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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費健 , 王建承 , 陳勝 , 鄧漾 , 朱堅 , 張卓 , 許志偉 , 陸曄 , 吳衛澤 , 雷若慶 , 韓天權 , 張圣道

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Keywords：

膽管; 良性疾病; CA19-9

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目的　報道10例血清CA19-9明顯升高的膽管良性疾病病例。
方法　回顧性分析2004年1月至2006年3月期間我院收治并經手術證實的10例血清CA19-9明顯升高（ gt;500 U/ml）的膽管良性病變病例。
結果　患者中男4例，女6例，年齡30~85歲，CA19-9為532.32~12 000.00 U/ml，除1例患者CA125輕度升高外，其他患者血清CEA、CA125及AFP均正常。膽總管結石8例，肝內膽管結石1例，原發性硬化性膽管炎1例；除1例外均存在不同程度阻塞性黃疸。經治療后8例CA19-9水平在30 d內降至正常，另2例分別于術后2個月和3個月內降至正常。
結論　CA19-9在膽管惡性腫瘤診斷方面的意義仍需進一步研究。

Citation： 費健,王建承,陳勝,鄧漾,朱堅,張卓,許志偉,陸曄,吳衛澤,雷若慶,韓天權,張圣道. 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.
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.
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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.

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. 　秦興雷，李志強，石景森，等. 血清和膽汁CA19-9聯合檢測對診斷膽道良惡性病變的價值 [J]. 中國普外基礎與臨床雜志， 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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