Elevation of Carbohydrate Antigen 19.9 in Benign Hepatobiliary Conditions and Its Correlation with Serum Bilirubin Concentration

Abstract

CA19.9 level is significantly influenced by serum bilirubin and elevated levels have been observed in patients with non-malignant HPB conditions. Adjusting CA19.9 according to bilirubin levels is likely to improve the specificity of this antigen in the differential diagnosis of benign and malignant HPB diseases and its reliability in the monitoring of disease response to chemotherapy.

Serum CA 19-9 as a Biomarker for Pancreatic Cancer—A Comprehensive Review

“…Ong et al studied 83 patients presenting with abnormal CA19-9 serum levels and radiological or clinical features suggestive of hepato-biliary-pancreatic (HPB) malignancy who were subsequently found to have benign disease. On multivariate analysis, these authors reported that hyperbilirubinemia (serum bilirubin >2 mg/dl) was an independent factor predictive of CA 19-9 serum level (p<0.028) [76,77]. Biliary drainage which results in a decrease in CA 19-9 serum levels suggests benign conditions.…”

Diagnostic Accuracy of Serum Carbohydrate Antigen 19-9 in Determining Etiology of Obstructive Jaundice

“…The mean ALP was 507.8 U/L before and 184.0 U/L after drainage in this group. Ong SL et al 15 found mean serum bilirubin 15.5mg/dl, range 1.2-26.0 mg/dl before biliary drainage and 8.2 mg/dl and range 1.2-14.5 mg/dl after biliary drainage in benign obstructive jaundice. The mean ALP in their study was 640 U/L before and 330 U/L after drainage.…”

Extremely high values of CA 19-9 in liver hydatidosis and frank biliary rupture

“…CA 19-9 elevation in benign biliary tract disease has frequently been reported, but a very high level of CA 19-9 (>500 IU/ml) in such cases has rarely been observed (3)(4)(5)(6)(7)9). Mirizzi's syndrome and acute cholangitis are the usual definitive diagnoses of patients with these extreme values (4,7).…”