Diagnostic role of serum CA 19-9 for cholangiocarcinoma in patients with primary sclerosing cholangitis

Mayo Clin Proc. 1993 Sep;68(9):874-9. doi: 10.1016/s0025-6196(12)60696-x.


Primary sclerosing cholangitis (PSC) predisposes to the development of cholangiocarcinoma, a usually fatal complication that is difficult to diagnose. Serum concentrations of CA 19-9, a tumor-associated antigen, are frequently increased in patients with only cholangiocarcinoma. The aim of this study was to assess the value of an increased serum CA 19-9 level for the diagnosis of cholangiocarcinoma in patients with preexisting PSC. We analyzed serum samples from 9 patients with PSC and superimposed cholangiocarcinoma and from 28 patients with only PSC. Serum concentrations of CA 19-9 were measured in a blinded manner with use of an immunoradiometric assay. The serum CA 19-9 concentrations were increased in 8 of 9 patients (89%) with PSC and cholangiocarcinoma (mean +/- SE, 391 +/- 86 U/ml; range, 4 to 677), whereas they were increased in only 4 of 28 patients (14%) with only PSC (mean +/- SE, 61 +/- 16 U/ml; range, 2 to 370). The sensitivity of a CA 19-9 value greater than 100 U/ml for cholangiocarcinoma in PSC was 89%, and the specificity was 86%. The measurement of serum concentrations of CA 19-9 is a promising test for detecting cholangiocarcinoma in patients with PSC.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenoma, Bile Duct / blood
  • Adenoma, Bile Duct / diagnosis*
  • Adenoma, Bile Duct / etiology*
  • Adult
  • Antigens, Tumor-Associated, Carbohydrate / blood*
  • Bile Duct Neoplasms / blood
  • Bile Duct Neoplasms / diagnosis*
  • Bile Duct Neoplasms / etiology*
  • Carcinoembryonic Antigen / blood
  • Cholangitis, Sclerosing / blood
  • Cholangitis, Sclerosing / complications*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Sensitivity and Specificity


  • Antigens, Tumor-Associated, Carbohydrate
  • Carcinoembryonic Antigen