Tumor Markers For The Diagnosis Of The Patient With Malignant Obstructive Jaundice

PurposeTo analyze the levels of the clinical serum tumor markers AFP, CEA, CA125, CA19-9 on patients with malignant obstructive jaundice for diagnosis.MethodsRetrospectively analysed the serum tumor markers AFP, CEA, CA125, CA19-9 levels of 205 hospitalized patients with obstructive jaundice in the First Affiliated Hospital of China Medical University and the significance of these tumor markers for diagnosis.ResultsThe levels of serum CA19-9 in pancreatic cancer group (489.29U/ml)and bile duct cancer group (394.26U/ml)were higher than that of duodenal cancer group (85.53U/ml), with statistically significance (P=0.001-0.002). The levels of AFP serum were normal, in both benign group and malignant group. Compared with benign group (2.3ug/L) and other malignant group (3.20-5.48 ug/L)the level of Serum CEA in pancreatic cancer group (11.08ug/L) was obviously higher (P>0.05). The levels of Serum CA125 in the pancreatic cancer group (29.26U/ml), bile duct cancer group (28.96 U/ml), ampullary cancer group (16.56 U/ml) and the benign group (29.64 U/ml) were higher than duodenal cancer group (11.83 U/ml), but the difference was not statistically significant (P=0.21-0.98). Four kinds of tumor markers in the diagnosis of malignant obstructive jaundice showed a similar trend. For the diagnosis of pancreatic cancer, the sensitivity of CA19-9 was up to 83%(P=0.00-0.014), the specificity of CEA was up to 81%(P=0.000-0.014). For the diagnosis of bile duct cancer, the sensitivity of CA19-9 was the highest 86%(P=0.001-0.014), the specificity of AFP up to 82%(P=0.000-0.013).There was no statistically difference among the tumor markers for the diagnosis in pairs of duodenal cancer and ampullary cancer (P> 0.05). The levels of CA19-9 and bilirubin were positively correlated in benign and malignant tumor markers in serum (r=0.344, p=0.002).ConclusionAFP has limited value on the diagnosis of malignant obstructive jaundice. CEA has a higher specificity on the diagnosis of pancreatic and bile duct cancer and it can be used as co-diagnosis of pancreatic cancer, bile duct cancer indicators.Though CA125 has limited value in the diagnosis malignant obstructive jaundice, It should be aware of the interference in the diagnosis of female patients with jaundice. Though CA19-9 has a high sensitivity, in the diagnosis of both pancreatic cancer, and bile duct cance. It has low specificity, and false positive rate. Andt the increased level of bilirubin also has a great influence on CA19-9. CA19-9 which can be used as a diagnostic indicator for pancreatic cancer and bile duct cancer with jaundice must be combined with other diagnostic tools.