간담췌 질환에서 CA 19-9의 양성률 고찰

Abstract

Purpose: CA19-9 is the most widely used pancreatic-tumor marker, and has become the standard against which other makers. However, the CA19-9 level is increased in conditions such as gallbladder cancer, cholangiocarcinoma, hepatocellular carcinoma, gallbladder polyp, acute cholangitis, and chronic pancreatitis. Therefore, this study aimed to determine the CA19-9 positive rate of the above diseases in Korea. Methods: A positive result was considered if the upper limit of normal was 37?40 U/ml. The CA19-9 level was measured in 53 patients with pancreatic cancer, 72 with cholangiocarcinoma, 41 with common bile duct cancer, 27 with gallbladder cancer, 35 with hepatocellular cancer, 70 with acute pancreatitis, 93 with chronic pancreatitis, and 30 with a gallbladder polyp from September 1998 to December 2000 in the Severance hospital. Results: When the cut-off value was >40 U/ml, a positive result was found in 79.2% (42/53) of pancreatic cancer patients, 58.3% (42/72) of cholangiocarcinoma patients, 37% (10/27) of gallbladder cancer patients, 31.7% (13/41) of common bile duct cancer patients, 19.7% (14/70) of acute pancreatitis patients, 14.2% (5/35) of hepatocellular cancer patients, 16% (5/93) of chronic pancreatitis patients, and the 3.3% (1/30) of patients with a gallbladder polyp. Conclusion: The highest positive rate was 79.2% in the pancreatic cancer patients. We confirmed that the Lewis phenotype distribution indieates that pancreatic cancer, cholangiocarcinoma, and chronic pancreatitis show high frequency in Le(a-b-) group when they were statistically compared with a healthy control group, but that acute pancreatitis showed a stastically higher frequency in the Le(a +b-) group than chronic pancreatitis.