Cholangiocarcinoma laboratory findings: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Cholangiocarcinoma}} | {{Cholangiocarcinoma}} | ||
{{CMG}};{{AE}} {{PSK}} | {{CMG}}; {{AE}}{{F.K}} [mailto:fkahe@bidmc.harvard.edu] [mailto:fkahe@bidmc.harvard.edu], {{PSK}} | ||
==Overview== | ==Overview== | ||
Laboratory tests for cholangiocarcinoma include [[ | Laboratory tests for cholangiocarcinoma include [[aspartate aminotransferase]] (AST) and [[alanine aminotransferase]] (ALT), [[prothrombin time]], [[albumin]] and total protein, [[bilirubin]], [[lactate dehydrogenase|L-Lactate dehydrogenase]] and [[alkaline phosphatase]]. | ||
==Laboratory Findings== | ==Laboratory Findings== | ||
Laboratory | *Laboratory findings consistent with the diagnosis of cholangiocarcinoma include: | ||
===Liver function tests=== | ===Liver function tests=== | ||
*Patients with cholangiocarcinoma have elevated concentration of following tests, which is usually suggestive of cholestatic pattern: | *Patients with cholangiocarcinoma have elevated concentration of following tests, which is usually suggestive of cholestatic pattern:<ref name="pmid18773062">{{cite journal |vauthors=Van Beers BE |title=Diagnosis of cholangiocarcinoma |journal=HPB (Oxford) |volume=10 |issue=2 |pages=87–93 |year=2008 |pmid=18773062 |pmc=2504383 |doi=10.1080/13651820801992716 |url=}}</ref><ref name="pmid21460876">{{cite journal |vauthors=Patel T |title=Cholangiocarcinoma--controversies and challenges |journal=Nat Rev Gastroenterol Hepatol |volume=8 |issue=4 |pages=189–200 |year=2011 |pmid=21460876 |pmc=3888819 |doi=10.1038/nrgastro.2011.20 |url=}}</ref> | ||
*[[Prothrombin time]] | *[[Prothrombin time]] | ||
*[[Albumin]] and total protein | *[[Albumin]] and total protein | ||
Line 30: | Line 18: | ||
*[[Gamma glutamyl transferase]] | *[[Gamma glutamyl transferase]] | ||
*[[Alpha-fetoprotein]] | *[[Alpha-fetoprotein]] | ||
*Transaminase levels (aspartate aminotransferase (AST) and alanine aminotransferase (ALT)) may initially be normal among patients with cholangiocarcinoma. | *Transaminase levels ([[aspartate aminotransferase]] (AST), and [[alanine aminotransferase]] (ALT)) may initially be normal among patients with cholangiocarcinoma. | ||
===Carcinoembryonic antigen=== | |||
*Serum levels of [[carcinoembryonic antigen]] (CEA) are often elevated, but not [[sensitivity (tests)|sensitive]] or [[specificity (tests)|specific]] enough to be used as a [[screening (medicine)|screening]] test. | |||
*It may be useful in association with imaging findings for suspected diagnosis of cholangiocarcinoma.<ref>Studies of the performance of serum markers for cholangiocarcinoma (such as carcinoembryonic antigen and CA19-9) in patients with and without primary sclerosing cholangitis include the following: | |||
*{{cite journal |author=Nehls O, Gregor M, Klump B |title=Serum and bile markers for cholangiocarcinoma |journal=Semin Liver Dis |volume=24 |issue=2 |pages=139-54 |year=2004 |id=PMID 15192787}} | |||
*{{cite journal |author=Siqueira E, Schoen R, Silverman W, Martin J, Rabinovitz M, Weissfeld J, Abu-Elmaagd K, Madariaga J, Slivka A, Martini J |title=Detecting cholangiocarcinoma in patients with primary sclerosing cholangitis |journal=Gastrointest Endosc |volume=56 |issue=1 |pages=40-7 |year=2002 |id=PMID 12085033}} | |||
*{{cite journal |author=Levy C, Lymp J, Angulo P, Gores G, Larusso N, Lindor K |title=The value of serum CA 19-9 in predicting cholangiocarcinomas in patients with primary sclerosing cholangitis |journal=Dig Dis Sci |volume=50 |issue=9 |pages=1734–40 |year=2005 |id=PMID 16133981}} | |||
*{{cite journal |author=Patel A, Harnois D, Klee G, LaRusso N, Gores G |title=The utility of CA 19-9 in the diagnoses of cholangiocarcinoma in patients without primary sclerosing cholangitis |journal=Am J Gastroenterol |volume=95 |issue=1 |pages=204-7 |year=2000 |id=PMID 10638584}}</ref><ref name="pmid12063953">{{cite journal |vauthors=Chen CY, Shiesh SC, Tsao HC, Lin XZ |title=The assessment of biliary CA 125, CA 19-9 and CEA in diagnosing cholangiocarcinoma--the influence of sampling time and hepatolithiasis |journal=Hepatogastroenterology |volume=49 |issue=45 |pages=616–20 |year=2002 |pmid=12063953 |doi= |url=}}</ref> | |||
===Carbohydrate antigen 19-9 (CA 19-9)=== | |||
*[[CA 19-9]] is a protein released by cancers of the [[pancreas]] and [[bile ducts]].<ref name="pmid15621994">{{cite journal |vauthors=Jang JY, Kim SW, Park DJ, Ahn YJ, Yoon YS, Choi MG, Suh KS, Lee KU, Park YH |title=Actual long-term outcome of extrahepatic bile duct cancer after surgical resection |journal=Ann. Surg. |volume=241 |issue=1 |pages=77–84 |year=2005 |pmid=15621994 |pmc=1356849 |doi= |url=}}</ref> | |||
*An elevated concentration of [[CA 19-9]] is suggestive of pancreatic cancer and cholangiocarcinoma. | |||
*CA 19-9 levels are not specific enough to be used as a screening test.<ref name="pmid14760772">{{cite journal |vauthors=Qin XL, Wang ZR, Shi JS, Lu M, Wang L, He QR |title=Utility of serum CA19-9 in diagnosis of cholangiocarcinoma: in comparison with CEA |journal=World J. Gastroenterol. |volume=10 |issue=3 |pages=427–32 |year=2004 |pmid=14760772 |pmc=4724921 |doi= |url=}}</ref> | |||
*It can be used as a [[Tumor markers|tumor marker]] to determine response to [[chemotherapy]]. | |||
==References== | ==References== |
Latest revision as of 15:59, 13 February 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Farima Kahe M.D. [2] [3] [4], Suveenkrishna Pothuru, M.B,B.S. [5]
Overview
Laboratory tests for cholangiocarcinoma include aspartate aminotransferase (AST) and alanine aminotransferase (ALT), prothrombin time, albumin and total protein, bilirubin, L-Lactate dehydrogenase and alkaline phosphatase.
Laboratory Findings
- Laboratory findings consistent with the diagnosis of cholangiocarcinoma include:
Liver function tests
- Patients with cholangiocarcinoma have elevated concentration of following tests, which is usually suggestive of cholestatic pattern:[1][2]
- Prothrombin time
- Albumin and total protein
- Bilirubin
- L-Lactate dehydrogenase
- Alkaline phosphatase
- Gamma glutamyl transferase
- Alpha-fetoprotein
- Transaminase levels (aspartate aminotransferase (AST), and alanine aminotransferase (ALT)) may initially be normal among patients with cholangiocarcinoma.
Carcinoembryonic antigen
- Serum levels of carcinoembryonic antigen (CEA) are often elevated, but not sensitive or specific enough to be used as a screening test.
- It may be useful in association with imaging findings for suspected diagnosis of cholangiocarcinoma.[3][4]
Carbohydrate antigen 19-9 (CA 19-9)
- CA 19-9 is a protein released by cancers of the pancreas and bile ducts.[5]
- An elevated concentration of CA 19-9 is suggestive of pancreatic cancer and cholangiocarcinoma.
- CA 19-9 levels are not specific enough to be used as a screening test.[6]
- It can be used as a tumor marker to determine response to chemotherapy.
References
- ↑ Van Beers BE (2008). "Diagnosis of cholangiocarcinoma". HPB (Oxford). 10 (2): 87–93. doi:10.1080/13651820801992716. PMC 2504383. PMID 18773062.
- ↑ Patel T (2011). "Cholangiocarcinoma--controversies and challenges". Nat Rev Gastroenterol Hepatol. 8 (4): 189–200. doi:10.1038/nrgastro.2011.20. PMC 3888819. PMID 21460876.
- ↑ Studies of the performance of serum markers for cholangiocarcinoma (such as carcinoembryonic antigen and CA19-9) in patients with and without primary sclerosing cholangitis include the following:
- Nehls O, Gregor M, Klump B (2004). "Serum and bile markers for cholangiocarcinoma". Semin Liver Dis. 24 (2): 139–54. PMID 15192787.
- Siqueira E, Schoen R, Silverman W, Martin J, Rabinovitz M, Weissfeld J, Abu-Elmaagd K, Madariaga J, Slivka A, Martini J (2002). "Detecting cholangiocarcinoma in patients with primary sclerosing cholangitis". Gastrointest Endosc. 56 (1): 40–7. PMID 12085033.
- Levy C, Lymp J, Angulo P, Gores G, Larusso N, Lindor K (2005). "The value of serum CA 19-9 in predicting cholangiocarcinomas in patients with primary sclerosing cholangitis". Dig Dis Sci. 50 (9): 1734–40. PMID 16133981.
- Patel A, Harnois D, Klee G, LaRusso N, Gores G (2000). "The utility of CA 19-9 in the diagnoses of cholangiocarcinoma in patients without primary sclerosing cholangitis". Am J Gastroenterol. 95 (1): 204–7. PMID 10638584.
- ↑ Chen CY, Shiesh SC, Tsao HC, Lin XZ (2002). "The assessment of biliary CA 125, CA 19-9 and CEA in diagnosing cholangiocarcinoma--the influence of sampling time and hepatolithiasis". Hepatogastroenterology. 49 (45): 616–20. PMID 12063953.
- ↑ Jang JY, Kim SW, Park DJ, Ahn YJ, Yoon YS, Choi MG, Suh KS, Lee KU, Park YH (2005). "Actual long-term outcome of extrahepatic bile duct cancer after surgical resection". Ann. Surg. 241 (1): 77–84. PMC 1356849. PMID 15621994.
- ↑ Qin XL, Wang ZR, Shi JS, Lu M, Wang L, He QR (2004). "Utility of serum CA19-9 in diagnosis of cholangiocarcinoma: in comparison with CEA". World J. Gastroenterol. 10 (3): 427–32. PMC 4724921. PMID 14760772.