Diagnostic and Prognostic Significance of CA 19-9 as Tumour Marker in Pancreatic, Hepatobiliary and Other Gastrointestinal Cancers

Abstract

Introduction: The CA 19-9 antigen isolated by Koprowski and colleagues in 1979 is a lacto-N-fucopentaose II-like substance and one of the tumour-associated antigens present in serum in the mucin fraction. Close attention has been paid to the role CA 19-9 in the diagnosis of digestive tract tumours. In this study, serum analysis of CA 19-9 levels in 91 patients with gastrointestinal, hepatobiliary and pancreatic carcinoma was done. These data was used to evaluate the clinicians with adequate information on use of CA 19-9 as tumour marker- both diagnostic and prognostic. Aim: To study the role of tumour marker, CA 19-9 as a diagnostic and prognostic tool, and also to monitor the response of gastrointestinal, hepatobiliary and pancreatic cancer to treatment. Materials and Methods: This cross-sectional study was done on 91 cases of gastrointestinal, hepatobiliary and pancreatic carcinomas conducted in tertiary care hospital associated with medical college in Jamnagar, Gujarat, India were studied from September 2012 to March 2015 for two years and five months. The sample size was of 91 patients. Statistical method used was sensitivity, specificity, positive predictive value and negative predictive value. The material used was serum of the patient both pre as well as postoperatively and CalBiotech CA 19-9 Elisa Kit was used to determine the Value. The collected data were entered into Microsoft Excel spread sheet. The statistical methods used for variables were Mean and median along with Sensitivity and Specificity. Software used was “Epi Info”, version 7.0. Results: Total 91 cases of gastrointestinal, hepatobiliary and pancreatic carcinomas were studied. Enzyme Linked Immunosorbent Assay (ELISA) was used preoperatively and post operatively to determine the CA 19-9 values in patients of gastrointestinal, hepatobiliary and pancreatic carcinomas. It was found that CA 19-9 is an important tumour marker with sensitivity of 76.31% and specificity of 73.33% for diagnosis of the gastrointestinal, hepatobiliary and pancreatic carcinoma. When aided with Fine Needle Aspiration Cytology (FNAC) and histopathological findings it helps in giving a sure shot diagnosis. It also provides useful prognostic information for the same. Conclusion: This study helps to understand the role of CA 19-9 as diagnostic and prognostic marker for pancreatic, hepatobiliary and gastrointestinal carcinomas.