Utility of CT Scan and CA 19-9 in Predicting Non –Resectability in Malignant Obstructive Jaundice
Background: Most patients with malignant obstructive jaundice (MOJ) present with non-resectable disease. Non curative laparotomy has been associated with adverse outcome. There is need to predict non-resectable disease and prepare patients for planned palliative procedures. Objective: To study the u...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Surgical Society of Kenya
2014-01-01
|
| Series: | The Annals of African Surgery |
| Subjects: | |
| Online Access: | https://www.annalsofafricansurgery.com/utility-of-ct-scan-and-ca-19-9-in-p |
| _version_ | 1818362672921444352 |
|---|---|
| author | Bitta C Githaiga J Kaisha W |
| author_facet | Bitta C Githaiga J Kaisha W |
| author_sort | Bitta C |
| collection | DOAJ |
| description | Background: Most patients with malignant obstructive jaundice (MOJ) present with non-resectable disease. Non curative laparotomy has been associated with adverse outcome. There is need to predict non-resectable disease and prepare patients for planned palliative procedures. Objective: To study the utility of Ca 19-9 serum levels and CT scan in predicting the non- resectability of MOJ tumours at Kenyatta National Hospital. Methods: Eligible consenting patients were recruited. All had a CT scan of the abdomen and serum CA 19-9 levels determined preoperatively and staging was done using the LRCC criteria. At surgery, intraoperative findings were then compared in terms of non-resectability with the preoperative CT scan prediction and the CA 19-9 levels. Results: A total of 49 patients were recruited into the study. During the study, 14 patients were later excluded due to inadequate information of imaging, non-surgical intervention or pre-operative death. At a confidence level of 95%, CA 19-9 level of 466 has 92.3% sensitivity and 100% specificity indicative of non resectability in MOJ lesions. When compared with intra-operative findings on non-resectability, the cut off level of 466 has a positive and negative predictive value of CA19-9 was 100% and 71.4%, respectively. CT scan had 85.2% sensitivity and 100% specificity on predicting non resectability of MOJ lesions, 84% sensitivity in detecting nodal involvement but predicted only 33% of liver metastases. Conclusion: Combining CA 19-9 levels and CT scan are useful tools in detecting non resectability of MOJ lesions preoperatively. |
| first_indexed | 2024-12-13T21:36:19Z |
| format | Article |
| id | doaj.art-4c40b642c7db42c4bb118da8cea7b903 |
| institution | Directory Open Access Journal |
| issn | 1999-9674 2523-0816 |
| language | English |
| last_indexed | 2024-12-13T21:36:19Z |
| publishDate | 2014-01-01 |
| publisher | Surgical Society of Kenya |
| record_format | Article |
| series | The Annals of African Surgery |
| spelling | doaj.art-4c40b642c7db42c4bb118da8cea7b9032022-12-21T23:30:40ZengSurgical Society of KenyaThe Annals of African Surgery1999-96742523-08162014-01-01111Utility of CT Scan and CA 19-9 in Predicting Non –Resectability in Malignant Obstructive JaundiceBitta C0Githaiga J1Kaisha W2Webuye District HospitalSchool of Medicine, University of NairobiSchool of Medicine, University of NairobiBackground: Most patients with malignant obstructive jaundice (MOJ) present with non-resectable disease. Non curative laparotomy has been associated with adverse outcome. There is need to predict non-resectable disease and prepare patients for planned palliative procedures. Objective: To study the utility of Ca 19-9 serum levels and CT scan in predicting the non- resectability of MOJ tumours at Kenyatta National Hospital. Methods: Eligible consenting patients were recruited. All had a CT scan of the abdomen and serum CA 19-9 levels determined preoperatively and staging was done using the LRCC criteria. At surgery, intraoperative findings were then compared in terms of non-resectability with the preoperative CT scan prediction and the CA 19-9 levels. Results: A total of 49 patients were recruited into the study. During the study, 14 patients were later excluded due to inadequate information of imaging, non-surgical intervention or pre-operative death. At a confidence level of 95%, CA 19-9 level of 466 has 92.3% sensitivity and 100% specificity indicative of non resectability in MOJ lesions. When compared with intra-operative findings on non-resectability, the cut off level of 466 has a positive and negative predictive value of CA19-9 was 100% and 71.4%, respectively. CT scan had 85.2% sensitivity and 100% specificity on predicting non resectability of MOJ lesions, 84% sensitivity in detecting nodal involvement but predicted only 33% of liver metastases. Conclusion: Combining CA 19-9 levels and CT scan are useful tools in detecting non resectability of MOJ lesions preoperatively.https://www.annalsofafricansurgery.com/utility-of-ct-scan-and-ca-19-9-in-pmalignant obstructive jaundicenon-resectabilityca 19-9ct scan. |
| spellingShingle | Bitta C Githaiga J Kaisha W Utility of CT Scan and CA 19-9 in Predicting Non –Resectability in Malignant Obstructive Jaundice The Annals of African Surgery malignant obstructive jaundice non-resectability ca 19-9 ct scan. |
| title | Utility of CT Scan and CA 19-9 in Predicting Non –Resectability in Malignant Obstructive Jaundice |
| title_full | Utility of CT Scan and CA 19-9 in Predicting Non –Resectability in Malignant Obstructive Jaundice |
| title_fullStr | Utility of CT Scan and CA 19-9 in Predicting Non –Resectability in Malignant Obstructive Jaundice |
| title_full_unstemmed | Utility of CT Scan and CA 19-9 in Predicting Non –Resectability in Malignant Obstructive Jaundice |
| title_short | Utility of CT Scan and CA 19-9 in Predicting Non –Resectability in Malignant Obstructive Jaundice |
| title_sort | utility of ct scan and ca 19 9 in predicting non resectability in malignant obstructive jaundice |
| topic | malignant obstructive jaundice non-resectability ca 19-9 ct scan. |
| url | https://www.annalsofafricansurgery.com/utility-of-ct-scan-and-ca-19-9-in-p |
| work_keys_str_mv | AT bittac utilityofctscanandca199inpredictingnonresectabilityinmalignantobstructivejaundice AT githaigaj utilityofctscanandca199inpredictingnonresectabilityinmalignantobstructivejaundice AT kaishaw utilityofctscanandca199inpredictingnonresectabilityinmalignantobstructivejaundice |