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Enhanced detection of cholangiocarcinoma with serum trypsinogen-2 in patients with severe bile duct strictures.
- Source :
-
Journal of hepatology [J Hepatol] 2007 Nov; Vol. 47 (5), pp. 677-83. Date of Electronic Publication: 2007 Jun 27. - Publication Year :
- 2007
-
Abstract
- Background/aims: Primary sclerosing cholangitis (PSC) is associated with a high risk of cholangiocarcinoma. Our aim was to evaluate the diagnostic value of trypsinogen-1, trypsinogen-2, tumour-associated trypsin inhibitor, human chorionic gonadotropin beta and trypsin-2-alpha(1)-antitrypsin for cholangiocarcinoma and to compare them with CA19-9 and CEA.<br />Methods: The study consisted of 84 patients with either PSC or cholangiocarcinoma or both referred for liver transplantation or other liver surgery. The serum concentrations were determined by time-resolved immunofluorometric assays.<br />Results: Forty-six patients were transplanted due to PSC; in 3 of the explanted livers cholangiocarcinoma was found incidentally. All transplanted patients had severe biliary strictures together with cirrhosis or pre-cirrhosis. Twenty-nine of 38 patients with cholangiocarcinoma were candidates for intervention. In all, 8 patients had both PSC and cholangiocarcinoma. Receiver-operating characteristics curve analysis showed that serum trypsinogen-2 had the highest accuracy in differentiating between cholangiocarcinoma and PSC. The area under the curve (AUC) value was 0.804 for trypsinogen-2 and 0.613 for CA19-9. Serum trypsinogen-2 also showed the highest accuracy for differentiation between PSC and PSC with simultaneous cholangiocarcinoma with an AUC value of 0.759.<br />Conclusions: Our results suggest that serum trypsinogen-2 is a most useful marker for diagnosing patients with cholangiocarcinoma, and it is superior to serum CA19-9 and CEA.
- Subjects :
- Adult
Aged
Aged, 80 and over
Bile Duct Neoplasms physiopathology
Bile Ducts, Intrahepatic physiopathology
Biomarkers, Tumor analysis
CA-19-9 Antigen analysis
CA-19-9 Antigen blood
Cholangiocarcinoma physiopathology
Constriction, Pathologic etiology
Diagnosis, Differential
Female
Humans
Male
Middle Aged
Predictive Value of Tests
Receptors, Cell Surface analysis
Receptors, Cell Surface blood
Sensitivity and Specificity
Trypsin analysis
Trypsinogen analysis
Bile Duct Neoplasms blood
Bile Duct Neoplasms diagnosis
Bile Ducts, Intrahepatic pathology
Biomarkers, Tumor blood
Cholangiocarcinoma blood
Cholangiocarcinoma diagnosis
Trypsin blood
Trypsinogen blood
Subjects
Details
- Language :
- English
- ISSN :
- 0168-8278
- Volume :
- 47
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Journal of hepatology
- Publication Type :
- Academic Journal
- Accession number :
- 17640760
- Full Text :
- https://doi.org/10.1016/j.jhep.2007.05.017