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Article in Chinese | WPRIM | ID: wpr-936357


OBJECTIVE@#To investigate the expression of aldehyde dehydrogenase 3B1 (ALDH3B1) in gastric cancer and explore its correlation with the pathological parameters and long-term prognosis of the patients.@*METHODS@#We analyzed the clinical data of 101 patients who underwent radical gastrectomy for gastric cancer in our hospital between January, 2013 and November, 2016, and examined the expression of ALDH3B1 in paraffin-embedded samples of gastric cancer tissues and adjacent tissues from these cases by immunohistochemical staining. We evaluated the correlation between ALDH3B1 expressions and histopathological parameters and assessed the predictive value of ALDH3B1 expression for long-term survival of the patients. We also examined the effect of lentivirus-mediated interference and overexpression of ALDH3B1 on the malignant behaviors of MGC-803 gastric cancer cells.@*RESULTS@#The expressions of ALDH3B1 and Ki67 were significantly higher in gastric cancer tissues than in adjacent tissues (P < 0.05). In gastric cancer patients, ALDH3B1 expression was positively correlated with peripheral blood CEA and CA19-9 levels (P < 0.01). The proportion of patients with CEA ≥5 μg/L, CA19-9 ≥37 kU/L, T stage of 3- 4, and N stage of 2-3 was significantly greater in high ALDH3B1 expression group than in low expression group. Kaplan-Meier survival analysis showed that the 5-year survival rate was significantly lower in gastric cancer patients with high ALDH3B1 expressions (P < 0.01). Univariate and Cox multiple regression analyses identified a high expression of ALDH3B1 (P < 0.05, HR= 0.231, 95% CI: 0.064-0.826), CEA≥5 μg/L (P < 0.01, HR=4.478, 95% CI: 1.530-13.110), CA19-9≥37 kU/L (P < 0.01, HR=3.877, 95% CI: 1.625-9.247), T stage of 3-4 (P < 0.01, HR=4.953, 95% CI: 1.768-13.880), and N stage of 2-3 (P < 0.05, HR=2.152, 95% CI: 1.152-4.022) as independent risk factors affecting 5-year survival after radical gastrectomy. The relative ALDH3B1 expression level, at the cut-off point of 4.66, showed a sensitivity of 76.47% and a specificity of 76% for predicting 5-year postoperative death (P < 0.01). In the cell experiment, overexpression of ALDH3B1 obviously promoted the proliferation, migration and invasion of MGC-803 cells.@*CONCLUSION@#As an independent risk factor affecting 5-year survival after radical gastrectomy, ALDH3B1 is highly expressed in gastric cancer and correlated with pathological parameters of the tumor, and a high ALDH3B1 expression may promote proliferation, invasion and metastasis of gastric cancer cells.

Aldehyde Oxidoreductases , CA-19-9 Antigen , Carcinoembryonic Antigen , Gastrectomy , Humans , Neoplasm Staging , Prognosis , Retrospective Studies , Stomach Neoplasms/pathology
Article in Chinese | WPRIM | ID: wpr-941017


OBJECTIVE@#To evaluate the diagnostic value of the serum tumor markers carcinoembryonic antigen (CEA), cytokeratin-19-fragment (CYFRA21-1), squamous cell carcinoma associated antigen (SCCAg), neuron-specificenolase (NSE) and pro-gastrin-releasing peptide (ProGRP) for lung cancers of different pathological types.@*METHODS@#This study was conducted among patients with established diagnoses of lung adenocarcinoma (LADC, n=137), lung squamous cell carcinoma (LSCC, n=82), small cell lung carcinoma (SCLC, n=59), and benign chest disease (BCD, n=102). The serum tumor markers were detected for all the patients for comparison of the positivity rates and their serum levels. ROC curve was used for analysis of the diagnostic efficacy of these tumor markers either alone or in different combinations.@*RESULTS@#In patients with LADC, the positivity rate and serum level of CEA were significantly higher than those in the other groups (P < 0.05); the patients with LSCC had the highest positivity rate and serum level of SCCAg among the 4 groups (P < 0.05). The positivity rates and serum levels of ProGRP and NSE were significantly higher in SCLC group than in the other groups (P < 0.05). CYFRA21-1 showed the highest positivity rate and serum level in LADC group and LSCC group. With the patients with BCD as control, CEA showed a diagnostic sensitivity of 62.8% and a specificity of 93.1% for LADC, and the sensitivity and specificity of SCCAg for diagnosing LSCC were 64.6% and 91.2%, respectively. CYFRA21-1 had the highest diagnostic sensitivity for LADC and LSCC. The diagnostic sensitivity and specificity of ProGRP for SCLC were 83.1% and 98.0%, respectively. When combined, CYFRA21-1 and CEA showed a high sensitivity (78.8%) and specificity (86.3%) for diagnosing LADC with an AUC of 0.891; CYFRA21-1 and SCCAg had a high sensitivity (84.1%) and specificity (87.3%) for diagnosing LSCC with an AUC of 0.912. NSE combined with ProGRP was highly sensitive (88.1%) and specific (98.0%) for diagnosis of SCLC, with an AUC of 0.952. For lung cancers of different pathological types, the combination of all the 5 tumor markers showed no significant differences in the diagnostic power from a combined detection with any two of the markers (P>0.05).@*CONCLUSION@#CEA, CYFRA21-1, SCCAg, NSE and ProGRP are all related to the pathological type of lung cancers and can be used in different combinations as useful diagnostic indicators for lung cancers.

Antigens, Neoplasm , Biomarkers, Tumor , Carcinoembryonic Antigen , Humans , Keratin-19 , Lung Neoplasms/pathology , Peptide Fragments , Peptide Hormones , Recombinant Proteins , Small Cell Lung Carcinoma/diagnosis
Chinese Journal of Oncology ; (12): 402-409, 2022.
Article in Chinese | WPRIM | ID: wpr-935228


Objective: To compare the prognostic evaluation value of preoperative neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and systemic immune-inflammation index (SII) in rectal cancer patients. Nomogram survival prediction model based on inflammatory markers was constructed. Methods: The clinical and survival data of 585 patients with rectal cancer who underwent radical resection in the First Affiliated Hospital of Xi'an Jiao tong University from January 2013 to December 2016 were retrospectively analyzed. The optimal cut-off values of NLR, PLR, LMR, and SII were determined by the receiver operating characteristic (ROC) curve. The relationship between different NLR, PLR, LMR and SII levels and the clinic pathological characteristics of the rectal cancer patients were compared. Cox proportional risk model was used for univariate and multivariate regression analysis. Nomogram prediction models of overall survival (OS) and disease-free survival (DFS) of patients with rectal cancer were established by the R Language software. The internal validation and accuracy of the nomograms were determined by the calculation of concordance index (C-index). Calibration curve was used to evaluate nomograms' efficiency. Results: The optimal cut-off values of preoperative NLR, PLR, LMR and SII of OS for rectal cancer patients were 2.44, 134.88, 4.70 and 354.18, respectively. There was statistically significant difference in tumor differentiation degree between the low NLR group and the high NLR group (P<0.05), and there were statistically significant differences in T stage, N stage, TNM stage, tumor differentiation degree and preoperative carcinoembryonic antigen (CEA) level between the low PLR group and the high PLR group (P<0.05). There was statistically significant difference in tumor differentiation degree between the low LMR group and the high LMR group (P<0.05), and there were statistically significant differences in T stage, N stage, TNM stage, tumor differentiation degree and preoperative CEA level between the low SII group and the high SII group (P<0.05). The multivariate Cox regression analysis showed that the age (HR=2.221, 95%CI: 1.526-3.231), TNM stage (Ⅲ grade: HR=4.425, 95%CI: 1.848-10.596), grade of differentiation (HR=1.630, 95%CI: 1.074-2.474), SII level (HR=2.949, 95%CI: 1.799-4.835), and postoperative chemoradiotherapy (HR=2.123, 95%CI: 1.506-2.992) were independent risk factors for the OS of patients with rectal cancer. The age (HR=2.107, 95%CI: 1.535-2.893), TNM stage (Ⅲ grade, HR=2.850, 95%CI: 1.430-5.680), grade of differentiation (HR=1.681, 95%CI: 1.150-2.457), SII level (HR=2.309, 95%CI: 1.546-3.447), and postoperative chemoradiotherapy (HR=1.837, 95%CI: 1.369-2.464) were independent risk factors of the DFS of patients with rectal cancer. According to the OS and DFS nomograms predict models of rectal cancer patients established by multivariate COX regression analysis, the C-index were 0.786 and 0.746, respectively. The calibration curve of the nomograms showed high consistence of predict and actual curves. Conclusions: Preoperative NLR, PLR, LMR and SII levels are all correlated with the prognosis of rectal cancer patients, and the SII level is an independent prognostic risk factor for patients with rectal cancer. Preoperative SII level can complement with the age, TNM stage, differentiation degree and postoperative adjuvant chemoradiotherapy to accurately predict the prognosis of rectal cancer patients, which can provide reference and help for clinical decision.

Biomarkers, Tumor , Carcinoembryonic Antigen , Humans , Inflammation/classification , Lymphocytes , Neutrophils , Nomograms , Preoperative Period , Prognosis , Rectal Neoplasms/surgery , Retrospective Studies
Chinese Journal of Oncology ; (12): 268-275, 2022.
Article in Chinese | WPRIM | ID: wpr-935210


Objective: To investigate the expression of cortactin in colorectal cancer and its correlation with clinicopathological parameters and prognosis. Methods: The expressions of cortactin in normal colorectal mucosal tissue and colorectal cancer tissue in paraffin-embedded tissue microarray from 319 patients who were diagnosed as colorectal cancer and treated in Cancer Hospital of Chinese Academy of Medical Sciences from 2006 to 2009 was detected by immunohistochemistry. Kaplan-Meier method and Log rank test were used for survival analysis, and Cox proportional risk regression model was used for multivariate analysis. Results: The positive expression rates of cortactin in colorectal cancer tissue and normal colorectal mucosal tissue were 61.1% (195/319) and 5.6% (18/319, P<0.001), respectively. T-stage, N-stage, American Joint Committee on Cancer (AJCC) stage, degree of tumor differentiation, neural invasion and preoperative carcinoembryonic antigen (CEA) levels were associated with the expression of cortactin (P<0.05). The positive expression of cortactin was associated with poorer disease-free survival (P=0.036) and overall survival (P=0.043), and the effect was more significant in patients with stage Ⅱ to Ⅲ. For patients with stage Ⅱ-Ⅲ colorectal cancer, postoperative adjuvant therapy was associated with disease-free survival (P=0.007) and overall survival (P=0.015). The vascular tumor embolus, pathological type, preoperative CEA level and cortactin expression were independent influencing factors for disease-free survival (P<0.05). The age, AJCC stage, preoperative CEA level and cortactin expression were independent influencing factors for overall survival (P<0.05). Preoperative CEA level and cortactin expression were independent influencing factors for disease-free survival and overall survival (P<0.05). Conclusion: Cortactin is expressed in colorectal cancer and in stage Ⅱ-Ⅲ patients, it is a potential predictor of colorectal cancer prognosis.

Biomarkers, Tumor/metabolism , Carcinoembryonic Antigen/metabolism , Colorectal Neoplasms/pathology , Cortactin/metabolism , Humans , Prognosis , Retrospective Studies
Rev. Assoc. Med. Bras. (1992) ; 67(1): 39-44, Jan. 2021. tab, graf
Article in English | LILACS | ID: biblio-1287789


SUMMARY OBJECTIVE: The aim of this retrospective study was to investigate the correlation of transiently elevated postoperative serum cancer antigen 125 levels and prognosis in patients with non-small cell lung cancer. METHODS: A total of 181 non-small cell lung cancer patients with normal levels of preoperative serum cancer antigen 125 were statistically summarized in this study. RESULTS: Out of the analyzed patients, 22 (12.2%) showed elevation of serum cancer antigen 125 within one month after surgery. Serum cancer antigen 125 level decreased to normal at three months postoperation. Serum cancer antigen 125 was positively correlated with pro-brain natriuretic peptide in non-small cell lung cancer postoperative patients (p=0.00035). Univariate analysis did not find significant difference in disease progression survival between those who experienced cancer antigen 125 elevation in the early postoperation and those who did not (p=0.646). CONCLUSIONS: In conclusion, transient elevation of cancer antigen 125 is associated to pro-brain natriuretic peptide increase after pulmonary surgery in non-small cell lung cancer patients.

Humans , Carcinoma, Non-Small-Cell Lung/surgery , Lung Neoplasms/surgery , Prognosis , Carcinoembryonic Antigen , Retrospective Studies , CA-125 Antigen
Rev. méd. Urug ; 37(2): e201, 2021. tab
Article in Spanish | LILACS, BNUY | ID: biblio-1280502


Resumen: Introducción: el antígeno carcinoembrionario (CEA) es un marcador tumoral de seguimiento y no una prueba de tamizaje y diagnóstico en cáncer colorrectal (CCR). Sin embargo, en la práctica clínica habitual se continúa solicitando con fines de diagnóstico inicial. Objetivo: evaluar el rendimiento del CEA para el diagnóstico de CCR en el Hospital Maciel y en la Cooperativa Médica de Florida, en el período 2000-2019. Material y método: se trata de un estudio prospectivo de evaluación del CEA como prueba diagnóstica del CCR. Los criterios de inclusión fueron: 1) videocolonoscopía total en los usuarios sin CCR y videocolonoscopía total o parcial para aquellos con CCR y la confirmación histológica de adenocarcinoma; 2) contar con determinación de CEA dentro de los 30 días previos o posteriores a la videocolonoscopía, y 3) para la estadificación, el informe anatomopatológico de la pieza quirúrgica y la confirmación histológica de metástasis a distancia. El número de casos incluidos se determinó por un mínimo de diez casos en cada celda de la tabla de contingencia. Resultados: se analizaron 211 casos. El análisis general determinó una sensibilidad de 33,6%, especificidad 70,4%, valor predictivo positivo (VPP) 69,1%, valor predictivo negativo (VPN) 35%, exactitud 45,9%. Para el estadio II, sensibilidad 18,8%, especificidad 70,4%, VPP 30%, VPN 56,2%, exactitud 49,5%. Estadio III: sensibilidad 31,6%, especificidad 70,4%, VPP 36,4%, VPN 65,8%, exactitud 56,8%. Estadio IV: sensibilidad 65%, especificidad 70,4%, VPP 55,3%, VPN 78,1%, exactitud 68,4%. Conclusiones: el CEA como prueba de confirmación diagnóstica del CCR muestra un bajo rendimiento, siendo aun menor en estadios precoces de la enfermedad.

Summary: Introduction: carcinoembryonic antigen (CEA) is a tumor marker used for follow up rather than a screening and diagnostic test for colorectal cancer (CCR). However, it continues to be requested in the regular clinical practice for initial diagnosis. Objective: to evaluate the effectiveness of CEA to diagnose colorectal cancer at Maciel Hospital and Cooperativa Medica de Florida Hospital from 2000 to 2019. Method: prospective study to evaluate CEA as a diagnostic test for colorectal cancer. The following inclusion criteria were used: 1) total videocolonoscopy in all users without CLC and total or partial videocolonoscopy for those with CRC and histologic confirmation of adenocarcinoma; 2) CEA determination within 30 days before or after videocolonoscopy and 3) for the purpose of staging, pathology report of the surgical piece and histological confirmation of distant metastases. The number of cases included was defined by a 10-case minimum in each cell of the contingency table. Results: 211 cases were analysed. The general analysis revealed 33.6% sensitivity, 70.4% specificity, VPP 69.1%, VPN 35%, accuracy 45.9%. In the case of staging II, sensitivity was 18.8%, specificity 70.4%, VPP 30%, VPN 56.2%, accuracy 49.5%. In the case of staging III, sensitivity 31.6%, specificity 70.4%, VPP 36.4%, VPN 65.8%, accuracy 56.8%. In the case of staging IV, sensitivity 65%, specificity 70.4%, VPP 55.3%, VPN 78.1%, accuracy 68.4%. Conclusions: CEA evidences low effectiveness to diagnose colorectal cancer, and it is still less effective in early stages of the disease.

Resumo: Introdução: o antígeno carcinogênico embrionário (CEA) é um marcador tumoral de acompanhamento e não um teste de rastreamento e diagnóstico em câncer colorretal (CRC). No entanto, na prática clínica de rotina, continua a ser solicitado nos diagnósticos iniciais. Objetivo: avaliar o desempenho do CEA no diagnóstico de câncer colorretal nos Hospitais Maciel de Montevidéu e da Cooperativa Médica de Florida, no período 2000-2019. Material e método: este é um estudo prospectivo avaliando o CEA como teste diagnóstico para câncer colorretal. Os critérios de inclusão foram: 1) videocolonoscopia total em usuários sem CCR e videocolonoscopia total ou parcial naqueles com CCR e confirmação histológica de adenocarcinoma; 2) determinação do CEA 30 dias antes ou após a videocolonoscopia e 3) estadiamento, laudo anatomopatológico da peça cirúrgica e confirmação histológica de metástases à distância. O número de casos incluídos foi determinado por um mínimo de 10 casos em cada célula da tabela de contingência. Resultados: foram analisados 211 casos. A análise geral determinou uma sensibilidade de 33,6%, especificidade 70,4%, VPP 69,1%, VPN 35%, precisão 45,9%. Para o estágio II, sensibilidade 18,8%, especificidade 70,4%, PPV 30%, NPV 56,2%, precisão 49,5%. Estágio III, sensibilidade 31,6%, especificidade 70,4%, PPV 36,4%, NPV 65,8%, precisão 56,8%. Estágio IV, sensibilidade 65%, especificidade 70,4%, PPV 55,3%, NPV 78,1%, precisão 68,4%. Conclusões: o CEA como teste de confirmação diagnóstica do câncer colorretal apresenta baixo desempenho, sendo ainda menor nos estágios iniciais da doença.

Colorectal Neoplasms/diagnosis , Carcinoembryonic Antigen , Mass Screening
Rev. bras. ginecol. obstet ; 42(9): 555-561, Sept. 2020. tab
Article in English | LILACS | ID: biblio-1137869


Abstract Objective To evaluate the role of clinical features and preoperativemeasurement of cancer antigen 125 (CA125), human epididymis protein(HE4), and carcinoembryonic antigen (CEA) serum levels in women with benign and malignant non-epithelial ovarian tumors. Methods One hundred and nineteen consecutive women with germ cell, sex cordstromal, and ovarian leiomyomas were included in this study. The preoperative levels of biomarkers were measured, and then surgery and histopathological analysis were performed. Information about the treatment and disease recurrence were obtained from the medical files of patients. Results Our sample included 71 women with germ cell tumors (64 benign and 7 malignant), 46 with sex cord-stromal tumors (32 benign and 14 malignant), and 2 with ovarian leiomyomas. Among benign germ cell tumors, 63 were mature teratomas, and, amongmalignant, fourwere immatureteratomas. Themost common tumors in the sex cordstromal group were fibromas (benign) and granulosa cell tumor (malignant). The biomarker serum levels were not different among benign andmalignant non-epithelial ovarian tumors. Fertility-sparing surgeries were performed in 5 (71.4%) women with malignant germ cell tumor. Eleven (78.6%) patients with malignant sex cord-stromal tumors were treated with fertility-sparing surgeries. Five women (71.4%) with germ cell tumors and only 1 (7.1%) with sex cord-stromal tumor were treated with chemotherapy. One woman with germ cell tumor recurred and died of the disease and one woman with sex cord-stromal tumor recurred. Conclusion Non-epithelial ovarian tumors were benign in the majority of cases, and the malignant caseswere diagnosed at initial stages with good prognosis. Themeasurements of CA125, HE4, and CEA serum levels were not useful in the preoperative diagnosis of these tumors.

Resumo Objetivo Avaliar o papel das características clínicas e a medida pré-operatória dos níveis séricos de CA125, HE4, e CEA em mulheres com tumores de ovário não epiteliais benignos e malignos. Métodos Cento e dezenovemulheres consecutivas comtumores ovarianos de células germinativas, do cordão sexual-estroma, e miomas ovarianos foram incluídas neste estudo. Os níveis pré-operatórios dos biomarcadores foram medidos, a cirurgia e a análise histopatológica foram realizadas. Informações sobre tratamento e recorrência da doença foram obtidas dos prontuários médicos das pacientes. Resultados Nossa amostra incluiu 71 mulheres com tumores de células germinativas (64 benignos e 7 malignos), 46 com tumores do cordão sexual-estroma (32 benignos e 14 malignos), e 2 com leiomiomas ovarianos. Entre os tumores benignos de células germinativas, 63 eram teratomas maduros, e, entre os malignos, quatro eram teratomas imaturos. Os tumores mais comuns do grupo do cordão sexual-estroma foram fibromas (benignos) e tumores de células da granulosa (malignos). Os níveis séricos dos biomarcadores não diferiram entre os tumores de ovário não epiteliais benignos e malignos. A cirurgia preservadora de fertilidade foi realizada em 5 (71,4%) mulheres com tumores malignos de células germinativas. Onze (78,6%) mulheres com tumores do cordão sexual-estromamalignos foram tratadas comcirurgia preservadora de fertilidade. Cinco (71,4%)mulheres com células germinativas e apenas 1 (7,1%) com tumor do cordão sexual-estroma foram tratadas com quimioterapia. Uma mulher com tumor de células germinativas recidivou e morreu da doença. Uma mulher com tumor do cordão sexual-estroma recidivou. Conclusão Os tumores de ovário não epiteliais foram benignos namaioria dos casos e os malignos foram diagnosticados em estágios iniciais, com bom prognóstico. A medida dos níveis séricos de CA125, HE4, e CEA não foram úteis no diagnóstico préoperatório desses tumores.

Humans , Female , Adult , Ovarian Neoplasms/surgery , Ovarian Neoplasms/diagnosis , Ovarian Neoplasms/blood , Ovarian Neoplasms/epidemiology , Biomarkers, Tumor/blood , Sex Cord-Gonadal Stromal Tumors/surgery , Sex Cord-Gonadal Stromal Tumors/diagnosis , Sex Cord-Gonadal Stromal Tumors/blood , Sex Cord-Gonadal Stromal Tumors/epidemiology , Neoplasms, Germ Cell and Embryonal/surgery , Neoplasms, Germ Cell and Embryonal/diagnosis , Neoplasms, Germ Cell and Embryonal/blood , Neoplasms, Germ Cell and Embryonal/epidemiology , Carcinoembryonic Antigen/blood , Cross-Sectional Studies , CA-125 Antigen/blood , WAP Four-Disulfide Core Domain Protein 2/analysis , Middle Aged
Rev Assoc Med Bras (1992) ; 66(5): 673-679, 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1136258


SUMMARY OBJECTIVE Analyze the over expression of neural precursor cell expressed developmentally down-regulated protein 9 (NEDD-9) deregulated associated with a poor prognosis in various carcinomas. Our objective was to investigate the relationship between the levels of NEDD-9, CA 15-3, and CEA and PET (SUVmax, MTV40, TLG40) with the clinical parameters of patients with breast cancer (BC). METHODS One hundred and eleven patients (82 BC patients who underwent 18F-FDG PET/CT and 29 healthy controls) were evaluated. SUVmax, MTV, and TLG of the primary tumor were compared with the molecular and histopathological subtypes. 18F-FDG, MTV, and TLG were evaluated based on the clinical data, i.e., nodal involvement, distant metastasis, ER and PR status, Ki-67, serum levels of NEDD-9, CA15-3, and CEA. We compared the NEDD-9 in the BC and healthy control groups. RESULTS The mean ± SD of SUVmax in the 82 patients was 13.0 ± 8.6. A statistically significant relationship (p = 0.022) was found between the molecular subtypes and 18F-FDG uptake. The relationship between 18F-FDG uptake and TLG measured in patients <50 years, ER-PR negativity, and HER2 positivity were statistically significant (p=0.015, 0.007, 0.046, and 0.001, respectively). MTV40, TLG40, and CA 15-3 in metastatic patients were statistically significant (p=0.004, 0.005, and 0.003, respectively). NEDD-9 in the BC group was significantly higher than in the healthy group (p=0.017). There was a positive correlation between SUVmax and Ki67 and CA 15-3; MTV40 and CEA; CA 15-3, CEA, SUVmax, and MTV40; a negative correlation was found between CEA, TLG40, and age. CONCLUSION The use of SUVmax, MTV40, and TLG40 parameters with NEDD-9 and tumor markers has been shown to provide a high diagnostic, predictive, and prognostic value for the management of BC. This is considered to be the basis of interventions focused on the treatment objectives related to NEDD-9.

RESUMO OBJETIVO Analisar a associação da superrexpressão das células NEDD-9 ao prognóstico negativo em vários tipos de carcinoma. Nosso objetivo foi investigar a relação entre os níveis de NEDD-9, CA 15-3 e CEA e PET (SUVmax, MTV40, TLG) e os parâmetros clínicos em pacientes com câncer de mama (CM). MÉTODOS Cento e onze pacientes (82 pacientes de CM submetidos a 18F-FDG PET/TC e 29 controles saudáveis) foram avaliados. SUVmax, MTV, e TLG do tumor primário foram comparados nos subtipos molecular e histopatológico. A captação de 18F-FDG, MTV, e TLG foi avaliada com base em dados clínicos (envolvimento nodal, metástase distante, status de ER e PR, Ki-67, níveis séricos de NEDD-9, CA15-3 e CEA). Foi comparada a NEDD-9 do grupo de CM e o controle saudável. RESULTADOS A média ± DP de SUVmax de 82 pacientes foi de 13,0 ± 8,6. Uma relação estatisticamente significativa (p=0,022) foi encontrada entre subtipos moleculares e captação de 18F-FDG. A relação entre captação de 18F-FDG e TLG medida em pacientes com idade <50 anos, ER-PR negativo e HER2 positivo foi estatisticamente significativa (p=0,015; 0,007; 0,046; e 0,001, respectivamente). MTV40, TLG40 e CA 15-3 em pacientes metastáticos foram estatisticamente significantes (p=0,004, 0,005 e 0,003, respectivamente). NEDD-9 no grupo BC foi significativamente maior do que no grupo saudável (p=0,017). Uma correlação positiva foi encontrada entre SUVmax e Ki67 e CA 15-3; MTV40 e CEA; CA 15-3, CEA, SUVmax e MTV40; uma correlação negativa foi encontrada entre CEA, TLG40 e idade. CONCLUSÃO O uso dos parâmetros SUVmax, MTV40 e TLG40 com NEDD-9 e marcadores tumorais demonstrou um alto valor diagnóstico, preditivo e prognóstico para o manejo do CM. Isso é considerado a base para intervenções focadas nos objetivos de tratamento relacionados às NEDD9.

Humans , Breast Neoplasms/blood , Positron Emission Tomography Computed Tomography , Prognosis , Carcinoembryonic Antigen/blood , Tomography, X-Ray Computed , Retrospective Studies , Mucin-1/blood , Radiopharmaceuticals , Fluorodeoxyglucose F18 , Positron-Emission Tomography , Microtubule-Associated Proteins/blood
J. coloproctol. (Rio J., Impr.) ; 39(3): 203-210, June-Sept. 2019. tab, graf
Article in English | LILACS | ID: biblio-1040319


ABSTRACT Introduction: The presence of lymph node metastasis in colorectal cancer is determinant for prognosis and for treatment planning. The relationship between visceral fat and the prognosis is not fully documented in the literature, so this study intended to evaluate whether there is a relationship between the presence of visceral obesity and the presence of lymph node metastases and the prognosis of patients with colorectal cancer. Materials and methods: A sample of 68 patients who underwent surgery for colorectal cancer at Hospital de Braga between 1/1/2007 and 31/12/2007 was constructed, and their clinical and pathological data were recorded. Visceral fat, subcutaneous, and total fat areas were measured on preoperative computed tomography. Visceral obesity was defined as a ratio of visceral fat to total fat area >0.29. The ratio of metastatic lymph node (; number of metastatic lymph node/number of lymph node examined) was calculated. Results: There was a significant association between visceral obesity and male sex (p = 0.032). Patient survival at 5 and 10 years of follow-up was higher in patients with subcutaneous obesity in both periods, but not significant. There was a significant association between the ratio of metastatic lymph node and survival at 5 and 10 years (p = 0.03 and p = 0.002, respectively), with higher survival when ratio of metastatic lymph node = 0% and worse for ≥ 18%. Conclusion: In this study, no significant association was observed between visceral obesity and the number of metastatic lymph node, nor with survival at 5 and 10 years.

RESUMO Introdução: A presença de metastização ganglionar no câncer colorretal é determinante como fator de prognóstico e para planear o tratamento. A relação entre a presença de gordura visceral e o prognóstico não está totalmente documentada na literatura. Assim, pretende-se avaliar a existência de relação entre obesidade visceral e a presença de metástases ganglionares e o prognóstico de doentes com câncer colorretal. Materiais e métodos: Construiu-se uma amostra de 68 doentes operados por câncer colorretal no Hospital de Braga, entre 1/1/2007 e 31/12/2007, e registaram-se os seus dados clínico-patológicos e de seguimento. As áreas de gordura visceral, gordura subcutânea e gordura total foram medidas na tomografia computorizada pré-operatória. Obesidade visceral foi definida como um razão da gordura visceral relativamente à área total de gordura >0,29. Calculou-se a razão de linfonodos metastizados. Resultados: Verificou-se uma associação significativa entre obesidade visceral e sexo masculino (p = 0,032). A sobrevida dos pacientes, aos 5 e 10 anos de seguimento, foi superior naqueles com obesidade subcutânea em ambos períodos, contudo não significativa. Verificou-se uma associação significativa entre a sobrevivência em função da razão de linfonodos metastizados, aos 5 e 10 anos (p = 0,03 e p = 0,002; respectivamente), com maior sobrevivência quando a razão de linfonodos metastizados = 0% e pior quando ≥ 18%. Conclusão: Neste estudo não se observou uma associação significativa entre a obesidade visceral e o número de linfonodos metastizados nem com a sobrevida aos 5 e 10 anos.

Humans , Male , Female , Prognosis , Colorectal Neoplasms , Obesity, Abdominal , Lymph Nodes , Carcinoembryonic Antigen , Neoplasm Staging
Article in Chinese | WPRIM | ID: wpr-772102


OBJECTIVE@#To study the clinical value of detecting carcinoembryonic antigen levels in pleural effusion (PCEA) and serum (SCEA) and their ratio (P/S) in the differential diagnosis of pleural effusions resulting from tuberculosis and lung cancer.@*METHODS@#This retrospectively study was conducted among 82 patients with pleural effusion caused by pulmonary tuberculous (TB; control group) and 120 patients with pleural effusion resulting from lung cancer in our hospital between April, 2016 and March, 2018. PCEA, SCEA and P/S were compared between the two groups and among the subgroups of lung cancer patients with squamous cell carcinoma (SqCa), adenocarcinoma (ACA), small cell carcinoma (SCLC). The receiveroperating characteristic curve (ROC) analysis was used to confirm the optimal critical value to evaluate the diagnostic efficiency of different combinations of PCEA, SCEA and P/S.@*RESULTS@#PCEA, SCEA and P/S were significantly higher in the overall cancer patients and in all the 3 subgroups of cancer patients than in the patients with TB ( < 0.05). The areas under the ROC curve of PCEA, SCEA and P/S were 0.925, 0.866 and 0.796, respectively; PCEA had the highest diagnostic value, whose diagnostic sensitivity, specificity, accurate rate, and diagnostic threshold were 83.33%, 96.34, 88.61%, and 3.26 ng/ml, respectively; SCEA had the lowest diagnostic performance; the diagnostic performance of P/S was between that of SCEA and PCEA, but its combination with SCEA greatly improved the diagnostic performance and reduced the rates of misdiagnosis and missed diagnosis. Parallel tests showed that the 3 indexes combined had significantly higher diagnostic sensitivity than each or any two of the single indexes ( < 0.05), but the diagnostic specificity did not differ significantly. The area under the ROC curve of combined detections of the 3 indexes was 0.941 for diagnosis of lung cancer-related pleural effusion, higher than those of any other combinations of the indexes.@*CONCLUSIONS@#The combined detection of PCEA, SCEA and P/S has a high sensitivity for diagnosis of lung cancer-related pleural effusion and provides important information for rapid and accurate diagnosis of suspected cases.

Carcinoembryonic Antigen , Blood , Case-Control Studies , Diagnosis, Differential , Humans , Lung Neoplasms , Blood , Pleural Effusion , Blood , Diagnosis , Allergy and Immunology , Pleural Effusion, Malignant , Blood , Chemistry , Diagnosis , ROC Curve , Retrospective Studies , Sensitivity and Specificity , Tuberculosis, Pulmonary
Article in Chinese | WPRIM | ID: wpr-941937


OBJECTIVE@#To evaluate the diagnostic value of 18F-FDG PET/CT and tumor markers (CEA,CA19-9,CA24-2) in detection for recurrence and metastasis of postoperative colorectal moderately differentiated adenocarcinoma.@*METHODS@#Fifty-five patients were enrolled in this study. All of the patients were tested with serum CEA within 2 weeks when they underwent 18F-FDG PET/CT scan, and some patients were tested with serum CA19-9 and CA24-2 simultaneously. According to the pathology and clinical results of their follow-up, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 18F-FDG PET/CT and tumor markers were calculated based on different divided groups, respectively.@*RESULTS@#According to the pathology and the results of their clinical follow-up, the sensitivity of 18F-FDG PET/CT, CEA, CA19-9, CA24-2 and the combination of those three tumor markers were 95.74%, 68.09%, 28.57%, 40.00% and 74.47%, respectively. The specificity of 18F-FDG PET/CT, CEA, CA19-9, CA24-2 and the combination of those three tumor markers were 75.00%, 50.00%, 66.67%, 71.43% and 50.00%, respectively. The positive predictive valueof 18F-FDG PET/CT, CEA, CA19-9, CA24-2 and the combination of those three tumor markers were 95.74%, 88.89%, 85.71%, 88.89% and 89.74%, respectively. The negative predictive value of 18F-FDG PET/CT, CEA, CA19-9, CA24-2 and the combination of those three tumor markers were 75.00%, 26.67%, 11.42%, 17.24%, 25.00%, respectively. The accuracy of 18F-FDG PET/CT, CEA, CA19-9, CA24-2 and the combination of those three tumor markers were 92.73%, 65.47%, 32.65%, 44.68% and 70.91%, respectively. There were 2 cases of false positive and 2 cases of false negative in 18F-FDG PET/CT.@*CONCLUSION@#18F-FDG PET/CT has high value in detecting recurrence and metastasis of postoperative colorectal carcinoma. Tumor markers have the positive value to imply the recurrence and metastasis of postoperative colorectal carcinoma and are useful to indicate when to perform the 18F-FDG PET/CT. The combination of tumor markers could improve the diagnostic efficiency to some extent.

Adenocarcinoma/diagnosis , Biomarkers, Tumor , CA-19-9 Antigen , Carcinoembryonic Antigen , Colorectal Neoplasms/diagnosis , Fluorodeoxyglucose F18 , Humans , Neoplasm Recurrence, Local , Positron Emission Tomography Computed Tomography , Positron-Emission Tomography , Recurrence
Laboratory Medicine Online ; : 146-152, 2019.
Article in English | WPRIM | ID: wpr-760502


BACKGROUND: Although routine screening of carcinoembryonic antigen (CEA) is not recommended for the early diagnosis of colorectal cancers, CEA levels are frequently measured in practice and during opportunistic health screening programs. We evaluated the frequency of false-positive results according to CEA level at a health screening center. METHODS: The medical records of 25,786 participants who underwent a general health check-up and CEA testing at the Seoul National University Hospital Healthcare System Gangnam Center from March 2015 to February 2016 were reviewed. CEA levels were measured using the Architect i2000sr (Abbott Laboratories, USA). The cut-off level for elevated CEA was 5.0 ng/mL. RESULTS: Among 25,786 participants who underwent CEA screening, 597 (2.3%) had CEA levels >5.0 ng/mL. Among 597 participants with elevated CEA levels, 12 (2.0%) had actual malignancies with CEA levels of 8.3–155.3 ng/mL. Diabetes, smoking, chronic obstructive pulmonary disease, and colonic polyps were considered as causes of false elevation. The false-positive rates of CEA according to level were as follows: 5.1–10.0 ng/mL, 99.5%; 10.1–15.0 ng/mL, 87.2%; 15.1–20.0 ng/mL, 100.0%; >20.0 ng/mL, 33.3%. A subsequent decrease in the CEA level after a 1-month follow-up was observed in 47.6% of all cases with elevated CEA levels. CONCLUSIONS: False elevation in CEA levels in the range of 5.0–20.0 ng/mL is common in patients who underwent testing at a health screening center. False-positive results above 20.0 ng/mL are less common. These data could provide a guide for the interpretation of elevated CEA level at a health screening center.

Biomarkers , Carcinoembryonic Antigen , Colonic Polyps , Colorectal Neoplasms , Delivery of Health Care , Early Diagnosis , Follow-Up Studies , Humans , Mass Screening , Medical Records , Pulmonary Disease, Chronic Obstructive , Seoul , Smoke , Smoking
Journal of Gastric Cancer ; : 301-314, 2019.
Article in English | WPRIM | ID: wpr-764499


PURPOSE: Peritoneal carcinomatosis in gastric cancer (GC) patients results in extremely poor prognosis. Malignant ascites samples are the most appropriate biological material to use to evaluate biomarkers for peritoneal carcinomatosis. This study identified exosomal MicroRNAs (miRNAs) differently expressed between benign liver cirrhosis-associated ascites (LC-ascites) and malignant gastric cancer-associated ascites (GC-ascites), and validated their role as diagnostic biomarkers for GC-ascites. MATERIALS AND METHODS: Total RNA was extracted from exosomes isolated from 165 ascites samples (73 LC-ascites and 92 GC-ascites). Initially, microarrays were used to screen the expression levels of 2,006 miRNAs in the discovery cohort (n=22). Subsequently, quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) analyses were performed to validate the expression levels of selected exosomal miRNAs in the training (n=70) and validation (n=73) cohorts. Furthermore, carcinoembryonic antigen (CEA) levels were determined in ascites samples. RESULTS: The miR-574-3p, miR-181b-5p, miR-4481, and miR-181d were significantly downregulated in the GC-ascites samples compared to the LC-ascites samples, and miR-181b-5p showed the best diagnostic performance for GC-ascites (area under the curve [AUC]=0.798 and 0.846 for the training and validation cohorts, respectively). The diagnostic performance of CEA for GC-ascites was improved by the combined analysis of miR-181b-5p and CEA (AUC=0.981 and 0.946 for the training and validation cohorts, respectively). CONCLUSIONS: We identified exosomal miRNAs capable of distinguishing between non-malignant and GC-ascites, showing that the combined use of miR-181b-5p and CEA could improve diagnosis.

Ascites , Biomarkers , Carcinoembryonic Antigen , Carcinoma , Cohort Studies , Diagnosis , Down-Regulation , Exosomes , Humans , Liver , MicroRNAs , Prognosis , RNA , Stomach Neoplasms
Journal of Gastric Cancer ; : 173-182, 2019.
Article in English | WPRIM | ID: wpr-764489


PURPOSE: Intraoperative peritoneal washing cytology (PWC) is used to determine treatment strategies for gastric cancer with suspected serosal invasion. However, a standard staining method for intraoperative PWC remains to be established. We evaluated the feasibility of a rapid and simple staining method using Shorr's stain for intraoperative PWC in advanced gastric cancer. MATERIALS AND METHODS: Between November 2012 and December 2014, 77 patients with clinical T3 or higher gastric cancer were enrolled. The sensitivity, specificity, and concordance between the Shorr staining method and conventional Papanicolaou (Pap) staining with carcinoembryonic antigen (CEA) immunohistochemistry (IHC) were analyzed. RESULTS: Intraoperative PWC was performed laparoscopically in 69 patients (89.6%). The average time of the procedure was 8.3 minutes, and the average amount of aspirated fluids was 83.3 mL. The average time for Shorr staining and pathologic review was 21.0 minutes. Of the 77 patients, 16 (20.7%) had positive cytology and 7 (9.1%) showed atypical findings; sensitivity and specificity were 73.6% and 98.2% for the Shorr method, and 78.9% and 98.2% for the Pap method with CEA IHC, respectively. Concordance of diagnosis between the 2 methods was observed in 90.9% of cases (weighted κ statistic=0.875) and most disagreements in diagnoses occurred in atypical findings (6/7). In overall survival, there was no significant difference in C-index between the 2 methods (0.459 in Shorr method vs. 0.458 in Pap with CEA IHC method, P=0.987). CONCLUSIONS: Shorr staining could be a rapid and reliable method for intraoperative PWC in advanced gastric cancer.

Carcinoembryonic Antigen , Diagnosis , Humans , Immunohistochemistry , Laparoscopy , Methods , Pilot Projects , Sensitivity and Specificity , Stomach Neoplasms
Clinical Endoscopy ; : 168-174, 2019.
Article in English | WPRIM | ID: wpr-763412


BACKGROUND/AIMS: Pathological diagnosis of biliary strictures with atypical or suspicious cells on endoscopic retrograde brush cytology and indeterminate strictures on imaging is challenging. The aim of this study was to identify markers for malignant strictures in such cases. METHODS: We retrospectively analyzed data collected from 146 consecutive patients with indeterminate biliary strictures on imaging who underwent endoscopic retrograde brush cytology from 2007 to 2013. Factors associated with malignant strictures in patients with atypical or suspicious cells on brush cytology were identified. RESULTS: Among the 67 patients with a malignant disease (48 cholangiocarcinoma, 6 gallbladder cancer, 5 pancreatic cancer, 5 ampulla of Vater cancer, and 3 other types), 36 (53.7%) had atypical or suspicious cells on brush cytology. Among these, the factors that independently correlated with malignant strictures were stricture length (odds ratio [OR], 5.259; 95% confidence interval [CI], 1.802– 15.294) and elevated carbohydrate antigen 19-9 (CA19-9) (OR, 3.492; 95% CI, 1.242–9.815), carcinoembryonic antigen (CEA) (OR, 4.909; 95% CI, 1.694–14.224), alkaline phosphatase (ALP) (OR, 3.362; 95% CI, 1.207–9.361), and gamma-glutamyl transpeptidase (rGT) (OR, 4.318; 95% CI, 1.512–12.262). CONCLUSIONS: Elevated levels of CA19-9, CEA, ALP, and rGT and stricture length are associated with malignant strictures in patients with indeterminate biliary strictures on imaging and atypical or suspicious cells on brush cytology.

Alkaline Phosphatase , Ampulla of Vater , Carcinoembryonic Antigen , Cholangiocarcinoma , Constriction, Pathologic , Diagnosis , Gallbladder Neoplasms , gamma-Glutamyltransferase , Humans , Pancreatic Neoplasms , Retrospective Studies
Article in English | WPRIM | ID: wpr-739575


PURPOSE: The predictive role of obesity on pathologic complete response (pCR) after neoadjuvant chemoradiation (nCRT) in rectal cancer remains controversial. This study aimed to evaluate the association between obesity and pathologic response in patients with rectal cancer following nCRT. METHODS: A total of 320 patients with primary rectal cancer who underwent curative resection after nCRT between January 2010 and September 2014 were enrolled in this study. Obesity was defined as body mass index of ≥25 kg/m2. Clinicopathologic characteristics were analyzed to identify independent predictive factors for pCR. RESULTS: Among the included patients, 23.4% (n = 75) were obese, and 14.7% (n = 47) showed pCR. Baseline characteristics were generally similar between obese and nonobese patients, except that women (P = 0.001) and cT2 tumors (P = 0.001) were more common in the obese group. Multivariate logistic regression analysis revealed that obesity (odds ratio [OR] = 2.051; 95% confidence interval [CI], 1.009–4.168), cT2 (OR, 3.614; 95% CI, 1.166–11.202), and pretreatment carcinoembryonic antigen <5 ng/mL (OR, 2.921; 95% CI, 1.365–6.253) were independent predictors for pCR. Obesity was not associated with disease-free survival or local recurrence-free survival. CONCLUSION: Obesity was an independent predictive factor for pCR following nCRT in rectal cancer, but was not associated with recurrence. Further studies are needed to clarify the association between obesity and prognosis of rectal cancer after nCRT.

Body Mass Index , Carcinoembryonic Antigen , Disease-Free Survival , Female , Humans , Logistic Models , Obesity , Polymerase Chain Reaction , Prognosis , Rectal Neoplasms , Recurrence
Article in English | WPRIM | ID: wpr-766024


Despite anatomical proximity, prostatic adenocarcinoma with rectal invasion is extremely rare. We present a case of rectal invasion by prostatic adenocarcinoma that was initially diagnosed from a rectal polyp biopsied on colonoscopy in a 69-year-old Korean man. He presented with dull anal pain and voiding discomfort for several days. Computed tomography revealed either prostatic adenocarcinoma with rectal invasion or rectal adenocarcinoma with prostatic invasion. His tumor marker profile showed normal prostate specific antigen (PSA) level and significantly elevated carcinoembryonic antigen level. Colonoscopy was performed, and a specimen was obtained from a round, 1.5 cm, sessile polyp that was 1.5 cm above the anal verge. Microscopically, glandular tumor structures infiltrated into the rectal mucosa and submucosa. Immunohistochemically, the tumor cells showed alpha-methylacyl-CoA-racemase positivity, PSA positivity, and caudal-related homeobox 2 negativity. The final diagnosis of the rectal polyp was consistent with prostatic adenocarcinoma. Here, we present a rare case that could have been misdiagnosed as rectal adenocarcinoma.

Adenocarcinoma , Aged , Carcinoembryonic Antigen , Colonoscopy , Diagnosis , Genes, Homeobox , Humans , Mucous Membrane , Polyps , Prostate-Specific Antigen , Rectum
Article in Chinese | WPRIM | ID: wpr-772335


BACKGROUND@#Mathematical predictive model is an effective method for preliminarily identifying the malignant pulmonary nodules. As the epidemiological trend of lung cancer changes, the detection rate of ground-glass-opacity (GGO) like early stage lung cancer is increasing rapidly, timely and proper clinical management can effectively improve the patients' prognosis. Our study aims to establish a novel predictive model of malignancy for non-solid pulmonary nodules, which would provide an objective evidence for invasive procedure and avoid unnecessary operation and the consequences.@*METHODS@#We retrospectively analyzed the basic demographics, serum tumor markers and imaging features of 362 cases of non-solid pulmonary nodule from January 2013 to April 2018. All nodules received biopsy or surgical resection, and got pathological diagnosis. Cases were randomly divided into two groups. The modeling group was used for univariate analysis and logistic regression to determine independent risk factors and establish the predictive model. Data of the validation group was used to validate the predictive value and make a comparison with other models.@*RESULTS@#Of the 362 cases with non-solid pulmonary nodule, 313 (86.5%) cases were diagnosed as AAH/AIS, MIA or invasive adenocarcinoma, 49 cases were diagnosed as benign lesions. Age, serum tumor markers CEA and Cyfra21-1, consolidation tumor ratio value, lobulation and calcification were identified as independent risk factors. The AUC value of the ROC curve was 0.894, the predictive sensitivity and specificity were 87.6%, 69.7%, the positive and negative predictive value were 94.8%, 46.9%. The validated predictive value is significantly better than that of the VA, Brock and GMUFH models.@*CONCLUSIONS@#Proved with high predictive sensitivity and positive predictive value, this novel model could help enable preliminarily screening of "high-risk" non-solid pulmonary nodules before biopsy or surgical excision, and minimize unnecessary invasive procedure. This model achieved preferable predictive value, might have great potential for clinical application.

Adenocarcinoma , Blood , Diagnosis , General Surgery , Adult , Aged , Biomarkers, Tumor , Blood , Carcinoembryonic Antigen , Blood , Female , Humans , Logistic Models , Lung Neoplasms , Blood , Diagnosis , General Surgery , Male , Middle Aged , Models, Theoretical , Multiple Pulmonary Nodules , Blood , Diagnosis , General Surgery , Prognosis , ROC Curve , Retrospective Studies