Dissertation committee:
Αλέξιος Φωτόπουλος, Αν.Καθηγητής, Δημήτριος Κάννας, Αν.Καθηγητής , Ανδρέας Πολυδώρου,Αν.Καθηγητής
Summary:
Background: Our study aim was to establish cut-off levels and to report the
usefulness of serum and bile Tumor Marker concentrations CEA, CA19-9, CA125,
CA72-4 and CA242 in serum, bile and in pancreatic fluid, alone and in combined
detection for discrimination of malignant from benign pancreatobiliary
diseases.
Methods: 95 patients were enrolled in the study. The 1st group consisted of
patients with malignant lesions (n=44) while the 2nd group consisted of
patients with benign disease (n=51). ERCP was performed in all patients. Bile
and pancreatic fluid was collected through an ERCP catheter, while serum
samples were collected before ERCP, for measurement of total serum bilirubin
and tumor markers CEA, CA19-9, CA125, CA242 and CA72-4.
Results: Median serum total bilirubin, CEA, CA19-9, CA125 ,CA72-4 and CA242
along with median CA125 and CA72-4 measured in bile and median CEA and CA125
measured in pancreatic fluid were statistically significant higher in patients
with malignant disease. Serum CA242 and CA19-9 exhibited the highest diagnostic
accuracy (76.8% and 73.7%, respectively). Bile CA125 exhibited 69.5% diagnostic
accuracy with CEA and CA72-4 having each 65.3%. CEA and CA125 measured in
pancreatic fluid exhibited 86.2% and 69% diagnostic accuracy respectively.
Combined detection, using any three of the five tumor markers (serum CA242,
serum CA19-9, bile CA125, bile CA72-4 and total serum bilirubin), optimized
results regarding sensitivity, specificity and diagnostic accuracy of 81.8%,
80.4% and 81.1% respectively.
Conclusion: Serum, bile and pancreatic fluid tumor markers, when studied alone,
lack the diagnostic yield to discriminate benign from malignant
pancreatobiliary disease. In case of combined detection using any three of the
five tumor markers (serum CA242, serum CA19-9, bile CA125, bile CA72-4 and
total serum bilirubin), results are optimized within an acceptable range
concerning diagnostic value and accuracy.
Keywords:
Bile tumor markers, Cholangiocarcinoma, Combined detection, Pancreatic cancer, Serum
