Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Thirty patients with nonseminomatous testicular cancer and no evidence of metastases outside the retroperitoneum were evaluated for discrepancy between the clinical and pathologic stages and also for frequency of elevations of the serum levels of human chorionic gonadotropin (hCG) and alphafetoprotein (AFP). When marker-level data were not considered in the staging, the clinical and pathologic stages differed in 47% of the patients; the inclusion of marker data reduced the staging error to 37%. Seven of ten patients with clinical Stage I, pathologic Stage II disease had normal marker levels (false-negative results). However, there were no false-positive results: abnormal marker levels before retroperitoneal lymphadenectomy always signalled persistent tumor unless the level could be accounted for by the metabolic decay rate of marker produced by the primary tumor. Comparison of marker-level data from these patients with data from 48 patients with Stage III disease demonstrated increasing frequency of elevated marker levels with increasing stage (P less than 0.001). Serial determinations of HCG and AFP are helpful in clinical staging and are necessary in clinical management.
 ...
PMID:Human chorionic gonadotropin and alphafetoprotein in the staging of nonseminomatous testicular cancer. 616 91

There were 60 patients at our cancer center who underwent serum tumor marker studies (beta subunit of human chorionic gonadotropins and alpha-fetoprotein) and pedal lymphangiography before retroperitoneal lymph node dissection. Surgical stage II cases were divided according to tumor, node and metastasis staging. Beta-human chorionic gonadotropin and/or alpha-fetoprotein was elevated in 9 per cent (1 of 11) and the N1 cases, 36 per cent (5 of 14) of the N2A cases, 50 per cent (13 of 26) of the N2B cases and 89 per cent (8 of 9) of the N3 cases. Lymphangiography was positive or suspicious in 9 per cent (1 of 11) of the N1 cases, 36 per cent (5 of 14) of the N2A cases, 46 per cent (12 of 26) of the N2B cases and 56 per cent (5 of 9) of the N3 cases. Serum tumor markers and lymphangiography combined suggested lymph node metastases in 18 per cent (2 of 11) of the N1 cases, 50 per cent (7 of 14) of the N2A cases, 73 per cent (19 of 26) of the N2B cases and 100 per cent (9 of 9) of the N3 cases. We conclude that tumor markers and lymphangiography measurements are equally effective in the diagnosis of retroperitoneal lymph node metastases and that diagnostic accuracy is enhanced significantly by combining these 2 modalities. Retroperitoneal lymph node dissection remains the most reliable staging procedure. Reports of the accuracy of clinical staging should be correlated with subcategories of stage II disease.
 ...
PMID:Correlation of serum tumor markers and lymphangiography with degrees of nodal involvement in surgical stage II testis cancer. 617 70

Thirty-seven consecutive patients with germ cell cancers (34 testicular, three extragonadal) and elevated serum levels of alpha-fetoprotein (AFP) and/or human chorionic gonadotropin (HCG) were treated with vinblastine, bleomycin, and cis-diamminedichloroplatinum induction chemotherapy. The AFP and/or HCG normalized in 36 patients. The AFP half-life was 7.9 days between Days 1 and 21 postchemotherapy but 6.0 days between Days 21 and 42 (p less than 0.05). The prolonged AFP half-life between Days 1 and 21 was related to a median increase of 57.5% (range, 22 to 219%) in the AFP level. This increase in the marker value occurred between Days 2 and 9 of therapy (median, Day 5). There was also a median increase of 181% (range, 27 to 600%) in the HCG level at a median of 5 days after the start of therapy. The increase in the AFP and HCG levels occurred in 63 and 70% of evaluable patients, respectively, and correlated with the presence of a large volume of metastatic disease (chi 2 = 8.87). Patients with relapsed or refractory disease had prolongation of the AFP half-life between Days 21 and 42 as compared to nonrelapsed patients. AFP and HCG half-life calculations should be used in the management of patients with germ cell cancers.
 ...
PMID:Acute changes of alpha-fetoprotein and human chorionic gonadotropin during induction chemotherapy of germ cell tumors. 618 70

Forty-four patients with nonseminomatous germ cell tumors with "poor prognostic features" were entered on the VAB-5 regimen and 38 are evaluable. VAB-5 represents an intensified version of the VAB-4 protocol. Poor prognostic features were considered to be bulky metastases ( greater than 5 cm in diameter), palpable retroperitoneal disease, liver metastases, brain metastases, involvement of two or more parenchymal organs, pure choriocarcinoma, alpha fetoprotein or human chorionic gonadotropin serum levels over 1000 ng/ml, lactic acid dehydrogenase serum levels over 400 mg/dl, and failure to prior chemotherapy. Eighteen of 38 evaluable patients became free of neoplasm, 11 with chemotherapy alone, and seven with combined chemotherapy and surgery. Fourteen of 18 complete responders remain alive and free of disease with a median follow-up of 50 months. Complete remission with testis tumor occurred in 13/15 without and 5/15 with prior chemotherapy and in none of eight patients with primary extragonadal germ cell tumors. Thirty-one patients received antibiotics when they developed fever during myelosuppression. Ten patients developed transient serum creatinine levels over 2 mg/dl after cis-platinum and one required hemodialysis with subsequent recovery. All patients had severe mucositis after induction. An apparent improvement of results over prior VAB protocols in patients with poor prognostic features was compromised by significant increases in toxicity and such patients require special study to improve cure rates.
 ...
PMID:VAB-5 combination chemotherapy in prognostically poor risk patients with germ cell tumors. 618 11

Sacrococcygeal teratoma (SCT) is an uncommon tumor that primarily occurs in female infants. Histologic assessments of these neoplasms for immature neuro-epithelial elements and malignant germ cell components correlate with recurrence and metastases, respectively. In this report of 15 SCTs, in addition to routine histologic evaluation the tumors were studied for the presence of carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP), and human chorionic gonadotropin (HCG) by the immunoperoxidase method. Both CEA and AFP were commonly (82% and 53%) present in benign epithelium of these teratomas. In three cases, a germ cell component was identified in which two were focally positive for both CEA and AFP. Although presence of these antigens did not correlate with tumor grade, immunoperoxidase for oncofetal antigens may be useful in predicting which serum marker to measure in patients with suspected recurrent teratoma.
 ...
PMID:Oncofetal antigens in sacrococcygeal teratomas. 618 36

189 orchidectomy specimens with germ cell tumours (95 pure seminomas and 94 non-seminomas) were studied for the presence of alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG) with the indirect immunoperoxidase technique. All seminomas were AFP negative, while 66% of the non-seminomas were positively stained for AFP. 21% of pure embryonal carcinomas (EC), 25% of EC components in mixed tumours, all yolk sac tumour (YST) components, 20% of pure teratomas (T) and 47% of T components were AFP positive. In EC and YST the immunohistochemical staining depicted characteristic previously unrecognized histological structures, presumably representing patterns of further differentiation. HCG was demonstrated in all choriocarcinoma (CC) components in the syncytiotrophoblasts and in syncytiotrophoblast-like cells (STLC) in 8% of seminomas and 30% of non-seminomas. 70% of all non-seminomatous tumours were positively stained for AFP and/or HCG. Neither AFP nor HCG positivity of the tumour tissue was especially associated with metastatic disease. Carcinoma-in-situ (CIS) present in seminiferous tubules adjacent to the tumours was never positively stained for AFP, but for HCG in a few cases.
 ...
PMID:Alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG) in testicular germ cell tumours. A prospective immunohistochemical study. 619 Mar 50

170 patients with testicular germ cell tumours (88 seminomas and 82 non-seminomas) were examined with immunologic techniques for the presence of the tumour markers alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG) in tumour tissue and preoperative serum samples. Patients with pure seminomas had AFP negative tumour tissue and normal levels of serum AFP, whereas 13% had HCG demonstrated in the tumour tissue, mainly in syncytiotrophoblast-like cells (STLC), and 9% had raised serum HCG. 55% of patients with HCG positive seminomas had raised serum HCG. HCG positive seminomas did not occur in higher frequency in metastatic disease than in localized. 65% of patients with non-seminomas had AFP positive tumour tissue and 66% had raised serum AFP. 85% of the former group had raised serum AFP and 83% of the latter had AFP demonstrated in the tumour tissue. 69% of the patients with raised serum AFP had a positively stained yolk sac tumour (YST) component, while 15% had positively stained tumour components other than YST, inclusive teratoma components. Although 71% of patients with metastatic disease had raised serum AFP, AFP positive tumours with or without raised serum AFP did not occur with higher frequency in metastatic than in localized disease at the time of diagnosis. 46% of patients with non-seminomas had HCG positive tumours and 29% had raised serum HCG. 61% of the former group had raised serum HCG and 96% of the latter had HCG demonstrated in the tumour tissue. HCG positive tumours with or without raised serum HCG did not occur more frequently in metastatic than in localized disease at the time of diagnosis. 28% of patients with non-seminomas had raised serum AFP as well as HCG, whereas 23% had neither AFP nor HCG in tumour tissue and serum. A search for new tumour markers in this rather large marker negative group of patients is recommended.
 ...
PMID:Alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG) in testicular germ cell tumours. A comparison of histologic and serologic occurrence of tumour markers. 619 Mar 51

Serum from seven of 15 patients with nonseminomatous testicular germ cell tumors impaired the transformation of lymphocytes from normal donors by phytohemagglutinin to less than 50% of that with addition to the cultures of normal AB serum. Similarly, serum from eight patients impaired the transformation by Staphylococcus aureus Cowan I. The impairment of the lymphocyte transformation did not correlate with the serum concentrations of alpha-fetoprotein (S-AFP) and human chorionic gonadotropin (S-HCG). The patients with metastases and serum that impaired lymphocyte transformation to less than 50% of that with addition of serum from the controls and the other patients survived in the same way (0.50 less than p less than 0.75, log-rank test). The prognosis of patients with testicular germ cell tumors seems not be influenced by S-AFP and S-HCG through an impact on lymphocyte functions determined as the response to the two mitogens.
 ...
PMID:Suppression of the mitogen response of normal lymphocytes by serum from patients with testicular germ cell tumors. 619 1

A series of 170 consecutive patients with testicular germ cell tumors (88 seminomas and 82 non-seminomas) had preoperative serum samples and primary tumor tissue examined for the presence of the tumor markers, alphafetoprotein (AFP) and human chorionic gonadotropin (HCG) by immunologic techniques. Staging was performed, using a clinico- radiological system, i.e., stage I, tumor confined to testis; stage II, metastases to abdominal lymph nodes only: stage III, metastases to supradiaphragmatic lymph nodes and/or extranodal disease. Seminoma:all 36% had stage II+III disease. 55% of the patients with AFP had localized disease, and 45% had stage II+III. The frequency of patients with stage I non-seminoma with raised serum HCG was 63% compared to 37% in stage II+III. Within the group of HCG-positive non-seminomas, 60% were in stage I and 40% in stage II. Since a high frequency of patients with metastatic disease did not occur among the patients with AFP or HCG in preoperative serum samples or in primary tumor tissue, we conclude that neither AFP nor HCG are especially associated with metastatic properties. The higher frequency of patients with raised serum values among all patients with metastatic disease compared to localized disease may only reflect a greater tumor burden.
 ...
PMID:Tumor markers in testicular germ cell tumors related to the stage of the disease at the time of diagnosis. 619 49

Serum lactate dehydrogenase (S-LDH) was raised in 41 of 82 patients with testicular germ cell tumors, none of three with subclinical testicular tumors, and 10 of 341 without testicular germ cell tumors, 215 of whom had a previous history of tumor. 13 of 38 with testicular germ cell tumors, none of three with subclinical testicular germ cell tumors, and seven of 341 without tumor lesions had raised levels of isoenzyme S-LDH-1. 46 of 52 had concordant changes in S-LDH and total tumor volume whereas in six this relationship was not noted. Concordant changes in S-LDH-1 and total tumor volume were found in most cases. Higher S-LDH and S-LDH-1 levels were noted in the blood from the testicular vein on the side of the tumor at orchiectomy than in peripheral blood. The S-LDH activity predicted survival in a multivariate analysis of risk factors in 39 patients with stage 3 metastases from testicular germ cell tumors. 70-75% of 37 with tumor lesions had concordantly raised or normal S-LDH and serum concentrations of alphafetoprotein (S-AFP) and human chorionic gonadotropin (S-hCG); 25-30% had discordant levels. The diagnostic specificity of S-LDH and S-LDH-1 with regard to tumors in 252 with a history of testicular germ cell tumors was 68%, the diagnostic sensitivity 90%, the nosographic specificity 97%, the nosographic sensitivity 41% for S-LDH and 35% for S-LDH-1, and the effectiveness of the tests 88% for S-LDH and 90% for S-LDH-1. Tumor tissue from a testicular germ cell tumor transplanted into athymic mice had a high activity of LDH-1. There was a good correlation between S-LDH-1 and tumor volume. S-LDH may be used as a tumor marker in patients with testicular germ cell tumors in addition to other diagnostic tests. In patients with a history of testicular germ cell tumors and an unexplained elevation of S-LDH, raised S-LDH-1 may indicate the presence, and normal S-LDH-1 the absence, of testicular germ cell tumors.
 ...
PMID:Lactate dehydrogenase and its isoenzymes in testicular germ cell tumors: an overview. 619 55


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>