مستوى الدلائل الكيمياحياتية ومعاملات الاورام في التمييز بين سائل الاستسقاء السرطاني الخبيث وسائل الاستسقاء غير السرطاني == The Level Of Biochemical Parameters And Tumour Markers In The Differentiation Between Malignant From Non - Malignant Ascitic Fluid
Author name:
عبد الله علي محمد
Supervisor name:
ناصر محمد فهد الربيعي | رباح هياب سريح
General topic:
Medicine
Specific topic:
Clinical Biochemistry
Degree:
Master
University:
Mustansiriyah University - Faculty Of Medicine - Department Of Biochemistry
Language:
English
University location:
Baghdad
First pages:
19T1168 - p.pdf
Abstract:
الاستسقاء هو مصطلح يطلق على الجهاز الهضمي لتراكم السوائل في التجويف البريتوني (البطني) الناجمة عن كل من الامراض غير الخبيثة مثل تليف الكبد، والتهاب الصفاق السلي... الخ، والامراض الخبيثة مثل سرطان غشاء البطن المنتشر، وسرطان الثدي وسرطان المبيض. لقد تم | Ascites is a gastroenterological term for an accumulation of fluid in the peritoneal cavity caused by both non - malignant disease such as cirrhosis, tuberculous peritonitis..etc, and by malignant disease such as metastatic adenocarcinoma, breast cancer and ovarian cancer. The work in this thesis was done to evaluate the role of the multiple biochemical parameters and group of tumour markers in the differentiation between malignant ascites from non - malignant ascites. A number of parameters were obtained from (60) sixty patients : (30) thirty with malignant ascites and (30) thirty with non - malignant ascites (as controls), all patients admitted to the department of gastroenterology in Medical City - Baghdad Teaching Hospital, Oncology Teaching Hospital and Al - Amal Hospital between December 2013 and July 2014. The biochemical parameters and tumour markers which have been measured in the present study included : total protein, albumin, uric acid, calcium(Ca++), carcinoembryonic antigen(CEA),cancer antigen(CA19 - 9), cancer antigen(CA15 - 3), cancer antigen(CA125) and ? - human chorionic gonadotropin (? - hCG).The statistical analysis for the data obtained in the present study showed : 1 - Highly significant increase of CA15 - 3, ? - hCG and ascitic fluid/serum (A/S) total protein ratio in malignant ascitic fluid while there is significant decrease of serum ascites albumin gradient (SAAG) and serum ascites cholesterol gradient (SACG) in malignant ascites compared with non - malignant ascites patients (p<0.0005, p<0.0005, p<0.05, p<0.0005 and p<0.005 respectively). Thus the level of these parameters in ascitic fluid could be used as a good parameters in differentiation between malignant ascites from non - malignant ascites patients.2 - Significant increase in serum CA15 - 3 and ? - hCG level in malignant ascites patients compared to non - malignant ascites (p<0.05 and p<0.0005 respectively). 3 - Significant increase of CEA, CA19 - 9, total protein, albumin, uric acid and Ca++ level in ascitic fluid of malignant ascites patients compared to non - malignant ascites (p<0.0005, p<0.005, p<0.005, p<0.005, p<0.05 and p<0.05 respectively), thus the level of these parameters in ascitic fluid could be used as a helpful parameters in differentiation between malignant ascites from non - malignant ascites patients. 4 - Significant increase in serum of CEA, CA19 - 9, albumin, uric acid and Ca++ level in malignant ascites patients compared to non - malignant ascites (p<0.05, p<0.05, p<0.05, p<0.05 and p<0.05 respectively) while there is no significant differences in serum total protein level of malignant ascites compared to non - malignant ascites (p>0.05). 5 - CA125 level in ascitic fluid and serum of malignant ascites patients shows no significant increase compared to non - malignant ascites (p>0.05 and p>0.05 respectively), therefor CA125 test in ascitic fluid cannot be used as a parameter in differentiation between malignant ascites from non - malignant ascites patients.CA15 - 3, ? - hCG, (A/S) total protein ratio, SAAG and SACG can be considered as a good parameters in differentiation of malignant from non - malignant ascites, while CEA, CA19 - 9, total protein, albumin,Ca++ and uric acid level in spite of their increase in malignant ascitic fluid but this increase is not considered as a diagnostic factor and can be used as a helpful parameters in the differentiation between malignant from non - malignant ascites. CA125 has no useful role in diagnosis or differentiation between malignant from non - malignant ascites.
