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PubMed1981

The present status of immunodiagnosis and immunotherapy of cancer.

A number of immunodiagnostic procedures in cancer is clinically important in the sense that the tests may confirm the results of other cancer diagnostic investigations. However, each one of the tests has its own area of application. Immunodiagnostic tests are used for the detection of relapse or metastases as well as for the histological verification of the tumor. A mass screening for tumors in the population and most probably the early tumor diagnosis by immunological means is impossible due to biological variables among the tumor bearers and to technical difficulties. Immunotherapy of tumors is still at an experimental stage. Although immunization is possible to animal tumors convincing data on similar effects in the human tumor system do not exist as yet. This conclusion is based on immunization experiments with adjuvants as well as with tumor preparations, transfer factor, thymosin, or immune RNA. The fact that tumor cytotoxic and tumor cytostatic immunological mechanisms do occur even in the human tumor system is a stimulus for future approaches.

Animals↗
PubMed1980

Preoperative carcinoembryonic antigen and survival after resection of lung cancer.

Carcinoembryonic antigen (CEA) was measured preoperatively in 43 patients who underwent complete resection of primary lung cancer. 7 of 43 patients (17%) had CEA levels in the cancer diagnostic range (greater than 40.9 microgram/litre), non of whom survived longer than 10 months. At two years, it was apparent that those patients with a preoperative CEA less than 21 microgram had a better survival rate than those with a CEA21-40.9 microgram/litre (P less than 0.005).

Carcinoembryonic Antigen↗
PubMed1994

[Puerperal and non-puerperal mastitis].

Report about 82 women with inflammatory breast diseases, who were hospitalized during january 1988 and december 1993. 37 women had a puerperal mastitis, 39 women a non-puerperal mastitis and 6 had perimamillary abscesses. In 35 (42.7%) of the 82 patients abscesses occurred. The different etiology and bacteriology as well as resulting treatment guidelines are discussed. In the treatment of puerperal mastitis, staphylococcus effective penicillins keep the first place. The therapy of non-puerperal mastitis consists in prolactin inhibiting drugs and broad spectrum antibiotics. In abscesses and fistulas surgical treatment is necessary, the same in recurrences. If the process is suspicious for breast cancer diagnostic excision is to perform.

Abscess↗
PubMed1993

1992 Federal Nursing Service Award recipient. An introduction to monoclonal antibody concepts for the oncology nurse.

Over the past 16 years, there has been an explosion of knowledge in the field of monoclonal antibody technology. There is an enormous potential for the use of monoclonal antibodies in the diagnosis and treatment of malignancies, and many clinical trials are under way. This paper serves as an introduction to monoclonal antibody concepts for the oncology nurse. Antibody/antigen principles, production of monoclonal antibodies, common side effects of use, and nursing implications are discussed. Results of a recent clinical trial and a patient case study are used to illustrate the application of radiolabeled monoclonal antibodies as a cancer diagnostic technique.

Antibodies, Monoclonal↗
PubMed1977

[Importance of roentgeno-radioisotope diagnosis in precise determination of the TNM system classification of rectal cancer].

The authors share their experience with the use of special methods of roentgeno-radioisotope investigation (selective inferior mesentericography, intravenous pelvic phlebography, vaso-vesiculography, direct inferior lymphography, scanning of hepatic lymph nodes) for precise determination of the lesion stage in 151 patients with rectal cancer. Diagnostic findings obtained by means of selective inferior mesentericography, intravenous pelvic phlebography and vaso-vesiculography allows the division of T category to be based on the anatomical principle of the organ and adjacent tissues structure. Lymphography and lymphoscanning render it possible to pinpoint further the category NX, thus differentiating NX, N0, N1, N2. The diagnostic data obtained were carefully checked during surgical interventions and by histological assay of the operative material. The results of the work have proved the methods employed to be highly reliable.

Aged↗
PubMed1997

Colon cancer. Molecular biology of the APC protein.

The discovery of a tumor suppressor gene opens a new pathway to discovery of the fundamental mechanisms that underlie tumor initiation and progression. An inherited tumor suppressor gene is of special interest in that it defines a step in the tumorigenesis pathway that can be rate limiting in development of that tumor type. In the case of colon cancer, we were fortunate in identifying an inherited tumor suppressor gene, the APC gene, that plays a major etiologic role in both the inherited disease, familial adenomatous polyposis (FAP), and in sporadic colon polyps. Characterization of the molecular biology of that gene, and the underlying mechanisms that result in the development of colon tumors, could provide new approaches to both colon cancer diagnostics, therapeutics and chemopreventives. We have embarked, therefore, on a series of exploratory studies designed to provides clues to possible functional roles for the APC protein. We have found through immunocytochemistry that APC protein is distributed throughout the cell, in both the cytoplasm and nucleus. Furthermore, within the nucleus much of the APC protein seems associated with the nucleoli. The cytoplasmic label is distributed in a punctate pattern, with concentrations at the leading edge of migrating cells at the ends of microtubules. Furthermore, following an extraction of the cells that leaves behind primarily cytoskeletal and nuclear scaffold structures, we see strong APC staining of these structures. The yeast two-hybrid system has offered a number of potentially interacting partners for APC, including a new binding site for alpha-tubulin. These results, and others recent discoveries concerning APC, suggest a rather global role for APC protein, modulating cellular activity and signal transduction pathway from the cell periphery to the nucleus.

Adenomatous Polyposis Coli Protein↗
PubMed1998

[Cancer in Madagascar. Experience of the Institut Pasteur de Madagascar from September 1992 to June 1996].

The Unit of the anatomo-pathology in the "Institut Pasteur de Madagascar" (IPM) examined in the period from September 1992 to June 1996 tissue specimens from 10,275 patients. Tumorous pathology presented 40% of the tissues and half of which were of malign etiology. 64% of the cancer diagnosed were in females. Cervical cancer was most frequently observed (17%), followed by breast cancer (16%). Cancer in the gastro-intestinal tract (15%) was most often located in the colon without sex difference. Stomach cancer occurring predominantly in males presented 25% of the total cases of cancer in the gastro-intestinal tract. Cancer of liver is rarely diagnosed despite the high prevalence of infection with hepatitis B virus. Skin cancer constituted 9% of the malign diagnosis and was mainly found in males. Children under 15 years old presented 7.4% of the total cases of malignancy with the haematopoietic tissues (30%) and the eyes (17%) as the most frequent topic locations. Due to a very low seroprevalence of the HIV in Madagascar, malign tumours associated to AIDS were only seen in a few rare cases. The review of cancer cases in the IPM may not be representative for the cancer epidemiology of Madagascar because of a general very low level of health care coverage, especially in the rural areas. Furthermore, a major part of the specimens originates from easily accessible organsystems, whereas other organs seem less investigated due to lack of appropriate available technique. Therefore, it is not feasible for the moment to establish a cancer register in Madagascar, although the Unit of Pathology in the IPM can offer a valid cancer diagnostical service.

Adolescent↗
PubMed1998

[Oncogenes--"reckless drivers" on signal pathways controlling cell division].

Today, about 20 years after the discovery of cellular genes with oncogenic potential, we possess substantial knowledge on the regulation of normal cell growth and division. At the same time, we have gained insight into the loss of growth control which occurs in cancer cells. The following is a brief review of the progress made in oncogene research and the knowledge we have gained. It is important to stress that our understanding of the cellular and molecular mechanisms involved is still in its infancy. However, pieces are being added to the puzzle at an increasingly faster pace, primarily because of the progress in gene technology during the last two decades. Research methods have been set up to allow greater cooperation across disciplinary boundaries, thus increasing the speed with which important discoveries occur. A goal for the future will be to identify all oncogenes and tumor suppressor genes and elucidate their functions. At the same time, one of the major challenges will be to translate the knowledge thus gained into the development of more powerful and specific therapeutic strategies. As a result of the increasing insight gained by modern oncogene research, the need for detailed cancer diagnostics based on molecular genetics will increase significantly in the future.

Animals↗
PubMed2026

Urinary Small Extracellular Vesicle DNA as a Biomarker for the Non-Invasive Diagnosis of Bladder Cancer.

Existing diagnostic technologies for bladder cancer (BC) suffer from low sensitivity, low specificity, or a lack of validation. Therefore, validated, non-invasive diagnostic biomarkers with high sensitivity and specificity for early detection of BC are needed to complement and improve upon the limitations of existing diagnostic methods. We used low-pass whole genome sequencing (LP-WGS) technology to detect copy number variations (CNVs) in small extracellular vesicle (sEV) DNA isolated from urine samples of patients. Based on these results, we constructed and validated a diagnostic model to differentiate between benign and malignant bladder lesions. We conducted a receiver operating characteristic analysis and calculated the area under the curve (AUC) to evaluate the performance of the diagnostic model. The urine sEV-DNA LP-WGS data revealed CNV differences between benign and malignant samples. The diagnostic model achieved an AUC of 0.953, a sensitivity of 86.7%, and a specificity of 100% in the training cohort and an AUC of 0.985, a sensitivity of 90%, and a specificity of 100% in the validation cohort. Even at the lowest coverage depth of 0.01X, the performance of the diagnostic model remained relatively robust. Notably, the performance of this diagnostic model surpassed that of the biomarker neuron-specific enolase (sensitivity: 85.7% vs. 64.3%; specificity: 100% vs. 87.5%) and urinary cytology (sensitivity: 100% vs. 66.7%; specificity: 100% vs. 94.1%). Our study demonstrates that urine sEV-DNA exhibits high discriminatory power in distinguishing between benign and malignant bladder lesions, making it a promising tool for auxiliary diagnosis of BC.

Humans↗
PubMed2003

Effects of estrogen plus progestin on gynecologic cancers and associated diagnostic procedures: the Women's Health Initiative randomized trial.

CONTEXT: The effects of continuous combined hormone therapy on gynecologic cancers have not been investigated previously in a randomized trial setting. OBJECTIVE: To determine the possible associations of estrogen plus progestin on gynecologic cancers and related diagnostic procedures. DESIGN, SETTING, AND PARTICIPANTS: Randomized, double-blind, placebo-controlled trial of 16 608 postmenopausal women, who had not had a hysterectomy at baseline and who had been recruited from 40 US clinical centers between September 1993 and October 1998 (average follow-up, 5.6 years). INTERVENTION: One tablet per day containing 0.625 mg of conjugated equine estrogens plus 2.5 mg of medroxyprogesterone acetate (n = 8506) or placebo (n = 8102). MAIN OUTCOME MEASURE: Incident invasive cancer of the ovary and endometrium. RESULTS: In 5.6 years of follow-up, there were 32 cases of invasive ovarian cancer, 58 cases of endometrial cancer, 1 case of nonendometrial uterine cancer, 13 cases of cervical cancer, and 7 cases of other gynecologic cancers. The hazard ratio (HR) for invasive ovarian cancer in women assigned to estrogen plus progestin compared with placebo was 1.58 (95% confidence interval [CI], 0.77-3.24). The HR for endometrial cancer was 0.81 (95% CI, 0.48-1.36). No appreciable differences were found in the distributions of tumor histology, stage, or grade for either cancer site. The incidence of other gynecologic cancers was low and did not differ by randomization assignment. More women taking estrogen plus progestin required endometrial biopsies (33% vs 6%; P<.001). CONCLUSIONS: This randomized trial suggests that continuous combined estrogen plus progestin therapy may increase the risk of ovarian cancer while producing endometrial cancer rates similar to placebo. The increased burden of endometrial biopsies required to assess vaginal bleeding further limits the acceptability of this regimen. These data provide additional support for caution in the use of continuous combined hormones.

Aged↗
PubMed2003

Update on cervical cancer screening. Current diagnostic and evidence-based management protocols.

Pap smear screening for cervical cancer has been a preventive health success. Although improved technology is increasing the accuracy of this technique, more women who have never been tested will need to undergo screening in order to further decrease the incidence of cervical cancer in the United States. The establishment of infection with high-risk genital HPV types as a causative factor in cervical cancer is a major breakthrough in understanding of this disease. Testing for the presence of high-risk HPV DNA should increase the ability to identify women who are truly at risk for cancer and true cancer precursors and to more efficiently plan further diagnostic evaluation. The 2001 revisions in TBS reflect our improved understanding of the epidemiology and natural history of cervical epithelial abnormalities and cervical cancer. These revisions are designed to facilitate communication between the clinician and the laboratory and to improve the clinician's ability to accurately interpret the cytology report and plan initial management of any abnormalities.

DNA, Viral↗
PubMed1980

The diagnostic efficacy of mammography and palpation in early detection of breast cancer.

The diagnostic efficacy of mammography and physical examination, separately and considered together, are evaluated in 912 cases of breast cancer detected at the Center for Social Diseases of the Florence District, where there is a mass-screening program (110 cases) and a diagnostic service for self-referred women (810 cases). The overall sensitivity of the 2 methods increases with age; the trends of diagnostic efficacies of mammography and palpation according to age are similar, except in the 40-44 year age group, in which physical examination has a lower percentage of false-negative cases. In the screening group, there is a greater proportion of nonpalpable cancers and mammography has a larger diagnostic efficacy except in the 40-44 year age group. These results agree with the better sensitivity of mammography in smaller lesion (TI) and with the larger proportion of noninterpretable mammographies in younger women, because of the density of mammalian glands.

Adult↗
PubMed2006

Cancer risks following diagnostic and therapeutic radiation exposure in children.

The growing use of interventional and fluoroscopic imaging in children represents a tremendous benefit for the diagnosis and treatment of benign conditions. Along with the increasing use and complexity of these procedures comes concern about the cancer risk associated with ionizing radiation exposure to children. Children are considerably more sensitive to the carcinogenic effects of ionizing radiation than adults, and children have a longer life expectancy in which to express risk. Numerous epidemiologic cohort studies of childhood exposure to radiation for treatment of benign diseases have demonstrated radiation-related risks of cancer of the thyroid, breast, brain and skin, as well as leukemia. Many fewer studies have evaluated cancer risk following diagnostic radiation exposure in children. Although radiation dose for a single procedure might be low, pediatric patients often receive repeated examinations over time to evaluate their conditions, which could result in relatively high cumulative doses. Several cohort studies of girls and young women subjected to multiple diagnostic radiation exposures have been informative about increased mortality from breast cancer with increasing radiation dose, and case-control studies of childhood leukemia and postnatal diagnostic radiation exposure have suggested increased risks with an increasing number of examinations. Only two long-term follow-up studies of cancer following cardiac catheterization in childhood have been conducted, and neither reported an overall increased risk of cancer. Most cancers can be induced by radiation, and a linear dose-response has been noted for most solid cancers. Risks of radiation-related cancer are greatest for those exposed early in life, and these risks appear to persist throughout life.

Body Burden↗
PubMed1984

Diagnostic imaging of urothelial cancer.

Technologic advances in diagnostic imaging offer new ways to evaluate urothelial tumors. Computed tomography, ultrasound, and magnetic resonance imaging each have potential to provide information previously unavailable without surgical intervention.

Adult↗
PubMed1977

[Breast cancer--evaluation of diagnostic procedures (author's transl)].

The different diagnostic procedures used in the diagnosis of breast cancer are discussed. Clinical examination and mammography are the most important diagnostic steps. Needle biopsy with cytology is a very helpful further diagnostic procedure for the so-called triple diagnosis. The most important diagnostic procedure should be the diagnostic extirpation of the tumor with examination by frozen resection.

Adult↗
PubMed1997

Coincidence of bladder and prostate cancer.

PURPOSE: Diagnostic bias can be a problem when determining the coincidence of prostate and bladder cancer. The objective of this study was to calculate the coincidence of bladder and prostate cancer after correcting for diagnostic bias. MATERIALS AND METHODS: The cancer registry at 1 medical institution provided the number of patients diagnosed with prostate or bladder cancer between 1989 and 1994. The expected incidences of bladder and prostate cancer were calculated using 1987 to 1991 Surveillance, Epidemiology and End Results data. Diagnostic bias was determined by reviewing the charts of all patients with both types of cancer. RESULTS: Of 100 patients with a diagnosis of bladder cancer 25 (25%) also had prostate cancer and 25 of 651 (3.8%) with prostate cancer also had bladder cancer. Diagnostic bias was involved in diagnosing bladder cancer in 3 of 25 patients and prostate cancer in 7 of 25. When these patients are eliminated from the incidence data, the rate of prostate cancer in those with bladder cancer is 17% and the rate of bladder cancer in those patients with prostate cancer is 3.2%. In an age, sex and race matched general population the expected rates of prostate and bladder cancer were 0.9 and 0.18%, respectively. CONCLUSIONS: The rate of bladder cancer in patients with prostate cancer is 18 times higher (p < 0.01) and the rate of prostate cancer in those with bladder cancer is 19 times higher (p < 0.01) than expected. These rates do not include cases involving diagnostic bias.

Aged↗
PubMed2005

The challenge of systematic reviews of diagnostic and staging studies in cancer.

PURPOSE: Most diagnostic and staging studies focus on test performance characteristics while others may address long term clinical outcomes such as disease-free or overall survival, quality of life or cost. However, controversy remains as to which outcomes to measure and when long term outcomes based on large and costly randomized trials are required. METHODS: The comparative advantages for reviews of diagnostic and staging studies based on test performance characteristics in observational studies versus the assessment of outcomes in randomized controlled trials are presented. RESULTS: The measurement of diagnostic test performance is based on sensitivity, specificity, predictive value, the diagnostic odds ratio and Receiver Operating Characteristic (ROC) analysis. Alternatively, the clinical impact of a diagnostic test should consider the overall benefits and harms generally measured in terms of disease-free or overall survival, toxicity or quality of life and costs. Methods are available to systematically summarize these measures across studies, assess clinical and methodological heterogeneity and to evaluate the quality of studies. The advantages and disadvantages of studies of test performance or overall clinical impact are highlighted in the context of two examples: screening mammography and sentinel node biopsy. CONCLUSION: There appears to be an important role for systematic reviews of both studies of test performance and of long-term clinical impact in the evaluation of new diagnostic and staging procedures.

Diagnosis, Differential↗
PubMed2004

Peptide-based radiopharmaceuticals: future tools for diagnostic imaging of cancers and other diseases.

Small synthetic receptor-binding peptides are the agents of choice for diagnostic imaging and radiotherapy of cancers due to their favorable pharmacokinetics. Molecular modification techniques permit the synthesis of a variety of bioactive peptides with chelating groups, without compromising biological properties. Various techniques have been developed that allow efficient and site-specific labeling of peptides with clinically useful radionuclides such as (99m)Tc, (123)I, (111)In, and (18)F. Among them, (99m)Tc is the radionuclide of choice because of its excellent chemical and imaging characteristics. Recently, many (99m)Tc-labeled peptides have proven to be useful imaging agents. Beside (99m)Tc-labeled peptides, several peptides radiolabeled with (111)In and (123)I have been prepared and characterized. In addition, (18)F-labeled peptides hold clinical potential due to their ability to quantitatively detect and characterize a variety of human diseases using positron-emission tomography. The availability of this wide range of peptides labeled with different radionuclides offers multiple diagnostic and therapeutic applications. Various receptors are over-expressed in particular tumor types and peptides binding to these receptors can be used to visualize tumor lesions scintigraphically. Thus, radiolabeled peptides have potential use as carriers for the delivery of radionuclides to tumors, infarcts, and infected tissues for diagnostic imaging and radiotherapy. Many radiolabeled peptides are currently under investigation to determine their potential as imaging agents. These peptides are designed mainly for thrombus, tumor, and infection/inflammation imaging. This article presents recent developments in small synthetic peptides for imaging of thrombosis, tumors, and infection/inflammation.

Fluorine Radioisotopes↗