Impact of CA19-9 in Diagnosis of Combined Hepatocellular Carcinoma and Cholangiocarcinoma | ||||
| Benha Journal of Applied Sciences | ||||
| Article 31, Volume 5, Issue 8 part (1) - (2), December 2020, Page 195-199 PDF (428.96 K) | ||||
| Document Type: Original Research Papers | ||||
| DOI: 10.21608/bjas.2020.187206 | ||||
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| Authors | ||||
| Y.S. Younes1; B.A. Abdul-Aziz1; W.A. El-Agawy2; W.M.M. Ahmed1 | ||||
| 1Hepatology, Gastroenterology & Infectious Diseases Dept., Faculty of Medicine, Benha Univ., Benha, Egypt | ||||
| 2Tropical Medicine Dept., Faculty of Medicine, Benha Univ., Benha, Egypt | ||||
| Abstract | ||||
| Hepatocellular carcinoma (HCC) is the sixth most common cancer worldwide. Intrahepatic cholangiocarcinoma (ICC) accounts for about 10-15% of all primary hepatic malignancy. Combined hepatocellular carcinoma and cholangiocarcinomas (cHCC-CCs) are rare malignancies representing 1.0-4.7% of all primary liver cancers. ICC and cHCC-CC preoperative diagnosis is desirable because frequency of lymph node metastasis. Also they have been considered a contraindication for liver transplantation (LT).The study aimed to assess the importance of CA19-9 in diagnosis of cHCC-CC "non-invasively" in patients with typical radiological features of HCC which may alter the interventional procedure. This observational cross-sectional study was conducted on 62 patients with typical radiological criteria of HCC and elevated CA19-9 level, who attended to National Hepatology and Tropical Medicine Research Institute (NHTMRI); Cairo, Benha university hospitals within the period between October 2017 and April 2019. All studied subjects underwent history taking, clinical examination, biochemical workup, tumor markers, abdominal ultrasound, and dynamic study (CT/MRI). Target liver biopsy was done for histopathology and immuno-histochemistry. The studied patients were classified into three groups based on pathological diagnosis. 20 patients were diagnosed as HCC, 40 patients were diagnosed as ICC, and 2 patients were diagnosed as cHCC-CC with statistically significant difference between HCC and ICC as regard CA19-9 and alpha-fetoprotein (AFP). CA19-9 and AFP cut offs were ˃ 64.8 U/mL and ˂ 23.6 ng/mL, respectively favoring the diagnosis of ICC. CA19-9 level was 176.3 and 156.7 U/mL while AFP level was 460 and 170 ng/mL in cHCC-CC cases, respectively. The use of CA19-9 can help in diagnosis of ICC and suspicion of cHCC-CC in cases of typical radiological criteria of HCC. | ||||
| Keywords | ||||
| Hepatocellular carcinoma; Intrahepatic cholangiocarcinoma; Combined hepatocellular carcinoma and cholangiocarcinoma; Alpha-fetoprotein; Carbohydrate Antigen 19-9 | ||||
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