Diagnostic Role of Serum CA 19-9 for Cholangiocarcinoma in Patients With Primary Sclerosing Cholangitis

Nichols, Jenna; Gores, Gregory J.; LaRusso, Nicholas F.; Wiesner, Russell H.; Nagorney, David M.; Ritts, Roy E.

doi:10.1016/s0025-6196(12)60696-x

Cited by 211 publications

(98 citation statements)

References 13 publications

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“…Of all three, CA 19-9 has the most utility. In patients with PSC a value of >100 U/ml has a sensitivity of 89% and specificity of 86%, and in patients without PSC the sensitivity is 53%, for the diagnosis of cholangiocarcinoma (7,55). Increasing the cutoff to >129 U/ml in patients PSC provided a sensitivity of 78.6%, and improved the specificity to 98.5%, and a positive predictive value of 56.6% (56).…”

Section: Diagnosismentioning

confidence: 99%

Cholangiocarcinoma: Modern advances in understanding a deadly old disease

Malhi

Gores

2006

Journal of Hepatology

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243

193

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Cholangiocarcinomas are tumors that arise anywhere in the biliary tract, presumably of cholangiocyte origin. The global incidence of this rare disease is on the rise. Several known risk factors exist, and link chronic biliary inflammation to the pathogenesis of cholangiocarcinoma. Among these, amplification of the epidermal growth factor receptor, the interleukin-6 signaling pathway, inducible nitric oxide, erb-2, and cyclooxygenase-2 are well defined. Most patients present late, with a median survival of months. Although, imaging studies and clinical context often indicate cholangiocarcinoma, pathologic and cytologic diagnosis is difficult to obtain. Advanced cytologic tests with fluorescent in situ hybridization or digital image analysis can increase diagnostic sensitivity. Surgical resection is the current therapy of choice for both intrahepatic and ductal cholangiocarcinomas. However, the 5 year survival is poor, with 60 to greater than 90% recurrence rates. In a single center experience, liver transplantation with neoadjuvant chemoirradiation, for highly selected patients has a 5 year disease free survival of greater than 80%. Future targeted therapies will depend on a better understanding of the cellular and molecular biology of cholangiocarcinomas.

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Section: Diagnosismentioning

confidence: 99%

Cholangiocarcinoma: Modern advances in understanding a deadly old disease

Malhi

Gores

2006

Journal of Hepatology

Self Cite

243

193

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“…A threshold value of 100 U/mL is 89% sensitive and 86% specific in detecting cholangiocarcinoma in PSC. 54 Serological screening with an index Ն 400 U for the two tumor markers, CA 19-9 and carcinoembryonic antigen (CEA) [CA 19-9 ϩ (CEA ϫ 40)], is 86% accurate in detecting cholangiocarcinoma and has a 100% specificity and positive predictive value, but with a sensitivity of only 67%. 55 The tumor marker, CA 125, has a sensitivity of 66% and a specificity of 92% in differentiating PSC from PSC plus cholangiocarcinoma.…”

Section: Malignancymentioning

confidence: 99%

Primary sclerosing cholangitis

1999

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“…Its usefulness in the diagnosis of early bile duct cancer, however, is not so clear as CA 19-9 levels higher than 100 U/mL were noted in only 15% of early bile duct cancer patients [4] . Since increased serum levels of CA 19-9 less than 100 U/mL are not rare in benign conditions as well [32,33] , measurement of serum CA 19-9 level may have a limited value in the diagnosis of early bile duct cancer.…”

Section: Laboratory Datamentioning

confidence: 99%