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)

Five tumor markers were measured simultaneously in serum by radioimmunoassay: carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP), human chorionic gonadotrophin (HGC), the beta subunit of HCG, and Kappa casein. In a population of 935 normal subjects these antigens were undetectable or found within precise limits. In patients with tumors of various origins the rate of pathologically elevated levels was 72% at the beginning of the clinical course (194 cases). This high rate was primarily due to the simultaneous measurement of CEA, betaHCG, HCG, and casein. AFP was of little importance. The simultaneous measurement of these tumor markers may be one biochemical element of diagnosis of carcinoma, although this criterion is neither absolute nor specific, as 14.7% of patients with non-neoplastic disorders (234 cases) were positive for one antigen. In the presence of metastases (112 cases) the rate of pathologic levels of at least one antigen was increased: 86% due to CEA and casein assay at the same time as their absolute levels were increased. Surgical removal reduces the rate of positivity of these antigens to 37%. As was shown in patients with breast cancer, the rate was 10% when the tumor had been removed at Stage N- and 54% when it was removed at Stage N+. Thus, the persistence of pathologic levels could be correlated with the capacity for recurrence or metastases. Finally chemotherapy, radiotherapy, or both, do not decrease the rate of positivity of the tumor markers.
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PMID:Simultaneous assays of cancer-associated antigens in various neoplastic disorders. 6 15

The new radioimmunoassays for AFP and beta-HCG are highly specific for nonseminomatous, germ-cell testicular tumor in genitourinary patients who do not have liver disease or other cancers. When used together, they are an accurate and sensitive indicator of metastases and are helpful in determining the effectiveness of therapy. However, they are not very useful in the differential diagnosis of scrotal masses.
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PMID:Serum alpha-fetoprotein and human chorionic gonadotropin in the management of testicular tumors. 8 63

Between 1973 and 1977, 247 patients with malignant teratoma have been treated in two units in London. Seventeen have developed brain metastases, an overall incidence of 6.2%. The median survival from diagnosis of cerebral metastases is 6 weeks and all patients except one have died. The survivor is disease-free 12 months after completing treatment, which included extensive use of chemotherapy, surgery and radiotherapy. Serum gonadotrophin (HCG) and alpha-foetoprotein (AFP) estimations have been performed in 264 patients as a means of monitoring the effects of therapy. In 42 patients (37 of whom had Stage IV disease) the peak HCG level was greater than 10(4) iu/l, and the incidence of brain metastases in this group was 26%, significantly higher than in the group with HCG levels below 10(4) iu/l, for which the incidence of cerebral deposits was 1.8% (P less than 0.0001). No significant correlation was seen between peak AFP levels and the incidence of brain metastasis. With the aim of improving results by earlier diagnosis, cerebrospinal fluid (CSF) specimens have been examined for HCG and AFP levels in 56 subjects, 9 of whom had brain metastases. A serum: CSF HCG ratio less than 40 is an accurate indication of the presence of brain metastases, and may have considerable predictive value. However, false-negative serum: CSF HCG rations (greater than 40) frequently occur in patients with proven brain deposits. Estimation of AFP in spinal fluid has not contributed to the early diagnosis of brain metastases in malignant teratoma.
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PMID:Brain metastases in malignant teratoma: a review of four years' experience and an assessment of the role of tumour markers. 8 52

The diagnostic value of the serum tumour markers, beta-HCG and AFP, is investigated in 71 patients with malignant testicular tumours. Regular screening with beta-HCG and AFP, has improved the early diagnosis of recurrences and metastases in nonseminomatous testicular tumours.
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PMID:[Diagnostic progress in testicular carcinoma]. 9

After a mole has been evacuated there are two ways of treating the condition: routine chemotherapy from the beginning or chemotherapy reserved for selected cases. They offer the same chances of cure. Seeing that the risk of malignancy in our country is 5 per cent and that selective chemotherapy only exposes a small number of patients to the risk of such treatment, we have adopted the scheme of follow-up suggested by Bagshawe and recommended by OERTC. The follow-up is based on radio-immune assay for HCG carried out at regular intervals for two years. Only cases where the level of HCG is higher than 25,000 international units per litre, one month after curettage, or cases where the rise in HCG is associated with metastases, are treated with chemotherapy. In our experience, which is based on 20 cases, we acknowledge the value of radio-immune assaying. It is superior to immunological tests used for pregnancy diagnosis in sensitivity. It also appears to us that systematic treatment routinely administered and treatment based on raised levels of HCG two months after evacuation of a mole are useless. Only 3 cases were treated with chemotherapy out of the 20 cases that were followed up. We have had no malignancy after 2 and 3 years of checking back on the patients. Treatment given routinely from the start would have been unnecessary exposure to the risks of chemotherapy for 17 patients. Had we taken into account the abnormal rise in HCG after 8 weeks we would still have treated 7 patients instead of 3 with the same results as far as cure. We have worked out a graph for the drop in the levels of HCG after a mole has been evacuated. This may serve as a base for criteria for treatment in the future. Cases where the levels of HCG are above the 95 percentile are considered as at risk to evolve into malignant forms of disease. Consequently earlier treatment can be started (before the 6th month) without altering the number of patients who are going to be treated.
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PMID:[Prevention of the malignant form of trophoblastic disease after a hydatidiform mole: systematic or selective chemotherapy]. 18 22

Carcinoma of the bronchus can produce several polypeptide hormones and therefore has the capacity to cause most syndromes of endocrine hyperfunction. All pituitary hormones can be synthesized ectopically; furthermore, the production of hormones from the hypothalamus (CRF), the placenta (HCG, HPL) and the C-cells of the thyroid (calcitonin), as well as parathormone and prostaglandins has been described. The paraneoplastic syndrome may often be more dangerous for the patient than the tumor growth itself, and can lead to early death. On the other hand, it may allow the early detection of an unsuspected tumor. The ectopic hormones and other nonendocrine proteins and peptides can be used as tumor markers, and can demonstrate the effect of treatment and early recurrence or metastases. An ideal tumor marker should have the following characteristics: 1. production exclusively by neoplastic tissue, 2. direct correlation with tumor size, 3. substances common to all tumor types ("large spectrum tumor marker") although specific tumor markers for special tumors should be available, 4. the assays must be easy and automation should be possible. At present no tumor marker satisfies all these conditions. The measurement of several tumor markers and the use of discriminant analysis may extend their diagnostic value and open the way for biochemical detection of cancer in the future.
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PMID:[Ectopic hormone formation and tumor markers in bronchial neoplasms]. 22 36

A series of five benign and 60 malignant colonorectal neoplasms has been examined immunohistochemically for the presence of HCG. This hormone was not demonstrated in any of the benign tumours but was present in 43% of the malignant neoplasms. The incidence of HCG secretion was unrelated to the sex of the patient but tended to be decreased in patients of advanced age. The HCG-containing tumours, which were predominantly from the left side of the large intestine, had all penetrated the full thickness of the bowel wall while a significant proportion of those tumours lacking HCG were still confined to the bowel wall. Despite the greater degree of local aggressiveness shown by the HCG-secreting tumours there was no correlation between HCG production and the presence of local metastases but, as the presence of HCG is associated with local invasion, it is suggested that preoperative immunohistochemical studies of HCG in biopsies of large bowel neoplasms may be of value in the planning of surgical procedures.
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PMID:An immunohistochemical study of the significance of HCG secretion by large bowel adenocarcinomata. 44 71

A study of the incidence and clinical course of testicular germ-cell tumor metastatic to the gastrointestinal tract is presented. Gastrointestinal tract metastasis occurred in 25 cases, 5% of all patients evaluated with germ-cell tumor of the testis. Although embryonal carcinoma was the dominant component in all cases, element of choriocarcinoma were found in 20 cases and HCG was positive in 22 cases. Metastasis occurred most commonly by direct invasion from adjacent tumor. The most frequent site of gastrointestinal involvment was the proximal small intestine. Ivolvement of the duodenum was noted in seven cases. The most common gastrointestinal tract manifestations were intestinal obstruction and gastrointestinal bleeding. Although a variety of therapeutic modalities were tried, the average length of survival from the time of diagnosis of gastrointestinal metastasis to death was six months.
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PMID:Gastrointestinal tract metastasis in patients with germ-cell tumor of the testis. 56 78

One-third of all testis tumors secrete HCG which can be detected in the serum by radioimmunoassay. beta-HCG levels can be used for diagnosis and follow-up of testis tumors. Seminomas with elevated serum beta-HCG levels probably have nonseminomatous metastases.
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PMID:Use of serum beta-chain human chorionic gonadotropin in the management of testis tumor. 74 72

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


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