Multivariate explanatory model for sporadic carcinoma of the colon in Dukes' stages I and IIa.

OBJECTIVE: We obtained before an explanatory model with six dependant variables: age of the patient, total cholesterol (TC), HDL cholesterol (HDL-C), VLDL cholesterol (VLDL-C), alkaline phosphatase (AP) and the CA 19.9 tumour marker. Our objective in this study was to validate the model by means of the acquisition of new records for an additional analysis. DESIGN: Non-paired case control study. SETTING: Urban and rural hospitals and primary health facilities in Western Andalusia and Extremadura (Spain). PATIENTS: At both the primary care facilities and hospital level, controls were gathered in a prospective manner (n= 275). Cases were prospective and retrospective manner collected on (n=126). MAIN OUTCOME MEASURES: Descriptive statistics, logistic regression and bootstrap analysis. RESULTS: The AGE (odds ratio 1.02; 95% CI 1.003-1.037) (p= 0.01), the TC (odds ratio 0.986; 95% C.I. 0.980-0.992) (p< 0.001) and the CA 19.9 (odds ratio 1.023; 95% C.I. 1.012- 1.034) (p<0.001) were the variables that showed significant values at logistic regression analysis and bootstrap. Berkson's bias was statistically assessed. CONCLUSIONS: The model, validated by means of logistic regression and bootstrap analysis, contains the variables AGE, TC, and CA 19.9 (three of the original six) and has a level 4 over 5 according to the criteria of Justice et al. (multiple independent validations) [Ann. Intern. Med.1999; 130: 515].

[Mondor's disease: study of two topographic localizations]. / Enfermedad de Mondor: estudio de dos formas topográficas.

Superficial thoracic wall and dorsal vein of the penis phlebitis are uncommon diseases. Both are known as Mondor's disease. Two cases have been diagnosed in a short period of time in a Southern. Spain primary care clinics.

[CA 19.9 and HDL-cholesterol behaviour in a sporadic colorectal carcinoma sample]. / Compartimiento del CA 19.9 y de fracción HDL-colesterol en una muestra de pacientes con carcinoma colorrectal esporádico.

BACKGROUND AND OBJECTIVE: We have carried out a comparative prediction analysis in sporadic colorectal carcinoma of plasmatic lipids and currently tumor markers used in this neoplasia (carcinoembrionary antigen - CEA, CA 19.9 and sialic acid -SA). PATIENTS AND METHODS: Transversal hospital-based case-control study. Sample was composed by 53 sporadic colorectal neoplasia patients just before surgery and 40 non matched controls. A 90 per cent of cases were at Dukes A and B stages. A multivariable model was fitted with non-conditional logistic regression. Confidence intervals were calculated at 95 per cent of confidence. Model sensibility and specificity were performed at 50 per cent cutting point. We also explored possible interactions. RESULTS: All three tumor markers (CEA, CA 19.9 and SA) were elevated in cases (p<0.01). Multivariable model included: Total cholesterol (TC) (OR= 0.69; CI: 0.50-0.96) high density lipoprotein fraction (HDL) (OR = 0.30; CI: 0.11-0.83) very low density lipoprotein fraction (VLDL) (OR = 2.21; CI = 1.07-4.55) years of age (OR = 1.11; CI = 0.98-1.26) CA 19.9 (OR = 1.20; CI = 1.02-1.42) and alkaline phosphatase (OR = 1.09; CI = 1.01 - 1.19). No interactions were found out. Model sensibility reached 96.23% and a specificity of 92.50%. CONCLUSIONS: HDL showed a similar diagnostic strength than CA 19.9 in this sporadic colorectal carcinoma sample but with an inverse OR. This multivariable model is going to be validated.