Editorial

CA 19-9: Not a Magic Marker for Pancreatic Cancer

Authors: Sumanth R. Daram, MD

Abstract

Serum carbohydrate antigen (CA) 19-9 is considered to be the most sensitive/specific marker for pancreatic cancer, although it has also been associated with biliary, hepatocellular, gastric, colonic and nongastrointestinal malignancies.1 For pancreatic adenocarcinoma, CA 19-9 is reported to have a sensitivity of 70 to 90%, specificity of about 90%, a positive predictive value of 69%, and a negative predictive value of 90%.2

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References

1. Koprowski H, Steplewski Z, Mitchell K, et al. Colorectal carcinoma antigens detected by hybridoma antibodies. Somat Cell Mol Genet 1979;5:957–971.
 
2. Duffy MJ. CA 19-9 as a marker for gastrointestinal cancers: a review. Ann Clin Biochem1998;35:364–370.
 
3. Sakahara H, Endo K, Nakajima K, et al. Serum CA 19-9 concentrations and computed tomography findings in patients with pancreatic carcinoma. Cancer 1986;57:1324–1326.
 
4. Albert MB, Steinberg WM, Henry JP. Elevated serum levels of tumor marker CA 19-9 in acute cholangitis. Dig Dis Sci 1988;33:1223–1225.
 
5. Kim J, Lee K, Lee J, et al. Clinical usefulness of carbohydrate antigen 19-9 as a screening test for pancreatic cancer in an asymptomatic population. J Gastroenterol Hepatol 2004;19:182–186.
 
6. Lowe D, Lee J, Schade R, et al. Patient with markedly elevated CA 19-9 not associated with malignancy. South Med J 2006;99:306–308.
 
7. Maestranzi S, Przemioslo R, Mitchell H, et al. The effect of benign and malignant liver disease on the tumour markers CA 19-9 and CEA. Ann Clin Biochem 1998;35:99–103.
 
8. Mann DV, Edwards R, Ho S, et al. Elevated tumour marker CA 19-9: clinical interpretation and influence of obstructive jaundice. Eur J Surg Oncol 2000;26:474–479.
 
9. Shimomura C, Eguchi K, Kawakami A, et al. Elevation of a tumor-associated antigen CA 19-9 in patients with rheumatic diseases. J Rheumatol 1989;16:1410–1415.