Abstract: Objective To explore the application of serum cancer antigen19-9（CA19-9）,CA125 and carcinoembryonic antige （CEA） in the diagnosis of serum alpha-fetoprotein （AFP） negative patients with intrahepatic cholangiocarcinoma （ICC）. Methods 60 patients with ICC were recruited in our hospital between June 2014 and June 2016,and they were divided into two groups,e.g. AFP-negative group and AFP-positive group with 30 in each group according to the results of serum AFP detection. Serum CA19-9,CA125 and CEA levels were detected by array-ELISA. Receiver operating characteristic（ROC） curves were used to evaluate the diagnostic efficacy of each and joint detection of CA19-9,CA125 and CEA for diagnosis of ICC. Results Serum levels of CA19-9,CA125 and CEA in AFP negative group were 138.8（85.7~185.1）U/ml,109.6（48.4~201.8）U/ml, 11.2（17.5~21.9） ng/ml,much higher than 【（38.0（16.9~75.5）U/ml,18.1（9.3~48.1）U/ml,5.5（3.1~8.5）ng/ml）,P<0.01】 in AFP-positive group;The ROC curve area of serum CA19-9,CA125 and CEA in AFP negative group were 0.85,0.83 and 0.81,respectively,significantly higher than[（0.55,0.45 and 0.42）,P<0.05] in AFP positive group; the cut-off-value of serum CA19-9,CA125 and CEA in diagnosis of ICC were 124.89 U/ml,96.04 U/ml and 11.97 ng/ml respectively;The sensitivity,specificity and accuracy rates of CA19-9,CA125 and CEA were （73.33%,76.67% and 71.67%）,（66.67%,70.00% and 68.33%） and（60.00,70.00% and 65.00）,respectively;ROC curve area under joint detection showed that （CA19-9/CA125/CEA）>（CA19-9/CA125）>（CA19-9/CEA）> （CA125/CEA）,the ROC curve area of joint diagnosis in the AFP negative group were 0.94,0.88,0.86 and 0.85,respectively,significantly higher than those in the AFP positive group [（0.74,0.62,0.58 and 0.52）,P<0.05];the sensitivity,specificity and accuracy of joint detection[（CA19-9/CA125/CEA）,（CA19-9/CA125）,（CA19-9/CEA） and 9CA125/CEA）] increased,and they were（90%,90% and 90%）,（83.33%,83.33% and 81.67%）,（76.67%,83.33% and 80%） and（70%,76.67% and 73.33%）,respectively,with the efficacy of （CA19-9/CA125/CEA） was the best. Conclusion We believe that the combination of serum CA19-9,CA125 and CEA detection can improve the correct diagnosis of serum AFP negative patients with ICC,which needs further clinical investigation.

Key words: Intrahepatic cholangiocarcinoma, Cancer antigen19-9, CA125, Carcinoembryonic antigen, Diagnosis