ABSTRACT
Colorectal cancer is one of the most frequent malignant neoplasms which affects humans. Last year studies indicate a constantly increasing inception rate. Multidisciplinary teams direct all their efforts towards detection of cancer in it's asymptomatic phase. In parallel with development of diagnostic imaging is development of clinical immunodiagnostics. The last allows for quantitative determination of active neoplasmic process markers. In the following article authors show the most frequent markers used in immunodiagnostic. Colorectal cancer known as "tumor burden markers CEA, CA 19-9 as well as the "new one" tissue polypeptide specific antigen proliferation marker--TPS.
Subject(s)
Antigens, Tumor-Associated, Carbohydrate/metabolism , Carcinoembryonic Antigen/metabolism , Colorectal Neoplasms/diagnosis , Colorectal Neoplasms/metabolism , Keratin-18/metabolism , Humans , Immunologic Tests , Peptides/metabolism , PrognosisABSTRACT
BACKGROUND: The aim of this study is to diagnose the evaluation of concentration of CEA and TPS in postoperative monitoring of patients with colorectal cancer. PATIENTS AND METHODS: We measured 178 consecutive patients with histopathologically confirmed colorectal cancer: 101 men and 78 women ages 22-86 (average age 54.7). Markers' CEA nad TPS concentration were evaluated before operation and every month after operation during the first 3 months and then every 3 months during 2 years. Relapse was detected in 47 patients. RESULTS: In postoperative period in non-relapse group the mean (the average) concentration of CEA was 1.92+/-2.03 ng/ml and TPS 65.54+/-33.96 U/l and respectively in relapse group for CEA was 1.92+/-2.03 ng/ml and for TPS 65.54+/-33.96 U/l. The obtained results in investigated group show significantly statistical. The relapse was confirmed by using CEA concentration in 42 patients (89.4%). In case of TPS concentration relapse was confirmed in 38 patients (80.85%). The relapse was detected in 45 patients (95.74) if increase in CEA or TPS concentration was treated as a way of detecting relapse. TPS markers point out that the increase of TPS concentartion may be ahead of relapse symptoms at about 2-6 months. CONCLUSIONS: TPS is a useful marker in postoperative monitoring of patients with colorectal cancer. The evaluation of TPS concentration allow to diagnose the recurrence of colorectal cancer earlier than by using burden markers--CEA. Common evaluation of TPS and CEA increase sensitivity in detection of relapse in patients with colorectal cancer.
Subject(s)
Biomarkers, Tumor/blood , Carcinoembryonic Antigen/blood , Colorectal Neoplasms/blood , Keratins/blood , Monitoring, Immunologic , Adult , Aged , Aged, 80 and over , Female , Follow-Up Studies , Humans , Male , Middle Aged , Predictive Value of Tests , Recurrence , Sensitivity and SpecificityABSTRACT
Chronic anal fissure is one of the most common anus diseases. The main ailments reported by the sick are: stubborn pain connected with defecation and bleeding. Etiopathogenesis of this disease has not been exactly explained yet. The most important factors are anodermal blood flow disturbances and excessive cramp of internal anal sphincter (IAS). Lateral sphincterotomy is the main way of treatment. However, a very dangerous complication as a stool incontinence may occur. As far as a pharmacological treatment is concerned, nitric oxide donors, calcium channel antagonist and botulinum toxin have been used. In some patients threatened with stool incontinence botulinum toxin may be used as an alternative way of treatment right after surgical treatment. Other ways of conservative treatment seem to be less effective due to the side effects and the frequency of repeating doses. The view on the etiopathogenesis of anal fissure, the ways of surgical treatment and the mechanism of activity of drugs used in the conservative treatment are presented in this paper.
