ORIGINAL ARTICLE |
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Year : 2019 | Volume
: 32
| Issue : 4 | Page : 1452-1458 |
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Diagnostic value of platelet indices, carbohydrate antigen 19-9 and carcinoembryonic antigen in differentiating malignant from benign gastric ulcers
Ayman M El Lehleh1, Naglaa S El-Abd1, Suzy F Gohar2, Mohammad O Zarad3
1 Department of Tropical Medicine, Faculty of Medicine, Menoufia University, Menoufia, Egypt 2 Department of Clinical Oncology, Faculty of Medicine, Menoufia University, Menoufia, Egypt 3 Medical Physiology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
Correspondence Address:
Mohammad O Zarad Medical Physiology Department, Faculty of Medicine, Al-Azhar University, Cairo Egypt
Source of Support: None, Conflict of Interest: None | Check |
DOI: 10.4103/mmj.mmj_186_19
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Objective
To elucidate the value of platelet indices, carbohydrate antigen 19-9 (CA 19-9) and carcinoembryonic antigen (CEA) in differentiating malignant from benign gastric ulcers.
Background
Gastric cancer is one of the most common malignant diseases and benign gastric ulcer is a worldwide disease, responsible for substantial premature mortality. Clinical symptoms of early gastric cancer could not be used to distinguish gastric cancer from ulcers. Platelet indices: mean platelet volume (MPV) and platelet distribution width (PDW) are a group of platelet parameters investigated as platelet activation indicators.
Patients and methods
This prospective study included 150 patients: 30 patients with malignant gastric ulcer, 60 patients with benign gastric ulcer, and 60 healthy control participants. Upper endoscope with tissue biopsy and pathological evaluation, Helicobacter pylori stool antigen, platelet count, PDW, MPV, CEA, CA 19-9, computed tomography scan of the chest, abdomen, and the pelvis were assessed.
Results
Platelet count, MPV, PDW, CEA, and CA 19-9 were significantly higher in malignant gastric ulcer patients than benign ulcer patients and controls. MPV and PDW showed sensitivity, specificity, and area under the curve (93.3, 70 and 0.934% and 96.7, 86.7 and 0.966%, respectively) in predicting malignancy in gastric ulcer patients with improved diagnostic accuracy when combined with CEA and CA 19-9. Higher platelet count and PDW were significantly associated with advanced clinicopathological parameters of gastric cancer.
Conclusion
Changes in platelet indices are valuable markers in predicting malignancy in gastric ulcer patients. Significant increase in platelet count and PDW correlate and could be reliable markers, together with other markers of gastric cancer (CEA and CA 19-9), for clinicopathological features of malignant gastric ulcer.
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