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

Yıl 2015, Cilt: 25 Sayı: 3, 81 - 84, 01.09.2015

Öz

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

Kaynakça

  • Hardin DM Jr. Acute appendicitis: review and update. Am Fam Physician 1999;60:2027-34.
  • Yokoyama S, Takifuji K, Hotta T, et al. C-Reactive protein is an independent surgical indication marker for appendicitis: a retros- pective study. World J Emerg Surg 2009;4:36.
  • Gracey D, McClure MJ. The impact of ultrasound in suspected acute appendicitis. Clin Radiol 2007;62:573-8.
  • Poortman P, Oostvogel HJ, Bosma E, et al. Improving diagnosis of acute appendicitis: results of a diagnostic pathway with standard use of ultrasonography followed by selective use of CT. J Am Coll Surg 2009;208:434-41.
  • van Randen A, Bipat S, Zwinderman AH, Ubbink DT, Stoker J, Boermeester MA. Acute appendicitis: meta-analysis of diagnostic performance of CT and graded compression US related to preva- lence of Disease. Radiology 2008;249:97-106.
  • Miralles C, Orea M, España P, et al. Cancer antigen 125 associated with multiple benign and malignant pathologies. Ann Surg Oncol 2003;10:150-4.
  • Zeillemaker AM, Verbrugh HA, Hoynck van Papendrecht AA, Leguit P. CA 125 secretion by peritoneal mesothelial cells. J Clin Pathol 1994;47:263-5.
  • Basaran A. CA-125 for diagnosis of acute appendicitis: new possi- bility for an old tumor marker. Colorectal Dis 2010;12:155-6.
  • Morris-Stiff G, Teli M, Jardine N, Puntis MC. CA19-9 antigen le- vels can distinguish between benign and malignant pancreaticobi- liary disease. Hepatobiliary Pancreat Dis Int 2009;8:620-6.
  • Perkins GL, Slater ED, Sanders GK, Prichard JG. Serum tumor markers. Am Fam Physician 2003;68:1075-82.
  • Duffy MJ. Tumor markers in clinical practice: a review focusing on common solid cancers. Med Princ Pract 2013;22:4-11.
  • Martin EW Jr, Kibbey WE, DiVecchia L, Anderson G, Catalano P, Minton JP. Carcinoembryonic antigen: clinical and historical as- pects. Cancer 1976;37:62-81.

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

Yıl 2015, Cilt: 25 Sayı: 3, 81 - 84, 01.09.2015

Öz

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

Kaynakça

  • Hardin DM Jr. Acute appendicitis: review and update. Am Fam Physician 1999;60:2027-34.
  • Yokoyama S, Takifuji K, Hotta T, et al. C-Reactive protein is an independent surgical indication marker for appendicitis: a retros- pective study. World J Emerg Surg 2009;4:36.
  • Gracey D, McClure MJ. The impact of ultrasound in suspected acute appendicitis. Clin Radiol 2007;62:573-8.
  • Poortman P, Oostvogel HJ, Bosma E, et al. Improving diagnosis of acute appendicitis: results of a diagnostic pathway with standard use of ultrasonography followed by selective use of CT. J Am Coll Surg 2009;208:434-41.
  • van Randen A, Bipat S, Zwinderman AH, Ubbink DT, Stoker J, Boermeester MA. Acute appendicitis: meta-analysis of diagnostic performance of CT and graded compression US related to preva- lence of Disease. Radiology 2008;249:97-106.
  • Miralles C, Orea M, España P, et al. Cancer antigen 125 associated with multiple benign and malignant pathologies. Ann Surg Oncol 2003;10:150-4.
  • Zeillemaker AM, Verbrugh HA, Hoynck van Papendrecht AA, Leguit P. CA 125 secretion by peritoneal mesothelial cells. J Clin Pathol 1994;47:263-5.
  • Basaran A. CA-125 for diagnosis of acute appendicitis: new possi- bility for an old tumor marker. Colorectal Dis 2010;12:155-6.
  • Morris-Stiff G, Teli M, Jardine N, Puntis MC. CA19-9 antigen le- vels can distinguish between benign and malignant pancreaticobi- liary disease. Hepatobiliary Pancreat Dis Int 2009;8:620-6.
  • Perkins GL, Slater ED, Sanders GK, Prichard JG. Serum tumor markers. Am Fam Physician 2003;68:1075-82.
  • Duffy MJ. Tumor markers in clinical practice: a review focusing on common solid cancers. Med Princ Pract 2013;22:4-11.
  • Martin EW Jr, Kibbey WE, DiVecchia L, Anderson G, Catalano P, Minton JP. Carcinoembryonic antigen: clinical and historical as- pects. Cancer 1976;37:62-81.
Toplam 12 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Original Article
Yazarlar

Hande Köksal Bu kişi benim

Sevil Kurban Bu kişi benim

Yayımlanma Tarihi 1 Eylül 2015
Yayımlandığı Sayı Yıl 2015 Cilt: 25 Sayı: 3

Kaynak Göster

Vancouver Köksal H, Kurban S. Akut apandisitte Ca125, CA19.9 ve karsinoembriyonik antijen gibi tümör belirteçlerinin rolü. Genel Tıp Derg. 2015;25(3):81-4.