Gallbladder bile tumor marker quantification for detection of pancreato-biliary malignancies

• Published in: Anticancer research Vol. 20; no. 6D; p. 4941
• Main Authors: Brockmann, J, Emparan, C, Hernandez, C A, Sulkowski, U, Dietl, K H, Menzel, J, Wolters, H, Glodny, B, Senninger, N
• Format: Journal Article
• Language: English
• Published: Greece 01.11.2000
• Subjects: Antigens, Tumor-Associated, Carbohydrate - metabolism; Bile Ducts - metabolism; Biliary Tract Neoplasms - diagnosis; Biliary Tract Neoplasms - metabolism; Biomarkers, Tumor - metabolism; CA-125 Antigen - metabolism; CA-19-9 Antigen - metabolism; Carcinoembryonic Antigen - metabolism; Gallbladder - metabolism; Humans; Pancreatic Neoplasms - diagnosis; Pancreatic Neoplasms - metabolism; Prognosis
• ISSN: 0250-7005

The pre-operative differentiation of tumors of the pancreas, Papilla of Vater and the biliary tract is still unsatisfactory. Tumor marker analysis of the pancreatic juice did not improve the pre-operative diagnosis by a great deal. Bile from resected gallbladders of patients suffering from carcinomas of the pancreato-biliary system was analysed for CA 19-9, CEA, CA 72-4, CA 125 and AFP concentrations. The results were compared to patients suffering from acute cholecystitis, cholecystolithiasis as well as those suffering from benign tumors of the pancreato-biliary region. Extreme high CA 19-9 concentrations were found in bile. Evaluations of the tumor-antigens CA 19-9, CA 72-4 and CEA in gallbladder bile were superior to any serum and pancreatic juice examination with respect to sensitivity and specificity. Observed sensitivities amounted to 100% for patients suffering from bile duct carcinoma (CA 19-9) and papillary carcinoma (CEA) at a specificity of 100%. CA 19-9 showed a sensitivity of 76.5% for pancreatic carcinomas at a specificity of 96.4%. CA 19-9 showed significant differences for the local tumor burden and for the degree of lymph node metastasis. Examination of tumor antigens in the gallbladder results in a high degree of discrimination for malignant and benign lesions of the subhepatic pancreato-biliary system. CA 19-9 must follow a entero-hepatic circulation, since it showed raised bile concentrations (factor: 10(4)) compared to serum analysis. Analysis of CA 19-9, CEA and CA 72-4 gives an opportunity for improvement in the detection of cancers of the pancreato-biliary system. Since the clinical important differentiation of tumors of the head of the pancreas (carcinoma vs. pancreatitis) remains unclear, an improvement by bile analyses must be assumed.