[Tumor markers. II. Their significance in the follow-up of patients after radical resection of lung neoplasms]. / Marcatori tumorali. II. Loro significato nel follow-up dei pazienti sottoposti a resezione radicale di neoplasie polmonari.

The clinical field in which tumor markers proved to be most useful is the monitoring of cancer patients. The present study was carried out in order to evaluate the role of tumor markers in the prognostic assessment, and pre-clinical identification of disease recurrence in patients with completely resectable non-small cell bronchial carcinoma. Tumor markers have been measured: a) pre-operatively, in 109 patients with resectable lung cancer and b) post-operatively, in 61 patients who underwent complete resections and were followed for at least one year after surgery. The carcinoembryonic antigen (CEA), the neuron specific enolase (NSE), the tissue polypeptide antigen (TPA), the carbohydrate antigen 19-9 (CA 19-9) and the carbohydrate antigen 50 (CA 50) have been determined in each patient. Long-term survival was significantly correlated with serum levels of the CEA, CA 50 and CA 19-9, while not with those of TPA and NSE. For pre-clinical detection of cancer recurrence, TPA and NSE were the most suitable indicators.

[Tumor markers. I. Their significance in the preoperative assessment of lung neoplasms]. / Marcatori tumorali. I. Loro significato nella valutazione pre-chirurgica delle neoplasie polmonari.

The present study has been carried out in order to evaluate the role of tumor markers in the presurgical assessment of patients with bronchial carcinoma. The carcinoembryonic antigen (CEA), the neuron specific enolase (NSE), the tissue polypeptide antigen (TPA), the carbohydrate antigen 19-9 (CA 19-9) and the carbohydrate antigen 50 (CA 50) have been preoperatively measured in 133 subjects with potentially resectable lung cancers, and in 75 healthy smokers. Sixty-one patients had squamous cell carcinoma, 55 adenocarcinoma and 17 small cell carcinoma. Lobectomy (or bilobectomy) was performed in 74 cases, pneumonectomy in 36 cases, exploratory thoracotomy in 15 cases and a palliative resection in 8 cases. When individual markers were considered, TPA showed the highest sensitivity (85%) and CA 19-9 the lowest sensitivity (11%). Specificity was uniformly superior to 90%. When marker associations were considered, the combined measurement of TPA and NSE gave the best results: both the sensitivity and specificity rates approached 90%. The application of the TPA-NSE association allowed detection of 94% of small cell carcinomas, 89% of adenocarcinomas and 85% of squamous cell carcinomas. A positive correlation was found between the complete resectability of lung cancer and serum levels of CEA, CA 50 and CA 19-9. By using the discriminant analysis, a statistical model yielding identification of about 74% of patients with tumors which were judged potentially resectable according to the pre-operative non-invasive diagnostic procedures and were found to be unresectable at thoracotomy, has been get available.

[The reliability of the grading assessment of the biopsy samples in malignant colorectal neoplasms]. / Attendibilità della valutazione del grading sui prelievi bioptici per le neoplasie maligne colo-rettali.

The authors evaluate the results of preoperative bioptic grading compared with those obtained from postoperative specimens. Altogether, there was nonagreement in 45% of cases; therefore there is the risk of underestimating the biological aggressiveness of the disease. In fact, 68% of patients who were assessed as G1 in preoperative staging were found to have a higher degree of neoplastic dedifferentiation.

[Nuclear DNA content in tumors of the colon and rectum. Relationship between ploidy and site of the neoplasm]. / Contenuto nucleare di DNA nei tumori del colon-retto. Rapporto tra ploidia e sede della neoplasia.

The DNA distribution pattern was determined 30 colo-rectal carcinomas. The DNA content in individual cells was measured according to a cytophotometric method based on light transmission measurement of Feulgen-stained nuclei. The DNA non diploid carcinomas were significantly more common from the left (descending and sigmoid) colon and rectum (P = 0.0002). No relationship existed between DNA pattern and age, sex, Dukes' stage, tumor grade.

[Colorectal cancer: prognosis after curative surgical treatment without extended elective lymphadenectomy in patients in Dukes C stage]. / Il cancro colorettale: prognosi dopo trattamento chirurgico curativo senza linfoadenectomia allargata di principio nei pazienti allo stadio Dukes C.

A retrospective analysis has been carried out on a group of 103 Dukes C cases from a series of 412 patients with colorectal carcinoma, operated on from January 1970 to November 1983. The 5-year survival rate was 32% in patients who had a curative resection (median survival: 24 months). Larger numbers of lymph nodes were obtained with right or left colectomy. As regards the treatment of rectal cancer, similar numbers of nodes were obtained either with anterior resection or with Miles' operation. Prognosis was significantly correlated to tumor location, number of involved nodes (p less than 0.01) and grading of the primary tumor (p less than 0.01). The use of extended left colectomy with elective abdominopelvic lymphadenectomy was associated with a small raise of survival and a definite increase of perioperative morbidity and mortality compared to conservative surgical resection.