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Polycystic Ovary Syndrome, Endometriosis, and Female Infertility
Published in Michelle Tollefson, Nancy Eriksen, Neha Pathak, Improving Women's Health Across the Lifespan, 2021
Mahima Gulati, Joy Brotherton, Jill Chasse
Ultrasound and magnetic resonance imaging can be used to diagnose endometriomas (ovarian cysts filled with endometriotic fluid) or rectovaginal endometriotic nodules; however, peritoneal endometriotic implants cannot be seen on imaging. While tumor markers such as CA-125 and other serum markers of inflammation may be elevated, they are nonspecific. Traditionally, endometriosis has been diagnosed surgically, preferably via laparoscopy with histologic confirmation obtained through biopsy. However, in more recent years, there has been a push to endorse clinical diagnosis based on symptomatology. Aggressive early diagnosis and medical management aim to limit the number of surgeries a woman with endometriosis will have in her lifetime.41,42
Ovarian, Fallopian Tube, and Primary Peritoneal Cancer
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Robert D. Morgan, Andrew R. Clamp, Gordon C. Jayson
Mucinous ovarian carcinoma accounts for ~3% of all epithelial ovarian tumours.32 These tumors are composed of gastrointestinal-type cells containing intra-cytoplasmic mucin. They often present in relatively younger women between the ages of 40 and 50 years, with early-stage disease detected as a large (frequently >10 cm) unilateral solid/cystic mass arising from the pelvis. Tumor markers such as CEA and CA 19-9 may be elevated. Histological examination may reveal a precursor/borderline lesion, suggestive of transformation from benign to malignant tissue. IHC expression of CK7 and an absence of CK20 expression, in the context of an atypical/borderline proliferative tumor, provide supportive evidence of a primary mucinous ovarian adenocarcinoma versus metastasis to the ovary from a primary gastrointestinal cancer. Mutations in mucinous tumors include KRAS, BRAF, CDKN2A, and TP53 as well as amplifications in MYC and HER2.33
Preoperative radiological assessment
Published in Steven J. Kronowitz, John R. Benson, Maurizio B. Nava, Oncoplastic and Reconstructive Management of the Breast, 2020
Imaging of the patient with newly diagnosed breast cancer aids clinical staging by firstly mapping disease extent in preparation for surgical planning and secondly screening of the contralateral breast for synchronous disease. The American Joint Committee on Cancer staging system for breast cancer (7th edition) provides a tumor-node-metastasis classification scheme used by clinicians to determine both prognosis and treatment.2 The role of biologic tumor markers has emerged as an additional tool beyond grade and stage to assist in the prognostic assessment and treatment strategy.3,4 Staging information helps determine surgical planning, the role and timing of chemotherapy or hormonal therapy, and the scope of radiation therapy. Under this classification scheme, as the size of the tumor and regional lymph node metastases increase, there is a general increase in cancer stage, conferring a poorer prognosis and diminished survival rate.
Preoperative prognostic value of alfa-fetoprotein density in patients with hepatocellular carcinoma undergoing radiofrequency ablation
Published in International Journal of Hyperthermia, 2022
Bo-Wen Zhuang, Wei Li, Bin Qiao, Nan Zhang, Man-Xia Lin, Wei Wang, Ming Kuang, Ming-De Lu, Xiao-Yan Xie, Xiao-Hua Xie
Serum tumor markers, such as prostate-specific antigen (PSA), carcinoembryonic antigen (CEA), and alfa-fetoprotein (AFP), are well-established prognostic biomarkers of increased tumor virulence in prostate cancer, colorectal cancer, and HCC, respectively. They have been shown to be predictive factors of worse tumor phenotype and worse prognosis [9–13]. Moreover, tumor size and tumor number have been proposed as predictors of oncological outcome in various tumors [14,15]. Recently, tumor biomarker density has been described to improve the predictive ability by minimizing the confounders of tumor size and number of lesions [16–18]. For example, PSA density has been shown to be superior to PSA and the Gleason score in predicting poorer prognosis in prostate cancer patients undergoing radical prostatectomy [16]. As shown by Huo et al., CEA density is an independent predictor of overall survival (OS) during percutaneous ablation of pulmonary metastases from colorectal cancer [18]. However, the role of AFP density as a predictor of tumor prognosis in HCC patients undergoing RFA has not been identified.
Effect of neoadjuvant treatment combined with radical gastrectomy on postoperative complications and prognosis of gastric cancer patients
Published in Scandinavian Journal of Gastroenterology, 2021
Yang Zhou, Zhen Tian, Jing Zeng, Wei Zhou, Keyan Wu, Weigan Shen
The patients were followed up by outpatient and telephone. The date of each patient’s surgery was used as the starting point of the observation, and the date of death or the last follow-up was used as the end of follow-up. The OS of patients was defined as the time from the date of surgery to the death of the patient due to any cause. The cut-off time for follow-up was January 31, 2020. The patients were followed up every 1–3 months for the first 3 years, every 6 months for the next 2 years, and then once every year thereafter. The main content of the follow-up included the assessment of tumour markers, including carcinoembryonic antigen (CEA), alpha-fetoprotein (AFP), carbohydrate antigen 19-9 (CA199), CA125, and CA724. B-ultrasound examinations were performed every 3 months after gastrectomy, and CT or MRI examinations were performed every 6 months. There was no patient lost to follow-up in this study.
Reference change value and measurement uncertainty in the evaluation of tumor markers
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2021
Hatice Bozkurt Yavuz, Mehmet Akif Bildirici, Hüseyin Yaman, Süleyman Caner Karahan, Yüksel Aliyazıcıoğlu, Asım Örem
Tumor markers are widely used and they are preferred for diagnosis and follow-up of the wide range of cancers. Alpha fetoprotein (AFP) is considered diagnostic for hepatocellular carcinoma, non-seminomatous testicular carcinoma [14]. Cancer antigen 15-3 (CA 15-3) antigen levels are increased in many patients with epithelial breast carcinoma. High CA 15-3 antigen levels can also be found in patients with lung, ovarian, pancreas, and colorectal cancer, as well as in non-malignant conditions, such as benign breast and liver disease, cirrhosis, and hepatitis [15]. Cancer antigen 125 (CA 125) may be present in increased concentrations in some ovarian malignancies [16]. Cancer antigen 19-9 (CA 19-9) antigen is elevated in patients with colorectal, pancreatic, gallbladder, hepatocellular, stomach, and esophageal cancers. Non-cancerous conditions that may increase CA 19-9 antigen levels include cirrhosis, cholangitis, hepatitis, pancreatitis, and non-malignant gastrointestinal diseases [17]. Measuring serum Carcino Embriyonic Antigen (CEA) level has been shown to have important benefits in terms of prognosis and follow-up of patients with malignant diseases, especially colorectal cancer [18].