The Significance Of CA-199 In The Differential Diagnosis Of Benign And Malignant Obstructive Jaundice Without Obvious Mass Occupation

ObjectiveCarbohydrate antigen 199(CA-199),a tumor marker for malignancies of the hepatobiliary tract and pancreas,has frequently been shown to be deranged in a number of non-malignant conditions that are associated with jaundice.In clinical work,regular examination such as US and CT,usually had no obvious findings of bile duct occupying or Cholangiocarcinoma.So how to judge the benign and malignant diseases through CA-199 and bilirubin is the key to the work.This study aims to demonstrate the correlation between CA-199 and serum bilirubin concentration in patients with benign conditions.And looking for appropriate CA-199 values to improve the specificity and sensitivity of the benign diagnosis.MethodsWe collected the data of patienrs in the First Affiliated Hospital of Zhengzhou University from 2010 to 2017 with direct bilirubin elevation,and there was no significant abnormality in US/CT check.Diagnosis of benign disease or exclusion of malignant diagnosis after ERCP,surgical biopsy,diagnostic treatment,or follow-up only Statistics the data of bilirubin levels and CA-199 levels on admission and after one week of treatment.Analysis the relationship between CA-199 levels and bilirubin levels.We adjusted the CA-199 value by bilirubin,thereby improving the sensitivity and specificity of benign diseases in patients with obstructive jaundice.ResultsTotal of patients included in the study is49,male: female = 23:26,age 28~ 89 year,mean 58.8year.We found that CA-199 levels are affected by bilirubin levels,after the treatment,the decrease of CA-199 level is consistent with the decrease of bilirubin level.But the malignant group does not have the above phenomenon.ConclusionCA-199 is a tumor-associated antigen,it is commonly used in clinical work for the diagnosis of tumors and the detection of postoperative therapeutic effects.Our study found that elevated CA-199 was found not only in tumors,but also in some benign diseases such as pancreatitis and cholangitis,and its CA-199 can be raised to a higher level.Before treatment,the increase of benign CA-199 was positively correlated with the elevation of bilirubin.After treatment,the level of CA-199 decreased with the decrease of bilirubin level.The downward trend was positively correlated.