Persistent Elevation of CA 19-9 Levels in the Long-term Follow-up before Laryngeal Cancer.

INTRODUCTION: CA 19-9 is used as a tumor marker in colon, pancreas, biliary, and gastric cancers. Laryngeal cancer is the most common malignant epithelial tumor among head and neck cancers and has no specific tumor marker. CASE REPORT: A 66-year-old male patient had severe reflux symptoms during 5 years and had an isolated CA 19-9 elevation. Follow-up analysis revealed that he had larynx cancer and after laryngectomy, CA 19-9 levels decreased to normal range. DISCUSSION: Currently, CA 19-9 is not a marker for malignancy. Laryngeal carcinoma has no specific tumor marker, but laryngeal squamous cell carcinoma may be manifested by elevated CA 19-9 levels.How to cite this article: Özkan H, Karakaya F, Karaeren Z, Perçinel S. Persistent Elevation of CA 19-9 Levels in the Long-term Follow-up before Laryngeal Cancer. Euroasian J Hepato-Gastroenterol 2017;7(1):92-94.

Is omitting the 3rd hour measurement in the 100 g oral glucose tolerance test feasible?

BACKGROUND: To evaluate the diagnostic value of the 3rd hour plasma glucose level in the 100 g oral glucose tolerance test (OGTT). METHODS: Records of all pregnant patients with abnormal 50 g glucose challenge test (GCT) between January 2005 and December 2013 were reviewed (n=1963). The 100 g OGTT results were analyzed separately for both Carpenter & Couston (CC) and National Diabetes Data Group (NDDG) criteria. RESULTS: The number of patients diagnosed with gestational diabetes mellitus (GDM) was 297 (15.1%) according to CC criteria and 166 (8.4%) according to NDDG criteria. The 1st hour plasma glucose level showed the highest correlation with GDM diagnosis (ρ=0.595 for CC and ρ=0.567 for NDDG). However, the 3rd hour plasma glucose level showed the weakest correlation with GDM diagnosis (ρ=0.216 for CC and ρ=0.213 for NDDG). The 3rd hour value of 100 g OGTT was one of the two elevated measurements in 10.8% of patients when CC criteria are used and in 13.8% of patients when NDDG criteria are used. CONCLUSION: Omitting 3rd hour plasma glucose measurement in 100 g OGTT results in unacceptable rates of underdiagnosed patients.

Diagnostic and prognostic role of serum glypican 3 in patients with hepatocellular carcinoma.

α-Feto protein (AFP) is the widely used tumor marker in the diagnosis of hepatocellular carcinoma (HCC). The aim of this study was to assess the diagnostic and prognostic validity of a novel marker, serum Glypican-3 (GPC3) and to compare AFP in patients with HCC. One hundred and twenty-eight patients (75 patients with HCC, 55 patients with cirrhosis, and 28 healthy controls) were included in this study. Cut-off value of GPC3 was 3.9 pg/ml. AFP was divided into four subgroups, according to cut-off values with 13, 20, 100, and 200 ng/ml. Sensitivity, specificity, and positive and negative predictive values of GPC3 and AFP13, AFP20, AFP100, AFP200 subgroups and also GPC3+AFP13, GPC3+AFP20 , GPC3+AFP100 , GPC3+AFP200 combinations were compared. Serum GPC3 levels were significantly higher in patients with HCC and cirrhosis compared with control subjects (P<0.05). The median serum GPC3 levels were 3.9 pg/ml in controls, 5.51 pg/ml in patients with cirrhosis, and 5.13 pg/ml in those with HCC. The median serum AFP levels were 1.37 ng/ml in controls, 2.32 ng/ml in cirrhotics, and 50.65 ng/ml in HCC patients. The sensitivity, specificity, and positive and negative predictive values of GPC3 was 61.33, 41.82, 58.97, and 44.43%, respectively. The values for AFP were 68.57, 94.55, 94.12, and 70.27%, respectively. There was no correlation between GPC3 levels and prognostic parameters. GPC3 is not a useful diagnostic and prognostic marker for HCC.

Diagnostic and prognostic validity of Golgi protein 73 in hepatocellular carcinoma.

BACKGROUND: Golgi protein 73 (GP73) expressions have been detected in hepatocellular carcinoma (HCC) and bile duct carcinoma. AIM: Our purpose was to determine the serum levels of GP73 in patients with HCC and to compare them with α-fetoprotein (AFP) levels. MATERIALS AND METHODS: Seventy-five patients with HCC, 55 patients with cirrhosis and 28 healthy controls were included. RESULTS: The median serum GP73 levels were 0.27 ng/ml (range = 0.078-4.95) in controls, 0.32 ng/ml (range = 0.078-39.63) in cirrhotics and 0.21 ng/ml (range = 0.053-4.98) in those with HCC. The median serum AFP levels were 1.37 ng/ml (range = 0.61-6.89) in controls, 2.32 ng/ml (range = 0.61-85.24) in cirrhotics and 50.65 ng/ml (range = 0.8-37,642) in HCC patients (p < 0.0001 for HCC vs. controls and cirrhotics). The sensitivity, specificity, and positive and negative predictive values of GP73 were 82, 9, 55 and 27%, respectively. Whereas the levels were 68, 94, 94 and 70%, respectively, for AFP(13) and 60, 98, 97 and 64% for AFP(20), respectively. There was no correlation between GP73 levels and other prognostic parameters including tumor size, tumor type, Child-Pugh classification, TNM staging, Cancer of the Liver Italian Program score, portal vein thrombosis and extrahepatic metastasis. CONCLUSIONS: GP73 has a lower diagnostic and prognostic value for HCC. AFP is superior to GP73 for diagnosis of early HCC.

A reference interval study of urinary lactulose excretion: a useful test of intestinal permeability in adults.

BACKGROUND/AIMS: Measurement of lactulose excretion in urine following oral ingestion is used as a noninvasive method of assessing small intestinal permeability. The aim of this study was to determine the adult reference interval of urinary lactulose excretion following oral administration. METHODS: Thirty seven volunteers (mean age 37.3 +/- 15 years) with no history of gastrointestinal disease were recruited as study subjects. All subjects were fasted overnight (10 hours), emptied their bladders and then drank a 50-mL solution containing 15 mL of Duphalac (10 g lactulose) and 35 mL flavoured water. Urine was collected for six hours in a bottle. Comparisons were made for 37 samples. RESULTS: In adults, the mean urinary lactulose concentration was 0.58 +/- 0.39 mmol/L. CONCLUSION: This study determined the adult reference range for lactulose excreted in the urine, using a sensitive quantitative assay based on hydrolysing lactulose and enzymatically assaying fructose, one of the component monosaccharides.