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Biomedical subjects

C J Oon

Publications and source records attributed to C J Oon.

At least 91 records · Page 5Linked to original sources

Comparison of various assays for detection of AFP in differentiating patients with primary hepatocellular carcinoma from controls.

Four assays for the detection of alphafetoprotein (AFP) in the diagnosis of primary hepatocellular carcinoma (HCC) were evaluated. The frequency of AFP detection was compared in 89 HCC patients and in 71 patients with chronic active hepatitis/cirrhosis. Of the four assays, immunodiffusion, counterimmunoelectrophoresis (CIE), supplement CIE, and radioimmunoassay, the best for differentiating patients with HCC from those with chronic active hepatitis and cirrhosis was CIE.

Carcinoma, Hepatocellular↗

HLA antigen in Chinese patients with hepatocellular carcinomas.

One hundred and fourteen Chinese patients with hepatocellular carcinomas (HCC) were studied for alpha-fetoprotein (AFP), hepatitis B surface antigen (HBsAg), anti-HBsAg, and HLA markers. Younger patients with HCC (less than 60 yr old) were more significantly associated with elevated serum AFP (P less than 0.0001) and serum HBsAg (P less than 0.0001) than were older (greater than or equal to 60 yr old) patients. A strong correlation existed between serum AFP and HBsAg among the patients (P less than 0.0001). Of 27 AFP-negative patients, 15 (55.6%) had HLA-B15 compared to 53 of 238 (22.3%) healthy controls (corrected P less than 0.003, relative risk = 4.4). The frequency of HLA-B15 was even higher in the AFP-negative plus HBsAg-negative subgroup (61%). AFP-negative patients also had a significant lack of blood group A.

ABO Blood-Group System↗

The evaluation of tumour marker proteins in the diagnosis of primary hepatocellular carcinoma.

The sera of 122 patients with biopsy confirmed primary hepatocellular carcinoma (PHC) were examined for the presence of alphafoetoprotein (AFP), alpha 1antitrypsin 1 (AAT), alpha 1acidglycoprotein (AGP) 1, gammaglutamyl transpeptidase (GGT), carcinoemryonic antigen (Roche) (CEA) and the "Hepatoma-Liver antigen" H-L Ag). 83% of patients had elevation of AFP of more than 18 ng/ml 7.4% and 15.5% had levels between 19--100 ng/ml and 100-500 ng/ml respectively. Raised AAT, AGP, GGT, CEA and HL Ag were found in many patients with PHC. Grossly elevated AFP were usually diagnostic of PHC. The combination of AAT, AGP, CEA and HL Ag were useful in the diagnosis of AFP negative cases.

Antigens, Neoplasm↗

Primary hepatocellular carcinoma in the Asian Pacific region.

This survey was conducted to obtain current data relating to the epidemiology, aetiological factors, diagnostic tests in use, effect of various treatments and the evaluation of the extent of any population screening procedures. From replies to questionnaires sent to countries in West, South, North, South East Asian and Oceania the data showed that Primary Hepatocellular Carcinoma is common in most areas, but has a lower incidence amongst the non useful method of diagnosis. New biochemical and immunological markers are being studied. Untreated disease seldom survived more than 3 months. Various treatment protocols are being done since about 85% of tumours are non resectible at presentation. A population screening is done in China and on a risk groups in Taiwan and Singapore.

Asia, Southeastern↗

A pilot study on the screening of primary hepatocellular carcinoma in selected high risk groups in the population using multiple tumour markers.

A prospective one year study on groups of 377 high risk individuals was done using alphafoetoprotein (AFP), alpha 1antitrypsin (A1AT), alpha 1-acidglycoprotein 1 (A1GP), gammaglutamyltraspeptidase (GGT) and isocitrate dehydrogenase (ICD) to detect hepatocellular carcinoma (HCC). The high risk groups screened were: cirrhosis, unexplanable hepatomegalies, chronic hepatitis B surface antigen (HBsAg) carrier, family members of afflicted HCC cases, individuals on hormonal therapy and males over the age of 30 years. 58/377 (15%) were found to have HCC. This consisted of 16/43 (37%) clinical cirrhosis, 40/71 (56%) unexplanable hepatomegalies, 1/33 (3%) chronic HBsAg, 1/156 (0.6%) family members. AFP remained the most useful test but the others such as A1AT, A1Gp, GGT and ICD recognised both malignant and asymptomatic nonmalignant diseases. Only 4 (7%) patients had resectible tumours detected and 1 patient was found to have liver dysplasia. HBsAg positivity and persistently raised AFP. The significance of HBsAg amongst family members and other group is discussed in terms of genetic susceptibility, environmental oncogenic vulnerability and ultimate screening.

Adult↗

Adriamycin in the treatment of resectible and irresectible primary hepatocellular carcinoma.

The treatment of 205 patients with primary hepatocellular carcinoma in Singapore from 1975 to 1980 is reviewed. Adriamycin given at a dose of 40 mg/m(2) intravenously every 4 weeks for irresectible tumours achieved a response rate of 32% alone and has significantly prolonged the median survival time to 4 1/2 months (135 days) in these individuals. Despite this response only 1/34 (3%) patient showed complete remission and is alive at 2 1/2 years. Use of other combinations with Adriamycin e.g. 5 Fluorouracil and Vincristine produced a significant response in the first 16 weeks (p < 0.005) but not thereafter, when completed with the historical group. To improve the response and to consolidate this response, split doses of total hepatic irradiation (to a maximum of 3,150 rads) and alternate day administration of intravenous Adriamycin 10 mg (to a maximum of 90 mg) were given. 12/23 patients (50%) responded. This was followed by a four weekly Adriamycin, 5 F.U. and Vincristine. Median survival time was 5 1/2 months (165 days). Relapse occurred in all patients. Similarly in 5 patients who had resections, early recurrences occurred in 3/5 (60%) within 3 months, inspite of postoperative chemotherapy with Adriamycin, 5 F.U., Vincristine and Cyclophosphamide given every four weeks. In view of the high recurrence rate following effective treatment, further studies on the biological behaviour of these abnormal livers is required.

Antineoplastic Agents↗

Primary hepatocellular carcinoma developing in a female patient on long term oral contraceptives--a case report.

The association between hepatic tumours and oestrogen and progestogen therapy is well established. The risk of developing primary hepatocellular carcinoma (PHC) is small. In Africa and Asia where hepatitis B virus (HBV) infections are common, the development of PHC is also high. The presence of Hepatitis B core antibody indicates previous exposure to HBV and carries a risk of developing PHC by more than 34 times of non-infected normal. A Chinese female 29 years who had been on oral oestrogen and progestogen contraceptives continuously for 8 years developed PHC. She had no known illness due to HBV but was found to have concomitantly positive Hepatitis B core antibody in her sera. The presence of this HB core antibody and the long term consumption of oestrogen/progesterone derivatives may have been responsible for the early presentation of PHC in this patient. It is the first report in this country of PHC developing in a pill consumer since the introduction of oral contraceptives a decade ago In view of the prevalence of Hepatitis B in the region, this case finding warrants further study to determine whether (a) there is a higher frequency in pill consumers (b) an earlier age of presentation of hepatic malignancy. Meanwhile, it may be prudent to recommend alternative methods of birth control in individuals known to have been previously exposed to HBV infection, clinically or otherwise.

Adult↗

Changes in serum alpha 1 antitrypsin, alpha1 acid glycoprotein and beta 2 glycoprotein I in patients with malignant hepatocellular carcinoma.

Serum alpha 1 antitrypsin, alpha 1 acid glycoprotein and beta 2 glycoprotein I concentrations were determined in 36 patients with malignant hepatocellularcarcinoma, 30 with cirrhosis and 35 with hepatitis by quantitative immunoelectrophoresis. Serum alpha 1 antitrypsin and alpha 1 acid glycoprotein levels were significantly higher in patients with hepatocellularcarcinoma than in those with cirrhosis (p less than 0.001) or hepatitis (p less than 0.001). Elevated levels of alpha 1 antitrypsin were found in 88.9% of patients with hepatoma compared to 23.3% of patients with cirrhosis and 28.6% of patients with hepatitis. Raised levels of alpha 1 acid glycoprotein were also found in 80.6% of patients with hepatoma compared to 20% of patients with cirrhosis and in only 5.7% of patients with hepatitis. beta 2 glycoprotein I levels were similar in the three conditions and therefore not useful for differential diagnosis. In monitoring the progress of tumor growth alpha 1 antitrypsin and alpha 1 acid glycoprotein levels were found to increase during the growth phase. Measurements of these two glycoproteins are suggested for differential diagnosis of these liver diseases, as tumor markers for the detection of hepatocarcinoma, and for the monitoring of the progress during treatment.

Carcinoma, Hepatocellular↗

Clinical trial of combination chemotherapy and specific active immunotherapy in disseminated melanoma.

Fifty-six patients with disseminated malignant melanoma were randomly allocated to two treatment groups. The first group C received combination chemotherapy consisting of DTIC and ICRF 159. The second group (C+I) received the same chemotherapy but were also immunized with 2 X 10(7) irradiated allogeneic melanoma cells mixed with 50 mug of percutaneous BCG. The survival rates in both treatment groups C and (C+I) were not significantly different, and only minor enhancement of the chemotherapy was found in the (C+I) group. A similar pattern of tissue response was observed in both groups: lymph node, skin and, to some extent liver metastases, respond better than other sites.

Antigens, Neoplasm↗