Granulomatosis with polyangiitis mimicking cancer: a diagnostic dilemma

Řezáč, Jakub; Honsová, Eva; Mašek, Martin; Ryšavá, R; Neprašová, Michaela; Jančová, Eva; Hrušková, Zdenka; Tesař, Vladimı́r

doi:10.1007/s40620-021-01128-5

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“…when the disease is active and untreated) [ 26 , 27 ], (ii) some AIDs (e.g. sarcoidosis, or granulomatosis with polyangiitis) can mimic tumors [ 27 , 28 ], (iii) some AIDs (e.g. myositis) are associated with an elevated risk of cancer, and (iv) some cancers have autoimmune manifestations [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Relevance of blood tumor markers in inpatients with significant involuntary weight loss and elevated levels of inflammation biomarkers

Gronnier,

Hedhli,

Sauzay

et al. 2024

BMC Cancer

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Purpose To assess the diagnostic performance of a panel of standard tumor markers (TMs) in patients hospitalized with significant involuntary weight loss (IWL) and elevated levels of inflammation biomarkers, and a combination of the TM panel and the finding of the computed tomography (CT) scan. Methods We conducted a retrospective study in the internal medicine department at Amiens-Picardie University Medical Center (Amiens, France) between January 1st, 2015, and November 1st, 2021. The inclusion criteria were age 18 or over, significant IWL (≥ 5 kg over 6 months), elevated inflammation biomarkers (e.g. C-reactive protein), and assay data on two or more standard TMs (carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19 − 9, CA 15 − 3, CA 125, neuron-specific enolase (NSE), alpha-fetoprotein (AFP), calcitonin, and prostate-specific antigen (PSA)). The result of each TM assay was interpreted qualitatively (as positive or negative), according to our central laboratory’s usual thresholds. Results Cancer was diagnosed in 50 (37.0%) of the 135 patients included. Positivity for one or more TMs had a positive predictive value (PPV) of 0.55 [0.43–0.66], and a negative predictive value (NPV) of 0.84 [0.75–0.93] for cancer diagnosis. When combined with the presence of suspicious CT findings (e.g. a mass, enlarged lymph nodes and/or effusion), positivity for one or more TMs had a PPV of 0.92 [0.08–0.30]. In the absence of suspicious CT findings, a fully negative TM panel had an NPV of 0.96 [0.89-1.00]. Conclusion A negative TM panel argues against the presence of a cancer, especially in the absence of suspicious CT findings.

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