The Value of CA19-9 and CEA in Predicting Resectability of Hilar Cholangiocarcinoma

Objective To evaluate the predictability of preoperative serum Carbonhydrate antigen (CA19-9) and Carcino-embryonic antigen (CEA) for tumor resectability in the patients with hilar cholangiocarcinoma (HC). Methods One hundred and three HC patients pathologically diagnosed from 2003 to 2012 were divided into radical resection group and palliative treatment group according to their surgical therapy and resection results, and preoperative serum CA19-9 and CEA data was collected and analyzed retrospectively. Receiver operating characteristic (ROC) curve analysis was applied to find the best cut-off point, and the resectability prediction of different detection methods was evaluated. Results In the application of ROC analysis, the cut-off point of CA19-9 and CEA were 400 μg/L and 8 μg/L with the largest Youden's index 0.2345 (AUC=0.605±0.057) and 0.1635 (AUC=0.631±0.055) respectively. The ROC-AUC, sensitivity, specificity, negative predictive value and positive predictive value in the combine detection (parallel test) with this new cut-off point were 0.660±0.054, 62.79%, 65.00%, 56.25% and 83.33% respectively. Conclusion The HC patients with "CA19-9＜400 μg/L + CEA＜8 μg/L" may have big opportunity to have radical resection while those with"CA19-9≥400 μg/L or CEA≥8 μg/L" may have small opportunity.