European Academic Research ISSN 2286-4822
ISSN-L 2286-4822
Impact Factor: 3.4546 (UIF)
DRJI Value : 5.9 (B+)
Article Details :
Article Name :
Clinical significance of serum CA 19-9, CA 19-9/CRP ratio and CA19-9/total bilirubin ratio in differentiation between malignant and benign obstructive jaundice
Author Name :
Moataz M Sayed, Ahmed I ElShafie, Mohamed Lotfy, Sara M Abdelhakam, Marwa Rushdy
Publisher :
Bridge Center
Article URL :
Abstract :
Background and AIM: Serum carbohydrate antigen (CA19-9) is increased not only in patients with pancreatic or biliary cancers, but also in benign biliary diseases. The aim of the present study was to investigate the diagnostic value of CA19-9, CA19-9/CRP ratio and CA19-9/total bilirubin ratio in differentiation between benign and malignant obstructive jaundice in Egyptian patients. Methods: The current prospective study included 50 patients with obstructive jaundice who were referred for Endoscopic Retrograde Cholangiopancreatography (ERCP). They were classified into two groups; Group (1): 25 patients with malignant obstructive jaundice, and Group (2) 25 patients with benign obstructive jaundice. All included patients were subjected to: detailed history-taking, full clinical examination and laboratory investigations which included CBC, liver and renal profiles, serum C-reactive protein (CRP) and CA 19-9. Results: Before ERCP, CA19-9 levels were significantly higher in malignant than in benign group, but after ERCP, CA19-9 levels became much significantly higher in malignant than in benign group and there was statistically significant decrease in CA19-9 level in the benign group. Serum CA19-9 at cut-off value of 37 U/ml showed sensitivity 80% and specificity 44% in differentiating between malignant and benign obstructive jaundice. When CA19-9 cut-off value was pushed up from 37 to 100 U/ml, the sensitivity decreased to 64% while the specificity increased to 64%. By using CA19-9/total bilirubin ratio (before ERCP) at cut-off value = 15.84, the sensitivity decreased to 68% but specificity increased to 68%. By using the ratio of CA19-9/CRP (before ERCP) at cut-off value = 34.3, the sensitivity and specificity were increased to 84% and 88%, respectively. Conclusion: CA19-9/CRP ratio (before ERCP) at cut-off value = 34.3 has a better sensitivity and specificity to differentiate between the malignant and benign obstructive jaundice than CA19-9 alone and CA19-9/total bilirubin ratio.
Keywords :
Serum carbohydrate antigen (CA 19-9), C-reactive protein, bilirubin, malignant, benign, obstructive jaundice.

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