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)

Alpha-fetoprotein (AEP) serum levels were determined by a new radioimmunoassay (sensitivity about 5 ng/ml) in 47 patients with teratocarcinoma of the testis and in 58 cases with seminoma before operation and during the postoperative course of the disease. In 140 healthy adult persons normal AFP levels below 15 ng/ml were measured. Of 14 preoperative cases with teratocarcinoma, 12 (86%) showed pathologic AFP levels over 20 ng/ml up to 3875 ng/ml. Postoperatively, cases free of metastases developed normal AFP concentrations within 4 to 10 weeks, whereas cases with distant metastases retained constant or increasing pathologic levels following a clinical deterioration. Only in three postoperative cases were Ouchterlony-positive results (AFP sensitivity about 10 000 ng/ml) observed. In contrast, patients with seminoma showed normal AFP levels below 20 ng/ml pre- and postoperatively. According to the results, AFP radioimmunoassay is recommended as an important tool for the differentiation of teratocarcinoma from other tumors of the testis and as a useful parameter for the control of therapy and the course of the disease.
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PMID:[Radioimmunologic serum determinations of alpha-fetoprotein in patients with tumors of the testis (author's transl)]. 7 Aug 76

Serum AFP was determined serially by radioimmunoassay in 13 patients with ovarian germ cell tumors and in one patient with bilateral pure gonadoblastoma. There were 4 patients with pure dysgerminoma, one with pure endodermal sinus tumor (EST) and 8 with mixed germ cell tumors, all containing EST. The patients with dysgerminoma and gonadoblastoma had normal serum AFP at all times. All patients with tumors containing EST had raised serum AFP, although in most cases it was first determined between 1 and 3 weeks after operation and there was no evidence of metastases. Serum AFP became normal 5 to 7 weeks after operation and began to rise when disease recurred. Serum AFP determinations detected presence of recurrent disease long before it became detectable by other methods. Serum CEA was determined serially by radioimmunoassay in 8 of these patients, including 2 who dies with metastases, and was normal on all occasions.
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PMID:Serum alphafetoprotein (AFP) in diagnosis and management of endodermal sinus (yolk sac) tumor and mixed germ cell tumor of the ovary. 7 54

Current therapy for metastatic non-seminomatous testis tumors is effective but toxic. Careful investigation is needed to select those who need treatment and yet avoid needless toxicity in patients who have no disease. Current radiographic investigations and measurement of two biochemical tumor markers (AFP & BHCG) provided accurate monitoring in 19 patients. Preoperative urography and lymphography correctly predicted the presence or absence of retroperitoneal metastases in 9 of 12 patients but did not show microsocpic metastases in 3. There was good correlation between the clinical, readiographic and biochemical evidence of disease progression and regression. Serial ultrasonography and tumor marker determinations were particularly useful in following asymptomatic abdominal metastases. Radiography and tumor marker determinations each have specific advantages which make them complementary.
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PMID:Radiologic, clinical and biochemical features of non-seminomatous testicular tumors. 7 61

The new radioimmunoassays for AFP and beta-HCG are highly specific for nonseminomatous, germ-cell testicular tumor in genitourinary patients who do not have liver disease or other cancers. When used together, they are an accurate and sensitive indicator of metastases and are helpful in determining the effectiveness of therapy. However, they are not very useful in the differential diagnosis of scrotal masses.
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PMID:Serum alpha-fetoprotein and human chorionic gonadotropin in the management of testicular tumors. 8 63

The diagnostic value of the serum tumour markers, beta-HCG and AFP, is investigated in 71 patients with malignant testicular tumours. Regular screening with beta-HCG and AFP, has improved the early diagnosis of recurrences and metastases in nonseminomatous testicular tumours.
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PMID:[Diagnostic progress in testicular carcinoma]. 9

A case of embryonal cell carcinoma of the testes with widespread metastases, and the presence of AFP in the patient's serum, is reported. The usefulness of the detection of AFP for the diagnosis of this type of tumor is stressed. The use of polyacrylamide disc electrophoresis in combination with double-diffusion in gel are considered as a highly sensitive method for the detection of AFP in routine clinical work. The literature dealing with the characterization of AFP and its frequency and significance in various diseases is reviewed.
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PMID:Alpha-fetoprotein in a patient with embryonal cell carcinoma of the testes. 80 96

Serum levels of AFP, hCG and CEA were initially and serially measured in 59 patients with testicular germ cell tumors, and serially in 37 with ovarian and 3 with extragonadal germ cell tumors. Patients with seminoma/dysgerminoma or mature teratoma had normal serum AFP and sporadically slightly elevated hCG. Some patients with embryonal carcinoma, pure or with admixture of seminoma, had serum AFP elevated to maximum 100 U/ml, yet its use for monitoring therapy was limited. Patients with yolk sac tumors had elevated AFP and sometimes CEA levels, those with choriocarcinoma had elevated hCG, and those with compound tumors had one or more of the markers highly elevated. High AFP and/or hCG levels indicated the presence of the relevant tumor cells both in the primary and in residual tumor and/or metastases, also those missed in histological material, and thus were useful in restaging. Unfortunately, their absence in serum did not exclude the presence of marker-negative subpopulations of tumor cells. Changes in marker values paralleled the effects of treatment: the level increasing from any nadir heralded recurrence in patients in remission; elevated or increasing levels during therapy implied resistance to the therapy; decreasing levels indicated regression even though a return to the normal range did not mean eradication of all tumor cells.
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PMID:Serum AFP, hCG and CEA in the management of patients with testicular, ovarian and extragonadal germ cell tumors. 137 75

Detection of serum and cellular AFP and hCG has made a significant contribution in understanding and management of testicular cancer. It is essential to remember the following events in utilizing these markers: (1) Histologic diagnosis of seminoma, but AFP is elevated. There is usually an element of choriocarcinoma. (2) Histologic diagnosis of seminoma and highly elevated hCG greater than 100 ng/ml has usually an element of choriocarcinoma. (3) Histologic diagnosis of choriocarcinoma with an elevated serum AFP. There is usually an element of embryonal carcinoma. (4) Pathologic stage I nonseminomatous testicular cancer with elevated serum markers is either stage II or stage III. (5) In a recent study of 23 patients undergoing resection of residual nonseminomatous testicular cancer after intensive chemotherapy, 21 had either teratoma in primary tumor or bulky metastatic disease. The markers were normalized after chemotherapy and prior to resection. (6) Although normalization of these markers after chemotherapy indicates effective therapeutic response, one should look of residual tumor utilizing radiologic investigations.
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PMID:Current status of tumor markers in testicular cancer. A practical review. 138 31

A 49-year-old male patient was admitted to our hospital complaining of right scrotal mass. Serum tumor markers, HCG, beta-HCG and AFP, were all elevated. After right high inguinal orchiectomy, a pathological report revealed a mixed-type germ cell tumor, which was composed of choriocarcinoma, embryonal carcinoma and seminoma. Because of persistent elevation of these tumor markers, RPLND was performed. There were viable tumor cells in the dissected lymph node specimens. As pulmonary metastases developed after RPLND, the patient was treated with 3 courses of VAB-6 combination chemotherapy (vinblastine, actinomycin-D, cyclophosphamide, bleomycin and cis-platinum). Pulmonary metastases disappeared and tumor markers returned to normal range except for moderate elevation of serum HCG. Two months later, pulmonary metastases developed again with re-elevation of tumor markers. Four courses of EP salvage chemotherapy (etoposide and cisplatinum) were given. After EP chemotherapy, the patient was given etoposide orally for about 7 months. During this period, no abnormality was found except for slight elevation of serum HCG. Five months after discontinuing chemotherapy, serum HCG returned to normal and complete remission was obtained.
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PMID:[A case of complete remission obtained with etoposide cis-platinum combination chemotherapy in advanced testicular cancer]. 168 34

Between 1981 and 1986, 279 consecutive patients with clinical stage I (CS1) nonseminomatous germ cell tumors (NSGCT) of the testis underwent pathological staging (PS) with retroperitoneal lymphadenectomy (RPLND). Patients with retroperitoneal metastases (PS2) received adjuvant chemotherapy. The median follow-up time after RPLND was 50 months (range, 30 to 90). Clinical and histopathologic features were registered prospectively and analyzed for association with risk of having PS2, relapse despite pathological stage 1 (PS1) or the combined risk of either event, metastatic disease (MET). Seventy-five (26.9%) of the patients had PS2 disease, and 30 (14.7%) of the 204 PS1 patients relapsed, indicating that at least 105 (37.6%) of this CS1 population had subclinical MET at the time of orchiectomy. Four (1.4%) of the 279 CS1 patients died of testicular cancer. Multivariate analyses showed several variables to be significantly associated with outcome for the CS1 patients; vascular invasion in primary tumor and normal preorchiectomy serum alpha-fetoprotein (Pre-AFP) level indicated PS2 disease. If Pre-AFP was excluded from the model, the absence of teratoma or yolk sac elements in the primary tumor became significant predictors of PS2. Vascular invasion, absence of teratoma, and a short interval between orchiectomy and RPLND indicated increased risk of relapse in PS1 patients. Vascular invasion, normal Pre-AFP, absence of teratoma elements, and a short orchiectomy to RPLND interval were predictive of MET. Our results indicate that prognostic factors useful for stratification of CS1 patients with NSGCT to different treatment options may be established.
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PMID:Prognostic factors in clinical stage I nonseminomatous germ cell tumors of the testis: multivariate analysis of a prospective multicenter study. Swedish-Norwegian Testicular Cancer Group. 168 73


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