Carcinoembryonic antigen levels in peritoneal washings can predict peritoneal recurrence after curative resection of gastric cancer

Article Abstract:

In so-called "curative" resection for cancer, the surgeon is able to remove the entire known tumor mass, and no areas of cancer invasion are known to be left behind. Nevertheless, the word "curative" often turns out to be inappropriate, as microscopically small deposits of tumor cells may be left behind and eventually cause recurrent disease. In the case of stomach cancer, recurrence is common even when the surgical removal of the tumor is considered curative. Most often, cancer recurs in the peritoneal cavity, that is, within the peritoneum, the membrane which lines the abdominal cavity. Based on the theory that it might be possible to make a more accurate prognosis in cases of stomach cancer by identifying the presence of cancer cells in the peritoneum, some researchers have rinsed the abdominal cavity with saline after surgery and examined the wash fluid for tiny floating cancer cells. While it was possible to find cancer cells in this fashion in some patients, it is clear that this method bears some similarity to finding needles in a haystack and is not likely to prove reliable for routine testing. Taking a different tack, researchers tried to find out if these peritoneal rinsings may contain traces of carcinoembryonic antigen (CEA), a protein which is made by some cancer cells but only rarely by noncancerous cells. This method has the advantage of employing a convenient chemical analysis rather than a laborious search for cells. Peritoneal wash fluid was obtained from 25 stomach cancer patients with known dissemination in the abdominal cavity, 25 patients with no known dissemination but some invasion of the membrane, and 70 patients with no invasion of the membrane. In addition, fluid from nine patients with unrelated diseases was also analyzed. Elevated amounts of CEA were found in 80 percent of the patients with visible dissemination, in 64 percent of the patients with membrane invasion, and in only nine of the 70 patients with no invasion of the membrane. Increased CEA was found in none of the patients with unrelated diseases. The presence of elevated CEA had a profound effect on the prognosis. The two-year survival rate of the patients with elevated CEA was 21 percent, while none of the patients with normal levels of CEA have died after two years (a survival rate of 100 percent). (Consumer Summary produced by Reliance Medical Information, Inc.)

Stomach cancer

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Tumor-associated glycoprotein-72 serum levels complement carcinoembryonic antigen levels in monitoring patients with gastrointestinal carcinoma: a longitudinal study

Article Abstract:

Tumor markers are substances that are produced only by tumor cells, or produced in significantly higher quantities by tumor cells when compared with healthy cells. Tumor markers may be used to screen for cancer and to monitor cancer patients for signs of recurrence. However, rarely is a single tumor marker completely satisfactory for this purpose, as there are wide variations in the expression of most of these substances. One of the first tumor markers identified is CEA, the carcinoembryonic antigen; this marker has proved useful in evaluating patients with stomach cancer and colorectal cancer. Researchers have now studied the usefulness of combining the measurement of CEA with that of a second tumor marker, TAG-72, in the evaluation of patients with cancers of the gastrointestinal system. TAG-72, or tumor-associated glycoprotein-72, and CEA were measured in the blood of 82 patients with gastrointestinal adenocarcinoma. The first measurements were made prior to the surgical removal of the tumor and then every 3 months for 26 months following surgery. Thirty-two and 34 of the patients had elevated levels of TAG-72 and CEA, respectively, prior to surgery. Forty-six patients had increased amounts of one or the other marker. While these results represent 56.1 percent of the total patient population, they account for 82.2 percent of the patients with advanced stages of cancer. This fraction is 24.4 percent better than the fraction that would be identified by using CEA alone. Among 31 patients who were monitored for up to 791 days, the amounts of TAG-72 and CEA in the blood have remained normal for the 20 patients who have not yet developed recurrent cancer. Among the 11 patients who developed recurrent cancer, 9 had elevated levels of TAG-72 and 6 had elevated levels of CEA. Only one patient had elevated CEA without also having elevated TAG-72. It is especially interesting to note that 6 of the 11 patients with recurrent disease had normal TAG-72 levels prior to surgery; four of these, however, developed increased levels prior to or along with the appearance of symptoms of cancer recurrence. The results of this study suggest that measuring both TAG-72 and CEA tumor markers may be a useful means of monitoring gastrointestinal cancer patients for signs of cancer recurrence. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Tumor antigens, Gastrointestinal cancer, Digestive system cancer, Tumor markers

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An immunohistochemical analysis of ras oncogene expression in epithelial neoplasms of the colon

Article Abstract:

Understanding of the malignant transformation of cells has been greatly advanced in recent years by the recognition that the cancer-causing genes of some viruses have counterparts in normal cells. A number of such oncogenes have been described, and it is believed that at least in some cases the transformation of a normal cell into a malignant cell results from a mutation in one of these oncogenes. One such oncogene is the ras gene, which encodes a 21,000 molecular weight protein. Antibodies to this protein, designated ras p21, may be used to histochemically stain tissue sections, and thereby identify the precise location of this protein within healthy or cancerous tissue. Two such antibodies were used to stain different types of colonic tumors to observe the patterns of distribution of this protein. Tumors examined included 6 villoglandular adenomas, 5 carcinomas in situ, 24 differentiated adenocarcinomas, 53 poorly differentiated adenocarcinomas, 6 carcinoids, and 2 neuroendocrine carcinomas. There were no significant differences in staining between malignant and benign tumors, and there was no difference among tumors of different stages. Superficial and deeply invasive tumors also had comparable staining patterns. The staining of the villoglandular polyps and carcinomas in situ is interpreted to suggest that the expression of p21 occurs even in the early stages of tumor development. (Consumer Summary produced by Reliance Medical Information, Inc.)

Research, Causes of, Genetic aspects, Cancer, Tumors, Carcinogenesis, Oncogenes, Gastrointestinal tumors

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