The purpose of this study was to reevaluate the significance of serum PHI in gastrointestinal cancer at histopathologically defined stages prior to primary treatment. A total of 248 patients with malignant tumors of the gastrointestinal tract and a collective of 42 patients with noncancerous diseases were studied. The results are compared with those obtained with the established markers tissue polypeptide antigen (TPA) and carcinoembryonic antigen (CEA). Phosphohexose isomerase (PHI) revealed an overall diagnostic sensitivity of 69%, combined with a specificity of 74%. The corresponding data for TPA were found to be 73 and 47% while for CEA 26 and 95% respectively were determined. Even in the early stages of colorectal and esophageal carcinoma, PHI showed a sensitivity of about 60%. A continuous rise of PHI serum levels, correlating well with the extent of the tumor disease, could be detected. In contrast to TPA and CEA, PHI assay can be carried out with a minimum of laboratory efforts, in a short time and at low costs. These findings suggest that serum PHI assay is a useful aid for screening of gastrointestinal cancer, especially esophageal and gastric carcinoma, and a reliable marker for treatment control and follow-up.

A sandwich enzyme immunoassay was developed to detect circulating immune complexes containing carcinoembryonic antigen (CEA) and immunoglobulin (Ig) G, IgA, or IgM using a nitrocellulose-bound anti-CEA antibody as the solid phase reagent. Elevated levels of CEA-containing circulating immune complexes (CEA-IC) were found in 15.4% of 117 sera from patients with colorectal cancer in a postsurgery follow-up study. Also in 24.5% of 102 sera from patients with breast cancer in different states of disease CEA-IC were found. The predominant Ig determined in CEA-IC of colorectal cancer patients was IgA, followed by IgG and IgM, whereas IgG and IgM were the most frequent Igs in CEA-IC of breast cancer patients. Elevated CEA levels were found in 12.0% of the colorectal cancer patients and in 25.4% of sera from breast cancer patients. No significance for the coincidence of elevated CEA levels and CEA-IC was recorded in all patients sera tested. In sera of patients with disease recurrence, however, both parameters were shown to be elevated (CEA 80.7% and CEA-IC 42.3%). The data presented indicate the detection of CEA-IC as an additional parameter for the identification of patients at increased risk for disease recurrence.

Die Aortographie ist die wichtigste Untersuchungsmethode und Voraussetzung für die chirurgische Indikation bei arteriellen Verschlußerkrankungen. Das Risiko der Aortographie ist genau bekannt [13, 25]. Drei von 1000 Untersuchungen verlaufen fatal. In etwa 1% muß mit schweren Komplikationen gerechnet werden [25]. Die außerordentlich ernste Prognose der arteriellen Durchblutungsstörungen läßt dieses Risiko aber gering erscheinen [14]. Die Toxizität der Kontrastmittel konnte-durch die Entwicklung trijodierter Benzoesäure-Derivate-erheblich vermindert werden. Dadurch wurde die Injektion auch großer Kontrastmittelmengen und die Wiederholung solcher Injektionen in die Aorta möglich [29]. Große Untersuchungsreihen verliefen ohne Zwischenfall [24]. Eine genaue Analyse der mitgeteilten schwerwiegenden Komplikationen, das sind vor allem die Anurie und Paraplegie, zeigt, daß fast die Hälfte dieser Zwischenfälle nach extrem hohen oder wiederholten Kontrastmittelinjektionen auftraten [2, 18, 25]. Um diese Frage weiter zu klären, haben wir experimentell die Auswirkung von wiederholten Kontrastmittelinjektionen in die Aorta, speziell im Hinblick auf die Nierendurchblutung, geprüft. Material und Methodik Als Versuchstiere dienten 12 Bastardhunde mit einem Gewicht von 18 bis 38 kg. In Trapanal-Intubationsnarkose wurden die Tiere in Rückenlage laparotomiert. Die Kontrastmittelinjektion erfolgte ca. 3 cm unterhalb des Abganges der linken A. renalis in die