Intrahepatic cholangiocarcinoma with increased serum CYFRA 21-1 level |
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Authors: | Takeshi Kashihara Atsushi Ohki Tomoko Kobayashi Tomomi Sato Hitoshi Nishizawa Kohei Ogawa Hajime Tako Fusao Kawakami Motomu Tsuji Koichi Tamaoka |
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Institution: | (1) Departments of Internal Medicine,,;(2) Pathology, and,;(3) Radiology, Itami City Hospital, 1-100 Koyaike, Itami 664, Japan, JP |
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Abstract: | CYFRA 21-1 is a fragment of cytokeratin 19 (CK 19). Four patients with large intrahepatic (or peripheral) cholangiocarcinoma
(CC) and high serum levels of CYFRA 21-1 (normal, ≤2 ng/ml) are reported. CYFRA 21-1 levels exceeded 9 ng/ml in all 4 patients.
Carcinoembryonic antigen (CEA), was high in 1 (CEA; normal range, ≤5.0 ng/ml) and carbohydrate antigen 19-9 (CA 19-9) was
high in 3 (CA19-9; normal range, ≤36 U/ml). We also measured serum levels of CYFRA 21-1 in 13 patients with hepatocellular
carcinoma (HCC) more than 5 cm in diameter. Levels of CYFRA 21-1 exceeded 2 ng/ml in 9 of the HCC patients and were higher
than 9 ng/ml in 2 of the HCC patients. Levels of alpha fetoprotein (AFP) and/or protein induced by vitamin K absence or antagonist
II (PIVKA II) were elevated in all HCC patients (AFP, PIVKA II, respectively; normal range, ≤10.0 ng/ml and ≤0.1 AU/ml) CYFRA
21-1 levels were measured twice or three times during the clinical course in 2 CC patients and in 6 HCC patients, and increased
gradually with tumor growth in the 2 CC patients and in 3 of the 6 HCC patients. Marked increases in serum CYFRA 21-1 levels
in patients with large liver cancers, particularly in those with normal levels of AFP and PIVKA II, would suggest the existence
of intrahepatic CC rather than HCC.
(Received May 8, 1997; accepted Oct. 30, 1997) |
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Keywords: | : intrahepatic cholangiocarcinoma CYFRA 21-1 cytokeratin 19 hepatocellular carcinoma |
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