Background/aim: A cholangiocarcinoma, the second most common primary hepatic malignancy, can present with diagnostic dilemmas. The aim of this study is to assess the role of CA 19-9 in patients with a cholangiocarcinoma without primary sclerosing cholangitis.
Methods: The prospectively collected information on patients with biopsy-proven cholangiocarcinomas who had the CA 19-9 level measured was obtained (n = 68) from our computer database and medical records. These patients were compared with patients who had benign liver tumours (n = 25) and benign bile duct strictures (n = 13) who also had their CA 19-9 concentration measured.
Results: Sensitivity and specificity of CA 19-9 in the diagnosis of a cholangiocarcinoma were 77.9 and 76.3%, respectively, when using a cut-off value of 35 kU/l, while sensitivity and specificity were 67.5 and 86.8%, respectively, when the cut-off value was raised to 100 kU/l. The specificity was found to be higher in patients with peripheral cholangiocarcinomas (96%) using a CA 19-9 cut-off value >100 kU/l. A CA 19-9 value >600 kU/l was associated with non-resectable tumours (p = 0.05).
Conclusions: This study demonstrates that CA 19-9 is a useful adjunct in the diagnosis of cholangiocarcinomas without primary sclerosing cholangitis, especially in the diagnosis of peripheral cholangiocarcinomas. However, it does not provide a reliable guide for the pathological staging of these tumours.
Copyright 2006 S. Karger AG, Basel.