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2007 Program and Abstracts | 2007 Posters
Value of Serum Levels of CA-125 in the Diagnosis and Monitoring of Abdominal Tuberculosis
Vimal Bhandar*, Anurag Manoj, Bharat Sharma
surgery, vmmc&safdarjung hospital, New Delhi, India

Background:In the Indian sub-continent abdominal tuberculosis remains a common disease and accounts for 0.8% of hospital admissions in Delhi. Approximately 11% of them have small intestinal obstruction and 5.7% of intestinal perforations are due to intestinal tuberculosis.Histopathological proof, though diagnostic, is not available in all cases.
Aim: This study highlights the case of diagnosing abdominal tuberculosis with the help of serum levels of CA-125 and in monitoring the disease activity and its response to therapy.
Material and Methods:Fifty diagnosed cases of abdominal tuberculosis and 50 controls were included in the study. All of them underwent clinical, radiological and hematological examination.
RESULTS: The most common presentation in the chronic group was subacute intestinal obstruction occurring in 22% of cases and the most common presentation in acute group was acute intestinal obstruction (22%). Twenty-two patients had acute presentation and underwent laparotomy; twenty had a chronic presentation and were managed conservatively. Biopsy was taken in all patients undergoing laparotomy. Serum levels of CA-125 was assayed at 0 months 3months and 6 months while they were assessed clinically. It was observed that the test was significantly positive when the disease was active with a sensitivity and specificity of 90% and 96% respectively. Sensitivity reduced to 12% and 6% at 3 months and 6 months respectively. The specificity, however, remained unchanged.
Conclusions:It was concluded from the present study that this marker is beneficial in determination of tuberculous activity and in the differentiation between active and inactive abdominal tuberculosis.Review:Sheth SS.Elevated CA125inadvanced abdominal or pelvic tuberculosis.Int j Gynaecol Obstet 1996 Feb; 52(2):167-71
clinical diagnosis of cases

Diagnosis number of patients(n=50) Percentage
Acute intestinal obstruction 12 24
Perforation peritonitis 10 20
Tuberculoous ascites 6 12
sub-acute intestinal obstruction 11 12
Mesenteric lymphadenopathy 6 12
combination of above 5 10

sensitivity,specificity.PPV & NPV FOR SERUM CA - 125 in diagnosis of abdominal tuberculosis at 0.3 & 6 months

stage of assessment o month (%) 3 month (%) 6 month (%)
sensitivity 90 12 8
specificity 96 96 96
PPV 95.74 75 66.67
NPV 95.57 52.17 51.06

2007 Program and Abstracts | 2007 Posters
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