Biomedical subjects

C Kainz

Publications and source records attributed to C Kainz.

At least 163 records · Page 9Linked to original sources

PubMedDate not supplied

Serum levels of angiogenin (ANG) in invasive cervical cancer and in cervical intraepithelial neoplasia (CIN).

BACKGROUND: The propensity of malignant tumors to increase in size, to invade locally and to metastasize is dependent on angiogenesis, which is induced by a variety of proteins including the family of fibroblast growth factors, vascular endothelial growth factor and angiogenin (ANG). The aim of the present study was to measure the serum levels of ANG in patients with CIN and invasive cervical cancer and to evaluate a possible correlation between ANG and various clinicopathologic parameters. MATERIALS AND METHODS: Blood was collected from 62 patients with invasive cervical cancer and 47 patients with CIN. Serum samples of 30 age-matched healthy women acting as a control group were obtained. Determination of serum levels of ANG was performed using a quantitative human ANG immunoassay. RESULTS: The overall median ANG serum level was 272.0 pg/ml (range 101.6-869.2). The median serum levels of ANG were 248.9 (range 101.6-307.2) for healthy female controls, 246.8 (range 169.7-468.1) for patients with CIN and 308.1 pg/ml (range 180.1-869.2) for patients with invasive cervical cancer. Serum levels of ANG were significantly elevated in patients with invasive cervical cancer compared with patients with CIN (p < 0.05) as well as healthy female controls (p < 0.05). No difference was found between ANG serum levels in women with CIN, and healthy controls (p < 0.05). No correlations were found between serum levels of ANG and clinico-pathologic parameters (p > 0.05). CONCLUSIONS: Our data indicate the important role of ANG in tumor angiogenesis in invasive cervical cancer as ANG serum levels were significantly elevated in these patients. However, elevated ANG serum levels seem to occur only after the transformation from pre-invasive to invasive lesions.

Adenocarcinoma↗

PubMedDate not supplied

Serum levels of CA 125 and TPS during treatment of ovarian cancer.

Two hundred and sixty ovarian cancer patients (including all FIGO stages) were enrolled in a prospective multicentre study. In this interim study we analyzed 206 patients receiving combined chemotherapy for at least 3 courses for two-year overall survival (OS). CA 125 and TPS were applied for monitoring treatment and the relationship between marker levels, marker changes and clinical assessments was established. Preoperative CA 125 or TPS levels were not correlated with OS in FIGO stage I and II patients. After 3 chemotherapy courses the marker levels were not correlated with OS in stage I and II. Partial debulking in stage II patients was a bad prognostic factor. CA 125 or TPS levels (using a CA 125 discrimination level of 25 kU/l and a TPS discrimination level of 100 U/l) after 3 courses of chemotherapy were highly significantly correlated with OS in FIGO stages III and IV patients: CA 125 two-year OS 67% versus 26% (p < 0.0001) and TPS two-year OS 55% versus 22% (p < 0.0001). The prognostic value of CA 125 levels after 3 chemotherapy courses could be further increased by combining CA 125 and TPS levels. When both CA 125 and TPS levels were below their respective discrimination levels, the two-year overall survival was 75%. When both levels were above the discrimination level, the two-year overall survival was only 17%.

Antineoplastic Agents↗

PubMedDate not supplied

Immunohistochemistry in stage FIGO III cervical cancer: prognostic value of tumor associated antigens and intermediate filaments.

The prediction of prognosis in cervical carcinomas solely by histological examination is doubtful. Our study was undertaken to evaluate whether Cytokeratin 5D3, Cytokeratin high molecular weight (HMW), Cytokeratin AE1/AE3, Carcinoembryonic Antigen (CEA) and CA 19.9 could have a prognostic value in primarily irradiated stage FIGO III cervical cancer. We investigated 45 pretreatment punch biopsies of cervical cancer stage FIGO III. All patients underwent a combined standardised primary irradiation treatment. In the cases with expression of Cytokeratin AE1/AE3 survival was significantly better than in cases without expression. The expression of CEA also had a significantly positive effect on survival. The best prognosis was found in cases with coexpression of AE1/AE3 and CEA (Wilcoxon p = 0.006, log-Rank p = 0.03). The other investigated tumor associated antigen and intermediate filaments did not correlate with survival. The application of Cytokeratin AE1/AE3 and CEA allows a prediction of prognosis in patients with stage FIGO III cervical cancer undergoing irradiation treatment.

Adenocarcinoma↗

PubMedDate not supplied

Mutant p53 product in patients with stage III cervical cancer.

Mutations in the p53 gene stimulate cell division. In our study we assessed the prognostic value of mutant p53 overexpression in cervical cancer stage FIGO III detected by immunohistochemistry. In 43 tissue specimens were detected p53 overexpression in 20 cases. Mean survival time was 36.4 (SE +/- 7.66) months in the p53 protein positive group. The group without p53 overexpression showed a mean survival time of 28.6 (SE +/- 3.85) months. p53 protein overexpression had no prognostic value in patients with stage III cervical cancer.

Female↗

PubMedDate not supplied

Squamous cell carcinoma antigen, tumor associated trypsin inhibitor and tissue polypeptide specific antigen in follow up of stage III cervical cancer.

189 clinical and serological examinations were performed in 30 patients before treatment and during follow up of squamous cell cervical cancer stage FIGO III. The serum levels of the tumor markers squamous cell carcinoma antigen (SCC), tumor associated trypsin inhibitor (TATI) and tissue polypeptide specific antigen (TPS) were determined. Sensitivity/specificity for SCC was 63%/91%, TATI 54%/74%, TPS 59%/86% and for a combination of SCC and TPS 81%/77%. In 14 women with recurrence of disease SCC showed lead time effects in seven patients in a time range from three to nine months. SCC was pre-therapeutically elevated in nine cases and showed lead time in five of them. Pretherapeutic TPS serum levels were elevated in seven cases. In all of them lead time effects appeared ranging from three to nine months. TPS never showed lead time effects in patients without elevated pretherapeutic levels. A combination of SCC and TPS in our material provided lead time in 10 of 14 cases.

Adult↗

PubMedDate not supplied

[Effectiveness and tolerance of tramadol with or without an antiemetic and pethidine in obstetric analgesia].

The aim of this prospective, randomised, blind study was to investigate the analgesic potency and tolerance of intramuscular Tramadol compared to a standard obstetric analgesia with Pethidine. Triflupromazine was administrated in combination with the two tested analgesics in order to study its efficacy in alleviating the emetic side effects of the tested analgesics. 66 parturients were randomly assigned to three groups: group A: 100 mg Tramadol (Tramal), group B: 100 mg Tramadol (Tramal) and 10 mg Triflupromazine (Psyquil), group C: 50 mg Pethidine (Alodan) and 10 mg Triflupromazine (Psyquil). No significant differences concerning duration of labour, FHR-alterations, umbilical cord blood gases, respiration pattern and Apgar Scores of the neonate occurred. In all three groups the analgesic effect was equally good. Combination of the analgesic with the antiemetic showed no reduction of the incidence and severity of side effects.

Adult↗

PubMedDate not supplied

Prognostic value of cytokeratins and carcinoembryonic antigen expression in primary surgically treated cervical cancer.

In a previous study we have shown the prognostic value of expression of cytokeratins and carcinoembryonic antigen (CEA) in cervical cancer FIGO stage III. The present study was performed to evaluate the prognostic value of cytokeratins and CEA in patients with cervical primary cancer stage IB to IIB, surgically treated by radical hysterectomy and lymphadenectomy. Seventy-six patients were included in the study. By application of immunohistochemistry we found AE1/AE3 (cytokeratins) expression in 27 (35.5%) cases and CEA expression in 56 (73.7%) cases. Multivariate analysis for the end points of relapse-free survival and overall survival showed that neither AE1/AE3 expression nor CEA expression had a prognostic value in the studied population. In contrast to patients with primary irradiated cervical carcinoma FIGO stage III, patients with primary surgically treated tumors stage IB to IIB showed no significant prognostic value of cytokeratin or CEA expression of the tumor.

Biomarkers, Tumor↗

PubMedDate not supplied

Prognostic value of tumour microvessel density in cancer of the uterine cervix stage IB to IIB.

High intensity of tumour angiogenesis has been correlated with an increased potential of metastasis and poor prognosis in human malignancies. We investigated 43 patients with cervical cancer stages IB (n = 13), IIA (n = 8) and IIB (n = 22). All patients were treated by radical hysterectomy and lymphadenectomy. In the tumour specimen blood vessels were highlighted by staining endothelial cells for factor VIII. Microvessels were counted on a 200x field (0.74 mm2) in the most active areas of neovascularisation. The mean microvessel counts per field for stage IB, IIA and IIB tumours were 59.6 +/- 28.1, 56.3 +/- 24.3 and 55.7 +/- 55.6, respectively (p-value = n.s.). We found no significant correlation of microvessel density and established prognostic factors like pelvic lymph node involvement, vascular space invasion and stromal reaction. Patients with tumours showing low microvessel density (< 40 microvessels per field) had a significantly poorer recurrence-free interval (log-rank test: p-value = 0.01).

Female↗

PubMedDate not supplied

Tissue polypeptide specific antigen and cancer associated serum antigen in the follow-up of ovarian cancer.

420 clinical and serological examinations prior to surgery and during follow-up were performed in 30 patients suffering from ovarian cancer. The population consisted of three FIGO stage Ia, nine stage Ic, four stage II and fourteen stage III cases. Serous carcinoma of the ovary, mucinous carcinoma and other kinds of ovarian cancer were found in 16, 9 and 5 cases, respectively. The serum levels of the tumor markers tissue polypeptide specific antigen (TPS), cancer associated serum antigen (CASA) and carbohydrate antigen 125 (CA 125) were determined. Cut-off values of 97 U/l, 4 U/ml and 35mU/ml for TPS, CASA and CA 125, respectively, were selected according to the 95% of serum concentrations measured in healthy controls. Sensitivity, specificity, PPV and NPV of CA 125 were 75%/96%/69%/92%, respectively. Sensitivity, specificity, PPV and NPV of TPS were 67%/84%/59%/90%, respectively. CASA showed a sensitivity of 58%, specificity of 96% and a PPV and NPV of 73%/94%, respectively. The combination of TPS and CA125 increased the sensitivity to 81%, reaching a specificity of 82% and a PPV and NPV of 58/96%, respectively. The combination of CASA and CA125 showed a sensitivity, specificity, PPV and NPV of 88/85/65/96%, respectively. Twelve patients developed recurrence of disease after response to primary treatment. TPS, CASA and CA 125 detected recurrent disease in six, two and four cases, respectively. For TPS mean lead time was 4.6 months (range 2-18 months), for CASA 1.7 months (range 1-6 months), and for CA 125 3.5 months (range 1-24 months. As a matter of fact TPS never showed lead time effects in patients without elevated pretherapeutic levels. A combination of all makers showed a mean lead time of 6.72 months. Detection of recurrent disease by CA 125 is improved when CA 125 is used in combination with TPS, especially in those patients with pretherapeutically elevated TPS serum levels.

Biomarkers, Tumor↗

PubMedDate not supplied

Infiltrating lobular breast carcinoma: detection of occult regional lymph node metastasis by immunohistochemistry.

Twenty-two patients primarily operated for infiltrating lobular breast carcinoma (ILC) stage T2 with negative axillary lymph nodes in routine histology were investigated in order to detect occult metastasis in the nodes by immunohistochemistry. After testing a panel of monoclonal antibodies against cytokeratins, AE1/AE3 as the most sensitive marker for ILC cells was selected for the study. The immunohistochemical investigation of the 226 regional lymph nodes showed one case of a tumor cell embolus in the subcapsular sinus. Despite the fact that our routine examination included serial sections of the lymph nodes, an occult micrometastasis could be detected by immunohistochemistry only. As so far no significant prognostic value of micrometastasis to axillary lymph nodes of ILC has been shown, at the moment the clinical impact of the detection of micrometastasis is limited. Immunohistochemical methods do not appear to be an improvement for clinical decisions if careful histological examination of serial sections of lymph nodes in ILC is carried out.

Antibodies, Monoclonal↗

PubMedDate not supplied

[Morbidity and mortality of retarded and normal weight premature infants].

Differences of fetal outcome between appropriate for gestational age (AGA) and small for gestational age (SGA) preterm newborns with birth weight below 2500 g and gestational age ranging from 27 to 36 weeks have been evaluated. As described by Rohrer SGA have been divided into symmetrical retarded and asymmetrical retarded newborns using ponderal index. Therefore distribution of ponderal index on our local population has been analysed. SGA more often had an Apgar score below 6 five minutes post partum (p = 0.01) and their mothers more often announced abuse of nicotine during pregnancy. AGA have been on respiratory ventilation significantly longer than SGA (p = 0.001) and photo therapy because of hyperbilirubinaemia more often had to be performed on AGA (p = 0.02). AGA have spent a longer time at the neonatal intensive care unit than SGA (p = 0.0006). No differences could be found in mortality between AGA and SGA. Preterms with low ponderal index had no different outcome than SGA with normal ponderal index.

Apgar Score↗

PubMedDate not supplied

[Comparison of surface tension with determination of the L/S ratio in amniotic fluid for prediction of fetal lung maturity].

In 83 specimen of amniotic fluid both a dynamic measurement of the surface tension by the Wilhelmy-balance and a determination of the lecithin-sphingomyelin-ratio were performed in 1987-1992 in order to predict a respiratory-distress-syndrome (RDS) of the newborn. 7 cases showed divergent results of both methods. In comparison with the measurement of surface tension by the Wilhelmy-balance, determination of the lecithin/sphingomyelin-ratio showed more false positive results (4:1). Both methods provided false negative results in two cases each. In two cases both methods showed false positive results, with RDS occurring in spite of predicted lung maturity. In our high risk-collective 5 of 83 newborns developed a severe RDS. All of them were delivered by caesarean section. A secondary deficiency of surfactant as a result of fetal hypoxia or acidosis as well as a possible influence of the way of delivery might be responsible for the development of RDS. The Wilhelmy-balance, which can be used as a bed-side-method, provides similar results in the prediction of fetal lung maturity compared to the L/S-ratio.

Amniocentesis↗

PubMedDate not supplied

Vascular space invasion and inflammatory stromal reaction as prognostic factors in patients with surgically treated cervical cancer stage IB to IIB.

We assessed the prognostic value of the local tumor characteristics inflammatory stromal reaction (ISR) and vascular space invasion (VSI) together with established prognostic criteria, in cervical cancer patients. One hundred and forty-two patients with carcinoma of the cervix stage IB to IIB undergoing radical hysterectomy and lymphadenectomy between October 1980 and September 1990 were included in the study. Pelvic lymph node involvement, stage, parametrial involvement, age and histological tumor type were analysed together with VSI and ISR as prognostic factors. The most important prognostic parameters for recurrence-free interval and overall survival in the univariate analysis were pelvic lymph node involvement (P-value < 0.0001/0.0001) and stage (P-value < 0.0001/0.0005). ISR and VSI showed a significant prognostic value for recurrence-free interval (both P-values = 0.0014) and overall survival (ISR: P-value < 0.0001; VSI: P-value = 0.0018). In the multivariate analysis ISR showed an independent prognostic value for overall survival (P-value = 0.03, Relative Risk = 5.4, 95%-confidence interval 1.2-24.5). ISR, reflecting the biological behavior of the tumor, should be considered in the evaluation of prognosis in surgically treated squamous cell carcinoma of the cervix.

Adult↗

PubMedDate not supplied

Infiltrating ductal carcinoma of the breast: extensive intraductal component has no impact on lymph node involvement and survival.

The extensive intraductal component (EIC) in infiltrating ductal carcinoma (IDC) was reported to be a predictor of local recurrence. We investigated the influence of this histopathological parameter on nodal status and overall survival. In 115 patients suffering from an IDC with tumor stage FIGO I and II, 35 were EIC positive. We did not find a correlation with the nodal status. The mean follow up was 73 (+/- 38) months. EIC showed no influence on overall survival. Based on our findings, the presence of EIC is not a criterion for therapeutic decisions in IDC.

Breast Neoplasms↗

PubMedDate not supplied

Basaloid carcinoma and keratinizing squamous cell carcinoma of the vulva: a case of two primary carcinomas.

Basaloid carcinomas of the vulva have been reported to occur mostly in young women and are often associated with Human Papillomavirus (HPV) infection, whereas older women mostly suffer from keratinizing squamous cell carcinomas unassociated with HPV. The rare case of a 75 year old woman coincidentally suffering from a basaloid carcinoma and a keratinizing squamous cell carcinoma of the vulva is reported. With in situ hybridisation, hybrid capture and immunohistochemical methods we searched for HPV and expression of cytokeratin AE1/AE3, cytokeratin HMW and cytokeratin 8, 18, 19. HPV was not found in either of the carcinomas. Cytokeratin HMW showed a focal staining reaction in the keratinizing squamous cell carcinoma and no expression in the basaloid carcinoma. Immunohistochemical staining reaction for cytokeratin AE1/AE3 was found in both tumors with the same staining pattern. Cytokeratin 8, 18, 19 was not detected in either of the two carcinomas.

Aged↗

PubMedDate not supplied

Serum evaluation of basic FGF in breast cancer patients.

Basic fibroblast growth factor (bFGF) is a potent endothelial cell mitogen found in a variety of normal and tumour tissues and is of prognostic relevance in human malignancies such as renal cell carcinoma and leukaemia. This study presents the data of 104 serum samples of 20 patients suffering from breast cancer. Mean serum levels of bFGF in these patients were 13.9 +/- 17. 1 (min 0, max 56.4) pg/ml and 2.4 +/- 5.9 (min 0, max 24.7) pg/ml, respectively (p = 0.01). Basic FGF reached a sensitivity of 61% at a specificity of 87% when applying a cut-off level of 5 pg/ml. A continuous increase of bFGF serum levels before the clinical detection of relapse (lead time) was seen in 3 out of 8 cases with a mean lead time of 4 months. Preoperative serum levels were not of prognostic value and showed no correlation with axillary lymph node metastasis. These preliminary results indicate that, in breast cancer patients, soluble bFGF may be useful in early detection of primary tumours, recurrences and monitoring of therapy.

Adult↗

PubMedDate not supplied

CD-44 is not involved in the metastatic spread of ovarian cancer in vivo.

It has been shown that isoforms of the adhesion molecule CD44 are involved in the metastatic spread of several human malignancies. To determine whether CD44 plays a role in metastasis of human ovarian cancer, the tumours and corresponding metastases of 28 patients were investigated. CD44 was detected by immunohistochemistry in 2 primary tumours (7.1%) and 3 metastases (10.7%). In no case did both the primary tumour and metastasis show CD44 expression simultaneously. The results presented here suggest that CD44 does not play a crucial role in the metastatic spread of human ovarian cancer.

Adult↗

PubMedDate not supplied

Expression of the adhesion molecule CD44v3 is a prognostic factor in vulvar carcinoma.

Our aim was to evaluate the prognostic value of CD44v3 overexpression in vulvar cancer patients. Twenty-five cases of squamous cell carcinoma of the vulva with International Federation of Gynecology and Obstetrics (FIGO) stages I to III were examined for overexpression of the CD44 isoform CD44v3. The correlation of CD44v3 overexpression with clinical stage, histologic grade and overall survival was investigated. Follow-up ranged from 36 to 120 months. Clinical stage and histologic grade did not correlate with CD44v3 overexpression. CD44v3 overexpression was associated with poorer overall survival (log rank: P < 0.03). Immunohistochemically detected CD44v3 overexpression is significantly correlated with a reduced overall survival rate for patients with vulvar carcinoma.

Adult↗