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| 1 | Adjusting CA19-9 values to predict malignancy in obstructive jaundice:Influence of bilirubin and C-reactive protein显示文摘AIM:To find a possible relationship between inflammation and CA19-9 tumor marker by analyzing data from patients with benign jaundice(BJ) and malignant jaundice(MJ).METHODS:All patients admitted for obstructive jaundice,in the period 2005-2009,were prospectively enrolled in the study,obtaining a total of 102 patients.On admission,all patients underwent complete standard blood test examinations including C-reactive protein(CRP),bilirubin,CA19-9.Patients were considered eligible for the study when they presented obstructive jaundice confirmed by instrumental examinations and increased serum bilirubin levels(total bilirubin > 2.0 mg/dL).The standard cut-off level for CA19-9 was 32 U/mL,whereas for CRP this was 1.5 mg/L.The CA19-9 level was adjusted by dividing it by the value of serum bilirubin or by the CRP value.The patients were divided into 2 groups,MJ and BJ,and after the adjustment a comparison between the 2 groups of patients was performed.Sensitivity,specificity and positive predictive values were calculated before and after the adjustment.RESULTS:Of the 102 patients,51 were affected by BJ and 51 by MJ.Pathologic CA19-9 levels were found in 71.7% of the patients.In the group of 51 BJ patients there were 29(56.9%) males and 22(43.1%) females with a median age of 66 years(range 24-96 years),whereas in the MJ group there were 24(47%) males and 27(53%) females,with a mean age of 70 years(range 30-92 years).Pathologic CA19-9 serum level was found in 82.3% of MJ.CRP levels were pathologic in 66.6% of the patients with BJ and in 49% with MJ.Bilirubin and CA19-9 average levels were significantly higher in MJ compared with BJ(P = 0.000 and P = 0.02),while the CRP level was significantly higher in BJ(P = 0.000).Considering a CA19-9 cut-off level of 32 U/mL,82.3% in the MJ group and 54.9% in the BJ group were positive for CA19-9(P = 0.002).A CA19-9 cut-off of 100 U/mL increases the difference between the two groups:35.3% in BJ and 68.6% in MJ(P = 0.0007).Adjusting the CA19-9 value by dividing it by serum bilirubin level meant that 21.5% in the BJ and 49% in the MJ group remained with a positive CA19-9 value(P = 0.003),while adjusting the CA19-9 value by dividing it by serum CRP value meant that 31.4% in the BJ group and 76.5% in the MJ group still had a positive CA19-9 value(P = 0.000004).Sensitivity,specificity,positive predictive values of CA19-9 > 32 U/mL were 82.3%,45% and 59.1%;when the cutoff was CA19-9 > 100 U/mL they were,respectively,68.6%,64.7% and 66%.When the CA19-9 value was adjusted by dividing it by the bilirubin or CRP values,these became 49%,78.4%,69.4% and 76.5%,68.6%,70.9%,respectively.CONCLUSION:The present study proposes CRP as a new and useful correction factor to improve the diag-nostic value of the CA19-9 tumor marker in patients with cholestatic jaundice. | Gaetano La Greca Maria Sofia Rosario Lombardo Saverio Latteri Agostino Ricotta Stefano Puleo Domenico Russello | 2012 | World Journal of Gastroenterology2012，18，31： | 20 |
| 2 | The minimally invasive management of visceral artery aneurysms and pseudoaneurysms显示文摘 | Grant T. Fankhauser William M. Stone Sailendra G. Naidu Gustavo S. Oderich Joseph J. Ricotta Haraldur Bjarnason Samuel R. Money | 2011 | Journal of Vascular Surgery2011，，4： | 2 |
| 3 | An information-theoretical measure of taxonomic diversity显示文摘 | Ricotta C Avena G | 2003 | Acta Biotheoretica2003，51，1： | 1 |
| 4 | Cetuximab for treatment of metastatic colorectal cancer显示文摘 | Cerea G Ricotta R Schiavetto I | | Ann Oncol0，17，7： | 1 |
| 5 | Fenestrated and branched stent grafts显示文摘 | Ricotta JJ 2nd Oderich GS | 2008 | Perspect Vasc Surg Endovasc Ther2008，20，2： | 1 |
| 6 | Evaluation of intra-abdominal and renal hemodynamics显示文摘 | Caldwell CB Ricotta JJ | 1986 | Current Surgery1986，43，： | 1 |
| 7 | The remote sensing approach in broadscalephenological studies显示文摘 | Ricotta C Avena G C | | 0，，： | 1 |
| 8 | Cetuximab for treatment of metastatic colorectal canoer显示文摘 | Gerea G Ricotta R Schiavetto I | | 0，，07： | 1 |
| 9 | The role of carotid screening before coronary artery bypass 显示文摘 | Faggioli GL Curt GR Ricotta JJ | 1990 | J Vasc Surg1990，12，： | 1 |
| 10 | On the relationship between Pielou's evenness and landscape dominance within the context of Hill's diversity profiles 显示文摘 | Carlo Ricotta Giancarlo Avena | 2003 | Ecological Indicators2003，，2： | 1 |
| 11 | Multicenter validation study of real time (B-mode) ultrasound,arteriography,and pathologic examination显示文摘 | Ricotta JJ Bryan FA Bond MG | | 0，，03： | 1 |
| 12 | Using satellite imagery to assess plant species richness:The role of multispectral systems显示文摘 | Rocchini D Ricotta C Chiarucci A | | 0，，： | 1 |
| 13 | Common femoral artery endartcrectomy for lower-extremity ischemi- a: evaluating the need for additional distal limb revascu- larization 显示文摘 | Malgor R D Ricotta J J Bower T C | 2012 | Ann Vasc Surg2012，26，7： | 1 |
| 14 | The role of carotid screening before coronary artery bypass显示文摘 | Curl GR Ricotta JJ | 1990 | J Vasc Surg1990，12，： | 1 |
| 15 | Quantifying the network connectivity of landscape mosaics: a graphtheoretical approach显示文摘 | Ricotta C Stanisci A Avena G C | 2000 | Community Ecology2000，1，1： | 1 |
| 16 | Management of acute ischemia of the upper extremity 显示文摘 | Ricotta JJ Scudder PA McAndrew JA | 1983 | Am J Surg1983，145，5： | 1 |
| 17 | Changes in visceral blood flow with elevated intrabdominal pressure显示文摘 | Caldwell C B Ricotta J J | 1987 | J Surg Res1987，43，1： | 1 |
| 18 | Fractal modelling of the remotely sensed two-dimensional net primary production patternwith annual cumulative AVHRR NDVI data 显示文摘 | RICOTTA C A VENA G C | 1998 | Intern J Remote Sens1998，19，12： | 1 |
| 19 | Quantifying the network connectivity of landscape mosaics: a graph-theoretical ap- proach显示文摘 | Ricotta C Stanisci A Avena C G | 2000 | Community Ecol2000，1，： | 1 |
| 20 | Role of alaccase in the degradation of pentachlorophenol显示文摘 | Ricotta A | 1996 | Bull Environ ContamToxtcol1996，57，4： | 1 |
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