[The place of tumor markers in breast and gynecologic neoplasms]

The main tumor markers used in breast and gynaecological neoplasias are reviewed with their individual characteristics: carcino-embryonic antigen (CEA), alpha-fetoprotein (AFP), chorionic gonadotropin hormone (CGH), CA 125, CA 15.3 and Squamous Cell Carcinoma Antigen (SCC). Their indications are specified according to the following cancer locations: breast, trophoblast, ovary, endometrium and cervix. The major clinical applications of the tumor markers routinely used are emphasized.

Significance of PSA and PAP in patients with or without prostatic cancer

Coupled prostate-specific antigen (PSA) and prostatic acid phosphatase (PAP) measurements (using the radioimmunoassay method) were carried out on 220 controls, 33 patients with prostatic hyperplasia, and 71 with carcinoma. The mean PSA value was 3.70 +/- 3.31 ng in the controls. A level of 10 ng was adopted as the upper limit of normal. Four of the eight cases of prostatic hyperplasia with a high PSA level (between 10 and 25 ng) underwent surgery. Histological tests confirmed benign hyperplasia. In the localized cancers, the PSA level was normal. In the metastatic cancers, PSA proved to be more sensitive than PAP. Thus, PSA is of little use in the early diagnosis of cancer; its systematic measurement as a means of cancer screening for the general public may even be misleading.

Genomic organization of low copy number sequences that are associated with deca-satellite DNA in the monkey genome

A previously described segment of African green monkey DNA (cloned in phage lambda MkA) contains deca-satellite linked to DNA sequences that are estimated to occur once per genome. Sequences homologous to the low copy number sequences in lambda MkA are also associated with species-specific satellite DNAs in the human and mouse genomes. A second clone, lambda Mk8, contains a monkey DNA region that is colinear and homologous to a portion of the low copy number sequences in lambda MkA, but no satellite sequences. The two cloned segments are markedly different starting at a point proximal to the satellite DNA region in lambda MkA. DNA-blotting experiments indicate that lambda Mk8 but not lambda MkA represents the typical genomic organization and that the low copy number segments occur only once per haploid genome. The data suggest that rearrangements such as deletions or inversions occurring in monkey cells account in part for the structure of lambda MkA. Additional rearrangements may have occurred during cloning in E. coli. This unique chromosomal region may be particularly susceptible to recombination.

[Value of the assay of squamous cell carcinoma in cancer of the uterine cervix]

The squamous cell carcinoma (SCC) antigen was assayed by radioimmunoassay in patients with squamous cell carcinoma of the uterine cervix at different stages before any treatment and in patients under treatment. Low levels of SCC antigen were detected in the early stages of the disease, showing that this antigen cannot be considered an aid to diagnosis. In the more advanced cancers, an increase of SCC antigen levels proportional to the stage of the disease was observed. However, SCC antigen assays are mainly useful in the follow-up of patients to evaluate therapeutic effectiveness.

Isolation and molecular characterization of beta-lactamase-producing Haemophilus parainfluenzae from the genital tract

Three Haemophilus parainfluenzae strains isolated from the urogenital tract harbored a beta-lactamase-coding 3.2-megadalton plasmid identical, by restriction endonuclease digestion and hybridization with radioactive and biotin-labeled probes specific for the TEM-1 beta-lactamase and TnA sequences, to the 3.2-megadalton "African-type" plasmid found in Neisseria gonorrhoeae.

[Cancer of the ovary. Comparative value of serum CA-125, immunochemistry and biological tests of inflammation]

The marker CA-125 is not specific of malignant ovarian tumors but, when its titration is positive, its evolution permits to follow correctly the development of the tumor. The authors report their experience with 180 titrations coupled with the titration of inflammation markers.

[Non-seminomatous germinal tumors of the ovary and testis in children]

The authors report a series of 17 non-seminomatous malignant germ cell tumours of the gonads in children, seen over a period of 18 years. 10 of these tumours were located in the ovaries and 7 were testicular. These are rare tumours with a highly polymorphous histological appearance. The overall 3-year survival was 10 (15 girls and 5 boys) out of 17. Choriocarcinomas and stage IV tumours have a very poor prognosis. Among the testicular tumours, the embryonal tumours have the most reserved prognosis. Whether the tumour arises in the ovary or in the testis, surgery is essential in order to define the therapeutic strategy.

Clinical pharmacokinetics of 6-hour infusion of high-dose methotrexate. Preliminary trial of monitoring high infusion doses

Methotrexate (MTX) in serum was measured by RIA in 12 cancer patients receiving high doses of MTX (2 to 8 g/m2) in 6 hour infusions 69 treatments were studied. The peak serum level was proportional to the dose administered and was always greater than 10(-4) M. 2 elimination phases were seen: the first had a mean half-life of 2.36 h and the second a mean half-life of 16.14 h. 24 hours after beginning the infusions there were very large variations in individual serum concentrations of MTX, from 2.4 10(-6) M to 1.9 10(-5) M by 24 h after 8 g/m2. To control these variations, a mathematical model for prediction of the individual pharmacokinetic pattern of a 6 hour-infusion of high-dose MTX by kinetic analysis of a low-test dose is proposed. A program was created for an Apple III computer using toxic and therapeutic serum levels of MTX selected by the clinician. The computer program is adaptable to any infused substance for variable infusion times, thus introducing new advances over existing methods.

Value of the estimation of thyroglobulin levels in the surveillance of treated differentiated thyroid carcinoma

Thyroglobulin levels were measured, without interruption of hormone treatment, in 115 patients who had undergone thyroidectomy for differentiated carcinoma. Thyroglobulin levels were invariably high in patients with iodine fixing metastases. The estimation of thyroglobulin was found to be more sensitive than the detection of metastases by their uptake of 131 iodine. A new protocol is suggested for monitoring treated differentiated carcinoma.

Lymphocytes T and pharmacokinetics after a single oral dose of levamisole in healthy and cancer subjects

Levamisole, an anthelmintic drug with immunopotentiating activity, is shown to have variable effects on cell-mediated immunity. We have studied the effect of a single oral dose (2.5 mg/kg or 5 mg/kg) on early and spontaneous E rosettes percentages in healthy and cancer patients. Pharmacokinetic study of this compound was conducted in parallel. The results indicated that single administration of levamisole (2.5 mg/kg) in healthy men can promote an increase of early E rosettes with mean peak plasma level of 0.8 micrograms. ml-1. On the other hand, there was no change in the proportion of early E rosettes in cancer patients and in the proportion of spontaneous E rosettes in healthy and cancer subjects.