فهرست مطالب moein moghadam ahmadi

Currently, patients diagnosed with gastric cancer typically undergo surgical or laparoscopic examination to assess the presence of metastasis.

This study involved 35 candidates for gastric adenocarcinoma surgery, consisting of 21 males and 14 females from medical centers in Rasht, Iran, in 2021. Patients reported initial complaints such as abdominal pain, nausea, weight loss, loss of appetite, and anemia. All data was analyzed using SPSS version 21.

Peritoneal lavage cytology results indicated 14 positive cases and 21 negative cases for peritoneal metastasis, while laparoscopic examination during surgery showed 12 positive cases and 23 negative cases. There was concordance between the two methods in 23 cases regarding the presence or absence of peritoneal metastasis, while 12 cases showed inconsistency. Specifically, five cases had negative peritoneal lavage cytology and positive laparoscopic examination, and seven had positive peritoneal lavage cytology and negative laparoscopic examination. Although peritoneal lavage cytology aligned with intraoperative findings regarding patient feasibility.

The study illustrated that solely on peritoneal lavage cytology results is not enough for determining peritoneal invasion in patients with gastric cancer.

Acute appendicitis is one of the most common emergencies of general surgery. Contrary to simple appendicitis, the complicated cases are associated with higher morbidity and mortality. Except for pathology, no accurate diagnostic test has been found to identify complicated cases. 

Here in, we aim to evaluate the serum C-Reactive Protein (CRP) level in both acute simple and complicated appendicitis. 

In this diagnostic accuracy study, 199 patients with acute appendicitis were enrolled. The serum CRP level was evaluated in patients. Post-operatively, the patients were divided into simple and complicated appendicitis based on histopathological examination. Eventually, analysis of the CRP level and type of appendicitis was performed. 

Fifty-three patients were categorized into complicated appendicitis and 146 patients into simple appendicitis. The median of CRP was significantly higher in the complicated group. Additionally, the optimal cutoff point was as follows: [65.0 (25.0) vs 25.0 (51.0); P-value< 0.001]. The optimal cutoff point for CRP was more than 42 with 81.1% sensitivity (95% CI: 68.0 to 90.6), and 67.8% specificity (95% CI: 59.6 to 75.3). The positive (PPV) and negative predictive values (NPV), based on the prevalence of complicated appendicitis (26.6%) for optimal cutoff point, were 47.8% (95% CI: 37.1 to 58.6) and 90.8% (95% CI: 83.8 to 95.5). 

Our study revealed that evaluation of serum CRP levels could be useful and beneficial in the diagnosis of acute complicated appendicitis.