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 early diagnosis of anastomotic recurrence after surgery for carcinoma of the colon and rectum is difficult. Whether repeat colonoscopy and serial serum CEA measurements were useful in diagnosing early anastomotic recurrence was examined. A total of 112 patients with carcinoma of the colon and rectum who had undergone resection and anastomosis were followed with frequent colonoscopy and serum CEA measurements. Seventeen patients developed anastomotic recurrence. Fourteen patients had elevated serum CEA levels, and 15 patients had endoscopic evidence suggesting recurrence at the anastomotic site. CT scans of the abdomen and pelvis demonstrated metastatic disease in seven patients, localized anastomotic disease in six patients, and no evidence of disease in four patients. Laparotomy was then carried out in 10 patients. In eight of 10 patients, it was possible to resect localized disease. In a 3-year follow-up study, eight patients were alive, four without any evidence of recurrent disease. Repeat colonoscopy and serum CEA measurements are recommended as postoperative surveillance for carcinoma of the colon and rectum. In select cases laparotomy and resection may prolong survival.
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PMID:Anastomotic recurrence of carcinoma of the colon and rectum. The value of endoscopy and serum CEA levels. 203 34

In the last decades several markers of pancreatic neoplasia have been proposed to obtain a diagnosis as earlier as possible. Prerequisites of a good tumor marker are high sensitivity and specificity. Among the various substances, serum determination of pancreatic enzymes has been found of no utility in early diagnosis of pancreatic cancer, due to its lack in sensitivity and specificity. Similar results with ribonuclease and deoxyribonuclease. Oncofetal antigens (CEA and POA) have been initially considered promising indices; however, further studies showed their limits. In particular CEA is greatly influenced by the presence of hepatic metastases; therefore, serum levels are detectable only in advanced stages. TPA is characterized by a high sensitivity, but lacks in specificity and its use is now avoided. A real progress in the field of tumor markers has been made in the last years with the monoclonal antibody technique: among them CA 19-9 showed a good sensitivity and a satisfactory specificity as regards the diagnosis of pancreatic cancer. However, it cannot be considered as absolute aid, since it is influenced by several factors, as tumor spread, jaundice and liver dysfunction.
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PMID:[Value and limitations of neoplasm markers in the diagnosis of pancreatic carcinoma]. 204 59

Peripheral blood leukocyte alkaline phosphatase scores and plasma carcinoembryonic antigen levels in 26 patients with metastatic colorectal cancer were compared to those in 30 healthy controls. Patients had metastases to the liver and abdomen. The mean leukocyte alkaline phosphatase score in the metastatic colorectal cancer patients was significantly higher than in the control group (246 +/- 65 vs, 52 +/- 26, p less than 0.001); and the mean carcinoembryonic antigen level in the patients was also significantly higher than in the controls (110 +/- 100 vs, 4.9 +/- 3 ng/ml, p less than 0.001). One hundred percent of the metastatic cancer patients had elevated LAP scores and 73% of these patients had elevated CEA levels. There was a difference between the mean CEA levels in the patients with liver metastases and those with abdominal metastases (162 +/- 135 vs, 39 +/- 53 ng/ml, p less than 0.04). The results suggest that although both markers were elevated in metastatic colorectal cancer, the LAP score seems to be more useful in detecting metastatic disease, since we found 11% false negatives with the CEA level and 0% false negatives with the LAP score.
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PMID:Leukocyte alkaline phosphatase and carcinoembryonic antigen in metastatic colorectal cancer patients. 204 30

Carcinoembryonic antigen has been demonstrated to be a valuable clinical aid in the management of patients with colorectal carcinoma. Its elevation in the serum prior to evidence of clinical recurrence in up to 80% of patients highlights its utility. CEA has also been found to be elevated in the serum of patients with other epithelial malignancies, but these have not been as well studied as has colorectal carcinoma. In patients with breast cancer CEA elevations may be found in 40-73% of patients presenting with disease in stages I-IV. In addition, 80% of patients will have a CEA elevation 3-10 months prior to clinical symptoms of recurrence. Seventy-seven percent of patients with bronchogenic lung cancer will have an elevated preoperative value. However, cigarette smoking also causes an increase in the CEA assay level and, thus, differentiation between benign and malignant conditions is more difficult. In small cell carcinoma of the lung, CEA assay levels above 10 ng/ml correlate highly with metastatic disease, while values less than 2.5 ng/ml correlate with localized disease. Pancreatic and gastric malignancies demonstrate CEA level elevations in just over 50% of cases. But these, however, have not been clinically useful. Epithelial neoplasms of the female reproductive tract (cervix, uterus, and ovary) also produce CEA in 47-75% of cases and may correlate with stage of disease at diagnosis and level of cellular differentiation. CEA assay levels are elevated in a variety of tumors and correlate with tumor stage, degree of differentiation, and effectiveness of therapy; they may also be the earliest marker of recurrence.
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PMID:CEA in tumors of other than colorectal origin. 206 50

Serum activities of bone alkaline phosphatase (b-ALP) and of tartrate resistant acid phosphatase (tr-ACP) were evaluated in 271 cancer patients; 120 of them had bone metastases (BM) and 151 had none. Correlation coefficients, specificities, sensitivities, negative and positive predicting values were computed. They showed the important contribution that these isoenzymes can bring to the diagnosis of BM in 80 patients with prostate cancer, and to the followup of 191 patients with breast cancer. The assay results were analysed in parallel with bone scan and radiography. They were also compared to those of serum antigens: PSA and PAP for prostate cancer, and CEA and CA15.3 for breast cancer. These results clearly indicate that both isoenzymes are better correlated with BM than antigens, these antigens being markers of the whole tumor burden--primary tumor, metastases, recurrence--whereas b-ALP and tr-ACP are specific markers of bone metabolism.
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PMID:[Evaluation of two serum isoenzyme phosphatases as bone metastasis markers]. 208 Dec 81

Carcinoembryonic antigen and some liver function tests (alkaline phosphatase, gamma-glutamyltranspeptidase, lactic dehydrogenase and cholinesterase) were evaluated in patients with primary colorectal cancer in order to define their role in the pre-operative detection of liver metastases. The records of 278 consecutive patients admitted to the Istituto Nazionale Tumori of Milan between January 1982 and December 1983 who were suffering from primary invasive colo-rectal cancer and who underwent laparotomy were retrospectively analyzed. At laparotomy, liver metastases were found in 38 pts (13.7%). Considering single tests, CEA was the most sensitive (71%); no single test was found to be reliably predictive, when the result was abnormal. On the contrary, the normal value of each test was associated with a good prediction. When we considered all the five tests together in the single patient their predictive value, when abnormal, proved to be quite good only if four or five results were abnormal. On the other hand, liver metastases in the presence of all normal tests were found only in two patients, so giving a negative predictive value of about 97%. So we conclude that, in the lack of an infallible imaging technique for liver evaluation, in the presence of all normal tests any other investigation on the liver could be avoided. However, when liver tests are pathologic, some other imaging technique should be performed in order to supply the surgeon with information about the extent and the spread of the metastases.
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PMID:The role of CEA and liver function tests in the detection of hepatic metastases from colo-rectal cancer. 209 Jan 87

Hepatic artery chemotherapy was given to 36 patients, using totally implantable devices consisting of a port and external pump. Twenty-seven patients had inoperable liver metastases of colorectal origin. The infusion system was inserted by laparotomy into the hepatic artery via the gastroduodenal artery. There was no operative mortality. Thirteen infusion systems could not be used for chemotherapy due to dislodgement, early death and lack of follow-up. FUdR was infused every two weeks. There were minor local complications like thrombosis of the system and dislodgement of the port. Toxic effects could be managed by reducing the dose. Response to chemotherapy was evaluated by survival, clinical condition, CEA, ultrasound and CT six months after onset of arterial chemotherapy. Ten/twenty-three patients (43%) responded to therapy, eight of them died on the average 19 months after initial chemotherapy. Six patients were non-responders, seven had stable disease. Five/ten patients developed extrahepatic metastases. Mean survival time was 13.1 months, mean interval until relapse 10.6 months.
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PMID:Hepatic artery infusion chemotherapy. 214 79

Radioimmunoimaging of bone marrow was performed for non-invasive detection of skeletal involvement in 15 patients with carcinoma of the breast and 17 patients with malignant lymphomas. Bone marrow scans were performed by means of a monoclonal 99mTc-labelled antibody, directed against NCA-95 and CEA. The presence and extent of skeletal involvement were controlled by skeletal scintigraphy, plain radiographs and CT; bone marrow biopsies were obtained in 19 patients as well. 20 subjects without suspected malignant disease served as controls. Haematopoietic bone marrow was imaged homogeneously and with high contrast in all controls. 15/15 patients with carcinoma of the breast and 10/17 patients with malignant lymphomas had multifocal bone marrow defects due to skeletal metastases. Bone marrow scans revealed significantly more lesions than skeletal scintigraphy both in carcinoma of the breast (p = 0.027) and malignant lymphomas (p = 0.015). Thus, radioimmunoscintigraphy of bone marrow may provide a new, sensitive approach for non-invasive detection of metastatic spread to the skeletal system.
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PMID:[Detection of bone marrow involvement in breast cancer and malignant lymphoma using immunoscintigraphy of the hematopoietic bone marrow]. 215 12

The aim of this study was to conduct immunohistochemical examinations of cell and tissue material compared with clinical examinations of markers to discover the possible mechanisms that can result in marker concentration increases in the plasma and other body fluids. From cell material and biopsies it was possible to identify in small-cell carcinomas TPA (52% of the carcinomas), NSE (57%) and no CEA. Of the non-small cell carcinomas (squamous cell and adenocarcinomas) 88% were TPA-positive, 52% CEA-positive and in metastases 100% TPA-positive and 66% CEA-positive. NSE was not found. Marker examinations in tissue and cell material can yield satisfactory results in recognising neuroendocrinal differentiations, and in diagnosis and differential diagnosis of metastases and lymphomas, compared with clinical tumour marker studies.
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PMID:[Analysis of tumor markers in lung biopsies and in bronchial lavage]. 216 99

The effectiveness of percutaneous ethanol injection therapy was investigated in 20 patients with hepatocellular carcinoma (six cases), or hepatic metastases (twenty-five cases). 131 ethanol injections were performed between december 1987 and march 1990 for 30 lesions. Indications for this procedure included inadequate response to conventional treatment and tumor diameter less than 5 cm. Histopathologic examination, performed in all cases, showed that the tumor was completely necrotic in 16 cases, partially necrotic in 8 cases and not modified in 6 cases (one patient was not evaluable). Alpha-feto-protein and CEA levels were decreased in 12/17 cases. 16 patients were still alive at the end of the study (the mean follow-up period was 11.3 months). We conclude that ethanol injection may be a valuable treatment for small hepatic tumors.
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PMID:[Ultrasound-guided percutaneous ethanol injection of small malignant tumors of the liver. Results in 20 patients]. 217 12


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