The role of tumour markers (CEA, TPA, CA 19-9) in colon and rectum carcinomas.
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Biomedical subjects
Publications and source records attributed to E Fiori.
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A comparative study was performed on the efficacy, safety and tolerability of three different antibiotics (imipenem, ceftazidime, ceftriaxone) in the prevention of postoperative infection. Evaluations were made on the basis of the results obtained in a group of 90 patients subdivided into three matched groups each of which was treated with one of the three compounds. The trend of cutaneous temperature showed differences at the limit of significance (p congruent to 0.05). Variations in leucocyte concentrations showed an analogous pattern in all patients, although there were fewer and with a shorter duration in subjects treated with imipenem. The wound healing process was improved in patients receiving prophylactic antibiotic treatment in the form of imipenem (0.01 < p < 0.05) who also showed a greater respect for therapeutic protocols (80%), a higher percentage of remission of fever and a shorter mean hospital stay (9 days). In the light of these preliminary results the authors express their favourable judgement regarding the choice of imipenem for the prophylaxis of postoperative infection; however, each of the three protocols showed a considerable prophylactic capacity as well as good tolerability and ease of use.
The Authors carried out a literature review on prognostic factors and current management of renal cell carcinoma. A significant factor influencing survival appears to be the extension of the primary tumor (T). The finding of no nodal involvement is not always a favourable prognostic factor if the tumor is no more confined. A perfect knowledge of the prognostic factors may be useful to identify those patients who need post-operative chemotherapy. Surgery is still the treatment of choice for renal cell carcinoma. Extensive lymphadenectomy does not influence long-term survival, nevertheless since there is no additional mortality or morbidity, it is considered useful for a correct staging and a better evaluation of long-term prognosis.
The records of 86 patients with primary adenocarcinoma of the gallbladder were reviewed. All patients were staged according to the Nevin classification. Twenty-nine patients underwent resection, 57 were submitted to palliative procedures or exploratory laparotomy. Survival was directly related to tumor staging and modality of treatment. The 5- and 10-year survival expectancy after curative resection was 46.8% in stage II patients, 14.2% and 0%, respectively, in stage V patients. None of the unresectable cases survived beyond 24 months, except for one patients who lived 62 months. No significant difference in survival expectancy was found between resectable and unresectable patients with stage V tumor.
Starting from the study of a personal case, the authors underline that adrenal cysts are a very rare pathology, occasionally observed and without symptoms. Moreover they point out diagnostic methods, don't permit a certain diagnosis and therapies are not univocal.
In relation to their experience, the Authors affirm that currently an early diagnosis of breast cancer, in an absolute preclinical stage, is obtainable by adequate screening using specific methods especially among women who are at greater risk. Primary prevention is not achievable at present; however some considerations based on protocols which provide a surgical prophylactic therapy in high risk breast pathologies and in very selected patients, are possible. In the light of these considerations secondary prevention has a predominant role and may be more effective and curative if the treatment is carried out in the earliest stages of the disease.
The authors evaluated serum CEA, TPA, CA19-9, SCC and CYFRA at diagnosis and in the follow-up of 18 anal canal tumors. Sensitivity at diagnosis was 38.8% for CEA, 55.5% for TPA, 16.6% for CA19-9, 50% for SCC and 5.5% for CYFRA. In the follow-up CEA showed 0% sensitivity and 73.3% specificity, TPA 33.3% sensitivity and 86.6% specificity, CA19-9 0% sensitivity and 80% specificity, SCC 0% sensitivity and 93.3% specificity, CYFRA 0% sensitivity and 100% specificity. The authors consider the usefulness of serum SCC and TPA at diagnosis of squamocellular anal cancer and of CEA in the diagnosis of cloacogenic tumors. Nevertheless these serum markers did not detect recurrences in the follow-up.