A comparison of the predictive value and diagnostic efficiency of FHAP and CEA as cancer markers

Previous studies have shown that fast homoarginine-sensitive alkaline phosphatase (FHAP) is roughly equivalent to CEA (Roche) as a marker in colon cancer. The present study compares FHAP with CEA-EIA (Abbott) as a marker in cancer of the colon, breast, lung, ovary, uterus, skin, and lymph nodes. Comparison is made with regard to sensitivity, specificity, predictive value of a positive test, and diagnostic efficiency. It was determined that FHAP and CEA-EIA were comparable as markers for cancers of the colon, breast, and lung. FHAP was more sensitive and specific and had a higher predictive value and diagnostic efficiency for cancers of the ovary, uterus, skin, and lymph nodes.     

Evaluation of serum CA 125 as a tumor marker in non-small cell lung cancer.

Serum CA 125 levels were evaluated in 130 healthy subjects and 133 patients with untreated pulmonary lesions. These were 33 patients with benign pulmonary conditions and 100 with lung cancer. The mean concentration of CA 125 was higher in patients with lung cancer (37 +/- 81 U/ml) than in those with nonmalignant disease (4.2 +/- 5.7 U/ml) (P less than 0.01). In the healthy control group CA 125 concentrations were significantly lower (0.63 +/- 1.5 U/ml) (P less than 0.001). In patients with lung cancer the concentration of this tumor marker was related to the tumor-node-metastasis (TNM) stage. At a cut-off value of 15 U/ml, CA 125 had a sensitivity of 44%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 65% with respect to healthy subjects; in patients with benign pulmonary conditions, these values were 44%, 94%, 94%, and 31%, respectively. At this cut-off value, a correlation between the respectability prognosis and the likelihood of survival 24 months posttreatment was observed. These findings suggest that CA 125 can be used as an adjunctive test in the management of patients with lung cancer patients.     

Semen quality and reproductive hormones before orchiectomy in men with testicular cancer.

PURPOSE: To obtain information about preorchiectomy gonadal function in patients with testicular germ cell cancer to improve the clinical management of fertility and other andrologic aspects in these men. PATIENTS AND METHODS: In group 1, a group of 83 consecutive patients with testicular germ cell cancer (TGCC) investigated before orchiectomy, semen analysis was carried out in 63 patients and hormonal investigations, including measurement of follicle-stimulating hormone, luteinizing hormone (LH), testosterone, estradiol, sex hormone-binding globulin (SHBG), inhibin B, and human chorionic gonadotropin (hCG), in 71 patients. Hormone levels in patients with elevated hCG (n = 41) were analyzed separately. To discriminate between general cancer effects and specific effects associated with TGCC, the same analyses were carried out in a group of 45 consecutive male patients with malignant lymphoma (group 2). Group 3 comprised 141 men employed in a Danish company who served as controls in the comparison of semen parameters. As a control group in hormone investigations, 193 men were selected randomly from the Danish National Personal Register to make up group 4. RESULTS: We found significantly lower sperm concentration (median, 15 x 10(6)/mL; range, 0 to 128 x 10(6)/mL) and total sperm count (median, 29 x 10(6)/mL; range, 0 to 589 x 10(6)) in patients with testicular cancer than in patients with malignant lymphomas (sperm concentration: median, 48 x 10(6)/mL; range, 0.04 to 250 x 10(6)/mL; sperm count: median, 146 x 10(6); range, 0.05 to 418 x 10(6)) (P < .001 and P < .001) and healthy men (sperm concentration: median, 48 x 10(6)/mL; range, 0 to 402 x 10(6)/mL; sperm count: median, 162 x 10(6); range, 0 to 1253 x 10(6)) (P < .001 and P < .001). FSH levels were increased in men with testicular cancer (median, 5.7 IU/L; range, 2.0 to 27 IU/L) compared with both men with malignant lymphomas (median, 3.3 IU/L; range, 1.01 to 12.0 IU/L) and healthy controls (median, 4.1 IU/L; range, 1.04 to 21 IU/L)(P = .001 and P = .007, respectively). Surprisingly, we found significantly lower LH in the group of men with TGCC (median, 3.6 IU/L; range, 1.12 to 11.9 IU/L) than in healthy men (median, 4.7 IU/L; range, 1.3 to 11.9 IU/L) (P = .01). We could not detect any differences between men with testicular cancer and men with malignant lymphomas and healthy men with regard to serum levels of testosterone, SHBG, and estradiol. Men with testicular cancer who had increased hCG levels had significantly lower LH and significantly higher testosterone and estradiol than those without detectable hCG levels. CONCLUSION: Spermatogenesis is already impaired in men with testicular cancer before orchiectomy. Neither local suppression of spermatogenesis by tumor pressure nor a general cancer effect seems to fully explain this impairment. The most likely explanation is preexisting impairment of spermatogenesis in the contralateral testis in men with testicular cancer. The question of whether also a pre-existing Leydig cell dysfunction is present in men with testicular cancer could not be answered in this study because the tumor seems to have a direct effect on the Leydig cells. Men with testicular cancer had low LH values as compared with controls. We speculate that increased intratesticular level of hCG also in men without measurable serum hCG may play a role by exerting LH-like effects on the Leydig cells, causing increased testosterone and estrogen levels and low LH values in the blood.     

Quantitative analysis of plasma circulating DNA at diagnosis and during follow-up of breast cancer patients

The aim of the present project was to quantify the level of plasma DNA in patients with malignant or non-malignant breast diseases and in healthy controls, then investigate whether such measurements have diagnostic or prognostic value. Plasma DNA from 121 women (61 patients with breast cancer, 33 control patients with benign breast diseases and 27 healthy control individuals) was quantified by a real-time quantitative polymerase chain reaction (PCR) method. Plasma DNA concentration in the breast cancer patients (median 65 ng/ml) was significantly higher (P<0.05) than that in the control patients (median 22 ng/ml) or healthy control (median 13 ng/ml). No association was observed between plasma DNA levels and clinicopathological parameters. The data suggest that quantification of plasma circulating DNA may be a valuable complementary diagnostic tool in discriminate breast cancer from unaffected individuals and may be proposed as an early detection test as well as a new, noninvasive assay to follow-up patients.     

Plasma levels of heat shock protein 70 in patients with prostate cancer: a potential biomarker for prostate cancer

Heat shock protein 70 (Hsp70) is a stress-inducible protein that is also known for its inhibitory effects on apoptosis. Increased Hsp70 expression is reported in a variety of tumor tissues. Heat shock protein 70 is detectable in plasma and could potentially be used as a biomarker for diagnosis or disease stratification. The relationship between plasma levels of Hsp70 and prostate cancer status has not been well studied. Our study was designed to test this relationship. One hundred twenty-five patients with localized/untreated or hormone-refractory prostate cancer were identified. Forty-five healthy male blood donors between 50 and 73 years of age served as controls. EDTA plasma was subjected to quantitative sandwich immunoassays for both Hsp70 and prostate-specific antigen (PSA). Wilcoxon rank-sum tests were used to examine differences by category. Maximally selected c2 statistics were used to identify cutoff points to best distinguish between categories. Plasma Hsp70 levels in the patients with localized untreated disease (n = 68; median, 0.8 ng/mL; interquartile range, 0.5-2.0) were significantly higher than those in the control group (n = 45; median, 0.5 ng/mL; interquartile range, 0.3-0.8; P = 0.0037). Although the primary cutoff point (1.15 ng/mL) significantly distinguished the localized untreated patients from the control group, plasma Hsp70 levels did not prove more effective than PSA as a predictor for diagnosis or stratification of patients with prostate cancer in the context of group comparisons. Nonetheless, several patients in the localized untreated group showed higher plasma levels of Hsp70 than the primary cutoff point even though their PSA levels were within normal range (< 4 ng/mL). Heat shock protein 70 is a marker of prostate cancer, although its clinical utility is uncertain. It is possible that when used in conjunction with PSA it might prove useful in identifying patients with early-stage prostate cancer who might otherwise be missed by PSA screening alone.     

Evaluation of the soluble fragments of cytokeratin 19 (CK19) in non-small cell lung cancer (NSCLC)

This study compared the diagnostic efficacy of serum CK19 determination (Cyfra 21-1) with other tumour markers, such as CEA, SCC, NSE, TPA, in patients with resected non-small lung cancer. Tumour marker levels were tested in 90 patients with benign lung disease and at diagnosis in 72 patients with proven NSCLC, 39 squamous cell carcinoma and 33 adenocarcinoma. At presentation baseline levels of all tumor markers were significantly higher (p<0.05) in lung cancer patients than in control subjects, except for NSE. A significant increase (p<0.05) in serum concentrations was observed from stage I to stage IIIb only for Cyfra 21-1 (stage I/II, median=2.7 ng/ml; stage IIIb, median=6.3 ng/ml) and TPA (stage I/II, median=89.8 IU/ml; stage IIIb, median=170.7 IU/ml). Receiver operating characteristic (ROC) analysis was performed to evaluate the best threshold values and the global accuracy of each marker. The highest global sensitivity for NSCLC was reached by TPA (70.8%), whereas that of Cyfra 21-1 was 50%. According to tumour histology, significant difference (p<0.05) in serum levels were found only for CEA (adenocarcinomas, median=5.6 ng/ml; squamous cell carcinoma, median=3.2 ng/ml) and SCC (adenocarcinomas, median=1.0 ng/ml; squamous cell carcinoma, median=1.5 ng/ml). As regards squamous cell carcinoma histotype, the highest sensitivity was obtained by TPA (74.4% at a specificity of 62.2%) and for adenocarcinomas by CEA (78.8% at a specificity of 85.6%). Tumour marker levels were also determined during the follow-up of 10 patients. The best sensitivity in detecting relapses was shown by CEA (90%), followed by TPA (70%), SCC (50%), Cyfra 21-1 (40%) and NSE (10%), even though the CEA test displayed a high percentage of false positive results (98.1%) in patients with no evidence of disease (NED).     

血浆EBV DNA定量分析在监测鼻咽癌患者复发和转移中的价值

目的 探讨血浆EB病毒DNA(EBV DNA)含量在监测鼻咽癌患者放疗后复发和转移中的临床价值.方法 采用荧光定量PCR方法 检测81例放疗后随诊的鼻咽癌患者血浆EBV DNA含量,比较缓解组与复发、转移组血浆EBV DNA差异.结果 放疗后缓解组患者血浆EBV DNA阳性率为15.7%,中位拷贝数为0 copy/ml;放疗后复发或转移组患者血浆EBV DNA阳性率93.3%,中位拷贝数6 432 copies/ml,差异均有显著性(P<0.001).结论 血浆EBV DNA定量检测有可能成为监测鼻咽癌患者放疗后复发、转移的肿瘤标记物.     

Circulating soluble Fas concentration in breast cancer patients.

Fas/Fas ligand (FasL) system, a major regulator of apoptosis, is involved in cancer cell death induced by the immune system and anticancer drugs. Fas is a cell-surface receptor that exists in two forms, transmembrane and soluble. The former induces apoptosis by ligation of FasL or agonistic anti-Fas antibody, whereas the latter inhibits Fas-mediated apoptosis by neutralizing its ligand. In this study, we examined circulating soluble Fas (sFas) concentration in 118 healthy people, 162 primary and 71 recurrent breast cancer patients by ELISA. In the healthy group, men showed higher sFas concentrations than women (P<0.001). In both sexes, sFas levels increased with age, and the age-matched cutoff value was determined. The median sFas concentration in primary and recurrent cancer patients was 0.815 and 1.510 ng/ml, both of which were higher than in normal female controls (0.580 ng/ml; P = 0.024 and P<0.001, respectively). Among primary cancer patients, although no significant correlation was found between sFas concentration and clinical parameters other than menopausal status, high-sFas patients had a worse prognosis than low-sFas patients for both overall and disease-free survival (P = 0.013 and P = 0.032, respectively). The multivariate analysis confirmed that circulating sFas concentration was an independent prognostic indicator (P = 0.020 for overall survival, P = 0.025 for disease-free survival). We looked at the recurrent cancer patients, and sFas levels were higher in patients with liver metastasis compared with those with other recurrent sites (P = 0.010), and high-sFas patients showed a worse prognosis than low-sFas patients (P = 0.037). Our data demonstrate that, compared with healthy female controls, breast cancer patients, especially those with liver metastases, have higher circulating sFas levels. sFas may be useful once these results are confirmed by larger studies.     

Detection of a new embryonic antigen (ESA-10) in the blood of patients with cancer: preliminary results in the United States

ESA-10 is an embryonic antigen expressed by tumor cells. A method to detect the antigen in the blood based on alterations in the erythrocyte sedimentation rate that occur when antiserum to ESA-10 is bound to the antigen in blood was devised and used here to determine the sensitivity and predictive value of the test in patients with biopsy proven non-hematologic malignancies, and in normal control subjects. The test was positive in 22 of 24 cancer patients tested, and negative in 30 of 35 control subjects. Of the five positive control subjects, one female had recently given birth and was lactating. Another control subject was recently diagnosed with prostate cancer, just months after having participated in this study. Therefore, this tumor marker test (Turtest^®) had a sensitivity of 91.7% and a positive predictive value of 81.5% in patients with biopsy proven cancer, and a specificity and negative predictive value in control subjects of 88.2 and 93.8%, respectively, if the control subject who subsequently developed prostate cancer is removed from the control group. Therefore, this simple test has potential as a clinically useful tumor marker with sensitivity and specificity equal to or greater than other commercially available tumor markers and should be explored further in larger studies.     

A new tumor marker MCA in breast cancer diagnosis

The serum concentration of the new tumor marker MCA (mucinous carcinoma associated antigen) was determined by an enzyme immunoassay kit method, which is based on the use of a monoclonal antibody b12. The mean MCA values in breast cancer patients (n = 40) were significantly higher than in patients with benign breast disease (n = 55, p less than 0.001) and in control subjects (n = 37, p less than 0.001). When we used the cut-off level 11 KU/l for MCA, 6/37 (16.2%) of control subjects 7/55 (12.7%) of patients with benign breast disease, 18/40 (45.0%) of all breast cancer patients 11/19 (57.9%) of breast cancer patients with axillary node involvement, and 1/1 breast cancer patient with distant metastases were above this cut-off level. For comparison, at the cut-off level of 5 micrograms/l the CEA test was positive in 7/40 (18%) cancer cases, and in 6/19 (32%) of cancer patients with nodal involvement. Patients with axillary nodal metastasis showed higher values than patients without metastasis in both tests (p less than 0.01). The combination of MCA at 11 KU/l cut-off level and CEA at the 5.0 micrograms/l cut-off level reached the diagnostic sensitivity of 0.53, efficiency of 0.73, and specificity of 0.87. It seems that MCA is a promising tumor marker in breast cancer. Especially high values may have diagnostic significance.     

Urinary human chorionic gonadotropin free beta-subunit and beta-core fragment: a new marker of gynecological cancers

Many investigators have shown that a small proportion (13-36%) of subjects with nontrophoblastic gynecological cancers have elevated serum levels of human chorionic gonadotropin (hCG). The low proportion with detectable levels and the accompanying low titers have limited the use of hCG as a tumor marker. hCG is a glycoprotein composed of two noncovalently linked subunits (alpha and beta), which are the products of separate genes. With the intent of expanding the use of hCG as a tumor marker we investigated levels of hCG free beta-subunit and asialo free beta-subunit and its core glycopeptide (composed of beta-subunit residues 6-40 disulfide-linked to 55-92), collectively called urinary gonadotropin fragments (UGF), in healthy and cancer patients. An immunoradiometric assay was developed, using the core glycopeptide-directed antibody B204, that similarly measures the hCG free beta-subunit and the asialo free beta-subunit and its core glycopeptide. Parallel urine and serum samples were collected from 87 women with active gynecological cancer and hCG and UGF were measured. Just 18% of the women tested had detectable serum levels of hCG (greater than 0.2 ng/ml); none had elevated serum levels in the UGF assay (greater than 0.2 ng/ml). Of the same group, 32% had detectable urine hCG levels (mean titer, 0.50 ng/ml) and 74% exhibited elevated urinary levels in the UGF assay (mean titer, 2.0 ng/ml). In a control group (urines from 50 nonpregnant healthy women), 47 negative and three borderline positive results (0.30, 0.35, and 0.48 ng/ml) were observed in the UGF assay. These results suggested a sensitivity of 74% and specificity of 92% for the UGF test for gynecological cancers. By disease, 70% of those with cervical, 73% of those with ovarian, and 77% of those with endometrial cancers had detectable UGF levels (greater than 0.2 ng/ml). By stage, 50, 62, 75, 86, and 100% of those with stage 1, 2, 3, 4, or recurrent disease, respectively, had positive results. UGF is a promising new marker of gynecological malignancies.     

乙肝病毒表面抗原浓度与恶性肿瘤患者肝功能损伤的相关性

目的:探讨乙肝病毒表面抗原(HBsAg)浓度与α-L-岩藻糖苷酶(AFU)、甲胎蛋白(AFP)、丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、γ-谷氨酰基转移酶(γ-GGT)、碱性磷酸酶(ALP)及乳酸脱氢酶(LDH)在恶性肿瘤中的相关性。方法:收集2019年06月01日到2020年05月31日期间我院81例HBsAg阳性住院肿瘤患者及同期81名健康体检者肝功能检测指标。应用SPSS 20.0统计学软件分析HBsAg阳性在恶性肿瘤中的意义。结果:HBsAg阳性组与对照组AFU、AFP、ALT、AST、γ-GGT、ALP及LDH比较差异有统计学意义(P＜0.05)。HBsAg浓度在性别、肿瘤类型中差异无统计学意义(P＞0.05),在年龄和分期中存在统计学差异(P＜0.05)。根据HBsAg浓度将肿瘤组分为0.03~25.00 IU/mL、25.01~250.00 IU/mL、250.01~2 500.00 IU/mL及>2 500.00 IU/mL四组,0.03~25.00 IU/mL组AFP、AST与HBsAg呈正相关(r=0.654,0.501,P＜0.05),>2 500.00 IU/mL组AFU、AFP、AST与HBsAg呈正相关(r=0.527,0.524,0.476,P＜0.05),25.01~250.00 IU/mL、250.01~2 500.00 IU/mL组各项与HBsAg浓度之间无相关性(P＞0.05);各组AFP阳性率随HBsAg浓度升高无升高趋势(P＞0.05),而AFU阳性率随HBsAg浓度升高呈升高趋势(P＜0.05)。HBsAg、HBeAg和HBcAb三项阳性组与AFU呈正相关(r=0.516,P＜0.05),HBsAg和HBcAb两项阳性组与ALP呈正相关(r=0.567,P＜0.05)。结论:HBsAg阳性在肿瘤患者肝功能损伤及疾病的严重程度或进展评估方面有一定的临床参考价值。     

Study on carbohydrate antigen NCC-ST-439 in breast cancer

We evaluated the clinical significance of serum NCC-ST-439 (ST439) in sera from 20 healthy women, 8 patients with benign breast disease and 105 patients with breast cancer (79 primary, 26 recurrent) by using enzyme immuno-assay (EIA). No false positive case was noted in the measuring of ST439 for healthy women and patients with benign breast disease. The positive rates of ST439 were 23% (18/79) in primary breast cancers and 50% (13/26) in recurrent breast cancers. The serum levels of ST439 in stage I breast cancer was significantly higher (p less than 0.05) than those in healthy women, but there was no significant difference among each stage. The serum levels of ST439 were not significantly different among the subsets such as T, n, m and histological types. The high levels of serum ST439 were observed in two cases with mucinous carcinoma. Although there were no relation between ST439 and receptor status, the higher serum levels of ST439 were observed in postmenopausal patients than premenopausal ones. The positive frequency of serum ST439 in stage I and II breast cancers was higher than that of CEA, TPA or CA15-3, while the positive rate in recurrent breast cancer was the lowest among 4 tumor markers. These results suggest that ST439 is a useful tumor marker for not only detecting the recurrence of breast cancer but also diagnosing primary breast cancer in early stage.     

Plasma erythropoietin concentrations in polycythaemia vera with special reference to myelosuppressive therapy

In 80 patients with polycythaemia vera (PV) a total of 108 venous blood samples were obtained and analysed for EDTA-plasma erythropoietin (EPO) concentration. At the time of study 21 of the PV patients were newly diagnosed and had prior to blood sampling neither received phlebotomy treatment nor therapy with myelosuppressive agents; these subjects had a mean plasma EPO concentration of 0.5+/-0.9 IU/L. Thirty-seven patients treated with phlebotomy only had a mean plasma EPO concentration of 2.5+/-2.9 IU/L. The mean plasma EPO concentrations for 26 patients treated with hydroxyurea, 13 patients treated with radiophosphorous and 11 patients given a combination of myelosuppressive agents were 8.9+/-8.0, 10.9+/-12.6 and 7.2+/-7.4 IU/L, respectively. Untreated patients and patients on phlebotomy only had significantly lower values for plasma EPO than patients on therapy with myelosuppressive drugs. This finding persisted also after a correction for differences in haemoglobin levels had been introduced. Thereby, the present results would suggest a difference in the EPO feedback system in untreated and phlebotomised PV patients compared to PV patients treated with myelosuppressive agents.     

The serum concentration of human kallikrein 10 represents a novel biomarker for ovarian cancer diagnosis and prognosis

Human kallikrein 10 (hK10) is a secreted serine protease that is highly expressed in ovarian tissue. We hypothesized that hK10 might represent a novel serological marker for ovarian cancer. We quantified by immunoassay, hK10 in sera from 97 normal women (controls), 141 patients with benign gynecologic diseases, and 146 patients with ovarian cancer. We then examined the diagnostic and prognostic value of this measurement in ovarian cancer. We found that normal serum hK10 ranged from 50 to 1040 ng/liter (mean = 439 ng/liter). hK10 concentration is significantly elevated in serum of presurgical ovarian cancer patients (range: 106-11,746 ng/liter; mean = 1067 ng/liter) but not in serum of patients with benign gynecologic diseases (range: 120-1200 ng/liter; mean = 447 ng/liter). When a cutoff of 700 ng/liter was selected (diagnostic specificity = 90%), the diagnostic sensitivity for ovarian cancer is 54%. About 35% of CA125-negative ovarian cancer patients (CA125 < 23 kU/liter) were hK10 positive at 90% specificity. In patients with stage I/II ovarian cancer, use of these two markers in combination results in a 21% increase in sensitivity, at 90% specificity, compared with CA125 alone. High serum hK10 was strongly associated with serous epithelial type, late-stage, advanced grade, large residual tumor (>1 cm), suboptimal debulking, and no response to chemotherapy (all Ps < 0.001). In univariate Cox survival analysis, high serum hK10 is associated with increased risk for relapse and death (hazard ratio = 2.59 and 3.15, respectively, P 相似文献   

In vitro and in vivo effects of a monoclonal antibody-toxin conjugate for use in autologous bone marrow transplantation for patients with breast cancer

We have devised a method utilizing a monoclonal antibody-toxin conjugate (LICR-LON-Fib75/abrin A-chain) for ridding bone marrow of infiltrating breast cancer cells to rescue patients with autologous bone marrow following high dose therapy. Initially we examined the activity of this conjugate in vitro. Five of seven human breast cancer cell lines were killed following exposure at 10(-8) M for 2 h; this concentration only reduced bone marrow colony formation to 83% (range, 50-100%) of control bone marrow. We then examined the pattern of bone marrow recovery after high dose melphalan (200 mg/m2) in patients with advanced breast cancer who were in remission following combination chemotherapy. To do this we compared the time of recovery of the blood count in three patients who received treated marrow and seven who received untreated marrow. Mean time to recovery of the peripheral white count (greater than 1.5 X 10(9)/liter) was 16.7 days (treated) and 18.3 days (untreated), respectively. Mean time to recovery of peripheral platelet count (greater than 50 X 10(9)/liter) was 23.7 days (treated) and 18.9 days (untreated), respectively. Patients continued in remission for 1-greater than 14 mo after high dose melphalan, and remission duration was similar in patients who received treated (6.2 mo) and untreated (7.3 mo) bone marrow. These findings indicate that treatment of bone marrow with LICR-LON-Fib75/abrin A-chain conjugate does not significantly impair bone marrow recovery, and it is, therefore, possible to rescue breast cancer patients with bone marrow that has been cleansed of infiltrating cancer cells. This may have an application in patients with poor-risk primary breast cancer who have micrometastases and who may benefit from intensive therapy, but it has minimal application in patients with more advanced disease.     

Increase in the circulating level of hepatocyte growth factor in gastric cancer patients.

We measured serum concentrations of hapatocyte growth factor (HGF) in patients with gastric cancer and compared these with the histological findings and conventional tumour markers, including CEA, CA19-9 and CA125, for evaluation of the significance of serum HGF levels as a tumour marker. The HGF levels were measured by an enzyme-linked immunosorbent assay (ELISA) system. The average levels of serum HGF in 89 healthy control subjects, 104 patients with primary gastric cancer and 15 patients with recurrent gastric cancer were 0.31 +/- 0.11 ng ml(1), 0.42 +/- 0.50 ng ml(-1) and 0.92 +/- 0.39 ng ml(-1) respectively. The average level in patients with recurrent disease was significantly higher than in healthy control subjects and in primary cancer patients (P< 0.001 and P< 0.003 respectively). Of 104 patients with primary gastric cancer, 35 (33.7%) showed an aberrant increase in the circulating level of HGF. The increased HGF levels were significantly associated with the degrees of histological tumour invasion and venous invasion. Of 15 patients with recurrent gastric cancer, 14 (93.3%) showed an aberrant increase. No correlation was found between serum HGF levels and CEA levels, CA19-9 levels and CA125 levels. However, the rate of the aberrant increase in HGF levels was significantly higher than that of any other tumour markers, including CEA, CA19-9 and CA125, in primary gastric cancer patients. In conclusion, the circulating levels of HGF were elevated in approximately one-third of patients with primary gastric cancer, particularly in those with high grades of histological tumour invasion and venous invasion, and frequently in patients with distant metastases, suggesting that HGF might play important roles in the tumour progression of gastric cancer. Furthermore, serum HGF levels may be of value as a tumour marker in patients with gastric cancer.     

晚期宫颈癌并发双侧输尿管梗阻40例治疗预后分析

  目的   分析晚期宫颈癌并发双侧输尿管梗阻的预后因素, 探讨其治疗意义。   方法   通过肾图、CT、肾功能检查诊断晚期宫颈癌并发双侧输尿管梗阻患者40例, 膀胱镜下输尿管逆行置管内引流13例, 经皮肾穿刺输尿管顺行置管内引流25例、外引流2例, 肾功能恢复正常后行放射治疗29例, 对比研究输尿管导管置入前是否接受过治疗、肾功能是否正常, 置管后是否接受放疗三种因素对预后的影响。   结果   输尿管导管置入后肾功能恢复正常率为91.3% (21/23)。未治疗组、术后和放疗后复发组中位生存时间分别为27、15、10个月(χ2=9.379, P=0.009)。置管后接受放疗组与未行放疗组中位生存时间分别为25、9个月(χ2=17.329, P < 0.001), 置管前肾功能是否正常对预后影响无显著性差异(χ2=1.37, P=0.242)。   结论   对于初治或术后复发的宫颈癌并发双侧输尿管梗阻患者, 在解除输尿管梗阻后, 应接受放射治疗, 可获得较好疗效。      

Serum interleukin 6 as a prognostic factor in patients with prostate cancer.

The present study was undertaken to evaluate the prognostic significance of the serum levels of interleukin 6 (IL-6) in patients with prostate cancer. Serum IL-6 levels were measured in 74 patients with prostate cancer. The tumor was stage B in 23 patients, stage C in 14 patients, and stage D in 37 patients. Prognostic significance of tumor histology, performance status (PS), bone metastasis, serum prostate-specific antigen (PSA) level, serum alkaline phosphatase (ALP) level, serum lactate dehydrogenase level, serum IL-6 levels, and hemoglobin on disease-specific survival was assessed using univariate and multivariate Cox's proportional hazards model analyses. Serum IL-6 was significantly correlated with the clinical stage of prostate cancer. Univariate analysis of all patients demonstrated that an extent of disease (EOD) on bone scanning > or = 1, IL-6 > or = 7 pg/ml, PS > or = 1, PSA > 100 ng/ml, and ALP > 620 IU/liter were associated with a significantly lower survival rate than their respective counterparts. In multivariate analysis, however, the only two significant prognostic factors were EOD and IL-6. In 51 patients with stage C and stage D prostate cancer, univariate analysis showed that EOD > or = 1, IL-6 > or = 7 pg/ml, PS > or = 1, PSA > 100 ng/ml, LDH > 200 IU/liter, and ALP > 620 IU/liter were significantly related to survival, whereas multivariate analysis again demonstrated that EOD > or = 1 and IL-6 > or = 7 pg/ml were significant prognostic factors. These results indicate that the serum IL-6 level is a significant prognostic factor for prostate cancer as well as EOD.     

Analysis of CA-125 levels in the sera of patients with non-ovarian carcinomas and non-malignant diseases

CA-125 is known as a marker of ovarian carcinoma; it is useful in monitoring response to treatment and it is even said to be a means of detecting ovarian carcinomas. We have studied the serum levels of CA-125 in 260 patients with advanced carcinomas (excluding ovarian cancer) and in 120 patients with non-malignant diseases (excluding gynaecological diseases). Our cut-off value was 20 IU/ml. Sensitivity was 0.53 and Specificity only 0.38; sensitivity was high in lung cancer (0.56), in breast cancer (0.46) and in cancer of the stomach (0.91). Five percent of the cancer patients had values higher than 233.5 IU/ml. Sensitivity was correlated with the presence of a metastatic disease (p less than 0.001). A second assay was obtained in 163 cases; a concordance between the variation of the serum level and the clinical evolution was found in 65% cases. A high rate of false positive values was found in cases of acute pneumonia (0.74) and of gastro-intestinal diseases (0.41). In view of these results, the optimal threshold value was set at 65 IU/ml. CA-125 appears to be a useful marker in the monitoring of advanced non-ovarian carcinomas.