Manohar Reddy Lingareddy1 , Mahesh Gajula2 , Adinatesh Katta Vishwanath3 , Shyam Prasad B. R.4
BACKGROUND Appendicitis is one of the common surgical emergencies worldwide affecting all age groups and sexes. Appendicitis is currently diagnosed based on symptoms and using imaging modalities. Biochemical investigations are not specific in diagnosis of acute appendicitis and complete blood cell counts may corroborate the diagnosis. The aim was to study the utility of serum CA-125 level in the diagnosis of acute appendicitis and to assess the value of CA-125 in predicting the severity/complications of acute appendicitis METHODS A prospective cross-sectional study was carried out in the Department of General Surgery in association with Department of Biochemistry, Government medical College and General Hospital from January 2018 to December 2019. 102 male subjects with acute appendicitis were included in the study. Age, socio economic status, presenting symptoms, leucocyte and CA 125 levels were recorded. Data obtained was tabulated in a pretested proforma and analysed using appropriate statistical methods. Test performance characteristics were summarized using hierarchical summary receiver operating characteristic (ROC) curves and bivariable random-effect models. RESULTS It is observed from the study that acute appendicitis is common in younger age group with mean+/- SD of 37.26 +/- 1.6 belonging to lower socio-economic status. Right iliac fossa pain was present in all cases. About 61.7% cases presented with strong right iliac fossa rebound tenderness. Leucocytosis was present in about 705 study subjects. ROC curve analysis showed that in the current study, CA-125 concentrations were significantly greater in patients with acute appendicitis than in the healthy subjects. In ROC curve analysis, the optimal cut-off value for the diagnosis of acute appendicitis was 10.4 U/mL, for which the sensitivity, specificity, PPV, and NPV were 82%, 60%, 88%, and 63%, respectively. CONCLUSIONS It can be stated that CA 125 blood level can be a new diagnostic acute-phase reactant that can be used in the diagnosis of acute appendicitis. Serum CA 125 could not differentiate between complicated and uncomplicated forms of acute appendicitis.
