Akut apandisitte Ca125, CA19.9 ve karsinoembriyonik antijen gibi tümör belirteçlerinin rolü

Year 2015, Volume: 25 Issue: 3, 81 - 84, 01.09.2015

Hande Köksal Sevil Kurban

Abstract

Amaç: Bu çalışmada, CA125, CA19.9 ve karsinoembriyonik antijen CEA gibi tümor belirteçlerinin serum değerlerinin akut apandisit AA tanısında herhangi bir değerinin olup olmadığı araştırıldı. Gereç ve yöntem: Akut apandisit tanısı ile ameliyat edilmiş 74 hasta ile 30 sağlıklı kişi bu çalışmaya dahil edildi. Histopatolojik inceleme sonrasında hastalar: akut fokal apandisit AFA , süpüratif, flegmenöz ve gangrenöz apandisiti içeren ilerlemiş akut apandisit AİA ve akut perfore apandisit APA olarak sınıflandırıldı. Tümör belirteçleri için kan örnekleri ameliyat öncesi dönemde alındı. Bulgular: Hastaların ve kontrol grubunun CA125, CA19.9 ve CEA düzeyleri sırasıyla 13,34±9,26 ve 13,33±8,73; 20,15±29,63 ve 12,75±17,6; 1,33±0.97 and 1,12±0,57 idi. Aradaki fark istatistiksel olarak anlamlı değildi. CEA düzeyleri hem hastalarda hem de kontrol grubunda normal sınırlar içerisindeydi. Serum Ca125 düzeyi; 74 hastanın 3’ünde, 30 sağlıklı kişinin 1’inde; serum CA19.9 düzeyi ise hastaların 15’inde, sağlıklı kişilerin 2’sinde yüksekti. Ancak bu aradaki farklar istatistiksel olarak anlamlı değildi. CA125, CA19.9 ve CEA düzeyleri lökosit sayısı, nötrofil oranı, semptomların süresi ve patolojik alt gruplara göre değerlendirildiğinde ise CA 19.9 seviyesi semptom süresi ≤ 24 saat olan hastalarda; > 24 saat olanlara göre ve histopatolojik olarak AFA tanısı alanlarda APA tanısı alanlara göre daha yüksek bulundu. Sonuç: AFA ve semptom süresi ≤ 24 saat olan hastalarda serum CA 19.9 düzeyleri yüksek olmasına karşın, AA tanısında hala hikaye ve fizik muayenenin ana tanı yöntemi olduğu kanısına vardık

Keywords

Akut apandisit, CA 125, CA 19.9, CEA

The role of tumor markers including CA125, CA19.9 and carcinoembriyonic antigen in acute appendicitis

Abstract

Objectives: The aim of this study is to clarify if the tumor markers including CA125, CA 19.9 and carcinoembriyonic antigen CEA concentrations have any role in the diagnosis of acute appendicitis AA . Material and methods: 74 patients with diagnosis of AA and 30 healthy persons were enrolled in this study. The patients were categorized as acute focal appendicitis AFA , acute advanced appendicitis AİA including acute supurative, phlegmonous and gangrenous appendicitis, and acute perforated appendicitis APA according to the results of histopathological examination. Serum samples were obtained during preoperative period. Results: The CA125; CA19.9; and CEA levels of the patients and control group were 13.34±9.26 and 13.33±8.73; 20.15±29.63 and 12.75±17.6; 1.33±0.97 and 1.12±0.57, respectively. These differences between the levels of tumor markers in study and control groups were not significant statistically. CEA levels were in normal limits in both the patients’ and control group. Although serum CA125 levels were high in 3 of 74 patients and 1 of 30 healthy persons and serum CA19.9 levels were high in 15 of the patients and 2 of the healthy per- sons, these differences were not significant. When serum CEA, CA125 and CA19-9 levels of patients were analyzed according to leu- kocyte count, neutrophil rates, duration of symptoms, and pathologic subgroup; the serum CA19.9 levels of the patients with duration of symptoms ≤ 24 hours were higher than the patients with the duration of the symptoms > 24 hours p=0.04 , and the serum CA 19.9 levels of the patients with diagnosis of APA were lower than AFA p=0.02 . Conclusion: We concluded that the history and physical examination of the patient are still the main diagnostic tool in diagnosis of the AA, although high CA 19.9 levels in the patients with AFA and having the duration of symptoms ≤ 24 hours

Keywords

Acute appendicitis, CA 125, CA 19.9, CEA

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