Search

CA19-9 serum has been suggested as a marker of unresectability but different cut-off levels have been published. A cut-off of 500 U/ml is currently considered in an international consensus as biological criteria of borderline resectable pancreatic adenocarcinoma. To evaluate whether serum CA19-9 threshold of 500 U/ml could be adequate predictor of resectability in pancreatic adenocarcinoma. Multicenter, observational, prospective study performed in Spain including 203 patients diagnosed with pancreatic adenocarcinoma. 43 (21.2%) cases were resectable and 160 (78.8%) unresectable. Among the 176 preoperative CA19-9 available values, 98 (58.3%) were ≤ 500 U/ml and 73 (42.7%) > 500 U/ml. Resectability rate in those patients with CA19-9 ≤ 500 U/ml was 60% while it was found to be 18% when CA19-9 > 500 U/ml. Statistical model to predict resectability based on CA19-9 provide an AUC of 0.6618 (95% CI 0.53-0.83) when only CA19-9 values > 500 U/ml are studied. Serum levels of CA19-9 higher than 500 U/ml are indicative of unresectable disease, however reduced sensitivity and specificity lead to a limited clinical applicability for resectability.

Recently, differential scanning calorimetry (DSC) has been acknowledged as a novel tool for diagnosing and monitoring several diseases. This highly sensitive technique has been traditionally used to study thermally induced protein folding/unfolding transitions. In previous research papers, DSC profiles from blood samples of patients were analyzed and they exhibited marked differences in the thermal denaturation profile. Thus, we investigated the use of this novel technology in blood serum samples from 25 healthy subjects and 30 patients with gastric adenocarcinoma (GAC) at different stages of tumor development with a new multiparametric approach. The analysis of the calorimetric profiles of blood serum from GAC patients allowed us to discriminate three stages of cancer development (I to III) from those of healthy individuals. After a multiparametric analysis, a classification of blood serum DSC parameters from patients with GAC is proposed. Certain parameters exhibited significant differences (P < 0.05) and allowed the discrimination of healthy subjects/patients from patients at different tumor stages. The results of this work validate DSC as a novel technique for GAC patient classification and staging, and offer new graphical tools and value ranges for the acquired parameters in order to discriminate healthy from diseased subjects with increased disease burden.

Background and Objectives: MicroRNAs (miRNAs) are small, noncoding RNAs that are involved in carcinogenesis through postranscriptional gene regulatory activity. Few studies have focused on the detection of miR-21 in serum rather than in tissue. The current study aimed to measure serum miR-21 expression levels and to evaluate their association with the outcome of colorectal cancer (CRC)., Methods: Blood samples were collected from 102 CRC patients undergoing surgery with curative intent. The expression levels of miR-21 were measured using a quantitative reverse transcription polymerase chain reaction (qRT-PCR). The results were analysed to assess the relationship between serum miR-21 levels and patient survival., Results: A univariate analysis revealed that lower expression levels of serum miR-21 were associated with higher local recurrence (P = 0.025) and mortality (P = 0.029). A logistic regression analysis demonstrated that the relative overexpression of miR-21 (expression > 1) was associated with a 51% reduction in the risk of recurrence. A Cox regression analysis identified miR-21 expression as an independent predictor of survival (P = 0.048); a relative increase in miR-21 expression (>1) was associated with a 50% reduction in the risk of mortality., Conclusion: The expression level of serum miR-21 correlates with the recurrence and mortality of CRC patients. Our results suggest that circulating serum miR-21 is a promising prognostic tumour marker, and they highlight the potential clinical utility of miR-21 expression as a prognostic marker for CRC prognosis., (© 2013 Wiley Periodicals, Inc.)

Objective: To know the changes experienced by the patient profile candidate for radical prostatectomy over the last 2 decades in our institution.., Material and Methods: We analyze retrospectively a series of 1.132 patients with prostate cancer stadium T1-T2, submitted to radical prostatectomy during the period 1989-2009. The series divides in five homogeneous groups as for the number of patients and arranged chronologically. There uses the free survival of biochemical progression (SLPB) as criterion principal forecast., Results: In spite of the changes in the diagnosis and treatment of the disease, from the point of view of the forecast (SLPB) we estimate two groups different from patients: the first 250 controlled ones and the rest. The point of chronological cut places in this series in 1.999. We find significant differences in the majority of the clinical-pathological variables as PSA's level to the diagnosis (P <0,001), percentage of palpable tumors (P <0,001), clinical stadium (P <0,001), Gleason in the prostate biopsy (P =0,004), groups at risk of D'Amico (P <0,001), pathological stage (P <0,001), and percentage of patients with lymph node (P <0,001). Nevertheless, there are not detected differences of statistical significance in the Gleason of the specimen of prostatectomy (P =0,06) and in the percentage of surgical margins (P =0,6)., Conclusions: This study analyzes a patients' wide proceeding sample from the whole Spanish geography and presents some important information that reflect the evolution that has suffered the cancer of prostate located, so much regarding the diagnosis as to the forecast, in our country in the last 20 years., (Copyright © 2012 AEU. Published by Elsevier Espana. All rights reserved.)

Objectives: To describe the clinical and pathological factors of prostate adenocarcinomas diagnosed in our department in the years 1995 and 2004., Material and Method: We review the 216 patients diagnosed in both years, recording several features., Results: The mean age was significatively lower in the year 2004. In that year, the increments of the PSA levels was the main reason for the diagnosis of the prostate cancer, followed by low urinary tract symptons (LUTS), while the LUTS was the main reason in 1995. There was a greater proportion of high grade tumors in 1995 and also in this year, high risk tumors were the most frequently found, while in 2004 low risk and low grade tumors were predominant., Conclusions: Due to the general determinations of PSA levels in asymptomatic patients in 2004, we found a greater proportion of high grade tumors in 1995 and lower grade tumors in 2004.

Objectives: The diagnosis of prostate cancer has changed significantly with the introduction of PSA in the clinical practice. Despite screening is under controversy the use of PSA has become widespread. The objective of this paper is to know the use of PSA in our health-care area and to analyze perceived risks and benefits., Methods: From the informatic archives we analyze PSA determinations performed in our health-care area (290.956 citizens) over 2000 and 2001. We also analyzed prostate biopsies generated and number of cancers detected., Results: 25.519 PSA determinations were performed. 59% came from general practitioners (GP), 34% from urologists and 7% from the rest of specialists. 39% are performed to men older than 70 years. PSA was normal in 78.7% of the patients and higher than 4 ng/ml in 21.2%. 488 prostatic biopsies were performed diagnosing 178 cancers (diagnostic yield 36.5%). Depending on the first PSA, diagnosis was started by a GP in 44% of the cases, a urologist in 46%, and the remaining 10% by other specialists. Mean time from first PSA to diagnosis was 5 months, without significant differences between GPs and specialities . The use of PSA by GPs is variable (between 8.1 and 45.8 determinations per 100 men over 50 years), without significant differences in prostate cancer detection by number of PSAs or differences in age. In comparison with the period 1982-1993 the incidence of prostate cancer goes from 30.76 to 52.8 new cases/100.000 inhabitants/year. There is a greater incidence and increase of cancer in the rural area (from 33.52 to 221.1 new cases/ 100.000 inhabitants/year)., Conclusions: We confirm the general use of this test and the trend to screening in the primary health-care level, which participates in an important manner in the diagnosis. PSA brings forward the diagnosis of prostate cancer 5 years in our area, and shoots its incidence rates. The high use of such marker in our population of advanced age may be considered inadequate.

Objectives: To decide the action politics (to perform or not transrectal prostatic biopsy) for a PSA cut point of 4 and 10 ng/ml through the construction of a mathematical decision tree., Methods: We calculate the usefulness of the biopsy through a subjective score, from 0 to 10, established after a survey of the 20 staff members of the health-care area, applying an global analysis with creation of total profile cards through an orthogonal design., Results: The main usefulness of prostate cancer screening would be not to perform transrectal prostatic biopsies when PSA is lower than 4 ng/ml.

Objective: To analyze the prognostic value of the preoperative serum levels of the carcinoembryonic antigen (CEA) in primary colorectal carcinoma., Material and Methods: Preoperative serum levels of CEA were analyzed in 275 colorectal cancer patients, who were followed up for a minimum of 5 years, or until death., Results: The percentage of positivities for the preoperative serum levels of CEA (> 6 ng/ml) was positively and significantly associated with the tumoral stage (A: 10,5%; B: 38,8%; C: 32,2%; y D: 72%; p < 0,0001). In addition, the elevated serum values of the antigen were significantly associated, in the univariate analysis, with short survival in the overall group of patients (p < 0,0001). However, the multivariate analysis only showed an independent prognosis value of the CEA in the subgroup of patients with stage C tumors., Conclusions: Preoperative serum levels of CEA may be useful to predict tumoral extension, and also for the prognosis regarding stage C colorectal cancer patients.