Inflammation But Not Biliary Obstruction Is Associated With Carbohydrate Antigen 19-9 Levels in Patients With Primary Sclerosing Cholangitis

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

“…Even in diseases primarily involving the biliary tract, it has been proposed that the degree of inflammation is more strongly associated with CA 19-9 levels rather than the degree of biliary obstruction. [18] Fucosylation, which is the addition of fructose molecules to glycoproteins, is heavily upregulated in the presence of inflammatory conditions and in cancer and plays an important role in the cellular proliferation and regulation of growth factor receptors. Therefore, increased levels of fucosylated oligosaccharides, such as CA 19-9, can be detected in clinical conditions where inflammation plays a major role.…”

Longitudinal analysis of CA19‐9 reveals individualised normal range and early changes before development of biliary tract cancer in patients with primary sclerosing cholangitis

“…The study was previously approved by the ethics committee of the University Hospital Heidelberg. The database, which had already been used as a basis for previously published studies, contained all available CA19‐9 and carcinoembryonic antigen values for each included patient until diagnosis of BTC, liver transplantation (LT), death, or until 31 December 2014, whichever came first. CA19‐9 and carcinoembryonic antigen values were derived by chart review.…”

“…Each CA19‐9 or carcinoembryonic antigen dataset contained further laboratory values obtained at the time of CA19‐9 or carcinoembryonic antigen measurement. The datasets were completed using information on the presence of a dominant stricture at the time of CA19‐9 measurement, based on findings of endoscopic retrograde cholangiography or magnetic resonance cholangiography and the presence of superimposed bacterial cholangitis, which was defined according to previously published criteria . In brief, patients were classified as with or without superimposed bacterial cholangitis at the time of CA19‐9 measurement based on the following diagnostic criteria.…”

“…CA19‐9 serum levels are further affected by episodes of superimposed bacterial cholangitis, and not all patients are genetically capable of synthesising CA19‐9. Approximately 10% of patients exhibit single nucleotide polymorphisms within the fucosyltransferase ( FUT ) 3 gene that cause a loss of CA19‐9 synthesis . However, these patients might benefit from screening with carcinoembryonic antigen, which also is not influenced by bacterial cholangitis .…”

S2k Leitlinie Autoimmune Lebererkrankungen

“…Diese unklar erhöhten CA19 -9-Werte treten bei etwa einem Drittel der PSC-Patienten auf, obwohl kein Tumor oder eine andere Erklärung vorliegt- [583]. Dabei scheint auch die Inflammation des Epithels eine Rolle zu spielen [584]. Die Datenlage für CEA ist deutlich schlechter im Vergleich zu CA19 -9, es liegen lediglich retrospektive Daten vor.…”