Jelly belly pseudomyxoma peritonei1/7/2024 The aim of the current study was to survey the expression of CEA, CA199 and CA125 in both serum and ascites to determine their value in the diagnosis and prediction of prognosis of appendiceal PMP. This might have an important role in the early diagnosis of PMP and potentially improve the prognosis. Therefore, it could be speculated that ascites tumor markers would more likely be positive. A previous study reported that the immune response of markers such as CEA also existed in mucus, suggesting that this kind of cell membrane glycoprotein could fall off the surface of the PMP cell membrane into mucinous ascites. For the patients without ascites, saline was used to lavage the abdominopelvic cavity, then aspirated and sent for tumor marker examination. If the ascites was a viscous liquid, it required filtration. In the present study, following laparotomy, ascites was collected for tumor marker testing. However, there are few relevant reports about ascites markers in appendiceal PMP. Moreover, other studies have reported the application of serum markers in the diagnosis and prognosis of appendiceal PMP. The application of the serum markers carcinoembryonic antigen (CEA), cancer antigen 199 (CA19-9) and CA125 in colorectal, pancreatic, and ovarian cancer has been widely reported in the literature. According to the 2016 Peritoneal Surface Oncology Group International (PSOGI) criteria, pathological diagnosis for PMP was classified into four categories: acellular mucin (AC), low-grade mucinous carcinoma peritonei (LG-MCP), high-grade mucinous carcinoma peritonei (HG-MCP), and high-grade mucinous carcinoma peritonei with signet ring cells (HGMC-S). Sugarbaker’s cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is considered the current standard of treatment. When the appendix ruptures, tumor cells spread throughout the abdominal cavity via paths of fluid re-absorption. However, symptoms of increased abdominal girth, intestinal obstruction and malnutrition can call attention to the accumulation of large amounts of mucinous tumor. Clinically, it may be discovered incidentally by abdominal imaging or surgically. Pseudomyxoma peritonei (PMP), often called “jelly-belly”, is a rare peritoneal malignancy that develops from a perforated epithelial tumor of the appendix, characterized by diffuse, progressive mucinous ascites. Furthermore, elevation of ascites CEA, high pathological grade and incomplete cytoreduction predicted poor prognosis of appendiceal PMP. ConclusionĬEA in ascites can be used to help specify the origin of PMP. Multivariate analysis indicated that completeness of cytoreduction (CCR), ascites CEA and pathological grade were independent risk factors for overall survival (OS). Univariate analysis showed that the higher the ascites tumor markers, the poorer the survival ( p = 0.014). CEA in ascites showed significant difference in the diagnosis of appendiceal PMP ( p = 0.000) the areas under the ROC curves (AUROCs) and specificity were 0.725, 70.7%, respectively. The sensitivities with optimal cut-off values for ascites markers of CEA, CA199 and CA125 were 83.5%, 88.9% and 72.6%, respectively. There were significant differences between the numbers of patients with positive CEA and CA199 in serum vs. The prognostic factors of appendiceal PMP with different pathologic subgroups were calculated by univariate and multivariate Cox proportional hazard regression models. Serum and ascites tumor markers were obtained, and their diagnostic values were compared by receiver operating characteristic (ROC) curves. The study comprised 183 patients with pathologically confirmed appendiceal PMP, enrolled from May 2012 to June 2020, in Aerospace Center Hospital. To investigate the expression of carcinoembryonic antigen (CEA), cancer antigen 199 (CA199) and CA125 in serum and ascites of appendiceal pseudomyxoma peritonei (PMP) patients relative to their diagnostic and predictive value.
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