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Clinical Interpretation of Elevated CA 19-9 Levels in Obstructive Jaundice Following Benign and Malignant Pancreatobiliary Disease / 대한소화기학회지
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wpr-107255
Biblioteca responsável: WPRO
ABSTRACT
BACKGROUND/

AIMS:

Elevated carbohydrate antigen (CA) 19-9 level may be unable to differentiate between benign and malignant pancreatobiliary disease with obstructive jaundice. The study aims to determine the clinical interpretation and the diagnostic value of CA 19-9 level in pancreatobiliary diseases with coexistent obstructive jaundice.

METHODS:

We retrospectively reviewed the data of 981 patients who underwent biliary drainage due to obstructive jaundice following pancreatobiliary disease at Sanggye Paik Hospital for 5 years. 114 patients with serial follow-up data for CA 19-9 level were included in this study (80 patients with malignancy and 34 patients with benign diseases). We compared the levels of CA 19-9 levels and the biochemical value before and after biliary drainage.

RESULTS:

The rate of CA 19-9 elevation (>37 U/mL) was significantly different between the benign group and the malignant group (59% vs. 90%, p=0.001). Despite the decrease in serum bilirubin after biliary drainage, CA 19-9 levels remained elevated in 12% of patients in the benign group and in 63% of patients in the malignant group (p<0.001). Finally, 12% of patients in the benign group turned out to have malignant disease. A receiver operating characteristic analysis provided a cut-off value of 38 U/mL for differentiating benign disease from malignant disease after biliary drainage (area under curve, 0.787; 95% confidence interval, 0.703 to 0.871; sensitivity, 62%; specificity, 88%).

CONCLUSIONS:

This study suggested that we should consider the possibility of malignant causes if the CA 19-9 levels remain high or are more than 38 U/mL after resolution of biliary obstruction.
Assuntos

Texto completo: Disponível Base de dados: WPRIM (Pacífico Ocidental) Assunto principal: Bilirrubina / Drenagem / Estudos Retrospectivos / Curva ROC / Seguimentos / Sensibilidade e Especificidade / Antígeno CA-19-9 / Icterícia Obstrutiva Tipo de estudo: Estudo diagnóstico / Estudo observacional / Estudo prognóstico Limite: Humanos Idioma: Inglês Revista: The Korean Journal of Gastroenterology Ano de publicação: 2017 Tipo de documento: Artigo
Texto completo: Disponível Base de dados: WPRIM (Pacífico Ocidental) Assunto principal: Bilirrubina / Drenagem / Estudos Retrospectivos / Curva ROC / Seguimentos / Sensibilidade e Especificidade / Antígeno CA-19-9 / Icterícia Obstrutiva Tipo de estudo: Estudo diagnóstico / Estudo observacional / Estudo prognóstico Limite: Humanos Idioma: Inglês Revista: The Korean Journal of Gastroenterology Ano de publicação: 2017 Tipo de documento: Artigo
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