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Biomedical subjects

A Ruibal

Publications and source records attributed to A Ruibal.

At least 217 records · Page 12Linked to original sources
PubMedDate not supplied

Preoperative CEA and TAG-72 serum levels as prognostic indicators in resectable gastric carcinoma.

We evaluated in 74 patients with resectable primary gastric carcinoma, the prognostic value of the preoperative circulating serum levels of CEA and TAG-72. Serum levels of CEA were above the cutoff level of 6 ng/ml in 18.9% of patients; TAG-72 levels were higher than 6 U/ml in 31% of patients. Pretreatment mean CEA levels were significantly lower (p < 0.01) in patients with stage I tumors (2.9 +/- 0.3 ng/ml) than in those with more advanced tumors (stage II: 14.5 +/- 6.8 ng/ml; stage III-IV: 6.8 +/- 1.5 ng/ml). Similarly, significant differences in mean TAG-72 serum levels were found between stage I (3.5 +/- 1.8 U/ml) and stage II and stage III-IV (30.4 +/- 20.7 U/ml and 26.1 +/- 9.7 U/ml, respectively) (p < 0.05). In addition, TAG-72 levels were also higher in poorly differentiated and moderately differentiated tumors (38.5 +/- 20.1 U/ml and 23.1 +/- 9.4 U/ml, respectively) than in well differentiated tumors (4.4 +/- 0.9 U/ml) (p < 0.05). The results further indicated that high preoperative serum levels of CEA predicted shorter relapse-free survival duration (p < 0.01), and that high TAG-72 levels were associated with shorter relapse-free and overall survival (p < 0.0001 and p < 0.0005, respectively). In addition, separate Cox multivariate analysis showed that preoperative TAG-72 was, after stage, the strongest factor to predict both relapse-free and overall survival (p < 0.0001 and p < 0.005, respectively) in patients with gastric cancer.

Adenocarcinoma↗
PubMedDate not supplied

Clinical significance of preoperative serum levels of CA 125 and TAG-72 in ovarian carcinoma.

In a prospective study we evaluated in 48 patients with primary ovarian carcinoma the prognostic value of the preoperative circulating serum levels of CA 125 and TAG-72. Serum levels of CA 125 were above the cutoff level of 35 U/ml in 68% of patients, TAG-72 levels were higher than 6 U/ml in 50% of patients, while the simultaneous use of the two markers increased the sensitivity to 75%. Pretreatment CA 125 and TAG-72 levels were significantly lower (p < 0.05, for both) in patients with well differentiated tumors than in those with moderate or poor differentiation. Similarly, both marker levels were significantly higher (p < 0.001) in patients with residual disease after cytoreductive surgery than in those with no residual tumor. In addition, the CA 125 levels were also higher in initial stages (I-II) than in more advanced stages (III-IV) (p < 0.05), whereas TAG-72 levels were higher (p < 0.05) in patients with mucinous or endometrioid tumors than in those with serous carcinomas. The results further indicated that high preoperative serum levels of CA 125 and TAG-72 were associated with a shorter overall survival (p < 0.001 and p < 0.01, respectively). Finally, separate Cox multivariate analysis showed that preoperative CA 125 and TAG-72 serum levels were, after stage, the strongest factors to predict overall survival (p < 0.0001, p < 0.05 and p < 0.005, respectively) in patients with ovarian carcinoma.

Adult↗
PubMedDate not supplied

Preoperative carbohydrate antigen 195 (CA195) and CEA serum levels as prognostic factors in patients with colorectal cancer.

We evaluated in 214 patients with primary colorectal cancer the prognostic value of the preoperative serum levels of CEA and CA195. For CEA these levels were above the cutoff of 6 ng/ml in 31.3% of patients, whereas for CA195 they were higher than 12 U/ml in 35.9% of patients. The simultaneous use of both antigens increased the sensitivity to 49%, which was significantly higher than that of CEA (p < 0.001) and CA195 (p < 0.01) taken singly. The mean preoperative CEA levels were significantly (p < 0.001) correlated with Dukes' stage only, while there was a significant correlation between preoperative serum levels of CA195 and Dukes' stage (p < 0.001), grade of differentiation (p < 0.01) and tumor location (p < 0.05). The results indicated that high preoperative serum levels of CEA and CA195 were associated with a shorter overall survival (p < 0.0001). In addition, separate Cox multivariate analysis showed that preoperative CA195 was, after Dukes' stage, the strongest factor to predict overall survival (p < 0.0001).

Adult↗
PubMedDate not supplied

Multicenter evaluation of the Elecsys CA 125 II assay.

The technical performance and clinical usefulness of the newly developed Elecsys CA 125 II assay (Boehringer Mannheim) was evaluated in a multicenter study. Imprecision studies were carried out using control sera and human pool sera with CA 125 concentrations from 11 to 1026 U/ml. Within-run CVs between 0.7 to 4.8% (median 1.7%) and between-day CVs between 2.4 to 10.9% (median 5.7%) were found. Method comparison studies with Enzymun-Test CA 125 II carried out in four laboratories yielded slopes between 0.94 to 1.07 and intercepts < 3 U/ml. A good comparability of the Elecsys CA 125 II assay was also found with one MEIA and the Centocor" IRMA. For a second MEIA and a second IRMA the slopes were 1.23 and 1.42, and the corresponding correlation coefficients were 0.987 and 0.977, respectively. The Elecys CA 125 II concentrations are clearly related to the tumor stage of ovarian carcinoma patients. The maximum of diagnostic efficiency of ovarian carcinoma patients compared with patients of benign gynecological diseases is reached at 150 U/ml with a specificity of 93% and a sensitivity of 69%. Follow-up studies of ovarian carcinoma patients reflect the status of the disease and the effect of various therapeutic applications. The technical and clinical evaluation of the Elecsys CA 125 II assay show a superior analytical performance with a broad measuring range up to 5000 U/ml and a short measuring time of 18 minutes.

Biomarkers, Tumor↗
PubMedDate not supplied

Cellular accumulation of uPA-PAI-1 [correction of UPA-PAI-1] and uPA-PAI-2 [correction of UPA-PAI-2] complexes in early (pT1) breast cancer: a new link in the uPA-UPAr-PAI chain.

OBJECTIVE: To investigate the role of uPA in early (pT1) breast cancer. METHODS: Immunohistochemistry (streptavidin-biotin-peroxidase system), using the Chemicon AB776 polyclonal antibody, which reacts with uPA-PA-1 and uPA-PAI-2 complexes, was performed. In addition, CD44std, Ki67, c-erb-B2, p53, ER and PR expression were studied on the same tissue samples by the same method. The results obtained were correlated with nodal invasion, with each other and with classical pathologic features such as histologic and nuclear grade by means of the Spearman test for nonparametric variables. RESULTS: The immunohistochemical reaction with uPA-PAI-1 and uPA-PAI-2 complexes was cytoplasmic and localized inside the tumor cells, with no, or only minimal reaction in the stromal cells. uPA-positivity detected by this method correlated significantly with ER expression (p = 0.031), PR expression (p = 0.030), favorable nuclear grade (p = 0.0087) and marginally with a low proliferation rate (p = 0.088), which was the opposite of the results reported by most other groups when studying either free uPA or uPA bound to its membrane receptor (uPAr) in similar tumors. CONCLUSION: From our results we conclude that uPA-PAI-1 and uPA-PAI-2 complexes are formed inside the tumor cells for the purpose of inactivating free or uPAr-bound uPA, which explains why our findings were the reverse of those obtained when studying these latter forms. A model incorporating our data and the present knowledge on the uPA-uPAr-PAI chain is proposed.

Breast Neoplasms↗
PubMedDate not supplied

Modulation of molecular marker expression by induction chemotherapy in locally advanced breast cancer: correlation with the response to therapy and the expression of MDR1 and LRP.

PURPOSE: To assess if molecular markers are able to predict the response to induction chemotherapy in locally advanced breast cancer, and if any variation in their expression is associated with the degree of axillary lymph node invasion. METHODS: Between 1995 and 1999, 48 patients with locally advanced breast cancer were submitted to induction chemotherapy at Fundación Tejerina--Centro de Patología de la Mama, Madrid, Spain. The patients carried either tumors larger than 5 cm in diameter with clinically positive axillary nodes, T4a or T4b tumors regardless of size, or inflammatory carcinomas. All received between 3 and 6 cycles of CAF standard polychemotherapy (Cyclophosphamide, Doxorubicin and 5-Fluorouracil) with the exception of one patient, who received CMF therapy (Cyclophosphamide, Methotrexate and 5-Fluorouracil), and another one, who received Taxotere-Doxorubicin. After completion of their induction chemotherapy scheme, 1 patient showed a "complete clinical response" (CCR, with disappearance of all clinical and radiological signs of tumor presence), 36 (75.0%) patients showed a "partial response" (PR, > 50%), 10 (20.8%) showed "no response" (NR, < 50%), and finally one progressed under treatment. Core biopsies were performed in all cases prior to treatment for histological diagnosis which allowed for the determination of the following parameters by means of immunohistochemistry: hormone receptors (ER and PR), oncogenes and tumor suppressor genes (c-erb-B2 and p53) and the proliferation marker Ki67. Initial tumor size, histologic and nuclear grade and histologic variety were also included as variables of the study. After chemotherapy, 37 patients were submitted to a rescue mastectomy at our center. The same aforementioned parameters were determined once again on the operative specimen, together with MDR1 expression (using two different antibodies) and LRP expression. As outcome variables, objective response to treatment and the presence of invaded axillary nodes were considered. RESULTS: Only the expression of the proliferation-associated Ki67 antigen, as well as nuclear grade were affected significantly (p < 0.05) by the previous chemotherapeutic treatment. All other studied parameters showed no significant change in expression. More disappointingly, even, none of the studied variables showed any significant power for predicting either an objective response to treatment, or the presence of invaded axillary nodes at surgery. Both outcome end-points were also unrelated to each other. Overexpression of the multidrug-resistance gene or the LRP gene, finally, showed no correlation whatsoever with the previous response to chemotherapy. CONCLUSION: According to these results, the parameters employed by us are of no practical use for predicting the response to treatment or the presence of invaded nodes at rescue surgery in locally advanced breast cancer. Clinical and surgical assessment remain thus the mainstay of treatment for this group of patients.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Tissue polypeptide antigen (TPA) in chronic active hepatitis and mild liver diseases.

Tissue polypeptide antigen (TPA) is a non-specific tumor marker with a broad reactivity. Increases in TPA are also observed in benign liver diseases. We conducted this study to evaluate the usefulness of TPA serum level determination in 15 patients with chronic active hepatitis (CAH) and in 30 patients with mild liver diseases (MLD) diagnosed at the time of evaluation. TPA levels were abnormal in 73.3% of CAH patients and in 40% of MLD patients. CAH patients had significantly higher TPA levels than MLD patients (p = 0.006). There was a significant correlation between TPA and ASAT (r = 0.581 p < 0.00001), suggesting that cytolysis plays an important role in the increase in TPA. A TPA value of twice the normal level will unlikely be due to MLD (specificity 90%). TPA can be used in the clinical characterization of these patients and in the selection of patients for biopsy.

Adolescent↗
PubMedDate not supplied

CA 15.3: early results of a new breast cancer marker.

A new antigen associated with breast cancer, CA 15.3, was determined in the serum of 690 breast cancer patients and controls. After establishing a maximum normal level of 40 U/ml in 140 healthy subjects and 350 patients with benign diseases, CA 15.3 was investigated in 190 breast cancer patients: CA 15.3 serum levels were statistically different in patients with no evidence of disease (20.6 +/- 11.2 U/ml), metastatic patients in response (33.5 +/- 24.0 U/ml) and metastatic patients not responding to therapy (stable disease, 98.9 +/- 50.4; progression, greater than 200). CA 15.3 serum levels seem to correlate with the extent of metastatic breast cancer. Further studies are needed to establish the role of this marker in the management of breast cancer patients.

Antigens, Neoplasm↗