Carcinoembryogenic Antigen Research Articles

Mitigating Effect of Matricin Against Benzo(a)pyrene-induced Lung Carcinogenesis in Experimental Mice Model.

Lung cancer is a life-threatening disease that is still prevalent worldwide. This study aims to evaluate the effects of matricin, a sesquiterpene, on the carcinogenic agent benzo(a)pyrene [B(a)P]-induced lung cancer in Swiss albino mice. Lung cancer was induced by oral administration of B(a)P at 50 mg/kg b. wt. in model Swiss-albino mice (group II) as well in experimental group III, and treated with matricin (100 mg/kg b. wt.) in group III. Upon completion of treatment for 18 weeks, the changes in body weight, tumor formation, enzymatic and non-enzymatic antioxidant levels (GSH, SOD, GPx, GR, QR, CAT), lipid peroxidation (LPO) level, pro-inflammatory cytokines (TNF-α, IL-6, IL-1β), immunoglobulin levels (IgG, IgM), apoptosis markers (Bax, Bcl-xL), tumor markers (carcinoembryogenic antigen (CEA), neuron-specific enolase (NSE)), and histopathological (H&E) alterations were determined. The results indicate that B(a)P caused a significant increase of tumor formation in the lungs, increased tumor markers and inflammatory cytokines in serum, and depletion of enzymatic/ non-enzymatic antioxidants and immunoglobulins, compared to the untreated control group. Matricin treatment significantly reversed the changes caused by B(a)P as evidenced by the biochemical and histopathological assays. The changes caused by matricin clearly indicate the cancer-preventive effects of matricin against B(a)P-induced lung cancer in animal models, which can be attributed to the antioxidant activity, immunomodulation, and mitigation of the NF-kβ pathway.

Prognostic value of tumor markers ProGRP, NSE and CYFRA 21-1 in patients with small cell lung cancer and chemotherapy-induced remission.

Despite successful response to first line therapy, patients with small-cell lung cancer (SCLC) often suffer from early relapses and disease progression. To investigate the relevance of serum tumor markers for estimation of prognosis at several time points during the course of disease. In a prospective, single-center study, serial assessments of progastrin-releasing peptide (ProGRP), neuron-specific enolase (NSE), cytokeratin-19 fragments (CYFRA 21-1) and carcino-embryogenic antigen (CEA) were performed during and after chemotherapy in 232 SCLC patients, and correlated with therapy response and overall survival (OS). ProGRP, NSE and CYFRA 21-1 levels decreased quickly after the first chemotherapy cycle and correlated well with the radiological response. Either as single markers or in combination they provided valuable prognostic information regarding OS at all timepoints investigated: prior to first-line therapy, after two treatment cycles in patients with successful response to first-line therapy, and prior to the start of second-line therapy. Furthermore, they were useful for continuous monitoring during and after therapy and often indicated progressive disease several months ahead of radiological changes. The results indicate the great potential of ProGRP, NSE and CYFRA 21-1 for estimating prognosis and monitoring of SCLC patients throughout the course of the disease.

Study on the correlation between controlling nutritional status score and clinical biochemical indicators in patients with colorectal cancer

PurposeThe controlling nutritional status (CONUT) score is an important tool for predicting the prognosis of colorectal cancer (CRC); however, its effectiveness is relatively insufficient. This study aimed to screen for more effective clinical indicators as supplements to the CONUT scoring system and improve the predictive value of CRC prognosis. Patients and methodsBetween 2014 and 2020, the clinical information of all CRC patients in our unit was retrospectively collected, and the CONUT scores were calculated based on the levels of serum albumin (ALB), lymphocytes (LC), and total cholesterol. The included patients were divided into the following three groups: normal nutrition (0–1), mild malnutrition (2–4), and moderate-to-severe malnutrition (5–12). The correlations between the CONUT score and baseline characteristics and clinical indicators were evaluated. ResultsThis study ultimately included 5014 CRC patients. The nutritional status of patients with colon cancer (CC) was worse than that of rectal cancer (RC). The nutritional status was worse in men than in women. The older the patient, the poorer the nutritional status, and the poorer the nutritional status, the longer the hospital stay. In addition, poor nutritional status in patients is indicated by higher values of neutrophils (NE), monocytes (MC), eosinophils (EOS), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), carcinoembryogenic antigen (CEA), and lower values of white blood cells (WBC), basophils (BAS), haemoglobin (HB), total protein (TP), triglycerides (TG), low density lipoprotein (LDL), aspartate transaminase (AST), and blood urea nitrogen (BUN), which was statistically significant (P < 0.05). Indicators that significantly correlated with the CONUT score reflected the immune nutritional status, including WBC (odds ratio [OR] = 0.036, P < 0.001), NE (OR = 30.815, P < 0.001), MC (OR = 41.388, P < 0.001), EOS (OR = 27.577, P < 0.001), BAS (OR = 0.006, P = 0.046), and LDL (OR = 0.319, P < 0.001). ConclusionAdditional variables such as WBC, NE, MC, EOS, BAS, and LDL may be used as supplementary indicators in the CONUT scoring system to more effectively predict the clinical prognosis of CRC patients.

Can combined use of tumor markers in pancreatic cancer be a solution to short- and long-term consequences?: A retrospective study.

As in other types of cancer, tumor markers are used in pancreatic ductal adenocarcinoma (PDAC) for disease follow-up, especially after surgery. There has been shown to be a significant correlation between the tumor marker levels and poor prognosis in locally or systemic advanced stage PDAC patients. However, there is no significant correlation between prognosis and marker levels in patients with early stage PDAC patients. This study aimed to examine the effect of the carbohydrate antigen 19-9 (Ca19-9)/carcinoembryogenic antigen (CEA) ratio in ductal adenocarcinoma of the pancreatic head on disease prognosis and mean survival. This retrospective study was conducted with 129 pancreatic head adenocarcinoma patients who were treated with whipple procedure at the Ankara University Surgical Oncology Clinic between 2010 and 2020. All patients' demographics, stage of the disease, CEA, CA 19-9 levels, and CEA/Ca 19-9 ratio were enrolled and compared statistically. A new cutoff value was calculated for the Ca19-9/CEA ratio. A Ca19-9/CEA ratio >29.77 showed 69.9% sensitivity and 70.9% specificity for the probability of the T3 and T4 stages. The cutoff value for the Ca19-9/CEA ratio was 27.18. This cutoff value had a sensitivity of 79.4% and a specificity of 80.3% for lymph node metastasis. Patients with a Ca19-9/CEA ratio below the cutoff value of 28.475 had a mean survival of 93.161 months and those with a value higher than the cutoff value had a mean survival of 28.541 months (P < .001). A simple combination of tumor markers was determined to have higher accuracy rates in predicting tumor prognosis and in determining mean survival, which are particularly needed in early stage cancers.

LBODP099 A Young Patient With Undifferentiated And Advanced Medullary Thyroid Carcinoma With Negative RET - CASE REPORT

Abstract A Young Patient With Undifferentiated And Advanced Medullary Thyroid Carcinoma With Negative RET – CASE REPORT INTRODUCTION: Medullary Thyroid Carcinoma (MTC) is a rare and aggressive form of thyroid cancer that arises from C cells, representing 5% of all thyroid malignancy. The biochemical characteristic of MTC is the elevation of serum calcitonin (CTN), which aids in the initial diagnosis and surveillance of this disease. Another important, but less specific marker in the follow-up is the carcinoembryogenic antigen (CEA). Although, it is observed in the Undifferentiated MTC that there is a disproportion between the expected values of CEA and CTN. Case Report A previously healthy 16 years old female patient was hospitalized for the investigation of cervical discomfort, involuntary weight loss and progressive back pain for 9 months. She had a BMI of 14.9kg/cm2, a palpable thyroid nodule measuring approximately 2. 0cm and painful cervical lymph node enlargement. Laboratory tests showed CTN 79.1pg/mL, CEA 4999.42ng/mL added with an independent PTH hypercalcemia. Thyroid US showed a solid nodule with lobulated contours, heterogeneous echotexture, predominantly hypoechogenic, with its longest axis parallel to the skin, measuring approximately 2.4×0.9×0.9 cm, located in the lower middle third of the right thyroid lobe (TI -RADS 4) added to multiple lymph nodes inthe anterior cervical area (in agreement with the neck CT). Regarding the staging Chest CT showed a metastasis suggestive nodulation; Cranial CT, bone scan and total spine MRI showed evidence of several infiltrative nodular formations with heterogeneous enhancement affecting the skullcap, sacrum, iliac bones and multiple vertebral bodies. Sacral bone biopsy was performed giving us the diagnose of a metastatic Medullary Thyroid Carcinoma (MTC). A FineNeedle Aspiration (FNA) of the thyroid nodule and cervical lymph node showed calcitonin levels of 31.1pg/mL added with positive immunohistochemistry for chromogranin,synaptophysin, CD56 and Calcitonin in a focal manner, confirming the hypothesis of Undifferentiated CMT. Genetic testing was performed by next-generation sequencing of the genes ATM, ATR, CDKN2A, EGLN1, FH, HRAS, KIF1B, KMT2D, MAX, MDH2, MERTK, MET, NF1, PIK3CA, RET, SDHA, SDHAF2, SDHB, SDHC, SDHD, TMEM127, TP53 (including promoter), VHL, which results were negative for all pathogenic variants, probably pathogenic or VUS therefore being considered a sporadic MTC. Patient was referred for cervical radiotherapy and started Vandetanib. Conclusion Serum CTN is the main diagnostic and surveillance marker of MTC. CEA is another marker that must be taken into account. We report the case of a young patient diagnosed with metastatic RET negative MTC with disproportionate values of CTN and CEA, which suggests its undifferentiated feature, revealing the importance of joint assessment of these two markers. Presentation: No date and time listed

Evaluation of Anticancer Potential of Mimosa diplotricha Ethanolic Leaf Extract on N-Methyl-NNitroso Urea Induced Colorectal Carcinogenesis in Wistar Albino Rats

Abstract: Background: Colorectal Cancer, (CRC) ranks third among global cancer incidence statistics and occupies fourth position as far as cancer related death is concerned and the aim of the study is to evaluate the therapeutic potential of Mimosa diplotricha ethanolic leaf extract in chemically induced colorectal carcinogenesis in Wistar albino rats. Materials and Methods: CRC was induced by intrarectal instillation of N-Methyl-N-Nitrosourea (MNU), 2mg per rat in 0.5ml of distilled water three times a week for five weeks. Rats were grouped as control, induced, induced and standard drug treated (15mg/kg.bw), induced and plant extract treated (in two doses 200mg/kg.bw and 400mg/kg.bw) and normal rats with respective plant extract treatment (200mg/kg.bw and 400mg/kg.bw). Treatment were carried out for 60 days followed which animals were euthanized and serum markers, oxidative stress, microbial enzymatic, histological and immunohistochemical parameters were analysed. Results: M. diplotricha was found to be effective in the down regulation of serum inflammatory and tumour markers like tumour necrosis factor alpha, transforming growth factor beta, carcinoembryogenic antigen and colon cancer specific antigen-4 levels. Oxidative stress parameters and histological data also supported the therapeutic efficacy of M. diplotricha. Expression of anti-apoptotic protein Bcl-2 was also found be downregulated in induced animals treated with M. diplotricha as evident from immunohistochemical data. Conclusion: The results of present research suggest that M. diplotricha ethanolic leaf extract showed a significant therapeutic potential against chemically induced colorectal carcinogenesis. Key words: CRC, Wistar rats, MNU, Mimosa diplotricha, Serum markers, Bcl-2.

391 An Audit of Nurse-Led Follow-Up of Patients with Colorectal Cancer in a District General Hospital

Abstract Introduction Rates of recurrence of colorectal cancer after potentially curative surgery vary between 30–65%. Regular post-operative surveillance of these patients is essential in detecting recurrence and improves overall survival. NICE guidelines recommend follow-up with measurement of serum carcinoembryogenic antigen (CEA) and with CT scans of the chest abdomen and pelvis. In our unit, patients have been followed up by Cancer Nurse Specialists (CSNs) since 2016. The aim of this audit is to determine the compliance with surveillance guidelines in our nurse-led follow-up programme. Method This is a retrospective audit of randomly selected post-operative patients with colorectal cancer who were followed up by CSNs. All patients with appointments with CSNs in 2 randomly selected months (1st January- 28th February 2020) were included. Data was collected using electronic patient records. Results 54 patients were identified. For low-risk patients, 100% (34/34) had their CT surveillance at 1 year, and, for those 30 months post- surgery, 100% (30/30) had their 30 months CT scan. 94% (32/34) had recommended CEA measurements. In high-risk patients, 85% (17/20) had their 1-year CT scan, 100% of eligible patients (19/19) had their 2-year CT, or a plan in place for one. Of patients eligible for a 3-year CT scan, 46% (6/13) had one. 95% (19/20) had recommended CEA measurements. Conclusions Nurse-led follow-up overall leads to adequate follow-up, better compliance with guidelines and improved continuity of care.

Regulation of CEACAM Family Members by IBD-Associated Triggers in Intestinal Epithelial Cells, Their Correlation to Inflammation and Relevance to IBD Pathogenesis.

Carcinoembryogenic antigen cellular adhesion molecules (CEACAMs) are intercellular adhesion molecules highly expressed in intestinal epithelial cells. CEACAM1, -3, -5, -6, -7 are altered in patients suffering from colon cancer and inflammatory bowel diseases (IBD), but their role in the onset and pathogenesis of IBD is not well known. Herein, we aim to correlate CEACAM1, -3, -5, -6, -7 expression to the degree of inflammation in pediatric and adult IBD colon biopsies and to examine the regulation of CEACAMs on human intestinal epithelial cell lines (C2BBe1/HT29) by different IBD-associated triggers (cytokines, bacteria/metabolites, emulsifiers) and IBD-drugs (6-Mercaptopurine, Prednisolone, Tofacitinib). Biopsies from patients with pediatric Crohn’s disease (CD) and adult ulcerative colitis (UC, active/inactive disease) showed a significant increase in CEACAM3, -5, -6 expression, while CEACAM5 expression was reduced in adult CD patients (active/inactive disease). Intestinal epithelial cells cultured with a pro-inflammatory cytokine cocktail and Adherent-invasive Escherichia coli (AIEC) showed a rapid induction of CEACAM1, -5, -7 followed by a reduced RNA and protein expression overtime and a constant expression of CEACAM3, correlating with IL-8 expression. Cells cultured with the emulsifier polysorbate-80 resulted in a significant induction of CEACAM3, -5, -6, -7 at a late time point, while SCFA treatment reduced CEACAM1, -5, -7 expression. No major alterations in expression of CEACAMs were noted on cells cultured with the commensal Escherichia coli K12 or the pathogen Salmonella typhimurium. IBD drugs, particularly Tofacitinib, significantly reduced cytokine-induced CEACAM1, -3, -5, -6, -7 expression associated with a reduced IL-8 secretion. In conclusion, we provide new evidence on the regulation of CEACAMs by different IBD-associated triggers, identifying a role of CEACAMs in IBD pathogenesis.

Serum CA19-9, CA-125 and CEA as tumor markers for mucinous ovarian tumors.

AimTo analyze the use of serum cancer antigen 19‐9 (CA19‐9), cancer antigen 125 (CA‐125) and carcinoembryogenic antigen (CEA) in predicting the malignant potential of mucinous ovarian tumor, and to assess the clinical factors associated with these tumors.MethodsThis retrospective study collected the data from 314 patients who were diagnosed with mucinous ovarian tumor. These patients had preoperative serum CA19‐9, CA‐125, CEA available and underwent surgery at Ramathibodi Hospital between January 2010 and December 2016. The diagnostic performance of CA19‐9, CA‐125 and CEA was analyzed using the receiver operator characteristic curve. The associations between clinicopathological factors and serum CA19‐9, CA‐125 and CEA level were also analyzed.ResultsA total of 314 patients were recruited in this study. They consisted of 221 patients with benign mucinous ovarian tumor (70.38%), 65 patients with borderline mucinous ovarian tumor (20.70%) and 28 patients with mucinous ovarian carcinoma (8.92%). Multivariate analysis revealed that the tumor size, elevated serum CA19‐9, CA‐125 and CEA influenced the tumor pathology. The mucinous ovarian tumor with large tumor size, elevated serum CA19‐9, CA‐125 and CEA more than the cut off values showed a positive correlation with the risk ratio of 1.60 (95% CI = 1.13–2.28; P = 0.005), 1.74 (95% CI = 1.22–2.47; P = 0.002), 1.90 (95% CI = 1.34–2.70; P < 0.001), 1.58 (95% CI = 1.10–2.29; P = 0.020), respectively. CA‐125 provided the highest diagnostic performance, with an area under receiver operator characteristic curve of 0.745, to differentiate between borderline, malignant or benign mucinous ovarian tumor.ConclusionPreoperative elevation of the serum CA19‐9, CA‐125, CEA and tumor size are useful predictors to differentiate between benign, borderline and malignant mucinous ovarian tumor. The best predictor is CA‐125, followed by CA19‐9 and CEA.

Hsa_circ_0002320: a novel clinical biomarker for colorectal cancer prognosis.

A great many circular RNAs (circRNAs) exist in different types of mammalian cells. Previous studies have verified that a low level of hsa_circ_0002320 is present in gastric cancer and that it might represent a good prognostic indicator. However, its value in colorectal cancer (CRC) is unclear. The aim of this research was to explore the value of hsa_circ_0002320 as a potential diagnostic biomarker for CRC prognosis.Plasma samples, CRC tissues, and adjacent normal tissues were obtained from 50 patients with CRC, before any treatment, and 100 plasma samples were acquired from healthy individuals. Hsa_circ_0002320 levels in these samples were analyzed by reverse transcription-quantitative polymerase chain reaction. Correlations between hsa_circ_0002320, clinicopathological characteristics, and overall survival (OS) of CRC patients were also investigated. Receiver-operating characteristic (ROC) curve analysis was used to assess the value of hsa_circ_0002320 for CRC diagnosis. Finally, a bioinformatics analysis was performed to verify the effect of hsa_circ_0002320 on CRC prognosis.Expression levels of hsa_circ_0002320 were significantly decreased in CRC plasma (P < .05). The expression level of hsa_circ_0002320 was significantly correlated with OS time (P < .05). Higher hsa_circ_0002320 reflected significantly greater OS; the HR of high hsa_circ_0002320 was 0.161 (95% CI, 0.066–0.393; P = .000). The area under the ROC curve of hsa_circ_0002320 in CRC was 0.823, which was higher than for the carcinoembryogenic antigen (area under the curve = 0.764). Kaplan-Meier analysis showed that CRC patients with low expression of hsa_circ_0002320 exhibited poorer OS times than those with high expression.Hsa_circ_0002320 could be a novel, noninvasive diagnostic blood biomarker for CRC prognosis.

Primary Tumor Location Is a Prognostic Factor for Intrahepatic Progression-Free Survival in Patients with Colorectal Liver Metastases Undergoing Portal Vein Embolization as Preparation for Major Hepatic Surgery.

The aim of this study was to identify prognostic factors affecting intrahepatic progression-free survival (ihPFS) and overall survival (OS) in patients with colorectal cancer liver metastases (CRCLM) undergoing portal vein embolization (PVE) and subsequent (extended) right hemihepatectomy. A total of 59 patients (mean age: 60.8 ± 9.3 years) with CRCLM who underwent PVE in preparation for right hemihepatectomy were included. IhPFS and OS after PVE were calculated using the Kaplan–Meier method. Cox regression analyses were conducted to investigate the association between the following factors and survival: patient age, laterality of the colorectal cancer (right- versus left-sided), tumor location (colon versus rectal cancer), time of occurrence of hepatic metastases (synchronous versus metachronous), baseline number and size of hepatic metastases, presence or absence of metastases in the future liver remnant (FLR) before PVE, preoperative carcinoembryogenic antigen (CEA) levels, time between PVE and surgery, history of neoadjuvant or adjuvant chemotherapy, and the presence or absence of extrahepatic disease before PVE. Median follow up was 18 months. The median ihPFS was 8.2 months (95% confidence interval: 6.2–10.2 months), and median OS was 34.1 months (95% confidence interval: 27.3–40.9 months). Laterality of the primary colorectal cancer was the only statistically significant predictor of ihPFS after PVE (hazard ratio (HR) = 2.242; 95% confidence interval: 1.125, 4.465; p = 0.022), with patients with right-sided colorectal cancer having significantly shorter median ihPFS than patients with left-sided cancer (4.0 ± 1.9 months versus 10.2 ± 1.5 months; log rank test: p = 0.018). Other factors, in particular also the presence or absence of additional metastases in the FLR, were not associated with intrahepatic progression-free survival. The presence of extrahepatic disease was associated with worse OS (HR = 3.050, 95% confidence interval: 1.247, 7.459; p = 0.015).

Use of tumor markers to distinguish endometriosis-related ovarian neoplasms from ovarian endometrioma

ObjectiveOnly few studies have focused on tumor markers used in the preoperative diagnosis of endometriosis-related ovarian neoplasms, and previous studies have only assessed serum CA125 levels. This study investigated the...

Apocrine Carcinoma of Breast in a Male Patient: Case Report

Introduction: Apocrine carcinoma of breast is a rare type of malignant tumor, the incidence of which varies between 0.3 - 0.4 % of all female breast cancers.Apocrine carcinoma is exceptional in male patients and very few cases have been described in literature. This tumor shows distinct microscopic and immunohistological features. We report an exceptional observation of apocrine carcinoma of breast in a man. Patient and observation: He’s a 54 years old man who had for 2months a painless nodule at the left axillary..The patient had family history of breast and prostate cancers. Physical examination revealed a left axilary lymphadenopathy movable relative to superficial and deep plans with no evidence mass of breasts. MRI of the breast was performed and revealed a mass that was 38 x 10 mm in size.A biopsy of the lymphadenopathy was performed. It objectified a carcinomatous proliferation. An immunohistochemical study showed that tumor cells express Her 2, but do not express estrogenic and progesterone receptors. A tumorectomy of the left breast was performed and didn’t show any malignant lesion of the breast. The axiler dissection of 13 lymphnodes showed 11 metastatics ones with 3 breaking capsular. The diagnosis of apocrine carcinoma of the breast was made in despite of the result of the tumorectomy. The CT did not indicate metastasis. The patient was administered adjuvant chemotherapy then he received radiation therapy on left susclavicular, axila and breast with a total dose of 42Gy,15 fractions of 2.8 Gy on 21 days with no late effects. 1 year of trastuzumab was administrated. There was no recurrence or metastasis approximately 2 years after radiation therapy. Then the patient presented a susclavicular lymphnode that was comfirmed on the pet-scanner with multiple mediastinal lymphnodes. A biopsy of the susclavicular lymphnode comfirmed the progression of the disease. The patient started chemotherapy in association with pertuzumab and trastuzumab. Discussion: Apocrine carcinoma of the breast is a rare malignant tumor whose incidence varies between 0.3% and 4% of all female’s breast cancer and represents 0.5 % of all invasive breast cancers. This tumor is exceptional in men. Indeed, only a dozen cases have been described in the literature . Most neoplasms are slowly progressive, small in size, and are most frequently seen in the axilla. They can be recurrent and metastasize to the lymph node, lung, and bone. Male patients have been advanced disease at presentation compared to women which may be due to lack of public awareness of breast cancer in male. Histologically, it has glandular structures with apocrine features and decapitation secretions. There is cytoplasmic PAS positivity of the tumor cells. The presence of neoplastic glands high in the dermis and immediate subepidermis favors the primary origin of tumor cells from apocrine sweat glands. Apocrine adenocarcinomas are positive for cytokeratins, carcinoembryogenic antigen (CEA) and epithelial membrane antigen (EMA) . Usually, these tumors do not express the estrogen receptor-alpha, progesterone receptors and bcl-2. Apocrine adenocarcinoma has poor prognosis and the prognostic factors include size, histological type, lymph node involvement, and distant metastasis. The 10-year disease free survival rate in the absence of metastasis to the lymph nodes is 56%. Treatment protocols of apocrine carcinoma are similar to non apocrine carcinoma of breast. However studies involving the use of anti androgens are in progress. The treatment of choice is wide local excision with clear margins, with or without regional lymph node dissection. The role of radiation therapy also remains uncertain in the absence of clinical trials. No clear correlation between treatment modality and recurrence in apocrine carcinoma was apparent, and survival rates of apocrine carcinoma were not different from other breast carcinomas. Conclusion: In conclusion, male apocrine carcinoma is a very rare, unique and morphologically-distinctive, invasive ductal carcinoma.. Although immunohistochemical staining might show differences in males, the prognosis is not different from other breast carcinomas. It has different hormonal profile, androgen receptor positivity makes patient with apocrine carcinoma eligible for targeted therapy.

The role of 68Ga-DOTATATE PET/CT and 18F-FDG PET/CT in the follow-up of patients with medullary thyroid cancer.

Medullary thyroid cancer (MTC) is an aggressive form of thyroid malignancy with local metastasis in 30%-50% of the cases and distant metastasis predominantly to lung, liver and skeleton in 13%-15% of patients. Identification of the lesion using imaging modalities is of crucial importance for disease management in the recurrent or metastatic MTC. In this study, we aimed to determine the efficacy of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) and gallium-68 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid tyrosine-3-octreotate (68Ga-DOTATATE) PET/CT imaging in patients with MTC and to evaluate the relationship between imaging findings and serum tumor markers. The records of MTC patients, who were treated and followed-up in our department between the years 2005 and 2018 were retrospectively analyzed. Seventy-three patients with MTC, who underwent either 68Ga-DOTATATE PET/CT (n=61) and/or 18F-FDG PET/CT (n=59) together with serum calcitonin (Ctn) and/or carcinoembryogenic antigen (CEA) measurement within 6 months period were included in the study. Gallium-68-DOTATATE PET/CT and 18F-FDG PET/CT scans performed within 6 months on the same patient (n=38) were analyzed separately for comparison of the efficacy of both modalities. The overall sensitivity of 18F-FDG PET/CT and 68Ga-DOTATATE PET/CT were 72.4% and 88.1%, respectively in detecting recurrent or metastatic disease. In the group of patients, who had both 18F-FDG PET/CT and 68Ga-DOTATATE PET/CT within 6 months interval (median: 1.14 months; range: 0.03 - 5.7 months), no significant difference was found in the overall sensitivity of both imaging modalities, however 68Ga-DOTATATE PET/CT was found to be more sensitive in detection of bone lesions compared to 18F-FDG PET/CT (P=0.005). Both 18F-FDG PET/CT and 68Ga-DOTATATE PET/CT are efficient imaging modalities in detection of recurrent or metastatic disease in MTC patients. Gallium-68-DOTATATE PET/CT could be more beneficial in detection of bone metastases with respect to 18F-FDG PET/CT.

Aerosol jet printing of biological inks by ultrasonic delivery

Printing is a promising method to reduce the cost of fabricating biomedical devices. While there have been significant advancements in direct-write printing techniques, non-contact printing of biological reagents has been almost exclusively limited to inkjet printing. Motivated by this lacuna, this work investigated aerosol jet printing (AJP) of biological reagents onto a nonfouling polymer brush to fabricate in vitro diagnostic (IVD) assays. The ultrasonication ink delivery process, which had previously been reported to damage DNA molecules, caused no degradation of printed proteins, allowing printing of a streptavidin-biotin binding assay with sub-nanogram ml−1 analytical sensitivity. Furthermore, a carcinoembryogenic antigen IVD was printed and found to have sensitivities in the clinically relevant range (limit of detection of approximately 0.5 ng ml−1 and a dynamic range of approximately three orders of magnitude). Finally, the multi-material printing capabilities of the aerosol jet printer were demonstrated by printing silver nanowires and streptavidin as interconnected patterns in the same print job without removal of the substrate from the printer, which will facilitate the fabrication of mixed-material devices. As cost, versatility, and ink usage become more prominent factors in the development of IVDs, this work has shown that AJP should become a more widely considered technique for fabrication.

Is Presence Time of Dermoid Cysts a Risk Factor for Malignancy Potential in Advanced Age

Background: We have aimed to identify the markers for malignant transformation and also determine the differences between the reproductive age and postmenopausal mature cystic teratoma (MCT) patients. Methods: Between 2008 and 2015, totally 246 patients informations diagnosed as MCT have been examined retrospectively. Demographic characteristics of the patients, preoperative examinations, final pathology results have been evaluated. Results: It is included 246 patients with a total of 117 postmenopausal, 129 reproductive age in the study. When demographic characteristics, tumor markers and mass size were compared, only Carcino Embryogenic Antigen (CEA) values were found to be statistically significantly higher in postmenopausal patients. Malignancy was detected in 5 patients (2.03%), all of them were in the postmenopausal period, also CA125 and CA15-3 were determined statistically high in malignant patients. Conclusions: We think that CA125 can be use as marker for MT in MCT as well as on epithelial ovarian tumors. The duration of mass inside the abdomen without being operated can be a risk factor for malignant transformation. Because of this reason even if it is asymptomatic, after MCT diagnose we think that it will be good to operate the patients without losing time for prevention of malignant transformation.

Medullary thyroid carcinoma with double negative calcitonin and CEA: a case report and update of literature review

BackgroundMedullary thyroid carcinoma is a malignant uncommon and aggressive tumour of the parafollicular C cells. In about 75% of cases it is sporadic while, in case of RET mutation, it is associated to multiple endocrine neoplasia type 2 (25% of cases). The biochemical features of medullary thyroid carcinoma include the production of calcitonin and carcinoembryogenic antigen. The above-mentioned features are useful in the diagnostic process as well as in the follow up and in the prognostication of the disease. Even if calcitonin elevation is strongly associated to MTC, it can also be found increased in many pathological different conditions as pregnancy, lactation, C-cells hyperplasia, autoimmune thyroiditis, end stage renal disease, lung and prostate cancer and several neuroendocrine tumours. Major medullary thyroid tumours are usually connected to high doses of circulating calcitonin, in fact non-secretory variants have hardly been described.Case presentationWe herein report the case of a 59 years old male, who had undergone total thyroidectomy for multinodular goiter with negative preoperative calcitonin, showing medullary thyroid carcinoma at definitive pathology. To the best of our knowledge, this is the first case documenting a non-secretory medullary thyroid carcinoma, with double negative markers at the time of diagnosis and at the relapse.ConclusionA Literature review underlining pathological hypothesis, differential diagnosis and alternative and innovative biomarkers to identify non-secretory medullary thyroid carcinoma was carried out.

Calcitonin negative Medullary Thyroid Carcinoma: a challenging diagnosis or a medical dilemma?

BackgroundMedullary thyroid carcinoma is a neuroendocrine tumor belonging form a malignant growth of the thyroid parafollicular C-cells, representing from 1 to 10% of all thyroid cancer. The biochemical activity of medullary thyroid carcinoma includes the production of calcitonin and carcinoembryogenic antigen, which are sensitive tumor markers, facilitating the diagnosis, follow-up and prognostication. The diagnosis is reached through the identification of high basal calcitonin serum level or after pentagastrin stimulation test. Medullary thyroid carcinoma is able to produce other relevant biomarkers as procalcitonin, carcinoembryionic antigen and chromogranin A. In Literature are described few cases of medullary thyroid carcinoma without elevation of serum calcitonin, an extremely rare event. The aim of this study was to analyse the presentation, the main features and therapeutic management of medullary thyroid carcinoma associated with negative serum calcitonin levels.MethodsUsing the PubMed database, a systematic review of the current Literature was carried out, up to February 2018. Finally, nineteen articles met our inclusion criteria and were selected according to the modified Newcastle-Ottawa scale.ResultsFourty-nine patients with definitive pathology confirming medullary thyroid carcinoma and with calcitonin serum level in the normal range were identified (24 female, 24 male and not reported gender in 1 case). Mean age was 51.7 years. Serum calcitonin levels were reported for 20 patients with a mean value of 8.66 pg/mL and a range of 0.8–38 pg/mL. Despite the low or undetectable calcitonin serum level, at immunochemistry in almost the half of the cases reported by the Authors, the tumors presented diffuse or focal positivity for calcitonin and carcinoembryionic antigen, while was reported a chromogranin A positivity in 41 of the 43 tested patients.ConclusionsCalcitonin negative medullary thyroid carcinoma is an extremely rare pathology. The diagnosis and the surveillance is often challenging and delayed, due to the lack of elevation of serum markers as calcitonin and carcinoembryionic antigen. Further studies are needed, to better define options for management of non secretory medullary thyroid carcinoma and to identify new and reliable biomarkers associated to diagnosis and relapse of this medical dilemma.

Abstract 1269: Preventive potentials of the fruits of Detarium microcarpum on N-methyl nitrosourea (MNU) induced colon carcinogenesis in rats

Abstract Detaruim microcarpum Guill. &amp; Perr is a leguminous African plant with significant nutritional and medicinal uses. In an experimental N-methyl nitroso urea (MNU) induced colon carcinogenesis in rats, various concentrations of pulverized D. microcarpum fruits were included in diets of rats and the chemopreventive effects of these supplemented diets were investigated. The rats were divided into 10 groups (n=7) and fed for 10 weeks with diets containing 2.5%, 5.0% and 10.0% D. microcarpum. Subsequently, the feeding continues for another 12 weeks but with concomitant intra-rectal administration of MNU at every 72 hour interval. Respective control groups fed similar concentrations of supplemented diets, normal diet with or without MNU intoxication were also included. All rats were sacrificed at the end of the 22 weeks experiment; blood collected for hematological analysis and serum was separated for carcinoembryogenic antigen (CEA) assay and other biochemical tests. Liver, kidney and colon were also collected for antioxidant and tissue peroxidation assays. Sections of the colon were subjected to histopathological studies and immunohistochemical (IHC) staining using mutL homolog 1 (MLH1) antibody. A significant (p&amp;lt;0.05) elevation was observed in levels of CEA (210 ± 18 pg/ml) in the MNU positive control group when compared with the test groups and the negative control group (70 ± 6 to 140 ±11 pg/ml). There were significant decreases (p&amp;lt;0.05) in the major hematological parameters (PCV, hemoglobin, WBC etc) levels, catalase and superoxide dismutase (SOD) activities in the MNU control group when compared to other groups. A concomitant significant increases (p&amp;lt;0.05) was also observed in the levels of liver function enzymes and kidney function biomarkers as well as thiobarbituric reactive substance (maliondealdehyde) in the MNU control group when compared to the test groups and other controls . It was further observed that these variations in the CEA and antioxidant status markers were dose dependent in many instances. Histopathological and IHC staining of the colons in the treated groups showed mild changes in tissues with no expression of the MLH1 antibody when compared with the MNU control group having moderate damage and expression of the antibody. Hence it was concluded that the inclusion of fruits of D. microcarpum in the diet protected the organs and tissues of the rats from induced MNU toxicity; ameliorated oxidative stress in colon carcinogenesis model and possibly prevented the initiation of the process of carcinogenesis implying that the fruits possess significant health benefits which may have warranted their usage in foods and also in traditional medicine in Africa. Citation Format: Mubarak L. Liman, Sunday E. Atawodi. Preventive potentials of the fruits of Detarium microcarpum on N-methyl nitrosourea (MNU) induced colon carcinogenesis in rats [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 1269. doi:10.1158/1538-7445.AM2017-1269

Fecal occult blood test/fecal carcinoembriogenic antigen dual rapid test as a useful tool for colorectal cancer screening

Background There are several screening tools for colorectal cancer (CRC). Most are limited in their application. The fecal occult blood test (FOBT) is a first-step screen for CRC that is limited by low sensitivity. This study aimed to prove the efficacy of combined FOBT and fecal carcinoembryogenic antigen (fCEA) as a CRC screening test.