Causes of Elevated Levels of Serum CA 19.9 in Patients without Prior Diagnosis of Malignant Disease

Abstract

Objective: Serum CA 19.9 is commonly used as a tumor marker for diagnosis and followup of gastrointestinal malignancies. However, elevated levels can be found in various clinical conditions. Methods: A total of 285 patients whose serum CA 19.9 level was ordered from various outpatient clinics other than oncology in a tertiary hospital setting and who had elevated CA 19.9 (>34 U/mL) levels were included in the study group. Statistical analysis of marker levels in relation to diagnosis of patients was performed. Results: Overall, 226 patients with benign disorders and 59 patients with malignant disease had elevated CA 19-9 levels. One hundred ten (39%) patients with increased CA 19-9 levels did not have any significant clinical condition associated with high CA 19-9 values. Median CA 19-9 levels were significantly higher in patients with malignancies than in patients with benign disorders (67.3 vs. 47.9; p<0.001). Receiver operating characteristic curve analysis identified a cutoff value of 66.3 U/mL for discrimination of malignant from benign gastrointestinal diseases (sensitivity 58.3% and specificity 82.7%; p<0.001). Conclusion: Serum CA 19-9 levels are significantly higher in patients with malignant diseases. However, there are diverse etiologies associated with elevated serum levels. During chronic inflammatory states, elevated serum CA 19-9 levels can be a frequent finding.

Clinicopathological Characteristics and Prognosis of Diffuse Large B-Cell Lymphoma in Relation to CA-125 and CA 19-9 Expression

“…CA 19-9 can also be detected in other cancerous organs, such as the liver, lung, breast, and others. 27,28 Although there have been several reports of unusual gastrointestinal DLBCL NOS presentations, obstructive jaundice, and high CA 19-9 levels have never before been documented. 29 Abdominal pain, weight loss, and obstructive jaundice are frequently accompanied by elevated CA 19-9 levels in cases of advanced pancreatic carcinoma but not in cases of DLBCL NOS.…”

“…CA 19-9 can also be detected in other cancerous organs, such as the liver, lung, breast, and others. 27 , 28 …”