Enhanced detection of cholangiocarcinoma with serum trypsinogen-2 in patients with severe bile duct strictures.

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. 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. 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. 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.

journal_name

J Hepatol

journal_title

Journal of hepatology

authors

Lempinen M,Isoniemi H,Mäkisalo H,Nordin A,Halme L,Arola J,Höckerstedt K,Stenman UH

doi

10.1016/j.jhep.2007.05.017

subject

Has Abstract

pub_date

2007-11-01 00:00:00

pages

677-83

issue

5

eissn

0168-8278

issn

1600-0641

pii

S0168-8278(07)00348-0

journal_volume

47

pub_type

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