepatic metastases from cancer of the breast. 84 88

Plasma CEA levels were evaluated by radioimmunoassay in patients with breast carcinoma in relation to clinical-pathologic staging, clinical tumor burden, prognosis and organ sites of involvement. Elevated levels were observed in 83/117 (70.9%) patients with metastatic disease, 2/14 preoperative patients and in 3/39 one-six month postoperative patients. Preoperative levels were elevated in two patients; the levels fell to normal after operation. Changes of elevated CEA levels followed the clinical response to therapy in 22/22 metastatic disease patient-trials. The levels decreased with a response in 15 trials and rose with progressive disease or relapse in seven trials. The incidence of CEA elevations and quantitative CEA levels both rose with increasing clinical tumor burden from the postoperative state through the preoperative state to two or more organ sites of metastatic involvement. No relationship was demonstrable among limited samples between preoperative or postoperative CEA levels and prognosis; however, in metastatic disease, pretherapy CEA levels greater than 5 ng/ml were associated with low response rates and early therapeutic failure to chemotherapy. The highest frequency of elevated CEA levels was observed in patients with osseous involvement (79%) and the lowest frequency with skin (52%) and breast (50%) metastases. Liver and osseous disease were also associated with higher mean CEA levels than were other sites of metastatic involvement. CEA levels appear to be elevated in the majority of patients with metastatic disease and be of prognostic importance in metastatic disease. The level in patients with metastatic disease appears to reflect the therapy-associated tumor burden of the host, especially in patients with elevated levels.
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PMID:Biological markers in breast carcinoma. III. Clinical correlations with carcinoembryonic antigen. 87 38

Serial determinations of CEA concentrations in serum were performed postoperatively in 303 patients with histologically confirmed adenocarcinoma of the gastrointestinal tract. The trend of the time course of computerised CEA curves made early diagnosis of recurrence or metastases possible. Diagnosis of recurrence by means of a rise in CEA concentration preceded positive clinical diagnosis by up to 10 months. In all 26 cases confirmation was obtained by second-look operation or other diagnostic means. Analysis of serial CEA measurements made it possible to distinguish between generalised metastasization and local recurrence of the tumour, on the one hand, and limited metastasization at the site of recurrence, on the other.
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PMID:[Carcinoembryonic antigen (CEA) (author's transl)]. 89 89

161 patients with adenocarcinoma of the gastrointestinal tract were studied to determine the value of the CEA test and a battery of non-specific immunological tests during the course of the disease. The ability of these tests to detect a tumor recurrence in radically operated patients was evaluated. A false negative preoperative CEA value was found in 40% of the patients with gastric carcinoma and 32% with colorectal carcinoma. Patients with a negative preoperative CEA value, and those with only slightly elevated values, had a distinctly better prognosis regarding initial operability and tendency to postoperative recurrence than patients with primarily markedly elevated values. With few exceptions, the development of distant metastases was detected earlier and more easily with the CEA test than by the usual routine follow-up methods. However, in the event of isolated local recurrence the CEA test was positive in only 1 of 5 patients. This reflects the direct correlation between tumor size and CEA elevation. The CEA test is a valuable supplement in the follow-up of patients with gastrointestinal carcinoma.
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PMID:[The CEA test and other immunological tests as disease course controls in gastrointestinal adenocarcinoma]. 92 29

Other approaches to determine whether patients have a high probability of metastases (and therefore no need for axillary dissection) have been the measurements of several circulating substances (e.g., polyamines, nucleosides, CEA and HCG). None of these are by themselves useful. There is a high percentage positive in those patients with metastatic disease (with up to 97% positive for either HCG, CEA, or guanosine (nucleoside). What we need is a correlation or a parameter of what the tumor cell number is, who to treat, and how long. Today's therapy is larger empiric. The ultimate goal is to individualize therapy. Figure 1 summarizes a planned treatment for a woman with a breast cancer in 1974.
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PMID:Cancer treatment combined modality approach. 102 65

Many patients with advanced non-thyroid malignancies have elevated plasma immunoreactive calcitonin concentrations. Breast and bronchial carcinomas contain immunoreactive calcitonin and an epidermoid bronchial carcinoma has been shown to produce immunoreactive calcitonin in vitro. We have established monolayer cultures of breast carcinomas and eight out of fifteen consecutive carcinomas released immunoreactive calcitonin; some released HCG (human chorionic gonadotrophin) or CEA (carcinoembryonic antigen). In addition, a primary human breast carcinoma has been shown to release and contain calcitonin after being passaged in 'nude' mice over 1 year. Chromatography of extracts and culture media of a bronchical carcinoma demonstrated that, in contrast with the other tumours, it secreted a form or forms of calcitonin having size, charge and immunological differences when compared to calcitonin M. Preliminary evaluation of plasma immunoreactive calcitonin estimations in patients with breast carcinoma showed that twenty-three out of twenty-eight patients with metastatic disease had elevated plasma calcitonin concentrations, whereas only one out of thirteen with localized disease had high levels.
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PMID:The ectopic secretion of calcitonin by lung and breast carcinomas. 105 52


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