CA 19-9 in Evaluation of adnexal mass: retrospective cohort analysis and review of the literature

2015 ◽  
Vol 30 (3) ◽  
pp. 333-340 ◽  
Author(s):  
Lena Sagi-Dain ◽  
Ofer Lavie ◽  
Ron Auslander ◽  
Shlomi Sagi
Keyword(s):  
Tumor Markers ◽  
Retrospective Cohort ◽  
Medical Center ◽  
Cohort Analysis ◽  
Serum Marker ◽  
Ca 125 ◽  
Ovarian Malignancy ◽  
Adnexal Masses ◽  
Retrospective Cohort Analysis ◽  
Nonsignificant Effect

Objective The aim of this study was to estimate the diagnostic accuracy of serum marker CA 19-9 levels in the triage of adnexal masses. Methods This retrospective cohort study was carried out in patients referred to the Gynecology Department at Carmel Medical Center due to adnexal masses. All patients underwent preoperative measurements of serum CA 125 and CA 19-9 and surgery with histopathologically confirmed diagnosis. Results Between January 2005 and December 2012, 503 patients with adnexal masses were evaluated with serum tumor markers. Combination of CA 19-9 with CA 125, compared with CA 125 levels alone, suggested a nonsignificant effect on sensitivity (86.9% vs. 88.9%, respectively, p = 0.54) or specificity (79.5% vs. 73.5%, p = 0.1) in differentiating malignant from benign adnexal masses. CA 19-9 was not helpful in detecting mucinous histological types or borderline tumors. Mean CA 19-9 levels were higher in metastatic cases compared with primary ovarian malignancy (488.7 ± 1,457 vs. 46.3 ± 149.8 U/mL, respectively, p = 0.001). In mature cystic teratomas, mean CA 19-9 levels were higher and CA 125 levels were lower than in ovarian carcinoma (p = 0.049 and p = 0.0012, respectively). Conclusions The combination of the tumor markers CA 19-9 and CA 125 did not contribute significantly to the detection of malignant adnexal masses compared with CA 125 alone. As our results suggest that higher CA 19-9 levels could be helpful in differentiating metastatic tumors from primary ovarian malignancy; this issue should be investigated in large well-designed prospective cohort trials.

CEA in Evaluation of Adnexal Mass: Retrospective Cohort Analysis and Review of the Literature

2015 ◽  
Vol 30 (4) ◽  
pp. 394-400 ◽  
Author(s):  
Lena Sagi-Dain ◽  
Ofer Lavie ◽  
Ron Auslander ◽  
Shlomi Sagi
Keyword(s):  
Predictive Value ◽  
Retrospective Cohort ◽  
Adnexal Mass ◽  
Medical Center ◽  
Cohort Analysis ◽  
Adnexal Masses ◽  
Retrospective Cohort Analysis ◽  
Serum Carcinoembryonic Antigen ◽  
Serum Ca125 ◽  
Sensitivity Specificity

Background The aim of this study was to estimate the diagnostic accuracy of serum carcinoembryonic antigen (CEA) levels in conjunction with Ca125 in the triage of adnexal masses. Methods This retrospective cohort study was carried out in 495 patients referred to the Gynecology Department at Carmel Medical Center due to adnexal mass, between 2005 and 2012. All patients underwent surgery with histopathologically confirmed diagnosis and preoperative measurements of serum Ca125 and CEA. For each marker, sensitivity, specificity, positive predictive value, negative predictive value and risk ratio were calculated. Results Combination of CEA with Ca125, compared with Ca125 levels alone, yielded a nonsignificant effect on sensitivity (87.4% vs. 88.9%, respectively, p = 0.64) and specificity (79.3% vs. 74.3%, p = 0.18) in differentiating malignant from benign adnexal masses. CEA levels were higher in mucinous histological types, but were not helpful in detection of borderline tumors. Significantly higher CEA (21.4 ± 53.6 vs. 3.2 ± 11.9 ng/mL, p = 0.0002) and lower Ca125 values (103.9 ± 84.9 vs. 796 ± 1,331.5 U/mL, p = 0.0338) were demonstrated in the 17 metastatic cases compared with 181 primary ovarian malignancies. Conclusions The combination of the tumor markers CEA and Ca125 did not contribute significantly to the detection of malignant adnexal masses compared with Ca125 alone. As our results suggest that higher CEA levels could be useful in differentiating metastatic tumors from primary ovarian malignancy and in diagnosis of mucinous histology, this issue should be investigated in large, well-designed, prospective cohort trials.

scholarly journals Evaluating mortality and recovery of extreme hyperbilirubinemia in critically ill patients by phasing the peak bilirubin level: A retrospective cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255230
Author(s):  
Hong Seok Han ◽  
Chi-Min Park ◽  
Dae-Sang Lee ◽  
Dong Hyun Sinn ◽  
Eunmi Gil
Keyword(s):  
Hospital Mortality ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Retrospective Cohort ◽  
Total Bilirubin ◽  
Medical Center ◽  
Cohort Analysis ◽  
Grade Point ◽  
Retrospective Cohort Analysis ◽  
Grade 3

Background Hyperbilirubinemia is a devastating complication in patients admitted to an intensive care unit (ICU). The sequential organ failure assessment (SOFA) score classifies hyperbilirubinemia without further detailed analyses for bilirubin increase above 12 mg/dL. We evaluated whether the level of bilirubin increase in patients with extreme hyperbilirubinemia (total bilirubin ≥ 12 mg/dL) affects and also helps estimate mortality or recovery. Methods A retrospective cohort analysis comprising 427 patients with extreme hyperbilirubinemia admitted to the ICU of Samsung Medical Center, Seoul, Korea between 2011 and 2015 was conducted. Extreme hyperbilirubinemia was classified into four grades: grade 1 (12–14.9 mg/dL), grade 2 (15–19.9 mg/dL), grade 3 (20–29.9 mg/dL), and grade 4 (≥ 30 mg/dL). These grades were then assessed for their association with hospital mortality and recovery from hyperbilirubinemia to SOFA grade (point) 2 or below (total bilirubin < 6 mg/dL). The influences of various factors, some of which caused extreme hyperbilirubinemia, while others induced bilirubin recovery, were assessed. Results A total of 427 patients (mean age: 59.8 years, male: 67.0%) were evaluated, and the hospital mortality for these patients was very high (76.1%). Extreme hyperbilirubinemia was observed in 111 (grade 1, 26.0%), 99 (grade 2, 23.2%), 131 (grade3, 30.7%), and 86 (grade 4, 20.1%) patients with mortality rates of 62.2%, 71.7%, 81.7%, and 90.7%, respectively (p < 0.001). The peak bilirubin value correlated with the mortality (odds ratio [OR], 1.09; 95% confidence interval [CI], 1.04–1.15, p < 0.001). Compared to those with grade 1 extreme hyperbilirubinemia, the mortality rate gradually increased as the grade increased (OR [95% CI]: 1.92 [0.70–5.28], 3.55 [1.33–9.48], and 12.47 [3.07–50.59] for grades 2, 3 and 4, respectively). The main causes of extreme hyperbilirubinemia were infection including sepsis and hypoxic hepatitis. The recovery from hyperbilirubinemia was observed in 110 (25.8%) patients. Mortality was lower for those who recovered from hyperbilirubinemia than for those who did not (29.1% vs. 92.4%, p < 0.001). The favorable factors of bilirubin recovery were albumin and ursodeoxycholic acid (UDCA). Conclusions This study determined that the level of extreme hyperbilirubinemia is an important prognostic factor in critically ill patients. We expect the results of this study to help predict the clinical course of and determine the optimal treatment for extreme hyperbilirubinemia.

scholarly journals Inpatient vs outpatient evaluation of suspected paraneoplastic cerebellar degeneration

2020 ◽  
pp. 10.1212/CPJ.0000000000000854
Author(s):  
Natalie Witek ◽  
Mitra Afshari ◽  
Yuanqing Liu ◽  
Bichun Ouyang ◽  
Deborah Hall
Keyword(s):  
Functional Outcomes ◽  
Retrospective Cohort ◽  
Medical Center ◽  
Cohort Analysis ◽  
Cerebellar Degeneration ◽  
Paraneoplastic Cerebellar Degeneration ◽  
Class Iii ◽  
Retrospective Cohort Analysis ◽  
To Receive

Objective:To determine the differences in outcomes of adult ataxic patients initially evaluated for paraneoplastic cerebellar degeneration (PCD) as inpatients or outpatients.Methods:In this retrospective cohort analysis, diagnosis, workup, and functional outcomes based on change in modified Rankin Scale (mRS) were compared between patients with ataxia who underwent workup for PCD initially as inpatients versus outpatients between March 2011 and June 2018 at Rush University Medical Center.Results:There were 78 patients included in the analysis; 59% were women, and the average age at symptom onset was 57 ± 19.5 years. Nineteen patients (24.3%) underwent evaluation as inpatients and 59 (75.6%) as outpatients. Admitted patients were more likely to receive immunotherapy (73.7% vs. 20.3%, p<0.0001) and received it faster than outpatients (0.40 months for inpatients, interquartile range (IQR) 0.03-1 vs. 6.6 months for outpatients, IQR 2-11.7; p=0.01). A greater percentage of inpatients improved based on mRS compared to those who underwent evaluation as outpatients (52.63% vs. 22.81%, p=0.01).Conclusions:More patients improved from baseline in the inpatient cohort.Classification of Evidence:This study provides Class III evidence that for patients undergoing initial evaluation for paraneoplastic cerebellar degeneration, patients undergoing inpatient evaluation have better outcomes compared to those undergoing outpatient evaluation.

Are perceptual disorder signs in diplegic cerebral palsied children stable over time? A retrospective cohort analysis

2020 ◽  
Vol 72 (2) ◽  
Author(s):  
Silvia Alboresi ◽  
Alice Sghedoni ◽  
Giulia Borelli ◽  
Stefania Costi ◽  
Laura Beccani ◽  
...  
Keyword(s):  
Retrospective Cohort ◽  
Cohort Analysis ◽  
Retrospective Cohort Analysis ◽  
Over Time

Preeclampsia and low sodium: a retrospective cohort analysis and literature review

2020 ◽  
Author(s):  
Serena Xodo ◽  
Fabiana Cecchini ◽  
Lisa Celante ◽  
Alice Novak ◽  
Emma Rossetti ◽  
...  
Keyword(s):  
Literature Review ◽  
Retrospective Cohort ◽  
Cohort Analysis ◽  
Low Sodium ◽  
Retrospective Cohort Analysis

scholarly journals Does Time-to-Chemotherapy after Primary Complete Macroscopic Cytoreductive Surgery Influence Prognosis for Patients with Epithelial Ovarian Cancer? A Study of the FRANCOGYN Group

2021 ◽  
Vol 10 (5) ◽  
pp. 1058
Author(s):  
Grégoire Rocher ◽  
Thomas Gaillard ◽  
Catherine Uzan ◽  
Pierre Collinet ◽  
Pierre-Adrien Bolze ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Epithelial Ovarian Cancer ◽  
Cytoreductive Surgery ◽  
Retrospective Cohort ◽  
Early Stage ◽  
Cohort Analysis ◽  
Recurrence Free Survival ◽  
Advanced Stage ◽  
Free Survival ◽  
Retrospective Cohort Analysis

To determine if the time-to-chemotherapy (TTC) after primary macroscopic complete cytoreductive surgery (CRS) influences recurrence-free survival (RFS) and overall survival (OS) in patients with epithelial ovarian cancer (EOC). We conducted an observational multicenter retrospective cohort analysis of women with EOC treated from September 2006 to November 2016 in nine institutions in France (FRANCOGYN research group) with maintained EOC databases. We included women with EOC (all FIGO stages) who underwent primary complete macroscopic CRS prior to platinum-based adjuvant chemotherapy. Two hundred thirty-three patients were included: 73 (31.3%) in the early-stage group (ESG) (FIGO I-II), and 160 (68.7%) in the advanced-stage group (ASG) (FIGO III-IV). Median TTC was 43 days (36–56). The median OS was 77.2 months (65.9–106.6). OS was lower in the ASG when TTC exceeded 8 weeks (70.5 vs. 59.3 months, p = 0.04). No impact on OS was found when TTC was below or above 6 weeks (78.5 and 66.8 months, respectively, p = 0.25). In the whole population, TTC had no impact on RFS or OS. None of the factors studied were associated with an increase in TTC. Chemotherapy should be initiated as soon as possible after CRS. A TTC greater than 8 weeks is associated with poorer OS in patients with advanced stage EOC.

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