Combined Detection Of CA19-9,CA242,CEA In Serum And Choler In Differential Diagnosis Of Benign And Malignant Biliary Obstruction

Objective: To investigate the value of CA19-9, CEA and CA242 in serum and choler in diagnosis of benign and malignant biliary obstruction. Method:From October 2013 to February 2015, 40 patients with pathological diagnosed malignant biliary obstruction and 40 patients with benign biliary obstruction were recruited in this study. Serum CA19-9, Serum CA242 and CEA were measured and recorded. Meanwhile, CA19-9, CA242 and CEA in choler, which obtained from laparotomy surgery or ERCP surgery or PTCD surgery, were measured and recorded.All data was analyzed to construct logistic regression model(probability prediction model). Area under the receiver operating characteristic curve(AUC) was used to evaluate the prediction accuracy.Results: there is no significant difference in serum CEA between benign and malignant biliary obstruction(P=0.225). The serum CA19-9, serum CA242, choler CEA, choler CA19-9 and choler CA242 in malignant biliary obstruction are significant higher that in benign biliary obstruction(P<0.001,P<0.001, P<0.001, P<0.001 and P<0.001, respectively). The AUC of serum CEA,serum CA19-9, serum CA242, choler CEA, choler CA19-9 and choler CA242 are0.501, 0.898, 0.669, 0.752, 0.937 and 0.946(P=0.988, P<0.001, P=0.009, P<0.001,P<0.001 and P<0.001, respectively).Using CA19-9, CEA and CA242 in serum to construct a probability prediction model, its AUC is 0.898 with an overall accuracy of81.25%; while using all 6 tumor biomarkers, the AUC is 0.973 with an overall accuracy of 97.5%. Conclusion: 1. CEA, CA19-9 and CA242 in choler in patients with malignant obstruction was significantly higher than in serum; 2. single examination showed serum CA19-9, choler CA19-9 and choler CA242 have a better value in diagnosis of benign and malignant biliary obstruction; 3. This study established an joint detection of the choler CA19-9 and choler CA242, which have thebest value in diagnosis of benign and malignant biliary obstruction. The probability prediction model can be used as a tool to predict benign and malignant disease.