The Clinical Utility and Limitations of Serum Carbohydrate Antigen (CA19-9) as a Diagnostic Tool for Pancreatic Cancer and Cholangiocarcinoma
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Sundeep Singh Shou-jiang Tang Jayaprakash Sreenarasimhaiah Luis F. Lara Ali Siddiqui
- چاپ و سال / کشور: 2011
Description
Background CA19-9 is a tumor marker for pancreatic cancer, cholangiocarcinoma, and other malignancies. However, its sensitivity and specificity is suboptimal in clinical practice, which we hypothesized limits its clinical utility. Aims To evaluate the clinical utility and limitations of CA19-9 as a tumor marker. Methods We performed a retrospective review of CA19-9 levels (U/ml) in 483 consecutive patients between 2006 and 2008 at two university hospitals. We abstracted clinical, radiographic, and pathological data and final diagnoses. Descriptive and non-parametric analyses were performed. Results Patients presenting with jaundice had the highest CA19-9 (420) compared to other complaints (\20) (p\0.01). The indications with the highest CA19-9 had evidence of biliary obstruction (71), liver mass (54), and pancreatic head mass (27) compared to other indications (\15) (p\0.01). The diagnoses with the highest CA19-9 (p\0.01) were cholangiocarcinoma (476), pancreatic cancer (161), and choledocholithiasis (138). Using a receiver operator curve to evaluate CA19-9, the area under the curve was 0.7 when evaluating all patients for pancreatic cancer or cholangiocarcinoma or patients with pancreatic head mass for pancreatic cancer. Conclusions This study found that for pancreatic cancer and cholangiocarcinoma, CA19-9 had poor clinical utility as a tumor marker and did not change patient management. Elevations in CA19-9 were associated with biliary obstruction based on clinical history, laboratory data, and diagnoses.
Dig Dis Sci (2011) 56:2491–2496 DOI 10.1007/s10620-011-1709-8 Received: 6 February 2011 / Accepted: 5 April 2011 / Published online: 23 April 2011
