1/12. skin metastases of gynecologic adenocarcinomas affect serum levels of hCGbeta but not those of SCC antigen.Squamous cell carcinoma antigen (SCC-Ag) has been shown to be elevated in patients with epidermoid carcinoma of the cervix but also in patients with benign tumors of epithelial origin and in benign skin disorders. Elevated serum levels of the free beta subunit of human chorionic gonadotropin (hCGbeta) have been observed in patients with cancer of different types, and cancer aggressiveness is related to hCGbeta expression. Therefore, we expected that extensive metastatic skin dissemination of gynecologic malignancies would cause a rise in the serum levels of SCC-Ag and hCGbeta. The serum levels of SCC-Ag, hCGbeta and CA 125 were monitored in 2 patients with extensive skin dissemination of ovarian and endometrial adenocarcinoma. skin metastases had no effect on serum levels of SCC-Ag but they caused an increase in serum levels of hCGbeta. SCC-Ag is not a marker for metastatic skin lesions of gynecologic carcinomas of nonepidermoid origin. hCGbeta expression is associated with aggressiveness of cancer and may be a useful marker indicating therapy resistance.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
2/12. Clear-cell epithelioid leiomyoma of the round ligament.A case of clear-cell epithelioid leiomyoma of the round ligament in a 69-year-old woman is described. The neoplasm presented as a firm left inguinal mass. A preoperative computed tomography (CT) scan demonstrated an enhancing lesion extending extra-abdominally from the region of the external inguinal ring. The surgical resection specimen was tan-white, well-circumscribed, and measured 5.8 cm in maximum dimension. Microscopic examination revealed a well-demarcated neoplasm comprised of polygonal cells with abundant clear cytoplasm arranged in clusters and single files with abundant intervening hyalinized stroma. There was minimal nuclear atypia and mitotic figures were rare. periodic acid-Schiff with diastase demonstrated intracytoplasmic glycogen. Immunohistochemical stains for pan-actin, smooth muscle actin, desmin, bcl-2, and vimentin were positive in the tumor cells, whereas stains for CD34, carcinoembryonic antigen, cytokeratin, epithelial membrane antigen, S100 protein, and neurofilaments were negative. Electron microscopy demonstrated features of smooth muscle differentiation including longitudinally oriented fine filaments with focal condensations, pinocytotic activity, and subplasmalemmal densities. This case illustrates the ubiquitous distribution of epithelioid smooth muscle neoplasms and highlights the potential pitfalls for diagnosis when they occur in an unusual location.- - - - - - - - - - ranking = 0.4keywords = antigen (Clic here for more details about this article) |
3/12. Chronic administration of single-agent paclitaxel in gynecologic malignancies.OBJECTIVE: There are currently limited published data available on the safety and feasibility of the prolonged administration of paclitaxel. The goal of this study was to review the cumulative toxicity associated with the continuous long-term administration of this agent to women with gynecologic cancers. methods: Eleven patients with gynecologic malignancies of varying histologic subtypes who received >15 consecutive courses of paclitaxel were identified in a retrospective review of individuals treated between 1994 and 1999 in the Gynecologic Oncology Program of the Cleveland Clinic Taussig Cancer Center. The analysis excluded paclitaxel delivered as a component of an initial chemotherapy regimen for the cancer. paclitaxel was administered at doses ranging from 80 to 175 mg/m(2) every 3-4 weeks as a 3-h infusion. RESULTS: In general, the patients included in this report were heavily pretreated and were continued on therapy either as a result of documentation of an objective response or with evidence of stabilization of disease (e.g., physical examination, radiographic evaluation, ca-125 antigen level) and the maintenance of a satisfactory quality of life. In the 11 patients, the median duration of therapy was 20 cycles (range: 16-36 cycles). alopecia was observed in all patients. A single patient experienced grade 3 anemia and grade 4 neutropenia. Of note, there was 1 case of grade 2 and no cases of grade 3 peripheral neuropathy in this population. CONCLUSION: Prolonged delivery of paclitaxel for >15 consecutive cycles can be safely administered to carefully selected patients with persistent or recurrent advanced gynecologic cancers.- - - - - - - - - - ranking = 0.2keywords = antigen (Clic here for more details about this article) |
4/12. carcinoembryonic antigen: clinical and historical aspects.To further define and determine the usefulness of CEA, 1100 CEA determinations have been made over the past two years at The ohio State University hospitals on patients with a variety of malignant and nonmalignant conditions. Correlation of CEA titers with history and clinical course has yielded interesting results not only in cancers of entodermally derived tissues, for which CEA has become an established adjunct in management, but also in certain other neoplasms and inflammatory states. The current total of 225 preoperative CEA determinations in colorectal carcinomas shows an 81% incidence of elevation, with postoperative titers remaining elevated in patients having only palliative surgery but falling to the negative zone after curative procedures. An excellent correlation exists between CEA levels and grade of tumor (more poorly differentiated tumors showing lower titers). Left-side colon lesions show significantly higher titers than right-side lesions. CEA values have been shown to be elevated in 90% of pancreatic carcinomas studied, in 60% of metastatic breast cancers, and in 35% of other tumors (ovary, head and neck, bladder, kidney, and prostate cancers). CEA levels in 35 ulcerative colitis patients show elevation during exacerbations (51%). During remissions titers fall toward normal, although in 31% still remaining greater than 2.5 ng/ml. In the six colectomies performed, CEA levels all fell into the negative zone postoperatively. Forty percent of adenomatous polyps showed elevated CEA titers (range 2.5-10.0) that dropped following polypectomy to the negative zone. Preoperative and postoperative CEA determinations are important in assessing the effectiveness of surgery. Serial CEA determinations are important in the follow-up period and in evaluation of the other modes of therapy (e.g., chemotherapy). These determinations of tumor antigenicity give the physician added prognostic insight into the behavior of the tumor growth. Rectal examination with guaiac determinations, sigmoidoscopy, cytology, barium enema, and a good clinical evaluation remain the primary tools for detecting colorectal disease. However, in the high-risk patient suspicious of developing cancer, CEA determinations as well as colonoscopy are now being used increasingly and provide additional highly valuable tools in the physician's armamentarium.- - - - - - - - - - ranking = 1keywords = antigen (Clic here for more details about this article) |
5/12. Detection of human papillomavirus types 6 and 11 E4 gene products in condylomata acuminatum.Polyclonal antiserum to an escherichia coli-produced beta-galactosidase/E4 fusion protein of human papillomavirus type 6b (antiserum 256), and affinity purified HPV 11 anti-E4 antibodies were tested for reactivity in Western blots with bacterially expressed trpE/E4 fusion proteins of HPV types 6b, 11, 16, and 18. To further characterize the affinity purified anti-E4 antibodies, a dot-immunobinding assay was performed using overlapping synthetic HPV 11 E1E4 peptides as antigens. Protein extracts of condylomata acuminatum from 18 patients containing HPV type 6 or 11 dna sequences were tested in Western blots using antiserum 256 or affinity purified HPV 11 anti-E4 antibodies. In the Western blots of the trpE proteins, antiserum 256 identified the HPV types 6b and 11 fusion proteins; the affinity purified HPV 11 anti-E4 antibodies identified only the HPV 11 fusion protein. In the dot-immunobinding assay, three HPV 11 peptides were recognized, each containing a shared 8 amino acid sequence that differs significantly from the corresponding sequences of HPV types 6b, 16, or 18. In the Western blots of protein extracts from 18 condylomata acuminatum samples shown to contain HPV types 6 or 11 dna, putative E4 gene products were identified in six samples by antiserum 256. The affinity purified HPV 11 anti-E4 antibodies identified putative E4 gene products in one of these same six lesions, which was shown to contain HPV 11 sequences by the Southern blot method. All six samples containing E4 gene products were from women. Three of these women were pregnant, one had serum antibodies to the human immunodeficiency virus, and one was a renal transplant recipient receiving glucocorticoids.(ABSTRACT TRUNCATED AT 400 WORDS)- - - - - - - - - - ranking = 0.2keywords = antigen (Clic here for more details about this article) |
6/12. A unique verrucous anogenital tumor associated with type 6b-related human papillomavirus.Multiple dark brown papillomatous tumors, showing some histological features of verrucous carcinoma or giant condyloma, developed mainly in the anogenital region of a Japanese woman. The tumors first appeared when she was 51 years old and annoyed her for over 20 years with several recurrences without any frank malignant transformation, after surgery. Immunohistochemically, papillomavirus genus-specific antigen was demonstrated only in small foci of the lesions resected at first operation. Southern blot analysis revealed human papillomavirus type 6b-related dna in a surgically resected specimen. The possible role of the human papillomavirus in the genesis of this unique tumor is discussed.- - - - - - - - - - ranking = 0.2keywords = antigen (Clic here for more details about this article) |
7/12. Gonadal tumor and h-y antigen in 46,XY pure gonadal dysgenesis.Six cases of Swyer's syndrome (46,XY pure gonadal dysgenesis) are reported. Three patients, without gonadal tumor, had female h-y antigen. Three patients, after gonadal tumor ablation, had intermediate h-y antigen levels. Repeated blood samples were obtained from two siblings. h-y antigen level in the first sibling, who presented with a gonadoblastoma and underwent a gonadectomy before the H-Y assays, was intermediate, and did not show any significant variation for 21 months. h-y antigen level in the second sibling showed an increase in the male range, presumably due to the presence of gonadoblastomas. After resection of the tumors, h-y antigen level became intermediate. These findings suggest a relation between the tumorization potentiality of the gonadal remnants and the h-y antigen levels in 46,XY pure gonadal dysgenesis.- - - - - - - - - - ranking = 2keywords = antigen (Clic here for more details about this article) |
8/12. Relationship of intestinal obstruction to serial plasma carcinoembryonic antigen levels.Since it has been suggested that colonic obstruction due to carcinoma may play a role in elevations of circulating carcinoembryonic antigen, serial plasma carcinoembryonic antigen levels were studies in 19 patients with intestinal obstruction due to tumor and nontumor causes. Regardless of cause, eight of ten patients with colonic obstruction did not show decreased carcinoembryonic antigen levels after decompression. Two patients with postoperative carcinoembryonic antigen reductions of greater than 40 per cent had ascite removed at operation. Removal of a large volume of carcinoembryonic antigen-rich ascites was thought to contribute to the fall in circulating carcinoembryonic antigen. Six patients with small intestinal obstruction and one patient with large and small intestinal obstruction did not show a reduction in postdecompression carcinoembryonic antigen levels. One patient with Crohn's disease who underwent ileal resection and one with intestinal obstruction due to carcinoma of the ovary who underwent resection at the time of decompression had a greater than 40 per cent reduction in postoperative carcinoembryonic antigen levels. Inflamed intestinal and carcinoma of the ovary are known sources of carcinoembryonic antigen and their removal could explain the decrease in carcinoembryonic antigen. Rehydration, as monitored by plasma osmolality and protein concentration, did not explain changes in plasma carcinoembryonic antigen. Thus, it appears that carcinoembryonic antigen production may play a more significant role in the regulation of circulating carcinoembryonic antigen than the physiopathologic processes associated with obstruction.- - - - - - - - - - ranking = 3.4keywords = antigen (Clic here for more details about this article) |
9/12. female adnexal tumour of probable Wolffian origin: a clinicopathological and immunohistochemical study of three cases.The clinical and pathological features of three adnexal tumours of probable Wolffian origin are reported. One case was an incidental finding in a patient who died from ovarian carcinoma; in the other two cases the patients presented with lower abdominal pain. The three tumours were well-circumscribed, solid masses arising in the leaves of the broad ligament and histological examination showed bland epithelial cells forming tubular, solid and microcystic patterns. The immunohistochemical profile of the tumours was similar to that of Wolffian duct remnants. They co-expressed cytokeratin and vimentin and lacked epithelial membrane antigen (EMA) reactivity, in contrast to tumours of Mullerian origin which usually express EMA. The differential diagnosis of female adnexal tumours is discussed.- - - - - - - - - - ranking = 0.2keywords = antigen (Clic here for more details about this article) |
10/12. retroperitoneal fibrosis due to malignancy: a case report.retroperitoneal fibrosis is idiopathic in two thirds of cases and is found most commonly as an isolated fibrotic plaque centered over the lumbar spine and entrapping one or both ureters. It has been postulated that fibrosis in the idiopathic cases results from a hypersensitivity reaction to antigens leaking into the retroperitoneum from atheromatous plaques in the aorta or common iliac arteries. In the remaining one third of cases, causes include ergot-derivative drugs, retroperitoneal haemorrhage or urine extravasation, and a desmoplastic response to a variety of tumours.- - - - - - - - - - ranking = 0.2keywords = antigen (Clic here for more details about this article) |
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