Influence of saliva on the results of global laboratory coagulation tests.

BACKGROUND: Oral wounds inevitably come into contact with saliva which can affect the time needed for bleeding to stop. The influence of saliva can be non-specific, related to dilution of blood, and/or mediated by salivary factors that affect haemostasis directly. The aim of this study was to assess if mixing blood with an individual's saliva would affect the rate of its coagulation measured by global coagulation tests, prothrombin time (PT) and activated partial thromboplastin time (APTT). METHODS: The study included 30 healthy non-smoking volunteers. Paired blood and unstimulated saliva samples were obtained from each participant and PT and APTT were determined in blood, blood + saliva and blood + water mixtures. Coagulation tests were performed using the mechanical clot detection method. RESULTS: PT was significantly longer in both blood + saliva and blood + water mixtures compared to blood alone. APTT was significantly longer only in blood + water mixture compared to blood. CONCLUSIONS: Similarly prolonged PT in both mixtures suggests that both saliva and water prolong coagulation evenly due to their non-specific effect of blood dilution. The finding that APTT was significantly prolonged only when blood was mixed with water could indicate presence of tissue factor in saliva, however, in a concentration too low to influence the results of PT.

Comparison of serum CA 19-9 and CEA levels in a population at high risk for colorectal cancer.

The sera of 563 patients who underwent colonoscopy were assayed for glycolipid antigen CA 19-9 and CEA. These patients represented a broad spectrum of clinical diseases ranging from advanced metastatic cancer of the colon, pancreas, or stomach to those with negative colonoscopic examination. Sensitivity and specificity for CA 19-9 and CEA were calculated using the following clinical definitions. Malignant or pre-malignant disease was defined as colon, pancreatic or stomach carcinoma, stomach dysplasia, atypical adenomatous polyp, atypical villous adenoma, carcinoma in situ and carcinoma in an adenomatous polyp. When the normal group included patients with adenomatous polyp, hyperplastic adenoma, inflammatory disease and patients with no disease apparent, the sensitivity and specificity for CA 19-9 was 23% and 96%, and for CEA, 23% and 95%, respectively. When adenomatous polyp patients were placed in the malignant or pre-malignant disease group, the sensitivity and specificity for CA 19-9 was 8% and 96%, and for CEA, 11% and 95%, respectively. When comparing CA 19-9 and CEA in colorectal carcinoma, the percent positivity of the CEA assay was equal to, or better than, CA 19-9 in all Dukes' stages. In pancreatic carcinomas CA 19-9 showed better diagnostic performance than CEA.

Clinical trial of Wistar Institute 17-1A monoclonal antibody in patients with advanced gastrointestinal adenocarcinoma: a preliminary report.

Immunotherapy using monoclonal antibody 17-1A has been performed on 22 patients with metastatic gastrointestinal cancer. Criteria for treatment included objective evidence of advanced colon, gastric, or pancreatic cancer (positive CAT scan or x-rays, elevated tumor markers, and/or abnormal liver function tests). The tumor tissue was antigenically positive in all cases. Performance status ranged from 50 to 100%. No adverse reactions were noted. Of the 22 cases treated, 4 (18%) have died, none have rapidly progressive disease, 4 (18%) have slowly progressive disease, 10 (45%) are considered stable with disease, and none are considered partial or complete responses. It is too early to classify the response in 4 cases. In 6 of 8 patients where anti-idiotypic data was available, death or progressive disease was correlated to negative anti-idiotypic response, and clinical stability to a positive anti-idiotypic response. In the patients considered to be stable, the percent change from pre-treatment serum 19-9 concentrations to current values ranged from -10% to +353%. In the patients who have died or have been classified as slowly progressive the serum 19-9 changes ranged from +13% to +707%.