No abstract

Colorectal cancer (CRC) can be cured in most cases if diagnosed at an early stage. Carcinoembryonic antigen (CEA) remains the most widely used cancer marker for determining prognosis of CRC. Previous studies have shown that plasmatic tumor M2 pyruvate kinase (Tu M2-PK) is highly sensitive in CRC detection at an early stage and equally as good as the results for established tumor markers with clinical potential for cancer prognosis and monitoring. The aim of this study was to assess the prognostic value of Tu M2-PK in plasma using a survival analysis in combination with CEA in serum in patients newly diagnosed with CRC. The initial study included 183 patients who had a complete diagnostic colonoscopy. This cohort study was designed to evaluate the survival in patients with histologically confirmed gastrointestinal cancers (n = 41). Tu M2-PK concentrations in EDTA plasma were determined immunologically using an ELISA assay. Plasma Tu M2-PK levels were significantly higher in patients with distant metastases, stage IV for TNM score, and advanced stage (C+D) subgroups of Dukes than other subgroups. The univariate Cox's analysis showed that CEA and Tu M2-PK gave high hazard ratios for risk of death (odds ratio CEA = 3.57 and odds ratioTu M2-PK = 2.23) and comparable values in average survival time. The results for both biomarkers did not overlap. These findings suggest that plasmatic Tu M2-PK levels of more than 20 U/mL may be a predictor of death risk.

INFLUENCIA DEL RETRASO EN EL PROCESAMIENTO PREANALÍTICO DE LA ORINA EN LA DETERMINACIÓN DEL NMP22 Objetivo: Evaluar la influencia del retraso en el procesamiento preanalítico de orinas en las que se realiza la determinación del marcador tumoral NMP22. Material y métodos: Se recogieron 28 muestras de orina: tumores vesicales (14), infecciones urinarias (4), litiasis (4), voluntarios sanos (1), y otras patologías vesicales benignas (5). De cada muestra, mantenida a temperatura ambiente, se fueron estabilizando alícuotas con el conservante suministrado por el fabricante a los 0, 30, 90 y 150 minutos, guardándose a 4ºC hasta su procesamiento. El análisis del NMP22 se realizó en autoanalizador IMMULITE One. Resultados: No se apreciaron diferencias significativas en los niveles del NMP22 entre los diferentes puntos de demora estudiados. Conclusiones: La demora de hasta dos horas y media en la adición de la solución conservante a la orina para determinación de NMP22 no afecta significativamente a los resultados obtenidos. Este hecho permite una mayor confianza y flexibilidad en los inmunoensayos cuantitativos que requieren estabilización de la muestra.

No abstract

We evaluated serum levels of soluble fragments of cytokeratin 19 (CYFRA 21-1) by immunoassay (ES-700; Roche Diagnostics, Mannheim, Germany) to assess its usefulness in the diagnosis and follow-up of bladder cancer. The study included 39 patients with a diagnosis of transitional cell carcinoma (group 1) and 190 patients (group 2) with no evidence of tumor. In group 2, 180 patients had a history of bladder cancer, and 10 had benign prostatic hyperplasia. Significant differences in CYFRA 21-1 concentrations between groups 1 and 2 (P<0.01) were noted. However, CYFRA 21-1 levels did not significantly differ between the patients with benign prostatic hyperplasia and those with bladder cancer (P=0.274). CYFRA 21-1 values were higher in invasive bladder cancer compared to that detected in superficial stages (P=0.011). Setting the optimal cutoff value at 2.5 ng/mL resulted in a sensitivity of 43.6% and a specificity of 82.1%. No statistical differences were found when we compared disease-free time among the 66 patients with recurrences (30.7 months with levels <2.5 ng/mL vs. 41.2 months with levels >2.5 ng/mL; P=0.248). The risk of recurrence in patients with levels lower than 2.5 ng/mL (0.79) was no different (P=0.097) from that found in patients with higher levels (1.69). CYFRA 21-1 serum levels do not provide enough sensitivity to justify its application in routine protocols for the detection and follow-up of bladder cancer.