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Abstract(s)
Introdução: Os marcadores tumorais são macromoléculas presentes no tumor ou em outros tecidos biológicos, cujo aparecimento ou alteração das suas concentrações séricas indica o aparecimento ou o crescimento de células neoplásicas. Atualmente estão a ser amplamente usados na prática clínica para rastreio, diagnóstico, prognóstico, avaliação da resposta à terapêutica e follow-up de pacientes com cancro. Em 1980, Robert Bast, M.D., identificou o ‘cancer antigen 125’, uma glicoproteína de alto peso molecular, produzida contra a linha celular do cancro do ovário.
Objetivos: Conhecer a frequência de pedidos do marcador Ca125 e correlacionar os seus níveis séricos com os principais diagnósticos clínicos encontrados, de forma a retirar conclusões que permitam um melhor uso do marcador tumoral no Centro Hospitalar Cova da Beira.
Métodos: Estudo retrospetivo, baseado na consulta de 439 processos clínicos, que correspondem a utentes do sexo feminino, a quem foi pedido o marcador tumoral no ano de 2014. As variáveis estudadas foram: idade, serviço requisitante, valor sérico do Ca125 em 2014, existência de pedidos do marcador a partir de 2008 e seu valor sérico.
Resultados: Das 439 pacientes, apenas em 41 (9,33%) o nível sérico do Ca125 encontrava-se acima dos valores de referência, 141 tinham pelo menos uma análise realizada entre 2008 e 2014 e destas 12,06% estavam acima do valor de referência. 78,59% das pacientes não tinham diagnóstico de qualquer patologia maligna entre 2008 e 2014. No ano 2014, em aproximadamente 91% das utentes não foi diagnosticada nenhuma patologia maligna e mesmo nos casos em que o Ca125 estava acima do normal, só em 24% foi diagnosticada patologia maligna. As patologias benignas mais encontradas foram do foro Gastrointestinal, nomeadamente gastrites e gastroenterites, alterações hepáticas e biliares e hemorroidas. Das patologias malignas diagnosticadas em 2014, a mais frequente foi a neoplasia do cólon, cego ou apêndice seguida pela neoplasia da mama e pela neoplasia da tiróide.
Conclusão: No presente estudo conclui-se que Ca125 tem baixa especificidade e está associado com uma grande variedade de condições diagnósticas, tanto benignas como malignas. Perante esta racionalização deficiente na aplicabilidade do Ca125, deverá haver mais debate sobre a sua utilização, com a criação de Guidelines mais específicas, de forma a ajudar os médicos a desenvolver uma abordagem mais racional, menos dispendiosa e mais centrada no paciente.
Introduction: Tumor markers are macromolecules which exist in the tumor or in other biological tissues, whose existence or the modification of their serum concentrations indicates the presence or growth of neoplastic cells. They are currently being widely used in clínical practice for screening, diagnosis, prognosis, assessment of response to therapy and follow-up of patients with cancer. In 1980 Robert Bast, M.D., identified the “cancer antigen 125”, a high-molecular-weight glycoprotein produced against the ovarian cancer cell line. Objectives: To determine the frequency of requests for the Ca125 marker and to correlate its serum levels with the main clínical diagnoses found, in order to draw conclusions that may allow a better use of the tumor marker in Centro Hospitalar Cova da Beira. Methods: Retrospective study, based on the consultation of 439 clínical cases corresponding to female users, whom a tumor marker was requested in 2014. The variables in study were: age, requesting service, serum Ca125 in 2014, the existence of markers requests made from 2008 and its serum value. Results: Of the 439 patients, only 41 (9.33%) had serum Ca125 levels above the reference values, 141 had at least one analysis performed between 2008 and 2014 and 12.06% of these patients were above the value of reference. 78.59% of the patients had no diagnosis of any malignant disease between 2008 and 2014. In 2014, no tumor pathology was diagnosed in approximately 91% of the patients and even in cases where Ca125 was above normal, only 24% was diagnosed as a malignant pathology. The most common benign pathologies were Gastrointestinal disorders, including gastritis and gastroenteritis, hepatic and biliary alterations, and hemorrhoids. Among the malignant diseases diagnosed in 2014, the most frequent was the neoplasm of the colon, blind or appendix followed by the neoplasm of the breast and by the neoplasm of the thyroid. Conclusion: In the present study we conclude that Ca125 has low specificity and is associated with a great variety of diagnostic conditions, both benign and malignant. Faced with this poor rationalization in the applicability of Ca125, there should be more debate about its use, with the creation of more specific Guidelines, in order to help physicians develop a more rational, less expensive and more patient-centered approach.
Introduction: Tumor markers are macromolecules which exist in the tumor or in other biological tissues, whose existence or the modification of their serum concentrations indicates the presence or growth of neoplastic cells. They are currently being widely used in clínical practice for screening, diagnosis, prognosis, assessment of response to therapy and follow-up of patients with cancer. In 1980 Robert Bast, M.D., identified the “cancer antigen 125”, a high-molecular-weight glycoprotein produced against the ovarian cancer cell line. Objectives: To determine the frequency of requests for the Ca125 marker and to correlate its serum levels with the main clínical diagnoses found, in order to draw conclusions that may allow a better use of the tumor marker in Centro Hospitalar Cova da Beira. Methods: Retrospective study, based on the consultation of 439 clínical cases corresponding to female users, whom a tumor marker was requested in 2014. The variables in study were: age, requesting service, serum Ca125 in 2014, the existence of markers requests made from 2008 and its serum value. Results: Of the 439 patients, only 41 (9.33%) had serum Ca125 levels above the reference values, 141 had at least one analysis performed between 2008 and 2014 and 12.06% of these patients were above the value of reference. 78.59% of the patients had no diagnosis of any malignant disease between 2008 and 2014. In 2014, no tumor pathology was diagnosed in approximately 91% of the patients and even in cases where Ca125 was above normal, only 24% was diagnosed as a malignant pathology. The most common benign pathologies were Gastrointestinal disorders, including gastritis and gastroenteritis, hepatic and biliary alterations, and hemorrhoids. Among the malignant diseases diagnosed in 2014, the most frequent was the neoplasm of the colon, blind or appendix followed by the neoplasm of the breast and by the neoplasm of the thyroid. Conclusion: In the present study we conclude that Ca125 has low specificity and is associated with a great variety of diagnostic conditions, both benign and malignant. Faced with this poor rationalization in the applicability of Ca125, there should be more debate about its use, with the creation of more specific Guidelines, in order to help physicians develop a more rational, less expensive and more patient-centered approach.
Description
Keywords
Ca125 Cancro do Ovário Marcador Tumoral Patologias Benignas Patologias Malignas