Anticancer research
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Anticancer research · Mar 2003
Usefulness of alpha-fetoprotein in the diagnosis of hepatocellular carcinoma.
With the widespread use of ultrasonography (US) and computerized tomography (CT), the usefulness of alpha-fetoprotein assay in the diagnosis of hepatocellular carcinoma (HCC) has decreased. The aim of our study was to evaluate the best cut-off value for serum alpha-fetoprotein to discriminate between liver cirrhosis (LC) and HCC and the factors influencing levels in a Sicilian population. Three hundred and seventy-two patients with LC and 197 with HCC-associated LC were studied. ⋯ There was a correlation between AFP serum values and TNM classification (p < 0.02) and on multiple logistic regression AFP levels > 30 ng/ml correlated positively only with the TNM stage (p < 0.0001). In conclusion, the best cut-off value for serum AFP in our study population was 30 ng/ml, but at this level sensitivity was low. This cut-off value was more useful in detecting non-viral HCC, because PPV was significantly higher than in viral HCC; therefore, our data confirm that the usefulness of AFP in the diagnosis of HCC of viral etiology is limited, being more useful in HCC of non-viral etiology.
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Anticancer research · Mar 2003
Randomized Controlled Trial Clinical TrialBiomodulation of cancer chemotherapy for metastatic colorectal cancer: a randomized study of weekly low-dose irinotecan alone versus irinotecan plus the oncostatic pineal hormone melatonin in metastatic colorectal cancer patients progressing on 5-fluorouracil-containing combinations.
Recent advances in immunobiological knowledge have suggested the possibility of enhancing the therapeutic activity of various chemotherapeutic agents by a concomitant administration of anti-oxidant drugs and/or immunomodulating neurohormones. In particular, the pineal neurohormone melatonin (MLT), which is able to exert both antioxidant and immunomodulating effects, has been proven to enhance the efficacy of various chemotherapeutic drugs, namely cisplatin, anthracyclines and 5-fluorouracil, whereas at present there are no data about its possible influence on cytotoxic drugs effective in the treatment of colon cancer other than 5-fluorouracil, such as irinotecan (CPT-11). The present study was performed to evaluate the influence of a concomitant administration of MLT on CPT-11 therapeutic activity in metastatic colorectal cancer. ⋯ However, taken together, patients treated with CPT-11 at 50% of the planned dose showed a percent of disease control comparable to that achieved in patients who had no dose reduction (6 out of 10 vs 13 out of 20). This preliminary study shows that the efficacy of weekly low-dose CPT-11 in pretreated metastatic colorectal cancer patients may be enhanced by a concomitant daily administration of the pineal hormone MLT, according to the results previously reported for other chemotherapeutic agents. Moreover, since the dose reduction of CPT-11 does not influence its efficacy, the dose of CPT-11 for successive studies might be not greater than 70 mg/m2.
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Anticancer research · Mar 2003
Comparative StudyMolecular detection of cancer cells in the peripheral blood of patients with breast cancer: comparison of CK-19, CEA and maspin as detection markers.
To investigate and compare the diagnostic value of the detection of cytokeratin 19 (CK-19), carcinoembryonic antigen (CEA) and maspin mRNA by nested RT-PCR in the peripheral blood of women with breast cancer. ⋯ RT-PCR positivity for CK-19 mRNA is the most sensitive detection marker for occult tumor cells in operable and metastatic breast cancer, although nested RT-PCR for maspin mRNA appears to be more specific.
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Anticancer research · Mar 2003
Case Reports Comparative StudyPro-gastrin-releasing peptide (ProGRP), neuron specific enolase (NSE), carcinoembryonic antigen (CEA) and cytokeratin 19-fragments (CYFRA 21-1) in patients with lung cancer in comparison to other lung diseases.
The study presents data comparing the new tumour marker, ProGRP, with the established markers, NSE, CYFRA 21-1 and CEA in the diagnosis of lung cancer. ProGRP as well as NSE have been reported to be useful markers for staging and monitoring treatment in patients with small cell lung cancer (SCLC). In order to determine the differences in the sensitivity and/or specificity particularly with regard to benign lung diseases, the present study investigated ProGRP in comparison to NSE, CEA and CYFRA 21-1 usually used in lung cancer. ⋯ Initial follow-up studies indicated that ProGRP can be used to monitor disease under chemotherapy. In non-small cell lung carcinomas, CYFRA 21-1 was the leading marker with 58.9% sensitivity where ProGRP seldom revealed positive results. ProGRP is a valuable tumour marker for the detection and monitoring of SCLC and a good tool for discriminating NSCLC versus SCLC.
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Anticancer research · Mar 2003
Comparative StudyCold-knife conization versus photodynamic therapy with topical 5-aminolevulinic acid (5-ALA) in cervical intraepithelial neoplasia (CIN) II with associated human papillomavirus infection: a comparison of preliminary results.
The optimal treatment of preinvasive cervical lesions is still not clear as all surgical techniques cause substantial cervical stroma destruction with the risk of a possible incompetent cervix. Photodynamic therapy can preserve fertility due to selective tissue destruction. The aim of the present study was to compare the efficacy of cold-knife conization versus photodynamic therapy with topical 5-aminolevulinic acid in eradicating cervical intraepithelial neoplasia (CIN) II and associated HPV infection. ⋯ The results presented in this study indicate that topical PDT with 5-ALA is in most cases a successful treatment of CIN II with comparable results to cold-knife conization. In contrast to cold-knife conization, PDT causes no substantial cervical stroma destruction with the risk of a possible subsequent incompetent cervix. Also the feasibility of topical PDT on an outpatient basis, the lack of significant post-treatment complications and the cost effectiveness make the topical approach with PDT preferable in selected circumstances. Due to the potential risk of invasive cancer with metastatic spread, patient's selection criteria must be strict and a pretreatment histological examination is obligatory.