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

Abstract

There is no validated clinical biomarker for disease severity or treatment response for nontuberculous mycobacterial pulmonary disease (NTM-PD). We investigated the correlation between elevated serum carbohydrate antigen (CA) 19-9 levels and NTM-PD disease activity, defined using an imaging severity score based on chest computed tomography (CT). We retrospectively examined 79 patients with NTM-PD who underwent serum CA19-9 level assessments and chest CT less than 1 month apart. NTM-PD severity was rated using a CT-based scoring system. The correlation between the CT score and serum CA19-9 levels was evaluated. Chest CT revealed nodular bronchiectasis without cavitation in most patients (78.5%). Serum CA19-9 levels were elevated in 19 (24%) patients. Serum CA19-9 levels were positively correlated with the total CT score and bronchiectasis, bronchiolitis, cavity, and consolidation subscores. Partial correlation analysis revealed a significant positive correlation between serum CA19-9 levels and CT scores for total score and bronchiectasis, bronchiolitis, cavitation, and consolidation subscores after controlling for age, sex, and BMI. Serum CA19-9 levels were positively correlated with the CT severity score for NTM-PD. Serum CA19-9 may be useful in evaluating disease activity or therapeutic response in patients with NTM-PD.

The Clinical Implications of Serum Carbohydrate Antigen 19-9 Levels in Patients with Nontuberculous Mycobacteria Pulmonary Disease

“…When we initially planned this study, our expectation was that higher serum CA19-9 levels would be linked to poorer treatment responses in NTM-PD patients, based on previous research indicating a positive correlation between serum CA19-9 levels and the extent of lung lesions observed in chest CT scans [22]. However, contrary to our initial expectations, our analysis revealed that elevated serum CA19-9 levels did not result in worse microbiological responses to antibiotic treatment.…”

“…Interestingly, recent research findings have illuminated the potential elevation of CA19-9 in the context of chronic respiratory diseases, including bronchiectasis or pulmonary mycobacterial infections [20]. Furthermore, investigations have highlighted a notable decline in serum CA19-9 levels following antibiotic treatment in patients with NTM-PD, a phenomenon intricately linked to the severity of pulmonary computed tomography (CT) lesions [21][22][23]. Consequently, there is a growing interest in discerning the effective utilization of CA19-9 in the management of NTM-PD patients, which warrants further investigation.…”

The Clinical Implications of Serum Carbohydrate Antigen 19-9 Levels in Patients with Nontuberculous Mycobacteria Pulmonary Disease

“…When we initially planned this study, we anticipated that higher serum CA19-9 levels would be associated with poorer treatment responses in NTM-PD patients based on a study that found a positive association between serum CA19-9 levels and the extent of lung lesions on chest CT [8]. Contrary to our expectations, our analysis revealed that elevated serum CA19-9 levels did not lead to worse microbiological responses to antibiotic treatment.…”

“…Interestingly, recent studies have reported that CA19-9 can also increase in chronic respiratory diseases, such as bronchiectasis or pulmonary mycobacterial infection [6]. Moreover, studies observed a decrease in serum CA19-9 levels after antibiotic treatment in NTM-PD patients, which has also been associated with the severity of pulmonary computed tomography (CT) lesions [7][8][9]. Thus, there is increasing interest in how CA19-9 can be used effectively in the management of NTM-PD patients.…”