tumour marker
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PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262439
Author(s):  
Deirdré Kruger ◽  
Nicola Lahoud ◽  
Yandiswa Y. Yako ◽  
John Devar ◽  
Martin Smith

Background/Objectives Pancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy associated with high metastatic risk. Prognosis remains poor even after resection. Previously our group identified biomarkers that improved diagnostic accuracy in PDAC beyond the established diagnostic tumour marker, CA19-9. Risk factors, symptoms and circulating biomarkers associated with a PDAC diagnosis may differ from those that alter disease progression and metastasis. This study aimed at assessing the risk factors, presenting symptoms and potential prognostic biomarkers in PDAC and determine their relationship with PDAC stage and/or metastatic status. Methods Seventy-two PDAC patients with imaging available for TNM staging at presentation were enrolled following informed consent. Demographic and clinical data were captured. Blood was collected and 38 cytokines/angiogenic factors measured. Nonparametric association tests, univariate and multivariate logistic regression were performed using STATA version 14.2. A p-value≤0.05 was considered significant and odds ratios reported for effect size. Results Most risk factors and symptoms did not differ across the stages of cancer. Although male gender and smoking are risk factors for PDAC, the majority of study patients with metastatic PDAC were non-smoking females. In addition to CA19-9, the platelet count (p<0.01), IL-15 (p = 0.02) and GM-CSF (p<0.01) were significant, independent negative predictors of metastatic PDAC. Moreover, using specific cut-off values in a combined panel, the odds in a patient with all three biomarker levels below the cut-offs is 21 times more likely to have metastatic PDAC (p<0.0001). Conclusions Platelet count, IL-15 and GM-CSF are potential prognostic indicators of metastatic disease in PDAC patients from our local South African population.


2022 ◽  
Author(s):  
Sandra Misale ◽  
Rona Yaeger ◽  
Riccardo Mezzadra ◽  
Jenna Sinopoli ◽  
Yu Bian ◽  
...  

Abstract KRAS G12C inhibitors, such as sotorasib, have rapidly moved through clinical development and are poised to transform care of patients with KRAS G12C mutant cancers, in particular non-small cell lung cancer (NSCLC) and colorectal cancer (CRC). Clinical efficacy is achieved in NSCLC as a single agent and in CRC in combination with anti-EGFR monoclonal antibodies, however, secondary resistance impairs the effects of KRAS G12C blockade. In this work, we sought to determine the mechanisms of acquired resistance to concomitant KRAS-EGFR inhibition. In cell lines, patient-derived xenograft, and patient samples, a heterogeneous pattern of putative resistance alterations expected primarily to prevent inhibition of ERK signalling by drug can be detected at progression. Serial analysis of patient blood samples on treatment demonstrates that most of these alterations are detected at a low frequency that does not increase substantially and sometimes disappears over time, with the exception of KRAS G12C amplification which rises in step with tumour marker levels and clinical progression. Here we show that a CRC cell line that acquired resistance to sotorasib-cetuximab combination through KRAS G12C amplification became addicted to these agents and undergoes oncogene-induced senescence upon drug withdrawal. Accordingly, the KRAS G12C signal in circulating DNA from relapsed patients harbouring G12C amplification rapidly recedes upon treatment holiday. These data indicate that KRAS G12C amplification is a recurrent resistance mechanism to KRAS-EGFR co-inhibition and suggest a potential therapeutic vulnerability, whereby therapies that target this senescence response at drug withdrawal may overcome resistance to KRAS G12C-EGFR inhibition.


2021 ◽  
Vol 7 (3) ◽  
pp. 97-104
Author(s):  
Ajeng Kurnia Wardhani ◽  
Indranila Kustarini Samsuria ◽  
Meita Hendrianingtyas ◽  
Edward Kurnia Setiawan Limijadi ◽  
Ria Triwardhani

ABSTRACT Background: expression of VEGF-C and CA 15-3 may be useful to differentiate between malignant and benign breast tumour because VEGF-C plays a role in promoting angiogenesis and lymphangiogenesis in malignant processes and CA 15-3 is the soluble form of transmembrane protein MUC1, a tumour marker which shows higher expression in breast cancer.Objective: to determine the diagnostic value of VEGF-C and CA 15-3 as tumour markers in patients with breast cancer.Methods: this diagnostic study recruited 76 patients that underwent surgical biopsy procedures at Dr. Kariadi and Pantiwilasa Citarum Hospitals Semarang. The VEGF-C and CA 15-3 levels in blood specimens taken before surgical biopsy procedure was determined using ELISA method. An ROC curve and AUC were used to establish the cut-off points and diagnostic value. Pathology examination results from the biopsy specimens were used as the gold standard.Results: the cut-off value for VEGF-C and CA 15-3 were 989.50 pg/mL and 74.00 U/mL. Sensitivity for VEGF-C, CA 15-3 and VEGF-C+CA 15-3 were 76.6%, 64.1% and 89.1%. Specificity for VEGF-C, CA 15-3 and VEGF-C+CA 15-3 were 75.0%, 75.0% and 50.0%. The AUC for VEGF-C, CA 15-3 and VEGF-C+CA 15-3 was 0.831 (95% CI = 0.727-0.934), 0.742 (95% CI = 0.628-0.856) and 0.840 (95% CI = 0.742-0.938).Conclusion: VEGF-C in combination with CA 15-3 is the best diagnostic parameter for breast cancer and has the best accuracy as a tumour marker for breast cancer.


2021 ◽  
Vol 12 ◽  
Author(s):  
Qianhui Liu ◽  
Mengting Yin ◽  
Guixing Li

ObjectiveAntithyroglobulin antibody (TgAb) is a potential tumour marker for detecting differentiated thyroid cancer (DTC) recurrence, but insufficient data have supported its clinical applications. Our study aimed to describe the changing trend of TgAb after surgery and identify the relationship between this trend and clinical outcomes.Patients and MethodsWe reviewed the electronic records of 1,686 DTC patients who had undergone total thyroidectomy (TT) and radioactive iodine (131I) therapy at West China Hospital of Sichuan University from January 2015 to December 2017. Finally, 289 preoperative TgAb-positive DTC patients were included and divided into four subgroups depending on the clinical outcome: Group A (tumour free), Group B (uncertain), Group C (incomplete biochemical response), and Group D (structural disease). The patient demographics, tumour characteristics, operations, pathology reports, and all serological biomarkers were reviewed and compared, and the prognostic efficacy of TgAb was evaluated.ResultsAmong all 1,686 patients, 393 (23.65%) were TgAb positive (&gt;40 IU/ml) preoperatively. The TgAb level in Group A decreased significantly after surgery and 131I therapy and stabilised at a low level after 1–2 years of 131I therapy. However, in the other three groups, the decrease in TgAb was not significant after treatment. Conversely, TgAb declined slowly and remained stable or increased. The variations in TgAb relative to the preoperative level of Group A were significantly larger than those of Groups B, C, and D at most time points of follow-up (p &lt; 0.001). By receiver operating characteristic (ROC) analyses, the variations of TgAb &gt; −77.9% at 6 months after 131I therapy (area under the curve (AUC) = 0.862; p &lt; 0.001) and TgAb &gt; −88.6% at 2 years after 131I therapy (AUC = 0.901; p &lt; 0.001) had good prognostic efficacy in tumour-free survival. When the variation in TgAb &gt; −88.6% at 2 years after 131I therapy was incorporated as a variable in the American Thyroid Association (ATA) categories, both intermediate- and high-risk patients also had a significantly increased chance of being tumour free (from 75.68% to 93.88% and 42.0% to 82.61%, respectively).ConclusionsFor preoperative TgAb-positive DTC patients, variations in TgAb &gt; −77.9% at 6 months after 131I therapy and TgAb &gt; −88.6% at 2 years after 131I therapy had good prognostic efficacy. Their incorporation as variables in the ATA risk stratification system could more accurately predict disease-free survival.


Author(s):  
S. Varsha ◽  
C. Bhavya Sree ◽  
Karthik Krishna Ramakrishnan ◽  
Seena Cheppala Rajan ◽  
Muthiah Pichandi

Introduction: Primary Ovary Neoplasms are the most frequent tumors showing epithelial differentiation. Tumour Marker CA-125, glycoprotein synthesized mainly by neoplastic cells with epithelial differentiation. Serum Level of CA-125 has a biological potential of these lesions. This study is mainly done to evaluate the association between serum CA-125 levels and imaging findings and to predict malignancy in various ovarian lesions. Objectives: To evaluate the capacity of CA125 and Imaging findings to predict malignancy in various ovarian pathologies. Materials and Methods: Study area: Department of Radiology, Saveetha Medical College and Hospital, Chennai, Study design: Retrospective study. Study period: 6months. Study population: Patients with history and clinical symptoms of ovarian lesions and USG detected ovarian lesions confirmed on Radiological Imaging. Sampling method: Purposive sampling Sample size: 30. Inclusion criteria: Patients with clinically suspected ovarian lesions or indeterminate ovarian lesions on USG who underwent Radiological imaging and CA-125 estimation. Exclusion criteria: Children less than 12years of age are excluded from this study. Results: Among 30 cases, 19(63.33%) were benign and 2(6.67%) were borderline and 9(30%) were malignant lesion in the present study. Ovarian pathologies is mostly seen in women of age above 25 yrs(86.67%). In this study Ovarian lesions are more commonly seen in married women(86.67%) and menstruating women(56.67%). Out of 30 Cases, Serum CA-125 level <35IU/ml is seen among 13(43.33%) and level >35IU/ml is seen among 17(56.67%). Out of 17 women with CA-125 level >35IU/ml, 9 had malignant lesions on histopathology while 7 women had benign lesions and 1 women had borderline lesion. Conclusion: The present study shows significant association of Serum CA-125 levels with mixed solid cystic ovarian lesions ill defined margins (possible Malignant Ovarian lesions) (p<0.05) especially in Post-menopausal women.


2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Victoria Morrison-Jones ◽  
Fangfei Gao ◽  
Peter Fletcher ◽  
Juan Valle ◽  
O James Garden ◽  
...  

Abstract Background Even after resection biliary tract cancer has a poor outlook. Follow-up is commonly utalises and the sialyl-Lewis tetra saccharide antigen Ca19.9, a known tumour marker in pancreatic and biliary malignancy (upper limit of normal (ULN) 37U/ml). However, the evidence base for the utility of Ca19.9 is limited. The UK BILCAP trial examined the use of adjuvant capecitabine chemotherapy in resected biliary tract cancer and establishing a new global standard of care. Ca19.9 was regularly measured as part of the BILCAP protocol, this provides an opportunity to assess the use of this marker in a large trial with complete patient follow-up. Methods Between March 2006 and December 2014 447 patients underwent resectional surgery (R0 or R1) then were randomised to receive capecitabine chemotherapy or observation. CT imaging and Ca19.9 were performed 3 monthly in year 1, 6 monthly in year 2, and annually thereafter up to 5 years. Follow up was continued until all patients had 5 years follow-up. Recurrence was based mainly on imaging criteria combined with the clinical presentation. The cohort was divided into progression and non- progression groups and the Ca19. 9 values recorded were investigated using descriptive analyses with cut-off of 37 (ULN), 100 and 400U/ml. Results Of 447 study patients 440 had at least one Ca19.9 measurement from either post-operative baseline (394) or a follow-up visit (422). Baseline Ca19-9 was elevated above 37U/ml in 96 patients and 82 (85%) went on to develop recurrence. The sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV) of the Ca19.9 on follow up are shown in the table. Conclusions Although high Ca19.9 levels predict recurrence as shown by acceptable positive predictive values at cut-offs of 100 and 400U/ml the negative predictive values are very poor as most patients develop recurrence without elevation of Ca19.9. Ca19.9 measurement is of very limited value in the follow up of patients with resected biliary cancer.


Author(s):  
Davide Lanza ◽  
Mentor Bilali

Hepatic adenomatosis (HA) is a very rare condition and defined as the presence of 10 or more adenomas in an otherwise normal liver. HA has an incidence of 10–24% in patient with hepatic adenoma and it is more common in women. Most patients with HA are asymptomatic with a normal liver function test and half of cases are detected incidentally on imaging. Although HA is considered a benign disease, some patients may develop potentially fatal complications, such as hypovolaemic shock due to rupture of the liver lesion or malignant transformation to hepatocellular carcinoma. We report the case of a 29-year-old woman who presented to the emergency room after a car accident. Whole-body computed tomography revealed multiple focal hepatic hypervascular lesions in the right lobe of the liver together with a fatty liver. Subsequent hepatic magnetic resonance imaging suggested the diagnosis of HA with a suspicion of focal nodular hyperplasia (FNH). The patient refused to undergo liver biopsy, so we instituted a 3-month surveillance program, which included clinical assessment, liver function tests, tumour marker assessment and blood tests as well as sonographic evaluation for follow-up of the liver lesions.


2021 ◽  
Vol 22 (3) ◽  
Author(s):  
Kim Bui ◽  
Belinda Kiely ◽  
Chris Brown ◽  
Prunella Blinman ◽  
Haryana Dhillon

2021 ◽  
Vol 11 (11) ◽  
pp. 1115
Author(s):  
Miguel Ángel Elorriaga ◽  
José Luis Neyro ◽  
Jon Mieza ◽  
Ignacio Cristóbal ◽  
Antoni Llueca

Background: Ovarian cancer has a low incidence, but high mortality due to a habitual diagnosis in advanced cancer stages. Currently, used biomarkers have good sensitivity, but low specificity. Aim: To determine the usefulness of the biomarkers and algorithms used up to now in the screening, diagnosis, response to treatments and identification of recurrence in patients with ovarian masses. Methodology: Systematic search of publications in English in the Medline-PubMed database with the terms: “biomarkers”, “tumour”, “tumour biomarkers”, “marker”, “tumour marker”, “ovarian cancer”, “ovarian”, “Neoplasms”, “cancer”, CA-125 Antigen; Human Epididymis-specific Protein E4; Risk of Malignancy Index (RMI); Risk of Ovarian Malignancy Algorithm (ROMA); Ovarian Neoplasms. Original articles, clinical trials, reviews, systematic reviews and meta-analyses, published between January 2000 and November 2020, were selected to determine the usefulness (among others) of CA 125 and HE4 antigen in ovarian cancer. Results: Finally, 39 transcendental publications were selected to write this article to determine the usefulness of tumour markers and algorithms in ovarian cancer. Conclusions: The usefulness of the tumour markers antigen CA125 and antigen HE4 individually or as a basis for decision-making algorithms has low specificity; however, there is little evidence that confirms their usefulness as markers in ovarian cancer screening.


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