Diagnostic value of CA 19-9 in pregnancies complicated by spinal neural tube defects: a preliminary study

Abstract

Objectives: Various physiological and pathological conditions can induce significant variations in plasma concentrations of tumor markers, such as CA 19-9, which is present in the serum and amniotic fluid of pregnant women. Herein, we aimed to determine the clinical importance of maternal serum CA 19-9 levels in the diagnosis of neural tube defects (NTDs). Material and methods:A total of 100 women were included in this controlled cross-sectional study. Thirty-three patients whose pregnancies were complicated by isolated meningocele or meningomyelocele constituted the study group, whereas 33 normal, healthy pregnant women constituted the control group, and 34 age-and body mass index (BMI)-matched non-pregnant women were chosen for the validation group. Results:The mean maternal serum CA 19-9 levels were 17.2 ± 17.0 IU/mL, 7.1 ± 5.9 IU/mL, and 4.7 ± 3.6 IU/mL in the study, control, and validation groups, respectively (p < 0.001). ROC analyses showed that elevated CA 19-9 values may predict NTDs (p < 0.001). The cut-off value for CA 19-9 was found to be 9.6 IU/mL at 70% (51%-84%, 95% CI) sensitivity and 84% (74%-92%, 95% CI) specificity. Conclusions:CA 19-9 may be a promising noninvasive marker for NTDs. Further studies are needed to reveal the clinical applicability and diagnostic potential of maternal serum CA 19-9 levels in the identification of NTDs.

Can maternal urinary and serum carbohydrate antigen 19-9 concentrations be utilized in the diagnosis of fetal hydronephrosis?

“…It was interesting that there was no statistically significant difference between groups for maternal serum CA 19-9 levels. Transplacental passage of CA 19-9 into maternal circulation has been described in previous studies (19,20,26). Our result may be due to the fact that, even though an increased concentration of the antigen may have been present in amniotic fluid it might be eliminated quickly in urine after transplacental passage.…”