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Biomedical subjects

A Gadducci

Publications and source records attributed to A Gadducci.

At least 91 records · Page 5Linked to original sources
PubMed1991

Comparison of tumor-associated trypsin inhibitor (TATI) with CA125 as a marker for diagnosis and monitoring of epithelial ovarian cancer.

Preoperative serum levels of CA125 and tumor-associated trypsin inhibitor (TATI) were measured in 220 patients undergoing laparotomy for adnexal masses. Of the 57 patients with epithelial ovarian cancer. 86% had serum CA125 higher than 35 kU/l and 81% higher than 65 kU/l while 51% had serum TATI above 22 micrograms/l. In eight patients with mucinous ovarian malignancies, serum levels of CA125 were above 65 kU/l in 6 cases while serum TATI was above 22 micrograms/l in 4 cases. Of the 163 patients with benign ovarian masses, 41% had serum CA125 levels above 65 kU/l and 17% above 65 kU/l whereas serum TATI was above 22 micrograms/l in 6%. In 11 cancer patients having elevated levels of both CA125 and TATI at diagnosis, the serum concentrations of these antigens were periodically measured during and after treatment. Changes in CA125 and TATI levels correlated with the clinical course in 84% and 37% of the instances, respectively. After the sixth course of chemotherapy, the diagnostic accuracy of the markers in the evaluation of the disease status at second-look laparotomy was 55% for CA125 with a cut-off level of 35 kU/l, 36% for a cut-off level of 65 kU/l, 55% for TATI, and 66% for the combination of CA125 and TATI with cut-off levels of 65 kU/l and 22 micrograms/l. CA125 is the most sensitive marker for epithelial ovarian cancer, but the concomitant measurement of TATI could be of benefit in both differential diagnosis of adnexal masses and monitoring of response of epithelial ovarian cancer to treatment.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1990

CAM26, CAM29 and mucin-like carcinoma associated antigen in epithelial ovarian cancer.

The levels of CA125 (reference values [RVs] 35 U/mL and 65 U/mL), CA15.3 (RV = 32 U/mL), Mucin-like carcinoma associated antigen (MCA; RV = 15 U/mL), CAM26 (RV = 75 U/mL) and CAM29 (RV = 15 U/mL) were preoperatively assayed in blood samples drawn from 42 patients with ovarian carcinoma and 101 patients with benign ovarian pathology undergoing laparotomy at the Department of Gynecology and Obstetrics of the University of Pisa. With 65 U/mL as RV, CA125 had a sensitivity (SE) of 80.9% and a specificity (SP) of 89.1% for ovarian carcinoma; with 35 U/mL as RV, CA125 had a SE of 85.7% and a SP of 66.3%; CA15.3 had a SE of 57.1% and a SP of 96.0%; MCA had a SE of 59.5% and a SP 86.1%; CAM26 had a SE of 21.4% and a SP of 96.0%, CAM29 had a SE of 64.3% and a SP of 97.0%. The association of CA125 with each of other antigens did not improve the SE of CA125 assay alone in the detection of patients with ovarian carcinoma. In conclusion, the present data showed that the measurement of CA15.3, MCA and CAM26 did not give any additional information with respect to CA125 assay in the diagnosis of ovarian carcinoma. The good SE and the very good SP and diagnostic accuracy of CAM29 could suggest further investigation in order to evaluate the role of this antigen in the management of patients with this malignancy.

Adenocarcinoma↗
PubMed1990

The potential of primary cytoreductive surgery in patients with FIGO stages III and IV ovarian carcinoma.

The present study included 40 patients with advanced ovarian carcinoma who underwent surgery and combination chemotherapy with cisplatin or carboplatin at the Department of Gynecology and Obstetrics of the University of Pisa. All the 20 optimally cytoreduced (residual disease lower than 2 cm) patients were clinically free of disease after the sixth course of chemotherapy; second-look laparotomy showed a pathological complete response (PCR) in 16 of them (80%). The 5-year actuarial progression- free and overall survival rates of this group of patients were 44.0% and 82.2% respectively. Among the 20 patients with residual disease greater than 2 cm after the first laparotomy, a clinical complete response was obtained in 3 (15%) and a clinical partial response in 12 (60%); a PCR was achieved in only 1 (5%) of them. The 5-year actuarial progression- free and overall survival rates of this group of patients were 0% and 14.2% respectively. The present paper confirms that surgery plays a major role in the treatment of ovarian carcinoma. Aggressive surgical removal with optimal tumor reduction can produce a favourable effect on patients survival time, since there is an inverse relationship between the volume of residual disease after the first laparotomy and the likelihood of response to chemotherapy.

Antineoplastic Agents↗
PubMed1990

Evaluation of some hemostatic parameters in patients with cervical carcinoma.

It is well known that cancer induces changes in hemostasis. Plasma levels of Fibrinopeptide A (FPA), D-Dimer (DD), von Willebrand Factor (FvW) and fibrinogen were-assayed at diagnosis in 66 patients with cervical carcinoma and in 67 healthy women as controls. FPA, DD and fibrinogen levels were significantly higher in patients with FIGO stage I b-IIa cervical carcinoma than in controls (2.25 +/- 0.25 vs 1.19 +/- 0.15 p less than 0.001; 307 +/- 35 vs 112 +/- 8 p less than 0.001; 375 +/- 23 vs 280 +/- 17 p less than 0.001 respectively). A further increase of DD, FPA but not of fibrinogen concentrations was observed in advanced stages of disease (3.52 +/- 0.81 vs 2.25 +/- 0.25 p less than 0.1; 943 +/- 98 vs 307 +/- 35 p less than 0.001; 407 +/- 26 vs 375 +/- 23 p = NS respectively). FvW levels in patients with early stage cervical carcinoma were in the normal range, while in patients with advanced cancer, they were significantly higher (175 +/- 8 vs 104 +/- 2 p less than 0.001). A significant correlation was found between plasmatic levels of FPA and DD, FPA and FvW, DD and FvW (r = 0.57 p less than 0.01; r = 0.76 p less than 0.01; r = 0.54 p less than 0.01 respectively). Our data seem to indicate that in patients with cervical carcinoma, and in particular in those with advanced cancer, there is an activation of blood coagulation and fibrinolysis.

Adult↗
PubMed1990

A comparison of pretreatment serum levels of four tumor markers in patients with endometrial and cervical carcinoma.

CA125 (reference value [RV] = 35 U/mL), CA50 (RV = 20 U/mL), CA72.4 (RV = 3.8 U/mL) and SCC (RV = 3.6 ng/mL) levels were retrospectively assayed in blood samples collected at diagnosis from 42 patients with endometrial carcinoma, 45 patients with cervical carcinoma and 68 patients with benign uterine pathology as controls. Among the patients with endometrial carcinoma. CA50 was the antigen with the highest sensitivity (SE) (34.4%) followed by CA125 (26.2%), CA72.4 (21.9%) and SCC (16.7%). The incidence of elevated serum CA125 and CA72.4 levels was significantly greater in advanced stages than in early ones (66.7% vs 19.4%, p = 0.032 for CA125; 66.7% vs 11.5%, p = 0.012 for CA72.4), while CA50 positivity was not significantly correlated with the extent of disease (50% in advanced stages vs 30.8% in early ones, p = 0.38). Among the patients with cervical carcinoma, CA125 and CA50 respectively showed a SE of 33.3% and of 42.9% for adenocarcinoma, while SCC had a SE of 33.3% and of 42.9% for squamous cell adenocarcinoma; in particular among the patients with squamous cell carcinoma, the incidence of elevated SCC levels was correlated with the extent of tumor (57.1% in advanced stages vs 12.5% in early ones, p = 0.013). In conclusion, CA50 and CA125 were the most sensitive tumor markers in both endometrial carcinoma and cervical adenocarcinoma, while SCC was the most reliable antigen for squamous cell carcinoma of the cervix. Because of the affinity of SCC, CA50 and CA125 for different histological types of cervical carcinoma, the combined evaluation of SCC with CA50 or CA125 showed an increased SE with respect to each marker alone.

Adenocarcinoma↗
PubMed1990

Adjuvant treatment of early stage ovarian carcinoma.

Surgery is considered the mainstay of diagnosis and treatment in early ovarian carcinoma. Only accurate staging laparotomy can detect subclinical metastases remote from the ovary, thus allowing the identification of the truly early tumors. However the complete macroscopic removal of neoplastic disease is not synonymous with cure. Many postoperative treatments have been carried out in order to improve the prognosis of patients with stage I-II ovarian carcinoma. The present paper reviews the main clinical trials on the employment of external radiotherapy, intraperitoneal radioisotope instillation and systemic chemotherapy in the management of early ovarian carcinoma. The patients appear to benefit from adjuvant treatment, with the exception of those with stage I Ai-I Bi well differentiated tumor, even if there is no agreement in literature about the superiority of a particular therapeutic approach. However the high response rates obtained in patients with advanced ovarian carcinoma with DDP containing combination chemotherapy have suggested to clinicians the use of such treatment also in early stage tumors. In our experience none of the 11 stage I ovarian cancer patients, who received 6 courses of DDP-based combination chemotherapy, have developed recurrent disease after a median follow-up of 54 months (with a range from 24 to 72 months).

Combined Modality Therapy↗
PubMed1990

A comparison of the usefulness of serum measurements of CA 125, CA 50 and TATI in patients with malignant and benign gynecological pathology.

CA 125, CA 50 and Tumor Associated Trypsin Inhibitor (TATI) levels were assayed in blood samples drawn at diagnosis from 149 patients with malignant or benign gynecological pathology. CA 125 serum levels greater than 35 U/ml and 65 U/ml were respectively found in 34/38 (89.5%) and in 33/38 (86.8%) patients with ovarian carcinoma, in 17/61 (27.9%) and in 6/61 (9.8%) with benign ovarian pathology, in 6/30 (20.0%) and in 1/30 (3.3%) with cervical carcinoma, in 6/20 (30.0%) and in 6/20 (30.0%) with endometrial carcinoma. TATI serum levels greater than 22 ng/ml were observed in 17/38 (44.7%) patients with ovarian carcinoma, in 3/61 (4.9%) with benign ovarian pathology, in 1/30 (3.3%) with cervical carcinoma and in 3/20 (15.0%) with endometrial carcinoma. CA 50 serum levels greater than 20 U/ml were found in 11/38 (28.9%) patients with ovarian carcinoma, in 19/61 (31.1%) with benign ovarian pathology, in 7/30 (23.3%) with cervical carcinoma and in 6/20 (30%) with endometrial carcinoma. This study confirmed that CA 125 is the most reliable marker for ovarian carcinoma; however TATI could have a role in the diagnostic evaluation of adnexal masses, because of its very good specificity, CA 125 and CA 50, but not TATI, could be of some benefit in the management of endometrial and cervical carcinoma.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1990

A comparative evaluation of the ability of serum CA 125, CA 19-9, CA 15-3, CA 50, CA 72-4 and TATI assays in reflecting the course of disease in patients with ovarian carcinoma.

The Authors compared the ability of serum CA 125, CA 19-9, CA 15-3, CA 50, CA 72-4 and Tumor-Associated Trypsin Inhibitor (TATI) assays in reflecting the disease course in a group of 27 patients with ovarian carcinoma. Before initial surgery, elevated levels of CA 125 (greater than 65 U/ml) were found in 27 patients, of CA 19-9 (greater than 40 U/ml) in 7, of CA 15-3 (greater than 32 U/ml) in 17, of CA 50 (greater than 20 U/ml) in 7, of CA 72-4 (greater than 3.8 U/ml) in 20, and of TATI (greater than 22 ng/ml) in 13. For each marker, only patients with elevated antigen levels at diagnosis were considered. CA 125, CA 19-9, CA 15-3, CA 50, CA 72-4 and TATI levels correlated with disease regression, stability or progression in 123/147 (83.7%), 24/34 (70.6%), 57/87 (65.5%), 26/38 (68.4%), 87/120 (72.5%), 33/75 (44.0%) instances respectively. Alterations in CA 125 levels correlated with disease status better than alterations in each other antigen levels. However serial measurement of the other tumor markers could be of help in the monitoring of patients with normal CA 125 values before initial surgery.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1989

The topical administration of steroids in the treatment of typical vulvar dystrophies.

Sixty-eight patients with histologically diagnosed typical vulvar dystrophies were treated with local administration of steroids. Twenty-three patients with hyperplastic dystrophies received topical fluorinated corticosteroids twice a day for 4 weeks and once a day for another 2 weeks. Thirty-five patients with lichen sclerosus were given local 2% testosterone propionate in vaseline twice a day for 8 weeks, once a day for another 8 weeks and then 3 times a week for another 8 weeks. Ten patients with mixed dystrophy first received topical fluorinated corticosteroids twice a day for 4 weeks and once a day for another 2 weeks, and then local 2% testosterone propionate in vaseline twice a day for 4 weeks and once a day for another 4 weeks. A relief of symptomatology and a regression of gross appearance were obtained in 82.6% and 69.6% of patients respectively with hyperplastic dystrophy, in 82.9% and 65.7% of those with lichen sclerosus and in 80% and 40% of those with mixed dystrophy. A recurrence of symptomatology often occurred at various times after the end of therapy.

Administration, Topical↗
PubMed1989

Surgery and radiotherapy in the treatment of early stage uterine sarcomas.

Twenty-three patients with early stage uterine sarcomas underwent surgery (5 patients) or surgery and pelvic irradiation (18 patients). Twelve (52%) of the patients developed a recurrence: relapsing disease was pelvic in 3 (25%) of them, extrapelvic in 8 (66.7%) and both pelvic and extrapelvic in one (8.3%). Out of the whole series the 2- and 5-year actuarial survival rates were 61% and 33% respectively. Among the patients with leiomyosarcoma the 2- and 5-year actuarial survival rates were 54% and 39% respectively. Among the patients with carcinosarcoma the 2- and 5-year actuarial survival rates were 66% and 23% respectively. The high incidence of extrapelvic recurrences after locoregional treatment seems to suggest the use of an adjuvant chemotherapy in the management of patients with early stage uterine sarcomas.

Adult↗
PubMed1989

The therapy of verrucous carcinoma of the vulva. Observations on three cases.

Vulvar verrucous carcinoma is a distinct variant of squamous cell carcinoma, with a very low biological aggressiveness. Surgery is considered to be the elective treatment, even if there is no agreement in literature about the extent of surgical resection. Radiotherapy cannot be used in the management of this neoplasia. Sometimes this therapeutic modality induces an anaplastic transformation of the tumor, which can turn into a more aggressive malignancy. In this paper the clinical histories of 3 patients with vulvar verrucous carcinoma are discussed, in particular as regards therapy.

Aged↗
PubMed1988

Osteosarcoma of the myometrium synchronous with bilateral papillary cystadenocarcinoma of the ovary and papillary adenocarcinoma of the cervix.

We report an extremely rare case of a 60-year-old woman with myometrial osteosarcoma associated with bilateral papillary cystadenocarcinoma of the ovary and papillary adenocarcinoma of the cervix. The uterine osteosarcoma is the seventh case reported in the world, while it is the second case of synchronous triple primary tumors of the upper female genital tract. Clinical and pathological features of previously reported cases of uterine osteosarcoma and triple primary neoplasias of the upper female genital tract are critically reviewed.

Adenocarcinoma, Papillary↗
PubMed1988

The association of ultrasonography and CA-125 test in the preoperative evaluation of ovarian carcinoma.

The aim of this study was to verify the role of the association of pelvic ultrasonography and CA-125 assay in the preoperative evaluation of ovarian carcinoma. The Authors examined 119 patients undergoing laparotomy for adnexal masses. Thirty-six had an ovarian carcinoma, the other 83 patients were affected by benign ovarian pathologies. Before surgery every patient underwent a pelvic ultrasonography. The data resulting from ultrasonography were processed on the basis of a personal scoring morphologic echostructural evaluation system. Furthermore in every patient the preoperative serum levels of CA-125 were measured. In the group of patients with ovarian carcinoma the ultrasonography score was greater than or equal to 10 in 26, while serum CA-125 was greater than or equal to 65 U/ml in 30 and greater than or equal to 35 U/ml in 31. In the group of patients with benign ovarian pathology the ultrasonography score was found to be greater than or equal to 10 in 2, while serum CA-125 was greater than or equal to 65 U/ml in 4 and greater than or equal to 35 U/ml in 20. Fixing 10 as reference value of ultrasonography score for ovarian carcinoma diagnosis, pelvic ultrasonography and a sensitivity of 72.2%, a specificity of 97.9%, a diagnostic accuracy of 89.9%. With a reference value of 65 U/ml CA-125 had a sensitivity of 83.3%, a specificity of 95.2%, a diagnostic accuracy of 91.9%. With a reference value of 35 U/ml CA-125 had a sensitivity of 86.1%, a specificity of 75.9%, a diagnostic accuracy of 79.0%.(ABSTRACT TRUNCATED AT 250 WORDS)

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1988

Factor VIIIR:Ag plasma levels in patients with cervical and ovarian carcinoma.

The Authors measured Factor VIII Related Antigen (FVIIIR:Ag), Factor VIII Coagulant Activity (FVIII:C) and fibrinogen plasma levels in 21 patients with cervical carcinoma and in 14 ones with ovarian carcinoma. In the women with cervical cancer, FVIIIR:Ag was significantly higher than controls only in advanced stages. No significant variation of fibrinogen according to stage and no correlation between FVIIIR:Ag and fibrinogen plasma levels were observed. In the patients with ovarian cancer FVIIIR:Ag was significantly increased in stage III-IV and not significantly in stage I. In these subjects too there was a lack of correlation between FVIIIR:Ag and fibrinogen plasma levels. These results seem to indicate that FVIIIR:Ag increase in advanced stages is due to its major release in circulation resulting from invasion of vascular endothelium and not to an aspecific reactivity. These data could suggest a role of FVIIIR:Ag as an aspecific marker of vascular involvement by cervical and ovarian neoplasms.

Adult↗
PubMed1988

Analysis of failures in patients with cervical carcinoma treated by radical surgery and external pelvic irradiation.

In this paper we examine 68 patients who had undergone radical abdominal hysterectomy according to Wertheim-Meigs for Ib-II cervical carcinoma. Post-surgical stage was T1bN0M0 in 35 patients, T1bN1M0 in 3, T2aN0M0 in 7, T2aN1M0 in 6, T2bN0M0 in 13, T2bN1M0 in 4. All the patients, except 5 with ureteral fistulas, had high energy external pelvic irradiation, reaching a dose of 45 Gy. Up to December 1986, the neoplasia had relapsed in 10 patient (14.7%). According to post-surgical stage we observed 1/38 relapses in T1b patients (2.63%), and 9/30 relapses in T2 ones (30%). Otherwise, we observed 3 relapses in the 55 patients with negative lymph-nodes (5.4%), and 7 recurrences in the 13 patients with histologically proven positive lymph-nodes (53.8%). In these last patients 3/7 relapses were distant (42.8%). Nodes status seems to be the most important prognostic factor in patients with IB-II cervical carcinoma. Since lymph-nodal involvement could be indicative of a systemic spreading of disease, we think that an adjuvant polychemotherapy, in addition to surgery and radiotherapy, could improve the prognosis of patients with positive lymph-nodes.

Adult↗