ELEVATION OF CARCINOEMBRYONIC ANTIGEN-RELATED TO BILIARY MALIGNANCY IN HEPATOLITHIASIS

Bile duct neoplasms occur relatively often in patients with hepatolith iasis in Taiwan. In this study, 49 patients with a positive immunopero xidase stain for carcinoembryonic antigen (CEA) in the bile duct gland s were examined in relation to the concentration of CEA in serum and b ile. The bile concentrations of CEA in 15 control patients, 16 patient s with hepatolithiasis only, 7 with hepatolithiasis and bile duct carc inoma, and 11 with bile duct carcinoma only were 4.09 +/- 4.12, 70.49 +/- 81.62, 137.73 +/- 66.15, and 144.3 +/- 117.31 ng/ml (mean +/- SD), respectively. A positive CEA stain from the bile duct was seen in 13. 33%, 81.23%, 85.71%, and 90.91% of each group, respectively. No strong ly positive staining, (2+ or 3+) was found in the control group, but i t was found frequently in the hepatolithiasis and bile duct carcinoma groups. The findings of this study therefore suggest the probability o f a combined neoplasm in patients with hepatolithiasis if the CEA valu e is unusually elevated in the serum or bile.