Abstract | BACKGROUND: METHODS: Between January 2005 and January 2012, a total of 37 preoperative patients at Sir Run Run Shaw Hospital were suspicious of having gallbladder cancer and was pathologically confirmed to be XGC after surgical operations. Before operations, all patients received a tumor biomarker test to verify diagnosis, which included serum CA 19-9, carcinoembryonic antigen (CEA), and CA 12-5. RESULTS: A measured amount (54.05%) of cases (20 in 37) had at least one elevation over the thresholds of CA 19-9 (37 IU/L), CEA (5 ng/ml), and CA 12-5 (35 IU/L), which increased the suspicion of malignancy and consequently enhanced the difficulty to make right diagnosis of XGC as benign. 45.95% of cases (17 in 37) had an elevation in CA 19-9. 2.70% of cases (one in 37) had an elevation in CEA and 24.32% of cases (nine in 37) had an elevation in CA 12-5. Analysis with Fisher's exact test discovered that the presence of common bile duct stone was a contributor to elevations of CA19-9 in patients with XGC. However, even in cases without common bile duct stones, 42.86% of patients (nine in 21) had elevations of at least one tumor biomarker. Among them, 26.09% of patients (six in 21) had elevations of CA 19-9, with the maximum of 536.29 IU/L. CONCLUSIONS: The elevations of tumor biomarkers in XGC were frequent, suggesting their inabilities to clarify the disease's nature, especially when there was a suspicion of gallbladder cancer. Intraoperative frozen pathology of gallbladder might be a possible solution. However, it is against the en bloc surgical principle and has the potential to cause tumor cell spreading. More research should be conducted, such as the discovery of a novel biomarker, so that XGC can less likely be misdiagnosed as malignancy until the final pathological judgment.
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Authors | Hong Yu, Tu-nan Yu, Xiu-jun Cai |
Journal | Chinese medical journal
(Chin Med J (Engl))
Vol. 126
Issue 16
Pg. 3044-7
(Aug 2013)
ISSN: 2542-5641 [Electronic] China |
PMID | 23981609
(Publication Type: Journal Article)
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Chemical References |
- Biomarkers, Tumor
- CA-125 Antigen
- CA-19-9 Antigen
- Carcinoembryonic Antigen
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor
(blood)
- CA-125 Antigen
(blood)
- CA-19-9 Antigen
(blood)
- Carcinoembryonic Antigen
(blood)
- Cholecystitis
(blood, diagnosis)
- Female
- Granuloma
(blood, diagnosis)
- Humans
- Male
- Middle Aged
- Xanthomatosis
(blood, diagnosis)
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