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 value of silver staining of nucleolar organizer regions (AgNORs) and human chorionic gonadotropin alpha-chain reaction (HCG-alpha) as markers of malignancy was investigated in 60 primary pancreatic endocrine tumours, 37 of which had metastasized at the time of surgery, and in one of which metastases developed 4 years after surgery. Assessment of AgNORs by digital image analysis revealed few but large AgNORs (mean number 2.5 +/- 1.1; mean area 0.32 +/- 0.1 microns 2) in the 22 benign tumours and many but small AgNORs (mean number 5.1 +/- 1.9, P < 0.05; mean area 0.18 +/- 0.09 microns 2, P < 0.01) in the malignant tumours. Quantification of the number of AgNORs per tumour cell nucleolus (AgNOR distribution score) showed that 96% (26/27) of tumours exhibiting at least 5% of cells with more than six AgNORs per nucleolus showed metastases either at the time of diagnosis or up to 4 years after surgery. HCG-alpha immunoreactive cells were present in 25/38 (66%) malignant tumours and in 4/22 (18%) benign tumours. Combined evaluation of AgNOR distribution and HCG-alpha scores showed a high positive predictive value of 96% in cases with a raised AgNOR distribution score irrespective of the HCG-alpha status. A good negative predictive value (81%) was, however, only obtained if both parameters, AgNOR distribution and HCG-alpha scores, were negative. Thus, investigation of AgNORs and HCG-alpha is helpful in predicting malignancy in a high percentage of pancreatic endocrine tumours.
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PMID:Nucleolar organizer regions and glycoprotein-hormone alpha-chain reaction as markers of malignancy in endocrine tumours of the pancreas. 767 59

We report the case of a 28-year-old woman who presented with multiple episodes of cerebral bleeding secondary to a choriocarcinoma with brain, lung and abdominal metastases, which had been partially treated 1 year before. The diagnosis was confirmed by a-high serum beta HCG level. This case emphasizes the importance of suspecting an underlying choriocarcinoma and obtaining a serum beta HCG level in young women presenting with a cerebral haemorrhage.
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PMID:[Cerebral hemorrhage disclosing metastatic choriocarcinoma]. 786 84

Hydatidiform moles and chorionic carcinomas associated with ectopic pregnancy are extremely rare. We report on three cases of non-metastatic GTD after tubar pregnancy of low and medium risk in the WHO prognostic score and FIGO-stage II in each case. Two of them required several courses of (poly-) chemotherapy to reach complete remission (CR). The follow-up was on average 36.6 months, without any metastases and recurrences. One woman was delivered of a healthy infant. All cases were surgically treated with extirpation of the affected adnexa. Additionally, in one case hysterectomy was necessary to reach CR. As reported in the literature, chorionic carcinomas associated with ectopic pregnancy are often very aggressive and show a metastasis rate of 75% at time of diagnosis. For this reason it is essential, to examine tubar pregnancy by histopathology carefully to define small and in situ changes. The cases presented stress the need for appropriate HCG and clinical monitoring.
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PMID:[Choriocarcinoma in extrauterine tubal pregnancy]. 808 95

A case of testicular tumor occurring after orchiopexy is presented. The patient, a 21-year-old male, who had undergone bilateral orchiopexy 14 years before was admitted to our clinic on February 17 in 1992 because of left testicular tumor. Computed tomography showed left inguinal and paraaortic lymphnode metastases. Left high orchiectomy was performed. The tumor was histologically diagnosed to be mixed tumors of embryonal carcinoma, yolk sac tumor and choriocarcinoma. After two courses of chemotherapy consisting of cisplatin, etoposide and bleomycin (PEB regimen), LDH and tumor markers (HCG, HCG-beta) returned to the normal range. The size of retroperitoneal metastasis was significantly reduced and inguinal metastasis disappeared. Therefore retroperitoneal and left inguinal lymphadenectomy were performed. Pathological examination of the resected retroperitoneal and left inguinal lymphnodes revealed embryonal carcinoma and no residual tumor cells, respectively. Additionally, two courses of chemotherapy were performed after surgery. His postoperative course was uneventful and ten months of follow-up showed no evidence of recurrence.
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PMID:[Testicular tumor following orchiopexy. A case report]. 810 90

Following chemotherapy for metastatic nonseminomatous testicular cancer, 86 patients with normal serum markers AFP and HCG underwent resection of residual tumour masses (63 laparotomy, 11 thoracotomy, 12 both). Prognostic factors for relapse and survival were analysed with Kaplan-Meier curves and Cox regression analysis. Putative prognostic factors included age, the primary histology, prechemotherapy level of the tumour markers AFP and HCG, the extent of disease (lymph nodes, lung and hepatic metastases) before and after chemotherapy, the histology of the resected material and the completeness of the surgical procedure. Eleven patients relapsed during follow-up (median 47 months), accounting for a 5 year relapse free percentage of 87.4%. Adverse prognostic factors were (1) prechemotherapy level of HCG (> or = 10,000 IU l-1; (2) incomplete resection; and (3) the extent of disease, especially of lung metastases (prechemotherapy number < or = 3,4-19, > or = 20; or size after chemotherapy > 1 cm; or presence of any residual lung metastasis after chemotherapy without residual abdominal metastases). The histology found at resection was not associated with the risk of relapse, which might be explained by the effectiveness of postresection chemotherapy, which in the majority of these patients was a salvage regimen rather than two further cycles of the initial cytostatics. A good and a poor risk group were formed, based on HCG level and completeness of resection. The effect of salvage chemotherapy after resection of viable cancer cells needs further investigation.
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PMID:Prognosis after resection of residual masses following chemotherapy for metastatic nonseminomatous testicular cancer: a multivariate analysis. 831 13

Univariate and multivariate analyses were performed in 632 patients treated with cisplatin combination chemotherapy for metastatic non-seminomatous testicular germ cell tumours. Multivariately, the most important poor prognosis factors for the prediction of survival were: HCG > or = 10,000 IU/l, lung metastases > or = 10, abdominal metastases with a horizontal diameter of > or = 5 cm and the presence of supraclavicular metastases. If patients had 2 or more of these factors the death rates increased from 30% for patients with 2 factors to 65% for patients with 3 or 4 factors. The patients studied here are not a random sample of the metastatic testicular cancer patients in general, as the population studied comprised a large proportion of low volume metastatic disease patients. Therefore, the final analysis will include patients from all the recently completed trials.
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PMID:Prognostic factors in metastatic non-seminomatous germ cell tumours: an interim analysis of the EORTC GU-Group experience. 838 50

An immunohistochemical and flow cytometric DNA study of two cases of metastasizing placental site trophoblastic tumor are presented. One patient aged 29 died rapidly of widespread metastases despite hysterectomy and multiagent chemotherapy. The patient had a low level of serum HCG. The course was complicated by the presence of a nephrotic syndrome. The other patient aged 34 had a vaginal metastasis and high levels of serum HCG, and was alive without disease for 9 years after hysterectomy and chemotherapy. Histologically, these tumors were characterized by a monomorphic trophoblastic cell population, probably derived from intermediate trophoblast in the placental site. The mitotic rate in these tumors was 2-4/10 high-power fields. Immunohistochemically, many tumor cells contained human placental lactogen and placental alkaline phosphatase. Beta-unit chorionic gonadotropin was present in many cells of the second patient, and only focally in the first. All specimens including the curettaged and metastatic lesions revealed a diploid DNA content in both cases. Neither DNA ploidy nor S-phase fraction was associated with survival of patient. Since predicting the biologic behavior of placental site trophoblastic tumor is very difficult, making a correct diagnosis on endometrial curettings, hysterectomy, and monitoring serum HCG level is essential in patients with this tumor.
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PMID:Metastasizing placental site trophoblastic tumor. An immunohistochemical and flow cytometric study of two cases. 839 53

A prospective multicentre study was carried out to determine the efficiency of various diagnostic methods in the assessment of the retroperitoneal space. The diagnostic findings were confirmed histologically after retroperitoneal lymph node dissection (RLND). The sensitivity was 71% for bipedal lymphography, 41% for computed tomography (CT), 31% for abdominal ultrasound and 37% for alpha-fetoprotein/human chorionic gonadotrophin (AFP/HCG). Specificity was 60, 94, 87 and 93% respectively. When all diagnostic methods were combined, sensitivity was 88% and specificity 48%. The value of all methods depends on the metastatic enlargement of the lymph nodes. The predictive value of a negative diagnosis was 73% for lymphography, 67% for CT, 61% for ultrasound and 65% for AFP/HCG; the predictive value of a positive diagnosis was 58, 85, 69 and 81% respectively. Despite these results, lymphography is indicated only when a surveillance strategy is planned, since it detected 58% of the lymph node metastases that were overlooked by CT and tumour markers. Despite this, 17% of patients with clinical stage I tumours had metastases. False positive rates are detrimental to primary chemotherapy: between 24% (at least 2 methods positive) and 46% (1 or more methods positive) of patients with clinical stage II A/B tumours had a pathological stage I and for these patients primary chemotherapy meant overtreatment.
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PMID:Retroperitoneal lymph node staging of testicular tumours. TNM Study Group. 840 30

In addition to the histological diagnosis, alpha fetoprotein (AFP) and chorion gonadotropin (HCG) are used in clinical staging, therapy monitoring, and follow-up. Elevated markers without localization of metastases by imaging procedures are generally classified as progressive disease. However, other causes may be responsible for the elevated tumor markers: other malignant or benign diseases such as hepatocellular carcinomas, gastrointestinal tumors, bronchial carcinomas and benign diseases of the liver for AFP, and vesicular mole, hepatocellular, stomach, pancreatic and urothelial carcinomas for HCG. Moreover, technical disturbances in the modern sandwich assays with monoclonal antibodies are possible by heterophilic antibodies. These human anti-animal antibodies are built after immunoscintigraphy, immunostimulation and oral immunization by macromolecules. As a result, if progressive disease of a malignant germ cell tumor is unlikely, several steps have to be taken to determine the true causes for the elevated tumor markers before chemotherapy can be applied.
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PMID:[The "false positive" tumor marker in malignant testicular tumor]. 851 31

In purpose of early diagnosis of gallbladder carcinoma, the serum levels of tumor markers CA 72-4, CA 19-9, CEA, AFP, Ferritin and beta HCG were determined in 124 patients with benign and malign diseases of gallbladder, before and 10 days after the operation. The most important clinical significance have CA 72-4 and CA 19-9, which are increased in Ca in situ and carcinoma of the first stage. These early stages of carcinoma cannot be diagnostified by preoperative echotomography, but radical operation is possible with recover by all means. These two tumor markers should be attended in risk group of patients for rising gallbladder carcinoma: calculosis and polyposis. The rest of tumor markers are increased in progressive carcinoma with infiltration of surrounding tissue and metastases.
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PMID:The evaluation of tumor markers levels in determination of surgical procedure in patients with gallbladder carcinoma. 856 9


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