False-positive eluate reactivity due to the low-ionic wash solution used with commercial acid-elution kits.

BACKGROUND: During the use of commercial red cell (RBC) acid-elution kits for adsorption and elution (adsorption/elution) studies with anti-D, unexpected reactive eluates (anti-D) were obtained from D- RBCs. Such results were not obtained with a parallel xylene method or, historically, with heat and ether methods. STUDY DESIGN AND METHODS: Single-donor and commercial polyclonal anti-D samples were incubated with D+ and D- RBCs. Acid eluates were prepared by the manufacturers' directions. Variations in the wash step of the eluate preparation included the use of commercial kit wash solution versus phosphate-buffered saline versus solutions of various ionic strengths. RESULTS: Anti-D was eluted from 20 of 22 samples of D- RBCs after incubation with commercial polyclonal anti-D (titer 512) and from 2 of 3 samples of D- RBCs incubated with single-donor anti-D (titer 256). With a low-titer (16) single-donor anti-D, 0 of 4 eluates from D- RBCs reacted. When phosphate-buffered saline was substituted for the commercial wash solution, 0 of 11 D- RBC eluates reacted, as compared with 9 of 11 D- RBCs that yielded positive 1+(-)2+ eluates with the commercial wash solution. If the recommended initial phosphate-buffered saline wash was omitted before the use of the commercial wash solution, the eluate reactivity was stronger (2+(-)3+). When low-ionic-strength (< 0.03 M) saline was substituted, anti-D was eluted from D- RBCs. All last washes were nonreactive. Antiglobulin tests on all adsorbing D- were negative. CONCLUSION: Commercial wash solutions used for acid elution are at low ionic strength and commonly yield superior eluates, but in the presence of high-titer antibodies, false-positive eluates can result. It is our belief that the low-ionic-strength wash solution caused aggregation of IgG and nonspecific attachment of IgG on RBCs. Aggregates will contain IgG serum antibodies in proportion to the titer of the antibody. It is this nonspecifically bound antibody that is eluted from antigen-negative RBCs.

Pretreatment values of serum CA 15-3 antigen related to prognostic factors in breast cancer patients.

In the present study results of serum CA 15-3 immunoassay obtained at diagnosis in 231 breast cancer women (average age: 54.6, range: 27-87 years) were correlated with prognostic factors of the disease; the cut-off level was established at 30.0 U/ ml. As a result, elevated mean values of serum CA 15-3 as well as positivity rates of the test were significantly associated with more advanced stage of breast cancer, presence of distant metastases, involvement of four and more axillary lymph nodes, high BLOOM and RICHARDSON grade [3], low contents of estrogen (ER) and progesterone (PgR) receptors. Although serum CA 15-3 concentrations should be paralleled the increasing tumor size, the difference being significant only for the proportion of positive results. Our findings suggest that pretreatment levels of CA 15-3 antigen represent the breast cancer extent and reflect the cell differentiation and aggressiveness of the tumor. We conclude that pretreatment concentrations of CA 15-3 antigen may be useful as a prognostic factor in breast cancer patients.

[Level of CA 15-3 antigen--a prognostic factor in patients with breast cancer?]. / Stezenie antygenu CA 15-3--czynnik rokowniczy u chorych na raka sutka?

Serum CA 15-3 concentrations were determined using sandwich enzyme immunoassay in 430 women: 214 breast cancer patients prior to any therapy, 161 patients with benign breast diseases, and 55 healthy controls; the cut-off limit was established at 30.0 U/ml. In breast cancer patients, CA 15-3 levels positively correlated with negative prognostic factors: higher tumor size (p < 0.001), positive axillary lymph nodes (p < 0.02), high histological grade (p < 0.01), low contents of estrogen (p < 0.05) and progesterone (p < 0.006) receptors. However serum CA 15-3 values raised in parallel with clinical stage of breast cancer, the difference was not significant. The overall diagnostic sensitivity and specificity of the test were 24.3% and 94.9%, respectively. The mean serum CA 15-3 values and the percentage of positive results in breast cancer patients were significantly higher as compared to benign breast diseases group (27.52 +/- 27.01 vs. 16.75 +/- 8.43, p < 0.001; 24.3% vs. 5.6%, p < 0.001, respectively) as well as to healthy controls (27.52 27.01 vs. 13.37 +/- 6.51, p < 0.001; 24.3% vs. 3.6%, p < 0.01, respectively). The sensitivity of the CA 15-3 test is low and thus not suitable for the differential diagnosis of breast lumps. Our data suggest potential prognostic value of pretreatment CA 15-3 assays in breast cancer patients.

p53 expression in breast cancer related to prognostic factors.

In this article the results of molecular marker p53 examinations were presented in relation to the following established breast cancer prognostic factors: age, histologic type, histologic grade, lymph node involvement, tumor size as well as estrogen a progesterone receptor status. Twenty one percent of these primary breast cancer specimens exhibited the overexpression of p53 protein. Significant associations were found between p53 overexpression and younger age, high histologic grade and low content of estrogen and progesterone receptors. Identification of p53-positive breast carcinomas potentially represents a clinically useful indicator of breast cancer aggressiveness.

2-Chloro-2'-deoxyadenosine (2-CdA) treatment in a patient with Waldenström's macroglobulinaemia complicated by severe neutrocytopenia.

A 68-year-old male patient with newly diagnosed Waldenström's macroglobulinaemia complicated by severe neutrocytopenia at presentation of the disease was treated with 2-CdA. Partial remission with an increase in neutrocyte count was achieved.

Evaluation of CA 15-3 tumor marker in the diagnosis of breast cancer. A pilot study.

Single determinations of serum CA 15-3 levels were performed by sandwich enzyme immunoassay in 160 women: 77 patients with nonmalignant breast tumors (64 had fibrocystic disease, 11 had fibroadenoma, 2 had intraductal papilloma) and 83 patients with primary breast cancer prior to any treatment; the cut-off limit was established at 30 U/ml. The overall diagnostic sensitivity and specificity of the CA 15-3 test was 19.3% and 94.8%, respectively. The positive and negative predictive values were 80.0% and 52.1%. The mean CA 15-3 value was significantly lower in patients with benign breast tumors as compared with the breast cancer group: 16.8 +/- 8.2 vs. 23.9 +/- 20.9 U/ml (p < 0.01) as well as the percentage of positive results of the test: 5.2% vs. 19.3% (p < 0.02). Serum CA 15-3 level in breast cancer patients correlated with: (1) clinical stage: a higher percentage of positive results was observed in patients with more advanced cancer: Stage I-0%, Stage II-10.6%, Stage III-29.6%, and Stage IV-100.0% according to UICC classification; the comparison of breast cancer patients with early stage of disease (I+II) and those with more advanced cancer (III+IV) revealed statistically significant (p < 0.01) difference in the mean serum CA 15-3 value (19.7 +/- 12.8 vs. 31.5 +/- 29.2 U/ml) as well as in the percentage of positive results (9.4% vs. 36.7%, p < 0.01); (2) the histological grading according to Bloom and Richardson: 5.41% of positivity was observed in low and intermediate grade cancers (I+II) vs. 66.7% in grade III (p < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

[Level of estrogen receptors (ER) as a function of histological malignancy stages of tumors in patients with breast neoplasm]. / Poziom receptorów estrogenowych (ER) jako funkcja stopnia zlosliwosci histologicznej nowotworu u chorych na raka sutka.

The presence of estrogen receptors (ER) has been studied in 70 patients with primary operable breast cancer. The tumors were graded histologically according to Bloom and Richardson criteria. A significant correlation was found between these two prognostic factors: the better--differentiated tumors (I + II histological grade) had significantly higher level of ER than that in the poor--differentiated tumors. Estrogen receptor content of primary breast cancer as a function of tumor grade can be useful in selection of the most efficient treatment modalities for individual patients.

[Evaluation of erythropoiesis under the influence of recombinant human erythropoietin (R-EPO) in dialyzed patients]. / Ocena odnowy ukladu czerwonokrwinkowego pod wplywem rekombinowanej erytropoetyny (r-Epo) u pacjentów dializowanych.

5 deeply anemic (Hb less than 8 g/dl, Ht less than 25%) dialyzed patients with chronic renal failure were treated during four months with r-Epo. Blood cells morphological parameters were estimated using hematological autoanalyser Technicon H1. Satisfactory increase of the Hb levels and RBC counts were observed in 4 patients, in one the improvement was insignificant. We observed three types of response to r-Epo treatment: 1) macrocytic type, 2) hypochromic type, and 3) non-hypochromic type, without lasting macrocytosis. Our results suggest that type of erythropoiesis depends on other active biological substances (iron, folic acid, vit. B12) necessary for correcting erythropoiesis. r-Epo administration appeared to be a safe and effective method of anaemia treatment in dialyzed patients. Its administration eliminated blood transfusion for six months.