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At least 235 records · Page 13Linked to original sources
PubMed2004

Prognostic value of thyroglobulin serum levels and 131I whole-body scan after initial treatment of low-risk differentiated thyroid cancer.

Diagnostic iodine-131 whole-body scan ((131)I-WBS) and serum thyroglobulin values (Tg) performed 6 to 12 months after thyroid ablation for differentiated thyroid carcinoma were evaluated in 194 consecutive patients at the Hospital de Navarra, (Pamplona, Spain). All patients underwent near-total thyroidectomy and (131)I ablation with 3.7 GBq. Patients with positive anti-Tg antibodies or with (131)I uptake outside the neck were previously excluded. Uptake of (131)I in the thyroid bed was detected in 27 patients (13.9%). Serum Tg levels were below 0.5 ng/mL in 133 patients, ranged from 0.5-10 ng/mL in 39 patients, and was above 10 ng/mL in 22 patients. After a follow-up of 7.7 +/- 3.3 years, persistence of the illness has been observed in 2 patients with undetectable Tg (1.5%), but metastases were not detected in any case. In those with Tg higher than 0.5 ng/mL, 29 of 61 patients had persistence of the disease (47.5%) with evidence of metastases in 15 (24.5%), irrespective of the initial total body scan (131)I uptake. In conclusion, serum Tg levels obtained after thyroid ablation has a good prognostic value and permits the selection of patients for further diagnostic studies, while diagnostic (131)I-WBS performed at that time did not correlate with results of Tg and scarcely provides additional information.

Biomarkers↗
PubMed1991

[Surgical techniques in prostate cancer].

Diagnostic, therapeutic and palliative procedures in carcinoma of the prostate are discussed. Staging lymphadenectomy of pelvic lymph nodes has recently been performed via the laparoscope. Our results achieved with this procedure in, to date, 25 patients revealed lymph nodes metastasis in 50% of the cases, although the CT scan was unremarkable. Radical prostatovesiculectomy is accepted as the method of choice for the curative treatment of non-metastatic carcinoma of the prostate. Life expectancy following radical prostatectomy in tumor stage 2 or below, is similar to the general population of the same age. The palliative procedure of choice in prostatic carcinoma is plastic orchiectomy, in which the androgen-producing gonadal tissue is removed and testicular coat, together with the epididymi left in situ. With this approach, partial remission, rarely even complete remission, can be achieved in 80% of the patients. Information in the literature on prolongation of survival as a result of androgen deprivation is, however, contradictory.

Humans↗
PubMed2004

Proteomic patterns as a diagnostic tool for early-stage cancer: a review of its progress to a clinically relevant tool.

The pace of development in novel technologies that promise improvements in the early diagnosis of disease is truly impressive. One such technology at the forefront of this revolution is mass spectrometry. New capabilities in mass spectrometry have provided the means for the development of proteomics, and the race is on to find innovative ways to apply this powerful technology to solving the problems faced in clinical medicine. One area that has garnered much attention over the past few years is the use of mass spectral patterns for cancer diagnostics. The use of these so-called 'proteomic patterns' for disease diagnosis relies fundamentally on the pattern of signals observed within a mass spectrum rather than the more conventional identification and quantitation of a biomarker such as in the case of cancer antigen-125- or prostate-specific antigen. The inherent throughput of proteomic pattern technology enables the analysis of hundreds of clinical samples per day. Currently, there are two primary means by which proteomic patterns can be acquired, surface-enhanced laser desorption/ionization (SELDI) and an electrospray ionization (ESI) method that has been popularized under the name, OvaCheck. In this review, an historical perspective on the development of proteomic patterns for the diagnosis of early-stage cancers is described. In addition, a critical assessment of the overall technology is presented with an emphasis on the steps required to enable proteomic pattern analysis to become a viable clinical tool for diagnosing early-stage cancers.

Early Diagnosis↗
PubMed1982

[Current diagnostic and treatment problems in thyroid cancer].

The paper deals with a 10-year experience (1971-1980) of treating tumors of head and neck at the Institute. Different aspects of early diagnosis of thyroid carcinoma, its adequate therapy and organisational measures required for its prevention are discussed on the basis of 1,304 case histories of thyroid cancer. Up-to-date methods of early diagnosis of thyroid cancer (diagnostic puncture and thyroidlymphography), which can be integrated with general medical practice, are recommended. Causes of errors leading to failure to remove the whole malignancy are discussed. Recommendations how to obviate this difficulty are given and measures aimed at ensuring a 5-year survival in 98% of cases and adapted to different groups of cancer patients are suggested.

Diagnosis, Differential↗
PubMed2000

The new human kallikrein gene family: implications in carcinogenesis.

The traditional human kallikrein gene family consists of three genes, namely KLK1 [encoding human kallikrein 1 (hK1) or pancreatic/renal kallikrein], KLK2 (encoding hK2, previously known as human glandular kallikrein 1) and KLK3 [encoding hK3 or prostate-specific antigen (PSA)]. KLK2 and KLK3 have important applications in prostate cancer diagnostics and, more recently, in breast cancer diagnostics. During the past two to three years, new putative members of the human kallikrein gene family have been identified, including the PRSSL1 gene [encoding normal epithelial cell-specific 1 gene (NES1)], the gene encoding zyme/protease M/neurosin, the gene encoding prostase/KLK-L1, and the genes encoding neuropsin, stratum corneum chymotryptic enzyme and trypsin-like serine protease. Another five putative kallikrein genes, provisionally named KLK-L2, KLK-L3, KLK-L4, KLK-L5 and KLK-L6, have also been identified. Many of the newly identified kallikrein-like genes are regulated by steroid hormones, and a few kallikreins (NES1, protease M, PSA) are known to be downregulated in breast and possibly other cancers. NES1 appears to be a novel breast cancer tumor suppressor protein and PSA a potent inhibitor of angiogenesis. This brief review summarizes recent developments and possible applications of the newly defined and expanded human kallikrein gene locus.

Chromosome Mapping↗
PubMed1986

Pancreatic cancer: continuing diagnostic and therapeutic dilemma.

Improved survival for patients with cancer of the pancreas awaits future therapeutic advances. A more immediate objective for these patients is to provide accurate diagnosis and effective palliation. Adherence to a diagnostic strategy should provide an accurate diagnosis with the least number of tests, minimizing cost to the patient in terms of both money and discomfort. Effective palliation using a variety of available techniques can and should be accomplished expeditiously in order to extend useful survival.

Adult↗
PubMedDate not supplied

Neoadjuvant chemotherapy in breast cancer: which diagnostic procedures can be used?

BACKGROUND: To improve breast cancer treatment, the evaluation of predictive factors is in the focus of clinical research. Significant discrepancies between the clinical assessment of response to neoadjuvant chemotherapy (NACT) and the pathological assessment of response from post-therapy surgical specimens have been demonstrated. We focused on comparing the value of various diagnostic methods used in medical routine. PATIENTS AND METHODS: A clinical evaluation of the primary tumour and regional lymph nodes before and after NACT was performed in 139 patients by physical examination, sonography and mammography. RESULTS: Mammography and physical examination correlated best with pathological findings in the measurement of the tumour, whereas sonography was the most accurate predictor of the status for axillary lymph nodes. CONCLUSION: Mammography and physical examination are the best non-invasive predictors of the real size of the primary breast cancer, whereas sonography correlates better with the proven status of axillary lymph nodes.

Adult↗
PubMed2001

Major depression and demoralization in cancer patients: diagnostic and treatment considerations.

Major depression and demoralization are very common in patients with cancer. A discussion of the diagnostic specificity of major depression and demoralization (also known as adjustment disorder) is presented here, followed by a review of some effects of comorbid depression and cancer. Finally, there are a brief review of studies of antidepressant pharmacotherapy in cancer patients, a treatment algorithm for antidepressant therapy, and suggestions for treatment of demoralization.

Adjustment Disorders↗
PubMed2006

Profiling the humoral immune response in colon cancer patients: diagnostic antigens from Streptococcus bovis.

The human bowel contains a large and dynamic bacterial population that is not only essential for intestinal health, but also critical for the development of diseases such as cancer. In this respect, the Gram-positive bacterium Streptococcus bovis has been associated with colon cancer for many years. To investigate the clinical importance of this association, an immunocapture mass spectrometry assay was developed that can generate infection-related protein profiles. The composition of these profiles is governed by the capture of specific antigens by serum antibodies from colon cancer patients. This assay showed that S. bovis antigen profiles could distinguish 11 out of 12 colon cancer patients from 8 control subjects, whereas antigen profiles derived from the gut bacterium Escherichia coli were not diagnostic for colon cancer. Moreover, S. bovis antigen profiles were also detected in polyp patients, indicating that infection with this bacterium does occur early during carcinogenesis. Highly accurate tandem mass spectrometry was used to identify one of the diagnostic antigens as a surface-exposed heparin-binding protein, which might be involved in attachment of S. bovis to tumor cells. Together, these findings corroborate the hypothesis that colonic lesions provide a specific niche for S. bovis, resulting in tumor-associated "silent" infections. These infections, however, only become apparent in colon cancer patients with a compromised immune system (bacteremia) or coincidental cardiac valve lesions (endocarditis). This makes profiling of the humoral immune response against "silent" S. bovis infections a promising diagnostic tool for the early detection of human colon cancer, which is crucial for the effective treatment of this disease.

Antibody Formation↗
PubMed2000

An overview of the prevention of oral cancer and diagnostic markers of malignant change: 1. Prevention.

The incidence of oral cancer appears to be on the increase, with patients presenting at an earlier age. An overview of the prevention of this important condition is given in this article, and diagnostic markers will be discussed in a later presentation. Greater awareness of the aetiological agents involved in the development of oral cancer, and their avoidance, should help reduce the number of cases. General dental practitioners have an important role to play in advising patients on healthier lifestyles (primary prevention), the detection of potentially malignant disease before it becomes malignant (secondary prevention) and screening for field changes in patients with a history of oral cancer. The role of chemoprevention (defined here as tertiary prevention) is also considered.

Carcinoma, Squamous Cell↗
PubMed2001

Telomerase and cancer: time to move from a promising target to a clinical reality.

The past 25 years have seen unparalleled advances in our understanding of the molecular basis of cancer. As a result, novel molecular targets have been identified that provide great potential for the development of new cancer diagnostics and therapies. Four key features of cancer cells distinguish them from their normal counterparts: loss of cell-cycle regulation, loss of control over invasion and metastasis, failure of apoptotic mechanisms, and bypass of senescence. This review examines our understanding of the bypass of senescence and the process of immortalization during carcinogenesis. In addition, the realistic opportunities for telomerase in cancer diagnostics and the challenges faced in clinical trial design for telomerase therapeutics are discussed.

Animals↗
PubMed2000

Small peripheral glandular lesions detected by screening CT for lung cancer. A diagnostic dilemma for the pathologist.

The early detection of lung cancer by helical CT provides an important opportunity for radiologic-pathologic and clinical correlation of borderline glandular lesions. Little is known about the clinical course of atypical adenomatous hyperplasia, solitary noninvasive, nonmucinous BAC, and early-phase invasive adenocarcinomas, therefore, a single protocol for specimen handling and a central tissue registry are essential. The most important separation among the various types of adenocarcinoma is the diagnosis of BAC, a potentially curable malignancy, from invasive adenocarcinoma. Therefore, for small lesions of 2 cm or less, the entire tumor should be processed. For larger lesions, one section per centimeter should be sampled, and if the initial sections show a purely lepidic growth pattern, additional sections should be taken to exclude an invasive component. If foci of invasion are identified, the tumor should be classified as an adenocarcinoma with bronchioloalveolar features. At the International Conference on Screening for Lung Cancer held in October 1997, it was recommended that an international panel be used to reach consensus on difficult lesions of the lung detected by CT screening, and that a tissue bank of these lesions be established to ensure further clinical, radiographic, light microscopic, immunohistochemical, and molecular studies of putative precursor lesions and small carcinomas. Through the collection of these lesions, we can further our understanding of the biologic behavior of lung cancer, particularly because little is known about the progression from a purely lepidic growth pattern to invasive adenocarcinoma.

Adenocarcinoma↗
PubMed1982

[Studies on recurrent and metastatic cases of the early stomach cancer--from diagnostic aspect].

There were 256 cases of the early stomach cancer resected, from 1967 to '77 in National Hospital-Sapporo. First, 4 recurrent cases of these 256 cases (1.6%) are analyzed and concluded. 1) Common items of these recurrent cases were male and submucosal invasion in depth of cancer. 2) Modes of recurrence of the gastric remnant were shown in 3 of 4 recurrent cases. These 3 cases died within 6 months, on the average, from the diagnosis of recurrence. Therefore, earlier detection and operation of recurrent cancer is important. 3) There are some cases in which the possibility of multiple or double cancers exist, so careful examination before initial operation is most necessary. Second, the early stomach cancers with metastasis to the regional lymph nodes (n+ group) are analyzed. 1) There were 20 cases of n+ group (7.8%). 2) There were 12 cases of depressed type early cancers with metastasis to the regional nodes (depressed type n+ group), and 137 cases of the single depressed type early cancers without metastasis to the nodes (depressed type n- group). Statistical comparison between the depressed type n+ group and n- group disclosed that the maximum diameter of the lesion of the n+ group was longer than that of the n- group, and histological type of cancer of the n+ group was more undifferentiated than that of the n- group. Items of the depth of invasion and site of the lesion are not statistically significant at this time, however, close attention should be paid to these items.

Adult↗
PubMed1990

Analysis of the dose-volume histogram in uterine cervical cancer by diagnostic CT.

The dose-volume histogram of the target volume during intracavitary irradiation in cases of uterine cervical cancer was calculated from diagnostic computed tomography data in order to study the correlation with prognosis. The minimum dose applied to the target volume was most closely related with the prognosis. However, for the actual planning of three-dimensional treatment, a dose of 80% of the volume of the dose-integration volume curve, on which the histogram was integrated in the order of high dose, was recommended as an index dose for dose optimization.

Adult↗
PubMed1996

Thyroid cancer after diagnostic administration of iodine-131.

To provide quantitative data on the risk of thyroid cancer after exposure to 131I, 34,104 patients administered 131I for diagnostic purposes were followed for up to 40 years. The mean thyroid dose was estimated as 1.1 Gy, and 67 thyroid cancers occurred in contrast to 49.7 expected (standardized incidence ratio = 1.35; 95% confidence interval 1.05-1.71). Excess cancers were apparent only among patients referred because of a suspected thyroid tumor, and no increased risk was seen among those referred for other reasons. Further, risk was not related to radiation dose to the thyroid gland, time since exposure or age at exposure. The slight excess of thyroid cancer thus appeared to be due to the underlying thyroid condition and not radiation exposure. Among those under age 20 years when 131I was administered, a small excess risk (3 cancers compared to 1.8 expected) was about 2-10 times lower than that predicted from data for the A-bomb survivors. These data suggest that protraction of dose may result in a lower risk than an acute X-ray exposure of the same total dose.

Adolescent↗
PubMed1994

[Early detection of non-palpable (T0) breast cancer: the diagnostic procedure for pathological discharge from the nipple].

Detection of non-palpable (T0) breast cancer by pathological nipple discharge is possible 3 years or more earlier than tumorous breast cancer. However, the definite diagnosis of T0 breast cancer has been considered to be very difficult because the standard diagnostic method such as exfoliative cytology and ductography were not totally reliable. In 1985 we first demonstrated the significance of CEA measurement in nipple discharge for diagnosis of T0 breast cancer. Since then CEA activity in nipple discharge was estimated in 60 patients with breast diseases by means of enzyme immunoassay using monoclonal anti CEA antibody. They include 17 with T0 breast cancer, 9 with borderline lesion, 20 with intraductal papilloma and 14 with fibrocystic diseases. When the cut off value of CEA concentration was set at 600 ng/ml, the sensitivity, specificity and accuracy were 76.5%, 100% and 92.2%, respectively. These levels were higher than those for mammography or cytology. In the past 7 years, 13 cases of T0 breast cancer were detected in our hospital. They accounted for 2.5% of total breast cancer cases. In conclusion, CEA measurement in nipple discharge is a useful method for the diagnosis of non-palpable breast cancer.

Biomarkers, Tumor↗
PubMed2004

Risk of cancer from diagnostic X-rays: estimates for the UK and 14 other countries.

BACKGROUND: Diagnostic X-rays are the largest man-made source of radiation exposure to the general population, contributing about 14% of the total annual exposure worldwide from all sources. Although diagnostic X-rays provide great benefits, that their use involves some small risk of developing cancer is generally accepted. Our aim was to estimate the extent of this risk on the basis of the annual number of diagnostic X-rays undertaken in the UK and in 14 other developed countries. METHODS: We combined data on the frequency of diagnostic X-ray use, estimated radiation doses from X-rays to individual body organs, and risk models, based mainly on the Japanese atomic bomb survivors, with population-based cancer incidence rates and mortality rates for all causes of death, using life table methods. FINDINGS: Our results indicate that in the UK about 0.6% of the cumulative risk of cancer to age 75 years could be attributable to diagnostic X-rays. This percentage is equivalent to about 700 cases of cancer per year. In 13 other developed countries, estimates of the attributable risk ranged from 0.6% to 1.8%, whereas in Japan, which had the highest estimated annual exposure frequency in the world, it was more than 3%. INTERPRETATION: We provide detailed estimates of the cancer risk from diagnostic X-rays. The calculations involved a number of assumptions and so are inevitably subject to considerable uncertainty. The possibility that we have overestimated the risks cannot be ruled out, but that we have underestimated them substantially seems unlikely.

Adolescent↗
PubMedDate not supplied

[Thyroid cancer. Epidemiological, diagnostic and therapeutic features].

A retrospective clinical study was made of 189 cases of thyroid cancer seen in our service between 1974 and 1994. Epidemiological, clinical, diagnostic, and therapeutic variables were analyzed for each histological type of thyroid carcinoma. Total thyroidectomy is the treatment of choice at our institution, followed by radioiodine treatment for differentiated carcinomas and external radiation and chemotherapy for anaplastic carcinomas. The 5-year survival rate after surgical treatment was 72% for all histological types of thyroid carcinoma. Permanent postoperative complications occurred in 2% of patients.

Aged↗