Diagnostic value of elevated serum carbohydrate antigen 199 level in acute cholangitis secondary to choledocholithiasis

Abstract

AIMTo investigate the diagnostic value of abnormal serum carbohydrate antigen 199 (CA199) level in acute cholangitis secondary to choledocholithiasis.METHODSIn this retrospective cohort study, the clinical data of 727 patients with choledocholithiasis admitted to the Third Affiliated Hospital of Zunyi Medical College from June 2011 to June 2017 were collected. Among these patients, 258 patients had secondary acute cholangitis and served as observation group, and the remaining 569 choledocholithiasis patients served as the control group. Serum liver function indexes and tumor markers were detected in both groups, and the receiver operating characteristic (ROC) curves were constructed for markers showing statistical significances. The cutoff value, sensitivity, and specificity of each marker were calculated according to the ROC curves.RESULTSThe results of liver function tests showed no significant differences between the two groups (P > 0.05). Tumor markers including serum CA125, CA153, carcinoembryonic antigen, and alpha fetoprotein levels were also not significantly different (P > 0.05); however, the serum CA199 level was significantly higher in the observation group than in the control group (P < 0.05). The ROC curve analysis showed that the area under the curve was 0.885 (95%CI: 0.841-0.929) for CA199, and the cutoff value of 52.5 kU/L had the highest diagnostic accuracy, with a sensitivity of 86.8% and a specificity of 81.6%.CONCLUSIONAbnormally elevated serum CA199 level has an important value in the diagnosis of acute cholangitis secondary to choledocholithiasis. It may be a specific inflammatory marker for acute cholangitis.

Factors related to the spontaneous passage of common bile duct stones through the papilla: a single-center retrospective cohort study

“…22 Mei et al showed that elevated serum CA 19-9 levels were an important diagnostic indicator of acute cholangitis, secondary to CBD stones. 23 In this study, we found that CA 19-9 levels were significantly higher in group A than in group B (P < 0.05). However, CA 19-9 was not associated with stone retention or spontaneous passage.…”

ERCP endoscopic minimally invasive treatment of acute suppurative obstructive cholangitis: A study of 47 patients

“…When AC occurs, the serum concentration of CA199 is significantly increased, and this increase is positively correlated with the severity of cholangitis, which can therefore be used as a predictor of AC ( 35 ); a finding that was consistent with the results of the present study. It has also been shown that CA199 has certain reference value for the diagnosis of AC when it reaches a level of 52.50 kU/l ( 36 ). In the present study, there were two cases where the CA199 values were >12,000 kU/l.…”

<p>Preoperative Bilirubin-Adjusted Carbohydrate Antigen 19-9 as a Prognostic Factor for Extrahepatic Cholangiocarcinoma Patients at a Single Center</p>

“…8 For example, the increase of CA19-9 can also be seen in conditions such as pancreatic cancer, 9 chronic pancreatitis, cholelithiasis, 10 and cholangitis. 11 The rise in CA19-9 in these diseases is a result of obstruction causing the CA19-9 secreted by the normal bile duct, or pancreatic epithelium, flow into the bloodstream. 10 Therefore, researchers used the total bilirubin level to calibrate CA19-9, which can rule out the effect of obstructive biliary disease on the increase of CA19-9.…”