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Serum CEA and CA 19‐9: Potential future diagnostic or screening tests for gallbladder cancer?
Author(s) -
Strom Brian L.,
Maislin Greg,
West Suzanne L.,
Atkinson Barbara,
Herlyn Meenhard,
Saul Scott,
RodriguezMartinez Hector A.,
RiosDalenz Jaime,
Iliopoulos Dimitrios,
Soloway Roger D.
Publication year - 1990
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.2910450505
Subject(s) - medicine , carcinoembryonic antigen , gallbladder cancer , gastroenterology , gallbladder , cancer , cutoff , gallstones , population , disease , physics , environmental health , quantum mechanics
The poor prognosis of gallbladder cancer and the presence of high‐risk populations make the identification of a screening test for this disease very desirable. As part of an ongoing case‐control study of gallbladder cancer being conducted in Mexico City, Mexico, and in La Paz, Bolivia, blood specimens were sought from all patients with cancer of the gallbladder and on controls of similar age and sex undergoing upper abdominal surgery. Each sample was analyzed for carcinoembryonic antigen (CEA) and CA 19‐9. Using the specimens from Bolivia, a serum CEA cutoff of 4.0 ng/ml yielded a sensitivity of 50.0% and a specificity of 92.7%, while a serum CA 19‐9 cutoff of 20.0 units/ml yielded a sensitivity of 79.4% and a specificity of 79.2%. Using ROC curve analysis, the latter was a much better test than the former ( p < 0.05). Using the tests in series or in parallel did not substantively improve the results. The specimens from Mexico were used for validation purposes, and yielded very similar results. In conclusion, serum CA 19‐9 and CEA are fairly good tests for discriminating patients with gallbladder cancer from patients with gallstones and no cancer, the former being a better test than the latter. These tests may be useful in identifying disease recurrences. In addition, if a sufficiently high‐risk population could be identified, this could potentially become a useful screening test for this serious disease, allowing early intervention. However, additional data are needed prior to recommending this clinically.