lewis-x-antigen and Genital-Neoplasms--Female

Recently, it has been revealed that cancer cells produce many substances that are hardly detectable in healthy people. Some of these substances are found in the bloodstream and are clinically used as serum tumor markers. Breakdown products of these serum tumor markers are discharged into the urine; and, therefore, urine can also be a good source of samples for cancer diagnosis. In addition, as other substances remain on or in the cancer cells, we may be able to develop new assay systems using cancer cells as the sample. 1. Serum tumor markers: Many of the recently developed tumor markers are sugar antigens, and are clinically useful for the diagnosis of ovarian cancers. These sugar antigens can be classified into three major categories; core protein-related antigens (CP-RA), core of sugar chain-related antigens (CSC-RA) and periphery of sugar chain-related antigens (PSC-RA). CA125, CA602, and CA130 belong to CP-RA; CA602, CA72-4, and sialyl Tn to CSC-RA; and CA19-9 and sialyl Lewis X (SLX), to PSC-RA. The positive rates of CP-RA in the sera of patients with ovarian epithelial cancers are usually very high except in the case of mucinous cystadenocarcinomas. Meanwhile, those of CSC-RA are higher than those of CP-RA in the sera of mucinous cystadenocarcinoma patients, and the false-positive rate of CSC-RA is lower than that of CP-RA in benign ovarian tumors. The diagnostic efficiency of PSC-RA is inferior to that of CA-RA and CSC-RA. Multi-variate analysis has revealed that the combination assay of these two groups of markers is the most effective among the sugar antigen assays for the diagnosis of epithelial ovarian cancers. 2. Urine tumor markers: beta-core fragment (beta-CF), a fragment of the hCG beta-subunit missing its carboxy-terminal peptide, is often detected in the urine of gynecological malignancies, indicating that urine can be a good sample source for cancer detection.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Antigens, Tumor-Associated, Carbohydrate; Biomarkers, Tumor; Chorionic Gonadotropin; Female; Forecasting; Genital Neoplasms, Female; Humans; Lewis X Antigen

Sialyl SSEA-1 antigen (SLX) is a highly specific tumor marker composed of sugar chain antigens that have Lewis X at their terminals and bind to sialic acid. This antigen is rarely detected in normal tissues, and is present in adenocarcinoma and fetal tissues. We studied the clinical usefulness of SLX in gynecological patients and obtained the following results. (1) The antigen was frequently positive in patients with ovarian cancer with a mean of 89.5 +/- 48.3 U/ml (72.8%, 8/11) and in those with endometriosis with a mean of 39.8 +/- 10.3 U/ml (75.0%, 6/8). (2) Among the gynecological malignancies, the percent positivity was low in those with cervical cancer (20.0%, 5/25), endometrial cancer (33.3%, 1/3), and cancer of the fallopian tube (33.3%, 1/3). (3) The antigen was negative in 20 with myoma uteri, 20 normal pregnant women, and 9 nonpregnant healthy women during the follicular, luteal, or menstrual phase. It was negative in 8 of 9 patients with benign ovarian cyst. False negative results were rare. (4) The SLX level was higher in the ascites than in the serum in patients with ovarian cancer and in those with benign ovarian tumors. (5) The serum SLX in patients with ovarian cancer, which was positive before tumor resection, became negative 2 weeks postoperatively. These results suggest that SLX is a tumor marker with a high specificity to adenocarcinoma of the reproductive organs.

Topics: Adenocarcinoma; Adult; Antigens, Neoplasm; Biomarkers, Tumor; Endometriosis; False Positive Reactions; Female; Genital Diseases, Female; Genital Neoplasms, Female; Glycolipids; Humans; Lewis X Antigen; Menstrual Cycle; Middle Aged; Myoma; Ovarian Neoplasms; Pregnancy; Uterine Cervical Neoplasms; Uterine Neoplasms

In order to estimate the clinical significance of sialyl Lewis Xi (SLXi) antigen, the antigen was measured with an "FH-6" Otsuka Kit in sera from patients with various gynecologic tumors and healthy women. The antigen in ovarian cyst fluids was also determined. Furthermore, serum SLXi antigen levels were serially followed up in the patients with elevated serum SLXi levels to evaluate the correlation between serum SLXi levels and the response to treatment. Results obtained were as follows. 1) Among the patients with uterine myoma, uterine malignancies and benign ovarian tumors, the incidence of elevated serum SLXi antigen levels was very low. 2) Among the patients with ovarian malignancies, serum SLXi antigen levels was significantly increased in the following order: clinical stage I (38%), stage II (50%) and stage III (65%). 3) The high SLXi value was observed in the cyst fluid from all ovarian mucinous adenomas and all ovarian cancers. In addition SLXi antigen level was significantly higher in the cyst fluid of mucinous adenocarcinomas than that of serous cystadenocarcinomas. 4) Serum SLXi values were correlated with the effect of treatment. Interestingly, the elevation of serum SLXi levels preceded the clinical detection of recurrence by 3 month in a case. Thus SLXi antigen appears to be a useful marker for monitoring of ovarian malignancies, especially of mucinous adenocarcinomas.

Topics: Adult; Aged; Biomarkers, Tumor; Female; Genital Neoplasms, Female; Glycolipids; Humans; Lewis X Antigen; Middle Aged