To investigate the clinical value of increase of serum cancer antigens(CA)19-9 in patients with cholangiocarcinoma.

Clinical data of 82 patients with pathologically confirmed cholangiocarcinoma underwent surgical resection in the First Hospital of Lanzhou University from January 2008 to March 2011 were analyzed retrospectively. There were 50 males and 32 females with age ranging from 40 to 85 years old and the median age of 58 years old. Another 85 patients (47 males and 38 females with age ranging from 25 to 83 years old and the median age of 57 years old) hospitalized for benign biliary diseases at the same period were enrolled in the study as the control group. The informed consents of all patients were obtained and the ethical committee approval was received. The parameter of liver function such as alanine aminotransferase (ALT) , aspartate aminotransferase (AST) , gamma-glutamyl transpeptidase (GGT) , alkaline phosphatase (ALP) , total protein (TP) , albumin (ALB) , globulin (GLB) , total bilirubin (TB) , direct bilirubin (DB) , as well as tumor markers, such as level of serum CA19-9, CA125, carcino-embryonic antigen (CEA) and alpha fetoprotein (AFP) of patients' peripheral venous blood taken 2 days after hospitalization were detected. The relations between the level of serum CA19-9 and laboratorial and clinical pathological indexes were observed. The relation between the level of serum CA19-9 and laboratorial indexes was analyzed using Spearman correlation test. Comparison of CA19-9 level between multigroup samples of clinical pathological indexes was conducted using Kruskal-Wallis test. Wilcoxon test was used for comparison between 2 groups.

The median level of serum CA19-9 of patients with cholangiocarcinoma was 318 (41,733) μg/L, which was statistically higher than that in the control group [43(14,139)μg/L] (Z=3.736, P<0.05). There were positive correlation for serum CA19-9 with ALP, TB, DB and CA125, while negative correlation with ALB(r=0.340, 0.394, 0.385, 0.480, -0.389; P<0.05). The lever of serum CA19-9 in patients with jaundice was evidently higher than the patients without jaundice(Z=-2.114, P=0.035) . The level of serum CA19-9 in patients with loss of weight≥ 5 kg was evidently higher than that in the patients with loss of weight <5 kg(Z=-2.200, P=0.028). The level of serum CA19-9 in patients with tumor diameter <2 cm, 2-3 cm, and >3 cm raised one by one. There were significant differences(H=25.698, P>0.05). There was no significant difference in the serum CA19-9 level between patients with different histological differentiation (H=0.864, P>0.05).

The level of serum CA19-9 in patients with cholangiocarcinoma is evidently higher than that in the patients with benign biliary diseases and it is correlated with the liver function, jaundice, loss of weight and tumor size. The level of serum CA19-9 may be an important index for the diagnosis, evaluation of the resectable feasibility and prognosis of patients with cholangiocarcinoma.