Abstract
Introduction: CA 19-9 (carbohydrate antigen), also called Cancer Antigen 19-9. or sialylatedlewisa antigen is a tumor marker that is used primarily in the management of pancreatic cancer. Carbohydrate antigen sialyllewisa (CA 19-9) is the most frequently applied serum tumor marker for diagnosis of cancers in the Hepatobiliary & Gastrointestinal tract.
Aims and Objectives: To evaluate the significance of CA 19-9 levels in Hepatobiliary and Gastrointestinal malignancies.
Material and Methods: The present study was conducted on 50 diagnosed cases of Hepatobiliary and GIT cancers constituted the study group and 30 age and gender-matched individuals were comprised the control group. The study was conducted in the Department of Biochemistry, Government Medical College Patiala. Venous blood sample was collected in plain vial and serum CA 19-9levels were evaluated by ELISA technique and the results were statistically analysed.
Results: The mean CA 19-9 levels were significantly higher in the study group as compared to control group (p value<0.001). And the CA 19-9 levels were<35 U/ml, in the cases those were on treatment of cancers.
Conclusion: From our study, it was concluded that for diagnosis of Hepatobiliary and GIT malignancies, serum CA 19-9 is simple, non invasive& cost effective biomarker which can be used along with other investigations such as imaging and cellular pathology, it increases the efficacy of diagnosis. For pancreatic carcinoma, it is a single & best diagnostic biomarker.
Keywords: CA 19-9, Tumor marker, Hepatobiliary Ca., Pancreatic tumor, stomach cancer, colon cancer.
References
- Yamada T, Alpers DH. Kaplowitz N, Laine L, OwyangC, Powell DW. Neoplasia of the gastrointestinal tract. Textbook of gastroent-erology. 5th edition, Chichester, west sussex: Blackwell pub 2009;(1) 1:603,1028.
- Daniel WC, RONALD AB, Eleftherios PD. Tumor marker. Tietz fundamentals of clinical chemistry. 6th edition, new delhi: Saunders Elsevier; 2012;20:337-339.
- Goonetilleke KS, Siriwardena AK. Systematic review of carbohydrate antigen (CA 19-9) as a biochemical marker in the diagnosis of pancreatic cancer.Eur J surgOncol 2007;33(3):266–70.
- Magnani Jl. The discovery biology and drug development of sialyllewisa andsialyllex. J Archives of Biochemistry and Biophysics 2004;426(2):122-31.
- Koprowski H, Herlyn M, Steplewski Z, Sears HF. Specific antigen in serum of patients with colon carcinoma. Science 1981;212: 53–5.
- Kannagi R.Carbohydrate antigen sialyl Lewis a-its pathophysiological significance and induction mechanism in cancer progression. Chang gung med J 2007;30(3):189-209.
- Ringel J, Lohr M. The MUC gene family: their role in diagnosis and early detection of pancreatic cancer. Cancer. 2003; 2: 9.
- Rhodes M, Ching C. Serum diagnostic tests for pancreatic cancer. Clingastroe-nterol. 1990; 4: 835-52.
- Kannagi R. Carbohydrate antigen sialyl Lewis a-its pathophysiological signific-ance and induction mechanism in cancer progression. Chang Gung Med J. 2007;30:189-209.
- Safi F, Roscher R, Bittner R, Schenk luhn B, Dopfer HP, Beger HG. High sensitivity and specificity of CA 19-9 for pancreatic carcin-oma in comparison to chronic pancreatitis. Serological and immunohisto-chemical findings. Pancreas. 1987;2: 398-403.
- Duraker N, Hot S, Polat Y, Hobek A, Gençler N, Urhan N. CEA, CA 19-9, and CA 125 in the differential diagnosis of benign and malignant pancreatic diseases with or without jaundice. J SurgOncol. 2007;95:142-7.
- Liao Q, Zhao YP, Yang YC, Li LJ, Long X, Han SM. Combined detection of serum tumor markers for differential diagnosis of solid lesions located at the pancreatic head. Hepatobiliary Pancreat Dis Int. 2007;6:641-5.
- Vestergaard EM, Hein HO, Meyer H, Grunnet N, Jørgensen J, Wolf H, et al. Reference values and biological variation for tumor marker CA 19-9 in serum for different Lewis and secretor genotypes and evaluation of secretor and Lewis genotyping in a Caucasian population. Clin Chem. 1999;45:54-61.
- Pavai S, Yap SF, The Clinical Significance of Elevated Levels of Serum CA 19·9. Med J Malaysia. 2003 Dec; 58.
- Amar H, Al-dujaili, Wafaa F, Al-Taei, Kisma TM, Gheid H. Al-Ubaidi. Comparative study of CA19-9 levels as tumor marker in sera and tissues of patients with stomach, colon and rectum cancers. Fac Med Baghdad. 2009; 51:2.
- Eskelinen M, Haglund U. Developments in serologic detection of human pancreatic adenocarcinoma. J. Gastroenterol. 1999; 34: 833–44.
- Rhodes JM, Ching CK. Serum diagnostic tests for pancreatic cancer. Gastroenterol. 1990;4: 833–52.
- Audisio RA, Veronesi P, Maisonneuve P, Chiappa A, Andreoni B, Bombardieri E, Geraghty JG Clinical relevance of serological markers in the detection and follow-up of pancreatic adenocarcinoma. Oncol. 1996; 5, 49–63.
- Aoki H, Ohnishi H, Hama K, Ishijima T, Satoh Y, Hanatsuka K et al. Autocrine loop between TGF-beta1 and IL-1beta through Smad3- and ERK-dependent pathways in rat pancreatic stellate cells. J. Physiol. Cell Physiol. 2006; 290.
- Okusaka T, Okada S, Ishii H, Nose H, Nakasuka H, Nakayama H, Nagahama H. Clinical response to systemic combined chemotherapy with 5-fluorouracil and cisplatin (FP therapy) in patients with advanced pancreatic cancer. J. Clin. Oncol. 1996; 26: 215–220.
- Tanaka M, Chari S, Adsay V, Fernandez-del Castillo C, Falconi M, Shimizu M, Yamaguchi K, Yamao K, Matsuno S. International consensus guidelines for management of intraductal papillary mucinous neoplasms and mucinous cystic neoplasms of the pancreas. 2006; 6: 17–32.
- Aseem B, Bharat J, Timilsina s. Serum CA 19-9 Levels in Benign and Malignant Diseases Associated with the Gastroint-estinal Tract. ACCLM 2015; 1(2):35-41.
- Kim HJ, Kim MH, Myung SJ, Lim BC, Park ET, Yoo KS, Seo DW, et al. A new strategy for the application of CA19-9 in the differentiation of pancreaticobiliary cancer: analysis using a receiver operating characteristic curve. Am J Gastroenterol. 1999;94(7):1941-46.
- Marcouizos G, Ignatiadou E, Papanikolaou GE, Ziogas D, Fatouros M. Highly elevated serum levels of CA 19-9 in choledocho-lithiasis: a case report. Cases J. 2009;2:6662.
- Xing LQ, Zuo RW, Jing SS. Min L, Lin W, Quan RH et Utility of serum CA19-9 in diagnosis of cholangiocarcinoma, In comparison with CEA. World Journal of Gastroenterology. 2004; 10(3):427-32.
- Chen YL, Chen CH, Hu RH, Ho MC, Jeng YM et al. Elevated Preoperative Serum CA19-9 Levels in Patients with Hepatocellular Carcinoma. The scientific world journal. 2013; 1:1-6.
Corresponding Author
Ashraf Ali
Junior Resident, Department of Biochemistry, GMC & Rajindra Hospital, Patiala
Mobile no: 8192021046, Email: This email address is being protected from spambots. You need JavaScript enabled to view it.