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PubMed1979

Assessment of the clinical usefulness of serum ribonuclease assays: an indicator for the detection of pancreatic cancer.

To evaluate diagnostic usefulness for pancreatic cancer, serum ribonuclease (RNase) level was determined in three groups of subjects; 1) normal volunteers as control, 2) patients with histologically determined pancreatic cancer, and 3) patients with miscellaneous diseases other than pancreatic cancer. A small increase of RNase values was recognized with age in the normal subjects and in the patients with nonpancreatic diseases, if renal function was normal. The mean RNase level in the control subjects was 97 +/- 41.2 units. A marked elevation of serum RNase level was demonstrated in the patients with pancreatic cancer (p less than 0.001) and in the patients with renal dysfuction, but no significant rise was noticed in the patients with pancreatitis. Mean values of RNase in the patients with pancreatic cancer and renal dysfuncton were 368 +/- 146 units and 342 +/- 78.1 units respectively. RNase values above 300 units were recognized in 15(71%) out of 21 patients with pancreatic cancer. Seven cases with elevated RNase over 300 units other than non-pancreatic malignancy and renal dysfunction were noticed in 6 instances of obstructive jaundice and in one instance of early gastric cancer (an 84-year-old male). The above-stated findings indicate that serum RNase determinations can be utilized as a diagnostic indicator for pancreatic cancer.

Adult↗
PubMed2003

[Assessment of clinical diagnostic accuracy for skin cancer].

BACKGROUND: There is an increase in the incidence rates of skin cancer in Chile. AIM: To study the clinical diagnostic accuracy (CDA) for skin cancer. MATERIAL AND METHODS: CDA was defined as the percentage of agreement between clinical and pathological diagnosis. Approximately 600,000 pathological reports from five hospitals in Santiago were reviewed. A total of 2,593 skin tumours; 230 Malignant Melanoma (MM); 412 Squamous Cell Carcinoma (SCC) and 1,951 Basal Cell Carcinoma (BCC) were studied. These tumours were clinically diagnosed and surgically treated by dermatologists. The CDA was studied for each tumour, by the anatomical localization of the tumour, Breslow Index in MM, by age and sex of the patient. RESULTS: The highest CDA was observed for BCC (76.2%); followed by MM (64.3%) and SCC (34.7%). By anatomical localization, for MM the highest CDA was observed in the soles (p < 0.05); for BCC, the highest CDA was in the face (p < 0.05). No significant differences were observed in SCC. By age, for MM, the CDA was higher in patients aged less than 50 years. No differences in CDA by age were observed in the other two tumours. By sex, no differences were found. A higher CDA was found in MM with Breslow indexes III and IV than for MM with Breslow indexes I and II. CONCLUSIONS: CDA is affected by the clinical variables analyzed in this study. A more accurate clinical diagnosis of skin cancer could be obtained taking into account these variables.

Basal Cell Carcinoma↗
PubMed2000

Current management of thyroid cancer--a change of therapeutic strategy over the last 20 years.

A radical change of epidemiological structure of thyroid cancer incidence in Poland has been reported for few years. The total incidence of thyroid cancer is successively increasing, mostly in form of well differentiated thyroid cancer, especially papillary cancer. The diagnostic and therapeutic approach to thyroid cancer have also changed. Ultrasound guided fine needle aspiration has become the first choice procedure in diagnostics of thyroid cancer. Careful assessment of prognostic factors is no longer helpful in choice of selective surgical procedure in thyroid cancer as elective total thyroidectomy is widely recommended. In well differentiated thyroid cancer a complementary treatment with radioiodine is mandatory in most cases. Own experience in treatment of thyroid cancer presented in the paper is based on over 520 consecutive patients with thyroid cancer treated in a single department specialised in endocrine surgery during last 20 years. Successive changes in epidemiological structure of thyroid cancer incidence as well as the evolution of diagnostic and therapeutic algorithm in thyroid cancer are presented in details. Radical surgical treatment of thyroid cancer is still a fundamental part of a complex treatment of thyroid cancer.

Female↗
PubMed1990

[Ultrasonic examination and lymphography in the diagnosis of metastases of rectal cancer].

The diagnostic effectiveness of ultrasound and lymphographic investigations was assessed in 89 rectal cancer patients. Lymphography was shown to be a more informative method as it permitted the detection of metastases in 6 patients in whom USI results were negative, metastatic involvement in 2 patients, specifying the type of pathological changes of the enlarged lymph nodes in 14 patients. In a normal lymphographic picture metastatic involvement was detected in 37 cases using echography. More extended metastatic spreading was found on USI (as compared to lymphography) in one patient. The combined use of echography and lymphography improved the diagnosis of rectal cancer lymphogenous metastases.

Adult↗
PubMed1986

[Abdominal computerized tomography in the after-care of ovarian cancers].

The diagnostic capacity of abdominal CT as a follow-up in ovarian cancer is demonstrated on 67 patients verified by a second-look operation. In the diagnosis of recurrence CT has a sensitivity of 83%, a specificity of 94% and an overall accuracy of 88%. With local recurrence or residual tumours CT has an accuracy of 91%, with liver metastases of 94%. The accuracy in finding peritoneal carcinosis is 84%. Ascites proved to be a sure sign of peritoneal carcinosis. Because of its high sensitivity second-look operation can be avoided in case of a positive report. In a negative report a second-look operation will be necessary to verify the success of therapy. In the follow-up of ovarian cancer CT should be performed every 6 month during the first 2 years and yearly for another 3 years.

Female↗
PubMed1993

[Cancer of unknown origin: diagnostic and therapeutic yield].

Patients with carcinoma of unknown origin represents at least 5% on the total neoplastic patients. A review of the main metastatic locations and the different histological types has been done; giving special attention to the most frequent primitive neoplasms. Diagnostic yield in this type of cancer is emphasized, since many times, it is advisable to limit the number of explorations directed to find the primary tumor, as they decrease patient quality of life while no profit is obtained from the knowledge of the primary tumor, for most of the patients. However, this must not drive us to the opposite end: diagnostic and therapeutic nihilism. We have to rule out, in a reasonable way, certain types of tumors which have an useful treatment even in advanced phases (oat all carcinoma, germinal neoplasms, lymphomas).

Humans↗
PubMed2004

Mammaglobin: a candidate diagnostic marker for breast cancer.

Mammaglobin, known for its mammary tissue specificity, has been discussed as a promising diagnostic marker in breast cancer for almost 10 years. In particular, the application of mammaglobin RT-PCR to detect disseminated breast cancer cells has been reported. More than 25 publications evaluate the detection of mammaglobin mRNA in lymph node, blood, and bone marrow specimens of breast cancer patients. Recently, structural details about the mammaglobin complex have been discovered, and these findings can be implemented to optimize detection of the secreted protein. This review summarizes the findings of almost 50 published studies and the current knowledge about the diagnostic utility of mammaglobin.

Amino Acid Sequence↗
PubMed1982

Observer variation in the interpretation of xeromammograms.

We have examined variation in the interpretation of xeromammograms among radiologists designated to take part in a Canadian multicenter randomized controlled trial of screening for breast cancer. Radiologists read 100 xeromammograms comprising 10 histologically proved cancers, 40 benign abnormalities, and 50 normal films. Radiologists' opinions differed widely on the frequency of suspected or identified cancer. The diagnostic category "suspicion of cancer" or "cancer" was selected by radiologists for 10-55% of the films, and biopsy or aspiration was recommended for 21 to 53% of patients whose films were examined. Agreement on specific diagnostic categories was greatest for the diagnosis of cancer; agreement was least for the diagnosis of benign abnormalities and intermediate for the diagnosis of normality. Known cancers were in general correctly identified. These results indicate a need for development of methods to reduce observer variation in a interpretation of xeromammograms while preserving diagnostic sensitivity and validity. Results also emphasize the importance of developing strategies to ensure quality control in multicenter trials.

Breast Neoplasms↗
PubMed1997

Icelandic women's identifications of stressors and social support during the diagnostic phase of breast cancer.

The purpose of this descriptive exploratory study was to describe the nature of stressors Icelandic women identify during the diagnostic phase of breast cancer, what sources of social support they draw upon, and their satisfaction with the social support they receive. Lazarus and Folkman's theory of stress, appraisal and coping was used as a theoretical framework for the study. Semi-structured interviews were conducted with 12 women in the diagnostic phase of breast cancer. Women experience the possibility of having cancer as an enormous threat. Social support was identified as a fundamental coping resource, where emotional support from husbands, family and close friends was of utmost importance. Health care professionals were not only the most important source of informational support but also a valuable source of emotional support.

Adaptation, Psychological↗
PubMed2000

Selective decrease of serum immunoglobulin G1 as marker for early stages of invasive breast cancer.

The diagnostic value of the decrease in percentage of immunoglobulin G1 (%lgG1) in breast cancer was analyzed with special emphasis on early tumor stages. IgG1 and total IgG were preoperatively measured in the sera of a total of 801 individuals using a modified quantitative affinity chromatography. Group A consisted of 174 healthy individuals of both sexes, group B of 324 female patients with benign breast disease, and group C of 303 patients with invasive and non-invasive breast cancer. Within group C, 13 patients presented with intraductal carcinoma, and 22 patients with a pT1a-tumour (diameter less than 0.5 cm). The %IgG1 values were compared among groups A, B and C. In addition, correlations were sought between %IgG1 values of group C and tumor size, stage (UICC), histopathological grade and oestrogen (ER) and progesteron receptor (PR) expression. The mean value of %IgG1 in group A was 63.3 +/- 0.5 s.e.m., in group B 57.75 +/- 0.4 s.e.m. and in group C 52.37 +/- 0.5 s.e.m. The differences of mean values were highly significant between all three groups. Sensitivity and specificity of %IgG1 to discriminate between group A and C were 75% and 87%, and between group B and C 62% and 63%, respectively. The significant decrease of %IgG1 in total serum IgG is able to distinguish patients with breast cancer of more than 5 mm in diameter from healthy controls and patients with benign breast diseases. Finally, calculated posterior probabilities revealed that within certain concentration limits %lgG1 may provide predictive information with high probabilities.

Adolescent↗
PubMed2003

Comparison of telomerase activity and matrix metalloproteinase-9 in voided urine and bladder wash samples as a useful diagnostic tool for bladder cancer.

OBJECTIVES: This study was undertaken to evaluate the diagnostic efficacy of telomerase in urine, and bladder wash and also the matrix metalloproteinase-9 (MMP-9) in urine, compared with voided urine cytology (VUC) and bladder wash cytology (BWC) for the detection of bladder cancer cells. MATERIAL AND METHODS: A total of 110 subjects provided a single preoperative voided morning urine sample for telomerase, matrix metalloproteinase-9 (MMP-9) and cytology. Bladder wash samples were obtained for telomerase and cytology. Cystoscopy was done for all patients as the reference standard for the identification of bladder cancer. Biopsy of any suspicious lesion was performed for histopathological examination. Of 110 cases 73 were histologically diagnosed as bladder cancer, whereas the remaining 16 had benign urological disorders. A group of 21 healthy volunteers were also enrolled in this study. RESULTS: The optimal threshold values for telomerase activity in urine, bladder wash and MMP-9 were calculated by receiver-operator characteristics (ROC) curves as 0.05, 0.088 and 0.51 (ng/ml), respectively. The levels and the positivity rates of the 2 parameters were significantly higher in the malignant group compared to either the benign group or normal controls. Of the entire group, telomerase activity in urine, bladder wash, and MMP-9 were positive in 92%, 87% and 61%, respectively in bladder cancer patients with positive cytology. Moreover, these positive rates for them were significantly higher in bilharzial bladder cancer cases (88%, 89%, 69%, respectively) compared to non-bilharzial cases (50%, 62.5%, 50%). The overall sensitivity and specificity were 83% and 88.6%, 86.3% and 78.3% for telomerase activity in urine, and in bladder wash, respectively; 66.6% and 80% for MMP-9 and 58.5% and 100% for voided urine cytology and 64.4% and 100% for bladder wash cytology. Combined sensitivity of VUC with the 2 biomarkers together was higher than either combined sensitivity of VUC with one of the biomarkers or than that of the biomarker alone. CONCLUSIONS: Our data indicate that urinary telomerase and MMP-9 had superior sensitivities over VUC. The combined use of markers increased the sensitivity of cytology from 58.46% to 95%. The higher sensitivities of markers in bilharzial bladder cancer than non-bilharzial type highlight their clinical utility in screening patients with urinary bilharziasis.

Adult↗
PubMed1989

[Diagnostic imaging for breast cancer].

With the westernization of the Japanese diet and way of life, the mortality due to breast cancer continues gradually to increase. This disease, however, is a type of cancer that can be well controlled by primary preventive measures and early detection. Numerous techniques of diagnostic imaging for breast cancer have been established, but the most common are mammography and ultrasonography. For X-ray mammography, a low tube voltage is necessary so that small differences in X-ray absorption by the various tissues within the breast may be detected, but when the surface dose is increased, it is a source of anxiety because of the possible development of secondary carcinoma. Ultrasonography of the breast, however, is free from the dangers of radiation exposure, and may be conducted in conjunction with palpation, thus representing a highly reliable approach. The diagnostic reliability of mammography and ultrasonography was investigated in 251 cases in which breast cancer was confirmed by these methods in a total of 752 outpatients who visited the Department of Breast Surgery of the Aichi Cancer Center Hospital in Nagoya, Japan. As a diagnostic procedure for breast cancer, mammography was shown to have a sensitivity of 89.2%, a specificity of 92.6%, and an accuracy rate of 91.5%, the respective values for the ultrasound technique being 84.9%, 88.9%, and 87.5%. These results are superior even to those of surgeons with 30 years of experience specializing in the breast (86.9%, 85.3%, and 85.8%), especially when tumors cannot be palpated.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1980

X-ray examination and/or endoscopy in the diagnosis of gastroduodenal ulcer and cancer.

The diagnostic value of barium meal and endoscopy for the diagnosis of gastric ulcer and cancer was studied in 173 unselected patients with upper abdominal dyspepsia. The predictive value of both positive and negative results was higher for endoscopy than for barium meal. This was also found in earlier studies comprising hospitalized patients, with a consequent higher prevalence of disease, but this study shows that the superiority of endoscopy is maintained in a low-prevalence outpatient population. The diagnostic efficiency of both endoscopy and X-ray was independent of the order of examination. Knowledge of the result of the first examination thus did not improve the efficiency of the second one. Parallel use of endoscopy and barium meal results in a maximum of diagnostic yield but requires the highcost of double examination and supplementary examinations in cases of discrepancy between the two results. Routine use of barium meal with selective use of endoscopy in X-ray-positive cases requires a smaller number of examinations but results in the loss of an unacceptable number of diagnoses. When both costs and diagnostic yield are considered, endoscopy seems to be the examination of choice, with X-ray examination reserved for exceptional cases when endoscopy for one reason or another cannot be carried out. Hospital facilities should be planned with the aim of developing endoscopic services capable of taking over the traditional leading role of X-ray examination in the gastroduodenal field.

Adolescent↗
PubMed2005

Detection of serum deoxyribonucleic acid methylation markers: a novel diagnostic tool for thyroid cancer.

CONTEXT: Serum DNA methylation markers may potentially be useful in diagnosing thyroid cancer and monitoring its recurrence. OBJECTIVE: The objective of the study was to assess the utility of serum DNA methylation as a diagnostic test for patients with thyroid nodules and a monitoring test to detect thyroid cancer recurrence in previously treated patients. DESIGN, SETTING, AND SUBJECTS: Using real-time quantitative methylation-specific PCR, we analyzed the methylation status of five genes (CALCA, CDH1, TIMP3, DAPK, and RARbeta2) on 96 bisulfite-treated serum DNA samples isolated preoperatively from either solid thyroid nodule patients or patients in follow-up for history of treated thyroid cancer. MAIN OUTCOME MEASURE: Diagnostic sensitivity, specificity, and accuracy of serum DNA methylation marker for thyroid cancer were measured. RESULTS: For the patients with thyroid nodules, when a positive result was defined by a serum methylation level above the appropriately chosen cutoff value for any one of the five genes, the preoperative diagnostic sensitivity for thyroid cancer was 68% (26 of 38), the specificity was 95% (18 of 19), and the overall preoperative diagnostic accuracy was 77%, with positive and negative predictive values of 96 and 60%, respectively. In a subset of patients with cytologically indeterminate thyroid nodules, serum DNA methylation testing could correctly diagnose eight of 11 (73%) cancers and four of four (100%) benign tumors, with a diagnostic accuracy of 80%. We also analyzed these serum DNA methylation markers in 39 previously treated thyroid cancer patients. Among the 10 patients proved to have recurrent disease by conventional measures, seven (70%) were positive on methylation testing. Among the 29 patients who had no corroboration of residual or recurrent disease by conventional studies, six (21%) were positive for serum DNA methylation markers. CONCLUSIONS: We have demonstrated the potential usefulness of serum DNA methylation markers as a novel tool for differential diagnosis of solid thyroid nodules and thyroid cancer recurrence monitoring.

Biomarkers↗
PubMed1999

Choice of management strategy for colorectal cancer based on a diagnostic immunohistochemical test for defective mismatch repair.

BACKGROUND: Despite intensive research into the molecular abnormalities associated with colorectal cancer (CRC), no diagnostic tests have emerged which usefully complement standard histopathological assessments. AIMS: To assess the feasibility of using immunohistochemistry to detect replication error (RER) positive CRCs and determine the incidence of RER positivity within distinct patient subgroups. METHODS: 502 CRCs were analysed for RER positivity (at least two markers affected) and/or expression of hMSH2 and hMLH1. RESULTS: There were 15/30 (50%) patients with metachronous CRCs, 16/51 (31%) with synchronous CRCs, 14/45 (31%) with a proximal colon carcinoma, and 4/23 (17%) who developed a CRC under the age of 50 showed RER positivity. However, 0/54 patients who developed a solitary carcinoma of the rectum/left colon over the age of 50 showed RER positivity. Immunohistochemical analysis revealed that 66/66 (100%) RER positive carcinomas were associated with complete lack of expression of either hMSH2 or hMLH1. This correlation was confirmed using a further 101 proximal colon carcinomas. Patients with a mismatch repair defective carcinoma showed improved survival but a 5.54 times relative risk of developing a metachronous CRC. A prospective immunohistochemical study revealed 13/117 (11%) patients had a mismatch repair defective carcinoma. A fivefold excess of hMLH1 defective cases was noted. CONCLUSIONS: All RER positive carcinomas were identified by the immunohistochemical test. This is the first simple laboratory test which can be performed routinely on all CRCs. It will provide a method for selecting patients who should be investigated for HNPCC, offered long term follow up, and who may not respond to standard chemotherapy regimens.

Adaptor Proteins, Signal Transducing↗
PubMed2004

Gender differences in patients needs and concerns to diagnostic tests for possible cancer.

BACKGROUND: Little is known about the difference between the concerns of men and women prior to undergoing diagnostic tests for cancer. METHODS: A convenience sample of 129 outpatients completed a survey. RESULTS: No statistically significant differences were found between male and female patients; however, patients evaluated for gender-specific cancers reported a significantly (P < .01) higher mean score for concerns related to sexuality, reproductive ability, and intimate relationships. Almost half (46%) of the patients reported not receiving any or not enough information before the procedure. CONCLUSIONS: Men and women have similar concerns; however, there are significant differences in the concerns of patients undergoing a procedure for a gender-specific versus a non-gender-specific cancer. Some patients reported inadequate procedural information, suggesting that improvements are needed in communication and health education efforts.

Aged↗
PubMed1977

A prospective comparison of current diagnostic tests for pancreatic cancer.

In 70 patients suspected of having pancreatic cancer, we prospectively compared results of seven diagnostic tests. Subsequent exploration (of 68) and liver biopsy (of two) demonstrated pancreatic cancer in 30, pancreatitis in seven, nonpancreatic neoplasms in nine and nonpancreatic non-neoplastic disease (or no disease) in 24. For detection of pancreatic disease, the best tests were the pancreatic-function test (cholecystokinin-stimulated enzyme outputs) and ultrasonography. The pancreatic scan was nonspecific (P less than 0.001), and thermography was insensitive (P less than 0.001). Endoscopic retrograde pancreatography and arteriography were significantly more sensitive than cytologic study in diagnosis of pancreatic cancer (P less than 0.001). Therefore, when pancreatic cancer is suspected, abdominal ultrasound should be performed first, and if it is negative, a pancreatic-function test next. A positive result from either test warrants an endoscopic retrograde pancreatography for definitive diagnosis. This sequence identified 88 per cent of patients without pancreatic disease and 89 per cent with pancreatic cancer.

Adult↗