What tumor markers are used for cholangiocarcinoma?

From the Guidelines

CA 19-9 is the most commonly used tumor marker for cholangiocarcinoma, although it has limited diagnostic sensitivity and specificity. Other tumor markers such as CEA, CA-125, and AFP may also be used, but they are not specific enough for diagnosis alone. The use of these markers is valuable for monitoring disease progression and treatment response, and should always be interpreted in conjunction with imaging studies and clinical findings 1.

Tumor Markers for Cholangiocarcinoma

• CA 19-9: elevated in approximately 69% of cholangiocarcinoma cases, though levels can also rise in other conditions like pancreatitis or other gastrointestinal cancers 1
• CEA: serves as a complementary marker, often used alongside CA 19-9
• CA-125 and AFP: may also be used, but are not specific enough for diagnosis alone
• Newer markers being investigated: CYFRA 21-1, MUC5AC, and various microRNAs, though these are not yet standard in clinical practice

Limitations of Tumor Markers

• Limited diagnostic sensitivity and specificity
• May be affected by other conditions such as bile duct obstruction or acute cholangitis
• Should always be interpreted in conjunction with imaging studies and clinical findings

Clinical Use of Tumor Markers

• Monitoring disease progression and treatment response
• Detecting recurrence after therapy
• Serial measurements are particularly useful for monitoring treatment effectiveness and detecting recurrence after therapy 1

From the Research

Tumor Markers for Cholangiocarcinoma

The following tumor markers are used for cholangiocarcinoma:

• Carbohydrate antigen 19-9 (CA 19-9) 2, 3, 4, 5, 6
• Carcinogenic Embryonic antigen (CEA) 2, 5
• Cancer Antigen 125 2
• Soluble fragment of cytokeratin 19 (CYFRA 21-1) 2
• Mucins 2
• Tumour Markers pyruvate-Kinase (TuM2-PK) 2
• Metalloproteinase-7 (MMP-7) 2

Sensitivity and Specificity of Tumor Markers

The sensitivity and specificity of these tumor markers vary:

• CA 19-9 has a sensitivity of 63% and a specificity of 85% in detecting cholangiocarcinoma in patients with primary sclerosing cholangitis 5
• The combination of CA 19-9 and CEA has a low sensitivity but a relatively high specificity for detecting cholangiocarcinoma in patients with primary sclerosing cholangitis 5

Clinical Use of Tumor Markers

These tumor markers are used in the diagnosis and monitoring of cholangiocarcinoma:

• CA 19-9 is the most commonly used tumor marker for cholangiocarcinoma 4
• The combination of tumor markers may increase their efficiency in diagnosing cholangiocarcinoma 2