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Biomedical subjects

R Lamerz

Publications and source records attributed to R Lamerz.

At least 19 recordsLinked to original sources
PubMed1991

Histologic, biochemical, and clinical parameters for monitoring multiple myeloma.

In a retrospective and prospective follow-up study from 1968 to 1989, bone marrow biopsy specimens, serum beta-2-microglobulin (SB2M) levels, and the clinical features of 251 patients with multiple myeloma (MM) and 28 patients with monoclonal gammopathy of undetermined significance (MGUS) were investigated. The main histologic variables (tumor cell type, tumor growth, tumor load, and fibrosis), SB2M level, serum thymidine kinase (STK) level, and various clinical parameters were analyzed to determine factors of value in monitoring the clinical phases of activity in MM. Our recently proposed prognostic strategy combining bone marrow histologic type, SB2M level, and signs of organ failure was tested for its ability to (1) diagnose the early and smoldering variants; (2) facilitate decisions on the time of initiation, the type and duration of initial induction therapy in the pretreatment phases (active and rapidly progressive phases); and (3) characterize variations in tumor regression and tumor-host interactions during chemotherapy (early treatment, plateau, relapse, transition, and refractory phases). The results indicate that this clinicopathologic monitoring combines information both on stage and aggressivity of MM and thus facilitates therapeutic decisions in the various clinical phases of MM.

Biomarkers, Tumor↗
PubMed1991

[Carcinoembryonic antigen in serum and pleural fluid to distinguish between bronchial carcinoma and pleural mesothelioma].

The concentrations of carcinoembryonic antigen (CEA) were measured, partly retrospectively and partly prospectively, in 94 patients with diffuse malignant mesothelioma and in 79 with bronchial carcinoma and pleural involvement. Serum concentrations were measured in all patients, pleural-fluid concentrations additionally in 53 patients of the former and 39 of the latter group. The concentrations were significantly higher in those with bronchial carcinoma (P less than 0.001). The two groups could be distinguished by serum concentrations, using 5.2 ng/ml as the limit, with a sensitivity of 68%, specificity of 98% and a predictive value of 96%. Measurement of CEA in pleural fluid (at a limit of 4.5 ng/ml) had a specificity of 94% and a positive predictive value of 90%, sensitivity being similar to that for serum. The negative predictive value for serum CEA concentration was 79%, for pleural fluid it was 81%. Thus in most cases measurement of CEA in serum and, to a lesser extent in pleural fluid, is a very simple method to exclude mesothelioma with a high degree of certainty. If the CEA concentration is below the stated level, either may be present.

Adult↗
PubMed1991

Predictive value of serum procollagen-III-peptide for the survival of patients with cirrhosis.

The value of the aminoterminal procollagen-III-peptide (P-III-P) in predicting death or survival was evaluated in a group of 43 patients with proven postnecrotic or alcoholic cirrhosis. Patients were followed-up prospectively for 2 years. The prognostic value of P-III-P was compared with the Child classification, fasting and postprandial serum bile acids, and standard laboratory tests such as bilirubin, prothrombin index, pseudocholinesterase, albumin, GOT, GPT, gamma-GT, and clinical findings such as ascites, encephalopathy (assessed with the number connection test = NCT), and nutritional status. Between patients who died and those who survived the following 2 years, there were significant differences in the following parameters at the time of inclusion in the study: encephalopathy judged by NCT (p = 0.001), serum albumin (p = 0.0012), postprandial serum bile acids (p = 0.0024), fasting serum bile acids (p = 0.0025), pseudocholinesterase (p = 0.0044), GOT (p = 0.015), bilirubin (p = 0.016), and prothrombin index (p = 0.01). None of the other parameters investigated, including SP-III-P (p = 0.46), revealed any statistically significant differences between patients who died and survivors. The prognostic significance of laboratory tests and recorded clinical findings was evaluated, either alone or in combination with life-table analysis using the Cox model. SP-III-P, alone or in combination with other parameters, failed to improve prediction of mortality in patients with cirrhosis. In comparison to the Child classification (p = 0.0004) the combination of NCT and postprandial serum bile acids showed a similar ability (p = 0.0003) to predict patient survival.

Biomarkers↗
PubMed1991

Identification of membrane antigens in granulocytes and colonic carcinoma cells by a monoclonal antibody specific for biliary glycoprotein, a member of the carcinoembryonic antigen family.

The gene coding for 'biliary glycoprotein (BGP)' is a member of the carcinoembryonic antigen (CEA) gene family. A monoclonal antibody (MAb) was induced against a BGP-preparation isolated from human bile. The antibody did not crossreact with the carcinoembryonic antigen (CEA) and different non-specific crossreacting antigens. The anti-BGP MAb was used to identify BGP-related antigens in membrane extracts from granulocytes and the colonic carcinoma cell line HT-29. In granulocyte membranes, a single antigen of Mr 160,000 was bound. In membranes from HT-29 cells, a main antigen of Mr 85,000 was present. At high antigen concentration, an additional antigen of Mr 115,000 was identified. Since several transcripts of the BGP gene have been identified, the different BGP related antigens are probably products of alternatively spliced mRNAs.

Antibodies, Monoclonal↗
PubMed1991

[Circulating "tumor markers" in gastrointestinal tumors].

Tumor markers (TM) of the neoplastic cell can be divided into non-shedded substances and antigens shedded in blood, urine or other body fluids. For clinicians circulating TM are more important. All relevant circulating TM are not useful in screening of asymptomatic patients because of insufficient sensitivity and specificity. With caution they are useful in the observation of risk groups. Circulating TM have their main significance as additional parameters in monitoring symptomatic patients with malignancies. Several follow up determinations are more important than one single measurement. During follow up of tumor patients TM should not be checked automatically if there are no diagnostic or therapeutical consequences. The clinically most important circulating TM in non-hormone secreting tumors of the gastrointestinal tract are the oncofetal antigens CEA and AFP and antigens defined by monoclonal antibodies e. g. CA 19-9 and CA 72-4. AFP is the primary TM in hepatocellular carcinoma, often elevated in hepatoblastoma and always normal in cholangiocellular carcinoma. CEA is the TM of first choice in patients with colorectal carcinomas and liver metastasis. CA 19-9 is TM of first choice in pancreatic carcinoma and additionally of diagnostic value in cholangiocellular carcinoma and tumors of the bile ducts. In cancer of the stomach CA 19-9 and CEA are secondary TM in combination with CA 72-4 as primary TM. Care should be taken that slight and moderate elevations of TM can be observed in benign diseases of liver, pancreas and bowel.

Biomarkers, Tumor↗
PubMed1990

Diagnostic significance of carcinoembryonic antigen in the differential diagnosis of malignant mesothelioma.

The histologic and cytologic distinction of malignant mesothelioma from carcinomas metastatic to the pleura or peritoneum is often problematic. For this reason immunologic methods are being increasingly used as diagnostic adjuncts. This review summarizes 40 studies on the expression of carcinoembryonic antigen in mesotheliomas and in lung and other carcinomas involving the pleura or peritoneum. Carcinoembryonic antigen was identified immunohistochemically in 11% of mesotheliomas and in 84% of carcinomas examined and immunocytochemically (in serous effusions) in 4% and 58%, respectively. In serum and in pleural or ascitic fluid, significantly elevated levels of carcinoembryonic antigen are commonly associated with (lung) carcinomas but rarely with mesotheliomas. Thus, together with identification of the antigen in serum, pleural fluid, or ascitic fluid, immunohistochemical and immunocytochemical techniques for detecting carcinoembryonic antigen provide a valuable aid for distinguishing malignant mesothelioma from metastatic carcinomas.

Biomarkers, Tumor↗
PubMed1989

[Clinical relevance of tumor markers].

Tumour markers are often circulating tumour-associated indicators of tumour development. As such they are not suitable for tumour screening and localization, but valuable as adjuncts for medical follow-up care of tumour patients, where their serum level alterations may anticipate the clinical detection of tumour behaviour by a lead time of 1 to 6 months before other methods. The following tumour may be controlled by established markers: endocrine tumours by NSE, calcitonin, parathormone, 5-HIAA, catecholamines/metabolites etc.; head-neck tumours: SCC, CEA; thyroid carcinoma: TG, calcitonin; lung cancer: CEA, NSE, SCC; liver cancer: AFP (PLC), CA 19-9 (cholangiocell.), CEA (secondary): biliary tract and pancreatic cancer: CA 19-9; colorectal carcinoma: CEA, CA 19-9; squamous cell carcinoma (ENT, oesophagus, anal): SCC; breast cancer: CEA and CA 15-3; ovarian cancer: CA 125 (epithelial), CA 19-9 (mucinous); germ cell tumours (ovary including trophoblastic tumours/testes): AFP and HCG; prostatic cancer: PAP and PSA; bladder cancer: TPA.

Biomarkers, Tumor↗
PubMed1989

Epidermal growth factor receptors and epidermal growth factor-like activity in colorectal mucosa, adenomas and carcinomas.

The epidermal growth factor (EGF) and alpha-tumor growth factor are mitogenic proteins which bind to the EGF-receptor and may play a role in carcinogenesis or tumor progression. Our study investigated whether colorectal carcinomas and adenomas express altered levels of EGF-receptors or overproduce EGF-like activity by comparing histologically normal mucosa to carcinomas resected from the same patients. EGF-receptors were characterized by radioligand binding studies. Carcinomas contained unchanged or decreased levels of EGF-receptors in 13/16 and moderately increased levels in 3/16 patients as compared to normal mucosa. Adenomas obtained from 2 patients with familial polyposis coli and from a third patient with a coincident carcinoma had similar numbers of EGF-receptors as normal mucosa. EGF-like growth factors, in contrast, were significantly elevated in carcinoma extracts as compared to extracts from normal mucosa of the same patients. Adenomas did not contain elevated levels of EGF-like activity. We conclude that increased expression of EGF-receptors is infrequent in colonic adenocarcinomas. Increased production of EGF-like growth factors may frequently occur but seems to be associated with tumor progression rather than with premalignant lesions as represented by adenomas.

Adenomatous Polyposis Coli↗
PubMed1988

Tumour associated antigens in diagnosis of serous effusions.

The use of tumour associated antigens in the diagnosis of serous effusions was studied in 76 patients with benign and 200 patients with malignant disease. Tissue polypeptide antigen (TPA), alpha fetoprotein, and CA 125 were found to be of little value. At cut off points of 3 ng/ml, 10 U/ml, and 30 U/ml, respectively, carcinoembryonic antigen (CEA), biliary glycoprotein I (BGP I), and CA 19-9 discriminated between benign and malignant serous effusions with a sensitivity of between 24% and 67%. The immunocytochemical staining for these markers resulted in malignant cells being detected in 18% to 33% of cases. Various combinations of conventional cytological examination, effusion fluid tumour marker determination, and immunocytochemical analysis identified malignant cells in serous effusions in up to 72% of cases; conventional cytology alone detected tumour cells in only 30%.

Antigens, CD↗
PubMed1988

Elevated serum CA 125 levels in patients with benign ascitic or pleural effusions.

The tumor-associated antigen CA 125 is widely used in monitoring of ovarian carcinomas. As this determinant is also expressed in proliferating mesothelia, we studied CA 125 levels in serum and effusion fluid of patients with ascitic and pleural effusions. Patients with benign and malignant disease were included. There was no statistically significant or diagnostically useful difference between 26 benign and 44 malignant cases in the CA 125 levels in effusions or sera. In 77% of benign cases, serum levels exceeding 105 U/ml (3 times the recommended upper limit of normal values) were found. Thus, in patients with serous effusions, elevated serum CA 125 values alone do not provide evidence for the presence of an (ovarian) malignancy, but may also indicate a proliferation of mesothelium due to benign disease.

Adult↗
PubMed1987

[High Ca 125 serum level in benign ascites or pleural effusion].

In 26 patients with benign and 44 patients with malignant ascites or pleural effusion the levels of the tumour marker Ca 125 were determined in the effusion and in the serum. No significant differences between both groups were seen. Values exceeding the tenfold level of the upper standard limit were often found even in patients with benign and non-carcinomatous malignant diseases. This is probably due to a production of the antigen even in benign proliferating cells of the mesothelium. Enhanced Ca 125 serum levels cannot therefore be interpreted as indicating the presence of an (ovarian) carcinoma if there is an ascites or pleural effusion; they can also be an expression of a proliferation of the mesothelium in benign processes of other organs.

Adult↗
PubMed1986

[Tumor markers in the diagnosis of ascitic and pleural puncture fluids].

The identification of carcinoma cells in ascitic and pleural effusions by the detection of tumor markers was studied using an indirect immunoperoxidase method. Punctates from 56 patients with carcinomas, 18 with other malignant diseases and 10 with benign diseases were examined. In 35% of carcinomatous punctates tumor cells were stained by a CEA antiserum. No positive cells were found, however, in non-carcinomatous benign or malignant effusions. The immunocytochemical staining of CEA could detect tumor cells in 36% of carcinoma cases classified suspicious or negative using conventional cytology only. A TPA antiserum as well as the monoclonal antibody OC 125 stained cells in carcinomatous as well as in non-carcinomatous malignant and in benign punctates.

Adult↗
PubMed1977

[CEA blood level in patients with Crohn's disease with reference to localization, duration and severity of the disease].

CEA-serum-levels were determined in 24 patients with Crohn's disease over a period up to 35 months. 13 patients showed elevated CEA-Levels (greater than 3 ng/ml). A positive correlation between the extent of the lesion and the CEA-serum-level could be demonstrated. This correlation could not be demonstrated in regard to the duration of the disease. The attempt to utilize CEA-serum-levels for the estimation of the activity of Crohn's disease showed a good correlation between the activity and CEA-levels in a few cases; the activity was measured by means of the Crohn's Disease Activity Index (CDAI), which was recommended in the National Crohn's Disease Study in the United States.

Adolescent↗