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Xu F, Huang M, Bai Y, Yin X, Yan J, Liu F, Chen J, Weng X. Landmarks in pancreatic cancer studies. Cancer Cell Int 2022; 22:383. [PMID: 36476236 PMCID: PMC9730569 DOI: 10.1186/s12935-022-02803-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 11/23/2022] [Indexed: 12/12/2022] Open
Abstract
Pancreatic cancer is a rare but fatal disease. Patients present advanced disease due to the lack of or typical symptoms when the tumor is still localized. A high-quality image processing system has been in practice to detect the pancreatic tumor and determine the possibility of surgery, and preoperative methods, such as ERCP are increasingly used to complement the staging modality. Pancreaticoduodenectomy is one of the complicated surgeries with potential morbidity. The minimally invasive pancreatic resections, both robot-assisted and laparoscopic, have become a part of standard surgical practice worldwide over the last decade. Moreover, advancements in adjuvant chemotherapy have improved the long-term outcomes in current clinical practice. The systemic conservative treatment, including targeted agents, remains the mainstay of treatment for patients with advanced disease. An increasing number of studies are focused on modulating the pancreatic tumor microenvironment to improve the efficacy of the immunotherapeutic strategies. Herein, the role of preoperative therapy, the novel surgical strategy, and individualized systemic treatment in pancreatic cancer is investigated. Also, the randomized controlled studies that have defined the neoadjuvant and surgical management of pancreatic cancer have been summarized.
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Affiliation(s)
- Fan Xu
- grid.413856.d0000 0004 1799 3643Department of Public Health, Chengdu Medical College, Chengdu, 610500 Sichuan China
| | - Min Huang
- grid.413856.d0000 0004 1799 3643Department of Physiology, Chengdu Medical College, Chengdu, 610500 Sichuan China
| | - Yun Bai
- grid.413856.d0000 0004 1799 3643Department of Public Health, Chengdu Medical College, Chengdu, 610500 Sichuan China
| | - Xueshi Yin
- grid.413856.d0000 0004 1799 3643Department of Clinic Medicine, Chengdu Medical College, Chengdu, 610500 Sichuan China
| | - Jingzhe Yan
- grid.440230.10000 0004 1789 4901Department of Abdominal Oncosurgery-2, Jilin Province Tumor Hospital, Changchun, 130012 China
| | - Fangfang Liu
- grid.412723.10000 0004 0604 889XArt college, Southwest Minzu University, Chengdu, 610041 Sichuan China
| | - Jie Chen
- grid.412277.50000 0004 1760 6738Department of Orthopedics, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, 200025 China ,grid.194645.b0000000121742757School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, 999077 China
| | - Xiechuan Weng
- grid.506261.60000 0001 0706 7839Department of Neuroscience, Beijing Institute of Basic Medical Sciences, Beijing, 100850 China
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Circulating Tissue Polypeptide-Specific Antigen in Pre-Diagnostic Pancreatic Cancer Samples. Cancers (Basel) 2021; 13:cancers13215321. [PMID: 34771485 PMCID: PMC8582400 DOI: 10.3390/cancers13215321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/01/2021] [Accepted: 10/21/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Detecting cancer early significantly increases the chances of successful (surgical) treatment. Pancreatic cancer is one of the deadliest cancer forms, since it is usually discovered at a late and already spread stage. Finding biomarkers showing pancreatic cancer at an early stage is a possible approach to early detection and improved treatment. The aim of our study was to assess the potential of tissue polypeptide specific antigen (TPS) as a biomarker for early pancreatic cancer detection. We studied TPS levels in blood plasma samples from a population-based biobank in Västerbotten, Sweden that were collected before individuals were diagnosed with pancreatic cancer. Although TPS levels are raised at diagnosis, this occurs late, and thus TPS does not seem to hold promise as an early detection marker for pancreatic cancer. Abstract Early detection of pancreatic ductal adenocarcinoma (PDAC) is challenging, and late diagnosis partly explains the low 5-year survival. Novel and sensitive biomarkers are needed to enable early PDAC detection and improve patient outcomes. Tissue polypeptide specific antigen (TPS) has been studied as a biomarker in PDAC diagnostics, and it has previously been shown to reflect clinical status better than the ‘golden standard’ biomarker carbohydrate antigen 19-9 (CA 19-9) that is most widely used in the clinical setting. In this cross-sectional case-control study using pre-diagnostic plasma samples, we aim to evaluate the potential of TPS as a biomarker for early PDAC detection. Furthermore, in a subset of individuals with multiple samples available at different time points before diagnosis, a longitudinal analysis was used. We assessed plasma TPS levels using enzyme-linked immunosorbent assay (ELISA) in 267 pre-diagnostic PDAC plasma samples taken up to 18.8 years before clinical PDAC diagnosis and in 320 matched healthy controls. TPS levels were also assessed in 25 samples at PDAC diagnosis. Circulating TPS levels were low both in pre-diagnostic samples of future PDAC patients and in healthy controls, whereas TPS levels at PDAC diagnosis were significantly increased (odds ratio 1.03; 95% confidence interval: 1.01–1.05) in a logistic regression model adjusted for age. In conclusion, TPS levels increase late in PDAC progression and hold no potential as a biomarker for early detection.
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Hefler LA, Tempfer CB, Bancher-Todesca D, Schatten C, Husslein P, Heinze G, Gregg AR. Placental Expression and Serum Levels of Cytokeratin-18 Are Increased in Women With Preeclampsia. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/107155760100800308] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Lukas A. Hefler
- Departments of Obstetrics and Gynecology and Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas; Departments of Obstetrics and Gynecology and Medical Computer Sciences, University of Vienna Medical School, Vienna, Austria
| | | | | | | | | | | | - Anthony R. Gregg
- Departments of Obstetrics and Gynecology and Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas; Departments of Obstetrics and Gynecology and Medical Computer Sciences, University of Vienna Medical School, Vienna, Austria
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Farina A, Delhaye M, Lescuyer P, Dumonceau JM. Bile proteome in health and disease. Compr Physiol 2014; 4:91-108. [PMID: 24692135 DOI: 10.1002/cphy.c130016] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The study of bile proteins could improve the understanding of physiological processes involved in the regulation of the hepato-biliary system. Researchers have tried for years to investigate the bile proteome but, until recently, only a few tens of proteins were known. The advent of proteomics, availing of large-scale analytical devices paired with potent bioinformatic resources, lately allowed the identification of thousands of proteins in bile. Nevertheless, the knowledge of their role in the hepato-biliary system still represents almost a "blank page in the book of physiology." In this review, we first guide the reader through the historical phases of the analysis of bile protein content, emphasizing the recent progresses achieved through the use of proteomic techniques. Thereafter, we deeply explore the involvement of bile proteins in health and disease, with a particular focus on the discovery of biomarkers for biliary tract malignancies.
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Affiliation(s)
- Annarita Farina
- Biomedical Proteomics Research Group, Department of Human Protein Sciences, Geneva University, Geneva, Switzerland
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Distler M, Pilarsky E, Kersting S, Grützmann R. Preoperative CEA and CA 19-9 are prognostic markers for survival after curative resection for ductal adenocarcinoma of the pancreas - a retrospective tumor marker prognostic study. Int J Surg 2013; 11:1067-72. [PMID: 24161419 DOI: 10.1016/j.ijsu.2013.10.005] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 09/30/2013] [Accepted: 10/11/2013] [Indexed: 12/30/2022]
Abstract
BACKGROUND The prognosis for patients with ductal adenocarcinoma of the pancreas (PDAC) remains poor even after curative resection. Carbohydrate antigen 19-9 (CA 19-9) and the carcinoembryonic antigen (CEA) are the most widely used serum-based tumor markers for the diagnosis and follow up of pancreatic cancer. In our analysis we aim to assess the prognostic value of a combination of both tumor markers in patients with pancreatic ductal adenocarcinoma (PDAC). PATIENTS AND METHODS Between 01/1995 and 08/2012 we performed a total of 264 pancreatic resections due to PDAC. Patients were stratified into 3 groups in regard to their preoperative tumor marker levels. Survival was compared between the groups using Kaplan Meier analysis and log rank test. Univariate subgroup analysis and multivariate analysis were performed. RESULTS For 259 cases complete follow up could be obtained. In patients with low preoperative CEA and CA 19-9 levels (group 1 n = 91) the mean survival was 33.3 month (CI 95% 25.1-41.5). If one of the analyzed tumor markers (CEA/CA19-9) was preoperatively elevated above the cut-off level (group 2 n = 106) mean survival was 28.5 month (CI 95% 22.1-35.1). 62 patients showed preoperative elevation of both, CEA and CA 19-9 (group 3); mean survival in this group was 23.9 month (CI 95% 13.9-33.9), p > 0.01. Multivariate analysis confirmed preoperative CEA/CA 19-9 level as independent prognostic factor (HR 1.299). CONCLUSION Preoperative CEA and CA 19-9 levels correlate with patient prognosis after curative pancreatic resection due to PDAC. This is especially true for the most frequently pT 3/4 stages of PDAC. Even if CEA and CA 19-9 might not be appropriate for screening, its serum levels should therefore be determined prior to operation and taken into account when resectability or operability is doubtful.
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Affiliation(s)
- Marius Distler
- Department of General, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, TU Dresden, Germany.
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Role of the hematopoietic cytokines SCF, IL-3, GM-CSF and M-CSF in the diagnosis of pancreatic and ampullary cancer. Int J Biol Markers 2012; 27:e186-94. [PMID: 22865301 DOI: 10.5301/jbm.2012.9348] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2012] [Indexed: 01/14/2023]
Abstract
BACKGROUND Previous studies have demonstrated altered levels of hematopoietic cytokines in the serum of patients with different types of cancer. METHODS We measured the serum levels of the hematopoietic cytokines stem cell factor (SCF), interleukin 3 (IL-3), macrophage-colony stimulating factor (M-CSF) and granulocyte-macrophage-colony stimulating factor (GM-CSF) in 40 pancreatic and ampullary cancer patients and 40 healthy volunteers, using ELISA. We also assessed the most widely used pancreatic tumor markers, carbohydrate antigen 19-9 (CA 19-9) and carcinoembryonic antigen (CEA), in both groups. We then correlated the concentrations of the cytokines' and the tumor markers in the patients' serum and we estimated their diagnostic ability by calculating diagnostic sensitivity and specificity, positive and negative predictive values and the receiver operating characteristic (ROC) curve. RESULTS The SCF and IL-3 levels were significantly lower and the M-CSF levels significantly higher in pancreatic cancer patients than in controls. There were significant positive correlations between the serum levels of CEA and M-CSF, GM-CSF and SCF, and between GM-CSF and IL-3. The area under the ROC curve and diagnostic sensitivity of M-CSF were greater than those of SCF and IL-3. The diagnostic sensitivity of the combined use of SCF and M-CSF reached 97.5%. CONCLUSION The diagnostic ability of M-CSF and SCF in pancreatic and ampullary cancer should stimulate further studies evaluating their clinical usefulness as tumor markers.
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Ozkan H, Demirbaş S, Ibiş M, Akbal E, Köklü S. Diagnostic validity of serum macrophage inhibitor cytokine and tissue polypeptide-specific antigen in pancreatobiliary diseases. Pancreatology 2011; 11:295-300. [PMID: 21757969 DOI: 10.1159/000328963] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Accepted: 05/03/2011] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIM Macrophage inhibitory cytokine (MIC-1) and tissue polypeptide-specific antigen (TPS) are novel markers for several inflammatory and malignant disorders, and there are no sufficient data about the utility of these antigens as serum tumor markers. We aimed at measuring the serum levels of MIC-1 and TPS in patients with benign and malignant pancreatobiliary diseases and at determining their diagnostic efficacy. PATIENTS AND METHODS Sera collected from patients with pancreatic adenocarcinomas (56 cases), periampullary carcinomas other than pancreatic carcinomas (15 cases), benign pancreatic diseases (31 cases), benign biliary diseases (15 cases) and healthy volunteers (33 cases) were analyzed for MIC-1 and TPS and the results were compared with CA 19-9. RESULTS Serum MIC-1 levels increased more significantly in patients with pancreatic carcinomas than in patients with benign pancreatobiliary diseases and healthy controls (p < 0.05). MIC-1 has a similar sensitivity (81%) but a lower specificity (73 vs. 97%) than CA 19-9 in patients with pancreatic carcinomas. Serum TPS was comparable among patients with malignant and benign pancreatobiliary diseases, and healthy controls. CONCLUSION MIC-1 is a valuable tumor marker for the diagnosis of pancreatic cancer. It has a good correlation with CA 19-9. TPS has no diagnostic importance to differentiate pancreatobiliary diseases. and IAP.
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Affiliation(s)
- Hasan Ozkan
- Department of Gastroenterology, Ankara University School of Medicine, Turkey
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Sharma C, Eltawil KM, Renfrew PD, Walsh MJ, Molinari M. Advances in diagnosis, treatment and palliation of pancreatic carcinoma: 1990-2010. World J Gastroenterol 2011; 17:867-97. [PMID: 21412497 PMCID: PMC3051138 DOI: 10.3748/wjg.v17.i7.867] [Citation(s) in RCA: 149] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2010] [Revised: 12/08/2010] [Accepted: 12/15/2010] [Indexed: 02/06/2023] Open
Abstract
Several advances in genetics, diagnosis and palliation of pancreatic cancer (PC) have occurred in the last decades. A multidisciplinary approach to this disease is therefore recommended. PC is relatively common as it is the fourth leading cause of cancer related mortality. Most patients present with obstructive jaundice, epigastric or back pain, weight loss and anorexia. Despite improvements in diagnostic modalities, the majority of cases are still detected in advanced stages. The only curative treatment for PC remains surgical resection. No more than 20% of patients are candidates for surgery at the time of diagnosis and survival remains quite poor as adjuvant therapies are not very effective. A small percentage of patients with borderline non-resectable PC might benefit from neo-adjuvant chemoradiation therapy enabling them to undergo resection; however, randomized controlled studies are needed to prove the benefits of this strategy. Patients with unresectable PC benefit from palliative interventions such as biliary decompression and celiac plexus block. Further clinical trials to evaluate new chemo and radiation protocols as well as identification of genetic markers for PC are needed to improve the overall survival of patients affected by PC, as the current overall 5-year survival rate of patients affected by PC is still less than 5%. The aim of this article is to review the most recent high quality literature on this topic.
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Serum biomarkers for improved diagnostic of pancreatic cancer: a current overview. J Cancer Res Clin Oncol 2010; 137:375-89. [PMID: 21193998 DOI: 10.1007/s00432-010-0965-x] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2010] [Accepted: 12/02/2010] [Indexed: 01/05/2023]
Abstract
PURPOSE Complete resection constitutes the only curative approach in pancreatic cancer but is possible only in a minority of patients due to advanced stages upon diagnosis. Consequently, early detection is crucial for curative treatment. Clinical routine still lacks efficient, non-invasive screening assays, and 80-90% of pancreatic carcinomas are detected at unresectable stages. A wide range of serum proteins have been in the focus of intensive search for biomarkers specific for pancreatic cancer. This article will give an overview on serum biomarkers with screening potential for pancreatic malignancy. DESIGN AND METHODS PUBMED database was searched for articles, and 43 manuscripts were selected that provided data regarding biomarkers used, type of assay, study population, sample cohort quality and diagnostic performance. RESULTS Superior values for diagnostic performance were shown for MIC-1, PAM4, OPN, HSP27, TPS, TSGF, and CAM17.1 as individual markers. Panels of biomarkers comprised CA 19-9, MCSF, CEA, SAA, Haptoglobin, TSGF, CA 242, and HSP27. Individually or in concerted form, sensitivity and specificity ranged from 77 to 100% and 84-100%, respectively. CONCLUSIONS While the above named markers show high screening potential for pancreatic cancer, standardized validation studies using multiplex assays are required to pave the way for clinical routine application.
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N/A, 王 建. N/A. Shijie Huaren Xiaohua Zazhi 2005; 13:2010-2012. [DOI: 10.11569/wcjd.v13.i16.2010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
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Abstract
Alteration of the expression of carbohydrate structures is frequently observed in tumor cells. This review summarizes the different changes of O- and N-linked glycoproteins observed in cancer cells, the impact of the tumor-related carbohydrate phenotypes on the clinical outcome of the cancer disease, and the various ways in which carbohydrate structures can interact with different carbohydrate-detecting adhesion molecules, selectins, and sialoadhesins. Various ways of inhibiting the formation of cell adhesion-engaged carbohydrates on the cell surface, or inhibiting the binding are discussed. Carbohydrate structures which are in clinical use as circulating tumor markers and the effect of genotypes on tumor marker concentrations are reviewed.
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Affiliation(s)
- T F Orntoft
- Department of Clinical Biochemistry, Aarhus University Hospital, Skejby, Aarhus N, Denmark.
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Abstract
Alteration of the expression of carbohydrate structures is frequently observed in tumor cells. This review summarizes the different changes of O- and N-linked glycoproteins observed in cancer cells, the impact of the tumor-related carbohydrate phenotypes on the clinical outcome of the cancer disease, and the various ways in which carbohydrate structures can interact with different carbohydrate-detecting adhesion molecules, selectins, and sialoadhesins. Various ways of inhibiting the formation of cell adhesion-engaged carbohydrates on the cell surface, or inhibiting the binding are discussed. Carbohydrate structures which are in clinical use as circulating tumor markers and the effect of genotypes on tumor marker concentrations are reviewed.
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Affiliation(s)
- T F Orntoft
- Department of Clinical Biochemistry, Aarhus University Hospital, Skejby, Aarhus N, Denmark.
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Ventrucci M, Ubalducci GM, Cipolla A, Panella MA, Ligabue A. Serum CA 242: the search for a valid marker of pancreatic cancer. Clin Chem Lab Med 1998; 36:179-84. [PMID: 9589807 DOI: 10.1515/cclm.1998.033] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Many efforts have been made to find valuable serum tumour markers which help the diagnosis of pancreatic cancer. In the present study we investigated the diagnostic value of CA 242 in comparison with two other routinely used tumour markers (CA 19-9 and CA 50). Two-hundred and seventy six subjects were enrolled in this study: 46 patients with pancreatic cancer preoperatively, 53 with chronic pancreatitis, 28 with acute pancreatitis, 49 with other malignancies, 50 with miscellaneous non-neoplastic digestive diseases, and 50 healthy subjects. CA 242 was determined in serum by means of a two-step fluoroimmunometric assay. Sensitivities of CA 242, CA 19-9 and CA 50 for pancreatic cancer when all patients were considered were 41.3%, 54.3% and 47.8%, respectively (95% specificity level). No significant improvement was achieved by combination of CA 242 with CA 19-9 and/or CA 50. Cholestasis affected serum levels of CA 242 in patients without pancreatic cancer, but not in those with this tumour. The metastatic stage of pancreatic cancer appeared to influence the levels of CA 242. In conclusion, CA 242 serum assay does not seem to improve diagnostic accuracy for pancreatic cancer compared to CA 19-9 and CA 50.
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Affiliation(s)
- M Ventrucci
- Dipartimento di Medicina Interna e Gastroenterologia, Università di Bologna, Italy.
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Abstract
Cancer remains the second leading cause of death in developed countries, and the incidence of certain tumors is increasing despite emphasis on prevention and screening. Tumor markers are biologic or biochemical substances that are produced by tumor cells and then secreted into the circulation in detectable amounts. This article covers some of the more common tumor markers currently being utilized for diagnostic and prognostic purposes.
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Affiliation(s)
- R J Pamies
- Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
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Orntoft TF, Bech E. Circulating blood group related carbohydrate antigens as tumour markers. Glycoconj J 1995; 12:200-5. [PMID: 7496132 DOI: 10.1007/bf00731320] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The various blood group related carbohydrate structures which are in clinical use as circulating tumour makers are reviewed. Their location on carbohydrate chains and their structural characteristics are shown, and their clinical performance in various malignant diseases is reviewed. The available data on their sensitivity, specificity and predictive value are shown; and carcinomas of the pancreas, ventricle, colon-rectum and ovary are identified as diseases in which these markers can be of good benefit for follow-up. Future research should be devoted to studies of the function of these structures, and to studies of their gene-transcription.
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Affiliation(s)
- T F Orntoft
- Department of Clinical Biochemistry, University Hospital, Denmark
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