Dilemma of elevated CA 19-9 in biliary pathology

Tsen, Adrianne; Barbara, Mary; Rosenkranz, Laura

doi:10.1016/j.pan.2018.09.004

Cited by 76 publications

(70 citation statements)

References 39 publications

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“…Jaundice and CA 19-9 have been shown to be associated. 11 This is also evident in our study where we found significantly elevated levels of CA 19-9 in patients with jaundice. However, the interpretation and relevance of this elevation remains unclear, especially for diagnostic purposes.…”

Section: Discussionsupporting

confidence: 82%

Prognostic Value of CA19-9 and CA242 in Gallbladder Cancer - An Exploratory Study

Agarwal¹,

Tiwari²,

Kumari³

et al. 2019

IJCMR

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Introduction: There are, at present, no biomarkers to predict to prognosis of Gallbladder cancer. We conducted a prospective exploratory study to evaluate the role to serum CA 19-9 and CA 242 as prognostic markers. Material and Methods: We enrolled consecutive patients for this study and CA 19-9 and 242 were estimated from venous samples. Association of these markers with clinical variables and median overall survival (OS) difference between patients who has raised versus normal levels of these markers was determined. Results: Sixty-two patients were enrolled for this study. Forty-four (71%) patients had elevated CA19-9. Thirty-nine (62.9%) patients had an raised CA242 levels. CA 19-9 was found to be significantly associated with the presence of jaundice (p=0.038) and advanced stage (p=0.009). Median OS of patients who had elevated CA 19-9 was 5.73 months compared to 8.33 months in patients who had normal CA 19-9. The difference was not statistically different (p= 0.15). Median OS for patients who had elevated CA 242 was 5.53 months, which was inferior to those who had normal levels (9.1 months). This difference approached, but was not statistically significant (p=0.055). Conclusion: This is the first study to show association between CA 19-9 and stage of disease in GBC. At present, CA 19-9 and CA 242 cannot be recommended as prognostic markers. However, role of CA 242 needs to be examined in a larger cohort of patients of GBC to establish its usefulness.

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Section: Discussionsupporting

confidence: 82%

Prognostic Value of CA19-9 and CA242 in Gallbladder Cancer - An Exploratory Study

Agarwal¹,

Tiwari²,

Kumari³

et al. 2019

IJCMR

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“…Hence, CA 19-9 levels have been used as a tumor marker in various malignancies, including GI, pancreatic cancer, and cholangiocarcinoma. Furthermore, elevated CA 19-9 levels have been detected in benign conditions, especially those related to cholestasis and biliary pathology [33]. However, elevated serum CA 19-9 levels have also been reported in cases of gynecological diseases, but the exact role of the marker in differentiating malignant from benign conditions, as well as in the prognosis of the disease and the correlation with elevated CA-125 levels, remains elusive [34].…”

Section: Discussionmentioning

confidence: 99%

Is There a Role of Elevated CA 19-9 Levels in the Evaluation of Clinical Characteristics of Mature Cystic Ovarian Teratomas? A Systematic Review and Meta-analysis

Prodromidou¹,

Pandraklakis²,

Loutradis³

et al. 2019

Cureus

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The role of preoperative CA 19-9 levels in patients with ovarian mature cystic teratoma (MCT) and the association of elevated levels of the biomarker with patients' and tumor characteristics were evaluated. Four electronic databases were searched for articles published up to September 2019. Trials that evaluated the significance of elevated CA 19-9 in patients with ovarian MCTs and publications with > 20 patients were considered eligible for inclusion. Seven studies that included 995 patients with an ovarian MCT who were evaluated with elevated (n = 364) or normal (n = 631) CA 19-9 levels were included. Mean tumor size was significantly increased in patients with elevated CA 19-9 levels (p = 0.038). The rate of ovarian torsion was significantly increased in the elevated CA 19-9 group (p = 0.04). The present study highlights the importance of CA 19-9 as a marker in the diagnosis of MCT, and a meta-analysis supports that it could raise a high degree of clinical suspicion of early recognition of torsion and early surgical management due to complications related to increased size. Nonetheless, the diagnostic value of CA 19-9 is still limited and CA 19-9 can still serve only as a supplementary diagnostic tool in patients with MCTs.

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“…Normal CA19-9 levels range between 0-37 U/L. This cutoff is currently used to detect pancreatic cancer but has also been studied for cholangiocarcinoma with a sensitivity of 77% to 78% and a specificity of 81% to 84% [3]. When using this marker for cholangiocarcinoma diagnosis, one must consider the effect that obstructive jaundice has over this marker.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, the most common causes of significant elevations of CA 19 -9 in benign biliary pathologies are acute cholangitis and choledocholithiasis, as demonstrated by a recent study by Tsen et al CA 19-9 levels in acute cholangitis were reported to be as high as 35,500 U/mL and a choledocholithiasis case with a CA19 -9 level of 405,000 K U/L 3. Therefore, CA 19 -9 levels must be interpreted with caution as there is no cut-off value that may help detect malignant versus benign pathologies [3].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Looks can be Deceiving: A Case Report on the Clinical Value of CA 19-9 in Obstructive Jaundice

Giron

Alcantar

2020

Cureus

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Dilemma of elevated CA 19-9 in biliary pathology

Cited by 76 publications

References 39 publications

Prognostic Value of CA19-9 and CA242 in Gallbladder Cancer - An Exploratory Study

Prognostic Value of CA19-9 and CA242 in Gallbladder Cancer - An Exploratory Study

Is There a Role of Elevated CA 19-9 Levels in the Evaluation of Clinical Characteristics of Mature Cystic Ovarian Teratomas? A Systematic Review and Meta-analysis

Looks can be Deceiving: A Case Report on the Clinical Value of CA 19-9 in Obstructive Jaundice

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