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PubMed1992

[Diagnostic value of the analysis of alpha fetoprotein levels in malignant neoplasms of the digestive system].

The concentration of alpha-fetoprotein (AFP) in serum was determined in 58 patients (35 males and 23 females) aged from 38 to 87 years treated surgically for malignant tumours of the digestive tract, including colonic carcinoma in 30, gastric carcinoma in 11, pancreatic carcinoma in 10 and oesophageal carcinoma in 7 cases. In 33 patients the tumour was disseminated (into the liver in 22 cases). On the ground of AFP concentration determinations in 40 patients (19 males and 21 females) aged 22 to 80 years operated on for non-neoplastic abdominal diseases the upper normal range was accepted as 9.42 ng/ml. Raised AFP concentration was found in only patient with advanced pancreatic carcinoma and multiple metastases to the liver and lymph nodes. The study showed that serum AFP level in cases of digestive tract malignancies is of limited diagnostic value.

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PubMedDate not supplied

[The program for early diagnosis of the upper respiratory tract and digestive system neoplasms offered to alcoholics in the region of Friuli-Venice Giulia].

The present study deals with data from an on-going collaborative programme of early diagnosis for upper aero-digestive tract tumors established since 1990 by three ENT Departments of the Friuli-Venezia Giulia Region, Northeastern Italy. The aim of the study was firstly to evaluate the socio-economic characteristics and clinical features of alcoholics in treatment who were offered a free ENT check-up, and secondly to test the feasibility of this type of referral of high-risk patients from non-medical associations to the ENT specialist. A total of 683 patients, of which 151 (78%) were males and 151 (22%) were females, underwent ENT examination. About 25% of the patients were symptomatic, the most frequent symptom being dysphonia (50%) followed by cough (19%), while dyspnoea, dysphagia and pain were present in about 5% of the patients. Other than nearly 50% negative findings, ENT examination revealed a high percentage of inflammatory lesions (30%) of the upper aero-digestive tract. In 37 patients (6%) a precancerous lesion was found and in four cases an histologically confirmed tumor was diagnosed. Although the present study cannot be considered a complete screening, it did clearly evaluate the amount of response given by this high-risk population of alcoholics in treatment to the offer of an ENT examination and gives encouraging results concerning the feasibility of early diagnosis programmes for upper aero-digestive tract tumors which do not follow the normal routine of a sanitary referral by a general practitioner.

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PubMed1990

[Primary non-Hodgkin's high grade malignant lymphoma of the digestive system. A prospective study of the combination of surgery-chemotherapy-radiotherapy].

We report a prospective study concerning the association of surgery-chemotherapy and radiotherapy in the treatment of primary high grade digestive non-Hodgkin's lymphomas in 19 patients. The analysis of 11 stages IE, 5 stages II1E and 3 stages II2E allowed us to evaluate the efficacy and the tolerance of this triple therapeutic association. Fifteen patients are alive and well with a median follow-up of 54 months. One of these patients relapsed, but after autologous bone marrow transplantation is in second unmaintained complete remission. Four patients died of intercurrent aetiology although one death was related to treatment morbidity. Our results and the analysis of literature data lead us to recommend the triple association in the treatment of stage II2E high grade primary digestive lymphomas (PDL) and for PDL without complete resection. However, surgery and chemotherapy appear to be sufficient in the treatment of stages IE and II1E with complete resection.

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