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Sample records for preoperative ca125 level

  1. Preoperative CA125 as a prognostic factor in stage I epithelial ovarian cancer

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    Petri, Anette Lykke; Høgdall, Estrid; Christensen, Ib Jarle;

    2006-01-01

    was evaluated and compared with other prognostic factors (age, grade, substages, histologic type). By the Kaplan-Meier estimate we demonstrated that patients with stage I EOC and preoperative serum CA125 levels U/mL had a significantly longer survival compared to stage I EOC patients with preoperative serum...... CA125 > or = 65 U/mL (p=0.01). The results from the present study may be useful for decision making respecting postoperative chemotherapy in stage I EOC patients. Serum CA125 levels might therefore be included as a prognostic factor in future clinical trials of stage I EOC....

  2. Preoperative CA125 as a prognostic factor in stage I epithelial ovarian cancer

    DEFF Research Database (Denmark)

    Petri, Anette Lykke; Høgdall, Estrid; Christensen, Ib Jarle

    2006-01-01

    was evaluated and compared with other prognostic factors (age, grade, substages, histologic type). By the Kaplan-Meier estimate we demonstrated that patients with stage I EOC and preoperative serum CA125 levels U/mL had a significantly longer survival compared to stage I EOC patients with preoperative serum...... CA125 > or = 65 U/mL (p=0.01). The results from the present study may be useful for decision making respecting postoperative chemotherapy in stage I EOC patients. Serum CA125 levels might therefore be included as a prognostic factor in future clinical trials of stage I EOC....

  3. Utility of Preoperative CA125 Assay in the Management Planning of Women Diagnosed with Uterine Cancer

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    N. Povolotskaya

    2014-01-01

    Full Text Available Objective. This study assesses the role of preoperative serum CA125 levels in the planning treatment options for women diagnosed with uterine cancer. Material and Method. Ninety five consecutive patients diagnosed with uterine cancer during a four-year period were identified. Age ranged from 35 to 89 years with a mean age of 69 years. The preoperative CA125 levels were dichotomised at 28 U/mL (using ROC analysis to identify the best discriminating threshold for 5-year survival. This level was then correlated with preoperative prognostic indicators: patient age, tumour grade, and histopathological tumour cell type. Survival data was plotted using Kaplan-Meier curves and analysed using the log-rank test. Univariate and multivariate analysis were performed to identify the predictors of overall survival. Results. The mean age of patients was 69 years (range: 35–89. On univariate analysis, the use of preoperative CA125 levels of greater or less than 28 U/mL correlated significantly with age (P=0.01, the grade of disease (P=0.02 and unfavourable tissue type (P=0.03. This threshold CA125 level had a sensitivity of 75%, specificity of 76%, positive predictive value of 35% and negative predicative value of 96.25%, and a likelihood ratio of 3.12 for predicting nodal disease. Using a threshold of preoperative CA125 level of 28 U/mL (area under curve: 0.60 was also a significant predictor of 5-year survival (log-rank test, P=0.01. Using Cox multivariate survival analysis to identify predictive preoperative factors overall, unfavourable cell type was the strongest predictor of survival (Chi square = 36.5, df = 4, and P=0.001, followed by preoperative CA125 level (CA125 > 28 U/mL, P=0.011 and unfavourable preoperative grade (P=0.017. Amongst patients with a favourable histological tissue type (endometrioid, preoperative CA125 levels predicted overall survival (Chi square = 6.039, df = 2, P=0.02; however unfavourable preoperative

  4. Prognostic significance of preoperative serum CA125, CA19-9 and CEA in gastric carcinoma

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    Wang, Wei; Chen, Xiao-Long; Zhao, Shen-Yu; Xu, Yu-Hui; Zhang, Wei-Han; Liu, Kai; Chen, Xin-Zu; Yang, Kun; Zhang, Bo; Chen, Zhi-Xin; Chen, Jia-Ping; Zhou, Zong-Guang; Hu, Jian-Kun

    2016-01-01

    The prognostic significance of preoperative serum CA125, CA19-9 and CEA in gastric carcinoma (GC) has been widely reported and is still under debate. Here, we evaluated the prognostic significance of preoperative serum CA125, CA19-9 and CEA in patients with GC. 1692 patients with GC who underwent gastrectomy were divided into the training (from January 2005 to December 2011, n = 1024) and the validation (from January 2012 to December 2013, n = 668) cohorts. Positive groups of CA125 (> 13.72 U/ml), CA19-9 (> 23.36 U/ml) and CEA (> 4.28 ng/ml) were significantly associated with more advanced clinicopathological traits and worse outcomes than that of negative groups (all P < 0.01). In Cox regression analysis, tumor size (P < 0.001, P = 0.005), pTNM stage (P < 0.001, P < 0.001) and CA125 (P = 0.026, P = 0.005) were independent prognostic factors both in two cohorts. Nomograms of these two cohorts based on the number of positive serum tumor markers (NPTM) were more accurate in prognostic prediction than TNM stage alone. Our findings suggested that elevated preoperative serum CA125, CA19-9 and CEA were associated with more advanced clinicopathological traits and less favorable outcomes. In addition, CA125 as an independent prognostic factor should be further investigated. Nomogram based on NPTM could accurately predict the prognosis of GC patients. PMID:27097114

  5. Diagnostic value of thrombocytosis and high CA 125 level in women with adnexal masses.

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    Atacag, T

    2012-01-01

    The aim of this study was to determine the diagnostic value of thrombocytosis and high CA 125 levels in women with benign and malign adnexal masses. Thrombocytosis (platelet counts > 400 x 10(9)/l) has been identified as a poor prognostic factor in many cancers including certain gynecologic malignant tumors such as endometrial, cervical, and ovarian cancers. Medical charts of 180 patients with adnexal masses were retrospectively reviewed and analyzed for the association of preoperative thrombocytosis and high CA 125 level with other clinical prognostic factors. Of the 180 participants, 68 (68% of malignant adnexal masses) had thrombocytosis and 74 patients (74% of malignant adnexal masses) had elevated CA 125 levels. The patients with preoperative thrombocytosis were found to have greater elevations of CA 125 levels, more advanced stage disease, and higher grade tumors. Presence of thrombocytosis and high CA 125 alone and in combination may be used as a prognostic factor in the management of women with adnexal masses since they are already used as clinical tests for several purposes.

  6. The prognostic value of pretreatment CA-125 levels and CA-125 normalization in ovarian clear cell carcinoma: a two-academic-institute study

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    Bai, Huimin; Sha, Guisha; Xiao, Meizhu; Gao, Huiqiao; Cao, Dongyan; Yang, Jiaxin; Chen, Jie; Wang, Yue; Zhang, Zhenyu; Shen, Keng

    2016-01-01

    Objectives The present study investigated the clinical implications of pretreatment carbohydrate antigen 125 (CA-125) levels and CA-125 normalization in patients with ovarian clear cell carcinoma (CCC), and it provides useful information for the improvement of monitoring strategies for this lethal disease. Methods The medical records of patients with ovarian CCC who had undergone primary staging surgery or cytoreductive surgery followed by systemic chemotherapy were retrospectively reviewed. A range of clinico-pathological parameters were collected and examined. Results A total of 375 women were included in the analysis. FIGO stage (p < 0.001) was identified as the only significant prognostic factor for relapse. Residual tumor and advanced stage (p = 0.001 and p < 0.001, respectively) were identified as independent adverse factors for survival. The potential risk factors associated with elevated pretreatment CA-125 levels included advanced-stage disease, positive residual tumors and negative endometriosis (p < 0.001, p = 0.001 and p <0.001, respectively). Pretreatment CA-125 levels were not associated with relapse-free survival (RFS) or overall survival (OS) (p = 0.060 and p = 0.176, respectively). CA-125 normalization after chemotherapy exhibited a positive linear correlation with advanced stage (r = 0.97, p = 0.001) and residual tumor (r = 0.81, p = 0.027) and a negative relationship with 5-year RFS (r = −0.97, p = 0.002) and 5-year OS (r = −0.97, p= 0.001). Patients with CA-125 levels that normalized before cycle 2 of chemotherapy had a similar prognosis as patients whose CA-125 levels normalized prior to chemotherapy (RFS: p = 0.327; OS: p = 0.654). By contrast, patients with CA-125 levels that normalized after cycle 2 of chemotherapy or never normalized were significantly more likely to experience disease progression. Conclusions Pretreatment CA-125 levels are not very useful for predicting clinical outcome. CA-125 levels following treatment are a valid

  7. Different Levels of CEA, CA153 and CA125 in Milk and Benign and Malignant Nipple Discharge.

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    Song Zhao

    Full Text Available The aim of this study was to assess the diagnostic values of three breast tumor markers (i.e., CEA, CA153 and CA125 in milk and nipple discharge in the prediction of different breast diseases diagnoses.Three hundred thirty-six patients (96 breast cancer and 240 benign disease patients with nipple discharge and a control group of 56 healthy parturient participants were enrolled in the present study. Nipple discharge samples were preoperatively collected from the patients, and milk was collected from the colostrum of the parturient participants. The samples were assayed for the CEA, CA153 and CA125 levels. Cutoff values were determined for the detection of breast diseases using ROC curves.The levels of CEA, CA153 and CA125 were significantly different between the nipple discharge and the milk (all ps < 0.001. In the nipple discharge, the CEA and CA153 levels in the breast cancer group were significantly greater than those in the benign group (all ps < 0.001, and cutoff values of 263.3 ng/mL and 1235.3 U/mL, respectively, were established. However, the expression of CA125 did not differ significantly between the breast cancer and benign groups.Differences in the apparent expression levels of CEA, CA153 and CA125 in patients with nipple discharge and healthy persons were validated. The present data suggest that CEA and CA153 might potentially be useful in the differential diagnoses of benign tumors and breast cancer. CA125 did not seem to be useful for breast cancer detection.

  8. CA125 in ovarian cancer

    DEFF Research Database (Denmark)

    Duffy, M J; Bonfrer, J M; Kulpa, J

    2005-01-01

    value in the detection of early ovarian cancer. At present, therefore, CA125, either alone or in combination with other modalities, cannot be recommended for screening for ovarian cancer in asymptomatic women outside the context of a randomized controlled trial. Preoperative levels in postmenopausal...... women, however, may aid the differentiation of benign and malignant pelvic masses. Serial levels during chemotherapy for ovarian cancer are useful for assessing response to treatment. Although serial monitoring following initial chemotherapy can lead to the early detection of recurrent disease......CA125 is currently the most widely used tumor marker for ovarian epithelial cancer. The aim of this article is to provide guidelines for the routine clinical use of CA125 in patients with ovarian cancer. Due to lack of sensitivity for stage I disease and lack of specificity, CA125 is of little...

  9. IgE myeloma with elevated level of serum CA125

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    Man-ling WANG; Qiang HUANG; Tian-xin YANG

    2009-01-01

    Objective: To explore clinical and laboratory features and significance of detecting serum carbohydrate antigen 125 (CA125) in immunoglobulin E (IgE) multiple myeloma. Methods: We reported the clinical findings of a male patient with IgE myeloma and elevated level of serum CA125 and reviewed the literature. Results: Laboratory tests of this patient on admission showed extremely high serum IgE and CA125, a bone marrow aspirate revealed abnormal plasma cells (38.4% of nucleated cells: 16.4% mature and 22% atypical), and in bone marrow biopsy, immunoperoxidase staining showed positive cytoplasmic staining for IgE and κ light chain within the vast majority of plasma cells. Computed tomography (CT) bone scans indicated wedge shape change and compressive fracture of thoracic vertebrae, and emission computed tomography (ECT) discovered multiple punctiform aggregation of radiation in both cervical ribs and spine. The serum IgE and CA125 gradually decreased to normal limits after eight cycles of chemotherapy. This patient is alive well with an 18-month complete remission. Conclusion: We reported the first case of IgE myeloma with elevated level of serum CA125. To further evaluate clinical characteristics and significance of CA125 in IgE myeloma, more cases are needed.

  10. The relationship between serum levels of CA 125 and the degree of differentiation in ovarian neoplasms

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    Eduardo Cambruzzi

    2014-02-01

    Full Text Available Introduction: Primary ovarian neoplasms exhibit a wide range of histopathological aspects, and tumors with epithelial differentiation are the most frequent. Among the malignant tumors, the most common histological type corresponds to serous adenocarcinoma, whose diagnosis is established in advanced stages of the disease in approximately 75% of the patients. Tumor marker CA 125 represents a glycoprotein synthesized mainly by neoplastic cells with epithelial differentiation, and its serum level seems to be associated with the biological potential of these lesions. Objective: To estimate the association between serum levels of CA 125 and the degree of differentiation in primary ovarian neoplasms. Method: Sixty distinct cases of primary ovarian tumors were selected, previously analyzed at the Laboratory of Pathology of the Hospital Complex of Universidade Luterana do Brasil (Ulbra, between 2005 and 2010, from patients undergoing concomitant analysis of CA 125. In each case, age, tumor size, histological type, degree of differentiation, presence of necrosis and tumor invasion of the albuginea or extraovarian tissues, pathological stage and serum CA 125 were determined. Results: A statistically significant relationship between CA 125 levels and histological grade (p = 0.001, age (p = 0.009, biological behavior of the tumor (malignant or benign - p = 0.002 and extraovarian invasion (p = 0.005 was found. No relationship between CA 125 levels and tumor size (p = 0.1006 and pathologic stage (p = 0.1 was determined. Histologic grade was associated with the presence of necrosis (p = 0.001, extraovarian invasion (p = 0.009 and tumor size (p = 0.008. Conclusion: In the present study, serum levels of CA 125 were associated with histological grade in primary ovarian neoplasms, especially in high-grade malignant tumors, suggesting that high levels of this glycoprotein are associated with lesions of more aggressive biological behavior.

  11. Is tissue CA125 expression in epithelial ovarian adenocarcinoma heterogenic?

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    Sparholt, Morten H; Høgdall, Claus K; Nedergaard, Lotte

    2013-01-01

    To evaluate if heterogeneity of tissue cancer antigen 125 (CA125) expression is present in epithelial serous adenocarcinomas. Furthermore, to investigate whether there is a correlation between levels of CA125 tissue expression, serum level of CA125, stage, and grade. A total of 10 patients...... diagnosed with serous ovarian adenocarcinomas were included. Preoperative blood samples were collected to determine serum CA125 levels. Tumor tissue from primary surgery was collected and processed for immunohistochemical analyses. CA125 was expressed in varying degrees in tumor tissues from all patients....... Mean tissue CA125 expression for each patient ranged from 36% to 98%. Intrapatient variations in tissue expression ranged from 10% to 90% point. No significant correlations between levels of CA125 tissue expression, serum level of CA125, stage, and grade were found. We found that the tissue expression...

  12. Ovarian fibroma with marked ascites and elevated serum levels of CA-125 in a young girl.

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    Sugiyama, Akihide; Urushihara, Naoto; Fukumoto, Koji; Fukuzawa, Hiroaki; Nagae, Hideki; Watanabe, Kentaro; Mitsunaga, Maki; Hasegawa, Shiro; Koyama, Masashi

    2011-05-01

    We report a case of ovarian fibroma with marked ascites and elevated serum CA-125 levels in a young girl. Ovarian fibromas are rare in children. They usually present as a solid mass and may be associated with ascites and elevated serum CA-125 levels. Because of their solid nature and these associations, they can be mistaken for a malignant tumor, resulting in unnecessary oophorectomy. Ovarian fibromas are benign neoplasms, and the prognosis is extremely good. Surgical management should be an ovarian-sparing tumor excision. Although uncommon in pediatric patients, ovarian fibromas should be included in the differential diagnosis of ovarian mass in children.

  13. The Effect of Atorvastatin Therapy in CAPD Patients on Inflammatory Markers (CRP and dialysate IL-6 and CA-125 Level

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    Özlem TİRYAKİ

    2011-09-01

    Full Text Available OBJECTIVE: Dialysate concentrations of CA-125 reflect the mesothelial cell mass. In patients with peritoneal dialysis ultrafiltration failure, low concentrations of CA-125 have been demonstrated. Statins have anti-inflammatory properties which may be of value in modulating responses to injury. In this study, the lipid-lowering effect of atorvastatin and its effects on the CA-125 levels were evaluated. MATERIALS and METHODS: The 100 patients included in the study were followed with CRF in the CAPD program. The patients were divided into two groups as those who used atorvastatin (group 1, n=60 and the control group (group 2, n=40. All patients were evaluated before treatment and 6 months later for serum total cholesterol, LDL, HDL, TG, CRP, and peritoneal effluent was analyzed for interleukin-6, and CA-125 levels. RESULTS: In group 1 patients, serum CRP and dialysate IL-6 values decreased and the dialysate CA- 125 level increased (p<0.001, whereas there was no change in the group 2 control patients. CONCLUSION: Atorvastatin use in patients with markers of inflammation caused decreased levels of CRP and IL-6, and the anti-inflammatory effects of statins may have played a role. The increased CA-125 levels in patients in group 1 may also be related to the anti-inflammatory effects in addition to the antihyperlipidemic effects.

  14. Correlation of Serum CA-125 and Progesterone Levels with Ultrasound Markers in The Prediction of Pregnancy Outcome in Threatened Miscarriage

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    Al Mohamady, Maged; Fattah, Ghada Abdel; Elkattan, Eman; Bayoumy, Rasha; Hamed, Dalia Ahmed

    2016-01-01

    Background The aim of this study was to evaluate the relationship between ultrasonographic findings and serum progesterone and cancer antigen-125 (CA-125) levels in threatened miscarriage and to predict pregnancy outcome. Materials and Methods In a prospective comparative case-control study, serum CA-125 and progesterone levels were measured for 100 pregnant women with threatened miscarriage who attended the outpatient clinic or the causality department of Obstetrics and Gynecology at Kasr El-Aini Hospital, Giza, Egypt, during the period from March 2013 to October 2013. Ultrasound was performed for fetal viability, crown-rump length (CRL), gestational sac diameter (GSD) and fetal heart rate (FHR). The patients were followed up and divided into two groups based on the outcome: 20 women who miscarried (group 1), and 80 women who continued pregnancy (group 2). The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and overall accuracy were tested for CA-125 and progesterone levels in prediction of the pregnancy outcome. Correlation of these chemical markers with the ultrasound markers was also examined. Results In the group that miscarried, CA-125 level was significantly higher (P<0.001) and serum progesterone level was significantly lower (P<0.001). For prediction of the outcome of pregnancy, the cut-off limit of 31.2 IU/ml for CA-125 level yielded sensitivity, specificity and an overall accuracy of 96.2, 100 and 99.4% respectively. The cut-off limit of 11.5 ng/ml for progesterone level yielded sensitivity, specificity and an overall accuracy of 97.5, 100 and 99.8% respectively. CA-125 level had a negative correlation with progesterone level and FHR levels (r=-0.716, P<0.001) and (r=-0.414, P<0.001) respectively. Serum progesterone level correlated with GSD (r=0.521, P<0.001) and with CRL (r=0.407, P<0.001) and FHR (r=0.363, P<0.001). CA-125 level was significantly higher in the group that showed hematoma as compared with the

  15. The prognostic value of pre-operative serum tetranectin, CA-125 and a combined index in women with primary ovarian cancer

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    Høgdall, Claus K; Nørgaard-Pedersen, Bent; Mogensen, Ole

    2002-01-01

    no significant value was found for CA125 by univariate statistics. In the Cox analyses, FIGO stage was the strongest and TN the second most prognostic variable, followed by age. CA125, Index1 and tumor types were of no prognostic value. The strongest prognostic value for TN was found at the cut-off level 8.2 mg...... cancer. Evaluation was by univariate life-tables analyses and the multivariate Cox analysis. In the Cox analyses, the variables were tested respectively in actual values and as dichotomy variables with different cut-off levels: 6.7, 7.3 and 8.2 mg/l for TN, 35, 65, 100 and 165 U/ml for CA125. RESULTS......: In stages I+II only CA125 was found to be significantly prognostic, whereas TN was of no prognostic value by univariate statistics. For stages III+IV patients significantly better survivals were found for patients with TN levels above the respective cut-offs compared to patients with low TN levels, whereas...

  16. Preoperative CA125 and fibrinogen in patients with endometrial cancer: a risk model for predicting lymphovascular space invasion

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    2017-01-01

    Objective The aim of this study was to build a model to predict the risk of lymphovascular space invasion (LVSI) in women with endometrial cancer (EC). Methods From December 2010 to June 2013, 211 patients with EC undergoing surgery at Shanghai First Maternity and Infant Hospital were enrolled in this retrospective study. Those patients were divided into a positive LVSI group and a negative LVSI group. The clinical and pathological characteristics were compared between the two groups; logistic regression was used to explore risk factors associated with LVSI occurrence. The threshold values of significant factors were calculated to build a risk model and predict LVSI. Results There were 190 patients who were negative for LVSI and 21 patients were positive for LVSI out of 211 patients with EC. It was found that tumor grade, depth of myometrial invasion, number of pelvic lymph nodes, and International Federation of Gynecology and Obstetrics (FIGO) stage (p0.05) were not associated with LVSI. Receiver operating characteristic (ROC) curves revealed that the threshold values of the following factors were correlated with positive LVSI: 28.1 U/mL of CA19-9, 21.2 U/mL of CA125, 2.58 mg/dL of fibrinogen (Fn), 1.84 U/mL of carcinoembryonic antigen (CEA) and (6.35×109)/L of white blood cell (WBC). Logistic regression analysis indicated that CA125 ≥21.2 (p=0.032) and Fn ≥2.58 mg/dL (p=0.014) were significantly associated with LVSI. Conclusion Positive LVSI could be predicted by CA125 ≥21.2 U/mL and Fn ≥2.58 mg/dL in women with EC. It could help gynecologists better adapt surgical staging and adjuvant therapies. PMID:27894164

  17. Rational application of tumor marker CA 125 in gynecological oncology

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    Đurđević Srđan

    2010-01-01

    Full Text Available Introduction CA 125 determination started in 1981, when Bast et al. discovered monoclonal antibody OC-125 belonging to immunoglobulin G class (IgG1 using Köhler and Milstein's technique of hybridization. CA 125 antigen is produced in amniotic cells of the 7 week-old embryo, while in adults it can be detected in epithelium of most organs which originate from Müller ducts. The upper level of referent values for CA 125 in serum is 35 U/mL and can be seen in about 99% of healthy people. Application of tumor marker CA 125 in gynecological oncology More than 83% of patients with epithelial ovarian carcinoma have elevated values of CA 125 higher than 35 U/mL at the moment of diagnosing the disease. In cases of ovarian carcinoma, preoperatively determined values of CA 125 in serum are correlated with the extent of the expansion of the disease , histological type of tumor and degree of differentiation of malignant cells. Elevated values up to 65 U/mL in serum can also be found in other malignant tumors (pancreas, breast, colon, bladder, lungs, liver and in different benign diseases. The level of serum CA 125 after the surgery can indicate regression or progression of ovarian carcinoma in more than 90% of the patients who had had elevated values of CA125 prior to the surgery. Postoperative levels of CA 125 >35 U/mL in patients with no residual tumor and values >65 U/mL in those with residual tumor implants represent a separate prognostic factor in further course of the disease. Conclusion The importance of continuous determination of CA 125 tumor marker has to be adjusted to each single case.

  18. 血清CA125联合子宫内膜芳香化酶检测诊断子宫内膜异位症%Diagnostic value of serum CA125 level and endometrial aromatase detection to endometriosis

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    邹华兰; 洛若愚; 熊霞鹂

    2011-01-01

    目的:探讨血清CA125、子宫内膜芳香化酶检测诊断子宫内膜异住症(endometriosis,EMs)的价值,方法:经腹腔镜或开腹手术确诊的EMs患者40例(EMs组),因盆腔炎行腹腔镜手术且排除EMs的患者20例(对照组),术前均抽血检测血清CA125水平,术中取其子宫内膜,采用免疫组织化学法检测芳香化酶的表达情况,并进行比较.结果:EMs组血清CA125水平高于对照组(P0.05).以血清CAl25≥35 μ/mL为临界值,诊断EMs的敏感性为55.0%,特异性为80.O%;免疫组织化学检测子宫内膜芳香化酶诊断EMs的敏感性为92.5%.特异性为90.0%;2种方法联合检测诊断EMs的敏感性95.0%,特异性70.5%.结论:血清CA125联合子宫内膜芳香化酶检测可提高EMs的早期诊断率和诊断准确性.%Objective To explore the value of serum CA125 level and endometrial aromatase detection to the diagnosis of endometriosis. Methods Forty patients with endometriosis diagnosed by laparoscopy or laparotomy (endometriosis group) and 20 patients receiving laparoscopy due to pelvic inflammatory disease(control group) were detected the serum CA125 level before operation. The expression of aromatase protein was detected with immunohistochemistry. The results were compared between two groups. Results Serum CA125 level was higher in endometriosis group than that in control group(P<0.05), and was higher in Ⅲ to Ⅳ stage of endometriosis than that in Ⅰ to Ⅱ stage (P<0.05). Aromatase expression of eutopic endometrium was higher in endometriosis group than that in control group(P<0.05), and showed no significant difference between Ⅲ to Ⅳ stage and Ⅰ to Ⅱ stages(P>0.05). As the cut-off of serum CA125≥35 u/mL, the sensitivity for endometriosis was 55.0% and the specificity was 80.0%. The diagnostic sensitivity of endometrial aromatase expression detected with immunohistochemistry was 92.5 % and the specificity was 90.0 %. The sensitivity of the combined methods for

  19. Predictive and prognostic values of cancer-associated serum antigen (CASA) and cancer antigen 125 (CA 125) levels prior to second-look laparotomy for ovarian cancer.

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    Kierkegaard, O; Mogensen, O; Mogensen, B; Jakobsen, A

    1995-11-01

    CA 125 and cancer-associated serum antigen (CASA) were measured prior to second-look laparotomy (SLL) to investigate their predictive and prognostic values in 93 patients treated for epithelial ovarian cancer FIGO stage II, III, or IV. Residual tumor was diagnosed at the SLL in 58 patients (62%). The optimal cutoff level was 15 U/ml for CA 125 and 8 U/ml for CASA. Using these levels, the sensitivity for detection of residual tumor was 40% for CA 125 and 22% for CASA. The combined use of the markers resulted in a sensitivity of 47% (diagnostic gain 6.9%; 95% confidence interval (CI), 0.14-13.44%). Microscopic tumor volumes were equally diagnosed by CASA and CA 125. The independent prognostic value of CA 125 (RR = 2.6; 95% CI, 2.0-3.2) and CASA (RR = 2.2; CI, 1.5-2.9) was established by means of Cox regression analysis of the covariation between survival, age, FIGO stage, histopathology, tumor grade, and bulk of residual tumor at the primary operation and CA 125 and CASA before the SLL. In conclusion, we found that CASA could supplement CA 125 measurement prior to SLL and reduce the number of SLLs. Furthermore, CASA had an independent prognostic value for survival which may be used together with other information in the planning of further treatment of the individual patient.

  20. Meigs' syndrome with elevated CA 125: case report

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    Sabas Carlos Vieira

    Full Text Available CONTEXT: Meigs' syndrome consists of a benign ovarian tumor accompanied by ascites and hydrothorax. Elevated serum CA 125 levels in postmenopausal women with solid adnexal masses, ascites and pleural effusion are highly suggestive for malignant ovarian tumor. However, patients with Meigs' syndrome can also have elevated serum CA 125 levels. The authors report a case of Meigs' syndrome with elevated CA 125 level. OBJECTIVE: This is a case report of Meigs' syndrome with elevated CA 125 level. CASE REPORT: A 65-year-old Brazilian woman had presented progressive dyspnea, weight loss and decline in general condition over the 7 months preceding admission to our service. In another hospital, the patient had been submitted to thoracic drainage due to pleural effusion. With recurrence of the pleural effusion and increase in abdominal volume due to ascites and a pelvic mass, the patient sought our service. Transvaginal ultrasound showed an extensive adnexal solid mass of 16.4 x 10.8 cm located in the pelvis without exact limits, and the serum CA 125 level was elevated. With a preoperative diagnosis of ovarian carcinoma, the patient was submitted to exploratory laparotomy, which revealed a left ovarian tumor. The frozen section diagnosis was thecoma. Total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed. The histology of the specimen confirmed the diagnosis of thecoma. The patient was asymptomatic with a normal serum CA 125 level 20 months after the operation.

  1. Prognostic impact of prechemotherapy serum levels of HER2, CA125, and HE4 in ovarian cancer patients

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    Steffensen, Karina Dahl; Waldstrøm, Marianne; Brandslund, Ivan;

    2011-01-01

    Human epididymis protein 4 (HE4) has attracted a lot of interest as a relatively novel biomarker for ovarian carcinoma. Research focus has been directed at HE4 as a diagnostic tool with potential for better triage of women with adnexal masses but the prognostic aspect of HE4 in ovarian cancer...... patients remains to be elucidated. The aim of the present study was to investigate the prognostic value of prechemotherapy serum HER2, cancer antigen 125 (CA125), and HE4 levels in ovarian cancer patients receiving standard combination chemotherapy....

  2. Pedunculated uterine leiomyoma associated with pseudo-Meigs' syndrome and elevated CA-125 level: CT features

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    Kebapci, Mahmut; Aslan, Ozgur; Kaya, Tamer [Department of Radiology, Osmangazi University School of Medicine, Meselik, 26480 Eskisehir (Turkey); Yalcin, Omer T.; Ozalp, Sinan [Department of Obstetrics and Gynecology, Osmangazi University School of Medicine, Meselik, 26480 Eskisehir (Turkey)

    2002-07-01

    A 38-year-old woman presented with a 1-week history of low back pain, distension, weakness, and loss of appetite. Laboratory studies showed a serum CA-125 level of 281 U/ml (normal value 1.2-32 U/ml). Abdominopelvic sonography revealed massive ascites, left pleural effusion, and a heterogeneous, hypoechogenic, and smoothly outlined solid mass. The mass had a close proximity and to the anterior side of the right ovary. Doppler sonography showed that the mass was hypervascularized. Computed tomography demonstrated numerous, tortuous vascular structures around the mass and along the omentum indicating its auxiliary vascularization from the omentum. Exploratory laparotomy and histopathological examination revealed pedunculated leiomyoma with parasitized blood supply from the omentum. Ascites and pleural effusion disappeared 6 months after surgery. We present the clinical and CT features of a parasitic leiomyoma adhering to the omentum. (orig.)

  3. Treatment of Ruptured Ovarian Endometrioma with Extremely High CA 125, Moderately High CA 19-9 and CA 15-3 Level

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    Muzeyyen Duran

    2013-06-01

    Full Text Available In this case report, a ruptured ovarian endometrioma with a very high CA-125 level, moderately elevated CA 19-9, and CA 15-3 levels is presented. A 20 years old patient, complaining from pelvic pain, 5 cm adnexial mass was detected on left side. Biochemical examination was revealed very high CA-125 value (2556IU/ml, moderately elevated CA 19-9 (134IU/ml, and CA 15-3 (65IU/ml values. Laparoscopy was done and a ruptured ovarian endometrioma of 5 cm was seen during operation. After the total excision of the cyst, tumor markers fell rapidly. Very high CA-125 value, moderately elevated CA19-9, and CA 15-3 values can be seen in cases with ruptured endometrioma. In young patients, endometrioma must be considered firstly and laparoscopy should be applied instead of more invasive methods unless there was any finding or strong suspicion about malignancy.

  4. Biomarker CA125

    DEFF Research Database (Denmark)

    Kargo, Anette Stolberg

    be detected months before symptoms arise and recurrence is visible on imaging. Therefore, biochemical detection of potential relapse by CA125 assessment can cause significant distress. A decision aid (DA) is a tool that provides information and describes advantages and disadvantages of a specific intervention...

  5. Serum tetranectin and CA125 in endometrial adenocarcinoma

    DEFF Research Database (Denmark)

    Lundstrøm, M S; Høgdall, C K; Nielsen, Anette Lynge;

    2000-01-01

    in relation to tumor grade, stage and cancer survival. RESULTS: The CA125 levels correlated significantly with tumor stage. Dichotomized according to a cut-off level of 35 U/ml, CA125 significantly correlated with cancer death. Multivariate regression analysis of cancer survival time showed that CA125 > 35 U/ml...

  6. The Significance of Serum and Dialysate CRP and CA125 Levels in the Frequency Peritoneal Dialysis-related Peritonitis Patients%频发腹膜透析相关性腹膜炎患者血清及透出液C反应蛋白和CA125检测的意义

    Institute of Scientific and Technical Information of China (English)

    曲廖准; 李拱榆; 唐小玲

    2011-01-01

    Objective: To identify the clinical significance of the changes of serum and dialysate C-reactive protein (CRP) and CA125 levels in the frequency peritoneal dialysis-related peritonitis. Method:Serum and dialysate CRP and CA125 levels of peritoneal dialysis-related peritonitis patients were detected in emission immunization and using the automatic biochemistry meter before or after anti-infection treatment.15 patients with two or more onsets in one year were induced into group A, the frequency peritoneal dialysis -related peritonitis group, and the other 44 patients were induced into group B, the pure peritonitis group,served as the control group. The clinical and laboratory data of the two groups were compared and analyzed.Result: Compared with those in the control group, after anti-infection treatment the patients in group A had significantly higher serum and dialysate CRP levels ( P<0. 05 ) than that in group B , but the similarly reduced dialysate CA125 levels. During the infection, dialysate CA125 levels in two groups were both increased, but non-statistics significance ( P>0.05 ). And at the the first time of anti-infection treatment, dialysate CA125 levels in group A were the same as group B( P>0. 05 ), but at the the last time were lower than that in group B( P<0. 05 ). Conclusion: Detecting the change of serum and dialysate CRP and CA125 levels in the frequency peritoneal dialysis-related peritonitis patients is instructive to estimate the prognosis of peritonitis and the function of peritoneum.%目的:探讨频发腹膜透析相关性腹膜炎患者血清及透出液C反应蛋白(CRP)和癌抗原125(CA125)浓度变化的临床意义.方法:采用放射免疫法及自动生化仪检测腹膜透析相关性腹膜炎患者抗感染治疗前后血清及透出液CRP和CA125浓度.1年内发生2次及以上腹膜炎的患者归入频发腹膜炎组(A组)共15例,其余44例归入单纯腹膜炎组(B组),对照分析两组间数据.结果:治疗后血

  7. Clinical significance of the expression of serum level of CA125 and survivin protein in endometrial carcinoma%血清CA125水平及Survivin蛋白在子宫内膜癌中的表达及临床意义

    Institute of Scientific and Technical Information of China (English)

    徐行丽; 井甜甜; 贾庆兰

    2010-01-01

    目的 研究血清CA125水平及Survivin蛋白在子宫内膜癌中的表达及临床意义.方法 正常子宫内膜组(40例)、子宫内膜不典型增生组(40例)及子宫内膜癌组(40例).比较各组手术前后及子宫内膜癌组不同临床、病理分期中血清CA125水平变化及Survivin蛋白的表达情况.结果 子宫内膜癌组血清CA125水平在手术前后均明显高于其余两组,差异均有统计学意义(P<0.05).子宫内膜不典型增生组及子宫内膜癌组的Survivin阳性表达率及强阳性表达率与正常子宫内膜组,差异有统计学意义(P<0.05).血清CA125在子宫内膜癌Ⅱ-Ⅳ期、病理级别高、深肌层浸润及复发组中的阳性表达率明显升高.Survivin蛋白的强阳性表达率在Ⅱ-Ⅳ期、G3、深肌层浸润及复发病例中明显升高.结论 血清CA125水平对子宫内膜癌的手术病理分期有一定的指导意义.Survivin蛋白对子宫内膜癌的早期诊断及临床预后有一定的参考价值.%Objective To study clinical significance of the expression of serum level of CA125 and survivin protein in endometrial carcinoma. Methods The normal endometrium group(40 cases) ,atypical endometrial hyperplasia group (40 cases)and endometrial cancer group (40 cases). Compared the changes of serum level of CA125 and the expression of survivin protein between before and after surgery in each group and in different clinical and pathological stagings in the group of endometrial carcinoma. Results The serum level of CA125in endometrial cancer group before and after surgery are significantly higher than other two groups, the differences are statistically significant(P < 0.05 ). Compare survivin positive expression rate and strong positive expression rate in atypical endometrial hyperplasia group and endometrial cancer group with the normal endometrium group, the differences are statistically significant( P < 0.05 ). The rate of positive expression of serum level of CA125 in

  8. Is CA-125 an additional help to radiologic findings for differentiation borderline ovarian tumor from stage I carcinoma?

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Joo; Kim, See Hyung; Kim, Young Hwan; Lee, Hee Jung (Dept. of Radiology, Keimyung Univ. Dongsan Hospital, College of Medicine, Daegu (Korea, Republic of)), email: kseehdr@dsmc.or.kr

    2011-05-15

    Background Borderline ovarian tumors (BOTs) are difficult to differentiate from stage I carcinoma using radiological findings. Little is known about the correlation between CA-125 levels and radiological findings for predicting BOTs or carcinoma. Purpose To assess the role of CA-125, in addition to that of radiological findings, in differentiating BOTs from stage I carcinoma. Material and Methods The study received institutional review board approval, with waiver of informed consent. We evaluated 100 patients (two groups: BOT, 58 patients; stage I carcinoma, 42 patients) using radiological findings, including location and size of each tumor, number and size of septations, papillary projections and vegetations, peritoneal implants, ascites, and preoperative CA-125 levels. The differences in CA-125 levels according to bilateral location, solid components, and thickness of septations between the two groups were evaluated using the McNemar test. Correlations of CA-125 level to size and number of septations were evaluated by the independent sample t test. Results No statistical correlation was found between CA-125 level and location, size, and number of septations between the two groups. Solid components within the tumors were similar in the two groups, but the CA-125 level was significantly higher in stage I carcinoma than in BOTs. The number of septations per tumor was similar in the two groups; thick septations were more frequent in stage I carcinoma than in BOTs, and a significantly higher titer of CA-125 was found in stage I carcinoma. Discriminant analysis of solid components and thickness of septations resulted in accurate diagnosis of 70.6% of the tumors (80.6% of BOTs and 69.7% of stage I carcinomas). Conclusion CA-125 levels for solid components and thickness of septations are lower in BOTs. These may be helpful in predicting the risk of carcinoma, even if BOTs cannot be conclusively differentiated from stage I carcinoma

  9. Predictors of pretreatment CA125 at ovarian cancer diagnosis

    DEFF Research Database (Denmark)

    Babic, Ana; Cramer, Daniel W; Kelemen, Linda E

    2017-01-01

    PURPOSE: Cancer antigen 125 (CA125) is a glycoprotein expressed by epithelial cells of several normal tissue types and overexpressed by several epithelial cancers. Serum CA125 levels are mostly used as an aid in the diagnosis of ovarian cancer patients, to monitor response to treatment and detect...

  10. Association of the neutrophil-to-lymphocyte ratio and CA 125 with the endometriosis score.

    Science.gov (United States)

    Kim, Seul Ki; Park, Jung Yeon; Jee, Byung Chul; Suh, Chang Suk; Kim, Seok Hyun

    2014-12-01

    To evaluate the association between the severity of endometriosis and the preoperative neutrophil-to-lymphocyte ratio (NLR) and serum level of cancer antigen 125 (CA 125). Data were obtained from the medical records of 419 patients who underwent laparoscopic conservative surgery for ovarian endometrioma between April 2005 and March 2013. Each patient's preoperative complete blood count was recorded and the endometriosis score was assessed. The endometriosis score was not associated with either the NLR or the serum level of CA 125. The endometriosis score was negatively related to preoperative hemoglobin, hematocrit, mean corpuscular volume, mean corpuscular hemoglobin, and mean corpuscular hemoglobin concentration. The only positive association was between NLR and the patients' age. NLR and preoperative serum anti-Müllerian hormone level were found to be negatively related. The severity of endometriosis was not associated with the serum level of CA 125 or the NLR. The presence of a negative correlation between the severity of endometriosis and red blood cell dynamics needs further investigation.

  11. Development of a nonsurgical diagnostic tool for endometriosis based on the detection of endometrial leukocyte subsets and serum CA-125 levels.

    Science.gov (United States)

    Gagné, Danièle; Rivard, Michèle; Pagé, Martin; Lépine, Manon; Platon, Christèle; Shazand, Kamran; Hugo, Patrice; Gosselin, Diane

    2003-10-01

    To determine whether the proportion of several leukocyte subsets is modulated in the endometrium of patients with endometriosis and, if yes, whether it can be used for diagnostic purposes. Case-control study. Eight clinical institutions of the Montreal area. Women who underwent laparoscopy or laparotomy between 1997 and 2001, who had regular menstrual cycles and were not under hormone treatment for the previous 3 months were selected. This study included 368 women, 173 with surgically confirmed endometriosis and 195 controls with no surgical evidence of endometriosis. Cytometry analysis was used to measure the proportion of several leukocyte subsets among CD45(+) endometrial cells. The proportion of CD3(+), CD16(+), CD3(-)HLADR(-), CD3(-)CD45RA(-), CD3(+)CD16(-), CD3(+)CD56(-), CD56(-)CD16(+), and CD16b(+) leukocytes was significantly altered in the endometrium of cases compared with controls. A multiple logistic regression model was adjusted with these endometrial leukocytes, serum CA-125 levels, risk factors, and confounders. The diagnostic performance of this predictive model was defined by a specificity of 95% and a sensitivity of 61%. Furthermore, the positive and negative predictive values were 91% and 75%, respectively. This predictive model represents a novel diagnostic tool to identify women with a high likelihood of suffering from endometriosis.

  12. Clinical significance of lueasurement of changes of serum CA153、CA125、Hcy and IL-8 levels after operation in patients with Breast cancer%乳腺癌患者手术治疗前后血清CA153、CA125、Hcy和IL-8水平检测的临床意义

    Institute of Scientific and Technical Information of China (English)

    王永东; 丁贤

    2014-01-01

    目的:探讨了乳腺癌患者手术治疗前后血清C A153、C A125、H c y和I L-8水平的变化及临床意义。方法:应用放射免疫分析法和免疫化学法对38例乳腺癌患者进行了手术治疗前后血清C A153、C A125、H c y和I L-8水平检测,并与35个正常健康人做比较。结果:乳腺癌患者在手术治疗前血清C A153、C A125、H c y和I L-8水平均非常显著地高于正常人组(P<0.05),手术治疗3个月后则与正常人比较无显著性差异(P>0.05),血清C A153水平与C A125、IL-8水平呈显著正相关(r=0.6028、0.5722、0.4986,P<0.01)结论:检测乳腺癌患者手术治疗前后血清CA153、CA125、Hcy和IL-8水平的变化对观察病情和预后判定均具有重要的临床价值。%Objective: to explore the clinical significance of changes of serum CA153、CA125、Hcy and IL-8 levels after operation in patients with Breast cancer. Methods: serum CA153、CA125、IL-8 (with RIA) serum Hcy(with immune chemistry)levels were determined in 38 patients with Breast cancer and 35 controls . Result: Before operation serum CA153、CA125、Hcy and IL-8 levels were significantly higher than those in controls (P0.05). serum CA153 levels were positively correlated with serum CA125、Hcy、IL-8 levels(r=0.6028、0.5722、0.4986,P<0.01). Conclusions:Detection of serum CA153、CA125、Hcy and IL-8 levels after operation might be of prognostic importance in patients with Breast cancer.

  13. Preoperative serum tetranectin, CA125 and menopausal status used as single markers in screening and in a risk assessment index (RAI) in discriminating between benign and malignant ovarian tumors

    DEFF Research Database (Denmark)

    Begum, F D; Høgdall, E; Kjaer, S K;

    2009-01-01

    risk for OC for quick referral to highly specialized centers in gynecologic oncology. These aims were addressed in the present study by evaluating serum tetranectin (TN) and serum CA125 on a large number of pre- and postmenopausal women with ovarian tumors and controls. METHODS: The potential ability...... of the markers to discriminate between the four groups (208 benign ovarian tumor, 153 borderline ovarian tumor (BOT), 445 OC and 1333 age matched controls) in OC screening was examined. We also constructed a risk assessment index (RAI) for discrimination between tumor groups based on these variables...

  14. Meigs’ Syndrome with Elevated Serum CA125: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Mongkol Benjapibal

    2009-04-01

    Full Text Available An elevated serum CA125 level in association with a pelvic mass, pleural effusion, and massive ascites usually signifies a dismal prognosis in a postmenopausal woman. However, surgery and histopathological examination are required for the correct diagnosis and treatment, since an elevated CA125 level can be falsely positive for ovarian malignancy. We present a case of Meigs’ syndrome due to right ovarian fibroma with elevated CA125 level in a postmenopausal woman.

  15. The Serum CA-125 Concentration Data Assists in Evaluating CT Imaging Information When Used to Differentiate Borderline Ovarian Tumor from Malignant Epithelial Ovarian Tumors

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Ji Eun; Choi, Hyuck Jae; Kim, Mi Hyun; Cho, Kyoung Sik [University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2011-08-15

    We wanted to evaluate the diagnostic value of serum CA-125 concentration, when used in combination with the preoperative contrast-enhanced CT results, to differentiate borderline ovarian tumors (BOTs) from stage I malignant epithelial ovarian tumors (MEOTs). Ninety-eight masses (46 BOTs and 52 stage I MEOTs) from 87 consecutive patients (49 with BOTs and 38 with stage I MEOTs) who had undergone preoperative contrast-enhanced computed tomography (CT) and surgical staging were evaluated retrospectively and independently by two radiologists. The preoperative serum CA-125 concentration was measured in all patients. The utility of analyzing serum CA-125 concentration in combination with the CT results was evaluated by receiver operating characteristic (ROC) curve analysis. An irregular tumor surface and lymphadenopathy were predictive of a MEOT. ROC analysis showed that the combination of CT data and the serum CA-125 level resulted in a higher diagnostic performance than did using the CT alone for differentiating BOTs from MEOTs. The areas under the curves (AUCs) without and with the use of the serum CA-125 level data were 0.67 (95% confidence interval [CI]: 0.57-0.77) and 0.78 (95% CI: 0.68-0.85), respectively, for reader 1 (p = 0.029) and 0.71 (95% CI: 0.61-0.80) and 0.81 (95% CI: 0.72-0.89), respectively, for reader 2 (p = 0.009). The serum CA-125 concentration is of additional diagnostic value when used in conjunction with the CT imaging results for differentiating BOTs from MEOTs.

  16. Ovarian Fibroma with Meigs Syndrome associated with Elevated CA125 - A Rare Case

    Directory of Open Access Journals (Sweden)

    Prasad. K. Shetty

    2010-07-01

    Full Text Available Postmenopausal women with solid adnexal masses, ascites and pleural effusion with elevated CA 125 are highly suggestive for malignant ovarian tumor. However in literature 28 cases Meigs syndrome (Benign ovarian tumor, ascites and right pleural effusion with raised CA 125 have been reported. We report a case of Meigs syndrome caused by right ovarian fibroma with elevated serum CA125 level in a postmenopausal woman

  17. Clinical Significance of Determination of Changes of Serum P-selectin, CEA, CA125 and TSGF Levels After Operation in Patients with Ovarian Cancer%卵巢癌患者手术前后血清P-selectin、CEA、CA125和TSGF检测的临床意义

    Institute of Scientific and Technical Information of China (English)

    周东霞

    2007-01-01

    目的:探讨了卵巢癌患者手术前后血清可溶性P选择素(P-selectin)、CEA、CA125和TSGF水平的变化及临床意义.方法:分别应用放免法和酶免法、化学法对33例卵巢癌患者进行了血清P-selectin、CEA、CA125和TSGF检测,并与35名正常健康人作比较.结果:手术前卵巢癌患者血清P-selectin、CEA、CA125和TSGF水平均非常显著地高于正常人组(P<0.01),手术治疗后一年复发组又非常明显地高于未复发组(P<0.01).结论:测定卵巢癌患者血清中P-selectin、CEA、CA125和TSGF水平的变化与卵巢癌患者的病情和预后密切相关,均具有重要的临床价值.

  18. Serum LDH and CA-125: Markers for Diagnosis of Ovarian Malignancy.

    Science.gov (United States)

    Deeba, F; Khatun, S; Alam, M M; Shahida, S M

    2015-04-01

    This prospective multi-centre study was carried out in the Department of obstetrics and gynaecology of Bangabandhu Sheikh Mujib Medical University, Dhaka Medical College Hospital and Bangladesh Medical College Hospital, Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh, during the period of January 2008 to December 2009, to establish the raised level of serum LDH and serum CA-125 in pre-operative discrimination of benign and malignant ovarian cancer to be used as a diagnostic marker and its validity by determining sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPP). A total number of 141 consecutive suspected subjects of ovarian tumour admitted in the above mentioned hospitals and enrolled for surgical management were included in this study. Serum LDH was done in all these subjects and they were followed up from the admission upto the postoperative tissue diagnosis of live tumor in respective pathology departments for histopathological correlation. The patients who were diagnosed as malignant placed in Group I and diagnosed benign ovarian tumor placed in Group II. Serous cystadenoma and mucinous cyst adenoma were more common in benign tumors, which were 38.9% and 20.4% respectively. However, more than a half (57.1%) had serous cyst adenocarcinoma in malignant tumors. In LDH for evaluation of malignancy, true positive 16 and false positive 18, false negative 12 and true negative 95 cases. LDH and serum CA-125 level (combined, i.e. both positive) for evaluation of malignancy, true positive 14 and false positive 0, false negative 14 and true negative 113 cases. LDH/serum CA-125 level (anyone positive) for evaluation of malignancy, true positive 25 and false positive 37, false negative 3 and true negative 76 cases. The validity of LDH were sensitivity 57.1%, specificity 84.1%, accuracy 78.7%, positive predictive values 47.1% and negative predictive values 88.8% for malignancy of ovarian tumour. The

  19. CA-125 IN SERUM AND TUMOR FROM PATIENTS WITH UTERINE SARCOMA

    NARCIS (Netherlands)

    DUK, JM; BOUMA, J; BURGER, GTN; DEBRUIJN, HWA

    1994-01-01

    Serial serum samples of 33 patients with primary sarcoma of the uterus were analyzed for CA 125 and frozen tissue sections of tumor from 23 patients were tested for this antigen. Before treatment, 12 of 30 evaluable patients showed serum CA 125 levels >16 Uml-1 (40%). There was no relationship betwe

  20. Using serum CA125 to assess the activity of potential cytostatic agents in ovarian cancer.

    Science.gov (United States)

    Hall, Marcia R; Petruckevitch, Ann; Pascoe, Joanna; Persic, Mojca; Tahir, Saad; Morgan, Jamie S; Gourley, Charlie; Stuart, Nick; Crawford, S Michael; Kornbrot, Diana E; Qian, Wendi; Rustin, Gordon J

    2014-05-01

    New strategies are required to rapidly identify novel cytostatic agents before embarking on large randomized trials. This study investigates whether a change in rate of rise (slope) of serum CA125 from before to after starting a novel agent could be used to identify cytostatic agents. Tamoxifen was used to validate this hypothesis. Asymptomatic patients with relapsed ovarian cancer who had responded to chemotherapy were enrolled and had CA125 measurements taken every 4 weeks, then more frequently when rising. Once levels reached 4 times the upper limit of normal or nadir, they started continuous tamoxifen 20 mg daily, as well as fortnightly CA125 measurements until symptomatic progression. Because of the potentially nonlinear relationship of CA125 over time, it was felt that to enable normal approximations to be utilized a natural logarithmic standard transformation [ln(CA125)] was the most suitable to improve linearity above the common logarithmic transformation to base 10. From 235 recruited patients, 81 started tamoxifen and had at least 4 CA125 measurements taken before and 4 CA125 measurements taken after starting tamoxifen, respectively. The mean regression slopes from using at least 4 1n(CA125) measurements immediately before and after starting tamoxifen were 0·0149 and 0·0093 [ln(CA125)/d], respectively. This difference is statistically significant, P = 0·001. Therefore, in a future trial with a novel agent, at least as effective as tamoxifen, using this effect size, the number of evaluable patients needed, at significance level of 5% and power of 80%, is 56. Further validation of this methodology is required, but there is potential to use comparison of mean regression slopes of ln(CA125) as an interim analysis measure of efficacy for novel cytostatic agents in relapsed ovarian cancer.

  1. Methods for Identification of CA125 from Ovarian Cancer Ascites by High Resolution Mass Spectrometry

    Directory of Open Access Journals (Sweden)

    Florian Weiland

    2012-08-01

    Full Text Available CA125 is the most widely used tumour marker in ovarian cancer with unsatisfactory sensitivity and specificity especially at early stage. It is quantified by antibody-based immunoassays; however different molecular weight isoforms have been described in the literature which have never been validated by mass spectrometry, potentially affecting the diagnostic accuracy and clinical reliability of the test. In this study, CA125 was detected by Western blot and its identity confirmed by mass spectrometry. Two-dimensional (2D gel electrophoresis in combination with mass spectrometry revealed that positive Western blot signals up to 500 kDa are most likely false-positive interactions of M11-like and OC125-like antibodies. Fibronectin, identified as one of these false-positive interaction partners, increased the reading for CA125 in a first generation ELISA significantly (p = 0.02. The existence of low-molecular weight isoforms of CA125 is therefore questionable and is most likely reflecting cross-reactivity of the antibodies with other proteins. This would explain the conflicting reports on the molecular structure of CA125 and also the inconsistency of CA125 levels by different ELISAs. Our results are also the first steps towards a mass spectrometric assay for CA125 quantification, which would improve sensitivity and reliability.

  2. Microarray Glycoprofiling of CA125 Improves Differential Diagnosis of Ovarian Cancer

    DEFF Research Database (Denmark)

    Chen, Kowa; Gentry-Maharaj, Aleksandra; Burnell, Matthew;

    2013-01-01

    The CA125 biomarker assay plays an important role in the diagnosis and management of primary invasive epithelial ovarian/tubal cancer (iEOC). However, a fundamental problem with CA125 is that it is not cancer-specific and may be elevated in benign gynecological conditions such as benign ovarian...... for profiling specific aberrant glycoforms, such as Neu5Aca2,6GalNAc (STn) and GalNAc (Tn), present on CA125 (MUC16) and CA15-3 (MUC1). In a blinded cohort study of patients with an elevated CA125 levels (30-500 kU/L) and a pelvic mass from the UK Ovarian Cancer Population Study (UKOPS), we measured STn-CA125......, ST-CA125 and STn-CA15-3. The combined glycoform profile was able to distinguish benign ovarian neoplasms from invasive epithelial ovarian/tubule cancer (iEOCs) with a specificity of 61.1% at 90% sensitivity. The findings suggest that microarray glycoprofiling could improve differential diagnosis...

  3. [The value of urine cystein proteinase and serum CA125 measurement in monitoring the treatment of malignant ovarian tumor].

    Science.gov (United States)

    Gao, G; Peng, Z; He, B

    1996-09-01

    Urine cystein proteinase (UCP) and serum CA125 were measured in 40 patients with malignant ovarian tumor (malignant group), 40 patients with benign ovarian tumor (benign group), and 40 normal control (normal group). 28 patients in the malignant group underwent UCP and CA125 measurement pre-operation, post-operation, and during three courses of chemotherapy. The enzyme activity of UCP in the malignant group was significantly higher than that in the benign and normal groups (P 2 cm in diameter were apparantly higher than those with no residual lesions (P < 0.05). UCP and CA125 values were measured in six patients before relaparotomy. The sensitivity, specificity, accuaracy, positive predictive value and negative predictive value for UCP assay are 980%, 100%, 83%, 100% and 50% and those for CA125 assay are 40%, 100%, 80%, 100%, and 25%, respectively.

  4. Prediction of the presence of ovarian cancer at surgery by an immunochemical panel: CA 125 and copper-to-zinc ratio.

    Science.gov (United States)

    Gal, D; Lischinsky, S; Friedman, M; Zinder, O

    1989-11-01

    Preoperative levels of the trace elements copper and zinc, in addition to the level of the known marker CA 125, were studied in sera of 32 patients undergoing exploratory laparotomy for suspicion of ovarian cancer and in sera of 49 patients with the diagnosis of ovarian cancer prior to second-look operation. Most patients (63/81) had stage III or IV disease. CA 125 levels greater than 35 U/ml, copper levels greater than 1.5 mg/liter, and zinc levels less than 0.9 mg/liter were considered pathologic. An immunochemical panel composed of CA 125 serum level and ratio of copper to zinc (Cu/Zn) (normal less than 1.65) was found to be most sensitive (98%) in predicting the existence of ovarian cancer before laparotomy, and its overall predictability was 89%. In 14 of 14 patients (100%) who had complete primary surgery for ovarian cancer, the panel was correct in predicting no tumor at second-look operation. In 13 of 14 patients (93%) who had incomplete primary surgery but had no clinical evidence of disease prior to second-look operation, the panel was correct in predicting ovarian cancer. In these two groups of patients, second-look operation could have been replaced by the results of the immunochemical panel.

  5. Cancer Antigen 125 (CA125, MUC16) Protein Expression in the Diagnosis and Progression of Pancreatic Ductal Adenocarcinoma.

    Science.gov (United States)

    Jiang, Kun; Tan, Elaine; Sayegh, Zena; Centeno, Barbara; Malafa, Mokenge; Coppola, Domenico

    2016-04-16

    Pancreatic ductal adenocarcinoma (PDAC) is an aggressive carcinoma, with most patients diagnosed at an advanced stage, with a 5-year survival rate of around 5%. An urgent need exists for identifying better diagnostic, prognostic, and therapeutic markers for this lethal disease. Recently, CA125 has been identified in PDAC, and the aim of this research is to study the changes in CA125 expression during the progression of benign pancreatic tissue (BPT) to PDAC and to assess its value as a biomarker of tumor growth. To address these questions, the cellular levels of CA125 in BPT and PDAC were measured using immunohistochemistry and compared on the basis of tumor staging, and the tissue microarray technology were constructed using resected pancreatic tissues. The staining reactions for each case were evaluated semiquantitatively using the histologic score system. Our investigation demonstrates a consistent and significant upregulation of CA125 during the transition from BPT to PDAC. We also found a direct correlation between CA125 immunohistochemistry score and tumor stage (P=0.02). In conclusion, our data indicate that CA125 plays a direct role in pancreatic carcinogenesis and suggests that it may eventually be used as a diagnostic and/or prognostic biomarker of pancreatic cancer. Prospective studies are recommended to evaluate further the diagnostic and prognostic capabilities of CA125 in PDAC, and further studies are warranted to assess the use of CA125 as a therapeutic marker.

  6. Characterization of Binding Epitopes of CA125 Monoclonal Antibodies

    DEFF Research Database (Denmark)

    Marcos-Silva, Lara; Narimatsu, Yoshiki; Halim, Adnan

    2014-01-01

    The most used cancer serum biomarker is the CA125 immunoassay for ovarian cancer that detects the mucin glycoprotein MUC16. Several monoclonal antibodies (mAbs) including OC125 and M11 are used in CA125 assays. However, despite considerable efforts, our knowledge of the molecular characteristics...

  7. MUC16 (CA125): tumor biomarker to cancer therapy, a work in progress.

    Science.gov (United States)

    Felder, Mildred; Kapur, Arvinder; Gonzalez-Bosquet, Jesus; Horibata, Sachi; Heintz, Joseph; Albrecht, Ralph; Fass, Lucas; Kaur, Justanjyot; Hu, Kevin; Shojaei, Hadi; Whelan, Rebecca J; Patankar, Manish S

    2014-05-29

    Over three decades have passed since the first report on the expression of CA125 by ovarian tumors. Since that time our understanding of ovarian cancer biology has changed significantly to the point that these tumors are now classified based on molecular phenotype and not purely on histological attributes. However, CA125 continues to be, with the recent exception of HE4, the only clinically reliable diagnostic marker for ovarian cancer. Many large-scale clinical trials have been conducted or are underway to determine potential use of serum CA125 levels as a screening modality or to distinguish between benign and malignant pelvic masses. CA125 is a peptide epitope of a 3-5 million Da mucin, MUC16. Here we provide an in-depth review of the literature to highlight the importance of CA125 as a prognostic and diagnostic marker for ovarian cancer. We focus on the increasing body of literature describing the biological role of MUC16 in the progression and metastasis of ovarian tumors. Finally, we consider previous and on-going efforts to develop therapeutic approaches to eradicate ovarian tumors by targeting MUC16. Even though CA125 is a crucial marker for ovarian cancer, the exact structural definition of this antigen continues to be elusive. The importance of MUC16/CA125 in the diagnosis, progression and therapy of ovarian cancer warrants the need for in-depth research on the biochemistry and biology of this mucin. A renewed focus on MUC16 is likely to culminate in novel and more efficient strategies for the detection and treatment of ovarian cancer.

  8. Analysis on the Results of CA 125 in Serum of Patients with Alcoholic Liver Disease%酒精性肝病患者血清CA125检测结果分析

    Institute of Scientific and Technical Information of China (English)

    吴秀镯; 刘雪凯

    2016-01-01

    Objective To analyse the results of CA 125 in serum of patients with alcoholic liver disease,and investi-gate the application value of CA125 in alcoholic liver disease. Methods A total of 96 patients with liver disease and 22 healthy people as normal control group were studied, and the patients were divided into alcoholic and non-alcoholic fatty liver group,post-hepatitis liver cirrhosis group and alcoholic liver cirrhosis group.Serum CA125 levels were determined using routine laboratory methods. Results Serum CA125 in alcoholic fatty liver group,post-hepatitis liver cirrhosis group and alcoholic cirrhosis group were respectively,significantly higher than that of normal group ( P0.05),simi-larly,there was not much difference between both groups of liver cirrhosis ( P>0.05) . Conclusion Serum CA125 of pa-tients with alcoholic liver disease has different levels of expression with exacerbations. It has been showing an increasing trend during the early stage of alcoholic fatty liver.There is some clinical value of CA125 in alcoholic liver disease.%目的:分析酒精性肝病患者血清CA125的水平变化,探讨血清CA125在酒精性肝病中的应用价值。方法本文共收集肝病患者96例,将其分为非酒精性脂肪肝组24例,酒精性脂肪肝组10例,肝炎后肝硬化组37例和酒精性肝硬化组25例,另22例健康体检者作为健康对照组,测定各组血清CA125的水平。结果酒精性脂肪肝组、肝炎后肝硬化组和酒精性肝硬化组CA125水平均明显高于健康对照组(P0.05)。结论血清CA125在酒精性肝病患者中随着肝脏病变的加重有不同程度的改变,早期酒精性脂肪肝时CA125已呈现升高趋势,CA125在酒精性肝病诊治及预后中具有一定的临床应用价值。

  9. How to Use CA-125 More Effectively in the Diagnosis of Deep Endometriosis

    Directory of Open Access Journals (Sweden)

    Marco Aurelio Pinho Oliveira

    2017-01-01

    Full Text Available Deep infiltrative endometriosis (DIE is a severe form of the disease. The median time interval from the onset of symptoms to diagnosis of endometriosis is around 8 years. In this prospective study patients were divided into two groups: cases (34 DIE patients and control (20 tubal ligation patients. The main objective of this study was to evaluate the performance of CA-125 measurement in the menstrual and midcycle phases of the cycle, as well as the difference in its levels between the two phases, for the early diagnosis of DIE. Area Under the Curve (AUC of CA-125 in menstrual phase and of the difference between menstrual and midcycle phases had the best performance (both with AUC = 0.96, followed by CA-125 in the midcycle (AUC = 0.89. The ratio between menstrual and midcycle phases had the worst performance. CA-125 may be useful for the diagnosis of deep endometriosis, especially when both are collected during menstruation and in midcycle. These may help to decrease the long interval until the definitive diagnosis of DIE. Multicentric studies with larger samples should be performed to better evaluate the cost-effectiveness of measuring CA-125 in two different phases of the menstrual cycle.

  10. Deciphering the Molecular Nature of Ovarian Cancer Biomarker CA125

    Directory of Open Access Journals (Sweden)

    Peter Hoffmann

    2012-08-01

    Full Text Available The ovarian cancer biomarker CA125 has been extensively investigated over the last 30 years. The knowledge about the exact molecular nature of this protein, however, remains fragmented. This review provides an overview of the structural research regarding CA125, and presents an orthogonal verification method to confirm the identity of this molecule. The need for independent identification of CA125 is exemplified by several reports where mutually exclusive data concerning the existence of isoforms and the glycan moieties is presented. Mass spectrometry can overcome the pitfalls of a single detection/identification method such as antibody probing. Independent verification of CA125 identity in characterization studies will help establish a refined model of its molecular structure that will promote the development of new approaches for diagnosis, prognosis and therapy of ovarian cancer.

  11. Ovarian fibroma with elevated CA125 and OVA1 in postmenopausal woman

    Directory of Open Access Journals (Sweden)

    Farideh Keypour

    2014-02-01

    During the postmenopausal years, the ovaries become atrophic. The incidence ovarian neoplasm increases with age. A suspicious or persistent complex mass and increased tumor marker like CA125 and OVA1 in post-menopausal woman requires surgical evaluation. The traditional diagnostic tools for ovarian tumors are bimanual examination, pelvic ultrasound and measuring serum biomarker like CA125 level, but these methods have low specificity and sensitivity. Now-a-days the role of some tumor marker such as OVA1in the management of ovarian tumor has been approved by FDA. [Int J Reprod Contracept Obstet Gynecol 2014; 3(1.000: 236-238

  12. Analysis of tumor marker CA 125 in saliva of normal and oral squamous cell carcinoma patients: a comparative study.

    Science.gov (United States)

    Balan, Jude J; Rao, Roopa S; Premalatha, B R; Patil, Shankargouda

    2012-09-01

    The mortality and morbidity associated with oral squamous cell carcinoma (OSCC) can be greatly reduced if tumor markers which can detect OSCC at an early stage are available. The use of saliva as an alternative to blood could provide a substantial advantage in sampling convenience. Cancer antigen 125 (CA 125) is a tumor-associated antigen found to be increased in epithelial tumors like oral, breast and ovarian cancers. To determine whether salivary CA 125 levels are increased significantly in OSCC patients than the control group. Sixty OSCC patients and 60 healthy controls were taken for the study. Saliva samples from both the groups were collected, centrifuged and supernatant fluid were subjected to ELISA for assessment of CA 125. The mean salivary CA 125 values of OSCC patients and control group were statistically analyzed using Mann-Whitney U-test. The mean salivary CA 125 concentration of OSCC group was 320.25 and that of control group was 33.14. Thus, CA 125 was found to be significantly increased in the saliva of OSCC patients than the control group (p convenience, reliability and noninvasive nature of salivary CA 125 testing makes it a feasible adjunctive diagnostic tool for detection of OSCC.

  13. 不同部位子宫内膜异位症与血清CA125、EmAb的关系%Evaluation of Serum CA125 and EmAb in Relation to Endometriosis in Different Locations

    Institute of Scientific and Technical Information of China (English)

    王玲玲; 邱慧玲

    2011-01-01

    目的:探讨血清CA125、EmAb与不同部位子宫内膜异位症(EM)之间的相关性.方法:选择经手术或腹腔镜确诊的EM患者96例和排除EM的对照组40例,按EM发生部位的不同分为3组:A组卵巢EM组42例;B组盆腔EM组40例,发生部位:子宫表面、膀胱腹膜反折、官骶韧带及阔韧带;C组腹壁切口EM组14例.D组为对照组,40例,系为临床和病理检查排除了EM者.用酶联免疫吸附法(ELISA法)检测CA125及EmAb.结果:卵巢EM组血清CA125水平显著高于对照组(P<0.05),盆腔及腹壁切口EM组CA125水平明显低于卵巢EM组(P<0.05),而这两组间比较无统计学意义(P>0.05);以血清CA125≥35 kU/L为阳性判断标准,CA125及EmAb诊断各组EM的敏感性分别为:卵巢EM组69.04%、45.23%,盆腔45.00%、32.50%,腹壁切口EM组42.85%、28.57%;诊断的特异性分别为95%、97.5%;当两项指标均为阳性时,诊断EM的特异性为100%.结论:CA125及EmAb在诊断EM发生方面具有一定的价值,联合运用血清CA125和EmAb检测对EM诊断有较好的特异性.%Objective: To evaluate the relationship between serum CA125 or EmAb levels and endometriosis in different locations. Methods: Ninety-six patients who had been diagnosed by laparoscopy or laparotomy with endometriosis and forty control women without endometriosis were included in this study. Three groups were divided according to the different locations of endometriosis as: Group A, ovarian endometriosis, 42 cases; Group B, pelvic endometriosis, 40 cases; Group C, scar endometriosis, 14 cases. Group D was the control group. The serum CA125 levels and EmAb assay were measured by enzyme-linked immunosorbent assay. Results.. The serum CA125 levels in ovarian endometriosis were higher than those in control women (P<0.05). The serum CA125 levels in pelvic endometriosis and scar endometriosis were lower than those in ovarian endometriosis (P<0. 05). The positive rate (sensitivity) of serum CA125 and EmAb was 69.04

  14. Prediction of pregnancy outcomes with combined ultrasound scanning of yolk sacs and serum CA125 determinations in early threatened abortion.

    Science.gov (United States)

    Xie, Y J; Chen, M; Chen, S J

    2014-01-01

    To assess the predictive value of the combination of ultrasound scanning, yolk sacs and CA125 levels for pregnancy outcomes in early threatened abortion. A total 196 pregnant women at less than 12 weeks gestation were enrolled. They were assigned into: (A) normal pregnancy (n = 61); (B) early threatened abortion but with favorable outcomes after active treatment (n = 56); (C) pregnancy with spontaneous miscarriage and threatened abortions (n = 79). The yolk sacs were examined and serum CA125 levels were measured. The visualization rate in groups A and B were significantly higher than that in group C. For the mean yolk sac diameter, there was a statistically significant difference between groups A and C (p 0.05). The mean serum CA125 levels were significantly different (p ultrasound scanning of yolk sacs and measurement of serum CA125 levels is of great value for predicting pregnancy outcomes.

  15. The values of the expression of CA125 in serum, ascites and tissue in patients with ovarian cancer%卵巢癌患者血清、腹水、组织中CA125检测意义

    Institute of Scientific and Technical Information of China (English)

    刘超; 马晓艳; 李海霞; 廖琪

    2008-01-01

    Objective To find the source of CA 125 in serum and the values of the expression of CA125 in serum, ascites and tissue in patients with epithelial ovarian cancer. Methods Detected the expression of CA125 in the primary lesions of epithelial ovarian cancer and the metastasis in abdominopelvic cavity (peritoneal and omental metastatic lesions) by S-P immunohistochemical methods. Compared the expression of CA 125 in tuberculose focus and acute inflammation focus in abdominopelvic cavity and detected CA125 in serum and ascites by ELISA. Results The levels of CA125 in serum of the patients with epithelial ovarian cancer [(523.66±158.02)kU/L],benign epithelial ovarian tumor [(138.11±26.52)kU/L] and tuberculosis of abdominopelvie cavity [(486.56±147.10)kU/L] were higher than that with the normal ovary [(17.48±3.37)kU/L], and there were significant differences (P<0.05).The levels of CA125 in serum of the patients with epithelial ovarian cancer and tuberculosis of abdominopelvic cavity were significantly higher than that with benign epithelial ovarian tumor, and there were significant differenees (P<0.01). The levels of CA125 in ascites of the patients with epithelial ovarian cancer [(996.85±337.87)kU/L] and tuberculosis of abdominopelvic cavity [(596.78±197.10)kU/L] were higher than that with benign epithelial ovarian tumor [(179.48±63.08)kU/L] and normal ovary [(177.70±51.72)kU/L], and there were significant differences (P<0.01).The level of CA125 in ascites of the patients with epithelial ovarian cancer was higher than that with tuberculosis of abdominopelvic cavity, and there was significant difference (P<0.01). By correlation analysis, the relationship of the level of CA 125 in serum and in ascites of the patients with epithelial ovarian cancer was positive correlation(r=0.687). Conclusion Besides the original and metastatie lesions (greater omenta and peritoneum) of epithelial ovarian cancer can express CA 125, the second Maller canal, for example the

  16. Stability of HE4 and CA125 in blood samples from patients diagnosed with ovarian cancer

    DEFF Research Database (Denmark)

    Sandhu, Noreen; Karlsen, Mona A; Høgdall, Claus

    2014-01-01

    OBJECTIVE: To investigate the influence of handling and storage on HE4 and CA125 serum and EDTA plasma levels to clarify any important consequences for a clinical setting. METHODS: Blood samples from 13 ovarian cancer (OC) patients were collected and allowed to clot or sediment for up to 72 hours...

  17. The Expression and Clinical Significance of Serum Hymidine Kinase and CA125 in Cervical Cancer%宫颈癌患者血清胸苷激酶、CA125的表达及临床意义

    Institute of Scientific and Technical Information of China (English)

    林丽平

    2014-01-01

    目的:探讨宫颈癌患者TK1及CA125对其诊断及治疗中的意义。方法联合检测50例宫颈癌患者、30例同期进行体检的健康妇女血清中TK1、CA125的含量,同时对宫颈癌患者在同期放化疗后再次测定TK1、CA125的含量并与治疗前进行比较。结果宫颈癌患者的TK1、CA125含量显著高于对照组(P<0.001),治疗后宫颈癌患者的TK1、CA125较治疗前显著下降(P<0.05)。结论 TK1、CA125的水平在宫颈癌的诊断、治疗及预后评估中有一定的价值。%Objective To investigate the value of serum thymidine kinase 1 (TK1) and cancer antigen 125(CA125) in the diagnosis and treatment of cervical cancer. Methods The combined detection of the content of serum TK1 and CA125 was performed in 50 cases with cervical cancer (the cervical cancer group) and 30 healthy controls (the control group) underwent physical examination over the same period. And for the patients with cervical cancer, after concurrent chemoradiotherapy, the content of TK1 and CA125 was measured again and the results were compared with those before treatment. Results The levels of TK1 and CA125 in the cervical cancer group were much higher than those in the control group (P<0.001). After treatment, the levels of TK1 and CA125 in the cervical cancer group declined significantly compared with those before treatment(P<0.05). Conclusion The levels of TK1 and CA125 have certain value in the diagnosis, treatment and evaluation of the prognosis of the cervical cancer.

  18. The clinical value of tissue polypeptide specific antigen,neuron-specific enolase,carcinoembryonic antigen and CA125 level in small cell lung cancer%四项肿瘤标志联合检测在小细胞肺癌中的临床价值

    Institute of Scientific and Technical Information of China (English)

    李学祥; 周善良; 王慜杰; 韩彬彬; 齐军

    2008-01-01

    目的 探讨小细胞肺癌(SCLG)患者血清中组织多肽特异性抗原(TPS)、神经元特异烯醇化酶(NSE)、癌抗原125(CA125)和癌胚抗原(CEA)水平,对SCLC临床诊断、病情监测的临床意义.方法 用ELISA法检测271例SCLC和80例肺良性疾病患者及224名健康对照者血清TPS水平;同时用电化学发光法检测血清NSE、CA125和CEA水平;并用约登指数和受试者工作特征曲线(ROC曲线)分析4项肿瘤标志及其各项肿瘤标志联合检测SCLC患者的效能.结果 SCLC组的TPS、NSE、CA125和CEA血清水平明显高于肺良性疾病组和健康对照组(Z均>1.90,P均<0.01);广泛期SCLC患者的血清TPS和NSE明显高于局限期患者(Z分别为2.69、2.27,P分别为0.009、0.02).治疗后不同预后患者的TPS和NSE浓度差异有统计学意义(Z分别为4.06、3.11,P分别为0.001、0.007).多指标联合检测时,以TPS+NSE组合的敏感度最高(86.7%),其特异度、阳性预测值(PPV)和阴性预测值(NPV)分别为75.0%、81.0%和82.2%.结论 血清TPS、NSE、CA125和CEA均可作为SCLC的诊断指标,以TPS+NSE联合检测的临床价值最好.%Objective To investigate the clinical value of tissue polypeptide specific antigen(TPS),neuron-specific enolase(NSE),carcinoembryonie antigen(CEA)and CA125 in serum of small cell lung cancer(SCLC)patients and its significance in diagnosis and disease monitoring.Methods Serum leveh of TPS was detected using ELISA and serum levels of NSE,CA125 and CEA was detected using ECLin 27 1 SCLC patients.80 pulmonary benign disease patients and 224 normal healthy people.Diagnostic values of these tumor markers were analyzed by receiver operative characteristic(ROC)curve.Results The levels of TPS,NSE,CA125 and CEA iu the serum of SCLC group were signifieanfly higher than those in pulmonary benign disease and healthy group(Z>1.90,P<0.01).The levels of TPS and NSE in the serum of extensive stage small cell lung cancer(ESCLC)patients were significantly

  19. Significance of a single CA 125 assay combined with ultrasound in the early detection of ovarian and endometrial cancer.

    Science.gov (United States)

    Vuento, M H; Stenman, U H; Pirhonen, J P; Mäkinen, J I; Laippala, P J; Salmi, T A

    1997-01-01

    We evaluated the utility of a single CA 125 measurement in combination with transvaginal sonography for early detection of ovarian and endometrial cancer in asymptomatic postmenopausal women. A sample of peripheral blood was taken from 1291 apparently healthy postmenopausal women, who were examined by conventional and color Doppler ultrasound for early detection of ovarian and endometrial cancer. Serum CA 125 was determined in all samples 3 years later by the IMx CA 125 assay (Abbott Laboratories, Abbott Park, IL). The cutoff level based on the 99th percentile was 30 U/ml. Elevated values were controlled by repeat sonography and an additional determination of CA 125. Record linkage with the files of the Finnish Cancer Registry was performed 3 1/2 years after the primary sonographic screening. The mean CA 125 concentration was 8.1 U/ml (range 0-1410 U/ml). Fourteen of the 1291 women had a CA 125 level greater than 30 U/ml. None of these had signs of either endometrial or ovarian malignancy in the primary sonography screening. Among the other women three cases of endometrial carcinoma (all stage Ib) and one ovarian carcinoma (stage Ia with borderline malignancy) were detected by sonography. All these patients had a CA 125 value <30 U/ml, the mean value being 11.4 U/ml (range 7.5-16.7 U/ml). During follow-up of 3.5 years, one stage Ia ovarian carcinoma, one abdominal carcinomatosis, and two endometrial carcinomas (both stage Ib) were diagnosed. In these patients the mean value for CA 125 was 12.7 U/ml (range 2.5-30.9 U/ml) at the primary sonography screening. A single CA 125 measurement provides no advantage in the early detection of ovarian and endometrial cancer in asymptomatic postmenopausal women compared with transvaginal sonography. The vast majority of women with an elevated CA 125 value have some reason other than an ovarian or endometrial malignancy for this finding.

  20. The diagnostic value of joint detection of serum CA19-9, CA125 and CA242 for cholangiocarcinoma

    Institute of Scientific and Technical Information of China (English)

    Cui Da-Peng; Han Lei; Liu Zhen-Xian; Yang He; Zhang Ying-Chun

    2016-01-01

    Objective:To study the diagnostic value of joint detection of serum CA19-9, CA125 and CA242 for cholangiocarcinoma.Methods:A total of 35 patients with cholangiocarcinoma who received surgical resection in our hospital were selected as malignant group, 30 patients with cholelithiasis who received surgical resection in our hospital during the same period were selected as benign group, serum samples were collected before surgery to determine CA19-9, CA125 and CA242 content, and cholangiocarcinoma tissue and normal bile duct tissue were collected after surgery to determine the content of proliferation and invasion molecules. Results:Serum CA19-9, CA125 and CA242 levels of malignant group were significantly higher than those of control group; PROX-1, Ki-67, Bcl-2, Bad, Gab1, LOXL2, TRPM7 and CXCL12 levels in cholangiocarcinoma tissue were higher than those in benign bile duct tissue, and E-cadherin level was lower than that in benign bile duct tissue; serum CA19-9, CA125 and CA242 levels were positively correlated with PROX-1, Ki-67, Bcl-2, Bad, Gab1, LOXL2, TRPM7 and CXCL12 levels, and negatively correlated with E-cadherin level.Conclusion:Joint detection of serum CA19-9, CA125 and CA242 can not only provide reference for the diagnosis of cholangiocarcinoma, but can also provide basis for the evaluation of proliferation, invasion and other malignant biological behaviors.

  1. Differential diagnosis of tuberculosis and lung cancer pleural effusion by CEA, CA125,CA50%CEA、CA125、CA50在结核及肺癌性胸水鉴别中的意义

    Institute of Scientific and Technical Information of China (English)

    冯金栋; 赵卫国; 保鹏涛

    2013-01-01

    Objective:To explore the significance of differential diagnosis of pleural effusion by detection of carci-noembryonic antigen (CEA) ,carbohydrate antigen (CA125) and carbohydrate antigen (CA50). Methods: A total of 126 specimens from pleural effusion diagnosed as TB in 70 cases and lung cancer in 56 cases were collected. CEA, CA125,CA50 in the pleural effusion were analyzed. ResuItS:The expression level and sensitivity of CEA and CA50 in pleural effusion of lung cancer was significantly higher than that in tuberculous (P 0.05). The specificity was only 5.71%. Combining CEA with CA125 to diagnose pleural effusion resulted fom lung cancer, the sensitivity was 92. 11% and combining CA125 with CA50 the sensitivity was 95. 24% . When the concetration of CEA was more than 10ng/ml or the concetration of CA125 was more than 2000U/ml,pleural effusion of lung cancer should be highly suspected. Conclusion;The use of CEA.CA125 and CA50 separately,or in combination is helpful to differential diagnosis of pleural effusion resulted from tuberculosis and lung cancer.%目的:探讨癌胚抗原(CEA)、糖类抗原(CA125)、糖类抗原(CA50)在胸水鉴别诊断中的意义.方法:收集已明确胸水性质的标本126例(结核性70例、癌性56例),检测胸水中CEA、CA125、CA50的数值,进行统计分析.结果:肺癌性胸水中CEA、CA50表达水平及敏感度明显高于结核性胸腔积液(P<0.05),特异性分别为95.71%和98.57%.同样CA125在肺癌性胸水中高表达(P<0.05),但两组敏感度无差异(P>0.05),特异性仅为5.71%;CEA和CA125联合诊断肺癌性胸水的敏感度为92.11%,CA125和CA50联合诊断敏感度为95.24%.CEA> 10ng/ml或CA125> 2000U/ml,可初步定为肺癌性胸水.结论:CEA、CA125、CA50单独或联合检测对鉴别诊断结核及肺癌性胸水有重要临床指导意义.

  2. The evaluation of serum HE4, CA125 and ROMA index in accessing the risk of ovarian cancer%血清HE4、CA125和ROMA指数评估卵巢癌风险性的初步评价

    Institute of Scientific and Technical Information of China (English)

    陈燕; 林莺莺; 郑瑜宏; 胡敏华; 陈岩松

    2013-01-01

    ),尤其是浆液性腺癌阳性率高达97.92%.而CA125在两组间差异无统计学意义.同时在子宫内膜癌组,CA125的阳性率显著低于HE4和ROMA指数,而在粘液性腺癌组,则是CA125的阳性率显著高于HE4和ROMA指数.结论:血清HE4、CA125的联合检测及ROMA指数的计算有助于评估腹盆腔肿块患者患卵巢癌的风险性,对于早期以及上皮性卵巢癌尤其是浆液性卵巢癌具有更好的预测价值,可提高卵巢癌的早期诊断效率,进而提高五年生存率.%Objective: To evaluate the serum combination of HE4, CA125 and ROMA index value in accessing the risk of ovarian cancer and to analyze the correlation of the three indicators of the clinical stage and pathological features of ovarian cancer. Methods : A total of 96 patients with primary ovarian cancer and 74 patients with benign ovarian tumor and 60 healthy subjects, that were treated at Fujian Provincial Cancer Hospital from January 2011 to September 2011, were considered for inclusion in this retrospective study. The serum levels of HE4 and CA125 were measured by ELISA before surgery. The ROMA index was calculated by ovarian cancer risk assessment software. The ROC curve was drawed to evaluate the diagnostic value of HE4, CA125 and ROMA index, as the control of benign ovarian tumor and healthy subjects. Univariate analyses were used to investigate the relationship between preoperative se-rologic markers and clinicopathological parameters. Results:The median levels of serum HE4, CA125 and ROMA index in the group of benign ovarian tumors and normal control group were in the normal range, while the median levels of the three indicators in ovarian cancer patients were 240.40 pmol/L, 88.37 U/ml and 79.70% , compared with benign ovarian tumors and normal control group, the differences were statistically significant (P < 0.05). As a reference to the benign group, the sensitivity and negative predictive value of ROMA index were highest (83. 33% and 82. 95

  3. Serum tumor marker CA 125 for monitoring ovarian cancer during follow-up

    DEFF Research Database (Denmark)

    Tuxen, Malgorzata K.; Sölétormos, G; Dombernowsky, P

    2002-01-01

    CA 125 is currently widely applied in the management of patients with ovarian cancer. However, a change in results of CA 125, which should be considered significant, has not been defined. The aim of this study was to investigate the ability of CA 125 to signal progressive ovarian cancer during fo...... utility of serological tumor markers in patients with ovarian cancer.......CA 125 is currently widely applied in the management of patients with ovarian cancer. However, a change in results of CA 125, which should be considered significant, has not been defined. The aim of this study was to investigate the ability of CA 125 to signal progressive ovarian cancer during...... follow-up after first-line chemotherapy. The study patients were selected retrospectively among 255 patients with stage IC-IV ovarian cancer. The evaluation of the CA 125 information was based on the analytical imprecision, the normal intra-individual biological variation, the sampling interval...

  4. Predictive value of CA125, VEGF,β-HCG in the early diagnosis of ectopic gestation and drug conservative treatment prognosis

    Institute of Scientific and Technical Information of China (English)

    Hua Shi; Shao-Hua Pei

    2016-01-01

    Objective:To investigate the predictive value of carbohydrate antigen 125 (CA125), vascular endothelial growth factor (VEGF),β-human chorionic gonadotropin (β-HCG) in the early diagnosis of ectopic gestation and its prognosis of the patients.Method:A total of 125 patients with ectopic gestation treated in our hospital from January 2015 to October 2015 were selected as the research object, and 120 patients with normal intrauterine pregnancy after routine physical examination were selected as the control group. The serum levels of CA125, VEGF,β-HCG in two groups were determined with ELISA.Results:The serum levels of CA125, VEGF in ectopic gestation group were significantly higher than control groups, while the level ofβ-HCG was lower than the normal control group. The levels of CA125, VEGF of effective group in patients with ectopic gestation were lower than ineffective group, while the level ofβ-HCG was higher than ineffective group. The detection area, sensitivity, specificity, positive predictive value, negative predictive value under the ROC curve were greater than single index detection when combined the detection of serum CA125, VEGF,β-HCG.Conclusion:the detection of serum CA125, VEGF,β-HCG can be used as the evaluation index in the early diagnosis and prognosis of ectopic gestation, by combing various indexes detection to improve the clinical diagnosis accuracy for ectopic gestation, and the detection method is simple and fast that worth clinical promotion.

  5. Tuberculosis peritoneal con niveles elevados de CA 125

    Directory of Open Access Journals (Sweden)

    Andrés José Gómez-Aldana

    2013-09-01

    Full Text Available Resumen La tuberculosis peritoneal hace parte de los diagnósticos diferenciales de ascitis; sin embargo, su documentación está dada por la presencia de granulomas necrotizantes al igual que el crecimiento de micobacterias en las muestras tomadas del peritoneo. Se presenta el caso de una paciente con dolor abdominal y ascitis en quien se documentaron lesiones nodulares en cavidad peritoneal, con niveles marcadamente elevados de "Antígeno Carbohidrato o Antígeno Cáncer" CA 125, sin cambios en otros órganos, realizando biopsias de peritoneo, con documentación de granulomas necrotizantes y crecimiento de micobacterias en el cultivo, por lo que se instauró tratamiento con adecuada respuesta logrando disminución progresiva de la ascitis y ganancia de peso.

  6.  The Values of CA-125, Progesterone, ß-HCG and Estradiol in the Early Prediction of Ectopic Pregnancy

    Directory of Open Access Journals (Sweden)

    Hala Abdul Qadir Al-Moayed

    2012-03-01

    Full Text Available  Objective: To explore the diagnostic value and measurement of serum CA-125, the single measurement of progesterone (P,ß-HCG, and estradiol (E2 in the early diagnosis of ectopic pregnancy.Methods: Serum levels of CA-125, progesterone, ß-HCG and estradiol were measured by Enzyme Linked Immuno Sorbent Assay (ELISA techniques in 40 symptomatic women with ectopic pregnancy and 24 women with normal intrauterine pregnancy during gestational age of 4-10 weeks at Al-Kadhmiya Teaching Hospital, Baghdad, Iraq, between November 2010 and June 2011.Results: The mean ±SEM serum levels of CA-125, progesterone, ß-HCG, and estradiol in patients with ectopic pregnancies (16.51±2.39U/ml; 2.54±0.47ng/ml; 72.75±12.27mIU/ml; 13.4±2.14pg/ml; respectively were significantly lower than the levels in normal intrauterine pregnancies (74.25±18.5U/ml; 28.36±3.7ng/ml; 249.54±18.0mIU/ml; 112.7±23.6pg/ml; respectively. When using a CA-125 concentration of 20.5 U/ml as a cut-off value for the diagnosis of ectopic pregnancy, sensitivity was 75.7�20specificity 100�20the positive predictive value was100�0and the negative predictive value 71.4�onclusion: The measurement of CA-125 and progesterone levels is useful in discriminating ectopic from normal gestations.

  7. Serum tumour marker CA 125 in monitoring of ovarian cancer during first-line chemotherapy

    DEFF Research Database (Denmark)

    Tuxen, M K; Sölétormos, G; Dombernowsky, P

    2001-01-01

    of this study was to assess the ability of CA 125 to monitor patients with ovarian cancer during postoperative chemotherapy. 255 patients with stage IC-IV ovarian cancer were allocated to the tumour marker monitoring study. The evaluation of CA 125 information was based on the analytical imprecision, the normal...... for identifying progression and non-progression during first-line chemotherapy was 91.9%. The median lead time for true positive results was 41 days. Using the new elaborated criterion the efficiency of CA 125 for identifying progression and non-progression during first-line chemotherapy was 90.5%. The median...... lead time for true positive results was 35 days. CA 125 gave reliable prediction of progressive disease during postoperative chemotherapy. The results indicate a high applicability of the presented progression criteria during CA 125 monitoring of patients with changing activity of ovarian cancer....

  8. Large prospective study of ovarian cancer screening in high-risk women: CA125 cut-point defined by menopausal status.

    Science.gov (United States)

    Skates, Steven J; Mai, Phuong; Horick, Nora K; Piedmonte, Marion; Drescher, Charles W; Isaacs, Claudine; Armstrong, Deborah K; Buys, Saundra S; Rodriguez, Gustavo C; Horowitz, Ira R; Berchuck, Andrew; Daly, Mary B; Domchek, Susan; Cohn, David E; Van Le, Linda; Schorge, John O; Newland, William; Davidson, Susan A; Barnes, Mack; Brewster, Wendy; Azodi, Masoud; Nerenstone, Stacy; Kauff, Noah D; Fabian, Carol J; Sluss, Patrick M; Nayfield, Susan G; Kasten, Carol H; Finkelstein, Dianne M; Greene, Mark H; Lu, Karen

    2011-09-01

    Previous screening trials for early detection of ovarian cancer in postmenopausal women have used the standard CA125 cut-point of 35 U/mL, the 98th percentile in this population yielding a 2% false positive rate, whereas the same cut-point in trials of premenopausal women results in substantially higher false positive rates. We investigated demographic and clinical factors predicting CA125 distributions, including 98th percentiles, in a large population of high-risk women participating in two ovarian cancer screening studies with common eligibility criteria and screening protocols. Baseline CA125 values and clinical and demographic data from 3,692 women participating in screening studies conducted by the National Cancer Institute-sponsored Cancer Genetics Network and Gynecologic Oncology Group were combined for this preplanned analysis. Because of the large effect of menopausal status on CA125 levels, statistical analyses were conducted separately in pre- and postmenopausal subjects to determine the impact of other baseline factors on predicted CA125 cut-points on the basis of 98th percentile. The primary clinical factor affecting CA125 cut-points was menopausal status, with premenopausal women having a significantly higher cut-point of 50 U/mL, while in postmenopausal subjects the standard cut-point of 35 U/mL was recapitulated. In premenopausal women, current oral contraceptive (OC) users had a cut-point of 40 U/mL. To achieve a 2% false positive rate in ovarian cancer screening trials and in high-risk women choosing to be screened, the cut-point for initial CA125 testing should be personalized primarily for menopausal status (50 for premenopausal women, 40 for premenopausal on OC, and 35 for postmenopausal women).

  9. The diagnostic accuracy of two human epididymis protein 4 (HE4) testing systems in combination with CA125 in the differential diagnosis of ovarian masses

    OpenAIRE

    Lenhard, Miriam; Stieber, Petra; Hertlein, Linda; Kirschenhofer, Angela; Fuerst, Sophie; Mayr, Doris; Nagel, Dorothea; Hofmann, Karin; Krocker, Katja; Burges, Alexander

    2011-01-01

    Background: Cancer antigen 125 (CA125) is the best known single tumor marker for ovarian cancer (OC). We investigated whether the additional information of the human epididymis protein 4 (HE4) improves diagnostic accuracy. Methods: We retrospectively analyzed preoperative sera of 109 healthy women, 285 patients with benign ovarian masses (cystadenoma: n = 78, leimyoma: n = 66, endometriosis: n = 52, functional ovarian cysts: n = 79, other: n = 10), 16 low malignant potential (LMP) ovarian tum...

  10. 肿瘤标志物CA 153、CA 125检验在肺癌诊断中的应用价值%Application Value of Tumor Marker CA 153 and CA 125 Test in Diagnosis of Lung Cancer

    Institute of Scientific and Technical Information of China (English)

    郜玲

    2016-01-01

    Objective To study tumor markers CA 153, application value of CA 125 test in the diagnosis of lung cancer.Methods A recently admitted to our hospital in patients with lung cancer 46 cases and the same period in our hospital, 50 cases of patients with benign lesions as the object of study, were compared the two kinds of CA 153 and CA 125 changes.Results The cancer sign abnormal rate of CA 153, CA 125 level were higher than benign lesion, P<0.05, was difference had statistically significance.Conclusion The diagnosis of lung cancer patients, the serum CA 153 and CA 125 detection of tumor markers is helpful to improve the diagnostic accuracy of lung cancer patients.%目的:研究分析肿瘤标志物CA 153、CA 125检验在肺癌诊断中的应用价值。方法我院近期收治的肺癌患者46例以及同期我院收治的50例良性病变患者作为研究对象,分别比较这两类人员CA 153以及CA 125的变化情况。结果癌症患者肿瘤标志物CA 153以及CA 125检测水平异常率均高于良性病变人群,P<0.05,差异有统计学意义。结论对于肺癌患者的诊断中,通过对患者血清CA 153以及CA 125肿瘤标志物的检测,有助于提高肺癌患者的诊断准确率。

  11. 血清CA125、CEA水平与宫颈癌相关性分析%Association of serum carcinoembryonic antigen and carbohydrate antigen 125 with cervical cancer

    Institute of Scientific and Technical Information of China (English)

    胡跃华

    2012-01-01

    Objective To analyze the association of serum carcinoembryonic antigen ( CEA )and carbohydrate antigen 125 ( CA125 ) with cervical cancer.Methods 100 patients with cervical cancer who had been treated in our hospital during the period of February 2007 to March 2011 were enrolled into a study group.Serum levels of CEA and CA125 were detected and their assoication with cervical cancer was analyzed; and the levels of these markers were compared with those from 60 non-cervical cancer patients ( control group ).Results Serum levels of CEA and CA125 were higher in the study group than in the control group,with a significant difference between 2 groups ( P< 0.05 ) except for stage Ⅰ cervical cancer.The correlation between CA125 and stages of cervical cancer was greater than that between CEA and cervical cancer ( P< 0.05 ).Conclusions Serum levels of CEA and CA125 are associated with cervical cancer at some degree.CA125 has more diagnostic values than CEA.%目的 分析研究血清CA125(糖链抗原125)、CEA(癌胚抗原)水平与宫颈癌的相关性.方法 将我院从2007年2月至2011年3月收治的100例宫颈癌病患设为实验组,进行血清CA125、CEA水平检测,并与宫颈癌分期相分析,将同期收治的60例非宫颈癌病患设为对照组,对比两组血清CA125、CEA水平.结果 实验组血清CA125、CEA水平均高于对照组,除Ⅰ期宫颈癌数据外,差异有统计学意义(P<0.05);血清CA125与宫颈癌分期的相关性高于血清CEA,差异有统计学意义(P<0.05 ).结论 血清CA125、CEA水平与宫颈癌有一定相关性,检测简单方便,且血清CA125比血清CEA更具诊断价值.

  12. Detection CEA,CA125,CA153 in breast cancer patients and its correlation with quality of life%乳腺癌患者CEA、CA125、CA153检测及其与生活质量的相关性分析

    Institute of Scientific and Technical Information of China (English)

    潘中华

    2013-01-01

    Objective To study the level of CEA,CA125,CA153 in breast cancer patients and its correlation with quality of life. Methods the breast cancer patients were selected as observation group,benign breast disease patients as benign control group, and healthy people as healthy control group,the peripheral blood levels of CEA,CA125, CA153 were detected and quality of life were observed. Results The CEA,CA125,CA153 levels and physical function,psychological function,social function,cognitive function,overall quality of life scores of observation group were significantly higher than benign control group and healthy control group;physical function,psychological function,social function,cognitive function,overall quality of life score were negatively correlated with CEA,CA125,CA153 levels. Conclusion The clinical value of positive CEA,CA125,CA153 examination in the diagnosis of breast cancer,which is closely related with the quality of life.%  目的研究乳腺癌患者血清中CEA、CA125、CA153的水平及其与生活质量的相关性。方法选择乳腺癌患者作为观察组、乳腺良性疾病患者作为良性对照组、健康体检者作为健康对照组,检测外周血中CEA、CA125、CA153的含量并观察生活质量相关指标。结果观察组患者CEA、CA125、CA153水平以及躯体功能、心理功能、社会功能、认知功能、总体生活质量评分明显高于良性对照组和健康对照组;躯体功能、心理功能、社会功能、认知功能、总体生活质量评分与CEA、CA125、CA153水平呈负相关。结论CEA、CA125、CA153检查对乳腺癌的诊断具有积极的临床价值,且与生活质量密切相关。

  13. Clinical significance of detecting CEA, CA199, AFP, HCG, CA153, CA125 in postoperative treatment of patients with ovarian cancer

    Institute of Scientific and Technical Information of China (English)

    Xue Pan; Zhen-Hua Du

    2016-01-01

    Objective:To explore the clinical significance of carcinoembryonic antigen (CEA), carbohydrate antigen 199 (CA199), a tire protein (AFP), human chorionic gonadotropin (HCG), carbohydrate antigen 153 (CA153) and carbohydrate antigen 125 (CA125) in the postoperative treatment of patients with ovarian cancer.Methods:210 cases of patients with ovarian cancer after initial treatment from January 2015 to December 2015, 232 cases of patients with ovarian benign tumor and 250 cases of healthy women were selected, CEA, CA199, AFP, HCG, CA153 and CA125 levels were detected, and the levels after chemotherapy in patients with ovarian carcinoma were detected.Results:CEA, CA199, AFP, HCG, CA153 and CA125 levels in patients with ovarian cancer were (12.37±7.43) ng/mL, (84.04±26.96) U/mL, (37.46±9.47) μg/L, (110.54±35.51) IU/L, (51.23±9.20) U/mL and (64.36±42.68) U/mL, respectively, which were significantly higher than that in normal controls and patients with benign ovarian lesions, and were considered to be statistically significant. Chemotherapy after two cycles, CEA, CA199, AFP, HCG, CA153 and CA125 levels in patients with ovarian cancer were significantly lower than that before chemotherapy, and were considered to be statistically different. Chemotherapy after four cycles, CEA, CA199, AFP, HCG, CA153 and CA125 levels in patients with ovarian cancer continue to decrease, and were significantly lower than that of chemotherapy after two cycles, and had statistical differences.Conclusion:CEA, CA199, AFP, HCG, CA153 and CA125 can be used as important indicators for monitoring the chemotherapy effects, early recurrence and metastasis of ovarian cancer.

  14. The strong prognostic value of KELIM, a model-based parameter from CA 125 kinetics in ovarian cancer

    DEFF Research Database (Denmark)

    You, Benoit; Colomban, Olivier; Heywood, Mark;

    2013-01-01

    Unexpected results were recently reported about the poor surrogacy of Gynecologic Cancer Intergroup (GCIG) defined CA-125 response in recurrent ovarian cancer (ROC) patients. Mathematical modeling may help describe CA-125 decline dynamically and discriminate prognostic kinetic parameters....

  15. Combined detection of CEA, CA19-9 and CA125 in the differential diagnosis of benign and malignant ascites%联合检测CEA、CA19-9和CA125对鉴别良恶性腹水的价值

    Institute of Scientific and Technical Information of China (English)

    卢冰贤; 周云英

    2011-01-01

    目的 探讨检测CEA(癌胚抗原)、CA19-9(糖类抗原19-9)和CA125(糖类抗原125)对鉴别良、恶性腹水的临床价值. 方法 化学发光法检测120例患者腹水CEA、CA19-9和CA125的含量. 结果 化学发光法检测恶性腹水中的CEA、CA19-9和CA125分别为(37±16) ng/ml、(236±78) U/ml和(602士211)U/ml,良性腹水分别为(13±2)ng/ml、(34士3)U/ml和(32±3)U/ml,差异均有统计学意义(P<0.05).同时,3种抗原检测的敏感性和特异性各有特点,需要联合检测. 结论 联合检测良、恶性腹水中CEA、CA19-9和CA125水平对鉴别诊断有一定临床意义.%Objective To explore the clinical value of detecting CEA (cancer embryo antigen), CA19-9 (sugar 19-9 antigen), and CA125 (sugar antigen 125) to differentiate benign and malignant ascites. Methods CA19-9, CEA, and CA125 levels were determined by chemiluminescence detection in 120 patients with ascites. Results Chemiluminescence of patients with malignant ascites revealed a CEA level of (37± 16) ng/ml, a CA19-9 level of (236±78) U/ml, and a CA125 level of (602 + 211) U/ml while chemiluminescence of patients with benign ascites revealed a CEA level of (13± 2) ng/ml, a CA19-9 level of (34±3) U/ml and a CA125 level of (32 ± 3) U/ml. Differences were statistically significant (P<0. 05). Testing with 3 different antigens revealed a particular sensitivity and specificity, and combined testing was required. Conclusion Combined testing of CA19-9, CEA, and CA125 levels has some clinical significance in the differential diagnosis of benign and malignant ascites.

  16. Pre-treatment prediction of chemoresistance in second-line chemotherapy of ovarian carcinoma: value of serological tumor marker determination (tetranectin, YKL-40, CASA, CA 125)

    DEFF Research Database (Denmark)

    Grønlund, B; Høgdall, E V S; Christensen, Ib Jarle;

    2006-01-01

    for the biochemical tumor markers tetranectin, YKL-40, CASA (cancer-associated serum antigen), and CA 125. The serum tumor marker levels at time of relapse were correlated with response status at landmark time after 4 cycles of second-line chemotherapy. Univariate and multivariate logistic regression analyses...... (OR 1.8; 95% CI: 1.0-3.3; p=0.045), and CASA (OR 1.8; 95% CI: 1.2-2.7; p=0.007) had predictive value for second-line chemoresistance, whereas serum CA 125 had no predictive value. In a multivariate logistic regression analysis, serum tetranectin and CASA both had independent predictive value...

  17. Serum concentrations of the biomarkers CA125, CA15-3, CA72-4, tPSA and PAPP-A in natural and stimulated ovarian cycles

    Directory of Open Access Journals (Sweden)

    Melissa Stemp

    2014-06-01

    Conclusion: Ovarian stimulation reduced serum PAPP‐A levels, CA125 and CA15‐3 levels were generally unaffected by ovarian stimulation but displayed cyclical changes throughout both natural and stimulated cycles, whilst tPSA and CA72-4 were not affected by the stage of the cycle or ovarian stimulation.

  18. Expression of CA-125 in threatened abortion, inevitable abortion, missed abortion and its clinical significance%CA-125在先兆流产、难免流产、稽留流产中的表达及其临床意义

    Institute of Scientific and Technical Information of China (English)

    姬超; 张书艳; 宋芳霞; 买苗

    2016-01-01

    Objective To investigate the expression of carbohydrate antigen 125 (CA-125) and its prognostic value in patients with threatened abortion, inevitable abortion, missed abortion. Methods A total of 120 patients who received tocolytic therapy in Department of Gynaecology and Obstetrics in our hospital from March 2013 to March 2015 were selected as subjects, which were divided into normal control group (n=48), abortion observation group (n=72) ac-cording to the pregnancy outcome. The expression of CA-125 in two groups were detected, and the comparative analysis was performed. Results The expression of CA-125 of patients in abortion observation group was (56.33±11.22) kU/L, which was significantly higher than that in control group of (16.18±7.88) kU/L, with statistically significant differ-ence (P0.05). The expression levels of CA-125 showed statistically significant difference between threatened abortion and missed abortion (P0.05),而先兆流产与稽留流产患者CA-125表达水平比较差异则具有统计学意义(P<0.05)。结论先兆流产、难免流产、稽留流产患者CA-125的表达较正常妊娠妇女高,CA-125表达水平随着流产的严重程度逐渐升高,这对患者病情的诊治具有一定的指导作用。

  19. Value of color Doppler ultrasonography, contrast-enhanced ultrasound and serum CA-125 detection in differential diagnosis of ovarian masses%彩色多普勒超声、超声造影及CA-125对卵巢病变的鉴别诊断价值

    Institute of Scientific and Technical Information of China (English)

    周琦; 刘百灵; 姜珏; 雷小莹

    2009-01-01

    目的 探讨彩色多普勒超声、超声造影及CA-125对卵巢病变的鉴别诊断价值.方法 分析总结65例卵巢病变的彩色多普勒超声、超声造影资料及血清CA-125水平,并对其诊断的准确性进行评价.结果 65例卵巢病变中,21例(21/35)良性病变者血清CA-125测值35μ/ml,而14例良性及2例恶性病变者血清CA-125测值存在交叉;彩色多普勒超声提示良性病变30例,恶性肿瘤22例,13例不能明确诊断(其中良性5例,恶性8例);超声造影提示良性病变34例,恶性肿瘤29例,误诊2例(1例卵泡膜细胞瘤,另1例交界性囊腺瘤);血清CA-125、彩色多普勒超声及超声造影对卵巢良恶性病变诊断的敏感性分别为66.7%、73.3%、96.7%,特异性为60.0%、85.7%、97.1%.结论 血清CA-125及超声检查有助于卵巢病变的诊断及鉴别诊断,而超声造影在显示肿瘤的血流灌注信息方面具有优越性,能进一步提高卵巢病变的早期诊断及鉴别诊断准确性.%Objective To assess the value of color Doppler ultrasonography, contrast-enhanced ultrasound and detection of serum CA-125 levels in the differential diagnosis of ovarian masses. Methods The findings of color Doppler ultrasonography, contrast-enhanced ultrasound and the serum levels of CA-125 were comparatively analyzed in 65 patients with ovarian masses, and the diagnostic accuracy of the 3 methods was estimated. Results Of the 65 cases of ovarian masses, 21 of the 35 patients with benign ovarian masses had serum CA-125 levels below 35 U/ml, and 28 of the 30 patients with malignant masses showed CA-125 levels over 35 U/ml. Color Doppler ultrasonography identified 30 benign and 22 malignant cases, but failed to produce definite results in 13 cases (including 5 with benign and 8 with malignant masses). By contrast-enhanced ultrasound, benign masses were found in 34 cases and malignant masses in 29 cases, and misdiagnosis occurred in 2 cases (including 1 case of thecoma and 1 of ovarian

  20. 试析心功能Ⅲ、Ⅳ级慢性心衰患者血清CA125与NT Pro-BNP浓度相关性

    Institute of Scientific and Technical Information of China (English)

    李金怡; 吕敏

    2016-01-01

    目的:探讨慢性心衰患者III、IV级心功能血清CA125与NT Pro-BNP浓度的相关性。方法将我院心血管内科收治的慢性心衰患者70例选为研究对象,心功能为III级、IV级,检测血清CA125与NT Pro-BNP浓度,探讨二者间相关性。结果心功能IV级血清CA125水平与NT Pro-BNP浓度明显高于心功能III级,对比差异明显(P<0.05),治疗后CA125与NT Pro-BNP浓度明显低于治疗前,对比差异明显(P<0.05)。结论CA125与NT Pro-BNP浓度呈正相关;对慢性心衰患者可采取CA125、NT Pro-BNP联合检测法。%Objective: To investigate patients with chronic heart failure III, IV grade heart function and serum CA125 NT Pro-BNP concentration correlation. Methods: Patients with chronic heart failure in cardiovascular medicine in our hospital treated 70 patients chosen for the study, cardiac function grade III, IV level, serum CA125 and Pro-BNP concentration NT, investigate the correlation between the two. Results:Class IV heart function and serum CA125 levels of NT Pro-BNP concentration was significantly higher than Class III heart function, contrast significantly different (P<0.05), after treatment, CA125 and NT Pro-BNP concentration was significantly lower than before treatment, significant differences in contrast (P<0.05). Conclusion:CA125 and NT Pro-BNP concentration was positively correlated;chronic heart failure patients can take CA125, NT Pro-BNP joint detection method.

  1. 非小细胞肺癌患者血清中TSGF及CA125水平检测的意义%Significance of Serum TSGF and CA125 Detection for the Patients with Non-small Cell Lung Cancer

    Institute of Scientific and Technical Information of China (English)

    唐艳; 李娜; 刘翠兰

    2012-01-01

    目的 探讨恶性肿瘤特异性生长因子(TSGF)和糖类抗原-125 (CA125)血清水平检测对非小细胞肺癌(NSCLC)患者诊断的临床价值.方法 选取50例NSCLC患者,及50例良性肺部病变患者,检测血清TSGF和CA125水平,比较不同组别患者及肺癌患者不同病理类型、不同临床分期血清TSGF和CA125的表达水平.结果 血清TSGF和CA125水平在肺癌组明显高于肺良性病变组(P<0.001);肺癌患者CA125表达水平与组织类型有关,肺腺癌明显高于肺鳞癌(P<0.01);肺癌患者血清TSGF和CA125的阳性率与NSCLC临床分期有关,临床分期越晚,其阳性率越高.结论 CA125及TSGF均对肺癌的辅助诊断具有一定价值,临床上需要结合症状、影像学及病理学综合判断,为NSCLC提供更好的诊疗效果.%Objective To explore the clinical values of serum tumor specific growth factor (TSGF) and carbohydrate antigen (CA125) detection in the diagnosis of non?small cell lung cancer (NSCLC). Methods The serum TSGF and CA125 levels were measured in 50 patients with NSCLC and 50 cases with benign lung diseases. The detection results were compared between the two groups and among patients with lung cancers of different pathological types and clinical stages. Results The serum TSGF and CA125 levels in the lung cancer group were significantly higher than those in the control group (P<0.001). The serum CA125 level was related with the pathological types of the lung carcinoma, which was statistically higher in the patients with lung adenocarcinoma than in those with lung squamous cell carcinoma (P<0.01). The positive rates of serum TSGF and CA125 in patients with NSCLC were related with the clinical stage of the carcinoma. The later the clinical stage, the higher the positive rates. Conclusions Serum TSGF and CA125 detection is of clinical significance in the diagnosis of patients with non - small cell lung cancer.

  2. Value of serum β-HCG, P, CA125, and color Doppler ultrasound in early diagnosis of ectopic pregnancy

    Institute of Scientific and Technical Information of China (English)

    Yan-Li Liu

    2016-01-01

    Objective:To explore the clinical value of serum β-HCG, P, CA125, and color Doppler ultrasound in the early diagnosis of ectopic pregnancy (EP). Methods:A total of 50 patients with EP who were admitted in our hospital from September, 2014 to September, 2015 were included in the study and served as the observation group, while 50 normal pregnant women were served as the control group. A volume of 5 mL of fasting elbow venous blood the day on admission in the two groups was extracted, and then was centrifuged for serum. The chemiluminescence immunoassay was used to detect the levels of serum β-HCG, P, and CA125. After 48h,β-HCG level was detected again. The vaginal color Doppler diasonograph was used to detect the changes of RI and PSV. The blood supply of LH was observed. Results:The levels of serumβ-HCG, P, and CA125 in the observation group were significantly lower than those in the control group (P<0.05). When β-HCG<2 000 IU/L, after 48 h, β-HCG level was doubled in 3 cases (6.0%) in the observation group, while in 49 cases (98.0%) in the control group, and the differences between the two groups were not statistically significant (P<0.05). RI in the observation group was significantly higher than that in the control group, while PSV was significantly lower than that in the control group (P<0.05). Blood supply in the observation group was in a half ring shape, accounting for 58.0%;in the control group was in a ring shape, accounting for 70.0%, and the difference was statistically significant (P<0.05). Conclusions:Determination of the levels of serumβ-HCG, P, and CA125 in the pregnant women, in combined with the vaginal color Doppler ultrasound detection of RI and PSV, can contribute to distinguish the normal intrauterine pregnancy with EP and prevent the misdiagnosis, which can provide an accurate reference value for the early diagnosis and timely treatment of EP, and can be used as an ideal method for the diagnosis of EP.

  3. Diagnostic Difficulties in Woman with Crohn’s Disease, Ascites, and Elevated Value of Serum CA125 Antigen

    Directory of Open Access Journals (Sweden)

    Maria Kłopocka

    2014-01-01

    Full Text Available Variety of symptoms and atypical clinical course of Crohn’s disease (CD often create the need for additional diagnostic procedures. In the described case of woman with CD, there was a suspicion of coexistence of ovarian cancer. This issue is particularly important in patients treated with immunosuppressants and biological agents. The discussion focused on the usefulness of CA125 (cancer antigen 125, mucin 16 serum level estimation in clinical practice and draws attention to the possible reasons for the increase of its value which is not associated to ovarian cancer.

  4. 血清肿瘤标志物 NSE、CA-125在非霍奇金淋巴瘤诊断及预后判定中的临床价值%Clinical significance of serum tumor makers NSE,CA125 in the diagnosis and prognosis assessment of non-Hodgkin’ s lymphoma

    Institute of Scientific and Technical Information of China (English)

    房丽; 王轶楠; 马守东; 肖建波; 李海丽; 王玲玲; 刘翠华

    2014-01-01

    目的:探讨血清肿瘤标志物NSE和CA-125在非霍奇金淋巴瘤( NHL)中的表达情况及临床意义。方法采用电化学发光免疫测定法测定56例NHL患者血清肿瘤标志物NSE和CA-125的表达水平,判定NSE和CA-125的表达与NHL患者临床特征及其预后的相关性。结果56例NHL患者化疗前血清NSE值(34 U.63±8.54)μg/L,CA-125(47.59±9.53)μg/L,均明显高于对照组,差异有统计学意义( P <0.05);且NSE、CA-125表达水平的高低与NHL患者B症状、临床分期、IPI预后指数及治疗效果等临床特征相关( P <0.05)。结论血清肿瘤标志物NSE、CA-125联合定量检测可提高NHL诊断敏感性,同时对NHL临床分期、疗效判定及预后等方面具有一定临床意义。%Objective To investigate the clinical significance of the two serum tumor markers-neuron specific enolase ( NSE) and carbohydrate antigen 125 ( CA-125 ) in the diagnosis and prognosis evaluation of non-Hodgkin ’ s lymphoma ( NHL) .Methods The serum levels of NSE and CA-125 in 56 patients with NHL were measured by electroche miluminescence immunoassay .The correlation between the expressions of NSE , CA125 and clinical characteristics as well as prognosis of patients with NHL were analyzed.Results Before chemotherapy the serum levels of NSE [( 34.63 ± 8.54)μg/L] and CA-125 [(47.59 ±9.53)μg/L] in 56 patients with NHL were significantly higher than those in control group ( P <0.05),furthermore,the expression levels of NSE and CA-125 were correlated with patient ’s symptoms,clinical stage,IPI prognosis index and therapeutic effect.Conclusion The quantitive detection of NSE combined with CA 125 plays an important role in diagnosis,clinical staging and prognosis assessment for patients with NHL ,which can increase diagnostic sensitivity.

  5. Biological variation and analytical imprecision of CA 125 in patients with ovarian cancer

    DEFF Research Database (Denmark)

    Tuxen, M K; Sölétormos, G; Rustin, G J;

    2000-01-01

    Despite the availability of serial data on CA 125 in ovarian cancer, the problem of interpreting a change over time is still unsolved. Changes in marker concentrations are due not only to patients improving or deteriorating but also to analytical imprecision and normal intra-individual biological...... variation. The aim of this study was to assess the analytical imprecision (CV(A)) and the intra- and inter-individual biological variation (CV(I) and CV(G), respectively) of CA 125 in a group of 26 patients with clinically stable ovarian cancer. Furthermore, the critical difference for a change between two...... consecutive CA 125 concentrations calculated as square root(2) x Z x (CV(A)2 + CV(I)2)(1/2) (Z =1.65 for unidirectional and 1.96 for bidirectional changes, p

  6. Assessment of Confounding Factors Affecting the Tumor Markers SMRP, CA125, and CYFRA21-1 in Serum

    Directory of Open Access Journals (Sweden)

    Daniel Gilbert Weber

    2010-01-01

    Full Text Available The purpose of this analysis was to evaluate if serum levels of potential tumor markers for the diagnosis of malignant mesothelioma and lung cancer are affected by confounding factors in a surveillance cohort of workers formerly exposed to asbestos. SMRP, CA125, and CYFRA21-1 concentrations were determined in about 1,700 serum samples from 627 workers formerly exposed to asbestos. The impact of factors that could modify the concentrations of the tumor markers was examined with linear mixed models. SMRP values increased with age 1.02-fold (95% CI 1.01–1.03 and serum creatinine concentration 1.32-fold (95% CI 1.20–1.45. Levels differed by study centers and were higher after 40 years of asbestos exposure. CA125 levels increased with longer storage of the samples. CYFRA21-1 values correlated with age 1.02-fold (95% CI 1.01–1.02, serum creatinine 1.21-fold (95% CI 1.14–1.30 and varied by study centers due to differences in sample handling. Tumor marker concentrations are influenced by subject-related factors, sample handling, and storage. These factors need to be taken into account in screening routine.

  7. Clinic Value of HE4,CA125 Combined with Risk of Ovarian Malignancy Algorithm (ROMA) in the Diagnosis for Ovarian Cancer%血清HE4和CA125水平联合ROMA预测和诊断卵巢癌的临床价值

    Institute of Scientific and Technical Information of China (English)

    李子军; 郑雅琴; 徐仙凤; 夏飞

    2013-01-01

    [Purpose] To evaluate clinic value of HE4,CA125 combined with ROMA in the diagnosis for ovarian cancer. [Methods] Serum HE4 and CA125 levels were detected by SLISA in 40 ovarian cancer patients and 30 ovarian benign cyst patients. ROMA was evaluated by HE4 md CA125 levels combined with menopause status.[Results] The serum CA125,HE4 levels were(223.50±87.48)pmol/L and (111.00± 24.11)U/mI in ovarian cancer group,respectively,(41.00±3.73)pmol/L and(32.00±3.86)U/ml in ovarian benign cyst group,with significant difference(P=0.000). If the cut-off values cf CA125,HE4 were 37U/ml and 71.5pmol/L,the sensitivity and specificity of CA125 for ovarian cancer diagnosis were 97.5% and 80.0%; those of HE4,80.0% and 100.0%; and those of ROMA, 97.5% and 80.0%, respectively .The area of ROC was 0.868(CA125),0.939(HE4),and 0.972(ROMA). The area of ROC of ROMA was higher than the others (P=0.001, P=0.000). [Conclusion ] ROMA is helpful with great va ue in the clinic predication and diagnosis for ovarian cancer.%[目的]探讨血清肿瘤标志物人附睾分泌蛋白4(HE4)、CA125和卵巢癌风险预测模型(ROMA)在卵巢癌预测和诊断中的应用价值.[方法]回顾性分析因卵巢肿瘤住院接受手术的患者70例,用ELISA法检测70例卵巢癌和卵巢良性肿瘤患者血清中HE4与CA125水平,计算出ROMA值,联合绝经状态评估患卵巢癌的风险性.[结果]卵巢癌组HE4和CA125血清水平分别为(223.50±87.48) pmol/L、(111.00±24.11)U/ml,卵巢良性肿瘤组分别为(4l.00±3.73)pmol/L、(32.00±3.86)U/ml,两组比较有统计学差异(P=0.000).若将CA125及HE4的切割值定在37U/ml、71.5pmol/L,则CA125、HE4预测和诊断卵巢癌的灵敏度、特异性分别为97.5%、80.0%,80.0%、100.0%;两者联合(ROMA计算)其预测和诊断卵巢癌的灵敏度、特异性分别为97.5%、80.0%;CA 125 ROC曲线下面积为0.868,HE4 ROC曲线下面积为0.939,ROMA ROC曲线下面积为0.972,与CA125、HE4比较有显著性差异(P=0

  8. The prognostic and predictive value of combined HE4 and CA-125 in ovarian cancer patients

    DEFF Research Database (Denmark)

    Steffensen, Karina Dahl; Waldstrøm, Marianne; Brandslund, Ivan;

    2012-01-01

    A risk-of-ovarian-malignancy algorithm (ROMA) based on human epididymis protein 4 (HE4) and CA-125 has been reported to categorize women with a pelvic mass into high or low risk of ovarian malignancy. Originally, the ROMA score was developed for diagnostic purposes and the clinical application of...

  9. Prognostic and predictive relevance of CA-125 at primary surgery of ovarian cancer

    NARCIS (Netherlands)

    Mury, Dina; Woelber, Linn; Jung, Sabine; Eulenburg, Christine; Choschzick, Matthias; Witzel, Isabell; Schwarz, Joerg; Jaenicke, Fritz; Mahner, Sven

    2011-01-01

    Despite radical surgery and chemotherapy, most patients with ovarian cancer develop recurrence and die due to progressive disease. To stratify patients for optimal therapy, prognostic and predictive factors are needed. We examined the role of pre- and postoperative CA-125 in this context. A total of

  10. Pelvic hematoma following angiography: another cause of elevated serum CA-125.

    Science.gov (United States)

    Eddy, G L

    1997-05-01

    The presence of a pelvic mass in a patient with an elevated serum CA-125 suggests the possibility of a gynecologic malignancy. However, an increasing number of nonneoplastic causes of elevated serum CA-125 have been reported. This is the first report of a pelvic hematoma associated with elevated serum CA-125. Two weeks following cardiac catheterization at time of myocardial infarction a patient was noted to have a complex pelvic mass on ultrasound and serum CA-125 of 53 units per milliliter. Abdominal-pelvic CT-scan showed a small left pleural effusion, minimal ascites, left lower quadrant abdominal wall masses consistent with omental metastases, and a 9.4 x 10.3 x 9.0-cm complex left adnexal mass. At exploratory laparotomy a large organized hematoma in the left paravesical space was adherent to both the left external iliac artery and the left bladder wall. This mass could have been managed expectantly with percutaneous aspiration if a nonmalignant diagnosis had been more strongly considered.

  11. 血清CA125、甲胎蛋白及胎盘生长因子在胎盘早剥预测中的初步研究%A preliminary study of serum CA125, alpha - fetoprotein, and placental growth factor for prediction of placental abruption

    Institute of Scientific and Technical Information of China (English)

    刘世凯; 宋莉莉; 陈铎

    2012-01-01

    目的:检测胎盘早剥、重度子痫前期及正常妊娠孕妇的血清CA125、甲胎蛋白和胎盘生长因子水平,探讨其与胎盘早剥的关系,为胎盘早剥的预测及早期诊断提供理论依据.方法:采用微粒酶免疫分析法( MEIA)和双抗体夹心ELISA法检测孕妇血清CA125、甲胎蛋白和胎盘生长因子水平.结果:胎盘早剥组CA125和甲胎蛋白明显高于其他两组,胎盘生长因子明显低于其他两组(P<0.05).结论:检测外周血CA125、甲胎蛋白和胎盘生长因子水平对于预测胎盘早剥具有一定的临床价值.%Objective: To detect the levels of serum CA125, alpha-fetoprotein, and placental growth factor in the pregnant women with placental abruption, the pregnant women with severe preeclampsia, and the normal pregnant women, explore their relationships with placental abruption, provide a theoretical basis for prediction and early diagnosis of placental abruption. Methods: Micropartical enzyme immu-noassay and double - antibody sandwich ELISA were used to detect the levels of serum CA125, alpha - fetoprotein, and placental growth factor. Resnlts: The levels of serum CA123 and alpha - fetoprotein in placental abruption group were significantly higher than those in the other two groups, the level of placental growth factor in placental abruption group was significantly lower than those in the other two groups (P <0.05) . Conclusion: Detecting the levels of CA125, alpha - fetoprotein, and placental growth factor in peripheral blood has a certain clinical value for predicting placental abruption.

  12. Understanding the Unique Attributes of MUC16 (CA125): Potential Implications in Targeted Therapy

    OpenAIRE

    2015-01-01

    CA125, the most widely used ovarian cancer (OC) biomarker, was first identified approximately thirty-five years ago in an antibody screen against OC antigen. Two decades later, it was cloned and characterized to be a transmembrane mucin, MUC16. Since then several studies have investigated its expression, functional and mechanistic involvement in multiple cancer types. Antibody based therapeutic approaches primarily using antibodies against the tandem repeat domains of MUC16 (for example Orego...

  13. Serum concentrations of the biomarkers CA125, CA15-3, CA72-4, tPSA and PAPP-A in natural and stimulated ovarian cycles

    Institute of Scientific and Technical Information of China (English)

    Melissa Stemp; Peter Roberts; Allison McClements; Vincent Chapple; Jay Natalwala; Michael Black; Phillip Matson

    2014-01-01

    Objective:Biomarkers associated with cancer screening (CA125, CA15‐3, CA72‐4, total prostate specific antigen [tPSA]) and the monitoring of pregnancy (pregnancy associated plasma protein‐A [PAPP‐A]) were measured during natural and stimulated ovarian cycles in disease‐free non-pregnant women to determine if they could reflect normal events relating to ovulation and/or endometrial changes. Methods: A total of 73 blood samples (10 women) collected throughout the natural menstrual cycle, and 64 blood samples (11 women) taken during stimulated ovarian cycles, were analysed on the Roche Cobas e411 automated analyser. Results:Detectable levels of tPSA were measured in at least one point in the cycle in 6/10 of women in the natural cycle and 10/11 of women in stimulated cycles, and CA72-4 was detected in only 12/21 women tested. Concentrations of CA125, tPSA, CA15‐3 and CA72‐4 showed no significant difference between the natural and stimulated ovarian cycle groups. On average the mean PAPP‐A of the natural group was (2.41±0.58) mIU/L higher than the stimulated group (t=4.10, P< 0.001). CA125 and CA15‐3 results were both significantly influenced by the stage of the cycle (P<0.0001), whereas tPSA and PAPP‐A concentrations revealed no significant changes (P≥0.65). CA72‐4 was not affected by the stage of the cycle nor ovarian stimulation. Conclusion:Ovarian stimulation reduced serum PAPP‐A levels, CA125 and CA15‐3 levels were generally unaffected by ovarian stimulation but displayed cyclical changes throughout both natural and stimulated cycles, whilst tPSA and CA72-4 were not affected by the stage of the cycle or ovarian stimulation.

  14. Selection of DNA Aptamers for Ovarian Cancer Biomarker CA125 Using One-Pot SELEX and High-Throughput Sequencing

    Directory of Open Access Journals (Sweden)

    Delia J. Scoville

    2017-01-01

    Full Text Available CA125 is a mucin glycoprotein whose concentration in serum correlates with a woman’s risk of developing ovarian cancer and also indicates response to therapy in diagnosed patients. Accurate detection of this large, complex protein in patient samples is of great clinical relevance. We suggest that powerful new diagnostic tools may be enabled by the development of nucleic acid aptamers with affinity for CA125. Here, we report on our use of One-Pot SELEX to isolate single-stranded DNA aptamers with affinity for CA125, followed by high-throughput sequencing of the selected oligonucleotides. This data-rich approach, combined with bioinformatics tools, enabled the entire selection process to be characterized. Using fluorescence anisotropy and affinity probe capillary electrophoresis, the binding affinities of four aptamer candidates were evaluated. Two aptamers, CA125_1 and CA125_12, both without primers, were found to bind to clinically relevant concentrations of the protein target. Binding was differently influenced by the presence of Mg2+ ions, being required for binding of CA125_1 and abrogating binding of CA125_12. In conclusion, One-Pot SELEX was found to be a promising selection method that yielded DNA aptamers to a clinically important protein target.

  15. Selection of DNA Aptamers for Ovarian Cancer Biomarker CA125 Using One-Pot SELEX and High-Throughput Sequencing.

    Science.gov (United States)

    Scoville, Delia J; Uhm, Tae Kyu Brian; Shallcross, Jamie A; Whelan, Rebecca J

    2017-01-01

    CA125 is a mucin glycoprotein whose concentration in serum correlates with a woman's risk of developing ovarian cancer and also indicates response to therapy in diagnosed patients. Accurate detection of this large, complex protein in patient samples is of great clinical relevance. We suggest that powerful new diagnostic tools may be enabled by the development of nucleic acid aptamers with affinity for CA125. Here, we report on our use of One-Pot SELEX to isolate single-stranded DNA aptamers with affinity for CA125, followed by high-throughput sequencing of the selected oligonucleotides. This data-rich approach, combined with bioinformatics tools, enabled the entire selection process to be characterized. Using fluorescence anisotropy and affinity probe capillary electrophoresis, the binding affinities of four aptamer candidates were evaluated. Two aptamers, CA125_1 and CA125_12, both without primers, were found to bind to clinically relevant concentrations of the protein target. Binding was differently influenced by the presence of Mg(2+) ions, being required for binding of CA125_1 and abrogating binding of CA125_12. In conclusion, One-Pot SELEX was found to be a promising selection method that yielded DNA aptamers to a clinically important protein target.

  16. Predicting Lymph Node Metastasis in Endometrial Cancer Using Serum CA125 Combined with Immunohistochemical Markers PR and Ki67, and a Comparison with Other Prediction Models.

    Directory of Open Access Journals (Sweden)

    Bingyi Yang

    Full Text Available We aimed to evaluate the value of immunohistochemical markers and serum CA125 in predicting the risk of lymph node metastasis (LNM in women with endometrial cancer and to identify a low-risk group of LNM. The medical records of 370 patients with endometrial endometrioid adenocarcinoma who underwent surgical staging in the Obstetrics & Gynecology Hospital of Fudan University were collected and retrospectively reviewed. Immunohistochemical markers were screened. A model using serum cancer antigen 125 (CA125 level, the immunohistochemical markers progesterone receptor (PR and Ki67 was created for prediction of LNM. A predicted probability of 4% among these patients was defined as low risk. The developed model was externally validated in 200 patients from Shanghai Cancer Center. The efficiency of the model was compared with three other reported prediction models. Patients with serum CA125 50% and Ki67 < 40% in cancer lesion were defined as low risk for LNM. The model showed good discrimination with an area under the receiver operating characteristic curve of 0.82. The model classified 61.9% (229/370 of patients as being at low risk for LNM. Among these 229 patients, 6 patients (2.6% had LNM and the negative predictive value was 97.4% (223/229. The sensitivity and specificity of the model were 84.6% and 67.4% respectively. In the validation cohort, the model classified 59.5% (119/200 of patients as low-risk, 3 out of these 119 patients (2.5% has LNM. Our model showed a predictive power similar to those of two previously reported prediction models. The prediction model using serum CA125 and the immunohistochemical markers PR and Ki67 is useful to predict patients with a low risk of LNM and has the potential to provide valuable guidance to clinicians in the treatment of patients with endometrioid endometrial cancer.

  17. Clinical value of serum CA19-9,CA125 and CP2 in mucinous ovarian tumor:a retrospective study of 273 patients%CA19-9、CA125和CP2在卵巢黏液性肿瘤诊断和监测中的价值

    Institute of Scientific and Technical Information of China (English)

    董丽; 崔恒; 李小平; 孙丽芳; 昌晓红; 梁旭东; 祝洪澜

    2008-01-01

    125(+)与CA125(-)、CP2(+)与CP2(-)患者间生存率比较,差异有统计学意义(P<0.05);而CA19-9(+)与CA19-9(-)患者间生存率比较,差异则无统计学意义(P>0.05).结论 CA19-9是诊断卵巢黏液性肿瘤的敏感指标,与CA125联合检测可提高对卵巢黏液性肿瘤诊断的敏感度,并对术后监测有重要临床意义.CA125和CP2联合检测则对诊断卵巢非黏液肿瘤更敏感.%Objective To evaluate the diagnostic and prognostic value of serum CA19-9,CA125 and CP2 in mucinous ovarian tumors.Methods In this retrospective study,the serum CA19-9,CA125 and CP2 levels of 273 hospitalized patients with ovarian tumors of either mucinous or non-mucinous type were analyzed.Results(1)CA19-9 had the biggest area under chive(AUC)in mucinous tumors followed with CA125 while CA125 and CP2 had bigger AUC in non-mucinous tumor.(2)For the diagnosis of mucinous tumors,CA19-9 and CA125 combination showed a greatly increased sensitivity compared with CA19-9 or CA125 alone(93.8%versus 75.0%and 66.7%,P<0.05)with no significant improvement of the specificity(P>0.05).For the diagnosis of non-mucinous tumors,CA125 and CP2 combination showed an increased sensitivity compared with CA125 or CP2 alone(85.0%versus 80.7%,P>0.05,85.0%versus 70.6%,P<0.05)with no significant improvement of the specificity(P>0.05).(3)Seventy percent of tumor marker-positive patients could undergo cytoreductive surgery.Compared with those who could not undergo cytoreductive surgery,they were more likely to have normal tumor marker two months after surgery (P<0.05)and longer interval to re-elevation of tumor markers(P>0.05),with lower reeurrence and death rate (P<0.05).All of the 20 tumor marker-negative patients could have eytoreduetive surgery with only 10%recurrence.(4)CA19-9 inereased mainly in recurrent mucinous tumor,while CA125 increased dominantly in recurrent non-mueinous tumor.(5)The survival rate of CA125 and CP2 positive patients was much lower than CA125

  18. Clinical Significance of the detection of CA153,CA125,CEA and SF Serum Test in Breast Cancer%肿瘤标志物CA153、CA125、CEA和SF联合检测对乳腺癌的诊断价值

    Institute of Scientific and Technical Information of China (English)

    刘征宇; 温蔚

    2009-01-01

    目的 探讨肿瘤标志物CA153、CA125、CEA和SF联合检测在乳腺癌中的临床应用价值.方法 利用化学发光免疫方法检测60例乳腺良性疾病(乳腺良性疾病组)和40例健康体检者(对照组)以及60例乳腺癌患(乳腺癌组)治疗前后血清CA15-3、CA125、CEA和SF的水平,并进行分析.结果 乳腺癌组治疗前CA153、CA125、CEA、SF水平[(52.8±21.3)u/ml、(44.2±20.1)ng/ml、(8.9±5.2)ng/ml、(350.5±113.8)ng/ml]均显著高于乳腺良性疾病组[(17.3±8.8)u/ml、(15.6±8.5)u/ml、(2.0±0.8)u/ml、(1220.7±46.91)ng/ml](t=2.671,t=2.684,t=2.898,t=2.844,P均<0.01);乳腺癌组患者血清CA15-3、CA125、CEA和SF治疗前的水平(同上)明显高于治疗后[(25.5±3.7)u/ml、(15.0±8.4)u/ml、(4.6±3.3)ng/ml、(98.5±58.6)ng/ml](t=2.210,t=2.165,t=2.224,t=2.234,P均<0.05);乳腺良性疾病组与正常对照组差异无统计学意义(t=1.644,t=1.757,t=1.67,t=1.741,P均>0.05);乳腺癌组CA153+CA125+CEA+SF四项联检阳性率53.3%低于CA153(56.7%)、CA125(58.3%)、CEA(63.3%)、SF(68.3%)(χ~2=2.52,χ~2=2.652,P>0.05;χ~2=3.85,χ~2=3.90,χ~2=3.98,P<0.05).结论 血清CA15-3、CA125、CEA、SF联合检测可提高乳腺癌的阳性检出率,对乳腺癌的早期诊断、疗效监测以及预后判断均有重要意义.%Objective To study the clinical significance of sernm CA153,CA125 and CEA test in breast cancer.Methods The levels of CA153,CA125,carcinoembryonic antigen(CEA)and ferritin were measured in 60 patients with breast cancer(breast cancer group),36 patients with benign breast diseases(benign breast diseases group)and 40 healthy people(control group)by chemiluminometry.The four indices were compared and analyzed for their complementary diagnostic value to breast cancer.Results The levels of CA153,CA125,CEA,SF[(52.8±21.3)u/ml,(44.2±20.1)ng/ml,(8.9±5.2)ng/ml,(350.5±113.8)ng/ml]in breast cancer group were significantly higher than that of benign breast disease group[(17.3±8.8)u/ml,(15.6±8.5)u

  19. 血清SccAg、CA125、CA19-9在宫颈癌及癌前病变中的表达及意义%Expressions and significances of serum SccAg, CA125, and CA19 -9 in cervical cancer and cervical precancerous lesion

    Institute of Scientific and Technical Information of China (English)

    甘玉杰; 熊小英; 符丽华; 谭玲玲

    2012-01-01

    Objective: To study the expressions and significances of serum squamous cell carcinoma antigen (SccAg) , cancer antigen 125 (CA125) , carbohydrate antigen 19-9 (CA19 -9) in cervical cancer and cervical precancerous lesion. Methods; Thirty-four serum samples in normal control group, one hundred and twenty - six serum samples in cervical intraepithelial neoplasia (CIN) group, and fifty - seven serum samples in cervical cancer group were detected, the three tumor markers in cervical cancer of different clinical stages, differentiation degrees, and pathological types were compared. Results; Serum SccAg expression changed in cervical precancerous lesion, the changes of CA125 and CA19 - 9 were not obvious. There was a positive correlation between serum SccAg level and clinical stages, pathological degrees, and lymph node metastasis of cervical cancer, CA125 and CA19 -9 had great application values in detection of cervical adeno-carcinoma. Conclusion; Comprehensively analyzing tumor markers can provide guidance and data for assisted diagnosis, diagnosis, treatment, and prognosis of the patients with cervical cancer.%目的:研究鳞状上皮细胞癌抗原(SccAg)、癌抗原125 (CA125)、癌抗原19-9 (CA19 -9)在癌前病变及宫颈癌中的表达和意义.方法:检测正常对照组血清34例、宫颈上皮内瘤变(CIN)组126例、宫颈癌组57例,对不同临床分期、分化程度和病理类型宫颈癌的三种肿瘤标志物进行比较.结果:SccAg在宫颈癌前病变已有变化,CA125和CA19 -9变化不明显,血清中SccAg的水平与肿瘤临床分期、肿瘤病理分级、淋巴结转移呈正相关,CA125和CA19 -9在检测腺癌中更有应用价值.结论:综合分析宫颈癌患者的肿瘤标志物能为患者的辅助诊断、病情诊治、预后提供指导信息.

  20. The Detection Value Analysis of Tumor Markers CEA,CA125 in Cervical Cancer%肿瘤标记物CEA、CA125在宫颈癌中的检测价值分析

    Institute of Scientific and Technical Information of China (English)

    戴伟萍

    2013-01-01

      目的:探讨肿瘤标记物 CEA、CA125在宫颈癌中的检测的临床价值.方法:选取笔者所在医院2011年1月-2012年8月经临床确诊的100例宫颈癌患者(宫颈癌组)及40例进行健康体检的妇女(对照组)为研究对象,测定两组的血清肿瘤标记物癌胚抗原(CEA)、糖抗原(CA125).结果:宫颈癌组的血清 CEA、CA125含量显著高于对照组(P<0.05).在宫颈癌组中,随着临床分期的增加 CEA、CA125的阳性率逐渐增加,Ⅲ、Ⅳ期较Ⅰ、Ⅱ期显著增加(P<0.05).结论:肿瘤标记物 CEA、CA125在宫颈癌中有较高的诊断价值,可辅助判断宫颈癌的临床分期.%Objective:To investigate the clinical value of tumor markers CEA,CA125 detection in cervical cancer and the significance.Methods:100 cases of cervical cancer (the cervical cancer group )that was clinical diagnosis from January 2011 to August 2012 in author’s hospital and 40 cases of healthy women (the control group) were chosen as the research object,two groups were measured in serum tumor marker carcinoembryonic antigen (CEA),carbohydrate antigens (CA125).Results:Serum CEA,CA125 in the cervical cancer group were significantly higher than those in the control group (P<0.05).In the cervical cancer group, CEA,CA125 positive rate increased gradually along with the clinical stagin,stage Ⅲ,Ⅳ were significantly than istage Ⅰ,Ⅱ (P<0.05).Conclusion:There is a high diagnostic value of the tumor markers CEA,CA125 in cervical carcinoma;they can help judge clinical cervical cancer staging.

  1. Biological variation and analytical imprecision of CA 125 in patients with ovarian cancer

    DEFF Research Database (Denmark)

    Tuxen, M K; Sölétormos, G; Rustin, G J

    2000-01-01

    variation. The aim of this study was to assess the analytical imprecision (CV(A)) and the intra- and inter-individual biological variation (CV(I) and CV(G), respectively) of CA 125 in a group of 26 patients with clinically stable ovarian cancer. Furthermore, the critical difference for a change between two...... consecutive CA 125 concentrations calculated as square root(2) x Z x (CV(A)2 + CV(I)2)(1/2) (Z =1.65 for unidirectional and 1.96 for bidirectional changes, p CV(A)2+CV(I)2)/CV(G)2)(1/2) were estimated. After the exclusion of outliers, CV(A......) and the average CV(I) and CV(G) were 12.1%, 24.0%, and 43.1%, respectively. The index of individuality was 0.62 and the critical difference calculated for unidirectional changes was 62.6%. CV(A) and CV(I) contribute considerably to the variation in serial results and should, therefore, be included in the criteria...

  2. An ultra-sensitive impedimetric immunosensor for detection of the serum oncomarker CA-125 in ovarian cancer patients

    Science.gov (United States)

    Johari-Ahar, M.; Rashidi, M. R.; Barar, J.; Aghaie, M.; Mohammadnejad, D.; Ramazani, A.; Karami, P.; Coukos, G.; Omidi, Y.

    2015-02-01

    Effective treatment of ovarian cancer depends upon the early detection of the malignancy. Here, we report on the development of a new nanostructured immunosensor for early detection of cancer antigen 125 (CA-125). A gold electrode was modified with mercaptopropionic acid (MPA), and then consecutively conjugated with silica coated gold nanoparticles (AuNP@SiO2), CdSe quantum dots (QDs) and anti-CA-125 monoclonal antibody (mAb). The engineered MPA|AuNP@SiO2|QD|mAb immunosensor was characterised using transmission electron microscopy (TEM), atomic force microscopy (AFM), cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS). Successive conjugation of AuNP@SiO2, CdSe QD and anti-CA-125 mAb onto the gold electrode resulted in sensitive detection of CA-125 with a limit of detection (LOD) of 0.0016 U mL-1 and a linear detection range (LDR) of 0-0.1 U mL-1. Based on the high sensitivity and specificity of the immunosensor, we propose this highly stable and reproducible biosensor for the early detection of CA-125.Effective treatment of ovarian cancer depends upon the early detection of the malignancy. Here, we report on the development of a new nanostructured immunosensor for early detection of cancer antigen 125 (CA-125). A gold electrode was modified with mercaptopropionic acid (MPA), and then consecutively conjugated with silica coated gold nanoparticles (AuNP@SiO2), CdSe quantum dots (QDs) and anti-CA-125 monoclonal antibody (mAb). The engineered MPA|AuNP@SiO2|QD|mAb immunosensor was characterised using transmission electron microscopy (TEM), atomic force microscopy (AFM), cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS). Successive conjugation of AuNP@SiO2, CdSe QD and anti-CA-125 mAb onto the gold electrode resulted in sensitive detection of CA-125 with a limit of detection (LOD) of 0.0016 U mL-1 and a linear detection range (LDR) of 0-0.1 U mL-1. Based on the high sensitivity and specificity of the immunosensor, we propose

  3. Preoperative prealbumin level as a risk factor for surgical site infection following elective spine surgery

    Directory of Open Access Journals (Sweden)

    David J Salvetti

    2015-01-01

    Conclusions: Our results reinforce the relationship between preoperative nutritional status and outcomes in elective spine surgery. The data indicate that preoperative prealbumin levels may be useful in risk stratification. Further study is needed to determine whether nutritional supplementation may reduce the risk of infection.

  4. Puerperal mastitis: a reproductive event of importance affecting anti-mucin antibody levels and ovarian cancer risk.

    Science.gov (United States)

    Cramer, Daniel W; Williams, Kristina; Vitonis, Allison F; Yamamoto, Hidemi S; Stuebe, Alison; Welch, William R; Titus, Linda; Fichorova, Raina N

    2013-11-01

    Test the hypothesis that puerperal mastitis may alter immunity related to the mucin (MUC) family of glycoproteins and lower risk of ovarian cancer. In two case-control studies conducted in New England between 1998 and 2008, we examined the association between self-reported mastitis and ovarian cancer in 1,483 women with epithelial ovarian cancer and 1,578 controls. IgG1 antibodies against (MUC1) CA15.3 and (MUC16) CA125 were measured using electrochemiluminescence assays in a subset of controls (n = 200). Preoperative CA125 was recorded in 649 cases. The association between ovarian cancer and mastitis was assessed using unconditional logistic regression to calculate adjusted odds ratios, OR, and 95 % confidence intervals (CI). Associations between mastitis and anti-CA15.3 and anti-CA125 antibodies and preoperative CA125 levels were evaluated using adjusted linear regression models. Prior mastitis was associated with a significantly lower risk of ovarian cancer: OR (and 95 % CI) of 0.67 (0.48, 0.94) adjusted for parity, breastfeeding, and other potential confounders. The association was strongest with 2 or more episodes of mastitis, and risk declined progressively with increasing number of children and episodes of mastitis. Among controls, prior mastitis was associated with significantly higher anti-CA15.3 and anti-CA125 antibody levels and, among cases, with significantly lower preoperative CA125 levels. Puerperal mastitis may produce long-lasting anti-mucin antibodies that may lower the risk of ovarian cancer, plausibly through enhanced immune surveillance. Studying immune reactions related to MUC1 and MUC16 in the 10-20 % of breastfeeding women who develop mastitis may suggest ways to duplicate its effects through vaccines based on both antigens.

  5. The significance of MT, VEGF, CA125, CEA and MMP-9 combine detection in NSCLC diagnosis%联合检测外周血CEA、CA125、VEGF、MT及MMP-9在晚期非小细胞肺癌诊断中的意义

    Institute of Scientific and Technical Information of China (English)

    丁瑞敏

    2015-01-01

    目的:探讨外周血金属硫蛋白(metallothionein, MT)、血管内皮细胞生长因子(vascular endothelial growth factor, VEGF)、糖链抗原125(carbohydrate antigen 125, CA125)、癌胚抗原(carcinoem-bryonic antigen, CEA)和基质金属蛋白酶-9(matrix metalloprotein-9, MMP-9)5项指标联合检测对晚期非小细胞肺癌(non-small-cell lung carcinoma, NSCLC)的诊断价值。方法选择2012年6月至2014年6月于我院就诊的NSCLC 患者80例及健康对照者72例为研究对象,检测受试者血清 MT、VEGF、CA125、CEA和MMP-9水平,对检测结果进行统计学分析。结果 NSCLC组MT、VEGF、CA125、CEA和MMP-9的检测结果均高于对照组,且差异均有统计学意义(P均<0.05)。5项指标联合检测的灵敏度和特异性均高于各指标单独检测的灵敏度和特异性。结论 MT、VEGF、CA125、CEA和MMP-9的检测可用于晚期NSCLC的辅助诊断,其联合检测可明显提高NSCLC的检出率。%Objective To analysis the significance of peripheral blood metallothionein(MT), vascular endothelial growth factor(VEGF), carbohydrate antigen 125(CA125), carcinoembryonic antigen(CEA), and matrix metalloprotein-9 (MMP-9) combine detection in advanced stage non-small-cell lung carcinoma (NSCLC) diagnosis. Methods 80 cases patients with advanced stage NSCLC and 72 cases healthy control people from June 2012 to June 2014 in our hospital were collected. The MT, VEGF, CA125, CEA and MMP-9 serum levels of all subjects were all detected and the results were analyzed statistically. Results The serum levels of MT, VEGF, CA125, CEA and MMP-9 in NSCLC group were all higher than that of control group, and the differences all had statistical significance (Pall< 0.05). The sensitivity and specificity of 5 index combine detection were all higher than that of each index alone detection. Conclusion The detection of MT, VEGF, CA125, CEA and MMP-9 can be used in the

  6. 子宫内膜癌患者血清CP2、CA125、唾液酸和癌胚抗原检测的临床意义%Clinical significance of serum CP2, CA125, salicylic acid and carcinoembryonic antigen in endometrial carcinoma

    Institute of Scientific and Technical Information of China (English)

    王志启; 王建六; 杨静华; 魏丽惠

    2008-01-01

    Objective To explore the clinical significance of CP2,CA125,salicylic acid(SA)and carcinoembryonic antigen(CEA)in endometrial carcinoma patients. Methods A retrospective study was carried out on 154 cases of endometrial carcinoma with tumor markers test results who were admitted to our department from Aug 1992 to Nov 2004.Results The patients were followed up for(38±28)months.23.4%,36.8%,19.0%and 30.3%of cases were with abnormal values of CP2,SA,CA125 and CEA.CP2 abnormal level was related with the stage,cell differentiation,adnexa metastasis,positive peritoneal cytology and pelvic lymph node metastasis(P=0.002,P=0.040,P=0.019,P=0.019,P:0.005).SA abnormal level was related with the adnexa metastasis and positive peritoneal eytology(P=0.021,P=0.000). CA125 abnormal level was related with the cell differentiation,cervical metastasis and pelvic lymph node metastasis(P=0.014,P=0.006,P=0.018).The survival was related with CP2,CA125 and CEA (P=0.016,P=0.000,P=0.016),especially CA125. Conclusions Among the commonly used tumor markers,CP2 is related with many clinical pathological parameters.CA125 elevation may strongly suggest worse prognosis.%目的 探讨肿瘤标志物CP2、CA125唾液酸(SA)和癌胚抗原(CEA)检测对子宫内膜癌患者的临床意义.方法 选取154例具有肿瘤标志物检测结果 的子宫内膜癌患者的临床病理资料进行回顾性分析.结果 子宫内膜癌患者血清CP2、SA、CA125和CEA水平升高的百分率分别为23.4%、36.8%、19.0%和30.3%.血清CP2水平升高与手术病理分期、病理分化程度、附件受累、腹腔细胞学检查阳性及盆腔淋巴结转移相关(P值分别为0.002、0.040、0.019、0.019、0.005);血清SA水平升高与附件受累、腹腔细胞学检查阳性相关(P值分别为0.021、0.000);血清CA125水平升高与病理分化程度、宫颈受累和盆腔淋巴结转移相关(P值分别为0.014、0.006、0.018);CEA与各临床病理特征间均无相关性(P均>0.05).血清CP2、CA

  7. Enormous ovarian fibroma with elevated Ca-125 associated with Meigs' syndrome. Presentation of a rare case.

    Science.gov (United States)

    Sofoudis, C; Kouiroukidou, P; Louis, K; Karasaridou, K; Toutounas, K; Gerolymatos, A; Papamargaritis, E

    2016-01-01

    In medicine, Meigs' syndrome is the triad of ascites, pleural effusion, and benign ovarian tumor (fibroma, Brenner tumour, and occasionally granulosa cell tumour). It resolves after the resection of the tumor. Because the transdiaphragmatic lymphatic channels are larger in diameter on the right, the pleural effusion is classically on the right side. The etiologies of the ascites and pleural effusion are poorly understood. Atypical Meigs' syndrome,characterized by a benign pelvic mass with right-sided pleural effusion but without ascites, can also occur. As in Meigs syndrome, pleural effusion resolves after removal of the pelvic mass. The authors would like to share their own experience of a case of Meigs' syndrome associated with an enormous ovarian fibroma and elevated Ca-125.

  8. Effect of endostar combined with paclitaxel liposome and radiotherapy simultaneously on serum CYFRA21-1, CEA, SCCA, CA125, IL-8 and T lymphocyte subsets in patients with advanced cervical cancer

    Institute of Scientific and Technical Information of China (English)

    Wen-Jing Yang; Lu Wang

    2016-01-01

    Objective:To study the effect of endostar combined with paclitaxel liposome and radiotherapy simultaneously on serum CYFRA21-1, CEA, SCCA, CA125, IL-8 and T lymphocyte subsets in patients with advanced cervical cancer.Methods:A total of 72 patients with advanced cervical cancer in our hospital from January 2014 to February 2016 were enrolled in this study. The subjects were divided into control group (n=36) and experiment group (n=36) randomly. The control group were treated with radiotherapy, the experiment group were treated with endostar combined with paclitaxel liposome and radiotherapy simultaneously. 3 weeks for a period of treatment and the two groups were treated for 4 periods. The serum CYFRA21-1, CEA, SCCA, CA125, IL-8 levels and peripheral blood CD3+, CD4+ and CD8+ cells of the two groups before and after treatment were compared.Results:There were no significantly differences of the serum CYFRA21-1, CEA, SCCA, CA125, IL-8 levels and peripheral blood CD3+, CD4+ and CD8+ cells of the two groups before treatment. The serum CYFRA21-1, CEA, SCCA, CA125 and IL-8 levels of the two groups after treatment were significantly lower than before treatment, and that of experiment were significantly lower than control group. The peripheral blood CD3+, CD4+ cells of the two groups after treatment were significantly lower than before treatment, CD8+ cells of the two groups after treatment were significantly higher than before treatment, and that of experiment group were significantly better than control group.Conclusion: Endostar combined with paclitaxel liposome and radiotherapy simultaneously can significantly reduce the serum CYFRA21-1, CEA, SCCA, CA125 and IL-8 levels, improve peripheral blood CD3+, CD4+ and CD8+ levels of patients with advanced cervical cancer, and it was worthy clinical application.

  9. Effect of paclitaxel liposome combined with nedaplatin on serum HE4, CA125, CA19-9, AFP, CEA and T lymphocyte subsets in patients with advanced ovarian cancer

    Institute of Scientific and Technical Information of China (English)

    Su-Yu Zhu; Jie Tan; Chen-Lu Zhang; Qun-Ying Wu; Xue-Xin Xie; Hua-Fang Yin

    2016-01-01

    Objective:To study the effect of paclitaxel liposome combined with nedaplatin on serum HE4, CA125, CA19-9, AFP, CEA and T lymphocyte subsets in patients with advanced ovarian cancer.Methods:A total of 80 patients with advanced ovarian cancer in our hospital from December 2012 to December 2015 were enrolled in this study. The subjects were divided into control group (n=40) and experiment group (n=40) randomly. The control group were treated with paclitaxel and cisplatin, the experiment group were treated with paclitaxel liposome combined with nedaplatin. 21 days for a period of treatment and the two groups were treated for 3 periods. The serum HE4, CA125, CA19-9, AFP, CEA levels and peripheral blood CD3+, CD4+, CD8+ and NK cells of the two groups before and after treatment were compared. Results:There were no significantly differences of the serum HE4, CA125, CA19-9, AFP, CEA level and peripheral blood CD3+, CD4+, CD8+ and NK cells of the two groups before treatment (P>0.05). The serum HE4, CA125, CA19-9, AFP and CEA level of the two groups after treatment were significantly lower than before treatment (P<0.05), and that of experiment were significantly lower than control group (P<0.05). The peripheral blood CD3+, CD4+, CD8+and NK cells of the two groups after treatment were significantly lower than before treatment (P<0.05), and that of experiment were significantly higher than control group (P<0.05). Conclusions:Paclitaxel liposome combined with nedaplatin can significantly reduce the serum HE4, CA125, CA19-9, AFP and CEA levels, improve peripheral blood CD3+, CD4+, CD8+ and NK levels of patients with advanced ovarian cancer, and it was worthy clinical application.

  10. CEA、CA125、CYFRA21-1和NSE在肺癌中的诊断价值%Diagnostic value of CEA, CA125, CYFRA21-1, and NSE in lung cancer

    Institute of Scientific and Technical Information of China (English)

    余才华; 马志红; 李鸿伟; 沈琦斌; 费淑祎; 刘亚萍

    2013-01-01

    目的 探讨综合运用Logistic回归和受试者工作特征曲线(ROC曲线)分析四项肿瘤标志物对肺癌的诊断价值.方法 采用放射免疫法检测1 12例原发性肺癌和74例肺良性疾病患者血清中癌胚抗原(CEA)、糖类抗原-125(CA125)、细胞角蛋白片段19(CYFRA21-1)和神经元特异性烯醇化酶(NSE)的表达水平.通过Logistic回归建立回归模型,用ROC曲线分析4项肿瘤标志物在肺癌诊断中的意义.结果 肺癌患者血清中CEA、CA125、CYFRA21-1和NSE的表达水平[4.53(2.22-11.53) ng/ml、28.97(11.39-62.10) U/ml、4.05(2.29-8.18) ng/ml、14.11(11.35-24.12)ng/ml]明显高于肺良性疾病患者[2.08(1.45-2.52) ng/ml、12.90(9.80-19.44)U/ml、1.53(1.21-2.17) ng/ml、11.38(9.07-12.80) ng/ml],差异有统计学意义(均P<0.01).通过Logistic回归建立回归方程Y=1/[1 +EXP(4.902-0.394X1-0.627X2-0.165X3)],经ROC曲线分析,新变量Y的ROC曲线下面积(AUC)为0.915 ±0.020,敏感度79.46%、特异度93.24%、准确度84.95%.结论 运用Logistic回归和ROC曲线综合分析可提高肺癌的诊断.%Objective To explore the diagnostic value of four tumor markers analyzed with Logistic regression and receiver operator characteristic (ROC) curve in patients with lung cancer.Methods The serum levels of carcinoembryonic antigen (CEA) 、carbohydrate antigen 125 (CA125),cytokeratin 19 fragment (CYFRA21-1) and neuron specific enolase (NSE) were determined by radioimmunoassay in 112 patients with lung cancer and 74 patients with benign pulmonary disease.Four tumor markers were analyzed by Logistic regression and ROC curve.Results The serum levels of CEA,CA125,CYFRA21-1 and NSE in lung cancer patients were [4.53(2.22-11.53)ng/ml,28.97 (11.39-62.10) U/ml,4.05(2.29-8.18)ng/ml,14.11 (11.35-24.12) ng/ml],respectively,which were significantly higher than those in health adults[2.08 (1.45-2.52) ng/ml,12.90 (9.80-19.44) U/ml,1.53 (1.21-2.17) ng/ml,11.38 (9.07-12.80) ng/ml] (all P < 0.01).According to

  11. Studies on the value of CA125 in the assessment,treatment and prognosis of patients with chronic heart failure%血清糖类抗原125对慢性心衰患者病情评估、疗效判定及预后预测价值的研究

    Institute of Scientific and Technical Information of China (English)

    李学强; 赵立坤

    2014-01-01

    Objective To discuss the value of CA125 in the assessment,treatment and prognosis of patients with chronic heart failure. Methods Chose 120 patients with chronic heart failure and 120 patients without chronic heart failure disease. CA125, NT-proBNP and echocardiography were assayed respectively;then patients with CHF were divided into three groups (markedly effective group, effective group and ineffective group) according to different therapeutic efficacy after two weeks stan-dard heart failure therapy,then compared CA125 and NT-proBNP degree between pretherapy and post-treatment in the three different groups. Observed the difference of rehospitalization and mortality among patients with high level and low level of CA125 degree in one year follow-up visit. Results The degree of CA125 and the level of NT-proBNP in patients with CHF was re-markablely higher than the group without CHF, the cases was grouped according to the ejection fraction of ventriculus sinister, the degree of CA125 and the level of NF-proNBNP of HTPEF group and HFREF group were obviously higher than the control group. The Heart failure group was graded by NYHA,the worse that the cardiac function was,the higher level of CA125 and NF-pro BNP were. In group with CHF, CA125 level was positively correlated with NT-proBNP(r=0.72,P0.05). In one year follow-up visit,the rehospitalization and mortality in group with high CA125 level(34.04%and 17.02%) were higher than that in group with low CA125 level (14.50% and 5.80%), there were statistically significant differences between the two groups (P<0.05). Conclusion The level of CA125 is valuable in the assessment, treatment and prognosis of patients with chronic heart failure.%目的:探讨血清糖类抗原125(CA-125)对慢性心衰患者病情评估、疗效判定及预后预测的价值。方法连续选取慢性心衰患者120例(心衰组),同时选取同期住院非心衰患者120例作为对照组,测定CA125、N端B型脑钠肽前体

  12. Assessment of biological variation and analytical imprecision of CA 125, CEA, and TPA in relation to monitoring of ovarian cancer

    DEFF Research Database (Denmark)

    Tuxen, M K; Sölétormos, G; Petersen, P H

    1999-01-01

    biological variation. The aim of the study was to assess (i) the analytical imprecision (CVA) and the average inherent intra- and interindividual biological variation (CVTI and CVG, respectively) for CA 125, CEA, and TPA in a group of healthy women; (ii) the significance of changes in serial results of each...... between smokers and nonsmokers or in CA 125 and CEA concentrations between pre- and postmenopausal women. Postmenopausal women had higher TPA concentrations than premenopausal (P = 0.015). CONCLUSION: CVA and CVTI contribute considerably to the variation in serial results and should, therefore...

  13. 血清 HE4和 CA125检测及 ROMA 模型在恶性卵巢癌诊断中的应用%Application of Serum HE4 and CA125 Detection and ROMA Model in the Diagnosis of Malignant Ovarian Carcinoma

    Institute of Scientific and Technical Information of China (English)

    张先华

    2015-01-01

    Objective To study the role of serum CA125,HE4 detection and ROMA model in the diagnosis of malignant ovarian carcinoma.Methods 204 patients with gynecological pelvic mass in the treatment of surgical operation were selected, and patients were divided into the benign group and the malignant ovarian cancer group in accordance with the pathological exami-nation results,and 140 healthy women were selected as the control group,CA125,HE4 level,and the calculation of ROMA value were tested.Results CA125 and HE4 level in the malignant ovarian cancer group were (478.53 ±930.42) U/ml and (228.02 ±374.24) pmol/L,and those of the benign group were respectively (50.64 ±62.04) U/ml,(37.42 ±9.28) pmol/L.CA125, HE4 level in the malignant ovarian cancer group were significantly higher than those of the benign group,there was significant difference (P0.05).Premenopausal patients with epithelial ovarian cancer high risk ROMA≥5.6%,low risk of ROMA<5.6%;postmenopa-usal patients with epithelial ovarian cancer high risk ROMA≥17.5%,low risk of ROMA<17.50%.Premenopause group sensi-tivity,specificity,positive predictive value,and negative predictive value were 59.12%,74.68%,35.04%,88.73%,and those of the postmenopausal group were respectively 58.27%,71.43%,95.52%,14.26%,the sensitivity,specificity,positive predictive value,and negative predictive value of the total were respectively 58.51%,74.49%,67.88%,66.05%.Conclusion The serum HE4 and CA125 detection and ROMA model has clinical value in the diagnosis of malignant ovarian carcinoma,it helps early dis-covery,early diagnosis and early treatment of malignant ovarian cancer.%目的:研究血清CA125、HE4检测及ROMA模型在恶性卵巢癌诊断中的作用。方法将204例盆腔包块待查患者按照病理学检查结果分为卵巢良性病变组和恶性卵巢癌组,并选取140例健康女性作为对照组,检测所有入选女性的CA125、HE4水平,并计算ROMA值。结果恶性卵巢癌组患者CA125、HE4

  14. Pre-treatment prediction of chemoresistance in second-line chemotherapy of ovarian carcinoma: value of serological tumor marker determination (tetranectin, YKL-40, CASA, CA 125)

    DEFF Research Database (Denmark)

    Grønlund, B; Høgdall, E V S; Christensen, Ib Jarle

    2006-01-01

    for the biochemical tumor markers tetranectin, YKL-40, CASA (cancer-associated serum antigen), and CA 125. The serum tumor marker levels at time of relapse were correlated with response status at landmark time after 4 cycles of second-line chemotherapy. Univariate and multivariate logistic regression analyses...... (OR 1.8; 95% CI: 1.0-3.3; p=0.045), and CASA (OR 1.8; 95% CI: 1.2-2.7; p=0.007) had predictive value for second-line chemoresistance, whereas serum CA 125 had no predictive value. In a multivariate logistic regression analysis, serum tetranectin and CASA both had independent predictive value...... for chemoresistance. The combined determination of tetranectin and CASA had a specificity of 90% with 33% sensitivity for the prediction of chemoresistance (area under the receiver operating characteristic curve = 0.78; 95% CI: 0.66-0.91; p=0.001). CONCLUSION: Low serum levels of tetranectin, or high serum levels...

  15. Pre-treatment prediction of chemoresistance in second-line chemotherapy of ovarian carcinoma: value of serological tumor marker determination (tetranectin, YKL-40, CASA, CA 125)

    DEFF Research Database (Denmark)

    Grønlund, B; Høgdall, E V S; Christensen, Ib Jarle

    2006-01-01

    for the biochemical tumor markers tetranectin, YKL-40, CASA (cancer-associated serum antigen), and CA 125. The serum tumor marker levels at time of relapse were correlated with response status at landmark time after 4 cycles of second-line chemotherapy. Univariate and multivariate logistic regression analyses...... (OR 1.8; 95% CI: 1.0-3.3; p=0.045), and CASA (OR 1.8; 95% CI: 1.2-2.7; p=0.007) had predictive value for second-line chemoresistance, whereas serum CA 125 had no predictive value. In a multivariate logistic regression analysis, serum tetranectin and CASA both had independent predictive value...... for chemoresistance. The combined determination of tetranectin and CASA had a specificity of 90% with 33% sensitivity for the prediction of chemoresistance (area under the receiver operating characteristic curve = 0.78; 95% CI: 0.66-0.91; p=0.001). CONCLUSION: Low serum levels of tetranectin, or high serum levels...

  16. Peri and post-menopausal women with complex adnexal masses, ascites, and raised CA-125: Is it ovarian cancer or tuberculosis?

    Science.gov (United States)

    Bagga, Rashmi; Muthyala, Tanuja; Saha, Subhas Chandra; Gainder, Shalini; Saha, Pradip Kumar; Srinivasan, Radhika; Rajwanshi, Arvind; Gupta, Nalini

    2016-01-01

    Pelvic and peritoneal tuberculosis may resemble advanced ovarian cancer due to the presence of ascites, complex adnexal masses, peritoneal deposits and raised CA-125 level, especially in peri- and postmenopausal women. Other common features among women with these two conditions are abdominal pain and distension, weight loss and reduced appetite. As the treatment of pelvic-peritoneal tuberculosis is completely different from that of ovarian cancer, it is important to reach a correct diagnosis. Sometimes women with pelvic-peritoneal tuberculosis may be subjected to a laparotomy for suspected ovarian cancer which is likely to increase their morbidity. In the present article, we report ten women in the peri- and post-menopausal age group where this diagnostic dilemma arose of whom seven were diagnosed only after a laparotomy had been performed for suspected ovarian cancer due to adnexal masses with ascites and raised CA-125 level. Ascitic fluid showing lymphocytic predominance, raised ADA level and absence of malignant cells are pointers to consider the possibility of pelvic- peritoneal tuberculosis, especially in endemic countries like India. In such situations, an effort should be made to obtain a cytological or histopathological diagnosis of either condition by ultrasound guided needle biopsy or laparoscopically obtained biopsy rather that proceeding with laparotomy for suspected ovarian cancer. PMID:28096645

  17. Effects of Icodextrin and Glucose Bicarbonate/Lactate-Buffered Peritoneal Dialysis Fluids on Effluent Cell Population and Biocompatibility Markers IL-6 and CA125 in Incident Peritoneal Dialysis Patients.

    Science.gov (United States)

    Opatrná, Sylvie; Pöpperlová, Anna; Lysák, Daniel; Fuchsová, Radka; Trefil, Ladislav; Racek, Jaroslav; Topolčan, Ondrej

    2016-04-01

    Icodextrin peritoneal dialysis (PD) solution has been shown to increase interleukin-6 (IL-6) levels in PD effluent as well as leukocyte and mesothelial cell count. Mesothelial cells release cancer antigen 125 (CA125), which is used as a marker of mesothelial cell mass. This 1-year prospective study was designed to compare peritoneal effluent cell population, its inflammatory phenotype and biocompatibility biomarkers IL-6 and CA125 between icodextrin (E) and glucose bicarbonate/lactate (P) based PD solutions. Using baseline peritoneal ultrafiltration capacity, 19 stable incident PD patients were allocated either to P only (N = 8) or to P plus E for the overnight dwell (N = 11). Flow cytometry was used to measure white blood cell count and differential and the expression of inflammatory molecules on peritoneal cells isolated from timed overnight peritoneal effluents. Compared to P, E effluent showed higher leukocyte (10.9 vs. 7.9), macrophages (6.1 vs. 2.5) and mesothelial cells (0.3 vs. 0.1)×10(6) /L count, as well as expression of HLA DR on mesothelial cells and IL-6 (320.5 vs. 141.2 pg/min) on mesothelial cells and CA125 appearance rate (159.6 vs. 84.3 IU/min), all P Icodextrin PD solution activates local inflammation without systemic consequences so the clinical relevance of this observation remains obscure. Correlation between effluent IL-6 and CA125 suggests that CA125 might be upregulated due to inflammation and thus is not a reliable marker of mesothelial cell mass and/or biocompatibility. © 2016 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy.

  18. Diagnostic value of joint detection of serum CA1 9-9,CA125 and CA242 for cholangiocarci-noma%血清 CA 19-9、CA 125、CA242联合检测对胆管癌诊断价值的评价

    Institute of Scientific and Technical Information of China (English)

    崔大鹏; 韩磊; 刘振显; 杨贺; 张迎春

    2016-01-01

    Objective:To study the diagnostic value of joint detection of serum CA1 9-9,CA125 and CA242 for cholan-giocarcinoma.Methods:A total of 35 patients with cholangiocarcinoma who received surgical resection in our hospital were se-lected as malignant group;30 patients with cholelithiasis who received surgical resection in our hospital during the same period were selected as benign group.Serum samples were collected before surgery to determine CA1 9-9,CA125 and CA242 content;and cholangiocarcinoma tissue and normal bile duct tissue were collected after surgery to determine the content of proliferation and invasion molecules.Results:Serum CA1 9-9,CA125 and CA242 levels of malignant group were significantly higher than those of control group (P <0.05);PROX-1,Ki-67,Bcl-2,Bad,Gab1,LOXL2,TRPM7 and CXCL12 levels in cholangiocar-cinoma tissue were significantly higher than those in benign bile duct tissue (P <0.05);and E-cadherin level was significantly lower than that in benign bile duct tissue (P <0.05);serum CA1 9-9,CA125 and CA242 levels were positively correlated with PROX-1,Ki-67,Bcl-2,Bad,Gab1,LOXL2,TRPM7 and CXCL12 levels,and negatively correlated with E-cadherin level. Conclusions:Joint detection of serum CA1 9-9,CA125 and CA242 can not only provide reference for the diagnosis of cholangio-carcinoma,but also can provide basis for the evaluation of proliferation,invasion and other malignant biological behaviors.%目的::研究血清 CA19-9、CA125、CA242联合检测对胆管癌的诊断价值.方法:选择在我院接受手术切除的35例胆管癌患者作为恶性组,同期在我院接受手术切除的30例胆石症患者作为良性组,术前采集血清标本并测定 CA19-9、CA125、CA242含量,术后采集胆管癌组织和正常胆管组织并测定增殖、侵袭分子的含量.结果:恶性组血清中 CA19-9、CA125、CA242的含量显著高于对照组(P <0.05);胆管癌组织中 PROX-1、Ki-67、Bcl-2、Bad、Gab1、LOXL2、TRPM7、CXCL12

  19. Construction and Expression of a Single Chain Antibody Mimicing Human Ovarian Cancer Antigen CA125

    Institute of Scientific and Technical Information of China (English)

    Aidong Li; Zheng Li; Yinghong Wang; Yongming Zhang; Jie Ma

    2006-01-01

    One concept for immune therapy of cancer involves induction of antigen mimic antibodies to trigger the immune response against tumor cells. Anti-idiotypic antibodies directed against the antigen-binding site of antibodies specific for tumor antigen may functionally and even structurally mimic antigen and induce anti-anti-idiotypic immune response. Monoclonal antibody WJ02 is one of such anti-idiotypic antibodies, which contains internal image of CA125. In order to improve the immunospecificity of mAb WJ02, we constructed a single chain of mAb WJ02 in Vl-linker-Vh orientation. The scFv-WJ02 could be expressed and secreted in the recombinant Pichia pastoris system. The secreted scFv protein with a molecular weight of 30 kD retained the biological activity of mAb WJ02, which was proved by a direct binding assay and inhibition experiment. Our results indicated that the scFv-WJ02 could be used as a possible tool for idiotypic therapy against ovarian cancer, which might enhance the possibility of eliminating nonspecific responses induced by mAb WJ02.

  20. Detection of Tumor Marker CA125 in Ovarian Carcinoma Using Quantum Dots

    Institute of Scientific and Technical Information of China (English)

    Hui-Zhi WANG; Hai-Yan WANG; Ru-Qiang LIANG; Kang-Cheng RUAN

    2004-01-01

    Semiconductor quantum dots (QDs) offer several advantages over organic dyes in fluorescence-imaging applications, such as higher quantum yield, exceptional photostability, and a narrow, tunable,and symmetric emission spectrum. To explore whether QDs could specifically and effectively label tumor markers and be used in immunohistochemistry as a novel type of fluorescent probe, we used quantum dots with maximum emission wavelength 605 nm (QD605) to detect the ovarian carcinoma marker CA125 in specimens of different types (fixed cells, tissue sections, and xenograft piece). Additionally, we compared the photostability of QD signals with that of a conventional organic dye, FITC. All labeling signals of QDs were found to be more specific and brighter than those of FITC. Moreover, the QDs exhibited exceptional photostability during continuous illumination for 1 h by a high-intensity laser (Ar laser power 100 mW) at 488 nm, while the FITC signals faded very quickly and became undetectable after 24 min of illumination. These results indicate that QD-based probes can offer substantial advantages over existing fluorophores in many applications, and can be used effectively in immunohistochemistry as a novel class of fluorescent probes.

  1. Tumor necrosis factor-α and interferon-γ stimulate MUC16 (CA125) expression in breast, endometrial and ovarian cancers through NFκB.

    Science.gov (United States)

    Morgado, Micaela; Sutton, Margie N; Simmons, Mary; Warren, Curtis R; Lu, Zhen; Constantinou, Pamela E; Liu, Jinsong; Francis, Lewis L W; Conlan, R Steven; Bast, Robert C; Carson, Daniel D

    2016-03-22

    Transmembrane mucins (TMs) are restricted to the apical surface of normal epithelia. In cancer, TMs not only are over-expressed, but also lose polarized distribution. MUC16/CA125 is a high molecular weight TM carrying the CA125 epitope, a well-known molecular marker for human cancers. MUC16 mRNA and protein expression was mildly stimulated by low concentrations of TNFα (2.5 ng/ml) or IFNγ (20 IU/ml) when used alone; however, combined treatment with both cytokines resulted in a moderate (3-fold or less) to large (> 10-fold) stimulation of MUC16 mRNA and protein expression in a variety of cancer cell types indicating that this may be a general response. Human cancer tissue microarray analysis indicated that MUC16 expression directly correlates with TNFα and IFNγ staining intensities in certain cancers. We show that NFκB is an important mediator of cytokine stimulation of MUC16 since siRNA-mediated knockdown of NFκB/p65 greatly reduced cytokine responsiveness. Finally, we demonstrate that the 250 bp proximal promoter region of MUC16 contains an NFκB binding site that accounts for a large portion of the TNFα response. Developing methods to manipulate MUC16 expression could provide new approaches to treating cancers whose growth or metastasis is characterized by elevated levels of TMs, including MUC16.

  2. Menstrual Cycle Dependent Variability for Serum Tumor Markers CEA, AFP, CA 19-9, CA 125 and CA 15-3 in Healthy Women

    Directory of Open Access Journals (Sweden)

    Ayşe Binnur Erbağci

    1999-01-01

    Full Text Available Information on menstrual cycle dependent variation of tumor markers in healthy women is a subject of diagnostic efficiency and has an impact in elucidating the normal function of these markers. In this study midfollicular and midluteal concentrations of serum CEA, AFP, CA 19-9, CA 125, CA 15-3 and their relations with LH, FSH, prolactin, estradiol and progesterone were evaluated during ovulatory cycles in a group of 23 healthy female individuals. Samples were collected on the 7th and 21st day of the same menstrual cycle. Tumor marker and hormone concentrations were determined with chemiluminescence or electrochemiluminescence EIA methods. A significant phase-dependent difference was observed for CA 15-3, midluteal concentrations (mean ± SEM; 26.33 ± 1.56 U/ml higher than the midfollicular (mean ± SEM; 19.27 ± 1.49 U/ml concentrations (p < 0.001. But an obvious difference for other tumor markers investigated did not exist. Significant correlations of follicular and luteal CA 125 levels with body mass index of the subjects were observed (r:0.52, p < 0.05 and r:0.57, p < 0.005, respectively.

  3. CYFRA21-1、CEA、NSE和CA125联合检测在非小细胞肺癌中的诊断价值%The Diagnostic Value of Combined Detection of CYFRA21-1,CEA,NSE and CA125 in Non Small Cell Lung Cancer

    Institute of Scientific and Technical Information of China (English)

    邢国燕; 赵树波

    2016-01-01

    Objective:To discuss the diagnostic value of combined detection of CYFRA21-1,CEA, NSE and CA125 in non small cell lung cancer.Method:92 cases of NSCLC and 95 cases of lung benign lesions from January 2010 to June 2015 in our hospital were selected as the research objects,92 cases of NSCLC were divided into 42 cases of lung squamous cell carcinoma group and 50 cases of lung adenocarcinoma group according to the different pathological types.The levels of CYFRA21-1, CEA, NSE and CA125 in all patients were measured by electrochemical luminescence method.Result:The CYFRA21-1,CEA,NSE and CA125 in NSCLC group were significantly higher than those in benign lung disease group,the differences were statistically significant (P<0.05).The sensitivity and specificity of CYFRA21-1 were respectively 71.40% and 89.10% in lung squamous cell carcinoma group,the sensitivity and specificity of CEA were respectively 60.00% and 84.30% in lung adenocarcinoma group.The sensitivity of CYFRA21-1 in the diagnosis of NSCLC was 46.53%,specificity was 85.26%.The sensitivity of CEA in the diagnosis of NSCLC was 42.58%,specificity was 81.05%.The sensitivity of NSE in the diagnosis of NSCLC was 57.43%,specificity was 76.85%.The sensitivity of CA125 in the diagnosis of NSCLC was 48.51%,specificity was 66.32%.Combined determination of the four parameters sensitivity was 93.26%,specificity was 98.25%.Conclusion:CYFRA21-1,CEA,CA125 and NSE have certain value for the early detection and diagnosis of NSCLC,and the combined detection of the four has obvious complementarity, which can significantly improve the diagnostic rate of NSCLC.%目的:探讨细胞角蛋白19片段(CYFRA21-1)、癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)、糖类抗原125(CA125)联合检测在非小细胞肺癌(NSCLC)中的诊断价值。方法:选取2010年1月-2015年6月本院收治的NSCLC患者92例和肺部良性病变患者95例作为研究对象,92例NSCLC患者根据病理类

  4. [Preoperative digitalization. Measurement of digoxin plasma levels (author's transl)].

    Science.gov (United States)

    Geiger, H J; Rietbrock, N

    1976-09-01

    In a study of 233 patients from the department of surgery and anesthesiology taking digoxin preparations 64, per cent exhibit digoxin levels in the therapeutic range (0.6--1.5 ng/ml), 19 per cent had subtoxic concentrations ranged from 1.6--2.0 ng/ml and 7 per cent were in the toxic range (greater than 2 ng/ml). In patients treated with digoxin before admission to hospital subtherapeutic levels were most frequent. An average loading dose of digoxin 1 mg or more on one day may result in subtoxic and toxic digoxin levels on the second day, in patients receiving less than 1 mg digoxin daily an increasing frequency of plasma digoxin concentrations of 1.5 ng/ml or higher values was present on the third day. Averaged plasma digoxin concentrations were correlated with daily maintenance dose. There was, however, a wide individual variation in digoxin plasma concentrations. A low incidence of toxic digoxin plasma levels was observed in patients receiving a daily oral maintenance dose of 0.375 mg digoxin (Lanicor). For prophylactic digitalization of patients with normal renal and thyroid function the following schedules or statistical guidlines are proposed: Lanicor (bioavailability 60%): oral loading dose of 0.75 mg over two days, and then daily oral maintenance dose of 0.375 mg; Novodigal (bioavailability 80%): oral loading dose of 0.6 mg over two days and then daily oral maintenance dose of 0.3 mg; Digoxin i.v.: intravenous loading dose of 0.5 (0.4) mg over two days and then 0.25 (0.2) mg daily intravenous maintenance dose. For any patient needing treatment with digitalis glycosides therapy must be individual and dynamic. The reasons for toxic concentrations were frequently attributed to wrong dosage.

  5. The clinical significance of the combined detection of CA125 and ADA in hydrothorax in the diagnosis of tuberculous pleurisy%联合检测胸水糖类抗原125、腺苷脱氨酶在结核性胸膜炎诊断中的意义

    Institute of Scientific and Technical Information of China (English)

    庄亚琴; 高习文; 周杰

    2014-01-01

    Objective:To explore the clinical significance of the joint detection of carbohydrate antigen 125(CA125) and adenosine deaminase( ADA) in hydrothorax in the diagnosis of tuberculous pleurisy. Methods:The levels of CA125 and ADA in hydrothorax of 54 patients with tuberculous pleurisy and 40 patients with malignant pleural effusion were measured using electrochemiluminescence assay. The four tumor markers(including carcino embryonic antigen,CA199,neuron-specific enolase,cylokerain fragments21 -1 were also detected. Results:The concentrations of CA125 and ADA in hydrothorax of tuberculous pleurisy were(702. 67 ± 367. 30) u/ml and (81. 74±18. 82)u/L,respectively,whose were higher than the normal level. The sensitivity of CA125(100. 0%) was higher than that of ADA(88. 9%) in hydrothorax. The positive rates of four tumor markers were low. The sensitivity and specificity of the joint detection of CA125 and ADA could be increased to 88. 9% and 90. 75%,respectively. Conclusions:The measurement of CA125 is beneficial in the diagnosis of tuberculous pleurisy. The combined detection of CA125 and ADA can improve the diagnostic positive rate of tuberculous pleurisy,combined other tumor indexes detection can help to exclude malignant pleural effusion.%目的:探讨胸水糖类抗原125(CA125)、腺苷脱氨酶(ADA)联合检测在结核性胸膜炎诊断中的临床意义。方法:应用电化学发光法测定54例结核性胸膜炎及40例恶性胸腔积液患者胸水CA125、ADA,同时检测胸水中癌胚抗原、CA199、神经特异性烯醇化酶、细胞角质素片段抗原。结果:结核性胸膜炎患者胸水CA125的水平[(702.67依367.30)u/ml]高于正常值,胸水ADA水平[(81.74依18.82)u/L]增高,胸水CA125的灵敏度(100.0%)高于胸水ADA(88.9%)。其余4项肿瘤指标阳性率低。胸水CA125联合ADA检测有较高的灵敏度(88.9%)及特异度(90.75%)。结论:胸水CA125测定对结核性胸膜炎的诊断具有临床价值,CA125

  6. Preoperative albumin level is a marker of alveolar echinococcosis recurrence after hepatectomy

    Science.gov (United States)

    Joliat, Gaëtan-Romain; Labgaa, Ismail; Demartines, Nicolas; Halkic, Nermin

    2017-01-01

    AIM To identify a preoperative blood marker predictive of alveolar echinococcosis (AE) recurrence after hepatectomy. METHODS All consecutive patients who underwent operation for liver AE at the Lausanne University Hospital (CHUV) between January 1992 and December 2015 were included in this retrospective study. Preoperative laboratory values of leukocytes, mean corpuscular volume (MCV), red blood cell distribution width (RDW), thrombocytes, C-reactive protein (CRP) and albumin were collected and analyzed. Univariate and multivariate Cox regression analyses were performed to determine the risk factors for AE recurrence after liver resection. A receiver operating characteristic (ROC) curve was used to define the best discrimination threshold of the blood marker. Moreover, recurrence-free survival curves were calculated using the Kaplan-Meier method. RESULTS The cohort included 68 adult patients (37 females) with median age of 61 years [interquartile range (IQR): 46-71]. Eight of the patients (12%) presented a recurrence over a median follow-up time of 76 mo (IQR: 34-128). Median time to recurrence was 10 mo (IQR: 6-11). Median preoperative leukocyte, MCV, RDW, thrombocyte and CRP levels were similar between recurrent and non-recurrent cases. Median preoperative albumin level was 43 g/L (IQR: 41-45) for non-recurrent cases and 36 g/L (IQR: 33-42) for recurrent cases (P = 0.005). The area under the ROC curve for preoperative albumin level to predict recurrence was 0.840 (95%CI: 0.642-1, P = 0.002). The cut-off albumin level value was 37.5 g/L for sensitivity of 94.5% and specificity of 75%. In multivariate analysis, preoperative albumin and surgical resection margins were independent predictors of AE recurrence (HR = 0.099, P = 0.007 and HR = 0.182, P = 0.045 respectively). CONCLUSION Low preoperative albumin level was associated with AE recurrence in the present cohort. Thus, preoperative albumin may be a useful biomarker to guide follow-up. PMID:28223729

  7. Prognostic value of pre-operative serum CA 15.3 levels in breast cancer.

    Science.gov (United States)

    Martín, Arancha; Corte, Ma Daniela; Alvarez, Ana Ma; Rodriguez, Juan Carlos; Andicoechea, Alejandro; Bongera, Miguel; Junquera, Sara; Pidal, Diego; Allende, Teresa; Muñiz, José L García; Vizoso, Francisco

    2006-01-01

    CA15.3 (also known as MUCI) is the most widely used marker in breast cancer. The aim of the present work was the evaluation of the prognostic value of preoperative serum CA15.3 levels in patients with primary breast cancer. This study included 818 women with a histologically verified diagnosis of invasive breast cancer. The serum values of CA15.3 were investigated at the time of primary diagnosis by means of an immunoradiometric assay based on the "sandwich" principle. The median follow-up period of patients free of recurrence was 38 months. Pre-operative CA15.3 serum levels ranged from 6 to 452 U/ml. Elevated CA15.3 levels (>30 U/ml) were found in 15.2% of patients. Statistical analysis showed that pre-operative CA15.3 serum levels were significantly higher in patients with large size tumors (T3 or T4) (p = 0.0001), as well as in those with node-positive tumors (p = 0.0001). In the univariate analysis, high CA15.3 levels were significantly associated with a lower probability of both relapse-free and overall survival in the overall group of patients (p = 0.0001 and p = 0.004, respectively) and in the subgroup with node-positive breast cancer (p = 0.001 and p = 0.03, respectively). In addition, multivariate analysis demonstrated that pre-operative levels of the antigen were significantly and independently associated with relapse-free survival in the overall group of patients, as well as in the subgroup of patients with node-positive breast cancer (p = 0.02 and p = 0.01, respectively). These results show that high pre-operative CA15.3 levels correlate with large size tumors and the presence of lymph node metastases and suggest that this antigen could be used as an additional prognostic marker.

  8. Pre-treatment prediction of chemoresistance in second-line chemotherapy of ovarian carcinoma: value of serological tumor marker determination (tetranectin, YKL-40, CASA, CA 125).

    Science.gov (United States)

    Gronlund, B; Høgdall, E V S; Christensen, I J; Johansen, J S; Nørgaard-Pedersen, B; Engelholm, S A; Høgdall, C

    2006-01-01

    To examine if the determination of the levels of serological tumor markers at time of relapse had any predictive value for chemoresistance in the second-line treatment of ovarian cancer patients. From a registry of consecutive single-institution patients with epithelial ovarian carcinoma pretreated with paclitaxel plus platinum, we selected 82 patients with (a) solid tumor recurrence, and (b) second-line chemotherapy consisting of topotecan (platinum-resistant disease) or paclitaxel plus carboplatin (platinum-sensitive disease). Stored serum samples were analyzed for the biochemical tumor markers tetranectin, YKL-40, CASA (cancer-associated serum antigen), and CA 125. The serum tumor marker levels at time of relapse were correlated with response status at landmark time after 4 cycles of second-line chemotherapy. Univariate and multivariate logistic regression analyses (chemoresistant vs non-chemoresistant disease) were performed. At landmark time, 26% of patients had progression according to the GCIG (Gynecologic Cancer Intergroup) progression criteria. In univariate logistic regression analysis, the tumor markers tetranectin (OR 0.4; 95% CI: 0.2-0.8; p=0.008), YKL-40 (OR 1.8; 95% CI: 1.0-3.3; p=0.045), and CASA (OR 1.8; 95% CI: 1.2-2.7; p=0.007) had predictive value for second-line chemoresistance, whereas serum CA 125 had no predictive value. In a multivariate logistic regression analysis, serum tetranectin and CASA both had independent predictive value for chemoresistance. The combined determination of tetranectin and CASA had a specificity of 90% with 33% sensitivity for the prediction of chemoresistance (area under the receiver operating characteristic curve = 0.78; 95% CI: 0.66-0.91; p=0.001). Low serum levels of tetranectin, or high serum levels of CASA or YKL-40, are associated with increased risk of second-line chemoresistance in patients with ovarian cancer.

  9. 电化学发光检测CA125在妇科肿瘤中的应用

    Institute of Scientific and Technical Information of China (English)

    周红

    2002-01-01

    @@ 近年来,随着对肿瘤研究的深入,肿瘤标记物在妇科肿瘤中的鉴别诊断、疗效评估及复发监测等方面的意义越来越重要.CA125作为一种肿瘤标记物现已广泛应用于妇科疾病的诊断.电化学发光技术(ECL)与以往传统的放射免疫分析(RIA)与酶联免疫吸附试验(ELISA)相比,具有简便快速、无污染、无危害、应用范围广等优点.我院于2000年7月起应用电化学发光技术(ECL)测定第二代CA125的值,旨在探索与总结应用ECL方法监测血清CA125对妇科肿瘤的诊断与疗效评估中价值,现报告如下.

  10. Poor concordance between CA-125 and RECIST at the time of disease progression in patients with platinum-resistant ovarian cancer: analysis of the AURELIA trial.

    Science.gov (United States)

    Lindemann, K; Kristensen, G; Mirza, M R; Davies, L; Hilpert, F; Romero, I; Ayhan, A; Burges, A; Rubio, M J; Raspagliesi, F; Huizing, M; Creemers, G-J; Lykka, M; Lee, C K; Gebski, V; Pujade-Lauraine, E

    2016-08-01

    Data on CA-125 as a predictor of disease progression (PD) in ovarian cancer come predominantly from patients with platinum-sensitive disease receiving chemotherapy alone. We assessed concordance between CA-125-defined and RECIST-defined PD using data from the Gynecologic Cancer InterGroup (GCIG) randomized phase III AURELIA trial in platinum-resistant ovarian cancer (PROC). Patients with PROC were randomized to receive single-agent chemotherapy with or without bevacizumab. PD by CA-125 was defined according to GCIG criteria (except that confirmatory CA-125 measurement was not required). This exploratory analysis included patients with RECIST PD and a CA-125 reading ≤28 days before and ≤21 days after RECIST-defined PD. Of 218 eligible patients, only 94 (43%, 95% confidence interval 36% to 50%) had concordant RECIST and CA-125 PD status (42% in the chemotherapy-alone arm; 45% in the bevacizumab combination arm, P = 0.6). There was no evidence of CA-125-defined PD in the remaining 124 patients despite PD according to imaging. There were no significant differences in baseline characteristics between patients with PD defined by both RECIST and CA-125 and those with RECIST-only PD. CA-125 was even less sensitive in detecting PD in patients with early (<8 weeks after randomization) compared with later RECIST-defined PD (69% versus 53%, respectively, not meeting CA-125 criteria; P = 0.053). There was no significant difference in survival after PD in patients with concordant PD by RECIST and CA-125 versus those with PD only by RECIST. We validated our findings in an independent study population of PROC. In this platinum-resistant population, PD was typically detected earlier by imaging than by CA-125, irrespective of bevacizumab treatment. Disease status by CA-125 at the time of PD was not prognostic for overall survival. Regular radiologic assessment as well as symptom benefit assessment should be considered during PROC follow-up. © The Author 2016. Published by

  11. 血清人附睾上皮分泌蛋白4、CA125和卵巢恶性肿瘤风险模型在卵巢癌疾病中的诊断价值%The diagnosis value of serum human epididymis secretory protein 4,CA125 and risk model of ovarian malig-nancy algorithm (ROMA)inovarian cancer

    Institute of Scientific and Technical Information of China (English)

    刘康生; 陈娟; 孙二虎; 顾平清

    2016-01-01

    Objective To explore the diagnosis value of combined serum human epididymis protein 4 (HE4), carbohydrate antigen CA125 with ROMA index in ovarian cancer.Methods The patients with ovarian cancer were di-agnosed confirmed by histological examination from biopsy.Sixty -four cases of ovarian cancer (A group)and 120 cases of benign ovarian disease(B group)were selected.And 38 healthy subjects were selected as control group(C group). The difference in HE4,CA125 between the groups were analyzed,combine with with menopause status;based on the val-ue of ROMA index predicted the incidence of ovarian cancer.HE4 and CA125 were detected by enzyme -linked immu-noassay (ELISA)and chemiluminescence.Results The serum levels of HE4,CA125 and ROMA in patients with ovar-ian cancer were significantly higher than those in controls(P 0.05).The Specificity and sensitivi-ty of HE4、CA125、ROMA were 98.33%,80.80%,82.50% and 75.00%,65.62%,81.25%,respectively.The speci-ficity of HE4 was best,the sensitivity of ROMA was best.The positive rate of serum HE4 was associated with age,ROMA was associated with age and menopausal status (P <0.05).Conclusion The serum levels of HE4、CA125 and ROMA index may be a helpful method to assess the risk of epithelioid ovarian cancer.%目的:探讨血清人附睾上皮分泌蛋白4(HE4)、CA125和卵巢恶性肿瘤风险模型(ROMA)对女性卵巢癌疾病的诊断应用价值。方法选择经石蜡切片病理报告确诊的患者:卵巢癌患者64例(A 组)、卵巢良性疾病120例(B 组)、健康女性对照者38例(C 组)。比较各组 HE4、CA125水平,结合绝经状态,根据 ROMA结果预测卵巢恶性肿瘤的发病情况。血清 HE4、CA125水平检测使用酶联免疫吸附法和微粒子化学发光法。结果卵巢癌组血清 HE4、CA125水平和 ROMA 值高于健康对照组(P <0.05),盆腔良性疾病组血清 CA125水平和 ROMA 值高于健康对照组(P <0.05

  12. The Effect of the Kampo Medicine Yokukansan on Preoperative Anxiety and Sedation Levels

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    Young-Chang Arai

    2014-01-01

    Full Text Available Background. Preoperative anxiety can lead to unfavorable physiological response such as tachycardia and hypertension. Prevention of preoperative anxiety improves surgical outcome and decreases inpatient stay. Yokukansan is one of prescriptions in Kampo, traditional Japanese herbal medicine, and is known to exert anxiolytic effects. The aim of the present study was to compare the effects of diazepam and Yokukansan on preoperative anxiety, salivary amylase activity, and sedation levels. Methods. Seventy American Society of Anesthesiologists physical status I or II patients presenting for hemicolectomy under general anesthesia combined with epidural anesthesia were enrolled. The Diazepam group received diazepam 5 mg orally and the Yokukansan group received Yokukansan 2.5 g orally. Results. Although levels of anxiety and salivary amylase activity were not different between the two groups, the modified Observer’s Assessment of Alertness/Sedation Scale of the Yokukansan group was significantly higher compared to that of the Diazepam group. Conclusion. Yokukansan alleviated preoperative anxiety without undesirable sedation, when compared with diazepam.

  13. Study of human epididymis protein 4 and CA125 expressed in menstrual cycle different stage%月经周期及年龄对血清人附睾分泌蛋白4和 CA125水平的影响

    Institute of Scientific and Technical Information of China (English)

    马潇潇; 张建洁; 陈雪; 王滨; 赵玉君; 郑艳; 蒲慧然; 黄泽俊; 龙燕

    2016-01-01

    Objective To investigate the fluctuations in serum concentration of human epididymal secretory protein human epididymis -specific protein 4( HE4)during the phases of the menstrual cycle and the correlation between HE4 values and age in healthy young women. Methods Forty - five women with regular menstrual cycles were included in the study. All selected candidates are divided into two groups based on age. Blood samples were collected at follicular(FP),ovulatory(OP),and luteal(LP)phases of the hormonal cycle. Results The values of HE4 observed were 38. 9 ± 1. 2 pmol/ L(FP),45. 7 ± 1. 1 pmol/ L(OP),and 41. 9 ± 1. 2 pmol/ L(LP). The difference between FP and OP was statistically significant( P = 0. 0002). By contrast,serum CA125 levels were 13. 9 ± 0. 7 IU / ml( FP),13. 2 ± 0. 4 IU / ml( OP),and 13. 6 ± 0. 4 IU / ml(LP),respectively. The differences between the three phases of the hormonal cycle were not statistically significant( P >0. 05). The levels of HE4 observed in serum samples of women less than or equal to 35 years were 37. 6 ± 1. 3 pmol/ L in the FP,46. 7 ± 1. 3 pmol / L in the OP,and 42. 7 ± 1. 5 pmol/ L in the LP. In this group,a statistically significant difference was observed in the FP compared with the OP( P < 0. 0001). The levels of HE4 observed in serum samples of women over 35 years were 44. 2 ± 0. 8 pmol/ L in the FP,42. 3 ± 1. 7 pmol/L in the OP,and 39. 1 ± 2. 0 pmol/ L in the LP,no statistically significant difference was observed during the different hormonal phases in the group of women over 35. The levels of CA125 observed in serum samples of women less than or equal to 35 years old were 12. 8 ± 0. 7 IU/ ml in the FP,12. 5 ± 0. 7 IU/ ml in the OP,and 13. 2 ± 0. 7 IU/ ml in the LP. There wasnˊt a statistically significant difference in the group. The levels of CA125 observed in serum samples of women over 35 years were 13. 3 ± 0. 7 IU/ ml in the FP,13. 6 ± 0. 8 IU/ ml in the OP,and 13. 7 ± 0. 6 IU/ml in the LP,no statistically

  14. Prognostic Value of Preoperative Serum Levels of Periostin (PN in Early Breast Cancer (BCa

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    Pier Vitale Nuzzo

    2015-07-01

    Full Text Available PN is a secreted cell adhesion protein critical for carcinogenesis. Elevated serum levels of PN have been implicated as playing an important role in different types of cancer, and a few reports suggest a potential role as a prognostic marker. We evaluated the prognostic significance of preoperative serum PN concentration in patients with BCa receiving curative surgery. Enzyme-Linked Immunosorbent Assay (ELISA was performed to determine the preoperative serum PN level in 182 patients. The correlations between serum PN concentration with clinical pathological features and PN expression in primary tumor samples were analyzed. The prognostic impact of serum PN levels with all-cause and BCa-specific mortality was also investigated. Appropriate statistics were used. Elevated serum PN levels were significantly associated with patient age (p = 0.005, adjuvant systemic therapy (p = 0.04 and progesterone receptor (PgR status (p = 0.02. No correlation between PN preoperative serum levels and other clinical-pathological parameters, including either the epithelial or the stromal PN expression of primary tumor or the combination of the two, was found. Similarly, no association between serum PN levels and either all-cause or BCa-specific mortality was found. However, subgroup analysis revealed a correlation between higher PN serum levels and all-cause mortality in patients with node-negative disease (p = 0.05 and in those with a low PgR expression (p = 0.03. Higher levels of serum PN were also found to correlate with BCa-specific mortality in the subgroup of patients who did not receive any adjuvant systemic therapy (p = 0.04. Our findings suggest that PN was detectable in the serum of early BCa patients before surgery and increased base-line serum levels predicted worse long-term survival outcomes in specific subgroups of patients.

  15. Prognostic Value of Preoperative Serum Levels of Periostin (PN) in Early Breast Cancer (BCa).

    Science.gov (United States)

    Nuzzo, Pier Vitale; Rubagotti, Alessandra; Argellati, Francesca; Di Meglio, Antonio; Zanardi, Elisa; Zinoli, Linda; Comite, Paola; Mussap, Michele; Boccardo, Francesco

    2015-01-01

    PN is a secreted cell adhesion protein critical for carcinogenesis. Elevated serum levels of PN have been implicated as playing an important role in different types of cancer, and a few reports suggest a potential role as a prognostic marker. We evaluated the prognostic significance of preoperative serum PN concentration in patients with BCa receiving curative surgery. Enzyme-Linked Immunosorbent Assay (ELISA) was performed to determine the preoperative serum PN level in 182 patients. The correlations between serum PN concentration with clinical pathological features and PN expression in primary tumor samples were analyzed. The prognostic impact of serum PN levels with all-cause and BCa-specific mortality was also investigated. Appropriate statistics were used. Elevated serum PN levels were significantly associated with patient age (p = 0.005), adjuvant systemic therapy (p = 0.04) and progesterone receptor (PgR) status (p = 0.02). No correlation between PN preoperative serum levels and other clinical-pathological parameters, including either the epithelial or the stromal PN expression of primary tumor or the combination of the two, was found. Similarly, no association between serum PN levels and either all-cause or BCa-specific mortality was found. However, subgroup analysis revealed a correlation between higher PN serum levels and all-cause mortality in patients with node-negative disease (p = 0.05) and in those with a low PgR expression (p = 0.03). Higher levels of serum PN were also found to correlate with BCa-specific mortality in the subgroup of patients who did not receive any adjuvant systemic therapy (p = 0.04). Our findings suggest that PN was detectable in the serum of early BCa patients before surgery and increased base-line serum levels predicted worse long-term survival outcomes in specific subgroups of patients.

  16. 血清CEA、CA-199、CA-125检测对胃癌诊断价值分析

    Institute of Scientific and Technical Information of China (English)

    邹洪南

    2012-01-01

    目的探讨CEA、CA-199、CA-125检测在胃癌诊断中的应用价值.方法采用电化学发光方法对95的侧胃癌患者检测CEA、CA-199、CA-125.结果胃癌患者血清CEA、CA-199、CA-125阳性率分别为31.7%、43.9%、38.6%.CEA+CA-199+CA-125联合检测阳性率79.9%.结论多项肿癌标志物联检可提高胃癌的阳性检出率.

  17. Preoperative pain level and patient expectation predict hospital length of stay after total hip arthroplasty.

    Science.gov (United States)

    Halawi, Mohamad J; Vovos, Tyler J; Green, Cindy L; Wellman, Samuel S; Attarian, David E; Bolognesi, Michael P

    2015-04-01

    The purpose of this study was to identify preoperative predictors of length of stay after primary total hip arthroplasty in a patient population reflecting current trends toward shorter hospitalization and using readily obtainable factors that do not require scoring systems. A retrospective review of 112 consecutive patients was performed. High preoperative pain level and patient expectation of discharge to extended care facilities (ECFs) were the only significant multivariable predictors of hospitalization extending beyond 2 days (P=0.001 and Pexpectation remained significant after adjusting for Medicare's 3-day requirement for discharge to ECFs (P<0.001). The study was adequately powered to analyze the variables in the multivariable logistic regression model, which had a concordance index of 0.857.

  18. Diagnostic value of the neutrophil-to-lymphocyte ratio and the combination of serum CA-125 for stages Ⅲ and Ⅳ endometriosis

    Institute of Scientific and Technical Information of China (English)

    YANG Hua; LANG Jing-he; ZHU Lan; WANG Shu; SHA Gui-hua; ZHANG Ying

    2013-01-01

    Background Currently,all the diagnostic indicators for endometriosis lack perfect sensitivity and specificity.According to the characteristic of endometriosis,we analyzed the new biomarker neutrophil-to-lymphocyte ratio (NLR) and the combination of NLR and serum CA-125 to investigate their diagnostic value for identifying stages Ⅲ and Ⅳ endometriosis.Methods The values of serum CA-125 and routine blood tests were collected from 197 patients with endometriosis,102 with benign tumors and 112 healthy individuals.We investigated the sensitivity and specificity of NLR and its combination with serum-CA-125 for diagnosing stages Ⅲ and Ⅳ endometriosis by using receiver operating characteristic (ROC).Results The mean values of NLR,the combination of serum CA-125 and NLR (combination) of the groups with stages Ⅲ and Ⅳ endometriosis were significantly higher than the other two groups.Serum CA-125,NLR,and the combined biomarkers could significantly discriminate the stages Ⅲ and Ⅳ endometriosis group from the other two groups (P<0.05).NLR shows a lower sensitivity of 57.9% and specificity of 65.2% with a cutoff value at 1.82.And the combination of biomarkers has the highest AUC of 0.949 with a sensitivity of 86.8% and specificity of 92.0% at the cutoff value of 44.40.In addition,for patients with negative CA-125,55.36% and 53.57% of the patients were able to be diagnosed with endometriosis by using NLR alone and the combination of biomarkers.Conclusion For diagnosing stages Ⅲ and Ⅳ endometriosis,the neutrophil-to-lymphocyte ratio is a better adjuvant to serum CA-125,and the neutrophil-to-lymphocyte ratio is valuable in diagnosing stages Ⅲ and Ⅳ endometriosis for patients with negative serum CA-125.

  19. 沙利度胺联合化疗对晚期卵巢癌患者血清VEGF、bFGF、TNF-α及CA125水平影响的研究%Effects on VEGF,bFGF,TNF-α and CA125 in advanced ovarian cancer patients treated with Thalidomide combined with chemotherapy

    Institute of Scientific and Technical Information of China (English)

    杨鑫磊; 刘文; 宿星; 李娜; 王于理; 巩平

    2012-01-01

    paclitaxel + carboplatin was executed on patients of advanced ovarian cancer. Method: Thirty patients of advanced ovarian cancer treated in First Affili-reatated Hospital of Shihezi University School of Medicine were randomly divided into Thalidomide group ( n = 15) and the control group ( n = 15 ) . The Thalidomide group was treated in the new therapy of paclitaxel + carboplatin + thalidomide while the control group paclitaxel + carboplatin. To collect the venous blood before and after two cycles of chemotherapy. Then to detect the detection of level index include VEGF,TNF - α, bFGF and CA125 with ELISA (enzyme linked immunosorbent assay). Results :Toxicity in the two groups had no significant difference in the prem-ise of thalidomide group was 66. 67% ,clinical benefit rate of 93. 33% ; the control group was 33. 33% .clinical bene-fit rate of 86. 67% . Thalidomide group was with the total efficiency and higher benefit rates, the efficiency difference between the two groups was statistically significant (P0. 05). Two groups of patients before and after treatment serum,VEGF,bFGF,TNF - α and CA125 levels change significantly (P0. 05) . Conclusion;This new therapy : thalidomide plus the chemotherapy regimen of paclitaxel + carbopla-tin can increase curative effect to patients with advanced ovarian cancer and does not increase the drug toxicity.

  20. Factors associated with preoperative anxiety levels of Turkish surgical patients: from a single center in Ankara

    Science.gov (United States)

    Erkilic, Ezgi; Kesimci, Elvin; Soykut, Cem; Doger, Cihan; Gumus, Tülin; Kanbak, Orhan

    2017-01-01

    Background Preoperative anxiety and stress are undoubtedly a difficult experience in patients undergoing elective surgery. These unpleasant sensations depend on several factors. The objective of this study was to evaluate the preoperative anxiety levels in a sample of Turkish population, as well as the underlying causes using the Spielberger State-Trait Anxiety Inventory (STAI anxiety) scale. Methods The study was conducted according to the Declaration of Helsinki and was approved by the local ethical committee. All participants gave written informed consent upon having received detailed information on the study. Upon entry in the study, state and trait anxiety questionnaires were completed by 186 patients scheduled for elective surgery. The influencing factors in regard to age, sex, educational status and others were also reported. Results There was a statistically significant positive correlation between state and trait anxiety scores in this Turkish population. While the most important predictive factors that affected state-STAI scores were age, sex and duration of sleep the night before surgery; educational status and age were the best predictors for determining the variation in trait-STAI scores. Conclusion The factors affecting anxiety levels in different populations might vary among different countries. Interestingly, in this sample of Turkish population, the trait anxiety levels were found to be higher from state-anxiety levels, especially in women and less educated people. Thus, doubts about operation and anesthesia are overlooked. This could be attributed to the low to intermediate life standards of people admitted to our hospital. PMID:28280304

  1. Prognostic associations of preoperative plasma levels of fibrinogen and D-dimer after curative resection in patients with colorectal cancer

    Institute of Scientific and Technical Information of China (English)

    王俊锋

    2013-01-01

    Objective To explore the associations of preoperative plasma levels of fibrinogen and D-dimer with clinico-pathologic parameters and overall survival in colorectal cancer patients after curative resection.Methods From

  2. Clinical and Prognostic Significance of Preoperative Plasma Fibrinogen Levels in Patients with Operable Breast Cancer.

    Directory of Open Access Journals (Sweden)

    Yu Mei

    Full Text Available Elevated plasma fibrinogen levels are associated with tumor progression and poor outcomes in different cancer patients. The objective of this study was to investigate the clinical and prognostic value of preoperative plasma fibrinogen levels in patients with operable breast cancer.Two hundred and twenty-three patients diagnosed with breast cancer were retrospectively evaluated in this study. Plasma fibrinogen levels were examined before treatment and analyzed along with patient clinicopathological parameters, disease-free survival (DFS and overall survival (OS. Both univariate and multivariate analyses were performed to identify the clinicopathological parameters associated with DFS and OS.Elevated preoperative plasma fibrinogen levels were directly associated with age of diagnose (≤47 vs. >47, p<0.001, menopause (yes vs. no, p<0.001, tumor size (T1&T2 vs. T3&T4, p = 0.033, tumor stage (I vs. II vs. III, p = 0.034 and lymph node involvement (N = 0 vs. 1≤N≤3 vs. N≥4, p<0.001, but not with histological grade, molecular type and other Immunohistochemical parameters (ER, PR, HER2 and Ki-67. In a univariate survival analysis, tumor stage, tumor size, lymph node involvement (p<0.001/p<0.001 and plasma fibrinogen (p<0.001/p<0.001 levels were associated with disease-free and overall survival, but just lymph nodes involvement (p<0.001, hazard ratio [HR] = 2.9, 95% confidence interval [CI] = 1.6-5.3/p = 0.006, HR = 3.2, 95% CI = 1.4-7.3 and plasma fibrinogen levels (p = 0.006, HR = 3.4, 95% CI = 1.4-8.3/p = 0.002, HR = 10.1, 95% CI = 2.3-44.6 were associated with disease-free and overall survival in a multivariate survival analysis, respectively.This study demonstrates that elevated preoperative plasma fibrinogen levels are associated with breast cancer progression and are independently associated with a poor prognosis in patients with operable breast cancer.

  3. Elevated Preoperative Serum Hs-CRP Level as a Prognostic Factor in Patients Who Underwent Resection for Hepatocellular Carcinoma.

    Science.gov (United States)

    Liu, Yu-Bin; Ying, Jie; Kuang, Su-Juan; Jin, Hao-Sheng; Yin, Zi; Chang, Liang; Yang, Hui; Ou, Ying-Liang; Zheng, Jiang-Hua; Zhang, Wei-Dong; Li, Chuan-Sheng; Jian, Zhi-Xiang

    2015-12-01

    To evaluate the effects of preoperative highly sensitive C-reactive protein (Hs-CRP) in serum on the prognostic outcomes of patients with hepatocellular carcinoma (HCC) following hepatic resection in Chinese samples.From January 2004 to December 2008, a total of 624 consecutive HCC patients who underwent hepatic resection were incorporated. Serum levels of Hs-CRP were tested at preoperation via a collection of venous blood samples. Survival analyses adopted the univariate and multivariate analyses.In our study, among the 624 screened HCC patients, 516 patients were eventually incorporated and completed follow-up. Positive correlations were found regarding preoperative serum Hs-CRP level and tumor size, Child-Pugh class, or tumor stage (all P Hs-CRP levels at preoperation (both P Hs-CRP-normal group, the overall survival (OS) and recurrence-free survival rates were evidently decreased in the Hs-CRP-elevated group. Further, preoperative serum Hs-CRP level might be having possible prediction effect regarding survival and recurrence of HCC patients after hepatic section in the multivariate analysis.Preoperative increased serum Hs-CRP level was an independent prognostic indicator in patients with HCC following hepatic resection in Chinese samples.

  4. Performance of biomarkers SMRP, CA125, and CYFRA 21-1 as potential tumor markers for malignant mesothelioma and lung cancer in a cohort of workers formerly exposed to asbestos

    Energy Technology Data Exchange (ETDEWEB)

    Gube, M. [RWTH Aachen University, Institute for Occupational and Social Medicine, Medical Faculty, Aachen (Germany); Westfaelische Technische Hochschule, Institut fuer Arbeitsmedizin und Sozialmedizin am Universitaetsklinikum Aachen, Rheinisch, Aachen (Germany); Taeger, D.; Weber, D.G.; Pesch, B.; Johnen, G.; Gross, I.M.; Wiethege, T.; Weber, A.; Bruening, T. [Institute of the Ruhr-Universitaet Bochum (IPA), Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Bochum (Germany); Brand, P.; Mueller-Lux, A.; Kraus, T. [RWTH Aachen University, Institute for Occupational and Social Medicine, Medical Faculty, Aachen (Germany); Raithel, H.J. [University of Erlangen-Nuremberg, Institute for Occupational, Social and Environmental Medicine, Erlangen-Nuremberg (Germany)

    2011-03-15

    The aim of the study is to examine the cancer-predictive values of SMRP (soluble mesothelin-related peptides), CA125, and CYFRA21-1 as potential tumor markers for lung cancer and malignant mesothelioma in a cohort of workers formerly exposed to asbestos. A voluntary surveillance program has been established for German workers with former asbestos exposure. A subgroup of 626 subjects with a mean age of 63 years (range 53-70 years) at baseline was enrolled in an extended health examination program with high-resolution computer tomography (HRCT) of the chest and blood drawing between 1993 and 1997. Serum concentrations of SMRP, CA125, and CYFRA21-1 were measured in archived serum samples in 2005 and 2006. A mortality follow-up was conducted through 2007. So far, 12 cases with lung cancer and 20 cases with malignant mesothelioma have been observed in this cohort. The average time between sample collection and diagnosis was 4.7 years. Analyzed biomarkers showed low sensitivities (5-25%) and positive predictive values (4-30%) for both cancer sites. Marker combinations resulted in sensitivities between 5 and 50% and positive predictive values ranging from 3 to 14%. Even in those cases, where biomarker concentrations were available within 36 months before diagnosis, no trend for increasing biomarker levels was observed. The analyzed tumor markers were characterized by high specificities, but low sensitivities. SMRP, CA125, and CYFRA21-1 alone or in combination were less suitable to serve as predictors for the diagnosis of lung cancer or malignant mesothelioma. However, a prospective study with annual sampling might reveal a better predictive value of these markers. (orig.)

  5. 健康女性绝经前后血清 HE4、CA125及 ROMA 参考值调查

    Institute of Scientific and Technical Information of China (English)

    李秋荣; 李建军

    2015-01-01

    目的:调查并建立本地区健康女性血清 HE4、CA125及 ROMA 参考值。方法利用化学发光免疫测定法检测健康女性血清 HE4和 CA125的水平,计算 ROMA 值。结果健康女性绝经前血清 HE4、CA125和 ROMA 值的95%可信区间分别为(41.6±22.4)pmol/L、(13.5±10.2)U /ml、(5.1±3.8)%。健康女性绝经后血清 HE4、CA125和 ROMA 值的95%可信区间分别为(49.9±23.2)pmol/L、(10.2±9.6)U /ml、(18.9±9.6)%。与绝经前女性相比,绝经后健康女性HE4、CA125浓度降低,ROMA 值增加,差异有统计学意义(P <0.05)。结论通过对180例健康女性的血清 HE4、CA125浓度以及 ROMA 值进行调查,制定出本地区血清 HE4、CA125浓度以及 ROMA 值95%参考区间,为评估当地健康女性HE4、CA125、ROMA 水平及建立相应的参考值提供了参考。

  6. Clinical significance of preoperative carcinoembryonic antigen level in patients with clinical stage IA non-small cell lung cancer

    Science.gov (United States)

    Suda, Takashi; Hachimaru, Ayumi; Tochii, Daisuke; Tochii, Sachiko; Takagi, Yasushi

    2017-01-01

    Background The objective of this study was to assess the preoperative serum carcinoembryonic antigen (CEA) level in patients with clinical stage IA non-small cell lung cancer (NSCLC) and to evaluate its clinical significance. Methods Between January 2005 and December 2014, a total of 378 patients with clinical stage IA NSCLC underwent complete resection with systematic node dissection. The survival rate was estimated starting from the date of surgery to the date of either death or the last follow-up by the Kaplan-Meier method. Univariate analyses by log-rank tests were used to determine prognostic factors. Cox proportional hazards ratios were used to identify independent predictors of poor prognosis. Clinicopathological predictors of lymph node metastases were evaluated by logistic regression analyses. Results The 5-year survival rate of patients with an elevated preoperative serum CEA level was significantly lower than that of patients with a normal CEA level (75.5% vs. 87.7%; P=0.02). However, multivariate analysis did not show the preoperative serum CEA level to be an independent predictor of poor prognosis. Postoperative pathological factors, including lymphatic permeation, visceral pleural invasion, and lymph node metastases, tended to be positive in patients with an elevated preoperative serum CEA level. In addition, the CEA level was a statistically significant independent clinical predictor of lymph node metastases. Conclusions The preoperative serum CEA level was not an independent predictor of poor prognosis in patients with pathological stage IA NSCLC but was an important clinical predictor of tumor invasiveness and lymph node metastases in patients with clinical stage IA NSCLC. Therefore, measurement of the preoperative serum CEA level should be considered even for patients with early-stage NSCLC.

  7. CA125、CYFRA21-1、HPV 联合检测 TCT 诊断宫颈癌的临床价值%Clinical value of CA125,CYFRA21-1,HPV detection combined with TCT in diagnosis of cervical cancer

    Institute of Scientific and Technical Information of China (English)

    黄伟强; 杨艳梅

    2015-01-01

    Objective To investigate the value of cytokeratin fragment antigen 21‐1(CYFRA21‐1) ,carbohydrate antigen‐125 (CA125) ,human papillomavirus (HPV ) detection with Thinprep cytologic test (TCT ) in the diagnosis of cervical cancer . Methods 70 patients with cervical cancer ,60 patients with benign cervical diseases and 70 healthy people were selected .CYFRA21‐1 ,CA125 ,HPV detection and TCT results were analyzed .Results The positive rates of HPV ,TCT ,CA125 and CYFRA21‐1 in cervical cancer group were significantly higher than those in cervical benign lesion group and the healthy group ,the difference were statistically significant (P TSGF>CEA>SIL‐2R .The specificity was CYFRA21‐1> TCT>CA125> HPV .In HPV ,TCT ,CA125 and CYFRA21‐1parallel diagnostic test ,the sensitivity was up to 100 .00% ,and in series diagnostic test ,the specificity was up to 98 .3% .Conclu‐sion HPV ,CA125 ,CYFRA21‐1 detection combined with TCT in diagnosis of cervical cancer has strong reliability ,it is worth u‐sing w idely in clinic .%目的:探讨细胞角蛋白21‐1(CYFRA21‐1)、糖类抗原‐125(CA125)、人乳头瘤病毒(HPV)检测联合新柏氏液基细胞学检查(TCT)在宫颈癌诊断的临床价值。方法选取宫颈癌患者70例,宫颈良性疾病60例和同期检查的健康者70例作为健康组,对3组人群CYFRA21‐1、CA125、HPV检测与TCT结果进行分析。结果 HPV、TCT、CA125与CYFRA21‐1在宫颈癌患者中检出阳性率明显高于宫颈良性病变组和健康组,差异有统计学意义(P<0.01);HPV、TCT、CA125与CYFRA21‐1诊断宫颈癌的敏感度从大到小依次为 TCT、CYFRA21‐1、CA125、HPV ,特异度从高到低分别是 CYFRA21‐1、TCT、CA125、HPV。 HPV、TCT、CA125与CYFRA21‐1进行并联诊断试验中敏感度高达100.00%,在串联诊断试验中特异度高达98.3%。结论 HPV、CA125、CYFRA21‐1检测与TCT联合诊断宫颈癌具有较强的可靠性

  8. HE4、CA125联合ROMA在卵巢癌及盆腔良性疾病中的诊断意义

    Institute of Scientific and Technical Information of China (English)

    吴学炜; 付光宇; 王瑞; 史小芹; 胡秀丽

    2012-01-01

    目的 探讨血清中人附睾上皮分泌蛋白4(HE4)、CA125水平和卵巢恶性肿瘤风险模型(ROMA)对卵巢癌及盆腔良性疾病的诊断意义.方法 共检测卵巢癌患者68例、卵巢良性疾病135例、健康女性对照者40例,比较各组HE4、CA125水平,结合绝经状态,根据ROMA值预测卵巢恶性肿瘤的发病风险.结果 卵巢癌组血清HE4、CA125水平和ROMA值高于健康对照组(P均<0.05),盆腔良性疾病组血清CA125水平和ROMA值高于健康对照组(P均<0.05),盆腔良性疾病组HE4水平与健康对照组差异无统计学意义(P>0.05).HE4、CA125和ROMA值的敏感性分别为76.47%、70.59%、85.29%,特异性分别为98.52%、74.81%、78.52%,ROMA值敏感性最好,HE4特异性最好.ROMA值绝经前后敏感性分别为73.33%和88.68%,特异性分别为77.36%和82.76%.结论 HE4可作为CA125单项检测卵巢癌的很好补充,且HE4在鉴别盆腔良恶性疾病中具有重要诊断价值,而ROMA值风险预测的敏感性和诊断符合率较HE4和CA125单项高,在临床上可以帮助评估患上皮细胞型卵巢癌的风险性.

  9. A comparison of CA125, HE4, risk ovarian malignancy algorithm (ROMA, and risk malignancy index (RMI for the classification of ovarian masses

    Directory of Open Access Journals (Sweden)

    Cristina Anton

    2012-01-01

    Full Text Available OBJECTIVE: Differentiation between benign and malignant ovarian neoplasms is essential for creating a system for patient referrals. Therefore, the contributions of the tumor markers CA125 and human epididymis protein 4 (HE4 as well as the risk ovarian malignancy algorithm (ROMA and risk malignancy index (RMI values were considered individually and in combination to evaluate their utility for establishing this type of patient referral system. METHODS: Patients who had been diagnosed with ovarian masses through imaging analyses (n = 128 were assessed for their expression of the tumor markers CA125 and HE4. The ROMA and RMI values were also determined. The sensitivity and specificity of each parameter were calculated using receiver operating characteristic curves according to the area under the curve (AUC for each method. RESULTS: The sensitivities associated with the ability of CA125, HE4, ROMA, or RMI to distinguish between malignant versus benign ovarian masses were 70.4%, 79.6%, 74.1%, and 63%, respectively. Among carcinomas, the sensitivities of CA125, HE4, ROMA (pre-and post-menopausal, and RMI were 93.5%, 87.1%, 80%, 95.2%, and 87.1%, respectively. The most accurate numerical values were obtained with RMI, although the four parameters were shown to be statistically equivalent. CONCLUSION: There were no differences in accuracy between CA125, HE4, ROMA, and RMI for differentiating between types of ovarian masses. RMI had the lowest sensitivity but was the most numerically accurate method. HE4 demonstrated the best overall sensitivity for the evaluation of malignant ovarian tumors and the differential diagnosis of endometriosis. All of the parameters demonstrated increased sensitivity when tumors with low malignancy potential were considered low-risk, which may be used as an acceptable assessment method for referring patients to reference centers.

  10. The effect of preoperative serum triglycerides and high-density lipoprotein-cholesterol levels on the prognosis of breast cancer.

    Science.gov (United States)

    Li, Xing; Tang, Hailin; Wang, Jin; Xie, Xinhua; Liu, Peng; Kong, Yanan; Ye, Feng; Shuang, Zeyu; Xie, Zeming; Xie, Xiaoming

    2017-04-01

    Although dyslipidemia has been documented to be associated with several types of cancer including breast cancer, it remains uncertainty the prognostic value of serum lipid in breast cancer. The purpose of this study is to evaluate the association between the preoperative plasma lipid profile and the prognostic of breast cancer patients. The levels of preoperative serum lipid profile (including cholesterol [CHO], Triglycerides [TG], high-density lipoprotein-cholesterol [HDL-C], low-density lipoprotein-cholesterol [LDL-C], apolipoprotein A-I [ApoAI], and apolipoprotein B [ApoB]) and the clinical data were retrospectively collected and reviewed in 1044 breast cancer patients undergoing operation. Kaplan-Meier method and the Cox proportional hazards regression model were used in analyzing the overall survival [OS] and disease-free survival [DFS]. Combining the receiver-operating characteristic and Kaplan-Meier analysis, we found that preoperative lower TG and HDL-C level were risk factors of breast cancer patients. In multivariate analyses, a decreased HDL-C level showed significant association with worse OS (HR: 0.528; 95% CI: 0.302-0.923; P = 0.025), whereas a decreased TG level showed significant association with worse DFS (HR: 0.569; 95% CI: 0.370-0.873; P = 0.010). Preoperative serum levels of TG and HDL-C may be independent factor to predict outcome in breast cancer patient. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. 卵巢癌患者血清TGF-α、TGF-β1和CA125的检测及意义%Significance of the determination of serum TGF-α, TGF-β1 and CA125 in patients with ovarian cancer

    Institute of Scientific and Technical Information of China (English)

    叶蔚; 车小群

    2005-01-01

    目的探讨卵巢癌患者血清中TGF-α、TGF-β1和CA125与卵巢癌患者预后的相互关系.方法采用放射免疫测定法和酶联免疫吸附法检测57例卵巢癌患者(恶性组)术前术后血清中TGF-α、TGF-β1和CA125水平,设52例卵巢良性肿瘤患者(良性组)及55名正常妇女(正常组)为对照组.结果恶性组术前TGF-α、TGF-β1、CA125水平比良性组及正常组明显增高(P均<0.01);术后TGF-α、CA125水平明显降低,TGF-β1水平明显升高(P均<0.01).结论检测卵巢癌患者血清中TGF-α、TGF-β1和CA125水平对判断患者预后有重要价值.

  12. 血清HE4、CA125及ROMA指数在卵巢癌诊断中的价值评价%Performance evaluation of serum HE4, CA125 and risk of ovarian malignancy algorithm in ovarian tumor

    Institute of Scientific and Technical Information of China (English)

    高岚; 许泼实; 张福明

    2015-01-01

    目的 探讨血清人附睾分泌蛋白4、CA125检测及ROMA指数鉴别诊断上皮性卵巢癌的临床应用价值.方法 分别采用ELISA法和微粒子化学发光法测定46例上皮性卵巢癌患者(EOC)、49例良性肿瘤患者和50例健康体检者血清HE4、CA125水平,计算出ROMA指数.结果 EOC与健康对照组相比,HE4、CA125及ROMA指数诊断上皮性卵巢癌的AUC分别为0.915、0.818和0.948;EOC与良性肿瘤相比,HE4、CA125及ROMA指数诊断卵巢恶性肿瘤的AUC分别为0.833、0.755和0.870.结论 人附睾分泌蛋白4是一种有效的卵巢癌肿瘤标志物,联合CA125检测计算ROMA指数可显著提高卵巢癌的诊断效率.

  13. Preoperative anemia does not predict complications after single-level lumbar fusion: a propensity score-matched multicenter study.

    Science.gov (United States)

    Kim, Bobby D; Edelstein, Adam I; Patel, Alpesh A; Lovecchio, Francis; Kim, John Y S

    2014-11-01

    Multicenter retrospective cohort study. To estimate the impact of preoperative anemia on 30-day complications in patients undergoing single-level lumbar fusion. Anemia has been widely implicated as a risk factor in various surgical procedures including elective spine surgery. No large-scale study has been performed to examine this relationship in single-level lumbar fusion surgery. The American College of Surgeons National Surgical Quality Improvement Program database was retrospectively reviewed to identify all patients who underwent single-level lumbar fusion procedures during 2006 to 2011. A propensity score-matching algorithm was used to match scores of anemic patients with that of nonanemic patients. Multivariate logistic regression analysis of unadjusted and propensity score-matched cohorts was performed to examine the effect of preoperative anemia on 30-day postoperative complication rates and length of hospital stay. A total of 2960 patients met inclusion criteria. The propensity score-matching procedure yielded scores of 491 pairs of well-matched nonanemic and anemic patients. The multivariate analysis of propensity score-matched population found preoperative anemia to carry no significant association with any of the complications analyzed, including overall complications, medical complications, surgical complications, reoperation, mortality, or length of total hospital stay. For patients undergoing single-level lumbar fusion, preoperative anemia is not independently associated with increased risk of 30-day complications or increased length of stay. Further studies are needed to independently validate this relationship in other spine surgical procedures. 3.

  14. Patient-, treatment-, and facility-level structural characteristics associated with the receipt of preoperative lower extremity amputation rehabilitation.

    Science.gov (United States)

    Bates, Barbara E; Hallenbeck, Richard; Ferrario, Toni; Kwong, Pui L; Kurichi, Jibby E; Stineman, Margaret G; Xie, Dawei

    2013-01-01

    To determine patient, treatment, or facility characteristics that influence decisions to initiate a rehabilitation assessment before transtibial or transfemoral amputation within the Veterans Affairs (VA) health care system. Retrospective database study. VA medical centers. A total of 4226 veterans with lower extremity amputations discharged from a VA medical center between October 1, 2002, and September 30, 2004. Evidence of a preoperative rehabilitation assessment after the index surgical stay admission but before the surgical date. Evidence was found that 343 of 4226 veterans (8.12%) with lower extremity amputations received preoperative rehabilitation assessments. Veterans receiving preoperative rehabilitation were more likely to be older, admitted from home, or transferred from another hospital. Patients who underwent surgical amputation at smaller-sized hospitals or in the South Central or Mountain Pacific regions were more likely to receive preoperative rehabilitation compared with patients in mid-sized hospitals or in the Northeast, Southeast, or Midwest regions. Patients with evidence of paralysis, patients treated in facilities with programs accredited by the Commission on Accreditation of Rehabilitation Facilities (P facility-level structural characteristics, we found that older patients were more likely to receive preoperative rehabilitation services (odds ratio [OR] 1.01, 95% confidence interval [CI] 1.01-1.02). Patients with a contributing amputation etiology of a previous amputation complication were more likely to receive preoperative consultation rehabilitation services (OR 1.50, 95% CI 1.02-2.19) compared with patients who did not have this etiology. Compared with patients treated in the Southeast region of the United States, those treated in the South Central region (OR 2.52, 95% CI 1.82-3.48) or Mountain Pacific region (OR 1.62, 95% CI 1.11-2.37) were more likely to receive preoperative consultation rehabilitation services. Patients with

  15. PPARγ Modulation of Cytokine-Stimulated MUC16 (CA125) Expression in Breast and Ovarian Cancer-Derived Cells.

    Science.gov (United States)

    Morgado, Micaela; Carson, Daniel D

    2017-01-01

    CA125 is serum tumor marker consisting of an epitope carried by a portion of the extremely large (>3 MDa), heavily glycosylated cell surface transmembrane mucin, MUC16. In malignancies, membrane bound mucins lose their polarized distribution, become aberrantly over-expressed and protect tumor cells from the actions of chemotherapeutic agents as well as the immune system. Previously, we described stimulation of MUC16 expression by the proinflammatory cytokines, tumor necrosis factor α (TNFα) and interferon γ (IFNγ), in breast and ovarian cancer cells and tissues. Herein, we show that PPARγ modulates cytokine-stimulated MUC16 in a complex manner: at low concentrations (20 µM) rosiglitazone antagonizes cytokine stimulation. Rosiglitazone actions were fully reversible by the PPARγ antagonist, GW9662. Furthermore, siRNA-mediated PPARγ knockdown also prevented a large portion of high dose rosiglitazone suppression of MUC16 expression indicating that rosiglitazone inhibition is largely PPARγ-dependent. Cytokines greatly (>75%) suppressed PPARγ expression. Conversely, PPARγ activation by rosiglitazone at either low or high concentrations greatly (>75%) suppressed NFκB/p65 expression. NFκB/p65 expression was largely preserved in the presence of cytokines at low, but not high, rosiglitazone concentrations accounting for the different concentration dependent effects on MUC16 expression. Collectively, these studies demonstrate that PPARγ is an important modulator of MUC16 expression. The ability to deliver high doses of PPARγ agonists to MUC16-expressing tumors offers an avenue to reduce expression of this protective glycoprotein and increase tumor sensitivity to killing by chemotherapeutic drugs and the immune system. J. Cell. Biochem. 118: 163-171, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  16. Preoperative, high IL-6 blood level is a risk factor of postoperative delirium onset in old patients

    Directory of Open Access Journals (Sweden)

    Miriam eCapri

    2014-10-01

    Full Text Available Background: Postoperative delirium (POD is a common complication in elderly patients undergoing surgery, but the underpinning causes are not clear. We hypothesized that inflammaging, the subclinical low and chronic grade inflammation characteristic of old people, can contribute to POD onset. Accordingly, we investigated the association of preoperative and circulating cytokines in elderly patients (>65 yrs, admitted for elective and emergence surgery.Methods: This is secondary analysis of a sub-cohort of patients belonging to a previous large case-control study, where 351 patients were clinically and cognitively thoroughly characterized, together with the assessment of POD (47 patients by Confusion Assessment Method (CAM and Delirium Rating Scale (DRS. 74 preoperative plasma samples were selected from a larger bio-bank and they included 37 subjects with POD and 37 without POD. Inflammaging related cytokines, i.e. IL-1 β, IL-2, IL-6, IL-8, IL-10 and TNF-α were assayed by ELISA in pre-operative blood samples; univariate and multivariable analyses have been applied to identify cytokines independently associated to POD. Associations of cytokine levels with functional status, cognitive decline, intra-hospital mortality and comorbidity were also analyzed independently of POD onset.Results:. High IL-6 and low IL-2 levels were significantly associated with POD. After adjustment for potential confounders in multivariate analysis, high level of preoperative IL-6 was confirmed to be significantly associated with risk of POD onset.. High level of IL-6 was also associated with several baseline features (including poor functional status, cognitive impairment, emergency admission and higher comorbidity burden and intra-hospital mortality.Conclusions: Preoperative, high plasma level of IL-6 ( ≥ 9 pg/mL was significantly associated with POD onset. We propose IL-6 as an additional risk factor of POD onset together with the previously identified factors

  17. Major Metabolite Levels of Preoperative Proton Magnetic Resonance Sectroscopy and Intraoperative Fluorescence Intensity in Glioblastoma.

    Science.gov (United States)

    Tian, Hai-Long; Zu, Yu-Liang; Wang, Chao-Chao; Lin, Tao; Guo, Zhen-Tao; Jiang, Bin; Yin, Xin; Guo, Wen-Qiang; Wang, Zhi-Gang

    2017-08-20

    Objective To compare the intraoperative major metabolite level of preoperative proton magnetic resonance spectroscopy((1)H-MRS)and fluorescence intensity marked with fluorescein sodium(FLs)in glioblastoma(GBM)and thus provide an objective basis for fluorescence surgical treatment of GBM. Methods All newly diagnosed patients by plain and enhanced magnetic resonance imaging from the April 1,2014 to December 31,2015 were enrolled in this study.All of them received (1)H-MRS and marked with FLs.The expression of Ki67 in tumor boundary were confirmed by postoperative pathology and determined by immunostaining assay.The relationship between (1)H-MRS metabolite levels and tumor fluorescence intensity was analyzed. Results Totally 33 patients were included in the study.Preoperative (1)H-MRS revealed high-grade gliomas in 25 cases.The N-acetylaspartate(NAA)decreased significantly and choline(Cho)increased significantly in high-grade gliomas.The ratios of Cho/NAA,NAA/creatine(Cr),and Cho/Cr significantly differed in different tumor regions(P=0.02,P=0.01,and P=0.00,respectively).Surgical results were marked with FLs intraoperatively.Tissue fluorescence were clearly seen.There were 29 patients undergoing total resection and 4 cases undergoing subtotal resection.No acute encephalocele occured after operation,while 2 patients suffered from epilepsy.Postoperative pathology results included:28 cases were diagnosed as GBM(22 cases consistent with (1)H-MRS diagnosis).The results of GBM fluorescence imaging included:the level of fluorescence intensity in tumor parenchyma was significantly higher than that in tumor boundary and peritumoral edema(P=0.01).The result of (1)H-MRS metabolite analysis included:The kurtosis of NAA and of Cho and the ratio of Cho/NAA were significantly different according the fluorescence intensity in tumor parenchyma(P=0.01,P=0.02,and P=0.01).While there was no difference in the kurtosis of NAA,the kurtosis of Cho and the ratio of Cho/NAA were significantly

  18. Application of the joint detection of serum follistatin and carbohydrate antigen125 in the differential diagnosis of ovarian endometriosis and benign tumor%血清FS、CA125联合检测在卵巢型子宫内膜异位症与卵巢良性肿瘤鉴别诊断中的应用

    Institute of Scientific and Technical Information of China (English)

    彭英

    2015-01-01

    目的:探讨血清卵泡抑素(follistatin,FS)、糖链抗原125(carbohydrate antigen125,CA125)联合检测在卵巢型子宫内膜异位症与卵巢良性肿瘤鉴别诊断中的应用价值。方法:选取2012年3月至2014年6月期间我院确诊治疗的卵巢型子宫内膜异位症患者38例作为异位组,同期选取卵巢良性肿瘤36例作为良性组,统计分析并采用电化学发光免疫法检测所有患者血清中FS、CA125表达水平。结果:异位组患者血清中FS、CA125表达水平明显高于良性组(P<0.05);在FS=1.53 mg/L时,对卵巢型子宫内膜异位症与卵巢良性肿瘤的鉴别诊断敏感度为61.36%,特异度为86.54%,准确度为84.51%,在CA125=25.42 U/ml时,鉴别诊断敏感度为83.32%,特异度为85.18%,准确度为90.25%,二者联合的鉴别诊断敏感度为93.26%,特异度为94.41%,准确度为97.14%。在鉴别诊断敏感度、特异度和准确度方面,FS联合CA125检测>CA125检测>FS检测(PCA125 detection >FS detection (P<0.05).Conclusion: FS and CA125 levels can be used as important reference indexes for the differential diagnosis of ovarian endometriosis and benign tumor, while the joint detection shows higher sensitivity, speciifcity and accuracy and is worthy of further clinical promotion.

  19. Annual surveillance by CA125 and transvaginal ultrasound for ovarian cancer in both high-risk and population risk women is ineffective

    DEFF Research Database (Denmark)

    Woodward, E R; Sleightholme, H V; Considine, A M

    2007-01-01

    OBJECTIVE: To assess the efficacy of annual CA125 and transvaginal ultrasound (TVU) scan as surveillance for ovarian cancer. DESIGN: Retrospective audit. SETTING: NHS Trust. POPULATION: Three hundred and forty-one asymptomatic women enrolled for ovarian cancer screening: 179 were in a high-risk...... group (>10% lifetime risk of developing ovarian cancer), 77 in a moderate risk group (4-10% lifetime risk of developing ovarian cancer) and 71 in a near population risk group (risk). METHODS: Retrospective audit of case records, laboratory CA125 results, radiology reports, histology records...... endometrial cancer. Twenty-eight women (93.3%) had no malignancy. Sensitivity, specificity, PPV and NPV for TVU in the whole cohort were 33.3, 85.8, 0.6 and 99.8%, respectively. For high-risk individuals, the figures for TVU were 33.3, 84.5, 1.1 and 99.6, respectively. Combining both modalities for the whole...

  20. Serum peptide/protein profiling by mass spectrometry provides diagnostic information independently of CA125 in women with an ovarian tumor

    DEFF Research Database (Denmark)

    Callesen, Anne; Madsen, Jonna S; Iachina, Maria;

    2010-01-01

    In the present study, the use of a robust and sensitive mass spectrometry based protein profiling analysis was tested as diagnostic tools for women with an ovarian tumor. The potential additional diagnostic value of serum protein profiles independent of the information provided by CA125 were also...... investigated. Protein profiles of 113 serum samples from women with an ovarian tumor (54 malign and 59 benign) were generated using MALDI-TOF MS. A total of 98 peaks with a significant difference (pwomen with benign tumors/cysts and malignant ovarian tumors were identified. After...... average linkage clustering, a profile of 46 statistical significant mass peaks was identified to distinguish malignant tumors and benign tumors/cysts. In the subgroup of women with normal CA125 values (

  1. Relationship of short-course preoperative radiotherapy and serum albumin level with postoperative complications in rectal cancer surgery

    Directory of Open Access Journals (Sweden)

    Trifunović Bratislav

    2015-01-01

    Full Text Available Background/Aim. The identification of risk factors could play a role in improving early postoperative outcome for rectal cancer surgery patients. The aim of this study was to determine the relationship between short-course preoperative radiotherapy (RT, serum albumin level and the development of postoperative complications in patients after anterior rectal resection due to rectal cancer without creation of diverting stoma. Methods. This retrospective study included patients with histopathologically confirmed adenocarcinoma of the rectum by and the clinical stage of T2-T4 operated on between 2007 and 2012. All the patients underwent open anterior rectal resection with no diverting stoma creation. Preoperative serum albumin was measured in each patient. Tumor location was noted intraoperatively as the distance from the inferior tumor margin to the anal verge. Tumor size was measured and noted by the pathologist who assessed specimens. Some of the patients received short-course preoperative RT, and some did not. The patients were divided into two groups (group 1 with short-course preoperative RT, group 2 with no short-course preoperative RT. Postoperative complications included clinically apparent anastomotic leakage, wound infection, diffuse peritonitis and pneumonia. They were compared between the groups, in relation to preoperative serum albumin level, patients age, tumor size and location. Results. The study included 107 patients (51 in the group 1 and 56 in the group 2. There were no significant difference in age (p = 0.95, and gender (p = 0.12 and tumor distance from anal verge (p = 0.53. The size of rectal carcinoma was significantly higher in the group 1 than in the group 2 (51.37 ± 12.04 mm vs 45.57 ± 9.81 mm, respectively; p = 0.007. The preoperative serum albumin level was significantly lower in the group 1 than in the group 2 (34.80 ± 2.85 g/L vs 37.55 ± 2.74 g/L, respectively; p < 0.001. A significant correlation between the tumor

  2. MUC16/CA125 in the Context of Modular Proteins with an Annotated Role in Adhesion-Related Processes: In Silico Analysis

    Directory of Open Access Journals (Sweden)

    Ninoslav Mitic

    2012-08-01

    Full Text Available Mucin 16 (MUC16 is a type I transmembrane protein, the extracellular portion of which is shed after proteolytic degradation and is denoted as CA125 antigen, a well known tumor marker for ovarian cancer. Regarding its polypeptide and glycan structures, as yet there is no detailed insight into their heterogeneity and ligand properties, which may greatly influence its function and biomarker potential. This study was aimed at obtaining further insight into the biological capacity of MUC16/CA125, using in silico analysis of corresponding mucin sequences, including similarity searches as well as GO (gene ontology-based function prediction. The results obtained pointed to the similarities within extracellular serine/threonine rich regions of MUC16 to sequences of proteins expressed in evolutionary distant taxa, all having in common an annotated role in adhesion-related processes. Specifically, a homology to conserved domains from the family of herpesvirus major outer envelope protein (BLLF1 was found. In addition, the possible involvement of MUC16/CA125 in carbohydrate-binding interactions or cellular transport of protein/ion was suggested.

  3. 腹壁切口子宫内膜异位症患者病灶组织中Ki67和血清CA125的测定及意义%Ki67 expression in women with abdominal incisional endometriosis

    Institute of Scientific and Technical Information of China (English)

    朱红丽; 仝进毅

    2014-01-01

    目的:检测腹壁切口子宫内膜异位症患者病灶组织中Ki67的表达和血清CA125水平,探讨其临床意义。方法收集住院手术经病理检查证实为腹壁切口子宫内膜异位症患者38例(研究组),盆腔子宫内膜异位症患者57例(对照组),用免疫组化方法测定两组患者病灶组织中Ki67的表达,放射免疫法测定血清CA125水平,分析其临床资料并进行随访。结果研究组患者Ki67阳性率(52.6%)显著高于对照组(24.6%)(P<0.05),两组Ki67阳性患者的血清CA125水平均显著高于阴性患者(均P<0.05)。研究组无复发病例,而对照组复发率为21.4%(P<0.05)。结论腹壁切口子宫内膜异位症的发病机制可能与盆腔子宫内膜异位症不同;子宫内膜异位症患者Ki67的表达与CA125水平存在一定的正相关。%Objective To investigate Ki67 expression in abdominal incisional endometriosis and its significance. Methods Patients with endometriosis (EMS) admitted in Hangzhou First People's Hospital from January 2010 to December 2013 were en-rol ed in the study, including 57 cases with pelvic endometriosis and 38 cases with abdominal incisional endometriosis. The ex-pression of proliferating cel nuclear antigen (Ki67) in tissue was detected with immunohistochemical method and serum CA- 125 levels were measured with radioimmunoassay. Results Ki67 expression in abdominal wal endometriosis was significantly high-er than that in pelvic endometriosis (P<0.05). Serum CA125 levels in abdominal wal endometriosis was significantly lower than that in pelvic endometriosis (P<0.05). Serum CA125 was significantly different between groups of different Ki67 expression (P<0.05). Cumulative recurrence rate in abdominal wal endometriosis was significantly lower than that in pelvic endometriosis. CA125 level was higher in EMS with positive Ki67 expression than that in EMS with negative Ki67 expression. Conclusion Ki67 is

  4. Expression of WT1, CA 125, and GCDFP-15 as useful markers in the differential diagnosis of primary ovarian carcinomas versus metastatic breast cancer to the ovary.

    Science.gov (United States)

    Tornos, Carmen; Soslow, Robert; Chen, Shirley; Akram, Muzaffar; Hummer, Amanda J; Abu-Rustum, Nadeen; Norton, Larry; Tan, Lee K

    2005-11-01

    Metastatic breast carcinoma to the ovary is sometimes difficult to differentiate from primary ovarian carcinoma. This problem is often encountered in breast carcinoma patients who develop adnexal masses. ER and PR can be positive in a high percentage of breast and ovarian carcinomas, and therefore cannot be used in the differential diagnosis of these entities. WT1 and CA125 have been identified as possible markers for ovarian cancer. However, no studies have been done that specifically compare the immunophenotype of breast carcinoma metastatic to ovary with that of primary ovarian cancer. Thirty-nine cases of metastatic breast carcinoma to the ovary, 36 primary breast carcinomas, and 42 primary ovarian carcinomas were examined immunohistochemically for the expression of WT1, CA125, carcinoembryonic antigen, MUC2, MUC1, and GCDFP. The percentage of cells stained and the intensity of staining were recorded. Thirty-two ovarian carcinomas (76%) were positive for WT1, including 31 of 33 (94%) serous carcinomas. Most of them had strong and diffuse staining. None of the breast cancers either primary or metastatic to the ovary expressed WT1. Thirty-eight (90%) ovarian carcinomas were positive for CA125, most of them with strong and diffuse staining. Most breast carcinomas were negative for CA125, with only 6 (16%) of the primary ones and 5 (12%) of the metastatic showing weak and focal positivity. All ovarian carcinomas were negative for GCDFP. Five primary breast cancers (14%) and 17 (43%) metastatic to the ovary were positive for GCDFP. Nine (21%) ovarian carcinomas, 8 (22%) primary breast carcinomas, and 13 (33%) metastatic to the ovary were positive for carcinoembryonic antigen. Almost all tumors examined were positive for MUC1 (100% ovarian carcinomas, 100% primary breast carcinomas, and 95% metastatic breast carcinomas to ovary). MUC2 was positive in 10 (24%) ovarian carcinomas, 3 (8%) primary breast cancers, and 12 (30%) metastases to the ovary. The presence of

  5. Association of preoperative levels of selected blood inflammatory markers with prognosis in gliomas

    Directory of Open Access Journals (Sweden)

    Auezova R

    2016-10-01

    Full Text Available Raushan Auezova,1 Nurzhan Ryskeldiev,1 Aidos Doskaliyev,1 Yerbol Kuanyshev,1 Berik Zhetpisbaev,1 Nurgul Aldiyarova,1 Natalia Ivanova,2 Serik Akshulakov,1 Lizette Auezova3 1Department of Pathology of the Central Nervous System, National Centre for Neurosurgery, Astana, Kazakhstan; 2Polenov Russian Scientific Research Institute of Neurosurgery (a branch of Federal Almazov North-West Medical Research Centre, Ministry of Health of the Russian Federation, Saint-Petersburg, Russia; 3Bioactive Molecules Research Group, Department of Chemistry and Biochemistry, Faculty of Sciences-II, Lebanese University, Beirut, Lebanon Background: Red cell distribution width (RDW, neutrophil–lymphocyte ratio (NLR, and platelet count (PLT routinely tested as part of the complete blood count are indicative of systemic inflammation. The prognostic significance of NLR and PLT in cancer was demonstrated in many studies while the role of RDW has been hardly investigated. The present study aimed to assess the association of RDW, NLR, and PLT with survival and tumor grade in glioma patients. Methods: Clinical data from 178 patients with primary gliomas treated in a single institution were retrospectively analyzed. Receiver operating characteristic curves for cutoff value determination, Kaplan–Meier survival analysis, various bivariate tests, and univariate and multivariate Cox regression analyses were performed. Results: Patients with high RDW (≥13.95 and NLR (≥4 levels had worse overall survival (OS (Wilcoxon test, P<0.026 and P<0.003, respectively while the effect of thrombocytosis (≥400×109/L on prognosis was not significant. Besides, a strong association between RDW and NLR was found (Spearman’s rho =0.230, P<0.02; χ2=8.887, P<0.03; Mann–Whitney U-test, P<0.017. Moreover, RDW and NLR were significantly associated with tumor grade. In univariate Cox analysis, elevated NLR (hazard ratio, HR 1.385; confidence interval, CI 1.020–1.881, P<0.037, older age

  6. Value of Combined Detection of Tumor Markers Such as CEA and CA125 in the Diagnosis of Lung Cancer%CEA、CA125等肿瘤标志物联合检测在肺癌诊断中的价值

    Institute of Scientific and Technical Information of China (English)

    李林; 王迪进; 万轲; 徐国辉

    2015-01-01

    Objective To study the value of serum carcinoembryonic antigen ( CEA ) , carbohydrate antigen 125 (CA125),cytokeratin 19 fragments (CYFRA21-1),neuron-specific enolase (NSE) and squamous cell carcinoma antigen (SCC) in the diagnosis of lung cancer.Methods 102 cases of lung cancer patients,65 cases of lung benign diseases and 80 cases of healthy patients were randomly selected.5ml peripheral venous blood was extracted from every research object and the SCC,NSE, CA125,CYFRA21-1 and CEA were detected.Results The positive rates of SCC,NSE,CA125,CYFRA21-1 and CEA of patients in lung cancer group were significantly higher than those in other 2 groups(P<0.05).The sensitivity of 5 tumor markers com-bined detection in the diagnosis of lung cancer (91.18%) was significantly higher than each one of CEA,CA125,CYFRA21-1, NSE and SCC(40.20%,42.16%,50.00%,36.27%,20.59%)(P<0.05).Conclusion CEA,CA125,CYFRA21-1,NSE and SCC have certain value in the clinical diagnosis and classification of lung cancer,and the combined detection of the 5 tumor mark-ers can significantly increase the sensitivity.%目的:探讨癌胚抗原(CEA)、糖类抗原125(CA125)、细胞角蛋白19片段21-1(CYFRA21-1)、神经元特异性烯醇化酶(NSE)以及鳞状上皮细胞癌相关抗原(SCC)5种肿瘤标志物联合检测在肺癌诊断中的价值。方法随机选择肺癌患者102例、肺良性疾病65例以及同期体检健康者80例作为研究对象。所有研究对象均于空腹抽取5 ml外周静脉血,检测CEA、CA125、CYFRA21-1、NSE和SCC浓度。结果肺癌组患者CEA、CA125、CYFRA21-1、NSE及SCC检测阳性率均显著高于肺良性疾病患者、健康组(P<0.05);5种肿瘤标志物联合检测诊断肺癌的敏感度(91.18%)显著高于CEA、CA125、CYFRA21-1、NSE及SCC单项检测敏感度(42.20%、42.16%、50.00%、36.27%、20.59%)(P<0.05)。结论CEA、CA125、CYFRA21-1、NSE及SCC在肺

  7. Preoperative Plasma Fibrinogen Level as a Significant Prognostic Factor in Patients With Localized Renal Cell Carcinoma After Surgical Treatment.

    Science.gov (United States)

    Lee, Hakmin; Lee, Sang Eun; Byun, Seok-Soo; Kim, Hyeon Hoe; Kwak, Cheol; Hong, Sung Kyu

    2016-01-01

    We sought to investigate the association of preoperative fibrinogen levels with clinicopathologic outcomes after surgical treatment of nonmetastatic renal cell carcinoma. We reviewed the records of 1511 patients who had their fibrinogen levels measured preceding surgery. The associations between preoperative fibrinogen level and risk of adverse clinicopathologic outcomes were tested using the multivariate logistic regression and multiple Cox-proportional hazards model, respectively. Based on plasma fibrinogen levels, we stratified the patients into 2 groups with a cut-off value of 328  mg/dL. Kaplan-Meier analysis showed significantly inferior survival outcomes in progression-free (P fibrinogen level (≥328  mg/dL) was significantly related to a higher Fuhrman grade (hazard ratio [HR] 1.374, P = 0.006) and a larger tumor size (≥7  cm) (HR 2.364, P fibrinogen level is a significant predictor for poor disease progression (HR 1.857, P fibrinogen levels were significantly associated with poor pathological features and worse survival outcomes in patients with nonmetastatic renal cell carcinoma after surgical treatment. Further evaluations such as prospective randomized trials are needed to understand the underlying mechanism for these associations.

  8. Correlation Analysis of CA125 and N-terminal pro-brain natriuretic peptide and cardiac function in patients with chronic heart failure%慢性心衰患者CA125与N-末端脑钠素原及心功能相关性研究

    Institute of Scientific and Technical Information of China (English)

    张建秀; 高华; 曹倩; 闫超

    2014-01-01

    目的:探讨慢性心衰患者血清肿瘤抗原糖类抗原125(C A 125)与N‐末端脑钠素原(WT‐‐ProBNP)及心功能相关性。方法:选择慢性心衰患者108例,根据NYHA 心功能分级标准进行分级,分别检测CA19‐9、CA125、NT‐ProBNP、E/E’及左心射血分数(LVEF)并检测LVEF及E/E’。结果:III级患者CA125、NT‐ProBNP较II级患者均出现显著性升高(P<0.05),IV级患者较II、III级患者均出现显著性升高(P<0.05)。III级患者LVEF、E/E’较II级患者均出现显著性差异(P<0.05),IV级患者LVEF较II级患者均出现显著性升高(P<0.05),E/E'较II、III级患者均出现显著性升高(P<0.05)。CA125与NT‐ProBNP、E/E'显著正相关(P<0.05),与LVEF显著负相关(P<0.05)。结论:CA125与心功能相关指标密切相关,对其水平检测有助于明确慢性心衰的进展。%Objective:To investigate correlation analysis of CA125 and N‐terminal pro‐brain natriuretic peptide and cardiac function in patients with chronic heart failure .Methods :108 patients with chronic heart failure were classified according to NYHA class grading standards ,CA19‐9 ,CA125 ,NT‐ProBNP ,E /E'and LVEF and detect LVEF and E /E'were detected .Results :In stage III patients CA125 ,NT‐ProBNP than stage II patients were significantly higher (P <0 .05) ,stage IV patients than stage II ,stage III patients were significantly higher (P <0 . 05) .LVEF ,E /E'in III patients compared with grade II patients were significantly different (P <0 .05) ,LVEF in grade IV was higher than that in grade II patients (P <0 .05) ,E /E'than grade II and grade III were significantly higher(P <0 .05) .CA125 and NT‐ProBNP ,E /E'showed significant positive correlation (P <0 .05) ,and LVEF was significantly negatively correlated (P <0 .05) .Conclusion:CA125 is closely related to heart function related in‐dicators ,which help to

  9. Randomised controlled trial comparing oral and intravenous paracetamol (acetaminophen) plasma levels when given as preoperative analgesia.

    Science.gov (United States)

    van der Westhuizen, J; Kuo, P Y; Reed, P W; Holder, K

    2011-03-01

    Gastric absorption of oral paracetamol (acetaminophen) may be unreliable perioperatively in the starved and stressed patient. We compared plasma concentrations of parenteral paracetamol given preoperatively and oral paracetamol when given as premedication. Patients scheduled for elective ear; nose and throat surgery or orthopaedic surgery were randomised to receive either oral or intravenous paracetamol as preoperative medication. The oral dose was given 30 minutes before induction of anaesthesia and the intravenous dose given pre-induction. All patients were given a standardised anaesthetic by the same specialist anaesthetist who took blood for paracetamol concentrations 30 minutes after the first dose and then at 30 minute intervals for 240 minutes. Therapeutic concentrations of paracetamol were reached in 96% of patients who had received the drug parenterally, and 67% of patients who had received it orally. Maximum median plasma concentrations were 19 mg.l(-1) (interquartile range 15 to 23 mg.l(-1)) and 13 mg.l(-1) (interquartile range 0 to 18 mg.l(-1)) for the intravenous and oral group respectively. The difference between intravenous and oral groups was less marked after 150 minutes but the intravenous preparation gave higher plasma concentrations throughout the study period. It can be concluded that paracetamol gives more reliable therapeutic plasma concentrations when given intravenously.

  10. Programmable bio-nano-chip systems for serum CA125 quantification: toward ovarian cancer diagnostics at the point-of-care.

    Science.gov (United States)

    Raamanathan, Archana; Simmons, Glennon W; Christodoulides, Nicolaos; Floriano, Pierre N; Furmaga, Wieslaw B; Redding, Spencer W; Lu, Karen H; Bast, Robert C; McDevitt, John T

    2012-05-01

    Point-of-care (POC) implementation of early detection and screening methodologies for ovarian cancer may enable improved survival rates through early intervention. Current laboratory-confined immunoanalyzers have long turnaround times and are often incompatible with multiplexing and POC implementation. Rapid, sensitive, and multiplexable POC diagnostic platforms compatible with promising early detection approaches for ovarian cancer are needed. To this end, we report the adaptation of the programmable bio-nano-chip (p-BNC), an integrated, microfluidic, and modular (programmable) platform for CA125 serum quantitation, a biomarker prominently implicated in multimodal and multimarker screening approaches. In the p-BNCs, CA125 from diseased sera (Bio) is sequestered and assessed with a fluorescence-based sandwich immunoassay, completed in the nano-nets (Nano) of sensitized agarose microbeads localized in individually addressable wells (Chip), housed in a microfluidic module, capable of integrating multiple sample, reagent and biowaste processing, and handling steps. Antibody pairs that bind to distinct epitopes on CA125 were screened. To permit efficient biomarker sequestration in a three-dimensional microfluidic environment, the p-BNC operating variables (incubation times, flow rates, and reagent concentrations) were tuned to deliver optimal analytical performance under 45 minutes. With short analysis times, competitive analytical performance (inter- and intra-assay precision of 1.2% and 1.9% and limit of detection of 1.0 U/mL) was achieved on this minisensor ensemble. Furthermore, validation with sera of patients with ovarian cancer (n = 20) showed excellent correlation (R(2) = 0.97) with gold-standard ELISA. Building on the integration capabilities of novel microfluidic systems programmed for ovarian cancer, the rapid, precise, and sensitive miniaturized p-BNC system shows strong promise for ovarian cancer diagnostics.

  11. 高危妇女CA125和经阴道超声筛查并不能在早期诊断卵巢癌

    Institute of Scientific and Technical Information of China (English)

    Olivier; R; I; Lubsen-BrandsmaM.; A.; C; Verhoef; S; Van; Beurden; M

    2006-01-01

    目的:筛查的主要目的在于发现早期的卵巢癌病例。然而,在一般人群中的筛查往往无法发现早期病例,且CA125及经阴道超声(TVU)的假阳性率较高,故效果欠佳。本研究的目的是评价通过盆腔检查,血清CA125和TVU对高危妇女连续病例进行卵巢癌筛查的效果。方法:收集1996年1月至2002年12月间的132例BRCA1,20例BRCA2线突变携带者,72例遗传性乳腺癌和卵巢癌(HBOC)家族成员和88例具有遗传性乳腺癌(HBC)家族史的乳腺癌患者的临床数据。结果:10例CA125水平升高且TVU阳性的患者中筛查到3例卵巢癌(1例FIGOIC期,1例ⅢB期和1例Ⅳ期)和1例癌症间期(Ⅳ期)。152例接受预防性双侧(输卵管)卵巢切除术[BP(S)O]患者中发现5例隐匿性卵巢/输卵管癌(2例IA期,1例IC期,1例ⅢB期和1例Ⅳ期)。

  12. Índice de risco de malignidade para tumores do ovário incorporando idade, ultra-sonografia e o CA-125

    Directory of Open Access Journals (Sweden)

    Fernandes Luís Roberto Araujo

    2003-01-01

    Full Text Available OBJETIVOS: calcular a sensibilidade, a especificidade e a acurácia das variáveis: idade da paciente, aspecto ultra-sonográfico e dosagem do marcador CA-125 para o diagnóstico diferencial entre tumores malignos e benignos do ovário. Estabelecer, ainda, índice de risco de malignidade (IRM com a incorporação dessas três variáveis e calcular a sua sensibilidade, especificidade e acurácia para aquele diagnóstico diferencial. MÉTODOS: foram incluídas prospectivamente 100 pacientes portadoras de tumor do ovário com indicação cirúrgica. As variáveis idade, resultado da ultra-sonografia e níveis do CA-125 foram avaliadas isoladamente e depois em conjunto, sob a forma de índice (IRM. O estudo compreendeu a avaliação da sensibilidade, da especificidade e da acurácia diagnóstica e a aplicação das medidas: razão de probabilidade, razão de chances e dos testes: t de Student, chi² e regressão logística com análise uni e multivariada. RESULTADOS: para a variável idade, a sensibilidade, a especificidade e a acurácia diagnóstica foram respectivamente 58,8, 68,2 e 65,0%. Para a ultra-sonografia, 88,2, 77,3 e 81,0%. Para a dosagem do CA-125 esses valores foram 64,7, 74,2 e 71,0%. Quando as três variáveis foram agrupadas sob a forma do IRM observou-se sensibilidade de 76,5%, especificidade de 87,9% e acurácia diagnóstica de 84,0%. CONCLUSÕES: o IRM constituído pela associação das variáveis idade da paciente, resultado da ultra-sonografia e dosagem do CA-125 é indicador valioso para se distinguir entre tumores malignos e benignos de ovário, principalmente no que diz respeito à sua especificidade.

  13. The correlation between aldehyde dehydrogenase-1A1 level and tumor shrinkage after preoperative chemoradiation in locally advanced rectal cancer

    Directory of Open Access Journals (Sweden)

    Rhandyka Rafli

    2015-12-01

    Full Text Available This study was performed to determine the correlation between aldehyde dehydrogenase-1A1 (ALDH1A1 level and tumor shrinkage after chemoradiation in locally advanced rectal cancer. This is a retrospective study of 14 locally advanced rectal cancer patients with long course neoadjuvant chemoradiation. ALDH1A1 level was measured using ELISA from paraffin embedded tissue. Tumor shrinkage was measured from computed tomography (CT scan or magnetic resonance imaging (MRI based on Response Evaluation Criteria in Solid Tumor v1.1 (RECIST v1.1. The mean of ALDH1A1 level was 9.014 ± 3.3 pg/mL and the mean of tumor shrinkage was 7.89 ± 35.7%. Partial response proportion was 28.6%, stable disease proportion was 50% and progressive disease proportion was 21.4%. There was a significant strong negative correlation (r = –0.890, plt; 0.001 between ALDH1A1 and tumor shrinkage. In conclusion, tumor shrinkage in locally advanced rectal cancer after preoperative chemoradiation was influenced by ALDH1A1 level. Higher level of ALDH1A1 suggests decreased tumor shrinkage after preoperative chemoradiation.

  14. Preoperative TSH level and risk of thyroid cancer in patients with nodular thyroid disease: nodule size contribution.

    Science.gov (United States)

    Zafón, Carles; Obiols, Gabriel; Mesa, Jordi

    2015-01-01

    Many reports have supported the relationship between high preoperative TSH levels and risk of thyroid cancer in nodular thyroid disease (NTD). We investigated whether TSH levels are related to the risk of differentiated thyroid carcinoma (DTC) in patients who have undergone total thyroidectomy for NTD. The relationship between TSH and size of malignant nodule was investigated. Finally, we assessed whether TSH levels are related to DTC and presence of additional benign nodules. A retrospective study of 980 patients was conducted. Variables included age at diagnosis, TSH level, nodule size, gender, final histology (benign versus DTC), and type of malignancy. Malignancy was present in 261 (26.6%) patients. These patients had higher median TSH levels as compared to those with no malignancy (1.61 mU/L (0.9-2.5) versus 0.9 mU/L (0.3-1.6); p-value<0.001). TSH was higher in patients with DTC in whom the largest nodule was malignant than in patients in whom the largest nodule was benign (1.80 mU/L (1.1-2.6) versus 1.38 mU/L (0.7-2.1) respectively; p-value=0.025). A significant correlation was seen between malignant nodule size and TSH level, but not between TSH levels and size of the largest benign nodule. Our study supported an association between preoperative TSH levels and risk of DTC in patients with NTD. There was also a direct relationship between malignant nodule size and TSH levels. By contrast, no relationship was found between the size of benign nodules and TSH levels. Copyright © 2014 SEEN. Published by Elsevier Espana. All rights reserved.

  15. Clinical Value of the Diagnose Postmenpausal Palpable Ovary Syndrome by Joint Detecting HE4, CA199 and CA125%联合检测HE4、CA125和CA199对绝经后卵巢可及综合征的诊断价值

    Institute of Scientific and Technical Information of China (English)

    黄西元; 石玉玲; 张速林

    2016-01-01

    目的:探讨联合检测人附睾蛋白4(HE4)、血清糖类抗原125(CA125)和199(CA199)在绝经后卵巢可及综合征(PMPOS)中的应用价值.方法:采用化学发光法(CLIA)检测125例PMPOS患者及60例健康志愿者(对照组)血清HE4、CA125和CA199的水平,其中PMPOS患者分为良性肿瘤组(良性组,n=50)和恶性肿瘤组(恶性组,n=75).结果:PMPOS恶性组患者血清HE4、CA125和CA199水平均显著高于良性组,有统计学差异(P<0.05);也显著高于对照组,有统计学差异(P<0.05).良性组的CA125水平略高于对照组,有统计学差异(P<0.05);但CA199和HE4水平与对照组比较无明显差异,无统计学差异(P>0.05).三者联合检测用于诊断PMPOS恶性肿瘤的敏感度达到81.2%,而特异度也保持在90.0%.结论:联合检测HE4、CA199和CA125可有效提高对PMPOS恶性卵巢肿瘤的诊断效率,具有较大的临床意义.

  16. Evaluation of Stress Intensity and Anxiety Level in Preoperative Period of Cardiac Patients.

    Science.gov (United States)

    Rosiek, Anna; Kornatowski, Tomasz; Rosiek-Kryszewska, Aleksandra; Leksowski, Łukasz; Leksowski, Krzysztof

    2016-01-01

    The stress related to patient's stay in a hospital increases when it is necessary to perform a surgery. Therefore, the study of the phenomenon of stress intensity in hospitalized patients has become an important issue for public health. The study was conducted in University Hospital No. 1 in the cardiosurgery clinic. The study involved 58 patients who were admitted as planned to the hospital. The study used a standardized questionnaire measuring intensity of the stress and also deepened interviews with patients about stress and anxiety felt before the surgery. The greater the patient's anxiety resulting from his state of health, the greater the intensity of stress in the preoperative period. This relationship is linear. The results of the study also made it possible to see intrapersonal factors (pain, illness, and suffering) and extrapersonal factors (anesthesia, surgery, and complications after surgery), which are causes of anxiety before surgery. The research showed high (negative) results of anxiety and stress associated with the disease, surgery, and complications after cardiac surgery. Active involvement in hospitalization elements, such as patient education before surgery, psychological support, and medical care organization taking into account patient's preferences, reduces the impact of stressors.

  17. CA-125、CA-199、CEA三项肿瘤标志物联合检测对卵巢癌的临床应用价值

    Institute of Scientific and Technical Information of China (English)

    常晋兰; 郭先锋

    2007-01-01

    目的 探讨血清CA-125、CA-199、CEA联合检测对卵巢癌的临床应用价值.方法 采用全自动免疫发光分析仪技术检测CA-125、CA-199、CEA;检测153例血清中(包括卵巢癌31例,卵巢良性肿块48例,健康妇女54例)CA-125、CA-199、CEA的值,并对卵巢癌患者进行治疗前后的CA-125、CA-199、CEA的值进行监测、随访.结果 卵巢癌患者CA-125、CA-199、CEA值及阳性检出率均高于良性肿瘤及健康妇女值,单独检测时敏感性分别为80.6%、58.1%、41.9%,联合测定CA-125、CA-199、CEA三项则敏感性达96.7%.结论 联合测定CA-125、CA-199、CEA有助于提高卵巢癌诊断的敏感性,同时对观察术后疗效监测有重要价值.

  18. Prediction of Long-term Post-operative Testosterone Replacement Requirement Based on the Pre-operative Tumor Volume and Testosterone Level in Pituitary Macroadenoma

    OpenAIRE

    Cheng-Chi Lee; Chung-Ming Chen; Shih-Tseng Lee; Kuo-Chen Wei; Ping-Ching Pai; Cheng-Hong Toh; Chi-Cheng Chuang

    2015-01-01

    Non-functioning pituitary macroadenomas (NFPAs) are the most prevalent pituitary macroadenomas. One common symptom of NFPA is hypogonadism, which may require long-term hormone replacement. This study was designed to clarify the association between the pre-operative tumor volume, pre-operative testosterone level, intraoperative resection status and the need of long-term post-operative testosterone replacement. Between 2004 and 2012, 45 male patients with NFPAs were enrolled in this prospective...

  19. Preoperative 3T high field blood oxygen level dependent functional magnetic resonance imaging for glioma involving sensory cortical areas

    Institute of Scientific and Technical Information of China (English)

    LI Shao-wu; WANG Jiang-fei; JIANG Tao; LI Shou-wei; ZHANG Wen-bo; LI Zi-xiao; ZHANG Zhong; DAI Jian-ping; WANG Zhong-cheng

    2010-01-01

    Background Localization of sensory cortical areas during the operation is essential to preserve the sensory function.Intraoperative direct electrostimulation under awake anesthesia is the golden standard but time-consuming. We applied 3T high field blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI) to identify the relationship between glioma and cortical sensory areas preoperatively and to guide intraoperative direct electrostimulation for quick and precise localization.Methods Five glioma patients with sensory cortex involvement by or next to the lesion had preoperative BOLD fMRI to determine the spatial relationship of cortical sensory areas to the tumours. Bilateral hand opposite movement was performed by these patients for fMRI. Precentral and postcentral gyri were identified by electrical stimulation during the operation. Karnofsky Performance Status scores of the patients' pre- and postoperative and the role of BOLD fMRI were evaluated.Results The cortical sensory areas were all activated in five glioma patients involving postcentral gyrus areas by BOLDf MRI with bilateral hand opposite movement. The detected activation areas corresponded with the results from cortical electrical stimulation.Conclusions The relationship between cortical sensory areas and tumour can be accurately shown by BOLD fMRI before operation. And the information used to make the tumour resection could obtain good clinical results.

  20. Preoperative red cell distribution width and neutrophil-to-lymphocyte ratio predict survival in patients with epithelial ovarian cancer

    Science.gov (United States)

    Li, Zheng; Hong, Na; Robertson, Melissa; Wang, Chen; Jiang, Guoqian

    2017-01-01

    Several parameters of preoperative complete blood count (CBC) and inflammation-associated blood cell markers derived from them have been reported to correlate with prognosis in patients with epithelial ovarian cancer (EOC), but their prognostic importance and optimal cutoffs are still needed be elucidated. Clinic/pathological parameters, 5-year follow-up data and preoperative CBC parameters were obtained retrospectively in 654 EOC patients underwent primary surgery at Mayo Clinic. Cutoffs for neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) were optimized by receiver operating characteristic (ROC) curve. Prognostic significance for overall survival (OS) and recurrence free survival (RFS) were determined by Cox proportional hazards models and Kaplan-Meier method. Associations of RDW and NLR with clinic/pathological parameters were analyzed using non-parametric tests. RDW with cutoff 14.5 and NLR with cutoff 5.25 had independent prognostic significance for OS, while combined RDW and NLR scores stratified patients into low (RDW-low and NLR-low), intermediate (RDW-high or NLR-high) and high risk (RDW-high and NLR-high) groups, especially in patients with high-grade serous ovarian cancer (HGSOC). Moreover, high NLR was associated with poor RFS as well. Elevated RDW was strongly associated with age, whereas high NLR was strongly associated with stage, preoperative CA125 level and ascites at surgery. PMID:28223716

  1. 99mTc-MDP 全身骨扫描和血清 CEA、NSE、CYFR21-1、CA125 测定对小细胞肺癌骨转移的临床评价%Clinical evaluation of 99mTc-MDP bone scintigraphy and serum CEA, NSE,CYFRA21-1 and CA125 in skeletal metastasis of the small cell lung cancer

    Institute of Scientific and Technical Information of China (English)

    张炜; 郭万华

    2015-01-01

    目的:分析99m Tc-MDP全身骨扫描小细胞肺癌骨转移病灶分布特点及血清肿瘤标志物CEA、NSE、CYFRA21-1、CA125与小细胞肺癌骨转移发生的相关性. 方法:回顾性分析56例经病理证实的小细胞肺癌患者 99m Tc-MDP全身骨扫描影像表现及血清肿瘤标志物水平,用ROC曲线及Spearman相关分析评价肿瘤标志物水平对肺癌骨转移发生及发展的诊断意义. 结果:21 例骨转移阳性病灶中胸部占46.60%,脊柱34.95%,骨盆9.71%,四肢5.83%,头颅2.91%. 骨转移阳性组CEA、NSE 质量浓度高于骨转移阴性组(均P<0.05),曲线下面积(AUC)分别为0.789、0.717,且CEA、NSE质量浓度与骨转移分级呈正相关(r值分别为0.540、0.417). 结论:小细胞肺癌以胸部及脊柱等中轴骨多发性骨转移为主,CEA、NSE血清水平随着骨转移病灶数的增加有显著上升趋势,对判定小细胞肺癌骨转移的发生及发展有一定的参考意义.%Objective:To analyze the distribution characteristic of the skeletal metastasis lesion in 99mTc-MDP bone scintigraphy and the correlation between serum tumor marker (CEA,NSE, CYFRA21-1 and CA125) and skeletal metastasis in small cell lung cancer .Methods:56 cases with small cell lung confirmed by pathology were examined with 99m Tc-MDP bone scintigraphy .Serum concentration of CEA , NSE, CYFRA21-1 and CA125 were measured one week before whole-body bone scanning .ROC curve and spearman correlation analysis were used to evaluate the serum tumor markers in diagnose the development of the skeletal metastasis .Results: 21 imaging positive lesions were identified as the skeletal metastasis .The distribution of the skeletal metastasis lesions were:chest(46.60%), spine(34.95%), pelvis(9.71%), four limbs(5.83%), skull(2.91%).CEA,NSE levels in bone metastasis group were significant higher than those in the negative group ( P<0.05 ) and the area of ROC curve were 0.789 and 0.717 respectively(P<0.05).There was a correlation between

  2. Definitions for response and progression in ovarian cancer clinical trials incorporating RECIST 1.1 and CA 125 agreed by the Gynecological Cancer Intergroup (GCIG)

    DEFF Research Database (Denmark)

    Rustin, Gordon John Sampson; Vergote, Ignace; Eisenhauer, Elizabeth

    2011-01-01

    the serum marker CA 125 and has specified the situations where these criteria should be used. However, the publications did not include detailed definitions, nor were they written to accommodate the new version of Response Evaluation Criteria In Solid Tumors (RECIST) criteria (version 1.1) now available....... Thus, we recommend that the definitions described later in detail are incorporated into clinical trial protocols to maintain consistency. The criteria for defining progression are now acceptable in clinical trials of recurrent disease as they have since been validated (Pujade-Lauraine, personal...... communication, 2010). The GCIG requests that data from all clinical trials using these definitions are made available to GCIG trial centers so that continual validation and improvement can be accomplished. These definitions were developed from analyzing patients receiving cytotoxic chemotherapy and have not yet...

  3. Evaluación del marcador HE4, CA125 e Índice ROMA en el diagnóstico diferencial de las masas anexiales

    OpenAIRE

    Martínez Díez, Marta

    2017-01-01

    Las masas anexiales son un hallazgo común en la práctica ginecológica, y a menudo se presentan dilemas tanto en el diagnóstico como en su manejo. El fin último del manejo de las mismas es el diagnóstico precoz del cáncer de ovario, el cual presenta una supervivencia baja en estadios avanzados y frente al cual todavía no existe métodos de screening. En la actualidad, el CA125 es el marcador tumoral recomendado tanto en la Oncoguía SEGO del Cáncer Epitelial de Ovario 2014 como en las guías NCCN...

  4. Evaluación del marcador HE4, CA125 e Índice ROMA en el diagnóstico diferencial de las masas anexiales

    OpenAIRE

    Martínez Díez, Marta

    2016-01-01

    Las masas anexiales son un hallazgo común en la práctica ginecológica, y a menudo se presentan dilemas tanto en el diagnóstico como en su manejo. El fin último del manejo de las mismas es el diagnóstico precoz del cáncer de ovario, el cual presenta una supervivencia baja en estadios avanzados y frente al cual todavía no existe métodos de screening. En la actualidad, el CA125 es el marcador tumoral recomendado tanto en la Oncoguía SEGO del Cáncer Epitelial de Ovario 2014 como en las guías NCCN...

  5. The correlation between preoperative levels of albumin and tlc and mortality in patients with femoral neck fracture.

    Science.gov (United States)

    Niccolai, F; Parchi, P D; Vigorito, A; Pasqualetti, G; Monzani, F; Lisanti, M

    2016-01-01

    A femoral neck fracture in an elderly patient often represents a major challenge for the orthopaedic surgeon who has to face not only the fracture, but also all the multiple issues related to age. Among others, malnutrition has been recognised as an important factor associated with severe aggravation in these patients. One-hundred-and-forty-seven patients were enrolled to investigate the use of two markers of patient nutritional status, i.e. serum albumin level and total leukocyte count (TLC), as predictors of mortality in the elderly patient suffering from proximal femur fracture. We found that low preoperative values of serum albumin and TLC proved to be directly related to worse outcomes. Therefore, these exams can be useful to identify patients with a femoral neck fracture that have higher risk of malnutrition and consequent higher mortality and that can benefit from some measures, such as albumin or protein nutritional supplement.

  6. Prediction of Long-term Post-operative Testosterone Replacement Requirement Based on the Pre-operative Tumor Volume and Testosterone Level in Pituitary Macroadenoma.

    Science.gov (United States)

    Lee, Cheng-Chi; Chen, Chung-Ming; Lee, Shih-Tseng; Wei, Kuo-Chen; Pai, Ping-Ching; Toh, Cheng-Hong; Chuang, Chi-Cheng

    2015-11-05

    Non-functioning pituitary macroadenomas (NFPAs) are the most prevalent pituitary macroadenomas. One common symptom of NFPA is hypogonadism, which may require long-term hormone replacement. This study was designed to clarify the association between the pre-operative tumor volume, pre-operative testosterone level, intraoperative resection status and the need of long-term post-operative testosterone replacement. Between 2004 and 2012, 45 male patients with NFPAs were enrolled in this prospective study. All patients underwent transsphenoidal surgery. Hypogonadism was defined as total serum testosterone levels of testosterone to patients with defined hypogonadism or clinical symptoms of hypogonadism. Hormone replacement for longer than 1 year was considered as long-term therapy. The need for long-term post-operative testosterone replacement was significantly associated with larger pre-operative tumor volume (p = 0.0067), and lower pre-operative testosterone level (p = 0.0101). There was no significant difference between the gross total tumor resection and subtotal resection groups (p = 0.1059). The pre-operative tumor volume and testosterone level impact post-operative hypogonadism. By measuring the tumor volume and the testosterone level and by performing adequate tumor resection, surgeons will be able to predict post-operative hypogonadism and the need for long-term hormone replacement.

  7. A combination of preoperative CT findings and postoperative serum CEA levels improves recurrence prediction for stage I lung adenocarcinoma.

    Science.gov (United States)

    Yamazaki, Motohiko; Ishikawa, Hiroyuki; Kunii, Ryosuke; Tasaki, Akiko; Sato, Suguru; Ikeda, Yohei; Yoshimura, Norihiko; Hashimoto, Takehisa; Tsuchida, Masanori; Aoyama, Hidefumi

    2015-01-01

    To assess the prognostic value of combined evaluation of preoperative CT findings and pre/postoperative serum carcinoembryonic antigen (CEA) levels for pathological stage I lung adenocarcinoma. This retrospective study included 250 consecutive patients who underwent complete resection for ≤ 3-cm pathological stage I (T1-2aN0M0) adenocarcinomas (132 men, 118 women; mean age, 67.8 years). Radiologists evaluated following CT findings: maximum tumor diameter, percentage of solid component (%solid), air bronchogram, spiculation, adjacency of bullae or interstitial pneumonia (IP) around the tumor, notch, and pleural indent. These CT findings, pre/postoperative CEA levels, age, gender, and Brinkman index were assessed by Cox proportional hazards model to determine the best prognostic model. Prognostic accuracy was examined using the area under the receiver operating characteristic curve (AUC). Median follow-up period was 73.2 months. In multivariate analysis, high %solid, adjacency of bullae or IP around the tumor, and high postoperative CEA levels comprised the best combination for predicting recurrence (Psensitivity of 85.7% and a specificity of 74.3% at the optimal threshold. The best cut-off values of %solid and postoperative CEA levels for predicting high-risk patients were ≥ 48% and ≥ 3.7 ng/mL, respectively. Compared to %solid alone, combined evaluation of %solid, adjacency of bullae or IP change around the tumor, and postoperative CEA levels improves recurrence prediction for stage I lung adenocarcinoma. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  8. Analysis on the value of combined detection of CYFRA21-1,NSE,CEA,CA125 in lung carcinoma%CYFRA21-1、NSE、CEA 和CA125联合检测对肺癌诊断的价值分析

    Institute of Scientific and Technical Information of China (English)

    陈乐

    2016-01-01

    Objective To investigate the value of combined detection by using tumor markers cytokeratin‐19 fragment antigen (CYFRA21‐l) ,neuron‐specific enolase (NSE) ,carcinoembryonic antigen (CEA) and carbohydrate cancer antigen 125(CA125) in lung cancer diagnosis .Methods 200 people who treated in the hospital in related departments from January 2012 to January 2014 were enrolled in the study .100 of them suffered from lung cancer ,53 suffered from benign lung disease ,the rest 47 were healthy people .Electrochemiluminescence method or enzyme‐linked immunosorbent assay(ELISA) were used to detect serum tumor mark‐ers CYFRA21‐1 ,NSE ,CEA ,CA125 and the sensitivity ,specificity and accuracy of different combinations of test items were evalua‐ted .Results In the single detection of those tumor markers for the diagnosis of lung cancer ,CYFRA21‐1 detection got the highest sensitivity and accuracy ,while CA125 got the highest specificity(95 .0% ) .The sensitivity and specificity of combined detection were both significantly higher than single detections .The sensitivity ,pecificity and accuracy of the combined detection of the 4 tumor markers were 92 .0% ,72 .0% ,and 87 .0% respectively .Conclusion In the clinical diagnosis of lung cancer ,the combined detection of several serum tumor markers get higher sensitivity and accuracy than single detection ,which is worthy of clinical promotion .%目的:探讨细胞角蛋白‐19片段抗原(CYFRA21‐1)、神经元特异性烯醇化酶(NSE)、癌胚抗原(CEA )和糖类癌抗原125(CA125)联合检测对肺癌患者的诊断价值。方法从2012年1月至2014年1月该院相关科室共选取研究对象200例,其中肺癌患者100例、肺良性病变患者53例、健康体检者47例。采用电化学发光方法或酶联免疫吸附测定(ELISA )检测患者血清CYFRA21‐1、NSE、CEA、CA125的水平,评价不同检测项目组合在肺癌诊断中的灵敏度、

  9. Preoperative plasma leptin levels predict delirium in elderly patients after hip fracture surgery.

    Science.gov (United States)

    Chen, Xue-Wu; Shi, Jun-Wu; Yang, Ping-Shan; Wu, Zhu-Qi

    2014-07-01

    Leptin is considered to be a modulator of the immune response. Hypoleptinemia increases the risk for Alzheimer's disease and vascular dementia. The present study aimed to investigate the ability of plasma leptin level to predict delirium in elderly patients after hip fracture surgery. Postoperative delirium (pod) was evaluated using the Confusion Assessment Method. Prolonged postoperative delirium (ppod) was defined as delirium lasting more than 4 weeks. Plasma leptin levels of 186 elderly patients and 186 elderly controls were measured by an enzyme-linked immunosorbent assay. Plasma leptin level was substantially lower in patients than in controls (4.6±2.2ng/ml vs. 7.5±1.8ng/ml, Pdelirium and also prolonged delirium in elderly patients after hip fracture surgery.

  10. Multiplexed magnetic nanoparticle-antibody conjugates (MNPs-ABS) based prognostic detection of ovarian cancer biomarkers, CA-125, β-2M and ApoA1 using fluorescence spectroscopy with comparison of surface plasmon resonance (SPR) analysis.

    Science.gov (United States)

    Pal, Manoj K; Rashid, Mohammad; Bisht, Manisha

    2015-11-15

    A multiplexed MNPs-Abs based fluorescence spectroscopic system in analysis of serum biomarkers; CA-125, β2-M and ApoA1 for the early detection of ovarian cancer was first time proposed. The lowest detection limits measured in multiplexed setup were 0.26 U/mL, 0.55 ng/mL and 7.7 ng/mL respectively for CA-125, β2-M and ApoA1. A comparative real sample analysis of healthy normal (Control), benign and ovarian cancer patients with SPR has also been done to validate the process. Moreover CA-125 detection only confirms 50-60% of early stage disease. This multiplexed system achieved sensitivity and specificity up to 94% and 98% respectively to distinguish early stage ovarian cancer patients from healthy individuals.

  11. Prognostic Significance of Preoperative and Postoperative Plasma Levels of Ghrelin in Gastric Cancer: 3-Year Survival Study

    Science.gov (United States)

    Soleyman-Jahi, Saeed; Abdirad, Afshin; Fallah, Amir Afraz; Ghasemi, Sevil; Sadeghi, Fatemeh; Heidari, Reza; Mahmoodzadeh, Habibollah; Zendehdel, Kazem

    2017-01-01

    OBJECTIVES: We aimed to investigate prognostic effects of plasma levels of ghrelin before and after gastrectomy in gastric cancer (GC). METHODS: We followed 81 GC patients up to 3 years in this study. They were candidates for curative gastrectomy with or without neoadjuvant chemotherapy. Plasma levels of total and active ghrelins before and after the operation were assessed. Association of plasma levels of ghrelin with survival were assessed and adjusted for other potential prognostic factors using Cox regression analyses. RESULTS: Both total and active ghrelins dropped after gastrectomy (Pcachexia (HR=2.99, 95% CI: 1.35–6.63), and receiving no neoadjuvant chemotherapy (HR=2.02, 95% CI: 1.04–3.92) were other poor prognostic factors. CONCLUSIONS: Preoperative and postoperative plasma levels of ghrelin could predict survival of GC patients with different patterns. This prognostic effect was independent of stage and cachexia. Measurement of plasma ghrelin in GC patients could complement conventional staging for more precise risk-stratification of the patients. Extrinsic admirations of ghrelin after total gastrectomy has potentials to improve survival of GC patients. PMID:28055030

  12. 混合型嗜酸粒细胞性胃肠炎伴血清CA125升高1例并文献复习

    Institute of Scientific and Technical Information of China (English)

    王文件

    2010-01-01

    @@ 嗜酸粒细胞性胃肠炎(eosinophilic gastroenteritis,EG)是以胃肠道某些部位嗜酸性粒细胞浸润为特征的一种少见疾病,Kaizser等在1937年首次报道EG病例,但伴血清CA125升高的EG病例罕有报道.现将我院收治的1例伴血清CA125明显升高的混合型嗜酸粒细胞性胃肠炎报告如下.

  13. Correlation Between Preoperative Serum Carcinoembryonic Antigen Levels and Expression on Pancreatic and Rectal Cancer Tissue

    Directory of Open Access Journals (Sweden)

    LSF Boogerd

    2017-05-01

    Full Text Available Carcinoembryonic antigen (CEA–targeted imaging and therapeutic agents are being tested in clinical trials. If CEA overexpression in malignant tissue corresponds with elevated serum CEA, serum CEA could assist in selecting patients who may benefit from CEA-targeted agents. This study aims to assess the relationship between serum CEA and CEA expression in pancreatic (n = 20 and rectal cancer tissues (n = 35 using histopathology. According to local laboratory standards, a serum CEA >3 ng/mL was considered elevated. In pancreatic cancer patients a significant correlation between serum CEA and percentage of CEA-expressing tumor cells was observed ( P  = .04, ρ = .47. All 6 patients with homogeneous CEA expression in the tumor had a serum CEA >3 ng/mL. Most rectal cancer tissues (32/35 showed homogeneous CEA expression, independent of serum CEA levels. This study suggests that selection of pancreatic cancer patients for CEA-targeted agents via serum CEA appears adequate. For selection of rectal cancer patients, serum CEA levels are not informative.

  14. A combination of preoperative CT findings and postoperative serum CEA levels improves recurrence prediction for stage I lung adenocarcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Yamazaki, Motohiko, E-mail: xackey2001@gmail.com [Department of Radiology, Niigata University Graduate School of Medical and Dental Sciences (Japan); Ishikawa, Hiroyuki [Department of Radiology, Niigata University Graduate School of Medical and Dental Sciences (Japan); Kunii, Ryosuke [Division of Cellular and Molecular Pathology, Niigata University Graduate School of Medical and Dental Sciences (Japan); Tasaki, Akiko; Sato, Suguru; Ikeda, Yohei; Yoshimura, Norihiko [Department of Radiology, Niigata University Graduate School of Medical and Dental Sciences (Japan); Hashimoto, Takehisa; Tsuchida, Masanori [Division of Thoracic and Cardiovascular Surgery, Niigata University Graduate School of Medical and Dental Sciences (Japan); Aoyama, Hidefumi [Department of Radiology, Niigata University Graduate School of Medical and Dental Sciences (Japan)

    2015-01-15

    Objectives: To assess the prognostic value of combined evaluation of preoperative CT findings and pre/postoperative serum carcinoembryonic antigen (CEA) levels for pathological stage I lung adenocarcinoma. Methods: This retrospective study included 250 consecutive patients who underwent complete resection for ≤3-cm pathological stage I (T1–2aN0M0) adenocarcinomas (132 men, 118 women; mean age, 67.8 years). Radiologists evaluated following CT findings: maximum tumor diameter, percentage of solid component (%solid), air bronchogram, spiculation, adjacency of bullae or interstitial pneumonia (IP) around the tumor, notch, and pleural indent. These CT findings, pre/postoperative CEA levels, age, gender, and Brinkman index were assessed by Cox proportional hazards model to determine the best prognostic model. Prognostic accuracy was examined using the area under the receiver operating characteristic curve (AUC). Results: Median follow-up period was 73.2 months. In multivariate analysis, high %solid, adjacency of bullae or IP around the tumor, and high postoperative CEA levels comprised the best combination for predicting recurrence (P < 0.05). A combination of these three findings had a greater accuracy in predicting 5-year disease-free survival than did %solid alone (AUC = 0.853 versus 0.792; P = 0.023), with a sensitivity of 85.7% and a specificity of 74.3% at the optimal threshold. The best cut-off values of %solid and postoperative CEA levels for predicting high-risk patients were ≥48% and ≥3.7 ng/mL, respectively. Conclusion: Compared to %solid alone, combined evaluation of %solid, adjacency of bullae or IP change around the tumor, and postoperative CEA levels improves recurrence prediction for stage I lung adenocarcinoma.

  15. Characterization of the tumor marker muc16 (ca125 expressed by murine ovarian tumor cell lines and identification of a panel of cross-reactive monoclonal antibodies

    Directory of Open Access Journals (Sweden)

    Goodell Cara AR

    2009-06-01

    Full Text Available Abstract Objectives The ovarian tumor marker CA125 is expressed on human MUC16, a cell surface bound mucin that is also shed by proteolytic cleavage. Human MUC16 is overexpressed by ovarian cancer cells. MUC16 facilitates the binding of ovarian tumor cells to mesothelial cells lining the peritoneal cavity. Additionally, MUC16 also is a potent inhibitor of natural killer cell mediated anti-tumor cytotoxic responses. Extensive studies using human as well as murine ovarian tumor cell models are required to clearly define the function of MUC16 in the progression of ovarian tumors. The major objective of this study was to determine if the murine ovarian tumor cells, MOVCAR, express Muc16 and to characterize antibodies that recognize this mucin. Methods RT-PCR analysis was used for detecting the Muc16 message and size exclusion column chromatography for isolating Muc16 produced by MOVCAR cells. Soluble and cell-associated murine Muc16 were analyzed, respectively, by Western blotting and flow cytometry assays using a new panel of antibodies. The presence of N-linked oligosaccharides on murine Muc16 was determined by ConA chromatography. Results We demonstrate that murine Muc16 is expressed by mouse ovarian cancer cells as an ~250 kDa glycoprotein that carries both O-linked and N-linked oligosaccharides. In contrast to human MUC16, the murine ortholog is primarily released from the cells and cannot be detected on the cell surface. Since the released murine Muc16 is not detected by conventional anti-CA125 assays, we have for the first time identified a panel of anti-human MUC16 antibodies that also recognizes the murine counterpart. Conclusion The antibodies identified in this study can be used in future purification of murine Muc16 and exhaustive study of its properties. Furthermore, the initial identification and characterization of murine Muc16 is a vital preliminary step in the development of effective murine models of human ovarian cancer. These

  16. Level of anxiety versus self-care in the preoperative and postoperative periods of total laryngectomy patients.

    Science.gov (United States)

    Almonacid, Clara Inés Flórez; Ramos, Alfredo Jurado; Rodríguez-Borrego, María-Aurora

    2016-06-14

    estimate the prevalence of anxiety in laryngectomy patients in the pre and postoperative periods and its relation with the self-care level. observational research of 40 patients with stage IV laryngeal cancer. Three observations took place: in the preoperative phase, at seven and at 14 days after the surgery; between June 2010 and December 2012. Two self-care levels were defined: self-sufficient and needing help for activities of daily living and treatment-related activities. To assess the anxiety levels, Zigmond's hospital anxiety scale (1983) was used. in the preoperative and postoperative phases, the patients presented high levels of anxiety. Concerning self-care, on average, self-sufficient patients presented lower levels of anxiety than patients who needed help to accomplish activities of daily living and activities deriving from the surgery, without significant differences. anxiety is present at all times in laryngectomy patients and the reduction of the self-care deficit seems to decrease it, without putting a permanent end to it. estimar a prevalência de ansiedade do paciente laringectomizado no pré-operatório e pós-operatório e sua relação com o nível de autocuidado. pesquisa observacional de 40 pacientes com câncer da laringe estágio IV. Foram realizadas 3 observações: no pré-operatório, a 7 e 14 dias pós-operatório, no período de junho de 2010 a dezembro de 2012. Dois níveis de autocuidado foram definidos: autossuficientes e precisar ajuda para as atividades da vida diária e relacionadas ao tratamento. Para avaliar a ansiedade, foi utilizada a escala de ansiedade hospitalar de Zigmond (1983). no pré-operatório e pós-operatório, os pacientes apresentaram níveis elevados de ansiedade. Com relação ao autocuidado, os pacientes autossuficientes apresentaram na média níveis inferiores de ansiedades que os pacientes que precisavam de ajuda para realizar as atividades da vida diária y as derivadas da cirurgia, sem chegar a ser

  17. A novel index for preoperative, non-invasive prediction of macro-radical primary surgery in patients with stage IIIC-IV ovarian cancer-a part of the Danish prospective pelvic mass study

    DEFF Research Database (Denmark)

    Karlsen, Mona Aarenstrup; Fagö-Olsen, Carsten; Høgdall, Estrid Vilma Solyom;

    2016-01-01

    The purpose of this study was to develop a novel index for preoperative, non-invasive prediction of complete primary cytoreduction in patients with FIGO stage IIIC-IV epithelial ovarian cancer. Prospectively collected clinical data was registered in the Danish Gynecologic Cancer Database. Blood...... samples were collected within 14 days of surgery and stored by the Danish CancerBiobank. Serum human epididymis protein 4 (HE4), serum cancer antigen 125 (CA125), age, performance status, and presence/absence of ascites at ultrasonography were evaluated individually and combined to predict complete tumor.......688 for age. The multivariate model (Cancer Ovarii Non-invasive Assessment of Treatment Strategy (CONATS) index), consisting of HE4, age, and performance status, demonstrated an AUC of 0.853. According to the Danish indicator level, macro-radical PDS should be achieved in 60 % of patients admitted to primary...

  18. Prolonged Preoperative Opioid Therapy Associated With Poor Return to Work Rates After Single-Level Cervical Fusion for Radiculopathy for Patients Receiving Workers' Compensation Benefits.

    Science.gov (United States)

    Faour, Mhamad; Anderson, Joshua T; Haas, Arnold R; Percy, Rick; Woods, Stephen T; Ahn, Uri M; Ahn, Nicholas U

    2017-01-15

    Retrospective comparative cohort study. Examine the effect of prolonged preoperative opioid use on return to work (RTW) status after single-level cervical fusion for radiculopathy. The use of opioids has a dramatic effect in a workers' compensation population. The costs of claims that involved opioids in the management plan are catastrophic particularly for those undergoing spinal surgical procedure. Data of patients who underwent single-level cervical fusion for radiculopathy and had received opioid prescriptions before surgery were retrospectively collected from Ohio Bureau of Workers' Compensation between 1993 and 2011 after work-related injury. Then, based on opioid use duration, short-term use (STO) group (6 mo) were constructed. A multivariate logistic regression analysis was used to determine whether successful RTW status was achieved. Chi-square and analysis of variance tests were used to compare other secondary outcomes after surgery. Prolonged preoperative opioid use was a negative predictor of successful RTW status (odds ratio = 0.73; 95% confidence interval: 0.55-0.98; P value: 0.04). Prolonged preoperative opioid use was associated with increasingly lower rates of achieving stable RTW status (P benefits awarded after surgery (P < 0.01). Prolonged preoperative opioid use was associated with poor functional outcomes after cervical fusion. STO and earlier inclusion of the surgical approach in the management plan may offer better surgical and functional outcomes after cervical fusion. 3.

  19. A novel index for preoperative, non-invasive prediction of macro-radical primary surgery in patients with stage IIIC-IV ovarian cancer-a part of the Danish prospective pelvic mass study.

    Science.gov (United States)

    Karlsen, Mona Aarenstrup; Fagö-Olsen, Carsten; Høgdall, Estrid; Schnack, Tine Henrichsen; Christensen, Ib Jarle; Nedergaard, Lotte; Lundvall, Lene; Lydolph, Magnus Christian; Engelholm, Svend Aage; Høgdall, Claus

    2016-09-01

    The purpose of this study was to develop a novel index for preoperative, non-invasive prediction of complete primary cytoreduction in patients with FIGO stage IIIC-IV epithelial ovarian cancer. Prospectively collected clinical data was registered in the Danish Gynecologic Cancer Database. Blood samples were collected within 14 days of surgery and stored by the Danish CancerBiobank. Serum human epididymis protein 4 (HE4), serum cancer antigen 125 (CA125), age, performance status, and presence/absence of ascites at ultrasonography were evaluated individually and combined to predict complete tumor removal. One hundred fifty patients with advanced epithelial ovarian cancer were treated with primary debulking surgery (PDS). Complete PDS was achieved in 41 cases (27 %). The receiver operating characteristic curves demonstrated an area under the curve of 0.785 for HE4, 0.678 for CA125, and 0.688 for age. The multivariate model (Cancer Ovarii Non-invasive Assessment of Treatment Strategy (CONATS) index), consisting of HE4, age, and performance status, demonstrated an AUC of 0.853. According to the Danish indicator level, macro-radical PDS should be achieved in 60 % of patients admitted to primary surgery (positive predictive value of 60 %), resulting in a negative predictive value of 87.5 %, sensitivity of 68.3 %, specificity of 83.5 %, and cutoff of 0.63 for the CONATS index. Non-invasive prediction of complete PDS is possible with the CONATS index. The CONATS index is meant as a supplement to the standard preoperative evaluation of each patient. Evaluation of the CONATS index combined with radiological and/or laparoscopic findings may improve the assessment of the optimal treatment strategy in patients with advanced epithelial ovarian cancer.

  20. A randomised controlled trial examining the effect of acupuncture at the EX-HN3 (Yintang) point on pre-operative anxiety levels in neurosurgical patients.

    Science.gov (United States)

    Wiles, M D; Mamdani, J; Pullman, M; Andrzejowski, J C

    2017-03-01

    Pre-operative anxiety is an unpleasant state of psychological distress that occurs in up to 87% of patients awaiting neurosurgical procedures. Sedative medication is undesirable in this population due to the need for early postoperative neurological assessment. Acupuncture has previously been shown to reduce pre-operative anxiety, but studies involving neurosurgical patients are lacking. This single-centre, prospective, randomised controlled trial was designed to determine the effect of acupuncture at the EX-HN3 (Yintang point) on pre-operative anxiety levels in neurosurgical patients. The study was prospectively registered before participant recruitment. After measuring baseline anxiety levels, 128 patients were randomly allocated in a 1:1 ratio by a web-based computer program to receive either acupuncture at the EX-HN3 (Yintang) point (acupuncture group) or no intervention (control group). Participants were not blinded, but all analyses were performed by a member of the research team who was unaware of the group allocation. The primary outcome measure was anxiety level after 30 min, as measured by the six-item short form of the State-Trait Anxiety Inventory (possible score range 20-80). Sixty-two patients in each group were subsequently analysed. Median (IQR [range]) anxiety State-Trait Anxiety Inventory score reduced significantly in the acupuncture group (46.7 (36.7-53.3 [23.3-70.0]) to 40.0 (30.0-46.7) [20.0-53.3]), p < 0.001), with no change seen in the control group (41.7 (33.3-53.3 [20.0-76.7]) to 43.3 (36.7-50.0 [20.0-76.7]), p = 0.829). There were no adverse events in either group. Acupuncture at the EX-HN3 point reduces pre-operative anxiety levels in patients awaiting neurosurgery.

  1. 血清CEA、CA-125、CA-153、CA-199、CA242联合检测对消化道肿瘤诊断的临床意义

    Institute of Scientific and Technical Information of China (English)

    杨德辉; 周力; 张永宏; 张澜林; 谭玉洁; 王焰; 秦雯

    2006-01-01

    目的:探讨血清CEA、CA-125、CA-153、CA-199、CA242联合检测对消化道肿瘤诊断的临床意义。方法:采用酶联免疫吸附法(ELISA法)检测130例恶性消化道肿瘤患者(食管癌32例、胃癌34例、胰腺癌30例、大肠癌34例)血清CEA、CA-125、CA-153、CA-199、CA242水平。结果:表明上述四种消化道肿瘤的血清CEA、CA-125、CA-153、CA-199、CA242与对照组比较结果统计学上均有显著性差异(P〈0.01)。除胰腺癌之外,其余3种消化道肿瘤五项肿瘤标记物联合检测的阳性率均显著高于单一标志物检测(P〈0.05),分别为食管癌62.5%、胃癌85.2%、大肠癌82.3%。结论:血清CEA、CA-125、CA-153、CA-199、CA242联合检测可以显著提高消化道恶性肿瘤诊断的敏感性。

  2. Evaluation of HE4, CA125, risk of ovarian malignancy algorithm (ROMA) and risk of malignancy index (RMI) as diagnostic tools of epithelial ovarian cancer in patients with a pelvic mass

    DEFF Research Database (Denmark)

    Karlsen, Mona Aarenstrup; Sandhu, Noreen; Høgdall, Claus

    2012-01-01

    Diagnostic factors are needed to improve the currently used serum CA125 and risk of malignancy index (RMI) in differentiating ovarian cancer (OC) from other pelvic masses, thereby achieving precise and fast referral to a tertiary center and correct selection for further diagnostics. The aim was t...... was to evaluate serum Human Epididymis protein 4 (HE4) and the risk of ovarian malignancy algorithm (ROMA) for these purposes....

  3. Can the Preoperative Serum Lactate Level Predict the Extent of Bowel Ischemia in Patients Presenting to the Emergency Department with Acute Mesenteric Ischemia?

    Directory of Open Access Journals (Sweden)

    Peter C. Ambe

    2017-01-01

    Full Text Available Purpose. Early recognition of acute mesenteric ischemia (AMI can be challenging. Extensive bowel necrosis secondary to AMI is associated with high rates of mortality. The aim of this study was to investigate the association between preoperative serum lactate level and the extent of bowel ischemia in patients with AMI. Methods. Data of patients with abdominal pain and elevated serum lactate undergoing emergency laparotomy for suspected AMI within 24 hours of presentation was retrospectively abstracted. The length of the ischemic bowel segment was compared with the preoperative serum lactate level. Results. 36 female and 39 male patients, with median age 73.1 ± 12.3 years, were included for analysis. The median preoperative lactate was 2.96 ± 2.59 mmol/l in patients with ≤50 cm, 6.86 ± 4.08 mmol/l in patients with 51–100 cm, 4.73 ± 2.76 mmol/l in patients with >100 cm ischemic bowel, and 14.07 ± 4.91 mmol/l in the group with multivisceral ischemia. Conclusion. Although elevated serum lactate might permit an early suspicion and thus influence the clinical decision-making with regard to prioritization of surgery in patients with suspected AMI, a linear relationship between serum lactate and the extent of bowel ischemia could not be established in this study.

  4. Can the Preoperative Serum Lactate Level Predict the Extent of Bowel Ischemia in Patients Presenting to the Emergency Department with Acute Mesenteric Ischemia?

    Science.gov (United States)

    Kang, Kai; Papadakis, Marios; Zirngibl, Hubert

    2017-01-01

    Purpose. Early recognition of acute mesenteric ischemia (AMI) can be challenging. Extensive bowel necrosis secondary to AMI is associated with high rates of mortality. The aim of this study was to investigate the association between preoperative serum lactate level and the extent of bowel ischemia in patients with AMI. Methods. Data of patients with abdominal pain and elevated serum lactate undergoing emergency laparotomy for suspected AMI within 24 hours of presentation was retrospectively abstracted. The length of the ischemic bowel segment was compared with the preoperative serum lactate level. Results. 36 female and 39 male patients, with median age 73.1 ± 12.3 years, were included for analysis. The median preoperative lactate was 2.96 ± 2.59 mmol/l in patients with ≤50 cm, 6.86 ± 4.08 mmol/l in patients with 51–100 cm, 4.73 ± 2.76 mmol/l in patients with >100 cm ischemic bowel, and 14.07 ± 4.91 mmol/l in the group with multivisceral ischemia. Conclusion. Although elevated serum lactate might permit an early suspicion and thus influence the clinical decision-making with regard to prioritization of surgery in patients with suspected AMI, a linear relationship between serum lactate and the extent of bowel ischemia could not be established in this study. PMID:28261615

  5. Preoperative anxiety in neurosurgical patients.

    Science.gov (United States)

    Perks, Anna; Chakravarti, Sucharita; Manninen, Pirjo

    2009-04-01

    Anxiety is common in surgical patients, with an incidence of 60% to 92%. There is little information on the incidence and severity of preoperative anxiety in patients scheduled for neurosurgery. The aim of this study was to measure the level of preoperative anxiety in neurosurgical patients and to assess any influencing factors. After the Institutional Review Board approval and informed written consent, 100 patients booked for neurosurgery were interviewed preoperatively. Each patient was asked to grade their preoperative anxiety level on a verbal analog scale, Amsterdam Preoperative Anxiety and Information Scale, and a set of specific anxiety-related questions. The anxiety scores and the responses to the questions were compared between the sex, age, weight, diagnosis, and history of previous surgery. The mean age (+/-SD) was 50+/-13 years. The preoperative diagnosis was tumor (n=64), aneurysm (n=14), and other (n=22). Overall verbal analog scale was 5.2+/-2.7; the score was higher for female (5.8+/-2.8) than male patients (4.6+/-2.5) (PAmsterdam Preoperative Anxiety and Information Scale anxiety and knowledge scores were greater for surgery than for anesthesia. Questionnaire results showed that the most common anxieties were waiting for surgery, physical/mental harm, and results of the operation. In conclusion, our study showed that neurosurgical patients have high levels of anxiety, with a higher incidence in females. There was a moderately high need for information, particularly in patients with a high level of preoperative anxiety.

  6. Cardio-pulmonary exercise testing: An objective approach to pre-operative assessment to define level of perioperative care.

    Science.gov (United States)

    Bhagwat, Milind; Paramesh, Kaggere

    2010-07-01

    Cardiopulmonary exercise testing is a non-invasive, objective method of assessing integrated response of heart, lungs and musculoskeletal system to incremental exercise. Though it has been in use for a few decades, the recent rise in its use as a preoperative test modality is reviewed. A brief account of cardiopulmonary exercise test, as it is carried out in practice and its applications, is given. The physiological basis is explained and relationship of pathophysiology of poor exercise capacity with various test variables is discussed. Its use for prediction of postoperative morbidity in various noncardiopulmonary surgical procedures is reviewed.

  7. 肝病患者肿瘤标记物CA19-9与CA125协同升高对重度肝纤维化具有高度特异性

    Institute of Scientific and Technical Information of China (English)

    Schoniger-Hekele; M.; Müller; C.

    2006-01-01

    肝硬化时肿瘤标记物的升高往往是非特异性的,目前尚无将其应用于鉴别肝纤维化程度的相关报道。该文旨在探讨肿瘤标记物是否能用于预测重度肝纤维化。研究选取125例接受过肝活检的酒精性肝炎、乙型肝炎或丙型肝炎患者,采用常规的实验室方法检测其肿瘤标记物CA19—9、CA15—3、CA125水平,并分析其与肝纤维化程度之间的相关性。其中,肝纤维化1~2级被定义为轻度纤维化,而3~4级则定义为重度纤维化。研究表明,肿瘤标记物CA19—9、CA15—3、CA125的水平随肝纤维化的程度而升高。应用于鉴别轻度(F1+F2)或重度肝纤维化(F3+F4)时,CA19—9、CA125、CA15—3的敏感度与特异度分别为70.5%、38.1%、19.0%与88.6%、89.7%、93.0%。CA19—9和CA125联合评分的logistic回归分析表明,CA19—9/CA125评分每升高1分,重度肝纤维化的可能性就增加1。6倍。与目前广泛应用的肝硬化Bonacini判断评分相比,CA19—9/CA125评分有相似特异度(97.1%vs100%),而敏感度更高(42.9%vs33.3%)。CA19—9与CA125的协同升高由:于二检测相对简便,因此除了可获得相似的特异度(98.5%)之外,亦能达到最佳的阳性预测值(92.9%),

  8. Expression of HE4 and CA1 2 5 in Ovarian Cancer Ascites%HE4和 CA125蛋白在卵巢癌腹水中的表达及其意义∗

    Institute of Scientific and Technical Information of China (English)

    陈颖; 郑丽琳; 袁晓青

    2015-01-01

    Objective]To investigate the clinical significance of HE4 protein and cancer antigen125(CA125)in ovarian cancer ascites.[Methods]5 1 cases of epithelial ovarian cancer (the ovarian cancer group),21 cases of the o-varian borderline tumor group and 1 5 cases of the control group (including 2 cases of tuberculous peritonitis,2 ca-ses of liver cirrhosis,1 1 cases of acute and chronic pelvic inflammatory disease)were selected.ELISA and radio-im-munity method were used to detect ascites,serum HE4 and CA125 protein expression.[Results]The positive rates of HE4 protein in ascites and serum of the ovarian borderline tumor group and the ovarian cancer group were sig-nificantly higher in than that in the control group(P <0.05).In ovarian cancer of different histological types,the positive expression of ascites in the endometrium ,the serous carcinoma and HE4 was significantly increased.In the early stage (Ⅰ/Ⅱ)of ovarian cancer,the sensitivity of HE4 in serum was significantly higher than that of CA125 (P <0.05).In ovarian cancer,the specificity of ascites and serum HE4 was 100%,which was significant-ly higher than that of CA125 (P <0.05).[Conclusions]Increased protein expression of HE4 were closely associat-ed with tumorigenesis and pathological behaviors of ovarian cancer,which may be used as specific tumor markers to predict the earlier ovarian cancer.Combination of HE4 and CA125 measurement in ascites has an higher diagnos-tic value in differentiate ovarian benign and malignant tumors.%【目的】探讨附睾分泌蛋白-4(human epididymis protein 4,HE4)和糖类抗原125(cancer antigen125, CA125)在卵巢癌腹水中的表达及临床意义。【方法】收集上皮性卵巢癌患者51例(卵巢癌组),卵巢交界性肿瘤21例(交界性肿瘤组),对照组15例(包括结核性腹膜炎2例、肝硬化2例,急、慢性盆腔炎11例)、分别采用ELISA 法和放射免疫法检测腹水、血清中 HE4和 CA125蛋白表达。【结果】交界性肿瘤组、

  9. 血清CA125及阴道超声在卵巢癌筛查中的应用%Screening Ovarian Cancer by Tumer Marker and Transvaginal Ultrasound

    Institute of Scientific and Technical Information of China (English)

    侯东敏; 陈焰

    2005-01-01

    卵巢癌是目前病死率最高的妇科肿瘤,早期诊断能明显提高患者的5年生存率.积极探讨早期卵巢癌的筛查方法,对提高卵巢癌患者的治愈率、降低病死率具有重要意义.血清CA125检测和阴道超声检查是有潜力的筛查方法.

  10. A phase 2, randomized, double-blind, placebo-controlled trial of clinical activity and safety of subcutaneous Å6 in women with asymptomatic CA125 progression after first-line chemotherapy of epithelial ovarian cancer

    DEFF Research Database (Denmark)

    Ghamande, Sharad A.; Silverman, Michael H.; Huh, Warner

    2008-01-01

    OBJECTIVES: A6 is a novel peptide that interferes with single-chain urokinase plasminogen activator activity and has shown anti-angiogenic, anti-migratory, and anti-invasive properties. We evaluated clinical efficacy and safety of subcutaneously administered A6 in women with epithelial ovarian...... cancer. METHODS: Women with epithelial ovarian, fallopian tube, or primary peritoneal cancer in clinical remission after first-line chemotherapy with 2 consecutive increases of CA125 values above normal but with no disease on physical examination or imaging studies were randomly assigned to receive daily...

  11. Plasma levels of angiopoietin-like protein 4 (ANGPTL4) are significantly lower preoperatively in colorectal cancer patients than in cancer-free patients and are further decreased during the first month after minimally invasive colorectal resection.

    Science.gov (United States)

    Shantha Kumara, H M C; Kirchoff, Daniel; Herath, Sajith A; Jang, Joon Ho; Yan, Xiaohong; Grieco, Michael; Cekic, Vesna; Whelan, Richard L

    2012-10-01

    Surgery has been associated with proangiogenic plasma protein changes that may promote tumor growth. Angiopoietin-like protein 4 (ANGPTL4) is expressed by endothelial cells and other tissues in response to hypoxia. Both intact ANGPTL4 and its partly degraded C-terminal fragment may promote tumor angiogenesis. This study had two purposes: to measure and compare preoperative plasma ANGPTL4 levels in patients with colorectal cancer (CRC) and benign colorectal disease (BCD) and to determine plasma levels after minimally invasive colorectal resection (MICR) for CRC. Plasma was obtained from an IRB-approved plasma/data bank. Preoperative plasma ANGPTL4 levels were measured for CRC and BCD patients, but postoperative levels were determined only for CRC patients for whom a preoperative, a postoperative day (POD) 3, and at least one late postoperative sample (POD 7-55) were available. Late samples were bundled into four time blocks and considered as single time points. ANGPTL4 levels (mean ± SD) were measured via ELISA and compared (significance, p MICR for CRC, levels are significantly lower for over a month compared with the preoperative level; the cause for this persistent decrease is unclear. The implications of both the lower preoperative level and the persistently decreased postoperative levels are unclear. Further studies are needed.

  12. 血清CA125检测在上皮性卵巢肿瘤中的应用%Application of serum carbohydrate antigen 125 in testing epithelial ovarian tumor

    Institute of Scientific and Technical Information of China (English)

    付晓宇; 宋磊

    2005-01-01

    卵巢肿瘤是女性生殖系统常见肿瘤,其组织学类型复杂且有良性、交界性及恶性之分。上皮性肿瘤占卵巢原发肿瘤的50%~70%。在卵巢原发性恶性肿瘤中,卵巢上皮癌是一种最常见的类型(占60%~90%),居妇科肿瘤死亡率的第一位。有效的肿瘤标记物能为卵巢癌的早期诊断、肿瘤复发和转移的监测、疗效观察及预后判断提供可靠的依据。血清糖类抗原125(carbohydrate antlgen 125,CA125)被认为是目前卵巢上皮癌最好的标记物。现就血清CA125对卵巢上皮性肿瘤的早期诊断、病情监测、复发预报、预后监测的应用综述如下:

  13. Do psychological interventions reduce preoperative anxiety?

    Science.gov (United States)

    Renouf, Tessa; Leary, Alison; Wiseman, Theresa

    The systematic review investigates whether, during preoperative assessments, nurse-delivered psychological interventions reduce anxiety levels preoperatively for patients undergoing elective surgery. Seventeen studies met the inclusion criteria for data extraction and in-depth critiquing. Of these, two were discarded due to lack of validity, while the remaining studies were organised thematically in a narrative synthesis, generating two principal results: patients' preoperative anxieties were lowered by nurse-delivered general preoperative psychological interventions; and patients valued individualised preoperative interventions delivered by nurses. However, the single oncology study in the review showed an elevation in preoperative anxiety, regardless of intervention, and highlights the need for more research in this under-reviewed area. In the meantime, the authors believe that service improvements should be implemented to ensure that, where possible, psychological preoperative interventions are individualised.

  14. Immunohistochemical distinction of renal cell carcinoma from other carcinomas with clear-cell histomorphology: utility of CD10 and CA-125 in addition to PAX-2, PAX-8, RCCma, and adipophilin.

    Science.gov (United States)

    Mentrikoski, Mark J; Wendroth, Scott M; Wick, Mark R

    2014-10-01

    Clear-cell renal cell carcinoma (CC-RCC) is the most common primary kidney malignancy, yet this morphology is not unique to renal primary tumors, as clear-cell variants of numerous nonrenal carcinomas of varying lineages exist. Therefore, because of CC-RCC's ability to metastasize to nearly any anatomic location, ancillary studies such as immunohistochemistry are often needed to establish the diagnosis. Despite CD10 and renal cell carcinoma monoclonal antibody (RCCma) being touted as sensitive and specific markers, some have suggested that more recent stains including PAX-2, PAX-8, or adipophilin (ADP) are more robust markers of CC-RCC. In this study, 26 cases of CC-RCC, and 51 nonrenal carcinomas with clear-cell histomorphology (CCM) were stained with CD10, RCCma, PAX-2, PAX-8, and ADP. CA-125 was also included to help distinguish CC-RCC from Müllerian clear-cell carcinomas, due the known expression of PAX-2 and PAX-8 in both these entities. RCCma highlighted 77% of CC-RCC and 27% of the CCM group, whereas CD10 was positive in 85% and 25%, respectively. ADP highlighted all CC-RCC and 45% of CCMs. PAX-2 was positive in 81% of CC-RCC and 24% of CCM, whereas PAX-8 stained 100% of CC-RCC and 39% of CCM. Müllerian-derived tumors (clear-cell carcinomas of the ovary, vagina, and cervix) were positive with PAX-2 and PAX-8 in 69% and 100% of cases, respectively. No cases of CC-RCC stained with CA-125, whereas 88% of the Müllerian-derived tumors were positive. In summary, although new markers such as PAX-2 and PAX-8 tend to be more sensitive markers of CC-RCC, they lose specificity when Müllerian tumors are included. Inclusion of a classic renal marker such as CD10 or RCCma in the immunohistochemical panel, as well as CA-125 obviates this difficulty.

  15. [Predictive value of combination detection of tissue Pgp1 expression and preoperative serum CEA level for colorectal cancer].

    Science.gov (United States)

    Wu, Fan; Chen, Lei; Wu, Wei; Jiang, Beihai; Su, Xiangqian

    2017-04-25

    To explore the predictive value of combination detection of Pgp1 expression in cancer tissue and serum CEA level for the prognosis of colorectal cancer (CRC) patients. Clinicopathological data, complete 5-year follow-up data and CRC tissue samples of 153 CRC patients with stage I( to II( tumor undergoing radical operation in our department from January 2004 to August 2006 were retrospectively collected. Immunohistochemical staining was used to detect the expression level of Pgp1. The combined evaluation of staining intensity and positive cell percentage was performed to determine the expression level of Pgp1. Pgp1 staining (-) and (+) was defined as low expression; and staining (++) and (+++) as high expression. Electrochemiluminescence immunoassay was used to detect the level of serum CEA. CEA > 5 μg/L was defined as positive. χ(2) and Fisher's exact test were performed to analyze the association of Pgp1 expression with CEA level and clinicopathological variables. Moreover, Kaplan-Meier method was used to analyze the survival. Univariate and multivariate Cox proportional hazard regression models were used to evaluate the roles of Pgp1 expression combined with serum CEA level in prognosis prediction. Of 153 patients, 105 were males and 48 females with mean age of 59 (27 to 90) years; 41 cases were rectal cancer, and 112 cases colon cancer; 23 patients were TNM stage I( tumor, and 130 patients stage II( tumor; median follow-up time was 64 months; 30 cases were dead. Positive rate of Pgp1 expression in colorectal cancer tissues was 66.0%(101/153). The expression of Pgp1 was associated with gender, tumor location, and survival during the follow-up (all Pcancer tissue indicates poor prognosis in patients with stage I( and II( tumor. Combination detection of Pgp1 expression and serum CEA can be applied to predict the prognosis of patients with stage I( and II( colorectal cancer.

  16. The importance of preoperative elevated serum levels of CEA and CA15-3 in patients with breast cancer in predicting its histological type.

    Directory of Open Access Journals (Sweden)

    J Słonina

    2010-06-01

    Full Text Available It is not known whether in patients with breast cancer the occurrence of elevated serum tumour markers depends on its histological type. The aim of the study was to assess relationship between breast cancer histological type and the presence of increased serum levels of CEA and CA 15-3. The study population was 428 patients (all women, mean age 52.5 years, treated at The Department of Surgery of Wroclaw Medical University from 2005 to 2008 due to breast cancer. All of them had their preoperative CA 15-3 and CEA serum concentrations measured. According to the TNM system, 21% of patients were in stage I, 32.5% in stage II, 46.5% in stage III of the disease. In patients with ductal type of the cancer the elevated serum levels of CEA and CA 15-3 were observed in 48.7% and 42.2%, in lobular type in 42.4% and 52.5%, and in non-ductal/tubular types in 48.1% and 40.4% (p=N/S. Stepwise logistic regression analyses showed that ductal breast cancer is related to elevated CEA and normal CA 15-3 serum levels. The histological types of breast cancer are not significantly related to elevated serum levels of CEA and/or CA 15-3.

  17. Randomized Clinical Trial To Compare The Effects Of Preoperative Oral Carbohydrate Loading Versus Placebo On Insulin Resistance And Cortisol Level After Laparoscopic Cholecystectomy*

    Directory of Open Access Journals (Sweden)

    Pędziwiatr Michał

    2015-08-01

    Full Text Available Postoperative insulin resistance, used as a marker of stress response, is clearly an adverse event. It may induce postoperative hyperglycemia, which according to some authors can increase the risk of postoperative complications. One of the elements of modern perioperative care is preoperative administration of oral carbohydrate loading (CHO-loading, which shortens preoperative fasting and reduces insulin resistance.

  18. Preoperative ultrasonographic evaluation of the contralateral patent processus vaginalis at the level of the internal inguinal ring is useful for predicting contralateral inguinal hernias in children: a prospective analysis.

    Science.gov (United States)

    Kaneda, H; Furuya, T; Sugito, K; Goto, S; Kawashima, H; Inoue, M; Hosoda, T; Masuko, T; Ohashi, K; Ikeda, T; Koshinaga, T; Hoshino, M; Goto, H

    2015-08-01

    The current study aimed to verify the usefulness of preoperative ultrasonographic evaluation of contralateral patent processus vaginalis (PPV) at the level of the internal inguinal ring. This was a prospective study of patients undergoing unilateral inguinal hernia repair at two institutions during 2010-2011. The sex, age at initial operation, birth weight, initial operation side, and the preoperative diameter of the contralateral PPV as determined using ultrasonography (US) were recorded. We analyzed the incidence of contralateral inguinal hernia, risk factors, and the usefulness of the preoperative major diameter of the contralateral PPV. The follow-up period was 36 months. All 105 patients who underwent unilateral hernia repair completed 36 months of follow-up, during which 11 patients (10.5 %) developed a contralateral hernia. The following covariates were not associated with contralateral hernia development: sex (p = 0.350), age (p = 0.185), birth weight (p = 0.939), and initial operation side (p = 0.350). The preoperative major diameter of the contralateral PPV determined using US was significantly wider among patients with a contralateral hernia than those without a contralateral hernia (p = 0.001). When the 105 patients were divided into two groups according to cut-off values of the preoperative major diameter of the contralateral PPV (wide group, >2.0 mm; narrow group, ≤2.0 mm), a significant association was observed between the preoperative major diameter of the contralateral PPV and patient outcomes (p = 0.001). We used US and confirmed the usefulness of a preoperative evaluation of the major diameter of the contralateral PPV at the level of the internal inguinal ring in pediatric patients with unilateral inguinal hernias.

  19. Mesonephric adenocarcinomas of the uterine cervix and corpus: HPV-negative neoplasms that are commonly PAX8, CA125, and HMGA2 positive and that may be immunoreactive with TTF1 and hepatocyte nuclear factor 1-β.

    Science.gov (United States)

    Kenny, Sarah L; McBride, Hilary A; Jamison, Jackie; McCluggage, W Glenn

    2012-06-01

    Mesonephric adenocarcinomas are rare neoplasms that most commonly arise in the uterine cervix and exceptionally rarely in the uterine corpus. Although the morphologic features of these neoplasms are well described, there has been relatively limited investigation of the immunoprofile. We report a series of 8 mesonephric adenocarcinomas arising in the uterine cervix (7 cases) and corpus (1 case) and undertake a comprehensive immunohistochemical analysis. This includes markers that have not been investigated previously in mesonephric adenocarcinomas but that are commonly used in gynecologic pathology and may be undertaken when other, mainly Mullerian, adenocarcinomas are considered in the differential diagnosis. Linear array human papillomavirus (HPV) genotyping was also performed. Our results broadly confirm the immunohistochemical profile demonstrated in previous studies with the majority of mesonephric adenocarcinomas staining positively with CD10 (6 of 8), epithelial membrane antigen (8 of 8), vimentin (8 of 8), and calretinin (7 of 8). Estrogen receptor was positive in 2, carcinoembryonic antigen in 3, and inhibin in 4 cases. p16 was positive in 5 cases (1 diffuse and strong), despite all being HPV negative (in 1 case, there was insufficient DNA for HPV analysis). Novel findings in our study were the demonstration of nuclear positivity with PAX8 and HMGA2 in 7 cases, CA125 immunoreactivity in all 8 cases, and TTF1 and hepatocyte nuclear factor 1-β staining in 3 cases. As PAX8, CA125, HMGA2, and hepatocyte nuclear factor 1-β are commonly positive in a variety of Mullerian adenocarcinomas arising in the female genital tract, this may result in diagnostic confusion. All cases were WT1 negative.

  20. Oregovomab: anti-CA-125 monoclonal antibody B43.13--AltaRex, B43.13, MAb B43.13, monoclonal antibody B43.13.

    Science.gov (United States)

    2006-01-01

    ViRexx Medical Corp is developing the murine monoclonal antibody oregovomab [OvaRex, MAb B43.13] for the treatment of ovarian cancer. Oregovomab targets the circulating tumour-associated antigen CA 125, which is shed from the surface of human ovarian cancer cells; the antibodies induce broad cellular and humoral immune responses against CA 125 via complex formation. Unlike free CA 125, CA 125-oregovomab complexes can prime dendritic cells, leading to downstream activation of T cells. The antibody is undergoing advanced clinical development. AltaRex, the originator of oregovomab, was acquired by, and merged into, ViRexx Medical Corp in December 2004. AltaRex (now ViRexx Medical Corp) has established several strategic corporate alliances for the development and/or commercialisation of oregovomab. Unither Pharmaceuticals, a subsidiary of United Therapeutics Corporation, entered into a licensing agreement with ViRexx in April 2002. The agreement covers most territories worldwide, except Europe and the Middle East, which are covered by other agreements (see below); ViRexx did retain the rights to most member nations of the EU and certain other countries. In August 2003, the agreement was extended, granting United Therapeutics Corporation development rights for Germany. AltaRex and Dompe entered into a distribution agreement for oregovomab in July 2004. Territories included in the agreement are Italy, Spain, Portugal, Hungary, Poland, Czech Republic, Switzerland, Austria and certain other Eastern European countries. Under the terms of the agreement, ViRexx retains responsibility for product development and registration of the antibody, upon commercialisation in the agreed territory. The two companies will work closely to achieve product registration throughout Europe. In June 2001, Dompe entered into a sublicensing agreement with FAES for the commercialisation of oregovomab in Spain and Portugal. ViRexx is also seeking collaboration partners for Northern European markets

  1. Prognostic significance of preoperative anemia, leukocytosis and thrombocytosis in chinese women with epithelial ovarian cancer.

    Science.gov (United States)

    Chen, Ying; Zhang, Lei; Liu, Wen-Xin; Liu, Xiang-Yu

    2015-01-01

    Malignant tumors are often accompanied by increased risk of hematological abnormalities. However, few studies have reported any prognostic impact of preoperative thrombocytosis, leukocytosis and anemia in epithelia ovarian cancer (EOC). This study aimed to investigate preoperative hematological parameters for anemia, leukocytosis and thombocytosis in relation to established prognostic factors and survival in EOC cases. A total of 816 Chinese women treated for EOC were retrospectively included in the study focusing on the relationship between preoperative hemoglobin, leukocyte and platelet counts, and a panel of clinicopathologic characteristics and outcome. Preoperative anemia was present in 13.4%, leukocytosis in 16.7% and thrombocytosis in 22.8% . Additionally, EOC patients with low differentiation grade, advanced stage, lymph node (LN) metastasis, residual disease ≥ 1cm, ascites volume >1,000ml, serum cancer antigen 125 (CA125) >675U/ml, and disease recurrence had the higher prevalence of preoperative anemia, leukocytosis and thrombocytosis (all pthrombocytosis (28.7% vs 17.3% or 26.0% vs 17.7%). Furthermore, in a Cox proportional hazard model, thrombocytosis was an independent factor for progression-free survival (PFS) and overall survival (OS) (pthrombocytosis in EOC patients is closely associated with more malignant disease phenotype and poorer prognosis. Significantly, thrombocytosis may independently predict the disease- specific survival for EOC patients.

  2. Can primary optimal cytoreduction be predicted in advanced epithelial ovarian cancer preoperatively?

    Directory of Open Access Journals (Sweden)

    Behtash Nadereh

    2010-02-01

    Full Text Available Abstract Introduction Prediction of optimal cytoreduction in patients with advanced epithelial ovarian caner preoperatively. Methods Patients with advanced epithelial ovarian cancer who underwent surgery for the first time from Jan. to June 2008 at gynecologic oncology ward of TUMS (Tehran University of Medical Sciences were eligible for this study. The possibility of predicting primary optimal cytoreduction considering multiple variables was evaluated. Variables were peritoneal carcinomatosis, serum CA125, ascites, pleural effusion, physical status and imaging findings. Univariate comparisons of patients underwent suboptimal cytoreduction carried out using Fisher's exact test for each of the potential predictors. The wilcoxon rank sum test was used to compare variables between patients with optimal versus suboptimal cytoreduction. Results 41 patients met study inclusion criteria. Statistically significant association was noted between peritoneal carcinomatosis and suboptimal cytoreduction. There were no statistically significant differences between physical status, pleural effusion, imaging findings, serum CA125 and ascites of individuals with optimal cytoreduction compared to those with suboptimal cytoreduction. Conclusions Because of small populations in our study the results are not reproducible in alternate populations. Only the patient who is most unlikely to undergo optimal cytoreduction should be offered neoadjuvant chemotherapy, unless her medical condition renders her unsuitable for primary surgery.

  3. Anxiety in preoperative anesthetic procedures.

    Science.gov (United States)

    Valenzuela Millán, Jaquelyn; Barrera Serrano, José René; Ornelas Aguirre, José Manuel

    2010-01-01

    Preoperative anxiety is a common and poorly evaluated condition in patients who will undergo an anesthetic and surgical intervention. The objective of this study was to determine the prevalence of anxiety in a group of patients undergoing elective surgery, as assessed by the Amsterdam Anxiety Preoperative and Information (AAPI) scale. We studied 135 patients scheduled for elective surgery applying the AAPI scale 24 h before the surgical procedure to evaluate the presence of anxiety and patient characteristics. A descriptive analysis with mean +/- standard deviation for categorical variables was done. For intragroup differences, chi(2) test was used. Pearson correlation for the association between anxiety and postoperative complications was carried out. A value of p =0.05 was considered significant. One hundred six patients were surgically treated, 88% were female (average age 44 +/- 12 years). Some degree of preoperative anxiety was present in 72 patients (76%; p = 0.001) with a grade point average on the AAPI scale equal to 17 +/- 7 points, of which 95 (70%, OR = 5.08; p = 0.002) were females. Results of this study suggest the presence of high levels of preoperative anxiety in patients scheduled for elective surgery. The origin of the anxiety appears to be related to many factors that can be evaluated in pre-anesthetic consultation. Further study is needed to prevent the presence of this disorder.

  4. Preoperative plasma plasminogen activator inhibitor type-1 and serum C-reactive protein levels in patients with colorectal cancer. The RANX05 Colorectal Cancer Study Group

    DEFF Research Database (Denmark)

    Nielsen, Hans Jørgen; Christensen, Ib Jarle; Sørensen, Steen

    2000-01-01

    BACKGROUND: Preoperative plasma plasminogen activator inhibitor-1 (PAI-1) is a prognostic variable in patients with colorectal cancer. It has been suggested, however, that plasma PAI-1 is a nonspecific prognostic parameter similar to the acute-phase reactant C-reactive protein (CRP). In the present...... statistical analysis including Dukes classification, gender, age, tumor location, perioperative blood transfusion, PAI-1 and CRP, plasma PAI-1 was a dependent prognostic variable, while serum CRP (P

  5. Preoperative preparation of children

    Directory of Open Access Journals (Sweden)

    Priya Reshma Aranha

    2017-01-01

    Full Text Available Surgery is a stressful and anxiety provoking experience for children. Millions of children undergo surgery every year. The majority of children experience significant preoperative anxiety which intern can affect their recovery. Preoperative anxiety may bring about physical and physiological changes in children, which can be particularly evident in terms of increased heart rate and blood pressure. To identify various strategies used to minimize the preoperative anxiety of children and update their clinical effectiveness among children undergoing surgery, the authors searched PubMed, MEDLINE, CINAHL, ScienceDirect, Google Scholar, Scopus, and Cochrane Library for identifying the relevant studies and retrieved available literature. It is concluded that utilization of the strategies available to reduce the preoperative anxiety of children will be a promising intervention to reduce anxiety, to promote relaxation, satisfaction, and speedy recovery. Many of these techniques are simple, cost-effective and can be easily carried out by nurses. It is essential to use the age appropriate and individualized methods in preparing children for surgery. Further research is required to strengthen the evidence.

  6. Preoperative prediction of severe postoperative pain.

    Science.gov (United States)

    Kalkman, C J; Visser, K; Moen, J; Bonsel, G J; Grobbee, D E; Moons, K G M

    2003-10-01

    We developed and validated a prediction rule for the occurrence of early postoperative severe pain in surgical inpatients, using predictors that can be easily documented in a preoperative setting. A cohort of surgical inpatients (n=1416) undergoing various procedures except cardiac surgery and intracranial neurosurgery in a University Hospital were studied. Preoperatively the following predictors were collected: age, gender, type of scheduled surgery, expected incision size, blood pressure, heart rate, Quetelet index, the presence and severity of preoperative pain, health-related quality of life the (SF-36), Spielberger's State-Trait Anxiety Inventory (STAI) and the Amsterdam Preoperative Anxiety and Information Scale (APAIS). The outcome was the presence of severe postoperative pain (defined as Numeric Rating Scale > or =8) within the first hour postoperatively. Multivariate logistic regression in combination with bootstrapping techniques (as a method for internal validation) was used to derive a stable prediction model. Independent predictors of severe postoperative pain were younger age, female gender, level of preoperative pain, incision size and type of surgery. The area under the receiver operator characteristic (ROC) curve was 0.71 (95% CI: 0.68-0.74). Adding APAIS scores (measures of preoperative anxiety and need for information), but not STAI, provided a slightly better model (ROC area 0.73). The reliability of this extended model was good (Hosmer and Lemeshow test p-value 0.78). We have demonstrated that severe postoperative pain early after awakening from general anesthesia can be predicted with a scoring rule, using a small set of variables that can be easily obtained from all patients at the preoperative visit. Before this internally validated preoperative prediction rule can be applied in clinical practice to support anticipatory pain management, external validation in other clinical settings is necessary.

  7. Interventions for preoperative smoking cessation

    DEFF Research Database (Denmark)

    Møller, A; Villebro, N

    2005-01-01

    Smokers have a substantially increased risk of intra- and postoperative complications. Preoperative smoking intervention may be effective in decreasing this incidence. The preoperative period may be a well chosen time to offer smoking cessation interventions due to increased patient motivation....

  8. A risk of malignancy index in preoperative diagnosis of ovarian cancer

    Institute of Scientific and Technical Information of China (English)

    马水清; 沈铿; 郎景和

    2003-01-01

    Objective To evaluate the ability of a risk of malignancy index (RMI), based on serum CA125 level, ultrasound findings and menopausal status, to discriminate benign from malignant pelvic mass. Methods One hundred and forty women with pelvic masses, at age 30 of years or more were admitted to the Peking Union Medical College Hospital between January 1998 and June 1999. The sensitivity, specificity and positive predictive value of serum CA125 level, ultrasound findings and the menopausal status in diagnosis of ovarian cancer were evaluated separately or combined into the RMI. Results RMI was more accurate than any individual criterion in diagnosing cancer. Using an RMI cutoff level of 200 to indicate malignancy, the RMI derived from this data set gave a sensitivity of 87.3%, a specificity of 84.4%, and a positive predictive value of 82.1%. Conclusions RMI is able to correctly discriminate malignant from benign pelvic mass. It can be introduced easily into clinical practice to facilitate the selection of patients for primary surgery.

  9. Pre-operative anaemia.

    Science.gov (United States)

    Clevenger, B; Richards, T

    2015-01-01

    Pre-operative anaemia is a relatively common finding, affecting a third of patients undergoing elective surgery. Traditionally associated with chronic disease, management has historically focused on the use of blood transfusion as a solution for anaemia in the peri-operative period. Data from large series now suggest that anaemia is an independent risk associated with poor outcome in both cardiac and non-cardiac surgery. Furthermore, blood transfusion does not appear to ameliorate this risk, and in fact may increase the risk of postoperative complications and hospital length of stay. Consequently, there is a need to identify, diagnose and manage pre-operative anaemia to reduce surgical risk. Discoveries in the pathways of iron metabolism have found that chronic disease can cause a state of functional iron deficiency leading to anaemia. The key iron regulatory protein hepcidin, activated in response to inflammation, inhibits absorption of iron from the gastrointestinal tract and further reduces bioavailability of iron stores for red cell production. Consequently, although iron stores (predominantly ferritin) may be normal, the transport of iron either from the gastrointestinal tract or iron stores to the bone marrow is inhibited, leading to a state of 'functional' iron deficiency and subsequent anaemia. Since absorption from the gastrointestinal tract is blocked, increasing oral iron intake is ineffective, and studies are now looking at the role of intravenous iron to treat anaemia in the surgical setting. In this article, we review the incidence and impact of anaemia on the pre-operative patient. We explain how anaemia may be caused by functional iron deficiency, and how iron deficiency anaemia may be diagnosed and treated.

  10. Preoperative exercise training to improve postoperative outcomes

    NARCIS (Netherlands)

    Valkenet, K.

    2017-01-01

    It is common knowledge that better preoperative physical fitness is associated with better postoperative outcomes. However, as a result of aging of the population and improved surgical and anaesthesia techniques, the proportion of frail patients with decreased physical fitness levels undergoing majo

  11. Pulmonary valve replacement in chronic pulmonary regurgitation in adults with congenital heart disease: impact of preoperative QRS-duration and NT-proBNP levels on postoperative right ventricular function.

    Science.gov (United States)

    Westhoff-Bleck, Mechthild; Girke, Stefan; Breymann, Thomas; Lotz, Joachim; Pertschy, Stefanie; Tutarel, Oktay; Roentgen, Philipp; Bertram, Harald; Wessel, Armin; Schieffer, Bernhard; Meyer, Gerd Peter

    2011-09-15

    Chronic severe pulmonary regurgitation (PR) causes progressive right ventricular (RV) dysfunction and heart failure. Parameters defining the optimal time point for surgery of chronic PR are lacking. The present study prospectively evaluated the impact of preoperative clinical parameters, cardiorespiratory function, QRS duration and NT-proBNP levels on post operative RV function and volumes assessed by cardiac magnetic resonance imaging (CMR) in patients with chronic severe PR undergoing pulmonary valve replacement. CMR was performed pre- and 6 months postoperatively in 27 patients (23.6 ± 2.9 years, 15 women) with severe PR. Postoperatively, RV endsystolic (RVESVI) and enddiastolic volume indices (RVEDVI) decreased significantly (RVESVI pre 78.2 ± 20.4 ml/m² BSA vs. RVESVI post 52.2 ± 16.8 ml/m²BSA, pfunction and volumes. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  12. Preoperative measurement of maternal abdominal circumference relates the initial sensory block level of spinal anesthesia for cesarean section: An observational study.

    Science.gov (United States)

    Kuok, Chi-Hang; Huang, Chung-Hsin; Tsai, Pei-Shan; Ko, Yuan-Pi; Lee, Wei-Shih; Hsu, Yung-Wei; Hung, Fang-Yu

    2016-12-01

    Lumbosacral cerebrospinal fluid volume is decreased as the enlarging uterus compresses the inferior vena cava during pregnancy. A subsequent greater cephalad spread of sensory blockade is observed. Gravid uterus plays a crucial role in affecting the spinal anesthesia level. We hypothesized that maternal abdominal circumference can reflect compressive effect of the uterus and investigated the relationship between abdominal circumference and the level of sensory blockade, and incidence of hypotension following spinal anesthesia with hyperbaric bupivacaine in term parturients. Forty-two term parturients scheduled for elective cesarean section were studied. Abdominal circumference was measured before spinal anesthesia; 0.5% hyperbaric bupivacaine (2 mL, 2.2 mL, or 2.4 mL) was injected in to the subarachnoid space at the L3-L4 intervertebral level according to the parturient's height. The level of sensory blockade was assessed using an ice cube 1 minute, 5 minutes, 10 minutes, and 15 minutes after the spinal injection. The level of sensory blockade at the 15(th) minute was defined as the level of maximum sensory blockade. Statistical correlation coefficients were evaluated with Spearman's rank correlation. The correlation coefficient between the abdominal circumference and spinal level measured by cold sensation loss at 5 minutes after spinal anesthesia was significantly positive (right side ρ=0.43, p=0.005; left side ρ=0.46, p=0.003). No significant correlation was found between abdominal circumference and the level of maximum sensory blockade, the incidence of hypotension, ephedrine dosage, nausea, and vomiting after spinal anesthesia. Parturients with greater abdominal circumference value have a higher level of sensory blockade at 5 minutes after spinal anesthesia. Abdominal circumference cannot predict the maximum sensory blockade level and the incidence of hypotension. Copyright © 2016. Published by Elsevier B.V.

  13. Preoperative plasma level of IL-10 but not of proinflammatory cytokines is an independent prognostic factor in patients with gastric cancer.

    Science.gov (United States)

    Szaflarska, Anna; Szczepanik, Antoni; Siedlar, Maciej; Czupryna, Antoni; Sierzega, Marek; Popiela, Tadeusz; Zembala, Marek

    2009-12-01

    There have been many discrepant observations on the serum levels of cytokines in cancer patients and their prognostic value. The purpose of this study was to determine the plasma levels of pro- and anti-inflammatory cytokines and their clinical significance in a large group of patients with gastric carcinoma. The levels of tumour necrosis factor alpha (TNF alpha), interleukin-12p40 (IL-12p40), IL-12p70, IL-18, IL-10 and soluble TNF receptors I and II sTNF-Rs were investigated in the plasma of 136 consecutive patients with biopsy proven gastric cancer using specific enzyme-linked immunoabsorbent assays (ELISA). Survival curves were estimated using the method of Kaplan and Meier and the differences in the survival rates were tested by the log-rank test. For multivariate analysis of prognostic factors, the Cox proportional hazard model was used. Proinflammatory cytokines and sTNF-Rs were higher in the whole group of patients in comparison to healthy volunteers. IL-10 was elevated mostly in advanced disease. The increased levels of IL-10 (>10 pg/ml) were associated with significantly poorer survival of patients, while the levels of the other cytokines and sTNF-Rs showed no correlation with prognosis. The increased level of IL-10 is an independent unfavorable prognostic factor in patients with gastric cancer.

  14. The analysis of serum CEA、CA125、CA199 in 174 patients with cancer%肿瘤患者血清中癌胚抗原、癌相关糖抗原125和199的检测结果分析

    Institute of Scientific and Technical Information of China (English)

    姚辉盛; 翁克丽

    2012-01-01

    Objective Discussion of patients with tumor of three kinds of serum tumor markers CEA, CA12-5 and CA19 -9 level changes, and in tumor assisted diagnosis application value Methods Using a chemiluminescence immune assay for the detection of particles in 60 cases with coloreclal cancer, 25 cases of patients with lung cancer, 40 cases of gastric cancer, 15 cases of patients with esophageal cancer, 18 cases of bladder carcinoma, 16 cases of cervical esophageal carcinoma patients and 50 healthy people 3 tumor markers in serum level. Results Colorectal cancer, lung cancer and gastric cancer patients with 3 kinds of serum tumor markers levels and positive rates were significantly higher than those in healthy people group (P<0. 01), there was a significant difference; in patients with cervical cancer CAI25 levels and positive rates were significantly higher than those in healthy group (P <0. 01), there was a significant difference. Conclusions 3 kinds of serum tumor markers for tumor diagnosis is of certain clinical value, the positive rate of combined detection is more higher, bladder cancer, esophageal cancer and cervical cancer patients should be combined with clinical symptoms, operation and pathology examination.%目的 探讨肿瘤患者血清中肿瘤标志物癌胚抗原(CEA)、癌相关糖抗原125和199水平的变化及其在肿瘤辅助诊断中的应用价值.方法 采用化学发光微粒免疫分析法检测60例结直肠癌患者、25例肺癌患者、40例胃癌患者、15例食管癌患者、18例膀胱癌患者、16例宫颈癌患者和50例健康人血清中CEA、CA12 -5和CA19 -9的水平.结果 结直肠癌、肺癌和胃癌患者的CEA、CA12 -5和CA19 -9水平及阳性率均明显高于对照组,差异有统计学意义(P<0.01);宫颈癌患者CA125水平及阳性率均明显高于对照组,差异有统计学意义(P<0.01).结论 CEA、CA12 -5和CA19 -9对于肿瘤的辅助诊断有一定的临床参考价值,联合检测的阳性率更高,膀

  15. Low pre-operative levels of serum albumin predict lymph node metastases and ultimately correlate with a biochemical recurrence of prostate cancer in radical prostatectomy patients

    Directory of Open Access Journals (Sweden)

    Atsushi Takenaka

    2013-01-01

    Full Text Available Introduction. To date, only few studies focusing on the issue of host general and immune activity have been performed in localized prostate cancer (PCa. The aim of this study was to elucidate potent non tumor–related biomarkers that express aggressiveness of PCa treated by radical prostatectomy (RP.Materials and methods. Data from 179 patients who underwent RP were analyzed. The correlations between various kinds of non tumor–related factors in addition to tumor–related factors and biochemical recurrence (BCR were analyzed. The correlations between pre–, intra– and post–operative factors were also analyzed. Results. Thirty–two cases (17.9% had a BCR. The factors found to be significantly predictive of BCR using a Cox–proportional hazard model were the pre–operative serum prostate specific antigen (PSA level and the existence of pathological lymph node metastasis (LNM. A low pre–operative serum albumin level (<4.0 g/dl was significantly correlated with BCR univariately. Logistic regression analysis revealed that a low pre–operative serum albumin level, an American Society of Anesthesiologists (ASA score above class 2, and a Gleason score above 8 in the biopsy specimens were significantly predictive of pathological LNM.Conclusions. Tumor–related characteristics are more important for predicting BCR. However, our results suggest that low pre–operative serum albumin level may indicate extensive disease of clinically localized PCa and may ultimately be correlated with BCR. Although multiple reasons may account for the significance of the serum albumin level, it is noteworthy that delayed diagnostic and therapeutic procedures in comorbid patients with low serum albumin levels may lead to PCa progression.

  16. Preoperative Hba1c level in prediction of short-term morbidity and mortality outcomes following coronary artery bypass grafting surgery

    Directory of Open Access Journals (Sweden)

    Ümit Arslan

    2015-05-01

    Conclusion ― We concluded that in those diabetic patients that elective coronart artery bypass graft is applied, highly reactive HbA1c levels (HbA1c ≥7, may indicate morbitity in the early stages of post operation.

  17. 术前纤维蛋白原水平与结直肠癌病理分期的关系%Relationship between the preoperative level of fibrinogen and the pathological staging in colorectal cancer

    Institute of Scientific and Technical Information of China (English)

    汪晓东; 刘丹; 吕东昊; 秦昌龙; 曾蓉; 李立

    2009-01-01

    Objective To evaluate the value of serum fibrinogen level to the preoperative staging of colorectal cancer. Methods Three hundred and five patients pathologically proved colorectal cancer were analyzed the relationships between the serum fibrinogen level measured preoperatively and pathological stages postoperatively. Results There were statistic differences of fibrinogen in T, N, M stages (P3.50 g/L), the accuracy, sensitivity and specificity of prediction to lymphatic metastasis were 62.4%, 53.3% and 69.1%, respectively. The level of fibrinogen was related to the age, the tumor differentiation and operation procedure. Conclusion The expressed level of fibrinogen is related with the colorectal cancer stage ancl lymphatic metastasis. Hyperfibrinogenemia is an effective predictor of lymphatic metastasis in colorectal cancer.%目的:探讨结直肠癌患者纤维蛋白原水平对结直肠癌术前分期的价值.方法:经病理诊断为结直肠癌患者305例于术前3 d测定血清纤维蛋白原的水平,分析纤维蛋白原术前水平与术后病理分期的关系.结果:纤维蛋白原在不同的T分期、N分期、TNM分期之间差异有统计学意义(P3.50 g/L)预测淋巴结转移的准确度为62.4%,敏感度为53.3%,特异度为69.1%.纤维蛋白原水平与年龄、分化程度、手术方案有关(P<0.05).结论:纤维蛋白原表达水平与结直肠癌分期以及淋巴结转移相关,高纤维蛋白血症可用于预测结直肠癌的淋巴结转移.

  18. Preoperative serum levels of epidermal growth factor receptor, HER2, and vascular endothelial growth factor in malignant and benign ovarian tumors

    DEFF Research Database (Denmark)

    Dahl Steffensen, Karina; Waldstrøm, Marianne; Jeppesen, Ulla;

    2008-01-01

    Background: Epidermal growth factor receptors ([EGFRs]; EGFR/HER1 and ErbB2/HER2) and vascular endothelial growth factor (VEGF) are essential to tumor growth and angiogenesis. The aim of the present study was to investigate the serum levels of these potential biomarkers in benign, borderline......, and malignant ovarian tumors. Patients and Methods: Serum from 233 patients (75 serous ovarian/tubal/peritoneal cancers, 24 borderline tumors, 110 benign ovarian tumors, and 24 with normal ovaries) were analyzed for EGFR, HER2, and VEGF using commercially available enzyme-linked immunosorbent assays (ELISA...

  19. Effect of acupressure on preoperative anxiety: a clinical trial.

    Science.gov (United States)

    Valiee, Sina; Bassampour, Shiva Sadat; Nasrabadi, Alireza Nikbakht; Pouresmaeil, Zahra; Mehran, Abbas

    2012-08-01

    Preoperative anxiety, as an emotional reaction, is common among patients undergoing surgery. The purpose of this study was to examine the effect of acupressure on preoperative anxiety before abdominal surgery. The 70 subjects of this clinical trial were randomly assigned into the acupressure group (n=35), which received acupressure at the true points, or the placebo group (n=35), which received acupressure at sham (false) points. Preoperative anxiety and vital signs before and after the intervention were measured in both groups. The findings demonstrated a reduction in the level of preoperative anxiety for both groups (Pacupressure group (Pacupressure at true points (third eye and Shen men) can reduce higher preoperative anxiety of patients before abdominal surgery and that it has had a more clinically beneficial effect than sham points.

  20. Preoperative alcoholism and postoperative morbidity

    DEFF Research Database (Denmark)

    Tonnesen, H; Kehlet, H

    1999-01-01

    BACKGROUND: Preoperative risk assessment has become part of daily clinical practice, but preoperative alcohol abuse has not received much attention. METHODS: A Medline search was carried out to identify original papers published from 1967 to 1998. Relevant articles on postoperative morbidity...... in alcohol abusers were used to evaluate the evidence. RESULTS: Prospective and retrospective studies demonstrate a twofold to threefold increase in postoperative morbidity in alcohol abusers, the most frequent complications being infections, bleeding and cardiopulmonary insufficiency. Wound complications...... to postoperative morbidity. CONCLUSION: Alcohol consumption should be included in the preoperative assessment of likely postoperative outcome. Reduction of postoperative morbidity in alcohol abusers may include preoperative alcohol abstinence to improve organ function, or perioperative alcohol administration...

  1. Implications of preoperative hypoalbuminemia in colorectal surgery

    Institute of Scientific and Technical Information of China (English)

    Adam Truong; Mark H Hanna; Zhobin Moghadamyeghaneh; Michael J Stamos

    2016-01-01

    Serum albumin has traditionally been used as a quantitative measure of a patient’s nutritional status because of its availability and low cost. While malnutrition has a clear definition within both the American and European Societies for Parenteral and Enteral Nutrition clinical guidelines, individual surgeons often determine nutritional status anecdotally. Preoperative albumin level has been shown to be the best predictor of mortality after colorectal cancer surgery. Specifically in colorectal surgical patients, hypoalbuminemia significantly increases the length of hospital stay, rates of surgical site infections, enterocutaneous fistula risk, and deep vein thrombosis formation. The delay of surgical procedures to allow for preoperative correction of albumin levels in hypoalbuminemic patients has been shown to improve the morbidity and mortality in patients with severe nutritional risk. The importance of preoperative albumin levels and the patient’s chronic inflammatory state on the postoperative morbidity and mortality has led to the development of a variety of surgical scoring systems to predict outcomes efficiently. This review attempts to provide a systematic overview of albumin and its role and implications in colorectal surgery.

  2. The Amsterdam preoperative anxiety and information scale provides a simple and reliable measure of preoperative anxiety.

    Science.gov (United States)

    Boker, Abdulaziz; Brownell, Laurence; Donen, Neil

    2002-10-01

    To compare three anxiety scales; the anxiety visual analogue scale (VAS), the anxiety component of the Amsterdam preoperative anxiety and information scale (APAIS), and the state portion of the Spielburger state-trait anxiety inventory (STAI), for assessment of preoperative anxiety levels in same day admission patients. Patients completed the three anxiety assessment scales both before and after seeing the anesthesiologist preoperatively. The scales used were the STAI, the six-question APAIS, and the VAS. APAIS was further subdivided to assess anxiety about anesthesia (sum A), anxiety about surgery (sum S) and a combined anxiety total (i.e., sum C = sum A + sum S). These scales were compared to one another. Pearson's correlation (pair-wise deletion) was used for validity testing. Cronbach's alpha analysis was used to test internal validity of the various components of the APAIS scale. A correlation co-efficient (r) > or = 0.6 and P scale sets were completed by 197 patients. There was significant and positive correlation between VAS and STAI r = 0.64, P anxiety components of the APAIS (sum C) and desire for information were 0.84 and 0.77 respectively. In addition to VAS, the anxiety component of APAIS (sum C) is a promising new practical tool to assess preoperative patient anxiety levels.

  3. Preoperative anxiety-an important but neglected issue: A narrative review

    Directory of Open Access Journals (Sweden)

    Teena Bansal

    2016-01-01

    Full Text Available Anxiety is an emotional state characterized by apprehension and fear resulting from the anticipation of a threatening event. The incidence of preoperative anxiety ranges from 11% to 80% in adult patients and also varies among different surgical groups. Preoperative anxiety may lead to various problems and a wide range of physiological and psychological responses. A variety of objective and subjective methods are available for measuring preoperative anxiety. Every patient scheduled for surgery should be assessed for the presence of anxiety in their routine preoperative anesthesia assessment, and counseling should be done by anesthesiologist in patients with a high level of anxiety. Surgery information reduces anxiety in the preoperative period.

  4. A preoperative checklist in esthetic plastic surgery

    OpenAIRE

    Anger,Jaime; Letizio,Nelson; Orel,Maurício; Souza Junior,José Leão de; Santos,Márcio Martines dos

    2011-01-01

    The authors present a checklist to be used at the last stage of a preoperative visit for esthetic plastic surgery composed of 29 yes/no questions, four blank spaces for entering data, and one question for ranking the level of risk of deep vein thrombosis. The criteria are divided into three tables relating to three areas: anesthesia, psychological aspects, and clinical risk factors. The answers are framed in four colors that identify the level of risk and suggest the degree of attention warra...

  5. Association of Preoperative Anemia With Postoperative Mortality in Neonates.

    Science.gov (United States)

    Goobie, Susan M; Faraoni, David; Zurakowski, David; DiNardo, James A

    2016-09-01

    Neonates undergoing noncardiac surgery are at risk for adverse outcomes. Preoperative anemia is a strong independent risk factor for postoperative mortality in adults. To our knowledge, this association has not been investigated in the neonatal population. To assess the association between preoperative anemia and postoperative mortality in neonates undergoing noncardiac surgery in a large sample of US hospitals. Using data from the 2012 and 2013 pediatric databases of the American College of Surgeons National Surgical Quality Improvement Program, we conducted a retrospective study of neonates undergoing noncardiac surgery. Analysis of the data took place between June 2015 and December 2015. All neonates (0-30 days old) with a recorded preoperative hematocrit value were included. Anemia defined as hematocrit level of less than 40%. Receiver operating characteristics analysis was used to assess the association between preoperative hematocrit and mortality, and the Youden J Index was used to determine the specific hematocrit cutoff point to define anemia in the neonatal population. Demographic and postoperative outcomes variables were compared between anemic and nonanemic neonates. Univariate and multivariable logistic regression analyses were used to determine factors associated with postoperative neonatal mortality. An external validation was performed using the 2014 American College of Surgeons National Surgical Quality Improvement Program database. Neonates accounted for 2764 children (6%) in the 2012-2013 American College of Surgeons National Surgical Quality Improvement Program databases. Neonates inlcuded in the study were predominately male (64.5%), white (66.3%), and term (69.9% greater than 36 weeks' gestation) and weighed more than 2 kg (85.0%). Postoperative in-hospital mortality was 3.4% in neonates and 0.6% in all age groups (0-18 years). A preoperative hematocrit level of less than 40% was the optimal cutoff (Youden) to predict in-hospital mortality

  6. Borderline Ovarian Tumors and Diagnostic Dilemma of Intraoperative Diagnosis: Could Preoperative He4 Assay and ROMA Score Assessment Increase the Frozen Section Accuracy? A Multicenter Case-Control Study

    Directory of Open Access Journals (Sweden)

    Salvatore Gizzo

    2014-01-01

    Full Text Available The aim of our study was to assess the value of a preoperative He4-serum-assay and ROMA-score assessment in improving the accuracy of frozen section histology in the diagnosis of borderline ovarian tumors (BOT. 113 women presenting with a unilateral ovarian mass diagnosed as serous/mucinous BOT at frozen-section-histology (FS and/or confirmed on final pathology were recruited. Pathologists were informed of the results of preoperative clinical/instrumental assessment of all patients. For Group_A patients, additional information regarding He4, CA125, and ROMA score was available (in Group_B only CA125 was known. The comparison between Group A and Group B in terms of FS accuracy, demonstrated a consensual diagnosis in 62.8% versus 58.6% (P: n.s., underdiagnosis in 25.6% versus 41.4% (P<0.05, and overdiagnosis in 11.6% versus 0% (P<0.01. Low FS diagnostic accuracy was associated with menopausal status (OR: 2.13, laparoscopic approach (OR: 2.18, mucinous histotype (OR: 2.23, low grading (OR: 1.30, and FIGO stage I (OR: 2.53. Ultrasound detection of papillae (OR: 0.29, septa (OR: 0.39, atypical vascularization (OR: 0.34, serum He4 assay (OR: 0.39, and ROMA score assessment (OR: 0.44 decreased the probability of underdiagnosis. A combined preoperative assessment through serum markers and ultrasonographic features may potentially reduce the risk of underdiagnosis of BOTs on FS while likely increasing the concomitant incidence of false-positive events.

  7. Interventions for preoperative smoking cessation

    DEFF Research Database (Denmark)

    Thomsen, Thordis; Villebro, Nete; Møller, Ann Merete

    2014-01-01

    : Randomized controlled trials that recruited people who smoked prior to surgery, offered a smoking cessation intervention, and measured preoperative and long-term abstinence from smoking or the incidence of postoperative complications or both outcomes. DATA COLLECTION AND ANALYSIS: The review authors......BACKGROUND: Smokers have a substantially increased risk of postoperative complications. Preoperative smoking intervention may be effective in decreasing this incidence, and surgery may constitute a unique opportunity for smoking cessation interventions. OBJECTIVES: The objectives of this review...... are to assess the effect of preoperative smoking intervention on smoking cessation at the time of surgery and 12 months postoperatively, and on the incidence of postoperative complications. SEARCH METHODS: We searched the Cochrane Tobacco Addiction Group Specialized Register in January 2014. SELECTION CRITERIA...

  8. Preoperative staging of rectal cancer.

    Science.gov (United States)

    Smith, Neil; Brown, Gina

    2008-01-01

    Detailed preoperative staging using high resolution magnetic resonance imaging (MRI) enables the selection of patients that require preoperative therapy for tumour regression. This information can be used to instigate neoadjuvant therapy in those patients with poor prognostic features prior to disturbing the tumour bed and potentially disseminating disease. The design of trials incorporating MR assessment of prognostic factors prior to therapy has been found to be of value in assessing treatment modalities and outcomes that are targeted to these preoperative prognostic subgroups and in providing a quantifiable assessment of the efficacy of particular chemoradiation treatment protocols by comparing pre-treatment MR staging with post therapy histology assessment. At present, we are focused on achieving clear surgical margins of excision (CRM) to avoid local recurrence. We recommend that all patients with rectal cancer should undergo pre-operative MRI staging. Of these, about half will have good prognosis features (T1-T3b, N0, EMVI negative, CRM clear) and may safely undergo primary total mesorectal excision. Of the remainder, those with threatened or involved margins will certainly benefit from pre-operative chemoradiotherapy with the aim of downstaging to permit safe surgical excision. In the future, our ability to recognise features predicting distant failure, such as extramural vascular invasion (EMVI) may be used to stratify patients for neo-adjuvant systemic chemotherapy in an effort to prevent distant relapse. The optimal pre-operative treatment regimes for these patients (radiotherapy alone, systemic chemotherapy alone or combination chemo-radiotherapy) is the subject of current and future trials.

  9. Quantitative Measurement of Cerebrovascular Reactivity by Blood Oxygen Level-Dependent MR Imaging in Patients with Intracranial Stenosis : Preoperative Cerebrovascular Reactivity Predicts the Effect of Extracranial-Intracranial Bypass Surgery

    NARCIS (Netherlands)

    Mandell, D. M.; Han, J. S.; Poublanc, J.; Crawley, A. P.; Fierstra, J.; Tymianski, M.; Fisher, J. A.; Mikulis, D. J.

    2011-01-01

    BACKGROUND AND PURPOSE: CVR is a measure of cerebral hemodynamic impairment. A recently validated technique quantifies CVR by using a precise CO2 vasodilatory stimulus and BOLD MR imaging. Our aim was to determine whether preoperative CO2 BOLD CVR predicts the hemodynamic effect of ECIC bypass surge

  10. Quantitative Measurement of Cerebrovascular Reactivity by Blood Oxygen Level-Dependent MR Imaging in Patients with Intracranial Stenosis : Preoperative Cerebrovascular Reactivity Predicts the Effect of Extracranial-Intracranial Bypass Surgery

    NARCIS (Netherlands)

    Mandell, D. M.; Han, J. S.; Poublanc, J.; Crawley, A. P.; Fierstra, J.; Tymianski, M.; Fisher, J. A.; Mikulis, D. J.

    BACKGROUND AND PURPOSE: CVR is a measure of cerebral hemodynamic impairment. A recently validated technique quantifies CVR by using a precise CO2 vasodilatory stimulus and BOLD MR imaging. Our aim was to determine whether preoperative CO2 BOLD CVR predicts the hemodynamic effect of ECIC bypass

  11. Quantitative Measurement of Cerebrovascular Reactivity by Blood Oxygen Level-Dependent MR Imaging in Patients with Intracranial Stenosis : Preoperative Cerebrovascular Reactivity Predicts the Effect of Extracranial-Intracranial Bypass Surgery

    NARCIS (Netherlands)

    Mandell, D. M.; Han, J. S.; Poublanc, J.; Crawley, A. P.; Fierstra, J.; Tymianski, M.; Fisher, J. A.; Mikulis, D. J.

    2011-01-01

    BACKGROUND AND PURPOSE: CVR is a measure of cerebral hemodynamic impairment. A recently validated technique quantifies CVR by using a precise CO2 vasodilatory stimulus and BOLD MR imaging. Our aim was to determine whether preoperative CO2 BOLD CVR predicts the hemodynamic effect of ECIC bypass surge

  12. Prognostic significance of preoperative fibrinogen in patients with colon cancer.

    Science.gov (United States)

    Sun, Zhen-Qiang; Han, Xiao-Na; Wang, Hai-Jiang; Tang, Yong; Zhao, Ze-Liang; Qu, Yan-Li; Xu, Rui-Wei; Liu, Yan-Yan; Yu, Xian-Bo

    2014-07-14

    To investigate the prognostic significance of preoperative fibrinogen levels in colon cancer patients. A total of 255 colon cancer patients treated at the Affiliated Tumor Hospital of Xinjiang Medical University from June 1(st) 2005 to June 1(st) 2008 were enrolled in the study. All patients received radical surgery as their primary treatment method. Preoperative fibrinogen was detected by the Clauss method, and all patients were followed up after surgery. Preoperative fibrinogen measurements were correlated with a number of clinicopathological parameters using the Student t test and analysis of variance. Survival analyses were performed by the Kaplan-Meier method and Cox regression modeling to measure 5-year disease-free survival (DFS) and overall survival (OS). The mean preoperative fibrinogen concentration of all colon cancer patients was 3.17 ± 0.88 g/L. Statistically significant differences were found between preoperative fibrinogen levels and the clinicopathological parameters of age, smoking status, tumor size, tumor location, tumor-node-metastasis (TNM) stage, modified Glasgow prognostic scores (mGPS), white blood cell (WBC) count, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and carcinoembryonic antigen (CEA) levels. Univariate survival analysis showed that TNM stage, tumor cell differentiation grade, vascular invasion, mGPS score, preoperative fibrinogen, WBC, NLR, PLR and CEA all correlated with both OS and DFS. Alpha-fetoprotein (AFP) and body mass index correlated only with OS. Kaplan-Meier analysis revealed that both OS and DFS of the total cohort, as well as of the stage II and III patients, were higher in the hypofibrinogen group compared to the hyperfibrinogen group (all P TNM stage, mGPS score, CEA, and AFP levels correlated with both OS and DFS. Preoperative fibrinogen levels can serve as an independent prognostic marker to evaluate patient response to colon cancer treatment.

  13. [Value of preoperative planning in total hip arthroplasty].

    Science.gov (United States)

    De Thomasson, E; Mazel, C; Guingand, O; Terracher, R

    2002-05-01

    Preoperative planning enables an assessment of the size of the implants needed before total hip replacement. Eggli and Müller demonstrated the reproduciblity of preoperative planning but did not evaluate its contribution to reducing limb length discrepancy. As femur lateralization and the position of the prosthetic center of rotation affect joint mechanics, it would be useful to assess their contribution to the efficacy of preoperative planning. We reviewed the files of 57 patients who underwent total hip arthroplasty for primary joint degeneration or necrosis limited to one hip. The healthy hip served as a control. The surgical plan was elaborated from the preoperative pelvis x-rays (AP and lateral views) and anatomic measurements on films obtained three months postoperatively. In 49 cases, preoperative planning predicted a restoration of the normal anatomy of the operated hip (center of rotation, femur lateralization, length of the operated limb). This objective was achieved in only 22.5% of the cases. Femur lateralization was the most difficult objective to achieve (59.2%). Equal limb length and good position of the center of rotation was achieved in 70% of the cases. For eight patients (14%) preoperative planning was not satisfactory, the implant offset not being adapted to the patient's anatomy. There are limits to preoperative planning, particularly for restitution of adequate femur lateralization. This difficulty appears to be related to three factors: inadequate adaptation of the implant to hip anatomy (14% of the cases in our experience), stiff rotation in degenerative hips inhibiting proper assessment of the length of the femoral neck, and relative imprecision of operative evaluation of femoral anteversion affecting femur lateralization and the level of the femoral cut. Although imperfect, preoperative planning is, in our opinion, essential before total hip arthroplasty in order to avoid major positioning errors and operative difficulties.

  14. [Preoperative fasting guidelines: an update].

    Science.gov (United States)

    López Muñoz, A C; Busto Aguirreurreta, N; Tomás Braulio, J

    2015-03-01

    Anesthesiology societies have issued various guidelines on preoperative fasting since 1990, not only to decrease the incidence of lung aspiration and anesthetic morbidity, but also to increase patient comfort prior to anesthesia. Some of these societies have been updating their guidelines, as such that, since 2010, we now have 2 evidence-based preoperative fasting guidelines available. In this article, an attempt is made to review these updated guidelines, as well as the current instructions for more controversial patients such as infants, the obese, and a particular type of ophthalmic surgery. Copyright © 2014 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Interventions for preoperative smoking cessation

    DEFF Research Database (Denmark)

    Thomsen, Thordis; Villebro, Nete; Møller, Ann Merete

    2010-01-01

    and keywords (surgery) or (operation) or (anaesthesia) or (anesthesia). MEDLINE, EMBASE and CINAHL were also searched, combining tobacco- and surgery-related terms. Most recent search April 2010. Selection criteria Randomized controlled trials that recruited people who smoked prior to surgery, offered......Background Smokers have a substantially increased risk of postoperative complications. Preoperative smoking intervention may be effective in decreasing this incidence, and surgery may constitute a unique opportunity for smoking cessation interventions. Objectives The objective of this review...... was to assess the effect of preoperative smoking intervention on smoking cessation at the time of surgery and 12 months postoperatively and on the incidence of postoperative complications. Search strategy The specialized register of the Cochrane Tobacco Addiction Group was searched using the free text...

  16. Interventions for preoperative smoking cessation

    DEFF Research Database (Denmark)

    Thomsen, Thordis; Villebro, N.; Møller, Ann Merete;

    2010-01-01

    Background Smokers have a substantially increased risk of postoperative complications. Preoperative smoking intervention may be effective in decreasing this incidence, and surgery may constitute a unique opportunity for smoking cessation interventions. Objectives The objective of this review...... was to assess the effect of preoperative smoking intervention on smoking cessation at the time of surgery and 12 months postoperatively and on the incidence of postoperative complications. Search strategy The specialized register of the Cochrane Tobacco Addiction Group was searched using the free text......; pooled RR 10.76 (95% confidence interval (CI) 4.55 to 25.46, two trials) and RR 1.41 (95% CI 1.22 to 1.63, five trials) respectively. Four trials evaluating the effect on long-term smoking cessation found a significant effect; pooled RR 1.61 (95% CI 1.12 to 2.33). However, when pooling intensive...

  17. Religiousness and preoperative anxiety: a correlational study

    Directory of Open Access Journals (Sweden)

    Karimollahi Mansoureh

    2007-06-01

    Full Text Available Abstract Background Major life changes are among factors that cause anxiety, and one of these changes is surgery. Emotional reactions to surgery have specific effects on the intensity and velocity as well as the process of physical disease. In addition, they can cause delay in patients recovery. This study is aimed at determining the relationship between religious beliefs and preoperative anxiety. Methods This survey is a correlational study to assess the relationship between religious beliefs and preoperative anxiety of patients undergoing abdominal, orthopaedic, and gynaecologic surgery in educational hospitals. We used the convenience sampling method. The data collection instruments included a questionnaire containing the Spielberger State-Trait Anxiety Inventory (STAI, and another questionnaire formulated by the researcher with queries on religious beliefs and demographic characteristics as well as disease-related information. Analysis of the data was carried out with SPSS software using descriptive and inferential statistics. Results were arranged in three tables. Results The findings showed that almost all the subjects had high level of religiosity and moderate level of anxiety. In addition, there was an inverse relationship between religiosity and intensity of anxiety, though this was not statistically significant. Conclusion The results of this study can be used as evidence for presenting religious counselling and spiritual interventions for individuals undergoing stress. Finally, based on the results of this study, the researcher suggested some recommendations for applying results and conducting further research.

  18. Validation of the French version of the Amsterdam preoperative anxiety and information scale (APAIS)

    OpenAIRE

    Maurice-Szamburski, Axel; Loundou, Anderson; Capdevila, Xavier; Bruder, Nicolas; Auquier, Pascal

    2013-01-01

    International audience; BackgroundMost patients are anxious before surgery. The level of preoperative anxiety depends on several factors and merits an objective evaluation. The Amsterdam Preoperative Anxiety and Information Scale (APAIS) is a self-report questionnaire comprising six questions that have been developed and validated to evaluate the preoperative anxiety of patients. This global index assesses three separate areas: anxiety about anaesthesia, anxiety about surgery, and the desire ...

  19. Validation of the Spanish version of the Amsterdam Preoperative Anxiety and Information Scale (APAIS)

    OpenAIRE

    Vergara-Romero, Manuel; Morales-Asencio, Jos? Miguel; Morales-Fern?ndez, Angelines; Canca-Sanchez, Jose Carlos; Rivas-Ruiz, Francisco; Reinaldo-Lapuerta, Jose Antonio

    2017-01-01

    Background Preoperative anxiety is a frequent and challenging problem with deleterious effects on the development of surgical procedures and postoperative outcomes. To prevent and treat preoperative anxiety effectively, the level of anxiety of patients needs to be assessed through valid and reliable measuring instruments. One such measurement tool is the Amsterdam Preoperative Anxiety and Information Scale (APAIS), of which a Spanish version has not been validated yet. Objective To perform a ...

  20. Clinical significance of plasma lysophosphatidic acid levels in the differential diagnosis of ovarian cancer

    Directory of Open Access Journals (Sweden)

    Yun-Jie Zhang

    2015-01-01

    Full Text Available Objective: To investigate the value of lysophosphatidic acid (LPA in the diagnosis of ovarian cancer. Materials and Methods: We first performed a hospital-based, case-control study involving 123 ovarian cancer patients and 101 benign ovarian tumor patients, and then conducted a meta-analysis with 19 case-control studies to assess the correlation between ovarian cancer and plasma LPA levels. Results: The case-control study results demonstrated that ovarian cancer patients have increased LPA and cancer antigen (CA-125 levels compared to patients with benign ovarian tumor (LPA: Ovarian cancer vs benign ovarian tumor: 5.28 ± 1.52 vs 1.82 ± 0.77 μmol/L; CA-125: Ovarian cancer vs benign ovarian tumor: 87.17 ± 45.81 vs. 14.03 ± 10.14 U/mL, which showed statistically significant differences (both P < 0.05. LPA with advanced sensitivity, specificity, positive predictive value, negative predictive value, and accuracy rate of diagnosis excelled CA-125 in the diagnosis of ovarian cancer (both P < 0.05. The areas under the receiver operating characteristic (ROC curve in the diagnosis of ovarian cancer (LPA: 0.983; CA-125: 0.910 were statistically significant compared with the reference (both P < 0.001 and the difference of the areas of ROC curve between LPA and CA-125 in the diagnosis of ovarian cancer showed statistically significant difference (P < 0.05. The meta-analysis results suggested that plasma LPA levels were higher in ovarian cancer tissues than in benign tissues (standardized mean difference (SMD =2.36, 95% confidence interval (CI: 1.61-3.11, P < 0.001 and normal tissues (SMD = 2.32, 95% CI: 1.77-2.87, P < 0.001. Conclusion: LPA shows greater value in the diagnosis of ovarian cancer compared to CA-125 and may be employed as a biological index to diagnose ovarian cancer.

  1. Predictors of preoperative anxiety in children.

    Science.gov (United States)

    Wollin, S R; Plummer, J L; Owen, H; Hawkins, R M F; Materazzo, F

    2003-02-01

    This study aimed to identify factors contributing to anxiety at induction of anaesthesia in children. One hundred and twenty children aged five to twelve years and scheduled for surgery requiring general anaesthesia were included. Children were interviewed and assessed prior to surgery. Parents completed anxiety measures prior to surgery and were interviewed after the induction of anaesthesia. The level of children's anxiety was determined at the time of induction of anaesthesia by the modified Yale Preoperative Anxiety Scale. Factors associated with increased levels of anxiety in the children included increased number of people in the room at induction of anaesthesia; longer waiting time between admission at the hospital and induction of anaesthesia; negative memories of previous hospital experiences; and having a mother who does not practise a religion. Suggestions for implementation of the findings and for future research are provided.

  2. Preoperative localization in primary hyperparathyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Han, Sanson; Kitamura, Hiroyuki; Takagita, Shin-ichi; Maetani, Toshiki; Iwahashi, Yuka; Miyazaki, Masakazu; Yamamoto, Norio [Tenri Hospital, Nara (Japan)

    1998-04-01

    Between 1992 and 1996, 31 cases (8 men and 23 women) with primary hyperparathyroidism (PHPT) were treated in our department. In this study, we compared which of the preoperative localization methods was most useful in the detection of PHPT. The sensitivity for detection of abnormal parathyroid glands was 88.6% on ultrasonography (US), 76.9% on magnetic resonance imaging (MRI), 74.3% on Tl-Tc subtraction scintigraphy and 68.8% on computed tomography. We concluded that US should be performed first, with MRI as a supplementary method, for the detection of abnormal parathyroid glands and the evaluation of invasion within the body. (author)

  3. Preoperative Evaluation for Noncardiac Surgery.

    Science.gov (United States)

    Cohn, Steven L

    2016-12-06

    This issue provides a clinical overview of preoperative evaluation for noncardiac surgery, focusing on risk factors, elements of evaluation, medication management, and practice improvement. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers.

  4. Preoperative fasting time in children.

    LENUS (Irish Health Repository)

    Adeel, S

    2012-02-01

    The aim of preoperative fasting is to prevent regurgitation and pulmonary aspiration while limiting potential problems of thirst, dehydration and hypoglycaemia. The American Society of Anaesthesiologists (ASA) has suggested guidelines for preoperative fasting for children undergoing elective surgery. We did a postal survey to determine the current practice regarding these guidelines amongst all specialist registrars in anaesthesia in Ireland. A questionnaire was sent to all specialist registrars in anaesthesia (90 in total), 60 (67%) were returned and analysed. The question asked was how long children should be kept fasting before elective surgery. The results of our survey suggest that most of the respondents are following the ASA guidelines for clear fluids and solids however there were differing opinion regarding the duration of fasting for formula milk and breast milk. In conclusion, we would recommend greater awareness and collaboration between anaesthetists, nurses and surgeons to ensure that fasting instructions are consistent with the ASA guidelines and that patient and their parents understand these directives as well.

  5. 情景式术前访视对乳腺癌患者不良情绪及应激水平的影响%Effect of situational preoperative visit on unhealthy emotions and stress level of patients with breast cancer

    Institute of Scientific and Technical Information of China (English)

    韩光; 张连波; 常颖; 刘素杰; 李万锋; 徐贵颖; 李司琪

    2013-01-01

    目的:观察情景式术前访视对乳腺癌患者不良情绪及应激水平的影响.方法:将60例乳腺癌患者随机分为观察组和对照组,两组入院时均查空腹静脉血皮质醇,但观察组是在术前到手术室专用的情景式模拟手术间访视后抽取静脉血,对照组则由手术室巡回护士到病房进行传统式常规术前访视后采静脉血.比较两组患者进入手术室后麻醉开始前的皮质醇水平,用心理行为评定量表(SAS SDS)对患者情绪状况进行评分.结果:两组入院时皮质醇水平比较无统计学差别(P>0.05);进行情景式术前访视和传统式术前访视后,观察组皮质醇水平低于对照组(P<0.05);观察组的SAS、SDS量表得分低于对照组(P<0.05).结论:情景式术前访视能有效降低乳腺癌患者术前应激激素的分泌水平,改善不良情绪,提高自我效能,有助于患者康复.%Objective:To observe the effect of situational preoperative visit on unhealthy emotions and stress level of patients with breast cancer.Methods:Sixty patients with breast cancer were randomly divided into observation group and control group,fasting cortisol levels in venous blood of patients in the two groups were detected on admission,the venous blood samples in observation group were abstracted after situational preoperative visit in simulation operating room,while the venous blood samples in control group were abstracted after traditional preoperative visit in ward.The levels of cortisol before start of anesthesia in operating room in the two groups were compared,SAS and SDS were used to evaluate the emotional status of patients.Results:There was no statistically significant difference in cortisol level on admission between the two groups (P > 0.05) ; after situational preoperative visit and traditional preoperative visit,cortisol level in observation group was statistically significantly lower than that in control group (P < 0.05) ; SAS and SDS scores in

  6. Preoperative information management system using wireless PDAs.

    Science.gov (United States)

    Sawa, Tomohiro; Okahara, Masaharu; Santo, Masayuki; Schmidt, Ulrich; Nakata, Yoshinori; Morita, Shigeho; Ohno-Machado, Lucila

    2003-01-01

    Personal Digital Assistant (PDA) and wireless communication are currently available in clinical settings. We developed wireless PDA software that assists anesthesiologists in pre-operative patient assessment. The device communicates with the hospital information system through a wireless LAN and is equipped with pre-programmed data entry templates for pre-operative assessment. As a preliminary test of the device, we randomly assigned residents in preoperative assessment to an intervention and a control arm and compared the results.

  7. Comparison of preoperative anxiety in reconstructive and cosmetic surgery patients.

    Science.gov (United States)

    Sönmez, Ahmet; Bişkin, Nurdan; Bayramiçli, Mehmet; Numanoğlu, Ayhan

    2005-02-01

    Surgery is a serious stressor and a cause of anxiety for the patients. Reconstructive surgery patients are mostly operated on because of certain functional impairment or disability; on the contrary, cosmetic surgery patients do not have any physical impairment and they are operated on because of mostly psychologic reasons. The aim of this study was to compare the anxiety levels in the reconstructive surgery patients and cosmetic surgery patients preoperatively. Thirty-two patients in the reconstructive surgery group and 30 patients in the cosmetic surgery group were included in the study. State Trait Anxiety Inventory was used to measure the anxiety levels in these 2 groups preoperatively. The 2 groups were similar in characteristics such as age, gender distribution, number of previous operations, and trait anxiety scores. Mean state anxiety scores obtained for the reconstructive surgery group was 38.0 +/- 8.7, while it was 44.2 +/- 10.79 for the cosmetic surgery group (t test, degrees of freedom = 60, P = 0.015). This study reveals that preoperative anxiety levels in the cosmetic surgery patients are higher than those of the reconstructive surgery patients. Therefore, adequate preoperative preparation for cosmetic surgery should include attempts to cope with anxiety. Anxiolytics may be used more liberally and professional psychologic assistance may be required.

  8. The Amsterdam Preoperative Anxiety and Information Scale (APAIS)

    Science.gov (United States)

    Moerman, N; van Dam, F S; Muller, M J; Oosting, H

    1996-03-01

    The purpose of the present study was to assess patients' anxiety level and information requirement in the preoperative phase. During routine preoperative screening, 320 patients were asked to assess their anxiety and information requirement on a six-item questionnaire, the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Two hundred patients also completed Spielberger's State-Trait Anxiety Inventory (STAI-State). Patients were able to complete the questionnaire in less than 2 min. On factor analysis, two factors emerged clearly: anxiety and the need for information. The anxiety scale correlated highly (0.74) with the STAI-State. It emerged that 32% of the patients could be considered as "anxiety cases" and over 80% of patients have a positive attitude toward receiving information. Moreover, results demonstrated that 1) women were more anxious that men; 2) patients with a high information requirement also had a high level of anxiety; 3) patients who had never undergone an operation had a higher information requirement than those who had. The APAIS can provide anesthesiologists with a valid, reliable, and easily applicable instrument for assessing the level of patients' preoperative anxiety and the need for information.

  9. Relationship between preschool children and the caregiver's preoperative anxiety. A cross study assessing modified Yale preoperative anxiety Scale (m-YPAS)

    OpenAIRE

    Emiliana Gomes de Mello; Vivian Brancalione Gonçalves; Neil Ferreira Novo; Eduardo Toshiyuki Moro

    2015-01-01

    Anxiety is a common event in children before surgery. Several ways have been proposed to assess the level of anxiety in pediatric patients. The modified Yale Preoperative Anxiety Scale (m-Ypas) was developed recently and allows the assessment of anxiety level from the observation of children's attitudes. The aim of the study was to evaluate the influence of variables such as anxiety of caregivers (parents or relatives), preoperative fasting and previous surgical experiences on children's anxi...

  10. Visual Analogue Scale for Anxiety and Amsterdam Preoperative Anxiety Scale Provide a Simple and Reliable Measurement of Preoperative Anxiety in Patients Undergoing Cardiac Surgery

    Directory of Open Access Journals (Sweden)

    Joaquín Hernández-Palazón

    2015-03-01

    Full Text Available Background: Anxiety is an emotional state characterized by apprehension and fear resulting from anticipation of a threatening event. Objectives: The present study aimed to analyze the incidence and level of preoperative anxiety in the patients scheduled for cardiac surgery by using a Visual Analogue Scale for Anxiety (VAS-A and Amsterdam Preoperative Anxiety and Information Scale (APAIS and to identify the influencing clinical factors. Patients and Methods: This prospective, longitudinal study was performed on 300 cardiac surgery patients in a single university hospital. The patients were assessed regarding their preoperative anxiety level using VAS-A, APAIS, and a set of specific anxiety-related questions. Their demographic features as well as their anesthetic and surgical characteristics (ASA physical status, EuroSCORE, preoperative Length of Stay (LoS, and surgical history were recorded, as well. Then, one-way ANOVA and t-test were applied along with odds ratio for risk assessment. Results: According to the results, 94% of the patients presented preoperative anxiety, with 37% developing high anxiety (VAS-A ≥ 7. Preoperative LoS > 2 days was the only significant risk factor for preoperative anxiety (odds ratio = 2.5, CI 95%, 1.3 - 5.1, P = 0.009. Besides, a positive correlation was found between anxiety level (APAISa and requirement of knowledge (APAISk. APAISa and APAISk scores were greater for surgery than for anesthesia. Moreover, the results showed that the most common anxieties resulted from the operation, waiting for surgery, not knowing what is happening, postoperative pain, awareness during anesthesia, and not awakening from anesthesia. Conclusions: APAIS and VAS-A provided a quantitative assessment of anxiety and a specific qualitative questionnaire for preoperative anxiety in cardiac surgery. According to the results, preoperative LoS > 2 days and lack of information related to surgery were the risk factors for high anxiety levels.

  11. Preoperative evaluation of oesophageal adenocarcinoma.

    Science.gov (United States)

    Khanna, Lauren G; Gress, Frank G

    2015-02-01

    The preoperative evaluation of oesophageal adenocarcinoma involves endoscopic ultrasound (EUS), computed tomography (CT), and positron emission tomography (PET). With routine Barrett's oesophagus surveillance, superficial cancers are often identified. EUS, CT and PET have a limited role in the staging of superficial tumours. Standard EUS has limited accuracy, but high frequency ultrasound miniprobes are valuable for assessing tumour stage in superficial tumours. However, the best method for determining depth of invasion, and thereby stage of disease, is endoscopic mucosal resection. In contrast, in advanced oesophageal cancers, a multi-modality approach is crucial. Accurate tumour staging is very important since the treatment of advanced cancers involves a combination of chemotherapy, radiation, and surgery. EUS is very useful for staging of the tumour and nodes. High frequency ultrasound miniprobes provide the ability to perform staging when the lesion is obstructing the oesophageal lumen. CT and PET provide valuable information regarding node and metastasis staging.

  12. Assessment of patient satisfaction with the preoperative anesthetic evaluation

    Directory of Open Access Journals (Sweden)

    Gebremedhn EG

    2014-09-01

    Full Text Available Endale Gebreegziabher Gebremedhn, Vidhya Nagaratnam Department of Anesthesia, School of Medicine, Gondar College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia Background: The evaluation of patient satisfaction is a core aspect of the continuous quality improvement in anesthesia service that can be affected by the preoperative anesthetist visit. This visit enables the anesthetist to know about the patient's general health status and the nature of surgery, to choose the type of anesthesia, and to discuss perioperative complications and their management with the patient. Patients have sometimes complained about the information given during the preoperative anesthetic evaluation in the University of Gondar teaching and referral hospital. The aim of this study was to determine the level of patient satisfaction with the preoperative anesthetist visit. Methods: A cross-sectional study was conducted from February 15 to April 15, 2013. All consecutive elective patients who were operated upon under anesthesia during the study period were interviewed 24 hours after operation. A pretested questionnaire and checklists, which were developed based on the hospital's anesthetic evaluation sheet, were used for data collection. Results: A total of 116 elective patients were operated upon under anesthesia during the study period. Of these, 102 patients were included in our study, with a response rate of 87.9%. Anesthetists introduced themselves to ~24% patients; provided information about anesthesia to ~32%, postoperative complications to ~21%, postoperative analgesia to ~18, and postoperative nausea and vomiting to ~21%; and spent adequate time with ~74%. Patients' questions were answered by the anesthetist in ~65% of cases, and ~65% of patients had reduced anxiety after the anesthetist visit. The patients' overall satisfaction with the preoperative anesthetist visit was ~65%. Conclusion and recommendation: Patient satisfaction with the

  13. Preoperative anxiety in surgical patients - experience of a single unit.

    Science.gov (United States)

    Matthias, Anne Thushara; Samarasekera, Dharmanbandhu Nandadeva

    2012-03-01

    Preoperative anxiety has a significant effect on the outcome of anesthesia and surgery. At present, there is no published data on the preoperative anxiety levels in Sri Lankan patients. In the West, several validated questionnaires such as The Amsterdam Preoperative Anxiety and Information Scale (APAIS) and State Trait Anxiety Inventory (STAI) are used. To measure the preoperative anxiety levels in patients using APAIS and to analyze the factors affecting anxiety and the role played by the anesthetist in allaying anxiety. One hundred patients scheduled for elective surgery were prospectively studied using the APAIS. The internal consistency was checked using Cronbach's alpha. The ages varied 25 to 72 years (mean=48.7 years, SD=13.6). Reliability of the APAIS was high; Cronbach's alpha=0.864 in the overall component and 0.84, 0.73 and 0.97 in the anxiety related to surgery, anesthesia and in the information desire components, respectively. Females were more anxious than males (p=0.02) and those who had never sustained surgery were more anxious than those who previously had surgery (p=0.05). An anesthetist's visit and premedication reduced total anxiety scores (Z=-3.07, p=0.002) and anesthesia related anxiety scores (Z=-3.45, p=0.001). The prevalence of anxiety is high among Sri Lankan patients. Females are more anxious than males and those who have never had surgery are more anxious than those who have had surgery. The anesthetist's visit could reduce anxiety. Sinhala version of the APAIS is highly reliable in assessing the preoperative anxiety levels. Copyright © 2012. Published by Elsevier B.V.

  14. Preoperative Smoking Status and Postoperative Complications

    DEFF Research Database (Denmark)

    Grønkjær, Marie; Eliasen, Marie; Skov-Ettrup, Lise Skrubbeltrang;

    2014-01-01

    To systematically review and summarize the evidence of an association between preoperative smoking status and postoperative complications elaborated on complication type.......To systematically review and summarize the evidence of an association between preoperative smoking status and postoperative complications elaborated on complication type....

  15. Preoperative anxiety and emergence delirium and postoperative maladaptive behaviors.

    Science.gov (United States)

    Kain, Zeev N; Caldwell-Andrews, Alison A; Maranets, Inna; McClain, Brenda; Gaal, Dorothy; Mayes, Linda C; Feng, Rui; Zhang, Heping

    2004-12-01

    Based on previous studies, we hypothesized that the clinical phenomena of preoperative anxiety, emergence delirium, and postoperative maladaptive behavioral changes were closely related. We examined this issue using data obtained by our laboratory over the past 6 years. Only children who underwent surgery and general anesthesia using sevoflurane/O(2)/N(2)O and who did not receive midazolam were recruited. Children's anxiety was assessed preoperatively with the modified Yale Preoperative Anxiety Scale (mYPAS), emergence delirium was assessed in the postanesthesia care unit, and behavioral changes were assessed with the Post Hospital Behavior Questionnaire (PHBQ) on postoperative days 1, 2, 3, 7, and 14. Regression analysis showed that the odds of having marked symptoms of emergence delirium increased by 10% for each increment of 10 points in the child's state anxiety score (mYPAS). The odds ratio of having new-onset postoperative maladaptive behavior changes was 1.43 for children with marked emergence status as compared with children with no symptoms of emergence delirium. A 10-point increase in state anxiety scores led to a 12.5% increase in the odds that the child would have a new-onset maladaptive behavioral change after the surgery. This finding is highly significant to practicing clinicians, who can now predict the development of adverse postoperative phenomena, such as emergence delirium and postoperative behavioral changes, based on levels of preoperative anxiety.

  16. [Evaluation of preoperative anxiety in patients requiring glaucoma filtration surgery].

    Science.gov (United States)

    Lemaitre, S; Blumen-Ohana, E; Akesbi, J; Laplace, O; Nordmann, J-P

    2014-01-01

    Preoperative anxiety is often expressed by patients requiring filtration surgery for their glaucoma. So far, there has been no scale for screening this group of patients for preoperative anxiety. The Amsterdam Preoperative Anxiety and Information Scale (APAIS) is a self-evaluation questionnaire which has been used in specialties other than ophthalmology and which makes it possible to identify the adult patients with a high level of preoperative anxiety over an upcoming surgical procedure. The purpose of this study is to estimate the preoperative anxiety in glaucoma patients requiring filtration surgery. We performed a prospective study of 36 adult patients with chronic glaucoma not responding to medical treatment and who were about to undergo filtration surgery (trabeculectomy or deep sclerectomy). The APAIS questionnaire was given to the patients after discussing the indication for surgery. A global anxiety score (ranging from 4 to 20) above 10 defined patients with a high level of preoperative anxiety. We attempted to identify among these patients the factors related to filtration surgery which caused them anxiety (lack of control of intraocular pressure, risk of blindness, presence of the filtering bleb). In our sample of patients, we found that glaucoma was a source of anxiety. That was also true for the surgical procedure, though most patients believe that once the decision had been made, their psychological status was not modified by the upcoming procedure. The patient-clinician relationship is important in any chronic disease, all the more so in glaucoma, since this disease remains asymptomatic for a long time. When filtration surgery is necessary, the patients are going to express less preoperative anxiety if they trust their physician and if individualized information has been given to them The French version of the APAIS is a quick scale, easily completed, that can be recommended for evaluating anxiety and patients' need for information prior to filtering

  17. Visual Analogue Scale for Anxiety and Amsterdam Preoperative Anxiety Scale Provide a Simple and Reliable Measurement of Preoperative Anxiety in Patients Undergoing Cardiac Surgery

    OpenAIRE

    Joaquín Hernández-Palazón; Diego Fuentes-García; Luis Falcón-Araña; Antonio Rodríguez-Ribó; Carlos García-Palenciano; María José Roca-Calvo

    2015-01-01

    Background: Anxiety is an emotional state characterized by apprehension and fear resulting from anticipation of a threatening event. Objectives: The present study aimed to analyze the incidence and level of preoperative anxiety in the patients scheduled for cardiac surgery by using a Visual Analogue Scale for Anxiety (VAS-A) and Amsterdam Preoperative Anxiety and Information Scale (APAIS) and to identify the influencing clinical factors. Patients and Methods: This prospective, longitu...

  18. International preoperative rectal cancer management: staging, neoadjuvant treatment, and impact of multidisciplinary teams.

    LENUS (Irish Health Repository)

    Augestad, Knut M

    2010-11-01

    Little is known regarding variations in preoperative treatment and practice for rectal cancer (RC) on an international level, yet practice variation may result in differences in recurrence and survival rates.

  19. The preoperative interview. Its effect on perioperative nurses' empathy.

    Science.gov (United States)

    Alverson, E

    1987-05-01

    Further studies need to be done to determine the impact preoperative visits have on the perioperative nurse's empathy level. The results of this study could be confirmed, or refuted, if a study with more subjects was conducted over a longer period of time. Also, subjects in both the control and experimental groups should be chosen randomly and should be from the same institution. To measure the long-term effect of preoperative visits on empathy levels, a study could be conducted that measures the levels at various times (eg, six months to a year following the first study). Other evaluations of empathy levels, such as observer rating and patient rating, could be used to supplement nurses self-rating scores to avoid using one standard instrument and rating scale. Few conclusions can be drawn from this limited study, but it does help nurses realize that preoperative interviews can help the nurse become more aware of the surgical patient as a human being. This increased awareness may help the nurse function more effectively and efficiently in helping the patient during intraoperative care.

  20. The pelvic support osteotomy: indications and preoperative planning

    OpenAIRE

    Pafilas, Dimitrios; Nayagam, Selvadurai

    2008-01-01

    The pelvic support osteotomy is a double level femoral osteotomy with the objective of eliminating a Trendelenburg and short limb gait in young patients with severe hip joint destruction as a consequence of neonatal septic arthritis. The osteotomy has seen several changes and a brief historical overview is provided to set the evolution of the modifications of the procedure in context. We present an analysis of the preoperative assessment that will assist the surgeon to plan out the procedure....

  1. Preoperative easily misdiagnosed telangiectatic osteosarcoma: clinical–radiologic–pathologic correlations

    Science.gov (United States)

    Gao, Zhen-Hua; Yin, Jun-Qiang; Liu, Da-Wei; Meng, Quan-Fei

    2013-01-01

    Abstract Purpose: To describe the clinical, imaging, and pathologic characteristics and diagnostic methods of telangiectatic osteosarcoma (TOS) for improving the diagnostic level. Materials and methods: The authors retrospectively reviewed patient demographics, serum alkaline phosphatase (AKP) levels, preoperative biopsy pathologic reports, pathologic materials, imaging findings, and treatment outcomes from 26 patients with TOS. Patient images from radiography (26 cases) and magnetic resonance (MR) imaging (22 cases) were evaluated by 3 authors in consensus for intrinsic characteristics. There were 15 male and 11 female patients in the study, with an age of 9–32 years (mean age 15.9 years). Results: Eighteen of 26 patients died of lung metastases within 5 years of follow-up. The distal femur was affected more commonly (14 cases, 53.8%). Regarding serum AKP, normal (8 cases) or mildly elevated (18 cases) levels were found before preoperative chemotherapy. Radiographs showed geographic bone lysis without sclerotic margin (26 cases), cortical destruction (26 cases), periosteal new bone formation (24 cases), soft-tissue mass (23 cases), and matrix mineralization (4 cases). The aggressive radiographic features of TOS simulated the appearance of conventional high-grade intramedullary osteosarcoma, though different from aneurysmal bone cyst. MR images demonstrated multiple big (16 cases) or small (6 cases) cystic spaces, fluid-fluid levels (14 cases), soft-tissue mass (22 cases), and thick peripheral and septal enhancement (22 cases). Nine of 26 cases were misdiagnosed as aneurysmal bone cysts by preoperative core-needle biopsy, owing to the absence of viable high-grade sarcomatous cells in the small tissue samples. Conclusion: The aggressive growth pattern with occasional matrix mineralization, and multiple big or small fluid-filled cavities with thick peripheral, septal, and nodular tissue surrounding the fluid-filled cavities are characteristic imaging features of

  2. A fresh look at preoperative body washing

    Science.gov (United States)

    Tanner, Judith; Gould, Dinah; Jenkins, Philip; Hilliam, Rachel; Mistry, Neetesh; Walsh, Susannah

    2012-01-01

    National guidelines do not support preoperative body washing to reduce surgical site infections, instead recommending bathing or showering with soap. Yet preoperative body washing continues to be widely used in many hospitals across Europe. This paper suggests that existing trials of preoperative body washing, upon which guidelines are based, are dated and proposes a new investigation of preoperative body washing using modern definitions of surgical site infection with standardised patient follow up, modern surgical techniques and well designed trials. This paper provides a critique of existing guidelines and describes a randomised trial with 60 participants to compare the effect of soap and two antiseptic washing products on colony forming units (CFUs) for up to six hours. Chlorhexidine gluconate and octenidine were significantly more effective than soap in reducing CFUs in the underarm, and chlorhexidine was significantly more effective than soap in reducing CFUs in the groin. PMID:22448182

  3. Preoperative steroid in abdominal wall reconstruction

    DEFF Research Database (Denmark)

    Jensen, Kristian Kiim; Brøndum, Tina Lee; Belhage, Bo

    2016-01-01

    INTRODUCTION: Preoperative administration of high-dose glucocorticoid leads to improved recovery and decreased length of stay after abdominal surgery. Even so, studies on administration of glucocorticoids for patients undergoing abdominal wall reconstruction (AWR) for giant ventral hernia repair ...

  4. Preoperative alcohol cessation prior to elective surgery

    DEFF Research Database (Denmark)

    Oppedal, Kristian; Møller, Ann Merete; Pedersen, Bolette

    2012-01-01

    Hazardous drinking has been associated with an increased postoperative complication rate after surgery. Common complications include postoperative infections, cardiopulmonary complications, and bleeding episodes. Preoperative abstinence may to some degree reverse alcohol-induced pathophysiological...

  5. Preoperative steroid in abdominal wall reconstruction

    DEFF Research Database (Denmark)

    Jensen, Kristian Kiim; Brøndum, Tina Lee; Belhage, Bo;

    2016-01-01

    INTRODUCTION: Preoperative administration of high-dose glucocorticoid leads to improved recovery and decreased length of stay after abdominal surgery. Even so, studies on administration of glucocorticoids for patients undergoing abdominal wall reconstruction (AWR) for giant ventral hernia repair ...

  6. Preoperative education for lumbar surgery for radiculopathy

    OpenAIRE

    Louw, A; Louw, Q; L. Crous

    2009-01-01

    To date no studies have been published on preoperative education forpatients who had lumbar surgery. The aim of this study was to determine if there is a demand for preoperative education for patients who had lumbar surgery for radiculopathy. A convenience sample of 47 patients who had lumbar surgery and a random sample of 141 physiotherapists involved in treating patients who had lumbar surgery completed a newly developed spinal surgery questionnaire. The data were analyzed using descriptive...

  7. Reliability and validity of Korean version of modified: Yale preoperative anxiety scale

    OpenAIRE

    Jung, Kyuwhan; Im, Mi-Hyang; Hwang, Jeong-Min; Oh, Ah-Young; Park, Moon Seok; Jeong, Woo-Jin; Kim, Seong-Chan; Jung, Sun-Woo; Sohn, Hyejin; Yoon, Mi-Ok; Jang, Mi-Suk; Moon, Suk-Bae

    2015-01-01

    Purpose The modified Yale Preoperative Anxiety Scale (mYPAS) was developed for evaluating the level of preoperative anxiety in children. The purpose of this study was to develop a Korean version of the mYPAS (K-mYPAS) and to establish its validity and reliability based on the Korean preoperative pediatric patients. Methods K-mYPAS was made through stringent back-translation procedure. Total enrolled 102 patients answered questionnaires of Korean version of State-Trait Anxiety Inventory for Ch...

  8. Ranitidine improves postoperative suppression of antibody response to preoperative vaccination

    DEFF Research Database (Denmark)

    Nielsen, Hans Jørgen; Hammer, J H; Moesgaard, F;

    1992-01-01

    The effect of the histamine-2 receptor antagonist ranitidine (100 mg intravenously every 12 hours for 72 hours) on postoperative serum antibody responses to preoperative immunization with six limit of flocculation tetanus toxoid and six limit of flocculation diphtheria toxoid was assessed...... in a double-blind, placebo-controlled randomized study in 26 patients undergoing major abdominal surgery. The preoperative antitetanus antibody level was less than 0.1 IU/ml in all patients, and they were inoculated with both antigens 48 hours before surgery. Serum samples for analysis of antitetanus toxoid...... and antidiphtheria toxoid were drawn before skin incision and on postoperative days 1, 3, 5, 7, 10, 14, 21, and 28. Ranitidine significantly increased the postoperative antibody response to tetanus toxoid, (p less than 0.01) and insignificantly increased that to diphtheria toxoid vaccination (p less than 0...

  9. Pre-operative pain and sensory function in groin hernia

    DEFF Research Database (Denmark)

    Aasvang, Eske K; Hansen, Jeanette B; Kehlet, Henrik

    2009-01-01

    mechanism. AIMS: To investigate the correlation between pre-operative pain intensity and sensory functions in the groin hernia area. METHODS: Patients with unilateral groin hernia were examined preoperatively by quantitative sensory testing (thermal, mechanical, and pressure [detection and pain thresholds...... (rho=-0.413, p=0.049), indicating a paradoxical association between level of mechanical pain threshold and magnitude of spontaneous pain. No other sensory modality was significantly correlated to pain intensity. New/increased pain during repetitive pinprick stimulation (wind-up) was seen in 3 patients......]) and assessments were correlated to patients' reports of intensity and frequency of spontaneous pain in the groin area. RESULTS: Forty-two patients were examined, whereof one was excluded since no hernia was found intraoperatively. Mechanical pain threshold was inversely correlated with spontaneous pain intensity...

  10. Identifying and assessing anxiety in pre-operative patients.

    Science.gov (United States)

    Pritchard, Michael John

    Increasing demands for hospitals to be more efficient mean that patients attending for an operation are generally admitted on the day of surgery. As a result, healthcare professionals have little time to talk to the patient to ascertain his or her wellbeing, to check for any signs of anxiety and ask whether the patient requires further information about the forthcoming procedure. Healthcare professionals should be encouraged to use appropriate interventions to identify and assess anxious patients. There are several instruments available to measure the patient's level of pre-operative anxiety. This article reviews the Amsterdam Preoperative Anxiety and Information Scale, which is easy for patients to complete and may help to identify which individuals need extra support.

  11. Influence of Preoperative Peripheral Parenteral Nutrition with Micronutrients after Colorectal Cancer Patients

    Science.gov (United States)

    Tang, Hsiu-Chih; Hu, Shu-Hui; Yang, Hui-Lan

    2015-01-01

    Background. The inflammatory reactions are stronger after surgery of malnourished preoperative patients. Many studies have shown vitamin and trace element deficiencies appear to affect the functioning of immune cells. Enteral nutrition is often inadequate for malnourished patients. Therefore, total parenteral nutrition (TPN) is considered an effective method for providing preoperative nutritional support. TPN needs a central vein catheter, and there are more risks associated with TPN. However, peripheral parenteral nutrition (PPN) often does not provide enough energy or nutrients. Purpose. This study investigated the inflammatory response and prognosis for patients receiving a modified form of PPN with added fat emulsion infusion, multiple vitamins (MTV), and trace elements (TE) to assess the feasibility of preoperative nutritional support. Methods. A cross-sectional design was used to compare the influence of PPN with or without adding MTV and TE on malnourished abdominal surgery patients. Results. Both preoperative groups received equal calories and protein, but due to the lack of micronutrients, patients in preoperative Group B exhibited higher inflammation, lower serum albumin levels, and higher anastomotic leak rates and also required prolonged hospital stays. Conclusion. Malnourished patients who receive micronutrient supplementation preoperatively have lower postoperative inflammatory responses and better prognoses. PPN with added fat emulsion, MTV, and TE provides valid and effective preoperative nutritional support. PMID:26000296

  12. Assessment of the usefulness of the standardized uptake values and the radioactivity levels for the preoperative diagnosis of thyroid cancer measured by using 18F-FDG PET/CT dual-time-point imaging

    Science.gov (United States)

    Lee, Hyeon-Guck; Hong, Seong-Jong; Cho, Jae-Hwan; Han, Man-Seok; Kim, Tae-Hyung; Lee, Ik-Han

    2013-02-01

    The purpose of this study was to assess and compare the changes in the SUV (standardized uptake value), the 18F-FDG (18F-fluorodeoxyglucose) uptake pattern, and the radioactivity level for the diagnosis of thyroid cancer via dual-time-point 18F-FDG PET/CT (positron emission tomographycomputed tomography) imaging. Moreover, the study aimed to verify the usefulness and significance of SUV values and radioactivity levels to discriminate tumor malignancy. A retrospective analysis was performed on 40 patients who received 18F-FDG PET/CT for thyroid cancer as a primary tumor. To set the background, we compared changes in values by calculating the dispersion of scattered rays in the neck area and the lung apex, and by comparing the mean and SD (standard deviation) values of the maxSUV and the radioactivity levels. According to the statistical analysis of the changes in 18F-FDG uptake for the diagnosis of thyroid cancer, a high similarity was observed with the coefficient of determination being R2 = 0.939, in the SUVs and the radioactivity levels. Moreover, similar results were observed in the assessment of tumor malignancy using dual-time-point. The quantitative analysis method for assessing tumor malignancy using radioactivity levels was neither specific nor discriminative compared to the semi-quantitative analysis method.

  13. Preoperative education for lumbar surgery for radiculopathy

    Directory of Open Access Journals (Sweden)

    A. Louw

    2009-02-01

    Full Text Available To date no studies have been published on preoperative education forpatients who had lumbar surgery. The aim of this study was to determine if there is a demand for preoperative education for patients who had lumbar surgery for radiculopathy. A convenience sample of 47 patients who had lumbar surgery and a random sample of 141 physiotherapists involved in treating patients who had lumbar surgery completed a newly developed spinal surgery questionnaire. The data were analyzed using descriptiveand inferential statistical tests. Results showed that 100% of the patients and 99% of therapists view preoperative education to be an important component for lumbar surgery for radiculopathy. The most important factors identifiedfor inclusion in preoperative educational programs were reason for surgery, risks associated with surgery, limitations following surgery and more education regarding pain. The preferred method of education delivery was verbal one-on-one education. This study demonstrates that there is a demand for preoperative education for patients who had lumbar surgery.

  14. [Preoperative assessment of lung disease patients.].

    Science.gov (United States)

    Ramos, Gilson; Ramos Filho, José; Pereira, Edísio; Junqueira, Marcos; Assis, Carlos Henrique C

    2003-02-01

    Lung complications are the most frequent causes of postoperative morbidity-mortality, especially in lung disease patients. So, those patients should be preoperatively carefully evaluated and prepared, both clinically and laboratorially. This review aimed at determining surgical risk and at establishing preoperative procedures to minimize peri and postoperative morbidity-mortality in lung disease patients. Major anesthetic-surgical repercussions in lung function have already been described. Similarly, we tried to select higher-risk patients, submitted or not to lung resection. To that end, clinical and laboratorial propedeutics were used. Finally, a proposal of a preoperative algorithm was presented for procedures with lung resection. Lung disease patients, especially those with chronic evolution, need to be preoperatively thoroughly evaluated. ASA physical status and Goldmans cardiac index are important risk forecasting factors for lung disease patients not candidates for lung resection. Adding to these criteria, estimated postoperative max VO2, FEV1 and diffusion capacity are mandatory for some patients submitted to lung resection. beta2-agonists and steroids should be considered in the preoperative period of these patients.

  15. Effect of Preoperative Play Interventions on Post Surgery Anxiety

    OpenAIRE

    Narges Alirezaei; Bahar Ashjaei; Zahra Shahrivar; Fatemeh Moharari; Javad Mahmoudi-gharaei; Jaleh Parizad

    2008-01-01

    "n "nObjective: Many studies have shown that the level of postoperative distress and anxiety in children is associated with the amount of anxiety during the pre operative period. In this study, we compared the effect of pre-operational attending in a playroom and using play activities on the level of anxiety increment after surgery in an intervention and a control group of Iranian children. "n "nMethod: In a clinical trial, 75 children aged 5 to 12 enrolled in the intervention and the control...

  16. Pre-operative fasting guidelines: an update

    DEFF Research Database (Denmark)

    Søreide, E; Eriksson, L I; Hirlekar, G

    2005-01-01

    Liberal pre-operative fasting routines have been implemented in most countries. In general, clear fluids are allowed up to 2 h before anaesthesia, and light meals up to 6 h. The same recommendations apply for children and pregnant women not in labour. In children......Liberal pre-operative fasting routines have been implemented in most countries. In general, clear fluids are allowed up to 2 h before anaesthesia, and light meals up to 6 h. The same recommendations apply for children and pregnant women not in labour. In children...

  17. [Spectrum and susceptibility of preoperative conjunctival bacteria].

    Science.gov (United States)

    Fernández-Rubio, M E; Cuesta-Rodríguez, T; Urcelay-Segura, J L; Cortés-Valdés, C

    2013-12-01

    To describe the conjunctival bacterial spectrum of our patients undergoing intraocular surgery and their antibiotic sensitivity during the study period. A retrospective study of preoperative conjunctival culture of patients consecutively scheduled for intraocular surgery from 21 February 2011 to 1 April 2013. Specimens were directly seeded onto blood-agar and MacConkey-agar (aerobiosis incubation, 2 days), and on chocolate-agar (6% CO2 incubation, 7 days). The identified bacteria were divided into 3 groups according to their origin; the bacteria susceptibility tests were performed on those more pathogenic and on some of the less pathogenic when more than 5 colonies were isolated. The sensitivity of the exigent growing bacteria was obtained with disk diffusion technique, and for of the non-exigent bacteria by determining their minimum inhibitory concentration. The Epidat 3.1 program was used for statistical calculations. A total of 13,203 bacteria were identified in 6,051 cultures, with 88.7% being typical colonizers of conjunctiva (group 1), 8.8% typical of airways (group 2), and the remaining 2.5% of undetermined origin (group 3). 530 cultures (8.8%) were sterile. The sensitivity of group 1 was: 99% vancomycin, 95% rifampicin, 87% chloramphenicol, 76% tetracycline. Levels of co-trimoxazole, aminoglycosides, quinolones, β-lactams and macrolides decreased since 2007. The group 2 was very sensitive to chloramphenicol, cefuroxime, rifampicin, ciprofloxacin and amoxicillin/clavulanate. In group 3, to levofloxacin 93%, ciprofloxacin 89%, tobramycin 76%, but ceftazidime 53% and cefuroxime 29% decreased. None of the tested antibiotics could eradicate all possible conjunctival bacteria. Bacteria living permanently on the conjunctiva (group 1) have achieved higher resistance than the eventual colonizers. Copyright © 2013 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  18. Estimating glomerular filtration rate preoperatively for patients undergoing hepatectomy

    Institute of Scientific and Technical Information of China (English)

    Yoshimi Iwasaki; Tokihiko Sawada; Shozo Mori; Yukihiro Iso; Masato Katoh; Kyu Rokkaku; Junji Kita; Mitsugi Shimoda; Keiichi Kubota

    2009-01-01

    AIM: To compare creatinine clearance (Ccr) with estimated glomerular filtration rate (eGFR) in preoperative renal function tests in patients undergoing hepatectomy. METHODS: The records of 197 patients undergoing hepatectomy between August 2006 and August 2008 were studied, and preoperative Ccr, a three-variable equation for eGFR (eGFR3) and a five-variable equation for eGFR (eGFR5) were calculated. Abnormal values were defined as Ccr < 50 mL/min, eGFR3 and eGFR5 < 60 mL/min per 1.73 m2. The maximum increases in the postoperative serum creatinine (post Cr) level and postoperative rate of increase in the serum Cr level (post Cr rate) were compared. RESULTS: There were 37 patients (18.8%) withabnormal Ccr, 31 (15.7%) with abnormal eGFR3, and 40 (20.3%) with abnormal eGFR5. Although there were no significant differences in the post Cr rate between patients with normal and abnormal Ccr, eGFR3 and eGFR5 values, the post Cr level was significantly higher in patients with eGFR3 and eGFR5 abnormality than in normal patients ( P < 0.0001). Post Cr level tended to be higher in patients with Ccr abnormality ( P = 0.0936 and P = 0.0875, respectively). CONCLUSION: eGFR5 and the simpler eGFR3, rather than Ccr, are recommended as a preoperative renal function test in patients undergoing hepatectomy.

  19. PREOPERATIVE ENDOSCOPIC MARKING OF UNPALPABLE COLONIC TUMORS

    Directory of Open Access Journals (Sweden)

    A. L. Goncharov

    2013-01-01

    Full Text Available The identification of small colon lesions is one of the major problems in laparoscopic colonic resection.Research objective: to develop a technique of visualization of small tumors of a colon by preoperative endoscopic marking of a tumor.Materials and methods. In one day prior to operation to the patient after bowel preparation the colonoscopy is carried out. In the planned point near tumor on antimesentery edge the submucous infiltration of marking solution (Micky Sharpz blue tattoo pigment, UK is made. The volume of entered solution of 1–3 ml. In only 5 months of use of a technique preoperative marking to 14 patients with small (the size of 1–3 cm malignant tumors of the left colon is performed.Results. The tattoo mark was well visualized by during operation at 13 of 14 patients. In all cases we recorded no complications. Time of operation with preoperative marking averaged 108 min, that is significantly less in comparison with average time of operation with an intra-operative colonoscopy – 155 min (р < 0.001.Conclusions. The first experience of preoperative endoscopic marking of non palpable small tumors of a colon is encouraging. Performance of a technique wasn't accompanied by complications and allowed to reduce significantly time of operation and to simplify conditions of performance of operation.

  20. Preoperational test report, primary ventilation system

    Energy Technology Data Exchange (ETDEWEB)

    Clifton, F.T.

    1997-11-04

    This represents a preoperational test report for Primary Ventilation Systems, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The system provides vapor space filtered venting of tanks AY101, AY102, AZ101, AZ102. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System.

  1. Preoperative evaluation : risk management and implementation aspects

    NARCIS (Netherlands)

    Klei, W.A. van

    2002-01-01

    In preoperative risk management the anesthesiologist uses diagnostic information to estimate the probability of outcomes and to decide on the anesthetic strategy in a particular patient. The aim of this thesis was explore to what extent simple patient characteristics, particularly obtained from

  2. Pre-operative fasting guidelines: an update

    DEFF Research Database (Denmark)

    Søreide, E; Eriksson, L I; Hirlekar, G

    2005-01-01

    Liberal pre-operative fasting routines have been implemented in most countries. In general, clear fluids are allowed up to 2 h before anaesthesia, and light meals up to 6 h. The same recommendations apply for children and pregnant women not in labour. In children...

  3. Preoperational test report, vent building ventilation system

    Energy Technology Data Exchange (ETDEWEB)

    Clifton, F.T.

    1997-11-04

    This represents a preoperational test report for Vent Building Ventilation Systems, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The system provides Heating, Ventilation, and Air Conditioning (HVAC) for the W-030 Ventilation Building. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System.

  4. Preoperative and intraoperative continuous use of ...

    African Journals Online (AJOL)

    2016-09-13

    Sep 13, 2016 ... in clinics to improve patient safety and effectiveness with. Introduction ... and control group according to different use of drugs. The two ... Key words: Anesthesia, dexmedetomidine, effect, intervention, preoperative, recovery, remifentanil .... will lead to postoperative pain in patients and severe agitation after ...

  5. Preoperational test, vent building ventilation system

    Energy Technology Data Exchange (ETDEWEB)

    Clifton, F.T., Westinghouse Hanford

    1996-08-20

    Preoperational Test Procedure for Vent Building Ventilation System, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The Vent Building ventilation system provides ventilation, heating, cooling, and zone confinement control for the W-030 Project Vent Building. The tests verify correct System operation and correct indications displayed by the central Monitor and Control system.

  6. Preoperative evaluation : risk management and implementation aspects

    NARCIS (Netherlands)

    Klei, W.A. van

    2002-01-01

    In preoperative risk management the anesthesiologist uses diagnostic information to estimate the probability of outcomes and to decide on the anesthetic strategy in a particular patient. The aim of this thesis was explore to what extent simple patient characteristics, particularly obtained from preo

  7. Preoperative shunts in thalamic tumours.

    Directory of Open Access Journals (Sweden)

    Goel A

    2000-10-01

    Full Text Available Thirty one patients with thalamic glioma underwent a pre-tumour resection shunt surgery. The procedure was uneventful in 23 patients with relief from symptoms of increased intracranial pressure. Eight patients worsened after the procedure. The level of sensorium worsened from excessively drowsy state to unconsciousness in seven patients. Three patients developed hemiparesis, 4 developed paresis of extra-ocular muscles and altered pupillary reflexes, and 1 developed incontinence of urine and persistent vomiting. Alteration in the delicately balanced intracranial pressure and movements in the tumour and vital adjacent brain areas could be the probable cause of the worsening in the neurological state in these 8 patients. On the basis of these observations and on review of literature, it is postulated that the ventricular dilatation following an obstruction in the path of the cerebrospinal fluid flow by a tumour could be a natural defense phenomenon of the brain.

  8. 心脏移植术前血N端B型利钠肽原水平与术后早期受者存活率的关系%Relationship between preoperative N-terminal-pro-brain natriuretic levels and early survival of HT recipients

    Institute of Scientific and Technical Information of China (English)

    黄燕; 黄洁; 胡盛寿; 宋云虎; 王巍; 廖中凯; 朱俊

    2013-01-01

    目的 探讨心脏移植术前血N端B型利尿钠肽原(NT-proBNP)水平与术后早期受者存活率的关系.方法 采用免疫法测定284例拟接受心脏移植的心力衰竭患者移植前血NT-proBNP水平,按NT-proBNP水平将284例患者分为≤5000 nmol/L组(≤5000组,237例)和>5000 nmol/L组(>5000组,47例),比较两组受者的术前一般情况、不同原发病者的NT-proBNP水平、两组围手术期体外膜肺氧合(ECMO)技术应用率及死亡率.采用Kaplan-Meier法计算两组受者1年存活率.结果 >5000组术前肺毛细血管楔压为(25.1±7.4)mm Hg(1 mm Hg=0.133 kPa),明显高于≤5000组的(21.4±9.2)mm Hg(P<0.05);心脏指数为(1.8±0.5)L·min-1·m-2,明显低于≤5000组的(2.1±0.6)L·min-1·m-2 (P<0.05).>5000组围手术期需用ECMO支持者占14.9%(7/47),ECMO相关死亡率为71.4%(5/7),1年存活率为91.3%;≤5000组围手术期需用ECMO支持者占6.8%(16/237),ECMO相关死亡率为12.5%(2/16),1年存活率为96.9%,2个组ECMO应用率、ECMO相关死亡率以及受者1年存活率的差异均有统计学意义(P<0.05).结论 术前血NT-proBNP水平较高(>5000 nmol/L)者围手术期ECMO应用率和1年死亡率均较高;术前测定血NT-proBNP水平有助于心脏移植时机的把握.%Objective To assess the correlation between pre-operative N-terminal-pro-brain natriuretic levels and early survival rate among heart transplantion (HT) recipients in a single Chinese center.Methods According to the pre-operative NT-proBNP level of 284 HT recipients,the recipients were divided into two distinctive groups,≤5000 nmol/L group (237 cases) and >5000 nmol/L group (47 cases).The baseline characteristics and mortality for recipients with different primary cardiac diseases and on extracorporeal membrane oxygenation (ECMO) support were compared.Kaplan Meier method was used to calculate the 1-year survival rate of the two groups.Results The pre-operative NT-proBNP >5000 nmol/L group

  9. 肝细胞癌患者血清细胞外基质蛋白1表达水平与术后复发及预后的关系%The prognostic significance of preoperative serum levels of extracellular matrix protein 1 in patients with hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    陈浩; 李建生; 荚卫东; 许戈良; 马金良; 任维华; 王伟

    2012-01-01

    Objective To evaluate the prtognostic significance of preoperative serum extracellular matrix protein 1 ( ECM1 ) levels in patients with hepatocellular carcinoma (HCC).Methods Preoperative serum levels of ECM1 were detected by enzyme-linked immunosorbent assay (ELISA) in 117 HCC patients and 53 healthy volunteers.Corrrlations to the clinicopathological characteristics and patients survival were analyzed.Results ECM1 were detected in all the samples of 117 HCC patients and 53 healthy volunteers,the median serum ECM1 level in HCC patients was significantly higher than that in healthy volunteers ( 166.39 vs 108.06 pg/ml,Z =- 7.805,P < 0.001 ).Median serum ECM 1 levels were significantly higher in patients with invasive phenotypes,such as larger tumor size (Z =- 3.454,P =0.001 ),multiple nodule ( Z =- 2.201,P =0.028 ),vascular invasion ( Z =- 4.685,P < 0.001 ),and advanced TN M stage ( Z =-4.610,P < 0.001 ).Patients with lower serum ECM1 level (≤ 180 pg/ml ) have significantly better overall and disease free survival than those with higher levels ( > 180 pg/ml).By Cox proportional-hazard model multivariate analysis,high serum ECM1 level ( > 180 pg/ml) was an independent factor for OS and DFS in HCC patients.Conclusions Serum ECM1 levels are significantly correhted to the invasive phenotypes and survival rate.Serum ECM1 level could be used as a predictive marker for HCC recurrence and prognostic factor of HCC patients after surgery.%目的 探讨细胞外基质蛋白-1(extracellular matrix protein 1,ECM1)在肝细胞癌(hepatocellular carcinoma,HCC)患者术前血清中的表达水平与肝癌临床病理特征及生存预后间的关系.方法 应用酶联免疫吸附法测定HCC患者及健康体检者血清中ECM1表达水平,分析血清ECM1表达水平与临床病理特征及生存预后间的关系.结果 117例HCC患者及53例正常对照血清ECM1中位表达浓度分别为166.39、108.06 pg/ml,差异有统计学意义(Z=-7.805,P <0.001).

  10. Preoperative Monocyte-to-Lymphocyte Ratio in Peripheral Blood Predicts Stages, Metastasis, and Histological Grades in Patients with Ovarian Cancer

    Directory of Open Access Journals (Sweden)

    Jiangdong Xiang

    2017-02-01

    Full Text Available PURPOSE: The monocyte-to-lymphocyte ratio (MLR has been shown to be associated with the prognosis of various solid tumors. This study sought to evaluate the important value of the MLR in ovarian cancer patients. METHODS: A total of 133 ovarian cancer patients and 43 normal controls were retrospectively reviewed. The patients' demographics were analyzed along with clinical and pathologic data. The counts of peripheral neutrophils, lymphocytes, monocytes, and platelets were collected and used to calculate the MLR, neutrophil-to-lymphocyte ratio (NLR. and platelet-to-lymphocyte ratio (PLR. The optimal cutoff value of the MLR was determined by using receiver operating characteristic curve analysis. We compared the MLR, NLR, and PLR between ovarian cancer and normal control patients and among patients with different stages and different grades, as well as between patients with lymph node metastasis and non–lymph node metastasis. We then investigated the value of the MLR in predicting the stage, grade, and lymph node positivity by using logistic regression. The impact of the MLR on overall survival (OS was calculated by Kaplan-Meier method and compared by log-rank test. RESULTS: Statistically significant differences in the MLR were observed between ovarian cancer patients and normal controls. However, no difference was found for the NLR and PLR. Highly significant differences in the MLR were found among patients with different stages (stage I-II and stage III-IV, grades (G1 and >G1, and lymph node metastasis status. The MLR was a significant and independent risk factor for lymph node metastasis, as determined by logistic regression. The optimal cutoff value of the MLR was 0.23. We also classified the data according to tumor markers (CA125, CA199, HE4, AFP, and CEA and conventional coagulation parameters (International Normalized Ratio [INR] and fibrinogen. Highly significant differences in CA125, CA199, HE4, INR, fibrinogen levels, and lactate

  11. 术前不同PaO2肺癌患者围麻醉手术期发生低氧血症的分析%Analysis of Incidence of Hypoxemia of Lung Cancer Patients with Different Preoperative PaO2 Levels During Surgery

    Institute of Scientific and Technical Information of China (English)

    苗国瑞; 邢珍; 王丽; 姚杰; 张媛; 王新生

    2015-01-01

    Object: To analyse of the incidence of hypoxemia in patients with lung cancer surgery, whose have different levels of preoperative PaO2. Method:According to the preoperative different PaO2 levels, 204 lung cancer patients with single lobectomy were divided into 3 groups,Group A,PaO260mmHg~;Group B,PaO265mmHg~;Group C(Group C1 and Group C2),PaO270mmHg~:Group C1,PaO2≥70 mmHg,when patients were admitted to hospital. Group C2,PaO2≥70 mmHg before surgery,but the patients of this Group had a low PaO2(PaO2<70 mmHg)when they were admitted to hospital. To compare the incidence of intraoperative hypoxemia of 3 groups patients by recordding the blood gas on the first day of admitted to hospital, the day before surgery, the time of 15 min after supine double lung ventilation(DLV), the time of 30 min after one-lung ventilation(OLV), 60 min after OLV,1 min before two-lung ventilation, 1 min before the end of surgery and extubation, and the time of being cured in ICU. Results:The PaO2 level was a significant difference in Group A、B and Group C on the time of 30 min and 60 min after OLV and 1 min before two-lung ventilation and extubation(P<0.05), The level of PaO2 in Group A and Group B had a significantly lower than Group C. Group A and Group B had a significantly higher incidence of intraoperative hypoxemia than Group C(P<0.05). The time of Group A and B be treatmented in the ICU were significantly longer than Group C (P<0.05). Conclusion:To a certain extent, preoperative PaO2 levels may predict the occurrence tendency of intraoperative hypoxemia. The patients with preoperative PaO2≥70mmHg can better tolerate thoracotomy.%目的:分析术前不同PaO2水平的肺癌患者围麻醉手术期低氧血症的发生率。方法:204例行单肺叶切除术的肺癌患者根据术前PaO2水平分成3组,A组PaO260 mmHg~,B组PaO265 mmHg~,C组PaO270 mmHg~:C组包括C1组和C2组,C1组患者入院时PaO2≥70 mmHg ,C2组患者入院时PaO2<70 mm

  12. Preoperative MRI findings predict two-year postoperative clinical outcome in lumbar spinal stenosis.

    Directory of Open Access Journals (Sweden)

    Pekka Kuittinen

    Full Text Available To study the predictive value of preoperative magnetic resonance imaging (MRI findings for the two-year postoperative clinical outcome in lumbar spinal stenosis (LSS.84 patients (mean age 63±11 years, male 43% with symptoms severe enough to indicate LSS surgery were included in this prospective observational single-center study. Preoperative MRI of the lumbar spine was performed with a 1.5-T unit. The imaging protocol conformed to the requirements of the American College of Radiology for the performance of MRI of the adult spine. Visual and quantitative assessment of MRI was performed by one experienced neuroradiologist. At the two-year postoperative follow-up, functional ability was assessed with the Oswestry Disability Index (ODI 0-100% and treadmill test (0-1000 m, pain symptoms with the overall Visual Analogue Scale (VAS 0-100 mm, and specific low back pain (LBP and specific leg pain (LP separately with a numeric rating scale from 0-10 (NRS-11. Satisfaction with the surgical outcome was also assessed.Preoperative severe central stenosis predicted postoperatively lower LP, LBP, and VAS when compared in patients with moderate central stenosis (p<0.05. Moreover, severe stenosis predicted higher postoperative satisfaction (p = 0.029. Preoperative scoliosis predicted an impaired outcome in the ODI (p = 0.031 and lowered the walking distance in the treadmill test (p = 0.001. The preoperative finding of only one stenotic level in visual assessment predicted less postoperative LBP when compared with patients having 2 or more stenotic levels (p = 0.026. No significant differences were detected between quantitative measurements and the patient outcome.Routine preoperative lumbar spine MRI can predict the patient outcome in a two-year follow up in patients with LSS surgery. Severe central stenosis and one-level central stenosis are predictors of good outcome. Preoperative finding of scoliosis may indicate worse functional ability.

  13. Preoperative staging of perforated diverticulitis by computed tomography scanning

    NARCIS (Netherlands)

    M.P.M. Gielens; I.M. Mulder (Irene); E. van der Harst (Erwin); M.P. Gosselink (Martijn Pieter); K.J. Kraal; H.T. Teng; J.F. Lange (Johan); J. Vermeulen (Jefrey)

    2012-01-01

    textabstractBackground: Treatment of perforated diverticulitis depends on disease severity classified according to Hinchey's preoperative classification. This study assessed the accuracy of preoperative staging of perforated diverticulitis by computerized tomography (CT) scanning. Methods: All patie

  14. The Amsterdam Preoperative Anxiety and Information Scale (APAIS)

    National Research Council Canada - National Science Library

    Moerman, N; Dam, van, F.S.A.M; Muller, M.J; Oosting, H

    1996-01-01

    ... phase.During routine preoperative screening, 320 patients were asked to assess their anxiety and information requirement on a six-item questionnaire, the Amsterdam Preoperative Anxiety and Information Scale (APAIS...

  15. Preoperative education interventions to reduce anxiety and improve recovery among cardiac surgery patients: a review of randomised controlled trials.

    Science.gov (United States)

    Guo, Ping

    2015-01-01

    To update evidence of the effectiveness of preoperative education among cardiac surgery patients. Patients awaiting cardiac surgery may experience high levels of anxiety and depression, which can adversely affect their existing disease and surgery and result in prolonged recovery. There is evidence that preoperative education interventions can lead to improved patient experiences and positive postoperative outcomes among a mix of general surgical patients. However, a previous review suggested limited evidence to support the positive impact of preoperative education on patients' recovery from cardiac surgery. Comprehensive review of the literature. The Cochrane Central Register of Controlled Trials from the Cochrane Library, MEDLINE, CINAHL, PsycINFO, EMBASE and Web of Science were searched for English-language articles published between 2000-2011. Original articles were included reporting randomised controlled trials of cardiac preoperative education interventions. Six trials were identified and have produced conflicting findings. Some trials have demonstrated the effects of preoperative education on improving physical and psychosocial recovery of cardiac patients, while others found no evidence that patients' anxiety is reduced or of any effect on pain or hospital stay. Evidence of the effectiveness of preoperative education interventions among cardiac surgery patients remains inconclusive. Further research is needed to evaluate cardiac preoperative education interventions for sustained effect and in non-Western countries. A nurse-coordinated multidisciplinary preoperative education approach may offer a way forward to provide a more effective and efficient service. Staff training in developing and delivering such interventions is a priority. © 2014 John Wiley & Sons Ltd.

  16. Assessment of Preoperative Anxiety in Cardiac Surgery Patients Lacking a History of Anxiety: Contributing Factors and Postoperative Morbidity.

    Science.gov (United States)

    Hernández-Palazón, Joaquín; Fuentes-García, Diego; Falcón-Araña, Luis; Roca-Calvo, María José; Burguillos-López, Sebastián; Doménech-Asensi, Paloma; Jara-Rubio, Rubén

    2017-04-26

    The aim of this study was to measure the level of preoperative anxiety in patients scheduled for cardiac surgery, identify any influencing clinical factors, and assess the relationship between anxiety and postoperative morbidity. A prospective and consecutive study. A single university hospital. The study comprised 200 patients scheduled for cardiac surgery. Each patient was asked to grade his or her preoperative anxiety level using the Visual Analogue Scale for Anxiety, Amsterdam Preoperative Anxiety and Information Scale, and set of specific anxiety-related questions. Demographic data (age, sex, body mass index) and anesthetic and surgical data (American Society of Anesthesiologists physical status, EuroSCORE surgical risk, preoperative length of stay, and previous anesthetic experience) were registered. Also, postoperative morbidity was assessed. Twenty-eight percent of the patients developed high preoperative anxiety. The mean Amsterdam Preoperative Anxiety and Information Scale score was 11.4 ± 4.3, and the mean Visual Analogue Scale for Anxiety score was 48 ± 21. Patients scheduled for coronary artery bypass surgery, who had no previous anesthetic experience, and who were hospitalized before surgery, had higher anxiety scores. Coronary bypass surgery (odds ratio 3.026; 1.509-6.067; p = 0.002) was associated independently with preoperative high-level anxiety. Anxiety most commonly was caused by waiting for surgery, not knowing what is happening, fearing not being able to awaken from anesthesia, and being at the mercy of staff. Anxiety did not modify the postoperative course. In patients waiting to undergo cardiac surgery, both fear of the unknown and lack of information, especially related to the surgery, are crucial factors in high levels of preoperative anxiety in cardiac surgery. Coronary bypass surgery is a determining factor for preoperative anxiety. The anxiety level did not modify the postoperative course in these patients. Copyright © 2017 Elsevier

  17. [Preoperative assessment of patients with diabetes mellitus].

    Science.gov (United States)

    Takeda, Kiyoshi

    2010-07-01

    The perioperative morbidity of diabetic patients is related to preoperative end-organ damage. Due to the microvascular pathology, autonomic neuropathy is common and cardiovascular abnormalities such as hypertension, painless myocardial ischemia, and orthostatic hypotension may predispose patients to perioperative cardiovascular instability. Autonomic dysfunction also contributes to delayed gastric emptying, and preoperative administration of a histamine antagonist and a gastric emptying agent is needed. Chronic hyperglycemia leads to glycosylation of tissue proteins and the accumulation of abnormal collagen can cause stiff joint syndrome resulting in difficult tracheal intubation. The primary goal of pre and intraoperative blood glucose control is to avoid hypoglycemia and ketosis. Moreover, the tight glycemic control has been reported to improve survival in critically ill patients who were treated in the intensive care unit.

  18. Preoperatively diagnosed mucocele of the appendix.

    Science.gov (United States)

    Rojnoveanu, Gh; Ghidirim, Gh; Mishin, I; Vozian, M; Mishina, A

    2014-01-01

    Mucocele of the appendix is an infrequent entity, characterized by distension of the lumen due to accumulation of mucoid substance and is rarely diagnosed preoperatively. If untreated, mucocele may rupture producing a potentially fatal entity known as pseudomyxoma peritonei. The type of surgical treatment is related to the dimensions and the histology of the mucocele. Appendectomy is used for simple mucocele or for cystadenoma. Right hemi-colectomy is recommended for cystadeno carcinoma. In this paper, we report a case of an asymptomatic 37-year-old woman in whom mucocele was found on a routine ultrasound examination and preoperative computed tomography scan. Surgery revealed a big appendix measuring 84 mm in length and 40 mm in diameter. The final pathologic diagnosis was simple mucocele. Celsius.

  19. Preoperative CSF Melatonin Concentrations and the Occurrence of Delirium in Older Hip Fracture Patients : A Preliminary Study

    NARCIS (Netherlands)

    Scholtens, Rikie M; de Rooij, Sophia E J A; Vellekoop, Annelies E; Vrouenraets, Bart C; van Munster, Barbara C

    2016-01-01

    BACKGROUND: Delirium is characterized by disturbances in circadian rhythm. Melatonin regulates our circadian rhythm. Our aim was to compare preoperative cerebrospinal fluid (CSF) melatonin levels in patients with and without postoperative delirium. METHODS: Prospective cohort study with hip fracture

  20. Preoperative Alcohol Consumption and Postoperative Complications

    DEFF Research Database (Denmark)

    Eliasen, Marie; Grønkjær, Marie; Skov-Ettrup, Lise Skrubbeltrang

    2013-01-01

    .30-2.49), prolonged stay at the hospital (RR = 1.24; 95% CI: 1.18-1.31), and admission to intensive care unit (RR = 1.29; 95% CI: 1.03-1.61). Clearly defined high alcohol consumption was associated with increased risk of postoperative mortality (RR = 2.68; 95% CI: 1.50-4.78). Low to moderate preoperative alcohol...... complications, prolonged stay at the hospital, and admission to intensive care unit....

  1. Preoperative Arterial Interventional Chemotherapy on Cervical Cancer

    Institute of Scientific and Technical Information of China (English)

    WANG Hui; LING HU-Hua; TANG Liang-dan; ZHANG Xing-hua

    2008-01-01

    Objective:To discuss the therapeutic effect of preoperative interventional chemotherapy on cervical cancer.Methods:Preoperative interventional chemotherapy by femoral intubation was performed in 25 patients with bulky cervical cancer.The patients received bleomycin 45 mg and cisplatin or oxaliplatin 80 mg/m2.Results:25 cases(including 8 cases with stage Ⅰ and 17 cases with stage Ⅱ)received one or two courses of preoperative interventional chemotherapy.The size of the focal lesions was decreased greatly and radical hysterectomy and lymphadenectomy were performed successfully in all the patients.All of the specimens were sent for pathological examination.Lymphocyte infiltration was found more obvious in the cancer tissues as compared with their counterpart before treatment.As a result,relevant vaginal bleeding was stopped completely shortly after the treatment.Conclusion:Arterial interventional chemotherapy was proved to reduce the local size of cervical cancer and thus control the hemorrhage efficiently.The patients with cervical cancer can receive radical hysterectomy therapy after the interventional chemotherapy.

  2. Citrus aurantium blossom and preoperative anxiety.

    Science.gov (United States)

    Akhlaghi, Mahmood; Shabanian, Gholamreza; Rafieian-Kopaei, Mahmoud; Parvin, Neda; Saadat, Mitra; Akhlaghi, Mohsen

    2011-01-01

    Reducing anxiety is very important before operation. Preoperative visit and use of premedication are popular methods to achieve this goal, but the role of anxiolytic premedication remains unclear and postoperative side-effects may result from routine premedication. Citrus aurantium is used as an alternative medicine in some countries to treat anxiety, and recently the anxiolytic role of this medicinal plant was established in an animal model study. The aim of this study was to assess the anxiolytic effect of Citrus aurantium blossomon preoperative anxiety. We studied 60 ASA I patients undergoing minor operation. In a randomized double-blind design, two groups of 30 patients received one of the following oral premedication two hours before induction of anesthesia: 1) Citrus aurantium blossom distillate 1mL.kg(-1) (C-group); 2) Saline solution 1mL.kg(-1) as placebo (P-group). Anxiety was measured before and after premedication using the Spielberger state-trait anxiety inventory (STAI-state) and the Amsterdam preoperative anxiety and information scale (APAIS) before operation. After premedication, both the STAI-state and the APAIS scales were decreased in C-group (ppreoperative anxiety before minor operation. Copyright © 2011 Elsevier Editora Ltda. All rights reserved.

  3. Preoperative imaging diagnosis of carotid body tumors.

    Science.gov (United States)

    Pacheco-Ojeda, Luis A; Martínez-Viteri, Miguel A

    2010-01-01

    Carotid body tumors (CBTs) are relatively frequent lesions encountered at high altitudes, such in as the Andean Mountains. A correct preoperative diagnosis is essential for surgical planning and performance. For this reason, we have reviewed the evolution of our experience in the imaging diagnosis of these tumors. Between 1980 and June 2008, 160 CBTs were diagnosed. A total of 138 tumors were operated on, 4 are waiting for surgery, and 18 were not operated on because of age, medical conditions, or patient refusal. We have reviewed retrospectively the modalities of imaging diagnosis in our patients who underwent operation. Among the 138 tumors operated on, a correct preoperative diagnosis was done in 127 cases (92%). The preoperative diagnosis of the remaining 11 patients was unspecified benign tumor for 6 patients and neck lymph node for 5 patients. The imaging methods performed by different radiologists were conventional ultrasound, color Doppler ultrasound, carotid conventional angiography (CA), axial tomography, magnetic resonance and magnetic resonance angiography, and computed tomographic angiography (CTA). Most patients had more than one image study. Review of radiologist reports revealed a correct diagnosis in all carotid CA, magnetic resonance studies, and CTA. Additionally, CTA appeared to be a valuable method to predict the Shamblin group. Clinical suspicion and current image techniques permit a correct diagnosis in practically all cases of CBT.

  4. Assessing preoperative anxiety using a questionnaire and clinical rating: a prospective observational study.

    Science.gov (United States)

    Laufenberg-Feldmann, Rita; Kappis, Bernd

    2013-12-01

    Preoperative anxiety and need for information can be detected during preoperative consultation via structured and standardised screening by the Amsterdam Preoperative Anxiety and Information Scale (APAIS) questionnaire. To identify the prevalence of preoperative anxiety and need for information, with regard to influencing factors such as age, sex, previous operation and grade of surgery, and to examine the level of agreement between patients' self-rating and physicians' ratings. Prospective observational study. Department of Anaesthesiology, University Medical Centre of the Johannes Gutenberg University Mainz, Germany. Two hundred seventeen patients scheduled for elective surgery. The patients completed questionnaires prior to the interaction with the anaesthesiologist. Physicians were blinded to the patients' ratings and provided their subjective ratings about patients' anxiety and need for information immediately after seeing the patient. Degree of anxiety and need for information, agreement of patients' self-reports and physician's rating. 18.9% of patients were classified as 'anxiety cases' (31.8% in women and 10.6% in men). The grade of the intended surgery but no other investigated factor was related to patients' anxiety. Age (older patients) was correlated with information requirement (r = 0.21, P = 0.002). Analysis of agreement showed only weak correlations between patients' self-reports and physicians' ratings, demonstrated in low weighted Kappa-coefficients (0.12 to 0.32). The APAIS is a useful instrument to assess the level of patients' preoperative anxiety and the need for information. Given the relationship between preoperative anxiety and postoperative outcome, it seems justified to incorporate this approach into the preoperative consultation. German Clinical Trials Register DRKS00003084.

  5. Preoperative Hemoglobin and Outcomes in Patients with CKD Undergoing Cardiac Surgery

    Science.gov (United States)

    Hitti, Sharbel; Silberman, Shuli; Tauber, Rachel; Merin, Ofer; Lifschitz, Meyer; Slotki, Itzchak; Bitran, Daniel; Fink, Daniel

    2014-01-01

    Background and objectives Preoperative anemia adversely affects outcomes of cardiothoracic surgery. However, in patients with CKD, treating anemia to a target of normal hemoglobin has been associated with increased risk of adverse cardiac and cerebrovascular events. We investigated the association between preoperative hemoglobin and outcomes of cardiac surgery in patients with CKD and assessed whether there was a level of preoperative hemoglobin below which the incidence of adverse surgical outcomes increases. Design, setting, participants, & measurements This prospective observational study included adult patients with CKD stages 3–5 (eGFR<60 ml/min per 1.73 m2) undergoing cardiac surgery from February 2000 to January 2010. Patients were classified into four groups stratified by preoperative hemoglobin level: <10, 10–11.9, 12–13.9, and ≥14 g/dl. The outcomes were postoperative AKI requiring dialysis, sepsis, cerebrovascular accident, and mortality. Results In total, 788 patients with a mean eGFR of 43.5±13.7 ml/min per 1.73 m2 were evaluated, of whom 22.5% had preoperative hemoglobin within the normal range (men: 14–18 g/dl; women: 12–16 g/dl). Univariate analysis revealed an inverse relationship between the incidence of all adverse postoperative outcomes and hemoglobin level. Using hemoglobin as a continuous variable, multivariate logistic regression analysis showed a proportionally greater frequency of all adverse postoperative outcomes per 1-g/dl decrement of preoperative hemoglobin (mortality: odds ratio, 1.38; 95% confidence interval, 1.23 to 1.57; P<0.001; sepsis: odds ratio, 1.31; 95% confidence interval, 1.14 to 1.49; P<0.001; cerebrovascular accident: odds ratio, 1.31; 95% confidence interval, 1.00 to 1.67; P=0.03; postoperative hemodialysis: odds ratio, 1.38; 95% confidence interval, 1.11 to 1.75; P<0.01). Moreover, preoperative hemoglobin<12 g/dl was an independent risk factor for postoperative mortality (odds ratio, 2.6; 95% confidence

  6. The pelvic support osteotomy: indications and preoperative planning.

    Science.gov (United States)

    Pafilas, Dimitrios; Nayagam, Selvadurai

    2008-09-01

    The pelvic support osteotomy is a double level femoral osteotomy with the objective of eliminating a Trendelenburg and short limb gait in young patients with severe hip joint destruction as a consequence of neonatal septic arthritis. The osteotomy has seen several changes and a brief historical overview is provided to set the evolution of the modifications of the procedure in context. We present an analysis of the preoperative assessment that will assist the surgeon to plan out the procedure. Specifically, we set out to answer the following questions: (a) Where should the first osteotomy be performed and what is the magnitude of valgus and extension correction desired at this level? (b) Where should the second osteotomy be performed and what is the magnitude of varus and derotation desired at this level?

  7. Preoperative preparation of patients with pituitary gland disorders.

    Science.gov (United States)

    Malenković, Vesna; Gvozdenović, Ljiljana; Milaković, Branko; Sabljak, Vera; Ladjević, Nebojsa; Zivaljević, Vladan

    2011-01-01

    This paper presents the most common disorders of pituitary function: acromegaly, hypopituitarism, diabetes insipidus and syndrome similar to diabetes insipidus, in terms of their importance in preoperative preparation of patients. Pituitary function manages almost the entire endocrine system using the negative feedback mechanism that is impaired by these diseases. The cause of acromegaly is a pituitary adenoma, which produces growth hormone in adults. Primary therapy of acromegaly is surgical, with or without associated radiotherapy. If a patient with acromegaly as comorbidity prepares for non-elective neurosurgical operation, then it requires consultation with brain surgeons for possible delays of that operation and primary surgical treatment of pituitary gland. If operative treatment of pituitary gland is carried out, the preoperative preparation (for other surgical interventions) should consider the need for perioperative glucocorticoid supplementation. Panhypopituitarism consequences are different in children and adults and the first step in diagnosis is to assess the function of target organs. Change of electrolytes and water occurs in the case of pituitary lesions in the form of central or nephrogenic diabetes insipidus as a syndrome of inappropriate secretion of antidiuretic hormone (SIADH). Preoperative preparation of patients with pituitary dysfunction should be multidisciplinary, whether it is a neurosurgical or some other surgical intervention. The aim is to evaluate the result of insufficient production of pituitary hormones (hypopituitarism), excessive production of adenohypophysis hormones (acromegaly, Cushing's disease and hyperprolactinemia) and the influence of pituitary tumours in surrounding structures (compression syndrome) and to determine the level of perioperative risk. Pharmacological suppressive therapy of the hyperfunctional pituitary disorders can have significant interactions with drugs used in the perioperative period.

  8. Anaesthesiologists H attitude towards preoperative patients education needs in 2005

    Directory of Open Access Journals (Sweden)

    R. Esmaeeli

    2006-01-01

    Full Text Available Background and purpose: lack of information about anaesthisia and fear of post operation contiousness, pain, nausea and vomiting increases the patientsH anxiety. There are various reports about patiensH desire for preoperation information in Iran and other countries. However, there is no study related to anaesthesiologistsH view about patientsH needs before anaesthesia and operation in the literature.Materials and Methods: This descriptive (cross- sectional study was done in 2005 on 110 anaesthesiologists working in hospitals of Mazandaran province. Questionnaire containing 4 questions about demographic and 18 questions related to anaesthesia was prepared. Attitude of the anaesthesiologists was divided into 5 categories based on Likert rating scale as follows: completely agreed, agreed, partially agreed, not agreed, completely not agreed. Chi-square test was used for the statistical analysis of the data.Results: Results of this study showed that the most positive attitude of anaesthesiologists about patient teaching was related to the proper explanation about duration of N.P.O before operation (%97.3. %52.7 of anaes the siologists were against giving explanation of the duration of N.P.O and post operation possible problems. In this regard no significant difference was observed between educational and non educational hospitals (P<0.018. No significant difference in terms of attitude was observed between anaesthesiologists at different level of education (P<0.07.Conclusion: Considering the positive attitude of the anaesthesiologists towards education and preoperation of the patients, it is recommended that such education be implemented and the patients be charged for preoperation consultation in order to give explanation about anaesthesia at proper time, when needed.

  9. Iron therapy for pre-operative anaemia.

    Science.gov (United States)

    Ng, Oliver; Keeler, Barrie D; Mishra, Amitabh; Simpson, Alastair; Neal, Keith; Brookes, Matthew J; Acheson, Austin G

    2015-12-22

    Pre-operative anaemia is common and occurs in up to 76% of patients. It is associated with increased peri-operative allogeneic blood transfusions, longer hospital lengths of stay and increased morbidity and mortality. Iron deficiency is one of the most common causes of this anaemia. Oral iron therapy has traditionally been used to treat anaemia but newer, safer parenteral iron preparations have been shown to be more effective in other conditions such as inflammatory bowel disease, chronic heart failure and post-partum haemorrhage. A limited number of studies look at iron therapy for the treatment of pre-operative anaemia. The aim of this Cochrane review is to summarise the evidence for use of iron supplementation, both enteral and parenteral, for the management of pre-operative anaemia. The objective of this review is to evaluate the effects of pre-operative iron therapy (enteral or parenteral) in reducing the need for allogeneic blood transfusions in anaemic patients undergoing surgery. We ran the search on 25 March 2015. We searched the Cochrane Injuries Group's Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), Ovid MEDLINE(R), Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily and Ovid OLDMEDLINE(R), EMBASE Classic and EMBASE (Ovid), CINAHL Plus (EBSCO), PubMed, clinical trials registries, conference abstracts, and we screened reference lists. We included all randomised controlled trials (RCTs) which compared pre-operative iron monotherapy to placebo, no treatment, standard of care or another form of iron therapy for anaemic adults undergoing surgery. Anaemia was defined by haemoglobin values less than 13 g/dL for males and 12 g/dL for non-pregnant females. Data were collected by two authors on the proportion of patients who receive a blood transfusion, amount of blood transfused per patient (units) and haemoglobin measured as continuous variables at pre-determined time-points: pre

  10. [Heart rate and blood pressure are not good parameters to evaluate preoperative anxiety.].

    Science.gov (United States)

    Conceição, Diogo Bruggemann da; Schonhorst, Leonardo; Conceição, Mário José da; Oliveira Filho, Getúlio Rodrigues de

    2004-12-01

    Surgical patients are subject to different levels of preoperative distress. Anxious patients may present unfavorable psychophysical reactions, such as hypertension and tachycardia. This study aimed at evaluating the level of preoperative anxiety in a population of surgical patients, and at detecting heart rate and blood pressure changes and their relationship with age, gender, education and previous surgical experience. Participated in this randomized study 145 adult patients of both genders, physical status ASA I - III, perfectly oriented in time and space, literate and scheduled for elective surgeries, to whom the Amsterdam preoperative anxiety questionnaire was applied during preanesthetic evaluation. Patients with scores > 11 were considered anxious. Age, gender, education, systolic and diastolic blood pressure, heart rate, previous surgical experience and history of hypertension were recorded. Sixty-nine patients (47.58%) were considered anxious, while 76 (52.41%) were considered not anxious. There were no significant differences between anxious and non-anxious patients in age, systolic and diastolic blood pressure, and heart rate. Among anxious patients 68.12% were females and 31.88% were males (p preoperative anxiety. Females are more anxious then males in the preoperative period.

  11. Music listening for anxiety relief in children in the preoperative period: a randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Mariana André Honorato Franzoi

    Full Text Available ABSTRACT Objective: to investigate the effects of music listening, for 15 minutes, on the preoperative anxiety levels in children undergoing elective surgery in comparison with conventional pediatric surgical care. Method: randomized controlled clinical trial pilot study with 52 children in the preoperative period, aged 3 to 12 years, undergoing elective surgery and randomly allocated in the experimental group (n = 26 and control group (n = 26. Anxiety was assessed in both groups by the application of the modified Yale Preoperative Anxiety Scale and measurement of the physiological variables, upon arrival and 15 minutes after the first measurement. Results: there was a statistically significant difference in preoperative anxiety between the two groups only in relation to the physiological variable, since the respiratory rate of preschool children in the experimental group reduced in the second measurement compared to the control group (p = 0.0453. The experimental group showed a statistically significant reduction in anxiety levels after 15 minutes of music listening (p = 0.0441, specifically with regard to the behavioral domains of activity, vocalization, emotional expression and apparent awakening state. Conclusion: music listening emerges as a potential nursing intervention for relief of preoperative anxiety in children undergoing surgical procedures. RBR-7mcr59.

  12. Music listening for anxiety relief in children in the preoperative period: a randomized clinical trial 1

    Science.gov (United States)

    Franzoi, Mariana André Honorato; Goulart, Cristina Bretas; Lara, Elizabete Oliveira; Martins, Gisele

    2016-01-01

    ABSTRACT Objective: to investigate the effects of music listening, for 15 minutes, on the preoperative anxiety levels in children undergoing elective surgery in comparison with conventional pediatric surgical care. Method: randomized controlled clinical trial pilot study with 52 children in the preoperative period, aged 3 to 12 years, undergoing elective surgery and randomly allocated in the experimental group (n = 26) and control group (n = 26). Anxiety was assessed in both groups by the application of the modified Yale Preoperative Anxiety Scale and measurement of the physiological variables, upon arrival and 15 minutes after the first measurement. Results: there was a statistically significant difference in preoperative anxiety between the two groups only in relation to the physiological variable, since the respiratory rate of preschool children in the experimental group reduced in the second measurement compared to the control group (p = 0.0453). The experimental group showed a statistically significant reduction in anxiety levels after 15 minutes of music listening (p = 0.0441), specifically with regard to the behavioral domains of activity, vocalization, emotional expression and apparent awakening state. Conclusion: music listening emerges as a potential nursing intervention for relief of preoperative anxiety in children undergoing surgical procedures. RBR-7mcr59. PMID:27992027

  13. Preoperative factors as a predictor for early postoperative outcomes after repair of congenital transposition of the great arteries.

    Science.gov (United States)

    Kim, Jung-Won; Gwak, Mijeung; Shin, Won-Jung; Kim, Hyun-Jung; Yu, Jeong Jin; Park, Pyung-Hwan

    2015-03-01

    Transposition of the great arteries (TGA) requires early surgical repair during the neonatal period. Several preoperative factors have been identified for the postoperative poor outcome after arterial switch operation (ASO). However, the data remain uncertain an association. Therefore, we investigated the preoperative factors which affect the early postoperative outcomes. Between March 2005 and May 2012, a retrospective study was performed which included 126 infants with an ASO for TGA. Preoperative data included the vasoactive inotropic score (VIS) and baseline hemodynamics. Early postoperative outcomes included the duration of mechanical ventilation, the length of stay in the intensive care unit and hospital, and early mortality. Multivariate linear regression and receiver operating characteristics analysis were performed. The duration of mechanical ventilation was significantly correlated with the preoperative mechanical ventilator support and VIS, and CPB time. On multivariate linear regression analysis, a higher preoperative VIS, preoperative B-type natriuretic peptide (BNP) level, and the CPB time were identified as independent risk factors for delayed mechanical ventilation. Preoperative VIS (OR 1.154, 95 % CI 1.024-1.300) and the CPB time (OR 1.034, 95 % CI 1.009-1.060) were independent parameters predicting early mortality. A preoperative VIS of 12.5 had the best combined sensitivity (83.3 %) and specificity (85.3 %) and an AUC of 0.852 (95 % CI 0.642-1.061) predicted early mortality. Our results suggest that preoperative VIS and BNP can predict the need for prolonged postoperative mechanical ventilation. Moreover, preoperative VIS may be used as a simple and feasible indicator for predicting early mortality.

  14. [Preoperative fasting period of fluids in bariatric surgery].

    Science.gov (United States)

    Simon, P; Pietsch, U-C; Oesemann, R; Dietrich, A; Wrigge, H

    2017-07-01

    Aspiration of stomach content is a severe complication during general anaesthesia. The DGAI (German Society for Anesthesiology and Intensive Care Medicine) guidelines recommend a fasting period for liquids of 2 h, with a maximum of 400 ml. Preoperative fasting can affect the patients' recovery after surgery due to insulin resistance and higher protein catabolism as a response to surgical stress. The aim of the study was to compare a liberal fasting regimen consisting of up to 1000 ml of liquids until 2 h before surgery with the DGAI recommendation. The prospective observational clinical study was approved by the ethics committee of the University of Leipzig. In the liberal fasting group (Glib) patients undergoing bariatric surgery were asked to drink 1000 ml of tea up to 2 h before surgery. Patients assigned to the restrictive fasting group (Gres) who were undergoing nonbariatric abdominal surgery were asked to drink no more than 400 ml of water up to 2 h preoperatively. Right after anaesthesia induction and intubation a gastric tube was placed, gastric residual volume was measured and the pH level of gastric fluid was determined. Moreover, the occurrence of aspiration was monitored. In all, 98 patients with a body mass index (BMI) of Glib 51.1 kg/m(2) and Gres 26.5 kg/m(2) were identified. The preoperative fasting period of liquids was significantly different (Glib 170 min vs. Gres 700 min, p Gres 5 ml, p = 0.355). The pH of gastric fluid was nearly similar (Glib 4.0; Gres 3.0; p = 0.864). Aspiration did not occur in any patient. There is evidence suggesting that a liberal fluid fasting regimen (1000 ml of fluid) in the preoperative period is safe in patients undergoing bariatric surgery.

  15. Preoperative anaemia and newly diagnosed cancer 1 year after elective total hip and knee arthroplasty

    DEFF Research Database (Denmark)

    Jørgensen, C. C.; Jans; Kehlet, H.

    2015-01-01

    BACKGROUND: Preoperative anaemia is a well-established risk factor for use of blood transfusions and postoperative morbidity. Consequently, focus on preoperative evaluation of haemoglobin levels is increasing. In this context, iron deficiency anaemia may be a symptom of undiscovered gastrointesti......BACKGROUND: Preoperative anaemia is a well-established risk factor for use of blood transfusions and postoperative morbidity. Consequently, focus on preoperative evaluation of haemoglobin levels is increasing. In this context, iron deficiency anaemia may be a symptom of undiscovered......·3%) and 79 (1·6%) new cancers in anaemic and non-anaemic patients, respectively (OR: 1·38; 95% CI: 0·81-2·35, P = 0·228). After propensity matching of 661 anaemic and 1305 non-anaemic patients, we found no association between preoperative anaemia and cancer (OR: 0·94; 95% CI: 0·51-1·73, P = 0·837) or with GI...... cancers specifically (OR: 0·80; 95% CI: 0·25-2·56, P = 0·707). CONCLUSION: Preoperative anaemia per se may not be related to being diagnosed with cancer 1 year after THA and TKA. The optimal criteria for preoperative referral of anaemic patients to gastroenterologist in elective THA and TKA need further...

  16. Are P.T.H. plasma levels useful for the selection of patients with secondary hyperparathyroidism for preoperative MIBI ({sup 99m}Tc)/{sup 123}I dual-isotope scintigraphy?;La concentration plasmatique de PTH permet-elle de selectionner les patients atteints d'hyperparathyroidie secondaire pour beneficier de la scintigraphie double isotope MIBI ({sup 99m}Tc)/{sup 123}I preoperatoire?

    Energy Technology Data Exchange (ETDEWEB)

    Balogova, S.; Sauer, A.M.; Dudczak, J.; Pascal, O.; Kerrou, K.; Huchet, V.; Montravers, F.; Talbot, J.N. [Universite Pierre-et-Marie-Curie, Service de medecine nucleaire, hopital Tenon, 75 - Paris (France); Perie, S.; Lacau St-Guily, J. [Universite Pierre-et-Marie-Curie, ORL, hopital Tenon, 75 - Paris (France); Nataf, V. [Universite Pierre-et-Marie-Curie, hopital Tenon, Service de radiopharmacie, 75 - Paris (France); Balogova, S. [Faculte de medecine, universite Comenius, Bratislava (Slovakia)

    2010-07-15

    The utility of preoperative scintigraphy in case of secondary hyperparathyroidism is questioned by some authors. Obviously, an imaging modality that will detect all hyperplastic glands, including the ectopic ones, would be of interest in those patients at high risk for surgery. However, scintigraphy has a limited detection rate in some patients. We investigated whether one of the following parameters would identify a subgroup of patients in whom the detection rate would be optimal: age, gender, hemodialysis and duration since its onset, and plasma levels of parathyrin (P.T.H.). Methods: Retrospective series of 38 patients referred for preoperative parathyroid scintigraphy due to secondary hyperparathyroidism who then underwent para thyroidectomy. Scintigraphy was performed 20 min and then 3 h after injection of 8 MBq/kg of sestamibi ({sup 99m}Tc) with a previous ingestion of 0.1 MBq/kg iodine-123, 3 h before. Result: No significant correlation was observed between the number of glands detected on scintigraphy (and confirmed by postoperative histology) and plasma P.T.H. levels (r = -0.17). A weak positive correlation (r = +0.34) was noted in the group of six non-hemo dialysed patients. No significant relationship between this number of detected glands and a clinical parameter was observed. Conclusion: In our experience, these parameters do not permit to select, among patients with secondary hyperparathyroidism and scheduled for para thyroidectomy, those who will better benefit from parathyroid scintigraphy. (authors)

  17. [Association of preoperative platelet count with the prognosis of patients with colorectal cancer].

    Science.gov (United States)

    Chen, Li-Ling; Zhang, Li; Li, Yue-Ling; Li, Xiao-Ling; Liu, Wen-Hui; Yan, Jin; Yang, Yan-Fang

    2016-04-01

    To explore the association between preoperative platelet count and the outcomes of patients with colorectal cancer (CRC). This study was conducted among a cohort of 486 CRC patients, who underwent surgery in Sichuan Provincial Cancer Hospital between January, 2010 and July, 2013 and were prospectively followed up for their outcomes. The association between preoperative platelet counts and clinicopathologic factors of the patients were analyzed. Survival analysis of the patients was performed using log-rank test, and the factors affecting the patients' outcomes were analyzed by univariate and multivariate analyses using the Cox proportional hazard model. In this cohort, preoperative platelet count was significantly associated with the tumor site, depth of tumor invasion (T), and distant metastasis (M) (all Prectal cancer, the overall postoperative survival differed significantly between high and low preoperative platelet count groups (Χ(2)=8.813, P=0.003 and Χ(2)=5.110, P=0.024, respectively), but this difference was not observed in patients with colon cancer (PTNM stage, vascular invasion, perineural invasion, and preoperative CEA level (RR=1.814, 95%CI: 1.056-3.115). In subgroup analysis, preoperative platelet count was identified as an independent prognostic factor in patients with rectal cancer (RR=2.718, 95% CI: 1.132-6.526), but not in patients with colon cancer (RR=1.396, 95%CI: 0.705-2.765). As an independent prognostic factor in CRC patients, preoperative platelet count may serve as an important indicator for predicting the outcomes of rectal cancer, but its prognostic value for colon cancer needs further clarification.

  18. Treatment Guidelines for Preoperative Radiation Therapy for Retroperitoneal Sarcoma: Preliminary Consensus of an International Expert Panel

    Energy Technology Data Exchange (ETDEWEB)

    Baldini, Elizabeth H., E-mail: ebaldini@partners.org [Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women' s Hospital, Boston, Massachusetts (United States); Wang, Dian [Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois (United States); Haas, Rick L.M. [Department of Radiotherapy, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam (Netherlands); Catton, Charles N. [Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Indelicato, Daniel J. [Department of Radiation Oncology, University of Florida Medical Center, Jacksonville, Florida (United States); Kirsch, David G. [Department of Radiation Oncology, Duke University Medical Center, Durham, North Carolina (United States); Roberge, David [Department of Radiation Oncology, Centre Hospitalier de l' Université de Montreal, Montreal, Quebec (Canada); Salerno, Kilian [Department of Radiation Oncology, Roswell Park Cancer Institute, Buffalo, New York (United States); Deville, Curtiland [Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins Sidney Kimmel Cancer Center, Washington, DC (United States); Guadagnolo, B. Ashleigh [Department of Radiation Oncology, MD Anderson Cancer Center, Houston, Texas (United States); O' Sullivan, Brian [Department of Radiation Oncology, Princess Margaret Cancer Centre, Toronto, Ontario (Canada); Petersen, Ivy A. [Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota (United States); Le Pechoux, Cecile [Department of Radiotherapy, Institut Gustave-Roussy, Villejuif (France); Abrams, Ross A. [Department of Radiation Oncology, Rush University Medical Center, Chicago, Illinois (United States); DeLaney, Thomas F. [Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts (United States)

    2015-07-01

    Purpose: Evidence for external beam radiation therapy (RT) as part of treatment for retroperitoneal sarcoma (RPS) is limited. Preoperative RT is the subject of a current randomized trial, but the results will not be available for many years. In the meantime, many practitioners use preoperative RT for RPS, and although this approach is used in practice, there are no radiation treatment guidelines. An international expert panel was convened to develop consensus treatment guidelines for preoperative RT for RPS. Methods and Materials: An expert panel of 15 academic radiation oncologists who specialize in the treatment of sarcoma was assembled. A systematic review of reports related to RT for RPS, RT for extremity sarcoma, and RT-related toxicities for organs at risk was performed. Due to the paucity of high-quality published data on the subject of RT for RPS, consensus recommendations were based largely on expert opinion derived from clinical experience and extrapolation of relevant published reports. It is intended that these clinical practice guidelines be updated as pertinent data become available. Results: Treatment guidelines for preoperative RT for RPS are presented. Conclusions: An international panel of radiation oncologists who specialize in sarcoma reached consensus guidelines for preoperative RT for RPS. Many of the recommendations are based on expert opinion because of the absence of higher level evidence and, thus, are best regarded as preliminary. We emphasize that the role of preoperative RT for RPS has not been proven, and we await data from the European Organization for Research and Treatment of Cancer (EORTC) study of preoperative radiotherapy plus surgery versus surgery alone for patients with RPS. Further data are also anticipated pertaining to normal tissue dose constraints, particularly for bowel tolerance. Nonetheless, as we await these data, the guidelines herein can be used to establish treatment uniformity to aid future assessments of efficacy

  19. Females, younger patients and patients with high BMI have the highest pre-operative knee awareness measured using the Forgotten Joint Score.

    Science.gov (United States)

    Li, Dana; Troelsen, A; Ingelsrud, L; Husted, H; Gromov, K

    2017-02-16

    The Forgotten Joint Score (FJS) is a novel measurement for patients' awareness of their knee in daily life. By identifying factors that could explain pre-operative FJS levels, the clinician could better prioritize and single out patients who would benefit most from TKA. The aim of this study was to identify possible factors that may explain the variance of pre-operative FJS levels and evaluate the relationship between pre-operative FJS and pre-operative Oxford Knee Score (OKS). Four-hundred and six individual knees undergoing primary TKA between 2014 and 2016 were included in the study. Age, gender, body mass index (BMI), pre-operative FJS and pre-operative OKS were obtained maximum 2 weeks prior to surgery. Kellgren-Lawrence (K-L) grade, alignment and joint space width (JSW) were evaluated on pre-operative radiographs. Mean FJS was 21.1 ± 15.6. Females, younger patients and patients with high BMI had significantly the worst pre-operative FJS (p < 0.005). Females scored 6.5 FJS points lower than males. A 0.2-point increase in FJS for every added year indicated improvement in knee awareness with age. A 0.4-point decrease in FJS points for every added BMI point indicated worse knee awareness with higher BMI. There was a strong positive correlation between pre-operative FJS and pre-operative OKS according to the Spearman's rank order test (p < 0.005). Females, younger patients and patients with high BMI had significantly the worst pre-operative joint awareness. FJS had a strong positive correlation to OKS in pre-operative patients for primary TKA. This information can be used for improved patient selection; clinically continuous low FJS despite weight loss and/or the passing of time may be indication for TKA. Prospective cohort study, Level II.

  20. Preoperative Assessment of Different Treatment Modalities in Bronchial Asthma Patients

    Directory of Open Access Journals (Sweden)

    Kawther A. Azzam M.D. and **Sahar S. Khattab MD

    2003-06-01

    Full Text Available This study was performed to assess the effectiveness of acupuncture and medical therapies of bronchial asthma preoperatively. Sixty patients suffered from mild to moderate bronchial asthma and coming for elective operations were chozen from the outpatient clinic of Al-Zahraa University Hospital. Patients were randomly divided into three equal groups (n=20 each. Group I patients (drug group received oral theophylline and Salbutamol (ventolin inhaler according to the needs. Group II patients (drug +ear acupuncture group received same medical treatment as in group I and added ear acupuncture. Group III patients (drug + ear and body acupuncture group received same medical treatment as in group I and II and added ear and body acupuncture. Ventilatory function tests through spirometer and interleukin-13 estimation were performed before treatment and after two weeks of treatment. Improvement of subjective and objective parameters had occurred with significant decrease in the mean serum level of interleukin-13 and decrease in the mean number of using b-agonist puffs after two weeks of treatment in the three groups, with the best results being in group III than in group II and then in group I. Conclusion: Interleukin-13 estimation togheter with ventilatory function tests is a useful parameter for pre-operative assessment and evaluation of asthmatic patients. Also medication was significantly reduced when combined with acupuncture.

  1. Preoperative urinary tract obstruction in scoliosis patients.

    Science.gov (United States)

    Suzuki, Shigeru; Kotani, Toshiaki; Mori, Kazuetsu; Kawamura, Ken; Ohtake, Akira

    2017-01-01

    While the association between scoliosis and cardiac and respiratory function impairments has been well characterized in clinical practice and research, the potential effect of scoliosis on urinary tract structure and renal function has received little attention. Therefore, the purpose of this study was to evaluate the preoperative clinical characteristics of urinary tract structure and renal function in pediatric patients with idiopathic scoliosis, using a combination of blood tests, urinalysis, and imaging. Preoperative measures of urinary tract structure and renal function were obtained for 16 patients, 13-17 years old, scheduled for corrective surgery for idiopathic scoliosis. Preoperative assessment included blood test and urinalysis, combined with structural imaging on ultrasound (US), magnetic resonance imaging (MRI), magnetic resonance urography (MRU), and radioisotope tracing (RI), using technetium-99 m mercaptoacetyltriglycine ((99m) Tc-MAG3). Differences in blood and urine tests between patients with and without urinary tract obstruction (UTO) were evaluated for significance using Mann-Whitney U test. For all 16 patients, blood tests and MRU were within normal limits. Dilatation of the renal pelvis was identified on US in eight patients (50.0%). UTO was identified on RI in six patients (37.5%). UTO was associated with elevated β2-microglobulin concentration. Urinary β2-microglobulin concentration >0.7 μg/mg Cr differentiated patients with UTO from those without UTO, with a sensitivity of 100% and specificity of 70%. β2-Microglobulin concentration may be a useful marker to screen for asymptomatic UTO in patients with idiopathic scoliosis. © 2016 Japan Pediatric Society.

  2. Placement of a gastric tube at varied preoperative moments in patients scheduled for gastrointestinal operation under general anesthesia:the effect of timing on cortisol level%术前置胃管时间对全麻胃肠道手术患者皮质醇的影响

    Institute of Scientific and Technical Information of China (English)

    袁玉萍; 尹罗庚; 贡国娟; 吴红梅

    2012-01-01

    Objective To observe the effect of preoperative placing timing of gastric tube on cortisol level of patients scheduled for gastrointestinal operation under general anesthesia. Methods Forty patients scheduled for gastrointestinal operation under general anesthesia were commensurately randomized into two groups. The gastric tube was placed in the morning on the day when patients were to receive the gastrointestinal surgery in the control group, while it was placed after induction of general anaesthesia in the observation group. Mean arterial pressure, heart rates and serum cortisol level were recorded on the operation morning, before induction of general anesthesia, 2 and 5 minutes after endotracheal intubation. Results There was significant group effect between the two groups in mean arterial pressure, heart rates and serum cortisol level at varied time points (P<0. 05 for all). Conclusion Placement of a gastric tube after induction of general anaesthesia alleviates discomfort of patients, avoids abrupt icrease in blood pressure, heart rates and serum cortisol level, and lessens stress-induced reaction.%目的 观察术前置胃管时间对全麻胃肠道手术患者皮质醇的影响.方法 将40例胃肠道手术需要置胃管的患者随机分为两组,各20例.对照组于术晨病房常规置胃管,观察组于全麻诱导后置胃管.每组分别监测术晨,麻醉诱导前,气管插管后2 min及5 min时平均动脉压、心率及血清皮质醇.结果 两组不同时段各观察指标比较,干预主效应均P<0.05.结论 将手术患者置胃管时间放在麻醉诱导后进行能减少患者的不适感,避免血压、心率及皮质醇急剧升高,减轻应激反应.

  3. Preoperative Evaluation: Estimation of Pulmonary Risk.

    Science.gov (United States)

    Lakshminarasimhachar, Anand; Smetana, Gerald W

    2016-03-01

    Postoperative pulmonary complications (PPCs) are common after major non-thoracic surgery and associated with significant morbidity and high cost of care. A number of risk factors are strong predictors of PPCs. The overall goal of the preoperative pulmonary evaluation is to identify these potential, patient and procedure-related risks and optimize the health of the patients before surgery. A thorough clinical examination supported by appropriate laboratory tests will help guide the clinician to provide optimal perioperative care. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Preoperational test report, recirculation ventilation systems

    Energy Technology Data Exchange (ETDEWEB)

    Clifton, F.T.

    1997-11-11

    This represents a preoperational test report for Recirculation Ventilation Systems, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The system provides vapor space cooling of tanks AY1O1, AY102, AZ1O1, AZ102 and supports the ability to exhaust air from each tank. Each system consists of a valved piping loop, a fan, condenser, and moisture separator; equipment is located inside each respective tank farm in its own hardened building. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System.

  5. Preoperational test report, raw water system

    Energy Technology Data Exchange (ETDEWEB)

    Clifton, F.T.

    1997-10-29

    This represents the preoperational test report for the Raw Water System, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The system supplies makeup water to the W-030 recirculation evaporative cooling towers for tanks AY1O1, AY102, AZ1O1, AZ102. The Raw Water pipe riser and associated strainer and valving is located in the W-030 diesel generator building. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System.

  6. Preoperative irradiation and cystectomy for bladder cancer.

    Science.gov (United States)

    Smith, J A; Batata, M; Grabstald, H; Sogani, P C; Herr, H; Whitmore, W F

    1982-03-01

    Between 1971 and 1974, 101 patients at Memorial Sloan-Kettering Cancer Center underwent planned integrated treatment for bladder cancer with 2000 rads by megavoltage delivered to the whole pelvis over five consecutive days followed by radical cystectomy within a week. The overall five-year survival rate was 39%; the hospital mortality rate was 2%. In the pelvis alone tumor recurred in 9% of the patients. These results support other studies demonstrating the efficacy of this and other regimens of preoperative irradiation and cystectomy.

  7. Preoperative risk factor analysis in orthotopic liver transplantation with pretransplant artificial liver support therapy

    Institute of Scientific and Technical Information of China (English)

    Jin-Zhong Yuan; Qi-Fa Ye; Ling-Ling Zhao; Ying-Zi Ming; Hong Sun; Shai-Hong Zhu; Zu-Fa Huang; Min-Min Wang

    2006-01-01

    AIM: To assess the value of pre-transplant artificial liver support in reducing the pre-operative risk factors relating to early mortality after orthotopic liver transplantation (OLT).METHODS: Fifty adult patients with various stages and various etiologies undergoing OLT procedures were treated with molecular adsorbent recycling system (MARS) as preoperative liver support therapy. The study included two parts, the first one is to evaluate the medical effectiveness of single MARS treatment with some clinical and laboratory parameters, which were supposed to be the therapeutical pre-transplant risk factors, the second part is to study the patients undergoing OLT using the regression analysis on preoperative risk factors relating to early mortality (30 d)after OLT.RESULTS: In the 50 patients, the statistically significant improvement in the biochemical parameters was observed (pre-treatment and post-treatment). Eight patients avoided the scheduled Ltx due to significant relief of clinical condition or recovery of failing liver function, 8 patients died, 34 patients were successfully bridged to Ltx, the immediate outcome of this 34patients within 30d observation was: 28 kept alive and 6patients died.CONCLUSION: Pre-operative SOFA, level of creatinine,INR, TNF-α, IL-10 are the main preoperative risk factors that cause early death after operation, MARS treatment before transplantion can relieve these factors significantly.

  8. Effects of preoperative simulation on minimally invasive Hybrid Lumbar Interbody Fusion (MIS-HLIF).

    Science.gov (United States)

    Rieger, Bernhard; Jiang, Hongzhen; Reinshagen, Clemens; Molcanyi, Marek; Zivcak, Jozef; Grönemeyer, Dietrich; Bosche, Bert; Schackert, Gabriele; Ruess, Daniel

    2017-07-10

    The main focus of this study was to evaluate how preoperative simulation affects the surgical workflow, radiation exposure and outcome of MIS-HLIF. 132 patients who underwent single level MIS-HLIF were enrolled in a cohort study design. Dose area product was analyzed in addition to surgical data. Once preoperative simulation was established, 66 cases (SIM cohort) were compared with 66 patients who had previously undergone MIS-HLIF without preoperative simulation (NO-SIM cohort). Dose area product was reduced considerably in the SIM cohort (320 cGy·cm(2) NO-SIM cohort: 470 cGy·cm(2); p<0.01). Surgical time was shorter for the SIM cohort (155 minutes; NO-SIM cohort: 182 minutes; p<0.05). SIM cohort had a better outcome in numeric rating scale (NRS) back at 6 months follow-up when compared to NO-SIM cohort (p<0.05). Preoperative simulation reduced radiation exposure and resulted in less back pain at the 6 months follow-up time point. Preoperative simulation provided guidance in determining the correct cage height. Outcome controls enabled the surgeon to improve the procedure and the software algorithm. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Total versus hemiarthroplasty for glenohumeral arthritis according to preoperative glenoid erosion

    Directory of Open Access Journals (Sweden)

    Marc-Frederic Pastor

    2015-06-01

    Full Text Available Clinical studies on primary osteoarthritis have shown better results of total shoulder arthroplasty (TSA compared to hemiarthroplasty (HA regarding the function, revision rate and postoperative pain relief. However, a clear recommendation for implantation of TSA or HA, depending on the glenoid type of erosion, does not exist. The aim of the study was to compare the results of TSA and HA with respect to the preoperative glenoid type. In this study, 41 patients were examined retrospectively; among them, 25 patients were treated with stemmed anatomic TSA and 16 with stemmed anatomic HA. The degree of osteoarthritis was determined according to Samilson and the glenoid erosion was classified according to Walch. The clinical outcome of the patients was determined by using the Constant Score (CS and the Simple Shoulder Test at final follow-up. Patients after TSA demonstrated a significantly improved internal rotation compared to HA patients. Patients with preoperative B1 glenoid showed better pain relief after TSA compared to HA. For patients with preoperative type A2 glenoid a significantly higher CS was found after TSA compared to HA. We were able to show good short-term results after TSA and HA. Our findings suggest a better internal rotation for TSA compared to HA, superior clinical outcome for patients with preoperative A2 glenoid and lower pain level for patients with a preoperative B1 glenoid. However, these results need to be confirmed by further studies.

  10. Preoperative chemoradiotherapy for locally advanced gastric cancer

    Directory of Open Access Journals (Sweden)

    Pepek Joseph M

    2013-01-01

    Full Text Available Abstract Background To examine toxicity and outcomes for patients treated with preoperative chemoradiotherapy (CRT for gastric cancer. Methods Patients with gastroesophageal (GE junction (Siewert type II and III or gastric adenocarcinoma who underwent neoadjuvant CRT followed by planned surgical resection at Duke University between 1987 and 2009 were reviewed. Overall survival (OS, local control (LC and disease-free survival (DFS were estimated using the Kaplan-Meier method. Toxicity was graded according to the Common Toxicity Criteria for Adverse Events version 4.0. Results Forty-eight patients were included. Most (73% had proximal (GE junction, cardia and fundus tumors. Median radiation therapy dose was 45 Gy. All patients received concurrent chemotherapy. Thirty-six patients (75% underwent surgery. Pathologic complete response and R0 resection rates were 19% and 86%, respectively. Thirty-day surgical mortality was 6%. At 42 months median follow-up, 3-year actuarial OS was 40%. For patients undergoing surgery, 3-year OS, LC and DFS were 50%, 73% and 41%, respectively. Conclusions Preoperative CRT for gastric cancer is well tolerated with acceptable rates of perioperative morbidity and mortality. In this patient cohort with primarily advanced disease, OS, LC and DFS rates in resected patients are comparable to similarly staged, adjuvantly treated patients in randomized trials. Further study comparing neoadjuvant CRT to standard treatment approaches for gastric cancer is indicated.

  11. Preoperative evaluation for lung cancer resection

    Science.gov (United States)

    Spyratos, Dionysios; Porpodis, Konstantinos; Angelis, Nikolaos; Papaiwannou, Antonios; Kioumis, Ioannis; Pitsiou, Georgia; Pataka, Athanasia; Tsakiridis, Kosmas; Mpakas, Andreas; Arikas, Stamatis; Katsikogiannis, Nikolaos; Kougioumtzi, Ioanna; Tsiouda, Theodora; Machairiotis, Nikolaos; Siminelakis, Stavros; Argyriou, Michael; Kotsakou, Maria; Kessis, George; Kolettas, Alexander; Beleveslis, Thomas; Zarogoulidis, Konstantinos

    2014-01-01

    During the last decades lung cancer is the leading cause of death worldwide for both sexes. Even though cigarette smoking has been proved to be the main causative factor, many other agents (e.g., occupational exposure to asbestos or heavy metals, indoor exposure to radon gas radiation, particulate air pollution) have been associated with its development. Recently screening programs proved to reduce mortality among heavy-smokers although establishment of such strategies in everyday clinical practice is much more difficult and unknown if it is cost effective compared to other neoplasms (e.g., breast or prostate cancer). Adding severe comorbidities (coronary heart disease, COPD) to the above reasons as cigarette smoking is a common causative factor, we could explain the low surgical resection rates (approximately 20-30%) for lung cancer patients. Three clinical guidelines reports of different associations have been published (American College of Chest Physisians, British Thoracic Society and European Respiratory Society/European Society of Thoracic Surgery) providing detailed algorithms for preoperative assessment. In the current mini review, we will comment on the preoperative evaluation of lung cancer patients. PMID:24672690

  12. Feasibility and preliminary effectiveness of preoperative therapeutic exercise in patients with cancer: a pragmatic study.

    NARCIS (Netherlands)

    Timmerman, H.; Groot, J.F. de; Hulzebos, H.J.; Knikker, R. de; Kerkkamp, H.E.M.; Meeteren, N.L. van

    2011-01-01

    The aim of this pilot study is to determine the feasibility and preliminary effectiveness of an individually designed preoperative therapeutic exercise program (PreTEP), in patients recently diagnosed with cancer and awaiting elective surgery. The purpose is to improve their physical fitness levels

  13. Preoperative Alpha-Fetoprotein Slope is Predictive of Hepatocellular Carcinoma Recurrence after Liver Transplantation

    Directory of Open Access Journals (Sweden)

    Kathy Han

    2007-01-01

    Full Text Available BACKGROUND: Liver transplantation (LT offers a possible cure for patients with hepatocellular carcinoma (HCC and cirrhosis. However, tumour progression while on the waiting list and tumour recurrence after LT are common. The prognostic significance of various pre- and postoperative variables were investigated in regard to tumour recurrence, with an emphasis on the slope of preoperative serum alpha-fetoprotein (AFP levels.

  14. Feasibility and preliminary effectiveness of preoperative therapeutic exercise in patients with cancer: A pragmatic study

    NARCIS (Netherlands)

    Timmerman, H.; Groot, J.F. de; Hulzebos, H.J.; Knikker, R. de; Kerkkamp, H.E.M.; Meeteren, N.L.U. van

    2011-01-01

    The aim of this pilot study is to determine the feasibility and preliminary effectiveness of an individually designed preoperative therapeutic exercise program (PreTEP), in patients recently diagnosed with cancer and awaiting elective surgery. The purpose is to improve their physical fitness levels

  15. Preoperative prognostic factors for mortality in peptic ulcer perforation: a systematic review

    DEFF Research Database (Denmark)

    Møller, Morten Hylander; Adamsen, Sven; Thomsen, Reimar Wernich

    2010-01-01

    metabolic acidosis, tachycardia, acute renal failure, low serum albumin level, high American Society of Anaesthesiologists score, and preoperative delay >24 h were associated with poor prognosis. Conclusions. In patients with PPU, a number of negative prognostic factors can be identified prior to surgery......, and many of these seem to be related to presence of the sepsis syndrome...

  16. Association between elevated pre-operative glycosylated hemoglobin and post-operative infections after non-emergent surgery

    Directory of Open Access Journals (Sweden)

    Joseph M. Blankush

    2016-09-01

    Conclusions: The risk factors of post-operative infection are multiple and likely synergistic. While pre-operative HbA1c level is not independently associated with risk of post-operative infection, there are scenarios and patient subgroups where pre-operative HbA1c is useful in predicting an increased risk of infectious complications in the post-operative period.

  17. Parental presence, clowns or sedative premedication to treat preoperative anxiety in children: what could be the most promising option?

    OpenAIRE

    Vagnoli, Laura; Caprilli, Simona; Messeri, Andrea

    2010-01-01

    Abstract Background and Objectives: A significant number of children undergo surgery experience high levels of anxiety in the presurgical period. The aim of this study is to investigate which intervention is more effective in reducing preoperative anxiety. Methods/Materials: The sample was composed of 75 subjects (ages 5-12 years) who had to undergo minor day-surgery. Children were randomly assigned to: the Clowns group (N = 25), accompanied to the preoperative room by the clown...

  18. Measuring preoperative anxiety in patients with intracranial tumors: the Amsterdam preoperative anxiety and information scale.

    Science.gov (United States)

    Goebel, Simone; Kaup, Lea; Mehdorn, Hubertus Maximilian

    2011-10-01

    Preoperative anxiety is a major problem in patients with brain tumors and is of high clinical relevance. However, to date no instruments have been validated for the assessment of preoperative anxiety for this patient group. The Amsterdam Preoperative Anxiety and Information Scale (APAIS) has shown promising results for the assessment of preoperative anxiety. The aim of this study was to determine its psychometric properties and the optimal cutoff score for patients with intracranial tumors to make it applicable in the neurosurgical setting. The sample totaled 180 neurosurgical patients with intracranial tumors. Patients were administered the APAIS along with the Hospital Anxiety and Depression Scale as the gold standard against which the APAIS was compared. Patients scoring 11 or above in the anxiety subscale of the Hospital Anxiety and Depression Scale were defined as clinical cases having anxiety. The psychometric properties of the APAIS were evaluated for a postulated 2-factor structure, Cronbach α, and correlations. The postulated 2-factor structure could not be replicated. Instead, we found a 3-factor solution (anxiety about the operation, anxiety about the anesthesia, information requirement). The area under the receiver operating characteristics curve ranged from ≥0.65 to ≥0.77. Optimal cutoff scores were calculated. The cutoff score for the anxiety scale was ≥10 for the whole sample and men only, and was ≥11 for women only. Analysis of the psychometric properties yielded satisfactory results (eg. Cronbach α for the anxiety scale >0.84). Despite its brevity, the APAIS is valid and recommendable for the assessment of preoperative anxiety in patients with intracranial tumors. As this is the first validation study focusing on patients with severe diseases and major surgeries, we recommend the application of our cutoff scores also for patients similar to our study population with regard to disease and surgery severity.

  19. The effect of preoperative smoking cessation or preoperative pulmonary rehabilitation on outcomes after lung cancer surgery: a systematic review.

    Science.gov (United States)

    Schmidt-Hansen, Mia; Page, Richard; Hasler, Elise

    2013-03-01

    The preferred treatment for lung cancer is surgery if the disease is considered resectable and the patient is considered surgically fit. Preoperative smoking cessation and/or preoperative pulmonary rehabilitation might improve postoperative outcomes after lung cancer surgery. The objectives of this systematic review were to determine the effectiveness of (1) preoperative smoking cessation and (2) preoperative pulmonary rehabilitation on peri- and postoperative outcomes in patients who undergo resection for lung cancer. We searched MEDLINE, PreMedline, Embase, Cochrane Library, Cinahl, BNI, Psychinfo, Amed, Web of Science (SCI and SSCI), and Biomed Central. Original studies published in English investigating the effect of preoperative smoking cessation or preoperative pulmonary rehabilitation on operative and longer-term outcomes in ≥ 50 patients who received surgery with curative intent for lung cancer were included. Of the 7 included studies that examined the effect of preoperative smoking cessation (n = 6) and preoperative pulmonary rehabilitation (n = 1) on outcomes after lung cancer surgery, none were randomized controlled trials and only 1 was prospective. The studies used different smoking classifications, the baseline characteristics differed between the study groups in some of the studies, and most had small sample sizes. No formal data synthesis was therefore possible. The included studies were marked by methodological limitations. On the basis of the reported bodies of evidence, it is not possible to make any firm conclusions about the effect of preoperative smoking cessation or of preoperative pulmonary rehabilitation on operative outcomes in patients undergoing surgery for lung cancer.

  20. Relationships between Preoperative Levels of P-selectin in Serum and Peritoneal fluid and Clinicopathologic Features in Patients with Ovarian Cancer%卵巢癌患者术前血清、腹腔液中 P-selectin 水平与临床病理特征的关系

    Institute of Scientific and Technical Information of China (English)

    陈丽霞

    2015-01-01

    ABSTRACT:Objective To measure the preoperative levels of P-selectin in serum and peritoneal fluid in patients with ovarian cancer,and to explore its clinical significance.Methods The preop-erative levels of P-selectin in serum and peritoneal fluid were measured by EL1SA in 60 cases of ovarian cancer(study group),30 cases of benign ovarian tumors(control group 1)and 30 healthy subjects(control group 2).The relationships between levels of P-selectin and clinicopathologic features of ovarian cancer were analyzed.Results The median levels of P-selectin in serum[(29.9± 7.2)μg· L-1 ]and peritoneal fluid in study group were,respectively,were significantly higher than those in control group 1 and control group 2(P <0.05),P-selectin in peritoneal fluid[(32.5± 7.1)μg·L-1 ]significantly higher than in control group 1(P <0.05).There were no significant differences in serum and peritoneal fluid P-selectin levels among serous carcinoma,mucinous car-cinoma and endometrioid carcinoma.However,serum and peritoneal fluid P-selectin levels in ovar-ian cancer patients with lymph node metastasis were significantly higher than those in ovarian cancer patients without lymph node metastasis(P <0.05),and those in patients with stage Ⅲ-Ⅳovarian cancer were significantly higher than those in patients with stage Ⅰ-Ⅱ ovarian cancer (P <0.05).Conclusion Serum and peritoneal fluid P-selectin levels significantly increase in pa-tients with ovarian cancer,suggesting that P-selectin may be involved in tumor invasion and me-tastasis.Therefore,P-selectin can be used as a potential marker for the diagnosis and treatment of ovarian cancer.%目的:测定卵巢癌患者术前血清和腹腔液中 P-选择素(P-selectin)水平,并探讨其临床意义。方法采用酶联免疫吸附试验(EL1SA)检测术前60例卵巢癌患者(研究组)及30例卵巢良性肿瘤(对照组1)和30例健康体检者(对照组2)的血清和腹腔液中 P-selectin 水平,对3组的所

  1. Pre-operative pain and sensory function in groin hernia

    DEFF Research Database (Denmark)

    Aasvang, Eske K; Hansen, Jeanette B; Kehlet, Henrik

    2009-01-01

    mechanism. AIMS: To investigate the correlation between pre-operative pain intensity and sensory functions in the groin hernia area. METHODS: Patients with unilateral groin hernia were examined preoperatively by quantitative sensory testing (thermal, mechanical, and pressure [detection and pain thresholds...... pain is not related to findings of hyperalgesia or other changes in sensory function that may support pain-induced pre-operative neuroplasticity as a pathogenic mechanism for the development of persistent postherniotomy pain....

  2. Change of level of high liquid carcinoembryonic antigen 125 in peritoneal dialysis patients with peritoneal infections and distribution of pathogens%透出液癌胚抗原125在腹膜透析患者腹膜感染时的变化与病原菌分布

    Institute of Scientific and Technical Information of China (English)

    申新宏; 陶瑾; 王焕

    2015-01-01

    OBJECTIVE To observe the change of level of the high liquid carcinoembryonic antigen 125 (CA125) in the peritoneal dialysis patients with peritoneal infections and explore the distribution of pathogens so as to provide guidance for prevention and treatment of peritoneal infections in the peritoneal dialysis patients .METHODS A total of 230 patients who underwent the peritoneal dialysis were enrolled in the study and were grouped according to the status of peritoneal infections during the peritoneal dialysis :26 patients with peritoneal infections were assigned as the infection group ,and 204 patients without peritoneal infections were set as the non‐infection group .The levels of CA125 in the dialysates and serum were determined by using electrochemiluminescence assay ,the C‐reactive protein (CRP) was detected with the use of automatic biochemical analyzer ,and the dialysates were collected from the patients with peritoneal infections for the bacterial culture .RESULTS The level of CA125 in the dialysates was (68 .44 ± 10 .78)U/ml in the infection group ,significantly higher than (29 .09 ± 9 .77)U/ml in the non‐infection group;the level of serum CRP of the infection group was (58 .95 ± 14 .63)mg/L ,significantly higher than (1 .12 ± 0 .57)mg/L of the non‐infection group(P<0 .05) .The level of CA125 in the dialysates of the patients with peri‐toneal infections was (68 .44 ± 10 .78)U/ml before the treatment of infections ,significantly higher than (29 .87 ± 9 .89)U/ml after the control of infections ;the level of serum CRP of the patients with peritoneal infections was (58 .95 ± 14 .63)mg/L before the treatment of infections ,significantly higher than (5 .27 ± 2 .03)mg/L after the control of infections(P<0 .05) .The positive rate of culture of pathogens from the dialysates was 100 .00% for the 26 patients with the peritoneal infections .Totally 41 strains of pathogens have been isolated , including 17(41 .46% ) strains of gram‐negative bacteria

  3. Preoperative anemia increases postoperative morbidity in elective cranial neurosurgery

    Science.gov (United States)

    Bydon, Mohamad; Abt, Nicholas B.; Macki, Mohamed; Brem, Henry; Huang, Judy; Bydon, Ali; Tamargo, Rafael J.

    2014-01-01

    Background: Preoperative anemia may affect postoperative mortality and morbidity following elective cranial operations. Methods: The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database was used to identify elective cranial neurosurgical cases (2006-2012). Morbidity was defined as wound infection, systemic infection, cardiac, respiratory, renal, neurologic, and thromboembolic events, and unplanned returns to the operating room. For 30-day postoperative mortality and morbidity, adjusted odds ratios (ORs) were estimated with multivariable logistic regression. Results: Of 8015 patients who underwent elective cranial neurosurgery, 1710 patients (21.4%) were anemic. Anemic patients had an increased 30-day mortality of 4.1% versus 1.3% in non-anemic patients (P neurosurgery was independently associated with an increased risk of 30-day postoperative mortality and morbidity when compared to non-anemic patients. A hematocrit level below 33% (Hgb 11 g/dl) was associated with a significant increase in postoperative morbidity. PMID:25422784

  4. Preoperational test report, recirculation condenser cooling systems

    Energy Technology Data Exchange (ETDEWEB)

    Clifton, F.T.

    1997-11-04

    This represents a preoperational test report for Recirculation Condenser Systems, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The four system provide condenser cooling water for vapor space cooling of tanks AY1O1, AY102, AZ1O1, AZ102. Each system consists of a valved piping loop, a pair of redundant recirculation pumps, a closed-loop evaporative cooling tower, and supporting instrumentation; equipment is located outside the farm on concrete slabs. Piping is routed to the each ventilation condenser inside the farm via below-grade concrete trenches. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System.

  5. Pre-operative antiseptic skin preparation.

    Science.gov (United States)

    Murkin, Claire Elizabeth

    Theatre nurses use antiseptic skin preparation products every day, but little thought seems to be given as to why a surgeon has a particular preference for one antiseptic skin preparation over another - whether it is for its efficacy, safety or application properties. Woodhead et al (2004) states that nurses still work in a ritualistic environment. Rituals are 'any action performed according to custom, without understanding the reasons why it is being practised'. Nursing practice should be evidence-based; nurses should understand the rationale behind the choice of a particular antiseptic, and be knowledgable about the clinical effectiveness of antiseptic's use pre-operatively, to achieve optimum results. This article focuses on the main types of antiseptic skin preparation while highlighting each product's activity and the relevant considerations for choosing the appropriate product for each patient. Theatre staff need to emphasize the importance of skin preparation and the correct application techniques, while educating the scrub team and surgeons with respect to skin preparation.

  6. Preoperational test report, recirculation condenser cooling systems

    Energy Technology Data Exchange (ETDEWEB)

    Clifton, F.T.

    1997-11-04

    This represents a preoperational test report for Recirculation Condenser Systems, Project W-030. Project W-030 provides a ventilation upgrade for the four Aging Waste Facility tanks. The four system provide condenser cooling water for vapor space cooling of tanks AY1O1, AY102, AZ1O1, AZ102. Each system consists of a valved piping loop, a pair of redundant recirculation pumps, a closed-loop evaporative cooling tower, and supporting instrumentation; equipment is located outside the farm on concrete slabs. Piping is routed to the each ventilation condenser inside the farm via below-grade concrete trenches. The tests verify correct system operation and correct indications displayed by the central Monitor and Control System.

  7. Preoperative information needs of children undergoing tonsillectomy.

    LENUS (Irish Health Repository)

    Buckley, Aoife

    2012-02-01

    AIMS AND OBJECTIVES: To identify the information needs of children undergoing tonsillectomy with reference to content of information, method of delivery, information providers and timing of information provision. BACKGROUND: Tonsillectomy can be anxiety provoking for children and preoperative preparation programmes are long recognised to reduce anxiety. However, few have been designed from the perspectives of children and to date little is known about how best to prepare children in terms of what to tell them, how to convey information to them, who can best provide information and what is the best timing for information provision. DESIGN: A qualitative descriptive study. METHOD: Data were collected from nine children (aged 6-9) using interviews supported by a write and draw technique. Data were coded and categorised into themes reflecting content, method, providers and timing of information. RESULTS: Children openly communicated their information needs especially on what to tell them to expect when facing a tonsillectomy. Their principal concerns were about operation procedures, experiencing \\'soreness\\' and discomfort postoperatively and parental presence. Mothers were viewed as best situated to provide them with information. Children were uncertain about what method of information and timing would be most helpful to them. CONCLUSION: Preoperative educational interventions need to take account of children\\'s information needs so that they are prepared for surgery in ways that are meaningful and relevant to them. Future research is needed in this area. RELEVANCE TO CLINICAL PRACTICE: Practical steps towards informing children about having a tonsillectomy include asking them what they need to know and addressing their queries accordingly. Child-centred information leaflets using a question and answer format could also be helpful to children.

  8. Relationship between preschool children and the caregiver's preoperative anxiety. A cross study assessing modified Yale preoperative anxiety Scale (m-YPAS

    Directory of Open Access Journals (Sweden)

    Emiliana Gomes de Mello

    2015-09-01

    Full Text Available Anxiety is a common event in children before surgery. Several ways have been proposed to assess the level of anxiety in pediatric patients. The modified Yale Preoperative Anxiety Scale (m-Ypas was developed recently and allows the assessment of anxiety level from the observation of children's attitudes. The aim of the study was to evaluate the influence of variables such as anxiety of caregivers (parents or relatives, preoperative fasting and previous surgical experiences on children's anxiety assessing m-YPAS. METHODS: We evaluated 39 preschool children submitted to elective surgery at a tertiary hospital in Sorocaba-Brazil. After preanesthetic evaluation, performed immediately after admission, children were referred to the pediatric ward where they were observed by the evaluator who applied the scale m-Ypas. Scores above 30 points were considered as anxiety. The level of caregivers's anxiety was evaluated assessing a linear visual scale of 0 to 10 points. Values a bove 3 were considered positive for anxiety. All children were premedicated with oral midazolam. Fasting time and the presence, or absence, of prior surgery were recorded. RESULTS: Thirty nine children were evaluated. The anxiety was observed in 36% of children and in 92% of caregivers. Children's anxiety was not related to caregiver's anxiety (p = 0.70. Fasting time (p = 0.28 or the presence, or absence, of previous surgery (p = 0:09 were not related to children's anxiety as well. CONCLUSION: The caregiver's anxiety, preoperative fasting time and previous surgery were not considered predictive factors for higher or lower level of preoperative anxiety in children.

  9. Influence of preoperative musculotendinous junction position on rotator cuff healing using single-row technique.

    Science.gov (United States)

    Tashjian, Robert Z; Hung, Man; Burks, Robert T; Greis, Patrick E

    2013-11-01

    The purpose of this study was to evaluate the correlation of rotator cuff musculotendinous junction (MTJ) retraction with healing after rotator cuff repair and with preoperative sagittal tear size. We reviewed preoperative and postoperative magnetic resonance imaging (MRI) studies of 51 patients undergoing arthroscopic single-row rotator cuff repair between March 1, 2005, and February 20, 2010. Preoperative MRI studies were evaluated for anteroposterior tear size, tendon retraction, tendon length, muscle quality, and MTJ position with respect to the glenoid. The position of the MTJ was referenced off the glenoid face as either lateral or medial. Postoperative MRI studies obtained at a minimum of 1 year postoperatively (mean, 25 ± 13.9 months) were evaluated for healing, tendon length, and MTJ position. We found that 39 of 51 tears (76%) healed, with 26 of 30 small/medium tears (87%) and 13 of 21 large/massive tears (62%) healing. Greater tendon retraction, worse preoperative muscle quality, and a more medialized MTJ were all associated with worse tendon healing (P MTJ lateral to the face of the glenoid, 93% healed, whereas only 55% of tears that had a preoperative MTJ medial to the face of the glenoid healed (P MTJ position change (MTJ medialization, and had less preoperative rotator cuff fatty infiltration (P MTJ medialization, tendon retraction, and muscle quality are all predictive of tendon healing postoperatively when using a single-row rotator cuff repair technique. The position of the MTJ with respect to the glenoid face can be predictive of healing, with over 90% healing if lateral and 50% if medial to the face. Lengthening of the tendon accounts for a significant percentage of the musculotendinous unit lengthening that occurs in healed tears as opposed to muscle elongation. Level IV, therapeutic case series. Copyright © 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  10. The effect of preoperative Lugol's iodine on intraoperative bleeding in patients with hyperthyroidism.

    Science.gov (United States)

    Yilmaz, Yeliz; Kamer, Kemal Erdinc; Ureyen, Orhan; Sari, Erdem; Acar, Turan; Karahalli, Onder

    2016-08-01

    To investigate the effect of preoperative Lugol's iodine on intraoperative bleeding in patients with hyperthyroidism. This controlled, randomized, prospective cohort was carried out on 40 patients who admitted for surgery due to hyperthyroidism. Cases were randomly assigned to receive either preoperative treatment with Lugol solution (Group 1) or no preoperative treatment with Lugol solution (Group 2). Group 3 (n = 10) consisted of healthy adults with no known history and signs of hyperthyroidism. Blood flow through the thyroid arteries of patients was measured by color flow Doppler ultrasonography. Free T3, free T4, TSH, thyroid volume and the resistance index of the four main thyroid arteries were measured in all patients. There was not a significant difference between gender, preoperative serum thyroid hormone levels, or thyroid gland volumes between groups 1 and 2. The mean blood flow of the patients in Group 1 was significantly lower than values in Group 2. When age, gender, thyroid hormone, TSH, thyroid volume, blood flow, and Lugol solution treatment were included as independent variables, Lugol solution treatment (OR, 7.40; 95% CI, 1.02-58.46; p = 0.001) was found to be the only significant independent determinant of intraoperative blood loss. Lugol solution treatment resulted in a 7.40-fold decrease in the rate of intraoperative blood loss. Preoperative Lugol solution treatment was found to be a significant independent determinant of intraoperative blood loss. Moreover, preoperative Lugol solution treatment decreased the rate of blood flow, and intraoperative blood loss during thyroidectomy.

  11. 老年髋部骨折患者术前血清白蛋白及淋巴细胞总数改变对其预后的影响%Effect of pre-operative serum albumin level and total lymphocyte count on outcomes of elderly patients with hip fracture

    Institute of Scientific and Technical Information of China (English)

    李佳; 龙安华; 张里程; 唐佩福

    2014-01-01

    Objective To determine the effect of pre-operative serum albumin (ALB) level and total lymphocyte count (TLC) on the prognosis of hip fracture in the elderly patients. Methods Clinical data of 640 elderly patients (over 60 years old) with hip fracture undergoing surgical treatment in our department from July 2006 to December 2010 were collected and retrospectively analyzed in this study. Their serum ALB level and TLC were recorded at admission. Their hospitalization time, in-hospital complications, and mortality at hospital and at 3 and 12 months after surgery were analyzed. Cox regression analysis was carried out on these data. The clinical significance of serum ALB level and TLC was evaluated in the prediction of prognosis. Results Among the 640 patients, those with lower serum ALB level accounted for 44.2%(283), and those with lower TLC accounted for 68.0%(435). The patients with lower albumin and lower TLC had higher incidence of postoperative complications (13.3%), and higher mortalities at hospital (4.3%), 3-month (6.7%) and 12-month (16.7%) post-operatively compared to the patients who had normal values of the 2 laboratory parameters (all P<0.05). Cox regression analysis indicated that serum ALB and TLC were predictive factors for mortality risk in the elderly with hip fracture. Conclusion Malnutrition at admission indicates poor clinical outcome after surgical treatment in the elderly patients with hip fracture. Lower serum ALB level and TLC are regarded as predictive factors for malnutrition and poor prognosis in these patients.%目的:探讨术前血清白蛋白(ALB)及淋巴细胞总数(TLC)改变对老年髋部骨折预后的影响。方法回顾性地分析2006年7月至2010年12月在解放军总医院行手术治疗老年髋部骨折的640例患者的临床资料。分别于入院时检测ALB和TLC。临床随访指标包括患者住院时间、住院并发症、住院死亡率、术后3个月死亡率、术后12个月死亡率。将所得资

  12. Effect of preoperative FOLFOX chemotherapy on CCL20/CCR6 expression in colorectal liver metastases

    Institute of Scientific and Technical Information of China (English)

    Claudia Rubie; Vilma Oliveira Frick; Pirus Ghadjar; Mathias Wagner; Christoph Justinger; Stefan Graeber; Jens Sperling; Otto Kollmar; Martin K Schilling

    2011-01-01

    AIM: To evaluate the influence of preoperative FOLFOX chemotherapy on CCL20/CCR6 expression in liver metastases of stage Ⅳ colorectal cancer (CRC) patients. METHODS: Using Real Time-PCR, enzyme-linked immunosorbent assay, Western Blots and immunohistochemistry, we have analyzed the expression of CCL20, CCR6 and proliferation marker Ki-67 in colorectal liver metastasis (CRLM) specimens from stage Ⅳ CRC patients who received preoperative FOLFOX chemotherapy (n = 53) and in patients who did not receive FOLFOX chemotherapy prior to liver surgery (n = 29). RESULTS: Of the 53 patients who received FOLFOX, time to liver surgery was ≤ 1 mo in 14 patients, ≤ 1 year in 22 patients and > 1 year in 17 patients, respectively. In addition, we investigated the proliferation rate of CRC cells in liver metastases in the different patient groups. Both CCL20 and CCR6 mRNA and protein expression levels were significantly increased in patients who received preoperative FOLFOX chemotherapy ≤ 12 mo before liver surgery (P < 0.001) in comparison to patients who did not undergo FOLFOX treatment. Further, proliferation of CRLM cells as measured by Ki-67 was increased in patients who underwent FOLFOX treatment. CCL20 and CCR6 expression levels were significantly increased in CRLM patients who had undergone preoperative FOLFOX chemotherapy. CONCLUSION: This chemokine/receptor up-regulation could lead to increased proliferation/migration through an autocrine mechanism which might be used by surviving metastatic cells to escape cell death caused by FOLFOX.

  13. [Preoperative information for paediatric patients. The anaesthesiologist's point of view].

    Science.gov (United States)

    Orliaguet, G

    2006-04-01

    Medical information is mandatory before any medical procedure, including pediatric anesthesia. Preoperative information covers many aspects, including medico-psychologic and judicial aspects. When the patient is a child, information must be delivered to the parents in priority. However, the French law has given a particular attention to the opinion of the child. In 70% of the cases, preoperative anxiety of the parents is more related to anesthesia than to the surgical procedure itself. We have to explain the most frequent adverse effects, as well as the more severe and well known complications to the parents, even though they are very infrequent. The only cases where preoperative information is not required are: emergency cases and refusal of the patient or the parents to be informed. While information is necessarily oral, it may be completed using a written document. The quality of the preoperative information directly influences the quality of the psychological preoperative preparation of the parents, and thereafter of the child. Preoperative preparation programs have been developed, but controversial results have been observed. The great majority of the studies on preoperative programs were performed in the USA, where the demand for preoperative information is very important. It is far from sure that the results of all these studies may be extrapolated to French parents, and French studies are needed.

  14. The role of anxiolytic premedication in reducing preoperative anxiety.

    LENUS (Irish Health Repository)

    Carroll, Jennifer K

    2012-01-01

    Prevention of preoperative anxiety with anxiolytic premedication is associated with improved preoperative outcomes in surgical patients. The objective of the authors\\' study was to evaluate the percentage of surgical patients that are prescribed premedication for preoperative anxiety before their anticipated surgical procedure. A prospective study was carried out by theatre nursing staff in the theatre reception bay of a university teaching hospital. A questionnaire was designed to record the number of patients that described symptoms consistent with preoperative anxiety. The number of patients that had been offered anxiolytic premedication for preoperative anxiety was also recorded. Consent was obtained from 115 consecutive surgical patients (male, n=52; female, n=63). Of these, 66% (n=76) reported anxiety before their surgical procedure (male: n=27, female: n=49). Premedication with a low-dose benzodiazepine was prescribed by an anaesthetist in 4% of cases (n=5). Patients that received premedication preoperatively reported effective relief of their anxiety symptoms This study demonstrates that preoperative patient anxiety is highly prevalent. The authors\\' findings suggest that premedication with anxiolytic pharmacological therapy may be an underused therapeutic resource for managing preoperative patient anxiety.

  15. Preoperative distress predicts persistent pain after breast cancer treatment

    DEFF Research Database (Denmark)

    Mejdahl, Mathias Kvist; Mertz, Birgitte Goldschmidt; Bidstrup, Pernille Envold Hansen;

    2015-01-01

    at the Department of Breast Surgery, Rigshospitalet, Denmark, were invited to participate in the study. Patients filled out a questionnaire preoperatively, and 4 and 8 months after surgery. Preoperative distress was measured with the Distress Thermometer (DT; 11-point scale, 0-10). We examined the association...

  16. Long-term effects of a preoperative smoking cessation programme

    DEFF Research Database (Denmark)

    Villebro, Nete Munk; Pedersen, Tom; Møller, Ann M;

    2008-01-01

    Preoperative smoking intervention programmes reduce post-operative complications in smokers. Little is known about the long-term effect upon smoking cessation.......Preoperative smoking intervention programmes reduce post-operative complications in smokers. Little is known about the long-term effect upon smoking cessation....

  17. New strategies for preoperative skin antisepsis.

    Science.gov (United States)

    Ulmer, Miriam; Lademann, Juergen; Patzelt, Alexa; Knorr, Fanny; Kramer, Axel; Koburger, Torsten; Assadian, Ojan; Daeschlein, Georg; Lange-Asschenfeldt, Bernhard

    2014-01-01

    During the past decades, encouraging progress has been made in the prevention of surgical site infections (SSI). However, as SSI still occur today, strategic prevention measures such as standardized skin antisepsis must be implemented and rigorously promoted. Recent discoveries in skin physiology necessitate the development of novel antiseptic agents and procedures in order to ameliorate their efficacy. In particular, alternate target structures in the skin need to be taken into consideration for the development of the next generation of antiseptics. Recent investigations have shown that a high number of microorganisms are located within and in the close vicinity of the hair follicles. This suggests that these structures are an important reservoir of bacterial growth and activity in human skin. To date, it has not been fully elucidated to what extent conventional liquid antiseptics sufficiently target the hair follicle-related microbial population. Modern technologies such as tissue-tolerable plasma (TTP) have been tested for their potential antiseptic efficiency by reducing the bacterial load in the skin and in the hair follicles. First experiments using liposomes to deliver antiseptics into the hair follicles have been evaluated for their potential clinical application. The present review evaluates these two innovative methods for their efficacy and applicability in preoperative skin antiseptics.

  18. Preoperative optimization of the vascular surgery patient

    Directory of Open Access Journals (Sweden)

    Zhan HT

    2015-07-01

    Full Text Available Henry T Zhan,1 Seth T Purcell,1,2 Ruth L Bush1 1Texas A&M Health Science Center College of Medicine, Bryan, 2Baylor Scott and White, Temple, TX, USA Abstract: It is well known that patients who suffer from peripheral (noncardiac vascular disease often have coexisting atherosclerotic diseases of the heart. This may leave the patients susceptible to major adverse cardiac events, including death, myocardial infarction, unstable angina, and pulmonary edema, during the perioperative time period, in addition to the many other complications they may sustain as they undergo vascular surgery procedures, regardless of whether the procedure is performed as an open or endovascular modality. As these patients are at particularly high risk, up to 16% in published studies, for postoperative cardiac complications, many proposals and algorithms for perioperative optimization have been suggested and studied in the literature. Moreover, in patients with recent coronary stents, the risk of noncardiac surgery on adverse cardiac events is incremental in the first 6 months following stent implantation. Just as postoperative management of patients is vital to the outcome of a patient, preoperative assessment and optimization may reduce, and possibly completely alleviate, the risks of major postoperative complications, as well as assist in the decision-making process regarding the appropriate surgical and anesthetic management. This review article addresses several tools and therapies that treating physicians may employ to medically optimize a patient before they undergo noncardiac vascular surgery. Keywords: perioperative care, intraoperative care, medical management, risk evaluation/stratification, medical treatment

  19. The effect of a preoperative education programme on perioperative anxiety in children: an observational study.

    Science.gov (United States)

    Rice, Mariam; Glasper, Alan; Keeton, Diana; Spargo, Paul

    2008-05-01

    The distress of children at the induction of anesthesia (DAI) is unpleasant for all involved and potentially harmful. Many strategies such as premedication or parental presence at induction have been described to minimize it. A preoperative education programme [the 'Saturday Morning Club' or (SMC)] has been in existence in our institution for a number of years and an observational study of children undergoing day case surgery was undertaken to assess the influence of attendance at the SMC on DAI. Ninety-four children aged between 2 and 16 years of age were included in the study; 21 attended the SMC and 73 did not. Patient anxiety using the modified Yale Preoperative Anxiety Scale was measured by blinded observers on the day ward, in the preoperative waiting room and at induction of anesthesia. Parental anxiety at the same locations was self reported using a visual analogue scale. Attendance at the SMC had a favorable effect on patient anxiety levels in all three locations but only reached statistical significance in the waiting room (P = 0.007, Mann-Whitney U-test). At present there is little evidence to support the use of preoperative education programmes in the UK and further studies are required to determine their benefit.

  20. The effect of videotaped preoperative information on parental anxiety during anesthesia induction for elective pediatric procedures.

    Science.gov (United States)

    McEwen, Andrew; Moorthy, Claire; Quantock, Christopher; Rose, Hannah; Kavanagh, Richard

    2007-06-01

    The purpose of this study was to determine whether audiovisual information, describing the process of undergoing and recovering from anesthesia, could reduce anxiety levels in parents before their child's induction of anesthesia. One hundred and eleven parents were recruited into this study. Of these 56 were randomized to a control group and 55 to an intervention group. All parents completed the Amsterdam Preoperative Anxiety and Information Scale (APAIS) questionnaires on admission to hospital on the day of surgery and then again just before accompanying their child to the anesthetic room. In addition to the normal preoperative preparation, parents randomized into the study group watched a short 8-min information video after completing the first questionnaire. The video illustrated the events and procedures surrounding a child's admission to hospital for day-case surgery, including the induction of anesthesia. The results were analyzed using repeated measures of anova. There was a statistically significant reduction in anxiety and desire for information in the intervention group compared with the control group (P anxiety in the intervention group indicates that preoperative information videos are an effective method of reducing anxiety in parents. Furthermore, the reduction in need for information score in the intervention group indicates that preoperative videos may be a useful tool for providing parents with information.

  1. Recognition and management of preoperative risk.

    Science.gov (United States)

    Nierman, E; Zakrzewski, K

    1999-08-01

    Internists are frequently asked to do preoperative consultations and to manage perioperative complications. Realistic goals are to identify patient factors that increase the risk of surgery, to quantify this risk in order to make decisions about the appropriateness of and timing of the surgery, to provide recommendations on how to minimize the risk, to identify and manage coexisting medical conditions and their associated medication requirements, to monitor the patient for perioperative problems, and to make recommendations to deal with these problems when they occur. With few exceptions, nonselective imaging and laboratory screening tests have repeatedly been shown to be of little value when the history and physical do not suggest a problem. The risk associated with the planned surgery can be estimated, with the most common serious complications being cardiac events. Updated versions of Goldman's risk indices are particularly helpful for this. Clinical variables are optimally combined with selective stress testing to discern which patients will benefit from preoperative revascularization. This has been studied best in the setting of vascular surgery. A critical guiding principle is that the value of revascularization must be judged in terms of long term gains rather than just immediate perioperative benefit. Other interventions include the selective use of beta blockers, adequate analgesia for all, control of hypertension, and appropriate volume management, especially in the settings of preexisting CHF or valvular disease. It must also be recognized that perioperative ischemia and CHF often present atypically. An approach that combines aspects of both the ACC/AHA and the ACP guidelines seems optimal. A variety of noncardiac issues must also be addressed. Postoperative pulmonary complications are common, especially with preexisting pulmonary disease, thoracic and upper abdominal surgery, and obesity. PFTs and ABGs are indicated in selected patients. Stopping

  2. Anterior mediastinal paraganglioma: A case for preoperative embolization

    Directory of Open Access Journals (Sweden)

    Shakir Murtaza

    2012-07-01

    Full Text Available Abstract Background Paraganglioma is a rare but highly vascular tumor of the anterior mediastinum. Surgical resection is a challenge owing to the close proximity to vital structures including the heart, trachea and great vessels. Preoperative embolization has been reported once to facilitate surgical treatment. Case presentation We report a case of anterior mediastinal paraganglioma that was embolized preoperatively, and was resected without the need for cardiopulmonary bypass and without major bleeding complications. Conclusion We make a case to further the role of preoperative embolization in the treatment of mediastinal paragangliomas.

  3. Pre-operative investigations: yield and conformity to national guidelines.

    Science.gov (United States)

    Juliana, H; Lim, T A; Inbasegaran, K

    2003-03-01

    Routine ordering of pre-operative investigations yields a low true positive rate and is not cost effective. In this study, case notes of 251 adults who underwent elective surgery were reviewed. Pre-operative investigations were classified as 'indicated' or 'not indicated', based on the national guidelines. Only 56% of all tests done were indicated. The overall rates of expected and unexpected abnormal values from pre-operative blood investigations were 51.1% and 34.4% respectively. This study found that selective testing based on guidelines was beneficial. However, the results also suggest that the local guidelines need to be reviewed.

  4. Preoperative factors influencing success in pterygium surgery

    Directory of Open Access Journals (Sweden)

    Torres-Gimeno Ana

    2012-08-01

    Full Text Available Abstract Background To identify preoperative, perioperative and postoperative risk factors that influence the success of pterygium surgery. Methods This is a prospective study of thirty-six patients with primary or recurrent pterygia. A detailed anamnesis and an ophthalmological examination were performed looking for the following factors: age, race, latitude and altitude of the main place of residence, hours of exposure to the sun, use of protective measures against UV-radiation, classification of pterygium, width of the pterygium at limbus, surgical technique (conjunctival autograft plus suturing versus tissue glue, graft alterations (misapposition, granuloma, haemorrhage, oedema, retraction or necrosis, and postoperative symptoms (foreign-body sensation, pain. The examinations were performed 2 and 7 days and 2, 6 and 12 months after surgery. In addition, recurrence was defined as any growth of conjunctiva into the cornea. Results A logistic regression and a survival analysis have been used to perform data analysis. A total number of 36 patients completed a one year follow-up. A total of 13 patients were born and lived in Spain, and 26 came from other countries, mostly Latin America. A total number of 8 males (no women presented a recurrence, mainly between 2 and 6 months. The hours of sun exposure through their life was independently related to surgical success. Pterygia of less than 5 mm of base width showed a weak positive correlation with recurrence. None of the other factors considered were significantly related to recurrence. Conclusions Male gender and high sun exposure are strongly and independently related to surgical success after the removal of pterygia.

  5. High preoperative bilirubin values protect against reperfusion injury after live donor liver transplantation.

    Science.gov (United States)

    Spetzler, Vinzent N; Goldaracena, Nicolas; Kaths, Johann M; Marquez, Max; Selzner, Nazia; Cattral, Mark S; Greig, Paul D; Lilly, Les; McGilvray, Ian D; Levy, Gary A; Ghanekar, Anand; Renner, Eberhard L; Grant, David R; Selzner, Markus

    2015-11-01

    Heme Oxygenase-1 and its product biliverdin/bilirubin have been demonstrated to protect against ischemia/reperfusion injury (IRI). We investigated whether increased preoperative bilirubin values of transplant recipients decrease IRI. Preoperative bilirubin levels of live donor liver recipients were correlated to postoperative liver transaminase as a marker of IRI. Additionally, two recipient groups with pretransplant bilirubin levels >24 μmol/l (n = 348) and ≤24 μmol/l (n = 118) were compared. Post-transplant liver function, complications, length of hospital stay, and patient and graft survival were assessed. Preoperative bilirubin levels were negatively correlated to the postoperative increase in transaminases suggesting a protective effect against IRI. The maximal rise of ALT after transplantation in high versus low bilirubin patients was 288 (-210-2457) U/l vs. 375 (-11-2102) U/l, P = 0.006. Bilirubin remained a significant determining factor in a multivariate linear regression analysis. The MELD score and its individual components as a marker of severity of chronic liver disease were significantly higher in the high versus low bilirubin group (P bilirubin levels of liver recipients before live donor transplantation is associated with decreased postoperative IRI.

  6. Validation of the Spanish version of the Amsterdam Preoperative Anxiety and Information Scale (APAIS).

    Science.gov (United States)

    Vergara-Romero, Manuel; Morales-Asencio, José Miguel; Morales-Fernández, Angelines; Canca-Sanchez, Jose Carlos; Rivas-Ruiz, Francisco; Reinaldo-Lapuerta, Jose Antonio

    2017-06-07

    Preoperative anxiety is a frequent and challenging problem with deleterious effects on the development of surgical procedures and postoperative outcomes. To prevent and treat preoperative anxiety effectively, the level of anxiety of patients needs to be assessed through valid and reliable measuring instruments. One such measurement tool is the Amsterdam Preoperative Anxiety and Information Scale (APAIS), of which a Spanish version has not been validated yet. To perform a Spanish cultural adaptation and empirical validation of the APAIS for assessing preoperative anxiety in the Spanish population. A two-step forward/back translation of the APAIS scale was performed to ensure a reliable Spanish cultural adaptation. The final Spanish version of the APAIS questionnaire was administered to 529 patients between the ages of 18 to 70 undergoing elective surgery at hospitals of the Agencia Sanitaria Costa del Sol (Spain). Cronbach's alpha, homogeneity index, intra-class correlation coefficient, and confirmatory factor analysis were calculated to assess internal consistency and criteria and construct validity. Confirmatory factor analysis showed that a one-factor model was better fitted than a two-factor model, with good fitting patterns (root mean square error of approximation: 0.05, normed-fit index: 0.99, goodness-of-fit statistic: 0.99). The questionnaire showed high internal consistency (Cronbach's alpha: 0.84) and a good correlation with the Goldberg Anxiety Scale (CCI: 0.62 (95% CI: 0.55 to 0.68). The Spanish version of the APAIS is a valid and reliable preoperative anxiety measurement tool and shows psychometric properties similar to those obtained by similar previous studies.

  7. Comparison of preoperative neuroradiographic findings and surgical findings in lumbar disc herniation

    Energy Technology Data Exchange (ETDEWEB)

    Takahara, Kazuhiro; Sera, Keisuke; Nakamura, Masakazu; Uchida, Takeshi [Nagasaki Mitsubishi Hospital (Japan); Ito, Nobuyuki

    1997-09-01

    Surgical findings in lumbar disc hernia were compared to pre-operative MRI, CTM and myelogram findings. Ninety-one cases were studied using Love`s method. The accuracy of hernia diagnosis in MRI was 59.3%, 41.2% in CTM, and 35.2% in myelogram. At the L5/S1 disc level, the accuracy of hernia diagnosis by CTM and myelogram was decreased. MRI was useful for the diagnosis and cure of lumbar disc herniation. (author)

  8. Preoperative physical therapy for elective cardiac surgery patients

    NARCIS (Netherlands)

    Hulzebos, E.H.J.; Smit, Y.; Helders, P.P.J.M.; Meeteren, N.L.U. van

    2012-01-01

    BACKGROUND: After cardiac surgery, physical therapy is a routine procedure delivered with the aim of preventing postoperative pulmonary complications. OBJECTIVES: To determine if preoperative physical therapy with an exercise component can prevent postoperative pulmonary complications in cardiac sur

  9. An audit of documented preoperative evaluation of surgery patients ...

    African Journals Online (AJOL)

    Southern African Journal of Anaesthesia and Analgesia 2015; 21(4):23-28 ... The information obtained from the standardised PAR form in each patient's file was audited using a ... inadequate preoperative assessment and management were.

  10. Preoperative preparation of patients with pituitary gland disorders

    National Research Council Canada - National Science Library

    Malenković, Vesna; Gvozdenović, Ljiljana; Milaković, Branko; Sabljak, Vera; Ladjević, Nebojsa; Zivaljević, Vladan

    2011-01-01

    This paper presents the most common disorders of pituitary function: acromegaly, hypopituitarism, diabetes insipidus and syndrome similar to diabetes insipidus, in terms of their importance in preoperative preparation of patients...

  11. Preoperative assessment and optimization in periampullary and pancreatic cancer

    Directory of Open Access Journals (Sweden)

    S Myatra

    2011-01-01

    Full Text Available Perioperative management of pancreatic and periampullary cancer poses a considerable challenge to the pancreatic surgeon, anesthesiologist, and the intensive care team. The preoperative surgical evaluation of a pancreatic lesion aims to define the nature of the lesion (malignant or benign, stage the tumor, and to determine resectability or other non-surgical treatment options. Patients are often elderly and may have significant comorbidities and malnutrition. Obstructive jaundice may lead to coagulopathy, infection, renal dysfunction, and adverse outcomes. Routine preoperative biliary drainage can result in higher complication rates, and metal stents may be preferred over plastic stents in selected patients with resectable disease. Judicious use of antibiotics and maintaining fluid volume preoperatively can reduce the incidence of infection and renal dysfunction, respectively. Perioperative fluid therapy with hemodynamic optimization using minimally invasive monitoring may help improve outcomes. Careful patient selection, appropriate preoperative evaluation and optimization can greatly contribute to a favorable outcome after major pancreatic resections.

  12. Preoperative mental health status may not be predictive of improvements in patient-reported outcomes following an anterior cervical discectomy and fusion.

    Science.gov (United States)

    Mayo, Benjamin C; Massel, Dustin H; Bohl, Daniel D; Narain, Ankur S; Hijji, Fady Y; Long, William W; Modi, Krishna D; Basques, Bryce A; Yacob, Alem; Singh, Kern

    2017-02-01

    OBJECTIVE Prior studies have correlated preoperative depression and poor mental health status with inferior patient-reported outcomes following lumbar spinal procedures. However, literature regarding the effect of mental health on outcomes following cervical spinal surgery is limited. As such, the purpose of this study is to test for the association of preoperative SF-12 Mental Component Summary (MCS) scores with improvements in Neck Disability Index (NDI), SF-12 Physical Component Summary (PCS), and neck and arm pain following anterior cervical discectomy and fusion (ACDF). METHODS A prospectively maintained surgical database of patients who underwent a primary 1- or 2-level ACDF during 2014-2015 was reviewed. Patients were excluded if they did not have complete patient-reported outcome data for the preoperative or 6-week, 12-week, or 6-month postoperative visits. At baseline, preoperative SF-12 MCS score was assessed for association with preoperative NDI, neck visual analog scale (VAS) score, arm VAS score, and SF-12 PCS score. The preoperative MCS score was then tested for association with changes in NDI, neck VAS, arm VAS, and SF-12 PCS scores from the preoperative visit to postoperative visits. These tests were conducted using multivariate regression controlling for baseline characteristics as well as for the preoperative score for the patient-reported outcome being assessed. RESULTS A total of 52 patients were included in the analysis. At baseline, a higher preoperative MCS score was negatively associated with a lower preoperative NDI (coefficient: -0.74, p 0.05 for each). The percentage of patients achieving a minimum clinically important difference at 6 months did not differ between the bottom and top MCS score halves (p > 0.05 for each). CONCLUSIONS The results of this study suggest that better preoperative mental health status is associated with lower perceived preoperative disability but is not associated with severity of preoperative neck or arm pain

  13. Efficacy of preoperative biliary tract decompression in patients with obstructive jaundice.

    Science.gov (United States)

    Gundry, S R; Strodel, W E; Knol, J A; Eckhauser, F E; Thompson, N W

    1984-06-01

    Fifty consecutive matched patients with benign or malignant biliary tract obstruction were compared to determine the efficacy of preoperative percutaneous biliary drainage (PBD). Twenty-five patients underwent PBD for an average of nine days before operation; 25 patients underwent percutaneous transhepatic cholangiography ( PTHC ) followed immediately by operation. Serum bilirubin levels before PTHC were 16.5 +/- 7.6 mg/dL and 14.9 +/- 7.6 mg/dL in PBD and non-PBD groups, respectively. Serum bilirubin levels decreased to 6.5 +/- 6.2 mg/dL preoperatively in patients having PBD. One week after operation, bilirubin levels were 4.2 +/- 4.3 mg/dL and 9.0 +/- 5.2 mg/dL in the PBD and non-PBD groups, respectively. Major morbidity (sepsis, abscess, renal failure, or bleeding) occurred in two patients (8%) having PBD and in 13 patients (52%) without PBD. One patient (4%) with PBD, and five patients (20%) without PBD, died. The mean hospital stay was shorter for the PBD group. Preoperative PBD reduces operative mortality and morbidity and results in a more rapid resolution of hyperbilirubinemia during the postoperative period.

  14. A randomized trial of preoperative oral carbohydrates in abdominal surgery

    OpenAIRE

    Sada, Fatos; Krasniqi, Avdyl; Hamza, Astrit; Gecaj-Gashi, Agreta; Bicaj, Besnik; Kavaja, Floren

    2014-01-01

    Background Carbohydrate-rich liquid drinks (CRLDs) have been recommended to attenuate insulin resistance by shortening the preoperative fasting interval. The aim of our study the effect of preoperative oral administration of CRLDs on the well-being and clinical status of patients. Methods A randomized, double blind, prospective study of patients undergoing open colorectal operations (CR) and open cholecyctectomy (CH) was conducted. Patients were divided into three groups: study, placebo, and ...

  15. Preoperative prediction model of outcome after cholecystectomy for symptomatic gallstones

    DEFF Research Database (Denmark)

    Borly, L; Anderson, I B; Bardram, Linda

    1999-01-01

    BACKGROUND: After cholecystectomy for symptomatic gallstone disease 20%-30% of the patients continue to have abdominal pain. The aim of this study was to investigate whether preoperative variables could predict the symptomatic outcome after cholecystectomy. METHODS: One hundred and two patients...... and sonography evaluated gallbladder motility, gallstones, and gallbladder volume. Preoperative variables in patients with or without postcholecystectomy pain were compared statistically, and significant variables were combined in a logistic regression model to predict the postoperative outcome. RESULTS: Eighty...

  16. Preoperative Nutritional Status of the Surgical Patients in Jeju

    OpenAIRE

    Moon, Myung-Sang; Kim, Sung-Soo; Lee, Sang-Yup; Jeon, Dal-Jae; Yoon, Min-Geun; Kim, Sung-Sim; Moon, Hanlim

    2014-01-01

    Background To assess the preoperative nutritional status of patients with various disorders and to provide data for pre- and postoperative patient management plans, particularly in the elderly. There is no published information on age-matched and disease-matched preoperative nutritional/immunologic status for orthopedic patients, especially in the elderly, in Jeju. Methods In total, 331 patients with four categories of orthopedic conditions were assessed: 92 elective surgery patients, 59 arth...

  17. Essential elements of the preoperative breast reconstruction evaluation

    OpenAIRE

    Cheng, Angela; Losken, Albert

    2015-01-01

    A plethora of options exist for breast reconstruction and preoperative evaluation must be thorough to lead to a successful outcome. We review multiple components of the preoperative assessment including the patient’s history, goals, imaging, and key elements of the physical exam. Consideration for tumor biology, staging, need or response to chemotherapy or radiation therapy is important in deciding on immediate versus delayed reconstruction. It is also important to consider the patient’s anat...

  18. Preoperative PET/CT in early-stage breast cancer

    DEFF Research Database (Denmark)

    Bernsdorf, M; Berthelsen, A K; Wielenga, V T;

    2012-01-01

    The aim of this study was to assess the diagnostic and therapeutic impact of preoperative positron emission tomography and computed tomography (PET/CT) in the initial staging of patients with early-stage breast cancer.......The aim of this study was to assess the diagnostic and therapeutic impact of preoperative positron emission tomography and computed tomography (PET/CT) in the initial staging of patients with early-stage breast cancer....

  19. Preoperative Chemoradiotheraph for Inflammatory Breast Cancer

    Institute of Scientific and Technical Information of China (English)

    Hongbo Ren; Qi Wang; Yaoxiong Yan; Shaolin Li; Biyou Huang

    2006-01-01

    OBJECTIVE To observe the effect of preoperative chemoradiotherapy for inflammatory breast cancer.METHODS From December 1996 to December 2000, we received and treated 21 patients with inflammatory breast carcinoma with a combinedmodality treatment. The chemotherapy protocol consisted of cyclophosphamide (CTX), pirarubicin (THP-ADM) and 5-fluorouracil (5-FU) or CTX, 5-Fu and methotrexate (MTX). The same infusion scheme was repeated on day 21. After 3~4 cycles the patients were treated with radiotherapy. When the radiation dose reached 40 Gy, the patients who were unable or unwilling to under go an operation received continued radiotherapy. When the radiation dose to the supra clavicular fossa and internal mammary lymph nodes reached 60 Gy and 50 Gy respectively, the radiotherapy was stopped. Chemotherapy was then continued with the original scheme. Patients who had indications for surgery and were willing to under go an operation received no treatment for 2 weeks, after which a total mastectomy was performed. Chemotherapy and radiotherapy was resumed with the original scheme after the operations. When the radiation dose reached 50 Gy, radiotherapy was stopped.RESULTS All patients were followed-up for more than 5 years with a follow-up rate of 100%. The overall 3 and 5-year survival rates of these patients were 42.9%, and 23.8% respectively. For patients in Stage ⅢB the 3 and 5-year survival rates were 50.0% and 27.8% respectively, and for patients in Stage Ⅳ, the 3 and 5-year survival rates were both 0.0%.There was a significant difference between the 2 stage groups (P<0.05,X2=11.60). For patients who received an operation, the 3 and 5-year survival rates were 80.0% and 33.3% respectively, For patients who were not treated with an operation, the 3 and 5-year survival rates were both0.0%, There was a significant difference between the operated and nonoperated groups (P<0.05, X2=11.64).CONCLUSION The prognosis of inflammatory breast carcinoma is poor

  20. Preoperative Planning of Orthopedic Procedures using Digitalized Software Systems.

    Science.gov (United States)

    Steinberg, Ely L; Segev, Eitan; Drexler, Michael; Ben-Tov, Tomer; Nimrod, Snir

    2016-06-01

    The progression from standard celluloid films to digitalized technology led to the development of new software programs to fulfill the needs of preoperative planning. We describe here preoperative digitalized programs and the variety of conditions for which those programs can be used to facilitate preparation for surgery. A PubMed search using the keywords "digitalized software programs," "preoperative planning" and "total joint arthroplasty" was performed for all studies regarding preoperative planning of orthopedic procedures that were published from 1989 to 2014 in English. Digitalized software programs are enabled to import and export all picture archiving communication system (PACS) files (i.e., X-rays, computerized tomograms, magnetic resonance images) from either the local working station or from any remote PACS. Two-dimension (2D) and 3D CT scans were found to be reliable tools with a high preoperative predicting accuracy for implants. The short learning curve, user-friendly features, accurate prediction of implant size, decreased implant stocks and low-cost maintenance makes digitalized software programs an attractive tool in preoperative planning of total joint replacement, fracture fixation, limb deformity repair and pediatric skeletal disorders.

  1. The importance of preoperative diagnosis of blister aneurysms.

    Science.gov (United States)

    Russin, Jonathan J; Kramer, Daniel R; Thomas, Debi; Hasson, Denise; Liu, Charles Y; Amar, Arun P; Mack, William J; Giannotta, Steven L

    2015-09-01

    We describe a series of 14 surgical blister aneurysm (BA) patients and compare outcomes in those with known cerebral BA to those lacking preoperative BA diagnosis/recognition. BA are broad, fragile, pathologic dilatations of the intracranial arteries. They have a low prevalence but are associated with substantially higher surgical morbidity and mortality rates than saccular aneurysms. A confirmed, preoperative BA diagnosis can alter operative management and technique. We performed a retrospective review of prospectively collected data on aneurysm patients undergoing surgery at a major academic institution. All patients from 1990 to 2011 with a postoperative BA diagnosis were included. Chart reviews were performed to identify patients with preoperative BA diagnoses and collect descriptive data. We identified 14 patients, 12 of whom presented with subarachnoid hemorrhage. The age of the cohort (mean ± standard deviation: 41.8 ± 13.9 years) was lower than that generally reported for saccular aneurysm populations. Preoperatively diagnosed BA had an intraoperative rupture (IOR) rate of 28.6% (2/7) compared to a 57.1% (4/7) rate in the undiagnosed patients. The mortality rate in the preoperatively diagnosed cohort was 14.3% (1/7) while that of the undiagnosed group was 42.8% (3/7). BA remain a diagnostic and treatment challenge with morbidity and mortality rates exceeding those of saccular aneurysms. Preoperative BA diagnosis may decrease IOR and mortality rates and improve patient outcomes.

  2. Evaluating the effects of preoperative fasting and fluid limitation.

    Science.gov (United States)

    Tosun, Betül; Yava, Ayla; Açıkel, Cengizhan

    2015-04-01

    The aim of the study was to evaluate the effects of preoperative fasting and fluid limitation in patients undergoing laparoscopic cholecystectomy. Although traditional long-term fasting is not recommended in current preoperative guidelines, this is still a common intervention. Visual analogue scale was used to assess hunger, thirst, sleepiness, exhaustion, nausea and pain; State and Trait Anxiety Inventory was used to assess the preoperative anxiety of 99 patients undergoing elective laparoscopic cholecystectomy. Mean time of preoperative fasting and fluid limitation were, respectively, 14.70 ± 3.14 and 11.25 ± 3.74 h. Preoperatively, 58.60% of the patients experienced moderate anxiety. Patients fasting 12 h or longer had higher hunger, thirst, nausea and pain scores. The mean trait anxiety score of patients fasting 12 h or longer was statistically significantly higher. Receiving nothing by mouth after midnight preoperatively is a persisted intervention and results in discomfort of patients. Clinical protocols should be revised and nurses should be trained in current fasting protocols. © 2014 Wiley Publishing Asia Pty Ltd.

  3. Molecular Characterization of Human MUC16 (CA125) in Breast Cancer

    Science.gov (United States)

    2015-04-01

    THIS PAGE Unclassified Unclassified 35 19b. TELEPHONE NUMBER (include area code) Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std...imparts tumorigenic and metastatic funcions through nuclear translocation of JAK2 to pancreatic cancer cells. Oncotarget 2015; 6(8):5772-87 4...s) PLTGNSDLPFWA ub ub ub ub ub ub n n Site # 2 Site # 1 Novel cleavage area Tandem repeat (TR) 60+ repeats of 156 aa SEA A N K1 T R SEA SEA A N K2SEA

  4. Molecular Characterization of Human MUC16 (CA125) in Breast Cancer

    Science.gov (United States)

    2014-02-01

    55 70 15 27 35 55 70 100 F1 14 HA CM V9 F7 27 35 5 15 27 35 5 70 70 F1 14 HA CM V9 SK V3 IB: HA IB: FLAG IB: Actin 27 35 55 70 15 27 35 55 70 15 27 35...55 70 100 F1 14 HA CM V9 F10 IB: HA IB: Actin IB: FLA 27 35 55 70 15 27 35 55 70 100 F1 14 HA CM V9 F7 27 35 5 15 27 35 5 70 70 F1 14 HA CM V9 SK V3

  5. Preoperative expectations and values of patients undergoing Mohs micrographic surgery.

    Science.gov (United States)

    Chuang, Gary S; Leach, Brian C; Wheless, Lee; Lang, Pearon G; Cook, Joel

    2011-03-01

    Dermatologists have championed Mohs micrographic surgery (MMS) for its unsurpassed treatment success for skin cancers, safety profile, cost-effectiveness, and tissue-sparing quality. It is unclear whether patients undergoing MMS also value these characteristics. To evaluate patients' preoperative expectations of MMS and identify the factors that may influence such expectations The study prospectively recruited participants who were newly diagnosed with skin cancer and referred for MMS. A questionnaire listing the characteristics of MMS was given to the participants asking them to score the importance of each characteristic on a 10-point scale. The participants were also asked to provide information regarding their gender, age, subjective health status, education level, family annual income, and their referral source On average, participants placed the highest value, in descending order, on a treatment that yielded the highest cure rate, reconstruction initiation only after complete tumor removal, and the surgeon being a skin cancer specialist. Overall, participants placed high values on characteristics of MMS that dermatologists have long esteemed. Our data corroborate that MMS is a valuable procedure that meets the expectations not just of physicians, but also of patients. The authors have indicated no significant interest with commercial supporters. © 2011 by the American Society for Dermatologic Surgery, Inc.

  6. Combined preoperative therapy for oral cancer with nedaplatin and radiation

    Energy Technology Data Exchange (ETDEWEB)

    Adachi, Masatoshi; Shibata, Akihiko; Hayashi, Munehiro [Nippon Dental Univ., Tokyo (Japan). Hospital] (and others)

    2002-03-01

    We performed preoperative combined therapy using nedaplatin (CDGP) and radiation in 12 patients with squamous cell carcinoma originating from the oral cavity and maxillary sinus, and examined for any adverse events that may have occurred during this therapeutic regimen. Regarding the irradiation, external irradiation utilizing a 6 MV linac (linear accelerator) at a dose of 2.0 Gy/day was performed 5 times a week, with the target total radiation dose set at 40 Gy. In addition, CDGP was intravenously administered 30 minutes before irradiation at a dose of 5 mg/m{sup 2}/day. Mucositis was observed in all 12 subjects, however, the severity was observed to be grade 1-2 with no major differences in comparison to the patients given standard radiation monotherapy. Two subjects developed grade 3 leucopenia and were thus given granulocyte colony stimulating factor (G-CSF). In addition, grade 2 and grade 3 thrombocytopenia were both observed in one subject each. The subject with grade 3 thrombocytopenia required a platelet transfusion during surgery. No marked changes in serum creatinine levels were noted. These findings are therefore considered to provide evidence supporting the safety of this combination therapy. (author)

  7. Preoperative anaemia and newly diagnosed cancer 1 year after elective total hip and knee arthroplasty.

    Science.gov (United States)

    Jørgensen, C C; Jans, Ø; Kehlet, H

    2015-07-01

    Preoperative anaemia is a well-established risk factor for use of blood transfusions and postoperative morbidity. Consequently, focus on preoperative evaluation of haemoglobin levels is increasing. In this context, iron deficiency anaemia may be a symptom of undiscovered gastrointestinal (GI) cancer requiring further investigation. However, the association between preoperative anaemia and cancer 1 year after elective total hip (THA) and total knee arthroplasty (TKA) is unknown. We evaluated 1-year cancer diagnoses, particularly GI cancers, in anaemic and non-anaemic THA and TKA patients. A prospective database on preoperative patient characteristics from six Danish orthopaedic centres was cross-referenced with the Danish Cancer Registry for information on diagnoses of new cancers 1 year after surgery. Crude cancer risk estimates were calculated using chi-square and Fisher's exact test in the total study cohort. Adjusted risk estimates were obtained using propensity scores and the Mantel-Haenzel statistic. Of 5400 procedures, 731 (13·5%) were in anaemic patients. These were older and had more comorbidity than non-anaemic patients. There were 17 (2·3%) and 79 (1·6%) new cancers in anaemic and non-anaemic patients, respectively (OR: 1·38; 95% CI: 0·81-2·35, P = 0·228). After propensity matching of 661 anaemic and 1305 non-anaemic patients, we found no association between preoperative anaemia and cancer (OR: 0·94; 95% CI: 0·51-1·73, P = 0·837) or with GI cancers specifically (OR: 0·80; 95% CI: 0·25-2·56, P = 0·707). Preoperative anaemia per se may not be related to being diagnosed with cancer 1 year after THA and TKA. The optimal criteria for preoperative referral of anaemic patients to gastroenterologist in elective THA and TKA need further investigation. © 2015 International Society of Blood Transfusion.

  8. A novel visual facial anxiety scale for assessing preoperative anxiety

    Science.gov (United States)

    Cao, Xuezhao; Yumul, Roya; Elvir Lazo, Ofelia Loani; Friedman, Jeremy; Durra, Omar; Zhang, Xiao; White, Paul F.

    2017-01-01

    Background There is currently no widely accepted instrument for measuring preoperative anxiety. The objective of this study was to develop a simple visual facial anxiety scale (VFAS) for assessing acute preoperative anxiety. Methods The initial VFAS was comprised of 11 similarly styled stick-figure reflecting different types of facial expressions (Fig 1). After obtaining IRB approval, a total of 265 participant-healthcare providers (e.g., anesthesiologists, anesthesiology residents, and perioperative nurses) were recruited to participate in this study. The participants were asked to: (1) rank the 11 faces from 0–10 (0 = no anxiety, while 10 = highest anxiety) and then to (2) match one of the 11 facial expression with a numeric verbal rating scale (NVRS) (0 = no anxiety and 10 = highest level of anxiety) and a specific categorical level of anxiety, namely no anxiety, mild, mild-moderate, moderate, moderate-high or highest anxiety. Based on these data, the Spearman correlation and frequencies of the 11 faces in relation to the 11-point numerical anxiety scale and 6 categorical anxiety levels were calculated. The highest frequency of a face assigned to a level of the numerical anxiety scale resulted in a finalized order of faces corresponding to the 11-point numeric rating scale. Results The highest frequency for each of the NVRS anxiety scores were as follow: A0, A1, A2, A3, A4, A5, A7, A6, A8, A9 and A10 (Fig 2). For the six categorical anxiety levels, a total of 260 (98.1%) participants chose the face A0 as representing ‘no’ anxiety, 250 (94.3%) participants chose the face A10 as representing ‘highest’ anxiety and 147 (55.5%) participants chose the face A8 as representing ‘moderate-high’ anxiety. Spearman analysis showed a significant correlation between the faces A3 and A5 assigned to the mild-moderate anxiety category (r = 0.58), but A5 was ultimately chosen due to its higher frequency compared to the frequency of A3 (30.6% vs 24.9%)(Fig 3

  9. The prognostic value of preoperative participation in activities of daily living on postoperative outcomes following lumbar discectomy.

    Science.gov (United States)

    Leonard, Dana A; Schoenfeld, Andrew J; Harris, Mitchel B; Bono, Christopher M

    2017-04-01

    In other surgical fields, preoperative level of participation in activities of daily living (ADLs) has been found to be important in predicting outcomes. To date, postoperative ADL measurements have only been used to characterize outcomes following lumbar discectomy. The present study's goal was to determine if patients' preoperative ability to perform ADLs correlates with their postoperative outcomes after lumbar discectomy at 3 months and 1 year. This retrospective study was performed using prospectively collected data from patients prospectively enrolled in a randomized clinical trial. All patients were 18 years or older, spoke English, had not previously had lumbar surgery, and underwent discectomy for a single-level lumbar disc herniation. Oswestry disability index (ODI) and visual analogue scale (VAS) back and leg pain scores were collected preoperatively and at 3 months and 1 year postoperatively. Simple linear regression analysis was performed to detect any significant correlations between three preoperative ODI domain values and postoperative scores. Additionally, regression analysis was used to determine the correlation between the preoperative ODI domains and percentage of good and poor outcomes, where an improvement of at least 18.8 points for ODI and at least 2 points for VAS constituted a good outcome. 90 subjects satisfied inclusion criteria (average age 42, 53 males, 37 females). Patients' ability to take care of themselves and to stand preoperatively were correlated with improvement in ODI postoperatively, with worse ability corresponding to more improvement (ppersonal care scores correlated with good improvement in leg pain. No significant correlations were found with back pain. When evaluating patients by dichotomized outcome (good or poor), only preoperative ability to participate in personal care was consistently significantly correlated to a good outcome. This is the first study to suggest that lower preoperative ability to take part in

  10. An anaesthetic pre-operative assessment clinic reduces pre-operative inpatient stay in patients requiring major vascular surgery.

    LENUS (Irish Health Repository)

    O'Connor, D B

    2012-02-01

    BACKGROUND: Patients undergoing major vascular surgery (MVS) require extensive anaesthetic assessment. This can require extended pre-operative stays. AIMS: We investigated whether a newly established anaesthetic pre-operative assessment clinic (PAC) would reduce the pre-operative inpatient stay, avoid unnecessary investigations and facilitate day before surgery (DBS) admissions for patients undergoing MVS. PATIENT AND METHODS: One year following and preceding the establishment of the PAC the records of patients undergoing open or endovascular aortic aneurysm repair, carotid endarterectomy and infra-inguinal bypass were reviewed to measure pre-operative length of stay (LoS). RESULTS: Pre-operative LoS was significantly reduced in the study period (1.85 vs. 4.2 days, respectively, P < 0.0001). Only 12 out of 61 patients in 2007 were admitted on the DBS and this increased to 33 out of 63 patients (P = 0.0002). No procedure was cancelled for medical reasons. CONCLUSION: The PAC has facilitated accurate outpatient anaesthetic assessment for patients requiring MVS. The pre-operative in-patient stay has been significantly reduced.

  11. Preoperative risk factors for anastomotic leakage after resection for colorectal cancer

    DEFF Research Database (Denmark)

    Pommergaard, Hans-Christian; Gessler, B; Burcharth, Jakob

    2014-01-01

    for cancer. The meta-analyses found that a low rectal anastomosis [OR = 3.26 (95% CI: 2.31-4.62)], male gender [OR = 1.48 (95% CI: 1.37-1.60)] and preoperative radiotherapy [OR = 1.65 (95% CI: 1.06-2.56)] may be risk factors for anastomotic leakage. Primarily as a result of observational design, the quality...... was used for bias assessment within studies, and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used for quality assessment of evidence on outcome levels. RESULTS: This review included 23 studies evaluating 110,272 patients undergoing colorectal resection......AIM: Colorectal anastomotic leakage is a serious complication. Despite extensive research, no consensus on the most important preoperative risk factors exists. The aim of this systematic review and meta-analysis was to evaluate risk factors for anastomotic leakage in patients operated...

  12. Influence of Music on Preoperative Anxiety and Physiologic Parameters in Women Undergoing Gynecologic Surgery.

    Science.gov (United States)

    Labrague, Leodoro J; McEnroe-Petitte, Denise M

    2016-04-01

    The aim of this study was to determine the influence of music on anxiety levels and physiologic parameters in women undergoing gynecologic surgery. This study employed a pre- and posttest experimental design with nonrandom assignment. Ninety-seven women undergoing gynecologic surgery were included in the study, where 49 were allocated to the control group (nonmusic group) and 48 were assigned to the experimental group (music group). Preoperative anxiety was measured using the State Trait Anxiety Inventory (STAI) while noninvasive instruments were used in measuring the patients' physiologic parameters (blood pressure [BP], pulse [P], and respiration [R]) at two time periods. Women allocated in the experimental group had lower STAI scores (t = 17.41, p music during the preoperative period in reducing anxiety and unpleasant symptoms in women undergoing gynecologic surgery.

  13. Biological predictive factors in rectal cancer treated with preoperative radiotherapy or radiochemotherapy.

    Science.gov (United States)

    Negri, F V; Campanini, N; Camisa, R; Pucci, F; Bui, S; Ceccon, G; Martinelli, R; Fumagalli, M; Losardo, P L; Crafa, P; Bordi, C; Cascinu, S; Ardizzoni, A

    2008-01-15

    We analysed the expression of microsatellite instability, p53, p21, vascular endothelial growth factor and thymidylate synthase (TS) in pretreatment biopsy specimens from 57 locally advanced rectal cancers. The aim of the study was to correlate the expression of these markers with pathological response. Nineteen patients were treated with preoperative concomitant radiotherapy (RT) and fluorouracil/oxaliplatin-based chemotherapy (RCT), while 38 had RT alone. Pathological complete remission (pCR) and microfoci residual tumour (micR) occurred more frequently in patients treated with RCT (P=0.002) and in N0 tumours (P=0.004). Among patients treated with RCT, high TS levels were associated with a higher response rate (pCR+micR; P=0.015). No such correlation was found in the RT group. The other molecular factors were of no predictive value. Multivariate analysis confirmed a significant interaction between nodal status and the probability of achieving a pathological response (P=0.023) and between TS expression and treatment, indicating that a high TS level is predictive of a higher pathological response in the RCT subset (P=0.007). This study shows that lymph node status is the most important predictive factor of tumour response to preoperative treatment. Thymidylate synthase expression assessed immunohistochemically from pretreatment tumour biopsies may be a useful predictive marker of rectal tumour response to preoperative RCT.

  14. Biological predictive factors in rectal cancer treated with preoperative radiotherapy or radiochemotherapy

    Science.gov (United States)

    Negri, F V; Campanini, N; Camisa, R; Pucci, F; Bui, S; Ceccon, G; Martinelli, R; Fumagalli, M; Losardo, P L; Crafa, P; Bordi, C; Cascinu, S; Ardizzoni, A

    2007-01-01

    We analysed the expression of microsatellite instability, p53, p21, vascular endothelial growth factor and thymidylate synthase (TS) in pretreatment biopsy specimens from 57 locally advanced rectal cancers. The aim of the study was to correlate the expression of these markers with pathological response. Nineteen patients were treated with preoperative concomitant radiotherapy (RT) and fluorouracil/oxaliplatin-based chemotherapy (RCT), while 38 had RT alone. Pathological complete remission (pCR) and microfoci residual tumour (micR) occurred more frequently in patients treated with RCT (P=0.002) and in N0 tumours (P=0.004). Among patients treated with RCT, high TS levels were associated with a higher response rate (pCR+micR; P=0.015). No such correlation was found in the RT group. The other molecular factors were of no predictive value. Multivariate analysis confirmed a significant interaction between nodal status and the probability of achieving a pathological response (P=0.023) and between TS expression and treatment, indicating that a high TS level is predictive of a higher pathological response in the RCT subset (P=0.007). This study shows that lymph node status is the most important predictive factor of tumour response to preoperative treatment. Thymidylate synthase expression assessed immunohistochemically from pretreatment tumour biopsies may be a useful predictive marker of rectal tumour response to preoperative RCT. PMID:18087284

  15. Preoperative psychological testing--another form of prejudice.

    Science.gov (United States)

    Ashton, David; Favretti, Franco; Segato, Gianni

    2008-10-01

    Preoperative psychological screening of bariatric surgery candidates has become routine, and a significant proportion of patients have their surgery deferred as a consequence. If psychological testing is being used as a form of preoperative triage, both patients and surgeons are entitled to know whether there is sufficient evidence to justify its use in this way. We define the argument for psychological screening as consisting of four premises (p1-p4) and a conclusion (C) as follows: (p1) A significant minority of obese patients will not be successful in losing weight following bariatric surgery-the "failure" group; (p2) A significant minority of patients will exhibit abnormal psychological profiles during preoperative testing; (p3) The majority of individuals referred to in (p2) will be found in group (p1) i.e., abnormal psychological profiles identified preoperatively predict less favorable weight loss outcomes postoperatively; (p4) Identifying patients with adverse psychological profiles preoperatively would allow either exclusion of those at high risk of failure or provide a more secure rationale for targeted pre- and postoperative support; (C) Psychological screening should be part of the routine preoperative assessment for patients undergoing obesity surgery. We reviewed the literature to find evidence to support the premises and show that (p1) can be justified but that (p2) is problematic and can only be accepted in a heavily qualified version. We find no evidence for (p3) and since (p4) and (C) are predicated on (p3), the argument clearly fails. There is no evidence to suggest that preoperative psychological screening can predict postoperative outcomes and no justification for using such testing as a means of discriminating between candidates presenting themselves for bariatric surgery.

  16. [Effectiveness of pre-operative education in reducing anxiety in surgical patients].

    Science.gov (United States)

    Díez-Álvarez, Esther; Arrospide, Arantzazu; Mar, Javier; Alvarez, Uzuri; Belaustegi, Alazne; Lizaur, Belen; Larrañaga, Aintzane; Arana, Jose M

    2012-01-01

    To evaluate the effectiveness of a structured pre-operative interview conducted by operating room nurses in order to reduce the pre-operative anxiety of patients, and to determine the profile of patients who can benefit from it. A randomised double-blind and prospective trial was conducted on a sample of 335 patients scheduled for surgery in two regional hospitals in the Basque Region of Spain, Alto Deba Hospital and Mendaro Hospital. We compared the alternative of using a structured briefing (test group) with the current situation without any formal intervention (control group). The effectiveness of the procedure was determined using the STAI state anxiety self-assessment questionnaire. The Chi-squared statistic was used to assess the differences in factors and the Student t-test for comparison of means in the continuous variables. The impact of the intervention on measures of state anxiety and trait anxiety was found to be not statistically significant, although the mean state anxiety state was slightly lower in the intervention group (18.96) than in the controls (20.03). Women undergoing surgery in the specialty of gynaecology showed the higher state anxiety compared with other specialties. As regards trait anxiety a higher ASA level is associated with higher anxiety. Furthermore, the consumption of psychotropic drugs is also related to a higher level of trait anxiety. The preoperative visit can be helpful when patients are selected according to specific characteristics: by type of anaesthesia, gender, or type of surgery. There may also be beneficial effects when preoperative education is tailored according to patient's anxiety risk. The time immediately before surgery may not be the best time for conducting the visit, as this may make the patients more anxious. Copyright © 2011 Elsevier España, S.L. All rights reserved.

  17. Prognostic value of preoperative absolute lymphocyte count in recurrent hepatocellular carcinoma following thermal ablation: a retrospective analysis.

    Science.gov (United States)

    Li, Xin; Han, Zhiyu; Cheng, Zhigang; Yu, Jie; Yu, Xiaoling; Liang, Ping

    2014-01-01

    To investigate the prognostic value of preoperative absolute lymphocyte count (ALC) in recurrent hepatocellular carcinoma (RHCC) following thermal ablation. We retrospectively analyzed the relationship between preoperative ALC and the clinicopathologic factors and long-term prognosis in 423 RHCC patients who underwent curative thermal ablation. Correlation analysis, receiver operating characteristic (ROC) calculation, Kaplan-Meier curves, and multivariate regression were used for statistical analysis. The median time to recurrence was 12 months for RHCC patients after thermal ablation. On multivariate Cox regression analysis, preoperative ALC was an independent risk factor for cancer recurrence, along with tumor differentiation and α-fetoprotein level. ALC ≥1.64×10(9)/L defined by ROC calculation was associated with prolonged survival (area under the curve 0.741, Pthermal ablation, which suggests that maintaining a high ALC in RHCC patients might improve cancer outcomes.

  18. Soft-laser use in the preoperative preparation and postoperative treatment of the patients with chronic lung abscesses

    Science.gov (United States)

    Ledin, A. O.; Dobkin, V. G.; Sadov, A. Y.; Galichev, K. V.; Rzeutsky, V. S.

    1999-07-01

    We counted expedient to include different methods of the soft-laser use in the preoperative medicinal program and in the postoperative period. During the preoperative preparation the basic group patients together with standard treatment received the combined soft-laser therapy, which included intravenous laser blood irradiation (ILBI) by He-Ve laser and external transcutaneous irradiation of the abscess projection by semi-conductorial arrenite-gallium laser. During postoperative treatment with ILBI remarkable changes were observed in the functional activity of the T- and B- cell. The soft-laser use allowed to achieve improvement of quality and shortening of terms of the preoperative preparation of 1,4 times, to level the immunosuppressive influence of surgery to reduce amount of the postoperative complications in 1,8 times and duration of the postoperative period in 1,5 times.

  19. Influence of Preoperative Musculotendinous Junction Position on Rotator Cuff Healing After Double-Row Repair.

    Science.gov (United States)

    Tashjian, Robert Z; Erickson, Gregory A; Robins, Richard J; Zhang, Yue; Burks, Robert T; Greis, Patrick E

    2017-06-01

    The primary purpose of this study was to determine the effect of the preoperative position of the musculotendinous junction (MTJ) on rotator cuff healing after double-row arthroscopic rotator cuff repair. A secondary purpose was to evaluate how tendon length and MTJ position change when the rotator cuff heals. Preoperative and postoperative magnetic resonance imaging (MRI) scans of 42 patients undergoing arthroscopic double-row rotator cuff repair were reviewed. Patients undergoing repairs with other constructs or receiving augmented repairs (platelet-rich fibrin matrix) who had postoperative MRI scans were excluded. Preoperative MRI scans were evaluated for anteroposterior tear size, tendon retraction, tendon length, muscle quality, and MTJ position with respect to the glenoid in the coronal plane. The position of the MTJ was referenced off the glenoid face as either lateral or medial. Postoperative MRI scans were evaluated for healing, tendon length, and MTJ position. Of 42 tears, 36 (86%) healed, with 27 of 31 small to medium tears (87%) and 9 of 11 large to massive tears (82%) healing. Healing occurred in 94% of tears that had a preoperative MTJ lateral to the face of the glenoid but only 56% of tears that had a preoperative MTJ medial to the glenoid face (P = .0135). The measured tendon length increased an average of 14.4 mm in patients whose tears healed compared with shortening by 6.4 mm in patients with tears that did not heal (P MTJ lateralized an average of 6.1 mm in patients whose tears healed compared with medializing 1.9 mm in patients whose tears did not heal (P = .026). The overall follow-up period of the study was from April 2005 to September 2014 (113 months). The preoperative MTJ position is predictive of postoperative healing after double-row rotator cuff repair. The position of the MTJ with respect to the glenoid face is a reliable, identifiable marker on MRI scans that can be predictive of healing. Level IV, retrospective review of case

  20. Assessment of Preoperative and Postoperative Anxiety: A ...

    African Journals Online (AJOL)

    Background: Research on measurement of anxiety in patients booked for surgery ... though heightened anxiety levels in such patients is commonly observed. ... the State Trait Anxiety Inventory (STAI), in the measurement of anxiety in patients ...

  1. Preoperative cryotherapy use in anterior cruciate ligament reconstruction.

    Science.gov (United States)

    Koyonos, Loukas; Owsley, Kevin; Vollmer, Emily; Limpisvasti, Orr; Gambardella, Ralph

    2014-12-01

    Unrelieved postoperative pain may impair rehabilitation, compromise functional outcomes, and lead to patient dissatisfaction. Preemptive multimodal analgesic techniques may improve outcomes after surgery. We hypothesized that patients using preoperative cryotherapy plus a standardized postoperative treatment plan will have lower pain scores and require less pain medication compared with patients receiving a standardized postoperative treatment plan alone after arthroscopically assisted anterior cruciate ligament reconstruction (ACLR). A total of 53 consecutive patients undergoing arthroscopically assisted ACLR performed by one of seven surgeons were randomly assigned to one of two groups. Group 1 received no preoperative cryotherapy and group 2 received 30 to 90 minutes of preoperative cryotherapy to the operative leg using a commercial noncompressive cryotherapy unit. Visual analog scale pain scores and narcotic use were recorded for the first 4 days postoperatively. Total hours of cold therapy and continuous passive motion (CPM) use and highest degree of flexion achieved were recorded as well. Group 1 consisted of 26 patients (15 allograft Achilles tendon and 11 autograft bone patellar tendon bone [BPTB]), and group 2 consisted of 27 patients (16 allograft Achilles tendon and 11 autograft BPTB). Group 2 patients reported less pain (average 1.3 units, p cryotherapy, hours of CPM use, or maximum knee flexion achieved. Complications did not occur in either group. This is the first report we are aware of showing the postoperative effects of preoperative cryotherapy. Our results support the safety and efficacy of preoperative cryotherapy in a multimodal pain regimen for patients undergoing ACL reconstruction.

  2. Preoperative thrombocytosis predicts poor survival in patients with glioblastoma

    Science.gov (United States)

    Brockmann, Marc A.; Giese, Alf; Mueller, Kathrin; Kaba, Finjap Janvier; Lohr, Frank; Weiss, Christel; Gottschalk, Stefan; Nolte, Ingo; Leppert, Jan; Tuettenberg, Jochen; Groden, Christoph

    2007-01-01

    Thrombocytosis, which is defined as a platelet count greater than 400 platelets/nl, has been found to be an independent predictor of shorter survival in various tumors. Release of growth factors from tumors has been proposed to increase platelet counts. Preoperative platelet counts and other clinical and hematological parameters were reviewed from the records of 153 patients diagnosed between 1999 and 2004 with histologically confirmed glioblastoma in order to evaluate the prognostic significance of preoperative thrombocytosis in these patients. The relationship between thrombocytosis and survival was initially analyzed in all patients regardless of further therapy. Univariate log-rank tests showed that the median survival time of 29 patients with preoperative thrombocytosis (19%) was significantly shorter (4 months; 95% confidence interval [95% CI], 3–6 months) compared to 124 patients with normal platelet counts (11 months; 95% CI, 8–13 months; p = 0.0006). Multivariate analysis (Cox proportional hazards model) confirmed preoperative platelet count, age, prothrombin time, and activated partial thromboplastin time to be prognostic factors of survival (all p thrombocytosis was diagnosed (6 months; 95% CI, 4–12 months) compared to patients with normal platelet count (13 months; 95% CI, 11–15 months; p = 0.0359). In multivariate analysis, age, platelet count, preoperative prothrombin time, and degree of tumor resection retained significance as prognostic factors of survival (all p thrombocytosis to be a prognostic factor associated with shorter survival time in patients with glioblastoma. PMID:17504931

  3. Significance of preoperative thrombocytosis in epithelial ovarian cancer

    Directory of Open Access Journals (Sweden)

    Crasta Julian

    2010-01-01

    Full Text Available Background: Reactive thrombocytosis is reported in a variety of solid tumors. A few studies have documented preoperative thrombocytosis in ovarian cancer and identified it as a marker of aggressive tumor biology. Aim: To study the incidence of preoperative thrombocytosis (platelets greater than 400x10 in epithelial ovarian cancer and its association with other clinicopathologic factors. Materials and Methods: Sixty-five patients with invasive ovarian epithelial cancer were retrospectively reviewed and analyzed for the association preoperative thrombocytosis with other clinical and histopathological prognostic factors. Means were analyzed by Student′s t test; proportions were determined by Chi-square analysis. Results: Twenty of 65 (37.5% patients had thrombocytosis at primary diagnosis. Patients with preoperative thrombocytosis were found to have lower hemoglobin (P < 0.0002, more advanced stage disease (P < 0.05 and higher grade tumors (P < 0.02. Patients with thrombocytosis had greater likelihood of subpotimal cytoreduction. Conclusions: Preoperative thrombocytosis is a frequent finding in ovarian carcinomas and their association with advanced stage disease and higher grade denotes that platelets play a role in the tumor growth and progression.

  4. Internet-Based Resources Frequently Provide Inaccurate and Out-of-Date Recommendations on Preoperative Fasting: A Systematic Review.

    Science.gov (United States)

    Roughead, Taren; Sewell, Darreul; Ryerson, Christopher J; Fisher, Jolene H; Flexman, Alana M

    2016-12-01

    Preoperative fasting is important to avoid morbidity and surgery delays, yet recommendations available on the Internet may be inaccurate. Our objectives were to describe the characteristics and recommendations of Internet resources on preoperative fasting and assess the quality and readability of these websites. We searched the Internet for common search terms on preoperative fasting using Google® search engines from 4 English-speaking countries (Canada, the United States, Australia, and the United Kingdom). We screened the first 30 websites from each search and extracted data from unique websites that provided recommendations on preoperative fasting. Website quality was assessed using validated tools (JAMA Benchmark criteria, DISCERN score, and Health on the Net Foundation code [HONcode] certification). Readability was scored using the Flesch Reading Ease score and Flesch-Kincaid Grade Level. A total of 87 websites were included in the analysis. A total of 48 websites (55%) provided at least 1 recommendation that contradicted established guidelines. Websites from health care institutions were most likely to make inaccurate recommendations (61%). Only 17% of websites encouraged preoperative hydration. Quality and readability were poor, with a median JAMA Benchmark score of 1 (interquartile range 0-3), mean DISCERN score 39.8 (SD 12.5), mean reading ease score 49 (SD 15), and mean grade level of 10.6 (SD 2.7). HONcode certification was infrequent (10%). Anesthesia society websites and scientific articles had higher DISCERN scores but worse readability compared with websites from health care institutions. Online fasting recommendations are frequently inconsistent with current guidelines, particularly among health care institution websites. The poor quality and readability of Internet resources on preoperative fasting may confuse patients.

  5. Computed tomography for preoperative planning in total hip arthroplasty: what radiologists need to know

    Energy Technology Data Exchange (ETDEWEB)

    Huppertz, Alexander [Charite - University Hospitals Berlin, Department of Radiology, Berlin (Germany); Imaging Science Institute Charite, Berlin (Germany); Radmer, Sebastian [Proendo, Orthopedic Surgery, Berlin (Germany); Wagner, Moritz; Hamm, Bernd [Charite - University Hospitals Berlin, Department of Radiology, Berlin (Germany); Roessler, Torsten [Klinikum Ernst von Bergmann, Department of Trauma and Orthopedic Surgery, Potsdam (Germany); Sparmann, Martin [Proendo, Orthopedic Surgery, Berlin (Germany); Charite - University Hospital, Berlin (Germany)

    2014-08-15

    The number of total hip arthroplasties is continuously rising. Although less invasive surgical techniques, sophisticated component design, and intraoperative navigation techniques have been introduced, the rate of peri- and postoperative complications, including dislocations, fractures, nerve palsies, and infections, is still a major clinical problem. Better patient outcome, faster recovery and rehabilitation, and shorter operation times therefore remain to be accomplished. A promising strategy is to use minimally invasive techniques in conjunction with modular implants, aimed at independently reconstructing femoral offset and leg length on the basis of highly accurate preoperative planning. Plain radiographs have clear limitations for the correct estimation of hip joint geometry and bone quality. Three-dimensional assessment based on computed tomography (CT) allows optimizing the choice and positions of implants and anticipating difficulties to be encountered during surgery. Postoperative CT is used to monitor operative translation and plays a role in arthroplastic quality management. Radiologists should be familiar with the needs of orthopedic surgeons in terms of CT acquisition, post-processing, and data transfer. The CT protocol should be optimized to enhance image quality and reduce radiation exposure. When dedicated orthopedic CT protocols and state-of-the-art scanner hardware are used, radiation exposure can be decreased to a level just marginally higher than that of conventional preoperative radiography. Surgeons and radiologists should use similar terminology to avoid misunderstanding and inaccuracies in the transfer of preoperative planning. (orig.)

  6. The preoperative measurement of template and postoperative assessment in artificial total hip replacement

    Institute of Scientific and Technical Information of China (English)

    Jin Jin; Chen Bin; Xu Hongguang; Li Qiyi; Li Yijia; Qiu Guixing

    2005-01-01

    Objective: To study the accuracy and importance of preoperative template measurement in total hip replacement (THR). Methods: Between Oct. 2003 and Sep. 2004, 19 patients (19 hips), including 11 male and 8female, ranged from 40 to 74 years old (mean 58.7 years old), underwent unilateral primary total hip replacement.Limb length and offset was measured, radiographic template was done preoperatively to anticipate optimal implantation component position and determine level of expected femoral neck cut, and plan to restore equality of limbs.After surgery, all factors above were reevaluated. Results: Fifteen patients with limb length difference obtained a significant improvement, it is decreased from 8.4mm to 4.4mm, 73.7% of them the limb length discrepancies was controlled within 5mm. Bilateral offset difference decreased from 6.3mm to 3.0mm. Coincidence rate between planned and actually used components was 52.6% on the acetabular side and 63.2% on the femoral side. Conclusion: Accurate and careful preoperative template measurement has significant value in balanced hip reconstruction by correcting leg length differences and restoring offset.

  7. Evaluating Compliance with Institutional Preoperative Testing Guidelines for Minimal-Risk Patients Undergoing Elective Surgery

    Directory of Open Access Journals (Sweden)

    Arunotai Siriussawakul

    2013-01-01

    Full Text Available Background. Few investigations preoperatively are important for low-risk patients. This study was designed to determine the level of compliance with preoperative investigation guidelines for ASA I patients undergoing elective surgery. Secondary objectives included the following: to identify common inappropriate investigations, to evaluate the impact of abnormal testing on patient management, to determine factors affecting noncompliant tests, and to estimate unnecessary expenditure. Methods. This retrospective study was conducted on adult patients over a one-year period. The institute’s guidelines recommend tests according to the patients’ age groups: a complete blood count (CBC for those patients aged 18–45; CBC, chest radiograph (CXR and electrocardiography (ECG for those aged 46–60; and CBC, CXR, ECG, electrolytes, blood glucose, blood urea nitrogen (BUN, and creatinine (Cr for patients aged 61–65. Results. The medical records of 1,496 patients were reviewed. Compliant testing was found in only 12.1% (95% CI, 10.5–13.9. BUN and Cr testings were the most frequently overprescribed tests. Overinvestigations tended to be performed on major surgery and younger patients. Overall, overinvestigation incurred an estimated cost of US 200,000 dollars during the study period. Conclusions. The need to utilize the institution’s preoperative guidelines should be emphasized in order to decrease unnecessary testing and the consequential financial burden.

  8. TAK1-regulated expression of BIRC3 predicts resistance to preoperative chemoradiotherapy in oesophageal adenocarcinoma patients

    Science.gov (United States)

    Piro, G; Giacopuzzi, S; Bencivenga, M; Carbone, C; Verlato, G; Frizziero, M; Zanotto, M; Mina, M M; Merz, V; Santoro, R; Zanoni, A; De Manzoni, G; Tortora, G; Melisi, D

    2015-01-01

    Background: About 20% of resectable oesophageal carcinoma is resistant to preoperative chemoradiotherapy. Here we hypothesised that the expression of the antiapoptotic gene Baculoviral inhibitor of apoptosis repeat containing (BIRC)3 induced by the transforming growth factor β activated kinase 1 (TAK1) might be responsible for the resistance to the proapoptotic effect of chemoradiotherapy in oesophageal carcinoma. Methods: TAK1 kinase activity was inhibited in FLO-1 and KYAE-1 oesophageal adenocarcinoma cells using (5Z)-7-oxozeaenol. The BIRC3 mRNA expression was measured by qRT–PCR in 65 pretreatment frozen biopsies from patients receiving preoperatively docetaxel, cisplatin, 5-fluorouracil, and concurrent radiotherapy. Receiver operator characteristic (ROC) analyses were performed to determine the performance of BIRC3 expression levels in distinguishing patients with sensitive or resistant carcinoma. Results: In vitro, (5Z)-7-oxozeaenol significantly reduced BIRC3 expression in FLO-1 and KYAE-1 cells. Exposure to chemotherapeutic agents or radiotherapy plus (5Z)-7-oxozeaenol resulted in a strong synergistic antiapoptotic effect. In patients, median expression of BIRC3 was significantly (P<0.0001) higher in adenocarcinoma than in the more sensitive squamous cell carcinoma subtype. The BIRC3 expression significantly discriminated patients with sensitive or resistant adenocarcinoma (AUC-ROC=0.7773 and 0.8074 by size-based pathological response or Mandard's tumour regression grade classifications, respectively). Conclusions: The BIRC3 expression might be a valid biomarker for predicting patients with oesophageal adenocarcinoma that could most likely benefit from preoperative chemoradiotherapy. PMID:26291056

  9. Computed tomography for preoperative planning in total hip arthroplasty: what radiologists need to know.

    Science.gov (United States)

    Huppertz, Alexander; Radmer, Sebastian; Wagner, Moritz; Roessler, Torsten; Hamm, Bernd; Sparmann, Martin

    2014-08-01

    The number of total hip arthroplasties is continuously rising. Although less invasive surgical techniques, sophisticated component design, and intraoperative navigation techniques have been introduced, the rate of peri- and postoperative complications, including dislocations, fractures, nerve palsies, and infections, is still a major clinical problem. Better patient outcome, faster recovery and rehabilitation, and shorter operation times therefore remain to be accomplished. A promising strategy is to use minimally invasive techniques in conjunction with modular implants, aimed at independently reconstructing femoral offset and leg length on the basis of highly accurate preoperative planning. Plain radiographs have clear limitations for the correct estimation of hip joint geometry and bone quality. Three-dimensional assessment based on computed tomography (CT) allows optimizing the choice and positions of implants and anticipating difficulties to be encountered during surgery. Postoperative CT is used to monitor operative translation and plays a role in arthroplastic quality management. Radiologists should be familiar with the needs of orthopedic surgeons in terms of CT acquisition, post-processing, and data transfer. The CT protocol should be optimized to enhance image quality and reduce radiation exposure. When dedicated orthopedic CT protocols and state-of-the-art scanner hardware are used, radiation exposure can be decreased to a level just marginally higher than that of conventional preoperative radiography. Surgeons and radiologists should use similar terminology to avoid misunderstanding and inaccuracies in the transfer of preoperative planning.

  10. Effect of preoperative biliary drainage on malignantobstructive jaundice: A meta-analysis

    Institute of Scientific and Technical Information of China (English)

    Yu-Dong Qiu; Jian-Ling Bai; Fang-Gui Xu; Yi-Tao Ding

    2011-01-01

    AIM: To evaluate the effect of preoperative biliary drainage(PBD) on obstructive jaundice resulting from malignant tumors.METHODS: According to the requirements of Cochrane systematic review, studies in the English language were retrieved from MEDLINE and Embase databases from 1995 to 2009 with the key word "preoperative biliary drainage". Two reviewers independently screened the eligible studies, evaluated their academic level and extracted the data from the eligible studies confirmed by cross-checking. Data about patients with and without PBD after resection of malignant tumors were processed for meta-analysis using the Stata 9.2 software, including postoperative mortality, incidence of postoperative pancreatic and bile leakage, abdominal abscess, delayed gastric emptying and incision infection.RESULTS: Fourteen retrospective cohort studies involving 1826 patients with malignant obstructive jaundice accorded with our inclusion criteria, and were included in meta-analysis. Their baseline characteristics were comparable in all the studies. No significant difference was found in combined risk ratio (RR) of postoperative mortality and incidence of pancreatic and bile leakage, abdominal abscess, delayed gastric emptying between patients with and without PBD. However, the combined RR for the incidence of postoperative incision infectionwas improved better in patients with PBD than in those without PBD (P<0.05).CONCLUSION: PBD cannot significantly reduce the postoperative mortality and complications of malignant obstructive jaundice, and therefore should not be used as a preoperative routine procedure for malignant obstructive jaundice.

  11. Effect of preoperative biliary drainage on outcome of classical pancreaticoduodenectomy

    Institute of Scientific and Technical Information of China (English)

    Chandra Shekhar Bhati; Chandrashekhar Kubal; Pankaj Kumar Sihag; Ankur Atal Gupta; Raj Kamal Jenav; Nicholas G Inston; Jagdish M Mehta

    2007-01-01

    AIM: To investigate the role of preoperative biliary drainage (PBD) in the outcome of classical pancreaticodu odenectomy.METHODS: A 10-year retrospective data analysis was performed on patients (n = 48) undergoing pancreaticoduodenectomy from March 1994 to March 2004 in department of surgery at SMS medical college, Jaipur, India. Demographic variables, details of preoperative stenting, operative procedure and post operative complications were noted.RESULTS: Preoperative biliary drainage was performed in 21 patients (43.5%). The incidence of septic complications was significantly higher in patients with biliary stent placement (P < 0.05, 0 vs 4). This group of patients also had a significantly higher minor biliary leak rate. Mortality and hospital stay in each group was comparable.CONCLUSION: Within this study population the use of PBD by endoscopic stenting was associated with a high incidence of infective complications. These findings do not support the routine use of biliary stenting in patients prior to pancreatico-duodenectomy.

  12. Upper airway imaging and its role in preoperative airway evaluation

    Directory of Open Access Journals (Sweden)

    Jagadish G Sutagatti

    2016-01-01

    Full Text Available Ultrasonography (USG is well-known as a fast, safe, and noninvasive technique. Its application for imaging of the airway is now gaining momentum. The upper airway has a complex anatomy, and its assessment forms a vital part of every preanesthetic evaluation. Ultrasound (US imaging can help in upper airway assessment in the preoperative period. There are various approaches to upper airway USG. The technique has its own advantages, disadvantages, and limitations. This simple yet challenging imaging technique is all set to become an important part of routine preoperative airway evaluation. This article reviews the various approaches to upper airway US imaging, interpretation of the images, limitations, and disadvantages of the technique and its varied clinical applications in the preoperative period. The scientific material presented here was hand searched from textbooks and journals, electronically from PubMed, and Google scholar using text words.

  13. Pancreatic Somatostatinoma Diagnosed Preoperatively: Report of a Case

    Directory of Open Access Journals (Sweden)

    Yasuhisa Mori

    2014-01-01

    Full Text Available Context Somatostatinoma is a rare neoplasm of the pancreas. Preoperative diagnosis is often difficult. Case report We report a 72-year-old woman with a pancreatic head tumor measuring 37 mm in diameter, and enlargement of the lymphnodes on the anterior surface of the pancreatic head and the posterior surface of the horizontal part of the duodenum.Laboratory data showed an elevated plasma somatostatin concentration. Examination of a biopsy specimen of thepancreatic head mass obtained by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA showedhistopathological features of a neuroendocrine tumor. Immunohistochemical staining showed that the tumor cells werepositive for somatostatin, leading to a preoperative diagnosis of pancreatic somatostatinoma. The patient underwentpylorus-preserving pancreaticoduodenectomy. The plasma somatostatin concentration decreased progressively aftersurgery. Conclusions A rare case of pancreatic somatostatinoma with lymph node metastases was presented.Immunohistochemical analysis of a biopsy specimen obtained by EUS-FNA was useful for preoperative diagnosis.

  14. CLINICAL AND BIOLOGICAL BEHAVIOR OF NEUROGENIC TUMOR AFTER PREOPERATIVE CHEMOTHERAPY

    Institute of Scientific and Technical Information of China (English)

    Gao Jiechun; Dong Kuiran; Jing Baixiang

    1998-01-01

    Objective: To study the significance of preoperative chemotherapy for the treatment of neurogenic tumor in children. Methods: VMA, MYCN gene and DNA content of 21 cases of neuroblastoma treated with preoperative chemotherapy were studied with a control group. Results: Resection rate was 95.5%. Mean survival time was 28.1±10.2 months, which was significantly higher than the control group (8.8±6.8 months, P<0.01).Post chemotherapeutic VMA was lower. DNA index was also reduced and the percentage of cells in G0+G1 phases was elevated. The MYCN expression was suppressed.Conclusion: Preoperative chemotherapy can induce the apoptosis of neurogenic tumor cells and inhibit its proliferative activity.

  15. Indications of laparoscopic cholecystectomy based on preoperative imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Wakizaka, Yoshitaka; Sano, Syuichi; Nakanishi, Yoshimi; Koike, Yoshinobu; Ozaki, Susumu; Iwanaga, Rikizo (Sapporo City General Hospital (Japan)); Uchino, Junichi

    1994-03-01

    We studied the indications for laparoscopic cholecystectomy (LC) and values of preoperative imaging findings in 82 patients who underwent preoperative imaging diagnostic tests (abdominal echogram, abdominal CAT scan, ERCP). We analyzed mainly patients who were considered to be indicated for LC but whose gallbladders could be removed by open laparotomy, or whose gallbladders were removed by open laparotomy but were considered indicated for LC from retrospective study. We found the following results. LC could be easily performed in patients with a history of severe acute cholecystitis if they had no findings of a thickened wall or negative gallbladder signs. Abdominal echogram and CAT scan were the best preoperative imaging tests for determining the gallbladder's state, especially for obstruction of the cystic duct. These results are important today when the operative indications of LC are extremely indefinite because of the accumulation of operative experience and technological improvements. (author).

  16. Preoperative Erythrocyte Sedimentation Rate Independently Predicts Overall Survival in Localized Renal Cell Carcinoma following Radical Nephrectomy

    Directory of Open Access Journals (Sweden)

    Brian W. Cross

    2012-01-01

    Full Text Available Objectives. To determine the relationship between preoperative erythrocyte sedimentation rate (ESR and overall survival in localized renal cell carcinoma (RCC following nephrectomy. Methods. 167 patients undergoing nephrectomy for localized RCC had ESR levels measured preoperatively. Receiver Operating Characteristics curves were used to determine Area Under the Curve and relative sensitivity and specificity of preoperative ESR in predicting overall survival. Cut-offs for low (0.0–20.0 mm/hr, intermediate (20.1–50.0 mm/hr, and high risk (>50.0 mm/hr groups were created. Kaplan-Meier analysis was conducted to assess the univariate impact of these ESR-based groups on overall survival. Univariate and multivariate Cox regression analysis was conducted to assess the potential of these groups to predict overall survival, adjusting for other patient and tumor characteristics. Results. Overall, 55.2% were low risk, while 27.0% and 17.8% were intermediate and high risk, respectively. Median (95% CI survival was 44.1 (42.6–45.5 months, 35.5 (32.3–38.8 months, and 32.1 (25.5–38.6 months, respectively. After controlling for other patient and tumor characteristics, intermediate and high risk groups experienced a 4.5-fold (HR: 4.509, 95% CI: 0.735–27.649 and 18.5-fold (HR: 18.531, 95% CI: 2.117–162.228 increased risk of overall mortality, respectively. Conclusion. Preoperative ESR values represent a robust predictor of overall survival following nephrectomy in localized RCC.

  17. Evaluating the prognostic significance of preoperative thrombocytosis in epithelial ovarian cancer.

    Science.gov (United States)

    Allensworth, S K; Langstraat, C L; Martin, J R; Lemens, M A; McGree, M E; Weaver, A L; Dowdy, S C; Podratz, K C; Bakkum-Gamez, J N

    2013-09-01

    Preoperative thrombocytosis has been implicated as a negative prognostic marker for epithelial ovarian cancer (EOC). We assessed whether thrombocytosis is an independent risk factor for EOC recurrence and death. Perioperative patient characteristics and process-of-care variables (National Surgical Quality Improvement Program (NSQIP)-defined) were retrospectively abstracted from 587 women who underwent EOC staging between 1/2/03-12/29/08. Thrombocytosis was defined as platelet count > 450 × 10(9)/L. Disease-free survival (DFS) and overall survival (OS) were determined using Kaplan-Meier methods. Associations were evaluated with Cox proportional hazards regression and hazard ratios (HR). The incidence of preoperative thrombocytosis was 22.3%. DFS was 70.8% and 36.0% at 1 and 3 years. OS was 83.3% and 54.3% at 1 and 3 years. Ascites, lower hemoglobin, advanced disease, and receipt of perioperative packed red blood cell transfusion were independently associated with thrombocytosis. Older age and the presence of coronary artery disease were associated with lower likelihood of thrombocytosis. Overall, thrombocytosis was an independent predictor of increased risk of recurrence. Among early stage (I/II) cases, there was a 5-fold increase in the risk of death and nearly 8-fold risk of disease recurrence independently associated with thrombocytosis. Preoperative thrombocytosis portends worse DFS in EOC. In early stage disease, thrombocytosis is a potent predictor of worse DFS and OS and further assessment of the impact of circulating platelet-derived factors on EOC survival is warranted. Thrombocytosis is also associated with extensive initial disease burden, measurable residual disease, and postoperative sequelae. Preoperative platelet levels may have value in primary cytoreduction counseling. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. Preoperative predictors of weight loss following bariatric surgery: systematic review.

    Science.gov (United States)

    Livhits, Masha; Mercado, Cheryl; Yermilov, Irina; Parikh, Janak A; Dutson, Erik; Mehran, Amir; Ko, Clifford Y; Gibbons, Melinda Maggard

    2012-01-01

    Obesity affects 32% of adults in the USA. Surgery generates substantial weight loss, but 20-30% fails to achieve successful weight loss. Our objective was to identify preoperative psychosocial factors associated with weight loss following bariatric surgery. We performed a literature search of PubMed® and the Cochrane Database of Reviews of Effectiveness between 1988 and April 2010. Articles were screened for bariatric surgery and weight loss if they included a preoperative predictor of weight loss: body mass index (BMI), preoperative weight loss, eating disorders, or psychiatric disorder/substance abuse. One thousand seven titles were reviewed, 534 articles screened, and 115 included in the review. Factors that may be positively associated with weight loss after surgery include mandatory preoperative weight loss (7 of 14 studies with positive association). Factors that may be negatively associated with weight loss include preoperative BMI (37 out of 62 studies with negative association), super-obesity (24 out of 33 studies), and personality disorders (7 out of 14 studies). Meta-analysis revealed a decrease of 10.1% excess weight loss (EWL) for super-obese patients (95% confidence interval (CI) [3.7-16.5%]), though there was significant heterogeneity in the meta-analysis, and an increase of 5.9% EWL for patients with binge eating at 12 months after surgery (95% CI [1.9-9.8%]). Further studies are necessary to investigate whether preoperative factors can predict a clinically meaningful difference in weight loss after bariatric surgery. The identification of predictive factors may improve patient selection and help develop interventions targeting specific needs of patients.

  19. Preoperative antibiotics for septic arthritis in children: delay in diagnosis.

    Science.gov (United States)

    MacLean, Simon B M; Timmis, Christopher; Evans, Scott; Lawniczak, Dominik; Nijran, Amit; Bache, Edward

    2015-04-01

    To review the records of 50 children who underwent open joint washout for septic arthritis with (n=25) or without (n=25) preoperative antibiotics. Records of 50 children who underwent open joint washout for presumed septic arthritis with (n=25) or without (n=25) preoperative antibiotics were reviewed. 17 boys and 8 girls aged 3 weeks to 16 years (median, 1.5 years) who were prescribed preoperative antibiotics before joint washout were compared with 12 boys and 13 girls aged one month to 14 years (median, 2 years) who were not. Following arthrotomy and washout, all patients were commenced on high-dose intravenous antibiotics. Patients were followed up for 6 to 18 months until asymptomatic. Patients who were referred from places other than our emergency department were twice as likely to have been prescribed preoperative antibiotics (p=0.0032). Patients prescribed preoperative antibiotics had a longer median (range) time from symptom onset to joint washout (8 [2-23] vs. 4 [1-29] days, p=0.05) and a higher mean erythrocyte sedimentation rate (93.1 vs. 54.3 mm/h, p=0.023) at presentation. Nonetheless, the 2 groups were comparable for weight bearing status, fever, and positive culture, as well as the mean (range) duration of antibiotic treatment (4.9 [4-7] vs. 4.7 [1-8] weeks, p=0.586). Preoperative antibiotics should be avoided in the management of septic arthritis in children. Their prescription delays diagnosis and definitive surgery, and leads to additional washouts and complications. A high index of suspicion and expedite referral to a specialist paediatric orthopaedic unit is needed if septic arthritis is suspected.

  20. Preoperative evaluation of synchronous colorectal cancer using MR colonography

    DEFF Research Database (Denmark)

    Achiam, Michael P; Andersen, Lars Peter Holst; Klein, Mads

    2009-01-01

    it is noninvasive, and most of the colon can be evaluated. Furthermore, it has higher patient acceptance, and no sedation or radiation is used. The purpose of this study was to determine the feasibility of performing MRC preoperatively in an everyday clinical situation in a group of patients who were not offered......RATIONALE AND OBJECTIVES: It is well known that synchronous cancers (incidence, 2%-11%) and polyps (incidence, 12%-58%) occur in patients with colorectal cancer. Magnetic resonance colonography (MRC) seems like the obvious choice as a diagnostic tool in preoperative evaluation, because...

  1. [Importance of preoperative and intraoperative imaging for operative strategies].

    Science.gov (United States)

    Nitschke, P; Bork, U; Plodeck, V; Podlesek, D; Sobottka, S B; Schackert, G; Weitz, J; Kirsch, M

    2016-03-01

    Recent advances in preoperative and postoperative imaging have an increasing influence on surgical decision-making and make more complex surgical interventions possible. This improves the possibilities for frequently occurring challenges and promoting improved functional and oncological outcome. This manuscript reviews the role of preoperative and intraoperative imaging in surgery. Various techniques are explained based on examples from hepatobiliary surgery and neurosurgery, in particular real-time procedures, such as the online use of augmented reality and in vivo fluorescence, as well as new and promising optical techniques including imaging of intrinsic signals and vibrational spectroscopy.

  2. MRI diagnosis and preoperative evaluation for pure epidural cavernous hemangiomas

    Energy Technology Data Exchange (ETDEWEB)

    Feng, Jie; Xu, Yi-Kai; Yang, Rui-Meng; Yu, Tian; Lin, Bing-Quan [Nanfang Hospital, Southern Medical University, Department of Diagnostic Imaging Center, Guangzhou, Guangdong (China); Li, Long [Guangdong Provincial Corps Hospital, Chinese People' s Armed Police Forces, Department of Radiology, Guangzhou, Guangdong (China); Ye, Xiang-Hua [Nanfang Hospital, Southern Medical University, Department of Radiotherapy, Guangzhou, Guangdong (China); Zhang, Nan [Nanfang Hospital, Southern Medical University, Department of Pathology, Guangzhou, Guangdong (China)

    2009-11-15

    The aims of the study were to summarize the characteristics of the spinal epidural cavernous hemangioma, especially for the MRI, and to improve the accurate rate of the preoperative diagnosis. The clinical and medical imaging data of six patients with pure spinal epidural cavernous hemangioma proved by operation and pathology were analyzed retrospectively. The level was thoracic (n = 2), thoracolumbar (n = 1), lumbar (n = 1), and sacral (n = 2). The tumor showed lobulated contour, and the areas the tumors appeared were dorsal side of spinal cord (n = 2), ventral side (n = 1), and lateral side (n = 3). In all six patients, the lesions were isointense to the spinal cord on T{sub 1}-weighted images and hyperintense on T{sub 2}-weighted images and showed homogeneously strong enhancement on contrast-enhanced T{sub 1}-weighted images. The characteristic MRI features were named as the ''wafting-silk'' sign. Widening of the intervertebral neural foramen (n = 4) and erosion of the adjacent bones (n = 3) can be observed. MRI of the epidural cavernous hemangioma showed the characteristic lobulated contour, which encircled the spinal cord. T{sub 1}WI on the MRI presented as isointense and T{sub 2}WI presented as hyperintense and a homogeneously strong enhancement, so we first proposed the sign of wafting silk. The widening of the intervertebral neural foramen and erosion of the adjacent bones can easily be observed. MR imaging has an important role in the detection and diagnosis of pure spinal epidural cavernous hemangioma. (orig.)

  3. IGFBP-4 tumor and serum levels are increased across all stages of epithelial ovarian cancer

    Directory of Open Access Journals (Sweden)

    Mosig Rebecca A

    2012-01-01

    Full Text Available Abstract Background We sought to identify candidate serum biomarkers for the detection and surveillance of EOC. Based on RNA-Seq transcriptome analysis of patient-derived tumors, highly expressed secreted proteins were identified using a bioinformatic approach. Methods RNA-Seq was used to quantify papillary serous ovarian cancer transcriptomes. Paired end sequencing of 22 flash frozen tumors was performed. Sequence alignments were processed with the program ELAND, expression levels with ERANGE and then bioinformatically screened for secreted protein signatures. Serum samples from women with benign and malignant pelvic masses and serial samples from women during chemotherapy regimens were measured for IGFBP-4 by ELISA. Student's t Test, ANOVA, and ROC curves were used for statistical analysis. Results Insulin-like growth factor binding protein (IGFBP-4 was consistently present in the top 7.5% of all expressed genes in all tumor samples. We then screened serum samples to determine if increased tumor expression correlated with serum expression. In an initial discovery set of 21 samples, IGFBP-4 levels were found to be elevated in patients, including those with early stage disease and normal CA125 levels. In a larger and independent validation set (82 controls, 78 cases, IGFBP-4 levels were significantly increased (p -5. IGFBP-4 levels were ~3× greater in women with malignant pelvic masses compared to women with benign masses. ROC sensitivity was 73% at 93% specificity (AUC 0.816. In women receiving chemotherapy, average IGFBP-4 levels were below the ROC-determined threshold and lower in NED patients compared to AWD patients. Conclusions This study, the first to our knowledge to use RNA-Seq for biomarker discovery, identified IGFBP-4 as overexpressed in ovarian cancer patients. Beyond this, these studies identified two additional intriguing findings. First, IGFBP-4 can be elevated in early stage disease without elevated CA125. Second, IGFBP-4

  4. High preoperative serum ferritin predicted poor prognosis in non-metastatic colorectal cancer.

    Science.gov (United States)

    Tingting, Hong; Di, Shen; Xiaoping, Chen; Xiaohong, Wu; Dong, Hua

    2017-03-01

    To validate the prognostic significance of preoperative serum iron metabolism parameters in non-metastatic colorectal cancer patients treated with curative resection.   Methods: We conducted a prospective cohort study in the Department of Surgical Oncology, WuXi 4th People's Hospital, WuxiChina, between  March 2010 and September 2013.  The relationships of serum iron metabolism parameters with other variables were examined. The prognostic significance was evaluated using the Kaplan Meier curve and Cox proportional hazards regression model.  Results: Five hundred and fourteen patients were eligible for analysis. The levels of the 3 iron metabolism parameters were interdependent. Hemoglobin level was positively correlated with serum iron and transferrin, and was negatively correlated with ferritin. Compared with peri-neural invasion (PNI)-negative patients, PNI-positive patients had higher serum iron (p=0.03) and ferritin levels (p=0.01). Compared with patients with the lowest quartile level of ferritin, patients with the highest quartile level of ferritin had a 2.21 (95% CI: 1.18-4.14) fold increased mortality risk in the univariate and 2.56 (95% CI: 1.10-5.96) in the multivariate Cox proportional hazards models. When stratified by TNM stages, it was only in stage III patients that serum ferritin remained statistically prognostically significant. Conclusions: Preoperative serum ferritin appeared as an independent adverse risk factor in non-metastatic colorectal cancer.

  5. Introduction of a paediatric anaesthesia comic information leaflet reduced preoperative anxiety in children.

    Science.gov (United States)

    Kassai, B; Rabilloud, M; Dantony, E; Grousson, S; Revol, O; Malik, S; Ginhoux, T; Touil, N; Chassard, D; Pereira de Souza Neto, E

    2016-07-01

    The aim of the study was to determine whether the introduction of a paediatric anaesthesia comic information leaflet reduced preoperative anxiety levels of children undergoing major surgery. Secondary objectives were to determine whether the level of understanding of participants and other risk factors influence STAIC-S (State-Trait Anxiety Inventory for Children-State subscale) score in children. We performed a randomized controlled parallel-group trial comparing preoperative anxiety between two groups of children aged >6 and comic information leaflet at home in addition to routine information given by the anaesthetist at least 1 day before surgery. The control group received the routine information only. The outcome measure was the difference between STAIC-S scores measured before any intervention and after the anaesthetist's visit. A multiple regression analysis was performed to explore the influence of the level of education, the anxiety of parents, and the childrens' intelligence quotient on STAIC-S scores. One hundred and fifteen children were randomized between April 2009 and April 2013. An intention-to-treat analysis on data from 111 patients showed a significant reduction (P=0.002) in STAIC-S in the intervention group (n=54, mean=-2.2) compared with the control group (n=57, mean=0.90). The multiple regression analysis did not show any influence on STAIC-S scores of the level of education, parental anxiety, or the intelligence quotient of the children. A paediatric anaesthesia comic information leaflet was a cheap and effective means of reducing preoperative anxiety, measured by STAIC-S, in children. NCT 00841022. © The Author 2016. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  6. Effects of preoperative and postoperative enteral nutrition on postoperative nutritional status and immune function of gastric cancer patients.

    Science.gov (United States)

    Ding, Dayong; Feng, Ye; Song, Bin; Gao, Shuohui; Zhao, Jisheng

    2015-03-01

    Effects of preoperative one week enteral nutrition (EN) support on the postoperative nutritional status, immune function and inflammatory response of gastric cancer patients were investigated. 106 cases of gastric cancer patients were randomly divided into preoperative one week EN group (trial group) and early postoperative EN group (control group), which were continuously treated with EN support until the postoperative 9th day according to different treatment protocols. All the patients were checked for their body weight, skinfold thickness, upper arm circumference, white blood cell count (WBC), albumin (ALB), prealbumin (PA), C-reactive protein (CRP), humoral immunity (IgA, IgG), T cell subsets (CD4, CD8 and CD4/CD8), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), etc. on the preoperative and the postoperative 1st and 10th day, respectively. PA and IgG levels of the experimental group were higher than those of the control group on the postoperative 10th day, whereas IL-6 level of the experimental group was lower than that of the control group. EN support for preoperative gastric cancer patients will improve the postoperative nutritional status and immune function, alleviate inflammatory response, and facilitate the recovery of patients.

  7. Epidermal growth factor receptor as a predictor of tumor response to preoperative chemoradiation in locally advanced gastric carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Sirak, I.; Petera, J.; Vosmik, M.; Melichar, B.; Dvorak, J.; Zoul, Z. [Dept. of Oncology and Radiotherapy, Charles Univ. Medical School and Univ. Hospital, Hradec Kralove (Czech Republic); Hatlova, J.; Tycova, V. [Dept. of Pathology, Charles Univ. Medical School and Univ. Hospital, Hradec Kralove (Czech Republic); Lesko, M. [Dept. of Surgery, Charles Univ. Medical School and Univ. Hospital, Hradec Kralove (Czech Republic); Hajduch, M. [Lab. of Molecular Pathology, Inst. of Pathology, Palacky Univ., Olomouc (Czech Republic)

    2008-11-15

    Purpose: the purpose of our study was a retrospective evaluation whether the intensity of epidermal growth factor receptor (EGFR) expression predicts tumor response to preoperative chemoradiotherapy in patients with locally advanced gastric carcinoma. Patients and methods: thirty-six patients with gastric adenocarcinoma (cT2-4 or N+) were studied. Preoperative treatment consisted of 30-45 Gy of gastric irradiation with continuous 5-fluorouracil and weekly cisplatin. Surgical resection was performed 4-6 weeks later. EGFR expression in pretreatment tumor biopsies was assessed by immunohistochemistry. Level of EGFR expression was determined from the intensity and extent of staining. Tumor response was defined as a reduction of at least one T-stage level and/or finding of intense tumor regression in histopathologic examination. Results: seventeen patients responded to preoperative chemoradiation - 8 patients (22%) had pathologic complete response, 9 patients (25%) were downstaged. Positive EGFR expression was found in 8 tumors (22%), and represented a significant predictive marker of poor tumor response in multivariate logistic regression analysis (p = 0.015). Response to chemoradiotherapy was found in 60% (16/28) of EGFR negative patients and in 13% (1/8) of EGFR positive patients (p = 0.044). None of the eight EGFR positive patients achieved pathologic complete response in comparison with 8/28 (29%) of patients with EGFR negative staining (p = 0.16). Conclusion: EGFR may represent a molecular marker predictive for poor response to preoperative chemoradiotherapy in locally advanced gastric carcinoma. (orig.)

  8. Preoperative prediction model of outcome after cholecystectomy for symptomatic gallstones

    DEFF Research Database (Denmark)

    Borly, L; Anderson, I B; Bardram, L

    1999-01-01

    patients completed all questionnaires. Twenty-one patients continued to have abdominal pain after the operation. Patients with pain 1 year after cholecystectomy were characterized by the preoperative presence of a high dyspepsia score, 'irritating' abdominal pain, and an introverted personality...

  9. [The 'paper-based' preoperative evaluation: sometimes, a suitable alternative].

    NARCIS (Netherlands)

    Bucx, M.J.L.; Wolff, A.P.; Scheffer, G.J.

    2012-01-01

    In the Netherlands, the majority of elective-surgery patients are evaluated by the anaesthesiologist at the preoperative assessment clinic. We believe that this visit can be omitted in selected patients as it has only minimal benefit, whereas its disadvantages can be substantial. Alternatively, the

  10. Accuracy of diagnostic imaging in nephroblastoma before preoperative chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Rieden, K. [Radiologische Klinik, Abt. Klinische Radiologie, Heidelberg (Germany); Weirich, A. [Kinderklinik, Univ. of Heidelberg (Germany); Troeger, J. [Radiologische Klinik, Abt. Paediatrische Radiologie, Univ. of Heidelberg (Germany); Gamroth, A.H. [Deutsches Krebsforschungszentrum, Heidelberg (Germany); Raschke, K. [Radiologische Klinik, Abt. Paediatrische Radiologie, Univ. of Heidelberg (Germany); Ludwig, R. [Kinderklinik, Univ. of Heidelberg (Germany)

    1993-04-01

    From July 1988 to February 1991, 130 children with the tentative diagnosis of nephroblastoma were treated preoperatively. The initial diagnostic images (excretory urography, ultrasound, CT, MRI) have been analysed both prospectively and retrospectively and the findings correlated with the intraoperative and histological results. Of the preoperatively treated patients 93.8% had a Wilms` tumour or one of its variants. Five patients had a different malignant tumour and 3 patients, i.e. 2.3% of those preoperatively treated or 1.6% of all registered patients, had benign tumours of the kidney. Wilms` tumour generally presented as a well-defined mass with an inhomogeneous morphology on CT. On ultrasound only 24% of the tumours were homogeneous. Intratumoral haemorrhage and cystic areas occurred frequently; calcifications were rare (8%). With regard to caval involvement only ultrasound and MRI enabled the correct diagnosis, while CT could not differentiate compressions from invasion. The pretherapeutic diagnostic imaging was of sufficient accuracy to start preoperative chemotherapy without diagnostic biopsy. (orig.)

  11. Ranitidine improves postoperative suppression of antibody response to preoperative vaccination

    DEFF Research Database (Denmark)

    Nielsen, Hans Jørgen; Hammer, J H; Moesgaard, F;

    1992-01-01

    The effect of the histamine-2 receptor antagonist ranitidine (100 mg intravenously every 12 hours for 72 hours) on postoperative serum antibody responses to preoperative immunization with six limit of flocculation tetanus toxoid and six limit of flocculation diphtheria toxoid was assessed...

  12. Preoperative subtyping of meningiomas by perfusion MR imaging

    NARCIS (Netherlands)

    Zhang, Hao; Roediger, Lars A.; Shen, Tianzhen; Miao, Jingtao; Oudkerk, Matthijs

    2008-01-01

    Introduction This paper aims to evaluate the value of perfusion magnetic resonance (MR) imaging in the preoperative subtyping of meningiomas by analyzing the relative cerebral blood volume (rCBV) of three benign subtypes and anaplastic meningiomas separately. Materials and methods Thirty-seven menin

  13. Pheochromocytoma : a review on preoperative treatment with phenoxybenzamine or doxazosin

    NARCIS (Netherlands)

    van der Zee, P A; de Boer, A|info:eu-rep