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X Filella

Publications and source records attributed to X Filella.

At least 55 records · Page 3Linked to original sources
PubMed1997

Free and total PSA in the diagnosis of prostate cancer.

The use of PSA in the diagnosis of prostate cancer is controversial. This is due to false-positive results caused by benign prostatic hyperplasia (BPH). Different forms of circulating PSA have recently been described. Initial studies indicate that the fraction of free PSA is lower in prostate cancer than in BPH, therefore suggesting that its measurement could be of some diagnostic value. We have assessed the serum value of the percentage of free/total PSA in the differential diagnosis of BPH and prostate cancer. The levels of PSA and free PSA (DELFIA) were measured in 145 BPH patients and 56 prostate cancer patients. Free PSA is a small fraction of PSA, and significantly lower levels are being found in prostate cancer. In those patients with a PSA level between 2 and 25 micrograms/l, the determination of the percentage of free PSA increased the diagnostic efficiency of PSA, while reducing the number of negative biopsies. We conclude that free PSA may be a useful marker for the diagnosis of prostate cancer.

Aged↗
PubMed1996

Detection of nonprostatic PSA in serum and nonserum samples from women.

Prostate-specific antigen (PSA) has been characterized as a specific prostate marker, although recent studies have suggested the existence of PSA of nonprostatic sources. We have assessed the presence of PSA by an ultrasensitive assay in 276 serum and nonserum samples from women. Our data show the presence of PSA in 90% of nonserum samples, including milk secretions, breast cysts, amniotic fluids and broncho-alveolar washings. We have also detected its presence in 58% of the sera tested, although it only exceeded 0.1 microg/l in 6 of the cases. We conclude that PSA can no longer be considered a specific prostate tissue marker; since the concentrations detected in women's serum are ultralow, this finding appears to interfere minimally with its value as a tumoral marker.

Biomarkers, Tumor↗
PubMed1996

Prostate-specific antigen detection by ultrasensitive assay in samples from women.

BACKGROUND: The Prostate Specific Antigen (PSA) has been characterized as a specific prostate marker. Recent studies have indicated the existence of a PSA of nonprostatic origin detected in lactating women and breast tumors. METHODS: We have evaluated the presence of PSA by an ultrasensitive assay (COBAS CORE) in 252 serum and non serum samples from women. RESULTS: The results demonstrate the presence of PSA in 100% of the breast secretions, 81% of the breast cysts, 80% of the bronchoalveolar lavage fluids and 71% of the cytosols of breast cancer. Likewise, PSA was detected in 14% of the sera evaluated, although the concentrations were always lower than 0.5 ng/ml. CONCLUSIONS: We conclude that PSA should not continue being considered as the specific prostate tissue marker although, given that the serum concentrations detected are very low, they do appear to interfere to a minimum extent in the usefulness of PSA as a tumor marker.

Breast↗
PubMed1996

Acute phase is the only significantly reduced component of the injury response after laparoscopic cholecystectomy.

The objective demonstration of improved postoperative recovery suggests that the surgical injury response induced by the laparoscopic approach is less intensive than that after open surgery. Twenty-five patients diagnosed as having noncomplicated gallstones were studied prospectively. They were operated by laparoscopy (group I, n = 12) or open surgery (group II, n = 13). Analgesia requirements (p < 0.026) and postoperative stay (p < 0.001) were significantly less in group 1. Cholecystectomy performed by either technical options induced a significant increase over basal values of glucose, lactate, white blood cell count, prolactin, ACTH, cortisol, interleukin 6, C-reactive protein, and PCO2. Both surgical procedures induced a significant reduction of total proteins, albumin, prealbumin, free fatty acids hemoglobin, hematocrit, and pH. There were no differences between the levels of growth hormone, insulin, glucagon, or PO2 during any of the periods studied. Comparison of the results of the two cholecystectomy techniques showed that laparoscopic cholecystectomy induced a significantly less intensive acute-phase response (area under the curve) of interleukin 6 (17 +/- 17 versus 47 +/- 26 pg/ml x hr x 10(2); p < 0.003), C-reactive protein (16 +/- 12 versus 35 +/-16 mg/dl x hr x 10; p < 0.004), and prealbumin (16 +/- 2.7 versus 13.8 +/- 2.3 mg/dl x hr x 10(2); p < 0.05). The surgical injury response after laparoscopic cholecystectomy is similar to that after open cholecystectomy, but the aeute-phase response component is less intense. This finding may be a consequence of the reduced size of the operative wound with laparoscopic cholecystectomy.

Adrenocorticotropic Hormone↗
PubMed1996

Value of PSA (prostate-specific antigen) in the detection of prostate cancer in patients with urological symptoms. Results of a multicentre study.

The aim of this multicentre study was to assess the usefulness of prostate-specific antigen (PSA) as a diagnostic procedure for prostate cancer in patients with urological symptoms, and compare it with digital rectal examination (DRE). The study included 2054 urological patients, aged over 50 years, and PSA levels were measured using an automated enzyme immunoassay. In the 680 cases with PSA levels > 3 micrograms/l and/or suspect DRE, transrectal ultrasound and prostate biopsy were also performed, leading to a diagnosis of cancer in 131 cases. The sensitivity of PSA was higher (95% and 73% for the cut-off values of 3 and 10 micrograms/l, respectively) than DRE (69%), both parameters being complementary. When DRE and PSA (> 10 micrograms/l) were combined, 118 cancers were diagnosed, with a PPV of 37%. We recommend using PSA and DRE in combination as a diagnostic procedure for prostate cancer in urological patients, since both methods are complementary.

Age Distribution↗
PubMed1996

Utility of C-erbB-2 in tissue and in serum in the early diagnosis of recurrence in breast cancer patients: comparison with carcinoembryonic antigen and CA 15.3.

To evaluate the utility of c-erbB-2, carcinoembryonic antigen (CEA) and CA 15.3 in the early diagnosis of recurrence, serial serum determinations of these antigens were performed in 200 patients (follow-up 1-4 years, mean 2.2 years) with primary breast cancer and no evidence of residual disease (NED) after radical treatment (radical mastectomy or simple mastectomy and radiotherapy). Eighty-nine patients developed metastases during follow-up. C-erbB-2, CEA and CA 15.3 were elevated (> 20 U ml-1, > 10 ng ml-1 or > 60 U ml-1 respectively) before diagnosis in 28%, 30% and 47% of the 89 patients with recurrence, with a lead time of 4.5 +/- 2.4, 4.9 +/- 2.4 and 4.8 +/- 2.4 months respectively. Tumour marker sensitivity was clearly related to the site of recurrence, with the lowest sensitivity found in locoregional relapse and the highest in patients with liver metastases. When patients with locoregional recurrences were excluded, sensitivity improved: 31% (c-erbB-2), 33% (CEA) and 56% (CA 15.3), with 76% having at least one of the three tumour markers. C-erbB-2 sensitivity in early diagnosis was significantly higher in patients with c-erbB-2 overexpression in tissue (8/10, 80%) than in those without overexpression (1/30, 3.3%) (P = 0.0001). Likewise, higher levels of both, c-erbB-2 and CA 15.3 at diagnosis of recurrence, higher sensitivity in early diagnosis of relapse and a higher lead time were found in PR+ patients (CA 15.3, P < 0.0001) or in PR- patients (c-erbB-2, P = 0.009). Specificity of the tumour markers was 100% for all three markers (111 NED patients). In conclusion, c-erbB-2 is a useful tool for early diagnosis of metastases, mainly in those patients with c-erbB-2 overexpression in tissue. Using all three markers simultaneously it is possible to increase the sensitivity in the early diagnosis of recurrence by 11.2%.

Bone Neoplasms↗
PubMed1996

Usefulness of prostate-specific antigen density as a diagnostic test of prostate cancer.

To evaluate the diagnostic usefulness of prostate-specific antigen density (PSAD) in prostate cancer (PC) prostate-specific antigen (PSA) concentrations were measured in 175 patients with benign prostatic hypertrophy (BPH) and 50 patients with PC. Patients with BPH were classified according to the presence of complications of the disease: urinary infection or the presence of a bladder catheter. PSAD levels were observed to be greater than 0.15 in 3% of the patients with uncomplicated BPH and in 40% of the patients with complicated BPH. PSA levels were higher than 10 micrograms/l in 3 and 27% of these patients, respectively. High levels of PSAD were observed in 80% of the patients with cancer. Sixty-four percent of the patients with cancer presented PSA levels greater than 10 micrograms/l. These results indicate that PSAD is a useful parameter in the differential diagnosis of PC and BPH with the diagnostic efficacy of PSAD being greater than that of the serum determination of PSA.

Biomarkers, Tumor↗
PubMed1996

Prognostic significance of SCC antigen in the serum of patients with head and neck cancer.

SCC antigen (Ag) is a tumor-associated Ag (TAA) obtained from squamous cell carcinoma of the uterine cervix. This study reports the evaluation of this TAA in patients with head and neck malignant diseases and its possible prognostic value. Serum samples from 28 patients with benign head and neck diseases from 399 patients with cancer were obtained prior to treatment. SCC Ag serum levels were determined by radioimmunoassay using 2.5 ng/ml as the upper limit of normality. Elevated SCC Ag serum levels were found in 14% of 28 patients with benign diseases, in 29% of 217 patients with primary tumors, in 48% of 46 patients with recurrence (43% in locoregional, 64% in metastases) and in 4% of 136 patients with no evidence of disease. In patients with primary tumors, SCC Ag serum levels were related to nodal involvement and tumor location with significantly higher levels in node-positive patients (p = 0.001) and in tumors located in the nasopharynx and piriform sinus (p = 0.02). Presurgical SCC Ag serum levels in patients with primary tumors had prognostic value with shorter disease-free survival in those patients with abnormal values of this TAA (p < 0.001), in both, node-negative and node-positive patients (p < 0.01). Multivariate analyses showed that SCC Ag is a significant independent predictor of disease-free survival even when other prognostic factors are considered. In conclusion, pretreatment SCC Ag serum levels are an independent prognostic indicator in patients with head and neck malignancies.

Antigens, Neoplasm↗
PubMed1996

Cytokines (IL-6, TNF-alpha, IL-1alpha) and soluble interleukin-2 receptor as serum tumor markers in multiple myeloma.

The serum levels of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), soluble interleukin-2 receptor (sIL-2r), and interleukin-1alpha (IL-1alpha) were measured in 30 healthy subjects, 22 patients with monoclonal gammopathy of undetermined significance (MGUS), five patients with smoldering multiple myeloma (SMM), and 46 with multiple myeloma (MM). Serum levels of IL-6, TNF-alpha, and sIL-2r were significantly increased in patients with active MM when compared with normal controls. Furthermore, MM patients with advanced aggressive disease had significantly higher levels of IL-6, TNF-alpha, and sIL-2r than those with MM in plateau phase. In conclusion, our data support the involvement of IL-6, TNF-alpha, and sIL-2r in MM. This confirms recent in vitro studies suggesting that these cytokines may play a central role in the pathogenesis of MM. Our data also show that serum levels of TNF-alpha, sIL-2r, and, particularly, IL-6 could be useful in the clinical management of patients with MM.

Biomarkers, Tumor↗
PubMed1995

Clinical usefulness of free PSA fraction as an indicator of prostate cancer.

The usefulness of the fPSA fraction in the differential diagnosis of benign prostate hyperplasia (BPH) and prostate cancer was evaluated, with the aim of improving the diagnostic efficacy of PSA. Serum PSA and fPSA determinations were performed by an enzymoimmunoassay technique on an ES-300 system. fPSA constitutes a minor fraction both in normal subjects and in patients with prostate disease, being significantly lower in patients with untreated prostate cancer than in patients with BPH. Likewise, the authors have observed that the sensitivity of the fPSA/PSA ratio has an inversely proportional relationship with the stage of the disease. The results obtained in patients with PSA levels between 4 and 20 micrograms/l are also of note. In this series of patients, the efficacy of the fPSA/PSA ratio was higher than that of PSA, showing a sensitivity of 44% and a specificity of 95% at the cut-off of 0.08.

Biomarkers, Tumor↗
PubMed1995

Use of serial carcinoembryonic antigen and CA 15.3 assays in detecting relapses in breast cancer patients.

UNLABELLED: To evaluate the utility of CEA and CA 15.3 for early diagnosis of recurrence, serial serum determinations of both antigens were performed in 1023 patients (follow-up: 1-10 years, mean 6.2 years) with primary breast cancer (CA 15.3 in 533 cases) and no evidence of residual disease (NED) after radical treatment (radical mastectomy or simple mastectomy and radiotherapy). 246 patients developed metastases during follow-up. RESULTS: CEA and CA 15.3 were elevated ( > 10 ng/ml or > 60 U/ml, respectively) prior to diagnosis in 40% (98/246) and 41% (37/91) of the patients with recurrence, with a lead time of 4.9 +/- 2.2 and 4.2 +/- 2.3 months, respectively. When patients with locoregional recurrences were excluded, sensitivity improved to 46% (CEA) and 54% (CA 15.3), and to 64% with both tumor markers (CEA and/or CA 15.3). Higher levels of both CEA and CA 15.3 at diagnosis of recurrence, higher sensitivity in early diagnosis of relapse, and a higher lead time were found in ER+ (CEA) or PgR+ patients (CA 15.3) than in those that were negative for these receptors in the primary tumor (p < 0.001). Specificity of the tumor markers was 99% for both CEA (777 NED patients) and for CA 15.3 (444 NED patients), respectively. In conclusion, CEA and CA 15.3 are useful tools for early diagnosis of metastases, mainly in those patients with ER+ or PR+ tumors.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1995

Carcinoembryonic antigen in staging and follow-up of patients with solid tumors.

The presence of a tumor antigen in human colonic carcinomas and their metastases was described about 25 years ago. This antigen, called carcinoembryonic antigen (CEA), is one of the first known tumor markers. Since then, many more have been described, but CEA, determined alone or in combination with others, is still one of the most used. CEA is not organ specific and abnormal values may be found in a wide range of carcinomas, especially those with gastrointestinal involvement. CEA assay should not be used for cancer diagnosis because its sensitivity in patients without cancer metastases is low. In addition, abnormal CEA values may be found in patients with benign diseases. However, the probability of malignancy increases directly with CEA concentration. Its main clinical applications are prognosis, early diagnosis of recurrence and follow-up of patients with carcinomas. In a wide range of malignancies, CEA serum levels are clearly related to tumor stage. Presurgical CEA serum levels are a well-established prognostic factor in colorectal, breast and lung cancer. Patients presenting with increased preoperative CEA serum levels have both a shorter disease-free interval and lower survival than those with normal CEA levels. In the early diagnosis of recurrence, CEA also plays an important role: in about 70-85% of patients with colorectal tumors and in 40-50% with breast cancer, CEA serial increase is the first sign of tumor recurrence. In patients with disseminated tumors, serial determinations are also a useful tool for therapy monitoring: CEA values decrease with effective treatment while stable or increasing values are observed when treatment is not effective.

Biomarkers, Tumor↗
PubMed1995

[Role of tissue polypeptide antigen as a marker in bladder cancer].

Presentation of a review of TPA serum levels in 207 patients, 160 of which had vesical carcinoma. This population comprises 37 patients who had suffered vesical carcinoma but whom, at entry in the study, did not display clinic evidence of that: 11 patients with benign vesical pathology; 84 patients with primary vesical tumour, and 76 patients with relapsing vesical tumour. Tumoral staging resulted in 72 Ta, 49 T1, 10 T2, 14 T3, and 15 Ta. Distribution with regard to degree of differentiation was as follows: 52 GI, 61 GII and 40 GIII. Sensitivity of serum TPA in our series was 39% and specificity 94%. When tumours were subdivided into surface and infiltrant tumours, sensitivity was 28% and 72% respectively (p < 0.01). Patients presenting normal levels of serum TPA took longer to relapse than those who had high levels. Mean time to relapse was 17 months for the first group, and 12 months for the second group. Serum TPA increased its performance with carcinomas of higher grade and stage, but it does not have enough sensitivity to be considered a useful marker in low stages. However, serum TPA relationship to the tumour's invasive degree and the disease-free interval are an indication for their likely use as a prognostic factor to delimit the groups with higher risk of relapse.

Biomarkers, Tumor↗
PubMed1994

Serum cytokines (IL-6, TNF-alpha, IL-1 beta and IFN-gamma) in ankylosing spondylitis: a close correlation between serum IL-6 and disease activity and severity.

The aim of our study was to analyse the serum interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1 beta) and interferon-gamma (IFN-gamma) levels in patients with AS and their relationship with disease activity. An ELISA test was used to analyse serum cytokine (IL-6, TNF-alpha, IL-1 beta and IFN-gamma) levels in 69 patients with AS. Results were compared with those from 43 patients with RA and 36 patients with non-inflammatory back pain. The relationship between serum concentrations of the different cytokines and parameters of disease activity and severity in AS patients was also evaluated. IL-6 and TNF-alpha serum levels, but not IL-1 beta and IFN-gamma, were significantly higher in AS than in NIBP. However, patients with RA showed higher serum levels of IL-6, TNF-alpha and IFN-gamma than both AS and NIBP patients. In AS, IL-6 correlated with clinical parameters of disease activity with significant correlation being observed with laboratory parameters of inflammation such as ESR, CRP, platelet count and clinical parameters of severity such as vertebral mobility. TNF-alpha did not correlate with laboratory or clinical parameters of activity. Macrophagic cytokines (TNF-alpha and IL-6), are increased in AS patients and IL-6 closely correlated with the activity of the disease.

Adult↗
PubMed1994

Reduced activity of serum creatine kinase in rheumatoid arthritis: a phenomenon linked to the inflammatory response.

In a case-controlled study, serum creatinine kinase (CK) activity was significantly lower in 40 patients with RA than in 40 age- and sex-matched patients with non-inflammatory arthropathies [mean 37.6 (S.D. 29.2) vs 77.7 (S.D. 45.3) IU/l respectively P < 0.0001]. In contrast, serum levels of aldolase and myosin were not significantly lower in RA patients. A significant inverse correlation between CK activity and ESR, CRP and platelet count was observed in RA. There was also a positive correlation between haemoglobin levels and CK values. No correlation was found between CK activity and a meager mass index, disease duration and radiological erosion. No inhibitor of CK activity in the sera of RA patients was found. CK serum activity was markedly reduced in RA, and is related to the inflammatory activity of the disease. This finding may stimulate further exploration on the effect of inflammatory response in muscle metabolism.

Adult↗
PubMed1994

Use of CA 19-9 in the early detection of recurrences in colorectal cancer: comparison with CEA.

The serum levels of CA 19-9 were determined in the follow-up of 370 patients with colorectal cancer and compared with CEA. An increase in CA 19-9 preceded clinical diagnosis of recurrence in 25% of 72 patients. The mean time between the rise in CA 19-9 and clinical diagnosis of relapse was 3.7 months (median 3). Sensitivity of CA 19-9 in the early diagnosis of recurrence was much lower than that obtained for CEA (75%). Only 1 patient had elevated CA 19-9 levels and normal CEA.

Antigens, Tumor-Associated, Carbohydrate↗
PubMed1994

Study of a new tumor marker, CYFRA 21-1, in malignant and nonmalignant diseases.

The diagnostic value of a new tumor marker, CYFRA 21-1, was studied in the sera of 50 controls, 206 patients with benign diseases and 469 patients with malignancies. Fifty controls showed mean serum concentrations of 1.2 +/- 0.5 ng/ml. Using 3.3 ng/ml as the cutoff, abnormal CYFRA levels were found in 13.1% of patients with benign diseases, mainly in those with liver cirrhosis (29.4%) or renal failure (20.8%), and in 44.4% (180/405) of patients with active cancer. Neither healthy subjects nor no evidence of disease (64 cases) patients had serum levels higher than this limit. CYFRA 21-1 results were significantly higher in patients with active cancer than in those with benign diseases or without active tumors (p < 0.0001). CYFRA serum levels were significantly higher in patients with metastases (59.5%) than in those with locoregional disease (33.7%; p < 0.001). CYFRA 21-1 sensitivity in patients with lung cancer was related to tumor histology with abnormal levels in 65.6% of patients with non-small cell lung cancer and in 25% of patients with small cell lung cancer (p < 0.0001). In breast cancer, CYFRA 21-1 concentrations were significantly higher in patients with metastases and in patients with primary tumors but with nodal involvement (p < 0.001).

Biomarkers, Tumor↗