THE VALUE OF TUMOUR ASSOCIATED ANTIGEN CA 19-9 IN DIAGNOSING MALIGNANT AND BENIGN BILIARY STRICTURES
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The diagnosis of cholangiocarcinoma is often difficuit, making management approaches problematic. A reliable serum tumor marker for cholangiocarcinoma would be a useful additional diagnostic .test. Previous studies have demonstrated that elevated serum concentrations of CA 19-9, a tumor-associated antigen, have good sensitivity and .specificity for cholangiocarcirtoma in patients with primary sclerosing cholangitis. However, the value of this tumor marker for cholangiocarcirtoma unassociated with primary sclerosing chotangitis is unclear. Thus, the aims of this study were to determine the usefulness of a serum CA 19-9 determination in the diagnosis of de novo. cholangiocarcinoma. Methods: We measured serum CA 19-9 concentrations in patients with cholangiocarcinoma (n=25),, nonmalignant liver disease (n=30), and benign bile duct strictures (n=15),- serum CA 19-9 concentrations were measured by a direct chemiluminometric technology. Results: The sensitivity of a CA 19-9 value > 100U/ mi in diagnosing cholangiocarcinoma was 53%. When compared with the nonmalignant Liver disease and the benign bile duct stricture groups, the, true negative rates were 76% and 92%, respectively. Patients witla.,unresectable cholangiocarcinoma had significantly greater mean CA 19-9:concentrations compared to patients with resectable cholangiocarcinoma. Conclusions: These data suggest that the serum CA 19-.9 determination is a useful addition to the available tests for thadiffetential diagnosis of cholangiocarcinoma.