Tumours of the oral cavity, cheek pouch, salivary glands, oesophagus, stomach and intestines.
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We developed a new simple enzymatic assay method for measuring urinary polyamines (total amount of putrescine, spermidine, and cadaverine), using an acylpolyamine amidohydrolase and a putrescine oxidase. First conjugated polyamines (putrescine, spermidine, and cadaverine) in urine were hydrolyzed by incubation with an acylpolyamine amidohydrolase at 30 degrees for 1 hr. then, free polyamines were separated by cation-exchange chromatography and incubated with a putrescine oxidase at 30 degrees for 30 min. Hydrogen peroxide formed in this reaction was measured spectrophotometrically (at 514 nm). Polyamine levels in urine were determined in 70 normal subjects, 124 patients with cancer, and 52 patients with diseases other than cancer. Elevation above 3 S.D.s of the normal mean was found in 90 (72.6%) of the 124 patients with cancer and in 6 (11.5%) of the 52 patients with diseases other than cancer. Serial studies in 19 patients with cancer indicated that polyamines in urine were reduced after successful surgery. Our new method is simple and rapid and therefore very useful for routine clinical application. Moreover, our data indicate that the determination of polyamine levels is useful as a marker of disease activity in patients with cancer.
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Recently, there has been an increasing interest in the diagnostic and prognostic usefulness of tumor-associated antigen of embryonic and fetal origin. Many approaches have been attempted to make an early diagnosis of the pancreatic cancer, where a specific screening blood test for the pancreatic cancer is required. By using antiserum to fetal pancreas, Banwo et al, discovered an oncofetal antigen that was present in human fetal pancreas, pancreatic tumor tissue, and sera from patients with the pancreatic cancer. Pancreatic oncofetal antigen (POA) was considered to be an oncofetal antigen for human pancreas, and its measurement seemed to be useful in the diagnosis of pancreatic cancer. But elevated levels of POA were also observed in the serum of some patients with cancer of the stomach, lung, colon, or liver as well as in the serum of some pregnant women and others with certain benign conditions. In summary, combined assay with various tumor markers was considered to be useful for the diagnosis of pancreatic cancer.
Prognostic parameters of patients with stomach and colorectal cancer, which could be established within a few days during hospitalization of patients for primary treatment, were characterized and compared in a clinical investigation with observed postoperative survival. Statistical analysis was based on data from a long-term follow-up study of 563 colorectal and 390 stomach cancer patients registered since 1974. The potential prognostic parameters included resectability, tumor extension, and preoperative serum CEA levels. Statistical examination revealed that each of the parameters was associated with highly significant differences in survival of the patients. Combinations of clinical parameters with distinct ranges of preoperative serum CEA levels gave additional valuable prognostic information, thus facilitating the management of patients for adjuvant postoperative treatment.
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A review of the basic principles concerning the biology, and in particular the kinetics, of the malignant cell, serves as a basis for the study of the main drugs which make up the current arsenal of the chemotherapist and to define their mode of action. The indications of chemotherapy in digestive carcinomas are then outlined, drawing the distinction between palliative chemotherapy used in tumours with spread, whether operable or inoperable, and adjuvant chemotherapy which may be indicated for certain carcinomas resected in a macroscopically satisfactory manner, but where the risk of recurrence is greater than 50%.