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

Abstract

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.

Role of carbohydrate antigen 19-9, carcinoembryonic antigen, and carbohydrate antigen 125 as the predictors of resectability and survival in the patients of Carcinoma Gall Bladder

“…[ 18 ] In contradiction Agarwal et al identified that with raised serum CA 19-9 and CA 242 levels median survival were less but was not statistically significant. [ 19 ] In the present study along with CEA and CA19-9, serum CA 125 levels were also evaluated as the prognostic marker to predict survival in GBC and similar to previous studies higher levels of tumor markers were found to be associated with poor overall median survival whereas contrary to previous studies CEA did not show a significant effect on the survival of GBC patients. Fang et al reported that preoperative CEA, CA125, and CA19-9 were associated with resectable cholangiocarcinoma whereas higher levels were associated with unresectable tumor.…”

Assessment of tumor markers CA 19-9, CEA, CA 125, and CA 242 for the early diagnosis and prognosis prediction of gallbladder cancer

“…These findings may be explained by the inclusion criteria, as in the present study, only early and suspicious cases of GBC were included. In accordance with this, a previous study by Agarwal et al [ 14 ] explained that CA 19-9 and CA 242 are not recommended as prognostic markers. By contrast, Agarwal et al [ 16 ] reported the prognostic role of tumor markers in terms of overall survival rate.…”

“…However, there was no association of tumor markers with the presence of gallstones and sex of the patient. In accordance with this, a prospective exploratory study conducted at a tertiary care center in Lucknow, did not find any association of CA 242 with tumor stage, presence of jaundice, gallstones and sex of the patient[ 14 ].…”

Inclusion of carbohydrate antigen 242 in addition to carbohydrate antigen 19.9 in serological workup of carcinoma gall bladder: a case series analysis

“…Our results were concordant to the reported literature where it has been found that CA19-9 and CA242 are significantly raised in GBC as compared to CC and HC. [18][19][20][21][22][23][24][25][26][27][28] The results displayed in table 5 clearly show that complimenting it with CA242 will not only add to specificity by which both may predict presence or absence of malignant change in gall bladder but also sensitivity while screening if we consider elevated levels of either of them inclusive.…”