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PubMed1992

Intra-operative electron beam radiotherapy and abdomino-pelvic surgery for cancer: influence on immunological parameters.

Evolution of some immunological parameters was observed during the first month in 20 patients with different abdomino-pelvic cancers who underwent surgery with intra-operative radiation therapy (IORT) (mean dose of 19.44 Gy, range 15, 25). Observed parameters before (DO-) and after procedure (DO+), on seventh (D7) and fourteenth (D14) days and fifth week (D30) were: lymphocyte count, lymphocyte subsets (CD19, CD3, CD4, CD8, CD56), natural killer (NK) activity, immunoglobulins, C3 and C4b fractions of complement, soluble receptor for interleukin 2 (sIL2-R). Results showed a decrease of circulating lymphocytes (DO-: 1189 +/- 168 cells/mm3; D7: 889 +/- 91; P = 0.011), of absolute number of CD3 lymphocytes (DO-: 785 +/- 114 cells/mm3; D7: 563 +/- 86; P = 0.025), of CD4 lymphocytes (DO-: 441 +/- 70 cells/mm3; DO+: 299 +/- 43; P = 0.013) and of CD8 lymphocytes (DO-:361 +/- 50 cells/mm3, D7:250 +/- 44; P = 0.006). All values returned towards preoperative levels by D30. Absolute number of NK cells was unchanged but NK activity was significantly diminished (effector target ratio 5:1 DO-:33 +/- 5%; DO+:44 +/- 7%; D7:18 +/- 3%; D14:21 +/- 4%; D30:25 +/- 4%). sIL2-R was significantly enhanced from D7 to D30. All these impairments are moderate and these observations provide some evidence of satisfactory tolerance to IORT for abdomino-pelvic cancers during the immediate postoperative period.

Abdominal Neoplasms↗

PubMed2006

[Study of relationship between cyclooxygenase and platelet-activating factor on peripheral blood mononuclear cells in patients with systemic inflammatory response syndrome and multiple organ dysfunction syndrome].

OBJECTIVE: To study the role of cyclooxygenase (COX) and platelet-activating factor (PAF) in pathophysiologic mechanisms of patients with systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS). METHODS: Twenty-eight adult patients whose diagnosis met American college of chest physicians/society of critical care medicine (ACCP/SCCM) criteria for SIRS and MODS were enrolled for study including 13 cases for SIRS group and 15 cases for MODS group. The normal control group consisted of 11 healthy volunteers who matched with study subjects for age and gender. Enzyme linked immunoadsorbent assay (ELISA) was used to measure the content of COX-2 and the activity of platelet-activating factor acetylhydrolase (PAF-AH) of peripheral blood mononuclear cells (PBMCs). Reverse transcription polymerase chain reaction (RT-PCR) was used to measure the COX-2 mRNA and PAF-AH mRNA expression of PBMCs. RESULTS: The content of COX-2 and the activity of PAF-AH of PBMCs and the expression of their mRNA in MODS group were higher than those in SIRS group and control group (all P<0.05). There was no significant difference between SIRS group and control group. The content of COX-2 and the activity of PAF-AH and the expression of their mRNA of PBMCs in non-survivors were higher than those in survived patients (all P<0.05). In 3 groups, positive correlation was found between the COX-2 content and PAF-AH activity (r=0.329, P<0.05). The leukocyte count, lymphocyte count, and PaO(2)/FiO(2) of peripheral blood in non-survivors showed no significant difference with those of survived patients (all P>0.05). The blood glucose and creatinine of non-survivors were higher than those of survived patients (P<0.05 and P<0.01). The total CO(2) content (TCO(2)) and pH value of non-survivors were lower than those of survived patients (both P<0.01). CONCLUSION: This study shows that COX-2 and PAF-AH play a role in the occurrence of MODS and they can be used as indexes to judge the prognosis of SIRS and MODS. Blood glucose, creatinine, TCO(2) and pH value of blood can be used as other indexes for judging the state and the prognosis of the illness.

1-Alkyl-2-acetylglycerophosphocholine Esterase↗

PubMed1991

[Immunologic studies in myelodysplastic syndrome].

Myelodysplastic syndrome is a clonal stem-cell disease, which predominantly involves myeloid cell lines. However, several observations refer to a possible pathological condition of the lymphoid system as well. Because of these controversial data, we investigated 25 patients with MDS at our clinic. Absolute lymphocyte counts, lymphocyte subpopulations (using methods of mAT, OKT 3, 4, 8, Leu7), T and B rosette tests and quantitative tests of immunoglobulins were made possibly during diagnosis or breaks in treatment. A significant ratio of our patients had lymphopenie. Using both rosette tests or mAT methods, the ratio of T-cells (primarily of T4-cells) reduced, and the decrease of NK-cells characterized with Leu7 mAT was also marked. Polyclonal hypergammaglobulinaemia could frequently and significantly be observed during immunoglobulin identification. All the observed abnormalities were rather marked in the group of patients with excess of blasts.

Adult↗

PubMed1979

National Cooperative Crohn's Disease Study: adverse reactions to study drugs.

Adverse reactions to the drugs employed in the National Cooperative Crohn's Disease Study were sought prospectively at each patient visit and by retrospective review of all patient charts. Prednisone caused evident side effects in over 50% of patients on high-dose suppressive therapy and in approximately one-third of patients on prophylactic dose. Thirty-two percent of patients on high-dose, and 26% on prophylactic-dose prednisone required dose reduction or withdrawal because of side effects. Comparable figures for sulfasalazine were 14% and 12%, and for azathioprine 32% and 20%. The incidence of nausea, vomiting, or anorexia among patients taking sulfasalazine was 46% and 34%, on high and low dose respectively; however, this incidence was no different than that observed among patients taking placebo. These symptoms occasioned withdrawal from the study of only 4% and 3% of patients on high and low doses of sulfasalazine, respectively. Azathioprine produced leukopenia at a dose of 2.5 mg/kg body weight in 15% of patients and the mean white cell count, lymphocyte count, granulocyte count, and hematocrit all fell significantly in patients on this dose. Pancreatitis occurred in 5% of patients taking azathioprine but in no other patients. Sulfasalazine proved to be the safest effective suppressive drug for Crohn's disease. Prednisone toxicity, though substantial, is acceptable in view of its demonstrated suppressive efficacy. Azathioprine was approximately as toxic as prednisone but no more effective than placebo in suppressing active disease. None of the drugs was effective prophylactically, and all showed appreciable long-term toxicity.

Adult↗

PubMed1994

[Nutritional and immunological assessment in patients with malignant obstructive jaundice--the influence of preoperative biliary decompression and abdominal surgery].

A clinical study was undertaken to evaluate the nutritional and immunological status of patients with malignant obstructive jaundice with serum bilirubin level of 5mg/dl or greater (N = 22). Healthy volunteers (N = 9) and patients with cholecystolithiasis (N = 26) were assessed as non-icteric control, as well as patients with obstructive jaundice due to choledocholithiasis (N = 3) were used as icteric control. We also evaluated the time-course of five patients with malignant obstructive jaundice before and after PTCD and surgery. Nutritional status was assessed by prognostic nutritional index (PNI), blood chemistry and rapid turnover protein. Cellular and humoral immunity were assessed by peripheral lymphocyte count, lymphocyte stimulation test, antibody dependent cell-mediated cytotoxicity, and serum immunoglobulins. The following results were obtained. 1) Nutritional and immunological status of patients with malignant obstructive jaundice were severely depressed. 2) Nutritional and immunological status were not improved by preoperative biliary decompression such as PTCD. 3) The immunological indices recovered postoperatively. However, the nutritional indices did not recover by the time of discharge. Intensive nutritional support before and after surgery may be mandatory for patients with malignant obstructive jaundice.

Abdomen↗

PubMed1993

[Lymphocyte subpopulations in maintenance hemodialysis patients receiving recombinant human erythropoietin].

The effect of recombinant human erythropoietin (rHuEPO) on the lymphocyte subpopulations of maintenance hemodialysis patients has been studied. Peripheral lymphocyte counts, lymphocyte subpopulations (Two color analysis) and PHA-induced proliferative response were measured before and after rHuEPO administration during 8 months in 22 stable hemodialysis patients (mean age 52 years, mean duration of dialysis 48 months). We could find a significant increase in the proportions of CD4+ Leu8- cells, HLA-DR+ cells, CD8+ HLA-DR+ cells, CD14+ HLA-DR+ cells and CD4+ Leu8-/CD8+ CD11b+ cells ratios after rHuEPO therapy. In addition, a significant decrease in the proportions of CD16+ CD57- cells and CD20+ cells could be found after rHuEPO therapy. These results suggest that rHuEPO administration to stable hemodialysis patients induces increases in lymphocytes categorized into helper subset groups and in activated T lymphocytes.

Adult↗

PubMedDate not supplied

Impaired systemic immunity and frequent infection in patients with Candida antigen after hepatectomy.

BACKGROUND/AIMS: Infection after hepatic resection constitutes a major cause of morbidity and mortality. We examined the role of Candida antigen in systemic immunity and the infectious complications after hepatectomy. MATERIAL AND METHODS: In 25 hepatectomized patients, the Candida antigen titers were measured by a latex agglutination test (CAND-TEC). In the patients with Candida antigen (n = 10; 40%) and those without (n = 15; 60%), multiple immunological parameters, including the total lymphocyte count, lymphocyte subpopulations, phytohemagglutinin (PHA) response, and natural killer (NK) activity, and the incidence of infectious complications were compared. RESULTS: In the preoperative and operative parameters, there were no significant differences between the two groups. In the postoperative immune parameters, a significant attenuation in the total lymphocyte number (p < 0.01) and NK activity (p < 0.01) was observed in the patients with Candida antigen, compared with the findings in patients without Candida antigen. A bacterial infection was identified in 5 of 10 patients (50.0%) with Candida antigen, and in 1 of 15 patients (6.7%) without Candida antigen (p < 0.05). In contrast, the Candida culture was negative for all patients. CONCLUSIONS: Both a profound attenuation of systemic immunity and frequent bacterial infections were observed in the hepatectomized patients with Candida antigen.

Adult↗

PubMed1997

[Prognostic significance of cellular immunity in surgical treatment of esophageal cancer].

The aim of the study was to investigate the influence of perioperative changes of the cellular immunity parameters on long-term survival following esophagectomy for carcinoma of the esophagus. In 39 patients several immunological parameters have been assessed before and 2 weeks after the operation: WBC, lymphocyte count, lymphocyte T% (E-rosette test), helper/suppressor lymphocyte T subpopulations (teophylline test), NBT test, and in vivo Multitest CMI (skin delayed hypersensitivity for recall antigens). Survival was analyzed using Kaplan-Meier method according to the stage (pTNM, UICC'92) and to the grade of perioperative cellular immunity (pCI) deterioration. Three groups of patients were identified with: 1) improvement or stabilization of pCI (n = 5); 2) deterioration of 1 or 2 pCI parameters (n = 21); and 3) deterioration of 3 or more pCI parameters (n = 13). Follow-up time ranged from 4 to 65 months. Eight patients died in hospital due to postoperative complications, 3 patients are alive (1 of them with Tis alive at 52 months of follow-up), and the remaining patients died during follow-up. Mean survival time of patients in stage II (n = 7), III (n = 17), and IV (n = 14) was 18, 17, and 6 months respectively (p = 0.017, log rank test). Mean survival time of patients in group 1, 2, and 3 was 21, 20, and 5 months respectively (p < 0.001, log rank test). On bivariate survival analysis encountering both factors, stage was found to be the only independent prognostic factor (p = 0.008, Cox regression model). Deterioration of the cellular immunity in the perioperative period is entirely related to the stage of the disease, which is the only independent prognostic factor in carcinoma of the esophagus.

Adenocarcinoma↗

PubMed1989

Simultaneous determination of absolute total lymphocyte and CD4+ lymphocyte levels in peripheral blood by flow cytometry.

A distinguishing feature of the Spectrum III flow cytometer is its capacity to analyze a constant volume of cell suspension. The authors have capitalized on this feature to directly and simultaneously measure the absolute numbers of all lymphocytes and CD4+ lymphocytes per microliter of peripheral blood. The study group consisted of 42 hospital patients, 12 former blood donors seropositive for human immunodeficiency virus (HIV), and 12 HIV-seronegative donors. Regression analysis revealed a highly significant correlation (r = 0.97) between Spectrum lymphocyte counts and lymphocyte counts determined by a Coulter Counter S-Plus IV. Similarly, Spectrum CD4 cell counts were significantly correlated (r = 0.98) with CD4 cell counts calculated from the Coulter lymphocyte counts and % CD4+ lymphocytes determined by flow cytometry. These findings indicate that the absolute numbers of lymphocytes and subsets of lymphocytes in peripheral blood can be rapidly and simultaneously measured by flow cytometry. Such an assay should prove useful in studies of HIV infection, where total lymphocyte and CD4 cell levels are important parameters for clinical staging and assessing responses to treatment.

CD4-Positive T-Lymphocytes↗

PubMed2003

Sequential changes in hematologic and biochemical parameters in African tick bite fever.

OBJECTIVE: To evaluate the sequential changes and to estimate the frequencies of abnormalities in some commonly measured biological variables in patients with African tick bite fever (ATBF), an emerging spotted fever group (SFG) rickettsiosis in international travelers to rural sub-Saharan Africa. METHODS: A study was done of hemoglobin, total leukocyte count, absolute lymphocyte count, blood platelet count and serum levels of C-reactive protein (S-CRP), alanine aminotransferase (S-ALAT), aspartate aminotransferase, lactic dehydrogenase, gamma-glutamyl transferase, alkaline phosphatase, bilirubin, sodium and creatinine during the first two weeks of illness and prior to the institution of antirickettsial therapy in 108 patients with travel-associated ATBF. RESULTS: There were significant falls in mean total leukocyte count, mean absolute lymphocyte count, and mean platelet count, and significant increases in mean S-CRP and S-ALAT. During the first ten days of illness, elevated S-CRP, lymphopenia and elevated S-ALAT were detected in 91.7%, 73.3% and 40.7% of patients, respectively. Most abnormalities were mild. For 55 patients who underwent both S-CRP and absolute lymphocyte count determination, at least one parameter was abnormal in 52 (94.5%) patients. CONCLUSIONS: The sequential changes in many biological parameters during the acute phase of ATBF mimic those reported in other SFG rickettsioses. Mild abnormalities are frequent, with increased S-CRP and lymphopenia being the two most consistent findings.

Adolescent↗

PubMed1992

Life stressors and coping style are associated with immune measures in HIV-1 infection--a preliminary report.

OBJECTIVE: Life stressors and coping style have been associated with alterations in cellular immunity similar to those seen in HIV-1 infection. The interval between infection with HIV-1 and the development of AIDS is lengthy and highly variable. This pilot study investigated whether life stressors and coping style may account for a portion of this variation. METHOD: A sample of eleven asymptomatic HIV-1 seropositive homosexual male volunteers responding to a local advertisement was assessed on life stressors, coping style and cellular phenotypic and functional immune measures--T4 "helper" cell/T8 "suppressor" cell ratio, T4 cell count, total lymphocyte count, and natural killer cell cytotoxicity. RESULTS: Significant associations were observed for both major life stressor impact over the previous year and passive coping style use with the total lymphocyte count; higher life stressor impact and passive coping style use were associated with lower total lymphocyte counts. Similarly, a trend in the same direction was found for the relationship of these two measures with the count of T4 cells, which are directly infected and killed by HIV-1. CONCLUSIONS: It is well documented that decrements in T4 cell and total lymphocyte counts are powerful predictors of subsequent clinical progression to AIDS. These preliminary findings suggest that life stressors and coping style may also be predictors of the development of AIDS.

Acquired Immunodeficiency Syndrome↗

PubMed1993

Risk of reactivation of tuberculosis in the course of human immunodeficiency virus infection.

OBJECTIVES: To establish, in a longitudinal study, whether reactivation of latent tuberculous infection takes place below an identifiable immunological threshold in subjects with human immunodeficiency virus (HIV) infection. METHODS: We followed up for 2 years 44 subjects with HIV infection who had a positive intradermal reaction to tuberculin. All subjects were asymptomatic at enrollment. End points of the study were the development of active tuberculosis or the final evaluation (24 months since the beginning) for those who did not develop tuberculosis over the study period. Total lymphocyte count, CD4+ lymphocyte count and beta-2 microglobulin serum levels were measured at baseline, during the period of observation (every 3-6 months) and at the end point. Multiple Antigen Skin Testing and purified protein derivative (PPD) testing were also performed at baseline and end point, as well as in intermediate phases of the study (every 6 and 12 months respectively). RESULTS: Ten subjects (22.7%) developed tuberculosis during the study period. Both baseline and end point values of the parameters investigated differed significantly between subjects who developed tuberculosis and those who did not. Cox's model showed that total and CD4+ lymphocyte counts as well as beta-2 microglobulin levels had a prognostic value at a univariate analysis; CD4+ and beta-2 microglobulin retained statistical significance in a multivariate evaluation. CD4+ lymphocyte count was the parameter most strongly associated with the development of tuberculosis. CONCLUSIONS: Tuberculosis in this setting most often reactivates only when immune surveillance has fallen to an identifiable level. Planners of antituberculous chemoprophylactic policies should consider the downgrading tendency of immune function in these subjects in order to choose the most appropriate time to intervene in the course of HIV infection. Starting prophylaxis in HIV-infected subjects only when CD4+ cells have dropped below the value of 500/mm3 seems to be a more fruitful option than the currently adopted strategy, which recommends time-limited (12 months) administration of daily isoniazid to all PPD+ HIV-infected subjects regardless their immunological status.

Adult↗

PubMed1996

[Clinical usefulness of Multitest in the evaluation of cellular immunity].

The aim of this work was to assess cellular immunity using the Multitest CMI and relate its results with lymphocyte counts and lymphocyte subpopulations determined using monoclonal antibodies against CD4 and CD8 and fluorescence microscopy. We studied 51 patients (31 male), 20 infected with HIV, 18 recurring infections, 5 with cancer, 2 with tuberculosis and 6 with miscellaneous diagnoses. According to Multitest results, patients were classified as normal, hypoergic or anergic. Twenty five percent of patients were normal, 65% hypoergic and 10% anergic. Eighty percent of anergic patients were infected with HIV. No differences in total lymphocyte count were observed between the three groups. CD4 lymphocyte count was lower in anergic patients when compared with the other two groups. All patients with CD4 counts below 200 cells/mm3 were anergic. It is concluded that Multitest CMI is useful for the assessment of cellular immunity and complements the determination of lymphocyte subpopulations.

Adult↗

PubMed1978

Postoperative immunologic monitoring of cancer patients undergoing radical surgery.

Immunologic parameters of cellular immunity in vitro and circulating immunoglobulin levels were evaluated before and after radical surgery in twenty-five patients with localized primary solid tumors. Peripheral blood lymphocyte counts, T-lymphocyte counts and lymphocyte blastogenesis after optimal stimulation with phytohemagglutinin were found significantly depressed at the time of diagnosis. Sequential determinations of immunologic parameters during the postoperative period showed a slight fall of lymphocyte counts and T-lymphocyte counts; subsequently these cell counts progressively returned to preoperative values. The blastogenic response of lymphocytes sharply decreased following surgery and then slowly returned to preoperative levels in one month. No significant alterations of circulating immunoglobulins were detected at diagnosis or during the postoperative period. These findings indicate that patients with localized tumors present impairment of some parameters of cellular immunity preoperatively and that postoperative immunodepression lasts about one month.

Adult↗

PubMed2003

Monokine levels in cancer and infection.

The levels of monocyte intracellular monokines (TNFalpha, MIP, and MIG) in patients with cancer or bacterial infection were studied by multiparameter flow cytometry and comparative fluorescence analysis. TNFalpha, MIP, and MIG levels in peripheral blood of patients with cancer or bacterial infection were higher than in normal controls (p < 0.005). In normal controls, no significant relationships were found among TNFalpha, MIG, MIP levels, monocyte count, and lymphocyte count in peripheral blood. In cancer patients, TNFalpha was strongly related to MIP (r = 0.809, p < 0.001) and MIG (r = 0.773, p < 0.001). Of the 3 monokines, TNFalpha and MIG levels were related to monocyte count, but none showed correlation with lymphocyte count in cancer patients. In patients with bacterial infection, TNFalpha was not significantly related to MIP (r = 0.423, p = 0.051), but it was related to MIG (r = 0.457; p = 0.033). None of the monokines (TNFalpha, MIP, MIG) was related to the monocyte count, but the MIP level was related to the peripheral blood lymphocyte count in patients with bacterial infection (r = 0.559, p = 0.008). These results suggest that circulating monocytes may play an important role in both cancer and bacterial infection through increased production of monokines. Moreover, correlations of the monokine levels with each other and their relationships to the monocyte count differ in patients with cancer and bacterial infection.

Adult↗

PubMed1999

Interaction of tamoxifen with concurrent cytotoxic adjuvant treatment affects lymphocytes and lymphocyte subsets counts in breast cancer patients.

The effects and interaction of endocrine and cytotoxic adjuvant treatment on measures of cellular immunity were assessed in 41 stage I-II breast cancer patients from International Breast Cancer Study Group trials. Counts of lymphocytes and lymphocyte subsets [(T, T4, T8, B, natural killer (NK) and activated T (AT) cells] were assessed by flow cytometry immediately before adjuvant therapy at baseline and on day 1 of the 3rd cycle. Twenty-two patients received cyclophosphamide, methotrexate and 5-fluorouracil (CMF), 7 CMF and tamoxifen (TAM), and 12 TAM alone. On day 1 of the 3rd cycle the counts of total lymphocytes (P = 0.003) and all lymphocyte subsets (P<0.05) except AT cells were significantly lower than baseline in the CMF treatment group. There was no significant change in the CMF+TAM or in the TAM treatment group. The combination of CMF and TAM resulted in less pronounced decrease in lymphocyte and subset counts from baseline to day 1 of the 3rd cycle. It seems possible that there is an interaction between TAM with CMF that affects lymphocyte and lymphocyte subset counts during cytotoxic treatment.

Adult↗

PubMed2005

Nutritional status of patients hospitalised in Poland.

AIM: Screening and extended assessment of the nutritional status of patients on admission and on discharge from hospital were carried out. DESCRIPTION: The studies were carried out in four teaching hospitals, four provincial hospitals and four county hospitals in Poland. SUBJECTS: Screening examinations were carried out for 3310 randomly selected patients (every 10th patient admitted to hospital, including 1916 female cases aged from 16 to 92 y and 1394 male patients aged from 16 to 100 y). Extended examinations were carried out on 210 patients aged from 16 to 87 y (including 122 female and 88 male). MAIN ASSESSMENT PARAMETERS: Anthropometric (height, weight, body mass index (BMI), waist-to-hip ratio (WHR), arm circumference) and biochemical indices (erythrocyte count, haemoglobin concentration, white blood cell count, blood lymphocyte count and serum albumin serum concentration). The extended examinations included determination of antioxidant vitamins (A, C, E), vitamin B(12) and folic acid. RESULTS: On admission to hospital, 10.43% of the patients surveyed had a BMI below 20 kg/m(2), in 20.74% of patients serum albumin concentration was below 3.5 g/dl, indicating possible protein energy malnutrition. In addition, 21.02% had lymphocyte count below 1.5 x 10(3)/mm(3). During hospitalisation, deterioration in the nutritional status of the patient population occurred. On discharge from hospital, the percentage of patients with BMI < 20 kg/m(2) increased to 11.21% and the percentage with low blood albumin (<3.5 g/dl) increased to 28.57%. On admission, vitamin C deficiency was present in 51.8% of patients, folic acid deficiency in 32%, vitamin E deficiency in 10%, vitamin B(12) deficiency in 6.8% and vitamin A deficiency in 1.4%. Vitamin deficiencies were present equally in malnourished, overweight and obese patients. CONCLUSIONS: In patients admitted to hospitals in Poland, malnutrition risk demonstrated by BMI was observed in 10.43% of patients. On the basis of biochemical indices, increased nutritional risk was demonstrated in 21% of patients. Vitamin malnutrition was seen in the majority of patients. A significant correlation between weight, BMI, arm circumference, blood lymphocyte count and the number of days spent in hospital was observed. SPONSORSHIP: The Committee of Scientific Research and the Ministry of Health-PBZ 012-14.

Adolescent↗

PubMed1975

Evaluation of biological markers in bladder cancer.

The value of biological markers of bladder cancer was studied in 66 patients. The markers included serum and urine carcinoembryonic antigens, serum and urine fibrinogen degradation products, total lymphocyte counts, urine lymphocytes and urine cytology. A high degree of accuracy (90 per cent) was found in correlating cytology and urinary fibrinogen degradation products with the activity of the disease. Serum and urine carcinoembryonic antigens, serum fibrinogen degradation products, total lymphocyte counts and urine lymphocytes were found to have no value in screening bladder cancer patients. Urinary fibrinogen degradation products and cytology in combination are recommended for screening and followup of patients at high risk.

Carcinoembryonic Antigen↗