摘要
AIM:The diagnosis of cholangiocarcinoma is often difficult,making management approaches problematic. A reliable serum marker for cholangiocarcinoma would be a useful diagnostic test. The aims of our study were to evaluate the usefulness of a serum CA19-9 determination in the diagnosis of cholangiocarcinoma.METHODS: We prospectively measured serum CA19-9 and CEA concentrations in patients with cholangiocarcinoma (n=35), benign biliary diseases (n=92), and healthy individuals (n=15). Serum CA19-9 and CEA concentrations were measured by an immunoradiometric assay without knowledge of the clinical diagnosis.RESULTS:The sensitivity of a CA19-9 value>37KU·L^-1 and a CEA value >22μg·L^-1 in diagnosing cholangiocarcinoma were 77.14% and 68.57%, respectively. When compared with the benign biliary diseases group,the true negative rates of serum CA19-9 and CEA were 84.78% and 81.52%,respectively. The false positive rates of serum CA19-9 and CEA were 15.22% and 18.48%, whereas the accuracy of serum CA19-9 and CEA were 82.68% and 77.95%,respectively. Serum CA19-9 and CEA concentrations were significantly elevated (P<0.001 and P<0.05) in patients with cholangiocarcinoma (290.31±5.34KU·L^-1 and 36.46±18.03μg·L^-1) compared with patients with benign biliary diseases (13.38±2.59KU·L^-1 and 13.84±3.85μg·L^-1) and healthy individuals (12.78±3.69KU·L^-1 and 11.48±3.37μg·L^-1). In 15 patients undergoing curative resection of cholangiocarcinoma,the mean serum CA19-9 concentration was decreased from a preoperative level of 286.41±4.36KU·L^-1 to a postoperative level of 62.01±17.43KU·L^-1 (P<0.001), and the mean serum CEA concentration from 39.41±24.35μg·L^-1 to 28.69±11.03μg·L6-1(P<0.05). In patients with cholangiocarcinoma,however, no correlation was found between serum CEA and CA19-9 concentrations (r=-0.036).CONCLUSION:These data suggest that the serum CA19-9 determination is a useful addition to the available tests for the differential diagnosis of cholangiocarcinoma. Serum CA19-9 is an effective tumor marker in diagnosing cholangiocarcinoma,deciding whether the tumor has been radically resected and monitoring effect of treatment.
AIM:The diagnosis of cholangiocarcinoma is often difficult, making management approaches problematic.A reliable serum marker for cholangiocarcinoma would be a useful diagnostic test.The aims of our study were to evaluate the usefulness of a serum CA19-9 determination in the diagnosis of cholangiocarcinoma. METHODS:We prospectively measured serum CA19-9 and CEA concentrations in patients with cholangiocarcinoma (n=35),benign biliary diseases (n=92),and healthy individuals (n=15).Serum CA19-9 and CEA concentrations were measured by an immunoradiometric assay without knowledge of the clinical diagnosis. RESULTS:The sensitivity of a CA19-9 value >37 KU·L^(-1) and a CEA value >22 μg·L^(-1) in diagnosing cholangiocarcinoma were 77.14% and 68.57%,respectively.When compared with the benign biliary diseases group,the true negative rates of serum CA19-9 and CEA were 84.78% and 81.52%, respectively.The false positive rates of serum CA19-9 and CEA were 15.22% and 18.48%,whereas the accuracy of serum CA19-9 and CEA were 82.68% and 77.95%, respectively.Serum CA19-9 and CEA concentrations were significantly elevated (P<0.001 and P<0.05) in patients with cholangiocarcinoma (290.31±5.34 KU·L^(-1) and 36.46±18.03 μg·L^(-1)) compared with patients with benign biliary diseases (13.38±2.59 KU·L^(-1) and 13.84±3.85 μg·L^(-1)) and healthy individuals (12.78±3.69 KU·L^(-1) and 11.48±3.37 μg·L^(-1)).In 15 patients undergoing curative resection of cholangiocarcinoma, the mean serum CA19-9 concentration was decreased from a preoperative level of 286.41±4.36 KU·L^(-1) to a postoperative level of 62.01±17.43 KU·L^(-1) (P<0.001),and the mean serum CEA concentration from 39.41±24.35 μg·L^(1) to 28.69±11.03 μg·L^(-1)(P<0.05).In patients with cholangiocarcinoma, however,no correlation was found between serum CEA and CA19-9 concentrations (r=0.036). CONCLUSION:These data suggest that the serum CA19-9 determination is a useful addition to the available tests for the differential diagnosis of cholangiocarcinoma.Serum CA19-9 is an effective tumor marker in diagnosing cholangiocarcinoma, deciding whether the tumor has been radically resected and monitoring effect of treatment.
