Extraordinarily Elevated CA19-9 Levels in Patients with Benign Disease of Biliary Tract (Report of 10 Cases)_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

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费健 , 王建承 , 陈胜 , 邓漾 , 朱坚 , 张卓 , 许志伟 , 陆晔 , 吴卫泽 , 雷若庆 , 韩天权 , 张圣道

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Keywords：

胆管; 良性疾病; CA19-9

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目的　报道10例血清CA19-9明显升高的胆管良性疾病病例。
方法　回顾性分析2004年1月至2006年3月期间我院收治并经手术证实的10例血清CA19-9明显升高（ gt;500 U/ml）的胆管良性病变病例。
结果　患者中男4例，女6例，年龄30~85岁，CA19-9为532.32~12 000.00 U/ml，除1例患者CA125轻度升高外，其他患者血清CEA、CA125及AFP均正常。胆总管结石8例，肝内胆管结石1例，原发性硬化性胆管炎1例；除1例外均存在不同程度阻塞性黄疸。经治疗后8例CA19-9水平在30 d内降至正常，另2例分别于术后2个月和3个月内降至正常。
结论　CA19-9在胆管恶性肿瘤诊断方面的意义仍需进一步研究。

Citation： 费健,王建承,陈胜,邓漾,朱坚,张卓,许志伟,陆晔,吴卫泽,雷若庆,韩天权,张圣道. Extraordinarily Elevated CA19-9 Levels in Patients with Benign Disease of Biliary Tract (Report of 10 Cases). CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2007, 14(5): 580-582. doi: Copy

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6.	Patel AH, Harnois DM, Klee GG, et al. The utility of CA19-9 in the diagnoses of cholangiocarcinoma in patients without primary sclerosing cholangitis [J]. Am J Gastroenterol， 2000; 95(1)∶204.
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11.	Lin CL, Changchien CS, Chen YS. Mirizzi’s syndrome with a high CA19-9 level mimicking cholangiocarcinoma [J]. Am J Gastroenterol， 1997; 92(12)∶2309.
12.	Ogawa T, Yokoi H, Kawarada Y. A case of inflammatory pseudotumor of the liver causing elevated serum CA19-9 levels [J]. Am J Gastroenterol， 1998; 93(12)∶2551.
13.	Trompetas V, Panagopoulos E, Ramantanis G. Gall-bladder agenesis presenting with obstructive jaundice and elevated CA19-9 [J]. Acta Chir Belg， 2004; 104(3)∶347.
14.	Basso D, Meggiato T, Fabris C, et al. Extra-hepatic cholestasis determines a reversible increase of glycoproteic tumour markers in benign and malignant diseases [J]. Eur J Clin Invest， 1992; 22(12)∶800.

1. 　Minato H, Nakanuma Y, Terada T. Expression of blood group-related antigens in cholangiocarcinoma in relation to non-neoplastic bile ducts [J]. Histopathology， 1996; 28(5)∶411.
2. 　Maestranzi S, Przemioslo R, Mitchell H, et al. The effect of benign and malignant liver disease on the tumour markers CA19-9 and CEA [J]. Ann Clin Biochem， 1998; 35(Pt 1)∶99.
3. 　Paganuzzi M, Onetto M, Marroni P, et al. CA19-9 and CA50 in benign and malignant pancreatic and biliary diseases [J]. Cancer， 1988; 61(10)∶2100.
4. 　秦兴雷，李志强，石景森，等. 血清和胆汁CA19-9联合检测对诊断胆道良恶性病变的价值 [J]. 中国普外基础与临床杂志， 2000； 7(3)∶161.
5. 　Bjornsson E, Kilander A, Olsson R. CA19-9 and CEA are unreliable markers for cholangiocarcinoma in patients with primary sclerosing cholangitis [J]. Liver， 1999; 19(6)∶501.
6. 　Patel AH, Harnois DM, Klee GG, et al. The utility of CA19-9 in the diagnoses of cholangiocarcinoma in patients without primary sclerosing cholangitis [J]. Am J Gastroenterol， 2000; 95(1)∶204.
7. 　Robertson AG, Davidson BR. Mirizzi syndrome complicating an anomalous biliary tract: a novel cause of a hugely elevated CA19-9 [J]. Eur J Gastroenterol Hepatol， 2007; 19(2)∶167.
8. 　Murray MD, Burton FR, Di Bisceglie AM. Markedly elevated serum CA19-9 levels in association with a benign biliary stricture due to primary sclerosing cholangitis [J]. J Clin Gastroenterol， 2007; 41(1)∶115.
9. 　Katsanos KH, Kitsanou M, Christodoulou DK, et al. High CA19-9 levels in benign biliary tract diseases. Report of four cases and review of the literature [J]. Eur J Intern Med， 2002; 13(2)∶132.
10. 　Albert MB, Steinberg WM, Henry JP. Elevated serum levels of tumor marker CA19-9 in acute cholangitis [J]. Dig Dis Sci， 1988; 33(10)∶1223.
11. 　Lin CL, Changchien CS, Chen YS. Mirizzi’s syndrome with a high CA19-9 level mimicking cholangiocarcinoma [J]. Am J Gastroenterol， 1997; 92(12)∶2309.
12. 　Ogawa T, Yokoi H, Kawarada Y. A case of inflammatory pseudotumor of the liver causing elevated serum CA19-9 levels [J]. Am J Gastroenterol， 1998; 93(12)∶2551.
13. 　Trompetas V, Panagopoulos E, Ramantanis G. Gall-bladder agenesis presenting with obstructive jaundice and elevated CA19-9 [J]. Acta Chir Belg， 2004; 104(3)∶347.
14. 　Basso D, Meggiato T, Fabris C, et al. Extra-hepatic cholestasis determines a reversible increase of glycoproteic tumour markers in benign and malignant diseases [J]. Eur J Clin Invest， 1992; 22(12)∶800.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Extraordinarily Elevated CA19-9 Levels in Patients with Benign Disease of Biliary Tract (Report of 10 Cases)

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