Usefulness of Serum Carbohydrate Antigen 19-9 in Surgical Management of Mass-forming Intrahepatic Cholangiocarcinoma

Naoki Matsumura, Masakazu Yamamoto and Ken Takasaki

Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University

Background: We studied the relationship between preoperative serum carbohydrate antigen 19-9 (CA19-9) and clinicopathological features and surgical outcomes. Methods: We analyzed preoperative serum CA19-9 in 50 patients with mass-forming intrahepatic cholangiocarcinoma (m-ICC) who underwent hepatectomy. Results: Preoperative serum CA19-9 was elevated (exceeded 37U/ml) in 27 of 50 patients. No significant relationship was seen between serum CA19-9 levels and gender, age, type of hepatitis virus, liver cirrhosis, tumor size, or histopathologic differentiation. Tumors in patients with CA19-9 of 100U/ml or more showed significantly more vascular invasion. Tumors in patients with CA19-9 of 200U/ml or more showed significantly more lymph node metastasis. Tumors in patients with CA19-9 of 500U/ml or more showed significantly more intrahepatic metastasis. In univariate and multivariate analysis, the serum CA19-9 level was a significant prognostic factor in m-ICC (P=0.0184, P=0.0398). Conclusions: The preoperative serum CA19-9 level appears useful in judging the extent of m-ICC and predicting surgical outcome.

Key words
mass-forming intrahepatic cholangiocarcinoma, carbohydrate antigen 19-9, sialyl-Lewis A (Le^a), prognostic factor

Reprint requests
Masakazu Yamamoto Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666 JAPAN

Accepted
October 31, 2001

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