Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027651 (tumor)
 685,946 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The prognostic and postoperative monitoring capabilities of the CEA assay were compared to pathological staging of the operative specimens, clinical followup including endoscopy, radiology and scanning techniques, as well as DNCB skin testing and laboratory enzyme determinations (alkaline phosphatase and transaminase). A total of 46 patients with curative resection for colorectal carcinoma were studied. This included 23 patients with recurrent tumors compared to 23 long-term survivors without signs of recurrence at the time of the study. Preoperative CEA determinations were a good prognostic tool comparable to pathological staging of the specimen. Post operative CEA monitoring was the earliest sign of recurrence in 14 of 23 patients and was positive at the time of recurrence determined by other methods in 20; it was negative in only three cases. The incidence of false positive results among the non recurrent group became a lesser problem when repeated elevated values were required before considering the patient as having a recurrence. From these data, it seems reasonable to propose the use of a second-look operation in patients with maintained elevation of circulating CEA and no clinical signs of tumor presence, if we are to treat recurrence at an early stage. Chemotherapy would be an alternative way to deal with this problem, since the absence of clinical signs in general correlate with small bulk of tumor which at this time may be more susceptible to chemotherapeutic agents.
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PMID:Carcinoembryonic antigen (CEA) as a prognostic and monitoring test in clinically complete resection of colorectal carcinoma. 124

To further define and determine the usefulness of CEA, 1100 CEA determinations have been made over the past two years at The Ohio State University Hospitals on patients with a variety of malignant and nonmalignant conditions. Correlation of CEA titers with history and clinical course has yielded interesting results not only in cancers of entodermally derived tissues, for which CEA has become an established adjunct in management, but also in certain other neoplasms and inflammatory states. The current total of 225 preoperative CEA determinations in colorectal carcinomas shows an 81% incidence of elevation, with postoperative titers remaining elevated in patients having only palliative surgery but falling to the negative zone after curative procedures. An excellent correlation exists between CEA levels and grade of tumor (more poorly differentiated tumors showing lower titers). Left-side colon lesions show significantly higher titers than right-side lesions. CEA values have been shown to be elevated in 90% of pancreatic carcinomas studied, in 60% of metastatic breast cancers, and in 35% of other tumors (ovary, head and neck, bladder, kidney, and prostate cancers). CEA levels in 35 ulcerative colitis patients show elevation during exacerbations (51%). During remissions titers fall toward normal, although in 31% still remaining greater than 2.5 ng/ml. In the six colectomies performed, CEA levels all fell into the negative zone postoperatively. Forty percent of adenomatous polyps showed elevated CEA titers (range 2.5-10.0) that dropped following polypectomy to the negative zone. Preoperative and postoperative CEA determinations are important in assessing the effectiveness of surgery. Serial CEA determinations are important in the follow-up period and in evaluation of the other modes of therapy (e.g., chemotherapy). These determinations of tumor antigenicity give the physician added prognostic insight into the behavior of the tumor growth. Rectal examination with guaiac determinations, sigmoidoscopy, cytology, barium enema, and a good clinical evaluation remain the primary tools for detecting colorectal disease. However, in the high-risk patient suspicious of developing cancer, CEA determinations as well as colonoscopy are now being used increasingly and provide additional highly valuable tools in the physician's armamentarium.
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PMID:Carcinoembryonic antigen: clinical and historical aspects. 124 68

The past decade has seen many advances in the detection, characterization, and clinical applications of tumor markers. Although cancer screening applications have been limited by low disease prevalences in asymptomatic populations, tumor markers may be of diagnostic value in specific situations. The major use of tumor markers in primary care is in monitoring disease recurrence and the response to therapy. These uses may obviate the need for second-look surgery as it has with CA 125 elevations in ovarian carcinoma. On the other hand, tumor markers may indicate a need for second-look surgery as when CEA levels are elevated in colorectal carcinoma. Despite the apparent usefulness of markers in detecting cancer recurrence, the clinician is reminded of the conditions justifying treatment with the discovery of an abnormal laboratory value as put forth by Fries and Holman: (1) the treatment should be known to be effective, (2) early treatment should be known to be more effective than therapy given after the disease is clinically apparent (or early treatment carry the risk of less toxicity), and (3) prediction of impending deterioration must be consistently accurate. When these criteria are met, the planning of therapeutic regimens on the basis of marker levels may be rationally considered. Until these criteria are met, elevated markers can only stimulate the clinician to be more vigilant in the search for response to therapy or recurrence. Exciting developments are on the horizon with respect to the use of tumor markers in radionuclide imaging, radioimmunoguided surgery, and development of drug delivery systems. Further research into the structure and function of these substances may provide further insights into the phenomena of malignant transformation, tumor invasion, metastasis, and the development of new therapeutic options. With new advances in molecular biology and with the identification of oncogenes, it may be possible in the future to detect mutant oncoproteins that are specific for early cancers and premalignant conditions. Delecting these oncoproteins may provide a basis for development of truly sensitive and specific markers that can be used to detect cancer at an early and curable stage.
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PMID:Tumor markers. 128 52

The clinicopathological and immunohistochemical features of 7 cases of benign and malignant Brenner tumor of the ovary, including 5 benign and 2 malignant tumors are described. Microscopically, all of the benign cases were composed of both epithelial nest and fibrous stroma. Two cases of the malignant Brenner tumor showed that the histologic features resembled the structure of non-keratinized squamous carcinoma or transitional cell carcinoma. Immunohistochemistry showed that tumor cells of the epithelial nest were keratin and EMA positive in 7 cases; CEA-positive in 5 cases; and negative in 2 cases of benign Brenner tumor. The results indicated that Brenner tumor is an epithelial neoplasm in nature. The diagnostic criteria and histogenetic origin are discussed.
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PMID:[Benign and malignant Brenner tumor of the ovary: a clinicopathological and immunohistochemical study]. 128 87

The plasma concentration of CEA, AFP and CA125 in 54 women with endometrial carcinoma and 12 with atypical hyperplasias, were investigated. In 20 of the patients the tumor markers were studied again 11 months after the surgical treatment. Elevation of CEA, AFP and CA125 levels was found in the third, and especially in the forth phase of the illness. Essential similarities between the histological differentiation and the levels of the tumor markers were not observed. The supposition was that the study of the CEA, AFP and CA125 is not a reliable criterion for the early diagnosis of the endometrial carcinoma. They have a prognostic significance only in patients of the second clinical phase after a surgical treatment. It is recommended two of the markers to be used, mostly CEA and CA125 and the study to be performed several times.
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PMID:[The tumor markers CEA, AFP and CA125 in patients with endometrial carcinoma]. 128 57

The incidence of periampullary cancer has been steadily rising in Korea. In the present study, we have reviewed 766 cases of surgically treated periampullary cancers, including 122 cases of our own, which were published in the Korean literature from 1984 to 1992. The 6th decade was the most prevalent age group, occupying 38% of the patients. The ratio of male of female was 1.7 to 1. Approximately 60% of lesion located at the head of the pancreas. Computed tomography which had 85% sensitivity was the most commonly employed modality for a diagnosis. The diagnostic sensitivity of percutaneous transhepatic cholangiography was 72%, of endoscopic retrograde cholangiopancreatography was 71%, and of ultrasonography was 54% in order of frequency. Tumor markers such as CA-19, CEA, and CA-125 were also studied in pancreatic cancer. The combinations of these markers recorded a higher positivity than using solely. The resection rate for lesions at the head of the pancreas was 21%, and that of distal common bile duct, ampulla of vater, and duodenum were 37%, 85%, and 50%, respectively. The morbidity and mortality rates after pancreatoduodenectomy were 44% and 12%, respectively. TNM staging revealed 66% of patients were in stage III, 26% in stage I, and 8% in stage II. The actual 5-year survival rates for cancer of the head of the pancreas was 11%, and that of duodenal cancer, distal choledochal cancer, and ampullary cancer were 21%, 18%, and 15%, respectively. In nonresected group, none survived over 18 months after treatment. Relatively high portion of lymph node metastatic patients may explain the poor survival observed in our series.
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PMID:Surgical treatment of periampullary cancer--review of 766 surgical experiences of 8 hospitals. 129 31

We report a primary choriocarcinoma of the urinary bladder in a 63-year-old man who presented with painless hematuria. He was diagnosed as having an invasive carcinoma and underwent a total cystectomy. The tumor was diffusely hemorrhagic and occupied the dome of the bladder. Histologically, it consisted of cyto-and syncytiotrophoblasts with extensive hemorrhage. No coexisting transitional cell carcinoma component was present. By immunohistochemistry, the tumor expressed beta-hCG and low-molecular weight cytokeratin intensely while it was negative for CEA or EMA. The post-cystectomy serum beta-hCG was 237mlU/ml, and decreased later. The pertinent literature is reviewed and diagnostic criteria are discussed.
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PMID:Primary choriocarcinoma of the urinary bladder--a case report. 129 42

The pharmacokinetics of various radiopharmaceuticals following i.v. administration in mice and rats has been studied and compared. Before injection the radiochemical purity (RP) of the compounds were determined by HPLC and PAGE. In all cases RP-s were higher than 90%. The biodistribution of 99mTc labelled anti CEA IgG was studied in mice bearing human colon carcinoma xenografts. Animals with different tumour weights showed different blood kinetic and tumor uptake. The pilot clinical study of the 99mTc labelled anti melanoma Fab and 111-In-DTPA labelled anti melanoma F(ab')2 showed differences in the pharmacokinetic parameters. (99mTc labelled: comp.A. 84.6%; T1/2:0.6 h, 111-In-labelled: comp.A.: 46%, T1/2 1.5 h.) The various isonitrile derivatives synthetized in our laboratory were labelled with 99mTc and the biodistribution were tested in rats. The kinetic study showed that all the three molecules have different half lives in the heart and liver (T1/2 for heart ranged 5.1-18.6 h, for liver T1/2:1.2-2.5 h). Reversed phase HPLC study of the collected bile showed the 15-100% of injected compounds are metabolized during hepatic excretion. Literature data and our recent observations confirm that the knowledge of pharmacokinetics of radiolabelled compounds both in research, development and clinical practice is of basic importance.
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PMID:Pharmacokinetics of radiopharmaceuticals. 130 81

The immunoscintigraphic detection of tumour foci less than 1 cm in diameter fails even with single photon emission tomography (SPET) owing to low contrast against background activity. In an attempt to improve detection of macroscopically invisible tumour spread, intraoperative scintimetry (IOSM) with a hand-held gamma-probe was performed in addition to SPET 24-30 and 41-48 h after injection of the technetium-99m carcinoembryonic antigen (CEA MoA) on 12 patients with colorectal carcinoma and 3 patients with different neoplastic and inflammatory diseases. Tumour specimens were measured in vitro in a gamma well counter. For comparison, the presence and amount of CEA in the tumour cells were evaluated immunohistochemically. After modification, the gamma-probe originally designed for iodine-131 was 20 times more sensitive; activities of 99mTc located close to the collimator hole were measured with absolute sensitivity of 100 cps = 2.5 kBq 99mTc. The unfavourably high background activity affected both the in vitro and in vivo analysis: SPET results had been considered positive in 8 of 15 cases. In vitro tumour/non-tumour (t/nt) ratios greater than 2.0 were found in 4 cases. In vivo IOSM resulted in t/nt ratios greater than 2.0 in only 3 patients. In most cases, there was no coincidence of elevated t/nt ratios from the different methods. A correlation was derived between positive immunoscintimetric in vitro findings and immunohistochemically proven interstitial localization of CEA in tumor cells. In conclusion, the measurement technique of IOSM seems adequate, but clinical success will depend on a more specific enrichment of MoA in tumour tissue.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Detection of colorectal carcinomas by intraoperative RIS in addition to preoperative RIS: surgical and immunohistochemical findings. 131 82

A 57-year-old male patient was admitted because of a severe lumbar pain and gross hematuria. The rectal examination revealed a fist-sized soft tissue mass in the small pelvic space. A huge non-papillary tumor, which occupied the intravesical space, was found on cystoscopic examination. CEA IAP, TPA, CA19-9 and NSE were abnormally elevated in the serum. The pelvic CT scan shown an enormous polypoid tumor arising from the anterior vesical wall, while no abnormal lesion was found in the head, neck, chest and abdominal CT scans. The bone scintigraphy revealed multiple abnormal accumulations. The transurethral biopsy of the tumor was carried out. The pathological examination revealed homogeneous and small tumor cells arranged in sheet and solid patterns, which were positive for the anti-NSE stain and anti-NF stain, but negative for Grimelius stain. The final diagnosis was small cell undifferentiated carcinoma of the urinary bladder. The patient died of cancer five months after diagnosis.
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PMID:[Small cell carcinoma of urinary bladder. A case report]. 131 15


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