论文部分内容阅读
AIM:The diagnosis of cholangiocarcinoma is often difficult,making management approaches problematic.A reliableserum marker for cholangiocarcinoma would be a usefuldiagnostic test.The aims of our study were to evaluate theusefulness of a serum CA19-9 determination in the diagnosisof cholangiocarcinoma.METHODS:We prospectively measured serum CA19-9 andCEA concentrations in patients with cholangiocarcinoma(n=35),benign biliary diseases (n=92),and healthyindividuals (n=15).Serum CA19-9 and CEA concentrationswere measured by an immunoradiometric assay withoutknowledge 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 cholangiocarcinomawere 77.14% and 68.57%,respectively.When comparedwith the benign biliary diseases group,the true negativerates of serum CA19-9 and CEA were 84.78% and 81.52%,respectively.The false positive rates of serum CA19-9 andCEA were 15.22% and 18.48%,whereas the accuracy ofserum CA19-9 and CEA were 82.68% and 77.95%,respectively.Serum CA19-9 and CEA concentrations weresignificantly elevated (P<0.001 and P<0.05) in patients withcholangiocarcinoma (290.31±5.34 KU·L~(-1) and 36.46±18.03μg·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 healthyindividuals (12.78±3.69 KU·L~(-1) and 11.48±3.37 μg·L~(-1)).In 15patients undergoing curative resection of cholangiocarcinoma,the mean serum CA19-9 concentration was decreased froma preoperative level of 286.41±4.36 KU·L~(-1) to a postoperativelevel of 62.01±17.43 KU·L~(-1) (P<0.001),and the mean serumCEA concentration from 39.41±24.35 μg·L~(1) to 28.69±11.03μg·L~(-1)(P<0.05).In patients with cholangiocarcinoma,however,no correlation was found between serum CEA andCA19-9 concentrations (r=0.036).CONCLUSION:These data suggest that the serum CA19-9determination is a useful addition to the available tests for thedifferential diagnosis of cholangiocarcinoma.Serum CA19-9 isan effective tumor marker in diagnosing cholangiocarcinoma,deciding whether the tumor has been radically resected andmonitoring effect of treatment.
AIM: The diagnosis of cholangiocarcinoma is often difficult, making management propositions problematic. A reliableserum marker for cholangiocarcinoma would be a useful diagostic 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 infants (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 cholangiocarcinomawere 77.14% and 68.57% respectively, the benign biliary diseases group, the true negatives 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%, while the accuracy of serum CA19-9 and CE The patients with Cholangiocarcinoma (290.31 ± 5.34 KU · L -1) and 36.46 ± 18.03 μg · L (P <0.001 and P <0.05) Compared with patients with benign biliary diseases (13.38 ± 2.59 KU · L -1 and 13.84 ± 3.85 μg · L -1) and healthy infdiiduals (12.78 ± 3.69 KU · L -1) 1) and 11.48 ± 3.37 μg · L -1). In 15patients undergoing curative resection of cholangiocarcinoma, the mean serum CA19-9 concentration was decreased froma 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 (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 CA19-9determination is a useful addition to the available tests for the differential diagnosis of cholangiocarcino ma.Serum CA19-9 isan effective tumor marker in diagnosed cholangiocarcinoma, deciding whether the tumor has been radically resected and monitoring effect of treatment.