Predictive value of CA 19-9 in patients with pancreatic tumours

2020 ◽  
Vol 14 (1) ◽  
pp. 45-48
Author(s):  
Faiza Abrar ◽  
Adnan Riaz ◽  
Kaukab Sultana ◽  
Tariq Feroz Khawaja
Keyword(s):  
Surgical Resection ◽  
Predictive Value ◽  
Local Population ◽  
Pancreatic Disease ◽  
International Studies ◽  
Malignant Tumours ◽  
Pancreatic Tumours ◽  
Benign Pathology ◽  
Pancreatic Tumour ◽  
Age Range

Background: Pancreatic carcinoma is a disease with high modality and has a high incidence of recurrence after surgical resection. The prognosis depends on early diagnosis and treatment. Numerous international studies have reported use of CA 19-9 in diagnosis of pancreatic cancer. We planned this study to validate role of CA 19-9 in our local population. The objective of this study is to correlate raised serum CA 19-9 levels in patients with pancreatic tumours to distinguish between benign and malignant pancreatic disease. Subjects and methods: The present study is a validation study. Thirty-five patients with diagnosis of pancreatic tumor on radiological imaging were included after their informed consent. Data collection forms were filled, blood samples were taken and serum CA 19-9 was estimated by ELISA in Biochemistry department, SIMS. Histopathology samples were collected at time of surgical resection, sent to pathology departments of respective hospitals and histopathological reports collected. All data was collected and analysed by using descriptive method. The study was conducted in Biochemistry department of PGMI and SIMS, Lahore from May 2015 till June 2016. Results: Out of 35 patients, nineteen (54.3%) were female and sixteen (45.7%) were male. Thirty [85.7%] patients were between third to seventh decades of their life. The mean age range around 47.28. Thirty-four patients had malignant tumor and 1 benign on histopathology. CA 19-9 was raised (>37 U/ml) in 33 out of 34 patients with malignant pathology. The patient with benign pathology had CA 19-9 level <37U/ml (the cut off value). Head of pancreas was the commonest site in 32 patients (65%) for tumour occurrence. Total 28 (82%) patients had adenocarcinoma as the histological type of pancreatic tumour. Cholangiocarcinoma in Periampullary region of pancreas was second in frequency, 4 patients (12%). CA 19-9 shows sensitivity of 97% and specificity of 100% to diagnose carcinoma of pancreas in patients with pancreatic tumour. CA 19-9 has 100% positive predictive value to diagnose benign tumour and 50% negative predictive value to diagnose malignant tumours. Conclusion: Raised levels of CA 19-9 has an important role in diagnosis of patients with pancreatic tumour to differentiate between benign and malignant pathology.

scholarly journals Resection of primary cardiac angiosarcoma infiltrating the right atrioventricular junction and tricuspid valve: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lubna Bakr ◽  
Hussam AlKhalaf ◽  
Ahmad Takriti
Keyword(s):  
Surgical Resection ◽  
Tricuspid Valve ◽  
Right Atrium ◽  
Large Mass ◽  
Small Mass ◽  
Malignant Tumours ◽  
Atrioventricular Junction ◽  
Cardiac Angiosarcoma ◽  
Complete Surgical Resection ◽  
The Right

Abstract Background Primary cardiac tumours are extremely rare. Most of them are benign. Sarcomas account for 95% of the malignant tumours. Prognosis of primary cardiac angiosarcoma remains poor. Complete surgical resection is oftentimes hampered when there is extensive tumour involvement into important cardiac apparatus. We report a case of cardiac angiosarcoma of the right atrium and ventricle, infiltrating the right atrioventricular junction and tricuspid valve. Case presentation Initially, a 22-year-old man presented with dyspnoea. One year later, he had recurrent pericardial effusion. Afterwards, echocardiography revealed a large mass in the right atrium, expanding from the roof of the right atrium to the tricuspid valve. The mass was causing compression on the tricuspid valve, and another mass was seen in the right ventricle. Complete resection of the tumour was impossible. The mass was resected with the biggest possible margins. The right atrium was reconstructed using heterologous pericardium. The patient’s postoperative course was uneventful. Postoperative echocardiography showed a small mass remaining in the right side of the heart. Histopathology and immunohistochemistry confirmed the diagnosis of angiosarcoma. The patient underwent adjuvant chemotherapy and radiotherapy later on. He survived for 1 year and 5 days after the surgery. After a diagnosis of lung and brain metastases, he ended up on mechanical ventilation for 48 h and died. Conclusions Surgical resection combined with postoperative chemotherapy and radiotherapy is feasible even in patients with an advanced stage of cardiac angiosarcoma when it is impossible to perform complete surgical resection.

scholarly journals A243 A RETROSPECTIVE REVIEW OF THE RADIOGRAPHIC DIAGNOSIS AND SURGICAL RESECTION RATES OF PANCREATIC SEROUS CYSTS

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 300-301
Author(s):  
M Monachese ◽  
S Li ◽  
M Salim ◽  
L Guimaraes ◽  
P D James
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Surgical Resection ◽  
Predictive Value ◽  
Resected Specimen ◽  
Cystic Lesions ◽  
Resonance Imaging ◽  
Guided Biopsy ◽  
Magnetic Resonance Imaging Mri

Abstract Background Pancreatic cystic lesions are increasingly identified in persons undergoing abdominal imaging. Serous cystic neoplasms (SCNs) have a very low risk of malignant transformation. Resection of SCNs is not recommended in the absence of related symptoms. The accuracy of computed tomography (CT) and magnetic resonance imaging (MRI) to identify SCNs is not known and may impact clinical care. Aims To evaluate the accuracy of computed tomography (CT) and magnetic resonance imaging (MRI) for the diagnosis of SCN. To see how this can impact the decision to resect suspected SCNs. Methods Retrospective cohort study of patients from the University Health Network with suspected SCNs from 2017–2020 who underwent either a CT or MRI of the abdomen. Reports noting pancreatic cystic lesions were identified and reviewed. Only cases with suspected SCNs were included. Clinical (age, sex, symptoms, treatment) and radiographic (type of imaging, reported cyst characteristics) data was collected. Pathology was reviewed for all cases where the cysts was biopsied or resected during follow-up. The gold standard for the diagnosis for SCN was pathology of resected specimen or EUS-guided biopsy cytopathology showing no evidence of a mucinous lesion, CEA level below 10ug per L and amylase level below 50 U/L. Results 163 patients were included in the study. 99 (61%) were female and 98 (60%) underwent CT scan. EUS-guided biopsy was performed in 24 (15%) of patients and 8 (5%) had surgical resection. Multidisciplinary review was performed in 6 of the 8 cases that went to surgery. Of the resected specimens, 5 (63%) were SCN, 1 was a mucinous cystic lesion, 1 was a neuroendocrine tumor and 1 was a carcinoma. Two patients underwent EUS evaluation prior to surgical resection. In one case SCN was resected when EUS reported an undetermined cyst type. Reasons for surgical resection were: the diagnosis of serous cyst was not definitive (n=5), symptoms (n=2), and high-risk mucinous cystic neoplasm identified on EUS (n=1). Of 30 patients with pathology available, 15 (50%) were confirmed to have a SCN. CT and MRI had a sensitivity, specificity, positive predictive value and negative predictive value of 93%, 25%, 52% and 80%, respectively. Conclusions Surgical resection for SCN lesions is driven by diagnostic uncertainty after cross-sectional imaging. Multidisciplinary review and EUS evaluation may improve diagnostic accuracy and should be considered prior to surgical resection of possible SCN lesions. Funding Agencies None

Patterns of Listening and Reading Skills in Visually Handicapped Students

1981 ◽  
Vol 75 (5) ◽  
pp. 215-218 ◽  
Author(s):  
Thomas A. Wood
Keyword(s):  
Predictive Value ◽  
Grade Level ◽  
Reading Skills ◽  
Residential Schools ◽  
Reading Scores ◽  
Verbal Intelligence ◽  
Listening Skills ◽  
Developmental Patterns ◽  
Visually Handicapped ◽  
Age Range

This study compared the developmental patterns of listening and reading skills of 71 visually handicapped students in the fourth, fifth, and sixth grades of four residential schools for the blind. Grade level, chronological age, intelligence, mode of reading, sex, socioeconomic status, and degree of visual impairment, were treated as predictor variables. Subjects were tested with the adapted version of the Durrell Listening-Reading Series. The results indicated that tested verbal intelligence accounted for most of the variance in listening and reading scores and had greater predictive value for listening than for reading. The other variables had little or no predictive value for either listening or reading. Furthermore, the development of listening skills was found to be stronger than reading skills at each grade level, and listening remained the superior mode across the age range.

“A COMPARATIVE STUDY OF RIPASA SCORE AND ALVARADO SCORE IN THE DIAGNOSIS OF ACUTE APPENDICITIS”

2021 ◽  
pp. 25-28
Author(s):  
M. Vijaya Kumar ◽  
Manasa Manasa
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Scoring System ◽  
Local Population ◽  
Scoring Systems ◽  
Signs And Symptoms ◽  
Alvarado Score ◽  
Predictive Values ◽  
Ripasa Score

Acute appendicitis is the most common condition encountered in the Emergency department .Alvarado and Modied Alvarado scores are the most commonly used scoring system used for diagnosing acute appendicitis.,but its performance has been found to be poor in certain population . Hence our aim was to compare the diagnostic accuracy of RIPASA and ALVARADO Scoring system and study and compare sensitivity, specicity and predictive values of these scoring systems. The study was conducted in Government district hospital Nandyal . We enrolled 176 patients who presented with RIF pain . Both RIPASA and ALVARADO were applied to them. Final diagnosis was conrmed either by CT scan, intra operative nding or post operative HPE report. Sensitivity,specicity, positive predictive value, negative predictive value, diagnostic accuracy was calculated both for RIPASA and ALVARADO. It was found that sensitivity and specicity of the RIPASA score in our study are 98.7% and 83.3%, respectively. PPV and NPV were 98.1% and 88.2% and sensitivity and specicity of the Alvardo score in our study are 94.3% and 83.3%, respectively. PPV and NPV were 98% and 62.5%.Diagnostic accuracy of RIPASA score and Alvarado score are 97% and 93% respectively. RIPASA is a more specic and accurate scoring system in our local population when compared to ALVARADO . It reduces the number of missed appendicitis cases and also convincingly lters out the group of patients that would need a CT scan for diagnosis (score 5-7.5 ) BACKGROUND: Acute appendicitis is one of the most commonly dealt surgical emergencies, with a lifetime prevalence rate of approximately 1 one in seven. The incidence is 1.5–1.9 per 1,000 in the male and female population, and is approximately 1.4 times greater in men than in women. Despite being a common problem, it remains a difcult diagnosis to establish, particularly among the young, the elderly and females of reproductive age, where a host of other genitourinary and gynaecological inammatory conditions can present with signs and symptoms that are 2 similar to those of acute appendicitis. A delay in performing an appendectomy in order to improve its diagnostic accuracy increases the risk of appendicular perforation and peritonitis, which in turn increases morbidity and mortality. A variable combination of clinical signs and symptoms has been used together with laboratory ndings in several scoring systems proposed for suggesting the probability of Acute Appendicitis and the possible subsequent management pathway. The Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) and ALVARADO score are new diagnostic scoring systems developed for the diagnosis of Acute Appendicitis and has been shown to have signicantly higher sensitivity, specicity and diagnostic accuracy. AIMS AND OBJECTIVES PRIMARY OBJECT 1. To compare RIPASA Scoring system and ALVARADO Scoring system in terms of diagnostic accuracy in Acute Appendicitis. 2. To study and compare sensitivity, specicity and predictive values of above scoring systems. SECONDARY OBJECT 1. To study the rate of negative appendicectomy based on above scoring systems. CONCLUSION: The RIPASA score is a simple scoring system with high sensitivity and specicity for the diagnosis of acute appendicitis. The 14 clinical parameters are all present in a good clinical history and examination and can be easily and quickly applied. Therefore, a decision on the management can be made early. Although the RIPASA score was developed for the local population of Brunei, we believe that it should be applicable to other regions. The RIPASA score presents greater Diagnostic accuracy and Sensitivity and equal specicity as a diagnostic test compared to the Alvarado score and is helpful in making appropriate therapeutic decisions. In hospitals like ours, the diagnosis of AA relies greatly on the clinical evaluation performed by surgeons. An adequate clinical scoring system would avoid diagnostic errors, maintaining a satisfactory low rate of negative appendectomies by adequate patient stratication, while limiting patient exposure to ionizing radiation, since 21 there is an increased risk of developing cancer with computed tomography, particularly for the paediatric age group.

Concordance Between the TIRADS Ultrasound Scoring Criteria, Fine-Needle Aspiration Cytology, and Thyroid Final Resection Diagnosis

2019 ◽  
Vol 152 (Supplement_1) ◽  
pp. S92-S92
Author(s):  
Hatem Kaseb ◽  
Ahmad Charifa ◽  
Rita Abi-Raad ◽  
Guoping Cai ◽  
Lynwood Hammers ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Sensitivity And Specificity ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Predictive Values ◽  
Fine Needle ◽  
Malignant Lesions ◽  
Needle Aspiration Cytology ◽  
Age Range ◽  
Thyroid Lesions

Abstract Objectives Thyroid imaging reporting and data system (TIRADS) criteria were recently introduced in our institution to aid in predicting diagnosis for various thyroid lesions. We evaluated the association of TIRADS imaging score and fine-needle aspiration (FNA) cytology with thyroid lesions that had a confirmed diagnosis at resection, with a focus on understanding the predictability of this diagnostic tool in malignancy prediction. Methods We assessed the concordance of TIRADS criteria and FNA diagnosis to the final anatomical diagnosis in the assessment of thyroid lesions. We retrieved the cases from the archives of the Yale pathology department between June 2017 and January 2018. Our inclusion criteria included patients who had a TIRADS score, cytology diagnosis, and final surgical resection diagnosis. A total of 65 subjects with an age range of 11 to 88 years were identified. Results The majority of the patients were females, 65% (42/65). Cases with TIRADS score 1-2 (likely benign) and Bethesda I/II nondiagnostic/benign were few since most of these cases did not go for surgical resection. The mildly suspicious TIRAD score 3 and FLUS category showed similar trends, 68% and 67%, respectively, in predicting malignant lesions. The TIRADS score 4 when compared to cytology (IV)/(V) demonstrated similar consistent results in malignancy prediction, both being high at 89% and 87%, respectively. The TIRADS score 5 demonstrated a 95% malignancy prediction. The overall sensitivity and specificity of TIRADS score in our cohort were 66% and 77%, respectively. The positive and negative predictive values of TIRADS score in our cohort were 89% and 39%, respectively. In comparison, the overall sensitivity and specificity of cytology assessment in our cohort were 91% and 44%, respectively. The positive and negative predictive values of cytology assessment in our cohort were 85% and 57%, respectively. Conclusion Our results demonstrated that both cytology and TIRAD score had similar trends in malignancy prediction. Cytological assessment had higher sensitivity but lower specificity compared to TIRADS score. While both techniques showed concordant high predictability of malignant lesions (approximately 91%), the use of both modalities adjunctively will be very useful in triaging cases for surgery. Overall, utilizing TIRADS score with cytology will help reduce the risk of unnecessary invasive procedures in patients with a low probability of malignant thyroid disease.

scholarly journals Eosinophil Infiltrates in Pilocytic Astrocytomas of Children and Young Adults

2014 ◽  
Vol 41 (5) ◽  
pp. 632-637 ◽  
Author(s):  
Jian-Qiang Lu ◽  
Omid Rashidipour ◽  
Beverly A. Wilson ◽  
Andrew S. Jack ◽  
Jeffrey Pugh ◽  
...  
Keyword(s):  
Eosinophilic Infiltration ◽  
Pediatric Age ◽  
Malignant Tumours ◽  
Adult Age ◽  
Tissue Eosinophilia ◽  
Pilocytic Astrocytomas ◽  
Divergent Differentiation ◽  
Cns Tumours ◽  
Leptomeningeal Infiltration ◽  
Age Range

AbstractObjectiveEosinophils may affect each stage of tumour development. Many studies have suggested that tumour-associated tissue eosinophilia (TATE) is associated with favourable prognosis in some malignant tumours. However, only a few studies exist on TATE in central nervous system (CNS) tumours. Our recent study exhibited eosinophils in atypical teratoid/rhabdoid tumours (AT/RTs), pediatric malignant CNS tumours with divergent differentiation. This study examines eosinophils in pilocytic astrocytomas (PAs).MethodsThe study included 44 consecutive cases of patients with PAs and no concurrent CNS inflammatory disease.ResultsWe found eosinophils in 19 (43%) of 44 PAs (patient age range, 0.5-72 years). Eosinophils were intratumoural and clearly distinguishable. The density of eosinophils was rare to focally scattered. PAs containing eosinophils were located throughout the CNS. Furthermore, eosinophilic infiltration was identified in 18 (62%) of 29 pediatric (age range, 0.5-18 years) PAs but only 1 (7%) of 15 (p<0.001, significantly less) adult (age range, 20-72 years) PAs. Eosinophilic infiltration showed no significant differences between PAs with and without MRI cystic formation, surgical procedures, or PAs with and without leptomeningeal infiltration. In comparison, eosinophils were absent in 10 pediatric (age range, 0.5-15 years) ependymomas (or anaplastic ependymomas).ConclusionsThese results suggest that eosinophils are common in pediatric PAs but rare in adult PAs. This difference is probably related to the developing immune system and different tumour-specific antigens in children. TATE may play a functional role in the development of pediatric PAs, as well as some other pediatric CNS tumours such as AT/RTs.

scholarly journals Predicting Neck Abscess with Contrast-Enhanced Computed Tomography

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Melisa Lim Seer Yee ◽  
Noraini Abdul Rahim ◽  
Ning Ajleaa Ngah ◽  
Yang Faridah Abdul Aziz ◽  
Sethu Subha
Keyword(s):  
Computed Tomography ◽  
Predictive Value ◽  
Imaging Modality ◽  
Local Population ◽  
High Sensitivity ◽  
Neck Abscess ◽  
Contrast Enhanced ◽  
Study Population ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Neck abscesses are difficult to diagnose and treat. Currently, contrast-enhanced computed tomography (CECT) is the imaging modality of choice. The study aims to determine the predictive value of CECT findings in diagnosing neck abscess, causes of neck abscess and the most common neck space involved in the local population. 84 consecutive patients clinically suspected to have neck abscess who underwent CECT and surgical confirmation of pus were included. Demographic and clinical data were recorded. 75 patients were diagnosed as having neck abscess on CECT; out of those 71 patients were found to have pus. Overall CECT findings were found to have a high sensitivity (98.6%) and positive predictive value (PPV) (94.7%) but lower specificity (67.2%) in diagnosing neck abscess. The CECT diagnostic criterion with the highest PPV is the presence of rim irregularity (96%). The most common deep neck space involved is the submandibular compartment, which correlates with the finding that odontogenic cause was the most common identifiable cause of abscess in the study population. Thus, in a patient clinically suspected of having neck abscess, CECT findings of a hypodense mass with rim irregularity are helpful in confirming the diagnosis and guiding clinical management.

scholarly journals Critical Review of Diagnostic Methods Used in Chronic Pancreatic Disease

1995 ◽  
Vol 9 (1) ◽  
pp. 51-60
Author(s):  
Ivan T Beck
Keyword(s):  
Endoscopic Ultrasound ◽  
Imaging Techniques ◽  
Pancreatic Disease ◽  
Dietary Lipids ◽  
Pancreatic Enzymes ◽  
Diagnostic Methods ◽  
Screening Tests ◽  
Malignant Tumours ◽  
Curative Surgery ◽  
Function Tests

This paper provides a balanced assessment of the various pancreatic function tests and imaging techniques used in the differential diagnosis of chronic pancreatic disease. Function tests that study the digestive capacity of the pancreas (fat absorption of dietary lipids, fluorescein- or radiolabelled fats, bentiromide test, etc) have high specificity, but very low sensitivity. This is because 90% of pancreas has to be destroyed before steatorrhea or creatorrhea occurs. Tests that directly measure pancreatic bicarbonate and protein secretion (secretin test, etc) are more accurate and may detect pancreatic dysfunction even before anatomical changes occur. Measurement of pancreatic enzymes in serum or urine, or the decreased decline of serum amino acids during their incorporation into pancreatic enzymes, are not sufficiently sensitive or specific to help diagnose pancreatic disease. Sensitive and specific tumour markers are not yet available. Thus screening tests are not cost-effective - if they are negative, they do not exclude pancreatic disease; and if positive, they have to be confirmed by more specific tests. Imaging techniques are the most commonly used methods of investigation. The usefulness of abdominal survey films, barium studies, percutaneous transhepatic cholangiography, endoscopic retrograde cholangiopancreatography (ERCP), ultrasonography, computed tomographic scan, magnetic resonance imaging and endoscopic ultrasonography is critically reviewed. Most of the radiological methods can be combined with cytology or biopsy. Histology demonstrating malignancy establishes this diagnosis, but negative biopsies do not exclude malignant tumours. Presently only ERCP and endoscopic ultrasound can diagnose cancers sufficiently early to allow for possible `curative' surgery, and only endoscopic ultrasound is capable to stage tumours for the assessment of resectability.

scholarly journals Validation of rapid antibody (IgG-IgM) test kit for SARS COV-2 infection in Qatar

2021 ◽  
Author(s):  
Jesha Mundodan ◽  
Samina Hasnain ◽  
Hayat Khogali ◽  
Soha Shawqi Al Bayat ◽  
Dina Ali ◽  
...  
Keyword(s):  
Predictive Value ◽  
Local Population ◽  
Rapid Test ◽  
Antibody Test ◽  
Molecular Testing ◽  
Rt Pcr ◽  
Test Kit ◽  
Asymptomatic Individuals ◽  
Sensitivity Specificity ◽  
Rapid Antibody

Background: In response to the growing coronavirus disease 2019 (COVID-19) pandemic and the shortage of laboratory based molecular testing capacity and reagents, multiple diagnostic test manufacturers have developed rapid and easy to use devices to facilitate testing outside laboratory settings. These kits are either based on detection of proteins from SARS-CoV-2 virus or detection of antigen or human antibodies generated in response to the infection. However, it is important to understand their performance characteristics and they must be validated in the local population setting.Design and Methods: The objective is to assess the validity of the rapid test for IgG and IgM immunoglobulins compared to the current gold standard reverse transcription polymerase chain reaction (RT-PCR) test. A total of 16951 asymptomatic individuals were tested by the Ministry of Public Health track-and-trace team using both rapid immunodiagnostic test and RT-PCR as part of screening across various random settings with potential risk of community interaction prior to gradual lifting of restrictions in Qatar.  Rapid test was considered to be posiive if both IgG and IgM are positive, while only IgG/IgM positive was considered as rapid test negative. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated.Results: The sensitivity of rapid test kit was found to be 0.9%, whereas the specificity was found to be 97.8%. the PPV was found to be 0.3% whereas the NPV was found to be 99.4%.Conclusion: Based on the outcome and results of the study, it appears that the sensitivity and PPV of the rapid antibody test are low. As such, this test is not recommended for use to assist in taking clinic-based decisions or decisions related to quarantine/isolation.

Sign in / Sign up

Export Citation Format

Share Document