CA 19-9 levels in patients with acute pancreatitis due to gallstone and metabolic/toxic reasons

Abstract

SUMMARY OBJECTIVE Acute pancreatitis (AP) is an important clinical event with an increased frequency due to increased life expectancy, obesity, and alcohol use. There are some data about the elevation of carbohydrate antigen (CA) 19-9 levels in benign and malignant pancreaticobiliary events in the literature, but in AP they are limited. The aim of this study was to evaluate the CA 19-9 level in patients with AP and determine its relationship according to the cause. METHODS Between 2010-2018, 173 patients evaluated with CA 19-9 levels as well as by standard laboratory tests were included in the study. CA 1 9-9 levels and laboratory findings were compared in patients with pancreatitis due to gallstone (group 1) and metabolic/toxic reasons such as hyperlipidemia, alcohol, or drug use (group 2). RESULTS There were 114 (66%) patients in the group 1 and 59 (34%) patients in the group 2. The majority of patients with high CA 19-9 level were in group 1 (92.1% vs 6.8%). CA 19-9 level, as well as amylase, lipase, AST, ALT and bilirubin levels were found to be statistically higher in patients with AP due to gallstone compared to patients with metabolic/toxic AP. CONCLUSIONS Patients with AP due to gallstone, were found to have a high level of CA 19-9 at admission. Early stage CA 19-9 levels may contribute to standard laboratory tests in the etiology of the disease in patients diagnosed with AP.

Robotic-assisted versus open distal pancreatectomy for benign and low-grade malignant pancreatic tumors: a propensity score-matched study

“…An elevated CA 19-9 level was identified in 44 cases in our study and was found to be an independent predictor of splenic vessel sacrifice (WT SPDP and DP with splenectomy). Elevated CA 19-9 levels have been reported to be associated with acute or chronic pancreatitis even in benign pancreatic tumors [47]. The inflammation caused by some types of benign and lowgrade malignant tumors, such as inflammatory neoplasms and IPMN, may increase the level of CA 19-9 and ultimately cause the failure of splenic vessel preservation, which may explain why an elevated CA 19-9 level was an independent risk factor for KT SPDP.…”

Does acute pancreatitis herald pancreatic ductal adenocarcinoma? A multicenter electronic health research network study

“…Investigation of isolated, asymptomatic elevation of CA 19-9 commonly yields benign etiology, including AP, particularly, acute biliary pancreatitis, chronic pancreatitis and other hepatobiliary diseases. 27,28 We observed that both CA 19-9 and CEA were more commonly elevated in patients with APUE and PDAC compared to PDAC patients without APUE. An interesting finding noted in our study is both CA19-9 and CEA were rarely elevated (<1%) in patients with APUE in the absence of pancreatic adenocarcinoma.…”

Biomarkers in the diagnosis of pancreatic cancer: Are we closer to finding the golden ticket?

“…CA19-9 has only been reported to be elevated in only 80% of all PC patients, and has been used in monitoring disease progress or responsiveness to treatment[ 27 , 28 ]. CA19-9 has also been demonstrated to be elevated in benign conditions such as chronic pancreatitis (CP), biliary obstruction and cholangitis highlighting a lack of specificity[ 29 , 30 ]. In addition to this, CA19-9 is related to the Lewis blood group antigens and only those patients who belong to the Le (α-β+) or Le (α + β-) blood groups will express the antigen, its sensitivity in the diagnosis of PC is questionable as 10% of the population have a Le (α-β-) phenotype which lacks the enzyme 1,4-fucosyl transferase that is essential for the production of CA19-9[ 31 , 32 ].…”