tailieunhanh - Ca-125: A Useful Marker to Distinguish Pulmonary Tuberculosis from Other Pulmonary Infections

Small samples and study area covering only 2 DOTS centers are some of the study limitations. Other limitations include exclusion of testing for latent TB infection (LTBI). This was as a result of shortcomings associated with use of the only available diagnostic tool- Tuberculin (Mantoux) skin test (TST). These include invasive nature of the test, the need for the patient to come back for follow up TST reading, cross-reactivity with environmental mycobacteria and previous BCG vaccination. There is a need to assess the magnitude of LTBI among HCWs using more reliable serological assays such as the T-cell based assays which measure the interferon –gamma released after stimulation by M. tuberculosis. Examples of such assays. | The Open Respiratory Medicine Journal 2009 3 123-127 123 Ca-125 A Useful Marker to Distinguish Pulmonary Tuberculosis from Other Pulmonary Infections J. Fortún 1 P. Martín-Dávila1 R. Mendez1 A. Martinez1 F. Norman1 J. Rubi2 E. Pallares2 E. Gómez-Mampaso3 and S. Moreno1 infectious Diseases 2Biochemistry and 3Microbiology Departments Ramón y Cajal Hospital Madrid Spain Abstract Introduction Ca-125 is secreted by different celomic epitheliums. Serum levels may be increased in malignant diseases like ovarian cancer but also in other medical conditions such as pulmonary and extrapulmonary tuberculosis. Methods From Jan-04 to Dec-06 a retrospective study analyzing Ca-125 levels in serum samples from patients with a diagnosis of pulmonary TB was performed. These results were compared with those samples obtained from patients with non-TB pulmonary infections. Results Eighty-nine patients were included in the study thirty-five with pulmonary TB and 54 with other respiratory infections. In patients with TB the mean Ca-125 value was IU ml SD . In the control group mean value was IU ml SD . The optimal cut-off for pulmonary tuberculosis was IU ml sensitivity specificity . Pulmonary TB was the only factor associated with a Ca-125 level . In 10 patients with TB Ca-125 levels were available 2 months after starting TB therapy and a decrease during treatment was shown. Conclusions Ca-125 values increase in patients with pulmonary TB and decline to normal values during treatment. Determination of Ca 125 may be usedin patients with a negative sputum AFB stain. Keywords Ca-125 tuberculosis pneumonia. INTRODUCTION Patients with tuberculosis TB present pulmonary involvement most frequently. Microscopic examination of acid-fast stained sputum smears remains the most useful diagnostic method and positive samples establish indications for initiation of TB therapy and respiratory isolation. However in some cases of pulmonary TB acid-fast bacilli .