THEVALUEOF TUMOURASSOCIATED ANTIGEN CA19-9 INDIAGNOSINGMALIGNANT AND BENIGNBILIARY STRICTURES ....
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The diagnosis ofcholangiocarcinoma is often difficult,makingmanage ment approaches problematic. A reliable serumtumopmarkerfor cholangiocarcinomawould be a useful additional diagnostic.test Previous studies have demonstrated that elevated serumconcentrations ofCA 19-9, atumor-associated antigen, have good sensitivity and.specipcityfor cholangiocarcinoma in patients with primary sclerosing chokmgitis. However, the value ofthis tumor markerfor cholangiocarcinoina.unassociated withprimary sclerosing cholangitis is unclear. Thus, the- aims! of this study were to determine the usefulness of a serum CA-19-9 determination in the diagnosis ofde novo cholangiocarcinoma.,.••..'.''Methods:We measured serumCA 19-9 concentrations inpatients with cholangiocarcinoma (n=251, nonmalignant liver disease (n=30), and- be nign bile dupt strictures. ^^rv=15),_ serum CA 19-9 concentrations were measured bya direct chemiluminometric technology. Results: The-sensitivity of a CA 19-9 value > WOU/ml in diagnosihg cholangiocarcinomawas 53%. When compared with the, nonmalignant liv er disease and the benign bile duct stricture groups: thetrue negative rateswere 76% apd 92%, respectively. Patients with\unresectable cholan giocarcinoma had significantly greater mean CA-19-9concentrations com pared to patients with resectable holangiocarcinoma,••;• Conclusions: These data suggest that the serum"CA 19.-9 determina tion is a useful addition to the available testsfor thd'dffferential diagnosis ofcholangiocarcinoma