Biomedical subjects

M Eskelinen

Publications and source records attributed to M Eskelinen.

142 records · Page 8Linked to original sources

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

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

Expression of tumour associated antigens 12H12, 2E11, 7A9, CEA and DF3 in human breast cancer.

Expression of tumour associated antigens 12H12, 2E11, 7A9, CEA and DF3 was determined immunohistochemically in paraffin embedded biopsy specimens from 42 breast carcinomas. The mean (SD) of staining index (I) for 12H12 was 0.95(0.94), for 2E11 1.30(0.99), for FA9 1.11(0.92), for CEA 0.03(0.1) and for DF3 1.32(0.93). Of the 42 carcinomas, 3 (7.1%) were totally negative for 12H12, 3/42 (7.1%) for 2E11, 6/42 (14.3%) for 7A9, 34/42 (81%) for CEA and 6/45 (13.3%) for DF3. The 12H12 positivity was related significantly to axillary lymph node status (r = 0.41, p < 0.01), expression of 7A9 (r = 0.71, p < 0.001), expression of 2E11 (r = 0.76, p < 0.001), expression of DF3 (r = 0.40, p < 0.01) and TPA serum level (r = 0.41, p < 0.01). The 2E11 positivity was related to axillary lymph node status (r = 0.43, p < 0.01), expression of 7A9 (r = 0.95, p < 0.001) and 12H12 (r = 0.76, p < 0.001). The 7A9 positivity was related to axillary lymph node status (r = 0.44, p < 0.01), expression of 7A9 (r = 0.71, p < 0.001), 12H12 (r = 0.71, p < 0.001) and 2E11 (r = 0.95, p < 0.001). The DF3 positivity was significantly related to expression of 12H12 (r = 0.40, p < 0.01). The CEA positivity was not significantly related to any of the tested variables. The results suggest that antigens 12H12, 2E11 and 7A9 should be subject to further analysis in breast cancer research. Particularly, they may be helpful in separating benign breast lesions from the more malignant ones. Secondly, the relationship between high expression of the antigens and axillary lymph node status suggests that these antigens may have also prognostic value.

Antigens, Neoplasm↗

PubMedDate not supplied

Clinical evaluation of tissue polypeptide antigen (TPA) in the diagnosis of pancreatic carcinoma.

The serum values of tissue polypeptide antigen (TPA) were measured in a prospective series of 100 patients with jaundice, 54 patients with suspicion of chronic pancreatitis or a pancreatic tumour, and 19 patients with unjaundiced cholestasis to assess its value in diagnosing pancreatic cancer. There were altogether 25 patients with a cancer of the pancreas including 2 patients with a cancer of the papilla of Vater. The highest serum TPA values were noticed in patients with pancreatic cancer, but raised values were also seen in patients with malignant or benign liver diseases, and with cholangiocarcinoma. The sensitivity of TPA was 52% with a specificity of 85% and an efficiency of 80%. In comparison to CEA, CA 50 and CA 242, TPA showed lower sensitivity but higher specificity. When TPA was combined with the other markers, the specificity and efficiency improved clearly in all combinations, being highest in that of TPA and CA 242 (specificity 94.5%, efficiency 87.2%). The results suggest that the TPA test has a useful complementary role in the clinical use of the current serum tumour markers in the diagnosis of pancreatic cancer.

Alkaline Phosphatase↗

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

Mitotic activity index, volume corrected mitotic index and human papilloma-virus suggestive morphology are not prognostic factors in carcinoma of the oesophagus.

Radiation treatment, endoscopic dilatations and laser treatment offer an alternative to surgery as palliation in oesophageal cancer, and therefore it is essential to assess the prognostic factors preoperatively in order to select the treatment individually. Mitotic activity index (MAI), volume corrected mitotic index (M/V-index) and histologic evidence for human papillomavirus (HPV) involvement together with other prognostic factors were studied in 61 patients with oesophageal squamous cell carcinomas. No patient was lost from follow-up and 18% of patients were alive at the end of follow-up. Evidence for HPV involvement was found in 11 (18%) of 61 patients, which was significantly (p < 0.001) less than in a previous series of Chinese patients. Histological grade (p = 0.025), lymph node status (p = 0.002), presence of distant metastasis (p = 0.004), surgical resection (p = 0.03) and nuclear pleomorphism (p = 0.04) were significant independent prognostic factors in univariate analysis. In multivariate analysis, the length of the tumour (p = 0.0002) as well as its histological grade (p = 0.0001) significantly predicted the patient survival. Surgical resection was almost included into the model (p = 0.11). On the other hand, MAI, M/V-index or HPV histology did not reach statistical significance as prognostic factors.

Aged↗

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

Prognostic evaluation of DNA flow cytometry and histo-morphological criteria in renal cell carcinoma.

Clinical, histological and flow cytometric data (DNA content, S phase fraction) were related to clinical behaviour in 124 patients with renal cell carcinoma followed up for more than nine years. 69% of the tumours were diploid and 31% were aneuploid. The S phase fraction (SPF) ranged between 0.5% and 17.2% and the mean (s.e.) was 3.8 (0.3)%. The SPF was higher in aneuploid than in diploid tumours [mean, s.e., 2.6 (0.2)% vs. 6.4 (0.6)%, p < 0.001]. DNA ploidy was not related to any of the analysed features, while S phase was related to nuclear grade (p < 0.001), combined nuclear grade (p = 0.0025) and node metastasis at diagnosis (p = 0.036). In a multivariate analysis, the recurrence-free survival of M0 tumours was independently predicted by combined nuclear grade (p < 0.001), M/V index (p = 0.007), T-category (p = 0.011) and location (left/right) (p = 0.022). Survival in the entire cohort was independently related to T-category (p < 0.001), M/V index (p = 0.001) and DNA ploidy (p = 0.050). Survival of M0 tumours was independently related to M/V index (p < 0.001), DNA ploidy (p = 0.005) and T-category (p = 0.003). DNA aneuploidy was related to favorable disease outcome both in univariate and multivariate analysis in the entire series and in all the subanalyses. The results suggest that genomic instability in aneuploid cells may reduce their capacity to resist immunological host response or aneuploid tumours may be more sensitive to treatment.

Adult↗

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↗

PubMedDate not supplied

Multivariate analysis of six serum tumor markers (CEA, CA 50, CA 242, TPA, TPS, TATI) and conventional laboratory tests in the diagnosis of hepatopancreatobiliary malignancy.

A prospective study of 277 patients with benign (n = 212) and malignant (n = 65) hepatopancreatobiliary disease was carried out to evaluate the value of six serum tumour markers (CEA, CA 50, CA 242, TPA, TPS, TATI) and 16 conventional laboratory tests in the distinction between benign and malignant diseases. In univariate analysis, all tumour marker tests except TATI showed significantly (p < 0.001) higher serum values in the patients with malignant disease than in the patients with benign disease. Among the conventional laboratory tests serum bilirubin, alkaline phosphatase and leucine aminopeptidase showed significantly. (p < 0.001) higher values in the patients with malignant disease, whereas serum protein and amylase levels were significantly (p < 0.01) higher in the patients with benign disease. In a multivariate analysis, serum bilirubin (p < 0.001), antithrombin III (p < 0.01) and blood hemoglobin (p < 0.05) were the most significant independent predictors of hepatopancreatobiliary malignancy. To sum up the contributions of the best tests a diagnostic score (DS) was developed. The sensitivity of DS in detecting malignancy was 73% with a specificity of 82% and an efficiency of 79%. In conclusion, our results speak against the use of multiple tumour marker tests, and rather suggest the use of a relatively limited amount of conventional laboratory tests in the distinction between benign and malignant hepatopancreatobiliary disease.

Alkaline Phosphatase↗

PubMedDate not supplied

Comparison of classic and quantitative prognostic factors in colorectal cancer.

Despite the many pathologic and clinical variables shown to influence survival rates in patients with colorectal cancer, the prediction of outcome after curative resection is still not completely reliable. Dukes-classification has been historically the strongest prognostic indicator and the most frequently employed method. In this study our aim was to search for significant independent histological and morphometric factors that could possibly be used in predicting the outcome of different stages of colorectal cancer. We analysed the clinical follow-up data of 308 patients with colorectal adenocarcinoma (followed-up for a mean of 14.4 years). The clinical findings were correlated to histological and morphometric factors to establish their value as predictors of colorectal adenocarcinoma Clinical, histological and morphometric factors were significantly interrelated. The large invasive tumours had larger nuclei, a larger variation in nuclear size, and they were also rapidly proliferating. In univariate survival analysis Dukes, the mean nuclear area (NA), standard deviation of nuclear area (SDNA), nuclear perimetry (PE) and the mean of the longest nuclear axis (Dmax) were the most important predictors of recurrence-free survival (RFS). TNM-categories, Dukes, histological grade and all the quantitative variables were significant predictors of cancer related survival. In a multivariate analysis of Tl-4N0-3M0 tumours (n = 164) N-category, nuclear area and the vear of operation and in local tumours (Tl-2N0M0) (n = 70) Dmax and Dukes predicted RFS. Important determinants of survival in all 269 cases were M-category. Dukes and Dmax and in local tumours (Tl-2N0M0) (n = 67) Dmax. These results indicate that although an accurate prognostic evaluation of colorectal carcinomas can be based on TNM- and Dukes-classification, nuclear morphometry can give additional prognostic information.

Adult↗

PubMedDate not supplied

Serum tumour markers CEA, AFP, CA 15-3, TPS and Neu in diagnosis of breast cancer.

The aim of the present study was to assess the clinical value of five serum tumour markers AFP, CA 15-3, CEA, TPS and Neu oncoprotein (p 185) in the diagnosis of breast cancer. The serum values were measured in a prospective series of patients with breast cancer (n = 233), benign breast disease (n = 176) and healthy control subjects (n = 215). The cut-off levels (90% specificity) were determined for each test. Using these cut-off levels the diagnostic sensitivity of the CEA test was 0.23, for the AFP test it was 0.16, for the CA 15-3 test 0.27, for the TPS test 0.18 and for the Neu oncoprotein test 0.19 in detecting breast cancer. Correlation coefficients (Pearson's) were statistically significant between CEA and CA 15-3, and between CA 15-3 and Neu oncoprotein measurements in breast cancer patients. In patients with benign breast disease the serum levels of AFP, CA 15-3, CEA and TPS correlated with age, being somewhat higher in older patients. Similarly, in population controls higher age correlated with higher levels of AFP, CA 15-3, Neu and TPS. In breast cancer patients there was no correlation between the age at diagnosis and any of the measured markers. The only marker statistically significantly associated with the stage of breast cancer was CA 15-3. In conclusion, our results indicate that serum CEA, AFP, CA 15-3, TPS and Neu oncoprotein are only of limited value in the diagnosis of breast cancer.

Adult↗

PubMedDate not supplied

Total and lipid-bound serum sialic acid in benign and malignant breast disease.

Elevation in the total sialic acid (TSA), TSA/total protein (TSA/TP) and lipid-bound sialic acid (LASA) concentration in serum occurs in breast cancer and we have studied the applicability of the assays in classification of undefined breast tumors. Sialic acid was determined by HPLC and the statistical evaluation included the receiver operating characteristic (ROC) and Youden's index analyses. In cancer patients, the serum LASA and TSA concentration was significantly higher (p < 0.05) than in patients with benign breast disease and all the markers were significantly higher (p < 0.0001) than in normal controls. All the markers had a low accuracy (AUCs < 0.75) in differentiating between breast cancer and benign breast disease and at the specificity level of 0.95 the corresponding sensitivities were 0.32 (TSA), 0.14 (TSA/TP) and 0.23 (LASA). The results indicate that both breast cancer and benign breast disease cause elevation of TSA, TSA/TP and LASA values in serum and do not provide reliable classification of undefined breast tumors.

Adolescent↗

PubMedDate not supplied

Clinical contribution of bcl-2, p53 and Ki-67 proteins in pancreatic ductal adenocarcinoma.

The expression of apoptosis suppressing protein bcl-2, tumour-suppressor protein p53, and proliferation marker Ki-67 and their possible prognostic value were analysed in pancreatic ductal adenocarcinoma. Fifty-two % (34/64) of the samples were positive for bcl-2 and immunostaining were mainly localized in the cytoplasm of tumour cells. Bcl-2 expression was not related to tumour grade, DNA ploidy or S-phase fraction or to any clinical parameters. In univariate analysis bcl-2 expression predicted favourable outcome (p = 0.008). Positive nuclear staining for p53 was found in 40% (24/59) of samples and 80% (60/74) of the tumours were positive for Ki-67. p53 and Ki-67 expressions were not related to patient survival. According to our results, bcl-2 expression seems to be a predictor of disease outcome and may have some clinical value in human pancreatic cancer.

Aged↗

PubMedDate not supplied

Prediction of survival in breast cancer: evaluation of different multivariate models.

BACKGROUND: We compared the performance of multivariate models based on mitotic activity index, lymph node status, and tumor size in the prognostication of breast cancer. MATERIAL AND METHODS: Cox and discriminant models for survival were created for two patient groups: a) 120 breast cancer patients, and b) 86 patients with ductal infiltrating carcinoma. The models were compared with the model of Baak et al (1985). RESULTS: The models distinguished between dying and surviving patients with an efficiency of 70.9-77.9% in mutual tests. With a single cutoff the model of Baak et al was less efficient (50.8-65.8%). If a region of uncertainty was allowed between two cutpoints, the efficiencies below and above the cutpoints increased. When the uncertain region included a third of the patients, the efficiency varied between 73.8 and 84.7%. CONCLUSION: Multivariate models seem to need a region of uncertainty between two discriminating cutpoints. These models resulted in the correct prediction of prognosis in about 75% and more of patients. With different materials the models differed in efficiency. With a region of uncertainty the model of Baak et al performed well with completely independent material.

Adult↗