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Human serum deoxythymidine-5'-triphosphatase activity as a parameter in the diagnosis and follow-up of large bowel carcinoma.

Serum deoxythymidine-5'-triphosphatase (dTTPase) levels were determined in 71 patients with large bowel cancers at different clinical stages: 10 patients in Duke's Stage A; 37, in Duke's Stage B; and 24, in Duke's Stage C. The dTTPase values of patients in Duke's Stage B and C are significantly elevated over normal healthy controls, and a correlation was observed between tumor stage and dTTPase activity. While dTTPase levels rise in patients with increasing tumor burdens, they decline in patients with undetectable tumor tissue after radical surgery. Six of 15 courses are documented, illustrating that, after successful operation, enzyme levels revert to normal. In all patients, carcinoembryonic antigen levels were determined along with dTTPase values, and both sets of data were correlated with each other indicating a correlation coefficient of zero. So, if both dTTPase and carcinoembryonic antigen are taken into account, the sensitivity of detection of colorectal carcinomas rises to 66% for all patients and to 92% for patients with a colorectal carcinoma of Duke's Stage C.

Carcinoembryonic Antigen↗

[Malignant histiocytosis of the intestine. An anatomo-clinical case report].

Clinico-pathological case report of a 11 year-old girl who successively presented persistent abdominal pain, pneumoperitoneum, repeated intestinal hemorrhages, superficial intestinal ulcerations, first localized on the jejunum and later extended to the all gut. After a course of 13 months, the child died from diffuse and repeated hemorrhages. The morphologic studies revealed a diffuse and homogeneous cellular infiltrate made of large round "lymphomatous" cells scattered within the lamina propria and submucosa. Initially this superficial cellular infiltrate was overshadowed by accompanying inflammatory cells and was not recognized as a tumoral process. Later on the dissemination of abnormal cells to the entire ileon, mesenteric lymph nodes, spleen and liver and the cellular appearance confirmed its neoplastic nature and allowed to consider this process as a malignant histiocytosis of the intestine as described by Isaacson and Wright. This case seems to be the first case reported in childhood.

Child↗

[Operability and late results of treating recurrences and metachronous malignant tumors of the large intestine].

The analysis of the authors' observations has proved that the surgery in case of the recurrence of cancer of the rectum and colon is a quite justified method of treatment (the average survival period is about 2.5 years). But according to the authors' data, the operability and late results in the treatment of primary multiple metachronal cancer of the colon are higher than in case of the recurrence of cancer and practically do not differ from the operability and late results in solitary cancer (59.1% of cases survived more than 5 years). The authors have come to the conclusion that in such cases the differential diagnosis is a very important prognostic criterium.

Adult↗

Monitoring of patients with carcinoma of the large intestine by use of acute phase proteins and carcinoembryonic antigen.

Fifty-two patients with resectable carcinoma of the colon and rectum have been monitored by three monthly serial estimations of three APRP (serum protein hexose, transferrin and ceruloplasmin) together with CEA. In 36 patients, subsequent clinical evidence of a recurrence of the disease developed during the study period. Monitoring with APRP can detect a recurrence of the disease at the subclinical stage in the majority of patients and appears to be complimentary to monitoring with CEA. However, due to the low incidence of surgical removal of recurrent carcinoma, this does not give real benefit for patients.

Acute Disease↗

Identification and characterization of a circulating tumor-associated oncofetal protein from a radiation-induced adenocarcinoma of the rat small bowel.

A tumor-associated protein from the cellular membranes of a radiation-induced rat small bowel adenocarcinoma was identified, found to be serologically unaltered in the circulatory system, and was observed to be susceptible to acid hydrolysis. The immunochemical reactivity was unchanged by heat, alkali, or neuraminidase digestion. The protein appeared to be a single immunologically active species, but it was structurally composed of a heterogeneous group of proteins.

Adenocarcinoma↗

Small bowel tumors and polyposis syndromes.

Tumors of the small bowel are uncommon and seldom suspected on a clinical basis. Together with the relative inaccessibility of the small bowel to endoscopic investigation, the rarity of these tumors undoubtedly delays the diagnosis. Small bowel tumors may be an interesting field of application for enteroscopy, which now can be readily performed with dedicated enteroscopic evaluation in patients with suspected small bowel neoplasia could improve prognosis and treatment. Enteroscopy may also play an important role in the surveillance of inherited polyposis syndromes, as in other precancerous condition of the small bowel. In Peutz-Jeghers syndrome it may reduce polyp-induced complications and improve planning for surgery; in familial adenomatous polyposis it may contribute to preventing upper gastrointestinal tract cancer.

Biopsy↗