Park Ki Ho, Kim Jae Seon, Lee Ju Han, Kim Hyo Jung, Kim Jin Yong, Yeon Jong Eun, Park Jong-Jae, Byun Kwan Soo, Bak Young-Tae, Lee Chang Hong
Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Korean J Gastroenterol. 2006 Jan;47(1):52-8.
BACKGROUND/AIMS: In spite of various diagnostic modalities, biliary cystic neoplasms (biliary cystadenoma and cystadenocarcinoma) remain to be difficult to diagnose preoperatively. Recently, there are some reports that elevated CA19-9 level in serum and/or cystic fluid could be a useful finding in the differential diagnosis of biliary cystic neoplasm. This study aimed to evaluate the expression of CA19-9 and to elucidate its significances in intrahepatic biliary cystic neoplasms and simple hepatic cysts.
In 8 patients with biliary cystic neoplasms and 6 simple hepatic cysts, symptoms, radiologic and laboratory findings were reviewed retrospectively. In 5 biliary cystic neoplasms (4 biliary cystadenomas, 1 biliary cystadenocarcinoma) and 5 simple hepatic cysts, immunohistochemical stainings for CA19-9 were performed with formalin-fixed, paraffin-embedded tissues.
In 8 biliary cystic neoplasms, two cases were suspected as biliary cystadenoma preoperatively and 6 cases could not be distinguished from simple cysts or cholangiocarcinoma preoperatively. In 6 simple hepatic cysts, 3 cases were diagnosed preoperatively and 3 cases could not be distinguished from biliary cystadenoma or pancreatic pseudocyst preoperatively. Expression of CA19-9 in simple hepatic cysts and biliary cystic neoplasms were 80% in both groups. Expression of CA19-9 is not related to the elevated level of CA19-9 in serum.
Our data suggests that the elevated level of CA19-9 in serum may not be helpful in the preoprative diagnosis of biliary cystic neoplasm.
背景/目的：尽管有多种诊断方法，但胆管囊性肿瘤（胆管囊腺瘤和囊腺癌）术前诊断仍很困难。最近，有报道称血清和/或囊液中CA19-9水平升高可能是胆管囊性肿瘤鉴别诊断的有用发现。本研究旨在评估CA19-9的表达，并阐明其在肝内胆管囊性肿瘤和单纯肝囊肿中的意义。
回顾性分析8例胆管囊性肿瘤患者和6例单纯肝囊肿患者的症状、影像学和实验室检查结果。对5例胆管囊性肿瘤（4例胆管囊腺瘤，1例胆管囊腺癌）和5例单纯肝囊肿，采用福尔马林固定、石蜡包埋组织进行CA19-9免疫组化染色。
8例胆管囊性肿瘤中，术前2例疑似胆管囊腺瘤，6例术前无法与单纯囊肿或胆管癌鉴别。6例单纯肝囊肿中，术前诊断3例，3例术前无法与胆管囊腺瘤或胰腺假性囊肿鉴别。单纯肝囊肿和胆管囊性肿瘤中CA19-9的表达在两组中均为80%。CA19-9的表达与血清中CA19-9水平升高无关。
我们的数据表明，血清中CA19-9水平升高可能无助于胆管囊性肿瘤的术前诊断。
