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Criteria of Schoeniger-Hekele and Mueller for Using CA19-9 and CA125 to Diagnose Severe Liver Fibrosis in a Pateint with Noncholestatic Liver Disease

Description

Schoeniger-Hekele and Mueller used serum levels of the tumor markers CA 19-9 and CA 125 to identify patients with liver disease who have significant hepatic fibrosis. The use of these markers may reduce the need for liver biopsy in some patients. The authors are from the University of Vienna.


 

Patient selection: noncholestatic liver disease without malignancy

 

Parameters:

(1) serum CA 19-9 in kU/L (upper limit of normal in the Roche Elecsys system 37 kU/L or 37 U/mL))

(2) serum CA 125 in kU/L (upper limit of normal in the Roche Elecsys system 35 kU/L or 35 U/mL)

 

The presence of both CA19-9 > ULN and CA125 > ULN indicates F3 or F4 hepatic fibrosis with a sensitivity of 31% and specificity 98.5%.

 

The authors developed a score combining serum values.

 

Parameters

Findings as kU/L

Points

serum CA 19-9

< 10 kU/L

0

 

10 to 20 kU/L

1

 

21 to 25 kU/L

2

 

26 to 33 kU/L

3

 

34 to 37 kU/L

4

 

> 37 kU/L

5

serum CA 125

< 10 kU/L

0

 

10 to 20 kU/L

1

 

21 to 25 kU/L

2

 

26 to 29 kU/L

3

 

30 to 35 kU/L

4

 

> 35 kU/L

5

 

The values can be converted to multiples of the ULN.

 

Parameters

Findings as ULN

Points

serum CA 19-9

< 0.27 ULN

0

 

0.27 to 0.55 ULN

1

 

0.56 to 0.69 ULN

2

 

0.70 to 0.89 ULN

3

 

0.90 to 1 ULN

4

 

> 1 ULN

5

serum CA 125

< 0.29 ULN

0

 

0.30 to 0.60 ULN

1

 

0.61 to 0.75 ULN

2

 

0.76 to 0.87 ULN

3

 

0.88 to 1 ULN

4

 

> 1 ULN

5

 

total score =

= SUM(points for the 2 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 10

• The higher the score the greater the risk of F3 or F4 hepatic fibrosis.

• A score of 7 had a sensitivity of 43% and specificity of 97%.

• The rule above corresponds to a score of 10.

 


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Specialty

Objective

ICD-10