Biomedical subjects

E Alhava

Publications and source records attributed to E Alhava.

At least 217 records · Page 12Linked to original sources

PubMedDate not supplied

Clinical value of serum tumour markers CEA, CA 50 and CA 242 in the distinction between malignant versus benign diseases causing jaundice and cholestasis; results from a prospective study.

A prospective study of 113 patients with jaundice and 20 patients with unjaundiced cholestasis was carried out to evaluate the value of serum tumour markers, carcinoembryonic antigen (CEA) and monoclonal antibodies CA 50 and CA 242, in the distinction between benign and malignant diseases causing jaundice and/or cholestasis. In the patients with malignant disease (n = 37) the serum values of all tumour markers were significantly higher than in the patients with benign disease (n = 96). The sensitivities of CEA, CA 50 and CA 242 in detecting malignancy were 70.2%, 94.5% and 56.7%, respectively, while the specificities were 57.2%, 33.3% and 77.0%, respectively. Serum alkaline phosphatase and bilirubin levels had a high positive correlation with CA 50, and CA 242 correlated positively with serum bilirubin levels. No correlation was seen between CEA and alkaline phosphatase or bilirubin levels. The CEA, CA 50 and CA 242 tests may be used as useful complements to other investigative methods in the distinction between benign and malignant causes of jaundice and/or cholestasis. In particular, the rather high specificity of the CA 242 test for malignant diseases seems promising.

Acute Disease↗

PubMedDate not supplied

Diagnostic accuracy of ultrasound, computed tomography and endoscopic retrograde cholangiopancreatography in the detection of pancreatic cancer in patients with jaundice or cholestasis.

A prospective study of jaundiced and/or cholestatic patients (N = 220) was carried out to evaluate the diagnostic accuracy of ultrasound (US), computed tomography (CT) and endoscopic retrograde cholangiopancreatography (ERCP) in the detection of pancreatic cancer. Thirty-one patients had the final diagnosis of pancreatic cancer and two patients had a cancer of the papilla of Vater. The sensitivities of US, CT and ERCP were 60%, 97%, 89% and specificities were 92%, 92%, 94%, respectively. The differences in sensitivity between US and other methods were statistically significant (US vs. CT p less than 0.01, US vs. ERCP p less than 0.05). In US studies, most false negative results were caused by unsatisfying visualization. On the basis of this study, we recommend CT as a diagnostic test of pancreatic cancer, if pancreatic cancer is suspected as a cause of jaundice and/or cholestasis.

Aged↗

PubMedDate not supplied

A decision support system for predicting a recurrence of breast cancer; a prospective study of serum tumour markers TAG 12, CA 15-3 and MCA.

The aim of the present study was to evaluate the clinical value of the preoperative serum tumour markers TAG 12, CA 15-3 and MCA in predicting a recurrence of breast cancer patients. The sensitivity of the TAG 12 test was 54%, that of the CA 15-3 test 15% and that of the MCA test 15% in predicting a recurrence of breast cancer. The most important predictor of breast cancer recurrence was TAG 12. In order to evaluate the contributions of different tumour marker serum test, a stepwise discriminant analysis was carried out. The discriminant function (DF) is DF = TAG 12 x 0.061 - CA 15-3 x 0.1336 - 0.396. The sensitivity of the DF in detecting recurrence of breast cancer was 63% with a specificity of 90% and an efficiency of 75%. In conclusion, the results indicate that a new tumour marker TAG 12 is superior to CA 15-3 and MCA in predicting breast cancer recurrence. In this study the discriminant function including TAG 12 and CA 15-3 was superior to single preoperative tumour marker tests. The results speak for the use of a decision support system to aid in predicting a recurrence of breast cancer.

Antigens, Neoplasm↗

PubMedDate not supplied

Clinical, histological and quantitative prognostic factors in cutaneous malignant melanoma.

A retrospective study including 55 cutaneous melanoma patients with 9.5 years follow-up was carried out to assess the significance of various prognostic factors. The histological samples were evaluated according to Clark's and Breslow's classifications and six nuclear features were measured by interactive morphometry. Mitotic activity was assessed by two different methods: mitotic activity index (MAI) and volume corrected mitotic index (M/V index). The overall disease-related five-year survival of patients was 76.4%. TNM stage (p = 0.0001), sex (p = 0.0024), M/V index (p = 0.003), standard deviation of nuclear form factor (p = 0.023), MAI (p = 0.02), shortest nuclear axis (p = 0.023) and Breslow's classification (p = 0.044) predicted survival in univariate analysis. A multivariate analysis including clinical, histological and morphometric features pointed the Clark's classification as the most important predictor of survival (p = 0.002), while the other variables included had no independent prognostic value. The prognostic importance of mitotic indices and morphometric features is clearly a subject for further studies in superficial melanomas.

Female↗

PubMedDate not supplied

Breast cancer in young women: clinical, histological and morphometric prognostic factors.

Clinical features, 8 histological features, 7 nuclear morphometric variables and 2 mitotic indices were entered in a univariate and in a multivariate survival analysis to assess their independent predictive value in 56 breast cancer patients under the age of 40 years who were followed up for over 10 years. The most important predictor of recurrence-free survival (RFS) in univariate analysis was the SD of nuclear perimetry (p = 0.003) followed by SD of nuclear area (p = 0.006), M/V index (p = 0.036), pN status (p = 0.046), nuclear area of 10 largest nuclei (p = 0.07), nuclear perimetry (p = 0.09) and nuclear area (p = 0.09) in that order. In pN(-) patients, SDPE (p = 0.04), SDNA (p = 0.07) and NA10 (p = 0.07) predicted RFS. In pN+ patients the most important predictor of RFS was the SDNA (p = 0.001) followed by NA 10 (p = 0.003), SDPE (p = 0.009), PE (p = 0.01), NA (p = 0.01) and Dmin (shortest diameter) (p = 0.04). In multivariate analysis the pN-status independently predicted RFS. Tumour size (p = 0.001), pN status (p = 0.002) and M/V-index (p = 0.079) were related to BS (breast cancer survival). In pN-patients, NA 10 (p = 0.097) predicted BS, whereas in pN+ tumours tumour size (p = 0.06) was the most important predictor of BS. In a multivariate analysis, tumour size (p = 0.02) and pN-status (p = 0.016) were independent predictors of BS.

Adult↗

PubMedDate not supplied

The value of clinical assessment in the diagnosis of icterus and cholestasis.

We studied the reliability of the clinical assessment and the discriminatory value of different symptoms and signs in diagnosing obstructive and non-obstructive diseases causing icterus and/or cholestasis. During a period of two-and-a-half years, clinical assessment done by both physicians-in-training and by senior physicians was completed for 266 patients, and the usefulness of different symptoms and signs was tested in 220 of these. Clinical assessment was found to be a reliable method in distinguishing between obstructive and non-obstructive conditions causing icterus, with the sensitivity of 92% and specificity of 86%. In cases of anicteric cholestasis, the sensitivity and specificity of clinical assessment were 74% and 80%, respectively. Abdominal pain and abdominal tenderness were significantly (p less than 0.01) associated with obstructive diseases, whereas an enlarged liver, fever and excessive consumption of alcohol were associated with non-obstructive diseases (p less than 0.01, p less than 0.05, p less than 0.05, respectively). Itching, vomiting, intolerance to fatty foods, previous cholecystectomy, abdominal tumour and clinical icterus had no discriminatory value. Clinical evaluation is a reliable method in the diagnostic workup of a patient with icterus or anicteric cholestasis, and it is still of crucial importance in directing further investigations.

Cholestasis↗

PubMedDate not supplied

Comparison of tumour markers TAG 12 with CA 15-3 and MCA in breast cancer diagnosis.

The aim of the present study was to evaluate the clinical value of the new tumour marker TAG 12 in sera from patients with breast cancer (n = 123), patients with benign breast disease (n = 30) and normal controls (n = 38). The results for TAG 12 were compared with those for CA 15-3 and MCA. The cut-off levels (90% specificity) determined for each test in the benign and control groups were 57.5 kU/1 for TAG 12, 24.8 kU/1 for CA 15-3 and 11.8 kU/1 for MCA. The diagnostic sensitivity of the TAG 12 test was 0.30, 0.19 for CA 15-3 test and 0.20 for MCA test in detecting breast cancer. TAG 12, CA 15-3 and MCA tests were tested in a multivariate analysis to find the best combination of independent predictors of breast cancer. The most important predictor of breast cancer was TAG 12. In order to evaluate the contributions of different tumour marker serum tests a stepwise discriminant analysis was carried out. The discriminant function is DF = TAG 12 x 0.0349 + CA 15-3 x 0.0568 + MCA x (-0.33) - 0.53. The sensitivity of the DF in detecting breast cancer was 31% with a specificity of 91% and a efficiency of 52%. The correlation coefficient in breast cancer patients between TAG 12 and CA15-3 measurements was 0.95, and 0.90 between TAG 12 and MCA measurements. In conclusion, the results indicate that TAG 12, CA 15-3 and MCA have only limited value in the diagnosis of breast cancer, but their role in monitoring and follow up of breast cancer patients is a subject for further investigation.

Adult↗

PubMedDate not supplied

The significance of nuclear morphometric variables as prognostic predictors in breast cancer.

The preoperative biopsies from primary breast carcinomas of 504 women were subjected to interactive morphometric analysis of a) the mean nuclear area (NA), b) standard deviation of nuclear area (SDNA), c) mean area of the 10 largest nuclei (NAl0), d) nuclear perimeter (PE), e) standard deviation of nuclear perimeter (SPDE), f) largest nuclear diameter (Dmax) and g) shortest nuclear diameter (Dmin), h) histological grade and i) classical prognostic variables. The above data were correlated with the disease outcome during the mean follow-up period of 11.2 years. Tumor size (p less than 0.0001), morphometric variables (p = 0.0001-0.005) and histological grade (p = 0.03) predicted axillary lymph node metastasis at the time of diagnosis. According to multivariate analysis, tumour size and NA predicted the axillary lymph node metastasis independently. Axillary lymph node status (p less than 0.0001) and histological grade (p = 0.01) predicted the tumour recurrence and recurrence-free survival, whereas the morphometric variables had no significant predictive value. Axillary lymph node status (p less than 0.0001), tumour size (p less than 0.0001), histological grade (p = 0.0012) and morphometric variables (p = 0.003-0.035) predicted the disease-related survival. Of the morphometric variables, NA and the Dmin were the two most important predictors of tumour-related survival in univariate analysis. Dmax had independent prognostic information in multivariate survival analysis. In the same analysis, tumour size and axillary lymph node status were more important predictors. In conclusion, the morphometric variables analysed have independent predictive value in female breast cancer. Their value is, however, inferior to that of the tumour size and axillary lymph node status, but equal to that of the histological grade.

Biopsy↗

PubMedDate not supplied

Hormone receptor status and mitotic activity as risk factors for recurrence and death in female breast carcinoma.

The estrogen (ER) and progesterone (PR) receptor status, volume corrected mitotic index (M/V index) and other classical prognostic factors were related to disease outcome in a series of 281 women with breast cancer followed up for over 8 years. The M/V index predicted recurrence only in ER+ or PR+ patients (p = 0.002-0.006). Similarly, the recurrence-free survival was related to M/V index only in ER+ (p = 0.0005) or PR+ (p less than 0.0001) patients. In survival analysis, ER+ (p = 0.0037) and PR+ (p less than 0.0001) patients were accurately divided into different prognostic groups by the M/V index, whereas in ER- and in PR-tumours the M/V index had only suggestive predictive value (p = 0.06-0.5). In N-tumours the M/V index predicted recurrence-free survival only in ER+ (p = 0.0228) and in PR+ (p = 0.0087) tumours. In survival analysis of N-tumours, the M/V index predicted cancer-related survival in ER+ (p = 0.0102) and in PR+ (p = 0.0014) tumours. In ER-/PR-, N-tumours, none of the variables tested had any prognostic value. The present results suggest that adjuvant hormone treatment might be indicated in ER+ or PR+ tumours with a M/V index greater than 10, regardless of the axillary lymph node status. The prognosis of ER+ or PR+ tumours with a M/V index less than 10 is favourable, the risk of recurrence being of the order of 15% only during the 10-year follow-up. Thus, the expensive and distressing adjuvant treatments could be omitted for these women with an inherently favourable disease outcome.

Breast Neoplasms↗

PubMedDate not supplied

Expression of C-242 antigen in pancreatic ductal adenocarcinoma.

This investigation was undertaken in order to analyse the expression of tumor associated antigen CA 242 in normal pancreas, in chronic pancreatitis and in pancreatic ductal adenocarcinoma, and to find out if the expression of CA 242 in carcinoma specimens would have prognostic significance. The expression of CA 242 was examined in the tissue specimens by the avidin-biotin-immunoperoxidase technique. According to our results, normal pancreas showed no or only weak staining for CA 242, whereas chronic pancreatitis samples stained somewhat intensely. Five out of 39 adenocarcinomas were negative for CA 242, 5 showed weak staining and 29 showed intermediate or intense staining. Positive staining was found mostly in the ductal cells as well as in intraluminal contents. We found no statistically significant difference of CA 242 expression between different grades. The staining intensity and survival had no clear statistical correlation but all carcinoma patients whose survival time was more than twelve months showed an intense staining for CA 242. The results suggests that the expression of tumour associated antigen CA 242 may have prognostic significance in pancreatic adenocarcinoma.

Antigens, Tumor-Associated, Carbohydrate↗

PubMedDate not supplied

A prospective study on the value of ultrasound, computed tomography and endoscopic retrograde cholangiopancreatography in the diagnosis of unjaundiced cholestasis.

The purpose of this study was to investigate the diagnostic accuracy of ultrasound (US), computed tomography (CT) and endoscopic retrograde cholangiopancreatography (ERCP) in the distinction between extrahepatic and intrahepatic causes of unjaundiced cholestasis. Moreover, attention was paid to the ability of these methods to distinguish between benign and malignant causes of obstruction. The inclusion criteria of laboratory values suggesting cholestasis were serum alkaline phosphatase 350 U/l and gammaglutamyl transpeptidase 100 U/l or liver-specific alkaline phosphatase elevated. The diagnostic value of the imaging methods was tested in 33 patients. The most common cause of unjaundiced obstruction was choledochal stone disease. The diagnostic sensitivities of US, CT and ERCP for the detection of extrahepatic cholestasis were 53%, 53% and 79%, respectively. In patients on whom all three imaging studies were done (n = 20), the difference between US and ERCP was statistically significant (p > 0.05). The specificities of US, CT and ERCP were 100%, 86% and 90%, respectively. CT was better than US in defining the benign nature of obstruction, but ERCP was superior in this respect. In malignant obstructions CT was comparable to ERCP. In conclusion, ERCP seems to be considerably sensitive for the detection of extrahepatic obstruction in cases of unjaundiced cholestasis, whereas US and CT are rather insensitive. The specificity of all these imaging methods is high. The results are in favour of CT as the best noninvasive investigation method, and also indicate the important role of ERCP. However, in many cases all three imaging methods are needed, and a flexible and complementary use of them is recommended.

Carcinoma, Papillary↗

PubMedDate not supplied

Clinical value of serum tumour markers TPA, TPS, TAG 12, CA 15-3 and MCA in breast cancer diagnosis; results from a prospective study.

The aim of this study was to assess the clinical value of five serum tumour markers, TPA, TPS, TAG 12, CA 15-3 and MCA, in the diagnosis of breast cancer. The serum values were measured in a prospective series of patients with breast cancer (n = 82) and benign breast disease (n = 25). The cut-off levels (90% specificity) determined for each test were 109.0 U/1 for TPA, 156.0 U/1 for TPS, 52.5 kU/1 cut-off level for TAG 12 and 24.9 kU/1 cut-off level for CA 15-3, and at the 12.0 kU/1 cut-off level for MCA. Using these cut-off levels the diagnostic sensitivity of the TPA test was 0.23, for the TPS test 0.15, 0.44 for the TAG 12 test, 0.13 for the CA 15-3 test and 0.10 for the MCA test in detecting breast cancer. When the cut-off levels were determined at 95th percentile level for each test, the cut-off level for TPA was 143.0 U/1, 279.0 U/1 cut-off level for TPS, 105.0 kU/1 cut-off level for TAG 12 and 36.7 kU/1 cut-off level for CA 15.3, and at the 15.3 kU/1 cut-off level for MCA. Using these cut-off levels the diagnostic sensitivity of the TPA test was 0.12, 0.01 for the TPS test, 0.06 for the TAG 12 test, 0.06 for the CA 15-3 test and 0.06 for the MCA test in detecting breast cancer. The correlation coefficients in breast cancer patients between TPA and TPS measurements was 0.82, between TPA and TAG 12 measurements it was 0.09, between TPA and CA 15-3 measurements it was 0.08, and 0.11 between TPA and MCA measurements. None of the serum markers studied were significant predictors in breast cancer diagnosis in a logistic regression analysis or in the discriminant analysis. Thus it seems that TPA, TPS, TAG 12, CA 15-3 and MCA have only limited value in breast cancer diagnosis, but their role in the follow-up and prediction of prognosis of breast cancer patients is a subject for further investigation.

Aged↗

PubMedDate not supplied

Tumor vascularity and basement membrane structure as prognostic factors in T1-2MO prostatic adenocarcinoma.

The basement membrane (BM) structure and vascular density (VD) were analysed using collagen IV immunostaining in a series of 88 T1-2MO prostatic adenocarcinomas. The results were correlated with the established prognostic factors and patient survival based on a follow-up of > 11 years. Prostatic cancer cells retained their capacity to synthesize BM components, although defects in the BM structures were associated with T2 category and high Gleason score. Progression of the tumours was related to the defects in BM continuity, and defective BMs were also a sign of poor outcome. High grade tumours were occupied by dense vascular network and dense VD was a sign of a poor outcome. Gleason score was a significant predictor of progression and patient survival, as was the T-category. Multivariate analysis of the prognostic factors indicated that Gleason score included all the available independent prognostic information. The results show that all prostatic adenocarcinomas continue to synthesize BM components, although the structure and continuity is disturbed in poorly differentiated tumours. A rich vascular network is a sign of highly malignant phenotype in prostatic adenocarcinoma. However, an assessment of the BM and VD is of limited independent prognostic value.

Adenocarcinoma↗

PubMedDate not supplied

Clinical evaluation of serum tumour markers CEA, CA 50 and CA 242 in colorectal cancer.

The aim of the present prospective study was to evaluate the clinical value ol serum tumour markers CEA, CA 50 and CA 242 in patients with colorectal cancer (n = 138) and patients with benign gastrointestinal disease (n = 104). The cutoff levels (90% specificity) determined for each test were 2.5 ng/ml for CEA, 17 U/ml for CA 50 and 17 U/ml for CA 242. The diagnostic sensitivity of the CEA test was 0.63, that of the CA 50 test was 0.30 and 0.30 for the CA 242 test in detecting colorectal cancer. CEA, CA 50 and CA 242 tests were tested in a multivariate analysis to find the best combination of independent predictors of colorectal cancer. The most important predictor of colorectal cancer was CEA followed by CA 242. In order to calculate the contributions of tumour marker tests, a diagnostic score (DS) was developed. The sensitivity of the DS in detecting colorectal cancer was 0.47 with a specificity of 0.88 and an efficiency of 0.67. On the basis of this study, serum CEA and CA 242 seem to possess diagnostic value in preoperative evaluation of patients with colorectal cancer.

Adult↗

PubMedDate not supplied

Sapphire probe versus bare fiber in interstitial laser hyperthermia (ILH). An experimental study with Wistar rats.

The aim of this study was to compare the effects of a bare laser fiber and a contact sapphire probe on normal Wistar rat liver in interstitial laser hyperthermia (ILH). We used two different powers (1W and 2W) and eight different exposure times (50s to 900s). The livers were examined after 3 days and in the long-term follow-up group after 2 months. The greatest necrotic lesions were achieved with 600-900J energy (2W, 300-450s) using a bare laser fiber. The diameter of the necrotic lesions plateaued with 2W power setting after 300J energy. Generally, necrotic lesions were greater using a bare fiber than a sapphire probe with equal energy levels. The lesions healed by granulation and fibrosis. No scars or necrotic lesions were found 2 months after treatment when a 1W power setting was used, whereas a power of 2W caused a clear scar in the rat liver. ILH treatment caused necrosis safely and the bare fiber produced a greater necrotic area than the sapphire probe.

Animals↗

PubMedDate not supplied

The value of combined use of serum tumour markers and nuclear magnetic spectroscopy of plasma in the detection of pancreatic cancer among patients with jaundice or cholestasis: results from a prospective study.

We studied a combined utilization of serum tumour markers and proton nuclear magnetic resonance 1H NMR spectroscopy of plasma in the detection of pancreatic cancer. Serum concentrations of carcinoembryonic antigen (CEA), carboanhydrate antigens CA 50 and CA 242, and 1H NMR spectra of plasma were determined in a series of 51 patients, of whom 25 had malignant and 26 benign hepatopancreatobiliary disorder. The measurements in 1H NMR spectra were performed both manually and by computed technique, and both methylene (CH2) and methyl (CH3) peaks were evaluated. In the patients with pancreatic cancer (n = 17, including two cases of cancer of the papilla of Vater), the mean serum values of all tumour markers were significantly (p = 0.001) higher than in the patients with benign disease. The diagnostic sensitivity of the tumour markers alone reached 82-100% with a specificity of 35-82%. In the 1H NMR spectra of sera, the mean linewidth of the CH3-peak both in the manual and computed measurement was significantly narrower in the patients with pancreatic cancer than in the benign disease group. Using the cut-off level of 33 Hz, the sensitivity and specificity of 1H NMR alone was in the manual measurement 53% and 76%, respectively, while in the computed measurement the corresponding figures were 94% and 20%. When the serum tumour markers and 1H NMR spectroscopy were evaluated as combinations, both in the manual and computed measurements the specificities and positive likelihood ratios were clearly better than those of the tumour markers alone, but efficiencies improved only slightly. The results suggest that the combined use of tumour marker tests and 1H NMR of plasma gives only slightly improved accuracy in the diagnosis of pancreatic cancer.

Adolescent↗

PubMedDate not supplied

Ag-NORs related to flow cytometry, morphometry and prognosis in patients with pancreatic cancer.

The number of silver stained nucleolar organiser regions (Ag-NORs) was enumerated in the biopsy specimens of 73 patients with human pancreatic adenocarcinoma. The number of Ag-NORs was related to histological features, S-phase fraction (SPF), DNA ploidy, morphometric nuclear features, clinical stage and survival. Grade I tumours had on average fewer Ag-NORs (mean +/- SD, 5.2 +/- 2.0) than grade II (mean +/- SD, 5.9 +/- 1.6) or grade III (mean +/- SD, 6.6 +/- 2.6) tumours. Patients with low SPF (0-7%) values had lower mean Ag-NORs counts (5.7 +/- 1.0) than patients with a high SPF (7%) (6.6 +/- 2.0) (p = 0.05) and the number of Ag-NORs was related almost significantly to mitotic index (p = 0.09). The Ag-NORs were not related significantly to DNA ploidy or to clinical stage. In survival analysis the number of Ag-NORs predicted prognosis significantly (p = 0.03). From the results we conclude that Ag-NORs are related to several malignant features in human pancreatic adenocarcinoma and that the number of Ag-NORs predicts survival.

Adenocarcinoma↗

PubMedDate not supplied

Small intestinal mucin antigen (SIMA); a novel tumour marker in colorectal cancer?

The aim of the present prospective study was to evaluate the clinical value of a new serum tumour marker small intestinal mucin antigen (SIMA) in the diagnosis of colorectal cancer. The serum SIMA values were measured in a prospective series of patients with colorectal cancer (n = 73) and patients with benign gastrointestinal disease (n = 87). SIMA values were determined using two different techniques. The cut-off levels (90 % specificity) determined for each test were 12.0 U/ml for SIMA I (Delphia), 9.8 U/ml for SIMA II (PCA-Delphia), 2.5 ng/ml for CEA, 17 U/ml for CA 50 and 17 U/ml for CA 242. The diagnostic sensitivity of the SIMA I test was 0.27, of the SIMA II test it was 0.19, of the CEA test it was 0.63, of the CA 50 test it was 0.30 and 0.30 for the CA 242 test in detecting colorectal cancer. The correlation coefficients (Pearson's r) in colorectal cancer patients between SIMA I and SIMA II measurements were 0.99, 0.71 between CEA and CA 50, 0.70 between CEA and CA 242 and 0.96 between CA 50 and CA 242 measurements. The correlation coefficients in colorectal cancer patients between other serum markers were non-significant. All marker tests were entered in a multivariate analysis to find the best combination of independent predictors of colorectal cancer. The most important predictor of colorectal cancer was SIMA I. In order to calculate the contributions of tumour marker tests, a diagnostic score (DS) was developed. The sensitivity of the DS in detecting colorectal cancer was 0.33 with a specificity of 0.90 and an efficiency of 0.65. In conclusion, the results indicate that the diagnostic sensitivity of a new tumour marker SIMA is equal to CA50 and CA 242, but inferior to the diagnostic sensitivity of the CEA test. However, multivariate discriminant analysis suggests some diagnostic value for SIMA I test because of its independent discriminant value.

Adult↗