담관계 암에서 담즙 CEA

Abstract

Background/Aims: CEA(carcinoembroyonic antigen) in the body fluid bathing tumor may be more reliable for diagnosis of malignancy than in the serum. We measured the levels of CEA in the serum and bile of patients with biliary tract diseases and investigated the diagnostic values in differentiation between malignant and begnin conditions. Methods: A total of 72 cases of obstructive jaundice admitted to the Yonsei Medical Center consisted of 58 cases with biliary cancer and 14 cases with benign biliary diseases were included. The levels of CEA in the serum and in the bile were analyzed comparatively to determined clinical values in differential diagnosis of biliary cancer. Results: Serum CEA were significantly higher in the biliary cancer(mean 38.0 ng/ml) than in the benign biliary diseases(mean 2.5 ng/ml) (p<0.05). The mean levels of bile CEA were 75.8 ng/ml and 63.8 ng/ml for the biliary cancer and benign biliary diseases respectively. There was no significant difference between malignant and benign conditions. However, if an abnormal CEA level was defined as 90 ng/ml or more in the bile, increased bile CEA levels were observed in 17 of 58 cases(29%) with biliary cancer and one of 14 case(7%) with benign diseases. The levels of bile CEA were significantly higher in the biliary cancer with cholangitis than in those without cholangitis. Conclusions: Bile CEA had limited value in differentiation between malignant and benign biliary obstruction but most cases with bile CEA more than 90 ng/ml were observed in the bilialy cancer. The concentration of bile CEA may be affected not only by tumor itself but also by inflammation of biliary tract.