Serif Yilmaz

Correlation of Tumour Markers in Ascitic Fluid and Serum: Are Measurements of Ascitic Tumour Markers a Futile Attempt?

Correlations between tumour markers in ascitic fluid and serum were investigated to determine whether ascitic fluid analysis had any diagnostic advantage over serum in 91 adults with ascites (55 malign; 36 benign). Serum and ascitic fluid were analysed for carcinoembryonic antigen (CEA), cancer antigen (CA) 125, CA19.9, CA72.4, CA15.3, α-fetoprotein (AFP) and cytokeratin-19 fragment (CYFRA). The tumour markers were skewed between the groups so were logarithmically transformed. Correlations between serum and ascitic fluid were tested using Pearsons correlation coefficient. Serum and ascitic fluid levels of CEA, CA125, CYFRA and AFP in the malign group were statistically different and CEA, CA19.9, CA5.3, CYFRA and AFP were statistically different in the benign group. For both groups, all tumour markers were highly correlated in serum and ascitic fluid, with the exception of CYFRA in the malign group. These results indicate that, where malignant ascites is suspected, analysing tumour markers in ascitic fluid does not have any advantage over serum analysis.

Upper Gastrointestınal Bleeding Caused by Small-Cell Lung Cancer: A Case Report

Lung cancer is one of the most common causes of death in the world. Although small-cell lung cancer (SCLC) comprises only 20%–25% of cases, it is an aggressive and fatal cancer that is usually not diagnosed until metastatic disease is already present (1). Distant metastasis from this cancer is usually recognized in the adrenal glands, bone, liver, brain, and kidneys but is uncommon in the digestive system. Duodenal metastasis is an extremely rare condition reported in the literature (2, 3). We report the case of a patient with SCLC who was suffering from hematemesis and melena reflecting upper gastrointestinal bleeding.

Adult Nephrotic Syndrome with Spontaneous Bacterial Peritonitis

The association of spontaneous bacterial peritonitis with nephrotic syndrome is common in children, but it is extremely rare in adults. Only 14 cases have been reported in the literature. We report two adult cases who developed spontaneous bacterial peritonitis during a course of nephrotic syndrome, and describe the clinical and laboratory findings. Both patients had renal failure at admission and had a diagnosis of nephrotic syndrome due to amyloidosis before the development of peritonitis. The causative agent could not be isolated from ascitic fluid culture in either patient.