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Measurement of serum carcinoembryonic antigen, carbohydrate antigen 19-9, cytokeratin-19 fragment and matrix metalloproteinase-7 for detecting cholangiocarcinoma: a preliminary case-control study.
[cholangiocarcinoma]
Cholangiocarcinoma
is
a
malignant
tumor
of
the
liver
arising
from
the
bile
duct
epithelium
,
accounting
for
10
-
25
%
of
all
primary
hepatic
cancers
.
The
clinical
presentation
of
this
tumor
is
not
specific
and
the
diagnosis
of
early
cholangiocarcinoma
is
difficult
,
especially
in
patients
with
other
biliary
diseases
.
Measurement
of
serum
carbohydrate
antigen
(
CA
)
19
-
9
and
carcinoembryonic
antigen
(
CEA
)
are
commonly
used
to
monitor
response
to
therapy
,
but
are
also
useful
for
confirming
the
presence
of
a
cholangiocarcinoma
.
In
this
setting
,
other
biomarkers
have
been
previously
tested
,
including
cytokeratin-
19
fragment
(
CYFRA
21
-
1
)
and
the
matrix
metalloproteinase-
7
(
MMP
7
)
.
The
purpose
of
this
retrospective
study
was
to
determine
the
clinical
usefulness
of
the
assay
of
serum
CEA
,
CA
19
-
9
,
CYFRA
21
-
1
and
MMP
7
,
individually
and
together
,
as
tumor
markers
for
the
diagnosis
of
cholangiocarcinoma
.
Twenty
-
four
patients
(
14
men
,
10
women
,
62
.
6
±
8
.
2
years
of
age
)
with
histologically-confirmed
cholangiocarcinoma
(
cases
)
and
25
age-
and
sex-matched
patients
with
benign
liver
disease
(
controls
)
underwent
measurement
of
these
biomarkers
.
The
mean
values
of
all
serum
markers
of
patients
with
cholangiocarcinoma
were
significantly
higher
(
p
<
0
.
01
)
than
that
of
the
controls
.
No
correlation
was
found
between
serum
tumor
markers
and
total
bilirubin
,
aspartate
aminotransferase
(
AST
)
and
alkaline
phosphatase
(
ALP
)
.
The
sensitivity
,
specificity
and
accuracy
were
:
CEA
:
52
%
,
55
%
,
and
58
%
;
CA
19
-
9
:
74
%
,
82
%
and
78
%
;
CYFRA
21
-
1
:
76
%
,
79
%
and
78
%
;
MMP
7
:
78
%
,
77
%
and
80
%
,
respectively
.
The
combination
of
all
serum
markers
afforded
92
.
0
%
sensitivity
and
96
%
specificity
in
detecting
cholangiocarcinoma
,
showing
the
highest
diagnostic
accuracy
(
94
%
)
.
In
conclusion
,
our
preliminary
results
suggest
that
the
measurement
of
all
four
biomarkers
together
can
help
in
the
early
detection
of
cholangiocarcinoma
.
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