Diagnostic Accuracy of tumor marker CA 19-9 in patients with cholangiocarcinoma taking ERCP as gold standard test'

Background: Majority of the cases of Cholangiocarcinoma at presentation are unresectable, it’s diagnosis at an early stage is pivotal but generally difficult due to lack of easy availaibility of confirmatory test at the moment in our country. Endoscopic Retrograde Cholangiopancreatography (ERCP) is not only helpful in reaching the diagnosis Aim: To find out the diagnostic accuracy of tumour marker CA 19-9, in suspected patients of Cholangiocarcinoma taking ERCP as gold standard test Methods: This cross sectional study was conducted in general and private clinics of Department of Gastroenterology of the Fatima Memorial Hospital Lahore from, October 21, 2014 to April 20, 2015. Sampling technique used was probability purposive sampling. Results: A total of 150 suspected patients of cholangiocarcinoma were included in the study in which 61 (40.7%) were male and 89(59.3%) were female with total mean age of 56.32±14.13 years. Among the studied patients, 88(58.7%) were found positive for malignant stricture on ERCP and CBD brushing cytology. Sensitivity, specificity and accuracy of the tumour marker CA 19-9 was 53.4%, 66.1% and 58% respectively. Conclusions: CA 19-9 is a very important tumor marker in making diagnosis of cholangiocarcinoma and in our country due to lack of easy access/availability to invasive diagnostic methods like endoscopic ultrasonography (EUS) and fine needle aspiration (FNA) of the tumor. It should be used as routine early diagnostic modality in suspected cases of Cholangiocarcinoma. Keywords: Cholangiocarcinoma, Cancer antigen (CA) 19-9, ERCP, biliary brushing and cytology