Tumor markers in advanced nonseminomatous testicular cancer

The serum levels of human chorionic gonadotropin (HCG), alphafetoprotein (AFP), lactic dehydrogenase (LDH), and carcinoembryonic antigen (CEA) were measured in 62 men with advanced nonseminomatous germ-cell testicular tumors. The HCG level was elevated in 64%, the AFP level in 67%, and the LDH level in 62%, including three of the six men with normal levels of the other two markers. At least one of these three markers was elevated in 91% of patients. Sustained or rising levels of HCG or AFP always were accompanied by persistent or recurrent tumor. Carcinoembryonic antigen was found not to be a useful marker in testicular cancer. Patients whose tumors contained yolk-sac elements always had elevated AFP levels, and patients with choriocarcinoma always had elevated levels of HCG. However, absence of these histologic types did not preclude elevations of the respective markers. Tumor markers are indispensable in the management of patients with testicular cancer, and several markers must be measured repeatedly if the greatest percentage of patients is to benefit.     

Tumor markers of bladder cancer: the schistosomal bladder tumors versus non-schistosomal bladder tumors

Recent data have redefined the concept of inflammation as a critical component of tumor progression. However, there has been little development on cases where inflammation on or near a wound and a tumor exist simultaneously. Therefore, this pilot study aims to observe the impact of a wound on a tumor, to build a new mouse tumor model with a manufactured surgical wound representing acute inflammation, and to evaluate the relationship between acute inflammation or wound healing and the process of tumor growth. We focus on the two phases that are present when acute inflammation influences tumor. In the early phase, inhibitory effects are present. The process that produces these effects is the functional reaction of IFN-γ secretions from a wound inflammation. In the latter phase, the inhibited tumor is made resistant to IFN-γ through the release of TGF-β to balance the inflammatory factor effect on the tumor cells. A pair of cytokines IFN-γ/TGF-β established a new balance to protect the tumor from the interference effect of the inflammation. The tumor was made resistant to IFN-γ through the release of TGF-β to balance the inflammatory effect on the tumor cells. This balance mechanism that occurred in the tumor cells increased proliferation and invasion. In vitro and in vivo experiments have confirmed a new view of clinical surgery that will provide more detailed information on the evaluation of tumors after surgery. This study also provides a better understanding of the relationship between tumor and inflammation, as well as tumor cell attacks on inflammatory factors.     

Tumor markers

A review of presentations at the Second International Conference of the Egyptian Society of Tumor Markers Oncology (ESTMO) and the First International Conference of the Mediterranean Society of Tumor Markers Oncology (MESTMO), Cairo, Egypt, January 1990.     

Tumor markers

Recently discovered new tumor markers were introduced, clinical data of tumor markers were also summarized using figures and tables. Monoclonal antibody technique and establishment of human cancer cultured cell line were very useful for discovery of new tumor markers.     

Tumor markers at the time of recurrence in patients with germ cell tumors

BACKGROUND: alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG), and lactate dehydrogenase (LDH) closely follow the course of germ cell tumors (GCTs) and are widely used for diagnosis, prognosis, and follow-up purposes. The objective of this study was to assess the concordance of tumor markers at the time of diagnosis and recurrence. METHODS: The authors reviewed the records of 794 patients with GCTs treated in three Spanish hospitals from 1977-1996 and analyzed the concordance between AFP, HCG, and LDH levels at diagnosis and first and second recurrence. A positive marker was defined as a level of AFP > 10 ng/mL, HCG > 5 IU/L, or LDH > the upper limit of normal. One hundred twenty-five patients were identified who developed a first recurrence (123 had marker levels recorded). The median age was 27 years (range, 14-78 years). Histology was seminoma in 36 patients (29%) and nonseminomatous GCT (NSGCT) in 87 patients (71%). RESULTS: Seventy-nine patients (64%) had elevated tumor markers at diagnosis and 76 (62%) at first recurrence. An elevated marker was present at first recurrence in 58 of 79 patients (73%) with initially positive markers and in 18 of 44 patients (41%) with initially negative markers. In 84 of 123 patients (68%), the same marker pattern (positive or negative) was present at the time of diagnosis and at first recurrence, 78% in seminomas and 64% in NSGCTs. The earliest indicator of recurrence was an elevated marker in patients with NSGCTs and a radiologic finding in patients with seminomas. Thirty patients developed a second recurrence, 27 of whom (90%) had the same marker pattern as at first recurrence. CONCLUSIONS: Tumor marker pattern at diagnosis is not a good predictor of the pattern at recurrence, particularly in patients with NSGCTs. Marker assessment should be included in the follow-up schedule regardless of levels at the time of diagnosis. Early detection of recurrence should not rely only on marker levels, even in patients with elevated levels at presentation.     

Serum markers in testicular germ-cell neoplasms

At the present time, serum determinations of alpha fetoprotein and beta-HCG are the most useful markers in the management of germ-cell testis tumors. Serial determinations are vital to the monitoring of the response of the patient's tumor to therapy. Subsequent elevation of tumor markers is often the first evidence of recurrence of tumor and allows effective treatment to be instigated while the volume of recurrent tumor is extremely low. This markedly increases the likelihood of achieving complete remissions.     

Progress in therapy for testicular tumors

Approximately 80% of patients with metastatic testicular tumors are cured by cisplatin-containing chemotherapy and surgery. However, the remaining 20% of patients with advanced testicular tumors can not be cured at present. Thus, therapy for these testicular tumors infractory to treatment is the most important issue. Recently, chemotherapy for such tumors is developing, especially salvage chemotherapy using novel anticancer agents(paclitaxel, gemcitabine,irinotecan, docetaxel, oxaliplatin, etc) and high-dose anticancer drugs. Some of the new modalities are very attractive. In this article, we reviewed mainly these new forms of chemotherapy for testicular tumors.     

Tumor markers in gastric cancer

There are two markers, pepsinogen isoenzymes and antibody against Helicobactor pyroli, for screening of high-risk group for gastric cancer. Most of markers are used in diagnosis, staging, monitoring and differentiating subgroups of gastric cancer. Markers in ascitic fluid are used for diagnosing peritoneal invasion of gastric cancer.     

Tumor markers in uterine cancers

In diagnosing uterine cancers, cells and tissue samples can be directly obtained from the lesion. Cytologic and histologic investigation is the best method for screening and early detection of primary uterine cancers. Tumor markers may be useful for monitoring the clinical course of therapy and early detection of recurrence for which cytologic examination can not be done. Moreover, high levels of tumor markers may represent tumor invasiveness and metastasis to lymph nodes and/or other organs, and may indicate a poor prognosis for the patient. Strictly speaking, tumor markers are not tumor-specific but tumor-associated substances. They can be elevated in sera from healthy individuals under various conditions, and from patients with benign tumors. Squamous cell carcinoma-associated antigen (SCC) is relatively tumor-specific, and widely used for monitoring patients with squamous cell carcinoma not only of the uterine cervix. On the other hand, there is no specific tumor marker for uterine corpus carcinoma. Combination assay of several tumor markers including cancer antigen 125 (CA125) as a core marker may be of greater diagnostic value in cases of uterine corpus carcinoma.     

Tumor markers in breast cancer

A number of breast cancer-orientated tumor markers have been utilized for various purposes in clinical practice in Japan. Their purposes are as follows: early detection of primary tumors, prediction of disease extent and prognosis, early detection of recurrent diseases, evaluation of therapeutic responses, monitoring patient outcome, and differential diagnosis of metastatic tumors of unknown origin. The clinical significance of the measurement of tumor markers for these purposes is overviewed in this article. In addition, the results are summarized for two clinical studies conducted by the Tumor Marker Study Group of Japanese Breast Cancer Society (Chairperson: Dr. Kurebayashi), a questionnaire survey on the current status of tumor markers in breast cancer in Japan and a multi-institutional study on the utility of tumor markers for evaluation of therapeutic responses. Future directions of clinical and experimental research for breast cancer-orientated tumor markers are also discussed.     

Tumor markers in breast cancer

Many serological markers have been utilized to indicate the status, risk, or presence of breast cancer. In May 1996, the American Society of Clinical Oncology (ASCO) convened a Tumor Marker Panel and determined clinical practice guidelines for the use of tumor markers in breast cancer. Eight markers containing carcinoembryonic antigen (CEA) and CA15-3 were evaluated and assigned by expert reviewers to be valuable markers of breast cancer. CA15-3 recognizes a mucin-like glycoprotein, MUC-1, which is frequently expressed in breast cancer tissues. BCA225, which may recognize antigens similar to MUC-1 glycoprotein, are sensitive and specific markers for breast cancer. However, it is not recommended to measure the 2 markers in combination. The measurement of carboxy-terminal telopeptide of type I collagen (I CTP) is worthwhile as a serological diagnostic method of bone metastasis from breast cancer. Other markers such as erbB-2, CYFRA 21-1 and PTHrP are candidates for clinical utilization as tumor markers in breast cancer.     

Tumor markers in malignant lymphoma

For malignant lymphoma, there is no highly sensitive or specific tumor marker for diagnosis. However, some tumor markers such as cell surface marker or karyotypic analysis are useful for diagnosis combined with other clinical and pathological information. International Prognostic Index (IPI), Follicular Lymphoma International Prognostic Index (FLIPI), and International Prognostic Score (IPS) are useful to predict prognosis, and utilized to decide therapeutic strategy of aggressive non-Hodgkin's lymphoma (NHL), follicular lymphoma and Hodgkin's lymphoma, respectively. Non-specific biological markers such as soluble interleukin-2 receptor (sIL-2 R) are utilized to evaluate therapeutic effect. In this paper, we describe about the significance of these tumor markers in malignant lymphoma.