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Urinary gonadotropin peptide in patients with cancer of digestive organs.

Urinary gonadotropin peptide (UGP) has been measured in gynecological and urological cancers, but its usefulness in the diagnosis of cancers of digestive organs has not been investigated. In this report, UGP was measured by sandwich enzyme immunoassay in 311 patients, including 166 patients with cancers of digestive organs and 43 healthy controls. Positive rates of UGP in various cancers of digestive organs were as follows: biliary tract 61.5%, pancreas 61.5%, esophagus 50.0%, liver 38.7%, colon and rectum 24.2%, and stomach 23.9%. The positive rate of UGP in benign diseases was 8.1%, and most false-positive patients were postmenopausal females. Positive rates of UGP were increased at advanced stages of gastric cancers, and UGP was decreased after tumor resection. From these results, it is suggested that UGP can be used as a tumor marker for the cancers of digestive organs.

Aged↗

Clinical application of a new monoclonal antibody (19B7) against PIVKA-II in the diagnosis of hepatocellular carcinoma and pancreatobiliary malignancies.

OBJECTIVES: A new monoclonal antibody (19B7) against prothrombin induced by vitamin K absence or antagonist-II (PIVKA-II) was clinically applied in patients diagnosed with hepatocellular carcinoma and pancreatobiliary malignancies, and the results were compared with those obtained using the conventional monoclonal antibody (MU-3) against PIVKA-II. METHODS: The assays were the standard E-1023 using MU-3, a high sensitivity kit using MU-3 and a highly sensitive avidin-biotin complex method, and a new monoclonal antibody (19B7) kit. RESULTS: The rate of PIVKA-II positivity in patients with hepatocellular carcinoma (n = 182) was 44% with E-1023, 55.5% with the high sensitivity kit, and 58.2% with the new monoclonal antibody kit. Small liver cancers <2 cm in diameter (n = 45) had a positivity rate of 15.6% with E-1023, 26.7% with the high sensitivity kit, and 31.1% with the new monoclonal antibody kit. The incidence of PIVKA-II positivity in patients with pancreatobiliary carcinoma (n = 91) was 29.7% with the high sensitivity kit and 52.7% with the new monoclonal antibody kit. The PIVKA-II ratio (plasma concentration with the high sensitivity kit/plasma concentration with the new monoclonal antibody kit) was calculated as > 1.0 in 89 of the 113 (78.8%) patients with hepatocellular carcinoma with the new monoclonal antibody kit assay level above 0.002 arbitrary units/ml, compared with <1.0 in almost all patients with pancreatobiliary malignancies. CONCLUSIONS: MU-3 has much greater affinity for PIVKA-II in hepatocellular carcinoma than does 19B7, whereas 19B7 has much greater affinity for PIVKA-II in pancreatobiliary malignancies than does MU-3. The new monoclonal antibody, 19B7, is useful for diagnosing hepatocellular carcinoma and can also distinguish patients with hepatocellular carcinoma from those with other pancreatobiliary malignancies when combined with a PIVKA-II assay using the conventional monoclonal antibody, MU-3.

Adult↗

Multiple primary visceral malignancy--a review with report of two cases.

Multiple primary cancers are being reported with increasing frequency in recent years, the frequency varying from 0.3 to 4.3% in different studies. A combination of primary cancer of larynx and lung is the most common followed by malignant neoplasm involving lip-larynx, skin-larynx, skin-lung, breast-ovary and breast-endometrium. Two interesting cases of rare combinations of primary cancers are being presented. In the first case primary adenocarcinoma of the gall bladder was associated with appendiceal adenocarcinoma. In the second case primary malignant papillary serous cystadenocarcinoma of right ovary and squamous cell carcinoma of cervix uteri were found.

Appendiceal Neoplasms↗

TRANSHEPATIC CHOLANGIOGRAPHY.

Percutaneous transhepatic cholangiography is a method of visualizing the biliary tree by the injection of radio-opaque medium through the abdominal wall and liver into an intrahepatic bile duct. The procedure is indicated in the immediate preoperative evaluation of patients with obstructive jaundice of unknown etiology and is usually diagnostic in these cases. It may also be of value in avoiding operation in poor-risk patients with obstructive jaundice. Biliary leak resulting in chemical peritonitis is a complication in about 5% of these procedures. Intraperitoneal hemorrhage is a complication in less than 1%. Death results from the procedure in less than 0.5% of cases. Transhepatic cholangiography during surgical operation is of value in demonstrating obstructive lesions of the bile ducts. However, preoperative percutaneous transhepatic cholangiography is preferred, since it makes possible adequate preparation for technically difficult repairs and resections.

Bile Duct Neoplasms↗