Report From the First and Second Spanish Killer Immunoglobulin-Like Receptor Genotyping Workshops: External Quality Control for Natural Killer Alloreactive Donor Selection in Haploidentical Stem Cell Transplantation.

An important factor affecting the success in the setting of related haploidentical hematopoietic stem cell transplantation (HSCT) is the graft-versus-leukemia effect mediated by natural killer (NK) cells when the donor displays NK alloreactivity versus the recipient. NK cell function is regulated by killer immunoglobulin-like receptors (KIR) and it has been described that donor KIR genotype influences transplantation outcome. This has led to a requirement of laboratories to have a quality assurance program for validation and control of their KIR genotyping methods. The goal of the 1st and 2nd Spanish KIR Genotyping Workshops was to provide an external proficiency testing program in KIR genotyping for Spanish immunology and transplant laboratories. These workshops were conducted during the years 2014-2016 and consisted of 17 participating laboratories typing a set of 20 samples. The presence/absence of 16 mandatory KIR loci (2DL1, 2DL2, 2DL3, 2DL4, 2DL5, 2DS1, 2DS2, 2DS3, 2DS4, 2DS5, 2DP1, 3DL1, 3DL2, 3DL3, 3DS1, and 3DP1) was evaluated per sample. Methods for KIR genotyping included polymerase chain reaction with the use of sequence-specific primers and sequence-specific oligoprobes. Consensus typing was reached in all samples, and the performance of laboratories in external proficiency testing was satisfactory in all cases. The polymorphism detected in the small sample studied in both workshops is indicative of an ample variety of KIR gene profiles in the Spanish population.

Sequencing of the new HLA-B*44:150 allele suggests recombination between B*44:02:01:01 and B*07:02:01 alleles.

B*44:150 was identical to B*44:02:01:01 except at the 3'-end region of exon 3, where a B*07-specific sequence was identified.

Significación de captaciones incidentales en colon en estudios 18F-FDG PET-TAC en pacientes sin tumor colorrectal conocido. Valoración del impacto en el manejo del paciente / Clinical relevance of incidental finding of focal uptakes in the colon during 18F-FDG PET/CT studies in oncology patients without known colorectal carcinoma and evaluation of the impact on management

Objetivos. Valorar la significación y el impacto de acumulaciones de FDG en el colon en pacientes con tumores no colorrectales. Material y métodos. Se revisaron retrospectivamente 2.220 estudios PET-TAC realizados de manera consecutiva en el Servicio de Medicina Nuclear de nuestro hospital del 2 de diciembre de 2008 al 31 de mayo de 2010. Se incluyeron aquellos pacientes en los que se describían captaciones focales de FDG a nivel colorrectal y no explicables por la historia clínica. Se excluyeron pacientes diagnosticados previamente de carcinoma colorrectal. Cumplieron el criterio de inclusión 86 pacientes (57 hombres, media de edad de 63,4 años, rango 46-85). Se estableció como prueba de referencia la colonoscopia con toma de biopsia. Se valoró el impacto de estos hallazgos en la actitud diagnóstico-terapéutica de estos pacientes. Resultados. En 54 de los 86 pacientes se realizó correlación colonoscópica, en los 32 restantes no se había realizado dicha exploración hasta la fecha. De los 54 en los que se realizó colonoscopia se tomó biopsia en 43 lesiones. Se detectó patología colónica en 49 pacientes, con un total de 54 focos incidentales de FDG, siendo estas patologías: 10 cánceres colorrectales primarios insospechados, tres metástasis, 27 pólipos adenomatosos con diferentes grados de displasia y 14 procesos inflamatorios. En los 5 pacientes restantes la colonoscopia fue normal (9%). La PET-TAC modificó la actitud diagnóstico-terapéutica en la mayoría de pacientes (49/ 54, 91%). Conclusiones. Estos resultados constatan la necesidad de confirmar mediante colonoscopia y biopsia las captaciones focales colorrectales de FDG en PET-TAC. Esta estrategia permite detectar y tratar precozmente lesiones malignas y premalignas(AU)

Aims. To assess the significance and the impact of focal FDG uptake in the colon in oncology patients without known colorectal carcinoma. Materials and methods. A retrospective study was undertaken on 2,220 18F-FDG PET/CT studies carried out consecutively in the Nuclear Medicine Department in our hospital from 2 December 2008 to 31 May 2010. Inclusion criteria were patients with abnormal 18F-FDG uptake in colorectal area that could not be explained (or not previously known) by their clinical histories. Patients previously diagnosed with colorectal carcinoma were excluded. A total of 86 patients (57 male, average age 63.4, range 46-85) were finally included. Colonoscopy with biopsy was established as a reference test. The impact of these findings on the diagnostic-therapeutic management in these patients was evaluated. Results. A colonoscopy was performed in 54 of the 86 patients, this examination not having been done up-to-date in the remaining 32 patients. Biopsy was obtained in 43 lesions of the 54 patient in whom a colonoscopy was performed. Colon disease was detected in 49 of these 54 patients, obtaining 54 FDG incidental foci which corresponded to 10 previously unsuspected primary colorectal carcinoma, 3 metastases, 27 adenomatous polyps with different degrees of dysplasia and 14 inflammatory processes. In the remaining 5 patients, the colonoscopy was normal. PET/CT modified the diagnostic and treatment management in most of the patients (49/54, that is 91%). Conclusions. These results confirm the need to determine the cause of abnormal 18F-FDG colorectal uptakes in the PET/CT studies by using colonoscopy and biopsy. This approach allows for the detection and early treatment of malignant and premalignant lesions(AU)

Clinical relevance of incidental finding of focal uptakes in the colon during 18F-FDG PET/CT studies in oncology patients without known colorectal carcinoma and evaluation of the impact on management.

AIMS: To assess the significance and the impact of focal FDG uptake in the colon in oncology patients without known colorectal carcinoma. MATERIALS AND METHODS: A retrospective study was undertaken on 2,220 (18)F-FDG PET/CT studies carried out consecutively in the Nuclear Medicine Department in our hospital from 2 December 2008 to 31 May 2010. Inclusion criteria were patients with abnormal (18)F-FDG uptake in colorectal area that could not be explained (or not previously known) by their clinical histories. Patients previously diagnosed with colorectal carcinoma were excluded. A total of 86 patients (57 male, average age 63.4, range 46-85) were finally included. Colonoscopy with biopsy was established as a reference test. The impact of these findings on the diagnostic-therapeutic management in these patients was evaluated. RESULTS: A colonoscopy was performed in 54 of the 86 patients, this examination not having been done up-to-date in the remaining 32 patients. Biopsy was obtained in 43 lesions of the 54 patient in whom a colonoscopy was performed. Colon disease was detected in 49 of these 54 patients, obtaining 54 FDG incidental foci which corresponded to 10 previously unsuspected primary colorectal carcinoma, 3 metastases, 27 adenomatous polyps with different degrees of dysplasia and 14 inflammatory processes. In the remaining 5 patients, the colonoscopy was normal. PET/CT modified the diagnostic and treatment management in most of the patients (49/54, that is 91%). CONCLUSIONS: These results confirm the need to determine the cause of abnormal (18)F-FDG colorectal uptakes in the PET/CT studies by using colonoscopy and biopsy. This approach allows for the detection and early treatment of malignant and premalignant lesions.

[Stiff-person syndrome: a case report]. / Síndrome de la persona rígida: a propósito de un caso.

INTRODUCTION: Stiff-person (stiff-man) syndrome is characterised by symptoms of muscular rigidity and spasms, which are generally of an axial nature. Involuntary contractions of the agonist and antagonist muscles caused by activity of the motor units during rest are the main clinical and electrophysiological marker of the disease. The nature of the syndrome is considered to be autoimmune, with positive glutamic acid decarboxylase (anti-GAD) antibodies in most patients. These antibodies exert an influence over GABAergic transmission. CASE REPORT: A 29-year-old female who was admitted to hospital with a diagnosis of psychogenic mutism. While in hospital the patient developed a clinical picture consisting in generalised stiffness that was predominantly axial and proximal with hyperreflexia in the four limbs and strong contraction of the muscles of the abdomen. The most striking lab finding was the presence of anti-GAD, anti-parietal cells, anti-microsomal/TPO and antithyroglobulin antibodies, together with oligoclonal immunoglobulin G bands in the cerebrospinal fluid. Treatment was established with benzodiazepines, antispastic agents and corticosteroids, and the clinical symptoms progressively improved until they had partially remitted at two months. The lab findings and clinical features are compatible with stiff-person syndrome in a patient with associated psychiatric comorbidity. CONCLUSIONS: Anti-GAD antibodies are not exclusive to stiff-person syndrome and can also be found in a number of other autoimmune disorders. Other mechanisms which can also produce a dysfunction of the GABAergic system have also been suggested. The syndrome can be difficult to diagnose from the clinical point of view and it must therefore be borne in mind in patients who begin with unexplainable stiffness and spasms because it is a potentially treatable pathology.

Síndrome de la persona rígida: a propósito de un caso / Stiff-person syndrome: A case report

Introducción. El síndrome de la persona rígida (stiff-man) se caracteriza por un cuadro de rigidez muscular y espasmos, generalmente de carácter axial. Las contracciones involuntarias de los músculos agonistas y antagonistas causadas por la actividad de las unidades motoras durante el reposo son el principal marcador clínico y electrofisiológico de la enfermedad. La naturaleza del síndrome se considera autoinmune, con anticuerpos antidecarboxilasa glutámica ácida (anti-GAD)positivos en la mayoría de los pacientes. Estos anticuerpos influyen en la transmisión gabérgica. Caso clínico. Mujer de 29 años que ingresó con el diagnóstico de mutismo psicógeno. Durante su ingreso desarrolló un cuadro que consistía en una rigidez generalizada de predominio axial y proximal con hiperreflexia en las cuatro extremidades y una importante contracción de la musculatura abdominal. En los estudios analíticos destacó la presencia de anticuerpos anti-GAD, anticélulas parietales, antimicrosomales TPO y antitiroglobulina, junto con la presencia de bandas oligoclonales de inmunoglobulina G en el líquido cefalorraquídeo. Se instauró un tratamiento con benzodiacepinas, antiespásticos y corticosteroides, con una mejoría progresiva del cuadro, hasta remitir parcialmente a los dos meses. Los hallazgos de laboratorio y el cuadro clínico son compatibles con un síndrome de la persona rígida en una paciente con comorbilidad psiquiátrica asociada. Conclusiones. Los anticuerpos anti-GAD no son exclusivos del síndrome de la persona rígida y también se pueden encontrar en numerosos trastornos autoinmunes. También se han postulado otros mecanismos por los cuales se produce una disfunción del sistema gabérgico.El síndrome puede ser de difícil diagnóstico desde el punto de vista clínico, por lo que debemos tenerlo presente en pacientes que comiencen con rigidez y espasmos inexplicables, dado que se trata de una patología potencialmente tratable

Introduction. Stiff-person (stiff-man) syndrome is characterised by symptoms of muscular rigidity and spasms, which are generally of an axial nature. Involuntary contractions of the agonist and antagonist muscles caused by activity of the motor units during rest are the main clinical and electrophysiological marker of the disease. The nature of the syndrome isconsidered to be autoimmune, with positive glutamic acid decarboxylase (anti-GAD) antibodies in most patients. These antibodies exert an influence over GABAergic transmission. Case report. A 29-year-old female who was admitted to hospital with a diagnosis of psychogenic mutism. While in hospital the patient developed a clinical picture consisting in generalised stiffness that was predominantly axial and proximal with hyperreflexia in the four limbs and strong contraction of the musclesof the abdomen. The most striking lab finding was the presence of anti-GAD, anti-parietal cells, anti-microsomal/TPO and antithyroglobulin antibodies, together with oligoclonal immunoglobulin G bands in the cerebrospinal fluid. Treatment was established with benzodiazepines, antispastic agents and corticosteroids, and the clinical symptoms progressively improveduntil they had partially remitted at two months. The lab findings and clinical features are compatible with stiff-person syndrome in a patient with associated psychiatric comorbidity. Conclusions. Anti-GAD antibodies are not exclusive to stiffperson syndrome and can also be found in a number of other autoimmune disorders. Other mechanisms which can also produce a dysfunction of the GABAergic system have also been suggested. The syndrome can be difficult to diagnose from the clinical point of view and it must therefore be borne in mind in patients who begin with unexplainable stiffness and spasms because it is a potentially treatable pathology

Distonía aguda tras abandono de paroxetina / Acute dystonia following paroxetine withdrawal

No disponible

[Serological and genetic markers in the diagnosis and follow-up of coeliac disease]. / Marcadores serológicos y genéticos en el diagnóstico y seguimiento de la enfermedad celíaca.

INTRODUCTION: Understanding of celiac disease has changed with the advent of serological markers (antigliadin IgA, anti-endomysial IgA and anti-transglutaminase IgA antibodies) and with the identification of major susceptibility genes (HLA-DQA1*05-DQB1*02). Reports of the efficacy of these diagnostic tests have varied, depending on the methodology used and the population investigated. OBJECTIVES: To determine the clinical utility of genetic and serological markers in the diagnosis of celiac disease, their relationship with histological lesions and their changes during treatment, in order to establish an optimal diagnostic algorithm in our environment. PATIENTS AND METHODS: We performed a retrospective study of 590 patients from the health area of Badajoz referred to the Immunology Laboratory for screening or follow-up of celiac disease. The results of intestinal histology, serological markers (antigliadin IgA, anti-endomysial IgA and anti-transglutaminase IgA antibodies), and genomic typing (HLA-DQA1*05-DQB1*02) were analyzed. RESULTS: The sensitivity and specificity of serological tests were greater than 90 %, with a negative predictive value of 98-100 %. HLA-DQA1*05-DQB1*02 was detected in 97 % of celiac patients, with a very high negative predictive value (99 %). On biopsy, 95 % of the patients with some grade of intestinal lesion were positive for antigliadin and/or anti-endomysial antibodies. CONCLUSION: To avoid missed diagnoses, the diagnostic algorithm of celiac disease should include at least two serological markers (antigliadin antibodies and anti-endomysial and/or anti-transglutaminase antibodies) and IgA quantification. Genomic typing should be carried out if one or more markers are positive or if the subject belongs to any of the risk groups. The physician should decide on the advisability of intestinal biopsy on the basis of the patient's clinical and immunological history.

Marcadores serológicos y genéticos en el diagnóstico y seguimiento de la enfermedad celíaca / Serological and genetic markers in the diagnosis and follow-up of coeliac disease

Introducción: El conocimiento de la enfermedad celíaca ha cambiado con la aparición de marcadores serológicos: anticuerpos antigliadina IgA (AAG), antiendomisio IgA (AAE) y antitransglutaminasa tisular IgA (ATGt-IgA) y con la identificación de genes asociados a la enfermedad: HLA-DQA1*05-DQB1*02. Los estudios de eficacia de estas pruebas diagnósticas varían dependiendo de la metodología utilizada y de la población investigada. Objetivos: Estudiar la rentabilidad clínica de los marcadores genéticos y serológicos, su relación con el grado de lesión intestinal y con el tratamiento de la enfermedad, para así poder establecer el algoritmo diagnóstico de enfermedad celíaca más adecuado en nuestro medio. Pacientes y métodos: Estudio retrospectivo de 590 pacientes del Área Sanitaria de Badajoz remitidos al Laboratorio de Inmunología para el diagnóstico o seguimiento de la enfermedad celíaca. Se analizan los resultados del examen histológico, marcadores serológicos (anticuerpos AAG, AAE y ATGt de isotipo IgA) y tipificación genómica (HLA-DQA1*05-DQB1*02). Resultados La sensibilidad y especificidad de los marcadores serológicos son superiores al 90 %, y el valor predictivo negativo (VPN) es del 98-100 %. El HLA-DQA1*05-DQB1*02 se detecta en el 97 % de los enfermos celíacos, destacando su elevado VPN (99 %). En el momento de la biopsia intestinal, el 95 % de los pacientes con algún grado de atrofia tienen serología positiva (AAG y/o AAE). Conclusión: Para evitar la pérdida de casos, los algoritmos diagnósticos de enfermedad celíaca deben de incluir la determinación de, al menos, dos marcadores serológicos (AAG y AAE y/o ATGt) y la cuantificación de IgA. La tipificación genómica, se realizará si algún marcador es positivo, o por pertenecer a grupos de riesgo. Con los datos clínicos e inmunológicos el gastroenterólogo infantil decidirá en cada caso la realización de la biopsia intestinal

Introduction: Understanding of celiac disease has changed with the advent of serological markers (antigliadin IgA, antiendomysial IgA and antitransglutaminase IgA antibodies) and with the identification of major susceptibility genes (HLA-DQA1*05-DQB1*02). Reports of the efficacy of these diagnostic tests have varied, depending on the methodology used and the population investigated. Objectives: To determine the clinical utility of genetic and serological markers in the diagnosis of celiac disease, their relationship with histological lesions and their changes during treatment, in order to establish an optimal diagnostic algorithm in our environment. Patients and methods: We performed a retrospective study of 590 patients from the health area of Badajoz referred to the Immunology Laboratory for screening or follow-up of celiac disease. The results of intestinal histology, serological markers (antigliadin IgA, antiendomysial IgA and antitransglutaminase IgA antibodies), and genomic typing (HLA-DQA1*05-DQB1*02) were analyzed. Results: The sensitivity and specificity of serological tests were greater than 90 %, with a negative predictive value of 98-100 %. HLA-DQA1*05-DQB1*02 was detected in 97 % of celiac patients, with a very high negative predictive value (99 %). On biopsy, 95 % of the patients with some grade of intestinal lesion were positive for antigliadin and/or antiendomysial antibodies. Conclusion: To avoid missed diagnoses, the diagnostic algorithm of celiac disease should include at least two serological markers (antigliadin antibodies and antiendomysial and/or antitransglutaminase antibodies) and IgA quantification. Genomic typing should be carried out if one or more markers are positive or if the subject belongs to any of the risk groups. The physician should decide on the advisability of intestinal biopsy on the basis of the patient’s clinical and immunological history

[Evaluation of cerebral blood perfusion in patients undergoing carotid endarterectomy using densitometric analysis of conventional cranial CT]. / Evaluación de la perfusión cerebral mediante análisis densitométrico de la tomografía craneal en pacientes sometidos a endarterectomía carotídea.

OBJECTIVE: To evaluate the efficacy of densitometric analysis of cranial CT imaging in the measurement of areas with low cerebral blood flow and lack of hemodynamic reserve in patients undergoing carotid endarterectomy. PATIENTS AND METHODS: 40 consecutive patients undergoing carotid endarterectomy have been included in the study. All of them had preoperative cranial CT, pre and postoperative basal and acetazolamide SPECT. Cranial CT imaging after digitalization and computer processing were obtained with 4 densitometric patterns: 1). normal cerebral blood perfusion; 2). ischemic or low brain blood perfusion (patron I); 3). parenchyma without cerebral hemodynamic reserve (patron nR), and 4). brain infarction. RESULTS: 32 out of 40 (80 %) patients had abnormal densitometric patterns: 19 nR patterns (47.5 %), 11 I pattern (27.5 %) and 2 established brain infarction. The correlation between densitometric cranial TC imaging and SPECT was 92% when analyzing areas with hypoperfusion (S: 96.5 %; E: 82 %). Cranial CT detected 12/13 of patients who lacked cerebral hemodynamic reserve in the SPECT analysis (S: 74 %; E: 92 %; Vpp: 95 %). CONCLUSIONS: There is a good correlation between analysis of densitometric cranial TC imaging and SPECT in determining low cerebral blood flow areas and lack of cerebral hemodynamic reserve. This method could help to improve carotid surgery indications in patients with carotid stenosis.

Hernia de hiato simulando un bocio endotorácico en la gammagrafía tiroidea / Hiatus hernia mimicking an endothoracic goiter in thyroid scintigraphy

No disponible

[Analysis of the cytosolic content of the pS2 protein in breast cancer]. / Análisis del contenido citosólico de la proteína pS2 en el cáncer de mama.

OBJECTIVE: To analyze pS2 cytosolic levels in breast carcinomas and their correlation with different clinical characteristics of the patients and their tumours. MATERIAL AND METHODS: Cytosolic pS2 levels were measured by radioimmunometric assay in tumours from 168 breast cancer patients. RESULTS: The pS2 values ranged from 0 to 251 ng/mg protein (mean SD: 21.8 38.1; median: 7.9 ng/mg protein). These protein levels were significantly (p < 0.05) higher in premenopausal patients (27.6 45.2) than in postmenopausal patients (19.5 33.8). Intratumour pS2 levels were also significantly (p < 0.05) correlated with histologic grade of the tumours, and were higher in well diferentiated tumours (grade I: 28.8 42.8) than in moderately differentiated tumours (grade II: 19.7 35.6) and than in poorly differentiated tumours (grade III: 18.9 37.3). Similarly, significant differences in pS2 content were found between positive estrogen receptor (ER) tumours and ER-negative tumours (29.1 46.5 vs 11.3 15.9, respectively; p<0.0001), as well as between positive progesterone receptor (PR) tumours and PR-negative tumours (29.1 49.8 vs 15.3 21.5, respectively; p < 0.05). CONCLUSIONS: The results suggest that pS2 may be a useful prognostic marker in breast cancer, and may also be useful to identify patients who are likely to benefit from hormone therapy.

Análisis del contenido citosólico de la proteína ps2 en el cáncer de mama / Analysis of the cytosolic content of the ps2 protein in breast cancer

Objetivo: Analizar los niveles citosólicos de pS2 en carcinomas de mama y su correlación con las diferentes características clínicas de las pacientes y de sus tumores.Material y métodos: Se determinaron por método inmunorradiométrico los niveles citosólicos de pS2 en 168 tumores de pacientes con cáncer de mama. Resultados: Los valores de pS2 variaron de 0 a 251 ng/mg proteína (media ñ DE: 21,8 ñ 38,1; mediana: 7,9 ng/mg proteína). Esos niveles de la proteína fueron significativamente (p < 0,05) más elevados en las pacientes premenopáusicas (27,6 ñ 45,2) que en las pacientes postmenopáusicas (19,5 ñ 33,8). Los niveles intratumorales de pS2 también estuvieron significativamente (p < 0,05) correlacionados con el grado histológico de los tumores, siendo más elevados en los tumores bien diferenciados (grado I: 28,8 ñ 42,8) que en los tumores moderadamente diferenciados (grado II: 19,7 ñ 35,6) y que en los tumores pobremente diferenciados (grado III: 18,9 ñ 937,3). Similarmente, se encontraron diferencias significativas en el contenido de pS2 entre los tumores receptor de estrógeno (RE)-positivos y los tumores RE-negativos (29,1 ñ 46,5 vs 11,3 ñ 15,9, respectivamente; p < 0,0001), así como también entre los tumores receptor de progesterona (RP)-positivos y los tumores RP-negativos (29,1 ñ 49,8 vs 15,3 ñ 21,5, respectivamente; p < 0,05). Conclusión: Estos resultados sugieren que la pS2 puede ser un útil marcador pronóstico en el cáncer de mama, así como también para identificar pacientes que pueden beneficiarse de terapia hormonal (AU)

Niveles séricos preoperatorios del CEA y pronóstico en el cáncer colorrectal / Preoperative serum levels of the carcinoembrionary antigen (cea) and prognosis in colorectal cancer

Objetivo: Analizar el valor pronóstico de los niveles séricos preoperatorios del antígeno carcinoembrionario (CEA) en el cáncer colorrectal primario. Material y métodos: Se analizaron los niveles séricos preoperatorios del CEA en 275 pacientes con carcinoma colorrectal, que fueron sometidos a un período mínimo de seguimiento clínico de cinco años, o hasta su fallecimiento. Resultados: El porcentaje de positividades para los niveles séricos preoperatorios del CEA (> 6 ng/ml) estuvo positiva y significativamente asociado con el estadio tumoral (A: 10,5 por ciento; B: 38,8 por ciento; C: 32,2 por ciento; y D: 72 por ciento; p < 0,0001). Además, los valores séricos elevados del antígeno estuvieron significativamente asociados, en el análisis univariante, con una supervivencia corta en el conjunto de los pacientes (p < 0,0001). Sin embargo, el análisis multivariante tan solo demostró valor pronóstico independiente del CEA en el subgrupo de pacientes con tumores en estadio C. Conclusiones: Los valores séricos preoperatorios del CEA tienen valor clínico para predecir la extensión de la enfermedad, así como para predecir el pronóstico de pacientes con cáncer colorrectal con estadio tumoral C. (AU)

[Preoperative serum levels of the carcinoembryonic antigen (CEA) and prognosis in colorectal cancer]. / Niveles séricos preoperatorios del CEA y pronóstico en el cáncer colorrectal.

OBJECTIVE: To analyze the prognostic value of the preoperative serum levels of the carcinoembryonic antigen (CEA) in primary colorectal carcinoma. MATERIAL AND METHODS: Preoperative serum levels of CEA were analyzed in 275 colorectal cancer patients, who were followed up for a minimum of 5 years, or until death. RESULTS: The percentage of positivities for the preoperative serum levels of CEA (> 6 ng/ml) was positively and significantly associated with the tumoral stage (A: 10,5%; B: 38,8%; C: 32,2%; y D: 72%; p < 0,0001). In addition, the elevated serum values of the antigen were significantly associated, in the univariate analysis, with short survival in the overall group of patients (p < 0,0001). However, the multivariate analysis only showed an independent prognosis value of the CEA in the subgroup of patients with stage C tumors. CONCLUSIONS: Preoperative serum levels of CEA may be useful to predict tumoral extension, and also for the prognosis regarding stage C colorectal cancer patients.

Relationship of tumoral hyaluronic acid and cathepsin D contents with histological type of gastric carcinoma.

The aim of this work was to evaluate the cytosolic contents of hyaluronic acid (HA) and cathepsin D (CatD) in gastric carcinomas and their possible relationships with the clinicopathological parameters of the tumors. Our study demonstrated a wide variability in the cytosolic levels of HA (mean +/- SEM: 3748 +/- 411 ng/mg protein) and cathepsin D (52 +/- 4 pmol/mg protein) in the tumors of 78 gastric cancer patients. In addition, the tumoral contents of HA and CatD were significantly higher (p<0.005) in diffuse type (HA: 6027 +/- 1099 ng/mg protein; CatD: 75 +/- 13 pmol/mg protein) than in intestinal type (HA: 2735 +/- 242 ng/mg protein; CatD: 42 +/- 3 pmol/mg protein) carcinomas. These data suggest that both markers may contribute to the biological characterization of gastric carcinomas.