Biliary malignancy is common in Asia and has high fatality. CA 19-9 has been used in diagnosis of biliary malignancy but can be raised in benign obstructive jaundice as well. CYFRA 21-1 can have an important role in patients with biliary tract cancer. The objective of this study is to compare accuracy of biomarkers CYFRA 21-1 with CA 19-9 for diagnosis of biliary tract cancers and to correlate level of biomarkers with the stage of disease. Patients with histopathological diagnosis of biliary

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... ct cancers managed at Tribhuvan University Teaching Hospital, Kathmandu, Nepal were enrolled in the study. Measurement of serum CK 19 fragments was performed and compared with CA 19-9. Demographic characteristics, physiological variables and laboratory values were analyzed. Of the 61 patients included the mean age was 53.41±12.5 years. Amongst the biliary malignancies, carcinoma of the gallbladder was commonest. Most patients (64%) were in the middle age group (40 to 60 years) and presented in advanced stage (Stage III and IV). CYFRA 21-1 had sensitivity of 80.3% and CA 19-9 of 68.9 % for the detection of Biliary Tract Cancers. Comparing the means of CYFRA 21-1 and CA 19-9 for stage of the disease, progressive rise of CYFRA 21-1 with the rise in stage of the disease was observed (p< 0.03). CYFRA is a more reliable test than CA 19-9 in all stages of biliary malignancy and can assist in distinguishing early and advanced malignancy. In carcinoma of gallbladder, highest CYFRA 21-1 values were observed.