Utility of serum CA19-9 in diagnosis of cholangiocarcinoma: In comparison with CEA

Table 1 Patients’ characteristics in three groups (mean ± SD)

Characteristics	Cholangiocarcinoma	Benign biliary diseases	Healthy individuals
N	35	92	15
Age (yr)	60.37 ± 11.2	49.78 ± 10.6	27.6 ± 4.7
Sex (M/F)	19/16	39/53	15/0
Total bilirubin (umol/L)	47.4 ± 2.1a	8.3 ± 0.7	8.6 ± 0.9
AST (U/L)	79 ± 21.2a	26 ± 3.5	21 ± 4.6
ALP (U/L)	193 ± 41.8a	114 ± 50.6	90 ± 18.3
CA19-9 (KU/L)	290.31 ± 5.34bc	13.38 ± 2.59	12.78 ± 3.69
CEA (μg/L)	36.46 ± 18.03a	13.84 ± 3.85	11.48 ± 3.37

^aP < 0.05, ^bP < 0.001 vs benign biliary diseases or healthy individuals. ^cP < 0.05 vs serum CEA. AST = aspartate aminotranferase, ALP = alkaline phosphatase, CA19-9 = carbohydrate antigen 19-9, CEA = carcinoembryonic antigen.

Table 2 Comparison of serum CA19-9 and CEA levels in patients with cholangiocarcinoma and benign biliary diseases

	CA19-9△	CA19-9	CEA	CA19-9 or CEA	CA19-9 and CEA
Sensitivity(true positive)*	65.71%(23/35)	77.14%(27/35)a	68.57%(24/35)	91.43%(32/35)	62.86%(22/35)
Specificity(true negative)**	88.04%(81/92)	84.78%(78/92)	81.52%(75/92)	76.09%(70/92)	86.96%(80/92)
Positive predictive value	67.65%(23/34)	65.85%(27/41)	58.54%(24/41)	59.26%(32/54)	64.71%(22/34)
Negative predictive value	87.10%(81/93)	90.70%(78/86)	87.21%(75/86)	95.89%(70/73)	88.89%(80/90)
Accuracy	81.89%(104/127)	82.68%(105/127)	77.95%(99/127)	80.31%(102/127)	80.31%(102/127)
False positive rate	11.98%(11/92)	15.22%(14/92)	18.48%(17/92)	23.91%(22/92)	13.04%(12/92)

*Number of positive tests/number of patients with cholangiocarcinoma. **Number of negative tests/number of patients with benign biliary diseases.

^aP < 0.05 vs CEA. ^△When the cutoff value of serum CA19-9 was 100 KU·L^-1

Table 3 Preoperative and postoperative change of serum CA19-9 and CEA concentrations in patients with cholangiocarcinoma undergoing curative resection (mean ± SD)

Groups	CA19-9 (KU/L)	CEA(μg/L)
After the resectable (n = 15)	62.01 ± 17.43a	28.69 ± 11.03c
Before the resectable (n = 15)	286.41 ± 4.36	39.41 ± 24.35
The unresectable (n = 20)	391.37 ± 5.76b	43.28 ± 20.68

^aP < 0.001, ^bP < 0.01, ^cP < 0.05 vs before the respectable group.

Table 4 Relation between serum CA19-9 and CEA levels and clinicopathologic features of tumors in 35 patients with cholangiocarcinoma (mean ± SD)

	No. of	CA19-9	CEA
	patients	(KU/L)	(μg/L)
Well-differentiated	16	261.67 ± 6.31	34.37 ± 11.29
adenocarcinoma
Moderately-differentiated	12	270.56 ± 4.57	38.42 ± 19.23
adenocarcinoma
Poorly-differentiated	5	302.71 ± 5.81	48.23 ± 23.64
adenocarcinoma
Anaplastic carcinoma	1	468	64
Adenosquamous carcinoma	1	293	27
Perineural infiltration
Positive	23	310.12 ± 7.11a	37.64 ± 10.35b
Negative	10	195.16 ± 6.48	21.28 ± 13.15
Venous invasion
Positive	17	318.49 ± 3.27b	39.78 ± 18.41b
Negative	18	253.08 ± 5.37	29.67 ± 20.13
Lymph node metastasis
Positive	18	345.66 ± 4.23a	46.37 ± 9.46b
Negative	17	265.30 ± 4.58	31.89 ± 16.46

^aP < 0.01, ^bP < 0.05, ^cP < 0.05 vs negative group.