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Query: UMLS:C0027651 (tumor)
 685,946 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cut-off values and grey-zone of tumor markers in blood were described. Cut-off values are a little different from reference intervals, and can discriminate tumor status from non-tumor status. Cut-off values are commonly determined by ROC (receiver operating characteristic) curve, that can show us the diagnostic efficiency of the test. The patients of control group used in ROC curve must be selected from benign diseases whose conditions are similar to those of tumors. Grey-zone is defined as the range between cut-off value from healthy subjects and that from benign diseases. Cost-efficiency must be considered when cut-off values and grey-zone of tumor markers in blood were set up.
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PMID:[Cut-off values and grey-zone of tumor markers in blood]. 869 24

GBNE is an arginine-specific metalloprotease that cleaves human chorionic gonadotropin free beta-subunit in pregnancy serum. We tested GBNE activity in 539 serum samples, from individuals that were healthy, with benign diseases, or with a broad mixture of cancers. The mean GBNE activity in 130 samples from healthy individuals, 151 from those with benign disease, and 258 from cancer patients was 5.4 +/- 0.32, 5.8 +/- 0.20 and 16 +/- 1.2 units, respectively. ROC analysis indicated 86% discrimination between control samples and cancer. A cut-off of 12 units was selected. This was equaled or exceeded by 3.1% of samples from healthy individuals, 3.9% from those with benign disease, and 57% from those with cancer. There was no significant difference in detection of the different cancer primaries, breast (sensitivity 56%), gastrointestinal (53%), genitourinary (62%), gynecological (58%) and lung (55%) cancers. Sensitivity was highest for early stage, and lowest for advanced malignancies, for all cancer primaries. Taken together, sensitivity was 70, 44, 43 and 24%, for stages I, II, III and IV, respectively. GBNE is suggested to be a nonorgan site-restricted tumor marker with high sensitivity for early stage cancers.
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PMID:Gonadotropin beta-subunit nicking enzyme (GBNE), a potential marker of early malignancies. 870 82

The goal of this study was to develop a technique to distinguish benign and malignant breast lesions in secondarily digitized mammograms. A set of 51 mammograms (two views/patient) containing lesions of known pathology were evaluated using six different morphological descriptors: circularity, mu R/sigma R (where mu R = mean radial distance of tumor boundary, sigma R = standard deviation); compactness, P2/A (where P = perimeter length of tumor boundary and A = area of the tumor); normalized moment classifier; fractal dimension; and a tumor boundary roughness (TBR) measurement (the number of angles in the tumor boundary with more than one boundary point divided by the total number of angles in the boundary). The lesion was segmented from the surrounding background using an adaptive region growing technique. Ninety-seven percent of the lesions were segmented using this approach. An ROC analysis was performed for each parameter and the results of this analysis were compared to each other and to those obtained from a subjective review by two board-certified radiologists who specialize in mammography. The results of the analysis indicate that all six parameters are diagnostic for malignancy with areas under their ROC curves ranging from 0.759 to 0.928. We observed a trend towards increased specificity at low false-negative rates (0.01 and 0.001) with the TBR measurement. Additionally, the diagnostic accuracy of a classification model based on this parameter was similar to that of the subjective reviewers.
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PMID:Quantitative classification of breast tumors in digitized mammograms. 904 73

Bone sialoprotein (BS), a protein synthesized by osteoblasts and osteoclasts and highly modified posttranslationally, constitutes a predominant fraction of the noncollagenous organic matrix in human bone. We report an assessment of serum concentrations of BS in patients with malignant bone diseases. In patients with bone metastases (according to scintigraphic criteria), serum BS concentrations were greater than in patients without bone metastases (P <0.05). However, ROC curve analysis revealed that serum BS was inferior to serum bone alkaline phosphatase in discriminating between patients with and without bone metastases. Patients with bone metastases showed a weak correlation between serum BS concentrations and bone formation markers. Only "traditional" markers of bone formation-but not BS-were correlated with urinary deoxypyridinoline (P <0.01). Liver and kidney dysfunction had no significant influence on BS values in these patients (as assessed by analysis of variance; P >0.05). In multiple myeloma patients treated with corticosteroids and bisphosphonates, BS concentrations were lower than in tumor patients without bone metastases (P <0.001), and the correlation between BS concentrations and the number of bisphosphonate courses applied was significant (r = -0.578; P <0.05). In postmenopausal women, serum BS concentrations averaged 142% greater than in premenopausal women. Further studies should be done, therefore, to elucidate whether serum BS is able to predict high bone turnover after menopause.
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PMID:Bone sialoprotein in serum of patients with malignant bone diseases. 899 Feb 27

Our objective was to investigate possible factors implicated in either early death from or scintigraphic resolution of pulmonary embolism. To that end we conducted a retrospective study of 116 patients with either a high likelihood of pulmonary thromboembolism (PTE) diagnosed by scintiscan or with a fair probability of PTE by scintiscan accompanied by a positive phlebograph. The images were taken upon admission, at 7 days, 10 days and 6 months. The factors analyzed were age, sex, trauma, immobility, surgery, obesity, hemiplegia, venous insufficiency, cardiopulmonary disease, neoplasia, chest X-ray and ECG alterations, D(A-a)O2 and size of perfusion defects upon admission and 7 to 10 days later. We performed single-variable analyses and multiple logical regression analyses using perfusion defect at 6 months as the dependent variable. The early mortality rate (13%) was higher in patients with neoplasms, a larger alveolar-arterial index and greater perfusion defects upon admission. Scintiscans became normal in 28%. Multivariate analysis to predict total or partial resolution at 6 months showed that size of perfusion defects at 7 to 10 days was the best predictive factor. A cutoff point was calculated by analyzing the ROC for this factor. Thus, when the defect at 7 to 10 days was equal to or greater than 1 segment, the probability of residual defects remaining after 6 months was twice as great (sensitivity 83%, specificity 57%). In conclusion, early death was more likely in PTE patients with neoplasms, larger defects upon admission and greater alveolar-arterial difference. Scintigrams showed resolution 6 months after admission in 28%. The size of perfusion defects 7 to 10 days after admission was the factor that best predicted total of partial resolution at 6 months.
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PMID:[The prognostic factors for early mortality and for total or partial gammagraphic resolution in venous thromboembolic disease]. 925 67

18FDG-positron emission tomography (PET) was performed preoperatively in 159 patients (89 pancreatic cancers, 48 inflammatory pancreatic tumors, 22 benign tumors) with pancreatic mass of unknown origin and its diagnostic value (ROC analysis) was compared with ERCP and computed tomography. In patients with normal fasted blood glucose level (< 130 mg%) and without active inflammation (n = 126), diagnostic value of PET was equal to ERCP (0.94) and higher than CT (0.84; p < 0.02); PET showed in 88% of cases no prediction of resectability or local tumor infiltration, no influence on explorative celiotomies, in 93% no increase of preoperative hospital stay, in 4% influence on surgical strategy, in 5% metastases as additional information. Though its additional information gain for the surgeon remains limited, PET is certainly a diagnostic achievement with high diagnostic value in preselected patients.
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PMID:[PET in pancreatic tumor of unknown origin--luxury or value?]. 957 85

The S-phase which assesses tumor proliferation has been considered to be an independent prognostic factor for breast carcinoma. Quantitative analysis of MIB-1 immunoreactivity is a newly recognized method of determining cellular proliferation that offers some advantages over flow cytometry when limited tumor tissue is available. However, it has been controversial whether there is a significant correlation between MIB-1 immunostaining and S-phase in defining proliferation activity in breast cancer. In order to explore the usefulness of MIB-1 as an additional proliferation parameter and a potential prognostic factor for breast cancer, we analyzed 94 cases of invasive ductal carcinoma of the breast by both flow cytometry (for S-phase and DNA ploidy) and quantitative MIB-1 immunohistochemical analysis using formalin-fixed paraffin-embedded tissue. MIB-1 staining was quantitatively analyzed by image analysis and by visual scoring. Forty-six cases were diploid by flow, while the remaining 48 cases were aneuploid tumors. T-test results indicated that S-phase means were significantly greater (p = 0.0001) in aneuploid cases (mean = 18) compared to diploid cases (mean = 7). MIB-1 means were also greater in aneuploid patients, but these differences were only marginally significant (p = 0.05). S-phase was positively correlated with MIB-1 (r = 0.36, p = 0.003 for image analysis and r = 0.34, p = 0.001 for visual scoring). ROC curve analysis indicated that MIB-1 quantitation is a good predictor of high S-phase (i.e., > 10 percent) in aneuploid cases. A MIB-1 cutoff value of 25 percent for image analysis achieved 82 percent specificity and 80 percent sensitivity for aneuploid high S-phase, while a MIB-1 cutoff value of 40 percent for visual scoring was 73 percent specific and 85 percent sensitive. However, in diploid cases, no comparable MIB-1 cutoffs could be achieved for detecting high S-phase. In summary, our study demonstrated that aneuploid breast carcinomas proliferate more aggressively than diploid tumors. Although linear correlation between MIB-1 and S-phase was weak, MIB-1 was considered to be a good predictor of high S-phase in aneuploid breast cancer patients, possibly due to a threshold effect. Image analysis and visual scoring of MIB-1 immunoreactivity appeared to be comparable in analyzing proliferative activity in breast cancer. Thus MIB-1 assessed by visual scoring may be a less expensive alternative to image analysis.
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PMID:Comparison of proliferation activity in breast carcinoma by flow cytometry analysis of S-phase and quantitative analysis of MIB-1. 984 98

Three hundred sixty-four cases of invasive ductal breast cancer diagnosed during the years 1988 to 1991 were analyzed to determine quantitative thresholds for mitotic activity. Mitotic counts were calculated in each sample and expressed as standardized mitotic index (SMI) and mitotic activity index (MAI). Based on Kaplan-Meier curves, univariate and multivariate analysis of Cox's regression, and maximum efficiencies of ROC analysis, optimal thresholds were determined on the basis of survival and recurrence of disease. In our material, with a follow-up time of 5 years 9 months, we found two thresholds--a lower and a higher--for both SMI (17 mitoses/mm2 and 32 mitoses/mm2) and MAI (13 mitoses/10 HPF and 35 mitoses/10 HPF). The thresholds were the same in the whole material and in subgroups divided according to the patients' age and axillary lymph node status at the time of diagnosis, and tumor size. The thresholds clearly separated patients with favorable, intermediate, and unfavourable outcome of disease. In our material, the risk of breast cancer death associated with the determined thresholds (ranging from 4.7 to 3.8) clearly exceeded those of menopausal status, axillary lymph node status and tumor size. The risk of breast cancer death associated with the determined thresholds was still emphasized in the groups of premenopausal and axillary lymph node-negative patients, and with tumor size less than 2 cm in diameter (risk ratios, 11.8, 6.0, and 6.7, respectively). The results suggest that the presented quantitative thresholds could be applied in grading of invasive ductal breast cancer.
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PMID:Morphometric grading in breast cancer: thresholds for mitotic counts. 1049 50

Since the OC 125 monoclonal antibody (Mab) was generated, other Mabs to the CA 125 glycoprotein have been produced and classified into two families associated with two major epitope regions on the CA 125 molecule. New generation assays, combining Mabs to two distinct regions of the molecule, compare favorably with that of the original assays as demonstrated by ROC curves. The original CA 125 assay suffered from interference of HAMA, an important drawback considering the increasing use of murine antibodies for immunodiagnosis and treatment of ovarian cancer. This problem has been solved for the majority of currently available tests. The sensitivity of the assays for early ovarian cancer remains low, precluding its indiscriminate use for screening and diagnosis of ovarian cancer. Its use in screening for early cancer, combined with ultrasonography, is limited to high risk populations, such as women from families with mutations in the BRCA1 or 2 gene. Although CA 125 assessment may play a limited role in the (early) detection of ovarian cancer, its role in the follow-up during and after therapy is well established. The major contribution of CA 125 is in the monitoring of tumor response to chemotherapy, where it is valuable in detecting those patients with an inadequate response to the chosen treatment. The role of CA 125 in early detection of recurrences remains to be established and is currently the subject of two large clinical trials.
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PMID:CA 125: fundamental and clinical aspects. 1020 33

TPA and CA 15.3 concentrations were routinely determined in serum of patients treated for breast cancer during a 15-month period. ROC curves did not show differences in the ability to differentiate between NED and PD on the basis of matching tumor marker values. During monitoring of patients with NED, TPA levels showed fluctuations of more than 25% that were not disease related. We concluded that CA 15.3 is a more slowly reacting marker of tumor burden than TPA, which is an immediate indicator of cell turnover.
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PMID:TPA and CA 15.3 measurements for breast cancer monitoring in a routine setting. 1036 49


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