Comparison of serum biomarkers cifra 21-1 and ca 19-9 in biliary tract cancers

Abstract

Background: Biliary malignancy is common in Asia and has high fatality. CA 19-9 has been used in diagnosis of biliary malignancy but can be raised in benign obstructive jaundice as well. CYFRA 21-1 can have an important role in patients with biliary tract cancer. The objective of this study is to compare accuracy of biomarkers CYFRA 21-1 with CA 19-9 for diagnosis of biliary tract cancers and to correlate level of biomarkers with the stage of disease.
Methods: Patients with histopathological diagnosis of biliary tract cancers managed at Tribhuvan University Teaching Hospital, Kathmandu, Nepal were enrolled in the study. Measurement of serum CK 19 fragments was performed and compared with CA 19-9. Demographic characteristics, physiological variables and laboratory values were analyzed.
Results: Of the 61 patients included the mean age was 53.41±12.5 years. Amongst the biliary malignancies, carcinoma of the gallbladder was commonest. Most patients (64%) were in the middle age group (40 to 60 years) and presented in advanced stage (Stage III and IV). CYFRA 21-1 had sensitivity of 80.3% and CA 19-9 of 68.9 % for the detection of Biliary Tract Cancers. Comparing the means of CYFRA 21-1 and CA 19-9 for stage of the disease, progressive rise of CYFRA 21-1 with the rise in stage of the disease was observed (p< 0.03).
Conclusions: CYFRA is a more reliable test than CA 19-9 in all stages of biliary malignancy and can assist in distinguishing early and advanced malignancy. In carcinoma of gallbladder, highest CYFRA 21-1 values were observed.
Keywords: Biliary tract cancers; CA 19-9; cholangiocarcinoma; CYFRA 21-1