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Biomedical subjects

J Lundin

Publications and source records attributed to J Lundin.

53 records · Page 3Linked to original sources
PubMed1996

Pre-operative serum levels of CA 242 and CEA predict outcome in colorectal cancer.

The prognostic value of the preoperative serum levels of CA 242 and CEA in patients with colorectal cancer was investigated. The serum concentrations of CA 242 and CEA were determined from preoperative serum samples of 259 patients with colorectal cancer (39 Dukes' A, 100 Dukes' B, 59 Dukes' C and 61 Dukes' D). Survival data of these patients were obtained to the end of 1993. There was a significantly longer survival in patients with a CA 242 level below 20 U/ml compared with patients with an elevated serum level. A difference was seen in overall survival (P < 0.0001), and in Dukes' B (P = 0.016) and Dukes' D (P = 0.009) stages. In Dukes' A and C colorectal cancer, the difference was not significant (P = 0.67 and P = 0.07, respectively). When 5 ng/ml was used as cut-off value for CEA, there was a significant difference in overall survival (P < 0.0001), but not within the different Dukes' stages. The prognosis was considerably worse in patients with concomitant elevation of CA 242 and CEA, compared with the prognosis of patients with normal levels or only one marker elevated (P < 0.0001). When analysing according to stage, a significant difference was seen in Dukes' B (P = 0.0004) and Dukes' C (P = 0.0007) stages. In a multivariate analysis, CA 242 was an independent prognostic factor (P < 0.0001). CEA was also an independent prognostic factor (P = 0.03), but only after exclusion of CA 242. Concomitant rise of CA 242 and CEA was found to be a strong independent prognostic factor (P < 0.0001). This study shows that the pre-operative serum CA 242 level is an independent prognostic factor in patients with colorectal cancer and that the prognosis of patients having a concomitant pre-operative elevation of CA 242 and CEA is poor.

Adult↗
PubMed1996

Independent prognostic value of preoperative serum markers CA 242, specific tissue polypeptide antigen and human chorionic gonadotrophin beta, but not of carcinoembryonic antigen or tissue polypeptide antigen in colorectal cancer.

The prognostic value of preoperative serum concentrations of carcinoembryonic antigen (CEA), CA 242, tissue polypeptide antigen (TPA), specific tissue polypeptide antigen (TPS) and human chorionic gonadotrophin beta (hCG beta) in 251 patients with colorectal cancer (39 Dukes' A, 98 Dukes' B, 56 Dukes' C and 58 Dukes' D) was investigated. When using the cut-off levels recommended for diagnostic purposes, there was a significantly longer overall survival in patients with low tumour marker levels compared with patients with elevated serum levels for all the investigated markers. In Dukes' stage B, C and D CA 242 emerged as a significant predictor of survival, whereas TPA, TPS and hCG beta showed a value only in Dukes' D. Unfortunately, no marker provided prognostic information in Dukes' A. In multivariate analysis, entering the tumour markers as continuous variables, Dukes' stage was the strongest prognostic factor, followed by CA 242. TPS, hCG beta and localisation of the tumour were also independent prognostic factors, whereas age, gender, CEA and TPA were not.

Adult↗
PubMed1995

A prognostic value of CA 19-9 but not of CEA in patients with gastric cancer.

The diagnostic and prognostic value of tumour markers CEA and CA 19-9 was studied in patients with gastric cancer. Pre-operative serum concentrations of CEA and CA 19-9 were determined in 100 gastric cancer patients and in 77 patients with relevant benign diseases. The sensitivity of both CEA (cut-off level 3 ng/ml) and CA 19-9 (cut-off level 37 U/ml) for gastric cancer was 30%. The specificities were 73% and 87%, respectively. There was a significant difference in prognosis, for both CEA (cut-off level 3 ng/ml, P < 0.05) and CA 19-9 (cut-off level 37 U/ml, P < 0.01), between patients with high vs low pre-operative serum levels. The overall 5-year survival was 26% and that of patients with low marker levels was 30% (CEA) and 35% (CA 19-9) compared with 15% (CEA) and 0% (CA 19-9) for patients with high marker levels. To evaluate whether the high vs low serum marker level was an independent prognostic factor, the patients were compared within the same stage of disease. There was still a significant difference in 5-year survival in stages II, III and IV between patients with high vs low pre-operative serum levels for CA 19-9 (P < 0.05), but not for CEA. In stage I, no differences in survival could be found for either marker. In conclusion, high pre-operative serum levels of CEA seem to predict higher stage of disease, whereas CA 19-9 might have an independent prognostic value in patients within the stage of II, III or IV gastric cancer. The diagnostic value of both CEA and CA 19-9 is limited.

Adult↗
PubMed1994

CA 242, a new tumour marker for pancreatic cancer: a comparison with CA 19-9, CA 50 and CEA.

The serum expression of a novel tumour marker, CA 242, defined by monoclonal antibody C 242, was studied in 179 patients with pancreatic cancer. The results were compared with CA 19-9, CA 50 and CEA. CA 242 is a carbohydrate closely related, but not identical, to CA 19-9 and CA 50. The overall sensitivity of the CA 242 assay was 74%: 55% in stage I, 83% in stage II-III and 78% in stage IV disease. The specificity calculated from 112 patients with benign diseases was 91%. CA 19-9 had a higher sensitivity of 83%, but the specificity was only 81%. When comparing the markers by receiver operating characteristic analysis, the sensitivities were almost identical at all specificity levels. The CA 242 level was elevated in 7%, 15% and 7% of patients with benign pancreatic, biliary and liver disease respectively. The corresponding figures for CA 19-9 were 19%, 28% and 15% respectively. The sensitivity of CA 242 was higher than that of CA 50 and CEA at all specificity levels. In conclusion, tumour marker CA 242 seems to be a useful diagnostic tool for the diagnosis of pancreatic cancer, and is an alternative to CA 19-9. The advantage of CA 242 over CA 19-9 is its higher specificity when using the recommended cut-off levels of the assays.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1994

The prognostic value of preoperative serum levels of CA 19-9 and CEA in patients with pancreatic cancer.

The prognostic value of preoperative serum levels of CA 19-9 and CEA was evaluated in 160 patients with pancreatic cancer. The survival of patients whose tumour marker value was below a certain cut-off level was compared with the survival of those with a higher value using the log-rank test. The lowest cut-off level dividing patients into groups with significant difference in survival (P < 0.05) was determined by graphical analysis of chi-square values at different cut-off levels. If stage of disease was not taken into account, there was a significant difference in survival between patients with low vs high preoperative CA 19-9 and CEA levels. When patients were classified according to stage, a difference was found for CA 19-9 in stage II-III patients. Patients with preoperative CA 19-9 below 370 U ml-1 had a significantly better prognosis than those with a higher level (P < 0.05). In stage I and stage IV patients, no significant difference was found between the groups at any cut-off level. The analysis of CEA showed a significant difference in survival only in stage IV patients, with CEA above 15 ng ml-1 being associated with shorter survival. In conclusion, in patients with stage II-III disease, particularly in patients with a non-resectable tumour, in whom the exact spread of the disease may be difficult to evaluate even at operation, the preoperative CA 19-9 level seems to have a prognostic value.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1985

Characterization of pre- and post-junctional adenosine receptors in guinea-pig ileum.

The receptors involved in adenosine-induced modulation of cholinergic neuroeffector transmission in guinea-pig ileum were explored by means of the non-selective stable analogue, 2-chloroadenosine and analogues with preference for AI receptors, L-N6-phenylisopropyladenosine (L-PIA), and A2 receptors, 5'-N-ethylcarboxamideadenosine (NECA) and D-N6-phenylisopropyladenosine (D-PIA). 2-chloroadenosine, L-PIA and NECA were equipotent in inhibiting contractile responses to nerve stimulation, whereas D-PIA exerted a similar activity only in high concentrations. The release of acetylcholine induced by nerve stimulation was inhibited to a similar degree by NECA, L-PIA and D-PIA. The phosphodiesterase inhibitor, ZK 62.7II, and the activator of adenylate cyclase, forskolin, enhanced the inhibitory effect of NECA, but not that of L-PIA, on contractile responses to nerve stimulation. Only NECA inhibited contractions induced by direct muscle stimulation and ZK 62.7II enhanced this inhibition. It is concluded that adenosine inhibits the neuroeffector transmission in guinea-pig ileum mainly by a prejunctional, cAMP-independent, mechanism, involving AI receptors and a supplementary activation of post-junctional A2 receptors. In addition there may be a prejunctional inhibitory effect of high agonist concentrations, exerted via A2 receptors and influenced by the prevailing levels of cAMP.

2-Chloroadenosine↗
PubMed1985

Pre- and postjunctional modulation of cholinergic neuroeffector transmission by adenine nucleotides. Experiments with agonist and antagonist.

Adenosine, 2-chloroadenosine, AMP, AMPNH2, ADP, ATP, AMPPNP and beta, gamma meATP dose-dependently and reversibly inhibited contractile responses to nerve stimulation in longitudinal plexus-containing muscle preparations of guinea pig ileum. All the purines, except for 2-chloroadenosine, were virtually equipotent and elicited maximal inhibition within 2 min after application. Adenosine deaminase abolished inhibition by adenosine but did not block the effect of 2-chloroadenosine or the adenine nucleotides. During transmural nerve stimulation, the nucleotidase-resistant analogues alpha, beta meADP and AMPPNP significantly depressed acetylcholine release measured by gas chromatography-mass spectrometry. The inhibitory effect of all the purines was competitively, reversibly and at comparable pA2 values antagonized by 8-p-sulphophenyltheophylline. The results indicate that nucleotides per se can inhibit neurotransmission via a prejunctional receptor common to nucleosides and nucleotides. An excitatory effect by all the di- and triphosphate nucleotides was also observed. The excitation was unaltered by atropine, tetrodotoxin and 8-p-sulphophenyltheophylline, thus suggesting an action at postjunctional ADP- and ATP-like receptive sites.

Adenine Nucleotides↗
PubMed1979

Effect of physostigmine and atropine on acetylcholine turnover in mouse brain.

The effect of physostigmine salicylate (0.5 mg/kg, i.p.) alone and in combination with atropine sulfate (25 mg/kg, i.p.) on levels of acetylcholine (ACh) and choline (Ch) and turnover of ACh has been studied in whole brain and striatum of mice. The animals were killed by focussed microwave irradiation and the turnover of ACh was studied after i.v. injection of deuterium labelled Ch by employing mass fragmentography. Physostigmine increased the levels of ACh in whole brain from 24.5--28.0 nmol/g(P less than 0.001) whereas there was no significant increase in striatum. The levels of Ch were also increased. The turnover rate of ACh was decreased in whole brain from 15.4 to 8.4 and in striatum from 52.9 to 24.4 nmol/g . min. Physostigmine given before or after atropine did not completely block the ACh lowering effect of atropine. When atropine was given before physostigmine the turnover rate of ACh in whole brain was increased to 24.2 nmoles/g . min. The results seem to indicate that there is no clear cut relation between the turnover rate and level of ACh in vivo. The increase of the turnover rate induced by atropine is masked unless a cholinesterase inhibitor is given to protect the newly synthesized labelled ACh released by atropine.

Acetylcholine↗
PubMedDate not supplied

Prognostic value of immunohistochemical expression of p53 in patients with pancreatic cancer.

The prognostic value of the immunohistochemical expression of p53 was evaluated in 133 patients with pancreatic cancer. Formalin-fixed paraffin-embedded specimens of ductal pancreatic adenocarcinomas retrieved at the time of operation were stained with the monoclonal antibody DO-7. Approximately half of the tumors (47%) showed a high level of p53 immunoreactivity (> or = 20% positive nuclei). No correlation was demonstrated between the level of p53 immunoreactivity and age of the patient, gender, TNM stage, resectability or site of the tumor. A high level of p53 staining was seen in a slightly smaller proportion (30%) of patients with well-differentiated tumors than in patients with moderately (50%) or poorly differentiated (50%) tumors, but the difference was not significant. In a multivariate survival analysis, stage, grade and postoperative chemotherapy emerged as independent prognostic factors. Surgical resectability, if entered instead of stage as a variable in a separate Cox model, predicted prognosis independently. In univariate analysis, the site of the tumor was also a significant prognostic variable. However, no association between the level of p53 immunoreactivity and survival in either uni- or multivariate analysis was found.

Carcinoma, Ductal, Breast↗
PubMedDate not supplied

A prognostic value of syndecan-1 in gastric cancer.

BACKGROUND: Syndecan-1, a cell surface heparan sulphate proteoglycan, has a role in cell adhesion, maturation and proliferation. Syndecan-1 has been reported to be a promising prognostic marker in various cancer forms. MATERIALS AND METHODS: We analysed tumour specimens from 296 gastric cancer patients. Syndecan-1 expression was studied by immunohistochemistry. RESULTS: Syndecan-1 immunoreactivity was observed in 234 (79%) patients. The expression of syndecan-1 did not correlate significantly with the presence of lymph node metastases, distant metastases, peritoneal spreading, penetration depth, tumour size, tumour location, Borrmann's classification, Laurén's classification, age or gender. Syndecan-1 immunoreactivity correlated significantly with survival in the whole patient series (p = 0.0499) and also in the subgroup of patients with stage I cancer (p = 0.0417), but not in patients with stage II, III or IV disease. In multivariate survival analysis, stage of disease and tumour size emerged as the only independent prognostic factors. CONCLUSIONS: In conclusion, immunohistochemical expression of syndecan-1 is a potential prognostic factor in gastric cancer, especially in patients with stage I disease.

Adult↗
PubMedDate not supplied

Prognostic significance of serum CA 242 in pancreatic cancer. A comparison with CA 19-9.

The prognostic value of the novel tumour marker CA 242 was studied in 175 patients with pancreatic cancer and the results were compared with those of CA 19-9. Preoperative serum levels of CA 242 and CA 19-9 were determined by commercially available assays. Patients were classified according to UICC TNM-stage, and divided into three groups of resectable, non-resectable and advanced disease. The lowest cut-off levels that divided patients into groups with significant difference in survival were calculated. Patients with resectable disease and preoperative CA 242 below 25 U/ml had a significantly better prognosis than those with a higher level (p < 0.05). The corresponding cut-off values were 100 U/ml in non-resectable (p < 0.05) and 3500 U/ml in advanced disease (p < 0.05). It is noteworthy that the overall survival rate of patients who underwent resection for cure, but had a high preoperative CA 242 level, approached that of patients with non-resectable disease. In multivariate analysis, only resectability (p < 0.0001) and preoperative serum CA 242 level (p = 0.01) were independent prognostic factors. If TNM-stage was used instead of resectability, the results were similar (stage p < 0.0001, CA 242 p = 0.006). When CA 242 was excluded from the model, preoperative serum CA 19-9 level approached the borderline of significance as an independent prognostic factor (p = 0.07). In conclusion, the preoperative serum level of the novel tumour marker CA 242 is an independent prognostic factor in pancreatic cancer. CA 242 yielded more prognostic information than CA 19-9.

Antigens, Tumor-Associated, Carbohydrate↗
PubMedDate not supplied

Prognostic value of Ki-67 expression, ploidy and S-phase fraction in patients with pancreatic cancer.

The prognostic value of Ki-67 expression, ploidy and s-phase fraction was evaluated in 133 patients with pancreatic cancer. Formalin-fixed paraffin-embedded surgical specimens of pancreatic ductal adenocarcinomas were stained with a polyclonal Ki-67 antibody. Ploidy and s-phase fraction was assessed by flow cytometry. The median percentage of Ki-67 positive nuclei was 26% (range 0-90%). The level of Ki-67 immunoreactivity was associated with TNM-stage, surgical resectability, tumour grade, ploidy and S-phase fraction. Ninetythree patients, with a nuclear expression of Ki-67 in < 50% of malignant cells, had a median survival of 12.8 months compared with 5.5 months for 25 patients with Ki-67 > or = 50% (p = 0.0008). Ploidy (p < 0.0001) and SPF (p = 0.002) were also significant prognostic factors in a univariate survival analysis. In a multivariate analysis, stage (or alternatively resectability), grade, ploidy and postoperative chemotherapy emerged as independent prognostic factors. When ploidy was excluded from the Cox multivariate model, S-phase fraction also predicted prognosis independently. Ploidy and S-phase fraction are independent prognostic factors in patients with pancreatic cancer. A high level of Ki-67 immunoreactivity is also an indicator of poor prognosis but seems to add little prognostic information to that provided by traditional parameters such as stage, resectability and grade.

Adenocarcinoma↗