ABSTRACT
BACKGROUND/AIMS: The aim of this study was to evaluate the prognostic significance of serum carcinoembryonic antigen (CEA) and carbohydrate antigen (CA19-9) levels in patients with gastric cancer. METHODOLOGY: During the period January 2000 and January 2003, 36 patients operated for primary gastric cancer, at Sisli Etfal Training and Research Hospital, Department of General Surgery, were analyzed. Serum CEA and CA19-9 levels were determined preoperatively and the correlation between the elevated levels of tumor markers and several clinicopathological features, and survival were evaluated. RESULTS: Elevated serum CEA and CA19-9 levels were determined in 10 of 35 patients (28.6%), and 9 of 31 patients (29%), respectively, and both markers were elevated in 3 of 31 patients (9.6%). Elevated levels of CEA correlated with depth of invasion (p=0.018) and pathological stage (p=0.029); elevated levels of CA19-9 correlated with lymph node metastasis (p=0.026); and elevated levels of both markers correlated well with lymph node metastasis (p=0.031). The survival of patients with normal CEA levels was significantly better than those with elevated levels (p=0.0072). CONCLUSIONS: Preoperative serum CEA and CA19-9 levels may add useful information in patients with gastric carcinoma, and CEA level is a predictor of prognosis.
Subject(s)
Biomarkers, Tumor/blood , CA-19-9 Antigen/blood , Carcinoembryonic Antigen/blood , Postoperative Complications/mortality , Stomach Neoplasms/diagnosis , Adult , Aged , Female , Gastrectomy , Humans , Lymph Nodes/pathology , Lymphatic Metastasis/pathology , Male , Middle Aged , Neoplasm Invasiveness/pathology , Neoplasm Staging , Predictive Value of Tests , Prognosis , Reference Values , Statistics as Topic , Stomach/pathology , Stomach Neoplasms/mortality , Stomach Neoplasms/pathology , Stomach Neoplasms/surgery , Survival AnalysisABSTRACT
BACKGROUND: We investigated the value of 5-hydroxyindolacetic acid (5-HIAA) levels in spot urine in the diagnosis of acute appendicitis. METHODS: Forty-three patients (11 females, 32 males; mean age 26.3 years; range 16 to 73 years) who were admitted to the emergency room with acute abdominal pain and suspected acute appendicitis were evaluated by means of physical examination, leukocyte counts, urine analysis, measurements of 5-HIAA in spot urine, abdominal x-rays, and sonography. Of these, 25 patients underwent appendectomy after a clinical diagnosis of acute appendicitis. Spot urine analyses were made in all the patients within the first hour of admission with the use of spectrophotometric and colorimetric methods; 5-HIAA levels were read at 540 nm. RESULTS: At laparotomy, 22 patients (88%; 3 females, 19 males; mean age 26.18 years; range 15 to 38 years) were found to have acute appendicitis (11 phlegmonous, 11 gangrenous), whereas three patients (12%; 2 females, 1 male) had negative findings. No significant differences were found between patients with confirmed acute appendicitis, patients without appendectomy, and those with negative laparotomy with respect to the mean leukocyte counts and 5-HIAA levels (p>0.05). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 5-HIAA for the diagnosis of acute appendicitis were calculated as 22%, 93%, 71%, 62%, and 63%, respectively. CONCLUSION: Measurement of 5-HIAA levels in spot urine is not helpful in the diagnosis of acute appendicitis.
Subject(s)
Appendicitis/diagnosis , Hydroxyindoleacetic Acid/urine , Abdominal Pain , Acute Disease , Adolescent , Adult , Appendectomy , Appendicitis/blood , Appendicitis/urine , Diagnosis, Differential , Female , Humans , Leukocyte Count , Male , Young AdultABSTRACT
BACKGROUND: We compared three repair techniques, namely, simple closure and omentoplasty, simple closure alone, and fibrin tissue adhesive, in the treatment of rat duodenal perforations induced in the postpyloric region. METHODS: Thirty male Sprague-Dawley rats (210-240 g) were included. Under ketamine and ether anesthesia, duodenal perforations of 2 mm were induced in all rats in the postpyloric region. The rats were assigned to three groups equal in number, which underwent repair with the use of simple closure and omentoplasty, simple closure alone, and fibrin glue, respectively. All the animals were sacrificed under deep ether anesthesia on the fourth postoperative day. To assess wound strength, bursting pressure measurements were performed. In addition, hydroxyproline content of the wound site was measured by absorbance spectrophotometry at 560 nm. RESULTS: The mean bursting pressure in the simple closure and omentoplasty group was significantly higher than those of the simple closure (p<0.05) and fibrin glue (p<0.001) groups. No significant difference existed between the simple closure and fibrin glue groups in this respect (p>0.05). Hydroxyproline values of the simple closure and omentoplasty (p<0.05) and simple closure (p<0.001) groups were significantly lower than that of the fibrin glue group. CONCLUSION: Fibrin tissue adhesives may have an application in the treatment of duodenal ulcer perforations, as an adjunct to laparoscopic or open surgical methods.
