A 55-year-old woman presents with intermittent right upper quadrant pain and elevated liver enzymes. MRCP shows dilated intrahepatic and extrahepatic bile ducts with multiple filling defects within the ducts and a stricture at the right hepatic duct bifurcation. This is consistent with primary sclerosing cholangitis (PSC) with cholangiocarcinoma. Which tumour marker combination is most useful for surveillance in PSC?
- A AFP and CEA
- B CA 125 and AFP
- C CA 19-9 and CEA ✓
- D CA 15-3 and CA 19-9
Correct answer: C. CA 19-9 and CEA
Explanation
CA 19-9 is the most useful serum marker for cholangiocarcinoma surveillance in PSC, typically used in combination with CEA; CA 19-9 >129 U/mL has 79% sensitivity and 98% specificity for CCA in PSC. AFP and CA 125 are markers for HCC and ovarian cancer, respectively, and are not the primary markers for cholangiocarcinoma.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.