[Serum CA125 in gastric cancer patients with peritoneal dissemination].
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Biomedical subjects
Publications and source records attributed to M Mai.
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In order to evaluate the usefulness of serum DU-PAN-2, we determined this antigen in 384 patients with various malignancies and in 215 patients with benign diseases using a sandwich enzyme immunoassay system (Kyowa Medex Co.). Elevated DU-PAN-2 levels (greater than 400 U/ml) were observed in 55% of hepatocellular cancers, 50% of pancreatic cancers, and 43% of biliary tract cancers. On the other hand, most false-positive cases with benign diseases were observed in patients with liver injury, especially in the acute phase of acute hepatitis, chronic active hepatitis, and liver cirrhosis. However, in only a few cases with other benign diseases including pancreatitis, increased levels were found. Moreover, among the pancreatic cancer or biliary tract cancer patients studied, DU-PAN-2 was positive in 7 of the 19 CA 19-9-negative (less than 37 U/ml) patients and 32 of the 68 CEA-negative (less than 5 ng/ml) patients. These results indicate that the assay of DU-PAN-2 by EIA may have diagnostic usefulness in digestive cancer, especially pancreatic cancer or biliary tract cancer.
The effect of combination chemotherapy with Interferon-beta, Mitomycin C and 5-fluorouracil (beta-MF chemotherapy) on 7 hepatic tumors by intra-arterial administration was studied. Complete remission (CR) was observed in one patient and partial remission (PR) in two patients, the efficacy rate being 42.9%. The survival period was more than one year in 6 patients. Fever was observed in 6 cases, although it was slight in all cases and preventable by pre-treatment with antipyretics. The authors consider that beta-MF chemotherapy can be expected to be one form of treatment for nonresectable gastrointestinal carcinoma.
This present study, a follow-up of our earlier investigation, further examines the time courses of recovery of oculomotor and vestibular function while patients are under the sedative effect of a single dose of secobarbital (Seconal). The assessment included tests for saccade and smooth pursuit, and the vestibulo-ocular reflex and its cancellation, as evaluated by sinusoidal and pseudorandom rotation in a high-frequency hydraulic chair (up to 5 Hz). Analysis of results showed that the vestibulo-ocular reflex (VOR) gain, depressed soon after drug intake, recovered substantially after a few hours. Changes in VOR gain were more pronounced with higher frequencies of rotation at 2 and 3 Hz, and greater with pseudorandom than sinusoidal stimulation. Under barbiturate influence, pursuit and VOR cancellation followed distinctly different time courses of recovery. This dissociation between VOR cancellation and pursuit supports the theory that these two systems are subserved by different mechanisms. Saccadic hypermetria was also observed after drug intake.
The growth rate of 49 cases with recurrent gastric cancer was investigated with two tumor markers (AFP & CEA). The average doubling time of liver metastases (24.7 +/- 11.9 days) in 18 cases was significantly shorter from that of lymph node metastases (41.1 +/- 22.4 days) in 13 cases and of peritonitis carcinomatosa (42.2 +/- 19.6 days) in 18 cases. Latent period of recurrent cancer calculated by these doubling times was ranged from 1.0 to 3.5 years (mean 1.7 years) in liver metastases, from 1.0 to 5.0 years (mean 2.7 years) in lymph nodes metastases and from 1.5 to 6.0 years (mean 2.7 years) in peritonitis carcinomatosa. Only in liver metastases, positive correlation between the doubling time (X) and the duration of survival (Y) was observed by expressing the formula Y = 0.45 X-0.58 (R = 0.661, p less than 0.05). It is noteworthy that there is a significant correlation in spite of large differences in background subjects (systemic condition, size of metastatic lesion, etc.) and the growth rate of tumor is considered to play a very important role for determining the degree of biological malignancy of individual cancer patients in relation to survival.
A case of hepatocellular carcinoma was treated with anti-alpha-fetoprotein (AFP) antibody-adriamycin via the hepatic artery with induced hypertension by angiotensin II. A minor response was achieved (from 13.5 X 9.0 cm to 10.5 X 7.5 cm) and serum AFP decreased from 310,000 ng/ml to 26,000 ng/ml. The patient has been doing well during a follow-up period of one year. This result suggests that targeting chemotherapy used for each drug delivery system would be more effective if combined with two or more similar modalities.
During the last 10 years, we have experienced 41 cases of minute cancer, which is equivalent to 13.9% of all resected early stomach cancers. Out of 44 lesions in 41 cases, 17 lesions were diagnosed preoperatively, while 27 were unexpectedly detected by serial sections of the resected stomach. Most lesions were located along the lesser curvature of the body and antrum. There was no nodal involvement or vessel permeation. Histologically differentiated adenocarcinomas were encountered in 86.4%, associated with intensive intestinal mucosa in many cases. We have stressed that dye endoscopy using indigo carmine and methylene blue is very useful for the diagnosis of minute cancer.
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The carbohydrate antigenic determinant (CA 19-9) EIA kit (FUJIREVIO INC) was examined both experimentally and clinically. In the basic study, the standard curve showed linearity from to 240 U/ml, and the intra-and interassay reproducibility was good. Serum levels of CA 19-9 were determined by EIA in 246 cancer patients and 180 patients with benign diseases, and CA 19-9 levels by EIA were compared with those by RIA in concurrent measurement. There was an excellent correlation between the two. The positive of CA 19-9 EIA was almost the same as that of CA 19-9 RIA in cancer patients. False-positive cases by CA 19-9 EIA were somewhat more numerous than those by CA 19-9 RIA in patients with benign diseases, especially liver diseases. However, CA 19-9 assay by EIA is simple and has an excellent reproducibility and accuracy, as does that by RIA. Thus, the CA 19-9 EIA is a very useful assay.
We calculate the CEA doubling time of liver metastasis (13 cases) from colonic cancer and studied the factors influencing the growth rate. The doubling time of liver metastasis from colonic cancer ranged from 10 to 112 days (mean 57.8 +/- 35.4 days) was found significantly different among differentiations in histological type. Namely, the doubling time of poorly differentiated adenocarcinoma was shorter than that of well differentiated adenocarcinoma. Moreover the postoperative survival time (Y: months) was found to be significantly correlated with doubling time (X: days); Y = 0.155X + 4.452, r = 0.718, p less than 0.05. These results suggest that the growth rate calculated as CEA doubling time of cancer plays an important role in determining the degree of biological behavior in colonic cancer patients.
A chronological analysis of gastric cancer originating from fundic gland mucosa was made by measuring the tumor size with reference to the serosal invasion and peritoneal dissemination. As for serosal invasion by cancer cells there were significant differences in the group with tumors exceeding 4 cm in diameter, and peritoneal dissemination was liable to be seen in the group with those exceeding 5 cm. This suggests that gastric cancer originating from fundic gastric mucosa must be detected before it reaches 4 cm in diameter and that the intraperitoneal administration chemotherapeutic agents is recommendable, considering residual microcancer dissemination.
An unusual gastric lesion comprising multiple bridges in a 62-year-old woman is presented. Radiographic and endoscopic examination revealed several mucosal bridges and mucosal tags. The resected stomach showed eight mucosal bridges and five mucosal tags along the course of the mucosal folds in the fundic gland area, the former measuring 3 cm in diameter. This paper concludes with short discussion of the etiology of these proliferative gastric lesions from a clinicopathological standpoint.
Oscillopsia during head movement occurs in patients with bilateral vestibular loss and may be transient or persistent. To investigate mechanisms underlying recovery we tested the vestibulo-ocular reflex (VOR), visual-vestibular interaction, and the cervico-ocular reflex (COR); we used a pseudorandom oscillatory stimulus with a frequency band width of 0 to 5 Hz in six patients with bilaterally absent caloric responses and in 10 normal controls. Seven control subjects had low-gain COR responses, but these were anticompensatory with respect to the VOR. Three asymptomatic patients with an absent or grossly deficient VOR had increased oculomotor responses at all frequencies when oscillated in light. Compensatory COR responses were detected in these patients but not in patients with persisting oscillopsia. In some patients with bilateral vestibular loss, augmented cervico-ocular and visual reflexes may compensate, at least partially, for an absent VOR.
We measured serum carcinoembryonic antigen (CEA) levels in 164 cancer patients, 153 patients with benign diseases and 45 healthy controls using monoclonal antibody and compared CEA levels by monoclonal antibody (m-CEA) with those by polyclonal antibody (p-CEA). There was a good correlation between m-CEA and p-CEA, especially in cancer patients. The positively of m-CEA was almost the same as that of p-CEA in cancer patients. But, false-positive cases by m-CEA were less common than by p-CEA in non-cancerous patients. Thus, the measurement of m-CEA was not less useful than that of p-CEA.
The purpose of this study was to catagorize the metastatic patterns of advanced gastric cancer into liver and peritoneal metastases from the stromal behavior of the primary lesion in 278 patients. According to our data, peritoneal disseminations were encountered 5.0% of the medullary type, 30.0% of the intermediate type and 38.0% of the scirrhous type, while the corresponding figures for liver metastases were 28.8%, 6.0% and 1.9%, respectively. The differences among the three types were significant with both patterns of metastasis. From the present data, we assume that the histological pattern in the stroma of primary gastric cancer shows the biological behavior of cancer growth and metastatic patterns, particularly in close relation to peritoneal dissemination and liver metastases.
In healthy young subjects barbiturate induced vestibular nystagmus was sequentially studied with repeated electronystagmographic recordings. The analysed data together with our earlier studies indicated that, except for vertical nystagmus, spontaneous and different types of positional nystagmus by themselves are not diagnostic of site of lesion. The transition from spontaneous to positional to paroxysmal nystagmus observed in follow up studies of several of these cases indicates that these various types of vestibular nystagmus are likely a measure and reflection of different degrees of vestibular decompensation.