[The analysis of tumor growth pattern by endoscopic ultrasonography in patients with depressed type of gastric cancer].
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Biomedical subjects
Publications and source records attributed to N Sawabu.
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The CA 15-3 RIA kit (Centocor Co.) based on a solid-phase radioimmunoassay was evaluated both experimentally and clinically. The results of a basic study of the reproducibility, recovery and dilution were very satisfactory. Serum levels of CA 15-3 were determined in 211 patients with malignancies including 13 breast cancers, 81 patients with benign diseases and 13 controls. Elevated levels of this antigen (greater than 25 U/ml) were observed in 16.7% of esophageal cancers, 9.7% of gastric cancers, 7.9% of colon cancers, 10% of hepatocellular cancers, 10% of biliary tract cancers, 10% of pancreatic cancers, 33% of lung cancers, and 75% of recurrent breast cancers. Thus, in malignant diseases the positivity was low except for recurrent breast cancer. On the other hand, the false-positive rate in benign diseases was only 3.7% and the false-positive cases had a level of 40 U/ml or less. These results indicate that the serum levels of CA 15-3 may have diagnostic value in patients with recurrent breast cancer.
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In order to evaluate the usefulness of serum DU-PAN-2, we determined this antigen in 384 patients with various malignancies and in 215 patients with benign diseases using a sandwich enzyme immunoassay system (Kyowa Medex Co.). Elevated DU-PAN-2 levels (greater than 400 U/ml) were observed in 55% of hepatocellular cancers, 50% of pancreatic cancers, and 43% of biliary tract cancers. On the other hand, most false-positive cases with benign diseases were observed in patients with liver injury, especially in the acute phase of acute hepatitis, chronic active hepatitis, and liver cirrhosis. However, in only a few cases with other benign diseases including pancreatitis, increased levels were found. Moreover, among the pancreatic cancer or biliary tract cancer patients studied, DU-PAN-2 was positive in 7 of the 19 CA 19-9-negative (less than 37 U/ml) patients and 32 of the 68 CEA-negative (less than 5 ng/ml) patients. These results indicate that the assay of DU-PAN-2 by EIA may have diagnostic usefulness in digestive cancer, especially pancreatic cancer or biliary tract cancer.
DU-PAN-2 is a high-molecular-weight glycoprotein defined by a murine monoclonal antibody (MAb) against a pancreatic ductal adenocarcinoma cell line. In order to evaluate the usefulness of this antigen as a tumor marker, we determined the serum level of the antigen by competitive inhibition radioimmunoassay in sera from 139 patients with various malignant tumors, chiefly digestive cancers, 98 patients with different benign diseases and 11 healthy subjects. Values in the healthy subjects were less than 100 U/ml. Levels above 100 U/ml were frequently observed in sera from benign diseases, but levels above 400 U/ml were found in only 6 of the patients with benign diseases. In contrast, levels exceeding 400 U/ml were detected in 72% of patients with pancreatic cancer, 44% of patients with hepatocellular cancer and 40% of patients with biliary tract cancer. The positivity was low in other cancers such as gastric cancer (19%) and colorectal cancer (7%). Serum levels of CEA and CA 19-9 were also determined in cancer patients. Among the pancreatic cancer patients studied, values above 400 U/ml were found in 5 of the 8 CEA-negative patients (less than 5 ng/ml) and 2 of the 3 CA 19-9 negative patients (less than 37 U/ml). These results indicate that determination of the serum DU-PAN-2 can aid in serological diagnosis of cancer of the digestive tract, more particularly of the pancreas.
In order to elucidate the factors affecting the serum levels of CA 19-9, we analyzed sera of 79 patients with pancreatic cancer and 169 with non-malignant diseases, chiefly consisting of hepatobiliary and pancreatic diseases. Serum CA 19-9 values in patients with pancreatic cancer had no relation to the location of the tumor or presence of jaundice. Similarly, no tendency was observed as to the location and size of tumor or to the grade of differentiation in 12 CA 19-9-negative patients with pancreatic cancer. Serum levels of CA 19-9 in patients with cholelithiasis complicated by cholangitis frequently showed markedly high values, but then rapidly normalized in parallel with the subsiding of inflammation. The behaviour of serum CA 19-9 showed little relation to renal or hepatic failures or to intrahepatic cholestasis. However, slightly elevated levels of the antigen were found in more than half of those patients with fulminant hepatitis showing massive necrosis. In chronic pancreatitis, the prevalence was only 8%; however, an increase was observed at the time of exacerbation in 2 of 5 positive patients. There was hardly any increase in serum levels of CA 19-9 after endoscopic retrograde cholangiopancreatography (ERCP), although serum levels of pancreatic enzymes rose after ERCP in almost all patients. Thus, it appears that CA 19-9 does not easily escape into the bloodstream, unlike pancreatic enzymes.
The carbohydrate antigenic determinant (CA 19-9) EIA kit (FUJIREVIO INC) was examined both experimentally and clinically. In the basic study, the standard curve showed linearity from to 240 U/ml, and the intra-and interassay reproducibility was good. Serum levels of CA 19-9 were determined by EIA in 246 cancer patients and 180 patients with benign diseases, and CA 19-9 levels by EIA were compared with those by RIA in concurrent measurement. There was an excellent correlation between the two. The positive of CA 19-9 EIA was almost the same as that of CA 19-9 RIA in cancer patients. False-positive cases by CA 19-9 EIA were somewhat more numerous than those by CA 19-9 RIA in patients with benign diseases, especially liver diseases. However, CA 19-9 assay by EIA is simple and has an excellent reproducibility and accuracy, as does that by RIA. Thus, the CA 19-9 EIA is a very useful assay.
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The presence of specific gamma-glutamyl transpeptidase isoenzyme (gamma-GTPI) and variant alkaline phosphatase (VAALP) were concurrently determined, and levels of basic fetoprotein (BFP) and carcinoembryonic antigen (CEA) in addition to alpha-fetoprotein (AFP) were measured in 144 hepatocellular carcinoma (HCC) patients in order to evaluate the diagnostic value of these tumor markers with respect to AFP-low or -negative patients and the tumor stage. Serum AFP levels below 400 ng/ml, commonly seen in sera of hepatobiliary diseases other than HCC, were noted in 42% of the patients. The diagnostic usefulness was increased by combination assay of these markers except for CEA. A definitive diagnosis of HCC could be made in 78% of the patients by a combination of gamma-GTPI, VAALP and AFP. Moreover, a diagnosis of malignancy could be made in 87% of cases by the inclusion of BFP. The prevalence of BFP and CEA increased in proportion to the tumor stage, whereas that of AFP and gamma-GTPI were independent of stage and were high even in patients in comparatively early stages. Furthermore, secreting type markers such as AFP and gamma-GTPI were relatively useful for diagnosis of HCC when the lesions were still small.
We measured serum carcinoembryonic antigen (CEA) levels in 164 cancer patients, 153 patients with benign diseases and 45 healthy controls using monoclonal antibody and compared CEA levels by monoclonal antibody (m-CEA) with those by polyclonal antibody (p-CEA). There was a good correlation between m-CEA and p-CEA, especially in cancer patients. The positively of m-CEA was almost the same as that of p-CEA in cancer patients. But, false-positive cases by m-CEA were less common than by p-CEA in non-cancerous patients. Thus, the measurement of m-CEA was not less useful than that of p-CEA.
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The authors discussed the clinical significance and some properties of the novel gamma-GTP isoenzyme (novel gamma-GTP) which was reported to be specific for sera of hepatocellular carcinoma (HCC) in our previous publications. One or more of specific bands (novel gamma-GTP) such as bands II, II' and I' were electrophoretically detectable in 109 (55%) of 200 patients with HCC, but only in 3% of 279 patients with other hepatobiliary diseases. Novel gamma-GTP was found in 38% of HCC patients with AFP levels below 400 ng/ml. The incidence of novel gamma-GTP was independent of the clinical stage as classified by liver scanning. Even in stage I, where filling defects were not seen, the incidence was 52%. It is concluded that novel gamma-GTP is useful in diagnosis of HCC patients with low levels of AFP or at a relatively early stage. Some properties of gamma-GTP purified from HCC tissues were investigated and compared with those of the normal kidney enzyme. The enzymes from HCC and kidney were identical in enzymatic and immunological properties, whereas a considerable difference was observed in electrophoresis, Con A affinity, effect of neuraminidase and isoelectric point. Respective bands II, II' and I' could be differentiated in Con A affinity and neuraminidase reaction. These results support the possibility that novel gamma-GTP in sera of HCC patients is largely due to a difference in carbohydrate moiety of gamma-GTPs.
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A carbohydrate antigenic determinant (CA 19-9) which monoclonal antibody (1116 NS-19-9) recognizes was found by Koprowski et al in 1979. Recently DelVillano et al have developed a forward sandwich radioimmunoassay (RIA) for quantitative measurement of CA 19-9. This CA 19-9 RIA Kit (CENTOCOR) was examined both experimentally and clinically. In the basic study, the standard curve obtained from this assay showed liniality, and the reproducibility of Intra-assay and Inter-assay was good. In the clinical study, using 37 U/ml as the reference value, the CA 19-9 RIA provided excellent sensitivity for pancreatic cancer (84%) and cancer of the biliary tract (69%), and excellent specificity, even among patients with benign gastrointestinal disorders. Moreover, CA 19-9 was suggested to be useful for monitoring of pancreatic cancer. Thus, the data indicate that CA 19-9 RIA can be a useful tumor marker for pancreatic cancer.
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The authors evaluated specific gamma-GTP isoenzyme (specific gamma-GTP) found in sera of patients with hepatocellular carcinoma (HCC). In addition to band II and II' which had been reported in our previous publication, band I' also had a high specificity for HCC. One or more of these bands were detectable in 109 (55%) of 200 patients with HCC, but only in seven (3%) of 279 patients with other hepatobiliary diseases. Specific gamma-GTP was found in 38% of HCC patients with alpha-fetoprotein (AFP) levels below 400 ng/ml. The incidence of this isoenzyme was independent of the clinical stage as classified by liver scanning. Even in Stage I, where filling defects were not seen, the incidence was 52%. We conclude that the specific gamma-GTP is useful in diagnosis of HCC patients with low levels of AFP or at a relatively early stage.
In order to elucidate the characteristics of novel gamma-GTP, which was reported in our previous publications to be specific to sera of HCC, gamma-GTP was purified from HCC tissues, and its physicochemical and immunologic properties were compared with those of the normal adult kidney enzyme. The enzyme from HCC tissue and from normal kidney were found to be similar or identical with respect to the Km value for substrate, optimal pH, thermostability, effect of various amino acids as acceptors, behavior to cations or ethylendiaminetetraacetate, and immunologic properties. However, the HCC tissue enzyme was distinguishable from the normal kidney enzyme with respect to molecular weight, electrophoretic mobility before and after neuraminidase treatment, Con-A-affinity, sensitivity to neuraminidase, and isoelectrophoretic point. These results support the conceivability that novel gamma-GTP in the sera of HCC patients is largely due to structural differences in the carbohydrate moieties.
The authors discussed the clinical significance and some properties of the novel gamma-GTP isoenzyme (novel gamma-GTP) which was reported to be specific for sera of hepatocellular carcinoma (HCC) in our previous publications. One or more of specific bands (novel gamma-GTP) such as bands II, II' and I' were electrophoretically detectable in 109 (55%) of 200 patients with HCC, but only in 3% of 279 patients with other hepatobiliary diseases. Novel gamma-GTP was found in 38% of HCC patients with AFP levels below 400 ng/ml. The incidence of novel gamma-GTP was independent of the clinical stage as classified by liver scanning. Even in stage I, where filling defects were not seen, the incidence was 52%. It is concluded that novel gamma-GTP is useful in diagnosis of HCC patients with low levels of AFP or at a relatively early stage. Some properties of gamma-GTP purified from HCC tissues were investigated and compared with those of the normal kidney enzyme. The enzymes from HCC and kidney were identical in enzymatic and immunological properties, whereas a considerable difference was observed in electrophoresis, Con A affinity, effect of neuraminidase and isoelectric point. Respective bands II, II' and I' could be differentiated in Con A affinity and neuraminidase reaction. These results support the possibility that novel gamma-GTP in sera of HCC patients is largely due to a difference in carbohydrate moiety of gamma-GTPs.