Biomedical subjects

W Reiter

Publications and source records attributed to W Reiter.

42 records · Page 3Linked to original sources

PubMedDate not supplied

Anti-p53 antibodies in serum of smokers and head and neck cancer patients.

Inactivation of the p53 gene occurs in various tumors favouring the accumulation of genetic aberration. It is assumed that p53 protein can become immunogenic in stimulating the production of circulating anti p53 antibodies. Sera from 97 patients with primary and 30 patients with recurrent squamous cell carcinoma of the head and neck were examined for p53 autoantibodies with an enzyme-linked immunosorbent assay (ELISA). Sera from 42 patients with benign ENT-diseases and 28 healthy smokers served as the control. 38.1% (37/97) of the patients with primary and 36.6% (11/30) with recurrent SCCHN had autoantibodies to p53 in their serum. The evidence of p53 antibodies was not dependent on histological grading, T- or UICC stage of the disease. 24.2% (17/70) of the control group also had autoantibodies to p53 in the serum. The values of the control group and the patient group are so closely related, that p53 autoantibodies can not serve as a marker of malignancy. The indication for p53 measurement by ELISA should be very closely defined and limited.

Autoantibodies↗

PubMedDate not supplied

Prognostic value of preoperative serum levels of CEA, CA 19-9 and CA 72-4 in gastric carcinoma.

UNLABELLED: We studied the relevance of CEA, CA 19-9, CA 72-4 and the common classical prognostic factors (age, sex, tumor infiltration, N-classification, staging, grading and Lauren classification) in gastric carcinoma. PATIENTS AND METHODS: Survival function estimates were calculated according the method to Kaplan-Meier. The patients were separated into two groups according to preoperative marker levels. Fixing specificity at 100% for healthy people, cut off levels were calculated. Survival curve differences were assessed using the log-rank-test. Multivariate Cox proportional hazards regression analysis was performed. The mantel-Haenszel method was used to assess the 2-year survival rate of patients with gastric carcinoma and high versus low levels of tumor-associated antigens adjusted to tumor stages. The study was performed on the frozen sera (stored at -80 degrees C) of 103 patients with histologically proven gastric carcinoma. RESULTS: The tumor stage (log-rank chi-square = 55.9; P < 0.0001) represents the best prognostic factor besides preoperative values of CA 19-9 (log-rank chi-square = 13.9; P < 0.001) and CEA (log-rank chi-square = 12.2; P < 0.001). CA 72.4 shows a log-rank chi-square of 6.9 (P < 0.01). We found no statistically significant correlation between survival and sex, tumor grade and Lauren classification. The importance of different parameters in providing additional prognostic information was evaluated by multivariate analysis. Only patients after curative surgical intervention (n = 55, R0) were considered. Cox proportional hazards regression analysis yielded an adjusted relative risk of 2.4 in patients with a preoperative CEA concentrations > or = 4 ng/mL vs. < 4 ng/mL, of 2.8 in patients with a preoperative CA 19-9 concentration > or = 60 U/mL vs. < CA 19-9 and of 1.8 for stage III/IV vs. stage I/II (P < 0.05). For CEA the 2-year survival rates in the group of patients with preoperative serum concentrations > or = 4 ng/mL versus < 4 ng/mL and stadium III/IV were 14% versus 29% and in stadium I/II 50% versus 83% (P < 0.05). For CA 19-9 the 2-years survival rates in the group of patients with preoperative serum concentrations > or = 60 U/mL versus < 60 U/mL and stadium III/IV were 14% versus 28% and in stadium I/II 40% versus 83% (P < 0.05). CONCLUSION: The postoperative R-classification and the tumor stage represent the best prognostic information besides the preoperative values of CA 19-9 or CEA, respectively. The predictive information provided by preoperative CEA and CA 19-9 serum levels is additional to that obtained from other factors investigated.

Antigens, Tumor-Associated, Carbohydrate↗

PubMedDate not supplied

Preoperative serum levels of CEA and CA 19-9 and their prognostic significance in colorectal carcinoma.

UNLABELLED: The prognostic information provided by preoperative serum CEA, CA 19-9 antigen assays as compared with the classical prognostic factors (age, sex, tumor infiltration, tumor stage (Dukes') and R-classification) in 495 patients with colorectal carcinoma was analysed. PATIENTS AND METHODS: Survival function estimates were calculated according to Kaplan-Meier. The patients were separated into two groups according to the preoperative marker levels. Fixing specificity at 100% for healthy people, cut off levels were calculated. Survival curve differences were assessed using the log-rank-test. Multivariate Cox's proportional hazard regression analysis was performed. The Mantel-Haenszel method was used to assess the survival rate of patients with colorectal carcinoma and high versus low levels of tumor-associated antigens according to tumor stages. The study was performed on the frozen sera (stored at -80 degrees C) of 495 patients with histologically proven colorectal carcinoma. RESULTS: The Dukes' stages (log-rank chi-square = 231.9; P < 0.0001) represent the best prognostic factor besides the preoperative values of CA 19-9 (log-rank chi-square = 162.5). CEA shows a log-rank chi-square of 71.4. Thus, CEA and CA 19-9 can be used to discriminate two groups of patients with significantly different survival times (P < 0.0001). The importance of different parameters in providing additional prognostic information was evaluated by multivariate analysis (Cox's model). Estimated relative risks of death adjusted for tumor stage were 5.5 for Dukes' stage A versus Dukes' stage B/C and Dukes' stage B/C versus Dukes' stage D, respectively and an increasing relative risk of 27.5 for Dukes' stage A versus Dukes' stage D (P < 0.001). The relative risk for preoperative CA 19-9 serum concentrations (> or = 60 U/mL versus < 60 U/mL) was 2.3 (P < 0.001) for preoperative CEA concentrations (> or = 4 ng/mL versus < 4 ng/mL) 1.4 (P < 0.07). For CEA the 2-years survival rates in the group of patients with preoperative serum concentrations > or = 4 ng/mL versus < 4 ng/mL and Dukes' stage D were 16% versus 38%, in Dukes' stage B/C 73% versus 91% and in Dukes' stage A 100% versus 98%. For CA 19-9 the 2-years survival rates in the group of patients with preoperative serum concentrations > or = 60 U/mL versus < 60 U/mL and Dukes' stage D were 10% versus 39%, in Dukes' stage B/C 58% versus 87%. In the group of patients with Dukes' stage A with serum levels > or = 60 U/mL a 2-year survival rate of 100% was found. In the corresponding group only one patient exists. CONCLUSION: The postoperative Dukes' classification provides the best prognostic information besides the preoperative values of CA 19-9. The predictive information provided by the preoperative CA 19-9 serum level is additional to that obtained from the other factors investigated.

CA-19-9 Antigen↗

PubMedDate not supplied

The ratio of free to total prostate specific antigen: an advantageous addition in the differential diagnosis of benign hyperplasia and cancer of the prostate?

UNLABELLED: This study examined the clinical relevance of the determination of free PSA (f-PSA) in addition to total PSA (t-PSA). PATIENTS AND METHODS: Both total PSA- and free PSA-values of frozen sera obtained pretherapeutically from 80 patients with carcinoma (PC) and 171 patients with benign hyperplasia of the prostate (BPH) were analysed by means of PSA IRMA and FREE PSA IRMA (IMMUNOCORP/IBL). RESULTS: At 95% specificity (true negative test results), a cut-off value of 16.8 [micrograms/L] was obtained for total PSA (9 patients with BPH [5%] were above this value). For this cut-off value we calculated a sensitivity (true positive test results) of 41%. Using the same criteria for the ratio Q = f-PSA:t-PSA a cut-off of 0.083 was found again at a specificity of 95%. In a second step only patients with total PSA values below the cut-off level of 16.8 [micrograms/L]) were considered. Of these patients 11 of 160 with BPH (missing values = 1) and 13 of 33 with PC (missing values = 2) were below the above mentioned ratio (Q = 0.083). Considering both steps (total PSA and Q) 46 patients with PC were detected correctly and 20 patients with BPH would have been biopsied unnecessarily (positive biopsy rate: 70%). CONCLUSION: High total PSA levels are a very good indicator for the presence of prostate cancer. There is still concern to improve the differentiation between the diagnosis between BPH and PC, when an intermediate or low value (< or = 95% specificity) is observed. The determination of Q is only useful in this range and might be helpful for the clinician's decision to apply or avoid biopsy.

Diagnosis, Differential↗

PubMedDate not supplied

Total and free PSA: a methodical and clinical evaluation of five assays.

UNLABELLED: We studied the methodical and clinical relevance of five determination assays for free PSA (f-PSA) in addition to the corresponding total PSA antigen (t-PSA). METHODS: Both the total PSA- and free-PSA-values of frozen sera obtained pretherapeutically from 80 patients with carcinoma (PC) and 171 patients with benign hyperplasia of the prostate (BPH) were analysed by means of Enzymun-Test PSA/BM, PSA-RIACT/ CIS, CanAg PSA EIA/ Dia, Tandem-E PSA/Hyb, PSA IRMA/ IBL and Enzymun-Test PSA free/BM, F PSA-RIACT/CIS, CanAg Anti Free PSA/Dia, Tandem-R free PSA/Hyb, FREE PSA IRMA/IBL. RESULTS: The coefficient of correlation between Hybritech PSA assay and the other assays was determined in patients with benign and malignant prostatic diseases. There was a strong overall correlation with all assays measuring total or free PSA, respectively. A satisfying correlation is also shown using a limited scale up to 50 ng/mL for total PSA and 5 ng/mL for free PSA. At 95% specificity sensitivities of total PSA between 40% and 50% of the ratio (Q) = free PSA/total PSA between 4% and 28% were calculated. In a second step only patients with total PSA values below the cutoff level of 16.5 [micrograms/l] (BM), 13.9 [micrograms/l] (CIS), 14.7 [micrograms/l] (Dia), 15.7 [micrograms/l] (Hyb) and 16.8 [micrograms/l] (IBL) were considered. Using the BM assays, of these patients 9 of 162 with BPH and 14 of 47 with PC [CIS: 14 of 162 with BPH and 4 of 48 with PC/Dia: 13 of 162 with BPH and 11 of 48 with PC/Hyb: 6 of 156 with BPH (missing values = 6) and 11 of 40 with PC/IBL: 11 of 160 with BPH (missing values = 1) and 13 of 33 with PC (missing values = 2)] were below the ratio Q = free PSA/total PSA. Considering both steps (total PSA and Q) using the BM assay 47 patlents with PC were detected correctly and 18 patients with BPH would have been biopsied unnecessarily (positive biopsy rate = pos. br.: 72%) [CIS: 38 patients with PC and 23 patients with BPH (pos. br.: 62%)/Dia: 43 patients with PC and 22 patients with BPH (pos. br.: 66%)/Hyb: 51 patients with PC and 15 patients with BPH (pos. br.: 77%)/IBL: 46 patients with PC and 20 patients with BPH (pos. br.: 70%)] CONCLUSIONS: High total PSA levels of all assays are a very good indicator for the presence of prostate cancer. There is still concern to improve the differentiation between BPH and PC, when an intermediate or low value (< 95% specificity) is observed. The determination of Q is only useful in this range and it might be helpful for the clinicians decision to apply or avoid biopsy.

Antibodies, Monoclonal↗

PubMedDate not supplied

Alpha 1-antichymotrypsin-PSA (ACT-PSA): a useful marker in the differential diagnosis of benign hyperplasia and cancer of the prostate?

UNLABELLED: This study examined the clinical relevance of the determination of alpha 1-antichymotrypsin complexed PSA (ACT-PSA) in addition to total PSA antigen (t-PSA). PATIENTS AND METHODS: Both total PSA- and ACT-PSA-values of frozen sera obtained pretherapeutically from 93 patients with carcinoma (PC) and 132 patients with benign hyperplasia of the prostate (BPH) were analyzed by means of PSA sandwich-ELISA (Dianova GmbH) and ACT-PSA sandwich-ELISA (Dianova GmbH). RESULTS: At 95% specificity (true negative test results), a cutoff value of 18.9 [micrograms/L] was obtained for total PSA (7 patients with BPH [5%] were above this value). For this cutoff value we calculated a sensitivity (true positive test results) of 41%. Using the same criteria for the ratio Q = ACT-PSA: t-PSA (percentage of ACT-PSA) a cutoff of 6.0 was found again at a specificity of 95%. In a second step only patients with total PSA values below the cutoff level of 18.9 [micrograms/L]) were considered. Out of these patients 119 of 125 with BPH and 3 of 54 with PC were below the above mentioned ratio (Q = 6.0). Considering both steps (total PSA and Q) 42 patients with PC were detected correctly and 15 patients with BPH would have been biopsied unnecessarily. CONCLUSION: High total PSA levels are a very good indicator for the presence of prostate cancer. There is still concern to improve the differentiation of the diagnosis between BPH and PC, when an intermediate or low value (< or = 95% specificity) is observed. The determination of Q = ACT-PSA: t-PSA is not to be recommended because it might not be helpful for the clinicians decision to perform biopsy.

Diagnosis, Differential↗