Carbohydrate antigen 19-9 levels in early acute pancreatitis

Yıl 2020, Cilt: 19 Sayı: 1, 5 - 10, 29.04.2019

Ömer Binicier Zehra Paköz

https://doi.org/10.17941/agd.728662

Öz

Background and Aims: There are many etiologic factors responsible for acute pancreatitis. Carbohydrate antigen 19-9 is a well-known tumor marker for gastrointestinal malignancies, especially pancreaticobiliary cancer. Carbohydrate antigen 19-9 levels also increase benign events such as cholestasis. Therefore, the purpose of this study is to retrospectively investigate the relationship between the underlying etiologies and carbohydrate antigen 19-9 levels in patients who were hospitalized due to acute pancreatitis.
Materials and Methods: We retrospectively analyzed the data of 109 patients who had increased carbohydrate antigen 19-9 levels in the first 24 hours during hospitalization. Additionally, we divided the patients into two groups, namely biliary and nonbiliary, based on their recent diagnoses in the etiologies of acute pancreatitis.
Results: We detected increased carbohydrate antigen 19-9 levels (more than 37 U/mL) in 63 (92%) of the patients in the biliary group, and in 8 (19%) of the patients in the non-biliary group (p <0.001). There was a statistically significant difference between the groups regarding the mean carbohydrate antigen 19-9 values (164.5 vs. 24.1 U/mL, respectively; p <0.005). Also, aspartate aminotransferase, alanine aminotransferase, total bilirubin, and direct bilirubin values were statistically different between the two groups (p <0.05). The receiver operating characteristic curve analysis suggested that the optimum carbohydrate antigen 19-9 level cut-off point for the prediction of pancreatitis caused by biliary reasons was 39.6 U/mL, with a sensitivity and specificity of 92.6% and 85.4%, respectively.
Conclusion: High levels of carbohydrate antigen 19-9 (especially above 39.6 U/mL) in patients with acute pancreatitis may be associated with biliary acute pancreatitis.

Anahtar Kelimeler

Acute pancreatitis, pancreatic diseases, biliary tract diseases, carbohydrate antigen 19-9

Erken akut pankreatitte karbonhidrat antijen 19-9 seviyeleri

Öz

Giriş ve Amaç: Akut pankreatit için birçok etiyolojik faktör bulunmaktadır. Karbonhidrat antijeni 19-9, gastrointestinal malignitelerde, özellikle pankreatikobiliyer kanserde iyi bilinen tümör belirtecidir. Karbonhidrat antijeni 19-9 seviyeleri ayrıca kolestaz gibi iyi huylu hadiselerde de artış gösterir. Bu nedenle akut pankreatit nedeniyle hastanede yatan hastalarda altta yatan etiyolojiler ile karbonhidrat antijeni 19-9 düzeyleri arasındaki ilişkiyi retrospektif olarak araştırmayı amaçladık.
Gereç ve Yöntem: Hastanede yatış sırasında ilk 24 saatte karbonhidrat antijeni 19-9 düzeyi bakılan 109 hastanın verilerini retrospektif olarak inceledik. Hastalar akut pankreatit etiyolojisindeki son tanılarına dayanarak biliyer ve non-biliyer olarak iki gruba ayrıldı.
Bulgular: Biliyer gruptaki hastaların 63'ünde (%92), non-biliyer gruptaki hastaların 8’inde (%19) karbonhidrat antijeni 19-9 düzeyi 37 U/mL'den yüksek saptandı (p <0.001). Gruplar arasında ortalama karbonhidrat antijeni 19-9 değerleri açısından istatistiksel olarak anlamlı fark vardı (164.5'e karşı 24.1; p <0.005). Ayrıca aspartat aminotransferaz, alanin aminotransferaz, total bilirübin ve direkt bilirübin değerleri iki grup arasında istatistiksel olarak farklıydı (p <0.05). Receiver operating characteristic eğri analizinde, biliyer nedenlerden dolayı pankreatitin öngörülmesi için optimum karbonhidrat antijeni 19-9 seviyesi kesme noktasının sırasıyla %92.6 ve %85.4 duyarlılık ve özgüllük ile 39.6 U/mL olduğunu görülmüştür.
Sonuç: Akut pankreatitli hastalarda yüksek karbonhidrat antijeni 19-9 (özellikle 39.6 U/mL'nin üzerinde) düzeyleri, biliyer nedenli akut pankreatitle ilişkili olabilir.

Anahtar Kelimeler

Akut pankreatit, pankreas hastalıkları, safra yolu hastalıkları, karbonhidrat antijeni 19-9

Kaynakça

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