Diagnostic role of serum CA 19-9 for cholangiocarcinoma in patients with primary sclerosing cholangitis.
Primary sclerosing cholangitis (PSC) predisposes to the development of cholangiocarcinoma, a usually fatal complication that is difficult to diagnose. Serum concentrations of CA 19-9, a tumor-associated antigen, are frequently increased in patients with only cholangiocarcinoma. The aim of this study was to assess the value of an increased serum CA 19-9 level for the diagnosis of cholangiocarcinoma in patients with preexisting PSC. We analyzed serum samples from 9 patients with PSC and superimposed cholangiocarcinoma and from 28 patients with only PSC. Serum concentrations of CA 19-9 were measured in a blinded manner with use of an immunoradiometric assay. The serum CA 19-9 concentrations were increased in 8 of 9 patients (89%) with PSC and cholangiocarcinoma (mean +/- SE, 391 +/- 86 U/ml; range, 4 to 677), whereas they were increased in only 4 of 28 patients (14%) with only PSC (mean +/- SE, 61 +/- 16 U/ml; range, 2 to 370). The sensitivity of a CA 19-9 value greater than 100 U/ml for cholangiocarcinoma in PSC was 89%, and the specificity was 86%. The measurement of serum concentrations of CA 19-9 is a promising test for detecting cholangiocarcinoma in patients with PSC.
Division of Gastroenterology and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905.
J C
JC
Nichols
G J
GJ
Gores
N F
NF
LaRusso
R H
RH
Wiesner
D M
DM
Nagorney
R E
RE
Ritts
D002759:Adenoma, Bile Duct / Q000097:blood / Q000175:diagnosis* / Q000209:etiology*; D000328:Adult; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000097:blood*; D001650:Bile Duct Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000209:etiology*; D002272:Carcinoembryonic Antigen / Q000097:blood; D015209:Cholangitis, Sclerosing / Q000097:blood / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity
D015295:Antigens, Tumor-Associated, Carbohydrate; D002272:Carcinoembryonic Antigen