Screening for colorectal cancer with immunological FOBT.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to S Ottó.
Explore the source record for details and available documents.
5-S-Cysteinyldopa (5-S-CD) is a precursor of pheomelanin. S-100B protein is a low molecular weight, acidic, calcium binding, cytoplasmic protein. In this study, the concentration changes of serum 5-S-CD and S-100B protein in melanomas of all stages were examined in parallel and patients were monitored during and after treatment. Serum samples were taken from 478 melanoma patients on 1924 occasions. Of these, 180 cases were regularly monitored. Concentrations of 5-S-CD were determined by high performance liquid chromatography (HPLC), S-100B protein by immunoluminometric assay. The mean/median concentrations of 5-S-CD and S-100B protein in Stage I, II and III patients and in the control group ranged around the normal level. In Stage IV patients, 58.4/50.6% sensitivity, 100% specificity and 100/86.6% positive predictive values were obtained concerning S-100B protein and 5-S-CD, respectively. Recurrence was observed in 57/180 of the regularly monitored patients in Stages I, II and III. In 10/57 (17.5%) of these patients suffering from any type of disease progression increases in both marker levels preceded the detection of metastasis by conventional methods. We can confirm that changes in both marker concentrations correlated with the stages of the patient. The markers are most sensitive in Stage IV patients and also have a high specificity in these patients. In Stage IV melanoma patients, 5-S-CD and S-100B protein levels are independent significant prognostic factors. In almost one fifth of patients both marker levels increased before the detection of metastatic disease with other appropriate, routinely scheduled investigations. This study suggests that serial serum marker measurements in the management and follow-up of melanoma patients should be examined further.
The author describes new varieties of fecal occult blood screening strategies in respect to old and up-to-date diagnostic methods. The limited sensitivity and specificity of the classical methods used for the demonstration of occult fecal blood necessitate the introduction of new techniques in the screening practice. The new discoveries in molecular biology are likely to improve the effectiveness of the early detection of colorectal cancers and their precursor lesions. Since the implementation of these novel techniques in mass screenings has not taken place yet, higher effectiveness can only be achieved by more specific and sensitive blood tests.
The authors report on promising diagnostic methods of occult intestinal bleeding and discusses the potential new strategy of early detection of colorectal carcinomas in respect to old and new diagnostic measures available. Because of the limited sensitivity and specificity of classical methods used for the demonstration of occult fecal blood, the authors recommend the introduction of new techniques and markers in screening practice. It is presumed that new discoveries in molecular biology will improve the accuracy of early colorectal cancer prevention. Their implementation into routine screening, however, will not take place in the near future. Until their realization, improved screening efficacy is expected from the use of more specific and sensitive blood tests.
This was the first time that authors detected se-S-100 and 5-SCD values with patients with malignant melanoma in Hungary. They examined the change of serum S-100 and 5-SCD value parallel. Sera were obtained with 184 melanoma patients 326 times. Patients were ranked into groups on the basis of clinical symptoms: free of symptoms and suffering from it (primary tumour, regional lymph node metastasis, soliter or multiplex distant metastasis). On the basis of the initial results the following have been found: S-100 protein and 5-SCD serum levels had no prognostic value in patients with primary melanoma. Patients without symptoms showed values around the normal level. There was significant difference in both markers between patients with or without symptoms. Significant differences were found between clinical stage I and II, as well as in clinical stage II and III. In the case of S-100 protein there was significant difference between the values of patients with soliter and multiplex distant metastasis.
Serum S-100 protein is widely used as a marker of melanoma and since 5-S-cysteinyldopa (5-S-CD) is a precursor of melanin its serum and urinary levels can reflect melanoma progression. In this study we examined the concentration changes of serum S-100 protein and 5-S-CD in 252 melanoma patients of different clinical stages. Serum samples were taken from 252 melanoma patients at 860 times, from June 1996 to July 1998. The serum S-100 protein was measured by the immunoluminometric assay, levels of 5-S-CD was determined by HPLC. The value of S-100 protein in patients with primary melanoma (0.11m mg/l) and in patients without symptoms (0.15 m mg/l) ranged around the normal level (0.01 0.12 m mg/l). There was a significant difference between the values of patients with or without symptoms. There was a similarly significant difference between the S-100 values of clinical Stage I (0.11 mg/l) and Stage III (2.91 mg/l) as well as between those of clinical Stage II (0.47 mg/l) and Stage III (2.91 mg/l), respectively. Analyzing the values of patients with symptoms we observed significant difference between the S-100 protein values of patients with primary tumor and those with solitary or multiple distant metastases. In case of 5-S-CD significant difference was found between clinical Stage I and III as well as clinical Stage II and III. Furthermore, there was a significant difference between the mean marker values of patients with primary tumor, lymph node, lung metastasis and clinical stage III.
Since 1995, a model cancer screening program has been in operation in Hungary, the overall purpose of which is to promote the establishment of effective and efficient screening programs by means of adapting the internationally agreed principles of organized screening to the needs and opportunities in Hungary. The establishment and operation of a national population-based cancer registration system is an other aim of the Program. The model program--financed partly from a loan from the World Bank, partly from local funds provided by the Government of Hungary--is to develop standard procedure for cervical, breast and colorectal screening and to end up with tested recommendations for introduction of organized screening of proved effectiveness, integrated into the health care system, on country-wide service bases in Hungary.
Explore the source record for details and available documents.
The authors produced various degradation products of human hemoglobin. With the aid of immune sera raised against native hemoglobin and their fragments, we examined the antigenicity of the intact molecule and fragments as well as the specificity and reactivity of the immune sera used. Since conventional guaiac-type reactions make no distinction between the different hemoglobin molecules and the methods described in recent years' publications only with immune sera raised against native intact hemoglobin, the demonstration of occult fecal blood has not reached the desired rate of efficacy in clinical practice. The authors recommend the introduction of a simple differential diagnostic methods suitable for the parallel examination of intact and fragmented hemoglobin.
One hundred ninety patients with germ cell line testicular tumours were treated according to the modified Einhorn scheme. The response rate was 67.9%. The most favourable results were found in the embryonal histologic type (RR = 76.9%) in the biological markers (beta-HCG and AFP) negative (RR = 97.4%) and in the minimal pulmonary extent group (RR = 94.1%). The authors treated 112 patients with including these VPB-resistant germ cell testicular tumour and those with recurrence after this treatment. The patients' mean age was 28.8 (limits 19 to 44) years. Patients were given Vepeside (100 mg/m in infusion for days 1-5), Adriablastin (40 mg/m in infusion on day 1) and Cisplatin (20 mg/m in infusion) for day 1-5. The treatment resulted in CR with 18 patients (16.1%) and PR with 42 (37.5%) (RR = 53.6%). The best results were obtained with the seminoma patients who were marker-negative and had small-volume metastasis. CR developed in 4 of 7 seminoma patients (57%) and in 7 of 25 marker-negative individuals (28%), and PR developed in 11 patients (44%) (RR = 72%). Out of 12 patients with small volume metastatis four (33%) showed CR and five revealed PR (41.7%), their RR turned out to be 74.6%. The average remission period was 37 (range 4-70) months in CR but merely 6.1 (range 2-38) months in PR. It can be stated that fairly good results can be achieved with second-line VpAP treatment in case of resistance developed to primary VPB therapy or subsequent relapse. The efficacy of combined chemotherapy of Vepesed+Holoxan +/- Adriablastin as third-choice was studied in advanced testicular cancer patients refractory to, or recurrent after, first- and second-line cytostatic therapy. Between September 1981 and January 1988 49 evaluable patients were treated with Vepesid (VP-16213--100 mg/m2 days 1-5), Holoxan (40 ml/kg days 1-5), hydration, urine-alkylation + Uromitexan +/- Adriablastin (40 mg/m day 1). The single dose of Uromitexan was 20% of the daily dose of Holoxan, and the patients received it i.v. just prior to Holoxan administration (h 0), the 4 and 8 h later. Two patients got into CR and 10 to PR. The rate of remission was 24.5%. The most severe side effect was leukopenia. The elevation of BUN and se. creatinine was transient and mild. In those cases where Holoxan was not included in the first- or second-line regimens, when combined with Vepesid and Adriablastin as third-choice therapy one could achieve further improvement. In case of CR the prolongation of life is also noteworthy. The first-, second- and third-line therapy plus salvage RLA and/or pulmonary metastasectomy achieved long-term survival only in one quarter of the patients.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Authors discuss about the laboratory determination and differential diagnostic problems of the homogenous and heterogenous immunoglobulin increases--in respect to the monoclonal IgA--in the serum and urine. Their investigating system is convenient for the early detection of the small M-components and to discover the other rare protein anomalies too.
The authors describe a modified version of counterimmunoelectrophoresis of easy performance and high sensitivity. With this method human haemoglobin can easily and specifically be determined either in fresh or dried biological samples. Glutaraldehyde pretreatment of the samples results in the development of complexes with highly favourable electrophoretic mobility and precipitating capacity. By this chemical modification and use of a double set of samples with varying antigen-antibody proportion, the sensitivity of haemoglobin detection in erythrocyte-containing haemolysate and native blood was 300 ng/ml. The examination is easily performed, and without considerable outlay, even with conventional laboratory facilities. It is equally suitable for the detection of occult colorectal bleeding and for species-specific study of blood stains of unknown origin. The authors succeeded in identifying human haemoglobin even in a 42-month dried blood stain.
Bence Jones proteins (monoclonal free light chains of immunoglobulins) are the earliest known biological markers of malignant cell dyscrasia; Bence Jones proteinuria is also present in many types of B cell-related neoplasms. Sometimes, it may also occur in Hodgkin's disease. In some cases, benign monoclonal gammapathy was found to be associated nontumorous diseases as well. The type of monoclonal light chain, the degree of polymerization, and the isoelectric point of the molecule may affect the course of the disease. Urine samples from 637 patients with true or suspected lymphoproliferative diseases were investigated over a 2-yr period by different immunochemical methods. Bence Jones proteinuria was identified in 71 cases by isoelectric focusing combined with immunofixation, while the pathological protein was detected only in 63 cases by conventional methods. Bence Jones proteins can be detected by this new method at a level below the sensitivity of conventional procedures. Bence Jones proteins in the urine may signal a malignant tumor or malignant transformation of an earlier disease. The early detection of monoclonal immunoglobulin light chains in the urine may be important in clinical diagnosis, therapy, and follow-up.
Double (kappa + lambda), Bence Jones (BJ) proteinuria was detected in a male patient of 73 years. The disease started as a solitary plasmacytoma in bone and transformed into multiple myeloma. At the beginning, isolated BJ lambda proteinuria was observed which was soon accompanied by transient excretion of BJ kappa protein.
The authors have developed a specific, sensitive, simple and economic method for the detection of occult colorectal bleeding. The new technique consists of the traditional guaiac type reaction and an immunochemical test which as a second-phase test using dried filter paper discs serves to eliminate or reduce the false-positive reactions, decreasing the necessity of further invasive diagnostic measures. They report on their experience obtained with the screening of a rural population of 3,346 persons; a positive colour reaction was observed in 546 individuals (16.3%) who were not on diet. In the second-phase immunochemical examination, however, this number decreased to 54 (1.6%). In this group of patients, who did have blood in their stools, 5 colorectal carcinomas (9.25%), each in the early Duke stage A, could be detected. The overall detection rate of carcinoma, polyp and colitis ulcerosa, likewise a precancerous state, was 40.73%. The results obtained so far suggest that this combined screening method represents an easier, cheaper and a more rapid diagnostic method for the detection of early colorectal carcinomas and precancerous states compared to the conventional ones. In mass screening the treatment and transportation of the test specimens are simple and hygienic.
Between December 1979 and July 1986, 190 patients with nonseminomatous germ-cell testicular tumors were treated according to the modified Einhorn scheme. The response rate was 67.89%. The most favorable results were found in the embryonal histologic type (RR = 76.9%), in the biological marker (AFP, HCG) negative (RR = 97.43%) and in the minimal pulmonary extent group (RR = 94.12%).