TPS and CA 19-9 measurements in the follow-up of patients with pancreatic cancer and chronic pancreatitis.

The aim of this study was to assess the value of TPS and CA 19-9 in a long-term follow-up analysis of 11 patients with chronic pancreatitis (CP) and 15 patients with pancreatic cancer (PC). In all monitored patients with chronic pancreatitis the initial TPS level was below 200 U/L, whereas CA 19-9 was elevated in two of them. In one patient a dramatic increase in the TPS concentration (820 U/L) was measured at the last follow-up visit (after 8.6 months), which led to the detection of PC. In all patients with PC the preoperative TPS level exceeded 200 U/L, whereas CA 19-9 was elevated in only nine patients. After the Kausch-Whipple operation 11 patients showed no evidence of disease and in eight of these patients both TPS and CA 19-9 were within the reference range; however, in three patients liver metastases were detected after 8-24 months from the last tumor marker measurement. In four of the 15 patients both markers were elevated at the end of the follow-up period and distant metastases were clinically confirmed. Our results indicate that in patients with CP and PC undergoing long-term follow-up, TPS reflects the clinical status of patients more accurately than CA 19-9.

Tissue polypeptide specific antigen (TPS), a marker for differentiation between pancreatic carcinoma and chronic pancreatitis. A comparative study with CA 19-9.

BACKGROUND: The value of serum tissue polypeptide specific antigen (TPS) as a complement to CA 19-9 in the detection of pancreatic carcinoma was determined prospectively. TPS and CA 19-9 levels obtained at the time of diagnosis in patients suspected of having chronic pancreatitis or pancreatic carcinoma were evaluated in receiver operating characteristic (ROC) curve analysis. METHODS: Serum TPS and CA 19-9 levels were measured by immunoassays in 122 subjects, 48 with pancreatic carcinoma and 74 with chronic pancreatitis. RESULTS: Elevated levels of CA 19-9 were detected preoperatively in 70% of pancreatic carcinoma patients and in 19% of chronic pancreatitis patients. Elevated levels of TPS were detected in 100% of patients with pancreatic carcinoma and in 22% of patients with chronic pancreatitis. The median levels of TPS and CA 19-9 for pancreatic carcinoma were significantly higher than those for chronic pancreatitis (P < 0.0001). Increasing the upper reference value of TPS allowed for better discrimination between chronic pancreatitis and pancreatic carcinoma. ROC curve analysis showed that the introduction of 200 U/L as a decision criterion for TPS did not reduce its sensitivity but significantly improved its specificity. At a specificity of 98% for TPS, discrimination between pancreatic carcinoma and chronic pancreatitis was found to be 97%. Increasing the upper reference level for CA 19-9 to attain a specificity of 98% decreased its sensitivity from 70% to 33%. CONCLUSIONS: At an elevated cut-off level for TPS (200 U/L), almost complete discrimination between pancreatic carcinoma and chronic pancreatitis was obtained. TPS will be more useful than CA 19-9 in the differential diagnosis of pancreatic carcinoma and chronic pancreatitis.

Lymphocyte subsets in patients with lung cancer treated with thiophosphoric acid alkaloid derivatives from Chelidonium majus L. (Ukrain).

Lymphocyte subsets were evaluated in nine men (aged 42-68 years, mean 57 years) with histologically proven lung cancer, previously untreated. Lymphocyte subpopulations were quantified by immunofluorescence using monoclonal antibodies against total T-cells, T-helper and T-suppressor cells. In addition, the percentage of NK cells and the helper/suppressor (H/S) ratio were evaluated. The number of B-cells was determined by surface immunoglobulin immunofluorescence. Chelidonium majus L. (preparation Ukrain) was applied as an intravenous injection every three days. One course consisted of 10 applications of 10 mg each. All immunological tests were performed before and after drug administration. The treatment was generally well tolerated. The results showed an increase in the proportion of total T-cells, and a significant decrease in the percentage of T-suppressor cells. The normalization of the H/S ratio was also noted. However, there were no signs of activation of NK, T-helper and B-cells. The restoration of cellular immunity was accompanied by an improvement in the clinical course of the disease. This effect was particularly pronounced in patients who responded to further chemotherapy. Objective tumour regression (CR+PR) was seen in 44.4% of treated patients. Four out of nine patients (44.4%) died of progressive disease during the course of this study. It is concluded that Ukrain can be immunologically effective in lung cancer patients and can improve human cellular response.

[Immunophenotypic characteristics of the epithelial cells of ovarian neoplasms]. / Immunofenotypowa charakterystyka komórek nablonkowych nowotworów jajnika.

Paper presents the progress in antigenic characterization of different histological types of ovarian carcinomas. The role of monoclonal antibodies is pointed out. Clinical significance of tumor-associated antigens and problems of tumor cell heterogeneity for immunological studies are also reviewed.

Prognostic significance of secondary cytogenetic changes and nonspecific cross-reacting antigen (NCA) in patients with Ph-positive chronic myeloid leukemia.

Cytogenetic analyses were carried out on peripheral blood and bone marrow cells of 31 chronic myeloid leukemia (CML) patients who presented with blastic, accelerated, or chronic phases. The percentage of cytoplasmic nonspecific cross-reacting antigen (cNCA, a marker of myelocytic differentiation)-containing cells was determined in the same blood or bone marrow samples. The patients were divided in two groups according to cytogenetic results: those with aberrations in addition to the Philadelphia chromosome (Ph1) and those with Ph1 only. Among the additional aberrations such changes, not typical of CML, were found: del(2)(p21), t(6;11)(q25;q23), and t(12;?)(p13;?). The survival time and the percentage of cNCA-positive cells of patients in blastic and accelerated phases were compared between the above-mentioned two groups of patients using the Student t test and the Kaplan-Meier estimator. The percentage of cNCA-positive cells was significantly lower and the survival time significantly shorter in the group of patients with additional aberrations. The probability of survival according to the Kaplan-Meier estimator was also lower for this group. These data suggest that the immunologically determined lower degree of maturity, that characterized cells bearing additional aberrations, coincides with and/or results in more rapid progression of the disease.

Lectin binding ability of B-chronic lymphocytic leukaemia cells.

The binding of five fluorescein-labelled lectins: peanut agglutinin (PNA), lentil agglutinin (LEN), soybean agglutinin (SBA), wheat germ agglutinin (WGA) and asparagus pea agglutinin (ASP) to human B-cell chronic lymphocytic leukaemia (B-CLL) and B lymphocytes of normal donors was studied. The specificity of the fluorescence was demonstrated by inhibition with appropriate saccharides. The proportion of B cells was estimated using anti-B cell monoclonal antibody. Both leukaemic and normal B cells showed the binding ability of all except of one (ASP) studied lectins. We have found the differences in surface carbohydrate patterns between B-CLL and normal B lymphocytes. B-CLL cells showed the considerably lower ability to bind SBA and slightly higher expression of PNA and LEN receptors in comparison to normal B cells. The analysis of WGA binding allowed for recognizing two groups of CLL patients: one with high and the second one with low WGA receptor expression. The double marker studies revealed that B cells could simultaneously react with anti-B cell monoclonal antibody and fluorochrome labelled lectins.

Heterogeneity of human natural killer cells with respect to lectin-binding ability.

The binding ability of peanut agglutinin (PNA), lentil agglutinin (LEN), soybean agglutinin (SBA), wheat germ agglutinin (WGA), and asparagus pea agglutinin (ASP) to human natural killer (NK) cells with the use of the double-marker immunofluorescence technique was studied. For identification of NK cells, VEP 13 (DC 16) monoclonal antibody was used. The receptor for PNA lectin was shown exclusively after neuraminidase treatment of cells, and VEP 13 antigen was neuraminidase resistant. The majority of VEP 13+ cells showed coexpression of lectin receptors for PNA, LEN, and WGA. Our results suggested that VEP 13 antigen and PNA receptor are two distinct membrane structures, whereas there is some competitive binding between LEN as well as WGA lectin and VEP 13 antibody. In double-marker experiments using PNA and LEN lectin, the small fraction of VEP 13+ cells lacking receptors for these lectins was found. In spite of neuraminidase treatment of the cells, no binding of SBA and ASP was shown. These results indicated apparent heterogeneity of NK cells with respect to lectin receptor expression. WGA lectin, which bound to all VEP 13+ cells, could probably be useful for isolation of NK cells.

Immunological reactivity of mucinous and serous ovarian adenocarcinomas.

Comparison of immunological reactivity of glycoprotein antigens extracted from individual cases of mucinous and serous ovarian adenocarcinomas was performed taking into account the immunological relationship with carcinoembryonic antigen (CEA), nonspecific cross-reacting antigen (NCA), alpha-1-antichymotrypsin, and alpha-1-acid glycoprotein. In all immunological tests, the specific immune sera against perchloric acid extracts of ovarian mucinous and serous cystadenocarcinomas and antisera against the reference antigens mentioned above were used. It was established that: 1) ovarian mucinous and serous adenocarcinomas are immunologically different and possess various tumor-associated antigens, 2) ovarian mucinous adenocarcinomas contain considerable amounts of CEA and NCA, whereas serous type neoplasms show negligible amounts or lack of these antigens; and 3) in both types of tumors, alpha-1-antichymotrypsin and alpha-1-acid glycoprotein activities are found. Immunological data indicate that ovarian mucinous and serous adenocarcinomas derive from separate lineages of epithelium.

Distribution of surface nonspecific cross-reacting antigen and influence of proteolytic enzymes on this antigen in myeloid cell series.

Discontinuous density-gradient centrifugation was used to separate myeloid cells of different myelocytic leukemias [acute myelocytic leukemia (AML), chronic granulocytic leukemia (CGL), and chronic granulocytic leukemia in blast crisis (CGL-BC)] into fractions containing granulocytes in individual stages of maturation. The distribution of surface nonspecific cross reacting antigen (sNCA), and cytoplasmic NCA (cNCA) in each cell fraction was estimated by immunofluorescence (IF), and the influence of proteolytic enzymes and neuraminidase on sNCA presence was analyzed. It was found that the percentage of sNCA- and cNCA-positive cells increased in more mature granulocyte fractions; only in the morphologically oldest granulocytes did the number of sNCA-positive cells decrease, probably as a result of the rise of NCA secretion into body fluids; proteolytic enzymes caused an increasing number of sNCA-expressing cells; and neuraminidase treatment usually reduced the percentage of sNCA-positive cells.