Adneksial kitlelerin malign-benign ayrımında tümör belirteçleri CA-125, HE-4 ve CA-125 İle HE-4 kombinasyonunun pre-operatif değerlendirmede etkinliklerinin araştırılması
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2012
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Maltepe Üniversitesi, Tıp Fakültesi
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info:eu-repo/semantics/openAccess
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AMAÇ:Adneksial kitlelerin preoperatif dönemde malign-benign ayrımında yarar sağlayabilecek iki tümör belirtecinin(CA- 125,HE-4) etkinliklerini değerlendirmektir.MATERYAL ve METOD: Maltepe Üniversitesi Tıp Fakültesi Eğitim ve Araştırma Hastanesinde,adneksial kitle endikasyonu ile laparotomi veya laparoskopi yöntemi ile opere edilen 76 olgu dahil edildi(22 epitelyal over malignite,23 benign adneksial kitle ve 31 tane sağlıklı kontrol grubu).CA-125 ve HE-4 düzeyleri preoperatif tespit edilerek,postoperatif histopatolojik sonuçlara göre değerlendirildi.BULGULAR: Yaptığımız çalışmada, CA-125 için cut-off değerini 35 kabul ettiğimizde sensitivite %81,82 çıkarken spesivitesi oldukça düşük çıktı (%56,52). Yine bu ayırımda PPD %64,3, NPD % 76,5 olarak bulundu. CA-125 cutt-off değeri sağlıklı-benign ve sağlıklı-malign ayırımda bulunan ideal değer olan 55 IU/ml'e çekildiğinde sensitivite %81,82, spesivite % 73,91, PPD % 75, NPD % 81'e çıkmıştır. Benign-malign karşılaştırmasında spesivite % 95'e çekildiğinde sensitivite değeri %13,64'e düşmüş CA-125 cut-off eğeri ise 1000'lere çıkmıştır ki bu pratikte kullanılamaz.Çalışmamızda,HE-4 için malign-benign ayrımında sensitivite %77,27,spesivite % 73,91,PPD % 73,9, NPD % 77,3 olarak bulundu.CA-125 için 55 ,HE-4 için 150 cut-off değerlerinde,benign-malign ayrımında, sensitivite % 59,09, spesifite %91,3, PPV %86,67 NPV %70 LR=+6,8 olarak bulundu.SONUÇ: Çalışmamızda incelediğimiz bu parametreler, adneksial kitlelerin malign-benign ayrımında tek başlarına kullanılabilecek etkinliğe sahip değildir.
OBJECTIVES: To determine the efficacy of two tumor markers (CA- 125,HE-4) in differentiating the adnexial masses as malign and benign during the preoperative period.MATERIALS AND METHODS: In the University of Maltepe, Faculty of Medicine, Education and Research Hospital, 76 cases (22 epithelial ovarian malignancies, 23 benign adnexial masses and 31 healthy control subjects) who were operated by laparotomy or laparoscopy with an indication of adnexial masses were included in this study. The preoperative levels of CA-125 and HE-4 were studied, and they were evaluated according to postoperative histopathological results.RESULTS: In our study, when the cut-off level for CA-125 was set to 35 sensitivity was 81,82% while specificity was quite low (56,52%). Again for this differentiation, ppd was found 64,3 % and NPD as 76,5%. When the cut-off level for CA-125 was pulled to an ideal level of 55 IU/ml for the differentiation of healthy-benign and healthy malign sensitivity was 81,82%, specificity was 73,91, PPD 75%, and NPD 81%. When the specificity was set as 95% in the comparison of enign and malign, the level of sensitivity falls to 13,64% and the cut-off level for CA-125 rises up to 1000 which cannot be used in the daily practice. In our study, differentiation of malign and benign for HE-4 sensitivity was found 77,27%, specificity 73,91, PPD 73,9% and NPD 77,3%.Cutt-off levels of 55 for CA-125, and 150 for HE-4 seemed to have a sensitivity of 59,09%, specificity of 91,3%, PPV 86,67%, NPV 70%, LR=+6,8 in the determination of malign and benign.CONCLUSION: The parameters investigated in our research do not have the sufficient efficacy in differentiation of malign and benign.
OBJECTIVES: To determine the efficacy of two tumor markers (CA- 125,HE-4) in differentiating the adnexial masses as malign and benign during the preoperative period.MATERIALS AND METHODS: In the University of Maltepe, Faculty of Medicine, Education and Research Hospital, 76 cases (22 epithelial ovarian malignancies, 23 benign adnexial masses and 31 healthy control subjects) who were operated by laparotomy or laparoscopy with an indication of adnexial masses were included in this study. The preoperative levels of CA-125 and HE-4 were studied, and they were evaluated according to postoperative histopathological results.RESULTS: In our study, when the cut-off level for CA-125 was set to 35 sensitivity was 81,82% while specificity was quite low (56,52%). Again for this differentiation, ppd was found 64,3 % and NPD as 76,5%. When the cut-off level for CA-125 was pulled to an ideal level of 55 IU/ml for the differentiation of healthy-benign and healthy malign sensitivity was 81,82%, specificity was 73,91, PPD 75%, and NPD 81%. When the specificity was set as 95% in the comparison of enign and malign, the level of sensitivity falls to 13,64% and the cut-off level for CA-125 rises up to 1000 which cannot be used in the daily practice. In our study, differentiation of malign and benign for HE-4 sensitivity was found 77,27%, specificity 73,91, PPD 73,9% and NPD 77,3%.Cutt-off levels of 55 for CA-125, and 150 for HE-4 seemed to have a sensitivity of 59,09%, specificity of 91,3%, PPV 86,67%, NPV 70%, LR=+6,8 in the determination of malign and benign.CONCLUSION: The parameters investigated in our research do not have the sufficient efficacy in differentiation of malign and benign.
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Yücel, E. (2012). Adneksial kitlelerin malign-benign ayrımında tümör belirteçleri CA-125, HE-4 ve CA-125 İle HE-4 kombinasyonunun pre-operatif değerlendirmede etkinliklerinin araştırılması / Investigating the efficiency of the tumor markers, CA-125,HE-4 and combination of CA-125 and HE-4, to distinguish the adnexial masses as benign and malignant tumors during the preoperative evaluation (Yayımlanmamış Uzmanlık Tezi). Maltepe Üniversitesi, Tıp Fakültesi, İstanbul.
