Serum immunosuppressive acidic protein as a tumor marker for renal cell carcinoma

Since there are no reliable tumor markers in renal cell carcinoma, the present study was undertaken to evaluate immunosuppressive acidic protein (IAP) in patients with this tumor. Serum IAP levels were measured in 143 consecutive patients before and/or after nephrectomy by turbidimetric immunoassay. IAP levels had increased according to tumor diameter. Positivity rates of IAP were noticed as 45%, 75%, and 100% for patients with stage I/II, stage III, and stage IV diseases, respectively. Three-year survival rates also correlated with IAP: 96%, 81%, and 44% in preoperative levels below 500, of 501-1,000, and of more than 1,001 micrograms/ml, respectively. Serum IAP levels decreased within 3 months after the operation and increased with recurrence. These results suggest that serum IAP may serve as a tumor marker in patients with renal cell carcinoma.     

Immunosuppressive acidic protein (IAP) and immunosuppressive substance (ISS) in patients with renal cell carcinoma

To clarify their usefulness as markers for renal cell carcinoma, serum immunosuppressive acidic protein (IAP) and serum immunosuppressive substance (ISS) were evaluated by TIA (turbidometric immunoassay) for IAP and by SRID (single radial immunodiffusion) for ISS. The mean level of IAP and ISS was beyond each upper normal limit (500, 700 micrograms/ml) in every stage, and especially high in the M1 group. The levels of IAP and ISS were significantly correlated with each other. The determination of IAP and ISS levels after treatment showed a good correlation to the clinical course of the disease. The positive rates of IAP and ISS increased as the stages progressed, respectively. When the influences of pretreatment IAP and ISS level on survival period were investigated, the low IAP or ISS level group (less than two times of the upper normal limit) tended to have a better prognosis than the high level group (more than two times of the upper normal limit) in the M1 patients. These findings suggested that IAP and ISS could be used as markers for monitoring a disease and predicting the prognosis in patients with renal cell carcinoma. As for the positive rate in the combination assay for IAP, TPA and ferritin, or ISS, TPA and ferritin, more than 80% of the patients with low stage renal cell carcinoma had at least one positive marker. This suggested that the combination assay of these three markers was clinically valuable as a disease monitor in patients with renal cell carcinoma.     

Prognostic value of serum immunosuppressive acidic protein in renal cell carcinoma

BACKGROUND: To determine whether the immunosuppressive acidic protein (IAP) could be a useful marker for renal cell carcinoma (RCC), serum IAP levels were compared with clinicopathological features in RCC patients. Furthermore, IAP cutoff level to predict the recurrence was determined using receiver operating characteristics (ROC) curve analysis. PATIENTS AND METHODS: Between January 1994 and December 1998, pretreatment serum IAP was measured in 123 consecutive patients with PCC at Kitasato University Hospital. Ninety-eight patients were received radical surgery and 86 patients were performed as clinically curable renal cell carcinoma (pT1-pT3N0M0). ROC curve analysis was utilized to set the cutoff value of IAP for prediction of cancer recurrence. Significance of prognostic factors in RCC recurrence was analyzed by Cox proportional hazard model. RESULTS: The mean age of the 123 patients was 58.6 years (range 33 to 90, median 59). The mean follow-up period was 24.8 months (range 1 to 78, median 26). The median IAP levels were 447 ug/ml in stage I, 629 ug/ml in stage II, 588 ug/ml in stage III and 1,150 ug/ml in stage IV (p < 0.05). Tumor size and venous involvement were significantly associated with IAP concentrations (p < 0.05). However, tumor grade did not correlate with IAP level. Of 86 patients with clinically curable tumor, 79 patients were disease-free after median follow-up of 27 months. Using ROC curve analysis, IAP cutoff level for prediction of cancer recurrence was set at 620 ug/ml. Disease-free survival rate in patients with preoperative IAP levels of 620 ug/ml or lower was 98.5% (67/68) at 27 months postoperatively, whereas that in patients with IAP greater than 620 ug/ml was 75.0% (12/18). This difference was statistically significant (p < 0.05). Results of multivariate analysis revealed that preoperative IAP and pT stage were statistically significant factors for tumor recurrence after radical surgery (p < 0.05). CONCLUSIONS: The present study indicates that preoperative IAP level is a useful prognostic marker in patients with RCC. In particular, patients with clinically curable tumors (pT1-3N0M0), whose preoperative IAP levels greater then 620 ug/ml may have high risk for recurrence after radical nephrectomy.     

Clinical evaluation of serum basic fetoprotein for prostatic cancer--comparative study with PAP, gamma-Sm and PSA]

The clinical significance of serum basic fetoprotein (BFP) in prostatic cancer was investigated together with serum prostatic acid phosphatase (PAP), gamma-seminoprotein (gamma-Sm) and prostate specific antigen (PA). Investigated in this study were 40 patients with prostatic cancer, ranging in age from 50 to 85 years (mean age: 69.5 years). According to clinical staging, 3 cases (7.5%) had a stage A disease, 10 cases (25.0%) a stage B disease, 7 cases (17.5%) a stage C disease, and 20 cases (50.0%) a stage D disease. The positive rates for serum BFP, PAP, gamma-Sm, and PSA were 60.0, 45.0, 63.6, and 68.4%, respectively, and these rates increased as the stage advanced. The above results suggest that BFP is the most useful marker of the four for monitoring prostatic cancer. In a combination assay of these four markers, 29 (87.9%) of 33 patients with prostatic cancer could be diagnosed by observing an elevated serum level in one of the markers. This suggests that a combination assay of BFP, PAP, gamma-Sm and PSA in patients with prostatic cancer is useful for diagnosis and monitoring of the disease.     

Clinical evaluation of serum basic fetoprotein in patients with urogenital malignancies and renal transplantation]

The serum basic fetoprotein (BFP) in patients with urogenital diseases was measured by enzyme immunoassay (EIA). The positive range of serum BFP was defined to be 75 ng/ml or more. In benign cases except for renal transplantation, the positive rate of serum BFP was 11.1% (5/45), and relatively high (21.4%, 3/14) in benign prostatic hypertrophy. In cases of urogenital cancers before treatment, the positive rate of serum BFP was 29.1% (16/55), and increased with the progression of clinical stage. Eleven of the patients with positive serum BFP before treatment were re-examined after treatment, and all of them exhibited a marked decrease of the titer of serum BFP. In seventeen renal transplant patients, the positive rate of serum BFP was 100% (8/8) in acute rejection, 66.7% (2/3) in chronic rejection and 0% (0/6) in rejection-free condition. We conclude that serum BFP is a clinically beneficial marker for renal transplant rejections and urogenital malignancies.     

Elevated levels of serum aldolase A in patients with renal cell carcinoma

Summary To clarify whether serum aldolase A is a useful biomarker for renal cell carcinoma (RCC), we determined serum levels of the aldolase A isozyme by an enzyme immunoassay in patients suffering from RCC, other urological tumors, and benign urological diseases. Fortysix of 126 patients with RCC (37%) had elevated serum aldolase A. The positive rates were 23% in stage I, 40% in stage II, 63% in stage III, and 46% in stage IV. In 10 (83%) of 12 patients whose serum levels had been elevated preoperatively, these were reduced to within the normal range after nephrectomy. Four of 7 patients (57%) with progressive disease had elevated of aldolase A. In contrast, the positive rates were only 9.9% in 71 patients with other urological tumors and 5.8% in 52 cases of benign urological diseases. High concentrations of aldolase A isozyme in RCC tissues might be reflected in elevated serum levels. The present findings indicate that serum aldolase A is a useful biomarker for monitoring the clinical course of patients with RCC.     

Serum iron as a tumor marker in renal cell carcinoma

To evaluate the feasibility of using serum iron as a tumor marker for renal cell carcinoma, a retrospective review of serum iron, hemoglobin, hematocrit, mean corpuscular volume and pathology in patients with renal cell carcinoma was carried out. From January 1985 to December 1989, preoperative serum iron was obtained in 82 patients; 27 had stage I, 5 stage II, 23 stage III and 27 had stage IV disease. The serum iron levels (micrograms/dl) were 81.6 +/- 33.2 in stage I, 57.8 +/- 18.9 in stage II, 59.6 +/- 34.6 in stage III and 45.6 +/- 32.7 in stage IV disease, which were significantly lower as compared with the data (114.6 +/- 38.9) of a control group. Postoperative serum iron levels were available in 31 patients following nephrectomy and all showed an increase as compared with preoperative data except 2: 1 with recurrence and the other with progression of disease. It was concluded that the serum iron level may be used as a useful tumor marker in staging and follow-up of renal cell carcinoma.     

Clinical evaluation of serum S100ao protein in patients with urogenital diseases and healthy volunteers

We investigated the clinical significance of the serum S100ao protein in patients with urogenital diseases. The serum levels of S100ao protein were measured in 179 patients with urogenital diseases and 180 healthy volunteers. The mean value of S100ao protein in serum from healthy volunteers was 203 +/- 107 pg/ml (Mean +/- SD). Therefore, the cut-off level was set to 524 pg/ml (Mean +/- 3SD). The levels of S100ao protein in serum were significantly higher in men than in women (P less than 0.05). The levels of S100ao protein in serum were significantly high in the patients in their fifties and sixties compared with the other patients (P less than 0.01). When serum levels exceeding the cut-off level were considered to be positive, the percentages of positivity in each disease were as follows: renal cell carcinoma; 38.7%, bladder tumor; 9.1%, prostatic carcinoma; 12.5%, testicular tumor; 0%, benign prostatic hypertrophy; 7.4%, urolithiasis; 7.1% and chronic renal failure; 100%. The levels of S100ao protein in serum were significantly correlated with those of BUN, serum creatinine and endogenous creatinine clearance, respectively. S100ao protein in serum was increased immediately after operation and returned to the normal range within one to two weeks after operation. As described above, the level of S100ao protein in serum was affected by renal function, operative procedures and age. However, the positive rate of S100ao protein was so high in patients with renal cell carcinoma that serum S100ao protein might be a valuable tumor marker in those patients.     

Study on serum levels of immunosuppressive acidic protein (IAP) as a marker of renal cell carcinoma

Immunosuppressive acidic protein (IAP) exhibits various types of immunosuppressive activity and is said to increase in cancer hosts. Based on measurements of IAP levels in normal subjects, cases of renal cysts and 46 cases of renal cell carcinoma we reached the following conclusions: The IAP levels in normal subjects ranged from 250-530 micrograms/ml, with a mean +/- S.D. of 362.5 +/- 68.9 micrograms/ml, which was comparable to the values in renal cyst cases (250-470 micrograms/ml, mean +/- S.D.: 353 +/- 70 micrograms/ml). 475 micrograms/ml was taken as the upper limit of the normal range. The pretreatment IAP values for cases of renal cell carcinoma ranged from 330-1,780 micrograms/ml, with a mean +/- S.D. of 820 +/- 820 and 73% were considered positive (i.e. beyond the 475 micrograms/ml limit). There was a statistical significance of p less than 0.01 between normal subjects and renal cell carcinoma cases and also between renal cyst cases and renal cell carcinoma cases. When the cases of renal cell carcinoma were divided into those with a pretreatment IAP level of 475 micrograms/ml or less and those with more than 475 micrograms/ml, the 3-year survival of the former was 90%, whereas that of the latter group was 39%, showing a statistically significant difference with p less than 0.05. Comparison of the IAP levels in the group of total nephrectomy cases that did not develop recurrence and those in which recurrence was recognized, revealed significantly higher IAP levels in the latter (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)     

Evaluation of serum S100ao protein in patients with renal cell carcinoma

In order to evaluate the clinical significance of S100ao protein, we measured serum S100ao protein in 36 patients with renal cell carcinoma by EIA developed by Kimura et al. In addition, the distribution of S100ao protein was studied by the immunohistochemical method. Previous study demonstrated that mean level of serum S100ao protein in healthy volunteers was 203 +/- 107 pg/ml, therefore the cut off level was set to 524 pg/ml. The results obtained in this study were as follows: 1) The mean level of serum S100ao protein was 1162 +/- 2056 pg/ml, and its positive rate was 44% in 36 patients with renal cell carcinoma. When the patients were divided into 2 groups according to tumor stage, the mean level of serum S100ao protein in the high stage group was significantly higher than that in the low stage group (p less than 0.01). 2) In the sequential study of serum S100ao protein, patients with progressive disease showed a gradual increase in the level of serum S100ao protein while patients with no evidence of tumor showed a normal level of serum S100ao protein. 3) There was no correlation between the level of serum S100ao protein and the histological grade of renal cell carcinoma. 4) Immunohistochemical analysis (10 cases) showed that S100ao protein was observed in all of 10 renal cell carcinomas. Thus, the present study suggests that serum S100ao protein might be a useful clinical marker especially in monitoring patients with renal cell carcinoma.     

食管鳞癌患者血清高迁移率族蛋白B1水平检测及临床意义

目的 探讨高迁移率族蛋白B1（HMGB1）在食管鳞癌患者血清中的表达及其作为食管鳞癌肿瘤标志物的可行性.方法 回顾性分析201 1年1-12月间天津医科大学附属肿瘤医院食管肿瘤科收治的78例食管鳞癌患者的临床病理资料,以酶联免疫吸附测定法、电发光免疫测定法和微粒酶联免疫测定法分别检测78例食管鳞癌患者术前和术后1个月血清HMGB1、癌胚抗原（CEA）、细胞角蛋白19片段抗原（Cyfra21-1）及鳞状上皮细胞癌相关抗原（SCC）的水平.以60名健康成人血清HMGB1的95％单侧参考值范围作为阳性判定标准（大于96 μg/L）;以CEA大于5.0 μg/L、Cyfra21-1大于3.3 μg/L、SCC大于1.5μg/L作为其他血清标记物的阳性判定标准.结果 78例食管鳞癌患者术前血清HMGB1水平为（748.7±92.4） μg/L,其表达水平与肿瘤大小、浸润深度、淋巴结转移及肿瘤分期有关（P＜0.01,P＜0.05）.术后1个月,患者血清HMGB1表达水平为 （181.4±20.5） μg/L,较术前明显下降（P＜0.01）;但在T4、N1和Ⅲ期中仍相对较高（P＜0.01,P＜0.05）.血清HMGB1对食管鳞癌诊断的灵敏度为 84.6％（66/78）,明显高于CEA[10.3％ （8/78）]、Cyfra21-1[25.6％（20/78）]和SCC [42.3％ （33/78）];但4种血清肿瘤标记物特异度均较高,分别为93.3％（56/60）、88.3％（53/60）、90.0％（54/60）和 93.3％（56/60）.结论 与CEA、Cyfra21-1和SCC相比,血清HMGB1检测食管鳞癌灵敏度高,易于检测,特异度好,可作为肿瘤标志物用于食管鳞癌的辅助诊断、病期评价及预后判断.     

Evaluation of gamma-enolase as a tumor marker for renal cell carcinoma

To evaluate whether serum gamma-enolase is a useful marker for renal cell carcinoma alpha and gamma-enolases in tissues of 36 renal cell carcinomas and 13 normal kidneys, and in sera of 103 renal cell carcinoma patients were determined with an enzyme immunoassay system. Tissue gamma and alpha-enolase levels were 34 and 2.3 times higher, respectively, in renal cell carcinoma than in normal renal cortex. The tissue gamma enolase-to-total enolase value of renal cell carcinoma (5.3 per cent) was significantly higher than that of normal cortex (0.29 per cent) and medulla (0.51 per cent). Over-all serum gamma-enolase levels were elevated (more than 6.0 ng. per ml.) in 53 of 103 patients (51 per cent) with renal cell carcinoma. In regard to stage the positive rates were 34 per cent (12 of 35) of patients with stage I, 22 per cent (2 of 9) with stage II, 80 per cent (12 of 15) with stage III, 61 per cent (22 of 36) with stage IV and 61 per cent (5 of 8) with recurrent disease. The mean value of serum gamma-enolase in renal cell carcinoma (8.0 +/- 5.7 ng. per ml.) was significantly higher than that of normal subjects (3.1 +/- 0.9 ng. per ml., p less than 0.001). The mean value of serum gamma-enolase in patients with high stage tumors (III and IV, 9.9 +/- 6.8 ng. per nl.) was significantly higher than that of low stage tumors (I and II, 5.8 +/- 3.0 ng. per ml., p less than 0.001). In 39 patients treated by complete surgical excision serum gamma-enolase was significantly reduced postoperatively (p less than 0.01). Furthermore, 7 of 8 patients whose serum gamma-enolase levels were determined serially had levels within the normal range postoperatively that increased when distant metastases appeared. These results indicate that serum gamma-enolase could be a useful tumor marker to stage disease and monitor treatment in patients with renal cell carcinoma.     

Is adrenalectomy a necessary component of radical nephrectomy? UCLA experience with 511 radical nephrectomies

PURPOSE: We determine the incidence and characteristics of adrenal involvement in localized and advanced renal cell carcinoma, and evaluate the role of adrenalectomy as part of radical nephrectomy. MATERIALS AND METHODS: The records of 511 patients undergoing radical nephrectomy with ipsilateral adrenalectomy for renal cell carcinoma at our medical center between 1986 and 1998 were reviewed. Mean patient age was 63.2 years (range 38 to 85), and 78% of the subjects were males and 22% were females. Patients were divided into subgroups of 164 with localized (stage T1-2 tumor, group 1) and 347 with advanced (stage T3-4N01M01, group 2) renal cell carcinoma. Staging of tumors was performed according to the 1997 TNM guidelines. A retrospective review of preoperative computerized tomography (CT) of the abdomen was performed. Radiographic findings were subsequently compared to postoperative histopathological findings to assess the predictive value of tumor characteristics and imaging in determining adrenal metastasis. RESULTS: Of the 511 patients 29 (5.7%) had adrenal involvement. Average size of the adrenal tumor was 3.86 cm. (standard deviation 1.89). Tumor stage correlated with probability of adrenal spread, with T4, T3 and T1-2 tumors accounting for 40%, 7.8% and 0.6% of cases, respectively. Upper pole intrarenal renal cell carcinoma most likely to spread was local extension to the adrenal glands, representing 58.6% of adrenal involvement. In contrast, multifocal, lower pole and mid region renal cell carcinoma tumors metastasized hematogenously, representing 32%, 7% and 4% of adrenal metastasis, respectively. The relationship between intrarenal tumor size (mean 8.9 cm., range 3 to 17) and adrenal involvement (independent of stage) was not statistically significant. Renal vein thrombus involvement was demonstrated in 8 of 12 cases (67%) with left and 2 of 9 (22%) with right adrenal involvement. Preoperative CT demonstrated 99.6% specificity, 99.4% negative predictive value, 89.6% sensitivity and 92.8% positive predictive value for adrenal involvement by renal cell carcinoma. CONCLUSIONS: With a low incidence of 0.6%, adrenal involvement is not likely in patients with localized, early stage renal cell carcinoma and adrenalectomy is unnecessary, particularly when CT is negative. In contrast, the 8.1% incidence of adrenal involvement with advanced renal cell carcinoma supports the need for adrenalectomy. Careful review of preoperative imaging is required to determine the need for adrenalectomy in patients at increased risk with high stage lesions, renal vein thrombus and upper pole or multifocal intrarenal tumors. With a negative predictive value of 99.4%, negative CT should decrease the need for adrenalectomy. In contrast, positive findings are less reliable given the relatively lower positive predictive value of this imaging modality. Although such positive findings may raise suspicion of adrenal involvement, they may not necessarily indicate adrenalectomy given the low incidence, unless renal cell carcinoma with risk factors, such as high stage, upper pole location, multifocality and renal vein thrombus, is present.     

Real indications for adrenalectomy in renal cell carcinoma

OBJECTIVES: We determined the incidence and characteristics of adrenal involvement in localized and advanced renal cell carcinoma, and evaluated the role of adrenalectomy as part of radical nephrectomy. PATIENTS AND METHODS: From 1993 to 1999, 210 patients with renal cell carcinoma (RCC) (139 men and 71 women, mean age 60.8 years, range 12-96 years) underwent radical nephrectomy with associated adrenalectomy. Patients were divided into two subgroups of 106 with localized (stage T1-2 tumor, group 1) and 104 with advanced (stage T3-4N01M01, group 2) renal cell carcinoma. A retrospective review of preoperative computerized tomography (CT) of the abdomen was performed. Radiographic findings were subsequently compared with postoperative histopathological results to assess the predictive value of tumor characteristics and imaging in determining adrenal metastasis. RESULTS: Of the 210 patients, 15 (7.1%) had adrenal involvement. Tumor stage correlated with probability of adrenal spread, with T3-4 and T1-2 accounting for 13.4% and 0.9% of cases, respectively (p < 0.001). Upper pole intrarenal RCC most likely to spread was local extension to the adrenal gland, representing 53.3% of adrenal involvement. In contrast, multifocal, lower pole and mid region RCC tumors metastasized hematogenously, representing 21.4%, 7%, and 14% of adrenal metastasis, respectively. The relationship between intrarenal tumor size (mean 7.8 cm, range 4-21) and adrenal involvement was not statistically significant. Preoperative CT demonstrated 97.7% specificity, 98.4% negative predictive value, 87% sensitivity and 80% positive value for adrenal involvement by RCC. CONCLUSIONS: Ipsilateral adrenalectomy should only be performed if a lesion is seen preoperatively on CT scan or if gross disease is seen at the time of nephrectomy. The prognosis is poor for RCC with ipsilateral involvement even with complete removal. Because of this poor prognosis we believe that adrenal involvement should constitute a separate stage category.     

术前预测肾细胞癌患者淋巴结转移的列线图模型

目的:探讨肾细胞癌患者淋巴结转移的术前预测因子,并建立列线图预测模型。方法:回顾性分析2016年1月至2020年12月于华中科技大学同济医学院附属同济医院接受手术治疗并行腹膜后淋巴结清扫或活检的173例肾细胞癌患者的临床资料。男109例,女64例;年龄(53.29±13.58)岁;肿瘤直径中位数70(23~150)mm...     

The influence of pNx/pN0 grouping in a multivariate setting for outcome modeling in patients with clear cell renal cell carcinoma

PURPOSE: Lymphadenectomy, especially extended lymphadenectomy, is not commonly performed in patients undergoing a radical nephrectomy for clear cell renal cell carcinoma. Surgeons may sample suspicious regional lymph nodes, but the lymph node status of many patients with renal cell carcinoma remains unknown, termed stage pNx. Outcome models based on large institutional reviews have been criticized for grouping stages pNx and pN0 cases because of concern that the pNx category may include unrecognized stages pN1/pN2 disease. We evaluated cancer specific survival differences in patients with clear cell renal cell carcinoma and a lymph node stage of pNx, pN0 or pN1/pN2. MATERIALS AND METHODS: We searched the registry at our institution for patients who underwent radical nephrectomy for clear cell histology renal cell carcinoma between 1970 and 1998. Those with distant metastases at surgery were excluded from study. Clinical features obtained from the medical record included age at surgery, history of tobacco use, hypertension and symptomatic disease at presentation. A single urological pathologist reviewed all tumor specimens for nuclear grade, tumor necrosis, surgical margin status, 1997 tumor stage and lymph node status. These features were compared in patients with stages pNx and pN0 tumors. Cox proportional hazards models were used to compare cancer specific survival in univariate fashion, and after adjusting for tumor stage and grade. RESULTS: The study cohort consisted of 1,535 patients with sporadic, unilateral clear cell renal cell carcinoma who underwent radical nephrectomy. There were 600 patients (39%) with stage pNx, 870 (57%) with stage pN0 and 65 (4%) with stages pN1/pN2 tumors. At an average of 4.2 years after surgery 414 patients died of renal cell carcinoma. On univariate analysis patients with stage pN0 tumors were significantly more likely to die of renal cell carcinoma than those with stage pNx tumors (risk ratio 1.40, 95% confidence interval 1.12 to 1.75, p = 0.003). However, after adjusting for tumor stage and nuclear grade the difference in outcome for stages pNx and pN0 tumors was not statistically significant (risk ratio 1.07 95% confidence interval 0.85 to 1.34, p = 0.583). Patients with stage pNx disease were significantly less likely to be symptomatic at presentation (p = 0.002), have tumors that were less than 5 cm. (p <0.001) and of lower stage (p <0.001) and grade (p = 0.005), and to have tumors with necrosis (p = 0.024) than patients with stage pN0 disease. CONCLUSIONS: Combining stages pNx and pN0 cases to create outcome prediction models after radical nephrectomy for clear cell renal cell carcinoma is appropriate in a multivariate setting that includes tumor stage and grade. Clinical features available preoperatively and during surgery can help guide the decision to perform limited lymph node sampling. When the tumor is 5 cm. or greater, shows pathological necrosis or is advanced grade 3 or 4, lymph node sampling adds little prognostic information.     

Preoperative elevation of serum C-reactive protein as an independent prognostic indicator of colorectal carcinoma

PURPOSE: The preoperative elevation of serum C-reactive protein (CRP) is thought to be a prognosticator of carcinomas of the digestive tract. We conducted this study to investigate the clinical importance of the preoperative elevation of serum CRP in patients with colorectal carcinoma (CRC). METHODS: We investigated the correlation between an elevated preoperative serum CRP level and the clinicopathologic factors, including prognosis, of 116 patients who underwent resection of CRC. RESULTS: Forty-seven (40.5%) patients had an elevated serum CRP value preoperatively (group H) and 69 (59.5%) did not (group L). There were significant differences in the tumor size, proportion of poorly differentiated tumors, depth of invasion, lymph node metastasis, lymphatic invasion, and tumor stage between the two groups. Survival was significantly lower in group H than in group L (P < 0.0001). Multivariate analysis showed that the preoperative elevation of serum CRP (P = 0.0007), as well as poor differentiation (P = 0.027) and advanced tumor stage (P = 0.007) were independent prognostic factors in patients with CRC. CONCLUSION: We found the preoperative elevation of serum CRP to be an independent prognostic indicator of CRC.     

胃癌和大肠癌患者血清肿瘤标志物联合检测的临床意义

目的评价血清肿瘤标记物联合检测对胃癌和大肠癌诊断和监测的价值.方法用PC-12多种肿瘤标志物蛋白芯片检测系统检测179例胃癌和大肠癌患者、82例胃和结直肠良性疾病患者及160例健康人血清中12种常见肿瘤标志物CA19-9、NSE、CEA、CA242、铁蛋白（Ferritin）、Beta-HCG、AFP、free-PSA、PSA、CA125、HGH、CA153的水平.结果肿瘤组的肿瘤标志物水平显著高于良性疾病组及健康组（P＜0.01）,其中CA19-9、CEA、CA242、CA125和CA153 5项在胃癌和大肠癌患者中水平较两对照组明显升高,差异有统计学意义（P＜0.01）.采用平行检测法,可以提高检测的敏感度（72.07%）和阴性预测值（79.25%）;采用系列检测,可提高检测的特异度（92.15%）和阳性预测值（84.67%）.肿瘤根治术后,肿瘤标记物水平显著下降.术后未降至正常者,复发或转移率为68.89%,而术后再升高者复发或转移率为77.78%.结论多种肿瘤标记物对胃癌和大肠癌的诊断、监测肿瘤复发和转移有一定的价值.     

Expression of cytokeratin 5 and calretinin in clear-cell renal cell carcinoma

PurposeCytokeratin 5 (CK5) and calretinin have been useful in different studies as immunohistochemical markers suggestive of mesothelioma, and their expression is analyzed for the histological differential diagnosis with adenocarcinomas, specially when confronting with metastatic tumors of unknown origin. We have analyzed the expression of CK5 and calretinin in clear cell renal cell carcinomaMethodsA series of 63 clear cell renal cell carcinomas was studied. 46 of these cases were embedded in two tissue arrays, and a second group, of 17 cases, was constituted by conventional paraffin blocks from high-grade tumors (grade 4 of Fuhrman)Immunohistochemical staining was performed with monoclonal antibodies against CK5 and calretinin, following the labeled sptreptavidin-biotin techniqueResultsNo positivity for calretinin was observed in any case, while CK5 was focally expressed, in an isolated group of cells, in 1 of the 63 cases (1,59%) which corresponded to a high-grade carcinoma (grade 4 of Fuhrman)ConclusionsExpression of calretinin was not observed in clear cell renal cell carcinoma and positivity for CK5 occurred only in one case, in a very small proportion of tumor cells. Therefore, in practice, although the positivity for these markers cannot completely exclude renal cell carcinoma, this result is very rare in this tumor and other diagnostic posibilities should be considered