[The diagnostic aspects of cancer of the large intestine].
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We present the results of 87 consecutively referred patients with malignant gastric tumours who presented to the North Middlesex Hospital between 1980 and 1984, inclusively. The results of this prospective study showed a high incidence of adenocarcinoma situated in the cardia (16 per cent of patients), and antral carcinomas presented more commonly with chronic blood loss. Delay in diagnosis was still a serious problem and weight loss remained an underestimated symptom, especially when combined with other upper gastrointestinal symptomology. The majority of tumours were adenocarcinomas. Six patients had unusual tumours which had special therapeutic and prognostic implications. The results of the above study are compared with the European experience of the management of malignant gastric tumours.
Malignant tumours of the nasal cavity and paranasal sinuses are rare. The incidence in the Western world is one per 100,000. The prognosis and therapeutic results are poor, as in most cases a considerable delay occurs before diagnosis. Doctor-delay is illustrated here by two cases a classical patient-delay by one. The etiology, histopathology, clinical manifestations and therapeutic possibilities are reviewed.
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Pleural fluid levels of cancer antigen 125 (CA 125), pancreatic oncofetal antigen (POA), and carcinoembryonic antigen (CEA) were determined in 56 patients with malignant pleural effusion and in 35 patients with tuberculous effusion. Malignant effusions had significantly higher pleural fluid CA 125 and CEA levels than those of tuberculous origin (p less than 0.005). No significant difference in POA titers was found between the two kinds of effusion. Assays of CA 125 and CEA in pleural fluid may be useful in separating malignant from tuberculous effusions. Concurrent measurement of CA 125 and CEA proved superior to determination of CEA alone in discriminating between the two groups.
Pleural fluid levels of the cancer antigen 15-3 (CA15-3) detected by monoclonal antibodies (115D8 and DF3) were determined in 40 patients with carcinomatous pleural effusions and in 41 patients with tuberculous pleural effusions. Using a cut off level of 16 U/ml, 15 of the 40 carcinomatous fluids but none of the 41 tuberculous fluids were positive. Pleural fluid levels of CA15-3 were not correlated with those of carcinoembryonic antigen (CEA) or carbohydrate antigen 19-9 (CA19-9). Combined assay of CEA and CA15-3, or CA19-9 and CA15-3, increased the positive rate from 79 to 82% and from 67 to 73%, respectively. Measurement of pleural fluid CA15-3 levels are less useful in separating carcinomatous from tuberculous effusions than is measurement of CEA or CA19-9.
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