Post-treatment alterations of serum cancer antigen 125, cancer antigen 19.9 and carcinoembryonic antigen levels in patients with gynecological malignancies in a tertiary care hospital in eastern India.

Gynecological carcinomas form a significant proportion of all malignancies in women across the globe. These are associated with an increase in the serum concentrations of certain tumor markers such as cancer antigen (CA)125, CA19.9 and carcinoembryonic antigen (CEA) that correlate with the tumor burden. Methods: Pre- and post-treatment serum levels of CA125, CA19.9 and CEA were determined in 36 patients of ovarian carcinoma, 31 patients of cervical carcinoma and 20 patients of endometrial carcinoma using enzyme-linked immunosorbent assay. The pre- and the post-treatment levels of these markers have been compared and correlated. Results: With primary treatment, CA125 level was significantly reduced in ovarian, endometrial (ps < 0.001) and cervical (p = 0.001) carcinomas and that of CA19.9 was significantly decreased in cervical and endometrial carcinomas (ps < 0.001). Surprisingly, post-treatment CEA level was significantly increased in cervical carcinoma (p = 0.001) with significant increase after radiotherapy (p = 0.003), but not after surgery (p = 0.091). Treatment had no effects on CA19.9 level in ovarian carcinoma and on CEA levels in ovarian and endometrial carcinomas. Pre- and post-treatment levels of CA125, CA19.9 and CEA showed strong positive correlation in cervical carcinoma, while those of CA19.9 showed very strong positive correlation in endometrial carcinoma. Conclusions: Post-treatment serum CA125 level best reflects the treatment effect in all three types of gynecological carcinomas. CA19.9 is reliable to evaluate treatment effect in patients of cervical and endometrial carcinomas. Studies involving larger population size should be conducted to identify the changes in CEA while assessing treatment effect in cervical carcinoma patients.

Clinico-investigative assessment and comparison of cardiovascular risk factors in young and elderly patients of acute coronary syndrome.

Coronary artery disease in Indians occurs at an earlier age than most other populations. Risk profile and angiographic severity of young acute coronary syndrome (ACS) patients differ from those in the elderly. Methods: This cross-sectional study included 46 young (≤45 years) and 45 elderly (>45 years) ACS patients. Clinical features, risk factor profiles and coronary angiograms of these patients were studied and compared. Results: Compared with the elderly, more young patients had chest pain and ST-elevated myocardial infarction. Smoking, atherogenic dyslipidemia and abdominal obesity were most frequent in young, while hypertension, high low-density lipoprotein (LDL) cholesterol and abdominal obesity were most prevalent in elderly. High serum homocysteine was the most prevalent novel risk factor in either group. Serum Lp(a) was significantly higher in the young group compared to elderly (p = 0.03). Angiographically, multivessel coronary disease and high Gensini score were more common in elderly. Young group had a low positive correlation between serum triglyceride level and Gensini score (rs = 0.33, p = 0.03). In the elderly, fasting blood glucose and serum triglyceride levels had low positive correlation with Gensini score (rs = 0.36, p = 0.01 and rs = 0.32, p = 0.04 respectively). Conclusions: Cardiovascular risk factors differ in young and elderly ACS patients. Lifestyle changes and behavioral modifications should be emphasized to prevent the development of ACS in the young Indians.