scholarly journals Clinicopathological Characteristics of LgG4-Related Lung Disease

2021 ◽  
Author(s):  
Jia Liu ◽  
Yuxiang Liu ◽  
Ximing Shen ◽  
Zhanghai He ◽  
Tingfeng Yu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Disease ◽  
Tumor Markers ◽  
Elevated Serum ◽  
Clinicopathological Characteristics ◽  
Common Symptom ◽  
Female Ratio ◽  
Serum Tumor Markers ◽  
Multiple Imaging ◽  
Serum Igg4

Abstract Background: Immunoglobulin G4-related lung disease (IgG4-RLD) is a rare entity. The aim of this study is to retrospectively analyzed the clinicopathological characteristics of IgG4-RLD pathologically confirmed in order to improve the diagnosis and treatment of the disease.Methods: We screened the pathological reports of 4838 patients with pulmonary surgery and/or biopsy specimens at Sun Yat-sen Memorial Hospital affiliated to Sun Yat-sen University from April 2017 to April 2021, and 65 patients with suspected IgG4-RLD had an immunohistochemical staining for IgG4 and IgG. Finally, 10 patients with definite IgG4-RLD pathologically comfirmed were enrolled and analyzed.Results: The incidence of IgG4-RLD pathologically confirmed was 0.2% (10/4838). Ten patients had a mean age of 59.7 years at diagnosis with a male: female ratio of 9:1. The initial clinical manifestations were lack of specificity and cough was the most common symptom (4/10). More than one organ was involved in most patients (8/10) and lymph node involvement was often seen (7/10). Serum IgG4 were detected and elevated in 6 patients. The levels of serum tumor markers were within normal range or slightly elevated. The chest computed tomography (CT) and/or 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET-CT) findings showed 5 patients of mix type, 3 patients of solid nodular type and 2 patients of bronchovascular type. All pulmonary mass and large nodules with solid pattern had spiculated margins and inhomogeneous enhancement with or without pleural indentation and lobulated appearance. Abundant lymphoplasmacytic infiltration and fibrosis were observed in all patients. The expressions of IgG4 and IgG in the plasma cells were up-regulated in the immunostained sections of lung. Seven patients received prednisone with or without additional immunosuppressive drugs and responded well.Conclusions: Our study suggests that multiple imaging findings combined with elevated serum IgG4 as well as serum tumor markers without significant increase could provide diagnostic support for IgG4-RLD.

scholarly journals Clinicopathological characteristics of IgG4-related lung disease

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jia Liu ◽  
Yuxiang Liu ◽  
Ximing Shen ◽  
Zhanghai He ◽  
Tingfeng Yu ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Disease ◽  
Elevated Serum ◽  
Clinical Manifestations ◽  
Common Symptom ◽  
Immunoglobulin G4 ◽  
Hilar Lymph Node ◽  
Female Ratio ◽  
Multiple Imaging ◽  
Serum Igg4

Abstract Background Immunoglobulin G4-related lung disease (IgG4-RLD) is a rare entity. We retrospectively analyzed the clinical and histopathological characteristics of patients with pathologically confirmed IgG4-RLD to improve the diagnosis rate and reduce the risk of misdiagnosis. Methods We screened the pathological reports of 4838 patients with pulmonary surgery and/or biopsy specimens from April 2017 to April 2021 at Sun Yat-Sen Memorial Hospital affiliated with Sun Yat-Sen University, and specimens from 65 patients with suspected IgG4-RLD were subjected to immunohistochemical staining for IgG4 and IgG. Finally, 10 patients with definite IgG4-RLD that was pathologically confirmed were enrolled and analyzed. Results The incidence of pathologically confirmed IgG4-RLD was 0.2% (10/4838). The ten patients had an average age of 59.7 years at diagnosis, and the male-to-female ratio was 9:1. The initial clinical manifestations were nonspecific, and cough was the most common symptom (4/10). More than one organ was involved in most patients (8/10), and mediastinal/hilar lymph node involvement was often observed (7/10). Serum IgG4 was analyzed in 6 patients and found to be elevated. Serum tumor marker levels were within the normal range or were slightly elevated. Computed tomography (CT) of the chest and/or 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET-CT) imaging revealed that 5 patients had a mixed type, 3 patients had the solid nodular type, and 2 patients had the bronchovascular type. All pulmonary masses and large nodules with solid patterns had spiculated margins and inhomogeneous enhancement with or without pleural indentation and a lobulated appearance. Abundant lymphoplasmacytic cell infiltration and fibrosis were observed in all patients. The expression of IgG4 and IgG was upregulated in the pulmonary sections. Seven patients were treated with glucocorticoids with or without additional immunosuppressants and responded well. Conclusions The results of our study suggest that multiple imaging findings, an elevated serum IgG4 concentration, and no significant increase in serum tumor biomarkers could provide diagnostic support for IgG4-RLD, especially for isolated IgG4-RLD or IgG4-RLD that includes other organ involvement that does not aid in establishing the diagnosis.

Elevated CA 19-9 Levels in Mature Cystic Teratoma of the Ovary

2009 ◽  
Vol 24 (1) ◽  
pp. 52-56 ◽  
Author(s):  
Min Sun Kyung ◽  
Joong Sub Choi ◽  
Seung Hwa Hong ◽  
Hak Soon Kim
Keyword(s):  
Tumor Markers ◽  
Elevated Serum ◽  
Cystic Teratoma ◽  
Ovarian Torsion ◽  
Mature Cystic Teratoma ◽  
Ca 125 ◽  
Clinical Value ◽  
Blood Samples ◽  
Serum Tumor Markers

The purpose of this study was to evaluate the clinical value of serum tumor markers in patients with ovarian mature cystic teratoma (MCT). We retrospectively evaluated 163 women who underwent surgery for MCT of the ovary between March 2003 and August 2007 and who provided preoperative blood samples for the measurement of CA 19-9 and CA 125. The rates of elevated serum CA 19-9 and CA 125 levels were 31.9% (52/163) and 13.5% (22/163), respectively. The rate of ovarian torsion was 12.9% (21/163). There were significant differences between the elevated CA 19-9 group and the normal CA 19-9 group in the diameters of the tumors and the rates of ovarian torsion. Elevated serum CA 19-9 levels correlated with larger tumor diameters and higher torsion rates. CA 19-9 may be a useful tool for the diagnosis of ovarian MCT. Elevated CA 19-9 levels appear to correlate with larger tumor diameters and higher rates of ovarian torsion.

Phase II study of neoadjuvant dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin (ddMVAC) chemotherapy in patients with muscle-invasive urothelial cancer (MI-UC): Pathologic and radiologic response, serum tumor markers, and DNA excision repair pathway biomarkers in relation to disease-free survival (DFS).

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 4530-4530
Author(s):  
Angela Q. Qu ◽  
Susanna J. Jacobus ◽  
Sabina Signoretti ◽  
Edward C. Stack ◽  
Katherine Maragaret Krajewski ◽  
...  
Keyword(s):  
Tumor Markers ◽  
Phase Ii ◽  
Residual Disease ◽  
Excision Repair ◽  
Elevated Serum ◽  
Disease Free Survival ◽  
Logrank Test ◽  
Tumor Biopsy ◽  
Serum Tumor Markers ◽  
Post Surgery

4530 Background: Neoadjuvant (NA) ddMVAC in patients (pts) with MI-UC is associated with significant pathologic response (PaR) and radiologic response (RaR). We examined the frequency of PaR and RaR as well as the level of serum and tissue biomarkers in correlation with DFS. Methods: Pts treated on phase II prospective study of NA ddMVAC (4 cycles) in MI-UC were evaluated for RaR (at least >50% decrease in the primary tumor and nodes after chemotherapy, with delayed enhancement of residual disease) and PaR (p<T1N0M0). Elevated serum tumor markers (CA125, C19-9 and ßHCG) at baseline and Day 1 of each cycle were documented. Expression level of baseline DNA ERCC1 protein in tumor biopsy tissues was determined by immunohistochemistry based on H-score <0.1 (negative) vs. >0.1 (positive). Fisher’s Exact test was used to evaluate association with response. Post-surgery DFS was estimated by the Kaplan-Meier method and compared between response and biomarker groups using the logrank test. Results: Of 39 pts (cT2:42%, cT3:42%, cT4:16%, and cN1:45%), 49% (90% CI 35-63) experienced PaR, and 62% (90% CI 47-75) achieved RaR after ddMVAC chemotherapy. Pts who achieved PaR experienced a DFS advantage, with 18-month DFS of 78% (95% CI 47-92) vs. 48% (95% CI 18-74) in those who did not (p=0.146). Those achieving RaR had a significantly longer DFS (p=0.006), with 18-month DFS of 87% (95% CI 57-97) vs. 29% (95% CI 5-60) in those who did not. Among 10 pts with any elevated serum tumor marker at baseline, only 2 pts showed normalization, both without a PaR. ERCC1(+) tumors were not associated with PaR, pT0 or RaR. DFS by ERCC1status was inconclusive due to limited sample size. 18-month DFS was 91% (95% CI 51-99) in ERCC1(+) tumors vs. 63% (95% CI 29-85) in ERCC1(-) tumors. Conclusions: ddMVAC achieves significant PaR and RaR in MI-UC pts that translates into a post-surgery DFS advantage. ERCC1(+) was not associated with response. More effective biomarkers of platinum response are needed to select pts most likely to benefit from NA therapy. Clinical trial information: NCT00808639.

Multicenter analysis of serum tumor markers, treatment patterns, and relapse in patients with testicular cancer in clinical stage IS.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 5052-5052
Author(s):  
Maximilian Peter Johannes Karl Brandt ◽  
Christian Guido Ruf ◽  
Klaus Peter Dieckmann ◽  
Isabella Syring ◽  
Christian Ruckes ◽  
...  
Keyword(s):  
Tumor Markers ◽  
Half Life ◽  
Clinical Stage ◽  
Elevated Serum ◽  
Treatment Patterns ◽  
Relapse Free Survival ◽  
Chi Square ◽  
Free Survival ◽  
Serum Tumor Markers ◽  
Chi Square Test

5052 Background: Testicular germ cell tumors (TGCT) in clinical stage I (CSI) are tumors confined to the testis without evidence of metastasis. Around 50% of all TGCT patients present with elevated serum tumor markers (TM) such as alpha-feto protein (AFP), beta-humanochoriongonadotropin (ß-HCG) and lactate-dehydrogenase (LDH). After ablatio testis, TMs usually return to normal according to half-life kinetics, however, in clinical stage IS (CSIS) TMs remain elevated or increase after surgery. Follow-up data on CSIS is scarce and our study aims to assess clinical characteristics and oncologic outcomes in a large TGCT cohort. Methods: In this multicenter study we collected data from 5 tertiary referring hospitals in Germany, included patients with CSIS and evaluated TM levels, treatment and the primary outcome relapse-free survival. False CSIS was defined as documented CSIS but TMs that returned to normal after respective half-life kinetics. Differences between predefined groups (chemotherapy, TM, true/false CSIS) was analyzed with fisher’s exact and chi-square test. Results: Overall, 2616 patient data files were analyzed. Forty-three patients (1.6%) were documented as CSIS of which 27 (63%) were true and 16 (37%) false CSIS. Six (14%) had seminomas and 37 (86%) non-seminomas. In the true CSIS group AFP, ß-HCG, AFP plus ß-HCG and LDH were elevated in 13, 6, 3 and 2 cases. Four true CSIS patients received surveillance, 21 had 3x or 2x courses of BEP (bleomycin, etoposide and cisplatin) and 2 carboplatin. Within the false CSIS group, 2 patients were treated with surveillance, 10 received 3x BEP, one 3x PEI (cisplatin, etoposide and ifosfamid) and 3 had carboplatin. Chi-Square test revealed no difference between true or false CSIS classification in respect to application of chemotherapy (any chemotherapy, p = 0.83). Relapse-free survival after 5 and 10 years was 88.9% and 77.8%, respectively. Three patients in the true CSIS group relapsed (2 seminomas had carboplatin, 1 non-seminoma had surveillance). All relapses were treated with 3 courses of BEP with no documented death in the CSIS population. Conclusions: Overall, less than 2% of all TGCT were documented CSIS of which 37% were falsely classified. We report a high proportion of relapse-free survival in CSIS treated with surveillance or BEP with a high heterogeneity in treatment patterns. Correct classification of CSIS remains of critical importance to avoid toxicity for patients that could be safely treated with surveillance.

scholarly journals Serum Tumor Markers Combined With Clinicopathological Characteristics for Predicting MMR and KRAS Status in 2279 Chinese Colorectal Cancer Patients: A Retrospective Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Ning Zhao ◽  
Yinghao Cao ◽  
Jia Yang ◽  
Hang Li ◽  
Ke Wu ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Retrospective Analysis ◽  
Tumor Markers ◽  
Clinicopathological Characteristics ◽  
Right Colon ◽  
Independent Predictive Factor ◽  
Kras Mutations ◽  
Serum Tumor Markers ◽  
The Status ◽  
Colorectal Cancer Patients

Although serum tumor markers (STMs), clinicopathological characteristics and the status of KRAS and MMR play an important role in optimizing the treatment and prognosis of colorectal cancer, their interrelationships remain largely unknown. A retrospective analysis of 2279 patients who tested for KRAS and MMR status, and STM measurements prior to treatment over the past four years was conducted. Of the 784 patients tested for KRAS and 2279 patients tested for MMR status, KRAS mutations and dMMR were identified in 276 patients (35.20%) and 177 patients (7.77%), respectively. Logistic regression analysis demonstrated that right colon, well and moderate differentiation and negative CA19-9 were independent predictors for KRAS mutations. The ROC curve yielded an AUC of 0.609 through the combination of these three factors. Age &lt; 65 was an independent predictive factor for dMMR, along with tumor size &gt; 4.6 cm, right colon, poor differentiation, harvested lymph nodes ≥ 22, no lymph node metastasis, no perineural invasion, negative CEA and positive CA72-4. When the nine criteria were used together, the AUC was 0.849. In summary, both STMs and clinicopathological characteristics were found to be significantly associated with the status of KRAS and MMR. The combination of these two factors possessed a strong predictive power for KRAS mutations and dMMR among CRC patients.

scholarly journals The pronounced lung lesions developing in LATY136F knock-in mice mimic human IgG4-related lung disease

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247173
Author(s):  
Yuko Waseda ◽  
Kazunori Yamada ◽  
Keishi Mizuguchi ◽  
Kiyoaki Ito ◽  
Satoshi Watanabe ◽  
...  
Keyword(s):  
Lung Disease ◽  
Salivary Glands ◽  
Transforming Growth Factor ◽  
Plasma Cells ◽  
Elevated Serum ◽  
Vascular Bundles ◽  
Pathological Changes ◽  
Tissue Samples ◽  
Lung Lesions ◽  
Serum Igg4

Rationale Immunoglobulin (Ig) G4-related disease (IgG4-RD) is a novel clinical disease entity characterized by an elevated serum IgG4 concentration and tumefaction or tissue infiltration by IgG4-positive plasma cells. Pathological changes are most frequently seen in the pancreas, lacrimal glands, and salivary glands, but pathological changes in the lung also exist. Linker for activation of T cell (LAT)Y136F knock-in mice show Th2-dominant immunoreactions with elevated serum IgG1 levels, corresponding to human IgG4. We have reported that LATY136F knock-in mice display several characteristic features of IgG4-RD and concluded that they constitute an appropriate model of human IgG4-RD in salivary glands, pancreas, and kidney lesions. Objectives The aim of this study is to evaluate whether lung lesions in LATY136F knock-in mice can be a model of IgG4-related lung disease. Methods Lung tissue samples from LATY136F knock-in mice (LAT) and wild-type mice (WT) were immunostained for IgG1 and obtained for pathological evaluation, and cell fractions and cytokine levels in broncho-alveolar lavage fluid (BALF) were analyzed. Results In the LAT group, IgG1-positive inflammatory cells increased starting at 4 weeks of age and peaked at 10 weeks of age. The total cell count and percentage of lymphocytes increased significantly in BALF in the LAT group compared to the WT group. In BALF, Th2-dominant cytokines and transforming growth factor-β were also increased. In the LAT group, marked inflammation around broncho-vascular bundles peaked at 10 weeks of age. After 10 weeks, fibrosis around broncho-vascular bundles and bronchiectasis were observed in LATY136F knock-in mice but not WT mice. Conclusions LATY136F knock-in mice constitute an appropriate model of lung lesions in IgG4-RD.

scholarly journals Two Patients with Extremely Elevated Tumor Markers: Where Is the Malignancy?

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Patrick P. J. van der Veek ◽  
Wouter H. de Vos tot Nederveen Cappel ◽  
Alexandra M. J. Langers ◽  
Bart van Hoek
Keyword(s):  
Tumor Markers ◽  
Malignant Disease ◽  
Elevated Serum ◽  
Serum Levels ◽  
Stone Disease ◽  
High Serum ◽  
Response To Treatment ◽  
Serum Tumor Markers ◽  
Painless Jaundice ◽  
Very High

Serum tumor markers are useful to evaluate a cancer's response to treatment, for early detection of cancer relapse, and, in some cases, to diagnose malignancy. In this paper, we present two patients with significantly elevated serum tumor markerswithoutevidence of malignant disease. An 18-year-old patient suffering from autoimmune hepatitis had markedly increased alpha-fetoprotein (aFP) levels (2,002 μg/L; normal <10 ug/L). Extensive imaging showed no signs of hepatocellular carcinoma or other cancer, and treatment with Prednisone led to rapid normalization of both liver enzymes and aFP. The second patient, a 60-year-old female with painless jaundice due to biliary stone disease, had very high serum levels of CA19-9 (18,000 kU/L, normal <27 kU/L). Liver biochemistry and serum CA19-9 concentration decreased to almost normal values (45 kU/L) after biliary stenting. These cases demonstrate that serum tumor markers can be elevated in benign disease and are therefore not appropriate to diagnose cancer.

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