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)

In this study, plasma concentrations of chromogranin A, calcitonin and carcinoembryonic antigen (CEA) were measured in 40 healthy volunteers as well as in 129 patients with recurrences and/or metastases of neuroendocrine tumors and of medullary thyroid carcinomas (MTCs). A double antibody assay was employed using polyclonal rabbit antibodies to a C-terminal fragment of the protein for detection of human chromogranin A. Using ROC analysis, a cutoff at 22 U/l chromogranin A was calculated. In patients with neuroendocrine tumours, much higher serum concentrations of chromogranin A than for patients with MTC (80% vs. 46%) were measured. The following sensitivities were found: chromogranin A; 46%, calcitonin 100%, CEA 52%. Furthermore, the mean values of chromogranin A concentrations correlated with the tumour mass and/or number of metastases in MTC and neuroendocrine tumours. Evaluation of follow-up studies remains to be completed; however, preliminary results showed similarities regarding the behaviour of chromogranin A and calcitonin. Despite the findings of this study, the observations could not confirm chromogranin A as a reliable marker for metastazing or recurrent MTC.
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PMID:Chromogranin A: an additional tumor marker for postoperative recurrence and metastases of medullary thyroid carcinomas? 1132 6

After chemotherapy for metastatic non-seminomatous testicular cancer, surgical resection is a generally accepted treatment to remove remnants of the initial metastases, since residual tumour may still be present (mature teratoma or viable cancer cells). In this paper, we review the development and external validation of a logistic regression model to predict the absence of residual tumour. Three sources of information were used. A quantitative review identified six relevant predictors from 19 published studies (996 resections). Second, a development data set included individual data of 544 patients from six centres. This data set was used to assess the predictive relationships of five continuous predictors, which resulted in dichotomization for two, and a log, square root, and linear transformation for three other predictors. The multiple logistic regression coefficients were reduced with a shrinkage factor (0.95) to improve calibration, based on a bootstrapping procedure. Third, a validation data set included 172 more recently treated patients. The model showed adequate calibration and good discrimination in the development and in the validation sample (areas under the ROC curve 0.83 and 0.82). This study illustrates that a careful modelling strategy may result in an adequate predictive model. Further study of model validity may stimulate application in clinical practice.
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PMID:Residual mass histology in testicular cancer: development and validation of a clinical prediction rule. 1178 38

The aim of the present study was to evaluate the clinical performance of the CA 15-3 assay on Elecsys systems in an international multicenter study (11 centers). A total of 1326 single samples (272 apparently healthy individuals, 34 pregnant women, 308 benign diseases, 273 cancers other than breast, 439 breast cancer) and 538 serial samples of 98 breast cancer patients during follow-up were analyzed. 95% of values in healthy individuals were below 25 kU/L, and 88% in benign breast diseases, respectively. In malignant breast disease at primary diagnosis the value distribution of Elecsys CA 15-3, sensitivity at 95% specificity, as well as the areas under the curve in ROC analysis were clearly correlated to tumor stages: UICC I to IV 88 to 25% of values < 25 kU/L, sensitivity 7 to 78%, areas under the curve 0.53 to 0.94. During follow-up, sensitivity/specificity for detection of recurrences were 90%/71%. In metastatic disease clinical progression/response to therapy were indicated in 91%/78% of patients at a specificity of 92%/78%. The findings indicate that the Elecsys CA 15-3 assay is very suitable in routine work for detection of recurrences as well as for therapy control in metastatic breast cancer.
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PMID:Clinical evaluation of the Elecsys CA 15-3 test in breast cancer patients. 1259 71

This study was designed to evaluate the utility of the bone markers total alkaline phosphatase (TAP), bone-specific alkaline phosphatase (BAP), aminoterminal propeptide of type I collagen (PINP), carboxyterminal propeptide of type I collagen (PICP), pyridinoline crosslinks (PYD), deoxypyridinoline crosslinks (DPD), cross-linked carboxyterminal telopeptide of type I collagen (ICTP), cross-linked carboxyterminal telopeptide of type I collagen (CTx, beta-CrossLaps) and tartrate-resistant acid phosphatase 5b (TRAP 5b) in comparison with bone scintigraphy for the diagnosis of bone metastasis in lung carcinoma patients. The study population consisted of 49 patients with bone metastasis confirmed by plain radiography and/or computed tomography, 89 patients without bone metastasis, 12 patients with benign lung diseases and 18 healthy persons. All patients were of male gender. The bone markers were measured using commercially available tests. Serum and urine were collected from fasting patients at the time of bone scan between 7.00 and 8.00 a.m. The sensitivity of bone scintigraphy was 100%, its specificity 76.4%, resulting in a diagnostic efficiency of 84.8%. The positive predictive value was calculated to be 70% and the negative one to be 100%. The concentrations of the bone markers TAP, BAP, PINP, PYD, DPD and ICTP were significantly higher in patients with bone metastasis than in those without bone metastasis (p<0.01). The levels of PICP and CTx only tended to be higher in the patients with bone metastasis compared to those without bone metastasis. There was no significant difference in the TRAP 5b levels between the two groups. There was also no difference in the marker levels between osteoblastic, osteolytic and mixed osteoblastic-osteolytic lesions. Contrary to BAP, PICP, CTx and TRAP 5b, the markers TAP, PINP, PYD, DPD and ICTP were found to be higher (p<0.01-0.05) in patients with bone metastasis than in patients with benign lung diseases. In addition, PYD, DPD and ICTP differentiated patients with benign lung diseases from the healthy controls. Based on cut-off values that correspond to 95% specificity in the group of healthy persons, the sensitivity of the marker assays were as follows (specificity in brackets): TAP 33.3% (97.5%), BAP 22% (100%), PINP 18.4% (97.5%), PICP 2.1% (95.2%), PYD 91.8% (24.1%), DPD 83.7% (34.5%), ICTP 75.5% (44.6%), CTx 45.8% (77.5%) and TRAP 5b 14% (84%). The corresponding data for the diagnostic efficiency were as follows: TAP 73.6%, BAP 77.1%, PINP 67.7%, PICP 61.1%, PYD 48.5%, DPD 55.2%, ICTP 56.1%, CTx 65.6% and TRAP 5b 58.7%, respectively. The positive predictive values ranged from 20% (PICP) to 100% (BAP) and the negative values from 62.7% (PICP) to 84% (PYD). In the ROC analysis, TAP, followed by RAP, PINP and PYD, showed the best performance. The levels of TAP, BAP, PINP, PYD, DPD and ICTP were found to be higher in the patients with bone metastasis compared to those with metastastic lesions in other sites (p<0.01, except for ICTP having a p value of < 0.05). The levels of TAP, BAP, PYD, DPD and ICTP increased significantly with the number of metastases. There was also a steady increase in T scores of the markers PINP, PYD, DPD and ICTP with the extent of the metastatic bone disease. It is concluded that the currently available bone markers cannot replace bone scintigraphy, either for screening or in the diagnosis of bone metastasis, in lung carcinoma patients. However, a panel consisting of TAP, BAP, PINP, PYD, DPD and ICTP may be of some value as an adjunct tool to bone scintigraphy for this purpose.
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PMID:Comparison of bone scintigraphy with bone markers in the diagnosis of bone metastasis in lung carcinoma patients. 1551 Jun 10

This study compared different acquisition protocols performance to detect small liver metastases (<2 cm). Thirty consecutive patients with histologically proven hepatic metastases were explored by MDCT at the liver equilibrium phase by four successive acquisitions. We compared the following protocols (1-4): 5/30/1.5 (section thickness/table speed/pitch); 5/15/0.75; 5/11.25/0.75; and 2.5/15/1.5 with the same X-ray dose. The gold standard was based on patient radiological follow-up. Evolutive lesions were considered as true positive (TP). The described lesions, not found on the follow-up exams despite tumoral progression, were considered as false positive (FP). Stable lesions could not be considered as metastasis and were eliminated. One hundred and seventy-six lesions were detected: 61 TP and 91 FP. Twenty-four lesions were eliminated. The mean kappa values for protocols 1, 2, 3 and 4 were, respectively, 0.43, 0.68, 0.73 and 0.51 (0.61-0.80: substantial agreement) and the mean areas under the ROC curve were, respectively, 0.76, 0.87, 0.86 and 0.80. The results of protocols 2 and 3 were significantly superior to those of protocols 1 and 4. MDCT protocols using thin sections or an increased table speed are less efficient in detecting small metastases.
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PMID:Detection of liver metastases under 2 cm: comparison of different acquisition protocols in four row multidetector-CT (MDCT). 1586 25

Skeletal metastases are a significant problem in prostate cancer (PC). The patients are also exposed to treatment-related skeletal changes. This cross-sectional study evaluated a marker of bone resorption, TRACP 5b in relation to the standard analyte total alkaline phosphatase (tALP) as a marker of skeletal changes. Serum levels of TRACP 5b, tALP and PSA were measured in 130 prostate cancer patients. Comparison was made between patients with (BM+, n = 25) and without (BM-, n = 105) skeletal metastases, and between those treated with (n = 64) or without (n = 66) androgen deprivation (AD). Sensitivities and specificities were calculated for each marker and diagnostic accuracy was evaluated by ROC curve analysis. ROC curves indicated the superior accuracy of tALP, whereas TRACP 5b and PSA were comparable. With tALP the best combination of sensitivity (96%) and specificity of (91%) was reached at a cut-off point 224 U/L, the corresponding values were for TRACP 5b sensitivity (76%), specificity (89%) with a cut-off point 4.89 U/L, and for PSA sensitivity (65%), specificity (81%) at 23 ng/L for skeletal metastases. Patients treated with AD showed with increasing duration an increase in TRACP 5b values. TRACP 5b was less specific than tALP as a marker of skeletal metastases. TRACP 5b may have a role in the diagnostics of skeletal changes in PC with a focus on treatment-related skeletal changes.
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PMID:Serum tartrate-resistant acid phosphatase 5b (TRACP 5b) as a marker of skeletal changes in prostate cancer. 1622 66

Lymph node metastasis (LNM) is a key factor for selection of treatment method and patients' prognosis in oesophageal squamous cell carcinoma (ESCC). However, no biomarkers able to support the clinical detection of LNM have been reported. Recently, vascular endothelial growth factor C (VEGF-C) was found to be a more accurate marker of LNM in lung cancer than computed tomography. Midkine is a multifunctional cytokine involved in cancer development. We investigated circulating midkine levels in ESCC patients (n=73) compared with those in healthy subjects (n=42) with double-antibody-sandwich indirect enzyme-linked immunosorbent assay (DASI-ELISA). We found that midkine was elevated in ESCC and involved in metastatic disease. Serum midkine (sMK) was a good marker of LNM, evaluated both clinically and pathologically, as revealed by ROC analysis. It also correlated with serum levels of VEGF-C. The increase of sMK was related to cancer cells, although a weak correlation was observed between sMK and platelet and leucocyte counts.
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PMID:Serum midkine depends on lymph node involvement and correlates with circulating VEGF-C in oesophageal squamous cell carcinoma. 1756 45

Vascular endothelial growth factor (VEGF) is a potent mediator of angiogenesis. Increased expression of VEGF may be associated with advanced stage and poor prognosis in patients with lung cancer. We investigated the relationship between serum VEGF level and lung cancer stage. We also studied the correlation between serum VEGF level and some other tumor markers. Forty newly diagnosed lung cancer (31 non-small cell, 9 small cell) patients and 25 age-matched controls were enrolled in this study. Serum VEGF levels of lung cancer group (345.16 +/- 159.36 pg/mL) were significantly higher than that of the control group (230.36 +/- 47.87 pg/mL) (p< 0.001). The area under the ROC curve was 0.727 (p< 0.05) for serum VEGF threshold of 249.8 pg/mL predictive sensitivity and specificity, for lung cancer were respectively 70.0% and 76.0%. There were no significant relationship between serum VEGF level and age, gender, histologic type, lung cancer stage, distant metastases and site of metastases. In addition, there were no correlation between serum VEGF level and other tumor markers (NSE, CYFRA 21-1, CEA, CA125, LDH).
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PMID:[The evaluation to relationship between serum vascular endothelial growth factor (VEGF) level, metastases and other tumor markers in patients with lung cancer]. 1833 Jul 55

Magnetic resonance imaging (MRI) is the most common and well-established imaging modality for evaluation of intracerebral neoplasms, but there are still some incompletely solved challenges, such as reliable distinction between high- and low-grade tumours, exact delineation of tumour extension, and discrimination between recurrent tumour and radiation necrosis. The aim of this study was to evaluate the contribution of two MRI techniques to non-invasively estimate brain tumour grade. Twenty-four patients referred to MRI examination were analyzed and diagnosed with single intra-axial brain tumour. Lastly, histopathological analysis was performed to verify tumour type. Ten patients presented low-grade gliomas, while the remaining patients showed high-grade tumours, including glioblastomas in eight cases, isolated metastases in four patients and two cases with anaplastic gliomas. MRI examinations were performed on a 1.5-T scanner (Signa, General Electric). The acquisition protocol included the following sequences: saggital T1-weighted localizer, axial T1- and T2-weighted MRI, single-voxel magnetic resonance spectroscopy (MRS), dynamic susceptibility contrast (DSC) MRI and contrast-enhanced T1-weighted MRI. MRS data was analyzed with standard software provided by the scanner manufacturer. The metabolite ratio with the largest significant difference between tumour grades was the choline/creatine (Ch/Cr) ratio with elevated values in high-grade gliomas and metastases. A Ch/Cr ratio equal or larger than 1.55 predicted malignancy grade with 92% sensitivity and 80% specificity. The area under the ROC curve was 0.92 (CI: 95%; 0.81-1). Regarding to perfusion parameters, relative cerebral blood volume (rCBV) maps were estimated from the MR signal intensity time series during bolus passage with two commercial software packages. Two different regions of interest (ROI) were used to evaluate rCBV: lesion centre and perilesional region. All rCBV values were normalized to CBV in a contrallateral normal appearing white matter region. Statistical differences were not found between different tumour types. However, the presence of blood-brain barrier (BBB) damage was illustrated from concentration-time curves calculated in DSC-MRI. A cluster analysis of the time series was used to identify regions with contrast agent extravasation where T1-effects are superimposed to T2-effects. The presence of BBB damage from concentration-time curves was highly correlated with enhancement of post-contrast T1-weighted images and predicted tumour malignancy with a 92% sensitivity and 90% specificity. A large spatial heterogeneity in concentration-time curves was observed from the cluster analysis, supporting the assumption that ROI selection to compute hemodynamic parameters must be done carefully in order to extract robust parameters.
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PMID:Malignancy assessment of brain tumours with magnetic resonance spectroscopy and dynamic susceptibility contrast MRI. 1844 89

The aim of the present study was to evaluate the clinical significance of the concentration of serum amyloid A (SAA) in patients with renal cell carcinoma (RCC). SAA protein was determined with enzyme-linked immunosorbent assay in serum samples of 55 healthy controls and 98 RCC patients subdivided into groups with localized tumor (N0M0, n=40), with lymph node metastases (N1M0, n=13), and distant metastases (M1, n=45). SAA concentrations in controls and N0M0 group of RCC were not different while SAA concentrations were significantly elevated in M1 patients compared to the N1M0 and N0M0 patients. In this respect, SAA provided an accurate detection of distant metastases with the area under the ROC curve of 0.86. SAA was identified as a significant independent factor of survival in RCC patients using the multivariate Cox proportional hazards regression model. SAA could be a useful analyte in predicting the survival outcome of RCC patients.
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PMID:Serum amyloid A as indicator of distant metastases but not as early tumor marker in patients with renal cell carcinoma. 1850 68


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