CA-125, but not galectin-3, complements CA 19-9 for discriminating ductal adenocarcinoma versus non-malignant pancreatic diseases

Background/objectivesCA 19-9 is the gold standard biomarker of pancreatic adenocarcinoma despite several weaknesses in particular a high rate of false positives or negatives. CA-125 corresponding to MUC16 and galectin-3, a lectin able to interact with mucin-associated carbohydrates, are tumor-associated proteins. We investigated whether combined measurement of CA 19-9, galectin-3 and CA-125 may help to better discriminate pancreatic adenocarcinoma versus non-malignant pancreatic diseases.MethodsWe evaluated by immunohistochemistry the expression of MUC4, MUC16 (CA-125) and galectin-3 in 31 pancreatic adenocarcinomas. We measured CA 19-9, CA-125 and Gal-3 in the serum from patients with pancreatic benign diseases (n = 58) or adenocarcinoma (n = 44). Clinical performance of the 3 biomarkers for cancer diagnosis and prognosis was analyzed.ResultsBy immunohistochemistry, MUC16 and Gal-3 were expressed in 74% and 84% of adenocarcinomas versus 0% and 3.2% in peri-tumoral regions, respectively. At the serum level, CA 19-9 and CA125 were significantly higher in patients with pancreatic adenocarcinoma whereas Gal-3 levels did not differ. The performance of CA 19-9 for cancer detection was higher than those of CA-125 or Gal-3 by ROC analysis. However, CA-125 offers the highest specificity for malignancy (81%) because of an absence of false positives among type 2 diabetic patients. Cancer deaths assessed 6 or 12 months after diagnosis varied according to the initial CA-125 level (p < 0.006).ConclusionGal-3 is not an interesting biomarker for pancreatic adenocarcinoma detection. CA 19-9 alone exhibits the best performance but measuring CA-125 provides complementary information in terms of diagnosis and prognosis.     

血清肿瘤标志物CEA、CA125、CYFRA21-1在支气管肺癌诊断、病理类型及TNM分期中的价值分析

目的探讨癌胚抗原(CEA)、糖类抗原(CA125)、细胞角蛋白19片段(CYFRA21-1)在肺癌诊断、病理类型及TNM分期中的应用价值。 方法收集2017年1月至2018年4月入住唐都医院的288例患者的临床资料,采用电化学免疫荧光发光法检测血清肿瘤标志物的浓度,分析CEA、CA125、CYFRA21-1与肺癌诊断、病理类型及TNM分期的关系。 结果肺癌组CEA、CA125、CYFRA21-1血清表达水平高于肺部良性病变组,P<0.05。单个肿瘤标志物在区分肺癌不同病理类型时,CYFRA21-1诊断价值最高。在肺癌不同TNM分期中,CEA、CA125阳性率随着肿瘤分期逐渐升高,各分期之间阳性率存在统计学意义,P<0.05。CYFRA21-1其阳性率随分期变化逐渐升高,但各组间无统计学意义,P>0.05。 结论CEA、CA125、CYFRA21-1在肺癌诊断价值中有意义,在不同病理类型中CYFRA21-1诊断价值较大,CEA、CA125、CYFRA21-1在肺癌TNM分期中诊断价值不同,利用血清肿瘤标志物进行TNM分期,可为病理TNM分期提供参考。     

血清和胸水中肿瘤标志物检测对老年人胸腔积液的诊断价值

目的　评价老年良、恶性胸腔积液患者血清和胸液中 5种肿瘤标志物单项和联合检测的诊断价值。　方法　采用酶联免疫吸附法同时检测 32例老年肺癌并胸腔积液 (恶性胸腔积液组 )和 30例老年良性胸腔积液患者血清和胸水中细胞角化素蛋白片段 19(CYFRA2 1 1)、神经元特异性烯醇化酶 (NSE)、糖链抗原 15 3(CA15 3)、糖链抗原 19 9(CA19 9)、糖链抗原 12 5 (CA12 5 )水平。　结果　恶性胸腔积液患者血清中上述 5项指标的水平分别为 ( 12 84± 6 4 8) μg/L、( 2 2 0 7± 11 2 5 )μg/L、( 6 5 74± 30 2 6 )kU/L、( 5 6 32± 2 5 6 7)kU/L和 ( 71 86± 31 4 5 )kU/L ,均高于良性胸腔积液患者血清中的水平 (P <0 0 1) ;恶性胸腔积液患者胸水中除NSE外 ,其他 4项指标的水平分别为 ( 18 6 4± 8 15 ) μg/L、( 5 9 31± 2 7 35 )kU/L、( 4 8 2 4± 2 1 5 6 )kU/L和 ( 6 2 16± 2 7 79)kU/L ,均高于良性胸腔积液患者胸水中的水平 (P <0 0 1) ;血清 5种肿瘤标志物平行联合检测可提高诊断的敏感性至90 6 % ,系列联合检测可使特异性提高至 93 3% ;胸液中 4项指标对恶性胸水诊断的敏感性和特异性分别是 :CYFRA2 1 184 4 %和 90 0 % ;CA15 36 2 5 %和 73 3% ;CA19 937 5 %和 6 6 7% ;CA12 55 6 3%和     

Evaluation of serum CA27.29, CA15-3 and CEA in patients with breast cancer

The Truquant BR radioimmunoassay (RIA) using monoclonal antibody BR 27.29 to recognize a peptide sequence on the MUC-1 gene product for quantification of the CA 27.29 antigen in serum was used in this report to evaluate in 145 patients with breast cancer and compared the other conventional serum markers such as CA15-3 and CEA. The upper limit of normal (25 u/ml) was determined from CA27.29 values 12.4 +/- 4.1 u/ml (mean +/- 3 S.D.) for 112 female subjects apparently free of disease. The CA15-3 levels above 25 u/ml and CEA levels above 5 ng/ml were considered positive values. Thirty-seven cases of 145 patients studied had elevated CA 27.29 levels (sensitivity: 25.5%), 35 of 145 had positive CA15-3 levels (sensitivity 24.1%) and 27 of 145 patients had positive CEA levels (sensitivity: 18.6%) (p < 0.05). One hundred and ten cases of the breast cancer patients (75.8%) did not have metastatic disease. In this group CA 27.29 sensitivity was 6.4%, while CA15-3 sensitivity was 5.5% and CEA sensitivity was 4.5% (p > 0.05). Mean values were 10.2 +/- 9.2 u/ml for CA 27.29, 14.1 +/- 5.6 u/ml for CA 15-3 and 1.7 +/- 1.5 ng/ml for CEA. Thirty-five patients (24.2%) had metastatic disease. In this group CA 27.29 sensitivity was 85.7%, CA15-3 sensitivity was 82.8% and CEA sensitivity was 62.8% (p < 0.05). Mean values for CA27.29 was 152.6 +/- 131.6 u/ml, CA15-3 was 123.1 +/- 107.6 u/ml and 21.8 +/- 36.9 ng/ml of CEA. With regard to the correlation of three tumor markers with clinical stages, patients had significantly higher levels of CA27.29 than CEA, but they were similar to CA 15-3 in metastatic breast cancer. These results suggest CA27.29 to be more sensitive and specific than CEA, but that it is similar to CA15-3 for metastatic breast cancer detection and monitoring.     

胰腺癌患者血清中巨噬细胞因子-1、糖链抗原19-9、糖链抗原242及癌胚抗原的检测分析

目的 探讨血清巨噬细胞因子-1（MIC-1）、糖链抗原（CA）19-9 、CA242及癌胚抗原（CEA）在胰腺癌中的应用价值.方法 分析129例胰腺癌患者和120例健康体检者4项肿瘤标志物的检测结果,计算各肿瘤标志物组合方式对提高胰腺癌诊断的作用.结果 胰腺癌患者血清中各项肿瘤标志物的水平与对照组比较差异有统计学意义（P〈0.05）.MIC-1＋CA19-9组合的敏感性与单项检测敏感性最高的MIC-1比较,差异有统计学意义（P〈0.05）;MIC-1＋CA19-9组合的特异性与单项检测特异性最高的CA19-9比较,差异无统计学意义（P〉0.05）.Ⅲ~Ⅳ期胰腺癌患者血清CA19-9、CA242水平与Ⅰ~Ⅱ期比较,差异有统计学意义（P〈0.05）.结论 4项肿瘤标志物的检测对胰腺癌的诊断均有一定的价值,MIC-1＋CA19-9联合检测可提高诊断的敏感性,同时未降低其特异性.CA19-9、CA242对判断胰腺癌的预后有一定价值.     

肿瘤标志物CEA、CA19-9在人结直肠癌检测中价值

目的探讨应用肿瘤标志物进行结直肠癌检测及预后判断的临床应用价值。方法汇总本院近3年收治的经手术治疗的结直肠癌患者191例,结合血清及组织学CEA、CA19-9的结果进行分析。结果归为DukeA期的患者仅占全部病例的12.57%。组织病理切片检查CEA、CA19-9阳性率分别为98.40%、74.24%;血清CEA、CA19-9阳性率分别为51.47%和22.39%;两项指标阳性率组织病理切片明显高于血清,P〈0.05,但其浓度与Duke分期具有正相关性。结论血清CEA、CA19-9测定对结直肠癌患者的诊断预后有临床应用价值,但对早期结直肠癌的筛查效果并不理想。     

肝硬化和肝癌患者血清CA125、CA199、AFP和CEA水平变化

目的 研究肝硬化和肝癌患者血清癌抗原（CA）125、CA199、甲胎蛋白（AFP）和癌胚抗原（CEA）的变化。方法 采用ELISA法检测223例肝硬化患者、97例肝癌患者和120例健康人血清CA125、CA199、AFP和CEA水平。结果 肝硬化和肝癌患者血清CA125分别为（261.64±32.47） U/ml和（265.80±30.44） U/ml,CA199分别为（25.73±3.39） U/ml和（30.54±3.29） U/ml,CEA分别为（4.03±0.36） ng/ml和（3.87±0.21） ng/ml,均显著高于健康人[（21.25±7.66） U/ml、（18.57±8.11） U/ml和（3.08±1.05） ng/ml,P<0.05];肝癌患者AFP（【20000.00±453.07） ng/ml】显著高于肝硬化患者[（7.52±2.01） ng/ml,P<0.05];肝硬化Child-Pugh C级患者CA125【（474.52±59.80） U/ml】、CA199【（27.80±5.94） U/ml】和CEA（【5.80±0.63） ng/ml】均显著高于Child-Pugh A级患者[分别为（55.65±8.82） U/ml、（18.81±0.46）U/ml和（3.20±0.10）ng/ml,P<0.05];腹水患者CA125为（385.16±36.09） U/ml、CA199为（26.55±2.87） U/ml、AFP为（13.63±1.82） ng/ml和CEA为（4.85±0.39） ng/ml,均显著高于无腹水患者[分别为（62.75±15.45） U/ml、（19.58±0.75） U/ml、（9.39±1.26） ng/ml和（3.54±0.16） ng/ml,P<0.05];酒精性肝硬化患者血清CA125【（318.48±48.80） U/ml】和CA199【（26.63±3.22） U/ml】显著高于病毒性[（215.77±26.26） U/ml和（19.06±0.64） U/ml,P<0.05]或原发性胆汁性肝硬化患者[（129.73±28.55）U/ml和（18.00±0.00）U/ml,P<0.05];病毒性肝炎肝硬化患者血清AFP（【56.41±26.75） ng/ml】显著高于酒精性或胆汁性肝硬化患者[分别为（5.44±0.30）ng/ml和（7.35±1.47） ng/ml,均为P<0.05],血清CEA【（3.53±0.17） ng/ml】则显著低于酒精性或胆汁性肝硬化患者[分别为（5.19±0.35）n g/ml和（5.73±0.98） ng/ml,均为P<0.05]。结论 肝硬化和肝癌患者CA125、CA199、AFP和CEA水平存在差异,肝硬化患者CA125、CA199、AFP、CEA水平与Child-Pugh分级、腹水和病因有关。     

Postoperative serum CA19-9, CEA and CA125 predicts the response to adjuvant chemoradiotherapy following radical resection in pancreatic adenocarcinoma

Objective

To evaluate the prediction of benefits from adjuvant chemoradiotherapy by postoperative serum CA19-9, CA125 and CEA.

Serum levels of the oncofetal antigens CA-125, CA 19-9 and CA 15-3 in patients with endometriosis

The levels of the oncofetal antigens CA-125, CA 19-9 and CA 15-3 were measured in serum samples taken from 8 women, aged 21 to 37 yr, before treatment, during the last fifteen days of a 6-month administration of danazol and finally three months after treatment withdrawal. The purpose of the study was to investigate: i) whether endometriosis belongs to the pathologic conditions which induce a concomitant increase in the values of CA-125, CA 19-9 and CA 15-3, and ii) the effect of danazol on the levels of these antigens. Our results indicate that before danazol treatment, three women showed pathologic levels of all three antigens, one of CA 19-9 and CA 15-3, one of CA 19-9 alone, and two of CA 15-3 alone. Administration of the drug significantly reduced the levels of CA-125 (p less than 0.001) and CA 19-9 (p less than 0.05) and to a lesser degree the levels of CA 15-3. Three months after danazol treatment discontinuation, the levels of these three antigens remained significantly lower (p less than 0.05) than the respective pretreatment values. Our findings substantiate the view that endometriosis must be classified with the pathologic conditions which induce a rise in the levels of all three antigens, and that ovarian function mainly influences the levels of CA-125 and CA 19-9.     

The correlation of CA15.3 and TPS with tumor course in patients with metastatic breast cancer

Purpose: This study was performed to deter mine the correlation of CA15.3 and TPS with disease course in patients with metastatic breast cancer.Methods: Levels of CA15.3 and tissue polypeptide antigen using the M₃ monoclonal antibody (TPS) were determined in the serum of 60 patients with metastatic breast cancer. CA15.3 and TPS were measured at two assay times.Results: A change of more than 25% in the serum level of CA15.3 or TPS was highly correlated with tumor response. The association between response and change in marker levels was stronger for CA15.3 (P=0.0001) than for TPS (P=0.0005). Distinct mismatches between marker changes and the tumor response were observed for both CA15.3 and TPS.Conclusion: CA15.3 and TPS are useful in the determination of response to treatment. Because of observed disagreement, marker changes can only be regarded as indicative of disease course.Abbreviations TPA tissue polypeptide antigen - TPS marker using mAb against epitope M₃ of TPA     

A comparative study of mucin-like carcinoma-associated antigen (MCA), CA 125, CA 19-9 and CEA in patients with ovarian cancer

A mucin-like carcinoma associated antigen (MCA), which is recognized by the monoclonal antibody b-12, was found to be elevated in sera of breast cancer patients. Since an immunohistochemical reaction of the monoclonal antibody b-12 was found in epithelial tumors of the ovary we investigated MCA serum levels in 50 patients with ovarian cancer (mean age 59 years, range 31-81 years). In addition, CA 125, CA 19-9 and CEA were determined to compare sensitivity, specificity and the predictive value of the positive test of each parameter used in this study. Blood samples were obtained in 20 patients with progressive disease and in 30 patients during disease free intervals. The MCA serum levels of patients with progressive ovarian cancer (mean +/- SD: 14.7 +/- 14.6 U/ml) did not differ significantly from those of patients in remission (mean +/- SD: 8.2 +/- 5.3 U/ml) or from values of a healthy control group (mean +/- SD: 7.7 +/- 3.8 U/ml, n = 70). Women with progressive disease displayed significantly higher CA 125 (p less than 0.0001) and CEA (p less than 0.0063) serum levels than patients in remission. No significant difference was found for CA 19-9 in patients with ovarian cancer, irrespective of the clinical status. Considering marker surge and tumor progression, the highest sensitivity was found for CA 125 (75%). Sensitivities of the other markers were significantly lower and reached only 25-35%. The predictive value of elevated marker levels as well as specificity of the marker substances were similar. Sensitivity could be extended to 90% if elevation of CA 125, CA 19-9, CEA and MCA were taken into consideration, however specificity was lowered by using this marker combination.     

联合检测血清CEA、CA125、FERRI、NSE在肺癌诊断中的应用价值

目的研究血清CEA、CA125、FERRI、NSE的检测在肺癌诊断中的临床意义。方法采用ELISA方法测定76例肺癌患者血清CEA、CA125、FERRI、NSE的水平,并检测20例非肿瘤患者组进行比较。结果 CEA、CA125、FERRI、NSE的联合检测的阳性率达到84.2%,明显高于各单项标记物的检测阳性率（分别为42.7%、34%、36%、38%）。Ⅲ＋Ⅳ期患者CEA、CA125、FERRI、NSE的阳性率明显高于Ⅰ＋Ⅱ期患者。CEA和CA125在腺癌患者中阳性率较高。NSE在小细胞癌患者中阳性率较高。FERRI在Ⅲ＋Ⅳ期患者中阳性率较高。肺癌患者中四种标记物的阳性率明显高于非肿瘤患者。结论 4项肿瘤标志物CEA、CA125、FERRI、NSE对肺癌的诊断都有一定意义。4项肿瘤标志物的水平与临床分期和病理类型密切相关。联合检测可提高诊断率。     

胸腔积液CA15-3、CA19-9和CEA对恶性胸腔积液的诊断价值

目的探讨胸腔积液中CA15-3、CA19-9和CEA在良性和恶性胸腔积液的水平及鉴别诊断价值。方法胸腔积液用化学发光法检测胸腔积液中的含量。结果恶性胸腔积液组的CA15-3、CA19-9、CEA的含量显著高于良性胸腔积液组。联合检测能提高诊断恶性胸腔积液的敏感度和准确度。结论胸腔积液CA15-3、CA19-9和CEA的联合检测对鉴别良恶性胸腔积液有重要价值。     

血清CA19—9、CEA、CA125联合检测诊断食管癌的价值

目的探讨多抗原联合检测诊断食管癌的价值。方法应用全自动化学免疫分析检测254例食管癌患者、40例食管炎患者和100例健康体检者血清CA19-9、CEA、CA125的表达。结果三项指标联合检测诊断食管癌的灵敏度和特异度均明显高于单独检测及任两项联合检测（P均〈0．01）。结论三项指标联合检测可提高诊断食管癌的灵敏度和特异度,有利于早期诊断食管癌。     

Prognostic significance of molecular subtype,metastatic site and primary tumor surgery for survival in primary metastatic breast cancer: A SEER-based study

The incidence of primary metastatic breast cancer (PMBC) has not decreased despite the increasing popularity of mammography screening and data on the survival among these patients are limited. Therefore, we conducted an extensive population-based study to investigate the factors influencing the survival of patients with PMBC.We identified 14,306 patients with de novo stage-IV breast cancer using the Surveillance, Epidemiology, and End Results data from 2010 to 2015. The overall survival (OS) time and breast cancer-specific survival (BCSS) time were compared by the Kaplan-Meier method. Univariate and multivariate analyses were performed to determine the effect of different prognostic factors.Patients with hormone receptor positive/human epidermal growth factor receptor 2 positive showed the longest median survival time in OS (39 months) and BCSS (43 months), and those with triple negative exhibited the shortest in OS (11 months) and BCSS (12 months). We concluded that patients who had undergone primary tumor surgery had better survival than those who did not. The incidence of distant visceral metastasis in the whole cohort was as follows: bone, lung, liver, and brain. This study also substantiated that patients with only brain metastasis had poorer survival than patients with metastasis at multiple sites metastasis, not including brain metastasis (P < .0001).This study confirmed that molecular subtypes, metastatic site and primary tumor surgery were associated with the survival of PMBC patients.     

Immunohistochemical Study of Colorectal Polyps with Antibodies against CEA,CA19-9, CA125, CA15-3 (DF3), PCNA and p53

Abstract: We analyzed the expression of CEA, CA19-9, CA125, CA15-3 (DF3), PCNA and p53 immunohistochemically in 14 tissue specimens of mucosal cancers in adenoma, seven tubulovillous adenoma specimens, and 16 tubular adenoma specimens. The rates of positive staining for mucosal cancer in adenoma, tubulovillous adenoma and tubular adenoma specimens, respectively, were: for CEA: 100%, 85.7% and 75%; for CA19-9: 71.4%, 71.4% and 56.2%; for CA125:0%, 0% and 0%;for CA15-3 (DF3): 64.3 %, 0% and 0 %; for PCNA: 100%, 88.9% and 56.2%; and for p53: 35.7%, 0% and 0% . The results suggest that the expressions of CEA, CA19-9, CA15-3 (DF3), PCNA and p53 are related to colorectal tumorigenesis. None of the specimens studied showed staining for CA125, suggesting that CA125 is not involved in the early stages of colorectal carcinogenesis. There was no significant difference in the rates of positive staining for CEA and CA19-9 among mucosal cancer in adenoma, tubular adenoma and tubulovillous adenoma specimens. However, the rates of positive staining for PCNA and p53 were significantly higher in mucosal cancer in adenoma specimens than for tubular adenoma specimens (p<0.05), and the rate of CA15-3 (DF3) positive staining was significantly higher for mucosal cancer in adenoma than for tubulovillous adenoma (p<0.01) and tubular adenoma (p< 0.001) specimens. Therefore, the CA15-3 (DF3) antigen is an immunohistochemical marker for colorectal carcinomas. The present results suggest that CA15-3 (DF3), PCNA and p53 play important roles in the genesis of colorectal adenomas.     

血清CEA和CA125水平对间质性肺病癌变的早期诊断学研究

目的比较ILD患者和ILD合并肺癌患者血清CEA和CA125的水平,探讨其在ILD合并肺癌早期诊断中的临床应用价值。方法设置ILD合并肺癌组(n=42)、ILD组(n=70)和对照组(n=60),测定并比较两组患者血清CEA和CA125的水平,通过受试者工作曲线评价CEA和CA125对ILD合并肺癌的诊断价值。结果 ILD合并肺癌组血清CEA、CA125水平均高于ILD组和对照组(P0.05);ILD组血清CEA、CA125水平均高于对照组(P0.05);血清CEA和CA125在诊断ILD合并肺癌的曲线下面积(area under curve,AUC)分别为0.722(95%CI:0.633~0.769,P0.05),0.751(95%CI:0.658~0.791,P0.05)。当血清CEA为6.2 ng/m L时,其诊断的敏感度为72.3%,特异度为69.2%;当血清CA125为60.4U/m L时,其诊断的敏感度为75.3%,特异度为79.7%。结论 ILD合并肺癌患者血清CEA和CA125较ILD患者要高,血清CEA和CA125对ILD合并肺癌的早期诊断具有参考价值。     

Multivariate analysis of a tissue CEA,TPA, and CA 19.9 quantitative study in colorectal cancer patients

Tissue CEA, TPA, and CA 19.9 concentrations from samples of surgical specimens were measured in 47 evaluable colorectal cancer patients (median follow-up, 20 months, 13 recurrences) and correlated with individual patient follow-up status. The quantitative method appeared to be sensitive, easily reproducible, and standardizable. The tissue marker concentration was analyzed by means of the multivariate discriminant analysis, to evaluate the risk of relapse in each patient; the tumor CEA (CEAT) showed the best discriminant capacity (P=.005). The relative Fisher function provided a reliable prognostic patient index, independently of other recognized prognostic factors (Dukes' stage and cellular differentiation grade). The Cox model showed a statistical significance analyzing the tumor (T) and healthy mucosa (M) CEA values (P=.001 andP=.006, respectively). The combination of these two variables allowed for identification of three classes of patients according to CEA T and M threshold values of 216 and 85 ng/mg of protein, respectively, and different disease-free curves were obtained for each group. The two-year disease-free rate was 81 percent for patients with low values of both CEA T and M, and 21.4 percent for the group with both values above these thresholds (P=.0008). In the third class (CEA T or M higher than the reported cut-off levels), the two-year disease-free rate was 65.9 percent. Read at the 32nd World Congress of Surgery, Sydney, Australia, September 20 to 26, 1987. Partially supported by C.N.R. Progetto Finalizzato Oncologia, grant no. 84.00849.44.     

Diagnostic value of serum CA242, CA 19-9, CA 15-3 and CA 125 in patients with carcinoma of the gallbladder.

BACKGROUND: Tumor markers have an increasing significance in the diagnosis and evaluation of tumor, but their role in gallbladder cancer has not been established. The present study was undertaken to determine the utility of serological markers in carcinoma of the gallbladder (CaGB). METHODS: This study was carried out in 55 cases and 8 healthy controls presenting to a single surgical unit of the University Hospital, Varanasi, India. CA242, CA19-9, CA15-3 and CA125 were assayed preoperatively in serum of patients with carcinoma of the gallbladder (39), cholelithiasis (16) and healthy controls (8) using ELISA technique. RESULTS: Mean concentration of all tumor markers was significantly raised in carcinoma of the gallbladder when compared with cholelithiasis. CA 242 was 12.10 vs 42.19 u/ ml, CA19-9 was 211.27 vs 86.06 uml, CA 15-3 was 71.42 vs 1.93u/ml and CA125 was 253.61 vs 65.5 u/ml <0.05). Sensitivity and specificity were calculated at various cut off points. Significant changes in CAl9-9 and CA242 occurred with advanced stage (p <0.05) and grade of tumor (p<0.00 1). When two tumor markers were combined, like CA242 and CA125, sensitivity and specificity improved to 87.5% and 85.7% respectively. Diagnostic accuracy is highest with a combination of CA 19-9 and CA 125 (80.65%). However, combination of tumor markers did not improve any further sensitivity or specificity of markers. CONCLUSION: Assay of CA242, CA15-3, CA19-9 and CA 125 are fairly good markers for discriminating patients of carcinoma of the gallbladder from cholelithiasis. CA242 and CA125 when used together achieved best sensitivity and specificity. Serum markers seem to be less sensitive when used individually in carcinoma of the gallbladder but may prove useful in combination.