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Carcinoembryonic Antigen Level in Primary Sclerosing Cholangitis Is Not Influenced by Dominant Strictures or Bacterial Cholangitis

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Abstract

Background

Carcinoembryonic antigen (CEA) can be used to screen for biliary tract cancer in patients with primary sclerosing cholangitis (PSC).

Aim

To study the influence of benign dominant strictures (DS), superimposed bacterial cholangitis (SBC), smoking status, and inflammatory bowel disease on CEA serum levels.

Methods

A retrospective analysis of CEA values in cancer-free PSC patients was performed. We included the maximal CEA value obtained during follow-up and information on the presence of DS and SBC at that time, and we analyzed the CEA values in the presence and absence of DS and SBC. Results are reported as medians with the interquartile range (IQR).

Results

The median maximal CEA level, which was 1.8 ng/mL (IQR 1.2–2.9) in the final 270 PSC patients included in the study, was not influenced by the presence of either DS or SBC (P = 0.320). Moreover, in 49 patients, the first CEA value available at the time of DS (1.5 ng/mL; IQR 1.2–2.1) and that at a time without DS (1.6 ng/mL; IQR 1.1–2.3) did not differ significantly (P = 0.397). Lastly, in 24 patients, the median CEA values at a time without SBC (1.8 ng/mL; IQR 1.2–2.5) and at the time of SBC (1.8 ng/mL; IQR 1.0–3.0) were comparable (P = 0.305). Smoking did not influence CEA-based cancer screening.

Conclusions

Serum CEA level is not influenced by the presence of DS or SBC and might therefore serve as a favorable parameter for improving cancer screening in PSC patients.

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Acknowledgements

We thank Petra Klöters-Plachky and Yvonne Leopold for excellent technical assistance.

Funding

AW was funded by a grant from the Medical Faculty of the University of Heidelberg. DNG was supported by a Grant from Deutsche Forschungsgemeinschaft (DFG).

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Authors and Affiliations

  1. Department of Internal Medicine IV, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120, Heidelberg, Germany

    Andreas Wannhoff, Christian Rupp, Kilian Friedrich, Johannes Knierim, Karl Heinz Weiss, Wolfgang Stremmel & Daniel N. Gotthardt

  2. Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany

    Christa Flechtenmacher

  3. Liver Cancer Center Heidelberg, University Hospital Heidelberg, Heidelberg, Germany

    Christa Flechtenmacher, Karl Heinz Weiss, Wolfgang Stremmel & Daniel N. Gotthardt

Authors
  1. Andreas Wannhoff
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  2. Christian Rupp
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  3. Kilian Friedrich
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  4. Johannes Knierim
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  7. Wolfgang Stremmel
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  8. Daniel N. Gotthardt
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Correspondence to Andreas Wannhoff.

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All procedures performed were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

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Informed consent was obtained from all individual participants included in the study.

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Wannhoff, A., Rupp, C., Friedrich, K. et al. Carcinoembryonic Antigen Level in Primary Sclerosing Cholangitis Is Not Influenced by Dominant Strictures or Bacterial Cholangitis. Dig Dis Sci 62, 510–516 (2017). https://doi.org/10.1007/s10620-016-4370-4

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  • DOI: https://doi.org/10.1007/s10620-016-4370-4

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