FUT2 and FUT3 genotype determines CA19-9 cut-off values for detection of cholangiocarcinoma in patients with primary sclerosing cholangitis.
J Hepatol
; 59(6): 1278-84, 2013 Dec.
Article
en En
| MEDLINE
| ID: mdl-23958938
ABSTRACT
BACKGROUND & AIMS:
Allelic variants of fucosyltransferases 2 and 3 (FUT2/3) influence serum levels of CA19-9, a screening parameter commonly used for detection of biliary malignancy in PSC. We aimed at improving diagnostic accuracy of CA19-9 by determining the impact of FUT2/3 genotypes.METHODS:
CA19-9 levels were measured in 433 PSC patients, 41 of whom had biliary malignancy. Genotypes for FUT3 and FUT2 were used to assign patients to one of three groups A, no FUT3 activity regardless of FUT2 activity; B, both FUT2 and FUT3 activity and C, no FUT2 activity without loss of FUT3 activity. Group-specific cut-off values were determined by Youden's index.RESULTS:
The median CA19-9 values of cancer-free patients were significantly different (p<0.001) in Groups A (2.0U/ml), B (17.0U/ml), and C (37.0U/ml). Biliary malignancy patients in Groups B and C had significantly higher CA19-9 values than cancer-free patients (p<0.001). The optimal cut-off, as determined by ROC analysis, for all patients was 88.5U/ml. Optimal cut-off values in Groups A, B, and C were 4.0U/ml, 74.5U/ml, and 106.8U/ml, respectively. Use of these values improved sensitivity of CA19-9 in Groups B and C. Further, use of group-dependent cut-off values with 90% sensitivity resulted in a 42.9% reduction of false positive results.CONCLUSIONS:
Use of FUT2/3 genotype-dependent cut-off values for CA19-9 improved sensitivity and reduced the number of false positive results.Palabras clave
AASLD; AUC; American Association for the Study of Liver Diseases; CA19-9; CCA; Cholangiocarcinoma; EASL; European Association for the Study of the Liver; FUT2; FUT3; Fucosyltransferase 2; Fucosyltransferase 3; GBCA; Gallbladder carcinoma; HD; Heidelberg; IBD; IQR; LT; MELD; Model of End-Stage Liver Disease; NPV; O; Oslo; PPV; PSC; Primary sclerosing cholangitis; ROC; SNP; WGA; area under the curve; carbohydrate antigen 19-9; cholangiocarcinoma; fucosyltransferase 2; fucosyltransferase 3; gallbladder carcinoma; inflammatory bowel disease; inter-quartile range; liver transplantation; negative predictive value; positive predictive value; primary sclerosing cholangitis; receiver operating characteristic; single-nucleotide polymorphism; whole-genome amplified
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Neoplasias de los Conductos Biliares
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Conductos Biliares Intrahepáticos
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Colangitis Esclerosante
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Colangiocarcinoma
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Antígeno CA-19-9
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Fucosiltransferasas
Tipo de estudio:
Diagnostic_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Hepatol
Asunto de la revista:
GASTROENTEROLOGIA
Año:
2013
Tipo del documento:
Article
País de afiliación:
Alemania