The Clinical Research On The Value Of Serum CA19-9 In Diagnosis Of Hepatobiliary And Pancreatic Diseases

Objective:1.Observation the value of serum CA19-9 in diagnosis and differential diagnosis of hepatobiliary and pancreatic diseases;2. Investigate the correlated relationships between serum bilirubin,liver transaminase and serum CA19-9;3.To know whether CA19-9 be combined with other tumor markers could be contributed to improve the efficiency when make diagnosis of hepatobiliary and pancreatic tumor;4.Draw ROC curve to determine the best positive CA19-9 reference values to improve its diagnostic value of hepatobiliary and pancreatic diseases.Methods:A retrospective investigation of the detectional features of serum CA19-9 in a group of 180 cases of benign and malignant diseases with varying degrees of liver dysfunction or biliary obstruction in hepato- biliary and pancreatic system from July 2007 to December 2009 in our hospital,combined with serum bilirubin, transaminase and other tumor markers (such as AFP,CEA and CA125) were analyzed and they were compared with each other.Results:1.Compared with benign disease,serum CA19-9 level of pancreatic adenocarcinoma and cholangiocarcinoma both were significantly higher than(P<0.05), but hepatocellular carcinoma(HCC) showed no significant difference (P=0.143);2.For malignant disease, serum CA19-9 level of pancreatic adenocarcinoma was significantly higher than that of cholangiocarcinoma and HCC (P<0.001),and cholangiocarcinoma was higher than HCC(P=0.003);3.The sensitivity of serum CA19-9 in diagnosing pancreatic adenocarcinoma,cholangiocarcinoma and HCC were 73.5%,53.8%, 23.5%,respectively. There was no significant difference in the diagnostic sensitivity between cancers of pancreatic and bile duct(P=O.171),but the sensitivity of them both were significantly higher than that of HCC(P0.10), but for malignant disease both had no significant correlation (P>0.10); 5.By drawing ROC curve for serum CA19-9 in diagnosing pancreatobiliary carcinoma, giving an optimal CA19-9 levels of 55.2U/ml;6.Malignant diseases with elevated level of serum CA19-9 were accompanied with other tumor markers had significantly higher Probability than that of benign diseases (P<0.001).Conclusion:serum CA19-9 is useful to differentiate malignant pancreatobiliary neoplasias in the hepatobiliary and pancreatic system diseases which had varying degrees of liver dysfunction and Biliary obstruction,but with less value for HCC.For benign disease, varying degrees of serum CA19-9 level may be appropriate to the degrees of liver dysfunction or biliary obstruction;But for malignant disease, serum CA19-9 level of expression is primarily related to the tumor itself ;When using an optimized cut-off and combining other tumor markers ,the diagnostic yield of pancreaticobiliary carcinoma is improved significantly.