Dataset Information

Differential diagnostic roles of the serum CA19-9, total bilirubin (TBIL) and the ratio of CA19-9 to TBIL for benign and malignant.

ABSTRACT: Background: Obstructive jaundice is one of the most common symptoms which can be caused by both malignant and benign hepato-biliary-pancreatic diseases. The differences and the differential diagnostic roles of the serum CA19-9, total bilirubin (TBIL) and especially, the ratio of CA19-9 to TBIL in these patients have not been well elucidated. This study compared the differences and the differential diagnostic roles of the increase-folds of the serum CA19-9, TBIL and the ratio of increase-folds of CA19-9 to increase-folds of TBIL in 508 cases of malignant (MOJ) and benign (BOJ) obstructive jaundice patients. Methods: Totally, 508 cases of obstructive jaundice patients with pathological results were retrospectively enrolled. 342 cases were MOJ, including gallbladder adenocarcinoma, extrahepatic cholangiocarcinoma, periampullar adenocarcinoma and pancreatic adenocarcinoma.The other 166 cases were BOJ, including cholelithiasis, primary sclerosing cholangitis (PSC), IgG4 related sclerosing cholangitis (IRSD), inflammatory stricture of bile duct, and adenoma. The data of the increase-folds of serum CA19-9, TBIL and the ratio of increase-folds of CA19-9 to increase-folds of TBIL was collected and analyzed. The ROC (receiver operating characteristic) curve was adopted to determine the optimal cutoff value to evaluate their differential diagnostic roles. Results: The CA19-9 was elevated in 94.15% of the MOJ, compared to 67.10% in BOJ (P<0.0001). The increase-folds of the CA19-9 (76.52±15.04 vs 3.55±0.41, P< 0.0001) and the increase-folds of TBIL (7.10±0.25 vs 5.95±0.36, P=0.0034) and the ratio (14.96±5.05 vs 0.79±0.93, P=0.0026) in MOJ were significantly higher than BOJ. The ROC curves indicated that the TBIL showed minimal differential diagnostic power (AUC=0.590), the increase-folds of CA19-9 and the ratio showed stronger differential diagnostic power (AUC=0.815 and AUC=0.889, respectively). The optimal value of the increase-folds of serum CA19-9 and the ratio for differential diagnosis was 4.5 and 0.88, respectively. Further, the combination of the increase-folds of serum CA19-9 and the ratio could increase the specificity and accuracy of the diagnosis of MOJ. Conclusion: The serum CA19-9, TBIL and the ratio in MOJ and BOJ are significantly different. The ratio of the increase-folds of CA19-9 to increase-folds of TBIL has stronger differential diagnostic roles than the increase-folds of CA19-9 or TBIL alone. The combination of the increase-folds of the CA19-9 and the ratio can further improve the specificity and accuracy of the diagnosis of MOJ.

SUBMITTER: Liu W

PROVIDER: S-EPMC5968769 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Differential diagnostic roles of the serum CA19-9, total bilirubin (TBIL) and the ratio of CA19-9 to TBIL for benign and malignant.

Liu Wei W Liu Qiaofei Q Wang Wenqin W Wang Penghui P Chen Jieming J Hong Tao T Zhang Ning N Li Binglu B Qu Qiang Q He Xiaodong X

Journal of Cancer 20180419 10

<b>Background:</b> Obstructive jaundice is one of the most common symptoms which can be caused by both malignant and benign hepato-biliary-pancreatic diseases. The differences and the differential diagnostic roles of the serum CA19-9, total bilirubin (TBIL) and especially, the ratio of CA19-9 to TBIL in these patients have not been well elucidated. This study compared the differences and the differential diagnostic roles of the increase-folds of the serum CA19-9, TBIL and the ratio of increase-f ...[more]

PMID: 29805707

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Project description:PurposeThe clinical practice of elastosonography for the detection of salivary gland tumors is still a controversial issue. The objective of this meta-analysis was to evaluate the effect of elastosonography for the diagnosis of salivary gland tumors and to compare the diagnostic value of elastosonography and conventional ultrasound in the diagnosis of salivary gland tumors.MethodsA comprehensive literature search through PubMed, EMBASE, and Cochrane Library was carried out from inception to November 2021. Two researchers independently extracted the data from the enrolled papers using a standard data extraction form. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) were calculated to evaluate the diagnostic performance of elastosonography. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was utilized to evaluate the quality of each included study. Meta-DiSc version 1.4, Review Manager 5.3, and StataSE 15 were used.ResultsSixteen studies with a total of 1105 patients with 1146 lesions were included in this meta-analysis. The pooled sensitivity, specificity, PLR, NLR, and DOR of elastosonography for the differentiation between benign and malignant salivary gland tumors were 0.73 (95%CI, 0.66-0.78), 0.64 (95%CI, 0.61-0.67), 2.83 (95%CI, 1.97-4.07), 0.45 (95%CI, 0.32-0.62), and 9.86 (95%CI, 4.49-21.62), respectively, with an AUC of 0.82. Four studies provided data regarding the conventional ultrasound for the differentiation between benign and malignant salivary gland tumors. The pooled sensitivity, specificity, and DOR were 0.62 (95%CI, 0.50-0.73), 0.93 (95%CI, 0.90-0.96), and 25.07 (95%CI, 4.28-146.65), respectively. The meta-regression and subgroup analyses found that assessment methods were associated with significant heterogeneity, and quantitative or semiquantitative elastosonography performed better than the qualitative one.ConclusionsElastosonography showed a limited value for diagnosing malignant salivary gland tumors; it could be considered as a supplementary diagnostic technology to conventional ultrasound, and quantitative or semiquantitative elastosonography was superior to the qualitative one.

Project description:Background: Although Carbohydrate antigen 19-9 (CA19-9) is considered clinically useful and informative for pancreatic carcinoma (PC), false positive results, and false negative results have restricted its clinical use. Especially missed or delayed diagnosis of PC patients with negative CA19-9 value limited the utility. To improve prognosis of PC patients, the discovery of reliable biomarkers to assist CA19-9 is desired. Serum IgG galactosylation based on our previous report was altered in PC patients comparing to healthy controls. The objective of this study was to explore the diagnostic significance of IgG galactosylation in assisting CA19-9 for PC in a comprehensive way. Methods: Serum IgG galactosylation profiles were analyzed by MALDI-MS in cohort 1 (n = 252) and cohort 2 in which all CA19-9 levels were negative (n = 133). In each cohort, not only healthy controls and PC patients but also benign pancreatic disease (BPD) patients were enrolled. Peaks were acquired by the software of MALDI-MS sample acquisition, followed by being processed and analyzed by the software of Progenesis MALDI. IgG Gal-ratio, which was calculated from the relative intensity of peaks G0, G1, and G2 according to the formula (G0/(G1+G2×2)), was employed as an index for indicating the distribution of IgG galactosylation. Results: The Gal-ratio was elevated in PC comparing with that in non-cancer group (healthy controls and BPD). The area under the receiver operating characteristic curve (AUC) of IgG Gal-ratio was higher than that of CA19-9 (0.912 vs. 0.814). The performance was further improved when Gal-ratio and CA19-9 were combined (AUC: 0.928). Meanwhile, Gal-ratio also had great diagnostic value with a sensitivity of 92.31% (AUC: 0.883) in detection of PC at early stage. Notably, IgG Gal-ratio has great sensitivity (90.63%) and specificity (76.81%) in CA19-9-negative PC patients. Conclusions: IgG Gal-ratio had a great performance in detection of PC and could be used to assist CA19-9 in improving diagnosis performance through early stage detection, differentiation from BPD, and PC diagnosis with CA19-9-negative level.

Dataset Information

Differential diagnostic roles of the serum CA19-9, total bilirubin (TBIL) and the ratio of CA19-9 to TBIL for benign and malignant.

Publications

Differential diagnostic roles of the serum CA19-9, total bilirubin (TBIL) and the ratio of CA19-9 to TBIL for benign and malignant.

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