Diagnosis of Cholangiocarcinoma in Patients with Primary Sclerosing Cholangitis Using the Serum Tumor Marker Score of Ramage et al

 

Parameters:

(1) CA 19-9, in U/mL

(2) CEA in ng/mL

 

index =

= (serum CA 19-9 in U/mL) + (40 * (serum CEA in ng/mL))

 

where:

• The upper end of the reference range for CEA in patients with PSC was set at 5 ng/mL (page 866, bottom second column).

• The upper end of the reference range for CA 19-9 in patients with PSC was set at 200 U/mL.

 

Interpretation:

• minimum index: 0

• maximum index: > 80,000

• An index value > 400 identified patients with PSC was associated with cholangiocarcinoma.

• In the study population, 86% of patients with cholangiocarcinoma had an index value > 400 (most > 600). 1 patient (out of 59) who did not have cholangiocarcinoma had an index of about 430; this patient was in a stable group not requiring liver transplantation.

 

Limitations:

• Since results for the serum tumor markers may vary between laboratories, the index cut-off may need to be adjusted for local test conditions.