caa a22 4500 445796421 CHVBK 20180317145126.0 cr unu---uuuuu 170323e20110801xx s 000 0 eng 10.1007/s10620-011-1709-8 doi (NATIONALLICENCE)springer-10.1007/s10620-011-1709-8 The Clinical Utility and Limitations of Serum Carbohydrate Antigen (CA19-9) as a Diagnostic Tool for Pancreatic Cancer and Cholangiocarcinoma [Elektronische Daten] [Sundeep Singh, Shou-jiang Tang, Jayaprakash Sreenarasimhaiah, Luis Lara, Ali Siddiqui] Background: CA19-9 is a tumor marker for pancreatic cancer, cholangiocarcinoma, and other malignancies. However, its sensitivity and specificity is suboptimal in clinical practice, which we hypothesized limits its clinical utility. Aims: To evaluate the clinical utility and limitations of CA19-9 as a tumor marker. Methods: We performed a retrospective review of CA19-9 levels (U/ml) in 483 consecutive patients between 2006 and 2008 at two university hospitals. We abstracted clinical, radiographic, and pathological data and final diagnoses. Descriptive and non-parametric analyses were performed. Results: Patients presenting with jaundice had the highest CA19-9 (420) compared to other complaints (<20) (p<0.01). The indications with the highest CA19-9 had evidence of biliary obstruction (71), liver mass (54), and pancreatic head mass (27) compared to other indications (<15) (p<0.01). The diagnoses with the highest CA19-9 (p<0.01) were cholangiocarcinoma (476), pancreatic cancer (161), and choledocholithiasis (138). Using a receiver operator curve to evaluate CA19-9, the area under the curve was 0.7 when evaluating all patients for pancreatic cancer or cholangiocarcinoma or patients with pancreatic head mass for pancreatic cancer. Conclusions: This study found that for pancreatic cancer and cholangiocarcinoma, CA19-9 had poor clinical utility as a tumor marker and did not change patient management. Elevations in CA19-9 were associated with biliary obstruction based on clinical history, laboratory data, and diagnoses. Springer Science+Business Media, LLC, 2011 Serum carbohydrate antigen nationallicence CA19-9 nationallicence Pancreatic cancer nationallicence Cholangiocarcinoma nationallicence Singh Sundeep Division of Gastroenterology and Hepatology, Stanford University, 300 Pasteur Dr., Always Building, Room M211, 94305, Stanford, CA, USA aut Tang Shou-jiang Division of Digestive Diseases, University of Mississippi, 2500 North State Street, 39216, Jackson, MS, USA aut Sreenarasimhaiah Jayaprakash Division of Digestive and Liver Diseases, University of Texas-Southwestern Medical Center, 5323 Harry Hines Blvd, 95390, Dallas, TX, USA aut Lara Luis Baylor University Medical Center, 3900 Junius St., Suite 605, 75246, Dallas, TX, USA aut Siddiqui Ali Division of Gastroenterology and Hepatology, Jefferson Digestive Disease Institute, Thomas Jefferson University, 132 South 10th St., Suite 480, Philadelphia, PA, USA aut Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/8(2011-08-01), 2491-2496 0163-2116 56:8<2491 2011 56 10620 https://doi.org/10.1007/s10620-011-1709-8 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10620-011-1709-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Singh Sundeep Division of Gastroenterology and Hepatology, Stanford University, 300 Pasteur Dr., Always Building, Room M211, 94305, Stanford, CA, USA aut NATIONALLICENCE 700 1- Tang Shou-jiang Division of Digestive Diseases, University of Mississippi, 2500 North State Street, 39216, Jackson, MS, USA aut NATIONALLICENCE 700 1- Sreenarasimhaiah Jayaprakash Division of Digestive and Liver Diseases, University of Texas-Southwestern Medical Center, 5323 Harry Hines Blvd, 95390, Dallas, TX, USA aut NATIONALLICENCE 700 1- Lara Luis Baylor University Medical Center, 3900 Junius St., Suite 605, 75246, Dallas, TX, USA aut NATIONALLICENCE 700 1- Siddiqui Ali Division of Gastroenterology and Hepatology, Jefferson Digestive Disease Institute, Thomas Jefferson University, 132 South 10th St., Suite 480, Philadelphia, PA, USA aut NATIONALLICENCE 773 0- Digestive Diseases and Sciences Springer US; http://www.springer-ny.com 56/8(2011-08-01), 2491-2496 0163-2116 56:8<2491 2011 56 10620 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer