Urinary carbohydrate antigen 19-9/creatinine ratio: A non-invasive marker for follow-up of unilateral ureteropelvic junction obstruction in children
Urinary carbohydrate antigen 19-9/creatinine ratio: A non-invasive marker for follow-up of unilateral ureteropelvic junction obstruction in children
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DOI：
10.1016/j.jpurol.2017.09.012
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发表时间：
2018-02-01
影响因子：
2
通讯作者：
Haghdani, Saeid
中科院分区：
文献类型：
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作者：
Alizadeh, Farshid;Taefnia, Ali Mohammad;Haghdani, Saeid
肾盂输尿管连接部梗阻（UPJO）是小儿肾积水最常见的原因。UPJO治疗的一个主要挑战是选择必须接受早期梗阻缓解的患者。目前，这种评估没有黄金标准。因此，本研究的目的是评估尿中碳水化合物抗原（CA）19-9和正常化CA 19-9的水平（Ca 19-9/Cr比值），并将其与对照组进行比较，以评估其作为UPJO患者诊断辅助工具的潜在临床应用。材料和方法从2013年1月至2016年6月，对照组（组1）30例有腹股沟疝、包皮环切术、鞘膜积液和隐睾病史的患儿，另组（组2）30例有单侧先天性UPJO病史的患儿。随机抽取对照组和确诊为先天性UPJO组患者术前（2A组）和术后6个月（2B组）的尿液标本，测定CA 199和肌酐。此外，随机尿CA 19-9/CR比值作为尿CA 19- 9正常化的指标。讨论UPJO组尿CA 19-9/Cr比值明显高于对照组。2A组尿CA 19-9也高于1组，但无统计学显著性。2B组梗阻完全解除后6个月尿CA 19-9/Cr比值及肾盂前后径较2A组术前明显减小。结论尿CA 19 9/Cr比值可作为UPJO患者诊断和长期随访的无创性指标。该比值上级于尿CA 19-9，因为它与UPJ梗阻的相关性更强。[图形]。
IntroductionUreteropelvic junction obstruction (UPJO) is the most common cause of hydronephrosis in children. One major challenge in the management of UPJO is to select the patients that must be subjected to early obstruction relief. Currently, there is no gold standard for this assessment. Therefore, the aim of the present study was to evaluate the urinary levels of carbohydrate antigen (CA) 19-9 and normalized CA 19-9 (Ca 19-9/Cr ratio) in UPJO patients before and after surgery and compare them with a control group to assess their potential clinical application as an assisting tool in diagnosis of UPJO patients.Material and methodsFrom Jan 2013 to Jun 2016, 30 children with history of inguinal hernia, circumcision, hydrocele, and undescended testis as the control group (group 1) and 30 children with unilateral congenital UPJO (group 2) were enrolled in the study. Random CA 199 and random creatinine were measured in the voided urine samples of control group and proven congenital UPJO group preoperatively (group 2A) and at 6 months after dismembered pyeloplasty (group 2B). In addition, the random urinary CA 19-9/CR ratio was evaluated as a marker to normalized urinary CA 19-9.DiscussionThe urinary CA 19-9/Cr ratio was significantly greater in the UPJO group than in the control group. The urinary CA 19-9 also was more in group 2A than in group 1; however, it was not statistically significant. The urinary CA 19-9/Cr ratio and renal pelvis anteroposterior diameter decreased significantly in the group 2B 6 month after complete relief of obstruction in comparison with group 2A preoperatively. Urinary CA 19-9 also decreased in 2B group though it was not significant.ConclusionUrinary CA 19-9/Cr ratio is suggested as a non-invasive marker that can assist in diagnosis and long-term follow-up of UPJO patients. This ratio is superior to urinary CA 19-9 as it is more strongly correlated with UPJ obstruction.[GRAPHICS].