CA19-9 serum levels in obstructive jaundice: clinical value in benign and malignant conditions

Marrelli, Daniele; Caruso, S.; Pedrazzani, Corrado; Neri, Alessandro; Fernandes, Eduardo; Marini, Mario; Pinto, Enrico; Roviello, Franco

doi:10.1016/j.amjsurg.2008.12.031

Cited by 205 publications

(140 citation statements)

References 29 publications

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“…CA 19-9 serum levels were elevated in 61% of benign causes and 86% of malignant causes, which resulted in a reduction in accuracy to 61%. Following biliary drainage CA 19-9 serum levels decreased in nearly all benign cases (41 of 42 patients, 98%) but in only 19 out of 38 (50%) patients with malignant biliary obstruction [78]. Kau et al reported a 40% reduction in CA 19-9 serum levels after relief of malignant biliary obstruction.…”

Section: Limitations Of Ca 19-9 Serum Levels As a Pancreatic Cancer Bmentioning

confidence: 99%

“…Marrelli et al evaluated an increased serum CA 19-9 cut-off level of 90 U/ml, and noted that the specificity increased to 95%, while the sensitivity declined to 61% [78]. Similarly, using a CA 19-9 serum cut-off level of >1,000 U/ml in the presence of hyperbilirubinemia, Kim et al reported a specificity of nearly 100%, but a sensitivity of less than 50% [25] False positive elevations of the CA 19-9 serum level have been noted in a variety of pathological conditions, most notably in the presence of obstructive jaundice.…”

Section: Limitations Of Ca 19-9 Serum Levels As a Pancreatic Cancer Bmentioning

confidence: 99%

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Serum CA 19-9 as a Biomarker for Pancreatic Cancer—A Comprehensive Review

Ballehaninna

Chamberlain

2011

Indian J Surg Oncol

213

161

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Section: Limitations Of Ca 19-9 Serum Levels As a Pancreatic Cancer Bmentioning

confidence: 99%

Section: Limitations Of Ca 19-9 Serum Levels As a Pancreatic Cancer Bmentioning

confidence: 99%

Serum CA 19-9 as a Biomarker for Pancreatic Cancer—A Comprehensive Review

Ballehaninna

Chamberlain

2011

Indian J Surg Oncol

213

161

View full text Add to dashboard Cite

show abstract

“…jaundice, such as choledocholithiasis, pancreatitis, and cholangitis (41)(42)(43). In the presence of cholangitis, CA19-9 and CEA levels are known to increase.…”

Section: Original Articlementioning

confidence: 99%

Roles of serum and biliary CEA, CA19-9, VEGFR3, and TAC in differentiating between malignant and benign biliary obstructions

İnce

Yıldız²,

Baysal³

et al. 2014

Turk J Gastroenterol

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Background/Aims: Despite the presence of many diagnostic methods, the differential diagnosis between benign and malignant biliary obstructions is still not easy. We aimed to evaluate the role of serum/biliary carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA 19-9), vascular endothelial growth factor receptor-3(VEGFR-3), and total antioxidant capacity (TAC) tests in this differential diagnosis. Materials and Methods: Patients (n:225; 110♂, 115♀) with diagnosis of malignant (n:96) or benign (n:129) biliary obstruction were included in this cross-sectional study. Serum and biliary CEA, CA 19-9, VEGFR-3, and TAC tests were analyzed, statistics were obtained, and significance was defined as p<0.05. Results: Mean age was 54.9±16.4 for the benign and 54.2±19.6 for the malignant group (p=0.89). Head of pancreas cancer (18.2%), cholangiocarcinoma (11.4%) and choledochal stone (48%) were the most common etiologies. The area under the curve (AUC)s by ROC analysis of serum/biliary CA 19-9, VEGFR-3, and TAC and serum CEA were 0.701/0.616, 0.622/0.663, 0.602/0.581, and 0713, respectively. Serum TAC had higher sensitivity (61.1%) and CEA had lower sensitivity (42.7%), whereas CEA had higher specificity (89.9%) and TAC had lower specificity (60.5%). In biliary tumor markers, CA 19-9 had higher sensitivity (74%) and VEGFR-3 had lower sensitivity (56.2%); however, VEGFR-3 had higher specificity (79.1%) and CA 19-9 had lower specificity (34.1%). Additionally, combination of serum CEA (p<0.001), CA 19-9 (p<0.001), VEGFR-3 (p<0.001), and biliary CA 19-9 (p=0.028) markers achieved 95% estimation probability, and the sensitivity, specificity, and accuracy were 88.5%, 45.7%, and 64%, respectively. Conclusion: Serum and biliary CEA, CA 19-9, VEGFR-3, and TAC tests would not be useful in the differentiation between malignant and benign biliary obstructions.

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“…However, despite this, the real clinical utility of this marker remains controversial. 12 Even for the crucial differentiation between benign strictures and CC in PSC, it is not of great help, as many patients with PSC and increased serum levels of CA 19-9 do not have CC. 13 In patients with PSC and CC, a wide range of sensitivity (38-89%) and specificity (50-98%) of CA 19-9 has been reported.…”

Section: Introductionmentioning

confidence: 99%