Evaluation of the importance of the Serum Levels of CA-125, CA19-9, CA-19-9, Carcinoembryonic Antigen and Alpha Fetoprotein for Diagnosis of Cholangiocarcinoma
Objective: To explore the application of joint detection of serum AFP, CA19-9, CA125 and CEA in identification and
diagnosis of cholangiocarcinoma (CC). Materials and Methods: The levels of serum AFP, CA19-9, CA125 and CEA of
both 30 patients with CC and 30 patients with hepatocellular carcinoma (HCC) were assessed. Receiver operating
characteristic (ROC) curves were used to evaluate the diagnostic effects of single and joint detection of those 4 kinds of
tumor markers for CC. Results: The levels of serum CA19-9, CA125 and CEA in CC patients were higher than that in HCC
patients, whereas that of serum AFP was significantly lowers.
The area under ROC curve of single detection of serum AFP, CA19-9, CA125 and CEA were 0.05, 0.86, 0.84 and 0.83, with
the optimal cut-off values of 15.4 ng/ml, 125.1 U/ml, 95.7 U/ml and 25.9 ng/ml, correspondingly, and the percentage correct
single diagnosis was <79%. With joint detection, the diagnostic effect of combined AFP, CA19-9, CA125 and CEA was the
highest, with an area under the ROC curve of 0.94 (95%CI 0.88~0.99). Conclusions: Single detection of serum CA19-9,
CA125 and EA is not meaningful. The sensitivity, specificity, the rate of correct diagnosis and the area under ROC curve of
joint detection of AFP, CA19-9, CA125 and CEA are highest, indicating that the joint detection of these 4 tumor markers is
of great importance in the diagnosis of CC.
Keywords - Cholangiocarcinoma - hepatocellular carcinoma - tumor markers - identification and diagnosis - ROC curve