Immunologic tests for the detection of gastrointestinal cancers

A comparison of nonoperative vs. preoperative radiotherapy in rectal carcinoma. A 10-year randomized trial

From 1978 to 1980, 68 patients with rectal cancer were randomly allocated to either preoperative irradiation plus surgery or surgical treatment without any preoperative measures. The primary aim of the trial was to investigate the 5-year survival rate in both groups; a secondary aim was to analyze the local recurrence rate and finally the anatomopathologic tumoral classification after surgery. All patients were followed at least 8 years. The preoperative irradiation group (Group A) was submitted to 4000 cGy for 4 weeks and surgery was performed 1 week after irradiation. All tumors were classified anatomically and pathologically according to Broders' and Dukes' classifications. The results indicated that there is a significant difference in the five-year survival rates in both groups: group A had a corrected survival rate of 80 percent; group B (nonirradiated) had a corrected survival rate of 80 percent; group B (nonirradiated) had a corrected survival rate of 34.4 percent. The local recurrence rate was 2.9 percent in group A and 23.5 percent in group B. Regarding tumor regression, before radiotherapy 64.6 percent of the tumors were Broders' Grades 3 and 4; after radiotherapy these were reduced to 20.5 percent. As to Dukes' classification, 26.4 percent of the tumors were type C in group A and, in group B, 47 percent were considered as Dukes' C.

Carcinoembryonic antigen in thyroid disease

Plasma carcinoembryonic antigen (CEA) levels were measured by the Z-Gel technique in 138 patients with benign thyroidopathies, 25 patients with thyroid cancer, and 141 normal persons. Levels were raised (above 5 ng/ml) in 2% of the normal subjects, in none of the patients with benign thyroidopathies, and in 20% of the patients with thyroid cancer. They were considerably raised in all cases of medullary carcinoma of the thyroid but they were also high in other histological types of thyroid cancer. Measurement of plasma CEA may be of value in the preoperative diagnosis and follow-up of patients with thyroid cancer.

Carcinoembryonic antigen and prognosis in patients with colon cancer

One-hundred and fifty patients with non-metastatic colo-rectal cancer were followed for a period of 24 to 36 months postoperatively. Preoperative CEA values have been shown to correlate with the extent of the disease and the patient's prognosis. The prognosis for recurrences is greater in patients with elevated pre-operative CEA values regardless of the stage of their disease. This tendency to have recurrences is 1.8 times higher in individuals with increased pre-operative CEA levels. This same relationship occurs to a greater or lesser extent at each stage of the disease.

Changes in composition of mucin in the mucosa adjacent to carcinoma of the colon as compared with the normal: a biochemical investigation

Fifteen surgical specimens from patients with carcinoma of the colon and rectum were studied. Scrapings from normal mucosa distant from the tumour and from macroscopically normal mucosa adjacent to the tumour (;transitional') were used for chemical estimation of hexosamines, sialic acid, and proteins. The presence of hexosamines and sialic acid was confirmed in both normal and transitional mucosa. Transitional mucosa showed increased levels of total hexosamines and sialic acid as compared with the normal and this was accompanied by an increase in neuraminidase-sensitive sialic acids. The present data have been compared with previous histochemical and autoradiographic studies and it is suggested that the changes described in the transitional mucosa are transformations representing an early stage of carcinogenesis.