ABSTRACT
High ascitic amylase concentration has been reported to be a characteristic of pancreatic ascites. However, values greater than 2000 U/l can also be seen in intestinal perforation. Fungal peritonitis is a serious entity that could also be caused by hollow viscous perforation. Herein we report a 22-year-old woman with epigastric pain, imitating an acute pancreatitis, and abdominal distention. Laboratory and radiological investigations revealed a high ascitic Amylase level with secondary fungal peritonitis due to gastric ulcer perforation. This case highlights the importance of careful clinical evaluation and a multi-disciplines approach in patients with high ascitic Amylase levels especially in limited-resources areas in order not to miss a diagnosis in which a surgical approach can be lifesaving. To the best of our knowledge, this is the first reported case of concomitant very high ascetic Amylase level and fungal peritonitis as a manifestation of gastric perforation.
ABSTRACT
AIM: This study aims to evaluate plasma osteopontin (OPN) levels as a potential biomarker for hepatocellular carcinoma (HCC). BACKGROUND: Osteopontin (OPN) is a secreted glycoprotein that is associated with tumorigenesis and metastasis. METHODS: We measured plasma levels of OPN in 26 HCC patients, 27 patients with chronic liver diseases (CLD), and 15 healthy control individuals using a standardized ELISA kit. RESULTS: The mean plasma OPN level was significantly higher in the HCC group than the CLD group or the normal control group (p-value =0.001/<0.0001). Plasma OPN levels were significantly higher in patients with a tumor size >5 cm in diameter than those with tumors ≤5 cm (p=0.02). OPN levels in the HCC group were not significantly affected by advancing degree of Child-Pugh class. Diagnostic sensitivity and specificity of OPN for HCC were 61% and 82%, respectively (cut-off value: 118.69ng/mL). The area under the ROC curve (AUC) value for OPN was 0.784. However, the AUC value was 0.844 for AFP. CONCLUSION: The plasma levels of OPN show low diagnostic accuracy for HCC compared to AFP. However, OPN may have a complementary role in diagnosing HCC in patients with non-diagnostic levels of AFP.
