fibrinopeptide-a and Liver-Neoplasms

CEA, GICA, TPA, Fibrinopeptide-A (FpA) and Gamma-GT serum levels were evaluated in 312 patients affected by gastric cancer, to assess their effectiveness in diagnosis, evaluation of disease extension and follow-up of gastric cancer. In 204 patients neoplasia was limited to the stomach, in 108 liver metastases, ascertained by ultrasonography and/or TAC, were present. CEA was increased in 224 cases (71.8%); mean values were significantly higher in metastatic patients than in metastasis-free group (p less than 0.001), but overlap of values between the two groups was observed in about one third of cases. GICA was increased in 268 patients (86%) and TPA in 306 (98%), without significant differences between metastatic and metastasis-free group. FpA was increased in all patients; when metastases were present it was significantly higher than in metastasis-free patients (p less than 0.001), with negligible overlap of values between the two groups. Gamma-GT was normal in 202 metastasis-free patients (99%) and increased in 105 patients with liver metastases (97%). On the basis of these data CEA does not seem to have striking diagnostic sensibility nor reliability in differentiating presence from absence of liver metastases in patients with gastric cancer. Combined assay of TPA, FpA and Gamma-GT seems to be the most reliable serological approach in diagnosis, staging and follow-up of gastric cancer.

Topics: Adult; Aged; Aged, 80 and over; Antigens, Neoplasm; Biomarkers, Tumor; Carcinoembryonic Antigen; Female; Fibrinopeptide A; gamma-Glutamyltransferase; Humans; Liver Neoplasms; Male; Middle Aged; Peptides; Radioimmunoassay; Stomach Neoplasms; Tissue Polypeptide Antigen

In 98 patients affected by colorectal cancer (43 patients with colon cancer, 55 patients with rectosigmoid cancer) the specificity of some tumor markers (CEA, GICA, TPA, alpha-FP, FpA, gamma-GT) has been tested in evidencing the coexistence of liver metastases and the site of the primary tumor, i.e. the rectosigmoid region (rectum + 15 cm of the adjacent sigmoid colon) vs the rest of the colon. Liver metastases, present in 19 patients with colon cancer and in 24 with recto-sigmoid cancer, were previously ascertained by various instrumental investigations. Unlike previous studies which indicated CEA or alpha-FP as the most reliable markers to suggest the coexistence of liver metastases in such patients, the reported results allow the following sequence, in decreasing order of sensitivity, to be proposed: gamma-GT; FpA; CEA and GICA to a similar degree; TPA, which increases only when liver metastases from colon cancer are present; lastly, alpha-FP, which rises only in very few cases of massive hepatic involvement.

Topics: alpha-Fetoproteins; Antigens, Neoplasm; Biomarkers, Tumor; Carcinoembryonic Antigen; Colonic Neoplasms; Fibrinopeptide A; gamma-Glutamyltransferase; Humans; Liver Neoplasms; Peptides; Tissue Polypeptide Antigen

Over a 2-month period, 40 patients with untreated malignancy were studied for protein-C (PRC), antithrombin-III (AT-III), fibrinopeptide A (FPA), routine hemostatic screens, and presence of liver metastases to determine pretreatment changes of hemostasis and relate them to subsequent development of thrombotic or hemorrhagic complications. These patients were observed for a mean period of 18 months. There were 23 males and 17 females with a median age of 64 years. Nine patients had lung carcinoma, 8 colon carcinoma, 7 lymphoma, 5 breast carcinoma, 5 head and neck carcinoma, 2 acute leukemia, 2 prostate carcinoma, 1 adenocarcinoma of unknown primary, and 1 sarcoma. Eight patients had liver metastases. PRC was measured by ELISA, AT-III by radial immunodiffusion, and FPA by RIA. Four patients had decreased AT-III, 28 had decreased levels of PRC, and 39 had elevated levels of FPA. All patients with liver metastases had low PRC. Albumin levels were lower in patients with low PRC (mean 3.3 g/dL v 4.0 g/dL for others). Eight patients, five with liver metastases, developed thrombotic (4), hemorrhagic (3), or both (1) complications. Statistically significant associations were found between (1) presence of liver metastases and development of thrombotic and hemorrhagic complications (P less than .001), (2) presence of liver metastases and decreased PRC (P = .001), and (3) lower albumin levels and decreased PRC (P = .0001). Our study documents early changes of hemostasis in untreated malignancy. We extend previous observations that decreased PRC levels in malignancy may be due to poor synthetic functions of liver. Presence of liver metastases was the only factor associated with subsequent development of thrombotic and hemorrhagic complications. Biochemical markers of hemostatic abnormalities, even though encountered frequently at the time of presentation, are of little predictive value for development of thrombotic and hemorrhagic complications.

Topics: Adult; Aged; Aged, 80 and over; Antithrombin III; Female; Fibrinopeptide A; Hemorrhage; Hemostasis; Humans; Liver Neoplasms; Male; Middle Aged; Neoplasms; Protein C; Prothrombin Time; Thrombosis