title: Yield of esophagogastroduodenoscopy and colonoscopy in cancer of unknown primary.
abstract: OBJECTIVE
  Carcinoma of unknown primary origin (CUP) is heterogeneous group of cancers. Role of gastrointestinal (GI) endoscopy in this entity is under investigated. Aim of this study was to evaluate yield of Colonoscopy and Esophagogastroduodenoscopy (EGD) in localizing primary tumor in patients with CUP.
  
  
  METHODS
  Patients with histopathologically proven CUP who underwent colonoscopy / EGD to find the primary tumor from December 2009 to December 2011 were included in the study. Abdominal symptoms and cytokeratin (CK) 7 and 20 markers were correlated with presence of primary in GI tract.
  
  
  RESULTS
  After giving informed consent 86 patients were included in final analysis. All patients underwent colonoscopy while 60(70%) got EGD along with colonoscopy. Mean age was 55.10 +/-11.94 years with 52(60%) male. Abdominal symptoms were present in 50%. CK7+/CK20- in 34(40%); CK7-/CK20+ in 2(2%) while CK7+/20+ in 7(8%) of metastatic tumor samples. Liver was metastatic site in 47(55%), Lymph node 12(14%) and Ascites in 8(9%). Endoscopy detected primary in 6 (7%) patients with 3 each in stomach and colon. No association of abdominal symptoms and cytokeratin markers was found with presence of GI primary site.
  
  
  CONCLUSIONS
  Yield of localizing primary lesion in the GI tract by pan-endoscopy was limited. Abdominal symptoms and cytokeratin markers do not predict presence of gastrointestinal malignancies.
authors.affiliation: Muhammad Tayyab Usmani, Section of Gastroenterology, Department of Medicine, Aga Khan University Hospital, Stadium Road, PO Box # 74800, Karachi, Pakistan.
authors.forename: Muhammad Tayyab
authors.initials: MT
authors.lastname: Usmani
authors.affiliation: Abdullah Bin Khalid, Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Abdullah
authors.initials: A
authors.lastname: Bin Khalid
authors.affiliation: Syed Hasnain Ali Shah, Section of Gastroenterology, Department of Medicine, Aga Khan University Hospital, Stadium Road, PO Box # 74800, Karachi, Pakistan.
authors.forename: Syed Hasnain
authors.initials: SH
authors.lastname: Ali Shah
authors.affiliation: Tauseef Ahmad, Section of Gastroenterology, Department of Medicine, Aga Khan University Hospital, Stadium Road, PO Box # 74800, Karachi, Pakistan.
authors.forename: Tauseef
authors.initials: T
authors.lastname: Ahmad
authors.affiliation: Saeed S. Hamid, Section of Gastroenterology, Department of Medicine, Aga Khan University Hospital, Stadium Road, PO Box # 74800, Karachi, Pakistan.
authors.forename: Saeed
authors.initials: S
authors.lastname: S Hamid
authors.affiliation: Syed M. Wasim Jafri, Section of Gastroenterology, Department of Medicine, Aga Khan University Hospital, Stadium Road, PO Box # 74800, Karachi, Pakistan.
authors.forename: Syed M
authors.initials: SM
authors.lastname: Wasim Jafri
keywords: Cancer of unknown primary (CUP); Colonoscopy; Esophagogasrtoduodenoscopy (EGD)