HE4 can Help Discriminate Women with Malignant Ovarian Tumors only if CA125 Levels are Elevated

2013 ◽  
Vol 28 (4) ◽  
pp. 377-386 ◽  
Author(s):  
Denise da Rocha Pitta ◽  
Luis Otávio Sarian ◽  
Elisabete Aparecida Campos ◽  
Liliana Lucci De Angelo Andrade ◽  
Luis Felipe Sallum ◽  
...  
Keyword(s):  
Permutation Test ◽  
Malignant Tumors ◽  
Roc Curves ◽  
Cross Sectional Study ◽  
Serum Markers ◽  
Ovarian Tumors ◽  
The Other ◽  
Benign Tumors ◽  
Cross Sectional ◽  
Increased Risk

Objective To evaluate the performance of mesothelin, CA125, HE4 and ROMA index in the detection of malignant ovarian tumors. Study Design This is a cross-sectional study including 199 women with adnexal masses (67 with malignant tumors and 132 with benign tumors) and 150 healthy women (controls). We used a recursive multivariate partitioning algorithm to assess the contribution of each of the serum markers and the ROMA index to the discrimination of women with malignant tumors. Also, the areas under the ROC curves (AUC) for each of the serum markers and for the ROMA index were compared using the Venkatraman's projection-permutation test. Results In the recursive model, CA125 had the best performance in discriminating women with malignant tumors. In women with normal-range CA125 levels, none of the other markers contributed to the discrimination of women with malignant tumors. In women with elevated CA125 levels, elevated HE4 levels were associated with an increased risk of harboring a malignant tumor. The AUC for mesothelin was smaller than that for all the other curves, and both the ROMA index and CA125 had better AUC than HE4. Conclusion In women with normal CA125 levels, neither mesothelin nor HE4 contributed to discriminate women with malignant ovarian tumors; however, for women with elevated CA125 levels HE4 may help discriminating those who have a malignant ovarian tumor.

scholarly journals Relationship between Serum Tumor Markers, CA-125, CEA, CA19-9, LDH, and βHCG with Histopathology and Age in Women with Ovarian Tumors

2020 ◽  
Vol 5 (4) ◽  
pp. 167-171
Author(s):  
Nilajkumar D Bagde ◽  
Madhuri N Bagde ◽  
Zamir A Lone
Keyword(s):  
Tumor Markers ◽  
Cross Sectional Study ◽  
Serum Markers ◽  
Ovarian Tumors ◽  
Ca 125 ◽  
Benign Tumors ◽  
Histopathological Analysis ◽  
Cross Sectional ◽  
Serum Tumor Markers

Introduction: Ovarian tumors pose a diagnostic predicament as it is difficult to differentiate benign from malignant without a histopathology report. Appropriate tumor markers may serve as diagnostic aid to better decision making in the management of these cases. We attempted to determine the relationship between age, serum markers, and histopathological sub types of ovarian tumors to help distinguish benign from malignant tumors.Methods: A retrospective cross sectional study of all cases with ovarian tumors that had available histopathology reports and tumor marker levels was done at a single centre. Variables examined were age, histopathology report and serum tumor markers CA-125, CEA, CA19-9, LDH, and βHCG. Results: Histopathological analysis revealed 26% teratomas, 28% cystadenomas, 14% corpus luteal cysts, 26% carcinomas and 6% endometriomas. CA-125 was the only marker that was significantly raised in malignant versus benign tumors (p=0.008) and increased with increasing age. All women with raised CEA reports had teratomas, and none with cancers had a raised CEA. CA19-9, LDH and βHCG were not significantly different in benign versus malignant tumors.Conclusions: CA-125 may be used as an adjuvant diagnostic tool for ovarian cancer in older women. The role of CEA as a marker for teratomas needs further evaluation.

scholarly journals Frequency of Ovarian Tumors According to WHO Histological Classification and Their Association to Age at Diagnosis

2017 ◽  
Vol 23 (2) ◽  
Author(s):  
Muhammad Arif Khan ◽  
Saira Afzal ◽  
Hassan Saeed ◽  
Hnia Usman ◽  
Rooqash Ali ◽  
...  
Keyword(s):  
Ovarian Neoplasms ◽  
Malignant Tumors ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Ovarian Tumors ◽  
Age At Diagnosis ◽  
Surface Epithelium ◽  
Histological Classification ◽  
Cross Sectional ◽  
Neoplastic Lesions

Ovarian tumors, or ovarian neoplasms, are benign or malignant tumors arising from the ovaries. They may arise from any of the three components of ovary i.e. surface epithelium, germ cells and the stroma of the ovary including sex cords. Tumors in the ovary can also be secondary or metastatic tumors.Objective:  To determine the frequency of Ovarian Tumors according to WHO Histological classification and their relation to age at diagnosis in almost one year.Methods:  A cross-sectional study was carried out, that included all the consecutive cases of ovarian neoplasms diagnosed at the Pathology department of a public sector university in Lahore from 1 January 2015 to 13 February 2016.Results:  In 95 female patients diagnosed with ovarian tumors, the mean age was found to be 29.58 ±11.493 with a range of 3-65 years. Tumors were most common between the ages of 15 to 30 years. The highest rates of malignancy were in the 0-15 and 45-60 age groups (Figure 1). About 78.9% of the tumors (75/95) were benign, 1.1% (1/95) were borderline and 20% (19/95) were malignant (Figure 3), 72.6% (69/95) were epithelial tumors, 23.2% (22/95) were germ cell and 4.2% (4/95) were sex cord stromal tumors (Figure 4). Among the 95 cases, serous tumors were the most common (49.5%), followed by mucinous (16.8%) and teratomas (15.8%).Conclusion:  According to our study, ovarian tumors were common between the age of 15 to 29 years. Benign neoplastic lesions were more common than malignant neoplastic lesions. The frequency of malignant and benign ovarian neoplasms found in our research differed from other studies conducted in Pakistan. There is a significant association of ovarian tumors in age less than 30 year as compared to older age groups (P < 0.001).

Sulfatides in ovarian tumors: clinicopathological correlates

2004 ◽  
Vol 14 (1) ◽  
pp. 89-93 ◽  
Author(s):  
A. M. Makhlouf ◽  
M. M. Fathalla ◽  
M. A. Zakhary ◽  
M. H. Makarem
Keyword(s):  
Malignant Tumors ◽  
Early Stage ◽  
Ovarian Tumors ◽  
University Hospital ◽  
Benign Tumors ◽  
Control Group ◽  
Tumor Type ◽  
Cross Sectional ◽  
Response To Chemotherapy ◽  
Advanced Stages

ObjectivesTo investigate the expression of sulfatides in the tissue homogenates of malignant ovarian tumors, benign ovarian tumors, and control tissues and to study the relation between this marker and other clinico-pathological criteria such as the tumor type, grade of differentiation, surgical stage and ovulatory years.DesignCross-sectional study.SettingDepartment of Obstetrics and Gynecology and Department of Biochemistry, Assuit university hospital.SubjectsForty-six patients had malignant ovarian tumors. Sixteen patients had benign ovarian neoplasm. Thirty patients, with normal ovaries, represented the control group.MethodsA sample of the tumor or from the normal ovary (the control group) was sent for histopathological and biochemical examination. Sulfatides were measured by a rapid and sensitive spectrophotometric method.ResultsThere was a significant rise in benign tumors [median and range 43 (38–53)], than in the control group, 21 (18–31), P-value = 0.000. In malignant tumors, the median value of sulfatides was significantly higher than in benign tumors [127 (71–193), P-value = 0.000]. Sulfatides were significantly higher in patients with more ovulatory years and tumors of advanced stages (stage III/IV) and poor differentiation.ConclusionsSulfatides may play a role in the pathogenesis of benign and malignant ovarian tumors. It may also predict advanced stages in patients who are apparently early stage. It is also a candidate to study of their association with response to chemotherapy.

scholarly journals Diagnostic Accuracy and Appropriate Cut Off Value of Risk of Malignancy Index in Preoperative Discrimination Between Malignant and Benign Ovarian Tumors: Prospective Cross-sectional Study

2021 ◽  
Author(s):  
bezza Kedida Dabi ◽  
Fanta Asefa Disasa ◽  
Ayantu Kebede Olika
Keyword(s):  
Diagnostic Accuracy ◽  
Menopausal Status ◽  
Cross Sectional Study ◽  
Ovarian Tumors ◽  
Ca 125 ◽  
Benign Tumors ◽  
Cross Sectional ◽  
Malignant Ovarian Tumor ◽  
Ultrasound Score ◽  
Benign Ovarian Tumors

Abstract BackgroundRisk of malignancy index (RMI) is scoring system which was introduced to differentiate between benign and malignant ovarian tumor. It incorporates CA-125, ultrasound score and menopausal status for prediction of ovarian malignancies in preoperative period. There is no universal screening method to discriminate between benign and malignant adnexal masses yet. So, this study was conducted to determine the diagnostic accuracy of RMI and determine best cut off value for RMI.MethodsProspective cross-sectional study was carried out among women with ovarian mass admitted to Gynecology ward and operated from September 1, 2019 to June 30, 2020.Data analysis was carried out using SPSS version 26. CA-125 level, menopausal status and ultrasound score were used to calculate RMI. Finally, RMI score was compared to histopathology result used as gold standard.ResultsNinity nine patients were enrolled in this study. Prevalence of benign ovarian tumors were 61.6% (61/99) and that of malignant ovarian tumors were 38.4% (38/99). The mean age for benign tumors was 30±9yrs and the mean age for malignant tumors was 50.6±10.8yrs. Among benign tumors, serous cystadenoma was the most common (36%), followed by dermoid cyst (32.9%), mucinous cyst adenoma (14.8%). The most common malignant ovarian tumor was serous cyst adenocarcinoma (63.2%), followed by mucinous cystadenocarcinoma (23.8%) and dysgerminoma (5.3%). Overall, using RMI score cut off value 220 has good sensitivity (84.2%), specificity (77%), PPV (69.5%), NPV (88.7%) and diagnostic accuracy (79.8%) for discriminating between benign and malignant ovarian tumors.ConclusionFrom this study there were high proportion of women with RMI>=220 in malignant ovarian tumors group. The study shows that there is significant role of RMI in prediction of ovarian malignancy thus helping in deciding which patients need referral to a center where gynecologic oncologists are available. It is good practice to use it in developing countries including our country because of its simplicity, safety and applicability in initial evaluations of patients with adnexal mass.

scholarly journals Histopathologic Profile of Salivary Gland Tumors among Specimens from a Tertiary Care Hospital: A Descriptive Cross-sectional Study

2020 ◽  
Vol 58 (230) ◽  
Author(s):  
Dilasma Ghartimagar ◽  
Arnab Ghosh ◽  
Manish Kiran Shrestha ◽  
Sushma Thapa ◽  
Om Prakash Talwar
Keyword(s):  
Salivary Gland ◽  
Malignant Tumors ◽  
Cross Sectional Study ◽  
Salivary Gland Tumors ◽  
Benign Tumors ◽  
Care Hospital ◽  
Sectional Study ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Female Ratio

Introduction: Salivary gland tumors are rare, comprising about 3% of all head and neck neoplasms. About 80% of the tumors are in parotids, 10% in submandibular glands and the remainders are distributed in sublingual and minor salivary glands. This study was conducted to evaluate the relative frequencies, types, site of distribution and the histopathological features of salivary gland tumors. Methods: A descriptive cross-sectional study was conducted in the Department of Pathology, Manipal College of Medical Sciences, Pokhara from January 2011 to December 2019. Ethical approval was taken from the institutional review committee of Manipal College of Medical Sciences (Ref: 314). Convenient sampling was done among specimen. Data were entered in Microsoft Excel and analyzed using Statistical Package for the Social Sciences version 21. Results: Among the 130 specimens, the patients’ age ranged from 6 to 78 years with a mean age of 37.26 years for benign tumors and 48.45 years for malignant tumors. There was female predominance with a male to female ratio of 1:1.36. There were 98 cases of benign tumors, commonest being pleomorphic adenoma with 82 (83.67%) cases which was noticed more frequently in fourth decade of life. Among the 32 malignant tumors, mucoepidermoid carcinoma was the commonest tumor 20 (62.5%), followed by adenoid cystic carcinoma 7 (23.33%). Conclusions: Benign salivary gland tumors were more common than malignant tumors and the most common site of location was the parotid for both the benign and malignant tumors. Female outnumbered the male population in benign tumors whereas males were slightly more than females in malignant tumors. This study corroborated well with other previously published studies.

scholarly journals Modified Risk of Malignancy Index (RMI 5) in ovarian tumor

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Rijuta Joshi ◽  
Gehanath Baral
Keyword(s):  
Ovarian Tumor ◽  
Malignant Tumors ◽  
Statistical Significance ◽  
Menopausal Status ◽  
Cross Sectional Study ◽  
Mean Value ◽  
Ca 125 ◽  
Benign Tumors ◽  
Cross Sectional ◽  
Ultrasound Score

Aims: To evaluate the role of modified RMI (RMI 5) in pre-operative evaluation of ovarian tumor. Methods: It was a prospective cross sectional study done in Paropakar Maternity and Women’s Hospital from May to August 2018. During the study, 72 women with ovarian tumor were analyzed. RMI5 was calculated using the ultrasound score, Doppler score, menopausal status and CA125. Cut-off of 200 was used for malignancy discrimination. Chi square test was used to calculate the statistical significance which was set at 0.05. Receiver Operator Characteristics curves for RMI and its individual parameters were plotted using SPSS. Results: There were 72 ovarian tumors operated in four months and mean age was36 years with 10 (14%) at post-menopause. The mean value of RMI 5 was 38 for benign tumors, 80 for borderline tumors and 899 for malignant tumors. The area under curve for RMI 5 was 0.993 for cut-off of 200. The diagnostic accuracy of RMI 5 was 94.4 which was similar to that of Doppler score 2 (94.7) while it was much higher than that of the rest of the parameters (CA-125: 72, ultrasound score: 87 and postmenopausal status: 88.9). Conclusions: RMI 5 is better for malignancy prediction of ovarian masses instead of individual parameters like menopausal status, CA125 and ultrasound score.

scholarly journals SARS-CoV-2 seroprevalence and asymptomatic viral carriage in healthcare workers: a cross-sectional study

Thorax ◽  
2020 ◽  
Vol 75 (12) ◽  
pp. 1089-1094 ◽  
Author(s):  
Adrian Shields ◽  
Sian E Faustini ◽  
Marisol Perez-Toledo ◽  
Sian Jossi ◽  
Erin Aldera ◽  
...  
Keyword(s):  
Intensive Care ◽  
Healthcare Workers ◽  
Venous Blood ◽  
Cross Sectional Study ◽  
Nasopharyngeal Swab ◽  
Sectional Study ◽  
University Hospitals ◽  
Cross Sectional ◽  
General Internal ◽  
Increased Risk

ObjectiveTo determine the rates of asymptomatic viral carriage and seroprevalence of SARS-CoV-2 antibodies in healthcare workers.DesignA cross-sectional study of asymptomatic healthcare workers undertaken on 24/25 April 2020.SettingUniversity Hospitals Birmingham NHS Foundation Trust (UHBFT), UK.Participants545 asymptomatic healthcare workers were recruited while at work. Participants were invited to participate via the UHBFT social media. Exclusion criteria included current symptoms consistent with COVID-19. No potential participants were excluded.InterventionParticipants volunteered a nasopharyngeal swab and a venous blood sample that were tested for SARS-CoV-2 RNA and anti-SARS-CoV-2 spike glycoprotein antibodies, respectively. Results were interpreted in the context of prior illnesses and the hospital departments in which participants worked.Main outcome measureProportion of participants demonstrating infection and positive SARS-CoV-2 serology.ResultsThe point prevalence of SARS-CoV-2 viral carriage was 2.4% (n=13/545). The overall seroprevalence of SARS-CoV-2 antibodies was 24.4% (n=126/516). Participants who reported prior symptomatic illness had higher seroprevalence (37.5% vs 17.1%, χ2=21.1034, p<0.0001) and quantitatively greater antibody responses than those who had remained asymptomatic. Seroprevalence was greatest among those working in housekeeping (34.5%), acute medicine (33.3%) and general internal medicine (30.3%), with lower rates observed in participants working in intensive care (14.8%). BAME (Black, Asian and minority ethnic) ethnicity was associated with a significantly increased risk of seropositivity (OR: 1.92, 95% CI 1.14 to 3.23, p=0.01). Working on the intensive care unit was associated with a significantly lower risk of seropositivity compared with working in other areas of the hospital (OR: 0.28, 95% CI 0.09 to 0.78, p=0.02).Conclusions and relevanceWe identify differences in the occupational risk of exposure to SARS-CoV-2 between hospital departments and confirm asymptomatic seroconversion occurs in healthcare workers. Further investigation of these observations is required to inform future infection control and occupational health practices.

scholarly journals MicroRNAs-1299, -126-3p and -30e-3p as Potential Diagnostic Biomarkers for Prediabetes

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 949
Author(s):  
Cecil J. Weale ◽  
Don M. Matshazi ◽  
Saarah F. G. Davids ◽  
Shanel Raghubeer ◽  
Rajiv T. Erasmus ◽  
...  
Keyword(s):  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Predictive Ability ◽  
Roc Curves ◽  
Tolerance Test ◽  
Cross Sectional Study ◽  
Oral Glucose ◽  
Cross Sectional ◽  
Receiver Operating

This cross-sectional study investigated the association of miR-1299, -126-3p and -30e-3p with and their diagnostic capability for dysglycaemia in 1273 (men, n = 345) South Africans, aged >20 years. Glycaemic status was assessed by oral glucose tolerance test (OGTT). Whole blood microRNA (miRNA) expressions were assessed using TaqMan-based reverse transcription quantitative-PCR (RT-qPCR). Receiver operating characteristic (ROC) curves assessed the ability of each miRNA to discriminate dysglycaemia, while multivariable logistic regression analyses linked expression with dysglycaemia. In all, 207 (16.2%) and 94 (7.4%) participants had prediabetes and type 2 diabetes mellitus (T2DM), respectively. All three miRNAs were significantly highly expressed in individuals with prediabetes compared to normotolerant patients, p < 0.001. miR-30e-3p and miR-126-3p were also significantly more expressed in T2DM versus normotolerant patients, p < 0.001. In multivariable logistic regressions, the three miRNAs were consistently and continuously associated with prediabetes, while only miR-126-3p was associated with T2DM. The ROC analysis indicated all three miRNAs had a significant overall predictive ability to diagnose prediabetes, diabetes and the combination of both (dysglycaemia), with the area under the receiver operating characteristic curve (AUC) being significantly higher for miR-126-3p in prediabetes. For prediabetes diagnosis, miR-126-3p (AUC = 0.760) outperformed HbA1c (AUC = 0.695), p = 0.042. These results suggest that miR-1299, -126-3p and -30e-3p are associated with prediabetes, and measuring miR-126-3p could potentially contribute to diabetes risk screening strategies.

scholarly journals Illness severity and risk of mental morbidities among patients recovering from COVID-19: a cross-sectional study in the Icelandic population

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e049967
Author(s):  
Karen Sól Saevarsdóttir ◽  
Hildur Ýr Hilmarsdóttir ◽  
Ingibjörg Magnúsdóttir ◽  
Arna Hauksdóttir ◽  
Edda Bjork Thordardottir ◽  
...  
Keyword(s):  
Severe Disease ◽  
Symptom Burden ◽  
Cross Sectional Study ◽  
Illness Severity ◽  
University Education ◽  
Adjusted Relative Risk ◽  
Sectional Study ◽  
Cross Sectional ◽  
Symptoms Of Depression ◽  
Increased Risk

ObjectiveTo test if patients recovering from COVID-19 are at increased risk of mental morbidities and to what extent such risk is exacerbated by illness severity.DesignPopulation-based cross-sectional study.SettingIceland.ParticipantsA total of 22 861 individuals were recruited through invitations to existing nationwide cohorts and a social media campaign from 24 April to 22 July 2020, of which 373 were patients recovering from COVID-19.Main outcome measuresSymptoms of depression (Patient Health Questionnaire), anxiety (General Anxiety Disorder Scale) and posttraumatic stress disorder (PTSD; modified Primary Care PTSD Screen for DSM-5) above screening thresholds. Adjusting for multiple covariates and comorbidities, multivariable Poisson regression was used to assess the association between COVID-19 severity and mental morbidities.ResultsCompared with individuals without a diagnosis of COVID-19, patients recovering from COVID-19 had increased risk of depression (22.1% vs 16.2%; adjusted relative risk (aRR) 1.48, 95% CI 1.20 to 1.82) and PTSD (19.5% vs 15.6%; aRR 1.38, 95% CI 1.09 to 1.75) but not anxiety (13.1% vs 11.3%; aRR 1.24, 95% CI 0.93 to 1.64). Elevated relative risks were limited to patients recovering from COVID-19 that were 40 years or older and were particularly high among individuals with university education. Among patients recovering from COVID-19, symptoms of depression were particularly common among those in the highest, compared with the lowest tertile of influenza-like symptom burden (47.1% vs 5.8%; aRR 6.42, 95% CI 2.77 to 14.87), among patients confined to bed for 7 days or longer compared with those never confined to bed (33.3% vs 10.9%; aRR 3.67, 95% CI 1.97 to 6.86) and among patients hospitalised for COVID-19 compared with those never admitted to hospital (48.1% vs 19.9%; aRR 2.72, 95% CI 1.67 to 4.44).ConclusionsSevere disease course is associated with increased risk of depression and PTSD among patients recovering from COVID-19.

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