Bile levels of carcino-embryonic antigen in patients with hepatopancreatobiliary disease.
OBJECTIVE
To evaluate the value of biliary carcino-embryonic antigen (CEA) in the differential diagnosis of malignant and benign hepatopancreatobiliary disease.


METHODS
One hundred patients were prospectively studied. Benign diseases were present in 39% of the patients while 61% had malignant diseases.


METHODS
Samples of serum were taken from all patients just before endoscopic retrograde cholangiopancreatography (ERCP) and samples of biliary CEA were obtained during ERCP.


RESULTS
The sensitivity of serum CEA and carbohydrate antigen 19-9 (CA 19-9) in detecting malignancy were 50% and 92%, respectively, while the respective specificities were 95% and 72%. The mean biliary CEA level of the benign group was significantly different from that of the malignant group (35.7 +/- 8.7 ng/ml vs 268 +/- 85.5 ng/ml), but there was considerable overlap between the two groups. With a cut-off level of 20 ng/ml, the sensitivity and specificity were 84% and 64% respectively. The mean bilirubinaemia value was significantly higher in malignant disease than in benign disease (57.4 +/- 13.9 mumol/l vs 235 +/- 19.8 mumol/l). Multidimensional analysis indicated that only bilirubinaemia (P < 109-3)) was independently predictive of malignant disease.


CONCLUSIONS
Biliary CEA assessment seems useless in distinguished between benign and malignant causes of cholestasis.
Buffet
C
C
Service des Maladies du Foie et de l'Appareil digestif, Hopital Bicêtre, Le Kremlin-Bicêtre, France.
Fourré
C
C
Altman
C
C
Prat
F
F
Fritsch
J
J
Choury
A
A
Briantais
M J
MJ
Desgrez
A
A
Etienne
J P
JP
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001646:Bile / Q000737:chemistry*; D001660:Biliary Tract Diseases / Q000175:diagnosis*; D001661:Biliary Tract Neoplasms / Q000175:diagnosis; D014408:Biomarkers, Tumor / Q000032:analysis*; D018395:CA-19-9 Antigen / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000032:analysis* / Q000097:blood; D002779:Cholestasis / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis*; D008113:Liver Neoplasms / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000175:diagnosis*; D010190:Pancreatic Neoplasms / Q000175:diagnosis; D011446:Prospective Studies; D012680:Sensitivity and Specificity
D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen