Koroglu Mert, Koroglu Banu Kale, Akhan Okan, Coskun Hasan Senol, Yildizz Harun, Yesildag Ahmet, Oyar Orhan
Department of Radiology, Suleyman Demirel University School of Medicine, Isparta, Turkey.
Hepatogastroenterology. 2006 Jul-Aug;53(70):491-6.
BACKGROUND/AIMS: Some tumor markers such as CA 19-9 are shown to be increased in obstructive jaundice due to either benign or malignant causes. In this study the clinical importance of raised serum levels of tumor markers have been evaluated, with particular reference to obstructive jaundice and percutaneous biliary drainage.
We conducted a prospective longitudinal before-after trial. Twenty-one patients with obstructive jaundice were investigated, 5 with benign obstruction and 16 with malignant disease. All patients were examined with abdominal CT prior to biliary drainage. All patients underwent percutaneous transhepatic cholangiography, and 20 of 21 patients underwent percutaneous biliary drainage within 3 days after the CT examination.
The mean CA 19-9 at presentation was lower in the group with benign disease (95 +/- 60.9 IU/mL) than those with malignancy (461.9 +/- 331.4 IU/mL). The mean CA 19-9 level in the benign group 1 week after drainage was 12 +/- 11.8 IU/mL. The mean CA 19-9 level in the malignant group after drainage was 249.7 +/- 279.5 IU/mL.
A prominently high serum CA 19-9 level at the presentation and a high serum CA 19-9 level after successful biliary drainage should prompt investigation for a malignant etiology of obstructive jaundice.
背景/目的：一些肿瘤标志物，如CA 19-9，在因良性或恶性原因导致的梗阻性黄疸中会升高。在本研究中，对血清肿瘤标志物水平升高的临床重要性进行了评估，尤其涉及梗阻性黄疸和经皮胆道引流。
我们进行了一项前瞻性前后对照试验。对21例梗阻性黄疸患者进行了研究，其中5例为良性梗阻，16例为恶性疾病。所有患者在胆道引流前均接受了腹部CT检查。所有患者均接受了经皮肝穿刺胆管造影，21例患者中有20例在CT检查后3天内接受了经皮胆道引流。
良性疾病组就诊时的平均CA 19-9水平（95±60.9 IU/mL）低于恶性疾病组（461.9±331.4 IU/mL）。引流1周后良性组的平均CA 19-9水平为12±11.8 IU/mL。恶性组引流后的平均CA 19-9水平为249.7±279.5 IU/mL。
就诊时血清CA 19-9水平显著升高以及成功胆道引流后血清CA 19-9水平升高，应促使对梗阻性黄疸的恶性病因进行调查。
