Ca 19-9 Assay in Patients with Extrahepatic Cholestatic Jaundice

Barone, Daniela; Onetto, M.; Conio, Mássimo; Paganuzzi, Michela; Saccomanno, S.; Aste, H.; Pugliese, V.

doi:10.1177/172460088800300204

Cited by 29 publications

(22 citation statements)

References 16 publications

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“…Elevated values of CA 19-9 and CEA are frequently seen in benign extrahepatic biliary obstruction, and it has been suggested that in patients with pancreatic cancer obstruction of the common bile duct might contribute to the elevation of serum marker levels Carr-Locke, 1980;Haglund et al, 1986Haglund et al, , 1989Barone et al, 1988;. If the patients of this study had been further divided into patients with or without jaundice, the groups would have been too small for meaningful statistical analysis.…”

Section: Discussionmentioning

confidence: 93%

The prognostic value of preoperative serum levels of CA 19-9 and CEA in patients with pancreatic cancer

Lundin

Roberts²,

Kuusela³

et al. 1994

Br J Cancer

105

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The prognostic value of preoperative serum levels of CA 19-9 and CEA was evaluated in 160 patients with pancreatic cancer. The survival of patients whose tumour marker value was below a certain cut-off level was compared with the survival of those with a higher value using the log-rank test. The lowest cut-off level dividing patients into groups with significant difference in survival (P < 0.05) was determined by graphical analysis of chi-square values at different cut-off levels. If stage of disease was not taken into account, there was a significant difference in survival between patients with low vs high preoperative CA 19-9 and CEA levels. When patients were classified according to stage, a difference was found for CA 19-9 in stage II-III patients. Patients with preoperative CA 19-9 below 370 U ml-1 had a significantly better prognosis than those with a higher level (P < 0.05). In stage I and stage IV patients, no significant difference was found between the groups at any cut-off level. The analysis of CEA showed a significant difference in survival only in stage IV patients, with CEA above 15 ng ml-1 being associated with shorter survival. In conclusion, in patients with stage II-III disease, particularly in patients with a non-resectable tumour, in whom the exact spread of the disease may be difficult to evaluate even at operation, the preoperative CA 19-9 level seems to have a prognostic value.

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Section: Discussionmentioning

confidence: 93%

The prognostic value of preoperative serum levels of CA 19-9 and CEA in patients with pancreatic cancer

Lundin

Roberts²,

Kuusela³

et al. 1994

Br J Cancer

105

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“…Of clinical relevance is the finding that endogenous interferents, such as hemoglobin, bilirubin, triglycerides and rheumatoid factor, do not influence GI Monitor concentrations in vitro. However, as mentioned above, it is well known that cholestatic diseases which are often associated with high bilirubin levels can in vivo cause considerable elevations of CA19-9 antigen in serum (8,9,(17)(18)(19).…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, very high levels (up to 100,000 kU/L) have been reported in human body secretions, such as bile fluid, urine, sputum, milk, amniotic fluid and ovarian cysts (8)(9)(10). However, some benign diseases have been associated with elevated CA19-9 antigen levels, including particularly non-malignant gastrointestinal diseases with a cholestatic component, such as liver cirrhosis, cholangitis, hepatitis and pancreatitis (8,9,(17)(18)(19).…”

Section: Introductionmentioning

confidence: 99%

Alternative antibody for the detection of CA19-9 antigen: a European multicenter study for the evaluation of the analytical and clinical performance of the Access® GI Monitor assay on the UniCel® DxI 800 Immunoassay System

Holdenrieder¹,

Molina²,

Gion³

et al. 2008

Clinical Chemistry and Laboratory Medicine

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Background: Gastrointestinal cancer antigen CA19-9 is known as a valuable marker for the management of patients with pancreatic cancer. Methods: The analytical and clinical performance of the Access ᮋ GI Monitor assay (Beckman Coulter) was evaluated on the UniCel ᮋ DxI 800 Immunoassay System at five different European sites and compared with a reference method, defined as CA19-9 on the Elecsys System (Roche Diagnostics). Results: Total imprecision (%CV) of the GI Monitor ranged between 3.4% and 7.7%, and inter-laboratory reproducibility between 3.6% and 4.0%. Linearity upon dilution showed a mean recovery of 97.4% (SDq7.2%). Endogenous interferents had no influence on GI Monitor levels (mean recoveries: hemoglobin 103%, bilirubin 106%, triglycerides 106%). There was no high-dose hook effect up to 115,000 kU/L. Clinical performance investigated in sera from 1811 individuals showed a good correlation between the Access ᮋ GI Monitor and Elecsys CA19-9 (Rs0.959, slopes1.004, interceptsq0.17). GI Monitor serum levels were low in healthy individuals (ns267, medians6.0 kU/L, 95th percentiles23.1 kU/L), higher

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“…It is the most extensively used marker for pancreatic cancer and is often considered as the golden standard against which other markers can be compared (4). Although CA 19-9 has a high sensitivity for pancreatic cancer, its clinical utility is limited by the fact that its concentration is also elevated in patients with obstructive jaundice of benign causes (5).…”

Section: Introductionmentioning

confidence: 99%

TPS, CA 19-9, VEGF-A, and CEA as Diagnostic and Prognostic Factors in Patients with Mass Lesions in the Pancreatic Head

Sandblom

Granroth

Rasmussen

2008

Upsala Journal of Medical Sciences

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Introduction: Although numerous tumour markers are available for periampullary tumours, including pancreatic cancer, their specificity and sensitivity have been questioned. Materials and methods:To assess the diagnostic and prognostic values of tissue polypeptide specific antigen (TPS), carbohydrate antigen 19-9 (CA 19-9), vascular endothelial growth factor (VEGF-A), and carcinoembryonic antigen (CEA) we took serum samples in 56 patients with mass lesions in the pancreatic head. Among these patients, further investigations revealed pancreatic cancer in 20 patients, other malignant diseases in 12 and benign conditions in 24.Results: Median CEA in all patients was 3.4 μg/L (range 0.5-585.0), median CA 19-9 was105 kU/L (range 0.6-1 300 00), median TPS 123.5 U/L (range 15.0-3350) and median VEGF-A 132.5 ng/L (range 60.0-4317). Area under the curve was 0.747, standard error (standard error [SE] =0.075) for CEA, 0.716 (SE=0.078) for CA 19-9 and 0.822 (SE=0.086) for TPS in ROC plots based on the ability of the tumours to distinguish between benign and malignant conditions. None of the markers significantly predicted survival in the subgroup of patients with pancreatic cancer. Discussion: Our study shows that the markers may be used as fairly reliable diagnostic tools, but cannot be used to predict survival.

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Ca 19-9 Assay in Patients with Extrahepatic Cholestatic Jaundice

Cited by 29 publications

References 16 publications

The prognostic value of preoperative serum levels of CA 19-9 and CEA in patients with pancreatic cancer

The prognostic value of preoperative serum levels of CA 19-9 and CEA in patients with pancreatic cancer

Alternative antibody for the detection of CA19-9 antigen: a European multicenter study for the evaluation of the analytical and clinical performance of the Access® GI Monitor assay on the UniCel® DxI 800 Immunoassay System

TPS, CA 19-9, VEGF-A, and CEA as Diagnostic and Prognostic Factors in Patients with Mass Lesions in the Pancreatic Head

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