diagnostic value of serum and bile cyfra 21-1, CEA and CA 19-9 in cases of cholangiocarcinoma

ABSTRACT

The aim of the present study was to assess the diagnostic value of Cyfra 21-1, CA 19-9 and CEA in serum and bile of patients with CCA. The present study was conducted on 20 patients with cholangiocarcinoma [CCA group] diagnosed on clinical and pathological grounds, in addition to 20 cases with benign cholestatic disorder and 20 matched healthy subjects as a control group. Cyfra 2 1-1, CEA and CA 19-9 were measured in serum and bile of patients and in serum of controls. Serum CEA, CA 19-9 and Cyfra 21-1 concentrations were significantly higher in patients with cholangiocarcinoma than patients with benign cholestatic disorder and controls. Moreover, the mean bile .concentrations of CEA, CA 19-9 and Cyfra 21-1 were significantly higher than serum concentrations. The sensitivity, specificity and diagnostic accuracy of serum and bile Cyfra 21-1 were significantly higher than those obtained using either CEA or CA 19-9. The serum and bile concentrations of CEA, CA 19-9 and Cyfra 21-1 were significantly higher in late stages of CCA in comparison to early stages. The addition of tumor markers CEA, CA l9-9 and Cyfra 21-1 to brush cytology increases its sensitivity in diagnosis of cholangiocarcinoma from 44% up to 84%. CEA, CA 19-9 and Cyfra 21-1 measurements in bile are important for the supplementary diagnosis of cholangiocarcinoma. Cyfra 21-1 is a superior tumor marker than CEA in diagnosis cholangiocarcinoma. Combining brush cytology with CEA, CA 19-9 and Cyfra 21-1 can raise the diagnostic yield