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)

Computed tomography, ultrasound, nuclear scintigraphy, and laboratory tests (lactic dehydrogenase, alkaline phosphatase, and 5-nucleotidase) were compared in 135 patients with gastro-intestinal carcinoma to define the most useful test to detect hepatic metastases. Thirty-six patients (26.7 per cent) had hepatic metastases at laparotomy. Sensitivities were low: 46.2 per cent for nuclear scintigraphy, 57.6 per cent for ultrasound, 67.7 per cent for computed tomography and 62.9 per cent for lactic dehydrogenase. Accuracies ranged from 62.9 (lactic dehydrogenase) to 77.6 per cent (nuclear scintigraphy). No significant differences were found. Accurate and efficient detection of hepatic metastases is hampered by relatively low sensitivity, specificity and accuracy of the conventional imaging tests and laboratory tests.
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PMID:Hepatic metastases: comparative study of diagnostic ultrasound, CT, nuclear scintigraphy and laboratory tests. 194 96

This retrospective study aimed to assess the usefulness and clinical importance of current, commonly used, diagnostic staging procedures in breast cancer. The analysis comprises all 398 women clinically staged I-III (UICC criteria), and irradiated with radical intent in the Professorial Unit of Radiotherapy at the Middlesex Hospital over a ten-year period (1978-1987). The routine initial screening in this institution included the following staging investigations within 4 weeks of referral: 99mTc MDP bone scan; chest X-ray; liver function tests (including serum alkaline phosphatase) and liver ultrasound scan. Further enquiry and examination of the patient, clear progression of disease, additional radiographs or a recommended repeat interval scan provided sufficient additional information to confirm metastatic disease. The overall rate of detection of metastatic disease at three months was 29/389 (7.4%) for skeletal scintigraphy, 10/386 (2.6%) for chest radiographs, 8/271 (2.9%) for liver ultrasound and 3/347 (0.8%) for serum alkaline phosphatase. In total 37/398 (9.3%) of patients were confirmed to have metastatic disease by three months. Skeletal scintigraphy alone appears to identify 78% (29/37) of those with detectable metastatic disease at 3 months. Skeletal scintigraphy and liver ultrasound will identify 95% (35/37).
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PMID:How far investigations for occult metastases in breast cancer aid the clinician. 203 84

Peripheral blood leukocyte alkaline phosphatase scores and plasma carcinoembryonic antigen levels in 26 patients with metastatic colorectal cancer were compared to those in 30 healthy controls. Patients had metastases to the liver and abdomen. The mean leukocyte alkaline phosphatase score in the metastatic colorectal cancer patients was significantly higher than in the control group (246 +/- 65 vs, 52 +/- 26, p less than 0.001); and the mean carcinoembryonic antigen level in the patients was also significantly higher than in the controls (110 +/- 100 vs, 4.9 +/- 3 ng/ml, p less than 0.001). One hundred percent of the metastatic cancer patients had elevated LAP scores and 73% of these patients had elevated CEA levels. There was a difference between the mean CEA levels in the patients with liver metastases and those with abdominal metastases (162 +/- 135 vs, 39 +/- 53 ng/ml, p less than 0.04). The results suggest that although both markers were elevated in metastatic colorectal cancer, the LAP score seems to be more useful in detecting metastatic disease, since we found 11% false negatives with the CEA level and 0% false negatives with the LAP score.
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PMID:Leukocyte alkaline phosphatase and carcinoembryonic antigen in metastatic colorectal cancer patients. 204 30

Acid and alkaline phosphatase were determined in 107 breast cancer patients to study their potential value in case of bone metastases. The patients were divided into 4 groups: A, patients without metastases (n = 34); B, metastatic patients without bone lesions (n = 37); C, patients with metastases in and outside of bones (n = 24), D, patients with bone-only metastases (n = 12). Tartrate resistant acid phosphatase (TR-ACP), and bone alkaline phosphatase (bone-ALP) were significantly higher in patients with metastases than in patients without. However, no difference in TR-ACP was observed between subgroups of metastatic patients.
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PMID:Plasma acid and alkaline phosphatase in patients with breast cancer. 206 38

Serum activities of bone alkaline phosphatase (b-ALP) and of tartrate resistant acid phosphatase (tr-ACP) were evaluated in 271 cancer patients; 120 of them had bone metastases (BM) and 151 had none. Correlation coefficients, specificities, sensitivities, negative and positive predicting values were computed. They showed the important contribution that these isoenzymes can bring to the diagnosis of BM in 80 patients with prostate cancer, and to the followup of 191 patients with breast cancer. The assay results were analysed in parallel with bone scan and radiography. They were also compared to those of serum antigens: PSA and PAP for prostate cancer, and CEA and CA15.3 for breast cancer. These results clearly indicate that both isoenzymes are better correlated with BM than antigens, these antigens being markers of the whole tumor burden--primary tumor, metastases, recurrence--whereas b-ALP and tr-ACP are specific markers of bone metabolism.
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PMID:[Evaluation of two serum isoenzyme phosphatases as bone metastasis markers]. 208 Dec 81

To assess biological response, therapeutic activity, and side effects, a randomized, double-blind trial of two doses of interferon-beta ser (IFN-beta ser), differing by 20-fold 4.5 and 90 x 10(6) units), was undertaken in 64 patients with metastatic renal carcinoma. Patients were treated intravenously with injections daily for 10 days with an 11-day rest before treatment was reinitiated. The trial confirmed the relatively good toleration of IFN-beta ser; in the first cycle only 4/63 patients had anorexia of moderate or greater severity. Median weight change over the duration on study was -1.5 kg; in the first cycle only 7% of patients had performance status decline greater than 1 level. Statistically significant changes (p less than 0.05) occurred in granulocytes, lymphocytes, calcium, cholesterol, alkaline phosphatase, and aspartate transferase (AST); however, except for AST, overall clinical differences in the two doses were not great. Of 60 patients evaluated, 1 developed neutralizing antibody. When assessed 24 h after IFN-beta ser at 4.5 x 10(6) units, significant (p less than 0.05) augmentation had occurred in beta 2-microglobulin, HLA-DR, and HLA-DQ expression on monocytes, 2',5'-oligoadenylate (2-5A) synthetase in peripheral mononuclear cells, and natural killer (NK) and K cells functional activity. Although the 90 x 10(6) unit dose also resulted in stimulation of these responses, little additional augmentation of biological response occurred at the higher dose. Except for a decline in monocyte HLA-DR expression, biological responses remained increased at both doses over the 10-day period of treatment. However, no objective regressions of metastatic disease occurred. In view of objective responses in metastatic renal carcinoma in other trials with IFN-beta ser, consideration should be given to alternative schedules.
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PMID:Biological and clinical effects of interferon-beta ser at two doses. 208 72

Carcinoembryonic antigen and some liver function tests (alkaline phosphatase, gamma-glutamyltranspeptidase, lactic dehydrogenase and cholinesterase) were evaluated in patients with primary colorectal cancer in order to define their role in the pre-operative detection of liver metastases. The records of 278 consecutive patients admitted to the Istituto Nazionale Tumori of Milan between January 1982 and December 1983 who were suffering from primary invasive colo-rectal cancer and who underwent laparotomy were retrospectively analyzed. At laparotomy, liver metastases were found in 38 pts (13.7%). Considering single tests, CEA was the most sensitive (71%); no single test was found to be reliably predictive, when the result was abnormal. On the contrary, the normal value of each test was associated with a good prediction. When we considered all the five tests together in the single patient their predictive value, when abnormal, proved to be quite good only if four or five results were abnormal. On the other hand, liver metastases in the presence of all normal tests were found only in two patients, so giving a negative predictive value of about 97%. So we conclude that, in the lack of an infallible imaging technique for liver evaluation, in the presence of all normal tests any other investigation on the liver could be avoided. However, when liver tests are pathologic, some other imaging technique should be performed in order to supply the surgeon with information about the extent and the spread of the metastases.
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PMID:The role of CEA and liver function tests in the detection of hepatic metastases from colo-rectal cancer. 209 Jan 87

Fluosol, a perfluorcarbon emulsion, has the ability to carry oxygen in solution. In conjunction with oxygen breathing and radiation, Fluosol has been shown in animal models to enhance local tumor control. In September 1985, a Phase I/II Study was instituted to evaluate the effect of this adjuvant therapy with radiation in non small cell carcinoma of the luing. Fifty patients were enrolled in the study which was closed for accrual in November 1987. Five patients were withdrawn prior to the institution of radiation: one patient diagnosed with bone metastasis and four patients withdrawn due to mild to moderate reactions to Fluosol. Of the 49 patients administered Fluosol, 34 mild to moderate adverse reactions were noted in 22 patients to either the test dose/infusion (16 reactions including withdrawn patients) or post infusion (18). Flushing, dyspnea and hypertension (test dose/infusion) and chills and/or fever (postinfusion) were the typical symptoms. Transient elevation of blood chemistries (SGOT, SGPT, alkaline phosphatase, BUN) were noted in some patients. Six patients had transient depression of WBC counts (toxicity scores of 1 or 2) and two patients had transient depression of platelets (toxicity score of 1). None of these altered treatment. Forty-five patients received Fluosol of which 34 completed the planned therapy. Six patients were diangosed with metastatic disease during therapy and three patients died of their disease during treatment. One patient was withdrawn due to ineligibility and one patient withdrawn due to moderate reactions to Fluosol during the 3rd and 4th infusions. The total dose of Fluosol was escalated from 42 mL/Kg to 49 mL/Kg in 5, 6, or 7 weekly infusions. Patients breathed 100% oxygen for a minimum of one-half hr prior to and during radiation treatment. Radiation therapy was administered at a daily fraction of 165 to 200 cGy per fraction to a total dose of 5940 to 6800 cGy. Seventeen of 34 patients (50%) achieved a complete response to treatment and 11 patients (32%) had a partial response. Thirteen patients remain alive (range of 12 to 20 months) including 10 of 17 complete responders, 2 of 11 partial responders, and 1 treated with chemotherapy postradiation. The median absolute survival time of the patients completing therapy was 15.5 months and the 12 and 18 month absolute survival rates were 81% and 74%, respectively. The 45 patients starting protocol therapy had a median absolute survival of 9.2 months with a 12-month and 18-month survival of 45% and 35%, respectively.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Fluosol and oxygen breathing as an adjuvant to radiation therapy in the treatment of locally advanced non-small cell carcinoma of the lung: results of a phase I/II study. 216 21

Between Nov. 1981 and Nov. 1987 103 patients preselected for chemotherapy combined with surgery, therefore with local extension within homolateral mediastinal lymph nodes, with no signs of remote metastases, PS greater than or equal to 70, with no contraindication for resectional surgery including pneumonectomy, no diabetes, no prior treatment underwent first staging. Staging included: case history, physical examination, full blood count, biochemical tests (alkaline phosphatase, SGOT, GGTP, LDH), CEA, X-ray assessment including CT scan of the chest, bronchoscopy, peritoneoscopy, liver scan (US was not routinely used at the beginning), bilateral bone marrow trephine biopsy, and bone scan. Staging was discontinued when secondaries were detected in one, the more so as in two organs or systems (25 pts), and/or bronchoscopic contraindication for thoracotomy (11 pts), and this group of patients was out of the study. To 67 patients chemotherapy was given and after 3 courses these patients were reevaluated. In 21 patients PD, NC or CR was found. Forty six patients with PR underwent supplementary staging procedures: CT of the brain, CT of the upper retroperitoneal space and liver. Metastatic sites were found in 7 patients. Limited disease was identified in 39 patients. Limited-stage disease can be determined only after exclusion of extensive disease on the ground of: case history, physical assessment, X-ray of the chest (PA + lateral) + CT chest scan, bronchoscopy with biopsy or cytology, and outside the chest: 1. bone marrow trephbine biopsy and bone scan--bone marrow and skeleton, 2. CT head scan--brain, 3. CT abdominal scan--upper retroperitoneal space and liver.
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PMID:[Identification of a limited form of small cell lung cancer among 103 patients pre-selected for chemotherapy combined with surgery]. 217 35

This review delineates the subcellular distribution, biochemical characteristics, and metabolic functions of 5'-nucleotidase (5'NT), summarizes the analytical biochemistry of 5'NT, and assesses the clinical significance of 5'NT determinations in body fluids, cells, and tissues. Salient aspects of the clinical biochemistry of 5'NT, discussed herein, are as follows: (A) Serum 5'NT activity is generally elevated in hepatobiliary diseases, especially with intrahepatic obstruction, but, unlike serum alkaline phosphatase, serum 5'NT activity is not increased in infancy, childhood, pregnancy, or osteoblastic disorders. (B) In cancer patients, elevated serum 5'NT activity does not always indicate hepatobiliary involvement; in some cases, 5'NT may be released into serum from the primary tumor or local metastases. (C) Genetic deficiency of erythrocyte pyrimidine 5'NT activity is a common cause of hereditary non-spherocytic hemolytic anemia. (D) Acquired deficiency of erythrocyte pyrimidine 5'NT activity occurs in patients with beta-thalassemia and lead poisoning. (E) 5'NT activity is low in circulating monocytes, increases markedly upon their differentiation to tissue macrophages, and subsequently diminishes during macrophage activation. (F) Lymphocyte ecto-5'NT activity, a plasma membrane marker of cell maturation, is generally low in immunodeficiency states, and undergoes characteristic changes in patients with certain lymphomas and leukemias.
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PMID:The clinical biochemistry of 5'-nucleotidase. 218 4


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