F-18 FDG PET/CT in the assessment of patients with unexplained CEA rise after surgical curative resection for colorectal cancer.

PURPOSE: We evaluated the role of quantitative assessment by maximum standardized uptake value (SUVmax) on F-18 fluorodeoxyglucose [F-18]FDG positron emission tomography/computed tomography (PET/CT) in stratifying colorectal cancer (CRC) patients with unexplained carcinoembryonic antigen (CEA) rise after surgical curative resection. MATERIAL AND METHODS: Forty asymptomatic patients (mean age, 64 ± 12 years) with previous CRC and current serum CEA levels >5 ng/ml underwent [F-18] FDG PET/CT 13 ± 3 months after complete surgical resection. The SUVmax was registered on anastomosis and peri-anastomotic tissue lesions, if present. The patients were followed for 24 ± 9 months thereafter. Re-intervention, evidence of newly discovered distant metastases, and death were recognized as main events and constituted surrogate end points. The receiver-operator-curve (ROC) analysis was performed to estimate the optimal SUVmax cut-off to predict patients at high risk of main events. PET/CT results were then related to disease outcome (overall survival; OS). RESULTS: The mean SUVmax at the anastomotic site was 6.2 ± 3 (range 2.6-15). At multivariate logistic regression analysis, the anastomotic SUVmax remained as the only significant contributor to the prediction of the events (p = 0.004; OR 1.97). The ROC analysis recognized that the optimal threshold of SUVmax to differentiate patients was 5.7. A worse OS was observed in patients presenting with a SUVmax greater than 5.7 as compared to those having lesser (median survival: 16 vs. 31 months; p = 0.002). CONCLUSIONS: The quantitative assessment by SUVmax on [F-18]FDG PET/CT may be helpful in patients presenting with unexplained CEA rise after curative resection of CRC, by identifying those at risk of main events.

Serum A1 and B apolipoprotein determination: comparison of an immunoturbidimetric method with a monoclonal-antibody-based radial immunodiffusion assay.

Epidemiological and clinical evidence have indicated that apolipoprotein A1 and B determination can better define the lipoprotein pattern in normal subjects and in subjects with coronary heart disease. In this paper, a recent immunoturbidimetric method for routine apolipoprotein A1 and B measurement (using the Turbitimer system and commercially available antisera) has been evaluated. The precision and the accuracy of the method have been previously considered. Within-run and between-run coefficients of variation (ranging from 1.67% to 5.04%) for both assays indicate good precision of the method. Accuracy was evaluated on 2 consecutive days (n = 10 each run) using a standard serum for apolipoprotein A1 and B. The bias obtained was 3.79% for apolipoprotein A1 and 2.30% for B. Apolipoproteins A1 and B were then measured in 100 normal and hyperlipemic sera with the immunoturbidimetric assay and radial immunodiffusion (using the monoclonal antibodies). The data obtained were evaluated by linear regression analysis (Al, r = 0.893; B, r = 0.862). The good correlation between the two methods suggests that the immunoturbidimetric assay can be usefully performed for routine apolipoprotein A1 and B determination because of its lower cost, rapidity, and simplicity.

[Hypercupremia: a marker of articular phlogosis?]. / L'ipercupremia: un marker della flogosi articolare?

Serum copper, iron and ceruloplasmin concentrations were determined in 45 subjects (20 males and 23 females, medium age 50.3, range 25-76) diagnosed as psoriatic arthritis patients, 63 patients (30 males and 33 females, medium age 32.4, range 10-78) with psoriasis, and in 60 blood donors (32 women and 28 men) as reference value group. Mean serum copper, iron and ceruloplasmin were significantly different (p less than .001) in psoriatic arthritis when compared with controls or subjects with psoriasis alone. The number of synovial joints affected was significantly correlated to changes in these serum parameters. Indeed serum copper, iron and ceruloplasmin were found significantly different from normals in the polyarticular subgroup, (p less than .001) while only copper and ceruloplasmin were different in mono-oligoarticular form (respectively p less than .001 and p less than .01). No significant changes were found in the spondiloarticular subgroup. In the polyarticular subgroup a direct correlation was found between another disease activity marker (e.g.ESR) and serum changes in iron, cerulosplasmin and copper (p less than .001).