In-Vitro Investigation of the Effect of Anti-Inflammatory and Analgesics on Measurement of Tumor Markers

Abstract

It has been shown that some drugs used for parenteral affect biochemical measurements. Anti-inflammatory and analgesic drugs may also have the potential to affect measurement methods. To investigate the effects of seven different anti-inflammatory and analgesic pharmacological agents commonly used in wards and intensive care units on thyroglobulin, CA125, CA15-3, CA19-9, CEA, PSA and total HCG tests measured by immunoassay technique. The study was performed using by hormone control material (BioRad Lyphocheck Immunoassay Plus Control) in the PETINIA immunoassay method (Siemens, Atellica, USA). 20 µL of Tenoxicam, Dexamethasone, methylprednisolone, paracetamol, diclofenac sodium, dexketoprofen, metamizole sodium were added into 180 µL of the control solution respectively. After vortexing the sample, it was incubated for 20 minutes at room temperature. Thyroglobulin, CA125, CA15-3, CA19-9, CEA, total PSA and total HCG tests were studied from the control sample. The study was re-performed by adding 20 µL of distilled water. The measurements were repeated 3 times and the mean values were recorded. Percentage deviation rates from the target value were calculated. Metamizole sodium led to negative interference in the CA 19-9, total HCG, CA 125, CEA, total PSA and CA15-3 at rate of -42.1%, -24.62%, -24.34%, -23.66%, -14.33%, -13.91%, respectively. With the administration of metamizole sodium, the only positive interference was determined at rate of 6.02% in thyroglobulin. Paracetamol-induced, the maximum deviation was calculated at the rate of -26.41% in CA 19-9. CA 19-9 deviated -12.22% from diclofenac sodium and -22.41% from dexketoprofen. With methylprednisolone administration, positive interference was detected at a rate of 14.46% in thyroglobulin and negative interference at a rate of -12% in total PSA. The highest deviation due to dexketoprofen was seen in CA 19-9 at rate of -22.41%. This study demonstrated the potential of anti-inflammatory, analgesic, and antipyretic agents to affect tumor marker measurements. Especially in the follow-up of cancer patients, anti-inflammatory interference may increase the likelihood of malpractice by causing erroneous clinical evaluations.