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High serum CA19-9 levels are associated with an increased risk of cholangiocarcinoma in patients with intrahepatic duct stones: a case–control study

 Jung Hyun Jo  ;  Moon Jae Chung  ;  Jeong Youp Park  ;  Seungmin Bang  ;  Seung Woo Park  ;  Kyung Sik Kim  ;  Woo Jung Lee  ;  Si Young Song  ;  Jae Bock Chung 
 Surgical Endoscopy , Vol.27(11) : 4210-4216, 2013 
Journal Title
 Surgical Endoscopy  
Issue Date
Antigens, Tumor-Associated, Carbohydrate/blood* ; Bile Duct Neoplasms/blood* ; Bile Duct Neoplasms/diagnosis ; Bile Duct Neoplasms/epidemiology* ; Bile Ducts, Intrahepatic ; Biomarkers, Tumor/blood* ; Case-Control Studies ; Causality ; Cholangiocarcinoma/blood* ; Cholangiocarcinoma/diagnosis ; Cholangiocarcinoma/epidemiology* ; Comorbidity ; Female ; Gallstones/blood ; Gallstones/diagnosis ; Gallstones/epidemiology* ; Gallstones/surgery ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Risk Factors
Hepatolithiasis ; Cholangiocarcinoma
BACKGROUND: Hepatolithiasis is a known risk factor for cholangiocarcinoma (CC). Due to the high risk of complications that accompany endoscopic and surgical stone removal, it is often difficult to decide whether it is beneficial to remove intrahepatic ductal stones. We conducted a case-control study to determine the risk of developing CC and the benefit of stone removal in patients with hepatolithiasis. METHODS: Twenty-three patients with CC group between 2002 and 2012 were included in this study. For each patient with CC, four control patients with hepatolithiasis were enrolled based on age and sex matching. Finally, 115 patients with hepatolithiasis were enrolled. RESULTS: The mean length of time that intrahepatic stones were present was 116.57 (± 98.77) months in the CC group and 80.56 (± 101.10) months in the control group. History of gastrectomy [OR 5.756 (1.329-24.930), p = 0.019], history of choledochoenterostomy (OR 4.938 [1.129-21.595], p = 0.034), serum CA19-9 level [OR 1.001 (1.000-1.001), p = 0.022], and complete removal of stones [OR 0.167 (0.052-0.539), p = 0.003] were independent predictive factors of CC. In patients who had undergone incomplete removal of stones, the occurrence of CC was significantly reduced overall as well as in a subgroup of patients with elevated CA19-9 (p = 0.015 and p = 0.006, respectively) compared to patients with a CA19-9 of <22 U/mL (p = 0.477). CONCLUSIONS: History of gastrectomy or choledochoenterostomy, high levels of serum CA19-9, and incomplete removal of stones were potential predictive factors of CC in patients with hepatolithiasis. Additionally, complete removal of stones may reduce the risk of CC in patients with high serum CA19-9 levels (>22 U/mL).
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Sik(김경식) ORCID logo https://orcid.org/0000-0001-9498-284X
Park, Seung Woo(박승우) ORCID logo https://orcid.org/0000-0001-8230-964X
Park, Jeong Youp(박정엽) ORCID logo https://orcid.org/0000-0003-0110-8606
Bang, Seungmin(방승민) ORCID logo https://orcid.org/0000-0001-5209-8351
Song, Si Young(송시영) ORCID logo https://orcid.org/0000-0002-1417-4314
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Chung, Moon Jae(정문재) ORCID logo https://orcid.org/0000-0002-5920-8549
Chung, Jae Bock(정재복)
Jo, Jung Hyun(조중현) ORCID logo https://orcid.org/0000-0002-2641-8873
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