Receiver operating characteristic (ROC) curve analysis of the tumor markers CEA, CA 19-9 and CA 72-4 in gastric cancer.

Pre-surgery serum levels of CA 72-4, CEA and CA 19-9 were quantified by the enzyme immunoassay method in 167 patients with histological diagnosis of gastric adenocarcinoma and in 92 patients with an endoscopic diagnosis of benign gastric pathology. CA 72-4 showed a better correlation between its serum levels and the different clinical stages of the disease than CEA and CA 19-9. At the individual study of stages I-II, CA 72-4 proved positive in 36.9% of patients while CEA and CA 19-9 appeared positive in 10.8% and 8.6%, respectively. In the ROC curve, at a specificity of 95%, the sensitivities of CA 72-4, CEA and CA 19-9 were 59.8%, 21% and 26.3% respectively. The discriminatory capacity of the test (area under the ROC curve +/- SD) was 0.86 +/- 0.03 in the case of CA 72-4, 0.52 +/- 0.03 for CEA and 0.58 +/- 0.03 for CA 19-9. In conclusion, in our series and with regard to CEA and CA 19-9, CA 72-4 shows better sensitivity and discriminatory capacity. CEA and CA 19-9 do not provide significant benefits when combined with CA 72-4 due to the good results obtained with the later marker alone.

Prevalence of abnormal levels of serum tumour markers in elderly people.

The study was conducted to evaluate the prevalence of abnormal levels of several serum tumour markers in an institutionalized elderly population. Serum tumour markers assay of carcinoembryonic antigen (CEA), the carbohydrate antigens CA 19-9, CA 72-4 and CA 15-3 (Enzymun-test, Boehringer Mannheim GmbH Diagnostic), alpha-fetoprotein (AFP) and prostate specific antigen (PSA) (Abbot Diagnostic Division) were performed in 228 unselected, institutionalized elderly subjects, whose mean age (SD) was 82.4 (5. 79) range (66-99 years). Patients with acute or neoplastic diseases were excluded from the study. The serum markers were also measured in 52 healthy young adults (controls). Using the established threshold values, 92 subjects (40%) were found to have at least one elevated marker. PSA was elevated in 33%, CA 19-9 in 16%, CEA in 11. 5%, CA 15-3 in 11%, CA 72-4 in 8% and AFP in 3%. We found a significant difference in the serum levels between the two groups for CEA, CA 19-9. CA 15-3, and PSA (p < 0.0001). Healthy aged people appear to have an elevated prevalence of elevated levels of serum tumour markers. The results suggest that apart from PSA, elevated antigen levels in elderly subjects are related to the ageing process itself rather than to occult pathology.

Changes in serum lipid and lipoprotein measures after maximal exercise in men.

Normolipidaemic, healthy male volunteers (age range 20-23 years) were studied after a session of three maximal exercises and serum lipid and lipoprotein concentrations were measured. The exercise programmes, one of which was performed each week, consisted of a triangular progressive test (TPT), a rectangular sustained test (RST) and an interval endurance test (IET). There was a significant (P less than 0.05) increase of 14% in serum total cholesterol concentrations after TPT, 9.6% after RST and 14% after IET. Serum triglyceride concentrations increased by 17% after TPT, 5.7% after RST and 8.2% after IET, but increases were not significant. High-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C), and apolipoprotein (A-I, A-II) concentrations rose significantly (P less than 0.05) after TPT. There were also insignificant increases in AI, AII and LDL-C after RST and IET, whereas HDL-C rose significantly (P less than 0.05) after IET. It is concluded that the three maximal exercises had similar metabolic effects which were independent of the exercise duration.

Effects of calcium, magnesium, tobramycin and theophylline on phenobarbitone binding to serum proteins.

Binding of phenobarbitone to human serum proteins was determined in vitro using ultrafiltration. At therapeutic concentrations of 10-600 microM, 63.51 +/- 2.5% of the phenobarbitone was bound to total serum proteins. The binding kinetics were non-saturable and the plasma apparent affinity coefficient (NKa) was 0.791 +/- 0.09 for normal serum and 0.664 +/- 0.06 for chromatographed serum. Tobramycin and theophylline at therapeutic concentrations of 10 and 15 micrograms/ml, respectively, reduced NKa compared with the values found in normal serum. Calcium and especially magnesium at physiological concentrations of 2.5 and 5 mM, respectively, increased NKa compared with values obtained in chromatographed serum, whereas at supraphysiological concentrations of magnesium of 15 mM NKa was reduced. It is concluded that free phenobarbitone concentrations in serum can be modified by calcium, magnesium, tobramycin and theophylline, and this fact must be considered when studying enzyme induction and other properties of phenobarbitone.