scholarly journals Evaluation of serum carbohydrate antigen 19-9 as a diagnostic marker for pancreatic malignancy

2020 ◽  
Vol 7 (9) ◽  
pp. 2824
Author(s):  
A.K.M. Ahsan Ullah ◽  
S. M. Ferdous Ahmed ◽  
A. S. M. Lokman Hossain Chowdhury ◽  
Saad Mohammed ◽  
M. Mozammel Haque ◽  
...  
Keyword(s):  
Tumor Marker ◽  
Carbohydrate Antigen ◽  
Predictive Values ◽  
Benign Condition ◽  
Pancreatic Diseases ◽  
Pancreatic Malignancy ◽  
Serum Carbohydrate Antigen ◽  
High Level ◽  
Sensitivity Specificity ◽  
Medical University

Background: Carbohydrate antigen (CA) 19-9 is considered as a tumor marker in biliary-pancreatic malignancy. Though a high level may indicate the presence of a malignant disorder, it may rise even in benign condition. Similarly, the value may be normal even in malignant condition.Methods: An observational comparative study was conducted in the Department of Surgery of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from 01 June 2016 to 31 May 2017 to find out the sensitivity and specificity of CA 19-9 as a tumor marker in pancreatic malignancy in our perspective and to find out a cut-off value of CA 19-9 which might prove as a definitive indication of pancreatic malignancy.Results: The study shows when the cut off value of CA 19-9 is 37 U/ml. The sensitivity, specificity, positive and negative predictive values (PPV and NPV) were 77.8%, for all four characteristics respectively. But if the serum CA 19-9 threshold used to diagnose pancreatic cancer was raised to 100 and 120, sensitivity decreased to 72.2% and 66.7% and NPV decreased to 76.2% and 73.9% respectively. However, specificity increased to 88.9% and 94.4% and PPV increased to 86.7% and 92.3% respectively.Conclusions: Serum CA 19-9 level may be considered as an important determinant in the diagnosis of malignant pancreatic diseases and to assess the resectability of the lesions preoperatively, but other adjuncts are necessary in the overall management of pancreatic diseases.

scholarly journals Investigation of a measles outbreak in Zimbabwe, 2010: potential of a point of care test to replace laboratory confirmation of suspected cases

2015 ◽  
Vol 143 (16) ◽  
pp. 3442-3450 ◽  
Author(s):  
A. SHONHAI ◽  
L. WARRENER ◽  
D. MANGWANYA ◽  
R. SLIBINSKAS ◽  
K. BROWN ◽  
...  
Keyword(s):  
Point Of Care ◽  
N Gene ◽  
Predictive Values ◽  
Point Of Care Test ◽  
Measles Outbreak ◽  
Laboratory Confirmation ◽  
High Level ◽  
Sensitivity Specificity ◽  
Level Of Agreement

SUMMARYBlood and oral fluid (OF) samples were collected from 103 suspected measles cases between February and November 2010 during a nationwide measles outbreak in Zimbabwe. Siemens measles IgM enzyme immunoassay (EIA) on serum, Microimmune measles IgM capture EIA on OF, real-time haemagglutinin (H) gene PCR and nested nucleocapsid (N) gene PCR on OF were performed, confirming 75 measles cases. These samples were then used to evaluate a newly developed point of care test (POCT) for measles and determine its potential for identifying measles cases in outbreaks. After performing POCTs on OF samples, nucleic acid was extracted from the used test strips and the measles H and N genes amplified by RT–PCR. The sensitivity, specificity, positive and negative predictive values of the POCT for IgM in OF was 75·0% [95% confidence interval (CI) 63·4–84·5], 96·2% (95% CI 80·4–99·9), 98·2% (95% CI 90·3–100) and 58·1% (95% CI 42·1–73·0), respectively. The N gene sequences showed high level of agreement between original OF and corresponding POCT strips. Measles genotype B3 was identified in all cases. We conclude that the measles POCT has the potential to be used, at the point of contact, in outbreak situations and provide molecular characterization of the virus at a later date.

scholarly journals Predictive value of CONUT score combined with serum CA199 levels in postoperative survival of patients with pancreatic ductal adenocarcinoma: a retrospective study

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e8811
Author(s):  
Ankang Wang ◽  
Bo Sun ◽  
Min Wang ◽  
Hao Shi ◽  
Zhiwei Huang ◽  
...  
Keyword(s):  
Pancreatic Ductal Adenocarcinoma ◽  
Radical Resection ◽  
Carbohydrate Antigen ◽  
Ductal Adenocarcinoma ◽  
Free Survival ◽  
Kaplan Meier ◽  
Serum Carbohydrate Antigen ◽  
Medical University ◽  
Conut Score

Background The preoperative controlling nutritional status (CONUT) score and serum carbohydrate antigen 199 (CA199) levels are individually correlated with the prognosis of pancreatic ductal adenocarcinoma (PDAC). The objective of this study aimed to investigate the efficacy of CONUT score and CA199 (CONUT-CA199) combination in predicting the prognosis of PDAC patients undergoing radical surgery. Methods We retrospectively analyzed the preoperative CONUT scores and serum CA199 levels of 294 patients with PDAC who underwent radical resection at the Affiliated Hospital of Southwest Medical University between March 2012 and July 2019. Patients were divided into four groups on the basis of their preoperative CONUT scores and serum CA199 levels: CONUTlow/CA199low (1), CONUTlow/CA199high (2), CONUThigh/CA199low (3) and CONUThigh/CA199high (4). The prognostic effects were compared among the groups. Results CONUThigh was more frequent in patients with positive peripancreatic infiltration and Clavien–Dindo classification of ≥IIIa (P < 0.001). Kaplan–Meier analysis revealed obvious difference in overall survival (OS) and recurrence-free survival (RFS) among patients with PDAC having CONUT-CA199 scores of 1, 2, 3 and 4 (P < 0.001). Peripancreatic infiltration, lymph node metastasis, pTNM stage, CONUT score, serum CA199 levels and CONUT-CA199 classification were found to be the independent prognostic factors for OS and RFS in multivariate analyses. In time-dependent receiver operating characteristic (ROC) analyses, the area of the CONUT-CA199 score under the ROC curve (AUC) was higher than that of the preoperative CONUT score or serum CA199 levels for the prediction of OS and RFS. Conclusion CONUT-CA199 classification may be more effective in predicting the postoperative prognosis of PDAC patients.

scholarly journals Diagnostic Accuracy of Serum Carbohydrate Antigen 19-9 in Determining Etiology of Obstructive Jaundice

2017 ◽  
Vol 7 (2) ◽  
pp. 95-100 ◽  
Author(s):  
Rokanuzzaman Bhuyian ◽  
Mohammad Golam Azam ◽  
Md Abdur Rob ◽  
Tareq M Bhuiyan ◽  
Md Anisur Rahman
Keyword(s):  
Obstructive Jaundice ◽  
Diagnostic Accuracy ◽  
Biliary Drainage ◽  
Elevated Serum ◽  
Tumour Marker ◽  
Carbohydrate Antigen ◽  
Morphological Findings ◽  
Serum Carbohydrate Antigen ◽  
Sensitivity Specificity ◽  
Hepatobiliary Tract

Background: Serum carbohydrate antigen 19-9 (CA 19-9), a tumour marker for malignancies of the hepatobiliary tract and pancreas, frequently elevated in a number of non-malignant conditions that are associated with jaundice. The CA 19-9 tends to normalize following the restoration of biliary drainage. This study was designed to assess the clinical application of CA19-9 in diagnosing pancreatobiliary malignancies in patients with obstructive jaundice and in discriminating between benign and malignant causes.Methods: Sixty three patients presented with obstructive jaundice on the basis of clinical, biochemical and imaging methods with elevated CA 19-9 were included in this study. Serum CA 19-9 levels were measured on admission and two weeks following endoscopic biliary drainage performed through an ERCP procedure at the department of Gastrointestinal, hepatobiliary and pancreatic disorders (GHPD) of BIRDEM general hospital. Malignant and benign cases were differentiated by ultrasonogram, CT scan, MRCP and morphological findings during ERCP procedure. Diagnostic accuracy of CA19-9 in the detection of malignancy was estimated by the receiver operating characteristic (ROC) curve.Results: Age was 53.76±14.48 years (mean±SD) and sex was 32:31 (M:F). Median value of CA 19-9 in malignant cases was higher (1000 U/ml) than benign cases (93 U/ml) (p=0.001). After biliary drainage serum CA19-9 levels normalized in 15(50%) benign and 1(3%) malignant cases (p=0.001). The AUC of CA 19-9 was 0.825. Sensitivity, specificity, PPV and NPV at cut off value 90 U/ml were 100, 50, 68.8 and 100; at 100 U/ml were 100, 53.3, 70.2 and 100; at 200 U/ml were 90.9, 66.7, 75 and 87, at 500 U/ml were 63.6, 76.7,75 and 65.7 respectively. Diagnostic accuracy of CA 19-9 was observed more at cut off value 200 U/ml.Conclusions: Deranged CA19-9 is frequently observed in benign conditions with jaundice and shown to normalize following improvement of biliary drainage. Caution is necessary in the interpretation of an elevated serum CA 19-9 value as a marker for malignancy, especially in patients with benign cholestasis.Birdem Med J 2017; 7(2): 95-100

scholarly journals Persistent High Level of Urinary Tumor Marker Carbohydrate Antigen 19-9 in Prenatally Diagnosed Dysplastic Kidney

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Reza Khorramirouz ◽  
Maryam Ebadi ◽  
Fatemeh Rahimi Sherbaf ◽  
Abdol-Mohammad Kajbafzadeh
Keyword(s):  
Tumor Marker ◽  
Congenital Abnormality ◽  
Carbohydrate Antigen ◽  
Epithelial Lining ◽  
Gastrointestinal Malignancies ◽  
Dysplastic Kidney ◽  
Urinary Levels ◽  
Cyst Aspiration ◽  
High Level

Tumor marker carbohydrate antigen 19-9 (CA 19-9) level has gained clinical significance in gastrointestinal malignancies and in various solid and cystic diseases. Dysplastic kidney is a congenital abnormality resulting from atresia of the ureteral bud during the embryogenesis which can be unilateral or bilateral. We report unilateral dysplastic kidney with extremely large cyst diagnosed by routine ultrasonography in the 32nd week of gestational age with high levels of CA 19-9 in cystic and amniotic fluid, as well as persistent high urinary levels of this tumor marker during the 1-year follow-up. Persistent high urinary CA 19-9 level even after cyst aspiration may be attributable to remained function of dysplastic kidney due to remained epithelial lining.

Serum carbohydrate antigen elevations in endometrial adenocarcinomas: Characterization of DU-PAN-2 expression as a tumor marker

2004 ◽  
Vol 30 (1) ◽  
pp. 59-64 ◽  
Author(s):  
Masanori Yasuda ◽  
Kaoru Saito ◽  
Youichi Kobayashi ◽  
Toshinari Muramatsu ◽  
Tsuyoshi Miyamoto ◽  
...  
Keyword(s):  
Tumor Marker ◽  
Carbohydrate Antigen ◽  
Serum Carbohydrate Antigen

Discriminating Malignancy in Thyroid Nodules: The Nomogram Versus the Kwak and ACR TI-RADS

2020 ◽  
Vol 163 (6) ◽  
pp. 1156-1165
Author(s):  
Juan Xiao ◽  
Qiang Xiao ◽  
Wei Cong ◽  
Ting Li ◽  
Shouluan Ding ◽  
...  
Keyword(s):  
Thyroid Nodules ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Diagnostic Study ◽  
Diagnostic Efficiency ◽  
Training Set ◽  
Multivariable Logistic Regression Model ◽  
Predictive Values ◽  
Validation Set ◽  
Sensitivity Specificity

Objective To develop an easy-to-use nomogram for discrimination of malignant thyroid nodules and to compare diagnostic efficiency with the Kwak and American College of Radiology (ACR) Thyroid Imaging, Reporting and Data System (TI-RADS). Study Design Retrospective diagnostic study. Setting The Second Hospital of Shandong University. Subjects and Methods From March 2017 to April 2019, 792 patients with 1940 thyroid nodules were included into the training set; from May 2019 to December 2019, 174 patients with 389 nodules were included into the validation set. Multivariable logistic regression model was used to develop a nomogram for discriminating malignant nodules. To compare the diagnostic performance of the nomogram with the Kwak and ACR TI-RADS, the area under the receiver operating characteristic curve, sensitivity, specificity, and positive and negative predictive values were calculated. Results The nomogram consisted of 7 factors: composition, orientation, echogenicity, border, margin, extrathyroidal extension, and calcification. In the training set, for all nodules, the area under the curve (AUC) for the nomogram was 0.844, which was higher than the Kwak TI-RADS (0.826, P = .008) and the ACR TI-RADS (0.810, P < .001). For the 822 nodules >1 cm, the AUC of the nomogram was 0.891, which was higher than the Kwak TI-RADS (0.852, P < .001) and the ACR TI-RADS (0.853, P < .001). In the validation set, the AUC of the nomogram was also higher than the Kwak and ACR TI-RADS ( P < .05), each in the whole series and separately for nodules >1 or ≤1 cm. Conclusions When compared with the Kwak and ACR TI-RADS, the nomogram had a better performance in discriminating malignant thyroid nodules.

scholarly journals Correlation between serum carbohydrate antigen 19-9 levels and computed tomography severity score in patients with nontuberculous mycobacterial pulmonary disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kangjoon Kim ◽  
Seung Hyun Yong ◽  
Su Hwan Lee ◽  
Sang Hoon Lee ◽  
Ah Young Leem ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Disease Activity ◽  
Pulmonary Disease ◽  
Severity Score ◽  
Partial Correlation ◽  
Elevated Serum ◽  
Carbohydrate Antigen ◽  
Chest Ct ◽  
Clinical Biomarker ◽  
Serum Carbohydrate Antigen

AbstractThere is no validated clinical biomarker for disease severity or treatment response for nontuberculous mycobacterial pulmonary disease (NTM-PD). We investigated the correlation between elevated serum carbohydrate antigen (CA) 19-9 levels and NTM-PD disease activity, defined using an imaging severity score based on chest computed tomography (CT). We retrospectively examined 79 patients with NTM-PD who underwent serum CA19-9 level assessments and chest CT less than 1 month apart. NTM-PD severity was rated using a CT-based scoring system. The correlation between the CT score and serum CA19-9 levels was evaluated. Chest CT revealed nodular bronchiectasis without cavitation in most patients (78.5%). Serum CA19-9 levels were elevated in 19 (24%) patients. Serum CA19-9 levels were positively correlated with the total CT score and bronchiectasis, bronchiolitis, cavity, and consolidation subscores. Partial correlation analysis revealed a significant positive correlation between serum CA19-9 levels and CT scores for total score and bronchiectasis, bronchiolitis, cavitation, and consolidation subscores after controlling for age, sex, and BMI. Serum CA19-9 levels were positively correlated with the CT severity score for NTM-PD. Serum CA19-9 may be useful in evaluating disease activity or therapeutic response in patients with NTM-PD.

scholarly journals The Impact of Narrow-band Imaging on the Pre- and Intra- operative Assessments of Neoplastic and Preneoplastic Laryngeal Lesions. A Systematic Review

2020 ◽  
Author(s):  
Carmelo Saraniti ◽  
Enzo Chianetta ◽  
Giuseppe Greco ◽  
Norhafiza Mat Lazim ◽  
Barbara Verro
Keyword(s):  
White Light ◽  
Diagnostic Tool ◽  
Narrow Band ◽  
Narrow Band Imaging ◽  
Resection Margins ◽  
Predictive Values ◽  
White Light Endoscopy ◽  
Laryngeal Lesions ◽  
Sensitivity Specificity ◽  
The Impact

Introduction Narrow-band imaging is an endoscopic diagnostic tool that, focusing on superficial vascular changes, is useful to detect suspicious laryngeal lesions, enabling their complete excision with safe and tailored resection margins. Objectives To analyze the applications and benefits of narrow-band imaging in detecting premalignant and malignant laryngeal lesions through a comparison with white-light endoscopy. Data Synthesis A literature search was performed in the PubMed, Scopus and Web of Science databases using strict keywords. Then, two authors independently analyzed the articles, read the titles and abstracts, and read completely only the relevant studies according to certain eligibility criteria. In total, 14 articles have been included in the present review; the sensitivity, specificity, positive and negative predictive values, and accuracy of pre- and/or intraoperative narrow-band imaging were analyzed. The analysis showed that narrow-band imaging is better than white-light endoscopy in terms of sensitivity, specificity, positive and negative predictive values, and accuracy regarding the ability to identify cancer and/or precancerous laryngeal lesions. Moreover, the intraoperative performance of narrow-band imaging resulted more effective than the in-office performance. Conclusion Narrow-band imaging is an effective diagnostic tool to detect premalignant and malignant laryngeal lesions and to define proper resection margins. Moreover, narrow-band imaging is useful in cases of leukoplakia that may cover a possible malignant lesion and that cannot be easily assessed with white-light endoscopy. Finally, a shared, simple and practical classification of laryngeal lesions, such as that of the European Laryngological Society, is required to identify a shared lesion management strategy. Key Points

scholarly journals Predicting youth diabetes risk using NHANES data and machine learning

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nita Vangeepuram ◽  
Bian Liu ◽  
Po-hsiang Chiu ◽  
Linhua Wang ◽  
Gaurav Pandey
Keyword(s):  
Machine Learning ◽  
Large Scale ◽  
Clinical Guideline ◽  
Diabetes Risk ◽  
Screening Tools ◽  
Clinical Screening ◽  
Predictive Values ◽  
Screening Guideline ◽  
Demographic Subgroups ◽  
Sensitivity Specificity

AbstractPrediabetes and diabetes mellitus (preDM/DM) have become alarmingly prevalent among youth in recent years. However, simple questionnaire-based screening tools to reliably assess diabetes risk are only available for adults, not youth. As a first step in developing such a tool, we used a large-scale dataset from the National Health and Nutritional Examination Survey (NHANES) to examine the performance of a published pediatric clinical screening guideline in identifying youth with preDM/DM based on American Diabetes Association diagnostic biomarkers. We assessed the agreement between the clinical guideline and biomarker criteria using established evaluation measures (sensitivity, specificity, positive/negative predictive value, F-measure for the positive/negative preDM/DM classes, and Kappa). We also compared the performance of the guideline to those of machine learning (ML) based preDM/DM classifiers derived from the NHANES dataset. Approximately 29% of the 2858 youth in our study population had preDM/DM based on biomarker criteria. The clinical guideline had a sensitivity of 43.1% and specificity of 67.6%, positive/negative predictive values of 35.2%/74.5%, positive/negative F-measures of 38.8%/70.9%, and Kappa of 0.1 (95%CI: 0.06–0.14). The performance of the guideline varied across demographic subgroups. Some ML-based classifiers performed comparably to or better than the screening guideline, especially in identifying preDM/DM youth (p = 5.23 × 10−5).We demonstrated that a recommended pediatric clinical screening guideline did not perform well in identifying preDM/DM status among youth. Additional work is needed to develop a simple yet accurate screener for youth diabetes risk, potentially by using advanced ML methods and a wider range of clinical and behavioral health data.

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