CA19.9 in differentiating benign and malignant obstructive jaundice

Serum carbohydrate antigen 19-9 (CA 19-9), a tumour marker for malignancies of the hepatobiliary tract and pancreas, frequently elevated in a number of non-malignant conditions that are associated with jaundice. The CA 19-9 tends to normalize the following restoration of biliary drainage. Sixty three patients presented with obstructive jaundice on the basis of clinical and imaging methods with elevated CA 19-9 were studied. Diagnostic accuracy of CA19-9 in the detection of malignancy was estimated by the receiver operating characteristic (ROC) curve. Median value of CA 19-9 in malignant cases was higher (1000 U/ml) than benign cases (93 U/ml) (p=0.001). After biliary drainage serum CA19-9 levels normalized in 15(50%) benign and 1(3%) malignant cases (p=0.001). The AUC of CA 19-9 was 0.825. Diagnostic accuracy of CA 19-9 was observed more at cut off value 200 U/ml. Deranged CA19-9 is frequently observed in benign conditions with jaundice and shown to normalize following improvement of biliary drainage. Caution is necessary in the interpretation of an elevated serum CA 19-9 value as a marker for malignancy, especially in patients with benign cholestasis.

Autorentext

Dr. MG Azam, a distinguished Hepatologist was born in 1969. He graduated from Dhaka Medical College in 1994. He did his MD in Hepatology in 2004 under the University of Dhaka. He joined BIRDEM hospital in 1995 & obtained training at Kyoto University Japan. Currently he is Associated Professor at the department of Gastroenterology & Hepatology.