Initial clinical evaluation of an immunoradiometric assay for CA 19‐9 using the nci serum bank

Abstract

More than 1,600 coded sera obtained from blood donors and the NCI/Mayo Clinic Serum Bank were analyzed with an improved immunoradiometric assay for the carbohydrate antigenic determinant, CA 19-9. Results indicated that CA 19-9 is elevated in a large fraction of sera (67%) from patients with advanced adenocarcinomas of the upper gastrointestinal (GI) tract, including those with pancreatic, hepatobiliary and gastric carcinomas. Several of these sera had CA 19-9 exceeding 300,000 U/ml. A smaller fraction (18%) of patients with carcinomas of the large bowel had elevated serum CA 19-9 levels, the majority among patients with metastatic disease. In contrast, none of the healthy donors from the serum bank and only 4 of 1,023 of the blood donor specimens (0.4%) had CA 19-9 levels greater than or equal to 40 U/ml. Three of 235 sera (1.3%) from benign disease patients had levels of CA 19-9 in excess of 40 U/ml. These data suggest that the improved CA 19-9 immunoradiometric assay may have clinical utility as a diagnostic adjunct for adenocarcinoma of the upper GI tract and that the assay also may have some value in monitoring patients with advancing colorectal carcinoma, particularly in combination with CEA determinations. Rigorous prospective clinical trials will be necessary to verify these hypotheses.

The role of carbohydrate antigen 19-9 as a tumour marker of oesophageal cancer

“…Therefore, patients with oesophagitis, the most common benign condition of the oesophagus which can also present with dysphagia, were investigated for the presence of CA19-9 in the serum. Ritts et al (1984), in a series of eight patients with oesophageal cancer, noted one patient (13%) to have a CA19-9 level of >40Uml-1. Our series has shown that elevated levels of CA19-9 are present in 34% of patients with oesophageal cancer at the time of diagnosis.…”

“…Although the CA19-9 assay was originally developed to detect patients with colorectal adenocarcinoma (Koprowski et al, 1981), subsequent work revealed that the serum levels of this antigen were raised in a greater proportion of patients with pancreatic and hepatobiliary malignancies than those with large bowel cancer (Ritts et al, 1984;Kew et al, 1987). The oesophagus, like the pancreas and the liver, is a foregut derivative and this study was undertaken in the hope that CA19-9 might prove a useful tumour marker for oesophageal carcinoma.…”

“…Excessive quantities of this antigen have been found in patients with gastrointestinal malignancies, including colorectal, pancreatic and hepatocellular carcinomas (Ritts et al, 1984;Kew et al, 1987). The oesophagus, like the pancreas and liver, is a foregut derivative and it is possible that oesophageal carcinoma may also express this antigen.…”

Evaluation of CA 19-9 as a serum tumour marker in pancreatic cancer

“…Elevated serum CA 19-9 levels have previously been found in many different malignant diseases (Herlyn et al, 1982;Del Villano et al, 1983;Jalanko et al, 1984;Kuusela et al, 1984;Ritts et al, 1984). The test seems especially promising for the detection of pancreatic cancer, 70-79% of these patients showing increased serum CA 19-9 concentrations (Del Villano et al, 1983;Ritts et al, 1984).…”

Tumour markers

“…-Određivanje CEA se ne preporučuje za skrining kolorektalnog karcinoma; -CEA se može određivati pre hiruškog zahvata kod pacijenata sa kolorektalnim karcinomom kao pomoć pri utvrđivanju patološkog stadijuma bolesti i planiranju tretmana; -CEA ne treba koristiti u neposrednom postoperativnom periodu; -CEA se može meriti postoperativno ako je resekcija metastaza na jetri klinički indukovana; -CEA se može meriti za vreme tretmana radi praćenja odgovora na terapiju i dokumentovanja faze bolesti [13,36] Gastrointestinalni karcinom antigen (CA 19-9) je glikolipid, derivat krvne grupe Levis a/b [33]. Identifikovan je kao tumorski marker 1981. godine.…”