Longitudinal analysis of CA19-9 reveals individualised normal range and early changes before development of biliary tract cancer in patients with primary sclerosing cholangitis

• Verfasst von: Wannhoff, Andreas [VerfasserIn]
• Verfasst von: Brune, Maik [VerfasserIn]
• Verfasst von: Knierim, Johannes [VerfasserIn]
• Verfasst von: Weiss, Karl Heinz [VerfasserIn]
• Verfasst von: Rupp, Christian [VerfasserIn]
• Verfasst von: Gotthardt, Daniel [VerfasserIn]
• Titel: Longitudinal analysis of CA19-9 reveals individualised normal range and early changes before development of biliary tract cancer in patients with primary sclerosing cholangitis
• Verf.angabe: Andreas Wannhoff, Maik Brune, Johannes Knierim, Karl Heinz Weiss, Christian Rupp, Daniel N. Gotthardt
• E-Jahr: 2019
• Jahr: 27 January 2019
• Umfang: 10 S.
• Fussnoten: Gesehen am 01.04.2019
• Titel Quelle: Enthalten in: Alimentary pharmacology & therapeutics
• Ort Quelle: Oxford : Blackwell Science, 1987
• Jahr Quelle: 2019
• Band/Heft Quelle: 49(2019), 6, Seite 769-778
• ISSN Quelle: 1365-2036
• DOI: doi:10.1111/apt.15146
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1662607059

Abstract

Background Primary sclerosing cholangitis is associated with an increased risk of biliary tract cancer. Carbohydrate antigen 19-9 (CA19-9) can be used to screen for these malignancies. Aim To perform a longitudinal analysis of CA19-9 in patients with primary sclerosing cholangitis. Methods We conducted a retrospective analysis of CA19-9 values in patients who had primary sclerosing cholangitis, with and without biliary malignancy. We calculated the index of individuality and reference change value in patients who were cancer-free. Long-term analysis of CA19-9 in cancer-free patients was performed and we assessed the change of CA19-9 prior to diagnosis of cancer. Results We obtained 1818 CA19-9 values from 247 patients, including 32 with malignancy. Median CA19-9 in cancer-free individuals was 15.6 U/mL. The index of individuality was 0.37 and the reference change value was 46.23%. In cancer-free patients, no significant change in CA19-9 was observed at 1, 2, 5, 7, 10, 15, and 20 years after initial diagnosis of primary sclerosing cholangitis. In patients with biliary tract cancer, CA19-9 was higher at 3 months prior to diagnosis (P < 0.05) than at 6 months before diagnosis and was also higher than at 3 months prior to last follow-up in cancer-free patients (P < 0.05). In 92.9% of patients with biliary cancer, we found an increase in CA19-9 of >46.23% in the year prior to cancer diagnosis. Conclusions CA19-9 in patients with primary sclerosing cholangitis is highly individual, and the reference change value should be preferred to reference intervals. In this study, CA19-9 remained stable in patients who were cancer-free but increased early in those who developed biliary tract cancer. Regular CA19-9 measurement might improve early detection of these malignancies.