Significances of serum level and immunohistochemical stain of CA19-9 in simple hepatic cysts and intrahepatic biliary cystic neoplasms

• Published in: The Korean journal of gastroenterology Vol. 47; no. 1; pp. 52 - 58
• Main Authors: Park, Ki Ho, Kim, Jae Seon, Lee, Ju Han, Kim, Hyo Jung, Kim, Jin Yong, Yeon, Jong Eun, Park, Jong-Jae, Byun, Kwan Soo, Bak, Young-Tae, Lee, Chang Hong
• Format: Journal Article
• Language: Korean
• Published: Korea (South) 01-01-2006
• Subjects: Adult; Aged; Biliary Tract Neoplasms - diagnosis; CA-19-9 Antigen - analysis; CA-19-9 Antigen - blood; Cystadenocarcinoma - diagnosis; Cystadenoma - diagnosis; Cysts - diagnosis; Diagnosis, Differential; Female; Humans; Immunohistochemistry; Liver Diseases - diagnosis; Male; Middle Aged
• ISSN: 1598-9992

In spite of various diagnostic modalities, biliary cystic neoplasms (biliary cystadenoma and cystadenocarcinoma) remain to be difficult to diagnose preoperatively. Recently, there are some reports that elevated CA19-9 level in serum and/or cystic fluid could be a useful finding in the differential diagnosis of biliary cystic neoplasm. This study aimed to evaluate the expression of CA19-9 and to elucidate its significances in intrahepatic biliary cystic neoplasms and simple hepatic cysts.
In 8 patients with biliary cystic neoplasms and 6 simple hepatic cysts, symptoms, radiologic and laboratory findings were reviewed retrospectively. In 5 biliary cystic neoplasms (4 biliary cystadenomas, 1 biliary cystadenocarcinoma) and 5 simple hepatic cysts, immunohistochemical stainings for CA19-9 were performed with formalin-fixed, paraffin-embedded tissues.
In 8 biliary cystic neoplasms, two cases were suspected as biliary cystadenoma preoperatively and 6 cases could not be distinguished from simple cysts or cholangiocarcinoma preoperatively. In 6 simple hepatic cysts, 3 cases were diagnosed preoperatively and 3 cases could not be distinguished from biliary cystadenoma or pancreatic pseudocyst preoperatively. Expression of CA19-9 in simple hepatic cysts and biliary cystic neoplasms were 80% in both groups. Expression of CA19-9 is not related to the elevated level of CA19-9 in serum.
Our data suggests that the elevated level of CA19-9 in serum may not be helpful in the preoprative diagnosis of biliary cystic neoplasm.