E. V. Mackay

Carcinoembryonic antigen in cancer of the female reproductive system: sequential levels and effects of treatment.

Summary: Carcinoembryonic antigen (CEA) in serum was studied serially in 27 patients with cancer of the female reproductive system and 7 patients with other cancers, particularly of the colon or rectum, after surgical excision, irradiation, or no treatment. CEA became undetectable 2 weeks after complete surgical excision of cancer, whereas persistence of elevated levels of CEA indicated residual cancer. However, there was no decline in levels of CEA after radical radiotherapy of cervical carcinoma over a 10‐week period of study, suggesting continuous release of CEA from tumour tissues undergoing radiation‐induced necrosis. Sequential levels of CEA in serum represent a good index of effectiveness of surgical excision of cancer and should thus be of great value in post‐operative follow‐up.

Seminal plasma biochemistry I. Preliminary report: A possible mechanism for the liquefaction of human seminal plasma and its relationship to spermatozoal motility

Biochemie des Samen‐Plasmas I Vorläufige Mitteilung: Ein möglicher Mechanismus bei der Verflüssigung des humanen Samen‐Plasmas und seine Beziehung zur Spermatozoen‐Beweglichkeit

Predictive value of serial carcinoembryonic antigen levels in long-term follow-up of ovarian cancer

The predictive value of serial levels of carcinoembryonic antigen (CEA) in tumor monitoring was examined in 213 patients with ovarian cancer; each patient had been followed‐up at monthly intervals for at least 12 months. CEA was not detectable throughout the period of observation in 35% of the patients. In general, patterns showing a disappearance of CEA or persistently low levels were associated with a good prognosis, whereas those showing a reappearance or highly elevated and rising levels were associated with a poor prognosis. A transient reappearance of CEA was observed in 10 patients; this did not appear to be associated with tumor recurrence or progression. “False positive” results were obtained in 6 patients in whom no tumor has been clinically detectable to date. “False negative” results were obtained in 4 patients with obvious tumor progression. In terms of a good or poor prognosis, the use of CEA levels was highly accurate in patients with minimal or no residual disease (97% and 89%, respectively); the rate fell to 62% in patients with extensive disease. As the clinical significance and limitations become better known, serial CEA levels should contribute substantially to the monitoring of patients with ovarian cancer.

Contraception with a Six‐Monthly Injection of Progestogen: Part 1. Effects on Blood Pressure, Body Weight and Uterine Bleeding Pattern, Side‐Effects, Efficacy, and Acceptability

: A clinical study of the use of medroxyprogesterone acetate as a method of contraception, administered as 6‐monthly intramuscular injections of 300 mg., was carried out in 61 women. A total of 989 months of study were completed and 14 women received 4 injections or more.

Cigarette smoking by pregnant women with particular reference to their past and subsequent breast feeding behaviour.

Summary: 1,790 postpartum women were asked about their smoking habits and baby feeding practices and about a number of other attitudes and physical attributes. For those variables not concerned with baby feeding, our findings generally support previous research; for example, smokers in comparison to non‐smokers tended to have more emotional problems, more reproductive failures and babies with lower birth‐weights. For baby feeding, we found that smokers tended to (i) have little prior knowledge of breast feeding, (ii) favour bottle feeding, (iii) have been fed by bottle by their mothers, and (iv) wean earlier than non‐smokers or ex‐smokers. In fact, non‐smokers as a group were similar to breast feeders as a group, and smokers like bottle feeders for over 20 characteristics. These similarities were mostly the result of features of smoking and baby feeding behaviour being found in a common personality type; for example, use of tobacco and choice of bottle feeding are probably attributes of nervous, insecure mothers. But some similarities were the result of the influence of tobacco smoke; for example smokers who do breast feed wean earlier, probably because chemicals in tobacco smoke inhibit milk production.

Predictive value of serial CA 125 antigen levels in ovarian cancer evaluated by second-look laparotomy

Serial serum CA 125 levels were measured before definitive surgery and during chemotherapy for 12 months or more in 64 patients with ovarian cancer. In the 42 patients who had a complete clinical remission and thus were subjected to a second-look laparotomy, an absence of disease was not predicted by patterns of CA 125 levels. Whilst rising or persistently high levels indicated the presence of tumour in 92% of patients, declining levels to negative predicted the absence of tumour in only 50%. Although the majority of these patients showed microscopic foci or a tumour mass less than 1 cm, 3 patients had a larger amount of disease. In the follow-up of 49 patients, the accuracy of prediction of a good outcome was better than that of a poor outcome on the basis of CA 125 patterns, with rates of 92% and 79%, respectively. Our findings indicate that CA 125 lacks sensitivity in detecting small tumour masses (less than 1 cm dia.) but rising or persistently high levels suggest a strong likelihood of a residual tumour to be found at a second-look laparotomy.

A multiparametric approach to tumor markers detectable in serum in patients with carcinoma of the ovary or uterine cervix

Abstract A comparison of several serum tumor markers (lactate dehydrogenase (LDH), sialyltransferase (ST), carcinoembryonic antigen (CEA), β 2 microglobulin ( β 2 M), γ-chain fetal hemoglobulin (HbF), immune complexes (ImCp), and spermine (Spm)) was made in patients with carcinoma of the ovary or cervix uteri and healthy control subjects. The greatest positive results were obtained with the markers LDH (40%) and β 2 M (46%) for patients with carcinoma of the cervix and ovary, respectively. However, based on false positive results, the most suitable single marker for patients with carcinoma of the cervix was Spm (30%). When a multiparametric approach was taken, a combination of four of the seven markers resulted in an increase in the positive results, that is, the cancer patients were positive for one of the four markers. This was 76% for patients with carcinoma of the cervix using the markers LDH, ST, Spm, and β 2 M and 79% for patients with carcinoma of the ovary using the markers ST, CEA, HbF, and β 2 M. All markers in both groups of cancer patients were elevated above control levels with the exception of ST which was decreased in patients with carcinoma of the ovary. ST, CEA, and HbF were found to be associated by multilinear regression analysis in the ovarian cancer group. As the ST approached normal levels CEA and HbF became elevated. Similarly there was a linear relationship between β 2 M and ImCp demonstrating positively at similar times.

Bivariate Analyses Of Attitudes Towards Breast‐Feeding

1,790 postpartum women were asked about their breast‐feeding attitude, physical and other attitudinal variables. Bivariate analyses were conducted between attitude and each of 38 other variables. Of the causally independent variables, education and occupation were the most strongly related to attitude, and along with doctors preference were perhaps the most important influences on a mothers baby‐feeding attitude. No physical or health measure was strongly related to attitude towards breast‐feeding, although there were consistent associations between favourable attitudes and optimal categories of the physical and health variables. A hypothesized model of the influences on breast‐feeding attitude and behaviour is presented.

Carcinoembryonic antigen in cancer of the female reproductive system: its detection in serum by a microradioimmunoassay.

Summary: Carcinoembryonic antigen (CEA) is demonstrable in whole serum of patients with cancers of the female reproductive system. Positive results, taken arbitrarily as levels of CEA exceeding 5 ng./ml., were obtained in 60% of such patients; the highest incidence of positive results was present in patients with ovarian and breast cancer (73% and 70%). By comparison, none of 73 patients with benign gynaecological conditions such as cervicitis and dysfunctional uterine bleeding, and only 4% of unselected blood donors, had a positive result. The incidence of high levels of CEA (values of 10 ng./ml. or more) was lower in patients with cancer of the reproductive system (56 of 171) than in those with cancer of the digestive system (96 of 138). There was no difference in incidence of positive results for patients with adenocarcinoma and with squamous cell carcinoma of the female genital organs. In general, a higher incidence of positive results and higher levels of CEA were present in patients with extensive or meta‐static disease, but positive results were found even in those with pre‐invasive lesions (carcinoma in situ and severe dysplasia).

Immune Complexes in Ovarian Cancer: Association between IgM Class Complexes and Antinuclear Autoantibodies in Ascitic Fluid

Samples of ascitic fluid from patients with ovarian cancer were analyzed for autoantibodies to nuclear and cytoplasmic antigens and for immune complexes (ICs) detectable by the Clq deviation and polyethylene glycol (PEG) precipitation (either IgG or IgM class) assays. The predominant autoantibody was antinuclear (ANA); this was detected in 29 of 58 samples (59% showing the homogeneous and 41% the speckled pattern). The antibody was not reactive to saline extractable nuclear antigens. A strong association between this autoantibody and the PEG-precipitated IgM class ICs was shown, suggesting the possible participation of this autoantibody in IgM class ICs formation. The lack of association between C1q-reactive and IgG class ICs and the autoantibodies indicates that the IgG class ICs may be more related to the tumor.