Biomedical subjects

C Haglund

Publications and source records attributed to C Haglund.

90 records · Page 5Linked to original sources

PubMed1986

Tissue expression of the tumor marker CA 50 in benign and malignant pancreatic lesions. A comparison with CA 19-9.

The expression of the tumor marker antigen CA 50, defined by the monoclonal antibody (MAb) C 50, was studied by the immunoperoxidase technique in formalin-fixed, paraffin-embedded tissue sections from normal pancreata, from pancreata with pancreatitis and from benign and malignant pancreatic neoplasms. The results were compared with those obtained with Mab 1116 NS 19-9. The C 50 antibody reacts, like the 1116 NS 19-9 antibody, with sialosylfucosyllactotetraose (corresponding to sialylated blood group antigen Lewisa), but also with another sugar moiety, sialosyllactotetraose. Thirty-two of 37 well- to moderately-differentiated adenocarcinomas and all cystadenocarcinomas were positive for CA 50. The staining was most intense in the apical border of the cells, and in the intraluminal mucus. The number of positive cells was smaller in poorly differentiated adenocarcinomas and only occasional cells were stained in anaplastic carcinomas. In acute and chronic pancreatitis small terminal ducts, centro-acinar cells and some large ducts stained for CA 50. In normal pancreas only a few small terminal ducts were CA-19-9-positive, whereas both ducts and centro-acinar cells were C-50-positive. Normal pancreatic tissue adjacent to carcinoma usually stained more strongly for CA 50 than the carcinoma, whereas the opposite was true for CA 19-9. Eight out of 11 CA-19-9-negative carcinomas were CA-50-positive. Serous cystadenomas and malignant islet-cell tumors were focally positive for CA 50, but negative for CA 19-9. It seems apparent that the C 50 antibody reacts with another determinant than sialylated Lewisa in CA-19-9-negative specimens, serous cystadenomas and malignant islet-cell tumors. Serum CA 50 and CA 19-9 levels were determined in 29 patients with pancreatic cancer. The sensitivity was similar for both markers (76%), and there was a positive correlation between the serum levels. However, there was no correlation between the serum levels and the histological expression of the CA 50 and CA 19-9 antigens.

Adenocarcinoma↗

PubMed1986

Tumour-associated trypsin inhibitor, TATI, in patients with pancreatic cancer, pancreatitis and benign biliary diseases.

The serum and urine concentrations of a tumour-associated trypsin inhibitor, TATI, were determined by radioimmunoassay in patients with pancreatic cancer and with benign pancreatic and biliary diseases. Elevated serum levels (greater than 20 micrograms l-1) were found in 85% of the patients with pancreatic cancer, and elevated urine levels (greater than 50 micrograms g-1 creatinine) in 96% of the patients. Thus low TATI level, especially in urine, makes the possibility of pancreatic cancer less likely. Serial assay of TATI in serum from three patients with surgically removed pancreatic cancer showed elevation of the TATI level at the time of detection of recurrence. However, high serum and urine levels were also seen in pancreatitis and in benign extrahepatic cholestasis. Thus TATI is a sensitive, although not specific, indicator of pancreatic and biliary disease, but the use of TATI as a tumour marker in the primary diagnosis of pancreatic cancer is limited. Immunohistochemical staining of pancreatic lesions showed that half of the pancreatic tumours expressed TATI, but the pancreatic tissue adjacent to a carcinoma always stained stronger than the carcinoma. It therefore seems that the main source of TATI in serum and urine of patients with pancreatic cancer are the normal acini and not the tumour tissue. In pancreatitis the staining was intense and clearly stronger than in normal pancreas.

Acute Disease↗

PubMed1986

Tumour marker antigen CA125 in pancreatic cancer: a comparison with CA19-9 and CEA.

CA125 is a tumour marker test based on a monoclonal antibody against an antigen from an ovarian carcinoma cell line. Serum concentrations of CA125 were determined in 95 patients with pancreatic cancer and in 106 patients with benign pancreatic, biliary and hepatocellular diseases. The CA125 concentrations were compared with the CA19-9 and CEA levels. Almost half (45%) of the patients with pancreatic cancer had an elevated CA125 level (greater than 35 U ml-1). Elevated values were also found in benign diseases (24%), especially in patients with pancreatitis and benign hepatocellular diseases, but more seldom in extrahepatic cholestasis. It seems that CA125 is of limited value in the diagnosis of pancreatic cancer. Combination of the CA125 with the CA19-9 test increases the sensitivity only 6% as compared to the CA19-9 assay alone. There may, however, be a use for CA125 in differentiating between obstructive jaundice of benign and malignant origin.

Antigens, Neoplasm↗

PubMed1986

Gastrointestinal cancer-associated antigen CA 19-9 in histological specimens of pancreatic tumours and pancreatitis.

The expression of the gastrointestinal cancer associated antigen CA 19-9, defined by the monoclonal antibody 1116 NS 19-9, was studied by immunoperoxidase staining in routine formalin-fixed, paraffin-embedded tissue sections from normal pancreata, pancreata with pancreatitis and from benign and malignant pancreatic neoplasms. The formalin-fixed specimens were treated with pepsin, which enhanced the staining intensity. Eighty-five per cent of well to moderately differentiated adenocarcinomas were positive. The staining was most intense in the apical border of cells lining the lumina of malignant glands, and in mucus inside the lumina, but cytoplasmic staining was also seen. In poorly differentiated adenocarcinomas the number of positive cells was smaller and in anaplastic carcinomas only occasional cells were stained. All mucinous cystadenomas and cystadenocarcinomas stained intensely, whereas serous cystadenomas, and all benign and malignant islet cell tumours were negative. Ducts in chronic pancreatitis and in normal pancreata were positive in 96% and 79%, respectively, but the staining was focal and usually weaker than in carcinomas. In acute pancreatitis (92% positive) the staining was more intense, and the CA 19-9 expression was seen predominantly in small terminal ducts and in centroacinar cells. There was an apparent correlation between the degree of differentiation of the ductal adenocarcinomas and the expression of CA 19-9, whereas the correlation between tissue expression and serum levels of CA 19-9 was poor.

Adenocarcinoma↗

PubMed1986

Evaluation of CA 19-9 as a serum tumour marker in pancreatic cancer.

Serum concentrations of the CA 19-9 antigen were determined in 91 patients with pancreatic cancer and in 111 patients with benign pancreatic, biliary and hepatocellular diseases. The CA 19-9 concentration was above the cut-off limit (37 U ml-1) in 78% of the patients with pancreatic cancer and high levels (greater than 500 U ml-1) were seen in 56% of these patients. Elevated levels were also seen in benign diseases (22%), especially in patients with extrahepatic cholestasis (up to 440 U ml-1). Hepatocellular jaundice and pancreatitis were associated with normal values (84% of the patients), or with only slightly elevated CA 19-9 levels (up to 88 U ml-1). The CA 19-9 test can be useful as an additional diagnostic tool for the detection of pancreatic cancer. Preliminary results suggest that the CA 19-9 assay can be used in the monitoring of surgically treated patients.

Alkaline Phosphatase↗

PubMed1986

Tumour markers in pancreatic cancer.

The serum levels of three new tumour markers defined by monoclonal antibodies, CA 19-9, CA 50 and CA 125, were analysed and compared with carcinoembryonic antigen (CEA) in samples from 91 patients with pancreatic cancer and from 111 patients with benign pancreatic, biliary tract and hepatocellular diseases. High serum concentrations of CA 19-9 and CA 50 were found in most patients with pancreatic cancer, 78% and 72%, respectively. The serum levels of these two markers showed a positive correlation, while no other correlation was found between the markers. Benign extrahepatic cholestasis was often associated with moderately elevated CA 19-9 and CA 50 levels. The CA 125 and CEA levels were elevated in about half of the patients with pancreatic cancer. Both CA 19-9 and CA 50 seem promising in the follow-up of patients with pancreatic cancer.

Antigens, Neoplasm↗

PubMed1984

Expression of laminin in pancreatic neoplasms and in chronic pancreatitis.

The distribution of laminin, a basement membrane glycoprotein, was studied by immunohistological techniques in 10 samples of normal pancreatic tissue, in 15 samples of chronic pancreatitis, and in 33 pancreatic neoplasms. Sections of formalin-fixed, paraffin-embedded specimens were pretreated with pepsin and immunostained for laminin. As judged by the expression of laminin, normal pancreatic glands were surrounded by a continuous, intact basement membrane. In chronic pancreatitis the basement membrane was also mainly continuous, but focally weaker and thinner than around normal glands. In pancreatic adenocarcinomas laminin was irregularly distributed and in large areas totally absent. In anaplastic carcinomas no extracellular laminin was seen, but two cases showed some intracellular laminin in a punctate pattern. The findings suggest that these cancers have defects in the deposition of a basement membrane or that it is degraded. Our data suggest that the integrity of the basement membrane correlates with the degree of malignancy in ductal adenocarcinomas, but this is not the case for mucinous cystic neoplasms or for islet cell tumors. In these neoplasms a nearly intact basement membrane was seen both in malignant tumors and in their benign counterparts.

Adenocarcinoma↗

PubMedDate not supplied

Prognostic value of immunohistochemical expression of p53 in patients with pancreatic cancer.

The prognostic value of the immunohistochemical expression of p53 was evaluated in 133 patients with pancreatic cancer. Formalin-fixed paraffin-embedded specimens of ductal pancreatic adenocarcinomas retrieved at the time of operation were stained with the monoclonal antibody DO-7. Approximately half of the tumors (47%) showed a high level of p53 immunoreactivity (> or = 20% positive nuclei). No correlation was demonstrated between the level of p53 immunoreactivity and age of the patient, gender, TNM stage, resectability or site of the tumor. A high level of p53 staining was seen in a slightly smaller proportion (30%) of patients with well-differentiated tumors than in patients with moderately (50%) or poorly differentiated (50%) tumors, but the difference was not significant. In a multivariate survival analysis, stage, grade and postoperative chemotherapy emerged as independent prognostic factors. Surgical resectability, if entered instead of stage as a variable in a separate Cox model, predicted prognosis independently. In univariate analysis, the site of the tumor was also a significant prognostic variable. However, no association between the level of p53 immunoreactivity and survival in either uni- or multivariate analysis was found.

Carcinoma, Ductal, Breast↗

PubMedDate not supplied

Ki-67 immunoreactivity, ploidy and S-phase fraction as prognostic factors in patients with gastric carcinoma.

Expression of the Ki-67 antigen was determined by immunohistochemical analysis of paraffin-embedded specimens from 242 patients with gastric adenocarcinoma and the prognostic value of Ki-67 immunoreactivity was compared with ploidy and S-phase fraction (SPF) obtained by DNA flow cytometry. A high percentage of Ki-67 immunostaining was associated with the intestinal type of cancer (p = 0.0002) and male sex (p = 0.003), but correlated only weakly with the SPF (rs = 0.343) and not at all with ploidy. The intestinal type of gastric carcinoma was more frequently aneuploid and had a higher SPF than diploid tumours (p < 0.0001 for both). While the SPF was associated with male sex and stage of disease, both ploidy and SPF were associated with nodal status and age. There was no association between SPF or ploidy and tumour location or the presence of distant metastases. Both SPF and ploidy correlated with survival according to the univariate analysis. In a multivariate survival analysis, the stage of disease, DNA ploidy and presence of distant metastases emerged as independent prognostic parameters. There was no significant difference in survival between patients having tumours with high and low Ki-67 labelling, neither in univariate nor in multivariate survival analyses. In patients with gastric carcinoma, the level of Ki-67 immunoreactivity added no prognostic information to that obtained by DNA flow cytometry.

Adult↗

PubMedDate not supplied

A prognostic value of syndecan-1 in gastric cancer.

BACKGROUND: Syndecan-1, a cell surface heparan sulphate proteoglycan, has a role in cell adhesion, maturation and proliferation. Syndecan-1 has been reported to be a promising prognostic marker in various cancer forms. MATERIALS AND METHODS: We analysed tumour specimens from 296 gastric cancer patients. Syndecan-1 expression was studied by immunohistochemistry. RESULTS: Syndecan-1 immunoreactivity was observed in 234 (79%) patients. The expression of syndecan-1 did not correlate significantly with the presence of lymph node metastases, distant metastases, peritoneal spreading, penetration depth, tumour size, tumour location, Borrmann's classification, Laurén's classification, age or gender. Syndecan-1 immunoreactivity correlated significantly with survival in the whole patient series (p = 0.0499) and also in the subgroup of patients with stage I cancer (p = 0.0417), but not in patients with stage II, III or IV disease. In multivariate survival analysis, stage of disease and tumour size emerged as the only independent prognostic factors. CONCLUSIONS: In conclusion, immunohistochemical expression of syndecan-1 is a potential prognostic factor in gastric cancer, especially in patients with stage I disease.

Adult↗

PubMedDate not supplied

A comparison of serum and tissue hCG beta as prognostic markers in colorectal cancer.

BACKGROUND: Production of the glycoprotein hormone hCG beta has been associated with aggressive behavior in nontrophoblastic tumors. In this study the prognostic value of serum level and tissue expression of hCG beta were compared in 232 patients with colorectal cancer. MATERIALS AND METHODS: Serum levels were measured with a hCG beta specific immunofluorometric assay. Tissue specimens were stained with the same monoclonal antibody as in the serum assay. RESULTS: The proportion of patients with a positive immunohistochemical expression of hCG beta was higher (22%) than the proportion with elevated serum levels (17%). The correlation between serum and tissue expression was moderate (kappa 0.298). Both serum and tissue expression of hCG beta were independent prognostic factors. hCG beta serum level was a stronger prognostic factor than tissue expression both in uni- and in multivariate analysis. The accuracy when predicting 5-year survival status of the patients was highest (63%) when using the combined results of serum and tissue expression. CONCLUSIONS: There is a moderate correlation between hCG beta expression in serum and in tissue. The predictive accuracy of serum hCG beta was higher than the predictive accuracy of tissue expression, and the prognostic accuracy was further slightly increased when using a combination of tissue and serum expression.

Adult↗

PubMedDate not supplied

CEA, CA 19-9 and CA 72-4 improve the diagnostic accuracy in gastrointestinal cancers.

BACKGROUND: CEA, CA 19-9, CA 242 and CA 72-4 are commonly used tumour markers for gastrointestinal malignancies. The advantage of the concomitant use of these markers is under debate. MATERIALS AND METHODS: Serum concentrations of the markers were measured at the time of diagnosis in 161 patients with benign and 125 with malignant gastrointestinal diseases. Concomitant use of the markers was evaluated in a logistic regression model. RESULTS: CA 19-9, CA 242 or CA 72-4 showed similar sensitivity of 44% for gastric cancer, whereas CEA was elevated in 25% of the cases. In patients with colorectal cancer, CEA was most frequently elevated (54%), followed by CA 242 (46%), CA 19-9 (36%) and CA 72-4 (25%). High CA 19-9 and CA 242 serum levels were frequent in patients with cholangiocarcinoma (86% and 68%, respectively) and pancreatic cancer (80% and 63%, respectively). In the benign disease group, serum CA 19-9 was most frequently elevated, i.e. in 24%, 25% and 38% of patients with pancreatic, biliary and liver disorders, respectively. The overall accuracy of CEA, CA 19-9, CA 242 and CA 72-4 was 66%, 71%, 71% and 66%, respectively (p > 0.18). When combined in a logistic regression model, CA 72-4, CA 19-9 and CEA provided independent diagnostic information, whereas CA 242 contributed with independent diagnostic information only on excluding CA 19-9. The probability of cancer for each patient, calculated with the model, was applied as a diagnostic test and was compared with the single markers by ROC-curve analysis. The AUC value of the probability index was significantly higher than the values of the different tumour markers. CONCLUSION: An algorithm based on the combination of CEA, CA 19-9 and CA 72-4 improved the diagnostic accuracy in gastrointestinal tract malignancies compared with these markers alone.

Antigens, Tumor-Associated, Carbohydrate↗

PubMedDate not supplied

Degradation of environmental pollutants by Trametes trogii.

The ability of the ligninolytic fungus Trametes trogii to degrade in vitro different xenobiotics (PCBs, PAHs and dyes) was evaluated. Either 200 ppm of a PCB mixture (Aroclor 1150) or 160 ppm of an industrial PAH mixture (10% V/V of PAHs, principal components hexaethylbenzene, naphthalene, 1-methyl naphthalene, acenaphthylene, anthracene, fluorene and phenanthrene), were added to trophophasic and idiophasic cultures growing in a nitrogen limited mineral medium (glucose/asparagine) and in a complex medium (malt extract/glucose). Gas-liquid chromatography proved that within 7 to 12 d more than 90% of the organopollutants added were removed. The decrease in absorbance at 620 nm demonstrated that cultures of this fungus were able to transform 80% of the dye Anthraquinone-blue (added at a concentration of 50 ppm) in 1.5 h. Enzyme estimations indicated high activity of laccase (up to 0.55 U/mL), as well as lower production of manganese-peroxidase. Laccase activity, detected in all the conditions assayed, could be implicated in the degradation of these organopollutants. Considering the results obtained, T. trogii seems promising for detoxification.

Aroclors↗

PubMedDate not supplied

Prognostic significance of serum CA 242 in pancreatic cancer. A comparison with CA 19-9.

The prognostic value of the novel tumour marker CA 242 was studied in 175 patients with pancreatic cancer and the results were compared with those of CA 19-9. Preoperative serum levels of CA 242 and CA 19-9 were determined by commercially available assays. Patients were classified according to UICC TNM-stage, and divided into three groups of resectable, non-resectable and advanced disease. The lowest cut-off levels that divided patients into groups with significant difference in survival were calculated. Patients with resectable disease and preoperative CA 242 below 25 U/ml had a significantly better prognosis than those with a higher level (p < 0.05). The corresponding cut-off values were 100 U/ml in non-resectable (p < 0.05) and 3500 U/ml in advanced disease (p < 0.05). It is noteworthy that the overall survival rate of patients who underwent resection for cure, but had a high preoperative CA 242 level, approached that of patients with non-resectable disease. In multivariate analysis, only resectability (p < 0.0001) and preoperative serum CA 242 level (p = 0.01) were independent prognostic factors. If TNM-stage was used instead of resectability, the results were similar (stage p < 0.0001, CA 242 p = 0.006). When CA 242 was excluded from the model, preoperative serum CA 19-9 level approached the borderline of significance as an independent prognostic factor (p = 0.07). In conclusion, the preoperative serum level of the novel tumour marker CA 242 is an independent prognostic factor in pancreatic cancer. CA 242 yielded more prognostic information than CA 19-9.

Antigens, Tumor-Associated, Carbohydrate↗

PubMedDate not supplied

Prognostic value of Ki-67 expression, ploidy and S-phase fraction in patients with pancreatic cancer.

The prognostic value of Ki-67 expression, ploidy and s-phase fraction was evaluated in 133 patients with pancreatic cancer. Formalin-fixed paraffin-embedded surgical specimens of pancreatic ductal adenocarcinomas were stained with a polyclonal Ki-67 antibody. Ploidy and s-phase fraction was assessed by flow cytometry. The median percentage of Ki-67 positive nuclei was 26% (range 0-90%). The level of Ki-67 immunoreactivity was associated with TNM-stage, surgical resectability, tumour grade, ploidy and S-phase fraction. Ninetythree patients, with a nuclear expression of Ki-67 in < 50% of malignant cells, had a median survival of 12.8 months compared with 5.5 months for 25 patients with Ki-67 > or = 50% (p = 0.0008). Ploidy (p < 0.0001) and SPF (p = 0.002) were also significant prognostic factors in a univariate survival analysis. In a multivariate analysis, stage (or alternatively resectability), grade, ploidy and postoperative chemotherapy emerged as independent prognostic factors. When ploidy was excluded from the Cox multivariate model, S-phase fraction also predicted prognosis independently. Ploidy and S-phase fraction are independent prognostic factors in patients with pancreatic cancer. A high level of Ki-67 immunoreactivity is also an indicator of poor prognosis but seems to add little prognostic information to that provided by traditional parameters such as stage, resectability and grade.

Adenocarcinoma↗

PubMedDate not supplied

Ki-67, ploidy and S-phase fraction as prognostic factors in gastric cancer.

The prognostic value of the immunohistochemical expression of Ki-67 in paraffin embedded specimens was studied in 242 patients with gastric adenocarcinoma. The results were compared with ploidy and S-phase fraction (SPF) obtained by DNA flow cytometry. Both SPF and ploidy correlated with survival in univariate analysis. In multivariate survival analysis, stage of disease, DNA ploidy and presence of distant metastases emerged as independent prognostic parameters. There was no significant difference in survival between patients having tumours with high and low Ki-67 labelling, neither in univariatenor in multivariate survival analysis.

Adult↗

PubMedDate not supplied

Does Helicobacter pylori in the gastric stump increase the cancer risk after certain reconstruction types?

BACKGROUND: In the intact stomach, Helicobacter pylori associated gastritis is considered to be a risk factor for cancer. After partial gastrectomy increased mucosal cell proliferation associated with chronic bile reflux has been claimed to increase the risk for cancer in the gastric stump, whereas the influence of H. pylori infection is not so clear. MATERIAL AND METHODS: The study was a retrospective study with 130 patients, who had undergone partial gastrectomy for peptic ulcer. The cell proliferation rate was determined from immunohistochemical stainings of gastroscopy biopsies with Ki-67 antibodies from gastric remnants. RESULTS: The mean labelling index (LI) was 30.8%. There was no clear association between H. pylori infection and proliferation rate. A significant difference in proliferation rate was seen between patients with a reconstruction type known to be associated with bile reflux and those with a reconstruction without bile reflux. The difference was small in H. pylori negative patients but strong in those with bile reflux and H. pylori infection. The LI increased with age. Smoking had no significant effect on proliferation whereas use of NSAIDs seemed to inhibit proliferation. CONCLUSIONS: Ki-67 is a convenient method for assessing the proliferation rate of the gastric epithelium. Bile reflux and H. pylori infection seem to have a synergistic effect on cell proliferation in the gastric remnant and may explain the increased risk of cancer after partial gastrectomy.

Age Factors↗

PubMedDate not supplied

The course of Helicobacter pylori infection after partial gastrectomy for peptic ulcer disease.

BACKGROUND/AIMS: While the number of patients operated on for peptic ulcer disease is decreasing, many underwent surgery before the Helicobacter pylori era. Some of them later develop ulcer relapses. The aim of this study was to evaluate the course of H. pylori infection in the gastric remnant after surgery for peptic ulcer disease. METHODOLOGY: This study included 90 consecutive partial gastrectomy patients, obtained from gastroscopy registers of the Department of Surgery, Helsinki University Central Hospital, between 1985 and 1988, in whom both pre- and postoperative samples were available. All of the patients had undergone partial gastrectomy at some time between 1925 and 1988. The median interval between operation and reference gastroscopy was 5 years. RESULTS: Twenty-three patients had a recurrent ulcer, and an additional six patients had a history of an earlier ulcer recurrence. Preoperative H. Pylori infection (68%) did not correlate significantly with the ulcer recurrence rate. The recurrence rate was higher in patients with Billroth I (BI) (27%) and Billroth II (BII) (33%) reconstructions than in those with a Roux-en-Y type reconstruction (9%, BII vs Roux-en-Y, p = 0.02, BI vs Roux-en-Y, p = 0.12). At the time of reference gastroscopy, the proportion of H. pylori positive patients was 38%. The presence of H. pylori at the time of reference gastroscopy did not correlate with ulcer recurrence. A recurrent. ulcer was more often found in patients with histologically normal gastric mucosa in the stump than in those with H. Pylori infection (35% and 19%, p = 0.25). CONCLUSIONS: A persistent H. pylori infection is frequently seen in the gastric remnant after operation for peptic ulcer disease, but the infection does not seem to cause ulcer relapses in the gastric stump or in the anastamosis.

Female↗