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Marinescu MC, Oprea VD, Munteanu SN, Nechita A, Tutunaru D, Nechita LC, Romila A. Carbohydrate Antigen 125 ( CA 125): A Novel Biomarker in Acute Heart Failure. Diagnostics (Basel) 2024; 14:795. [PMID: 38667440 PMCID: PMC11048787 DOI: 10.3390/diagnostics14080795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 04/02/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Heart failure is a global major healthcare problem with millions of hospitalizations annually and with a very high mortality. There is an increased interest in finding new and reliable biomarkers for the diagnostic, prognostic and therapeutic guidance of patients hospitalized for acute heart failure; Our review aims to summarize in an easy-to-follow flow recent relevant research evaluating the possible use and the clinical value of measuring CA 125 serum levels in acute HF. METHODS A thorough search in the main international databases identified a relevant pool of 170 articles, providing recently published data for this narrative review that used PRISMA guidelines. RESULTS There are data to sustain the role of carbohydrate antigen 125 (CA 125), a worldwide used marker of ovarian cancer, in patients with heart failure. Several studies have shown links between CA 125 levels and congestion seen in acute heart failure, high mortality and readmission rates at 6 months follow-up after discharge from acute heart failure and also a role of CA 125 in the guidance of heart failure therapy. There are also clinical trials that showed that several particularities of CA 125 make it even better than N-terminal pro b-type natriuretic peptide (NT-pro BNP)-a classical and more utilized marker of heart failure) in several scenarios of acute heart failure. CONCLUSIONS Although the mechanism behind the upregulation of serum CA 125 in patients with congestive HF has not been confirmed nor fully understood.
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Affiliation(s)
- Mihai Cristian Marinescu
- Faculty of Medicine and Pharmacy, “Dunărea de Jos” University in Galați, 800216 Galați, Romania; (S.N.M.); (A.N.); (D.T.); (L.C.N.); (A.R.)
- St. Apostle Andrei Clinical Emergency County Hospital, 800578 Galați, Romania
| | - Violeta Diana Oprea
- Faculty of Medicine and Pharmacy, “Dunărea de Jos” University in Galați, 800216 Galați, Romania; (S.N.M.); (A.N.); (D.T.); (L.C.N.); (A.R.)
- St. Apostle Andrei Clinical Emergency County Hospital, 800578 Galați, Romania
| | - Sorina Nicoleta Munteanu
- Faculty of Medicine and Pharmacy, “Dunărea de Jos” University in Galați, 800216 Galați, Romania; (S.N.M.); (A.N.); (D.T.); (L.C.N.); (A.R.)
- St. Apostle Andrei Clinical Emergency County Hospital, 800578 Galați, Romania
| | - Aurel Nechita
- Faculty of Medicine and Pharmacy, “Dunărea de Jos” University in Galați, 800216 Galați, Romania; (S.N.M.); (A.N.); (D.T.); (L.C.N.); (A.R.)
- St. Ioan Emergency Clinical Hospital for Children, 800487 Galați, Romania
| | - Dana Tutunaru
- Faculty of Medicine and Pharmacy, “Dunărea de Jos” University in Galați, 800216 Galați, Romania; (S.N.M.); (A.N.); (D.T.); (L.C.N.); (A.R.)
- St. Apostle Andrei Clinical Emergency County Hospital, 800578 Galați, Romania
| | - Luiza Camelia Nechita
- Faculty of Medicine and Pharmacy, “Dunărea de Jos” University in Galați, 800216 Galați, Romania; (S.N.M.); (A.N.); (D.T.); (L.C.N.); (A.R.)
- St. Apostle Andrei Clinical Emergency County Hospital, 800578 Galați, Romania
| | - Aurelia Romila
- Faculty of Medicine and Pharmacy, “Dunărea de Jos” University in Galați, 800216 Galați, Romania; (S.N.M.); (A.N.); (D.T.); (L.C.N.); (A.R.)
- St. Apostle Andrei Clinical Emergency County Hospital, 800578 Galați, Romania
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Dominoni M, Pasquali MF, Musacchi V, De Silvestri A, Mauri M, Ferretti VV, Gardella B. Neutrophil to lymphocytes ratio in deep infiltrating endometriosis as a new toll for clinical management. Sci Rep 2024; 14:7575. [PMID: 38555302 PMCID: PMC10981721 DOI: 10.1038/s41598-024-58115-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 03/25/2024] [Indexed: 04/02/2024] Open
Abstract
Several mechanisms, including altered local and systemic immune system, apoptosis, and new angiogenesis, are responsible for the development and progression of endometriosis. Over the years many markers have been studied, like CA 125 and, recently, neutrophil-to-lymphocyte ratio (NLR). This tool is cost-effectiveness and non-invasiveness as a marker of systemic inflammatory diseases. The aim of this study is to assess the role of NLR in the real-life management of patients with endometriosis in order to evaluate the possible association between this value and symptoms. We performed a retrospective analysis of 199 premenopausal women affected by endometriosis, from January 2013 to December 2020, evaluating the characteristics of disease, the symptoms and the NLR. Analyzing the neutrophiles, the mean ± SD value was 6.1 ± 4.5 × 103/ul, while for lymphocytes mean ± SD value was 1.8 ± 0.7.NLR was categorized according to its median value (> 2.62 vs ≤ 2.62). The comparison between NLR values and CA 125, endometriosis stage, dysmenorrhea and presence of chronic pelvic pain, adjusting for previous therapy did not find a significant association. An interesting result, although not significant, was the association between NLR and chronic pelvic pain (OR = 1.9). In the sub-group of patients without previous therapy this association is even stronger (OR = 4.8, 95% CI 0.5-50.2, p = 0.190). The link between NLR and chronic pelvic pain can provide a further hint to the clinician even when taking symptoms into account to develop a particular therapeutic treatment related to the various expressions of NLR. Finally, NLR may enable the creation of customized follow-up protocols that divide patients into high- and low-risk categories for endometriosis recurrence.
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Affiliation(s)
- Mattia Dominoni
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100, Pavia, Italy.
- Department of Obstetrics and Gynecology, IRCCS Fondazione Policlinico San Matteo, 27100, Pavia, Italy.
| | - Marianna Francesca Pasquali
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100, Pavia, Italy
- Department of Obstetrics and Gynecology, IRCCS Fondazione Policlinico San Matteo, 27100, Pavia, Italy
| | - Valentina Musacchi
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100, Pavia, Italy
- Department of Obstetrics and Gynecology, IRCCS Fondazione Policlinico San Matteo, 27100, Pavia, Italy
| | - Annalisa De Silvestri
- SSD Biostatistica e Clinical Trial Center, IRCCS Fondazione Policlinico San Matteo, 27100, Pavia, Italy
| | - Matteo Mauri
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100, Pavia, Italy
- Department of Obstetrics and Gynecology, IRCCS Fondazione Policlinico San Matteo, 27100, Pavia, Italy
| | - Virginia Valeria Ferretti
- SSD Biostatistica e Clinical Trial Center, IRCCS Fondazione Policlinico San Matteo, 27100, Pavia, Italy
| | - Barbara Gardella
- Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100, Pavia, Italy
- Department of Obstetrics and Gynecology, IRCCS Fondazione Policlinico San Matteo, 27100, Pavia, Italy
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Nagarkar R, Gopichand M, Pal SK, Gupta A, Saquib NM, Sagar G, Rao KVS, Siddiqui Z, Longkumer I. The High Sensitivity of the Multi-Cancer Detection Test ONCOVERYX-F Offers a Promising Platform for Ovarian Cancer Screening. Int J Womens Health 2024; 16:1-7. [PMID: 38193139 PMCID: PMC10771777 DOI: 10.2147/ijwh.s444258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/28/2023] [Indexed: 01/10/2024] Open
Abstract
We evaluated the potential relevance of our multi-cancer detection test, OncoVeryx-F, for ovarian cancer screening. For this, we compared its accuracy with that of CA125-based screening. We demonstrate here that, in contrast to CA125-based detection, OncoVeryx-F detected ovarian cancer with very high sensitivity and specificity. Importantly here, Stage I cancers too could be detected with an accuracy of >98%. Furthermore, again unlike CA 125, the detection accuracy of OncoVeryx-F remained comparable in both Caucasian and South Asian/Indian women. Thus, the robustness and accuracy of OncoVeryx-F, particularly for early-stage detection, underscores its potential utility for ovarian cancer screening.
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Affiliation(s)
- Rajnish Nagarkar
- Surgical Oncology, HCG Manavta Cancer Centre, Nashik, Maharashtra, India
| | | | | | - Ankur Gupta
- Research and Development Section, PredOmix Technologies Private Limited, Gurugram, India
- Research and Development Section, PredOmix Health Sciences Private Limited, Singapore
| | - Najmuddin Mohd Saquib
- Research and Development Section, PredOmix Technologies Private Limited, Gurugram, India
- Research and Development Section, PredOmix Health Sciences Private Limited, Singapore
| | - Ganga Sagar
- Research and Development Section, PredOmix Technologies Private Limited, Gurugram, India
| | - Kanury V S Rao
- Research and Development Section, PredOmix Technologies Private Limited, Gurugram, India
- Research and Development Section, PredOmix Health Sciences Private Limited, Singapore
| | - Zaved Siddiqui
- Research and Development Section, PredOmix Technologies Private Limited, Gurugram, India
- Research and Development Section, PredOmix Health Sciences Private Limited, Singapore
| | - Imliwati Longkumer
- Biochemistry, North East Cancer Hospital and Research Institute, Guwahati, Assam, India
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Muley T, Schneider MA, Meister M, Thomas M, Heußel CP, Kriegsmann M, Holdenrieder S, Wehnl B, Rolny V, Mang A, Gerber R, Herth F. CYFRA 21-1, CA 125 and CEA provide additional prognostic value in NSCLC patients with stable disease at first CT scan. Tumour Biol 2024; 46:S163-S175. [PMID: 37840516 DOI: 10.3233/tub-220042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023] Open
Abstract
BACKGROUND Serum tumor markers (STM) may complement imaging and provide additional clinical information for patients with non-small cell lung cancer (NSCLC). OBJECTIVE To determine whether STMs can predict outcomes in patients with stable disease (SD) after initial treatment. METHODS This single-center, prospective, observational trial enrolled 395 patients with stage III/IV treatment-naïve NSCLC; of which 263 patients were included in this analysis. Computed Tomography (CT) scans were performed and STMs measured before and after initial treatment (two cycles of chemotherapy and/or an immune checkpoint inhibitor or tyrosine kinase inhibitor); analyses were based on CT and STM measurements obtained at first CT performed after cycle 2 only PFS and OS were analyzed by Kaplan-Meier curves and Cox-proportional hazard models. RESULTS When patients with SD (n = 100) were split into high- and low-risk groups based on CYFRA 21-1, CEA and CA 125 measurements using an optimized cut-off, a 4-fold increase risk of progression or death was estimated for high- vs low-risk SD patients (PFS, HR 4.17; OS, 3.99; both p < 0.0001). Outcomes were similar between patients with high-risk SD or progressive disease (n = 35) (OS, HR 1.17) and between patients with low-risk SD or partial response (n = 128) (PFS, HR 0.98; OS, 1.14). CONCLUSIONS STMs can provide further guidance in patients with indeterminate CT responses by separating them into high- and low-risk groups for future PFS and OS events.
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Affiliation(s)
- Thomas Muley
- Translational Research Unit, Thoraxklinik, University Hospital, Heidelberg, Germany
- Translational Lung Research Center, German Center for Lung Research (DZL), Heidelberg, Germany
| | - Mark A Schneider
- Translational Research Unit, Thoraxklinik, University Hospital, Heidelberg, Germany
- Translational Lung Research Center, German Center for Lung Research (DZL), Heidelberg, Germany
| | - Michael Meister
- Translational Research Unit, Thoraxklinik, University Hospital, Heidelberg, Germany
- Translational Lung Research Center, German Center for Lung Research (DZL), Heidelberg, Germany
| | - Michael Thomas
- Translational Lung Research Center, German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Oncology, Thoraxklinik, University Hospital, Heidelberg, Germany
| | - Claus Peter Heußel
- Translational Lung Research Center, German Center for Lung Research (DZL), Heidelberg, Germany
- Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik, University Hospital, Heidelberg, Germany
- Diagnostic and Interventional Radiology, University Hospital, Heidelberg, Germany
| | - Mark Kriegsmann
- Department of Pathology, Institute of Pathology, University Hospital, Heidelberg, Germany
| | - Stefan Holdenrieder
- Department of Laboratory Medicine, Deutsches Herzzentrum München, Munich, Germany
| | | | | | - Anika Mang
- Roche Diagnostics GmbH, Penzberg, Germany
| | | | - Felix Herth
- Translational Lung Research Center, German Center for Lung Research (DZL), Heidelberg, Germany
- Department of Pulmonology and Critical Care, Thoraxklinik, University Hospital, Heidelberg, Germany
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Trulson I, Klawonn F, von Pawel J, Holdenrieder S. Improvement of differential diagnosis of lung cancer by use of multiple protein tumor marker combinations. Tumour Biol 2024; 46:S81-S98. [PMID: 38277317 DOI: 10.3233/tub-230021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND Differential diagnosis of non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) in hospitalized patients is crucial for appropriate treatment choice. OBJECTIVE To investigate the relevance of serum tumor markers (STMs) and their combinations for the differentiation of NSCLC and SCLC subtypes. METHODS Between 2000 and 2003, 10 established STMs were assessed retrospectively in 311 patients with NSCLC, 128 with SCLC prior systemic first-line therapy and 51 controls with benign lung diseases (BLD), by automatized electrochemiluminescence immunoassay technology. Receiver operating characteristic (ROC) curves and logistic regression analyses were used to evaluate the diagnostic efficacy of both individual and multiple STMs with corresponding sensitivities at 90% specificity. Standards for Reporting of Diagnostic Accuracy (STARD guidelines) were followed. RESULTS CYFRA 21-1 (cytokeratin-19 fragment), CEA (carcinoembryonic antigen) and NSE (neuron specific enolase) were significantly higher in all lung cancers vs BLD, reaching AUCs of 0.81 (95% CI 0.76-0.87), 0.78 (0.73-0.84), and 0.88 (0.84-0.93), respectively. By the three marker combination, the discrimination between benign and all malignant cases was improved resulting in an AUC of 0.93 (95% CI 0.90-0.96). In NSCLC vs. BLD, CYFRA 21-1, CEA and NSE were best discriminative STMs, with AUCs of 0.86 (95% CI 0.81-0.91), 0.80 (0.74-0.85), and 0.85 (0.79-0.91). The three marker combination also improved the AUC: 0.92; 95% CI 0.89-0.96). In SCLC vs. BLD, ProGRP (pro-gastrin-releasing peptide) and NSE were best discriminative STMs, with AUCs of 0.89 (95% CI 0.84-0.94) and 0.96 (0.93-0.98), respectively, and slightly improved AUC of 0.97 (95% CI 0.95-0.99) when in combination. Finally, discrimination between SCLC and NSCLC was possible by ProGRP (AUC 0.86; 95% CI 0.81-0.91), NSE (AUC 0.83; 0.78-0.88) and CYFRA 21-1 (AUC 0.69; 0.64-0.75) and by the combination of the 3 STMs (AUC 0.93; 0.91-0.96), with a sensitivity of 88% at 90% specificity. CONCLUSIONS The results confirm the power of STM combinations for the differential diagnosis of lung cancer from benign lesions and between histological lung cancer subtypes.
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Affiliation(s)
- Inga Trulson
- Munich Biomarker Research Center, Institute of Laboratory Medicine, German Heart Centre Munich, Munich, Germany
| | - Frank Klawonn
- Ostfalia University, Department of Computer Science, Wolfenbüttel, Germany
- Helmholtz Centre for Infection Research, Biostatistics, Braunschweig, Germany
| | | | - Stefan Holdenrieder
- Munich Biomarker Research Center, Institute of Laboratory Medicine, German Heart Centre Munich, Munich, Germany
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Muzykiewicz KP, Iwanska E, Pniewska KW, Janeczek M, Nowak-Jastrzab M, Kalamacki A, Karolewski K, Blecharz P. The prognostic value of the post-treatment serum CA 125 level in patients with advanced endometrial cancer. Ginekol Pol 2023:VM/OJS/J/96205. [PMID: 38126890 DOI: 10.5603/gpl.96205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 09/24/2023] [Accepted: 11/23/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVES The goal of this analysis was to assess the prognostic value of the post-treatment serum CA 125 level in each member of a group of advanced endometrial cancer (aEC) patients in comparison to other clinical and pathological parameters. MATERIAL AND METHODS Records of 266 patients treated at the Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Cracow Branch between the years 2006 and 2018 were included in the study. Follow-up ranged from 1 to 138 months. Progression free survival (PFS) and overall survival (OS) were set as the endpoints. The tests chi-squared, Fisher, log-rank, Mann-Whitney, Kruskal-Wallis and Cox proportional hazard ratio were used for statistical analyses. RESULTS In the analysed group, there was a significant association between an elevated serum CA 125 level following adjuvant treatment and shorter PFS and OS. After setting a cut-off value for CA 125 there was a statistically significant correlation between the marker and PFS and OS. Multivariate analysis indicated that the post-treatment serum CA 125 level is an independent prognostic factor of the course of aEC. CONCLUSIONS The post-treatment serum CA 125 level correlates significantly with both PFS and OS in each patient with aEC. The marker is an independent prognostic factor in this group. A low post-treatment level of the marker is a strong indicator of good 5-year survival, with 82% of patients reaching 5-year OS.
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Affiliation(s)
- Konrad P Muzykiewicz
- Department of Gynecologic Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Branch in Cracow, Poland, Poland.
| | - Ewa Iwanska
- Department of Gynecologic Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Branch in Cracow, Poland, Poland
| | - Karolina W Pniewska
- Department of Gynecologic Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Branch in Cracow, Poland, Poland
| | - Maja Janeczek
- Department of Gynecologic Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Branch in Cracow, Poland, Poland
| | - Malgorzata Nowak-Jastrzab
- Department of Gynecologic Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Branch in Cracow, Poland, Poland
| | - Andrzej Kalamacki
- Department of Gynecologic Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Branch in Cracow, Poland, Poland
| | - Kazimierz Karolewski
- Department of Gynecologic Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Branch in Cracow, Poland, Poland
| | - Pawel Blecharz
- Department of Gynecologic Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Branch in Cracow, Poland, Poland
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Schröder L, Domroese CM, Rupp ABA, Gihr KME, Niederau C, Mallmann MR, Holdenrieder S. Clinical Applicability of Tissue Polypeptide Antigen and CA-125 in Gynecological Malignancies. Biomedicines 2023; 11:2960. [PMID: 38001961 PMCID: PMC10669758 DOI: 10.3390/biomedicines11112960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 10/26/2023] [Accepted: 10/30/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Nowadays there still is no sufficient screening tool for ovarian and uterine cancer. OBJECTIVE The current study aimed to investigate whether cancer antigen 125 (CA-125), tissue polypeptide antigen (TPA) or the combination of both markers are able to act as screening tools for ovarian or uterine cancer. METHODS A total of 275 blood samples from different cohorts (ovarian cancer, uterine cancer, benign control group) were prospectively drawn and analyzed. RESULTS Established biomarkers TPA and CA-125 showed elevated serum concentrations in patients with malignant tumors as compared to healthy women and women with benign diseases. In ROC curve analyses, both biomarkers were well able to discriminate between malignant and healthy, benign or overall non-malignant cases in the whole sample, with AUCs of 0.842 and above. While TPA was the best diagnostic marker in patients with uterine cancer, CA 125 was the best in patients with ovarian cancer. CONCLUSIONS TPA and CA-125 both showed promising results for the detection of gynecologic malignancies. The combination of CA-125 and TPA did not improve sensitivity in comparison to single markers.
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Affiliation(s)
- Lars Schröder
- Department of Obstetrics and Gynecology, Medical Faculty, University Hospital Cologne, University of Cologne, 50937 Cologne, Germany;
- Department of Obstetrics and Gynecology, Ketteler Hospital, 63071 Offenbach, Germany
| | - Christian M. Domroese
- Department of Obstetrics and Gynecology, Ketteler Hospital, 63071 Offenbach, Germany
| | - Alexander B. A. Rupp
- Institute of Clinical Chemistry and Clinical Pharmacology, University Hospital Bonn, 53127 Bonn, Germany
- Munich Biomarker Research Center, Institute of Laboratory Medicine, German Heart Center Munich, Technical University Munich, Lazarettstraße 36, 80636 Munich, Germany
| | - Kathrin M. E. Gihr
- Institute of Clinical Chemistry and Clinical Pharmacology, University Hospital Bonn, 53127 Bonn, Germany
| | | | - Michael R. Mallmann
- Department of Obstetrics and Gynecology, Ketteler Hospital, 63071 Offenbach, Germany
| | - Stefan Holdenrieder
- Institute of Clinical Chemistry and Clinical Pharmacology, University Hospital Bonn, 53127 Bonn, Germany
- Munich Biomarker Research Center, Institute of Laboratory Medicine, German Heart Center Munich, Technical University Munich, Lazarettstraße 36, 80636 Munich, Germany
- CEBIO GmbH—Center for Evaluation of Biomarkers, 81679 Munich, Germany
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Schröder L, Mallmann MR, Domroese CM, Wefers N, Dolscheid-Pommerich R, Stoffel-Wagner B, Trulson I, Vahldiek K, Klawonn F, Holdenrieder S. Method Comparison and Clinical Performance of Breast Cancer Tumor Markers on Novel Multiplex Immunoassay and Automatized LOCI Technology Platforms. Diagnostics (Basel) 2023; 13:3101. [PMID: 37835844 PMCID: PMC10572608 DOI: 10.3390/diagnostics13193101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/24/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023] Open
Abstract
Tumor marker determinations are valuable tools for the guidance of breast cancer patients during the course of disease. They are assessed on diverse analytical platforms that may be associated with differences according to the methods applied and the clinical performance. To investigate the method dependency and clinical significance of breast cancer protein tumor markers, CEA, CA 15-3, CA 125, CA 19-9 and AFP were measured in a total of 154 biobanked samples from 77 patients with breast cancer, 10 with DCIS, 31 with benign breast diseases and 36 healthy controls using a Millipore multiplex biomarker panel (MP) and an automized version of the routinely used Vista LOCI technology. The markers were compared between methods and investigated for diagnostic performance. CEA, CA 15-3 and AFP showed good correlations between both platforms with correlation coefficients of R = 0.85, 0.85 and 0.92, respectively, in all samples, but similarly also in the various subgroups. CA 125 and CA 19-9 showed only moderate correlations (R = 0.71 and 0.56, respectively). Absolute values were significantly higher for CEA, CA 15-3, CA 125 and AFP in the Vista LOCI as compared with the MP method and vice versa for CA 19-9. The diagnostic performance for discrimination of breast cancer from healthy controls was similar for both methods with AUCs in ROC curves for CEA (MP 0.81, 95% CI 0.72-0.91; LOCI 0.81; 95% CI 0.72-0.91) and CA-15-3 (MP 0.75, 95% CI 0.65-0.86; LOCI 0.67, 95% CI 0.54-0.79). Similar results were obtained for the comparison of breast cancer with benign breast diseases regarding CEA (AUC MP 0.62, 95% CI 0.51-0.73; LOCI 0.64, 95% CI 0.53-0.74) and CA-15-3 (MP 0.70, 95% CI 0.6-0.81; LOCI 0.66, 95% CI 0.54-0.77). Both platforms show moderate to good method comparability for tumor markers with similar clinical performance. However, absolute levels in individual patients should be interpreted with care.
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Affiliation(s)
- Lars Schröder
- Department of Gynecology, Ketteler-Hospital Offenbach, 63071 Offenbach, Germany
- Department of Gynecology, University Hospital Bonn, 53127 Bonn, Germany
- Department of Obstetrics and Gynecology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
| | - Michael R Mallmann
- Department of Gynecology, University Hospital Bonn, 53127 Bonn, Germany
- Department of Obstetrics and Gynecology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
| | - Christian M Domroese
- Department of Gynecology, University Hospital Bonn, 53127 Bonn, Germany
- Department of Obstetrics and Gynecology, Faculty of Medicine and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
| | - Natalie Wefers
- Institute of Clinical Chemistry and Clinical Pharmacology, University Hospital Bonn, 53127 Bonn, Germany
| | - Ramona Dolscheid-Pommerich
- Institute of Clinical Chemistry and Clinical Pharmacology, University Hospital Bonn, 53127 Bonn, Germany
| | - Birgit Stoffel-Wagner
- Institute of Clinical Chemistry and Clinical Pharmacology, University Hospital Bonn, 53127 Bonn, Germany
| | - Inga Trulson
- Munich Biomarker Research Center, Institute of Laboratory Medicine, German Heart Center, Technical University Munich, 80636 Munich, Germany
| | - Kai Vahldiek
- Department of Computer Science, Ostfalia University, 38302 Wolfenbüttel, Germany
| | - Frank Klawonn
- Munich Biomarker Research Center, Institute of Laboratory Medicine, German Heart Center, Technical University Munich, 80636 Munich, Germany
- Department of Computer Science, Ostfalia University, 38302 Wolfenbüttel, Germany
- Helmholtz Centre for Infection Research, Biostatistics, 38124 Braunschweig, Germany
| | - Stefan Holdenrieder
- Institute of Clinical Chemistry and Clinical Pharmacology, University Hospital Bonn, 53127 Bonn, Germany
- Munich Biomarker Research Center, Institute of Laboratory Medicine, German Heart Center, Technical University Munich, 80636 Munich, Germany
- Center for the Evaluation of Biomarkers, 81679 Munich, Germany
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Bratei AA, Stefan-van Staden RI, Ilie-Mihai RM, Gheorghe DC. Simultaneous Assay of CA 72-4, CA 19-9, CEA and CA 125 in Biological Samples Using Needle Three-Dimensional Stochastic Microsensors. Sensors (Basel) 2023; 23:8046. [PMID: 37836876 PMCID: PMC10575467 DOI: 10.3390/s23198046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/12/2023] [Accepted: 09/21/2023] [Indexed: 10/15/2023]
Abstract
Two-needle 3D stochastic microsensors based on boron- and nitrogen-decorated gra-phenes, modified with N-(2-mercapto-1H-benzo[d]imidazole-5-yl), were designed and used for the molecular recognition and quantification of CA 72-4, CA 19-9, CEA and CA 125 biomarkers in biological samples such as whole blood, urine, saliva and tumoral tissue. The NBGr-2 sensor yielded lower limits of determination. For CEA, the LOD was 4.10 × 10-15 s-1 g-1 mL, while for CA72-4, the LOD was 4.00 × 10-11 s-1 U-1 mL. When the NBGr-1 sensor was employed, the best results were obtained for CA12-5 and CA19-9, with values of LODs of 8.37 × 10-14 s-1 U-1 mL and 2.09 × 10-13 s-1 U-1 mL, respectively. High sensitivities were obtained when both sensors were employed. Broad linear concentration ranges favored their determination from very low to higher concentrations in biological samples, ranging from 8.37 × 10-14 to 8.37 × 103 s-1 U-1 mL for CA12-5 when using the NBGr-1 sensor, and from 4.10 × 10-15 to 2.00 × 10-7 s-1 g-1 mL for CEA when using the NBGr-2 sensor. Student's t-test showed that there was no significant difference between the results obtained utilizing the two microsensors for the screening tests, at a 99% confidence level, with the results obtained being lower than the tabulated values.
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Affiliation(s)
- Alexandru-Adrian Bratei
- Laboratory of Electrochemistry and PATLAB, National Institute of Research for Electrochemistry and Condensed Matter, 202 Splaiul Independentei Str., 060021 Bucharest, Romania; (A.-A.B.); (R.-M.I.-M.); (D.-C.G.)
- Faculty of Chemical Engineering and Biotechnologies, National University of Science & Technology Politehnica Bucharest, 060021 Bucharest, Romania
- Department of Pathology, Emergency University Hospital, 050098 Bucharest, Romania
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, 540139 Targu Mures, Romania
| | - Raluca-Ioana Stefan-van Staden
- Laboratory of Electrochemistry and PATLAB, National Institute of Research for Electrochemistry and Condensed Matter, 202 Splaiul Independentei Str., 060021 Bucharest, Romania; (A.-A.B.); (R.-M.I.-M.); (D.-C.G.)
- Faculty of Chemical Engineering and Biotechnologies, National University of Science & Technology Politehnica Bucharest, 060021 Bucharest, Romania
| | - Ruxandra-Maria Ilie-Mihai
- Laboratory of Electrochemistry and PATLAB, National Institute of Research for Electrochemistry and Condensed Matter, 202 Splaiul Independentei Str., 060021 Bucharest, Romania; (A.-A.B.); (R.-M.I.-M.); (D.-C.G.)
| | - Damaris-Cristina Gheorghe
- Laboratory of Electrochemistry and PATLAB, National Institute of Research for Electrochemistry and Condensed Matter, 202 Splaiul Independentei Str., 060021 Bucharest, Romania; (A.-A.B.); (R.-M.I.-M.); (D.-C.G.)
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Osredkar J, Jagarlamudi KK, Cviič D, Škof E, Cvjetićanin B, Zore A, Lukanović D, Eriksson S, Meglič L. Clinical Significance of the TK1-Specific Activity in the Early Detection of Ovarian Cancer. Oncology 2023; 102:17-29. [PMID: 37673047 DOI: 10.1159/000533428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 07/07/2023] [Indexed: 09/08/2023]
Abstract
INTRODUCTION Ovarian cancer is the eighth most common cause of cancer death in women. One of the major concerns is almost two-thirds of cases are typically diagnosed in the late stage as the symptoms are unspecific in the early stage of ovarian cancer. It is known that the combination of TK1 protein with CA 125 or HE4 showed better performance than either of them alone. That is why, the aim of the study was to investigate whether the TK1-specific activity (TK1 SA) could function as a complement marker for early-stage diagnosis of ovarian cancer. METHODS The study included a set of 198 sera consisting of 134 patients with ovarian tumors (72 benign and 62 malignant) and 64 healthy age-matched controls. The TK1 SA was determined using TK1 activity by TK-Liaison and TK1 protein by AroCell TK 210 ELISA. Further, CA 125, HE4, as well as risk of ovarian malignancy algorithm index were also determined in the same set of clinical samples. RESULTS The TK1 SA was significantly different between healthy compared to ovarian cancer patients (p < 0.0001). Strikingly, TK1 SA has higher sensitivity (55%) compared to other biomarkers in the detection of benign ovarian tumors. Further, the highest sensitivity was achieved by the combination of TK1 SA with CA 125 and HE4 for the detection of benign tumors as well as malignant ovarian tumors (72.2% and 88.7%). In addition, TK1 SA could significantly differentiate FIGO stage I/II from stage III/IV malignancies (p = 0.026). Follow-up of patients after surgery and chemotherapy showed a significant difference compared to TK1 SA at the time of diagnosis. CONCLUSIONS These results indicate that TK1 SA is a promising blood-based biomarker that could complement CA 125 and HE4 for the detection of early stages of ovarian cancer.
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Affiliation(s)
- Joško Osredkar
- Institute of Clinical Chemistry and Biochemistry, University Medical Centre Ljubljana, Ljubljana, Slovenia
- University of Ljubljana, Faculty of Pharmacy, Ljubljana, Slovenia
| | - Kiran Kumar Jagarlamudi
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Science, Uppsala, Sweden
- Research and Development Division, AroCell AB, Stockholm, Sweden
| | - Diana Cviič
- Institute of Clinical Chemistry and Biochemistry, University Medical Centre Ljubljana, Ljubljana, Slovenia
- University of Ljubljana, Faculty of Pharmacy, Ljubljana, Slovenia
| | - Erik Škof
- Institute of Oncology, Ljubljana, Slovenia
- University Ljubljana, Medical Faculty, Ljubljana, Slovenia
| | - Branko Cvjetićanin
- Division of Gynecology, Department of Gynecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Andrej Zore
- Division of Gynecology, Department of Gynecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - David Lukanović
- Division of Gynecology, Department of Gynecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Staffan Eriksson
- Department of Anatomy, Physiology and Biochemistry, Swedish University of Agricultural Science, Uppsala, Sweden
- Research and Development Division, AroCell AB, Stockholm, Sweden
| | - Leon Meglič
- University Ljubljana, Medical Faculty, Ljubljana, Slovenia
- Division of Gynecology, Department of Gynecology, University Medical Centre Ljubljana, Ljubljana, Slovenia
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Napoli N, Kauffmann EF, Ginesini M, Lami L, Lombardo C, Vistoli F, Campani D, Boggi U. Ca 125 is an independent prognostic marker in resected pancreatic cancer of the head of the pancreas. Updates Surg 2023; 75:1481-1496. [PMID: 37535191 PMCID: PMC10435596 DOI: 10.1007/s13304-023-01587-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 07/05/2023] [Indexed: 08/04/2023]
Abstract
The prognostic value of carbohydrate antigen 125 (Ca 125) is emerging also in pancreatic cancer (PDAC). In this study, we aim to define the prognostic value of Ca 125 in resected PDAC of the head of the pancreas. This is a single-center, retrospective study. Data from patients with a pre-operative assay of Ca 125 who underwent a pancreatic resection for PDAC between 2010 and 2018 were analyzed. As per National Comprehensive Cancer Guidelines, tumors were classified in resectable (R-PDAC), borderline resectable (BR-PDAC), and locally advanced (LA-PDAC). The Kaplan-Meier method was used to evaluate the overall survival. Cox proportional hazard regression was used to evaluate the role of pre-operative Ca 125 in predicting survival (while adjusting for confounders). The maximally selected log-rank statistic was used to identify a Ca 125 cut-off defining two groups with different survival probability. Inclusion criteria were met by 207 patients (R-PDAC: 80, BR-PDAC: 91, and LA-PDAC: 36). Ca 125 predicted overall survival before and after adjusting for confounding factors in all categories of anatomic resectability (R-PDAC: HR = 4.3; p = 0.0249) (BR-PDAC: HR = 7.82; p = 0.0024) (LA-PDAC: HR = 11.4; p = 0.0043). In BR-PDAC and LA-PDAC (n = 127), the division in two groups (high vs. low Ca 125) correlated with T stage (p = 0.0317), N stage (p = 0.0083), mean LN ratio (p = 0.0292), and tumor grading (p = 0.0143). This study confirmed the prognostic value of Ca125 in resected pancreatic cancer and, therefore, the importance of biologic over anatomic resectability. Ca 125 should be routinely assayed in surgical candidates with PDAC.
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Affiliation(s)
- Niccolò Napoli
- Division of General and Transplant Surgery, University of Pisa, Pisa, Italy.
| | | | - Michael Ginesini
- Division of General and Transplant Surgery, University of Pisa, Pisa, Italy
| | - Lucrezia Lami
- Division of General and Transplant Surgery, University of Pisa, Pisa, Italy
| | - Carlo Lombardo
- Division of General and Transplant Surgery, University of Pisa, Pisa, Italy
| | - Fabio Vistoli
- Division of General and Transplant Surgery, University of Pisa, Pisa, Italy
| | | | - Ugo Boggi
- Division of General and Transplant Surgery, University of Pisa, Pisa, Italy
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Keum J, Lee WM, Choi JS, Bae J, Cho S, Kang BK. Diagnostic Clues for Women with Acute Surgical Abdomen Associated with Ruptured Endometrioma. J Pers Med 2023; 13:1226. [PMID: 37623476 PMCID: PMC10455920 DOI: 10.3390/jpm13081226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/23/2023] [Accepted: 07/31/2023] [Indexed: 08/26/2023] Open
Abstract
(1) Background: An investigation of the preoperative diagnostic clues used to identify ruptured endometrioma by comparing the ruptured and unruptured states in patients who underwent laparoscopic operations due to endometrioma. (2) Methods: Patients with ruptured endometriomas (14 patients) and unruptured endometriomas (60 patients) were included, and clinical symptoms, laboratory findings, and radiological findings were analyzed. (3) Results: There were no significant differences in age, parity, last menstrual cycle days, or median size of endometrioma between two groups (group A: ruptured; group B: unruptured). The median serum level of CA 125 was 345.1 U/mL in group A and 49.8 U/mL in group B (p = 0.000). The median serum levels of CA 19-9 in group A and B were 46.0 U/mL and 19.1 U/mL, respectively (p = 0.005). The median serum level of CRP in group A was 1.2 g/dL, whereas it was 0.3 in group B (p = 0.000). ROC analysis showed that the optimal CA 125 cutoff value was 100.9 U/mL; the optimal CA 19-9 cutoff value was 27.7 U/mL; and the optimal CRP cutoff value was 1.0 g/dL. (4) Conclusions: Ruptured endometrioma can be diagnosed preoperatively using a combination of clinical symptoms, laboratory findings, and radiological findings. If a physician suspects a ruptured endometrioma, surgery should be performed to ensure optimal prognosis.
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Affiliation(s)
- Jihyun Keum
- Division of Gynecologic Oncology and Gynecologic Minimally Invasive Surgery, Department of Obstetrics and Gynecology, Hanyang University College of Medicine, Seoul 04763, Republic of Korea; (J.K.); (J.S.C.); (J.B.); (S.C.)
| | - Won Moo Lee
- Division of Gynecologic Oncology and Gynecologic Minimally Invasive Surgery, Department of Obstetrics and Gynecology, Hanyang University College of Medicine, Seoul 04763, Republic of Korea; (J.K.); (J.S.C.); (J.B.); (S.C.)
| | - Joong Sub Choi
- Division of Gynecologic Oncology and Gynecologic Minimally Invasive Surgery, Department of Obstetrics and Gynecology, Hanyang University College of Medicine, Seoul 04763, Republic of Korea; (J.K.); (J.S.C.); (J.B.); (S.C.)
| | - Jaeman Bae
- Division of Gynecologic Oncology and Gynecologic Minimally Invasive Surgery, Department of Obstetrics and Gynecology, Hanyang University College of Medicine, Seoul 04763, Republic of Korea; (J.K.); (J.S.C.); (J.B.); (S.C.)
| | - Seongsil Cho
- Division of Gynecologic Oncology and Gynecologic Minimally Invasive Surgery, Department of Obstetrics and Gynecology, Hanyang University College of Medicine, Seoul 04763, Republic of Korea; (J.K.); (J.S.C.); (J.B.); (S.C.)
| | - Bo Kyeong Kang
- Department of Radiology, Hanyang University College of Medicine, Seoul 04763, Republic of Korea;
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Guillaume L, Chapelle V, Deltombe M, Nevraumont A, Mairesse A, Maisin D, Gruson D. Biological variation of CA 15-3, CA 125 and HE 4 on lithium heparinate plasma in apparently healthy Caucasian volunteers. Clin Chem Lab Med 2023; 61:1319-1326. [PMID: 37043610 DOI: 10.1515/cclm-2022-0966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 03/17/2023] [Indexed: 04/14/2023]
Abstract
OBJECTIVES Tumor markers are well-known for being important tools in the support of diagnosis, monitoring of treatment efficacy and follow-up of cancers. CA 125, CA 15-3 and HE 4 have demonstrated potential efficacy in other clinical indications. The main objective was to evaluate the biological variation of these glycoproteins using two different immunoassays in an apparently healthy Caucasian population. METHODS Nineteen healthy volunteers including 11 women and 8 men were sampled weekly for 5 consecutive weeks. Samples were analyzed in duplicate on Lumipulse® G600II (Fujirebio) and on the Cobas e602 (Roche Diagnostics) analyzers. After assessment of normality, exclusion of outliers and analysis of homogeneity of variance, analytical variation (CVA), within-subject biological variation (CVI) and between-subject biological variation (CVG) were determined using a nested ANOVA. RESULTS CVA, CVI and CVG were determined on both analyzers and both genders. For CA 125, the CVA ranges from 1.0 to 3.4%, the CVI from 5.7 to 13.8% and the CVG from 32.2 to 42.9%. For CA 15-3, the CVA is between 1.1 and 3.4%, the CVI between 3.9 and 6.5% and the CVG between 43.7 and 196.9%. Lastly, HE 4 has CVA values between 1.4 and 2.4%, CVI between 5.1 and 10.5% and CVG between 7.1 and 12.6%. CONCLUSIONS Our study provided updated data on the biological variation of CA 125, HE 4 and CA 15-3. These data allow to improve the clinical interpretation and thus the management of the patient.
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Affiliation(s)
- Louise Guillaume
- Department of Clinical Biochemistry, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Virginie Chapelle
- Department of Clinical Biochemistry, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Matthieu Deltombe
- Department of Clinical Biochemistry, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Arnaud Nevraumont
- Department of Clinical Biochemistry, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Antoine Mairesse
- Department of Clinical Biochemistry, Cliniques de l'Europe de Bruxelles, Brussels, Belgium
| | - Diane Maisin
- Department of Clinical Biochemistry, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Damien Gruson
- Department of Clinical Biochemistry, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium
- Pôle de recherche en Endocrinologie, Diabète et Nutrition, Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium
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Stefanopol IA, Petecariu A, Baroiu L, Neagu AI, Bogdan-Goroftei RE, Nechifor A, Ciortea DA, Sarbu N. Giant Benign Struma Ovarii with High-Grade Fever, Elevated CA 125, and Hormonal Function in an Adolescent Patient. Children (Basel) 2023; 10:children10050856. [PMID: 37238404 DOI: 10.3390/children10050856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/26/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023]
Abstract
Struma ovarii (SO) is a monodermal teratoma containing at least 50% thyroid tissue. Classically, SO is a hormonally inactive benign neoplasm that occurs in premenopausal women, and has unspecific clinical and imaging features. Its treatment is surgical and its diagnosis is established histopathologically. We report the case of a euthyroid 16-year-old girl presenting with abdominal girth increase. An abdomino-pelvic ultrasound showed a giant multicystic mass with transonic content and multiple septa, and magnetic resonance imaging suggested the diagnosis of right ovarian mucinous cystadenoma. Blood tests showed inflammatory syndrome, iron deficiency anemia, mild hepatocytolysis, and elevated serum CA 125 levels. High-grade fever occurred on the third day of hospitalization, but none of the preoperative tests could identify its origin. Cystectomy was performed, and the histopathological examination revealed benign SO with a few small cysts with purulent content. The patient developed hypothyroidism postoperatively. In conclusion, this case report reunites most of the uncommon features of SO and confirms the superiorityof histopathology in its definitive diagnosis, as well as the suitability of ovarian sparing techniques, as the best treatment option for cystic ovarian pathology in pediatric patients, even in cases of large tumoral size and elevated serum CA 125 levels.
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Affiliation(s)
- Ioana Anca Stefanopol
- Clinical Surgical Department, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, 800216 Galați, Romania
- Department of Pediatric Surgery, "Sf Ioan" Clinical Emergency Hospital for Children, 800487 Galați, Romania
| | - Alexandru Petecariu
- Department of Pediatric Surgery, "Sf Ioan" Clinical Emergency Hospital for Children, 800487 Galați, Romania
| | - Liliana Baroiu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, 800216 Galați, Romania
- Infectious Diseases Department, "Sf Cuv Parascheva" Clinical Hospital of Infectious Diseases, 800179 Galați, Romania
| | - Anca-Iulia Neagu
- Clinical Surgical Department, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, 800216 Galați, Romania
- Department of Anatomopathology, "Sf Ioan" Clinical Emergency Hospital for Children, 800487 Galați, Romania
| | - Roxana-Elena Bogdan-Goroftei
- Clinical Medical Department, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, 800216 Galați, Romania
- Emergency Department, "Sf Ioan" Clinical Emergency Hospital for Children, 800487 Galați, Romania
| | - Alexandru Nechifor
- Clinical Medical Department, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, 800216 Galați, Romania
| | - Diana-Andreea Ciortea
- Clinical Medical Department, Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, 800216 Galați, Romania
- Pediatric Department, "Sf Ioan" Clinical Emergency Hospital for Children, 800487 Galați, Romania
| | - Nicolae Sarbu
- Faculty of Medicine and Pharmacy, "Dunărea de Jos" University, 800216 Galați, Romania
- Department of Radiology and Medical Imaging, "Sf Ioan" Clinical Emergency Hospital for Children, 800487 Galați, Romania
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Cviič D, Jagarlamudi K, Meglič L, Škof E, Zore A, Lukanović D, Eriksson S, Osredkar J. A Dual Biomarker TK1 Protein and CA125 or HE4-Based Algorithm as a Better Diagnostic Tool than ROMA Index in Early Detection of Ovarian Cancer. Cancers (Basel) 2023; 15. [PMID: 36900385 DOI: 10.3390/cancers15051593] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/20/2023] [Accepted: 02/26/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND The early detection of ovarian cancer is presently not effective, and it is crucial to establish biomarkers for the early diagnosis of ovarian cancer to improve the survival of patients. MATERIALS AND METHODS The aim of this study was to investigate the role of thymidine kinase 1 (TK1) in combination with CA 125 or HE4 to serve as a potential diagnostic biomarkers for ovarian cancer. In this study, a set of 198 serum samples consisting of 134 ovarian tumor patients and 64 healthy age-matched controls were analyzed. The TK1 protein levels in serum samples were determined using the AroCell TK 210 ELISA. RESULTS A combination of TK1 protein with CA 125 or HE4 showed better performance than either of them alone in the differentiation of early stage ovarian cancer from the healthy control group, but also a significantly better performance than the ROMA index. However, this was not observed using a TK1 activity test in combination with the other markers. Furthermore, the combination of TK1 protein and CA 125 or HE4 could differentiate early stage disease (stage I, II) more efficiently from advanced-stage (stage III, IV) disease (p < 0.0001). CONCLUSIONS The combination of TK1 protein with CA 125 or HE4 increased the potential of detecting ovarian cancer at early stages.
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Jagodzińska A, Chudecka-Głaz A, Michalczyk K, Pius-Sadowska E, Wieder-Huszla S, Jurczak A, Machaliński B. The Diagnostic Role of FGF 21 in Endometrial Cancer and Other Pathologies of the Uterine Corpus. Diagnostics (Basel) 2023; 13:diagnostics13030399. [PMID: 36766504 PMCID: PMC9914808 DOI: 10.3390/diagnostics13030399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 01/08/2023] [Accepted: 01/14/2023] [Indexed: 01/24/2023] Open
Abstract
Endometrial cancer is becoming an increasing problem. Taking into account its pathomechanisms, we aimed to investigate whether FGF 21, an important metabolism regulator, could be used as a biomarker for endometrial cancer. The study included 233 patients who were classified into five subgroups depending on the result of the histological examination: endometrial carcinomas, sarcomas, endometrial polyps, fibroids, and normal endometrium. Statistically significantly higher FGF 21 levels were found in patients diagnosed with malignant lesions (p < 0.001). FGF 21 concentration correlated with the degree of cellular differentiation (p = 0.020) and the presence of lymph node metastases (p = 0.009). The diagnostic performance characteristics of FGF 21 as an EC diagnostic marker demonstrated an AUC of 0.677. Of all of the assessed biomarkers, FGF 21 had the highest specificity (90%), yet limited sensitivity (41%). Additionally, HE4 and CA 125 were confirmed to have roles as EC biomarkers, with a higher accuracy for HE4 (79% vs. 72%).
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Affiliation(s)
- Anna Jagodzińska
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, 70-204 Szczecin, Poland
| | - Anita Chudecka-Głaz
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, 70-204 Szczecin, Poland
| | - Kaja Michalczyk
- Department of Gynecological Surgery and Gynecological Oncology of Adults and Adolescents, Pomeranian Medical University, 70-204 Szczecin, Poland
- Correspondence:
| | - Ewa Pius-Sadowska
- Department of General Pathology, Pomeranian Medical University in Szczecin, al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
| | - Sylwia Wieder-Huszla
- Department of Clinical Nursing, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland
| | - Anna Jurczak
- Department of Clinical Nursing, Pomeranian Medical University in Szczecin, 71-210 Szczecin, Poland
| | - Bogusław Machaliński
- Department of General Pathology, Pomeranian Medical University in Szczecin, al. Powstańców Wielkopolskich 72, 70-111 Szczecin, Poland
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Abe T, Saida T, Fujieda K, Inoue K, Satoh T, Nakajima T. A case of Pseudo-Meigs' syndrome due to Brenner tumor. Radiol Case Rep 2023; 18:1349-1352. [PMID: 36712189 PMCID: PMC9873576 DOI: 10.1016/j.radcr.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 12/29/2022] [Accepted: 01/03/2023] [Indexed: 01/22/2023] Open
Abstract
A 65-year-old woman with suspected ascites-associated abdominal distention had elevated CA125 levels. Contrast-enhanced computed tomography to search for the cause of the ascites showed bilateral pleural effusions, ascites, and an ovarian tumor. On magnetic resonance imaging the tumor exhibited a lobulated structure and markedly low signal intensity on both T1- and T2-weighted imaging, with no restrictions on diffusion-weighted images. Progressive enhancement was observed at tumor margins. Meigs syndrome due to fibroma was suspected, and total hysterectomy, bilateral salpingo-oophorectomy, and partial omentectomy were performed. Postoperatively, the pleural effusion and ascites resolved promptly without specific treatment. On pathological examination, the ovarian tumor was diagnosed as a benign Brenner tumor with scattered nests of transitional epithelium within a large amount of stroma. Based on the clinical course, the patient was diagnosed with pseudo-Meigs' syndrome due to a Brenner tumor.
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Affiliation(s)
- Tetsuya Abe
- Department of Radiology, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan
| | - Tsukasa Saida
- Department of Radiology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan,Corresponding author.
| | - Kaoru Fujieda
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Kei Inoue
- Department of Radiology, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan
| | - Toyomi Satoh
- Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
| | - Takahito Nakajima
- Department of Radiology, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
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Niu L, Wang W, Xu Y, Xu T, Sun J, Lv W, Zhang J, Qiu L, Dong X, Shang Y, Zhang L, Wang J. The value of ultrasonography combined with carbohydrate antigen 125 and 19-9 detection in the diagnosis of borderline ovarian tumors and prediction of recurrence. Front Surg 2023; 9:951472. [PMID: 36760664 PMCID: PMC9904407 DOI: 10.3389/fsurg.2022.951472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 10/10/2022] [Indexed: 01/09/2023] Open
Abstract
Objective This study aimed to investigate the clinical value of ultrasonography combined with tumor markers in the diagnosis and prediction of recurrence of borderline ovarian tumors (BOTs) and analyze the value of the combination of two different auxiliary examinations in the diagnosis and prediction of recurrence of BOTs. Methods Here, 221 patients with BOTs confirmed by postoperative pathology were enrolled. Their clinical data, including the ultrasonography features, tumor markers, and clinicopathological data, were retrospectively analyzed. Results The statistical data of the 221 cases with BOTs were as follows: 94 (42.5%) with left-sided lesions, 102 (46.2%) with right-sided lesions, and 25 (11.3%) with bilateral lesions. Moreover, 93 cases (42.1%) had a borderline serous tumor, 110 (49.8%) had a borderline mucinous tumor, 12 (5.4%) had a borderline serous mucinous tumor, 2 (0.9%) had a borderline endometrioid tumor, 1 (0.5%) had a borderline Brenner tumor, and 2 (0.9%) had a clear cell BOT. There were 104 cases (47.1%) with a tumor diameter of ≤10 cm and 117 cases (52.9%) with a tumor diameter of >10 cm as suggested by ultrasonography. There were 89 cases (40.3%) with septation, 44 (19.9%) with papilla, and 97 (43.9%) with blood flow as demonstrated by ultrasonography. Carbohydrate antigen 125 (CA 125) was elevated in 132 cases (59.7%), and CA 19-9 was elevated in 52 cases (23.5%). Conclusion In general, BOTs are difficult to diagnose preoperatively and have a certain recurrence rate. Ultrasonography combined with CA 125 and CA 19-9 is significant for the preoperative diagnosis and selection of surgical modality for BOTs and could be used as a guideline to achieve good preoperative preparation and avoid secondary surgery.
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Affiliation(s)
- Lina Niu
- Department of Gynecology, Yuncheng Central Hospital, Yuncheng, China
| | - Weibin Wang
- Department of Gynecology, Yuncheng Central Hospital, Yuncheng, China
| | - Yongjun Xu
- Department of Pharmacy, Yuncheng Central Hospital, Yuncheng, China
| | - Tao Xu
- Department of Pathology, Yuncheng Central Hospital, Yuncheng, China
| | - Jiali Sun
- Department of Ultrasound, Yuncheng Central Hospital, Yuncheng, China
| | - Weiqin Lv
- Department of Gynecology, Yuncheng Central Hospital, Yuncheng, China
| | - Junli Zhang
- Department of Gynecology, Yuncheng Central Hospital, Yuncheng, China
| | - Lirong Qiu
- Department of Gynecology, Yuncheng Central Hospital, Yuncheng, China
| | - XuFeng Dong
- Department of Infectious Disease Prevention and Control Division, Shanxi Center for Disease Control and Prevention, Taiyuan, China
| | - Yun Shang
- Department of Gynecology, Yuncheng Central Hospital, Yuncheng, China
| | - Lizhen Zhang
- Department of Gynecology, Yuncheng Central Hospital, Yuncheng, China
| | - Junxia Wang
- Department of Gynecology, Yuncheng Central Hospital, Yuncheng, China,Correspondence: Junxia Wang
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TÜRKCAN C, AKGÖL S. Polymeric nanoparticle-based electrochemical sensor for the detection of CA 125. Turk J Chem 2022; 47:137-147. [PMID: 37720868 PMCID: PMC10504010 DOI: 10.55730/1300-0527.3524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 02/20/2023] [Accepted: 11/02/2022] [Indexed: 02/25/2023] Open
Abstract
In this paper, Cys-graft-p(HEMA) nanomaterials and a new electrochemical method were developed for determination of CA 125. Cys-graft-p(HEMA) nanomaterials were synthesized with emulsion polymerization method and modified with grafting procedure. It was determined that Cys-graft-p(HEMA) nanomaterials had 50 nm dimension and spherical morphology, and per gram polymeric material contained 0.011 mmol L-cysteine. Electrode surface was prepared step by step for electrochemical analysis with optimization process. Linear determination range was determined as 5-400 U/mL (R= 0.9935). Detection limit (LOD) was calculated as 1.87 U/mL, and quantification limit (LOQ) was determined as 5.62 U/mL. The fabricated sensor system showed good repeatability, accuracy, reality, and storage stability. According to the results obtained, Cys-graft p(HEMA) nanomaterials that is used for the first time in biosensor has the potential to find use in the sector with rapid determination time (10 min), extensive determination range, accuracy of methods. Novelties of this study are rapid analysis, determination range, appropriate of prototype device development, and developing new designed material. Developed material and method can be used in the preliminary diagnosis of the disease and combined with a prototype device that can allow the follow-up of the treatment process in diagnosed patients.
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Affiliation(s)
- Ceren TÜRKCAN
- Departmet of Biomedical Engineering, Faculty of Engineering and Architecture, İstanbul Arel University, İstanbul,
Turkey
| | - Sinan AKGÖL
- Department of Biochemistry, Faculty of Science, Ege University, İzmir,
Turkey
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20
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Hernández A, Sanz A, Spagnolo E, Carbonell M, Rodríguez E, López A, Raganato R, Del Forno S, Ramiro-Cortijo D. Evaluation of Women's Age and Ultrasonographic Features to Choose Surgical Treatment for Endometriosis Associated with Ovarian Cancer. J Clin Med 2022; 11:jcm11092414. [PMID: 35566541 PMCID: PMC9100079 DOI: 10.3390/jcm11092414] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/08/2022] [Accepted: 04/24/2022] [Indexed: 12/15/2022] Open
Abstract
Adequate surgical management of malignant endometriosis remains a clinical challenge in gynecology. Age, sonography variables, and tumor biomarkers have been reported as candidates in the clinical decision. This study aims were to analyze the factors of women’s age, body mass index, ultrasound features, and tumor biomarkers to predict endometriosis-associated ovarian cancer in a large series of endometriomas and to study the surgical treatment performed in this cohort. In this retrospective study, we reviewed the medical records of patients with ultrasound diagnosis of ovarian cyst classified as endometrioma (benign as well as with risk of malignancy), surgically treated in the endometriosis unit of Hospital Universitario La Paz (Madrid, Spain) between January 2019 and July 2021. According to the final histology examination, the women were clustered as non-endometriosis-associated ovarian cancer (OE, benign endometriomas, n = 59) and endometriosis-associated ovarian cancer (EAOC) (n = 17). Demographic, clinical, and surgical data were collected from these women. International Ovarian Tumor Analysis (IOTA) criteria were assessed for the ultrasound examination. The age of the women in the EAOC group was 50.0 [43.0; 63.0] years, which was significantly higher than OE (39.0 [34.0; 46.0] years; p-value < 0.001). In addition, the body mass index for the OE group (24.9 ± 5.3 kg/m2) was significantly higher than for the EAOC group (23.3 ± 4.6 kg/m2; p-value < 0.001). However, the tumor biomarker levels (CA 125, CA 19.9 and He4) were not significantly different among the groups. We performed 51.4% cystectomies and 48.6% adnexectomies, with an association between the adnexectomy and EAOC group (p-value < 0.001). In addition, a significant association was found between ultrasound features suspicious for malignancy and the EAOC group. Conclusively, women’s age and ultrasound features, such as papillary projections, septa, and positive echo-Doppler, were the main factors to consider when evaluating the malignancy risk associated with endometriosis.
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Affiliation(s)
- Alicia Hernández
- Department of Obstetrics and Gynecology, Hospital Universitario La Paz, Paseo de la Castellana, 261, 28046 Madrid, Spain; (A.H.); (A.S.); (M.C.); (E.R.); (A.L.)
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo 2, 28029 Madrid, Spain
| | - Angela Sanz
- Department of Obstetrics and Gynecology, Hospital Universitario La Paz, Paseo de la Castellana, 261, 28046 Madrid, Spain; (A.H.); (A.S.); (M.C.); (E.R.); (A.L.)
| | - Emanuela Spagnolo
- Department of Obstetrics and Gynecology, Hospital Universitario La Paz, Paseo de la Castellana, 261, 28046 Madrid, Spain; (A.H.); (A.S.); (M.C.); (E.R.); (A.L.)
- Correspondence:
| | - María Carbonell
- Department of Obstetrics and Gynecology, Hospital Universitario La Paz, Paseo de la Castellana, 261, 28046 Madrid, Spain; (A.H.); (A.S.); (M.C.); (E.R.); (A.L.)
| | - Elena Rodríguez
- Department of Obstetrics and Gynecology, Hospital Universitario La Paz, Paseo de la Castellana, 261, 28046 Madrid, Spain; (A.H.); (A.S.); (M.C.); (E.R.); (A.L.)
| | - Ana López
- Department of Obstetrics and Gynecology, Hospital Universitario La Paz, Paseo de la Castellana, 261, 28046 Madrid, Spain; (A.H.); (A.S.); (M.C.); (E.R.); (A.L.)
| | - Riccardo Raganato
- Department of Orthopaedic Surgery and Traumatology, Hospital Universitario La Paz, Paseo de la Castellana, 261, 28046 Madrid, Spain;
| | - Simona Del Forno
- Division of Gynecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero, S. Orsola Hospital, University of Bologna, Via Masserenti 13, 40138 Bologna, Italy;
| | - David Ramiro-Cortijo
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo 2, 28029 Madrid, Spain;
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21
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He P, Wang JJ, Duan W, Song C, Yang Y, Wu QQ. Estimating the risk of malignancy of adnexal masses: validation of the ADNEX model in the hands of nonexpert ultrasonographers in a gynaecological oncology centre in China. J Ovarian Res 2021; 14:169. [PMID: 34857005 PMCID: PMC8638097 DOI: 10.1186/s13048-021-00922-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 11/17/2021] [Indexed: 11/24/2022] Open
Abstract
Background This study aims to validate the diagnostic accuracy of the International Ovarian Tumor Analysis (IOTA) the Assessment of Different NEoplasias in the adneXa (ADNEX) model in the preoperative diagnosis of adnexal masses in the hands of nonexpert ultrasonographers in a gynaecological oncology centre in China. Methods This was a single oncology centre, retrospective diagnostic accuracy study of 620 patients. All patients underwent surgery, and the histopathological diagnosis was used as a reference standard. The masses were divided into five types according to the ADNEX model: benign ovarian tumours, borderline ovarian tumours (BOTs), stage I ovarian cancer (OC), stage II-IV OC and ovarian metastasis. Receiver operating characteristic (ROC) curve analysis was used to evaluate the ability of the ADNEX model to classify tumours into different histological types with and without cancer antigen 125 (CA 125) results. Results Of the 620 women, 402 (64.8%) had a benign ovarian tumour and 218 (35.2%) had a malignant ovarian tumour, including 86 (13.9%) with BOT, 75 (12.1%) with stage I OC, 53 (8.5%) with stage II-IV OC and 4 (0.6%) with ovarian metastasis. The AUC of the model to differentiate benign and malignant adnexal masses was 0.97 (95% CI, 0.96–0.98). Performance was excellent for the discrimination between benign and stage II-IV OC and between benign and ovarian metastasis, with AUCs of 0.99 (95% CI, 0.99–1.00) and 0.99 (95% CI, 0.98–1.00), respectively. The model was less effective at distinguishing between BOT and stage I OC and between BOT and ovarian metastasis, with AUCs of 0.54 (95% CI, 0.45–0.64) and 0.66 (95% CI, 0.56–0.77), respectively. When including CA125 in the model, the performance in discriminating between stage II–IV OC and stage I OC and between stage II–IV OC ovarian metastasis was improved (AUC increased from 0.88 to 0.94, P = 0.01, and from 0.86 to 0.97, p = 0.01). Conclusions The IOTA ADNEX model has excellent performance in differentiating benign and malignant adnexal masses in the hands of nonexpert ultrasonographers with limited experience in China. In classifying different subtypes of ovarian cancers, the model has difficulty differentiating BOTs from stage I OC and BOTs from ovarian metastases.
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Affiliation(s)
- Ping He
- Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, 251 Yaojiayuan Road, Chaoyang District, Beijing, 100026, P.R. China.,Beijing Maternal and Child Health Care Hospital, 251 Yaojiayuan Road, Chaoyang District, Beijing, 100026, P.R. China
| | - Jing-Jing Wang
- Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, 251 Yaojiayuan Road, Chaoyang District, Beijing, 100026, P.R. China.,Beijing Maternal and Child Health Care Hospital, 251 Yaojiayuan Road, Chaoyang District, Beijing, 100026, P.R. China
| | - Wei Duan
- Beijing Maternal and Child Health Care Hospital, 251 Yaojiayuan Road, Chaoyang District, Beijing, 100026, P.R. China.,Department of Gynecologic Oncology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, P.R. China
| | - Chao Song
- Capacity Building and Continuing Education Center, National Health Commission, Beijing, P.R. China
| | - Yu Yang
- Capacity Building and Continuing Education Center, National Health Commission, Beijing, P.R. China
| | - Qing-Qing Wu
- Department of Ultrasound, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, 251 Yaojiayuan Road, Chaoyang District, Beijing, 100026, P.R. China. .,Beijing Maternal and Child Health Care Hospital, 251 Yaojiayuan Road, Chaoyang District, Beijing, 100026, P.R. China.
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22
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Li M, Wu Z, Tudahun I, Liu N, Lin Q, Liu J, Wang Y, Chen M, Chen Y, Qi N, Zhu Q, Li J, Li W, Tang J, Liu Q. High Serum Carbohydrate Antigen (CA) 125 Level Is Associated With Poor Prognosis in Patients With Light-Chain Cardiac Amyloidosis. Front Cardiovasc Med 2021; 8:692083. [PMID: 34778387 PMCID: PMC8581134 DOI: 10.3389/fcvm.2021.692083] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 09/24/2021] [Indexed: 11/13/2022] Open
Abstract
Background and Aims: Patients with light-chain cardiac amyloidosis (AL-CA) are characterized by high levels of serum carbohydrate antigen 125 (CA 125). However, studies have not explored the correlation between CA 125 and AL-CA. The aim of this study was to explore the clinical implications of an increase in CA 125 in patients with AL-CA. Methods and Results: A total of 95 patients diagnosed with AL-CA at the Second Xiangya Hospital were enrolled in this study. Out of the 95 patients with AL-CA, 57 (60%) patients had elevated serum CA 125 levels. The mean age was 59.7 ± 10.0 years with 44 (77.2%) men in the high serum CA 125 group, and 61.8 ± 9.6 years with 28 (73.7%) men in the normal group. Patients with high CA 125 showed higher rates of polyserositis (79.3% vs. 60.5%, p = 0.03), higher levels of hemoglobin (117.4 ± 21.9 g/L vs. 106.08 ± 25.1 g/L, p = 0.03), serum potassium (4.11 ± 0.47 mmol/L vs. 3.97 ± 0.40 mmol/L, p = 0.049), low-density lipoprotein-cholesterol (3.0 ± 1.6 mmol/L vs. 2.3 ± 1.10 mmol/L, p = 0.01), and cardiac troponin T (96.0 pg/mL vs. 91.9 pg/mL, p = 0.005). The median overall survival times for patients with high or normal serum CA 125 were 5 and 25 months, respectively (p = 0.045). Multivariate Cox hazard analysis showed that treatment without chemotherapy (HR 1.694, 95% CI 1.121–2.562, p = 0.012) and CA 125 (HR 1.002, 95% CI 1.000–1.004, p = 0.020) was correlated with high all-cause mortality. The time-dependent receiver operating characteristic (t-ROC) curve showed that the prediction accuracy of CA 125 was not inferior to that of cardiac troponin T, N-terminal pro-B-type natriuretic peptide (NT-proBNP), and lactate dehydrogenase (LDH) based on the area under the curve. Conclusions: CA 125 is a novel prognostic predictor. High serum CA 125 values are correlated with low overall survival, and the accuracy of predicting prognosis is similar to that of traditional biomarkers in AL-CA.
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Affiliation(s)
- Muzheng Li
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Zhijian Wu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ilyas Tudahun
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Na Liu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Qiuzhen Lin
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jiang Liu
- Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yingmin Wang
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Mingxian Chen
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yaqin Chen
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Nenghua Qi
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Qingyi Zhu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, China
| | - JunLi Li
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Wei Li
- Department of Cardiology, Huaihua Hospital of Traditional Chinese Medicine, Huaihua, China
| | - Jianjun Tang
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Qiming Liu
- Department of Cardiovascular Medicine, The Second Xiangya Hospital of Central South University, Changsha, China
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23
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Hegde P, B R S, Ballal S, Swamy BM, Inamdar SR. Rhizoctonia bataticola lectin induces apoptosis and inhibits metastasis in ovarian cancer cells by interacting with CA 125 antigen differentially expressed on ovarian cells. Glycoconj J 2021; 38:669-688. [PMID: 34748163 DOI: 10.1007/s10719-021-10027-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 09/15/2021] [Accepted: 10/14/2021] [Indexed: 10/19/2022]
Abstract
A N-glycan specific lectin from Rhizoctonia bataticola [RBL] was shown to induce growth inhibitory and apoptotic effect in human ovarian, colon and leukemic cells but mitogenic effect on normal PBMCs as reported earlier, revealing its clinical potential. RBL has unique specificity for high mannose tri and tetra antennary N-glycans, expressed in ovarian cancer and also recognizes glycans which are part of CA 125 antigen, a well known ovarian cancer marker. Hence, in the present study diagnostic and therapeutic potential of RBL was investigated using human ovarian epithelial cancer SKOV3 and OVCAR3 cells known for differentially expressing CA 125. RBL binds differentially to human ovarian normal, cyst and cancer tissues. Flow cytometry, western blot analysis of membrane proteins showed the competitive binding of RBL and CA 125 antibody for the same binding sites on SKOV3 and OVCAR3 cells. RBL has strong binding to both SKOV3 and OVCAR3 cells with MFI of 173 and 155 respectively. RBL shows dose and time dependent growth inhibitory effect with IC50 of 2.5 and 8 μg/mL respectively for SKOV3 and OVCAR3 cells. RBL induces reproductive cell death, morphological changes, nuclear degradation and increased release of ROS in SKOV3 and OVCAR3 cells leading to cell death. This is also supported by increase in hypodiploid population, altered MMP leading to apoptosis possibly involving intrinsic pathway. Adhesion, wound healing, invasion and migration assays demonstrated anti-metastasis effect of RBL apart from its growth inhibitory effect. These results show the promising potential of RBL both as a diagnostic and therapeutic agent.
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Affiliation(s)
- Prajna Hegde
- Department of Studies in Biochemistry, Karnatak University, Dharwad-580003, Karnatak, India
| | - Sindhura B R
- Department of Studies in Biochemistry, Karnatak University, Dharwad-580003, Karnatak, India
| | - Suhas Ballal
- Department of Studies in Biochemistry, Karnatak University, Dharwad-580003, Karnatak, India
| | - Bale M Swamy
- Department of Studies in Biochemistry, Karnatak University, Dharwad-580003, Karnatak, India
| | - Shashikala R Inamdar
- Department of Studies in Biochemistry, Karnatak University, Dharwad-580003, Karnatak, India.
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Jabi R, Elmir S, El Arabi S, Merry A, Bouziane M. Rectorrhagia revealing colonic metastasis from an ovarian primary, an exceptional case report. Int J Surg Case Rep 2021; 88:106490. [PMID: 34710771 PMCID: PMC8556754 DOI: 10.1016/j.ijscr.2021.106490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/06/2021] [Accepted: 10/06/2021] [Indexed: 12/09/2022] Open
Abstract
INTRODUCTION Ovarian cancer is a gynecological cancer with a very poor prognosis despite the improvement of therapeutic means, of which metastases at the colic level are exceptional. We report an exceptional case which makes it possible to enrich the poor literature published on the subject. CASE PRESENTATION Through this article, we present a very rare case of colonic metastases from ovarian cancer. Biological monitoring and rectal bleeding allowed this rare secondary location to be discovered. Resection then anastomosis allowed our patient to heal. The objectives of this work are threefold: i), to report this very rare case ovarian metastasis ii), to highlight nulliparity as a risk factor in our patient iii), to report that our therapeutic management interrupted and delayed because of COVID 19. DISCUSSION AND CONCLUSION Our case report shows that we have to take into consideration this very rare presentation and this even in the absence of true clinical sign. Our work reported also another case of colonic metastasis of a primary ovarian in the very rare case described in the literature and emphasizes the importance of surgical management.
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Affiliation(s)
- Rachid Jabi
- Department of General Surgery, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Oujda, Morocco; Laboratory of Anatomy, Microsurgery and Surgery Experimental and Medical Simulation (LAMCESM), Mohammed Ist University, Oujda, Morocco.
| | - Siham Elmir
- Department of Physical Medicine and Rehabilitation, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Oujda, Morocco
| | - Soumia El Arabi
- Department of Medical Radiology, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Oujda, Morocco
| | - Achraf Merry
- Department of Anatomopathology, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Oujda, Morocco
| | - Mohammed Bouziane
- Department of General Surgery, Mohammed VI University Hospital, Faculty of Medicine and Pharmacy, Oujda, Morocco; Laboratory of Anatomy, Microsurgery and Surgery Experimental and Medical Simulation (LAMCESM), Mohammed Ist University, Oujda, Morocco
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Bozkurt Yavuz H, Bildirici MA, Yaman H, Karahan SC, Aliyazıcıoğlu Y, Örem A. Reference change value and measurement uncertainty in the evaluation of tumor markers. Scand J Clin Lab Invest 2021; 81:601-605. [PMID: 34543131 DOI: 10.1080/00365513.2021.1979244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The use of measurement uncertainty among clinical laboratories becomes widespread. Measurement uncertainty can be reported with the result, as well as be used in certain reference change value (RCV) calculation equations. RCV is especially recommended for use in tests with a low individuality index. In our study, we calculated the measurement uncertainty of AFP, CA 125, CA 15-3, CA 19-9, CEA tumor markers with the ISO TS 20914:2019. We compared results with limits. Two Beckman Coulter DXI-800 (Minnesota, USA) autoanalysers' results were used. We calculated the RCV values using the classical Fraser method, logarithmic Lund Method, and Clinical Laboratory Standards Institute (CLSI) method as Minimal Difference (MD). We found the same permissible measurement uncertainty limit as 15.97% for all five tumor markers. The highest RCV value was found as 90% upstream for AFP test with Lund logarithmic approach, the lowest RCV value was found as 12% for CEA with MD, all other RCV results were between these two values. We do not recommend the use of MD, as values for Biological variation are not used in the MD approach. We also recommend using the logarithmic approach, although it gives higher results. There are also clinical studies on the significance of tumor markers in a follow-up that show different results. These differences may be because the studies are conducted with different systems. Therefore, each laboratory needs to calculate its own RCV values. We also recommend informing the clinicians about the tests with high measurement uncertainty.
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Affiliation(s)
| | | | - Hüseyin Yaman
- Department of Clinical Biochemistry, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Süleyman Caner Karahan
- Department of Clinical Biochemistry, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Yüksel Aliyazıcıoğlu
- Department of Clinical Biochemistry, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
| | - Asım Örem
- Department of Clinical Biochemistry, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
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26
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Mulita F, Liolis E, Kehagias D, Tchabashvili L, Kaplanis C, Iliopoulos F, Perdikaris I, Kehagias I. An enormous pelvic tumor in a 46-year-old woman with an elevated serum CA 125 level, what lies beneath it? Investigation of uterine tumors in postmenopausal women. Prz Menopauzalny 2021; 20:154-157. [PMID: 34703417 PMCID: PMC8525254 DOI: 10.5114/pm.2021.109773] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 06/09/2021] [Indexed: 02/07/2023]
Abstract
Abdominal and pelvic pain with an associated pelvic mass is a very common emergency situation. There is always a management dilemma for most emergency physicians regarding these patients. A 46-year-old postmenopausal woman was admitted to our emergency department (ED) with complaints of massive abdominal distention. Abdominal and pelvis magnetic resonance imaging (MRI) was performed, which revealed a huge pelvic abdominal mass. All tumor markers were within normal limits. However, the ovarian cancer antigen (CA 125) level was elevated. As there was a strong suspicion of malignancy, the patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy. Her final histopathology report was suggestive of uterine leiomyoma. Uterine leiomyomas are the most common benign uterine tumors in women. Surgical treatment is the gold standard, especially for older women with severe symptoms and no desire for future fertility. Although the combination of a pelvic tumor and a high-level of CA 125 arouses suspicion of gynecological malignancy, other benign conditions should always be considered in the differential diagnosis. There is limited evidence to support an association between elevated CA 125 levels and uterine fibroids so far. However, conditions such as the coexistence of adenomyosis and tumor size can affect the level of this marker in uterine fibroids.
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Affiliation(s)
- Francesk Mulita
- Corresponding author: Dr. Francesk Mulita, Department of Surgery, General University Hospital of Patras, Rio, Greece , e-mail:
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Nañez A, Stram DA, Garcia C, Powell CB. Ovarian cancer surveillance in the clinical follow up of women with known BRCA1 or BRCA2 pathogenic variants in a large health care system. Gynecol Oncol 2021:S0090-8258(21)00600-4. [PMID: 34330534 DOI: 10.1016/j.ygyno.2021.07.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/09/2021] [Accepted: 07/21/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To assess CA 125 and transvaginal ultrasound surveillance in women with BRCA1 or BRCA2 pathogenic variants in a pragmatic clinical setting with>1 year follow up. METHODS Retrospective cohort study in a large integrated health care system of women identified from 1/1/2003 to 12/31/2017 with a BRCA1 or BRCA2 pathogenic variant with at least one intact ovary. Demographic and clinical data were collected from date of genetic testing until oophorectomy, an ovarian cancer diagnosis, or 7/1/2019. Primary outcome was frequency and findings of CA 125 tests and ultrasounds performed; secondary outcome was epithelial ovarian cancers diagnosed. RESULTS There were 1418 women, age ≥ 30 years with a BRCA1 or BRCA2 pathogenic variant with at least one intact ovary. Of the total of 1683 ultrasounds and 2437 CA 125 tests done, 1022 ultrasounds and 1709 CA 125 tests were performed for surveillance in 771 women followed >1 year. Of these women 241 (31%) women had no surveillance, and 530 (69%) women underwent any surveillance. Only 108 (20%) underwent regular surveillance. The number who underwent regular surveillance declined each year. Twenty-one women underwent surveillance indicated surgery with only 2 ovarian cancers found by surveillance. CONCLUSIONS Many women with BRCA1 or BRCA2 pathogenic variants undergo ultrasound and CA 125 surveillance testing but abnormal surveillance testing led to diagnosis of ovarian cancer in only two cases. These findings question the use of CA 125 and ultrasound surveillance in the clinical setting for ovarian cancer detection in women with BRCA1 or BRCA2 pathogenic variants.
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Stabile G, Zinicola G, Romano F, Laganà AS, Pozzolo CD, Ricci G. Pelvic mass, ascites, hydrothorax: a malignant or benign condition? Meigs syndrome with high levels of CA 125. Prz Menopauzalny 2021; 20:103-7. [PMID: 34321989 DOI: 10.5114/pm.2021.106100] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 03/26/2021] [Indexed: 01/08/2023]
Abstract
Introduction Abdominal-pelvic mass, ascites and pleural effusion are suggestive of malignant metastatic ovarian cancer. This triad is also present in a rare benign condition called Meigs syndrome. Rarely this condition is associated with an increased CA 125 level. Case report A 62-year-old woman with a history of abdominal pain underwent an ultrasound (US) examination and a chest X-ray. The imaging revealed the presence of a large pelvic mass and ascites with a monolateral pleural effusion and a high level of the tumor marker CA 125. The patient underwent a total abdominal hysterectomy, salpingoophorectomy, removal of the pelvic mass, pelvic lymphadenectomy and peritoneal biopsies. The histology showed an ovarian fibrothecoma. Discussion The US analysis according to international ovarian tumor analysis simple rules revealed “inconclusive results”; the logistic regression model LR2 and Adnex suggested a high risk of malignancy. The presence of ascites and the size of the lesion associated with a high level of CA 125 affected the correct assessment of the risk of malignancy, exposing the patient to overtreatment Conclusions Meigs syndrome is characterized by the resolution of symptoms after surgical removal of the pelvic mass. However, it mimics the clinical picture of a malignant metastatic ovarian cancer. Clinicians have to exclude ovarian cancer and recognize the syndrome to reduce inappropriate procedures.
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Bharali P, Anirvan P, Gogoi M, Singh SP. CA125 in acute pancreatitis: Prognosticator or red herring? Pancreatology 2021; 21:676. [PMID: 33676845 DOI: 10.1016/j.pan.2021.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 02/19/2021] [Accepted: 02/20/2021] [Indexed: 12/11/2022]
Affiliation(s)
- Pankaj Bharali
- Department of Gastroenterology, Srirama Chandra Bhanja Medical College & Hospital, Cuttack, Odisha, India.
| | - Prajna Anirvan
- Department of Gastroenterology, Srirama Chandra Bhanja Medical College & Hospital, Cuttack, Odisha, India.
| | - Mrinal Gogoi
- Department of Gastroenterology, Srirama Chandra Bhanja Medical College & Hospital, Cuttack, Odisha, India.
| | - Shivaram Prasad Singh
- Department of Gastroenterology, Srirama Chandra Bhanja Medical College & Hospital, Cuttack, Odisha, India.
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Kokot I, Piwowar A, Jędryka M, Sołkiewicz K, Kratz EM. Diagnostic Significance of Selected Serum Inflammatory Markers in Women with Advanced Endometriosis. Int J Mol Sci 2021; 22:2295. [PMID: 33669013 PMCID: PMC7956504 DOI: 10.3390/ijms22052295] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/10/2021] [Accepted: 02/22/2021] [Indexed: 12/17/2022] Open
Abstract
Endometriosis is a gynecological disease, the pathogenesis of which seems to be directly associated with inflammatory processes. Serum concentrations of IL-1β, IL-6, hs-CRP, IgG, YKL 40 and PRL, in comparison to the well-known CA 125 levels, were studied with the aim of identifying an additional noninvasive inflammatory marker or set of markers characteristic for endometriosis. The study group included 43 women with endometriosis (E), 35 women with benign gynecological disorders but without endometriosis (NE, non-endometriosis) as a comparative group, and a control group consisting of 18 healthy subjects (C). The serum concentrations of IL-1β, IL-6, hs-CRP, YKL-40, PRL and CA 125 were significantly higher in the E group (median values: 0.41 pg/mL, 2.42 pg/mL, 2.33 mg/L, 79.30 ng/mL, 21.88 ng/mL and 68.00 U/mL, respectively) than in the control group (median values: 0.21 pg/mL, 0.98 pg/mL, 0.52 mg/L, 49.77 ng/mL, 12.08 ng/mL and 12.20 U/mL respectively), with the significance of p = 0.011, p < 0.001, p = 0.028, p = 0.005, p < 0.001 and p < 0.001, respectively. The IgG concentrations were significantly lower in the endometriosis group (median value: 1061.21 mg/dL) as compared to healthy women (median value: 1210.50 mg/dL; p = 0.025). Significant differences in concentrations of IL-6 (p = 0.040), hs-CRP (p = 0.007) and CA 125 (p < 0.001) were observed in stage III vs. stage IV of endometriosis. Significantly higher concentrations of IL-6 (p = 0.010), hs-CRP (p = 0.037) and PRL (p < 0.001) were observed in the NE group vs. the control group. Only CA 125 concentrations were significantly higher in endometriosis patients as compared to the non-endometriosis group (p < 0.001). The proposed panel of inflammatory markers, especially IL-6, PRL and CA 125, may become a useful tool to identify women with advanced endometriosis who could qualify for treatment.
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Affiliation(s)
- Izabela Kokot
- Department of Laboratory Diagnostics, Division of Laboratory Diagnostics, Faculty of Pharmacy, Wroclaw Medical University, Borowska Street 211A, 50-556 Wroclaw, Poland; (K.S.); (E.M.K.)
| | - Agnieszka Piwowar
- Department of Toxicology, Faculty of Pharmacy, Wroclaw Medical University, Borowska Street 211A, 50-556 Wroclaw, Poland;
| | - Marcin Jędryka
- Department of Oncology, Gynecological Oncology Clinic, Faculty of Medicine, Wroclaw Medical University, Hirszfeld Square 12, 53-413 Wroclaw, Poland;
- Department of Oncological Gynecology, Wroclaw Comprehensive Cancer Center, Hirszfeld Square 12, 53-413 Wroclaw, Poland
| | - Katarzyna Sołkiewicz
- Department of Laboratory Diagnostics, Division of Laboratory Diagnostics, Faculty of Pharmacy, Wroclaw Medical University, Borowska Street 211A, 50-556 Wroclaw, Poland; (K.S.); (E.M.K.)
| | - Ewa Maria Kratz
- Department of Laboratory Diagnostics, Division of Laboratory Diagnostics, Faculty of Pharmacy, Wroclaw Medical University, Borowska Street 211A, 50-556 Wroclaw, Poland; (K.S.); (E.M.K.)
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Malsagova KA, Pleshakova TO, Galiullin RA, Kozlov AF, Shumov ID, Popov VP, Tikhonenko FV, Glukhov AV, Ziborov VS, Petrov OF, Fortov VE, Archakov AI, Ivanov YD. Highly Sensitive Detection of CA 125 Protein with the Use of an n-Type Nanowire Biosensor. Biosensors (Basel) 2020; 10:bios10120210. [PMID: 33353197 PMCID: PMC7766891 DOI: 10.3390/bios10120210] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 12/17/2020] [Accepted: 12/17/2020] [Indexed: 12/18/2022]
Abstract
The detection of CA 125 protein in a solution using a silicon-on-insulator (SOI)-nanowire biosensor with n-type chip has been experimentally demonstrated. The surface of nanowires was modified by covalent immobilization of antibodies against CA 125 in order to provide the biospecificity of the target protein detection. We have demonstrated that the biosensor signal, which results from the biospecific interaction between CA 125 and the covalently immobilized antibodies, increases with the increase in the protein concentration. At that, the minimum concentration, at which the target protein was detectable with the SOI-nanowire biosensor, amounted to 1.5 × 10−16 M.
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Affiliation(s)
- Kristina A. Malsagova
- Laboratory of nanotechnology, Institute of Biomedical Chemistry, 119121 Moscow, Russia; (T.O.P.); (R.A.G.); (A.F.K.); (I.D.S.); (V.S.Z.); (A.I.A.); (Y.D.I.)
- Correspondence: ; Tel.: +7-499-246-3761
| | - Tatyana O. Pleshakova
- Laboratory of nanotechnology, Institute of Biomedical Chemistry, 119121 Moscow, Russia; (T.O.P.); (R.A.G.); (A.F.K.); (I.D.S.); (V.S.Z.); (A.I.A.); (Y.D.I.)
| | - Rafael A. Galiullin
- Laboratory of nanotechnology, Institute of Biomedical Chemistry, 119121 Moscow, Russia; (T.O.P.); (R.A.G.); (A.F.K.); (I.D.S.); (V.S.Z.); (A.I.A.); (Y.D.I.)
| | - Andrey F. Kozlov
- Laboratory of nanotechnology, Institute of Biomedical Chemistry, 119121 Moscow, Russia; (T.O.P.); (R.A.G.); (A.F.K.); (I.D.S.); (V.S.Z.); (A.I.A.); (Y.D.I.)
| | - Ivan D. Shumov
- Laboratory of nanotechnology, Institute of Biomedical Chemistry, 119121 Moscow, Russia; (T.O.P.); (R.A.G.); (A.F.K.); (I.D.S.); (V.S.Z.); (A.I.A.); (Y.D.I.)
| | - Vladimir P. Popov
- Rzhanov Institute of Semiconductor Physics, Siberian Branch of Russian Academy of Sciences, 630090 Novosibirsk, Russia; (V.P.P.); (F.V.T.)
| | - Fedor V. Tikhonenko
- Rzhanov Institute of Semiconductor Physics, Siberian Branch of Russian Academy of Sciences, 630090 Novosibirsk, Russia; (V.P.P.); (F.V.T.)
| | - Alexander V. Glukhov
- JSC Novosibirsk Plant of Semiconductor Devices with OKB, 630082 Novosibirsk, Russia;
| | - Vadim S. Ziborov
- Laboratory of nanotechnology, Institute of Biomedical Chemistry, 119121 Moscow, Russia; (T.O.P.); (R.A.G.); (A.F.K.); (I.D.S.); (V.S.Z.); (A.I.A.); (Y.D.I.)
- Joint Institute for High Temperatures of Russian Academy of Sciences, 125412 Moscow, Russia; (O.F.P.); (V.E.F.)
| | - Oleg F. Petrov
- Joint Institute for High Temperatures of Russian Academy of Sciences, 125412 Moscow, Russia; (O.F.P.); (V.E.F.)
| | - Vladimir E. Fortov
- Joint Institute for High Temperatures of Russian Academy of Sciences, 125412 Moscow, Russia; (O.F.P.); (V.E.F.)
| | - Alexander I. Archakov
- Laboratory of nanotechnology, Institute of Biomedical Chemistry, 119121 Moscow, Russia; (T.O.P.); (R.A.G.); (A.F.K.); (I.D.S.); (V.S.Z.); (A.I.A.); (Y.D.I.)
| | - Yuri D. Ivanov
- Laboratory of nanotechnology, Institute of Biomedical Chemistry, 119121 Moscow, Russia; (T.O.P.); (R.A.G.); (A.F.K.); (I.D.S.); (V.S.Z.); (A.I.A.); (Y.D.I.)
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Deng GC, Yan H, Guo ZP, Dai G. Correlation Between Baseline Serum Tumor Markers and Clinical Characteristic Factors in Patients with Advanced Pancreatic Cancer. Onco Targets Ther 2020; 13:11151-11163. [PMID: 33173307 PMCID: PMC7646411 DOI: 10.2147/ott.s269720] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 09/29/2020] [Indexed: 12/18/2022] Open
Abstract
PURPOSE In pancreatic cancer (PC), CA 19-9, CEA and CA 125 are the most widely used tumor markers. The aim of this study was to explore the prognostic significance of baseline levels of serum CA 19-9, CEA, and CA 125, and to evaluate the clinical significance of these markers in PC patients. PATIENTS AND METHODS A total of 278 patients with advanced PC that had received first-line chemotherapy treatments were examined. Correlation analysis between the tumor markers and clinical characteristics was performed using a Pearson's Chi-squared test or Fisher's exact test. A Pearson's correlation test was utilized to investigate the relationship between tumor markers and peripheral blood parameters. Univariate analysis was estimated using a Kaplan-Meier analysis and compared using a Log rank test. Multivariate analysis was performed using a Cox proportional hazards regression model. RESULTS Both individually and collectively, the baseline CA 19-9, CEA and CA 125 levels were positively associated with the primary tumor site (p < 0.01), liver metastasis (p < 0.05), and number of organ metastases (p < 0.05). Furthermore, CA 19-9, CEA and CA 125 were correlated to baseline WBC (p < 0.001) and LDH (p < 0.01) levels. Additionally, CA 19-9 was correlated with years of smoking (p = 0.024); diabetes and years of diabetes (p = 0.012); baseline glycemic levels (p = 0.004); and neutrophil counts (p < 0.001). Moreover, CA 125 levels were associated with the baseline neutrophil counts (p < 0.001) and peritoneal metastasis (p = 0.008). When examining neutrophil, LDH, CA 19-9 and CA 125 levels were found to be associated with overall survival (OS) and shown to be independent prognostic factors. CONCLUSION CA 19-9, CEA and CA 125 are correlated with multiple clinical factors. Baseline neutrophil, LDH, CA 19-9 and CA 125 levels are associated with OS and may potentially serve as prognostic factors.
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Affiliation(s)
- Guo-chao Deng
- School of Medicine, Nankai University, Tianjin300071, People’s Republic of China
- Department of Medical Oncology, The First Medical Center of Chinese People’s Liberation Army (PLA) General Hospital, Beijing, 100853, People’s Republic of China
| | - Huan Yan
- Department of Medical Oncology, The First Medical Center of Chinese People’s Liberation Army (PLA) General Hospital, Beijing, 100853, People’s Republic of China
| | - Zhi-peng Guo
- Department of Medical Oncology, The First Medical Center of Chinese People’s Liberation Army (PLA) General Hospital, Beijing, 100853, People’s Republic of China
| | - Guanghai Dai
- School of Medicine, Nankai University, Tianjin300071, People’s Republic of China
- Department of Medical Oncology, The First Medical Center of Chinese People’s Liberation Army (PLA) General Hospital, Beijing, 100853, People’s Republic of China
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Ekanayake CD, Munasinghe N, Kumarasinghe I, Rasnayake S. Elevated CA 125 level in a mucinous cystadenoma and a teratoma: a case report. J Med Case Rep 2020; 14:141. [PMID: 32878645 PMCID: PMC7469355 DOI: 10.1186/s13256-020-02458-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 07/23/2020] [Indexed: 11/10/2022] Open
Abstract
Background The presence of a suspicious ovarian cyst with elevated cancer antigen 125 level in a woman of reproductive age poses a serious therapeutic dilemma. Mature cystic teratomas and mucinous cystadenomas may also cause an increase in cancer antigen 125. Case presentation A 43-year-old Sinhalese woman with a history of anovulatory subfertility for 5 years presented with heavy menstrual bleeding and secondary dysmenorrhea of 6 months’ duration. Imaging (pelvic ultrasound and computed tomography of the abdomen and pelvis) revealed a hemorrhagic cyst (6 × 4 cm) on the right side and a multilocular cyst with solid areas (10 × 7 cm) on the left side. Her cancer antigen 125 level was 2715 U/ml. Following a multidisciplinary team meeting, a fertility-sparing staging laparotomy was performed, which included right cystectomy, left oophorectomy, infracolic omentectomy, and peritoneal washings. Histology revealed a mucinous cystadenoma of the right ovary and a mature cystic teratoma on the left ovary. No malignant cells were observed in peritoneal washings. The patient’s cancer antigen 125 level dropped to 74.8 U/ml 1 month after surgery. Conclusion Rarely, teratomas and mucinous cystadenomas may also give rise to an extremely high cancer antigen 125 level. The risk of malignancy index and risk of malignancy algorithm may both be misleading in these instances. Therefore, multidisciplinary input, fertility-sparing surgery, and follow-up are paramount to achieve optimal treatment and patient satisfaction.
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Affiliation(s)
- Chanil Deshan Ekanayake
- Department of Clinical Sciences, Faculty of Medicine, General Sir John Kotelawala Defence University, Ratmalana, Sri Lanka.
| | - Nayoman Munasinghe
- Department of Clinical Sciences, Faculty of Medicine, General Sir John Kotelawala Defence University, Ratmalana, Sri Lanka
| | - Iranthi Kumarasinghe
- Department of Paraclinical Sciences, Faculty of Medicine, General Sir John Kotelawala Defence University, Ratmalana, Sri Lanka
| | - Sachini Rasnayake
- Department of Clinical Sciences, Faculty of Medicine, General Sir John Kotelawala Defence University, Ratmalana, Sri Lanka
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Zhai Y, Hui Z, Men Y, Luo Y, Gao Y, Kang J, Sun X, Wang J. Combined neat model for the prognosis of postoperative stage III-N2 non-small cell lung cancer. Thorac Cancer 2020; 11:2610-2617. [PMID: 32725794 PMCID: PMC7471036 DOI: 10.1111/1759-7714.13585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/02/2020] [Accepted: 07/03/2020] [Indexed: 01/26/2023] Open
Abstract
Background Lung cancer serum tumor markers including carcinoembryonic antigen (CEA), cytokeratin 19 fragment (CYFRA21‐1), and carbohydrate antigen 125(CA125) as prognostic predictors is controversial. Therefore, this study aimed to evaluate the association between these markers and the survival of patients with postoperative stage III‐N2 non‐small cell lung cancer (NSCLC). Methods We enrolled 1011 patients with pathologically confirmed stage III‐N2 NSCLC who underwent resection and whose pretreatment serum tumor marker levels were available. Patients were categorized according to their serum levels into low‐, medium‐, and high‐risk groups. Overall survival (OS), progression‐free survival (PFS), local regional relapse‐free survival (LRFS), and distant metastasis‐free survival (DMFS) were calculated from the date of resection. Their association with each serum tumor marker was assessed using the log‐rank test. Results Abnormal CEA levels were associated with worse five‐year OS, PFS and DMFS; abnormal CYFRA21‐1 levels were associated with worse five‐year OS and LRFS; and abnormal CA125 levels were associated with worse five‐year OS, PFS, LRFS and DMFS. Among the risk groups, there were significant differences in five‐year OS, PFS, LRFS and DMFS (P = 0.000). In propensity score matching analysis, the model also achieved prognostic significance for all four survival classifications (P = 0.001–0.004) among the three risk groups. Conclusions The combined model achieved prognostic significance for all survival outcome types. The serum tumor markers tested are useful prognostic predictors for postoperative NSCLC patients but not for all survival outcomes. The combination of the three indices is more reliable in predicting all four of the survival outcomes. Key points Significant findings of the study Serum CEA, CYFRA21‐1, and CA125 levels can be used as prognostic factors of postoperative N2 non‐small cell lung cancer patients but not for all survival outcomes, suggesting that combinative detection of all three indices would be more reliable. What this study adds Our model utilizes available technology, with conventional cutoff values, inexpensive costs, and simple mathematics methods and, thus, can be feasibly employed by clinicians or oncologists.
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Affiliation(s)
- Yirui Zhai
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zhouguang Hui
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.,Department of VIP Medical Services, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yu Men
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.,Department of VIP Medical Services, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yang Luo
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yushun Gao
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jingjing Kang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xin Sun
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jianyang Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Kumar V, Rajan S, Gupta S, Akhtar N, Sharma S, Sinha P, Misra S, Chaturvedi A. Diagnostic Value of Risk of Malignancy Algorithm (ROMA) in Adnexal Masses. J Obstet Gynaecol India 2020; 70:214-9. [PMID: 32476768 DOI: 10.1007/s13224-019-01295-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Accepted: 11/01/2018] [Indexed: 10/25/2022] Open
Abstract
Background Differentiating malignancy from benign diseases is the key to successful management of adnexal masses. Risk of malignancy algorithm (ROMA) has been used for this purpose. We have prospectively studied the diagnostic value of ROMA in patients presented with adnexal masses. Methods We prospective calculated ROMA values prior to surgery for adnexal masses. The risk calculated was then correlated with the histological findings, and results were analyzed according to menopausal status. ROMA cutoff value was determined using ROC curve, and sensitivity, specificity and predictive values were calculated. Statistics were performed on SPSS software (version 20.0). Results There were 94 patients with adnexal masses included in the study, 65 (69.1%) had epithelial ovarian cancer and 29 (30.9%) were diagnosed benign on histopathology. In both pre- and postmenopausal patients, ROMA values were significantly higher in patients with malignancy compared to those with benign disease (p < 0.05). ROMA score was of a significant diagnostic value in both premenopausal (AUC = 0.914, Z = 10.81, p < 0.001) and postmenopausal patients (AUC = 0.975, Z = 21.51, p < 0.001). In premenopausal females, ROMA > 13.3% was able to discriminate malignant from benign patients with 97.06% sensitivity and 85.00% specificity. The positive and negative predictive values were 91.7% and 94.4%. Similarly, in postmenopausal females, ROMA value of > 76% achieved 87.10% sensitivity and 100.00% specificity in discriminating malignant from benign patients with 100% positive and 69.2% negative predictive value. The overall accuracy of ROMA in pre- and postmenopausal patients was 87.0% and 85%, respectively. Conclusions ROMA is a useful and accurate test for differentiating epithelial ovarian cancer from benign ovarian masses. Further studies are needed to compare performance of ROMA with the Risk of Malignancy Index (RMI), CA 125 and HE4. Such comparative studies will be helpful to the clinician in deciding the best diagnostic tool for women with adnexal masses.
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Aslan K, Onan MA, Yilmaz C, Bukan N, Erdem M. Comparison of HE 4, CA 125, ROMA score and ultrasound score in the differential diagnosis of ovarian masses. J Gynecol Obstet Hum Reprod 2020; 49:101713. [PMID: 32084612 DOI: 10.1016/j.jogoh.2020.101713] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 02/04/2020] [Accepted: 02/07/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To compare the value of ultrasonography (USG) score, cancer antigen 125 (CA 125), human epididymis protein 4 (HE 4) and risk of malignancy algorithm (ROMA) in differential diagnosis ovarian masses. METHODS This prospective study was conducted between May 2012 and September 2013 in a single center. Eighty-four women who had an ovarian mass on imaging and underwent surgery were included. The diagnostic performances of CA 125, HE 4, ROMA score and USG score for ovarian cancer were analyzed. RESULTS There were 65 (77.3 %) women with benign ovarian tumors and 19 (22.7 %) women with malignant ovarian tumors. According to receiver operating characteristic (ROC) analysis; area under curve (AUC) was 0.874 for the USG score (p < 0.001), 0.794 for the CA 125 (p < 0.001), 0.9 for the HE 4 (p < 0.001), and 0.893 for the ROMA (p < 0.001). The USG score ≥ 3 had a sensitivity of 68.4 % and specificity of 90.7 %.The CA 125 ≥ 35 IU/l, had a sensitivity of 84.2 %, specificity of 49.2 %, the HE 4 ≥ 150 pM, had a sensitivity of 84.2 %, specificity of 98.4 % and the ROMA score had a sensitivity of 84.2 %, specificity of 75.3 % CONCLUSION: The HE 4 had higher accuracy than ROMA score, USG score and CA 125, in predicting ovarian cancer. Besides, the USG score was a simple and achievable method with acceptable performance.
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Nyangoh-Timoh K, Bendifallah S, Dion L, Ouldamer L, Levêque J. [Borderline Ovarian Tumours: CNGOF Guidelines for Clinical Practice - Value of Tumor Markers]. ACTA ACUST UNITED AC 2020; 48:277-286. [PMID: 32004789 DOI: 10.1016/j.gofs.2020.01.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate the diagnostic value of serum biomarkers in the management strategy of borderline ovarian tumours (BOT) to make management recommendations. METHODS English and French review of literature from 1990 to 2019 based on publications from Pubmed, Medline, Cochrane, with keywords: borderline ovarian tumors, tumour markers, CA125, CA19 9, ACE, CA72 4, TAG72, HE4, ROMA, mucinous, serous, mucinous, endometrioid ovarian tumours, peritoneal implants, recurrence, overall survival, follow-up. Among 1000 references, 400 were selected and only 30 were screened for this work. RESULTS Literature review: there is low evidence in literature concerning the discriminating value of serum tumour biomarkers (CA125, CA19-9, CEA, CA72-4, HE4) and specific score between presumed benign ovarian tumour/BOT/ovarian cancer (LE4). Serum CA125 antigen is higher in case of serous borderline ovarian tumour (LE4), increase with the tumor height, the FIGO stage, notably in case of serous borderline ovarian tumor. However, a normal value rate of serum CA125 antigen does not rule out a BOT (LE4). The preoperative positivity rate of CA19 9 in case of TFO is relatively lower than that of CA125 and is higher in mucinous TFO. The preoperative rate of serum CA19 9 antigen increases with the tumour height and the FIGO stage (LE4) and are higher in case of mucinous BOT (LE4). Preoperative rates of serum HE4 are not different between histologic type of BOT. A high level of serum biomarkers (CA125) is a predictive factor of peritoneal implants (LE4) and an independent predictive factor of recurrence (CA125) (LE4). RECOMMENDATIONS no recommendation can be made about the use of serum tumour biomarkers (CA125, CA19-9, CEA, CA72-4, HE4) or specific score in order to distinguish benign ovarian tumor/borderline ovarian tumor/ovarian cancer in case of indeterminate mass. In case of suspicion of mucinous ovarian tumour on imaging, the systematic dosage of serum CA19-9 antigen can be proposed (grade C). In case of an ovarian indeterminate mass on imaging; dosage of serum HE4 and C125 is recommended. If preoperative dosage of serum tumor biomarkers is normal, their systematic dosage is not recommended in the follow-up of BOT (grade C). If preoperative dosage of CA125 is high, the systematic dosage of CA125 is recommended in the follow-up of BOT with no precisions about the rhythm and the duration of the follow-up (grade B).
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Affiliation(s)
- K Nyangoh-Timoh
- Département de gynécologie-obstétrique et reproduction humaine, 16, boulevard de Bulgarie, 35000 Rennes, France; UFR médecine université de Rennes 1, CHU Anne-de-Bretagne, Bretagne, France
| | - S Bendifallah
- Service de chirurgie gynécologique et mammaire, maternité, et médecine de la reproduction, hôpital Tenon, AP-HP, 4, rue de la Chine, 75020 Paris, France; Sorbonne Université, 75006 Paris, France
| | - L Dion
- Département de gynécologie-obstétrique et reproduction humaine, 16, boulevard de Bulgarie, 35000 Rennes, France; UFR médecine université de Rennes 1, CHU Anne-de-Bretagne, Bretagne, France
| | - L Ouldamer
- Département de gynécologie, hôpital Bretonneau, centre hospitalier universitaire de Tours, 2, boulevard Tonnellé, 37000 Tours, France
| | - J Levêque
- Département de gynécologie-obstétrique et reproduction humaine, 16, boulevard de Bulgarie, 35000 Rennes, France; UFR médecine université de Rennes 1, CHU Anne-de-Bretagne, Bretagne, France.
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Nowak A, Soja M, Masternak M, Mokros Ł, Wilczyński J, Szubert M. Evaluation of adnexal tumours in the International Ovarian Tumor Analysis system in reference to histopathological results. Prz Menopauzalny 2019; 18:141-5. [PMID: 31975980 DOI: 10.5114/pm.2019.90812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 11/07/2019] [Indexed: 11/21/2022]
Abstract
Aim of the study To retrospectively evaluate how the International Ovarian Tumor Analysis (IOTA) simple rules used in ultrasound examinations estimate the probability of malignant and benign tumour occurrence in the studied population. Material and methods The study was performed on a group of 425 patients with ovarian tumours operated in the Clinic of Surgical and Oncological Gynecology at the Medical University of Lodz in the years 2014-2015. Adnexal tumours were rated according to IOTA simple rules, classifying them as probably malignant, probably benign, or unclassified. The results of the study were compared with final histopathological results. The statistical analysis was performed using STATISTICA 13 PL with Medical Pack. Results We analysed data on n = 43 (11%) patients with malignant, n = 346 (86%) patients with benign, and n = 12 (3%) patients with borderline tumours, respectively. Malignant tumour patients were significantly older (mean age 61.0 ±11.6 vs. 43.6 ±16.2 years, p< 0.001), had higher BMI (mean 27.3 ±7.0 vs. 25.2 ±5.2, p< 0.05), more pregnancies (median 2 vs. 1, p = 0.001), and higher cancer antigen 125 (CA 125) concentrations (median 251.5 vs. 18.5, p< 0.001) than patients with a benign tumour. Also, they more often suffered from diabetes mellitus (19% vs. 8%, p = 0.02) and arterial hypertension (60% vs. 42%, p< 0.01) than benign tumour patients. Conclusions In our study, IOTA performance in predicting or ruling out a malignant tumour was highly satisfactory and similar to that of CA 125. Both the methods may be complementary and used to assess the risk of malignant vs. benign ovarian neoplasm, although the context of other clinical variables may also be important.
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Abstract
Intra-abdominal tuberculosis (TB) is rare in Australia, but it can be found in those who emigrate from endemic areas. We report a rare case of a 28-year-old lady from the Philippines who presented with abdominal pain, ascites and an elevated cancer antigen (CA) 125 with an initial concern of ovarian malignancy. She underwent a diagnostic laparoscopy which revealed typical features of intra-abdominal TB and histological features of granulomatous inflammation. The symptoms and signs of intra-abdominal TB are non-specific and can mimic many other conditions. The gold-standard mode of diagnosis in intra-abdominal TB is laparoscopy with tissue biopsy. Ovarian malignancy is relatively rare in pre-menopausal women; hence an elevated CA 125 warrants a broader differential diagnosis. It is important to have intra-abdominal TB as a differential even in the non-endemic settings to avoid delay in diagnosis and appropriate management.
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Affiliation(s)
- Yaying Eileen Xu
- General Surgical Department, Caboolture Hospital, Brisbane, 4510, Australia
| | - Kimberley Tan
- General Surgical Department, Caboolture Hospital, Brisbane, 4510, Australia
| | - Rasika Hendahewa
- General Surgical Department, Caboolture Hospital, Brisbane, 4510, Australia
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Choi HJ, Lee YY, Sohn I, Kim YM, Kim JW, Kang S, Kim BG. Comparison of CA 125 alone and risk of ovarian malignancy algorithm (ROMA) in patients with adnexal mass: A multicenter study. Curr Probl Cancer 2019; 44:100508. [PMID: 31708114 DOI: 10.1016/j.currproblcancer.2019.100508] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 09/11/2019] [Accepted: 10/10/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND This multicenter study aimed to evaluate the performance of CA 125 and risk of ovarian malignancy algorithm (ROMA) in differentiating epithelial ovarian cancer (EOC) from benign adnexal mass. We consecutively enrolled 782 patients referred to tertiary hospitals with adnexal mass requiring surgical treatment. A total 322 of patients with benign adnexal disease and 327 patients with EOC were included in the analysis. Using reference cut-off values in premenopausal women, ROMA had better specificity (0.926 vs. 0.787, P < 0.001) and accuracy (0.875 vs. 0.777, P < 0.001) than CA 125 alone and comparable sensitivity (0.707 vs. 0.747, P = 0.549). Using optimum cut-off values in premenopausal women, CA 125 and ROMA had comparable specificity (0.922 vs. 0.947, P < 0.001) and accuracy (0.871 vs. 0.868, P = 0.879); however, sensitivity for CA 125 was inferior to that of ROMA (0.707 vs. 0.613, P = 0.039). In postmenopausal women, sensitivity, specificity, and accuracy were comparable between CA 125 alone and ROMA using either reference cut-off values or optimum cut-off values.ROMA showed better diagnostic performance in differentiating EOC from benign adnexal tumors among premenopausal women. However, in postmenopausal women, ROMA did not show any benefit over CA 125 alone.
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Affiliation(s)
- Hyun-Jin Choi
- Department of Obstetrics and Gynecology, Chung-Ang University College of Medicine, Seoul, Republic of Korea
| | - Yoo-Young Lee
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - Insuk Sohn
- Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Seoul, Republic of Korea
| | - Yong-Man Kim
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Songpa-gu, Seoul, Republic of Korea
| | - Jae-Weon Kim
- Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Sokbom Kang
- Gynecologic Oncology Research Branch, Research Institute and Hospital, National Cancer Center, Goyang, Republic of Korea
| | - Byoung-Gie Kim
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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Shen Y, Zhao L, Lu S. Diagnostic performance of HE4 and ROMA among Chinese women. Clin Chim Acta 2019; 500:42-46. [PMID: 31626761 DOI: 10.1016/j.cca.2019.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 10/01/2019] [Accepted: 10/02/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Human epididymis protein 4 (HE4) has been suggested as a new biomarker for the detection of ovarian cancer. Because there are few reports on HE4 in terms of ovarian cancer diagnosis in the Chinese population, we evaluated the diagnostic performances of HE4 and the ROMA in Chinese women with pelvic masses. METHODS The serum concentrations of CA 125 and HE4 in 318 Chinese women with pelvic masses (39 of which were ovarian cancers) were determined. RESULTS For the discrimination of benign gynecological diseases from ovarian cancer, the sensitivity and specificity values were 87.2% and 75.8% for the ROMA and 51.3% and 97.3% for HE4. The ROMA also showed higher sensitivity than HE4 in both the early and advanced stages. In the ROC curve analysis, the AUC values for ROMA, HE4 and CA 125 were 0.927, 0.907 and 0.785, respectively. CONCLUSIONS As a new tumor marker, HE4 shows high specificity and efficacy in the Chinese population, while the ROMA that combines HE4 and CA 125 shows high sensitivity and a high Youden's index. These markers should be extended to China since they have good diagnostic performances.
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Affiliation(s)
- Yuhuan Shen
- Department of Clinical Laboratory, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, 310014 Hangzhou, China
| | - Li Zhao
- Women's Hospital, School of Medicine, Zhejiang University, No. 1 Xueshi Road, 310006 Hangzhou, China
| | - Shiming Lu
- Women's Hospital, School of Medicine, Zhejiang University, No. 1 Xueshi Road, 310006 Hangzhou, China.
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Lee Y, Lee Y, Lee S, Jung S, Chon S. Correlation of preoperative biomarkers with severity of adhesion in endometriosis. J Gynecol Obstet Hum Reprod 2019; 49:101637. [PMID: 31520750 DOI: 10.1016/j.jogoh.2019.101637] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 07/26/2019] [Accepted: 09/10/2019] [Indexed: 01/04/2023]
Abstract
This study was undertaken to evaluate the correlation between preoperative Serum markers and pelvic adhesions in endometriosis patients and to explore the markers' clinical value for outcome prediction. Preoperative blood Serum and CA 125 results were obtained and pelvic adhesion scores were calculated. The patient group with adhesion scores less than 28 points was defined as the mild adhesion group, and those with a score of 28 or more were members of the severe adhesion group. The CA 125 level was significantly higher in the severe adhesion group than in the mild adhesion group. The CA 125 level, size of the largest cyst, and WBC count were associated with the level of pelvic adhesion. Adhesion scores were significantly higher in the CA 125 ≥ 35 U/mL group than in the CA 125 < 35 U/mL group. Patients with a preoperative CA 125 level higher than 35 U/mL are at high risk for pelvic adhesion.
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Affiliation(s)
- Yoojung Lee
- Department of Obstetrics and Gynecology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Yaeheun Lee
- Department of Obstetrics and Gynecology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Seungho Lee
- Department of Obstetrics and Gynecology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea.
| | - Sunyong Jung
- Department of Obstetrics and Gynecology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Seungjoo Chon
- Department of Obstetrics and Gynecology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
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Simsek SY, Serbetcioglu G, Alemdaroglu S, Yetkinel S, Durdag GD, Celik H. Clinicopathologic characteristics of recurrent endometrioid endometrial cancer patients and analysis of methods used durıing surveillance. J Gynecol Obstet Hum Reprod 2019; 48:473-477. [PMID: 31212025 DOI: 10.1016/j.jogoh.2019.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/07/2019] [Accepted: 06/08/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To determine cilinicopathologic characteristics of recurrent endometrioid type endometrial cancer patients and analyze the methods applied in detection of recurrent disease during follow-up period. METHODS We have retrospectively reviewed the file records of the 226 patients who had endometrioid type carcinoma. Bimanual pelvic examination, speculum examination, carcinogenic antigen-125 (CA125) testing, vaginal cuff cytologic screening, transabdominal ultrasound (TAUS) and transvaginal ultrasound(TVUS) imagings were performed within the context of routine follow-up control examinations in the post-treatment period in every 3 months within the first 2 years and in every 6 months in the following 2 years and with annual control in the consecutive years. RESULTS Mean follow-up durations was 25.7±18.9 months while recurrence rate was 3.1%. The study patient group underwent totally 1116 times TVUS and 1084 times whole TA-US evaluations, 973 times vaginal cuff cytological screening, 1125 times pelvic and general physical examinations beside 1060 times CA-125 testings were performed in accordance with our routinely performed follow-up protocol. The asymptomatic recurrent cases ; one of those was dignosed with pelvic examination while diagnosis was established using TA-USG evaluation in the other asymptomatic patient. The other 5 cases were symptomatic. Pelvic examination, Computed Tomograhy and Magnetic Resonance Imaging were utilized in diagnosing 1, 3 and 1 of those patients, respectively. CONCLUSION The presence of symptoms and pelvic examination seem to be the most effective modalities in detecting recurrence in follow-up of endometrial cancer. It would be reasonable to optimize intervals between follow-up visits and to determine the appropriate evaluations by considering risk levels of the patients.
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Affiliation(s)
- S Y Simsek
- Baskent University Adana Dr. Turgut Noyan Teaching Hospital, Turkey.
| | - G Serbetcioglu
- Baskent University Izmir Zubeyde Hanım Research Hospital, Turkey
| | - S Alemdaroglu
- Baskent University Adana Dr. Turgut Noyan Teaching Hospital, Turkey
| | - S Yetkinel
- Baskent University Adana Dr. Turgut Noyan Teaching Hospital, Turkey
| | - G D Durdag
- Baskent University Adana Dr. Turgut Noyan Teaching Hospital, Turkey
| | - H Celik
- Baskent University Adana Dr. Turgut Noyan Teaching Hospital, Turkey; Baskent University Izmir Zubeyde Hanım Research Hospital, Turkey
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Pils S, Paternostro C, Mayerhoefer ME, Reinthaller A, Feichtinger M. Heavy black tea consumption and elevated CA 19-9 and CA 125 levels. A case report on a patient with ovarian endometriotic cysts. Gynecol Endocrinol 2019; 35:478-480. [PMID: 30727790 DOI: 10.1080/09513590.2018.1564743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
In this case report, we present a case of false positive CA 19-9 and CA 125 levels in a patient with suspected endometriotic cysts. The patient is a 34-year-old nulliparous woman with heavy black tea consumption and elevated CA 19-9 and CA 125 levels. After discontinuation of black tea intake and careful exploration of other possible factors, CA 19-9 and CA 125 levels dropped markedly. As a conclusion, heavy black tea consumption can lead to false positive results of elevated CA 19-9 and CA 125 levels.
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Affiliation(s)
- Sophie Pils
- a Department of Gynecology and Gynecological Oncology , Gynecologic Cancer Unit Comprehensive Cancer Center Medical University of Vienna , Vienna , Austria
| | - Chiara Paternostro
- a Department of Gynecology and Gynecological Oncology , Gynecologic Cancer Unit Comprehensive Cancer Center Medical University of Vienna , Vienna , Austria
| | - Marius E Mayerhoefer
- b Department of Biomedical Imaging and Image-Guided Therapy , Medical University of Vienna , Vienna , Austria
| | - Alexander Reinthaller
- a Department of Gynecology and Gynecological Oncology , Gynecologic Cancer Unit Comprehensive Cancer Center Medical University of Vienna , Vienna , Austria
| | - Michael Feichtinger
- a Department of Gynecology and Gynecological Oncology , Gynecologic Cancer Unit Comprehensive Cancer Center Medical University of Vienna , Vienna , Austria
- c Wunschbaby Institut Feichtinger , Vienna , Austria
- d Department of Oncology-Pathology , Karolinska Institutet , Stockholm , Sweden
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Marin-Leiva J, Jeri-Yabar A, Hernandez Fernandez W, Damian Bello E. Biliary Peritonitis due to a Ruptured Amebic Liver Abscess Mimicking a Periampullary Tumor and Liver Metastases with the Elevation of CA 19-9 and CA 125: A Case Report. GE Port J Gastroenterol 2019; 26:121-124. [PMID: 30976617 DOI: 10.1159/000489721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Accepted: 04/21/2018] [Indexed: 11/19/2022]
Abstract
Introduction An amebic liver abscess is the most common presentation of extraintestinal amebiasis. This condition is the result of a parasite infection caused by Entamoeba histolytica. Materials and Methods We report a case of a 53-year-old male who presented with abdominal pain in the right upper quadrant, jaundice, and a 10-kg weight loss within a 1-month span. Results and Conclusion A wide range of symptoms and findings in the imaging tests suggestive of neoplasia, elevated levels of CA 19-9 and CA 125, and the presentation of biliary peritonitis as a complication makes this case a challenge for its approach and management.
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Affiliation(s)
| | - Antoine Jeri-Yabar
- aSchool of Medicine, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
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Zajkowska M, Zbucka-Krętowska M, Sidorkiewicz I, Lubowicka E, Będkowska GE, Gacuta E, Szmitkowski M, Ławicki S. Human Plasma Levels of Vascular Endothelial Growth Factor, Matrix Metalloproteinase 9, and Tissue Inhibitor of Matrix Metalloproteinase 1 and Their Applicability as Tumor Markers in Diagnoses of Cervical Cancer Based on ROC Analysis. Cancer Control 2018; 25:1073274818789357. [PMID: 30037277 PMCID: PMC6058422 DOI: 10.1177/1073274818789357] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Cervical cancer (CC) remains a major diagnostic problem. The introduction of
human papillomavirus vaccination significantly reduced the number of new cases;
however, the search for new methods that would earlier indicate the development
of cancerous changes is vital. The aim of this study was to investigate the
diagnostic power of those parameters in comparison to Cancer Antigen 125 (CA
125) and Squamous Cell Carcinoma Antigen (SCC-Ag) in patients with CC and in
relation to the control group. The study included 100 patients with CC and 50
healthy women. Plasma levels of tested parameters were determined by
enzyme-linked immunosorbent assay, CA 125, and SCC-Ag by chemiluminescent
microparticle immunoassay. Plasma levels of all parameters in the total cancer
group showed statistical significance (in all cases P <
.05). In stage I cancer, only vascular endothelial growth factor (VEGF) and
tissue inhibitors of metalloproteinase 1; in stage II, all the tested parameters
and CA 125; and in stage III + IV, VEGF, matrix metalloproteinase 9 (MMP-9), and
CA 125 showed statistical significance when compared to the healthy volunteers
group. Vascular endothelial growth factor showed the highest value of
sensitivity from all tested parameters (I: 75%, II: 76%, III + IV: 94%, and 82%
in total CC group). The highest specificity was obtained by MMP-9 (94%). In the
total CC, stage I, and stage II groups, all tested parameters showed
statistically significant area under the receiver operating characteristics
curve (AUC), but maximum range was obtained for the combination VEGF + SCC-Ag
(I: 0.9146, II: 0.8941, III + IV: 0.9139, total CC group: 0.9347). The combined
analysis of tested parameters and tumor markers resulted in an increase in
sensitivity and AUC values, which provides hope for developing new panel of
biomarkers that may be used in the diagnosis of CC in the future.
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Affiliation(s)
- Monika Zajkowska
- 1 Department of Biochemical Diagnostics, Medical University of Bialystok, Bialystok, Poland
| | - Monika Zbucka-Krętowska
- 2 Department of Reproduction and Gynecological Endocrinology, Medical University of Bialystok, Bialystok, Poland
| | - Iwona Sidorkiewicz
- 2 Department of Reproduction and Gynecological Endocrinology, Medical University of Bialystok, Bialystok, Poland
| | - Emilia Lubowicka
- 3 Department of Esthetic Medicine, Medical University of Bialystok, Bialystok, Poland
| | - Grażyna Ewa Będkowska
- 4 Department of Haematological Diagnostics, Medical University of Bialystok, Bialystok, Poland
| | - Ewa Gacuta
- 5 Department of Perinatology, Medical University of Bialystok, Bialystok, Poland
| | - Maciej Szmitkowski
- 1 Department of Biochemical Diagnostics, Medical University of Bialystok, Bialystok, Poland
| | - Sławomir Ławicki
- 1 Department of Biochemical Diagnostics, Medical University of Bialystok, Bialystok, Poland
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Laffont A, Goussot V, Berriolo-Riedinger A, Riedinger JM. [ CA 125 assay in the extension assessment of newly diagnosed breast cancers: why and how?]. Ann Biol Clin (Paris) 2018; 76:553-61. [PMID: 30154065 DOI: 10.1684/abc.2018.1368] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
CA 125 assay is sometimes combined in practice with the one of CA 15-3 and CEA in the extension assessment of breast cancers. The purpose of this work is to evaluate the contribution of the initial CA 125 as an indicator of distant metastases (DM) or of serous inflammation (SI). This retrospective study concerns a population of 620 patients with breast cancer without metastatic extension (n=325) or metastatic breast cancer (n=295) diagnosed at the Georges-François Leclerc center from 1998 to 2014. Seventy-four patients had SI. We showed that initial CA 125 level is linked to the TNM clinic status, the HER2 status, the nature and the number of metastatic locations, the inflammation of the tumor or serous. The ROC curves and logistic regression analyses show that CA 125 is an independent predictive criterion of DM presence (threshold of 55 kU/L): this is the only positive marker in 7% of patients with DM. At the threshold of 110 kU/L, the CA 125 is the only predictive biologic factor for SI. In conclusion, these data present the independent predictive value of CA 125 on the presence of DM or SI on condition of usinga specific threshold for each of these uses.
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Stanciu AE, Stanciu MM, Vatasescu RG. NT-proBNP and CA 125 levels are associated with increased pro-inflammatory cytokines in coronary sinus serum of patients with chronic heart failure. Cytokine 2018; 111:13-9. [PMID: 30098475 DOI: 10.1016/j.cyto.2018.07.037] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 07/04/2018] [Accepted: 07/31/2018] [Indexed: 02/08/2023]
Abstract
PURPOSE Heart failure (HF) is considered to be a complex syndrome associated with neurohormonal and cytokine activation, that contribute to its progression. There are evidences which showed that, carbohydrate antigen 125 (CA 125), a tumor marker widely used for ovarian cancer therapy monitoring, was significantly elevated in HF patients. We hypothesized that inflammatory stimuli may be responsible for amino-terminal fragment of the prohormone B-type natriuretic peptide (NT-proBNP) and CA-125 production and release in chronic HF (CHF). We aimed to measure the levels of NT-proBNP, CA 125, pro-anti-inflammatory cytokines (IL-6, IL-1β, IL-8, TNF-α and IL-4), from peripheral venous (PV) and coronary sinus (CS) blood samples, in patients with CHF and to assess their correlation with echocardiographic indices. METHODS We enrolled 32 subjects (20M/12F) with CHF (III-IV NYHA functional class) who were to undergo cardiac resynchronization therapy (CRT) device implantation and 30 healthy controls (18M/12F). Two blood samples, from PV and CS, were collected at the time of CRT for each CHF patient. Serum levels of biomarkers were measured by ELISA. Cardiac function was assessed echocardiographically. RESULTS All investigated biomarkers were significantly higher in CHF patients than in non-CHF controls (P < 0.001). There were positive correlations between biomarkers concentrations in PV and CS (r between 0.54 and 0.98, all P < 0.003). NT-proBNP, IL-6 and IL-1β levels were 17%, 86% and 36% higher in CS than in PV, these increases being very well correlated each other, while CA 125 levels were 86% higher in PV than in CS. Moreover, CS NT-proBNP, CS IL-6 and CS IL-1β serum concentrations were inversely related to the echocardiographically determined left ventricular ejection fraction (LVEF) (r = -0.61, P < 0.001; r = -0.71, P < 0.001 and r = -0.48, P = 0.005, respectively). A positive relationship was found between CA 125 and IL-1β (r = 0.51, P = 0.003) in CS serum and between CA 125 and IL-6 (r = 0.43, P = 0.015), TNF-α (r = 0.46, P = 0.008) in PV serum. CA 125 concentrations were closely related to NT-proBNP both in CS (r = 0.46, P = 0.008) and PV (r = 0.52, P = 0.002). CONCLUSIONS CS sampling of NT-proBNP, CA 125 and pro-anti-inflammatory cytokines provides an additional insight into the possible mechanisms by which these biomarkers lead to left ventricular remodeling. Our results clearly suggest that serum NT-proBNP and CA 125 levels not only in PV, but also in CS of patients with CHF, may be dependent on inflammation as a consequence of cytokine network activation.
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Teh BH, Yong SL, Sim WW, Lau KB, Suharjono HN. Evaluation in the predictive value of serum human epididymal protein 4 (HE4), cancer antigen 125 ( CA 125) and a combination of both in detecting ovarian malignancy. Horm Mol Biol Clin Investig 2018; 35:/j/hmbci.ahead-of-print/hmbci-2018-0029/hmbci-2018-0029.xml. [PMID: 30063463 DOI: 10.1515/hmbci-2018-0029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 06/19/2018] [Indexed: 11/15/2022]
Abstract
Background This study was conducted to evaluate the performance of human epididymal protein 4 (HE4), cancer antigen 125 (CA 125) and a combination of both via the Risk of Ovarian Malignancy Algorithm (ROMA) in detecting ovarian malignancy. Methods This was a diagnostic study enrolling 129 patients with pelvic mass(es) suspected of originating in the ovary who had been scheduled for surgery or radiological-guided biopsy. Serum HE4 and CA 125 levels were measured. HE4, CA 125 and ROMA were evaluated for sensitivity, specificity, positive predictive value and negative predictive value. The receiver operating characteristic (ROC) plots were graphed and area under the curve (AUC) values were calculated to investigate the accuracy of each marker for predicting ovarian malignancy. Results Overall, CA 125 remained significantly more sensitive (88.9% vs. 51.9%, p = 0.006) but less specific (56.9% vs. 95.1%, p < 0.001) than HE4. HE4 was superior to CA 125 in specificity (97.7% vs. 54.5%, p < 0.001) for premenopausal women. ROMA was non-significantly more sensitive (100.0% vs. 92.3%, p = 1.000) than CA 125 but both were equally specific (71.4%) for the postmenopausal group. In the premenopausal group, the AUC of serum HE4 was higher than serum CA 125 (0.851 vs. 0.817) but was equivalent to ROMA (0.851 vs. 0.859). In the postmenopausal group, ROMA exhibited an excellent AUC value as compared to CA 125 and HE4 (AUC of 0.907 vs. 0.874 vs. 0.863, respectively). Conclusion HE4 is useful in ruling out ovarian malignancy among premenopausal women. For postmenopausal women, ROMA appears to be an all-rounder with overall good sensitivity and specificity.
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Affiliation(s)
- Beng Hock Teh
- Department of Obstetrics and Gynaecology, Sarawak General Hospital, Sarawak, Malaysia
| | - Soon Leong Yong
- Department of Obstetrics and Gynaecology, Sibu Hospital, Batu 5 ½, Jalan Ulu Oya, 96000 Sibu, Sarawak, Malaysia, Phone: +6017-9197139
| | - Wee Wee Sim
- Department of Obstetrics and Gynaecology, Sarawak General Hospital, Sarawak, Malaysia
| | - Kim Bee Lau
- Department of Pathology, Sarawak General Hospital, Sarawak, Malaysia
| | - Haris Njoo Suharjono
- Department of Obstetrics and Gynaecology, Sarawak General Hospital, Sarawak, Malaysia
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Kim B, Park Y, Kim B, Ahn HJ, Lee KA, Chung JE, Han SW. Diagnostic performance of CA 125, HE4, and risk of Ovarian Malignancy Algorithm for ovarian cancer. J Clin Lab Anal 2018; 33:e22624. [PMID: 30009497 DOI: 10.1002/jcla.22624] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 06/25/2018] [Accepted: 06/26/2018] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE We evaluated the diagnostic performance of CA 125, HE4, and ROMA for ovarian cancer in Koreans and set optimal cutoffs. METHOD Serum levels of HE4 and CA 125 and the ROMA score were determined in 762 patients with benign gynecological disease and 70 with ovarian cancer. Receiver operating characteristic curves were constructed to calculate the areas under the curve (AUC). CA 125, HE4, and ROMA exhibiting maximum Youden index were determined, respectively, as the optimal cutoffs, and sensitivity and specificity were evaluated by applying those cutoffs. RESULTS In benign diseases, CA 125 significantly increased in patients with uterine myoma, adenomyosis, endometrial pathology, or endometriosis, but HE4 only increased in patients with adenomyosis. For the diagnosis of ovarian cancer, the combination of CA 125, HE4, and age showed the highest AUC value of 0.892 in the premenopausal group, and ROMA demonstrated the best diagnostic performance, with an AUC of 0.935 in postmenopausal patients. When the optimal cutoff values for CA 125 and HE4 were applied, the sensitivities of CA 125, HE4, and ROMA in premenopausal women were all the same at 0.714, while the specificities were 0.841, 0.974, and 0.972, respectively. In the postmenopausal group, the sensitivities of these markers were 0.857, 0.804, and 0.929, and the specificities were 0.836, 0.887, and 0.800, respectively. CONCLUSION Although all markers demonstrated good diagnostic performance, they varied depending on the pathologic types of benign diseases and ovarian cancer. For accurate diagnosis of ovarian cancer, CA 125, HE4, and ROMA should be used complementarily.
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Affiliation(s)
- Boyeon Kim
- Department of Laboratory Medicine, National Health Insurance Service Ilsan Hospital, Goyang-si, Korea.,Department of Laboratory Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Yongjung Park
- Department of Laboratory Medicine, National Health Insurance Service Ilsan Hospital, Goyang-si, Korea
| | - Banseok Kim
- Department of Laboratory Medicine, National Health Insurance Service Ilsan Hospital, Goyang-si, Korea
| | - Hyo Jun Ahn
- Department of Laboratory Medicine, National Health Insurance Service Ilsan Hospital, Goyang-si, Korea
| | - Kyung-A Lee
- Department of Laboratory Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Eun Chung
- Department of Obstetrics and Gynecology, National Health Insurance Service Ilsan Hospital, Goyang-si, Korea
| | - Sang Won Han
- Department of Obstetrics and Gynecology, National Health Insurance Service Ilsan Hospital, Goyang-si, Korea
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