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At least 973 records · Page 54Linked to original sources
PubMed1978

The value of diagnostic aids in detecting pancreas cancer.

By contract with the National Cancer Institute, the accuracy of diagnostic techniques was assessed in 184 patients suspected of having pancreas cancer. Of 138 patients who were operated upon, 89 were found to have pancreas duct cancer, 30 had cancer of a different site of origin in the head of the pancreas region and in 19 there was no evidence of cancer at operation. All of the 46 patients who were not operated upon, 13 proven to have cancer and 33 patients discharged as free of cancer, were followed in our clinic. The majority of our patients presented with signs and symptoms of biliary obstruction. Computerized transaxial tomography (CTT) gave a "correct" diagnosis in 31 of 33 patients (94%) with proven cancer, there were 2 patients with a false negative report and a false positive diagnosis occurred in 8 of 20 patients (40%) without cancer. Celiac angiography (CA) gave a correct diagnosis in 78 of 94 patients (83%) with cancer, a false negative in 17%, and a false positive in 32%. 76Selenomethionine pancreas scan correctly diagnosed 27 of 36 patients (75%) with cancer, gave a false negative in 25% and a false positive in 31%. Ultrasonography gave a correct diagnosis in 18 of 27 patients with cancer (67%), a false negative in 33% and a false positive in 28%. Endoscopic retrograde cholangiopancreatography diagnosed correctly 8 of 11 cases (73%) of cancer, there were false negative diagnoses in 3 cases (27%) and false positives in 3 of 14 patients (21%). Duodenal aspiration techniques gave a very low percentage of correct diagnoses. Chronic pancreatitis most commonly gave rise to a false positive diagnosis. Serum alkaline phosphatase was elevated in 82% of patients, gave 18% false negatives and 33% false positives. Carcinoembryonic antigen (CEA) was elevated (greater than 2.5 ng/ml) in most of the pancreas cancer patients but also in patients with other cancers and with non-cancerous diseases. In our hands, CTT, CA, alkaline phosphatase, 75Se-methionine and ultrasonography, in descending order, have given the highest percentage of correct diagnoses but false positive and false negative diagnoses prevented any single test from being conclusive.

Biopsy, Needle↗
PubMed1992

[Clinical usefulness of tumor markers for the diagnosis of ovarian cancer].

The most useful diagnostic methods for ovarian cancer at present are diagnostic imaging and measurement of tumor markers. Although many tumor markers have been measured to detect patients with ovarian cancer, the values of diagnostic efficiency are not so high when a single tumor marker is assessed. Therefore, the use of a combination of tumor markers might be expected to yield a higher value. In this study, tumor markers were measured to select an ovarian cancer group from a group in which ovarian tumor was palpable by the pelvic examination. We selected CA 602 from core-protein related markers, CA 54/61 from sugar chain core-related markers, and galactosyltransferase associated with tumor (GAT) for their combined use from among eleven markers examined. As a result, the combined use of each two markers or of all three markers appeared to be beneficial to discriminate ovarian cancers from benign ovarian tumors. The combination of all three markers gave a somewhat higher positive rate and diagnostic efficiency value than that of the two markers. The role of tumor markers in the future screening of ovarian cancer was also discussed in this paper.

Antigens, Neoplasm↗
PubMed1989

[Diagnostic imaging of pancreatic cancer].

Despite the multitude of the imaging procedures which are nowadays at our disposal the diagnostics of the carcinoma of the pancreas and particularly of the early carcinoma is now as ever difficult. On the basis of a multicentric team study about the diagnostic course in 62 patients with diagnosed carcinoma of the pancreas we conclude to an effective diagnostic proceeding. Hereby a broad use of the ultrasound diagnostics is to be demanded and the bioptic clarification of focal findings is early to be carried out. With the help of the serial CT the differentiation between chronic pancreatitis and carcinoma of the pancreas finds particular consideration, it was successful with a reliability of 84%.

Biopsy, Needle↗
PubMed1994

Early detection of prostate cancer: the nature of cancers detected with current diagnostic tests.

The goal of an early detection program is not to detect all prostate cancers, but only to detect those that are potentially morbid or lethal (clinically important cancers). The prevalence of such cancers in the population of 50-year-old men can be estimated to be about 6%, using both epidemiologic and pathologic data. Screening trials using PSA and/or TRUS instead of or in addition to DRE have approached this rate of detection. As Fig 1 illustrates, screening appears to detect almost all of the clinically important cancers in the study population. The fear that these tests will detect a high proportion of latent, or clinically unimportant, cancers appears to be unfounded. Our studies and those of others support the concept that 85% to 90% of cancers detectable with current tests are clinically important. The detection of nonpalpable cancers by PSA or TRUS reduces the proportion of cancers detected at an advanced stage without increasing significantly the detection of latent or clinically unimportant cancers. Despite this analysis, we still lack definitive data to show that screening and treating early stage cancers will decrease the mortality rate of this disease. Such a conclusion will require a long-term, randomized screening trial or a comparison of mortality rates among large populations of men differing primarily in the extent of screening for prostate cancer.

Biopsy↗
PubMedDate not supplied

Infectious causes of chronic inflammatory diseases and cancer.

Powerful diagnostic technology, plus the realization that organisms of otherwise unimpressive virulence can produce slowly progressive chronic disease with a wide spectrum of clinical manifestations and disease outcomes, has resulted in the discovery of new infectious agents and new concepts of infectious diseases. The demonstration that final outcome of infection is as much determined by the genetic background of the patient as by the genetic makeup of the infecting agent is indicating that a number of chronic diseases of unknown etiology are caused by one or more infectious agents. One well-known example is the discovery that stomach ulcers are due to Helicobacter pylori. Mycoplasmas may cause chronic lung disease in newborns and chronic asthma in adults, and Chlamydia pneumoniae, a recently identified common cause of acute respiratory infection, has been associated with atherosclerosis. A number of infectious agents that cause or contribute to neoplastic diseases in humans have been documented in the past 6 years. The association and causal role of infectious agents in chronic inflammatory diseases and cancer have major implications for public health, treatment, and prevention.

Animals↗
PubMed2003

Clinical performance of PET/CT in evaluation of cancer: additional value for diagnostic imaging and patient management.

UNLABELLED: This study assessed the clinical performance of a combined PET/CT system using (18)F-FDG in oncologic patients. METHODS: (18)F-FDG PET/CT was used to evaluate 204 patients with 586 suspicious lesions. All patients had available follow-up data, enabling assessment of the clinical significance of hybrid PET/CT findings. Differences in interpretation between PET, CT, and fused PET/CT data were prospectively documented for detection, localization, and characterization of each evaluated site. The additional value of PET/CT for data interpretation over that of separate PET and CT was classified into several criteria, including change in lesion characterization to either definitely benign or definitely malignant, precise anatomic localization of malignant (18)F-FDG uptake, and retrospective lesion detection on PET and CT. The clinical impact of information provided by PET/CT on patient management was assessed on the basis of follow-up data concerning further diagnostic or therapeutic approach. Analysis of data was performed for the whole study population, for different types of cancer, and for different anatomic sites. RESULTS: PET/CT provided additional information over the separate interpretation of PET and CT in 99 patients (49%) with 178 sites (30%). PET/CT improved characterization of equivocal lesions as definitely benign in 10% of sites and as definitely malignant in 5% of sites. It precisely defined the anatomic location of malignant (18)F-FDG uptake in 6%, and it led to retrospective lesion detection on PET or CT in 8%. The results of PET/CT had an impact on the management of 28 patients (14%). Hybrid PET/CT data obviated the need for further evaluation in 5 patients, guided further diagnostic procedures in 7 patients, and assisted in planning therapy for 16 patients. CONCLUSION: Hybrid PET/CT improves the diagnostic interpretation of (18)F-FDG PET and CT in cancer patients and has an impact on both diagnostic and therapeutic aspects of patient management.

Adolescent↗
PubMed2006

TRPM8 in prostate cancer cells: a potential diagnostic and prognostic marker with a secretory function?

During the past 5 years it has emerged that the transient receptor potential (TRP) family of Ca(2+)-and Na(+)-permeable channels plays a diverse and important role in cell biology and in pathology. One member of this family, TRPM8, is highly expressed in prostate cancer cells but the physiological and pathological functions of TRPM8 in these cells are not known. Here we address these questions, and the issue of whether or not TRPM8 is an effective diagnostic and prognostic marker in prostate cancer. TRPM8 is known to be activated by cool stimuli (17-25 degrees C) and cooling compounds such as menthol. The activation mechanism(s) involves voltage sensing of membrane potential, phosphatidylinositol 4,5-bisphosphate and Ca(2+). In addition to prostate cancer cells, TRPM8 is expressed in sensory neurons where it acts as a sensor of cold. In prostate epithelial cells, expression of TRPM8 is regulated by androgen and is elevated in androgen-sensitive cancerous cells compared with normal cells. While there is some evidence that in prostate cancer cells Ca(2+) and Na(+) inflow through TRPM8 is necessary for survival and function, including secretion at the apical membrane, the function of TRPM8 in these cells is not really known. It may well differ from the role of TRPM8 as a cool sensor in sensory nerve cells. Androgen unresponsive prostate cancer is difficult to treat effectively and there are limited diagnostic and prognostic markers available. TRPM8 is a potential tissue marker in differential diagnosis and a potential prognostic marker for androgen-unresponsive and metastatic prostate cancer. As a consequence of its ability to convey Ca(2+) and Na(+) and its expression in only a limited number of cell types, TRPM8 is considered to be a promising target for pharmaceutical, immunological and genetic interventions for the treatment of prostate cancer.

Biomarkers, Tumor↗
PubMed2006

High-sensitivity blood-based detection of breast cancer by multi photon detection diagnostic proteomics.

We have developed several new methods for blood-based cancer detection by diagnostic proteomics. Ultrasensitive methods of immunoassay using multiphoton-detection (IA/MPD) increase sensitivity by 200- to 1,000-fold (1 femtogram/mL). This has allowed the measurement of cancer biomarkers with very low concentrations in blood that could not be measured for full patient cohorts with conventional immunoassays. Sensitivity and specificity in cancer detection have been found to be potentiated by use of immunoassay panels which include tissue-specific cancer biomarkers as well as cytokines and angiogenic factors. The ultrasensitive immunoassays revealed that patient to patient variations in the concentrations of individual biomarkers in blood can extend over many orders of magnitude (up to six) and that the distributions of biomarker concentrations over patient cohorts are non-Gaussian. New methods of data analysis which correlate abundances of multiple, different biomarkers have been developed to deal with such data sets. Sensitivity and specificity of about 95% have been achieved for blood-based detection of breast cancer in pilot studies on 250 patients and 95 controls. Pilot studies indicate that this methodology may also allow differentiation of malignant breast cancer from benign lesions and can provide similar sensitivity and specificity for other epithelial cancers such as prostate cancer, ovarian cancer and melanoma. The methods developed for selection, application, and evaluation of very high sensitivity biomarker panels are expected to have general relevance for diagnostic proteomics.

Adult↗
PubMedDate not supplied

The use of diagnostic bronchoscopy in lung cancer.

BACKGROUND: The role of fibreoptic bronchoscopy in the diagnosis of bronchogenic carcinoma is well established. However, in developing countries, where the burden of illness is large and diagnostic facilities are limited, only a small number of patients are diagnosed at a stage when they might benefit from operation. We felt it would be desirable to identify subsets of patients suspected of harbouring lung cancers, in whom bronchoscopy would have not only a high diagnostic yield but also provide useful information which might influence treatment, the patient's quality of life and duration of survival. METHOD: We analysed the records of 588 patients, who had been bronchoscoped for suspected lung cancer, over a period of 8 years at a tertiary referral centre in north India. The patients were divided into different clinical subgroups on the basis of their clinical and radiological presentation, and the diagnostic yield from bronchoscopy in each group was calculated. A decision analysis model was constructed and the expected value of clinical information was determined for each group. RESULTS: A tissue diagnosis was established by bronchoscopy in 177 (30%) patients and by additional investigations in 43 (7.3%) patients. A positive tissue diagnosis was obtained most often in patients with clinical and radiological evidence of pulmonary collapse (50%) and mass lesions (38-42%). Only 12% of patients with malignancy underwent resection and 70% of them belonged to the above two groups. The expected value of clinical information was greatest in patients with collapse (0.077) or mass lesions (0.067-0.065). CONCLUSIONS: A diagnostic work-up including fibreoptic bronchoscopy is indicated early in patients with collapse or mass lesions of the lung. Patients with non-resolving pneumonia, pleural effusion, metastatic disease and non-specific lesions on chest X-ray should receive a low priority for bronchoscopy.

Adolescent↗
PubMedDate not supplied

Diagnostic imaging approaches and relationship to hepatobiliary cancer staging and therapy.

Diagnostic imaging plays an essential role in management of hepatobiliary tumors. High resolution images provided by computed tomography (CT), magnetic resonance imaging (MRI), and ultrasound (US) allow detection of tumor within the liver. CT arterial portography remains the standard for detection of small lesions in the range of 1.5 cm, but noninvasive techniques such as contrast-enhanced helical CT and MR hold promise for comparable lesion detection. MRI provides lesion characterization for differentiation of benign and malignant tumors. Lesion characterization has been further improved by faster CT and MR techniques that allow imaging in both arterial and portal venous phases for characterization of lesions based on the rate and pattern of enhancement. Functional imaging such as 2-fluoro-2-deoxy-D-glucose-positron-emission tomography (FDG-PET) is increasingly utilized for detection of intrahepatic tumor and extrahepatic disease. Accuracy of FDG-PET for extrahepatic disease is better than conventional imaging and has been shown to change management in a significant number of patients. Imaging is also invaluable for surgical planning. Segmental anatomy is well shown by CT, MRI, and US. CT or MR angiography with newer 3D techniques delineate vascular variants and areas of encasement or occlusion by tumor. Biliary involvement at the hilus may be shown by US and MR cholangiography. Imaging detection of vascular involvement, bile duct extension, and lobar atrophy may alter the surgical approach.

Bile Duct Neoplasms↗
PubMed1991

A case-control study of oral cancer and pre-diagnostic concentrations of selenium and zinc in nail tissue.

A case-control study of oral cancer was conducted in western Washington state between 1983 and 1987. Cases (n = 379) were identified through a population-based registry, and controls (n = 514) were selected by telephone using random digit dialing. Subjects participated in a personal interview, completed a food-frequency questionnaire, and submitted clippings from the nails of each great toe for the determination of selenium and zinc concentrations. The odds ratio (OR) for low selenium levels in nail tissue (lowest 25% of the distribution compared to the upper 75%) was 1.4 (95% confidence interval (CI) 1.0-2.2). Likewise, the odds ratio for low zinc levels in nails was 1.6 (95% CI 1.0-2.3), but for low dietary zinc was 1.0 (95% CI 0.7-1.7). Men with oral cancer had lower nail selenium levels than did the controls (OR = 1.9), but women with oral cancer did not (OR = 0.6). Individuals 20 to 39 years of age with oral cancer, in particular, were more likely to have lower selenium levels in nail tissue than controls (OR = 16.4). There was a significant interaction between selenium and ascorbic acid levels which could not be explained by cigarette use. Subjects at greatest risk had low levels of both nutrients (OR = 3.8 for smokers and OR = 5.7 for non-smokers). However, since the elements were deposited in the nail matrix close to the date of diagnosis, the differences in the element concentrations between cases and controls may have been a result of the disease. Further etiologic studies of selenium, vitamin intake and oral carcinoma are warranted.

Adult↗
PubMed1984

Diagnosis and staging of ovarian cancer.

The diagnostic process in ovarian carcinoma is divided into the pre- and intraoperative procedures, examinations of tumor tissue, and follow-up. For preoperative diagnosis, the probability of a palpable adnexal mass being a malignant tumor should first be ascertained by sonography. This should be followed by an appropriate general examination, a search for tumor outside the abdominal cavity and in the liver parenchyma as well as by determination of markers. Intraoperative diagnosis determines the tumor stage and must be carried out all the more comprehensively when the ovarian carcinoma is more limited. Histologic subtype and degree of differentiation are in direct relation to the tumor stage, whereas the size of the primary tumor is often indirectly proportional to its extent. Besides the morphological analysis, the determination of possible chemoresistance and chemosensitivity, as well as further investigations on fresh tumor tissue are included in the tissue examination. Follow-up after a curative operation consists of gynecologic examination and Douglas lavages if tumor is still present in CT Scans and sonographs. To verify a relapse, laparoscopy can be used, but to ascertain a complete remission, a laparotomy is necessary.

Animals↗
PubMed1997

The emergence of the 'waiting game': a critical examination of the psychosocial issues in diagnosing breast cancer.

Undergoing diagnostic investigations for symptoms of breast disease constitutes an intensely stressful experience for any woman. The widespread use of contemporary fine-needle techniques throughout specialist breast clinics, whilst removing the necessity of hospitalization and general anaesthesia for many women, has introduced the notion of the 'waiting game'. The ability to ascertain definitive results within a matter of hours has led to diversification in the structure of diagnostic breast services; however, the significance of the 'waiting game' in terms of distress experienced by women has not been investigated. This paper systematically reviews the research that has explored psychosocial morbidity in this phase of the disease trajectory, and provides summative recommendations for further research.

Biopsy↗
PubMed1985

[New developments in the area of markers in diagnosis and monitoring of ovarian cancer].

The diagnostic and prognostic prediction of ovarian carcinoma can be substantially improved by combining serological markers synchronized with radiological and morphological methods. The validity of the following markers was investigated in a prospective trial between 1977 and 1983: CEA, TPA, SP-1, SP-3, alpha-1-antitrypsin, alpha-2-macroglobulin, c-reactive protein. The results were correlated with those of the CA 12-5 determination. Pre-operatively, ovarian carcinoma was indicated by CA 12-5 (93.7%), sialyl transferase (65.6%), TPA (53.1%), CEA (28.1%). These markers would appear suitable to control the clinical course.

Antigens, Neoplasm↗
PubMed1977

[Hormonal factors in the prediction of hormonedependency of breast cancer].

Biological diagnostic of hormonedependency of breast tumors is important for the choice of treatment. Modifications of the metabolism of steroids, oestrogens, androgens, and glucocorticoids allowed a first approach. More recently, investigations have been made on breast tissue receptors for hormones that are involved in the growth of the normal gland. It is actually suggested that one could predict the hormonedependency of a tumor when it contains both receptors for oestradiol and progesterone.

Breast Neoplasms↗
PubMed1990

[An economic assessment of check-up fluorographic studies in detecting lung cancer].

The diagnostic value and cost-effectiveness of photoroentgenography were assessed on the basis of the data for 1977-1986 provided by 41 health care establishments of Leningrad. The mean overall cost of a single examination including the procedure and analysis was 0.29 +/- 0.01 rubles. Identification of a lesion in the lung, mediastinum or thoracic wall, whatever its nature, costed 18.8 rubles.

Costs and Cost Analysis↗
PubMed1990

[Early gastric cancer: staging and diagnostic-therapeutic trends].

The Authors in reviewing the main epidemiological and histological features of Early Gastric Cancer, dwell upon the atypical symptomatology pointing out the importance of an early diagnosis for a successful surgical treatment. Furthermore, they affirm the primary role of subtotal gastrectomy, associated with regional lymphadenectomy and omentectomy. At last, the need to extend postoperative follow-up to the main abdominal and thoracic organs for the frequency of synchronous or metachronous neoplasms is stressed.

Adenocarcinoma↗
PubMed1983

[Significance of laboratory chemical parameters for the detection of metastases in breast cancer].

The diagnostic value of 7 laboratory parameters for the detection of metastases was investigated in 136 patients with verified breast carcinoma after mastectomy. The post-operative interval was 6 to 80 months (means = 27.5). 61 patients had multiple metastases as determined by physical examination, X-rays, computertomography, sonographic and scan procedures, while the other 75 patients had no evidence of metastases. Carcinoembryonic antigen (CEA), alkaline phosphatase (AP) and lactate dehydrogenase (LDH) proved to be reliable parameters for the presence of metastases; the combination of these 3 parameters had a sensitivity of 73.0% and a specificity of 94.7% in the detection of metastases. The additional determination of gamma-glutamyltranspeptidase (gamma-GT), blood sedimentation rate (BSR), C-reactive protein (CRP) and serum iron (Fe) increased the sensitivity of metastases detection to 83.8%, but the specificity decreased to 46.2%.

Adult↗