The Value Of Serum CA19-9in The Diagnosis Of Benign And Malignant Obstructive Jaundice Disease

Purpose To calculate and analyze the diagnostic value of serum CA19-9between thebenign and malignant obstructive jaundice disease, explore the impact of the serum totalbilirubin and the cholangitis on the level of serum CA19-9.Methods Retrospective analyzed the serum CA19-9levels of hospitalized patients withvarying degrees of obstructive jaundice in Hepatic Surgery of Ningxia Medical UniversityGeneral Hospital, admitted in June2009to June2012. To calculate and analyze the index ofserum CA19-9and serum total bilirubin.Results1. According to the results of the serum CA19-9, the serum CA19-9has a highdiagnostic value of cholangiopancreatic neoplasm in specificity (86.36%,68.00%), sensitivity(69.05%,86.54%), positive predictive value (0.63%,84.91%) and negative predictive value(70.83%,59.38%).2. According to the receiver operating characteristic, the serum CA19-9has a higher diagnostic value in pancreatic cancer (AUC:0.822) and bile duct cancer (AUC:0.787), but it has a lower diagnostic value in ampulary carcinoma (AUC:0.674) andgallbladder carcinoma (AUC:0.692).3. By comparing the serum CA19-9between themalignant group and the simple bile duct stones group, the level of the serum CA19-9between the two has statistical significance (P=0.035＜0.05); the level of the serum CA19-9between the malignant group and the bile duct stones with cholangitis group has no statisticalsignificance (P=0.295＞0.05); the level of the serum CA19-9between the simple bile ductstones group and the bile duct stones with cholangitis group has statistical significance(P=0.019＜0.05).4. According to the correlation analysis, the serum CA19-9and the serumtotal bilirubin of the malignant group has correlation (rs=0.405, P=0.000), but according to the result of the simple scatter, it has low correlation; the serum CA19-9and the serum totalbilirubin of the simple bile duct stones group has positive correlation (rs=0.613，P=0.000＜0.05); the serum CA19-9and the serum total bilirubin of the bile duct stones with cholangitisgroup has no correlation (rs=0.262，P=0.239＞0.05).Conclusion The serum CA19-9has high diagnostic value of pancreatic cancer and bileduct cancer, but it has a low diagnostic value of ampullary carcinoma and gallbladdercarcinoma; the serum CA19-9can be elevated in benign disease, especially in the bile ductstones with cholangitis, the total bilirubin and the cholangitis have a great impact on the levelof serum CA19-9; the serum CA19-9and the serum total bilirubin have a low correlation inthe malignant group, they have no correlation in the bile duct stones with cholangitis andhave a positive correlation in the simple bile duct stones; in diagnosis of the patients withhigh serum CA19-9, we should differentiate between the malignant disease and the bile ductstones with cholangitis; in the diagnosis of malignant diseases, we should combine with otherdiagnosis methods instead of using serum CA19-9simply.