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PubMedDate not supplied

Current status of carcinoembryonic antigen (CEA) and CEA-S assays in the evaluation of neoplasm of the gastrointestinal tract.

Carcinoembryonic antigen (CEA) is heterogeneous and may represent a set of closely related glycoproteins which have been referred to as isomeric species of CEA. The existence of other CEA-related glycoproteins such as non-specific cross reacting antigen (NCA) has been recognized. Recently a highly purified homogeneous isomeric species of CEA described as CEA-S has shown differences in diagnostic results upon analysis of clinical sera as well as quantitative immunochemical differences. In a blind study of 308 sera, the CEA and CEA-S assays were compared. A significant difference in false positive results was observed between the CEA and CEA-S assay results. In contrast to the low but significant evidence of elevated CEA in sera of random normal persons and patients with liver disease or inflammatory disease of the gastrointestinal tract or lung, none of the sera had elevated concentrations of CEA-S. Among patients with tumor of the gastrointestinal tract that were considered surgically resectable, 46 percent were elevated using the CEA-S assay and only 34.7 percent were elevated above 5 nanograms per ml by the CEA assay. The CEA assays detect CEA-related molecules produced by lung, breast and other tumors; the CEA-S assay appears equally sensitive to CEA of gastrointestinal origin but detects only a small subgroup of breast, lung and, rarely, other types of tumors.

Carcinoembryonic Antigen↗
PubMed2002

[Photodynamic therapy in the gastrointestinal tract. Possibilities and limits].

BACKGROUND: Photodynamic therapy (PDT) is characterized by the extensive selective accumulation of a photoactive agent, the photosensitizer, in malignant or precancerous tumour cells. The photoactive compound is activated by light beam of a specific wavelength and causes cell death. A significant proportion of patients with gastrointestinal malignancies cannot undergo curative treatment, as either the cancer is too advanced or the patient's general constitution is too poor to allow invasive strategies. In such cases, PDT has already proven to be a promising therapeutic modality for selected dysplasias and malignancies in the gastrointestinal tract. MATERIAL AND METHODS: A retrospective review of the literature was performed in order to determine the experience gained with PDT and to assess its clinical value in the curative and palliative management of gastrointestinal neoplasms. RESULTS: PDT seems to be an adequate treatment for selected forms of early cancer and small lesions of the GI tract or for small residual areas after the tumour has been debulked by other techniques (e.g. limited surgical resection, thermal ablation). Especially for patients who refuse or are ineligible for conventional surgery, PDT offers promising results compared to currently accepted clinical approaches. CONCLUSIONS: As a primary or adjuvant mode for either curative or palliative treatment of gastrointestinal neoplasms, PDT is a potentially effective, minimally invasive therapeutic modality. However, further clinical assessment by means of comparative, standardized studies is essential to the definition of its role in oncology.

Combined Modality Therapy↗
PubMed2005

Gastrointestinal neurofibromatosis: an unusual cause of gastric outlet obstruction.

Neurofibromatosis type-1 (NF-1), also known as von Recklinghausen disease, is a common autosomal dominant condition occurring in approximately 1/3000 births. NF-1 is known to be associated with gastrointestinal neoplasms in 2-25 per cent of patients. We report the first case of gastric outlet obstruction with perforation caused by neurofibroma in a patient with NF-1. The literature is reviewed, examining 61 previously reported cases of noncarcinoid gastrointestinal (GI) neoplasms in patients with NF-1 for symptoms, location, and types of neoplasms. Neoplasms were located most often in the small intestine (72%). Neurofibromas, found in 52 per cent of patients, were the most frequently diagnosed benign neoplasms followed by leiomyomas (13%), ganglioneurofibromas (9.8%), and gastrointestinal stomal tumor (GIST) (6.5%). Adenocarcinoma was present in 23 per cent of patients. Patients with NF-1 and GI symptoms are at risk for gastrointestinal neoplasms from which symptomatic patients are likely to experience significant morbidity.

Adult↗
PubMed1975

Tumour immunology and the gut.

This review set out to answer several questions related to tumour immunology and the gut. It is evident that in patients with gastrointestinal cancer there is a general depression of the immune response and this seems to be correlated with the stage of the disease. Paradoxically a specific immune response against definable tumour antigens can be demonstrated, both cellular and humoral mechanisms being involved although the complexities of this paradox require further analysis. Immunotherapy has been employed in gastrointestinal tumours in a sporadic way. The results suggest that gastrointestinal neoplasms may respond at least as well as other tumours. A firm conclusion awaits the results of controlled trials in which the bulk of the tumour has been effectively dealt with by other means or where combined immunochemotherapy is being used.

Animals↗
PubMed1996

[Gastric adenocarcinoma in hamartomatous polyp in Peutz-Jeghers syndrome].

The Peutz-Jeghers syndrome is characterized by gastrointestinal polyposis and mucocutaneous melanin pigmentation. Between the complications are the appearance of gastrointestinal neoplasms. There is an increasing evidence suggesting the hamartoma-adenoma-carcinoma sequence in Peutz-Jeghers syndrome. We present a 32-years-old man with Peutz-Jeghers syndrome who developed an adenocarcinoma arising in a gastric hamartomatous polyp. We discuss the risk to develop gastrointestinal neoplasms and the necessity for periodic surveillance.

Adenocarcinoma↗
PubMed2001

International gastroenterology research: subject areas, impact, and funding.

AIMS: To examine the volume and potential impact of gastroenterology research outputs from 1985 to 1998 from 14 developed countries; the overlap with research in cancer, infectious diseases, and genetics; and the funding sources for this research. To determine if countries' research outputs correlated with their burden of corresponding diseases and inputs to their research. METHODS: Selective retrieval of papers from the Science Citation Index and manual look up of a sample to determine funding sources. Classification of journals by four categories of research level (clinical/basic) and potential impact (low/high). RESULTS: Gastroenterology represents about 8% of world biomedical research but over 11% in Italy, Japan, and Spain. Its potential impact is highest (but declining) for the USA. It has increased noticeably in most European countries, particularly in Finland. Gastroenterology research has become more clinical in Japan, Spain, Australia, and the Netherlands but more basic in Canada, Germany, Finland, Israel, and South Africa. Funding comes primarily from national governments, followed by national private non-profit sources and industry but little industrial funding occurs in some countries. There is a strong and positive correlation between reported deaths from gastrointestinal neoplasms and countries' outputs of research in gastrointestinal oncology. CONCLUSIONS: Bibliometric analysis can reveal differences between countries in their research in a subject when a common methodology is applied to an international database. Variations in research methods in different countries can plausibly explain some of the variation in the potential impact of the work.

Asia↗
PubMedDate not supplied

Endoscopic fine needle aspiration biopsy.

A catheter assembly that can be passed through the biopsy channel of a standard fiberoptic gastroduodenoscope was devised to permit fine needle aspiration biopsy of gastrointestinal neoplasms under direct vision of the endoscope. This technique for endoscopic aspiration biopsy was performed in ten consecutive patients with esophageal and gastric carcinomas, along with the conventional endoscopic brushing and biopsy. Endoscopic aspiration biopsy gave a positive diagnosis in all ten cases while the other two techniques gave inconclusive results in one patient with an ulcerative growth. We feel that endoscopic aspiration biopsy can be used to obtain representative samples from gastrointestinal neoplasms, and it may add to the diagnostic accuracy of endoscopic biopsy and brushing cytology.

Adenocarcinoma↗
PubMed1998

Detection of colonic cells in peripheral blood of colorectal cancer patients by means of reverse transcriptase and polymerase chain reaction.

Circulating tumour cells play a central role in the metastatic process, but little is known about the relationship between this cellular subpopulation and the development of secondary disease. This study was aimed at assessing the presence of colonic cells in peripheral blood of patients with colorectal cancer in different evolutionary stages, by means of reverse transcriptase polymerase chain reaction (RT-PCR) targeted to carcinoembryonic antigen (CEA) mRNA. In vitro sensitivity was established in a recovery experiment by preparing serial colorectal cancer cell dilutions. Thereafter, 95 colorectal cancer patients and a control group including healthy subjects (n=11), patients with other gastrointestinal neoplasms (n=11) or inflammatory bowel disease (n=9) were analysed. Specific cDNA primers for CEA transcripts were used to apply RT-PCR to peripheral blood samples. Tumour cells were detected down to five cells per 10 ml blood, thus indicating a sensitivity limit of approximately one tumour cell per 10(7) white blood cells. CEA mRNA expression was detected in 39 out of 95 colorectal cancer patients (41.1%), there being a significant correlation with the presence of distant metastases at inclusion. None of the healthy volunteers and only 1 of 11 patients (9.1%) with other gastrointestinal neoplasms had detectable CEA mRNA in peripheral blood. By contrast, CEA mRNA was detected in five of the nine patients (55.6%) with inflammatory bowel disease. These results confirm that it is feasible to amplify CEA mRNA in the peripheral blood, its presence being almost certainly derived from circulating malignant cells in colorectal cancer patients. However, CEA mRNA detectable in blood of patients with inflammatory bowel disease suggests the presence of circulating non-neoplastic colonic epithelial cells.

Adult↗