title: Carcinoembryonic Antigen Level in Primary Sclerosing Cholangitis Is Not Influenced by Dominant Strictures or Bacterial Cholangitis.
abstract: Carcinoembryonic antigen (CEA) can be used to screen for biliary tract cancer in patients with primary sclerosing cholangitis (PSC).
  
  
  
  To study the influence of benign dominant strictures (DS), superimposed bacterial cholangitis (SBC), smoking status, and inflammatory bowel disease on CEA serum levels.
  
  
  
  A retrospective analysis of CEA values in cancer-free PSC patients was performed. We included the maximal CEA value obtained during follow-up and information on the presence of DS and SBC at that time, and we analyzed the CEA values in the presence and absence of DS and SBC. Results are reported as medians with the interquartile range (IQR).
  
  
  
  The median maximal CEA level, which was 1.8 ng/mL (IQR 1.2-2.9) in the final 270 PSC patients included in the study, was not influenced by the presence of either DS or SBC (P = 0.320). Moreover, in 49 patients, the first CEA value available at the time of DS (1.5 ng/mL; IQR 1.2-2.1) and that at a time without DS (1.6 ng/mL; IQR 1.1-2.3) did not differ significantly (P = 0.397). Lastly, in 24 patients, the median CEA values at a time without SBC (1.8 ng/mL; IQR 1.2-2.5) and at the time of SBC (1.8 ng/mL; IQR 1.0-3.0) were comparable (P = 0.305). Smoking did not influence CEA-based cancer screening.
  
  
  
  Serum CEA level is not influenced by the presence of DS or SBC and might therefore serve as a favorable parameter for improving cancer screening in PSC patients.
authors.affiliation: Department of Internal Medicine IV, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany. Andreas_Wannhoff@med.uni-heidelberg.de.
authors.forename: Andreas
authors.initials: A
authors.lastname: Wannhoff
authors.affiliation: Department of Internal Medicine IV, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Rupp
authors.affiliation: Department of Internal Medicine IV, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.
authors.forename: Kilian
authors.initials: K
authors.lastname: Friedrich
authors.affiliation: Department of Internal Medicine IV, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.
authors.forename: Johannes
authors.initials: J
authors.lastname: Knierim
authors.affiliation: Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany.|Liver Cancer Center Heidelberg, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Christa
authors.initials: C
authors.lastname: Flechtenmacher
authors.affiliation: Department of Internal Medicine IV, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.|Liver Cancer Center Heidelberg, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Karl Heinz
authors.initials: KH
authors.lastname: Weiss
authors.affiliation: Department of Internal Medicine IV, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.|Liver Cancer Center Heidelberg, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Stremmel
authors.affiliation: Department of Internal Medicine IV, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany.|Liver Cancer Center Heidelberg, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Daniel N
authors.initials: DN
authors.lastname: Gotthardt
mesh_terms: D000328:Adult; D001424:Bacterial Infections / Q000097:blood*; D001649:Bile Duct Diseases / Q000097:blood*; D001650:Bile Duct Neoplasms / Q000097:blood* / Q000175:diagnosis; D014408:Biomarkers, Tumor / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood*; D018281:Cholangiocarcinoma / Q000097:blood* / Q000175:diagnosis; D002761:Cholangitis / Q000097:blood*; D015209:Cholangitis, Sclerosing / Q000097:blood*; D003251:Constriction, Pathologic / Q000097:blood; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000097:blood; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen
keywords: Bacterial cholangitis; Carcinoembryonic antigen; Cholangiocarcinoma; Dominant stricture; Gallbladder carcinoma; Primary sclerosing cholangitis