Study of some tumor markers and their use in breast cancer relapse

Tissue polypeptide antigen [TPA], cancer antigen 15-3 [CA15.3] and carcinoembryonic antigen[CEA] were evaluated by ELISA in 61 patients of breast cancer to evaluate their role in breast cancer relapse, as well as 16 apparently healthy age matched females as control group. The patients were divided into: Post operative group [26 patients] and relapse group [35 patients], eight patients with local recurrent breast cancer and 27 patients with distant metastasis at different sites. Statistically significant elevation was found for the three tested markers in the relapse group compared to the control and post operative group [P < 0.001], also a statistically significant elevation was found in CEA, CA15.3 and TPA in metastatic group compared to local recurrence group [P = 0.01, 0.03 and 0.01 respectively]. TPA level was statistically higher in grade III than in grade II [P = 0.0009]. In relapse group, right sided tumor showed statistically significant elevation of CEA, TPA than the left sided tumor [P = 0.005 and 0.03 respectively]. According to TNM staging CEA showed statistically significant correlation between Ml and Mo [P = 0.01]. In relapse group CA15.3 showed a statistically significant difference between tumor sized > 2 cm and tumor < 2cm [P = 0.04]. In the relapse group there was a statistically significant correlation between multiple lesions and solitary lesions [P = 0.02]. Among the same group there was a significant positive correlation between the percentage of L.N positivity and each of CEA, CA15.3 and TPA. [r - 0.04, 0.42 and 0.51] [P - 0.03, 0.02 and 0.003 respectively]. Another positive correlation was found between tumor size and L.N positivity [r = 0.44] [p = 0.01]. In both post - operative and relapse group there were positive correlations between CA15.3 and CEA [r - 0.45 and 0.56] [P = 0.02 and 0.001 respectively] Positive correlations were found similarly between TPA and CEA [r - 0.50] [P - 0.003] and CA15.3 and TPA [r - 0.57] [P<0.001] in relapse group. Evaluation of tumor markers, separately showed acceptable accuracy profiles regarding the relapse and distant metastatic patients, with CEA being the most sensitive marker, followed by CA15.3 and lastly TPA. In relapse group the most useful combinations for diagnosis could be [CEA and CA15.3] double combination and [CEA, CA15.3 and TPA] triple combination. In distant metastasis group, the combination of choice could be [CEA and TPA] or [CEA and CA15.3] double combinations and CEA, CA15.3 and TPA] triple combination. The use of the 3 markers merit is to be tried in greater number of breast cancer patients

Carcinoma of the tongue treatment results: 129 patients

One hundred and twenty nine patients were treated during 10 years period. The relative frequency to all malignancies was 0.55% and 4.7% of all head and neck tumors. The mean age was 50.6 years. The male to female ratio was 1.6: 1 Local lesion was the main presentation, associated with pain in 42.5% of patients. The duration of symptoms varied from 1 month to more than 1 year, with an average delay of 6 months before diagnosis. Tumors of the anterior two-thirds constituted 78% of the cases, the posterior third 9%, the junctional area 11% and lesions involving the whole tongue were 2% of cases. Squamous cell carcinoma was the main histopathological type, and most of the patients were of stages III and IV. All patients were treated by radiation therapy, either as radical or postoperative modality. The locoregional control rate was 70.5%. Failure was mainly in stage III patients treated by surgery and postoperative irradiation, followed by stage IV patients treated by radical external bean irradiation. Surgery was more successful than radiation therapy as a salvage method for treatment failure