Value of combined serum CEA, CA72-4, and CA19-9 marker detection in diagnosis of colorectal cancer.

BACKGROUND: The aim of this study was to examine whether the combination of serum tumor markers (carcinoembryonic antigen [CEA], carbohydrate antigen [CA]72-4, CA19-9) improves sensitivity and accuracy in the diagnosis of colorectal cancer and precancerous lesion tubular adenoma. METHODS: An automatic electrochemiluminescence immunoassay with matched kits (ECLIA) was performed on a Roche Cobas e411 analyzer to determine the levels of serum CEA, CA72-4, and CA19-9 in 35 patients with early colorectal cancer, 87 patients with tubular adenoma, and 58 healthy people undergoing colonoscopy after positive fecal immunochemical test (FIT) in a colorectal cancer screening program 2021 January to April. The values of these three tumor markers in the diagnosis of colorectal cancer and tubular adenoma were analyzed. RESULTS: 180 patients (92 female and 88 male) were included into the study. We compared serum CEA, CA72-4 and CA19-9 markers among 3 groups: healthy people (mean age 64,0 ±8,6), patients with tubular adenoma (mean age 62,7 ± 6,4) and colorectal cancer (mean age 59,2 ±6,2). The levels of serum CEA, CA72-4, and CA19-9 were higher in the colorectal cancer group than in the tubular adenoma group and healthy subjects, and these differences were significant (p < 0.05). The combination of CEA, CA72-4, and CA19-9 had a higher diagnostic value for colorectal cancer compared to single markers, and the positive detection rate was 54.3%. The diagnostic power when using all three markers was the best, and applied for colorectal cancer and tubular adenoma. CONCLUSIONS: The combination of CA72-4, CEA, and CA19-9 markers increases the sensitivity and accuracy in the diagnosis of colorectal cancer and can thus be considered an important tool for early colorectal diagnosis.

Cancer mortality and morbidity among patients with schizophrenia: A hospital-based cohort study, 1992-2020.

OBJECTIVE: Due to the inconsistency of the evidence about the cancer risk among patients with schizophrenia, the aim of this study was to analyse cancer mortality and morbidity in patients with schizophrenia treated in a single centre in Lithuania during the study period of 1992-2020. MATERIALS AND METHODS: A retrospective cohort study was conducted in Vilnius Republican Psychiatric Hospital, the biggest specialised psychiatric hospital in Lithuania, with approximately 5000 hospital admissions annually. The patients' cohort was established by identifying all patients with the diagnosis of schizophrenia (ICD-10 code F20) in the hospital database from 1 January 1992 until 31 December 2017. The cancer cases and cancer deaths in the cohort were identified in the Lithuanian Cancer Register through linkage procedures. The analysis of risk was based on a comparison of observed and expected numbers of cancers and deaths. Expected number of cancer cases were calculated by multiplication of the exact person-years under observation in the cohort by sex, calendar year and a 5-year age-group-specific national incidence and mortality rate. All statistical analyses were carried out using STATA 15 statistical software. RESULTS: During the follow-up, out of 8553 patients, 673 cases of cancer were diagnosed in both sexes. Statistically significantly lower risk for overall cancer incidence was observed in men (SIR 0.74, 95% CI 0.66-0.83), but not in women (SIR 1.07, 95% CI 0.97-1.18). Statistically significant lower overall cancer mortality risk was observed in men (SMR 0.82, 95% CI 0.70-0.96), while in the women's group, risk of cancer deaths was significantly higher compared to the general population (SMR 1.28, 95% CI 1.11-1.48). We observed lower risk for pancreatic cancer (SIR 0.36, 95% CI 0.14-0.96), non-melanoma skin cancer (SIR 0.54, 95% CI 0.33-0.88) and prostate cancer (SIR 0.69, 95% CI 0.55-0.87) in men and higher risk for malignant neoplasm of liver (SIR 2.58, 95% CI 1.53-4.36) and skin melanoma (SIR 2.03, 95% CI 1.12-3.66) in men and for breast cancer (SIR 1.38, 95% CI 1.14-1.66) and corpus uteri cancer (SIR 1.56, 95% CI 1.18-2.07) in women. CONCLUSIONS: The current results of our study indicate lower risk of overall cancer incidence and mortality in male patients with schizophrenia, while female patients had a higher mortality risk, alongside variations in the risk of different cancer types. This information is important not only for patients, but for healthcare specialists to develop effective disease-specific preventive interventions and programmes.

Parity and Risk of Thyroid Cancer: a Population-Based Study in Lithuania.

An association between parity and thyroid cancer risk has been investigated in a number of independent studies but yielded contradictory findings. The aim of this study was to explore the association between parity and thyroid cancer risk. The population-based cohort study in Lithuanian was conducted. The study dataset based on the linkages between all records from the 2001 population census, all cancer incidence records from the Lithuanian Cancer Registry, and all death and emigration records from Statistics Lithuania for the period between 6 April 2001 and 31 December 2009. Cox's proportional hazards regression models were used to estimate the hazard ratios (HRs) for parity, age at first birth, number of children, place of residence, education, and age at census. The cohort of 868,105 women was followed for 8.6 years, and 1775 thyroid cancer cases were diagnosed during the study period. The significantly higher thyroid cancer risk was observed among parous women (HR = 1.45, 95% CI: 1.20, 1.75) and in women with 1, 2, and 3 children, after adjusting for the possible confounding effects of relevant demographic variables. The findings of this study are consistent with the hypothesis that parity might be associated with the risk of thyroid cancer in women.

Validity and reliability of a Lithuanian version of low anterior resection syndrome score.

BACKGROUND: Up to 90 % of patients undergoing low anterior resection complain of increased daily bowel movements, urgency, and a variable degree of incontinence. A symptom-based scoring system for bowel dysfunction after low anterior resection for rectal cancer has recently been developed and validated. The aim of our study was to adapt the low anterior resection syndrome (LARS) scale questionnaire to the Lithuanian language, and assess its psychometric properties. METHODS: The LARS questionnaire was translated into Lithuanian by the Scientific Advisory Committee of the Medical Outcomes Trust using a standard procedure of double-back translation. The Lithuanian version of the LARS (LARS-LT) questionnaire was completed by 111 patients who underwent low anterior resection with total mesorectal excision in the period from January 1, 2008, to December 31, 2012, at the National Cancer Institute. An anchor question from the Wexner score assessing the impact of bowel function on lifestyle was included. A subgroup of 20 patients completed the LARS-LT questionnaire twice. Validity was tested using a factor analysis, and internal reliability was estimated using the Cronbach's alpha and intraclass correlation coefficients. RESULTS: Twenty-seven patients (25 %) had no LARS, 26 (24 %) had minor LARS, and 55 (56 %) had major LARS. The response rate was 60.7 %. The LARS-LT showed significantly high reliability and internal consistency [Cronbach's α = 0.88, interclass correlation coefficient-0.86 (0.71-0.98)]. The LARS score showed significant correlations with the lifestyle question (p < 0.05). It could not detect differences between female and male patient groups (p = 0.33), patients' age (p = 0.45), patients who had/had not undergone radiation therapy (p = 0.07), and those in whom the distal edge of the tumor was close to or far from the anal verge (p = 0.17). CONCLUSIONS: The Lithuanian version of the LARS-LT shows acceptable psychometric properties and can be considered a valuable and specific instrument to assess bowel function in rectal cancer patients, both for research purposes and in clinical practice.

Epidemiology of basal cell carcinoma in Lithuania, 1996-2010.

BACKGROUND: Nonmelanoma skin cancer is the most common cancer among the white population. OBJECTIVES: To describe the epidemiology of basal cell carcinoma (BCC) in Lithuania by analysing population-based incidence, with special emphasis on sex- and subsite-specific changes over time. METHODS: Data from the Lithuanian Cancer Registry for the period 1996-2010 were used to analyse trends in the incidence rates for BCC. Only the first case of BCC per patient was included in this analysis. Age-standardized rates were calculated for both sexes. Standardization was performed using the direct method (European standard population). RESULTS: Since 1996, overall BCC incidence rates have increased from 27.4 to 46.0 cases per 100,000 in Lithuania. In 1996, the incidence of BCC was higher among women than men (28.2 vs. 27.6 per 100,000, respectively). Incidence of BCC during the study period increased faster among men than among women (by 3.3% and 2.6% per year, respectively), while the incidence among both sexes in 2010 became almost equal -46.4 among men and 47.4 among women per 100,000. The head and neck was the most common site of BCCs for both sexes (31.0 and 32.9 per 100,000 among men and women, respectively). CONCLUSIONS: The incidence of BCC in Lithuania is lower than that reported in Northern and Western Europe. The population-based data for BCC from Lithuania are closely comparable, with regard to age, tumour localization and place of residence, with the existing literature from other European cancer registries.

Incidence of prostate cancer in Lithuania after introduction of the Early Prostate Cancer Detection Programme.

In Lithuania, prostate-specific antigen (PSA) testing is offered to healthy asymptomatic men as a screening test in the population-based Early Prostate Cancer Detection Programme (EPCDP). The aim of this study was to analyse the incidence of prostate cancer before and after introduction of the EPCDP in Lithuania. Prostate cancer incidence and mortality data from the Lithuanian Cancer Registry were analysed for the period 1990-2008. Age-specific incidence and mortality data were adjusted to the European Standard Population. There have been extraordinary changes in the incidence of prostate cancer in Lithuania following introduction of the EPCDP, and there is strong evidence that these changes are the result of increased detection rates, especially in men of screening age. Further observation of changes in prostate cancer incidence and mortality in Lithuania may help to determine the extent to which PSA testing at the population level influences incidence and mortality in the general population.

Oncologic outcomes of surgery in t3 prostate cancer: experience of a single tertiary center.

Aim. The aim of this study is to present the oncologic outcomes and to determine the prognostic factors of overall survival (OS), cancer-specific survival (CSS), disease-progression-free survival (DPFS), and biochemical-progression-free survival (BPFS) after surgery for pT3 prostate cancer (PCa). Methods. Between 2002 and 2007, a pT3 stage after radical prostatectomy was detected in 182 patients at our institution. The Kaplan-Meier analysis was used to calculate OS, CSS, DPFS, and BPFS. Cox regression was used to identify predictive factors of survival. Results. pT3a was detected in 126 (69%) and pT3b in 56 (31%) of cases. Five-year OS, CSS, DPFS, and BPFS rates were 90.7%, 94%, 91.8%, and 48.4%, respectively. Survival was significantly different when comparing pT3a to pT3b groups. The 5-year OS, CSS, DPFS, and BPFS were 96% versus 72%, 98% versus 77%, 97.3% versus 79.3%, and 60% versus 24.2%, respectively. Specimen Gleason score was the most significant predictor of OS, CSS, DPFS, and BPFS. The risk of death increased up to 3-fold when a Gleason score 8-10 was present at the final pathology. Conclusions. Radical prostatectomy may offer very good CSS, OS, DPFS, and BPFS rates in pT3a PCa. However, outcomes in patients with pT3b or specimen Gleason ≥8 were significantly worse, suggesting the need for multimodality treatment in those cases.

Triple negative breast cancer: adjuvant chemotherapy effect on survival.

PURPOSE: The purpose of this study was to evaluate the overall survival of patients with triple negative breast cancer and the impact of different adjuvant chemotherapy regimens on survival. MATERIAL/METHODS: The study group consisted of 99 breast cancer patients with immunohistochemically confirmed triple negative breast cancer. The impact of various factors as well as the impact of different chemotherapy regimens on survival was evaluated. RESULTS: The overall survival of breast cancer patients was 97.0% (95% CI 90.9-99.0), 84.9% (95% CI 76.1-90.6) and 66.5% (95% CI 55.5-75.3) 10, 30 and 60 months after diagnosis, respectively. Univariate analysis demonstrated that the following were significant risk factors for breast cancer patients survival: patient's age, stage of disease, tumour size, lymph node status, type of surgery and chemotherapy. Better survival was related to younger patients' age, smaller tumour size, lower stage of disease, no lymph nodes involvement. Survival rates were higher among patients who received adjuvant chemotherapy and underwent quadrantectomy. In the multivariate statistical analysis the significant independent prognostic variables influencing survival were lymph node status and adjuvant chemotherapy. Survival rates of the patients, who received adjuvant anthracycline containing chemotherapy were higher, than those in non-anthracycline containing treatment group, but the difference was not statistically significant. CONCLUSION: Patients who had lymph node status N2-3 and those who did not receive adjuvant chemotherapy showed worse prognosis and survival than other patients. The impact of chemotherapy type (anthracycline containing or non-anthracycline containing) on patients survival was not statistically significant.

Outcome and treatment strategy in female lung cancer: a single institution experience.

PURPOSE: To assess the survival rate of female lung cancer treated at the Institute of Oncology of the Vilnius University, Lithuania during the period between 1996-2005. MATERIALS AND METHODS: During the period between 1996-2005, 471 women diagnosed with lung cancer were treated at the Department of Thoracic Surgery and Oncology of the Institute of Oncology, Vilnius University. Data on morphology, stage and treatment was collected from the medical records. All lung cancer cases by histology were classified in two groups: non-small cell lung cancer (includes squamous cell carcinoma, large cell carcinoma, adenocarcinoma and other less common types) and small cell lung cancer. The vital status of the study group was assessed as of December 31, 2007, by passive follow-up, using data from the population registry. It was found that 411 (87.3%) of the patients had died. Survival was estimated according to the Kaplan-Meier method. RESULTS: The median survival of female lung cancer diagnosed during 1996-2005 in Lithuania show to be 8.7 months (8.4 (95% CI 7.2-10.8) months with non-small cell lung cancer and 9.3 (95% CI 6.3-13.0) months with small-cell lung cancer). Survival was more than 20 months in resectable non-small cell lung cancer (stages I, II, IIIA). Non-small cell lung cancer survival in advanced stages was less than 7 months. Small-cell lung cancer patients median survival at limited and extended stages of the disease were 9.5 (95% CI 2.9-18.4) compared to 9.2 (95% CI 6.2-13.7) months. Non-small cell lung cancer patients most frequently were treated by surgery (27.0%), surgery and chemotherapy or radiotherapy (19.6%). Small cell lung cancer patient treatment included chemo and radiotherapy (27.0%), chemotherapy (19.0%), radiotherapy (17.5%), surgery (27.9%). CONCLUSIONS: The single center study of female lung cancer diagnosed during 1996-2005 in Lithuania show a significantly better chance of survival in resectable non-small cell lung cancer. Advanced stages of the disease at the time of diagnosis and choice of treatment options of female lung cancer in the country still remains an issue.

Mortality and cancer incidence among Lithuanian cement producing workers.

AIMS: To investigate mortality and cancer incidence of cement producing workers. METHODS: A total of 2498 cement workers who have been employed at Portland cement producing departments for at least one year from 1956 to 2000 were followed up from 1 January 1978 to 31 December 2000. The cohort contributed 43,490 person-years to the study. Standardised incidence ratios (SIR) and standardised mortality ratios (SMR) were calculated as ratios between observed and expected numbers of cancers and deaths. The expected numbers were based on sex specific incidence and mortality rates for the total Lithuanian population. RESULTS: Significantly increased SMRs were found for all malignant neoplasms (SMR 1.3, 95% CI 1.0 to 1.5) and for lung cancer (SMR 1.4, 95% CI 1.0 to 1.9) among male cement workers. SIR for all cancer sites was 1.2 (95% CI 1.0 to 1.4). Excess risk was found for cancer of the lung (SIR 1.5, 95% CI 1.1 to 2.1). The SIR for urinary bladder cancer was also increased (SIR 1.8, 95% CI 0.9 to 3.5). The overall cancer incidence was not increased among females (SIR 0.8, 95% CI 0.6 to 1.1). With increasing cumulated exposure to cement dust, there were indications of an increasing risk of lung and stomach cancers among males. CONCLUSIONS: This study supported the hypothesis that exposure to cement dust may increase the lung and bladder cancer risk. A dose related risk was found for stomach cancer, but no support was found for an increased risk of colorectal cancer.