The Evaluation of Joint Detection of CA19-9, AFP and CEA in Identification and Diagnosis of Cholangiocarcinoma

Abstract

Serum CA19-9 is most sensitive marker for diagnosis of cholangiocarcinoma. However it can be found varies in different types of liver cancer. In recent years, the joint detection of multiple tumor markers met the requirements of the elevating sensitivity and the high accuracy of diagnosis. There was no previous data collection at Chonburi hospital. The objective of this study is to explore the application of joint detection of serum CA19-9, AFP and CEA in identification and diagnosis of cholangiocarcinoma. This study was conducted during 1 January 2012 to 15 March 2019 at Chonburi Hospital in patients diagnosed cholangiocarcinoma and hepatocellular carcinoma (HCC) by histopathology confirmation.

In cholangiocarcinoma patients had levels of serum CA19-9 and CEA significantly higher than in HCC patients, whereas serum AFP was significantly lower. The area under ROC curve of single detection of serum CA19-9, AFP and CEA were 0.91, 0.13 and 0.72, which led to the optimal cut-off values at 136.00 U/ml, 39.79 ng/ml and 12.95 ng/ml respectively. In case use only CA19-9 marker gives accuracy 81.5%.The diagnostic effect of combined CA19-9, AFP and CEA was the highest at 87.7%.

Conclusions: To differentiate between cholangiocarcinoma and HCC, the joint detection of serum CA 19-9, AFP and CEA can help for diagnosis. A cut-off values for cholangiocarcinoma are serum CA19-9 more than 136.00 U/ml, AFP lower than 39.79 ng/ml and CEA more than 12.95 ng/ml, which provided sensitivity 88.2%, specificity 87.1% and accuracy 87.7%