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Tzu-Chen Lin

Publications and source records attributed to Tzu-Chen Lin.

21 records · Page 2Linked to original sources

Prognostic value of DNA ploidy patterns of colorectal adenocarcinoma.

BACKGROUND/AIMS: The significance of prognostic value of DNA ploidy patterns of colorectal cancer has not yet been fully understood. The present study was designed to determine the prognostic value of DNA ploidy patterns for colorectal adenocarcinomas after resection. METHODOLOGY: We have prospectively collected tumor specimens from 420 patients with colorectal cancer since 1996. The DNA ploidy patterns were determined with the use of DNA flow cytometry. The correlation of DNA ploidy pattern and various characteristics of tumors and the prognostic significance of DNA ploidy patterns were evaluated by univariate as well as Cox's proportional hazard model. The disease-free survival curves were calculated with Kaplan-Meier's analysis, and the survival difference was determined by log-rank test. RESULTS: DNA ploidy patterns were diploid in 115 (27.4%) and aneuploid in 305 patients (72.6%). The pattern of DNA ploidy did not correlate with age, gender, location, differentiation, and stage of the tumors. In 146 patients who were followed up for at least 2 years, the disease-free survival curves were similar between the diploid and aneuploid group. Multivariate analysis disclosed that tumor staging was associated with the survival of patients but the DNA ploidy pattern had no prognostic significance. CONCLUSIONS: The DNA ploidy pattern was not a significant prognostic factor in short-term follow-up.

Adenocarcinoma↗

EIA versus RIA in detecting carcinoembryonic antigen level of patients with metastatic colorectal cancer.

BACKGROUND/AIMS: Little literature exists comparing the differences between enzyme immunoassay (EIA) and radioimmunoassay (RIA) in the detection of serum carcinoembryonic antigen (CEA) levels of patients with metastatic colorectal cancer. Because EIA has the advantage of avoiding the use of radioisotopes, the potential of using EIA instead of RIA in detecting CEA of patients with colorectal cancer is of interest to us. METHODOLOGY: Between March and August 2001, a total of 120 blood specimens, including 60 specimens from patients with metastatic colorectal cancer and another 60 from patients with non-malignant diseases, were examined in this study. Serum CEA levels were examined by EIA and RIA methods in parallel. The CEA-EIA tests were done using EIA kits manufactured by Abbott Laboratories at Illinois in the United States. Comparison was done with the conventional CEA-RIA tests using RIA kits manufactured by CIS laboratory at France. The blood samples were sent to Veterans General Hospital-Taipei for EIA and RIA determination. The cut-off value for CEA was set at 5.0 ng/mL. RESULTS: The correlation between the Abbott-EIA and the CIS-RIA methods in detecting serum CEA levels was high. The results give a correlation coefficient of 0.992 with a linear regression line y=0.975 x + 0.215 (p<0.0001). Agreement in the Abbott-EIA and CIS-RIA tests in diagnosis was observed in 113 patients (94%), including 53 positive (>5 ng/mL) and 60 negative (<5 ng/mL) in both tests. The sensitivity was similar in both assays (83% vs. 80%) at a cut-off level of 5 ng/mL. The ability to discriminate between colorectal cancer and non-malignant diseases was good in both assays (p<0.001). The specificity and positive predictive value were slightly higher with the Abbott-EIA method compared with CIS-RIA assay (92% vs. 83% and 91% vs. 83%, respectively). The Abbott-EIA method achieved a similar diagnostic accuracy to CIS-RIA method (88% vs. 82%). CONCLUSIONS: These data suggest that the Abbott-EIA has similar diagnostic power to CIS-RIA in the measurement of CEA levels of patients with metastatic colorectal cancer, with an additional advantage of avoiding the use of radioisotopes. We believe that ELA has the potential to replace RIA in the measurement of CEA in clinical practice.

Adult↗

Metastatic potential in T1 and T2 colorectal cancer.

BACKGROUND/AIMS: Survival of patients with colorectal cancer confined to the muscularis propria (stage I) is excellent after curative resection. However, some patients are likely to develop lymph node and distant metastasis that can ultimately cause death. The purpose of this study was to identify the possible predictors of lymph node and distant metastasis in T1 and T2 colorectal cancers. METHODOLOGY: In total 208 patients with T1 and T2 colorectal cancers who underwent surgical resection in Taipei Veterans General Hospital from July 1996 to December 2001 were enrolled. The clinicopathological variables including age, gender, tumor location (rectum/colon), preoperative carcinoembryonic antibody level, depth of tumor invasion, lymphovascular invasion, and unfavored histology corresponding to the metastasis assessed pathologically were analyzed. Categorical variables were analyzed using Chi-square with Yates' correction. The independent predictor of lymph node and distant metastasis was determined with multivariate binary logistic regression. RESULTS: Of the 208 T1 and T2 colorectal cancer patients, 36 (17.3%) had lymph node metastasis and 5 (2.4%) had distant metastasis at surgery. The risk of lymph node metastasis was 14.3% (8/56) in T1 and 18.4% (28/52) in T2 colorectal cancer. The tumors with evidence of lymphovascular invasion had a significantly higher incidence of lymph node metastasis than those without lymphovascular invasion (43.6% vs. 9.4%; p<0.001). The independent risk factor for lymph node metastasis was lymphovascular invasion only (95% confidence interval, 3.37-19.97; p<0.001), whereas that for distant metastasis was preoperative carcinoembryonic antibody level >5ng/mL only (95% confidence interval, 0.03-0.21; p<0.001). The negative predictive value of possible adverse risk factors including preoperative carcinoembryonic antibody level >5ng/mL, lymphovascular invasion, and unfavored differentiation for metastasis was 93.5%. CONCLUSIONS: Considering the negative predictive value of combined possible adverse risk factors, the risk of metastasis still was 6.5%. Therefore radical surgery was recommended for all T1 and T2 stage colorectal cancer patients except if the patient had a very high surgical risk.

Adenocarcinoma↗