The diagnostics significance of serum cancer antigen-125 in abdominal tuberculosis

Anil Kumar; Shiv S. Paswan; Bindey Kumar; Pragati Raj; . Sunita

doi:10.18203/2349-2902.isj20180053

Authors

Anil Kumar Department of General Surgery, All India Institute of Medical Sciences, Patna, Bihar, India
Shiv S. Paswan Department of General Surgery, All India Institute of Medical Sciences, Bhubaneshwar, Odisha, India
Bindey Kumar Department of Paediatric Surgery, All India Institute of Medical Sciences, Patna, Bihar, India
Pragati Raj Intern, All India Institute of Medical Sciences, Patna, Bihar, India
. Sunita MBBS Student, All India Institute of Medical Sciences, Patna, Bihar, India

DOI:

https://doi.org/10.18203/2349-2902.isj20180053

Keywords:

Abdominal, CA-125, Koch’s, Tuberculosis

Abstract

Background: Various serum markers have been shown to be helpful in diagnosing tubercular infection, but none has been proven to be specific. The present study was undertaken to ascertain the role of serum cancer antigen (CA) -125 in diagnosing and monitoring therapeutic response in abdominal tuberculosis.

Methods: Fifty diagnosed cases of abdominal tuberculosis and equal number of controls were included in the study. All the patients underwent clinical, radiological and hematological examination. Twenty-two patients had acute presentation and underwent laparotomy and twenty-eight patients had a chronic presentation and were managed conservatively. Biopsy was taken in all patients undergoing laparotomy. Serial measurement of serum levels of CA-125 were done at 0, 3 and 6 months in all the patients.

Results: The CA-125 levels were significantly higher in tuberculosis patients than in control group (PPV 95.74% at 0 month). It was also observed that the levels correlated significantly with the disease activity (sensitivity 90 percent, specificity 96 percent) and return to normal level with the treatment given. It was shown that sensitivity reduced to 12 percent and 6 percent at 3 months and 6 months respectively after completion of treatment. The specificity however remained unchanged.

Conclusions: The measurement of CA-125 may be a valuable parameter in diagnosing and determination of disease activity in abdominal tuberculosis.

Metrics

Metrics Loading ...

References

Candocia SA, Locker GY. Elevated serum CA -125 secondary to tuberculous peritonitis, cancer. 1993;72(6):2016-18.

Marshall JB. Tuberculosis of the gastrointestinal tract and peritoneum. Am J Gastroenterol. 1993;88(7):989-99.

Yilmaz A, Ece F, Bayramgurler B, Akkaya E, Baran R. The value of CA-125 in the evaluation of tuberculosis activity. Respir Med. 2001;95(8):666-9.

Donoghue HD, Holton J. Intestinal tuberculosis. Current opinion in Infect Dis. 2009;22(5):490-6.

Fortun J, Martin-Davilla P, Mendez R, Martinez A, Norman F, Rubi J, et al. CA-125 :A useful marker to distinguish pulmonary tuberculosis from other pulmonary infections. Open Respir Med J. 2009;3:123-7.

Debi U, Ravisankar V, Prasad KS, Sinha SK, Sharma AK. Abdominal tuberculosis of the gastrointestinal tract: Revisited. World J Gastroenterol. 2014;20(40):14831-40.

Muneef MA, Memish Z, Mahmoud SA, Sadoon SA, Bannatyne R, Khan Y. Tuberculosis in the belly: a review of 46 cases involving the gastro intestinal tract and peritoneum. Scand J Gastroenterol. 2001;36(5):528-32.

Uygur-Bayramicli O, Dabak G, Dabak R. A clinical dilemma: abdominal tuberculosis. World J Gastroenterol. 2003;9(5):1098-101.

Singh MM, Bhargawa AN, Jain KP. Tuberculous peritonitis: an evaluation of pathogenic mechanisms, diagnostic procedures and therapeutic measures. N Engl J Med. 1969;281(20):1091-4.

Hussain SF, Phillip C. Elevation of tumour marker CA-125 in serum and body fluids: interpret with caution. Indian J Med Res. 2007;125(1):10-2.

Miralles C, Orea M, Espana P. Cancer antigen 125 associated with multiple benign and malignant pathologies. Ann Surg Oncol. 2003;10(2):150-4.

Buamah P. Benign conditions associated with raised serum CA-125 concentration. J Surg Oncol. 2000;75(4):264-5.

Kadayifci A, Simsek H, Savas MC, Toppare M. Serum tumor markers in chronic liver disease. Neoplasma. 1996;43(1):17-21.

Moncayo R, Moncayo H. Serum levels of CA 125 are elevated in patients with active systemic lupus erythematosus. Obstet Gynecol. 1991;77(6):932-4.

Uzunkoy A, Harma M. Diagnosis of abdominal tuberculosis: experience from 11 cases and review of literature. World J Gastroenterol. 2004;10(24):3647-9.

Wu JF, Li HJ, Lee PI, Ni YH, Yu SC, Chang MH. Tuberculous peritonitis mimicking peritoneal carcinomatosis: a case report. Eur J Pediatr. 2003;162(12):853-5.

Piura B, Rabinovich A, Leron E, Yanai-Inbar I, Mazor M. Peritoneal tuberculosis - an uncommon disease that may deceive the gynaecologist. Eur J Obstet Gynecol Reprod Biol. 2003;110(2):230-4.

Thakur V, Mukherjee U, Kumar K. Elevated serum cancer antigen 125 levels in advanced abdominal tuberculosis. Med Oncol. 2001;18(4):289-91.

Mizutani H, Horiba M, Shindoh J, Kimura T, Son M, Wakahara K. A case of tuberculous peritonitis diagnosed by a direct smear of ascitic fluid complicated with an active pulmonary tuberculosis and intestinal tuberculosis. Kekkaku. 2001;76(6):479-84.

Wani AM, Akhtar M. CA-125 a marker for diagnosis and follow-up of pleuroperitoneal and lymph node tuberculosis. Ann Saudi Med. 2008;28(2):142-3.

Rodriguez LR, Lado FL. CA-125 adenosine deaminase, and PCR for Mycobacterium tuberculosis in the diagnosis of peritoneal tuberculosis. Scand J Infect Dis. 2006;38(8):749-50.

Corapçioglu F, Güvenç BH, Sarper N, Aydogan A, Akansel G, Arisoy ES. Peritoneal tuberculosis with elevated serum CA 125 level mimicking advanced ovarian carcinoma in an adolescent. Turk J Pediatr. 2006;48(1):69-72.

Younossian AB, Rochat T, Favre L, Janssens JP. Ascites and highly elevated CA-125 levels in a case of peritoneal tuberculosis. Scand J Infect Dis. 2006;38(3):216-8.

Jung EY, Hur YJ, Lee YJ, Han HS, Sang JH, Kim YS. Peritoneal carcinomatosis mimicking a peritoneal tuberculosis. Obstet Gynecol Sci. 2015;58(1):69-72.

Said FA, Mohamed BI, El-Sharkawy E, Al-Sherif M. Role of cancer antigen 125 in active pulmonary tuberculosis. Egyptian J Chest Dis Tuberculos. 2013;62(3):419-24.

Mohammad OI, Okab AA, El Behisy MM, Sudhom FGT. Value of CA-125 in diagnosis and assessment of severity of active pulmonary tuberculosis. gyptian J Chest Dis Tuberculos. 2016;65(1):205-9.