A clinical evaluation of carbohydrate antigen 19‐9 and carcinoembryonic antigen in patients with pancreatic carcinoma

Abstract

We have studied serum carbohydrate antigen 19-9 (CA 19-9) and carcinoembryonic antigen (CEA) in 221 persons to assess their usefulness in the diagnosis of pancreatic carcinoma. Although serum CA 19-9 and CEA in all healthy controls were within normal limits, the positive ratings of serum CA 19-9 and CEA in all benign disease were 9.8% and 18.1%, respectively. Sensitivity of serum CA 19-9 for pancreatic carcinoma was 70.5%, which was higher than that found in healthy controls, benign disease, and other malignant disease except biliary carcinoma; but sensitivity of serum CEA levels (67.7%) was not different from that seen in malignant disease. Three of 34 patients (8.8%) with pancreatic carcinoma who had a above-normal levels of serum CA 19-9 but not serum CEA were resectable. Although there was no correlation between serum CA 19-9 and CEA, advanced stages of pancreatic, gastric, and colorectal carcinoma tend to show high serum CA 19-9 and CEA, but no statistical differences were observed in relation to the stages of these carcinomas. Comparative studies of serum CA 19-9 and CEA for sensitivity and the predictive value of true positive and negative results for detecting pancreatic, gastric, and colorectal carcinoma showed that serum CA 19-9 has significantly higher sensitivity and predictive value of true positive results for pancreatic carcinoma than for gastric and colorectal carcinoma (P less than 0.05). However, serum CEA measurements did not show any difference between these carcinomas, and the highest predictive value of a true negative result for excluding pancreatic carcinoma was also observed in serum CA 19-9. These results indicate that although the CA 19-9 assay is not specific for pancreatic carcinoma, it is more useful adjunct method for diagnosing pancreatic carcinoma, possibly in resectable stages.

CA 19-9 as a Marker for Gastrointestinal Cancers: A Review

“…However, others have reported high levels of this marker in small numbers of patients with pancreatitis. Thus, Satake et al 34 found CA 19-9 concentrations > 37 U/mL in 4/15 (26.6%) of patients with acute pancreatitis and in 2/30 of patients with chronic pancreatitis. In another study," CA 19-9 concentrations > 37 U/mL were detected in 27% of 66 patients with chronic pancreatitis and in 11 YO of 37 patients with acute pancreatitis.…”

Multiple Hepatic Receptors Cooperate to Eliminate Secretory Mucins Aberrantly Entering the Bloodstream: Are Circulating Cancer Mucins the “Tip of the Iceberg”?

“…For example, the CA19-9 antibody detects sialyl Lewis A (Neu5Aca2-3Galh1-3[Fuca1-4]GlcNAc) presented on a circulating high-molecular-weight mucin, providing an assay for diagnosis and monitoring of stomach, colon, and pancreatic cancer (25); and O-glycans on circulating MUC16 recognized by antibody CA-125 provides for diagnosis and monitoring of ovarian cancers (26). ''False-positives'' in such assays arise in acute and chronic pancreatitis (27)(28)(29), acute cholangitis (30), cystic fibrosis (31), bacterial pneumonia (32), endometriosis (33), benign ovarian cysts, the first trimester of pregnancy, and pelvic inflammatory disease (33)(34)(35)(36). Thus, although such biomarker assays have focused on cancer detection, epithelial mucins can also apparently ''spill'' into the circulation in a broad range of pathologies involving hollow organs and/or glands, including injury or inflammation.…”

Clinical Utility of TPS, TPA and CA 19-9 Measurement in Pancreatic Cancer

“…sclerosing cholangitis (I), and (c) gastrointestinal benign diseases ( I Ocases): duodenal ulcer (2). ulcera tive colitis (2), gallstones (6).…”