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Lombardi CM, Cimino G, Pellicori P, Bonelli A, Inciardi RM, Pagnesi M, Tomasoni D, Ravera A, Adamo M, Carubelli V, Metra M. Congestion in Patients with Advanced Heart Failure: Assessment and Treatment. Heart Fail Clin 2021; 17:575-586. [PMID: 34511206 DOI: 10.1016/j.hfc.2021.05.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Heart failure (HF) is characterized by frequent hospital admissions due to acute decompensation and shortened life span with a progressive clinical course leading to an advanced stage where traditional therapies become ineffective. Due to aging of the population and improved therapies, only a small of proportion of patients with advanced HF are candidates for surgical treatments, such as mechanical circulatory support or heart transplantation. In most cases, prompt identification and management of congestion is paramount to improving symptoms and quality of life and avoiding progression to severe multiorgan dysfunction and death.
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Affiliation(s)
- Carlo Mario Lombardi
- Cardiology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Giuliana Cimino
- Cardiology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Pierpaolo Pellicori
- Robertson Institute of Biostatistics and Clinical Trials Unit, University of Glasgow, Glasgow, UK
| | - Andrea Bonelli
- Cardiology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Riccardo Maria Inciardi
- Cardiology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Matteo Pagnesi
- Cardiology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Daniela Tomasoni
- Cardiology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Alice Ravera
- Cardiology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Marianna Adamo
- Cardiology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Valentina Carubelli
- Cardiology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Marco Metra
- Cardiology Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
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Giamougiannis P, Martin-Hirsch PL, Martin FL. The evolving role of MUC16 (CA125) in the transformation of ovarian cells and the progression of neoplasia. Carcinogenesis 2021; 42:327-343. [PMID: 33608706 DOI: 10.1093/carcin/bgab010] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 01/19/2021] [Accepted: 02/15/2021] [Indexed: 12/23/2022] Open
Abstract
MUC16 (the cancer antigen CA125) is the most commonly used serum biomarker in epithelial ovarian cancer, with increasing levels reflecting disease progression. It is a transmembrane glycoprotein with multiple isoforms, undergoing significant changes through the metastatic process. Aberrant glycosylation and cleavage with overexpression of a small membrane-bound fragment consist MUC16-related mechanisms that enhance malignant potential. Even MUC16 knockdown can induce an aggressive phenotype but can also increase susceptibility to chemotherapy. Variable MUC16 functions help ovarian cancer cells avoid immune cytotoxicity, survive inside ascites and form metastases. This review provides a comprehensive insight into MUC16 transformations and interactions, with description of activated oncogenic signalling pathways, and adds new elements on the role of its differential glycosylation. By following the journey of the molecule from pre-malignant states to advanced stages of disease it demonstrates its behaviour, in relation to the phenotypic shifts and progression of ovarian cancer. Additionally, it presents proposed differences of MUC16 structure in normal/benign conditions and epithelial ovarian malignancy.
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Affiliation(s)
- Panagiotis Giamougiannis
- Department of Gynaecological Oncology, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK.,School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, UK
| | - Pierre L Martin-Hirsch
- Department of Gynaecological Oncology, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK.,Division of Cancer Sciences, University of Manchester, Manchester, UK
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D'Aloia A, Vizzardi E, Metra M. Can Carbohydrate Antigen-125 Be a New Biomarker to Guide Heart Failure Treatment?: The CHANCE-HF Trial. JACC. HEART FAILURE 2016; 4:844-846. [PMID: 27810078 DOI: 10.1016/j.jchf.2016.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 09/07/2016] [Indexed: 12/28/2022]
Affiliation(s)
- Antonio D'Aloia
- Cardiology, Cardio-Thoracic Department, Civil Hospitals, Brescia, Italy
| | - Enrico Vizzardi
- Cardiology, Cardio-Thoracic Department, Civil Hospitals, Brescia, Italy; Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy
| | - Marco Metra
- Cardiology, Cardio-Thoracic Department, Civil Hospitals, Brescia, Italy; Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
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Sharma SK, Wuest M, Wang M, Glubrecht D, Andrais B, Lapi SE, Wuest F. Immuno-PET of epithelial ovarian cancer: harnessing the potential of CA125 for non-invasive imaging. EJNMMI Res 2014; 4:60. [PMID: 26116121 PMCID: PMC4883985 DOI: 10.1186/s13550-014-0060-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 10/24/2014] [Indexed: 12/22/2022] Open
Abstract
Background Epithelial ovarian cancer (EOC) is characterized by the overexpression of cancer antigen 125 (CA125), a mucinous glycoprotein that serves as a tumor biomarker. Early diagnosis of EOC is plagued by its asymptomatic nature of progression and the limitations of currently used immunoassay techniques that detect CA125 as a shed antigen in serum samples. Presently, there is no technique available for the in vivo evaluation of CA125 expression in malignant tissues. Moreover, there could be an unexplored pathophysiological time window for the detection of CA125 in EOC, during which it is expressed on tumor cells prior to being shed into the bloodstream. A method for the in vivo evaluation of CA125 expression on ovarian neoplasms earlier along disease progression and/or recurrence can potentially contribute to better disease management. To this end, the present work utilizes an anti-CA125 monoclonal antibody (MAb) and a single-chain variable fragment (scFv) labeled with the positron-emitting radionuclide 64Cu for preclinical molecular imaging of CA125 expression in vivo. Methods Anti-CA125 MAb and scFv were prepared and functionally characterized for target binding prior to being tested as radiotracers in a preclinical setting. Results Immunoblotting, immunofluorescence, and flow cytometry revealed specific binding of CA125-targeting vectors to NIH:OVCAR-3 cells and no binding to antigen-negative SKOV3 cells. 64Cu-labeled anti-CA125 MAb and scFv were obtained in specific activities of 296 and 122 MBq/mg, respectively. Both radioimmunoconjugate vectors demonstrated highly selective binding to NIH:OVCAR-3 cells and virtually no binding to SKOV3 cells. In vivo radiopharmacological evaluation using xenograft mouse models injected with 64Cu-labeled anti-CA125 MAb provided a standardized uptake value (SUV) of 5.76 (29.70 %ID/g) in OVCAR3 tumors 24 h post-injection (p.i.) versus 1.80 (5.91 %ID/g) in SKOV3 tumors. 64Cu-labeled anti-CA125 scFv provided an SUV of 0.64 (3.21 %ID/g) in OVCAR3 tumors 24 h p.i. versus 0.25 (1.49 %ID/g) in SKOV3 tumors. Results from small-animal PET imaging were confirmed by ex vivo autoradiography and immunohistochemistry. Conclusions Radiolabeling of anti-CA125 MAb and scFv with 64Cu did not compromise their immunoreactivity. Both radioimmunoconjugates presented specific tumor uptake and expected biological clearance profiles. This renders them as potential immuno-PET probes for targeted in vivo molecular imaging of CA125 in EOC. Electronic supplementary material The online version of this article (doi:10.1186/s13550-014-0060-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sai Kiran Sharma
- Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, 8613 - 114 Street, Edmonton, AB, T6G 2H1, Canada,
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Shield-Artin KL, Bailey MJ, Oliva K, Liovic AK, Barker G, Dellios NL, Reisman S, Ayhan M, Rice GE. Identification of ovarian cancer-associated proteins in symptomatic women: A novel method for semi-quantitative plasma proteomics. Proteomics Clin Appl 2012; 6:170-81. [DOI: 10.1002/prca.201100008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Kristy L. Shield-Artin
- Department of Medicine; Monash University; Melbourne Victoria Australia
- Omics Facility; BakerIDI Medical Research Institute; Melbourne Victoria Australia
| | - Mark J. Bailey
- Veterinary medicine research and Development; Pfizer; Parkville Victoria Australia
| | - Karen Oliva
- Centre for Clinical Research; University of Queensland; Herston Queensland Australia
| | - Ana K. Liovic
- Omics Facility; BakerIDI Medical Research Institute; Melbourne Victoria Australia
| | - Gillian Barker
- Centre for Clinical Research; University of Queensland; Herston Queensland Australia
| | - Nicole L. Dellios
- Centre for Clinical Research; University of Queensland; Herston Queensland Australia
| | - Simone Reisman
- Centre for Clinical Research; University of Queensland; Herston Queensland Australia
| | - Mustafa Ayhan
- Centre for Clinical Research; University of Queensland; Herston Queensland Australia
| | - Gregory E. Rice
- Centre for Clinical Research; University of Queensland; Herston Queensland Australia
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Carbohydrate antigen-125: additional accuracy in identifying patients at risk of acute heart failure in acute coronary syndrome. Coron Artery Dis 2009; 20:274-80. [DOI: 10.1097/mca.0b013e3283229d82] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Faggiano P, D'Aloia A, Antonini-Canterin F, Vizzardi E, Nicolosi GL, Cas LD. Tumour markers in chronic heart failure. Review of the literature and clinical implications. J Cardiovasc Med (Hagerstown) 2006; 7:573-9. [PMID: 16858234 DOI: 10.2459/01.jcm.0000237903.95882.06] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Over the last years a growing interest for the biochemical abnormalities detectable in heart failure has become evident. In particular, large scientific evidence has been provided on hormones (catecholamines, renin-angiotensin-aldosterone system, natriuretic peptides) and cytokines (tumour necrosis factor, interleukins, etc.). Quite recently the attention of clinicians and researchers has also been directed towards high serum levels of tumour markers in this syndrome. Carbohydrate antigen 125 has been observed to increase in patients with congestive heart failure, to correlate with haemodynamic and clinical parameters of severity, and to show significant changes after adequate treatment. The aim of this paper is to review the data currently available on serum levels of tumour markers in patients with chronic heart failure, focusing the attention on the potential clinical use of carbohydrate antigen 125.
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Bjørge L, Stoiber H, Dierich MP, Meri S. Minimal residual disease in ovarian cancer as a target for complement-mediated mAb immunotherapy. Scand J Immunol 2006; 63:355-64. [PMID: 16640659 DOI: 10.1111/j.1365-3083.2006.01751.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Ovarian cancer is potentially well suited for local monoclonal antibody (mAb) immunotherapy, because it remains within the peritoneal cavity for a long period of time before giving rise to distant metastases. At the stage of minimal residual disease, the cells appear to be in a state of dormancy (G(0)) or at least have lower rates of tumour cell proliferation. They should be a promising target for immunotherapy. Here we first examined the cell-cycle expression of CD59 and decay-accelerating factor (DAF; CD55) on four different ovarian carcinoma cell lines, using simultaneous flow cytometric analysis of DNA content or the cell-cycle-specific nuclear proliferation protein Ki67 and CD59 or DAF surface expression. We found that CD59 and DAF are stably expressed throughout the cell cycle. The polyvalent approach to target-independent antigens to improve the efficiency of mAb complement (C)-mediated damages was promising, and tumour cells become sensitive to C damage, when incubated with cross-linked mAb against different tumour-associated antigens. Although, such immune complex-mediated C activation was rather ineffective in killing the cells, it could be potentiated by the addition of blocking mAb against CD59 and DAF. Our results suggest that the activities of intrinsic C regulators must be neutralized to make minimal residual disease a promising target for antibody therapy.
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Affiliation(s)
- L Bjørge
- Department of Obstetrics and Gynecology, Institute of Clinical Medicine, Haukeland University Hospital, Bergen, Norway.
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Scholler N, Garvik B, Hayden-Ledbetter M, Kline T, Urban N. Development of a CA125-mesothelin cell adhesion assay as a screening tool for biologics discovery. Cancer Lett 2006; 247:130-6. [PMID: 16677756 PMCID: PMC2734268 DOI: 10.1016/j.canlet.2006.03.029] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2005] [Revised: 03/21/2006] [Accepted: 03/28/2006] [Indexed: 01/10/2023]
Abstract
Preventing peritoneal implantation of ovarian carcinoma cells could prolong patient remission and survival. CA125 is expressed on most ovarian cancer cells and was reported to be a ligand of mesothelin, a peritoneal protein. We developed a cell adhesion assay with CA125-expresser ovarian cancer cells and human mesothelin-transfected cells and we confirmed that CA125 and mesothelin mediate cell attachment. We also showed that this assay supplies a high-throughput screening system for reagents able to block CA125/mesothelin-dependent cell attachment with a sensitive quantitative readout. We finally demonstrated that a mesothelin chimeric protein and anti-CA125 antibodies block CA125/mesothelin-dependent cell attachment.
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Affiliation(s)
- Nathalie Scholler
- Molecular Diagnostics Program, Public Health Sciences, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA 98109-1024, USA.
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Faggiano P, D'Aloia A, Brentana L, Bignotti T, Fiorina C, Vizzardi E, Dei Cas L. Serum levels of different tumour markers in patients with chronic heart failure. Eur J Heart Fail 2005; 7:57-61. [PMID: 15642532 DOI: 10.1016/j.ejheart.2004.04.009] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2003] [Revised: 02/09/2004] [Accepted: 04/07/2004] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND serum levels of carbohydratic antigen 125 (CA 125), a tumour marker related to ovarian cancer, are increased in patients with heart failure (CHF). To our knowledge there are no data concerning the levels of other tumour markers in CHF. METHODS we measured serum levels of Alpha-Fetoprotein (AFP), Carcinoembrionic antigen (CEA), CA 19.9, CA 15.3 and CA 125, in 191 pts (86 males, mean age 67+/-10 years) with mild to severe CHF due to left ventricular systolic dysfunction. RESULTS Only CA-125 was increased in CHF patients: mean values were significantly higher (P<0.05) in NYHA classes III (60+/-22 UI/ml) and IV (192+/-115 UI/ml) compared to NYHA class I-II patients (16+/-11). Mean values of the other tumor markers were within the normal range. AFP was above the upper normal limit in 2/191 patients (1%), CEA in 5/191 (2.6%), CA 19.9 in 0, CA 15.3 in 2/191 (1%) and CA 125 in 126/191 patients (66%). In 30 NYHA IV patients, tumour markers were repeated after 5-20 days of aggressive medical treatment, when a clinical improvement (reduction of at least 1 NYHA class) was reached: mean serum levels of CA 125 decreased from 107+/-85 to 19+/-8 U/ml (P<0.05); no changes in other tumour markers were observed. CONCLUSIONS Of the tumour markers evaluated, only CA 125 seems to be related to the presence and severity of CHF and shows significant changes in response to medical therapy. The biologic and clinical relevance of this observation needs to be defined.
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Affiliation(s)
- Pompilio Faggiano
- Cattedra di Cardiologia, Università di Brescia Unità Operativa di Policardiografia e di Cardiologia, Spedali Civili, Via S. Antonio 6, 25133 Brescia, Italy.
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D'Aloia A, Faggiano P, Aurigemma G, Bontempi L, Ruggeri G, Metra M, Nodari S, Dei Cas L. Serum levels of carbohydrate antigen 125 in patients with chronic heart failure: relation to clinical severity, hemodynamic and Doppler echocardiographic abnormalities, and short-term prognosis. J Am Coll Cardiol 2003; 41:1805-11. [PMID: 12767668 DOI: 10.1016/s0735-1097(03)00311-5] [Citation(s) in RCA: 130] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the serum levels of carbohydrate antigen 125 (CA125) in patients with congestive heart failure (CHF). BACKGROUND CA125 is a glycoprotein produced by serosal epithelium, found to be increased in ovarian cancer. METHODS Serum levels of CA125 were obtained in 286 patients (122 males and 164 females; age 69 +/- 13 years) with CHF (left ventricular ejection fraction 30 +/- 11%). A non-invasive evaluation was obtained by Doppler echocardiography; right heart catheterization was performed in 88 patients. An attempt to adjust medical therapy to maximally tolerated doses was done, and CA125 was repeated after 18 days (range 7 to 40) in 80 patients. The mean follow-up duration was 6 +/- 3 months in 240 patients. RESULTS The mean value of CA125 was 68 +/- 83 U/ml (range 3 to 537): 71 +/- 85 in men and 56 +/- 64 U/ml in women (p = NS). CA125 above the normal value (<35 U/ml) was found in 152 (53%) of 286 patients; it was higher in patients with advanced New York Heart Association (NYHA) functional class (n = 140 in class I/II: 15 +/- 9 U/ml; n = 63 in class III: 57 +/- 18 U/ml; n = 83 in class IV: 167 +/- 94 U/ml; p < 0.005). CA125 was related to the deceleration time of early filling on transmitral Doppler (r = -0.63, p < 0.05) and to pulmonary artery wedge pressure (r = 0.66, p < 0.05) and right atrial pressure (r = 0.69, p < 0.05). During 6 +/- 3 months of follow-up, a combined end point of mortality and CHF hospitalization was observed in 16 of 127 patients with CA125 <35 U/ml, compared with 70 of 113 patients with CA125 >35 U/ml (p < 0.01). After medical treatment optimization, NYHA class decreased by more than one grade in 56 of 80 patients and was unchanged or increased in 24 patients: CA125 decreased from 125 +/- 98 to 53 +/- 61 U/ml (p < 0.001) in the former and changed from 130 +/- 81 to 153 +/- 61 U/ml (p = NS) in the latter. CONCLUSIONS Our data suggest that CA125 is related to CHF severity and short-term prognosis. Furthermore, fluctuations of CA125 serum levels over time may reflect changes induced by therapy. Therefore, measurements of CA 125 serum levels might be proposed for the serial assessment of CHF patients.
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Affiliation(s)
- Antonio D'Aloia
- Cattedra di Cardiologia, Università di Brescia, Brescia, Italy
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Whitehouse C, Solomon E. Current status of the molecular characterization of the ovarian cancer antigen CA125 and implications for its use in clinical screening. Gynecol Oncol 2003; 88:S152-7. [PMID: 12586109 DOI: 10.1006/gyno.2002.6708] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Caroline Whitehouse
- Cancer Genetics Laboratory, Division of Medical and Molecular Genetics, GKT School of Medicine, Guy's Hospital, London
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Jiménez Lacave A, Allende Monclús M. [False negative and false positive results of tumor markers: their limitation in clinical practice. Clinical applications of CA-125]. Rev Clin Esp 2001; 201:715-7. [PMID: 11835885 DOI: 10.1016/s0014-2565(01)70959-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- A Jiménez Lacave
- Servicios de Oncología Médica y Medicina Nuclear, Hospital Central de Asturias, Oviedo, Spain
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