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1.
Arq. bras. med. vet. zootec. (Online) ; 73(3): 747-751, May-June 2021. tab
Article in English | ID: biblio-1278348

ABSTRACT

Marcadores sorológicos são rotineiramente utilizados na prática clínica para o estadiamento de linfomas e para a determinação de seu prognóstico em humanos. No entanto, pouco se sabe sobre sua utilização em cães, mesmo os linfomas sendo neoplasias com alta prevalência nessa espécie. No presente estudo, as concentrações séricas do receptor solúvel de interleucina-2 (sIL-2R) e do antígeno do câncer 125 (CA 125) foram mensurados em 10 cães saudáveis e em 15 cães com linfoma cutâneo, utilizando-se o kit ELISA canino e a leitura em um Stat Fax modelo 2100 (sIL-2R), bem como o kit ELISA humano e a leitura pelo ELISYS UNO humano (CA 125). Os resultados mostraram que não houve diferença significativa (P<0,05) nas concentrações dos marcadores entre os grupos. Além disso, os resultados não apontaram significância clínica no estadiamento tumoral e estabelecimento do prognóstico em cães diagnosticados com linfoma cutâneo.(AU)


Subject(s)
Animals , Dogs , Biomarkers/blood , Receptors, Interleukin-2/blood , CA-125 Antigen/blood , Lymphoma/veterinary , Prognosis , Skin Neoplasms/veterinary
2.
Rev. Assoc. Med. Bras. (1992) ; 66(1): 61-66, Jan. 2020. tab, graf
Article in English | LILACS | ID: biblio-1091900

ABSTRACT

SUMMARY OBJECTIVE To relate disease-free survival and overall survival with type I and type II ovarian cancer and preoperative laboratory parameters biomarkers. METHODS A retrospective study was carried out based on the collection of data from medical records of patients with ovarian tumors. Kaplan-Mayer curves were drawn based on the statistical analysis of the data and were compared using the Log-rank test. RESULTS Disease-free survival in type I ovarian cancer was significantly higher than in type II (p=0.0013), as well as in those with normal levels of CA-125 (p=0.0243) and with a platelet-lymphocyte ratio (PLR) lower than 200 (p=0.0038). The overall survival of patients with type I ovarian cancer was significantly higher than in patients with type II, as well as in patients with normal CA-125 serum levels (p=0.0039) and those with a preoperative fasting glucose of less than 100 mg/dL. CONCLUSION CA-125 levels may predict greater overall and disease-free survival. PLR < 200 may suggest greater disease-free survival, whereas normal fasting glucose may suggest greater overall survival.


RESUMO OBJETIVO Relacionar a sobrevida livre de doença e sobrevida global com câncer de ovário tipos I e II, assim como com parâmetros laboratoriais pré-operatórios biomarcadores. MÉTODOS Estudo retrospectivo realizado com base na coleta de dados de prontuários de pacientes com tumor ovariano. As curvas de Kaplan-Mayer foram realizadas em relação à análise estatística dos dados, sendo comparadas pelo teste de Log-rank. RESULTADOS A sobrevida livre de doença nas pacientes com câncer de ovário tipo I foi significativamente maior do que nas pacientes com câncer de ovário tipo II (p = 0,0013), bem como maior naquelas com níveis normais de CA-125 (p = 0,0243) e com relação plaquetas-linfócitos (RPL) inferior a 200 (p = 0,0038). A sobrevida global de pacientes com câncer de ovário tipo I foi significativamente maior do que em pacientes com tipo II, maior em pacientes com níveis séricos normais de CA-125 (p = 0,0039) e naquelas com glicemia de jejum pré-operatória menor que 100 mg / dL. CONCLUSÃO Os níveis de CA-125 podem predizer uma sobrevida global e livre de doença. A RPL < 200 pode sugerir uma maior sobrevida livre de doença, enquanto uma glicemia normal de jejum, uma maior sobrevida global.


Subject(s)
Humans , Female , Adolescent , Adult , Aged , Aged, 80 and over , Young Adult , Ovarian Neoplasms/mortality , Ovarian Neoplasms/blood , Ovarian Neoplasms/pathology , Platelet Count , Reference Values , Biomarkers, Tumor/blood , Predictive Value of Tests , Retrospective Studies , Lymphocyte Count , Disease-Free Survival , CA-125 Antigen/blood , Kaplan-Meier Estimate , Preoperative Period , Middle Aged , Neutrophils
3.
Article in English | WPRIM | ID: wpr-787201

ABSTRACT

A differential diagnosis of ascites is always challenging for physicians. Peritoneal tuberculosis is particularly difficult to distinguish from peritoneal carcinomatosis because of the similarities in clinical manifestations and laboratory results. Although the definitive diagnostic method for ascites is to take a biopsy of the involved tissues through laparoscopy or laparotomy, there are many limitations in performing biopsies in clinical practice. For this reason, physicians have attempted to find surrogate markers that can substitute for a biopsy as a confirmative diagnostic method for ascites. CA 125, which is known as a tumor marker for gynecological malignancies, has been reported to be a biochemical indicator for peritoneal tuberculosis. On the other hand, the sensitivity of serum CA 125 is low, and CA 125 may be elevated due to other benign or malignant conditions. This paper reports the case of a 66-year-old male who had a moderate amount of ascites and complained of dyspepsia and a febrile sensation. His abdominal CT scans revealed a conglomerated mass, diffuse omental infiltration, and peritoneal wall thickening. Initially, peritoneal tuberculosis was suspected due to the clinical symptoms, CT findings, and high serum CA 125 levels, but non-specific malignant cells were detected on cytology of the ascitic fluid. Finally, he was diagnosed with primary malignant peritoneal mesothelioma after undergoing a laparoscopic biopsy.


Subject(s)
Aged , Ascites , Ascitic Fluid , Biomarkers , Biopsy , CA-125 Antigen , Carcinoma , Diagnosis, Differential , Dyspepsia , Hand , Humans , Laparoscopy , Laparotomy , Male , Mesothelioma , Methods , Peritoneum , Peritonitis, Tuberculous , Sensation , Tomography, X-Ray Computed
4.
Article in English | WPRIM | ID: wpr-764574

ABSTRACT

OBJECTIVE: To identify the power of tumor markers for predicting ovarian cancer according to menopausal status. METHODS: The medical records of 876 women with ovarian cysts were retrospectively reviewed. Cancer antigen 125 (CA 125), human epididymis protein 4 (HE4), and Risk of Ovarian Malignancy Algorithm (ROMA) were analyzed. Sensitivity, specificity, and the receiver operating characteristic (ROC) curve analyses of these tumor markers were evaluated. RESULTS: The sensitivity of ROMA was 66.7% and the specificity was 86.8% to detect ovarian malignancy. The patients were divided into 2 groups according to menopausal status: premenopause (n=532, 60.7%) and postmenopause (n=344, 39.3%). For diagnostic accuracy, ROMA was lower than HE4 in premenopausal women (82.7% vs. 91.4%) and lower than CA 125 in postmenopausal women (86.9% vs. 88.7%). The ROC curve analysis revealed that the power of ROMA was not significantly better than that of HE4 in premenopausal women (area under the curve [AUC], 0.731 vs. 0.732, p=0.832), and it was also not significantly better than that of CA 125 in postmenopausal women (AUC, 0.871 vs. 0.888, p=0.440). CONCLUSION: The discrimination power of tumor markers for ovarian cancer was different according to menopausal status. In predicting ovarian malignancy, ROMA was neither superior to HE4 in premenopausal women nor superior to CA 125 in postmenopausal women.


Subject(s)
Biomarkers, Tumor , CA-125 Antigen , Discrimination, Psychological , Epididymis , Female , Humans , Male , Medical Records , Menopause , Ovarian Cysts , Ovarian Neoplasms , Postmenopause , Premenopause , Retrospective Studies , ROC Curve , Rome , Sensitivity and Specificity
5.
Article in English | WPRIM | ID: wpr-764552

ABSTRACT

OBJECTIVES: In our institutional experience, involved-field radiation therapy (IFRT) yields favorable outcomes in patients with recurrent epithelial ovarian cancer (EOC). This retrospective study aimed to investigate the clinical benefits of IFRT in this patient population. METHODS: Among patients treated with IFRT for recurrent EOC between 2010 and 2017, 61 patients with 90 treatments were included. IFRT encompassed all treatable lesions identified via imaging studies with 10–15-mm margins. Prescribed doses were ≥45 Gy (equivalent dose in 2 Gy/fraction). RESULTS: Patients were followed up for a median of 19.0 (Interquartile range, 8.6–34.9) months after IFRT. The 2-year in-field control, progression-free survival, and overall survival (OS) rates were 42.7%, 24.2%, and 78.9%, respectively. Fifty-three IFRT sessions (58.9%) were followed by systemic chemotherapy, and the median chemotherapy-free interval (CFI) was 10.5 (95% confidence interval=7.3–13.7) months. A higher carbohydrate antigen-125 (CA-125) level correlated with a worse 2-year OS (69.2% vs. 91.0%; p=0.001) and shorter median CFI (4.7 vs. 11.9 months; p12 months. For patients with a normal CA-125 level and/or platinum-sensitive tumor, IFRT prolonged CFI regardless of pre-existing carcinomatosis, gross tumor volume, and number of treatment sites. CONCLUSION: Our early experience demonstrates the safety and feasibility of IFRT as an effective salvage therapy and enables a “chemotherapy holiday” in selected recurrent EOC settings. The CA-125 value before IFRT (within normal range) and/or platinum sensitivity could be used as selection criteria for IFRT.


Subject(s)
CA-125 Antigen , Carcinoma , Disease-Free Survival , Drug Therapy , Humans , Ovarian Neoplasms , Patient Selection , Platinum , Retrospective Studies , Salvage Therapy , Tumor Burden
6.
Article in English | WPRIM | ID: wpr-764551

ABSTRACT

OBJECTIVES: The global obesity epidemic has great impact on the prevalence of low-grade endometrial carcinoma. The preoperative tumor serum marker cancer antigen 125 (CA-125) might contribute to improved identification of high-risk patients within this group. The study aimed to investigate the prognostic value of CA-125 in relation to established preoperative prognosticators, with a focus on identifying patients with poor outcome in low-grade endometrial carcinoma (EC) patients. METHODS: Prospective multicenter cohort study including all consecutive patients surgically treated for endometrial carcinoma in nine collaborating hospitals from September 2011 until December 2013. All preoperative histopathological diagnoses were reviewed in a blinded manner. Associations between CA-125 and clinicopathological features were determined. Univariable and multivariable analysis by Cox regression were used. Separate analyses were performed for preoperatively designated low-grade and high-grade endometrial carcinoma patients. RESULTS: A total of 333 patients were analyzed. CA-125 was associated with poor prognostic features including advanced International Federation of Gynecology and Obstetrics (FIGO) stage. In multivariable analysis, age, preoperative tumor and CA-125 were significantly associated with disease-free survival (DFS); preoperative grade, tumor type, FIGO and CA-125 were significantly associated with disease-specific survival (DSS). Low-grade EC patients with elevated CA-125 revealed a DFS of 80.6% and DSS of 87.1%, compared to 92.1% and 97.2% in low-grade EC patients with normal CA-125. CONCLUSION: Preoperative elevated CA-125 was associated with poor prognostic features and independently associated with DFS and DSS. Particularly patients with low-grade EC and elevated CA-125 represent a group with poor outcome and should be considered as high-risk endometrial carcinoma.


Subject(s)
Biomarkers , CA-125 Antigen , Cohort Studies , Diagnosis , Disease-Free Survival , Endometrial Neoplasms , Female , Gynecology , Humans , Obesity , Obstetrics , Prevalence , Prospective Studies
7.
Article in English | WPRIM | ID: wpr-764544

ABSTRACT

OBJECTIVE: To treat advanced ovarian cancer, interval debulking surgery (IDS) is performed after 3 cycles each of neoadjuvant chemotherapy (NAC) and postoperative chemotherapy (IDS group). If we expect that complete resection cannot be achieved by IDS, debulking surgery is performed after administering additional 3 cycles of chemotherapy without postoperative chemotherapy (Add-C group). We evaluated the survival outcomes of the Add-C group and determined their serum cancer antigen 125 (CA125) levels to predict complete surgery. METHODS: A retrospective chart review of all stage III and IV ovarian, fallopian tube, and peritoneal cancer patients treated with NAC in 2007–2016 was conducted. RESULTS: About 117 patients comprised the IDS group and 26 comprised the Add-C group. Univariate and multivariate analyses revealed that Add-C group had an equivalent effect on progression-free survival (PFS; p=0.09) and overall survival (OS; p=0.94) compared with the IDS group. Multivariate analysis revealed that patients who developed residual disease after surgery had worse PFS (hazard ratio [HR]=2.18; 95% confidence interval [CI]=1.45–3.28) and OS (HR=2.33; 95% CI=1.43–3.79), and those who received <6 cycles of chemotherapy had worse PFS (HR=5.30; 95% CI=2.56–10.99) and OS (HR=3.05; 95% CI=1.46–6.38). The preoperative serum CA125 cutoff level was 30 U/mL based on Youden index method. CONCLUSIONS: Administering 3 additional cycles of chemotherapy followed by debulking surgery exhibited equivalent effects on survival as IDS followed by 3 cycles of postoperative chemotherapy. Preoperative serum CA125 levels of ≤30 U/mL may be a useful predictor of achieving complete surgery.


Subject(s)
CA-125 Antigen , Cytoreduction Surgical Procedures , Disease-Free Survival , Drug Therapy , Fallopian Tubes , Female , Humans , Methods , Multivariate Analysis , Neoadjuvant Therapy , Ovarian Neoplasms , Retrospective Studies
8.
Article in English | WPRIM | ID: wpr-764542

ABSTRACT

OBJECTIVE: A subset of patients with recurrent ovarian cancer (ROC) may benefit from antiestrogen therapy with higher response rates reported in tumors that are strongly estrogen receptor (ER)-positive (ER+). PARAGON is a basket trial that incorporates 7 phase 2 trials investigating the activity of anastrozole in patients with ER+ and/or progesterone receptor (PR)-positive (PR+) recurrent/metastatic gynecological cancers. METHODS: Postmenopausal women with ER+ and/or PR+ ROC, who were asymptomatic and had cancer antigen 125 (CA125) progression after response to first line chemotherapy, where chemotherapy was not clinically indicated. Patients received anastrozole 1 mg daily until progression or unacceptable toxicity. RESULTS: Fifty-four patients were enrolled (52 evaluable). Clinical benefit at three months (primary endpoint) was observed in 18 patients (34.6%; 95% confidence interval [CI]=23%–48%). Median progression-free survival (PFS) was 2.7 months (95% CI=2.1–3.1). The median duration of clinical benefit was 6.5 months (95% CI=2.8–11.7). Most patients progressed within 6 months of starting anastrozole but 12 (22%) continued treatment for longer than 6 months. Anastrozole was well tolerated. In the exploratory analysis, ER histoscores and the intensity of ER staining did not correlate with clinical benefit rate or PFS. CONCLUSION: A subset of asymptomatic patients with ER+ and/or PR+ ROC and CA125 progression had durable clinical benefit on anastrozole, with acceptable toxicity. Anastrozole may delay symptomatic progression and the time to subsequent chemotherapy. The future challenge is to identify the subset of patients most likely to benefit from an aromatase inhibitor and whether the clinical benefit could be increased by the addition of other agents.


Subject(s)
Aromatase , Aromatase Inhibitors , CA-125 Antigen , Disease-Free Survival , Drug Therapy , Estrogen Receptor Modulators , Estrogens , Female , Humans , Ovarian Neoplasms , Progesterone , Receptors, Progesterone
9.
Article in English | WPRIM | ID: wpr-764519

ABSTRACT

OBJECTIVES: The aim of this study was to develop a new prognostic classification for epithelial ovarian cancer (EOC) patients using gradient boosting (GB) and to compare the accuracy of the prognostic model with the conventional statistical method. METHODS: Information of EOC patients from Samsung Medical Center (training cohort, n=1,128) was analyzed to optimize the prognostic model using GB. The performance of the final model was externally validated with patient information from Asan Medical Center (validation cohort, n=229). The area under the curve (AUC) by the GB model was compared to that of the conventional Cox proportional hazard regression analysis (CoxPHR) model. RESULTS: In the training cohort, the AUC of the GB model for predicting second year overall survival (OS), with the highest target value, was 0.830 (95% confidence interval [CI]=0.802–0.853). In the validation cohort, the GB model also showed high AUC of 0.843 (95% CI=0.833–0.853). In comparison, the conventional CoxPHR method showed lower AUC (0.668 (95% CI=0.617–0.719) for the training cohort and 0.597 (95% CI=0.474–0.719) for the validation cohort) compared to GB. New classification according to survival probability scores of the GB model identified four distinct prognostic subgroups that showed more discriminately classified prediction than the International Federation of Gynecology and Obstetrics staging system. CONCLUSION: Our novel GB-guided classification accurately identified the prognostic subgroups of patients with EOC and showed higher accuracy than the conventional method. This approach would be useful for accurate estimation of individual outcomes of EOC patients.


Subject(s)
Area Under Curve , CA-125 Antigen , Classification , Cohort Studies , Gynecology , Humans , Machine Learning , Methods , Obstetrics , Ovarian Neoplasms , Prognosis
10.
Article in English | WPRIM | ID: wpr-761553

ABSTRACT

A differential diagnosis of ascites is always challenging for physicians. Peritoneal tuberculosis is particularly difficult to distinguish from peritoneal carcinomatosis because of the similarities in clinical manifestations and laboratory results. Although the definitive diagnostic method for ascites is to take a biopsy of the involved tissues through laparoscopy or laparotomy, there are many limitations in performing biopsies in clinical practice. For this reason, physicians have attempted to find surrogate markers that can substitute for a biopsy as a confirmative diagnostic method for ascites. CA 125, which is known as a tumor marker for gynecological malignancies, has been reported to be a biochemical indicator for peritoneal tuberculosis. On the other hand, the sensitivity of serum CA 125 is low, and CA 125 may be elevated due to other benign or malignant conditions. This paper reports the case of a 66-year-old male who had a moderate amount of ascites and complained of dyspepsia and a febrile sensation. His abdominal CT scans revealed a conglomerated mass, diffuse omental infiltration, and peritoneal wall thickening. Initially, peritoneal tuberculosis was suspected due to the clinical symptoms, CT findings, and high serum CA 125 levels, but non-specific malignant cells were detected on cytology of the ascitic fluid. Finally, he was diagnosed with primary malignant peritoneal mesothelioma after undergoing a laparoscopic biopsy.


Subject(s)
Aged , Ascites , Ascitic Fluid , Biomarkers , Biopsy , CA-125 Antigen , Carcinoma , Diagnosis, Differential , Dyspepsia , Hand , Humans , Laparoscopy , Laparotomy , Male , Mesothelioma , Methods , Peritoneum , Peritonitis, Tuberculous , Sensation , Tomography, X-Ray Computed
11.
Braz. j. med. biol. res ; 52(12): e9124, 2019. tab, graf
Article in English | LILACS | ID: biblio-1055465

ABSTRACT

Carbohydrate antigen 125 (CA125) has long been used as an ovarian cancer biomarker. However, because it is not specific for ovarian cells, CA125 could also be used to monitor congestion and inflammation in heart disease. Acute heart failure (HF) is used to identify patients with a worse prognosis in ST-segment elevation myocardial infarction (STEMI). We aimed to determine the association of CA125 with acute HF in STEMI and to compare CA125 with N-terminal pro brain natriuretic peptide (NTproBNP) with a cross-sectional study. At admission, patients were examined to define Killip class and then underwent coronary angioplasty. Blood samples, preferably taken in the hemodynamic ward, were centrifuged (1500 g for 15 min at ambient temperature) and stored at −80°C until biomarker assays were performed. Patients were divided into two groups according to the presence or absence of congestion. Patients in Killip class ≥II were in the congestion group and those with Killip <II in the absence of congestion group. We evaluated 231 patients. The mean age was 63.3 years. HF at admission was identified in 17.7% of patients. CA125 and NTproBNP levels were higher in patients with Killip class ≥II than those with Killip class <II (8.03 vs 9.17, P=0.016 and 772.45 vs 1925, P=0.007, respectively). The area under the receiver operator characteristic curve was 0.60 (95%CI 0.53−0.66, P=0.024) for CA125 and 0.63 (95%CI 0.56−0.69, P=0.001) for NTproBNP. There was no statistical difference between the curves (P=0.69). CA125 has similar use to NTproBNP in identifying acute HF in patients presenting with STEMI.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Pulmonary Edema/etiology , CA-125 Antigen/blood , ST Elevation Myocardial Infarction/complications , Pulmonary Edema/diagnosis , Pulmonary Edema/blood , Biomarkers/blood , Cross-Sectional Studies , Predictive Value of Tests , Risk Factors , ROC Curve , ST Elevation Myocardial Infarction
12.
Article in Chinese | WPRIM | ID: wpr-781257

ABSTRACT

OBJECTIVE@#To compare the performance of serum cancer antigen 125 (CA125), human epididymis protein 4 (HE4), Risk of Ovarian Malignancy Algorithm (ROMA) and Copenhagen index (CPH-I) for differential diagnosis of benign and malignant diseases in patients with ovarian mass.@*METHODS@#We retrospectively analyzed the data of 719 women with pelvic mass, and the performance of preoperative serum levels of CA125 and HE4, ROMA and CPH-I for differential diagnosis of the masses was compared.@*RESULTS@#Of the 710 women analyzed, 531 were diagnosed with benign ovarian lesions, 44 with borderline ovarian tumors (BOTs), 119 with epithelial ovarian cancers (EOCs), and 25 with non-EOCs. In differentiating ovarian cancer (OC) and BOT from benign lesions, the area under the receiver-operator characteristic (ROC) curve (AUC) was 0.854 for HE4, 0.856 for ROMA, 0.854 for CPH-I, and 0.792 for CA125, demonstrating better diagnostic performance of HE4, ROMA, and CPH-I than CA125 alone; the diagnostic sensitivity was 56.9% for HE4, 70.2% for CA125, 69.1% for ROMA, and 63.8% for CPH-I; the specificity was the best with HE4 (94.4%) and CPH-I (94.7%). In sub-analysis of EOC benign lesions, the AUCs of HE4, ROMA, and CPH-I increased to 0.946, 0.947, and 0.943, respectively, all greater than that of CA125 (0.888). In other sub-analyses, HE4, ROMA, and CPH-I all showed greater AUCs than CA125 alone.@*CONCLUSIONS@#This study confirms the accuracy of HE4, ROMA, and CPH-I for differentiating malignant from benign ovarian mass, and all these 3 tests show better performance than CA125. Furthermore, HE4 and CPH-I is superior to ROMA and CA125 in terms of specificity, while CA125 and ROMA have better diagnostic sensitivities.


Subject(s)
Algorithms , Biomarkers, Tumor , CA-125 Antigen , Carcinoma, Ovarian Epithelial , Female , Humans , Neoplasms, Glandular and Epithelial , Ovarian Neoplasms , Proteins , Retrospective Studies , WAP Four-Disulfide Core Domain Protein 2
13.
Rev. méd. Chile ; 146(12): 1422-1428, dic. 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-991352

ABSTRACT

Background: Conventional serum tumor markers (CSTM) are widely used for monitoring patients with cancer. However, their usefulness as a diagnostic tool is controversial in primary or metastatic liver cancer (PMLC). Aim: To evaluate the diagnostic performance of the most commonly requested CSTM in the diagnostic approach of PMLC. Material and Methods: Review of medical records of patients aged over 18 years with a liver biopsy, attended from 2005 to 2017 in a tertiary hospital and a regional cancer center in Colombia. The results of liver biopsies were compared with tumor markers such as carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP), CA 19-9, CA 125 and prostate specific antigen (PSA) using a receiver operating characteristic (ROC) curve analysis. Results: We reviewed 2063 medical records and retrieved 118 eligible patients (59 cases and 59 controls, 70% males). Thirty percent had obstructive jaundice. There was heterogeneity in the amount of tumor markers requested according to medical criteria. Only CA 19-9 showed discriminative capacity (> 17.6 U/m), with a cut-off point lower than that reported in the literature and a sensitivity of 69.5%, specificity of 91.6%, a positive likelihood ratio (LR) of 8.32, and a negative LR of 0.33. Conclusions: Except for CA 19-9, tumor markers were not useful for the initial diagnostic approach in patients with suspected primary or metastatic malignant liver tumors.


Subject(s)
Humans , Male , Female , Middle Aged , Biomarkers, Tumor/blood , Liver Neoplasms/diagnosis , Liver Neoplasms/blood , alpha-Fetoproteins/analysis , Carcinoembryonic Antigen/blood , Predictive Value of Tests , Retrospective Studies , ROC Curve , Prostate-Specific Antigen , CA-19-9 Antigen/blood , CA-125 Antigen/blood , Neoplasm Metastasis/diagnosis
14.
Oncol. (Guayaquil) ; 28(2): 150-162, Ago. 30, 2018.
Article in Spanish | LILACS | ID: biblio-1000122

ABSTRACT

Introducción: El cáncer de ovario es una causa común de muerte entre las mujeres que desarrollan neoplasias ginecológicas. La supervivencia depende de factores clínicos y del tipo de cirugía. El objetivo del presente estudio es describir la supervivencia de un grupo de pacientes con diagnóstico de cáncer de ovario tomando en cuenta varios factores. Métodos: El presente estudio longitudinal retrospectivo se realizó en mujeres con cáncer de ovario tratadas en el Instituto Nacional de Oncología y Radiobiología, La Habana-Cuba entre el 1 de enero y el 31 de diciembre de 2005, con seguimiento de por lo menos 5 años. Las variables fueron edad, tipo histológico del tumor, etapa clínica de la FIGO, grado de diferenciación celular, valores del biomarcador CA-125, tipo de cirugía realizada, respuesta a la quimioterapia utilizada, supervivencia, recurrencias. El paquete estadístico utilizado fue SPSS 11.0 para Windows. Se aplicaron pruebas estadísticas como la prueba no paramétrica de Kruskal-Wallis, la prueba no paramétrica de MannWhitney y la prueba de Chi-cuadrado de Pearson. Resultados: Se registraron 29 casos de mujeres con cáncer de ovario. Once casos (37.9 %) fueron en menores de 45 años. En Etapa clínica III, 18 casos (62.1 %). De grado indiferenciado en 17 casos (58.6 %). 16 casos (55.2 %) fueron del tipo histológico seroso. El valor del CA-125 fue >35 U/mL en 13 casos (61.9 %). Las mujeres con etapa clínica I, tuvieron un Intervalo Libre de la Enfermedad (ILE) de 46 meses versus 27 meses en mujeres con etapa III y 12 meses en etapa IV (P>0.05). El grado de diferenciación celular Bien diferenciado determinó estadísticamente el mejor ILE: 55 meses versus 27 meses en el grado moderadamente diferenciado y de 21 meses en el grado indiferenciado (P=0.025). El tipo histológico así como los niveles de CA-125 no determinaron diferencias estadísticas de ILE, así como en Supervivencia Global Media (SGM). Según el tipo de tratamiento no existieron diferencias estadísticas significativas en el ILE, SGM. Sin embargo las cirugías clasificadas como "óptimas" por parte del equipo quirúrgico tuvieron mayor ILE (Delta 17 meses) P=0.038. Conclusión: En esta serie de casos presentada, las pacientes con cáncer de ovario en Etapa clínica I tuvieron una mejor supervivencia que las pacientes con Etapa clínica III. Así mismo las cirugías clasificadas como óptimas tuvieron mayor intervalo libre enfermedad y mayor supervivencia libre de enfermedad.


Introduction: Ovarian cancer is a common cause of death among women who develop gynecological neoplasms. Survival depends on clinical factors and the type of surgery. The objective of the present study is to describe the survival of a group of patients diagnosed with ovarian cancer taking into account several factors. Methods: The present retrospective longitudinal study was conducted in women with ovarian cancer treated at the National Institute of Oncology and Radiobiology, Havana-Cuba between January 1 and December 31, 2005, with follow-up of at least 5 years . The variables were age, histological type of the tumor, clinical stage of the FIGO, degree of cellular differentiation, values of the CA-125 biomarker, type of surgery performed, response to the chemotherapy used, survival, recurrences. The statistical package used was SPSS 11.0 for Windows. Statistical tests were applied, such as the non-parametric Kruskal-Wallis test, the nonparametric Mann-Whitney test and the Pearson Chi-square test. Results: There were 29 cases of women with ovarian cancer. Eleven cases (37.9%) were in children under 45 years of age. In Clinical Stage III, 18 cases (62.1%). Of undifferentiated degree in 17 cases (58.6%). 16 cases (55.2%) were of the serous histological type. The value of CA-125 was> 35 U/ mL in 13 cases (61.9%). Women with clinical stage I had a Disease Free Interval (DFI) of 46 months versus 27 months in women with stage III and 12 months in stage IV (P> 0.05). The degree of differentiated cellular differentiation statistically determined the best DFI: 55 months versus 27 months in the moderately differentiated degree and 21 months in the undifferentiated degree (P = 0.025). The histological type as well as CA-125 levels did not determine statistical differences of DFI, as well as in Average Global Survival (AGS). According to the type of treatment, there were no significant statistical differences in the FID and AGS. However, surgeries classified as "optimal" by the surgical team had a greater DFI (Delta 17 months) P = 0.038. Conclusion: In this case series presented, patients with ovarian cancer in clinical stage I had a better survival than patients with clinical stage III. Likewise, surgeries classified as optimal had greater free disease interval and greater disease-free survival.


Subject(s)
Female , Adult , Middle Aged , Ovarian Neoplasms , Ovary , Survivorship , Women , CA-125 Antigen , Neoplasms
15.
Article in English | WPRIM | ID: wpr-716068

ABSTRACT

The purpose of this study was to investigate the relationship between serum tumor markers and dietary intakes in healthy adults to address a nutrition guide for cancer prevention. We analyzed tumor-related markers, carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP), prostate-specific antigen (PSA), and cancer antigen 125 (CA125) in serum and daily food and nutrient intakes using a 24-hour recall method in 23 healthy men and 32 healthy women. The average age was 50.7 years for men and 48.9 years for women. There were no significant differences in biochemical tumor markers and food intake between the men and women except energy intake. A significantly positive correlation was found between serum AFP, a biochemical marker of liver cancer, and serum glutamic oxaloacetic transaminase (GOT) and/or glutamic pyruvate transaminase (GPT) in both men and women. CEA had a significant and negative correlation with energy intake for men and food intake in women. PSA, a biomarker of prostate cancer, was significantly and positively correlated with the intake of animal iron and cholesterol in men. CA125, a biomarker of gynecologic cancers, was significantly and positively correlated with meat intake in women. As this study revealed the significant relationship between biochemical tumor markers and dietary factors, further studies are needed to elucidate the underlying mechanism of this relationship.


Subject(s)
Adult , alpha-Fetoproteins , Animals , Aspartate Aminotransferases , Biomarkers , Biomarkers, Tumor , CA-125 Antigen , Carcinoembryonic Antigen , Cholesterol , Diet , Eating , Energy Intake , Female , Humans , Iron , Liver Neoplasms , Male , Meat , Methods , Prostate-Specific Antigen , Prostatic Neoplasms , Pyruvic Acid
16.
Clinics ; 72(1): 30-35, Jan. 2017. tab, graf
Article in English | LILACS | ID: biblio-840034

ABSTRACT

OBJECTIVES: To evaluate the postoperative pathological characteristics of hysterectomy specimens, preoperative cancer antigen (CA)-125 levels and imaging modalities in patients with endometrial cancer and to build a risk matrix model to identify and recruit patients for retroperitoneal lymphadenectomy. METHODS: A total of 405 patients undergoing surgical treatment for endometrial cancer were retrospectively reviewed and analyzed. Clinical (age and body mass index), laboratory (CA-125), radiological (lymph node evaluation), and pathological (tumour size, grade, lymphovascular space invasion, lymph node metastasis, and myometrial invasion) parameters were used to test the ability to predict lymph node metastasis. Four parameters were selected by logistic regression to create a risk matrix for nodal metastasis. RESULTS: Of the 405 patients, 236 (58.3%) underwent complete pelvic and para-aortic lymphadenectomy, 96 (23.7%) underwent nodal sampling, and 73 (18%) had no surgical lymph node assessment. The parameters predicting nodal involvement obtained through logistic regression were myometrial infiltration >50%, lymphovascular space involvement, pelvic lymph node involvement by imaging, and a CA-125 value >21.5 U/mL. According to our risk matrix, the absence of these four parameters implied a risk of lymph node metastasis of 2.7%, whereas in the presence of all four parameters the risk was 82.3%. CONCLUSION: Patients without deep myometrial invasion and lymphovascular space involvement on the final pathological examination and with normal CA-125 values and lymph node radiological examinations have a relatively low risk of lymph node involvement. This risk assessment matrix may be able to refer patients with high-risk parameters necessitating lymphadenectomy and to decide the risks and benefits of lymphadenectomy.


Subject(s)
Humans , Female , Adult , Aged , CA-125 Antigen/blood , Endometrial Neoplasms/pathology , Lymphatic Metastasis/diagnosis , Endometrial Neoplasms/surgery , Lymph Node Excision , Lymphatic Metastasis/prevention & control , Neoplasm Invasiveness , Predictive Value of Tests , Retrospective Studies , Risk Factors
17.
Article in Chinese | WPRIM | ID: wpr-351353

ABSTRACT

<p><b>OBJECTIVE</b>To screen out retinoblastoma (RB)-related serum tumor markers by measuring the levels of serum alpha fetoprotein (AFP), carcino-embryonic antigen (CEA), neuron-specific enolase (NSE), carbohydrate antigen 125 (CA125), carbohydrate antigen 153 (CA153), carbohydrate antigen 199 (CA199), and carbohydrate antigen 724 (CA724) in children with RB.</p><p><b>METHODS</b>The levels of seven serum tumor markers (AFP, CEA, NSE, CA125, CA153, CA199, and CA724) were determined in 20 children with RB and 20 healthy children (control) using a chemiluminescent immunoassay.</p><p><b>RESULTS</b>The serum levels and positive rates of NSE, CA153, and CA199 in the RB group were significantly higher than those in the control group (P<0.05). However, there were no significant differences in the levels of AFP, CEA, CA125, and CA724 between the two groups (P>0.05). NSE had the highest sensitivity, but a relatively low specificity for the diagnosis of RB. CA153 and CA199 had a relatively high specificity, but a relatively low sensitivity for the diagnosis of RB.</p><p><b>CONCLUSIONS</b>The serum levels and positive rates of NSE, CA153, and CA199 are high in children with RB. Combined measurement of these three serum tumor markers may have an important diagnostic value for RB.</p>


Subject(s)
Antigens, Tumor-Associated, Carbohydrate , Blood , Biomarkers, Tumor , Blood , CA-125 Antigen , Blood , Child, Preschool , Female , Humans , Infant , Male , Phosphopyruvate Hydratase , Blood , Retinal Neoplasms , Blood , Diagnosis , Retinoblastoma , Blood , Diagnosis
18.
Reprod. clim ; 32(1): 24-30, 2017. tab
Article in English | LILACS | ID: biblio-882434

ABSTRACT

Introduction: Pregnancy loss is a common medical problem in reproductive-age as more than fifty percent of human pregnancies are aborted before term. The majority are unrecognized occurring before or with the expected next menses. About 10­12 percent of all clinically diagnosed pregnancies are lost as first-trimester or early second trimester. The rate of fetal death after 14 weeks' gestation is much lower than the rate of pre-embryonic and embryonic loss. CA125 is a member of the mucin family glycoproteins. CA125 has found application as a tumor marker or biomarker that its level may be increased in the serum of some patients with specific types of cancers. Some studies detected that the abortion risk is increased in pregnant women with higher CA125 levels. Progesterone belongs to the C21 group of progestogen. Its main source in humans is the corpus luteum. Human chorionic gonadotropin (HCG) is a glycoprotein produced by syncytiotrophoblast. Aim of the work: The aim of this study was to determine the effectiveness of measuring maternal serum -HCG, progesterone, CA125 in prediction of first trimester abortion. Patients: The study included 90 pregnant women attending the ANC clinic in El-Shatby Maternity University Hospital. Patients were divided equally into two groups: Group I: 45 women with threatened abortion, subdivided into 2 subgroups: Subgroup A ­ Cases ended in abortion; Subgroup B ­ Cases continued as normal pregnancies. Group II: 45 pregnant women with normal pregnancy and were further subdivided into two subgroups: Subgroup C ­ Cases ended in abortion; Subgroup D ­ Cases continued as normal pregnancies. Exclusion criteria: (1) Multiple pregnancies; (2) Anembryonic pregnancy; (3) Pregnant women with prior treatment with progesterone; (4) History of endometriosis; (5) Fibromyoma with pregnancy. Methods: After clinical and sonographic examination, 3 mL venous blood have been taken once for estimation of serum level of -hCG, progesterone and CA125 by quantitative ELISA. Results: This is a case­control study. Out of the 90 pregnancies, 15 cases (16.6%) had aborted during follow-up, 9 cases (60%) of them had history of threatened abortion while 6 cases (40%) had no history of threatened abortion. Regarding Serum Progesterone level between studied groups, the calculated p value was <0.001. For Serum HCG, the calculated p value was <0.001. In Serum CA125 the calculated p value was <0.001.(AU)


Introdução: A perda da gravidez é problema clínico comum em mulheres em idade fértil, pois em mais de 50% das gestações humanas ocorre aborto antes do termo. Em sua maioria, tais abortos passam despercebidos; ocorrem antes da próxima menstruação ou juntamente com a próxima menstruação. Cerca de 10-12% de todos os abortos clinicamente diagnosticados ocorrem no primeiro trimestre ou no início do segundo trimestre. O percentual de mortes fetais após 14 semanas de gestação é muito mais baixo do que o percentual de abortos pré-embrionários ou embrionários. Foi constatado que CA125 tem aplicação como marcador tumoral ou como biomarcador, pois seu nível pode aumentar no soro de alguns pacientes portadores de tipos específicos de neoplasias. CA125 é um membro da família das glicoproteínas mucinas. Alguns estudos observaram que o risco de aborto aumenta em gestantes com níveis mais elevados de CA125. Progesterona pertence ao grupo C21 dos progestágenos. Em seres humanos, sua principal fonte é o corpo lúteo. Gonadotrofina coriônica humana (HCG) é uma glicoproteína produzida pelo sinciciotrofoblasto. Objetivo: Determinar a eficácia da determinação, no soro materno, de -HCG, progesterona e CA125 na previsão do aborto no primeiro trimestre. Pacientes: O estudo abrangeu 90 gestantes atendidas na clínica ANC na Maternidade do Hospital Universitário El-Shatby. As pacientes foram divididas equitativamente em dois grupos. Grupo I: 45 gestantes com ameaça de aborto, subdivididas em dois subgrupos: Subgrupo A ­ Casos que terminaram em aborto; Subgrupo B ­ Casos que tiveram continuidade como gestações normais. Grupo II: 45 gestantes com gestação normal, subdivididas em dois subgrupos: Subgrupo C ­ Casos que terminaram em aborto; Subgrupo D ­ Casos que tiveram continuidade como gestações normais. Critérios de exclusão: 1. Gestações múltiplas; 2. Gestação anembriônica; 3. Gestantes previamente tratadas com progesterona; 4. História de endometriose; 5. Fibromioma com gestação. Métodos: Após exame clínico e ultrassonográfico, 3 mL de sangue venoso foram coletados uma vez para estimar o nível sérico de -hCG, progesterona e CA125 por Elisa quantitativo. Resultados: Este é um estudo de casos-controle. Das 90 gestações, durante o seguimento ocorreram 15 (16,6%) casos de aborto; nove (60%) tinham história de ameaça de aborto, seis (40%) não tinham história de ameaça de aborto. Com relação ao nível sérico de progesterona entre os grupos estudados, calculamos p < 0,001. Para o nível sérico de CA125, calculamos p < 0,001.(AU)


Subject(s)
Humans , Female , Pregnancy , Adult , Young Adult , Abortion , Biomarkers/blood , CA-125 Antigen/blood , Chorionic Gonadotropin, beta Subunit, Human/blood , Pregnancy Trimester, First , Progesterone/blood
19.
Pakistan Journal of Medical Sciences. 2017; 33 (4): 1013-1017
in English | IMEMR | ID: emr-188631

ABSTRACT

Objective: To investigate the clinical significance of human epididymal secretory protein E4 [HE4] in combination with cancer antigen 125 [CA125] in the diagnosis of endometrial cancer


Methods: One hundred and fifty patients with endometrial cancer who were admitted to Binzhou People's Hospital, Shandong, China, between June 2013 and July 2014, were enrolled and set as an endometrial cancer group; another one hundred patients with benign uterine diseases and one hundred healthy females were also enrolled, The serum was collected from the subjects for the detection of HE4 level


The level of CA125 was detected using electrochemiluminescence assay [ELISA]. Receiver Operating Characteristic [ROC] curve was drawn to analyze the cutoff points of HE4 and CA125 levels for the diagnosis of endometrial cancer. The diagnostic efficacy based on the detection of the two indexes separately and jointly was evaluated


Results: The area under curve [AUC] for diagnosis of endometrial cancer based on HE4 was superior to that based on CA125 [0.819 vs 0.757]


The optimal diagnosis cutoff point of HE4 and CA125 on the ROC curves was 92.21 pmol/Land 31.32KU/L, respectively. The sensitivity, Youden index, coincidence rate and negative predicted value of diagnosing endometrial cancer with HE4 in combination with CA125 [73.2%, 0.641 , 83.5% and 83,4%] were significantly higher than those of diagnosing endometrial cancer with the two indexes separately. The ROC- AUC value of serum HE4 and CA125 was 0.749 and 0.528 respectively, much lower than that of HE4 in combination with CA125 [0.794; P<0.05]


Conclusion: Serum HE4 and CA125 are the ideal marker combination for the diagnosis of endometrial cancer. HE4 combined with CA125 is beneficial to the diagnosis of endometrial cancer; hence it is worth promotion in clinical practice


Subject(s)
Humans , Women , Adult , Middle Aged , Aged , CA-125 Antigen , Epididymal Secretory Proteins , Enzyme-Linked Immunosorbent Assay , Uterine Diseases
20.
Article in Chinese | WPRIM | ID: wpr-303912

ABSTRACT

<p><b>OBJECTIVE</b>To establish an evaluation model of peritoneal metastasis in gastric cancer, and to assess its clinical significance.</p><p><b>METHODS</b>Clinical and pathologic data of the consecutive cases of gastric cancer admitted between April 2015 and December 2015 in Department of General Surgery, Zhongshan Hospital of Fudan University were analyzed retrospectively. A total of 710 patients were enrolled in the study after 18 patients with other distant metastasis were excluded. The correlations between peritoneal metastasis and different factors were studied through univariate (Pearson's test or Fisher's exact test) and multivariate analyses (Binary Logistic regression). Independent predictable factors for peritoneal metastasis were combined to establish a risk evaluation model (nomogram). The nomogram was created with R software using the 'rms' package. In the nomogram, each factor had different scores, and every patient could have a total score by adding all the scores of each factor. A higher total score represented higher risk of peritoneal metastasis. Receiver operating characteristic (ROC) curve analysis was used to compare the sensitivity and specificity of the established nomogram. Delong. Delong. Clarke-Pearson test was used to compare the difference of the area under the curve (AUC). The cut-off value was determined by the AUC, when the ROC curve had the biggest AUC, the model had the best sensitivity and specificity.</p><p><b>RESULTS</b>Among 710 patients, 47 patients had peritoneal metastasis (6.6%), including 30 male (30/506, 5.9%) and 17 female (17/204, 8.3%); 31 were ≥ 60 years old (31/429, 7.2%); 38 had tumor ≥ 3 cm(38/461, 8.2%). Lauren classification indicated that 2 patients were intestinal type(2/245, 0.8%), 8 patients were mixed type(8/208, 3.8%), 11 patients were diffuse type(11/142, 7.7%), and others had no associated data. CA19-9 of 13 patients was ≥ 37 kU/L(13/61, 21.3%); CA125 of 11 patients was ≥ 35 kU/L(11/36, 30.6%); CA72-4 of 11 patients was ≥ 10 kU/L(11/39, 28.2%). Neutrophil/lymphocyte ratio (NLR) of 26 patients was ≥ 2.37(26/231, 11.3%). Multivariate analysis showed that Lauren classification (HR=8.95, 95%CI:1.32-60.59, P=0.025), CA125(HR=17.45, 95%CI:5.54-54.89, P=0.001), CA72-4(HR=20.06, 95%CI:5.05-79.68, P=0.001), and NLR (HR=4.16, 95%CI:1.17-14.75, P=0.032) were independent risk factors of peritoneal metastasis in gastric cancer. In the nomogram, the highest score was 241, including diffuse or mixed Lauren classification (54 score), CA125 ≥ 35 kU/L (66 score), CA72-4 ≥ 10 kU/L (100 score), and NLR ≥ 2.37 (21 score), which represented a highest risk of peritoneal metastasis (more than 90%). The AUC of nomogram was 0.912, which was superior than any single variable (AUC of Lauren classification: 0.678; AUC of CA125: 0.720; AUC of CA72-4: 0.792; AUC of NLR: 0.613, all P=0.000). The total score of nomogram increased according to the TNM stage, and was highest in the peritoneal metastasis group (F=49.1, P=0.000). When the cut-off value calculated by ROC analysis was set at 140, the model could best balanced the sensitivity (0.79) and the specificity (0.87). Only 5% of patients had peritoneal metastasis when their nomogram scores were lower than 140, while 58% of patients had peritoneal metastasis when their scores were ≥ 140(χ=69.1, P=0.000).</p><p><b>CONCLUSION</b>The risk evaluation model established with Lauren classification, CA125, CA72-4 and NLR can effectively predict the risk of peritoneal metastasis in gastric cancer, and provide the reference to preoperative staging and choice of therapeutic strategy.</p>


Subject(s)
Antigens, Tumor-Associated, Carbohydrate , Blood , Area Under Curve , CA-125 Antigen , Blood , CA-19-9 Antigen , Blood , Female , Humans , Leukocyte Count , Logistic Models , Lymphocytes , Pathology , Male , Middle Aged , Neoplasm Metastasis , Diagnosis , Neutrophils , Pathology , Nomograms , Peritoneal Neoplasms , Prognosis , ROC Curve , Retrospective Studies , Risk Assessment , Methods , Risk Factors , Sensitivity and Specificity , Stomach Neoplasms , Blood , Classification , Diagnosis , Pathology
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