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)

Hepatic arterial chemoembolization (CE) with a mixture of particulate collagen and chemotherapeutic agents was evaluated as therapy for hepatic metastases from colorectal carcinoma. This article describes the characteristics sequential pattern of change seen on liver CT scans following CE. Thirty CT scans were performed on seven patients who had undergone a total of 11 CE procedures. All patients had baseline, immediate postprocedural, and follow-up CT exams at 1 to 2 month intervals following CE. Immediate post-procedural CT scans mapped the area of embolization owing to the density of the contrast mixed with the CE agents. Some lesions seen easily on baseline were more difficult to see as they became isodense with normal liver. Reflux of embolic material into the cystic artery and gallbladder wall was also observed on postprocedural scans in three patients. In all patients, early follow-up scans (1 month after CE) demonstrated changes in lesions seen on baseline scans consistent with tumor necrosis. This was corroborated by a decrease in carcinoembryonic antigen (CEA) levels. In three patients, however, low attenuation regions developed in areas in which there had been no lesion before. The significance of these is uncertain, but the low CEA values and the subsequent evolution in appearance of these sites on CT suggest that they were regions of hepatic ischemia/infarction as opposed to heretofore unidentifiable metastases, now "unmasked." Intermediate follow-up scans (2-3 months) revealed maximal effect on tumor volume, with a decrease of > or = 25% in five of seven patients (71%). Late follow-up scans (> or = 3 months after the last CE) confirmed recurrent disease and new lesions in all cases.
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PMID:CT findings after hepatic chemoembolization. 143 Apr 41

Clearance of carcinoembryonic antigen (CEA) from the circulation is by binding to Kupffer cells in the liver. We have shown that CEA binding to Kupffer cells occurs via a peptide sequence YPELPK representing amino acids 107-112 of the CEA sequence. This peptide sequence is located in the region between the N-terminal and the first immunoglobulin like loop domain. Using native CEA and peptides containing this sequence complexed with a heterobifunctional crosslinking agent and ligand blotting with biotinylated CEA and NCA we have shown binding to an 80kD protein on the Kupffer cell surface. This binding protein may be important in the development of hepatic metastases.
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PMID:A peptide sequence on carcinoembryonic antigen binds to a 80kD protein on Kupffer cells. 144 12

The aim of this study was to compare carcinoembryonic antigen (CEA) and CA19-9 for the detection of local recurrences and distant metastases after complete resection of gastric carcinoma. At least one postoperative measurement of CEA and CA19-9 was performed in 54 patients. Among these, 32 had recurrence (59%) with a median follow-up of 618 days. Significantly higher sensitivity was observed for CA19-9 in comparison with CEA (68.8% vs 38.2% respectively), but specificity was slightly lower (81.8% vs 95.6% respectively). Increased CEA plasma level never preceded the diagnosis of recurrence while increasing CA19-9 preceded diagnosis in 13 patients (40.6%) from 1 to 22 months (median = 4.5 months). Increasing the normal range of CA19-9 to 80 UI/mL (2.5 x N) raises the specificity to 100% with acceptable sensitivity (53.1%). This study shows that CA19-9, compare with CEA, allows diagnosis of recurrence more often and earlier in the follow-up of resected gastric cancer.
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PMID:[Stomach adenocarcinomas: comparison between CA 19-9 and carcinoembryonic antigen for the diagnosis of recurrences after surgical treatment]. 148 53

A case of pulmonary adenocarcinoma, which was initially manifested as a gastric submucosal tumor, is presented. Endoscopy showed a submucosal tumor in the fundic region in a 79-year-old Japanese woman. Initial biopsy specimens of the stomach revealed atypical spindle cell proliferation, suggesting primary leiomyosarcoma of the stomach. However, biopsy specimens obtained one year later were diagnosed as malignant lymphoma or malignant histiocytosis of the stomach. Autopsy revealed a large necrotic lesion in the right S8 region with metastases in multiple organs. Microscopy demonstrated well to moderately differentiated adenocarcinoma containing spindle or pleomorphic sarcomatous elements. Metastatic nodules including the gastric tumors all showed sarcomatous elements with no epithelial component. Immunohistochemistry showed positive reactions for keratin, epithelial membrane antigen, and carcinoembryonic antigen in areas of carcinoma, whereas most of the sarcomatous elements revealed no positivity for any of the antibodies used, except for focal keratin and EMA positivity in the primary site. This is a rare case of pulmonary adenocarcinoma with sarcomatous elements discovered as a gastric tumor at initial diagnosis, resulting from metastasis of the sarcomatous element in the submucosa.
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PMID:A case of pulmonary adenocarcinoma with sarcomatous elements initially manifested as a submucosal tumor of the stomach. 150 6

This review discusses recent papers on endometrial carcinoma variants, immunohistochemical studies, and prognostic indicators. The aggressive nature of uterine papillary serous carcinoma is confirmed, even in the absence of myometrial or vascular invasion, with a comprehensive review of the histology, clinical presentation, and proposed treatment protocols. The possible etiologic role of radiation in the development of uterine papillary serous carcinoma is alluded to. The virulence of endometrial carcinomas with trophoblastic differentiation, endometrial carcinomas with a malignant giant cell component, and clear cell carcinomas of the endometrium is documented. A series of immunohistochemical studies is presented suggesting that uterine carcinosarcomas are metaplastic carcinomas derived from a common stem cell and that a shared histogenesis of endometrial stromal tumors and uterine mesoderm exists. Immunohistochemical techniques may clarify diagnostic problems of uterine tumors and their metastases and differentiate mucinous tumors of endometrium from endocervical origin. Staining of both carcinoembryonic antigen and ferritin in neoplastic endometria may be helpful in their differentiation from hyperplasias in curettage specimens. Significant prognosticators in endometrial carcinoma are depth of myometrial invasion and lymphovascular space involvement with greatest prognostic information provided by the depth of myometrial invasion above DNA index.
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PMID:Malignant endometrial pathology. 150 78

Levels of tissue carcinoembryonic antigen (CEA) in 54 abdominal fine-needle biopsy specimens from 50 patients were measured to ascertain the use of tissue CEA levels in diagnosis of malignancy. Biopsy was performed in the following sites: liver (n = 34), retroperitoneum (n = 8), adrenal gland (n = 3), pancreas (n = 2), omentum (n = 2), pelvis (n = 2), spleen (n = 2), and stomach (n = 1). Histologic findings proved malignancy in 39 patients and benign disease in 11 patients. In these 11 patients, the mean levels of tissue CEA were lower than the normal level of serum CEA (3 ng/mL). Tissue CEA levels were higher than serum CEA levels in nine patients with colonic carcinoma and in 12 of 16 patients with noncolonic CEA-secreting malignancies. Four patients with noncolonic CEA-secreting malignancies had tissue CEA levels within the normal range (less than 3 ng/mL). Tissue CEA levels were also normal in 13 patients with various non-CEA-secreting tumors. Tissue CEA levels may prove useful in biopsy of necrotic or cystic lesions and assessment of response to ablative therapy for colon metastases.
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PMID:Measurement of tissue carcinoembryonic antigen levels from fine-needle biopsy specimens: technique and clinical usefulness. 833 94

The distribution of regional lymph node metastases in carcinoma of the left side of the colon, rectum, and anus can be well shown by routine CT of the abdomen and pelvis. Recognition of the location of nodes in the mesocolic, left colic, and IMA nodal groups can help in developing a systematic approach to the detection of nodal metastasis. This can be especially important in preoperative planning for cases in which resection may be curative. In addition, an understanding of the distribution of nodal metastasis will make it possible to recognize early recurrent nodal disease, particularly with an increase in associated increase in levels of carcinoembryonic antigen, and to predict certain clinical sequences such as hydronephrosis of the left kidney associated with left colic nodal metastases.
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PMID:Regional lymph node metastases in carcinoma of the left side of the colon and rectum: CT demonstration. 152 37

The distribution of 111In-labelled anti-carcinoembryonic antigen (CEA) monoclonal antibody fragments [F(Ab')2] was studied in five patients either with known inoperable medullary carcinoma of the thyroid (MCT) or evidence of recurrence/metastases based on elevated calcitonin (hCT) levels. All five cases had elevated serum CEA levels and positive immunohistochemical stains for both hCT and CEA prior to scintigraphy. In two patients with identified inoperable disease both planar and SPECT scans were positive. In the remaining three patients, where the recurrence/metastatic sites were unknown, SPECT images were positive in two. Of these, only one had positive planar images. These results indicate that 111In-labelled anti-CEA F(ab')2 scintigraphy, especially in conjunction with SPECT, is useful for the diagnostic evaluation of patients with MCT. The limiting factor of this technique is the high level of non-specific uptake, particularly in the liver, but improvements in the specificity of newer anti-CEA antibodies and the ability to label these with 99Tcm is addressing this problem.
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PMID:Imaging of medullary carcinoma of the thyroid using 111In-labelled anti-CEA monoclonal antibody fragments. 155 12

Sixty-six consecutive patients who underwent curative resection for rectal cancer were studied prospectively to evaluate the roles of sequential carcinoembryonic antigen (CEA), tissue plasminogen activator (TPA), and carcinomatous antigen 19-9 (Ca 19-9) determinations in the early diagnosis of resectable recurrences. Thirty-three recurrences were detected between 6 and 42 months. CEA, TPA, and Ca 19-9 showed a sensitivity of 72.7 percent, 78.8 percent, and 60.1 percent, respectively, and a specificity of 60.6 percent, 60.6 percent, and 87.9 percent, respectively. In 23 cases the rise in the value of CEA and/or TPA and/or Ca 19-9 was the first sign of recurrences, and the diagnosis was established later by clinical methods. In this group, the lead time was two months for liver metastases and four months for disseminated metastases. As far as the relationship between localization of recurrence and marker level increase is concerned, of 16 hepatic metastases CEA, TPA, and Ca 19-9 showed a sensitivity of 94 percent (P less than 0.05), 69 percent, and 62 percent, respectively. Of six patients with local recurrences, CEA, TPA, and Ca 19-9 showed a sensitivity of 50 percent, 100 percent (P less than 0.05), and 83.3 percent, respectively. Of three patients with peritoneal carcinomatosis, CEA, TPA (P less than 0.05), and Ca 19-9 showed a sensitivity of 0 percent, 100 percent, and 0 percent, respectively. No significant differences were reported among the three markers according to multiple metastases and metachronous polyps. Fourteen patients (42.4 percent) underwent surgical treatment for recurrent disease, and eight of them (57 percent) showed a resectable disease, for a total resectability rate of 24.2 percent. The findings of our study indicate that a follow-up program based on CEA, TPA, and Ca 19-9 assays is related to an early diagnosis and a good resectability rate for both local and metastatic recurrences from rectal cancer.
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PMID:Role of CEA, TPA, and Ca 19-9 in the early detection of localized and diffuse recurrent rectal cancer. 156 99

Careful patient selection for hepatic resection of colorectal cancer metastases is essential to improve current poor results. Carcinoembryonic antigen level and number of metastases were significant preoperative prognostic indicators of 5-year disease-free survival in patients selected clinically for hepatic surgery. Surgical margin, weight of hepatic tissue resected, carcinoembryonic antigen level, and flow cytometry were significant postoperative prognostic indicators. Patients with a carcinoembryonic antigen level less than 200 ng/mL, 1-cm surgical margins, and less than 1,000 g of liver tissue removed had a greater than 50% estimated 5-year disease-free survival rate. If the metastases were diploid on flow cytometry, an additional survival advantage may have been gained. Inadequate surgical margins led to high rates of liver-only recurrence. Nonhepatic recurrence was unrelated to surgical margins. Intraoperative liver examination by ultrasound during primary colon cancer resection and adjuvant chemotherapy may offer earlier selection of biologically appropriate patients and improved outcome; both recommendations require clinical trials.
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PMID:Technical and biological factors in disease-free survival after hepatic resection for colorectal cancer metastases. 157 26


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