EXPLORE ON DIAGNOSTIC AND PROGNOSTIC VALUES OF EXTRAHEPATIC CHOLANGIOCA RCINOMA: UTILITY OF SERUM CA19-9 AND SERUM CEA

摘要

Objective To evaluate th e validity of a serum carbohydrate antigen 19-9(CA19-9) determination in the dia gnosis of extrahepatic cholangiocarcinoma(EHCC). Methods Serum CA19-9 concentration and serum carcinoembryonic antigen(CEA) concentration wer e prospectively measured by an immunoradiometric assay without knowledge of the clinical diagnosis in patients with EHCC (n=51), benign biliary diseases ( n=42), and healthy individuals (n=15). Using a receiver operating characte ristic (ROC) curve define a new strategy for interpreting CA19-9 and CEA in EHC C. Results The sensitivity of CA19-9 and CEA in diagnosing E HCC were 86.3% (44/51) and 25.5%(13/51), respectively. When compared with the be nign biliary diseases group, the true negative rates of serum CA19-9 and serum CEA were 85.7% (36/42) and 95.2%(40/42), respectively. The false positive rates of serum CA19-9 and serum CEA were 14.3 %( 6/42) and 4.8 %( 2/42), whereas the accuracy of serum CA19-9 and serum CEA were 57.0%(53/93) and 86.0%(80/93), resp ectively. Serum CA19-9 concentration and serum CEA concentration were significa ntly elevated (P05), respectively. In 22 patients undergoing curative resection of EHCC, the mean serum CA19-9 concentration decreased from preoperative level of (456.6±1 20.4) kU·L -1 to postoperative level (62.8±17.3) kU·L -1(P< 0. 001). The outcomes showed that serum CA19-9 had greater diagnosis performance s than serum CEA. Conclusion Serum CA19-9 is an effective tum or marker in diagnosing of cholangiocarcinoma, deciding whether the tumor has be en radically resected and monitoring effect of