Younes, Y., Abdul-Aziz, B., El-Agawy, W., Ahmed, W. (2020). Impact of CA19-9 in Diagnosis of Combined Hepatocellular Carcinoma and Cholangiocarcinoma. Benha Journal of Applied Sciences, 5(Issue 8 part (1) - (2)), 195-199. doi: 10.21608/bjas.2020.187206
Y.S. Younes; B.A. Abdul-Aziz; W.A. El-Agawy; W.M.M. Ahmed. "Impact of CA19-9 in Diagnosis of Combined Hepatocellular Carcinoma and Cholangiocarcinoma". Benha Journal of Applied Sciences, 5, Issue 8 part (1) - (2), 2020, 195-199. doi: 10.21608/bjas.2020.187206
Younes, Y., Abdul-Aziz, B., El-Agawy, W., Ahmed, W. (2020). 'Impact of CA19-9 in Diagnosis of Combined Hepatocellular Carcinoma and Cholangiocarcinoma', Benha Journal of Applied Sciences, 5(Issue 8 part (1) - (2)), pp. 195-199. doi: 10.21608/bjas.2020.187206
Younes, Y., Abdul-Aziz, B., El-Agawy, W., Ahmed, W. Impact of CA19-9 in Diagnosis of Combined Hepatocellular Carcinoma and Cholangiocarcinoma. Benha Journal of Applied Sciences, 2020; 5(Issue 8 part (1) - (2)): 195-199. doi: 10.21608/bjas.2020.187206
Impact of CA19-9 in Diagnosis of Combined Hepatocellular Carcinoma and Cholangiocarcinoma
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.