Elevated serum CA 19-9 levels in patients with pulmonary nontuberculous mycobacterial disease

Abstract

Increased serum CA 19-9 levels in patients with nonmalignant diseases have been investigated in previous reports. This study evaluates the clinical significance of serum CA 19-9 elevation in pulmonary nontuberculous mycobacterial disease and pulmonary tuberculosis. The median CA 19-9 level was higher in patients with pulmonary nontuberculous mycobacterial disease than in patients with pulmonary tuberculosis (pulmonary nontuberculous mycobacterial disease: 13.80, tuberculosis: 5.85, p<0.001). A multivariate logistic regression analysis performed in this study showed that Mycobacterium abscessus (OR 9.97, 95% CI: 1.58, 62.80; p=0.014) and active phase of pulmonary nontuberculous mycobacterial disease (OR 12.18, 95% CI: 1.07, 138.36, p=0.044) were found to be risk factors for serum CA 19-9 elevation in pulmonary nontuberculous mycobacterial disease. The serum CA 19-9 levels showed a tendency to decrease during successful treatment of pulmonary nontuberculous mycobacterial disease but not in pulmonary tuberculosis. These findings suggest that CA 19-9 may be a useful marker for monitoring therapeutic responses in pulmonary nontuberculous mycobacterial disease, although it is not pulmonary nontuberculous mycobacterial disease-specific marker.

Correlation between serum carbohydrate antigen 19-9 levels and computed tomography severity score in patients with nontuberculous mycobacterial pulmonary disease

“…Hong et al 13 examined the clinical significance of CA19-9 as a biomarker for monitoring treatment for NTM-PD. In that study, patients with good treatment response showed a significant decline in the CA19-9 level, while no difference was observed in the CA19-9 level between before and after treatment in non-responders.…”

“…Consequently, there is dire need for a simple biomarker that reflects the disease activity of NTM-PD. Few studies have reported on the hematological biomarkers of NTM-PD, including IgA antibodies against glycopeptidolipids (GPL) 11 , serum Krebs von den Lungen-6 (KL-6) 12 , and carbohydrate antigen 19-9 (CA19-9) 13,14 .…”

“…We focused on a previous study, which suggested a correlation between active NTM-PD and serum CA19-9 levels 13 . In that study, patients with NTM-PD exhibited elevated serum CA19-9 levels, which plummeted significantly after treatment for NTM-PD.…”

Assessing Response to Therapy for Nontuberculous Mycobacterial Lung Disease: Quo Vadis?

“…Elevated blood levels of CA 19-9 are also seen in various forms of chronic lung disease, including bronchiectasis. Recently, CA 19-9 was examined as biomarker of treatment response among 24 patients with NTM lung disease in South Korea ( Hong et al, 2016 ). Among 17 patients with treatment response (defined as symptomatic improvement and sputum culture conversion within 12 months of therapy), CA 19-9 levels significant declined, while no difference was observed among the 7 patients without clinical response.…”

Pulmonary non-tuberculous mycobacterial infections: current state and future management

“…In addition, for elderly patients infected with PNTM who need to be treated with macrolides, rifamycin and FQs, comorbidities and associated concomitant therapies should be determined since these drugs may interact with those that interact with P-450 and disturb the metabolism of drugs [367]. Hong et al (2015) suggested that serum carbohydrate antigen (CA) 19-9 can be a useful marker to monitor the therapeutic responses in PNTM as it is higher in PNTM than in TB, and its concentration is reduced after successful PNTM treatment but not in TB [368].…”