ABSTRACT
Objective:To investigate the expression of soluble T cell immunoglobulin and mucin domain-3 (Tim-3) in peripheral blood of patients with pancreatic cancer and its diagnostic value in combination with serum Carbohydrate antigen 19-9 (CA19-9) .Methods:106 newly diagnosed pancreatic cancer patients and 65 age and sex matched healthy individuals were enrolled. Tim-3 concentration was quantitatively determined by enzyme-linked immunosorbent assay (ELISA). According to the expression levels of soluble Tim-3 and serum CA19-9, a binary logistic regression model of receiver operating characteristic (ROC) curve was established to compare the diagnostic effects of serum CA19-9 and soluble Tim-3 alone or combined with the two tests.Results:The levels of soluble Tim-3 in the pancreatic cancer group were significantly higher than those in the healthy control group ( P<0.001). The expression level of soluble Tim-3 was significantly higher in patients with stage III-IV pancreatic cancer than in patients with stage I-II ( P=0.003). The AUC of soluble Tim-3 diagnosis for stage I-II pancreatic cancer was 0.856 (95%CI: 0.765 to 0.992 P<0.001), Serum CA19-9 The AUC used for the stage I-II pancreatic cancer diagnosis was 0.862 (95%CI: 0.772 to 0.926 P<0.001), The AUC for the combined diagnosis was 0.949 (95%CI: 0.880 - 0.985 P<0.001) ; In a healthy population and in patients with stage III-IV pancreatic cancer, the AUC of soluble T I I-IV pancreatic cancer in stage III was 0.927 (95%CI: 0.873 to 0.963 P<0.001), the AUC of serum CA19-9 used for the diagnosis of stage III-IV pancreatic cancer was 0.933 (95%CI: 0.881 to 0.968 P<0.001), the AUC for the combined diagnosis was 0.989 (95%CI: 0.956 to 0.999 P<0.001) . Conclusions:The combination of soluble Tim-3 and serum CA19-9 can improve the diagnostic rate of pancreatic cancer patients.
ABSTRACT
SUMMARY BACKGROUND: Serum tumor markers are molecules that are secreted by tumor cells and may be present in small amounts in the serum of healthy individuals. Their role as prognostic factors in lung cancer remains controversial. OBJECTIVE: To assess the prognostic role of CEA, CA 19-9, CA 15-3, and CA 125 in non-squamous non-small cell lung cancer. PATIENTS AND METHODS: A total of 112 patients with non-squamous non-small cell lung cancer from two Oncology Centers were retrospectively analyzed. Tumor marker levels were measured prior to treatment. Data regarding clinical characteristics and overall survival were collected. RESULTS: Median overall survival of all patients was 15.97 months. Pre-treatment elevations of CA 125 and CA 15-3 were associated with shorter overall survival (p=0.004 and p=0.014, respectively). Single CEA and CA 19-9 elevations were not associated with a worse prognosis. Patients with two or more elevated markers had a statistically significant decrease in overall survival (p=0.008). In the multivariate analysis, smoking status and number of positive tumor markers at diagnosis were independently associated with a worse prognosis. CONCLUSION: High pre-treatment levels of tumor markers were correlated with decreased survival in patients with non-squamous non-small cell lung cancer.
ABSTRACT
ABSTRACT Introduction: posterior urethral valves represent an important cause of childhood chronic kidney disease. The identification of biomarkers that indicate early kidney damage and even adequate clearance could reduce how many patients head towards kidney failure. Objective: this study evaluated how this easy-analysis biomarker (CA 19-9) could help identifying potential renal damage and adequate clearance in obstructive uropathies. Methods: 46 female Wistar rats were divided into 5 groups, with different patterns of partial urinary tract obstruction: group control; group OIV: infravesical obstruction; group OIVd: infravesical obstruction with reversion, obstruction relief 7 postoperative days later; group OUu: unilateral ureteral obstruction; group OUb: bilateral ureteral obstruction. The CA 19-9s performance was compared to another biomarker: Ngal. Determination of basal CA 19-9 and Ngal in urine and blood and serum creatinine levels was performed in the rats prior to surgery (T0) and after 14 days (T1). Group OIVd underwent intermediate (Ti) collection before clearance. Results: the urinary concentration of CA 19-9 increased in groups OIV, OIVd and OUb; elevation at T1 and Ti, reached statistical significance compared to the T0 value (p<0,05). Changes in urinary CA 19-9 were more expressive in infravesical obstruction groups (AUC 0.81). Obstruction relief in group OIVd promoted significant urinary CA 19-9 reduction (p<0,05) in the final evaluation. Conclusions: CA 19-9 urinary concentration increased in partial urinary tract obstruction. Its best performance was in the bladder neck obstruction group, in which the elevation was detected early (6 days after infravesical obstruction) and the CA19-9 urinary concentration declined after clearance.
RESUMO Introdução: a válvula de uretra posterior representa uma importante causa de doença renal crônica na infância. A identificação de biomarcadores que monitorem danos renais precoces e o sucesso da desobstrução do trato urinário podem reduzir o número de pacientes que evoluem para insuficiência renal. Objetivo: avaliar o desempenho do biomarcador antígeno carboidrato CA 19-9 nas obstruções parciais do trato urinário. Método: 46 ratas Wistar foram divididas em 5 grupos: grupo controle; grupo OIV: obstrução infravesical; grupo OIVd: obstrução infravesical com alívio da obstrução após 7 dias; grupo OUu: obstrução ureteral unilateral; grupo OUb: obstrução ureteral bilateral. O desempenho do CA 19-9 foi comparado a outro biomarcador, a Ngal. A dosagem de CA 19-9 e Ngal na urina e no sangue, e os níveis de creatinina sérica foram avaliados nas ratas antes da cirurgia (T0) e após 14 dias (T1). O grupo OIVd foi submetido a uma coleta intermediária (Ti). Resultados: a concentração urinária de CA19-9 aumentou nos grupos OIV, OIVd e OUb; a elevação em T1 e Ti alcançou significância estatística em relação ao valor de T0 (p<0,05). As alterações no CA 19-9 urinário foram mais expressivas nos grupos de obstrução infravesical (AUC 0,81). O alívio da obstrução no grupo OIVd promoveu redução do CA 19-9 urinário (p<0,05). Conclusões: a concentração urinária de CA19-9 aumentou na obstrução parcial do trato urinário. Seu melhor desempenho foi no grupo de obstrução infravesical, no qual a elevação foi detectada precocemente (6 dias de pós-operatório) com queda após a retirada do fator obstrutivo.
ABSTRACT
Objective To explore the diagnostic value of cfDNA in pancreatic cancer. Methods A total of 467 patients with pancreatic cancer and 129 healthy controls were enrolled. cfDNA concentration was detected using the QuantiDNA Direct cfDNA Test (DiaCarta) kit. Mann-Whitney U test was used to compare cfDNA concentration between different groups, and Chi-square test was used to analyze the relationship between cfDNA and pathological data of pancreatic cancer. Diagnostic efficacy was evaluated by ROC analysis. Results The cfDNA level of patients with pancreatic cancer was significantly higher than that of healthy controls (20.85 vs. 15.15 ng/ml, P=0.0027). The positive rate of cfDNA in pancreatic cancer was higher than that in healthy controls (77.73% vs. 59.68%). The sensitivity levels of cfDNA, CEA, and CA19-9 as diagnostic markers were 62.65%, 64.04%, and 60.32%, and their specificity levels were 61.05%, 70.53%, and 87.37%, respectively. The sensitivity and specificity of the combined detection were 77.26% and 53.58% respectively. The areas under the curve of cfDNA, CEA, CA199, and combined detection were 0.62, 0.67, 0.74, and 0.67, respectively. Conclusion cfDNA is elevated in patients with pancreatic cancer and may serve as an effective marker for its diagnosis.
ABSTRACT
Objective To evaluate the value of PLT and its parameters combined with AFP, CA199, CA125 and CEA on the preoperative differential diagnosis of hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC). Methods We analyzed retrospectively 274 patients with liver cancer who underwent surgery in the Second Hospital of Lanzhou University. They were divided into 229 cases in HCC group and 45 cases in ICC group according to postoperative pathological results. The differences of PLT, its parameters and tumor markers between the two groups were compared. ROC curve was used to evaluate the differential diagnosis effect on HCC and ICC by significantly different indicators in single and combined forms. The best scheme was verified in the patients with determined and undetermined preoperative diagnosis. Results Compared with HCC group, the levels of PLT, PCT, CA199 and CA125 in ICC group were higher (P < 0.05) and the level of AFP was lower (P < 0.05). The diagnostic analysis results of ROC curve showed that in single test, the AUC of AFP for HCC diagnosis was the largest (0.827). The AUC of the combined groups was higher than the single groups of tumor markers; the AUC of the PCT+AFP+CA199+CA125 group was the highest in all combination groups, and AUC was 0.891. The verification of the best combination group showed that the AUC was 0.924 in the preoperative determined diagnosis group and 0.854 in the undetermined diagnosis group. Conclusion Tumor markers in combination with PLT and PCT can increase the preoperative differential diagnosis efficacy of HCC and ICC. The combination of PCT, AFP, CA199 and CA125 before operation is helpful to further determine the diagnosis and plan the operation scheme.
ABSTRACT
Objective To analyze the screening results of tumor markers carbohydrate antigen 724 (CA-724), carbohydrate antigen 153 (CA-153), carbohydrate antigen 125 (CA-125), carbohydrate antigen 199 (CA-199) and carcinoembryonic antigen (CEA) in the 45 ~ 60-year-old health examination population in Chengdu area. Methods A total of 2 268 healthy people aged 45 ~ 60 years old living in Chengdu area from May 2019 to August 2020 were selected. Levels of serum tumor markers CA-724, CA-153, CA-125, CA-199 and CEA were detected by electrochemiluminescence. Positive rates of different tumor markers and confirmed diagnosis of malignant tumors were statistically analyzed. People with positive and negative tumor markers were respectively included in the positive group and the negative group, and their serum tumor markers were compared. The screening results of tumor markers in the health examination population of different gender and age, and the diagnostic efficiency of each tumor marker for malignant tumors were analyzed. Results Among the 2 268 healthy people, the positive rates of CA-724, CA-153, CA-125, CA-199 and CEA were 10.05%, 4.98%, 1.10%, 7.01% and 4.76%, respectively. A total of 72 cases were positive for tumor marker detection, with a total positive rate of 3.17% (72/2,268). Among them, 12 cases were diagnosed as early or mid-term tumors by pathology, imaging and other examinations, with a total tumor detection rate of 0.53% (12/2,268), including 8 cases of malignant tumors, with a detection rate of 0.35% (8/2,268). The levels of CA-724, CA-153, CA-125, CA-199 and CEA in the tumor markers positive group were higher than those in the negative group (P<0.05). The CA-125 and CA-199 positive rates in males were lower than those in females, while CEA positive rate was higher in males than in females (P<0.05). Positive rates of CA-153, CA-199 and CEA in different age groups showed statistically significant differences (P<0.05). Positive expression of CA-153 and CA-199 mainly occurred in the 51~60 years old group, and positive expression of CEA mainly occurred in the 45~50 years old group. ROC curve analysis showed that combined detection of CA-724, CA-153, CA-125, CA-199 and CEA had the highest sensitivity, specificity and accuracy in predicting malignant tumors, and the area under the curve was the largest (0.865). Conclusion Tumor markers CA-724, CA-153, CA-125, CA-199 and CEA are highly expressed in the 45 ~ 60-year-old health examination population in Chengdu area, and positive rate of CA-724 is the highest. Levels of tumor markers in people of different gender and age are also different. Joint detection of various tumor markers is conducive to early detection and treatment of the disease, and reduction of deterioration risk.
ABSTRACT
Objective To investigate the expression level of serum miR-486-5p in patients with pancreatic cancer and the value of serum miR-486-5p combined with carbohydrate antigen 19-9 (CA19-9) in predicting the resectability of pancreatic cancer. Methods A total of 60 patients who were diagnosed with pancreatic cancer in Qingdao Municipal Hospital from September 2018 to December 2020 were enrolled, among whom 32 patients had resectable or borderline resectable pancreatic cancer (operable group) and 28 had unresectable pancreatic cancer (non-operable group), and a benign pancreatic disease group with 30 patients and a healthy control group with 44 individuals were also established. Quantitative real-time PCR was used to measure the serum level of miR-486-5p in each group, and the relative expression level of miR-486-5p was calculated to analyze its association with the clinical features of pancreatic cancer, including age, sex, tumor location, tumor size, TNM stage, lymphatic metastasis, and distant metastasis. The Mann-Whitney U test was used for comparison of non-normally distributed continuous variables between two groups, and the chi-square test was used for comparison of categorical variables. The receiver operating characteristic (ROC) curve was plotted, and a binary logistic regression analysis was used to calculate the combined predictive value and then investigate the value of serum miR-486-5p combined with CA19-9 in predicting the resectability of pancreatic cancer. Results The relative expression level of serum miR-486-5p in the operable group [2.16 (1.38~3.30)] and the non-operable group [4.65 (2.80~9.90)] was significantly higher than that in the benign pancreatic disease group [1.01 (0.52~1.53)] and the healthy control group [0.99 (0.24~1.01)] (all P < 0.001). There were significant differences in the number of patients with low or high expression of miR-486-5p between the patients with different TNM stages, presence or absence of lymphatic metastasis, and presence or absence of distant metastasis ( χ 2 =13.765, 5.157, and 6.638, all P < 0.05). Compared with CA19-9 alone, miR-486-5p+CA19-9 had a significantly better value in distinguishing the operable group from the benign pancreatic disease group (area under the ROC curve [AUC]=0.87, 95% confidence interval [ CI ]: 0.760-0.942; with a sensitivity of 81.3% and a specificity of 83.3%), distinguishing the operable group from the healthy control group (AUC=0.92, 95% CI : 0.836-0.970; with a sensitivity of 90.6% and a specificity of 86.4%), and distinguishing the operable group from the non-operable group (AUC=0.94, 95% CI : 0.884-0.998; with a sensitivity of 85.7% and a specificity of 93.7%) ( Z =2.841, 2.510, and 2.387, all P < 0.05), and the optimal cut-off values were 3.12, 3.21, and 6.63, respectively. Conclusion MiR-486-5p can be used as a serum biomarker for the diagnosis of pancreatic cancer, and miR-486-5p combined with CA19-9 has a better clinical value than CA19-9 alone in predicting the resectability of pancreatic cancer in the patients with benign pancreatic diseases and the healthy population.
ABSTRACT
Objective To investigate the expression level of serum miR-486-5p in patients with pancreatic cancer and the value of serum miR-486-5p combined with carbohydrate antigen 19-9 (CA19-9) in predicting the resectability of pancreatic cancer. Methods A total of 60 patients who were diagnosed with pancreatic cancer in Qingdao Municipal Hospital from September 2018 to December 2020 were enrolled, among whom 32 patients had resectable or borderline resectable pancreatic cancer (operable group) and 28 had unresectable pancreatic cancer (non-operable group), and a benign pancreatic disease group with 30 patients and a healthy control group with 44 individuals were also established. Quantitative real-time PCR was used to measure the serum level of miR-486-5p in each group, and the relative expression level of miR-486-5p was calculated to analyze its association with the clinical features of pancreatic cancer, including age, sex, tumor location, tumor size, TNM stage, lymphatic metastasis, and distant metastasis. The Mann-Whitney U test was used for comparison of non-normally distributed continuous variables between two groups, and the chi-square test was used for comparison of categorical variables. The receiver operating characteristic (ROC) curve was plotted, and a binary logistic regression analysis was used to calculate the combined predictive value and then investigate the value of serum miR-486-5p combined with CA19-9 in predicting the resectability of pancreatic cancer. Results The relative expression level of serum miR-486-5p in the operable group [2.16 (1.38~3.30)] and the non-operable group [4.65 (2.80~9.90)] was significantly higher than that in the benign pancreatic disease group [1.01 (0.52~1.53)] and the healthy control group [0.99 (0.24~1.01)] (all P < 0.001). There were significant differences in the number of patients with low or high expression of miR-486-5p between the patients with different TNM stages, presence or absence of lymphatic metastasis, and presence or absence of distant metastasis ( χ 2 =13.765, 5.157, and 6.638, all P < 0.05). Compared with CA19-9 alone, miR-486-5p+CA19-9 had a significantly better value in distinguishing the operable group from the benign pancreatic disease group (area under the ROC curve [AUC]=0.87, 95% confidence interval [ CI ]: 0.760-0.942; with a sensitivity of 81.3% and a specificity of 83.3%), distinguishing the operable group from the healthy control group (AUC=0.92, 95% CI : 0.836-0.970; with a sensitivity of 90.6% and a specificity of 86.4%), and distinguishing the operable group from the non-operable group (AUC=0.94, 95% CI : 0.884-0.998; with a sensitivity of 85.7% and a specificity of 93.7%) ( Z =2.841, 2.510, and 2.387, all P < 0.05), and the optimal cut-off values were 3.12, 3.21, and 6.63, respectively. Conclusion MiR-486-5p can be used as a serum biomarker for the diagnosis of pancreatic cancer, and miR-486-5p combined with CA19-9 has a better clinical value than CA19-9 alone in predicting the resectability of pancreatic cancer in the patients with benign pancreatic diseases and the healthy population.
ABSTRACT
Background: A combination of serum tumor markers are used in the evaluation and prognosis of carcinoma gallbladder (GBC). Aim of the study was to find the significance of combined use of CA19-9, CA125 and CEA in advanced stage of GBC and to find the cut-off value of each of these tumor markers in metastatic GBC. Methods: This was a retrospective observational cohort study over 1 year, which was carried out in 42 cases of advanced GBC. The patients were grouped in to locally advanced and metastatic stage on the basis of CECT scan findings. CA19-9, CA125 and CEA were assayed in all patients. These tumor markers were analysed with these two groups of GBCs. Statistical analysis was performed using R statistical software v3.6.2.Results: Out of 42 cases CA19-9 was elevated in 18 (78%), CA125 in 16 (70%) and CEA in 9 (39%) patients with metastatic disease. The cut-off value of CA19-9, CA125 and CEA was determined by ROC curve were >109 U/ml, 55.4 U/ml and 2.56 μg/l respectively. CA19-9 had the highest sensitivity 78.3% followed by CA125 69.6% and CEA has the highest specificity 68.4% for the diagnosis of metastatic stage of the disease. Specificity of these tumor markers were highest when used in combination.Conclusions: Combined use of triple tumor markers increases its specificity in the diagnosis of advanced stage of GBC but their cut-off level is statistically not significant in predicting metastatic GBC.
ABSTRACT
@#[Abstract] Objective: To investigate the value of pre-treatment kisspeptin (KISS-1) expression for diagnosis and prognosis prediction of pancreatic cancer. Methods: The clinical data of 90 patients with pancreatic cancer (pancreatic cancer group) in Cancer Hospital of Hubei Province from April 2015 to December 2018 were retrospectively analyzed; in addition, 40 patients with benign pancreatic lesions were selected as the benign pancreatic lesion group and 30 healthy people were chosen as control group. The serum levels of KISS-1 and CA19-9 in each group were detected by ELISA. The diagnostic efficacies of CA19-9 and KISS-1 in pancreatic cancer and their relationship with the prognosis of pancreatic cancer were analyzed. Results: The serum KISS-1 level in the pancreatic cancer group was significantly higher than that in the benign pancreatic lesion group and the control group (both P<0.01); the area under the curve (AUC) of serum KISS-1, CA19-9 and their combination for pancreatic cancer detection was 0.757 (95% CI: 0.684-0.831, P=0.000), 0.900 (95% CI: 0.854-0.946, P=0.000), and 0.906 (95% CI: 0.861-0.950, P=0.000), respectively. The AUC value of the combined detection was statistically different from that of KISS-1 (Z=3.124, P=0.024), and the AUC value of CA19-9 was also statistically differently from KISS-1 (Z=3.253, P=0.025). Correlation analysis showed that there was a significant negative correlation between KISS-1 and CA19-9 (r=-0.358, P=0.002). The results of survival curve analysis showed that the survival time of patients with serum KISS-1≥73.6 pg/ml was significantly better than that of patients with KISS-1<73.6 pg/ml (χ2=4.520, P=0.036); KISS-1<73.6 pg/ml was independently related to the patient's prognosis with an OR of 2.37 (1.08-4.75). Conclusion: Serum KISS-1 is helpful for the early diagnosis of pancreatic cancer, and the combined detection of KISS-1 and CAI9-9 can improve the sensitivity and specificity of pancreatic cancer diagnosis, and also is beneficial for prognosis evaluation.
ABSTRACT
Objective To investigate the diagnostic values of ultrasonography combined with serum cancer antigen 125 (CA125),serum carbohydrate antigen 199 (CA199),serum carcinoembryonic antigen (CEA) in ovarian malignant tumors.Methods From November 2015 to December 2017,140 patients with ovarian cancer admitted to the hospital were selected as subjects,and ultrasound examination was carried out with IU22 ultrasound diagnostic instrument.The patients were divided into 92 cases of benign ovarian tumors and 4-8 cases of malignant ovarian tumors through pathological diagnosis.The serum CA125,CA199 and CEA of all patients were detected by automatic biochemical analyzer,and receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of four combined detection in ovarian malignancies.Results The coincidence rate of ultrasound diagnosis in ovarian benign tumor patients was significantly higher than that in ovarian cancer patients (P ＜ 0.05).The levels of serum CA125,CA199 and CEA in benign ovarian tumors were significantly lower than those in malignant ovarian tumors (P ＜0.05),and the levels of serum CA125,CA199 and CEA in patients with stage Ⅰ to Ⅱ were significantly lower than those in stage Ⅲ to Ⅳ (P ＜ 0.05).The area of serum CA125,CA199 and CEA under the ROC curve was 0.788,0.750 and 0.708,respectively.The boundary points of diagnosis were 50.61 U/ml,36.47 U/ml and 4.32 ng/ml,respectively.The area under the combined diagnosis curve of the serum CA125,CA199 and CEA was 0.832.The sensitivity,specificity and accuracy of the combined detection were higher than that of single index detection and serum combined detection.Conclusions Ultrasound combined with serum CA125,CA199 and CEA levels detection can improve the sensitivity,specificity and accuracy of diagnosis of ovarian benign and malignant tumors,which has certain clinical value.
ABSTRACT
SUMMARY OBJECTIVE Acute pancreatitis (AP) is an important clinical event with an increased frequency due to increased life expectancy, obesity, and alcohol use. There are some data about the elevation of carbohydrate antigen (CA) 19-9 levels in benign and malignant pancreaticobiliary events in the literature, but in AP they are limited. The aim of this study was to evaluate the CA 19-9 level in patients with AP and determine its relationship according to the cause. METHODS Between 2010-2018, 173 patients evaluated with CA 19-9 levels as well as by standard laboratory tests were included in the study. CA 1 9-9 levels and laboratory findings were compared in patients with pancreatitis due to gallstone (group 1) and metabolic/toxic reasons such as hyperlipidemia, alcohol, or drug use (group 2). RESULTS There were 114 (66%) patients in the group 1 and 59 (34%) patients in the group 2. The majority of patients with high CA 19-9 level were in group 1 (92.1% vs 6.8%). CA 19-9 level, as well as amylase, lipase, AST, ALT and bilirubin levels were found to be statistically higher in patients with AP due to gallstone compared to patients with metabolic/toxic AP. CONCLUSIONS Patients with AP due to gallstone, were found to have a high level of CA 19-9 at admission. Early stage CA 19-9 levels may contribute to standard laboratory tests in the etiology of the disease in patients diagnosed with AP.
RESUMO OBJETIVO A pancreatite aguda (PA) é um evento clínico importante e cada vez mais frequente devido ao aumento da expectativa de vida, obesidade e do consumo de álcool. Existem alguns dados na literatura sobre a elevação dos níveis do antígeno carboidrato (CA) 19-9 em eventos pancreato-biliares benignos e malignos, mas eles são limitados em relação à PA. O objetivo deste estudo foi avaliar o nível de CA 19-9 em pacientes com PA e determinar sua relação com a causa da doença. PACIENTES E MÉTODOS Entre 2010 e 2018, 173 pacientes submetidos a uma avaliação dos níveis de CA 19-9, bem como testes laboratoriais padrão, foram incluídos no estudo. Os níveis de CA 19-9 e os achados laboratoriais foram comparados em pacientes com pancreatite devido a cálculos biliares (grupo 1) e razões metabólicas/tóxicas, como hiperlipidemia, álcool, ou uso de drogas (grupo 2). RESULTADOS Um total de 114 (66%) pacientes foi incluído no grupo 1 e 59 (34%) no grupo 2. A maioria dos pacientes com alto nível de CA 19-9 estavam no grupo 1 (92,1% versus 6,8%). O CA 19-9, bem como os níveis de amilase, lipase, AST, ALT e bilirrubina foram estatisticamente mais altos em pacientes com PA devido a cálculos biliares em comparação àqueles com PA devido a alterações metabólicas/tóxicas. CONCLUSÃO Pacientes com PA devido a cálculos biliares apresentaram um alto nível de CA 19-9 no momento da internação. O nível de CA 19-9 na fase inicial pode contribuir para testes laboratoriais padrão na etiologia da doença em pacientes com diagnóstico de PA.
Subject(s)
Humans , Male , Female , Adult , Aged , Aged, 80 and over , Young Adult , Pancreatitis/etiology , Pancreatitis/metabolism , Gallstones/complications , Gallstones/metabolism , CA-19-9 Antigen/blood , Reference Values , Predictive Value of Tests , Retrospective Studies , ROC Curve , Statistics, Nonparametric , Middle AgedABSTRACT
Dermoid cyst (mature cystic teratoma) with well differentiated derivatives of all the three-germ cell layer is a benign tumour with ovaries being the commonest site. Dermoid cyst accounts for more than half of ovarian tumours in girls below 20 years of age. 80% of dermoid cyst are seen in reproductive age group between 20-40 years. Size of dermoid cyst usually varies between 5-10 cm and it may be bilateral in 10% of cases. Malignant transformation is very rare occurrence only in 1-3% cases, however torsion may occur in 15% of dermoid cyst. Carbohydrate antigen or cancer antigen 19-9 is usually raised in gastrointestinal tumours, pancreatic malignancy, pseudocyst of pancreas. However, it may be raised in some other malignancies and benign condition like torsion of dermoid cyst. Authors report an unusual case of torsion large dermoid cyst with tissue necrosis along with significantly elevates levels of serum CA 19-9. A 30-year-old P1L1 female presented with chief complaint of heaviness and pain lower abdomen and loss of five kilogram weight for last three months. A provisional diagnosis of dermoid was made. Serum CA 19-9 level were 1126 IU significantly raised. An exploratory laparotomy done under regional anaesthesia. A large demoid cyst 12*10 cm with torsion and areas of gangrene in ovarian tissue was seen replacing left ovary. Large and small intestine, stomach, pancreas were explored to rule out any pathology. Histopathology confirmed diagnosis of mature cystic teratoma. There was significant fall in serum Ca 19-9 levels to 247 U/ml two weeks after surgery and levels returned to normal limit six weeks after surgery.
ABSTRACT
Introduction: There are, at present, no biomarkers topredict to prognosis of Gallbladder cancer. We conducted aprospective exploratory study to evaluate the role to serum CA19-9 and CA 242 as prognostic markers.Material and Methods: We enrolled consecutive patients forthis study and CA 19-9 and 242 were estimated from venoussamples. Association of these markers with clinical variablesand median overall survival (OS) difference between patientswho has raised versus normal levels of these markers wasdetermined.Results: Sixty-two patients were enrolled for this study.Forty-four (71%) patients had elevated CA19-9. Thirty-nine(62.9%) patients had an raised CA242 levels. CA 19-9 wasfound to be significantly associated with the presence ofjaundice (p=0.038) and advanced stage (p=0.009). MedianOS of patients who had elevated CA 19-9 was 5.73 monthscompared to 8.33 months in patients who had normal CA19-9. The difference was not statistically different (p= 0.15).Median OS for patients who had elevated CA 242 was 5.53months, which was inferior to those who had normal levels(9.1 months). This difference approached, but was notstatistically significant (p=0.055).Conclusion: This is the first study to show associationbetween CA 19-9 and stage of disease in GBC. At present,CA 19-9 and CA 242 cannot be recommended as prognosticmarkers. However, role of CA 242 needs to be examined ina larger cohort of patients of GBC to establish its usefulness.
ABSTRACT
Background: There is a dearth of reliable blood and urine markers for transitional cell carcinoma of urinary bladder. CA 19-9 is a well-known marker for gastrointestinal malignancies and is being investigated for other malignancies including carcinoma bladder. In this prospective study, we evaluated the role of serum CA 19-9 as a tumor marker and correlated its level with tumor grade and stage.Methods: One hundred and fifteen patients with transitional cell carcinoma of urinary bladder and 69 healthy volunteers, as controls were included in the study. Preoperative blood sample was analysed for level of CA 19-9 using ELISA kit (normal - 0 U/ml to 37U/ml) and were correlated with grade and TNM stage of tumor.Results: The range of the control group is 2-38U/ml (mean: 17.67±9.68U/ml); TCC group is 1-94U/ml (mean: 37.12±31.52U/ml) (p=0.304). When CA 19-9 level >37IU/ml was taken as cut-off for a positive test, sensitivity of detecting T3 disease, T4 disease, MIBC, presence of node and high grade tumour were 80%, 75%, 70.3%, 78% and 57.8% respectively. However, there was a statistically significant increase in levels of CA19-9 in relation to higher grade (<0.001), presence of muscle invasion (<0.001), T stage (<0.001) and N stage (<0.001).Conclusions: Serum CA19-9 is almost invariably raised in patients with high grade and invasive disease. Thus, it has a place as a prognostic marker rather than as a diagnostic tool due to its low sensitivity for TCC bladder.
ABSTRACT
Objective To evaluate the diagnostic value of CEA, CA19-9, CA72-4, AFP, and CA125 in gastric stromal tumors. Methods 41 patients with gastric stromal tumors and 11 patients with gastric leiomyoma were recruited in this study from Qilu Hospital of Shandong University during May 2014 to December 2017. The tissue was collected by surgery, and HE staining was done. Immunohistochemistry was employed to detect the expression of CD34, CD117, and DOG-1. Serum of all cases and 41 healthy volunteers in the same hospital were collected. The levels of CEA, CA19-9, CA72-4, AFP and CA125 were examined by electrochemiluminescence assay, and the differences in each group were compared by M-W test or K-W test. Then the relationship between those biomarkers and the clinical parameters of gastric stromal tumors was analyzed. Moreover, AUC (Area Under the curve), cut-off value, sensitivity, specificity, positive predictive value, negative predictive value with drawing ROC curve (receiver operating characteristic curve) were also calculated. Results Spindle cells or epithelioid cells were observed in the tissue of gastric stromal tumors. The expression of CD34, CD117, DOG-1 were positive. The level of the serum CEA 1.53 (1.15, 2.22) ng/ml in patients with gastric stromal tumor patients was higher than that in healthy controls 1.06 (0.62, 1.48) ng/ml and that in patients with gastric leiomyoma 0.79 (0.39, 1.39) ng/ml (the U value was 446.5, and 113.0 respectively, P<0.05). The level of CA19-9 in gastric stromal tumors 9.30 (4.95, 12.70) U/ml was higher than that in healthy controls 6.62 (4.56, 8.82) U/ml (the U value was 615.5, P<0.05). There were no significant differences in AFP, CA125, and CA72-4 of three groups (the H value was 4.348, 1.073, and 3.897, P>0.05). Furthermore, the level of CEA was closely related to TNM stage (the U value was 129.0, P<0.05). The diagnostic value of CEA and CA19-9 was statistically not significant (P>0.05). However, the combination of two markers might increase diagnostic efficiency. The sensitivity, specificity, positive predictive value, negative predictive value and AUC was 92.7％, 48.8％, 64.4％, 87.0％ and 0.752 respectively. Conclusion The combination of CEA and CA19-9 has better sensitivity and negative predictive value in auxiliary diagnosis of gastric stromal tumors.
ABSTRACT
PURPOSE: The purpose of this study is to evaluate the prognostic value of preoperative serum CA 19-9 levels in colorectal cancer patients. METHODS: Between 2008 and 2011, 4,794 consecutive patients who underwent curative resection for colorectal cancer were analyzed. These patients were classified into 2 groups according to preoperative CA 19-9 (high CA 19-9: ≥37 ng/mL, n = 440; normal CA 19-9: <37 ng/mL, n = 4,354). We used 1:20 propensity score matching to adjust for potential baseline confounders between groups. RESULTS: After matching, 424 patients (10.5%) among 4,021 patients with colorectal cancer showed a high pre-CA 19-9 level (≥37 ng/mL). There were no significant differences between these 2 groups in age, sex, preoperative CEA level, or T, N, and M stage after matching. Of the 424 patients with high pre-CA 19-9, 141 (33.3%) exhibited cancer recurrence more frequently than patients with normal preoperative CA 19-9 (18.5%). Patients with an elevated preoperative CA 19-9 level showed significantly poorer survival than those with normal levels. The 5-year overall survival rate was 79.7% in the high preoperative CA 19-9 group and 91.9% in the normal preoperative CA 19-9 group (P < 0.001). The 5-year disease-free survival rate was 70.2% in the high preoperative CA 19-9 group and 82.7% in the normal preoperative CA 19-9 group (P < 0.001). CONCLUSION: Patients with an elevated preoperative CA 19-9 level in colorectal cancer have a significantly poorer prognosis than those with normal levels of CA 19-9. We therefore suggest preoperative CA 19-9 level can be used as an additional prognostic indicator of poor outcomes in colorectal cancer.
Subject(s)
Humans , CA-19-9 Antigen , Colorectal Neoplasms , Disease-Free Survival , Prognosis , Propensity Score , Recurrence , Survival RateABSTRACT
Objective@#To explore preoperative predictive markers for invasive malignancy in intraductal papillary mucinous neoplasm(IPMN).@*Methods@#The retrospective case-controlled study was adopted.Seventy-nine patients who underwent surgery and with pathologically confirmed IPMN from January 2005 to December 2014 at Department of Pancreatic Surgery, Zhongshan Hospital Fudan University were enrolled.Forty-six patients were male and 33 were female,with an average age of (62.9±8.9)years (range:37-82 years).Tumor sites:56 tumors were located at the head of the pancreas,22 were located at the body and tail of the pancreas,and 1 was located across the whole pancreas.Surgical procedures: 51 patients underwent pancreaticoduodenectomy, 22 patients underwent distal pancreatectomy, 4 patients underwent segmental pancreatectomy and 2 patients underwent total pancreatectomy.IPMNs were classified into non-invasive lesions and invasive carcinomas according to the histopathological findings of the tumor.Thirty-two tumors were non-invasive lesions and 47 were invasive carcinomas.The preoperative findings were compared between patients with non-invasive IPMN and patients with invasive carcinoma by univariate analysis using t test and χ2 test accordingly,and factors with statistically significance were subsequently submitted to multivariate analysis.@*Results@#Univariate analysis showed that tumor size(P=0.022), carcinoembryonic antigen(P=0.012), CA19-9(P=0.011), lymphocytes(P=0.034), neutrophil-to-lymphocyte ratio(P=0.010)and platelet-to-lymphocyte ratio(PLR)(P=0.004)were predictive markers with statistical significance.Multivariate analysis showed that CA19-9(P=0.012)and PLR(P=0.025) were independent predictive markers for invasive malignancy in IPMN.The area under curve of the combination factor of CA19-9 and PLR(0.864) was larger than that of CA19-9(0.806) or PLR(0.685) alone, and all the authentic indicators of the combination factor were better than those of each alone.@*Conclusions@#CA19-9 and PLR are independent predictive markers for invasive malignancy in IPMN.The combination of CA19-9 and PLR has improved efficacy than each alone.
ABSTRACT
Objective: To investigate the difference of ovarian benign diseases and healthy regulatory T cells (Tregs) and tumor markers CA 125 and CA 19-9 in patients with ovarian cancer, and to analyze their correlation with clinicopathological factors and prognosis. Methods: We selected 43 cases pathologically diagnosed ovarian cancer patients in gynecological department from October 2016 to October 2017 in our hospital as a malignant group, another 55 cases of benign ovarian patients treated in the same period as benign group, 50 cases of healthy physical examination women as control group. The Tregs number and expression levels of tumor markers CA 125 and CA 19-9 in ovarian cancer were compared among the three groups, and their relationship with clinicopathological factors and prognosis was analyzed. Results: The proportions of Tregs in the malignant and benign groups were higher than those in the control group, and the proportions of Tregs, CA 125 and CA 19-9 in the malignant group were higher than that in the benign group (P0.05). Conclusion: Tregs, CA 125, and CA 19-9 can all be promising markers for clinical diagnosis, treatment and prognosis of ovarian cancer.