Pattern on blood levels of erythropoietin patients and proinflammatory cytokines in anemic on regular hemodialysis

The objective of this study was to assess the blood levels of cytokines as interleukin-1 B [IL-1 B], interleukin-6 [IL-6] and Epo in anemic patients on regular hemodialysis [HD] and evaluate their relation to the anemic status of those patients. Sera levels of IL-1 B, IL-6 and Epo were measured by ELISA technique in 40 patients on regular HD. The patients were compared with 20 healthy controls. A statistically significant decrease of serum Epo level and a statistically significant elevation for the sera levels of IL-1 B and IL-6 were detected in the patients compared with the controls. A Positive correlation between IL-1 B and IL-6 was detected. Statistically significant negative correlations between IL-1 B and hemoglobin [Hb] level were observed. Also, statistically significant negative correlations between IL-6 and Hb were observed. Hence, these cytokines would be involved in the pathophysiology of end stage renal disease [ESRD] anemic patients

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

Prognostic significance of some tumor markers in head and neck carcinomas

Carcinoembryonic antigen [CEA], ferritin, tissue polypeptide antigen [TPA] and alkaline phosphatase [ALP] isoenzymes were evaluated in 41 patients with head and neck cancer before and [2-6] months after receiving treatment. The study included as well 13 apparently healthy age matched individuals as control group. Statistically significant elevation was found for CEA, ferritin, TPA and ALP in the patients before treatment compared to the control [P = 0.001, 0.0001, 0.04, 0.001 respectively], another statistically significant elevation was found for all the studied markers in patients before treatment compared to their levels after treatment [P < 0.001 for CEA, ferritin, TPA and ALP and 0.001 for PALP]. Ferritin was the only marker that showed statistically significant elevation in grade III compared to grade I and II [p - 0.001]. A significant elevation could be detected in the level of TPA and PALP in patients with positive regional L.N mecastasis compared with those without regional L.N metastasis [P = 0.03 and 0.04 respectively]. A statistically significant positive correlation was detected between ferritin level and tumor grade [r = 0.5, P 4 X 001]. Also a statistically significant negative correlations were found between TPA and regional L.N metastasis [r = -0.3, P = 0.04] and between ALP and CEA mean values in treated patients [r = -0.4, p = 0.009] Evaluation of tumor markers, separately revealed that CEA and then ferritin showed higher sensitivity [97.6 percent and 94.6 percent respectively], followed by ALP and TPA [75.6 percent and 5 8.3 percent respectively]. The specificity of CEA was higher than the other studied markers [100 percent]. As regards double combination, it was found that [CEA and ferritin] combination showed the highest sensitivity and specificity followed by [CEA and ALP] and [ferritin and ALP] [sensitivity, [either abnormal] 89 percent, 90 percent and 81 percent for the three previous combination respectively, [both abnormal] 46 percent, 23 percent, and 32 percent respectively] [specificity, "either abnormal" and "both abnormal was 100 percent and 92 percent for [CEA and Ferritin] and [CEA and ALP] respectively, and 100 percent and 85 percent for [ferritin and ALP]. All the triple combinations showed much lower sensitivity and specificity. Sixty one of untreated patients gave PALP bands. After treatment a reduction in PALP percentage was seen in 82 percent of patients. This reduction in PALP activity correlated to tumor stage, being one of the prognostic factors. A strategy requiring 2 or more markers to be abnormal while having both sensitivity and specificity high in monitoring head and neck cancer patients or detecting recurrence could be attained by trying more tumor markers to make firm conclusion