Relationship of CA 19-9 with choledocholithiasis and cholangitis

Doğan, Ümit; Gümürdülü, Yüksel; Golge, Necmettin; Kara, Banu

doi:10.4318/tjg.2011.0186

Cited by 30 publications

(17 citation statements)

References 20 publications

(28 reference statements)

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“…Multiple influences on survival include pathological criteria and nutritional and performance status (Schnelldorfer et al , 2008), but CA 19-9 may have further independent predictive value (Tsavaris et al , 2009). However, CA 19-9 results may be confusing because it can be elevated in the presence of biliary inflammation (Dogan et al , 2011) and is not produced in Lewis antigen-negative subjects (Vestergaard et al , 1999). …”

Section: Discussionmentioning

confidence: 99%

Serum apolipoprotein C-II is prognostic for survival after pancreatic resection for adenocarcinoma

et al. 2012

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Background:Pancreaticoduodenectomy remains a major undertaking. A preoperative blood test, which could confidently predict the benefits of surgery would improve the selection of pancreatic cancer patients for surgery. This study aimed to identify protein biomarkers prognostic for long-term survival and to validate them with clinico-pathological information.Methods:Serum from 40 preoperative patients was used to train for predictive biomarkers using surface-enhanced laser desorption/ionisation time-of-flight mass spectrometry (SELDI), and the results were verified on 21 independent samples. Two predictive proteins were identified by tryptic peptide mass fingerprinting and sequencing, and validated on serum from another 57 patients by enzyme-linked immunosorbent assay (ELISA). The influence of these proteins on growth and invasion of two cancer cell lines was tested in-vitro.Results:The SELDI panel of m/z 3700, 8222 and 11 522 peaks predicted <12 months' survival (ROC AUC: 0.79, 0.64–0.90; P<0.039). When CA19-9 was added, the ROC AUC increased to 0.95 (0.84–0.99; P<0.0001). The six subjects in the verification group who died within 12 months were correctly classified. The m/z 8222 and 11 522 proteins were identified as Serum ApoC-II and SAA-1, respectively. In the validation samples, ELISA results confirmed that ApoC-II was predictive of survival (Kaplan–Meier P<0.009), but not SAA-I. ApoC-II, CA19-9 and major-vessel involvement independently predicted survival. ApoC-II and SAA-1 increased cell growth and invasion of both cancer cell lines.Conclusion:Serum ApoC-II, CA19-9 and major-vessel invasion independently predict survival and improves selection of patients for pancreaticoduodenectomy.

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Section: Discussionmentioning

confidence: 99%

Serum apolipoprotein C-II is prognostic for survival after pancreatic resection for adenocarcinoma

et al. 2012

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“…Our study is in line with the few and small studies performed on patients without PSC. [17][18][19][20] Taken together, these studies describe an increase in the CA19-9 level in case of acute bacterial cholangitis, but not biliary obstruction without signs of infection. Most importantly, comparison of the CA19-9 level between patients with SBC and those with biliary tract cancer did not reveal significant differences, and ROC analysis proved that CA19-9 is of no use in this situation.…”

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 98%

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

Wannhoff

Rupp

Friedrich

et al. 2015

Clinical Gastroenterology and Hepatology

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“…However, it is neither a very specific nor sensitive marker, and increased levels of CA19-9 have been described in other malignancies, including lung cancers and malignant pleural effusions (2-6). Raised levels of CA 19-9 have been described in a host of benign conditions involving various organ systems such as the hepatobiliary, respiratory, genitourinary and endocrine systems and in rheumatic diseases (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). The benign causes of raised CA 19-9 levels are summarised in Table.…”

Section: Discussionmentioning

confidence: 99%

Elevated CA 19-9 Levels Observed in Association with a Pulmonary Neuroendocrine Tumour and Amyloid

Faruqi

Gumparthy²,

Wahbi³

2013

Intern. Med.

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Investigations completed in a 77-year-old ex-smoker presenting with weight loss showed raised CA 19-9 levels. The findings of chest radiograph, abdominal computed tomography (CT) and gastrointestinal endoscopic examinations were all normal. On follow-up, the patient developed left upper lobe collapse on chest radiograph with increasing CA 19-9 levels. Chest CT findings suggested the presence of a left upper lobe tumour. The results of a biopsy of the left upper lobe nodule seen on bronchoscopy suggested a diagnosis of amyloidosis; however, this was not the only diagnosis. The left upper lobe mass comprised a neuroendocrine tumour with amyloid deposition just beneath the bronchial epithelium and focally between the nests of the tumour cells. We report and discuss this uncommon association and presentation. Case ReportA 77-year-old woman who was an ex-smoker of 40 packyears presented with complaints of weight loss and a decreased appetite. She was known to have mild diverticular disease and experienced a disease flare up with an increased stool frequency of 2-3 bowel movements/day on admission. There was no history of haematochezia, malena, cough, expectoration or haemoptysis. She was known to have bronchial asthma and was receiving treatment with inhaled corticosteroids. On examination, she was not found to have any pallor, clubbing or lymphadenopathy. She had a body mass index of 16. Her heart rate was 80 beats/min and her blood pressure was 130/80 mmHg. The findings of a systemic examination were normal.The initial diagnoses considered included malignancy (possibly gastrointestinal), mal-absorption syndrome and thyroid dysfunction, and investigations were accordingly organised. Other than a serum albumin level of 2.7 g/dL, the patient's biochemical profile was normal. Liver function tests were within the normal range and showed a bilirubin level of 16 umol/L, an alkaline phosphatase level of 92 IU/L and an alanine aminotransferase level of 29 IU/L. A full blood count and thyroid function tests were normal. Chest radiograph findings were normal. Sigmoidoscopy and colonoscopy results were normal other than showing mild diverticular disease. Oesophagogastroduodenoscopy findings were normal, as was the subsequent report of a duodenal biopsy. Tumour marker tests showed that the levels of Carbohydrate Antigen 19-9 (CA 19-9) were raised at 300 ku/L (normal <40 ku/L). The tests were subsequently repeated, and the CA 19-9 level was found to be 326 ku/L. The Carcinoembryonic Antigen, Alpha-fetoprotein and Cancer Antigen 125 levels were normal. Ultrasound and subsequent computed tomography (CT) of the abdomen and pelvis were normal. The diarrhoea resolved, and the patient was feeling better. A dietary opinion was sought, and the patient was started on nutritional supplements. She was discharged three weeks from admission, as nothing specific was found, with plans to follow up with repeat CA 19-9 level measurements.Two months after discharge the patient was again admitted, as her symptoms of anorexia and weight lo...

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Relationship of CA 19-9 with choledocholithiasis and cholangitis

Abstract: phosphatase (r=0.5, p<0.01), gamma glutamyl transpeptidase (r=0.5, p<0.01) and bilirubin (r=0.4, p<0.01)

Cited by 30 publications

References 20 publications

Serum apolipoprotein C-II is prognostic for survival after pancreatic resection for adenocarcinoma

Serum apolipoprotein C-II is prognostic for survival after pancreatic resection for adenocarcinoma

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

Elevated CA 19-9 Levels Observed in Association with a Pulmonary Neuroendocrine Tumour and Amyloid

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