Malign plevral sıvıların tanısında CYFRA 21-1, CA 19-9, CA-125 ve mutant p53 düzeylerinin değeri
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Date
2000
Authors
Sevinç, Can
İşlekel, Hüray
Akkoçlu, Atila
Yenice, Sedef
Kılınç, Oğuz
İtil, Oya
Uçan, Eyüp Sabri
Çırmın, Arif
Altın, Remzi
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Abstract
Plevral sıvıların ayırıcı tanısında tümör belirleyicilerinin rolü henüz tam olarak tanımlanamamıştır. Bu çalışmada malign plevral sıvı tanısına katkılarını araştırmak amacıyla sitokeratin 19 fragmanı olan CYFRA 21-1, CA 19-9, CA-125 ve tümör baskılayıcı genlerden p53'ün mutant form ürünü düzeyleri malign plevral sıvılarda (n=20) kantitatif olarak ölçüldü. Bu değerler benign plevral sıvılardaki düzeyler (n=10) ile karşılaştırıldı. CYFRA 21-1 konsantrasyonları katı-faz sandviç immunoradyometrik ölçüm yöntemi ile ölçülürken, diğer parametreler ELISA yöntemi ile belirlendi. CYFRA 21-1, CA-125 ve CA 19-9'un plevral sıvı düzeyleri malign sıvılarda benign sıvılara göre istatistiksel olarak anlamlı biçimde yüksek bulundu. Mutant p53'ün ortalama düzeyi açısından iki grup arasında istatistiksel farklılık saptanamazken, plevral sıvılarda ölçülebilecek düzeyde mutant p53 düzeyi esas alındığında, malign sıvıların %65'inde, benign sıvıların ise %30'unda mutant p53 varlığı belirlendi. En yüksek tanısal duyarlılığa CYFRA 21-1 ve CA 19-9 (%100), özgüllüğe CA 19-9 (% 80), pozitif öngörü değerine CA 19-9 (%90), negatif öngörü değerine CYFRA 21-1 ve CA 19-9 (%100), toplam tanısal doğruluğa ise CA 19-9 (%93) ile ulaşıldığı saptandı. Sonuç olarak, malign ve benign plevral sıvıların ayırt edilmesinde CYFRA 21-1 ve CA 19-9 düzeylerinin ölçülmesinin geleneksel tanı yöntemleri ile birlikte kullanıldığında yararlı olabileceğini düşünmekteyiz.
Value of CYFRA 21-1, Ca 19-9, Ca-125 and Mutant p53 in Diagnosis of Malignant Pleural Fluids The role of tumor marker determination in the differential diagnosis of pleural effusions has not been established definitely. In this study, to evaluate the contributions of cytokeratin 19 fragment CYFRA 21-1, CA 19-9, CA-125 and mutant form of tumor suppressor gene p53 to the diagnosis of malignant and benign diseases, pleural fluid levels of these parameters were determined quantitatively in malignant fluids (n=20). These values were compared with benign samples (n=10). CYFRA 21-1 concentration was measured by a solid-phase sandwich immunoradiometric assay, while the other parameters were determined by ELISA. In patients with malignant diseases, the mean pleural fluid CYFRA 21-1, CA 19-9 and CA 125 levels were significantly higher than those in patients with benign diseases. While there were no significant differences between the mean mutant p53 levels in malignant and benign pleural fluids, mutant p53 was positive in 65% of malignant fluids and 30% of benign fluids when the detectable mutant p53 levels were considered. For purposes of discrimination between malignancy and benignancy, the highest diagnostic sensitivity, specificity, positive predictivity, negative predictivity and accuracy were provided by CYFRA 21-1 and CA 19-9 (%100), CA 19-9 (% 80), CA 19-9(%90), CYFRA 21-1 and CA 19-9 (%100), and CA 19-9 (%93), respectively. In conclusion, it can be stated that determination of CYFRA 21-1 and CA 19-9 seems valuable as an adjunct to the conventional diagnostic methods for the discrimination between malignant and benign pleural fluids.
Value of CYFRA 21-1, Ca 19-9, Ca-125 and Mutant p53 in Diagnosis of Malignant Pleural Fluids The role of tumor marker determination in the differential diagnosis of pleural effusions has not been established definitely. In this study, to evaluate the contributions of cytokeratin 19 fragment CYFRA 21-1, CA 19-9, CA-125 and mutant form of tumor suppressor gene p53 to the diagnosis of malignant and benign diseases, pleural fluid levels of these parameters were determined quantitatively in malignant fluids (n=20). These values were compared with benign samples (n=10). CYFRA 21-1 concentration was measured by a solid-phase sandwich immunoradiometric assay, while the other parameters were determined by ELISA. In patients with malignant diseases, the mean pleural fluid CYFRA 21-1, CA 19-9 and CA 125 levels were significantly higher than those in patients with benign diseases. While there were no significant differences between the mean mutant p53 levels in malignant and benign pleural fluids, mutant p53 was positive in 65% of malignant fluids and 30% of benign fluids when the detectable mutant p53 levels were considered. For purposes of discrimination between malignancy and benignancy, the highest diagnostic sensitivity, specificity, positive predictivity, negative predictivity and accuracy were provided by CYFRA 21-1 and CA 19-9 (%100), CA 19-9 (% 80), CA 19-9(%90), CYFRA 21-1 and CA 19-9 (%100), and CA 19-9 (%93), respectively. In conclusion, it can be stated that determination of CYFRA 21-1 and CA 19-9 seems valuable as an adjunct to the conventional diagnostic methods for the discrimination between malignant and benign pleural fluids.
Description
Keywords
Plevral efüzyon, Plevral efüzyon, Malign, CA-19-9 antijen, Genler, p53, Enzim bağlı immünosorbent tayini, Tanı, Ayırıcı
Turkish CoHE Thesis Center URL
Citation
1
WoS Q
N/A
Scopus Q
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Volume
3
Issue
3
Start Page
21
End Page
26