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ABSTRACT: To evaluate a wide detection of tumor markers practiced during admission for the diagnosis of cancer in patients with idiopathic deep venous thrombosis.
Prospective study including 48 patients with documented DVT who lacked a predisposing cause to DVT. It was determined in serum: carcinoembryonic antigen, alphafetoprotein, CA 19-9, CA 125, beta-2-microglobulin, SCC (squamous cell antigen), NSE (neuron-specific enolase), PSA (prostate-specific antigen) in the males and CA15-3 in the women. The patients were evaluated for cancer during admission and followed up at 6 and 12 months.
The age was 65 years. A positive tumor marker at least was detected in 23 patients (48%). A cancer was diagnosed in 8 patients (16%), 4 in the group with elevated tumor markers and 4 in the group with normal tumor markers. We don't find significant differences in cancer incidence between both groups. However, of the 4 cases of cancer diagnosed in the group with elevated markers only 1 was considered true positive since in the others three cases the elevate tumor marker was not appropriated with the cancer diagnosed. Six tumors were diagnosed during admission and two during follow-up period. According to these results was obtained a sensitivity of 12%, a specificity of 52%, a positive predictive value of 5% and a negative predictive value of 75%.
The cancer incidence is similar to previous series. We have found a poor sensitivity, specificity and positive predictive value. However, the negative predictive value was of 75% and the patients who were normals for results of all tumor markers and was asymptomatic during admission hadn't a subsequent cancer diagnosis.
Anales de medicina interna (Madrid, Spain: 1984) 12/2002; 19(11):561-6.
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ABSTRACT: We prospectively evaluated serum and plasma concentrations of total and free prostate specific antigen (PSA), and PSA complexed to alpha1-antichymotrypsin in 170 patients who underwent biopsy, including 59 with prostate cancer and 111 with benign prostatic hyperplasia. We compared the usefulness of the ratios of free-to-total and complexed-to-total PSA for distinguishing between prostate cancer and benign prostatic hyperplasia, and studied the influence of blood clotting on the ratios.
Blood samples were processed to generate serum and citrated plasma. To calculate complexed-to-total and free-to-total PSA we assayed plasma and serum samples for total and complexed PSA using homemade immunoassays, and total and free PSA using the Immulite assay. The 2 total PSA assays were compared using the Tandem-E PSA assay. Receiver operating characteristics curves were constructed for the total population, and for 2 to 20, 4 to 20, 2 to 10 and 4 to 10 ng./ml. total PSA.
In all groups complexed-to-total PSA had higher specificity than free-to-total and total PSA, especially at 90 to 100% sensitivity. Generally citrated plasma samples provided higher specificity than serum samples for all sensitivity values. The best performance for complexed-to-total and free-to-total PSA was obtained in the subset of patients in whom total PSA was 2 to 10 ng./ml.
Our results indicate that the complexed-to-total PSA ratio performed better for classifying disease status than the free-to-total PSA ratio in the whole patient population and in the diagnostic gray zone of 2 to 10 ng./ml. In addition, plasma samples should be used to calculate the complexed-to-total and free-to-total PSA ratio.
The Journal of Urology 01/1999; 160(6 Pt 1):2081-8. · 3.75 Impact Factor
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ABSTRACT: In order to find out the degree to which rupture of the blood-brain barrier (BBB) could influence the diagnostic effectiveness of five equations used to determine the intrathecal synthesis of IgG, a comparative study was performed with results from 733 patients with different neurological processes either related to an immune response (PNI) or not (PNNI). Rupture of the BBB was determined by a quotient of cerebrospinal fluid (CSF)/serum albumin (COA) higher than that obtained in the control group. When the BBB was retained, there was no clear superiority of one formula over another, but an altered BBB was the conditioning factor in the divergence. The extended Index was the least influenced by the rupture of the BBB, while Tourtellotte's equation was the most affected. In agreement with the clinical information data, the IgG Index was the most sensitive equation, while the extended Index was the most specific.
Revista Clínica Española 12/1993; 193(8):413-8. · 2.01 Impact Factor
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ABSTRACT: The polyacrylamide gel electrophoresis of spinal fluid from 488 patients suffering neurological diseases and from a control group are reviewed. One hundred and eleven cases (22.7%) showed oligoclonal bands (OB). The highest percentage of OB appeared in the group of patients with definite multiple sclerosis (84%), followed by those with probable multiple sclerosis (46%) and inflammatory infectious diseases (43%); the group of patients with a possible multiple sclerosis (7%), vascular malignancies (11%) and other diseases (4%) showed a lower incidence of OBs. No OBs were found in groups of patients with degenerative diseases, dementia or the control group. These results confirm the great usefulness of this test to support the diagnosis of multiple sclerosis, although it also shows that it is not a specific test so it should always be evaluated within a clinical context.
Revista Clínica Española 11/1989; 185(5):231-4. · 2.01 Impact Factor
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Neurologia (Barcelona, Spain) 2(4):158-61. · 0.79 Impact Factor
