A new radioimmunoassay detecting early stages of colon cancer: a comparison with CEA, AFP, and Ca 19-9.

A previous study reported the results of a radioimmunoassay that analysed immune complexes (IC) with a specific labeled polyclonal antibody for the detection of the early stages of colon cancer. In order to investigate further the possible clinical use of this assay, a blind study that screened 505 patients referred for colonoscopy, compared their pathology reports with the results of four assays that measure levels of circulating tumor markers. These were CEA, AFP, Ca 19-9, and our previously described radioimmunoassay (RIA). Of the patients with no malignancies, the results that were in the normal range were as follows: CEA-473/495 (95.6 per cent), Ca 19-9-486/495 (98.2 per cent) and our RIA-488/495 (98.6 per cent). AFP levels were in the normal range for all patients in the study. The only assay to identify any Dukes' C and D patients was Ca 19-9, which detected 2/3 (67 per cent). Of the patients with Dukes' A and B colon cancer, CEA only identified 1/7 (14 per cent), AFP and Ca 19-9 0/7 (0 per cent), and our own RIA 5/7 (71 per cent). The positive results of our assay were significantly different from those of the other three assays with p values all less than 0.05. These preliminary results suggest that this RIA, because of its ability to detect the early stages of colon cancer, may be an effective complement to the currently available assays. The combination may provide a more comprehensive evaluation in monitoring colon cancer.

Radiologic findings in hemorrhagic colitis due to Escherichia coli O157:H7.

Hemorrhagic colitis due to Escherichia coli O157:H7 is a distinct clinical entity characterized by abdominal pain, watery diarrhea progressing to bloody diarrhea, and little or no fever. It has been reported to have a mortality as high as 31%. This form of colitis is not described in the radiologic literature. This paper describes the radiographic findings, and stresses the need for radiologists to be familiar with the disease in order to assist in early diagnosis. Key clinical and epidemiological features are reviewed.

Granulocytopenia complicating colchicine therapy for primary biliary cirrhosis.

A case is presented of a 76-yr-old woman with primary biliary cirrhosis and adult polycystic liver disease who developed bone marrow toxicity associated with chronic low-dose colchicine therapy. Two months after starting colchicine therapy (0.6 mg b.i.d. p.o.), the patient developed hematologic toxicity as evidenced by transient but profound granulocytopenia which promptly reversed 4 days after the drug was stopped. Bone marrow examination revealed moderate hypocellularity of all cell lines and striking dysplastic changes in the late myeloid and erythroid series. There was no apparent toxicity involving other organ systems. The patient fully recovered. This case is compared with previous descriptions of colchicine toxicity.