Evaluation of biliary CEA and CA 19-9 levels in early diagnosis of colorectal liver metastasis

ABSTRACT

The study revealed that patients with overt liver metastasis had a bile CEA concentration greater than 10 ngm./ml, and some of them had a bile CA19-9 concentration greater than 200 U./ml. This study also showed that biliary CEA elevated in 80% of patients with out overt liver metastasis and on follow up of those patients, 37.5% developed overt liver metastasis within 6 months follow up period. While biliary CA 19-9 was elevated in 65% of patients without overt liver metastasis and on follow up of those patients, 33.5% of cases developed overt liver metastasis within 6 months follow up period. CEA and CA 19-9 produced in very small liver metastasis may not reach the systemic circulation in sufficient quantity in gallbladder bile. So elevated biliary CEA and CA 19-9 concentration [to less extent] with no evidence of liver metastasis, even without elevation of serum CEA or CA 19-9 can be used for early diagnosis of liver metastasis, detection of micro metastasis after curative therapy of colorectal cancers, screening for the presence of liver secondary and differential diagnosis of liver mass