title: Significance of serum and bile tumor markers in the diagnostic approach of patients with malignant pancreatobiliary disease.
abstract: OBJECTIVE
  Serum and bile tumor markers are under intense scrutiny for the diagnosis of malignant disease. The purpose of our study was to report the usefulness of serum and bile tumor markers for the discrimination between benign and malignant pancreatobiliary diseases.
  
  
  METHODS
  Between March 2010 and May 2013, 95 patients with obstructive jaundice or history of biliary obstruction, were included in the study. During ERCP, bile samples were obtained for measurement of tumor markers CEA, CA19- 9, CA125, CA72-4 and CA242. Serum samples were taken before ERCP for the same measurements. The patients were divided into two groups: patients with malignant disease and patients with benign disease.
  
  
  RESULTS
  Serum tumor marker levels were significantly higher in patients with malignant disease. Serum CA242 and CA19-9 exhibited the highest diagnostic accuracy (76.8% and 73.7%, respectively). CA125 and CA72-4 levels in bile samples were significantly higher in patients with malignant disease. Bile CA125, CEA and CA72-4 achieved the best diagnostic accuracy (69, 65 and 65), respectively). The combined detection of CA19-9, CA242 in serum and CA125, CA72-4 in bile along with total bilirubin levels, showed the best diagnostic accuracy (81%).
  
  
  CONCLUSIONS
  Serum and bile tumor markers, when studied alone, lack the diagnostic yield to discriminate benign from malignant pancreatobiliary diseases. In cases of diagnostic dilemmas the combination of serum and bile markers might be helpful.
authors.affiliation: 2nd Department of Surgery, Aretaieion Hospital, University of Athens, Athens, Greece.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Natsios
authors.forename: Antonios
authors.initials: A
authors.lastname: Vezakis
authors.forename: Georgios
authors.initials: G
authors.lastname: Kaparos
authors.forename: Georgios
authors.initials: G
authors.lastname: Fragulidis
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Karakostas
authors.forename: Evangelia
authors.initials: E
authors.lastname: Kouskouni
authors.forename: Emmanouil
authors.initials: E
authors.lastname: Logothetis
authors.forename: Andreas
authors.initials: A
authors.lastname: Polydorou
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001646:Bile / Q000737:chemistry*; D001661:Biliary Tract Neoplasms / Q000175:diagnosis*; D014408:Biomarkers, Tumor / Q000032:analysis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis*; D011446:Prospective Studies
chemical_list: D014408:Biomarkers, Tumor