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 introduction of endoscopic ultrasonography (EUS) has opened a window in the diagnosis of the perigastrointestinal lymph nodes. Initial euphoria has been sobered by the fact that false-positive and false-negative diagnoses may occur. We review here the use of EUS to stage gastrointestinal cancer, and particularly to predict the presence or absence of lymph-node metastases. The role of EUS-guided fine-needle aspiration using a radial scanner or a curved array echoendoscope is mentioned.
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PMID:Endoscopic ultrasonography of perigastrointestinal lymph nodes. 771 87

The anatomic extent of tumor (TNM, pTNM) and, in case of treatment, the residual tumor status following treatment (residual tumor, or R classification) are the strongest predictors for outcome of patients with gastrointestinal cancer. The results of the pTNM and the R classifications depend on the methods used. In particular, the pN classification correlates with the number of nodes examined. The findings of micrometastases or isolated tumor cells in bone marrow should be indicated, and such cases must be analyzed separately from other metastatic cases. The same applies to patients with positive cytology in ascites fluid or peritoneal washings without gross involvement of the peritoneum. For the R classification the additional descriptors (conv), for conventional methods used, and (soph), for sophisticated, are recommended to indicate the methods used for classification. In general, long-term survival can be expected only after R0 resection (resection without residual tumor). The observed 5-year survival after R0 resection is 15% to 40% for esophageal carcinoma, 40% to 75% for gastric carcinoma, and 55% to 60% for colorectal carcinoma; the respective figures for R1 and R2 resections are only about 5% each. In R1 and R2 cases prognosis is determined primarily by the absence or presence of distant metastases, and pT and pN are of minor significance. After R0 resection there is a wide spectrum of prognoses. Careful pTNM classification allows a good estimation of the prognosis and can be considered the gold standard for any analysis of treatment results.
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PMID:pTNM and residual tumor classifications: problems of assessment and prognostic significance. 775 21

Although adjuvant chemotherapy has made some progress in the treatment of colorectal cancer, chemotherapy of metastatic disease remains disappointing. Autologous bone marrow or stem cell transplantation following supralethal chemotherapy is presently not of major significance in tumors of the intestine. The registry of the EBMT (European Cooperative Group for Blood and Marrow Transplantation) contains at March 1993 a total of 2085 cases of autotransplants for solid tumors, of which only 19 were performed for disseminated gastrointestinal cancer (15 gastric, 4 colon). It remains to be shown, whether the presently poor results can be improved upon inclusion of lymphokine-activated killer cells (LAK-cells) by use of cytokine combinations or by the use of tumor infiltrating lymphocytes (TIL) post transplantation.
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PMID:[Autologous bone marrow transplantation in intestinal carcinoma]. 776 52

The authors illustrate their experience in the systematic use of intraoperative ultrasonography of the liver in patients undergoing surgery due to gastrointestinal cancer. The liver is the organ in which metastases from colorectal, stomach, pancreatic, and biliary cancer are most often localised. Between January 1991 and April 1992 95 patients underwent intraoperative ultrasonographic controls of the liver. In all cases the liver was studied using traditional image diagnosis: standard ultrasonography and CAT. On the basis of their experience the authors observed 12 cases negative for metastases using CAT and traditional ultrasonography which were positive using intraoperative ultrasonography, 2 cases which were positive for secondary hepatic lesions using traditional diagnostic tools but negative following histological tests guided by intraoperative ultrasonography. In the case of false negatives using traditional methods, those metastases revealed by intraoperative ultrasonography were above all located deep down and in segments which are difficult to explore, or were so small that they were not visible or palpable during intraoperative controls of the viscera. Intraoperative ultrasonography of the liver has been found to be a more sensitive test (97% of the best series) than standard ultrasonography (65%) or CAT (43%). Higher resolution due to the characteristics of the method is coupled with the possibility that intraoperative ultrasonography may be used to guide biopsies of the metastases revealed, thus allowing histological confirmation to be obtained: for this reason the risk of false positives is virtually zero.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Intraoperative ultrasonography in the diagnosis of liver metastasis from gastrointestinal neoplasms]. 812 89

Overproduction of matrix metalloproteinases (MMPs) is a common characteristic of metastatic cancer cells. Since MMPs can be identified in plasma, we proposed that enhanced MMP-9 secretion by invasive cancer cells may be detected by plasma assay. To this end, we developed a specific sandwich enzyme-linked immunosorbent assay which uses two mouse monoclonal antibodies to human M(r) 92,000 type IV collagenase (MMP-9). The plasma concentration of MMP-9 (mean +/- SD) in 60 healthy subjects (9 +/- 11 ng/ml), 136 patients without cancer, and 179 patients with cancer of the lung, genitourinary tract, or lymphomas-leukemias did not differ significantly. In contrast, plasma MMP-9 was significantly increased (P < 0.01) in 122 patients with gastrointestinal tract cancer and breast cancer (18 +/- 23 and 21 +/- 22 ng/ml, respectively). Whereas carcinoembryonic antigen levels were significantly increased in patients with stage IV gastrointestinal cancer, MMP-9 concentrations were not significantly increased in patients with metastatic disease as compared to those with nonmetastatic cancer. Combining both assays improves sensitivity of detection of colon cancer. MMP-9 was also significantly increased during pregnancy which is consistent with the extensive ongoing tissue remodeling and the leaching of the tissue proteinase into plasma.
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PMID:M(r) 92,000 type IV collagenase is increased in plasma of patients with colon cancer and breast cancer. 841 38

The objective of this study is the evaluation of serum levels of lipid-bound sialic acid (LSA) as a of marker cancer. This is a case-control study, and the levels of LSA were determined with blinded duplicates of cases and controls. Histologic verification of all cancer cases was used to confirm the diagnosis. The study included 135 patients with cancer (breast carcinoma, head and neck squamous cell carcinoma, lung cancer and gastrointestinal cancer) and 95 controls (57 normal subjects and 38 with chronic non-malignant diseases). Marker determination was done by the spectrophotometric procedure of Katopodis with resorcinol. The mean LSA level in the 57 healthy individuals was 15.09 mg/dl(95% C.I., 13.51-16.67), in the entire control group of 95 non-tumoral individuals it was 19.21 mg/dl (17.18-21.24), and in the 135 cancer patients it was 26.64 mg/dl (24.42-28.87). There was a statistically significant difference between patients with chronic non-tumoral diseases and healthy individuals (p < 0.001) and also between cancer patients and healthy individuals (p > 0.001), but not between cancer patients and patients with chronic non-tumoral diseases (p> 0.05). The mean LSA serum values related to tumor site were (mg/dl): breast cancer, 21.49; gastrointestinal tumors, 28.45; head and neck cancer, 28.61 and lung cancer, 32.54. The means according to clinical stage were: complete remission, 18.50 significantly higher than the healthy controls (p< 0.05); local disease, 23.50 (p < 0.01); locoregional disease, (p < 0.05); local disease, 23.50 (p < 0.01); locoregional disease, 27.21 (p < 0.001); metastatic disease, 34.49 (p < 0.001), and relapses, 20.87 (p< 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Evaluation of lipid-bound sialic acid (LSA) as a tumor marker. 855 Oct 61

Serum cytokines and hepatic acute-phase responses were studied in seven patients undergoing simultaneous resection of primary gastrointestinal cancer and synchronous metastatic liver tumours and in 12 undergoing partial hepatectomy alone for metachronous hepatic metastases. The incidence of postoperative infectious complications was significantly higher after simultaneous resection than after partial hepatectomy alone (P < 0.05). Although the peak interleukin 6 level was significantly higher after simultaneous resection (P < 0.05), plasma levels of acute-phase proteins were significantly lower (P < 0.05). The results suggest that simultaneous resections further reduce the hepatic acute-phase response and render patients liable to infection compared with partial hepatectomy alone, and result in a higher incidence of postoperative infective complications.
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PMID:Reduced hepatic acute-phase response after simultaneous resection for gastrointestinal cancer with synchronous liver metastases. 881

CD44 is a ubiquitous multistructural and multifunctional cells surface adhesion molecule involved in cell-cell and cell-matrix interactions. Twenty exons are involved in the genomic organization of this molecule. The first five and the last 5 exons are constant, whereas the 10 exons located between these regions are subjected to alternative splicing, resulting in the generation of a variable region. Differential utilization of the 10 variable region exons, as well as variations in N-glycosylation, O-glycosylation, and glycosaminoglycanation (by heparan sulfate or chondroitin sulfate), generate multiple isoforms (at least 20 are known) of different molecular sizes (85-230 kDa). The smallest CD44 molecule (85-95 kDa), which lacks the entire variable region, is standard CD44 (CD44s). As it is expressed mainly on cells of lymphohematopoietic origin, CD44s is also known as hematopoietic CD44 (CD44H). CD44s is a single-chain molecule composed of a distal extracellular domain (containing, the ligand-binding sites), a membrane-proximal region, a transmembrane-spanning domain, and a cytoplasmic tail. The molecular sequence (with the exception of the membrane-proximal region) displays high interspecies homology. After immunological activation, T lymphocytes and other leukocytes transiently upregulate CD44 isoforms expressing variant exons (designated CD44v). A CD44 isform containing the last 3 exon products of the variable region (CD44V8-10, also known as epithelial CD44 or CD44E), is preferentially expressed on epithelial cells. The longest CD44 isoform expressing in tandem eight exons of the variable region (CD44V3-10) was detected in keratinocytes. Hyaluronic acid (HA), an important component of the extracellular matrix (ECM), is the principal, but by no means the only, ligand of CD44. Other CD44 ligands include the ECM components collagen, fibronectin, laminin, and chondroitin sulfate. Mucosal addressin, serglycin, osteopontin, and the class II invariant chain (Ii) are additional, ECM-unrelated, ligands of the molecule. In many, but not in all cases, CD44 does not bind HA unless it is stimulated by phorbol esters, activated by agonistic anti-CD44 antibody, or deglycosylated (e.g., by tunicamycin). CD44 is a multifunctional receptor involved in cell-cell and cell-ECM interactions, cell traffic, lymph node homing, presentation of chemokines and growth factors to traveling cells, and transmission of growth signals. CD44 also participates in the uptake and intracellular degradation of HA, as well as in transmission of signals mediating hematopoiesis and apoptosis. Many cancer cell types as well as their metastases express high levels of CD44. Whereas some tumors, such as gliomas, exclusively express standard CD44, other neoplasms, including gastrointestinal cancer, bladder cancer, uterine cervical cancer, breast cancer and non-Hodgkin's lymphomas, also express CD44 variants. Hence CD44, particularly its variants, may be used as diagnostic or prognostic markers of at least some human malignant diseases. Furthermore, it has been shown in animal models that injection of reagents interfering with CD44-ligand interaction (e.g., CD44s- or CD44v-specific antibodies) inhibit local tumor growth and metastatic spread. These findings suggest that CD44 may confer a growth advantage on some neoplastic cells and, therefore, could be used as a target for cancer therapy. It is hoped that identification of CD44 variants expressed on cancer but not on normal cells will lead to the development of anti-CD44 reagents restricted to the neoplastic growth.
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PMID:CD44: structure, function, and association with the malignant process. 911 68

In addition to clinical examination and various diagnostic procedures, patients with gastrointestinal cancer (GIC) were also monitored by tumor marker (TM) determination. In total, 202 patients with GIC were postoperatively followed-up. According to in vivo diagnostic procedures, there were 133 (66%) patients without metastases, 63 (31%) patients with distant metastases, 48 (76%) of them with liver metastases, and six (3%) patients with local recurrences. During the 1990-1995 period, they were followed-up by serum TM concentration measurements on 1-8 occasions. At the time of initial diagnosis, TM were determined in a varying percent of the patients: CA 19-9 (100%), TPA (54%), CA 72-4 (49%), IAP (41%), CEA (41%) and AFP (25%). In the group of patients without metastases, the percentage of normal TM values ranged between 73%-100%, and TM sensitivity between 0%-86%. No ideal TM has as yet been discovered either for any malignant disease or for patients with GIC. Therefore, in the follow-up of patients with GIC we suggest the concentrations of at least two instead of only one TM (CA 19-9 and TPA or CEA) to be determined. It is also difficult to choose the best TM among numerous TM kits available on the market and to keep using it during a longitudinal follow-up study.
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PMID:Follow-up of patients with gastrointestinal cancer by tumor marker determination. 920 90

In Norway, about 2,800 cases of colorectal cancer are diagnosed every year. Two-thirds of the patients undergo potentially curative surgery and almost half of them develop local or distant metastases. The follow-up of colorectal cancer patients involves four strategies: Educating the patients about the disease, symptoms of relapse, and risk of hereditariness; Early diagnosis of relapse, to make curative re-surgery possible; Diagnosis of metachronous/synchronous cancer(s); Recording the results of current surgical techniques. The Norwegian Gastrointestinal Cancer Group recommend a four-year follow-up programme (every third month for two years and then twice a year) of colorectal cancer patients. It is suggested that patients treated with low anterior resection are followed regularly by means of rectoscopy and local examination (digital or by ultrasound) undertaken by specialist (surgeon or gastroenterologist). The others should be followed up mainly by general practitioners. Carcinoembryonic antigen (CEA)-monitoring is suggested every third month for two years, and then every sixth month. Colonoscopy is recommended at one and four year follow-up. Patients with normal CEA levels prior to surgery should be evaluated by ultrasound of the liver every sixth month for four years.
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PMID:[Follow up after potential curative surgery of colorectal cancer. Guidelines from the Norwegian Gastrointestinal Cancer Group]. 966 37


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