Do serum CA 19-9 and CA 125 levels predict the severity of HCV-related liver fibrosis?

To study the value of measurement of serum tumor markers CA 19-9 and CA 125 as predictors of severity of liver fibrosis in patients with chronic hepatitis C. Fifty patients with chronic hepatitis C were recruited from the Hepatology and Gastroenterology Department at Ain Shams University Hospital. They were 31 men and 19 women, with ages ranging from 18 to 50 years. Participants were subjected to full clinical examination, liver function tests, viral markers [hepatitis B surface antigen, hepatitis C virus antibody], a fetoprotein, autoimmune markers, assay of serum levels of CA 19-9 and CA 125, abdominal ultrasonography, and ultrasound-guided liver biopsy. Histopathological examination for staging of liver fibrosis was performed using the Ishak scoring system. There was a highly significant positive correlation between serum levels of CA 19-9 and CA 125 and the stage of liver fibrosis [P<0.01]. There was also a difference in the mean values of serum CA 19-9 among different stages of liver fibrosis. Similar differences were seen for CA 125. The best cut-off value for CA 19-9 in predicting severe liver fibrosis and cirrhosis [stages 5, 6] was found to be 33.87 U/ml with sensitivity of 93.8% and specificity of 88.2%, whereas the best cut-off value for CA 125 in predicting severe liver fibrosis and cirrhosis [stages 5, 6] was found to be 25 U/ml with sensitivity of 93.8% and specificity of 82.4%. Combined elevation of CA 19-9 and CA 125 above the cut-off value showed less sensitivity [87.5%] than that of each of CA 19-9 [93.8%] and CA 125 [93.8%], and a better specificity [88.24%] than that of CA 19-9 [88.2%] and CA 125 [82.4%]. Serum CA 19-9 and CA 125 may be used as noninvasive markers of severe hepatitis C virus-related liver fibrosis. This needs to be validated by more studies

diagnostic value of faecal calprotectin in differentiating inflammatory bowel disease [IBD] from Irriable bowel syndrome [IBS]

Patients with inflammatory bowel disease and irritable bowel syndrome can have overlapping symptoms, yet a different management. Hence, a noninvasive biological marker is needed for the assessment of patients with lower bowel symptoms. This study aimed at evaluating the diagnostic value of faecal calprotectin as a potential marker in differentiating patients with inflammatory bowel disease from those with irritable bowel syndrome. Twenty patient with IBD and twenty patients with lBS were recruited from Am Shams hospital gastroenterology outpatient clinic in the period between January 2008 to November 2009, In addition, a control group of 10 healthy individuals was included. Faecal calprotectin level using an ELISA technique [Calprest [R] was measured in the stool of all groups. Also, atypical p-ANCA and ASCA were performed in the IBD group. At a cut off value of 8.1 mg/L, fecal calprotectin had a negative predictive value [NPV] of 100% to exclude lBS patients with a sensitivity of 100% and a positive predictive value [PPV] to confirm IBD of 95.24% with a specificity of 95%. The diagnostic accuracy of faecal caiprotectin in predicting IBD activity was 100% at a cut off value of 25.5 mg/L. Fecal calprotectin appears to be a clinically useful noninvasive marker in differentiating IBD from lBS