AI Summary & Key Takeaways
AI InsightConclusion: It was concluded that serum CA19-9 levels are increased both in malignant and benign obstructive biliary diseases, albeit more significantly in the former.
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Abstract
Background/aims: The value of serum tumor markers carbo-hydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA) in the differential diagnosis of obstructive biliary disease is dubious. We aimed to define their usefulness prospectively. Methods: Thirty-seven consecutive patients' (12 female, 25 male, median age: 54, range: 19-83 years) who were referred for endoscopie retrograde cholanugiopancreatography (ERCP) or percutaneous transhepatic cholangiography (PTC) examination for obstructive jaundice were included (all with dilatation of biliary tree in ultrasonography or computerised tomography). Bile was obtained through the nasobiliary or external drainage catheter, placed with ERCP or PTC, respectively. Serum samples were taken from all patients at the time of acquisition of bile. Serum and bile samples were stored at -50 0C until they were tested. CA19-9 and CEA levels were measured with chemi-luminescent enzyme immunoassay methods in serum and bile samples by using immulite GI-MA and CEA commercial kits, respectively (DPC*, Los Angeles). Results: In 22 patients with malignant disease, serum CEA levels were 38.6±115.8 ng/ml and CA19-9 were 386.9+409.7 U/ml, while in 15patients with benign disease the serum CEA levels were 1.8±1.6 ng/ml and CA19-9 were 128.9±302.2 U/ml. The difference for both values was significant (p<0.05). In malignant disease bile CEA and CA19-9 levels were 160.8±457.8 ng/ml, 14000.9±19798 U/ml respectively, while in benign disease the corresponding levels were 21.08±48.6 ng/ml for CEA .and 14818.9±24665.7 U/ml for CA19-9. The differences were not significant in this case (p>0.05). Conclusion: It was concluded that serum CA19-9 levels are increased both in malignant and benign obstructive biliary diseases, albeit more significantly in the former. However, increase in serum CEA is mostly restricted to malignant diseases. Measurement of these markers in bile is of no value.
Özet
Amaç: Benign ve malign safra yolları hastalıklarının ayırıcı tanısında serum CEA ve CA19-9 düzeyinin rolü tartışmalıdır. Prospektif olarak dizayn edilmiş bu çalışmada, kullanabilirliklerini araştırdık. Yöntem: Çalışmaya Ağustos 1999- Nisan 2000 tarihleri arasında ERCP laboratuvarına veya servisimize tıkanma sarılığı nedeniyle başvuran 37 (12 Kadın, 25 Erkek, ortanca yaş; 54 sınırlar;19-83) hasta alındı. Safra PTK yoluyla yerleştirilen eksternal katater veya ERCP ile yerleştirilen NBD yoluyla elde edildi. Serum örnekleri, safra örneklerinin alımı ile eş zamanlı alındı. Serum ve safra örnekleri, çalışma anına kadar -50 C'de bekletildi. CA19-9 düzeyi immulite GI-MA, CEA immulite CEA (DPC Los Angeles) ticari kiti kullanılarak, semilüminisent enzim immunassay yöntemiyle çalışıldı. Bulgular: Yirmiiki malign hastalıkta serum CEA:38.6±115.8 ng/ml, CA19-9: 386.9±409.7 U/ml iken benign nedenlere bağlı tıkanma sarılığı olan 15 olguda bu oran sırasıyla 1.8±1.6 ng/ml, 128.9±302.2 U/ml olarak bulundu. Serum CEA ve CA19-9 düzeyi malign hastalıklarda anlamlı olarak daha yüksekti (p 0.05). Sonuç: Sonuç olarak malign ve benign safra yolları hastalıkların ayırıcı tanısında serum CEA, CA19-9 düzeyinin tayini anlamlıyken, safra da her iki tümör antijeninin tayini güvenilir olma-yan işaretleyiciler olarak değerlendirildi.