Diagnostic role of biliary carcinoembryonic antigen in patients with pancreatobiliary diseases.
- Author:
Yeon Ik CHOO
1
;
Kwang Ro JOO
;
Jong Ho PARK
;
Sung Jo BANG
;
Do Ha KIM
;
Jung Woo SHIN
;
Neung Hwa PARK
;
Jae Hoo PARK
;
Ji Ho LEE
Author Information
1. Department of Internal Medicine, Ulsan University Hospital, Ulsan, Korea. gicolon@unitel.co.kr
- Publication Type:Original Article
- Keywords:
Carcinoembryonic antigen;
Bile;
Pancreatic diseases;
Biliary tract diseases
- MeSH:
Baths;
Bile;
Biliary Tract Diseases;
Bilirubin;
Carcinoembryonic Antigen*;
Drainage;
Humans;
Multivariate Analysis;
Pancreatic Diseases;
Prospective Studies;
Sensitivity and Specificity
- From:Korean Journal of Medicine
2003;65(5):520-526
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUN: Recently there has been notion that fluids bathing tumors might contain higher levels of carcinoembryonic antigen (CEA) than those found in the blood. Thus, we evaluated the diagnostic role of biliary CEA in patients with pancreatobiliary diseases. METHODS: One hundred and twenty one patients were prospectively studied. The patients were grouped as control (n=21), benign diseases (n=57), and malignant diseases (n=43). All patients underwent endoscopic or percutaneous biliary drainage. Bile was obtained and analyzed for CEA concentration on the next day of biliary drainage procedure. RESULTS: The mean biliary CEA were significantly different among the groups: control, 3.6 +/- 6.5 ng/mL; benign diseases, 35.4 +/- 59.2 ng/mL; malignant diseases, 77.9 +/- 126.6 ng/mL. But, there was considerable overlap among the groups. With a cut-off level of 22 ng/mL, the sensitivity and specificity were 58.1% and 60.5%, respectively. Among the variables, biliary CEA, total bilirubin, and gamma-GT were directly correlated with presence of malignancy. However, multivariate analysis revealed that biliary CEA was not enough to differentiate malignant diseases from benign diseases. CONCLUSION: Although biliary CEA levels might be predictive of malignancy, it is very difficult to differentiate with fair certainty between the two diseases because of the considerable overlap. Thus, biliary CEA appears to have a limitation for routine clinical application in distinguishing between benign and malignant diseases.
