title: The Role of Biliary Carcinoembryonic Antigen-Related Cellular Adhesion Molecule 6 (CEACAM6) as a Biomarker in Cholangiocarcinoma.
abstract: OBJECTIVE
  The aim of the present study is to determine if CEACAM6 can be detected in the bile of patients with biliary cancer and can serve as a diagnostic biomarker for cholangiocarcinoma.
  
  
  BACKGROUND
  Distinguishing bile duct carcinoma from other diagnoses is often difficult using endoscopic or percutaneous techniques. The cell surface protein CEACAM6 is over-expressed in many gastrointestinal cancers and may be selectively elevated in biliary adenocarcinoma.
  
  
  METHODS
  Bile from patients with benign biliary disease and cholangiocarcinoma (hilar, intrahepatic and distal) was collected at the time of index operation. The concentration of CEACAM6 was quantified by sandwich enzyme-linked immunosorbent assay (ELISA) and correlated to pathologic diagnosis. Diagnostic capability of CEACAM6 was evaluated by Wilcoxon rank-sum, linear regression, multiple regression, and receiver operating characteristic (ROC) curve analysis.
  
  
  RESULTS
  Bile from 83 patients was analyzed: 42 with benign disease and 41 with cholangiocarcinoma. Patients in the benign cohort were younger, predominantly female, and had lower median biliary CEACAM6 levels than patients in the malignant cohort (7.5 ng/ml vs. 40 ng/ml; p = <.001). ROC curve analysis determined CEACAM6 to be a positive predictor cholangiocarcinoma with a CEACAM6 level >14 ng/ml associated with 87.5% sensitivity, 69.1% specificity, and a likelihood ratio of 2.8 (AUC 0.74). Multiple regression analysis suggested elevated alkaline phosphatase and the presence of biliary endoprostheses may influence CEACAM6 levels.
  
  
  CONCLUSIONS
  Biliary CEACAM6 can identify patients with extrahepatic cholangiocarcinoma with a high degree of sensitivity and should be investigated further as a potential screening tool.
authors.affiliation: Section of General, Thoracic and Vascular Surgery, Department of Surgery, Virginia Mason Medical Center, Seattle, Washington, United States of America.|Benaroya Research Institute, Seattle, Washington, United States of America.
authors.forename: J Bart
authors.initials: JB
authors.lastname: Rose
authors.affiliation: Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York, United States of America.
authors.forename: Camilo
authors.initials: C
authors.lastname: Correa-Gallego
authors.affiliation: Benaroya Research Institute, Seattle, Washington, United States of America.
authors.forename: Yu
authors.initials: Y
authors.lastname: Li
authors.affiliation: Benaroya Research Institute, Seattle, Washington, United States of America.
authors.forename: James
authors.initials: J
authors.lastname: Nelson
authors.affiliation: Section of General, Thoracic and Vascular Surgery, Department of Surgery, Virginia Mason Medical Center, Seattle, Washington, United States of America.
authors.forename: Adnan
authors.initials: A
authors.lastname: Alseidi
authors.affiliation: Section of General, Thoracic and Vascular Surgery, Department of Surgery, Virginia Mason Medical Center, Seattle, Washington, United States of America.
authors.forename: W Scott
authors.initials: WS
authors.lastname: Helton
authors.affiliation: Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York, United States of America.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Allen
authors.affiliation: Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York, United States of America.
authors.forename: Michael I
authors.initials: MI
authors.lastname: D'Angelica
authors.affiliation: Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York, United States of America.
authors.forename: Ronald P
authors.initials: RP
authors.lastname: DeMatteo
authors.affiliation: Department of Surgery, City of Hope Cancer Center, Duarte, California, United States of America.
authors.forename: Yuman
authors.initials: Y
authors.lastname: Fong
authors.affiliation: Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York, United States of America.
authors.forename: T Peter
authors.initials: TP
authors.lastname: Kingham
authors.affiliation: Section of General, Thoracic and Vascular Surgery, Department of Surgery, Virginia Mason Medical Center, Seattle, Washington, United States of America.|Benaroya Research Institute, Seattle, Washington, United States of America.
authors.forename: Kris V
authors.initials: KV
authors.lastname: Kowdley
authors.affiliation: Hepatopancreatobiliary Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York, United States of America.
authors.forename: William R
authors.initials: WR
authors.lastname: Jarnagin
authors.affiliation: Section of General, Thoracic and Vascular Surgery, Department of Surgery, Virginia Mason Medical Center, Seattle, Washington, United States of America.
authors.forename: Flavio G
authors.initials: FG
authors.lastname: Rocha
mesh_terms: D000328:Adult; D000368:Aged; D015703:Antigens, CD / Q000378:metabolism*; D001646:Bile / Q000378:metabolism*; D001650:Bile Duct Neoplasms / Q000378:metabolism* / Q000473:pathology; D014408:Biomarkers, Tumor / Q000378:metabolism*; D015815:Cell Adhesion Molecules / Q000378:metabolism*; D018281:Cholangiocarcinoma / Q000378:metabolism* / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D058851:GPI-Linked Proteins / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000378:metabolism*
chemical_list: D015703:Antigens, CD; D014408:Biomarkers, Tumor; C504117:CEACAM6 protein, human; D015815:Cell Adhesion Molecules; D058851:GPI-Linked Proteins; D009363:Neoplasm Proteins