Role Of Serum Levels Of Tumor Markers In The Prognosis Of Patients With Carcinoma Gall Bladder And Their Correlation With Its Staging

Introduction: Carcinoma gall bladder is the 4th most common gastrointestinal cancer. Expression of serum levels of tumor markers CA 19-9, CEA and CA-125 was assessed in these patients and it was correlated with the staging of the disease for prognosticating the patients. Method: The study was carried out at AIIMS, Rishikesh,a tertiary care centre in India. Histopathologically proven cases were included in the study. Patients were examined properly following detailed history taking, and investigated with serum CA19-9,CEA,CA-125 levels and CECT abdomen to stage the disease. The resectability and operability was determined based on the reports and staging done as per AJCC 8TH staging system. The data was analyzed, evaluated by Kruskal Wallis test and Spearman’s correlation was used to assess the correlation, if any, between the tumor markers and the clinicoradiological staging of carcinoma gall bladder. Result: Analysis of data from 75 patients of proven carcinoma gall bladder suggests no statistically significant difference in the stage wise mean values of the three tumor markers in different stages of carcinoma gall bladder. However, Spearman’s correlation showed positive correlation of serum levels of CEA (p value – 0.032) and CA 125 (p value- 0.041) with staging of carcinoma gall bladder, but no such significant correlation exists with CA 19-9 ( p value- 0.39). Conclusion: We conclude that the levels of CEA and CA 125 are higher in advanced stages of carcinoma gall bladder and vice versa but this is not true for CA 19-9. Levels of CA 19 9 in these patients do not seem to correlate with the severity of the malignancy in our study, yet around 68% of the patients in the study had raised CA 19 9 levels, irrespective of the stage. This can be used to prognosticate these patients but a study with larger sample size needs to re-evaluate and validate these results.