The Value of Serum CA 19-9 in Predicting Cholangiocarcinomas in Patients with Primary Sclerosing Cholangitis

  title={The Value of Serum CA 19-9 in Predicting Cholangiocarcinomas in Patients with Primary Sclerosing Cholangitis},
  author={Cynthia Levy and James F. Lymp and Paul Angulo and Gregory J. Gores and Nicholas F. LaRusso and Keith D. Lindor},
  journal={Digestive Diseases and Sciences},
CA 19-9 has been used with questionable accuracy to aid diagnosis of cholangiocarcinoma complicating primary sclerosing cholangitis. We aimed to characterize the test properties of CA 19-9 and of a change in CA 19-9 over time in predicting cholangiocarcinoma. Charts of 208 patients were reviewed. Fourteen patients had cholangiocarcinoma. Median CA 19-9 was higher with cholangiocarcinoma (15 vs. 290 U/ml, p < 0.0001). A cutoff of 129 U/ml provided: sensitivity 78.6%, specificity 98.5%, adjusted… 

Utility of serum tumor markers, imaging, and biliary cytology for detecting cholangiocarcinoma in primary sclerosing cholangitis

Tumor serology combined with cross‐sectional liver imaging may be useful as a screening strategy and cholangiography with cytologic examination is helpful for the diagnosis of cholangsiocarcinoma in patients with PSC.

Increased Serum Levels of Carbohydrate Antigen 19-9 and Outcomes in Primary Sclerosing Cholangitis Patients Without Cholangiocarcinoma

Thirty-two percent of patients with PSC had elevated serum CA 19-9 in the absence of CCA, and there was a trend towards shorter OLT-free survival in PSC patients with elevated CA-19-9.

CA 19-9 as a Marker of Survival and a Predictor of Metastization in Cholangiocarcinoma

Predictive factors for overall survival were identified, namely presence of metastasis, surgery, and chemotherapy, and CA 19-9 levels ≥103 U/L were predictive factors for survival and metastization.

Many patients with primary sclerosing cholangitis and increased serum levels of carbohydrate antigen 19-9 do not have cholangiocarcinoma.

Diagnostic Accuracy of Serum CA19-9 in Patients with Cholangiocarcinoma: A Systematic Review and Meta-Analysis

Serum CA19-9 is a useful non-invasive biomarker for CCA detection and may become a clinically useful tool to identify high-risk patients.

The value of serum CA19‐9 in predicting primary sclerosing cholangitis in patients with ulcerative colitis

The results showed that the CA19‐9 level in patients with PSC was significantly higher than that of patients diagnosed with other EIMs and it could be concluded that cut‐off of >129 U/mL may not be an accurate cut-off for the diagnosis of CCA in IBD patients.

Carbohydrate Antigen 50: Values for Diagnosis and Prognostic Prediction of Intrahepatic Cholangiocarcinoma

Serum CA50 levels were increased and associated with the severity of bile duct pathology and a higher level of CA50 was associated with poor clinical outcome and shorter survival in iCCA patients, suggesting CA50 can be a diagnostic and poor prognostic marker candidate for i CCA.

The Detection of Cholangiocarcinoma in Primary Sclerosing Cholangitis Patients: Single Center Experience

Brush cytology has moderate sensitivity in differentiating strictures in PSC patients and CA 19-9 has high sensitivity but bilirubin level can affect the CA19-9, therefore, advanced techniques and parameters are needed for detecting CCA in P SC patients.

Incidence, Diagnosis, and Therapy of Cholangiocarcinoma in Patients with Primary Sclerosing Cholangitis

If tumors are small or incidental findings, liver transplantation leads to a 3- to 5-year survival rate of 35%.



The utility of CA 19-9 in the diagnoses of cholangiocarcinoma in patients without primary sclerosing cholangitis

Data suggest that the serum CA 19-9 determination is a useful addition to the available tests for the differential diagnosis of cholangiocarcinoma.

CA19-9 does not predict cholangiocarcinoma in patients with primary sclerosing cholangitis undergoing liver transplantation.

  • A. FisherN. Theise P. Sheiner
  • Medicine
    Liver transplantation and surgery : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
  • 1995
An elevated serum CA19-9 level in a patient with stage IV primary sclerosing cholangitis does not reliably predict coexisting cholangsiocarcinoma, and Persistently high or rising serum CA 19-9 levels do not indicate more urgent need for liver transplantation.

Predicting cholangiocarcinoma in patients with primary sclerosing cholangitis: An analysis of the serological marker CA 19‐9

The measurement of serum concentrations of CA 19‐9 is a promising test for detecting cholangiocarcinoma in patients with PSC.

CA 19-9 and CEA are unreliable markers for cholangiocarcinoma in patients with primary sclerosing cholangitis.

Tumor markers as a diagnostic tool in diagnosing cholangiocarcinoma in patients with PSC are unfortunately not as valuable as previously reported.

Elevated tumour marker CA19-9: clinical interpretation and influence of obstructive jaundice.

  • D. MannR. EdwardsS. HoW. LauG. Glazer
  • Medicine
    European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
  • 2000
Confident discrimination between benign and malignant disease could not be made on the basis of a solitary elevated CA19-9 measurement, and Hyperbilirubinaemia was associated with a further deterioration in specificity and caution is warranted when interpreting the results in jaundiced patients.

Detecting cholangiocarcinoma in patients with primary sclerosing cholangitis.

Screening patients with primary sclerosing cholangitis for cholangsiocarcinoma with CA19-9 and carcinoembryonic antigen is reasonable, but the ideal intervals at which to obtain these tests and the cost-effectiveness require further study.

The Effect of Benign and Malignant Liver Disease on the Tumour Markers CA19-9 and CEA

The serum concentrations of CA19-9 and carcinoembryonic antigen (CEA) were measured in 150 consecutive patients with histologically proven liver disease admitted to a liver unit for transplant