Mucin-like carcinoma-associated antigen (MCA) is a new tumor associated antigen expressed on breast cancer cells independent of histological type and recognized by a two-site sandwich EIA (Roche) using the Mab b-12 as capture and detection antibody and a MCA cut-off of 11 U/ml. MCA serum levels were determined in 409 breast cancer patients and in 100 pts with benign breast disease histologically confirmed and staged according to UICC. The sensitivity of MCA regarding the stage of disease was elevated only in metastatic patients (89%) and the MCA values of this group were significantly different compared to those of patients with early or locally advanced breast cancer. In the group of benign patients, the specificity was 81%. The correlation between MCA values and number of involved axillary lymph nodes showed significant differences in the O versus 4-10 node subgroup (p < 0.001), in O versus > 10 and in 1-3 versus 4-10 node subgroup (p < 0.05); elevated MCA sensitivity was found in the 4-10 and > 10 subgroups. In our experience, the determination of MCA is not useful for early diagnosis of breast cancer nor does it indicate the extent of lymph node involvement. With regard to the prediction of tumor recurrence in postoperative patients free of disease, MCA levels increased concomitantly with the clinical evidence of relapse. These findings suggest that the MCA assay is highly sensitive only in patients with metastatic breast cancer; therefore one of the most promising test application seems to be for monitoring the clinical course of advanced disease patients.

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Correlation between HPLC-determined lonidamine serum levels and clinical response in patients with advanced ovarian cancer.

Lonidamine is an energolytic derivative of indazolcarboxilic acid which has been demonstrated to enhance cisplatin activity in ovarian cancer cell lines either sensitive or resistant to this drug, thus suggesting the potential reverting activity of the mechanisms of drug resistance. A study was performed on nine patients with advanced ovarian cancer treated with lonidamine (LND) plus cisplatin (CDDP) as salvage therapy after the failure of first-line platinum containing chemotherapy. Serum LND was determined with a high-performance liquid chromatography (HPLC) method. The objective clinical response included one complete and three partial responses (overall response 44%). High LND serum levels were observed in three of four responding patients. The serum LND concentrations for these patients, detected one hour after the first and second dose administrations, were 15.2 +/- 1.1 and 14.6 +/- 1.4 micrograms/ml, respectively. Toxicity was mild to moderate, except for myalgia. The high serum levels of lonidamine detected in three of four responding patients suggests that the syngerism between LND and CDDP observed ovarian cancer cell lines may be confirmed in clinical practice. However, the potential role of LND in enhancing CDDP activity can be definitely established in large randomized trials.

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PubMedDate not supplied

Rigid fixation by means of titanium mesh in edentulous ridge expansion for horizontal ridge augmentation in the maxilla.

The edentulous ridge expansion has been introduced in recent years to reestablish an appropriate alveolar ridge width. This technique consists of the placement of implants in the space formed after the dislocation of the buccal plate in a labial direction. In guided bone regeneration, the quantity of bone regenerated under the membranes has been demonstrated to be directly related to the amount of the space under the membranes. This space can diminish as a result of membrane collapse. To avoid this problem, a new technique of edentulous ridge expansion, which involved the use of a titanium mesh barrier to protect the regenerating tissues and to achieve a rigid fixation of the bone segments, was used in association with autologous bone in 25 patients. At second-stage surgery in all patients, it was possible to see tissue, under the mesh, that had the macroscopic characteristics of mature bone and was superficially covered by a thin soft tissue layer. The microscopic examination showed that all autologous bone particles were embedded in newly formed bone. The use of a rigid mesh can assist bone regeneration in non-space-making defects, since it probably does not interfere with the blood flow to the underlying tissues because of the presence of microholes within the mesh.

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PubMedDate not supplied

Comparison of nuclear matrix protein 22 and bladder tumor antigen in urine of patients with bladder cancer.

Recently, two new tumor markers for bladder cancer have been introduced: NMP22 test and BTA TRAK assay. This study was designed to evaluate the urinary values of these two proteins using quantitative enzyme immunoassays in well microplates. Urine samples from 47 healthy subjects, 26 with benign genitourinary disorders and 109 patients with a histological diagnosis of bladder cancer were collected. The specificity, the positive predictive value, the negative predictive value and the efficiency were established for NMP 22 and BTA, and the cut off values were fixed at a specificity of 95% in the benign disease group (12 U/ml and 23 U/ml respectively). We observed a very high concordance between the two urinary tumor markers (73%), although the overall sensitivity of BTA in bladder cancer patients seems to be better than that of NMP22 (62% vs 54% respectively), especially in the superficial disease group (36% for BTA and 14% for NMP22).

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