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 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

Alpha-fetoprotein (AFP)-producing hepatoid adenocarcinoma of the stomach is a rare and recently discovered entity. We report an unusual combination of hepatocellular carcinoma and hepatoid adenocarcinoma of the stomach with multiple liver metastases. The patient, a 62-year-old Japanese man, was clinically diagnosed as having hepatocellular carcinoma because of the presence of liver tumors, a markedly elevated serum AFP level, and a positive hepatitis C virus (HCV) antibody titer. Autopsy revealed multiple tumors in the liver; one was a primary hepatocellular carcinoma without metastasis, and the others were metastases from latent hepatoid adenocarcinoma of the stomach. In the hepatocellular carcinoma, bile production was observed although the tumor was immunohistochemically negative for AFP. On the other hand, both the primary gastric and metastatic liver hepatoid adenocarcinomas were positive for AFP. Therefore, hepatoid adenocarcinoma of the stomach was responsible for the excessive production of AFP and was the cause of death.
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PMID:Primary hepatocellular carcinoma and hepatoid adenocarcinoma of the stomach with liver metastasis: an unusual association. 876 86

Alpha-fetoprotein (AFP) is a useful serum tumor marker especially for hepatocellular carcinoma and yolk-sac tumor. Increased serum levels of AFP have also been found in adenocarcinoma of the stomach, the pancreas, the colon and the lung, and in some squamous cell carcinomas of the lung. We describe a patient with a recurrent gallbladder carcinoma, presenting with increasing serum levels of AFP as the tumor progresses. Remarkable are the histologic changes in the metastases of the tumor, which showed more dedifferentiation as the number of cells containing AFP increased.
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PMID:Increasing serum levels of alpha-fetoprotein in a patient with relapsing gallbladder carcinoma. 892

The assessment of new and more sensitive serum markers for hepatocellular carcinoma (HCC) represents a useful contribution to the diagnosis of small liver tumors, still amenable by surgery. We evaluated the efficacy of the tumor markers proposed during recent years for the study of HCC: alpha fetoprotein (AFP), carcinoembryonic antigen (CEA), serum ferritin (SF), tissue polypeptide antigen (TPA), and, finally, the more recently proposed des-gamma-carboxy prothrombin (DCP). Of the 227 patients included in this retrospective study, 111 had HCC, and 85 of these were also cirrhotic. The remaining 116 patients, considered as the control group, included 23 patients with liver metastases from colorectal cancer, 26 with benign hepatic lesions, 20 with tumors other than HCC without hepatic metastases, and 47 with other liver diseases. For each single tumor marker, the sensitivity, specificity, positive and negative predictive values, diagnostic accuracy, and Younden index were assessed. AFP and DCP proved to be the most effective, with sensitivity, specificity, and diagnostic accuracy of 54.9%, 97.4%, and 76.6% and of 53.3%, 88.1%, and 71.1%, respectively. The same parameters evaluated for combined use of the two markers were 74.2%, 87.2%, and 80.9%, respectively. Analysis of the other markers produced no further significant contribution. Of the 111 patients with HCC, 35 (33.3%) were positive for both AFP and DCP, 43 (41%) were positive for one of them, and 27 (25.7%) were completely negative. In the 44 patients who underwent liver resection or transplantation, DCP correlated significantly with the histological presence of microvascular thrombosis, the major factor determining long-term survival after curative surgery. As a tumor marker for HCC, DCP is at least as effective as AFP; the combined use of AFP and DCP significantly improves the chances of identifying HCC by serodiagnosis.
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PMID:The role of tumor markers in the diagnosis of hepatocellular carcinoma, with special reference to the des-gamma-carboxy prothrombin. 934 75

A 42-year-old male presented with bilateral scrotal swelling and sense of abdominal fullness. Ultrasonography and computed tomographic (CT) scan showed right testicular tumor, left scrotal hydrocele and excessive ascites, but no distant metastases. The serum lactic acid dehydrogenase (LDH) value was as high as 4,060 IU/L and beta human chorionic gonadotropin (hCG) value was 4.0 ng/ml while alpha fetoprotein (AFP) value was within the normal range. Right high orchiectomy was performed as well as the ascites and the left scrotal fluid sampling. Histological examinations revealed anaplastic seminoma in the right testis, and similar cells were found in the ascites and the left scrotal fluid. The patient received three courses of BEP chemotherapy consisting of bleomycin, VP-16 and cisplatin. The ascites and tumor markers (LDH and beta hCG) decreased markedly. Intraperitoneal dissemination of the tumor cells seems to be caused by invasion along the right spermatic cord, but the route of dissemination into the left hydrocele fluid is not known. To the best of our knowledge, this is the first case report of testicular tumor that showed intraperitoneal dissemination without any evidence of metastasis to the lymph nodes or distant organs.
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PMID:[Intraperitoneal dissemination of testicular tumor: a case report]. 971 44

Awareness of early spread of hepatocellular carcinoma is crucial in selecting patients for surgical intervention. Alpha-fetoprotein is widely used as a serum marker for hepatocellular carcinoma. Our aim was to evaluate the specificity of alpha-fetoprotein-mRNA transcription in cells in the peripheral blood for diagnosing early spread of hepatocellular carcinoma in black Africans. Alpha-fetoprotein-, albumin- and prothrombin-mRNA were detected in peripheral blood mononuclear cells by reverse transcription-polymerase chain reaction. Alpha-fetoprotein-mRNA was shown in peripheral blood mononuclear cells in 53% (35/66) of patients with hepatocellular carcinoma, but also in 45% (10/22) of healthy blacks, 64% (14/22) of black patients with acute hepatitis, 55% (11/20) of those with chronic hepatitis or cirrhosis and 75% (9/12) of those with hepatic metastases (from a number of primary sites). Specificity of albumin- and prothrombin-mRNA was better than that of alpha-fetoprotein-mRNA, although the sensitivity was reduced. The corresponding prevalence of albumin-mRNA for each group of patients or controls was 30% (20/66), 9% (2/22), 41% (9/22), 10% (2/20), and 17% (2/12), respectively, and for prothrombin-mRNA 27% (18/66), 4.5% (1/22), 27% (6/22), 20% (4/20) and 17% (2/12), respectively. We conclude that the non-specificity of alpha-fetoprotein-mRNA transcription in peripheral blood in recognizing malignant hepatocytes in the circulation severely limits its usefulness in diagnosing the early spread of hepatocellular carcinoma in black Africans.
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PMID:Non-specificity of messenger RNA of alpha-fetoprotein in peripheral blood in detecting early spread of hepatocellular carcinoma in black Africans. 979 85

Alpha-fetoprotein (AFP)-producing esophageal tumors are extremely rare. We report herein the case of a 51-year-old man found to have an AFP-producing adenocarcinoma arising from esophageal proper mucosa. The patient presented for investigation of dysphagia, and esophagogram and endoscopy revealed a lesion about 2 cm in size with a depressed center surrounded by low nodular protrusions in the lower esophagus. The preoperative serum AFP concentration was elevated to 52.4 ng/ml. A subtotal esophagectomy was performed, and macroscopic examination of the resected specimen revealed a superficial protruding lesion. Histopathological studies showed a poorly differentiated adenocarcinoma with a single lymph node metastasis. The tumor had infiltrated the submucosal layer, but there was no evidence of lymphatic or venous invasion. Immunohistochemical study revealed tumor cells positive for AFP. There were no findings of Barrett's epithelium or any mucosal changes due to reflux esophagitis. An elevated AFP level 2 years after the operation led us to suspect tumor recurrence; however, diagnostic imaging studies showed no evidence of a recurrence or metastases. The serum AFP levels responded well to chemotherapy with transient decreased levels, but continued to rise until finally, 5 years after the operation, adenocarcinoma cells were detected in the pleural effusion. Thus, careful monitoring of the serum AFP levels at regular intervals could be a useful marker to indicate recurrence of esophageal carcinoma.
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PMID:Alpha-Fetoprotein-producing esophageal adenocarcinoma: report of a case. 1175 90

Monoclonal antibodies are used to detect serum antigens associated with specific malignancies. These tumor markers are most useful for monitoring response to therapy and detecting early relapse. With the exception of prostate-specific antigen (PSA), tumor markers do not have sufficient sensitivity or specificity for use in screening. Cancer antigen (CA) 27.29 most frequently is used to follow response to therapy in patients with metastatic breast cancer. Carcinoembryonic antigen is used to detect relapse of colorectal cancer, and CA 19-9 may be helpful in establishing the nature of pancreatic masses. CA 125 is useful for evaluating pelvic masses in postmenopausal women, monitoring response to therapy in women with ovarian cancer, and detecting recurrence of this malignancy. Alpha-fetoprotein (AFP), a marker for hepatocellular carcinoma, sometimes is used to screen highly selected populations and to assess hepatic masses in patients at particular risk for developing hepatic malignancy. Testing for the beta subunit of human chorionic gonadotropin (beta-hCG) is an integral part of the diagnosis and management of gestational trophoblastic disease. Combined AFP and beta-hCG testing is an essential adjunct in the evaluation and treatment of nonseminomatous germ cell tumors, and in monitoring the response to therapy. AFP and beta-hCG also may be useful in evaluating potential origins of poorly differentiated metastatic cancer. PSA is used to screen for prostate cancer, detect recurrence of the malignancy, and evaluate specific syndromes of adenocarcinoma of unknown primary.
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PMID:Serum tumor markers. 1452 94

Alpha-fetoprotein producing gastric cancer (AFP-GC) rarely occurs, but it is classified as a special subtype of gastric cancer (GC). This tumor, as represented by the production of AFP, exhibits not only specific function but also different histology compared with ordinary-GC (O-GC). Clinically, it is likely to metastasize to the liver and, as a consequence, poor prognosis is recognized as one of the features. Recently, AT motif binding factor-1 (ATBF1) was identified as a modulator of AFP production by hepatocellular carcinoma, and the decreased expression of the protein was also reported in AFP-GC. However, little is known about the biological significance of the decreased expression. In this study, to clarify the biological characteristics of AFP-GC, antibody was raised against ATBF1 and immunohistochemistry was carried out. The antibody specifically recognized ATBF1, and the degree of expression could be characterized by immunohistochemistry. ATBF1 was expressed in O-GC and the area of tubular adenocarcinoma components of AFP-GC. On the other hand, the expression pattern varied in the hepatoid carcinoma components of AFP-GC, and AFP was expressed in the area without ATBF1 expression. Taken together, these results corroborated the previous reports that ATBF1 regulated AFP expression and inhibited transcription. Furthermore, in terms of differentiation induction, ATBF1 expression was decreased in the areas with little glandular formation. This may suggest that aberrant expression of ATBF1 induces the expression of various factors that are otherwise suppressed, and that this somehow determines the biological features of AFP-GC.
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PMID:Alteration of the AT motif binding factor-1 expression in alpha-fetoprotein producing gastric cancer: is it an event for differentiation and proliferation of the tumors? 1465 95

We describe the clinicopathologic findings in a so far unrecognized thymic tumor. The tumor occurred in a 70-year-old woman with respiratory distress but neither myasthenia gravis nor other symptoms. Metastases or another primary tumor were absent. The well-circumscribed neoplasm was located in the thymic region, measured 18 x 12 x 8 cm, and showed a homogeneous, tan-colored, soft cut surface. By histology, the tumor lacked a true capsule and a lobular growth pattern, was almost devoid of stroma, and infiltrated among remnant thymus lobules. The polygonal tumor cells formed solid sheets, trabeculae, or occurred as single cells that resembled hepatocytes. Proliferative activity was low. Portal structures, sinuses, and bile were absent as were areas of conventional thymoma, adenocarcinoma, or germ cell tumor. The tumor expressed cytokeratins 7 and 19, alpha1-antitrypsin, alpha1-antichymotrypsin, and hep-Par-1. Alpha-fetoprotein (AFP), human beta-chorionic gonadotropin (beta-HCG), placental alkaline phosphatase, CD5, CD30, CD31, CD34, CD45, CD68, CD99, S-100, HMB45, desmin, actin, or neuroendocrine markers were not expressed, and intratumorous CD1a+ or TdT+ immature T cells were absent. AFP was repeatedly undetectable in the blood. Mediastinal tumor recurrence was detected 6 months after surgery. Following radiochemotherapy, the patient has remained free of disease for 26 months. We conclude that this tumor is a thymic carcinoma (WHO type C thymoma). A diagnosis of hepatoid yolk sack tumor appears unlikely considering absence of a bona fide germ cell component, lack of AFP expression, and the patient's female gender. Because of its morphologic and immunohistochemical features, we propose the term "hepatoid thymic carcinoma" for this new type of thymic carcinoma.
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PMID:Hepatoid thymic carcinoma: report of a case. 1504 16


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