Evaluation of tumor marker test requests in a hospital setting

Katar, Muzaffer

doi:10.14744/ijmb.2020.46220

Evaluation of tumor marker test requests in a hospital setting

Muzaffer KATAR (Tokat Gaziosmanpaşa Üniversitesi, Tıp Fakültesi, Tıbbi Biyokimya Anabilim Dalı, Tokat, Türkiye)

International Journal of Medical Biochemistry

1 0

Yıl: 2021 Cilt: 4 Sayı: 1 Sayfa Aralığı: 8 - 13 Metin Dili: İngilizce DOI: 10.14744/ijmb.2020.46220 İndeks Tarihi: 05-06-2021

Evaluation of tumor marker test requests in a hospital setting

Öz:

Objectives: Early diagnosis and treatment of oncological disease is extremely important and tumor marker tests area valuable tool; however, requests for testing should not be used in excess or without sufficient cause. The aim of thisstudy was to analyze and evaluate the appropriateness of requests for tumor marker tests at a single hospital.Methods: Tumor marker tests for carcinoembryonic antigen (CEA), cancer antigen (CA) 15-3, CA 19-9, and CA 125 performed by a single biochemistry laboratory between January 1, 2018 and December 31, 2019 were assessed retrospectively. These tumor markers can be used for screening, diagnostic confirmation, estimating prognosis, and monitoringfor recurrence. The departments of internal medicine, gastroenterology, endocrine diseases, chest diseases, generalsurgery, gynecology and obstetrics, and medical oncology were the most common sources of the requests.Results: There were 1420 (40%) requests for CEA, 671 (19%) for CA15-3, 868 (25%) for CA 19-9, and 585 (16%) for CA125 during the study period. A significant difference based on gender was determined in requests for CEA and CA 125(p<0.001 and p=0.033, respectively). In all, 312 (22%) of requests for CEA markers, 202 (30.1%) for CA 15-3, 204 (23.5%)for CA 19-9, and 113 (19.3%) for CA 125 requests were above the reference range. Significant positive correlations weredetermined between age and CEA, CA 15-3, and CA 19-9 tumor markers (r=0.262, p<0.001; r=0.096, p=0.013; r=0.090,p=0.008, respectively). The preliminary diagnoses supporting the requests included non-specific pain, acute vaginitis,anemia, anxiety disorder, dyspepsia, neoplasia, and thyroid disorder.Conclusion: The results of this study suggest that outpatient clinics made an excessive number of tumor markerrequests inconsistent with the preliminary diagnosis. Overutilization of laboratory testing incurs significant costsand affects workload, and may also have other potentially adverse effects on patient care.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Kwok J, Jones B. Unnecessary repeat requesting of tests: an audit in a government hospital immunology laboratory. J Clin Pathol 2005;58(5):457−62. [CrossRef]
2. van Walraven C, Raymond M. Population-based study of repeat laboratory testing. Clin Chem 2003;49(12):1997−2005.
3. Bennett A, Garcia E, Schulze M, Bailey M, Doyle K, Finn W, et al. Building a laboratory workforce to meet the future: ASCP Task Force on the Laboratory Professionals Workforce. Am J Clin Pathol 2014;141(2):154−67. [CrossRef]
4. Blanckaert N. Clinical pathology services: remapping our strategic itinerary. Clin Chem Lab Med 2010;48(7):919−25. [CrossRef]
5. Wolfe A. Institute of Medicine Report: crossing the quality chasm: a new health care system for the 21st century. Policy, Politics, & Nursing Practice 2001;2(3):233−5. [CrossRef]
6. Sturgeon C. Practice guidelines for tumor marker use in the clinic. Clin Chem 2002;48(8):1151−9. [CrossRef]
7. Hayes DF, Bast RC, Desch CE, Fritsche H Jr, Kemeny NE, Jessup JM, et al. Tumor marker utility grading system: a framework to evaluate clinical utility of tumor markers. J Natl Cancer Inst 1996;88(20):1456−66. [CrossRef]
8. Duffy MJ. Evidence for the clinical use of tumour markers. Ann Clin Biochem 2004 ;41(Pt 5):370−7. [CrossRef]
9. Hayes DF. Prognostic and predictive factors for breast cancer: translating technology to oncology. J Clin Oncol 2005;23(8):1596−7. [CrossRef]
10. American College of Obstetricians anf Gynecologists. ACOG Committee Opinion: number 280, December 2002. The role of the generalist obstetrician-gynecologist in the early detection of ovarian cancer. Obstet Gynecol 2002;100(6):1413−6. [CrossRef]
11. Amin MB, Edge S, Greene F , Byrd DR, Brookland RK, Washington MK, et al. American Joint Committee on Cancer. AJCC cancer staging manual. 6th edition. New York: Springer- Verlag; 2009. p. 128−30.
12. Gold P, Krupey J, Ansari H. Position of the carcinoembryonic antigen of the human digestive system in ultrastructure of tumor cell surface. J Natl Cancer Inst 1970;45(2):219−25.
13. Bast RC Jr, Ravdin P, Hayes DF, Bates S, Fritsche H Jr, Jessup JM, et al; American Society of Clinical Oncology Tumor Markers Expert Panel. 2000 update of recommendations for the use of tumor markers in breast and colorectal cancer: clinical practice guidelines of the American Society of Clinical Oncology. J Clin Oncol 2001;19(6):1865−78. [CrossRef]
14. Gilligan TD, Seidenfeld J, Basch EM, Einhorn LH, Fancher T, Smith DC, et al ; American Society of Clinical Oncology. American Society of Clinical Oncology Clinical Practice Guideline on uses of serum tumor markers in adult males with germ cell tumors. J Clin Oncol 2010;28(20):3388−404. [CrossRef]
15. Khatcheressian JL, Wolff AC, Smith TJ, Grunfeld E, Muss HB, Vogel VG, et al; American Society of Clinical Oncology. American Society of Clinical Oncology 2006 update of the breast cancer follow-up and management guidelines in the adjuvant setting. J Clin Oncol 2006;24(31):5091−7. [CrossRef]
16. van Walraven C, Naylor CD. Do we know what inappropriate laboratory utilization is? A systematic review of laboratory clinical audits. JAMA 1998;280(6):550−8. [CrossRef]
17. McPherson RA, Pincus M . Diagnosis and management of cancer using serologic tumor markers. Henry's Clinical Diagnosis and Management by Laboratory Methods. 19th ed. USA: Saunders; 2001.
18. Saatlı B, Janbakhisov T, Emekçi Ö, Çağlıyan E, Saygılı U. Peritoneal Karsinomatoza Bulgusu Olmayan Çok Yüksek Serum CA 125 Değeri Olan Adneksiyal Kitlelerin Klinikopatolojik Değerlendirilmesi. J DEU Med 2013;27(1):33−8.
19. Bast RC Jr, Feeney M, Lazarus H, Nadler LM, Colvin RB, Knapp RC. Reactivity of a monoclonal antibody with human ovarian carcinoma. J Clin Invest 1981;68(5):1331−7. [CrossRef]
20. Van Gorp T, Veldman J, Van Calster B, Cadron I, Leunen K, Amant F, Timmerman D, Vergote I. Subjective assessment by ultrasound is superior to the risk of malignancy index (RMI) or the risk of ovarian malignancy algorithm (ROMA) in discriminating benign from malignant adnexal masses. Eur J Cancer 2012;48(11):1649−56. [CrossRef]
21. Şahin Y, Ayata D, Muhtaroğlu S, Ökten S. Pelvik Kitlelerde Preoperatif Serum CA 125 Değerleri. J Clin Obstet Gynecol 1993;3(3):225−28.
22. Yetimalar H, Köksal A, Uğur H, Zeteroğlu Ü. Transvaginal Ultrasonografi İle Adneks Kitlelerinin Benign-Malign Ayrımının Yapılması. J Clin Obstet Gynecol 2001;11(3):174−9. 23. Wang Y, Yan W, Wu Q, Chen G, Zhang J. The implication of tumor biomarker CA19-9 in the diagnosis of intracranial epidermoid cyst. Oncotarget 2017;8(2):2164−70. [CrossRef]
24. Liu F, Kong X, Dou Q, Ye J, Xu D, Shang H, et al. Evaluation of tumor markers for the differential diagnosis of benign and malignant ascites. Ann Hepatol 2014;13(3):357−63. [CrossRef]
25. Acharya A, Markar SR, Matar M, Ni M, Hanna GB. Use of Tumor Markers in Gastrointestinal Cancers: Surgeon Perceptions and Cost-Benefit Trade-Off Analysis. Ann Surg Oncol 2017;24(5):1165−73. [CrossRef]
26. Ma L, Xie XW, Wang HY, Ma LY, Wen ZG. Clinical Evaluation of Tumor Markers for Diagnosis in Patients with Non-small Cell Lung Cancer in China. Asian Pac J Cancer Prev 2015;16(12):4891−4.
27. Eisenberg JM. Doctors' decisions and the cost of medical care: the reasons for doctors' practice patterns and ways to change them. 1st ed. USA: Health Administration Pr; 1986.

APA	Katar M (2021). Evaluation of tumor marker test requests in a hospital setting. , 8 - 13. 10.14744/ijmb.2020.46220
Chicago	Katar Muzaffer Evaluation of tumor marker test requests in a hospital setting. (2021): 8 - 13. 10.14744/ijmb.2020.46220
MLA	Katar Muzaffer Evaluation of tumor marker test requests in a hospital setting. , 2021, ss.8 - 13. 10.14744/ijmb.2020.46220
AMA	Katar M Evaluation of tumor marker test requests in a hospital setting. . 2021; 8 - 13. 10.14744/ijmb.2020.46220
Vancouver	Katar M Evaluation of tumor marker test requests in a hospital setting. . 2021; 8 - 13. 10.14744/ijmb.2020.46220
IEEE	Katar M "Evaluation of tumor marker test requests in a hospital setting." , ss.8 - 13, 2021. 10.14744/ijmb.2020.46220
ISNAD	Katar, Muzaffer. "Evaluation of tumor marker test requests in a hospital setting". (2021), 8-13. https://doi.org/10.14744/ijmb.2020.46220

APA	Katar M (2021). Evaluation of tumor marker test requests in a hospital setting. International Journal of Medical Biochemistry, 4(1), 8 - 13. 10.14744/ijmb.2020.46220
Chicago	Katar Muzaffer Evaluation of tumor marker test requests in a hospital setting. International Journal of Medical Biochemistry 4, no.1 (2021): 8 - 13. 10.14744/ijmb.2020.46220
MLA	Katar Muzaffer Evaluation of tumor marker test requests in a hospital setting. International Journal of Medical Biochemistry, vol.4, no.1, 2021, ss.8 - 13. 10.14744/ijmb.2020.46220
AMA	Katar M Evaluation of tumor marker test requests in a hospital setting. International Journal of Medical Biochemistry. 2021; 4(1): 8 - 13. 10.14744/ijmb.2020.46220
Vancouver	Katar M Evaluation of tumor marker test requests in a hospital setting. International Journal of Medical Biochemistry. 2021; 4(1): 8 - 13. 10.14744/ijmb.2020.46220
IEEE	Katar M "Evaluation of tumor marker test requests in a hospital setting." International Journal of Medical Biochemistry, 4, ss.8 - 13, 2021. 10.14744/ijmb.2020.46220
ISNAD	Katar, Muzaffer. "Evaluation of tumor marker test requests in a hospital setting". International Journal of Medical Biochemistry 4/1 (2021), 8-13. https://doi.org/10.14744/ijmb.2020.46220