Application of serum tumor markers, multi-slice spiral CT and magnetic resonance imaging in the diagnosis of bile duct carcinoma

Objective: To evaluate the application value of serum tumor markers, multi-slice spiral CT and magnetic resonance imaging (MRI) in the diagnosis of bile duct carcinoma (BDC). Methods: 70 cases of patients with BDC (BDC group) treated in our hospital from April 2014 to December 2016 were enrolled, while another 50 cases of patients with benign lesions of common bile duct were selected as the control group at the same time. The levels of serum markers (CA19-9, CA125, CEA) were detected, and multi-slice spiral CT and MRI examination were performed among these patients. The imaging signs of BDC and benign lesions of bile duct were analyzed. Results: The levels of CA19-9, CEA, CA125 and serum total bilirubin (TBIL) in BDC group were significantly higher than those in the control group (P < 0.01), and there was a positive correlation between serum CA19-9, CEA, CA125 levels and TBIL level in BDC group (P < 0.01). CT and MRI of benign lesions of common bile duct showed that the bile duct dilatation was not obvious, also the lymph node enlargement and bile duct stenosis or truncation were rare while CT and MRI of BDC showed the characteristics of mass tube wall of infiltration type, hilar common bile duct truncation, bile duct dilatation, hepatic lobe atrophy, portal vein invasion and lymph node enlargement. There were no significant differences of the sensitivity, specificity and accuracy among levels of serum tumor markers, CT and MRI measures in the diagnosis of BDC (P > 0.05) but the sensitivity, specificity and accuracy of combined diagnosis of these three (92.75%, 88.24%, 90.83%) were higher than those of single diagnoses (P < 0.05). Conclusion: The levels of serum markers of BDC including CA19-9, CEA and CA125 are abnormally high, and the CT and MRI findings are characteristic. The information from any single diagnosis of these three methods is limited, while the diagnostic efficiency of combination of these three is high. In clinical practice, the combined detection of levels of serum tumor markers, CT and MRI is recommended. (authors)