The role of carbohydrate antigen 19-9 in the clinical evaluation of mature cystic teratomas: an observational study at a tertiary care centre

Background: Carbohydrate antigen (CA) 19-9 is a tumour marker mainly used in the evaluation of gastrointestinal tract malignancies including pancreas, colon and biliary tract. Cases of ovarian tumours such as mucinous neoplasms have been reported to have high levels of CA 19-9. However, its role in the management of cystic teratomas (MCT) which are the most common benign ovarian tumours encountered in gynaecology, is not studied in depth in literature.Methods: In our study, we observed the levels of CA 19-9 in 40 patients presenting with MCT. Its association to the cyst size, contents, laterality and torsion or rupture were documented.Results: The various clinical parameters evaluated in our study such as larger cyst size, presence of torsion and tooth as a content had a positive association with elevated CA 19-9 levels (p<0.05). However, CA 19-9 had no significant relationship with the laterality of the cyst. Thus, CA 19-9 may serve as an important adjunct tool to ultrasonography in the management of dermoid cysts (MCT), particularly in those with larger sizes and at risk of torsion.Conclusions: High levels of CA 19-9 can be observed in benign ovarian tumors like mature cystic teratoma (MCT) and it need not always be associated with malignancy or malignant transformation of benign tumors. Levels more than 100 IU may warrant further imaging studies to rule out gastro-intestinal pathologies. Unnecessary medical investigations or patient anxiety can be avoided in cases of moderate elevation in CA 19-9 levels.

Comprehensive review of adnexal masses in a tertiary care hospital

Background: Adnexal masses can be either be a physiological luteal cyst, a benign tubo-ovarian mass or a malignancy. The signs and symptoms along with tumour markers and imaging modalities are considered to differentiate between a benign and a malignant adnexal mass. Adnexal masses in pregnancy can be asymptomatic or can present with acute abdomen in cases of ectopic pregnancy and torsion. The aim was to study the prevalence of various histopathologic types of adnexal masses in different age groups.Methods: This was a retrospective study carried out in the department of obstetrics and gynecology in a tertiary care hospital from May-2019 to April-2022. Women with sonographically diagnosed adnexal mass were evaluated. Data regarding ultrasound findings, tumour markers, RMI score and the management done were recorded from medical record charts. Descriptive statistics was applied and results shown in the form of frequencies and percentages.Results: Among 31 study participants, the most common presentation was pain abdomen. Majority (93.5%) patients had benign adnexal pathology and 6.45% had malignant pathology. The most common ovarian pathology encountered was Benign surface epithelial tumours (48.4%). Early diagnosis of 2 tubal ectopic and 1 ovarian ectopic pregnancy was made and managed conservatively.Conclusions: Early diagnosis and intervention is helpful in adolescent girls to conserve their ovarian function. Early diagnosis of ectopic pregnancy in stable patients can be managed conservatively. A high RMI should raise a suspicion of malignancy.

Comprehensive review of adnexal masses in a tertiary care hospital

Background: Adnexal masses can be either be a physiological luteal cyst, a benign tubo-ovarian mass or a malignancy. The signs and symptoms along with tumour markers and imaging modalities are considered to differentiate between a benign and a malignant adnexal mass. Adnexal masses in pregnancy can be asymptomatic or can present with acute abdomen in cases of ectopic pregnancy and torsion. The aim was to study the prevalence of various histopathologic types of adnexal masses in different age groups.Methods: This was a retrospective study carried out in the department of obstetrics and gynecology in a tertiary care hospital from May-2019 to April-2022. Women with sonographically diagnosed adnexal mass were evaluated. Data regarding ultrasound findings, tumour markers, RMI score and the management done were recorded from medical record charts. Descriptive statistics was applied and results shown in the form of frequencies and percentages.Results: Among 31 study participants, the most common presentation was pain abdomen. Majority (93.5%) patients had benign adnexal pathology and 6.45% had malignant pathology. The most common ovarian pathology encountered was Benign surface epithelial tumours (48.4%). Early diagnosis of 2 tubal ectopic and 1 ovarian ectopic pregnancy was made and managed conservatively.Conclusions: Early diagnosis and intervention is helpful in adolescent girls to conserve their ovarian function. Early diagnosis of ectopic pregnancy in stable patients can be managed conservatively. A high RMI should raise a suspicion of malignancy.

Clinical Usefulness of Cancer Markers in Cancer

Background: Objectives: Cancer is the uncontrolled growth of abnormal cells anywhere in a body these cells can infiltrate normal body tissues of body. The definitive diagnosis of cancer being histo - pathological examination of tissue. The measurement of tumor markers is currently one of the most rapidly growing areas in laboratory medicine and is helpful in differential diagnosis of tumor type in metastatic deposits and also during follow - up evaluations. Methods: Advanced Cancer Institute is a tertiary care cancer institute in Mal wa region of Punjab, old cases with proven history and in the advanced stage of disease, measurement of tumor markers in them is a very important tool for their evaluation of treatment outcome and in staging, emphasis of our study is to highlight and to encourage tumor marker assays for early diagnosis of cancer by checking baseline levels in healthy and in high risk population for screening for the presence of cancer. Results: The Study was carried out Department of Microbiology, Total of 300 Blood Samples were checked in Automated Immune Analyzer (Biomeriux) with different panels of Tumor markers (PSA,AFP,CEA19.9,CA - 125,CA15.3)Kits available in our Lab. of commonly diagnosed cancer. Conclusion: Focus has to be directed towards identification a nd proper use of suitable tumor markers which may prove to be an invaluable tool to early detect the deadly disease in mankind and not to use markers only as a prognostic indicator in proven cases.

Diagnosis and treatment of biliary pancreatic duct dilatation / 中华消化外科杂志

Objective@#To summarize the diagnosis and treatment of biliary pancreatic duct dilatation.@*Methods@#The retrospective and descriptive study was conducted. The clinical data of 22 patients with biliary pancreatic duct dilatation who were admitted to Renji Hospital of Shanghai Jiaotong University School of Medicine between October 2013 to September 2017 were collected. There were 6 males and 16 females, aged from 33 to 82 years, with an average age of 66 years. Surgical exploration was decided according to clinical symptoms, results of laboratory test and imaging examinations. For patients with space occupying lesions, surgical procedure was selected based on results of pathological examination. Patients without surgical exploration or space occupying lesions were allocated into follow-up. Observation indicators: (1) surgical exploration; (2) relationship of clinical symptoms and preoperative examinations with surgical exploration positive for space occupying lesions; (3) surgical treatment; (4) follow-up. Follow-up using outpatient examination was performed on patients up to October 2018. Follow-up was performed on patients with positive surgical exploration to detect postoperative complications.For patients with positive results of imaging examinations, no jaundice, normal laboratory indicators or mild abnormality, liver function, tumor markers and B-ultrasound were re-examined each month, and computed tomography (CT) and magnetic resonance imaging (MRI) was performed once every 3 months. Surgical exploration was performed when total bilirubin (TBil) or tumor markers showed a progressive increase. Follow-up was performed on patients with negative results of imaging examination, jaundice, and mildly elevated CA19-9. TBil and CA19-9 were re-examined monthly, and if they were progressively elevated, patients were transferred to surgical exploration. For patients with negative results of imaging examination, no symptoms, and negative laboratory test, liver function, tumor markers, and B-ultrasound were re-examined once every 3 months, and enhanced CT and MRI were re-examined once every 6 months within one year. Follow-up was performed once every 6 months during the second year, and once a year after two years. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was analyzed using the t test. Count data were descibed as absolute numbers, and they were analyzed using the chi-square test under R×C chart or Fisher exact probability.@*Results@#(1) Surgical exploration: of 22 patients, 11 underwent surgical exploration, and 11 underwent follow-up. Of the 11 patients with surgical exploration, 4 were positive for space occupying lesions including 1 of false negative, and 7 were negative for space occupying lesions. (2) Relationship of clinical symptoms and preoperative examinations with surgical exploration positive for space occupying lesions. ① Relationship of clinical symptoms and laboratory test with surgical exploration positive for space occupying lesions: juandice was significantly associated with surgical exploration positive for space occupying lesions (P<0.05), and elevated TBil and DBil were significantly associated with surgical exploration positive for space occupying lesions (χ2=0, 0, P<0.05), with a sensitivity of 75.0% and specificity of 100.0%. ② Relationship between imaging examination and surgical exploration positive for space occupying lesions: results of CT, MRI, endoscopic retrograde cholangio-pancreatography, endoscopic ultrasonography, PET-CT, and combined imaging examinations had no significant association with surgical exploration positive for space occupying lesions (χ2=0, 0.77, 0, 0, 1.00, 0, 0, 0, 0, P>0.05). PET-CT had no significant association with surgical exploration positive for space occupying lesions (P>0.05). ③ Relationship of imaging examination and laboratory test with surgical exploration positive for space occupying lesions: positive imaging examination combined with elevated TBil and CA19-9 was significantly associated with surgical exploration positive for space occupying lesions (P<0.05), with a sensitivity of 50.0% and specificity of 100.0%. ④ Relationship of preoperative diameters of biliary ducts and pancreatic ducts with surgical exploration positive for space occupying lesions: of 22 patients, the diameters of biliary ducts and pancreatic ducts were (13.8±4.3)mm and (4.6±1.5)mm for patients with positive surgical exploration, (13.0±2.8)mm and (3.5±0.5)mm for patients with negative surgical exploration, (11.6±2.4)mm and (3.2±0.4)mm for patients with follow-up, respectively, showing no significant difference between them (t=0.22, 0.36, P>0.05). (3) Surgical treatment: 9 of 11 patients with surgical exploration followed the standard procedure. Of the 9 patients, 4 were found space-occupying lesions at the choledocho-pancreatico-duodenal junction (3 undergoing pancreaticoduodenectomy and 1 undergoing duodenal papilla partial resection), 5 with negative exploration underwent common bile duct incision and T-tube drainage (one patient was unable to pinch the T-tube one month after operation and detected obstruction at the lower end of the bile duct by radiography, and was confirmed pancreatic head cancer by reoperation 3 months after the first operation). Two patients didn′t follow the exploratory procedure, and underwent the child operation only based on the preoperative imaging findings, without intraoperative pathological examination. Postoperative pathological examination showed chronic ampulla and chronic pancreatitis, respectively. (4) Follow-up: 22 patients were followed up for 12-60 months, with a median follow-up time of 36 months. Two of 11 patients with surgical exploration had postoperative gastroplegia, 1 had bile leakage, 1 had incisional infection, and they were improved after symptomatic treatment. Four patients undergoing surgeries for positive exploration had no recurrence during follow-up. Of 5 patients with negative exploration undergoing common bile duct incision and T-tube drainage, 1 was confirmed pancreatic head cancer and underwent pancreaticoduodenectomy, 4 were removed T-tube after by T-tube cholangiography at 2 months after surgery. During the follow-up, no positive signs showed in laboratory test or imaging examination. No recurrence occurred in the two patients undergoing pancreaticoduodenectomy. Of 11 patients with follow-up, 10 had abdominal pain before surgery, including 3 with pain during follow-up and 7 with symptoms disappeared. There was no abnormalities in the laboratory test.@*Conclusions@#The positive imaging examinations combined with jaundice and elevated CA19-9 is an absolute indication for surgical exploration in patients with biliary duct dilatation. Those patients who do not meet this criteria should be distributed into the follow-up. If no positive pathological results were obtained during the operation, the surgery should be terminated and the patients should be transferred into follow-up. The reckless biliary anastomosis or biliary stents placement is opposed.

Diagnosis and treatment of biliary pancreatic duct dilatation / 中华消化外科杂志

Objective To summarize the diagnosis and treatment of biliary pancreatic duct dilatation.Methods The retrospective and descriptive study was conducted.The clinical data of 22 patients with biliary pancreatic duct dilatation who were admitted to Renji Hospital of Shanghai Jiaotong University School of Medicine between October 2013 to September 2017 were collected.There were 6 males and 16 females,aged from 33 to 82years,with an average age of 66 years.Surgical exploration was decided according to clinical symptoms,results of laboratory test and imaging examinations.For patients with space occupying lesions,surgical procedure was selected based on results of pathological examination.Patients without surgical exploration or space occupying lesions were allocated into follow-up.Observation indicators:(1) surgical exploration;(2) relationship of clinical symptoms and preoperative examinations with surgical exploration positive for space occupying lesions;(3) surgical treatment;(4) follow-up.Follow-up using outpatient examination was performed on patients up to October 2018.Follow-up was performed on patients with positive surgical exploration to detect postoperative complications.For patients with positive results of imaging examinations,no jaundice,normal laboratory indicators or mild abnormality,liver function,tumor markers and B-ultrasound were re-examined each month,and computed tomography (CT) and magnetic resonance imaging (MRI) was performed once every 3 months.Surgical exploration was performed when total bilirubin (TBil) or tumor markers showed a progressive increase.Follow-up was performed on patients with negative results of imaging examination,jaundice,and mildly elevated CA19-9.TBil and CA19-9 were re-examined monthly,and if they were progressively elevated,patients were transferred to surgical exploration.For patients with negative results of imaging examination,no symptoms,and negative laboratory test,liver function,tumor markers,and B-ultrasound were re-examined once every 3 months,and enhanced CT and MRI were re-examined once every 6 months within one year.Follow-up was performed once every 6 months during the second year,and once a year after two years.Measurement data with normal distribution were represented as Mean±SD,and comparison between groups was analyzed using the t test.Count data were descibed as absolute numbers,and they were analyzed using the chi-square test under R×C chart or Fisher exact probability.Results (1) Surgical exploration:of 22 patients,11 underwent surgical exploration,and 11 underwent followup.Of the 11 patients with surgical exploration,4 were positive for space occupying lesions including 1 of false negative,and 7 were negative for space occupying lesions.(2) Relationship of clinical symptoms and preoperative examinations with surgical exploration positive for space occupying lesions.① Relationship of clinical symptoms and laboratory test with surgical exploration positive for space occupying lesions:juandice was significantly associated with surgical exploration positive for space occupying lesions (P＜0.05),and elevated TBil and DBil were significantly associated with surgical exploration positive for space occupying lesions (x2 =0,0,P＜0.05),with a sensitivity of 75.0％ and specificity of 100.0％.(② Relationship between imaging examination and surgical exploration positive for space occupying lesions:results of CT,MRI,endoscopic retrograde cholangiopancreatography,endoscopic ultrasonography,PET-CT,and combined imaging examinations had no significant association with surgical exploration positive for space occupying lesions (x2 =0,0.77,0,0,1.00,0,0,0,0,P＞0.05).PET-CT had no significant association with surgical exploration positive for space occupying lesions (P＞0.05).③ Relationship of imaging examination and laboratory test with surgical exploration positive for space occupying lesions:positive imaging examination combined with elevated TBil and CA19-9 was significantly associated with surgical exploration positive for space occupying lesions (P＜0.05),with a sensitivity of 50.0％ and specificity of 100.0％.④ Relationship of preoperative diameters of biliary ducts and pancreatic ducts with surgical exploration positive for space occupying lesions:of 22 patients,the diameters of biliary ducts and pancreatic ducts were (13.8±4.3)mm and (4.6±1.5)mm for patients with positive surgical exploration,(13.0±2.8)mm and (3.5±0.5) mm for patients with negative surgical exploration,(11.6±2.4) mm and (3.2±0.4) mm for patients with follow-up,respectively,showing no significant difference between them (t =0.22,0.36,P＞0.05).(3) Surgical treatment:9 of 11 patients with surgical exploration followed the standard procedure.Of the 9 patients,4 were found space-occupying lesions at the choledocho-pancreatico-duodenal junction (3 undergoing pancreaticoduodenectomy and 1 undergoing duodenal papilla partial resection),5 with negative exploration underwent common bile duct incision and T-tube drainage (one patient was unable to pinch the T-tube one month after operation and detected obstruction at the lower end of the bile duct by radiography,and was confirmed pancreatic head cancer by reoperation 3 months after the first operation).Two patients didn't follow the exploratory procedure,and underwent the child operation only based on the preoperative imaging findings,without intraoperative pathological examination.Postoperative pathological examination showed chronic ampulla and chronic pancreatitis,respectively.(4) Follow-up:22 patients were followed up for 12-60 months,with a median followup time of 36 months.Two of 11 patients with surgical exploration had postoperative gastroplegia,1 had bile leakage,1 had incisional infection,and they were improved after symptomatic treatment.Four patients undergoing surgeries for positive exploration had no recurrence during follow-up.Of 5 patients with negative exploration undergoing common bile duct incision and T-tube drainage,1 was confirmed pancreatic head cancer and underwent pancreaticoduodenectomy,4 were removed T-tube after by T-tube cholangiography at 2 months after surgery.During the follow-up,no positive signs showed in laboratory test or imaging examination.No recurrence occurred in the two patients undergoing pancreaticoduodenectomy.Of 11 patients with follow-up,10 had abdominal pain before surgery,including 3 with pain during follow-up and 7 with symptoms disappeared.There was no abnormalities in the laboratory test.Conclusions The positive imaging examinations combined with jaundice and elevated CA19-9 is an absolute indication for surgical exploration in patients with biliary duct dilatation.Those patients who do not meet this criteria should be distributed into the follow-up.If no positive pathological results were obtained during the operation,the surgery should be terminated and the patients should be transferred into follow-up.The reckless biliary anastomosis or biliary stents placement is opposed.

Utility Of Salivary Ca-125 And Ldh As Tumor Markers In Oral Malignancy

Background: The mortality and morbidity associated with oral Squamous cell carcinoma (OSCC) can be greatly re-duced if tumor markers which can detect OSCC at an early stage are available. This study attempts to use saliva as the diagnostic medium to determine the correlation of salivary CA 125 and LDH in tobacco users with and without potentially malignant disorders. Changes in CA 125 and LDH level can be used as a marker in patients with and with-out premalignant disease and can be used as a deterrent in continuation of the habit. Aims:To assess the role of CA 125 & LDH as a tumour marker in Oral cancer patients. Materials and methods:Cross sectional observational study .Time period: December 2015 to August 2017.Study area: OPD of tertiary care hospital in pune. Total partici-pants: 150 persons. Under non-stimulatory conditions whole saliva sample was collected from each individual and was centrifuged. The resulting supernatant was used for estimation of CA 125 and LDH levels. Results:In present study, mean Salivary LDH level was found to be lowest among cases of healthy individuals while it was highest among individuals who were diagnosed and underwent treatment for malignancy. However there was insignificant difference seen between levels of diagnosed case of oral malignancy and the ones who underwent treatment for oral malignancy. Also mean Salivary CA-125 was lowest in healthy individuals and highest in individuals diagnosed with oral malignancy and the levels were seen to be reduced significantly in the one who underwent treatment for oral malignancies than those who didn’t. Conclusion:Salivary CA 125 and LDH has a role in early detection of oral malig-nancies and can be used as a diagnostic marker. However LDH levels are persistently raised even after treatment for oral malignancy.

Metastatic papillary serous carcinoma of testis: A rare case

Papillary serous carcinomas of testis are very rare, and only case reports have been reported in the literature. These neoplasms are characterised histologically by papillary fronds and numerous psammoma bodies and exhibit immunoreactivity for markers of ovarian serous carcinomas. These are very aggressive and are both chemo and radioresistant with surgery remained the main stay of management.

Urinary Bladder Cancer with Focus on Occupational Dye Workers.

Benzidine based azo dyes are proven carcinogens, mutagens and have been linked to bladder cancer of human beings and laboratory animals. The textile and dyestuff manufacturing industry are the two major sources for releasing of azo dyes. Various research groups have started work on genotoxic effect of textile dyes in occupational workers of textile dye industry. Bladder cancer is the most common form of cancer in dye industries. Most of people between age 50 and 70 group of are diagnosed with bladder cancer. Men are more likely than the women to develop bladder cancer. Bladder cancer is a disease in which abnormal cells multiply without control in the bladder. The most common type of bladder cancer begins in cells lining the inside of the bladder and is called transitional cell carcinoma. Tumor markers are substances that can be found in the body when cancer is present. They are most often found in the blood or urine. The review deals about the impacts of the industry dyes on human health.

Performance Evaluation of the SelexOn Analyser for Seven Biomarkers / 임상검사와정도관리

BACKGROUND: SelexOn (Infopia, Korea) is a novel immunoassay instrument that measures the concentration of alpha-fetoprotein (AFP), creatine kinase isoenzyme (CK-MB), D-dimer, high-sensitivity C-reactive protein (hs-CRP), myoglobin, prostate-specific antigen (PSA), and thyroid-stimulating hormone (TSH) in whole blood. We evaluated the analytical performance of SelexOn. METHODS: The analytical performance of SelexOn was evaluated for precision and linearity, and compared with the ADVIA Centaur XP Immunoassay System (Siemens, Germany) and the STA-R coagulation analyser (Diagnostica Stago, France). RESULTS: Within-run CV ranged from 2.9% to 8.9% for all biomarkers. Between-run precision ranged from 1.6% to 11.3% for all biomarkers, except at low levels of D-dimer (16.1%). Observed linearity ranges were AFP, 8.7 to 47.0 ng/mL; CK-MB, 4.7 to 38.7 ng/mL; D-dimer, 393.2 to 2,760.3 ng/mL; hs-CRP, 2.1 to 9.0 mg/L; myoglobin, 67.2 to 441.5 ng/mL; PSA, 2.6 to 23.7 ng/mL; and TSH, 3.3 to 38.9 mIU/L. Upon comparing SelexOn with the Centaur XP and STA-R systems, values of AFP, CK-MB, hs-CRP, and PSA showed good correlation, with correlation coefficients greater than 0.975. The correlation coefficients of TSH, myoglobin, and D-dimer were 0.9723, 0.9649, and 0.8379, respectively. The concordance was excellent for hs-CRP (kappa [kappa]=0.958), PSA (kappa=0.854), and TSH (kappa=0.810); good for AFP (kappa=0.655), CK-MB (kappa=0.759), and myoglobin (kappa=0.783); and moderate for D-dimer (kappa=0.561). CONCLUSIONS: SelexOn demonstrated acceptable precision, linearity, and correlation with the Centaur XP and the STA-R for seven biomarkers. Because of its speed and performance, SelexOn may facilitate the rapid screening of patients for cardiovascular disease, thyroid disease, prostate cancer, and hepatocellular carcinoma.

Selenium and Hepatocellular Carcinoma / Jurnal Sains Kesihatan Malaysia

While cancer is considered to be one of the leading causes of death worldwide, there is a growing scientific and public interests on selenium as a dietary and antioxidant of many diseases, in particular, cancer. Despite advanced technology and significant improvement of surgical, chemical, hormonal and radio therapies, hepatocellular carcinoma (HCC) is still common in Asia and Africa and is increasing in the developed countries. Prognosis of HCC at an early stage is still challenging. At the moment, combination of Alpha feto protein (AFP) and ultrasonography tests offers more accurate and sensitive results for the diagnosis of HCC. Selenium (also known as the moon element) has been recognized for almost 49 years as an antioxidant and anti cancer agent. The weight of evidence supports the position of selenium as an anti cancer agent for HCC but the molecular mechanism of how selenium inhibits HCC is still unknown. Numerous theories have been proposed and selenium induced apoptosis and cell cycle arrest is the predominant one so far.

Valores de referencia del antígeno prostático específico / Refence values of prostate specific antigen

En el presente estudio se determinaron los valores de referencia del PAS (antígeno prostático específico) en individuos en estado de salud para patologías prostáticas, teniendo en cuenta la falta de información en individuos en estas condiciones. Se incluyeron en el estudio, 618 individuos del sexo masculino, con edades comprendidas entre 40 y 69 años, que concurrieron al laboratorio “Medical Center” entre 1999 y 2001, procedentes de consultorios urológicos, con solicitudes de estudios laboratoriales. Para la selección de los individuos se siguieron las recomendaciones del Panel de Expertos en Teoría de los Valores de Referencia de la IFCC (Federación Internacional de Química Clínica). Individuos sin patología prostática, clínicamente sin dificultad en la micción y examen dígito rectal normal, con resultados negativos a los auxiliares de diagnóstico citoscopía y ecografía. Se realizó la medición con el método inmunoensayo de partículas (MEIA), IMX Abbott, USA. En primer término se analizó el tipo de distribución de los valores de concentración de PAS de todos los individuos, empleando el test de Kolmogorov ­ Smirnov. Los valores de referencia de PAS obtenidos, entre los percentiles 2,5% y 97,5% mostraron diferencias de valores por grupo etário, con aumento progresivo (Kruskall­Wallis, p<0,0001). Los valores de referencia del PAS en ng/mL, fueron: de 40 a 49 años de 0,25 a 2; de 50 a 59 años de 0,64 a 3,24; de 60 a 69 años de 0,54 a 3,7. Los valores obtenidos servirán de guía para aplicar criterios de medicina preventiva que ayudaran al profesional de la salud en el diagnóstico precoz de patología prostática.

Development of prostate hyperplasia is an almost universal phenomenon in aging men. The PSA levels in serum are useful in the clinical evaluation in men over the age of 45. The objective of this study was to establish the reference values of prostate specific antigen (PSA) in serum in a selected Paraguayan population by microparticle enzimoimmunoassay MEIA. Six hundred eighteen people were evaluated with ages ranging from 40 to 69 years old who attended to “Laboratory Medical Center” in Asunción, Paraguay during 1999­2001. All were subjected to digital rectal examination, biopsy and echograph to assure the prostate disease free state. The International Federation of Chemical Chemistry (IFCC) reference value guidelines were used for individual selection. PSA concentrations were determined by microparticle enzimoimmunoassay (Autoanalyzer IMXABBOT/USA). The PSA concentration was presented as percentiles since neither the values nor the logarithms fitted into a normal distribution (Kolmogorov­Smirnov Test). Therefore, a nonparametric test (Kruskal­Wallis) was used for the estimation of differences between datum groups. According to age, our data showed statistical differences (p<0,0001). At increasing levels of PSA: 40 ­ 49 years old the serum value ranged from 0.25 ­ 2.0 ng/mL, 50 ­ 59 years old from 0.64 to 3.24 ng/mL and 60 ­ 69 from 0.54 to 3.7 ng/mL. These data represented the percentiles 2.5% and 97.5%. These PSA reference values will serve in screening programs as tools to detect prostate diseases in our population.

Expressão imuno-histoquímica dos marcadores pcna, KI67 e p53 em carcinomas epidermóides do trato aerodigestivo superior / Immunohistochemical expression of markers pcna, Ki67 and p53 in squamous cell carcinomas of upper aerodigestive tract

Objetivo: Os carcinomas epidermóides do trato aerodigestivo superior são tumores de comportamento biológico heterogêneo. O objetivo deste trabalho é verificar se a expressão imuno-histoquímica dos marcadores Ki67, PCNA e P53 apresenta correlações com parâmetros prognósticos clínico-patológicos. Métodos: Determinação da expressão imuno-histoquímica dos antígenos Ki67, PCNA e P53 em espécimes tumorais fixados e embebidos em parafina de 53 pacientes com carcinoma epidermóide em diferentes sítios primários do trato aerodigestivo superior. Resultados: Os marcadores tiveram altos índices de expressão imuno-histoquímica, sendo 46,5% para o Ki67, 66,5% para o PCNA e 36,5% para o P53. Não houve correlação da expressão do Ki67 e do PCNA com o estadiamento TNM (AJCC), nem com o grau de malignidade. Aexpressão do Ki67 apresentou correlação positiva com a expressão do PCNA (p = 0,037). O mesmo aconteceupara o PCNA e o número de mitoses por campo (p = 0,001). Conclusões: De acordo com estes resultados, concluiu-se que a determinação da imunorreatividade dos marcadores Ki67 e PCNA é um método objetivo e quantificável para avaliar proliferação celular que pode subsidiar as informações prognósticas.

Background: Squamous cell carcinomas of upper aerodigestive tract are tumors with heterogeneous biological behaviour. The aim of present study is to assess whether any correlation exists between immunohistochemical expression of Ki67, PCNA and P53 markers and clinicopathologic parameters. Methods: Immunohistochemical determination of Ki67, PCNA and P53 antigens in fixated and paraffinembedded tumour especimens from 53 patients with squamous cell carcinoma in different primary locations of upper aerodigestive tract. Results: The markers had high evidence average rates with 46,5% forKi67, 66,5% for PCNA and 36,5% for P53. There was neither correlation of Ki67 and PCNA evidence nor with TNM staging nor with malignancy degree. The expression of Ki67 demonstrated correlation with the expression of PCNA (p = 0,037). The same ocurred to PCNA and the number of mitoses (p = 0,001). Conclusions: According to these results, it has been concluded that the determination of immunoreactivityof Ki67 and PCNA proliferation markers is an accurate and quantitative method which may provide prognostic information.

Prostatic tumour markers in BPH and prostate cancer.

The blood levels of acid phosphatase (AP), prostatic acid phosphatase (PAP) and prostate specific antigen (PSA) in 80 cases of begin prostatic hypertrophy (BPH) patients and 22 cases of prostate cancer patients were studied. It was shown that the average levels of AP, PAP and PSA in BPH patients were 4.06 U/L, 1.27 U/L and 7.45 ng/ml. respectively, while those in prostate cancer patients were 5.09 U/L, 1.63 U/L and 62.63 ng/ml. respectively. In a comparison between the two groups of patients, the levels of AP and PAP were not found to be significantly different (p > 0.05), whereas in the case of PSA there was a significant difference (p < 0.005). Therefore, although AP and PAP cannot be used to differentiate between BPH and prostate cancer, PSA could be utilized However, no exact level of PSA was observed which would allow differentiation between the groups because although the PSA levels in 64 per cent of the BPH patients were higher than normal none were over 40 ng/ml.; those in 14 per cent of prostate cancer were normal. There was correlation between PSA level and adenoma tissue weight, from TUR-P, with an average value of 0.35 ng/ml. per 1 gram of tissue. It is import to note that in a patient who has a PSA level of over 40 ng/ml., or a PSA level that has no correlation to the weight of the prostate, there is a high possibility of prostate cancer. Therefore, a pathological tissue examination should be approved for this patient.