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 sera of 563 patients who underwent colonoscopy were assayed for glycolipid antigen CA 19-9 and CEA. These patients represented a broad spectrum of clinical diseases ranging from advanced metastatic cancer of the colon, pancreas, or stomach to those with negative colonoscopic examination. Sensitivity and specificity for CA 19-9 and CEA were calculated using the following clinical definitions. Malignant or pre-malignant disease was defined as colon, pancreatic or stomach carcinoma, stomach dysplasia, atypical adenomatous polyp, atypical villous adenoma, carcinoma in situ and carcinoma in an adenomatous polyp. When the normal group included patients with adenomatous polyp, hyperplastic adenoma, inflammatory disease and patients with no disease apparent, the sensitivity and specificity for CA 19-9 was 23% and 96%, and for CEA, 23% and 95%, respectively. When adenomatous polyp patients were placed in the malignant or pre-malignant disease group, the sensitivity and specificity for CA 19-9 was 8% and 96%, and for CEA, 11% and 95%, respectively. When comparing CA 19-9 and CEA in colorectal carcinoma, the percent positivity of the CEA assay was equal to, or better than, CA 19-9 in all Dukes' stages. In pancreatic carcinomas CA 19-9 showed better diagnostic performance than CEA.
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PMID:Comparison of serum CA 19-9 and CEA levels in a population at high risk for colorectal cancer. 280 13

The purpose of these studies was to determine whether the biological and metastatic behaviors of tumor cells isolated from fresh surgical specimens of human colon carcinomas are influenced by the isolation method and the organ site of implantation and growth in nude mice. Three surgical specimens were obtained from three different patients. Two tumors were primary human colorectal carcinomas (HCC) classified as Dukes' B2 (KM12) and Dukes' D stages (KM20), and the third was from a liver metastasis (KM23). The tumors were enzymatically dissociated, and viable cells were implanted into the subcutis or spleen of different nude mice or were established in culture. Tumors developed in both sites of implantation, but hepatic metastases were found only in those nude mice that received splenic implantations of HCC cells. Cells from Dukes' D stage tumors produced more hepatic disease than cells from the Dukes' B tumor. Cells of the parental KM12C (culture) were injected into the spleen or cecum of nude mice to produce experimental and spontaneous hepatic metastases, respectively. HCC lesions were harvested from livers of nude mice and established as individual cell lines in culture. This procedure yielded cell lines KM12SM (spontaneous metastasis) and KM12L1 (experimental metastasis). The selection cycle for cells implanted into the spleen was repeated three more times to produce the cell line designated KM12L4. Cells of the parental KM12C and the three selected variants were injected into nude mice by different routes: i.v., s.c. into the cecum, and into the spleen. Subsequent to implantation into the spleen, all cell lines were shown to be tumorigenic. Cells from the selected KM12L4 and KM12SM lines produced a significantly higher number of experimental liver metastases than the parental cells. Moreover, subsequent to the injection into the cecum, cells of the once-selected KM12SM (for spontaneous metastasis) produced a higher incidence of spontaneous liver metastasis than all other lines. The human origin of all the lines was confirmed by isoenzyme and karyotype analyses. The two highly metastatic lines (KM12L4 and KM12SM) were tetraploid and produced elevated levels of type IV collagenolytic activity. Collectively, the results demonstrate that the orthotopic implantation of HCC cells into the appropriate organ environment can be used for efficient isolation and for study of metastatic subpopulations of cells from human colon carcinoma.
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PMID:Influence of organ environment on the growth, selection, and metastasis of human colon carcinoma cells in nude mice. 284 63

Eighty-two patients with colo-rectal cancers (29 colon and 53 rectum) were admitted and underwent radical resection from January 1982 to June 1984. There were 54 males and 28 females. The ages ranged from 25 to 74 years. According to Dukes's classification, there were 2 Stage A, 47 (57.3%) Stage B and 33 (40.2%) Stage C. Histologically, 70.7% were adenocarcinoma, 20.7% mucinous carcinoma and 8.6% others. All these patients were randomized into two groups: trial group and control group. In the trial group, there were 45 patients treated by radical resection plus adjuvant intraluminal 5-FU chemotherapy and intravenous 5-FU chemotherapy on the first and second days postoperatively. The intraluminal dose of 5-FU was 30 mg/kg injected into the bowel lumen of the isolated diseased segment between the tape ligatures. The intravenous dose was 10 mg/kg given on the first and second days after operation. In the control group, there were 37 patients treated by radical resection alone. The survival rates were calculated by the life-table method and the results showed that in patients with Dukes' C, the 5-year survival rate of the trial group was 61.8%, and that of the control group was 27.3% (P less than 0.05). In addition, hepatic metastasis in the trial group was less than that in the control group. The results of the randomized trial indicated that adjuvant intraluminal 5-FU chemotherapy may be an important approach to improve the results of radical resection for advanced colo-rectal cancer and to prevent hepatic metastases. Further clinical studies are recommended.
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PMID:[Reevaluation of intraluminal fluorouracil chemotherapy as an adjuvant to radical resection of colorectal cancer--results of a randomized trial]. 285 81

Between July 1975 and July 1986, 112 patients with adenocarcinoma of the rectum were treated using preoperative irradiation followed by excisional surgery on the colorectal surgery service of Jewish Hospital at Washington University Medical Center in St. Louis. There were 68 men and 44 women in this study, with ages ranging from 19 to 94 years of age. In all cases, the rectal cancers were believed to be transmurally invasive based on initial clinical examination. Included in this group were 13 patients with poorly differentiated tumors and 51 patients with tumors fixed to surrounding tissues. Between 1975 and 1980, we used 2000 cGy preoperative irradiation followed by immediate excisional surgery to treat 22 patients. Excisional surgery for cure was divided between abdomino-perineal resection of the rectosigmoid in eleven patients, low anterior resection of the rectosigmoid in eight patients, and a low Hartmann's procedure in three patients. Five-year survival for 20 patients with potentially curable lesions (Dukes' A, B, and C), was 85%, and there was no local recurrence. Between 1980 and 1986, 90 patients were treated with 4500 cGy preoperative irradiation over a 5-week period followed by a 6-week waiting period, before excisional surgery. There were 72 patients with Dukes' A, B, and C lesions. Fifty patients underwent abdomino-perineal resection of the rectosigmoid, 33 patients underwent low anterior resection of the rectum, and seven patients underwent a low Hartmann's procedure. Five-year survival was 86%. Local recurrence was 1.8%. Tumor fixation and histologic dedifferentiation were the only factors that influenced survival. Five-year survival of patients with fixed poorly differentiated tumors was 27% as compared to 87% in patients with nonfixed well-differentiated tumors (p less than 0.0001). Tumor fixation was not a significant factor in itself. Preoperative external beam irradiation improves survival, local control, and resectability in patients with rectal cancer. This effect may be due to the treatment of the "tangential" margins and local lymph node metastases. Preoperative staging can be accomplished by determining fixation and differentiation of the tumor when preoperative irradiation is used.
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PMID:Preoperative irradiation for rectal cancer. Improved local control and long-term survival. 291 63

Three cases of primary signet-ring cell carcinoma of the rectum are described. They accounted for 0.2% of the 1531 cases of colorectal adenocarcinoma in the 12 yr period from 1972-1983 in the University Department of Pathology at Queen Mary Hospital. The patients were young, aged 18, 24 and 27 yr respectively, in striking contrast to the mean age of 62 in patients with the usual types of colorectal cancer. They were also younger than most patients with this tumour in the literature. They presented with alteration of bowel habit, blood and mucus in stool, and weight loss. Pathological features included constrictive narrowing of the gut lumen by intestinal wall thickened by a desmoplastic reaction to diffusely infiltrating signet-ring carcinoma cells, widespread lymph node and peritoneal metastases, and absent hepatic metastasis. Microscopically, the mucosa was largely intact, but had multifocal tumour involvement. This peculiar feature was responsible for three consecutive negative biopsies in one case. Care in distinguishing it from mucinous adenocarcinoma is emphasized. All three patients presented with Dukes' C lesions. The prognosis is poor.
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PMID:Primary colorectal signet-ring cell carcinoma in young patients: report of 3 cases. 298 77

Between 1964 and 1981, 579 patients were operated upon for carcinoma of the colon. Hepatic and/or peritoneal metastases were present in 17.3%. Excision was performed in 530 cases (91.5%). Carcinomas of the left colon were usually treated by segmental resection. The peritoneum and lymph nodes were involved in 21.7% and 31% respectively of the patients who underwent resection. There were 6 post-operative deaths: 2 after exploratory or derivative surgery and 4 after excision of the tumour. All but 8 of the 395 patients operated upon before 1978 were followed up; 229 survived for more than 5 years, 58% of all operated patients and 63.6% of those who had their tumour excised. The 5-year survival rate was 6% after palliative excision and 73.6% after curative excision (caecum and ascending colon: 81%; transverse colon: 83%; descending colon: 65%; sigmoid flexure: 70.7%). Tumoral invasion in depth and lymph node involvement had a significant influence on prognosis. Based on Dukes' classification, the 5-year survival rates for stages A, B, C and D tumours were 89%, 75.4%, 54% and 6% respectively. The time elapsed between the first symptoms and the operation did not alter the prognosis which was slightly better in women and in young patients.
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PMID:[Colonic cancers. Results of surgical treatment and prognosis. 579 cases]. 315 45

Preoperative serum concentrations of carcinoembryonic antigen (CEA), tissue polypeptide antigen (TPA) and a monoclonal-antibody-defined carcinoma-associated carbohydrate antigen, CA-50, were measured in 272 consecutive patients with histopathologically proven rectal carcinoma. The levels of all three tumour markers correlated directly to the stage of the disease. The serum TPA reflected both the local tumour burden and any metastatic spread, as shown by analysing mean levels of S-TPA and by the use of a Walker and Duncan regression model. S-CA-50 separated patients with and without distant metastases, but not with regard to the local tumour burden. Although the level of S-CEA correlated to the tumour stage, it did not discriminate patients with respect to locally advanced growth or generalized disease. In a multivariate analysis, the serum level of TPA was found to be the most informative preoperatively. Both S-CA-50 and S-CEA gave information additional to that provided by S-TPA in the prediction of the tumour stage (Dukes' stage A-D), and S-CA-50 was also useful in the prediction of metastatic disease.
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PMID:Preoperative serum markers in carcinoma of the rectum and rectosigmoid. I. Prediction of tumour stage. 316 69

Thirty-four hepatic resections were performed on 33 patients. These included 4 trisegmentectomies, 14 lobectomies, 7 segmentectomies, and 9 wedge resections. Twenty patients had metastatic colorectal cancer, 4 had a primary liver tumor, 2 had giant cavernous hemangioma, 1 had metastatic leiomyosarcoma, 5 had various benign lesions including focal nodular hyperplasia, and 1 patient had resection for trauma. Operative morbidity included four subphrenic abscesses, one bile leak, one bile duct injury, one case of cholestasis, and one case of phlebitis. There were no operative deaths. The median survival of the patients with metastatic colorectal cancer was 40 months, and the 5-year actuarial survival rate was 35 percent. Survival rates were not significantly different between patients with a solitary metastasis and those with multiple lesions and was not influenced by size of the metastases. However, survival was significantly better in patients whose primary colorectal lesion was Dukes' B as compared with those whose lesion was Dukes' C. The results indicate that liver resection can be performed safely with acceptable morbidity and improved long-term survival.
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PMID:Hepatic resection for primary and metastatic tumors. 318 7

Neuroendocrine carcinomas were diagnosed in 13 of 683 patients who had colon cancers removed from January 1980 to June 1987 for an incidence of 1.9%. The patients were 28 to 89 years of age (median, 72 years). There were seven male and six female patients. The treatment was as follows: right hemicolectomy, 5; transverse colectomy, 1; left hemicolectomy, 1; low anterior resection, 2; abdominal-perineal resection, 1; and in 3 patients with rectal tumors, biopsy examination only was performed. Microscopic stages were as follows: Dukes' stage B, 1; stage C, 6; stage D, 5; and stage indeterminate, 1. By light microscopy, the tumors showed solid clusters or ribbons of round to fusiform, small to intermediate-sized cells with variably abundant mitoses. Eight tumors had foci of glandular and/or squamous differentiation. By immunohistochemistry, all tumors showed one or more neuroendocrine markers, including neuron-specific enolase, chromogranin, synaptophysin, serotonin, and various neuropeptides. By electron microscopy, single membrane-bound neurosecretory granules were noted. The sites of metastases included regional nodes, 8; liver, 5; bone, 1. Four patients were treated with a combination of chemotherapy and radiation therapy. These tumors were, as a group, aggressive, with eight patients dead within 12 months of diagnosis. Median survival was 7 months, with three patients alive at 2, 38, and 68 months, respectively. Specifically, small- and intermediate-cell neuroendocrine carcinomas of the colon and rectum behaved very aggressively and displayed numerous structural and functional similarities with their bronchopulmonary counterparts.
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PMID:Neuroendocrine carcinomas of the colon and rectum: a clinicopathologic evaluation. 319 34

Carcinoembryonic antigen (CEA) is still the best marker both for primary diagnosis and post-treatment monitoring of patients with colorectal cancer. Monoclonal antibodies, especially CA 19-9 and CA 50 may give additional information whereas CA 125 seems to be of no value in patients with colorectal cancer. The sensitivity of CEA determination for Dukes' A carcinomas is as low as 30%, but increases to 85% for Dukes' D carcinomas. The best clinical benefit of CEA is in postoperative monitoring of surgically treated patients with colorectal cancer. The sensitivity and specificity for distant metastases are 85%. The sensitivity in the detection of local recurrence is low (40%) but the specificity is still high (80%). A high CEA level postoperatively strongly suggests either local recurrence or disseminated disease, but a negative value does not exclude their presence. If CEA is negative both preoperatively and one month postoperatively, CA 19-9 or CA 50 may be used in the monitoring of these patients.
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PMID:Tumour markers in colorectal cancer. 320 Nov 59


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