CA 19-9 as a serum marker in urothelial carcinoma

Abstract

Introduction:CA 19-9 is a carbohydrate antigen related to Lewis A blood group antigen. It is well-known marker for pancreatic carcinoma and is being investigated for other malignancies including carcinoma bladder. We evaluated the role of serum CA 19-9 as a tumor marker and correlated its level with tumor stage and grade.Materials and Methods:Seventy-five patients with histologically proven urothelial carcinoma were included in this study as case and 25 healthy volunteers as control. Preoperative 5 ml blood sample was collected. Serum level of CA 19-9 was measured using solid-phase enzyme-linked immunosorbent assay kit. The value of CA19-9 was expressed in U/ml and 37 U/ml was taken as cut-off upper value of normal.Results:The range of CA19-9 in patients of urothelial carcinoma was 2 to 122 U/ml with a mean of 26.33±29.28, while in control, it was 8.48±5.01 U/ml (P<0.001). The sensitivity of CA19-9 was 29%. Serum CA19-9 was significantly elevated in invasive disease in comparison with superficial disease (47.17±34.43 vs 16.53±20.13) (P<0.001). Significantly high proportion of patients with invasive disease had value ≥37 U/ml (14/24 [58.3%] vs 8/51 [15.7%]) with P value <0.001. High proportion of high-grade tumor had raised value, 14/34 (41.25%); all patients with metastatic disease had value more than 37 U/ml.Conclusions:Serum CA19-9 is a marker of aggressiveness of urothelial carcinoma and is almost invariably raised in patients with metastatic disease. Thus, it may be used as a prognostic marker but not as a screening tool due to its low sensitivity.

Over forty years of bladder cancer glycobiology: Where do glycans stand facing precision oncology?

“…In bladder cancer, serum CA19-9 is a marker of aggressiveness and advanced stage disease, being almost invariably raised in patients with metastatic cancer. As such, it constitutes a valuable marker of poor prognosis [ 234 ]. Notwithstanding, its value as a screening tool has been opposed by its low sensitivity (29%) [ 234 ].…”

“…As such, it constitutes a valuable marker of poor prognosis [ 234 ]. Notwithstanding, its value as a screening tool has been opposed by its low sensitivity (29%) [ 234 ]. On the other hand, urinary CA19-9 is a better screening parameter, with optimum sensitivity and specificity, than its serum counterpart for diagnosis of low grade and early stage bladder cancer.…”

Tumor-Specific Zr-89 Immuno-PET Imaging in a Human Bladder Cancer Model

“…Most bladder cancers are transitional cell carcinomas arising from transitional epithelium, a specialized mucous membrane. Serum levels of CA19.9 are moderately increased in patients with advanced and metastatic bladder cancer [ 9 , 10 ]. It is well documented that the CA19.9 antigen in serum is displayed on mucin; however, not all mucins are shed from the cell surface [ 23 , 24 ].…”

“…Serum CA19.9 is significantly increased in 35–58 % of patients with known urothelial carcinoma and is significantly increased in > 70 % of muscle-invasive cases versus non-muscle-invasive cancers, making a potentially important prognostic marker [ 2 , 7 – 9 ]. While several serum and cytology markers for urothethial cancers have been identified, they lack the sensitivity needed for appropriate screening [ 10 ]. In fact, serum CA 19.9 suffers similar limitations.…”

Persistent High Level of Urinary Tumor Marker Carbohydrate Antigen 19-9 in Prenatally Diagnosed Dysplastic Kidney

“…The diagnostic value of CA 19-9 level in genitourinary tract abnormalities has been reported in urothelial carcinoma [ 5 ]. Our previous report has elucidated the association of increased urinary and serum CA 19-9 levels and congenital ureteropelvic junction obstruction (UPJO) in children [ 6 ], indicating the significance of this tumor marker in such benign genitourinary conditions.…”