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Biomedical subjects

M Frenay

Publications and source records attributed to M Frenay.

67 records · Page 4Linked to original sources

[Comparison of echography and x-ray computed tomography in cancer of the ovary].

A retrospective study with an 18 month follow-up period was conducted on 184 patients (with 172 epithelial ovarian tumors) to compare the value of ultrasonography and CT for detection of pelvic masses, adenopathies, urinary stasis, hepatic metastasis and peritoneal or intestinal involvement. Ultrasound and CT findings were compared with histology data for 47 patients; ultrasound and CT data were compared with the clinical course for 53 patients. Ultrasonography was better than CT for the detection of pelvic masses, and was also slightly better for liver metastases and urinary stasis. CT was more effective for the diagnosis of lumbo-aortic and pelvic adenopathies, and peritoneal and intestinal involvement, but the sensitivity of imaging techniques remains insufficient for both of these lesion types. Combined examination by ultrasonography and CT every 6 months suffices for follow-up of patients who have undergone surgery and can evaluate tumoral response in patients treated by first-line chemotherapy.

Female↗

Value of urinary hydroxyproline and bone isoenzyme of alkaline phosphatase in the early detection and follow-up of bone metastasis in breast cancer patients.

A multiparametric biological study of 178 evaluable breast cancer patients was performed to evaluate the usefulness of individual parameters for the prediction, diagnosis and follow-up of bone metastasis (BM) as compared to physical tests. Serum and urinary calcium and phosphorus were of little discriminative value. The sensitivity and specificity for the urinary hydroxyproline/creatinine ratio (UHP/creat.) were respectively 75% and 81.4% versus 43.2% and 91.4% for the bone isoenzyme of alkaline phosphatase in serum (BIE). During an average follow-up of 14.3 months for 51 patients with bone metastasis, variations in UHP-creat. and BIE correlated with clinical and physical findings; the best correlation was given by UHP/creat. Twenty patients who were initially free of bone metastasis were followed-up for a mean metastasis-free interval of 14 months; UHP/creat. predicted the appearance of bone metastasis in 50% of cases with a lead time of 5.5 months versus 40% and 8.5 months for BIE. Combined use of UHP/creat. and BIE gave a prediction rate of 70% and a mean lead time of 7 months, and this combination of markers thus merits consideration in the management of breast cancer patients.

Alkaline Phosphatase↗

Relationship between systemic 5-FU passage and response in colorectal cancer patients treated with intrahepatic chemotherapy.

The study described herein was conducted to analyze the relationship between tumor exposure to 5-FU and clinical response. Six patients were placed on continuous 5-day intrahepatic 5-FU chemotherapy for colorectal cancer metastasized to the liver. The starting dose was 600-800 mg/m2 per day; cycles were repeated at 4-week intervals. The 5-FU dose was increased by 250 mg/day at each cycle. All six patients received 3 or more cycles, for a total of 37 cycles. Response was evaluated after each cycle by ultrasonography or computed tomography (CT). Pharmacokinetic data revealed a high individual cycle-to-cycle variability for all six patients in the 5-FU area under the curve (AUC day 1 to day 5) corrected for the dose. These variations in drug biodisposition, reflecting hepatic 5-FU uptake, were significantly related to measurable modifications in the tumor mass in 71% of cycles. The correlation between the reduction in local drug exposure and tumor regrowth was better than that between the increase in local drug exposure and tumor reduction. These findings constitute an original illustration in humans of the experimental concept of the drug exposure/tumor response relationship for 5-FU.

Aged↗

HPLC micromethod for simultaneous measurement of estradiol, progesterone, androgen and glucocorticoid receptor levels. Application to breast cancer biopsies.

Estradiol (ER), progesterone (PR), androgen (AR) and glucocorticoid receptor (GR) levels were assayed in 25 breast cancer tumors. The tissue was pulverized and homogenized in buffer, then divided into two parts: one was assayed by the standard dextran-coated charcoal method (DCC), with Scatchard plot analysis, the other was assayed by a micromethod developed in our laboratory, as described below: --incubation of the cytosol with several ligands (labelled and unlabelled) selected to avoid unwanted cross-reactions --DCC separation, followed by extraction of all receptor-bound steroids by precipitation of proteins with methanol/TCA --separation of these steroids on a high pressure liquid chromatography (HPLC) column using a methanol/water solvent --collection of the fractions of the column outlet and counting. Use of three labelled ligands and appropriate unlabelled ligands allowed assays of the four receptors. This micromethod was highly correlated with the standard method: ER = 0.985 (P less than 0.001); PR = 0.999 (P greater than 0.001); AR = 0.989 (P less than 0.001); GR = 0.867 (P less than 0.001). Thresholds of positivity were not modified. This micromethod allowed simultaneous measurement of several receptors in 40 mg biopsy specimens and can be applied to other hormone-dependent tissues.

Breast Neoplasms↗

Optimised analysis of tamoxifen and its main metabolites in the plasma and cytosol of mammary tumours.

Recent biochemical and pharmacological findings concerning tamoxifen (TMX) have proven that both the unchanged drug and the main metabolites, N-desmethyltamoxifen (NDT) and 4-hydroxytamoxifen (4OHT) are biologically active. An HPLC method based on on-line post-column UV irradiation with fluorescence detection is described. Optimized conditions allowed complete and rapid separation of TMX 4OHT, NDT and two other recently reported metabolites, Y and Z. This method was applied to plasma and cytosol drug and metabolite analyses. In plasma, from the moment of initial drug administration until the steady state (after 1 month or more of continuous oral TMX treatment), the values of NDT to TMX ratios were completely reversed: 22 to 215 in mean %, P less than 0.01. The presence of metabolites Y and Z is significant. 4OHT, hardly detectable at the first dose, was measured at the steady state with high interpatient variability. It is hypothesized that metabolite evolution with time may be due to auto-induction of drug metabolism. In cytosols, which were all obtained during continuous TMX treatment, the ratios between TMX and metabolites were comparable to those observed in plasma, but with greater interpatient variability. Metabolite Y was not detectable in cytosols. This variability was not linked to the levels of cytosolic oestradiol receptors before initiation of treatment.

Breast Neoplasms↗

[Comparative study of 3 markers in ovarian cancer: CA 125, CA 19,9 and CEA].

CA 125 is today the best tumour marker to follow up the evolution of epithelial cancers of the ovary where it is elevated in about 80% of cases (as compared with a positive finding in only 20% for CEA and CA 19,9): it is no use as a screening test, it does reflect the quality of the first debulking operation, it makes it possible to follow the clinical evolution of the disease and thus to modify the adjuvant treatment, it helps to indicate whether a second look operation should be carried out; but it does not dispense altogether with the second look operation because even when CA 125 returns to normal the disease is sometimes still not eradicated, finally, it gives an opportunity to look early for any recurrences.

Antigens, Neoplasm↗

Epidermal growth factor receptor assay: validation of a single point method and application to breast cancer.

Epidermal growth factor (EGF) is a 6000 kDa peptide which exerts its biological effects by binding to a specific cell membrane receptor (EGF-R). Extensive studies on EGF-R in breast tumors have demonstrated the prognostic value of such assays. EGF-R measurement is also reportedly potentially useful in other tumors. Classically, the EGF-R content of tumor cell membrane preparations is evaluated by competition between a given concentration of labeled ligand and various concentrations of unlabeled ligand. The large quantity of tumor tissue required (approx. 0.5 g) is a serious limitation for wide-spread use of EGF-R assays. In order to validate a miniaturized EGF-R assay method, the principle of a single-dose technique (SD) using a single concentration of labeled ligand (1 nM) was investigated in the present work. Only 100-150 mg wet tissue were required for routine analysis by the SD method. The correlation between the SD method and Scatchard analysis calculated from 41 different breast carcinoma samples was very satisfactory (r = 0.973, p less than 0.001). Analysis of intra-assay and inter-assay reproducibility revealed a comparable EGF-R status in given samples. The correlation between EGF-R levels and steroid receptors was investigated in 105 individual breast tumors. EGF-R levels were inversely correlated with the estradiol receptor values. No correlation was found with progesterone receptors. The simplified SD method for EGF-R measurement appears suitable for large scale clinical studies aimed at investigating the potential utility of this biological tumor marker.

Biomarkers, Tumor↗

Renal failure secondary to thrombotic complications of suprarenal inferior vena cava filter in cancer patients.

PURPOSE: To evaluate renal function before and after suprarenal inferior vena cava (IVC) filter placement. METHODS: We describe, in a personal series of 13 consecutive cases (all of them stage IV cancer patients, one LGM filter, one Antheor filter, 11 Greenfield filters) in our institution, two cases of fatal renal vein thrombosis after placement of a suprarenal filter. Evaluation of renal function was based on serum urea (in mmol/L; normal 3.30-6.60), serum creatinine (in micromol/L; normal <115.1), and calculation of serum creatinine clearance. RESULTS AND CONCLUSION: This study suggests that in advanced-stage cancer patients who have a single functional kidney, renal functional insufficiency, or previous renal vein thrombosis, IVC filter placement above the renal veins may not be appropriate. Suprarenal filter placement should be performed only after analysis of predicted survival, after detailed discussions with the patient, and most importantly after renal function evaluation.

Adult↗