Diagnostic Value of Serum Biomarkers for Intrahepatic Cholangiocarcinoma

OBJECTIVE: To explore the diagnostic value of carbohydrate antigen 19-9 (CA 19-9) and carcinoembryonic antigen (CEA) for the diagnosis of intrahepatic cholangiocarcinoma (ICC). STUDY DESIGN: Case control study. PLACE AND DURATION OF STUDY: First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China, from June 2016 to March 2018. METHODOLOGY: Patients with ICC (n = 51) diagnosed by histological examination after surgery were matched 1:4 to control subjects (n = 204) based on age (±2 years), gender, and ethnicity. Serum CA 19-9 and CEA levels were determined and compared. Receiver operating characteristic (ROC) curves were generated, and areas under the receiver operating characteristic curve (AUC) were calculated. The cutoff values, sensitivities, specificities, and Youden index values were calculated and compared. RESULTS: The levels of CA 19-9 and CEA were elevated in the ICC patients relative to control subjects (p <0.001). CA 19-9 and CEA showed diagnostic efficacy for ICC, with AUC values of 0.6916 and 0.6376, respectively. The cutoff value, sensitivity, specificity, and Youden index for CA 19-9 were 26 U/ml, 58.82%, 83.82%, and 0.4262, respectively. The cutoff value, sensitivity, specificity, and Youden index for CEA were 1.95 ng/ml, 90.2%, 35.29%, and 0.2549, respectively. The combination of CA 19-9 and CEA exhibited the best diagnostic efficacy, with the sensitivity, specificity, and Youden index being 90.2%, 88.24%, and 0.7844, respectively. CONCLUSION: Combined CA 19-9 and CEA levels have diagnostic value for ICC. The combination of CA 19-9 and CEA can assist surveillance and diagnosis of ICC prior to surgery.