[Clinical evaluation of a cancer antigen CA 125 associated with ovarian cancer. II. Serum CA 125 levels in normal pregnancy].
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Biomedical subjects
Publications and source records attributed to T Tamada.
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UNLABELLED: Immunohistochemical staining was performed for carcinoembryonic antigen (CEA) in tissues taken from 41 cases of cervical and 67 cases of endometrial adenocarcinomas. Utilizing this method, smear specimens from 21 cases with cervical and 25 cases with endometrial adenocarcinomas were investigated at the cell level. THE RESULTS: 1) The investigation at the tissue level indicated that CEA staining was positive in 80% of cases of cervical adenocarcinoma. On the other hand, the positive rate was as low as 55% of the endometrial adenocarcinoma cases. It further declined to 35% when limited to pure adenocarcinoma without squamous elements. In addition, a difference was recognized between the cervical and endometrial groups in their localization. It was apparent that while even the cytoplasm in most of the cervical adenocarcinoma appeared to be markedly stained, such a tendency was observed and was weak in only a part of the cell membrane in the endometrial adenocarcinoma cases. 2) The studies with smear specimens indicated that while 57% (13/21) of the cervical adenocarcinoma cases were CEA positive, only 12% (3/25) were positive in endometrial adenocarcinoma cases. Therefore, a difference was recognized between the two at the cell level in their CEA staining characteristics. 3) Our observation revealed that CEA was more prominent in the poorly differentiated type than in the well differentiated one, in both cervical and endometrial adenocarcinoma. This seems to indicate a relationship between the histological differentiation and production of CEA. On the basis of the above findings, it was inferred that although both cervical and endometrial adenocarcinoma occur in the common Müllerian duct organ, they might have different biological characteristics.(ABSTRACT TRUNCATED AT 250 WORDS)
In order to investigate the effect of UFT, a new antitumor agent, 5-fluorouracil (5-FU) levels in serum and various tissues were measured by the gas chromatographic-mass fragmentographic method. The subjects used for the study were nude mice which had received implants of human endometrial carcinoma. The results were as follows: As compared with tegafur, the concentration of 5-FU in serum rose quickly when UFT was administered, and the values were clearly high. The concentration of 5-FU obtained in tumor tissues with the use of UFT were 2.5 times higher than those obtained by the use of tegafur. Even with one third of the dose of UFT, values were still 1.5 times higher. In normal tissues, the administration of UFT against that of tegafur resulted in higher concentrations of 5-FU. On the other hand, when one third of the dose of UFT was used, 5-FU concentrations in major organs, such as the liver or kidney, showed clearly low values. Based on these findings, it became clear that the 5-FU concentration in tumor tissue is specifically raised by tegafur coadministered with Uracil (UFT), while such an effect is prevented from proceeding in normal tissue.
We measured concentrations of 5-FU in cancerous and normal cervical tissues in 16 patients with cervical cancer to whom UFT or tegafur had been administered. The results were as follows: Concentrations of 5-FU in cancerous tissues measured 30 minutes and 2 hours after UFT administration were 0.181 +/- 0.034 microgram/g and 0.562 +/- 0.145 micrograms/g respectively, while in patients to whom tegafur had been administered, they were 0.105 +/- 0.030 microgram/g and 0.126 +/- 0.015 microgram/g respectively. The comparison of 5-FU concentrations in cancerous tissues within each individual patient indicated that the value was higher after UFT administration than after tegafur administration in 13 cases (81.3%). When classified by histological typing, cases of non-keratinizing carcinoma showed the highest value, followed by keratinizing cases and adenocarcinomas, which indicated the lowest value with administration of UFT. However, there were no differences among these three types when tegafur was administered. Based on the above findings, it was indicated that UFT is an antitumor agent with a higher tumor specificity, especially in non-keratinizing carcinoma.
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The effect of progesterone on pulsatile and basal release of gonadotrophins was studied in 10 hypogonadal women. The day before progesterone treatment, control blood samples were obtained at 15 min intervals between 15.00 and 20.00 h. The next day, 50 mg of progesterone was administered im at 06.00 h and blood samples again were obtained at 15 min intervals between 15.00 and 20.00 h. Serum progesterone levels were 28.4 +/- 4.4 ng/ml at 15.00 h, 24.2 +/- 3.9 ng/ml at 17.30 h and 20.7 +/- 2.5 ng/ml (mean +/- SD) at 20.00 h. Progesterone prolonged the interval between LH pulses from 85 +/- 27 to 155 +/- 55 min (mean +/- SD), augmented their amplitude 2-fold, and caused average declines in LH and FSH concentrations of 27 and 15%, respectively. The results suggest that progesterone suppresses the mean levels of LH and FSH concentrations by acting in the brain to decrease the pulse frequency of gonadotrophin-releasing hormone.
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The present experiments were performed to elucidate the mechanism of the selection and maturation of a dominant follicle in women. Eight normally menstruating women undergoing myonectomy or tubal surgery volunteered for the present study. In 3 patients who were operated on Day 9-11, a visual dominant follicle was removed. The other 5 patients underwent the removal of a newly developing corpus luteum on Day 15-21. After taking 3 or 4 preoperative blood samples in the morning after their hospitalization, blood was obtained at 3 or 6 h intervals for the first 36-45 h and at 1-3 day intervals thereafter for 21-34 days. Serum FSH, LH, estradiol and progesterone were measured by radioimmunoassay. Follicleectomy was followed by a sudden drop in estradiol and a minor increase in progesterone. FSH increased for a few days and then declined. There was a drastic, but short-term increase in LH following follicleectomy which was performed before a preovulatory gonadotropin surge. A LH surge occurred 10.7 +/- 1.2 days (mean +/- S.E.) after follicular ablation followed by a luteal phase. In contrast, there was no remarkable LH release in 4 out of 5 patients who underwent luteectomy. A slightly higher level of FSH was sustained for 2-7 postoperative days. "Luteal phase" rises in estradiol and progesterone terminated promptly following luteectomy. A LH surge was observed 14.2 +/- 1.7 days after surgery followed by a luteal phase. After either type of operation, a sustained increase in FSH was followed by a gradual increase in estradiol which preceded a gonadotropin surge. These hormonal sequences resemble those seen in the normal follicular phase. The present data demonstrated that follicleectomy and luteectomy bring on some characteristic hormonal changes which may exert stimulatory or suppressive effects on the selection and maturation of a dominant follicle after the removal of a main ovarian cyclic structure culminating in ovulation at a certain interval.
The method of pulsatile administration of gonadotropin-releasing hormone (Gn-RH) has been proven as a useful means for induction of ovulation in anovulatory women. In our series of clinical trials, 23 out of 29 anovulatory patients ovulated with pulsatile administration of Gn-RH. Seven patients who ovulated volunteered for the present study with daily hormonal analysis and follicular sonometory . Two patients have oligomenorrhea, 3 patients secondary amenorrhea-1st grade (the sole administration of gestagen required for withdrawal bleeding) and the remaining 2 patients secondary amenorrhea-2nd grade (the combined administration of estrogen and gestagen required for withdrawal bleeding). A diagnosis of hyperprolactinemia was made for one patient with secondary amenorrhea-1st grade. Pulsatile administration of Gn-RH was performed by the use of a self-administered infuser . The infuser was connected to an i.v. indwelling catheter via a specially designed blood backflow eliminater . Five micrograms or less of Gn-RH was given every 2 hr from 07:00 to 23:00 hr daily. Five patients received HCG during the preovulatory period. In one patient, a short term treatment of HMG was added to Gn-RH treatment. Follicular sonometry revealed the development of a single dominant follicle which reached between 20 and 28 mm (23.7 +/- 0.12 mm, mean +/- S.E.) in diameter at the preovulatory period. Disappearance of a dominant follicle was recognized in the early luteal phase. Characteristic increases in estradiol were recognized concomitantly with the development of a dominant follicle. Progesterone levels after ovulation were within the limits of its normal "luteal phase" rise. The present data suggest that pulsatile administration of low dose Gn-RH with nocturnal interruption of treatment is effective for normal progress of follicular development in various types of anovulatory patients, culminating in single ovulation. This paper includes the discussion on our method which may be responsible for a high success rate of ovulation induction.
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