No abstract

Since the possibility of malignancy is high in equivocal lesions, such lesions were considered malignant for calculating the various test characteristics in this study. The age of patients ranged from 16 to 67 years (mean 41.2 years). A summary of results as compared to histology is given in Table 2. Table-3. It is evident that when used alone, FNAC had highest sensitivity, specificity and positive predictive value, zero false positive rate and minimal false negative rate. PE had a reasonable sensitivity, though lowest specificity and highest false positive rate. The combination of all four investigative modalities showed 100% sensitivity and Negative predictive value and zero false negative rate; however there was sharp decline in specificity, positive predictive value and accuracy rate, in addition, it had resulted in high false positive rate (71.4%). There was no equivocal result on FNAC in this study. The results indicate that FNAC alone was able to give a definitive diagnosis in most of cases where the mass was easily felt and well defined. It was unable to give a correct diagnosis in one lesion (False negative rate-2.4%) due to small size of lesion. Summary of various test characteristics is shown in

We found that majority of patients enjoy a good and non-capacitating QoL. Factors that may contribute to poorer health perceptions and QoL include experiencing a menopausal transition as part of therapy, and feeling more vulnerable after cancer. Overall QoL was better in the older and illiterate patients. Patients with no co morbidity and early stage disease fared better against patients with co morbidities and advanced stage of malignancy. The parameters used in QoL studies in west may not be directly applicable to Indian patients but it does give us a start. We need to adapt to these parameters and draw our conclusion. But there are many methodological challenges inherent in working with our population. Researchers interested in studying our clientele's QoL need to be cognizant of certain issues to ensure high quality results.

Five percent of patients with liver secondaries from colorectal carcinoma are potentially resectable and several studies have demonstrated significantly improved survival following resection. Two hundred and ten patients operated for colorectal carcinoma were followed up. Computed tomography confirmed potentially resectable metastasis to the liver in 38. On exploration 18 patients who had 4 or less hepatic metastases and no extrahepatic disease, underwent resection of their secondaries. Fourteen were males and 4 females with a mean age of 43.5 (SD 13.6, range 18-72) years. Ten patients presented with synchronous liver metastasis and 8 had metachronous disease. There was no post-operative mortality. All 18 have been followed up. for a median period of 23.5 (range 12-38) months. Seven patients are alive and well with no evidence of recurrence at a median period of 28 months (survival 39%). Four are alive with local recurrence in the liver. Median time to recurrence was 22 months. Seven patients have died of disseminated disease. The disease free survival at 28 months is 39% and the overall survival 61%. A close follow-up protocol for all patient undergoing curative surgery for colorectal cancer is essential, if such patients are to be selected early.

Carcinoembryonic antigen (CEA) and alpha fetoprotein levels (AFP) were assayed by enzyme-labelled immunoassay in 75 cases of gastrointestinal (GI) and primary hepatic malignancies. Mean CEA levels were found to be significantly higher (p<0.005) in metastatic non-operative group of GI malignancies (range 5.32 nglmL to 175.2 nglmL) as compared to early pre-operative cases (range 1.25 nglmL to 33.2 nglmL) and post-operative cases (range 1.41 nglm L to 22.24 nglmL). Varia ble levels of AFP were visualised in 12 cases of primary hepatic malignancies with eight cases having values less than 100 nglmL. When both CEA and AFP were assayed simultaneously, the markers were helpful in differentiating cases of primary hepatic malignancies with low levels of CEA from 3 cases of secondaries in the liver where CEA levels were found to be highly raised (80.4 nglmL to 146.4 nglmL). To evaluate the variation of CEA and AFP levels in different patients having same stage of the disease, immunological monitoring for the functions of T and B cells was carried out by estimation of cytoklne, i.e. interleukin-l alpha (lL-Ia), interleukin-2R (I1-2R) and various immunoglobulins. IL-Ia and 1L-2R levels were significantly higher (p<0.05) in the groups of patients having higher CEA and AFP. This indicates an important T cell (THI and TH2) function in the tumour antigen production. MJAFII997;