Serum CA 242 as a Potential Diagnostic Tool for Gallbladder Cancer: A Clinical Evaluation

Gallbladder cancer (GBC) is a prevalent form of biliary cancer with a dismal prognosis. Most patients present in late stages of disease when surgery is not a viable option. Hence, biomarkers for early detection of GBC are desperately needed. Routine serum tumor markers have shown variable predictability in different populations. CA 242 is emerging as a promising biomarker in gastrointestinal cancers. This study explored diagnostic potential of serum CA 242 and its correlation with other tumor markers in gallbladder cancer. In this prospective cross-sectional study, 50 GBC patients, 20 benign gallbladder disease (chronic calculous cholecystitis) patients, and 10 healthy controls were included. Serum CA 242 concentration was determined using the high-sensitivity ELISA method. Serum CEA, CA 125, and CA19-9 levels were analyzed using chemiluminescence. Receiver operating characteristic (ROC) was plotted to determine diagnostic potential of CA 242. The Mann-Whitney U test was used to compare CA 242 levels among different subgroups. Spearman's correlation was done to correlate CA 242 with other tumor markers. The median level of CA 242 in the GBC group was significantly higher (29.29 [1.40-171.50]) pg/ml compared to the non-GBC group (1.60 [1.2-2.00]) pg/ml. ROC analysis revealed that area under the curve for serum CA 242 was 0.756 (95% CI, 0.651-0.862), with a sensitivity of 64.0%, specificity of 93.3%, and diagnostic accuracy of 75.0% at an appropriate cut-off value of 6.6 pg/ml. There was significant positive correlation between CA 242 and serum CEA (r = 0.487, P = 0.000) and CA19-9 (r = 0.472, P = 0.001). No difference was observed in different subgroups like abdominal pain, obstructive jaundice, liver infiltration, lymph node involvement, metastasis, TNM staging, and resectability with serum CA 242. Serum CA 242 showed a promising potential as a diagnostic biomarker in GBC more so as a confirmatory biomarker in conjunction with other tumor markers. No association was however observed in terms of clinicopathological characteristics.

The online version contains supplementary material available at 10.1007/s13193-025-02332-6.