Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0677930 (primary tumor)
 20,210 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 45-year-old woman who underwent gastrectomy for gastric carcinoma which had metastasized to the liver and ovaries, showed high serum levels of hCG, AFP and CEA. To locate the source, an immunohistochemical technique was utilized. HCG-producing cells were detected in poorly differentiated adenocarcinoma of a primary tumor and an ovarian metastatic site, and AFP-producing cells in poorly differentiated adenocarcinoma forming a medullary pattern of primary site and metastatic foci. CEA-producing cells were found diffused in primary tumor and metastatic foci. From the viewpoint of oncodevelopmental gene expression (Cancer Res 36:3423, 1976), it is interesting that the serum levels of these three tumor markers (hCG, AFP, CEA) were elevated simultaneously.
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PMID:Ovarian and hepatic metastases of gastric carcinoma associated with high serum levels of human chorionic gonadotropin (hCG), alpha-fetoprotein (AFP), and carcinoembryonic antigen (CEA): a case report. 137 79

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

Twenty-eight patients with poor prognosis, advanced metastatic non seminomatous germ cell tumors (NSGCT) were treated with early high dose chemotherapy and autologous bone marrow transplantation (ABMT) rescue. The primary tumor was testicular in 19 patients and extragonadal in nine patients. For 19 patients with a testicular primary, the median probability of complete remission (CR) was 0.05 according to our prognostic mathematical model based on pretreatment levels of serum HCG and AFP. The same prognostic model was used for extragonadal primaries. Treatment consisted of two cycles of a modified double dose of cisplatin, vinblastine, bleomycin, VP-16 regimen (mPVeBV) followed by a high dose cisplatin-etoposide-cyclophosphamide regimen (PEC) followed by ABMT. Of the 28 patients, 17 (61%) achieved CR, one of which was surgical CR (sCR), five died of rapidly progressive disease early during the first cycle of mPVeBV, two had treatment-related deaths, three did not respond and one patient refused treatment. Of the 17 patients initially in CR, three relapsed after 4, 4 and 7 months respectively and have subsequently died. Two other patients died while still in CR: one committed suicide and one died of an infectious complication due to transfusion-related AIDS. Twelve patients are alive in CR after a median follow-up of 66 months (range 7-72 months). The non parametric 3-year survival rate is 40%. To demonstrate the effect of intensive chemotherapy with ABMT, a randomized multicenter French study was set up to evaluate the PVeBV regimen with or without high dose treatment and ABMT in poor risk NSGCT patients.
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PMID:A phase II trial of early intensive chemotherapy with autologous bone marrow transplantation in the treatment of poor prognosis non seminomatous germ cell tumors. 142 10

Evaluation of the patient with metastasis of unknown origin should be structured to quickly identify treatable tumors or the need for palliation while avoiding prolonged hospital stays and testing that will result in neither improved treatment nor better prognosis. The evaluation should be symptom-directed and pathologically oriented. It is the responsibility of the family physician in caring for a patient with MUO to ensure that communication is facilitated between surgeon, oncologist, pathologist, and patient. The physical examination should include thyroid, breasts, pelvic, and rectal examinations. General lab analyses should include fecal occult blood testing, complete blood count, urinalysis, serum calcium, and liver function studies. Men should have assays for prostate-specific antigen and serum prostatic acid phosphatase. Women should undergo mammography and pelvic ultrasound. Undifferentiated carcinoma is likely to originate from either small cell bronchogenic, lymphoma, or germ cell, and thus, serum should be assayed for HCG and AFP. Further radiologic studies, in the absence of specific symptoms, should be limited to chest radiographs and abdominal CT. Contrast studies should be included only if there is organ dysfunction. Biopsy of the malignant tissue should be done early, and studies should include histochemistry, immunohistology, and electron microscopy. Tissues from female patients should be studied for estrogen and progesterone receptors. When a biopsy is planned, advance communication between the family physician or surgeon and the pathologist greatly increases the chance of identifying a primary site. It is important that the surgeon obtain sufficient material to enable study, not only by standard histologic techniques, but also by electron microscopy, special stains, estrogen receptor activity, hormonal markers, and tumor markers. Treatment of patients for whom a primary tumor remains undiscovered must include toxic therapies only for those with good functional status who are likely to respond. Therapy must be pursued for palliation of symptoms when they develop. As physicians, we must control the urge to do something at those times when doing nothing is more appropriate. We must provide continuous support for both the patient and family, protecting to the best of our ability their quality of life. A physician should never convey the impression that it is "not cost-effective" to look for the source of a patient's malignancy. It can be emphasized that further search for a primary tumor carries both medical risk and expense, yet is unlikely to locate the primary tumor or improve the response to therapy or the quality of life.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Metastasis of unknown origin. 146 85

A 66-year-old woman was hospitalized in a state of shock with rupture of hepatocellular carcinoma and multiple pulmonary metastasis. Her bleeding was successfully controlled by emergency transcatheter arterial embolization with Lipiodol (Lp-TAE). Treatments with UFT, OK-432 and two additional Lp-TAE caused the disappearance of pulmonary metastasis with AFP levels decreased and natural killer cell activity increased. The patient died one and a half years after the emergency Lp-TAE. The disappearance of pulmonary metastatic lesions seemed to be caused by improvement of the patient's immunity, which related to the regression of primary tumor after Lp-TAE. It was suggested that Lp-TAE is worth undertaking even in rupture of hepatocellular carcinoma with remote metastatic lesions.
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PMID:[Rupture of hepatocellular carcinoma with multiple pulmonary metastasis successfully treated by transcatheter arterial embolization (TAE) of tumor: a case report]. 165 29

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

A case of AFP producing gastric carcinoma with liver metastasis that showed marked response to combined chemotherapy with UFT and Adriamycin (ADM) is reported. A 61-year-old man was admitted because of lassitude and abdominal fullness. An upper GI series and computed tomography revealed gastric cancer (Borrmann III) and multiple liver tumors. He had a remarkably high serum AFP level (90,000 ng/ml) and a high CEA level (270 ng/ml). The presence of AFP in the tumor cells of the biopsy specimen was proved immunohistochemically. He was treated with 600 mg of UFT orally every day and ADM (10 mg, iv, on days 1-4, repeated every 14 days), resulting in marked regression (PR, partial response) of both the primary tumor and liver metastasis on the 33 rd day after the start of treatment, with decreasing of serum levels of AFP and CEA. The patient has been asymptomatic without evidence of recurrence for a follow-up period of more than three months with continuing treatment in our outpatient clinic. UFT-ADM therapy appears to be useful for gastric cancer.
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PMID:[Alpha-fetoprotein producing gastric cancer responding to combined chemotherapy with UFT and adriamycin]. 243 Jan 21

Fifty patients with clinical stage II nonseminomatous germ cell tumor of the testis (NSGCTT) were treated with primary chemotherapy followed by a retroperitoneal lymph node dissection (RPLND) in selected patients. The study population included 34 patients with retroperitoneal masses and elevated levels of serum biomarkers (alpha-fetoprotein [AFP] and beta-human chorionic gonadotropin [BHCG] ), five with needle aspiration biopsy-proven retroperitoneal metastases but normal levels of biomarkers, and 11 in whom there were rising levels of serum biomarkers but no radiographic evidence of retroperitoneal metastases. Forty-eight patients (96%) achieved a complete response (CR), with a mean disease-free survival of 132 weeks (range, 55 to 273 weeks). Two patients developed recurrent disease. One died and one achieved a second CR with further therapy (48 + weeks). Postchemotherapy RPLND was required in 11 patients (22%). Patients with embryonal carcinoma had a lower frequency of RPLND (8%) than patients with teratomatous elements in their primary tumor [36%, P = .014]. To reduce the frequency of double therapy (surgery +/- chemotherapy), we propose individualized therapy. Patients presenting with clinical stage II embryonal carcinoma of the testis should receive primary chemotherapy. Patients with clinical stage II NSGCTT and teratomatous elements in their primary tumor continue to require an RPLND. Those patients with intermediate volume disease (greater than 2 cm less than or equal to 5 cm in maximum diameter) may be treated with an RPLND only. Patients with higher volume teratomatous elements (greater than 5 cm less than or equal to 10 cm in maximum diameter) are likely to require the combination of chemotherapy and surgery.
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PMID:Primary chemotherapy for clinical stage II nonseminomatous germ cell tumors of the testis: a follow-up of 50 patients. 243 89

The nuclear DNA content of 77 resected specimens from 65 cases of hepatocellular carcinoma (HCC) was measured by means of flow cytometry. The DNA index (DI) was calculated and the correlation between the DNA ploidy pattern and clinicopathological findings was studied. In the cases of HCC with a diameter of less than 5 cm, the 3-year survival rate of the aneuploid cases was 44.5 per cent, which was significantly lower than the 91.4 per cent of the diploid cases (p less than 0.001). Serum AFP levels were over 1000 ng/ml in 46.4 per cent of the aneuploid tumors and 18.5 per cent of the diploid tumors (p less than 0.05). The DI's were investigated in several sites of the same tumor and no difference was seen among the different sites in 16 out of 17 tumors. From 8 recurrent cases out of 12 who underwent a second resection, seven did not show any significant differences in DI from their primary tumor. On the other hand, four cases of second primary tumors showed different DI's to those of their first primary tumor. Intra-hepatic metastatic tumors exhibited the same DI's as their primary tumors. Thus, the nuclear DNA ploidy pattern may serve as a stable and valuable marker in predicting the malignant potential and prognosis of HCC.
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PMID:Flow cytometric analysis of the nuclear DNA content of hepatocellular carcinoma. 255 44

Over the last few years, many tumor markers have been proposed to clinicians but only a limited number of them meet the necessary criteria to be useful for either screening, diagnosis, prognosis or follow-up of gastrointestinal (GI) tumors. Both CEA and Ca 19-9 have proven to be clinically useful for the detection of recurrent tumors. AFP remains the most useful marker for the follow-up of hepatocellular carcinoma (HCC). Its interest for the early detection of primary tumor is debated. Recent data suggest that assays based on monoclonal antibodies to AFP could be used for detection HCC in high risk populations. Decarboxy-prothrombin assay may be a complement to the AFP test in this localization. In addition to GI hormones, serotonin and urinary 5HIAA, Neuron Specific Enolase appears to be a valuable marker for the follow-up of neuroendocrine tumors of the GI tract. Only a few of the new tumor-associated antigens detected by monoclonal antibodies, appear to be promising clinical ly e.g. Ca50 TAG-72, PAO. Monoclonal antibodies to tumor-associated markers have also been used with other techniques: Immunohistochemistry: this technique is useful to the pathologist for the diagnosis of undifferentiated tumors by demonstrating the presence of specific antigens on tissue samples. Immunoscintigraphy: it can be useful for the detection of either metastases of recurrences of colorectal cancer by using anti-ACE antibodies labeled with Iodine 131 iodine 123 or indium 111. However immunoscintigraphy is less sensitive than both ultrasonography and CT scan for localizing hepatic metastases. At the present time the best indication of this method remains the diagnosis of pelvic recurrences.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The value of tumor markers in digestive oncology]. 269 5


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