The usefulness and specificity of the main tumor markers (carcinoembryonic antigen, CEA; gastrointestinal cancer-associated antigen, GICA; tissue polypeptide antigen, TPA; fibrinopeptide A, FpA; gamma-glutamyltransferase, gamma-GT) have been investigated in the diagnosis and follow-up of the circumscribed and disseminated gastric cancers (GCs). The comprehensive evaluation of all of these markers has given the most reliable results. For the diagnosis and follow-up of GCs, the present study has shown that the sensitivity and specificity of the above markers have the following decreasing order: FpA, TPA, GICA, CEA, gamma-GT. However gamma-GT has proved to be a reliable index of the presence of hepatic metastases.
Lumbar bone mass (LBM) determination by quantitative computerized tomography in pre-, peri- and postmenopausal women was utilized to identify subjects at risk to develop osteoporosis. The results were related to determinations of bone metabolic markers (serum osteocalcin and urinary calcium excretion). Osteocalcin was the only metabolic marker which underwent significative changes. However, we found very poor correlations between LBM and metabolic markers and it is concluded that bone mass determination remains the method of choice to select women for preventive therapy.
Endometrial thickness was evaluated in apparently normal postmenopausal women by transvaginal ultrasonography and the results were compared with the response to the progesterone challenge test (PCT). A positive correlation between amount of withdrawal bleeding after PCT and endometrial thickness was found, also demonstrated by the significative correlation between bleeding length and endometrial thickness. Among women referring withdrawal bleeding, 100 and 22 % of cases classified as overt flow and spotting, respectively, were characterized by pathologic histological findings. The combined use of these two procedures is suggested as an effective screening mean in the preventive endometrial management of apparently normal postmenopausal women to select candidates for diagnostic invasive procedures.
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