A Case of Cholelithiasis with Extremely High Value of CA19-9 and DUPAN-2 in Serum and Speciment

Shoji Uetsuji, A Hon Kwon, Yasuo Kamiyama, Tokio Okusa, Masazumi Tsuji*

First Department of Surgery, Kansai Medical University
*Second Department of Surgery, Kansai Medical University

A case of cholelithiasis with elevated serum CA19-9 and DUPAN-2 levels, which were normalized after improvement of obstructive jaundice, was reported. A 66-year-old man complained of jaundice, abdominal pain and fever. Ultrasonography, computed tomography and endoscopic retrograde cholangiography revealed a choledocholithiasis. Endoscopic lithotomy was performed for improvement of obstructive jaundice due to common bile duct stone. Preoperative serum levels of CA19-9 and DUPAN-2 were 9300 U/ml and 826 U/ml, and both postoperative serum levels were normalized. Immunohistochemical staining of CA19-9 and DUPAN-2 revealed positive reaction on the epithelium of gallbladder. It is suggested that CA19-9 and DUPAN-2 are secreted from bile duct epithelium and flows back into blood in situation of cholecystitis or obstruction of bile duct. It is necessary to recognize such as this case in cholelithiasis.

Key words
cholelithiasis, CA19-9, DUPAN-2

Reprint requests
Shoji Uetsuji First Department of Surgery, Kansai Medical University
1 Fumizono, Moriguchi City, 570 JAPAN

Accepted
October 7, 1992

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